bluuebunny/crossref_metadata_2025 huggingface dataset:
Mechanical properties of VMoNO as a function of oxygen concentration: Toward development of hard and tough refractory oxynitrides
Authors: Edström Daniel , Sangiovanni Davide G. , Landälv Ludvig , Eklund Per , Greene J. E. , Petrov Ivan , Hultman Lars , Chirita Valeriu
Published: October 2019

Improved toughness is a central goal in the development of wear-resistant refractory ceramic coatings. Extensive theoretical and experimental research has revealed that NaCl-structure VMoN alloys exhibit surprisingly high ductility combined with high hardness and toughness. However, during operation, protective coatings inevitably oxidize, a problem that may compromise material properties and performance. Here, the authors explore the role of oxidation in altering VMoN properties. Density functional theory and theoretical intrinsic hardness models are used to investigate the mechanical behavior of cubic V0.5Mo0.5N1−xOx solid solutions as a function of the oxygen concentration x. Elastic constant and intrinsic hardness calculations show that oxidation does not degrade the mechanical properties of V0.5Mo0.5N. Electronic structure analyses indicate that the presence of oxygen reduces the covalent bond character, which slightly lowers the alloy strength and intrinsic hardness. Nevertheless, the character of metallic d-d states, which are crucial for allowing plastic deformation and enhancing toughness, remains unaffected. Overall, the authors’ results suggest that VMoNO oxynitrides, with oxygen concentrations as high as 50%, possess high intrinsic hardness, while still being ductile.
Palmitoylation of NOD1 and NOD2 is required for bacterial sensing
Authors: Lu Yan , Zheng Yuping , Coyaud Étienne , Zhang Chao , Selvabaskaran Apiraam , Yu Yuyun , Xu Zizhen , Weng Xialian , Chen Ji Shun , Meng Ying , Warner Neil , Cheng Xiawei , Liu Yangyang , Yao Bingpeng , Hu Hu , Xia Zonping , Muise Aleixo M. , Klip Amira , Brumell John H. , Girardin Stephen E. , Ying Songmin , Fairn Gregory D. , Raught Brian , Sun Qiming , Neculai Dante
Published: October 2019

NODs require S-palmitoylation to signal

The compartmentalization of proteins within the cell is essential for their function. The addition of lipid molecules redistributes proteins to the cell surface or to membrane-bound organelles. Working in transgenic mice and in tissue cultured cells, Lu
et al.
found that nucleotide oligomerization domain–like receptors 1 and 2 (NOD1 and NOD2), two proteins responsible for detecting bacterial products, required lipid modifications for their recruitment to the cell membrane and function. The specific modification, palmitoylation at a cysteine thiol, was mediated by the enzyme ZDHHC5. Loss of ZDHHC5 or removal of key modification residues in NOD1 and NOD2 abolished their function, compromising antibacterial responses. Human variants of NOD2 display altered palmitoylation, which could help to explain many inflammatory conditions, such as irritable bowel syndrome.

Science
, this issue p.
460
Dynamic control of plant water use using designed ABA receptor agonists
Authors: Vaidya Aditya S. , Helander Jonathan D. M. , Peterson Francis C. , Elzinga Dezi , Dejonghe Wim , Kaundal Amita , Park Sang-Youl , Xing Zenan , Mega Ryousuke , Takeuchi Jun , Khanderahoo Bardia , Bishay Steven , Volkman Brian F. , Todoroki Yasushi , Okamoto Masanori , Cutler Sean R.
Published: October 2019

Plant thirst quenched without water

Drought causes many billions of dollars of annual losses to farmers worldwide. Central to a plant's water use efficiency are signaling pathways regulated by the hormone abscisic acid and its receptors. Vaidya
et al.
screened a pool of candidate small molecules and used structure-guided design to optimize the function of an abscisic acid receptor agonist (see the Perspective by Phillips and Sussman). Application of the agonist protected
Arabidopsis
, wheat, and tomato from underwatering.

Science
, this issue p.
eaaw8848
; see also p.
416
Super-elastic ferroelectric single-crystal membrane with continuous electric dipole rotation
Authors: Dong Guohua , Li Suzhi , Yao Mouteng , Zhou Ziyao , Zhang Yong-Qiang , Han Xu , Luo Zhenlin , Yao Junxiang , Peng Bin , Hu Zhongqiang , Huang Houbing , Jia Tingting , Li Jiangyu , Ren Wei , Ye Zuo-Guang , Ding Xiangdong , Sun Jun , Nan Ce-Wen , Chen Long-Qing , Li Ju , Liu Ming
Published: October 2019

Flexible ferroelectrics

High-quality ferroelectric materials, which polarize in response to an electric field, are usually oxides that crack when bent. Dong
et al.
found that high-quality membranes of barium titanate are surprisingly flexible and super-elastic. These films accommodate large strains through dynamic evolution of nanodomains during deformation. This discovery is important for developing more robust flexible devices.

