bluuebunny/crossref_metadata_2025 huggingface dataset:
Testing the impact of satellite anisotropy on large- and small-scale intrinsic alignments using hydrodynamical simulations
Authors: Samuroff S , Mandelbaum R , Di Matteo T
Published: November 2019

Galaxy intrinsic alignments (IAs) have long been recognized as a significant contaminant to weak lensing-based cosmological inference. In this paper we seek to quantify the impact of a common modelling assumption in analytic descriptions of IAs: that of spherically symmetric dark matter haloes. Understanding such effects is important as the current generation of IA models are known to be limited, particularly on small scales, and building an accurate theoretical description will be essential for fully exploiting the information in future lensing data. Our analysis is based on a catalogue of 113 560 galaxies between z = 0.06 and 1.00 from massiveblack-ii, a hydrodynamical simulation of box length $100 \, h^{-1}$ Mpc. We find satellite anisotropy contributes at the level of $\ge 30\!-\!40{{\ \rm per\ cent}}$ to the small-scale alignment correlation functions. At separations larger than $1 \, h^{-1}$ Mpc the impact is roughly scale independent, inducing a shift in the amplitude of the IA power spectra of $\sim 20{{\ \rm per\ cent}}$. These conclusions are consistent across the redshift range and between the massiveblack-ii and the illustris simulations. The cosmological implications of these results are tested using a simulated likelihood analysis. Synthetic cosmic shear data are constructed with the expected characteristics (depth, area, and number density) of a future LSST-like survey. Our results suggest that modelling alignments using a halo model based upon spherical symmetry could potentially induce cosmological parameter biases at the ∼1.5σ level for S8 and w.
Explaining GRB prompt emission with sub-photospheric dissipation and Comptonization
Authors: Bhattacharya Mukul , Kumar Pawan
Published: November 2019

Even though the observed spectra for GRB prompt emission is well constrained, no single radiation mechanism can robustly explain its distinct non-thermal nature. Here we explore the radiation mechanism with the photospheric emission model using our Monte Carlo Radiative Transfer (MCRaT) code. We study the sub-photospheric Comptonization of fast cooled synchrotron photons while the Maxwellian electrons and mono-energetic protons are accelerated to relativistic energies by repeated dissipation events. Unlike previous simulations, we implement a realistic photon to electron number ratio Nγ/Ne ∼ 105 consistent with the observed radiative efficiency of a few percent. We show that it is necessary to have a critical number of episodic energy injection events Nrh, cr ∼ few 10s − 100 in the jet in addition to the electron-proton Coulomb coupling in order to inject sufficient energy Einj, cr ∼ 2500 − 4000 mec2 per electron and produce an output photon spectrum consistent with observations. The observed GRB spectrum can be generated when the electrons are repeatedly accelerated to highly relativistic energies γe, in ∼ few 10s − 100 in a jet with bulk Lorentz factor Γ ∼ 30 − 100, starting out from moderate optical depths τin ∼ 20 − 40. The shape of the photon spectrum is independent of the initial photon energy distribution and baryonic energy content of the jet and hence independent of the emission mechanism, as expected for photospheric emission.
Adult Use of and Transitions From Nicotine and Non-nicotine-Containing E-cigarettes: Data From the Population Assessment of Tobacco and Health (PATH) Study, 2013–2016
Authors: Nguyen Zarndt Anh , Donaldson Elisabeth A , Bernat Jennifer K , Henrie James A , Portnoy David B
Published: November 2019

Introduction

Studies largely focus on nicotine-containing e-cigarettes (NiCE) though non-nicotine-containing e-cigarettes (NoCE) exist; NoCE prevalence and patterns of use are largely unknown. This study examines self-reported prevalence and patterns of NiCE/NoCE use.

Methods

We analyzed adult (18+ years) data from the Population Assessment of Tobacco and Health (PATH) study from Wave 1 (2013–2014, n = 32,320), Wave 2 (2014–2015, n = 28,632), and Wave 3 (2015–2016, n = 28,148). We test associations between Wave 1 self-reported current NoCE/NiCE use status and demographic characteristics and assess the proportion of self-reported current NoCE/NiCE users at Wave 1 or Wave 2 who continue to use NoCE or NiCE, switch to NiCE or NoCE, discontinue e-cigarette use, switch to use other nicotine products (ONP), or add ONP use 1 year later (i.e., at Wave 2 or 3).

