bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of Syntectonic Sedimentation and Décollement Rheology on the Geometry and Evolution of Orogenic Wedges: Analog Modeling of the Kuqa Fold‐and‐Thrust Belt (NW China)
Authors: Pla Oriol , Roca Eduard , Xie Huiwen , Izquierdo‐Llavall Esther , Muñoz Josep Anton , Rowan Mark G. , Ferrer Oriol , Gratacós Òscar , Yuan Neng , Huang Shaoying
Published: July 2019

Contractional deformation in the outer parts of fold‐and‐thrust belts is in part controlled by the presence of syntectonic sediments and multiple décollements (e.g., the Apennines, the Appalachians, the Pyrenees, the Zagros, or the Sub‐Andean and Kuqa fold‐and‐thrust belts). To better understand the influence of these parameters in the kinematic evolution of fold‐and‐thrust systems, we carried out an experimental study including four 3‐D sandbox models inspired by one of the previously mentioned prototypes, the Kuqa fold‐and‐thrust belt. This belt contains two décollements: a weak synorogenic salt layer and a deeper, preorogenic, and frictionless décollement (i.e., organic‐rich shales) showing along strike variations of rheology. The experimental results show that increasing synkinematic sedimentation rate (i) generates a progressive change from distributed to localized deformation and (ii) delays the development of frontal contractional structures detached on the salt, favoring the formation and reactivation of more hinterland thrusts and backthrusts. With respect to the rheology, our study reveals that as the viscosity of the prekinematic décollement increases, (i) the deformation propagates more slowly toward the foreland, and (ii) the underlying thrust stack becomes broader and lower and has a gentler thrust taper angle. The rheology of the prekinematic décollement defines the distribution and geometry of the structures detached on it that in turn influence the development of overlying, salt‐detached structures. Subsalt structures can (i) determine the areal extent of the salt and therefore of any fold‐and‐thrust system detached on it and (ii) hamper or even prevent the progressive foreland propagation of deformation above the salt.
Two Decades of Experimental Manipulation Reveal Potential for Enhanced Biomass Accumulation and Water Use Efficiency in Ponderosa Pine Plantations Across Climate Gradients
Authors: Liles G. C. , Maxwell T. M. , Silva L. C. R. , Zhang J. W. , Horwath W. R.
Published: July 2019

In this study, we report 20 years of data from three ponderosa pine plantations in northern California. Our sites span a natural gradient of forest productivity where climate variability and edaphic conditions delineate marked differences in baseline productivity (approximately threefold). Experimental herbicide application and fertilization significantly reduced competition and improved tree growth by 1.4‐ to 2.2‐fold across sites. At the site of lowest productivity, where soils are poorly developed and water limiting, tree growth increased strongly in response to understory suppression. Small but significant improvements in tree growth were observed in response to understory suppression at the moderate‐productivity site. At the site of highest productivity, where climate is favorable and soils well developed, fertilization increased productivity to a greater extent than did understory suppression. In most cases, the effect of understory suppression and fertilization caused an unexpected growth release, exceeding the anticipated maximum productivity by >5 m of additional height and 60–100% more basal area. At the site of highest productivity, however, understory suppression caused a weak increase on late‐season growth compared to fertilization alone, suggesting a beneficial effect of understory vegetation on long‐term growth at that site. Tree ring cellulose carbon isotopes indicate a negative relationship between intrinsic water use efficiency (iWUE) and tree growth in control stands, which shifted to a positive relationship as both iWUE and tree growth increased in response to management. Cellulose oxygen isotope ratios (δ18O) were positively correlated with iWUE and negatively correlated with vapor pressure deficit across sites, but δ18O was not a strong predictor of tree growth.
Genetic discrimination by Australian insurance companies: a survey of consumer experiences
Authors: Tiller Jane , Morris Susan , Rice Toni , Barter Krystal , Riaz Moeen , Keogh Louise , Delatycki Martin B. , Otlowski Margaret , Lacaze Paul
Published: July 2019

We report previously undocumented evidence of genetic discrimination by Australian insurance companies, obtained through direct consumer reports. We surveyed 174 consumers with cancer-predisposing variants, recruited by cancer organisations Lynch Syndrome Australia and Pink Hope. Questions related to experiences accessing risk-rated insurance after genetic testing. Results indicate that both legal (permitted under current regulation) and illegal discrimination is occurring. Although some respondents had not applied for risk-rated insurance, or had insurance in place before genetic testing (n = 100), those seeking new policies (n = 74) commonly experienced difficulties obtaining insurance (86%, 64/74). Of those experiencing difficulties, 50% (32/64) had no prior history or symptoms of cancer, and had undertaken risk reduction through surveillance and/or preventative surgery. Seventy-seven percent (49/64) reported difficulties related to life insurance. Follow-up telephone interviews with four respondents further described cases of apparent illegal breaches. All reports of discrimination identified were, to our knowledge, previously unreported in the literature. The number of cases suggests a systemic problem with the Australian life insurance industry. We support calls for government oversight of the inherently conflicted model of industry self-regulation in Australia, and an immediate ban on the use of genetic test results in insurance underwriting.
A ratiometric electrochemical biosensor for ultrasensitive and highly selective detection of the K-ras gene via exonuclease III-assisted target recycling and rolling circle amplification strategies
Authors: Xiao Qi , Feng Jinrong , Li Jiawen , Liu Yi , Wang Dan , Huang Shan
Published: July 2019

