bluuebunny/crossref_metadata_2025 huggingface dataset:
Three novel genetic variants in NRF2 signaling pathway genes are associated with pancreatic cancer risk
Authors: Yang Wenjun , Liu Hongliang , Duan Bensong , Xu Xinyuan , Carmody Dennis , Luo Sheng , Walsh Kyle M. , Abbruzzese James L. , Zhang Xuefeng , Chen Xiaoxin , Wei Qingyi
Published: April 2019

Pancreatic cancer (PanC) is one of the most lethal solid malignancies, and metastatic PanC is often present at the time of diagnosis. Although several high‐ and low‐penetrance genes have been implicated in PanC, their roles in carcinogenesis remain only partially elucidated. Because the nuclear factor erythroid2‐related factor2 (NRF2) signaling pathway is involved in human cancers, we hypothesize that genetic variants in NRF2 pathway genes are associated with PanC risk. To test this hypothesis, we assessed associations between 31 583 common single nucleotide polymorphisms (SNP) in 164 NRF2‐related genes and PanC risk using three published genome‐wide association study (GWAS) datasets, which included 8474 cases and 6944 controls of European descent. We also carried out expression quantitative trait loci (eQTL) analysis to assess the genotype‐phenotype correlation of the identified significant SNP using publicly available data in the 1000 Genomes Project. We found that three novel SNP (ie, rs3124761, rs17458086 and rs1630747) were significantly associated with PanC risk (P = 5.17 × 10−7, 5.61 × 10−4 and 5.52 × 10−4, respectively). Combined analysis using the number of unfavorable genotypes (NUG) of these three SNP suggested that carriers of two to three NUG had an increased risk of PanC (P < 0.0001), compared with those carrying zero to one NUG. Furthermore, eQTL analysis showed that both rs3124761 T and rs17458086 C alleles were associated with increased mRNA expression levels of SLC2A6 and SLC2A13, respectively (P < 0.05). In conclusion, genetic variants in NRF2 pathway genes could play a role in susceptibility to PanC, and further functional exploration of the underlying molecular mechanisms is warranted.
Local attitudes toward Apennine brown bears: Insights for conservation issues
Authors: Glikman Jenny A. , Ciucci Paolo , Marino Agnese , Davis Elizabeth O. , Bath Alistair J. , Boitani Luigi
Published: April 2019

Human‐carnivore coexistence is a multi‐faceted issue that requires an understanding of the diverse attitudes and perspectives of the communities living with large carnivores. To inform initiatives that encourage behaviors in line with conservation goals, we focused on assessing the two components of attitudes (i.e., feelings and beliefs), as well as norms of local communities coexisting with Apennine brown bears (Ursus arctos marsicanus) for a long time. This bear population is under serious extinction risks due to its persistently small population size, which is currently confined to the long‐established protected area of Abruzzo, Lazio and Molise National Park (PNALM) and its surrounding region in central Italy. We interviewed 1,611 residents in the PNALM to determine attitudes and values toward bears. We found that support for the bear's legal protection was widespread throughout the area, though beliefs about the benefits of conserving bears varied across geographic administrative districts. Our results showed that residents across our study areas liked bears. At the same time, areas that received more benefits from tourism were more strongly associated with positive feelings toward bears. Such findings provide useful information to improve communication efforts of conservation authorities with local communities.
Temporal correlation of population composition and environmental variables in the marine invader Ciona robusta
Authors: Caputi Luigi , Toscano Francesco , Arienzo Michele , Ferrara Luciano , Procaccini Gabriele , Sordino Paolo
Published: April 2019

The capacity for ascidians to inhabit coastal sea floor worldwide relies on their peculiar tolerance to environmental variables and pollution, which is considered, together with high levels of genetic diversity, among the main drivers of their invasive potential. In spite of the continued interest in the genetics of invasive species, little attention has been paid toward the microevolutionary processes that drive structure and fate of ascidian populations over time under chemically polluted conditions. Understanding the interplay between environmental and population dynamics is critical to predict the biodiversity of marine coastal ecosystems. In the present study, a local population of the ascidian Ciona robusta living in the Fusaro Lagoon has been monitored over a 13‐month period of sampling. Physico‐chemical parameters (temperature, salinity, turbidity, dissolved oxygen, heavy metals), genetic composition (microsatellites, ITS‐2), abundance and biomass (wet and dry weight) were assessed with the aim to infer fine‐scale temporal variation of population structure with respect to rapid environmental change. Analysis of biomass showed that C. robusta is highly sensitive to salinity and oxygen concentrations. Further, genetic analysis suggested a highly dynamic population structure, likely due to the strong clustering of temporal samples and distinct responses to environmental conditions, including bioaccumulation of heavy metals. Here, we hypothesize that rapid variation in allele frequencies of neutral markers in C. robusta populations may increase the ability of the species to colonize habitats that are subject to strong variation and are under heavy human pressure.
Morphological and genetic characterization of bloom‐forming Raphidophyceae from Brazilian coast
Authors: Branco Suema , Almeida Lidiane L. , Alves‐de‐Souza Catharina , Oliveira Mair M.M. , Proença Luis A.O. , Menezes Mariângela
Published: April 2019

