bluuebunny/crossref_metadata_2025 huggingface dataset:
Movement of target organs and anatomical landmarks caused by body position change during urological laparoscopic surgery
Authors: Nagaya Naoya , Shimizu Fumitaka , Kanayama Mayuko , Hotta Zen‐u , Nozaki Taishi , Wakumoto Yoshiaki , Tujimura Akira , Horie Shigeo
Published: March 2019

Introduction

The aim of our study was to elucidate the impact of patients' physical characteristics on the movement of target organs and anatomical landmarks by comparing supine and lateral CT images.

Methods

This study consisted of 55 patients who underwent laparoscopic surgery in the lateral position. CT images of the area between the abdomen and pelvis were taken preoperatively with patients in both supine and lateral positions. We measured the moving distance of target organs and anatomical landmarks on the body surface used for access port settings. We investigated which covariates from patients' body composition most affected moving distance in correlation analysis. Then, using multiple linear regression analysis, we examined whether we could predict the movement of target organs and anatomical landmarks solely based on information obtained from supine CT images.

Results

The moving distance of both the hilum of the kidney and the outer edge of the rectus abdominis muscle were significantly associated with some physical characteristics. Multiple regression analysis showed that a larger visceral fat area could be a useful index for predicting the movement of the kidney toward the counter side. Lower CT density of back muscles and higher BMI could be useful indexes for predicting the movement of the rectus abdominis muscle.

Conclusion

Our results suggested that body composition characteristics obtained from preoperative CT images can help predict the movement of target organs and anatomical landmarks used to determine proper port‐site placement for laparoscopic surgery performed with the patient in the lateral position.
‘You're in this world now’: Students’, teachers’, and parents’ experiences of school transition and how they feel it can be improved
Authors: Bagnall Charlotte Louise , Skipper Yvonne , Fox Claire Louise
Published: March 2019

Background

Primary–secondary school transition is a major life event for 11‐year‐old children in the United Kingdom and can also be a stressful period for parents and teachers. However, most research focuses on the impact of transition on children's academic performance and social well‐being and we have a limited understanding of their emotional experiences in the lead up to and during the transition, from the perspective of key stakeholders: students, parents, and teachers.

Aims

To explore transfer students’, parents’, and teachers’ experiences in the lead up to and over the transition period, and how they feel it could be improved.

Sample

The sample consisted of 45 year seven students, 8 year seven parents, 8 year seven teachers, and 8 year six teachers, recruited from five primary and five secondary schools.

Method

Students participated in face‐to‐face semi‐structured focus groups and adults in asynchronous online focus groups. Transcribed audio‐recordings were analysed using inductive thematic analysis.

Results

Students, parents, and teachers were shown to navigate a similar process over primary–secondary school transition. All talked about managing their own and others’ emotions, relationships, and expectations. These were shaped by shared communication across primary and secondary schools and between the stakeholders, and impacted by how good transition provision was seen to be.

Conclusions

There is a need to understand the transition period from the perspective of students, teachers, and parents, to improve school transition. This information will allow us to design emotional centred support interventions that reflect these lived experiences.
Urea in cancer patients with chronic SIAD‐induced hyponatremia: Old drug, new evidence
Authors: Nervo Alice , D'Angelo Valentina , Rosso Daniela , Castellana Eleonora , Cattel Francesco , Arvat Emanuela , Grossi Emidio
Published: March 2019

Background

Syndrome of inappropriate antidiuresis (SIAD) is the main cause of hyponatremia in cancer patients. International guidelines indicate urea as an interesting option for chronic SIAD. Nevertheless, strong data to support its use are lacking, and its role in oncologic patients has not been described so far.

Material and Methods

We retrospectively analysed 36 cancer patients affected by moderate or profound SIAD‐induced chronic hyponatremia, who started oral urea (initial daily dose 15 g or 30 g) without fluid restriction between July 2013 and July 2018. We analysed mean serum sodium (sNa) increase after 24 hours and percentages of patients who reached eunatremia within 14, 30 and 60 days of treatment, stratifying according to the degree of hyponatremia at diagnosis. Clinical evaluation and biochemical assessment were periodically performed.

Results

Mean sNa was 123 [±4] mmol/L at baseline; after 24 hours of treatment, a mean increase of 5 [±3] mmol/L was observed. Eunatremia was reached by 55.6%, 86.1% and 91.7% patients within 14, 30 and 60 days of treatment, respectively. Trends in sNa normalization were similar in patients with moderate and profound hyponatremia at diagnosis. Rapid sNa overcorrection was avoided in all cases. Urea  was interrupted within  the first  2 months  of treatment in 10 patients, in half cases for rapid neoplastic progression and in the remaining patients for the drug taste.

Conclusions

In our study, urea was effective in correcting chronic hyponatremia among cancer patients with SIAD. Almost all patients reached eunatremia within the first month of therapy, and urea was globally well tolerated.
Objective evaluation of the visibility of colorectal lesions using eye tracking
Authors: Kumahara Kana , Ikematsu Hiroaki , Shinmura Kensuke , Murano Tatsuro , Inaba Atsushi , Okumura Kei , Nishihara Keiichiro , Sunakawa Hironori , Furue Yasuaki , Ito Renma , Sato Daiki , Minamide Tatsunori , Okamoto Naoki , Yamamoto Yoichi , Suyama Masayuki , Takashima Kenji , Nakajo Keiichiro , Yoda Yusuke , Hori Keisuke , Oono Yasuhiro , Yano Tomonori
Published: March 2019

Background and Aim

To assess the visibility of colorectal lesions using blue laser imaging (BLI)‐bright and linked‐color imaging (LCI) with an eye‐tracking system.

