bluuebunny/crossref_metadata_2025 huggingface dataset:
The evolution and application of carrying capacity in aquaculture: towards a research agenda
Authors: Weitzman Jenny , Filgueira Ramón
Published: August 2019

Carrying capacity has become a fundamental concept within the context of environmental management. Carrying capacity for aquaculture has been studied since the 1960s and has attracted a dedicated literature focused on measuring the environmental and production limits of aquaculture developments. Nevertheless, management and policy face emerging challenges across environmental and social aspects and the growing need to manage multiple objectives in increasingly crowded aquatic ecosystems. Therefore, promoting more sustainable aquaculture development should consider how the tools, methods and research used to support management and decision‐making should advance to meet such challenges. Here, the conceptual and practical applications of carrying capacity are reviewed and future prospects discussed. Carrying capacity for aquaculture has developed a range of models, indicators and approaches to study the relationships between aquaculture and ecosystem components. Carrying capacity supports diverse management objectives to support physical, production, ecological and social goals, although greater emphasis has focused on ecological and production capacities. This review introduces research needs and strategies to advance methods and tools and improve carrying capacity utilization for more holistic, ecosystem‐based aquaculture decision‐making. This paper presents a five‐pillar research agenda for carrying capacity that (i) recognizes system complexity and is (ii) policy‐relevant, (iii) adaptive, (iv) interdisciplinary and (v) meaningful. By promoting knowledge uptake and addressing literature gaps, the proposed agenda could help operationalize a holistic approach to managing for aquaculture sustainability.
Outcome-Dependent Sampling in Cluster-Correlated Data Settings with Application to Hospital Profiling
Authors: McGee Glen , Schildcrout Jonathan , Normand Sharon-Lise , Haneuse Sebastien
Published: August 2019

Hospital readmission is a key marker of quality of healthcare and an important policy measure, used by the Centers for Medicare and Medicaid Services to determine, in part, reimbursement rates. Currently, analyses of readmissions are based on a logistic–normal generalized linear mixed model that permits estimation of hospital-specific measures while adjusting for case mix differences. Recent moves to identify and address healthcare disparities call for expanding case mix adjustment to include measures of socio-economic status while minimizing additional burden to hospitals associated with collecting data on such measures. Towards resolving this dilemma, we propose that detailed socio-economic data be collected on a subsample of patients via an outcome-dependent sampling scheme, specifically the cluster-stratified case–control design. Estimation and inference, for both the fixed and the random-effects components, are performed via pseudo-maximum-likelihood wherein inverse probability weights are incorporated in the usual integrated likelihood to account for the design. In comprehensive simulations, cluster-stratified case–control sampling proves to be an efficient design whenever interest lies in fixed or random effects of a generalized linear mixed model and covariates are unobserved or expensive to collect. The methods are motivated by and illustrated with an analysis of N = 889661 Medicare beneficiaries hospitalized between 2011 and 2013 with congestive heart failure at one of K = 3116 hospitals. Results highlight that the framework proposed provides a means of mitigating disparities in terms of which hospitals are indicated as being poor performers, relative to a naive analysis that fails to adjust for missing case mix variables.
One‐step deposition of nano‐to‐micron‐scalable, high‐quality digital image correlation patterns for high‐strain in‐situ multi‐microscopy testing
Authors: Hoefnagels J.P.M. , van Maris M.P.F.H.L. , Vermeij T.
Published: August 2019

Digital image correlation (DIC) is of vital importance in the field of experimental mechanics, yet producing suitable DIC patterns for demanding in‐situ (micro)mechanical tests remains challenging, especially for ultrafine patterns, despite the large number of patterning techniques reported in the literature. Therefore, we propose a simple, flexible, one‐step technique (only requiring a conventional physical vapour deposition machine) to obtain scalable, high‐quality, robust DIC patterns, suitable for a range of microscopic techniques, by deposition of a low‐melting temperature solder alloy in the so‐called island growth mode, without elevating the substrate temperature. Proof of principle is shown by (near‐)room temperature deposition of InSn patterns, yielding highly dense, homogeneous DIC patterns over large areas with a feature size that can be tuned from as small as ~10 nm to ~2 μm and with control over the feature shape and density by changing the deposition parameters. Pattern optimisation, in terms of feature size, density, and contrast, is demonstrated for imaging with atomic force microscopy, scanning electron microscopy, optical profilometry, and optical microscopy. Moreover, the performance of the InSn DIC patterns and their robustness to large deformations is validated in two challenging case studies of in‐situ micromechanical testing: (a) self‐adaptive isogeometric digital height correlation of optical surface height profiles of a coarse, bimodal InSn pattern providing microscopic 3D deformation fields (illustrated for delamination of Al stretchable interconnects on a PI substrate) and (b) DIC on scanning electron microscopy images of a much finer InSn pattern allowing quantification of high strains near fracture locations (illustrated for rupture of a polycrystalline Fe foil). As such, the high controllability, performance, and scalability of the DIC patterns, created by island growth of a solder alloy, offer a promising step towards more routine DIC‐based in‐situ micromechanical testing.
Serological evidence of Borrelia circulation among blood donors in the São Paulo state, Brazil
Authors: Slavov S. N. , Christova I. S. , Ferreira A. R. , Rodrigues E. S. , Bianquini M. L. , Hespanhol M. R. , Covas D. T. , Kashima S.
Published: August 2019

Objective

The objective of this study was to examine the Borrelia seroprevalence among blood donors in Southeast Brazil.