Massive fish kills caused by bloom‐forming species of the Raphidophyceae occur in many marine coastal areas and often cause significant economic losses. The ultrastructure and phylogeny of marine raphidophytes from the Brazilian coast have not been fully analyzed. Here, we present the first combined morphological and genetic characterization of raphidophyte strains from the Brazilian coast. Ten strains of four raphidophyte species (Chattonella subsalsa, C. antiqua, Heterosigma akashiwo, and Fibrocapsa japonica) were characterized based on morphology (including ultrastructure) and LSU rDNA sequences. Chattonella subsalsa and C. antiqua formed two distinct genetic clades. We found that the cell size is the only phenotypic feature separating C. subsalsa and C. antiqua strains from Brazil, whereas traditional characteristics used for species separation in the genus Chattonella (i.e., tail size, chloroplast presence in the tail, ‘oboe‐shaped’ mucocysts, and presence of thylakoids in the pyrenoid matrix) were not sufficiently discriminative, due to their overlapping in the two taxa. The phylogenetic analysis indicated intra‐specific geographic differences among C. subsalsa sequences, with two subclades: one formed by isolates from Brazil, USA, and Iran, and another by a sequence from the Adriatic Sea (Italy). Fibrocapsa japonica also showed intra‐specific geographic differences, with a sequence from a Brazilian strain grouped with strains from Japan, Australia, and Germany, all of them distinct from the Italian isolates. This is the first combined morphological and phylogenetic analysis of raphidophytes from the South Atlantic. Our findings broaden knowledge of the biodiversity of this important bloom‐forming algal group.
Immunomodulatory effect of curcumin on lipopolysaccharide‐ and/or flagellin‐induced production of prostaglandin E2 and relative expression of proinflammatory cytokines in the primary bubaline endometrial stromal cells
Authors: Rashid Dar Rouf , Ali Ajaz , Ahmad Sheikh Firdous , Kumar Singh Sanjay , Patra Manas Kumar , Panigrahi Manjit , Kumar Harendra , Krishnaswamy Narayanan
Published: April 2019

Contents

Developing alternate therapies for bovine endometritis is important in the context of drug residues in the milk and emergence of antimicrobial resistant bacteria. In this regard, we studied the immunomodulatory effect of curcumin 30 µM, on lipopolysaccharide‐ (LPS) and/or flagellin (100 ng/ml each)‐induced prostaglandin E2 (PGE2) and proinflammatory cytokines (PIC) using primary bubaline endometrial stromal cells. After 24 hr treatment, the supernatant was assayed for PGE2 while cells were used for relative quantification of cytokines like IL‐1β, IL‐6, IL‐8 and TNF α transcripts using a control group as calibrator. LPS was found to possess potent stimulatory effect on PGE2 production, whereas the flagellin was not as potent as LPS in stimulating the PGE2 production either per se or in combination with LPS. LPS markedly up‐regulated the transcripts of IL‐8 and IL‐6 as compared to IL‐1β and TNF α in the bubaline endometrial stromal cells. Except for IL‐8, flagellin did not up‐regulate other PICs. There was no additive effect between LPS and flagellin on the up‐regulation of inflammatory cytokines. Curcumin inhibited the LPS‐induced up‐regulation of PIC with strong down‐regulation of IL‐8. The inhibitory effects of curcumin on the inflammatory mediators suggest a potential in the treatment of bovine endometritis.
Dynamic knee control and movement strategies in athletes and non‐athletes in side hops: Implications for knee injury
Authors: Markström Jonas L. , Grip Helena , Schelin Lina , Häger Charlotte K.
Published: April 2019

Athletes exposed to rapid maneuvers need a high level of dynamic knee stability and robustness, while also controlling whole body movement, to decrease the risk of non‐contact knee injury. The effects of high‐level athletic training on such measures of movement control have not, however, been thoroughly evaluated. This study investigated whether elite athletes (who regularly perform knee‐specific neuromuscular training) show greater dynamic knee robustness and/or different movement strategies than non‐athletic controls, in relation to overall knee function. Thirty‐nine women (19 athletes, 20 controls) performed standardized rebound side hops (SRSH) while a motion capture system synchronized with two force plates registered three‐dimensional trunk, hip, and knee joint angles and moments. Dynamic knee robustness was evaluated using finite helical axis (FHA) inclination angles extracted from knee rotation intervals of 10°, analyzed with independent t tests. Angle and moment curves were analyzed with inferential methods for functional data. Athletes had superior knee function (less laxity, greater hop performances, and strength) but presented similar FHA inclination angles to controls. Movement strategies during the landing phase differed; athletes presented larger (a) hip flexion angles (during 9%‐29% of the phase), (b) hip adduction moments (59%‐99%), (c) hip internal rotation moments (83%‐89%), and (d) knee flexion moments (79%‐93%). Thus, elite athletes may have a greater ability than non‐athletes to keep the knee robust while performing SRSH more efficiently through increased engagement of the hip. However, dynamic knee robustness associated with lower FHA inclination angles still show room for improvement, thus possibly decreasing knee injury risk.
Cytomegalovirus retinitis in children and adolescents with acute leukemia following allogeneic hematopoietic stem cell transplantation
Authors: Zöllner Stefan K. , Herbrüggen Heidrun , Kolve Hedwig , Mihailovic Natasa , Schubert Friederike , Reicherts Christian , Rössig Claudia , Groll Andreas H.
Published: April 2019

