bluuebunny/crossref_metadata_2025 huggingface dataset:
Digital Resources: DocuMedia Projects in Argentina
Authors: Comba Silvana , Toledo Edgardo , Lovato Anahí , Irigaray Fernando
Published: March 2019

In the current media ecology, audiences are constantly tempted by many types of content scattered across connected platforms. Since cultural goods consumption is a practice that now takes place in a constant flow across different platforms, news and documentary narratives must take advantage of the malleability of digital language to engage citizens. Narratives change according to the dominant intellectual technology of the time. In this way, oral narratives are different from printed media and the transmedia storytelling that digital communication promotes.

DocuMedia: Social Media Journalism is a series of interactive documentaries developed in Argentina at Rosario National University to bring users new narratives of local interest around journalistic research topics. DocuMedia is the result of crossing documentary, investigative journalism, and data journalism techniques with a focus on users’ participation and the expansion of narrative plots. DocuMedia projects are an example of location-based storytelling, that is, a narrative that stems from hyperlocal space and place and operates as a device of constant social reconstruction. In these experiences, memory is understood as the meanings that citizens share and, above all, develop as a social practice, through which identity is expressed and shaped.

The fifth DocuMedia project, Women for Sale: Human Trafficking with Sexual Exploitation in Argentina, was launched in 2015 and took on the challenge of making the leap from multimedia journalism to transmedia journalism. The transmedia framework for Women for Sale included a webdoc, or interactive multimedia documentary, a serial graphic novel of five episodes (print and digital version), posters on the street with augmented reality interaction, short videos projected on indoor and outdoor LED screens, television spots, a collaborative map, a television documentary, mobisodes, the e-book What Happens Next? Contributions and Challenges for the Reconstruction of Rights of Trafficking and Sexual Exploitation Victims, and a social media strategy designed to share information about trafficking in Argentina and to call community to action.
polychromy, architectural, Greek and Roman
Authors: Zink Stephan
Published: March 2019

The polychromy of Greek and Etrusco-Roman architecture comprises the chromatic effects and surface treatments of exterior façades and roofs, as well as interior floors, walls, and ceilings. Colour and/or contrasts of light and shadow are the basis for all architectural ornamentation. The practice is characterized by a large variety of materials and techniques, which draw from different genres of the visual arts such as stone, plaster and stucco working, toreutics, tessellation, sculpture, panel painting, terracotta, and glass making. The treatment of architectural surfaces is thus intimately connected to changes in both construction knowledge and building economies, while their visual effects depend on changing architectural forms and designs. Both texts and archaeological remains underline the importance of colour and material as an integral part of ancient architectural design; they play a key role for the sensory and atmospheric experience of architecture and could influence its symbolic meaning.

Despite strong regional traditions and a general lack of standardization, a few overall developments can be pinpointed: a triple colour scheme of dark (black, blue), light (white, cream), and red hues dominated both Archaic Greek and Etrusco-Italic architectural polychromy; its chromatic polarity became fundamental for the Greek Doric order and, as a basic combination, it remained a recurring motif of architectural surfaces into the Roman Imperial periods. During the Greek Classical period, green, yellow, and increasingly, gilding joined the basic colour palette. Late Classical/Hellenistic innovations included illusionistic painting techniques, intermediality (the imitation of one material by means of another), as well as the increase of light and shadow effects. While variation (Greek poikilia) of both colours and materials was a guiding principle, it seems that there were also occasional reductions of polychrome accentuations on exteriors.

Etrusco-Italic and Roman architecture participated in many of these developments, despite its own materiality and designs. On Italic soil, some of the Hellenistic concepts were even brought to entirely new levels of application, especially the achievement of colour effects through an antithetical combination of material colours (coloured marbles, metals), which became a veritable signature of Roman architecture. The concept of variation (Latin varietas) remained fundamentally important, especially for interiors; mono- or bichromatisms were also advanced, along with stark light and shadow contrasts achieved through surface carving and texturing. Rather than specific colour combinations, Late Antique and early Byzantine architecture favored general polychromacity and, in particular, surfaces with light-bearing qualities to create effects of glitter, brilliance, and reflectance; they were seen as a quality of divinity.
changing landscapes, human impact on
Authors: Bintliff John
Published: March 2019

The Classical world witnessed many forms of physical landscape change due to long-term and short-term geological and climatological processes. There have also been alterations to the land surface resulting from an interaction between human impact and these natural factors. Cyclical changes in land use, agricultural technology, economy, and politics have continually transformed the rural landscapes of the Mediterranean and the wider Classical world and their mapping, in turn, can shed light on fundamental aspects of ancient society that are not always documented in Classical texts.
Bracketing Paradoxes in Morphology
Authors: Newell Heather
Published: March 2019