Methods

Eleven endoscopists evaluated 90 images of 30 colorectal lesions. The lesions were randomly selected. Three images of each lesion comprised white light imaging (WLI), BLI‐bright, and LCI in the same position. Participants gazed at the images, and their eye movements were tracked by the eye tracker. We analyzed whether the participants could detect the lesion and how long they took to detect the lesion. We assessed the miss rate and detection time among the imaging modalities.

Results

One endoscopist was excluded, and 10 endoscopists were assessed. Overall, 12.6% of lesions were missed with WLI, 6.0% with BLI‐bright, and 4.3% with LCI; the miss rate of BLI‐bright and LCI was significantly lower than that of WLI (P < 0.01), with no significant difference between the former modalities (P = 0.54). Mean (± SD) detection times were 1.58 ± 1.60 s for WLI, 1.01 ± 1.21 s for BLI‐bright, and 1.10 ± 1.16 s for LCI. Detection time for BLI‐bright and LCI was significantly shorter than that for WLI (P < 0.0001), with no significant difference between the former modalities (P = 0.34). Regarding the miss rate and detection time between the expert and the non‐experts, there was a significant difference with WLI but not with BLI‐bright and LCI.

Conclusion

Blue laser imaging‐bright and LCI improved the detection of colorectal lesions compared with WLI using an eye‐tracking system.
Exploring organizational support for the provision of structured self‐management education for people with Type 2 diabetes: findings from a qualitative study
Authors: Carey M. E. , Agarwal S. , Horne R. , Davies M. , Slevin M. , Coates V.
Published: March 2019

Aim

To explore the organizational context in which Type 2 diabetes structured group education is provided.

Methods

Four Clinical Commissioning Groups in England providing Type 2 diabetes structured self‐management education participated in a qualitative study exploring the context for provision of that education. Using UK National Diabetes Audit returns, two Clinical Commissioning Groups were selected that had non‐attendance rates of ≤25%, and two that had non‐attendance rates of ≥50%. Between May 2016 and August 2017, 20 interviews were conducted with Clinical Commissioning Group staff including: commissioners, healthcare professionals, managers, general practitioners and diabetes educators. Data gathering was prolonged as it proved challenging to engage with healthcare staff as a result of frequent local restructuring and service disruption.

Results

Local audits revealed discrepancies in basic data such as referral and attendance numbers compared with national audit data. There was a commonality in the themes identified from interviews: diabetes education was rarely embedded in service structure; where education uptake was poor, a lack of central support to delivery teams was noticeable; and where education uptake was positive, delivery teams were actively engaged, sometimes relying on enthusiastic individuals. Both situations put the local sustainability of diabetes education at risk.

Conclusions

There appears to be a link between attendance rates and organizational issues, therefore, when considering how to increase attendance rates, the state of the diabetes education infrastructure should be reviewed. Good uptake of diabetes education can be too reliant on the enthusiastic commitment of small teams or individuals delivering the education.
The aesthetic as mirror of faith in Kierkegaard's Fear and Trembling
Authors: Schönbaumsfeld Genia
Published: March 2019

One of the most intractable issues in Kierkegaard scholarship continues to be the question of what one is to make of the relation between infinite resignation and faith in Fear and Trembling. Most commentators follow Kierkegaard's pseudonymous author in claiming that progression to faith is a “linear” process that requires infinite resignation as a first step. The problem with such a reading is that it leads to paradox: It seems to require attributing to the “knight of faith” two inconsistent belief‐attitudes simultaneously—on the one hand, the willingness to resign one's heart's desires (infinite resignation) and, on the other, the conviction that one will somehow receive back what one has resigned. But this is a confused way of thinking about faith. I will show that faith's alleged paradoxicality is only apparent and that the element of resignation that constitutes an aspect of it actually bears some striking similarities to what the aesthete has in mind when he speaks, in Either/Or, of throwing hope overboard in order to make possible a truly artistic way of life. Hence, on my interpretation, the knight of faith does not need to adopt two contradictory attitudes at the same time (or constantly to “annul” one of them), but must rather practice a form of spiritual discipline in many ways analogous to the aesthete's endeavour to become a “poet of possibility.”
A detailed radiographic description of the nutrient foramen of the dorsal cortex of the proximal phalanx in horses
Authors: Frietman S. , van Proosdij R. , ter Braake F. , de Heer N.
Published: March 2019