Results

Maintaining the same self-reported NiCE/NoCE and ONP use status 1 year later was the most common use pattern between waves. However, 15.65% of exclusive NoCE users in Wave 2 transitioned to NoCE plus nicotine product use in Wave 3. Also, some exclusive NoCE users transitioned to exclusive NiCE use (17.77% Waves 1–2; 11.55% Waves 2–3).

Discussion

Some exclusive NoCE users transitioned to NiCE or added nicotine product use, suggesting there may be other factors (e.g., familiarity with using an aerosolizing device) in addition to the presence of nicotine in influencing initiation or sustained use of nicotine products.

Implications

Studies largely focus on nicotine-containing e-cigarettes (NiCE) though non-nicotine-containing e-cigarettes (NoCE) exist; this study adds to the literature by describing demographic characteristics and tobacco use of adult self-reported NoCE users. In addition, the study examines transitions in self-reported NoCE/NiCE use, revealing that some exclusive NoCE users transition to other nicotine product use 1 year later.
A Systems Theory Re-Construction of Law and Religion
Authors: Sandberg Russell
Published: November 2019

Law and Religion has rapidly developed as an academic sub-discipline in English and Welsh Law Schools in the 21st century amidst a significant amount of legislation, litigation, and public debate about religion. However, there are signs that this sub-discipline is becoming inward looking and stagnating. This article takes a step back and uses Niklas Luhmann’s social systems theory to explore how Law and Religion has developed as a sub-discipline. Bringing together Luhmann’s work on law and his work on religion, a systems theory of Law and Religion is developed for the first time. Deriving from but refining and developing social systems theory, the article argues that Law and Religion requires a radical rethink if it is to flourish as an area of study.
Innovation and Investment in the Roman Rural Economy Through the Lens of Marzuolo (Tuscany, Italy)*
Authors: Van Oyen Astrid
Published: November 2019

The presence, uptake and economic impact of innovations in the Roman world have been much debated. Not subject to debate, however, is the agency behind innovation, which is assumed to be the large, elite landowner. Evidence of experimentation at the rural terra sigillata production site of Marzuolo (Tuscany, Italy) does not fit dominant models of external investment in the Roman world and challenges the directionality of innovation. Instead, this article makes the case that experimentation at Marzuolo was driven by intensification on the part of local smallholders, but was curbed by a lack of capital investment. A later, scaled-up terra sigillata production phase at the same site, linked to infrastructural investments, shows predatory investment behaviour by a landowner who appropriated a tried and tested facility. Recasting innovation as an open-ended process of trial and error that is centred on human capital development, labour and relations of production, changes the terms of study of the Roman economy and aligns it with broader conversations in economic history.
Zero-correlation entanglement
Authors: Ohira Toru
Published: November 2019

We consider a quantum entangled state for two particles, each particle having two basis states, which includes an entangled pair of spin 1/2 particles. We show that, for any quantum entangled state vectors of such systems, one can always find a pair of observable operators $\mathcal{X}, \mathcal{Y}$ with zero correlations ($\langle{\psi}|\mathcal{X}\mathcal{Y}|{\psi}\rangle - \langle{\psi}|\mathcal{X}|{\psi}\rangle\langle{\psi}|\mathcal{Y}|{\psi}\rangle= 0$). At the same time, if we consider the analogous classical system of a “classically entangled” (statistically non-independent) pair of random variables taking two values, one can never have zero correlations (zero covariance, $E[XY] - E[X]E[Y] = 0$). We provide a general proof to illustrate the different nature of entanglements in classical and quantum theories.
Background prevalence of subclinical Shiga toxin-producing Escherichia coli in children attending childcare facilities in the Irish Midlands
Authors: Burns H , Fallon U , Collins A , Ni Shuilleabhain C
Published: November 2019

Background

Exclusion of asymptomatic shedders of Shiga toxin-producing Escherichia coli (STEC) from childcare facilities (CCFs) is a recognized measure to minimize risk of secondary transmission. This is predicated on factors including an assumption of low background prevalence of STEC amongst CCF attendees. There is a paucity of scientific evidence regarding the true prevalence of STEC in paediatric populations. The study aimed to develop and test a methodology to estimate background prevalence of STEC amongst CCF attendees at regional level in Ireland.

