bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of clipping on bacterial contamination of canine arthrocentesis sites before and after skin preparation
Authors: Lavallée Justin M. , Shmon Cindy , Beaufrère Hugues , Chirino‐Trejo Manuel , Linn Kathleen
Published: June 2020

Objective

To determine the influence of hair removal as part of the aseptic skin preparation of canine arthrocentesis sites and to characterize the bacterial flora remaining after aseptic skin preparation.

Study design

Randomized controlled trial.

Study population

Thirteen shorthaired beagle‐cross dogs.

Methods

A coin toss was used to randomly determine to have one carpus, elbow, tarsus, and stifle clipped. The contralateral side was left unclipped. Aseptic skin preparation was performed on all sites with 4% chlorhexidine followed by 70% isopropyl alcohol. The skin of each site was sampled for aerobic and anaerobic bacterial cultures before and after aseptic skin preparation. Bacterial cultures were submitted for laboratory testing to determine the colony‐forming units (CFU) of bacteria and bacterial species isolated for each site.

Results

Each group (clipped and unclipped) included 52 sites. Aseptic skin preparation reduced bacterial CFU in both groups. There was no association between values for CFU per milliliter after skin preparation of dogs and side (P = .07), joint (P = .71), pre–aseptic skin preparation CFU (P = .94), or clipping (P = .42). Staphylococcus spp were the most common of the bacterial species cultured.

Conclusion

In clean shorthaired dogs without visible evidence of dermatological disease, leaving arthrocentesis sites unclipped rather than performing traditional surgical clipping did not result in increased bacterial skin counts after aseptic skin preparation.

Clinical significance

In this study we did not find evidence to support that clipping of canine arthrocentesis sites is required for effective aseptic skin preparation. A prospective clinical trial is required to determine whether a change in practice would be associated with increased morbidity.
Minimizing Temperature Nonuniformity by Optimal Arrangement of Hotspots in Vertically Stacked Three-Dimensional Integrated Circuits
Authors: Rangarajan Srikanth , Hadad Yaser , Choobineh Leila , Sammakia Bahgat
Published: June 2020

The semiconductor packaging technologies have seen its growth from multichip module (MCM), system in package (SiP), system on chip (SoC) to the heterogeneous integration of the MCM. Thermal management of multichip vertically integrated systems poses additional constraints and limitations beyond those for single chip modules. Three-dimensional-integrated circuits (3D ICs) technology is a potential approach for next-generation semiconductor packaging technologies. A 3D IC is formed by vertical interconnection of multiple substrates containing active devices which offer reduced die footprint and interconnect length. This paper discusses the optimal arrangement of two hotspots on each layer of a two-die stacked 3D IC. An analytical heat transfer model for prediction of three-dimensional temperature field of a 3D IC based on the solution of governing energy equations has been developed and used for this study. The model is subject to adiabatic boundary conditions at the walls except for the bottom wall which is subject to convective boundary condition. A feed-forward back propagation artificial neural network (ANN) is employed for obtaining the functional relationship between the location of the hotspots and the objectives. Genetic algorithm is employed for solving two nonconflicting objective functions subject to set of constraints. The first objective aims to minimize the maximum temperature on both layers, and the second objective aims to achieve temperature uniformity in the layers. The results of the optimization study are expected to provide recommendations on the design guidelines for arranging hotspots on vertically stacked substrates.
Additively Printed Multilayer Substrate Using Aerosol-Jet Technique
Authors: Lall Pradeep , Goyal Kartik , Kothari Nakul , Leever Benjamin , Miller Scott
Published: June 2020

Printing technologies, such as aerosol-jet, open possibilities of miniaturizing interconnects and designing circuits on nonplanar surfaces. Aerosol-jet is a direct-printing technique that provides an alternative manufacturing option to traditional subtractive methods that entail lithography or etching. Additionally, the aerosol-jet technique allows the circuits fabrication using noncontact method. Wide impact areas range from healthcare to wearables to future automotive applications. The aerosol-jet printer from Optomec utilized in this study consists of two types of atomizers, depending on ink viscosity. The ultrasonic atomizer, supports ink with a viscosity range of 1–5 cP, and the pneumatic atomizer that has a larger range of 1–1000 cP. This paper focuses on utilizing the aerosol-jet technique, using both atomizers to develop process parameters, in order to successfully print bimaterial, multilayer circuitry. The insulating material between two conductive lines used in the paper is of very high viscosity of 350 cP, which is suitable for the pneumatic atomizer and silver nanoparticle ink with comparatively low viscosity of 30 cP for the ultrasonic atomizer as a conductive ink. This paper also presents a statistical modeling approach that predicts line attributes, including microvia-diameter, before starting the print process, enabling us to pre-adjust the dimensions in computer-aided design for the desired output. Process parameters can obtain a fine print with satisfactory electrical properties, which develops improved dimensional accuracy. The importance of precleaning the substrate in addition to the printing process efficiency gaged as a function of process capability index and process capability ratio is also presented.
Reconceptualizing Teacher Identity: Teachers’ Becoming in the Dynamic Complexity of Teaching Situations
Authors: Puchegger Romana , Bruce Toni
Published: June 2020

