bluuebunny/crossref_metadata_2025 huggingface dataset:
WED 142 ‘anti-hu syndrome’ – a case of paraneoplastic sensory neuropathy with encephalitis
Authors: Srishti Gupta , Amit Jaiswal , Michael Knopp
Published: October 2018

A 75-year-old female was referred to the neurology outpatients department with a 6 month history of progressive amnesia and cognitive decline as well as symptoms/signs suggestive of a sensory neuropathy. Past medical history included TIA, cervical spondylosis and recent investigation for hyponatraemia which had been attributed to SIADH. She had been a smoker with a 50+pack year history and consumed minimal alcohol. An MRI brain scan demonstrated bilateral hippocampal T2 hyperintensity. A lumbar puncture demonstrated normal CSF constituents and negative viral PCRs. Full autoimmune and paraneoplastic screening was undertaken which was all normal except for a positive anti-Hu antibody. A CT-TAP highlighted a mass lesion in the right middle lobe of the lung and biopsy confirmed small cell lung cancer (T1aN2M0). A diagnosis of anti-Hu antibody related paraneoplastic syndrome was made and an initial treatment course of IV Methylprednisolone was administered. The patient’s cancer was treated with chemotherapy and adjuvant radiotherapy. Despite a good response with regard to her tumour and hyponatraemia, the patient did not improve significantly cognitively. This case highlights the need for awareness of the combination of symptoms/signs of the described ‘anti-Hu syndrome’ with paraneoplastic sensory neuropathy and/or encephalomyelitis.
THUR 173 Longterms: 10-year experience of fingolimod in RRMS patients
Authors: Jeffrey Cohen , Nadia Tenenbaum , Alit Bhatt , Ron Pimentel , Ludwig Kappos
Published: October 2018

Objectives

Present results for up to 10 years of fingolimod treatment in RRMS patients.

Methods

LONGTERMS is an open-label, single-arm, extension study evaluating the long-term safety, tolerability and efficacy of fingolimod in patients who previously participated in earlier fingolimod studies. Key efficacy measures: annualised relapse rate (ARR), proportion of patients free of 6 month confirmed disability progression (6 m-CDP), annualised rate of new or newly enlarging T2 lesions (ARneT2), and annualised rate of brain atrophy (ARBA). Safety analyses: adverse events (AEs) and serious AEs (SAEs) frequencies.

Results

3168 patients were included in the analysis. ARR decreased with longer exposure from 0.26 (Month [M] 0–12) to 0.20 (M0–60) and 0.19 (M0–120). Most patients remained free from 6 m-CDP at M60 (79.3%) and M120 (68.1%). ARneT2 decreased from 1.31 (M0–12) to 0.90 (M0–60), and 0.71 (M0–120). Change in brain volume was stable throughout the study (−0.37 [M12], −0.33 [M60] and −0.32 [M120]). Long-term exposure did not raise new safety concerns. No increase in frequencies of AEs or SAEs per year was observed over long-term fingolimod treatment.

Conclusions

Long-term follow-up confirmed the established safety profile of fingolimod. Treatment was associated with a sustained low level of disease activity as expressed by clinical and MRI outcomes.

Disclaimer

Previously presented at ECTRIMS 2017
THUR 174 The magnify-ms study: mavenclad® tablets in active rms
Authors: de Stefano N , Achiron A , Barkhof F , Chan A , Derfuss T , Hodgkinson S , Leocani L , Montalban X , Prat A , Schmierer K , Sellebjerg F , Vermersch P , Wiendl H , Keller B , Roy S
Published: October 2018

Authors Disclaimer: http://medpub-poster.merckgroup.com/ABN2018DISC_MAGNIFY.pdf

Background

Cladribine tablets (CT) improve clinical and MRI outcomes in patients with active RMS, with significant differences versus placebo after 24 weeks.

Objective

Describe the design of a study to assess the onset of CT’s clinical and MRI effects in patients with active RMS.

Methods

MAGNIFY-MS is a 2 year prospective Phase IV trial (including approximately 100 centres in Europe). Eligible patients will receive two years treatment with CT 3.5 mg/kg cumulative dose. Frequent MRI assessments (including lesion count, lesion volume, brain volume and MTR) will be performed at screening, baseline and 1, 2, 3, 6, 12, 15, 18 and 24 months. Various T- and B-cell subtype counts and functional profiling (eg cytokine production) will be assessed. Clinical outcomes will include changes in cognition (SDMT), disability (EDSS/KFS, 9HPT, T25FW), relapses, NEDA, NEDAP and safety at timepoints up to 24 months.

Results

Aim recruit 300 patients. Primary endpoint: change in the count of combined unique active lesions at end of 6 months versus baseline. Final outcomes expected in 2021.

Conclusions

MAGNIFY-MS will provide important information on the effects of CT, including early MRI changes, insights into effects on a range of disability and cognition markers, and detailed characterization of immune cell reconstitution.

