bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between chest computed tomography findings and respiratory adverse events in rheumatoid arthritis patients undergoing long‐term biological therapy
Authors: Matsumoto Takuya , Iwano Shingo , Takahashi Nobunori , Asai Shuji , Watanabe Tatsuo , Asai Nobuyuki , Sobue Yasumori , Ito Satoru , Ishiguro Naoki , Kojima Toshihisa
Published: November 2018

Objective

This study aimed to assess the association between chest computed tomography (CT) findings and incidence of respiratory adverse events (RAEs), and to detect risk factors for RAEs, in RA patients treated with long‐term biological therapy.

Methods

Clinical and radiological data of 332 RA patients who were treated with biological disease‐modifying antirheumatic drugs were collected. CT data were assessed by an experienced radiologist. Patients were categorized into the interstitial lung disease (ILD) group (n = 29), airway disease (AD) group (n = 76), co‐existing ILD and AD (Co‐existing) group (n = 6), and the group without detectable change (WDC, n = 221) based on CT findings and scores. The incidence of RAEs was calculated for each group, and risk factors for RAEs from CT findings were explored.

Results

We identified 41 RAEs, including acute onset or exacerbation of ILD (ILD events, n = 15), respiratory tract infection events (infection events, n = 21), and other events (n = 6). Cumulative incidences of ILD events were 20.2, 3.75, 47.2, and 1.94 (/1000 patient‐years: PY) in the ILD, AD, Co‐existing, and WDC groups, respectively, and those of infection events were 11.3, 17.6, 23.6, and 2.39 (/1000PY), respectively. Severity, as assessed by CT scores, was correlated with the incidence of RAEs. Risk factors for ILD events were reticular and honeycomb changes, and those for infection events were consolidation, bronchial wall thickening, bronchiectasis, bronchiolitis, air trapping, and atelectasis after adjusting for background factors.

Conclusion

Our findings highlight particular CT findings that are associated with RAEs in RA patients undergoing long‐term biological therapy.
Association between PD‐L1 expression and lymph node metastasis in cutaneous squamous cell carcinoma
Authors: Kamiya Shiori , Kato Junji , Kamiya Takafumi , Yamashita Toshiharu , Sumikawa Yasuyuki , Hida Tokimasa , Horimoto Kohei , Sato Sayuri , Takahashi Hitomi , Sawada Masahide , Kubo Terufumi , Torigoe Toshihiko , Uhara Hisashi
Published: November 2018

Aim

To clarify the relationship between programmed cell death ligand 1 (PD‐L1) expression in cutaneous squamous cell carcinoma (cSCC) and clinicopathological variables.

Methods

We examined PD‐L1 expression in tumor cells (TCs) and tumor infiltrating immune cells (ICs) in 46 cases of cSCC by immunohistochemistry. In each case, we employed two methods—intensity and proportion scores—to evaluate PD‐L1 expression in TCs. For the evaluation of PD‐L1 expression in ICs, only the proportion score was used. Association between PD‐L1 expression and clinicopathological variables was analyzed using Fisher's exact test.

Results

High intensity scores in TCs were observed in 18 of the 46 cases (39.1%) and low intensity scores were observed in 28 cases (60.9%). Applying the proportions, using cut‐off values of ≥1% and 50%, positive scores in TCs were observed in 36 (78.3%) and 20 cases (43.5%), respectively. PD‐L1‐positive ICs were observed in 29 (63%) and seven cases (15.2%), using cut‐off values of ≥1% and 10%, respectively. The high intensity scores in TCs correlated with lymph node metastasis (P = 0.008) and female gender (P = 0.017), although positive proportions in TCs or ICs were not significantly related to lymph node metastasis. A multivariate analysis showed that high intensity of PD‐L1 expression in TCs was an independent risk factor for lymph node metastasis.

Conclusions

The results suggested that high intensity of PD‐L1 expression in TCs is associated with lymph node metastasis in cSCC.
Treatment of alopecia areata: An Australian expert consensus statement
Authors: Cranwell William C , Lai Vivien WY , Photiou Louise , Meah Nekma , Wall Dmitri , Rathnayake Deepani , Joseph Shobha , Chitreddy Vijaya , Gunatheesan Shyamalar , Sindhu Kamaldeep , Sharma Pooja , Green Jack , Eisman Samantha , Yip Leona , Jones Leslie , Sinclair Rodney
Published: November 2018