Bracketing paradoxes—constructions whose morphosyntactic and morpho-phonological structures appear to be irreconcilably at odds (e.g., unhappier)—are unanimously taken to point to truths about the derivational system that we have not yet grasped. Consider that the prefix un- must be structurally separate in some way from happier both for its own reasons (its [n] surprisingly does not assimilate in Place to a following consonant (e.g., u[n]popular)), and for reasons external to the prefix (the suffix -er must be insensitive to the presence of un-, as the comparative cannot attach to bases of three syllables or longer (e.g., *intelligenter)). But, un- must simultaneously be present in the derivation before -er is merged, so that unhappier can have the proper semantic reading (‘more unhappy’, and not ‘not happier’). Bracketing paradoxes emerged as a problem for generative accounts of both morphosyntax and morphophonology only in the 1970s. With the rise of restrictions on and technology used to describe and represent the behavior of affixes (e.g., the Affix-Ordering Generalization, Lexical Phonology and Morphology, the Prosodic Hierarchy), morphosyntacticians and phonologists were confronted with this type of inconsistent derivation in many unrelated languages.
Terracing: From Agriculture to Multiple Ecosystem Services
Authors: Socci Paolo , Errico Alessandro , Castelli Giulio , Penna Daniele , Preti Federico
Published: March 2019

Agricultural terraces are widely spread all over the world and are among the most evident landscape signatures of the human fingerprint, in many cases dating back to several centuries. Agricultural terraces create complex anthropogenic landscapes traditionally built to obtain land for cultivation in steep terrains, typically prone to runoff production and soil erosion, and thus hardly suitable for rain-fed farming practices. In addition to acquiring new land for cultivation, terracing can provide a wide array of ecosystem services, including runoff reduction, water conservation, erosion control, soil conservation and increase of soil quality, carbon sequestration, enhancement of biodiversity, enhancement of soil fertility and land productivity, increase of crop yield and food security, development of aesthetic landscapes and recreational options. Moreover, some terraced areas in the world can be considered as a cultural and historical heritage that increases the asset of the local landscape. Terraced slopes may be prone to failure and degradation issues, such as localized erosion, wall or riser collapse, piping, and landsliding, mainly related to runoff concentration processes. Degradation phenomena, which are exacerbated by progressive land abandonment, reduce the efficiency of benefits provided by terraces. Therefore, understanding the physical processes occurring in terraced slopes is essential to find the most effective maintenance criteria necessary to accurately and adequately preserve agricultural terraces worldwide.
A Bioanalytical Method for Eliglustat Quantification in Rat Plasma
Authors: Reddy Venkata Krishna , Swamy Narayana , Rathod Rajeswari , Sengupta Pinaki
Published: March 2019

A simple and sensitive bioanalytical HPLC–UV method has been developed and validated for quantification of eliglustat in rat plasma. The liquid–liquid extraction method was found to be more efficient compared to protein precipitation technique. Chromatographic separation of eliglustat was achieved using Kromasil C18 column with a mobile phase consisting of a mixture of methanol and ammonium acetate (pH 3.2) in a ratio of 60:40. Detection wavelength was set at 282 nm. The developed method was specific, accurate, precise with good recovery and stability profile. The calibration curve constructed over a range of 0.3–10 μg/mL was linear (R2 > 0.997). Accuracy in intra and inter-day assay were found to be 96.27–107.35% and 96.80–106.57%, respectively. The corresponding precision (%CV) values were within 4.31–10.90% and 4.82–9.97%, respectively. Till date, no method is available for bioanalysis of eliglustat in any type of biological matrix. This is the first time to report a bioanalytical method for this molecule. The developed bioanalytical method was applied to quantitate eliglustat in the plasma samples of a single dose oral pharmacokinetic study in Sprague Dawley rat.
Focal scar and diffuse myocardial fibrosis are independent imaging markers in repaired tetralogy of Fallot
Authors: Cochet Hubert , Iriart Xavier , Allain-Nicolaï Antoine , Camaioni Claudia , Sridi Soumaya , Nivet Hubert , Fournier Emmanuelle , Dinet Marie-Lou , Jalal Zakaria , Laurent Francois , Montaudon Michel , Thambo Jean-Benoît
Published: March 2019

Aims

To identify the correlates of focal scar and diffuse fibrosis in patients with history of tetralogy of Fallot (TOF) repair.

Methods and results

Consecutive patients with prior TOF repair underwent electrocardiogram, 24-h Holter, transthoracic echocardiography, exercise testing, and cardiac magnetic resonance (CMR) including cine imaging to assess ventricular volumes and ejection fraction, T1 mapping to assess left ventricular (LV) and right ventricular (RV) diffuse fibrosis, and free-breathing late gadolinium-enhanced imaging to quantify scar area at high spatial resolution. Structural imaging data were related to clinical characteristics and functional imaging markers. Cine and T1 mapping results were compared with 40 age- and sex-matched controls. One hundred and three patients were enrolled (age 28 ± 15 years, 36% women), including 36 with prior pulmonary valve replacement (PVR). Compared with controls, TOF showed lower LV ejection fraction (LVEF) and RV ejection fraction (RVEF), and higher RV volume, RV wall thickness, and native T1 and extracellular volume values on both ventricles. In TOF, scar area related to LVEF and RVEF, while LV and RV native T1 related to RV dilatation. On multivariable analysis, scar area and LV native T1 were independent correlates of ventricular arrhythmia, while RVEF was not. Patients with history of PVR showed larger scars on RV outflow tract but shorter LV and RV native T1.

