bluuebunny/crossref_metadata_2025 huggingface dataset:
Key aspects of electric vertical take-off and landing conceptual design
Authors: Bacchini Alessandro , Cestino Enrico
Published: November 2019

The recent advances in battery energy density and electric propulsion systems for automotive applications are enabling the development of the electric vertical take-off and landing (VTOL) aircraft. The electric VTOL is a new means of transport that can fly like an aircraft and take off and land vertically like a helicopter, sometimes called personal aerial vehicle. This paper compares it to the existing vehicles that may compete with it and addresses the estimation of its performances in hover, cruise flight, and the transition phase. The main parameters affecting performances are then discussed. Considerable space is dedicated to the battery mass to total mass ratio.
Natural oils as coupling agents in recycled polypropylene wood flour composites: Mechanical, thermal and morphological properties
Authors: Poletto Matheus
Published: November 2019

Recycled polypropylene was reinforced with treated and non-treated wood flour with different natural oils. Four natural oils were used as coupling agents, namely hexanoic (C6), octanoic (C8), decanoic (C10) and dodecanoic (C12) acids. The mechanical, thermal and morphological properties of the resulting composites were evaluated. The usage of natural oils as coupling agents clearly improved the interfacial adhesion between wood flour and the polypropylene matrix while enhancing the mechanical and thermal properties. Better results were obtained when C8 was used. The improvement in the mechanical and thermal properties of the composites imparted by C8 is similar to that promoted by maleic anhydride-grafted polypropylene. The mechanical and thermal properties of the composites were affected by the boiling temperature and chain length of the natural oil used.
Alveolar Cleft Reconstruction Using Morphogenetic Protein (rhBMP-2): A Systematic Review and Meta-Analysis
Authors: Uribe Francisca , Alister Juan Pablo , Zaror Carlos , Olate Sergio , Fariña Rodrigo
Published: November 2019

Objective:

This study aimed to review the existing evidence regarding reconstruction of the alveolar cleft using recombinant human bone morphogenetic protein-2 (rhBMP-2) in terms of bone volume and bone height.

Design:

Systematic review and meta-analysis.

Patients—Participants:

A systematic search was done. Randomized and nonrandomized clinical trials, where rhBMP-2 was used in the reconstruction of human alveolar cleft were included.

Interventions:

Reconstruction of alveolar cleft with rhBMP-2.

Main Outcome Measures:

Average bone volume formation and average bone height formation in the alveolar cleft. Mean difference was calculated and pooled by meta-analysis.

Results:

Of 709 identified articles, 5 studies met the inclusion criteria. The average bone volume formation was higher in the rhBMP-2 group than in the control group (61.11% vs 59.12%). The average bone height formation was higher in the control group compared to the rhBMP-2 group (75.4% vs 61.5%). The risk of bias in the selected articles was high. The meta-analysis showed that rhBMP-2 treatment may benefit bone formation compared to iliac crest graft (low certainty evidence; mean difference: −208.76; 95% confidence interval: −253.59 to −163.93; −I2 = 0%).

Conclusions:

The results obtained in primary articles are promising but have a high risk of bias and have low quality of evidence; therefore, it is necessary to conduct controlled clinical trials with a greater number of patients to recommend the use of rhBMP-2 in the treatment of the alveolar cleft. PROSPERO registration number: CRD42018077741.
Energy Cooperatives and Municipalities in Local Energy Governance Arrangements in Switzerland and Germany
Authors: Schmid Benjamin , Meister Thomas , Klagge Britta , Seidl Irmi
Published: November 2019

Participation of citizens in local energy decisions is increasingly recognized as helpful for a successful decentralized energy transition. In this article, we focus on energy cooperatives in which private individuals jointly develop facilities to generate energy from renewable sources, thus involving citizens both politically and economically. Focusing on Switzerland and Germany, we show that there is a strong linkage between such cooperatives and municipalities, characterized by collaboration and support, and that the cooperatives are well suited as collaborating partners. We also show that federalist structures are most suited for such local arrangements as municipalities must have leeway to support cooperatives in a targeted manner and to compensate for shortcomings in the energy policy of superordinate governmental levels. Based on these results, we suggest that local governments should be given sufficient financial capacities and autonomy to strengthen implementation of a decentralized energy transition that involves citizens. However, we also recognize that municipal structures alone are often insufficient and that superordinate policies, especially national subsidies, remain essential. Hence, policies at the municipal and national levels should take greater account of citizen initiatives, such as energy cooperatives, which exhibit various noncommodifiable advantages relevant to the energy transition.
New Composite Measure for ADL Limitations: Application to Predicting Nursing Home Placement for Michigan MI Choice Clients
Authors: Hong Hyokyoung G. , An Hong-Su , Sarzynski Erin , Oberst Kathleen
Published: November 2019

