bluuebunny/crossref_metadata_2025 huggingface dataset:
Hypocalcaemia and traumatic coagulopathy: an observational analysis
Authors: Vasudeva Mayank , Mathew Joseph K. , Fitzgerald Mark C. , Cheung Zoe , Mitra Biswadev
Published: December 2019

Background and Objectives

Haemorrhage‐associated calcium loss may lead to disruption of platelet function, intrinsic and extrinsic pathway‐mediated haemostasis and cardiac contractility. Among shocked major trauma patients, we aimed to investigate the association between admission hypocalcaemia and adverse outcomes.

Materials and Methods

Data were extracted from the Alfred Trauma Registry and the Alfred Applications and Knowledge Management Department for all adult major trauma patients presenting directly from the scene with a shock index ≥1 from 1 July 2014 to 30 June 2018. Patients with pre‐hospital blood transfusion were excluded. Ionized hypocalcaemia was defined as <1·11 mmol/l, and acute traumatic coagulopathy was defined as initial INR >1·5. Multivariable logistic regression analysis was used to assess the association between admission hypocalcaemia and acute traumatic coagulopathy that was adjusted for Injury Severity Score, initial GCS, bicarbonate and lactate.

Results

There were 226 patients included in final analysis with 113 (50%) patients recording ionized hypocalcaemia on presentation prior to any blood product transfusion. Ionized hypocalcaemia was associated with coagulopathy in patients with shock index ≥1 (adjusted OR 2·9; 95% CI: 1·01–8·3, P = 0·048). Admission ionized hypocalcaemia was also associated with blood transfusion requirement in the first 24 h post‐admission in 62·5% of hypocalcaemic patients as compared to 37·5% of normocalcaemic patients (P < 0·001). Admission ionized hypocalcaemia was associated with death at hospital discharge (25·6% among hypocalcaemic patients compared to 15·0% of normocalcaemic patients (P = 0·047)).

Conclusion

Hypocalcaemia was a common finding in shocked trauma patients and was independently associated with acute traumatic coagulopathy. The early, protocolized administration of calcium to trauma patients in haemorrhagic shock warrants further assessment in randomized controlled trials.
Unsteady Flow and Heat Transfer Characteristics of Primary and Secondary Corrugated Channels
Authors: Harikrishnan S. , Tiwari Shaligram
Published: December 2019

Direct numerical simulations (DNS) have been performed using open source computational fluid dynamics (CFD) package openfoam to investigate the unsteady flow and heat transfer characteristics of primary and secondary corrugated wavy channels for fixed values of wavelength and amplitude by varying Reynolds number (Re). Computations are carried out by considering only one module of the wavy channel and applying periodic boundary conditions to reduce the time for computations. Numerical method has been validated thoroughly against the numerical and experimental results reported in the literature. Steady as well as unsteady flow characteristics in the primary and secondary corrugated channels have been elaborated and explained with the help of streamlines, velocity contours, isosurfaces of velocity, and Q value. Temperature and Nusselt number contours are presented to illustrate the heat transfer characteristics of wavy channels.
More Is Not Always Better: Coinfections with Defensive Symbionts Generate Highly Variable Outcomes
Authors: Weldon S. R. , Russell J. A. , Oliver K. M.
Published: December 2019

The hyperdiverse arthropods often harbor maternally transmitted bacteria that protect against natural enemies. In many species, low-diversity communities of heritable symbionts are common, providing opportunities for cooperation and conflict among symbionts, which can impact the defensive services rendered. Using the pea aphid, a model for defensive symbiosis, we show that coinfections with two common defensive symbionts, the antipathogen
Regiella
and the antiparasite
Hamiltonella
, produce outcomes that are highly variable compared to single infections, which consistently protect against designated enemies. Compared to single infections, coinfections often reduced defensive services during enemy challenge yet improved aphid fitness in the absence of enemies. Thus, infection with multiple symbionts does not necessarily create generalist aphids with “Swiss army knife” defenses against numerous enemies. Instead, particular combinations of symbionts may be favored for a variety of reasons, including their abilities to lessen the costs of other defensive symbionts when enemies are not present.
Stability of Microbial Community Profiles Associated with Compacted Bentonite from the Grimsel Underground Research Laboratory
Authors: Engel Katja , Ford Sian E. , Coyotzi Sara , McKelvie Jennifer , Diomidis Nikitas , Slater Greg , Neufeld Josh D.
Published: December 2019

The Materials Corrosion Test in Grimsel Underground Research Laboratory, Switzerland, enables an evaluation of microbiological implications of bentonite clay at densities relevant for a deep geological repository. Our research demonstrates that after 13 months of exposure within a granitic host rock, the microbial 16S rRNA gene signatures of saturated bentonite clay within the modules were consistent with the profiles in the original clay used to pack the modules. Such results provide evidence that densities chosen for this emplacement test are refractory to microbial activity, at least on the relatively short time frame leading to the first time point sampling event, which will help informin situengineered barrier system science. This study has important implications for the design of deep geological repository sites under consideration for the Canadian Shield.
Sm-Nd isochron dating and geochemical (rare earth elements, 87Sr/86Sr, δ18O, δ13C) characterization of calcite veins in the Jiaoshiba shale gas field, China: Implications for the mechanisms of vein formation in shale gas systems
Authors: Gao Jian , He Sheng , Zhao Jian-xin , He Zhiliang , Wu Changwu , Feng Yuexing , Nguyen Ai Duc , Zhou Jiaxi , Yi Zhixing
Published: December 2019