Alopecia areata (AA) severity varies from a single small patch to complete loss of scalp hair, body hair, eyelashes and eyebrows. While 40% of all affected individuals only ever get one patch and will achieve a spontaneous complete durable remission within 6 months, 27% will develop additional patches but still achieve complete durable remission within 12 months and 33% will develop chronic AA. Without systemic treatment, 55% of individuals with chronic AA will have persistent multifocal relapsing and remitting disease, 30% will ultimately develop alopecia totalis and 15% will develop alopecia universalis. The unpredictable course and psychological distress attributable to AA contributes to the illness associated with AA. Numerous topical, intralesional and systemic agents are currently used to treat AA; however, there is a paucity of data evaluating their use, effectiveness and tolerability. Topical therapy, including topical glucocorticosteroids, minoxidil and immunotherapy, can be used in cases of limited disease. There are no universally agreed indications for initiating systemic treatment for AA. Possible indications for systemic treatment include rapid hair loss, extensive disease (≥50% hair loss), chronic disease, severe distress or a combination of these factors. Currently available systemic treatments include glucocorticosteroids, methotrexate, ciclosporin, azathioprine, dapsone, mycophenolate mofetil, tacrolimus and sulfasalazine. The optimal treatment algorithm has not yet been described. The purpose of this consensus statement is to outline a treatment algorithm for AA, including the indications for systemic treatment, appropriate choice of systemic treatment, satisfactory outcome measures and when to discontinue successful or unsuccessful treatment.
Multicentre retrospective study to assess diagnostic accuracy of ultrasound for superficial endometriosis—Are we any closer?
Authors: Chowdary Prathima , Stone Kate , Ma Tony , Readman Emma , McIlwaine Kate , Druitt Marilla , Ellett Lenore , Cameron Melissa , Maher Peter
Published: November 2018

Background

To establish whether the ultrasound findings of minimal endometriosis are confirmed at laparoscopy and that a correlation can be established as to the anatomical sites in this mild form of the disease.

Aims

Patients with pain and suspicion of endometriosis had an ultrasound scan by a sonologist with expertise in endometriosis as part of their pre‐operative workup.

Measurements and Main results

The clinical histories of 53 patients who had laparoscopy to investigate pelvic pain were reviewed. Ultrasounds were performed between 2012 and 2015 by a single sonologist with expertise in endometriosis assessments. The ultrasound findings were divided into subgroups as follows – presence of uterosacral ligament thickness, thickened pericolic fat, ovarian mobility and focal tenderness. These were compared with operative findings of those patients with superficial endometriosis. Evidence Level 3 – observational studies with controls and health services research that includes adjustment for likely confounding factors.

Results

Seventy‐nine percent (42/53) of the patients had laparoscopic findings consistent with their ultrasound findings (95% CI 68–90%, P < 0.0001). Of the subgroups that we reviewed, uterosacral thickening (P < 0.05) and thickened pericolic fat (P < 0.05) were the most associated with superficial endometriosis at the time of laparoscopy.

Conclusion

Markers on ultrasound that reliably demonstrated inflammation (thickened uterosacral ligaments and thickened pericolic fat) were shown to be significantly associated with the disease.
Radiation effects on male fertility
Authors: De Felice F. , Marchetti C. , Marampon F. , Cascialli G. , Muzii L. , Tombolini V.
Published: November 2018

Background

Spermatogenesis is a process of dynamic cell differentiation. Ionizing radiation impairs spermatogenesis, and spermatogonia are more radiosensitive than spermatocytes or spermatids. Consistent with this assumption and due to improvement in tumor curability, nowadays, fertility preservation represents a public health need.

Objectives

To discuss radiotherapy‐induced risk to male fertility and raise oncologic awareness of male fertility in daily clinical practice.

Materials and Methods

PubMed and Clinicaltrials.gov databases were searched for papers in English.

Results

We provide an overview of clinical landscape. Four main issues were proposed: (i) spermatogenesis and radiobiological general concepts; (ii) impairment of spermatogenesis; (iii) impairment of testosterone‐producing Leydig cells; (iv) clinical radiotherapy evidence in oncology.

Conclusion

This review can be useful in daily clinical work and offer some directions for future research.
Variations in sagittal and coronal stem tilt and their impact on prosthetic impingement in total hip arthroplasty
Authors: Tanaka Takeyuki , Takao Masaki , Sakai Takashi , Hamada Hidetoshi , Tanaka Sakae , Sugano Nobuhiko
Published: November 2018

Optimization of the combined anteversion of cup and stem has been emphasized to avoid prosthetic impingement in total hip arthroplasty (THA). However, no study has focused on the impact of variations in sagittal and coronal stem tilt against the whole femur on prosthetic range of motion. The purposes of the present study were a) to quantify the anatomical variation of sagittal and coronal tilt of the proximal canal axis against the femoral retrocondylar coordinate system, that is variation of sagittal and coronal stem tilt and b) to determine their impact on the zone of impingement‐free cup position using computer simulation. Preoperative computed tomography images of 477 femurs from 409 consecutive patients who underwent THA using computed tomography‐based computer navigation were stored. Virtual implantation of an anatomical stem was performed on the navigation workstation. The safe zone of the cup position with regard to prosthetic impingement was determined by motion simulation in the range of sagittal and coronal stem tilt of the subjects. The sagittal and coronal stem tilt varied by 10°, which was smaller than the stem anteversion variation. However, there was about 3 times the difference in the impingement‐free zone of cup position in the ranges of sagittal and coronal stem tilt. The safe zone was significantly decreased by posterior tilt and valgus tilt of the stem. Range of motion simulation revealed that the variations in sagittal or coronal stem tilt significantly influenced the safe zone of the cup. In conclusion, although the variations in sagittal and coronal stem tilt against the femoral retrocondylar coordinate system were small, their impact on prosthetic impingement was significant.
Silk enhances the ligamentization of the polyethylene terephthalate artificial ligament in a canine anterior cruciate ligament reconstruction model
Authors: Zhi Yunlong , Jiang Jia , Zhang Peng , Chen Shiyi
Published: November 2018

