bluuebunny/crossref_metadata_2025 huggingface dataset:
HIV pretreatment drug resistance among cisgender MSM and transgender women from Lima, Peru
Authors: Trebelcock William L , Lama Javier R , Duerr Ann , Sanchez Hugo , Cabello Robinson , Gilada Trupti , Segura Patricia , Reisner Sari L , Mayer Kenneth H , Mullins James , Bender Ignacio Rachel A
Published: November 2019

Introduction

Transmitted, or any pretreatment drug resistance (TDR, PDR) can compromise efficacy of first‐line antiretroviral therapy (ART). In Peru, genotypic resistance testing is not routinely performed before ART initiation, and estimated PDR prevalence prior to 2012 ranged from 1.0% to 4.7%. We aimed to update estimates of PDR prevalence in men who have sex with men (cis‐MSM) and transgender women (TW).

Methods

We obtained HIV sequences from three studies of ART‐naïve cisgender‐MSM and TW (n = 470) in Lima, Peru from 2013 to 2017, almost two‐thirds of whom had acute or recent infections. Sanger sequences of HIV pol were interrogated for surveillance drug resistance mutations (SDRM) using the Stanford Calibrated Population Resistance (CPR) tool and scored for resistance to nucleoside reverse transcriptase inhibitors (NRTIs) and non‐nucleoside reverse transcriptase inhibitors (NNRTIs) with the HIVdb programme. We calculated binomial proportions and 95% confidence intervals. χ2 and exact or trend tests were used to examine predictors of PDR.

Results

Seventy‐seven (16.4%) individuals had PDR (95% CI: 13.2 to 20.0); most resistance was likely TDR since 63% were incident infections. SDRM were present in 9.8% (7.3 to 12.9). Resistance to any NRTI was present in <1% of individuals, while efavirenz resistance was present in 10% (6.9% to 12.4%). TW were not statistically more likely than cis‐MSM to have PDR (11.4% vs. 9.1%, p = 0.54). Age, incident versus prevalent infection, or residence district did not predict PDR. Prevalence of SDRM increased from 3% in 2013 to 21% 2017 within incident infections (p = 0.04), but not when including prevalent infections.

Conclusions

Prevalence of NNRTI resistance in three studies of ART‐naïve MSM and TW in Lima, Peru reaches 10%. Because our study reports PDR in a population in which most acquired HIV recently, the overall prevalence of PDR, including previously treated persons, is likely underestimated. These results underscore the need for a nationally representative survey of PDR in Peru and consideration of non‐NNRTI anchored first‐line ART options. This study also represents the first evaluation of PDR in cis‐MSM versus TW in South America, and demonstrates that, although TW are at higher risk of acquiring HIV, they are at similar risk of acquiring a virus with resistance mutations.
Lymph node regression after neoadjuvant chemotherapy: A predictor of survival in gastric cancer
Authors: Pereira Marina Alessandra , Ramos Marcus Fernando Kodama Pertille , Dias Andre Roncon , Cardili Leonardo , Ribeiro Renan Ribeiro e , Charruf Amir Zeide , de Castria Tiago Biachi , Zilberstein Bruno , Ceconello Ivan , Avancini Ferreira Alves Venancio , Ribeiro Ulysses , de Mello Evandro Sobroza
Published: November 2019

Background and Objective

Neoadjuvant chemotherapy (nCMT) has been increasingly used in advanced gastric cancer (GC). However, the prognostic impact of tumor response remains unclear. This study aimed to evaluate if tumor response at the primary site and lymph nodes (LN) correlate with survival in GC patients after nCMT.

Methods

Patients with gastric adenocarcinoma treated with nCMT followed by gastrectomy were evaluated. Residual tumor was graded from 0% to 100%, defining two groups: poor (PR) and major response (MR). LN regression rate (LNRR) was determined based on tumor/fibrosis examination at each LN and a cutoff value established by receiver operating characteristic curve.

Results

Among 62 cases, 20 (32.2%) had MR and 42 (67.7%) PR. Smaller size, diffuse histology, lower ypT status and less advanced stage were associated with the MR group. Based on cutoff value of 57, 45.6% and 54.4% patients were classified as low‐LNRR and high‐LNRR. High‐LNRR correlated with absence of venous, lymphatic and perineural invasion, and less advanced stage. Survival was equivalent between MR and PR (P = .956). High‐LNRR had better disease‐free survival (DFS) than low‐LNRR (P < .001). In multivariate analysis, only LNRR associated with DFS.

Conclusion

High‐LNRR associates with DFS in GC treated with nCMT. Response at the primary site does not correlate with survival.
Risk assessment of hypertension in carotid body surgeries: A NSQIP analysis
Authors: Siddiqui Emaad , Shah Aakash , Para Ashok , Baredes Soly , Park Richard Chan Woo
Published: November 2019

Objectives

Carotid body tumors (CBT) are rare paragangliomas of the carotid body at the carotid bifurcation. The purpose of this study was to determine the effect of hypertension on outcomes in carotid body tumor surgery.

Study Design

A retrospective database review.

Methods

Data on carotid body resections performed from 2005 to 2014 were drawn from the American College of Surgeons’ National Surgical Quality Improvement database. Two groups were created based on the presence of preoperative hypertension. These groups were analyzed for demographics, comorbidities, and postoperative complications using bivariate and multivariate methods.

