bluuebunny/crossref_metadata_2025 huggingface dataset:
Radioactive ruthenium leak traced to Russia
Authors: Cartlidge Edwin
Published: October 2019

The 2017 Europe-wide outbreak of ruthenium-106 may have been caused by an explosion at the Mayak reprocessing plant in southern Russia during the creation of a neutrino source for an experiment in Italy. Edwin Cartlidge investigates
Glimpsing Chernobyl's hidden hotspots
Authors: Martin Peter , Scott Tom
Published: October 2019

More than three decades after the world’s worst nuclear disaster at Chernobyl, Peter Martin and Tom Scott visit the exclusion zone surrounding the plant to map radiation levels using new drone-based technology
The universe under a dome
Authors: Cockbill Louisa
Published: October 2019

I have always found it difficult to get my head around the infinite complexity of our universe. Yet somehow I’m a school science presenter, with the task of teasing out the inexpressible and unknown details of science into a tangible reality for children.
Aerogel insulator could make Mars cosier for humans
Authors: Dumé Belle
Published: October 2019

Most suggestions for making Mars more hospitable for future astronauts involve changing the whole of the red planet – and would probably take centuries to enact.
Disquiet over $3m supergravity prize
Authors: Banks Michael
Published: October 2019

The decision to award a $3m Special Breakthrough Prize to three pioneers of the theory of “supergravity” has polarized opinion in the physics community, as Michael Banks reports
Femtosecond laser additive and subtractive micro-processing: enabling a high-channel-density silica interposer for multicore fibre to silicon-photonic packaging
Authors: Djogo Gligor , Li Jianzhao , Ho Stephen , Haque Moez , Ertorer Erden , Liu Jun , Song Xiaolu , Suo Jing , Herman Peter R
Published: October 2019

Great strides have been made over the past decade to establish femtosecond lasers in advanced manufacturing systems for enabling new forms of non-contact processing of transparent materials. Research advances have shown that a myriad of additive and subtractive techniques is now possible for flexible 2D and 3D structuring of such materials with micro- and nano-scale precision. In this paper, these techniques have been refined and scaled up to demonstrate the potential for 3D writing of high-density optical packaging components, specifically addressing the major bottleneck for efficiently connecting optical fibres to silicon photonic (SiP) processors for use in telecom and data centres. An 84-channel fused silica interposer was introduced for high-density edge coupling of multicore fibres (MCFs) to a SiP chip. Femtosecond laser irradiation followed by chemical etching was further harnessed to open alignment sockets, permitting rapid assembly with precise locking of MCF positions for efficient coupling to laser written optical waveguides in the interposer. A 3D waveguide fanout design provided an attractive balancing of low losses, mode-matching, high channel density, compact footprint, and low crosstalk. The 3D additive and subtractive processes thus demonstrated the potential for higher scale integration and rapid photonic assembly and packaging of micro-optic components for telecom interconnects, with possible broader applications in integrated biophotonic chips or micro-displays.
Strategies to improve equity in faculty hiring
Authors: Bhalla Needhi
Published: October 2019

Through targeted recruitment and interventions to support their success during training, the fraction of trainees (graduate students and postdoctoral fellows) in academic science from historically underrepresented groups has steadily increased. However, this trend has not translated to a concomitant increase in the number of faculty from these underrepresented groups. Here, I focus on proven strategies that departments and research institutions can develop to increase equity in faculty hiring and promotion to address the lack of racial and gender diversity among their faculty.
A high-quality genome assembly from a single, field-collected spotted lanternfly (Lycorma delicatula) using the PacBio Sequel II system
Authors: Kingan Sarah B , Urban Julie , Lambert Christine C , Baybayan Primo , Childers Anna K , Coates Brad , Scheffler Brian , Hackett Kevin , Korlach Jonas , Geib Scott M
Published: October 2019

Background

A high-quality reference genome is an essential tool for applied and basic research on arthropods. Long-read sequencing technologies may be used to generate more complete and contiguous genome assemblies than alternate technologies; however, long-read methods have historically had greater input DNA requirements and higher costs than next-generation sequencing, which are barriers to their use on many samples. Here, we present a 2.3 Gb de novo genome assembly of a field-collected adult female spotted lanternfly (Lycorma delicatula) using a single Pacific Biosciences SMRT Cell. The spotted lanternfly is an invasive species recently discovered in the northeastern United States that threatens to damage economically important crop plants in the region.

Results

The DNA from 1 individual was used to make 1 standard, size-selected library with an average DNA fragment size of ~20 kb. The library was run on 1 Sequel II SMRT Cell 8M, generating a total of 132 Gb of long-read sequences, of which 82 Gb were from unique library molecules, representing ~36× coverage of the genome. The assembly had high contiguity (contig N50 length = 1.5 Mb), completeness, and sequence level accuracy as estimated by conserved gene set analysis (96.8% of conserved genes both complete and without frame shift errors). Furthermore, it was possible to segregate more than half of the diploid genome into the 2 separate haplotypes. The assembly also recovered 2 microbial symbiont genomes known to be associated with L. delicatula, each microbial genome being assembled into a single contig.