Anterior cruciate ligament (ACL) reconstruction is the leading treatment for ACL rupture. Ligament Advanced Reinforcement System (LARS), which is made of polyethylene terephthalate (PET), is the most frequently used artificial ligament for ACL reconstruction. However, PET is hydrophobic, so it is difficult to induce the ingrowth of the autologous tissue. The aim of this study is to explore the effects of silk hybrid on the ligamentization of the PET artificial ligament in a canine ACL reconstruction model. Silk/PET hybrid suspensory ligament was fabricated with silk in the weft yarn and PET in the warp yarn, while PET suspensory ligament was fabricated with PET in both the weft and warp yarns. After fabrication, the micromorphology of the ligaments was observed and mechanical testing was performed. Though the failure loads of the degummed silk/PET hybrid suspensory ligaments were significantly lower than those of the PET suspensory ligaments (P < 0.001), both of them were enough for ACL reconstructions of beagle dogs. In the animal study, 14 beagle dogs were divided into PET suspensory ligament group and silk/PET hybrid suspensory ligament group randomly, with 7 dogs in each. The dogs underwent ACL reconstructions in their right knees. At postoperative 6 months, the dogs were sacrificed, and the specimens were evaluated with gross observation, histology, immunohistochemistry, and mechanical testing. The histological and immunohistochemical results showed that the native ACL of the beagle dog held abundant fibroblasts and collagen. The PET‐regenerated ligament was loose, and there was a small amount of autologous tissue and collagen. Compared to the PET‐regenerated ligament, the silk/PET hybrid‐regenerated ligament had a compact structure, and there was more regenerated autologous tissue and collagen. In conclusion, compared to the PET ligament, the silk/PET hybrid ligament kept greater ability to induce the ingrowth of the autologous tissue, indicating that the silk hybrid had enhanced the ligamentization of the PET artificial ligament.
Mediastinoscopic salvage esophagectomy for recurrent esophageal squamous cell carcinoma after definitive chemoradiotherapy in a previously pneumonectomized patient
Authors: Okumura Tomoyuki , Seto Yasuyuki , Aikou Susumu , Moriyama Makoto , Sekine Shinich , Hashimoto Isaya , Shibuya Kazuto , Hojo Shozo , Yoshioka Isaku , Nagata Takuya , Fujii Tsutomu
Published: November 2018

We herein report a case of mediastinoscopic salvage esophagectomy for recurrent esophageal squamous cell carcinoma after definitive chemoradiotherapy in a previously pneumonectomized patient. A 66‐year‐old man with a medical history of left‐sided pneumonectomy for lung cancer was diagnosed with local recurrence of lower esophageal squamous cell carcinoma (cT3N0M0 cStage II) 9 years after definitive chemoradiotherapy. The mediastinoscopic cervical approach and laparoscopic transhiatal approach were combined, and the thoracic esophagus was safely mobilized to separate the esophagus from the stump of the left bronchus and to divide dense adhesions between the esophagus and fibrotic tissue at the site of the previous left mediastinal pleural resection. The esophagectomy was uneventful and followed by reconstruction with a gastric conduit via the retrosternal route. The pathological diagnosis was esophageal squamous cell carcinoma (pT3‐AD, pN1, M0, pStage III), indicating R0 resection. Even as salvage surgery, mediastinoscopic esophagectomy is a safe and curative treatment strategy for esophageal cancer patients who have previously undergone pneumonectomy.
Football and Stereotypes: Narratives of Difference between Argentina and Brazil
Authors: ALABARCES PABLO
Published: November 2018

Through an analysis of football, this work explores how stereotypes such as tropicalism and Europeanism are used to construct narratives of national identity in Argentina and Brazil. These stereotypes, which are the consequence of colonial perspectives that seek to reduce heterogeneity in order to gain symbolic power, appear to be effective when we consider their prominence in a range of media. This study argues that these stereotypes need to be deconstructed using methodologies based in the social sciences, while also considering the role of humour in their production and dissemination.
Compassionate versus consequentialist conservation
Authors: Hampton Jordan O. , Warburton Bruce , Sandøe Peter
Published: November 2018

Ethical treatment of wildlife and consideration of animal welfare have become important themes in conservation, but ethical perspectives on how best to protect wild animals and promote their welfare are diverse. There are advantages to the consequentialist harms ethical framework applied in managing wild herbivores for conservation purposes. To minimize harms while achieving conservation goals, we argue that overabundant wild herbivores should in many cases be managed through consumptive in situ killing. Advantages of this policy are that the negative welfare states imposed on animals last only a short time; remaining animals are not deprived of positive welfare states (e.g., linked to rearing offspring); poor welfare states of animals in overabundant populations are avoided (e.g., starvation); negative welfare impacts on heterospecifics through resource depletion (i.e., competition) are prevented; harvesting meat reduces the number of (agricultural) animals raised to supply meat; and minimal costs maximize funding for other wildlife management and conservation priorities. Alternative ethical approaches to our consequentialist framework include deontology (containing animal rights) and virtue ethics, some of which underpin compassionate conservation. These alternative ethical approaches emphasize the importance of avoiding intentional killing of animals but, if no population reduction occurs, are likely to impose considerable unintentional harms on overabundant wildlife and indirectly harm heterospecifics through ineffective population reduction. If nonlethal control is used, it is likely that overabundant animals would be deprived of positive welfare states and economic costs would be prohibitive. We encourage conservation stakeholders to consider animal‐welfare consequentialism as an ethical approach to minimize harms to the animals under their care as well as other animals that policies may affect while at the same time pursuing conservation goals.
Addressing the conundrums of p‐phenylenediamine hair dye allergy by applying Friedmann's principles of contact sensitization
Authors: Ferguson Felicity J. , Pongpairoj Korbkarn , Basketter David A. , White Ian R. , McFadden John P.
Published: November 2018