Background

There is evidence that Borrelia spirochetes are circulating in Brazil; however, there are no studies that characterise these bacteria and investigate their seroprevalence in the Brazilian population. Such a situation, combined with a recent outbreak of tick‐borne Rocky Mountain spotted fever in the São Paulo state demonstrates the increasing role of ticks as arthropod vectors in Brazil.

Methods

For the purpose of the study, 452 blood donors from Ribeirão Preto city, São Paulo state were tested using anti‐Borrelia immunoglobulin G (IgG) assay. The positive results were also confirmed by Western blot for anti‐borrelia IgM/IgG.

Results

The anti‐Borrelia IgG enzyme‐linked immunosorbent assay (ELISA) showed nine positive and nine borderline reactive samples, giving a total seroprevalence of 2·0% of anti‐Borrelia IgG among Brazilian blood donors. The confirmation of the seropositive and borderline samples by Borrelia Western blot was demonstrated by IgG‐positive results in 16 samples (a seroprevalence of 3.5%). Anti‐Borrelia IgM antibodies were also detected in one sample.

Conclusions

Our results demonstrate that Borrelia‐like spirochetes may be circulating among blood donors from the São Paulo State and that the ticks have an important epidemiological role as vectors of bacterial infections in this Brazilian region. These results not only alert us to possible actions that might be undertaken in order to completely characterise the aetiological agents of Lyme‐like syndromes in Brazil but also the possible impact that these bacterial agents might have on haemotherapy practices.
Cannabis glandular trichomes alter morphology and metabolite content during flower maturation
Authors: Livingston Samuel J. , Quilichini Teagen D. , Booth Judith K. , Wong Darren C. J. , Rensing Kim H. , Laflamme‐Yonkman Jessica , Castellarin Simone D. , Bohlmann Joerg , Page Jonathan E. , Samuels A. Lacey
Published: August 2019

The cannabis leaf is iconic, but it is the flowers of cannabis that are consumed for the psychoactive and medicinal effects of their specialized metabolites. Cannabinoid metabolites, together with terpenes, are produced in glandular trichomes. Superficially, stalked and sessile trichomes in cannabis only differ in size and whether they have a stalk. The objectives of this study were: to define each trichome type using patterns of autofluorescence and secretory cell numbers, to test the hypothesis that stalked trichomes develop from sessile‐like precursors, and to test whether metabolic specialization occurs in cannabis glandular trichomes. A two‐photon microscopy technique using glandular trichome intrinsic autofluorescence was developed which demonstrated that stalked glandular trichomes possessed blue autofluorescence correlated with high cannabinoid levels. These stalked trichomes had 12–16 secretory disc cells and strongly monoterpene‐dominant terpene profiles. In contrast, sessile trichomes on mature flowers and vegetative leaves possessed red‐shifted autofluorescence, eight secretory disc cells and less monoterpene‐dominant terpene profiles. Moreover, intrinsic autofluorescence patterns and disc cell numbers supported a developmental model where stalked trichomes develop from apparently sessile trichomes. Transcriptomes of isolated floral trichomes revealed strong expression of cannabinoid and terpene biosynthetic genes, as well as uncharacterized genes highly co‐expressed withCBDAsynthase. Identification and characterization of two previously unknown and highly expressed monoterpene synthases highlighted the metabolic specialization of stalked trichomes for monoterpene production. These unique properties and highly expressed genes of cannabis trichomes determine the medicinal, psychoactive and sensory properties of cannabis products.
Asymmetric cultural discounting and pattern of trade in cultural products: Empirical evidence in motion pictures
Authors: Shin Sunny Y. , McKenzie Jordi
Published: August 2019

We extend the seminal home market effect model of Helpman and Krugman (Market structure and foreign trade, MIT Press, Cambridge, MA, 1985) by incorporating asymmetric cultural discounting. In addition to the home market effect, our model predicts that a country subject to a relatively lower cultural discount factor becomes a net exporter as trade liberalisation accelerates. Using international box office revenues in the motion picture industry and developing a measure of asymmetric cultural discount based on tourist‐arrival statistics, we find empirical support for this hypothesis. Our model provides an explanation for the continued cultural dominance of smaller English‐speaking countries in larger non‐English‐speaking countries, which cannot be explained by the home market effect alone.
Effect of single dose administration activated charcoal containing sorbitol on serum sodium concentration and hydration status in dogs
Authors: Mix Katherine A. , Stafford Jennifer , Hofmeister Erik
Published: August 2019

Objective

To assess the administration of a commercially available activated charcoal suspension with sorbitol (ACS) on serum sodium concentrations and hydration status in healthy dogs.

Design

Prospective study.

Setting

Private referral hospital.

Animals

Nine healthy adult dogs.

Interventions

Dogs were administered 1 mg/kg maropitant (Cerenia; Pfizer Animal Health, New York, NY) intravenously 1 hour prior to charcoal administration. Dogs were administered a single dose of 2 g/kg ACS.

Measurements and Main Results

Blood samples and body weights were obtained prior to charcoal administration and 2, 4, 6, 8, 10, and 12 hours post ACS administration. Venous sodium, potassium, chloride, blood urea nitrogen, creatinine, lactate, packed cell volume, and total plasma protein were measured at each time interval. All dogs returned 2–4 weeks after ACS administration for a 12 hour period of water restriction and to serve as their own control group. The same measurements were repeated during water restriction period as following ACS administration. The increase in serum sodium concentration was significantly higher following ACS administration when compared to control period (P = 0.0002). All dogs administered ACS experienced a significant degree of weight loss (P = 0.0371) when compared to the control period. Following administration of ACS, the hematocrit of the dogs administered ACS was found to be significantly increased (P = 0.0001), when compared to the control period.