Cytomegalovirus retinitis (CMVR) may occur after allogeneic hematopoietic stem cell transplantation (HSCT). However, little is known about its incidence, strategies for ophthalmic surveillance, and timely implementation of adequate antiviral treatment in pediatric allogeneic HSCT recipients. We provide a retrospective analysis of the epidemiology and clinical features of CMVR in pediatric allogeneic HSCT patients transplanted at our center over a 16‐year period. Two patients of this cohort with leukemia are presented. Our analysis is supplemented by a systematic review on pediatric patients with leukemia and CMVR in the setting of allogeneic HSCT. The overall incidence of CMVR in our cohort was 1% (4/338) and 14.2% (3/21) in leukemic patients. In published cases, CMVR occurred at a median of 143 days after transplantation, and, in the majority of patients, was preceded by CMV detection in blood by a median of 93 days. Continued immune suppression following engraftment likely triggers CMVR. Preemptive treatment with ganciclovir as standard is usually successful. Foscarnet is used in case of resistance to ganciclovir or drug‐induced granulocytopenia. Overall, CMVR after HSCT in pediatric leukemic patients is rare, but a potentially higher vulnerability of this population for involvement of the eye warrants a standardized ophthalmological examination plan.
Exploring the Impact of Healthcare on Economic Growth in Africa
Authors: Somé Juste , Pasali Selsah , Kaboine Martin
Published: April 2019

This paper empirically investigates the relationship between health expenditures, health outcomes and economic growth in Africa using data from 48 African countries over the period 2000-2015 in a panel data regression framework. In line with wider literature on economic growth as well as health economics, the paper first finds that maternal, infant and child mortality rates are all negatively and significantly associated with economic growth in Africa. In addition, life expectancy at birth is positively associated with economic growth. A 9.4-year increase in life expectancy leads to 1 per cent increase in real GDP per capita. Second, the paper finds that health expenditures have direct and indirect effects on economic growth that are positive and economically meaningful. In particular, a 10 per cent increase in health expenditures leads to an increase in annual average real GDP per capita by 0.24 per cent. Third, education emerges as a strong determinant of both economic growth and health outcomes in Africa, particularly when female education is considered. The main policy implication of this paper is that governments should aim at spending more and efficiently on the overall health system to progress over health outcomes and benefit from the positive externalities leading to economic growth. In addition, it is crucial that governments partner with private sector for resource mobilization and effective service delivery.
Conformationally supple glucose monomers enable synthesis of the smallest cyclodextrins
Authors: Ikuta Daiki , Hirata Yasuaki , Wakamori Shinnosuke , Shimada Hiroaki , Tomabechi Yusuke , Kawasaki Yuri , Ikeuchi Kazutada , Hagimori Takara , Matsumoto Shintaro , Yamada Hidetoshi
Published: April 2019

Sweet spot for making oligosaccharides

Sugars pose a challenge for chemists: how to string together functional group–rich building blocks that can adopt multiple conformations. Two papers in this issue used sugar building blocks constrained by a macrocyclic linker to encourage formation of a specific glycosidic linkage (see the Perspective by Pohl). Ikuta
et al.
used glucose building blocks containing a linker that changes the sugar conformation to synthesize cyclic oligomers with only three or four units. The linker changes the conformation of the glucose monomers, enabling them to come together despite the strain in the final structure. Komura
et al.
prepared sialic acid building blocks with a linker that allows for selective formation of the α-anomeric linkage with a range of nucleophiles. They synthesized dimers of sialic acid with many different linkages and a pentamer with four α(2,8) linkages. This method enabled chemical synthesis of components of mammalian glycans involved in brain development, cell adhesion, and immune response.

Science
, this issue p.
674
, p.
677
; see also p.
631
Impact of antibiotic treatment and host innate immune pressure on enterococcal adaptation in the human bloodstream
Authors: Van Tyne Daria , Manson Abigail L. , Huycke Mark M. , Karanicolas John , Earl Ashlee M. , Gilmore Michael S.
Published: April 2019

A genomics analysis shows how a gut commensal adapts rapidly to bloodstream infection, resisting both antibiotics and host innate immune pressure.
With macrophages, tumors won’t go hungry
Authors: El-Kenawi Asmaa
Published: April 2019

Metabolic cross-talk between macrophages and tumor cells results in cancer progression and therapeutic resistance.
Demystifying anhedonia in childhood with large-scale networks
Authors: Gee Dylan G.
Published: April 2019

Children with anhedonia show specific alterations in large-scale brain networks.
A rare case of osteomyelitis of the clavicle in a child due to Group A streptococcal infection
Authors: Ahmed Molla Imaduddin , Nadeem Muhammad , Bandi Srini
Published: April 2019

Acute osteomyelitis of the clavicle is rare in the paediatric age group. We treated a 5-year-old boy who presented initially with fever and left shoulder pain, and subsequently developed swelling in the region of the left clavicle. Group AStreptococcus(GAS) was isolated in blood culture. MRI of the clavicle showed osteomyelitis of the medial clavicle. The child had incision and drainage of his clavicular collection. The child received intravenous benzylpenicillin and oral cephalexin in the initial presentation; he was treated with 2 weeks of intravenous ceftriaxone and 4 weeks of oral penicillin thereafter with the resolution of his symptoms. There are no previous case reports of osteomyelitis of the clavicle in children caused by GAS. This case highlights the importance of identifying the microbial aetiology in these children to ensure early initiation of treatment with appropriate antibiotics.
Breast MALT lymphoma and AL amyloidosis complicating Sjögren’s syndrome
Authors: Belfeki Nabil , Bellefquih Salima , Bourgarit Anne
Published: April 2019

Marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) lymphomas of the breast with mammary amyloidosis are exceedingly rare entities. This report describes the case of women with long-standing Sjögren’s syndrome presenting with breast MALT lymphoma and amyloïd light-chain (AL) amyloidosis. Breast microcalcification needle biopsy made the positive diagnosis. This unusual finding should be kept in mind. It emphasises the need for careful clinical examination of nodes and extranodal organs supposedly affected in patients with autoimmune disease.
Plasma N-terminal pro-B-type natriuretic peptide (BNP) in mesalazine-induced myopericarditis
Authors: Paschalis Theodoros , Paschali Myrella , Mandal Amit K J , Missouris Constantinos G
Published: April 2019

Mesalazine (5-aminosalicylic acid)-based products are a widely used treatment for inflammatory bowel disease in children and adults. Associated myopericarditis is an uncommon but recorded phenomenon related to drug hypersensitivity. Unless recognised, this important complication may culminate in the development of dilated cardiomyopathy and severe heart failure. We report the case of a boy with Crohn’s disease who developed myopericarditis 14 days after starting treatment with mesalazine. Discontinuation of the drug rapidly led to normalisation of left ventricular structure and function, and a parallel improvement in the levels of plasma N-terminal pro-B-type natriuretic peptide and other markers of myocardial damage. Clinicians should be aware of this potentially life-threatening adverse effect of mesalazine therapy, which is quickly and fully reversible on cessation of the agent.
A novel device for rapid, safe and precise delivery of intravitreal injections
Authors: Waqar Salman , Ayaz Ali , Karamat Irfan , Anwar Saba , McLeod James , McLeod Alan
Published: April 2019

Background

Delivery of therapeutic agents via intravitreal (IVT) injections is well established as the mainstay of treatment for many ophthalmic conditions. High demand means that injections are increasingly being delivered either by ophthalmic nurse practitioners (UK) or by ophthalmologists in office-based settings (North America/mainland Europe). Most patients require frequent IVT injections, and there is a need to make the procedure more comfortable and safe.

Methods

We describe a novel device designed to ensure rapid, safe and precise delivery of injections while improving the patient experience. In addition, we present details of a local National Health Service pathway initiated to facilitate clinician-led innovations. It is hoped that this model can also be replicated internationally. We also present results from two sites: one, comparing outcomes of 25 patients who received the injection with the device, against 25 patients who received injections using the current standard method; the other a retrospective notes evaluation of 60 patients injected with the device.

Results

No adverse events were noted and the device appears to be well tolerated by patients. Use of the guide did not result in a statistically significant increase in pain (p value > 0.05) but the mean score (on a unidimensional numerical rating scale) was noted to be slightly better. All patients gave very positive informal feedback.

Conclusions

We have described the design process and successful early-use results of a novel device developed to facilitate safe, precise and rapid delivery of IVT injections by both ophthalmologists and allied health professionals.
Cross-sectional study of the use of antimicrobials following common infections by rural residents in Anhui, China
Authors: Chai Jing , Coope Caroline , Cheng Jing , Oliver Isabel , Kessel Anthony , Hu Zhi , Wang DeBin
Published: April 2019

Objective

To describe help seeking behaviour from a medical doctor and antimicrobial use for common infections among rural residents of Anhui province, China.

Design

A cross-sectional retrospective household survey.

Setting

12 administrative villages from rural Anhui, China.

Participants

2760 rural residents selected through cluster-randomised sampling using an interviewer administered questionnaire.

Method

Logistic regression models were used to estimate associations between exposures (health insurance and antimicrobial-related knowledge), adjusted for confounders (sex, age and education), and help-seeking behaviour from a medical doctor and antimicrobial use following common infections, including acute respiratory tract infections (ARTIs), gastrointestinal tract infections (GTIs) and urinary tract infections (UTIs).

Results

In total 2611 (94.6%) rural residents completed the questionnaire. Help seeking from a medical doctor was highest for ARTIs (59.4%) followed by GTIs (42.1%), and UTIs (27.8%). Around two-thirds (82.3% for ARTIs, 87.0% for GTIs and 66.0% for UTIs) of respondents sought help within 3 days following symptom onset and over three quarters (88% for ARTIs, 98% for GTIs and 77% for UTIs) reported complete recovery within 7 days. Of the help-seeking respondents, 94.5% with ARTI symptoms recalled being prescribed either oral or intravenous antimicrobials (GTIs 81.7% and UTIs 70.4%). Use of antimicrobials bought from medicine shops without prescriptions ranged from 8.8% for GTIs to 17.2% for ARTIs; while use of antimicrobials leftover from previous illnesses or given by a relative ranged from 7.6% for UTIs to 13.4% for ARTIs. Multivariate logistic regression analysis revealed that respondents with a higher antimicrobial-related knowledge score and lack of insurance were associated with lower levels of help-seeking for ARTIs; while respondents with a higher antimicrobial-related knowledge score were less likely to be prescribed either oral or intravenous antimicrobials.

Conclusions

Excessive antimicrobial use in the studied primary care settings is still prevalent.
Genome-wide association study of suicide attempt in a Mexican population: a study protocol
Authors: González-Castro Thelma Beatriz , Genis-Mendoza Alma Delia , Tovilla-Zárate Carlos Alfonso , Martínez-Magaña José Jaime , Juárez-Rojop Isela Esther , Sarmiento Emmanuel , Nicolini Humberto
Published: April 2019

Introduction

Suicidality is a complex behaviour and a major health problem; the speciﬁc features that could predispose to suicidal behaviour have been extensively investigated, most frequently in European and Asian populations. Therefore, our aim is to present a protocol that will explore suicide attempt in Mexican individuals diagnosed with psychiatric disorders, through a genome-wide association study (GWAS).

