bluuebunny/crossref_metadata_2025 huggingface dataset:
A question of size and fear: competition and predation risk perception among frugivores and predators
Authors: Carreira Daiane Cristina , Brodie Jedediah F , Mendes Calebe P , Ferraz Katia Maria P M B , Galetti Mauro
Published: March 2020

Mammalian spatial and temporal activity patterns can vary depending on foraging behavior or the perception of predation or competition risk among species. These behaviors may in turn be altered by human influences such as defaunation. Herein, we evaluate whether frugivores avoid areas with high visitation rates by potential predators or competitors, and whether this avoidance changes in areas with different degrees of defaunation. We installed 189 cameras under fruit trees in six areas of the Atlantic Forest, Brazil, that differ in the abundance of top predators and large frugivores. Small predators and small frugivores were more frequent at night while large frugivores were more frequent during the day, but small frugivores visited and spent less time at fruiting trees on brighter nights, unlike large predators and large frugivores. Small frugivores also were less frequent in areas with high visitation by large frugivores and more frequent in highly defaunated areas. Our results suggest that the dynamics among mammalian functional groups varied according to diel patterns, potential competitors, and defaunation. We highlight the importance of understanding how species interactions are changing in areas exposed to strong human impacts to mitigate the indirect effects of defaunation.
Quantifying the interannual litterfall variations in China’s forest ecosystems
Authors: Jia Bingrui , Sun Hongru , Yu Wenying , Zhou Guangsheng
Published: March 2020

Aims

Litterfall is a key parameter in forest biogeochemical cycle and fire risk prediction. However, considerable uncertainty remains regarding the litterfall variations with forest ages. Quantifying the interannual variation of forest litterfall is crucial for reducing uncertainties in large-scale litterfall prediction.

Methods

Based on the available dataset (N = 318) with continuous multi-year (≥2 years) measurements of litterfall in Chinese planted and secondary forests, coefficient of variation (CV), variation percent (VP), and the ratio of next-year litterfall to current-year litterfall were used as the indexes to quantify the interannual variability in litterfall.

Important Findings

The interannual variations of litterfall showed a declining trend with increasing age from 1 to 90 years. The litterfall variations were the largest in 1–10 years (mean CV = 23.51% and mean VP = −28.59% to 20.89%), which were mainly from tree growth (mean ratio of next-year to current-year = 1.20). In 11–40 years, the interannual variations of litterfall gradually decreased but still varied widely, mean CV was ~18% and mean VP ranged from −17.69% to 21.19%. In 41–90 years, the interannual variations minimized to 8.98% in mean CV and ~8% in mean VP. As a result, forest litterfall remained relatively low and constant when stand age was larger than 40 years. This result was different from the previous assumptions that forest litterfall reached relatively stable when stand age was larger than 30, 20 or even 15 years. Our findings can improve the knowledge about forest litter ecology and provide the groundwork for carbon budget and biogeochemical cycle models at a large scale.
Formation of the polar debris disc around 99 Herculis
Authors: Smallwood Jeremy L , Franchini Alessia , Chen Cheng , Becerril Eric , Lubow Stephen H , Yang Chao-Chin , Martin Rebecca G
Published: March 2020

We investigate the formation mechanism for the observed nearly polar aligned (perpendicular to the binary orbital plane) debris ring around the eccentric orbit binary 99 Herculis. An initially inclined non-polar debris ring or disc will not remain flat and will not evolve to a polar configuration, due to the effects of differential nodal precession that alter its flat structure. However, a gas disc with embedded well coupled solids around the eccentric binary may evolve to a polar configuration as a result of pressure forces that maintain the disc flatness and as a result of viscous dissipation that allows the disc to increase its tilt. Once the gas disc disperses, the debris disc is in a polar aligned state in which there is little precession. We use three-dimensional hydrodynamical simulations, linear theory, and particle dynamics to study the evolution of a misaligned circumbinary gas disc and explore the effects of the initial disc tilt, mass, and size. We find that for a wide range of parameter space, the polar alignment time-scale is shorter than the lifetime of the gas disc. Using the observed level of alignment of 3° from polar, we place an upper limit on the mass of the gas disc of about $0.014 \, \mathrm{M}_\odot$ at the time of gas dispersal. We conclude that the polar debris disc around 99 Her can be explained as the result of an initially moderately inclined gas disc with embedded solids. Such a disc may provide an environment for the formation of polar planets.
Do the solar flares originating from an individual active region follow a random process or a memory-dependent correlation?
Authors: Lei W H , Li C , Chen F , Zhong S J , Xu Z G , Chen P F
Published: March 2020

We investigate the waiting time statistics of solar flares both in a flare-productive active region (AR 12673) of the solar cycle 24 and in a three-dimensional magnetohydrodynamic (MHD) simulated AR. The statistical models of a discrete random process and a continuous memory-dependent process are applied to interpret the waiting time distributions (WTDs) of solar flares. Our results indicate that the occurrence of a solar flare in an individual AR maintains a certain amount of memory, and probably arises from MHD turbulence rather than from intermittent avalanches in a self-organized criticality system. It differs from the occurrence of ‘super flares’ when treating the star/Sun as a single non-linear system.
An ALMA view of SO and SO2 around oxygen-rich AGB stars
Authors: Danilovich T , Richards A M S , Decin L , Van de Sande M , Gottlieb C A
Published: March 2020