Conclusion

Patients that are administered a single dose of ACS are at risk of developing dehydration and secondary hypernatremia as observed in the dogs during the study period. Patients receiving ACS should have electrolytes monitored and would benefit from fluid therapy as previously recommended.
Evaluation of validity and limitations of the soybean canopy height‐to‐row spacing ratio as an onsite index to control weeds using diverse soybean accessions
Authors: Kurokawa Shunji , Kaga Akito , Tsuda Mai , Sekine Daisuke , Shibuya Tomoko
Published: August 2019

A canopy height‐to‐row spacing ratio (CHRSR) of 1.0 is expected to be a simple and practical onsite index for soybean growers to determine when further weed control is no longer necessary. This is decided when relative photosynthetic photon flux density (PPFD) reaches 50% under the soybean canopy. To evaluate the validity of this index, a 2‐year field experiment was conducted to compare days after sowing (DAS) to reach a relative PPFD of 50% (defined as PPFD50) and DAS to reach a CHRSR of 1.0 (defined as CHRSR1.0) in 190 accessions with different canopy architectures from a soybean core collection. A total of 104 accessions, for which final relative PPFD reached <10% in 2014, were examined for the differences between CHRSR1.0 and PPFD50. The mean and median values of the difference in 2014 were 0.02 and 2.2, respectively. Similarly, the mean and median values in 2015 were 2.8 and 2.6, respectively. Thus, CHRSR1.0 tended to be achieved slightly later than PPFD50, so a consideration was made that there would be a negligible risk of failure if growers used CHRSR1.0 to determine the termination time for weed control in the most of accessions. Although there were some accessions with a standing type of morphological characteristics or with a smaller or narrower leaf, showing negative differences between CHRSR1.0 and PPFD50 larger than 1 week, a CHRSR of 1.0 could be used to estimate PPFD50 in most of accessions without risk of failure to control weeds.
Changes in skin blood flow, respiration and blood pressure in participants reporting motion sickness during sinusoidal galvanic vestibular stimulation
Authors: Javaid Anadil , Chouhna Houda , Varghese Ben , Hammam Elie , Macefield Vaughan G.
Published: August 2019

New Findings

What is the central question of the study?

We have previously shown that sinusoidal galvanic vestibular stimulation induces greater modulation of skin sympathetic nerve activity, but not muscle sympathetic nerve activity, in participants who report nausea during simulated motion, but the effects on skin blood flow and blood pressure are unknown.

What is the main finding and its importance?

During vestibular stimulation, nausea was associated with a greater increase in skin blood flow and a progressive reduction in skin sympathetic nerve activity, but no changes in muscle sympathetic nerve activity. This emphasizes the differential changes in sympathetic outflow to different tissues during nausea.

We tested the hypothesis that galvanic vestibular stimulation, which produces illusions of side‐to‐side swaying, causes a greater reduction in skin blood flow in participants who report stimulation‐induced nausea. A retrospective analysis was performed on data obtained in 30 participants. Bipolar sinusoidal galvanic vestibular stimulation (sGVS) was applied across the mastoid processes (±2 mA, 0.08 Hz) for 21 min. ECG, continuous blood pressure, respiration and skin blood flow were recorded. Muscle sympathetic nerve activity was recorded in 17 participants and skin sympathetic nerve activity in 12. Ten participants reported motion sickness, whereas 20 did not. Both groups showed an initial reduction in skin (finger) blood flow during sGVS, followed by a sustained increase and a subsequent return towards baseline levels throughout the stimulation; the increase was greater in those who experienced nausea. The increase fits with the progressive reduction in skin sympathetic nerve activity observed in the nauseous group. Mean blood pressure was significantly lower in those who experienced nausea and showed a much larger increase at the onset of sGVS, compared with those who did not. Moreover, the respiratory rate was higher at the outset for the subjects who experienced nausea, decreasing progressively during sGVS, whereas respiratory rate remained constant in those who did not experience nausea. Heart rate was more labile in the subjects who experienced nausea, showing a sustained increase towards the end of stimulation. We have shown that several autonomic parameters change during the nausea induced by vestibular stimulation, but a sustained decrease in skin blood flow is not a hallmark of incipient motion sickness.
A new species of Phytoscutus Muma (Acari: Mesostigmata: Phytoseiidae) from Amazonas state, Brazil, with redefinition of the sexpilis species group Chant & McMurtry and a key to the world species of the genus

Authors: Demite Peterson R. , Cruz Wilton P. da , Cavalcante Ana C. C.
Published: August 2019

A new species, Phytoscutus moraesi n. sp., is described based on specimens collected on Arecaceae plants, in Amazonas state, Brazil. Phytoscutus moraesi n. sp. is included in the sexpilis species group Chant & McMurtry, which is herein redefined to accommodate this new species. A key is provided for the world species of Phytoscutus.
Two new species of Pseudopygmephorellus (Acari: Heterostigmata: Pygmephoridae) phoretic on beetles of the genus Rhyparus (Coleoptera: Scarabaeidae: Aphodiinae) from Papua New Guinea and Indonesia

