bluuebunny/crossref_metadata_2025 huggingface dataset:
Tympanostomy Tubes—A Visual Guide for the Young Otolaryngologist
Authors: Isaacson Glenn
Published: June 2020

Objectives:

To illustrate some of the common dilemmas in tympanostomy tube care and describe time-tested ways to address them.

Methods:

Computerized literature review.

Results:

Issues including the correct diagnosis of recurrent acute otitis media, tympanostomy tube types and techniques for tube placement, management of tube clogging and otorrhea, and methods for tube removal and patching are illustrated.

Conclusions:

Tympanostomy tube placement is the most common surgery performed in children requiring general anesthesia. While some elements of tympanostomy tube care have been addressed in clinical studies, much of clinical practice is guided by shared experience.
Using Machine Learning Methods to Develop a Short Tree-Based Adaptive Classification Test: Case Study With a High-Dimensional Item Pool and Imbalanced Data
Authors: Zheng Yi , Cheon Hyunjung , Katz Charles M.
Published: June 2020

This study explores advanced techniques in machine learning to develop a short tree-based adaptive classification test based on an existing lengthy instrument. A case study was carried out for an assessment of risk for juvenile delinquency. Two unique facts of this case are (a) the items in the original instrument measure a large number of distinctive constructs; (b) the target outcomes are of low prevalence, which renders imbalanced training data. Due to the high dimensionality of the items, traditional item response theory (IRT)-based adaptive testing approaches may not work well, whereas decision trees, which are developed in the machine learning discipline, present as a promising alternative solution for adaptive tests. A cross-validation study was carried out to compare eight tree-based adaptive test constructions with five benchmark methods using data from a sample of 3,975 subjects. The findings reveal that the best-performing tree-based adaptive tests yielded better classification accuracy than the benchmark method IRT scoring with optimal cutpoints, and yielded comparable or better classification accuracy than the best benchmark method, random forest with balanced sampling. The competitive classification accuracy of the tree-based adaptive tests also come with an over 30-fold reduction in the length of the instrument, only administering between 3 to 6 items to any individual. This study suggests that tree-based adaptive tests have an enormous potential when used to shorten instruments that measure a large variety of constructs.
Good life egalitarianism
Authors: Malleson Tom
Published: June 2020

This article carves out a new path between the two dominant wings of contemporary egalitarianism. The luck egalitarian emphasis on choice and personal responsibility is misplaced because individuals differ so deeply, and arbitrarily, in their choice-making capacities. Allowing inequalities to result from ‘choice’ is akin to allowing inequalities to stem from the possession of any other morally arbitrary factor – such as skin colour or gender. The move towards relational egalitarianism has been a case of two-steps forward, one-step back. While the shift away from the focus on choice is salutary, the concurrent rejection of luck is problematic, given the prevalence and importance of luck-based discrepancies in opportunities to lead a good life. A new conceptual framework is presented: good life egalitarianism. The guiding idea is that given the unavoidable arbitrariness of human capacities, the foundation for a good life should be assured for people regardless of the actual choices that they make. The essential goods necessary for leading a good life – such as the opportunities to self-determine and to enjoy non-dominating social relationships – should be guaranteed to all.
Capitalism as a space of reasons: Analytic, neo-Hegelian Marxism?
Authors: Evans Justin
Published: June 2020

I suggest that we can read Marx in the light of recent analytic, neo-Hegelian thought. I summarize the Pittsburgh School philosophers’ claims about the myth of the given, the claim that human experience is conceptual all the way out, and that we live in a space of reasons. I show how Hegel has been read in those terms, and then apply that reading of Hegel to Marx’s argument that capital is akin to what Hegel called Geist, or spirit. We can understand capitalism as a space of reasons that is contradictory: while the space of reasons is supposed to make human freedom possible, our space of reasons makes freedom impossible. Reading Marx in this way is helpful, because it avoids the flaws of analytical Marxism, existentialism and structuralism. However, it raises a large problem of its own: Can the theory of the space of reasons be applied to a society that is not free of alienation? I argue that it can, but only in ways that would not satisfy the analytic neo-Hegelians themselves.
The Church Climate Action: Identifying the Barriers and the Bridges
Authors: Nche George C
Published: June 2020

For many decades, efforts are being channelled towards fostering effective robust church-based climate action across the globe. However, this desired action has unfortunately been in short supply. This has been attributed to some factors that serve as barriers to effective church-based climate action. In an extensive review, this article did not only identify these barriers but also the bridges or pathways out of these barriers/challenges. After a critical review of about 150 empirical studies with a few anecdotal literature, findings showed that beyond the theological barriers that are commonly referenced in many studies, the church also faces institutional barriers in their bid to address climate change. The biblical concept of stewardship, climate change awareness/knowledge creation, strategic communication and engagement, and strategic fundraising and mobilisation were found to be the bridges/pathways towards achieving a robust church-based climate action. Implications of findings for the church and research are discussed.
Explaining the importance of Euler’s method in rigid-body dynamics
Authors: Martins Flavius PR , Fleury Agenor T , Trigo Flavio C
Published: June 2020

