bluuebunny/crossref_metadata_2025 huggingface dataset:
Missing Treasures: Tracking Lost Ladino Books
Authors: Cohen Dov
Published: September 2019

A comprehensive project conducted over the past few years to locate and document every book printed in Ladino, revealed that between the years 1490–1960, nearly four thousand titles were published. In this article, I will show that many Ladino books were lost over the generations. Some of those missing books were referenced in assorted sources. Others did not come to researchers’ attention until fairly recently. This study contains several examples of Ladino books from the 16th century, which were lost and then rediscovered – due to the fact that their fragments were preserved in the Cairo Genizah or found in the bindings of antique books.
The Point of Moore’s Proof
Authors: Raff Charles
Published: September 2019

The current standard interpretation of Moore’s proof assumes he offers a solution to Kant’s famously posed problem of an external world, which Moore quotes at the start of his 1939 lecture “Proof of an External World.” As a solution to Kant’s problem, Moore’s proof would fail utterly. A second received interpretation imputes an aim of refuting metaphysical idealism that Moore’s proof does not at all achieve. This study departs from received interpretations to credit the aim Moore announced for the proof Moore performed in his 1939 lecture. Moore’s aim was to impose a counter-example to a stated presupposition of Kant’s problem of an external world. Moore’s lecture nevertheless neither endorses a replacement for Kant’s problem nor acknowledges that an immediate implication of achieving his announced aim would subvert Kant’s famously posed problem of an external world.
Why Not Persuade the Skeptic? A Critique of Unambitious Epistemology
Authors: Veber Michael
Published: September 2019

What constitutes a solution to the problem of skepticism? It has been traditionally held that one must produce an argument that would rationally persuade skeptical philosophers that they are mistaken. But there is a trend in recent epistemology toward the idea that we can solve the problem without giving skeptics any good reason to change their minds. This is what I call unambitious epistemology. This paper is a critique of that project.
On the Underpinning Mechanisms of (Epistemically) Reliable Processes
Authors: Beni Majid Davoody
Published: September 2019

The paper aims to evaluate the success of two different philosophical interpretations of prediction error minimisation theory in dissolving a notorious problem of philosophy, i.e., the New Evil Demon Problem (ned). In this paper, I argue that the inferentialist interpretation could not dissolve the strong form of ned. Alternatively, the embodied construaldissolves ned. However, in doing so, i.e., in dispensing with the cognitive judgment, the embodied construal might also eliminate some basic concepts of epistemology.
Extending Bayesian Models of the Rubber Hand Illusion
Authors: Litwin Piotr
Published: September 2019

Human body sense is surprisingly flexible — in the Rubber Hand Illusion (RHI), precisely administered visuo-tactile stimulation elicits a sense of ownership over a fake hand. The general consensus is that there are certain semantic top-down constraints on which objects may be incorporated in this way: in particular, to-be-embodied objects should be structurally similar to a visual representation stored in an internal body model. However, empirical evidence shows that the sense of ownership may extend to objects strikingly distinct in morphology and structure (e.g., robotic arms) and the hypothesis about the relevance of appearance lacks direct empirical support. Probabilistic multisensory integration approaches constitute a promising alternative. However, the recent Bayesian models of RHI limit too strictly the possible factors influencing likelihood and prior probability distributions. In this paper, I analyse how Bayesian models of RHI could be extended. The introduction of skin-based spatial information can account for the cross-compensation of sensory signals giving rise to RHI. Furthermore, addition of Bayesian Coupling Priors, depending on (1) internal learned models of relatedness (coupling strength) of sensory cues, (2) scope of temporal binding windows, and (3) extension of peripersonal space, would allow quantification of individual tendencies to integrate divergent visual and somatosensory signals. The extension of Bayesian models would yield an empirically testable proposition accounting comprehensively for a wide spectrum of RHI-related phenomena and rendering appearance-oriented internal body models explanatorily redundant.
Bird population declines in the Chametla wetland (Southern Gulf of California): Evidence of stress at the assemblage level
Authors: Brabata G. , Battisti C. , Carmona R. , Sánchez-Caballero C.A.
Published: September 2019

The Chametla wetland is used by shorebirds as a stopover site during their autumn migration and it is also an important breeding area for several species of waterbirds. The objective of this work was to compare the bird assemblages in Chametla wetland during three sampling periods: 1) 1991–1992; 2) 1997–1998 which was subjected to El Nino Southern Oscillation (ENSO) climate conditions and 3) 2005–2006. Bird communities were characterized in terms of species composition and diversity, using similarity analysis. Bird assemblage composition differed across years and seasons. Seasonal variations in composition and diversity were related to the presence/absence of phenological-characterized species (migratory vs. wintering species). The highest species richness was recorded under the ENSO period (1997–1998). We observed a sharp decrease in shorebird numbers, with evident stress at the assemblage level throughout the entire study period. There seems to be a transition of the bird assemblages from shorebird dominance to a dominance by long-legged wading birds and waterfowl species, which could be related to water level variation and changes in the quality/availability of food in the intertidal zone. The joint pressures of regional climate variation combined with local anthropogenic perturbations may lead to changes in bird assemblage in the Chametla wetland.
Measuring natural selection on multivariate phenotypic traits: a protocol for verifiable and reproducible analyses of natural selection
Authors: Palacio Facundo Xavier , Ordano Mariano , Benitez-Vieyra Santiago
Published: September 2019