Research in physical education often focuses on how to improve the education of teachers and the achievement of students, based on an assumption of a relatively stable teacher identity. The focus of this study is to unsettle this perspective, drawing on complexity thinking and the concept of becoming to reconceptualize teacher identity as a fluid, dynamic identity performance that depends on multiple levels of interacting elements in teachers’ contexts, and significantly challenges the concept of being embedded in ideas of “best practice.” The results of an in‐depth qualitative study with seven health and physical education teachers showed that each teacher performed an adaptive multiplicity of self that responded to constraints in each moment of context‐specific teaching. The results suggest the need for a reconceptualization of teacher identity that understands it as comprised of many different performances of “teacher” and expressed in context‐specific moments ofteacher becoming.
Unprecedented dipole alignment in α-phase nylon-11 nanowires for high-performance energy-harvesting applications
Authors: Choi Yeon Sik , Kim Sung Kyun , Smith Michael , Williams Findlay , Vickers Mary E. , Elliott James A. , Kar-Narayan Sohini
Published: June 2020

α-Phase nylon-11 nanowires exhibit unprecedented dipole alignment, leading to high-performance triboelectric generators.
Nanoparticle-based thymulin gene therapy therapeutically reverses key pathology of experimental allergic asthma
Authors: da Silva Adriana L. , de Oliveira Gisele P. , Kim Namho , Cruz Fernanda F. , Kitoko Jamil Z. , Blanco Natalia G. , Martini Sabrina V. , Hanes Justin , Rocco Patricia R. M. , Suk Jung Soo , Morales Marcelo M.
Published: June 2020

Nanoparticle-based thymulin gene therapy provides near-complete resolution of key pathology of chronic allergic asthma.
Information theory tests critical predictions of plant defense theory for specialized metabolism
Authors: Li Dapeng , Halitschke Rayko , Baldwin Ian T. , Gaquerel Emmanuel
Published: June 2020

Information theory provides a common currency for comparison of specialized metabolomes and tests defense theory predictions.
Reducing achievement gaps in undergraduate general chemistry could lift underrepresented students into a “hyperpersistent zone”
Authors: Harris R. B. , Mack M. R. , Bryant J. , Theobald E. J. , Freeman S.
Published: June 2020

Underrepresented students who earn a grade of C or better stay in STEM at higher rates than well-represented students.
Inhibition of the translesion synthesis polymerase REV1 exploits replication gaps as a cancer vulnerability
Authors: Nayak Sumeet , Calvo Jennifer A. , Cong Ke , Peng Min , Berthiaume Emily , Jackson Jessica , Zaino Angela M. , Vindigni Alessandro , Hadden M. Kyle , Cantor Sharon B.
Published: June 2020

Translesion synthesis is a cancer adaptation that suppresses replication stress–induced gaps that limit fitness.
R-loops coordinate with SOX2 in regulating reprogramming to pluripotency
Authors: Li Yaoyi , Song Yawei , Xu Wei , Li Qin , Wang Xinxiu , Li Kuan , Wang Juehan , Liu Zicong , Velychko Sergiy , Ye Rong , Xia Qing , Wang Lei , Guo Rong , Dong Xiaotao , Zheng Zhikai , Dai Yushuang , Li Haojie , Yao Mingze , Xue Yuanchao , Schöler Hans R. , Sun Qianwen , Yao Hongjie
Published: June 2020

R-loop dynamics occur before changes in gene expression and are required for somatic cell reprogramming.
Accelerated evolution of a minimal 63–amino acid dual transcription factor
Authors: Brödel Andreas K. , Rodrigues Rui , Jaramillo Alfonso , Isalan Mark
Published: June 2020

The smallest gene activator-repressor with polymerase recruitment is engineered using a 63–amino acid peptide.
A direct-acting antiviral drug abrogates viremia in Zika virus–infected rhesus macaques
Authors: Lim So-Yon , Osuna Christa E. , Best Katharine , Taylor Ray , Chen Elsa , Yoon Gyeol , Kublin Jessica L. , Schalk Dane , Schultz-Darken Nancy , Capuano Saverio , Safronetz David , Luo Ma , MacLennan Steve , Mathis Amanda , Babu Yarlagadda S. , Sheridan William P. , Perelson Alan S. , Whitney James B.
Published: June 2020

Galidesivir, a broad-spectrum direct-acting adenosine analog antiviral drug, abrogates viremia in rhesus macaques infected with Zika virus.
Locoregional delivery of stem cell–based therapies
Authors: Ng Nathan Norton , Thakor Avnesh Sinh
Published: June 2020

Image-guided, minimally invasive procedures target delivery of stem cell–based therapies to regenerate, replace, or repair damaged tissues and organs.
Culture-Based Virus Isolation To Evaluate Potential Infectivity of Clinical Specimens Tested for COVID-19
Authors: Huang Chung-Guei , Lee Kuo-Ming , Hsiao Mei-Jen , Yang Shu-Li , Huang Peng-Nien , Gong Yu-Nong , Hsieh Tzu-Hsuan , Huang Po-Wei , Lin Ya-Jhu , Liu Yi-Chun , Tsao Kuo-Chien , Shih Shin-Ru
Published: June 2020

Real-time reverse transcription-PCR (RT-PCR) is currently the most sensitive method to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19). However, the correlation between detectable viral RNA and culturable virus in clinical specimens remains unclear. Here, we performed virus culture for 60 specimens that were confirmed to be positive for SARS-CoV-2 RNA by real-time RT-PCR. The virus could be successfully isolated from 12 throat and nine nasopharyngeal swabs and two sputum specimens.
Evaluation of the COVID-19 IgG/IgM Rapid Test from Orient Gene Biotech
Authors: Dellière Sarah , Salmona Maud , Minier Marine , Gabassi Audrey , Alanio Alexandre , Le Goff Jérôme , Delaugerre Constance , Chaix Marie-Laure
Published: June 2020

