bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient-Centred Outcomes in Anaemia and Renal Disease: A Systematic Review
Authors: Staibano Phillip , Perelman Iris , Lombardi Julia , Davis Alexandra , Tinmouth Alan , Carrier Marc , Stevenson Ciara , Saidenberg Elianna
Published: November 2019

Background: Anaemia is a nearly universal complication of chronic kidney disease (CKD). Erythropoiesis-stimulating agents (ESAs) have been demonstrated to improve clinical outcomes and quality of life (QOL) in renal patients with anaemia. Patient-reported outcome measures (PROMs) are increasingly being used to evaluate the patient-centred impact of medical therapy. Here, we describe a systematic review of studies that evaluated patient-centred outcomes (PCOs) in renal patients undergoing anaemia treatment. Methods: We conducted a search of Medline (Ovid), EMBASE (Ovid), PsychINFO, and CINAHL databases for studies published until March 2018 that investigated an intervention to treat anaemia in renal patients and used at least one PROM. We also performed a quality assessment for all included studies. Statistical analyses characterized each study, PROMs used, the quality of PCO reporting, and the association between haematological outcomes and PCOs. Results: Of the 3,533 studies identified in the database search, 21 met all eligibility criteria. Fourteen (67%) of the studies were randomized-controlled trials. Most studies (81%) investigated CKD patients, 14% investigated post-renal transplant patients and 5% assessed patients with heart disease on haemodialysis. The most common anaemia intervention, used in 95% of studies, was ESAs. Forty-three percent of studies utilized one PROM, most commonly the SF-36, a measure of QOL not specifically created for use in nephrology patients. About a third of studies selectively reported PROM subscales, rather than reporting all subscales. Notable biases among included studies included lack of blinding, selective outcome reporting, and lack of power estimates for PCOs. We did not find a statistically significant association between improvements in haemoglobin and QOL. Conclusions: Future studies employing anaemia and nephrology-specific PROMs and conducted with greater rigour, standardization in the research methods, and reporting of PCOs in renal populations will improve understanding of PCOs in this patient group and hopefully improve patient outcomes and experiences.
Taxol Improves Pre-Implantation Development Potential of Mouse Embryos
Authors: Esmaeilzadeh Khadijeh , Gourabi Hamid , Sheidai Masoud , Fakhri Mostafa , Bazrgar Masood
Published: November 2019

Aim: The objective of the present study was to investigate the development of mouse embryos and the chromosomal status after the pre-implantation treatment with paclitaxel (Taxol) based on the reports that indicate Taxol improves the developmental potential of vitrified human and mouse oocytes. Methods: Outbred female mice were superovulated and in vitro fertilization (IVF) was carried out using sperms from the same strain. Two-cell stage mouse embryos were cultured in the presence of Taxol for 24 h. After the determination of a non-toxic dose of Taxol, embryo development in control and Taxol-treated groups was compared during 3.5 days post-IVF. The aneuploidy rate of embryos was assessed by fluorescence in situ hybridization for chromosomes 2 and 11. Results: Development to morula and blastocyst stages was considerably enhanced following the addition of Taxol 0.01 µM compared to a similar situation in controls (p < 0.0001). Moreover, the degeneration rate was decreased following treatment with this concentration of Taxol (p < 0.01). The rate of aneuploidy in embryos and individual blastomeres did not vary between groups (p = 0.518 and 0.810 respectively). Conclusion: Pre-implantation treatment with Taxol 0.01 µM had a positive effect on the development to morula/blastocyst stages and decreased the degeneration rate without affecting the aneuploidy rate of chromosomes 2 and 11.
The “First 1,000 Days+” as Key Contributor to the Double Burden of Malnutrition
Authors: Hoffman Daniel , Arts Maaike , Bégin France
Published: November 2019

Growth from conception through age 2 years, the “First 1,000 days,” is important for long-term health of the growing fetus and child and is influenced by several factors including breastfeeding and complementary feeding. Low- and middle-income countries face a complicated array of factors that influence healthy growth, ranging from high food insecurity, poor sanitation, limited prenatal or neonatal care, and high levels of poverty that exacerbate the “vicious cycle” associated with intergenerational promotion of growth retardation. It is now well recognized that the period prior to conception, both maternal and paternal health and diet, play an important role in fetal development, giving rise to the concept of the “First 1,000 Days+”. Breastfeeding and complementary feeding practices can be improved through a combination of interventions such as baby-friendly hospitals, regulations for marketing of foods and beverages to children, adequate counseling and support, and sound social and behavior change communication, but continued research is warranted to make such programs more universal and fully effective. Thus, improving the overall understanding of factors that influence growth, such as improved breastfeeding and age-appropriate and adequate complementary feeding, is critical to reducing the global prevalence of the double burden of malnutrition.
Assessing Breastfeeding Practices Objectively Using Stable Isotope Techniques
Authors: Slater Christine , Kaestel Pernille , Houghton Lisa
Published: November 2019