Science
, this issue p.
475
Immune cells for microbiota surveillance
Authors: Oh Julia , Unutmaz Derya
Published: October 2019

Commensal microbes regulate specialized T cells, which promote wound healing in skin
Proteorhodopsin Overproduction Enhances the Long-Term Viability of Escherichia coli
Authors: Song Yizhi , Cartron Michaël L. , Jackson Philip J. , Davison Paul A. , Dickman Mark J. , Zhu Di , Huang Wei E. , Hunter C. Neil
Published: October 2019

Proteorhodopsin (PR) is part of a diverse, abundant, and widespread superfamily of photoreactive proteins, the microbial rhodopsins. PR, a light-driven proton pump, enhances the ability of the marine bacterium
Vibrio
strain AND4 to survive and recover from periods of starvation, and heterologously produced PR extends the viability of nutrient-limited
Shewanella oneidensis
. We show that heterologously produced PR enhances the viability of
E. coli
cultures over long periods of several weeks and use single-cell Raman spectroscopy (SCRS) to detect PR in 9-month-old cells. We identify a densely packed and consequently stabilized cell membrane as the likely basis for extended viability. Similar considerations are suggested to apply to marine bacteria, for which high PR levels represent a significant investment in scarce metabolic resources. PR-stabilized cell membranes in marine bacteria are proposed to keep a population viable during extended periods of light or nutrient limitation, until conditions improve.
Chlamydia psittaci
-Infected Dendritic Cells Communicate with NK Cells via Exosomes To Activate Antibacterial Immunity
Authors: Radomski Nadine , Karger Axel , Franzke Kati , Liebler-Tenorio Elisabeth , Jahnke Rico , Matthiesen Svea , Knittler Michael R.
Published: October 2019

Dendritic cells (DCs) and natural killer (NK) cells are critically involved in the early response against various bacterial microbes. Functional activation of infected DCs and NK cell-mediated gamma interferon (IFN-γ) secretion essentially contribute to the protective immunity against
Chlamydia
. How DCs and NK cells cooperate during the antichlamydial response is not fully understood.
Decoupling Filamentous Phage Uptake and Energy of the TolQRA Motor in Escherichia coli
Authors: Samire Poutoum , Serrano Bastien , Duché Denis , Lemarié Emeline , Lloubès Roland , Houot Laetitia
Published: October 2019

Filamentous phages are widely distributed symbionts of Gram-negative bacteria, with some of them being linked to genome evolution and virulence of their host. However, the precise mechanism that permits their uptake across the cell envelope is poorly understood. The canonical phage model Fd requires the TolQRA protein complex in the host envelope, which is suspected to translocate protons across the inner membrane. In this study, we show that phage uptake proceeds in the presence of the assembled but nonfunctional TolQRA complex. Moreover, our results unravel an alternative route for phage import that relies on the ExbB-ExbD proteins. This work provides new insights into the fundamental mechanisms of phage infection and might be generalized to other filamentous phages responsible for pathogen emergence.
Adolescent with facial swelling
Authors: Looi Wen Shen , Goh Si Hui , Tan Colin Jingxian , Yeoh Kheng Wei , Seng Michaela Su-Fern
Published: October 2019

Background

A previously well 15-year-old girl presented with a 2-month history of facial swelling that progressively worsened to involve the neck. There was associated dyspnoea, orthopnoea, headache and throat discomfort. Two weeks before presentation, the patient had an episode of fever for 5 days. On examination, vital signs were within normal limits. Swelling, plethora and venous distension of the face and neck were apparent (figure 1).

Figure 1

(A) Patient before the onset of symptoms. (B) Patient at presentation.

Questions

What is the most likely diagnosis?

Superior vena cava syndrome

Angioedema

Anasarca

Diphtheria

Describe the chest X-ray (figure 2).

What are the acute concerns?

What investigations would you order?

Figure 2

Chest X-ray of the patient at presentation.

Answers can be found on page 02.
Hormone use among Nepali transgender women: a qualitative study
Authors: Regmi Pramod R , van Teijlingen Edwin , Neupane Sanjeev Raj , Marahatta Sujan Babu
Published: October 2019

Objectives

There is a dearth of information on transgender individuals in Nepal, particularly studies exploring their use of hormone therapies. The objectives of this study therefore were to explore (1) how hormones are used, (2) types of hormones used and (3) side effects experienced by transgender women after hormone use. This is the first study of its kind in Nepal addressing this important public health issue.

Setting

The study was conducted in four districts of Nepal: Kathmandu, Sunsai, Banke and Kaski.

Design and participants

This qualitative study comprises eight focus group discussions (FGDs) and nine interviews. FGDs and three face-to-face interviews were held with transgender women aged 18 years and older and six interviews with stakeholders working with and advocating on behalf of this population. The study was conducted between September 2016 and March 2017.

Results

Our participants were young. The majority of FGD participants had completed school-level education and 40% had been using hormones for 1 to 3 years. Five overlapping themes were identified: (1) reasons and motivations for hormone use; (2) accessibility and use of hormones; (3) side effects; (4) utilisation of healthcare services and (5) discontinuation of hormone use.

Conclusion

Hormone use was common in our sample. Most received information on hormone therapy online and through their peer networks. A few study participants sought doctors’ prescriptions for hormone therapy, but hormones were more likely to be bought from local private pharmacies or abroad through friends. This kind of self-medication is associated with a range of risks to the physical and mental health of transgender individuals. Incorporating information, education and communication about hormone therapy into existing health promotion interventions targeted to this population may help transgender people to make better informed choices.
Open-labelled randomised controlled trial of 12 hours versus 24 hours modified Pritchard regimen in the management of eclampsia and pre-eclampsia in Ghana (MOPEP Study): study protocol
Authors: Beyuo Titus , Lawrence Emma , Langen Elizabeth S , Oppong Samuel A
Published: October 2019

Introduction

Hypertensive disorders of pregnancy continue to be a major contributor to maternal and perinatal morbidity and mortality. Magnesium sulfate therapy is the standard of care for seizure prophylaxis and treatment for pre-eclampsia and eclampsia respectively, despite wide disparities in dosing regimens and routes of administration. This study compares the clinical efficacy of magnesium sulfate in the reduction of seizure occurrence or recurrence with the 12 hours versus 24 hours modified Pritchard regimens in the management of severe pre-eclampsia and eclampsia.