The purpose of this study was to provide a detailed radiographic description of the nutrient foramen (NF) of the dorsal cortex of the proximal phalanx (Pl) which may aid the veterinary practitioner in identification of theNFand subsequently prevents misinterpretation of this radiographic finding. Medical records of 190 horses (116 Standardbreds, 64 Warmbloods and 10 Friesians) presented for standard radiographic screening were retrospectively reviewed. All four lateromedial radiographs of the metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joints were evaluated for presence, localisation and trajectory of a dorsalNFby a registered radiologist and a surgical resident. In 27.5% (209/760) radiographs, a full‐cortexNFwas identified. The Standardbred‐group represented the majority with 30% (138/464) diagnosedNF, followed by the Warmblood‐group with 26% (66/256)NFand the Friesian‐group with 13% (5/40)NF. MostNFhad a unilateral distribution (62%). Fifty per cent of theNFentered the dorsal cortex at 47.4–59.2% of the total dorsal length of Pl. Four different trajectory types were noted; a sigmoid‐shaped course (44%), a straight course (33%), a palmar/plantar‐curved course (14%) and a dorsal‐curved course (9%). The consistent entrance location of theNFinto the dorsal cortex and medullary cavity, together with its typical trajectory aids the veterinary practitioner in distinguishing anNFfrom a pathologic fissure or fracture. Comparison with radiographs of the contralateral limb is unreliable as mostNFare identified unilaterally.
Contested Ground: Network Governance in Australia's Migration Industry
Authors: Khan Marina
Published: March 2019

This article challenges current understandings of the Australian migration industry's position in a network governance framework by shedding light on Registered Migration Agents’ (RMA) lived experiences of their profession. Using qualitative interview data collected from ten migration intermediaries across Australia, this article examines their experiences of their role in relation to the state and industry bodies. Placing migration intermediaries at the meso‐level of analysis, between macro‐level forces of the state and micro‐level agency of their clients, I argue primarily that the migration industry of Australia is a “contested ground” where intermediaries are embedded within complex negotiations with the state and legal frameworks, whilst also negotiating their legitimacy in a stigmatised profession. The findings of this study reveal migration intermediaries’ experiences of network governance as pivotal stakeholders, operating within a space characterized by complex configurations of autonomy and bureaucratic control.
Experimental determination of phase equilibria in the CaO‐BaO‐SiO2‐12 mol pct. Al2O3‐13 mol pct. MgO system at 1573 K and 1623 K
Authors: Wang Zhanjun , Sohn Il
Published: March 2019

Phase equilibria of the CaO‐BaO‐SiO2‐12mol pct. Al2O3‐13mol pct. MgO system with a wide substitution range of CaO with BaO have been experimentally determined at 1623 K (1350°C) and 1573 K (1300°C) using high‐temperature equilibration followed by X‐ray diffraction (XRD), scanning electron microscopy (SEM), and electron probe microanalysis (EPMA) analysis. The (Ca,Ba)3MgSi2O8, BaAl2O4, BaAl2Si2O8 and Ca2(Al0.46Mg0.54)(Al0.46Si1.54)O7 phases have been designated within the phase diagram. The liquidus temperature initially decreased and then increased for the samples substituting CaO with BaO at a constant (C + B)/S ratio between 1.50 and 1.86. For samples with a constant BaO/CaO ratio, the liquidus temperature showed similar trends with a lower (C + B)/S ratio from 1.22 to 0.67. The volume fraction of crystal phases of the samples as‐quenched from 1573 K (1300°C) correlated well with the variation of liquidus and the primary phases. In addition, the change in the Gibbs free energy of the reactions and the bond parameter (Xp × Z/Rk) of the cations were analyzed, where the maximum change in the Gibbs free energy was found for the formation of Ca3MgSi2O8; furthermore, the stronger basic tendency of Ba2+ than Ca2+ facilitates Ba2+ substitution for Ca2+ and bonding with acidic tendency cations to form Ba‐containing phases.
The pattern‐recognition molecule mindin binds integrin Mac‐1 to promote macrophage phagocytosis via Syk activation and NF‐κB p65 translocation
Authors: Liu Yuan‐sheng , Wang Li‐fen , Cheng Xiao‐Shen , Huo Ya‐Ni , Ouyang Xiao‐Mei , Liang Lai‐Ying , Lin Ying , Wu Jian‐Feng , Ren Jian‐Lin , Guleng Bayasi
Published: March 2019

Mindin has a broad spectrum of roles in the innate immune system, including in macrophage migration, antigen phagocytosis and cytokine production. Mindin functions as a pattern‐recognition molecule for microbial pathogens. However, the underlying mechanisms of mindin‐mediated phagocytosis and its exact membrane receptors are not well established. Herein, we generated mindin‐deficient mice using the CRISPR‐Cas9 system and show that peritoneal macrophages from mindin‐deficient mice were severely defective in their ability to phagocytize E  coli. Phagocytosis was enhanced when E  coli or fluorescent particles were pre‐incubated with mindin, indicating that mindin binds directly to bacteria or non‐pathogen particles and promotes phagocytosis. We defined that 131I‐labelled mindin binds with integrin Mac‐1 (CD11b/CD18), the F‐spondin (FS)‐fragment of mindin binds with the αM‐I domain of Mac‐1 and that mindin serves as a novel ligand of Mac‐1. Blockade of the αM‐I domain of Mac‐1 using either a neutralizing antibody or si‐Mac‐1 efficiently blocked mindin‐induced phagocytosis. Furthermore, mindin activated the Syk and MAPK signalling pathways and promoted NF‐κB entry into the nucleus. Our data indicate that mindin binds with the integrin Mac‐1 to promote macrophage phagocytosis through Syk activation and NF‐κB p65 translocation, suggesting that the mindin/Mac‐1 axis plays a critical role during innate immune responses.
A ‘wind of change’ to biosimilars: The NOR‐SWITCH trial and its extension
Authors: Kay Jonathan
Published: March 2019

