bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors Associated with High Preoperative Anxiety: Results from Cluster Analysis
Authors: Jarmoszewicz Krzysztof , Nowicka‐Sauer Katarzyna , Zemła Adam , Beta Sebastian
Published: March 2020

Background

Preoperative anxiety is a common patients’ reaction related to serious adverse events post‐operatively. The aim was to explore the characteristics of cardiac surgery patients experiencing high preoperative anxiety.

Methods

A total of 127 patients (mean age 64.48 years; 34.6% women) assessed their level of anxiety while waiting for surgery, need for information, depression and illness perception with the use of Amsterdam Preoperative Anxiety and Information Scale, Visual Analogue Scale, Hospital Anxiety and Depression Scale and Brief Illness Perception Questionnaire, respectively. Clinical and socio‐demographic data were gathered using structured interview and medical files review. K‐means and hierarchical cluster analyses were performed. α 0.05 was considered significant.

Results

The analysis revealed two different clusters: Cluster 1 involved 46 patients (36.2%; mean age 58.91); Cluster 2 involved 81 patients (63.8%; mean age 67.65). Patients from Cluster 2 had significantly higher anxiety on the day prior to surgery (12.09 vs. 7.93), at a decision stage (6.16 vs. 3.85) and during prehospitalization week (8.01 vs. 4.41). These patients also had more negative illness perception (43.84 vs. 28.35), depressive symptoms (4.9 vs. 2.5) and higher information desire (6.68 vs. 5.54) than patients from Cluster 1. Female sex and planned combined surgery were additional contributors to higher anxiety.

Conclusions

Patients scheduled for cardiac surgery experienced high anxiety throughout the presurgery period. Early intervention addressing not only anxiety but also illness perception and depressive symptoms seems vital. The results can be helpful in planning tailored, needs‐based psycho‐educational intervention which might improve patients’ preoperative psychological state.
Task Deconstruction of Colonic Endoscopic Submucosal Dissection (cESD): An Expert Consensus
Authors: Dickinson Karen J. , Dunkin Brian J. , Nguyen‐Lee John J. , Ali Aman B. , Zajac Stephanie
Published: March 2020

Background

Slow adoption of colonic ESD (cESD) in the US is multifactorial due to: lack of clinical training construct (e.g., gastric ESD in Japan), complication risks, and technical difficulty. More than 28,000 patients/year undergo colonic resection for benign lesions that could be managed effectively with cESD. Selected patients could avoid surgery if procedural adoption of cESD increased due to more accessible training. Current US cESD training is scarce, and existing programs are piecemeal. There is a need to develop an effective national training program for practicing endoscopists. A prerequisite to training development is a comprehensive task list delineating procedural steps. The aim of this work was to describe an evidence‐based method of deconstructing cESD into the essential steps to provide a task list to guide teaching and assessment.

Methods

Subject‐matter experts (SMEs) performed a literature review to create an initial procedural step list. Eleven clinical cESD SMEs and four educational SMEs formed a ‘cESD Working Group’ to develop consensus regarding steps. Through a two‐stage modified Delphi process, a consensus on a comprehensive standard cESD deconstructed task list was reached. The aim was to standardize cESD teaching to efficiently bring a novice to safe performance.

Results

A literature review identified eight initial cESD steps. First‐round Delphi consensus was gained on seven steps. Semi‐structured focus group discussions resulted in consensus on a modified version of 7 of the initial steps, with addition of two steps. Consensus on procedural actions needed to perform each step was achieved after the hands‐on laboratory. The final result was a ten‐step deconstructed task list for standard cESD.

Conclusion

The development of a standardized cESD procedural task list provides a foundation to safely and efficiently teach cESD to practicing endoscopists. This list can be used to develop a training pathway to increase procedural adoption. Selected patients currently undergoing colonic resections could benefit from increased adoption of cESD.
Trajectory and early predictors of apathy development in first-episode psychosis and healthy controls: a 10-year follow-up study
Authors: Lyngstad Siv Hege , Gardsjord Erlend Strand , Engen Magnus Johan , Haatveit Beathe , Ihler Henrik Myhre , Wedervang-Resell Kirsten , Simonsen Carmen , Melle Ingrid , Færden Ann
Published: March 2020

Apathy is prevalent in first-episode psychosis (FEP) and associated with reduced global functioning. Investigations of the trajectory of apathy and its early predictors are needed to develop new treatment interventions. We here measured the levels of apathy over the first 10 years of treatment in FEP and in healthy controls (HC). We recruited 198 HC and 198 FEP participants. We measured apathy with the Apathy Evaluation Scale, self-report version, psychotic symptoms with the Positive and Negative Syndrome Scale, depression with the Calgary Depression Scale for Schizophrenia, functioning with the Global Assessment of Functioning Scale, and also estimated the duration of untreated psychosis (DUP). The longitudinal development of apathy and its predictors were explored using linear mixed models analyses. Associations to functioning at 10 years were investigated using multiple hierarchical linear regression analyses. In HC, mean apathy levels were low and stable. In FEP, apathy levels decreased significantly during the first year of treatment, followed by long-term stability. High individual levels of apathy at baseline were associated with higher apathy levels during the follow-up. Long DUP and high baseline levels of depression predicted higher apathy levels at follow-ups. The effect of DUP was persistent, while the effect of baseline depression decreased over time. At 10 years, apathy was statistically significantly associated with reduced functioning. The early phase of the disorder may be critical to the development of apathy in FEP.
Other primary headaches—thunderclap-, cough-, exertional-, and sexual headache
Authors: Bahra Anish
Published: March 2020