Results

Of the 452 patients included in the analysis, 49.3% had hypertension. Those with hypertension were significantly more likely to have additional comorbidities, which were controlled for by multivariate analysis to focus on hypertension. These hypertensive patients also had significantly longer hospital stays. Multivariate analysis showed that patients with hypertension undergoing carotid body resections had increased risk for overall medical complications but did not have increased risk for postoperative surgical complications or specific medical complications

Conclusion

This statistically robust study revealed that hypertension does not independently increase a patient's risk for specific postoperative surgical complications following a carotid body tumor resection. However, hypertension increases the risk for postoperative medical complications and longer hospital stays. It is notable that almost half of all CBT patients have hypertension, and these hypertensives patients are significantly more likely to carry additional comorbid conditions that may have an adverse effect on outcomes including overall medical complications.

Level of Evidence

NA Laryngoscope, 130: 2008–2012, 2020
Clinical characteristics and treatment‐associated survival of head and neck Ewing sarcoma
Authors: Torabi Sina J. , Izreig Said , Kasle David A. , Benchetrit Liliya , Salehi Parsa P. , Judson Benjamin L.
Published: November 2019

Objectives

Ewing sarcoma of the head and neck (ESHN) is a rare malignancy for which limited data exists. Herein we examine anatomic distribution of ESHN, demographic characteristics, and multi‐modal therapy as potential determinants in the overall survival (OS) of patients with ESHN.

Methods

A retrospective study of the National Cancer Database (NCDB) from 2004–2016 was performed. A multivariate Cox regression and univariate Kaplan‐Meier survival analyses were conducted.

Results

We identified 284 patients with ESHN eligible for demographic analysis and 223 for survival analysis. Approximately half (50.3%) of patients with ESHN were under the age of 18. Pediatric patients (<18) were less likely to present with distant metastases (≤8.0% vs. 9.5–19.0%, P = .006) and more likely to present with osseous disease (90.2% vs. 75.2%, P = .001) than adults. Adult age (HR: 2.727, 95% CI, 1.381–5.384, P = .004) and distant metastatic disease at the time of presentation (HR: 8.161, 95% CI, 2.922–22.790, P < .001) were independently associated with worse OS. The addition of local therapy (either surgery, radiotherapy, or both) to chemotherapy was not associated with improved survival when compared to treatment with chemotherapy alone.

Conclusion

Predictors of OS in patients with ESHN included age < 18 years and non‐metastatic disease at the time of diagnosis. Tumor site of origin (osseous vs. extraosseous primary) or the addition of local therapy to chemotherapy had no impact on OS. Our analysis suggests that chemotherapy serves as the primary modality in treating ESHN, while further study of this rare malignancy is required to discern the utility of combined systemic and local therapy. Laryngoscope, 130:2385–2392, 2020
“Social credit effect” in a sharing economy: A theory of mind and prisoner's dilemma game theory perspective on the two‐way review and rating system
Authors: Moriuchi Emi
Published: November 2019

Using random samples, we conducted three studies to explore the relationships among interpersonal mentalizing in predicting future sharing economy service usage. The primary focus of this research was to examine Uber passengers' theory of mind in a broader theoretical base of human abilities. The results confirm the dimensions of interpersonal mentalizing such as their experience with the sharing economy service and their current star ratings from the Uber driver. In addition, this study confirms that the dimensions of interpersonal mentalizing are dependent on the situation and the ratings they received from the Uber driver. In extreme rating situations (1‐star rating), interpersonal dimensions did not have an effect on their negative beliefs about the two‐way evaluation system. However, with moderate (3‐star) and high ratings (4.75 and above star rating), the interpersonal dimensions such as nonverbal cues and the ability to shape behaviors and interactions serve as determinants of Uber passengers' belief in the evaluation system, which then leads to their future usage of the sharing economy services. In sum, these findings shed light on the complementary role of the autonomous abilities of Uber passengers to improve their star ratings, which then leads to their future usage of sharing economy services.
Epitaxial Growth of High‐Quality AlGaInAs‐Based Active Structures on a Directly Bonded InP‐SiO2/Si Substrate
Authors: Besancon Claire , Vaissiere Nicolas , Dupré Cécilia , Fournel Frank , Sanchez Loic , Jany Christophe , David Sylvain , Bassani Franck , Baron Thierry , Decobert Jean
Published: November 2019

Hybrid integration of III–V materials onto silicon by wafer bonding technique is one of the mature and promising approaches to develop advanced photonic integrated devices into the silicon photonics platform (SPP). Epitaxial regrowth of III–V materials on InP thin seed layer bonded to an oxidized silicon wafer has shown its potential to extend the III–V mature multiregrowth technologies into the SPP. In the approach, an epitaxial InP layer grown on a 4 in. InP wafer is directly bonded onto a SiO2/Si 200 mm wafer. After InP substrate removal, the new template (InPoSi) is evaluated for epitaxial regrowth: an eight periods strain‐compensated AlGaInAs multiquantum wells (MQW) heterostructure surrounded by two InP cladding layers is grown by metal‐organic vapor phase epitaxy (MOVPE) simultaneously on the InPoSi substrate and on an InP substrate as a reference. For the first time, in situ reflectance and curvature measurements are carried out on InPoSi, enabling the assessment of surface roughness and thermal strain of the III–V materials during growth. High material quality is obtained as attested by X‐ray diffraction, photoluminescence, atomic force microscopy, and transmission electron microscopy.
Skeletal stem cell-mediated suppression on inflammatory osteoclastogenesis occurs via concerted action of cell adhesion molecules and osteoprotegerin
Authors: Li Xin , Ding Li , Wang Yu-Xing , Li Zhong-Li , Wang Qian , Zhao Zhi-Dong , Zhao Sen , Wang Hua , Wu Chu-Tse , Mao Ning , Zhu Heng
Published: November 2019

