bluuebunny/crossref_metadata_2025 huggingface dataset:
Economic evaluation of a dedicated cardiac resynchronisation therapy preassessment clinic
Authors: Sidhu Baldeep Singh , Rua Tiago , Gould Justin , Porter Bradley , Sieniewicz Benjamin , Niederer Steven , Rinaldi Christopher Aldo , Carr-White Gerald
Published: July 2020

Introduction

Patient evaluation before cardiac resynchronisation therapy (CRT) remains heterogeneous across centres and it is suspected a proportion of patients with unfavourable characteristics proceed to implantation. We developed a unique CRT preassessment clinic (CRT PAC) to act as a final review for patients already considered for CRT. We hypothesised that this clinic would identify some patients unsuitable for CRT through updated investigations and review. The purpose of this analysis was to determine whether the CRT PAC led to savings for the National Health Service (NHS).

Methods

A decision tree model was made to evaluate two clinical pathways; (1) standard of care where all patients initially seen in an outpatient cardiology clinic proceeded directly to CRT and (2) management of patients in CRT PAC.

Results

244 patients were reviewed in the CRT PAC; 184 patients were eligible to proceed directly for implantation and 48 patients did not meet consensus guidelines for CRT so were not implanted. Following CRT, 82.4% of patients had improvement in their clinical composite score and 57.7% had reduction in left ventricular end-systolic volume ≥15%. Using the decision tree model, by reviewing patients in the CRT PAC, the total savings for the NHS was £966 880. Taking into consideration the additional cost of the clinic and by applying this model structure throughout the NHS, the potential savings could be as much as £39 million.

Conclusions

CRT PAC appropriately selects patients and leads to substantial savings for the NHS. Adopting this clinic across the NHS has the potential to save £39 million.
C‐reactive protein in dogs with suspected bacterial diskospondylitis: 16 cases (2010–2019)
Authors: Nye George , Liebel Francois‐Xavier , Harcourt‐Brown Tom
Published: July 2020

Objectives

C‐reactive protein (CRP) is an acute phase protein used in multiple canine inflammatory conditions including steroid responsive meningitis‐arteritis, immune‐mediated polyarthritis and bronchopneumonia. The aim of this study was to assess whether serum CRP is elevated in cases of diskospondylitis.

Methods

Medical records from 2010 to 2019 were searched to identify dogs diagnosed with diskospondylitis based on findings consistent on CT or MRI and with CRP tested.

Results

A total of 16 dogs met the inclusion criteria. All cases had back pain. Fourteen cases had elevated CRP, with a median value of 100.7 mg/l (reference range for CRP values: 0–10 mg/l), 12 were pyrexic and six had leucocytosis. The two dogs with normal CRP were normothermic and did not have leucocytosis. CRP was measured four to six weeks into antimicrobial treatment in eight of 14 dogs and was normal in all cases. One dog developed a suspected bacterial empyema diagnosed on MRI; this occurred two weeks after antibiotic treatment was discontinued based on a normal CRP level at follow‐up.

Conclusions

Serum CRP is elevated in cases of diskospondylitis and may be clinically more useful to screen dogs with back pain than pyrexia or leucocytosis alone. Further long‐term clinical evaluation in a prospective study is needed to assess its use as a treatment monitoring tool and in decision making.
Ontogenesis, histochemistry, and seasonal and luminous environmental characterization of secretory cavities in leaves ofMyrcia splendens(Myrtaceae)
Authors: Costa Isabela Santiago Carneiro da , Lucena Eliseu Marlônio Pereira de , Bonilla Oriel Herrera , Radosavljevic Aleksandar , Coutinho Ítalo Antônio Cotta
Published: July 2020

Secretory cavities produce compounds that protect plants from herbivory and pathogenic microorganisms. These cavities have been reported in many genera. However, there are few studies on secretory cavity ontogeny in the genus Myrcia (Myrtaceae) as well as the effects of luminosity and seasonality on such secretory cavities. Therefore, the objective of this study was to provide new information regarding the ontogenesis, structure, histochemistry, and effects of seasonality in Myrcia splendens (Sw.) DC. We collected and analyzed leaves from 10 specimens of M. splendens exposed to sun and shade during both the wet and dry seasons. The samples were subjected to standard anatomical techniques for light microscopy. Myrcia splendens has schizo-lysigenous ontogenesis with exudates composed of lipids, essential oils, oil-resins, and alkaloids. The largest secretory cavities were found in leaves exposed to sunlight during the dry season. The presence of lipophilic compounds may be an important strategy for protecting the plant from herbivores. The seasonal variations observed in the leaf’s secretory cavities demonstrate the anatomical plasticity of such species to the availability of light and water. As the total area of the leaf cavities in M. splendens reflects the seasonal variation, this should be taken into account when aiming to grow crops for producing essential oils or for alkaloid extractions.
Different effects of amiodarone and dofetilide on the dispersion of repolarization between well-coupled ventricular and Purkinje fibers1
Authors: Árpádffy-Lovas Tamás , Husti Zoltán , Baczkó István , Varró András , Virág László
Published: July 2020