Disclosure statement

This study was sponsored by EMD Serono, Inc., a business of Merck KGaA, Darmstadt, Germany (in the USA), and Merck Serono SA – Geneva, an affiliate of Merck KGaA Darmstadt, Germany (ROW).
THUR 177 Efficacy of alemtuzumab retreatment after 2 initial courses
Authors: Basil Sharrack , Barry Singer , Aaron Boster , Ann Bass , Regina Berkovich , Giancarlo Comi , Óscar Fernández , Jin Kim Ho , Volker Limmroth ,   al et,   on behalf of the CARE-MS II and CAMMS03409 Investigators
Published: October 2018

Efficacy of alemtuzumab retreatment (course [C] 3) after the initial 2 courses were evaluated (CARE-MS II, NCT00548405; extension, NCT00930553). Patients received alemtuzumab retreatment (12 mg/day, 3 consecutive days;≥12 months apart) as needed for relapse and/or MRI activity or another disease-modifying therapy (DMT) per investigator’s discretion. Assessments 12 months before C3 and up to 3 years after C3: annualised relapse rate (ARR); improved/stable Expanded Disability Status Scale (EDSS) score (versus core study baseline); 6 month confirmed disability improvement (CDI). Patients receiving another DMT were excluded. Analyses included patients who received C3 or more, with data censored at the time of C4 if a fourth course was received. Through Year 6, 88% of patients entering the extension remained on study, with 45% receiving ≥1 retreatment. ARR decreased from 0.85 (12 months before C3) to 0.20 (12 months after C3; rate ratio [95% CI], 0.24 [0.17–0.34]; p<0.0001), and remained low (0.27) 3 years after C3. 68% of patients maintained stable/improved EDSS 12 months after C3. The percentage with CDI increased from 4% (12 months before C3) to 14% (12 months after C3; p=0.0126). These findings demonstrate the efficacy of alemtuzumab C3 in patients with disease activity after the initial 2 courses.

Study support: Sanofi and Bayer HealthCare Pharmaceuticals.
THUR 180 Patient support program for RRMS patients treated with DMF
Authors: Joana Monterroso , Janette Curlis , Leontia Gribben
Published: October 2018

Introduction

In the UK, the number of multiple sclerosis (MS) patients far exceeds the capacity of MS specialist nurses (MSSNs).

Methods

Biogen and IQVIA developed a remote, nurse-led, script-based telephone line providing educational assistance and supporting treatment adherence among relapsing-remitting MS (RRMS) adult patients receiving delayed-release dimethyl fumarate (DMF; TECFIDERA). Following DMF initiation, 8 calls are scheduled over the first 3 months, followed by quarterly calls for the remainder of the first treatment year. The program began in March 2015; a new online treatment satisfaction survey started in July 2017.

Results

Based on summarized call data through November 2017, 941 total patients were enrolled from 136 UK hospitals, with a mean (median, range) of 6.9 (2, 1–117) patients/hospital. An average of 11.5 calls/patient were received. Across all 11 scheduled calls, the average time/call was 8.3 min. Over 33 months, cumulative DMF discontinuation among enrolled patients was 15.7%. Between July and November 2017, 31 patients on treatment for ≥1 year completed satisfaction surveys; 74% reported scores ≥4 (scale: 1 [poor] to 5 [excellent]).

Discussion

This program has been widely used and positively received across the UK by DMF-treated patients and may reduce the burden on MSSNs.

Support

Biogen. Disclosures on poster.
WED 181 Switching early from oral DMT to fingolimod in RRMS patients
Authors: Tjalf Ziemssen , Diego Silva , Jennie Medin , Christian Cornelissen , Kathrin Ringwald , Stanley Cohan
Published: October 2018

Objectives

Compare the effect of fingolimod in RRMS patients who switched from first-line oral disease modifying therapies (oDMTs) vs patients who switched from injectable disease-modifying therapies (iDMTs) in PASSAGE and PANGAEA 2.0 studies.

Methods

Patients who switched to fingolimod from dimethyl fumarate or teriflunomide (oDMT cohort; PASSAGE n=157, PANGAEA 2.0 n=72), or treatment naïve or after iDMTs (iDMT cohort; PASSAGE n=3484, PANGAEA 2.0 n=270). Annualised relapse rate (ARR) was recorded at months (M) 12 and 24.

Results

PASSAGE: Fingolimod reduced ARR at M12 to 0.30 and 0.26 (oDMT and iDMT cohort). Increasingly higher BL ARR were observed in the oDMT cohort patients who had received two or three DMTs (ARR=1.47 and 1.53).

PANGAEA 2.0: Fingolimod reduced ARR at M12 in both cohorts but was higher in the oDMT than in the iDMT cohort (0.19 vs 0.10, p=0.01). The BL ARR in the oDMT cohort increased with the number of failed DMTs before the switch (two DMTs, 1.58; three DMTs, 1.86) and was reduced with fingolimod treatment at M12 (two DMTs, 0.18; three DMTs, 0.21).

Conclusions

Fingolimod is effective in controlling disease activity in RRMS patients switching from other oDMTs. Switching early results in better relapse control within 1 year of initiation.

Disclaimer

Previously presented at ECTRIMS 2017.
WED 186 Effect of cladribine tablets on immune cells in patients with ms
Authors: Stuve Olaf , Soelberg-Sorensen Per , Giovannoni Gavin , Leist Thomas , Hyvert Yann , Damian Doris , Boschert Ursula
Published: October 2018

Background

Cladribine tablets 3.5 mg/kg (CT3.5) demonstrated efficacy in patients with early (ORACLE-MS) and relapsing MS (CLARITY/CLARITY-Extension).

Objective

Evaluate B, T lymphocyte and natural killer (NK) cell profiles after CT administration in ORACLE-MS, CLARITY and CLARITY-Extension.

Methods

Longitudinal evaluation of peripheral blood lymphocytes was conducted for patients receiving the CT (either part of the initial 3.5 mg/kg active treatment groups or placebo switched to active treatment). Absolute lymphocyte counts (ALC) and subtype dispositions were evaluated at baseline, and Weeks 5, 13, 24, 48.