The Wufeng and Longmaxi organic-rich shales host the largest shale gas plays in China. This study examined the petrography, rare earth element (REE) and other trace-element geochemistry, Sm-Nd geochronology, and isotope geochemistry (87Sr/86Sr, δ18O, δ13C) of fracture-cementing minerals within core samples of the Wufeng and Longmaxi Formations from the Jiaoshiba shale gas field in order to (1) characterize the mineral phases occurring in the veins (mineralized fractures); (2) determine the ages of the calcite by the Sm-Nd isochron dating method; (3) understand the sources of calcite-precipitating fluids; and (4) explore the possible mechanisms responsible for calcite vein formation in shale gas systems. The fractures hosted in the Longmaxi Formation are mineralized with quartz as the predominant fracture cement, and calcite as an intracementation phase postdating the earlier quartz cement. In contrast, the fractures hosted in the Wufeng Formation are dominantly mineralized by calcite, which occurs either as the only cement present or as a cement phase predating later quartz cement. Calcite veins within the Longmaxi Formation have a Sm-Nd isochron age of 160 ± 13 Ma and δ13C values of –4.71‰ to –3.11‰, δ18O values of 17.1‰–17.4‰, and 87Sr/86Sr values of 0.72437–0.72869. Calcite veins within the Wufeng Formation yielded a Sm-Nd isochron age of 133 ± 15 Ma and are characterized by δ13C values of –2.29‰ to –1.03‰, δ18O values of 17.3‰–17.7‰, and 87Sr/86Sr values of 0.72202–0.72648. The similarity between 87Sr/86Sr values of the calcite and those of their respective surrounding host rocks (0.72670–0.72875 of the Longmaxi shales; 0.72030–0.72648 of the Wufeng shales), combined with relatively depleted δ13C and uniform fluid δ18O isotopic features, indicates that the calcite-precipitating fluids within the Wufeng and Longmaxi Formations were derived largely from their respective surrounding host-rock sources. REE data equally indicate that the distinguishable Eu anomalies (6.20–19.35; 4.45–11.91), Y anomalies (1.03–1.50; 1.44–1.70), and Y/Ho ratios (28.80–39.16; 38.86–45.18) of calcite veins within the Longmaxi and Wufeng Formations were controlled by their respective surrounding host rocks. The Sm-Nd isochron ages and fluid inclusion data of fracture cements suggest that fracture opening and calcite precipitation in composite veins within the Wufeng and Longmaxi Formations were triggered by gas generation overpressurization.
Persistence of melt-bearing Archean lower crust for >200 m.y.—An example from the Lewisian Complex, northwest Scotland
Authors: Taylor Richard J.M. , Johnson Tim E. , Clark Chris , Harrison Richard J.
Published: December 2019

Geochronological data from zircon in Archean tonalite–trondhjemite–granodiorite (TTG) gneisses are commonly difficult to interpret. A notable example is the TTG gneisses from the Lewisian Gneiss Complex, northwest Scotland, which have metamorphic zircon ages that define a more-or-less continuous spread through the Neoarchean, with no clear relationship to zircon textures. These data are generally interpreted to record discrete high-grade events at ca. 2.7 Ga and ca. 2.5 Ga, with intermediate ages reflecting variable Pb loss. Although ancient diffusion of Pb is commonly invoked to explain such protracted age spreads, trace-element data in zircon may permit identification of otherwise cryptic magmatic and metamorphic episodes. Although zircons from the TTG gneiss analyzed here show a characteristic spread of Neoarchean ages, they exhibit subtle but key step changes in trace-element compositions that are difficult to ascribe to diffusive resetting, but that are consistent with emplacement of regionally extensive bodies of mafic magma. These data suggest suprasolidus metamorphic temperatures persisted for 200 m.y. or more during the Neoarchean. Such long-lived high-grade metamorphism is supported by data from zircon grains from a nearby monzogranite sheet. These preserve distinctive trace-element compositions consistent with derivation from a mafic source, and they define a well-constrained U-Pb zircon age of ca. 2.6 Ga that is intermediate between the two previously proposed discrete metamorphic episodes. The persistence of melt-bearing lower crust for hundreds of millions of years was probably the norm during the Archean.
Edge influence on composition and structure of a Pinus palustris woodland following catastrophic wind disturbance
Authors: Goode Jonathan D. , Kleinman Jonathan S. , Hart Justin L. , Bhuta Arvind A.R.
Published: December 2019

Forest edges are an important legacy of natural and anthropogenic disturbances. Edges of intact forest fragments are influenced by adjacent non-forested ecosystems, resulting in compositional and structural differences at the edge and into the intact forest. Edge influence (EI) is the altered biotic and abiotic interactions that occur along the edge-to-interior gradient in disturbed forests. Few studies have analyzed natural disturbance created edges, particularly in woodland structures, which contain fewer trees per hectare and are typically less light-limited than forests. The goal of our study was to examine the EI of a tornado-created edge in a Pinus palustris Mill. (longleaf pine) woodland in Alabama. In 2011, an EF-3 tornado impacted a restored P. palustris woodland, resulting in a distinct edge. We installed transects perpendicular to the edge to quantify biotic and abiotic response variables and calculate the distance of EI. Reduced structural forest complexity and basal area (negative EI) were evident 70 m into the interior woodland. Ground flora richness and diversity experienced a positive EI, with higher richness and diversity at the edge. Results of this study add to our understanding of EI on woodland composition and structure and naturally created edges and may help guide natural disturbance based silvicultural systems.
Tachyonic inflation in loop quantum cosmology
Authors: Xiao Kui
Published: December 2019

