bluuebunny/crossref_metadata_2025 huggingface dataset:
Determinants of diagnostic discordance for non‐diabetic hyperglycaemia and Type 2 diabetes using paired glycated haemoglobin measurements in a large English primary care population: cross‐sectional study
Authors: Bachmann M. O. , Lewis G. , John W. G. , Turner J. , Dhatariya K. , Clark A. , Pascale M. , Sampson M. ,   Norfolk Diabetes Prevention Study
Published: August 2019

Aim

To investigate factors influencing diagnostic discordance for non‐diabetic hyperglycaemia and Type 2 diabetes.

Methods

Some 10 000 adults at increased risk of diabetes were screened with HbA1c and fasting plasma glucose (FPG). The 2208 participants with initial HbA1c ≥ 42 mmol/mol (≥ 6.0%) or FPG ≥ 6.1 mmol/l were retested after a median 40 days. We compared the first and second HbA1c results, and consequent diagnoses of non‐diabetic hyperglycaemia and Type 2 diabetes, and investigated predictors of discordant diagnoses.

Results

Of 1463 participants with non‐diabetic hyperglycaemia and 394 with Type 2 diabetes on first testing, 28.4% and 21.1% respectively had discordant diagnoses on repeated testing. Initial diagnosis of non‐diabetic hyperglycaemia and/or impaired fasting glucose according to both HbA1c and FPG criteria, or to FPG only, made reclassification as Type 2 diabetes more likely than initial classification according to HbA1c alone. Initial diagnosis of Type 2 diabetes according to both HbA1c and FPG criteria made reclassification much less likely than initial classification according to HbA1c alone. Age, and anthropometric and biological measurements independently but inconsistently predicted discordant diagnoses and changes in HbA1c.

Conclusions

Diagnosis of non‐diabetic hyperglycaemia or Type 2 diabetes with a single measurement of HbA1c in a screening programme for entry to diabetes prevention trials is unreliable. Diagnosis of non‐diabetic hyperglycaemia and Type 2 diabetes should be confirmed by repeat testing. FPG results could help prioritise retesting. These findings do not apply to people classified as normal on a single test, who were not retested.
Pythagorean self‐awareness intervention: A novel cognitive stress management technique for body weight control
Authors: Simos Dimitrios S. , Kokkinos Alexandros , Tentolouris Nikolaos , Dimosthenopoulos Charilaos , Mantzou Emily , Artemiadis Artemios , Bacopoulou Flora , Nicolaides Nicolas C. , Kosta Ourania , Chrousos George P. , Darviri Christina
Published: August 2019

Background

Over the past decades, the prevalence of obesity has markedly increased worldwide. Stress is recognized as a substantial contributor to increased body weight; therefore, stress management interventions, especially cognitive behavioural, are becoming increasingly popular. The impact of stress management on stress‐ and obesity‐related biomarkers (eg blood lipid profile, HBA1c, inflammatory biomarkers, such as CRP) has been scarcely studied. The aim of this study was to assess the effect of a novel cognitive behavioural stress management intervention, called ‘Pythagorean Self‐Awareness Intervention’ (PSAI), in overweight/obese adults.

Materials and methods

This was a two‐armed 1:1 randomized, nonblind controlled study including overweight/obese individuals. The control group followed a personalized Mediterranean low‐calorie diet, and the intervention group followed the same diet in addition to the PSAI intervention for 8 weeks. Measurements included demographic, anthropometric (ie BMI, waist‐to‐hip ratio), stress (ie perceived stress, salivary cortisol), dietary behaviour (ie emotional eating) and metabolic parameters (ie blood lipid profile, HBA1c, CRP, body composition in fat and water). Outcome per‐protocol analysis was performed using mixed linear models adjusted for age and gender.

Results

A total of 49 of 62 eligible adults were analysed in the study (there were three dropouts in the intervention group and 10 dropouts in the control group); 28 were assigned to the intervention group (mean age 54.7 ± 11.9 years) and 21 to the control group (mean age 51.8 ± 11.9 years). The intervention group showed a statistically significant decrease in perceived stress, cortisol concentrations 30 minutes after awakening, cortisol's area under the curve, BMI, waist‐to‐hip ratio, restrained, emotional and external eating behaviour, fasting glucose, LDL, triglycerides, HbA1c and body and trunk fat, compared with the control group. Based on the observed effect sizes, clinically meaningful changes may be more evident in stress perception, restrained and external eating behaviour, Hb1ac and trunk fat. The compliance to the PSAI intervention reached 100%, and there were no adverse effects.

Conclusions

The PSAI technique may be an effective stress management method for overweight/obese adults. Future and larger randomized controlled studies are needed to allow generalization of these findings.
Spatio‐temporal scaling of biodiversity in acoustic tropical bird communities
Authors: de Camargo Ulisses , Roslin Tomas , Ovaskainen Otso
Published: August 2019

