bluuebunny/crossref_metadata_2025 huggingface dataset:
Microbial - Planktonic foodweb dynamics of a eutrophic Area of Concern: Hamilton Harbour
Authors: Munawar M. , Fitzpatrick M.
Published: October 2017

Hamilton Harbour, located on the western end of Lake Ontario, has a long history of cultural eutrophication as well as industrial contamination. We explored the structure and function of the microbial – planktonic foodweb during the growing seasons (May–October) of 2004 and 2006 in order to consider the flow of autochthonous production from lower to higher trophic levels. Our analyses included microscope based assessments of bacteria, heterotrophic nanoflagellates, ciliates, phytoplankton and zooplankton as well as radioisotope based measurements of primary productivity and bacterial growth. While routine measures of total phosphorus (avg: 25–33 µg l−1) and chlorophyll a (avg: 12–15 µg l−1) were indicative of eutrophy, mean phytoplankton biomass in 2004 (2.0 g m−3) and 2006 (2.2 g m−3) suggested mesotrophic conditions. However, the appearance of algal blooms in the summer of 2006 was an obvious indicator of cultural eutrophication. With respect to the microbial – planktonic foodweb, the organic carbon pool increased from a mean of 757.5 mg C m−3 in 2004 to 1160.3 mg C m−3 in 2006 and this increase was almost evenly split between autotrophs (198.7 mg C m−3) and heterotrophs (204.1 mg C m−3). The increased autotrophic carbon is readily attributable to the observed algal blooms driven by warmer temperatures and higher concentrations of soluble reactive phosphorus. However, the increase in heterotrophic carbon, primarily heterotrophic nanoflagellates, was apparent from the earliest observations in 2006 and remained consistently high throughout the year. We hypothesize that the increased heterotrophic carbon was the consequence of increased allochthonous carbon being shunted through the microbial foodweb; the energy generated was not likely transferred to zooplankton and passed on to higher trophic levels. More research into the dynamics of allochthonous and autochthonous carbon in eutrophic environments is called for.
Efficacy of decoys and familiar versus unfamiliar playback calls in attracting Common Terns to a rehabilitated wetland on Lake Ontario
Authors: Pynenburg Brendan P. , Moore David J. , Quinn James S.
Published: October 2017

Common Terns (Sterna hirundo) are colonial-nesting waterbirds that have experienced long-term population declines on the Great Lakes. Lack of nesting habitat, especially due to competition with Ring-billed Gulls (Larus delwarensis), is thought to be an important cause of this decline. Therefore, it is important to create and maintain good nesting habitats for Common Terns, as was done in Windermere Basin, a historically polluted wetland in Hamilton Harbour. It was extensively restored from 2010–2013, including the construction of three new habitat islands designed for Common Tern nesting. We used playback systems and decoys to attract Common Terns to the new islands in 2013 and assessed the effectiveness of three different call types: local colony sounds recorded in Hamilton Harbour, foreign calls recorded elsewhere in the Great Lakes, and on the Atlantic Coast of North America. These playback types were rotated through sound systems on the three new islands, and a control island had no equipment. Two-hundred and seventy-three pairs of Common Terns successfully nested in the new habitat, and 244 chicks were hatched. However, we did not find evidence that social attractants were effective. Furthermore, there was no significant difference in the effect of the Hamilton Harbour, Great Lakes and Atlantic Coast of North America playbacks on Common Tern numbers or nests, but there was a significant negative effect of Gull numbers on Tern numbers. Colonizing individual Terns likely had prior experience nesting in Windermere Basin, and took advantage of the newly available habitat. These early colonizers would have been more salient to other Terns than the social attractants used in our experiment. Gull numbers declined after we carried out several nest removals (under permit). Therefore, availability of good quality habitat, with Gull numbers controlled, appeared important in re-establishing colonies of Common Terns in the Great Lakes region. Further research is required on the efficacy of social attractants.
Environmental monitoring to guide and assess the effectiveness of Randle Reef sediment remediation on the recovery of Hamilton Harbour
Authors: Graham Matthew , Hartman Erin , Joyner Rupert , Kim Kay , Santiago Roger
Published: October 2017

Randle Reef is a 60 hectare portion of the Hamilton Harbour bed, heavily contaminated with polycyclic aromatic hydrocarbons and heavy metals. Remediation of contaminated sediment at Randle Reef is currently underway and is expected to be completed by 2022. In order to measure the effectiveness of the remedial effort on the surrounding ecosystem as well as enable the project's success to be critically evaluated, short and long term site-specific monitoring studies are required. As such, research scientists and sediment remediation specialists have collaborated to develop a site-specific, comprehensive series of environmental monitoring plans. The monitoring plans use several metrics to determine the state of the ecosystem prior to, during and post remediation. Monitoring studies have been designed to measure physical, biological and chemical trends over time. These studies will be used to determine the overall effectiveness of the remediation project and ultimately lead to the eventual delisting of Hamilton Harbour from the list of Great Lakes Areas of Concern. This article is a synopsis of the environmental monitoring studies that have been designed to guide and assess the effectiveness of the Randle Reef Sediment Remediation Project.
The efficacy of resistance training in hypoxia to enhance strength and muscle growth: A systematic review and meta‐analysis
Authors: Ramos‐Campo Domingo J. , Scott Brendan R. , Alcaraz Pedro E. , Rubio‐Arias Jacobo A.
Published: October 2017