Functional status measured by activities of daily living (ADL) may be used to predict nursing home placement. Scoring of ADL measures is summarized for convenience, yet this is accompanied by losing detail regarding deficits. We sought to determine whether a revised composite measure tailored to Michigan Medicaid beneficiaries would better identify those at risk for nursing home admission. We compared composite ADL measures created by exploratory factor analysis and additive modeling to Medicaid Enrollment, MI Choice Waiver program, and Nursing Facility claims data from 2013 to 2017. There were moderate to high levels of correlation between ADLs (.4-.82). Exploratory factor analysis extracted two factors, corresponding to domains of mobility or self-care tasks. Application of the self-care-based ADL limitations composite measure provided prediction power equivalent to an additive measure incorporating all ADL limitations for nursing home admission. This approach demonstrated improved interpretability with the need for just five measures.
The Effect of Ethnicity and Number of Co-Viewers on Affective and Cognitive Identification With Media Characters
Authors: Tal-Or Nurit
Published: November 2019

This research examines the distinctiveness of two components of identification with media characters: cognitive and affective. It also explores how these components are differentially affected by the viewing environment. In an experiment, Jewish and Arab Israelis watched a clip depicting the Israeli–Palestinian conflict with either one or two Jewish or Arab co-viewers. As hypothesized, these components of identification loaded on different factors and showed different relationships when referring to in-group and out-group characters. Moreover, the Jewish participants showed more affective identification with the Jewish protagonist when watching with two Arabs, which, in turn, affected their attitudes about the in-group.
Reflexivities as Affective Ways of Relating That Produce
Authors: Serra Undurraga Jacqueline Karen Andrea
Published: November 2019

In this article, I consider reflexivities (in plural) as affective ways of relating to ourselves/others/texts that produce. The way in which I relate to myself when I am reflexive expresses an implicit notion of subjectivity and, drawing on a Foucauldian understanding, produces this very subjectivity. Building from this, I engage Barad, perhaps counterintuitively given her challenge to reflexivity, to think about different reflexivities as apparatuses that produce the boundaries—the agential cuts—that create its objects (including the subjectivities involved). In that sense, each reflexivity produces its own world. Crucially, reflexivity is not produced by an isolated subject but from intra-actions. I invite the reader to question the ways in which we are relating to ourselves/others/texts—including how we engage affectively—and what they are doing. I suggest that different reflexivities can be useful in different contexts because of how they keep on producing these very contexts.
Latin American politics underground: Networks, rhizomes and resistance in cartonera publishing
Authors: Bell Lucy , O’Hare Patrick
Published: November 2019

Cartonera publishing emerged in post-crisis Buenos Aires with the birth of Eloísa cartonera (2003), whose founders proposed a radically new model of making books out of recycled cardboard, purchased from, and made with, cartoneros (waste-pickers). Since then, this model has been adapted across Latin America by an ever-growing number of collectives (currently around 250). In this article we ask: What relations and/or networks have enabled this model of underground cultural production to grow on such a scale? What modalities of resistance do they enable? Our contention is that Deleuze and Guattari’s theory of rhizomes helps in understanding the ways in which cartoneras work, network and spread. Examining texts and practices across Argentina, Mexico and Brazil through literary analysis and ethnography, we make a case for the political significance of cartonera networks and, more broadly, the possibilities afforded by rhizomatic formations for emerging modes of micro-political action and transnational cultural activism.
Kind mobile notifications for healthcare professionals
Authors: Serral Estefanía , Valderas Pedro , Derboven Jan
Published: November 2019

The inclusion of the Internet of Things in healthcare is producing numerous automatic notifications for health professionals. These notifications must be delivered in the right moment and in the right way to be appropriately attended, and at the same time, ensuring no important task is interrupted. In this work, we have applied a human-centred design method to deal with this issue. By collaborating with health professionals in Belgium, we have designed and validated DELICATE, a conceptual framework that categorizes the different attention needs for each notification, and links them with the delivery mechanisms that are more appropriate for each particular context. As an aid for designers, we also define methodological guidelines to clearly determine how DELICATE can be used to develop a notification system. Finally, as a proof-of-concept validation of the framework, we have implemented it in an Android application and tested it using real scenarios. This validation has shown that DELICATE can be used to design a notification system that delivers kind healthcare notifications.
Understanding the relationship between new media literacy, communication skills, and democratic tendency: Model development and testing
Authors: Tugtekin Esra Barut , Koc Mustafa
Published: November 2019

New media provides new sources of information and communication that are crucial for participatory behaviors. Therefore, scholars conceptualize new media literacy (NML) that citizens should have to function successfully in this digital era. This study proposed and tested a structural model that examines multiple relationships among NML, communication skills (CS), and democratic tendency (DT). Data were collected from 1047 Turkish university students and analyzed through structural equation modeling. Using a comprehensive theoretical framework from the literature, NML was operationalized through four factors: functional consuming (FC), critical consuming (CC), functional prosuming (FP), and critical prosuming (CP). The results showed that FC and FP had a positive effect on CC, CP, and CS; CC had a positive effect on CP and DT; and CS had a positive effect on CC and DT. Findings of indirect effects revealed that CC and CS played mediation roles in the relationship of FC and FP with DT.
Light, entrainment and alertness: A case study in offices
Authors: Figueiro MG , Steverson B , Heerwagen J , Yucel R , Roohan C , Sahin L , Kampschroer K , Rea MS
Published: November 2019