This article reviews the disorders of thunderclap, cough, exertional and sexual headache. These are a group of paroxysmal and precipitated headaches, which often occur in bouts with prolonged remissions. Indometacin seems to be the most effective preventative. Each can occur in primary and secondary form. Thunderclap headache is the most frequently reported headache syndrome associated with a secondary pathology. Discussed are the complexities of whether all patients with thunderclap headache should have further investigation if timely computerised tomography is normal and, the relevance of abnormal imaging in these disorders, differentiating what is deemed to be secondary and managing the pain.
Drooling in Parkinson’s Disease: Prevalence and Progression from the Non-motor International Longitudinal Study
Authors: van Wamelen Daniel J. , Leta Valentina , Johnson Julia , Ocampo Claudia Lazcano , Podlewska Aleksandra M. , Rukavina Katarina , Rizos Alexandra , Martinez-Martin Pablo , Chaudhuri K. Ray
Published: March 2020

Sialorrhoea in Parkinson’s disease (PD) is an often neglected yet key non-motor symptom with impact on patient quality of life. However, previous studies have shown a broad range of prevalence figures. To assess prevalence of drooling in PD and its relationship to quality of life, we performed a retrospective analysis of 728 consecutive PD patients who had a baseline and follow-up assessment as part of the Non-motor International Longitudinal Study (NILS), and for whom drooling presence and severity were available, assessed through the Non-Motor Symptoms Scale (NMSS). In addition, we analysed the prevalence of associated dysphagia through self-reported outcomes. Quality of life was assessed through the PDQ-8 scale. Baseline (disease duration 5.6 years) prevalence of drooling was 37.2% (score ≥ 1 NMSS question 19), and after 3.27 ± 1.74 years follow-up, this was 40.1% (p = 0.17). The prevalence of drooling increased with age (p < 0.001). The severity of drooling, however, did not change (p = 0.12). While in 456 patients without drooling at baseline, only 16% (n = 73) had dysphagia (question 20 of the NMSS), in those with drooling this was 34.3% (p < 0.001). At follow-up, the number of patients with dysphagia had increased, 20.4% with no drooling had dysphagia, and 43.6% with drooling had dysphagia. Both at baseline and follow-up, drooling severity was significantly positively associated with quality of life (PDQ-8; r = 0.199; p < 0.001). In moderately advanced PD patients, subjective drooling occurs in over one-third of patients and was significantly associated with decreased quality of life. Dysphagia occurred significantly more often in patients with drooling.
Trends in incidence of anal cancer in Austria, 1983–2016
Authors: Heer Emily , Hackl Monika , Ferlitsch Monika , Waldhoer Thomas , Yang Lin
Published: March 2020

Background

Recent reports have noted increasing rates of anal cancer among high-income countries worldwide; however, little is known about these trends in Austria.

Methods

Data on anal cancer from 1983 to 2016 were obtained from Statistics Austria. All tumors (n = 3567) were classified into anal squamous cell carcinomas (ASCC), anal adenocarcinomas (AADC), and others (unspecified carcinoma and other specific carcinoma). Anal cancer incidence rates were calculated in 5‑year cycles and incidence average annual percentage change (AAPC) to evaluate trends by sex, histology and age group.

Results

The incidence rate of anal cancer was higher among females than males (relative risk, RR = 1.66, 95% confidence interval, CI: 1.55–1.79, p < 0.0001). From 1983 through 2016, incident anal cancer increased significantly (0.92 per 100,000 person-years to 1.85 per 100,000 person-years, AAPC = 1.93, 95% CI: 1.52 to 2.34, p < 0.0001), particularly among those 40–69 years old. From 1983 through 2016, the increasing anal cancer incidence was primarily driven by ASCC (0.47–1.20 per 100,000 person-years, AAPC = 2.23, 95% CI: 1.58 to 2.88, p < 0.0001) and others (other than ASCC and AADC, AAPC = 1.78, 95% CI: 1.01–2.55), yet stable in AADC (AAPC = 0.88, 95% CI: −0.48–2.25).

Conclusions

Despite being a rare cancer in Austria, the increase in anal cancer incidence rate from 1983 to 2016 was substantial, particularly in ASCC. The observed rising trends reflect the need to investigate associated risk factors that have increased over time to inform preventive measures.
Semi-invariant Riemannian metrics in hydrodynamics
Authors: Bauer Martin , Modin Klas
Published: March 2020

Many models in mathematical physics are given as non-linear partial differential equation of hydrodynamic type; the incompressible Euler, KdV, and Camassa–Holm equations are well-studied examples. A beautiful approach to well-posedness is to go from the Eulerian to a Lagrangian description. Geometrically it corresponds to a geodesic initial value problem on the infinite-dimensional group of diffeomorphisms with a right invariant Riemannian metric. By establishing regularity properties of the Riemannian spray one can then obtain local, and sometimes global, existence and uniqueness results. There are, however, many hydrodynamic-type equations, notably shallow water models and compressible Euler equations, where the underlying infinite-dimensional Riemannian structure is not fully right invariant, but still semi-invariant with respect to the subgroup of volume preserving diffeomorphisms. Here we study such metrics. For semi-invariant metrics of Sobolev $$H^k$$Hk-type we give local and some global well-posedness results for the geodesic initial value problem. We also give results in the presence of a potential functional (corresponding to the fluid’s internal energy). Our study reveals many pitfalls in going from fully right invariant to semi-invariant Sobolev metrics; the regularity requirements, for example, are higher. Nevertheless the key results, such as no loss or gain in regularity along geodesics, can be adopted.
Improved quality assessment of colour surfaces for additive manufacturing based on image entropy
Authors: Okarma Krzysztof , Fastowicz Jarosław
Published: March 2020