Authors: Khaustov Alexander , Frolov Andrey
Published: August 2019

Two new species of Pseudopygmephorellus Khaustov, 2008 (Acari: Prostigmata: Pygmephoridae) are described: P. orientalis sp. nov., collected on Rhyparus breviceps in Papua New Guinea and R. sumatrensis in Sumatra, Indonesia; and P. ovalisetus sp. nov., collected on R. breviceps in Papua New Guinea. A key to world species of Pseudopygmephorellus is provided.
Fabrication of the nanofluidic channels type leak assembly based on the glass frit sealing method
Authors: Zhou Wentian , Bi Hailin , Yu Zhenhua , Wang Xudi , Cheng Yongjun , Xi Zhenhua , Wei Wei
Published: August 2019

The Torr-Seal gluing method was often used to attach the nanofabricated leak elements to the vacuum system. However, such new leaks are difficult to be applied in ultrahigh vacuum due to the strong outgassing effect of Torr-Seal. To eliminate such issue and achieve enclosed sealing of leak element and CF flange, a new nanofluidic channels type leak assembly has been fabricated based on the glass frit sealing method. Nanofluidic channels with a feature dimension of ∼162 nm were enclosed as a leak element using reactive ion etching and silicon direct bonding processes. The outgassing rate of the leak assembly was analyzed by a residual gas analyzer. The results exhibit that the outgassing rate with the glass paste is 1 order of magnitude lower than that with the Torr-Seal. The flow conductance of helium, nitrogen, and argon was characterized by the difference method. It is found that the measured values are close to the calculated values and the molecular flow is achieved from vacuum to atmosphere pressure.
Sedentary and Physical Activity Behavior in “Blue-Collar” Workers: A Systematic Review of Accelerometer Studies
Authors: Gilson Nicholas D. , Hall Caitlin , Holtermann Andreas , van der Beek Allard J. , Huysmans Maaike A. , Mathiassen Svend Erik , Straker Leon
Published: August 2019

Background: This systematic review assessed evidence on the accelerometer-measured sedentary and physical activity (PA) behavior of nonoffice workers in “blue-collar” industries. Methods: The databases CINAHL, Embase, MEDLINE, PubMed, and Scopus were searched up to April 6, 2018. Eligibility criteria were accelerometer-measured sedentary, sitting, and/or PA behaviors in “blue-collar” workers (≥10 participants; agricultural, construction, cleaning, manufacturing, mining, postal, or transport industries). Data on participants’ characteristics, study protocols, and measured behaviors during work and/or nonwork time were extracted. Methodologic quality was assessed using a 12-item checklist. Results: Twenty studies (representing 11 data sets), all from developed world economies, met inclusion criteria. The mean quality score for selected studies was 9.5 (SD 0.8) out of a maximum of 12. Data were analyzed using a range of analytical techniques (eg, accelerometer counts or pattern recognition algorithms). “Blue-collar” workers were more sedentary and less active during nonwork compared with work time (eg, sitting 5.7 vs 3.2 h/d; moderate to vigorous PA 0.5 vs 0.7 h/d). Drivers were the most sedentary (work time 5.1 h/d; nonwork time 8.2 h/d). Conclusions: High levels of sedentary time and insufficient PA to offset risk are health issues for “blue-collar” workers. To better inform interventions, research groups need to adopt common measurement and reporting methodologies.
A Carbonic Anhydrase Pseudogene Sensitizes Select
Brucella
Lineages to Low CO
2
Tension
Authors: Varesio Lydia M. , Willett Jonathan W. , Fiebig Aretha , Crosson Sean
Published: August 2019

Brucella
spp. are highly related, but they exhibit differences in animal host preference that must be determined by genome sequence differences.
B. ovis
and the majority of
B. abortus
strains require high CO
2
tension to be cultivated
in vitro
and harbor conserved insertional mutations in the carbonic anhydrase gene,
bcaA
, which underlie this trait. Mutants that grow in a standard atmosphere, first reported nearly a century ago, are easily selected in the laboratory. These mutants harbor varied indel polymorphisms in
bcaA
that restore its consensus reading frame and rescue its function. Loss of
bcaA
function has evolved independently in the
B. ovis
and
B. abortus
lineages and results in a dramatically increased sensitivity to CO
2
limitation.
Evaluation of a Novel Multiplex High-Definition PCR Assay for Detection of Tick-Borne Pathogens in Whole-Blood Specimens
Authors: Buchan Blake W. , Jobe Dean A. , Mashock Michael , Gerstbrein Derek , Faron Matthew L. , Ledeboer Nathan A. , Callister Steven M.
Published: August 2019

The prevalence of tick-borne infections has been steadily increasing in both number and geographic distribution in the United States and abroad. This increase, in conjunction with the continued recognition of novel pathogens transmitted by ticks, has made accurate diagnosis of these infections challenging. Mainstay serologic tests are insensitive during the acute phase of infection and are often cross-reactive with similar pathogenic and nonpathogenic organisms.
A genetic link between iron oxide-apatite and iron skarn mineralization in the Jinniu volcanic basin, Daye district, eastern China: Evidence from magnetite geochemistry and multi-mineral U-Pb geochronology
Authors: Hu Hao , Li Jian-Wei , Harlov Daniel E. , Lentz David R. , McFarlane Christopher R.M. , Yang Yue-Heng
Published: August 2019

