bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinicopathological Characteristics and Surgical Outcomes of Primary Cystic Duct Carcinoma: A Multi‐institutional Study
Authors: Sakata Jun , Hirose Yuki , Prasoon Pankaj , Kitami Chie , Minagawa Masahiro , Nomura Tatsuya , Yokoyama Naoyuki , Aono Takashi , Yuza Kizuki , Miura Kohei , Katada Tomohiro , Takizawa Kazuyasu , Nagahashi Masayuki , Kobayashi Takashi , Wakai Toshifumi
Published: June 2020

Background

The role of surgery in the management of primary cystic duct carcinoma (CDC) remains unclear especially in advanced disease. This study aimed to evaluate long‐term outcomes in patients undergoing surgery for primary CDC.

Methods

From a multi‐institutional database, we identified 41 patients who underwent surgery for primary CDC, defined as a part of gallbladder carcinoma with the tumor centre located in the cystic duct.

Results

Of the 41 patients, 31 (75.6%) underwent preoperative biliary drainage for jaundice. Twenty‐eight (68.3%) patients underwent extensive resection including major hepatectomy (n = 21), pancreaticoduodenectomy (n = 4), or both procedures (n = 3). Thirty‐four (82.9%) patients had ≥ pT3 tumor, while 31 (75.6%) patients had involvement of contiguous organs/structures. Nodal and distant metastasis was found in 26 (63.4%) and 7 (17.1%) patients, respectively. Most patients (90.2%) had perineural invasion. Median overall survival was 23.7 months in all 41 patients. Factors independently associated with both overall and disease‐specific survival were pN (P = 0.003 and P = 0.007, respectively) and pM (P = 0.003 and P = 0.013, respectively) classification. Median survival was 75.3, 17.7, and 5.2 months for patients with pN0M0 (n = 14), pN1/2pM0 or pN0pM1 (n = 21), and pN1/2pM1 (n = 6) disease, respectively (P < 0.001).

Conclusions

Primary CDC is characterized by locally advanced disease with aggressive histopathological characteristics at surgery, leading to extensive resection during treatment. Surgery provides potential benefits for patients with pN0pM0 disease, whereas pN1/2 and/or pM1 status appear to have strong adverse effects on survival.
SFPQ and Tau: critical factors contributing to rapid progression of Alzheimer’s disease
Authors: Younas Neelam , Zafar Saima , Shafiq Mohsin , Noor Aneeqa , Siegert Anna , Arora Amandeep Singh , Galkin Alexey , Zafar Ayesha , Schmitz Mathias , Stadelmann Christine , Andreoletti Olivier , Ferrer Isidre , Zerr Inga
Published: June 2020

Dysfunctional RNA-binding proteins (RBPs) have been implicated in several neurodegenerative disorders. Recently, this paradigm of RBPs has been extended to pathophysiology of Alzheimer’s disease (AD). Here, we identified disease subtype specific variations in the RNA-binding proteome (RBPome) of sporadic AD (spAD), rapidly progressive AD (rpAD), and sporadic Creutzfeldt Jakob disease (sCJD), as well as control cases using RNA pull-down assay in combination with proteomics. We show that one of these identified proteins, splicing factor proline and glutamine rich (SFPQ), is downregulated in the post-mortem brains of rapidly progressive AD patients, sCJD patients and 3xTg mice brain at terminal stage of the disease. In contrast, the expression of SFPQ was elevated at early stage of the disease in the 3xTg mice, and in vitro after oxidative stress stimuli. Strikingly, in rpAD patients’ brains SFPQ showed a significant dislocation from the nucleus and cytoplasmic colocalization with TIA-1. Furthermore, in rpAD brain lesions, SFPQ and p-tau showed extranuclear colocalization. Of note, association between SFPQ and tau-oligomers in rpAD brains suggests a possible role of SFPQ in oligomerization and subsequent misfolding of tau protein. In line with the findings from the human brain, our in vitro study showed that SFPQ is recruited into TIA-1-positive stress granules (SGs) after oxidative stress induction, and colocalizes with tau/p-tau in these granules, providing a possible mechanism of SFPQ dislocation through pathological SGs. Furthermore, the expression of human tau in vitro induced significant downregulation of SFPQ, suggesting a causal role of tau in the downregulation of SFPQ. The findings from the current study indicate that the dysregulation and dislocation of SFPQ, the subsequent DNA-related anomalies and aberrant dynamics of SGs in association with pathological tau represents a critical pathway which contributes to rapid progression of AD.
Using patient-reported symptoms of dyspnea for screening reduced respiratory function in patients with motor neuron diseases
Authors: Helleman Jochem , Kruitwagen-van Reenen Esther T. , Bakers J. , Kruithof Willeke J. , van Groenestijn Annerieke C. , Jaspers Focks Rineke J. H. , de Grund Arthur , van den Berg Leonard H. , Visser-Meily Johanna M. A. , Beelen Anita
Published: June 2020

Background

Poor monitoring of respiratory function may lead to late initiation of non-invasive ventilation (NIV) in patients with motor neuron diseases (MND). Monitoring could be improved by remotely assessing hypoventilation symptoms between clinic visits. We aimed to determine which patient-reported hypoventilation symptoms are best for screening reduced respiratory function in patients with MND, and compared them to the respiratory domain of the amyotrophic lateral sclerosis functional rating scale (ALSFRS-R).