Methods and analysis

This study is an open labelled randomised controlled trial. The study participants are patients admitted to the Korle Bu Teaching Hospital (KBTH) in Accra, Ghana with a diagnosis of antepartum, intrapartum or postpartum eclampsia or pre-eclampsia with severe features. All study participants will be administered a loading dose of magnesium sulfate, followed by maintenance dosing. Participants in the control group will receive magnesium sulfate for 24 hours after diagnosis, while those in the treatment group will receive magnesium sulfate for 12 hours after diagnosis. The primary outcome of this study is the occurrence of a seizure any time after the completion of treatment in the assigned group. Secondary outcome measures include maternal health outcomes, magnesium sulfate toxicities and fetal health outcomes. Data collection was started in October 2018 with a target enrolment of 1245 participants with severe pre-eclampsia and 844 participants with eclampsia with a projected study period of 2–3 years.

Ethics and dissemination

Ethical approval was obtained from the KBTH Institutional Review Board (IRB) in Ghana. University of Michigan involvement is limited to protocol development and statistical analysis of de-identified data, and has been granted a Not Regulated Determination by the University of Michigan IRB. Results of the study will be shared at clinical forums at the KBTH and will be submitted for publication in an international peer-reviewed journal.

Trial registration number

Pan African Clinical Trial Registry through the South African Medical Research Council (PACTR201811515303983).
Should we resuscitate elderly patients with blunt traumatic cardiac arrest? Analysis of National Trauma Registry Data in Japan
Authors: Norii Tatsuya , Matsushima Kazuhide , Miskimins Richard J , Crandall Cameron S
Published: October 2019

Objectives

Recent studies suggest that survival after traumatic cardiac arrest (TCA) has been improving. Many elderly adults enjoy active lifestyles, which occasionally result in TCA. The epidemiology and efficacy of resuscitative procedures on blunt TCA in elderly patients are largely unknown. Our primary aim was to compare the survival to discharge following blunt TCA between non-elderly adult (ages 18–59 years) and elderly patients (age ≥60 years).

Methods

We analysed 2004–2015 observational cohort data from a nationwide trauma registry in Japan. We included all adult patients (18 years and older) who experienced blunt TCA. We excluded patients missing data for age, survival, mechanism of injury or initial vital signs. Resuscitative procedures included thoracotomy and resuscitative endovascular balloon occlusion of the aorta. We compared survival for elderly patients (age ≥60 years old) to younger adults.

Results

Of 8347 patients with blunt TCA, 3547 (42.5%) were elderly. Survival differed significantly by age: 164/4800 (3.4%) of younger adults survived whereas 188/3547 (5.3%) of elderly patients survived (p<0.001). Survival increased but Injury Severity Scores (ISSs) declined with increasing patient age. The efficacy of resuscitative procedures did not vary by age. In logistic regression models, increasing age was independently associated with better survival.

Conclusion

In a cohort of patients with blunt TCA, survival increased with increasing patient age. A number of patients with low ISS in the elderly group raises the possibility that this improved survival is due to preceding or concomitant medical cardiac arrest in the older cohort. Clinicians should be cautious about applying TCA algorithms to elderly patients and should not be discouraged from resuscitating TCA because of patient age.
BET 2: Is there an association between iodine, shellfish and contrast agent allergies?
Authors: Long Benjamin , Chassee Todd , Jones Jeffrey S
Published: October 2019

A shortcut review was carried out to establish whether having a shellfish or iodine allergy changed the risk of allergic reaction in patients receiving radiocontrast medium more than other concomitant allergies. One relevant paper (a systematic review) was identified for inclusion using the reported search strategy. The author, date and country of publication; group studied; study type; relevant outcomes; results and study weaknesses of this paper are tabulated. It is concluded that there is no evidence that allergy to shellfish or iodine alters the risk of reaction to intravenous contrast more than any other allergies.
Audit of the impact of the York faecal calprotectin care pathway on colonoscopy activity
Authors: Turvill James , Turnock Daniel
Published: October 2019

Background

The York faecal calprotectin care pathway (YFCCP) was developed to optimise effective primary care differentiation between irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). We undertook an audit of colonoscopy activity at York Teaching Hospitals after the introduction of the YFCCP, to assess its impact.

Methods

Faecal calprotectin (FC) results were reconciled with colonoscopy activity in patients 18–60 years after the implementation of the YFCCP. This permitted individual patient tracking of their FC values, the timing of those requests by primary care, the date of subsequent referral and investigation and the end clinical diagnoses.

Results

Primary care uptake of FC increased fourfold with the introduction of the YFCCP. Following implementation, FC-related referrals for colonoscopy fell from 24% to 13%. The number of patients needed to colonoscope to diagnose organic colonic disease (IBD, significant adenomatous polyps or colorectal cancer) fell from 6.8 to 3.8 when the YFCCP was applied. This represents a cost saving of £41 015 per thousand patients tested in primary care. We estimate that outpatient time to diagnosis fell from a median of 41 to 29 days.