A tachyon field might be responsible for cosmological inflation at an early time and contribute to cosmological dark matter at a later time. We investigate tachyonic inflation by analyzing a tachyon field with different potentials in the framework of loop quantum cosmology. No matter which tachyon field energy dominates at the bounce, the evolution of the background can be divided into three phases: super-inflation, damping, and slow-roll inflation. The duration of each phase depends on the initial condition. During the slow-roll inflation, when the initial condition is $$V(T_\mathrm{B})/\rho _\mathrm{c}\ge 10^{-6}$$V(TB)/ρc≥10-6, the number of e-folds is very high ($$N\gg 60$$N≫60) for $$V\propto T^{-n}$$V∝T-n with $$n=1$$n=1 and 1 / 2. For an exponential potential, to get enough e-folds, $$V(T_\mathrm{B})/\rho _\mathrm{c}$$V(TB)/ρc should be greater than $$7.802\times 10^{-4}$$7.802×10-4. Furthermore, the probability of slow-roll inflation is obtained. We find that the probability of obtaining slow-roll inflation with 60 or more e-folds is very close to 1.
A comparative study between ESSnuSB and T2HK in determining the leptonic CP phase
Authors: Ghosh Monojit , Ohlsson Tommy
Published: December 2019

In this paper, we perform a comparative analysis between the future proposed long-baseline experiments ESSnuSB and T2HK in measuring the leptonic CP phase [Formula: see text]. In particular, we study the effect of the neutrino mass ordering degeneracy and the leptonic mixing angle [Formula: see text] octant degeneracy in the measurement of leptonic CP violation and precision for both experiments. Since the ESSnuSB (T2HK) experiment probes the second (first) oscillation maximum to study neutrino oscillations, the effect of these degeneracies are significantly different in both experiments. Our main conclusion is that for the ESSnuSB experiment, the information on the neutrino mass ordering does not play a major role in the determination of [Formula: see text], which is not the case for the T2HK experiment. However, the information on the true octant compromises the CP sensitivity of the ESSnuSB experiment as compared to T2HK if [Formula: see text] lies in the lower octant. These conclusions are true for both the 540 km and 360 km baseline options for the ESSnuSB experiment. In addition, we investigate the effect of different running times in neutrino and antineutrino modes and the effect of [Formula: see text] precision in measuring [Formula: see text].
EFFECT OF LOWER EXTREMITY EXOSKELETON ROBOT IMPROVING WALKING FUNCTION AND ACTIVITY IN PATIENTS WITH COMPLETE SPINAL CORD INJURY
Authors: BAI XINGANG , GOU XIANG , WANG WENCHUN , DONG CHAO , QUE FANGXU , LING ZESHA , WANG LAN , ZHOU TINGTING , CHEN TIAN , PANG RIZHAO , ZHANG ANREN , CHENG HONG
Published: December 2019

The objective of this research was to evaluate the effectiveness and safety of Lower Extremity Exoskeleton Robot improving walking function and activity in patients with complete spinal cord injury. A prospective, open and self-controlled trial was conducted which include eight patients with complete spinal cord injury accepted Lower Extremity Exoskeleton Robot training with Aider 1.0 and Aider 1.1 for 2 weeks. The 6[Formula: see text]min Walk Test (6MWT), 10[Formula: see text]m Walk Test (10 MWT), Hoffer walking ability rating, Lower Extremity Motor Score (LEMS), Spinal Cord Independence Motor (SCIM), Walking Index for Spinal Cord Injury Version II (WISCI II) were recorded before, 1 week and 2 weeks after training. During the training, the incidence of adverse events (AE), the incidence of serious adverse events (SAE), the incidence of device defects and other safety indicators were observed. Compared with the pre-training, indicators (6MWT, 10MWT, Hoffer walking ability rating, WISCI II) were significantly different after 1 week of training and after 2 weeks of training. Four adverse events occurred during the training period and the incidence of adverse events was 50%. And there was no SAE or device defects. Therefore, it is safe and effective to use the lower extremity exoskeleton robot to complete the walking ability of patients with complete spinal cord injury.
Superconducting Qubits: Current State of Play
Authors: Kjaergaard Morten , Schwartz Mollie E. , Braumüller Jochen , Krantz Philip , Wang Joel I.-J. , Gustavsson Simon , Oliver William D.
Published: December 2019

Superconducting qubits are leading candidates in the race to build a quantum computer capable of realizing computations beyond the reach of modern supercomputers. The superconducting qubit modality has been used to demonstrate prototype algorithms in the noisy intermediate-scale quantum (NISQ) technology era, in which non-error-corrected qubits are used to implement quantum simulations and quantum algorithms. With the recent demonstrations of multiple high-fidelity, two-qubit gates as well as operations on logical qubits in extensible superconducting qubit systems, this modality also holds promise for the longer-term goal of building larger-scale error-corrected quantum computers. In this brief review, we discuss several of the recent experimental advances in qubit hardware, gate implementations, readout capabilities, early NISQ algorithm implementations, and quantum error correction using superconducting qubits. Although continued work on many aspects of this technology is certainly necessary, the pace of both conceptual and technical progress in recent years has been impressive, and here we hope to convey the excitement stemming from this progress.
Prevalence and Management of Septic Shock among Children Admitted at the Kenyatta National Hospital, Longitudinal Survey
Authors: Vekaria-Hirani Varsha , Kumar Rashmi , Musoke Rachel N. , Wafula Ezekiel M. , Chipkophe Idris N.
Published: December 2019