Conclusion

Focal scar and biventricular diffuse fibrosis can be characterized on CMR after TOF repair. Scar size relates to systolic dysfunction, and diffuse fibrosis to RV dilatation. Both independently relate to ventricular arrhythmias. The finding of shorter T1 after PVR suggests that diffuse fibrosis may reverse with therapy.
Gender and Age of Migration Differences in Mortality Among Older Mexican Americans
Authors: Reyes Adriana M , Garcia Marc A
Published: March 2019

Objectives

Using a gendered life course perspective, we examine whether the relationship between age of migration and mortality is moderated by gender among a cohort of older Mexican Americans.

Methods

Data from the Hispanic Established Populations for the Epidemiological Study of the Elderly and recently matched mortality data are used to estimate Cox proportional hazard models.

Results

Our findings indicate that the relationship between age of migration and mortality is moderated by gender, suggesting a more nuanced perspective of the immigrant mortality paradox. Among men, midlife migrants exhibit an 18% lower risk of mortality compared to their U.S.-born co-ethnics, possibly due to immigrant selectivity at the time of migration. Conversely, late-life migrant women exhibit a 17% lower risk of mortality relative to U.S.-born women, attributed in part to socio-cultural characteristics that influence lifestyle risk factors across the life course.

Discussion

Selection mechanisms and acculturation processes associated with the immigrant experience are contingent on both age and gender, suggesting the utility of an integrated life course approach to contextualize the mortality profiles of older immigrants. These findings demonstrate the heterogeneity among immigrants and highlight the need to understand gender differences in the migration process when assessing the immigrant mortality paradox.
Atlantic salmon return rate increases with smolt length
Authors: Gregory Stephen D , Ibbotson Anton T , Riley William D , Nevoux Marie , Lauridsen Rasmus B , Russell Ian C , Britton J Robert , Gillingham Phillipa K , Simmons Olivia M , Rivot Etienne
Published: March 2019

Recent declines in Atlantic salmon Salmo salar populations are generally attributed to factors in their marine life-phase. However, it is postulated that factors affecting their freshwater life-phase might impact their marine survival, such as the influence of body size. While larger smolts are widely hypothesized to have higher marine survival rates, empirical support remains scant, in part due to inadequate data and ambiguous statistical analyses. Here, we test the influence of smolt body size on marine return rates, a proxy for marine survival, using a 12-year dataset of 3688 smolts tagged with passive integrated transponders in the River Frome, Southern England. State-space models describe the probability of smolts surviving their marine phase to return as 1 sea-winter (1SW) or multi-sea-winter adults as a function of their length, while accounting for imperfect detection and missing data. Models predicted that larger smolts had higher return rates; the most parsimonious model included the effect of length on 1SW return rate. This prediction is concerning, as freshwater juvenile salmon are decreasing in size on the River Frome, and elsewhere. Thus, to maximize adult returns, restoration efforts should focus on freshwater life-stages, and maximize both the number and the size of emigrating smolts.
Regulation of collagen type XVII expression by miR203a-3p in oral squamous cell carcinoma cells
Authors: Yasukochi Atsushi , Kawakubo-Yasukochi Tomoyo , Morioka Masahiko , Hazekawa Mai , Nishinakagawa Takuya , Ono Kazuhiko , Nakashima Manabu , Nakamura Seiji
Published: March 2019

Collagen type XVII (COL17) is expressed in various tissues and its aberrant expression is associated with tumour progression. In this study, we investigated the regulation of COL17 expression in oral squamous cell carcinoma (OSCC) using the cell lines NA, SAS, Ca9-22, and Sa3. COL17 was induced upon p53 activation by cisplatin in SAS; however, this effect was more limited in NA and hardly in Ca9-22 and Sa3, with mutated p53. Moreover, COL17 was found to be regulated by miR203a-3p in all cell lines. Our data suggest that COL17 expression in OSCC cell lines is regulated by p53 and miR203a-3p.
Characterization of an Intradiol Ring-Cleavage Dioxygenase Gene Associated With Abamectin Resistance in Tetranychus cinnabarinus (Acari: Tetranychidae)
Authors: Xu Zhifeng , Liu Peilin , Hu Yuan , Hu Jia , Qi Cuicui , Wu Qiong , He Lin
Published: March 2019

Tetranychus cinnabarinus (Boisduval), i.e., carmine spider mite, is a worldwide pest that can cause serious damage to plants. Problems of resistance have arisen since abamectin usage in the control of T. cinnabarinus. Unfortunately, there are only limited data on the extent of this problem. To understand the development of abamectin resistance in the carmine spider mite, we prokaryotically expressed an intradiol ring-cleavage dioxygenase (ID-RCD) gene sequence, TcID-RCD1, which had a significant upregulated expression of over 7.7 times in an abamectin-resistant strain (AbR) when compared with that of a susceptible strain (SS). The crude enzyme activity also indicated that the AbR had a higher activity than that exhibited in SS. When susceptible individuals were treated with abamectin, TcID-RCD1 was also overexpressed. Furthermore, using the RNA interference (RNAi) technique, TcID-RCD1 was successfully knocked down, with the expression level decreasing significantly to approximately 39% in the SS strain compared with the control. And the mortality of mites feeding on dsTcID-RCD1 increased significantly when treated with abamectin. These results strongly suggest that TcID-RCD1 is involved in abamectin resistance in T. cinnabarinus.
Dietary Pattern and Risk of Multiple Myeloma in Two Large Prospective US Cohort Studies
Authors: Lee Dong Hoon , Fung Teresa T , Tabung Fred K , Colditz Graham A , Ghobrial Irene M , Rosner Bernard A , Giovannucci Edward L , Birmann Brenda M
Published: March 2019

Background

The limited data on specific dietary components and risk of multiple myeloma (MM) show no consistent association. Studies have not examined the association of dietary pattern with MM risk.