In the first conundrum, permanent hair dyeing involves the use of aromatic amines such as p‐phenylenediamine (PPD), whose oxidation is pivotal to the dyeing process, but also generates potent allergens. Despite prolonged efforts by industry to search for safer alternatives, hair dyeing is still reliant on this type of aromatic amine. In the second conundrum, patch testing with 1% PPD remains the most useful screen for hair dye contact allergy. However, there is a very small but real risk of actively sensitizing the patient. Lowering the PPD concentration below 1% significantly reduces test sensitivity and diagnostic utility. Here, we argue that by applying Friedmann's principles of contact sensitization each conundrum can be addressed from a new perspective. These principles indicate that, when the exposed area of skin is small (<1 cm2), induction of contact allergy is sharply reduced, whereas elicitation of allergy is unaffected. Careful reflection on this principle suggests that we can predict where hair dye sensitization is most likely to occur, indicates a strategy to reduce the chance of contact sensitization occurring in consumers as a result of hair dyeing, and how we might mitigate the risk of active sensitization resulting from diagnostic patch testing.
An experimental translocation identifies habitat features that buffer camouflage mismatch in snowshoe hares
Authors: Wilson Evan C. , Shipley Amy A. , Zuckerberg Benjamin , Peery M. Zachariah , Pauli Jonathan N.
Published: November 2018

Conservation for species impacted by climate change often occurs at scales impractical for local land managers. Snowshoe hares (Lepus americanus) are one of the most well‐documented species declining from climate change–specifically a reduction in snowcover–yet clear management strategies have yet to emerge. To test whether camouflage mismatch is reducing hare survival we translocated 96 hares to a site recently extirpated of snowshoe hares, and monitored coat color change, mismatch with snow, habitat use, and weekly survival in winter‐spring of 2017. Hare survival was low during periods of camouflage mismatch, and mismatched hares were 3.2 × less likely to survive, but this pattern varied by habitat. We found that aspen‐alder stands >5 hectares negated the mortality costs of mismatch. We provide experimental evidence that mismatch is driving the range contraction of snowshoe hares, and identify specific habitats to buffer the consequences of climate change on this declining winter specialist.
Pain management and safety profiles after preoperative vs postoperative thoracic epidural insertion for bilateral lung transplantation
Authors: Axtell Andrea L. , Heng Elbert E. , Fiedler Amy G. , Melnitchouk Serguei , D'Alessandro David A. , Tolis George , Astor Todd , Dalia Adam A. , Cudemus Gaston , Villavicencio Mauricio A.
Published: November 2018

Objective

Thoracic epidural analgesia provides effective pain control after lung transplantation; however, the optimal timing of placement is controversial. We sought to compare pain control and pulmonary and epidural morbidity between patients receiving preoperative vs postoperative epidurals.

Methods

Institutional records were reviewed for patients undergoing a bilateral lung transplant via a bilateral anterior thoracotomy with transverse sternotomy incision between January 2014 and January 2017. Pain control was measured using visual analog scale pain scores (0‐10). Pulmonary complications included a composite of pneumonia, prolonged intubation, and reintubation/tracheostomy.

Results

Among 103 patients, 72 (70%) had an epidural placed preoperatively and 31 (30%) had an epidural placed within 72 hours posttransplant. There were no differences in the rates of cardiopulmonary bypass (3% vs 0%, P = 0.59); however, patients with a preoperative epidural were less likely to be placed on extracorporeal membrane oxygenation intraoperatively (25% vs 52%, P = 0.01). Pain control was similar at 24 hours (1.2 vs 1.7, P = 0.05); however, patients with a preoperative epidural reported lower pain scores at 48 (1.2 vs 2.1, P = 0.02) and 72 hours posttransplant (0.8 vs 1.7, P = 0.02). There were no differences in primary graft dysfunction (42% vs 56%, P = 0.28), length of mechanical ventilation (19.5 vs 24 hours, P = 0.18), or adverse pulmonary events (33% vs 52%, P = 0.12). No adverse events including epidural hematoma, paralysis, or infection resulted from epidural placement.

Conclusion

Preoperative thoracic epidural placement provides improved analgesia without increased morbidity following lung transplantation.
Designing a Diversity and Inclusion Plan That Works
Authors: Pope Patricia
Published: November 2018

“Should we focus on improving representation, or should we create a more inclusive culture first?” According to these D&I leaders, it's not “either/or”—it's really “both/and.”

Common‐sense steps your company can take to go beyond the surface and truly build diversity and inclusion—from a leader in the field.
Not Your Average Banker: A Conversation About Diversity
Authors: Rahim Joanna , Jeffries Freddi
Published: November 2018

Two creatives look back on their careers and comment on how those experiences have shaped them.