The use of multiple regression analysis to quantify the regime and strength of natural selection in nature has been an influential approach in evolutionary biology over the last 36 years. However, many studies fail to report the protocol of estimation of selection coefficients (selection gradients) and the specific model assumptions, thus failing to verify and reproduce the estimation of selection coefficients. We present a brief overview of the Lande and Arnold’s approach and a step-by-step R routine to aid researchers to perform a verifiable and reproducible regression analysis of natural selection. The steps involved in the analysis include: (1) assessing collinearity between phenotypic traits, (2) testing normality of model residuals, and (3) testing multivariate normality of phenotypic traits. We also performed a series of simulations to test the effect of non-symmetrical (skewed) phenotypic traits on the estimation of linear selection gradients. These showed that the bias in the linear gradient increased with increased skewness in phenotypic traits for the quadratic model, whereas the linear gradient of a model with only linear terms was nearly independent of trait skewness. If none of the above assumptions are met, selection gradients need to be estimated from two separate equations, whereas standard errors must be computed using other methods (e.g. bootstrapping). We expect that the procedure outlined here and the availability of analytical codes motivate the verifiability and reproducibility of the Lande and Arnold’s approach in the study of microevolution.
Spontaneous Emission of Terbium Complex In-Filled in Single-Crystal Colloidal Multilayer
Authors: Wang DongDong , Wang YongSheng , Zhang Hui , Deng Lier , Zhang ChunXiu , Han Xiao , Hou Y. H.
Published: September 2019

Highly monodisperse submicron-sized silica spheres were synthesized by a chemical method, and single-crystal colloidal multilayers were prepared by a vertical deposition technique. Rare earth complex Tb(ACAC)3phen was in-filled in this structure to investigate the photonic
bandgap effect on the spontaneous emission. The photon density of states in the photonic crystal was calculated numerically to investigate the origin of the abnormally enhanced photoluminescence in the photonic bandgap region. Our results are suggestive of a new way to probe the position of
fluorescent molecules in such photonic bandgap materials.
Russo-Iranian Relations in the Light of Putin’s Foreign Policy and the Iranian Nuclear Crisis
Authors: Biswas Samprity , Chakraborty Suryasekhar
Published: September 2019

Historically, Russia and Iran have shared a complex relationship that continues to color the contours of their present bilateral dealings. The complicated patterns of cooperation and conflict between them have been determined by a host of domestic and external factors on both sides, most pronouncedly manifested by their respective relationship with the USA. This article attempts to analyze Russia’s relationship with Iran in the geopolitical setting of the post-Cold War period. The aim of the article is to see how this bilateral relationship has evolved over time, exploring the underlying changes and continuities, from the Yeltsin period to the Putin era, in which Russia’s foreign policy has come to be characterized by an assertive fervor. Russia, under President Putin, has been pushed further toward the globalist end as the USA has attempted to consolidate Western values and institutions, at times to the extent of ignoring and undermining the principles of international law. It is within this broader context that this article will analyze the extent to which Russia’s disillusionment with the USA has played a role in pushing Russia toward adopting a pragmatic and flexible approach from time to time vis-à-vis Iran, in general, and the Iranian nuclear crisis, in particular. The article argues that Russia’s active involvement in minimizing the impact of sanctions on Iran and its method of dealing with Iran, through dialogue rather than force, is not only driven by Russia’s economic interests in the region, but is also a dependent variable of the larger Russia–USA rivalry at the systemic level characterized by both geopolitical competitions and ideational contestations over norms, beliefs, and practices of global governance.
Extremity Findings of Methotrexate Embryopathy
Authors: Mantilla-Rivas Esperanza , Brennan Ashleigh , Goldrich Agnes , Bryant Justin R. , Oh Albert K. , Rogers Gary F.
Published: September 2019

Background: Methotrexate (MTX) is widely used as an immunosuppressant, chemotherapeutic, and abortifacient agent. It is also a potent teratogen, and intentional or unintentional exposure during pregnancy is associated with heterogeneous birth anomalies. Methods: We retrospectively reviewed a cohort of patients who presented to our clinic with limb anomalies in the setting of MTX embryopathy. Results: In our case series, we describe 7 cases of patients who had limb anomalies with heterogeneous functionality, from severely debilitating to completely asymptomatic. Most of the upper extremity anomalies in our group were managed conservatively. Conclusions: Methotrexate embryopathy is a rare but clinically important entity with phenotypic and functional variability. This series underscores the need for proper counseling of patients and raises concern regarding using this medication for the purpose of abortion.
The Macroeconomics of Demonetization: Theory and Some Conjectures
Authors: Chattopadhyay Subhasankar
Published: September 2019

The withdrawal of high-denomination paper money in India—popularly termed ‘demonetization’—has generated interest among common people to understand what the usual macroeconomic consequences of such one-time monetary shock are. This article conjectures (a) that such unanticipated supply-side replacement of paper money of higher denominations may lead to a currency ‘trap’ in the short run and a permanent increase in the hoarding of lower denomination currencies in the long run and (b) that the effect on the GDP in the medium run can be ambiguous in a simple IS-LM framework once the effects of variable price level and changing inflation expectations are captured through the presence of an informal sector.

