bluuebunny/crossref_metadata_2025 huggingface dataset:
Depression as a predictor of postoperative delirium after cardiac surgery: a systematic review and meta-analysis
Authors: Falk Anna , Kåhlin Jessica , Nymark Carolin , Hultgren Rebecka , Stenman Malin
Published: October 2020

OBJECTIVES

Depression is common in patients with cardiac disease. The importance of preoperative depression for development of postoperative delirium (POD) following cardiac surgery is not well known. The aim is to provide a summary estimate of depression as a predictor of POD following cardiac surgery.

METHODS

Systematic search of MEDLINE, EMBASE, Cochrane Library, Web of Science Core Collection and Psycinfo (Ovid) was performed from inception to October 2019, including cohort studies reporting odds ratios (ORs) and 95% confidence intervals (CIs) for POD following cardiac surgery in patients with preoperative depression compared to patients without depression. ORs and 95% CIs for POD were calculated using random-effects meta-analyses. Subgroup and sensitivity analyses were performed.

RESULTS

Seven studies were included with a combined study population of 2066 patients. The pooled prevalence of POD in the combined study population was 26% and preoperative depression was present in ∼9% of the total study population. All studies showed a positive association between preoperative depression and POD; and in 5 studies, the association was statistically significant. Patients with depression had a pooled OR of 2.31 (95% CI 1.37–3.90) for POD.

CONCLUSIONS

This systematic review and meta-analysis confirm the findings that the previous association between preoperative depression and increased risk for developing POD reported for other patient groups is found also in cardiac surgery. Depression screening prior to cardiac surgery may be effective in identifying patients at higher risk for POD.
Safety and efficacy of transvenous lead extraction of very old leads
Authors: Pecha Simon , Ziegelhoeffer Tibor , Yildirim Yalin , Choi Yeong-Hoon , Willems Stephan , Reichenspurner Hermann , Burger Heiko , Hakmi Samer
Published: October 2020

OBJECTIVES

Transvenous lead extraction using mechanical rotational- or laser sheaths is an established procedure. Lead dwell time has been recognized as a risk factor for extraction failure and procedure-related complications. We therefore investigated the safety and efficacy of transvenous extraction of leads with an implant duration of more than 10 years.

METHODS

Between January 2013 and March 2017, a total of 403 patients underwent lead extraction in 2 high-volume lead extraction centres. One hundred and fifty-four patients with extraction of at least 1 lead aged over 10 years were included in this analysis. Laser lead extraction was the primary extraction method, with additional use of mechanical rotational sheaths or femoral snares, if necessary. All procedural- and patient-based data were collected into a database and retrospectively analysed.

RESULTS

Mean patient’s age was 65.8 ± 15.8 years, 68.2% were male. Three hundred and sixty-two leads had to be extracted. The mean lead dwell time of treated leads was 14.0 ± 6.1 years. Complete procedural success was achieved in 91.6% of cases, while clinical success was achieved in 96.8%. Failure of extraction occurred in 3.2%. Leads that could not be completely removed had a significantly longer lead dwell time (18.2 vs 13.2 years; P = 0.016). Additional mechanical rotational sheaths or femoral snares were used in 26 (16.9%) patients. Overall complication rate was 4.6%, including 5 (3.3%) major and 2 (1.3%) minor complications. There was no procedure-related mortality.

CONCLUSIONS

Transvenous lead extraction in leads aged over 10 years is safe and effective when performed in specialized centres and with use of multiple tools and techniques. Leads that could not be completely extracted had a statistically significant longer lead dwell time.
3D reconstruction of as-built model of plant piping system from point clouds and port information
Authors: Lee Inhwan Dennis , Lee Ikjin , Han Soonhung
Published: October 2020

This paper proposes a reconstruction method of the as-built model of plant piping, where the port point of the fitting is used as the secondary reference point, which represents a connection point between the fitting and its connected pipeline. The connection point between a fitting and a pipeline is a critical point of reference in the as-built model. In this study, a fitting model is registered to the point clouds first by using the state-of-the-art technique, which is based on an iterative closest point (ICP) algorithm and also considers the alignment of the port direction with the connected pipelines. Then, the port points of the registered fitting are considered as connection points, and the nozzle points of the connected pipelines are adjusted along its axis based on the information. After the registration process, which uses the detailed shape of fitting and the directions of adjacent pipelines at the same time, the port point on the registered fitting becomes a better estimate of the connection point compared with the nozzle point of a pipeline detected.
The EU in Search for Stronger Enforcement Rules: Assessing the Proposed Amendments to Trade Enforcement Regulation 654/2014
Authors: Weiß Wolfgang , Furculita Cornelia
Published: October 2020

Considering the new focus of the European Union (EU) trade policy on strengthening the enforcement of trade rules, the article presents the proposed amendments to the EU Trade Enforcement Regulation 654/2014. It analyzes the EU Commission proposal and the amendments suggested by the European Parliament Committee on International Trade (INTA), in particular with regard to uncooperative third parties and the provision of immediate countermeasures. The amendments will be assessed in view of their legality under World Trade Organization (WTO), Free Trade Agreement (FTA), and general international law and in view of their political implications for the EU’s multilateralist stance. Finally, the opportunity to amend Regulation 654/2014 to use it for the enforcement of FTA trade and sustainable development chapters will be explored. The analysis shows that the shift towards more effective enforcement should be pursued with due care for respecting existing international legal commitments and with more caution to multilateralism.
Aedes albopictus (Diptera: Culicidae) Has Not Become the Dominant Species in Artificial Container Habitats in a Temperate Forest More Than a Decade After Establishment
Authors: Westby Katie M , Juliano Steven A , Medley Kim A
Published: October 2020