The purpose of this study is essentially pedagogical and aims to provide an additional argument in clarification of a question often raised by first-year undergraduate mechanical engineering students concerning the reason for using two frames of reference—one fixed in space and one fixed in the rigid-body—to describe its motion. The reasoning employed to illustrate the inappropriateness of using a single reference frame entails showing that the equations of motion, thus obtained, are far more complex than the equations resulting from application of the traditional Euler Method. This point is illustrated through the well-known frictionless symmetrical spinning top problem.
Modeling, analysis, and control of wind-driven induction generators supplying DC loads under various operating conditions
Authors: Akbarali Mahaboob Subahani , Subramanium Senthil Kumar , Natarajan Kumaresan
Published: June 2020

A configuration of a self-excited induction generator supplying DC loads with constant voltage through a diode bridge rectifier and a buck-type DC–DC converter is proposed. The rectifier input current is made continuous, by connecting a suitably designed series filter inductor. The method of binary search algorithm is used to solve for the operating parameters of the generator. The performance of the entire unit is predetermined for the various patterns of speed and power operations. For the dynamic analysis of the induction machine, an abc-dq modeling has been employed and the simulation results on the unit are obtained under both steady state and transient state using MATLAB/Simulink toolbox. A prototype model of the unit has been built in the laboratory and the experimental results have been presented, thereby validating the performance and usefulness of the system.
Hemolysis and methemoglobinemia in a child with left ventricular assist Levitronix PediMag
Authors: Butragueño Laiseca Laura , Estepa Pedregosa Lorena , Sánchez Galindo Amelia Caridad , Santiago Lozano María José
Published: June 2020

A 5-month-old male was treated with left ventricular assist device due to cardiac failure secondary to dilated cardiomyopathy. The patient developed acute severe intravascular hemolysis with methemoglobinemia and renal failure, related to a mechanical problem due to pump cylinder misalignment. Secondary severe methemoglobinemia has not been previously described in patients undergoing ventricular assist device. Early detection of the signs and symptoms of hemolysis is crucial to prevent further complications.
Grindability studies of thermomechanically processed advanced high strength steel using sol-gel and fused alumina grain-based grinding wheels
Authors: Magham Hari Srinivasa Rao , Vijayaraghavan L , Sankaran S , Arunachalam N
Published: June 2020

Advanced high strength steels have excellent strength-to-weight ratio and are widely used for automotive and structural applications. Grinding is commonly used as a final machining process for these materials to achieve the required dimensional tolerance and surface quality. In this work, the grindability of as-received microstructure of ferrite-pearlite and in-house developed ferrite-bainite-martensite steels using polycrystalline white fused alumina and microcrystalline sol-gel alumina grinding wheels under flood and minimum quantity lubrication conditions is studied. Grindability of these steels was evaluated based on the wheel wear, grinding forces, force ratio, specific cutting energy, surface roughness (Ra), and surface morphology. The sol-gel alumina wheel was observed with higher wear flat area and forces under all the grinding conditions as compared with white fused alumina wheel. The white fused alumina wheel exhibited higher force ratio values for all the grinding conditions than the sol-gel alumina wheel. The energy required per unit volume of material removal is lower for the white fused alumina wheel in both the steels under flood and minimum quantity lubrication conditions. This is due to the retention of sharpness of abrasive grains by self-sharpening for white fused alumina wheel than the sol-gel alumina. The presence of fractured, melted, and hollow chips on the ferrite-pearlite and ferrite-bainite-martensite steels under both the grinding condition confirms the change in material removal mechanism with the presence of higher wear flat area of the sol-gel alumina wheel. Based on the obtained results, the white fused alumina wheel was found to be a suitable grinding wheel for grinding of both the steels under all grinding conditions compared to the sol-gel alumina wheel.
Semi-physical NOx and soot model for CI engines: Study of its calibration procedure and portability
Authors: Karaky Hassan , Marty Pierre , Tauzia Xavier , Maiboom Alain , Mauviot Gilles
Published: June 2020

A series of papers has previously presented a semi-physical model for NOx and soot emissions prediction for diesel engines. In this paper, the work is continued with an original analysis of the model’s capacity to be ported to a new engine and a sensitivity analysis of the number of training points required to obtain the desired accuracy. These two aspects are rarely developed in similar studies.
Three-dimensional simulation of performance in through-mask electrochemical micromachining
Authors: Tsai Te-Hui , Lin Ming-Yuan , Fan Zhi-Wen , Lin Hung-Lin
Published: June 2020