Increased transmural dispersion of repolarization is an established contributing factor to ventricular tachyarrhythmias. In this study, we evaluated the effect of chronic amiodarone treatment and acute administration of dofetilide in canine cardiac preparations containing electrotonically coupled Purkinje fibers (PFs) and ventricular muscle (VM) and compared the effects to those in uncoupled PF and VM preparations using the conventional microelectrode technique. Dispersion between PFs and VM was inferred from the difference in the respective action potential durations (APDs). In coupled preparations, amiodarone decreased the difference in APDs between PFs and VM, thus decreasing dispersion. In the same preparations, dofetilide increased the dispersion by causing a more pronounced prolongation in PFs. This prolongation was even more emphasized in uncoupled PF preparations, while the effect in VM was the same. In uncoupled preparations, amiodarone elicited no change on the difference in APDs. In conclusion, amiodarone decreased the dispersion between PFs and VM, while dofetilide increased it. The measured difference in APD between cardiac regions may be the affected by electrotonic coupling; thus, studying PFs and VM separately may lead to an over- or underestimation of dispersion.
Post-Newtonian limit: second-order Jefimenko equations
Authors: Carlos David Pérez , Espinoza Augusto , Chubykalo Andrew
Published: July 2020

The purpose of this paper is to get second-order gravitational equations, a correction made to Jefimenko’s linear gravitational equations. These linear equations were first proposed by Oliver Heaviside in [1], making an analogy between the laws of electromagnetism and gravitation. To achieve our goal, we will use perturbation methods on Einstein field equations. It should be emphasized that the resulting system of equations can also be derived from Logunov’s non-linear gravitational equations, but with different physical interpretation, for while in the former gravitation is considered as a deformation of space-time as we can see in [2–5], in the latter gravitation is considered as a physical tensor field in the Minkowski space-time (as in [6–8]). In Jefimenko’s theory of gravitation, exposed in [9, 10], there are two kinds of gravitational fields, the ordinary gravitational field, due to the presence of masses, at rest, or in motion and other field called Heaviside field due to and acts only on moving masses. The Heaviside field is known in general relativity as Lense-Thirring effect or gravitomagnetism (The Heaviside field is the gravitational analogous of the magnetic field in the electromagnetic theory, its existence was proved employing theGravity Probe Blaunched by NASA (See, for example, [11, 12]). It is a type of gravitational induction), interpreted as a distortion of space-time due to the motion of mass distributions, (see, for example [13, 14]). Here, we will present our second-order Jefimenko equations for gravitation and its solutions.
Classification of spatial Lp AF algebras
Authors: Christopher Phillips N. , Grazia Viola Maria
Published: July 2020

We define spatial [Formula: see text] AF algebras for [Formula: see text], and prove the following analog of the Elliott AF algebra classification theorem. If [Formula: see text] and [Formula: see text] are spatial [Formula: see text] AF algebras, then the following are equivalent:

[Formula: see text] and [Formula: see text] have isomorphic scaled preordered [Formula: see text]-groups. [Formula: see text] as rings. [Formula: see text] (not necessarily isometrically) as Banach algebras. [Formula: see text] is isometrically isomorphic to [Formula: see text] as Banach algebras. [Formula: see text] is completely isometrically isomorphic to [Formula: see text] as matricial [Formula: see text] operator algebras.

As background, we develop the theory of matricial [Formula: see text] operator algebras, and show that there is a unique way to make a spatial [Formula: see text] AF algebra into a matricial [Formula: see text] operator algebra. We also show that any countable scaled Riesz group can be realized as the scaled preordered [Formula: see text]-group of a spatial [Formula: see text] AF algebra.
Conditional interpretation of time in quantum gravity and a time operator in relativistic quantum mechanics
Authors: Bauer M. , Aguillón C. A. , García G. E.
Published: July 2020

The problem of time in the quantization of gravity arises from the fact that time in Schrödinger’s equation is a parameter. This sets time apart from the spatial coordinates, represented by operators in quantum mechanics (QM). Thus “time” in QM and “time” in general relativity (GR) are seen as mutually incompatible notions. The introduction of a dynamical time operator in relativistic quantum mechanics (RQM), that follows from the canonical quantization of special relativity and that in the Heisenberg picture is also a function of the parameter [Formula: see text] (identified as the laboratory time), prompts to examine whether it can help to solve the disfunction referred to above. In particular, its application to the conditional interpretation of time in the canonical quantization approach to quantum gravity is developed.
Embeddings of shearlet coorbit spaces into Sobolev spaces
Authors: Führ Hartmut , Koch René
Published: July 2020

We investigate the existence of embeddings of shearlet coorbit spaces associated to weighted mixed Lp-spaces into classical Sobolev spaces in dimension three by using the description of coorbit spaces as decomposition spaces. This different perspective on these spaces enables the application of embedding results that allow the complete characterization of embeddings for certain integrability exponents, and thus provides access to a deeper understanding of the smoothness properties of coorbit spaces, and of the influence of the choice of shearlet groups on these properties. We give a detailed analysis, identifying which features of the dilation groups have an influence on the embedding behavior, and which do not. Our results also allow to comment on the validity of the interpretation of shearlet coorbit spaces as smoothness spaces.
Understanding and Machine Consciousness
Authors: Sanz Ricardo , Aguado Esther
Published: July 2020

The domain of machine consciousness is a melting pot of computers, robots, neuropsychology, sociology and philosophy. This is both an opportunity and a serious risk of stagnation in entertaining but never-ending discussions that may prove useless concerning the construction of better machines. This paper analyzes this situation, defends an engineering approach to machine consciousness research and proposes a strategy focused on machine understanding to get out of the current impasse.
Beyond the Household: Caribbean Families and Biocultural Models of Alloparenting
Authors: Nelson Robin G.
Published: July 2020