JEL Classification: E 12, E 26, E 44, E 52
Book review: Saumen Chattopadhyay, Macroeconomic of the Black Economy
Authors: Schneider Friedrich
Published: September 2019

Saumen Chattopadhyay, Macroeconomic of the Black Economy, Delhi, India: Orient Blackswan Publisher, 2018, ₹666, 276 pp. (hardcover). ISBN: 978-93-5287-281-7.
ACUTE ABDOMEN systemic sonographic approach to acute abdomen in emergency department: a case series
Authors: Al Ali Maryam , Jabbour Sarah , Alrajaby Salma
Published: September 2019

Background

Acute abdomen is a medical emergency with a wide spectrum of etiologies. Point-of-care ultrasound (POCUS) can help in early identification and management of the causes. The ACUTE–ABDOMEN protocol was created by the authors to aid in the evaluation of acute abdominal pain using a systematic sonographic approach, integrating the same core ultrasound techniques already in use—into one mnemonic. This mnemonic ACUTE means: A: abdominal aortic aneurysm; C: collapsed inferior vena cava; U: ulcer (perforated viscus); T: trauma (free fluid); E: ectopic pregnancy, followed by ABDOMEN which stands: A: appendicitis; B: biliary tract; D: distended bowel loop; O: obstructive uropathy; Men: testicular torsion/Women: ovarian torsion. The article discusses two cases of abdominal pain the diagnosis and management of which were directed and expedited as a result of using the ACUTE–ABDOMEN protocol. The first case was of a 33-year-old male, who presented with a 3-day history of abdominal pain, vomiting and constipation. Physical exam revealed a soft abdomen with generalized tenderness and normal bowel sounds. Laboratory tests were normal. A bedside ultrasound done using the ACUTE–ABDOMEN protocol showed signs of intussusception. This was confirmed by CT-abdomen. The second case was of a 70-year-old female, a known case of diabetes and hypertension, who presented with a 3-hour history of abdominal pain, vomiting and diarrhea. She had a normal physical exam and laboratory studies. Her symptoms mimicking simple gastroenteritis had improved. However, bedside ultrasound, using the ACUTE–ABDOMEN protocol showed localized free fluid with dilated small bowel loop in right lower quadrant with absent peristalsis. A CT abdomen confirmed a diagnosis of intestinal obstruction. These two cases demonstrate that the usefulness of applying POCUS in a systematic method—like the “ACUTE–ABDOMEN” approach—can aid in patient diagnosis and management.

Case presentation

We are presenting two cases of undifferentiated acute abdomen pain, where ACUTE ABDOMEN sonographic approach was applied and facilitated the accurate patient management and disposition.

Conclusion

ACUTE ABDOMEN sonographic approach in acute abdomen can play an important role in ruling out critical diagnosis, and can guide emergency physician or any critical care physician in patient management.
Hepatitis B virus reactivation sustained by a hepatitis B virus surface antigen immune-escape mutant isolate in a patient who was hepatitis B core antibody positive during treatment with sofosbuvir and velpatasvir for hepatitis C virus infection: a case report
Authors: Foroghi Biland Luca , Ferrari Ludovica , Malagnino Vincenzo , Teti Elisabetta , Cerva Carlotta , Gentile Adele , Aragri Marianna , Salpini Romina , Svicher Valentina , Andreoni Massimo , Sarmati Loredana
Published: September 2019

Background

Although several cases of hepatitis B virus reactivation have been described in patients with a history of hepatitis B virus infection while undergoing treatment for hepatitis C virus infection with direct acting antivirals, the question of whether hepatitis B virus surface antigen immune-escape mutations might play a role has not been addressed so far.

Case presentation

We report a case of hepatitis B virus reactivation in a Caucasian patient infected with hepatitis C virus during treatment with sofosbuvir and velpatasvir. A 50-year-old man with a genotype 1a hepatitis C virus infection was considered for therapy. His serological profile was hepatitis B virus surface antigen-negative, hepatitis B virus core antibody-positive, hepatitis B virus surface antibody-negative, and anti-hepatitis D virus-positive. The detection of hepatitis B virus deoxyribonucleic acid (DNA) indicated active viral replication during the direct acting antiviral treatment that spontaneously returned to undetectable levels after treatment completion. Starting from week 12 after the end of treatment, hepatitis B virus surface antibody titers and hepatitis B virus e antibody developed. Sequencing analysis revealed the hepatitis B virus genotype D3 and the presence of two relevant immune-escape mutations (P120S and T126I) in the major hydrophilic region by analyzing the S region.

Conclusions

We speculate that the presence of the hepatitis B virus surface antigen mutations, endowed with the enhanced capability to elude the immune response, could play a role in hepatitis B virus reactivation. This observation confirms that occult hepatitis B infection should also be carefully monitored, through surveillance of the hepatitis B virus viral load before and during direct acting antiviral treatment of hepatitis C virus.
High oral corticosteroid exposure and overuse of short-acting beta-2-agonists were associated with insufficient prescribing of controller medication: a nationwide electronic prescribing and dispensing database analysis
Authors: Sá-Sousa Ana , Almeida Rute , Vicente Ricardo , Nascimento Nilton , Martins Henrique , Freitas Alberto , Fonseca João Almeida
Published: September 2019

Background

Recurrent use of oral corticosteroids (OCS) and over-use of short-acting beta-2-agonists (SABA) are factors associated with adverse side effects and asthma-related death. We aim to quantify high OCS exposure, SABA over-use and its association with prescription and adherence to maintenance treatment for respiratory disease, among patients with prescriptions for respiratory disease, from the Portuguese electronic prescription and dispensing database (BDNP).