Aedes albopictus (Skuse) (Diptera: Culicidae) is one of the most invasive species globally, and has led to rapid declines and local extirpations of resident mosquitoes where it becomes established. A potential mechanism behind these displacements is the superior competitive ability of Ae. albopictus in larval habitats. Research on the context-dependent nature of competitive displacement predicts that Ae. albopictus will not replace native Aedes triseriatus (Say) (Diptera: Culicidae) in treeholes but could do so in artificial container habitats. Aedes albopictus remains rare in temperate treeholes but less is known about how Ae. albopictus fares in artificial containers in forests. Tyson Research Center (TRC) is a field station composed of mostly oak-hickory forest located outside Saint Louis, MO. The container community has been studied regularly at TRC since 2007 with permanently established artificial containers on the property since 2013. Aedes albopictus was detected each year when these communities were sampled; however, its abundance remains low and it fails to numerically dominate other species in these communities. We present data that show Ae. albopictus numbers have not increased in the last decade. We compare egg counts from 2007 to 2016 and combine larval sample data from 2012 to 2017.We present average larval densities and prevalence of Ae. albopictus and two competitors, Ae. triseriatus and Aedes japonicus (Theobald) (Diptera: Culicidae), as well as monthly averages by year. These data highlight a circumstance in which Ae. albopictus fails to dominate the Aedes community despite it doing so in more human-impacted habitats. We present hypotheses for these patterns based upon abiotic and biotic environmental conditions.
Supercooling Points of Adult Dermacentor variabilis (Acari: Ixodidae) From a Population Near the Northern Distribution Limit
Authors: Yunik Matthew E M , Chilton Neil B
Published: October 2020

The northern distributional limit of Dermacentor variabilis Say, the American dog tick, is expanding in Saskatchewan and Manitoba (western Canada). The ability of D. variabilis to continue to expand its range northwards will depend upon the ability of individuals within populations at the species distributional edge to withstand very low temperatures during winter. One component of cold hardiness is the supercooling point (SCP), the temperature below 0°C at which an individual freezes. In this study, the SCP was determined for 94 questing D. variabilis adults (44 females and 50 males) from an established population near Blackstrap Provincial Park in Saskatchewan. SCP values ranged from −18.2 to −6.7°C, with a median of −13.3°C. This suggests that host-seeking D. variabilis adults differ in their ability to survive exposure to subzero temperatures, for at least a short period of time, without freezing. The distribution of SCPs was bimodal, but there was no significant difference in SCP values between female and male ticks, and no relationship between SCP and tick body weight. It remains to be determined what factors contribute to the variation in SCP values among questing D. variabilis adults.
Commemorative Print: Serialized Monuments during the Shakespeare Tercentenary Debates
Authors: Poland Matthew
Published: October 2020

This essay concerns Victorian debates about how best to commemorate Shakespeare at the tercentenary of his birth in 1864. Victorian enthusiasm for Shakespeare was all but ubiquitous, but it evolved in unpredictable ways. The National Shakespeare Committee’s proposal for a Shakespeare statue, for instance, ended in controversy and failure. By contrast, alternative forms of commemoration enjoyed notable success, such as Howard Staunton’s serialized facsimile of the First Folio (1864–66). Both the controversy and its potential resolution in Staunton’s Folio are revealed in essays published in the Reader, a short-lived literary weekly. Staunton’s facsimile came to be regarded by the Reader and commentators in other periodicals as the most apposite of tercentenary monuments. It remade the First Folio for middle-class Victorian readers, trading on the prestige of the First Folio and remaking a high-end book version of Shakespeare in the image of ‘shilling monthly’ serial literature. Taken together, the Tercentenary monument controversies and the Staunton Folio show the Victorian relationship to Shakespeare to be less settled than we have previously appreciated.
Probabilities of first-order sentences on sparse random relational structures: An application to definability on random CNF formulas
Authors: Larrauri Lázaro Alberto
Published: October 2020

We extend the convergence law for sparse random graphs proven by Lynch to arbitrary relational languages. We consider a finite relational vocabulary $\sigma $ and a first-order theory $T$ for $\sigma $ composed of symmetry and anti-reflexivity axioms. We define a binomial random model of finite $\sigma $-structures that satisfy $T$ and show that first-order properties have well defined asymptotic probabilities when the expected number of tuples satisfying each relation in $\sigma $ is linear. It is also shown that these limit probabilities are well behaved with respect to several parameters that represent the density of tuples in each relation $R$ in the vocabulary $\sigma $. An application of these results to the problem of random Boolean satisfiability is presented. We show that in a random $k$-CNF formula on $n$ variables, where each possible clause occurs with probability $\sim c/n^{k-1}$, independently any first-order property of $k$-CNF formulas that implies unsatisfiability does almost surely not hold as $n$ tends to infinity.
Periodicities in the K2 light curve of HP Librae
Authors: Solanki Siddhant , Kupfer Thomas , Blaes Omer , Breedt Elmé , Scaringi Simone
Published: October 2020