An objective method of assessing breastfeeding practices is required to evaluate progress toward the World Health Organization Global Target 2025: to increase exclusive breastfeeding (EBF) rates in the first 6 months to at least 50% by 2025. Currently, assessment of EBF at the population level is based on mother or caregiver reporting, which risks recall and social desirability bias. A more objective method is the deuterium oxide dose to mother (DTM) technique, in which lactating mothers are given a small amount of deuterium-labeled water. The infant receives deuterium during breastfeeding, and a compartmental model is used to determine the amount of human milk consumed by the infant, and the exclusivity of breastfeeding practices. If the amount of human milk consumed by an infant is determined using the DTM technique and the concentration of nutritional components or potentially toxic contaminants is measured, then the infant’s intake of essential nutrients or environmental contaminants can be ascertained.
The International Atomic Energy Agency International Doubly Labelled Water Database: Aims, Scope and Procedures
Authors: Speakman John R. , Pontzer Herman , Rood Jennifer , Sagayama Hiroyuki , Schoeller Dale A. , Westerterp Klaas R. , Wong William W. , Yamada Yosuke , Loechl Cornelia , Murphy-Alford Alexia J.
Published: November 2019

Background: The doubly labelled water (DLW) method is an isotope-based technique that quantifies total energy expenditure (TEE) over periods of 1–3 weeks from the differential elimination of stable isotopes of oxygen and hydrogen. The method was invented in the 1950s, but limited ability to measure low isotope enrichments combined with the high cost of isotopes meant it only became feasible to use in humans in the 1980s. It is still relatively expensive to use, and alone small samples are unable to tackle some of the important questions surrounding energy balance such as how have expenditures changed over time and how do expenditures differ with age, between sexes and in different environments? Summary: By combining information across studies, answers to such questions may be possible. The International Atomic Energy Agency (IAEA) DLW database was established to pool DLW data across multiple studies. It was initiated by the main labs currently using the method and is hosted by the IAEA. At present, the database contains 6,621 measures of TEE by DLW from individuals in 23 countries, along with various additional data on the study participants. Key Messages: The IAEA DLW database is a key resource enabling future studies of energy demands.
Regional Overview on Maternal Nutrition and Examples of Health System Programme and Policy Responses: Asia and the Pacific
Authors: de Silva Angela , Untoro Juliawati , Blankenship Jessica , Udomkesmalee Emorn
Published: November 2019

Background: The double burden of malnutrition in Asia and the Pacific is driving a renewed focus on maternal malnutrition. Summary: Though adverse consequences of maternal malnutrition have been long recognized, there is slow progress in addressing nutritional problems of women/adolescent girls. Coverage and quality of current maternal nutrition interventions, mostly delivered through antenatal care programmes vary across countries, and are often sub-optimum. Further, despite a marked increase in overweight and obesity in women of reproductive age, at present, most programmes are focused on under-nutrition and micronutrient deficiencies. Key Messages: The recent antenatal care recommendations released by World Health Organization provide a benchmark for countries to evaluate their programmes and identify gaps and challenges to improving maternal nutrition. Asian and Pacific countries need to address all forms of maternal malnutrition. For countries that historically focused on maternal under-nutrition, expanding their programmes to incorporate interventions to address overweight and obesity will be challenging. Innovative methods for nutrition counselling, both in terms of content and using novel channels of communication, are needed. Protocols and guidance on managing excessive weight gain as well as determining appropriate pregnancy weight gains are needed, while managing micronutrient deficiencies, particularly in settings where inherited disorders of red blood cells exist.
Translational and Implementation Research to Bridge Evidence and Implementation
Authors: Kraemer Klaus , van Zutphen Kesso Gabrielle
Published: November 2019

Background: The role of science in guiding interventions and programs and contributing to progress in achieving global targets is undeniable. In public health nutrition, biological research in the past century focused largely on single nutrients and provided the basis for addressing nutritional deficiencies. This focus has now expanded to consider evidence including, but not limited, to knowledge about food, diet, behavior, context, and culture. The complex double burden of malnutrition will need to be addressed through a wider lens that appreciates the multiple and interrelated facets that underpin it. Summary: Despite the acknowledged importance of translational research in improving nutritional outcomes, significant gaps remain in the process leading from science to practice. This article sheds light on 2 examples that demonstrate this, namely, anemia and stunting. Further, much work is still required to translate the current evidence base into effective actions that result in impact at scale, pointing toward the need for more implementation research in nutrition. Key Messages: While discoveries may take time to surface and implementers are impatient to address the challenge at hand, it is essential to identify and deploy the best available evidence while continuously advancing the evidence base, and to seek the right balance between action and inaction.
The Double Burden of Malnutrition: Research Agenda for Reversing Global Trends
Authors: Hoffman Daniel
Published: November 2019

The double burden of malnutrition (DBM) is becoming more prevalent throughout the world, but most alarming is the fact that it is also prevalent in lower-income countries, those with limited research and policy funding. To that end, a number of research gaps have been identified related to the biology, research methodologies/data systems, and programs and policies that could be improved to best address the DBM across the globe, especially in diverse settings with limited resources. Clearly, understanding the biology of the DBM is fundamental to developing policies, but research needs to become more interdisciplinary and communicate better with policymakers. At the same time, research methods need to become more innovative, and data systems must advance to accommodate new research methods and approaches. Filling these gaps will allow for broad and effective policies to be implemented through both public and private groups, an area that could be leveraged through transparent public-private engagement and programs. Without novel and integrated approaches to research, efforts to reverse the DBM will be limited. Therefore, the time has come for truly cooperative and collaborative efforts on all fronts to work together and promote the health of future generations across the globe.
A Proposal for a System of Classification for Anthroposophic Meditation
Authors: Sparby Terje
Published: November 2019