Methods

This prospective multi-center study included 100 patients with MND, who were able to perform a supine vital capacity test. Reduced respiratory function was defined as a predicted supine vital capacity ≤ 80%. We developed a 14-item hypoventilation symptom questionnaire (HYSQ) based on guidelines, expert opinion and think-aloud interviews with patients. Symptoms of the HYSQ were related to dyspnea, sleep quality, sleepiness/fatigue and pneumonia. The diagnostic performances of these symptoms and the ALSFRS-R respiratory domain were determined from the receiver operating characteristic (ROC) curves, area under the curve (AUC), sensitivity, specificity, predictive values and accuracy.

Results

Dyspnea-related symptoms (dyspnea while eating/talking, while lying flat and during light activity) were combined into the MND Dyspnea Scale (MND-DS). ROC curves showed that the MND-DS had the best diagnostic performance, with the highest AUC = 0.72, sensitivity = 75% and accuracy = 71%. Sleep-quality symptoms, sleepiness/fatigue-related symptoms and the ALSFRS-R respiratory domain showed weak diagnostic performance.

Conclusion

The diagnostic performance of the MND-DS was better than the respiratory domain of the ALSFRS-R for screening reduced respiratory function in patients with MND, and is, therefore, the preferred method for (remotely) monitoring respiratory function.
Antenatally detected urinary tract dilatation: a 12–15-year follow-up
Authors: Herthelius Maria , Axelsson Rimma , Lidefelt Karl-Johan
Published: June 2020

Background

Antenatally diagnosed urinary tract dilatation (UTD) still burdens healthcare providers and parents. This study was conducted to establish long-term outcome in an unselected group of children with antenatally detected UTD.

Methods

Seventy-one out of 103 children born in 2003–2005 and diagnosed with antenatal UTD agreed to participate in a 12–15-year follow-up including blood and urine samples, a kidney ultrasound exam, and kidney scintigraphy. The records were searched for previous urinary tract infections.

Results

Among children with an anteroposterior diameter (APD) ≤ 7 mm and no calyceal, kidney, ureteral, or bladder pathology in the early postnatal period, no one tested had reduced estimated glomerular filtration rate (eGFR), albuminuria, or UTD at the follow-up at a mean age of 13.6 years. One child had kidney damage not affecting kidney function. Among children with postnatal APD > 7 mm and/or kidney, calyceal, ureteral, or bladder pathology, 15% had persistent UTD and 32–39% (depending on the method used) had kidney damage. Major postnatal urinary tract ultrasound abnormalities and a congenital anomalies of the kidney and urinary tract (CAKUT) diagnosis were factors associated with an increased risk for permanent kidney damage (odds ratios 8.9, p = 0.016; and 14.0, p = 0.002, respectively). No one had reduced eGFR. One child (1/71, 1%) had a febrile urinary tract infection after the age of 2.

Conclusions

We conclude that in children with postnatal APD ≤ 7 mm, no calyceal dilatation, normal bladder, ureters, and kidney parenchyma, the outcome is excellent. There is no need for long-term follow-up in these patients.
Heat flow with Dirichlet boundary conditions via optimal transport and gluing of metric measure spaces
Authors: Profeta Angelo , Sturm Karl-Theodor
Published: June 2020

We introduce thetransportation-annihilation distance$$W_p^\sharp $$Wp♯between subprobabilities and derive contraction estimates with respect to this distance for the heat flow with homogeneous Dirichlet boundary conditions on an open set in a metric measure space. We also deduce the Bochner inequality for the Dirichlet Laplacian as well as gradient estimates for the associated Dirichlet heat flow. For the Dirichlet heat flow, moreover, we establish a gradient flow interpretation within a suitable space ofcharged probabilities. In order to prove this, we will work with thedoublingof the open set, the space obtained by gluing together two copies of it along the boundary.
Perioperative complications of abdominal surgery in smokers
Authors: Inoue Yoshikazu , Katoh Takahiko , Masuda Shota , Lu Xi , Koga Tadashi , Sadohara Tomohiro , Sadanaga Michiaki , Tanaka Eiji
Published: June 2020

Purpose

This study examined the association between smoking and perioperative complications of laparoscopic abdominal surgery and whether these complications were reduced with ≥ 4 weeks of preoperative smoking cessation.

Methods

A total of 555 patients who underwent gastric and colorectal cancer surgeries under general anesthesia were divided into the following groups retrospectively: 290 individuals without smoking history (NS group), 144 previous smokers (stopped smoking more than 8 weeks before surgery, PS group), and 121 current smokers (CS group) divided to two groups according to preoperative smoking cessation for < 4 (CS1, n = 76) and 4–8 weeks (CS2, n = 45).

Results

When compared with the NS group, postoperative hospitalization duration was significantly longer in the CS1 group (p < 0.01), whereas differences between the CS2 or PS groups and NS group were not significant. The total number of postoperative complications was higher in all groups of smoking than in NS group, independent on preoperative smoking cessation; however, suture failure was significantly more frequent only in CS1 group. Although pack-years did not significantly affect complication rates in smokers, duration of smoking cessation time in PS group was a negative predictor of postoperative complications.