Methods

Computerized Infectious Disease Reporting data were used to compile a list of outbreaks of STEC occurring in CCFs in the Irish Midlands since the introduction of polymerase chain reaction (PCR)-based testing. Laboratory data were used to determine background prevalence of STEC in screened children in each outbreak individually and across all outbreaks.

Results

A pooled summary prevalence estimate of 2.9% (95% confidence interval 1.4–5.5%) was determined for the entire screened cohort across all outbreaks. Sensitivity analysis supported the validity of the estimate.

Conclusions

The relatively high prevalence estimate of 2.9% suggests that a public health risk assessment approach to return of prolonged asymptomatic shedders to the CCF may be appropriate in peak STEC season in the Midlands.
Species Selection Regime and Phylogenetic Tree Shape
Authors: Verboom G Anthony , Boucher Florian C , Ackerly David D , Wootton Lara M , Freyman William A
Published: November 2019

Species selection, the effect of heritable traits in generating between-lineage diversification rate differences, provides a valuable conceptual framework for understanding the relationship between traits, diversification, and phylogenetic tree shape. An important challenge, however, is that the nature of real diversification landscapes—curves or surfaces which describe the propensity of species-level lineages to diversify as a function of one or more traits—remains poorly understood. Here, we present a novel, time-stratified extension of the QuaSSE model in which speciation/extinction rate is specified as a static or temporally shifting Gaussian or skewed-Gaussian function of the diversification trait. We then use simulations to show that the generally imbalanced nature of real phylogenetic trees, as well as their generally greater than expected frequency of deep branching events, are typical outcomes when diversification is treated as a dynamic, trait-dependent process. Focusing on four basic models (Gaussian-speciation with and without background extinction; skewed-speciation; Gaussian-extinction), we also show that particular features of the species selection regime produce distinct tree shape signatures and that, consequently, a combination of tree shape metrics has the potential to reveal the species selection regime under which a particular lineage diversified. We evaluate this idea empirically by comparing the phylogenetic trees of plant lineages diversifying within climatically and geologically stable environments of the Greater Cape Floristic Region, with those of lineages diversifying in environments that have experienced major change through the Late Miocene-Pliocene. Consistent with our expectations, the trees of lineages diversifying in a dynamic context are less balanced, show a greater concentration of branching events close to the present, and display stronger diversification rate-trait correlations. We suggest that species selection plays an important role in shaping phylogenetic trees but recognize the need for an explicit probabilistic framework within which to assess the likelihoods of alternative diversification scenarios as explanations of a particular tree shape. [Cape flora; diversification landscape; environmental change; gamma statistic; species selection; time-stratified QuaSSE model; trait-dependent diversification; tree imbalance.]
Initial development of the Hookah Smoker Scale: Assessing young adults’ mental schemas about hookah “smokers”
Authors: Phan Lilianna , Mays Darren , Tercyak Kenneth P , Johnson Andrea C , Rehberg Kathryn , Lipkus Isaac M
Published: November 2019

Many young adult hookah tobacco users do not consider themselves hookah “smokers,” but data on this topic are limited. There are no existing measures of young adults’ mental schemas of hookah “smokers.” We examined the factor structure and reliability of the Hookah Smoker Scale and examined associations with perceived harm and addictiveness and attitudes toward hookah. Two hundred and forty-six young adult (ages 18–30) hookah smokers participated in a cross-sectional online study. Participants completed items assessing schemas characterizing hookah smokers and valid measures of perceived harm and addictiveness of hookah smoking, risk appraisals, and attitudes toward hookah. Exploratory factor analysis using principal axis factoring with oblique rotation extracted a 12-item scale with three dimensions (Regular Use, Social-Enabled Use, and Self-Enabled Use). The scale explained 69.7% of the variance (eigenvalue = 9.2). Cronbach’s α for the scale was .89, with Cronbach’s α ≥ .80 for four-item subscales. Higher subscale scores indicate stronger beliefs that the dimension characterizes a hookah smoker. Higher Regular Use scores (score variance = 46.9%; eigenvalue = 5.6) were associated with greater perceived harm and addictiveness (β = 0.21, p = .01), greater risk appraisals (β = 0.20, p = .02), and more negative attitudes toward hookah (β = −0.18, p = .03). The Hookah Smoker Scale is a promising measure that can be used to identify targets for preventing and reducing young adults’ hookah tobacco use. Findings also suggest young adults associate health risks of hookah with daily smoking, but not with intermittent social smoking patterns.
Up‐regulation of PGC‐1α in neurons protects against experimental autoimmune encephalomyelitis
Authors: Dang Chun , Han Bin , Li Qian , Han Ranran , Hao Junwei
Published: November 2019