In the current study, we investigated how skeletal stem cells (SSCs) modulate inflammatory osteoclast (OC) formation and bone resorption. Notably, we found that intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and osteoprotegerin (OPG) play a synergistic role in SSC-mediated suppression of inflammatory osteoclastogenesis. The effect of SSCs on inflammatory osteoclastogenesis was investigated using a lipopolysaccharide-induced mouse osteolysis model in vivo and human osteoarthritis synovial fluid (OASF) in vitro. OC formation was determined by tartrate-resistant acid phosphatase staining. Bone resorption was evaluated by microcomputerized tomography, serum C-terminal telopeptide assay, and pit formation assay. The expression of ICAM-1, VCAM-1, and OPG in SSCs and their contribution to the suppression of osteoclastogenesis were determined by flow cytometry or enzyme linked immunosorbent assay. Gene modification, neutralization antibodies, and tumor necrosis factor-α knockout mice were used to further explore the mechanism. The results demonstrated that SSCs remarkably inhibited inflammatory osteoclastogenesis in vivo and in vitro. Mechanistically, inflammatory OASF stimulated ICAM-1 and VCAM-1 expression as well as OPG secretion by SSCs. In addition, ICAM-1 and VCAM-1 recruited CD11b+ OC progenitors to proximity with SSCs, which strengthened the inhibitory effects of SSC-derived OPG on osteoclastogenesis. Furthermore, it was revealed that tumor necrosis factor α is closely involved in the suppressive effects. In summary, SSCs express a higher level of ICAM-1 and VCAM-1 and produce more OPG in inflammatory microenvironments, which are sufficient to inhibit osteoclastogenesis in a “capture and educate” manner. These results may represent a synergistic mechanism to prevent bone erosion during joint inflammation by SSCs.

Significance Statement Skeletal stem cells (SSCs), tissue-specific stem cells from the skeleton, have been highlighted in recent scientific research and translational medicine. Although SSCs have been shown to contribute to skeletal development and regeneration, the regulation in osteoclastogenesis, the bone remodeling, and the application potential of SSCs in inflammatory bone diseases are incompletely understood. This study indicates a population of murine long-bone-derived SSCs have the potential to induce the expression of OPG, as well as ICAM-1 and VCAM-1 under inflammatory microenvironments and suppressed inflammatory osteoclast formation and bone resorption in vivo and in vitro. These findings indicate the possibility of using SSCs to alleviate bone loss in diseases.
Identification of the optimal treatment regimen in the presence of missing covariates
Authors: Huang Ying , Zhou Xiao‐Hua
Published: November 2019

Covariates associated with treatment‐effect heterogeneity can potentially be used to make personalized treatment recommendations towards best clinical outcomes. Methods for treatment‐selection rule development that directly maximize treatment‐selection benefits have attracted much interest in recent years, due to the robustness of these methods to outcome modeling. In practice, the task of treatment‐selection rule development can be further complicated by missingness in data. Here, we consider the identification of optimal treatment‐selection rules for a binary disease outcome when measurements of an important covariate from study participants are partly missing. Under the missing at random assumption, we develop a robust estimator of treatment‐selection rules under the direct‐optimization paradigm. This estimator targets the maximum selection benefits to the population under correct specification of at least one mechanism from each of the two sets—missing data or conditional covariate distribution, and treatment assignment or disease outcome model. We evaluate and compare performance of the proposed estimator with alternative direct‐optimization estimators through extensive simulation studies. We demonstrate the application of the proposed method through a real data example from an Alzheimer's disease study for developing covariate combinations to guide the treatment of Alzheimer's disease.
Enhanced Electrochemical Performance of Co2NiO4/Ti3C2Tx Structures through Coupled Synergistic Effects
Authors: Song Jianrong , Hu Pengfei , Liu Ying , Song Weixing , Wu Xiang
Published: November 2019

In this work, Co2NiO4/MXene (Ti3C2Tx) composites as efficient electrode materials for supercapacitors are successfully synthesized by a facile one‐pot hydrothermal route. The as‐prepared products deliver a capacitance of 719.5 F g−1 at 0.5 A g−1 and keep 83.1% of initial capacitance after 10000 cycles, revealing the remarkable electrochemical performance compared with other two single electrodes. An asymmetric supercapacitor is fabricated, which presents an energy density of 49.74 Wh kg−1 at a power density of 2752.21 W kg−1, demonstrating that the products can be potential candidates in high performance energy storage devices.
Construction of Urchin‐Like ZnO/TiO2 Direct Z‐Scheme System to Improve Charge Separation
Authors: Zhou Yi , Tan Yawen , Xiang Ye , Zhu Jie
Published: November 2019

The Z‐scheme system urchin‐like ZnO/TiO2 composite superstructure material was successfully prepared via a facile hydrothermal method for the first time. SEM showed that the amount of ammonia can affect the morphology of ZnO. By controlled the addition amount of Ti(SO4)2, reaction time and temperature, the photocatalytic activity of urchin‐like ZnO/TiO2(UZT‐4(10.4‐150‐12)) composite was the highest. The photocatalytic degradation rate of rhodamine B was 95.5%, and the rate constant was 0.0141 min−1, which was 3.59 times than urchin‐like ZnO. XPS measurements confirmed that there is a Z‐scheme heterojunction between urchin‐like ZnO and TiO2. The improvement of photocatalytic degradation RhB activity should be attributed to a direct Z‐scheme system, which not only can increase the separation efficiency of photogenerated electron‐hole pairs but also possesses excellent oxidation and reduction ability for high photocatalytic performances.
Dinuclear Molybdenum(II) Complexes with Thioether Functionalized Silylamide Ligands
Authors: Morgenstern Uwe , Wagner Christoph , Merzweiler Kurt
Published: November 2019