Methods

In prospective cohorts of 69 751 women (Nurses’ Health Study, 1984–2014) and 47 232 men (Health Professionals Follow-up Study, 1986–2014), we examined the association between dietary pattern and risk of MM using Cox proportional hazard models. Diet was assessed repeatedly every 4 years with food frequency questionnaires and was used to calculate dietary patterns including the Alternate Healthy Eating Index-2010, Alternate Mediterranean Diet, Dietary Approaches to Stop Hypertension, Prudent and Western patterns, the empirical dietary inflammatory pattern (EDIP), and empirical dietary indices for insulin resistance (EDIR) and hyperinsulinemia (EDIH).

Results

During 2 792 257 person-years of follow-up, we identified 478 incident MM cases (215 women, 263 men). In men, high EDIP was statistically significantly associated with a 16% increase in MM risk (hazard ratio [HR] = 1.16, 95% confidence interval [CI] = 1.02 to 1.32 per 1-SD increase). Moreover, EDIR and EDIH had a suggestive positive association (EDIR: HR = 1.09, 95% CI = 0.96 to 1.24; and EDIH: HR = 1.11, 95% CI = 0.97 to 1.28 per 1-SD increase). We observed no other associations with MM risk in men and no associations for any dietary pattern with MM risk in women.

Conclusions

We present the first evidence for a role of diets with higher inflammatory or insulinemic potential in MM development. Further studies are warranted to explore these associations in other populations, including the apparent restriction to men.
Explicit professionalism. A cross-level study of institutional change in the wake of evidence-based practice
Authors: Møller Anne M
Published: March 2019

This article shows how a new normative standard for public professionalism has evolved from the introduction of evidence-based practice in Danish child protective services. The concept of ‘theorization’ from institutional theory is discussed and applied as the main analytical lens to explore how new ideas are introduced, interpreted, and negotiated in the organizational field. Based on a cross-level ethnographic case study, the study traces the process of theorization and shows how actors are informed by local translations and theorizations as they challenge, negotiate and develop collective understandings in the field. Theorization is therefore conceptualized as a continuous multidirectional process of recursive intertwinement between field-level and organizational developments, which may or may not entail institutional change. The study also contributes to our understanding of changing forms of professionalism by proposing the concept ‘explicit professionalism’ as a way of capturing the new normative standard for public professional work that has evolved from the process of theorizing evidence-based practice. Explicit professionalism is both a descriptive concept and a normative ideal and, it is suggested, an important dimension of new forms of organizational and organizing professionalism, which can aid our understanding of related developments in different professional fields.
The mitochondrial oxidation resistance protein AtOXR2 increases plant biomass and tolerance to oxidative stress
Authors: Colombatti Francisco , Mencia Regina , Garcia Lucila , Mansilla Natanael , Alemano Sergio , Andrade Andrea M , Gonzalez Daniel H , Welchen Elina
Published: March 2019

This study demonstrates the existence of the oxidation resistance (OXR) protein family in plants. There are six OXR members in Arabidopsis that contain the highly conserved TLDc domain that is characteristic of this eukaryotic protein family. AtOXR2 is a mitochondrial protein able to alleviate the stress sensitivity of a yeast oxr1 mutant. It was induced by oxidative stress and its overexpression in Arabidopsis (oeOXR2) increased leaf ascorbate, photosynthesis, biomass, and seed production, as well as conferring tolerance to methyl viologen, antimycin A, and high light intensities. The oeOXR2 plants also showed higher ABA content, changes in ABA sensitivity, and modified expression of ABA- and stress-regulated genes. While the oxr2 mutants had a similar shoot phenotype to the wild-type, they exhibited increased sensitivity to stress. We propose that by influencing the levels of reactive oxygen species (ROS), AtOXR2 improves the efficiency of photosynthesis and elicits basal tolerance to environmental challenges that increase oxidative stress, allowing improved plant growth and biomass production.
H i 21 cm mapping of the host galaxy of AT2018cow: a fast-evolving luminous transient within a ring of high column density gas
Authors: Roychowdhury Sambit , Arabsalmani Maryam , Kanekar Nissim
Published: March 2019

We report Giant Metrewave Radio Telescope H i 21 cm imaging of CGCG 137–068, the host galaxy of the fast-evolving luminous transient (FELT) AT2018cow. This is the first study of the gas properties of a FELT host galaxy. We obtain a total H i mass of (6.6 ± 0.9) × 108 M⊙ for the host galaxy, which implies an atomic gas depletion time of 3 Gyr and a gas-to-stellar mass ratio of 0.47, consistent with values in normal star-forming dwarf galaxies. At spatial resolutions of ≥6 kpc, the H i of CGCG 137–068 appears to be distributed in a disc, in mostly regular rotation. However, at spatial resolutions of 2 kpc, the highest column density H i is found to lie in an asymmetric ring around the central regions, with H i column densities ≥1021 cm−2; AT2018cow lies within this high column density ring. This H i ring could be suggestive of an interaction between CGCG 137–068 and a companion galaxy. Such a ring is ideal for the formation of compact regions of star formation hosting massive stars, favouring massive star progenitor models for AT2018cow. We measure a 1.4 GHz flux density of 1.13 ± 0.13 mJy for AT2018cow on 2018 August 27.
A comparison of technique survival in Canadian peritoneal dialysis and home hemodialysis patients
Authors: Trinh Emilie , Hanley James A , Nadeau-Fredette Annie-Claire , Perl Jeffrey , Chan Christopher T
Published: March 2019

Background

High discontinuation rates remain a challenge for home hemodialysis (HHD) and peritoneal dialysis (PD). We compared technique failure risks among Canadian patients receiving HHD and PD.