Conclusion

This audit of FC activity and colonoscopy outcomes provides substantial supportive evidence for the effectiveness of the YFCCP. Popular in primary care, it has led to a reduction in referrals. The diagnostic accuracy determined in this audit is in line with earlier evaluations. Accepting the weaknesses of audit we conclude that this evaluation likely underestimates the benefits of the YFCCP in terms of resource use saving and time to diagnosis.
UniqueMLH1mutations in colonic adenomas in an obligate germline Lynch syndrome carrier
Authors: Serra Stefano , Capo-Chichi Jose-Mario , McCarthy Aoife J , Sabatini Peter , Chetty Runjan
Published: October 2019

Background

An obligate germline Lynch syndrome carrier had four colonic adenomas removed.

Materials and methods

The adenomas were evaluated for grade of dysplasia, MLH1, PMS2, MSH2 and MSH6 protein expression, microsatellite instability (MSI),BRAF, methylation status and a next-generation sequencing (NGS) panel of 52 cancer genes.

Results

There were four tubular or tubulovillous adenomas from the hepatic flexure, rectosigmoid and rectum; one with low-grade and high-grade dysplasia, one with high-grade dysplasia only and two with low-grade dysplasia. All four adenomas showed retention of MLH1, MHS2 and MSH6 but complete loss of PMS2 in both low-grade and high-grade dysplasia areas.

Two of the four adenomas were MSI-high,BRAF V600Ewild type and were notMLH1methylated. NGS identified anMLH1germline variant: NM_000249.3: c.1558+1 G>A, p.(?) in all tissue (adenomas and normal), which likely explains the pathophysiology of Lynch syndrome in this patient. Other variants were also detected inMLH1andMSH6in all four adenomas tested; these being reported previously in somatic colorectal cancers.

Conclusion

We highlight anMLH1variant in the colonic adenomas in an obligate Lynch syndrome carrier that resulted in PMS2 protein loss in the absence of mutations of thePMS2gene.
Retrospective analysis of the 13-year trend in acute and elective surgery for patients aged 60 years and over at Auckland City Hospital, New Zealand
Authors: Deng Carolyn , Mitchell Simon , Paine Sarah-Jane , Kerse Ngaire
Published: October 2019

Background

As the worldwide population has aged, the number of surgical procedures performed on older patients has increased. It is not known whether this increase has been proportional to growth in the elderly population. The aim of this study was to assess the population-adjusted incidence of acute and elective general and orthopaedic surgery in older patients at a tertiary hospital in New Zealand.

Methods

This was a retrospective study using routinely collected electronic data from Auckland District Health Board (DHB) and New Zealand Ministry of Health databases. Population estimates and numbers of general surgical and orthopaedic procedures from 2004 to 2016 were obtained. Annual age-specific incidence rates of surgical procedures were calculated and trends analysed using negative binomial regression.

Results

The incidence of elective surgery increased by 5.35% annually from 2004 to 2016. The rate of increase is lower in the Māori population (2.14%) compared with other ethnic groups (4.22%–5.62%). The incidence of acute surgery in those aged 70 years and above decreased from 2004 to 2016. The European and other ethnic group had the highest rate of acute surgery, and higher rates of elective surgery than Pacific and Asian peoples.

Conclusion

The increasing number of elective general surgical and orthopaedic procedures performed on older patients in Auckland DHB is beyond what is expected for population growth alone. This has significant implication for clinicians, healthcare providers and governmental institutions. Ethnic differences are evident and warrants further attention as these may reflect disparities in access to surgery.
Prevalence of human papillomavirus infection, cervical intraepithelial neoplasia and cervical cancer in imprisoned women worldwide: a systematic review and meta-analysis
Authors: Escobar Nadia , Plugge Emma
Published: October 2019

Background and objectives

Imprisoned women have higher rates of abnormalities at cervical screening and some studies suggest that cervical cancer is the most common cancer in this population. The aim of this work was to summarise the current evidence on the prevalence of human papilloma virus (HPV) infection, cervical cancer and precancerous lesions in women in prison worldwide and to compare these rates with the general population.

Methods

We systematically searched and reviewed published and unpublished data reporting the prevalence of any HPV infection, cervical intraepithelial neoplasia (CIN) and cervical cancer in imprisoned women. We created forest plots with prevalence estimates from studies with comparable outcomes and of prevalence ratios using data from national screening programmes as a comparison group.

Findings

A total of 53 533 imprisoned women from 10 countries and 35 studies were included in the review. The prevalence of HPV among prisoners ranged from 10.5% to 55.4% with significant heterogeneity. The prevalence of CIN diagnosed by cytology in prisoners ranged from 0% to 22%. Ratios comparing the prevalence of CIN in imprisoned women to that in the community ranged from 1.13 to 5.46. Cancer prevalence estimates were at least 100 times higher than in populations participating in national screening programmes.

Conclusion

Imprisoned women are at higher risk of cervical cancer than the general population. There is a high prevalence of HPV infection and precancerous lesions in this population. Targeted programmes for control of risk factors and the development of more effective cervical screening programmes are recommended.

PROSPERO registration number

CRD42014009690.
Pharmacologic properties of high-dose ambroxol in four patients with Gaucher disease and myoclonic epilepsy
Authors: Kim Yoon-Myung , Yum Mi-Sun , Heo Sun Hee , Kim Taeho , Jin Hee Kyung , Bae Jae-sung , Seo Go Hun , Oh Arum , Yoon Hee Mang , Lim Hyun Taek , Kim Hyo-Won , Ko Tae-Sung , Lim Hyeong‐Seok , Osborn Mark J , Tolar Jakub , Cozma Claudia , Rolfs Arndt , Zimran Ari , Lee Beom Hee , Yoo Han-Wook
Published: October 2019

Background

Ambroxol (ABX) has been suggested as an augmentative pharmacological agent for neuronopathic Gaucher disease (nGD). This study assessed the long-term safety and efficacy of combined therapy with high-dose ABX and enzyme replacement therapy (ERT) in nGD.