Method and analysis

We will perform a GWAS by comparing 700 individuals who have suicide attempt history, with control subjects without suicide attempt history (n=500). The genotyping will be conducted using the Infinium PsychArray BeadChip and quality controls will be applied to single nucleotides (SNPs) genotyped. After that, we will perform the imputation using reference panels provided by the Haplotype Reference Consortium. We will perform two different workflows: (A) the classic GWAS analysis applying the same weight to all the variants and (B) an algorithm with prediction of deleteriousness of variants.

Ethics and dissemination

This study was approved by the ethics and investigation committees of the National Institute of Genomic Medicine on 22 July 2015, No CEI 215/13. We plan to disseminate research findings in scientific conferences and as a manuscript in peer-reviewed journals.

Trial registration number

CEI 215/13.
Patients’ and health professionals’ attitudes and perceptions towards the initiation of preventive drugs for primary prevention of cardiovascular disease: protocol for a systematic review of qualitative studies
Authors: Qadi Olla , Marshall Tom , Adderley Nicola , Bem Danai
Published: April 2019

Introduction

Lipid-lowering drugs and antihypertensive agents can be prescribed for the primary prevention of cardiovascular disease. In some cases, patients eligible for primary prevention of cardiovascular disease according to the European guidelines are not always started on preventive drugs. Existing research explores the attitudes of health professionals and patients towards cardiovascular preventive drugs but does not always differentiate between the attitudes towards drug initiation for primary or secondary prevention. We aim to systematically review qualitative studies assessing health professionals’ and patients’ attitudes and perceptions towards drug initiation for primary prevention of cardiovascular disease.

Methods and analysis

MEDLINE, MEDLINE In Process, EMBASE, PsycINFO, CINAHL, Applied Social Sciences Index and Abstracts, Conference Proceedings Citation Index (Web of Science), Healthcare Management Information Consortium, and Open Grey will be searched without restrictions on date or language of publication. Searches will be limited to studies of qualitative design, standalone or in the context of a mixed-method design, focusing on cardiovascular drug initiation for primary prevention. The primary outcome is the attitudes of health professionals and patients towards drug initiation for primary prevention of cardiovascular disease. Two reviewers will independently carry out the study selection, data extraction and quality assessment. The Critical Appraisal Skills Programme Qualitative Research Checklist will be used to assess the quality of included studies. The findings will be analysed using Thomas and Harden’s thematic synthesis approach.

Ethics and dissemination

This systematic review does not require ethical approval as primary data will not be collected. The results of the study will be published in a peer-reviewed journal and presented at relevant conferences.

PROSPERO registration number

CRD42018095346.
Labour market attachment after mild traumatic brain injury: nationwide cohort study with 5-year register follow-up in Denmark
Authors: Graff Heidi Jeannet , Siersma Volkert , Møller Anne , Kragstrup Jakob , Andersen Lars L , Egerod Ingrid , Malá Rytter Hana
Published: April 2019

Objectives

Sickness absence after mild traumatic brain injury (mTBI) is frequent due to postconcussive symptoms. We examined labour market attachment following mTBI up to 5 years postinjury.

Design and setting

Nationwide cohort study with register follow-up.

Participants

Patients between 18 and 60 years with mTBI (International Classification of Diseases, version 10 diagnosis S06.0) were extracted from the Danish National Patient Register (n=19 732). Controls were matched on sex, age and municipality (n=18 640). Patients with spinal cord and column injuries, traumatic brain injury and concussions 5 years preinjury or as secondary diagnosis to the concussion in the inclusion period were excluded.

Primary and secondary outcome measures

Data were extracted from the Danish Register for Evaluation of Marginalization. Primary outcome was ‘not attending ordinary work’ defined as receiving any social transfer payment. Secondary outcomes were health-related benefits, limited attachment to the labour market, permanent lack of attachment to the labour market and death.

Results

5 years after diagnosis, 43% of patients were not attending ordinary work. The odds increased from 6 months (OR 1.30, 95% CI 1.24 to 1.36) to 5 years (OR 1.54, 95% CI 1.45 to 1.63). The odds of health-related benefits were 32% (OR 1.32, 95% CI 1.22 to 1.42) at 6 months and 22% (OR 1.22, 95% CI 1.12 to 1.33) at 5 years. Limited attachment to the labour market showed increased odds at 5 years (OR 1.38, 95% CI 1.27 to 1.51) and the odds of permanent lack of attachment to the labour market were higher for patients compared with controls (OR 2.59, 95% CI 2.30 to 2.92). Death was more than two times higher at 5 years postinjury (OR 2.62, 95% CI 2.10 to 3.26).

Conclusions

43% of concussed patients were not attending ordinary work 5 years postinjury and received health and social transfer benefits. We conclude that mTBI has a long-term impact on labour market attachment. Prevention and treatment of persisting postconcussive symptoms should be considered.

Trial registration number

NCT03214432; Results
Advance care planning and place of death, hospitalisation and actual place of death in lung, heart and cancer disease: a randomised controlled trial
Authors: Skorstengaard Marianne Hjorth , Jensen Anders Bonde , Andreassen Pernille , Brogaard Trine , Brendstrup Elisabeth , Løkke Anders , Aagaard Susanne , Wiggers Henrik , Neergaard Mette Asbjoern
Published: April 2019

Objectives

Advance care planning (ACP) can be a way to meet patients’ end-of-life preferences and enhance awareness of end-of-life care. Thereby it may affect actual place of death (APOD) and decrease the rate of hospitalisations. The aim was to investigate if ACP among terminally ill patients with lung, heart and cancer diseases effects fulfilment of preferred place of death (PPOD), amount of time spent in hospital and APOD.