We analyse Kepler/K2 light-curve data of the AM CVn system HP Librae (HP Lib). We detect with confidence four photometric periodicities in the system: the orbital frequency, both positive and negative superhumps, and the positive apsidal precession frequency of the accretion disc. This is only the second time that the apsidal precession frequency has ever been directly detected in the photometry of a helium accreting system, after SDSS J135154.46-064309.0. We present phase-folded light curves and sliding power spectra of each of the four periodicities. We measure rates of change of the positive superhump period of ∼10−7 d. We also redetect a quasi-periodic oscillation (QPO) at ∼300 cyc d–1, a feature that has been stable over decades, and show that it is harmonically related to two other QPOs, the lowest of which is centred on the superhump/orbital frequency. The continuum power spectrum is consistent with a single power law with no evidence of any breaks within our observed frequency range.
AstroSat observations of the first Galactic ULX pulsar Swift J0243.6+6124
Authors: Beri Aru , Naik Sachindra , Singh Kulinder Pal , Jaisawal Gaurava K , Bhattacharyya Sudip , Charles Philip , Ho Wynn C G , Maitra Chandreyee , Bhattacharya Dipankar , Dewangan Gulab C , Middleton Matthew , Altamirano Diego , Gandhi Poshak , Raichur Harsha
Published: October 2020

Swift J0243.6+6124, the first Galactic ultraluminous X-ray pulsar, was observed during its 2017–2018 outburst with AstroSat at both sub- and super-Eddington levels of accretion with X-ray luminosities of LX ∼ 7 × 1037 and 6 × 1038 erg s−1, respectively. Our broad-band timing and spectral observations show that X-ray pulsations at ${\sim}9.85~\rm {s}$ have been detected up to 150 keV when the source was accreting at the super-Eddington level. The pulse profiles are a strong function of both energy and source luminosity, showing a double-peaked profile with pulse fraction increasing from ∼$10{{{\ \rm per\ cent}}}$ at $1.65~\rm {keV}$ to 40–80 ${{\ \rm per\ cent}}$ at $70~\rm {keV}$. The continuum X-ray spectra are well modelled with a high-energy cut-off power law (Γ ∼ 0.6–0.7) and one or two blackbody components with temperatures of ∼0.35 and $1.2~\rm {keV}$, depending on the accretion level. No iron line emission is observed at sub-Eddington level, while a broad emission feature at around 6.9 keV is observed at the super-Eddington level, along with a blackbody radius ($121\!-\!142~\rm {km}$) that indicates the presence of optically thick outflows.
Long-term photospheric instabilities and envelopes dynamics in the post-AGB binary system 89 Herculis
Authors: Gangi M , Giarrusso M , Munari M , Ferrara C , Scalia C , Leone F
Published: October 2020

We present a long-term optical spectroscopic study of the post-asymptotic giant branch (AGB) binary system 89 Herculis, with the aim to characterize the relationship between photospheric instabilities and dynamics in the close circumstellar environment of the system. This study is based on spectra acquired with the high-resolution Catania Astrophysical Observatory Spectropolarimeter and archive data, covering a time interval between 1978 and 2018. We find long-term changes in the radial velocity curve of the system, occurring mostly in amplitude, which correlate with the variability observed in the blueshifted absorption component of the P Cygni-like H α profile. Two possible scenarios are discussed. We also find strong splitting in the s-process elements of Ba ii 6141.713- and 6496.898-Å  lines, with short-term morphological variations. A Gaussian decomposition of such profiles allows us to distinguish four shell components, two expanding and two infalling toward the central star, which are subject to the orbital motion of the system and are not affected by the long-term instabilities. Finally, we find that the numerous metal lines in emission could originate in regions of a structured circumbinary disc that have sizes proportional to the energy of the corresponding upper level transition Eup. This study demonstrates the potential of long-term high-resolution spectroscopy in linking together the instability processes occurring during the late evolutionary stages of post-AGBs and the subsequent phase of PNe.
A fake interacting dark energy detection?
Authors: Di Valentino Eleonora , Mena Olga
Published: October 2020

Models involving an interaction between the dark matter and the dark energy sectors have been proposed to alleviate the long-standing Hubble constant tension. In this paper, we analyse whether the constraints and potential hints obtained for these interacting models remain unchanged when using simulated Planck data. Interestingly, our simulations indicate that a dangerous fake detection for a non-zero interaction among the dark matter and the dark energy fluids could arise when dealing with current cosmic microwave background (CMB) Planck measurements alone. The very same hypothesis is tested against future CMB observations, finding that only cosmic variance limited polarization experiments, such as PICO or PRISM, could be able to break the existing parameter degeneracies and provide reliable cosmological constraints. This paper underlines the extreme importance of confronting the results arising from data analyses with those obtained with simulations when extracting cosmological limits within exotic cosmological scenarios.
WikiPathways: connecting communities
Authors: Martens Marvin , Ammar Ammar , Riutta Anders , Waagmeester Andra , Slenter Denise N , Hanspers Kristina , A. Miller Ryan , Digles Daniela , Lopes Elisson N , Ehrhart Friederike , Dupuis Lauren J , Winckers Laurent A , Coort Susan L , Willighagen Egon L , Evelo Chris T , Pico Alexander R , Kutmon Martina
Published: October 2020