Two women discuss the career journeys that brought them to Lloyds Banking Group.
Accuracy of new recommendations for adrenal incidentalomas in the evaluation of excessive cortisol secretion and follow‐up
Authors: Ruiz Ana , Michalopoulou Theodora , Megia Ana , Näf Silvia , Simón‐Muela Inmaculada , Solano Esther , Martínez Laia , Vendrell Joan
Published: November 2018

Objective

To evaluate whether the 2016 European Society of Endocrinology (ESE) recommendations for the management of adrenal incidentalomas accurately classifies those patients who do not require further follow‐up.

Design and Methods

Single centre retrospective study. From 2010 to 2015, 130 patients with adrenal incidentaloma were evaluated and followed‐up. Clinical, analytical and radiological data were recorded and the presence of comorbidities was assessed. Patients were grouped as nonfunctional or subclinical Cushing syndrome according to American guidelines; and nonfunctional, possible autonomous cortisol secretion and autonomous cortisol secretion, according to ESE guidelines.

Results

Based on American guidelines, 94% of patients had nonfunctional adrenal incidentalomas and 6% had subclinical Cushing syndrome. Based on ESE guidelines, patients were classified into nonfunctional (54%), possible autonomous cortisol secretion (40%) and autonomous cortisol secretion (6%) groups. No differences were observed in demographic characteristics and comorbidities between groups in either classification. Following ESE guidelines, no patient in the nonfunctional group was reclassified into the possible autonomous or autonomous cortisol secretion groups during follow‐up, but one patient in the possible autonomous cortisol secretion group was reclassified into the autonomous cortisol secretion group. Also, 30 patients included in the groups of possible autonomous or autonomous cortisol secretion experienced progression of a comorbidity associated with cortisol excess, with diabetes mellitus as the most frequent comorbidity observed.

Conclusion

Although adrenal incidentalomas with an excess of cortisol secretion were more frequently diagnosed with the new ESE recommendations, patients who did not require longer follow‐up after first evaluation were accurately classified.
Inhibitors in haemophilia A and B: Management of bleeds, inhibitor eradication and strategies for difficult‐to‐treat patients
Authors: Ljung Rolf , Auerswald Guenter , Benson Gary , Dolan Gerry , Duffy Anne , Hermans Cedric , Jiménez‐Yuste Victor , Lambert Thierry , Morfini Massimo , Zupančić‐Šalek Silva , Santagostino Elena
Published: November 2018

The standard therapy for patients with haemophilia is prophylactic treatment with replacement factor VIII (FVIII) or factor IX (FIX). Patients who develop inhibitors against FVIII/FIX face an increased risk of bleeding, and the likelihood of early development of progressive arthropathy, alongside higher treatment‐related costs. Bypassing agents can be used to prevent and control bleeding, as well as the recently licensed prophylaxis, emicizumab, but their efficacy is less predictable than that of factor replacement therapy. Antibody eradication, by way of immune tolerance induction (ITI), is still the preferred management strategy for treating patients with inhibitors. This approach is successful in most patients, but some are difficult to tolerise and/or are unresponsive to ITI, and they represent the most complicated patients to treat. However, there are limited clinical data and guidelines available to help guide physicians in formulating the next treatment steps in these patients. This review summarises currently available treatment options for patients with inhibitors, focussing on ITI regimens and those ITI strategies that may be used in difficult‐to‐treat patients. Some alternative, non‐ITI approaches for inhibitor management, are also proposed.
Drought legacies are dependent on water table depth, wood anatomy and drought timing across the eastern US
Authors: Kannenberg Steven A. , Maxwell Justin T. , Pederson Neil , D'Orangeville Loïc , Ficklin Darren L. , Phillips Richard P.
Published: November 2018

Severe droughts can impart long‐lasting legacies on forest ecosystems through lagged effects that hinder tree recovery and suppress whole‐forest carbon uptake. However, the local climatic and edaphic factors that interact to affect drought legacies in temperate forests remain unknown. Here, we pair a dataset of 143 tree ring chronologies across the mesic forests of the eastern US with historical climate and local soil properties. We found legacy effects to be widespread, the magnitude of which increased markedly in diffuse porous species, sites with deep water tables, and in response to late‐season droughts (August–September). Using an ensemble of downscaled climate projections, we additionally show that our sites are projected to drastically increase in water deficit and drought frequency by the end of the century, potentially increasing the size of legacy effects by up to 65% and acting as a significant process shaping forest composition, carbon uptake and mortality.
Monitoring of the mare during the perinatal period at the clinic and in the stable
Authors: Masko M. , Domino M. , Skierbiszewska K. , Zdrojkowski Ł. , Jasinski T. , Gajewski Z.
Published: November 2018

