bluuebunny/crossref_metadata_2025 huggingface dataset:
Sequenced-based paternity analysis to improve breeding and identify self-incompatibility loci in intermediate wheatgrass (Thinopyrum intermedium)
Authors: Crain Jared , Larson Steve , Dorn Kevin , Hagedorn Traci , DeHaan Lee , Poland Jesse
Published: August 2020

Key Message

Paternity assignment and genome-wide association analyses for fertility were applied to aThinopyrum intermediumbreeding program. A lack of progeny between combinations of parents was associated with loci near self-incompatibility genes.

In outcrossing species such as intermediate wheatgrass (IWG, Thinopyrum intermedium), polycrossing is often used to generate novel recombinants through each cycle of selection, but it cannot track pollen-parent pedigrees and it is unknown how self-incompatibility (SI) genes may limit the number of unique crosses obtained. This study investigated the potential of using next-generation sequencing to assign paternity and identify putative SI loci in IWG. Using a reference population of 380 individuals made from controlled crosses of 64 parents, paternity was assigned with 92% agreement using Cervus software. Using this approach, 80% of 4158 progeny (n = 3342) from a polycross of 89 parents were assigned paternity. Of the 89 pollen parents, 82 (92%) were represented with 1633 unique full-sib families representing 42% of all potential crosses. The number of progeny per successful pollen parent ranged from 1 to 123, with number of inflorescences per pollen parent significantly correlated to the number of progeny (r = 0.54, p < 0.001). Shannon’s diversity index, assessing the total number and representation of families, was 7.33 compared to a theoretical maximum of 8.98. To test our hypothesis on the impact of SI genes, a genome-wide association study of the number of progeny observed from the 89 parents identified genetic effects related to non-random mating, including marker loci located near putative SI genes. Paternity testing of polycross progeny can impact future breeding gains by being incorporated in breeding programs to optimize polycross methodology, maintain genetic diversity, and reveal genetic architecture of mating patterns.
Analysis of Metallo-β-lactamases, oprD Mutation, and Multidrug Resistance of β-lactam Antibiotic-Resistant Strains of Pseudomonas aeruginosa Isolated from Southern China
Authors: Li Fei , Chen Danna , Li Lijuan , Liang Dezhi , Wang Fengping , Zhang Bashan
Published: August 2020

The purpose of this study was to analyze the metallo-β-lactamases (MBLs) genotype and oprD mutations of the β-lactam antibiotic-resistant Pseudomonas aeruginosa (PA) strains isolated from southern China. We collected 110 strains of β-lactam antibiotic-resistant PA from 2 hospitals during January 2016–December 2017 from Dongguan, South China. MBLs were detected, amplified, and typed using EDTA disc synergy test, PCR, and Sanger gene sequencing. The mutations and expression levels of oprD were detected using Sanger gene sequencing and qPCR. A total of 16.36% (18/110) β-lactam antibiotic-resistant PA strains produced MBLs, and the main genotypes of MBLs were IMP-25, VIM-2, and SIM-2. Sanger gene sequencing results showed that 107 of the 110 strains harbored mutations in oprD sequence, while 3 strains were negative for oprD amplification (2.73%). Among the 107 strains with positive amplification (97.27%), the rate of intentional mutations (including deletions, insertions, and premature stop codons) was 93.46% (100/107) and that of no disrupted mutation was 6.54% (7/107). qPCR analysis confirmed that the expression level of the OprD protein in the 7 strains of no disrupted mutation was significantly reduced. Among the β-lactam antibiotic-resistant PA strains in southern China, 16.36% were positive for MBLs. The loss rate of oprD was 2.73%, and almost all PA strains showed oprD amplification variation or transcription downregulation. Thus, impaired oprD expression and MBLs production may be some of the mechanisms of β-lactam antibiotic-resistance of PA strains in southern China.
Correction to: Off‑the‑shelf barrier for emergency intubation in the cardiac catheterization laboratory during the coronavirus disease 2019 (COVID‑19) pandemic
Authors: Scheller Bruno , Vukadinovic Davor , Link Andreas , Ewen Sebastian , Mahfoud Felix
Published: August 2020

During submission the author name Andreas Link was unfortunately omitted. The correct author list reads as follows.
MetaboAge DB: a repository of known ageing-related changes in the human metabolome
Authors: Bucaciuc Mracica Teodora , Anghel Anca , Ion Catalin Florentin , Moraru Corina Violeta , Tacutu Robi , Lazar Gligor Andrei
Published: August 2020

Accumulating metabolomics data is starting to become extremely useful in understanding the ageing process, by providing a snapshot into the metabolic state of tissues and organs, at different ages. Molecular studies of such metabolic variations during “normal” ageing can hence guide lifestyle changes and/or medical interventions aimed at improving healthspan and perhaps even lifespan. In this work, we present MetaboAge, a freely accessible database which hosts ageing-related metabolite changes, occurring in healthy individuals. Data is automatically filtered and then manually curated from scientific articles reporting statistically significant associations of human metabolite variations or correlations with ageing. Up to date, MetaboAge contains 408 metabolites annotated with their biological and chemical information, and more than 1515 ageing-related variations, graphically represented on the website grouped by validation methods, sex and age-groups. The MetaboAge database aims to continually structure the expanding information from the field of metabolomics in relation to ageing, thus making it more accessible for further research in gerontology.
Real-world survival outcomes of heavily pretreated patients with refractory HR+, HER2−metastatic breast cancer receiving single-agent chemotherapy—a comparison with MONARCH 1
Authors: Rugo Hope S. , Dieras Veronique , Cortes Javier , Patt Debra , Wildiers Hans , O’Shaughnessy Joyce , Zamora Esther , Yardley Denise A. , Carter Gebra Cuyun , Sheffield Kristin M. , Li Li , Andre Valerie A. M. , Li Xiaohong I. , Frenzel Martin , Huang Yu-Jing , Dickler Maura N. , Tolaney Sara M.
Published: August 2020