Reactive oxygen species (ROS) generation and mitochondrial dysfunction are related to neuron loss in multiple sclerosis (MS). Although peroxisome proliferator‐activated receptor‐γ coactivator 1α (PGC‐1α) appears to play a key role in modulating levels of mitochondrial ROS, antioxidants, and uncoupling proteins (UCPs), and PGC‐1α expression is reduced in the neocortex of patients with MS, it is unclear what its role is in neurons and in the manifestation of clinical symptoms of MS. Here, we show in wild‐type (WT) experimental autoimmune encephalomyelitis (EAE) mice that PGC‐1α is decreased 13 d after EAE induction followed by a steady decline up to 20 d. These changes were accompanied by parallel alterations in levels of superoxide dismutase 2, peroxiredoxin 3, thioredoxin 2, UCP4, and UCP5. In transgenic (TG) mice with neuron‐specific overexpression of PGC‐1α (PGC‐1αf/fEno2‐Cre), clinical symptoms after EAE induction were delayed and less severe than in WT mice. The degrees of apoptotic neuron loss and demyelination were also less severe in PGC‐1α‐TG mice. Overexpression of PGC‐1α in neuronal neuroblastoma spinal cord 34 cells subjected to EAE inflammatory conditions showed similar results to those obtained in vivo. RNA sequencing analysis showed that apoptotic processes were significantly enriched in the top 10 significant gene ontology (GO) terms of differentially expressed genes, and the apoptotic pathway was significantly enriched in Kyoto Encyclopedia of Genes and Genomes pathway analysis. Our findings indicate that up‐regulation of neuronal PGC‐1α protected neurons from apoptosis in EAE. Manipulating PGC‐1α levels in MS may help stave off this devastating disease.—Dang, C., Han, B., Li, Q., Han, R., Hao, J. Up‐regulation of PGC‐1α in neurons protects against experimental autoimmune encephalomyelitis. FASEB J. 33, 14811‐14824 (2019). www.fasebj.org
Right ventricular function during and after thoracic surgery
Authors: Gelzinis Theresa , Assaad Sherif , Perrino Albert C.
Published: November 2019

Purpose of review

Right ventricular (RV) dysfunction following thoracotomy and pulmonary resection is a known phenomenon but questions remain about its mechanism, risk factors, and clinical significance. Acute RV dysfunction can present intraoperatively and postoperatively, persisting for 2 months after surgery.

Recent findings

Recently, the pulmonology literature has emphasized pulmonary arterial capacitance, rather than pulmonary vascular resistance, as a marker to predict disease progression and outcome in patients with pulmonary hypertension and heart failure. Diagnostic focus has emerged on the use of cardiac MRI and new echocardiographic parameters to better quantify the presence of RV dysfunction and the role of pulmonary capacitance in its development.

In this review, we examine the most recent literature on RV dysfunction following lung resection, including possible mechanisms, time span of RV dysfunction, and available diagnostic modalities. The clinical relevance of these factors on preoperative assessment and risk stratification are presented.
Understanding osteoarthritis pathogenesis: a multiomics system-based approach
Authors: Ratneswaran Anusha , Rockel Jason S. , Kapoor Mohit
Published: November 2019

Purpose of review

Osteoarthritis is a heterogeneous, multifactorial condition regulated by complex biological interactions at multiple levels. Comprehensive understanding of these regulatory interactions is required to develop feasible advances to improve patient outcomes. Improvements in technology have made extensive genomic, transcriptomic, epigenomic, proteomic, and metabolomic profiling possible. This review summarizes findings over the past 20 months related to omics technologies in osteoarthritis and examines how using a multiomics approach is necessary for advancing our understanding of osteoarthritis as a disease to improve precision osteoarthritis treatments.

Recent findings

Using the search terms ‘genomics’ or ‘transcriptomics’ or ‘epigenomics’ or ‘proteomics’ or ‘metabolomics’ and ‘osteoarthritis’ from January 1, 2018 to August 31, 2019, we identified advances in omics approaches applied to osteoarthritis. Trends include untargeted whole genome, transcriptome, proteome, and metabolome analyses leading to identification of novel molecular signatures, cell subpopulations and multiomics validation approaches.