Complications in late gestation are challenging problems for the equine clinician and are causes of considerable distress to owners. Health problems in a pregnant mare in each stage of gestation can adversely affect the pregnancy. It is important to obtain a thorough history and perform a detailed and systematic examination of the pregnant mare so that the mare may be classified as normal or high‐risk. However, even after a thorough examination, practitioners may face problems with the interpretation and assessment of risk. Normal mares should foal in the stable or pasture. Mares classified as having a high‐risk pregnancy need to be monitored precisely for signs of oncoming foaling with attendance of trained personnel when labour begins. A valuable method for monitoring of the high‐risk mare is assessing fetoplacental well‐being. Fetoplacental well‐being is most accurately assessed with ultrasonography as well as several available hormone profiles. We are proposing our scoring system of the mare's health, which may be useful in the assessment of risk during pregnancy and help clinicians to decide whether sending the mare to the clinic is reasonable or unnecessary.
Prevention of hemodialysis catheter infections: Ointments, dressings, locks, and catheter hub devices
Authors: Golestaneh Ladan , Mokrzycki Michele H.
Published: November 2018

Tunneled central venous catheters used for the provision of hemodialysis are associated with excess morbidity and mortality. Catheter related exit site and blood stream infections are major risks of their use. Although catheter‐avoidance is the best strategy to reduce infections and mortality in the hemodialysis population, the use of catheters remains unacceptably high.

In this review, the existing clinical practice guidelines for the prevention of hemodialysis catheter associated infections are outlined, and a comprehensive evidenced‐based summary of interventions is provided. This includes details about the use of topical antimicrobial ointments and dressings, intranasal ointment application, prophylactic use of antibiotic and non‐antibiotic catheter lock solutions, and catheter hub devices for the prevention of catheter blood stream infections.
Imperial entertainments: The British Empire, the early United States, and enduring Atlantic connections
Authors: Eacott Jonathan
Published: November 2018

This paper brings together recent developments in leisure and entertainment history in the British Empire and Early America to suggest the opportunity for a new focus on the implications of the circulation of British imperial entertainments outside of Britain and its colonies. Since the last third of the twentieth century, scholars of Britain and its empire have been deeply interested in tracking and explaining the emergence of new forms of entertainment over the early modern and modern periods. Meanwhile, historians of Early America have been invested in uncovering the importance of entertainments in the making of theAmerican Revolutionand in advocating for competing visions of the new American nation. These two fields have largely developed independently. Nevertheless, British imperial entertainments continued to be important in the Early Republic. Work on American Anglophilia and Anglo‐American politics has begun to reconsider the lingering importance of Britain to the early United States. The implications of British entertainments in naturalizing imperial and Orientalist pursuits and ways of thinking in the United States and other emerging nation states remain to be explored.
Time to colonoscopy for patients accessing the direct access colonoscopy service compared to the normal service in Newcastle, Australia
Authors: Clarke Louise , Pockney Peter , Gillies Donna , Foster Robert , Gani Jon
Published: November 2018

Background

The 2017 National Bowel Cancer Screening Program report records a median time from positive faecal occult blood test to colonoscopy of 53 days. There is some intrinsic delay in accessing specialist medical opinion prior to colonoscopy.

Aim

To examine the effect of the introduction of a Direct Access Colonoscopy Service (DACS).

Methods

Using prospectively maintained databases, patients undergoing normal service (NS) colonoscopy and those referred to DACS were compared. The primary outcome measure was the time from general practitioner (GP) referral to colonoscopy. Secondary outcome measures included the proportion of patients who met the current recommended 30 days from GP referral to colonoscopy, and the proportion of patients who waited longer than 90 days.

Results

There were 289 patients in the NS group, and 601 patients who progressed on the DACS pathway. The demographics of both groups were comparable. DACS patients had a median waiting time of 49 days, significantly shorter than NS patients whose median wait was 79 days (P < 0.0001). Approximately 15.1% patients in the DACS group had their colonoscopy within 30 days from GP referral, significantly better than in the NS group (4.5%, P < 0.001). In the NS group, 41.2% patients waited longer than 90 days from GP referral to colonoscopy, compared with 16.3% in the DACS group (P < 0.001).

Conclusion

DACS reduces waiting times to colonoscopy and is associated with an increased proportion of patients undergoing colonoscopy in a timely manner.
An ILS heuristic for the ship scheduling problem: application in the oil industry
Authors: Cunha Victor , Santos Iuri , Pessoa Luciana , Hamacher Silvio
Published: November 2018

This paper addresses a real‐life rescheduling problem of a pipe‐laying support vessel (PLSV) fleet in charge of subsea oil well connections. The short‐term schedule of these vessels is subject to uncertainties inherent to its operations, resulting in ships idleness or delays in oil production. The objective of this study is to develop methods to support a Brazilian oil and gas company in overcoming impacts caused by operational disruptions, while reaching its planned production level. The PLSV rescheduling problem was treated as an identical parallel machine scheduling problem, where the machines represent the vessels and the jobs are the activities for the subsea well connections. We propose a mathematical programming model and a method based on the iterated local search (ILS) metaheuristic to solve the problem. This paper contributes to this by considering simultaneously setup times, machine eligibility, release dates, due dates, and machine availability. Both methods were applied on 10 instances based on real PLSV data. Taking into account an objective function that measures the operational impact on schedules, the ILS provided an average improvement above 91% in schedules when compared to the initial solution provided by the studied company. The ILS outperformed a mathematical programming model for the problem, in eight instances, within a 30‐minute execution time limit, fitting to the company process.
Independent risk factors for pressure ulcer development in a high‐risk nursing home population receiving evidence‐based pressure ulcer prevention: Results from a study in 26 nursing homes in Belgium
Authors: Anrys Charlotte , Van Tiggelen Hanne , Verhaeghe Sofie , Van Hecke Ann , Beeckman Dimitri
Published: November 2018