Alloparental or extramaternal care is an integral aspect of human childrearing. This behavior has been explored both as an extension of the primary mother–infant dyad that evolved to meet the demands of altricial offspring and as an economic exchange of energy and resources. Much of this research centers on foraging or small-scale communities and positions the household as the central unit through which to explore negotiations of care. In this review, I use evidence from Black Caribbean communities living in industrialized countries to challenge the broad applicability of the analytical model of the bounded household and to question whether our current articulations of theory and empirical assessments of extramaternal care are well suited to investigations of these behaviors in the vast majority of contemporary human populations. Alloparental practices in the Caribbean reflect dynamic responses to maternal migration and the local influence of global labor markets. The children who remain at home experience variability in the care received from their surrogate parents. The dynamic aspect of the care practices enacted by these transnational families reveals the behavioral flexibility that has been integral to human survival.
Processing Temporal Growth Factor Patterns by an Epidermal Growth Factor Receptor Network Dynamically Established in Space
Authors: Koseska Aneta , Bastiaens Philippe I.H.
Published: July 2020

The proto-oncogenic epidermal growth factor (EGF) receptor (EGFR) is a tyrosine kinase whose sensitivity and response to growth factor signals that vary over time and space determine cellular behavior within a developing tissue. The molecular reorganization of the receptors on the plasma membrane and the enzyme-kinetic mechanisms of phosphorylation are key determinants that couple growth factor binding to EGFR signaling. To enable signal initiation and termination while simultaneously accounting for suppression of aberrant signaling, a coordinated coupling of EGFR kinase and protein tyrosine phosphatase activity is established through space by vesicular dynamics. The dynamical operation mode of this network enables not only time-varying growth factor sensing but also adaptation of the response depending on cellular context. By connecting spatially coupled enzymatic kinase/phosphatase processes and the corresponding dynamical systems description of the EGFR network, we elaborate on the general principles necessary for processing complex growth factor signals.
How Food Affects Colonization Resistance Against Enteropathogenic Bacteria
Authors: Kreuzer Markus , Hardt Wolf-Dietrich
Published: July 2020

Food has a major impact on all aspects of health. Recent data suggest that food composition can also affect susceptibility to infections by enteropathogenic bacteria. Here, we discuss how food may alter the microbiota as well as mucosal defenses and how this can affect infection. Salmonella Typhimurium diarrhea serves as a paradigm, and complementary evidence comes from other pathogens. We discuss the effects of food composition on colonization resistance, host defenses, and the infection process as well as the merits and limitations of mouse models and experimental foods, which are available to decipher the underlying mechanisms.
Membrane Dynamics in Phototrophic Bacteria
Authors: Mullineaux Conrad W. , Liu Lu-Ning
Published: July 2020

Photosynthetic membranes are typically densely packed with proteins, and this is crucial for their function in efficient trapping of light energy. Despite being crowded with protein, the membranes are fluid systems in which proteins and smaller molecules can diffuse. Fluidity is also crucial for photosynthetic function, as it is essential for biogenesis, electron transport, and protein redistribution for functional regulation. All photosynthetic membranes seem to maintain a delicate balance between crowding, order, and fluidity. How does this work in phototrophic bacteria? In this review, we focus on two types of intensively studied bacterial photosynthetic membranes: the chromatophore membranes of purple bacteria and the thylakoid membranes of cyanobacteria. Both systems are distinct from the plasma membrane, and both have a distinctive protein composition that reflects their specialized roles. Chromatophores are formed from plasma membrane invaginations, while thylakoid membranes appear to be an independent intracellular membrane system. We discuss the techniques that can be applied to study the organization and dynamics of these membrane systems, including electron microscopy techniques, atomic force microscopy, and many variants of fluorescence microscopy. We go on to discuss the insights that havebeen acquired from these techniques, and the role of membrane dynamics in the physiology of photosynthetic membranes. Membrane dynamics on multiple timescales are crucial for membrane function, from electron transport on timescales of microseconds to milliseconds to regulation and biogenesis on timescales of minutes to hours. We emphasize the open questions that remain in the field.
Understanding the Lingual Frenulum: Histological Structure, Tissue Composition, and Implications for Tongue Tie Surgery
Authors: Mills Nikki , Geddes Donna T. , Amirapu Satya , Mirjalili S. Ali
Published: July 2020

Lingual frenotomy has become an increasingly common surgical procedure, performed for a broad range of indications from birth through adulthood. This study utilizes histology to define the structure and tissue composition of the lingual frenulum and floor of mouth (FOM) fascia. En bloc specimens of anterior tongue, lingual frenulum, and FOM tissues were harvested from ten embalmed adult cadavers. An additional three fresh tissue cadaveric specimens were frozen with the tongue supported in an elevated position, to enable harvesting and paraffin embedding of the elevated lingual frenulum as a discrete specimen. All 13 specimens were prepared as ten-micron coronal sections using stains to determine the general morphology of the lingual frenulum, its relationship to neighbouring structures (Mason’s Trichrome), presence of elastin fibers (Verhoeff-van Gieson), and collagen typing (Picrosirius Red). Our results have shown a submucosal layer of fascia spanning horizontally across the FOM was present in all specimens, with variability in fascial thickness and histologic composition. This FOM fascia suspends the sublingual glands, vessels, and genioglossus from its deep surface. The elevated lingual frenulum is formed by a central fold of this FOM fascia together with the overlying oral mucosa with variability in fascial thickness and composition. With tongue elevation, the fascia mobilizes to a variable extent into the fold forming the frenulum, providing a structural explanation for the individual variability in lingual frenulum morphology seen in clinical practice.
Review of Serum Biomarkers and Models Derived from Them in HBV-Related Liver Diseases
Authors: Wu JianPing , Mao WeiLin
Published: July 2020