Click here to view the Original article by Goll et al.
Therapeutic efficacy of cryotherapy on facial swelling, pain, trismus and quality of life after surgical removal of mandibular third molars: A systematic review
Authors: Larsen Marie Kjærgaard , Kofod Thomas , Starch‐Jensen Thomas
Published: March 2019

The objective was to test the hypothesis of no difference in facial swelling, pain, trismus and immediate quality of life after surgical removal of mandibular third molars, with or without post‐operative cryotherapy. A MEDLINE (PubMed), EMBASE database and Cochrane library search in combination with a hand search of relevant journals were conducted by including human randomised controlled trials published in English until 17 July 2018. The search identified 37 titles. Six studies with low or unclear risk of bias fulfilled the inclusion criteria. Intermittent cryotherapy for 30 minutes during the first post‐operative days significantly diminished facial swelling, pain and trismus compared with no cryotherapy. Patient's satisfaction and perception of recovery were significantly increased with cryotherapy. Therapeutic efficacy of intermittent cryotherapy on post‐operative facial swelling, pain and trismus seems to be improved compared with continuous cryotherapy. Considerable variations in study design, diversity of used evaluation methods, outcome measures and various methodological confounding factors posed serious restrictions to review the literature in a quantitative systematic manner. Thus, conclusions drawn from the results of this systematic review should be interpreted with caution. Further well‐designed randomised controlled trials including standardised protocol, larger patient sample, blinded outcome assessors, patient‐reported outcome measures and three‐dimensional volumetric analysis of facial swelling are required before evidence‐based recommendations can be provided.
Computational aspects of robust optimized certainty equivalents and option pricing
Authors: Bartl Daniel , Drapeau Samuel , Tangpi Ludovic
Published: March 2019

Accounting for model uncertainty in risk management and option pricing leads to infinite‐dimensional optimization problems that are both analytically and numerically intractable. In this article, we study when this hurdle can be overcome for the so‐called optimized certainty equivalent (OCE) risk measure—including the average value‐at‐risk as a special case. First, we focus on the case where the uncertainty is modeled by a nonlinear expectation that penalizes distributions that are “far” in terms of optimal‐transport distance (e.g. Wasserstein distance) from a given baseline distribution. It turns out that the computation of the robust OCE reduces to a finite‐dimensional problem, which in some cases can even be solved explicitly. This principle also applies to the shortfall risk measure as well as for the pricing of European options. Further, we derive convex dual representations of the robust OCE for measurable claims without any assumptions on the set of distributions. Finally, we give conditions on the latter set under which the robust average value‐at‐risk is a tail risk measure.
Gastric accommodation measurements by single photon emission computed tomography and two‐dimensional scintigraphy in diabetic patients with upper gastrointestinal symptoms
Authors: Chedid Victor , Halawi Houssam , Brandler Justin , Burton Duane , Camilleri Michael
Published: March 2019

Objective

To compare estimates of gastric accommodation (GA) with single photon emission computed tomography (SPECT) to measurements based on intragastric meal distribution immediately post‐meal ingestion (IMD0).

Methods

We evaluated 108 diabetics with upper gastrointestinal (UGI) symptoms who had undergone gastric emptying of solids (GE) by scintigraphy and GA measurements by SPECT. Immediately after ingestion of a 99mTc‐labeled egg meal (time 0), we estimated IMD0 as radioactive counts or area of the proximal half of the stomach on two‐dimensional images. Gastric volume (GV) during fasting and after 300 mL Ensure® was measured by SPECT to quantify accommodation volume (AV) or postprandial to fasting volume ratio (GVR). From the measured proximal gastric area, we estimated the volume of proximal stomach (4/3 × π × r3). We performed regression analyses to assess relationships between IMD0 and GA (AV) and GVR.

Results

There was a significant correlation between area and radioactivity counts in the proximal stomach (r = 0.67, P < 0.001); however, there was considerable interpersonal variation [bias 0.20 (95% CI −0.07, 0.47)]. There were no significant correlations between total GV or AV or VR by SPECT and measurements using IMD0: proximal gastric counts, area, and estimated volume as continuous variables of dichotomized patient groups, based on published cutoff values. There were no significant differences in total gastric area or the IMD0 parameters (% area or % radioactive counts) between those with and without UGI symptoms except for fullness and satiety.

Conclusions

Intragastric meal distribution immediately post‐meal ingestion is not significantly correlated with GA measurement by SPECT.
Rosmarinic acid in Canna generalis activates the medial deterrent chemosensory neurone and deters feeding in the tobacco hornworm Manduca sexta
Authors: Simmonds Monique S. J. , Stevenson Philip C. , Hanson Frank E.
Published: March 2019

For all but a very few highly specialized insect feeders, Canna generalis L. (Cannaceae) is unacceptable as a food plant and is a highly potent feeding deterrent for the tobacco hornworm Manduca sexta Johan. (Lepidoptera). The present study describes the isolation of an active deterrent compound, rosmarinic acid (RA) from the ethanol extract of canna leaves. A two‐choice bioassay shows that RA is a feeding deterrent in the concentration range 0.3–3 mm. Bilateral ablation of the oral chemoreceptors eliminates this deterrence. The results reported in the behavioural literature show that only the epipharyngeal sensilla and the medial (but not the lateral) styloconica contribute to this deterrence elicited by canna foliage or extract, and the data obtained in the present study show the same results using RA. Electrophysiological recordings from the medial styloconica show that RA primarily stimulates the ‘deterrent neurone’ in a concentration‐dependent manner with a threshold of approximately 0.03 mm and a peak frequency of 69 spikes s–1 at 0.1 mm RA. An extract of canna leaves elicits similar responses. Adding RA to canna extract does not elicit another class of spikes, indicating that both stimuli activate the same neurone. We discuss the significance of the results with respect to furthering our knowledge about the sensory basis of food selection, and specifically about the range of compounds that stimulate deterrent chemosensitive neurones of lepidopteran larvae.
Seed conglomeration: a disruptive innovation to address restoration challenges associated with small‐seeded species
Authors: Hoose Benjamin W. , Call Ryan S. , Bates Thomas H. , Anderson Rhett M. , Roundy Bruce A. , Madsen Matthew D.
Published: March 2019