The aim of this study was to identify independent risk factors for pressure ulcer (PU) development in a high‐risk nursing home population receiving evidence‐based PU prevention. This study was part of a randomised controlled trial examining the (cost‐)effectiveness of static air support surfaces compared with alternating pressure air mattresses. The sample consisted of 308 residents at a high risk of PU development (presence of non‐blanchable erythema, Braden score ≤ 12 or Braden subscale “mobility” ≤ 2). PU incidence was monitored for 14 days. Demographic variables; functional, physical, and psychological characteristics; and data on skin assessment were collected. Independent risk factors were identified using multiple logistic regression analysis. The overall PU incidence (category II‐IV) was 8.4% (n = 26), and 1.9% (n = 6) of the residents developed a deep PU (category III‐IV). PUs (category II‐IV) were significantly associated with non‐blanchable erythema, a lower Braden score, and pressure area‐related pain in high‐risk residents even if preventive care was provided. These results highlight the need of a systematic risk assessment, including pain assessment and skin observations, in order to determine and tailor preventive care to the needs of high‐risk individuals.
Joint breeding value evaluation for fertility in Finnish and Norwegian blue foxes
Authors: Kempe Riitta M. , Strandén Ismo
Published: November 2018

We developed a multiple‐trait animal model for blue fox fertility evaluation and estimated genetic parameters simultaneously for seven traits: first three litter sizes (LS), pregnancy rate (PREG), whelping success (WHELP), grading size (gSI) and fur quality (gQU). Grading size and quality were included into the new multiple‐trait model as correlated traits. Litter size of the first parity had the highest unfavourable genetic correlations with gSI (−0.57) and gQU (−0.56). Thus, selection for higher gSI and gQU slows down the genetic gain in fertility traits. WHELP had moderate to fairly high negative genetic correlations with gSI and gQU (−0.44 and −0.36, respectively), indicating that larger animals are more likely to lose their pups during pregnancy or immediately after birth. Our new model corrected the slight overestimation of estimated breeding values (EBVs) especially for first litter size. The accuracy of LS, PREG and WHELP estimation is likely to benefit from the new multiple‐trait animal model. PREG and WHELP improved steadily from 1998 to 2014, and LS traits have shown a moderate genetic trend since 2007, whereas the positive genetic trend for gSI has levelled down, at least temporarily. The fairly high effective population size (150) allows to increase selection intensity, and the new fertility evaluation enables further improvement of fertility traits.
Benzene induces haematotoxicity by promoting deacetylation and autophagy
Authors: Qian Shanhu , Han Yixiang , Shi Yifen , Xu Wanling , Zhu Yiyi , Jiang Songfu , Chen Yi , Yu Zhijie , Zhang Si , Yang Yiping , Yu Kang , Zhang Shenghui
Published: November 2018

Chronic exposure to benzene is known to be associated with haematotoxicity and the development of aplastic anaemia and leukaemia. However, the mechanism underlying benzene‐induced haematotoxicity, especially at low concentrations of chronic benzene exposure has not been well‐elucidated. Here, we found that increased autophagy and decreased acetylation occurred in bone marrow mononuclear cells (BMMNCs) isolated from patients with chronic benzene exposure. We further showed in vitro that benzene metabolite, hydroquinone (HQ) could directly induce autophagy without apoptosis in BMMNCs and CD34+ cells. This was mediated by reduction in acetylation of autophagy components through inhibiting the activity of acetyltransferase, p300. Furthermore, elevation of p300 expression by Momordica Antiviral Protein 30 Kd (MAP30) or chloroquine reduced HQ‐induced autophagy. We further demonstrated that in vivo, MAP30 and chloroquine reversed benzene‐induced autophagy and haematotoxicity in a mouse model. Taken together, these findings highlight increased autophagy as a novel mechanism for benzene‐induced haematotoxicity and provide potential strategies to reverse this process for therapeutic benefits.
The quaternary structure of human tyrosine hydroxylase: effects of dystonia‐associated missense variants on oligomeric state and enzyme activity
Authors: Szigetvari Peter D. , Muruganandam Gopinath , Kallio Juha P. , Hallin Erik I. , Fossbakk Agnete , Loris Remy , Kursula Inari , Møller Lisbeth B. , Knappskog Per M. , Kursula Petri , Haavik Jan
Published: November 2018

Tyrosine hydroxylase (TH) is a multi‐domain, homo‐oligomeric enzyme that catalyses the rate‐limiting step of catecholamine neurotransmitter biosynthesis. Missense variants of human TH are associated with a recessive neurometabolic disease with low levels of brain dopamine and noradrenaline, resulting in a variable clinical picture, from progressive brain encephalopathy to adolescent onset DOPA‐responsive dystonia (DRD). We expressed isoform 1 of human TH (hTH1) and its dystonia‐associated missense variants in E. coli, analysed their quaternary structure and thermal stability using size‐exclusion chromatography, circular dichroism, multi‐angle light scattering, transmission electron microscopy, small‐angle X‐ray scattering and assayed hydroxylase activity. Wild‐type (WT) hTH1 was a mixture of enzymatically stable tetramers (85.6%) and octamers (14.4%), with little interconversion between these species. We also observed small amounts of higher order assemblies of long chains of enzyme by transmission electron microscopy. To investigate the role of molecular assemblies in the pathogenesis of DRD, we compared the structure of WT hTH1 with the DRD‐associated variants R410P and D467G that are found in vicinity of the predicted subunit interfaces. In contrast to WT hTH1, R410P and D467G were mixtures of tetrameric and dimeric species. Inspection of the available structures revealed that Arg‐410 and Asp‐467 are important for maintaining the stability and oligomeric structure of TH. Disruption of the normal quaternary enzyme structure by missense variants is a new molecular mechanism that may explain the loss of TH enzymatic activity in DRD. Unstable missense variants could be targets for pharmacological intervention in DRD, aimed to re‐establish the normal oligomeric state of TH.