Methods

This was a 1-year (2016) retrospective population-based analysis of a random sample of adult patients from the BDNP, the nationwide compulsory medication prescription system. We assessed high OCS exposure (dispensing ≥ 4 packages containing 20 doses of 20 mg each of prednisolone-equivalent, ≥ 1600 mg/year) on patients on persistent respiratory treatment (PRT-prescription for > 2 packages of any respiratory maintenance medications). Excessive use of SABA was defined as having a ratio of SABA-to-maintenance treatment > 1 or having SABA over-use (dispensing of > 1 × 200 dose canister/month, of 100 μg of salbutamol-equivalent). Factors associated with high OCS exposure were assessed by multinomial logistic regression.

Results

The estimated number of patients on PRT was 4786/100,000 patients. OCS was prescribed to more than 1/5 of the patients on PRT and 101/100,000 were exposed to a high-dose (≥ 1600 mg/year). SABA excessive use was found in 144/100,000 patients and SABA over-use in 24/100,000. About 1/6 of SABA over-users were not prescribed any controller medication and 7% of them had a ratio maintenance-to-total ≥ 70% (high prescription of maintenance treatment). Primary adherence (median%) to controller medication was 66.7% for PRT patients, 59.6% for patients exposed to high OCS dose and 75.0% for SABA over-users. High OCS exposure or SABA over-use were not associated with primary adherence. High OCS exposure was associated with a maintenance-to-total medication ratio < 70% (insufficient prescription of maintenance treatment), age > 45 years old and male sex.

Conclusions

Exposure to high-dose of OCS (101 per 100,000 patients) and SABA over-use (24 per 100,000) were frequent, and were associated with a low maintenance-to-total prescription ratio but not with primary non-adherence. These results suggest there is a need for initiatives to reduce OCS and SABA inappropriate prescribing.
Estimation of Compressive Strength and Member Size of Steel Fiber Reinforced Concrete Using Stress Wave-Driven Nondestructive Test Methods
Authors: Hong Seonguk , Kim Seunghun
Published: September 2019

Among fiber-reinforced composites, steel fiber has been widely-used for concrete infrastructure such as silos, tunnels, specifically aiming at reducing the weight of concrete and enhancing its strength by overcoming the brittleness. However, there is still little known about appropriate quality management and applicability assessment for steel fiber composites. This study fills this knowledge gap by testing the possibility of maintenance through steel fiber concrete thickness estimation and assessing the applicability of the quality management instrument. To this end, this study utilizes two different stress wave-driven non-destructive test methods: ultrasonic pulse velocity and impact-echo methods. The ultrasonic pulse velocity method was employed to estimate the compressive strength of steel fiber reinforced concrete, while the impact-echo method was applied to estimate the thickness of various steel fiber reinforced concrete members. As a quality management factor of concrete, correlations between steel fiber mixing ratios and compressive strengths were experimentally explored and validated by error ratios for twenty-four specimens. The reliability was relatively high overall. The average error rate of all the specimens with steel fiber mixing ratios of 0, 0.75 and 1% was 3.36%. Accordingly, the results prove the applicability of the non-destructive test methods for building quality management.
Prevalence and associated risk factors of anaemia among women attending antenatal and post-natal clinics at a public health facility in Ghana
Authors: Kofie Philip , Tarkang Elvis E. , Manu Emmanuel , Amu Hubert , Ayanore Martin Amogre , Aku Fortress Yayra , Komesuor Joyce , Adjuik Martin , Binka Fred , Kweku Margaret
Published: September 2019

Background

Anaemia among pregnant women and post-partum mothers is a public health challenge in Ghana, especially in the Volta Region. While literature abounds on anaemia among pregnant women, the same cannot be said for anaemia among post-partum mothers in the region. This study, therefore, examined the prevalence and associated risk factors of anaemia among women attending antenatal care and post-natal care.

Methods

This descriptive cross-sectional survey recruited 409 pregnant women and 194 post-natal mothers attending antenatal and post-natal care, at the Hohoe Municipal Hospital. Background characteristics were collected using a semi-structured questionnaire, blood samples were analysed for the presence of anaemia and malaria parasitaemia and folders were reviewed for estimated blood loss.

Results

We found the prevalence of anaemia among pregnant women and post-partum mothers to be 33 and 16% respectively. Higher malaria parasitaemia (2%) was found in pregnant women compared with postpartum mothers (1%). We found that 4% of post-partum mothers had abnormal blood loss (301mls-500mls) whereas 5% of them had postpartum haemorrhage (>500mls) during child birth. A univariate logistics regression of anaemia status on some risk factors in pregnant women showed no significant association between anaemia and any of the risk factors. Among post-partum mothers, only mothers’ age was statistically significant in the univariate analysis [COR = 0.27 (95% CI:0.103, 0.72);0.008]. Mothers aged 20–29 were 73% less likely to be anaemic.