A ratiometric electrochemical biosensor for ultrasensitive and highly selective detection of the K-ras gene via Exo III-assisted target recycling and RCA strategies.
Cell derived extracellular vesicles: from isolation to functionalization and biomedical applications
Authors: Zhu Lian , Xu Na , Zhang Zhi-Ling , Zhang Tong-Cun
Published: July 2019

The shedding approaches of extracellular vesicles (EVs) are different. EVs possess lots of excellent characteristics. Researches on EVs are mainly focused on isolation, surface functional engineering and biomedical applications.
An Fe-doped NiTe bulk crystal as a robust catalyst for the electrochemical oxygen evolution reaction
Authors: Zhong Lei , Bao Yufei , Yu Xu , Feng Ligang
Published: July 2019

An Fe doped NiTe bulk crystal was demonstrated to exhibit an extremely active and stable performance for the electrochemical oxygen evolution reaction.
High energy-storage density of lead-free (Sr1−1.5xBix)Ti0.99Mn0.01O3 thin films induced by Bi3+–VSr dipolar defects
Authors: Yang Xinrui , Li Weili , Qiao Yulong , Zhang Yulei , He Jun , Fei Weidong
Published: July 2019

Capacitors with high energy storage density, low cost, ultrafast charge–discharge capability, and environmental friendliness are in high demand for application in new energy vehicles, modern electrical systems, and high-energy laser weapons.
Photophysical and biological investigation of phenol substituted rhenium tetrazolato complexes
Authors: Akabar Nurshadrina , Chaturvedi Vishal , Shillito Georgina E. , Schwehr Bradley J. , Gordon Keith C. , Huff Gregory S. , Sutton Joshua J. , Skelton Brian W. , Sobolev Alexandre N. , Stagni Stefano , Nelson Delia J. , Massi Massimiliano
Published: July 2019

Rhenium tetrazolato complexes appended to phenol substituents are exploited for cell labelling.
Robust voltage control algorithm incorporating model uncertainty impacts
Authors: Bakhshideh Zad Bashir , Toubeau Jean‐François , Lobry Jacques , Vallée François
Published: July 2019

This study addresses the voltage control problem of the medium‐voltage distribution systems under uncertainty of the network model. A robust voltage control algorithm (RVCA) is developed in order to manage the voltage constraints considering uncertainties associated with the parameters of load, line, and transformer models. The RVCA determines a corrective solution that remains immunised against any realisation of uncertainty associated with the parameters of the network model. To this end, prior to formulating the voltage control problem, Monte Carlo (MC) simulations are used to characterise uncertain parameters of the network component models and load flow (LF) calculations are carried out to evaluate their impacts. The voltage constraints management under the uncertain environment is then formulated as a robust optimisation (RO) problem. The latter is constructed based on the results obtained through the MC simulations and LF calculations. Once the RO is solved, in order to check the robustness of the solution, system voltages are evaluated using the LF calculations considering the new set‐points of control variables and uncertainty of network parameters. The simulation results reveal that neglecting model uncertainty in the voltage control problem can lead to infeasible solutions while the proposed RVCA, at an extra cost, determines a corrective solution which remains protected against the studied uncertainties.
Adaptive neural network‐based fault‐tolerant trajectory‐tracking control of unmanned surface vessels with input saturation and error constraints
Authors: Qin Hongde , Li Chengpeng , Sun Yanchao
Published: July 2019

The unmanned surface vessel (USV) plays an important role in smart ocean. This study proposes an adaptive fault‐tolerant tracking control for USVs in the presence of input saturations and error constraints. A tan‐type barrier Lyapunov function is utilised for the error constraints and the neural networks are employed to treat the model uncertainty. Moreover, the adaptive technique combined with the backstepping method not only enables the actuator fault‐tolerant controller to address the fault effects but also handles the external disturbances and input saturations. The proposed control approach can track the desired trajectory with error constraints and the system is guaranteed to be uniformly bounded under certain actuator failure. Numerical simulation is carried out to verify the effectiveness of this control strategy.
Space‐variant analysis and target echo simulation of geosynchronous SAR
Authors: Zhang Min , Zhou Peng , Zhang Xi , Dai Yongshou , Sun Weifeng
Published: July 2019

The geosynchronous synthetic aperture radar (GEO SAR) echo simulation has an important significance for GEO SAR system design and image algorithm verification. The study discusses the main steps of the GEO SAR echo simulation process and the calculation of key parameters. At the same time, because GEO SAR has a high orbital altitude and a long‐time delay, the error caused by the ‘go‐stop‐go’ hypothesis must be taken into account. For this reason, the authors have studied the slant range iterative model without the assumption. It is used to calculate the distance between the satellite and target in the echo simulation. Experimental results show that the method is effective and feasible. Based on this, the space variant characteristics of GEO SAR are analysed in detail. It can be seen that the echo signals do not satisfy the range and azimuth invariance.
Target localisation from bistatic range measurements in multistatic passive radar using MDS
Authors: Zhao Yongsheng , Liu Zhixin , Hu Dexiu , Zhao Yongjun , Zhao Chuang
Published: July 2019