A reliable automatic visual quality assessment of 3D-printed surfaces is one of the key issues related to computer and machine vision in the Industry 4.0 era. The colour-independent method based on image entropy proposed in the paper makes it possible to detect and identify some typical problems visible on the surfaces of objects obtained by additive manufacturing. Depending on the quality factor, some of such 3D printing failures may be corrected during the printing process or the operation can be aborted to save time and filament. Since the surface quality of 3D-printed objects may be related to some mechanical or physical properties of obtained objects, its fast and reliable evaluation may also be helpful during the quality monitoring procedures. The method presented in the paper utilizes the assumption of the increase of image entropy for irregularly distorted 3D-printed surfaces. Nevertheless, because of the local nature of distortions, the direct application of the global entropy does not lead to satisfactory results of automatic surface quality assessment. Therefore, the extended method, based on the combination of the local image entropy and its variance with additional colour adjustment, is proposed in the paper, leading to the proper classification of 78 samples used during the experimental verification of the proposed approach.
Take-over expectation and criticality in Level 3 automated driving: a test track study on take-over behavior in semi-trucks
Authors: Lotz Alexander , Russwinkel Nele , Wohlfarth Enrico
Published: March 2020

With the introduction of advanced driving assistance systems managing longitudinal and lateral control, conditional automated driving is seemingly in near future of series vehicles. While take-over behavior in the passenger car context has been investigated intensively in recent years, publications on semi-trucks with professional drivers are sparse. The effects influencing expert drivers during take-overs in this context lack thorough investigation and are required to design systems that facilitate safe take-overs. While multiple findings seem to cohere in passenger cars and semi-trucks, these findings rely on simulated studies without taking environments as found in the real world into account. A test track study was conducted, simulating highway driving with 27 professional non-affiliated truck drivers. The participants drove an automated Level 3 semi-truck while a non-driving-related task was available. Multiple time critical take-over situations were initiated during the drives to investigate four main objectives regarding driver behavior. (1) With these results, comparison of reaction times and behavior can be drawn to previous simulator studies. The effect of situation criticality (2) and training (3) of take-over situations is investigated. (4) The influence of warning expectation on driver behavior is explored. Results obtained displayed very quick time to hands on steering and time to first reaction all under 2.4 s. Highly critical situations generate very quick reaction times M = 0.81 s, while the manipulation of expectancy yielded no significant variation in reaction times. These reaction times serve as a reference of what can be expected from drivers under optimal take-over conditions, with quick reactions at high speed in critical situations.
Genetic diversity of provitamin-A cassava (Manihot esculenta Crantz) in Sierra Leone
Authors: Kamanda I. , Blay E. T. , Asante I. K. , Danquah A. , Ifie B. E. , Parkes E. , Kulakow P. , Rabbi I. , Conteh A. , Kamara J. S. , Mensah H. K. , Whyte J. B. A. , Sesay Sayo
Published: March 2020

Understanding the genetic diversity among accessions and germplasm is an important requirement for crop development as it allows for the selection of diverse parental combinations for enhancing genetic gain in varietal selection, advancement and release. The study aimed to characterize 183 provitamin A cassava (Manihot esculentaCrantz) accessions and five Sierra Leonean varieties using morphological traits, total carotenoid content and SNP markers to develop a collection for conservation and further use in the cassava breeding program. Both morphological parameters and 5634 SNP markers were used to assess the diversity among the provitamin-A cassava accessions and varieties. Significant differences were observed among the accessions for most of the traits measured. The first five PCs together accounted for 70.44% of the total phenotypic variation based on yield and yield components among the 183 provitamin-A cassava accessions and five Sierra Leonean varieties. The present study showed that provitamin-A cassava accessions in Sierra Leone have moderate to high diversity based on morphological and molecular assessment studies. The similarity index among the 187 and 185 cassava accessions grouped them into 6 and 9 distinct clusters based on morphological and molecular analyses, respectively. A significant positive, but low correlation (r = 0.104;p < 0.034), was observed between the two dendrograms. The results obtained will serve as a guide and basis of germplasm management and improvement for total carotenoid content, yield and African cassava mosaic disease resistance in Sierra Leone.
Type 2 diabetes – unmet need, unresolved pathogenesis, mTORC1-centric paradigm
Authors: Bar-Tana Jacob
Published: March 2020