Conclusion

Providing more than 4 weeks of smoking cessation before gastrointestinal surgery can reduce the duration of hospitalization and rate of suture failure.
Testing the ability for autonomous oral hygiene in hospitalized geriatric patients—clinical validation study
Authors: Schüler Ina Manuela , Kurtz Barbara , Heinrich-Weltzien Roswitha , Lehmann Thomas , Kwetkat Anja
Published: June 2020

Objectives

This study aimed to evaluate if the Timed Test for Money Counting (TTMC) complemented with testing the range of shoulder motion by griping the backside of the neck (NG) predicts the ability of geriatric inpatients to perform effective plaque reduction by autonomously conducted oral hygiene.

Material and methods

This clinical validation study involved 74 hospitalized geriatric inpatients, 48 (64.9%) females, aged between 66 and 98 years (mean age 84.1 years). Oral health status was examined. Dental plaque was assessed with the Turesky modified Quigley-Hein Index (TI) on teeth and the Denture Hygiene Index (DHI) on removable dentures. The performance and duration of TTMC and NG were recorded. After autonomous tooth brushing and denture cleaning by the patient, dental plaque was scored again with the TI and DHI. Geriatric assessment data were collected from medical records.

Results

Forty-nine (66.2%) geriatric inpatients completed the TTMC&NG successfully. Passing the TTMC&NG was significantly associated with better plaque removal on teeth and dentures by autonomously conducted oral hygiene. The sensitivity of the TTMC&NG for above average plaque reduction was 86.4% on teeth and 77.8% on dentures. The test revealed a negative predictive value of 75.0% to detect below average plaque reduction on teeth and 72.7% on dentures.

Conclusions

The TTMC&NG served as a suitable predictor for the ability of geriatric inpatients to perform autonomously effective tooth brushing and denture cleaning.

Clinical relevance

This simple and short test might help the medical staff to identify geriatric inpatients unable to perform effective oral hygiene by themselves.
Levels of different subtypes of tumour-infiltrating lymphocytes correlate with each other, with matched circulating lymphocytes, and with survival in breast cancer
Authors: Verma Rashmi , Hanby Andrew M. , Horgan Kieran , Verghese Eldo T. , Volpato Milene , Carter Clive R. , Hughes Thomas A.
Published: June 2020

Purpose

Breast cancer tumour-infiltrating lymphocytes associate with clinico-pathological factors, including survival, although the literature includes many conflicting findings. Our aim was to assess these associations for key lymphocyte subtypes and in different tumour compartments, to determine whether these provide differential correlations and could, therefore, explain published inconsistencies. Uniquely, we also examine whether infiltrating levels merely reflect systemic lymphocyte levels or whether local factors are predominant in recruitment.

Methods

Immunohistochemistry was used to detect tumour-infiltrating CD20+ (B), CD4+ (helper T), CD8+ (cytotoxic T) and FoxP3+ (regulatory T) cells in breast cancers from 62 patients, with quantification in tumour stroma, tumour cell nests, and tumour margins. Levels were analysed with respect to clinico-pathological characteristics and matched circulating levels (determined by flow-cytometry).

Results

CD4+ lymphocytes were the most prevalent subtype in tumour stroma and at tumour edge and CD8+ lymphocytes were most prevalent in tumour nests; FoxP3+ lymphocytes were rarest in all compartments. High grade or hormone receptor negative tumours generally had significantly increased lymphocytes, especially in tumour stroma. Only intra-tumoural levels of CD8+ lymphocytes correlated significantly with matched circulating levels (p < 0.03), suggesting that recruitment is mainly unrelated to systemic activity. High levels of stromal CD4+ and CD20+ cells associated with improved survival in hormone receptor negative cases (p < 0.04), while tumour nest CD8+ and FoxP3+ cells associated with poor survival in hormone receptor positives (p < 0.005).

Conclusions

Lymphocyte subtype and location define differential impacts on tumour biology, therefore, roles of tumour-infiltrating lymphocytes will only be unravelled through thorough analyses that take this into account.
The reasonable doubt standard as inference to the best explanation
Authors: Jellema Hylke
Published: June 2020

Explanationist accounts of rational legal proof view trials as a competition between explanations. Such accounts are often criticized for being underdeveloped. One question in need of further attention is when guilt is proven beyond a reasonable doubt (BARD) in criminal trials. This article defends an inference to the best explanation (IBE)-based approach on which guilt is only established BARD if (1) the best guilt explanation in a case is substantially more plausible than any innocence explanation, and (2) there is no good reason to presume that we have overlooked evidence or alternative explanations that could realistically have exonerated the defendant. This is a comparative account, which I argue is better suited for arriving at accurate verdicts than the non-comparative ‘no plausible alternative’ account that many explanationists tacitly assume. Furthermore, this account is not susceptible to the most important arguments against IBE in criminal trials or to arguments against other, non-explanationist interpretations of the BARD standard. I use a case study to illustrate how this account provides meaningful guidance for decision makers in criminal trials.
A modal theory of discrimination
Authors: Melchior Guido
Published: June 2020

Discrimination is a central epistemic capacity but typically, theories of discrimination only use discrimination as a vehicle for analyzing knowledge. This paper aims at developing a self-contained theory of discrimination. Internalist theories of discrimination fail since there is no compelling correlation between discriminatory capacities and experiences. Moreover, statistical reliabilist theories are also flawed. Only a modal theory of discrimination is promising. Versions of sensitivity and adherence that take particular alternatives into account provide necessary and sufficient conditions on discrimination. Safety in contrast is not sufficient for discrimination as there are cases of safety that are clearly instances of discrimination failure. The developed account of discrimination between objects will be extended to discrimination between kinds and between types.
Modeling the Failure Behavior of Self-Piercing Riveting Joints of 6xxx Aluminum Alloy
Authors: Hönsch Florian , Domitner Josef , Sommitsch Christof , Götzinger Bruno
Published: June 2020