While the coronavirus disease 2019 (COVID-19) pandemic has peaked in many countries already, the current challenge is to assess population immunity on a large scale. Many serological tests are available and require urgent independent validation. Here, we report performance characteristics of Orient Gene Biotech COVID-19 IgG/IgM Rapid Test Cassette (OG) and compare it to Abbott SARS-CoV-2 IgG immunoassay (ASIA). Patients (
n
 = 102) with a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcriptase PCR (RT-PCR) were tested.
Mutagenic Analysis of Hazara Nairovirus Nontranslated Regions during Single- and Multistep Growth Identifies both Attenuating and Functionally Critical Sequences for Virus Replication
Authors: Mega Daniele F. , Fuller Jack , Álvarez-Rodríguez Beatriz , Mankouri Jamel , Hewson Roger , Barr John N.
Published: June 2020

Nairoviruses are a group of RNA viruses that include many serious pathogens of humans and animals, including one of the most serious human pathogens in existence, Crimean-Congo hemorrhagic fever virus. The ability of nairoviruses to multiply and cause disease is controlled in major part by nucleotides that flank the 3′ and 5′ ends of nairoviral genes, called nontranslated regions (NTRs). NTR nucleotides interact with other virus components to perform critical steps of the virus multiplication cycle, such as mRNA transcription and RNA replication, with other roles being likely. To better understand how NTRs work, we performed the first comprehensive investigation of the importance of NTR nucleotides in the context of the entire nairovirus replication cycle. We identified both dispensable and critical NTR nucleotides, as well as highlighting the importance of 3′ and 5′ NTR interactions in virus growth, thus providing the first functional map of the nairovirus NTRs.
Elevated magma fluxes deliver high-Cu magmas to the upper crust
Authors: Cox Daniel , Watt Sebastian F.L. , Jenner Frances E. , Hastie Alan R. , Hammond Samantha J. , Kunz Barbara E.
Published: June 2020

Porphyry Cu-Au ore deposits are globally associated with convergent margins. However, controls on the processing and distribution of the chalcophile elements (e.g., Cu) during convergent margin magmatism remain disputed. Here, we show that magmas feeding many Chilean stratovolcanoes fractionate sulfides with a high-Cu/Ag ratio early in their crustal evolution. These magmas show evidence of lower-crustal garnet and amphibole crystallization, and their degree of sulfide fractionation and Cu depletion increase with both crustal thickness and the extent of garnet fractionation. However, samples from a small proportion of volcanoes with elevated eruptive fluxes depart from this Cu-depleting trend, instead erupting Cu-rich magmas. This implies that at these atypical sites, elevated magma productivity and crustal throughput, potentially facilitated by “pathways” exploiting major crustal fault systems, enable rapid magma transit, avoiding lower-crustal Cu-depleting sulfide fractionation and potentially playing an important role in porphyry ore genesis.
Uncommonly sited rare tumour causing nasal obstruction
Authors: Apthorp Christina , Sharma Shweta , Barrak Aldeerawi H
Published: June 2020

​

​The study aims to discuss a case of an uncommonly sited rare tumour causing nasal obstruction and a literature review of angioleiomyomas in the nose. A 64-year-old woman presented with blockage of the right nostril, associated with a visible swelling on the undersurface of the alar cartilage, in the lateral wall of the nasal cavity. Anterior rhinoscopy highlighted a 1 cm cystic lesion, with areas of firmness, present at the mucocutaneous junction with a broad base. It was not attached to the underlying cartilage. There was no ulceration or bleeding on palpation. Nasal endoscopy did not show any extension further and the rest of the nasal cavity was clear. Endonasal resection of the tumour using a two-handed technique. This paper highlights not only the importance of considering angioleiomyomas within a differential diagnosis of nasal obstructions but also the uncommon site.

​
Transradial intracranial aneurysm treatment via an aberrant right subclavian artery
Authors: Jha Nihar , Selkirk Gregory , Crockett Matthew Thomas , Phillips Timothy John
Published: June 2020

We report two cases of successfully treated intracranial saccular aneurysms via transradial access with aberrant right subclavian artery anatomy. Two patients aged 74 and 82 years with anterior communicating artery aneurysms deemed suitable for endovascular treatment and anomalous aortic arch anatomy (aberrant right subclavian artery) underwent successful treatment with transradial access. Transradial access was obtained in both patients, in the first patient, without prior knowledge of the aortic arch anatomy. Aberrant right subclavian artery anatomy was negotiated, and the aneurysms were successfully treated in both cases with intrasaccular flow disrupting devices (WEB-SL).
Rare case of life-threatening thrombocytopenia occurring after radiotherapy in a patient treated with immune checkpoint inhibitor
Authors: Hendrix Aurore , Yeo Anne-Emmanuella , Lejeune Sarah , Seront Emmanuel
Published: June 2020

Immune checkpoint inhibitors (ICIs) improve significantly outcome of patients with advanced renal cancer. Although immune-related adverse events involve frequently skin, digestive tract, lung, liver and endocrine organs, haematological toxicities are rare. We describe the case of a patient with metastatic renal cancer who was treated with nivolumab. Eight courses of nivolumab were administered without any toxicity; brain metastases were then diagnosed and treated with stereotactic radiotherapy. As the extra-cranial disease was stable, the ninth course of nivolumab was administered 5 days after the end of radiotherapy. One week later, he presented with rectal and nasal bleeding in a context of severe thrombocytopenia (1000/mm3). High dose of steroids and intravenous immunoglobulin reversed slowly the thrombocytopenia. This case highlights the possibility of life-threatening thrombocytopenia with ICIs. Interestingly, the close time relation with radiotherapy highlights a potential interaction, warranting a close follow-up of patients in this situation.
Ten-year incidence and assessment of safe screening intervals for diabetic retinopathy: the OPHDIAT study
Authors: Chamard Chloé , Daien Vincent , Erginay Ali , Gautier Jean-Francois , Villain Max , Tadayoni Ramin , Carriere Isabelle , Massin Pascale
Published: June 2020

Background

To estimate the 10-year incidence of referable diabetic retinopathy (DR) in a French population with type 1 and 2 diabetes mellitus (DM). A secondary objective was the assessment of safe screening intervals in patients with diabetes without retinopathy.