It is well established that light affects both visual and non-visual systems. Laboratory studies have shown that, depending upon the time of exposure, short-wavelength light of sufficient amount and exposure duration will either entrain or disrupt the synchrony between our biological clock and our local position on Earth. Laboratory studies have also shown that light across the entire visible spectrum can enhance alertness, both day and night. Scant attention has been given to testing the effects of light on building occupants’ non-visual responses, and, consequently, lighting specifiers have been offered little guidance on the design and application of lighting for non-visual effects. The present study helps to fill that gap through field-testing of light exposures from a novel luminaire designed to promote entrainment and alertness throughout the day in actual office environments. The data support the inference that light exposures, when properly applied, can promote circadian entrainment and increase alertness.
Hybrid design method for wind-adaptive architecture
Authors: Kabošová Lenka , Foged Isak , Kmeť Stanislav , Katunský Dušan
Published: November 2019

The linkage of individual design skills and computer-based capabilities in the design process offers yet unexplored environment-adaptive architectural solutions. The conventional perception of architecture is changing, creating a space for reconfigurable, “living” buildings responding, for instance, to climatic influences. Integrating the element of wind to the architectural morphogenesis process can lead toward wind-adaptive designs that in turn can enhance the wind microclimate in their vicinity. Geometric relations coupled with material properties enable to create a tensegrity-membrane structural element, bending in the wind. First, the properties of such elements are investigated by a hybrid method, that is, computer simulations are coupled with physical prototyping. Second, the system is applied to basic-geometry building envelopes and investigated using computational fluid dynamics simulations. Third, the findings are transmitted to a case study design of a streamlined building envelope. The results suggest that a wind-adaptive building envelope plays a great role in reducing the surface wind suction and enhancing the wind microclimate.
An introductory preview of Autonomous Intelligent Cyber-defense Agent reference architecture, release 2.0
Authors: Kott Alexander , Théron Paul , Mancini Luigi V , Dushku Edlira , Panico Agostino , Drašar Martin , LeBlanc Benoît , Losiewicz Paul , Guarino Alessandro , Pihelgas Mauno , Rzadca Krzysztof
Published: November 2019

The North Atlantic Treaty Organization (NATO) Research Task Group IST-152 developed a concept and a reference architecture for intelligent software agents performing active, largely autonomous cyber-defense actions on military assets. The group released a detailed report, briefly reviewed in this article, where such an agent is referred to as an Autonomous Intelligent Cyber-defense Agent (AICA).

In a conflict with a technically sophisticated adversary, NATO military networks will operate in a heavily contested battlefield. Enemy malware will likely infiltrate and attack friendly networks and systems. Today’s reliance on human cyber defenders will be untenable on the future battlefield. Instead, artificially intelligent agents, such as AICAs, will be necessary to defeat the enemy malware in an environment of potentially disrupted communications where human intervention may not be possible.

The IST-152 group identified specific capabilities of AICA. For example, AICA will have to be capable of autonomous planning and execution of complex multi-step activities for defeating or degrading sophisticated adversary malware, with the anticipation and minimization of resulting side effects. It will have to be capable of adversarial reasoning to battle against a thinking, adaptive malware. Crucially, AICA will have to keep itself and its actions as undetectable as possible, and will have to use deceptions and camouflage.

The report identifies the key functions and components and their interactions for a potential reference architecture of such an agent, as well as a tentative roadmap toward the capabilities of AICA.
Cancer antigen 125 is associated with disease status in uterine carcinosarcoma
Authors: Ross Malcolm Strachan , Chandler Chelsea Kilpatrick , Matsuo Koji , Vargo John Austin , Elishaev Esther , Siripong Nalyn , Berger Jessica Layne , Kelley Joseph Leo , Taylor Sarah Elizabeth
Published: November 2019

Uterine carcinosarcoma is a rare and aggressive tumor with poor outcomes. Cancer antigen 125 is routinely used to track the disease course of ovarian cancer and has been suggested as a biomarker in other aggressive forms of uterine cancer. We sought to characterize cancer antigen 125 as a potential biomarker of disease status in uterine carcinosarcoma. Clinical and pathological data were abstracted for patients who had surgical staging for a pathologically confirmed uterine carcinosarcoma at our institution from January 2000 to March 2014. Non-parametric tests were used to compare changes in cancer antigen 125. Elevated cancer antigen 125 (>35 U/mL) as a predictor of survival was assessed via Kaplan–Meier curves. Among the 153 patients identified, 66 patients had at least one paired measure of cancer antigen 125 drawn preoperatively, post-treatment, or at the time of disease recurrence, and 19 patients had cancer antigen–125 levels at all three time points. Analysis of the 51 patients with both preoperative and post-treatment values found a significant drop in cancer antigen 125 ( p < 0.001). Among the 30 patients who had end-of-treatment and recurrence levels, a significant increase was noted ( p = 0.001). There was no significant difference in cancer antigen–125 levels preoperatively compared to at recurrence among the 23 patients with levels at both time-points ( p = 0.99). Elevated preoperative cancer antigen 125 was not associated with overall survival ( p = 0.12); elevated post-treatment cancer antigen 125 was associated with a worse overall survival ( p < 0.001). Based on this dataset, there seems to be utility in trending a cancer antigen–125 level in patients with uterine carcinosarcoma. A cancer antigen–125 level could predict recurrence and provide prognostic information regarding survival.
Cannabidiol as a potential treatment for psychosis
Authors: Davies Cathy , Bhattacharyya Sagnik
Published: November 2019