Through-mask electrochemical micromachining (TMEMM) is a kind of microfabrication. The major feature of through-mask electrochemical micromachining is that the tool is not limited by the shape, and can be processed in various shapes according to the pattern on the mask. This paper uses the finite element method to create a three-dimensional model to discuss the influence of flow direction, voltage, and electrolyte flow rate on the shape of the through-mask electrochemical micromachining. The simulation results show that processing shape is deeply affected by processing parameters, electrolyte flow rate affects processing temperature distribution, and temperature distribution at the bottom of aperture affects processing depth and flatness during processing, which in turn causes the difference in orifice size and roundness. At the same flow rate, the larger voltage, the larger average radius, flatness, and roundness. At the same voltage, the faster flow rate, the lower average depth, flatness, and average radius. Overall, it has best-processed aperture profile at a flow rate of 0.5 m/s. As a whole, the through-mask electrochemical micromachining is indeed suitable for array microfabrication of various shapes. In this study, experiments were added to verify the simulation results. At a fixed electrolyte flow rate, when the voltage, concentration, and mask aperture are changed, it will have an effect on the overall experimental results. From the experimental results, we know that the electrolyte flow rate and temperature distribution will indeed affect the overall processability.
Utilizing time series data embedded in electronic health records to develop continuous mortality risk prediction models using hidden Markov models: A sepsis case study
Authors: Gupta Akash , Liu Tieming , Crick Christopher
Published: June 2020

Continuous mortality risk monitoring is instrumental to manage a patient’s care and to efficiently utilize the limited hospital resources. Due to incompleteness and irregularities of electronic health records (EHR), developing continuous mortality risk prediction using EHR data is a challenge. In this study, we propose a framework to continuously monitor mortality risk, and apply it to the real-world EHR data. The proposed method employs hidden Markov models (temporal technique) that take account of both the previous state of patient’s health and the current value of clinical signs. Following the Sepsis-3 definition, we selected 3898 encounters of patients with suspected infection to compare the performance of temporal and non-temporal methods (Decision Tree (DT), Logistic Regression (LR), Naive Bayes (NB), Random Forest (RF), and Support Vector Machine (SVM)). The area under receiver operating characteristics (AUROC) curve, sensitivity, specificity and G-mean were used as performance measures. On the selected data, the AUROC of the proposed temporal framework (0.87) is 9–12% greater than the nontemporal methods (DT: 0.78, NB: 0.79, SVM: 0.79, LR: 0.80 and RF: 0.80). The results also show that our model (G-mean=0.78) provides a better balance between sensitivity and specificity compared to clinically acceptable bed-side criteria (G-mean=0.71). The proposed framework leverages the longitudinal data available in EHR and performs better than the non-temporal methods. The proposed method facilitates information related to the time of change of the patient’s health that may help practitioners to plan early and develop effective treatment strategies.
Eradication of caprine arthritis encephalitis virus in the goat population of South Tyrol, Italy: analysis of the tailing phenomenon during the 2016–2017 campaign
Authors: Nardelli Stefano , Bettini Astrid , Capello Katia , Bertoni Giuseppe , Tavella Alexander
Published: June 2020

Since 2007, the Autonomous Province of Bolzano–South Tyrol (Italy) has carried out a compulsory eradication program against caprine arthritis encephalitis virus (CAEV) in goats. A drastic seroprevalence reduction was achieved during the initial phase (2007–2011); however, a tailing phenomenon has been observed during the latest years, hampering the achievement of the final goal. CAEV belongs to a group of lentiviruses, called small ruminant lentiviruses (SRLVs), which are antigenically related and can infect both goats and sheep. We investigated the possible link between the tailing phenomenon in goats and the role of sheep as a virus reservoir by comparing serologic results between multispecies farms (where goats and sheep coexist) and monospecies farms (goats only). Goats on multispecies farms had a higher prevalence and seroconversion rate (even if to a rather moderate extent), higher antibody titers, and a higher probability of conclusive results in the genotyping analysis, with more frequent identification of SRLV genotype A (sheep-related) infections. Sheep can serve as a SRLV reservoir, thus contributing to scattered positive tests in goats, causing the tailing phenomenon.
Longitudinal evaluation of cardiovascular function in six healthy cats aged 1–8 years
Authors: Sugimoto Keisuke , Aoki Takuma , Fujii Yoko
Published: June 2020

Objectives

The purpose of this study was to determine the impact of ageing on the cardiovascular system of healthy adult cats.

Methods

Six experimental cats were used. Echocardiography and measurements of systolic blood pressure (SBP) were performed every year for 8 years (from 1 year of age to 8 years of age) in all cats. Age-related changes to left ventricular (LV) structures, LV systolic and diastolic function, and SBP were assessed.

Results

There were no significant changes in LV structures and SBP. Peak longitudinal strain rate during systole was decreased at 8 years of age, and peak longitudinal strain rate during diastole was decreased from 6 years of age.