Methods

Using the Canadian Organ Replacement Register, we studied adult patients who initiated HHD or PD within 1 year of beginning dialysis between 2000 and 2012, with follow-up until 31 December 2013. Technique failure was defined as a transfer to any alternative modality for a period of ≥60 days. Technique survival between HHD and PD was compared using a Fine and Gray competing risk model. We also examined the time dependence of technique survival, the association of patient characteristics with technique failure and causes of technique failure.

Results

Between 2000 and 2012, 15 314 patients were treated with a home dialysis modality within 1 year of dialysis initiation: 14 461 on PD and 853 on HHD. Crude technique failure rates were highest during the first year of therapy for both home modalities. During the entire period of follow-up, technique failure was lower with HHD compared with PD (adjusted hazard ratio = 0.79; 95% confidence interval 0.69–0.90). However, the relative technique failure risk was not proportional over time and the beneficial association with HHD was only apparent after the first year of dialysis. Comparisons also varied among subgroups and the superior technique survival associated with HHD relative to PD was less pronounced in more recent years and among older patients. Predictors of technique failure also differed between modalities. While obesity, smoking and small facility size were associated with higher technique failure in both PD and HHD, the association with age and gender differed. Furthermore, the majority of discontinuation occurred for medical reasons in PD (38%), while the majority of HHD patients experienced technique failure due to social reasons or inadequate resources (50%).

Conclusions

In this Canadian study of home dialysis patients, HHD was associated with better technique survival compared with PD. However, patterns of technique failure differed significantly among these modalities. Strategies to improve patient retention across all home dialysis modalities are needed.
Do Surveys Overestimate or Underestimate Socioeconomic Differences in Voter Turnout? Evidence from Administrative Registers
Authors: Lahtinen Hannu , Martikainen Pekka , Mattila Mikko , Wass Hanna , Rapeli Lauri
Published: March 2019

Surveys generally overestimate the overall level of voter turnout in elections due to both the misreporting of voting and nonresponse. It is sometimes argued that socioeconomic differences in turnout are exaggerated in surveys because social desirability has a more pronounced effect on eligible voters in more advantaged socioeconomic positions. However, the contribution of nonresponse bias has not been taken into consideration in these assessments. Using a register-linked survey with information on the education, occupational social class, income, and voting in the 2015 Finnish parliamentary elections of both respondents and nonrespondents, this study shows that nonresponse bias leads to not only a larger overestimation of the overall level of turnout than social desirability, but also an underestimation of educational, social class, and income-related differences in the propensity to vote. Socioeconomic differences in the probability of voting in register-based data were at least two-thirds larger than differences obtained when using standard survey techniques. This finding implies that socioeconomic inequality in electoral participation is a more pressing social problem than previous evidence might indicate.
Treatment of Sjögren’s syndrome: current therapy and future directions
Authors: Fox Robert I. , Fox Carla M. , Gottenberg Jacques Eric , Dörner Thomas
Published: March 2019

SS is usually described as having severe fatigue, dryness, diffuse pain, glandular swelling, and various extraglandular (systemic) manifestations. Clinical trials have generally failed because the vast majority of enrolled patients had no extraglandular manifestations at the time of enrolment but suffered from fatigue, dryness and pain that did not significantly respond to the study medication. A number of hypotheses on the pathogenesis of pSS have been put forward, including disturbances of innate and adaptive immunity as well as abnormalities of the interface between immune disorders and the neuro-endocrine system related to lacrimal and secretory gland dysfunction. Thus, future therapies must be designed for improvement of the symptoms of dry eyes and dry mouth, extraglandular disease, and fatigue and cognitive deficits. Given the inadequacies and limitations of current treatment options, we suggest that innovative directions involving interactions with neuroscientists and neuropsychiatrists together or combined with new immune targeting may be hold promise for better treating pSS.
Viral invasion fitness across a continuum from lysis to latency†
Authors: Weitz Joshua S , Li Guanlin , Gulbudak Hayriye , Cortez Michael H , Whitaker Rachel J
Published: March 2019

