bluuebunny/crossref_metadata_2025 huggingface dataset:
Benign prostatic hyperplasia – what do we know?
Authors: Devlin Conor M. , Simms Matthew S. , Maitland Norman J.
Published: September 2020

Objectives

To present historical and contemporary hypotheses on the pathogenesis of benign prostatic hyperplasia (BPH), and the potential implications for current medical therapies.

Methods

The literature on BPH was reviewed. BPH is a prevalent disease with significant health and economic impacts on patients and health organisations across the world, whilst the cause/initiation of the disease process has still not been fully determined.

Results

In BPH, pathways involving androgens, oestrogens, insulin, inflammation, proliferative reawakening, stem cells and telomerase have been hypothesised in the pathogenesis of the disease. A number of pathways first described >40 years ago have been first rebuked and then have come back into favour. A system of an inflammatory process within the prostate, which leads to growth factor production, stem cell activation, and cellular proliferation encompassing a number of pathways, is currently in vogue. This review also highlights the physiology of the prostate cell subpopulations and how this may account for the delay/failure in treatment response for certain medical therapies.

Conclusion

BPH is an important disease, and as the pathogenesis is not fully understood it impacts the effectiveness of medical therapies. This impacts patients, with further research potentially highlighting novel therapeutic avenues.
Quantifying the Interplay of Semantics and Phonology During Failures of Word Retrieval by People With Aphasia Using a Multiplex Lexical Network
Authors: Castro Nichol , Stella Massimo , Siew Cynthia S. Q.
Published: September 2020

Investigating instances where lexical selection fails can lead to deeper insights into the cognitive machinery and architecture supporting successful word retrieval and speech production. In this paper, we used a multiplex lexical network approach that combines semantic and phonological similarities among words to model the structure of the mental lexicon. Network measures at different levels of analysis (degree, network distance, and closeness centrality) were used to investigate the influence of network structure on picture naming accuracy and errors by people with Anomic, Broca's, Conduction, and Wernicke's aphasia. Our results reveal that word retrieval is influenced by the multiplex lexical network structure in at least two ways—(a) the accuracy of production and error type on incorrect productions were influenced by the degree and closeness centrality of the target word, and (b) error type also varied in terms of network distance between the target word and produced error word. Taken together, the analyses demonstrate that network science techniques, particularly the use of the multiplex lexical network to simultaneously represent semantic and phonological relationships among words, reveal how the structure of the mental lexicon influences language processes beyond traditionally examined psycholinguistic variables. We propose a framework for how the multiplex lexical network approach allows for understanding the influence of mental lexicon structure on word retrieval processes, with an eye toward a better understanding of the nature of clinical impairments, like aphasia.
Optical coherence tomography detects retinal changes in hereditary cerebral amyloid angiopathy
Authors: van Etten E. S. , de Boer I. , Steenmeijer S.R. , Al‐Nofal M. , Wermer M. J. H. , Notting I. C. , Terwindt G. M.
Published: September 2020

Background and purpose

Investigating mutation carriers with Dutch‐type hereditary (D‐) cerebral amyloid angiopathy (CAA), offers the possibility to identify markers in pre‐ and symptomatic stages of CAA. Optical coherence tomography (OCT) has shown potential to detect retinal changes in several neurodegenerative diseases. The aim of the present exploratory study was to investigate thinning of retinal layers as a possible (early) biomarker in D‐CAA mutation carriers.

Methods

Twenty‐one D‐CAA mutation carriers (n = 8 presymptomatic, n = 13 symptomatic, median age 50 years) and nine controls (median age 53 years) were scanned using spectral‐domain OCT. Symptomatic mutation carriers were defined as having a history of ≥1 symptomatic intracerebral hemorrhage. D‐CAA mutation carriers and controls were recruited from our D‐CAA cohort and a healthy control cohort. Total peripapillary retinal nerve fiber layer (pRNFL) thickness, six regions of pRNFL, total macular volume (TMV), and individual macular region thickness were measured and analysed, adjusted for age.

Results

The overall median (interquartile range) thickness of pRNFL was lower in symptomatic, but not presymptomatic D‐CAA mutation carriers compared with controls [91 (86–95) µm vs. 99 (87–108) µm; P = 0.006]. Both presymptomatic [111 (93–122) µm vs. 131 (123–143) µm; P < 0.001] and symptomatic carriers [119 (95–128) µm vs. 131 (123–143) µm; P = 0.034] had a thinner temporal‐superior quadrant of the pRNFL versus controls. TMV or individual macular layer thickness did not differ between carriers and controls.

Conclusions

Thinning of the retinal nerve fiber layer may be a candidate marker of disease in hereditary CAA. Further studies are needed to determine whether retinal thinning is present in sporadic CAA and estimate its value as a marker for disease progression.
Global root traits (GRooT) database
Authors: Guerrero‐Ramírez Nathaly R. , Mommer Liesje , Freschet Grégoire T. , Iversen Colleen M. , McCormack M. Luke , Kattge Jens , Poorter Hendrik , van der Plas Fons , Bergmann Joana , Kuyper Thom W. , York Larry M. , Bruelheide Helge , Laughlin Daniel C. , Meier Ina C. , Roumet Catherine , Semchenko Marina , Sweeney Christopher J. , van Ruijven Jasper , Valverde‐Barrantes Oscar J. , Aubin Isabelle , Catford Jane A. , Manning Peter , Martin Adam , Milla Rubén , Minden Vanessa , Pausas Juli G. , Smith Stuart W. , Soudzilovskaia Nadejda A. , Ammer Christian , Butterfield Bradley , Craine Joseph , Cornelissen Johannes H. C. , de Vries Franciska T. , Isaac Marney E. , Kramer Koen , König Christian , Lamb Eric G. , Onipchenko Vladimir G. , Peñuelas Josep , Reich Peter B. , Rillig Matthias C. , Sack Lawren , Shipley Bill , Tedersoo Leho , Valladares Fernando , van Bodegom Peter , Weigelt Patrick , Wright Justin P. , Weigelt Alexandra
Published: September 2020