Treatment of molybdenum(II) acetate with thioether functionalized silylamides R2Si(NLi‐C6H4–2‐SR')2 leads to the formation of dinuclear MoII complexes [Mo2{R2Si(NC6H4‐2‐SR')2}2]. According to X‐ray crystal structure analyses the complexes [Mo2{Me2Si(NC6H4‐2‐SMe)2}2] and [Mo2{Ph2Si(NC6H4‐2‐SPh)2}2] comprise a Mo2‐unit which is coordinated by two μ‐κ‐N,N' silylamide ligands. The coordination sphere around the molybdenum atoms consists of two amide nitrogen atoms and two thioether sulfur atoms in a distorted square‐planar arrangement. The Mo‐Mo distances are 211.0(1) and 211.7(1) pm, resp. In the complex [Mo2{Ph2Si(NC6H4‐2‐SMe)2}2] the silyl amide units act as tetradentate κ‐N,N',S,S'chelating ligands and the Mo‐Mo distance is 218.6(1) pm.
Razor-type dermatomes enable quick and thin vaginal dissection with less bleeding in colpocleisis
Authors: Kato Kumiko , Hayashi Yuji , Adachi Mami , Ando Ryota , Kawanishi Hideji , Matsui Hirotaka , Kato Takashi , Hirabayashi Hiroki , Suzuki Shoji , Hattori Ryohei
Published: November 2019

Introduction and hypothesis

Although colpocleisis is a low-invasive surgical option to treat pelvic organ prolapse, it sometimes involves a long operative time with substantial bleeding. To streamline the vaginal dissection process in colpoclesis, we introduced the usage of dermatomes.

Methods

All patients were sexually inactive women with post-hysterectomy prolapse. Data of the dermatome group were retrospectively compared with those of the historical control group based on operative features, perioperative complications and pathology of dissected tissue. In the dermatome group, 34 women underwent total colpocleisis with vaginal dissection using dermatomes; 4 were done mainly with electric dermatomes, and 30 were done with razor-type dermatomes. In the control group, 20 women underwent total colpocleisis with vaginal dissection using Metzenbaum scissors.

Results

Using dermatomes in vaginal dissection was helpful to shorten total operative time (including perineoplasty) by one third from 76 to 51 min, to shorten the time of colpocleisis by half, from 62 to 32 min, and to reduce intraoperative bleeding by 76%, from 62 to 15 ml. In addition, none in the dermatome group and 2/20 patients in the control group had unintended peritoneal opening. Dissection with scissors removed not only the epithelium and submucosal layer but also the muscle layer. This was minimized with razor-type dermatomes and never occurred with electric dermatomes. Whereas electric dermatomes are difficult to get accustomed to and are expensive, razor-type dermatomes enable thinner dissection compared with scissors, are easy to handle and are inexpensive.

Conclusions

Razor-type dermatomes enable quick and thin vaginal dissection with less bleeding. Therefore, they can be recommended as a practical tool for colpocleisis, a prolapse operation mainly for frail elderly patients.
Correction to: Preclinical assessment of transiently TCR redirected T cells for solid tumour immunotherapy
Authors: Mensali Nadia , Myhre Marit Renée , Dillard Pierre , Pollmann Sylvie , Gaudernack Gustav , Kvalheim Gunnar , Wälchli Sébastien , Inderberg Else Marit
Published: November 2019

The original version of this article unfortunately included a mistake in Fig. 2b where the images of mice in the tumour control group (right), day 30 (bottom) should be removed as the wrong images (duplicate of day 17) were inserted by mistake. At this time point the tumour control mice were no longer alive and the images were replaced by black areas.
Changes in intestinal microflora in digestive tract diseases during pregnancy
Authors: Jin Min , Li Dong , Ji Rui , Liu Wen , Xu Xiaofei , Li Yanqing
Published: November 2019

Purpose

This study aimed to investigate the gut microbiome composition in pregnant women with digestive diseases to analyze the relationships between the microflora changes and digestive diseases during pregnancy.

Methods

Fecal samples obtained from 71 pregnant women [six acute fatty liver (AF group), 21 constipation (C group), 24 excessive vomiting (V group) and 20 normal pregnancy (CP group)] and 26 non-pregnant (NP group) women were subjected to 16 s rRNA sequencing. Differential analysis of intestinal flora at the genera level was performed.

Results

The relative abundance of Coprobacillus, Acinetobacter, Enterococcus, Weissella and Lysinibacillus was increased in the digestive diseases (AF, C and V) groups compared with CP group, whereas that of five common genera, including Terrisporobacter, Dysgonomonas, Adlercreutzia, Fusicatenibacter and Blautia, was decreased in digestive diseases groups. Additionally, in digestive diseases (AF, C and V) groups, the abundance of 13 common genera, such as Carnobacterium, Coprobacillus and Psychrobacter, was higher than NP group, whereas that of 27 common genera, such as Blautia and Terrisporobacter, was lower than NP group. About 69 genera were differentially abundant between AF and C groups; two genera (Aerococcus and Senegalimassilia) were identified between AF and V groups; moreover, total 63 genera were obtained between C and V groups.