The prevailing paradigm in ecological studies of viruses and their microbial hosts is that the reproductive success of viruses depends on the proliferation of the ‘predator’, that is, the virus particle. Yet, viruses are obligate intracellular parasites, and the virus genome—the actual unit of selection—can persist and proliferate from one cell generation to the next without lysis or the production of new virus particles. Here, we propose a theoretical framework to quantify the invasion fitness of viruses using an epidemiological cell-centric metric that focuses on the proliferation of viral genomes inside cells instead of virus particles outside cells. This cell-centric metric enables direct comparison of viral strategies characterized by obligate killing of hosts (e.g. via lysis), persistence of viral genomes inside hosts (e.g. via lysogeny), and strategies along a continuum between these extremes (e.g. via chronic infections). As a result, we can identify environmental drivers, life history traits, and key feedbacks that govern variation in viral propagation in nonlinear population models. For example, we identify threshold conditions given relatively low densities of susceptible cells and relatively high growth rates of infected cells in which lysogenic and other chronic strategies have higher potential viral reproduction than lytic strategies. Altogether, the theoretical framework helps unify the ongoing study of eco-evolutionary drivers of viral strategies in natural environments.
The Effect of Patient Characteristics on Acupuncture Treatment Outcomes
Authors: Witt Claudia M. , Vertosick Emily A. , Foster Nadine E. , Lewith George , Linde Klaus , MacPherson Hugh , Sherman Karen J. , Vickers Andrew J.
Published: March 2019

Objectives:

To optimally select chronic pain patients for different treatments, as it is of interest to identify patient characteristics that might moderate treatment effect. Our aim was to evaluate the impact of possible moderators on the effect of acupuncture treatment using a large data set.

Methods:

We used data from an individual patient data meta-analysis of high-quality randomized trials of acupuncture for chronic headache and migraine, osteoarthritis, and back, neck, and shoulder pain. Using meta-analytic trial-level and patient-level regression analyses, we explored the impact of 5 documented patient characteristics (patients’ age at baseline, sex, pain duration, baseline pain severity and baseline psychological distress) on the effect of acupuncture.

Results:

A total of 39 trials met the inclusion criteria: 25 use sham-acupuncture controls (n = 7097) and 25 non-acupuncture controls (n = 16,041). Of the 5 patient characteristics analyzed, only baseline pain severity was found to potentially moderate the treatment effect of acupuncture, with patients reporting more severe pain at baseline experiencing more benefit from acupuncture compared to either sham-control or non-acupuncture control. Baseline psychological distress showed small treatment moderating effects, and results for sex were inconsistent. There was no strong evidence that age or duration of pain influenced the response to acupuncture.

Discussion:

Of 5 patient characteristics tested, we found only baseline severity of pain to potentially moderate the effect of acupuncture treatment. For clinical practice, the evidence from this analysis does not justify stratifying chronic pain patients into subgroups that should or should not receive acupuncture on the basis of these 5 characteristics. Future acupuncture trials should assess other potentially important effect moderators.
Race, Research, and Women's Health
Authors: Ghidei Luwam , Murray Anne , Singer Janet
Published: March 2019

Medicine has a complex history of mishandling the concept of race. This is a crucial time for the field of obstetrics and gynecology to address racial and ethnic disparities. In this commentary, we address misconceptions about race, show how race can be misused in research and clinical care, and suggest new standards to guide authors as they conduct research on disparities and race.
Perioperative Antibiotic Use and Associated Infectious Outcomes at the Time of Myomectomy
Authors: Kim Annie J. , Clark Nisse V. , Jansen L. Joya , Ajao Mobolaji O. , Einarsson Jon I. , Gu Xiangmei , Cohen Sarah L.
Published: March 2019

OBJECTIVE:

To report the frequency of perioperative antibiotic use at time of myomectomy and associated risk of infectious outcomes.

METHODS:

We conducted a retrospective cohort study including all women who underwent any route of myomectomy from 2009 to 2016 at two academic hospitals in Boston, Massachusetts. Cases involving chromopertubation or conversion to hysterectomy were excluded from further analysis. Medical records were queried for the use or nonuse of perioperative antibiotics, as well as baseline patient factors and perioperative outcomes. Statistical analyses included univariate comparisons between treatment groups, as well as multivariable logistic regression analyses of infectious morbidity controlling for patient age, route of surgery, presence of high-risk factors, any intraoperative complication, myoma weight, and entrance into the endometrial cavity. Matched cohort analysis also was performed to confirm findings in the setting of underlying differences between groups.

RESULTS:

A total of 1,211 patients were included in the myomectomy cohort, 92.7% of whom received perioperative antibiotics at the time of surgery. Demographic characteristics were similar between the group that received and the group that did not receive antibiotics. The cases with antibiotic use were associated with longer operative times, higher estimated blood loss, and greater myoma burden. No difference was noted with regard to intraoperative or postoperative complications. Surgical site infection occurred more commonly in the group that did not receive antibiotics (2.9% vs 6.8% in the antibiotic and no-antibiotic groups, respectively; effect size 0.43, 95% CI 0.18–0.97 P=.04), representing a nearly fourfold increase in odds of any surgical site infection in the absence of perioperative antibiotic use (adjusted odds ratio 3.77, 95% CI 1.30–10.97, P=.015).

CONCLUSION:

A high frequency of antibiotic use was noted at time of myomectomy, despite lack of clear evidence supporting the practice. Patients who received perioperative antibiotics had fewer postoperative infectious outcomes and, in particular, experienced a lower incidence of surgical site infection.
Association of a Delayed Cord-Clamping Protocol With Hyperbilirubinemia in Term Neonates
Authors: Yang Sophia , Duffy Jennifer Y. , Johnston Robert , Fall Carolyn , Fitzmaurice Laura E.
Published: March 2019

OBJECTIVE:

To evaluate the implementation of a delayed cord-clamping protocol at an academic medical center, and its short-term associations on term neonates.