Self-piercing riveting (SPR) is a mechanical joining process which is applied for joining similar and dissimilar lightweight materials in modern car body manufacturing. For qualifying SPR joints, cross sections must be investigated with respect to predefined quality features. Thus, numerous tests must be carried out in order to determine the maximum load capacity of SPR joints for different load angles. The growing number of materials used for the body-in-white requires a reliable and time efficient routine for predicting the joining behavior and the load capacity of SPR joints. In this study, the load capacity of three SPR joints was investigated numerically and experimentally using so-called KS2 samples. The results of axisymmetric two-dimensional finite element simulations (Hönsch et al in J Phys Conf Ser 1063:1-6, 2018) are the basis for three-dimensional simulations of the destructive testing procedure. The experimental setup of destructive testing was modeled using the FE software Simufact Forming 15. The numerically determined load capacity was validated with experimental data. Comparing the failure modes and the force–displacement curves revealed good agreement of simulations and experiments. Therefore, the presented simulation is a powerful tool for predicting the behavior of SPR joints under different load cases.
Application of hue spectra fingerprinting during cold storage and shelf-life of packaged sweet cherry
Authors: Le Nguyen Lien Phuong , Visy Anna , Baranyai László , Friedrich László , Mahajan Pramod V.
Published: June 2020

Presented work investigated the application of a new color analysis technique in post-harvest life of sweet cherry (Prunus avium L. ‘Hudson’). The hue spectra fingerprinting creates a histogram of image colors by summarizing the saturation. The advantage of this calculation method is that vivid colors make peaks while neutral background color is eliminated without object segmentation. Partial Least Squares (PLS) regression was used to estimate reference parameters during 9 d cold storage at 10 ± 0.5 °C (RH = 90 ± 1%) and following 2 d shelf-life at 20 ± 0.5 °C. The reference parameters of respiration, weight loss, fruit firmness and total soluble solid (TSS) content were measured. Samples were split into seven groups according to the number of perforations of polypropylene film and fructose concentration of moisture absorber. It was observed that parameters TSS and fruit firmness were the most sensitive to the length of storage. Weight loss was affected significantly by packaging. All reference parameters were estimated by PLS model with R2 > 0.917, but weight loss and respiration obtained high estimation error of RMSE% = 48.02% and 11.76%, respectively. TSS and fruit firmness prediction were successful with RMSE% = 0.84% and 1.85%, respectively. Desiccation and color change of peduncle became visible in the green range of hue spectra. Color change of red fruit was observed with decreasing saturation in the red range of hue spectra. Our findings suggest that hue spectra fingerprinting can be a useful nondestructive method for monitoring quality change of sweet cherry during post-harvest handling and shelf-life.
Disclosure duties in German insurance contract law
Authors: Wandt Manfred , Bork Kevin
Published: June 2020

This paper analyses disclosure duties in insurance contract law in Germany on the basis of questions developed in preparation of the World Congress of the International Insurance Law Association (AIDA) 2018. As risk factors are within the policyholder’s sphere of knowledge, the insurer naturally depends on gaining such knowledge from its policyholder in order to calculate and evaluate premium and risk. Legal approaches as to how the insurer may obtain relevant information and the legal consequences differ in national insurance contract laws around the globe. Taking part in this legal comparison, the paper describes the key elements of such a mechanism from a German perspective and comprises both duties of the policyholder and duties of the insurer.

As for the policyholder, these issues are differences between a duty to (spontaneously) disclose and a duty not to misrepresent as a reaction to questions of the insurer, the prerequisites and remedies of such duty, the subjective standard of the disclosure duty and a duty to notify material changes during the contract term. On the other hand, the paper also addresses an insurer’s duty to investigate, a duty to ascertain the policyholder’s understanding of the policy and a duty to inform during the contract term or after the occurrence of an insured event. In doing so, the paper offers a comprehensive and critical overview on the transfer of knowledge in the insurance (pre-)contractual relationship.
On functions preserving regular semimetrics and quasimetrics satisfying the relaxed polygonal inequality
Authors: Jachymski Jacek , Turoboś Filip
Published: June 2020

We obtain characterizations of non-negative functions on $$[0,+\infty )$$

[
0
,
+
∞
)

which preserve some classes of semimetrics. In particular, one of our main results says that for a non-decreasing function $$f:[0,+\infty )\rightarrow [0,+\infty )$$

f
:
[
0
,
+
∞
)
→
[
0
,
+
∞
)

the following statements are equivalent: (i) for any semimetric space (X, d), if d satisfies the relaxed polygonal inequality, then so does $$f\circ d$$

f
∘
d

; (ii) there exist a constant $$c\geqslant 1$$

c
⩾
1

and a subadditive function $$g:[0,+\infty ) \rightarrow [0,+\infty )$$

g
:
[
0
,
+
∞
)
→
[
0
,
+
∞
)

such that $$g^{-1}\left( \{ 0 \} \right) = \{ 0 \}$$

g

-
1

{
0
}

=

{
0
}

and $$g\leqslant f \leqslant cg$$

g
⩽
f
⩽
c
g

. We also obtain a complete characterization of functions preserving regularity of a semimetric space in the sense of Bessenyei and Páles. Finally, we give another proof of the theorem of Pongsriiam and Termwuttipong on functions transforming metrics into ultrametrics.
On the distribution of the Picard ranks of the reductions of a K3 surface
Authors: Costa Edgar , Elsenhans Andreas-Stephan , Jahnel Jörg
Published: June 2020