Purpose

In MONARCH 1 (NCT02102490), single-agent abemaciclib demonstrated promising efficacy activity and tolerability in a population of heavily pretreated women with refractory HR+, HER2− metastatic breast cancer (MBC). To help interpret these results and put in clinical context, we compared overall survival (OS) and duration of therapy (DoT) between MONARCH 1 and a real-world single-agent chemotherapy cohort.

Methods

The real-world chemotherapy cohort was created from a Flatiron Health electronic health records-derived database based on key eligibility criteria from MONARCH 1. The chemotherapies included in the cohort were single-agent capecitabine, gemcitabine, eribulin, or vinorelbine. Results were adjusted for baseline demographics and clinical differences using Mahalanobis distance matching (primary analysis) and entropy balancing (sensitivity analysis). OS and DoT were analyzed using the Kaplan–Meier method and Cox proportional hazards regression.

Results

A real-world single-agent chemotherapy cohort (n = 281) with eligibility criteria similar to the MONARCH 1 population (n = 132) was identified. The MONARCH 1 (n = 108) cohort was matched to the real-world chemotherapy cohort (n = 108). Median OS was 22.3 months in the abemaciclib arm versus 13.6 months in the matched real-world chemotherapy cohort with an estimated hazard ratio (HR) of 0.54. The median DoT was 4.1 months in MONARCH 1 compared to 2.9 months in the real-world chemotherapy cohort with HR of 0.76.

Conclusions

This study demonstrates an approach to create a real-world chemotherapy cohort suitable to serve as a comparator for trial data. These exploratory results suggest a survival advantage and place the benefit of abemaciclib monotherapy in clinical context.
A Systematic Review of Household and Family Alcohol Use and Adolescent Behavioural Outcomes in Low- and Middle-Income Countries
Authors: Jokinen Tahir , Alexander Emma C. , Manikam Logan , Huq Tausif , Patil Priyanka , Benjumea Darrin , Das Ishani , Davidson Leslie L.
Published: August 2020

Exposure to alcohol misuse is considered an adverse childhood experience impacting on neurodevelopmental and behavioural outcomes in adolescents including substance use, mental illness, problem behaviours, suicidality, and teenage pregnancy. Most research on this issue has focussed on higher income countries, whereas patterns of alcohol use and related factors may be different in low- and middle-income countries (LMICs). This systematic review therefore seeks to collate all published studies from 1990–2020 on the topic set in LMICs. 43 studies were included, totalling 70,609 participants from 18 LMICs. Outcomes assessed included: substance use; depression/anxiety; suicidal ideation; problem behaviour; emotional dysfunction; teenage pregnancy; and self-harm. Despite heterogeneity in the studies identified, this review documented some association between exposure to household alcohol misuse and adverse adolescent outcomes in LMICs, including mental health problems, problem behaviours, and suicidality. The mechanisms leading to these outcomes are likely varied, and further research in different socio-economic and cultural contexts, particularly in the form of longitudinal studies, is called for.
Bias in natriuretic peptide-guided heart failure trials: time to improve guideline adherence using alternative approaches
Authors: Stienen Susan , Bhatt Ankeet , Ferreira João Pedro , Vaduganathan Muthiah , Januzzi James , Adams Kirkwood , Tardif Jean-Claude , Rossignol Patrick , Zannad Faiez
Published: August 2020

Treatment of patients with heart failure with reduced ejection fraction (HFrEF) with currently available therapies reduces morbidity and mortality. However, implementation of these therapies is a problem with only few patients achieving guideline-recommended maximal doses of therapy. In an effort to improve guideline adherence and uptitration, several trials have investigated a biomarker-guided strategy (using natriuretic peptide targets in specific), but although conceptually promising, these trials failed to show a consistent beneficial effect on outcomes. In this review, we discuss different methodological issues that may explain the failure of these trials and offer potential solutions. Moreover, alternative approaches to increase heart failure guideline adherence are evaluated.
Probing conformational transitions towards mutagenic Watson–Crick-like G·T mismatches using off-resonance sugar carbon R1ρ relaxation dispersion
Authors: Rangadurai Atul , Szymanski Eric S. , Kimsey Isaac , Shi Honglue , Al-Hashimi Hashim M.
Published: August 2020