The current paradigm of type 2 diabetes (T2D) is gluco-centric, being exclusively categorized by glycemic characteristics. The gluco-centric paradigm views hyperglycemia as the primary target, being driven by resistance to insulin combined with progressive beta cells failure, and considers glycemic control its ultimate treatment goal. Most importantly, the gluco-centric paradigm considers the non-glycemic diseases associated with T2D, e.g., obesity, dyslipidemia, hypertension, macrovascular disease, microvascular disease and fatty liver as ‘risk factors’ and/or ‘outcomes’ and/or ‘comorbidities’, rather than primary inherent disease aspects of T2D. That is in spite of their high prevalence (60–90%) and major role in profiling T2D morbidity and mortality. Moreover, the gluco-centric paradigm fails to realize that the non-glycemic diseases of T2D are driven by insulin and, except for glycemic control, response to insulin in T2D is essentially the rule rather than the exception. Failure of the gluco-centric paradigm to offer an exhaustive unifying view of the glycemic and non-glycemic diseases of T2D may have contributed to T2D being still an unmet need. An mTORC1-centric paradigm maintains that hyperactive mTORC1 drives the glycemic and non-glycemic disease aspects of T2D. Hyperactive mTORC1 is proposed to act as double-edged agent, namely, to interfere with glycemic control by disrupting the insulin receptor-Akt transduction pathway, while concomitantly driving the non-glycemic diseases of T2D. The mTORC1-centric paradigm may offer a novel perspective for T2D in terms of pathogenesis, clinical focus and treatment strategy.
Formal institution building in financialized capitalism: the case of repo markets
Authors: Wansleben Leon
Published: March 2020

Money markets are at the heart of financialized capitalism, as those markets that provide the funding liquidity needed for credit creation and leveraged trading. How have these markets evolved, grown, and become critical for larger financial flows? To answer this question, I distinguish an early period of financial globalization marked by regulatory arbitrage, offshoring, deregulation, and informal trading practices from a period of regime-consolidation marked by formal institutionalization. Concentrating on repo markets as the key funding sources for market-based banking, I demonstrate that new institutional arrangements for these markets were initiated by private sector associations, but supported and authorized by public authorities. Bond trader groups codified new contractual arrangements and these were validated via reforms of bankruptcy codes and changes in central banks’ policy frameworks in the United States and European Union. Through these modifications and re-articulations in institutional conditions, transactions and large exposures on money markets became routine affairs—for shadow banking actors like money market funds as well as for commercial banks. The article concludes by discussing the continuity of regime-consolidation efforts after the transatlantic financial crisis and hypothesizes that they reveal “neo-patrimonial” features.
Effect of Bariatric Surgery on Diagnosed Chronic Kidney Disease and Cardiovascular Events in Patients with Insulin-treated Type 2 Diabetes: a Retrospective Cohort Study from a Large UK Primary Care Database
Authors: Alkharaiji Mohammed , Anyanwagu Uchenna , Donnelly Richard , Idris Iskandar
Published: March 2020

Aims

To compare the effect of bariatric surgery on renal, chronic kidney disease (CKD) and cardiovascular (CV) outcomes among obese patients with insulin-treated type 2 diabetes (T2D) with and without microalbuminuria (i.e., uACR > 3.0 mg/mmol).

Methods

A retrospective cohort study was conducted among 11,125 active patients with T2D from The Health Improvement Network (THIN) database. Propensity score matching (up to 1:6 ratio) was used to identify patients who underwent bariatric surgery (N = 131) with a non-bariatric cohort (N = 579). Follow-up was undertaken for 10 years (6487 person-years) to compare differences in risk of cardiovascular events and in renal outcomes.

Results

For the matched cohort at baseline: mean age 52 ± 13 years (60% female); weight 116 ± 25 kg, body mass index (BMI) 41 ± 9kg/m2, estimated glomerular filtration rate (eGFR); 70.4 ± 20 mL/min/1.73 m2, and median albumin-creatinine ratio (uACR) 2.0 mg/mmol (interquartile range (IQR): 0.9–5.2 mg/mmol). Bariatric surgery was associated with a 54% reduction in developing CKD compared to their matched non-bariatric cohort (adjusted hazard ratio [aHR]: 0.46; 95%CI: 0.24–0.85, P = 0.02). Among patients with microalbuminuria at baseline, bariatric surgery was protective against CKD (aHR: 0.42, 95%CI: 0.18–0.99, P = 0.050). eGFR was significantly increased from baseline favouring the bariatric group during 75% of the follow-up time (calculated mean difference between groups: 4.1 mL/min/1.73 m2; P < 0.05), especially at 5-year point (74.2 vs 67.8 mL/min/1.73 m2; P < 0.001). However, no significant change was observed with non-fatal CVD episodes (aHR: 0.36, 95%CI: 0.11–1.13, P = 0.079). Albumin levels were significantly reduced throughout the 2 years following the surgery (3.9 vs 4.1 g/dL, P < 0.001). uACR and total protein levels had little or no statistical association to the intervention.

Conclusion

Bariatric surgery may protect patients with diabetes with or without microalbuminuria against the risk of CKD and with a modest protective effect on non-fatal CVD risk. Bariatric surgery is also associated with improvements in overall renal outcomes such as eGFR.
Multicenter, Phase 1, Open Prospective Trial of Gastric Electrical Stimulation for the Treatment of Obesity: First-in-Human Results with a Novel Implantable System
Authors: Paulus G.F. , van Avesaat M. , van Rijn S. , Alleleyn A.M.E , Swain J.M. , Abell T.L , Williams D.B. , Bouvy N.D. , Masclee A.A.M.
Published: March 2020

Background and Aims

To assess safety of the Exilis™ gastric electrical stimulation (GES) system and to investigate whether the settings can be adjusted for comfortable chronic use in subjects with morbid obesity. Gastric emptying and motility and meal intake were evaluated.

Method

In a multicenter, phase 1, open prospective cohort study, 20 morbidly obese subjects (17 female, mean BMI of 40.8 ± 0.7 kg/m2) were implanted with the Exilis™ system. Amplitude of the Exilis™ system was individually set during titration visits. Subjects underwent two blinded baseline test days (GES ON vs. OFF), after which long-term, monthly follow-up continued for up to 52 weeks.