WikiPathways (https://www.wikipathways.org) is a biological pathway database known for its collaborative nature and open science approaches. With the core idea of the scientific community developing and curating biological knowledge in pathway models, WikiPathways lowers all barriers for accessing and using its content. Increasingly more content creators, initiatives, projects and tools have started using WikiPathways. Central in this growth and increased use of WikiPathways are the various communities that focus on particular subsets of molecular pathways such as for rare diseases and lipid metabolism. Knowledge from published pathway figures helps prioritize pathway development, using optical character and named entity recognition. We show the growth of WikiPathways over the last three years, highlight the new communities and collaborations of pathway authors and curators, and describe various technologies to connect to external resources and initiatives. The road toward a sustainable, community-driven pathway database goes through integration with other resources such as Wikidata and allowing more use, curation and redistribution of WikiPathways content.
OncoVar: an integrated database and analysis platform for oncogenic driver variants in cancers
Authors: Wang Tao , Ruan Shasha , Zhao Xiaolu , Shi Xiaohui , Teng Huajing , Zhong Jianing , You Mingcong , Xia Kun , Sun Zhongsheng , Mao Fengbiao
Published: October 2020

The prevalence of neutral mutations in cancer cell population impedes the distinguishing of cancer-causing driver mutations from passenger mutations. To systematically prioritize the oncogenic ability of somatic mutations and cancer genes, we constructed a useful platform, OncoVar (https://oncovar.org/), which employed published bioinformatics algorithms and incorporated known driver events to identify driver mutations and driver genes. We identified 20 162 cancer driver mutations, 814 driver genes and 2360 pathogenic pathways with high-confidence by reanalyzing 10 769 exomes from 33 cancer types in The Cancer Genome Atlas (TCGA) and 1942 genomes from 18 cancer types in International Cancer Genome Consortium (ICGC). OncoVar provides four points of view, ‘Mutation’, ‘Gene’, ‘Pathway’ and ‘Cancer’, to help researchers to visualize the relationships between cancers and driver variants. Importantly, identification of actionable driver alterations provides promising druggable targets and repurposing opportunities of combinational therapies. OncoVar provides a user-friendly interface for browsing, searching and downloading somatic driver mutations, driver genes and pathogenic pathways in various cancer types. This platform will facilitate the identification of cancer drivers across individual cancer cohorts and helps to rank mutations or genes for better decision-making among clinical oncologists, cancer researchers and the broad scientific community interested in cancer precision medicine.
A Mixed-Methods Systematic Review and Synthesis of Secondary Care Interventions to Reduce Secondhand Smoke Exposure Among Children and Young People
Authors: Ferris Erica , Cummins Carole , Chiswell Christopher , Jones Laura L
Published: October 2020

Introduction

Childhood secondhand smoke exposure (SHSe) is linked with increased morbidity and mortality. Hospital or secondary care contact presents a “teachable moment” to support parents to change their home smoking behaviors to reduce children’s SHSe.

Aims and Methods

This mixed-methods review explores: (1) if existing interventions in this context are effective, (2) if they are reported in sufficient detail to be replicated, (3) the experiences of health care professionals delivering such interventions, and (4) the experiences of parents receiving such interventions. Five electronic databases and the gray literature were searched for relevant literature published and indexed January 1980 to February 2020. Fourteen papers reporting 12 studies (nine quantitative and five qualitative) were included. Aligned with the Joanna Briggs Institute method, a segregated approach was used involving independent syntheses of the quantitative and qualitative data followed by an overall mixed-methods synthesis.

Results

There was some evidence of effective interventions that resulted in a short-term (<6 months) reduction in children’s SHSe when SHSe was subjectively measured. This was not seen in longer-term follow-up (>6 months) or when SHSe was measured objectively. Inconsistencies with reporting make replication challenging. Experiential evidence suggests a mismatch between stakeholder preferences and interventions being offered.

Conclusions

The pediatric secondary care interventions included in this analysis failed to show statistically significant evidence of longer-term effectiveness to reduce children’s SHSe in all but one low-quality study. There was also inadequate reporting of interventions limiting assessment of effectiveness. It offers further insights into areas to target to develop effective interventions.

Implications

This review used rigorous methods to explore the current, global literature on how children’s exposure to secondhand smoke is being tackled in secondary care. This review identified only one low-quality intervention study showing a statistically significant reduction in children’s SHSe beyond 6 months. Synthesis with qualitative research identifies a mismatch between what parents want in an intervention and what has been delivered to date. Reporting quality needs to be improved to ensure that interventions can be replicated and studies conducted within the National Health Service to ensure suitability to this setting.
The Active Electrode in the Living Brain: The Response of the Brain Parenchyma to Chronically Implanted Deep Brain Stimulation Electrodes
Authors: Evers Judith , Lowery Madeleine
Published: October 2020

BACKGROUND

Deep brain stimulation is an established symptomatic surgical therapy for Parkinson disease, essential tremor, and a number of other movement and neuropsychiatric disorders. The well-established foreign body response around implanted electrodes is marked by gliosis, neuroinflammation, and neurodegeneration. However, how this response changes with the application of chronic stimulation is less well-understood.