Psychotic disorders such as schizophrenia are heterogeneous and often debilitating conditions that contribute substantially to the global burden of disease. The introduction of dopamine D2 receptor antagonists in the 1950s revolutionised the treatment of psychotic disorders and they remain the mainstay of our treatment arsenal for psychosis. However, traditional antipsychotics are associated with a number of side effects and a significant proportion of patients do not achieve an adequate remission of symptoms. There is therefore a need for novel interventions, particularly those with a non-D2 antagonist mechanism of action. Cannabidiol (CBD), a non-intoxicating constituent of the cannabis plant, has emerged as a potential novel class of antipsychotic with a unique mechanism of action. In this review, we set out the prospects of CBD as a potential novel treatment for psychotic disorders. We first review the evidence from the perspective of preclinical work and human experimental and neuroimaging studies. We then synthesise the current evidence regarding the clinical efficacy of CBD in terms of positive, negative and cognitive symptoms, safety and tolerability, and potential mechanisms by which CBD may have antipsychotic effects.
Walking pace improves all-cause and cardiovascular mortality risk prediction: A UK Biobank prognostic study
Authors: Argyridou Stavroula , Zaccardi Francesco , Davies Melanie J , Khunti Kamlesh , Yates Thomas
Published: November 2019

Aims

The purpose of this study was to quantify and rank the prognostic relevance of dietary, physical activity and physical function factors in predicting all-cause and cardiovascular mortality in comparison with the established risk factors included in the European Society of Cardiology Systematic COronary Risk Evaluation (SCORE).

Methods

We examined the predictive discrimination of lifestyle measures using C-index and R2 in sex-stratified analyses adjusted for: model 1, age; model 2, SCORE variables (age, smoking status, systolic blood pressure, total and high-density lipoprotein cholesterol).

Results

The sample comprised 298,829 adults (median age, 57 years; 53.5% women) from the UK Biobank free from cancer and cardiovascular disease at baseline. Over a median follow-up of 6.9 years, there were 2174 and 3522 all–cause and 286 and 796 cardiovascular deaths in women and men, respectively. When added to model 1, self-reported walking pace improved C-index in women and men by 0.013 (99% CI: 0.007–0.020) and 0.022 (0.017–0.028) respectively for all-cause mortality; and by 0.023 (0.005–0.042) and 0.034 (0.020–0.048) respectively for cardiovascular mortality. When added to model 2, corresponding values for women and men were: 0.008 (0.003–0.012) and 0.013 (0.009–0.017) for all-cause mortality; and 0.012 (–0.001–0.025) and 0.024 (0.013–0.035) for cardiovascular mortality. Other lifestyle factors did not consistently improve discrimination across models and outcomes. The pattern of results for R2 mirrored those for C-index.

Conclusion

A simple self-reported measure of walking pace was the only lifestyle variable found to improve risk prediction for all-cause and cardiovascular mortality when added to established risk factors.
Ultrafiltration in Pediatric Cardiac Surgery Review
Authors: Bierer Joel , Stanzel Roger , Henderson Mark , Sett Suvro , Horne David
Published: November 2019

Introduction:

The use of cardiopulmonary bypass in pediatric cardiac surgery is associated with significant inflammation, fluid overload, and end-organ dysfunction yielding morbidity and mortality. For decades, various intraoperative ultrafiltration techniques such as conventional ultrafiltration, modified ultrafiltration (MUF), zero-balance ultrafiltration (ZBUF), and combination techniques (ZBUF-MUF) have been used to mitigate these toxicities and promote improved postoperative outcomes. However, there is currently no consensus on the ultrafiltration technique or strategy that yields the most benefit for infants and children undergoing open heart surgery.

Methods:

A librarian-conducted PubMed literature search from 1990 to 2018 yielded 90 clinical studies or publications on the various forms of ultrafiltration and the impact on physiologic markers and clinical outcomes. All publications were reviewed, summarized, and conclusions synthesized. The data sets were not combined for systematic or meta-analysis due to significant heterogeneity in study protocols and patient populations.

Results:

Modified ultrafiltration significantly promotes improved myocardial function, reduction in fluid overload, and reduced bleeding and transfusion complications. Furthermore, ZBUF has shown a consistent reduction in inflammatory cytokines and improved pulmonary function and compliance. There is conflicting evidence that MUF, ZBUF, and ZBUF-MUF culminate in reduced ventilation time and intensive care unit stay.