Automated analysis of acoustic communities is a rapidly emerging approach for the characterization and monitoring of biodiversity. To evaluate its utility, we should verify that such ‘bioacoustics’ can accurately detect ecological signal in spatiotemporal acoustic data. Targeting the ‘Biological Dynamics of Forest Fragments Project’ sites in Brazil, we ask: What is the relative contribution of the spatial, temporal and habitat dimension to variation in bird acoustic communities in a previously fragmented tropical rainforest? Does the functional diversity of bird communities scale similarly to space and time as does species diversity, when both are recorded by bioacoustics means? Overall, is the imprint of landscape fragmentation 30 years ago still audible in the present‐day soundscape? We sampled forty‐four sites in secondary forest and 107 sites in old‐growth forest, resulting in 11 000 h of audio recordings. We detected 60 bird species with satisfactory precision and recovered a linear log–log relation between sampling time and species diversity. Sites in primary forest host more species than sites in secondary forest, but the difference decreased with sampling time, as the slope was slightly higher in secondary than primary forests. Functional diversity, as exposed by vocalizing birds, accumulates faster than does species diversity. The similarity among local communities decreases with distance in both time and space, but stability in time is remarkably high: two acoustic samples from the same site one year (or more) apart prove more similar than two samples taken at the same time but from sites situated just a few hundred meters apart. These findings suggest that habitat modification can be heard as a long‐lasting imprint on the soundscape of regenerating habitats and identify soundscape–area and soundscape–time relations as a promising tool for biodiversity research, applied biomonitoring and restoration ecology.
Single‐cell RNA‐Seq characterization of anatomically identified OLM interneurons in different transgenic mouse lines
Authors: Winterer Jochen , Lukacsovich David , Que Lin , Sartori Andrea M. , Luo Wenshu , Földy Csaba
Published: August 2019

Inhibitory GABAergic interneurons create different brain activity patterns that correlate with behavioural states. In this characterizing study, we used single‐cell RNA‐Seq to analyse anatomically‐ and electrophysiologically identified hippocampal oriens‐lacunosum moleculare (OLM) interneurons. OLMs express somatostatin (Sst), generate feedback inhibition and play important roles in theta oscillations and fear encoding. Although an anatomically‐ and biophysically homogenous population, OLMs presumably comprise of two functionally distinct types with different developmental origins, inferred from the expression pattern of serotonin type‐3a (5‐HT3a, or Htr3a) receptor subunit and 5‐HT excitability in a set of OLMs. To broadly characterize OLM cells, we used the Sst‐Cre and the BAC transgenic Htr3a‐Cre mouse lines and separately analysed SstCre‐OLM and Htr3aCre‐OLM types. We found a surprisingly consistent expression of Npy in OLMs, which was previously not associated with the identity of this type. Our analyses furthermore revealed uniform expression of developmental origin‐related genes, including transcription factors and neurexin isoforms, without providing support for the current view that OLMs may originate from multiple neurogenic zones. Together, we found that OLMs constitute a highly homogenous transcriptomic population. Finally, our results revealed surprisingly infrequent expression of Htr3a in only ~10% of OLMs and an apparently specific expression of the 5‐HT3b subunit‐coding gene Htr3b in Htr3aCre‐OLMs, but not in SstCre‐OLMs. However, additional in situ hybridization experiments suggested that the differential expression of Htr3b may represent an unexpected consequence arising from the design of the Htr3a‐Cre BAC transgenic line.
Do security breaches matter? The shareholder puzzle
Authors: Michel Allen , Oded Jacob , Shaked Israel
Published: August 2019

This article analyzes the effect of computer breaches on publicly traded equities from 2005 to 2017. An event study is performed and breaches analyzed conditioned on whether the breach announcement has been made in the mainstream media or through other channels. We find that in the period prior to the announcement date in the media, the mean abnormal return is negative, reflecting a likely leakage of information. In the period following the announcement date, the mean abnormal return is positive, often more than offsetting the previous declines. The findings have important implications for analysts, portfolio managers, institutional investors, and regulators.
Biochemical and biophysical comparison of human and mouse beta‐2 microglobulin reveals the molecular determinants of low amyloid propensity
Authors: Achour Adnane , Broggini Luca , Han Xiao , Sun Renhua , Santambrogio Carlo , Buratto Jeremie , Visentin Cristina , Barbiroli Alberto , De Luca Chiara Maria Giulia , Sormanni Pietro , Moda Fabio , De Simone Alfonso , Sandalova Tatyana , Grandori Rita , Camilloni Carlo , Ricagno Stefano
Published: August 2019

The molecular bases of amyloid aggregation propensity are still poorly understood, especially for proteins that display a stable folded native structure. A prototypic example is human beta‐2 microglobulin (β2m), which, when accumulated in patients, gives rise to dialysis‐related amyloidosis. Interestingly, although the physiologic concentration of β2m in mice is five times higher than that found in human patients, no amyloid deposits are observed in mice. Moreover, murine β2m (mβ2m) not only displays a lower amyloid propensity both in vivo and in vitro but also inhibits the aggregation of human β2m in vitro. Here, we compared human and mβ2m for their aggregation propensity, ability to form soluble oligomers, stability, three‐dimensional structure and dynamics. Our results indicate that mβ2m low‐aggregation propensity is due to two concomitant aspects: the low‐aggregation propensity of its primary sequence combined with the absence of high‐energy amyloid‐competent conformations under native conditions. The identification of the specific properties determining the low‐aggregation propensity of mouse β2m will help delineate the molecular risk factors which cause a folded protein to aggregate.
A case for a functional linguistic knowledge base in world language teacher education
Authors: Troyan Francis J. , Sembiante Sabrina F. , King Nicole
Published: August 2019