We present and analyse SO and SO2, recently observed with high angular resolution and sensitivity in a spectral line survey with ALMA, for two oxygen-rich AGB stars: the low mass-loss rate R Dor and high mass-loss rate IK Tau. We analyse 8 lines of SO detected towards both stars, 78 lines of SO2 detected towards R Dor, and 52 lines of SO2 detected towards IK Tau. We detect several lines of 34SO, 33SO, and 34SO2 towards both stars, and tentatively S18O towards R Dor, and hence derive isotopic ratios for these species. The spatially resolved observations show us that the two sulphur oxides are co-located towards R Dor and trace out the same wind structures in the circumstellar envelope. Much of the emission is well reproduced with a Gaussian abundance distribution spatially centred on the star. Emission from the higher energy levels of SO and SO2 towards R Dor provides evidence in support of a rotating inner region of gas identified in earlier work. The new observations allow us to refine the abundance distribution of SO in IK Tau derived from prior observations with single antennas, and confirm that the distribution is shell like with the peak in the fractional abundance not centred on the star. The confirmation of different types of SO abundance distributions will help fine-tune chemical models and allows for an additional method to discriminate between low and high mass-loss rates for oxygen-rich AGB stars.
Performance analysis of the Karhunen–Loève Transform for artificial and astrophysical transmissions: denoizing and detection
Authors: Trudu Matteo , Pilia Maura , Hellbourg Gregory , Pari Pierpaolo , Antonietti Nicolò , Maccone Claudio , Melis Andrea , Perrodin Delphine , Trois Alessio
Published: March 2020

In this work, we propose a new method of computing the Karhunen–Loève Transform (KLT) applied to complex voltage data for the detection and noise level reduction in astronomical signals. We compared this method with the standard KLT techniques based on the Toeplitz correlation matrix and we conducted a performance analysis for the detection and extraction of astrophysical and artificial signals via Monte Carlo (MC) simulations. We applied our novel method to a real data study-case: the Voyager 1 telemetry signal. We evaluated the KLT performance in an astrophysical context: our technique provides a remarkable improvement in computation time and MC simulations show significant reconstruction results for signal-to-noise ratio (SNR) down to −10 dB and comparable results with standard signal detection techniques. The application to artificial signals, such as the Voyager 1 data, shows a notable gain in SNR after the KLT.
On the early evolution of massive star clusters: the case of cloud D1 and its embedded cluster in NGC 5253
Authors: Silich Sergiy , Tenorio-Tagle Guillermo , Martínez-González Sergio , Turner Jean
Published: March 2020

We discuss a theoretical model for the early evolution of massive star clusters and confront it with the ALMA, radio, and infrared observations of the young stellar cluster highly obscured by the molecular cloud D1 in the nearby dwarf spheroidal galaxy NGC 5253. We show that a large turbulent pressure in the central zones of D1 cluster may cause individual wind-blown bubbles to reach pressure confinement before encountering their neighbours. In this case, stellar winds energy is added to the hot shocked wind pockets of gas around individual massive stars that leads them to meet and produce a cluster wind in time-scales less than 105 yr. In order to inhibit the possibility of cloud dispersal, or the early negative star formation feedback, one should account for mass loading that may come, for example, from pre-main-sequence (PMS) low-mass stars through photoevaporation of their protostellar discs. Mass loading at a rate in excess of 8 × 10−9 M⊙ yr−1 per each PMS star is required to extend the hidden star cluster phase in this particular cluster. In this regime, the parental cloud remains relatively unperturbed, while pockets of molecular, photoionized and hot gas coexist within the star-forming region. Nevertheless, the most likely scenario for cloud D1 and its embedded cluster is that the hot shocked winds around individual massive stars should merge at an age of a few million of years when the PMS star protostellar discs vanish and mass loading ceases that allows a cluster to form a global wind.
H–He collision-induced satellite in the Lyman α profile of DBA white dwarf stars
Authors: Allard Nicole F , Kielkopf John F , Xu Siyi , Guillon Grégoire , Mehnen Bilel , Linguerri Roberto , Al Mogren Muneerah Mogren , Hochlaf Majdi , Hubeny Ivan
Published: March 2020

The spectra of helium-dominated white dwarf stars with hydrogen in their atmosphere present a distinctive broad feature centred around 1160 Å in the blue wing of the Lyman α line. It is extremely apparent in WD 1425+540 recently observed with Hubble Space Telescope(HST) Cosmic Origins Spectrograph (COS). With new theoretical line profiles based on ab initio atomic interaction potentials we show that this feature is a signature of a collision-induced satellite due to an asymptotically forbidden transition. This quasi-molecular spectral satellite is crucial to understanding the asymmetrical shape of Lyman α seen in this and other white dwarf spectra. Our previous work predicting this absorption feature was limited by molecular potentials that were not adequate to follow the atomic interactions with spectroscopic precision to the asymptotic limit of large separation. A new set of potential energy curves and electronic dipole transition moments for the lowest electronic states of the H–He system were developed to account accurately for the behaviour of the atomic interactions at all distances, from the chemical regime within 1 Å out to where the radiating H atoms are not significantly perturbed by their neighbours. We use a general unified theory of collision-broadened atomic spectral lines to describe a rigorous treatment of hydrogen Lyman α with these potentials and present a new study of its broadening by radiative collisions of hydrogen and neutral helium. These results enable ab initio modelling of radiative transport in DBA white dwarf atmospheres.
Agency as a Two-Way Power: A Defence
Authors: Steward Helen
Published: March 2020