Conclusion:

Various modes of ultrafiltration have been shown to be associated with improved physiologic function or clinical outcomes in pediatric cardiac surgery. There are some inconsistent trial results that can be explained by heterogeneity in ultrafiltration, clinical staff preferences, and institution protocols. Ultrafiltration has some essential benefit as it is ubiquitously used at pediatric heart centers; however, the optimal protocol could be yet identified.
Autologous Right Auricular Versus PTFE Cavopulmonary Lateral Tunnel: Influence of Surgical Technique on Arrhythmias
Authors: Arrigoni Sara C. , van den Heuvel Freek , Willems Tineke P. , Veeger Nic J.G.M. , Schoof Paul , Ebels Tjark
Published: November 2019

Background:

To compare the incidence of arrhythmias and the overall survival at long-term follow-up of the right auricular baffle technique (RA) versus Gore-Tex® (GT) baffle as intra-atrial cavopulmonary lateral tunnel, as well as the Nakata index and tunnel dimensions on cardiac magnetic resonance.

Methods:

Data were retrospectively collected. Serial 24-hour Holter recordings and cardiac magnetic resonance findings of the two groups were compared.

Results:

There was no significant difference in the estimated freedom from arrhythmias (87% at 10 years and 78% at 15 years vs 80% at 10 years and 70% at 15 years in RA and GT, respectively; P = .44) nor cumulative survival (86% at 10 years and 84% at 15 years vs 97% at 10 years and 81% at 15 years in RA and GT, respectively; P = .8). Also, no difference between the groups was observed in the Nakata index. The tunnel dimensions on cardiac magnetic resonance were significantly wider in the RA group. In reference to other potential risk indicators, using Cox proportional hazard regression analysis, only age (5 years or older at the time of total cavopulmonary connection) was associated with an increased risk for both arrhythmia and mortality.

Conclusions:

This study demonstrated that there was no difference in freedom from arrhythmias, Nakata index, or survival between the two groups. This study confirmed the growth potential of the right auricular tunnel. However, the growth of the tunnel did not influence the incidence of arrhythmias.
Ivabradine as an Adjunct for Refractory Junctional Ectopic Tachycardia Following Pediatric Cardiac Surgery: A Preliminary Study
Authors: Kumar Vivek , Kumar Gaurav , Tiwari Nikhil , Joshi Sajan , Sharma Vipul , Ramamurthy Ravi
Published: November 2019

Objectives:

Junctional ectopic tachycardia (JET) is a relatively common narrow complex rhythm typically characterized by atrioventricular dissociation or retrograde atrial conduction in a 1:1 pattern. Junctional ectopic tachycardia can be a life-threatening disorder, causing severe hemodynamic compromise and increased morbidity and mortality. The treatment of refractory JET can be very difficult, even with multimodal therapeutic interventions. The purpose of this study was to assess the role of ivabradine in cases of JET refractory to amiodarone and esmolol.

Methods:

A total of 480 congenital heart surgeries were carried out at our center in 2017. Twenty (4.16%) patients had postoperative JET. Among these, five infants, aged 7 to 12 months (median: 8 months), had refractory JET. These patients (three tetralogy of Fallot, one ventricular septal defect, one complete atrioventricular septal defect) were treated with oral ivabradine in the dose range of 0.1 to 0.2 mg/kg/12 h as an adjunct to amiodarone.

Results:

All five patients achieved rate reduction and eventual conversion to sinus rhythm. Mean duration to achieve heart rate of <140 bpm after initiation of ivabradine therapy was 16.8 hours (±7.2 hours), while mean duration to achieve sinus rhythm was 31.6 hours (±13.6 hours). No patient had any recurrence of JET. No patient exhibited any hemodynamic derangement nor side effects attributable to oral ivabradine.

Conclusion:

Oral ivabradine has the potential to be used as an adjunct to amiodarone in the treatment of JET in infants after surgery for congenital heart disease.
Olympic Ceremony and Diplomacy: South Korean, North Korean, and British Media Coverage of the 2018 Olympic Winter Games’ Opening and Closing Ceremonies
Authors: Lee Jung Woo
Published: November 2019

In this article, I examined South Korean, North Korean, and British newspaper coverage of the opening and closing ceremonies of the 2018 Winter Olympics in order to identify the diplomatic gestures and conduct presented during these ceremonial events. This study looks at three diplomatically important components of the opening and closing ceremonies: artistic performance, a parade of nations, and the presence of world leaders. The media coverage of these components reveals that (1) the dissemination of a message of peace and unity, (2) the representation of unified Korean identity and Korean cultural heritage, and (3) the communication and negotiation between the high-level state officials are the three most visible acts of diplomacy at these celebrational occasions of the 2018 PyeongChang Winter Olympics. In effect, the combination of cultural diplomacy, sport diplomacy, and interstate diplomacy is actively at work during these ritualistic events. Therefore, the Olympic ceremonies present a global podium where dynamic and dramatic games of diplomacy take place.
Surgical Anatomy of the Medial Cuneiform (Cotton) Osteotomy
Authors: Wei Baofu , Lau Brian C. , Amendola Annunziato
Published: November 2019

Background:

The Cotton osteotomy, or dorsal-opening wedge osteotomy of the medial cuneiform (MC), is used to address medial column alignment to restore the static-triangle of support. There are many described techniques regarding the incision and osteotomy. Successful completion of the osteotomy requires knowledge of the anatomy, particularly the location of the medial dorsal cutaneous nerve (MDCN). This study describes the relationship between MDCN, tibialis anterior, extensor-hallucis-longus tendon, and ligamentous attachments to the MC. A technique to determine a safe location for the osteotomy is also described.