Conclusion

Our data revealed that the abundance of Acinetobacter, Enterococci, Paenibacillus, Blautia and Collinsella might be associated with the digestive diseases during pregnancy. These findings further supported the idea that targeting the gut microbiota could be a new prevention or therapeutic approach for improving digestive diseases during pregnancy.
AVO analysis aids in differentiation between false and true amplitude responses: a case study of El Mansoura field, onshore Nile Delta, Egypt
Authors: Hussein Mohamed , El-Ata Ahmed Abu , El-Behiry Mohamed
Published: November 2019

The seismic amplitude versus offset (AVO) analysis has become a prominent in the direct hydrocarbon indicator in last decade, aimed to characterizing the fluid content or the lithology of a possible reservoir and reducing the exploration drilling risk. Our research discusses the impact of studying common depth point gathers on Near, Mid and Far-offsets, to verify the credibility of the amplitude response in the prospect evaluation, through analyzing a case study of two exploratory wells; one has already penetrated a gas-bearing sandstone reservoir and the second one is dry sand, but drilled in two different prospects, using the AVO analysis, to understand the reservoir configuration and its relation to the different amplitude response. The results show that the missing of the short-offset data is the reason of the false anomaly encountered in the dry sand, due to some urban surface obstacles during acquiring the seismic data in the field, especially the study area is located in El Mansoura city, which it is a highly cultivated terrain, with multiple channels and many large orchards on the edge of the river, and sugar cane and rice fields. Several lessons have been learned, which how to differentiate between the gas reservoirs and non-reservoirs, by understanding the relation between the Near and Far-offset traces, to reduce the amplitude anomalies to their right justification, where missing of Near-offset data led to a pseudo-amplitude anomaly. The results led to a high success of exploration ratio as the positives vastly outweigh the negatives.
Emergency department resource optimisation for improved performance: a review
Authors: Ahsan Kazi Badrul , Alam M. R. , Morel Doug Gordon , Karim M. A.
Published: November 2019

Emergency departments (EDs) have been becoming increasingly congested due to the combined impacts of growing demand, access block and increased clinical capability of the EDs. This congestion has known to have adverse impacts on the performance of the healthcare services. Attempts to overcome with this challenge have focussed largely on the demand management and the application of system wide process targets such as the “four-hour rule” intended to deal with access blocks. In addition, EDs have introduced various strategies such as “fast tracking”, “enhanced triage” and new models of care such as introducing nurse practitioners aimed at improving throughput. However, most of these practices require additional resources. Some researchers attempted to optimise the resources using various optimisation models to ensure best utilisation of resources to improve patient flow. However, not all modelling approaches are suitable for all situations and there is no critical review of optimisation models used in hospital EDs. The aim of this article is to review various analytical models utilised to optimise ED resources for improved patient flow and highlight benefits and limitations of these models. A range of modelling techniques including agent-based modelling and simulation, discrete-event simulation, queuing models, simulation optimisation and mathematical modelling have been reviewed. The analysis revealed that every modelling approach and optimisation technique has some advantages and disadvantages and their application is also guided by the objectives. The complexity, interrelationships and variability of ED-related variables make the application of standard modelling techniques difficult. However, these models can be used to identify sources of flow obstruction and to identify areas where investments in additional resources are likely to have most benefit.
Advances in Epigenetics and Epigenomics in Chronic Lymphocytic Leukemia
Authors: Xanthopoulos Charalampos , Kostareli Efterpi
Published: November 2019

Purpose of Review

The development and progression of chronic lymphocytic leukemia (CLL), a highly heterogenous B cell malignancy, are influenced by both genetic and environmental factors. Environmental factors, including pharmacological interventions, can affect the epigenetic landscape of CLL and thereby determine the CLL phenotype, clonal evolution, and clinical outcome. In this review, we critically present the latest advances in the field of CLL epigenomics/epigenetics in order to provide a systematic overview of to-date achievements and highlight the potential of epigenomics approaches in light of novel treatment therapies.

Recent Findings

Recent technological advances have enabled broad and precise mapping of the CLL epigenome. The identification of CLL-specific DNA methylation patterns has allowed for accurate CLL subtype definition, a better understanding of clonal origin and evolution, and the discovery of reliable biomarkers. More recently, studies have started to unravel the prognostic, predictive, and therapeutic potential of mapping chromatin dynamics and histone modifications in CLL. Finally, analysis of non-coding RNA expression has indicated their contribution to disease pathogenesis and helped to define prognostic subsets in CLL.

Overall, the potential of CLL epigenomics for predicting treatment response and resistance is mounting, especially with the advent of novel targeted CLL therapies.
Investigating market power in the Belgian pork production chain
Authors: Maes Dries , Vancauteren Mark , Van Passel Steven
Published: November 2019

