bluuebunny/crossref_metadata_2025 huggingface dataset:
Aesthetic management of a fractured mandibular central incisor with two canals using fibre post
Authors: Abhisek Guria , Bharath Makonahalli Jaganath , Sahadev Chickmagaravalli Krishnegowda , Patil Sanjayagouda B
Published: March 2020

Mandibular incisors show variations in their root canal anatomy from regular pattern in some cases. Magnification plays a vital role to identify those unusual canal morphologies. A certain modification in access cavity preparation is required to locate those extra canals. Not only the functional restoration but also aesthetic harmony should be restored while treating anterior teeth. In these cases, post space preparation should be done with extra care to prevent vertical root fracture. This case report illustrates the importance of proper radiograph and magnification in the successful identification and management of complex canal systems in mandibular incisors.
Managing choledocholithiasis in pregnancy: a novel approach
Authors: Chamberlain Stacey Louise , Croagh Daniel
Published: March 2020

The management of choledocholithiasis in pregnancy can present a challenge due to radiation risk to the fetus and the possibility of severe maternal pancreatitis. We describe a case in which both these risks were avoided using a trans-cystic stent placed under endoscopic guidance during laparoscopic cholecystectomy.
Adrenoleukodystrophy presenting as glue sniffing
Authors: Meher Rajesh Kumar , Aghoram Rajeswari , Nair Pradeep Pankajakshan
Published: March 2020

Adrenoleukodystrophy classically presents in childhood with bronze skin, spastic tetraparesis, dysphagia, behavioural abnormalities and adrenal insufficiency. However, atypical presentations are known. Here we report an adolescent with adrenoleukodystrophy who first sought medical attention for glue sniffing.
Bilateral superior semicircular canal dehiscence: bilateral conductive hearing loss with subtle vestibular symptoms
Authors: Pereira Diogo , Leonardo Abílio , Duarte Delfim , Oliveira Nuno
Published: March 2020

Superior semicircular canal dehiscence is caused by a bone defect on the roof of the superior semicircular canal. The estimated prevalence when unilateral varies between 0.4% and 0.7% and is still unknown when bilateral. Patients may present with audiologic and vestibular symptoms that may vary from asymptomatic to disabling. We report a case of a 72-year-old Caucasian woman presented to otolaryngology department reporting imbalance, bilateral pulsatile tinnitus, hypoacusis while being very sensitive to certain sounds. Physical examination was unremarkable, except for the Rinne test that was negative in both sides. The patient underwent an audiometry revealing a mild bilateral conductive hearing loss. A temporal bone CT scan was performed which evidenced bilateral superior semicircular canal dehiscence. Cervical vestibular evoked myogenic potentials and electrocochleography confirmed diagnosis. Although rare, superior semicircular canal dehiscence shall be considered in conductive hearing loss with vestibular symptoms.
Hepatic encephalopathy: a rare cause of focal seizures in chronic liver disease
Authors: Tern Paul Jie Wen , Bryce Kathleen , Marelli Laura , Ruban Aruchuna
Published: March 2020

Hepatic encephalopathy (HE) is an extremely rare cause of focal seizures and is usually a diagnosis of exclusion when more commoner causes such as infection, autoimmune and malignancy have been discounted. The literature reports patients with generalised cerebral oedema and rarely status epilepticus, but these are often in the context of acute liver failure as opposed to chronic liver disease. Here we discuss a case of HE leading to focal neurological deficits and seizures in a 48-year-old woman with a background of chronic alcoholic liver disease. MRI scan showed extensive left-sided tempo-parietal-occipital cortical oedema and electroencephalogram showed widespread moderate HE with runs of epileptiform discharges. The treatment involves antiepileptic therapy as well as standard management of HE with laxatives, rifaximin and optimisation of nutrition.
Decreased risk of colorectal cancer among patients with type 2 diabetes receiving Chinese herbal medicine: a population-based cohort study
Authors: Jhang Jing-Siang , Livneh Hanoch , Yang Shu-Yi , Huang Hui-Ju , Chan Michael W Y , Lu Ming-Chi , Yeh Chia-Chou , Tsai Tzung-Yi
Published: March 2020

Objectives

Patients with type 2 diabetes have a higher risk of colorectal cancer (CRC), but whether Chinese herbal medicines (CHMs) can reduce this risk is unknown. This study investigated the effect that CHMs have on CRC risk in patients with type 2 diabetes.

Research design and methods

This cohort study used the Taiwanese National Health Insurance Research Database to identify 54 744 patients, newly diagnosed with type 2 diabetes, aged 20–70 years, who were receiving treatment between 1998 and 2007. From this sample, we randomly selected 14 940 CHMs users and 14 940 non-CHMs users, using propensity scores matching. All were followed through 2012 to record CRC incidence. Cox proportional hazards regression was used to compute the hazard ratio (HR) of CRC by CHMs use.

Results

During follow-up, 235 CHMs users and 375 non-CHMs users developed CRC, incidence rates of 1.73% and 2.47% per 1000 person-years, respectively. CHM users had a significantly reduced risk of CRC compared with non-CHM users (adjusted HR=0.71; 95% CI 0.60 to 0.84). The greatest effect was in those receiving CHMs for more than 1 year. Huang-Qin, Xue-Fu-Zhu-Yu-Tang, Shu-Jing-Huo-Xue-Tang, Liu-Wei-Di-Huang-Wan, Ji-Sheng-Shen-Qi-Wan, Gan-Lu-Yin, Shao-Yao-Gan-Cao-Tang and Ban-Xia-Xie-Xin-Tang were significantly associated with lower risk of CRC.