Conclusions and relevance

This study revealed that some measures of cardiac function recorded in six healthy cats from 1 to 8 years of age were affected as the cats got older; however, there were no structural changes or changes in measurements that are routinely assessed in clinical practice.
Acute disseminated encephalomyelitis in children and adults: A focused review emphasizing new developments
Authors: Otallah Scott
Published: June 2020

Acute disseminated encephalomyelitis (ADEM) was originally described in the medical literature more than 200 years ago. However, consensus clinical diagnostic criteria are less than 15 years old. Accurate diagnostic testing for myelin oligodendrocyte glycoprotein (MOG) autoantibodies has only become clinically available in the last 3–5 years and has facilitated a rapidly evolving understanding of patients with recurrent demyelination following ADEM. The field is working to optimize treatment for these patients with hopes of prospective treatment studies in the not too distant future. New imaging data suggest that even monophasic demyelination may have long-term impacts that were previously unrecognized. Recent developments in the literature are described in order to guide practice for providers who treat both adults and children with monophasic and recurrent forms of ADEM with and without MOG antibodies.
Transitioning youth with autism spectrum disorders and other special health care needs into adult primary care: A provider survey
Authors: Ames Jennifer L , Massolo Maria L , Davignon Meghan N , Qian Yinge , Cerros Hilda J , Croen Lisa A
Published: June 2020

Health care continuity during the transition from pediatric to adult care is critical to helping individuals with autism spectrum disorders manage complex medical and psychiatric co-morbidities that start in childhood and evolve with age. We conducted a brief online survey of pediatric and adult providers at Kaiser Permanente Northern California, a large integrated health care delivery system, to assess departmental policies and personal approaches to transitioning patients with special health care needs, including autism spectrum disorders. A total of 354 pediatric (43% response rate) and 715 adult providers (30% response rate) completed the survey. A large majority of departments did not have transition policies in place. Many providers in both primary care and mental health did not provide transition resources, review legal changes, use standardized assessment tools, or communicate with the next/previous provider. Transition planning was usually delayed until age 17 or later. Most providers did not have consistent approaches to the transition of care for youth with special health care needs and may be inadequately prepared to handle the process for patients with autism spectrum disorders. As the population of transition-age youth with autism spectrum disorders continues to grow, there is urgent need to understand how to best implement transition policies that promote early communication between providers and families and track outcomes among transitioning patients with special health care needs.

Lay Abstract

The transition from pediatric to adult care is a critical inflection point for the long-term health of youth with autism spectrum disorders and other special health care needs. However, for many patients, their caregivers, and providers, the transition lacks coordination. This survey study demonstrates that pediatric and adult providers struggle to implement many components of transition best practices for youth with autism and other chronic conditions, highlighting the urgent need for enhanced medical coordination and additional transition training and resources.
Teacher education in cooperative learning and its influence on inclusive education
Authors: Muñoz-Martínez Yolanda , Monge-López Carlos , Torrego Seijo Juan Carlos
Published: June 2020

This article presents the study of the perception of teachers and principals participating in a teacher training program about cooperative learning with the focus on the transformation of teaching practices for inclusive education. The aim is to analyze the effect of a teacher training program on teaching practices and school transformation. We carried out an exploratory case study involving eight public schools of the Community of Madrid. Twenty-nine teachers (including principals) and two counselors agreed to participate. The process involved discussion groups, in-depth interviews, questionnaires about the training received, and analysis of documents (reports, stories, and projects). The results found that there is a positive influence on how students live together, their learning, emotional intelligence, and social relationships.
Lessons from the nursery: The role of childcare in a cognitive behavioral treatment intervention for Latinas
Authors: Choi Shinwoo , Piedra Lissette M , Byoun Soo-Jung
Published: June 2020

Providing childcare along with interventions for disadvantaged mothers increases the benefit. However, program designers rarely focus on the implementation of that care and how it affects program participants. Using the common factors model as a lens, this paper explores the challenges that arose in the third year of an intervention that provided childcare to Spanish-speaking immigrant mothers enrolled in a Cognitive Behavioral Treatment (CBT) group when the socioeconomic status of beneficiaries and the population of children needing care changed. We used data collected by the childcare coordinator—participant observation, field notes, and administrative documentation—to examine the meanings participants assigned to problems in the childcare program, their resolution, and how it affected the therapeutic alliance. Data analysis focuses on the extent emerging themes were consistent with the concepts from the common factors approach. Four lessons for providers of interventions with similar supports emerge: attend to the physical environment, anticipate that learning from and rectifying mistakes can improve the therapeutic relationship, select and train childcare providers to understand they are clinical helpers, and recognize that participants view the childcare service as an extension of the intervention. Findings underscore the importance of support services in fostering the success of social work interventions in community settings.
Predicting the overall horizontal bearing capacity of jack-up rigs using deck–foundation–soil-coupled model
Authors: Yin Qilin , Zhai Jinjin , Dong Sheng
Published: June 2020

The overall bearing capacity of a jack-up rig under horizontal load is conducted using finite element models that consider the deck–foundation–soil interaction. In these models, the simplified horizontal load acts on the deck and increases until the platform loses its stability. The effects of the self-weight of the platform W and load direction α on the ultimate horizontal bearing capacity Hult are investigated, and W- Hult failure envelopes under different α conditions are obtained. Two typical seabed types, including the double-layer seabed of sand overlying soft clay and the single-layer seabed of sand, are considered. The results show that a critical self-weight Wcritical exists in the double-layer seabed. Based on Wcritical, the failure of the platform presents two different modes. When W <  Wcritical, the windward leg is pulled up, and Hult increases with the increase in W. When W >  Wcritical, the failure mode is the leeward leg or legs puncturing the bearing sand layer, and Hult decreases with the increase in W. In the single-layer seabed, the failure mode is the windward leg being pulled up, and Hult increases with the increase in W throughout the whole range. The W- Hult envelopes in these two types of seabeds are basically the same when W <  Wcritical.
Engaging Youth Through Digital Badges to Promote Health in Underserved Communities
Authors: Heinert Sara W. , Quasim Nasseef , Ollmann Emily , Socarras Melissa , Suarez Natalia
Published: June 2020