Results

Baseline distributions of ALC and temporal profiles of CD19+ B and CD4+ and CD8+ T lymphocytes were generally consistent across studies. Rapid reductions were observed for CD19+ B cells (~75% reduction; Week 5), with nadirs at Week 13 (~80% reduction). Reconstitution of CD19+ B cells towards baseline occurred from Week 24–48. Lesser, discontinuous reductions also occurred for CD4+ and CD8+ T cells that had not fully returned to baseline by Week 48. CD16+/CD56+ NK cells were transiently reduced with CT, with recovery evident at Weeks 24 (29%) and 48 (23%).

Conclusions

CT3.5 achieved early, discontinuous reduction of peripheral blood B cells, with rapid reconstitution towards baseline; a moderate, discontinuous reduction of T cells; and early, transient NK cell reductions.

Disclaimer

http://medpub-poster.merckgroup.com/ABN2018DISC_LymphBTNKCell.pdf
WED 188 Pangaea 2.0 interim results: switching to fingolimod
Authors: Christian Cornelissen , Tjalf Ziemssen , Raimar Kern
Published: October 2018

Objectives

Present first interim results of PANGAEA 2.0 including effectiveness data of patients switching from other oral disease modifying therapies (oDMTs; dimethyl fumarate and teriflunomide) to fingolimod.

Methods

PANGAEA 2.0 is an ongoing non-interventional study. As of January 2017 PANGAEA 2.0 included 1419 patients, 1116 were included in this analysis of which 183 switched from other oDMTs to fingolimod.

Results

Slight differences were observed in the number of relapses 12 months (M) before baseline (mean ± SD) (1.4±1.0 vs 1.6±1.0), the EDSS (2.2±1.6 vs 2.4±1.7) and the MSSS (3.5±2.5 vs 3.8±2.5). 67.4% of the patients switched from dimethyfumarate to fingolimod and 32.6% from teriflunomide. For 30.2% of the patients fingolimod was the second therapy since diagnosis. The annualized relapse rate (ARR,±95% CI) 6M after switch to fingolimod was reduced from 1.6±0.22 to 0.2±0.05 for the patients switching from other oDMTs. For all patients the ARR was reduced from 1.3±0,06 to 0,14±0,02. The EDSS (±95% CI) remained stable at 2.4±0.37 (2.5±0.50 respectively).

Conclusions

These data indicate that active disease patients switching from dimethyl fumarate or teriflunomide to fingolimod can benefit from this switch.

Disclaimer

previously presented at ECTRIMS 2017.
UK Armed Forces Continuous Attitude Survey: a short history and description of a key strategic information tool
Authors: Elliott-Mabey Nicola , Davison H
Published: October 2018

The tri-Service Armed Forces Continuous Attitude Survey, commonly known as AFCAS, was introduced in 2007 to coherently assess and monitor the attitudes of Regular Service personnel in key policy and management areas and is used by groups internal and external to the Ministry of Defence. It is a statistically valid and robust survey which is annually distributed to almost 28 000 regular serving personnel. AFCAS data have been used to inform the development and evaluation of a wide range of personnel policies, including remuneration, accommodation, flexible working, career management and training. AFCAS allows for the tracking of attitudes over time, as well as the analysis of differences between respondent cohorts. AFCAS is well regarded as it is a one-stop shop survey for strategic personnel issues. This article describes the purpose, content, conduct and use of the survey to inform Armed Forces personnel policy.
Impact of landmark endovascular stroke trials on logistical performance measures: a before-and-after evaluation of real-world data from a regional stroke system of care
Authors: Kollikowski Alexander Marco , Amaya Franco , Stoll Guido , Müllges Wolfgang , Schuhmann Michael Klaus , Pham Mirko
Published: October 2018

Background and purpose

Endovascular treatment of large-vessel occlusion stroke often necessitates patient transfer by a twin-track approach: endovascular thrombectomy (ET) in endovascular-capable facilities preceded by intravenous thrombolysis in primary stroke centers. We tested the open hypothesis that recent landmark trials on ET had any significant effect on logistical performance measures among different modes of admission.

Methods

We retrospectively categorized 250 patients who presented at our institution as: (A) primarily admitted or transferred from (B) inner-city and (C) regional hospitals. The period from May 2015 to June 2017 was compared with the preceding period of August 2009 to April 2015 with respect to real-life transfer distances and sectional time metrics from symptom onset to angiographic recanalization.

Results

Onset-to-recanalization time decreased in the primary admission path, whereas delays persisted for inter-hospital transfer: (A: 261 min (210–315) vs 198 (167–264) P<0.0001; B: 257 (214–306) vs 265 (199– 360) P=0.566; and C: 371 (322–415) vs 346 (307–405) P=0.559). Onset-to-recanalization time was negatively correlated with recanalization success (mTICI; r=-0.4195 P<0.0001). The rate of secondarily referred patients (26% vs 48% P=0.0004) and off-hour presentation (36% vs 44% P=0.004) increased, as did the catchment area (C: 52.2 km (30,4–64,5) vs 64.4 (43,2–78,9) P=0.032). Improvement in door-in-door-out time at the referring hospitals (C: 113 min (30) vs 86 (29) P=0.0236) did not translate into reduced total referral times or the accelerated initiation of ET.