The target localisation in a multistatic passive radar system using bistatic range measurements from multiple transmitter–receiver pairs is considered. A novel closed‐form solution employing multidimensional scaling (MDS) analysis technique is proposed, which is based on the optimisation of a cost function related to the scalar product matrix in the classical MDS framework. The proposed solution is robust to large measurement noise. Simulation results demonstrate the proposed solution achieves a significant performance improvement over existing spherical interpolation, spherical intersection and two‐step weighted least squares methods, and attains the Cramer–Rao lower bound at a relatively higher measurement noise level before the threshold effect occurs.
Upper limits on the water vapour content of the β Pictoris debris disk
Authors: Cavallius M. , Cataldi G. , Brandeker A. , Olofsson G. , Larsson B. , Liseau R.
Published: July 2019

Context. The debris disk surrounding β Pictoris has been observed with ALMA to contain a belt of CO gas with a distinct peak at ~85 au. This CO clump is thought to be the result of a region of enhanced density of solids that collide and release CO through vaporisation. The parent bodies are thought to be comparable to solar system comets, in which CO is trapped inside a water ice matrix.

Aims. Since H2O should be released along with CO, we aim to put an upper limit on the H2O gas mass in the disk of β Pictoris.

Methods. We used archival data from the Heterodyne Instrument for the Far-Infrared (HIFI) aboard the Herschel Space Observatory to study the ortho-H2O 110–101 emission line. The line is undetected. Using a python implementation of the radiative transfer code RADEX, we converted upper limits on the line flux to H2O gas masses. The resulting lower limits on the CO/H2O mass ratio are compared to the composition of solar system comets.

Results. Depending on the assumed gas spatial distribution, we find a 95% upper limit on the ortho-H2O line flux of 7.5 × 10−20 W m−2 or 1.2 × 10−19 W m−2. These translate into an upper limit on the H2O mass of 7.4 × 1016–1.1 × 1018 kg depending on both the electron density and gas kinetic temperature. The range of derived gas-phase CO/H2O ratios is marginally consistent with low-ratio solar system comets.
Safety and Accuracy of Minimally Invasive Long Bone Fracture Repair Using a 2.5-mm Interlocking Nail: A Cadaveric Feline Study
Authors: Nabholz Katrin , Pozzi Antonio , Schmierer Philipp A. , Smolders Lucas A. , Knell Sebastian C.
Published: July 2019

Objectives The Targon Vet System (TVS) is a 2.5-mm interlocking nail that can be applied minimally invasively. The purpose of this study was to test if the TVS could be safely applied percutaneously to different feline long bones without fluoroscopic guidance.

Methods A gap fracture was created in 96 feline humeri, femora and tibiae (n = 32/group). Paired bones were randomly assigned to two treatment groups: (1) TVS inserted percutaneously with fluoroscopy and (2) TVS inserted percutaneously without fluoroscopy. Intraoperative evaluation (complications, procedure time, attempts), radiographs (pre-/postoperative alignment, length) and anatomical dissection (neurovascular injury, rotational alignment) were compared between treatment groups.

Results The use of fluoroscopy did not lead to significant differences in any of the outcome measures. Intraoperative complications predominantly occurred in the distal humerus (12/32) and the proximal femur (7/32). In total, 20/96 complications occurred with no complications for the tibia. Neurovascular structures were only damaged at the medial side of the distal humerus (10/32).

Clinical Significance We conclude that the TVS can be safely applied percutaneously to the tibia and with limitations to the femur in normal cadaveric cats without fluoroscopy. Despite the limitations of a cadaveric study, the high number of complications is leading us to consider the humerus not safe for the TVS. A learning curve has to be expected and technical recommendations should be respected to decrease complications.
Concepts in Periodic Discharges: A Descriptive Study
Authors: Khanna Laxmi , Agarwal Nandini , Kandel Sabita
Published: July 2019

Introduction Periodic discharges are now known as the ictal–interictal continuum and represent ongoing injury in acute or chronic neurological illnesses.

Objective The aim of our study was to identify periodic discharges in patients who have undergone continuous bedside electroencephalography (EEG) monitoring and to classify the EEG according to the current American Clinical Neurophysiology Society terminology.

Materials and Methods The continuous bedside EEG records of intensive care patients admitted from August 2017 to July 2018 were analyzed. The clinical spectrum, the treatment, and outcome of each of these patients were monitored.

Results Fifty cases of periodic discharges (11 children, 39 adults) were identified over 1 year from 2017 to 2018. The clinical presentation included 32% seizures, 16% status epilepticus, 20% coma, 16% fever with altered sensorium, 8% abnormal behavior, 4% strokes, and 4% traumatic brain injury. The diagnosis was 20% autoimmune encephalitis, 8% herpes encephalitis, 20% multiorgan failure, 4% traumatic brain injury, 16% status epilepticus, 16% posthypoxic encephalopathy, 4% strokes, 4% intracerebral bleeds, 4% meningitis, and 4% severe dementia. Lateralized periodic discharges were identified in 20%, bilateral independent periodic discharges in 20%, and generalized periodic discharges in 60%. Fifty-six percent patients recovered with residual neurological deficits and 44% succumbed to their illness.