This paper presents a dilemma which it has been alleged by Kim Frost must be faced by any defender of the notion of a two-way power and offers a solution to the dilemma which is distinct from Frost’s own. The dilemma is as follows: assuming that powers are to be individuated by what they are powers to do or undergo, then either there is a unified description of the manifestation-type which individuates the power, or there is not. If there is, then two-way powers are revealed really to be one-way powers, after all. If there is not, then it is difficult to explain why the two-way power does not simply dissolve into a mere combination of two one-way powers. The paper offers an account of what a two-way power is that is distinct from the one Frost takes for granted, and argues that this different conception is the key to avoiding the dilemma. It is also argued that this alternative conception has several further advantages over its rival and also that it has no less of a claim than Frost’s notion to be prefigured in Aristotle’s original discussion.
The genomic landscape of 8-oxodG reveals enrichment at specific inherently fragile promoters
Authors: Gorini Francesca , Scala Giovanni , Di Palo Giacomo , Dellino Gaetano Ivan , Cocozza Sergio , Pelicci Pier Giuseppe , Lania Luigi , Majello Barbara , Amente Stefano
Published: March 2020

8-Oxo-7,8-dihydro-2′-deoxyguanosine (8-oxodG) is the most common marker of oxidative stress and its accumulation within the genome has been associated with major human health issues such as cancer, aging, cardiovascular and neurodegenerative diseases. The characterization of the different genomic sites where 8-oxodG accumulates and the mechanisms underlying its formation are still poorly understood. Using OxiDIP-seq, we recently derived the genome-wide distribution of 8-oxodG in human non-tumorigenic epithelial breast cells (MCF10A). Here, we identify a subset of human promoters that accumulate 8-oxodG under steady-state condition. 8-oxodG nucleotides co-localize with double strand breaks (DSBs) at bidirectional and CG skewed promoters and their density correlate with RNA Polymerase II co-occupancy and transcription. Furthermore, by performing OxiDIP-seq in quiescent (G0) cells, we found a strong reduction of oxidatively-generated damage in the majority of 8-oxodG-positive promoters in the absence of DNA replication. Overall, our results suggest that the accumulation of 8-oxodG at gene promoters occurs through DNA replication-dependent or -independent mechanisms, with a possible contribution to the formation of cancer-associated translocation events.
Preferential production of RNA rings by T4 RNA ligase 2 without any splint through rational design of precursor strand
Authors: Chen Hui , Cheng Kai , Liu Xiaoli , An Ran , Komiyama Makoto , Liang Xingguo
Published: March 2020

Rings of single-stranded RNA are promising for many practical applications, but the methods to prepare them in preparative scale have never been established. Previously, RNA circularization was achieved by T4 RNA ligase 2 (Rnl2, a dsRNA ligase) using splints, but the yield was low due to concurrent intermolecular polymerization. Here, various functional RNAs (siRNA, miRNA, ribozyme, etc.) are dominantly converted by Rnl2 to the rings without significant limitations in sizes and sequences. The key is to design a precursor RNA, which is highly activated for the efficient circularization without any splint. First, secondary structure of target RNA ring is simulated by Mfold, and then hypothetically cut at one site so that a few intramolecular base pairs are formed at the terminal. Simply by treating this RNA with Rnl2, the target ring was selectively and efficiently produced. Unexpectedly, circular RNA can be obtained in high yield (>90%), even when only 2 bp form in the 3′-OH side and no full match base pair forms in the 5′-phosphate side. Formation of polymeric by-products was further suppressed by diluting conventional Rnl2 buffer to abnormally low concentrations. Even at high-RNA concentrations (e.g. 50 μM), enormously high selectivity (>95%) was accomplished.
A GoldenBraid cloning system for synthetic biology in social amoebae
Authors: Kundert Peter , Sarrion-Perdigones Alejandro , Gonzalez Yezabel , Katoh-Kurasawa Mariko , Hirose Shigenori , Lehmann Peter , Venken Koen J T , Shaulsky Gad
Published: March 2020

GoldenBraid is a rapid, modular, and robust cloning system used to assemble and combine genetic elements. Dictyostelium amoebae represent an intriguing synthetic biological chassis with tractable applications in development, chemotaxis, bacteria–host interactions, and allorecognition. We present GoldenBraid as a synthetic biological framework for Dictyostelium, including a library of 250 DNA parts and assemblies and a proof-of-concept strain that illustrates cAMP-chemotaxis with four fluorescent reporters coded by one plasmid.
Vadadustat, an oral hypoxia-inducible factor prolyl hydroxylase inhibitor, for treatment of anemia of chronic kidney disease: two randomized Phase 2 trials in Japanese patients
Authors: Nangaku Masaomi , Farag Youssef M K , deGoma Emil , Luo Wenli , Vargo Dennis , Khawaja Zeeshan
Published: March 2020

Background

Vadadustat is an investigational, oral hypoxia-inducible factor prolyl hydroxylase inhibitor in development in Japan for the treatment of chronic kidney disease (CKD)-induced anemia.

Methods

Two Phase 2, multicenter, double-blind, placebo-controlled studies randomized Japanese patients with nondialysis-dependent (NDD, n = 51) or dialysis-dependent (DD, n = 60) CKD-induced anemia to once-daily vadadustat (150, 300 or 600 mg) or placebo. A 6-week, fixed-dose primary efficacy period was followed by a 10-week vadadustat dose adjustment/maintenance period. The primary endpoint was the mean change in hemoglobin (Hb) level from pretreatment to Week 6.