Conclusions

We demonstrate that field-collected arthropods can be used for the rapid generation of high-quality genome assemblies, an attractive approach for projects on emerging invasive species, disease vectors, or conservation efforts of endangered species.
Polysomnographic features differentiating disorder of arousals from sleep-related hypermotor epilepsy
Authors: Proserpio Paola , Loddo Giuseppe , Zubler Frederic , Ferini-Strambi Luigi , Licchetta Laura , Bisulli Francesca , Tinuper Paolo , Agostoni Elio Clemente , Bassetti Claudio , Tassi Laura , Menghi Veronica , Provini Federica , Nobili Lino
Published: October 2019

Objective

The differential diagnosis between sleep-related hypermotor epilepsy (SHE) and disorders of arousal (DOA) may be challenging. We analyzed the stage and the relative time of occurrence of parasomnic and epileptic events to test their potential diagnostic accuracy as criteria to discriminate SHE from DOA.

Methods

Video-polysomnography recordings of 89 patients with a definite diagnosis of DOA (59) or SHE (30) were reviewed to define major or minor events and to analyze their stage and relative time of occurrence. The “event distribution index” was defined on the basis of the occurrence of events during the first versus the second part of sleep period time. A group analysis was performed between DOA and SHE patients to identify candidate predictors and to quantify their discriminative performance.

Results

The total number of motor events (i.e. major and minor) was significantly lower in DOA (3.2 ± 2.4) than in SHE patients (6.9 ± 8.3; p = 0.03). Episodes occurred mostly during N3 and N2 in DOA and SHE patients, respectively. The occurrence of at least one major event outside N3 was highly suggestive for SHE (p = 2*e-13; accuracy = 0.898, sensitivity = 0.793, specificity = 0.949). The occurrence of at least one minor event during N3 was highly suggestive for DOA (p = 4*e-5; accuracy = 0.73, sensitivity = 0.733, specificity = 0.723). The “event distribution index” was statistically higher in DOA for total (p = 0.012) and major events (p = 0.0026).

Conclusion

The stage and the relative time of occurrence of minor and major motor manifestations represent useful criteria to discriminate DOA from SHE episodes.
Comparing internet-delivered cognitive therapy and behavior therapy with telephone support for insomnia disorder: a randomized controlled trial
Authors: Sunnhed Rikard , Hesser Hugo , Andersson Gerhard , Carlbring Per , Morin Charles M , Harvey Allison G , Jansson-Fröjmark Markus
Published: October 2019

Study Objectives

Our aim was to compare the effects of Internet-delivered cognitive therapy (CT) and behavior therapy (BT) against a waitlist (WL) condition to better understand their unique contribution in the treatment of insomnia.

Methods

Two hundred and nineteen participants with insomnia disorder were randomized to CT (n = 72), BT (n = 73), or WL (n = 74). The treatment arms consisted of 10 weekly internet-delivered modules with 15 min of telephone support per week. At pre, post, and follow-up, participants completed measures of insomnia severity, sleep diaries, functional impairment, anxiety, depression, quality of life, adverse events, satisfaction and perception of content, workload, and activity in treatment. Measures of completed exercises, modules, therapist support, and platform logins were also measured at posttreatment.

Results

Moderate to large effect sizes for both CT and BT outperformed the WL on the majority of outcomes, with significant differences in favor of both therapy groups. Both treatment groups had significantly larger proportion of treatment remitters (CT: 35.8%, BT: 40%, WL: 2.7%) and responders (CT: 74.6%, BT 58.6%, WL: 10.8%) compared to the WL at posttreatment. There were no significant differences between the two therapy groups in terms of outcomes, except for sleep onset latency in favor of BT (6 min difference at posttreatment) and adverse events in favor of CT (CT 14.1% vs BT 43.2%).

Conclusions

This study indicates that both Internet-delivered CT and BT are effective as stand-alone therapies for insomnia disorder. Results highlight the need for examining which therapy and subcomponents that are necessary for change.

ClinicalTrials.gov Identifier

NCT02984670
Biological effects of verbascoside and its anti-inflammatory activity on oral mucositis: a review of the literature
Authors: Nigro Olga , Tuzi Alessandro , Tartaro Tiziana , Giaquinto Alice , Vallini Ilaria , Pinotti Graziella
Published: October 2019

Oral mucositis is among the most common tissue toxicities associated with both cytotoxic cancer regimens and head and neck radiotherapy. Current management of oral mucositis might comprise growth factors and cytokines, anti-inflammatory agents, anesthetics, analgesics, antimicrobial and coating agents, cryotherapy and mucosal protectants. Despite its long history and its impact on patients, there are currently no effective options for the prevention or treatment of mucositis. In recent years, more attention has been focused on the role of natural drugs. Verbascoside belongs to the phenylpropanoid glycosides family. Several biological properties have been described, such as anti-inflammatory, antimicrobial, antitumor and antioxidant. Verbascoside, particularly when in solution with polyvinylpyrrolidone and sodium hyaluronate, thanks to barrier effect, is useful in re-epithelialization and in reducing pain, oral mucositis score, burning and erythema.
Preoperative Diaphragm Function Is Associated With Postoperative Pulmonary Complications After Cardiac Surgery
Authors: Cavayas Yiorgos Alexandros , Eljaiek Roberto , Rodrigue Élise , Lamarche Yoan , Girard Martin , Wang Han Ting , Levesque Sylvie , Denault André Y.
Published: October 2019

Objectives:

Postoperative pulmonary complications increase mortality, length, and cost of hospitalization. A better diaphragmatic strength may help face an increased work of breathing postoperatively. We, therefore, sought to determine if a low preoperative diaphragm thickening fraction (TFdi) determined by ultrasonography helped predict the occurrence of postoperative pulmonary complications after cardiac surgery independently of indicators of frailty, sarcopenia, and pulmonary function.