Motivation

Trait data are fundamental to the quantitative description of plant form and function. Although root traits capture key dimensions related to plant responses to changing environmental conditions and effects on ecosystem processes, they have rarely been included in large‐scale comparative studies and global models. For instance, root traits remain absent from nearly all studies that define the global spectrum of plant form and function. Thus, to overcome conceptual and methodological roadblocks preventing a widespread integration of root trait data into large‐scale analyses we created the Global Root Trait (GRooT) Database. GRooT provides ready‐to‐use data by combining the expertise of root ecologists with data mobilization and curation. Specifically, we (a) determined a set of core root traits relevant to the description of plant form and function based on an assessment by experts, (b) maximized species coverage through data standardization within and among traits, and (c) implemented data quality checks.

Main types of variables contained

GRooT contains 114,222 trait records on 38 continuous root traits.

Spatial location and grain

Global coverage with data from arid, continental, polar, temperate and tropical biomes. Data on root traits were derived from experimental studies and field studies.

Time period and grain

Data were recorded between 1911 and 2019.

Major taxa and level of measurement

GRooT includes root trait data for which taxonomic information is available. Trait records vary in their taxonomic resolution, with subspecies or varieties being the highest and genera the lowest taxonomic resolution available. It contains information for 184 subspecies or varieties, 6,214 species, 1,967 genera and 254 families. Owing to variation in data sources, trait records in the database include both individual observations and mean values.

Software format

GRooT includes two csv files. A GitHub repository contains the csv files and a script in R to query the database.
Prognostic significance of present atrial fibrillation on a single office electrocardiogram in patients with atrial fibrillation
Authors: Krisai P. , Hämmerle P. , Blum S. , Meyre P. , Aeschbacher S. , Melchiorre‐Mayer P. , Baretella O. , Rodondi N. , Conen D. , Osswald S. , Kühne M. , Zuern C. S. ,   for the Swiss‐AF investigators
Published: September 2020

Background

Evidence for the association of atrial fibrillation (AF) present on the ECG and cardiovascular outcomes in AF patients is limited.

Objective

To investigate the prognostic significance of AF on a single surface ECG for cardiovascular outcomes in AF patients.

Methods

A total of 3642 AF patients were prospectively enrolled. Main exclusion criteria were rhythms other than sinus rhythm (SR) or AF. The primary end‐point was a composite of all‐cause death and hospitalizations for congestive heart failure (CHF). Secondary end‐points were all‐cause death, CHF hospitalizations, cardiovascular death, myocardial infarction, any stroke and stroke subtypes. Associations were assessed with multivariable Cox proportional hazards models.

Results

Mean age was 71 years, 28% were female, and mean follow‐up was 3.4 years. Patients with SR on the ECG at study enrolment (56%) were younger (69 vs. 74 years, P < 0.0001), had more often paroxysmal AF (73 vs. 18%, P < 0.0001) and fewer comorbidities. The incidence of the primary end‐point was 1.8 and 3.1 per 100 person‐years in patients with SR and AF, respectively. The multivariable‐adjusted hazard ratio was 1.4 (95% confidence intervals 1.1; 1.7; P = 0.001) for patients with AF on the ECG compared to patients with SR. The hazard ratios (95% confidence intervals) were 1.4 (1.1; 1.8; P = 0.006) for all‐cause death, 1.5 (1.2; 1.9; P = 0.001) for CHF and 1.6 (1.1; 2.2; P = 0.006) for cardiovascular death. None of the other associations were statistically significant.

Conclusions

The presence of AF in a single office ECG had significant prognostic implications with regard to mortality and CHF hospitalizations in patients with AF. These patients present a high‐risk group and might benefit from intensified treatment.
Reduction of circulating sphingosine‐1‐phosphate worsens mdx soleus muscle dystrophic phenotype
Authors: Germinario Elena , Bondì Michela , Blaauw Bert , Betto Romeo , Danieli‐Betto Daniela
Published: September 2020

New Findings

What is the central question of the study?

What are the consequences of reducing circulating sphingosine‐1‐phosphate (S1P) for muscle physiology in the murine model of Duchenne muscular dystrophy (DMD)?

What is the main result and its importance?

Reduction of the circulating S1P level in mdx mice aggravates the dystrophic phenotype, as seen by an increase in fibre atrophy, fibrosis and loss of specific force, suggesting that S1P signalling is a potential therapeutic target in DMD. Although further studies are needed, plasma S1P levels have the intriguing possibility of being used as a biomarker for disease severity, an important issue in DMD.