Various styles of ore deposits may form from a single magmatic-hydrothermal system. Identification of a possible genetic link between different ore types in a region is not only of critical importance for a better understanding of the magmatic-hydrothermal processes, but can also help in successful mineral exploration. Both iron oxide-apatite (IOA) and iron skarn deposits are closely associated with intrusive rocks of intermediate to felsic in composition, but whether these two ore types can form from the same magmatic intrusion remains poorly understood. In this study, we present a comparative study between a newly identified subsurface IOA ore body located at the apex of a diorite porphyry and the iron skarn ore bodies located immediately above it in the Jinniu volcanic basin of the Daye district, Middle-Lower Yangtze River metallogenetic belt (MLYRMB), eastern China in order to highlight a genetic link between these two styles of mineralization. The IOA ores are dominated by Ti-rich magnetite with variable amounts of fluorapatite, diopside, and actinolite. This mineralogical assemblage is distinctly different from the iron skarn ores, which consist mainly of Ti-depleted magnetite and subordinate pre-ore garnet and diopside, and post-ore quartz, chlorite, calcite, and pyrite. In addition, magnetite from the IOA ores is characterized by well-developed ilmenite lamellae and has high concentrations of Ni, V, Co, and Ga, consistent with high temperature crystallization, whereas magnetite grains from the iron skarn ores usually exhibit oscillatory growth zones and contain much lower Ni, V, Co, and Ga, indicating their formation under relatively low temperatures. Titanite and fluorapatite from the IOA ores have U-Pb ages of 132.5 ± 2.4 Ma to 128.4 ± 3.0 Ma, which match a titanite U-Pb age for the associated iron skarn ores (132.3 ± 2.0 Ma), and are consistent with zircon U-Pb ages for the ore-hosting diorite porphyry (130.4 ± 0.7 Ma to 130.3 ± 0.5 Ma). This age consistency supports a possible genetic link among the diorite porphyry, IOA ores, and iron skarn ores. We propose that the IOA and skarn ores are the products of two consecutive mineralization stages of the same magmatic-hydrothermal system, involving a high-temperature, hypersaline fluid coexisting with the diorite porphyry magma during emplacement and a subsequent low temperature, diluted hydrothermal fluid. Other IOA and iron skarn deposits of similar ages (130 Ma) are found in a series of volcanic basins in the MLYRMB, which forms one of the world’s largest IOA metallogenic belts. The close association of the two ore styles identified at Daye provides a useful exploration guide for IOA and iron skarn deposits both on a local and regional scale.
Linking the progressive expansion of reducing conditions to a stepwise mass extinction event in the late Silurian oceans
Authors: Bowman Chelsie N. , Young Seth A. , Kaljo Dimitri , Eriksson Mats E. , Them Theodore R. , Hints Olle , Martma Tõnu , Owens Jeremy D.
Published: August 2019

The late Ludlow Lau Event was a severe biotic crisis in the Silurian, characterized by resurgent microbial facies and faunal turnover rates otherwise only documented during the “big five” mass extinctions. This asynchronous late Silurian marine extinction event preceded an associated positive carbon isotope excursion (CIE), the Lau CIE, although a mechanism for this temporal offset remains poorly constrained. Here, we report thallium isotope data from locally reducing late Ludlow strata within the Baltic Basin to document the earliest onset of global marine deoxygenation. The initial expansion of anoxia coincided with the onset of the extinction and therefore preceded the Lau CIE. Additionally, sulfur isotope data record a large positive excursion parallel to the Lau CIE, interpreted to indicate an increase in pyrite burial associated with the widely documented CIE. This suggests a possible global expansion of euxinia (anoxic and sulfidic water column) following deoxygenation. These data are the most direct proxy evidence of paleoredox conditions linking the known extinction to the Lau CIE through the progressive expansion of anoxia, and most likely euxinia, across portions of the late Silurian oceans.
Novel clinical phenotype of generalised lymphatic dysplasia in a neonate: a missed diagnosis
Authors: Abiramalatha Thangaraj , Johnson Thanka , Balakrishnan Umamaheswari , Amboiram Prakash
Published: August 2019

We report a preterm neonate who had a large cervical cystic hygroma and right chylothorax. She was operated on day-21 and a near-complete resection of cystic hygroma was done. She developed refractory hypoxemia and shock post surgery and died after 24 hours. During autopsy, the chest cavity was found to be filled with chyle. Histopathological examination showed dilated lymphatics in the pleura, hepatic capsule, serosa of stomach and intestines, peri-pancreatic regions, peri-renal capsule and peri-adrenal tissues suggestive of generalised lymphatic dysplasia. Clinical exome sequencing did not reveal any pathogenic mutation in the genes involved in primary lymphatic dysplasia, noonan syndrome or rasopathies.
High-risk squamous cell carcinoma and its impact on a 62-year-old male surgeon
Authors: Jubran Jubran , Sengelmann Roberta D
Published: August 2019

Cutaneous squamous cell carcinoma (cSCC) is a form of non-melanoma skin cancer responsible for more deaths in the USA than all other skin cancers combined. Some features, including anatomic site, are considered high risk in nature and pose a challenge for complete tumour removal. We present a case of a 62-year-old male surgeon with a multiply recurrent cSCC of the right conchal bowl. The tumour described herein was doubly recurrent to excision with a standard margin and could ultimately not be cleared with Mohs micrographic surgery. Ultimately, it necessitated auriculectomy and parotidectomy. This case exemplifies the pitfalls of traditional wide local excision with standard pathologic processing for high-risk cSCC.
Initiation of levothyroxine in a patient with hypothyroidism inducing adrenal crisis requiring VA ECMO: a tale of preventable disaster
Authors: Kang Mandip Singh , Sandhu Charnjeet Singh , Singh Natasha , Evans Timothy
Published: August 2019