Design:

Prospective observational cohort study.

Setting:

Montreal Heart Institute, an academic cardiac surgery center in Canada.

Patients:

Adults undergoing nonemergency cardiac surgery.

Interventions:

We measured the preoperative thickness of the right and left hemidiaphragms at their zone of apposition at end-expiration (Tdi,ee) and peak-inspiration (Tdi,ei) with ultrasonography. Maximal thickening fraction of the diaphragm during inspiration (TFdi,max) was calculated using the following formula: TFdi,max = (Tdi,ei–Tdi,ee)/Tdi,ee. We also evaluated other potential risk factors including demographic parameters, comorbidities, Clinical Frailty Scale, grip strength, 5-meter walk test, and pulmonary function tests. We repeated TFdi,max measurements within 24 hours of extubation. The primary composite outcome of this study was the occurrence of postoperative pulmonary complications, defined as pneumonia, clinically significant atelectasis, or prolonged mechanical ventilation (> 24 hr).

Measurement and Main Results:

Of the 115 patients included, 34 (29.6%) developed postoperative pulmonary complications, including two with pneumonia, four with prolonged mechanical ventilation, and 32 with clinically significant atelectasis. Those with postoperative pulmonary complications had prolonged ICU and hospital length of stays. They had a lower TFdi,max (37% [interquartile range, 31–45%] vs 44% [interquartile range, 33–58%]; p = 0.03). In multiple logistic regression, a TFdi,max less than 38.1% was associated with postoperative pulmonary complications (odds ratio, 4.9; 95% CI, 1.81–13.50; p = 0.002). All patients who developed pneumonia or prolonged mechanical ventilation had a TFdi,max less than 38.1%. Respiratory rate and diabetes were also independently associated with postoperative pulmonary complications, while pulmonary function tests and the assessed indicators of frailty and sarcopenia were not.

Conclusions:

A low preoperative TFdi,max can help to identify patients at increased risk of postoperative pulmonary complications after cardiac surgery.
Reducing the Second Victim Phenomenon
Authors: Whittle Shanda N. , Horton-Deutsch Sara
Published: October 2019

The second victim phenomenon is one in which nurses and other health care providers use dysfunctional mechanisms, such as anger, projection of blame, or drugs and/or alcohol, to cope with serious mistakes in the absence of a healthier means for healing. The main purpose of this article is to provide evidence and practices that support the need for caring organizational support systems following serious adverse clinical events. Recommendations are provided on key elements of programs to prevent the prevalence, symptoms, and impact of the second victim phenomenon on our health care professionals, our patients, and our health care system.
Homocysteine is an independent predictor of long-term cardiac mortality in patients with stable coronary artery disease in the era of statins
Authors: Rallidis Loukianos S. , Kosmas Nikolaos , Rallidi Taxiarchoula , Pavlakis Georgios , Kiouri Estela , Zolindaki Maria
Published: October 2019

Background

Homocysteine (Hcy) is considered a risk factor for cardiovascular disease.

Objective

To explore the long-term prognostic value of Hcy in patients with stable coronary artery disease (CAD) in the era of statins.

Methods

A total of 876 consecutive patients with stable CAD were recruited and followed up for a median of 6.1 years. Lipids and Hcy levels were measured at baseline. Primary endpoints were cardiac death and secondary endpoints were hospitalizations for acute coronary syndrome, myocardial revascularization, arrhythmic event or ischemic stroke.

Results

Follow-up data were obtained from 842 patients of whom 70 had a cardiac death (8.3%), while 258 (30.6%) met the secondary endpoints. Seven hundred four patients (83.6%) were on statins. In univariate Cox regression analysis Hcy predicted the occurrence of cardiac death [hazard ratio: 1.030; 95% confidence interval (CI): 1.018–1.042, P < 0.001] but not the occurrence of secondary endpoints (hazard ratio: 1.010; 95% CI: 0.999–1.020, P = 0.081). Hcy remained an independent predictor of cardiac death after adjustment for conventional risk factors, ejection fraction and statin use (hazard ratio: 1.030; 95% CI: 1.017–1.044, P < 0.001). Patients in the highest tertile of Hcy levels (>14.1 μmol/L) had three times higher risk of cardiac death compared with patients in the lowest tertile (<10.3 μmol/L) (hazard ratio = 3.036, CI: 1.983–4.649, P < 0.001).