OBJECTIVE

To integrate the most recent evidence from basic science, patient, and postmortem studies on the effect of such an “active” electrode on the parenchyma of the living brain.

METHODS

A thorough and in-part systematic literature review identified 49 papers.

RESULTS

Increased electrode-tissue impedance is consistently observed in the weeks following electrode implantation, stabilizing at approximately 3 to 6 mo. Lower impedance values are observed around stimulated implanted electrodes when compared with unstimulated electrodes. A temporary reduction in impedance has also been observed in response to stimulation in nonhuman primates. Postmortem studies from patients confirm the presence of a fibrous sheath, astrocytosis, neuronal loss, and neuroinflammation in the immediate vicinity of the electrode. When comparing stimulated and unstimulated electrodes directly, there is some evidence across animal and patient studies of altered neurodegeneration and neuroinflammation around stimulated electrodes.

CONCLUSION

Establishing how stimulation influences the electrical and histological properties of the surrounding tissue is critical in understanding how these factors contribute to DBS efficacy, and in controlling symptoms and side effects. Understanding these complex issues will aid in the development of future neuromodulation systems that are optimized for the tissue environment and required stimulation protocols.
Student attitudes towards linear algebra: an attempt to roll back the fog
Authors: Griffiths Barry J , Shionis Samantha
Published: October 2020

In this study, we look at student perceptions of a first course in linear algebra, focusing on two specific aspects. The first is the statement by Carlson that a fog rolls in once abstract notions such as subspaces, span and linear independence are introduced, while the second investigates statements made by several authors regarding the negative emotions that students can experience during the course. An attempt is made to mitigate this through mediation to include a significant number of applications, while continually dwelling on the key concepts of the subject throughout the semester. The results show that students agree with Carlson’s statement, with the concept of a subspace causing particular difficulty. However, the research does not reveal the negative emotions alluded to by other researchers. The students note the importance of grasping the key concepts and are strongly in favour of using practical applications to demonstrate the utility of the theory.
Blood culture positivity rate for Trypanosoma cruzi in patients with chronic Chagas disease differs among different clinical forms
Authors: Nielebock Marco Antonio Prates , de Freitas Campos Miranda Luciana , Americano do Brasil Pedro Emmanuel Alvarenga , de Jesus S. Pereira Thayanne Oliveira , da Silva Aline Fagundes , Hasslocher-Moreno Alejandro Marcel , Sangenis Luiz Henrique Conde , Saraiva Roberto Magalhães
Published: October 2020

Background

The purpose of this research was to compare the clinical and epidemiological characteristics of patients with chronic Chagas disease with and without positive blood cultures for Trypanosoma cruzi.

Methods

This was a retrospective longitudinal study that included 139 patients with chronic Chagas disease who underwent blood culture for T. cruzi. Blood cultures were performed using Novy–MacNeal–Nicolle medium enriched with Schneider's medium. Multivariate Cox proportional hazards regression analysis adjusting for age and sex was performed to identify if positive blood culture for T. cruzi was associated with all-cause mortality.

Results

The blood culture positivity rate was 30.9%. Most patients were born in the Northeast and Southeast regions of Brazil. Patients with positive blood cultures were older (52±13 vs 45±13 y; p=0.0009) and more frequently women (72.1% vs. 53.1%; p=0.03) than patients with negative blood cultures. The frequency of patients with cardiac or cardiodigestive forms was higher among patients with positive vs negative blood cultures (74.4% vs 54.1%; p=0.02). A total of 28 patients died during a mean follow-up time of 6.6±4.1 y. A positive blood culture was associated with all-cause mortality (hazard ratio 2.26 [95% confidence interval 1.02 to 5.01], p=0.045).

Conclusions

We found a higher proportion of patients with Chagas heart disease among patients with T. cruzi–positive blood cultures. A positive blood culture was associated with an increased risk of all-cause mortality. Therefore T. cruzi persistence may influence Chagas disease pathogenesis and prognosis.
Fungicide Efficacy Against Pseudoperonospora humuli and Point Mutations Linked to Carboxylic Acid Amide Resistance in Michigan
Authors: Higgins Douglas S. , Miles Timothy D. , Hausbeck Mary K.
Published: October 2020

Hops have expanded as a niche crop in Michigan and other production areas in the eastern United States, but growers in these regions face annual downy mildew outbreaks incited by Pseudoperonospora humuli, exacerbated by frequent rainfall and high relative humidity. We evaluated the efficacy of foliar- and drench-applied fungicides against downy mildew and examined Michigan isolates for point mutations linked to carboxylic acid amide (CAA) resistance. Disease severity and density were assessed weekly in 2016 and 2017 in nontrellised research hop yards in Michigan. Area under the disease progress curve values for disease severity were significantly lower for plants treated with oxathiapiprolin, ametoctradin/dimethomorph, fluopicolide, cyazofamid, or mandipropamid (90.6 to 100% control) compared with those treated with fosetyl-Al (64.3 to 93.0% control) at both locations for both years. Drench treatments of fluopicolide and oxathiapiprolin/mefenoxam reduced disease density and severity at both locations but were only moderately effective (76.4 to 91.5% control). To assess CAA resistance, the cellulose synthase CesA3 gene was aligned using reference downy mildew species and primers designed to amplify the 1105 and 1109 amino acids. Point mutations conferring CAA resistance were not detected at these loci for sporangia from 42 symptomatic shoots collected from 11 commercial hop yards. These efficacy results for hop downy mildew are needed to guide disease recommendations in this expanding Michigan industry. The absence of resistant genotypes indicates that Michigan growers can continue to utilize CAA-containing commercial fungicides as part of an overall downy mildew management program.
Phenotypic and Genotypic Variation of Puccinia helianthi in South Africa
Authors: Meyer Wilku B. , Boshoff Willem H. P. , Minnaar-Ontong Adré , Young Anthony J. , Kong Gary , Thompson Susan , Pretorius Zacharias A. , Visser Botma
Published: October 2020