Conclusion

Recent landmark trials already led to a considerable streamlining of ET workflow if patients were directly admitted. Prehospital time management and triage seem to be the major determinants of optimization.
Human papillomavirus infection and associated factors for cervical intraepithelial neoplasia in women living with HIV in China: a cross-sectional study
Authors: Wang Qian , Ma Xiaomeng , Zhang Xiaosong , Ong Jason J , Jing Jun , Zhang Lei , Wang Lin-Hong
Published: October 2018

Objective

Women living with HIV (WLHIV) face disproportionately higher risks of acquiring human papillomavirus (HPV) compared with HIV negative counterparts. We aimed to investigate the prevalence of HPV in WLHIV in Chinese hospital setting and identify associated factors to the progression of late-stage cervical intraepithelial neoplasia (CIN2+) in this population.

Method

This retrospective study collected data from 183 WLHIV on antiretroviral treatment (ART), based on reproductive health questionnaires. Gynaecological examination results including serum (for HIV viral load, CD4 T-cell count, hepatitis B infections, syphilis) and vaginal swabs for common bacterial sexually transmitted infections (STIs). Multivariate-logistic regression was applied to analyze the contributing factors to CIN2+.

Results

HIV coinfection with other Sexually Transmitted Infections (STIs) were observed in 99 participants (54.1%, (99/183)). HPV (43.7% (80/183)) was the most prevalent STI. The three most prevalent HPV subtypes were all high-risk HPV (HR-HPV), including HPV52 (33.8% (27/80)), HPV58 (21.3% (17/80)) and HPV33 (13.75% (11/80)). About a third (37.5%, 30/80) of women with HPV had HR-HPV. Multiple HPV coinfections were common in HIV-HPV coinfected women (41.3%, 33/80). Cytological examinations revealed that 77.5% (62/80) HPV+ women had detectable cervical lesions. In comparison, only 4.9% (5/103) HPV negative womenwith Atypia and 1.0% (1/103) with CIN1 were diagnosed. Multivariate logistic regression revealed that HPV16 (OR=19.04, 2.53 to 122.92; p=0.004) and HPV18 (OR=11.54, 1.45 to 91.64; p=0.021) infections were significantly associated with CIN2+ in HIV-HPV coinfected women.

Conclusion

A high prevalence of HPV was found in women on ART. HPV16/18 infection are strong associated factors to CIN2+ in HIV-HPV coinfected women.
Can vaccines for contagious agalactia reduce disease progression in infected animals: a preliminary study?
Authors: Loria Guido Ruggero , Puleio Roberto , Agnello Stefano , Marogna Gavino , Nicholas Robin A J
Published: October 2018

A flock of sheep in Central Sicily was affected by a severe outbreak of contagious agalactia (CA) caused by Mycoplasma agalactiae, affecting nearly 30% resulting in a large drop in milk production. Many ewes had warm and swollen udders that often became sclerotic and was accompanied by keratoconjunctivitis and arthritis in both adults and young. As antibiotic treatment appeared ineffective, the whole flock was given two doses of an inactivated vaccine against M agalactiae two weeks apart. A small group was selected for close examination and additional tests. A fortnight after the last vaccination mycoplasma excretion fell in all but one of the selected ewes and was undetectable in all but two animals two weeks after that. In nearly all the selected ewes, there was an improvement in milk quality and udder condition. This work provided preliminary evidence for the continued use of CA vaccines to slow or prevent disease progression.
Seasonal changes in the occurrence of embolisms among broad-leaved trees in a temperate region
Authors: Umebayashi Toshihiro , Fukuda Kenji
Published: October 2018

Sap freeze–thaw events are a main determinant of the distribution of broad-leaved woody plants in cool regions but the effect in other climates remains unknown. We used cryoscanning electron microscopy to examine the differences in plant growth patterns based on seasonal variation in xylem water distribution in four broad-leaved species (one ring-porous and three diffuse-porous species) in a temperate region of Japan. Leaf fall was detected in November for the ring-porous species Maackia amurensis Rupr. et Maxim., although embolisms were detected in large earlywood vessels in January of the following year. The percentage of embolisms in latewood vessels varied significantly between years. By contrast, xylem embolisms in diffuse-porous species (deciduous and evergreen) were barely detectable during winter. In one evergreen species, embolisms and refilling were detected in some vessels during the growing season. Based on the variation in the number of freeze–thaw events among years in Asian monsoon forests, we infer that M. amurensis obtained no benefit from extending leaf phenology because of the occurrence of vessel embolisms in winter. On the other hand, the leaf phenologies of deciduous and evergreen diffuse-porous species were less constrained by winter embolisms. Maackia amurensis persists in cool temperate regions by limiting the photosynthetic period.
Plenty of room at the bottom: niche variation and segregation in large-bodied benthivores of boreal lakes
Authors: Johnston T.A. , Ehrman A.D. , Hamilton G.L. , Nugent B.K. , Cott P.A. , Gunn J.M.
Published: October 2018

Realized trophic niches of aquatic consumers are expected to reflect the particular abiotic and biotic conditions of the ecosystems they occupy. We examined patterns in the position, size, and shape of trophic niches of two common benthivorous fishes, white sucker (Catostomus commersonii) and lake whitefish (Coregonus clupeaformis), across boreal lakes using a stable isotope approach. In sympatry, white sucker niche positions reflected greater benthic reliance (higher δ13C) and lower trophic elevation (lower δ15N) compared with lake whitefish, and white sucker niche sizes (dispersion in δ13C–δ15N space) were also larger. Niche sizes of both species increased with maximum depth of lakes. Separation of trophic niche positions of the two species increased with increasing water clarity, but their niche sizes did not increase with increasing separation in their niche positions. White sucker occupied a niche position with slightly greater pelagic reliance and trophic elevation and had smaller trophic niches in the absence than in the presence of lake whitefish. Trophic niches of these benthivores appear to be shaped by both environmental factors and interspecific interactions.
ACM BCB 2019
Authors: Staff ACM
Published: October 2018