Recent studies have reported that resistance training in hypoxia (RTH) may augment muscle size and strength development. However, consensus on the effects of RTH via systematic review and meta‐analysis is not yet available. This work aimed to systematically review studies which have investigated using RTH versus normoxic resistance training (NRT) to improve muscular size and strength, and to perform a meta‐analysis to determine the effect of RTH on these adaptive parameters. Searches were conducted in PubMed, Web of Science and the Cochrane Library from database inception until 17 June 2017 for original articles assessing the effects of RTH on muscle size and strength versus NRT. The effects on outcomes were expressed as standardized mean differences (SMD). Nine studies (158 participants) reported on the effects of RTH versus NRT for muscle cross‐sectional area (CSA) (n = 4) or strength (n = 6). RTH significantly increased CSA (SMD = 0.70, 95% confidence intervals (CI) 0.05, 1.35; p = .04) and strength (SMD = 1.88; 95% CI = 1.20, 2.56; p < .00001). However, RTH did not produce significant change in CSA (SMD = 0.24, 95% CI −0.19, 0.68, p = .27) or strength (SMD = 0.20; 95% CI = −0.27, 0.78; p = .23) when compared to NRT. Although RTH improved muscle size and strength, this protocol did not provide significant benefit over resistance training in normoxia. Nevertheless, this paper identified marked differences in methodologies for implementing RTH, and future research using standardized protocols is therefore warranted.
Centre vortex removal restores chiral symmetry
Authors: Trewartha Amalie , Kamleh Waseem , Leinweber Derek B
Published: October 2017

The influence of centre vortices on dynamical chiral symmetry breaking is investigated through the light hadron spectrum on the lattice. Recent studies of the quark propagator and other quantities have provided evidence that centre vortices are the fundamental objects underpinning dynamical chiral symmetry breaking in

SU
(
3
)

gauge theory. For the first time, we use the chiral overlap fermion action to study the low-lying hadron spectrum on lattice ensembles consisting of Monte Carlo, vortex-removed, and vortex-projected gauge fields. We find that gauge field configurations consisting solely of smoothed centre vortices are capable of reproducing all the salient features of the hadron spectrum, including dynamical chiral symmetry breaking. The hadron spectrum on vortex-removed fields shows clear signals of chiral symmetry restoration at light values of the bare quark mass, while at heavy masses the spectrum is consistent with a theory of weakly interacting constituent quarks.
ArachnoServer 3.0: an online resource for automated discovery, analysis and annotation of spider toxins
Authors: Pineda Sandy S , Chaumeil Pierre-Alain , Kunert Anne , Kaas Quentin , Thang Mike W C , Le Lien , Nuhn Michael , Herzig Volker , Saez Natalie J , Cristofori-Armstrong Ben , Anangi Raveendra , Senff Sebastian , Gorse Dominique , King Glenn F
Published: October 2017

ArachnoServer is a manually curated database that consolidates information on the sequence, structure, function and pharmacology of spider-venom toxins. Although spider venoms are complex chemical arsenals, the primary constituents are small disulfide-bridged peptides that target neuronal ion channels and receptors. Due to their high potency and selectivity, these peptides have been developed as pharmacological tools, bioinsecticides and drug leads. A new version of ArachnoServer (v3.0) has been developed that includes a bioinformatics pipeline for automated detection and analysis of peptide toxin transcripts in assembled venom-gland transcriptomes. ArachnoServer v3.0 was updated with the latest sequence, structure and functional data, the search-by-mass feature has been enhanced, and toxin cards provide additional information about each mature toxin.

Availability and implementation

http://arachnoserver.org

Supplementary information

Supplementary data are available at Bioinformatics online.
Strong Instability of Ground States to a Fourth Order Schrödinger Equation
Authors: Bonheure Denis , Castéras Jean-Baptiste , Gou Tianxiang , Jeanjean Louis
Published: October 2017

In this note, we prove the instability by blow-up of the ground state solutions for a class of fourth order Schrödinger equations. This extends the first rigorous results on blowing-up solutions for the biharmonic nonlinear Schrödinger due to Boulenger and Lenzmann [8] and confirm numerical conjectures from [1–3, 11].
The UCSC Genome Browser database: 2018 update
Authors: Casper Jonathan , Zweig Ann S , Villarreal Chris , Tyner Cath , Speir Matthew L , Rosenbloom Kate R , Raney Brian J , Lee Christopher M , Lee Brian T , Karolchik Donna , Hinrichs Angie S , Haeussler Maximilian , Guruvadoo Luvina , Navarro Gonzalez Jairo , Gibson David , Fiddes Ian T , Eisenhart Christopher , Diekhans Mark , Clawson Hiram , Barber Galt P , Armstrong Joel , Haussler David , Kuhn Robert M , Kent W James
Published: October 2017

The UCSC Genome Browser (https://genome.ucsc.edu) provides a web interface for exploring annotated genome assemblies. The assemblies and annotation tracks are updated on an ongoing basis—12 assemblies and more than 28 tracks were added in the past year. Two recent additions are a display of CRISPR/Cas9 guide sequences and an interactive navigator for gene interactions. Other upgrades from the past year include a command-line version of the Variant Annotation Integrator, support for Human Genome Variation Society variant nomenclature input and output, and a revised highlighting tool that now supports multiple simultaneous regions and colors.
A Quality Improvement Initiative to Increase Scoring Consistency and Accuracy of the Finnegan Tool
Authors: Timpson Wendy , Killoran Cheryl , Maranda Louise , Picarillo Alan , Bloch-Salisbury Elisabeth
Published: October 2017

Background:

Current practice for diagnosing neonatal abstinence syndrome and guiding pharmacological management of neonatal drug withdrawal is dependent on nursing assessments and repeated evaluation of clinical signs.