Background: The investigation of the specific connections between different techniques of meditation and their respective effects depends upon a classification of the meditative activity involved. Universal systems of classification need to be developed based both on traditional sources and contemporary science. In this article, a system of classification for anthroposophical meditation is proposed. Methods: The system was developed from a close textual analysis of meditation instructions given by Rudolf Steiner. The system of classification arising from the investigation was compared to three other classificatory systems that have recently been suggested. Results: The analysis resulted in a system of classification with two main branches: (1) the shared features of anthroposophical meditation and (2) the different aspects of specific anthroposophical meditations. The first branch contains the following sub-categories: understanding, internal conditions, external conditions, sequence, timeframe and dealing with hindrances. The second branch contains: source, aim, activity, sequence and timeframe. Other systems of classification tend to leave out the dimension of the meditative activity. Conclusion: The proposed classification system can be used as a starting point for further refinements of the classification of anthroposophic meditation, but it can also be used as a standard for future studies of the connections between different meditations and their effects.
Complications of Isolated Fungal Sphenoiditis: Patient Clinical Characteristics
Authors: Promsopa Chakapan , Polwiang Pittaya , Chinpairoj Suchet , Kirtsreesakul Virat
Published: November 2019

Objective: To evaluate the clinical characteristics of patients with complications of isolated fungal sphenoiditis. Materials and Methods: The records of patients diagnosed with isolated fungal sphenoiditis at Songklanagarind Hospital from January 2004 to December 2017 were retrospectively reviewed. Data related to demographics, clinical presentation, underlying disease, type of complication, surgical procedure, and clinical outcome were collected. Results: Among the 35 participating patients, complications were found at a rate of 40%. The most common complication was visual loss (71.43%). We also compared the clinical characteristics between patients with and without complications via univariate analysis. The enrolled patients consisted of 12 men and 23 women (1:2). The mean age was older in the complications group 64 (41–84) vs. 57.43 (36–81) years, respectively. Underlying diabetes mellitus and complete opacity of the sphenoid sinus were factors that related significantly to the occurrence of complications. After treatment, 35.72% of the participants made a complete recovery; underlying diabetes mellitus was associated with a poor prognosis. Conclusion: This report indicates that practitioners must be careful of complications arising in elderly and female patients with isolated fungal sphenoiditis, who have a complete opacity of the sphenoid sinus and underlying diabetes mellitus.
Tailoring Antibiotic Prophylaxis for Ureteroscopic Procedures Based on Local Resistance Profiles May Lead to Reduced Rates of Infections and Urosepsis
Authors: Zisman Ariel , Badaan Shadie , Kastin Alexander , Kravtsov Alexander , Amiel Gilad E. , Mullerad Michael
Published: November 2019

Introduction and Objectives: Urinary tract infections (UTI) following ureteroscopy (URS) occur in about 4% of patients. Due to the resistant bacterial strains we encounter in our institution, we retrospectively examined whether a double-drug antibiotic prophylactic treatment (APT) can reduce urosepsis after URS. Materials and Methods: Between February 2015 and March 2016, we performed 344 URS for stone treatment. Starting from September 2015, we changed the APT. Exclusion criteria included procedures involving percutaneous nephrolithotomy, pediatric or pregnant patients, and patients with preoperative clinical UTI. Results: Fifty-seven patients were excluded. Group 1 (n = 106) were the last to receive the conventional APT (oral ciprofloxacin), while the second group (n = 181) were the first to receive the new ­regimen (intravenous gentamycin and ampicillin). A distinct percentage of both groups had a preoperative positive urine culture (29% in group 1 and 19% in group 2). Seven of 9 septic events developed in patients with preoperative positive urine culture (p < 0.001). Patients undergoing retrograde intrarenal surgery were at increased risk for sepsis when treated with conventional APT (p < 0.01). Post-URS sepsis was 7.5% using the conventional APT and 0.5% with the new APT (p < 0.0001). Conclusions: A distinct number of patients undergoing URS stone treatment have positive preoperative urine cultures. “One size fits all” APT is not sufficient according to our data. A regimen tailored to the local antibiotic resistance of the uropathogens can lower the rate of sepsis.
Prothrombotic and Proinflammatory Activities of the β-Hemolytic Group B Streptococcal Pigment
Authors: Siemens Nikolai , Oehmcke-Hecht Sonja , Hoßmann Jörn , Skorka Sebastian B. , Nijhuis Roel H.T. , Ruppen Corinne , Skrede Steinar , Rohde Manfred , Schultz Daniel , Lalk Michael , Itzek Andreas , Pieper Dietmar H. , van den Bout Christiaan J. , Claas Eric C.J. , Kuijper Ed J. , Mauritz Robert , Sendi Parham , Wunderink Herman F. , Norrby-Teglund Anna
Published: November 2019

A prominent feature of severe streptococcal infections is the profound inflammatory response that contributes to systemic toxicity. In sepsis the dysregulated host response involves both immunological and nonimmunological pathways. Here, we report a fatal case of an immunocompetent healthy female presenting with toxic shock and purpura fulminans caused by group B streptococcus (GBS; serotype III, CC19). The strain (LUMC16) was pigmented and hyperhemolytic. Stimulation of human primary cells with hyperhemolytic LUMC16 and STSS/NF-HH strains and pigment toxin resulted in a release of proinflammatory mediators, including tumor necrosis factor, interleukin (IL)-1β, and IL-6. In addition, LUMC16 induced blood clotting and showed factor XII activity on its surface, which was linked to the presence of the pigment. The expression of pigment was not linked to a mutation within the CovR/S region. In conclusion, our study shows that the hemolytic lipid toxin contributes to the ability of GBS to cause systemic hyperinflammation and interferes with the coagulation system.
Long-Term Suppression of Disabling Tremor by Thalamic Stimulation in a Patient with Spinocerebellar Ataxia Type 2
Authors: Isobe Takashi , Sato Hiromasa , Goto Tetsuya , Yako Takehiro , Yoshida Kunihiro , Hashimoto Takao
Published: November 2019