Sphingosine‐1‐phosphate (S1P) is an important regulator of skeletal muscle properties. The dystrophin‐deficient mdx mouse possesses low levels of S1P (∼50%) compared with wild type. Increased S1P availability was demonstrated to ameliorate the dystrophic phenotype in Drosophila and in mdx mice. Here, we analysed the effects produced by further reduction of S1P availability on the mass, force and regenerative capacity of dystrophic mdx soleus. Circulating S1P was neutralized by a specific anti‐S1P antibody (S1P‐Ab) known to lower the extracellular concentration of this signalling lipid. The S1P‐Ab was administered intraperitoneally in adult mdx mice every 2 days for the duration of experiments. Soleus muscle properties were analysed 7 or 14 days after the first injection. The decreased availability of circulating S1P after the 14 day treatment reduced mdx soleus fibre cross‐sectional area (−16%, P < 0.05), an effect that was associated with an increase in markers of proteolytic (MuRF1 and atrogin‐1) and autophagic (p62 and LC3‐II/LC3‐I ratio) pathways. Moreover, an increase of fibrosis was also observed (+26%, P < 0.05). Notably, the treatment also caused a reduction of specific tetanic tension (−29%, P < 0.05). The mdx soleus regenerative capacity was only slightly influenced by reduced S1P. In conclusion, neutralization of circulating S1P reduces the mass and specific force and increases fibrosis of mdx soleus muscle, thus worsening the dystrophic phenotype. The results confirm that active, functional S1P signalling might counteract the progression of soleus mdx pathology and validate the pathway as a potential therapeutic target for muscular dystrophies.
The first record of Rickettsia hoogstraalii (Rickettsiales: Rickettsiaceae) from Argas persicus (Acari: Argasidae) in Iran

Authors: Kooshki Habibollah , Goudarzi Gholamreza , Faghihi Faezeh , Telmadarraiy Zakkyeh , Edalat Hamideh , Hosseini-chegeni Asadollah
Published: September 2020

The rickettsiae (Rickettsiales: Rickettsiaceae) are obligate intracellular and Gram-negative bacteria. They depend on arthropod vector as well as the mammalian host for survival in the nature. 327 soft tick specimens associated the aviary were collected in Khorramabad county of Lorestan province, western Iran. Ticks were identified as Argas persicus according to taxonomical key. Then, 64 tick specimens were analyzed for the presence of rickettsial DNA. Out of 64 specimens, 6 of them were positive and totally three DNA sequences including a single sequence of each ompA, ompB and sca4 genes was obtained from A. persicus ticks. Rickettsia hoogstraalii was detected in Ar. persicus representing the ﬁrst record of this species in Iran. Sca4 gene fragment was unable to specify rickettsial infection in Ar. persicus ticks according to BLAST analysis.
A new species of the genus Cryptognathus Kramer (Acari: Cryptognathidae) from the Aegaen region of Turkey

Authors: Akyol Mustafa
Published: September 2020

A new species viz. Cryptognathus karabagiensis sp. nov., collected from soil and litter under Spartium junceum (Fabaceae), Cedrus libani (Pinaceae), Vitis vinifera (Vitaceae) and Pistacia terebinthus (Anacardiaceae) in Afyonkarahisar, Manisa and Muğla provinces (the Aegaen region of Turkey), is described and illustrated based on adult females. Also, an updated key to all known species of the genus Cryptognathus is presented.
Transfer learning for efficient classification of grouper sound
Authors: Ibrahim Ali K. , Zhuang Hanqi , Chérubin Laurent M. , Schärer-Umpierre Michelle T. , Nemeth Richard S. , Erdol Nurgun , Ali Ali Muhamed
Published: September 2020

A transfer learning approach is proposed to classify grouper species by their courtship-associated sounds produced during spawning aggregations. Vessel sounds are also included in order to potentially identify human interaction with spawning fish. Grouper sounds recorded during spawning aggregations were first converted to time-frequency representations. Two types of time frequency representations were used in this study: spectrograms and scalograms. These were converted to images, and then fed to pretrained deep neural network models: VGG16, VGG19, Google Net, and MobileNet. The experimental results revealed that transfer learning significantly outperformed the manually identified features approach for grouper sound classification. In addition, both time-frequency representations produced almost identical results in terms of classification accuracy.
Development of Styrene Maleic Acid Lipid Particles as a Tool for Studies of Phage-Host Interactions
Authors: de Jonge Patrick A. , Smit Sibinga Dieuwke J. C. , Boright Oliver A. , Costa Ana Rita , Nobrega Franklin L. , Brouns Stan J. J. , Dutilh Bas E.
Published: September 2020

Bacteriophages (viruses that infect bacteria or phages) impact every microbial community. All phage infections start with the binding of the viral particle to a specific receptor molecule on the host cell surface. Due to its importance in phage infections, this first step is of interest to many phage-related research and applications. However, many phage receptors are difficult to isolate. Styrene maleic acid lipid particles (SMALPs) are a recently developed approach to isolate membrane proteins in their native environment. In this study, we explore SMALPs as a tool to study phage-receptor interactions. We find that different phage species bind to SMALPs, while maintaining specificity to their receptor. We then characterize the time and concentration dependence of phage-SMALP interactions and furthermore show that they lead to genome ejection by the phage. The results presented here show that SMALPs are a useful tool for future studies of phage-receptor interactions.
Management of recurrent central giant cell granuloma of mandible using intralesional corticosteroid with long-term follow-up
Authors: Nilesh Kumar , Dadhich Anuj , Patil Rahul
Published: September 2020