Conclusion

Hcy is an independent predictor of cardiac death in patients with stable CAD in the era of statins.
Implementation and Evaluation of Wright’s Competency Model
Authors: Durkin Gregory J.
Published: October 2019

Wright’s competency model is increasingly used by healthcare organizations around the globe. This article describes the implementation of Wright’s model over a 4-year period. Creation of a steering group and decentralization of the effort were keys to success in achieving over 98% participation across all nursing areas and six other healthcare professions. Clinical and leadership staff were surveyed pre- and postimplementation on 11 measures. All levels of staff reported positive improvement in each measure.
Building a Renowned Clinical Nurse Specialist Team
Authors: Fischer-Cartlidge Erica , Houlihan Nancy , Browne Kevin
Published: October 2019

Purpose:

This article will describe the outcomes associated with restructuring clinical nurse specialists (CNSs) into a centralized model with dedicated efforts focused on team and individual development.

Methods:

A multiphase journey was undertaken to rebuild a team of CNSs after years of open vacancies and role confusion. After restructuring to a centralized model, a multiphase approach was taken that included innovative recruitment strategies, development of a talent pipeline through enhancement of student clinical placements, team and individual development activities, and value identification. Description of methods used for individual and team development is discussed in depth within this article, including achieving role standardization and optimization.

Outcomes:

Numerous outcomes were associated with this effort and are described within this article. Among them were the hiring of 21 CNSs, increased representation on hospital-wide committees and councils, quantification of the work contribution of CNSs within the organization, and a $1 568 229.36 cost avoidance associated with CNS work efforts, all in the first 24 months.

Conclusion:

As challenges facing the role put it at risk and healthcare becomes increasingly value based, the need for expert clinicians who can demonstrate their value becomes essential. Clinical nurse specialists and hospital leadership can benefit from exploring successful interventions to rebuild CNS teams to achieve these goals.
Use of an Indeterminate Range in HIV Early Infant Diagnosis: A Systematic Review and Meta-Analysis
Authors: Luo Robert , Boeras Debi , Broyles Laura N. , Fong Youyi , Hsiao Nei-Yuan , Kiyaga Charles , Mazanderani Ahmad Haeri , Myer Landon , Shapiro Roger , Sherman Gayle , Penazzato Martina , Doherty Meg , Vojnov Lara
Published: October 2019

Background:

Expanded access to HIV antiretrovirals has dramatically reduced mother-to-child transmission of HIV. However, there is increasing concern around false-positive HIV test results in perinatally HIV-exposed infants but few insights into the use of indeterminate range to improve infant HIV diagnosis.

Methods:

A systematic review and meta-analysis was conducted to evaluate the use of an indeterminate range for HIV early infant diagnosis. Published and unpublished studies from 2000 to 2018 were included. Study quality was evaluated using GRADE and QUADAS-2 criteria. A random-effects model compared various indeterminate ranges for identifying true and false positives.

Results:

The review identified 32 studies with data from over 1.3 million infants across 14 countries published from 2000 to 2018. Indeterminate results accounted for 16.5% of initial non-negative test results, and 76% of indeterminate results were negative on repeat testing. Most results were from Roche tests. In the random-effects model, an indeterminate range using a polymerase chain reaction cycle threshold value of ≥33 captured over 93% of false positives while classifying fewer than 9% of true positives as indeterminate.

Conclusions:

Without the use of an indeterminate range, over 10% of infants could be incorrectly diagnosed as HIV positive if their initial test results are not confirmed. Use of an indeterminate range appears to lead to substantial improvements in the accuracy of early infant diagnosis testing and supports current recommendations to confirm all initial positive tests.
Thoracic Radiologists’ Versus Computer Scientists’ Perspectives on the Future of Artificial Intelligence in Radiology
Authors: Eltorai Adam E.M. , Bratt Alexander K. , Guo Haiwei H.
Published: October 2019

Background:

There is intense interest and speculation in the application of artificial intelligence (AI) to radiology. The goals of this investigation were (1) to assess thoracic radiologists’ perspectives on the role and expected impact of AI in radiology, and (2) to compare radiologists’ perspectives with those of computer science (CS) experts working in the AI development.

Methods:

An online survey was developed and distributed to chest radiologists and CS experts at leading academic centers and societies, comparing their expectations of AI’s influence on radiologists’ jobs, job satisfaction, salary, and role in society.

Results:

A total of 95 radiologists and 45 computer scientists responded. Computer scientists reported having read more scientific journal articles on AI/machine learning in the past year than radiologists (mean [95% confidence interval]=17.1 [9.01-25.2] vs. 7.3 [4.7-9.9], P=0.0047). The impact of AI in radiology is expected to be high, with 57.8% and 73.3% of computer scientists and 31.6% and 61.1% of chest radiologists predicting radiologists’ job will be dramatically different in 5 to 10 years, and 10 to 20 years, respectively. Although very few practitioners in both fields expect radiologists to become obsolete, with 0% expecting radiologist obsolescence in 5 years, in the long run, significantly more computer scientists (15.6%) predict radiologist obsolescence in 10 to 20 years, as compared with 3.2% of radiologists reporting the same (P=0.0128). Overall, both chest radiologists and computer scientists are optimistic about the future of AI in radiology, with large majorities expecting radiologists’ job satisfaction to increase or stay the same (89.5% of radiologists vs. 86.7% of CS experts, P=0.7767), radiologists’ salaries to increase or stay the same (83.2% of radiologists vs. 73.4% of CS experts, P=0.1827), and the role of radiologists in society to improve or stay the same (88.4% vs. 86.7%, P=0.7857).