This article contributes to broader discussions of the knowledge base for language teacher education; the standards and policies that inform world language teacher education; and the need for a systematic, principled, and robust theory of language to underpin contexualized world language teaching and learning. Specifically, it proposes that the foundation for world language teacher education be broadened and that the linguistics component of the ACTFL/CAEP Program Standards for the Preparation of Foreign Language Teachers be more clearly defined. The argument is supported using data from a longitudinal ethnographic case study that depicts a candidate's appropriation of systemic functional linguistics (SFL) first as a world language teacher candidate and then as a novice teacher in his first year of teaching. Findings depict the candidate's learning and flexible use of SFL and the associated genre pedagogy to contextualize language use for his students across multiple levels of instruction. Given its alignment with contemporary goals as stated in the World‐Readiness Standards for Learning Languages, instructional approaches, and assessment paradigms, SFL seems to hold great potential as a contextualized and unifying theoretical foundation for world language teacher education.
The mode of action of Fruitless: Is it an easy matter to switch the sex?
Authors: Sato Kosei , Yamamoto Daisuke
Published: August 2019

The fruitless (fru) locus was originally defined by a male sterile mutation that promotes male‐to‐male courtship while suppressing male‐to‐female courtship in Drosophila melanogaster. The fru promoter‐1 pre‐RNA generates a set of BTB‐zinc finger family FruM proteins expressed exclusively in the male neurons, leading to the formation of sexual dimorphisms in neurons via male‐specific neuroblast proliferation, male‐specific neural survival, male‐specific neuritegenesis or male‐specific arbor patterning. Such a wide spectrum of phenotypic effects seems to result from chromatin modifications, in which FruBM recruits Bonus, Histone deacetylase 1 (HDAC1) and/or Heterochromatin protein 1a (HP1a) to ~130 target sites. One established FruBM transcriptional target is the axon guidance protein gene robo1. Multiple transcriptional regulator‐binding sites are nested around the FruBM‐binding site, and mediate sophisticated modulation of the repressor activity of FruBM. FruBM also binds to the Lola‐Q transcriptional repressor to protect it from proteasome‐dependent degradation in male but not female neurons as FruBM exists only in male neurons, leading to the formation of sexually dimorphic neural structures. These findings shed light on the multilayered network of transcription regulation orchestrated by the master regulator FruBM.
Examination of non‐shrinkage firing using low‐temperature co‐fired alumina containing a small quantity of Cu–Ti–Nb–Ag–O additive
Authors: Shigeno Koichi , Tezuka Mana
Published: August 2019

In this study, we examined non‐shrinkage firing in the planar direction using low‐temperature co‐fired alumina (LTCA) containing a small quantity of Cu–Ti–Nb–Ag–O additive. A good restraint effect was obtained using AL‐43‐L alumina as a constraint layer whose particle diameter was several times larger (1 to 2 μm) than that of alumina in the LTCA material TM‐5D (0.2 μm). The x‐y shrinkage ratio of the non‐shrinkage fired sample using AL‐43‐L as the constraint layer was within 2 %. However, the density of the non‐shrinkage fired sample was much lower than that of the normal shrinkage fired sample. By producing a powder using a freeze‐dry method, we obtained a well‐sintered alumina with a relative density of approximately 95 % at 950°C, which is lower than the melting point of silver. That is, we achieved both suppression of the shrinkage rate in the x‐y direction and ensured sinterability below the melting point of silver. The thermal conductivity of the sample was 16.2 W/mK, which is extremely high for low‐temperature co‐fired ceramics materials.
Adsorption of Pb and Cd in rice husk and their immobilization in porous glass‐ceramic structures
Authors: Sharifikolouei Elham , Baino Francesco , Galletti Camilla , Fino Debora , Ferraris Monica
Published: August 2019

Rice husk, an agricultural waste, is abundantly available in many countries such as China, India, Brazil, US, and South East Asia. Despite the massive production of rice husk, it is mainly disposed to landfill. In this work, utilization of rice husk for a potential waste‐water treatment is evaluated, along with subsequent encapsulation of the adsorbed heavy metals (Pb and Cd) inside a porous glass‐ceramic.

Vitrified bottom ash (another source of waste) was mixed with foaming agents in dif‐ ferent weight ratios (40:60, 50:50, and 60:40) to prepare a glass matrix for encapsulation of Pb‐/Cd‐loaded rice husk. It was shown that using 40 wt% vitrified bottom ash with 60 wt% foaming agents leads to a foam glass with the best pore size distribution. Therefore, this batch was further mixed with 70 volume% (5 wt%) heavy metal‐loaded rice husk and was heat‐treated at 750°C for 3 hours. The final glass‐ceramic porous structure was char acterized using SEM, XRD, compression test, and it was shown that it is safe to be used as it passes the EN12457‐2 leaching test.
Biocompatibility of borosilicate glass‐ceramics based LTCC materials for microfluidic biosensor application
Authors: Liang Yongyuan , Ma Mingsheng , Qian Suxiang , Zhuang Hui , Li Kunqiang , Liu Zhifu , Li Yongxiang
Published: August 2019

Three kinds of borosilicate glass‐ceramics Low temperature co‐fired ceramics (LTCC) substrate materials, Ca‐B‐Si‐O (CBS), Ca‐Al‐B‐Si‐O (CABS), and Ca‐Mg‐B‐Si‐O (CMBS), have been prepared, and the biocompatibility of these materials was evaluated. Compared with CBS and CMBS samples, the CABS sample presented the lowest crystallinity and dissolution in the bioleaching experiments. The direct and indirect cell culturing results showed that the CABS sample also possessed the best biocompatibility to the bone mesenchymal stem cells (BMSCs) due to its good bio‐stability and surface micro‐pore structure. The effects of surface topography and released ions on cytocompatibility were analyzed. These results were expected to offer some guideline information for developing LTCC substrate materials used in the microfluidic biosensors for the future biological and medical application.
Numerical studies on SiO2 generation in swirling turbulent non‐premixed flames using SiCl4 as the precursor
Authors: Huang Yaosong
Published: August 2019