Central giant cell granuloma (CGCG) is an expansile osteolytic lesion of the jawbone. Conventional treatment of CGCG is surgical and vary from simple curettage to more aggressive resection of the jaw. However, surgical management is associated with drawbacks including requirement of hospitalisation and general anaesthesia, damage to vital anatomic structures and continuity defect of the mandible requiring reconstruction surgery. Use of intralesional injections of corticosteroid for the management of CGCG have been inconsistently used as an alternative non-surgical method of management of CGCG with varying success. While the use of such conservative modality over ablative surgery can significantly reduce postoperative morbidity, follow-up of such cases for a long period is important to study the possible recurrence. This paper reports successful treatment of a recurrent CGCG of posterior mandible by intralesional administration of triamcinolone acetonide in a 27-year old female patient, with long-term follow-up of 10 years.
Bacterial infections as novel risk factors of severe diabetic retinopathy in individuals with type 1 diabetes
Authors: Simonsen Johan Rasmus , Järvinen Asko , Hietala Kustaa , Harjutsalo Valma , Forsblom Carol , Groop Per-Henrik , Lehto Markku
Published: September 2020

Background/Aims

Diabetic retinopathy (DR) is associated and shares many risk factors with other diabetic complications, including inflammation. Bacterial infections, potent inducers of inflammation have been associated with the development of diabetic complications apart from DR. Our aim was to investigate the association between bacterial infections and DR.

Methods

Adult individuals with type 1 diabetes (n=1043) were recruited from the Finnish Diabetic Nephropathy Study (FinnDiane), a prospective follow-up study. DR was defined as incident severe diabetic retinopathy (SDR), identified as first laser treatment. Data on DR were obtained through fundus photographs and medical records, data on bacterial infections from comprehensive national registries (1 January 1995 to 31 December 2015). Risk factors for DR and serum bacterial lipopolysaccharide (LPS) activity were determined at baseline.

Results

Individuals with incident SDR (n=413) had a higher mean number of antibiotic purchases/follow-up year compared with individuals without incident SDR (n=630) (0.92 [95% CI 0.82 to 1.02] vs 0.67 [0.62–0.73], p=0.02), as well as higher levels of LPS activity (0.61 [0.58–0.65] vs 0.56 [0.54–0.59] EU/mL, p=0.03). Individuals with on average ≥1 purchase per follow-up year (n=269) had 1.5 times higher cumulative incidence of SDR, compared with individuals with <1 purchase (n=774) per follow-up year (52% vs 35%, p<0.001). In multivariable Cox survival models, the mean number of antibiotic purchases per follow-up year as well as LPS activity were risk factors for SDR after adjusting for static confounders (HR 1.16 [1.05–1.27], p=0.002 and HR 2.77 [1.92–3.99], p<0.001, respectively).

Conclusion

Bacterial infections are associated with an increased risk of incident SDR in type 1 diabetes.
One-hour plasma glucose combined with skin autofluorescence identifies subjects with pre-diabetes: the DIAPASON study
Authors: La Sala Lucia , Tagliabue Elena , de Candia Paola , Prattichizzo Francesco , Ceriello Antonio
Published: September 2020

Introduction

The major challenge for diabetes prevention is early identification of individuals at risk to allow for implementation of measures to delay the onset of future disease. Measures such as fasting plasma glucose (FPG), 2-hour plasma glucose (2hPG), and glycosylated hemoglobin (HbA1c) are equally appropriate for identifying pre-diabetes and diabetes, but do not all identify the disease in the same individual. We tested the utility of a diagnostic method combining FPG, 2hPG and HbA1c for early evaluation and easy identification of pre-diabetes.

Research design and methods

531 subjects underwent skin autofluorescence (SAF) and glycemia analyses. We created two classification groups based on the American Diabetes Association diagnosis guidelines: (1) based on 2hPG and (2) based on a new combination of three glycemia parameters (the three-criteria strategy (3-c)). Logistic regression modeling was used to estimate the associations.

Results

SAF showed high associations for both 3-c definition and 2hPG definition alone. These associations appeared stronger in 3-c than those in 2hPG. The non-invasive SAF measurement outperformed 2hPG in the detection of dysglycemia or pre-diabetes. Stepwise selections identified 1-hour postload glucose (1hPG) as variable identifying pre-diabetes using the 2hPG criterion, and the model based on 1hPG plus SAF appeared to be the best association using the 3-c strategy.

Conclusions

1hPG coupled with SAF showed a strong association in the evaluation of pre-diabetes using the 3-c method.
Cost and cost drivers associated with setting-up a prime vendor system to complement the national medicines supply chain in Tanzania
Authors: Kuwawenaruwa August , Wyss Kaspar , Wiedenmayer Karin , Tediosi Fabrizio
Published: September 2020

Introduction

Economic analysis of supply chain management interventions to improve the availability of healthcare commodities at healthcare facilities is important in generating evidence for decision-makers. The current study assesses the cost and cost drivers for setting-up a public-private partnership programme in Tanzania in which all public healthcare facility orders for complementary medicines are pooled at the district level, and then purchased from one contracted supplier, the prime vendor (referred to as ‘Jazia Prime Vendor System’ (Jazia PVS)).

Methods

Financial and economic costs of Jazia PVS were collected retrospectively and using the ingredients approach. The financial costs were spread over the implementation period of January 2014–July 2019. In addition, we estimated the financial rollout costs of Jazia PVS to the other 23 regions in the country over 2 years (2018–2019). A multivariate sensitivity analysis was conducted on the estimates.