Conclusion

Integrating CHMs into the clinical management of patients with type 2 diabetes may be beneficial in reducing the risk of CRC.
Assessing the effect of closed-loop insulin delivery from onset of type 1 diabetes in youth on residual beta-cell function compared to standard insulin therapy (CLOuD study): a randomised parallel study protocol
Authors: Boughton Charlotte , Allen Janet M , Tauschmann Martin , Hartnell Sara , Wilinska Malgorzata E , Musolino Gianluca , Acerini Carlo L , Dunger Professor David , Campbell Fiona , Ghatak Atrayee , Randell Tabitha , Besser Rachel , Trevelyan Nicola , Elleri Daniela , Northam Elizabeth , Hood Korey , Scott Eleanor , Lawton Julia , Roze Stephane , Sibayan Judy , Kollman Craig , Cohen Nate , Todd John , Hovorka Roman
Published: March 2020

Introduction

Management of newly diagnosed type 1 diabetes (T1D) in children and adolescents is challenging for patients, families and healthcare professionals. The objective of this study is to determine whether continued intensive metabolic control using hybrid closed-loop (CL) insulin delivery following diagnosis of T1D can preserve C-peptide secretion, a marker of residual beta-cell function, compared with standard multiple daily injections (MDI) therapy.

Methods and analysis

The study adopts an open-label, multicentre, randomised, parallel design, and aims to randomise 96 participants aged 10–16.9 years, recruited within 21 days of diagnosis with T1D. Following a baseline mixed meal tolerance test (MMTT), participants will be randomised to receive 24 months treatment with conventional MDI therapy or with CL insulin delivery. A further 24-month optional extension phase will be offered to all participants to continue with the allocated treatment. The primary outcome is the between group difference in area under the stimulated C-peptide curve (AUC) of the MMTT at 12 months post diagnosis. Analyses will be conducted on an intention-to-treat basis. Key secondary outcomes are between group differences in time spent in target glucose range (3.9–10 mmol/L), glycated haemoglobin (HbA1c) and time spent in hypoglycaemia (<3.9 mmol/L) at 12 months. Secondary efficacy outcomes include between group differences in stimulated C-peptide AUC at 24 months, time spent in target glucose range, glucose variability, hypoglycaemia and hyperglycaemia as recorded by periodically applied masked continuous glucose monitoring devices, total, basal and bolus insulin dose, and change in body weight. Cognitive, emotional and behavioural characteristics of participants and parents will be evaluated, and a cost–utility analysis performed to support adoption of CL as a standard treatment modality following diagnosis of T1D.

Ethics and dissemination

Ethics approval has been obtained from Cambridge East Research Ethics Committee. The results will be disseminated by peer-reviewed publications and conference presentations.

Trial registration number

NCT02871089; Pre-results.
‘Scared to death’ dyspnoea from the hospitalised patient’s perspective
Authors: Banzett Robert B B , Sheridan Andrew R , Baker Kathy M , Lansing Robert W , Stevens Jennifer P
Published: March 2020

Because dyspnoea is seldom experienced by healthy people, it can be hard for clinicians and researchers to comprehend the patient’s experience. We collected patients’ descriptions of dyspnoea in their own words during a parent study in which 156 hospitalised patients completed a quantitative multidimensional dyspnoea questionnaire. These volunteered comments describe the severity and wide range of experiences associated with dyspnoea and its impacts on a patients’ life. They provide insights not conveyed by structured rating scales. We organised these comments into the most prominent themes, which included sensory experiences, emotional responses, self-blame and precipitating events. Patients often mentioned air hunger (‘Not being able to get air is the worst thing that could ever happen to you.’), anxiety, and fear (‘Scared. I thought the world was going to end, like in a box.’). Their value in patient care is suggested by one subject’s comment: ‘They should have doctors experience these symptoms, especially dyspnoea, so they understand what patients are going through.’ Patients’ own words can help to bridge this gap of understanding.
The effects of sildenafil on ciliary beat frequency in patients with pulmonary non-tuberculous mycobacteria disease: phase I/II trial
Authors: Fowler Cedar , Wu Un-In , Shaffer Robyn , Smith Caroline , Barnhart Lisa , Bryant Clare , Olivier Kenneth , Holland Steven M
Published: March 2020

Rationale

Pulmonary non-tuberculous mycobacterial (PNTM) disease has increased over the past several decades, especially in older women. Abnormal mucociliary clearance and abnormal nasal nitric oxide (nNO) have been associated with PNTM disease in other patient cohorts. Mucociliary clearance can be affected by NO-cyclic guanosine monophosphate signalling and, therefore, modulation of the pathway may be possible with phosphodiesterase inhibitors such as sildenafil as a novel therapeutic approach.

Objective

To define ex vivo characteristics of PNTM disease affected by sildenafil.

Methods

Subjects with PNTM infections were recruited into an open-label dose-escalation trial of sildenafil. Laboratory measurements and mucociliary measurements—ciliary beat frequency, nNO and 24-hour sputum production—were collected throughout the study period. Patients received sildenafil daily during the study period, with escalation from 20 to 40 mg three times per day.

Measurements and main results

Increased ciliary beat frequency occurred after a single dose of 40 mg sildenafil and after extended dosing of 40 mg sildenafil. The increase ciliary beat frequency was not seen with 20 mg sildenafil dosing. There were no changes in sputum production, nNO production, Quality of Life-Bronchiectasis-NTM module (QOL-B-NTM) questionnaire or the St George’s Respiratory Questionnaire during the study period.