We report on our results concerning the distribution of the geometric Picard ranks ofK3 surfaces under reduction modulo various primes. In the situation that$${\mathop {{\mathrm{rk}}}\nolimits \mathop {{\mathrm{Pic}}}\nolimits S_{{\overline{K}}}}$$rkPicSK¯is even, we introduce a quadratic character, called the jump character, such that$${\mathop {{\mathrm{rk}}}\nolimits \mathop {{\mathrm{Pic}}}\nolimits S_{{\overline{{\mathbb {F}}}}_{\!{{\mathfrak {p}}}}} > \mathop {{\mathrm{rk}}}\nolimits \mathop {{\mathrm{Pic}}}\nolimits S_{{\overline{K}}}}$$rkPicSF¯p>rkPicSK¯for all good primes at which the character evaluates to$$(-1)$$(-1).
A Taxonomy of Initiatives at Work in the Sharing Economy
Authors: Fernandes Bruno , Chimenti Paula , Nogueira Roberto
Published: June 2020

It is crucial to classify SE initiatives to better understand such a multifaceted phenomenon. However, previous attempts to classify SE initiatives seem not to contemplate the full SE complexity. Therefore, this study proposes a new classification using a broad taxonomic approach. It started by systematically selecting a set of initiatives. Then, an intensive search on secondary data about the initiatives selected was conducted in order to identify relevant attributes. Next, the attributes identified were successively aggregated resulting in four attribute groups. In the end, each initiative was analysed from the perspective of each attribute group, resulting in five SE categories: commodity intermediary, wealth redistributor, unique-service intermediary, skill redistributor, and decentralized commodity intermediary. Findings suggest that generalizations from studies focused on specific initiatives might be problematic, entrepreneurs should consider the characteristics of different SE categories to design appropriate platforms, and policymakers should avoid regulating all SE initiatives in a homogeneous manner.
Mapping sea-ice types from Sentinel-1 considering the surface-type dependent effect of incidence angle
Authors: Lohse Johannes , Doulgeris Anthony P. , Dierking Wolfgang
Published: June 2020

Automated classification of sea-ice types in Synthetic Aperture Radar (SAR) imagery is complicated by the class-dependent decrease of backscatter intensity with Incidence Angle (IA). In the log-domain, this decrease is approximately linear over the typical range of space-borne SAR instruments. A global correction does not consider that different surface types show different rates of decrease in backscatter intensity. Here, we introduce a supervised classification algorithm that directly incorporates the surface-type dependent effect of IA. We replace the constant mean vector of a Gaussian probability density function in a Bayesian classifier with a linearly variable mean. During training, the classifier first retrieves the slope and intercept of the linear function describing the mean value and then calculates the covariance matrix as the mean squared deviation relative to this function. The IA dependence is no longer treated as an image property but as a class property. Based on training and validation data selected from overlapping SAR and optical images, we evaluate the proposed method in several case studies and compare to other classification algorithms for which a global IA correction is applied during pre-processing. Our results show that the inclusion of the per-class IA sensitivity can significantly improve the performance of the classifier.
Social Categories in Context
Authors: TAYLOR ELANOR
Published: June 2020

Social categories play a central role in inquiry. Some authors have argued that social categories can only play this role because they have a particular metaphysical status, such as a connection to natural kinds or to comparatively joint-carving properties. This reflects the broadly realist idea that categories that play important roles in inquiry do so for metaphysical reasons. In this paper I argue that such metaphysical views of social categories cannot accommodate ‘empty’ social categories, cases in which social categories that cannot have the metaphysical features attributed to them by such accounts still play a central role in inquiry. I defend an alternative approach: context-dependent naturalness, an analogue of metaphysical naturalness that concerns context-dependent, rather than metaphysical, structure.
Megalencephaly–Capillary Malformation–Polymicrogyria with Cerebral Venous Thrombosis
Authors: Fortin Olivier , Ashour Mohammed , Lacroix Caroline , Sabapathy Christine A. , Myers Kenneth A.
Published: June 2020

Megalencephaly–capillary malformation–polymicrogyria (MCAP) syndrome (OMIM #602501) is characterized by megalencephaly, midline capillary malformations, and cortical malformations. This genetic overgrowth syndrome is associated with mosaic gain-of-function pathogenic PIK3CA variants (OMIM #171834).
Formative evaluation results of a phase 2 Center of Biomedical Research Excellence (COBRE)
Authors: Kimberly Judy A. , Rounds Sharon I. , Harrington Elizabeth O. , McNamara Susan
Published: June 2020

Introduction:

Because a primary focus of Centers of Biomedical Research Excellence (COBRE) is the development of junior-level investigators into competent and successful research scientists, evaluation of their skills, mentoring experiences, and usefulness of COBRE services is paramount to the transition of the Center to a self-sustaining, collaborative, multidisciplinary research environment. A formative evaluation, focused on the processes of a COBRE, was undertaken and is presented here.