Background. Paediatric septic shock is a subset of sepsis associated with high mortality. Implementing the existing international Surviving Sepsis Campaign Guidelines 2012 (SSCG) have contributed to reduction of mortality in many places but these have not been adopted in our setting. The current study aimed at documenting the practice at a national referral hospital. Methods. A hospital based longitudinal survey carried out among 325 children from September to October 2016. Children aged 0 days (≥37 weeks gestation) to12 years were included. The aim was to determine the prevalence, audit the management and determine the outcome at 72 hours of septic shock among children admitted at the Kenyatta National Hospital (KNH). A standard questionnaire was used for data collection and Surviving Sepsis Guideline 2012 was used as a reference for auditing the management of septic shock. Data was stored in MS-EXCEL and analysed in STATA 12. Results. The prevalence of septic shock was 50 (15.4%), with a median age of 4 months. Septic shock was recognized by the attending clinician in 28 (56%). The level of care to children with septic shock was not to the level recommended by the SSCG 2012. Odds of being diagnosed with septic shock reduced with age (odds ratio 4.38 (1.7–11.0), p=0.002) and no child aged above 60 months age was diagnosed with septic shock. The mortality was 35 (70%) at 72 hours of admission, with a median of 14 hours. Infants had the highest case fatality of 82.6%. It was found that lack of mechanical ventilation, and presence of hypotension at admission were associated with greater mortality (p values of 0.03 and 0.01 respectively). Conclusion. The prevalence rate of septic shock is 15.4% among children admitted at the KNH and is associated with high mortality. The advanced degree of shock contributed to mortality. The level of care at KNH was not to the level of SSCG 2012, and hence the need to include septic shock management guidelines/protocols in our local Kenyan paediatric guideline.
Archimedean Muirhead Aggregation Operators of q‐Rung Orthopair Fuzzy Numbers for Multicriteria Group Decision Making
Authors: Qin Yuchu , Cui Xiaolan , Huang Meifa , Zhong Yanru , Tang Zhemin , Shi Peizhi
Published: December 2019

q‐Rung orthopair fuzzy number (qROFN) is a flexible and superior fuzzy information description tool which can provide stronger expressiveness than intuitionistic fuzzy number and Pythagorean fuzzy number. Muirhead mean (MM) operator and its dual form geometric MM (GMM) operator are two all‐in‐one aggregation operators for capturing the interrelationships of the aggregated arguments because they are applicable in the cases in which all arguments are independent of each other, there are interrelationships between any two arguments, and there are interrelationships among any three or more arguments. Archimedean T‐norm and T‐conorm (ATT) are superior operations that can generate general and versatile operational rules to aggregate arguments. To take advantage of qROFN, MM operator, GMM operator, and ATT in multicriteria group decision making (MCGDM), an Archimedean MM operator, a weighted Archimedean MM operator, an Archimedean GMM operator, and a weighted Archimedean GMM operator for aggregating qROFNs are presented to solve the MCGDM problems based on qROFNs in this paper. The properties of these operators are explored and their specific cases are discussed. On the basis of the presented operators, a method for solving the MCGDM problems based on qROFNs is proposed. The effectiveness of the proposed method is demonstrated via a numerical example, a set of experiments, and qualitative and quantitative comparisons. The demonstration results suggest that the proposed method has satisfying generality and flexibility at aggregating q‐rung orthopair fuzzy information and capturing the interrelationships of criteria and the attitudes of decision makers and is feasible and effective for solving the MCGDM problems based on qROFNs.
Effects of Construction Sequences and Volume Loss on Perpendicularly Crossing Tunnels
Authors: Zang Yanwei , Gan Penglu , Yan Jia-jia , Liu Shiming , Yan Zihai
Published: December 2019

The number of constructed tunnels has been gradually increasing for the past decades due to rapid development in urban areas. However, the soil‐structure interaction problems arising from perpendicularly crossing tunnels attract relatively little research attention in the past. In this study, six three‐dimensional finite element analyses were conducted to simulate tunnel excavation nearby a perpendicularly crossing existing tunnel, in an attempt to investigate the effects of construction sequences on cross‐cutting tunnels. The hypoplastic constitutive model for sand is adopted in the numerical analysis to consider the soil small‐strain stiffness. Computed results are presented and discussed in terms of ground surface settlement, displacement and deformation of the existing tunnel, and bending moment induced on the existing tunnel. The stress‐transfer mechanism in soil nearby the existing tunnel due to tunnelling is also studied.
Multiple Hepatic and Renal Hydatid Cysts Managed with Laparoscopic Surgery
Authors: Kouba Lamia , Alsaid Bayan , Almeree Taisser , Allouche Mazen , Alshalabi Abdulghani
Published: December 2019

Cystic echinococcosis is a parasitic disease caused by Echinococcus granulosus. The liver and lungs are the most commonly infected organs. We present the first-of-a-kind case of laparoscopic excision of 8 hydatid cysts, of which seven were in the liver and one was in the kidney of a 40-year-old patient. The patient presented with fatigue and fever and a one-year history of vague abdominal pain. Albendazole was administered before surgical intervention. The postoperative follow-up period was notable for a renal fistula. The patient subsequently underwent CT-guided percutaneous removal of a central hepatic hydatid cyst that was inaccessible using laparoscopic techniques. Cystic echinococcosis is endemic in the Mediterranean region. The growing number of immigrants and refugees from endemic areas could increase the prevalence of the disease in nonendemic countries. Therefore, it is important for physicians worldwide to be familiar with the diagnostic modalities and possible treatment options for hydatid disease.
Clinical Results and MRI Evaluation of Patellar Osteochondral Fracture Fixation following Patellar Dislocation
Authors: Małecki Krzysztof , Pruchnik–Witosławska Kornelia , Gwizdała Dominika , Grzelak Piotr , Flont Paweł , Niedzielski Kryspin Ryszard
Published: December 2019