The beneficial effect of thalamic deep brain stimulation (DBS) on action tremor has been reported in a few cases of spinocerebellar ataxia (SCA); however, several factors should be taken into account regarding the indication for DBS in advanced cases. We performed DBS of the ventral intermediate nucleus (Vim) of the thalamus for treatment of coarse action tremor in a patient with SCA2 (spinocerebellar ataxia type 2) in the wheelchair-bound stage. Although improvement of the tremor of the proximal part was incomplete, the patient regained substantial parts of daily functioning. The effect lasted for more than 6 years, and the suppression of tremor significantly contributed to maintaining the level of the patient’s expression into the bedridden stage. Vim DBS can be a treatment option for tremor in SCA patients, even in the advanced stage, as long as the tremor is depriving the patient of behavioral expression. As residual proximal tremor may hamper functional recovery, DBS of other targets or multi-targets should be further explored to attain a better outcome.
The Correlation between Atrial Fibrillation and Prognosis and Hemorrhagic Transformation
Authors: Dang Hui , Ge Wan-Qian , Zhou Chao-Fan , Zhou Cheng-Ye
Published: November 2019

Objective: Atrial fibrillation (AF) is the recognized risk factor for hemorrhagic transformation (HT) in thrombolysis patients with acute ischemic stroke (AIS). But the impact of AF on prognosis is still controversial. In our study, we aimed to assess the relationship between AF and HT and prognosis. Methods: We assessed 184 patients diagnosed with AIS and received thrombolysis from January 2016 to October 2017. Based on the imaging results during hospitalization, the patients were divided into HT and non-HT groups in which the HT was containing 40 patients. According to the modified Rankin Scale (mRS), we divided the patients into favorable prognosis (mRS score of 0–2) and the poor (mRS score >2) after 3 and 6 months of follow-up. Our analysis included demographics, onset to treatment time, initial blood pressure, baseline National Institutes of Health Stroke Scale (NIHSS) score, HT, anticoagulants, AF, smoking, and other past history. Results: At baseline, there was a significant difference (p < 0.05) between the HT and non-HT groups in the level of age, hyperlipidemia, AF, NIHSS, and the application of anticoagulants. After 3 and 6 months of follow-up, we found that only NIHSS (OR3 month 1.421, 95% CI 1.280–1.578, p < 0.001, and OR6 month 1.326, 95% CI 1.217–1.445, p < 0.001) was associated with prognosis instead of AF, HT, and anticoagulants. Meanwhile, patients with AF tended to be older, higher NIHSS score and less hyperlipidemia (p < 0.05). Conclusion: The present study indicated that there is no significant correlation between AF and prognosis, although there is some indeed related with HT. That was, the prognosis with AF had a similar response trend compared with the non-AF.
Artificial Intelligence Techniques for Automated Diagnosis of Neurological Disorders
Authors: Raghavendra U. , Acharya U. Rajendra , Adeli Hojjat
Published: November 2019

Background: Authors have been advocating the research ideology that a computer-aided diagnosis (CAD) system trained using lots of patient data and physiological signals and images based on adroit integration of advanced signal processing and artificial intelligence (AI)/machine learning techniques in an automated fashion can assist neurologists, neurosurgeons, radiologists, and other medical providers to make better clinical decisions. Summary: This paper presents a state-of-the-art review of research on automated diagnosis of 5 neurological disorders in the past 2 decades using AI techniques: epilepsy, Parkinson’s disease, Alzheimer’s disease, multiple sclerosis, and ischemic brain stroke using physiological signals and images. Recent research articles on different feature extraction methods, dimensionality reduction techniques, feature selection, and classification techniques are reviewed. Key Message: CAD systems using AI and advanced signal processing techniques can assist clinicians in analyzing and interpreting physiological signals and images more effectively.
Evaluation of Upper Endoscopic and Endoscopic Ultrasound Features in the Differential Diagnosis of Gastrointestinal Stromal Tumors and Leiomyomas in the Upper Gastrointestinal Tract
Authors: Vaicekauskas Rolandas , Urbonienė Jurgita , Stanaitis Juozas , Valantinas Jonas
Published: November 2019