The CHAMPIONS NETWork program trains Chicago high school students as health advocates while preparing them to become future health professionals. We added digital badging to the curriculum in its third year of programming (2018). This article describes methods and student feedback about digital badging, allowing others to implement similar technology-driven opportunities to engage youth and promote healthy living. Program staff created seven online experiences (XPs) on health advocacy that made up a playlist. Students adopted three adults as clients and completed four XPs themselves and three with clients. Completion of all XPs resulted in a digital badge—an electronic portfolio of health advocacy experiences to be shared with employers and colleges. Following the 2019 cohort’s completion of the digital badge, we conducted two focus groups with students about their feedback on the digital badge. Results showed that students most liked the healthy eating and cardiopulmonary resuscitation XPs. They had more positive reactions to the experience than negative, and especially appreciated aspects of active learning, as well as the badge’s long-term benefits. This technology can potentially help any student with access to an electronic device become a health advocate, and could become a new tool for career development while improving population health.
The Unavoidable Intentionality of Affect: The History of Emotions and the Neurosciences of the Present Day
Authors: Reddy William M.
Published: June 2020

The “problem of emotions,” that is, that many of them are both meaningful and corporeal, has yet to be resolved. Western thinkers, from Augustine to Descartes to Zajonc, have handled this problem by employing various forms of mind–body dualism. Some psychologists and neuroscientists since the 1970s have avoided it by talking about cognitive and emotional “processing,” using a terminology borrowed from computer science that nullifies the meaningful or intentional character of both thought and emotion. Outside the Western-influenced contexts, emotion and thought are not seen as distinct kinds of things. Here a solution of sorts is proposed by thinking of emotional expression as a dynamic activity that declares and stirs emotions at the same time. As such, its dynamism may help historians to understand the dramatic changes and trends they investigate.
Innovative force sensor for indoor climbing holds – real-time measurements and data processing, design and validation
Authors: Maffiodo Daniela , Sesana Raffaella , Gabetti Stefano , Colombo Alessandro
Published: June 2020

In this article, a system to measure the evolution of load in time and space during indoor climbing is described. The system is based on a set of dedicated multiaxial load cells, which measure the load on each hold of an indoor climbing wall. When the climber hangs on a hold, the load signal is read and sent to a digital acquisition and processing system. Sensor design allows for measurement of the force components applied to the climbing holds, regardless of the application point of the force on the hold. Local deformations were measured through strain gauges. Based on the electrical configuration of the strain gauges, the values of the applied forces can be computed, making the contributions to the deformation due to bending moments and torsion negligible. The sensor was designed, assuming a maximum applicable load of 200 kg without plastic deformation. The design process was based on both analytical and finite element method analyses. An experimental calibration and testing campaign was performed to validate the sensor design.
Association Between Deviated Nasal Septum With Inferior Turbinate Hypertrophy and the Risk of Male Infertility
Authors: Chen Hsin-Chien , Chung Chi-Hsiang , Chien Wu-Chien
Published: June 2020

Objectives

Obstructive sleep apnea is associated with an increased risk of male infertility, and one of its causes is deviated nasal septum with inferior turbinate hypertrophy (DNS/ITH). However, the risk of male infertility associated with DNS/ITH remains unclear.

Methods

Using the Taiwan Longitudinal Health Insurance Database, we conducted a retrospective matched cohort study to investigate the risk of infertility in male patients diagnosed with DNS/ITH (N = 61,761) from 2000 to 2015 in comparison with matched controls without DNS/ITH (N = 247,044). We further analyzed the effect of septoturbinoplasty (STP), including septoplasty and turbinoplasty, on the risk of male infertility in DNS/ITH patients.

Results

At the end of the follow-up period, 46 (0.07%, 46/61,761, incidence rate: 6.25 per 100,000 person-years) patients developed infertility in the DNS/ITH group versus 72 (0.03%, 72/247,044, incidence rate: 2.28 per 100,000 person-years) in the control group; the incidence rate was 2.740-fold higher in the DNS/ITH group (log-rank P < 0.001). Cox proportional hazards regression revealed that the risk of infertility increased in the DNS/ITH group [adjusted hazard ratio (HR): 1.080, 95% confidence interval (CI), 1.049–1.514, P = 0.001]. Compared with the control group, the risk of infertility was highest in the DNS/ITH group without STP (adjusted HR: 2.842, 95% CI, 1.715–4.082, P < 0.001), followed by the DNS/ITH group with STP (adjusted HR: 1.074, 95% CI, 1.035–1.488, P = 0.012). The intervention of STP reduced the risk of infertility in the DNS/ITH group by 45.1% compared with those without STP (P = 0.033).