Results

The procedure was safe, and electrical stimulation was well tolerated and comfortable in all subjects. No significant differences in gastric emptying halftime (203 ± 16 vs. 212 ± 14 min,p > 0.05), food intake (713 ± 68 vs. 799 ± 69 kcal,p > 0.05), insulin AUC (2448 ± 347 vs. 2186 ± 204,p > 0.05), and glucose AUC (41 ± 2 vs.41 ± 2,p > 0.05) were found between GES ON and OFF. At week 4, 13, and 26, a significant (p < 0.01) reduction in weight loss was observed but not at week 52. At this time point, the mean excess weight loss (EWL) was 14.2 ± 4.5%.

Conclusion

Gastric electrical stimulation with the Exilis™ system can be considered as safe. No significant effect on food intake, gastric emptying, or gastric motility was observed. The reduction in weight loss with Exilis™ GES was significant but short lasting. Further electrophysiological research is needed to gain more insight in optimal stimulation parameters and lead localization.
Lipoprotein insulin resistance score and branched-chain amino acids increase after adrenalectomy for unilateral aldosterone-producing adenoma: a preliminary study
Authors: Adolf Christian , Berends Annika M. A. , Connelly Margery A. , Reincke Martin , Dullaart Robin P. F.
Published: March 2020

Background and aims

Primary aldosteronism (PA) due to unilateral aldosterone-producing adenoma (APA) is preferentially treated by unilateral adrenalectomy (ADX), but little is known about the changes in lipid and glucose metabolism that may occur after ADX.

Methods

We studied 19 non-diabetic patients who did not use lipid-lowering drugs with PA due to APA before and 6 months after unilateral ADX. Fasting plasma lipids, lipoprotein subfractions, branched-chain amino acids (BCAA), and GlycA, a pro-inflammatory glycoprotein biomarker, were measured by nuclear magnetic resonance (NMR) spectroscopy. The Lipoprotein Insulin Resistance (LP-IR) score, which is based on six lipoprotein variables, was calculated.

Results

In all patients, hyperaldosteronism was resolved after ADX. Body mass index and fasting plasma glucose were unchanged, but HbA1c increased (p = 0.002). Plasma triglycerides, large triglyceride-rich lipoprotein (TRL) cholesterol, and large TRL particles were increased (p < 0.01), resulting in an increase in TRL size (p = 0.027). High-density lipoprotein size was decreased (p = 0.015). LP-IR scores (p = 0.001) and total BCAA (p = 0.017) were increased, but GlycA remained unaltered.

Conclusions

Based on increases in LP-IR scores and BCAA, which each have been shown to predict new onset type 2 diabetes mellitus independent of conventional risk factors in the general population, this preliminary study suggests that diabetes risk is not improved but may even be increased after ADX for APA despite remission of PA.
Quantitative Risk Analysis of a Rainfall-Induced Complex Landslide in Wanzhou County, Three Gorges Reservoir, China
Authors: Xiao Lili , Wang Jiajia , Zhu Yanbo , Zhang Jun
Published: March 2020

On 4 April 2013, a 1.5 million cubic meter landslide occurred in Sunjia Town, Wanzhou County, Three Gorges Reservoir, China. After initiation, the Sunjia landslide traveled about 30 m toward the northeast and destroyed most of the infrastructure in its path. The landslide was triggered by heavy rainfall and previous slope excavations, but this slope also displayed a complicated failure process: the overlying earth slope first deformed and then induced sliding along underlying rock surfaces. Surface displacements that resulted from continuous creeping of the post-event slope were observed by an emergency monitoring system that revealed the disequilibrium state of the slope. To discuss the stability and future movements of the remaining unstable debris deposits, we developed a geotechnical model of the post-slide slope, calculated how it can slide again in an extreme rainfall scenario, and estimated the potential runout distance using the Tsunami Squares method. We then estimated the number of people and the value of the infrastructure threatened by this potential landslide. Lastly, we analyzed the vulnerability of elements at risk and quantitatively evaluated the hazard risk associated with the most dangerous scenario. This quantitative risk analysis provides a better understanding of, and technical routes for, hazard mitigation of rainfall-induced complex landslides.
An Australasian Commentary on the AASM Manual for the Scoring of Sleep and Associated Events
Authors: Jorgensen Greg , Downey Carl , Goldin Jeremy , Melehan Kerri , Rochford Peter , Ruehland Warren
Published: March 2020

The aim of this document was to provide a commentary on the AASM Manual for Scoring of Sleep and Associated Events in an Australasian context. A panel of Australasian sleep professionals developed the commentary. Each member was tasked with reviewing an assigned section and reporting back with potential AASM Manual clarifications and alterations. These suggestions were evaluated by the panel and ultimately resulted in the recommendations in this document. The panel recognised that the AASM manual significantly advanced the standardisation of polysomnography recording, analysis, and reporting; however, there were sections of the AASM Manual where the panel determined there were clarifications, additions, or alterations required. Some of the key panel recommendations included: (1) advice to exclude arousals in awake epochs in the arousal index, (2) recommendation of a single hypopnoea definition, as well as single options for EEG and EOG placements, (3) a minimum duration for the central and mixed components of a mixed apnoea, (4) the addition of a baseline definition for scoring respiratory events, (5) the addition of criteria for defining oxygen desaturation, and (6) advice change so that the scoring and reporting of respiratory effort-related arousals (RERAs) and snoring is ‘recommended’ rather than ‘optional’. While it is anticipated that the recommendations will improve standardisation across Australasian sleep services many of the recommendations are also relevant in a global setting and should be considered for inclusion in future updates of the AASM Manual.
Loss of Nanoparticles in a Particulate Matter Sampling System Applied for Environmental Ultrafine Particle Measurements
Authors: Zoller Julian , Gulden Jonas , Meyer Jörg , Dittler Achim
Published: March 2020