Conclusions:

Thoracic radiologists and CS experts are generally positive on the impact of AI in radiology. However, a larger percentage, but still small minority, of computer scientists predict radiologist obsolescence in 10 to 20 years. As the future of AI in radiology unfolds, this study presents a historical timestamp of which group of experts’ perceptions were closer to eventual reality.
Cranial Fossa Volume in Differing Subtypes of Apert Syndrome
Authors: Lu Xiaona , Forte Antonio Jorge , Wilson Alexander , Alperovich Michael , Steinbacher Derek M. , Alonso Nivaldo , Persing John A.
Published: October 2019

Background:

Based on an established classification system of Apert syndrome subtypes, detailed regional morphology and volume analysis may be useful to provide additional clarification to individual Apert cranial structure characteristics, and treatment planning.

Methods:

Computed tomography scans of 32 unoperated Apert syndrome and 50 controls were included and subgrouped as: type I, bilateral coronal synostosis; type II, pansynostosis; type III, perpendicular combination synostosis. Three-dimensional analysis of craniometric points was used to define structural components using Materialise Mimics and 3-Matics software.

Results:

Occipitofrontal circumference of all subtypes of Apert syndrome patients is normal. Intracranial volumes of types I and II were normal, but type III was 20% greater than controls. Middle cranial fossa volume was increased in all 3 types, with the greatest increase in type II (86%). Type II developed a 69% increase in anterior cranial fossa volume, whereas type III had 39% greater posterior cranial fossa volume. Increased cranial fossa depth contributed most to above increased volume. The anteroposterior lengths of middle and posterior cranial fossae were reduced in type I (15% and 17%, respectively). However, only the anterior cranial fossa was significantly shortened in type III.

Conclusions:

Occipitofrontal circumference and overall intracranial volume is not always consistent in individual subunits of Apert syndrome. Detailed and segmental anterior, middle, and posterior cranial fossae volumes and morphology should be analyzed to see what impact this may have related to surgical planning.
Is Three-Dimensional Virtual Planning in Cranial Reconstruction for Advanced Cutaneous Squamous Cell Carcinoma of the Skull a Feasible Option?
Authors: van de Vijfeijken Sophie E.C.M. , Slot Mariam , Strackee Simon , Becking Alfred G. , de Lange Jan , Smeele Ludi E. , Schreuder Willem H.
Published: October 2019

Background:

Cutaneous squamous cell carcinoma (cSCC) is a common type of malignant skin disorder. An uncommon feature is local bony invasion, as can rarely be seen in lesions on the scalp. The optimal treatment strategy in these rare cases is still under debate.

Objective:

The aim of this case report is to present a 1-stage three-dimensional planned surgical resection and reconstruction of a cSCC with bony invasion into the scalp and to discuss the alternative options and potential pitfalls.

Materials and methods:

A patient diagnosed with rT4N0M0 cSCC of the scalp underwent a cranial resection and reconstruction in 1 stage. With the use of computer-assisted design and computer-assisted manufacturing a patient-specific implant (PSI) of poly (ether ether ketone) was manufactured. After the PSI was inserted, it was covered with a latissimus dorsi muscle and a split-thickness skin graft.

Results:

Intraoperatively the resection template generated an accurate resection and accurate and fast placement of the PSI. The reconstruction had a clinical satisfactory esthetic result, but was hampered by the development of a small wound dehiscence was observed over the postoperative course.

Conclusion:

Three-dimensional planned resection and reconstruction for composite defects of the skull after resection of a cSCC of the scalp with bony invasion may lead to an accurate and predictable resection and accurate and fast placement of the PSI. However, patient specific characteristics should be considered to assess potential risks and benefits before opting for this one-stage treatment strategy.
The Impact of Ethnicity on Craniosynostosis in the United States
Authors: Sacks Gina N. , Skolnick Gary B. , Trachtenberg Ali , Naidoo Sybill D. , Lopez Joseph , Oh Albert K. , Chao Jerry W. , Dorafshar Amir , Vercler Christian J. , Buchman Steven R. , Patel Kamlesh
Published: October 2019

While many studies have examined potential risk factors for nonsyndromic craniosynostosis, there have been no publications to date investigating the role of ethnicity in the United States. The current study was undertaken as the first multi-center investigation to examine the relationship between ethnicity and nonsyndromic craniosynostosis, looking at both overall prevalence as well as potential correlation between ethnicity and pattern of affected suture site. A chart review of patients diagnosed with nonsyndromic craniosynostosis treated at four major children's hospitals was performed to obtain ethnicity data. Analysis was preformed based on ethnic group as well as suture site affected. To account for potential

One regional selection bias, the KID database (1997–2012) was utilized to identify all cases of craniosynostosis on a national level. This data was analyzed against birth rates by ethnicity obtained from CDC WONDER natality database.