Conclusion

Clinicians should be aware of the risk of infertility in male patients presenting with DNS/ITH. Improving the nasal airway by STP may decrease the risk of male infertility.
European Guideline on IgG4‐related digestive disease – UEG and SGF evidence‐based recommendations
Authors: Löhr J‐Matthias , Beuers Ulrich , Vujasinovic Miroslav , Alvaro Domenico , Frøkjær Jens Brøndum , Buttgereit Frank , Capurso Gabriele , Culver Emma L , de‐Madaria Enrique , Della‐Torre Emanuel , Detlefsen Sönke , Dominguez‐Muñoz Enrique , Czubkowski Piotr , Ewald Nils , Frulloni Luca , Gubergrits Natalya , Duman Deniz Guney , Hackert Thilo , Iglesias‐Garcia Julio , Kartalis Nikolaos , Laghi Andrea , Lammert Frank , Lindgren Fredrik , Okhlobystin Alexey , Oracz Grzegorz , Parniczky Andrea , Mucelli Raffaella Maria Pozzi , Rebours Vinciane , Rosendahl Jonas , Schleinitz Nicolas , Schneider Alexander , van Bommel Eric FH , Verbeke Caroline Sophie , Vullierme Marie Pierre , Witt Heiko ,   the UEG guideline working group
Published: June 2020

The overall objective of these guidelines is to provide evidence‐based recommendations for the diagnosis and management of immunoglobulin G4 (IgG4)‐related digestive disease in adults and children. IgG4‐related digestive disease can be diagnosed only with a comprehensive work‐up that includes histology, organ morphology at imaging, serology, search for other organ involvement, and response to glucocorticoid treatment. Indications for treatment are symptomatic patients with obstructive jaundice, abdominal pain, posterior pancreatic pain, and involvement of extra‐pancreatic digestive organs, including IgG4‐related cholangitis. Treatment with glucocorticoids should be weight‐based and initiated at a dose of 0.6–0.8 mg/kg body weight/day orally (typical starting dose 30‐40 mg/day prednisone equivalent) for 1 month to induce remission and then be tapered within two additional months. Response to initial treatment should be assessed at week 2–4 with clinical, biochemical and morphological markers. Maintenance treatment with glucocorticoids should be considered in multi‐organ disease or history of relapse. If there is no change in disease activity and burden within 3 months, the diagnosis should be reconsidered. If the disease relapsed during the 3 months of treatment, immunosuppressive drugs should be added.
Spatiality at the Cyber-Margins: Black-Oriented Blogs and the Production of Territoriality Online
Authors: Davis Patricia G.
Published: June 2020

This essay analyzes the challenges African American–oriented blogs must confront in terms of spatiality, specifically that associated with racial trolling. I argue that racial trolling, which encompasses a set of actions wherein users make inflammatory comments in a manner designed specifically to advance racist tropes, represents a mode of spatial aggression that operates in ways reproductive of the power relations that characterize the offline world. I further argue that neoliberalism, which has transformed these sites from relatively small, niche communities of primarily black users to commercially oriented sites open to mass participation, has strengthened the mobility of whiteness on the internet and exacerbated the trolling behaviors. In confronting the challenges these spatial aggressions pose, community members invoke their own sense of agency regarding space, mobilizing various types of user moderation as means of preserving these sites as their own cyber-territories. In constructing this argument, I conduct a critical technocultural discourse analysis (CTDA) of discourse from the comments sections of two black-oriented websites, TheRoot and VerySmartBrothas.
Impairments in sensory-motor gating and information processing in a mouse model of Ehmt1 haploinsufficiency
Authors: Davis Brittany A , David François , O’Regan Ciara , Adam Manal A , Harwood Adrian J , Crunelli Vincenzo , Isles Anthony R
Published: June 2020

Regulators of chromatin dynamics and transcription are increasingly implicated in the aetiology of neurodevelopmental disorders. Haploinsufficiency of EHMT1, encoding a histone methyltransferase, is associated with several neurodevelopmental disorders, including Kleefstra syndrome, developmental delay and autism spectrum disorder. Using a mouse model of Ehmt1 haploinsufficiency ( Ehmt1D6Cre/+), we examined a number of brain and behavioural endophenotypes of relevance to neurodevelopmental disorders. Specifically, we show that Ehmt1D6Cre/+ mice have deficits in information processing, evidenced by abnormal sensory-motor gating, a complete absence of object recognition memory, and a reduced magnitude of auditory evoked potentials in both paired-pulse inhibition and mismatch negativity. The electrophysiological experiments show that differences in magnitude response to auditory stimulus were associated with marked reductions in total and evoked beta- and gamma-band oscillatory activity, as well as significant reductions in phase synchronisation. The pattern of electrophysiological deficits in Ehmt1D6Cre/+ matches those seen in control mice following administration of the selective NMDA-R antagonist, ketamine. This, coupled with reduction of Grin1 mRNA expression in Ehmt1D6Cre/+ hippocampus, suggests that Ehmt1 haploinsufficiency may lead to disruption in NMDA-R. Taken together, these data indicate that reduced Ehmt1 dosage during forebrain development leads to abnormal circuitry formation, which in turn results in profound information processing deficits. Such information processing deficits are likely paramount to our understanding of the cognitive and neurological dysfunctions shared across the neurodevelopmental disorders associated with EHMT1 haploinsufficiency.
pyMeSHSim: an integrative python package for biomedical named entity recognition, normalization, and comparison of MeSH terms
Authors: Luo Zhi-Hui , Shi Meng-Wei , Yang Zhuang , Zhang Hong-Yu , Chen Zhen-Xia
Published: June 2020