Current air monitoring networks consist of many measuring stations equipped with sampling systems for the measurement of PM2.5 and PM10 particulate matter. To measure the quantity of particulate matter, the sample air flow is fed to the measuring device through a sampling system. In Baden Württemberg, but also across a wide area in Germany, these sampling systems consist of a Sigma-2-Sampling Head (manufacturer Palas GmbH) and an Intelligent Aerosol Drying System (IADS, manufacturer Palas GmbH). To investigate the suitability of these two common components for sampling of ultrafine particles (< 100 nm), the particle loss inside a sampling system consisting of a Sigma-2-Sampling Head, an IADS, and an additional nafion-dryer (MD-700-24S-1, manufacturer Perma Pure LLC) is measured in this study. A low sampling flow rate of only 0.9 l/min was employed to reduce energy consumption, complexity, and the cost of additional instrumentation. This sample flow rate is typical for scanning mobility particle sizers which are commonly used to measure ultrafine particles. The investigations show a 37% loss of spherical 10 nm copper particles in the used sampling system, which is higher than the allowed losses specified in DIN CEN/TS 16976 for 7 nm particles. The root cause of these losses was investigated and correlations were derived to describe the particle penetration in the sampling system.
Designs and methods for implementation research: Advancing the mission of the CTSA program
Authors: Hwang Soohyun , Birken Sarah A. , Melvin Cathy L. , Rohweder Catherine L. , Smith Justin D.
Published: March 2020

Introduction:

The US National Institutes of Health (NIH) established the Clinical and Translational Science Award (CTSA) program in response to the challenges of translating biomedical and behavioral interventions from discovery to real-world use. To address the challenge of translating evidence-based interventions (EBIs) into practice, the field of implementation science has emerged as a distinct discipline. With the distinction between EBI effectiveness research and implementation research comes differences in study design and methodology, shifting focus from clinical outcomes to the systems that support adoption and delivery of EBIs with fidelity.

Methods:

Implementation research designs share many of the foundational elements and assumptions of efficacy/effectiveness research. Designs and methods that are currently applied in implementation research include experimental, quasi-experimental, observational, hybrid effectiveness–implementation, simulation modeling, and configurational comparative methods.

Results:

Examples of specific research designs and methods illustrate their use in implementation science. We propose that the CTSA program takes advantage of the momentum of the field's capacity building in three ways: 1) integrate state-of-the-science implementation methods and designs into its existing body of research; 2) position itself at the forefront of advancing the science of implementation science by collaborating with other NIH institutes that share the goal of advancing implementation science; and 3) provide adequate training in implementation science.

Conclusions:

As implementation methodologies mature, both implementation science and the CTSA program would greatly benefit from cross-fertilizing expertise and shared infrastructures that aim to advance healthcare in the USA and around the world.
Intensive care unit rounding checklists to reduce catheter-associated urinary tract infections
Authors: Nassikas Nicholas J. , Monteiro Joao Filipe G. , Pashnik Barbara , Lynch Judith , Carino Gerardo , Levinson Andrew T.
Published: March 2020

Objective:

To assess whether the implementation of an intensive care unit (ICU) rounding checklist reduces the number of catheter-associated urinary tract infections (CAUTIs).

Design:

Retrospective before-and-after study that took place between March 2013 and February 2017.

Setting:

An academic community hospital 16-bed, mixed surgical, cardiac, medical ICU.

Patients:

Participants were all patients admitted to the adult mixed ICU and had a diagnosis of CAUTI.

Intervention:

Initiation of an ICU rounding checklist that prompts physicians to address any use of urinary catheters with analysis comparing the preintervention period before roll out of the rounding checklist versus the postintervention periods.

Results:

There were 19 CAUTIs and 9,288 urinary catheter days (2.04 CAUTIs per 1,000 catheter days). The catheter utilization ratio increased in the first year after the intervention (0.67 vs 0.60;P= .0079), then decreased in the second year after the intervention (0.53 vs 0.60;P= .0992) and in the third year after the intervention (0.53 vs 0.60;P= .0224). The rate of CAUTI (ie, CAUTI per 1,000 urinary catheter days) decreased from 4.62 before the checklist was implemented to 2.12 in the first year after the intervention (P= .2104). The CAUTI rate was 0.45 in the second year (P= .0275) and 0.96 in the third year (P= .0532).