Results

Jazia PVS start-up and recurrent financial costs amounted to US$2 170 989.74 and US$709 302.32, respectively. The main cost drivers were costs for short-term experts, training of staff and healthcare workers and the Jazia PVS technical and board management activities. The start-up financial cost per facility was US$2819.47 and cost per capita was US$0.37.

Conclusion

In conclusion, the study provides useful information on the cost and cost drivers for setting-up a complementary pharmaceutical supply system to complement an existing system in low-income settings. Despite the substantial costs incurred in the initial investment and operations of the Jazia PVS, the new framework is effective in achieving the desired purpose of improving availability of healthcare commodities.
Use of eHealth in the management of pulmonary arterial hypertension: review of the literature
Authors: Gonzalez-Garcia Manuel C , Fatehi Farhad , Varnfield Marlien , Ding Hang , Karunanithi Mohan , Yang Ian , Cordina Rachael , Feenstra John
Published: September 2020

Background

Pulmonary arterial hypertension (PAH) is a severe chronic condition associated with poor quality of life and high risks of mortality and hospitalisation. The utilisation of novel diagnostic technologies has improved survival rates although the effectiveness of Electronic Health (eHealth) interventions in patients with a chronic cardiopulmonary disease remains controversial. As the effectiveness of eHealth can be established by specific evaluation for different chronic health conditions, the aim of this study was to explore and summarise the utilisation of eHealth in PAH.

Method

We searched PubMed, CINAHL and Embase for all studies reporting clinical trials on eHealth solutions for the management of PAH. No limitations in terms of study design or date of publication were imposed.

Results

18 studies (6 peer-reviewed journal papers and 12 conference papers) were identified. Seven studies addressed the accuracy, safety or reliability of eHealth technologies such as intra-arterial haemodynamic monitoring of the pulmonary artery pressure, self-administered 6-Minute walk test App, computerised step-pulse oximeter and ambulatory impedance cardiography. Two studies evaluated eHealth as part of the medical management and showed a reduction in hospitalisation rate.

Conclusions

The evidence of eHealth supporting the management of people with PAH is limited and only embraced through a few studies of small sample size and short-term duration. Given the proposed clinical benefits in heart failure, we postulate that the evaluation of eHealth for the clinical management of PAH is highly warranted.
Case-control study on ocular changes and ophthalmic Doppler velocimetric indices among preeclamptic and normotensive pregnant women in Ibadan, Nigeria
Authors: Onwudiegwu Chiemelie , Adekanmi Ademola , Olusanya Bolutife , Lawal Olatunji , Adedokun Babatunde , Morhason-Bello Imran , Oladokun Adesina
Published: September 2020

Objective

To compare the ocular changes and Doppler velocimetric indices in preeclamptic and normotensive pregnant women.

Methods and analysis

This was a case-control study of 71 preeclamptic women and 72 parity-matched normotensive pregnant women conducted at the University College Hospital, Ibadan, Nigeria. Demographic data were obtained using questionnaires. All participants had visual acuity assessment, funduscopy, intraocular pressure measurement and orbital Doppler ultrasonography. The differences in parameters between the two groups were tested using Student’s t-test for quantitative variables and χ2tests for categorical variables.

Results

There were no significant differences between cases and controls with respect to sociodemographic variables. The mean pulsatility index was 1.35±0.46 in cases and 2.1±0.4 in controls (p<0.001); the resistivity index was 0.7±0.18 in cases and 0.83±0.27 among the controls (p=0.01). A similar pattern was observed in the peak systolic velocity (p<0.001) and the peak ratio (p<0.001). There was no significant difference between the groups concerning end-diastolic velocity (p=0.535). Three preeclampsia patients (5.2%) had abnormalities on funduscopy compared with none of the controls. Preeclamptic women had significantly higher intraocular pressures in both eyes at baseline and at 24 hours post delivery.

Conclusion

This study demonstrated lower Doppler velocimetry and impedance parameters and higher intraocular pressure among preeclampsia cases compared with controls. Abnormal funduscopic findings were observed in a few preeclamptic women and none among the controls. Ophthalmic artery Doppler parameters could be useful in identifying those women who are likely to suffer preeclampsia and its complications.
Consensus guidelines on managing Rett syndrome across the lifespan
Authors: Fu Cary , Armstrong Dallas , Marsh Eric , Lieberman David , Motil Kathleen , Witt Rochelle , Standridge Shannon , Nues Paige , Lane Jane , Dinkel Tristen , Coenraads Monica , von Hehn Jana , Jones Mary , Hale Katie , Suter Bernhard , Glaze Daniel , Neul Jeffrey , Percy Alan , Benke Timothy
Published: September 2020

Background

Rett syndrome (RTT) is a severe neurodevelopmental disorder with complex medical comorbidities extending beyond the nervous system requiring the attention of health professionals. There is no peer-reviewed, consensus-based therapeutic guidance to care in RTT. The objective was to provide consensus on guidance of best practice for addressing these concerns.

Methods

Informed by the literature and using a modified Delphi approach, a consensus process was used to develop guidance for care in RTT by health professionals.

Results

Typical RTT presents early in childhood in a clinically recognisable fashion. Multisystem comorbidities evolve throughout the lifespan requiring coordination of care between primary care and often multiple subspecialty providers. To assist health professionals and families in seeking best practice, a checklist and detailed references for guidance were developed by consensus.