NMR off-resonance R1ρ relaxation dispersion measurements on base carbon and nitrogen nuclei have revealed that wobble G·T/U mismatches in DNA and RNA duplexes exist in dynamic equilibrium with short-lived, low-abundance, and mutagenic Watson–Crick-like conformations. As Watson–Crick-like G·T mismatches have base pairing geometries similar to Watson–Crick base pairs, we hypothesized that they would mimic Watson–Crick base pairs with respect to the sugar-backbone conformation as well. Using off-resonance R1ρ measurements targeting the sugar C3′ and C4′ nuclei, a structure survey, and molecular dynamics simulations, we show that wobble G·T mismatches adopt sugar-backbone conformations that deviate from the canonical Watson–Crick conformation and that transitions toward tautomeric and anionic Watson–Crick-like G·T mismatches restore the canonical Watson–Crick sugar-backbone. These measurements also reveal kinetic isotope effects for tautomerization in D2O versus H2O, which provide experimental evidence in support of a transition state involving proton transfer. The results provide additional evidence in support of mutagenic Watson–Crick-like G·T mismatches, help rule out alternative inverted wobble conformations in the case of anionic G·T−, and also establish sugar carbons as new non-exchangeable probes of this exchange process.
Artifacts annotations in anesthesia blood pressure data by man and machine
Authors: Pasma Wietze , Wesselink Esther M. , van Buuren Stef , de Graaff Jurgen C. , van Klei Wilton A.
Published: August 2020

Physiologic data from anesthesia monitors are automatically captured. Yet erroneous data are stored in the process as well. While this is not interfering with clinical care, research can be affected. Researchers should find ways to remove artifacts. The aim of the present study was to compare different artifact annotation strategies, and to assess if a machine learning algorithm is able to accept or reject individual data points. Non-cardiac procedures requiring invasive blood pressure monitoring were eligible. Two trained research assistants observed procedures live for artifacts. The same procedures were also retrospectively annotated for artifacts by a different person. We compared the different ways of artifact identifications and modelled artifacts with three different learning algorithms (lasso restrictive logistic regression, neural network and support vector machine). In 88 surgical procedures including 5711 blood pressure data points, the live observed incidence of artifacts was 2.1% and the retrospective incidence was 2.2%. Comparing retrospective with live annotation revealed a sensitivity of 0.32 and specificity of 0.98. The performance of the learning algorithms which we applied ranged from poor (kappa 0.053) to moderate (kappa 0.651). Manual identification of artifacts yielded different incidences in different situations, which were not comparable. Artifact detection in physiologic data collected during anesthesia could be automated, but the performance of the learning algorithms in the present study remained moderate. Future research should focus on optimization and finding ways to apply them with minimal manual work. The present study underlines the importance of an explicit definition for artifacts in database research.
MiR-21-5p but not miR-1-3p expression is modulated by preconditioning in a rat model of myocardial infarction
Authors: Raupach Annika , Torregroza Carolin , Niestegge Julia , Feige Katharina , Klemm-Meyer Swantje , Bauer Inge , Brandenburger Timo , Grievink Hilbert , Heinen André , Huhn Ragnar
Published: August 2020

Isoflurane (Iso) preconditioning (PC) is known to be cardioprotective against ischemia/reperfusion (I/R) injury. It was previously shown that microRNA-21-5p (miR-21-5p) is regulated by Iso-PC. It is unclear, if expression of cardiac enriched miR-1-3p is also affected by Iso-PC, and associated with activation of HIF1α (hypoxia-inducible factor 1-alpha).  Male Wistar rats (n = 6–8) were randomly assigned to treatment with or without 1 MAC Iso for 30 min, followed by 25 min of regional myocardial ischemia, with 120 min reperfusion. At the end of reperfusion, myocardial expression of miR-1-3p, miR-21-5p and mRNAs of two HIF-1α-dependent genes, VEGF (vascular endothelial growth factor) and HO-1 (heme oxygenase-1), were determined by quantitative PCR. Protein expression of a miR-21 target gene, PDCD4 (programmed cell death protein 4), was assessed by western blot analysis. Infarct sizes were analyzed with triphenyltetrazoliumchloride staining. MiR-21-5p expression was increased by Iso, whereas expression of miR-1-3p was not altered. The expression of VEGF but not HO-1 was induced by Iso. Iso-PC reduced infarct sizes compared to untreated controls. No regulation of miRNA and mRNA expression was detected after I/R. PDCD4 protein expression was not affected after Iso exposure. Expression of miR-21-5p, in contrast to miR-1-3p, is altered during this early time point of Iso-PC. HIF1α signaling seems to be involved in miR-21-5p regulation.
Evolutionary stability of ambiguity in context signaling games
Authors: Mühlenbernd Roland
Published: August 2020

In Lewisean signaling games with common interests, perfect signaling strategies have been shown to be optimal in terms of communicative success and evolutionary fitness. However, in signaling game models that involve contextual cues, ambiguous signaling strategies can match up to or even outperform perfect signaling. For a minimalist example of such a context signaling game, I will show that three strategy types are expected to emerge under evolutionary dynamics: perfect signaling, partial ambiguity and full ambiguity. Moreover, I will show that partial ambiguity strategies are the most expected outcome and have the greatest basin of attraction among these three types when sender and receiver costs are arbitrarily small or similar. I will demonstrate that the evolutionary success of partial ambiguity is due to being risk dominant, which points to a better compatibility with other strategy types.
Pricing games of NFV infrastructure providers
Authors: Toka Laszlo , Zubor Marton , Korosi Attila , Darzanos George , Rottenstreich Ori , Sonkoly Balazs
Published: August 2020