Conclusions Continuous bedside EEG monitoring has revolutionized the approach to seizures in critically ill patients. Despite a vigilant approach and diligent diagnosis of these abnormal rhythms, the mortality rate was 20% in patients with lateralized periodic discharges and 60% with bilateral and generalized periodic discharges (p ≤ 0.05).
Effect of Vitamin C as an Adjunct in Nonsurgical Periodontal Therapy in Uncontrolled Type 2 Diabetes Mellitus Patients
Authors: Kunsongkeit Piyapat , Okuma Nis , Rassameemasmaung Supanee , Chaivanit Pechngam
Published: July 2019

Objective The main purpose of this article is to evaluate periodontal parameters of chronic periodontitis patients with uncontrolled type 2 diabetes mellitus after initial periodontal therapy plus vitamin C.

Materials and Methods A double-blind, placebo-controlled, clinical trial was conducted. Subjects received initial periodontal therapy plus 500 mg/day vitamin C for 2 months (n = 15) or placebo (n = 16). Fasting blood sugar (FBS), hemoglobin A1c (HbA1C), and plasma vitamin C level were assessed at baseline and 2 months post-treatment. Plaque Index, Sulcus Bleeding Index, Gingival Index, pocket depth, and clinical attachment level were measured at baseline, 1 month, and 2 months post-treatment.

Results Almost all subjects had low level of plasma vitamin C at baseline. In the test group, plasma vitamin C was significantly increased to an adequate level at the end of 2 months. After periodontal treatment, FBS and HbA1c were not significantly different compared with baseline in the test group. In the control group, FBS was significantly decreased from baseline. However, no significant difference between groups was found either in FBS or HbA1c. All periodontal parameters were significantly improved from baseline in both groups. However, no significant difference was found between groups.

Conclusion Supplementation of 500 mg/day vitamin C did not give an additional benefit in promoting periodontal status in periodontitis patients with uncontrolled type 2 diabetes mellitus.
Modifications of Glass Ionomer Cement Powder by Addition of Recently Fabricated Nano-Fillers and Their Effect on the Properties: A Review
Authors: Moheet Imran Alam , Luddin Norhayati , Rahman Ismail Ab , Kannan Thirumulu Ponnuraj , Nik Abd Ghani Nik Rozainah , Masudi Saman Malik
Published: July 2019

The aim of this article is to provide a brief insight regarding the recent studies and their recommendations related to the modifications to glass ionomer cement (GIC) powder in order to improve their properties. An electronic search of publications was made from the year 2000 to 2018. The databases included in the current study were EBSCOhost, PubMed, and ScienceDirect. The inclusion criteria for the current study include publication with abstract or full-text articles, original research, reviews or systematic reviews, in vitro, and in vivo studies that were written in English language. Among these only articles published in peer-reviewed journals were included. Articles published in other languages, with no available abstract and related to other nondentistry fields, were excluded. A detailed review of the recent materials used as a filler phase in GIC powder has revealed that not all modifications produce beneficial results. Recent work has demonstrated that modification of GIC powder with nano-particles has many beneficial effects on the properties of the material. This is due to the increase in surface area and surface energy, along with better particle distribution of the nano-particle. Therefore, more focus should be given on nano-particle having greater chemical affinity for GIC matrix as well as the tooth structure that will enhance the physicochemical properties of GIC.
A population of free-living highland wild dogs in Indonesian Papua
Authors: McIntyre James K. , Wolf Lisa L. , Sacks Benjamin N. , Koibur Johon , Brisbin Jr I. Lehr
Published: July 2019

A 10-day rapid assessment has confirmed a small population of indigenous wild-living dogs in the highlands of Papua Province, Indonesia. The goal of the assessment was to observe, census, assess health and reproductive status, and collect biological samples or other data for this understudied canid. Trail cameras and DNA hair traps were deployed and baited with scent attractants, and game calls were used to elicit vocal responses or lure the dogs within observation range. Adults and pups of both sexes as well as a den were documented in 149 photographs. DNA testing of scat samples confirmed a canid origin with a close relationship to other oceanic canids including NGSD (New Guinea Singing Dog) and dingoes.
Teaching management, spirituality, and religion: André Delbecq as a pioneer
Authors: Allen  , Williams
Published: July 2019

André Delbecq is remembered as a pioneer for his groundbreaking courses on spirituality for executive leaders. He generously shared his experiences with other educators in multiple presentations and articles beginning in the late 1990s. His writings provide insight into the content of his classes and practical teaching approach in the classroom. In this article and the accompanying video, edited from an interview with André in 2015, we provide an overview of André’s entry into teaching management, spirituality, and religion, and we reflect on his teaching philosophy. The video provides the reader with a glimpse of André’s warmth, passion, and wisdom on this topic. His work and approach stand as a guiding light for those similarly interested in preparing leaders for the spiritual challenges of leadership roles.
The results of high-frequency audiometry in tinnitus patients
Authors: Mujdeci Banu , Dere H. Hüseyin
Published: July 2019

Objective:

To evaluate high-frequency (HF) audiometry in subjects with unilateral subjective tinnitus and normal pure tone thresholds (≤25 dB HL) at 0.25-8 kHz.