Silica nanoparticles have been widely applied in many fields due to their excellent properties. SiO2 generation is crucial for silica particle formation, but in a swirling reactor the SiO2 generation is still unclear. In this study, numerical simulations are performed to investigate the SiO2 generation and distributions of temperature and velocity during silica particle synthesis using a swirling reactor. A computational model is first developed to describe the heat and mass transport in the swirling turbulent flame. Simulation models are validated with experimental data in the case without SiO2 chemistry. Then, effects of the fuel velocity and swirl number on SiO2 generation are investigated. Results show that most of the SiO2 molecules are generated in the region far away from reactor inlets and a relatively high SiO2 generation efficiency is obtained for a fuel velocity of 32.7 m/second. Distributions of the flame temperature, velocity and SiO2 concentration are found to vary with the swirl number and high chemical reaction rates for SiO2 generation are obtained when a swirl number of 0.5 is employed. Uncertainty analysis shows that the average relative errors of the results from different models are within 18%.
The hypercoagulable state in multiple myeloma: The contribution of thrombin generation test
Authors: Baccouche Hela , Hadhri Meriam , Aissi Wafa , Chakroun Aya , Bahri Dhouha , Mahjoub Sonia , Ben Romdhane Neila
Published: August 2019

Background

Multiple myeloma is a hematologic malignancy which confers a high venous thromboembolic risk. This risk is linked to patient‐related factors, disease‐specific mechanisms, and antimyeloma therapy, especially immunomodulatory drugs. Some studies have suggested that the thrombin generation assay may be a predictive marker of thrombosis. This study aimed to assess the hypercoagulable state in patients with multiple myeloma at diagnosis and after myeloma therapy.

Methods

Thirty‐one patients with multiple myeloma were included in a prospective study and were compared with 31 matched controls with age and gender. Thrombin generation assay was performed in patients at diagnosis prior to treatment initiation and at the end of myeloma therapy, and in controls. Parameters of lag time, peak thrombin concentration, time to peak, endogenous thrombin potential, and velocity index were analyzed.

Results

Median age of patients at diagnosis was 58 years (11 men and 20 women). Twenty‐three patients (74%) were classified as high vascular risk and received thromboprophylaxis. No thromboembolic events have been reported during follow‐up, except a symptomatic pulmonary embolism in one patient which occurred at diagnosis. At baseline, patients with myeloma had significantly elevated velocity index as compared to controls (178 vs 128 nmol/L/min; P = .013). High‐risk patients showed an elevation of plasma thrombin generation as compared to low‐risk patients (endogenous thrombin potential = 1244 vs 1052 nmol/L/min; P = .043). Myeloma therapy did not significantly change the thrombin generation parameters.

Conclusion

Thrombin generation appears to be higher in patients with myeloma compared with controls, especially in high‐risk patients, and does not change significantly after treatment completion.
A comparative study on in vitro behavior of calcium silicate ceramics synthesized from biowaste resources
Authors: Palakurthy Srinath , Azeem P. Abdul , Venugopal Reddy K. , Penugurti Vasudevarao , Manavathi Bramanandam
Published: August 2019

Calcium silicate ceramics have received significant attention for biomedical applications for their excellent bioactivity and osteoconduction properties. Sol‐gel process is extensively used for the fabrication of calcium silicates. In sol‐gel process, calcium nitrate tetra hydrate (Ca(NO3)2·4H2O) and tetraethylorthosilicate (TEOS) are used as precursors. However, these precursors are expensive. The objective of this work was to compare in vitro behavior of calcium silicate (CaSiO3) produced using biowaste such as rice husk ash (RHA) and eggshells (coded; NCS) with CaSiO3 prepared using TEOS and Ca(NO3)2·4H2O (coded; CCS). Thermal investigation results revealed that the crystallization temperature for NCS is relatively lower (772°C) than for CCS (870°C). Bioactivity was studied in vitro using simulated body fluid (SBF) with respect to mineralization rate of hydroxyapatite. Mineralization of a greater hydroxyapatite was observed on NCS ceramics than CCS ceramics after incubation for 3, 7, 14 days in SBF solution, which was confirmed using X‐ray diffractometer, Fourier transform infrared spectroscopy, scanning electron microscopy‐energy dispersive spectroscopy. Degradation studies were conducted in Tris‐HCl solution and the test results revealed that NCS ceramics has lower dissolution rate than CCS ceramics. The antimicrobial assay has shown that NCS samples exhibit significant zone of inhibition against Escherichia coli and Staphylococcus aureus which confirmed that the CaSiO3 prepared from RHA and eggshell can prevent bacteria from adhering to the surface. In addition cell culture studies revealed that NCS ceramics possess good cytocompatibility with MG‐63 cells and significantly promoted cell proliferation.
Solvothermal synthesis of columnar Gd2O2S:Eu3+ and a comparative study with columnar Gd2O3:Eu3+
Authors: Qian Benfu , Wang Di , Wang Hongyang , Zou Haifeng , Song Yanhua , Zhou Xiuqing , Sheng Ye
Published: August 2019