Sunflower (Helianthus annuus L.) is the third largest grain crop by area planted in South Africa (SA). The annual yield is negatively affected by sunflower rust caused by Puccinia helianthi Schw. (Phe). Four Phe races were described in SA in the middle 1990s, but since then, no new race descriptions have been conducted. This has resulted in an information gap on the current Phe population, making it difficult to explain increased disease incidence and loss of resistance in previously resistant hybrids. To address this, 114 Phe field isolates along with 23 historic isolates were phenotyped using the international set of 11 sunflower differentials containing the R1, R2/R10, R3, R4a, R4b, R4c, R4d, R5, Pu6, and Radv resistance genes. Three new Phe races were identified, bringing the total number of South African races recorded to seven. No avirulence was detected attributable to the R1 gene, with the R4d and Radv genes remaining effective. Four main genetic lineages were detected with no obvious correlation between phenotype and genotype. The detection of three genetic lineages consisting exclusively of field isolates collected post-2006 suggested the possible recent entry of exotic introductions into SA. This, combined with the fact that one lineage consisted exclusively of the most virulent race Phe7721, confirmed a clear shift in the Phe population that could explain the increased virulence and occurrence of the disease in SA.
Syringe or Mask? Loop Electrosurgical Excision Procedure Under Local or General Anesthesia: A Randomized Trial
Authors: Rezniczek Günther A. , Hecken Julia M. , Rehman Sadia , Dogan Askin , Tempfer Clemens B. , Hilal Ziad
Published: October 2020

(Abstracted from Am J Obstet Gynecol 2020; doi: 10.1016/j.ajog.2020.06.041)

The loop electrosurgical excision procedure (LEEP) is one of the most commonly performed gynecological surgeries. The procedure can be performed either under local anesthesia (LA) or general anesthesia (GA).
Predictive Factors for Recurrence in Infantile Blount Disease Treated With Tibial Osteotomy
Authors: Maré Pieter H. , Thompson David M. , Marais Leonard C.
Published: October 2020

Background:

This study aimed to determine the recurrence rate in infantile Blount disease (IBD) in a cohort of patients treated with a tibial osteotomy; and also to identify which factors were associated with recurrence.

Methods:

We reviewed the records of 20 patients, under the age of 7 years, with IBD (35 involved extremities) treated by proximal tibial realignment osteotomy to physiological valgus at a single institution over 4 years. We then analyzed the data to determine the rate of recurrence and identify the risk factors for recurrence.

Results:

The mean age of the included patients was 4.2 years (range, 2 to 6 y). We observed a recurrence rate of 40% (n=14) at a mean follow-up of 42 months (range, 21 to 72 mo). Knee instability [odds ratios OR, 6.6; 95% confidence interval (CI), 2.0-22.2], Langenskiöld stage (OR, 6.3; 95% CI, 2.0-19.4), and severity of the deformity, as measured by medial physeal slope (MPS) (OR, 1.2; 95% CI, 1.1-1.4), were associated with recurrence. On multiple logistic regression analysis, MPS remained the most relevant predictor of recurrence. Receiver operating curve analysis showed that an MPS ≥60 degrees predicted recurrence with a sensitivity of 79% and specificity of 95% (area under the curve=0.925). Postoperatively, increased varus alignment on weight-bearing as measured by the tibio-femoral angle was indicative of knee instability and associated with increased odds of recurrence (OR, 1.5; 95% CI, 1.1-1.9; P=0.004).

Conclusions:

We observed a recurrence rate of 40% in children with IBD under 7 years treated with acute correction to a tibio-femoral angle of 5 to 10 degrees valgus through a dome proximal tibial osteotomy. Knee instability, Langenskiöld stage, and MPS were associated with recurrence. Cases with an MPS ≥60 degrees seem to be particularly at risk for recurrence. Further research is needed to validate these findings.

Level of Evidence:

Level IV.
Analysis of 280 Magnetically Controlled Growing Rod Lengthenings Comparing External Remote Control Readouts and Radiographic Measurements: Impact of Patient and Deformity Factors
Authors: Arhewoh Reme E. , Mo Michelle , Luhmann Scott J.
Published: October 2020

Background:

This study aimed to assess the accuracy of the external remote control (ERC) digital readout to the radiographic measurement of magnetically controlled growing rod (MCGR) actuators undergoing lengthenings/expansions and to analyze the impact of patient and spinal deformity factors on the accuracy of the ERC digital readout.