Methods

The study was designed as a randomised controlled trial. Patients were assessed using general and disease-specific criteria and randomised into groups: one received usual care and one received usual care plus ACP. The intervention consisted of a discussion between a healthcare professional, the patient and their relatives about preferences for end-of-life care. The discussion was documented in the hospital file.

Results

In total, 205 patients were randomised, of which 111 died during follow-up. No significant differences in fulfilment of PPOD (35% vs 52%, p=0.221) or in amount of time spent in hospital among deceased patients (49% vs 23%, p=0.074) were found between groups. A significant difference in APOD was found favouring home death in the intervention group (17% vs 40%, p=0.013).

Conclusion

Concerning the primary outcome, fulfilment of PPOD, and the secondary outcome, time spent in hospital, no differences were found. A significant difference concerning APOD was found, as more patients in the intervention group died at home, compared with the usual care group.

Trial registration number

NCT01944813.
Efficacy of endovascular thrombectomy in patients with M2 segment middle cerebral artery occlusions: meta-analysis of data from the HERMES Collaboration
Authors: Menon Bijoy K , Hill Michael D , Davalos Antoni , Roos Yvo B W E M , Campbell Bruce C V , Dippel Diederik W J , Guillemin Francis , Saver Jeffrey L , van der Lugt Aad , Demchuk Andrew M , Muir Keith , Brown Scott , Jovin Tudor , Mitchell Peter , White Phil , Bracard Serge , Goyal Mayank
Published: April 2019

Background

The Society of Neurointerventional Surgery revised its operational definition of emergent large vessel occlusion (ELVO) recently to include proximal M2 segment middle cerebral artery (MCA) occlusions. We sought to assess the benefit of endovascular thrombectomy (EVT) over best medical care for M2 segment MCA occlusion.

Methods

Patient level data from trials in the HERMES Collaboration were included. The HERMES core laboratory identified patients with M2 segment MCA occlusions and further classified them as proximal versus distal, anterior versus posterior division, and dominant versus co-dominant versus non-dominant. Primary outcome was modified Rankin Scale (mRS) score 0–2 at 90 days. Secondary outcomes were modified Thrombolysis in Cerebral Infarction (mTICI) rates at end of procedure, 90-day mRS shift, 90-day mRS 0–1, 24 hours National Institute of Health Stroke Scale (NIHSS) score 0–2, symptomatic intracerebral hemorrhage (ICH), and death.

Results

130 patients with M2 MCA (proximal location n=116 vs distal n=14, anterior division n=72 vs posterior n=58, dominant n=73 vs co-dominant n=50 vs non-dominant n=7) were included. Successful reperfusion (mTICI 2b or 3) among those undergoing EVT was seen in 59.2% of patients. Treatment effect favored EVT (adjusted OR 2.39, 95% CI 1.08 to 5.28, p=0.03) for 90-day mRS 0–2 (58.2% EVT vs 39.7% control). Direction of benefit favored EVT for other outcomes. Treatment effect favoring EVT was maximal in patients with proximal M2 segment MCA occlusions (n=116, adjusted OR 2.68, 95% CI 1.13 to 6.37) and in dominant M2 segment MCA occlusions (n=73, adjusted OR 4.08, 95% CI 1.08 to 15.48). No sICH (0%) was observed in patients treated with EVT compared with five (7.9%) in the control arm.

Conclusion

Patients with proximal M2 segment MCA occlusions eligible for EVT trial protocols benefited from EVT.
Progressive thrombosis of unruptured aneurysms after coil embolization: analysis of 255 consecutive aneurysms
Authors: Funakoshi Yusuke , Imamura Hirotoshi , Tani Shoichi , Adachi Hidemitsu , Fukumitsu Ryu , Sunohara Tadashi , Omura Yoshihiro , Matsui Yuichi , Sasaki Natsuhi , Fukuda Tatsumaru , Akiyama Ryo , Horiuchi Kazufumi , Kajiura Shinji , Shigeyasu Masashi , Sakai Nobuyuki
Published: April 2019

Introduction

We have observed that aneurysms treated by insufficient coil embolization and filled with contrast agent immediately after the procedure are often completely occluded at follow-up. However, there are limited studies showing progressive thrombosis of aneurysms after coil embolization. Herein, we describe our experience with coil embolization for aneurysms, and discuss the factors involved in progressive thrombosis.

Methods

A total of 255 aneurysms treated by coil embolization in our institute between January 2011 and June 2017 and observed >6 months were included. ‘Progressive thrombosis’ indicated that aneurysms that were neck remnant (NR) or dome filling (DF) immediately after coil embolization changed to complete obliteration (CO) at the 6-month follow-up digital subtraction angiography. The factors involved in progressive thrombosis were assessed.

Results

In all aneurysms (n=255), 24 (9.4%) were CO, 82 (32.2%) were NR, and 149 (58.4%) were DF immediately after the procedure. At 6-month digital subtraction angiography, 123 (48.2%) were CO, 95 (37.3%) were NR, and 37 (14.5%) were DF. Retreatment for major recanalization was performed in eight cases (3.1%). One hundred and three aneurysms showed progressive thrombosis. There were significant differences in aneurysm location (P=0.0002), aneurysm dome diameter (P=0.0015), aneurysm neck diameter (P=0.0068), volume embolization ratio (P=0.0054), and endovascular procedure with stent (P=0.0264) between the progressive thrombosis and no thrombosis groups.