The next ACM BCB 2019 will be at Niagara Falls. September 7-10, 2019.
CRA-W grad cohort
Authors: Salac Jean Paula , Chon Jieun
Published: October 2018

The Computing Research Association Women (CRA-W) Grad Cohort was held in San Francisco, California, USA on April 13-14, 2018. Two participants in the event contributed the following comments about their experience.
The Anthropology of Mining: The Social and Environmental Impacts of Resource Extraction in the Mineral Age
Authors: Jacka Jerry K.
Published: October 2018

This article examines the social and environmental costs of living in the mineral age, wherein contemporary global livelihoods depend almost completely on the extraction of mineral resources. Owing to the logic of extractivism—the rapid and widespread removal of resources for exchange in global capitalist markets—both developed and developing countries are inextricably entangled in pursuing resource extraction as a means of sustaining current lifestyles as well as a key mechanism for promoting socioeconomic development. The past 15 years has seen a massive expansion of mineral resource extraction as many developing countries liberalized their mining sectors, allowing foreign capital and mining companies onto the lands of peasant farmers and indigenous people. This mining expansion has also facilitated the rise of artisanal and small-scale mining (ASM). Transformations in livelihoods and corporate practices as well as the environmental impacts and social conflicts wrought by mining are the central foci of this article.
Guido Altarelli
Authors: Maiani Luciano , Martinelli Guido
Published: October 2018

In this article we review the life and work of Guido Altarelli (1941–2015).
Structure of S=−2 Hypernuclei and Hyperon–Hyperon Interactions
Authors: Hiyama Emiko , Nakazawa Kazuma
Published: October 2018

We review recent progress in S=−2 hypernuclei such as double-Λ hypernuclei and Ξ hypernuclei, which are composed of a nucleus and one or two hyperons, such as a Λ or a Ξ particle. Through observations of [Formula: see text]He, such as the Nagara event, we obtain important information about the ΛΛ interaction. Using this information, we perform a four-body calculation of ααΛΛ for [Formula: see text]Be, which was observed at KEK as the Demachi–Yanagi event. We interpret this event as the [Formula: see text] excited state. We calculate energy levels of [Formula: see text]Be within the framework of an αα nΛΛ five-body cluster model, and then interpret the Hida event, which was observed at KEK as the ground state of [Formula: see text]Be. Motivated by observation of the Kiso event of [Formula: see text]C, by using the Skyrme–Hartree–Fock and relativistic mean-field frameworks, we calculate the energy spectra of this hypernucleus. We interpret this event as the 14N(g.s.)+Ξ−(0 p) state. Finally, we propose an experiment on [Formula: see text]H and [Formula: see text]Li to extract information about the spin- and isospin-averaged parts of the Ξ N interaction.
A Comprehensive Analysis on Transient Electromagnetic Force Behavior of Stator Windings in Turbo-Generator
Authors: Jiang Hong-Chun , He Yu-Ling , Tang Gui-Ji , Xu Ming-Xing
Published: October 2018

This paper presents a comprehensive analysis on the transient electromagnetic force behavior of the stator windings in a QFSN-600-2YHG type turbo-generator. Different from other studies, this paper investigates not only the distribution regularities of the resultant force and the force density, but also the force harmonic characteristics, and the mechanical responses which will cause sensitive impact on the insulation wearing. The whole work is generally based on a proposed simplified model and the 3D finite element coupling calculation. The simplified model contains two parts. The first part is the theoretical model that employs the approximate solution of the image current to obtain the analytic formula of the electromagnetic force on the end windings conveniently. The second part is the FEA model that employs only the end windings and one-tenth of the stator core to save the calculating memory and, meanwhile, obtain the qualified electromagnetic force as well as the mechanical response. It is shown that the nose-top, the connection point between the line part and the end part, and the middle of the involute are the three most dangerous positions of the end winding to sustain serious insulation wearing. Moreover, the winding, which endures the maximum mechanical response, is neither always consistent with the one that has the largest resultant electromagnetic force nor directly in accordance with the winding that affords the most intensive electromagnetic force density. The findings in this paper will be beneficial for the insulation monitoring and the manufacturing improvement on the stator windings.
Mutual Information Better Quantifies Brain Network Architecture in Children with Epilepsy
Authors: Zhang Wei , Muravina Viktoria , Azencott Robert , Chu Zili D. , Paldino Michael J.
Published: October 2018