Conclusion

Sildenafil, 40 mg, increased ciliary beat frequency acutely as well as with extended administration.
Cardiovascular risk factors and the risk of major adverse limb events in patients with symptomatic cardiovascular disease
Authors: Hageman Steven H J , de Borst Gert Jan , Dorresteijn Johannes A N , Bots Michiel L , Westerink Jan , Asselbergs Folkert W , Visseren Frank L J
Published: March 2020

Aim

To determine the relationship between non-high-density lipoprotein cholesterol (non-HDL-c), systolic blood pressure (SBP) and smoking and the risk of major adverse limb events (MALE) and the combination with major adverse cardiovascular events (MALE/MACE) in patients with symptomatic vascular disease.

Methods

Patients with symptomatic vascular disease from the Utrecht Cardiovascular Cohort - Secondary Manifestations of ARTerial disease (1996–2017) study were included. The effects of non-HDL-c, SBP and smoking on the risk of MALE were analysed with Cox proportional hazard models stratified for presence of peripheral artery disease (PAD). MALE was defined as major amputation, peripheral revascularisation or thrombolysis in the lower limb.

Results

In 8139 patients (median follow-up 7.8 years, IQR 4.0–11.8), 577 MALE (8.7 per 1000 person-years) and 1933 MALE/MACE were observed (29.1 per 1000 person-years). In patients with PAD there was no relation between non-HDL-c and MALE, and in patients with coronary artery disease (CAD), cerebrovascular disease (CVD) or abdominal aortic aneurysm (AAA) the risk of MALE was higher per 1 mmol/L non-HDL-c (HR 1.14, 95% CI 1.01 to 1.29). Per 10 mm Hg SBP, the risk of MALE was higher in patients with PAD (HR 1.06, 95% CI 1.01 to 1.12) and in patients with CVD/CAD/AAA (HR 1.15, 95% CI 1.08 to 1.22). The risk of MALE was higher in smokers with PAD (HR 1.45, 95% CI 0.97 to 2.14) and CAD/CVD/AAA (HR 7.08, 95% CI 3.99 to 12.57).

Conclusions

The risk of MALE and MALE/MACE in patients with symptomatic vascular disease differs according to vascular disease location and is associated with non-HDL-c, SBP and smoking. These findings confirm the importance of MALE as an outcome and underline the importance of risk factor management in patients with vascular disease.
Potent STING activation stimulates immunogenic cell death to enhance antitumor immunity in neuroblastoma
Authors: Wang-Bishop Lihong , Wehbe Mohamed , Shae Daniel , James Jamaal , Hacker Benjamin C. , Garland Kyle , Chistov Plamen P. , Rafat Marjan , Balko Justin M. , Wilson John T.
Published: March 2020

Background

Neuroblastoma (NB) is a childhood cancer for which new treatment options are needed. The success of immune checkpoint blockade in the treatment of adult solid tumors has prompted the exploration of immunotherapy in NB; however, clinical evidence indicates that the vast majority of NB patients do not respond to single-agent checkpoint inhibitors. This motivates a need for therapeutic strategies to increase NB tumor immunogenicity. The goal of this study was to evaluate a new immunotherapeutic strategy for NB based on potent activation of the stimulator of interferon genes (STING) pathway.

Methods

To promote STING activation in NB cells and tumors, we utilized STING-activating nanoparticles (STING-NPs) that are designed to mediate efficient cytosolic delivery of the endogenous STING ligand, 2’3’-cGAMP. We investigated tumor-intrinsic responses to STING activation in both MYCN-amplified and non-amplified NB cell lines, evaluating effects on STING signaling, apoptosis, and the induction of immunogenic cell death. The effects of intratumoral administration of STING-NPs on CD8+T cell infiltration, tumor growth, and response to response to PD-L1 checkpoint blockade were evaluated in syngeneic models of MYCN-amplified and non-amplified NB.

Results

The efficient cytosolic delivery of 2’3’-cGAMP enabled by STING-NPs triggered tumor-intrinsic STING signaling effects in both MYCN-amplified and non-amplified NB cell lines, resulting in increased expression of interferon-stimulated genes and pro-inflammatory cytokines as well as NB cell death at concentrations 2000-fold to 10000-fold lower than free 2’3’-cGAMP. STING-mediated cell death in NB was associated with release or expression of several danger associated molecular patterns that are hallmarks of immunogenic cell death, which was further validated via cell-based vaccination and tumor challenge studies. Intratumoral administration of STING-NPs enhanced STING activation relative to free 2’3’-cGAMP in NB tumor models, converting poorly immunogenic tumors into tumoricidal and T cell-inflamed microenvironments and resulting in inhibition of tumor growth, increased survival, and induction of immunological memory that protected against tumor re-challenge. In a model of MYCN-amplified NB, STING-NPs generated an abscopal response that inhibited distal tumor growth and improved response to PD-L1 immune checkpoint blockade.