A series of predictive scoring systems is available for stratifying the severity of conditions and assessing the prognosis in patients with HBV-related liver diseases. We show nine of the most popular serum biomarkers and their models (i.e., serum cystatin C, homocysteine, C-reactive protein, C-reactive protein to albumin ratio, aspartate aminotransferase to platelet ratio index, fibrosis index based on four factors, gamma-glutamyl transpeptidase to platelet ratio, albumin-bilirubin score, and gamma-glutamyl transpeptidase to albumin ratio) that have gained great interest from clinicians. Compared with traditional scoring systems, these serum biomarkers and their models are easily acquired, simple, and relatively inexpensive. In the present review, we summarize the latest studies focused on these serum biomarkers and their models as diagnostic and prognostic indexes in HBV-related liver diseases.
Rapid Determination of Catechin Content in Black Tea by Fluorescence Spectroscopy
Authors: Du Chenxu , Ma Chaoqun , Gu Jiao , Li Lei , Zhu Chun , Chen Lvming , Wang Tingyu , Chen Guoqing
Published: July 2020

Catechin can effectively prevent the occurrence of cancers due to its strong antioxidant capacity. In this study, the catechin contents of black teas from 12 different regions of south China were investigated using fluorescence spectroscopy. Herein, the catechin contents of various black teas with constant concentration were determined at the optimal excitation and emission wavelength combining the standard addition method and fluorescence spectroscopy. The results indicated that there was a linear relationship between the obtained concentration and fluorescence intensity, where the R values were all greater than 0.99 and the limit of quantification (LOQ) was 0.02 μg/mL. Furthermore, the content of catechin monomer in the chlorophyll environment was measured under the same experimental conditions to demonstrate the correctness of the above experimental methods. It revealed that the experimental error was about 1.14% compared with the actual content. The current work was proved to be an efficient way to detect fluorescence spectrum through diluting the concentration of tea samples, thereby increasing the determination limit of catechin.
Similar Strains of Coagulase-Negative Staphylococci Found in the Gastrointestinal Tract and Bloodstream of Bacteremic Neonates
Authors: Adeghate Jennifer O. , Juhász Emese , Iván Miklós Á. , Pongrácz Júlia , Kristóf Katalin
Published: July 2020

Objectives. Premature neonates are susceptible to opportunistic and nosocomial infections. Efforts have been made to determine whether the neonatal gut microbiome possesses potential for causing bloodstream infections in newborns via microbial translocation from the gastrointestinal tract. We aimed to examine similarities in coagulase-negative staphylococci (CoNS) strains found in the gastrointestinal tract and bloodstream in bacteremic neonates. Methods. CoNS strains isolated from blood cultures and perianal and pharyngeal swab samples of neonates from two neonatal intensive care units were investigated using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and pulsed-field gel electrophoresis. Molecular mass and genetic similarities of CoNS strains were compared. Results. Marked similarity was found in the molecular mass and genetic profile of examined CoNS isolates from blood cultures and perianal/pharyngeal samples. The percentage of neonates developing bacteremia following perianal and pharyngeal colonization by CoNS was significantly higher when compared to those colonized by Enterobacteriales species (p<0.0002). Conclusions. CoNS colonizing the gut may be a source of bacteremia in neonates. Enterobacteriales species do not contribute as significantly to bacteremia when compared to CoNS, and may be protective against gut mucosa-originated systemic infection.
The Relationship between Anterior Chamber Angle and Intraocular Pressure Early after V4c Implantable Collamer Lens Implantation
Authors: Hu Zongli , Chen Chunlin , Sun Min , Yuan Rongdi , Ye Jian
Published: July 2020

Purpose. To confirm the relationship between anterior chamber angle (ACA) and intraocular pressure (IOP) early after V4c implantable collamer lens (ICL) implantation. Methods. Patients were assigned to two groups: (1) right eyes (control group) and (2) left eyes (experimental group), with miosis conducted immediately after ICL implantation in the left eyes. IOP, angle opening distance (AOD), trabecular-iris angle (TIA), and pupil diameter (PD) were compared between two groups at postoperative hours 1, 2, and 24. The relationship between ACA, PD, and IOP was analyzed by multiple linear regression. Result. Thirty-six eyes of 18 patients were enrolled. The prevalence of ocular hypertension (OHT, defined as IOP ≥ 21 mmHg) was 61.11% and 16.67% in the right and left eyes, respectively, (χ2 = 7.481, p=0.006). At postoperative hours 1 and 2, IOP and PD were significantly higher p<0.001 in the right eyes, and TIA and AOD were significantly lower p<0.05 in the right eyes than in the left eyes. There was no significant difference at 24 h postoperative in these parameters. After the right eye ICL implantation, the changes of AOD 500 and PD were both linearly correlated with postoperative IOP change (β = −23.707 and 1.731, respectively; p = 0.013 and 0.002, respectively). Conclusion. The ACA was significantly narrowed immediately after V4c ICL implantation. There was a negative linear correlation between ACA and early IOP and a positive linear correlation between PD and early IOP. We recommend the use of intracameral miotics immediately after V4c ICL implantation to reduce the incidence of IOP spikes.
Assessment of Changes in the Hemoglobin Level under the Influence of Comprehensive Spa Therapy Using Therapeutic Radon‐Sulfur Waters and Its Correlation with Free Radical Reactions
Authors: Kuciel-Lewandowska Jadwiga , Kasperczak Michał , Paprocka-Borowicz Małgorzata
Published: July 2020