Purpose. Metrics of the brain network architecture derived from resting-state fMRI have been shown to provide physiologically meaningful markers of IQ in children with epilepsy. However, traditional measures of functional connectivity (FC), specifically the Pearson correlation, assume a dominant linear relationship between BOLD time courses; this assumption may not be valid. Mutual information is an alternative measure of FC which has shown promise in the study of complex networks due to its ability to flexibly capture association of diverse forms. We aimed to compare network metrics derived from mutual information-defined FC to those derived from traditional correlation in terms of their capacity to predict patient-level IQ. Materials and Methods. Patients were retrospectively identified with the following: (1) focal epilepsy; (2) resting-state fMRI; and (3) full-scale IQ by a neuropsychologist. Brain network nodes were defined by anatomic parcellation. Parcellation was performed at the size threshold of 350 mm2, resulting in networks containing 780 nodes. Whole-brain, weighted graphs were then constructed according to the pairwise connectivity between nodes. In the traditional condition, edges (connections) between each pair of nodes were defined as the absolute value of the Pearson correlation coefficient between their BOLD time courses. In the mutual information condition, edges were defined as the mutual information between time courses. The following metrics were then calculated for each weighted graph: clustering coefficient, modularity, characteristic path length, and global efficiency. A machine learning algorithm was used to predict the IQ of each individual based on their network metrics. Prediction accuracy was assessed as the fractional variation explained for each condition. Results. Twenty-four patients met the inclusion criteria (age: 8–18 years). All brain networks demonstrated expected small-world properties. Network metrics derived from mutual information-defined FC significantly outperformed the use of the Pearson correlation. Specifically, fractional variation explained was 49% (95% CI: 46%, 51%) for the mutual information method; the Pearson correlation demonstrated a variation of 17% (95% CI: 13%, 19%). Conclusion. Mutual information-defined functional connectivity captures physiologically relevant features of the brain network better than correlation. Clinical Relevance. Optimizing the capacity to predict cognitive phenotypes at the patient level is a necessary step toward the clinical utility of network-based biomarkers.
Endoscopic Ultrasound Elastography for Evaluation of Lymph Nodes: A Single Center Experience
Authors: Altonbary Ahmed Youssef , Hakim Hazem , El-Shamy Ahmed Mohamed
Published: October 2018

Background and Aim. The differentiation between malignant and benign lymph nodes (LNs) is important for tumor staging, for detection of prognosis, and for selection of the best treatment strategy in many cancers. On B-mode EUS, there are some known criteria that suggest the malignant nature of LNs; these criteria may be found in benign LNs. The aim of the work is to evaluate the effectiveness of elasticity score and SR to differentiate between benign and malignant LNs. Patients and Methods. The study was designed as a retrospective study that included 40 patients with abdominal or mediastinal LNs, either associated with primary masses or isolated, referred for EUS evaluation. Elasticity scores and SR were determined during the examination and finally, EUS-FNA was done at the end of the procedure. Results. In this 2-years study, 40 patients were enrolled (24 malignant; 16 benign). There were 23 males and 17 females. Their mean age was 52.5 years (range: 28–77). ES alone had a specificity of 87.5%, sensitivity of 41.7%, PPV of 83.3%, NPV of 50%, and accuracy of 60%. Based on the ROC curve analysis results, the best cut-off level of SR to obtain the maximum area under the curve (AUC) was 6.7 with a specificity of 99.9%, sensitivity of 57.1%, PPV of 99.9%, NPV of 64%, and accuracy of 77.5%. Conclusion. The use of elasticity score and SR increases the reliability of differentiation between benign and malignant LNs and can decrease the number of unnecessary biopsies.
Effect of Physical and Chemical Hair Removal Methods on Skin Barrier Function in vitro: Consequences for a Hydrophilic Model Permeant
Authors: Pany Astrid , Klang Victoria , Brunner Marion , Ruthofer Johanna , Schwarz Elisabeth , Valenta Claudia
Published: October 2018

Background: Although very common in our society, the effect of hair removal on physiological skin parameters and on the ingress of applied chemicals has not been systematically investigated. Thus, as a first step, the aim of the present study was to elucidate the effect of hair removal through epilation (electric epilation, waxing) and depilation (dry and wet shaving, depilatory cream) on skin properties in vitro using the porcine ear model. Methods: Attenuated total reflection Fourier transform infrared spectroscopy, measurement of the transepidermal water loss (TEWL), visualization by capacitance-based contact imaging, confocal Raman spectroscopy (CRS), diffusion cell studies and tape stripping experiments were employed. Results: Increased TEWL and altered skin permittivity maps were observed. Decreased stratum corneum thickness was observed after waxing. Diffusion cell studies showed increased skin permeation especially in case of dry shaving, electric epilation and waxing. Conclusion: Considering CRS and diffusion cell data, a moderate if significant decrease in skin barrier function was found after hair removal by dry shaving (physical skin/material interaction) and epilation methods (plucking out the entire hair, for example, by electrical epilation and waxing). Subsequent experiments will include testing of different permeants covering a broad range of physicochemical properties in vitro and confirming our findings in vivo.
Incidence and Prognosis of Acute Kidney Injury After Cardiac Arrest in Children
Authors: Cañete Paloma , Fernández Andrés , Solís Ana , del Castillo Jimena , Fernández Sarah , López-Herce Jesús ,   Grupo Español de Reanimación Cardiopulmonar Pediátrica y Neonatal
Published: October 2018

Background/Aims: The incidence of acute kidney injury (AKI) after cardiac arrest (CA) in adults is associated with a high mortality, but there are few data about the incidence and prognosis of AKI after CA in children. The aim of our study was to analyze the incidence of AKI in children who have experienced an in-hospital CA and its association with mortality. Methods: A retrospective observational study in a prospective database was performed including children between the ages 1 month and 16 years, who had undergone an in-hospital CA. Information on clinical, analytical, and monitorization data, treatment, mortality and cause of death were recorded. Results: Fifty-six children were included in the study (57.6% males). Return of spontaneous circulation (ROSC) was achieved in 49 children (87.7%). Thirty-one patients (55.3%) survived. Four patients (8.1%) were being treated with continuous renal replacement therapies (CCRT) before CA. After ROSC, 7 other children (14.3%) had severe acute kidney injury requiring CRRT. Mortality of children who required CRRT after CA (57.1%) was not significantly higher than that in children who did not (26.3%; p = 0.18). But mortality of patients who need CRRT before or after CA (72.7%) was significantly higher than the remaining patients (26.3%; p = 0.03). Conclusions: The frequency of AKI in children after recovering a CA is moderate. AKI that needs CCRT before or after CA is associated with a higher mortality.
A Comparative Study of Short-Term Blood Pressure Variability in Hemodialysis Patients with and without Intradialytic Hypertension
Authors: Bikos Athanasios , Angeloudi Elena , Memmos Evangelos , Loutradis Charalampos , Karpetas Antonios , Ginikopoulou Evi , Panagoutsos Stylianos , Pasadakis Ploumis , Liakopoulos Vassilios , Papagianni Aikaterini , Sarafidis Pantelis
Published: October 2018