Methods:

Two instruments, one for completion by junior investigators and one for completion by mentors, were developed for the purpose of evaluating this COBRE. Areas of inquiry were relationships between junior investigators and mentors, research self-efficacy, mentee progress, and satisfaction with the COBRE. All eight of the COBRE’s current junior investigators and six of their mentors completed the online questionnaires.

Results:

Junior investigators were very positive about mentors and vice versa. Junior investigators were least positive about their progress as academicians and most positive about their abilities to develop collaborations with other scholars/professionals. Mentors felt as though junior investigators could benefit most by increasing the number of publications they had generated.

Conclusions:

Activities provided by the CardioPulmonary Vascular Biology (CPVB) COBRE were extremely positive. Junior investigators felt as though the scientific, academic, and professional development opportunities afforded by this COBRE were integral to their success as researchers; however they would like more assistance developing professional networks (i.e., serving on committees of professional societies). Leadership of the CPVB COBRE may consider expanding the role of their advisory committee to ensure these opportunities are provided.
Cohorting KPC+ Klebsiella pneumoniae (KPC-Kp)–positive patients: A genomic exposé of cross-colonization hazards in a long-term acute-care hospital (LTACH)
Authors: Hawken Shawn E. , Hayden Mary K. , Lolans Karen , Yelin Rachel D. , Weinstein Robert A. , Lin Michael Y. , Snitkin Evan S.
Published: June 2020

Objective:

Cohorting patients who are colonized or infected with multidrug-resistant organisms (MDROs) protects uncolonized patients from acquiring MDROs in healthcare settings. The potential for cross transmission within the cohort and the possibility of colonized patients acquiring secondary isolates with additional antibiotic resistance traits is often neglected. We searched for evidence of cross transmission of KPC+ Klebsiella pneumoniae (KPC-Kp) colonization among cohorted patients in a long-term acute-care hospital (LTACH), and we evaluated the impact of secondary acquisitions on resistance potential.

Design:

Genomic epidemiological investigation.

Setting:

A high-prevalence LTACH during a bundled intervention that included cohorting KPC-Kp–positive patients.

Methods:

Whole-genome sequencing (WGS) and location data were analyzed to identify potential cases of cross transmission between cohorted patients.

Results:

Secondary KPC-Kp isolates from 19 of 28 admission-positive patients were more closely related to another patient’s isolate than to their own admission isolate. Of these 19 cases, 14 showed strong genomic evidence for cross transmission (<10 single nucleotide variants or SNVs), and most of these patients occupied shared cohort floors (12 patients) or rooms (4 patients) at the same time. Of the 14 patients with strong genomic evidence of acquisition, 12 acquired antibiotic resistance genes not found in their primary isolates.

Conclusions:

Acquisition of secondary KPC-Kp isolates carrying distinct antibiotic resistance genes was detected in nearly half of cohorted patients. These results highlight the importance of healthcare provider adherence to infection prevention protocols within cohort locations, and they indicate the need for future studies to assess whether multiple-strain acquisition increases risk of adverse patient outcomes.
Policies and practices of SHEA Research Network hospitals during the COVID-19 pandemic
Authors: Calderwood Michael S. , Deloney Valerie M. , Anderson Deverick J. , Cheng Vincent Chi-Chung , Gohil Shruti , Kwon Jennie H. , Mody Lona , Monsees Elizabeth , Vaughn Valerie M. , Wiemken Timothy L. , Ziegler Matthew J. , Lofgren Eric
Published: June 2020

To understand hospital policies and practices as the COVID-19 pandemic accelerated, the Society for Healthcare Epidemiology of America (SHEA) conducted a survey through the SHEA Research Network (SRN). The survey assessed policies and practices around the optimization of personal protection equipment (PPE), testing, healthcare personnel policies, visitors of COVID-19 patients in relation to procedures, and types of patients. Overall, 69 individual healthcare facilities responded in the United States and internationally, for a 73% response rate.
A low dosage of the dopamine D2-receptor antagonist sulpiride affects effort allocation for reward regardless of trait extraversion
Authors: Ohmann Hanno Andreas , Kuper Niclas , Wacker Jan
Published: June 2020

Dopamine (DA) is known to be involved in various aspects of reward processing and goal-directed behavior. The present preregistered study aims at directly accessing the causal influence of DA activity on reward motivation in humans, while also accounting for trait extraversion. Therefore, we examined the effect of a single dose of the DA D2 receptor antagonist sulpiride (200 mg) on effort allocation in a modified version of the Effort-Expenditure for Reward Task (EEfRT). Based on its presumably DA increasing action, we expected the low dose of sulpiride to increase participants’ willingness to allocate effort during the modified EEfRT relative to placebo, especially in trials with low probability of reward attainment. Further, we expected a moderating effect of trait extraversion on the effects of sulpiride. Two hundred and three healthy male participants were tested in a randomized, double-blind between-subjects design. Contrary to our expectations, sulpiride reduced the average number of clicks within the modified EEfRT and did not interact with reward attributes, suggesting a more global and not reward-specific effect of sulpiride. Furthermore, trait extraversion did not moderate the effect of sulpiride. Our results provide initial support for the validity of the modified version of the EEfRT, suggesting a possible inhibiting effect of a low dose of sulpiride on approach motivation regardless of trait extraversion. However, given the mixed pattern of findings and the possible confounding role of motoric abilities, further studies examining these effects are clearly warranted.
Measuring patient satisfaction with video consultation: a systematic review of assessment tools and their measurement properties
Authors: Barsom Esther Z. , van Hees Ewout , Bemelman Willem A. , Schijven Marlies P.
Published: June 2020