Small‐seeded species are an integral component of many natural systems. However, small‐seeded species are often omitted from restoration projects due to limited flow through seeders, low broadcast distance, and inconsistent seeding rates. To address these problems, we developed a novel technique within a rotary coater that allows for the conglomeration of small, low‐purity seeds using a combination of clay, compost, water, and a polymer binder. We used Wyoming big sagebrush (Artemisia tridentata ssp. wyomingensis), which has a seed size of approximately 1 mm or less, as a model species to evaluate the technology. We demonstrated improved flowability of conglomerates over untreated (control) seeds through measurements of the Hausner ratio (8% decrease), the angle of repose (21% decrease), and delivery through a broadcast seeder. Seeding rates of conglomerated seed were more consistent than control seed over rugged terrain. Conglomerates were also broadcast 2.2 times further than control seed, which may mitigate the overall cost of implementing this technology. Laboratory trials demonstrated that the final germination of conglomerated seed averaged 15% higher than control seed. Field trials at two sites demonstrated that seedling emergence was similar for control and conglomerated seed. With no deleterious effects observed from the conglomeration treatment, additional research is merited for using conglomerates as a platform to apply various additives, such as fungicides, plant growth hormones, fertilizers, and biologicals. The potential outcomes of these strategies may have a significant impact on future seeding attempts by improving seed delivery and increasing overall seeding success.
Giant prevention study has sobering message
Authors: Cohen Jon
Published: March 2019

Mixed results suggest "ending AIDS" through treatment will be harder than expected.
Private sector nears rank of top Ph.D. employer
Authors: Langin Katie
Published: March 2019

With academic jobs no longer the norm, universities adapt with career data and training.
Rare diseases prompted care in ancient times
Authors: Curry Andrew
Published: March 2019

People with dwarfism and cleft palate may have been revered, bones suggest.
Males as somatic investment in a parthenogenetic nematode
Authors: Grosmaire Manon , Launay Caroline , Siegwald Marion , Brugière Thibault , Estrada-Virrueta Lilia , Berger Duncan , Burny Claire , Modolo Laurent , Blaxter Mark , Meister Peter , Félix Marie-Anne , Gouyon Pierre-Henri , Delattre Marie
Published: March 2019

Mysterious males

In parthenogenetic species, females produce female offspring, generally without the input of males. Given this, the production of males would seem to be a waste of resources. Grosmaire
et al.
report that in a particular soil nematode, males are regularly produced at a rate of about 9%. They found that the male sperm was required for egg activation, yet the sperm DNA never transmitted on to the subsequent female generation. Provided that male DNA is preferentially passed on through sibling mating, male production is evolutionarily stable.

Science
, this issue p.
1210
Human sound systems are shaped by post-Neolithic changes in bite configuration
Authors: Blasi D. E. , Moran S. , Moisik S. R. , Widmer P. , Dediu D. , Bickel B.
Published: March 2019

The first fricatives

In 1985, the linguist Charles Hockett proposed that the use of teeth and jaws as tools in hunter-gatherer populations makes consonants produced with lower lip and upper teeth (“f” and “v” sounds) hard to produce. He thus conjectured that these sounds were a recent innovation in human language. Blasi
et al.
combined paleoanthropology, speech sciences, historical linguistics, and methods from evolutionary biology to provide evidence for a Neolithic global change in the sound systems of the world's languages. Spoken languages have thus been shaped by changes in the human bite configuration owing to changes in dietary and behavioral practices since the Neolithic.

Science
, this issue p.
eaav3218
Histone modifiers are oxygen sensors
Authors: Gallipoli Paolo , Huntly Brian J. P.
Published: March 2019

Hypoxia signals directly to chromatin via histone demethylases to alter gene expression
Management of patients with an advance decision and suicidal behaviour: a systematic review
Authors: Nowland Rebecca , Steeg Sarah , Quinlivan Leah M , Cooper Jayne , Huxtable Richard , Hawton Keith , Gunnell David , Allen Neil , Mackway-Jones Kevin , Kapur Navneet
Published: March 2019

Background

The use of advance care planning and advance decisions for psychiatric care is growing. However, there is limited guidance on clinical management when a patient presents with suicidal behaviour and an advance decision and no systematic reviews of the extant literature.

Objectives

To synthesise existing literature on the management of advance decisions and suicidal behaviour.

Design

A systematic search of seven bibliographic databases was conducted to identify studies relating to advance decisions and suicidal behaviour. Studies on terminal illness or end-of-life care were excluded to focus on the use of advance decisions in the context of suicidal behaviour. A textual synthesis of data was conducted, and themes were identified by using an adapted thematic framework analysis approach.