Methods

Observational, prospective and multicentric study between June 2004 and September 2017 based on a regional screening programme for DR in the Paris region. The incidence of referable DR in patients without retinopathy at baseline was calculated by the Turnbull survival estimator. A safe screening interval was defined as a 95% probability of remaining without referable DR.

Results

Among the 25 745 participants with type 1 (n=6086) or type 2 (n=19 659) DM, the 10-year cumulative incidence of referable DR was 19.10% (95% CI 17.21% to 21.14%) and 17.03% (15.78% to 18.35%), median (IQR) follow-up=3.33 (4.24) years. The safe screening interval for patients without DR at the first examination for type 1 and 2 DM was 2.2 (95% CI 2.0 to 2.4) and 3.0 (2.9 to 3.1) years, respectively. In a subgroup of low-risk patients with type 2 DM, the safe screening interval was 4.2 (3.8 to 4.6) years.

Conclusions

These data suggest that in Paris area, a 2-year, 3-year and 4-year screening interval was considered safe for type 1 DM, type 2 DM and for low-risk patients with type 2 DM, respectively, without DR at the first examination. While these data might be used to support the consideration of extending screening intervals, a randomised clinical trial would be suitable to confirm the safety for patients with DM.
Comparison of 13 formulas for IOL power calculation with measurements from
partial coherence interferometry
Authors: Savini Giacomo , Di Maita Marco , Hoffer Kenneth J , Næser Kristian , Schiano-Lomoriello Domenico , Vagge Aldo , Di Cello Luca , Traverso Carlo E
Published: June 2020

Background/aims

To compare the accuracy of 13 formulas for intraocular lens (IOL) power
calculation in cataract surgery.

Methods

In this retrospective interventional case series, optical biometry
measurements were entered into these formulas: Barrett Universal II (BUII) with
and without anterior chamber depth (ACD) as a predictor, EVO 2.0 with and
without ACD as a predictor, Haigis, Hoffer Q, Holladay 1, Holladay 2AL, Kane,
Næser 2, Pearl-DGS, RBF 2.0, SRK/T, T2 and VRF. The mean prediction error (PE),
median absolute error (MedAE), mean absolute error and percentage of eyes with
a PE within ±0.25, ±0.50, ±0.75 and ±1.00 diopters (D) were
calculated.

Results

Two hundred consecutive eyes were enrolled. With all formulas, the mean PE
was zero. The BUII with no ACD had the lowest standard deviation (±0.343 D),
followed by the T2 (0.347 D), Kane (0.348 D), EVO 2.0 with no ACD (0.348 D) and
BUII with ACD (0.353 D) formulas. The difference among the MedAEs of all
formulas was statistically significant (p<0.0001); the lowest values were
achieved with the Kane (0.214 D), RBF 2.0 (0.215 D), BUII with and without ACD
(0.218 D) and SRK/T (0.223 D). A percentage ranging from 80% to 88.5% of eyes
showed a PE within ±0.50 D and all formulas achieved more than 50% of eyes with
a PE within ±0.25 D.

Conclusion

All investigated formulas achieved good results; there was a tendency
towards better outcomes with newer formulas. Traditional formulas can still be
considered an accurate option.
Flash glucose monitoring helps achieve better glycemic control than conventional self-monitoring of blood glucose in non-insulin-treated type 2 diabetes: a randomized controlled trial
Authors: Wada Eri , Onoue Takeshi , Kobayashi Tomoko , Handa Tomoko , Hayase Ayaka , Ito Masaaki , Furukawa Mariko , Okuji Takayuki , Okada Norio , Iwama Shintaro , Sugiyama Mariko , Tsunekawa Taku , Takagi Hiroshi , Hagiwara Daisuke , Ito Yoshihiro , Suga Hidetaka , Banno Ryoichi , Kuwatsuka Yachiyo , Ando Masahiko , Goto Motomitsu , Arima Hiroshi
Published: June 2020

Introduction

The present study aimed to evaluate the effects of flash glucose monitoring (FGM) and conventional self-monitoring of blood glucose (SMBG) on glycemic control in patients with non-insulin-treated type 2 diabetes.

Research design and methods

In this 24-week, multicenter, open-label, randomized (1:1), parallel-group study, patients with non-insulin-treated type 2 diabetes at five hospitals in Japan were randomly assigned to the FGM (n=49) or SMBG (n=51) groups and were provided each device for 12 weeks. The primary outcome was change in glycated hemoglobin (HbA1c) level, and was compared using analysis of covariance model that included baseline values and group as covariates.

Results

Forty-eight participants in the FGM group and 45 in the SMBG group completed the study. The mean HbA1c levels were 7.83% (62.1 mmol/mol) in the FGM group and 7.84% (62.2 mmol/mol) in the SMBG group at baseline, and the values were reduced in both FGM (−0.43% (−4.7 mmol/mol), p<0.001) and SMBG groups (−0.30% (−3.3 mmol/mol), p=0.001) at 12 weeks. On the other hand, HbA1c was significantly decreased from baseline values in the FGM group, but not in the SMBG group at 24 weeks (FGM: −0.46% (−5.0 mmol/mol), p<0.001; SMBG: −0.17% (−1.8 mmol/mol), p=0.124); a significant between-group difference was also observed (difference −0.29% (−3.2 mmol/mol), p=0.022). Diabetes Treatment Satisfaction Questionnaire score was significantly improved, and the mean glucose levels, SD of glucose, mean amplitude of glycemic excursions and time in hyperglycemia were significantly decreased in the FGM group compared with the SMBG group.