Methods

ABX+ERT therapy was administered for 4.5 years in four patients with nGD. ABX was initiated at a dose of 1.5 mg/kg/day, and the dose was escalated up to 27 mg/kg/day. The target plasma level was 10 µmol/L or less. The changes in glucocerebrosidase activity, biochemical, safety and neurocognitive findings were assessed.

Results

Enhanced residual GCcase activity was observed in all patients, as evidenced in both in vitro and in vivo studies. During the first 2 years of study with ABX (up to 21 mg/kg/day), mean seizure frequencies and neurocognitive function worsened. After ABX dosage was increased up to 27 mg/kg/day of ABX, its trough plasma concentration was 3.2–8.8 µmol/L. Drug-to-drug interaction, especially with antiepileptic drug significantly affected the pharmacokinetic parameters of ABX. Importantly, at 27 mg/kg/day of ABX, the seizure frequencies markedly decreased from the baseline, and the neurocognitive function was improved. In addition, Lyso-Gb1, a biomarker for the severity and progression of GD, was normalised in all patients. High-dose ABX was well-tolerated with no severe adverse events.

Conclusions

Long-term treatment with high-dose ABX+ERT was safe and might help to arrest the progression of the neurological manifestations in GD.
Risk of metastatic pheochromocytoma and paraganglioma in SDHx mutation carriers: a systematic review and updated meta-analysis
Authors: Lee Hansong , Jeong Seongdo , Yu Yeuni , Kang Junho , Sun Hokeun , Rhee Je-Keun , Kim Yun Hak
Published: October 2019

Background

Pheochromocytoma and paraganglioma (PPGL) are tumours that arise from chromaffin cells. Some genetic mutations influence PPGL, among which, those in genes encoding subunits of succinate dehydrogenase (SDHA, SDHB, SDHC and SDHD) and assembly factor (SDHAF2) are the most relevant. However, the risk of metastasis posed by these mutations is not reported except for SDHB and SDHD mutations. This study aimed to update the metastatic risks, considering prevalence and incidence of each SDHx mutation, which were dealt formerly all together.

Methods

We searched EMBASE and MEDLINE and selected 27 articles. The patients included in the studies were divided into three groups depending on the presence of PPGL. We checked the heterogeneity between studies and performed a meta-analysis using Hartung-Knapp-Sidik-Jonkman method based on a random effect model.

Results

The highest PPGL prevalence was for SDHB mutation, ranging from 23% to 31%, and for SDHC mutation (23%), followed by that for SDHA mutation (16%). The lowest prevalence was for SDHD mutation, ranging from 6% to 8%. SDHAF2 mutation showed no metastatic events. The PPGL incidence showed a tendency similar to that of its prevalence with the highest risk of metastasis posed by SDHB mutation (12%–41%) and the lowest risk by SDHD mutation (~4%).

Conclusion

There was no integrated evidence of how SDHx mutations are related to metastatic PPGL. However, these findings suggest that SDHA, SDHB and SDHC mutations are highly associated and should be tested as indicators of metastasis in patients with PPGL.
Outcomes associated with endovascular treatment among patients with acute ischemic stroke in the USA
Authors: Rai Ansaar T , Crivera Concetta , Kottenmeier Emilie , Kalsekar Iftekhar , Kumari Rashmi , Patino Nataly , Chekani Farid , Khanna Rahul
Published: October 2019

Background

Few studies have examined the trends in clinical and economic outcomes of patients with acute ischemic stroke (AIS) who receive endovascular therapy (ET) in the real-world setting.

Objective

To evaluate characteristics and trends in clinical and economic outcomes among commercially insured patients with AIS undergoing ET between 2011 and 2017.

Methods

Patients with AIS undergoing ET from January 1, 2011 to June 30, 2017 were identified from administrative claims contained in the IBM MarketScan Commercial and Medicare Supplemental databases. The Mann–Kendall trend test was performed to examine clinical and economic trends.

Between 2011 and 2017, 3411 patients (mean age 62.85±15 years) with a primary diagnosis of AIS underwent ET (coverage: Commercial 59%, n=2008; Medicare Supplemental 41%, n=1403). In the Commercial cohort, discharge to home increased significantly (from 29.54% to 39.18%, p<0.05). Length of stay declined significantly among the overall cohort (from 10.96 to 9.05 days, p<0.01) and the Medicare Supplemental cohort (from 10.03 to 8.43 days, p<0.05). All-cause 365-day readmission decreased significantly among the overall cohort (from 47.5% to 36.7%, p<0.05) and the Commercial cohort (from 51.54% to 36.43%, p<0.05) but remained unchanged in the Medicare Supplemental cohort. While index procedure cost did not change significantly ($93 955 to $87 906, p=0.8806), total cost significantly declined in the overall cohort (from $166 922 to $130 678, p<0.05).