Background: Differentiation between benign and malignant subepithelial lesions (SELs) in the upper gastrointestinal tract (UGT) leads to far-reaching clinical consequences. An accurate diagnosis can be challenging because of the insufficient diagnostic yield of upper endoscopy, endoscopic ultrasound (EUS), and different types of biopsy. Aim: Our aim was to reveal the efficacy of upper endoscopic and EUS features for the differential diagnosis of hypoechogenic SELs (gastrointestinal stromal tumors [GISTs] and leiomyomas) in the UGT. Materials and Methods: The research covers a case series study of 27 hypoechogenic SELs in the UGT between 2012 and 2015 at Vilnius University Hospital Santaros Klinikos. Upper endoscopic and EUS features of SELs were recorded. In order to standardize the diagnostic approach to GISTs and leiomyomas, we assigned scores for seven upper endoscopic and EUS features. Results: The mean total scores in the GIST group were significantly higher than those in the leiomyoma group: 3.25 ± 1.71 and 0.53 ± 0.83 (p < 0.0001), respectively. Increment by one score increased the odds ratio for GIST 5.87 times (95% CI 1.63–21.11; p = 0.007). The total score demonstrated very good discriminatory features of GISTs against leiomyomas (area under the receiver operating characteristic curve 0.94 [0.86–1]). The cutoff value of 1.5 total score indicated 83.3% sensitivity and 93.3% specificity in diagnosing GISTs. Conclusions: Upper endoscopy and EUS are useful methods in making a definite diagnosis of SELs. Their diagnostic accuracy for the differential diagnosis of GISTs and leiomyomas is sufficient.
Prevalence and Electronic Health Record-Based Phenotype of Loss-of-Function Genetic Variants in Arrhythmogenic Right Ventricular Cardiomyopathy-Associated Genes
Authors: Carruth Eric D. , Young Wilson , Beer Dominik , James Cynthia A. , Calkins Hugh , Jing Linyuan , Raghunath Sushravya , Hartzel Dustin N. , Leader Joseph B. , Kirchner H. Lester , Smelser Diane T. , Carey David J. , Kelly Melissa A. , Sturm Amy C. , Alsaid Amro , Fornwalt Brandon K. , Haggerty Christopher M.
Published: November 2019

Background:

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is associated with variants in desmosome genes. Secondary findings of pathogenic/likely pathogenic variants, primarily loss-of-function (LOF) variants, are recommended for clinical reporting; however, their prevalence and associated phenotype in a general clinical population are not fully characterized.

Methods:

From whole-exome sequencing of 61 019 individuals in the DiscovEHR cohort, we screened for putative loss-of-function variants in
PKP2
,
DSC2
,
DSG2
, and
DSP
. We evaluated measures from prior clinical ECG and echocardiograms, manually over-read to evaluate ARVC diagnostic criteria, and performed a PheWAS (phenome-wide association study). Finally, we estimated expected penetrance using Bayesian inference.

Results:

One hundred forty individuals (0.23%; 59±18 years old at last encounter; 33% male) had an ARVC variant (G
+
). None had an existing diagnosis of ARVC in the electronic health record, nor significant differences in prior ECG or echocardiogram findings compared with matched controls without variants. Several G
+
individuals satisfied major repolarization (n=4) and ventricular function (n=5) criteria, but this prevalence matched controls. PheWAS showed no significant associations of other heart disease diagnoses. Combining our best genetic and disease prevalence estimates yields an estimated penetrance of 6.0%.

Conclusions:

The prevalence of ARVC loss-of-function variants is ≈1:435 in a general clinical population of predominantly European descent, but with limited electronic health record-based evidence of phenotypic association in our population, consistent with a low penetrance estimate. Prospective deep phenotyping and longitudinal follow-up of a large sequenced cohort is needed to determine the true clinical relevance of an incidentally identified ARVC loss-of-function variant.
Benefit of Intravenous Thrombolysis in Acute Ischemic Stroke Patients With High Cerebral Microbleed Burden
Authors: Schlemm Ludwig , Endres Matthias , Werring David J. , Nolte Christian H.
Published: November 2019

Background and Purpose—

Cerebral microbleeds (CMBs) are a risk factor for intracranial hemorrhage. Whether intravenous thrombolysis (IVT) improves functional outcome in acute ischemic stroke patients with CMBs is unknown. We aimed to estimate the treatment effect of IVT in patients with acute ischemic stroke and a high burden (>10) of CMBs.

Methods—

We devised a multistep algorithm to model 90-day modified Rankin Scale scores in patients with ≤10 versus >10 CMBs who do or do not receive IVT. Parameters were extracted from recently published meta-analyses and included pairwise relationships between CMBs, IVT, 3-month functional outcome, and intracranial hemorrhage. Uncertainty was quantified in probabilistic sensitivity analyses.

Results—

In patients with >10 CMBs as compared with ≤10 CMBs, point estimates of the odds ratios for favorable outcome (modified Rankin Scale ≤2) associated with IVT were 7% to 10% lower but still >1 (range, 1.03–1.51). On the other hand, IVT in patients with >10 CMBs significantly increased the odds of mortality. The point estimates for the net treatment effect of IVT (change in the utility-weighted modified Rankin Scale score) in patients with >10 CMBs were in favor of withholding IVT in older patients with more severe strokes and longer treatment delays. However, because the general pretest probability of >10 CMBs is low (0.6%–2.7%), pretreatment magnetic resonance imaging to quantify CMB burden would be justified only if it delayed IVT by <10 minutes.