Conclusions

The overall multisystem issues of RTT require primary care providers and other health professionals to manage complex medical comorbidities within the context of the whole individual and family. Given the median life expectancy well into the sixth decade, guidance is provided to health professionals to achieve current best possible outcomes for these special-needs individuals.
Point-of-care ultrasound for the pediatric regional anesthesiologist and pain specialist: a technique review
Authors: Kars Michelle S , Gomez Morad Andrea , Haskins Stephen C , Boublik Jan , Boretsky Karen
Published: September 2020

Point-of-care ultrasound (PoCUS) has been well described for adult perioperative patients; however, the literature on children remains limited. Regional anesthesiologists have gained interest in expanding their clinical repertoire of PoCUS from regional anesthesia to increasing numbers of applications. This manuscript reviews and highlights emerging PoCUS applications that may improve the quality and safety of pediatric care.

In infants and children, lung and airway PoCUS can be used to identify esophageal intubation, size airway devices such as endotracheal tubes, and rule in or out a pulmonary etiology for clinical decompensation. Gastric ultrasound can be used to stratify aspiration risk when nil-per-os compliance and gastric emptying are uncertain. Cardiac PoCUS imaging is useful to triage causes of undifferentiated hypotension or tachycardia and to determine reversible causes of cardiac arrest. Cardiac PoCUS can assess for pericardial effusion, gross ventricular systolic function, cardiac volume and filling, and gross valvular pathology. When PoCUS is used, a more rapid institution of problem-specific therapy with improved patient outcomes is demonstrated in the pediatric emergency medicine and critical care literature.

Overall, PoCUS saves time, expedites the differential diagnosis, and helps direct therapy when used in infants and children. PoCUS is low risk and should be readily accessible to pediatric anesthesiologists in the operating room.
Sleep-disordered breathing in patients on opioids for chronic pain
Authors: Selvanathan Janannii , Peng Philip W H , Wong Jean , Ryan Clodagh M , Chung Frances
Published: September 2020

The past two decades has seen a substantial rise in the use of opioids for chronic pain, along with opioid-related mortality and adverse effects. A contributor to opioid-associated mortality is the high prevalence of moderate/severe sleep-disordered breathing, including central sleep apnea and obstructive sleep apnea, in patients with chronic pain. Although evidence-based treatments are available for sleep-disordered breathing, patients are not frequently assessed for sleep-disordered breathing in pain clinics. To aid healthcare providers in this area of clinical uncertainty, we present evidence on the interaction between opioids and sleep-disordered breathing, and the prevalence and predictive factors for sleep-disordered breathing in patients on opioids for chronic pain. We provide recommendations on how to evaluate patients on opioids for risk of moderate/severe sleep-disordered breathing in clinical care, which could lead to earlier use of therapeutic interventions for opioid-associated sleep-disordered breathing, such as opioid cessation or positive airway pressure therapy. This would improve quality of life and well-being of patients with chronic pain.
Daring discourse: should the ESP block be renamed RIP II block?
Authors: Lonnqvist PA , Karmakar Manoj Kumar , Richardson Jonathan , Moriggl Bernhard
Published: September 2020

During the time period 1984 to the turn of the millennium, interpleural nerve blockade was touted as a very useful regional anesthetic nerve blockade for most procedures or conditions that involved the trunk and was widely practiced despite the lack of proper evidence-based support. However, as an adequate evidence base developed, the interest for this type of nerve block dwindled and very few centers currently use it—thereby to us representing the rest in peace (RIP) I block. Unfortunately, we get adeja-vùsensation when we observe the current fascination with the erector spinae plane block (ESPB), which since 2019 has generated as many as 98 PubMed items. This daring discourse point out the lack of a proper evidence base of the ESPB compared with other established nerve blocking techniques as well as the lack of a proven mechanism of action that explains how this nerve block technique can be effective regarding surgical procedures performed on the front of the trunk. Emerging meta-analysis data also raise concern and give cause to healthy skepticism regarding the use of ESPB for major thoracic or abdominal surgery. Against this background, we foresee that ESPB (and variations on this theme) will end up in a similar fashion as interpleural nerve blockade, thereby soon to be renamed the RIP II block.
Long-term outcomes of brainstem arteriovenous malformations after different management modalities: a single-centre experience
Authors: Chen Yu , Li Ruinan , Ma Li , Meng Xiangyu , Yan Debin , Wang Hao , Ye Xun , Jin Hengwei , Li Youxiang , Gao Dezhi , Sun Shibin , Liu Ali , Wang Shuo , Chen Xiaolin , Zhao Yuanli
Published: September 2020

Objective

The aims of this study are to clarify the long-term outcomes of brainstem arteriovenous malformations (AVMs) after different management modalities.

Methods

The authors retrospectively reviewed 61 brainstem AVMs in their institution between 2011 and 2017. The rupture risk was represented by annualised haemorrhagic rate. Patients were divided into five groups: conservation, microsurgery, embolisation, stereotactic radiosurgery (SRS) and embolisation+SRS. Neurofunctional outcomes were evaluated by the modified Rankin Scale (mRS). Subgroup analysis was conducted between different management modalities to compare the long-term outcomes in rupture or unruptured cohorts.