Materials and methods:

The study group; consisted of 20 patients with unilateral subjective tinnitus (12 women, 8 men) and normal hearing threshold levels. A control group was also selected as 20 subjects (11 women, 9 men) having normal pure tone thresholds below 25 dBHL at 0.25-8 kHz and not complaining of tinnitus. The HF audiometry testing was used. HF hearing threshold measurements were performed in a sound-treated booth using the clinic audiometer (Interacoustics AC 40, Danimarka) with Koss R80 HF headphone at 10, 12.5, 14 and 16 kHz.

Results:

The pure tone hearing thresholds showed difference between tinnitus ears of study group and control group at 10, 12.5, 14 and 16 kHz (p < .05). Similarly HF hearing thresholds showed difference between tinnitus ears and non-tinnitus ears in the study group at 10, 12.5, 14 and 16 kHz (p < .05).

Conclusions:

The routinely use of HF audiometry in tinnitus subjects with normal pure tone thresholds with conventional audiometry can provide useful information about the patients’ hearing status.
A Quantitative Validation of the Control Banding Nanotool
Authors: Zalk David M , Paik Samuel Y , Chase Wesley D
Published: July 2019

Eleven years (by publication) years after the development and application of the control banding (CB) Nanotool for the qualitative assessment and control of engineered nanoparticles (ENP), there remains no quantitative gold standard to serve as an alternative to the qualitative assessment. Many CB models have been developed during the years subsequent to the initial development of the CB Nanotool and the literature continues to blossom with comparisons and applications of these various tools; however, these developments have hitherto been made in the absence of validating and verifying their effectiveness using existing, albeit limited, quantitative methods. This paper reviews the existing literature on the CB Nanotool to evaluate its effectiveness in a variety of settings and presents a summary of qualitative and quantitative information from its application in a broad range of ENP handling activities performed in two different research institutions. A total of 28 ENP activities were assessed using the CB Nanotool (Version 2.0). Due to the lack of guidance on a single exposure assessment methodology, a combination of real-time monitoring, filter analysis, and microscopic analysis was used to assess various quantitative metrics, including mass concentration, particle number concentration, and particle speciation. All the results indicated that the control outcomes from the CB Nanotool qualitative assessment were sufficient to prevent workers from being exposed to ENP at levels beyond established exposure limits or background levels. These data represent an independent quantitative validation of CB Nanotool risk level outcomes and give further credence to the use of the CB Nanotool to effectively control worker exposures in the absence of quantitative air monitoring results.
Ontogeny and evolution of the sound-generating structures in the infraorder Delphinida (Odontoceti: Delphinida)
Authors: Frainer Guilherme , Moreno Ignacio B , Serpa Nathalia , Galatius Anders , Wiedermann Dirk , Huggenberger Stefan
Published: July 2019

The ontogeny of the structures involved in sound generation and modulation in dolphins was investigated through a comparison of the soft nasal structures of foetal, perinatal, neonatal and adult specimens of Pontoporiidae, Phocoenidae and Delphinidae. Foetal samples were sectioned at 10 µm in the saggital and coronal planes, and stained for histological examination. Computed tomography and magentic resonance imaging scan series were combined with new data to represent the ontogenetic stages of the three groups. The images were analysed in 3D-Slicer to characterize the general head topography. The origins of the melon and the vestibular air sac were detected between Carnegie stages C16 and F22. The three groups analysed showed distinct formation of the nasal plug and nasal plug muscles, mainly with regard to the loss of fat pathways (or their maintenance in Pontoporiidae) and the development of the nasal plug muscles on both sides (during perinatal development of Phocoenidae) or just on the left side (during postnatal development in Delphinidae). Broadband vocalizing delphinidans might have evolved under heterochronic events acting on the formation of sound-generating structures such as the rostrum and vestibular air sacs, and on the transformation of the branches of the melon, probably leading to a reduced directionality of the sonar beam.
DNA methylation patterns in bladder tumors of African American patients point to distinct alterations in xenobiotic metabolism
Authors: Vantaku Venkatrao , Amara Chandra Sekhar , Piyarathna Danthasinghe Waduge Badrajee , Donepudi Sri Ramya , Ambati Chandrashekar R , Putluri Vasanta , Tang Wei , Rajapakshe Kimal , Estecio Marcos Roberto , Terris Martha K , Castro Patricia D , Ittmann Michael M , Williams Stephen B , Lerner Seth P , Sreekumar Arun , Bollag Roni , Coarfa Cristian , Kornberg Michael D , Lotan Yair , Ambs Stefan , Putluri Nagireddy
Published: July 2019