Results

Overall 634 articles were identified, of which 35 were retained for full text screening. Fifteen relevant articles were identified following screening. Those articles pertained to actual clinical cases or fictional scenarios. Clinical practice and rationale for management decisions varied. Five themes were identified: (1) tension between patient autonomy and protecting a vulnerable person, (2) appropriateness of advance decisions for suicidal behaviour, (3) uncertainty about the application of legislation, (4) the length of time needed to consider all the evidence versus rapid decision-making for treatment and (5) importance of seeking support and sharing decision-making.

Conclusions

Advance decisions present particular challenges for clinicians when associated with suicidal behaviour. Recommendations for practice and supervision for clinicians may help to reduce the variation in clinical practice.
Outcome of surgical repair of adult digital nerve injury: a systematic review
Authors: Dunlop Rebecca L E , Wormald Justin Conrad Rosen , Jain Abhilash
Published: March 2019

Objectives

A systematic review to assess the evidence supporting surgical repair of digital nerve injury versus no repair in adults in terms of clinical outcomes.

Design

A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-compliant systematic review with methodology based on the Cochrane Handbook of Systematic Reviews of Interventions.

Data sources

Databases included OvidMEDLINE, EMBASE, AMED, clinicaltrials.gov and the Cochrane Database of Systematic Reviews, searched from inception until 10 November 2018.

Eligibility criteria

Adult digital nerve injury in which either direct repair or no repair was undertaken and an outcome measure was recorded.

Data extraction and synthesis

Study data extracted included demographics, injury type and extent, timing, treatment details, outcome data and time points, adverse outcomes, hand therapy and return to work. The National Institute of Health quality assessment tool for case series was used to assess risk of bias.

Results

Thirty studies were included. One compared surgical repair with non-repair. All studies were case series of between 15 and 110 nerve injuries, with heterogeneous patient, injury and treatment characteristics. Two studies detailed nerve repair without magnification. Static 2-point discrimination (s2PD) was the most commonly reported outcome measure. Return of protective sensation was achieved in most cases in the nerve repair and no nerve repair groups. Repair resulted in better s2PD than no repair, but <25% repaired nerves achieved normal levels. Adverse outcomes were similar between repair and no repair groups.

Conclusions

Only level IV evidence is available to support surgical repair of digital nerves in adults. Return of normal sensibility is uncommon and almost all unrepaired nerves regained protective sensation by 6 months and all patients declined further surgery. There was no difference in adverse outcomes. There is currently a lack of high-quality evidence to support surgical repair of digital nerve injuries in adults and further research is needed.

PROSPERO registration number

CRD42017065092.
Study of arching behaviour and strength of concrete masonry infills under out-of-plane loading
Authors: Nasiri Ehsan , Liu Yi
Published: March 2019

A numerical study using a three-dimensional finite element model was conducted to investigate the arching behaviour and strength of concrete masonry infills bounded by reinforced concrete frames subjected to out-of-plane loading. Physical specimens were concurrently tested to provide results for validation of the model as well as evidence of directional characteristics of arching behaviour of masonry infills. A subsequent parametric study using the model included a wide range of infilled frame geometric properties. The results showed in detail the difference in one-way and two-way arching in terms of both strength and failure mechanism, and the contributing factors to this difference. Evaluation of the two main design equations for out-of-plane strength of masonry infills led to proposal of modifications to provide a more rational consideration of directional behaviour of concrete masonry infills. A comparison study using the available test results showed a marked improvement of strength prediction based on the proposed modification.
Introduction to Human-Building Interaction (HBI)
Authors: Alavi Hamed S. , Churchill Elizabeth F. , Wiberg Mikael , Lalanne Denis , Dalsgaard Peter , Fatah gen Schieck Ava , Rogers Yvonne
Published: March 2019

Buildings and urban spaces increasingly incorporate artificial intelligence and new forms of interactivity, raising a wide span of research questions about the future of human experiences with, and within, built environments. We call this emerging area Human-Building Interaction (HBI) and introduce it as an interdisciplinary domain of research interfacing Human-Computer Interaction (HCI) with Architecture and Urban Design. HBI seeks to examine the involvement of HCI in studying and steering the evolution of built environments. Therefore, we need to ask foundational questions such as the following: what are the specific attributes of built environments that HCI researchers should take into account when shifting attention and scale from “artefacts” to “environments”? Are architecture and interaction design methods and processes compatible? Concretely, how can a team of interaction designers bring their tools to an architectural project, and collaborate with other stakeholders? Can and will architecture change the theory and practice of HCI? Furthermore, research in HBI should produce knowledge and practical guidelines by experimenting novel design instances that combine architecture and digital interaction. The primary aim of this article is to specify the mission, vision, and scope of research in HBI. As the introductory article to the TOCHI special issue, it also provides a summary of published manuscripts and describes their collective contribution to the development of this field.
Vortex and the Balance between Vorticity and Strain Rate
Authors: Kolář Václav , Šístek Jakub
Published: March 2019

A new analysis of the vortex-identification Q-criterion and its recent modifications is presented. In this unified framework based on different approaches to averaging of the cross-sectional balance between vorticity and strain rate in 3D, new relations among the existing modifications are derived. In addition, a new method based on spherical averaging is proposed. It is applicable to compressible flows, and it inherits a duality property which allows its use for identifying high strain-rate zones together with vortices. The new quantity is applied to identification of vortices and high strain-rate zones in the flow around an inclined flat plate, in the flow past a sphere, and for the reconnection process of two Burgers vortices.
Generating Plasma by Cumulative Detonation in a Combustion Chamber
Authors: Šonský Jiří , Tesař Václav
Published: March 2019