Purpose:

This single-center quality improvement initiative was designed to improve accuracy and consistency of Finnegan scores among neonatal nurses.

Methods:

One-hundred seventy neonatal nurses participated in a single-session withdrawal-assessment program that incorporated education, scoring guidelines, and a restructured Finnegan scale. Nurses scored a standardized video-recorded infant presenting with opioid withdrawal before and after training.

Results:

Nearly twice as many nurses scored at target (Finnegan score of 8) posttraining (34.7%; mean error = 0.559, SD = 1.4) compared with pretraining (18.8%; mean error = 1.31, SD = 1.95; Wilcoxon, P < .001). Finnegan scores were significantly higher than the target score pretraining (mean = 9.31, SD = 1.95) compared with posttraining (mean = 8.56, SD = 1.40, Wilcoxon P < .001); follow-up assessments reverted to pretraining levels (mean = 9.16, SD = 1.8). Score dispersion was greater pretraining (variance 3.80) compared with posttraining (variance 1.96; Kendall's Coefficient, P < .001) largely due to score disparity among central nervous system symptomology.

Implications for Practice:

Education, clinical guidelines, and a restructured scoring tool increased consistency and accuracy of infant withdrawal-assessments among neonatal nurses. However, more than 60% of nurses did not assess withdrawal to the target score immediately following the training period and improvements did not persist over time.

Implications for Research:

This study highlights the need for more objective tools to quantify withdrawal severity given that assessments are the primary driver of pharmacological management in neonatal drug withdrawal.

Video Abstract available at
https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx.
The Cost and Utility of Postreduction Radiographs After Closed Reduction of Pediatric Wrist and Forearm Fractures
Authors: Goodman Avi D. , Zonfrillo Mark R. , Chiou Daniel , Eberson Craig P. , Cruz Aristides I.
Published: October 2017

Background:

Formal radiographs are frequently obtained after reduction of closed pediatric wrist and forearm fracture performed under mini C-arm fluoroscopy. However, their utility has not been clearly demonstrated to justify the increased time, cost, and radiation exposure. We hypothesized that formal postreduction radiographs do not affect the rereduction rate of pediatric wrist and forearm fractures. We further sought to determine the time, monetary, and opportunity costs associated with obtaining these radiographs.

Methods:

A total of 119 patients presented to our urban, level I pediatric trauma center from April 2015 to September 2015 with isolated, closed wrist and forearm fractures who underwent sedation and reduction using mini C-arm fluoroscopy. Demographic and injury variables were collected, along with incidence of rereduction and need for future surgery. Time intervals for sedation, awaiting x-ray, and total encounter periods were noted, and total direct and variable indirect costs for each encounter were obtained from our institution’s cost accounting and billing databases. Marginal time and monetary costs were noted and further calculated as a percentage of the total encounter. Opportunity costs were calculated for the time spent obtaining the postreduction radiographs.

Results:

Of 119 patients with isolated, closed wrist or forearm fractures, none required rereduction after initial reduction using sedation and mini C-arm fluoroscopy. Postreduction radiographs required an average of 26.2 minutes beyond the end of sedation, or 7.3% of the encounter time and cost. The direct cost of the x-ray was 2.6% of the encounter cost. With our institution’s annual volume, this time could have been used to see an additional 656 patients per year.

Conclusions:

Postreduction formal radiographs did not result in changes in management. There are significant direct and opportunity costs for each patient who undergoes additional formal radiographs. Pediatric patients with isolated, closed wrist or forearm fractures do not routinely need formal radiographs after reduction under mini C-arm fluoroscopy.

Level of Evidence:

Level IV—Therapeutic.
Long-term Surgical Outcomes After Early Definitive Spinal Fusion for Early-onset Scoliosis With Neurofibromatosis Type 1 at Mean Follow-up of 14 Years
Authors: Tauchi Ryoji , Kawakami Noriaki , Castro Michael Anton , Ohara Tetsuya , Saito Toshiki , Morishita Kazuaki , Yamauchi Ippei
Published: October 2017

Background:

Several authors mentioned surgical outcome for scoliosis associated with neurofibromatosis type 1 (NF-1). However, no studies have summarized long-term surgical outcomes after surgical treatment of early-onset scoliosis (EOS) with NF-1. The purpose of this study is to evaluate the long-term surgical outcome after early definitive spinal fusion for EOS in NF-1 patients.

Methods:

We performed a retrospective review on a cohort of 11 patients diagnosed with EOS associated with NF-1 between 1990 and 2009 in our hospital. The study included 7 male and 4 female NF-1 patients with a mean age at fusion surgery of 8 years 4 months who underwent early definitive spinal fusion for EOS. We reviewed radiographs, computed tomography and magnetic resonance images for each patient. The data collected included type of NF-1, Cobb angles, kyphotic angle, spinal length (T1-S1), and pulmonary function. We also evaluated progression of the dystrophic change through radiographs and computed tomography during the follow-up period.