Methods:

Twelve fresh-frozen adult foot specimens were used for this study (7 male and 5 female). The MDCN and its branches were dissected and its relationship with the MC was documented. Osteotomy tilt angle and relationship to structures around the MC were measured.

Results:

MDCN traveled medially and distally over the dorsum of the MC, and a small branch to the MC was observed. The tilt angle was 80.1 ±1.4 degrees. There was no significant difference between the distance from the distal-articular surface to the midline of the cuneiform and to the interosseous ligament ( P = .69), or between the distance from the distal-articular surface to the second tarsometatarsal joint and to the origin of the Lisfranc ligament ( P = .12).

Conclusions:

The dorsal-medial-oblique incision effectively protected MDCN and the MC. We believe the osteotomy should be performed in the safe zone to maintain the stability of the opening wedge.

Clinical relevance:

The dorsal-medial-oblique incision could reduce the risk of injury to the MDCN and the tibialis-anterior tendon.
An Attachment Including a +20-D Lens to Gain Extended Field Images in Wide-Angle Optical Coherence Tomography Angiography
Authors: Sawada Osamu , Mori Takamasa , Ichiyama Yusuke , Obata Shumpei , Kakinoki Masashi , Sawada Tomoko , Saishin Yoshitsugu , Ohji Masahito
Published: November 2019

Purpose:

This article evaluates the clinical usefulness of an attachment involving a +20-D lens to gain extended field images on wide-angle optical coherence tomography angiography (OCTA).

Methods:

An attachment with a +20-D lens was developed to take OCTA images of anterior segments, and it was used to obtain extended field images of the posterior segment in this study. Ten eyes of 5 individuals who did not have a history of ocular or systemic disease underwent wide-angle OCTA with a 12 × 12-mm center field using the PLEX Elite 9000 with and without the attachment. The ratio of the area of the center field to the area of the extended field with the attachment was calculated.

Results:

The mean area of the center image was 125 disc areas and that of the field extended by the attachment was 210 disc areas. The mean ratio between the center field and the extended field was 1.67.

Conclusions:

The attachment involving the +20-D lens seems to be clinically useful to gain extended field images on wide-angle OCTA.
PyGMQL: scalable data extraction and analysis for heterogeneous genomic datasets
Authors: Nanni Luca , Pinoli Pietro , Canakoglu Arif , Ceri Stefano
Published: November 2019

Background

With the growth of available sequenced datasets, analysis of heterogeneous processed data can answer increasingly relevant biological and clinical questions. Scientists are challenged in performing efficient and reproducible data extraction and analysis pipelines over heterogeneously processed datasets. Available software packages are suitable for analyzing experimental files from such datasets one by one, but do not scale to thousands of experiments. Moreover, they lack proper support for metadata manipulation.

Results

We present PyGMQL, a novel software for the manipulation of region-based genomic files and their relative metadata, built on top of the GMQL genomic big data management system. PyGMQL provides a set of expressive functions for the manipulation of region data and their metadata that can scale to arbitrary clusters and implicitly apply to thousands of files, producing millions of regions. PyGMQL provides data interoperability, distribution transparency and query outsourcing. The PyGMQL package integrates scalable data extraction over the Apache Spark engine underlying the GMQL implementation with native Python support for interactive data analysis and visualization. It supports data interoperability, solving the impedance mismatch between executing set-oriented queries and programming in Python. PyGMQL provides distribution transparency (the ability to address a remote dataset) and query outsourcing (the ability to assign processing to a remote service) in an orthogonal way. Outsourced processing can address cloud-based installations of the GMQL engine.

Conclusions

PyGMQL is an effective and innovative tool for supporting tertiary data extraction and analysis pipelines. We demonstrate the expressiveness and performance of PyGMQL through a sequence of biological data analysis scenarios of increasing complexity, which highlight reproducibility, expressive power and scalability.
VARUS: sampling complementary RNA reads from the sequence read archive
Authors: Stanke Mario , Bruhn Willy , Becker Felix , Hoff Katharina J.
Published: November 2019

Background

Vast amounts of next generation sequencing RNA data has been deposited in archives, accompanying very diverse original studies. The data is readily available also for other purposes such as genome annotation or transcriptome assembly. However, selecting a subset of available experiments, sequencing runs and reads for this purpose is a nontrivial task and complicated by the inhomogeneity of the data.

Results

This article presents the software VARUS that selects, downloads and aligns reads from NCBI’s Sequence Read Archive, given only the species’ binomial name and genome. VARUS automatically chooses runs from among all archived runs to randomly select subsets of reads. The objective of its online algorithm is to cover a large number of transcripts adequately when network bandwidth and computing resources are limited. For most tested species VARUS achieved both a higher sensitivity and specificity with a lower number of downloaded reads than when runs were manually selected. At the example of twelve eukaryotic genomes, we show that RNA-Seq that was sampled with VARUS is well-suited for fully-automatic genome annotation with BRAKER.