Conclusions

Progressive thrombosis can occur in aneurysms after coil embolization depending on aneurysm location and size, and stent use. Thus, the degree of coil embolization and combination with a stent should be adjusted depending on aneurysm type.
Multiple system atrophy mimicked by multi-organ pathology
Authors: Khan Sana , Sivakumar Gnanamurthy , Currie Stuart , Alty Jane
Published: April 2019

Both multiple system atrophy and Parkinson’s disease may present with parkinsonism and autonomic dysfunction. We describe a patient who initially met the diagnostic criteria for multiple system atrophy and had atypical features for Parkinson’s disease including blackouts and pyramidal signs. Ultimately, he was found to have three separate diagnoses rather than a single unifying one.
Negative‐pressure wound therapy for high‐risk surgical incision wounds using an ultra‐portable device: 11 cases
Authors: Garcia‐Pertierra Sofia , Vizcaino Reves Nuria , Calvo Aguado Araceli
Published: April 2019

Negative‐pressure wound therapy (NPWT) involves the application of subatmospheric pressure to a wound to help in the healing process. The objective of this case series was to evaluate the clinical experience using ultra‐portable NPWT devices on high‐risk closed incisions after surgical management of complex non‐healing wounds. Data were available for eight dogs and three cats. Wound aetiologies varied from traumatic, neoplastic and foreign body. Application and maintenance of the portable device were technically easy in most cases, finding some difficulties when applied to curved body surfaces. All patients’ outcome was highly rewarding. This case series suggests that portable NPWT helps in achieving full recovery, increases comfort allowing early ambulation and feeding, and reduces hospitalisation time. Their reduced size is suitable for smaller animals, enhancing their therapeutic use in veterinary medicine.
Seroprevalence of dogs in Hong Kong to human and canine influenza viruses
Authors: Su Wen , Kinoshita Reimi , Gray Jane , Ji Yue , Yu Dan , Peiris Joseph Sriyal Malik , Yen Hui‐Ling
Published: April 2019

As a unique mammalian host for influenza A viruses, dogs support the transmission of canine influenza viruses (CIVs) of H3N8 and H3N2 subtypes and are susceptible to infection by avian and human influenza viruses. A cross‐sectional serological study was performed to assess the exposure history of dogs in Hong Kong to CIV and human influenza viruses. Among 555 companion dogs sampled in 2015–2017, 1.3 per cent and 9.5 per cent showed hemagglutination inhibition (HI) antibody titre to CIV of H3N8 or H3N2 subtypes and to A(H1N1)pdm09 human influenza viruses, respectively. Among 182 shelter dogs sampled in 2017–2018, none showed HI titre to CIV and 1.1 per cent reacted to H3N2 human influenza virus. There was a poor correlation between ELISA and HI test results. The higher seropositive rates to human influenza viruses suggests that the contact dynamics of dogs under urban settings may affect the exposure risk to human influenza viruses and CIVs.
Assessment of ceftiofur residues in cow milk using commercial screening test kits
Authors: Durel Luc , Gallina Guglielmo , Pellet Terence
Published: April 2019

Ceftiofur, a third‐generation cephalosporin, is one of the most used antibiotics in dairy industry. Intramuscular injection of 1 mg/kgBW ceftiofur hydrochloride (HCl) generally results in 0 hour withdrawal time for the milk in dairy cows. Nevertheless, farmers and dairy processors occasionally complain about ceftiofur‐based products in case of positive result to a commercial rapid screening test for the presence of violative residues of antimicrobials (inhibitors) in the bulk milk tank. Six lactating cows were injected with a 50 mg/ml ceftiofur HCl‐based product at the dosage regimen of 1 mg/kg, intramuscularly, once a day, for five consecutive days, as per label. Milk samples were then collected just before the very last injection (T0) and then at 12, 24, 36, 48, 60, 72, 84 and 96 hours after the last injection. Individual milk samples were tested using three commercial screening test kits for inhibitor residues: DelvotestSP NT, SNAP Beta‐Lactam ST Plus and ROSA MRL Beta‐Lactam Test. Since bulk tank is screened in real operating conditions, samples were also diluted to 1:4, 1:10 and tested again. For the Delvotest SP NT, which lowest detected concentration is close the MRL of the ceftiofur (100 µg/kg), all results were negative. For the ROSA MRL Beta‐Lactam Test and the SNAP Beta‐Lactam ST Plus, several samples yielded positive and doubtful results at T0and T12. However, after dilution to 1:10, all results were negative. Consequently, when used as officially instructed, the tested 50 mg/ml ceftiofur HCl‐based injectable veterinary products are safe, and milk should be free of violative residues of ceftiofur. With consideration to the low specificity and the low positive predictive value of commercial screening tests, positive reactions of the bulk milk should be interpreted as false positive or another risky usage of β‐lactam‐based medicines in the farm must be investigated.
Multimodal Wireless Sensor Networks for Monitoring Applications: A Review
Authors: Aranda Juan , Mendez Diego , Carrillo Henry
Published: April 2019