Racial/ethnic disparities have a significant impact on bladder cancer outcomes with African American patients demonstrating inferior survival over European-American patients. We hypothesized that epigenetic difference in methylation of tumor DNA is an underlying cause of this survival health disparity. We analyzed bladder tumors from African American and European-American patients using reduced representation bisulfite sequencing (RRBS) to annotate differentially methylated DNA regions. Liquid chromatography–mass spectrometry (LC-MS/MS) based metabolomics and flux studies were performed to examine metabolic pathways that showed significant association to the discovered DNA methylation patterns. RRBS analysis showed frequent hypermethylated CpG islands in African American patients. Further analysis showed that these hypermethylated CpG islands in patients are commonly located in the promoter regions of xenobiotic enzymes that are involved in bladder cancer progression. On follow-up, LC-MS/MS revealed accumulation of glucuronic acid, S-adenosylhomocysteine, and a decrease in S-adenosylmethionine, corroborating findings from the RRBS and mRNA expression analysis indicating increased glucuronidation and methylation capacities in African American patients. Flux analysis experiments with 13C-labeled glucose in cultured African American bladder cancer cells confirmed these findings. Collectively, our studies revealed robust differences in methylation-related metabolism and expression of enzymes regulating xenobiotic metabolism in African American patients indicate that race/ethnic differences in tumor biology may exist in bladder cancer.
Acute kidney injury in an infant of a kidney allograft recipient
Authors: Aktürk Serkan , Sadioğlu Rezzan Eren , Şengül Şule , Keven Kenan
Published: July 2019

Tacrolimus has been used in pregnant organ recipients for >20 years, and the relationship between fetal complications and the amount of tacrolimus crossing the placenta is still controversial. We report the case of a kidney transplant recipient who used tacrolimus and gave birth to an offspring that developed, shortly after birth, an acute kidney injury caused by tacrolimus exposure, which was detected by measuring tacrolimus levels in the umbilical vein, as well as in maternal blood. Even if whole-blood levels of tacrolimus are within the therapeutic range throughout pregnancy, the amount of tacrolimus could reach toxic levels.
Natural evolution of cardiac sarcoidosis in an asymptomatic patient: a case report
Authors: Degtiarova Ganna , Gheysens Olivier , Van Cleemput Johan , Wuyts Wim , Bogaert Jan
Published: July 2019

Background

Sarcoidosis is a multi-organ granulomatous disease of unknown aetiology. Adverse outcome related with cardiac involvement, makes early diagnosis of cardiac sarcoidosis crucial.

Case summary

In a 55-year-old man presenting with recurrent pulmonary infections, computed tomography (CT) showed several enlarged mediastinal lymph nodes and no lung pathology. Subsequent mediastinoscopy revealed the diagnosis of sarcoidosis. Further screening for organ involvement showed multifocal cardiac involvement both on cardiac magnetic resonance (CMR) and 18-F-fluorodeoxyglucose-positron emission tomography-computed tomography (18F-FDG PET-CT). Because of the lack of functional deterioration and clinical symptoms, no steroid treatment was initiated and regular follow-up of cardiac abnormalities was performed by CMR. Unremarkable progression of cardiac involvement during the first 2 years of follow-up turned into a dramatic involvement after 4 years, with the increase in the number and size of lesions at late gadolinium enhancement (LGE) CMR. Late gadolinium enhancement areas matched the regions of strongly increased 18F-FDG uptake. For the first time, the patient started complaining on shortness of breath, electrocardiography showed an atrioventricular block Grade 1. Cardiac biomarkers and cardiac function were still preserved. Steroid treatment was started. Although an electrophysiology study was negative, Holter monitoring showed ventricular arrhythmia. Cardioverter-defibrillator was implanted.

Discussion

This case shows the progression of cardiac sarcoidosis on CMR in an asymptomatic untreated patient over a 4-year period, and rises the awareness of possible severe cardiac damage even in the absence of clinical signs of cardiac involvement. Combination of PET and CMR is appealing to better understand the evolution of cardiac sarcoidosis and may help in the management of such patients.
Uneventful survival of a rural child after penetrating cardiac injury by a thorn: a case report
Authors: De Decker Rik , Li Yifan Joshua , von Delft Dirk , Meyer Heidi , Mureko Alfred
Published: July 2019

Background

Paediatric penetrating cardiac injury is extremely rare, precluding published management guidelines, therefore warranting a case-by-case approach with learning points gleaned from each case.

Case summary

A 7-year-old boy presented to a rural hospital with a stab wound to the chest by a Withaak (Vachellia tortilis) thorn. The patient was haemodynamically stable on presentation, but a 2 cm subcutaneous, pulsatile mass was present at the cardiac apex. Echocardiography revealed a foreign body penetrating from the apex into the heart, with evidence for a fistula between a cardiac chamber and the pulsatile mass. Angiography confirmed the existence of the fistula between the right ventricle (RV) and the pulsatile mass. A controlled extraction under general anaesthaesia via median sternotomy was performed in-theatre, with blood products and cardiac bypass on standby. The patient recovered without complications and was discharged after 4 days.

Discussion

Our case illustrates the limitations of echocardiography in identifying the precise anatomical definition of penetrating cardiac injuries. Angiography is therefore indicated in such cases. The injury to the RV and the haemostatic effects of the in situ thorn were favourable prognostic factors. We believe that the mortality risk reduction of extraction under full control warrants the minor morbidity of a median sternotomy.
Evolution of B-type natriuretic peptide and N-terminal pro-brain natriuretic peptide during acute decompensated heart failure in a chronic heart failure patient with reduced ejection fraction treated with Sacubitril/Valsartan: a case report
Authors: Tiepolo Ambre , Nougué Hélène , Damoisel Charles , Launay Jean-Marie , Vodovar Nicolas , Mebazaa Alexandre
Published: July 2019

Background

B-type natriuretic peptide (BNP) and the N-terminal proBNP (NT-proBNP) exhibit different evolution in chronic heart failure patients with reduced ejection fraction treated with Sacubitril/Valsartan; BNP increasing or remaining stable, while NT-proBNP decreases. However, how this difference translates upon acute decompensation is unknown.

