bluuebunny/crossref_metadata_2025 huggingface dataset:
Gearóid Ó Lochlainn: The Gate Theatre’s Other Irish-Speaking Founder
Authors: Ó Siadhail Pádraig
Published: November 2020

The association of the Gate Theatre with the Irish language has been always conceived via Micheál mac Liammóir; however, another of its founders, Gearóid Ó Lochlainn, was also Irish-speaking. Ó Lochlainn was a versatile actor in Irish and English, wrote a series of plays in Irish and translated into Irish works by Shakespeare, Ibsen and others. This chapter seeks to fill a gap in the story of the Gate by providing a brief biographical sketch of Ó Lochlainn, including his time in Denmark, a discussion of his role in efforts to establish Irish-language theatre in Dublin (specifically, An Comhar Drámuíochta, which was hosted by the Gate Theatre in 1930-1934), a summary of his involvement with the Gate, a critique of his original plays and his translations which, in introducing Dublin’s Irish-language theatregoers to world drama, complemented the mission of the Gate, and an assessment of Ó Lochlainn’s achievement.
The Transnational Roots of Key Figures from the Early Years of the Gate Theatre, Dublin
Authors: Clare David , Morris Nicola
Published: November 2020

In Gate Theatre studies, the venue’s original artistic directors, Hilton Edwards and Micheál mac Liammóir, are commonly described as ‘Englishmen’. This chapter breaks new ground by exploring the Irish roots of Edwards and mac Liammóir, and the rumours that mac Liammóir had Spanish and Jewish ancestry. ‘The Boys’ were not the only figures associated with the early Gate to have transnational backgrounds. Coralie Carmichael, the theatre’s biggest female star in its early years, was of mixed Moroccan and Scottish ancestry, and Nancy Beckh, who worked as an actor, costume designer and milliner at the Gate between 1932 and 1956, was a Dubliner of half-German descent. Using critical theories around new interculturalism, the chapter suggests that the mixed backgrounds of these artists helped them to create intercultural performances. It further demonstrates that these performances cannot be simply dismissed as those of people condescendingly engaging in cultural imperialism or shallow cosmopolitanism.
The Other Gates: Anglo-American Influences on and from Dublin
Authors: Purkis Charlotte
Published: November 2020

An important influence on the foundation of the Dublin Gate Theatre in 1928 was the London Gate Theatre Studio. This chapter offers a historiographical survey concerning how the range of connections between these theatres have been treated by theatre commentators up to the present. Alongside this re-examination is a discussion of two other theatres that were also inspired by the London Gate, but established independently by the two London co-directors, Peter Godfrey and Velona Pilcher. Godfrey revived the early programming from London in 1943 at his ‘transplanted’ theatre in Hollywood, which also connected Los Angeles emigré culture back to Ireland. In London, Pilcher worked with a group of women associates to found a ‘new Gate’, the Watergate Theatre Club in 1949, which, with its avant-garde artistic ethos, had a cultural impact on the post-war London scene similar to the achievements of the earlier Gate theatres.
Prussian Discipline and Lesbian Vulnerability: Christa Winsloe’s Children in Uniform at the Gate
Authors: Ivory Yvonne
Published: November 2020

This chapter examines the Dublin production and critical reception of Christa Winsloe’s Children in Uniform, which ran to full houses at the Gate for three weeks in April 1934. The play, which deals with the love between a Prussian schoolgirl and her female teacher, had premiered in Leipzig (1930), run successfully in Berlin (1931), and been adapted for the screen as Mädchen in Uniform (1931) before it was translated into English for a successful London run in 1932-1933. Edwards and mac Liammóir probably saw the original German play in Berlin in 1931. Using the prompt copy, lighting plots, photographs and reviews, the chapter shows how Edwards used expressionistic lighting and sonic leitmotifs to underscore the authoritarian regime within which the relationship between the women develops. In following the Berlin staging, Edwards produced a more subversive version of the play than that seen by London audiences or cinema goers.
Overview of MIGS
Authors: Wang Jing , Barton Keith
Published: November 2020

The term, minimally- or micro-invasive glaucoma surgery (MIGS), has entered common ophthalmic parlance and is playing an increasing role in the management of glaucoma patients. In common, the devices and procedures referred to are safer, less tissue invasive and associated with faster recovery than traditional filtering surgery, such as trabeculectomy or aqueous shunt implantation. MIGS can be categorized according to the tissue they target (or bypass): trabecular meshwork (TM) MIGS, subconjunctival MIGS, suprachoroidal MIGS and newer cycloablation procedures. A number of MIGS devices and techniques (e.g. TM MIGS) have relatively modest efficacy, but potential utility in a very large group of glaucoma patients with disease that is insufficiently severe to justify the invasiveness of conventional filtration surgery and the consequent intensity of postoperative care yet, burdened with medication and the attendant side effects and compliance issues thereof. On the other hand, subconjunctival MIGS devices, which are associated with bleb-related complications, can potentially achieve efficacy approaching that of traditional filtering surgery and are appropriate in selected individuals when larger IOP reductions are required, the exception being cases where glaucoma is very advanced. This book covers the techniques that are most commonly regarded as eligible to sit under the MIGS umbrella.