Amongst the 2112 cases of nonsyndromic craniosynostosis at all institutions, Caucasians and African Americans were consistently the predominant ethnic groups. There was a statistically significant difference in the distribution of affected suture type with African Americans more likely to present with unicoronal synostosis and Caucasians more likely to present with metopic synostosis (P = 0.005). The national data revealed that there were more cases of craniosynostosis in Caucasians and fewer in African Americans than expected when compared to population birth rates. Our findings demonstrate that the Caucasian race is associated with increased rates of synostosis.
Posttransplant Calcineurin Inhibitors Levels and Intrapatient Variability Are Not Associated With Long-term Outcomes Following Liver Transplantation
Authors: Di Maira Tommaso , Sapisochin Gonzalo , Lilly Les , Fonés Victoria , Berenguer Marina
Published: October 2019

Background.

There is an interest in understanding the association between early calcineurin inhibitors exposure post-liver transplantation (LT) and long-term outcomes. We aimed to analyze this association exploring median calcineurin inhibitor levels and intrapatient variability (IPV) in a multicenter, retrospective cohort.

Methods.

Tacrolimus (Tac) and Cyclosporine (CsA) levels obtained during the first 15 days post-LT were collected. High immunosuppression (IS) was considered as a median of Tac, CsA blood trough levels 12 hours after drug administration, or blood levels 2 hours after drug administration higher than 10, 250, or 1200 ng/mL, respectively, or a peak of Tac >20 ng/mL. Optimal IS was defined as a median of Tac, CsA blood trough levels 12 hours after drug administration, or blood levels 2 hours after drug administration levels between 7 and 10, 150 and 250, or 800 and 1200 ng/mL. Low IS was defined as below the thresholds of optimal IS. IPV was estimated during the first 15 days post-LT.

Results.

The study included 432 patients with a median follow-up of 8.65 years. IS regimen was based on either Tac or CsA in 243 (56.3%) and 189 (43.8%), respectively. There were no differences in terms of graft loss among low versus optimal and high IS groups (P = 0.812 and P = 0.451) nor in high versus low IPV (P = 0.835). Only viral hepatitis and arterial hypertension were independently associated with higher graft loss (hazard ratio = 1.729, P = 0.029 and hazard ratio = 1.570, P = 0.021).

Conclusions.

In contrast to what has previously been reported, no association was found between very early postoperative over IS or high IPV and long-term outcome measures following LT. Strategies aimed at reducing these long-term events should likely focus on other factors or on a different IS time window.
Tumor treating fields for glioblastoma: should it or will it ever be adopted?
Authors: Thomas Alissa A. , Rauschkolb Paula K.
Published: October 2019

Purpose of review

The purpose of this review is to discuss how a new treatment modality, tumor treating fields, may be incorporated into the oncologic care for patients with glioblastoma.

Recent findings

Tumor treating fields are a new treatment modality available to patients with newly diagnosed and recurrent glioblastoma. Alternating electric fields are delivered via a wearable, removable device affixed to the scalp of patients with supratentorial glioblastoma. With continuous use, the application of tumor treating fields combined with temozolomide chemotherapy has been shown to improve overall survival compared with temozolomide alone in patients with newly diagnosed glioblastoma. Adverse events attributable to the device are limited to localized skin reactions. Despite compendium guidelines in support of its use and Food and Drug Administration (FDA) approval, tumor treating fields have been slow to be adopted in the neuro-oncology community. Critics have raised concerns about the generalizability of the study data, patient quality of life, and mechanism of action of this therapy.

Tumor treating fields are available for the treatment of both newly diagnosed and recurrent glioblastoma and represent a new category of treatment modalities in oncologic therapy. This novel device has received FDA approval but has been slow to be adopted into clinical practice.
Enhanced Depth Imaging Optical Coherence Tomography of Optic Nerve Head Drusen in Children
Authors: Sim Peng Yong , Soomro Hibba , Karampelas Michael , Barampouti Faye
Published: October 2019

Background:

To assess the utility of enhanced depth imaging optical coherence tomography (EDI-OCT), compared with other conventional imaging modalities, for detecting and characterizing optic nerve head drusen (ONHD) in children.

Methods:

We report a retrospective cross-sectional case series of consecutive pediatric patients (age ≤16 years) with ONHD confirmed using B-scan ultrasonography. All eyes were evaluated using spectral-domain OCT of the optic nerve head in conventional (non-EDI) and EDI modes, fundus autofluorescence (FAF), and standard automated perimetry. Detection rates and the capacity to characterize ONHD were compared between EDI-OCT, non–EDI-OCT, and FAF.

Results:

Twenty-eight eyes of 15 patients (mean age 11 years; 60% female) were identified with definite ONHD that were confirmed by B-scan ultrasound. Among the technologies, EDI-OCT, non–EDI-OCT, FAF, and automated perimetry had findings consistent with ONHD in 24, 21, 18, and 4 eyes, respectively. EDI-OCT had a significantly better detection capability (86% of eyes) compared with FAF (P = 0.04) but not with non–EDI-OCT (P = 0.15). Similar to results previously reported in adult patients, EDI-OCT detected ONHD at different levels of depth; most were located anterior to the lamina cribrosa. ONHD detected by EDI-OCT appeared as hypo‐reflective ovoid regions bordered by hyper-reflective material or as isolated hyper-reflective bands without a hypo-reflective core. The mean greatest diameter of ONHD seen on EDI-OCT was 449.7 (SD ±114.1) μm.