Conclusions

We have demonstrated that activation of the STING pathway, here enabled by a nanomedicine approach, stimulates immunogenic cell death and remodels the tumor immune microenvironment to inhibit NB tumor growth and improve responses to immune checkpoint blockade, providing a multifaceted immunotherapeutic approach with potential to enhance immunotherapy outcomes in NB.
Pre-existing antitherapeutic antibodies against the Fc region of the hu14.18K322A mAb are associated with outcome in patients with relapsed neuroblastoma
Authors: Goldberg Jacob L , Navid Fariba , Hank Jacquelyn A , Erbe Amy K , Santana Victor , Gan Jacek , de Bie Fenna , Javaid Amal M , Hoefges Anna , Merdler Michael , Carmichael Lakeesha , Kim KyungMann , Bishop Michael W , Meager Michael M , Gillies Stephen D , Pandey Janardan P , Sondel Paul M
Published: March 2020

Purpose

Patients with cancer receiving tumor-reactive humanized monoclonal antibody (mAb) therapy can develop a human antihuman antibody (HAHA) response against the therapeutic mAb. We evaluated for HAHA in patients with neuroblastoma treated in a phase I study of humanized anti-GD2 mAb (immunoglobulin (Ig)G1 isotype), hu14.18K322A (NCT00743496). The pretreatment sera (collected prior to mAb treatment) from 9 of 38 patients contained antitherapeutic antibodies, even though they had no prior mAb exposure. We sought to characterize these pre-existing antitherapeutic antibodies (PATA).

Experimental design

The PATA+ pretreatment samples were characterized via ELISA; clinical associations with PATA status were evaluated.

Results

Pretreatment sera from eight of nine PATA+ patients also bound rituximab and demonstrated preferential ELISA reactivity against the Fc portions of hu14.18K322A and rituximab as compared with the Fab portions of these mAbs. These PATA+ sera also recognized dinutuximab (human IgG1 isotype) and mouse IgG2a isotype mAbs, but not a mouse IgG1 isotype or the fully human panitumumab (IgG2 isotype) mAb. Of the 38 treated patients, only 4 patients (all in the PATA+ cohort) demonstrated no disease progression for>2.5 years without receiving further therapy (p=0.002).

Conclusions

This study demonstrates an association between clinical outcome and the presence of PATA against determinant(s) on the Fc component of the therapeutic mAb, suggesting that the PATA may be playing a role in augmenting mAb-based antitumor effects. Further analyses for the presence of PATA in a larger cohort of patients with relapsed neuroblastoma, analyses of their clinical correlates, identification of their immunological targets, and potential antitumor mechanisms are warranted.
Molecular and immunological features of a prolonged exceptional responder with malignant pleural mesothelioma treated initially and rechallenged with pembrolizumab
Authors: Minchom Anna , Yuan Wei , Crespo Mateus , Gurel Bora , Figueiredo Ines , Wotherspoon Andrew , Miranda Susana , Riisnaes Ruth , Ferreira Ana , Bertan Claudia , Pereira Rita , Clarke Matt , Baker Chloe , Ang Joo Ern , Fotiadis Nicos , Tunariu Nina , Carreira Suzanne , Popat Sanjay , O'Brien Mary , Banerji Udai , de Bono Johann , Lopez Juanita
Published: March 2020

Background

This case represents an exceptional response to pembrolizumab in a patient with epithelioid mesothelioma with a further response on rechallenge.

Case presentation

A 77-year-old woman with advanced epithelioid mesothelioma extensively pretreated with chemotherapy demonstrated a prolonged response of 45 months to 52 cycles of pembrolizumab. On rechallenge with pembrolizumab, further disease stability was achieved. Serial biopsies and analysis by immunohistochemistry and immunofluorescence demonstrated marked immune infiltration and documented the emergency of markers of immune exhaustion. Whole exome sequencing demonstrated a reduction in tumor mutational burden consistent with subclone elimination by immune checkpoint inhibitor (CPI) therapy. The relapse biopsy had missense mutation in BTN2A1.

Conclusion

This case supports rechallenge of programme death receptor 1 inhibitor in cases of previous CPI sensitivity and gives molecular insights.
Trends in hospital procedure volumes for intra-arterial treatment of acute ischemic stroke: results from the paul coverdell national acute stroke program
Authors: Asaithambi Ganesh , Tong Xin , Lakshminarayan Kamakshi , Coleman King Sallyann M , George Mary G
Published: March 2020

Background

Rates of intra-arterial revascularization treatments (IAT) for acute ischemic stroke (AIS) are increasing in the USA. Using a multi-state stroke registry, we studied the trend in IAT use among patients with AIS over a period spanning 11 years. We examined the impact of IAT rates on hospital procedure volumes and patient outcome after stroke.

Methods

We used data from the Paul Coverdell National Acute Stroke Program (PCNASP) and explored trends in IAT between 2008 and 2018. Patient outcomes were examined by rates of IAT procedures across hospitals. Specifically, outcomes were compared across low-volume (<15 IAT per year), medium-volume (15–30 IAT per year), and high-volume hospitals (>30 IAT per year). Favorable outcome was defined as discharge to home.

Results

There were 612 958 patients admitted with AIS to 687 participating hospitals within the PCNASP during this study. Only 2.9% of patients (mean age 68.5 years, 49.3% women) received IAT. The percent of patients with AIS receiving IAT increased from 1% in 2008 to 5.3% in 2018 (p<0.001). The proportion of low-volume hospitals decreased over time (p<0.001), and the proportions of medium-volume (p=0.007) and high-volume hospitals (p<0.001) increased between 2008 and 2018. When compared with medium-volume hospitals, high-volume hospitals had a higher (p<0.0001) and low-volume hospitals had a lower (p<0.0001) percent of patients discharged to home.