Wireless sensor networks (WSNs) are a widely used solution for monitoring-oriented applications (e.g., water quality on watersheds, pollution monitoring in cities). These kinds of applications are characterized by the necessity of two data-reporting modes: time-driven and event-driven. The former is used mainly for continually supervising an area and the latter for event detection and tracking. By switching between both modes, a WSN can improve its energy efficiency and event-reporting latency, compared to single data-reporting schemes. We refer to those WSNs, where both data-reporting modes are required simultaneously, as multimodal wireless sensor networks (M2WSNs). In this paper, we present, from an energy-efficiency perspective, a review of switching mechanisms for M2WSNs. Besides, we explore two sophisticated techniques required in M2WSNs for further energy saving and event-reporting latency reduction purposes: duty-cycling and wake-up radio. We highlight future directions concerning switching and network management techniques for M2WSNs. To our knowledge, this review is first of its kind.
Evolutionary Game Theory: A Generalization of the ESS Definition
Authors: Accinelli Elvio , Martins Filipe , Oviedo Jorge
Published: April 2019

In this paper, we study the concept of Evolutionarily Stable Strategies (ESSs) for symmetric games with [Formula: see text] players. The main properties of these games and strategies are analyzed and several examples are provided. We relate the concept of ESS with previous literature and provide a proof of finiteness of ESS in the context of symmetric games with [Formula: see text] players. We show that unlike the case of [Formula: see text], when there are more than two populations an ESS does not have a uniform invasion barrier, or equivalently, it is not equivalent to the strategy performing better against all strategies in a neighborhood. We also construct the extended replicator dynamics for these games and we study an application to a model of strategic planning of investment.
Stability Analysis of Shear Deformable Trapezoidal Composite Plates
Authors: Kumar Amit , Singha M. K. , Tiwari Vikrant
Published: April 2019

The stability characteristics of shear deformable trapezoidal composite plates are studied here. Thestrain smoothing technique is employed to approximate the membrane strains and curvatures of the edge-based smoothing cells. The transverse shear strains within the Reissner–Mindlin quadrilateral element are obtained using the edge-consistent interpolation approach. At the beginning, the performance of the present numerical technique is examined for the buckling analysis of trapezoidal panels under in-plane compressive or shear stresses. Thereafter, new results on the buckling and postbuckling behaviors of trapezoidal composite plates are presented, for which comparable numerical results are rare in the literature. Representative numerical results are presented to highlight the interaction between the higher pre-buckling stresses and increased stiffness near the shorter edge with fiber orientation and loading direction on the buckling resistance of trapezoidal panels.
Contiguity of States and Super Wave Operators
Authors: Rebolledo Rolando
Published: April 2019

This paper characterises contiguity for families of states defined on a von Neumann algebra. It extends earlier research of my own published in [1], motivated by scattering theory and the celebrated work of Lucien Le Cam in classical probability. It is well-known that Le Cam did a major contribution to develop asymptotic methods in statistical decision theory, defining various new concepts, among them, contiguity of probability measures. In particular, contiguity of quantum states allows to explore different aspects of the large time behaviour of noncommutative Markov semigroups, among them, the super wave operator characterisation. I illustrate these results via quantum and classical examples of evolutions.
A Framework for Governance of Sustainability Indicator Systems in Strategic Environmental Assessment Processes
Authors: da Silva Antonio Waldimir Leopoldino , Netto Marinilse , Selig Paulo Maurício , de Ávila Lerípio Alexandre
Published: April 2019

Sustainability indicators (SIs) are considered an important tool in Strategic Environmental Assessment (SEA), but their choice and management present shortcomings and must be improved. This work aimed to develop a governance model of SI systems for SEA. The study was carried out by means of documentary research on SEA reports and interviews with leaders of Brazilian SEA working teams, through the application of Content Analysis. The resulting framework, called G-SINDS, is composed of six phases and three transverse elements. Each phase represents a stage of construction of the SI system, with methodological procedures adaptable to the specificity of each SEA process. The transverse elements are factors that affect each phase, in order to perfect them. The G-SINDS represents an innovative model, since it involves the “life cycle of the indicators”, is directed to the SEA and is based on principles and techniques of knowledge management, constituting a means of improving the execution of SEA processes.
Development of Electrochemical Sensor for Detection of L-Tryptophan Based on Exfoliated Graphene/PEDOT:PSS
Authors: Duan Saisai , Wang Wei , Yu Chenglei , Liu Mengjie , Yu Longyu
Published: April 2019

A practical sensor based on a glassy carbon electrode (GCE) modified with exfoliated graphene (GR) and poly (3,4-ethylenedioxythiophene): poly (styrene sulfonate) (PEDOT:PSS) was prepared to determine L-tryptophan (L-Trp) via differential pulse voltammetry (DPV). Optical microscopy was utilized to characterize the surface morphology of the composite electrode. Electrochemical behaviors of the composite electrodes were carried out via cyclic voltammetry (CV). According to DPV results, there are linear relationships between the peak currents and the concentrations in the ranges of 0.1–100[Formula: see text][Formula: see text]mol[Formula: see text]L[Formula: see text] and 100–1000[Formula: see text][Formula: see text]mol[Formula: see text]L[Formula: see text] for L-Trp, with the detection limit of 0.015[Formula: see text][Formula: see text]mol[Formula: see text]L[Formula: see text] for L-Trp. Moreover, the modified electrode can eliminate the interference effects of Ca[Formula: see text], Mg[Formula: see text], K[Formula: see text], Na[Formula: see text], L-tyrosine and ascorbic acid, which exhibit excellent stability and reproducibility.