Introduction. Hemoglobin is a protein present in erythrocytes of higher organisms. Its main function is to transport oxygen from the lungs to tissues and carbon dioxide from tissues to the lungs. Hemoglobin contains Fe2+, catalyzes free radical reactions, and may initiate oxidation reactions by enzymatic and nonenzymatic degradation. The aim of the study was to evaluate the effect of balneophysiotherapy on the hemoglobin level in osteoarthritis patients and to try to assess the association of those metabolic changes with free radical reactions. Materials and Methods. The study was conducted in Przerzeczyn‐Zdrój spa resort. It included patients receiving spa treatment over 21‐day sessions. The studied group consisted of n = 122 patients with joint and back pain due to osteoarthritis or disc herniation. Their age ranged between 32 and 67 years with a mean age of 53.5. Blood samples were collected before treatment and after 21 days at the spa. Standard tests were used. The results were statistically analyzed using the sign test and the Wilcoxon test. Results. In the study group, we observed a drop in the hemoglobin level following spa treatment. Before treatment, the mean hemoglobin level was 14.1549 g%, and after treatment, it was 14.0008 g%. Conclusions. (1) In the study, we concluded that balneophysiotherapy in osteoarthritis patients resulted in a decrease in the mean hemoglobin level. (2) The decrease in the mean hemoglobin level in osteoarthritis patients treated at the spa resort may indicate an association with free radical reactions. This trial was registered with NCT03405350.
On Metrization of the Topologies Induced by Fuzzy Metrics
Authors: Wu Jianrong , Yang Hao
Published: July 2020

In this paper, we focus on finding the metric functions in a fuzzy metric space. After introducing the concept of a stratified function in a fuzzy metric space, we prove that the topology generated by the family of stratified functions coincides with the topology generated by the fuzzy metric. Moreover, we get the concrete form of metric function under some special conditions.
Seismic Response and Vibration Reduction Analysis of Suspended Structure under Wave Passage Excitation
Authors: Cai Wenhua , Yu Bujun , Wu Fajong , Shao Jianhua
Published: July 2020

In order to study the influence of traveling wave effect on the seismic response and damping effect of suspended structure, a series of shaking table tests of the 1 : 20 suspended structure have been carried out to compare and analyze the dynamic responses of suspended structures under two points and a consistent input. The vibration damping effect and vibration reduction law of suspended structure are discussed at different apparent wave velocity and in the different connection. The research shows that the damping suspended structure has a good damping effect, and the amplitude reduction of the top displacement peak response is up to 15%, which corresponds to smaller apparent velocities. Moreover, the upper bound of the maximum acceleration response at the structures’ top under nonuniform input motions equals that of the uniform motion. However, there is a hysteresis in the acceleration response under wave travelling excitations, and the smaller the apparent wave velocity, the more obvious the hysteresis.
Computational Cytology: Lessons Learned from Pap Test Computer-Assisted Screening
Authors: Lew Madelyn , Wilbur David C. , Pantanowitz Liron
Published: July 2020

Background: In the face of rapid technological advances in computational cytology including artificial intelligence (AI), optimization of its application to clinical practice would benefit from reflection on the lessons learned from the decades-long journey in the development of computer-assisted Pap test screening. Summary: The initial driving force for automated screening in cytology was the overwhelming number of Pap tests requiring manual screening, leading to workflow backlogs and incorrect diagnoses. Several companies invested resources to address these concerns utilizing different specimen processing techniques and imaging systems. However, not all companies were commercially prosperous. Successful implementation of this new technology required viable use cases, improved clinical outcomes, and an acceptable means of integration into the daily workflow of cytopathology laboratories. Several factors including supply and demand, Food and Drug Administration (FDA) oversight, reimbursement, overcoming learning curves and workflow changes associated with the adoption of new technology, and cytologist apprehension, played a significant role in either promoting or preventing the widespread adoption of automated screening technologies. Key Messages: Any change in health care, particularly those involving new technology that impacts clinical workflow, is bound to have its successes and failures. However, perseverance through learning curves, optimizing workflow processes, improvements in diagnostic accuracy, and regulatory and financial approval can facilitate widespread adoption of these technologies. Given their history with successfully implementing automated Pap test screening, cytologists are uniquely positioned to not only help with the development of AI technology for other areas of pathology, but also to guide how they are utilized, regulated, and managed.
Fieber (nicht nur) bei Kindern – häufiges Symptom, seltene Ursache
Authors: Adler Sabine
Published: July 2020