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The genomic basis of adaptation to calcareous and siliceous soils in Arabidopsis lyrata
Authors: Guggisberg Alessia , Liu Xuanyu , Suter Léonie , Mansion Guilhem , Fischer Martin C. , Fior Simone , Roumet Marie , Kretzschmar Ruben , Koch Marcus A. , Widmer Alex
Published: November 2018

Edaphic conditions are important determinants of plant fitness. While much has been learnt in recent years about plant adaptation to heavy metal contaminated soils, the genomic basis underlying adaptation to calcareous and siliceous substrates remains largely unknown. We performed a reciprocal germination experiment and whole‐genome resequencing in natural calcareous and siliceous populations of diploid Arabidopsis lyrata to test for edaphic adaptation and detect signatures of selection at loci associated with soil‐mediated divergence. In parallel, genome scans on respective diploid ecotypes from the Arabidopsis arenosa species complex were undertaken, to search for shared patterns of adaptive genetic divergence. Soil ecotypes of A. lyrata display significant genotype‐by‐treatment responses for seed germination. Sequence (SNPs) and copy‐number variants (CNVs) point towards loci involved in ion transport as the main targets of adaptive genetic divergence. Two genes exhibiting high differentiation among soil types in A. lyrata further share trans‐specific single nucleotide polymorphisms with A. arenosa. This work applies experimental and genomic approaches to study edaphic adaptation in A. lyrata and suggests that physiological response to elemental toxicity and deficiency underlies the evolution of calcareous and siliceous ecotypes. The discovery of shared adaptive variation between sister species indicates that ancient polymorphisms contribute to adaptive evolution.
Genomic and transcriptomic signals of thermal tolerance in heat‐tolerant corals (Platygyra daedalea) of the Arabian/Persian Gulf
Authors: Kirk Nathan L. , Howells Emily J. , Abrego David , Burt John A. , Meyer Eli
Published: November 2018

Scleractinian corals occur in tropical regions near their upper thermal limits and are severely threatened by rising ocean temperatures. However, several recent studies have shown coral populations can harbour genetic variation in thermal tolerance. Here, we have extended these approaches to study heat tolerance of corals in the Persian/Arabian Gulf, where heat‐tolerant local populations experience extreme summer temperatures (up to 36°C). To evaluate whether selection has depleted genetic variation in thermal tolerance, estimate potential future adaptive responses and understand the functional basis for these corals’ unusual heat tolerance, we conducted controlled crosses in the Gulf coralPlatygyra daedalea. Heat tolerance is highly heritable in this population (h2 = 0.487–0.748), suggesting substantial potential for adaptive responses to selection for elevated temperatures. To identify genetic markers associated with this variation, we conducted genomewide SNP genotyping in parental corals and tested for relationships between paternal genotype and offspring thermal tolerance. Resulting multilocus SNP genotypes explained a large fraction of variation in thermal tolerance in these crosses (69%). To investigate the functional basis of these differences in thermal tolerance, we profiled transcriptional responses in tolerant and susceptible families, revealing substantial sire effects on transcriptional responses to thermal stress. We also studied sequence variation in these expressed sequences, identifying alleles and functional groups of differentially expressed genes associated with thermal tolerance. Our findings demonstrate that corals in this population harbour extensive genetic variation in thermal tolerance, and heat‐tolerant phenotypes differ in both gene sequences and transcriptional stress responses from their susceptible counterparts.
How development happens: Safe and sustainable energy, community development projects, and implementation challenges in Timor‐Leste
Authors: NINER SARA , LAY JOTHAM , WARREN NARELLE , O'CONNELL MICHAEL , EDGINGTON‐MITCHELL DANIEL
Published: November 2018

This article describes how seed funding from one major Australian University, designed to encourage interdisciplinary collaborations among academics, led to the implementation of a safe and sustainable energy supply at a community development project in remote Timor‐Leste. This article reflects on the process, the results, and insights developed during the project primarily from the point of view of the academics. A participatory process of co‐design was virtually impossible to implement due to time and resource constraints that barely allowed genuine collaboration between academics. The consequent nurturing of a social relationship between partners across borders, which would have allowed a genuine process of co‐design, was therefore not possible. Misunderstandings around the local context, tensions in understandings of timelines, and competing priorities all provided additional barriers to timely implementation of the development project. The final conclusion is that even with the best of intentions, if resource constraints do not allow the time and space to develop collaborative social relations and prioritize “process over product,” then genuine partnerships and participatory development have little chance of flourishing.