Columnar Gd2O2S:Eu3+ nanophosphors have been synthesized through solvothermal reaction and subsequent calcination process. The structure, morphology, and luminescence properties of samples were investigated via X‐ray diffraction (XRD), Fourier transform infra‐red (FT‐IR) spectra, UV‐vis absorption spectra, field emission scanning electron microscope (FE‐SEM), and photoluminescence (PL) spectra. The Judd‐Ofelt (J‐O) parameters of Gd2O2S:Eu3+ nanophosphors with different doping concentration were calculated by emission spectra to understand the symmetry, coordination environment, and luminescence behavior of Eu3+ ions in Gd2O2S matrix. In addition, the luminescence properties of columnar Gd2O2S:Eu3+ and Gd2O3:Eu3+ were compared in detail. The comparison results show that there are subtle differences in luminescence intensity, main peak position, luminescence color, and fluorescence lifetime between them, which are closely related to their different substrate's structure, including the band‐gap energy, crystallinity, and symmetry, etc.
Relational Poetic Encounters: Opening Spaces at Tate Liverpool
Authors: Georges Darlene St.
Published: August 2019

This article explores poetic inquiry through a creation‐research framework as a method of exploring issues surrounding identity and subjective relationality. As a Métis visual artist, poet and educator, the author explores knowledge and meaning based in ontological experience and Indigenous understandings of the subjective inward journey and its role in our relational interconnectedness. The implications of the connection between the inward and outward paradigms of experience, knowledge and knowing creates a space to value and honour our unique understanding of the world. Through a found poetry activity designed and implemented in the gallery space at the Tate Exchange, Liverpool, the author delves into a reflective analysis of the potential of understanding the Other within us and the Other in front of us through critical creative praxis in a generative public context.
Implicit Bias, (Global) White Ignorance, and Bad Faith: The Problem of Whiteness and Anti‐black Racism
Authors: Beckles‐Raymond Gabriella
Published: August 2019

In Britain, policy‐makers tend to view racism as a social attitude rather than an institutional/structural phenomenon. Not until the publication of the MacPherson Report (1999) was the idea of ‘institutional racism’ officially recognised. According to Jules Holroyd, implicit bias as a concept can help us understand and combat the kind of unwitting prejudice the Macpherson report describes. This article explores whether implicit bias is indeed a viable framework for understanding institutional/structural racism. To do so, I bring together Charles Mills’ notion of ‘global white ignorance’ and Lewis Gordon's interpretation of ‘bad faith’. Through Mills’ and Gordon's analyses, which together illuminate both the structural and psychic dimensions of racism I offer an account of the psychodynamics of racism far more consistent with our observations of how racism actually operates in Britain. Specifically, we see that institutional/structural racism is neither unconscious nor is it unmotivated as implicit bias would suggest. As such, I reject implicit bias as a useful or necessary explanatory framework for helping us understand institutional racism as a structural phenomenon.
Electrocardiographic changes in loperamide toxicity: Case report and review of literature
Authors: Teigeler Todd , Stahura Heather , Alimohammad Rizwan , Kalahasty Gautham , Koneru Jayanthi N. , Ellenbogen Michael , Ellenbogen Kenneth A. , Padala Santosh K.
Published: August 2019

Introduction

Loperamide, an antidiarrheal agent, is a µ‐opioid receptor agonist increasingly abused to prevent opioid withdrawal or to produce euphoric effects. At supra‐therapeutic doses, loperamide can cause cardiac toxicity due to blockade of Na and IKr channels, resulting in wide QRS rhythms, severe bradycardia, prolonged QTc, polymorphic ventricular tachycardia, cardiac arrest, and death. There are limited data on the cardiotoxic effects of high dose loperamide.

Methods and Results

A case report of loperamide toxicity is presented and then added to a contemporary review of the literature. In total, the presentation and management of 36 cases of loperamide cardiotoxicity are summarized. The overall median daily dose (interquartile range) of loperamide was 200 (134‐400) mg. The median QRS duration was 160 (125‐170) ms. The median QTc duration was 620 (565‐701) ms. Ventricular tachycardia was experienced by 24/36 (67%) of patients, 20 of which were specified to be polymorphic. Treatment was supportive, providing advanced cardiopulmonary life support and aggressive electrolyte repletion. Isoproterenol infusion or overdrive pacing was employed in 19/36 (53%) of cases. The median time to electrocardiogram normalization or hospital discharge, whichever came first, was 5 (3.5‐10) days.

Conclusion

Loperamide overdose is a toxidrome that remains underrecognized, and in patients with unexplained cardiac arrhythmias, loperamide toxicity should be suspected. Prompt recognition is critical due to the delayed recovery and high risk for life‐threatening arrhythmias.
Individual asymmetry as a predictor of fitness in the batCarollia perspicillata
Authors: Monteiro Leandro R. , Mellado Breno , Nogueira Marcelo R. , de Morais‐Jr Marcio M.
Published: August 2019