The pathogeneses of recurrent fever are quite complicated when excluding repeated infections. Recurrent fever is a common symptom for autoinflammatory diseases, relapse of Systemic-onset juvenile idiopathic arthritis (SoJIA) and recurrent Kawasaki disease (KD). There are no specific diagnostic laboratory tests for the diseases. Some studies showed that KD was the precursor of hemophagocytic lymphohistiocytosis (HLH). Macrophage activation syndrome (MAS) is another form of HLH in SoJIA. Cytokine disturbances are considered to be involved in the pathogenesis of the diseases. We describe a Chinese female toddler that developed three separate fever episodes with eventual diagnose of SoJIA within about 10 months. The first episode was diagnosed as IKD, immunoglobulin nonresponsive KD, and HLH. The second and third episodes were diagnosed as IKD and SoJIA, respectively. The fever was hard to be relieved by antipyretics, and the peak axillary temperature was above 40°C. For every fever episode, infections were excluded. For the first episode, trends over time of hemoglobin, platelets, fibrinogen, and triglycerides indicated HLH, which was finally diagnosed and treated according to the HLH-2004 protocol. For the second episode 6 months later, after excluding an HLH relapse and infections, IKD was finally diagnosed. Oral aspirin was administered, and the HLH treatment was ceased. The third episode occurred 3 months later, and SoJIA was finally diagnosed. For each episode, except for relative tests, we only tested for cytokines interleukin-1β, interleukin-6, and interferon-γ, due to limited laboratory test availability. These cytokines were elevated during remission and rose much higher in the fever phases. The case showed the difficulty to differentiating the recurrent fever in clinical practice. Surveillance of routine laboratory parameters over time might reveal a trend that indicates possible disease, even when parameter values do not meet diagnostic criteria. Changes in cytokine profiles are promising markers for differentiating recurrent fever diseases in future. An unknown immunological defect for the case may contribute to the recurrent immunological insults, and we are following up the recurrence of fever episode.
Endocrine Therapy in Early Breast Cancer
Authors: Krauss Katja , Stickeler Elmar
Published: July 2020

Background: Endocrine therapy with a standard duration of 5 years is well known as an effective treatment for endocrine-sensitive breast cancer. Summary: In the adjuvant setting this treatment reduces the 15-year mortality rates by about 30 and 40% with tamoxifen and aromatase inhibitor, respectively. The well-known long-term recurrence risk of luminal cancers led to multiple trials examining the benefit of extended endocrine treatment for up to 15 years. Additional benefit with extended therapy was seen for patients with high recurrence risk. Also, additional ovarian suppression for premenopausal women exhibited a significant benefit for patients at higher risk. Key Messages: The data of the last years will be summarized and discussed, also considering the side effects of the different treatment options.
CED – Erkrankungsaktivität und Steroidtherapie als Risikofaktoren für COVID-19?
Authors: Bengsch Bertram
Published: July 2020

Die durch das SARS-CoV-2 Virus verursachte Pandemie und COVID-19-Erkrankung stellen weltweit die Gesundheitssysteme vor große Herausforderungen. Es bestehen große Unsicherheiten, ob Patientengruppen mit autoimmun-vermittelten Vorerkrankungen und immunsuppressiven Therapien ein höheres Risiko für ungünstigere Verläufe einer COVID-19-Erkrankung haben. Um den Einfluss von COVID-19 auf Patienten mit chronisch-entzündlichen Darmerkrankungen (CED) zu untersuchen, haben Lukin et al. in einer aktuellen Arbeit in Gastroenterology in der stark betroffenen Metropole New York zum einen eine Fall-Kontrollstudie durchgeführt, um die klinischen Verläufe von CED-Patienten, die an COVID-19 erkrankt waren, zu untersuchen, sowie eine longitudinale Analyse in einer definierten Kohorte von CED-Patienten mit aktiver Erkrankung vorgenommen, um den Einfluss der CED-Erkrankungsaktivität und des Therapieregimes auf das Risiko einer COVID-19-Erkrankung zu prüfen. Die Ergebnisse der Untersuchungen legen nahe, dass CED-Pa­tienten kein erhöhtes Risiko für einen schweren Verlauf von COVID-19 haben. Patienten mit Colitis ulcerosa waren etwas stärker betroffen als Patienten mit Morbus Crohn. COVID-19 führte bei CED-Patienten zu verstärkter gastrointestinaler Symptomatik. Patienten mit aktiver CED und Steroidtherapie waren häufiger von COVID-19 betroffen als Patienten mit Biologikatherapie.
Redefining Adverse and Reverse Left Ventricular Remodeling by Cardiovascular Magnetic Resonance Following ST-Segment–Elevation Myocardial Infarction and Their Implications on Long-Term Prognosis
Authors: Bulluck Heerajnarain , Carberry Jaclyn , Carrick David , McEntegart Margaret , Petrie Mark C. , Eteiba Hany , Hood Stuart , Watkins Stuart , Lindsay Mitchell , Mahrous Ahmed , Ford Ian , Oldroyd Keith G. , Berry Colin
Published: July 2020

Background:

Cut off values for change in left ventricular end-diastolic volume (LVEDV) and LV end-systolic volume (LVESV) by cardiovascular magnetic resonance following ST-segment–elevation myocardial infarction have recently been proposed and 4 patterns of LV remodeling were described. We aimed to assess their long-term prognostic significance.