Irrespective of the modest efficacy of many MIGS devices and techniques, the favourable safety profile lowers the threshold for early glaucoma surgery, especially when combined with cataract surgery, potentially delaying the requirement for more invasive surgery and associated risks.
Globalization of MIGS
Authors: Sng Chelvin C. A. , Tham Clement C. , Budenz Donald L. , Healey Paul R. , Wang Ningli
Published: November 2020

Globalization is a comprehensive phenomenon with significant implications for global health. The globalization of minimally invasive glaucoma surgery (MIGS) is currently still a work in progress, with these devices slowly making inroads into Asia, Australasia, South America, and South Africa. Although MIGS companies can enjoy a quantum leap in economies of scale by serving global markets rather than only a confined domestic market, there are considerable economic, logistical, training, legal, and regulatory challenges that they need to overcome. The globalization of MIGS may benefit glaucoma patients worldwide, by reducing medication burden, improving the quality of life, and potentially decreasing the global incidence of glaucoma-related blindness.
iStent: Trabecular Micro-Bypass Stent
Authors: Larsen Christine L. , Samuelson Thomas W.
Published: November 2020

Within the class of procedures termed minimally invasive glaucoma surgery (MIGS), the iStent Trabecular Micro-Bypass Stent (Glaukos Corporation, San Clemente, CA, USA) is an intraocular implant that resides within Schlemm’s canal and allows for direct bypass of the trabecular meshwork by aqueous fluid. The acceptance of MIGS is growing due to its role in lowering intraocular pressure in mild-to-moderate glaucoma combined with its favorable safety profile. With transscleral glaucoma-filtering surgery, there is an increased potential for significant complications including hypotony, suprachoroidal hemorrhage, and long-term risk of endophthalmitis. By contrast, the iStent minimizes these risks and has demonstrated similarities to cataract surgery in terms of associated complications. Multiple publications have described both the safety and efficacy of the implant. These studies are reviewed in addition to a description of the implantation technique and postoperative management pearls. The second-generation model, the iStentinject, may ease implantation and the use of multiple stents may potentially play a role in more advanced disease.
Ab-Interno Trabeculotomy
Authors: Rabin Richard L. , Han Jaehong , Rhee Douglas J.
Published: November 2020

The Trabectome (NeoMedix Corporation, San Juan Capistrano, CA, USA) is a US Food and Drug Administration—approved surgical device which removes a segment of the trabecular meshwork and the inner wall of the Schlemm’s canal using an ab-interno approach, enhancing aqueous outflow via increased access to the Schlemm’s canal and the collector channels. This is a bleb-less procedure which spares the conjunctiva, hence does not adversely affect the outcome of subsequent conventional glaucoma filtration surgeries. Multiple studies have shown that Trabectome surgery results in a reduction in IOP and the number of ocular hypotensive agents, though the efficacy is modest compared with conventional filtration surgery. The safety profile of Trabectome surgery is favorable compared with conventional glaucoma surgery, with the most common complication being intraoperative and postoperative bleeding. Additional research is required to understand how the efficacy of Trabectome surgery can be maximized.
XEN Gel Implant
Authors: Au Leon , Stalmans Ingeborg
Published: November 2020

Among all the novel glaucoma surgical devices, the XEN Gel Implant (Allergan plc, Dublin, Ireland) is the only one which uses anab-internoapproach to drain aqueous to the subconjunctival space, similar to conventional filtration surgery. Most MIGS procedures target the Schlemm’s canal and the collector channels which can be difficult to locate. The patency of the downstream drainage system cannot be accurately assessed and the episcleral venous pressure cannot be routinely measured, leading to unpredictable surgical outcomes for trabecular bypass surgery. In contrast, subconjunctival aqueous drainage is more effective at lowering the intraocular pressure, as is evidenced by the efficacy of trabeculectomy which has a long track record. The main advantages of the XEN Gel Implant over other filtering procedures include its less invasive surgical procedure and the favorable safety profile, fast visual recovery, and short surgery duration, rendering this implant particularly suited for patients who are unable to tolerate a long surgical duration or a delayed visual recovery. Although designed as a stand-alone procedure, XEN implantation can be combined with phacoemulsification in patients with concurrent cataract. Although its pressure-lowering ability appears to be superior to trabecular bypass and suprachoroidal MIGS devices, there are surgical nuances which can be difficult to master and the pre- and postoperative management is critical in the success of the XEN Glaucoma Treatment System.
PRESERFLO MicroShunt
Authors: Kerr Nathan M. , Ahmed Iqbal Ike K. , Pinchuk Leonard , Sadruddin Omar , Palmberg Paul F.
Published: November 2020

The PRESERFLO® MicroShunt (Santen Pharmaceutical Co. Ltd., Osaka, Japan), formerly called the InnFocus MicroShunt®, is a trans-scleral device that shunts aqueous humour from the anterior chamber to a filtering bleb under the conjunctiva and Tenon’s capsule. Manufactured from an inert biocompatible material called poly(styrene-block-isobutylene-block-styrene), or ‘SIBS’, the device elicits minimal foreign body reaction and inflammation; potentially reducing the risk of bleb-related fibrosis and failure. The MicroShunt is 8.5 mm long with a 70 μm lumen and is designed to minimize hypotony based on the Hagen–Poiseuille equation. Inserted via an ab-externo approach, the MicroShunt eliminates the need for creation of a scleral flap, sclerostomy, iridectomy, scleral flap suturing and postoperative suture lysis. Clinical trials show promising results with the MicroShunt achieving intraocular pressure reduction approaching that of trabeculectomy, the current gold standard for treating refractory glaucoma.
Suprachoroidal MIGS Devices
Authors: Garcia-Feijoo Julian , Martinez-de-la-Casa Jose Maria , Perucho Lucia
Published: November 2020