METHODS:

This was a retrospective cohort study of women aged 18 years or older delivering a term neonate at an academic medical center before and 5–7 months after implementation of a universal delayed cord-clamping protocol (October–December 2015 and October–December 2016, respectively). The primary outcome measure was the mean peak neonatal transcutaneous bilirubin level, with secondary outcome measures including mean initial transcutaneous bilirubin levels, mean serum bilirubin levels, number of serum bilirubin levels drawn, incidence of clinical jaundice, and phototherapy.

RESULTS:

Protocol adherence was 87.8%. Data are presented on 424 neonates. The mean peak neonatal transcutaneous bilirubin levels were significantly higher among neonates in the postprotocol group (10.0±3.4 mg/dL vs 8.4±2.7 mg/dL, P<.01). More neonates in the postprotocol group were diagnosed with jaundice (27.2% vs 16.6%; odds ratio [OR] 1.88; 95% CI 1.17–3.01) and required serum blood draws (43.7% vs 29.4%; OR 1.86; 95% CI 1.25–2.78). However, there were no differences in mean peak serum bilirubin levels between groups (9.7±3.0 mg/dL vs 9.1±3.1 mg/dL, P=.17) or need for phototherapy (5.2% vs 6.6%, OR 1.28; 95% CI 0.57–2.89).

CONCLUSION:

Implementation of a delayed cord-clamping protocol for term neonates was associated with significantly higher mean transcutaneous bilirubin levels, an increased number of serum blood draws, and more clinical diagnoses of jaundice, although there was no increase in the incidence of phototherapy.
The Validity of Patient-reported Outcome Measurement Information System (PROMIS) Parent Proxy Instruments to Assess Function in Children With Talipes Equinovarus
Authors: Masrouha Karim Z. , Moses Michael J. , Sala Debra A. , Litrenta Jody , Lehman Wallace B. , Chu Alice
Published: March 2019

Background:

Idiopathic talipes equinovarus (ITEV) is a prevalent structural deformity of the foot and ankle in children. The disease-specific instrument (DSI) has commonly been used as an outcomes metric in these patients. The Patient-Reported Outcomes Measurement Information System (PROMIS) was developed to examine the quality of life across various medical conditions. PROMIS has been validated for multiple conditions; however, no studies have evaluated the use of the PROMIS in children with ITEV.

Methods:

A prospective analysis was performed whereby the 2 questionnaires were mailed out to the parents of 91 patients, aged 5 to 17 years, with ITEV. Construct validity of the PROMIS Parent Proxy Profile short forms version was assessed by comparing its domains of Mobility, Fatigue, Pain Interference, and Pain Intensity to the DSI Function domain and PROMIS domains of Anxiety, Depressive Symptoms, Peer Relationships, and Pain Intensity to DSI Satisfaction domain.

Results:

Thirty-one complete responses (34% response rate) were returned. The patients’ current mean age was 8.8 years, 7 were female individuals, and 12 had unilateral ITEV. Bivariate correlation analysis, using Spearman correlation coefficients, demonstrated a moderate positive correlation between the DSI Function domain and the PROMIS Mobility domain (r
s=0.52) and a moderate negative correlation between the DSI Function domain and the PROMIS Pain Interference domain (r
s=−0.56), as well as the PROMIS Pain Intensity domain (r
s=−0.75). A fair negative correlation (r
s=−0.38) with PROMIS Fatigue domain was found. Correlations between the DSI Satisfaction domain and the PROMIS domains were fair or had little relationship.

Conclusions:

These results provide support for the validity of the PROMIS Mobility, Pain Interference, and Pain Intensity domains in this population, however there are no items in PROMIS that can assess overall satisfaction, as with the DSI.

Level of Evidence:

Level II—prospective comparative study.
Does Riluzole Influence Bone Formation?
Authors: Schroeder Gregory D. , Kepler Christopher K. , Grad Sibylle , Alini Mauro , Fang Taolin , Markova Dessislava Z. , Koerner John D. , Rajasekaran Shanmuganathan , Chapman Jens , Kandziora Frank , Schnake Klaus J. , Dvorak Marcel F. , Oner F. Cumhur , Vaccaro Alexander R.
Published: March 2019

Study Design.

A post-test design biological experiment.

Objective.

The aim of this study was to evaluate the osteogenic effects of riluzole on human mesenchymal stromal cells and osteoblasts.

Summary of Background Data.

Riluzole may benefit patients with spinal cord injury (SCI) from a neurologic perspective, but little is known about riluzole's effect on bone formation, fracture healing, or osteogenesis.

Methods.

Human mesenchymal stromal cells (hMSCs) and human osteoblasts (hOB) were obtained and isolated from healthy donors and cultured. The cells were treated with riluzole of different concentrations (50, 150, 450 ng/mL) for 1, 2, 3, and 4 weeks. Cytotoxicity was evaluated as was the induction of osteogenic differentiation of hMSCs. Differentiation was evaluated by measuring alkaline phosphatase (ALP) activity and with Alizarin red staining. Osteogenic gene expression of type I collagen (Col1), ALP, osteocalcin (Ocn), Runx2, Sox9, Runx2/Sox9 ratio were measured by qRT-PCR.