A 31-year-old man with a recent diagnosis of hypothyroidism presented to the emergency department as a transfer from the clinic for severe hypotension and hypoglycaemia. The patient endorsed a 2-week history of severe fatigue, weight loss, nausea and non-bloody emesis. He was aggressively hydrated and vasopressors were initiated. Despite these measures, the patient remained hypotensive and went into pulseless electrical activity. Return of spontaneous circulation was achieved via advanced cardiac life support protocol, and venous arterial extracorporeal membrane oxygenation (ECMO) was initiated. On day 3 of hospitalisation, the patient was weaned off ECMO support, and subsequent autoimmune work-up confirmed the diagnosis of autoimmune polyglandular syndrome type 2 with positive antiperoxidase antibodies (267 IU/mL), supporting the diagnosis of Hashimoto’s thyroiditis.
Multidrug-resistant tuberculosis (MDR-TB) and multidrug-resistant HIV (MDR-HIV) syndemic: challenges in resource limited setting
Authors: Francisco Christian , Lansang Mary Ann , Salvana Edsel Maurice , Leyritana Katerina
Published: August 2019

Tuberculosis (TB) is common among persons living with HIV. This public health concern is aggravated by infection with multidrug-resistant organisms and adverse effects of polypharmacy. There are few published cases of multidrug-resistant tuberculosis (MDR-TB) in multidrug-resistant HIV (MDR-HIV) infected patients. We report a case of a 29-year-old Filipino man with HIV on zidovudine (AZT)-containing antiretroviral therapy (ART) but was eventually shifted to tenofovir due to anaemia. He presented with left flank tenderness, which was found to be due to an MDR-TB psoas abscess, and for which second-line anti-TB treatment was started. HIV genotyping showed MDR-HIV infection susceptible only to AZT, protease inhibitors and integrase inhibitors. Subsequently, he developed neck abscess that grewMycobacterium aviumcomplex and was treated with ethambutol and azithromycin. ART regimen was revised to AZT plus lamivudine and lopinavir/ritonavir. Erythropoietin was administered for recurrent AZT-induced anaemia. Both abscesses resolved and no recurrence of anaemia was noted.
Calciphylaxis due to metastatic well-differentiated neuroendocrine carcinoma
Authors: Afridi Summia Matin , Raja Ahmad , Zhou Xia , Jain Akriti
Published: August 2019

A 70-year-old man with history of metastatic well-differentiated neuroendocrine carcinoma was presented to the hospital with a painful left lower extremity ulcer which started around 3 months prior to presentation. He was treated with antibiotics for cellulitis on multiple occasions with no improvement in his symptoms. On initial laboratory evaluation, he was found to have acute kidney injury and a normal calcium level. The patient underwent a skin biopsy and was found to have cellulitis and calciphylaxis of small-sized and medium-sized vessels. Since the patient did not have any underlying risk factors of calciphylaxis, the most likely cause of his calciphylaxis was thought to be his underlying malignancy. Physicians should keep this differential in mind while treating non-healing ulcers in such patients since they are at higher risk of superimposed infections and usually require aggressive wound care.
Needs-based provision of medical care to nursing home residents: protocol for a mixed-methods study
Authors: Czwikla Jonas , Schulz Maike , Heinze Franziska , Kalwitzki Thomas , Gand Daniel , Schmidt Annika , Tsiasioti Chrysanthi , Schwinger Antje , Kloep Stephan , Schmiemann Guido , Wolf-Ostermann Karin , Gerhardus Ansgar , Rothgang Heinz
Published: August 2019

Introduction

Nursing home residents typically have greater needs for medical care than community-dwelling elderly. However, restricted cognitive abilities and limited mobility may impede their access to general practitioners and medical specialists. The provision of medical care in nursing homes may therefore be inappropriate in some areas of medical care. The purpose of this mixed-methods study is to systematically assess, evaluate and explain met and unmet medical care needs in German nursing homes and to develop solutions where medical care is found to be inappropriate.

Methods and analysis

First, statutory health insurance claims data are analysed to identify differences in the utilisation of medical care between nursing home residents and community-dwelling elderly with and without need for long-term care. Second, the health status and medical care of 500 nursing home residents are assessed and evaluated to quantify met and unmet medical care needs. Third, qualitative expert interviews and case conferences and, fourth, quantitative analyses of linked data are used to provide structural, case-specific and generalisable explanations of inappropriate medical care among nursing home residents. Fifth, a modified Delphi study is employed to develop pilot projects aiming to improve medical care in nursing homes.

Ethics and dissemination

This study was approved by the Ethics Committee of the University of Bremen on 23 November 2017. Research findings are disseminated through presentations at national and international conferences and publications in peer-reviewed scientific journals.

Trial registration number

DRKS00012383.
Observational study to assess the effects of social networks on the seasonal influenza vaccine uptake by early career doctors
Authors: Edge Rhiannon , Keegan Thomas , Isba Rachel , Diggle Peter
Published: August 2019

Objectives

To evaluate the effect of social network influences on seasonal influenza vaccination uptake by healthcare workers.

Design

Cross-sectional, observational study.

Setting

A large secondary care NHS Trust which includes four hospital sites in Greater Manchester.