The suprachoroidal outflow pathway has the potential to reduce intraocular pressure (IOP) significantly but has been associated with sight-threatening complications including severe and prolonged hypotony. Historically, suprachoroidal devices have been implantedab externo requiring a conjunctival peritomy and scleral flap dissection. Additionally, the long-term efficacy of previous attempts to harness this space has been disappointing due to occlusion of implanted devices by fibrosis in the suprachoroidal space. More recently, there have been a number of suprachoroidal devices that are injectedab interno., including the CyPass Micro-Stent (Alcon Laboratories Inc., Fortworth, Texas, USA), the iStent Supra (Glaukos Corporation, San Clemente, CA, USA) and the MINIject (iSTAR Medical Isnes, Belgium). These have utilized a clear corneal entry, thereby sparing the conjunctiva. Early results with theseab-internodevices showed safety and efficacy in IOP-lowering that is similar to Schlemm’s canal minimally invasive glaucoma surgery devices and procedures. Despite theab-internoapproach, their long-term efficacy also seems to be limited by fibrosis. In addition, the first commercially availableab-internosuprachoroidal device, the CyPass Micro-Stent, has been voluntarily withdrawn globally by the manufacturer in August 2018, after 5-year follow-up data demonstrated a higher level of endothelial cell loss with the device than in controls. The iStent Supra and MINIject are not yet available commercially.
New Modalities of Cycloablation and High-Intensity-Focused Ultrasound
Authors: Kolomeyer Natasha Nayak , Moster Marlene R.
Published: November 2020

Cycloablative or cyclodestructive procedures aim to lower intraocular pressure (IOP) by decreasing the function of the ciliary body and thereby decreasing the rate of aqueous production. Cycloablative procedures were typically used in refractory glaucoma in eyes with poor visual potential; however, more focused energy and targeted destruction of the ciliary body have led to an increase in cyclodestructive treatment options that are now an important adjunct to our surgical armamentarium. This chapter highlights the history of these procedures while focusing on current modalities including transscleral diode cyclophotocoagulation (TSCPC), micropulse transscleral diode cyclophotocoagulation (MP-TSCPC, MicroPulse P3, IRIDEX IQ810 Laser System, Mountain View, CA, USA), and High-Intensity Focused Ultrasound (HIFU). Specifically, this chapter discusses the protocols, indications, results, and complications of each featured procedure.
Dynamic mode decomposition analysis of rotating detonation waves
Authors: Bohon M. D. , Orchini A. , Bluemner R. , Paschereit C. O. , Gutmark E. J.
Published: November 2020

A rotating detonation combustor (RDC) is a novel approach to achieving pressure gain combustion. Due to the steady propagation of the detonation wave around the perimeter of the annular combustion chamber, the RDC dynamic behavior is well suited to analysis with reduced-order techniques. For flow fields with such coherent aspects, the dynamic mode decomposition (DMD) has been shown to capture well the dominant oscillatory features corresponding to stable limit-cycle or quasi-periodic behavior within its dynamic modes. Details regarding the application of the technique to RDC—such as the number of frames, the effect of subtracting the temporal mean from the processed dataset, the resulting dynamic mode shapes, and the reconstruction of the dynamics from a reduced set of dynamic modes—are analyzed and interpreted in this study. The DMD analysis is applied to two commonly observed operating conditions of rotating detonation combustion, viz., (1) a single spinning wave with weak counter-rotating waves and (2) a clapping operating mode with two counter-propagating waves at equal speed and strength. We show that care must be taken when applying DMD to RDC datasets due to the presence of standing waves (expressed as either counter-propagating azimuthal waves or longitudinal pulsations). Without accounting for these effects, the reduced-order reconstruction fails using the standard DMD approach. However, successful application of the DMD allows for the reconstruction and separation of specific wave modes, from which models of the stabilization and propagation of the primary and counter-rotating waves can be derived.
Review of Rare Earth Elements as Fertilizers and Feed Additives: A Knowledge Gap Analysis
Authors: Tommasi Franca , Thomas Philippe J. , Pagano Giovanni , Perono Genevieve A. , Oral Rahime , Lyons Daniel M. , Toscanesi Maria , Trifuoggi Marco
Published: November 2020

Rare earth elements (REEs) are key constituents of modern technology and play important roles in various chemical and industrial applications. They also are increasingly used in agricultural and zootechnical applications, such as fertilizers and feed additives. Early applications of REEs in agriculture have originated in China over the past several decades with the objective of increasing crop productivity and improving livestock yield (e.g., egg production or piglet growth). Outside China, REE agricultural or zootechnical uses are not currently practiced. A number of peer-reviewed manuscripts have evaluated the adverse and the positive effects of some light REEs (lanthanum and cerium salts) or REE mixtures both in plant growth and in livestock yield. This information was never systematically evaluated from the growing body of scientific literature. The present review was designed to evaluate the available evidence for adverse and/or positive effects of REE exposures in plant and animal biota and the cellular/molecular evidence for the REE-associated effects. The overall information points to shifts from toxic to favorable effects in plant systems at lower REE concentrations (possibly suggesting hormesis). The available evidence for REE use as feed additives may suggest positive outcomes at certain doses but requires further investigations before extending this use for zootechnical purposes.
Femoral neck shaft angle in relation to the location of femoral stress fracture in young military recruits: femoral head versus femoral neck stress fracture
Authors: Kim Dong-Kyu , Kim Tae Ho
Published: November 2020

Objective

To evaluate the influences of the femoral neck shaft angle (FNSA) on the location of the femoral stress fracture and to assess the potential differences in FNSA between fractured and normal femurs.