Case summary

Herein, we described in a 78-year-old woman with chronic heart failure with reduced ejection fraction treated with Sacubitril/Valsartan who had acute decompensated heart failure (ADHF). BNP and NT-proBNP were markedly high during ADHF and showed parallel return to baseline level after clinical improvement.

Discussion

BNP and NT-proBNP retained similar value for the diagnosis of ADHF in patient treated with Sacubitril/Valsartan. These findings strongly suggest that either BNP or NT-proBNP can be used indifferently in this context, while their relative use is debated in chronic heart failure.
Development and validation of a concise scale for assessing patient experience of primary care for adults in Japan
Authors: Aoki Takuya , Fukuhara Shunichi , Yamamoto Yosuke
Published: July 2019

Background

The existing scales to measure patient experience of primary care for adults tend to be with many items and difficult to use outside of the research setting.

Objective

To develop a Japanese version of Primary Care Assessment Tool Short Form as a concise scale for assessing patient experience of primary care and to examine its validity and reliability.

Methods

We conducted a cross-sectional survey in a primary care practice-based research network in Japan (25 primary care facilities). We evaluated the structural validity, criterion-related validity, convergent validity and the internal consistency reliability of the scale.

Results

Data were analysed for 1725 primary care outpatients. A 13-item scale was constructed, and the confirmatory factor analysis showed excellent goodness of fit of the six-factor model (first contact, longitudinality, coordination, comprehensiveness (services available), comprehensiveness (services provided) and community orientation). Pearson correlation coefficients between the total score and the overall rating of care and the original scale total score were 0.43 and 0.94, respectively. The total score was positively associated with influenza and pneumococcal vaccination (P < 0.001; P = 0.009 for trend). All of the multi-item scales achieved good internal consistency and the overall Cronbach’s alpha was 0.77.

Conclusions

We developed a concise patient experience scale, which comprises six domains measuring primary care attributes and evaluated its validity and reliability. This scale can be used as a rapid assessment tool reducing the burden of respondents and provide effective information for further quality improvement and practice-based research in the Japanese primary care settings.
Comparison of laparoscopic selective colectomy based on barium-strip examination and subtotal colectomy for adult slow-transit constipation
Authors: Zhong Zhao Hui , Yang Shen , Zhao Yong , Wang Yuan , Yong Wei Dong , Zhang Ling Ling , Wang Qiu Sheng , Huang Xun
Published: July 2019

Background

Surgical management of adult slow-transit constipation (ASTC) can be effective for patients with intractable symptoms. This study aimed to evaluate whether barium-strip examination and selective colectomy improved post-operative outcomes in ASTC patients in comparison with subtotal colectomy.

Methods

A retrospective cohort study of 53 cases with refractory ASTC was conducted between June 2008 and June 2014. Patients were evaluated by the barium-strip technique, colonoscopy, defecography and anorectal manometry. Patients in the standard group underwent laparoscopic subtotal colectomy and patients in the laparoscopic selective colectomy (LSC) group underwent LSC at the precise location identified by barium strip. Spontaneous bowel movements, the Wexner Constipation Scale and the Gastrointestinal Quality of Life Index (GIQLI) were assessed post-operatively at 3, 6, 12 and 24 months.

Results

A total of 49 patients were included in the analysis. The median follow-up was 37 months (range, 26–60 months). The mean post-operative hospital stay was 12 days and similar between groups (P = 0.071). The length of colon resection, operative time and intra-operative blood loss were reduced in the LSC group (all P < 0.05). No major complications occurred. A similar number of patients (24 in the standard group and 25 in the LSC group) exhibited hypoganglionosis or aganglionosis in the colon-wall muscle layer (P = 0.986). Although there were no significant differences in post-operative spontaneous bowel movements and the Wexner Constipation Scale between the two groups, the mean GIQLI of the LSC group was significantly higher at 3, 6 and 24 months post-operatively (all P < 0.05).