Future online services will be provisioned over the federation of infrastructure providers for economic reasons: for effective usage of resources and for a wide geographic reach of customers. The technical enablers of this setup, envisioned also for 5G services, are the virtualization techniques applied in data centers, and in access and core networks. Business aspects around the provisioning of these services however pose still unresolved questions. In this heterogeneous setup those who want to deploy an online service face the problem of selecting the compute and network resource set that fulfills the technical requirements of the service deployment and that is preferable also from an economic point of view. Infrastructure providers compete among themselves for these customers, and shape their business offerings with profit maximization in mind. We model this resource market with the tool set of graph and game theory in order to study its characteristics. We show that customers need to tackle a hard problem if they want to meet both their technical and business needs, let alone minimizing costs. Furthermore, we derive the best pricing strategies that the providers should follow given their expectation about customers’ demand. Interestingly, we show that equilibrium prices and the attainable income strongly depend on the provider’s location within the network.
Soil water solutes reduce the critical micelle concentration of quaternary ammonium compounds
Authors: Mulder Ines , Schmittdiel Malte , Frei Henning , Hofmann Laura , Gerbig Dennis , Siemens Jan
Published: August 2020

Quaternary alkyl ammonium compounds (QAACs) are produced in large quantities for use as surfactants and disinfectants and also found in soils, sediments, and surface waters, where they are potentially involved in the selection of antibiotic resistance genes. Micelle formation influences fate and effects of QAACs. The critical micelle concentration (CMC) of six homologs of benzylalkylammonium chlorides (BAC) was determined in deionized water, 0.01 M CaCl2 solution, and aqueous soil extracts, using both spectrofluorometric and tensiometric methods. Additionally, eight organic model compounds were employed at concentrations of 15 mg C L−1 as background solutes in order to test the effect of dissolved organic carbon (DOC) on CMCs. Results found CMCs decreased with an increasing length of the alkyl chain from 188 mM for BAC-C8 to 0.1 mM for BAC-C18. Both methods yielded similar results for measurements in water and CaCl2 solution; however, the spectrofluorescence method did not work for soil extracts due to fluorescence quenching phenomena. In soil extracts, CMCs of BAC-C12 were reduced below 3.7 mM, while the CMC reduction in soil extracts was less pronounced for BAC-C16. Besides ionic strength, molecular structures of BACs and dissolved organic compounds also affected the CMC. The number of carboxyl groups and small molecular weights of the DOC model compounds reduced the CMCs of BAC-C12 and BAC-C16 at pH 6. This study highlights that CMCs can be surpassed in soil solution, pore waters of sediments, or other natural waters even at (small) concentrations of QAACs typically found in the environment.
N-terminal pro B-type natriuretic peptide (NT-proBNP): a possible surrogate of biological age in the elderly people
Authors: Muscari Antonio , Bianchi Giampaolo , Forti Paola , Magalotti Donatella , Pandolfi Paolo , Zoli Marco ,   The Pianoro Study Group
Published: August 2020

NT-proB-type natriuretic peptide (NT-proBNP) increases with age and is associated with all-cause mortality. With this study, we assessed its possible utilization as a marker of biological age in comparison with other variables. The study included 1079 non-institutionalized elderly subjects (mean age 72.8 ± 5.5 years, 561 women). Baseline measurements were performed of serum NT-proBNP and of some laboratory variables previously utilized to estimate biological age (creatinine, albumin, C-reactive protein, cholesterol, blood glucose, leukocytes, lymphocytes, hemoglobin, mean cell volume). During 7 years of follow-up, 114 all-cause deaths occurred. The logarithm of NT-proBNP was the most age-related parameter (r = 0.35, P < 0.0001). Its relationship with mortality, according to Cox regression and ROC curve (AUC = 0.707, 95% CI 0.654–0.759), was stronger than that of all other variables, including age. In multivariate analysis, only NT-proBNP and age remained independently associated with mortality. The regression lines between age and NT-proBNP (pg/ml) allowed a separate estimation of biological age (“proBNPage”) for men (= [log(NT-proBNP) + 1.2068]/0.0827) and for women (= [log(NT-proBNP) − 1.5258]/0.0478). The hazard ratio of all-cause mortality for the fifth quintile of proBNP age (≥ 85 years) compared with the first quintile (< 61 years) was 7.9 (95% CI 3.6–17.5). Similarly, the difference between pro-BNPage and chronological age was associated with a hazard ratio of 3.5 in the fifth quintile (95% CI 1.9–6.4) and was associated with disease count (P for trend = 0.0002). In conclusion, NT-proBNP was the best indicator of biological age, which can be estimated by simple formulas and might be used for prognostic purposes or as a surrogate end point in epidemiological and intervention studies.
Do expected downturns kill political budget cycles?
Authors: Bohn Frank , Sturm Jan-Egbert
Published: August 2020

The political budget cycle (PBC) literature argues that governments expand deficits in election years. However, what happens when an economic downturn is expected? Will the government allow the deficit to expand even further, or will it resort to spending cuts and tax increases? When voters expect less than full automatic stabilization, our model shows that opportunistic government behavior leads to smaller deficits, thereby responding procyclically to expected downturns. Panel data evidence for 74 democracies covering the period 2000-2016 robustly supports the theoretical procyclicality prediction. Moreover, expected downturns remain significant when other context-conditional PBC effects are included in the empirical analysis.
Low long-term mortality in patients with sleep apnoea and positive airway pressure therapy: analysis of a large German healthcare database
Authors: Woehrle H. , Schoebel C. , Oldenburg O. , Young P. , Fietze I. , Ficker J. H. , Bischoff-Everding C. , Libutzki B. , Arzt M.
Published: August 2020

Background

There are limited data on long-term mortality in sleep apnoea (SA) patients with and without positive airway pressure (PAP) therapy. This retrospective cohort study investigated long-term hospitalisation and mortality rates in SA patients from a German statutory health insurance (SHI) database who did versus did not receive PAP therapy.