Conclusions:

EDI-OCT detects ONHD in most eyes identified as having drusen on B-scan ultrasonography. This technique has the potential to be an effective alternative first-line diagnostic and monitoring tool for ONHD, particularly for detecting buried drusen in children.
Bioinspired aerofoil adaptations: the next steps for theoretical models
Authors: Ayton Lorna J.
Published: October 2019

The extended introduction in this paper reviews the theoretical modelling of leading- and trailing-edge noise, various bioinspired aerofoil adaptations to both the leading and trailing edges of blades, and how these adaptations aid in the reduction of aerofoil–turbulence interaction noise. Attention is given to the agreement between current theoretical predictions and experimental measurements, in particular, for turbulent interactions at the trailing edge of an aerofoil. Where there is a poor agreement between theoretical models and experimental data the features neglected from the theoretical models are discussed. Notably, it is known that theoretical predictions for porous trailing-edge adaptations do not agree well with experimental measurements. Previous works propose the reason for this: theoretical models do not account for surface roughness due to the porous material and thus omit a key noise source. The remainder of this paper, therefore, presents an analytical model, based upon the acoustic analogy, to predict the far-field noise due to a rough surface at the trailing edge of an aerofoil. Unlike previous roughness noise models which focus on roughness over an infinite wall, the model presented here includes diffraction by a sharp edge. The new results are seen to be in better agreement with experimental data than previous models which neglect diffraction by an edge. This new model could then be used to improve theoretical predictions for far-field noise generated by turbulent interactions with a (rough) porous trailing edge.

This article is part of the theme issue ‘Frontiers of aeroacoustics research: theory, computation and experiment’.
Sound from aeroelastic vortex–fibre interactions
Authors: Jaworski J. W.
Published: October 2019

The motion of a line vortex moving past a one-dimensional flexible fibre is examined theoretically. A Schwarz–Christoffel conformal mapping enables the analytical solution of the potential flow field and its hydrodynamic moment on the flexible fibre, which is composed of a rigid segment constrained to angular motions on a wedge. The hydroelastic coupling of the vortex path and fibre motion affects the noise signature, which is evaluated for the special case of acoustically compact fibres embedded in a half plane. Results from this analysis attempt to address how the coupled interactions between vortical sources and flexible barbules on the upper surface of owl wings may contribute to their acoustic stealth. The analytical formulation is also amenable to application to vortex sound prediction from flexible trailing edges provided that an appropriate acoustic Green's function can be determined.

This article is part of the theme issue ‘Frontiers of aeroacoustics research: theory, computation and experiment’.
SALTClass: classifying clinical short notes using background knowledge from unlabeled data
Authors: Bagheri Ayoub , Oberski Daniel , Sammani Arjan , van der Heijden Peter G.M. , Asselbergs Folkert W.
Published: October 2019

Background

With the increasing use of unstructured text in electronic health records, extracting useful related information has become a necessity. Text classification can be applied to extract patients’ medical history from clinical notes. However, the sparsity in clinical short notes, that is, excessively small word counts in the text, can lead to large classification errors. Previous studies demonstrated that natural language processing (NLP) can be useful in the text classification of clinical outcomes. We propose incorporating the knowledge from unlabeled data, as this may alleviate the problem of short noisy sparse text.

Results

The software package SALTClass (short and long text classifier) is a machine learning NLP toolkit. It uses seven clustering algorithms, namely, latent Dirichlet allocation, K-Means, MiniBatchK-Means, BIRCH, MeanShift, DBScan, and GMM. Smoothing methods are applied to the resulting cluster information to enrich the representation of sparse text. For the subsequent prediction step, SALTClass can be used on either the original document-term matrix or in an enrichment pipeline. To this end, ten different supervised classifiers have also been integrated into SALTClass. We demonstrate the effectiveness of the SALTClass NLP toolkit in the identification of patients’ family history in a Dutch clinical cardiovascular text corpus from University Medical Center Utrecht, the Netherlands.

Conclusions

The considerable amount of unstructured short text in healthcare applications, particularly in clinical cardiovascular notes, has created an urgent need for tools that can parse specific information from text reports. Using machine learning algorithms for enriching short text can improve the representation for further applications.