Materials and methods

Thirty-seven patients with femoral stress fractures who underwent both plain hip radiographs and MRI, from January 2016 to September 2019, were retrospectively included. Patients were classified as having either femoral head stress fracture (group A, n = 26) or femoral neck stress fracture (group B, n = 11). The FNSA was measured in anteroposterior (AP) hip radiograph. The Mann-Whitney U testing was used to compare the continuous values between the two groups. A receiver operating characteristic (ROC) analysis was used to evaluate the value of FNSA for predicting the risk of femoral stress fracture.

Results

The FNSA was significantly higher in group A (median 135.9°, range 129.5–138.6°) than group B (median 124.3°, range 119.5–129.0°) (p < 0.001), but there were no significant differences in other clinical factors. Furthermore, the FNSA was significantly higher at the fractured femurs (median 135.9°, range 129.9–138.6°) than contralateral normal femurs (median 127.9°, range 123.8–132.1°) in the patients with unilateral femoral head stress fracture (n = 22) (p < 0.001). The ROC analysis revealed that the area under curve (AUC), sensitivity, and specificity for predicting the risk of femoral head stress fracture were 0.807, 72.7%, and 68.2%, respectively, at a FNSA cutoff of 131.0°.

Conclusion

FNSA was associated with the location of the femoral stress fracture. In addition, FNSA could serve as a predictive factor for the risk of femoral head stress fractures.
IL-15 superagonist N-803 improves IFNγ production and killing of leukemia and ovarian cancer cells by CD34+ progenitor-derived NK cells
Authors: Van der Meer J. M. R. , Maas R. J. A. , Guldevall K. , Klarenaar K. , de Jonge P. K. J. D. , Evert J. S. Hoogstad-van , van der Waart A. B. , Cany J. , Safrit J. T. , Lee J. H. , Wagena E. , Friedl P. , Önfelt B. , Massuger L. F. , Schaap N. P. M. , Jansen J. H. , Hobo W. , Dolstra H.
Published: November 2020

Allogeneic natural killer (NK) cell transfer is a potential immunotherapy to eliminate and control cancer. A promising source are CD34 + hematopoietic progenitor cells (HPCs), since large numbers of cytotoxic NK cells can be generated. Effective boosting of NK cell function can be achieved by interleukin (IL)-15. However, its in vivo half-life is short and potent trans-presentation by IL-15 receptor α (IL-15Rα) is absent. Therefore, ImmunityBio developed IL-15 superagonist N-803, which combines IL-15 with an activating mutation, an IL-15Rα sushi domain for trans-presentation, and IgG1-Fc for increased half-life. Here, we investigated whether and how N-803 improves HPC-NK cell functionality in leukemia and ovarian cancer (OC) models in vitro and in vivo in OC-bearing immunodeficient mice. We used flow cytometry-based assays, enzyme-linked immunosorbent assay, microscopy-based serial killing assays, and bioluminescence imaging, for in vitro and in vivo experiments. N-803 increased HPC-NK cell proliferation and interferon (IFN)γ production. On leukemia cells, co-culture with HPC-NK cells and N-803 increased ICAM-1 expression. Furthermore, N-803 improved HPC-NK cell-mediated (serial) leukemia killing. Treating OC spheroids with HPC-NK cells and N-803 increased IFNγ-induced CXCL10 secretion, and target killing after prolonged exposure. In immunodeficient mice bearing human OC, N-803 supported HPC-NK cell persistence in combination with total human immunoglobulins to prevent Fc-mediated HPC-NK cell depletion. Moreover, this combination treatment decreased tumor growth. In conclusion,  N-803 is a promising IL-15-based compound that boosts HPC-NK cell expansion and functionality in vitro and in vivo. Adding N-803 to HPC-NK cell therapy could improve cancer immunotherapy.
Colorectal Cancer Screening in Ghana: Physicians’ Practices and Perceived Barriers
Authors: Lussiez Alisha , Dualeh Shukri H. A. , Dally Charles K. , Opoku Baafuor K. , Raghavendran Krishnan , Aitpillah Francis , Boateng Edward , Darkwah Dominic , Gyasi‐Sarpong Kofi Christian , Kolars Joseph C. , Kwakye Gifty
Published: November 2020

Introduction

Ghana has seen a rise in the incidence of colorectal cancer (CRC) over the past decade. In 2011, the Ghana National Cancer Steering Committee created a guideline recommending fecal occult blood testing (FOBT) for CRC screening in individuals over the age of 50. There is limited data available on current Ghanaian CRC screening trends and adherence to the established guidelines.

Methods

We conducted a survey of 39 physicians working at the Komfo Anokye Teaching Hospital in Kumasi, Ghana. The survey evaluates physician knowledge, practice patterns, and perceived personal‐, patient‐ and system‐level barriers pertaining to CRC screening.

Results

Almost 10% of physicians would not recommend colorectal cancer screening for asymptomatic, average risk patients who met the age inclusion criteria set forth in the national guidelines. Only 1 physician would recommend FOBT as an initial screening test for CRC. The top reasons for not recommending CRC screening with FOBT were the lack of equipment/facilities for the test (28.1%) and lack of training (18.8%). The two most commonly identified barriers to screening identified by >85% of physicians, were lack of awareness of screening/not perceiving colorectal cancer as a serious health threat (patient‐level) and high screening costs/lack of insurance coverage (system‐level).