Conclusion

The prevalence of anaemia among pregnant women found in this study points to a situation of moderate public health problem according to WHO cut-off values for the public health significance of anaemia. Strategies should therefore be put in place to encourage thorough health education and promotion programmes among both pregnant and post-partum women.
Redirecting differentiation of mammary progenitor cells by 3D bioprinted sweat gland microenvironment
Authors: Wang Rui , Wang Yihui , Yao Bin , Hu Tian , Li Zhao , Liu Yufan , Cui Xiaoli , Cheng Liuhanghang , Song Wei , Huang Sha , Fu Xiaobing
Published: September 2019

Background

Mammary progenitor cells (MPCs) maintain their reproductive potency through life, and their specific microenvironments exert a deterministic control over these cells. MPCs provides one kind of ideal tools for studying engineered microenvironmental influence because of its accessibility and continually undergoes postnatal developmental changes. The aim of our study is to explore the critical role of the engineered sweat gland (SG) microenvironment in reprogramming MPCs into functional SG cells.

Methods

We have utilized a three-dimensional (3D) SG microenvironment composed of gelatin-alginate hydrogels and components from mouse SG extracellular matrix (SG-ECM) proteins to reroute the differentiation of MPCs to study the functions of this microenvironment. MPCs were encapsulated into the artificial SG microenvironment and were printed into a 3D cell-laden construct. The expression of specific markers at the protein and gene levels was detected after cultured 14 days.

Results

Compared with the control group, immunofluorescence and gene expression assay demonstrated that MPCs encapsulated in the bioprinted 3D-SG microenvironment could significantly express the functional marker of mouse SG, sodium/potassium channel protein ATP1a1, and tend to express the specific marker of luminal epithelial cells, keratin-8. When the Shh pathway is inhibited, the expression of SG-associated proteins in MPCs under the same induction environment is significantly reduced.

Conclusions

Our evidence proved the ability of differentiated mouse MPCs to regenerate SG cells by engineered SG microenvironment in vitro and Shh pathway was found to be correlated with the changes in the differentiation. These results provide insights into regeneration of damaged SG by MPCs and the role of the engineered microenvironment in reprogramming cell fate.
Trends in diagnostic prevalence and treatment patterns of male and female ankylosing spondylitis patients in the United States, 2006–2016
Authors: Walsh Jessica , Hunter Theresa , Schroeder Krista , Sandoval David , Bolce Rebecca
Published: September 2019

Background

There has been much variation between epidemiological studies that report the prevalence of ankylosing spondylitis (AS). This study aimed to analyze the diagnostic prevalence rates and treatment patterns of male and female AS patients in the United States adult insured population from 2006 to 2016.

Methods

Trends in AS prevalence were calculated for the 11-year period covering January 1, 2006 to December 31, 2016. Adult (18+ years old) AS patients were included in this retrospective analysis of medical and pharmacy claims data from the IBM Marketscan Commercial, Medicaid and Medicare-Supplemental Claims database. Prevalence was determined as having ≥1 AS diagnostic codes (ICD-9:720.0; ICD-10:M45.x). Trends in treatment patterns were also analyzed and stratified by gender.

Results

The AS prevalence increased from 0.04 to 0.09% from 2006 to 2016. The mean age between 2006 and 2016 ranged from 49.52–50.00 years. In 2006, approximately 40% of AS patients were female, while in 2016 over 47% of AS patients were female. Rates of use of TNF inhibitors and oral glucocorticoids increased, while NSAIDs and non-biologic DMARDs (sulfasalazine & methotrexate) rates decreased. Opioid use rates were stable. In 2016, males were more likely to be prescribed biologics, while females were more likely to be prescribed methotrexate, sulfasalazine, NSAIDs, muscle relaxants, anticonvulsants, opioids, and glucocorticoids.

Conclusions

The prevalence of AS diagnosis codes more than doubled between 2006 and 2016, but the very low prevalence suggests that AS continues to be underdiagnosed and under-addressed in routine clinical practice. Despite the increase in female AS patients, females were less likely to be prescribed biologics compared to male AS patients.
Value of mNGS in sonication fluid for the diagnosis of periprosthetic joint infection
Authors: Zhang Chongjing , Fang Xinyu , Huang Zida , Li Wenbo , Zhang Chao-fan , Yang Bin , Zhang Wenming
Published: September 2019

Objective

To evaluate the effectiveness of metagenomics next-generation sequencing (mNGS) for the detection of pathogenic microorganisms in periprosthetic joint infection (PJI) using the sonication fluid from removed prosthesis.

Methods

In this prospective diagnostic cohort study, 44 patients who underwent revision arthroplasty in our hospital from December 2016 to December 2018 were screened. Seven cases were excluded due to incomplete clinical data, insufficient synovial fluid or failure of sequencing. According to the PJI diagnostic criteria recommended by the Musculoskeletal Infection Society (MSIS), the patients were defined as PJI or aseptic failure (AF). Conventional culture, sonication fluid culture and mNGS were performed, in order to assess the value of mNGS using sonication fluid for the diagnosis of PJI, and the mNGS results were analyzed and compared with the conventional and sonication fluid culture.