Aim. The aim of the study was to analyze the clinical results and MRI scans after transpatellar osteochondral fracture fixation following patellar dislocation. Methods. Our study group comprised 17 patients with patellar dislocation followed by osteochondral fracture of the articular surface of the patella. All patients underwent surgery where the fractured osteochondral fragments of the patella were attached using the transpatellar suture technique. The mean age at the time of surgery was 14.1 years, and the mean follow-up period was 7.5 years. Results. The results of the patellar compression test and the apprehension test were negative in all patients. The mean Lysholm and Kujala scores were 89.2 and 89.6, respectively. The MRI scan revealed healing of the fixed fragment and restoration of the articular surface in all patients. In 16 cases, subchondral bone of the fixed fragment area was described as irregular: its articular cartilage was narrowed and not homogenous. Progressive degenerative changes were observed in the patellofemoral joint at follow-up in three patients. Conclusions. By fixing osteochondral fragments, the patellar articular surface can be restored. The MRI scans show that the cartilage in the reconstructed surface is narrowed after a mean 7.5-year follow-up.
Hourly Fluid Balance in Patients Receiving Continuous Renal Replacement Therapy
Authors: Naorungroj Thummaporn , Neto Ary Serpa , Zwakman-Hessels Lara , Yanase Fumitaka , Eastwood Glenn , Bellomo Rinaldo
Published: December 2019

Introduction: Little is known about early (first 48 h) hourly and cumulative fluid balance (FB) during continuous renal replacement therapy (CRRT). Objectives: To study the characteristics and outcome associations of early hourly and cumulative FB. Methods: We studied FB in CRRT patients (2016–2018). Results: Among 350 patients, mean hourly FB became negative after 20 CRRT hours, but within 6 CRRT hours in patients with baseline fluid overload. A negative early FB was never achieved in patients receiving vasopressor therapy (p < 0.001). Mortality was 31%. The percentage of hourly negative FB was independently associated with decreased ICU mortality. A time-weighted hourly FB between 18.5 and –33 mL/h was also significantly and independently associated with decreased mortality. Conclusions: In CRRT patients, an early FB conservative approach is possible, modulated by patient characteristics, and associated with a low mortality. Moreover, avoidance of an early positive FB is associated with decreased mortality.
Incidence, Risk, and Prognosis of Cancer in Patients on Chronic Hemodialysis
Authors: Chen Xiaohong , Li Yang , Ding Xiaoqiang , Shen Bo , Xiang Fangfang , Guo Man , Zou Jianzhou , Liu Zhonghua , Lv Wenlv , Cao Xuesen
Published: December 2019

Background: Information concerning the cancer issue in Chinese patients on hemodialysis (HD) was lacking. Thus, we examined data from our dialysis registry to investigate the incidence of cancer, identify the possible factors, and explore outcomes after cancer diagnosis in patients on chronic HD. Methods: A retrospective cohort study of 639 new-onset end-stage renal disease patients who started HD therapy during the period from July 1999 to December 2017 was retrieved from the database in our dialysis center. All eligible patients were followed up until renal transplantation, death, or end of study (March 31, 2019). The definition of a newly diagnosed cancer was that diagnosed 6 months after HD therapy initiation. Results: Within a median follow-up period of 5.61 years, 58 patients (9.08%) have been diagnosed with cancer with the incidence of 1,494 per 105 person-years. The mean duration from HD initiation to cancer diagnosis was 5.22 ± 3.55 years. Digestive cancer (32.76%) was the most common followed by urologic cancer (18.97%) and lung cancer (15.52%). Advanced age at starting HD therapy (hazard ratio [HR] 1.04) and erythropoietin dosage ≥20,000 U/week (HR 1.95) were independent predictors for cancer occurrence. Of the 256 deaths during the follow-up period, 29 cases (11.33%) were attributed to cancer, with the mortality rate of 717 per 105 person-years. The 1-, 5-, and 10-year cumulative survival rates after cancer diagnosis were 58.73, 34.64, and 20.41%, respectively. A total of 32 patients (55.17%) did not receive any anti-cancer therapy, and the mortality in those patients was significantly increased as compared to patients who received anti-cancer therapy. Conclusion: Cancer is common in HD patients due to the improved survival, and it has a negative effect on patient prognosis. Many patients have failed to receive optimal anti-cancer therapy, which calls for effective communication and cooperation among patients, dialysis unit, and oncology teams.
A Case of Salazosulfapyridine-Induced Hypersensitivity Syndrome in a Rheumatoid Arthritis Patient with Relapse of Skin Erythema
Authors: Itoi-Ochi Saori , Nakagawa Yukinobu , Tanemura Atsushi , Hirao Makoto , Fujimoto Manabu
Published: December 2019

We experienced a rare case of drug-induced hypersensitivity syndrome (DIHS) in which salazosulfapyridine (SASP) reactivated human herpesvirus 6 (HHV-6) and cytomegalovirus (CMV), which resulted in a relapse of skin symptoms after changing to mizoribine. At the time of recurrence of skin erythema after the initiation of mizoribine, the serum DNA titers of not HHV-6 but CMV were elevated. A drug-induced lymphocyte stimulation test was negative for mizoribine but positive for SASP. In this case, DIHS developed with SASP in association with HHV-6 and CMV reactivation. The immunocompromised state induced by herpes virus reactivation and mizoribine might have caused the relapse of skin erythema.
Correlative Comparison of Three Ocular Axes to Tilt and Decentration of Intraocular Lens and Their Effects on Visual Acuity
Authors: Zhang Fan , Zhang Jian , Li Wei , Zhou Lin , Feng Di , Zhang Haixia , Fang Wei , Sun Ran , Liu Zhicheng
Published: December 2019