Conclusions

Glycemic control was better with FGM than with SMBG after cessation of glucose monitoring in patients with non-insulin-treated type 2 diabetes.

Trial registration number

UMIN000026452, jRCTs041180082.
Regional difference in the susceptibility of non-alcoholic fatty liver disease in China
Authors: Xia Mingfeng , Sun Xiaoyang , Zheng Lili , Bi Yufang , Li Qiang , Sun Lirong , Di Fusheng , Li Hong , Zhu Dalong , Gao Yanyan , Bao Yuqian , Wang Yao , He Lanjie , Wu Bingjie , Wang Shanshan , Gao Jian , Gao Xin , Bian Hua
Published: June 2020

Introduction

Non-alcoholic fatty liver disease (NAFLD) is a global health problem with high geographic heterogeneity. We aimed to investigate regional-specific concomitant rate of NAFLD and quantitative relationship between liver fat content (LFC) and glucose metabolism parameters in representative clinical populations from six provinces/municipalities of China.

Research design and methods

A total of 2420 eligible Han Chinese were enrolled consecutively from 10 clinics of obesity, diabetes and metabolic diseases located at six provinces/municipalities of China, and divided into North (Tianjin, Shandong and Heilongjiang) and South (Shanghai, Jiangsu and Henan) groups according to their geographical latitude and proximity of NAFLD concomitant rate. LFC was assessed by a quantitative ultrasound method. Multivariate regression models and analysis of covariance were used to assess the regional difference in the risk of NAFLD.

Results

The concomitant rate of NAFLD was 23.3%, 44.0% and 55.3% in individuals with normal glucose tolerance (NGT), pre-diabetes and diabetes, respectively. A higher concomitant rate of NAFLD was found in the participants from the North comparing with the South group, regardless of glucose metabolism status (34.7% vs 16.2% in NGT, 61.5% vs 34.7% in pre-diabetes and 67.1% vs 48.1% in diabetes). This regional difference remained significant after adjustment for age, gender, alcohol drinking, cigarette smoking, confounding metabolic parameters and liver enzymes. For any given blood glucose, participants from the North had higher LFC than those from the South group.

Conclusions

Half of Han Chinese with pre-diabetes/type 2 diabetes had NAFLD, and the individuals from the North cities were more susceptible to NAFLD.
Surgical treatment of insertional Achilles tendinopathy: results after removal of the subcutaneous bursa alone—a case series
Authors: Alfredson Håkan , Spang Christoph
Published: June 2020

Background

Insertional Achilles tendinopathy is well known to be difficult to treat, especially when there is intra-tendinous bone pathology. This study is a case series on patients with chronic insertional Achilles tendon pain and major intra-tendinous bony pathology together with bursa and tendon pathology, treated with excision of the subcutaneous bursa alone.

Methods

Eleven patients (eight men and three women) with a mean age of 44 years (range 24–62) and a chronic (>6 months) painful condition from altogether 15 Achilles tendon insertions were included. In all patients, ultrasound examination showed intra-tendinous bone pathology together with pathology in the tendon and subcutaneous bursa, and all were surgically treated with an open excision of the whole subcutaneous bursa alone. This was followed by full weight-bearing walking in a shoe with open heel for 6 weeks.

Results

At follow-up 21 (median, range 12–108) months after surgery, 9/11 patients (12/15 tendons) were satisfied with the result of the operation and 10/11 (13/15 tendons) were back in their previous sport and recreational activities. The median VISA-A score had improved from 41 (range 0–52) to 91 (range 33–100) (p<0.01).

Conclusion

In patients with chronic painful insertional Achilles tendinopathy with intra-tendinous bone pathology, tendon and bursa pathology, open removal of the subcutaneous bursa alone can relieve the pain and allow for Achilles tendon loading activities. The results in this case series highlight the need for more studies on the pain mechanisms in insertional Achilles tendinopathy and the need for randomised studies to strengthen the conclusions.

Level of evidence

IV Case series.
Guideline review: Tofacitinib for adults with moderately to severely active ulcerative colitis - NICE guidance
Authors: Nwaogu Akudo , Bond Ashley , Smith Philip J
Published: June 2020

Tofacitinib is an oral, Janus kinase (JAK) molecule, which selectively inhibits Janus-associated tyrosine kinases JAK1 and JAK3. It has already shown efficacy in the treatment of rheumatoid arthritis and the prevention of organ allograft rejection in kidney transplantation. Two separate phase III placebo-controlled trials, assessing 8-week efficacy of tofacitinib induction for ulcerative colitis (UC), demonstrated superiority when compared with placebo. Tofacitinib also demonstrated robust efficacy versus placebo in the 52-week maintenance component of the same study. Tofacitinib has been recommended by the National Institute for Health and Care Excellence as an effective treatment option for adult patients with moderate to severe UC when conventional therapy or a biological agent cannot be tolerated or the disease has responded inadequately or lost response to treatment. We review the guidelines and provide brief commentary on the post hoc analysis related to lipid increases and thromboembolism risk, which have lead to changes in current therapeutic guidance.
Impact of the COVID-19 outbreak on endoscopy training in a tertiary care centre in Germany
Authors: Roemmele Christoph , Manzeneder Johannes , Messmann Helmut , Ebigbo Alanna
Published: June 2020

Objective

The COVID-19 crisis has impacted on all aspects of health care including medical education and training. We describe the disruption of endoscopy training in a tertiary care center in Germany.