Conclusion

High-volume hospitals were associated with a higher rate of favorable outcome. With the increased use of IAT among patients with AIS, the proportion of low-volume hospitals performing IAT significantly decreased.
Development and validation of a contextualised measure of resilience in veterinary practice: the Veterinary Resilience Scale–Personal Resources (VRS–PR)
Authors: Matthew Susan M , Carbonneau Kira J , Mansfield Caroline F , Zaki Sanaa , Cake Martin A , McArthur Michelle L
Published: March 2020

Background

This article reports on the development and validation of a contextualised measure of personal resources for resilience in veterinary practice.

Methods

Exploratory factor analysis and structural equation modelling were used to evaluate data from two surveys of veterinary practitioners.

Results

Exploratory factor analysis of the first survey (n=300) revealed six items comprising the Veterinary Resilience Scale–Personal Resources (VRS–PR). These items focused on flexibility, adaptability, optimism, building strengths, enjoying challenges, and maintaining motivation and enthusiasm at work. Structural equation modelling using the second survey (n=744) confirmed the factor structure of the VRS–PR and established convergent validity with an established measure of general resilience, the Brief Resilience Scale. Examination of the mean and standard deviation of the combined survey data enabled scores on the VRS–PR to be provisionally classified into ‘low’, ‘moderate’ and ‘high’ (reported by approximately 13%, 72% and 15% of respondents, respectively). Respondents also reported results spanning ‘low’, ‘moderate’ and ‘high’ classifications for the Brief Resilience Scale (approximately 34%, 57% and 9%, respectively).

Conclusion

The VRS–PR may be used to evaluate the extent to which respondents draw upon the personal resources captured in the scale and identify areas for improvement.
Apolipoprotein E2 modulates cell cycle function to promote proliferation in pancreatic cancer cells via regulation of the c-Myc–p21Waf1signalling pathway
Authors: Du Shaoxia , Wang Hui , Cai Jun , Ren Runling , Zhang Wenwen , Wei Wei , Shen Xiaohong
Published: March 2020

Apolipoprotein E2 (ApoE2) is reportedly critical for cell proliferation and survival, and has been identified as a potential tumour-associated marker in many kinds of cancer. However, studies of the function and mechanisms of ApoE2 in pancreatic cancer proliferation and development are rare. In this study, we performed an analysis to determine the modulatory effects of ApoE2–LRP8 (lipoprotein receptor-related protein 8) pathway on cell cycle and cell proliferation, and explored its mechanisms in pancreatic cancer. High expression levels of ApoE2–LRP8/c-Myc were detected in tumour tissues and cell lines by immunohistochemistry and Western blotting. It was also shown that ApoE2–LRP8 induced phosphorylation of ERK1/2 to activate c-Myc and contribute to cell-cycle-related protein expression. ApoE2 conditions induced c-Myc binding to target gene sequences in the p21Waf1promoter, resulting in decreased transcription. ERK/c-Myc contributes to the promotion of the expression levels of cyclin D1, cdc2, and cyclin B1, and reduces p21Waf1activity, thereby promoting cell cycle distribution. We demonstrated the function of ApoE2–LRP8 in the activation of the ERK–c-Myc–p21Waf1signalling cascade and the modulation of G1/S and G2/M transition, indicating ApoE2–LRP8’s important role in the cancer cell proliferation. ApoE2 could serve as a diagnostic marker and chemotherapeutic target in pancreatic cancer.
Effects of overstory competition on canopy recruitment patterns of naturally regenerated longleaf pine on two site types
Authors: Curtin Patrick J. , Knapp Benjamin O. , Jack Steven B. , Vickers Lance A. , Larsen David R. , Guldin James M.
Published: March 2020

Recent interest in continuous cover forest management of longleaf pine (Pinus palustris Mill.) ecosystems raises questions of long-term sustainability because of uncertainty in rates of canopy recruitment of longleaf pine trees. We destructively sampled 130 naturally regenerated, midstory longleaf pines across an 11 300 ha, second-growth longleaf pine landscape in southwestern Georgia, United States, to reconstruct individual tree height growth patterns. We tested effects of stand density (using a competition index) and site quality (based on two site classifications: mesic and xeric) on height growth and demographics of midstory trees. We also compared height growth of paired midstory and overstory trees to infer stand regeneration and recruitment dynamics. In low-density stands, midstory trees were younger and grew at greater rates than trees within high-density stands. Midstory trees in low-density stands were mostly from a younger regeneration cohort than their paired overstory trees, whereas midstory–overstory pairs in high-density stands were mostly of the same cohort. Our results highlight the importance of releasing midstory longleaf pine trees from local competition for sustained height growth in partial-harvesting management systems. They also demonstrate patterns of long-term persistence in high-density stands, indicating flexibility in the canopy recruitment process of this shade-intolerant tree species.
A note on Hayman’s conjecture
Authors: An Ta Thi Hoai , Phuong Nguyen Viet
Published: March 2020

In this paper, we will give suitable conditions on differential polynomials [Formula: see text] such that they take every finite nonzero value infinitely often, where [Formula: see text] is a meromorphic function in complex plane. These results are related to Problems 1.19 and 1.20 in a book of Hayman and Lingham [Research Problems in Function Theory, preprint (2018), https://arxiv.org/pdf/1809.07200.pdf ]. As consequences, we give a new proof of the Hayman conjecture. Moreover, our results allow differential polynomials [Formula: see text] to have some terms of any degree of [Formula: see text] and also the hypothesis [Formula: see text] in [Theorem 2 of W. Bergweiler and A. Eremenko, On the singularities of the inverse to a meromorphic function of finite order, Rev. Mat. Iberoamericana 11(2) (1995) 355–373] is replaced by [Formula: see text] in our result.
Research on the Economical Influence of the Difference of Regional Logistics Developing Level in China
Authors: Zhang Caiming
Published: March 2020