Purpose: To evaluate which ocular axis, the corneal topographic axis (CTA), pupillary axis (PA) or line of sight (LOS), for measuring the tilt and decentration of intraocular lens (IOL) is most relevant to correct distance visual acuity (CDVA). Methods: A Scheimpflug device (Pentacam HR) was prospectively used to determine the tilt and decentration of IOLs in vivo 3 months after cataract surgery. A new method was developed to reliably measure PA and LOS. We further evaluated CTA and then used Spearman correlation coefficient and linear regression to assess the correlation between CDVA and IOL displacement based on the data of three different ocular axes. Results: Forty-six eyes from 46 patients were evaluated. The majority of decentration and tilt of IOL with reference to CTA, PA and LOS were towards the subtemporal direction. We found that the horizontal meridian data measured using CTA and PA were statistically significantly different (p = 0.011 for tilt; p = 0.005 for decentration). The correlation between CDVA and the distance of decentration temporally (r = –0.344, p = 0.035) and inferiorly (r = –0.336, p = 0.042) of the IOL with regard to CTA was significant. PA and LOS measurements had no correlation with any indices. Conclusion: Assessment of tilt and decentration of the IOL with reference to different ocular axes was markedly different. IOL tilt and decentration measured by CTA were significantly correlated with CDVA.
Optic Nerve Hypoplasia, Corpus Callosum Agenesis, Cataract, and Lissencephaly in a Neonate with a Novel COL4A1 Mutation
Authors: Grego Lisa , Pignatto Silvia , Rassu Nicolò , Passone Eva , Cogo Paola , Lanzetta Paolo
Published: December 2019

We report the case of a girl with a novel mutation of the COL4A gene (c.2716+2T>C) presenting microcephaly, parenchymal hemorrhages, lissencephaly, and bilateral cataracts, associated with agenesis of the corpus callosum and hypoplasia of the optic nerve. COL4A1, located on chromosome 13, encodes the α1 chain of type IV collagen, a key component of the basement membrane in various organs, such as eye, brain, kidneys, and muscles. Different mutations have been described and may remain asymptomatic or determine porencephaly, cerebral hemorrhages, renal cysts, hematuria, and dysgenesis of the anterior segment of the eye.
A controlled Valsalva Maneuver causes neither Diffusion-Positive Hippocampal Lesions nor Clinical Symptoms after Transient Global Amnesia
Authors: Gomez-Choco Manuel , Mariaca Ariel Fernando , Gaebel Christian , Valdueza José Manuel
Published: December 2019

Valsalva maneuver (VM) precedes frequently transient global amnesia (TGA) and up to 84% of the patients with TGA present hippocampal diffusion-weighted imaging-positive (DWI+) lesions on brain magnetic resonance imaging (MRI). We studied 20 patients with TGA and hippocampal DWI+ lesions. Median age (range) of the patients was 67 (57–80) years and 55% were women. TGA had been preceded by a VM-associated activity in 14 patients (70%), and brain MRI had been performed at a median (range) of 47.5 (42–79) h after TGA. These patients underwent a second MRI after a controlled-induced VM at least 3 months after TGA. This MRI was performed at a median (range) of 46.8 (41–138) h after the controlled-induced VM. None of the patients who reproduced TGA symptoms presented new DWI+ lesions on the second MRI. In patients with a previous episode of TGA, VM cannot elicit TGA in isolation and the interplay of other simultaneous factors is needed.
Integrated Multiomics Approach to Identify Genetic Underpinnings of Heart Failure and Its Echocardiographic Precursors
Authors: Andersson Charlotte , Lin Honghuang , Liu Chunyu , Levy Daniel , Mitchell Gary F. , Larson Martin G. , Vasan Ramachandran S.
Published: December 2019

Background:

Heart failure (HF) may arise from alterations in metabolic, structural, and signaling pathways, but its genetic architecture is incompletely understood. To elucidate potential genetic contributors to cardiac remodeling and HF, we integrated genome-wide single-nucleotide polymorphisms, gene expression, and DNA methylation using a transomics analytical approach.

Methods:

We used robust rank aggregation (where the position of a certain gene in a rank order list [based on statistical significance level] is tested against a randomly shuffled rank order list) to derive an integrative transomic score for each annotated gene associated with a HF trait.

Results:

We evaluated ≤8372 FHS (Framingham Heart Study) participants (54% women; mean age, 55±17 years). Of these, 62 (0.7%) and 35 (0.4%) had prevalent HF with reduced ejection fraction and HF with preserved left ventricular ejection fraction, respectively. During a mean follow-up of 8.5 years (minimum–maximum, 0.005–18.6 years), 223 (2.7%) and 234 (2.8%) individuals developed incident HF with reduced ejection fraction and HF with reduced ejection fraction, respectively. Top genes included
MMP20
and
MTSS1
(promotes actin assembly at intercellular junctions) for left ventricular systolic function;
ITGA9
(receptor for
VCAM1
[vascular cell protein 1]) and
C5
for left ventricular remodeling;
NUP210
(expressed during myogenic differentiation) and
ANK1
(cytoskeletal protein) for diastolic function;
TSPAN16
and
RAB11FIP3
(involved in regulation of actin cytoskeleton) for prevalent HF with reduced ejection fraction;
ANKRD13D
and
TRIM69
for incident HF with reduced ejection fraction;
HPCAL1
and
PTTG1IP
for prevalent HF with reduced ejection fraction; and
ZNF146
(close to the
COX7A1
enzyme) and
ZFP3
(close to
SLC52A1
—the riboflavin transporter) for incident HF with reduced ejection fraction. We tested the HF-related top single-nucleotide polymorphisms in the UK biobank, where
rs77059055
in
TPM1
(minor allele frequency, 0.023; odds ratio, 0.83;
P
=0.002) remained statistically significant upon Bonferroni correction.