Background

Many disease causing genes have been identified through different methods, but there have been no uniform annotations of biomedical named entity (bio-NE) of the disease phenotypes of these genes yet. Furthermore, semantic similarity comparison between two bio-NE annotations has become important for data integration or system genetics analysis.

Results

The package pyMeSHSim recognizes bio-NEs by using MetaMap which produces Unified Medical Language System (UMLS) concepts in natural language process. To map the UMLS concepts to Medical Subject Headings (MeSH), pyMeSHSim is embedded with a house-made dataset containing the main headings (MHs), supplementary concept records (SCRs), and their relations in MeSH. Based on the dataset, pyMeSHSim implemented four information content (IC)-based algorithms and one graph-based algorithm to measure the semantic similarity between two MeSH terms. To evaluate its performance, we used pyMeSHSim to parse OMIM and GWAS phenotypes. The pyMeSHSim introduced SCRs and the curation strategy of non-MeSH-synonymous UMLS concepts, which improved the performance of pyMeSHSim in the recognition of OMIM phenotypes. In the curation of 461 GWAS phenotypes, pyMeSHSim showed recall > 0.94, precision > 0.56, and F1 > 0.70, demonstrating better performance than the state-of-the-art tools DNorm and TaggerOne in recognizing MeSH terms from short biomedical phrases. The semantic similarity in MeSH terms recognized by pyMeSHSim and the previous manual work was calculated by pyMeSHSim and another semantic analysis tool meshes, respectively. The result indicated that the correlation of semantic similarity analysed by two tools reached as high as 0.89–0.99.

Conclusions

The integrative MeSH tool pyMeSHSim embedded with the MeSH MHs and SCRs realized the bio-NE recognition, normalization, and comparison in biomedical text-mining.
Transcriptome analysis of the brain provides insights into the regulatory mechanism for Coilia nasus migration
Authors: Wang Meiyao , Xu Gangchun , Tang Yongkai , Xu Pao
Published: June 2020

Background

Coilia nasus(C. nasus) is an important anadromous fish species that resides in the Yangtze River of China, and has high ecological and economical value. However, wild resources have suffered from a serious reduction in population, attributed to the over-construction of water conservancy projects, overfishing, and environmental pollution. The Ministry of Agriculture and Rural Affairs of the People’s Republic of China has issued a notice banning the commercial fishing of wildC. nasusin the Yangtze River. WildC. nasuspopulations urgently need to recover. A better understanding ofC. nasusmigration patterns is necessary to maximize the efficiency of conservation efforts. JuvenileC. nasusexperience a simultaneous effect of increasing salinity and cold stress during seaward migration, and the brain plays a comprehensive regulatory role during this process. Therefore, to explore the early seaward migration regulation mechanism of juvenileC. nasus, we performed a comparative transcriptome analysis on the brain of juvenileC. nasusunder salinity and cold stress simultaneously.

Results

Relevant neurotransmitters, receptors, and regulatory proteins from three categories of regulatory pathway play synergistic regulatory roles during the migration process: neuronal signaling, the sensory system, and environmental adaptation. The significant differential expression of growth-related hormones, thyroid receptors, haptoglobin, and prolactin receptors was similar to the results of relevant research on salmonids and steelhead trout.

Conclusions

This study revealed a regulatory network that the brain of juvenileC. nasusconstructs during migration, thereby providing basic knowledge on further studies could build on. This study also revealed key regulatory genes similar to salmonids and steelhead trout, thus, this study will lay a theoretical foundation for further study on migration regulation mechanism of anadromous fish species.
RelB regulates the homeostatic proliferation but not the function of Tregs
Authors: Zhou Shuping , Wu Weiwei , Wang Zhaoxia , Wang Zhaopeng , Su Qinghong , Li Xiaofan , Yu Yong , Zhang Weidong , Zhu Mingzhao , Lin Wei
Published: June 2020

Background

RelB, a member of the NF-κB family, plays a critical role in the development of T cells. However, the role of RelB in Foxp3+regulatory T cells (Tregs) remains controversial.