Conclusions

Although with some variation across the samples studied, outcomes including discharge to home, length of stay, readmission, and total cost associated with endovascular stroke therapy seemed to have improved between 2011 and 2017. Index admission cost remained unchanged.
The diagnosis of primary central nervous system vasculitis
Authors: Rice Claire M , Scolding Neil J
Published: October 2019

The diagnosis of primary central nervous system (CNS) vasculitis is often difficult. There are neither specific clinical features nor a classical clinical course, and no blood or imaging investigations that can confirm the diagnosis. Contrast catheter cerebral angiography is neither specific nor sensitive, yet still underpins the diagnosis in many published studies. Here we describe an approach to its diagnosis, emphasising the importance of obtaining tissue, and present for discussion a new, binary set of diagnostic criteria, dividing cases into only ‘definite’ primary CNS vasculitis, where tissue proof is available, and ‘possible,’ where it is not. We hope that these criteria will be modified and improved by discussion among experts, and that these (improved) criteria may then be adopted and used as the basis for future prospective studies of the clinical features and diagnosis of this difficult and dangerous disorder, particularly for coordinated multicentre therapeutic trials.
Skull base imaging, anatomy, pathology and protocols
Authors: Quirk Bernadine , Connor Steven
Published: October 2019

The skull base is the major bony and soft tissue interface for the intracranial and extracranial compartments. Its anatomy is complex, containing multiple traversing foramina that act as conduits for various neurovascular structures. The optimum imaging modality depends on the specific diagnostic question and area of interest; both CT and MR have complementary roles. This article focuses on the applied compartmental anatomy of the skull base and specific imaging protocols, and discusses the range of pathologies that neurologists will encounter.
New Zealand tobacco retailers’ understandings of and attitudes towards selling Electronic Nicotine Delivery Systems: a qualitative exploration
Authors: Bateman Jerram , Robertson Lindsay , Marsh Louise , Thornley Louise , Hoek Janet
Published: October 2019

Introduction

In 2017, the New Zealand Government signalled its intent to legalise the widespread sale of Electronic Nicotine Delivery Systems (ENDS), which many New Zealand retailers have actually sold for several years. Although ENDS uptake may reduce the harm smokers face, it requires them to adopt an entirely new practice; we therefore explored how effectively existing non-specialist tobacco retailers could advise and support potential quitters.

Methods

Using in-depth interviews with 18 tobacco retailers (prior to legislative change), we explored knowledge of ENDS, attitudes towards selling ENDS and supporting customers’ cessation attempts, perceptions of ENDS’ risks and benefits, and views on the proposed legislation.

Results

Participants generally had poor knowledge of ENDS products and provided either no advice or gave incorrect information to customers. They believed that the main benefit consumers would realise from using ENDS rather than tobacco would be cost savings; relatively, few saw ENDS as smoking cessation devices. Those who stocked ENDS did so despite reporting very low customer demand, and saw tobacco as more important to their business than ENDS, citing higher repeat business, ancillary sales and rebates. Participants typically supported liberalising ENDS availability, though several expressed concerns about potential youth uptake.

Conclusions

Tobacco retailers’ limited understanding of ENDS, and the higher value they placed on tobacco, suggests they may have little capacity or inclination to support ENDS users to quit smoking. Licensing schemes for both ENDS and smoked tobacco could simultaneously reduce supply of smoked tobacco while requiring ENDS retailers to meet minimum knowledge standards.
Communicating risk differences between electronic and combusted cigarettes: the role of the FDA-mandated addiction warning and a nicotine fact sheet
Authors: Yang Bo , Popova Lucy
Published: October 2019

Introduction

The US Food and Drug Administration requires e-cigarettes to carry a nicotine addiction warning. This research compared the effects of messages communicating comparative risk of electronic and combusted cigarettes (CR messages) with and without the mandated warning and tested the effects of showing a nicotine fact sheet (NFS) before exposure to CR messages with warning.

Method

In an online experiment, 1528 US adult smokers were randomised to one of four conditions: (1) three CR messages, (2) three CR messages in condition one with an addiction warning, (3) an NFS followed by the three messages in condition 2 and (4) control messages. Outcomes included message reactions and perceived effectiveness, e-cigarette-related and cigarette-related beliefs and behavioural intentions and nicotine-related beliefs.

Results

CR messages with and without an addiction warning did not differ. The NFS condition produced higher odds of correctly understanding the risk of nicotine and stronger beliefs that switching to e-cigarettes could reduce health risks (response efficacy) than other treatments. Compared with control, all messages made it more likely for people to report e-cigarettes are less harmful than cigarettes and increased response efficacy and switch intentions to e-cigarettes. Only NFS condition increased correct beliefs about the risk of nicotine and self-efficacy about switching to e-cigarettes.

Conclusion

Including an addiction warning on CR messages did not reduce intentions to switch to e-cigarettes. Communicating accurate risk of nicotine together with CR messages and addiction warning increased smokers’ self-efficacy beliefs about switching completely to e-cigarettes, making it a potentially promising antitobacco communication strategy.
Carbon nanotubes and carbon fibers in a flash: an easy and convenient preparation of carbon nanostructures using a conventional microwave
Authors: Veloz-Castillo María Fernanda , Paredes-Arroyo Antonio , Vallejo-Espinosa Gerardo , Delgado-Jiménez José Francisco , Coffer Jeffery L. , González-Rodríguez Roberto , Mendoza Maria E. , Campos-Delgado Jessica , Méndez-Rojas Miguel A.
Published: October 2019