Results

All of 61 brainstem AVMs (12 unruptured and 49 ruptured) were followed up for an average of 4.5 years. The natural annualised rupture risk was 7.3%, and the natural annualised reruptured risk in the ruptured cohort was 8.9%. 13 cases were conservative managed and 48 cases underwent intervention (including 6 microsurgery, 12 embolisation, 21 SRS and 9 embolisation+SRS). In the selection of interventional indication, diffuse nidus were often suggested conservative management (p=0.004) and nidus involving the midbrain were more likely to be recommended for intervention (p=0.034). The risk of subsequent haemorrhage was significantly increased in partial occlusion compared with complete occlusion and conservative management (p<0.001, p=0.036, respectively). In the subgroup analysis, the follow-up mRS scores of different management modalities were similar whether in the rupture cohort (p=0.064) or the unruptured cohort (p=0.391), as well as the haemorrhage-free survival (p=0.145). In the adjusted Bonferroni correction analysis of the ruptured cohort, microsurgery and SRS could significantly improve the obliteration rate compared with conservation (p<0.001, p=0.001, respectively) and SRS may have positive effect on avoiding new-onset neurofunctional deficit compared with microsurgery and embolisation (p=0.003, p=0.003, respectively).

Conclusions

Intervention has similar neurofunctional outcomes as conservation in these brainstem AVM cohorts. If intervention is adopted, partial obliteration should be avoided because of the high subsequent rupture risk.

Trial registration number

NCT04136860.
Long-term effects of inoculating lodgepole pine seedlings with plant growth-promoting bacteria originating from a disturbed gravel mining ecosystem
Authors: Padda Kiran Preet , Puri Akshit , Chanway Chris P.
Published: September 2020

Gravel mining is prevalent in forest landscapes across Canada, typically resulting in complete loss of vegetation and topsoil. Despite such extreme disturbance, lodgepole pine (Pinus contorta Dougl. var. latifolia Engelm.) trees are thriving at unreclaimed gravel pits located in central-interior British Columbia, possibly owing to, at least in part, the association of pine trees with their endophytic bacteria. To test this possibility, several bacterial strains were previously isolated from pine trees growing at these pits; of the strains isolated, 14 were identified as effective nitrogen fixers. In this study, we evaluated the inoculation effect of these 14 strains on lodgepole pine growth under nitrogen-poor conditions. Eighteen months after sowing and inoculation, each strain had colonized the rhizosphere and internal tissues of pine seedlings and had significantly enhanced their length (24%–65%) and biomass (100%–300%). Notably, three Pseudomonas strains increased pine seedling length by 1.6-fold and biomass by 4-fold. Most strains also demonstrated substantial potential to promote plant growth via phosphorus solubilization, siderophore production, 1-aminocyclopropane-1-carboxylic acid (ACC) deaminase activity, indole-3-acetic acid production, lytic enzyme activity, and catalase activity. Our results suggest that such nitrogen-fixing bacteria could be sustaining pine growth on bare gravel, indicating a possible ecological association that may explain natural tree regeneration in such a disturbed ecosystem.
Anomaly Detection for Industrial Control Networks Based on Improved One-Class Support Vector Machine
Authors: Qu Haicheng , Zhou Jianzhong , Qin Jitao , Tian Xiaorong
Published: September 2020

In traditional network anomaly detection algorithms, the anomaly threshold needs to be defined manually. Keeping this as background, this study proposes an anomaly detection algorithm (VAEOCSVM), which combines the variable auto-encoder (VAE) and one-class support vector machine (OCSVM) to realize anomaly detection in industrial control networks. First, the VAE model is used to obtain the distribution of the original normal sample data represented by the low-dimensional code; the reconstruction error of the VAE model is merged into the new input. Then, using OCSVM’s hinge-loss objective function and the random Fourier feature fitting radial basis function (RBF) kernel method, the OCSVM model is represented and solved using the deep neural network and gradient descent method. Finally, the decision function of the OCSVM model is constructed by using the solved parameter information to realize the detection of abnormal data. The proposed algorithm is compared with other machine-learning-based anomaly detection algorithms in terms of multiple indicators such as precision, recall, and [Formula: see text] score. The experimental results using various datasets show that the proposed algorithm has a better outlier recognition ability than the machine-learning-based anomaly detection algorithms.
A black hole inside dark matter and the rotation curves of galaxies
Authors: Haddad Fateen , Haddad Nidal
Published: September 2020

In this paper, we find a four-dimensional metric for a large black hole immersed in dark matter. Specifically, we look for and find a static spherically symmetric black hole solution to the Einstein equations which gives, in the Newtonian limit, the rotation curves of galaxies, including the flat region and the baryonic Tully–Fisher relation, and which has a regular horizon. We obtain as well the energy–momentum tensor of the dark matter sourcing this spacetime and it turns, in special, to satisfy the four energy conditions (dominant, weak, null and strong) everywhere outside the horizon. This black-hole-dark-matter system represents a successful simplified model for galaxies, opens a new area for exploring the relativistic regime of dark matter, and shows that the theory of General Relativity together with dark matter can account for the rotation curves of galaxies.
Impact of Ground Parameters on Performances of an Active Phased Array Element of the Low-Frequency Radio Telescope GURT
Authors: Tokarsky Peter , Konovalenko Alexander , Kalinichenko Mykola , Yerin Serge
Published: September 2020