Conclusion

Despite creation of national guidelines for CRC screening, there has been low uptake and implementation. This is due to several barriers at the physician‐, patient‐ and system‐levels including lack of resources and physician training to follow‐up on positive screening results, limited monetary support and substantial gaps in knowledge at the patient level.
The Impact of COVID-19 on Interventional Radiology Services in the UK
Authors: Zhong Jim , Datta Anubhav , Gordon Thomas , Adams Sophie , Guo Tianyu , Abdelaziz Mazin , Barbour Fraser , Palkhi Ebrahim , Adusumilli Pratik , Oomerjee Mohammed , Lake Edward , Walker Paul
Published: November 2020

Introduction

The coronavirus disease 2019 (COVID-19) has created unprecedented challenges on the healthcare system. The aim of this multi-centre study was to measure the impact of COVID-19 on IR services in the UK.

Material and Methods

Retrospective cross-sectional study of IR practice in six UK centres during the COVID-19 pandemic was carried out. All therapeutic IR procedures were identified using the respective hospital radiology information systems and COVID-19 status found on the hospital patient record systems. The total number of therapeutic IR procedures was recorded over two time periods, 25/03/2019–21/04/2019 (control group) and 30/03/2020–26/04/2020 (COVID-19 group). The data points collected were: procedure type, aerosol-generating nature, acute or elective case, modality used, in- or out-of-hours case and whether the procedure was done at the bedside (portable).

Results

A 31% decrease in overall number of IR procedures was observed during COVID-19 compared to the control group (1363 cases vs 942 cases); however, the acute work decreased by only 0.5%. An increase in out-of-hours work by 10% was observed. COVID-19 was suspected or laboratory proved in 9.9% of cases (n = 93), and 15% of total cases (n = 141) were classed as aerosol-generating procedures. A 66% rise in cholecystostomy was noted during COVID-19. Image-guided ablation, IVC filters, aortic stent grafting and visceral vascular stenting had the greatest % decreases in practice during COVID-19, with 91.7%, 83.3%, 80.8% and 80.2% decreases, respectively.

Conclusion

During the global pandemic, IR has continued to provide emergency and elective treatment highlighting the adaptability of IR in supporting other specialties.
Growth and characterization of InP-based 1750 nm emitting membrane external-cavity surface-emitting laser
Authors: Broda Artur , Jeżewski Bartosz , Sankowska Iwona , Szymański Michał , Hoser Paweł , Muszalski Jan
Published: November 2020

The epitaxial growth and emission properties of a membrane external-cavity surface-emitting laser (MECSEL) are demonstrated in the 1750 nm band. A heterostructure consisting of InGaAs quantum wells enclosed by InGaAlAs barriers was deposited on InP by molecular beam epitaxy. The emitted power exceeded 1.5 W, which is the highest that has been reported in this spectral range to date.
Choice resolutions
Authors: Cantone Domenico , Giarlotta Alfio , Watson Stephen
Published: November 2020

We describe a process to compose and decompose choice behavior, called resolution. In the forward direction, resolutions amalgamate simple choices to create a complex one. In the backward direction, resolutions detect when and how a primitive choice can be deconstructed into smaller choices. A choice is resolvable if it is the resolution of smaller choices. Rationalizability, rationalizability by a preorder, and path independence are all preserved (backward and forward) by resolutions, whereas rationalizability by a weak order (equivalently, ) is not. We characterize resolvable choices, and show that resolvability generalizes .
Correction to: The influence of atrial fibrillation on the levels of NT-proBNP versus GDF-15 in patients with heart failure
Authors: Santema Bernadet T. , Chan Michelle M. Y. , Tromp Jasper , Dokter Martin , van der Wal Haye H. , Emmens Johanna E. , Takens Janny , Samani Nilesh J. , Ng Leong L. , Lang Chim C. , van der Meer Peter , ter Maaten Jozine M. , Damman Kevin , Dickstein Kenneth , Cleland John G. , Zannad Faiez , Anker Stefan D. , Metra Marco , van der Harst Pim , de Boer Rudolf A. , van Veldhuisen Dirk J. , Rienstra Michiel , Lam Carolyn S. P. , Voors Adriaan A.
Published: November 2020

The original article can be found online.
Pulmonary embolism in patients with COVID-19: characteristics and outcomes in the Cardio-COVID Italy multicenter study
Authors: Ameri Pietro , Inciardi Riccardo M. , Di Pasquale Mattia , Agostoni Piergiuseppe , Bellasi Antonio , Camporotondo Rita , Canale Claudia , Carubelli Valentina , Carugo Stefano , Catagnano Francesco , Danzi Giambattista , Dalla Vecchia Laura , Giovinazzo Stefano , Gnecchi Massimiliano , Guazzi Marco , Iorio Anita , La Rovere Maria Teresa , Leonardi Sergio , Maccagni Gloria , Mapelli Massimo , Margonato Davide , Merlo Marco , Monzo Luca , Mortara Andrea , Nuzzi Vincenzo , Piepoli Massimo , Porto Italo , Pozzi Andrea , Provenzale Giovanni , Sarullo Filippo , Sinagra Gianfranco , Tedino Chiara , Tomasoni Daniela , Volterrani Maurizio , Zaccone Gregorio , Lombardi Carlo Mario , Senni Michele , Metra Marco
Published: November 2020

Background

Pulmonary embolism (PE) has been described in coronavirus disease 2019 (COVID-19) critically ill patients, but the evidence from more heterogeneous cohorts is limited.

Methods

Data were retrospectively obtained from consecutive COVID-19 patients admitted to 13 Cardiology Units in Italy, from March 1st to April 9th, 2020, and followed until in-hospital death, discharge, or April 23rd, 2020. The association of baseline variables with computed tomography-confirmed PE was investigated by Cox hazards regression analysis. The relationship between d-dimer levels and PE incidence was evaluated using restricted cubic splines models.