Based on the model of Cobb–Douglas (CD) production function, this paper establishes a panel data regression model, and divides all provinces of China except Hong Kong Special Administrative Region, Macao Special Administrative Region and Taiwan Province into four groups according to their levels of logistics development. With the panel data of these four groups for 20 years (1997–2016), the paper analyzes the relationship between the logistics development and the economic growth in various regions in China. In this model, this paper selects the logistics capacity, the logistics investment and the logistics manpower as the three input indicators which represent the logistics development of different regions, and selects the regional GDP as the output indicator which represents economic growth. After empirical analysis, this paper finds that there is a positive correlation between logistics and economic growth, and the impact of each indicator on the regional economic growth is different. There are three conclusions in this paper. Firstly, logistics capacity has the greatest economical promotion effect on areas with advanced logistics. The second is that logistics investment has the greatest economical promotion effect on the developed and general areas of logistics development. And the third is that the economical promotion of the logistics investment and the logistics capacity is more obvious in the underdeveloped areas of logistics.
Robust Drift Characterization from Event Streams of Business Processes
Authors: Ostovar Alireza , Leemans Sander J. J. , Rosa Marcello La
Published: March 2020

Process workers may vary the normal execution of a business process to adjust to changes in their operational environment, e.g., changes in workload, season, or regulations. Changes may be simple, such as skipping an individual activity, or complex, such as replacing an entire procedure with another. Over time, these changes may negatively affect process performance; hence, it is important to identify and understand them early on. As such, a number of techniques have been developed to detect
process drifts
, i.e., statistically significant changes in process behavior, from process event logs (offline) or event streams (online). However, detecting a drift without characterizing it, i.e., without providing explanations on its nature, is not enough to help analysts understand and rectify root causes for process performance issues. Existing approaches for drift characterization are limited to simple changes that affect individual activities. This article contributes an efficient, accurate, and noise-tolerant automated method for characterizing complex drifts affecting entire process fragments. The method, which works both offline and online, relies on two cornerstone techniques, one to automatically discover process trees from event streams (logs) and the other to transform process trees using a minimum number of change operations. The operations identified are then translated into natural language statements to explain the change behind a drift. The method has been extensively evaluated on artificial and real-life datasets, and against a state-of-the-art baseline method. The results from one of the real-life datasets have also been validated with a process stakeholder.
An Experimental Study of Algorithms for Online Bipartite Matching
Authors: Borodin Allan , Karavasilis Christodoulos , Pankratov Denis
Published: March 2020

We perform an experimental study of algorithms for online bipartite matching under the known i.i.d input model with integral types. In the last decade, there has been substantial effort in designing complex algorithms to improve worst-case approximation ratios. Our goal is to determine how these algorithms perform on more practical instances rather than worst-case instances. In particular, we are interested in whether the ranking of the algorithms by their worst-case performance is consistent with the ranking of the algorithms by their average-case/practical performance. We are also interested in whether preprocessing times and implementation difficulties that are introduced by these algorithms are justified in practice. To that end, we evaluate these algorithms on different random inputs as well as real-life instances obtained from publicly available repositories. We compare these algorithms against several simple greedy-style algorithms. Most of the complex algorithms in the literature are presented as being non-greedy (i.e., an algorithm can intentionally skip matching a node that has available neighbors) to simplify the analysis. Every such algorithm can be turned into a greedy one without hurting its worst-case performance. On our benchmarks, non-greedy versions of these algorithms perform much worse than their greedy versions. Greedy versions perform about as well as the simplest greedy algorithm by itself. This, together with our other findings, suggests that simplest greedy algorithms are competitive with the state-of-the-art worst-case algorithms for online bipartite matching on many average-case and practical input families. Greediness is by far the most important property of online algorithms for bipartite matching.
Probing Electrochemical Behaviour of Lignocellulosic, Orange Peel Derived Hard Carbon as Anode for Sodium Ion Battery
Authors: Saha Arka , Sharabani Tali , Evenstein Eliran , Nessim Gilbert Daniel , Noked Malachi , Sharma Rosy
Published: March 2020

Hard carbon (HC) has emerged as potential anode material for sodium-ion batteries (SIB). However, it is plagued with several issues like low capacity, poor cyclability, significant electrolyte degradation on interface. Realization of HC as anode requires fundamental understanding of the effect of its porous structure/composition on electrochemical performance. Herein, we report the use of lignocellulosic orange peel precursor for HC synthesis with tuneable surface area (SA), controlled porosity using phosphoric acid treatment. Physicochemical properties of HC were further tailored using N-doping. The electrochemical response of various HCs was tested with careful attention to the effect of HC SA and nitrogen content on the performances as anode. We show that optimized bio-waste based HC exhibits Na+specific capacity of 125 mAhg−1at 70 mAg−1with significantly suppressed CO2evolution during cycling, indicating mitigated electrolyte degradation and superior performance. We believe that this study sheds light on design rules for bio-waste low-cost precursors for synthesizing HC with tailored physical and electrochemical properties. Using such design guidelines, is crucial for developing HC based anode materials for SIB’s.
Cost‐Effectiveness of Real‐World Administration of Concomitant Viscum album L. Therapy for the Treatment of Stage IV Pancreatic Cancer
Authors: Thronicke Anja , Reinhold Thomas , von Trott Philipp , Matthes Harald , Schad Friedemann
Published: March 2020