This paper presents the technique of numerical estimation of ground parameters impact on the performances of an active antenna used as an element of a phased array antenna of a modern low-frequency radio telescope. Three ground conditions were considered, two of them wet and dry, which correspond to the extreme values of seasonal deviations of its parameters, as well as its median state (“normal ground”). The results of computer simulation are given for the active antenna of the GURT radio telescope with a ground screen in the form of a square wire grid of [Formula: see text][Formula: see text]m and without it. It is shown that the addition of the ground screen markedly reduces the influence of the ground conditions on some parameters of the antenna, in particular, the dipole impedance and radiation efficiency. At the same time, the ground screen does not protect the most important antenna parameters for radio astronomy, such as sensitivity and absorption area, from the impact of the ground conditions changes. Variations of these parameters for an active antenna with a screen remain approximately the same as without it.
Genetic Diversity in Mycobacterium tuberculosis Clinical Isolates and Resulting Outcomes of Tuberculosis Infection and Disease
Authors: Peters Julian S. , Ismail Nabila , Dippenaar Anzaan , Ma Shuyi , Sherman David R. , Warren Robin M. , Kana Bavesh D.
Published: September 2020

Tuberculosis claims more human lives than any other bacterial infectious disease and represents a clear and present danger to global health as new tools for vaccination, treatment, and interruption of transmission have been slow to emerge. Additionally, tuberculosis presents with notable clinical heterogeneity, which complicates diagnosis, treatment, and the establishment of nonrelapsing cure. How this heterogeneity is driven by the diversity ofclinical isolates of the causative agent, Mycobacterium tuberculosis, has recently garnered attention. Herein, we review advances in the understanding of how naturally occurring variation in clinical isolates affects transmissibility, pathogenesis, immune modulation, and drug resistance. We also summarize how specific changes in transcriptional responses can modulate infection or disease outcome, together with strain-specific effects on gene essentiality. Further understanding of how this diversity of M. tuberculosis isolates affects disease and treatment outcomes will enable the development of more effective therapeutic options and vaccines for this dreaded disease.
Synthesis of Dimeric Molecules via Ag-Catalyzed Electrochemical Homocoupling of Organic Bromides Paired with Electrooxidation of Urea
Authors: Medvedev Jury J. , Steksova Yulia P. , Medvedeva Xenia V. , Pivovarova Yekaterina , Krivoshapkina Elena F. , Klinkova Anna
Published: September 2020

We present a sacrificial anode-free approach to reductive homocoupling of organohalides that does not require a co-catalyst. In this approach, a divided electrochemical cell with aprotic and aqueous compartments separated by an anion exchange membrane enables coupling of the cathodic homocoupling reaction with anodic oxidation of urea. We show that, in contrast with traditional one-compartment cells relying on sacrificial anodes, the proposed cell configuration maintains stable cell voltage in the course of galvanostatic electrolysis. A synthetic potential of this method was assessed using a series of 13 organic bromides that demonstrated a strong dependence of the reaction outcome on the structure of the organic substrate, more specifically, the dissociation energy of the C–Br bond and the redox properties of formed radicals, which are discussed in detail. While not being suitable for the synthesis of byarylstructures, this method is excellent for C(sp3)-C(sp3) coupling to corresponding dimeric products with up to quantitative yields. Simultaneous electrochemical treatment of nitrogenous waste in the adjacent half-cell provides an additional incentive for wide adaptation of this sustainable synthetic approach.
Activated Carbon for Dyes Removal: Modeling and Understanding the Adsorption Process
Authors: El maguana Y. , Elhadiri N. , Benchanaa M. , Chikri R.
Published: September 2020

Batch adsorption experiments have been conducted to investigate the removal of methyl orange from aqueous solution by an activated carbon prepared from prickly pear seed cake by phosphoric acid activation. The adsorption process has been described by using kinetic and isotherm models. The kinetic of adsorption was examined by pseudo-first-order, pseudo-second-order, and intraparticle diffusion models. Adsorption isotherm was modeled using Langmuir, Freundlich, Temkin and Dubinin–Radushkevich isotherms. The adsorption process of methyl orange was well explained by the pseudo-second-order model and Freundlich isotherm. Also, pseudo-n-order model has been applied to estimate the order of adsorption kinetic and it was found equal to 2 which confirm the good accuracy of the pseudo-second order. Moreover, Dubinin–Radushkevich isotherm reveals that the adsorption of methyl orange onto activated carbon was a physisorption process in nature. The adsorption capacity of activated carbon was found to be 336.12 mg/g at temperature 20°C andpH∼7. These results demonstrated that the prickly pear seed cake is a suitable precursor for the preparation of appropriate activated carbon for dyes removal from aqueous solution.
New Approach in the Management of Vertical Root Fracture with the Help of Biodentine and CBCT
Authors: Baranwal H. C. , Singh Nidhi , Kumar Neeraj , Garg Riya , Yadav Jyoti , Tripathi Richik
Published: September 2020

Introduction. Vertical root fracture is a big challenge to dentists for its diagnosis and treatment. As the tooth presents poor prognosis, the most common treatment modality is extraction. One can save the tooth from extraction by the reconstruction of fracture fragments followed by intentional reimplantation. New treatment options have arrived for healing of the fracture site by hard tissue barrier formation with the help of bioceramic materials. Case Report. The present case report describes successful management of complete vertical root fracture of a maxillary left central incisor by trauma in a 35-year-old male with the help of Biodentine, a bonding agent, a fiber post, and dual-cure resin cement without tooth extraction, followed by all ceramic crowns. Up to two years of follow-up, there is no problem in the tooth, and radiographically, there is no radiolucency along the fracture line. Periodontal status and probing depth were within a normal physiological limit. Conclusion. Functional and aesthetic outcomes are achieved by combined therapy in the present case report.