Background

Video consultation (VC) is considered promising in delivering healthcare closer to the patient and improving patient satisfaction. Indeed, providing care-at-distance via VC is believed to be promising for some situations and patients, serving their needs without associated concomitant costs. In order to assess implementation and perceived benefits, patient satisfaction is frequently measured. Measuring patient satisfaction with VC in healthcare is often performed using quantitative and qualitative outcome analysis. As studies employ different surveys, pooling of data on the topic is troublesome. This systematic review critically appraises, summarizes, and compares available questionnaires in order to identify the most suitable questionnaire for qualitative outcome research using VC in clinical outpatient care.

Methods

PubMed, Embase, and Cochrane were searched for relevant articles using predefined inclusion criteria. Methodological quality appraisal of yielded questionnaires to assess VC was performed using the validated COSMIN guideline.

Results

This systematic search identified twelve studies that used ten different patient satisfaction questionnaires. The overall quality of nine questionnaires was rated as “inadequate” to “doubtful” according to the COSMIN criteria. None of the questionnaires retrieved completed a robust validation process for the purpose of use.

Conclusion and recommendations

Although high-quality studies on measurement properties of these questionnaires are scarce, the questionnaire developed by Mekhjian has the highest methodological quality achieving validity on internal consistency and the use of a large sample size. Moreover, this questionnaire can be used across healthcare settings. This finding may be instrumental in further studies measuring patient satisfaction with VC.
Different factors predict adolescent substance use versus adult substance abuse: Lessons from a social-developmental approach
Authors: Allen Joseph P. , Loeb Emily L. , Narr Rachel K. , Costello Meghan A.
Published: June 2020

This 17-year prospective study applied a social-developmental lens to the challenge of distinguishing predictors of adolescent-era substance use from predictors of longer term adult substance use problems. A diverse community sample of 168 individuals was repeatedly assessed from age 13 to age 30 using test, self-, parent-, and peer-report methods. As hypothesized, substance use within adolescence was linked to a range of likely transient social and developmental factors that are particularly salient during the adolescent era, including popularity with peers, peer substance use, parent–adolescent conflict, and broader patterns of deviant behavior. Substance abuse problems at ages 27–30 were best predicted, even after accounting for levels of substance use in adolescence, by adolescent-era markers of underlying deficits, including lack of social skills and poor self-concept. The factors that best predicted levels of adolescent-era substance use were not generally predictive of adult substance abuse problems in multivariate models (either with or without accounting for baseline levels of use). Results are interpreted as suggesting that recognizing the developmental nature of adolescent-era substance use may be crucial to distinguishing factors that predict socially driven and/or relatively transient use during adolescence from factors that predict long-term problems with substance abuse that extend well into adulthood.
Positive and negative parenting in conduct disorder with high versus low levels of callous–unemotional traits
Authors: Pauli Ruth , Tino Peter , Rogers Jack C. , Baker Rosalind , Clanton Roberta , Birch Philippa , Brown Abigail , Daniel Gemma , Ferreira Lisandra , Grisley Liam , Kohls Gregor , Baumann Sarah , Bernhard Anka , Martinelli Anne , Ackermann Katharina , Lazaratou Helen , Tsiakoulia Foteini , Bali Panagiota , Oldenhof Helena , Jansen Lucres , Smaragdi Areti , Gonzalez-Madruga Karen , Gonzalez-Torres Miguel Angel , Gonzalez de Artaza-Lavesa Maider , Steppan Martin , Vriends Noortje , Bigorra Aitana , Siklosi Reka , Ghosh Sreejita , Bunte Kerstin , Dochnal Roberta , Hervas Amaia , Stadler Christina , Fernandez-Rivas Aranzazu , Fairchild Graeme , Popma Arne , Dikeos Dimitris , Konrad Kerstin , Herpertz-Dahlmann Beate , Freitag Christine M. , Rotshtein Pia , De Brito Stephane A.
Published: June 2020

Less is known about the relationship between conduct disorder (CD), callous–unemotional (CU) traits, and positive and negative parenting in youth compared to early childhood. We combined traditional univariate analyses with a novel machine learning classifier (Angle-based Generalized Matrix Learning Vector Quantization) to classify youth (N = 756; 9–18 years) into typically developing (TD) or CD groups with or without elevated CU traits (CD/HCU, CD/LCU, respectively) using youth- and parent-reports of parenting behavior. At the group level, both CD/HCU and CD/LCU were associated with high negative and low positive parenting relative to TD. However, only positive parenting differed between the CD/HCU and CD/LCU groups. In classification analyses, performance was best when distinguishing CD/HCU from TD groups and poorest when distinguishing CD/HCU from CD/LCU groups. Positive and negative parenting were both relevant when distinguishing CD/HCU from TD, negative parenting was most relevant when distinguishing between CD/LCU and TD, and positive parenting was most relevant when distinguishing CD/HCU from CD/LCU groups. These findings suggest that while positive parenting distinguishes between CD/HCU and CD/LCU, negative parenting is associated with both CD subtypes. These results highlight the importance of considering multiple parenting behaviors in CD with varying levels of CU traits in late childhood/adolescence.
Supporting Tenants with Multiple and Complex Needs in Houses in Multiple Occupation: The Need to Balance Planning Restrictions and Housing Enforcement with Support
Authors: Iafrati Steve
Published: June 2020