Results

Statistically significant (P < 0.01) dose-dependent increases in mean Hb values were observed at Week 6 in all vadadustat groups versus placebo [placebo and vadadustat 150, 300 and 600 mg: −0.47, 0.43, 1.13 and 1.62 (NDD-CKD) and −1.48, −0.28, 0.08 and 0.41 (DD-CKD), respectively]. By Week 16, 91% (NDD-CKD) and 71% (DD-CKD) of vadadustat-treated participants achieved target Hb levels (10.0–12.0 g/dL) and significant dose-dependent changes in iron utilization and mobilization biomarkers were observed with vadadustat. During the primary efficacy period, the incidence of treatment-emergent adverse events (AEs) with placebo and vadadustat 150, 300 and 600 mg was 36, 33, 58 and 54% (NDD-CKD) and 40, 53, 73 and 40% (DD-CKD), respectively. The most common AEs during the primary efficacy period were nausea and hypertension (NDD-CKD) and diarrhea, nasopharyngitis and shunt stenosis (DD-CKD). Of 23 serious AEs in 18 patients, 1 was deemed related (hepatic function abnormal); no deaths were reported.

Conclusions

The efficacy and safety results from these studies support the development of vadadustat for the treatment of anemia in patients with CKD.
A Group of O-Acetyltransferases Catalyze Xyloglucan Backbone Acetylation and Can Alter Xyloglucan Xylosylation Pattern and Plant Growth When Expressed in Arabidopsis
Authors: Zhong Ruiqin , Cui Dongtao , Phillips Dennis R , Richardson Elizabeth A , Ye Zheng-Hua
Published: March 2020

Xyloglucan is a major hemicellulose in plant cell walls and exists in two distinct types, XXXG and XXGG. While the XXXG-type xyloglucan from dicot species only contains O-acetyl groups on side-chain galactose (Gal) residues, the XXGG-type xyloglucan from Poaceae (grasses) and Solanaceae bears O-acetyl groups on backbone glucosyl (Glc) residues. Although O-acetyltransferases responsible for xyloglucan Gal acetylation have been characterized, the biochemical mechanism underlying xyloglucan backbone acetylation remains to be elucidated. In this study, we showed that recombinant proteins of a group of DUF231 members from rice and tomato were capable of transferring acetyl groups onto O-6 of Glc residues in cello-oligomer acceptors, indicating that they are xyloglucan backbone 6-O-acetyltransferases (XyBATs). We further demonstrated that XyBAT-acetylated cellohexaose oligomers could be readily xylosylated by AtXXT1 (Arabidopsis xyloglucan xylosyltransferase 1) to generate acetylated, xylosylated cello-oligomers, whereas AtXXT1-xylosylated cellohexaose oligomers were much less effectively acetylated by XyBATs. Heterologous expression of a rice XyBAT in Arabidopsis led to a severe reduction in cell expansion and plant growth and a drastic alteration in xyloglucan xylosylation pattern with the formation of acetylated XXGG-type units, including XGG, XGGG, XXGG, XXGG,XXGGG and XXGGG (G denotes acetylated Glc). In addition, recombinant proteins of two Arabidopsis XyBAT homologs also exhibited O-acetyltransferase activity toward cellohexaose, suggesting their possible role in mediating xyloglucan backbone acetylation in vivo. Our findings provide new insights into the biochemical mechanism underlying xyloglucan backbone acetylation and indicate the importance of maintaining the regular xyloglucan xylosylation pattern in cell wall function.
What Constitutes Sufficient Evidence for Case Formulation–Driven CBT for Psychosis? Cumulative Meta-analysis of the Effect on Hallucinations and Delusions
Authors: Turner David T , Burger Simone , Smit Filip , Valmaggia Lucia R , van der Gaag Mark
Published: March 2020

Objective

Following 2 decades of research on cognitive behavioral therapy for psychosis (CBTp), it is relevant to consider at which point the evidence base is considered sufficient. We completed a cumulative meta-analysis to assess the sufficiency and stability of the evidence base for hallucinations and delusions.

Method

We updated the systematic search from our previous meta-analytic review from August 2013 until December 2019. We identified 20 new randomized controlled trials (RCTs) resulting in inclusion of 35 RCTs comparing CBTp with treatment-as-usual (TAU) or active controls (AC). We analyzed data from participants with psychosis (N = 2407) over 75 conventional meta-analytic comparisons. We completed cumulative meta-analyses (including fail-safe ratios) for key comparisons. Publication bias, heterogeneity, and risk of bias were examined.

Results

Cumulative meta-analyses demonstrated sufficiency and stability of evidence for hallucinations and delusions. The fail-safe ratio demonstrated that the evidence base was sufficient in 2016 for hallucinations and 2015 for delusions. In conventional meta-analyses, CBTp was superior for hallucinations (g = 0.34, P < .01) and delusions (g = 0.37, P < .01) when compared with any control. Compared with TAU, CBTp demonstrated superiority for hallucinations (g = 0.34, P < .01) and delusions (g = 0.37, P < .01). Compared with AC, CBT was superior for hallucinations (g = 0.34, P < .01), but not for delusions although this comparison was underpowered. Sensitivity analyses for case formulation, primary outcome focus, and risk of bias demonstrated increases in effect magnitude for hallucinations.