Results

The study included 689 patients (67.3 ± 13.2 year-old, 69.4% males), of whom 43.6% were non-invasively ventilated and 15.8% invasively. 52 (7.5%) had PE over 15 (9–24) days of follow-up. Compared with those without PE, these subjects had younger age, higher BMI, less often heart failure and chronic kidney disease, more severe cardio-pulmonary involvement, and higher admission d-dimer [4344 (1099–15,118) vs. 818.5 (417–1460) ng/mL, p < 0.001]. They also received more frequently darunavir/ritonavir, tocilizumab and ventilation support. Furthermore, they faced more bleeding episodes requiring transfusion (15.6% vs. 5.1%, p < 0.001) and non-significantly higher in-hospital mortality (34.6% vs. 22.9%, p = 0.06). In multivariate regression, only d-dimer was associated with PE (HR 1.72, 95% CI 1.13–2.62; p = 0.01). The relation between d-dimer concentrations and PE incidence was linear, without inflection point. Only two subjects had a baseline d-dimer < 500 ng/mL.

Conclusions

PE occurs in a sizable proportion of hospitalized COVID-19 patients. The implications of bleeding events and the role of d-dimer in this population need to be clarified.

Graphic abstract
Description and application of a method to quantify criterion-related cut-off values for questionnaire-based psychosocial risk assessment
Authors: Diebig Mathias , Angerer Peter
Published: November 2020

Purpose

The psychosocial risk assessment is a systematic intervention process for organizations that aims at improving psychosocial working conditions as well as employee health. Based on a screening of working conditions, interventions to reduce risk factors are implemented and evaluated. What is missing for most screening instruments however are cut-off values to categorize working conditions into uncritical vs. critical, whereas the latter indicates an elevated risk for illness. To estimate and evaluate cut-off values, two studies were conducted using the receiver operating characteristic (ROC) analysis.

Methods

In Study 1, a sample of 229 participants answered an online survey on depression (PHQ) and psychosocial working conditions using a questionnaire (DYNAMIK) that covers five factors important to workers' health: workload, boundary permeability, participation, leader support, and usability. Using the ROC analysis, criterion-related cut-off values were generated to predict depressive symptoms. In Study 2, these cut-off values were used to classify working conditions in the two categories of ‘critical’ and ‘uncritical’ in an independent sample (N = 295). It was tested for differences in the results of the two groups concerning the direct criterion of depressive symptoms and the indirect criterion of effort-reward imbalance.

Results

In Study 1, cut-off values differed between the five scales and showed different values for sensitivity and specificity. In Study 2, participants exposed to critical working conditions reported more depressive symptoms as well as an effort-reward imbalance.

Conclusions

Cut-off values are useful to identify working conditions as either critical or uncritical. This knowledge is important when deciding which working conditions should be optimized within the context of psychosocial risk assessment.
Among-individual differences in foraging modulate resource exploitation under perceived predation risk
Authors: Eccard Jana A. , Liesenjohann Thilo , Dammhahn Melanie
Published: November 2020

Foraging is risky and involves balancing the benefits of resource acquisition with costs of predation. Optimal foraging theory predicts where, when and how long to forage in a given spatiotemporal distribution of risks and resources. However, significant variation in foraging behaviour and resource exploitation remain unexplained. Using single foragers in artificial landscapes of perceived risks and resources with diminishing returns, we aimed to test whether foraging behaviour and resource exploitation are adjusted to risk level, vary with risk during different components of foraging, and (co)vary among individuals. We quantified foraging behaviour and resource exploitation for 21 common voles (Microtus arvalis). By manipulating ground cover, we created simple landscapes of two food patches varying in perceived risk during feeding in a patch and/or while travelling between patches. Foraging of individuals was variable and adjusted to risk level and type. High risk during feeding reduced feeding duration and food consumption more strongly than risk while travelling. Risk during travelling modified the risk effects of feeding for changes between patches and resulting evenness of resource exploitation. Across risk conditions individuals differed consistently in when and how long they exploited resources and exposed themselves to risk. These among-individual differences in foraging behaviour were associated with consistent patterns of resource exploitation. Thus, different strategies in foraging-under-risk ultimately lead to unequal payoffs and might affect lower trophic levels in food webs. Inter-individual differences in foraging behaviour, i.e. foraging personalities, are an integral part of foraging behaviour and need to be fully integrated into optimal foraging theory.
Parasite infestation influences life history but not boldness behavior in placental live-bearing fish
Authors: Hagmayer Andres , Furness Andrew I. , Pollux Bart J. A.
Published: November 2020

Parasites can negatively affect the reproductive success of hosts. Placental species may be particularly susceptible, because parasite-induced stress during pregnancy could potentially influence embryo development. Here, we examine the consequences of a trematode infestation (black spot disease, BSD) for fetal development and adult behavior in 19 natural populations of the placental live-bearing fish species Poeciliopsis retropinna (Poeciliidae) in Costa Rica. First, we observed substantial variation in parasite infestation among populations which correlated with a number of local environmental conditions (elevation, river width, depth, and flow velocity). Furthermore, we observed substantial variation in parasite infestation among females within populations associated with maternal age and size. We found that the infestation rate significantly influenced embryonic development, with more heavily parasitized females producing smaller and worse-conditioned offspring at birth, possibly, because a costly immune response during pregnancy limits, either directly or indirectly, nourishment to developing embryos. Finally, a behavioral experiment in the field showed that the infestation rate did not affect an individual’s boldness. Our study indicates that in placental live-bearing fish parasite infestation leads to reduced embryo provisioning during pregnancy, resulting in a smaller offspring size and quality at birth potentially with negative implications for offspring fitness.
Coccygectomy for coccygodynia: a cohort study with a long-term follow-up of up to 29 years
Authors: Hochgatterer R. , Gahleitner M. , Allerstorfer J. , Maier J. , Luger M. , Großbötzl G. , Gotterbarm T. , Pisecky L.
Published: November 2020

Purpose

We aim to critically review the effectiveness and safety of coccygectomy with special regard to long-term outcomes.