Background: Short-term blood pressure (BP) variability (BPV) is associated with increased cardiovascular risk in hemodialysis. Patients with intradialytic hypertension have high risk of adverse outcomes. Whether BPV is increased in these patients is not clear. The purpose of this study was to compare short-term BPV in patients with and without intradialytic hypertension. Methods: Forty-one patients with and 82 patients without intradialytic hypertension (intradialytic SBP rise ≥10 mm Hg to > 150 mm Hg) matched in a 1: 2 ratio for age, sex, and hemodialysis vintage were included. All subjects underwent 48-h ambulatory BP monitoring during a regular hemodialysis and the subsequent interdialytic interval. Brachial and aortic BPV were calculated with validated formulas and compared between the 2 groups during the 48-h and the 44-h periods and during the 2 daytime and nighttime periods respectively. Results: During 48-h or 44-h periods and daytime or nighttime, brachial SBP/DBP and aortic SBP/DBP were significantly higher in cases than in controls. All brachial SBP/DBP BPV indexes [SD, weighted SD (wSD), coefficient-of-variation (CV) and average-real-variability (ARV)] were not significantly different between groups during the 48- or 44-h periods (48-h: SBP-ARV 11.59 ± 3.05 vs. 11.70 ± 2.68, p = 0.844, DBP-ARV: 8.60 ± 1.90 vs. 8.90 ± 1.63, p = 0.357). Analysis stratified by day or night between days 1 and 2 revealed, in general, similar results. No significant differences in dipping pattern were observed between groups. Analysis of aortic BPV had similar findings. Conclusions: BPV is similar between those with and without intradialytic hypertension. However, those with intradialytic hypertension have a sustained increase in systolic and diastolic BP during the entire interdialytic interval.
Consistent individual and sex-specific differences in behaviour of common cuckoo chicks: is there a potential impact on host-parasite coevolutionary dynamics?
Authors: Trnka Alfréd , Samaš Peter , Grim Tomáš
Published: October 2018

Research on brood parasitism has focused primarily on specific host anti-parasite behaviours and parasite counter-adaptations, and little is known about other aspects of their behaviours such as consistent behavioural differences between individuals. Therefore, we examined consistency in behaviour of nestlings of common cuckoos (Cuculus canorus) raised by great reed warblers (Acrocephalus arundinaceus). Cuckoo chicks showed high repeatability of both aggressive behaviour and breath rate, and both traits were strongly correlated with each other. This represents the first evidence for consistent differences in behaviour among avian brood parasites. Males were consistently more aggressive and less stressed than females. Nestlings of both sexes that hatched later in the season exhibited higher levels of aggression and lower stress responses than nestlings hatched earlier. This suggests that rearing conditions (e.g., food availability and quality) may modulate stress and aggressive phenotypes of brood parasites. We discuss potential effects of the observed patterns on host-parasite dynamics.
Regional Vegetation Histories: An Overview of the Pollen Evidence from the Central Mediterranean
Authors: Kouli Katerina , Masi Alessia , Mercuri Anna Maria , Florenzano Assunta , Sadori Laura
Published: October 2018

Vegetation patterns during the 1st millennium AD in the central Mediterranean, exhibit a great variability, due to the richness of these habitats and the continuous shaping of the environment by human societies. Variations in land use, witnessed in the pollen record, reflect the role that local vegetation and environmental conditions played in the choices made by local societies. The interdisciplinary study of off-site cores remains the key evidence for palaeoenvironmental transformations mirroring the ‘semi-natural’ vegetation, and revealing temporal fluctuations and the amount of human impact on a regional scale.
Variation in the Continuity of Land-Use Patterns through the First Millennium AD in Lowland Britain
Authors: Rippon Stephen , Fyfe Ralph
Published: October 2018

This paper explores the contribution that palaeoenvironmental evidence, and in particular palynology, is making to our understanding of landscape evolution in Britain during the 1st millenniumAD. This was a period of profound social and economic change including a series of invasions, some associated with a mass folk migration. Archaeologists and historians continue to debate the significance of these events, and palaeoenvironmental evidence is now starting to provide an additional perspective. Key to this has been obtaining pollen sequences, although there remains a need for more evidence from lowland areas, alongside higher resolution sampling and improved dating. It is suggested that although the 1st millenniumADsaw some significant long-term shifts in climate, these are unlikely to have had a significant causal effect on landscape change in lowland areas (both in areas with and without significant Anglo-Saxon immigration). The analysis of pollen data from across Britain shows very marked regional variations in the major land-use types (arable, woodland, improved pasture, and unimproved pasture) throughout the Roman and Early Medieval periods. While Britain ceasing to be part of the Roman empire appears to have led to a decline in the intensity of agriculture, it was the ‘long 8th c.’ (the later 7th to early 9th c.) that saw a more profound change, with a period of investment, innovation, and intensification, including an expansion in arable cultivation.
Climatic Changes and Their Impacts in the Mediterranean during the First Millennium AD
Authors: Labuhn Inga , Finné Martin , Izdebski Adam , Roberts Neil , Woodbridge Jessie
Published: October 2018