Design/Method

The reorganization of a high-volume endoscopy unit during the German COVID-19 outbreak is described with special focus on endoscopy trainees. Changes in case volume of gastroenterology fellows were evaluated and compared to a year prior to the outbreak.

Results

Reallocation of resources led to the transfer of gastroenterology fellows to intensive care and infectious disease units. Case volume of fellows declined between January and April 2020 by up to 63%. When compared with data from the year prior to the outbreak, endoscopy performed by fellows reduced by up to 56%. Educational meetings and skill evaluation were cancelled indefinitely.

Conclusion

The COVID-19 outbreak has had a negative impact on endoscopy training of gastroenterology fellows in a high-volume center in Germany. This must be taken into consideration when planning “return-strategies” after the pandemic.
Prognostic role of PET/MRI hybrid imaging in patients with pulmonary arterial hypertension
Authors: Kazimierczyk Remigiusz , Szumowski Piotr , Nekolla Stephan G , Blaszczak Piotr , Malek Lukasz A , Milosz-Wieczorek Barbara , Misko Jolanta , Jurgilewicz Dorota , Hladunski Marcin , Knapp Malgorzata , Sobkowicz Bozena , Mysliwiec Janusz , Grzywna Ryszard , Musial Wlodzimierz J , Kaminski Karol A
Published: June 2020

Objective

Right ventricular (RV) function is a major determinant of survival in patients with pulmonary arterial hypertension (PAH). Metabolic alterations may precede haemodynamic and clinical deterioration. Increased RV fluorodeoxyglucose (FDG) uptake in positron emission tomography (PET) was recently associated with progressive RV dysfunction in MRI, but the prognostic value of their combination has not been established.

Methods

Twenty-six clinically stable patients with PAH (49.9±15.2 years) and 12 healthy subjects (control group, 44.7±13.5 years) had simultaneous PET/MRI scans. FDG uptake was quantified as mean standardised uptake value (SUV) for both left ventricle (LV) and RV. Mean follow-up time of this study was 14.2±7.3 months and the clinical end point was defined as death or clinical deterioration.

Results

Median SUVRV/SUVLVratio was 1.02 (IQR 0.42–1.21) in PAH group and 0.16 (0.13–0.25) in controls, p<0.001. In PAH group, SUVRV/SUVLVsignificantly correlated with RV haemodynamic deterioration. In comparison to the stable ones, 12 patients who experienced clinical end point had significantly higher baseline SUVRV/SUVLVratio (1.21 (IQR 0.87–1.95) vs 0.53 (0.24–1.08), p=0.01) and lower RV ejection fraction (RVEF) (37.9±5.2 vs 46.8±5.7, p=0.03). Cox regression revealed that SUVRV/SUVLVratio was significantly associated with the time to clinical end point. Kaplan-Meier analysis showed that combination of RVEF from MRI and SUVRV/SUVLVassessment may help to predict prognosis.

Conclusions

Increased RV glucose uptake in PET and decreased RVEF identify patients with PAH with worse prognosis. Combining parameters from PET and MRI may help to identify patients at higher risk who potentially benefit from therapy escalation, but this hypothesis requires prospective validation.
COVID-19: to be or not to be; that is the diagnostic question
Authors: Coleman Jamie J , Manavi Kaveh , Marson Ella J , Botkai Adam H , Sapey Elizabeth
Published: June 2020

Since the first cases in December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread across the globe, resulting in the COVID-19 pandemic. Early clinical experiences have demonstrated the wide spectrum of SARS-CoV-2 presentations, including various reports of atypical presentations of COVID-19 and possible mimic conditions.

This article summarises the current evidence surrounding atypical presentations of COVID-19 including neurological, cardiovascular, gastrointestinal, otorhinolaryngology and geriatric features. A case from our hospital of pneumocystis pneumonia initially suspected to be COVID-19 forms the basis for a discussion surrounding mimic conditions of COVID-19. The dual-process model of clinical reasoning is used to analyse the thought processes used to make a diagnosis of COVID-19, including consideration of the variety of differential diagnoses.

While SARS-CoV-2 is likely to remain on the differential diagnostic list for a plethora of presentations for the foreseeable future, clinicians should be cautious of ignoring other potential diagnoses due to availability bias. An awareness of atypical presentations allows SARS-CoV-2 to be a differential so that it can be appropriately investigated. A knowledge of infectious mimics prevents COVID-19 from overshadowing other diagnoses, hence preventing delayed diagnosis or even misdiagnosis and consequent adverse outcomes for patients.
Might limiting liquid nicotine concentration result in more toxic electronic cigarette aerosols?
Authors: Talih Soha , Salman Rola , El-Hage Rachel , Karam Ebrahim , Karaoghlanian Nareg , El-Hellani Ahmad , Saliba Najat , Eissenberg Thomas , Shihadeh Alan
Published: June 2020