Results:

The mean follow-up duration was 14 years (5 y 10 mo to 25 y). All patients underwent anterior and posterior fusion surgeries in either 1 or 2 stages. Seven cases had subtotal tumor resection from the concave side followed by rib strut grafting. The mean preoperative Cobb angle of the primary curve was corrected from 71.2 to 24.1 degrees and was maintained at the final follow-up at 23.5 degrees. Mean values for preoperative and final follow-up T1-S1 heights were 30.7 and 36.2 cm, respectively. Mean values for preoperative and final follow-up % forced vital capacity (the present/the predicted) were 75.0% and 74.4%, respectively. The dystrophic change progressed in all cases during the long-term follow-up.

Conclusions:

Our goals for NF-1 scoliosis are to obtain deformity correction, to achieve stable instrumentation by using longer fusion levels and to attain a solid fusion mass that can tolerate continual erosion during the long-term follow-up. We achieve this by using a circumferential approach for EOS associated with NF-1.

Level of Evidence:

Level IV—case series.
Raising Mean Arterial Pressure Alone Restores 20% of Intraoperative Neuromonitoring Losses
Authors: Yang Joshua , Skaggs David L. , Chan Priscella , Shah Suken A. , Vitale Michael G. , Neiss Geraldine , Feinberg Nicholas , Andras Lindsay M.
Published: October 2017

Study Design.

Multicenter prospective.

Objective.

To assess the effect of intraoperative interventions in restoring intraoperative neuromonitoring (IONM) signals in pediatric spine surgery.

Summary of Background Data.

No prior studies have prospectively examined the rate of return of IONM signals by increasing blood pressure (BP) alone.

Methods.

Patients undergoing posterior spinal deformity surgery were enrolled at their preoperative appointment. Surgeons completed an intraoperative data form on patients who experienced an IONM change defined as a 50% or greater decrease in either transcranial motor evoked potentials or somatosensory evoked potentials.

Results.

Four hundred fifty two patients were enrolled with 30 (7%) having IONM change. Thirty patients met inclusion criteria (mean age, 12 yrs, range, 5–19) and had the following diagnoses: idiopathic scoliosis (43%), neuromuscular scoliosis (13%), congenital scoliosis (10%), early onset scoliosis (7%), and other (27%). 20% (6/30) had return of signals due to an increase in BP alone with no other interventions (mean arterial pressure [MAP] increased from mean of 68 [range, 58–76] to 86 mmHg [range, 75–95]). Signals returned to baseline after mean of 16 minutes (range, 2–45). In 60% of patients (18/30), MAP was raised from a mean of 72 mmHg (range, 55–84) to 86 mmHg (range, 75–100) in conjunction with other interventions and had mean return of signals in 37 minutes (range, 8–210). Six (20%) of patients had signals return to baseline after a mean of 6 minutes (range, 3–13) in which MAP did not change appreciably. All patients had return of signals at the conclusion of the procedure with one patient having postoperative neurological sequale.

Conclusion.

In this prospective study of 452 pediatric spinal deformity surgeries, raising MAPs above 85 mmHg should be considered the first step in response to IONM signal changes, as this alone was successful in 20% of patients without sacrificing deformity correction.

Level of Evidence: 2
An update on noninvasive follicular thyroid neoplasm with papillary-like nuclear features
Authors: Range Danielle Elliott , Jiang Sara Xiaoyin
Published: October 2017

Purpose of review

Noninvasive encapsulated follicular variant of papillary thyroid carcinoma (PTC) has been established in the literature as a clinically indolent tumor. Despite this, it was traditionally treated like all other PTCs. In an attempt to reduce overtreatment of this entity, a panel of experts reclassified this entity as noninvasive follicular neoplasm with papillary-like nuclear features (NIFTP). This reclassification has led to a flurry of literature elucidating the molecular, cytologic and clinical parameters of this ‘new’ entity and the implications for patient management. The purpose of this review is to examine the latest literature on this tumor and explore how its emergence has impacted our current understanding of the diagnosis, management and outcomes in this entity.

Recent findings

NIFTP is a low grade tumor with an indolent clinical course. Recent studies have begun to document the variable incidence of NIFTP, the ultrasound and cytologic findings, and the impact of the NIFTP terminology on established rates of malignancy in fine-needle aspiration and clinical outcome studies.