Belgian pork production has faced stagnating prices for decades. It remains unclear whether excessive market power from slaughterhouses or meat retailers has played a role in this trend. While market power studies can reveal some of the market dynamics in this setting, this type of research has not yet been applied to the Belgian pork market. The present paper investigates oligopolies and oligopsonies in the pork production sector. We build a new model that focuses on market power dynamics in the market for live pigs and distinguishes horizontal and vertical market power parameters, both for pig farmers and for slaughterhouses. The results follow from an empirical application using unique slaughterhouse data for 2001–2015. The results indicate that the farmers benefit from a significant power advantage in the live pig market, when very modest price demands are taken as a reference. The final market price of live pigs approaches the price requested by the farmers. On the other hand, the measured vertical market power also suggests that a pig farmer does not receive the (modest) full-wage-based salary. The market power of the slaughterhouses is also limited. Market power as a result of collusion—that is, horizontal market power—is present, but is not strong. However, there are significant differences between the slaughterhouses in terms of mark-up on the input prices. These differences reflect differences in company strategy, and this diversity further reduces the possibility to create sector-wide collusive behaviour.
The Chronostratigraphy of the Aurignacian in the Northern Carpathian Basin Based on New Chronometric/Archeological Data from Seňa I (Eastern Slovakia)
Authors: Chu Wei , Kaminská Ľubomíra , Klasen Nicole , Zeeden Christian , Lengyel György
Published: November 2019

The northern Carpathian Basin has important geological, paleoenvironmental, and archeological records that are key to our understanding of the first modern human occupation of Europe. However, the nature and timing of hominin settlements in the region during the Late Pleistocene remain poorly understood. New fieldwork at Seňa I, Slovakia, has identified the only known stratified open-air Aurignacian site in the region and assigned the assemblage to at least 33.5 ± 2.4 ka ago through infrared-stimulated luminescence dating. Additionally, new archeological and geoscientific data are presented. This paper discusses the Seňa I findings in the context of the regional archeological record and shows how they contribute to the establishment of clear time constraints for the Aurignacian in eastern central Europe.
In-Home Strategic National Stockpile Dispensing by Means of Home Health Agencies: An Alternative Means of Dispensing to Vulnerable Populations
Authors: McNeill Charleen , Milburn Ashlea Bennett
Published: November 2019

The Federal Emergency Management Agency prescribes a 48-h timeline between the declaration of an emergency and the treatment of the last person with Strategic National Stockpile (SNS) medical countermeasures (MCM). Many states struggle to meet the 48-h window. Issues surrounding adequate staffing, critical to maintaining necessary Points Of Dispensing (POD) throughput, are noted in the literature. The use of public and private partnerships in the health-care sector may improve POD throughput. This study describes a novel strategy for partnering with home health agencies (HHAs) to augment MCM distribution. The HHA In-Home Dispensing Model we propose authorizes HHAs to act as Closed PODs following a head of household model. Here, we evaluate the effectiveness of the model using a case study. First, we provide an overview of the methods used to estimate the duration of in-home nurse dispensing shifts. We then present the results for our case study area. Next, we discuss how the model can be used and its limitations. We conclude that the HHA In-Home SNS Dispensing Model shows promise and should receive further consideration, as it can decrease demand at open PODs and increase the reach of MCMs to vulnerable populations who might otherwise have difficulty receiving them.
Introduction to the Special Issue: The Donbas Conflict
Authors: Laruelle Marlene
Published: November 2019

Many scholarly studies of the Ukrainian conflict look at its origins, focusing either on the international level (external interference) or the domestic one (including ethnic, linguistic, economic, and regional tensions) (Pikulicka-Wilczewska and Sakwa 2015). The international level of analysis draws attention to external factors, namely Russia’s conscious decision to fragment Ukraine and make it a “failed state” in order to avoid its moving closer to the European Union and the North Atlantic Treaty Organization (NATO). Even though Moscow denies playing any role in the conflict, several international and independent Russian sources have confirmed the direct involvement of Russian regular troops (Urban 2015; Sutyagin 2015; Yashin and Shorina 2015). For scholars who emphasize the primacy of the international aspect of the conflict, the current war in Donetsk and Luhansk is not a civil war but a war orchestrated and directed from Moscow against Ukraine via Russian proxies (Motyl 2014; Kuzio 2015).
Avoiding long Berge cycles: the missing cases k = r + 1 and k = r + 2
Authors: Ergemlidze Beka , Győri Ervin , Methuku Abhishek , Salia Nika , Tompkins Casey , Zamora Oscar
Published: November 2019

The maximum size of an r-uniform hypergraph without a Berge cycle of length at least k has been determined for all k ≥ r + 3 by Füredi, Kostochka and Luo and for k < r (and k = r, asymptotically) by Kostochka and Luo. In this paper we settle the remaining cases: k = r + 1 and k = r + 2, proving a conjecture of Füredi, Kostochka and Luo.
Experience of nurses who work with children with palliative care needs: A mixed-method systematic review
Authors: Atout Maha
Published: November 2019

Objective

The importance of palliative care education for nurses has been recognized worldwide. The study aims to explore the experiences of nurses working with children with palliative care needs and to identify any related educational needs.

Methods

The electronic databases of CINAHL, Cochrane, PubMed, OVID, Social Care Online, Web of Science, Scopus, and ProQuest were searched for the period 2000–2015.

Results

Finding revealed that working with children with palliative care needs is an emotionally struggling job for nurses, especially when they try to manage the transition of pediatric patients from curative to palliative care. Staffing level and time constraints comprise a major obstacle in pediatric palliative care. Focusing on invasive treatment and technology in spite of the feelings that it will not improve patients' health status intensifies the feeling of guilt and helplessness for nurses. Finally, nurses asserted the importance of receiving pediatric palliative care education, especially how to communicate with children with palliative care needs and their families.