Conclusions

The evidence base for the effect of CBTp on hallucinations and delusions demonstrates sufficiency and stability across comparisons, suggesting limited value of new trials evaluating generic CBTp.
Changing managerial roles in Danish universities
Authors: Hansen Hanne Foss , Lind Jonas Krog , Stage Andreas Kjær
Published: March 2020

The article analyses changes in university managerial roles in the wake of a range of reforms, most notably a radical Danish management reform in 2003, using institutional work as the theoretical framework. Both qualitative and quantitative data is drawn upon, the former consisting of interviews with academics and managers on all levels and the latter in the form of payroll data for all Danish university employees. By combining these data in a mixed methods study, the analysis reveals how managerial roles have changed slowly, steadily, and substantially in the years since the reforms, resulting in extensive change. The article hereby questions the resilience of universities as organisational incarnations of a traditional collegial template.
Transition into Liminal Legality: DACA’s Mixed Impacts on Education and Employment among Young Adult Immigrants in California
Authors: Hamilton Erin R , Patler Caitlin , Savinar Robin
Published: March 2020

The Deferred Action for Childhood Arrivals (DACA) program, implemented by executive order in 2012, granted a subset of undocumented youth temporary relief from deportation, work authorization, and other benefits. While theories of immigrant integration predict that legalization will enable immigrant socioeconomic mobility, past research on DACA’s effects on education and employment have reached mixed conclusions, possibly reflecting the limitations of different methodological approaches to the question. Using multiple data sources and mixed methods, we analyzed both whether and how DACA impacted education and employment among undocumented immigrants in California. Our difference-in-differences analysis of the 2007–2017 waves of the California Health Interview Study employs a more precise definition of the DACA-eligible population than previous studies, yet we also find mixed effects. Our analysis of surveys and in-depth interviews collected with DACA recipients in California provides context for this finding. DACA enabled college for some, but discouraged it for others. DACA recipients perceived substantial occupational mobility, but this was not reflected in movement out of the secondary labor market for many. Our findings suggest that without access to permanent legal status, DACA recipients will experience liminal legality with limited and contingent impacts on socioeconomic integration.
The Interplay Between Emotional Intelligence, Tramadol Dependence, and Comorbid Personality Disorder
Authors: Nagy Abdelhamid Nahla E. , Mohsen Ibrahim Nesreen M. , Hashem Reem E.M. , Marzouk Sarah A.I. , Abd El Moneam Mohamed H.
Published: March 2020

Objectives:

Various studies have proven the presence of disturbances in emotional processing among patients with substance abuse. In the current study, we aimed to examine the relationship between emotional intelligence (EI), tramadol dependence, and comorbid personality disorders.

Methods:

Thirty adult male patients with tramadol dependence and 30 healthy controls were enrolled in the current study. Participants were assessed by the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I diagnosis (SCID-I) and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis-II Personality Disorders (SCID-II). EI was assessed using the Schutte Self-Report Emotional Intelligence Test.

Results:

With respect to the Schutte Self-Report Emotional Intelligence Test score, there was a statistically significant difference between patients with tramadol dependence and the control group in all domains of EI (P<0.001). With respect to the SCID-II, the most common personality disorders reported among patients with tramadol dependence were borderline personality disorder (13, 43.3%), followed by depressive personality disorder (12, 40%) and narcissistic personality disorder (10, 33.3%). There was no statistically significant difference between common personality disorders and all domains of EI.

Conclusion:

The susceptibility to tramadol dependence is most likely to underlie disturbances in EI, suggesting that treatment strategies targeting the management of emotions would reduce this risk.
Isoflurane Sedation in Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation Treatment for Cardiogenic Shock—An Observational Propensity-Matched Study
Authors: Scherer Clemens , Kupka Danny , Stocker Thomas J , Joskowiak Dominik , Scheuplein Hanna , Schönegger Carmen Maria , Born Frank , Stremmel Christopher , Lüsebrink Enzo , Stark Konstantin , Orban Mathias , Petzold Tobias , Peterss Sven , Hausleiter Jörg , Hagl Christian , Massberg Steffen , Orban Martin
Published: March 2020

Objectives:

The feasibility and hemodynamic effects of isoflurane sedation in cardiogenic shock in the presence of venoarterial extracorporeal membrane oxygenation treatment are currently unknown.

Design:

Retrospective single-center study.

Setting:

Cardiac ICU of Munich university hospital.

Patients/Subjects:

Cardiogenic shock patients with venoarterial extracorporeal membrane oxygenation treatment under sedation with volatile isoflurane between November 2018 and October 2019 have been enrolled in this study and were matched by propensity score in a 1:1 ratio with IV sedated patients treated between January 2013 and November 2018 from the cardiogenic shock registry of the university hospital of Munich.

Measurements and Main Results:

Isoflurane sedation was used in 32 patients with cardiogenic shock and venoarterial extracorporeal membrane oxygenation treatment. The mean age of conventionally sedated patients was 58.4 ± 13.8 years and 56.3 ± 11.5 years for patients with isoflurane sedation (p = 0.51). Administration of isoflurane was associated with lower IV sedative drug use during venoarterial extracorporeal membrane oxygenation treatment (86% vs 32%; p = 0.01). Mean systolic arterial pressure was similar (94.3 ± 12.6 vs 92.9 ± 10.5 mm Hg; p = 0.65), but mean heart rate was significantly higher in the conventional sedation group, when compared with the isoflurane group (85.2 ± 20.5 vs 74.7 ± 15.0 beats/min; p = 0.02). Catecholamine doses, venoarterial extracorporeal membrane oxygenation blood and gas flow, ventilation time (304 ± 143 vs 398 ± 272 hr; p = 0.16), bleeding complications bleeding academic research consortium 3a or higher (59.3% vs 65.3%; p = 0.76), and 30-day mortality (59.2% vs 63.4%, p = 0.80) were similar in both groups. The overall sedation costs per patient were significantly lower in the conventional group, when compared with the isoflurane group (537 ± 624 vs 1280 ± 837 €; p < 0.001).