The recent literature on molecular, radiographic and cytologic characteristics of NIFTP are building our understanding of this neoplasm and support its indolent nature.
Milrinone Dosing and a Culture of Caution in Clinical Practice
Authors: Chong Luke Yong Zheng , Satya Kumar , Kim Bernard , Berkowitz Robert
Published: October 2017

Milrinone is an invaluable agent in the treatment of end-stage heart failure patients who are refractory to optimal medical therapy. In addition to its use in acute decompensated heart failure, milrinone can also be employed as a home infusion therapy or a bridge to cardiac transplant. Concerns about its adverse effects, such as an increased risk of arrhythmias and hypotension, often limit the doses of milrinone used in clinical practice. In addition, milrinone is infrequently used or avoided entirely in patients with acute renal failure or end-stage renal disease because the drug is primarily cleared by renal excretion. Despite these concerns, studies that comprehensively reconcile the dose–response relationship and adverse events are scarce, and no clear provisions exist to guide milrinone dosing. After a brief discussion of the pharmacokinetics of milrinone, this article examines milrinone dosing, observed hemodynamic benefits, and documented adverse events across different studies.
Devices for Autonomic Regulation Therapy in Heart Failure With Reduced Ejection Fraction
Authors: Wagner Benjamin R. , Frishman William H.
Published: October 2017

Heart failure (HF) is associated with significant morbidity and mortality and an increasing economic burden. The persistence of HF’s risk factors, coupled with an aging population, also leads to an increase in its incidence and prevalence. It is well established that sympathetic hyperactivity and parasympathetic withdrawal are instrumental in the development and worsening of HF. Therefore, restoring autonomic balance to the cardiovascular system is an attractive therapeutic approach. The following is a review of current clinical trials of device-based autonomic regulation therapy in the management of HF with a reduced ejection fraction.
Distribution of Elastic Fibers in the Lacrimal Sac and Nasolacrimal Duct of Japanese Cadavers
Authors: Kitaguchi Yoshiyuki , Takahashi Yasuhiro , Nakano Takashi , Naito Munekazu , Ikeda Hiroshi , Miyazaki Hidetaka , Kakizaki Hirohiko
Published: October 2017

Purpose:

To investigate the distribution of elastic fibers in lacrimal sac and nasolacrimal duct of Japanese cadavers.

Methods:

We examined 8 lacrimal sacs and nasolacrimal ducts of 7 Japanese cadavers (4 right sides, 4 left sides; 3 males, 4 females; average age of 89 years at death) that were preserved with 10% buffered formalin. The harvested specimens were transversely sectioned. All specimens were stained with Elastica van Gieson. Micrographs were taken, and then converted to white and black images, and the elastic fiber density of 4 locations (middle and upper levels of lacrimal sac, and middle and lower levels of nasolacrimal duct) was compared.

Results:

Elastic fibers showed greater distribution in the lamina propria, compared with the submucosal tissue, at all locations (p < 0.001). Elastic fiber density within the lamina propria at the middle lacrimal sac level (13.5% ± 4.3%) was similar to the density observed at the upper lacrimal sac level (13.2% ± 2.3%, p = 0.87) and the lower nasolacrimal duct level (17.8% ± 6.0%, p = 0.088), but was significantly greater than the density observed at the middle nasolacrimal duct level (9.5% ± 3.8%, p = 0.0001).

Conclusions:

Elastic fibers in the lacrimal sac and nasolacrimal duct are primarily distributed in the lamina propria, with a greater density at the upper and middle lacrimal sac levels, and at the lower nasolacrimal duct level, compared with the middle nasolacrimal duct level. This distribution of elastic fibers likely reflects the magnitude of mechanical stress within the lacrimal drainage system.
Neurosteroid Levels in Patients With Bipolar Disorder and a History of Cannabis Use Disorders
Authors: Mason Brittany L. , Van Enkevort Erin , Filbey Francesca , Marx Christine E. , Park John , Nakamura Alyson , Sunderajan Prabha , Brown E. Sherwood
Published: October 2017

Purpose/Background

In animal models, levels of the neurosteroid pregnenolone increase after tetrahydrocannabinol (THC) administration and pregnenolone appears to attenuate the brain effects of THC. Given these interactions between pregnenolone and THC, we evaluated baseline neurosteroid levels in participants with a history of a cannabis use disorders (CUDs).

Methods/Procedures

Bipolar depressed participants were enrolled in a randomized placebo-controlled clinical trial to evaluate the efficacy of add-on pregnenolone for depression and before receiving pregnenolone or placebo. Baseline serum levels of neurosteroids (pregnenolone, allopregnanolone, pregnanolone, and androsterone) were analyzed in 53 participants with highly sensitive and specific gas chromatography/mass spectrometry. Current, active substance use disorders, or a positive baseline urine drug screen, were exclusionary. Participants were classified by past cannabis abuse or dependence diagnosis using the structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Data were analyzed by independent t tests for separate neurosteroids.

Findings/Results

Participants with a history of CUD had higher serum pregnanolone, lower allopregnanolone, a higher pregnanolone to allopregnanolone ratio, and a lower pregnenolone to pregnanolone ratio compared with those without a history of cannabis use. Similar findings were not observed based on a history of other substance use disorders with the exception of lower allopregnanolone in those with opioid use disorders. Notably, the majority of those with an opioid use disorder also had a CUD (75%).

Implications/Conclusions

These findings potentially suggest either enduring changes in neurosteroids in people with past CUDs or represent a vulnerability marker for a CUD.
Complexity of Chronic Conditions’ Impact on End-of-Life Expense Trajectories of Medicare Decedents
Authors: Sullivan Suzanne S. , Li Junxin , Wu Yow-Wu Bill , Hewner Sharon
Published: October 2017

OBJECTIVE

The aim of this study is to determine if the pattern of monthly medical expense can be used to identify individuals at risk of dying, thus supporting providers in proactively engaging in advanced care planning discussions.