All combustion processes in present-day engineering applications are of the deflagration type. This character limits achievable values of parameters, such as the highest reached temperature and the corresponding degree of gas ionisation. If it were possible to increase the parameter values and reach the plasmatic state, a number of potentially useful combustion applications might be improved—like propulsion or electricity generation. Authors demonstrate a combustion chamber with detonation-type combustion that can reach, by cumulative implosion, extreme temperatures of generated thermal plasma.
Evaluation Model and Approximate Solution to Inconsistent Max‐Min Fuzzy Relation Inequalities in P2P File Sharing System
Authors: Yang Xiao-Peng
Published: March 2019

Considering the requirement of biggest download speed of the terminals, a BitTorrent‐like Peer‐to‐Peer (P2P) file sharing system can be reduced into a system of max‐min fuzzy relation inequalities. In this paper we establish an evaluation model by the satisfaction degree, for comparing two arbitrary potential solutions of such system. Besides, based on the evaluation model, concept of approximate solution is defined. It is indeed a potential solution with highest satisfaction degree. Furthermore, effective algorithm is developed for obtaining the approximate solutions to inconsistent system. Numerical examples are provided to illustrate our proposed model and algorithm.
Numerical Simulation on the Influence of Injection Location, Injection Angle, and Divergence Half Angle on SITVC Nozzle Flow Field
Authors: Noaman H. R. , Tang Hai Bin , Khalil Elsayed
Published: March 2019

A numerical study has been performed to characterize the nozzle flow field of secondary injection thrust vector control (SITVC) and to estimate the performance parameters of SITVC. After validating the CFD turbulence models with an experimental data, a numerical simulation has been conducted in order to investigate the influence of changing the injection location, the injection angle, and the primary nozzle divergence half angle on the SITVC nozzle flow field structure and on the SITVC performance parameters. The secondary mass flow rate was kept constant for all cases during the simulation. The results showed that downstream injection near the nozzle exit Mp=2.75 increases the high-pressure zone upstream the injection leading to an increase in the side force; also, the higher divergence half angle 15° slightly increases the side force and it provides a wide range of deflection without shock impingement on the opposite wall becoming more effective for SITVC. The injection angle in the upstream direction 135° increases the side force, and by decreasing the injection angle to downstream direction 45°, the side force decreases. However, the SITVC performance parameters and the flow field structure are more influenced by the injection location and the primary nozzle divergence half angle while being less influenced by the injection angle.
Role of Inflammation in the Pathogenesis of Diverticular Disease
Authors: Tursi Antonio , Elisei Walter
Published: March 2019

Diverticulosis of the colon is the most common condition in Western societies and it is the most common anatomic alteration of the human colon. Recurrent abdominal pain is experienced by about 20% of patients with diverticulosis, but the pathophysiologic mechanisms of its occurrence are not completely understood. In the last years, several fine papers have showed clearly the role of low-grade inflammation both in the occurrence of symptoms in people having diverticulosis, both in symptom persistence following acute diverticulitis, even if the evidence available is not so strong. We do not know yet what the trigger of this low-grade inflammation occurrence is. However, some preliminary evidence found colonic dysbiosis linked to low-grade inflammation and therefore to symptom occurrence in those patients. The aim of this paper is to summarize current evidences about the role of inflammation in symptom occurrence in symptomatic uncomplicated diverticular disease and in symptom persistence after an episode of acute diverticulitis.
Relationship between Meditation and Waking Salivary Cortisol Secretion among Long-Term MBSR Instructors
Authors: Wagner Robb Sara , Haslam Alyson , Wirth Michael D. , Gay Jennifer L. , Middleton Lauren , Healy Mike , Hebert James R.
Published: March 2019

Background: A potential relationship between long-term meditation practice and stress reduction remains virtually unexplored. The purpose of this study was to characterize stress using salivary waking cortisol in a group of long-term meditators with training in the Mindfulness-Based Stress Reduction (MBSR) program. Materials and Methods: Four salivary cortisol samples were collected from meditators (n = 84) during the first hour of awakening. The waking cortisol rhythm was summarized using cortisol area under the curve (AUC) with respect to increased secretion above baseline (AUCI) and cortisol AUC above ground (above zero, AUCG); data on meditation duration and depth, perceived stress, and other covariates were collected via self-reported questionnaire. Results: Individuals in the highest quartile of years meditating (> 26 years) had statistically significantly elevated AUCG values (p = 0.01) as compared to individuals in the lowest quartile of years meditating (≤10 years). This relationship was more pronounced among individuals waking at or before 6: 30 a.m. Conclusions: Overall, an increasing number of years of meditation practice was related to a higher waking cortisol response. These intriguing findings warrant additional exploration, as the stress response can be complex.
Effect of Caffeic Acid on Ischemia-Reperfusion-Induced Acute Renal Failure in Rats
Authors: Kinra Manas , Arora Devinder , Mudgal Jayesh , Pai K.S.R. , Mallikarjuna Rao Chamallamudi , Nampoothiri Madhavan
Published: March 2019