Conclusions—

High CMB burden modifies the treatment effect of IVT. In patients with >10 CMBs, IVT is associated with higher mortality and, in older patients with severe strokes and longer treatment delays, a net utility loss. Patients with higher-than-average pretest probability of >10 CMB might profit from magnetic resonance imaging screening if it does not increase the treatment time.
Wenzhou Restaurants in Paris’s Chinatowns
Authors: Lipovsky Caroline , Wang (王玮) Wei
Published: November 2019

In light of the large number of Chinese immigrants in Paris originally from the Wenzhou region in China’s Zhejiang Province, this research focuses on two case studies of Wenzhou restaurants situated in different Paris Chinatowns. It seeks to identify the ways in which the Wenzhou owners mark their presence in the Parisian linguistic landscape through the signage of their shopfronts and premises. By infusing existing multimodal analysis with ethnographic linguistic landscape analysis (ELLA), this study examines the ways in which two Wenzhou restaurateurs display their specific cultural and ethnic identity in the linguistic landscape. The analysis of the signage of their premises, combined with ethnographic interviews, unveils the restaurateurs’ strategies to enact their cultural and ethnic Wenzhou identity through their shopfront signs, menus and premise decorations, and how they distinguish themselves from their Chinese competitors.
Between the Stage and the Street: Art and Artifice in Giordano Bruno’s Candelaio
Authors: Albanese Nicholas
Published: November 2019

The Italian Renaissance philosopher Giordano Bruno’s only literary work, the comedy titled Candelaio published in 1582, has been interpreted through a comparative analysis with either his philosophical writings or with other plays from the tradition of the commedia erudita. In this article, I focus on the Candelaio’s textual strategies by drawing on the analytical categories of dissonance and deflection in order to demonstrate how Bruno’s theatrical piece can be viewed as a polemical statement on aesthetics. The introductory peritexts of the work set the key parameters for reading his text as a conscious play on conventionality and thus provide the interpretive framework for disentangling the complex meanings embedded in the dramatic action of the five acts that follow. Ultimately, the comedy aims to question representational practices through an engagement with the debate over the nature and function of art and artifice that invested all of the arts during the Cinquecento.
Lantana caudata (Verbenaceae), a new species from the Brazilian Atlantic Forest

Authors: CARDOSO PEDRO HENRIQUE , NETO LUIZ MENINI , CABRAL ANDRESSA , SALIMENA FÁTIMA REGINA GONÇALVES
Published: November 2019

Lantana caudata, a new species of Verbenaceae, endemic to the Brazilian Atlantic Forest is described and illustrated. It is a tall shrub, characterized by the presence of pedicellate glandular trichomes on all parts of the plant; branches conspicuously prickly; lanceolate to elliptical leaves, with obtuse to cuneate base and caudate apex; peduncle long; and yellow, red or orange corolla. This species occurs in the transition between dense rainforest and inselbergs in Espírito Santo and between the same type of forest and campos de altitude in Minas Gerais. We discuss the diagnostic characters, morphological affinities and conservation status, and present a distribution map and illustration.
Doomed to a vile lot: new taxa, notes, and an updated generic key for the Old World corsairs (Heteroptera: Reduviidae: Peiratinae)
Authors: SWANSON DANIEL R.
Published: November 2019

Herein are erected several new taxa and taxonomic changes based on a study of the Old World genera of Peiratinae: Sphodrembas gen. nov. is erected for a single new species, Sphodrembas fumipennis sp. nov. from Kenya and Tanzania. Ectomocoris caccabatus sp. nov. is newly described and represents the first record of the genus from the Korean Peninsula. Chaulioleistes gen. nov. is erected for Peirates singularis Stål, 1874, resulting in Chaulioleistes singularis (Stål, 1874) comb. nov. Isdegardes Distant, 1909, described in Acanthaspidinae (=Reduviinae), is considered a junior synonym of the peiratine genus Phalantus Stål, 1863 syn. nov., resulting in Phalantus melanocephalus (Distant, 1909) comb. nov. for the type species of Isdegardes. Lestomerus wroughtoni Bergroth, 1915 is transferred to Brachysandalus Stål, 1866, resulting in Brachysandalus wroughtoni (Bergroth, 1915) comb. nov. The previously proposed synonymy of Polychitonocoris formosus Miller, 1940 with Calistocoris caesareus Reuter, 1881 is corroborated. All of the above taxonomic acts are supplemented with a key to the species of Calistocoris, a key to the species of Pachysandalus, and a key to the peiratine genera of the Old World. Also reported are thirteen new country records for eleven other species: Brachysandalus bicolor (Villiers, 1948) (Kenya, Tanzania); Ectomocoris bimaculatus Schouteden, 1909 (Ghana); Ectomocoris fenestratus (Klug, 1830) (Ghana); Ectomocoris maculicrus (Fairmaire, 1858) (Uganda, Zimbabwe); Lestomerus affinis (Audinet-Serville, 1831) (Malaysia); Lestomerus basilewskyi Villiers, 1962 (Kenya); Lestomerus bicolor (Villiers, 1948) (Kenya); Lestomerus dubius Villiers, 1948 (Cameroon); Pachysandalus schoutedeni Villiers, 1962 (Sudan); Peirates collarti Schouteden, 1931 (Cameroon); Peirates quadrinotatus (Fabricius, 1798) (Malaysia); and Phalantus africanus Stål, 1874 (Ghana).
On the sun-spiders of the ibirapemussu species-group of the genus Gaucha Mello-Leitão, 1924 (Solifugae, Mummuciidae), with description of a new species
Authors: CARVALHO LEONARDO S. , BOTERO-TRUJILLO RICARDO
Published: November 2019