Many events and developments in human history have been suspected to be, at least partly, influenced by climate and environmental changes. In order to investigate climate impacts on societies, reliable palaeoclimatic data of adequate dating precision, resolution, spatial representativeness, and so on, are needed. This paper presents a survey and analysis of published palaeoclimatic data of the Mediterranean for the 1st millenniumAD, and identifies regional patterns of hydro-climate variability, useful for comparison with archaeological/historical studies. It also provides general guidelines to palaeoclimatic data for archaeologists/historians interested in climatic change. We conclude with a discussion of how the emerging patterns of regional climate histories may have had an impact on Mediterranean societies in Late Antiquity.
Mysterious and Mortiferous Clouds: The Climate Cooling and Disease Burden of Late Antiquity
Authors: Newfield Timothy P.
Published: October 2018

What influence did climate have on disease in Late Antiquity? Natural archives of pre-instrumental temperature indicate significant summer cooling throughout the period. The coolest stretch spanned the 6th and 7th c., and corresponds startlingly to the appearance of the Justinianic Plague in the Mediterranean region. Drawing on principles from landscape epidemiology, this paper marries textual evidence for disease with palaeoclimatic data, in order to understand how gradual and dramatic climatic change, the 535–50 downturn especially, may have altered the pathogenic burden carried in Late Antiquity. Particular attention is paid to the Justinianic Plague, but the potential impacts of a changing climate on malaria and non-yersinial, non-plague, epidemics are not overlooked.
Modelling the Supply of Wood Fuel in Ancient Rome
Authors: Graham Benjamin , Van Dam Raymond
Published: October 2018

Provisioning the city of Rome required complex systems of management and procurement. Despite the importance of wood for baking the grain of theannonaand heating the water for baths (among other applications), there is little evidence for the human or ecological connections that supplied Rome with this crucial fuel. By examining parallel institutions, this article provides a model for explaining how the city of Rome met the energy demands of its massive population. We suggest some ways urban labour was linked to Italian forests, creating a sustainable mode of supply that lasted for centuries.
Sobralia fugax (Orchidaceae: Sobraliae)—a new species from Colombia described on the basis of morphological study and phylogenetic analyses
Authors: BARANOW PRZEMYSLAW , DUDEK MAGDALENA
Published: October 2018

A new species of Sobralia from Colombia is described and illustrated. Based on morphological and molecular evidence, it is classified under the type section of the genus. The new species is unique among the other species of the genus by its greenish, fleshy sepals and strongly recurvate ovary that determines the downward orientation of the flowers. Additionally, the sepals and petals are not reflexed, making the flower appearance much more slender and less open than in the other species of the section. As there are no other morphologically similar species within the section, the discussion is based on a comparison of the new taxon against its closest relatives according to our phylogenetic results inferred from ITS and matK regions.
Werneria microphylla (Asteraceae, Senecioneae), a new species from the Andean marshes of Peru
Authors: BELTRAN HAMILTON , LEIVA SEGUNDO
Published: October 2018

Werneria microphylla is described and illustrated as a remarkable new species from the high Andes of Peru. It is compared with the putatively most closely related species W. pygmaea and W. spathulata. The new species is a tiny perennial herb and the smallest species of the genus. It has been collected from Ancash to Puno departments thriving in Andean marshes.
Understanding the Equatorial Pacific Cold Tongue Time-Mean Heat Budget. Part II: Evaluation of the GFDL-FLOR Coupled GCM
Authors: Ray Sulagna , Wittenberg Andrew T. , Griffies Stephen M. , Zeng Fanrong
Published: October 2018

The heat budget of the Pacific equatorial cold tongue (ECT) is explored using the GFDL-FLOR coupled GCM (the forecast-oriented low ocean resolution version of CM2.5) and ocean reanalyses, leveraging the two-layer framework developed in Part I. Despite FLOR’s relatively weak meridional stirring by tropical instability waves (TIWs), the model maintains a reasonable SST and thermocline depth in the ECT via two compensating biases: 1) enhanced monthly-scale vertical advective cooling below the surface mixed layer (SML), due to overly cyclonic off-equatorial wind stress that acts to cool the equatorial source waters; and 2) an excessive SST contrast between the ECT and off-equator areas, which boosts the equatorward heat transport by TIWs. FLOR’s strong advective cooling at the SML base is compensated by strong downward diffusion of heat out of the SML, which then allows FLOR’s ECT to take up a realistic heat flux from the atmosphere. Correcting FLOR’s climatological SST and wind stress biases via flux adjustment (FA) leads to weaker deep advective cooling of the ECT, which then erodes the upper-ocean thermal stratification, enhances vertical mixing, and excessively deepens the thermocline. FA does strengthen FLOR’s meridional shear of the zonal currents in the east Pacific, but this does not amplify either the simulated TIWs or their equatorward heat transport, likely due to FLOR’s coarse zonal ocean resolution. The analysis suggests that to advance coupled simulations of the ECT, improved winds and surface heat fluxes must go hand in hand with improved subseasonal and parameterized ocean processes. Implications for model development and the tropical Pacific observing system are discussed.