Results.

No cytotoxicity or increased proliferation was observed in bone marrow derived hMSCs and primary hOBs cultured with riluzole over 7 days. ALP activity was slightly increased in hMSCs after treatment for 2 weeks with riluzole 150 ng/mL and slightly upregulated by 150% (150 ng/mL) and 90% (450 ng/mL) in hMSCs at 3 weeks. In hOBs, ALP activity almost doubled after 2 weeks of culture with riluzole 150 ng/mL (P < 0.05). More pronounced 2.6-fold upregulation was noticed after 3 weeks of culture with riluzole at both 150 ng/mL (P = 0.05) and 450 ng/mL (P = 0.05). No significant influence of riluzole on the mRNA expression of osteocalcin (OCN) was observed.

Conclusion.

The effect of riluzole on bone formation is mixed; low-dose riluzole has no effect on the viability or function of either hMSCs or hOBs. The activity of ALP in both cell types is upregulated by high-dose riluzole, which may indicate that high-dose riluzole can increase osteogenic metabolism and subsequently accelerate bone healing process. However, at high concentrations, riluzole leads to a decrease in osteogenic gene expression, including Runx2 and type 1 collagen.

Level of Evidence: N/A
Doneness preferences, meat and meat-derived heterocyclic amines intake, and N-acetyltransferase 2 polymorphisms: association with colorectal adenoma in Japanese Brazilians
Authors: Budhathoki Sanjeev , Iwasaki Motoki , Yamaji Taiki , Hamada Gerson S. , Miyajima Nelson T. , Zampieri Jose C. , Sharma Sangita , Pakseresht Mohammadreza , Kolahdooz Fariba , Ishihara Junko , Takachi Ribeka , Charvat Hadrien , Marchand Loïic Le , Tsugane Shoichiro
Published: March 2019

Intake of heterocyclic amines (HCAs) and other mutagenic compounds formed during cooking has been hypothesized to be responsible for the positive association observed between red meat and colorectal cancer. We evaluated whether well-done/very well-done preferences for various meat and fish items, higher intakes of meat and fish, and meat-derived and fish-derived HCA are associated with the risk of colorectal adenoma (CRA) in a Japanese–Brazilian population. We selected 302 patients with adenoma and 403 control individuals who underwent total colonoscopy between 2007 and 2013, and collected information on aspects of meat intake using a detailed questionnaire. We also estimated HCA intake of the study participants using an HCA database that matched the cooking methods of this population. Latent class analysis on the basis of response to doneness preferences for different cooking methods of commonly consumed meat and fish items identified four distinct subgroups. Compared with the subgroup characterized by a preference for rare/medium well-done cooking for most meat and fish items, the odds ratio of CRA for the well-done/very well-done preference subgroup was 1.19 (95% confidence interval: 0.51–2.75). High intake of mixed-meat dishes was suggestively associated inversely with CRA, whereas a high intake of poultry was associated positively with CRA. No clear association with intake of total or specific HCAs and no effect modification by N-acetyltransferase 2 acetylation genotype were observed. We found no statistically significant associations between meat and HCA intake and CRA. These findings do not support a positive association between meat and meat-derived HCA intake and the risk of CRA.
Pathologic Response to Neoadjuvant Therapy is Associated With Improved Long-term Survival in High-risk Primary Localized Malignant Peripheral Nerve Sheath Tumors
Authors: Shurell-Linehan Elizabeth , DiPardo Benjamin J. , Elliott Irmina A. , Graham Danielle S. , Eckardt Mark A. , Dry Sarah M. , Nelson Scott D. , Singh Arun S. , Kalbasi Anusha , Federman Noah , Bernthal Nicholas M. , Eilber Fritz C.
Published: March 2019

Background:

Malignant peripheral nerve sheath tumors (MPNSTs) comprise a rare, aggressive subtype of soft tissue sarcoma. While surgery is the mainstay of therapy for this disease, the role of neoadjuvant therapy remains undefined.

Methods:

This study reviewed patients 16 years of age and older who underwent surgical treatment for MPNST between 1974 and 2012 at the authors’ institution. Univariate and multivariate analyses were performed of clinicopathologic and treatment variables predictive of disease-specific survival (DSS) and disease-free survival.

Results:

Eighty-eight patients with primary localized MPNST underwent surgical treatment between 1974 and 2012 at our institution. Of these, 38 (43%) underwent neoadjuvant chemotherapy and had tissue available for analysis. Neoadjuvant radiation was given to 25 patients (68%). The median follow-up time for survivors was 12.5 years (range, 4 to 27 y). Nine patients (23%) had underlying MPNST. With a cutoff of ≥90% pathologic necrosis and/or fibrosis defining response, we identified 14 responders (36%). On univariate analysis, patient age, tumor size, and pathologic response were significantly associated with DSS (P=0.015, 0.011, and 0.030, respectively).

Conclusions:

Although the impact of neoadjuvant chemotherapy on the outcome of primary localized MPNST patients continues to be debated, this study shows that a pathologic response to therapy is associated with a significant improvement in DSS. The challenge moving forward is to determine upfront which patients will be “responders” to standard systemic therapy and which patients should be considered for newer investigational agents as part of a clinical trial.