Conclusions

With VARUS, genome annotation can be automatized to the extent that not even the selection and quality control of RNA-Seq has to be done manually. This introduces the possibility to have fully automatized genome annotation loops over potentially many species without incurring a loss of accuracy over a manually supervised annotation process.
Hooked on you: shape of attachment structures in cymothoid isopods reflects parasitic strategy
Authors: Baillie Charles , Welicky Rachel L. , Hadfield Kerry A. , Smit Nico J. , Mariani Stefano , D. Beck Robin M.
Published: November 2019

Background

Parasite attachment structures are critical traits that influence effective host exploitation and survival. Morphology of attachment structures can reinforce host specificity and niche specialisation, or even enable host switching. Therefore, it is important to understand the determinants of variation in attachment structures. Cymothoid isopods are striking ectoparasites of fishes that include the infamous ‘tongue-biters.’ They are known to parasitise hosts in one of four qualitatively distinct anatomical regions. Here, we quantify variation in cymothoid attachment structures — hook-like appendages called dactyli — and test whether differences in dactylus shape are correlated with parasite mode (where they attach), allometry, or both, using multivariate ordinary least squares regression. We also assess the influence of shared ancestry on shape using a molecular phylogeny to weight our models using phylogenetic generalised least squares regression.

Results

We find clear differences in shape between externally-attaching and internally-attaching cymothoids but also between anterior and posterior dactyli across various species with the same attachment mode. Allometric effects are significant for anterior but not posterior dactyli. Mouth-attaching species show greater shape variability than gill- and mouth-attaching species. We find no evidence that there are clade-specific patterns of association between parasite mode and dactylus shape.

Conclusions

Parasite mode appears to be the main driver of attachment morphology. This likely reflects several components of parasite ecology including feeding and functional demands of attachment in different microhabitats. Geometric morphometric approaches to the quantification of shape variation of simple structures is an effective tool that provides new insights into the evolvability of parasite attachment.
The dating of thrombus organization in cases of pulmonary embolism: an autopsy study
Authors: Mansueto Gelsomina , Costa Dario , Capasso Emanuele , Varavallo Federica , Brunitto Giuseppina , Caserta Rosanna , Esposito Salvatore , Niola Massimo , Sardu Celestino , Marfella Raffaele , Napoli Claudio , Paternoster Mariano
Published: November 2019

Background

Pulmonary embolism (PE) is associated to high mortality rate worldwide. However, the diagnosis of PE often results inaccurate. Many cases of PE are incorrectly diagnosed or missed and they are often associated to sudden unexpected death (SUD). In forensic practice, it is important to establish the time of thrombus formation in order to determine the precise moment of death. The autopsy remains the gold standard method for the identification of death cause allowing the determination of discrepancies between clinical and autopsy diagnoses. The aim of our study was to verify the morphological and histological criteria of fatal cases of PE and evaluate the dating of thrombus formation considering 5 ranges of time.

Methods

Pulmonary vessels sections were collected from January 2010 to December 2017. Sections of thrombus sampling were stained with hematoxylin and eosin. The content of infiltrated cells, fibroblasts and collagen fibers were scored using a semi-quantitative three-point scale of range values.

Results

The 30 autopsies included 19 males (63.3%) and 11 females (36.7%) with an average age of 64.5 ± 12.3 years. The time intervals were as follows: early (≤1 h), recent (> 1 h to 24 h), recent-medium (> 24 h to 48 h), medium (> 48 h to 72 h) and old (> 72 h). In the first hour, we histologically observed the presence of platelet aggregation by immunofluorescence method for factor VIII and fibrinogen. The presence of lymphocytes has been identified from recent thrombus (> 1 h to 24 h) and the fibroblast cells were peripherally located in vascular tissue between 48 and 72 h, whereas they resulted central and copious after 72 h.

Conclusions

After a macroscopic observation and a good sampling traditional histology, it is important to identify the time of thrombus formation. We identified histologically a range of time in the physiopathology of the thrombus (early, recent, recent-medium, medium, old), allowing to determine the dating of thrombus formation and the exact time of death.

Clinical trial number

NCT03887819.

Trial registration

The trial registry is Cliniclatrials.gov, with the unique identifying number NCT03887819. The date of registration was 03/23/2019 and it was “Retrospectively registered”.
Rapidly declining trend of signet ring cell cancer of the stomach may parallel the infection rate of Helicobacter pylori
Authors: Ohyama Hiroshi , Yoshimura Dai , Hirotsu Yosuke , Amemiya Kenji , Amano Hiroyuki , Miura Yuko , Ashizawa Hiroshi , Nakagomi Keiko , Takaoka Shinya , Hosoda Kenji , Suzuki Yoji , Oyama Toshio , Hada Masao , Kojima Yuichiro , Mochizuki Hitoshi , Omata Masao
Published: November 2019

Background

Studies indicate that gastric cancer (GC) incidence has decreased, whereas signet ring cell carcinoma (SRC) incidence has increased. However, recent trends in GC incidence are unclear. We used our hospital cancer registry to evaluate the changes in the incidence of GC, SRC, and non-SRC (NSRC) over time in comparison to changes in theH. pyloriinfection rates over time.