Methods

Patients had continuous insurance coverage from 01 January 2008 to 31 December 2013, complete medical records and ≥1 SA-related diagnosis in 2009. Those receiving PAP were matched with a control group not treated with PAP. Outcomes (hospitalisations including stays in the sleep laboratory) were compared between groups the year prior to and the 4 years after SA diagnosis. Mortality was assessed in the 4 years after SA diagnosis.

Results

2176 PAP therapy recipients were matched with 2176 controls. The PAP group had a higher rate of hospitalisation in the year before SA diagnosis than the control group (80.2% vs. 26.6%;p = 0.0016). After diagnosis, the PAP group had a higher hospitalisation rate only in year 1 (p < 0.05), and average length of stay per hospitalisation was lower in the PAP group (p < 0.05 vs. control at years 1, 2 and 4). Cumulative all-cause mortality after year 3 (3.4% vs. 4.6%;p = 0.0287) and after year 4 (4.8% vs. 6.5%;p = 0.0175) was significantly lower in SA patients receiving PAP versus controls (relative risk reduction for death after 4 years: 25.5%).

Conclusion

This real-world cohort study showed an association between long-term PAP therapy use and lower mortality, a higher rate of hospitalisations before and shorter hospital stays after treatment initiation.
Assessment of the risk of exposure to cadmium and lead as a result of the consumption of coffee infusions
Authors: Winiarska-Mieczan Anna , Kwiatkowska Katarzyna , Kwiecień Małgorzata , Zaricka Ewa
Published: August 2020

The paper aimed to analyse the safety of drinking coffee by adult Poles in terms of Pb and Cd content. The degree to which Cd and Pb passed from coffee grounds into the coffee infusion was also examined. Twenty-three samples of natural coffee were examined. The content of metals was determined using the ICP method. On average, dry coffee contained ca. 0.004 μg Cd and 0.05 μg Pb per 1 g, and 95.5% Cd and 94% Pb passed into the infusion. Drinking coffee supplies these metals in the amount of less than 2% TWI (tolerable weekly intake) for Cd and BMDL (benchmark dose lower confidence limit) for Pb. In the presented studies, the values of CDI (chronic daily intake), THQ (target hazard quotient) and HI (hazard index) indicators were lower than 1, which means that the risk of developing diseases connected with chronic exposure to Cd and Pb consumed with coffee must be evaluated as very low. The content of Cd and Pb in the analysed coffee infusions was very low, so drinking coffee does not pose a risk for consumers in terms of the content of these metals. However, it must be remembered that no threshold limits for toxic metal consumption exist because these metals accumulate in the body for a long time. The studies presented here also showed a low (r = 0.26) but still a positive correlation between the content of Pb in coffee and the degree (%) to which Pb passed into the infusion. This problem should be thoroughly investigated.
Assessment of energy-saving potential, associated costs and co-benefits of public buildings in Albania
Authors: Novikova Aleksandra , Szalay Zsuzsa , Horváth Miklós , Becker Johannes , Simaku Gjergji , Csoknyai Tamás
Published: August 2020

The paper presents the public building typology, energy demand estimations and retrofit scenarios, as well as associated costs and benefits for energy-saving measures in the public building stock of Albania. First, representative building types were identified to estimate their energy performance, and define retrofit packages. Second, this information was used to analyse the costs and benefits of the different thermal efficiency retrofits. Apart from specific benefits due to cost savings in the use phase, co-benefits were estimated to understand their dimension and influence on decision-making. Finally, energy efficiency supply curves were developed to show the priority sequence of retrofits and building types. It was found that due to the growing wealth in Albania, user behaviour will change a lot in the future. Energy usage in the public building sector will increase and mitigate savings resulting from energy-saving measures making saved energy costs invisible. However, if other benefits beyond energy savings are considered, the cost efficiency of the measures remain obvious. The recommended approach can be used to assist decision-making and allocate funds.
Stability of Thermocapillary Flow in High-Prandtl-Number Liquid Bridges Exposed to a Coaxial Gas Stream
Authors: Stojanovic Mario , Kuhlmann Hendrik C.
Published: August 2020