Conclusions:

Our study suggests that utilization of a daily rounding checklist is associated with a decrease in the rates of CAUTI in ICU patients. Incorporating a rounding checklist is feasible in the ICU.
Effect of dietary l-carnitine supplementation to sows during gestation and/or lactation on sow productivity, muscle maturation and lifetime growth in progeny from large litters
Authors: Rooney Hazel B. , O’Driscoll K. , Silacci P. , Bee G. , O’Doherty J. V. , Lawlor P. G.
Published: March 2020

Genetic selection for increased sow prolificacy has resulted in decreased mean piglet birth weight. This study aimed to investigate the effect of l-carnitine (CAR) supplementation to sows during gestation and/or lactation on sow productivity, semitendinosus muscle (STM) maturity and lifetime growth in progeny. Sixty-four sows were randomly assigned to one of the four dietary treatments at breeding until weaning: CONTROL (0 mg CAR/d), GEST (125 mg CAR/d during gestation), LACT (250 mg CAR/d during lactation) and BOTH (125 mg CAR/d during gestation and 250 mg CAR/d during lactation). The total number of piglets born per litter was greater for sows supplemented with CAR during gestation (17·3 v. 15·8 (sem 0·52); P < 0·05). Piglet birth weight (total and live) was unaffected by sow treatment (P > 0·05). Total myofibre number (P = 0·08) and the expression level of selected myosin heavy chain genes in the STM (P < 0·05) were greater in piglets of sows supplemented with CAR during gestation. Pigs from sows supplemented with CAR during gestation had lighter carcasses at slaughter than pigs from non-supplemented sows during gestation (83·8 v. 86·7 (sem 0·86) kg; P < 0·05). In conclusion, CAR supplementation during gestation increased litter size at birth without compromising piglet birth weight. Results also showed that the STM of piglets born to sows supplemented with CAR during gestation was more developed at birth. However, carcass weight at slaughter was reduced in progeny of sows supplemented with CAR during gestation. The CAR supplementation strategy applied during gestation in this study could be utilised by commercial pork producers to increase sow litter size and improve offspring muscle development.
Design and expression of polytopic construct of cathepsin-L1, SAP-2 and FhTP16.5 proteins of Fasciola hepatica
Authors: Aghamolaei S. , Kazemi B. , Bandehpour M. , Ranjbar M.M. , Rouhani S. , Javadi Mamaghani A. , Tabaei S.J.S.
Published: March 2020

The enzyme-linked immunosorbent assay (ELISA) technique can play an important role in the early detection of fascioliasis. However, they have some diagnostic limitations, including cross-reaction with other helminths. It seems that the combination of recombinant parasite proteins as antigen can reduce these problems. Hence, the present study was aimed to design and confirm the antigenic recombinant multi-epitope (rMEP) construct of three protein epitopes (linear and conformational B-cell epitopes) of the parasite using immunoinformatic tools. For this purpose, the tertiary structures of Fasciola hepatica cathepsin-L1, saposin-like protein 2 and 16.5-kDa tegument-associated protein were predicted using the I-TASSER server. Validation of the modelled structures was performed by Ramachandran plots. The antigenic epitopes of the proteins were achieved by analysing the features of the IEDB server. The synthesized gene was cloned into the pET-22b (+) expression vector and transformed into the Escherichia coli BL21. Sodium dodecyl sulfate polyacrylamide gel electrophoresis was used to verify and analyse the expression of the rMEP protein. Western blotting was utilized to confirm rMEP protein immunogenicity in two forms, one using an anti-His tag antibody and the other with human pooled sera samples (fascioliasis, non-fascioliasis and negative control sera). Our results demonstrated that the rMEP designed for the three proteins of F. hepatica was highly antigenic, and immune-detection techniques confirmed the antigen specificity. In conclusion, the presented antigenic multi-epitope may be very helpful to develop serodiagnostic kits such as indirect ELISA to evaluate the proper diagnosis of fascioliasis in humans and ruminants.
In vitro nematocidal activity of commercial fatty acids and β-sitosterol against Haemonchus contortus
Authors: Pineda-Alegría J.A. , Sánchez J.E. , González-Cortazar M. , von Son-de Fernex E. , González-Garduño R. , Mendoza-de Gives Pedro , Zamilpa A. , Aguilar-Marcelino L.
Published: March 2020

Haemonchus contortus is a haematophagous gastrointestinal nematode (GIN) that causes severe anaemia and even death in small ruminants, negatively impacting the economic viability of farms. Traditionally, this parasite has been controlled with chemical compounds; however, inadequate use of these types of products has favoured the emergence of anthelmintic resistance. Therefore, it is necessary to search for alternatives for GIN control. Previous studies have reported the anthelmintic activity of edible mushroom extracts against H. contortus. A recent study reported that a fraction constituted of different fatty acids and β-sitosterol isolated from the basidiomata of the edible mushroom Pleurotus djamor ECS-123 has ovicidal and larvicidal activity against H. contortus. Thus, this study aimed to assess the anthelmintic activity of the pure molecules: pentadecanoic acid, palmitic acid, β-sitosterol, stearic acid and linoleic acid. For this purpose, an egg-hatching inhibition test was carried out in which the compounds were evaluated individually and in combination at a final concentration of 20 mg mL−1. Furthermore, larval mortality was assessed using a combination of the five commercial compounds previously mentioned at different concentrations (1.25–20 mg mL−1). Palmitic acid and stearic acid, in some combinations, inhibited H. contortus egg hatching by 100%. On the other hand, in the larval mortality test, the combination of the five compounds showed dose-dependent behaviour, and 100% mortality was obtained 24 h post-incubation. Pure molecules and their combinations have anthelmintic-like activity against the eggs and larvae of H. contortus.
Endoscopic visualisation of the round window during cochlear implantation
Authors: Jain A , Sharma R , Passey J C , Meher R , Bansal R
Published: March 2020

Background

Endoscopes provide a magnified view of the middle ear and visualisation of hidden areas. Otoendoscopes facilitate excellent visualisation of the round window niche during cochlear implantation.

Objective

To compare microscopic and endoscopic visualisation of the round window membrane during cochlear implantation in 20 patients.