The measurement of fitness in wild populations is a challenging task, and a number of proxies have been proposed with different degrees of success. Developmental instability/stability (DI) is an organismal property associated with variance in bilateral asymmetry (fluctuating asymmetry—FA) and a correlated effect on fitness. This study provides evidence to corroborate the hypothesis that asymmetry partly reflectsDIand is correlated with a reduction in fitness measured by survival and reproduction in bats. We studied two colonies of the batCarollia perspicillatain southeastern Brazil over 5 years, marking and recapturing individuals. Gaussian mixture models for signed Forearm Asymmetry (ForA) distribution indicated that ~20% of asymmetry variation was due toDIheterogeneity among individuals. ForA, body condition (Scaled Mass Index—SMI) and Forearm Length (ForL) were used as predictors of survival probability in Cormack‐Jolly‐Seber models. Asymmetry was negatively associated with survival, whereasSMIand ForL were positively associated. The maleC. perspicillatadefend sites within the roost that are favoured by female harems, but there are mating opportunities for bachelor males, leading to both territorial disputes and sperm competition. As predicted by sexual selection, ForA was negatively associated with relative Testicle Length, a measure of reproductive potential. In females, ForA was negatively associated with the probability of two pregnancies (as opposed to one) in a given breeding season. The effect magnitudes and directions of associations suggest that asymmetry, even though not perfectly reflectingDIvariation, is a useful predictor for fitness components inC. perspicillata.
Increased risk of idiopathic pulmonary fibrosis in inflammatory bowel disease: A nationwide study
Authors: Kim Jihye , Chun Jaeyoung , Lee Changhyun , Han Kyungdo , Choi Seungho , Lee Jooyoung , Soh Hosim , Choi Kookhwan , Park Seona , Kang Eun Ae , Lee Hyun Jung , Im Jong Pil , Kim Joo Sung
Published: August 2019

Background and Aim

The relationship between inflammatory bowel disease (IBD) and idiopathic pulmonary fibrosis (IPF) remains unclear. We evaluated the risk for developing IPF in patients with IBD using a nationwide population‐based study.

Methods

Using claims data from the National Health Insurance service in Korea, patients with IBD, including Crohn's disease (CD) and ulcerative colitis (UC), were identified through both the 10th revision of the International Statistical Classification of Diseases and Related Health Problems and rare and intractable disease program codes from January 2010 to December 2013. We compared 38 921 IBD patients with age‐matched and sex‐matched individuals without IBD in a ratio of 1:3. Patients with newly diagnosed IPF were identified by both the 10th revision of the International Statistical Classification of Diseases and Related Health Problems and rare and intractable disease registration codes.

Results

During a mean 4.9‐year follow‐up, the incidence of IPF in patients with IBD was 33.21 per 100 000 person‐years. The overall risk of IPF was significantly higher in IBD patients than in non‐IBD controls (hazard ratio [HR], 1.62; 95% confidence interval [CI], 1.20–2.20; P = 0.003). In patients with CD, the incidence (per 100 000 person‐years) of IPF was 26.04; in controls, the incidence was 9.15 (HR, 2.89; 95% CI, 1.46–5.72; P = 0.002). The incidence of IPF in patients with UC tended to be higher than in controls (36.66 vs 26.54 per 100 000 person‐years; 95% CI, 0.99–1.99; HR, 1.41; P = 0.066). The risk of developing IPF in patients with IBD was higher in male patients than in female patients (P = 0.093 in CD; P = 0.147 in UC by interaction analysis).

Conclusions

Patients with IBD, especially CD, have an increased risk of developing IPF.
Quantification of dietary calcium requirement of fingerling Heteropneustes fossilis based on growth, feed conversion efficiency, mineralization and serum alkaline phosphatase activity
Authors: Zafar Noorin , Khan Mukhtar A.
Published: August 2019

Seven isonitrogenous (400 g/kg crude protein) and isocaloric (17.89 kJ/g gross energy) purified diets (casein‐gelatin based) with different concentrations of calcium (0, 1, 2, 3, 4, 5 and 6 g/kg) supplemented with calcium lactate at the levels of 0, 5.4, 10.8, 16.3, 21.8, 27.27 and 32.73 g/kg were prepared and fed for 12 weeks to triplicate groups of Heteropneustes fossilis (7.46 ± 0.03 g) to determine the optimum dietary calcium requirement. Analysed values of calcium in the diets were 2.41, 3.82, 4.56, 5.99, 6.71, 7.40 and 8.19 g/kg, respectively. Absolute weight gain, specific growth rate, protein retention efficiency, protein gain and feed conversion ratio of fish fed diets with increasing levels of dietary calcium improved up to 5.99 g/kg and then levelled off. Whole‐body protein, moisture and ash contents improved up to 5.99 g/kg dietary calcium and stabilized thereafter. However, whole‐body fat exhibited reverse pattern and decreased with incremental levels of dietary calcium up to 5.99 g/kg. Whole‐body and vertebrae mineralization was also significantly affected (p < .05) by the increasing dietary calcium levels. Alkaline phosphatase activity improved significantly (p < .05) up to 6.71 g/kg, and no change was recorded beyond this level. Serum calcium and phosphorus concentrations were not influenced (p > .05) by dietary calcium levels. The Ca–P ratio remained static in the whole body, vertebrae and serum. Broken‐line regression analysis of data obtained on growth, mineralization and serum ALP activity against increasing levels of dietary calcium reflected the optimum calcium requirement between 5.77–6.81 g/kg diet.
Effect of thyrotropin‐releasing hormone stimulation testing on the oral sugar test in horses when performed as a combined protocol
Authors: Hodge Elizabeth , Kowalski Alycia , Torcivia Catherine , Lindborg Sue , Stefanovski Darko , Hart Kelsey , Frank Nicholas , van Eps Andrew
Published: August 2019

Background

The use of parallel dynamic tests to identify insulin dysregulation (ID) and pituitary pars intermedia dysfunction (PPID) in horses could have better diagnostic utility than measuring baseline hormone concentrations, if the tests do not alter diagnostic interpretation of one another.