Results

Using a bone marrow chimeric mouse model, we demonstrated that the expansion of Foxp3+Tregs in vivo could be mediated by extrinsic mechanisms. RelB plays an important role in inhibiting the homeostatic proliferation of Tregs, but not their survival. Even with the heightened expansion,RelB−/−Treg cells displayed normal suppressive function in vitro. Among the expanded populations of Treg cells, most were nTreg cells; however, the population of iTregs did not increase. Mechanistically, RelB seems to regulate Treg proliferation independently of the signal transducer and activator of transcription 5 (STAT5) pathway.

Conclusions

These data suggest that RelB regulates Treg proliferation independently of the STAT5 pathway, but does not alter the function of Tregs. Further studies are warranted to uncover such mechanisms.
Restricted mean survival time of older adults with severe aortic stenosis referred for transcatheter aortic valve replacement
Authors: Rodighiero Julia , Piazza Nicolo , Martucci Giuseppe , Spaziano Marco , Lachapelle Kevin , de Varennes Benoit , Ouimet Marie-Claude , Afilalo Jonathan
Published: June 2020

Background

Few studies have measured frailty as a potential reason for foregoing transcatheter aortic valve replacement (TAVR) in older adults with severe aortic stenosis (AS). This study sought to determine the impact of frailty and other clinician-cited reasons on restricted mean survival time (RMST).

Methods

An analysis of the McGill Frailty Registry was conducted between 2014 and 2018 at the McGill University Health Center Structural Valve Clinic. Consecutive nonsurgical patients referred for TAVR were included. In those that underwent balloon aortic valvuloplasty or medical management, the primary clinician-cited reason for foregoing TAVR was codified. Vital status was ascertained at 1 year and analysed using RMST and Kaplan-Meier analyses.

Results

The study consisted of 373 patients with a mean age of 82.4 years, of which 233 underwent TAVR and 140 did not. Patients who did not undergo TAVR were more likely to be nonagenarians, with left ventricular dysfunction, chronic kidney disease, dementia, disability, depression, malnutrition, and frailty. The primary clinician-cited reason was: comorbidity in 34%, frailty in 23%, procedural feasibility and risks in 16%, and mild or unrelated symptoms in 27%. Compared to the TAVR group, 1-year RMST was reduced by 2.0 months in the medical management group (95% CI 1.2, 2.7) and by 1.1 months in the valvuloplasty group (95% CI -0.2, 2.5).

Conclusions

Patients with severe AS referred for TAVR may never undergo the procedure on the basis of comorbidity, frailty, procedural issues, and symptoms. The best treatment decision is one that follows from multi-disciplinary assessment encompassing frailty.
Quantitative fragmented QRS has a good diagnostic value on myocardial fibrosis in hypertrophic obstructive cardiomyopathy based on clinical-pathological study
Authors: Bi Xuanye , Yang Chengzhi , Song Yunhu , Yuan Jiansong , Cui Jingang , Hu Fenghuan , Qiao Shubin
Published: June 2020

Background

To investigate the relationship between fragmented QRS (fQRS) quantified by a new method and myocardial fibrosis (MF) and the diagnostic value of quantitative fQRS (Q-fQRS) to detect MF in hypertrophic obstructive cardiomyopathy (HOCM) patients based on histological validation.

Methods

We performed a retrospective study that included 69 patients with HOCM who underwent ventricular septal surgery. Nine individuals who died from accidents were studied as a control reference for the histological parameters. Septal myocardium samples were subjected to Masson’s trichrome staining to quantify the collagen volume fraction (CVF). An fQRS pattern was defined as the presence of additional R waves or RSR’, evidenced by notched R or S wave on electrocardiography (ECG). The Q-fQRS was quantified as the total amount of deflections in the QRS complex in all 12 routine ECG leads together. Cardiac magnetic resonance imaging was conducted, and late gadolinium enhancement (LGE) was measured at 2, 4, 6 and 8 standard deviations (SDs).

Results

Of the 69 patients, fQRS was documented in 38 (55.1%) patients, the mean number of leads with fQRS was 3.7 ± 1.6, and the mean Q-fQRS was 17 ± 7.2. Compared with HOCM patients without fQRS, HOCM patients with fQRS had a higher CVF and more LGE at 6 SD (P < 0.001; P = 0.040). Q-fQRS was correlated with CVF (r = 0.640, P < 0.001), and Q-fQRS showed the best correlation with LGE measured at 8 SD (r = 0.379, P = 0.002). Multivariate regression analyses revealed that Q-fQRS was independently associated with the extent of CVF in HOCM patients after adjusting for age, sex, body surface area and the extent of LGE at 6 SD (P < 0.001). When the patients were divided into subgroups with normal CVF or high CVF according to the CVF in controls, Q-fQRS and LGE at 6SD showed similar diagnostic value in detecting patients with high CVF, with sensitivities of 66.7% vs 68.6%, specificities of 76.7% vs 72.4%, and accuracies of 71% vs 70.3%.

Conclusions

HOCM patients with fQRS showed more extensive MF. Q-fQRS was an independent predictor for MF and had a good diagnostic value, with a sensitivity of 66.7% and specificity of 76.7%, in identifying patients with higher fibrotic burden.