Methods

Twenty patients who underwent cochlear implantation were included in the study. After maximum exposure of the round window, the accessibility of the round window membrane was graded according to the St Thomas Hospital classification, first by microscope and then by endoscope.

Results

With the use of the endoscope, visualisation of the round window membrane improved in all the patients as compared to the microscope. The electrode array was inserted via a round window or extended round window approach in all but two cases; the latter cases required bony cochleostomy because of unfavourable anatomy.

Conclusion

The main benefit of endoscope-assisted cochlear implantation is improved visibility of the round window region.
Voice outcome after vocal fold injection augmentation with carboxymethyl cellulose versus calcium hydroxyapatite
Authors: Cohen J T , Benyamini L
Published: March 2020

Background

Vocal fold injection augmentation is a recognised treatment modality for glottic insufficiency. Causes of glottal closure insufficiency include vocal fold paralysis, paresis, atrophy, sulcus vocalis, scarring and vocal fold deficiency after laryngeal surgery. A variety of materials exist for injection augmentation. This study aimed to compare voice improvement after injection augmentation between two injectable materials: carboxymethyl cellulose and calcium hydroxyapatite.

Method

This retrospective study included 66 consecutive patients with glottic insufficiency who underwent injection augmentation.

Results

Among the patients who received their first injection augmentation with carboxymethyl cellulose and their second injection augmentation with calcium hydroxyapatite (n = 28), voice quality improved significantly after both injection augmentations. No significant differences were observed in any of the objective and subjective voice quality measurements examined following carboxymethyl cellulose and calcium hydroxyapatite injections.

Conclusion

Voice improvement after injection augmentation depends mainly on the improvement of glottic closure, rather than the injection material.
Phylogenetic evidence for an expanded circumscription of Gabura (Arctomiaceae)
Authors: Magain Nicolas , Spribille Toby , DiMeglio Joseph , Nelson Peter R. , Miadlikowska Jolanta , Sérusiaux Emmanuël
Published: March 2020

Since the advent of molecular taxonomy, numerous lichen-forming fungi with homoiomerous thalli initially classified in the family Collemataceae Zenker have been transferred to other families, highlighting the extent of morphological convergence within Lecanoromycetes O. E. Erikss. & Winka. While the higher level classification of these fungi might be clarified by such transfers, numerous specific and generic classifications remain to be addressed. We examined the relationships within the broadly circumscribed genus Arctomia Th. Fr., which has been the recipient of several transfers from Collemataceae. We demonstrated that Arctomia insignis (P. M. Jørg. & Tønsberg) Ertz does not belong to Arctomia s. str. but forms a strong monophyletic group with Gabura fascicularis (L.) P. M. Jørg. We also confirmed that Arctomia borbonica Magain & Sérus. and the closely related Arctomia insignis represent two species. We formally transferred A. insignis and A. borbonica to the genus Gabura Adans. and introduced two new combinations: Gabura insignis and Gabura borbonica. We reported Gabura insignis from Europe (Scotland and Ireland) for the first time. While material from Europe and North America is genetically almost identical, specimens from Madagascar, South Africa and Reunion Island belong to three distinct phylogenetic lineages, all of which are present in the latter area and may represent distinct species. In its current circumscription, the genus Gabura may contain up to six species, whereas Arctomia s. str. includes only two species (A. delicatula Th. Fr. and A. teretiuscula P. M. Jørg.). The Gabura insignis group is shown to have an unexpectedly large, subcosmopolitan distribution. With the extended sampling from Arctomiaceae Th. Fr., the placement of Steinera sorediata P. James & Henssen in the genus Steinera Zahlbr. is confirmed and the presence of a new Steinera species from Chile is highlighted.
Associations between ambient air pollution and daily incidence of pediatric hand, foot and mouth disease in Ningbo, 2014–2016: a distributed lag nonlinear model
Authors: Gu Shaohua , Li Decheng , Lu Beibei , Huang Ruixue , Xu Guozhang
Published: March 2020

Hand, foot and mouth disease (HFMD) has high prevalence around the world, with serious consequences for children. Due to the long survival period of HFMD virus in ambient air, air pollutants may play a critical role in HFMD epidemics. We collected data on daily cases of HFMD among children aged 0–14 years in Ningbo City between 2014 and 2016. Distributed lag nonlinear models were used to assess the effects of particulate matter (PM2.5), sulphur dioxide (SO2), nitrogen dioxide (NO2) and ozone (O3) on the daily incidence of HFMD among children, with analyses stratified by gender and age. Compared with moderate levels of air pollution, high SO2 levels had a relative risk (RR) of 2.32 (95% CI 1.42–3.79) and high NO2 levels had a RR of 2.01 (95% CI 1.22–3.31). The RR of O3 was 2.12 (95% CI 1.47–3.05) and that of PM2.5 was 0.77 (95% CI 0.64–0.92) at moderate levels of air pollution. Specifically, high levels of SO2 and NO2 had RRs of 2.39 (95% CI 1.44–3.96) and 2.02 (95% CI 1.21–3.39), respectively, among 0–4-year-old children, while high O3 had an RR of 2.31 (95% CI 1.09–4.89) among 5–14-year-old children. Our findings suggest significant associations of high SO2 and NO2 levels and moderate O3 levels in HFMD epidemics, and also indicate that air pollution causes lagged effects on HFMD epidemics. Our study provides practical and useful data for targeted prevention and control of HMFD based on environmental evidence.