Results

Among the 37 patients, 24 were diagnosed with PJI (64.86%), while 13 were diagnosed with aseptic failure. Among the 24 patients diagnosed with PJI, 15 cases (62.5%), 17 cases (70.8%) and 24 cases (100%) yielded positive results in conventional culture, sonication fluid culture and mNGS, respectively. In addition, mNGS detected the same pathogenic microorganisms in 16 out of the 17 (94.12%) culture-positive (conventional + sonication fluid) PJI cases. In the only one discrepancy case,Enterococcus faecaliswas identified in the cultures, whileEnterobacter cloacaewas detected by mNGS. In the AF group, the results of the conventional culture were all negative. Nevertheless,Staphylococcus epidermidiswas detected in the sonication fluid culture and mNGS in one case. The diagnostic sensitivity of mNGS for PJI was 100%, which was significantly higher than 70.83% (P = 0.039) of the sonication fluid culture and 62.5% (P = 0.021) of the conventional culture. The diagnostic specificity of mNGS for PJI was 92.31%, which was not significantly different (P > 0.05) from those of the conventional culture (100%) and sonication fluid culture (92.31%).

Conclusion

We demonstrated that mNGS using sonication fluid can improve the detection rate of pathogenic microorganisms and provide valuable information for the diagnosis of PJI. In addition, mNGS can effectively identify pathogenic microorganisms in culture-negative PJIs cases, especially for the cases who have been treated with antibiotics before sample acquisition or have fastidious microorganisms. Therefore, this method can potentially help to guide the clinical use of antibiotics.
Catastrophic Intracardiac Thrombosis During Emergency Repair of an Expanding Aortic Pseudoaneurysm: A Case Report
Authors: Vadlamudi Ratna , Chan Jay , Sniecinski Roman M.
Published: September 2019

Catastrophic thrombosis is a rare but frequently fatal event following complex cardiac surgery. It is most often encountered following separation from cardiopulmonary bypass (CPB) and reversal of heparin anticoagulation, and somewhat paradoxically, at the time when bleeding from post-CPB coagulopathy is being treated. We report the case of a 41-year-old female taken to the operating room for repair of an expanding ascending aortic pseudoaneurysm. Following a prolonged operation, she developed intracardiac thrombus during transfusion of hemostatic blood products and procoagulant agents. Potential contributing factors are discussed.
The Ventrain Device: A Future Role in Difficult Airway Algorithms?
Authors: Morrison Stuart , Aerts Sophie , Saldien Vera
Published: September 2019

The Ventrain is a small, manually operated, single-use, inspiratory flow-adjustable ventilation device that generates positive pressure during inspiration and, through a Bernoulli effect within the device, active suction during expiration. It was designed to provide emergency ventilation during airway obstruction via narrow-bore cannulae. The device has been used successfully in elective procedures lasting >1 hour. It remains to be seen if its theoretical advantages in “can’t intubate, can’t oxygenate” (CICO) scenarios translate to reliable clinical benefit and allow inclusion in future airway algorithms. We advocate for regular simulation training and the detailed reporting of clinical experience with this encouraging new tool.
Pulmonary Hypertensive Crisis During General Anesthesia in a 3-Year-Old Autistic Boy With Undiagnosed Scurvy, Undergoing Cardiac Catheterization: A Case Report
Authors: Ichiyanagi Shogo , Takeshita Itsuki , Kandil Ali I. , Miyazu Mitsunori , Kojima Taiki
Published: September 2019

Pulmonary hypertension in children is commonly caused by underlying cardiac and pulmonary disease. Within the past 10 years, scurvy has been identified as a cause for pulmonary hypertension. We describe the case of a 3-year-old autistic boy with undiagnosed scurvy who was scheduled for cardiac catheterization. Immediately after induction, the patient became hemodynamically unstable, which worsened with administration of nitrous oxide. Cardiac catheterization revealed pulmonary hypertension, which dramatically improved with administration of vitamin C. Anesthesiologists should be aware that scurvy is more common than previously thought, even in developed countries and can cause unexpected circulatory collapse from pulmonary hypertensive crisis.
Paravertebral Block for a Patient With Achalasia Undergoing a Peroral Endoscopic Myotomy Procedure: A Case Report
Authors: Gutman David A. , George Renuka , Moore Lauren
Published: September 2019

In 2016, the American Medical Association officially dismissed pain as a vital sign quoting the opioid epidemic as a major reason. Clinically, pain remains very relevant and we present the case of a patient with achalasia treated via peroral endoscopic myotomy procedure (POEM). Given that similar patients previously failed traditional pain management modalities, regional anesthesia was used in this patient’s pain management. The positive outcomes yielded from this technique convinced our gastroenterological colleagues to request regional anesthesia for future patients, altering their approach to pain management.
Thermal Radiofrequency Ablation of the Articular Branch of the Lateral Pectoral Nerve: A Case Report and Novel Technique
Authors: Eckmann Maxim S. , Lai Bryan K. , Uribe Marco A. , Patel Samir , Benfield Jonathan A.
Published: September 2019