BACKGROUND

Identifying the right time to discuss end of life can be difficult. Improved predictive capacity has made it possible for nurse leaders to use large data sets to guide clinical decision making.

METHODS

We examined the patterns of monthly medical expense of Medicare beneficiaries with life-limiting illness during the last 24 months of life using analysis of variance, t tests, and stepwise hierarchical linear modeling.

RESULTS

In the final year of life, monthly medical expense increases rapidly for all disease groupings and forms distinct patterns of change.

CONCLUSION

Type of condition can be used to classify decedents into distinctly different cost trajectories. Conditions including chronic disease, system failure, or cancer may be used to identify patients who may benefit from supportive care.
Hydatid Cyst of the Parotid Gland: A Rare Location
Authors: Erdur Omer , Colpan Bahar , Sofuoglu Fuad , Kibar Ertugrul
Published: October 2017

Hydatid disease of the parotid gland is a very rare entity and may be easily overlooked in the diagnosis of parotid masses. Although Turkey remains an endemic area for echinococcosis, involvement of the parotid gland is extremely rare. A 26-year-old man presented with primary parotid gland mass without any other organ involvement. During the first surgery, the cyst was perforated accidentally and in a short time recurrence was occurred. Maximum attention was given for the second surgery for total removal without damaging the cyst with medical treatment. The clinicians should take hydatid disease of parotid gland into consideration and great care must be given for not damaging the capsule of the cystic tumors in order to prevent recurrences.
One-Year Survival after Inhospital Cardiac Arrest—Does Prearrest Sepsis Matter?
Authors: Koivikko Pia , Arola Olli , Inkinen Outi , Tallgren Minna
Published: October 2017

Aim:

Cardiac arrest is not a common complication of sepsis, although sepsis has been recognized as one condition behind cardiac arrest. Our aim was to evaluate the prevalence of sepsis among patients with inhospital cardiac arrest (IHCA), and to determine if sepsis is associated with inferior outcome after IHCA.

Methods:

All consecutive emergency team dispatches in Turku University Hospital in 2011 to 2014 (n = 607) were retrospectively reviewed to identify the patients undergoing cardiopulmonary resuscitation (CPR) for IHCA (n = 301). The patient records were reviewed for the criteria of severe sepsis, organ dysfunction, and chronic comorbidities before IHCA. Outcome was followed for 1 year.

Results:

The criteria for prearrest severe sepsis were met by 83/301 (28%) of the patients, and 93/301 (31%) had multiorgan dysfunction (3 or more organ systems). The patients with severe sepsis had higher mortality than those without severe sepsis, increasing from 30-day mortalities of 63/83 (76%) and 151/218 (69%), respectively (P = 0.256), to 1-year mortalities of 72/83 (87%) and 164/218 (75%), respectively (P = 0.030). Emergency admission, age, immunosuppression, DM, multiorgan dysfunction, and a nonshockable rhythm were independent predictors of 1-year mortality by multivariate logistic regression analysis. Six out of 83 patients with severe sepsis before IHCA (7%) survived 1 year with good neurological outcome (CPC scale 1).

Conclusions:

A high proportion of patients with IHCA have sepsis and multiorgan dysfunction, and their prognosis is worse than the prognosis of patients with IHCA in general.
Comparisons of Traditional Metabolic Markers and Compensatory Reserve as Early Predictors of Tolerance to Central Hypovolemia in Humans
Authors: Schiller Alicia M. , Howard Jeffrey T. , Lye Kristen R. , Magby Christian G. , Convertino Victor A.
Published: October 2017

Circulatory shock remains a leading cause of death in both military and civilian trauma. Early, accurate and reliable prediction of decompensation is necessary for the most efficient interventions and clinical outcomes. Individual tolerance to reduced central blood volume can serve as a model to assess the sensitivity and specificity of vital sign measurements. The compensatory reserve (CRM) is the measurement of this capacity. Measurements of muscle oxygen saturation (SmO2), blood lactate, and end tidal CO2 (EtCO2) have recently gained attention as prognostic tools for early assessment of the status of patients with progressive hemorrhage, but lack the ability to adequately differentiate individual tolerance to hypovolemia. We hypothesized that the CRM would better predict hemodynamic decompensation and provide greater specificity and sensitivity than metabolic measures. To test this hypothesis, we employed lower body negative pressure on healthy human subjects until symptoms of presyncope were evident. Receiver operating characteristic area under the curve (ROC AUC), sensitivity, and specificity were used to evaluate the ability of CRM, partial pressure of oxygen (pO2), partial pressure of carbon dioxide (pCO2), SmO2, lactate, EtCO2, potential of hydrogen (pH), base excess and hematocrit (Hct) to predict hemodynamic decompensation. The ROC AUC for CRM (0.94) had a superior ability to predict decompensation compared with pO2 (0.85), pCO2 (0.62), SmO2 (0.72), lactate (0.57), EtCO2 (0.74), pH (0.55), base excess (0.59), and Hct (0.67). Similarly, CRM also exhibited the greatest sensitivity and specificity. These findings support the notion that CRM provides superior detection of hemodynamic compensation compared with commonly used clinical metabolic measures.
Inhaled Loxapine for Agitation in Intoxicated Patients: A Case Series
Authors: Roncero Carlos , Ros-Cucurull Elena , Palma-Álvarez Raúl Felipe , Abad Alfonso Carlos , Fadeuilhe Christian , Casas Miquel , Grau-López Lara
Published: October 2017

Objectives

Episodes of agitation are frequent in intoxicated patients who have a substance use disorder, a psychiatric disorder or both (dual diagnosis). For managing the agitation, it is necessary to act promptly in a safe environment and addressing any underlying etiology. Inhaled loxapine improves symptoms of agitation in adults with psychiatric disorders (eg, schizophrenia) within 10 minutes of administration. Recently, some reports have documented the usefulness of loxapine in dual diagnoses patients with agitation. However, the efficacy of loxapine in intoxicated patients has not been deeply addressed.