Background. For patients receiving add‐on Viscum album L. (VA) treatments for late‐stage pancreatic cancer, an improved overall survival (OS) was observed. Only limited information regarding cost‐effectiveness (CE) for comparisons between standard of care and standard of care plus add‐on VA in stage IV pancreatic cancer treatment is available. The present study assessed the costs and cost‐effectiveness of standard of care plus VA (V) compared to standard of care alone (C) for a hospital in Germany. Methods. An observational study was conducted using data from the Network Oncology clinical registry. Patients included had stage IV pancreatic cancer at diagnosis and received C or V treatment in a certified German Cancer Center. Cost and cost‐effectiveness analyses (CEA) including the analysis of the incremental cost‐effectiveness ratios (ICER) were performed from the hospital’s perspective based on routine data from the financial controlling department and observed data on OS. The primary result of the analysis was tested for robustness in a bootstrap‐based sensitivity analysis. Results. 88 patients (C: n = 34; V: n = 54) were included, with a mean age 65.6 years and proportion of male patients 48.9%. Adjusted hospital’s total mean costs for patients from the C and V groups were €10068.97 (over an adjusted mean OS time of 7.1 months) and €12267.94 (over an adjusted mean OS time of 10.6 months), respectively. As to CEA analysis, a relevant total hospital’s savings of €260.81/month mean OS for V patients compared to C was calculated. The costs per additional OS month gained (ICER) with the V treatment compared to C were €628.28. Furthermore, a relevant hospital savings of €915.77 per mean hospital stay and additional costs of €75.09 per mean hospitalization day in the V group were observed compared to C. Conclusion. Based on this CEA analysis, from the hospital’s point of view, the costs per mean month of OS and per mean hospital stay were lower for patients under combinational standard of care plus VA compared to patients receiving standard of care alone for the treatment of stage IV pancreatic cancer. Further prospective cost‐effectiveness studies are mandatory to reevaluate our findings.
Abundance of Multidrug Resistance Efflux Pumps in the Urinary Metagenome of Kidney Transplant Patients
Authors: Rani Asha , Ranjan Ravi , Metwally Ahmed A. , Brennan Daniel C. , Finn Patricia W. , Perkins David L.
Published: March 2020

Antibiotic resistance including the emergence of multidrug resistant microbes has become a public health crisis. In this study, we analyzed the antibiotic resistance genes (ARGs) in the urinary metagenome of the kidney transplant and healthy subjects using metagenomic shotgun sequencing. Our data suggest an increased abundance of antibiotic resistance genes in the kidney transplant subjects. In addition, the antibiotic resistance genes identified in the transplant subjects were predominantly composed of multidrug efflux pumps (MDEPs) which are evolutionarily ancient, commonly encoded on chromosomes rather than plasmids, and have a low rate of mutation. Since the MDEPs had a low abundance in the healthy subjects, we speculate that the MDEPs may enhance the fitness of bacteria to survive in the high stress environment of transplantation that includes multiple stressors including surgery, antibiotics, and immunosuppressive agents.
Impact of Abdominal Obesity on Thyroid Auto-Antibody Positivity: Abdominal Obesity Can Enhance the Risk of Thyroid Autoimmunity in Men
Authors: Zynat Jazyra , Li Suli , Ma Yanrong , Han Li , Ma Fuhui , Zhang Yuyuan , Xing Bei , Wang Xinling , Guo Yanying
Published: March 2020

Background. The interrelation between obesity and autoimmune thyroid diseases is complex and has not been confirmed. The aim of the present study was to observe the relationship between thyroid autoimmunity and obesity, especially abdominal obesity, in a large population. Methods. A total of 2253 residents who had lived in Xinjiang for more than 3 years were enrolled. Serum thyroid hormone concentration, thyroid autoantibodies, lipid parameters, Weight, height, and waist and hip circumference were measured. Results. The prevalence of thyroid peroxidase antibody (TPOAb) and/or thyroglobulin antibody (TgAb) positive was 32.1% (21.2% in men and 37% in women, P<0.01). Compared with women, men had significantly higher TG levels, waist circumference, and hip circumference levels (P<0.01), while women showed higher TSH, TPOAb, and TgAb levels (P<0.01). The prevalence of overweight and obesity was 71.1% in men and 63.5% in women. Men had a higher prevalence of abdominal obesity than women (56.6% in men and 47.6% in women, P<0.01). TPOAb correlates positively with waist circumference (r = 0.100, P<0.05) in men. Binary logistic analysis showed that TPOAb positivity had increased risks of abdominal obesity in men, and the OR was 1.1044 (95% CI 1.035, 1.151, P<0.05). Conclusion. Our results indicate that men had higher lipid levels, thicker waist circumference, and higher prevalence of overweight, obesity, and abdominal obesity. Abdominal obesity is a risk factor for TPOAb positivity in men, suggesting that abdominal obesity can enhance the risk of thyroid autoimmunity in men.
Resveratrol and Diabetic Cardiomyopathy: Focusing on the Protective Signaling Mechanisms
Authors: Song Yan-Jun , Zhong Chong-Bin , Wu Wei
Published: March 2020