A new solifuge species in the genus Gaucha Mello-Leitão, 1924 and the ibirapemussu species-group is herein described based on males and females collected at Itacuruba, State of Pernambuco, and Jaicós, State of Piauí, both in Northeastern Brazil. Males of the new species can be readily recognized by having the movable finger MM and MSM teeth reduced and of similar size. The present finding raises to twelve the number of described species in the genus, five of which belong to the ibirapemussu species-group. Besides, a new locality record for the species Gaucha ibirapemussu (Carvalho et al., 2010) is here presented, along with an updated identification key for all Gaucha species.
Redescription of three rare species of Dasypoda bees with first description of D. iberica and D. tibialis females (Hymenoptera, Apoidea, Melittidae)
Authors: RADCHENKO VLADIMIR G. , GHISBAIN GUILLAUME , MICHEZ DENIS
Published: November 2019

Dasypoda bees are host-specialized solitary species distributed in the Palaearctic Region. In the framework of a global revision of this genus, comprehensive descriptions of three rare species (D. tibialis Morawitz, D. vulpecula Lebedev and D. iberica Warncke) are presented. The detailed morphology of the D. tibialis male and both sexes of D. vulpecula are given for the first time after a very partial original description. The females of D. tibialis and D. iberica are described for the first time and additional morphological characters of the male of D. iberica are provided. The lectotype of Dasypoda tibialis is designated. Host-plants and new localities are also presented.
The Relationships of Extreme Precipitation and Temperature Events with Ethnographic Reports of Droughts and Floods in Nonindustrial Societies
Authors: Felzer B. S. , Ember Carol R. , Cheng R. , Jiang M.
Published: November 2019

Our broad research goal is to understand how human societies adapt to natural hazards, such as droughts and floods, and how their social and cultural structures are shaped by these events. Here we develop meteorological data of extreme dry, wet, cold, and warm indices relative to 96 largely nonindustrial societies in the worldwide Standard Cross-Cultural Sample to explore how well the meteorological data can be used to hindcast ethnographically reported drought and flood events and the global patterns of extremes. We find that the drought indices that are best at hindcasting ethnographically reported droughts [precipitation minus evaporation (P − E) measures] also tend to overpredict the number of droughts, and therefore we propose a combination of these two indices plus the PDSI as an optimal approach. Some wet precipitation indices (R10S and R20S) are more effective at hindcasting ethnographically reported floods than others. We also calculate the predictability of those extreme indices and use factor analysis to reduce the number of variables so as to discern global patterns. This work highlights the ability to use extreme meteorological indices to fill in gaps in ethnographic records; in the future, this may help us to determine relationships between extreme events and societal response over longer time scales than are otherwise available.
The top 100 most influential articles in allergic rhinitis from 1970 to 2018: A bibliometric analysis
Authors: Wu Qingwu , Zheng Rui , Wang Weihao , Qiu Huijun , Huang Xuekun , Yang Qintai
Published: November 2019

Objective

This study aimed to identify the top 100 most influential articles in the field of allergic rhinitis (AR).

Methods

Web of Science was queried for 1970 to 2018. Articles were sorted in descending order of the citation count. All titles and abstracts were screened to identify the top 100 articles.

Results

The top 100 most influential articles in AR were identified. The earliest article was published in 1975, and the most recent in 2015. The most prolific decade was the 2000s, with 59 articles published. Twenty-nine journals contributed to the top 100 articles, with the Journal of Allergy and Clinical Immunology contributing most of the articles (n = 34). The top three countries of article origin were the United States (n = 34), followed by the United Kingdom and France (n = 14 each). The type of article covered clinical research (n = 68), reviews (n = 22), and basic research (n = 10). For the clinical research articles, there were 6 studies with level 1 evidence, 25 with level 2 evidence, 11 with level 3 evidence, and 26 with level 4 evidence.

Conclusions

This study identified the top 100 most influential articles in the area of AR. Recognition of important historical contributions to this field may guide future investigations into AR.
Digital Segmentation of Priority Populations in Public Health
Authors: Evans W. Douglas , Thomas Christopher N. , Favatas Dionisios , Smyser Joseph , Briggs Jodie
Published: November 2019

The rapid growth and diffusion of digital media technologies has changed the landscape of market segmentation in the last two decades, including its use in promoting prosocial and behavior change. New, population-specific and culturally appropriate prevention strategies can leverage the potential of digital media to influence health outcomes, especially for the greatest users of digital technology, including youth and young adults. Health behavior change campaigns are increasingly shifting resources to social media, creating opportunities for innovative interventions and new research methods. This article examines three case studies of digital segmentation: (1) tobacco control from the Truth Initiative, (2) community-based public health programs from the Centers for Disease Control and Prevention, and (3) substance use (including opioids) and other risk behavior prevention from Public Good Projects. These case studies of recent digital segmentation efforts in the not-for-profit, government, and academic sectors show that it increases reach and frequency of messages delivered to priority populations. The practice of digital segmentation is rapidly growing, shows early signs of effectiveness, and may enhance future public health campaigns. Additional research could optimize its use and effectiveness in promoting prosocial and behavior change campaign outcomes.
An exploratory study of how young people experience and perceive living with type 1 diabetes during late adolescence and emerging adulthood
Authors: Ingersgaard Marianne Vie , Hoeeg Didde , Willaing Ingrid , Grabowski Dan
Published: November 2019

Objective

Suboptimal glycemic control and psychosocial challenges are significant concerns for adolescents and emerging adults (collectively young people) with type 1 diabetes. Knowledge about young peoples’ attitudes towards living with type 1 diabetes is inadequate, but the issue is important in the development of strategies to improve glycemic control and psychosocial well-being. This study explored young peoples’ perceptions of living with type 1 diabetes.