Methods:

A prospective cohort of unselected patients with ST-segment–elevation myocardial infarction with paired acute and 6-month cardiovascular magnetic resonance, with the 5-year composite end point of all-cause death and hospitalization for heart failure was included. The prognosis of the following groups (group 1: reverse LV remodeling [≥12% decrease in LVESV]; group 2: no LV remodeling [changes in LVEDV and LVESV <12%]; group 3: adverse LV remodeling with compensation [≥12% increase in LVEDV only]; and group 4: adverse LV remodeling [≥12% increase in both LVESV and LVEDV]) was compared.

Results:

Two hundred eighty-five patients were included with a median follow-up was 5.8 years. The composite end point occurred in 9.5% in group 1, 12.3% in group 2, 7.1% in group 3, and 24.2% in group 4. Group 4 had significantly higher cumulative event rates of the composite end point (log-rank test,
P
=0.03) with the other 3 groups showing similar cumulative event rates (log-rank test,
P
=0.51). Cox proportional hazard for group 2 (hazard ratio, 1.3 [95% CI, 0.6–3.1],
P
=0.53) and group 3 (hazard ratio, 0.6 [95% CI, 0.2–2.3],
P
=0.49) were not significantly different but was significantly higher in group 4 (hazard ratio, 3.0 [95% CI, 1.2–7.1],
P
=0.015) when compared with group 1.

Conclusions:

Patients with ST-segment–elevation myocardial infarction developing adverse LV remodeling at 6 months, defined as ≥12% increase in both LVESV and LVEDV by cardiovascular magnetic resonance, was associated with worse long-term clinical outcomes than those with adverse LV remodeling with compensation, reverse LV remodeling, and no LV remodeling, with the latter 3 groups having similar outcomes in a cohort of stable reperfused patients with ST-segment–elevation myocardial infarction.

Registration

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT02072850.
Predictors of Atrial Fibrillation During Long‐Term Implantable Cardiac Monitoring Following Cryptogenic Stroke
Authors: Riordan Michael , Opaskar Amanda , Yoruk Ayhan , Younis Arwa , Ali Adil , McNitt Scott , Sahin Bogachan , Rosero Spencer , Goldenberg Ilan , Aktas Mehmet K.
Published: July 2020

Background

Following cryptogenic stroke, guidelines recommend cardiac monitoring for occult atrial fibrillation (AF). We aimed to evaluate predictors of AF during long‐term implantable cardiac monitoring.

Methods and Results

We studied 293 consecutive patients who underwent implantable cardiac monitor implant (Medtronic LINQ) following hospitalization for cryptogenic stroke at the University of Rochester Medical Center from January 2013 to September 2018. Multivariable Cox proportional hazards regression modeling was used to identify predictors of AF during long‐term monitoring. At 36 months of follow‐up, the cumulative rate of implantable cardiac monitor–detected AF events was 32% in the total study population. Multivariable analysis identified age ≥70 years as the most powerful predictor of the development of AF events during follow‐up (hazard ratio, 2.28 [95% CI, 1.39–3.76];
P
=0.001). Replacing age with the CHA
2
DS
2
‐VASc (congestive heart failure, hypertension, age, diabetes mellitus, stroke, vascular disease, age, sex category) score resulted in a weaker association, for which each 1‐point increment in the CHA
2
DS
2
‐VASC score was associated with an 18% increased risk of developing AF (95% CI, 1.00–1.38;
P
=0.047). Consistent results were shown using Kaplan–Meier analysis by age and by the CHA
2
DS
2
VASc score.

Conclusions

Cryptogenic stroke patients continue to develop AF episodes during 36 months of implantable cardiac monitoring following the index event. Age is the most powerful predictor of occult AF in this population.
Corporate-startup Collaboration: Its Diffusion to and within the Firm
Authors: Steiber Annika
Published: July 2020

In an age of digital transformation, startup collaboration as an avenue for corporate innovation has increased in importance. However, the diffusion of corporate-startup collaboration models, to and within firms, is not well researched. The purpose of this article is to view a corporate-startup collaboration model as an organizational innovation and thereby, by using an established framework for the diffusion of innovations on a real case, “FirstBuild”, improve our understanding of how this type of organizational innovation is diffused to and within firms. The theoretical contribution of the article is to be the first study to investigate the diffusion of a corporate-startup collaboration model and thereby fill an existing knowledge gap on how this type of innovation is diffused to and within a firm. This is of relevance for both corporations as well as policy makers in an ongoing digital transformation of countries and their large firms.
Review of six genera of Braconinae Nees (Hymenoptera, Braconidae) in China, with the description of eleven new species
Authors: LI YANG , HE JUN-HUA , CHEN XUE-XIN
Published: July 2020

The species of six genera (Atanycolus Foerster, Craspedolcus Enderlein, Ectemnoplax Enderlein, Shelfordia Cameron, Stenobracon Szépligeti and Vipio Latreille) of the subfamily Braconinae (Hymenoptera, Braconidae) from China are revised and 29 species are recognized, including 11 new species (Atanycolus carinatus sp. nov., A. longiquus sp. nov., A. maculipennis sp. nov., A. setosus sp. nov., Craspedolcus maculithorax sp. nov., C. nigrabdominalis sp. nov., Ectemnoplax bimaculosus sp. nov., Shelfordia fulva sp. nov., S. obscuripennis sp. nov., Stenobracon (Stenobracon) longatus sp. nov. and Vipio abnormis sp. nov.), which are described and illustrated. Ectemnoplax xizanginensis Wang, Chen et He, 2006, is proposed as a syn. nov. of E. peruliventris Enderlein, 1920. Two species, Shelfordia longicaudata van Achterberg, 1993, and Vipio mongolicus Telenga, 1936, are reported from China for the first time. Keys to the Chinese species of the genera Atanycolus, Craspedolcus, Ectemnoplax, Shelfordia, Stenobracon and Vipio are provided.
Environmental hazard testing of nanobiomaterials
Authors: Amorim M. J. B. , Fernández-Cruz M. L. , Hund-Rinke K. , Scott-Fordsmand J. J.
Published: July 2020