Hypothesis

Performing a thyrotropin‐releasing hormone (TRH) stimulation test before an oral sugar test (OST) would not affect results of OST.

Animals

Twenty‐six healthy university‐owned horses.

Methods

A prospective randomized placebo‐controlled, crossover design was used to evaluate 3 OST protocols: OST alone, TRH followed by OST (TRH + OST), and placebo followed by OST (placebo + OST). Agreement for plasma insulin concentrations and diagnostic interpretation were assessed with Bland‐Altman and logistic regression analyses, respectively.

Results

Bland‐Altman analysis of TRH + OST versus OST alone showed good agreement between testing protocols, with bias ± SD for insulin concentrations at baseline 0.4 ± 4.7 μIU/mL (95% limits of agreement [LOA], −8.8 to 9.7), 60 minute −0.5 ± 22.6 μIU/mL (95% LOA, −44.7 to 43.8), and 90 minute 1.9 ± 20.6 μIU/mL (95% LOA, −38.5 to 42.4) after OST, similar to placebo + OST versus OST alone. Diagnostic interpretation (positive/negative) was not different between protocols (TRH + OST versus OST alone [P = .78], placebo + OST versus OST alone [P = .77], or TRH + OST versus placebo + OST [P = .57]).

Conclusions and Clinical Importance

Concurrent testing for PPID and ID with a TRH stimulation test before an OST is an acceptable diagnostic tool for investigation of endocrinopathies in horses and allows accurate testing to be performed efficiently in 1 visit.
A hidden technological assumption in patent law: The case of gene patents and the disclosure requirement
Authors: Cohen‐Sasson Or
Published: August 2019

The disclosure requirement in patent law is designed to reveal knowledge regarding a patented invention to allow proper understanding and utilization of that invention. The contention offered here is the presence of an inherent incompatibility between the disclosure requirement and genetic inventions. Genetic inventions are highly contingent on big genetic statistical data (GSD), which is gathered during the commercial phase of a genetic invention. GSD are essential for various purposes, which at least some should be satisfied by the disclosure. However, since GSD can be gathered only at the postapplication period, GSD are not disclosed through the disclosure requirement. Therefore, there is a disclosure‐genetics incompatibility. This incompatibility prevents patent law from fully accomplishing its intended purpose. The origins of this incompatibility can be traced to the structure of the disclosure requirement, a consequence of a hidden technological assumption in patent law regarding the very perception of what is an invention. Patent law perceives all inventions as fully revealed objects and not as semirevealed objects. That creates a difficulty that may be more pervasive than for genetics alone. Thus, acknowledging this technological assumption facilitates the introduction of an insight regarding the fully revealed/semirevealed spectrum regarding inventions in other, nongenetic technological fields.
Changes in alpha‐foetoprotein and Gc‐globulin in relation to outcomes in non‐acetaminophen acute liver failure
Authors: Singh Sundeep , Hynan Linda S. , Rule Jody A. , Lee William M.
Published: August 2019

Background

Changes in Gc‐globulin (Gc) and in alpha‐foetoprotein (AFP) have been shown to be related to outcome in patients with acute liver failure (ALF). Gc is a serum protein that complexes with intravascular actin released during cellular necrosis. AFP, also made by hepatocytes, is associated with hepatocellular growth and regeneration. Previously, low absolute levels or decreases over time in either AFP or Gc portended to be a poor outcome.

Methods

In a retrospective analysis of the double‐blind trial of intravenous N‐acetylcysteine (NAC) for ALF not because of acetaminophen, sera on days 1 and 3 or days 2 and 4 following admission were available to measure AFP in 70 patients and Gc in 66 patients. Mann‐Whitney U tests were performed on the admission values, the absolute change and the fractional change of AFP and Gc to compare TFS (transplant‐free survival) and non‐TFS (death or transplantation). Logistic regression and receiver operating characteristic (ROC) analyses were performed to evaluate the markers in comparison and in addition to King's College Criteria (KCC).

Results

Transplant‐free survival patients were characterized by increases in AFP, whereas non‐TFS had significantly different (negative) absolute and fractional changes (P < .01). The addition of declining AFP levels to KCC improved the area under the curve in predicting non‐TFS (AUC >70%). Gc globulin values did not differ between TFS and non‐TFS in the 2‐day intervals studied (P> .2).

Conclusion

In this comparison of two prognostic markers in patients with non‐acetaminophen‐induced ALF, rising AFP but not rising Gc levels was associated with TFS. Trial Registration: ClinicalTrials.gov number NCT00004467.
Characterisation of candidemia in patients with recent surgery: A 7‐year experience
Authors: Orsetti Elena , Brescini Lucia , Mazzanti Sara , Trave Francesca , Morroni Gianluca , Masucci Annamaria , Barchiesi Francesco
Published: August 2019