Conclusions:

Volatile sedation with isoflurane is feasible—albeit at higher costs—in patients with cardiogenic shock and venoarterial extracorporeal membrane oxygenation treatment and was not associated with higher catecholamine dosage or extracorporeal membrane oxygenation flow rate compared with IV sedation.
Secretin-Stimulated Magnetic Resonance Imaging Reveals Variable Diagnostic Accuracy According to Etiology in Pancreatic Disease
Authors: Engjom Trond , Tjora Erling , Erchinger Friedemann , Madzak Adnan , Dimcevski Georg , Frøkjær Jens Brøndum , Haldorsen Ingfrid Salvesen
Published: March 2020

Objectives

Secretin-stimulated magnetic resonance imaging (s-MRI) is the best validated radiological modality assessing pancreatic exocrine secretion. In this prospective observational study, we compare the diagnostic accuracy of s-MRI for exocrine pancreatic failure due to different pancreatic diseases and healthy controls.

Methods

We performed s-MRI in 21 cystic fibrosis (CF) patients, 78 patients with chronic pancreatitis (CP) and 20 healthy controls. Exocrine failure was defined by fecal elastase-1 of less than 200 μg/g or bicarbonate concentration from endoscopic secretin test of less than 80 mmol/L.

Results

Eleven CF and 61 CP patients were exocrine insufficient. Insufficient CF patients had lower s-MRI volume output compared with all other groups (P < 0.05). Insufficient CP patients had reduced volume output compared with controls and sufficient CF (P < 0.05). Secretin-stimulated MRI yielded overall accuracy of 0.78 (95% confidence interval [CI], 0.70–0.86) for exocrine failure. When divided according to etiology, the test yielded accuracy of 0.95 (95% CI, 0.90–1) in CF and 0.73 (95% CI, 0.64–0.82) in CP.

Conclusions

The accuracy of s-MRI volume output measures to diagnose exocrine failure was higher in CF than in CP. Differences in s-MRI volume output in patients with exocrine failure may be due to different etiological and pathogenic mechanisms in CF and CP.
Radiographic and Endoscopic Features of Pancreaticoduodenal Malakoplakia
Authors: Hubbard Lauren , Iriana Sentia , Carey Adrienne , Odrobina Robert , Sossenheimer Michael , Rogers Douglas
Published: March 2020

Malakoplakia is a rare, granulomatous disorder that is typically triggered by infections in immunocompromised patients. Although it most commonly affects the urinary tract, cases may occasionally occur in the gastrointestinal tract. There are case reports of malakoplakia of the pancreas with associated pathologic description, but none with detailed imaging and endoscopic findings. In addition, description of magnetic resonance imaging characteristics of mass-forming malakoplakia in the literature is sparse. We present a case of pancreaticoduodenal malakoplakia in an immunocompromised patient, including detailed description of magnetic resonance imaging, computed tomography, and endoscopic findings with radiology-pathology correlation. Classic pathologic features of malakoplakia (eg, hypercellularity, inflammation, and mineralization of Michaelis-Gutmann bodies) lead to specific features on imaging, such as marked diffusion restriction, heterogeneous enhancement, calcification, and increased attenuation on nonenhanced computed tomography. These features may help differentiate malakoplakia from other more common lesions that occur in this location, especially if present in an immunocompromised patient.
Prediction of Pancreatic Cancer Based on Imaging Features in Patients With Duct Abnormalities
Authors: Chen Wansu , Butler Rebecca K. , Zhou Yichen , Parker Rex A. , Jeon Christie Y. , Wu Bechien U.
Published: March 2020

Objectives

Abnormalities of the main pancreatic duct may be an early indicator of pancreatic ductal adenocarcinoma (PDAC). We develop and validate algorithms that predict the risk of PDAC using features identified on cross-sectional imaging and other clinical characteristics collected through electronic medical records.

Methods

Adult patients with abdominal computed tomography or magnetic resonance imaging in January 2006 to June 2016 demonstrating dilatation of main pancreatic duct were identified. Pancreas-related morphologic features were extracted from radiology reports using natural language processing. The cumulative incidence of PDAC with death as a competing risk was estimated using multistate models. Model discrimination was assessed using c-index. The models were internally validated using bootstrapping.

Results

The cohort consisted of 7819 patients (mean age, 71 years; 65% female). A total of 781 patients (10%) developed PDAC within 3 years after the first eligible imaging study. The final models achieved reasonable discrimination (c-index, 0.825–0.833). The 3-year average risk of PDAC in the top 5% of the total eligible patients was 56.0%, more than 20 times of the average risk among the bottom 50% of patients.

Conclusions

Prediction models combining imaging features and clinical measures can be used to further stratify the risk of pancreatic cancer among patients with pancreas ductal dilatation.
Tenascin C in the Tumor-Nerve Microenvironment Enhances Perineural Invasion and Correlates With Locoregional Recurrence in Pancreatic Ductal Adenocarcinoma
Authors: Furuhashi Satoru , Sakaguchi Takanori , Murakami Tomohiro , Fukushima Mayu , Morita Yoshifumi , Ikegami Koji , Kikuchi Hirotoshi , Setou Mitsutoshi , Takeuchi Hiroya
Published: March 2020

Objectives

Perineural invasion is common in pancreatic ductal adenocarcinoma (PDAC) and worsens the postoperative prognosis. Tenascin C (TNC), an extracellular matrix glycoprotein, modulates tumor progression. We evaluated the functional roles of TNC, especially in perineural invasion of PDAC.