Significance of results

Further research is recommended with regard to nurses' experience in communication with children with palliative care needs. Nursing education in pediatric palliative care is significantly important, especially how to communicate with children with palliative care needs and their families.
Förderung sozial-emotionaler Kompetenz von angehenden Lehrkräften
Authors: Carstensen Bastian , Köller Michaela , Klusmann Uta
Published: November 2019

Zusammenfassung. Der Lehrerberuf ist gekennzeichnet durch stetige soziale Interaktionen, deren erfolgreiche Bewältigung hohe Anforderungen an die sozial-emotionalen Fähigkeiten der Lehrkräfte stellt. Insbesondere zum Berufseinstieg werden Unterrichtsstörungen und soziale Konflikte als häufigste Stressoren erlebt. Die vorliegende Studie stellt ein theoretisch fundiertes Training sozial-emotionaler Kompetenz für Lehramtsstudierende vor, das auf die sozialen Herausforderungen des Berufs vorbereiten soll. Es umfasst die Vermittlung theoretischen Wissens und die Durchführung praktischer Übungen in den Bereichen Wissen über Emotionen, Regulation von Emotionen sowie soziale Fähigkeiten. Die Evaluation des 13 Sitzungen umfassenden Trainings wurde über ein quasi-experimentelles Prä-Post Design mit insgesamt N = 137 Studierenden in Trainings- ( N = 99) und Vergleichsgruppe ( N = 38) realisiert. Effekte des Trainings konnten in allen Bereichen nachgewiesen werden, wobei insbesondere die emotionale Selbstaufmerksamkeit (Wissen über Emotionen) und die Anwendung kognitiver Umbewertung (Regulation von Emotionen) zu nennen sind. Im Bereich soziale Fähigkeiten zeigte sich das Training lediglich für das Konfliktmanagement wirksam. Gemeinsam mit der großen Akzeptanz bei den Studierenden sprechen die Ergebnisse für den Nutzen der Implementierung solcher Programme in die universitäre Ausbildung von Lehrkräften.
Radiation Exposure of Patient and Operating Room Personnel by Fluoroscopy and Navigation during Spinal Surgery
Authors: Bratschitsch G. , Leitner L. , Stücklschweiger G. , Guss H. , Sadoghi P. , Puchwein P. , Leithner A. , Radl R.
Published: November 2019

Intraoperative radiography imaging is essential for accurate spinal implant placement. Hazards caused by ionizing radiation raised concern on personnel’s work life long exposure in the operating room (OR). To particularize a cumulative risk estimation of radiation of personnel and patient, depending on used methods (C-arm fluoroscopy, O-arm navigation) and patient characteristics during spinal surgery, detailed investigation of radiation exposure in a clinical setting is required. Lumbosacral dorsal spinal fusion was performed in 37 patients (19 navigated, 18 fluoroscopy) during this prospective study. Radiation exposure was measured on several body regions with thermoluminescent dosimeters on patient and OR personnel (surgeon, assistant, sterile nurse, radiology technologist). Comparison between patient characteristics and radiation exposure was included. The highest patients values were measured in the surgery field and gonads area during navigation (43.2 ± 19.4 mSv; fluoroscopy: 27.7 ± 31.3 mSv; p = 0.02), followed by the thoracic region during fluoroscopy (7.7 ± 14.8 mSv; navigation: 1.1 ± 1.0 mSv; p = 0.06), other measured regions can be considered marginal in comparison. Amongst OR personnel exposure of the surgeon was significant higher during fluoroscopy (right hand: 566 ± 560 µSv and thoracic region: 275 ± 147 µSv; followed by thyroid and forehead) compared to navigation (right finger: 49 ± 19 µSv; similar levels for all regions; p < 0.001 in all regions). When compared to the surgeon, other OR personnel had significantly lower radiation doses on all body regions using fluoroscopy, and similar dose during navigation. The highest eye’s lens region value was measured during fluoroscopy for the patient (185 ± 165 µSv; navigation: 205 ± 60 µSv; p = 0.57) and the surgeon (164 ± 74 µSv; navigation: 92 ± 41 µSv; p < 0.001). There was a significant correlation between patient BMI and radiation exposure to the surgery field during fluoroscopy. To our knowledge, these data present the first real life, detailed comparison of radiation exposure on OR personnel and patients between clinical use of navigation and fluoroscopy. Although patient’s radiation dose is approximately 3-fold during navigation compared to the fluoroscopy, we found that a spinal surgeon could perform up to 10-fold number of surgeries (10.000 versus 883) until maximum permissible annual effective radiation dose would be reached. Especially for a spinal surgeon, who is mainly exposed amongst OR personnel, radiation prevention and protection must remain a main issue.
Synthesis and performance evaluation of PES/chitosan membranes coated with polyamide for acid mine drainage treatment
Authors: Machodi Mathaba J. , Daramola Michael O.
Published: November 2019