Diabetic cardiomyopathy (DCM) is a common cardiovascular complication of diabetic mellitus that is characterized by diastolic disorder in the early stage and clinical heart failure in the later stage. Presently, DCM is considered one of the major causes of death in diabetic patients. Resveratrol (RSV), a naturally occurring stilbene, is widely reported as a cardioprotective substance in many heart diseases. Thus far, the specific roles of RSV in DCM prevention and treatment have attracted great attention. Here, we discuss the roles of RSV in DCM by focusing its downstream targets from both in vivo and in vitro studies. Among such targets, Sirtuins 1/3 and AMP-activated kinase have been identified as key mediators that induce cardioprotection during hyperglycemia. In addition, many other signaling molecules (e.g., forkhead box-O3a and extracellular regulated protein kinases) are also regulated in the presence of RSV and exert beneficial effects such as opposing oxidative stress, inflammation, and apoptosis in cardiomyocytes exposed to high-glucose conditions. The beneficial potential of an RSV/stem cell cotherapy is also reviewed as a promising therapeutic strategy for preventing the development of DCM.
Body Weight, Obesity Perception, and Actions to Achieve Desired Weight among Rural and Urban Ghanaian Adults
Authors: Agyapong Nana Ama Frimpomaa , Annan Reginald Adjetey , Apprey Charles , Aduku Linda Nana Esi
Published: March 2020

Background. Accurate body weight perception is important to maintaining an ideal body weight. In Africa, a preference for a larger body size and its association with health and wellbeing has been well documented. It remains speculative if these perceptions have changed or improved and if differences exist among rural and urban dwellers. The main aim of this study was to assess the body weight and obesity perceptions among rural and urban Ghanaians. Methods. This cross-sectional study involved 565 participants. The Stunkard figure rating scale was used to assess the body weight perception of participants. Participants were to choose from the scale figures they perceived to represent their current body weight, desired body weight, ideal body weight, ideal look for a wealthy person, ideal look for a woman with children, and ideal look for a woman without children. Additionally, participants were asked to describe obesity and its threat to health in their terms. Responses of participants to the above questions are presented as frequencies. Differences between rural and urban participants as well as males and females with respect to the median figure chosen for each question were determined by Mann–Whitney U test. Results. The median age of participants was 40 (IQR 26). The prevalence of overweight and obesity observed among participants was 52.8%. The most frequently selected figure as current body image was figure 5 (23.5%). Figure 4 was most frequently chosen by both males (37.2%) and females (24.6%) as their desired body image (27.4%). Male participants (41.8%) chose figure 5 as ideal for their gender while females (27.4%) maintained figure 4 as ideal for their gender. Study participants associated overweight with wealth and childbirth, and attributed their current weights to hereditary (27%) and childbirth (27%). Most participants were not taking steps to achieve their desired body image, and only a few engaged in both dieting and exercise to lose weight. Majority of participants described obesity as the accumulation of fat (91.0%) and viewed it as a threat to health (91.0%). Differences were observed among rural and urban participants with regard to the figure chosen as ideal for a wealthy person. Conclusion. Results from this study show an improvement in obesity perception and the acknowledgment of obesity as a threat to health. There was a desire for a normal-weight figure among study participants. Attribution of current body weight to hereditary and childbirth seems to be a hindrance to the implementation of actions to achieve this normal figure weight. Public health education, screening for overweight and obesity, creation of supportive food environments, and culture-sensitive interventions are promising to curbing the obesity menace.
Hypoglycemia Prevention Practice and Associated Factors among Diabetic Patients on Follow-Up at Public Hospitals of Central Zone, Tigray, Ethiopia, 2018
Authors: Gebremichael Gebrewahd Bezabh , Mariye Zemicheal Teklewoini
Published: March 2020

Background. Hypoglycemia is an acute medical situation that occurs when blood glucose level falls below 70 mg/dl. Although prevention of hypoglycemia is one cornerstone in the management of diabetes mellitus, its prevention practice among patients with diabetes mellitus is insufficiently studied. Moreover, the existed scarce literature in Ethiopia revealed hypoglycemia prevention practice is inadequate. Thus, this study tried to assess hypoglycemia prevention practices and associated factors among diabetic patients.Methods. Hospital-based cross-sectional study design was employed from March 1 to April 1, 2018, in the central zone of Tigray regional state of Ethiopia. A total of 272 diabetes mellitus patients selected by a systematic random sampling method were included in the study. Data were entered into Epi-data version 3.1 and exported to SPSS version 23 for further analysis. The binary logistic regression model (AOR, 95% CI, andpvalue < 0.05) was used to determine the predictors of hypoglycemia prevention practice.Results. The mean age of respondents was 43.62 years, and about 100 (63.2%) participants had good hypoglycemia prevention practice. Good knowledge on hypoglycemia (AOR = 10.34; 95% CI [5.41, 19.89]), having a glucometer at home (AOR = 3.02; 95% CI [1.12, 8.12]), favorable attitude towards diabetes mellitus (AOR = 2.36 CI [1.26, 4.39]), and being governmental employee (AOR = 5.19, 95% CI [1.63, 16.58]) were positive predictors of good hypoglycemia prevention practice. However, being divorced (AOR = 0.13, 95% CI [0.32, 0.53]) was found negatively associated with good hypoglycemia prevention practice.Conclusion. Only two-thirds of the study participants were found to have good hypoglycemia prevention practices. Healthcare personnel and Ethiopian diabetic association should promote patients’ attitude towards DM and knowledge on hypoglycemia by strengthening information, education, and communication program. Stakeholders should also try to provide glucometers to diabetic patients.