Methods

We identified 2532 patients with GC enrolled in our registry between January 2007 and December 2018 and statistically analyzed SRC and NSRC incidence. TheH. pyloriinfection rate in patients with SRC was determined by serum anti-H. pyloriantibody testing, urea breath test, biopsy specimen culture, and immunohistochemical analysis (IHC) of gastric tissue. Additionally, genomic detection ofH. pyloriwas performed in SRCs by extracting DNA from formalin-fixed paraffin-embedded gastric tissue and targeting 16S ribosomal RNA ofH. pylori.

Results

Overall, 211 patients had SRC (8.3%). Compared with patients with NSRC, those with SRC were younger (P <  0.001) and more likely to be female (P <  0.001). Time series analysis using an autoregressive integrated moving average model revealed a significant decrease in SRC (P <  0.001) incidence; NSRC incidence showed no decline. There was no difference inH. pyloriinfection prevalence between the SRC and NSRC groups. IHC and genomic methods detectedH. pyloriin 30 of 37 (81.1%) SRCs.

Conclusions

Reduction inH. pyloriinfection prevalence may be associated with the decrease in the incidence of SRC, which was higher than that of NSRC.
Case report of congenital asplenia presenting with Haemophilus influenzae type a (Hia) sepsis: an emerging pediatric infection in Minnesota
Authors: Albrecht Tiffany , Poss Kristina , Issaranggoon Na Ayuthaya Satja , Triden Lori , Schleiss Katherine L. , Schleiss Mark R.
Published: November 2019

Background

In the pre-vaccine era, invasive disease with Haemophilus influenzae, type b (Hib) commonly presented with osteoarticular involvement. Haemophilus influenzae, type a (Hia) sepsis is a rare but emerging problem in recent years. Here, we report a case of sepsis with concomitant osteoarthritis due to Hia that was the presenting infectious disease manifestation of isolated asplenia in a young child. This unique observation adds to our understanding of sepsis and asplenia in children.

Case presentation

A five-year-old girl developed acute Hia bacteremia and sepsis. The patient developed arthritis shortly after onset of septic shock. Arthrocentesis was culture-negative, but given the difficulty differentiating between septic and reactive arthritis, prolonged antibiotic administration was provided for presumed osteoarticular infection, and the patient had an uneventful recovery. The finding of Howell-Jolly bodies on blood smear at the time of presentation prompted an evaluation that revealed isolated congenital asplenia. Evaluation for known genetic causes of asplenia was unrevealing. Investigation by the Minnesota Department of Health revealed an emergence of Hia infections over the past 5 years, particularly in children with an American Indian background.

Conclusions

Hia is an important pathogen in the differential diagnosis of invasive bacterial infections in children and shares overlap in clinical presentation and pathogenesis with Hib. Invasive Hia disease can be a presenting manifestation of asplenia in children. Hia is an emerging pathogen in American Indian children.
Prevalence of self-reported mental disorders in pregnancy and associations with adverse neonatal outcomes: a population-based cross-sectional study
Authors: Mongan David , Lynch Janine , Hanna Donncha , Shannon Ciaran , Hamilton Shona , Potter Claire , Gorman Colin , McCambridge Orlagh , Morrow Rachel , Mulholland Ciaran
Published: November 2019

Background

Mental disorders in pregnancy are common causes of morbidity and mortality with associated risks of adverse neonatal outcomes. Our aims were to evaluate the prevalence of self-reported mental disorders in women presenting to maternity services and to determine the association between history of self-reported maternal mental disorder and adverse neonatal outcomes.

Methods

Data on all singleton pregnancies known to maternity services in Northern Ireland over the period 2010 to 2015 were extracted from the Northern Ireland Maternity System (NIMATS), including frequency data for number of pregnancies where the mother reported a history of mental disorder. Odds ratios were derived from logistic regression analyses to determine the associations between self-reported maternal mental disorder and preterm birth, low infant birth weight and APGAR scores.

Results

In total, 140,569 singleton pregnancies were registered using NIMATS over this period. In 18.9% of these pregnancies, the mother reported a history of at least one mental disorder. After adjustment for potential confounding factors, significant associations were demonstrated between self-reported maternal mental disorder and preterm birth (odds ratio [OR] 1.31, 95% confidence interval [CI] 1.25–1.37), low infant birth weight (OR 1.29, 95% CI 1.21–1.38) and APGAR score < 7 at 1 min (OR 1.14, 95% CI 1.10–1.19) and 5 min (OR 1.23, 95% CI 1.12 to 1.34).

Conclusions

These findings emphasise the critical importance of routine enquiry regarding psychiatric history when women present to maternity services and the impact of maternal mental illnesses upon outcomes for their infants.