Methods

An exploratory, qualitative design was employed. Data were collected through five participatory workshops with 19 young people (age 15–25). Data were thematically analyzed.

Results

The overall depiction of living with type 1 diabetes was paradoxical; it affected everything and nothing. Living with type 1 diabetes was a balancing act between accommodating a “normal” way of living and self-management tasks of the treatment regimen. Participants’ perceptions reflected shifting accounts that could be divided into five themes: (1) special rules during youth, (2) striving for autonomy, (3) an uncertain future, (4) social support, and (5) stigma and disclosure.

Discussion

It is important to probe for the multiple and interrelated social contexts that underlie young peoples’ motives for adhering to and deviating from treatment regimens. Future studies should focus on relational aspects, including stigma mechanisms, the role of friends, and facilitation of balanced parental involvement.
An anatomical study on the Stener-type lesion of the radial collateral ligament of the metacarpophalangeal joint of the thumb
Authors: Jakubietz Rafael G , Erguen Sueleyman , Bernuth Silvia , Meffert Rainer H , Gilbert Fabian , Jakubietz Michael
Published: November 2019

The Stener-type lesion of the radial collateral ligament is rare. The insertion of the abductor pollicis brevis is believed to preclude its occurrence. The aim of this study was to determine whether this lesion can be induced mechanically. Four specimens were tested in neutral rotation and 20° of supination, in 45° and 30° of flexion, and in the neutral position. The angle of ulnar adduction to form a Stener-type lesion was measured. The lesion occurred only in 45° flexion in all specimens. A lesser angle of flexion decreased the rate of ligament displacement. In the neutral position no ligament displacement was found. A Stener-type lesion of the radial collateral ligament can occur in ulnar adduction and flexion of the metacarpophalangeal joint. Supination of the joint increases the likelihood of ligament displacement. As distal ruptures of the radial collateral ligament are uncommon, a high index of suspicion is required for diagnosis.
Tatsienensine, a Norditerpenoid Alkaloid From Delphinium tatsienense
Authors: Chen Feng-Zheng , Li Shu-Hua , Zhao Qi , Gou Xiao-jun
Published: November 2019

A novel C20-diterpenoid alkaloid with an unprecedented 19 carbon atoms, designated as tatsienensine (1), was isolated from the whole plant of Delphinium tatsienense. The structure of the compound and its relative configuration were established by NMR techniques and single-crystal X-ray diffraction.
When a Sense of “We” Is Lost: Investigating the Consequences of a Lost Common Identity Among Druze in Israel
Authors: Saguy Tamar , Sobol-Sarag Danit , Halabi Samer , Stroebe Katherine , Bruneau Emile , Hasan-Aslih Siwar
Published: November 2019

Research shows that inclusive identities are effective for improving intergroup relations. Little work, however, asked what happens once a sense of common identity is formed, but then lost. Given increasing diversity and integration attempts that might fail, this question is realistic and timely. We studied a religious minority in Israel, Arab-Druze ( N = 178), constituting 1.6% of the population. Druze have always had strong common ties with the Jewish majority, particularly younger Druze who serve in the Israeli army. We surveyed Druze in the aftermath of the nationality bill, which was considered by many to be highly exclusionary toward non-Jews. Drawing on research on minority exclusion, we expected that for younger Druze, a sense of common identity loss will predict radical forms of action. This was supported by our cross-sectional data and remained stable after controlling for more classic predictors of violent and nonviolent action.
Climate effects on the onset of flowering in the United Kingdom
Authors: Fox Nigel , Jönsson Anna Maria
Published: November 2019

Background

A warmer climate has consequences for the timing of phenological events, as temperature is a key factor controlling plant development and flowering. In this study, we analyse the effects of the long-term climate change and an extreme weather event on the first flowering day (FFD) of five spring-flowering wild plant species in the United Kingdom. Citizen science data from the UK Woodland Trust were obtained for five species: Tussilago farfara (coltsfoot), Anemone nemorosa (wood anemone), Hyacinthoides non-scripta (bluebell), Cardamine pratensis (cuckooflower) and Alliaria petiolate (garlic mustard).

Results

Out of the 351 site-specific time series (≥ 15-years of FFD records), 74.6% showed significant negative response rates, i.e. earlier flowering in warmer years, ranging from − 5.6 to − 7.7 days °C−1. 23.7% of the series had non-significant negative response rates, and 1.7% had non-significant positive response rates. For cuckooflower, the response rate was increasingly more negative with decreasing latitudes. The winter of 2007 reflects an extreme weather event, about 2 °C warmer compared to 2006, where the 2006 winter temperatures were similar to the 1961–1990 baseline average. The FFD of each species was compared between 2006 and 2007. The results showed that the mean FFD of all species significantly advanced between 13 and 18 days during the extreme warmer winter of 2007, confirming that FFD is affected by temperature.

Conclusion

Given that all species in the study significantly respond to ambient near-surface temperatures, they are suitable as climate-change indicators. However, the responses to a + 2 °C warmer winter were both more and less pronounced than expected from an analysis of ≥ 15-year time series. This may reflect non-linear responses, species-specific thresholds and cumulative temperature effects. It also indicates that knowledge on extreme weather events is needed for detailed projections of potential climate change effects.