Availability

SALTClass can be downloaded as a Python package from Python Package Index (PyPI) website athttps://pypi.org/project/saltclassand from GitHub athttps://github.com/bagheria/saltclass.
Highly efficient direct conversion of human monocytes into neuronal cells using a small molecule combination
Authors: Ninomiya Itaru , Kanazawa Masato , Koyama Akihide , Hatakeyama Masahiro , Onodera Osamu
Published: October 2019

Previous studies reported that human fibroblasts and astrocytes were successfully converted into neuronal cells by small molecules without introducing ectopic transgenes. Induced neuronal cells—reprogrammed directly from dermal fibroblasts or brain astrocytes—were obtained from some donors; however, the clinical applications of this approach would be limited because it requires an invasive biopsy to harvest enough cells for derivation. Here, we report that adult human peripheral blood monocytes may be directly converted into neuron-like cells using only a combination of small molecules without transgene integration. This method enables neuronal cell generation from TUJ1-positive cells after 3 days of induction (at over 80% conversion efficacy). These cells presented neuronal morphologies and markers, suggesting that terminally differentiated human cells may be efficiently transdifferentiated into a distantly related lineage. Overall, our study provides a strategy to develop neuronal cells directly from human adult peripheral blood monocytes using a generate transgene-free, chemical-only approach.
Deconstructing the structural conservation of distantly related bacterial nucleoid-associated proteins using functional chimeras
Authors: Lourenço Rogério F. , Saurabh Saumya , Herrmann Jonathan , Wakatsuki Soichi , Shapiro Lucy
Published: October 2019

Nucleoid-associated proteins (NAPs) are DNA-binding proteins critical for the organization and function of the bacterial chromosome. A subclass of NAPs, includingCaulobacter crescentusGapR andEscherichia coliH-NS, preferentially bind AT-rich regions of the nucleoid, but phylogenetic groups that encode GapR rarely encode H-NS. Here, utilizing genetic, biochemical, and biophysical studies of GapR in light of a recent DNA-bound crystal structure of GapR (Guo et al, 2018), we show that although evolutionarily distant, GapR and H-NS possess two regions that are structurally and functionally conserved. These regions are involved in self-association and DNA-binding, even though the two proteins oligomerize and regulate transcription differently. Functional analysis of GapR and H-NS protein chimeras identified structural elements present in H-NS but absent in GapR that rationalize differences in transcriptional regulation. In addition, we identified a sequence element unique to GapR that enables assembly into its tetrameric state. Using fluid-atomic force microscopy, we showed that GapR is capable of bridging DNA moleculesin vitro. Together, these results demonstrate that two distantly related NAPs utilize evolutionarily conserved structural elements to serve specialized cellular roles via distinct mechanisms.
Globalizing community festivals: the case of the community festival in Wanwei, Guangxi, China
Authors: Nguyen Cham
Published: October 2019

Purpose

The purpose of this paper is to concern the community festival of a Jing minority village in the China–Vietnam border area. Since it was designated as a national-level Intangible Cultural Heritage in 2006, the festival has undergone many changes. The festival has steadily expanded and evolved, assuming characteristics of globalization. How is the globalized character of the Wanwei festival manifested? What are the forces behind the elevation of this local festival onto the register of national events and how did it turn into an event organized by the township?

Design/methodology/approach

The paper is based on the results of the author’s research on the culture of Kinh people in Wanwei from 2000 to the present. From the anthropological approach, the author mainly uses method of participant observation and in-depth interviews. The author has observed the Wanwei communal festival from 2000 to the present, interviewing about 40 villagers in Wanwei in depth, they can be leaders, intellectuals, civil servants, officials or working people.

Findings

The paper is a case study of the new aspect of globalization of a village festival. The author argues that globalization can lead to a spread of global flows but in this process of globalization, villagers also want to define the local identity, they reinvent the tradition, rewrite history, create new nuances for the gods with many different purposes. Practicing the current Wanwei village festival is a vivid example of globalization from below and the politics of tradition.

Originality/value

The paper adds a theoretical dimension to current globalization research. The paper also points out the political, economic and social dynamics that govern the transformation of a village festival in particular and the village culture in general in the border areas. The paper is a testament to the dynamism and flexibility of villagers when participating in the current globalization process.
Analyzing the impact of corporate social responsibility on corporate financial performance: evidence from top Indian firms
Authors: Sekhon Amritjot Kaur , Kathuria Lalit Mohan
Published: October 2019

Purpose

Despite continuous research efforts, the literature is still inconclusive about the relationship between corporate social responsibility (CSR) and financial performance. With an aim to address this problem, this study aims to analyze the impact of CSR on financial performance in the Indian context.

Design/methodology/approach

Using a panel of top 137 companies from CNX-500 for 10 years (2008-2017), the impact of CSR on three indicators of financial performance, namely, Return on Assets (ROA), Return on Equity (ROE) and Net Profit Margin (NPM), is evaluated using the panel data regression analysis. The technique of content analysis is used to collect data on CSR from the annual reports of selected companies.

Findings

The study finds that the impact of CSR on financial performance may be neutral (with ROA and NPM) or negative (with ROE). The negative influence of CSR on ROE of firms supports the theory by Friedman (1970) that the only responsibility of business is to maximize profits and returns for its shareholders.

Originality/value

After amendments in Companies Act, 2013, there is limited literature addressing this scientific inquiry in the Indian context. The study period (2008-2017) includes CSR disclosures from both periods, before reforms and after reforms, which adds to the uniqueness of this research study. In addition, this study uses a research instrument consisting of a total of 178 CSR activities divided across 46 themes for collecting data from annual reports of the companies. The utilization of such a comprehensive research instrument, for the study, also adds to its peculiarity.