Methods

We examined immunohistochemical TNC expression in 78 resected PDAC specimens. The relationships between TNC expression and clinicopathological features were retrospectively analyzed. Interactions between cancer cells and nerves with TNC supplementation were investigated using an in vitro coculture model with PDAC cell line and mouse dorsal root ganglion (DRG).

Results

Tenascin C expression was predominant in perineural sites at the invasive tumor front. High perineural TNC expression in 30 patients (38%) was associated with perineural invasion, pathological T stage ≥3, and postoperative locoregional recurrence. High TNC expression was independently associated with postoperative, poor recurrence-free survival by multivariate analysis. In the in vitro coculture model, a TNC-rich matrix enhanced both PDAC cell colony extensions toward nerves and DRG axonal outgrowth toward cancer cell colonies, whereas TNC did not affect axonal outgrowth or cancer cell proliferation in separately cultured DRG and PDAC cells.

Conclusions

Strong perineural TNC expression indicated poor prognosis with locoregional recurrence. The neurotropism of TNC-induced PDAC suggests that TNC is a potential PDAC therapeutic target.
Streptococcus caledonicus sp. nov., isolated from sheep
Authors: Foster Geoffrey , Kirchner Miranda , Muchowski Jakub , Duggett Nicholas , Randall Luke , Knight Hazel I. , Whatmore Adrian M.
Published: March 2020

Five strains of an unidentified Gram-positive, catalase-negative, chain-forming coccus-shaped organism recovered from sheep in Scotland were characterized using phenotypic and molecular taxonomic methods. Based on morphological and biochemical criteria, the strains were tentatively identified as streptococci but they did not appear to correspond to any recognised species of the genus. Comparative 16S rRNA gene sequencing showed the strains were highly related to each other and confirmed their placement in the genus

Streptococcus

, with a maximum nucleotide identity of around 97 % to extant species. Best matches were with

Streptococcus hillyeri

followed by

Streptococcus porci

. Average nucleotide identity and in silico DNA–DNA hybridization values determined from whole-genome sequence were also consistent with the group representing a novel species. Best matches, again seen to

S. hillyeri

, followed by

S. porci

and

S. plurextorum

, were below accepted cut-off values for species delineation. Based on biochemical criteria and molecular genetic evidence, it is proposed that the unknown isolates from sheep be assigned to a new species of the genus

Streptococcus

as Streptococcus caledonicus sp. nov. The type strain of Streptococcus caledonicus is S784/96/1T=CCUG 73951T=NCTC 14363T.
Phenotypic and molecular characterization of macrolide resistance mechanisms among Streptococcus pneumoniae isolated in Tunisia
Authors: Midouni Ayadi B. , Mehiri E. , Draoui H. , Ghariani A. , Essalah L. , Raoult D. , Fournier P. E. , Slim-Saidi L. N.
Published: March 2020

Introduction.

Streptococcus pneumoniae

is responsible for many community infections, with the main ones being pneumonia and meningitis. Pneumococcus has developed increased resistance to multiple classes of antibiotics. The evolution of antibiotic resistance in pneumococcus was influenced by changes in serotype distribution under vaccine selection pressure.

Aim. The aim of this study was to determine the genes involved in macrolide resistance, the antimicrobial susceptibility, the serotype distribution and the spread of international antibiotic-resistant clones among clinical isolates of

S. pneumoniae

.

Methodology. We investigated 86 erythromycin-resistant

S. pneumoniae

strains isolated from respiratory (n=74) or non-respiratory (n=12) samples in Tunisia. Antimicrobial susceptibility was tested using the disk diffusion method. Macrolide-resistant strains were analysed by polymerase chain reaction (PCR) for ermA, ermB, mefA and msrD. We also investigated the macrolide resistance mechanisms in eight isolates (9.3%) by sequencing the L4 and L22 riboprotein-coding genes, plus relevant segments of the three 23S rRNA genes. Capsular serotypes were detected by multiplex PCR. Sequence types (STs) were explored using multilocus sequence typing (MLST).

Results. Among the 86 studied strains, 70 (81.4 %) were resistant to penicillin G. The prevalent serotypes were 19F, 14, 19A and 23F. We observed that the cMLSB phenotype (66/86, 76.7%) was the most common in these pneumococci. In addition, ermB was the most frequent resistance gene. No mutation in ribosomal protein L22 or L4 or 23S rRNA was detected. Overall, 44 STs were identified in this study, including 16 that were described for the first time. Resistance to lincomycin, tetracycline and trimethoprim/sulfamethoxazole was observed in 55 (64 %), 34 (39.5 %) and 31 (36 %) isolates, respectively. Furthermore, an increase in fluoroquinolone use in particular may lead to the emergence of levofloxacin-resistant strains. Multidrug resistance was observed in 83 isolates (96.5%). Three global antibiotic-resistant clones were identified: Denmark14 ST230, Portugal19F ST177 and Spain9V ST156.