The growing interest in nanomaterials in different application fields calls for the implementation of simple, economically appealing, and efficient preparative methods. Among the wide variety of nanomaterials, carbon nanostructures have a special place due to their potential technological applications. Here, we present a fast, cheap, and easy-to-implement microwave-assisted method for the preparation of carbon nanotubes (CNTs) and carbon fibers (CFs) at room pressure conditions. The synthesis involves heating a mixture of graphite and ferrocene contained in a simple glass tube using a conventional microwave oven. A mixture of multi-walled carbon nanotubes (MWCNTs) and Fe3O4 magnetic nanoparticles were obtained quickly (less than 30 s) and in good yields. The products were characterized using scanning electron microscopy (SEM), transmission electron microscopy (TEM), powder X-ray diffraction (XRD), and Raman spectroscopy.
OpenLoops 2
Authors: Buccioni Federico , Lang Jean-Nicolas , Lindert Jonas M. , Maierhöfer Philipp , Pozzorini Stefano , Zhang Hantian , Zoller Max F.
Published: October 2019

We present the new version of OpenLoops, an automated generator of tree and one-loop scattering amplitudes based on the open-loop recursion. One main novelty of OpenLoops 2 is the extension of the original algorithm from NLO QCD to the full Standard Model, including electroweak (EW) corrections from gauge, Higgs and Yukawa interactions. In this context, among several new features, we discuss the systematic bookkeeping of QCD–EW interferences, a flexible implementation of the complex-mass scheme for processes with on-shell and off-shell unstable particles, a special treatment of on-shell and off-shell external photons, and efficient scale variations. The other main novelty is the implementation of the recently proposed on-the-fly reduction algorithm, which supersedes the usage of external reduction libraries for the calculation of tree–loop interferences. This new algorithm is equipped with an automated system that avoids Gram-determinant instabilities through analytic methods in combination with a new hybrid-precision approach based on a highly targeted usage of quadruple precision with minimal CPU overhead. The resulting significant speed and stability improvements are especially relevant for challenging NLO multi-leg calculations and for NNLO applications.
Equilibrium-pinning control for complex networks with inter-node coupling strength saturation improvement
Authors: Huang Chen , Lu Xinbiao , Zhou Jun , Qian Huimin , Huang Haoqian , Qin Buzhi
Published: October 2019

In most conventional complex network equilibrium-pinning control, all the network nodes are usually balanced by attaching at least one controller to each node of the concerned network. When the node number is huge and the inter-node connections are complex, this control strategy requires the ability to manipulate the inter-node coupling strength to grow rapidly and intensively. In practical applications, however, the inter-node coupling strength cannot be increased unlimitedly; as a matter of fact, the coupling strength cannot be further changed after reaching some saturation threshold. In this paper, by exploiting the improved coupling strength saturation function, we suggest a new pinning control strategy that makes the network reach its equilibrium-pinning point more effectively than the network with saturated coupling strength. Numerical examples are illustrated to show the effectiveness of the main results.
Antcamphin M Inhibits TLR4-Mediated Inflammatory Responses by Upregulating the Nrf2/HO-1 Pathway and Suppressing the NLRP3 Inflammasome Pathway in Macrophages
Authors: Liu Wei-Hsiu , Shi Li-Shian , Chung Min-Chieh , Chang Tsu-Chung , Lee Shih-Yu
Published: October 2019

The medicinal mushroom Antrodia cinnamomea has been demonstrated to have anti-inflammatory properties. However, the bioactive compounds in A. cinnamomea need further investigation. The present study aimed to understand the mechanism of action of antcamphin M, an ergostanoid isolated from A. cinnamomea mycelium and to clarify its underlying mechanisms of action. RAW264.7 cells were pretreated with the indicated concentrations of antcamphin M, prior to stimulation with lipopolysaccharide (LPS). Cell viability, production of nitric oxide (NO), prostaglandin E2(PGE[Formula: see text], cytokines, and chemokines, as well as the inflammation-related signaling pathways were investigated. The study revealed that antcamphin M significantly decreased the LPS-induced production of NO, PGE2, pro-inflammatory cytokines, and keratinocyte chemoattractant CXCL1 (KC), along with the levels of inducible NO synthase (iNOS) and cyclooxygenase-2 (COX-2) proteins without significant cytotoxicity, indicating it had a better anti-inflammatory activity than that of gisenoside Rb1 and Rg1. Additionally, antcamphin M significantly inhibited the activation of MAPKs (p38, ERK, and JNK), NF[Formula: see text]B, and components of the NLRP3 inflammasome (NLRP3, ASC, and caspase-1) signaling pathways and also increased the levels of nuclear factor erythroid-2-related factor (Nrf2) and heme oxygenase-1 (HO-1). These findings suggest that antcamphin M possesses potent anti-inflammatory activities and could be a potential candidate for the development of anti-inflammatory drugs.
Equivalence principle for antiparticles and its limitations
Authors: Jentschura U. D.
Published: October 2019

We investigate the particle–antiparticle symmetry of the gravitationally coupled Dirac equation, both on the basis of the gravitational central-field problem and in general curved space–time backgrounds. First, we investigate the central-field problem with the help of a Foldy–Wouthuysen transformation. This disentangles the particle from the antiparticle solutions, and leads to a “matching relation” of the inertial and the gravitational mass, which is valid for both particles as well as antiparticles. Second, we supplement this derivation by a general investigation of the behavior of the gravitationally coupled Dirac equation under the discrete symmetry of charge conjugation, which is tantamount to a particle[Formula: see text]antiparticle transformation. Limitations of the Einstein equivalence principle due to quantum fluctuations are discussed. In quantum mechanics, the question of where and when in the Universe an experiment is being performed can only be answered up to the limitations implied by Heisenberg’s Uncertainty Principle, questioning an assumption made in the original formulation of the Einstein equivalence principle. Furthermore, at some level of accuracy, it becomes impossible to separate nongravitational from gravitational experiments, leading to further limitations.
The electronic states and the optical absorption for an asymmetrical quantum well applied with an external electric field
Authors: Liu Yu , Yu Youbin
Published: October 2019