Some jurisdictions have instituted limits on electronic cigarette (ECIG) liquid nicotine concentration, in an effort to control ECIG nicotine yield, and others are considering following suit. Because ECIG nicotine yield is proportional to the product of liquid nicotine concentration (milligram per millilitre) and device power (watts) regulations that limit liquid nicotine concentration may drive users to adopt higher wattage devices to obtain a desired nicotine yield. In this study we investigated, under various hypothetical regulatory limits on ECIG liquid nicotine concentration, a scenario in which a user of a common ECIG device (SMOK TF-N2) seeks to obtain in 15 puffs the nicotine emissions equivalent to one combustible cigarette (ie, 1.8 mg). We measured total aerosol and carbonyl compound (CC) yields in 15 puffs as a function of power (15–80 W) while all else was held constant. The estimated nicotine concentration needed to achieve combustible cigarette-like nicotine yield at each power level was then computed based on the measured liquid consumption. We found that for a constant nicotine yield of 1.8 mg, reducing the liquid nicotine concentration resulted in greater amount of liquid aerosolised (p<0.01) and greater CC emissions (p<0.05). Thus, if users seek a given nicotine yield, regulatory limits on nicotine concentration may have the unintended consequence of increasing exposure to aerosol and respiratory toxicants. This outcome demonstrates that attempting to control ECIG nicotine yield by regulating one factor at a time may have unintended health effects and highlights the need to consider multiple factors and outcomes simultaneously when designing regulations.
External sulfate attack in structural concrete made with Portland-limestone cement: an experimental study
Authors: Cefis Nicola , Tedeschi Cristina , Comi Claudia
Published: June 2020

This experimental study aims to assess the effect of external sulfate attack on structural concrete made with a common Portland-limestone cement. The experimental campaign, which ran for approximately three years, was performed on standard-sized cylinders ([Formula: see text]15 cm × 30 cm) subject to different exposure conditions. The overall swelling of the specimens due to chemical reactions was monitored over time. Scanning electron microscopy and energy dispersive X-ray spectrometry (SEM-EDS) observations and X-ray diffraction (XRD) tests were also carried out. Results showed the presence of secondary ettringite causing swelling and microcrack formation. The porosity increase due to sulfate attack of the outer skin of the specimens was measured. Ultrasonic measurements and compression tests on cores drilled from the cylinders immersed in different solutions allowed to confirm and quantify the consequent degradation of macroscopic elastic properties.
Branching fractions and CP asymmetries of the quasi-two-body decays in $$B_{s} \rightarrow K^0({\overline{K}}^0)K^\pm \pi ^\mp $$ within PQCD approach
Authors: Zou Zhi-Tian , Li Ying , Liu Xin
Published: June 2020

Motivated by the first untagged decay-time-integrated amplitude analysis of $$B_s \rightarrow K_SK^{\mp }\pi ^{\pm }$$Bs→KSK∓π± decays performed by LHCb collaboration, where the decay amplitudes are modeled to contain the resonant contributions from intermediate resonances $$K^*(892)$$K∗(892), $$K_0^*(1430)$$K0∗(1430) and $$K_2^*(1430)$$K2∗(1430), we comprehensively investigate the quasi-two-body decays in the three-body processes "Equation missing", and calculate the branching fractions and the time-dependent CP asymmetries within the perturbative QCD approach based on the $$k_T$$kT factorization. In the quasi-two-body space region the calculated branching fractions with the considered intermediate resonances are in good agreement with the experimental results of LHCb by adopting proper $$K\pi $$Kπ pair wave function, describing the interaction between the kaon and pion in the $$K\pi $$Kπ pair. Furthermore, within the obtained branching fractions of the quasi-two-body decays, we also calculate the branching fractions of the corresponding two-body decays, and the results consist with the LHCb measurements and the earlier studies within errors. For these considered decays, since the final states are not flavour-specific, the time-dependent CP could be measured. We then calculate six CP-violation observables, which can be tested in the ongoing LHCb experiment.
Wigner scattering theory for systems held together by Coulombic forces
Authors: Connerade Jean-Patrick
Published: June 2020

The relevance of Wigner Scattering theory and in particular of its K-matrix formulation is stressed for all systems held together by Coulombic forces including not only atoms and molecules but also clusters. Originally developed and formulated for nuclear scattering, Wigner’s theory is extremely general, with application in many branches of physics. Atomic Physics often makes use of an apparently separate formalism (MQDT) which is in fact a specialisation of Wigner’s theory. The advantage of the K-matrix is that analytic expressions can be given for interactions between resonances in terms of a meromorphic pole structure in the special case of asymptotically Coulombic potentials. By using the K-matrix, a number of novel effects (q-reversals, vanishing radiative and particle widths, vanishing fluctuations, etc.) are understood as general phenomena.

Graphical abstract
Flow-up bases for generalized spline modules on arbitrary graphs
Authors: Altınok Selma , Sarıoğlan Samet
Published: June 2020

Let [Formula: see text] be a commutative ring with identity. An edge labeled graph is a graph with edges labeled by ideals of [Formula: see text]. A generalized spline over an edge labeled graph is a vertex labeling by elements of [Formula: see text], such that the labels of any two adjacent vertices agree modulo the label associated to the edge connecting them. The set of generalized splines forms a subring and module over [Formula: see text]. Such a module is called a generalized spline module. We show the existence of a flow-up basis for the generalized spline module on an edge labeled graph over a principal ideal domain by using a new method based on trails of the graph. We also give an algorithm to determine flow-up bases on arbitrary ordered cycles over any principal ideal domain.
On cyclic automorphisms of a group
Authors: Brescia Mattia , Russo Alessio
Published: June 2020