The stability of thermocapillary flow in a liquid bridge made from 5cSt silicone oil (Pr = 68) is computed numerically. To improve the numerical model as compared to the standard approach, we consider the flow in the liquid bridge fully coupled to the flow in the ambient gas, temperature-dependent material parameters, and a dynamically deforming liquid–gas interface. We address the full two-phase-flow problem of interest for the space experiment JEREMI and investigate the effect of a steady axisymmetric coaxial gas flow which is imposed at the inlet of the annular gap between the liquid bridge and the outer confining cylinder. Under zero-gravity the flow is primarily driven by the imposed temperature gradient with viscous stresses from the gas phase being small. However, the heat transfer between liquid and the gas, and thus the temperature fields are strongly affected by the forced flow in the gas phase. As a result the stability of the steady axisymmetric flow depends sensitively on the flow direction and the temperature of the gas. If the temperature of the gas is identical to that of the support rod of the liquid bridge a gas stream opposing the thermocapillary stresses strongly destabilizes the basic flow. In a co-flow configuration the basic state is stabilized. Curves of neutral Reynolds numbers as functions of the strength of the annular gas flow are discussed for two aspect ratios of the liquid bridge.
Progress in heart failure management in the Netherlands and beyond: long-term commitment to deliver high-quality research and patient care
Authors: Meems L. M. G. , van Veldhuisen D. J. , de Boer R. A.
Published: August 2020

Heart failure (HF) remains a major global problem. In the Netherlands, 1.5–2.0% of the total population is diagnosed with HF. Over 30,000 HF patients are admitted annually in the Netherlands, and this number is expected to further increase given the ageing population and the chronic nature of HF. Despite ongoing efforts to reduce the burden of HF, morbidity and mortality rates of this disease remain high. However, several new treatment modalities have become available or are expected to become available in the coming years. This review will provide an overview of HF research conducted in the Netherlands (often in an international setting) that may have clinical consequences for diagnosis, treatment and prevention of HF, and will also evaluate outcomes of larger clinical trials that have been conducted in the Netherlands.
Incorporating design for remanufacturing in the early design stage: a design management perspective
Authors: Boorsma Nina , Balkenende Ruud , Bakker Conny , Tsui Tanya , Peck David
Published: August 2020

Adopting design approaches that allow products to last multiple use-cycles supports European Commission objectives to reduce greenhouse gas emissions and reduce primary material impacts. Remanufacturing is an example of an appropriate circular strategy and it can be applied in a variety of industries that are intensive materials users. However, most companies have not yet adopted design strategies facilitating remanufacturing at scale. In this paper, we explored how design management can facilitate the implementation of Design for Remanufacturing, based on a literature review and in-depth interviews. Seven companies active in business-to-business markets were interviewed about the design-related opportunities and barriers they see for remanufacturing. We found that access to technical knowledge is not a barrier, whereas integrating this knowledge into the existing design process is. We conclude that design management can contribute to the uptake of Design for Remanufacturing for the following reasons: by making the value of Design for Remanufacturing to the company at large explicit, by building bridges between internal and external stakeholders, and by embedding Design for Remanufacturing into existing processes by means of Key Performance Indicators (KPIs) and roadmaps.
Redesigning continuing professional development: Harnessing design thinking to go from needs assessment to mandate
Authors: Chorley Alexander , Azzam Khalid , Chan Teresa M.
Published: August 2020

Background The world of medicine is constantly changing, and with it the continuing professional development (CPD) needs of physicians. As the CPD landscape is shifting away from unidirectional delivery of knowledge through live large group learning (conferences) and is placing increased emphasis on new approaches for skills training not taught a decade ago, a new approach is needed.

Approach Using design thinking techniques, we hosted a full-day retreat for emergency medicine stakeholders in Hamilton and the surrounding region. Prior to the retreat we collected medico-legal data on emergency physicians in our region and performed a needs assessment survey. At the retreat, we had participants brainstorm ideas for CPD, generate archetypes for end-users, then generate solutions to the problems they had identified. These proposals were presented to the larger group for feedback and refinement.

Evaluation The Design Thinking Retreat generated five main pillars for action by our CPD team. 1) Simulation/procedural learning (staff simulation, procedural skills day, in situ simulation); 2) Asynchronous learning (website and podcast); 3) Synchronous learning (small group sessions for staff); 4) Community connectivity (online platform for collaboration and communication); and 5) Coaching & mentorship (focused coaching for specific practice improvement, improved onboarding for new staff).

Reflection These ideas have vastly increased engagement in CPD. Stakeholder consultation via design thinking may be a key approach for educators to use.
Pancreatic nodule positive for 68-Ga-DOTAPEPTIDE-PET: NET or ectopic spleen? The importance of a good differential diagnosis
Authors: Serra Francesco , De Matteis Gianluca , Delfanti Sara , Feltri Monica , Vanoli Alessandro , Cavenaghi Giorgio , Gallotti Anna , Maestri Marcello , Brugnatelli Silvia
Published: August 2020

Background

Accessory spleen is a congenital defect in which splenic tissue is present outside the spleen. In 20% of cases, accessory spleen is localized within the pancreatic tail, a condition known as IPAS. The identification of this benign anomaly, which affects about 2% of general population, is not easy because it is often mistaken for a pNET which is more common, at around 5%. A 68-Ga-DOTAPEPTIDE-PET normally identifies pNETs with high rate of sensitivity and specificity, but in some conditions, it produces false positives, including IPAS.

Materials and tools

A clinical case we recently encountered, prompted us to review the available medical literature on the topic. Typing “intrapancreatic accessory spleen” into PubMed database and limiting research to the last 10 years yielded 121 results from which we selected the most relevant articles for decision-making, with a brief explanation of the reasons for selecting those. Our analysis focused on the most critical and least descriptive articles, those which clearly indicated the importance of differential diagnosis by promoting the use of advanced investigations in case of pancreatic nodule suspected for IPAS. Ultimately, our objective was to update the available guidelines recommendations.