Participants

Foundation doctors (FDs) working at the Pennine Acute Hospitals NHS Trust during the study period. Data collection took place during compulsory weekly teaching sessions, and there were no exclusions. Of the 200 eligible FDs, 138 (70%) provided complete data.

Primary outcome measures

Self-reported seasonal influenza vaccination status.

Results

Among participants, 100 (72%) reported that they had received a seasonal influenza vaccination. Statistical modelling demonstrated that having a higher proportion of vaccinated neighbours increased an individual’s likelihood of being vaccinated. The coefficient for γ, the social network parameter, was 0.965 (95% CI: 0.248 to 1.682; odds: 2.625 (95% CI: 1.281 to 5.376)), that is, a diffusion effect. Adjusting for year group, geographical area and sex did not account for this effect.

Conclusions

This population exhibited higher than expected vaccination coverage levels–providing protection both in the workplace and for vulnerable patients. The modelling approach allowed covariate effects to be incorporated into social network analysis which gave us a better understanding of the network structure. These techniques have a range of applications in understanding the role of social networks on health behaviours.
Does parental concern about their child’s future risk of overweight vary by their ethnic background? Cross-sectional analysis of a national cohort study
Authors: Firman Nicola , Dezateux Carol
Published: August 2019

Objectives

Children from South Asian ethnic backgrounds are at increased risk of obesity and its associated future health risks; however, evidence is lacking as to whether parental concern about their child’s future overweight risk varies by ethnic background. We hypothesised that parents of 5-year-old children from South Asian backgrounds would be more likely to express such concerns.

Design

Cross-sectional.

Setting

UK.

Participants

15 039 singleton 5-year-old Millennium Cohort Study participants (48.9% girls; 86.7% White).

Primary outcome measure

Parent-reported concern (some/none) about future overweight risk.

Methods

We estimated the adjusted ORs (aORs) of some parental concern (ranging from a little to very concerned) by child’s ethnic background (reference group: White), adjusted for parent and child weight status, and child sex.

Results

Parents of girls from Pakistani (aOR 0.4; 95% CI 0.2 to 0.5), Bangladeshi (0.3; 0.2 to 0.5), Black African (0.5; 0.3 to 0.7) and Mixed (0.7; 0.5 to 0.99) ethnic backgrounds and of boys from Pakistani ethnic backgrounds (0.6; 0.4 to 0.9) were less likely to report concern about their child’s future overweight risk than parents of White girls and boys, respectively. Overweight (2.5; 2.2 to 2.8) and obesity (6.7; 5.7 to 7.9) in children, and overweight (1.4; 1.2 to 1.5) and obesity (1.9; 1.7 to 2.2) in parents, were associated with increased likelihood of concern.

Conclusions

Parents of children from South Asian ethnic backgrounds express less concern about their child’s future overweight risk. Qualitative studies are needed to understand the concerns of parents from different ethnic backgrounds to inform weight-management interventions in ethnically diverse populations.
Cognitive training and neuroplasticity in mild cognitive impairment (COG-IT): protocol for a two-site, blinded, randomised, controlled treatment trial
Authors: D'Antonio Jessica , Simon-Pearson Laura , Goldberg Terry , Sneed Joel R , Rushia Sara , Kerner Nancy , Andrews Howard , Hellegers Caroline , Tolbert Sierra , Perea Elena , Petrella Jeffrey , Doraiswamy Murali , Devanand Davangere
Published: August 2019

Introduction

Mild cognitive impairment (MCI) is common in older adults and represents a high-risk group for progression to Alzheimer’s disease (AD). Medication trials in MCI have generally failed, but new discoveries with brain plasticity in ageing have led to the study of cognitive training as a potential treatment to improve cognitive abilities. Computerised cognitive training (CCT) involves computerised cognitive exercises that target specific cognitive abilities and neural networks to potentially improve cognitive functioning through neuroplasticity.

Methods and analysis

In a two-site study (New York State Psychiatric Institute/Columbia University Medical Center and Duke University Medical Center), we will randomise 100 patients with MCI (Wechsler Memory Scale-III Logical Memory II score 0–11; Folstein Mini Mental State Examination ≥23) to home-based CCT (suite of exercises: memory, matching, spatial recognition, processing speed) or a home-based active control condition (computerised crossword puzzle training (CPT)) with 12 weeks of intensive training followed by regular booster sessions up to 78 weeks. All patients will receive standard neuropsychological and functional assessments in clinic as well as structural/functional brain MRI scans at study entry and endpoint. We will test if CCT, versus CPT, leads to improved cognitive functioning, transfers to functional ability and tasks of everyday life and impacts hippocampal volume changes and changes in the default mode network of the brain measured by resting-state functional MRI.

Ethics and dissemination

The study will be conducted following ethics approval and written informed consent will be obtained from all subjects. Study results will be disseminated via publication, clinicaltrials.gov, media and conference presentations. This will be the first controlled long-term trial to evaluate the effects of home-based CCT versus computerised CPT on cognitive abilities and functional measures and neural outcomes as determined by MRI indices in patients with MCI. Positive results from trial may support further development of home-based CCT.

Trial registration number

ClinicalTrials.gov identifier (NCT03205709).
Lymphoedema in advanced cancer: does subcutaneous needle drainage improve quality of life?
Authors: Landers Amanda , Holyoake Julia
Published: August 2019

Purpose

Lower limb lymphoedema in the palliative care population has limited treatment options. Subcutaneous needle drainage is an underused procedure that has previously been described in the literature for refractory lymphoedema. This study will quantify the potential improvements to quality of life and the adverse outcomes for this group of patients.