Conclusions:

Our integrative transomics approach offers insights into potential molecular and genetic contributors to HF and its precursors. Although several of our candidate genes have been implicated in HF in animal models, independent replication is warranted.
Stroke Risk Analysis, a System With a High Detection Rate of Atrial Fibrillation in Stroke and Transient Ischemic Attack
Authors: Gomis Meritxell , Dávalos Antoni , Purroy Francisco , Cardona Pere , Rodríguez-Campello Ana , Martí-Fábregas Joan , Pagola Jorge , Pardo Laura , Muñoz-Narbona Lucía , Benabdelhak Ikram , Lara-Rodríguez Blanca , Cuadrado-Godia Elisa , Martínez-Domeño Alejandro , Juega Jesús Maria , Serena Joaquin , Alvarez-Ballano Jesús , Paipa Andrés , Roquer Jaume , Abilleira Sònia , Neeter Rob , van de Groep Abraham , Molina Carlos
Published: December 2019

Background and Purpose—

Stroke Risk Analysis (SRA) comprises an algorithm for automated analysis of ECG monitoring, enabling the detection of paroxysmal atrial fibrillation (pxAF) and identifying patterns indicating a high risk of atrial fibrillation (R_AF). We compared Holter-enabled continuous ECG monitoring in combination with SRA (hSRA) with standard continuous ECG monitoring for pxAF detection in patients with acute ischemic stroke. Also, we sought to identify whether the detection of R_AF patterns during the first cycle (first 2 hours) of hSRA recording was associated with the detection of pxAF during the Stroke Unit stay.

Methods—

We enrolled 524 consecutive patients admitted in the Stroke Unit with acute ischemic stroke or transient ischemic attack with neither history of AF nor AF at admission into a prospective multicentric observational analytic clinical study with intrapatient comparison, who received both continuous ECG monitoring as well as hSRA up to 7 days. Investigators were blinded to hSRA results unless pxAF was detected on SRA.

Results—

Of the 524 consecutive acute stroke patients (median age, 70.0 years; 60% male; acute ischemic stroke 93%, transient ischemic attack 7%), 462 were eligible and included in the study. Among 462 patients with hSRA available for 66 hours, AF was documented by hSRA in 79 patients (17.1%). From this group, 45 AF cases (9.7%) were confirmed after review by an independent and blinded cardiologist. continuous ECG monitoring detected 21 AF cases (4.3%;
P
<0.0001). hSRA detected R_AF patterns in 92 patients. 35 out of the 92 R_AF patients showed an episode of AF during the Stroke Unit stay. Predictive values of R_AF patterns within the first cycle of hSRA were: sensitivity 71%, specificity 86%, positive predictive value 38%, and negative predictive value 96%.

Conclusions—

Automated analysis using SRA technology strongly improves pxAF detection in acute ischemic stroke patients compared with continuous ECG monitoring. The predictive value of a R_AF pattern, as detected by hSRA during the first few hours after admission, deserves further investigation.
Environmental Philanthropy and Civic Engagement: a Comparison of Mainland China, Taiwan, Hong Kong, and Singapore
Authors: Zheng (郑文娟) Wenjuan , Chen (陈臻祥) Zhenxiang , Ong (邓道明) Paul
Published: December 2019

Using the data from the World Value Survey, this paper uses a comparative lens to assess environmental philanthropy by focusing on four predominantly Chinese societies – mainland China, Taiwan, Hong Kong, and Singapore, which contributes to the debate on whether culture can sufficiently explain cross-regional variation in civic engagement, particularly in the domain of environmental philanthropy. We find that residents in mainland China shared similar environmental concerns and beliefs with people from the other regions, but they are least likely to volunteer, donate, and demonstrate for these causes. After accounting for personal characteristics, the sizeable interregional gaps on pro-environmental behaviors remain. These findings are consistent with the argument that structural differences, particularly the developing nature of civil society in mainland China, hinders environmental civic engagement.
A new species of the ghost shrimp genus Lepidophthalmus (Crustacea: Decapoda: Axiidea) from the southwestern Gulf of Mexico
Authors: FELDER DARRYL L.
Published: December 2019

A new species of Lepidophthalmus lacking a ventral median sclerite on the second abdominal somite is described from coastal waters of the southwestern Gulf of Mexico. Lepidophthalmus statoni sp. nov., originally recognized only as a unique population in allozyme studies, is sympatric with the ventrally plated species Lepidophthalmus manningi Felder & Staton, 2000, but more closely resembles Lepidophthalmus louisianensis (Schmitt, 1935) from the northern and northwestern Gulf of Mexico. Apparently restricted to intertidal and shallow subtidal tropical waters, the new species is known to range from western Campeche to middle-upper reaches of Veracruz, Mexico. As many members of the genus, it commonly inhabits euryhaline inlets, estuaries, and protected shorelines, including richly organic muddy to clayey sands and sandy muds adjacent to shoreline vegetation. Coloration is documented and discussed as a tool to facilitate field identifications, as are morphological characters.
Aegla nebeccana n. sp. (Crustacea, Aeglidae) from Ivaí Basin, Paraná, Brazil
Authors: TROMBETTA ALANA DE SOUZA , PÁEZ FERNANDA POLLI , SANTOS SANDRO , TEIXEIRA GUSTAVO MONTEIRO
Published: December 2019