Methods:

Single-surgeon database at 2 tertiary-care pediatric hospitals identified early-onset scoliosis patients with MCGR constructs. There were 14 males and 16 females with a minimum of 2 lengthenings included in the analysis. ERC readouts at each lengthening were recorded.

Results:

Sixty-six MCGR actuators were assessed in 30 patients which underwent 280 lengthenings (mean of 5.7 lengthenings). At individual lengthening sessions the ERC and radiographic measurements were correlated (r = 0.69, P<0.001). The summed radiographic measurements averaged 15% less than the summed ERC readouts (SD = 19%). The difference between the sum of radiographic measurements and ERCs was positively correlated with subsequent lengthenings (r = 0.94, P = 0.015). The accuracy of the ERC did not improve with increased grouped sessions (r = −0.54, P = 0.388) with no difference between the group with 2 and the group with ≥5 lengthenings (P = 0.670). In patients with dual rods, the difference was correlated between rods (r = 0.66, P<0.001) and the distraction of each rod was not significantly different from the other (P = 0.124). Patient weight correlated with the difference between the radiographs and ERC readouts (r = 0.27, P = 0.032). In patients with multiple grouped lengthenings, increased weight was positively correlated with an increase in measurement difference (mean r = 0.972).

Conclusions:

Summed radiographic measurements during lengthening sessions averaged 15% less than the summed ERC readouts. The accuracy of radiographic measurements did not increase when sessions were grouped together (2 vs. ≥5). There was no difference in the ERC accuracy over lengthening sessions early versus late. Patient weight, but not body mass index, was positively correlated with the discrepancy between the ERC and radiographic measures.

Level of Evidence:

Level III.
Molecular Diagnostics of Vascular Tumors of the Skin
Authors: Llamas-Velasco Mar , Mentzel Thomas
Published: October 2020

In this article, the authors have reviewed all the recent news regarding how the discovery of some novel and recurrent molecular and genetic changes has modified the classification of some entities and have addressed to the description of new variants of vascular tumors. And even more important, the authors also reviewed on how these findings, in addition to gain insight into the tumoral biology, portend significant clinical consequences not only regarding to their diagnosis but also to their management and prognosis because some of these mutations are potential targets for treatment. The authors have also highlighted immunohistochemical markers can help us as a surrogate marker of those molecular alterations.
Intravenously injected lidocaine or magnesium improves the quality of early recovery after laparoscopic cholecystectomy
Authors: Lu Jing , Wang Jin-Feng , Guo Chao-Lin , Yin Qin , Cheng Wei , Qian Bin
Published: October 2020

BACKGROUND

Previous data show that lidocaine or magnesium has unique characteristics of stress inhibition and antiinflammation.

OBJECTIVE

We aimed to observe the effects of lidocaine or magnesium on the quality of recovery (QoR) after laparoscopic cholecystectomy.

DESIGN

Single-centre, prospective, randomised, double-blind study.

SETTING

The Affiliated Hospital of Xuzhou Medical University from March 2019 to October 2019.

PATIENTS

One hundred and fourteen patients scheduled for laparoscopic cholecystectomy.

INTERVENTION

The enrolled patients were randomly divided into three groups. Lidocaine (group L), magnesium sulphate (group M) or 0.9% saline (group C) was administered intravenously 10 min before induction.

MAIN OUTCOME MEASURES

The quality of recovery 15 (QoR-15) score, the Hospital Anxiety and Depression Scale (HADS), and the Numerical Rating Scale (NRS) score were selected. The usage of propofol and remifentanil, haemodynamic parameters, anaesthesia recovery parameters and adverse events were also evaluated.

RESULTS

The QoR-15 scores for group L (132.0) and group M (134.0) were 6 and 8 points higher than that of group C (126.0) on POD1 (postoperative day 1) (adj
P < 0.05). However, the decrease of QoR-15 in Group L is less than the minimal clinically important difference (8).

The NRS scores on POD1 in group C 3, were higher than other two groups (adj
P < 0.05). The dosage of remifentanil in group L was lower than other two groups (adj
P < 0.05).

The physical independence of group L and group M and physical comfort of group M were improved compared with group C.

CONCLUSION

The results show that magnesium sulphate improved the QoR through improving physical comfort and physical independence in patients after laparoscopic cholecystectomy. However, lidocaine had limited effects on QoR under current conditions.

TRIAL REGISTRATION

ChiCTR1800019092 (www.chictr.org.cn).

CLINICAL TRIAL NUMBER AND REGISTRY URL

The study was registered in the Chinese Clinical Trials Register (ChiCTR1800019092) https://www.chictr.org.cn.
Validation of the blood pressure measurement technology used in the Novacor Diasys 3 Plus (DIP-0001-00) upper-arm device for ambulatory blood pressure measurement, according to AAMI/ANSI/ISO 81060-2:2013, ESH-IP 2010 and MEDDEV 2.7/1
Authors: Atkins Neil , Fania Claudio , Palatini Paolo
Published: October 2020

Objective

The objective of this study was to determine the accuracy of the auscultatory and oscillometric blood pressure (BP) measurement technologies of the Novacor Diasys 3 Plus (model number DIP-0001-00) BP monitor, intended for ambulatory BP measurement when used with the recommended Standard Plus (ACC-0210-00), Large Plus (ACC-0211-00) and Paediatric Plus (ACC-0212-00) cuffs.