An endomorphism [Formula: see text] of a group [Formula: see text] is called a cyclic endomorphism if the subgroup [Formula: see text] is cyclic for all elements [Formula: see text] of [Formula: see text]. It can be proved that every cyclic endomorphism is normal, i.e. it commutes with every inner automorphism of [Formula: see text] (see [F. de Giovanni, M. L. Newell and A. Russo, On a class of normal endomorphisms of groups, J. Algebra its Appl. 13 (2014) 6pp.]). In this paper, some further properties of cyclic endomorphisms will be pointed out. Moreover, the structure of a group [Formula: see text] in which the group [Formula: see text] of cyclic automorphisms has finite index in [Formula: see text] will be investigated.
Two-Dimensional Free Vibration Analysis of Axially Functionally Graded Beams Integrated with Piezoelectric Layers: An Piezoelasticity Approach
Authors: Singh Agyapal , Kumari Poonam
Published: June 2020

For the first time, a two-dimensional (2D) piezoelasticity-based analytical solution is developed for free vibration analysis of axially functionally graded (AFG) beams integrated with piezoelectric layers and subjected to arbitrary supported boundary conditions. The material properties of the elastic layers are considered to vary linearly along the axial ([Formula: see text]) direction of the beam. Modified Hamiltons principle is applied to derive the weak form of coupled governing equations in which, stresses, displacements and electric field variables acting as primary variables. Further, the extended Kantorovich method is employed to reduce the governing equation into sets of ordinary differential equations (ODEs) along the axial ([Formula: see text]) and thickness ([Formula: see text]) directions. The ODEs along the [Formula: see text]-direction have constant coefficients, where the ODEs along [Formula: see text]-direction have variable coefficients. These sets of ODEs are solved analytically, which ensures the same order of accuracy for all the variables by satisfying the boundary and continuity conditions in exact pointwise manner. New benchmark numerical results are presented for a single layer AFG beam and AFG beams integrated with piezoelectric layers. The influence of the axial gradation, aspect ratio and boundary conditions on the natural frequencies of the beam are also investigated. These numerical results can be used for assessing 1D beam theories and numerical techniques.
Analysis on stochastic dynamics of two-consumers-one-resource competing systems with Beddington–DeAngelis functional response
Authors: Zhao Shufen
Published: June 2020

In this paper, stochastic dynamics with Lévy noise of two-consumers-one-resource competing systems with Beddington–DeAngelis functional response are considered. We first show the existence of the global positive solution, then discuss the effects of noises on the extinction of the species and the stochastic persistence of the species. In the meanwhile, numerical simulations are carried to support results. Finally, we show the existence of the stationary distribution for a special case.
Visualizing veins from color skin images using convolutional neural networks
Authors: Tang Chaoying , Yuan Yimin , Xia Shuhang , Ma Gehua , Wang Biao
Published: June 2020

Intravenous cannulation is the most important phase in medical practices. Currently, limited literature is available about visibility of veins and the characteristics of patients associated with difficult intravenous access. In modern medical treatment, a major challenge is locating veins for patients who have difficult venous access. Presently, some products of vein locators are available in the market to improve vein access, but they need auxiliary equipment such as near infrared (NIR) illumination and camera, which add weight and cost to the devices, and cause inconveniences to daily medical care. In this paper, a vein visualization algorithm based on the deep learning method was proposed. Based on a group of synchronous RGB/NIR arm images, a convolutional neural network (CNN) model was designed to implement the mapping from RGB to NIR images, where veins can be detected from skin. The model has a simple structure and less optimization parameters. A color transfer scheme was also proposed to make the network adaptive to the images taken by smartphone in daily medical treatments. Comprehensive experiments were conducted on three datasets to evaluate the proposed method. Subjective and objective evaluations showed the effectiveness of the proposed method. These results indicated that the deep learning-based method can be used for visualizing veins in medical care applications.
Marine Parasites and Disease in the Era of Global Climate Change
Authors: Byers James E.
Published: June 2020

Climate change affects ecological processes and interactions, including parasitism. Because parasites are natural components of ecological systems, as well as agents of outbreak and disease-induced mortality, it is important to summarize current knowledge of the sensitivity of parasites to climate and identify how to better predict their responses to it. This need is particularly great in marine systems, where the responses of parasites to climate variables are less well studied than those in other biomes. As examples of climate's influence on parasitism increase, they enable generalizations of expected responses as well as insight into useful study approaches, such as thermal performance curves that compare the vital rates of hosts and parasites when exposed to several temperatures across a gradient. For parasites not killed by rising temperatures, some simple physiological rules, including the tendency of temperature to increase the metabolism of ectotherms and increase oxygen stress on hosts, suggest that parasites’ intensity and pathologies might increase. In addition to temperature, climate-induced changes in dissolved oxygen, ocean acidity, salinity, and host and parasite distributions also affect parasitism and disease, but these factors are much less studied. Finally, because parasites are constituents of ecological communities, we must consider indirect and secondary effects stemming from climate-induced changes in host–parasite interactions, which may not be evident if these interactions are studied in isolation.
Plant Virus–Derived Vectors: Applications in Agricultural and Medical Biotechnology
Authors: Abrahamian Peter , Hammond Rosemarie W. , Hammond John
Published: June 2020

Major advances in our understanding of plant viral genome expression strategies and the interaction of a virus with its host for replication and movement, induction of disease, and resistance responses have been made through the generation of infectious molecules from cloned viral sequences. Autonomously replicating viral vectors derived from infectious clones have been exploited to express foreign genes in plants. Applications of virus-based vectors include the production of human/animal therapeutic proteins in plant cells and the specific study of plant biochemical processes, including those that confer resistance to pathogens. Additionally, virus-induced gene silencing, which is RNA mediated and triggered through homology-dependent RNA degradation mechanisms, has been exploited as an efficient method to study the functions of host genes in plants and to deliver small RNAs to insects. New and exciting strategies for vector engineering, delivery, and applications of plant virus–based vectors are the subject of this review.