Discussion and conclusions

Despite concern in the medical literature, a differential IPAS diagnosis is still subordinate to other clinical, radiological, nuclear medicine, and cytological criteria. After reviewing the literature, we recommend that IPAS should always be considered as a possibility before diagnosis of pNET is made. IPAS should be suspected in the presence of the following findings: asymptomatic pancreatic nodule found incidentally, absence of laboratory findings of NETs, localization in the pancreatic tail, between 1 and 3 cm in size with well-defined margins, homogeneous enhancement, and similar attenuation to the spleen on CT and MRI. In these cases, the use of advanced investigations beyond 68-Ga-DOTAPEPTIDE-PET must be systematic. The recognition of IPAS is not only a diagnostic refinement, but it also avoids unnecessary surgery for the patient.
Sexual Function in Women With Polycystic Ovary Syndrome: Design of an Observational Prospective Multicenter Case Control Study
Authors: Pastoor Hester , Both Stephanie , Timman Reinier , Laan Ellen T.M. , Laven Joop S.E.
Published: August 2020

Introduction

The prevalence of polycystic ovary syndrome (PCOS) is 10–15% in women of reproductive age. Its characteristics are (i) clinical or biochemical hyperandrogenism, (ii) oligomenorrhea or amenorrhea, and (iii) polycystic ovaries on ultrasound. PCOS is associated with lower quality of life, depression, anxiety, diabetes, and cardiovascular disease. Treatment commonly entails oral contraceptive use to lower endogenous androgen levels. Androgen levels and comorbidities may affect sexual function. Previous studies have addressed a limited range of possible contributing factors. We will assess sexual function as well as genital and self-reported sexual arousal in a laboratory setting in women with PCOS compared to an age-matched healthy control group. Modulation by biopsychosocial factors mentioned will be studied.

Methods

This is a multicenter prospective case control study. The study population includes healthy women with and without PCOS, aged 18–40 years, in a stable heterosexual relationship for at least 6 months. Power is calculated at 67 participants in each group. Anticipating a drop out of 10%, 150 participants will be recruited.

Main outcome measures

The main outcomes measured are sexual function using the Female Sexual Function Index, Sexual Desire Inventory, and Female Sexual Distress Scale-Revised; genital sexual arousal measured as vaginal pulse amplitude; and self-reported sexual arousal in response to erotic stimuli in a laboratory setting. The mediators that will be investigated include testosterone, free androgen levels, oral contraceptive use, sensitivity to androgens (using CAG repeat length), body mass index, body image, mental health, and self-esteem.

Conclusion

Strengths of this study are the inclusion of a broad range of biopsychosocial outcome measures including DNA analysis, a healthy control group, and standardized assessment of genital and self-reported sexual arousal in a laboratory setting. With the design of this study we aim to provide an insight into which biopsychosocial factors associated with PCOS are related to sexual function, and how sexual function may be affected by treatment. These new insights may help to improve clinical management of PCOS while improving the quality of life.
Chronic Maternal Tobacco Smoke Exposure and/or Alpha-Lipoic Acid Treatment Causes Long-Term Deterioration of Testis and Sexual Behavior in Adult Male Rats
Authors: Yardimci Ahmet , Akkoc Ramazan Fazil , Tektemur Ahmet , Ulker Nazife , Kaya Tektemur Nalan , Erdem Guzel Elif , Canpolat Sinan , Ozan Ibrahim Enver
Published: August 2020

Background

Tobacco use during pregnancy is known to have several negative effects on the offspring's reproductive health in the long term. The use of alpha-lipoic acid (ALA) as a dietary supplement during pregnancy has increased greatly in recent years and has been known to have positive effects on various pregnancy outcomes including miscarriage, diabetic embryopathy, preterm delivery, and congenital malformations.

Aim

To evaluate the effects of tobacco smoke exposure (TSE) on sexual behavior, reproductive parameters, and testicles in adult male rats and to reveal the possible role of ALA administration on these parameters.

Methods

Pregnant rats (n = 7 per group) were treated with tobacco smoke (TS), ALA (20 mg/kg), and TS + ALA for a total of 11 weeks. The following parameters were compared with 8 control rats: puberty parameters, sexual behavior; levels of serum gonadotropins and testosterone, total antioxidant status, and total oxidant status; the expression of the apoptotic protease-activating factor-1 and caspase 9 mRNA levels in the testis; and assessment of immunohistochemistry and terminal deoxynucleotidyl transferase dUTP nick end labeling assay of testis.

Main Outcome Measure

Sexual behavior, changes in puberty parameters, and hormonal and genetic alterations were the outcomes analyzed in this study.

Results

Maternal TSE caused a significant decrease in the number of intromissions compared to the control group. Similarly, ALA decreased erectile function in sexual behavior by decreasing the number of intromissions and intromission ratio in the ALA group compared to the control group. In addition, TSE and ALA treatment caused an impairment of some consummatory sexual behaviors. Also, in parallel with this inhibitory effect, the age of pubertal onset was significantly delayed in the TS + ALA group compared to other groups. Also, histopathological changes in testicular tissue, oxidative stress markers, apoptotic index, and mRNA levels of apoptosis-related genes increased in all treatment groups.