Methods

Coccygectomy was performed in our clinic in 38 patients between 1990 and 2019. All these patients (32 females vs. 6 males) have failed to respond to conservative treatment for at least 6 months prior to surgery. All patients were available for follow-up after mean 12,3 years (2 months to 29 years, 11 patients had a minimum FUP of 24 years). We evaluated all patients clinically and radiologically.

Results

Nineteen patients reported traumatic and 17 patients reported idiopathic onset of their symptoms; one patient had clinical symptoms after childbirth and another patient had coccygodynia after extensive low back surgery. 36 of our 38 patients were free of pain at least 6 months after surgery and had good or excellent clinical results according to the VAS which improved from 6.37 (SD 1.08) preoperatively to 0.68 (SD 0.99) at the recent follow-up. Two patients showed an ODI > 22 at the recent follow-up (24 and 28) and 32 had an ODI equal or under 4. There was no statistical significant difference in terms of clinical outcome between the different radiological types of the coccyx. Postoperative complications were rare: 1 superficial infection and one re-operation 6 months after initial surgery due to an pre-existing exostosis which had not been removed at the index surgery; no neurological complications and no major bleeding occurred. No patient had recurrent onset of coccygodynia. 37 out of 38 patients would have coccygectomy again.

Conclusions

Coccygectomy is a safe treatment option in patients with coccygodynia and shows excellent long-term results. We recommend to perform coccygectomy if patients fail to respond to conservative treatment for 6 months.

Level of evidence

IV
Diagnosing type 2 diabetes using Hemoglobin A1c: a systematic review and meta-analysis of the diagnostic cutpoint based on microvascular complications
Authors: Butler Alexandra E. , English Emma , Kilpatrick Eric S. , Östlundh Linda , Chemaitelly Hiam S. , Abu-Raddad Laith J. , Alberti K. George M. M. , Atkin Stephen L. , John W. Garry
Published: November 2020

Aims

Diabetic microvascular complications of retinopathy, nephropathy and neuropathy may occur at hemoglobin A1c levels (HbA1c) below the 6.5% (48 mmol/mol) diagnostic threshold. Our objective was to assess the validity of the HbA1c diagnostic cutpoint of 6.5% based upon published evidence of the prevalence of retinopathy, nephropathy and neuropathy as markers of diabetes.

Methods

Data Sources PubMed, Embase, Cochrane, Scopus and CINAHL from 1990-March 2019, grey literature sources. Study Selection All studies reported after 1990 (to ensure standardized HbA1c values) where HbA1c levels were presented in relation to prevalence of retinopathy, nephropathy or neuropathy in subjects not known to have diabetes. Data Extraction Studies were screened independently, data abstracted, and risk of bias appraised. Data Synthesis Data were synthesized using HbA1c categories of < 6.0% (< 42 mmol/mol), 6.0–6.4% (42–47 mmol/mol) and ≥ 6.5% (≥ 48 mmol/mol). Random-effects meta-analyses were conducted for retinopathy, nephropathy and neuropathy prevalence stratified by HbA1c categories. Random-effects multivariable meta-regression was conducted to identify predictors of retinopathy prevalence and sources of between-study heterogeneity.

Results

Pooled mean prevalence was: 4.0%(95% CI: 3.2–5.0%) for retinopathy, 10.5% (95% CI: 4.0–19.5%) for nephropathy, 2.5% (95% CI: 1.1–4.3%) for neuropathy. Mean prevalence when stratified for HbA1c < 6.0%, 6.0–6.4% and ≥ 6.5% was: retinopathy: 3.4% (95% CI: 1.8–5.4%), 2.3% (95% CI: 1.6–3.2%) and 7.8%(95% CI: 5.7–10.3%); nephropathy: 7.1% (95% CI: 1.7–15.9%), 9.6% (95% CI: 0.8–26.4%) and 17.1% (95% CI: 1.0–46.9%); neuropathy: 2.1% (95% CI: 0.0–6.8%), 3.4% (95% CI: 0.0–11.6%) and 2.8% (95% CI: 0.0–12.8%). Multivariable meta-regression showed HbA1c ≥ 6.5% (OR: 4.05; 95% CI: 1.92–8.57%), age > 55 (OR: 3.23; 95% CI 1.81–5.77), and African-American race (OR: 10.73; 95% CI: 4.34–26.55), to be associated with higher retinopathy prevalence. Marked heterogeneity in prevalence estimates was found across all meta-analyses (Cochran’s Q-statistic p < 0.0001).