The lateral pectoral nerve (LPN) innervates anterior shoulder structures. We report a novel technique for radiofrequency ablation (RFA) of the articular branch of the LPN (abLPN) to treat persistent anterior shoulder pain. Ultrasound and fluoroscopy were used to identify bony and vascular landmarks to target the midlateral and superior-lateral coracoid process (CP). Multiple thermal RFA lesions were delivered along this location without complication using a 20-gauge cannula. As a result, the patient has continued substantial relief of resting and dynamic deep anterior shoulder pain beyond 3 months. Ablation of the abLPN may provide anterior shoulder analgesia without causing motor weakness.
Helmet CPAP as a Bridge From a Rapid Response Activation for Hypoxia Through Awake Tracheostomy in the Operating Room in a Patient With a Difficult Airway: A Case Report
Authors: Nocci Matteo , Detti Emanuele , Meneguzzi Marco , Scolletta Sabino
Published: September 2019

Continuous positive airway pressure (CPAP) has been used in multiple clinical settings with increasing frequency. However, its use in improving blood oxygenation for difficult airways has never been a specific consideration. Here, we present a rapid response team (RRT) intervention in a patient with severe hypoxia requiring emergent surgical tracheostomy. To restore an adequate level of blood oxygen saturation, helmet CPAP was used during transportation and surgical tracheostomy. In selected cases involving difficult airways, helmet CPAP may have some advantages. Additional studies are warranted to assess the benefits of introducing this device to RRT equipment.
Undiagnosed Systemic Mastocytosis Presenting as Postoperative Distributive Shock: A Case Report
Authors: Ripoll Juan G. , Ritter Matthew J. , Comfere Thomas B. , Smith Mark M. , Schaff Hartzell V. , Gilkey George D. , Warner Matthew A.
Published: September 2019

Systemic mastocytosis (SM) is a rare clinical condition resulting from a clonal proliferation of abnormal mast cells. The clinical presentation may vary from mild cutaneous manifestations to aggressive systemic symptoms including intermittent episodes of anaphylaxis. We present a case of a 69-year-old male with abrupt and recurrent episodes of anaphylaxis with refractory distributive shock following cardiac surgery with cardiopulmonary bypass. Following a complex postoperative course, a bone marrow biopsy ultimately confirmed the diagnosis. Although rare, SM should be considered in the differential diagnosis of postoperative patients with unexplained and recurrent episodes of distributive shock.
Iatrogenic Bladder Perforation During Laparoscopy: Revisiting the “Catheter Bag” Sign: A Case Report
Authors: Grzybowski Jeffrey S. , Simon Eric R. , Borden Shelly B.
Published: September 2019

We report a case of an iatrogenic bladder perforation sustained during laparoscopic lysis of adhesions performed for small bowel obstruction. The only sign, discovered by the anesthesiology team, was an inflated urinary catheter collection bag. This case revalidates the “catheter bag” sign and advocates for the placement of an indwelling transurethral urinary catheter before surgical incision in high-risk patients with previous pelvic and/or bladder pathology. In addition, vigilance from anesthesia providers and commitment to communication between anesthesia, surgical, and nursing care teams is emphasized to quickly discover complications and treat accordingly.
Applied and problem-oriented aspects and approaches of optimizing the motivation of professional activity
Authors: Никитина Татьяна , Nikitina Tatyana
Published: September 2019

The object of the work is the motivation of professional activity, its enhancement and stimulation. The subject are techniques and methods of psychological, educational, and other value-orienting activities aimed at the formation and provision of professional-relevant motivation. The purpose of the research is to establish and define the basis of professional motivation, consideration of applied and problem-oriented aspects and approaches to optimize problem solving, increase professional motivation. The research methodology represents a complex of general scientific and private scientific methods of scientific cognition: dialectic, historical legal, comparative legal, system analysis, formal logical, sociological, etc. motivation of professional activity. The use of the system analysis method contributed to determine the place of motivation among other factors determining the content of professional activity.

The scientific novelty of the research is expressed in the obtained new knowledge as a result of the research by the author of the traditional doctrinal approach to the consideration of the main institutional and functional foundations of the existing system of professional motivation. The formulated main provisions of the work allow defining reasonable approaches to studying and analyzing the practice of organizing and ensuring the motivation of professional activity, form an idea of the place of motivation as one of the key elements of the system of preparation for professional activity at the present stage of existence and improve the system of personnel training, theory and practice of personnel work .
To the question of examining of individual and personal characteristics of a traffic police officer
Authors: Жимирикина Юлия , Zhimirikina Julia
Published: September 2019

The purpose of the presented research is to identify the relationship of individual and personal characteristics of a police officer with his professional tasks. The object of the study is to identity of a police officer. The subject of research is the individual and personal characteristics of a police officer. The hypothesis of the study is the assumption that the individual and personal characteristics of a police officer in his professional tasks generally affect the success of their professional activities. Research methods were analysis and systematization of the scientific and psychological literature on the subject of the research; analysis of documents (reference legal acts regulating the activities of internal affairs bodies, etc.); empirical research methods, namely individual conversations, included observation in the course of practical activities of police officers of various profiles. The novelty of the work consists in expanding, supplementing and refining scientific views on the relationship of the individual and personal characteristics of a police officer with the professional tasks being solved. The theoretical and practical significance of the research consists in the analysis of the existing approaches to the study of individual and personal characteristics, in the analysis of the specific features of the motivational - need and value sphere of the employee of the State Traffic Inspectorate; identifying the dependence of the success of professional activity on the individual and personal characteristics.
Hubungan Lingkar Pinggang dan Lingkar Panggul dengan Tekanan Darah pada Pasien Program Pengelolaan Penyakit Kronis (Prolanis)
Authors: Sumardiyono Sumardiyono , Pamungkasari Eti Poncorini , Mahendra Anton Giri , Utomo Oki Saraswati , Mahajana Devita , Cahyadi Wakhid Ryan , Ulfia Mila
Published: September 2019

Introduction: Obesity is a state of excessive accumulation of fat in the body, which is a risk factor for cardiovascular disease. Obesity can be measured using anthropometric methods measuring waist circumference and hip circumference. This study aims to find the relationship between the size of waist circumference and hip circumference to blood pressure in prolanis participants in the working area of Kedawung I Public Health Center, Sragen Regency.