Conclusions

LSC based on barium-strip examination is an appropriate modality for treating ASTC.
Corruption in Anglophone West Africa health systems: a systematic review of its different variants and the factors that sustain them
Authors: Onwujekwe Obinna , Agwu Prince , Orjiakor Charles , McKee Martin , Hutchinson Eleanor , Mbachu Chinyere , Odii Aloysius , Ogbozor Pamela , Obi Uche , Ichoku Hyacinth , Balabanova Dina
Published: July 2019

West African countries are ranked especially low in global corruption perception indexes. The health sector is often singled out for particular concern given the role of corruption in hampering access to, and utilization of health services, representing a major barrier to progress to universal health coverage and to achieving the health-related Sustainable Development Goals. The first step in tackling corruption systematically is to understand its scale and nature. We present a systematic review of literature that explores corruption involving front-line healthcare providers, their managers and other stakeholders in health sectors in the five Anglophone West African (AWA) countries: Gambia, Ghana, Liberia, Nigeria and Sierra Leone, identifying motivators and drivers of corrupt practices and interventions that have been adopted or proposed. Boolean operators were adopted to optimize search outputs and identify relevant studies. Both grey and published literature were identified from Research Gate, Yahoo, Google Scholar, Google and PubMed, and reviewed and synthesized around key domains, with 61 publications meeting our inclusion criteria. The top five most prevalent/frequently reported corrupt practices were (1) absenteeism; (2) diversion of patients to private facilities; (3) inappropriate procurement; (4) informal payments; and (5) theft of drugs and supplies. Incentives for corrupt practices and other manifestations of corruption in the AWA health sector were also highlighted, while poor working conditions and low wages fuel malpractice. Primary research on anti-corruption strategies in health sectors in AWA remains scarce, with recommendations to curb corrupt practices often drawn from personal views and experience rather that of rigorous studies. We argue that a nuanced understanding of all types of corruption and their impacts is an important precondition to designing viable contextually appropriate anti-corruption strategies. It is a particular challenge to identify and tackle corruption in settings where formal rules are fluid or insufficiently enforced.
Morphological Murals: The Scaling and Allometry of Butterfly Wing Patterns
Authors: Palmer Rayleigh , McKenna Kenneth Z , Nijhout H F
Published: July 2019

The color patterns of butterflies moths are exceptionally diverse, but are very stable within a species, so that most species can be identified on the basis of their color pattern alone. The color pattern is established in the wing imaginal disc during a prolonged period of growth and differentiation, beginning during the last larval instar and ending during the first few days of the pupal stage. During this period, a variety of diffusion and reaction–diffusion signaling mechanisms determine the positions and sizes of the various elements that make up the overall color pattern. The patterning occurs while the wing is growing from a small imaginal disc to a very large pupal wing. One would therefore expect that some or all aspects of the color pattern would be sensitive to the size of the developmental field on which pattern formation takes place. To study this possibility, we analyzed the color patterns of Junonia coenia from animals whose growth patterns were altered by periodic starvation during larval growth, which produced individuals with a large range of variation in body size and wing size. Analyses of the color patterns showed that the positions and size of the pattern elements scaled perfectly isometrically with wing size. This is a puzzling finding and suggests the operation of a homeostatic or robustness mechanism that stabilizes pattern in spite of variation in the growth rate and final size of the wing.
The intertidal benthic community of mangrove dominated estuaries: the ecological implications of a decoupled habitat
Authors: Mattone Carlo , Sheaves Marcus
Published: July 2019

The benthic infauna of mangrove forests have received little research despite their importance in regulating ecological processes and nutrient cycling. The majority of studies of benthic community in mangrove systems have either focused on the adjacent tidal flats, or areas with high density of pneumatophores without entering within the forest, giving a misleading impression that mangrove infauna community is understood in detail. To fill the knowledge gap we investigated the composition and distribution of benthic taxa across a tidal gradient in two meso-tidal tropical estuarine mangrove forests in north Queensland, Australia. We used a 10-cm corer to sample inside the mangrove forest and on the adjacent tidal flat. Taxonomic composition was vastly different between the tidal flat and the mangrove forest. In fact, although peracarid (e.g. amphipods) characterized the community of tidal flats, they were never recorded within the forest. The contrasting community composition likely denotes contrasting ecological role of the two habitats. In particular, because peracarids are a key component of juvenile fish diets, their absence within the forest probably limits foraging opportunities for many juvenile fish within the forest, while their dominance on adjacent tidal flats suggests that these are likely to be the key feeding areas.
Everything You Need to Know About Satisfying IACUC Protocol Requirements
Authors: Mohan Swapna , Foley Patricia L
Published: July 2019

There have been recent efforts to reduce the administrative burden imposed on investigators. Although a complete and thorough review of proposed animal studies is an essential function of the Institutional Animal Care and Use Committee (IACUC), efforts to streamline and clarify this process may help investigators spend less time writing animal use protocols and responding to committee comments. The IACUC relies on well-written protocols for an efficient review process. A well-designed protocol form is also critical in guiding investigators through the process. However, it is ultimately the investigators’ responsibility to ensure that the information they provide answers all the IACUC’s questions with enough detail and quality for a fast and effective review. This article, aimed primarily for researchers but also IACUC administrators, provides an overview of the IACUC protocol review and approval process, the criteria that the IACUC uses for evaluations, and the type of information that should be included in the various sections of the protocol form. Some specific examples are also provided.
Simultaneous Approximation on Affine Subspaces
Authors: Huang Jing-Jing , Liu Jason J
Published: July 2019

We solve the convergence case of the generalized Baker–Schmidt problem for simultaneous approximation on affine subspaces, under natural diophantine type conditions. In one of our theorems, we do not require monotonicity on the approximation function. In order to prove these results, we establish asymptotic formulae for the number of rational points close to an affine subspace. One key ingredient is a sharp upper bound on a certain sum of reciprocals of fractional parts associated with the matrix defining the affine subspace.