Conclusions

The prevalence of nephropathy and moderate retinopathy was increased in subjects with HbA1c values ≥ 6.5% confirming the high specificity of this value for diagnosing T2DM; however, at HbA1c < 6.5% retinopathy increased at age > 55 years and, most strikingly, in African-Americans, suggesting there may be excess microvascular complication prevalence (particularly nephropathy) in individuals below the diabetes diagnostic threshold.
Anisotropic Wellbore Stability Analysis: Impact on Failure Prediction
Authors: Asaka Michinori , Holt Rune Martin
Published: November 2020

Shale formations are the main source of borehole stability problems during drilling operations. Suboptimal predictions of borehole failure may partly be caused by neglecting the anisotropic nature of shales: Conventional wellbore stability analysis is based on borehole stresses computed from isotropic linear elasticity (Kirsch solution) with the assumption of no induced pore pressure. This is very convenient for a practical implementation but does not always work for shales. Here, anisotropic wellbore stability analysis was performed targeting an offshore gas field to investigate in particular the impact of elastic anisotropy on borehole failure predictions. Stress concentration around a circular borehole in anisotropic shale was calculated by the Amadei solutions, and induced pore pressure was obtained from the Skempton parameters based on anisotropic poroelasticity. Borehole failure regions and modes were then predicted using the effective stresses and those are apparently consistent with observations. A comparison with the conventional approach suggests the importance of accounting for elastic anisotropy: Predicted failure regions, modes, and also the associated mud weight limits can be completely different. This observation may have significant implications for other fields since shale often show strong elastic anisotropy.
Effect of tolvaptan on renal involvement in patients with autosomal dominant polycystic kidney disease according to different gene mutations
Authors: Moriyama Tomofumi , Nakayama Yosuke , Soejima Mikiko , Yokota Yunosuke , Ota Kanji , Ito Sakuya , Kodama Goh , Nakamura Nao , Kurokawa Yuka , Yano Junko , Ueda Utako , Takamiya Yoshimi , Kaida Yusuke , Hazama Takuma , Shibata Ryo , Koda Yoshiro , Fukami Kei
Published: November 2020

Background

Autosomal dominant polycystic kidney disease (ADPKD) is an inherited disorder caused by mutations in the polycystic kidney disease (PKD) gene. Although tolvaptan has benefits for renal involvement, the different effects depending on the gene mutation type are unknown. Thus, we explore the different effects of tolvaptan on the annual changes in total kidney volume (%TKV) and estimated glomerular filtration rate (eGFR) according to the gene mutation type in ADPKD patients.

Methods

In total, 135 ADPKD patients were screened, and 22 patients taking tolvaptan for at least a year were retrospectively studied at the Kurume University Hospital. We examined the decline in renal function and %TKV by computed tomography and analyzed the gene mutation. Patients were classified into the following four groups according to gene mutation type:PKD1-truncated,PKD1-non-truncated,PKD2, and mutation not found. Patients were treated with tolvaptan, and the effects of tolvaptan were analyzed according to the gene mutation type.

Results

Patients (age: 52.3 ± 11.2 years) were administered tolvaptan at a dose of 45 or 60 mg. No variation was observed in the annual changes in eGFR (%eGFR) (before: − 10.5% ± 13.9%, after: − 14.4% ± 8.1%,P = 0.139), whereas %TKV was significantly improved after the tolvaptan treatment (before: 14.9% ± 8.0%, after: − 5.4% ± 7.6%,P < 0.001). Unlike %eGFR, tolvaptan treatment significantly improved %TKV, regardless of the type of gene mutation.

Conclusions

A year treatment with tolvaptan significantly improved %TKV in patients with ADPKD, regardless of the gene mutation type.
Modeling the mechanobioelectricity of cell clusters
Authors: Leronni Alessandro
Published: November 2020

We propose a continuum finite strain theory for the interplay between the bioelectricity and the poromechanics of a cell cluster. Specifically, we refer to a cluster of closely packed cells, whose mechanics is governed by a polymer network of cytoskeletal filaments joined by anchoring junctions, modeled through compressible hyperelasticity. The cluster is saturated with a solution of water and ions. We account for water and ion transport in the intercellular spaces, between cells through gap junctions, and across cell membranes through aquaporins and ion channels. Water fluxes result from the contributions due to osmosis, electro-osmosis, and water pressure, while ion fluxes encompass electro-diffusive and convective terms. We consider both the cases of permeable and impermeable cluster boundary, the latter simulating the presence of sealing tight junctions. We solve the coupled governing equations for a one-dimensional axisymmetric benchmark through finite elements, thus determining the spatiotemporal evolution of the intracellular and extracellular ion concentrations, setting the membrane potential, and water concentrations, establishing the cluster deformation. When suitably complemented with genetic, biochemical, and growth dynamics, we expect this model to become a useful instrument for investigating specific aspects of developmental mechanobioelectricity.
Influence of cereal harvest on adrenocortical activity in European hares (Lepus europaeus)
Authors: Cybulska Nicolas , Hackländer Klaus , Palme Rupert , Frey-Roos Alfred , Schai-Braun Stéphanie C.
Published: November 2020

Anthropogenic disturbances, such as habitat modifications and machines, are associated with increased levels of faecal glucocorticoid metabolites (fGCMs) in mammals, an indicator of a stress response. One human-caused process provoking incisive habitat alterations is harvesting arable crops. We investigated the effect of cereal harvest on fGCM concentrations in European hares (Lepus europaeus) in arable landscapes in lower Austria during the year 2018 by collecting 591 faecal samples before, during and after cereal harvest. fGCMs were analysed using an enzyme immunoassay, and data were analysed using linear mixed-effects models. We found that neither cereal harvest nor farming practice (organic vs. conventional) caused an overall increase in the hares’ stress level. Lower vegetation density and higher proportions of bare ground were negatively correlated with fGCM concentrations, whereas the proportion of stubble fields was significantly positively correlated with fGCM concentrations in European hares. A change to more open landscapes might decrease time spent avoiding predation, and fallen grains may provide a beneficial additional food source for the hares. This indicates that European hares are well adapted to an opening up of the landscape and short-term disturbances such as cereal harvesting. In conclusion, cereal harvest had no large impact on European hares’ adrenocortical activity in an arable landscape with small average field size and enough available non-farmed areas.