A new species of freshwater anomuran, Aegla nebeccana n. sp. (Decapoda: Aeglidae), is described from the Ivaí River sub-basin, a tributary of the Paraná River Basin, in Paraná state, southern Brazil. The species is illustrated in detail with drawings and photographs. It can be distinguished from its congeners based on both morphological and molecular evidence. Morphologically, the new species resembles Aegla meloi Bond-Buckup & Santos, 2015 by the general shape of the carapace and chelipeds, but differs by having a developed protograstic lobe and by the cheliped ischium ornamentation. Aegla nebeccana n. sp. has pronounced protogastric lobes, similar to Aegla castro Schmitt, 1942 and Aegla schimitti Bond-Buckup & Buckup, 1994 but differs clearly from these in relation to the morphology of the cheliped palmar crest. Based on molecular analysis, A. nebeccana is sister species of Aegla parva Bond-Buckup & Buckup 1994.
The Impact of Peripheral Artery Disease in Chronic Total Occlusion Percutaneous Coronary Intervention (Insights From PROGRESS-CTO Registry)
Authors: Xenogiannis Iosif , Gkargkoulas Fotis , Karmpaliotis Dimitri , Alaswad Khaldoon , Krestyaninov Oleg , Khelimskii Dmitrii , Choi James W. , Jaffer Farouc A. , Patel Mitul , Mahmud Ehtisham , Khatri Jaikirshan J. , Kandzari David E. , Doing Anthony H. , Dattilo Phil , Toma Catalin , Koutouzis Michalis , Tsiafoutis Ioannis , Uretsky Barry , Yeh Robert W. , Tamez Hector , Wyman R. Michael , Jefferson Brian K. , Patel Taral , Jaber Wissam , Samady Habib , Sheikh Abdul M. , Malik Bilal A. , Holper Elizabeth , Potluri Srinivasa , Moses Jeffrey W. , Lembo Nicholas J. , Parikh Manish , Kirtane Ajay J. , Ali Ziad A. , Hall Allison B. , Vemmou Evangelia , Nikolakopoulos Ilias , Dargham Bassel Bou , Rangan Bavana V. , Abdullah Shuaib , Garcia Santiago , Banerjee Subhash , Burke M. Nicholas , Brilakis Emmanouil S.
Published: December 2019

The impact of peripheral artery disease (PAD) in patients undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. We reviewed 3999 CTO PCIs performed in 3914 patients between 2012 and 2018 at 25 centers, 14% of whom had a history of PAD. We compared the clinical and angiographic characteristics and procedural outcomes of patients with versus without history of PAD. Patients with PAD were older (67 ± 9 vs 64 ± 10 years, P < .001) and had a higher prevalence of cardiovascular risk factors. They also had more complex lesions as illustrated by higher Japanese CTO score (2.7 ± 1.2 vs 2.4 ± 1.3, P < .001). In patients with PAD, the final crossing technique was less often antegrade wire escalation (40% vs 51%, P < .001) and more often the retrograde approach (23 vs 20%, P < .001) and antegrade dissection/reentry (20% vs 16%, P < .001). Technical success was similar between the 2 study groups (84% vs 87%, P = .127), but procedural success was lower for patients with PAD (81% vs 85%, P = .015). The incidence of in-hospital major adverse cardiac events was higher among patients with PAD (3% vs 2%, P = .046). In conclusion, patients with PAD undergoing CTO PCI have more comorbidities, more complex lesions, and lower procedural success.
Counseling Psychology and the Amelioration of Oppression: Translating Our Knowledge Into Action
Authors: Suzuki Lisa A. , O’Shaughnessy Tiffany A. , Roysircar Gargi , Ponterotto Joseph G. , Carter Robert T.
Published: December 2019

In the new millennium, counseling psychologists have answered the call to address oppression related to intersectional identities. We have played a major role in the development of practice guidelines and policies, as well as in the application of ethical principles in cultural contexts. The Counseling Psychologist has served to disseminate information addressing needs and interventions for diverse communities. In this article, we review the history and impact of our efforts to ameliorate oppression. The pressing challenges of economic and educational disparities are highlighted along with how counseling psychologists are uniquely situated to meet the needs of the underserved. Our research, training, and practice are anchored in methodological pluralism, global helping paradigms, participatory engagement, and the promotion of liberation and radical healing. We offer recommendations to deconstruct current models and reconstruct a decolonized approach, embrace interdisciplinary collaboration to fight cultural encapsulation, strengthen prevention and advocacy, train a culturally diverse workforce, and prioritize intersectional research.
Introducing an Observational Rating System for Studying Concordance in Patient–Physician Relationships
Authors: Friedlander Myrna L. , Kangos Kelsey A. , Maestro Kieran J. , Muetzelfeld Hannah K. , Wright Scott T. , Da Silva Nicole , Kimber Justin M. , Helmer Drew A. , McAndrew Lisa M.
Published: December 2019

We developed the System for Observing Medical Alliances (SOMA) to study relationships between medical providers and patients with medically unexplained symptoms (MUS). Based on literature in health psychology, medicine, and the psychotherapeutic alliance, the SOMA operationalizes three medical alliance dimensions: Engagement in the Consultation Process, Trust in the Provider, and Concordance of Illness Beliefs and Treatment Recommendations. Specific behavioral indicators, tallied as observed by trained judges, are used as the basis for rating each dimension. In a sample of 33 medical consultations with veterans who had MUS, interrater reliabilities ranged from .79 to .94. Notably, the other dimension ratings accounted for 40% of the variability in Concordance, with Trust in the Provider contributing unique variance. In addition to research, psychologists in integrated health settings can use the SOMA to consult and train medical providers on communication skills that enhance concordance.
Making Meaning out of MANOVA: The Need for Multivariate Post Hoc Testing in Gifted Education Research
Authors: Smith Kendal N. , Lamb Kristen N. , Henson Robin K.
Published: December 2019

Multivariate analysis of variance (MANOVA) is a statistical method used to examine group differences on multiple outcomes. This article reports results of a review of MANOVA in gifted education journals between 2011 and 2017 ( N = 56). Findings suggest a number of conceptual and procedural misunderstandings about the nature of MANOVA and its application, including pervasive use of univariate post hoc tests to interpret MANOVA results. Accordingly, this article aims to make MANOVA more accessible to gifted education scholars by clarifying its purpose and introducing descriptive discriminant analysis as a more appropriate post hoc technique. A heuristic data set is used to demonstrate the procedures for running a descriptive discriminant analysis, both in place of a one-way MANOVA and as a post hoc analysis to a factorial design. SPSS and R syntax are provided.