Background: Cyclooxygenase (COX)-lipooxygenase (LOX) pathway plays a key role in the pathogenesis of renal ischemia/reperfusion (IR). Objective: This study was aimed to evaluate the role of dietary phenol caffeic acid (CA), alone and in combination with selective COX-2 inhibitor celecoxib (CEL) in IR-induced acute renal failure (ARF) in rats. Materials and Methods: Renal IR was induced by bilateral occlusion of renal pedicels for 90 min followed by reperfusion for 24 h. Rats were randomized into 4 groups: Sham, IR, CA + IR, and CA + CEL + IR, with 7 day treatment before IR. Serum creatinine (SCr), blood urea nitrogen (BUN), antioxidant enzymes, tumor necrosis factor alpha (TNF-α), and histopathological changes were evaluated in the kidney after IR. Results: Renal IR caused significant derangement in renal function and histology. In the IR group, an increase in lipid peroxidation and decreased antioxidant defense enzyme activity were observed. Pretreatment with CA and CA + CEL showed a significant decrease in the BUN, SCr, TNF-α, oxidative stress markers and corrected the histological changes in the kidney. Conclusion: This study demonstrated the renoprotective potential of CA and combination of CA + CEL in IR-induced ARF in rats. The plausible mechanisms for the efficacy of CA could be attributed to its ability to modulate the ­COX-LOX system in renal IR.
Mother and Child Reunion in “Hypertensive” End-Stage Renal Disease: Will They Complement Each Other?
Authors: Timmermans Sjoerd A.M.E.G. , van Paassen Pieter ,   for the Limburg Renal Registry
Published: March 2019

Severe hypertension can lead to irreversible kidney failure and end-stage renal disease (ESRD) and vice versa. Patients are often classified as hypertensive ESRD with no confirmative proof and the true cause of disease can therefore be missed, affecting outcomes. We present a case of chronic thrombotic microangiopathy (TMA) after kidney transplantation in a recipient who had been classified as hypertensive ESRD and found to have a genetic defect in CD46, a transmembrane protein that regulates complement activation, indicating atypical hemolytic uremic syndrome (HUS). The pathogenic variant in CD46 was also found in the mother who donated the kidney, indicating that the TMA occurred on the background of atypical HUS instead of severe hypertension. The patient died from disseminated cancer originated in the mother’s kidney. Knowledge of the genetic background would have prevented recurrent disease and the cancer to occur. Patients classified as hypertensive ESRD suspect for TMA should therefore be screened for variants in complement genes to make informed decisions and save kidneys.
Extension of the Storage Period of Platelet Concentrates in Germany to 5 Days by Bacterial Testing: Is it Worth the Effort?
Authors: Vollmer Tanja , Hinse Dennis , Diekmann Jürgen , Knabbe Cornelius , Dreier Jens
Published: March 2019

The shelf life of platelet concentrates (PCs) was limited in Germany to 4 days after the day of production because platelet-related septic complications had been observed, mainly with PCs at the end of their shelf life. The reduction in PC shelf life gives rise to several problems, including an increased number of discarded products, accompanied by potential challenges of how to ensure an adequate supply of platelet products. The aim of this study was to show routine experience over the last 7 years using the Bactiflow (BF) assay to screen for bacterial contamination late in PC storage, followed by extension of PC shelf life.
Elevated Serum Non-HDL (High-Density Lipoprotein) Cholesterol and Triglyceride Levels as Residual Risks for Myocardial Infarction Recurrence Under Statin Treatment
Authors: Suzuki Kota , Oikawa Takuya , Nochioka Kotaro , Miura Masanobu , Kasahara Shintaro , Sato Masayuki , Aoyanagi Hajime , Shiroto Takashi , Takahashi Jun , Miyata Satoshi , Sakata Yasuhiko , Shimokawa Hiroaki
Published: March 2019

Objective—

Secondary prevention for recurrent myocardial infarction (MI) is one of the most important therapeutic goals in patients with old MI (OMI). Although statins are widely used for this purpose, there remains considerable residual risk even after LDL (low-density lipoprotein cholesterol) is well controlled by statins.

Approach and Results—

We examined clinical impacts of nHDL (nonhigh-density lipoprotein cholesterol) and its major components triglyceride and LDL as residual risks for acute MI recurrence, using the database of our CHART (Chronic Heart Failure Analysis and Registry in the Tohoku District)-2 Study, the largest-scale cohort study of cardiovascular patients in Japan. We enrolled 1843 consecutive old MI patients treated with statins (mean age 67.3 years, male 19.2%) in the CHART-2 Study. The incidence of recurrent acute MI during the median 8.6-year follow-up was compared among the groups divided by the levels of nHDL (<100, 100–129, and ≥130 mg/dL), LDL (<70, 70–99, and ≥100 mg/dL), triglyceride (<84, 84–149, and ≥150 mg/dL), and combination of LDL and triglyceride. Kaplan-Meier curves and multiple Cox proportional hazards models showed that higher levels of nHDL, but not LDL or triglyceride alone, were associated with higher incidence of recurrent acute MI. Furthermore, higher triglyceride levels were associated with higher incidence of recurrent MI in patients with LDL <100 mg/dL but not in those with LDL ≥100 mg/dL.

Conclusions—

These results indicate that management of residual risks for acute MI recurrence should include nHDL management considering both LDL and triglyceride in old MI patients under statin treatment.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00418041.