Methods

This report describes a case series of 12 patients (with addiction or dual disorder) who received inhaled loxapine for symptoms of psychomotor agitation during intoxication with different substances (eg, alcohol, cannabis, or cocaine) at 1 center in Spain.

Results

Data from 12 patients were reviewed, 5 patients were attended at the emergency room, 4 at the addiction and dual diagnosis unit, and 3 were treated during hospitalization for detoxification. All patients were under effects of substances. They had substance use disorder (including cannabis, cocaine, alcohol, hypnotics, and hallucinogens), and almost all (90%) presented 1 or more psychiatric disorders. One dose of inhaled loxapine was effective in 9 patients (75%), and in 3 patients, a second dose was required. Only mild dizziness was reported in 1 patient after the second dose.

Conclusions

The acute agitation was effectively and quickly managed with inhaled loxapine in all intoxicated patients and enabled the appropriate clinical evaluation of the agitated state and the patient's management.
The effect of leg-to-body ratio on male attractiveness depends on the ecological validity of the figures
Authors: Versluys Thomas M. M. , Skylark William J.
Published: October 2017

Leg-to-body ratio (LBR) predicts evolutionary fitness, and is therefore expected to influence bodily attractiveness. Previous investigations of LBR attractiveness have used a wide variety of stimuli, including line drawings, silhouettes, and computer-generated images based on anthropometric data. In two studies, community samples of heterosexual women from the USA rated the attractiveness of male figures presented as silhouettes and as detailed computer-generated images with three different skin tones (white, black, and an artificial grey). The effects of LBR depended on the image format. In particular, a curve-fitting analysis indicated that the optimally-attractive LBR for silhouettes was fractionally below the baseline, whereas the optima for more detailed computer-generated images was approximately 0.5 s.d. above the baseline and was similar for all three skin-tones. In addition, the participants' sensitivity to changes in the LBR was lowest for the silhouettes and highest for the grey figures. Our results add to evidence that the most attractive LBR is close to, but slightly above, the population mean, and caution that the effects of limb proportions on attractiveness depend on the ecological validity of the figures.
Engaging rural Australian communities in National Science Week helps increase visibility for women researchers
Authors: Hardy Margaret C. , Desselle Mathilde R. ,   the 2016 Catch a Rising Star Consortium
Published: October 2017

During a week-long celebration of science, run under the federally supported National Science Week umbrella, the Catch a Rising Star: women in Queensland research (CaRS) programme flew scientists who identify as women to nine regional and remote communities in the Australian State of Queensland. The aim of the project was twofold: first, to bring science to remote and regional communities in a large, economically diverse state; and second, to determine whether media and public engagement provides career advancement opportunities for women scientists. This paper focuses on the latter goal. The data show: (i) a substantial majority (greater than 80%) of researchers thought the training and experience provided by the programme would help develop her career as a research scientist in the future, (ii) the majority (65%) thought the programme would help relate her research to end users, industry partners or stakeholders in the future, and (iii) analytics can help create a compelling narrative around engagement metrics and help to quantify influence. During the week-long project, scientists reached 600 000 impressions on one social media platform (Twitter) using a program hashtag. The breadth and depth of the project outcomes indicate funding bodies and employers could use similar data as an informative source of metrics to support hiring and promotion decisions. Although this project focused on researchers who identify as women, the lessons learned are applicable to researchers representing a diverse range of backgrounds. Future surveys will help determine whether the CaRS programme provided long-term career advantages to participating scientists and communities.
The scaling structure of the global road network
Authors: Strano Emanuele , Giometto Andrea , Shai Saray , Bertuzzo Enrico , Mucha Peter J. , Rinaldo Andrea
Published: October 2017

Because of increasing global urbanization and its immediate consequences, including changes in patterns of food demand, circulation and land use, the next century will witness a major increase in the extent of paved roads built worldwide. To model the effects of this increase, it is crucial to understand whether possible self-organized patterns are inherent in the global road network structure. Here, we use the largest updated database comprising all major roads on the Earth, together with global urban and cropland inventories, to suggest that road length distributions within croplands are indistinguishable from urban ones, once rescaled to account for the difference in mean road length. Such similarity extends to road length distributions within urban or agricultural domains of a given area. We find two distinct regimes for the scaling of the mean road length with the associated area, holding in general at small and at large values of the latter. In suitably large urban and cropland domains, we find that mean and total road lengths increase linearly with their domain area, differently from earlier suggestions. Scaling regimes suggest that simple and universal mechanisms regulate urban and cropland road expansion at the global scale. As such, our findings bear implications for global road infrastructure growth based on land-use change and for planning policies sustaining urban expansions.
Co-infection does not predict disease signs inGopherustortoises
Authors: Weitzman Chava L. , Gov Ryan , Sandmeier Franziska C. , Snyder Sarah J. , Tracy C. Richard
Published: October 2017