The number of houses in multiple occupation (HMOs) in the UK has increased significantly in recent years, with the sector disproportionately housing vulnerable tenants. Government responses to the growth in HMOs has focused increasingly on landlord enforcement and planning controls, with limited attention on the needs of vulnerable residents. Drawing on new research with HMO tenants with multiple and complex needs (MCN), attendance at HMO working groups and consultations with stakeholders, this article argues that, whilst landlord enforcement and regulation are necessary, it is important to balance this approach with appropriate support for tenants with MCN. Whilst living in an HMO can exacerbate personal challenges, the research shows that positive outcomes are possible when tenants with MCN are supported to address their needs. At a time when the number of HMOs is continuing to increase, it is important to explore the significant role of support provided to tenants with MCN.
Effective resistivity extraction of low-loss silicon substrates at millimeter-wave frequencies
Authors: Nyssens Lucas , Rack Martin , Raskin Jean-Pierre
Published: June 2020

The effective resistivity (ρeff) is a figure of merit commonly used to assess the radio-frequency performance of a substrate from the measurements of coplanar waveguide lines. For highly resistive substrates, such as the trap-rich (TR) substrate, the extractedρeffdecreases by several orders of magnitude at millimeter-wave frequencies. The explanation for this decay is twofold. First, the imaginary part of the characteristic impedance${\rm \lpar \Im }\lpar Z_c\rpar \rpar$is not well extracted, which leads to an incorrect separation of the total losses among the metal and substrate losses. Second, the original expression ofρeffdoes not include dielectric losses, which might become non-negligible at millimeter-wave frequencies. This paper solves both issues by presenting a new procedure to extractρeffand the dielectric losses simultaneously, and by introducing a novel method to correct${\rm \Im }\lpar {Z_c} \rpar$. Furthermore, it is shown that this extraction method enables the correct extraction of substrate parameters up to 220 GHz of TR and high-resistivity silicon substrates. Finally, the origin of the large extracted value of dielectric loss is discussed in the potential presence of surface roughness and surface wave radiation. Both phenomena are discounted thanks to measurements of an additional reflective structure and a standard impedance substrate.
Translating developmental origins of health and disease in practice: health care providers’ perspectives
Authors: Molinaro Monica L. , Evans Marilyn , Regnault Timothy R.H. , de Vrijer Barbra
Published: June 2020

Currently, there is limited knowledge on how health care providers perceive and understand the Developmental Origins of Health and Disease (DOHaD), which may impact how they inform patients and their families throughout the perinatal period. This qualitative descriptive study explored if and how health care providers counsel on in utero programming and future health outcomes with parents, both preconception and during pregnancy. One-on-one, semi-structured interviews were conducted with 23 health care providers from varying health disciplines including obstetrics and gynaecology, midwifery, paediatrics, endocrinology and internal medicine. Audiotaped interviews were transcribed verbatim and analysed using inductive thematic analysis. Three themes were identified: Knowledge about DOHaD, Counselling on DOHaD in Practice Settings and Impact of DOHaD on Health. Health care providers not only expressed excitement over the potential health benefits of DOHaD counselling but also indicated barriers to knowledge translation, including a lack of knowledge among providers and a disconnect between basic scientists and practitioners. All health care providers expressed concerns on how and when to introduce the concept of DOHaD when counselling patients and called for the development of practice guidelines. Counselling on DOHaD needs to be framed in a way that is empowering, minimising the potential of coercion and guilt. More interaction and collaboration are needed between health care providers and researchers to identify strategies to support knowledge translation generated from DOHaD research into practice settings.
Impacts of Tiled Land Cover Characterization on Global Meteorological Predictions Using the MPAS‐A
Authors: Campbell Patrick C. , Bash Jesse O. , Herwehe Jerold A. , Gilliam Robert C. , Li Dan
Published: June 2020

Parameterization of subgrid‐scale variability of land cover characterization (LCC) is an active area of research and can improve model performance compared to the dominant (i.e., most abundant tile) approach. The “Noah” land surface model implementation in the global Model for Prediction Across Scales‐Atmosphere (MPAS‐A), however, only uses the dominant LCC approach that leads to oversimplification in regions of highly heterogeneous LCC (e.g., urban/suburban settings). Thus, in this work we implement a subgrid tiled approach as an option in MPAS‐A, version 6.0, and assess the impacts of tiled LCC on meteorological predictions for two gradually refining meshes (92–25 and 46–12 km) focused on the conterminous United States for January and July 2016. Compared to the dominant approach, results show that using the tiled LCC leads to pronounced global changes in 2‐m temperature (July global average change approximately −0.4 K), 2‐m moisture, and 10‐m wind speed for the 92–25 km mesh. The tiled LCC reduces mean biases in 2‐m temperature (July U.S. average bias reduction approximately factor of 4) and specific humidity in the central and western United States for the 92–25 km mesh and improves the agreement of vertical profiles (e.g., temperature, humidity, and wind speed) with observed radiosondes; however, there is increased bias and error for incoming solar radiation at the surface. The inclusion of subgrid LCC has implications for reducing systematic temperature biases found in numerical weather prediction models, particularly those that employ a dominant LCC approach.