The European Medicines Agency (EMA) regards the potential risks of human medicinal products to the environment and their impacts are assessed, as well as management to limit this impact. Hazard assessment of novel materials, which differ from conventional chemicals, e.g. nanobiomaterials, poses testing challenges and represents a work-in-progress with much focus on the optimization of required methodologies. For this work-in-progress, we here highlight where changes/updates are required in relation to the main elements for international testing based on OECD guidelines, supported by knowledge from the nanotoxicity area. The outline describes two major sections, nanobiomaterials and environmental hazards, including its challenges and learned lessons, with recommendations for implementation in OECD guidelines. Finally, the way forward via a testing strategy is described.
Correction to: Cross-cultural validation of the motivation to change lifestyle and health behaviours for dementia risk reduction scale in the Dutch general population
Authors: Joxhorst Tessa , Vrijsen Joyce , Niebuur Jacobien , Smidt Nynke
Published: July 2020

An amendment to this paper has been published and can be accessed via the original article.
Bilateral patellar tendon rupture on lupus undergoing corticosteroids: a case report
Authors: El Ouali Zakaria , Nassar Kawtar , Bassa Elie , Taoussi Reda , Sabiri Mouna , Rafai Mohamed , Janani Saadia
Published: July 2020

Background

Patellar tendon rupture is a rare condition, especially when it is bilateral. The most frequent associated pathologies are systemic lupus erythematosus, chronic renal failure, or treatments like corticosteroids. The aim of this case report is to draw attention to the non-specific clinical aspect of this condition, to recall its radiological signs, and highlight the diagnostic contribution of musculoskeletal ultrasound.

Case presentation

A 39-year-old man was diagnosed with a systemic lupus erythematosus with cutaneous, pulmonary, cardiac, hematological, renal, and immunological manifestations. He was treated with high-dose corticosteroids. Within 3 months he presented with a total functional impotence of the knees. On physical examination, there was a gap in the right infrapatellar region, his patellae were abnormally ascended, and his left knee was swollen. Insall-Salvati ratio on knees conventional radiographies was 2.5 in the right and 2.25 in the left knee, assessing bilateral patella alta. Ultrasound revealed a complete and bilateral patellar tendon rupture. The treatment consisted in a surgical repair and physiotherapy. The patient was able to mobilize independently after 6 months.

Conclusions

Bilateral patellar tendon rupture is exceptional. Systemic lupus erythematosus and corticosteroids are among trigger factors. Careful examination of the patellae should be done in front of knee extension deficit. Ultrasound plays a determining role in the diagnosis.
Using blockchain to log genome dataset access: efficient storage and query
Authors: Gürsoy Gamze , Bjornson Robert , Green Molly E. , Gerstein Mark
Published: July 2020

Background

Genomic variants are considered sensitive information, revealing potentially private facts about individuals. Therefore, it is important to control access to such data. A key aspect of controlled access is secure storage and efficient query of access logs, for potential misuse. However, there are challenges to securing logs, such as designing against the consequences of “single points of failure”. A potential approach to circumvent these challenges is blockchain technology, which is currently popular in cryptocurrency due to its properties of security, immutability, and decentralization. One of the tasks of the iDASH (Integrating Data for Analysis, Anonymization, and Sharing) Secure Genome Analysis Competition in 2018 was to develop time- and space-efficient blockchain-based ledgering solutions to log and query user activity accessing genomic datasets across multiple sites, using MultiChain.

Methods

MultiChain is a specific blockchain platform that offers “data streams” embedded in the chain for rapid and secure data storage. We devised a storage protocol taking advantage of the keys in the MultiChain data streams and created a data frame from the chain allowing efficient query. Our solution to the iDASH competition was selected as the winner at a workshop held in San Diego, CA in October 2018. Although our solution worked well in the challenge, it has the drawback that it requires downloading all the data from the chain and keeping it locally in memory for fast query. To address this, we provide an alternate “bigmem” solution that uses indices rather than local storage for rapid queries.

Results

We profiled the performance of both of our solutions using logs with 100,000 to 600,000 entries, both for querying the chain and inserting data into it. The challenge solution requires 12 seconds time and 120 Mb of memory for querying from 100,000 entries. The memory requirement increases linearly and reaches 470 MB for a chain with 600,000 entries. Although our alternate bigmem solution is slower and requires more memory (408 seconds and 250 MB, respectively, for 100,000 entries), the memory requirement increases at a slower rate and reaches only 360 MB for 600,000 entries.

Conclusion

Overall, we demonstrate that genomic access log files can be stored and queried efficiently with blockchain. Beyond this, our protocol potentially could be applied to other types of health data such as electronic health records.