Conclusion. This study shows that macrolide resistance among

S. pneumoniae

isolated in Tunisia is mainly related to target site modification. Our observations demonstrate a high degree of genetic diversity and capsular types among strains resistant to macrolides.
Clinical Characteristics on 25 Discharged Patients with COVID-19 Virus Returning
Authors: Yuan Jing , Kou Shanglong , Liang Yanhua , Zeng JianFeng , Pan Yanchao , Liu Lei
Published: March 2020

Here we report the clinical features of 25 discharged patients with COVID-19 recovery. Our analysis indicated that there was a significant inverse correlation existed between serum D-Dimer level and the duration of antiviral treatment, while lymphocyte concentration significantly positively correlated with the duration of virus reversal.
Clinical outcomes of 402 patients with COVID-2019 from a single center in Wuhan, China
Authors: Wu Yingjie , Guo Wei , Liu Huan , Qi Bei , Liang Ke , Xu Haibo , Peng Zhiyong , Xiao Shu-Yuan
Published: March 2020

The SARS-CoV-2 outbreak is causing widespread infections and significant mortality. Previous studies describing clinical characteristics of the disease contained small cohorts from individual centers or larger series consisting of mixed cases from different hospitals. We report analyses of mortality and disease severity among 402 patients from a single hospital. The cohort included 297 patients with confirmed and 105 with suspected diagnosis. The latter group met the criteria for clinical diagnosis but nucleic acid tests results were initially interpreted as suspicious. Data were compared between genders and among different age groups. The overall case fatality is 5.2%. However, patients 70 years of age or older suffered a significantly higher mortality (17.8%), associated with more patients having severe or critical illness (57.5%). Patients 50 years of age or older had a mortality of 8.0%, and those younger than 50 years, 1.2%. Male patients had a mortality of 7.6% versus 2.9% in females.
Screening of Potential Biomarkers for Gastric Cancer with Diagnostic Value Using Label-free Global Proteome Analysis
Authors: Song Yongxi , Wang Jun , Sun Jingxu , Chen Xiaowan , Shi Jinxin , Wu Zhonghua , Yu Dehao , Zhang Fei , Wang Zhenning
Published: March 2020

Gastric cancer (GC) is one of the most malignant tumors worldwide. Despite the recent decrease in mortality rates, the prognosis remains poor. Therefore, it is necessary to find novel biomarkers with early diagnostic value for GC. In this study, we present a large-scale proteomic analysis of 30 GC tissues and 30 matched healthy tissues using label-free global proteome profiling. Our results identified 537 differentially expressed proteins, including 280 upregulated and 257 downregulated proteins. The ingenuity pathway analysis (IPA) results indicated that the sirtuin signaling pathway was the most activated pathway in GC tissues whereas oxidative phosphorylation was the most inhibited. Moreover, the most activated molecular function was cellular movement, including tissue invasion by tumor cell lines. Based on IPA results, 15 hub proteins were screened. Using the receiver operating characteristic curve, most of hub proteins showed a high diagnostic power in distinguishing between tumors and healthy controls. A four-protein (ATP5B-ATP5O-NDUFB4-NDUFB8) diagnostic signature was built using a random forest model. The area under the curve (AUC) of this model was 0.996 and 0.886 for the training and testing set, respectively, suggesting that the four-protein signature has a high diagnostic power. This signature was further tested with independent datasets using plasma enzyme-linked immune sorbent assays, resulted in an AUC of 0.778 for distinguishing GC tissues from healthy controls, and using immunohistochemical tissue microarray analysis, resulting in an AUC of 0.805. In conclusion, this study identifies potential biomarkers and improves our understanding of the pathogenesis, providing novel therapeutic targets for GC.
Outcomes following short hospital stay after total knee replacement in a regional setting: A prospective analysis of an observational cohort in a public hospital treated 2018 - 2019
Authors: Fatima Manaal , Scholes Corey , Tutty Amanda , Ebrahimi Milad , Genon Michel , Martin Samuel J.
Published: March 2020

Functional outcomes and patient satisfaction following short length of stay (LoS) after total knee arthroplasty (TKA) in the regional context have not been explored. This study aimed to report on complications, functional outcomes and satisfaction of patients discharged from acute (≤2 days) stay, up to 6 weeks after TKA in a regional hospital.

Patients were prospectively recruited from August 2018 to August 2019. Demographic data, intraoperative factors and the incidence of complications and emergency department (ED) presentations were retrieved from hospital records. Preoperative and 6 weeks postoperative assessments collected range of motion (ROM), timed up and go (TUG), 6 minute walk test (6MWT) and total Oxford knee score (OKS), with patient satisfaction assessed at follow-up via a questionnaire. A directed acyclic graph approach was used to perform logistic and linear regression to assess relationships between patient and treatment characteristics with short-term outcomes.

Median LoS for the period was 2 days, influenced by age, gender, bilateral status and body mass index. A shorter LoS was significantly associated with functional outcomes and patient satisfaction, with 74.4% of patients satisfied with their knee and 88.4% satisfied with their LoS. At six weeks, significant improvements in all scores were found, however only the change in OKS exceeded the minimal clinically important difference (MCID) threshold. Patient satisfaction correlated with change in TUG exceeding MCID. Complications at 6 weeks post surgery were affected by Aboriginal and Torres Strait Islander status, marriage status, smoking history, history of chronic pain and mental health conditions, and the number of ED presentations was associated with preoperative TUG and comorbidities.

The findings establish that short LoS after TKA in a regional hospital is associated with good outcomes and a high patient satisfaction, but patient factors and comorbidities associated with an increased risk of complications and ED presentations should be considered for postoperative management and patient care.