In disease ecology, the host immune system interacts with environmental conditions and pathogen properties to affect the impact of disease on the host. Within the host, pathogens may interact to facilitate or inhibit each other's growth, and pathogens interact with different hosts differently. We investigated co-infection of twoMycoplasmaand the association of infection with clinical signs of upper respiratory tract disease in four congeneric tortoise host species (Gopherus) in the United States to detect differences in infection risk and disease dynamics in these hosts. Mojave Desert tortoises had greater prevalence ofMycoplasma agassiziithan Texas tortoises and gopher tortoises, while there were no differences inMycoplasma testudineumprevalence among host species. In some host species, the presence of each pathogen influenced the infection intensity of the other; hence, these two mycoplasmas interact differently within different hosts, and our results may indicate facilitation of these bacteria. Neither infection nor co-infection was associated with clinical signs of disease, which tend to fluctuate across time. FromM. agassiziiDNA sequences, we detected no meaningful differentiation of haplotypes among hosts. Experimental inoculation studies and recurrent resampling of wild individuals could help to decipher the underlying mechanisms of disease dynamics in this system.
Assessment of owner-directed aggressive behavioural tendencies of dogs in situations of possession and manipulation
Authors: Bálint Anna , Rieger Gabriella , Miklósi Ádám , Pongrácz Péter
Published: October 2017

Excessive aggression is a common behaviour problem in dogs that can have various destructive effects on the affected people and the implicated dog. Aggressive behaviour directed towards the owner or other family members is one of the most frequently occurring aggressive phenotypes. Here, we examine the reliability of a short questionnaire assessing aggressive behaviours by two, contextually different behavioural tests: ‘take away bone’ and ‘roll over’. Based on dogs' behaviour in the tests, we sorted dogs (
N
 = 93) in two groups for each test, namely a less and a more disobedient/resistant group. The two principal components obtained in our questionnaire—‘obedient’ and ‘aggressive towards owner’—showed significant differences between the behaviour groups. While dogs in the less disobedient/resistant groups had significantly higher ‘obedient’ and significantly lower ‘aggressive towards owner’ scores, dogs in the more disobedient/resistant groups had significantly higher ‘aggressive towards owner’ and significantly lower ‘obedient’ scores. Dogs' age, sex and neuter/spay status expressed their effect through interactions. Males, young dogs and intact dogs were less ‘obedient’ than older ones, while resistant spayed/neutered dogs were more aggressive towards the owner. The questionnaire used is a safe, easy to deploy and time-efficient tool to reliably assess certain owner-directed aggressive tendencies of family dogs.
Three-dimensional innate mobility of the human foot bones under axial loading using biplane X-ray fluoroscopy
Authors: Ito Kohta , Hosoda Koh , Shimizu Masahiro , Ikemoto Shuhei , Nagura Takeo , Seki Hiroyuki , Kitashiro Masateru , Imanishi Nobuaki , Aiso Sadakazu , Jinzaki Masahiro , Ogihara Naomichi
Published: October 2017

The anatomical design of the human foot is considered to facilitate generation of bipedal walking. However, how the morphology and structure of the human foot actually contribute to generation of bipedal walking remains unclear. In the present study, we investigated the three-dimensional kinematics of the foot bones under a weight-bearing condition using cadaver specimens, to characterize the innate mobility of the human foot inherently prescribed in its morphology and structure. Five cadaver feet were axially loaded up to 588 N (60 kgf), and radiographic images were captured using a biplane X-ray fluoroscopy system. The present study demonstrated that the talus is medioinferiorly translated and internally rotated as the calcaneus is everted owing to axial loading, causing internal rotation of the tibia and flattening of the medial longitudinal arch in the foot. Furthermore, as the talus is internally rotated, the talar head moves medially with respect to the navicular, inducing external rotation of the navicular and metatarsals. Under axial loading, the cuboid is everted simultaneously with the calcaneus owing to the osseous locking mechanism in the calcaneocuboid joint. Such detailed descriptions about the innate mobility of the human foot will contribute to clarifying functional adaptation and pathogenic mechanisms of the human foot.
Robust clustering of languages across Wikipedia growth
Authors: Ban Kristina , Perc Matjaž , Levnajić Zoran
Published: October 2017

Wikipedia is the largest existing knowledge repository that is growing on a genuine crowdsourcing support. While the English Wikipedia is the most extensive and the most researched one with over 5 million articles, comparatively little is known about the behaviour and growth of the remaining 283 smaller Wikipedias, the smallest of which, Afar, has only one article. Here, we use a subset of these data, consisting of 14 962 different articles, each of which exists in 26 different languages, from Arabic to Ukrainian. We study the growth of Wikipedias in these languages over a time span of 15 years. We show that, while an average article follows a random path from one language to another, there exist six well-defined clusters of Wikipedias that share common growth patterns. The make-up of these clusters is remarkably robust against the method used for their determination, as we verify via four different clustering methods. Interestingly, the identified Wikipedia clusters have little correlation with language families and groups. Rather, the growth of Wikipedia across different languages is governed by different factors, ranging from similarities in culture to information literacy.