Methods

The auscultatory measurement technology Novacor Diasys 3 Plus (model number DIP-0001-00) was evaluated according to the requirements of the AAMI/ANSI/ISO 81060-2:2013 standard, including an additional cardiac-stress study, a requirement for ambulatory BP measurement devices. It was also validated according to the requirements of the European Society of Hypertension International Protocol revision 2010. The oscillometric measurement technology was compared to that of the Novacor Diasys 3 (model number DIS-0001-00) according to the equivalence requirements of MEDDEV 2.7/1 rev 4. The protocol requirements for all three studies and the equivalence were followed precisely.

Results

The Novacor Diasys 3 Plus (model number DIP-0001-00) fulfilled all of the requirements for a pass in each of the three studies of the auscultatory measurement technology. In the primary AAMI/ANSI/ISO 81060-2:2013 study, the criterion 1 errors were + 3.6 ± 2.7 mmHg for SBP and + 3.0 ± 2.7 mmHg for DBP. It was also proven to be equivalent to the Novacor Diasys 3 (model number DIS-0001-00) with respect to the oscillometric measurement technology

Conclusion

The Novacor Diasys 3 Plus (model number DIP-0001-00), when used with the recommended cuffs, can be recommended for ambulatory BP measurement in the adult population.
The relationship between glycemic variability and blood pressure variability in normoglycemic normotensive individuals
Authors: Sezer Havva , Yazici Dilek , Copur Sidar , Dagel Tuncay , Deyneli Oguzhan , Kanbay Mehmet
Published: October 2020

Background and aim

Glycemic fluctuations around a mean glucose level, referred as glycemic variability and blood pressure variability (BPV) are considered as independent risk factors for cardiovascular diseases, all-cause mortality, and cardiovascular disease-mortality. With this background in mind, we aimed to investigate the association between glycemic variability and BPV and their association in normoglycemic and normotensive individuals.

Materials and method

Twenty-seven normotensive normoglycemic individuals were recruited. Twenty-four hour Holter devices were utilized to measure ambulatory blood pressure (BP) while continuous glucose monitoring (CGM) devices were applied to measure glycemic variability simultaneously to the subjects. These devices were kept on for 48 h. For BP recordings, daytime, nighttime, and 24-h BP determinations, their mean and SD were calculated. From CGM measurements, mean blood glucose (MBG), SD of blood glucose, the mean amplitude of glycemic excursions (MAGE), the mean of daily differences (MODD), coefficient of variation (correction of variability for the MBG), and daytime and nighttime blood glucose were determined.

Results

The mean age of the subjects was 23.8 ± 2.7 years and 66% were women (18/27). In the correlation analysis between glycemic variability parameters and BPV parameters, SD of 24-h SBP was correlated with the SD of MBG (r = 0.52, P = 0.006), MAGE (r = 0.49, P = 0.009), and MODD (r = 0.46, P = 0.015). SD of daytime SBP was correlated with, MAGE (r = 0.42, P = 0.03) and MODD (r = 0.43, P = 0.02).

Conclusion

We report correlation between glycemic variability and BPV variables in normoglycemic and normotensive healthy individuals.
Tracking COVID-19 via sewage
Authors: Rooney Christopher M. , Moura Ines B. , Wilcox Mark H.
Published: October 2020

Purpose of review

We discuss the potential role of the faecal chain in COVID-19 and highlight recent studies using waste water-based epidemiology (WBE) to track severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Recent findings

WBE has been suggested as an adjunct to improve disease surveillance and aid early detection of circulating disease. SARS-CoV-2, the aetiological agent of COVID-19, is an enveloped virus, and as such, typically not associated with the waste water environment, given high susceptibility to degradation in aqueous conditions. A review of the current literature supports the ability to detect of SARS-CoV-2 in waste water and suggests methods to predict community prevalence based on viral quantification.

The summary of current practices shows that while the isolation of SARS-CoV-2 is possible from waste water, issues remain regarding the efficacy of virial concentration and subsequent quantification and alignment with epidemiological data.
Diagnosis and management of pediatric epithelial salivary gland malignancy
Authors: You Peng , Dimachkieh Amy L. , Chelius Daniel C.
Published: October 2020

Purpose of review

Salivary tumors are uncommon among children but are more likely to be malignant compared with adults. A lack of experience makes consensus in treatment elusive. Amidst recent publication of large institutional and national series, this review aims to discuss the epidemiology, diagnosis, investigation, and treatment for pediatric epithelial salivary malignancies.

Recent findings

Pediatric salivary malignancies are often low grade and carry a favorable prognosis. High-grade tumors portend an increased risk of recurrence and a decreased survival. Surgeons should strive for oncologic resection with clear margins and avoid enucleation and excisional biopsies. Overt nodal metastases require concurrent neck dissection, whereas elective neck dissections may be reserved for cases with high risk of occult disease, such as advanced stage and high-grade neoplasms. Adjuvant radiation should be considered in high-grade tumors.

The paucity of high-level evidence clouds treatment decisions and further encourages pediatric salivary malignancies to be treated in an experienced center with a multidisciplinary approach.