Clinical Implications

The use of ALA and/or tobacco products during pregnancy may adversely affect the reproductive health of male newborns in the long term.

Strengths & Limitations

To the best of our knowledge, this study is the first to show the effects of maternal ALA treatment and/or TSE on the sexual behavior and reproductive parameters in male rats; however, the study is based on an animal model, and the present findings partially reflect the characteristics of human sexual behavior.

Conclusion

Maternal TSE and/or ALA treatment may impair sexual behavior in adulthood in male rats because of testicular damage caused by oxidative stress during gonadal development.
Just the Facts: Extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest
Authors: Fernando Shannon M. , Grunau Brian , Brodie Daniel
Published: August 2020

A 58-year-old man is brought by the ambulance to the emergency department (ED) of a tertiary care centre following an out-of-hospital cardiac arrest. Paramedics were called by the patient's wife after he had collapsed. She immediately initiated cardiopulmonary resuscitation (CPR). Prior to his collapse, he had been complaining of chest pain. His initial rhythm in the field was ventricular fibrillation, and he received defibrillation. An automated CPR device was applied prior to transport. En route, return of spontaneous circulation is achieved. An electrocardiogram shows ST-segment elevation in the anterior leads. Just prior to arrival, the patient suffers recurrent cardiac arrest with two further rounds of unsuccessful defibrillation in the ED. At this point, a decision is made to proceed with extracorporeal cardiopulmonary resuscitation (ECPR), prior to transport for cardiac catheterization.
Consideration of the Management of Pediatric Fever Clinics During the Novel Coronavirus Pneumonia Outbreak
Authors: Ding Hui , Shi Zhaoling , Ruan Zhen , Cheng Xiaoning , Li Ruying , Zhang Lu , Han Xuanming , Zhang Zhihong , Gao Nairong , Guo Yanzi , Zhang Meng , Ma Wenjuan , Liu Ziquan , Zhang Guocheng
Published: August 2020

Since the outbreak of 2019 novel coronavirus (2019-nCoV) infection in Wuhan City, China, pediatric cases have gradually increased. It is very important to prevent cross-infection in pediatric fever clinics, to identify children with fever in pediatric fever clinics, and to strengthen the management of pediatric fever clinics. According to prevention and control programs, we propose the guidance on the management of pediatric fever clinics during the nCoV pneumonia epidemic period, which outlines in detail how to optimize processes, prevent cross-infection, provide health protection, and prevent disinfection of medical staff. The present consideration statement summarizes current strategies on the pre-diagnosis, triage, diagnosis, treatment, and prevention of 2019-nCoV infection, which provides practical suggestions on strengthening the management of pediatric fever clinics during the nCoV pneumonia epidemic period.
Antibiotic-resistant pathogens associated with urinary tract infections in nursing homes: Summary of data reported to the National Healthcare Safety Network Long-Term Care Facility Component, 2013–2017
Authors: Eure Taniece R. , Stone Nimalie D. , Mungai Elisabeth A. , Bell Jeneita M. , Thompson Nicola D.
Published: August 2020

Objective:

Antibiotic resistance (AR) is a growing and highly prevalent problem in nursing homes. We describe selected AR phenotypes from pathogens causing urinary tract infections (UTIs) reported by nursing homes to the National Healthcare Safety Network (NHSN).

Design:

Pathogens and antibiotic susceptibility testing results for UTI events in nursing homes between January 2013 and December 2017 were analyzed. The pathogen distribution and pooled mean proportion of isolates that tested resistant to select antibiotic agents are reported.

Setting and Participants:

US nursing homes voluntarily participating in the Long-Term Care Facility component of the NHSN.

Results:

Overall, 243 nursing homes reported 1 or more UTIs: 121 (50%) were nonprofit facilities, median bed size was 91 (range: 9–801), and average occupancy was 87%. In total, 6,157 pathogens were reported for 5,485 UTI events. Moreover, 9 pathogens accounted for 90% of all reported UTIs; the 3 most frequently identified were Escherichia coli (41%), Proteus species (14%), and Klebsiella pneumoniae/oxytoca (13%). Among E. coli, fluoroquinolone, and extended-spectrum cephalosporin resistance were most prevalent (50% and 20%, respectively). Although Staphylococcus aureus and Enterococcus faecium represented <5% of pathogens reported, they had the highest rates of resistance (67% methicillin resistant and 60% vancomycin resistant, respectively). Multidrug resistance was most common in Pseudomonas aeruginosa (11%). For the resistant phenotypes we assessed, 36% of all UTIs reported were associated with a resistant pathogen.

Conclusions:

This is the first summary of AR among common pathogens causing UTIs reported to NHSN by nursing homes. Improved understanding of the resistance burden among common infections helps inform facility infection prevention and antibiotic stewardship efforts.
Historical Research through the Lens of Women: The Ming Qing Women's Writings Digital Archive and Database
Authors: Fong Grace S.
Published: August 2020

This essay provides an overview of the goals, main features, and digital tools of the Ming Qing Women's Writings (MQWW) project, which contains more than 400 collections of literary writings by women (17th – early 20th centuries). The website (http://digital.library.mcgill.ca/mingqing/) makes accessible a free archive of scanned images of texts with searchable components and a downloadable database. It highlights MQWW's functionalities and actual and potential applications for literary, biographical, and historical research.