Electric field influences on the electronic states and the optical absorption in an asymmetrical quantum well with semiparabolic potential are investigated. The formula for the absorption coefficients in this asymmetrical quantum well with electric field are deduced by applying iterative method and density-matrix approach. The results are discussed with GaAs/AlGaAs materials and show that the external electric field has a significant effect on the electronic states and absorption coefficients of asymmetric quantum wells.
Preparation and characterization of nanostructure CuS for biological activity
Authors: Taha Ali A. , AL-Jawad Selma M. H. , Redha Abdulah Mohammed
Published: October 2019

Nanostructure copper sulfide derived from copper nitrate trihydrate precursors have been prepared by hydrothermal route with three different time reactions. All prepared samples were inspected by X-ray diffraction (XRD), zeta potential, field emission scanning electron microscopy (FE-SEM), Fourier transforms infrared (FTIR) spectroscopy and UV-Vis spectrophotometer. XRD patterns show that all samples have confirmed the formation of the hexagonal phase. Absorbance spectra were measured using UV-Vis spectrophotometer. The optical band gap energy of CuS nanostructure also decreased as the reaction time increased. In particular, their optical band gap energies were 3.25, 3.2 and 3.1 eV for 5, 15 and 25 h, respectively. Antibacterial activity of CuS nanostructure against S. aureus, P. aeruginosa and E. coli was evaluated by a zone of inhibition. The test revealed the minimum concentration of CuS nanostructure has very strong antibacterial activity against gram-positive than for gram-negative. Anticancer treatment was applied based on employing CuS nanostructure by exploiting their unique morphological and optical properties as therapeutic agents against Murine fibroblast (L20B) and Rhabdomyosarcoma (RD) cancer cell lines without using laser. Cytotoxicity effect was evaluated by MTT assay; results demonstrated that CuS nanostructure for 15 h exhibits more toxicity effect than for 5 h and 25 h for all particles concentration, where as cytotoxicity reaches 100% at 0.5 mg/ml, the most influential concentration, at which it could be a promising agent for cancer treatment.
Some models of holographic dark energy on the Randall–Sundrum brane and observational data
Authors: Astashenok A. V. , Tepliakov A. S.
Published: October 2019

Some models of holographic dark energy for Randall–Sundrum brane are considered. For the first class of dark energy models, we take energy density in the form [Formula: see text], where [Formula: see text] is size of event horizon in universe and [Formula: see text] is parameter (Tsallis holographic energy). Analysis of observational data allows to define upper limit on value of [Formula: see text] ([Formula: see text] is current energy density in the universe and [Formula: see text] is brane tension). Then we investigate models for which dark energy density has the form [Formula: see text] where [Formula: see text] is Hubble parameter.
The Global Financial Crisis, Fiscal Stimulus Package and the Chinese Banking Sector — A Pre- and Post-Efficiency Analysis
Authors: Xiang Dong , Sharma Parmendra , Zhang Yuming
Published: October 2019

This study is the first to examine the impact of two recent key events on technical, cost and profit efficiencies of Chinese commercial banks — the 2007 Global Financial Crisis (GFC) and the subsequent Chinese Government’s 2009 fiscal stimulus package. Stochastic frontier analysis together with univariate and multivariate tests are used on a sample of 143 banks, including the big five, joint stock, city, rural and foreign, over the 2006–2013 period. Overall, there is substantial scope for improvement — cost efficiency could improve by up to 50%; technical and profit efficiencies by up to 30%. The effect of the crisis and the stimulus package on various overall and segment efficiencies is, at best, inconsistent and inconclusive.
The Joint Determinants of Capital Structure and Stock Rate of Return: A LISREL Model Approach
Authors: Chen Hong-Yi , Lee Cheng Few , Tai Tzu
Published: October 2019

We develop a simultaneous determination model of capital structure and stock returns. Specifically, we incorporate the managerial investment autonomy theory into the structural equation modeling with confirmatory factor analysis to jointly determine the capital structure and stock return. Besides attributes introduced in previous studies, we introduce indicators affecting a firm’s financing decision, such as managerial entrenchment, macroeconomic factors, government financial policy, and pricing factors. Empirical results show that stock returns, asset structure, growth, industry classification, uniqueness, volatility, financial rating, profitability, government financial policy, and managerial entrenchment are major factors of the capital structure.
A Meshfree Computational Approach Based on Multiple-Scale Pascal Polynomials for Numerical Solution of a 2D Elliptic Problem with Nonlocal Boundary Conditions
Authors: Oruç Ömer
Published: October 2019

A two-dimensional (2D) elliptic problem with nonlocal boundary conditions on both regular and irregular domains is solved numerically by Pascal polynomial basis unified with multiple-scale technique. Very accurate numerical solutions and quite reasonable condition numbers are obtained with the proposed method which is also a truly meshfree method since difficult meshing processes or numerical integrations over domains are not needed for considered problems. Four test problems are solved to show the accuracy and efficiency of the proposed method. Also stability of the method is studied against large noise effect.