Candidemia can complicate major surgical procedures. However, literature data are scanty on this topic. In this study, we evaluated the epidemiology, clinical and microbiologic characteristics and outcome of candidemia in adult patients with recent surgery hospitalised in a single University Hospital in Central Italy from 2010 to 2016. Of the 304 episodes of candidemia, 160 (53%) occurred in surgical patients (SPs) while the remaining 144 (47%) in patients without history of recent surgery (non‐SPs). Although either underlying chronic comorbidities (ie haematological malignancies, neurological and gastrointestinal diseases) or acute complications (ie pneumonia and septic shock) were less likely to occur in SPs than in non‐SPs, 30‐day mortality did not differ between groups being 38% and 42%, respectively. The specific risk factors significantly more common in SPs who died within 30 days were as follows: male gender, older age, being hospitalised in ICU rather than in other wards, having a higher Charlson's score, undergoing previous invasive procedures, haemodialysis, the presence of pneumonia, septic shock, acute kidney failure and the type of surgery. In particular, either gastrointestinal or cardiovascular surgeries were characterised by the highest mortality rates. Multivariate analysis showed that the occurrence of septic shock (HR 10.3131 [CI95% 1.176‐90.466; P = .035] and ICU stay (HR 2.016 [CI95% 1.178‐3.448; P = .011] was independently associated with higher mortality in SPs. Overall, these data show that candidemia in SPs is characterised by significant mortality and distinctive features.
Prolonged lead dwell time and lead burden predict bailout transfemoral lead extraction
Authors: Gould Justin , Sidhu Baldeep.S. , Porter Bradley , Sieniewicz Benjamin. J. , Teall Thomas , Williams Steven.E. , Shetty Anoop , Bosco Paolo , Blauth Christopher , Gill Jaswinder , Rinaldi Christopher. A.
Published: August 2019

Background

Transvenous lead extraction (TLE) may be performed by superior approach using the original implant vein or via a femoral approach; however, limited comparative data exists. We compare outcomes between femoral versus nonfemoral TLE approaches and determine predictors of bailout transfemoral lead extraction in patients undergoing initial TLE via the original implant vein by a superior approach.

Methods

All consecutive TLEs between October 2000 and March 2018 were prospectively collected (n = 1052). Patients were dichotomized into femoral (n = 118) and nonfemoral (n = 934) groups.

Results

Demographics were balanced between femoral vs nonfemoral groups. Patients in the femoral group had significantly higher mean lead dwell times (11.6 ± 9.7 vs 6.6 ± 6.6 years, P < .001), mean number of leads extracted (2.7 ± 1.3 vs 2.0 ± 1.0, P < .001), 30‐day procedure related major complications (including deaths) (8.5% vs 1.1%, P < .001) and emergency thoracotomy rates (4.2% vs 0.7%, P = .007). All‐cause 30‐day mortality rates were similar between groups (3.4% vs 2.0%, P = .315). Prolonged lead dwell time and increased number of leads extracted were predictive of a bailout transfemoral approach at multivariable analysis.

Conclusion

Femoral approach TLE is associated with increased risk of 30‐day procedure related major complications but not 30‐day all‐cause mortality. Prolonged lead dwell time and increased number of leads extracted are independent predictors for bailout transfemoral lead extraction. Such patients should be considered high risk of major complications and performed by high‐volume lead extraction centers with experience in multiple approaches and techniques including experience with transfemoral lead extraction.
The Historical Presidency: “An Ethnic Presence in the White House?”: Ethnicity, Identity Politics, and the Presidency in the 1970s
Authors: Merton Joe
Published: August 2019

This article excavates the relationship between the presidency and an emergent white, European “ethnic” identity politics during the 1970s. Rather than a response to cultural drift or backlash politics, presidential efforts to harness “ethnic” identity politics reflected a shifting institutional context. Yet despite establishing the White House as a critical center of the new politics and devising policy and political responses to it, the attentions of the presidency were not always propitious. Instead, the presidency’s efforts profoundly influenced the terms by which ethnic politics was received politically, with destructive consequences for this politics’ potential political incorporation, its interactions with other advocacy groups, and its long‐term future. Historians seeking to explain the fate of the “ethnic” moment of the 1970s should thus pay closer attention to the presidency as a contributor to both its rise and demise. Keywords: ethnicity, white ethnic, identity politics, 1970s, civil rights, social movements
Effects of acute prolonged sitting on cerebral perfusion and executive function in young adults: A randomized cross‐over trial
Authors: Stoner Lee , Willey Quentin , Evans William S. , Burnet Kathryn , Credeur Daniel P. , Fryer Simon , Hanson Erik D.
Published: August 2019

Exposure to acute prolonged sitting reportedly leads to decreased cerebral blood flow. However, it is unclear whether this exposure translates to decreased cerebral perfusion and executive function or whether simple strategies to break up sitting can maintain cerebral perfusion and executive function. This study sought to answer two questions: in young, healthy adults, (a) does prolonged (3 hr) sitting lead to decreased cerebral perfusion and executive function? and (b) does breaking up prolonged sitting, using intermittent calf raise exercises, prevent changes in cerebral perfusion and executive function? Twenty young, healthy participants (21.7 [2.5] years, 70% female, 25.5 [6.1] kg/m2) were randomized to 3 hr sitting with 10 calf raises every 10 min (CALF) and 3 hr sitting without intermittent calf raises (CON). Prefrontal cortex perfusion was assessed using near‐infrared spectroscopy to monitor total hemoglobin (tHB) concentration and tissue saturation index (TSI, oxygenated hemoglobin). Executive function was assessed using the Stroop word and color tasks. Following 3 hr sitting, tHb was significantly lower in CALF versus CON (−2.1 μM, 95% CI [−3.1, −1.1]). TSI was not significantly different between conditions (p = .667). Word (1.6 ms, 95% CI [0.7, 2.5]) and color (1.3 ms, 95% CI [−0.2, 2.8]) completion times were longer (worse) for CALF compared to CON. In conclusion, calf raises decreased both cerebral perfusion and executive function. Simple strategies, such as fidgeting or calf raises, which have been reported to preserve vascular function in the legs, appear not to be sufficient to benefit cerebral perfusion or executive function.