Method: This study was an observational analytic study using a cross sectional design. The subjects were prolanis participant patient with a history of hypertension in the Kedawung I Community Health Center in Sragen in July 2017. Sampling was done by simple random sampling. The number of subject were 60 persons.

Results: There were significant relationship between waist circumference and systolic/ diastolic blood pressure with weak strength (r = 0.304; p = 0.018 and r = 0.337; p = 0.008) and significant relationship between hip circumference with systolic/diastolic blood pressure with weak strength (r = 0.263; p = 0.042 and r = 0.306; p = 0.017).

Conclusion: the increasing size of waist and hip circumference may increase blood pressure in prolanis participants.
Modification on acute myocardial infarction model through left anterior descending coronary artery ligation: An experimental study on rats (Rattus norvegicus) using readily available materials
Authors: Nugroho Johanes , Yuniarti Wiwik Misaco , Wardhana Ardyan , Ghea Cornelia
Published: September 2019

Background and Aim: Several difficulties are involved in creating models for myocardial infarction (MI) in animals, such as low survival rates after acute MI, complicated techniques in creating animal models, complexities in confirming acute MI incidence, and complex surgical tools needed in the process. This study aimed to develop an animal model for acute MI using Wistar rats utilizing simple instruments that are readily available in standard animal laboratories.

Materials and Methods: We induced MI in 48 Wistar rats using the left anterior descending coronary artery ligation modification technique without tracheal incision and ventilator. This ligation technique was performed 1-2 mm distal to the left atrial appendage. MI occurrence was evaluated using heart enzyme parameters 24 h post-ligation and histological studies of the infarcted area 6 weeks after the ligation. Rats were divided into the coronary artery ligation group and sham group.

Results: Of the 48 rats, 24 (50%) died within 24 h post-ligation, but no further deaths occurred in the next follow-up period of 6 weeks. The average infarct size in six rats within 24 h of ligation was 35%±5.7%. The serum glutamic oxaloacetic transaminase level of the group treated with coronary artery ligation was statistically significantly higher than that of the sham group (p=0.000).

Conclusion: We developed an MI rat model with consistent infarction size, in which the long-term death of rats was not observed. Our ligation technique for an MI rat model can be a reference for experimental settings without ventilators for small animals.
Трехмерные локально симметрические (псевдо)римановы многообразия с векторным кручением и нулевым тензором кривизны
Authors: Клепиков Павел Николаевич , Родионов Евгений Дмитриевич , Хромова Олеся Павловна
Published: September 2019

Метрическая связность с векторным кручением (также известная как полусимметрическая связность) является одной из трех основных связностей, описанных Э. Картаном. Данная связность играет важную роль в случае двумерных поверхностей, так как при этом любая метрическая связность является связностью с векторным кручением.К. Яно была доказана важная теорема о связи конформных деформаций и метрических связностей с векторным кручением. А именно: риманово многообразие допускает метрическую связность с векторным кручением, тензор кривизны которой равен нулю, тогда и только тогда, когда оно является конформно плоским. Таким образом, возникает задача об изучении (псевдо)римановых многообразий с метрической связностью с векторным кручением, тензор кривизны которых равен нулю.Данная работа посвящена решению поставленной задачи в случае трехмерных локально симметрических многообразий. Кроме того, приводится математическая модель, позволяющая вычислять компоненты тензора кривизны метрической связности с векторным кручением в случае локально однородных (псевдо)римановых многообразий.
Трехмерные метрические группы Ли с векторным кручением и нулевым тензором кривизны
Authors: Клепикова Светлана Владимировна , Эрнст Игорь Владиславович
Published: September 2019

Последнее время становится актуальным изучение (псевдо)римановых многообразий с различными метрическими связностями, отличными от связности Леви-Чивита.Метрическая связность с векторным кручением (также известная как полусимметрическая связность) является одной из часто рассматриваемых связностей. Связь между конформными деформациями римановых многообразий и метрическими связностями с векторным кручением на них была установлена в работах К. Яно.А именно: риманово многообразие допускает метрическую связность с векторным кручением, тензор кривизны которой равен нулю, тогда и только тогда, когда оно является конформно плоским.Кроме того, данная связность играет важную роль в случае двумерных поверхностей, так как в этом случае любая метрическая связность является связностью с векторным кручением.Таким образом, возникает задача об изучении (псевдо)римановых многообразий с метрической связностью с векторным кручением, тензор кривизны которых равен нулю.Данная работа посвящена решению поставленной задачи в случае трехмерных метрических групп Ли. Кроме того, приводится математическая модель, позволяющая вычислять компоненты тензора кривизны метрической связности с векторным кручением в случае метрических групп Ли.