Methods

This was a multicentre, non-randomised, observational trial using a validated questionnaire before and after the procedure. A tailored mobility measurement was also used. It extends a published pilot previously undertaken.

Results

Thirty-two procedures were performed on 31 patients across three sites. The average drainage volume was 5.5 L. The domain of appearance (3.2 vs 2.8 vs 2.6) improved significantly and was sustained. All of the domains, except appearance, showed a significant improvement at 2 weeks. The cellulitis rate was 6%.

Conclusion

Subcutaneous needle drainage appears to improve quality of life in those with lower limb lymphoedema facing a life-limiting illness.
First pass effect with contact aspiration and stent retrievers in the Aspiration versus Stent Retriever (ASTER) trial
Authors: Ducroux Célina , Piotin Michel , Gory Benjamin , Labreuche Julien , Blanc Raphael , Ben Maacha Malek , Lapergue Bertrand , Fahed Robert
Published: August 2019

Background

The ‘first pass effect’ (FPE), which was originally described with stent retrievers, designates a (near-)complete revascularization obtained after a single device pass with no rescue therapy, and is associated with improved clinical outcome and decreased mortality.

Objective

We report the rate and benefits of FPE in the Aspiration versus Stent Retriever (ASTER) trial.

Materials and methods

ASTER is a randomized trial comparing angiographic revascularization with the stent retriever (SR) and contact aspiration (CA) thrombectomy techniques, assessed by an external core laboratory using the modified Thrombolysis in Cerebral Infarction (mTICI) scale. Rates of FPE (defined by mTICI 2c/3 after a single pass with no rescue therapy) were compared between patients treated with SR and CA techniques. Outcomes were compared between FPE-SR and FPE-CA patients, and between FPE and non-FPE patients.

Results

FPE was achieved in 97/336 patients (28.9%), with no significant difference between SR and CA (respectively 53/169 patients (31.3%) vs 44/167 patients (26.3%), adjusted RR for CA versus SR 0.84, 95% CI 0.54 to 1.31; p=0.44). After prespecified adjustment for allocated arm and randomization stratification factors, FPE in patients was associated with a significantly improved clinical outcome and a decreased mortality, and a significantly lower rate of hemorrhagic transformation and procedural complications than in non-FPE patients.

Conclusion

In the ASTER trial, similar rates of FPE were achieved with SR and CA, and FPE was associated with a significantly improved outcome. New techniques and devices to improve the rate of FPE are warranted.

Trial registration number

Unique identifier:NCT02523261.
Runout estimates and risk-informed decision making for bench scale open pit slope failures
Authors: Whittall John
Published: August 2019

Bench scale open pit slope failures are common occurrences in open pit mines and present a hazard to workers near freshly excavated faces. Objectively forecasting the zone of influence of bench scale failures is an important component of the mine’s risk management plan, as they occur more frequently than multi-bench scale landslides and can be more difficult to monitor. This paper presents a dataset of 167 bench scale open pit slope failures and tests runout and bench-width sizing methods to identify appropriate tools to estimate a stand-off distance from a fresh bench face. A length versus fall height and a Fahrböschung angle versus volume relationship calibrated to bench scale open pit slope failures provide reasonable runout estimates and are useful for decision-making when workers are near freshly excavated bench faces. Bench scale open pit failures appear to have a relatively constant fall height/horizontal runout distance (H/L) ratio up to 10 000 m3, after which H/L becomes inversely proportional to volume.
Clustering Approaches for Top-k Recommender Systems
Authors: Torres Nicolás , Mendoza Marcelo
Published: August 2019

Clustering-based recommender systems bound the seek of similar users within small user clusters providing fast recommendations in large-scale datasets. Then groups can naturally be distributed into different data partitions scaling up in the number of users the recommender system can handle. Unfortunately, while the number of users and items included in a cluster solution increases, the performance in terms of precision of a clustering-based recommender system decreases. We present a novel approach that introduces a cluster-based distance function used for neighborhood computation. In our approach, clusters generated from the training data provide the basis for neighborhood selection. Then, to expand the search of relevant users, we use a novel measure that can exploit the global cluster structure to infer cluster-outside user’s distances. Empirical studies on five widely known benchmark datasets show that our proposal is very competitive in terms of precision, recall, and NDCG. However, the strongest point of our method relies on scalability, reaching speedups of 20× in a sequential computing evaluation framework and up to 100× in a parallel architecture. These results show that an efficient implementation of our cluster-based CF method can handle very large datasets providing also good results in terms of precision, avoiding the high computational costs involved in the application of more sophisticated techniques.
Intensity dependent spectral properties of long-period fiber grating for applications in lightwave communication
Authors: Jain Vishal , Pawar Santosh , Kumbhaj Shubhada , Sen Pranay Kumar
Published: August 2019

Using nonlinear coupled mode equations, the spectral properties of long-period fiber grating are studied analytically taking into account the Kerr type optical nonlinearity in the medium. The nonlinear coupled-mode equations were solved for co-propagating core and cladding mode amplitudes and expressions for transmittivity and phase factor at high excitation intensity are obtained. It is observed that the resonance wavelength of grating shifts towards higher wavelength side with increasing excitation intensity. Also, the minimum transmittivity of the grating shows oscillating behavior with increasing grating length, whereas the phase of the transmitted wave increases monotonically with length at high input intensities.