In this article, performance evaluation of PES membrane infused with chitosan and coated with polyamide layer for treatment of acid mine drainage (AMD) is reported. PES/chitosan membranes were fabricated by varying chitosan concentration (0, 0.5, 0.75 and 1 wt%) using phase inversion method. PES/chitosan membranes were coated with polyamide (PA) via co-solvent assisted interfacial polymerization technique (CAIP). Scanning electron microscopy (SEM) and contact angle analysis show that chitosan and polyamide could enhance permeability without affecting rejection of the membrane. The permeability was improved with increasing chitosan content. Atomic absorption spectroscopy (AAS) was used to quantitatively determine cations in the permeate and the sulphate ions were analysed using ultraviolet and visible (UV-VIS) spectrophotometer. Pure water flux of PES/PA membrane was significantly improved from 56 to 93 l/m2.hr with 1 wt% chitosan addition. Cation rejection (90.4, 88.3, 89.3 and 75.7% for Mn2+,Fe2+, Mg2+ and Ca2+, respectively) was observed to be higher than anion rejection (56.33% for SO42−), when chitosan content was 0.75 wt%. These results indicate that the positively charged membranes under acidic condition had strong repulsive forces with the cations than attractions forces with anions. Polyethersulphone membrane modified with chitosan and coated with polyamide layer displayed potential for application in treatment of AMD.
The Effect of Strict Volume Control Assessed by Repeated Bioimpedance Spectroscopy on Cardiac Function in Peritoneal Dialysis Patients
Authors: Hong Yu Ah , Yoon Hye Eun , Choi Bum Soon , Shin Seok Joon , Kim Yong-Soo , Lee So Young , Lee Sang-Ho , Kim Su Hyun , Lee Eun Young , Shin Sug Kyun , Kwon Young Joo , Kim Jeong Ho , Chang Yoon Kyung , Kim Suk Young , Kim Ji Eun , Ahn Shin Young , Ko Gang Jee
Published: November 2019

Adequate fluid management plays an important role in decreasing cardiovascular risk in peritoneal dialysis (PD) patients. We evaluated whether strict volume control monitored by bioimpedance spectroscopy (BIS) affects cardiac function in PD patients. This study is a secondary analysis of a multicentre, prospective, randomized, controlled trial. Fluid overload was assessed by the average overhydration/extracellular water (OH/ECW) at baseline, 6 months and 12 months. Patients were categorized as time-averaged overhydrated (TA-OH/ECW ≥15%) or normohydrated (TA-OH/ECW <15%), and echocardiographic parameters were compared between groups. Among a total of 151 patients, 120 patients exhibited time-averaged normohydration. Time-averaged overhydrated patients had a significantly higher left atrial (LA) diameter and E/e′ ratio and a lower left ventricular (LV) ejection fraction at 12 months than time-averaged normohydrated patients. LA diameter, end-systolic volume and end-diastolic volume were decreased at 12 months compared to baseline in time-averaged normohydrated patients only. TA-OH/ECW was independently associated with ejection fraction at 12 months (β = −0.190; p = 0.010). TA-OH/ECW, but not OH/ECW at 12 months, was an independent risk factor for LV dysfunction (odds ratio 4.020 [95% confidence interval 1.285–12.573]). Overhydration status based on repeated BIS measurements is an independent predictor of LV systolic function in PD patients.
Changes in human walking dynamics induced by uneven terrain are reduced with ongoing exposure, but a higher variability persists
Authors: Kent Jenny A. , Sommerfeld Joel H. , Stergiou Nicholas
Published: November 2019

During walking, uneven terrain alters the action of the ground reaction force from stride to stride. The extent to which such environmental inconsistencies are withstood may be revealed by the regulation of whole-body angular momentum (L) during walking. L quantifies the balance of momenta of the body segments (thigh, trunk, etc.) about their combined center of mass, and remains close to zero during level walking. A failure to constrain L has been linked to falls. The aim of this study was to explore the ability of young adults to orchestrate their movement on uneven terrain, illustrated by the range of L (LR) and its variability (vLR). In eleven male adults, we observed significant increases in sagittal plane LR, and vLR in all three planes of motion during walking on an uneven in comparison to a flat surface. No reductions in these measures were observed within a 12-minute familiarisation period, suggesting that unimpaired adults either are unable to, or do not need to eliminate the effects of uneven terrain. Transverse plane LR, in contrast, was lower on immediate exposure, and then increased, pointing to the development of a less restrictive movement pattern, and would support the latter hypothesis.
G-CSFR antagonism reduces neutrophilic inflammation during pneumococcal and influenza respiratory infections without compromising clearance
Authors: Wang Hao , Aloe Christian , Wilson Nick , Bozinovski Steven
Published: November 2019

Excessive neutrophilic inflammation can contribute to the pathogenesis of pneumonia. Whilst anti-inflammatory therapies such as corticosteroids are used to treat excessive inflammation, they do not selectively target neutrophils and may compromise antimicrobial or antiviral defences. In this study, neutrophil trafficking was targeted with a granulocyte-colony stimulating factor receptor monoclonal antibody (G-CSFR mAb) during Streptococcus pneumoniae (serotype 19F) or influenza A virus (IAV, strain HKx31) lung infection in mice. Firstly, we demonstrated that neutrophils are indispensable for the clearance of S. pneumoniae from the airways using an anti-Ly6G monoclonal antibody (1A8 mAb), as the complete inhibition of neutrophil recruitment markedly compromised bacterial clearance. Secondly, we demonstrated that G-CSF transcript lung levels were significantly increased during pneumococcal infection. Prophylactic or therapeutic administration of G-CSFR mAb significantly reduced blood and airway neutrophil numbers by 30–60% without affecting bacterial clearance. Total protein levels in the bronchoalveolar lavage (BAL) fluid (marker for oedema) was also significantly reduced. G-CSF transcript levels were also increased during IAV lung infection. G-CSFR mAb treatment significantly reduced neutrophil trafficking into BAL compartment by 60% and reduced blood neutrophil numbers to control levels in IAV-infected mice. Peak lung viral levels at day 3 were not altered by G-CSFR therapy, however there was a significant reduction in the detection of IAV in the lungs at the day 7 post-infection phase. In summary, G-CSFR signalling contributes to neutrophil trafficking in response to two common respiratory pathogens. Blocking G-CSFR reduced neutrophil trafficking and oedema without compromising clearance of two pathogens that can cause pneumonia.