To address the complexity of osteoarthritis, integration of multitissue analyses by multiomics approaches with the inclusion of longitudinal clinical data is necessary for a comprehensive understanding of the disease process, and for appropriate development of efficacious diagnostics, prognostics, and biotherapeutics.
Clinical Considerations to Reduce Saphenous Neurovascular Bundle Injury During Suture Button Fixation of Syndesmosis Injuries
Authors: Page Brian J. , de la Fuente Guadalupe , Stahl Daniel L. , Brennan Michael L.
Published: November 2019

Objective:

To document angles, from 2 difference starting points, or danger zones that should be avoided to minimize risk of injury or irritation to the saphenous neurovascular bundle (SNVB) during suture button (SB) fixation for distal tibiofibular syndesmosis injuries.

Design:

Retrospective imaging study.

Setting:

Academic Level 1 trauma center.

Patients:

Forty-eight randomly selected patients with healthy ankles and computed tomography scans for nonankle diagnoses.

Main Outcome Measures:

Computed tomography scans and 3D reconstructed images were used to define the angle between the SNVB and 2 different fibular starting points, using the direct lateral (DL) and the posterolateral (PL) starting points. Descriptive analyses were performed to identify angles that should be avoided during suture button fixation. Distances from the SNVB using preset angles of 0, 10, 20, and 30 degrees were analyzed. In addition, the width of the SNVB, the midsubstance angle of the SNVB, and the distance from the 30-degree point to the tibialis anterior were recorded.

Results:

The mean angle between the SNVB and the standard DL starting point was 13.7 ± 5.0 degrees (P < 0.05), whereas the mean angle using the alternate PL starting point was 17.2 ± 5.3 degrees (P < 0.05). The SNVB width was 5.2 mm [range, 2.6–9.1 mm] (P < 0.05). The distances from the SNVB were greatest for the DL 30-degree group and the PL 0-degree group.

Conclusions:

The results document angles that should be avoided when using suture button fixation for syndesmosis injuries. Device characteristics and surgery-related variables may require intraoperative modifications, and knowledge of this anatomical relationship may reduce SNVB injury during those situations. Considering our results, we recommend that surgeons place suture buttons from the DL starting point with a 30-degree trajectory to avoid injuries to the SNVB.
Infraspinatus Tenotomy Improves Glenoid Visualization With the Modified Judet Approach
Authors: Garlich John M. , Samuel Katherine , Nelson Trevor J. , Monfiston Carl , Kremen Thomas , Metzger Melodie F. , Little Milton T. M.
Published: November 2019

Objectives:

To determine if the addition of an infraspinatus tenotomy to the modified Judet approach (MJA) improves glenoid visualization.

Methods:

We performed an MJA on 14 human cadaveric shoulders. After exposing the glenoid, the boundary of the visualized glenoid surface was marked with a 1.8- and 2.0-mm drill bit before and after performing an infraspinatus tenotomy, respectively. The humerus was disarticulated, and the pre- and post-tenotomy drill marks were verified. The area of the entire glenoid, and each of the 4 quadrants [anterior-superior (AS), anterior-inferior (AI), posterior-superior (PS), and posterior-inferior (PI)] were analyzed using a custom image-processing program. The amount of glenoid exposure and percentage of area visualized before and after the tenotomy were compared.

Results:

Adding an infraspinatus tenotomy to the MJA significantly increased total glenoid area (cm2) exposure by 33%, P < 0.0001. Three of 4 glenoid quadrants (PS, AS, and AI) had a significant increase in glenoid visualization, with the AS quadrant having the most substantial improvement after the tenotomy (+67%), P < 0.0001.

Conclusions:

The results provide the percentage of glenoid fossa that can be seen using an MJA and demonstrate that visualization significantly improves after adding an infraspinatus tenotomy.
MicroRNA-107 inhibits proliferation and invasion of laryngeal squamous cell carcinoma cells by targeting CACNA2D1 in vitro
Authors: Huang Chaoping , Wang Zhenxiao , Zhang Kun , Dong Yanbo , Zhang Aobo , Lu Cheng , Liu Liangfa
Published: November 2019

Our previous studies have confirmed that α2δ1 has the potential to function as a cancer stem cell marker, and CACNA2D1 is the coding gene of α2δ1. But it is unclear how microRNAs regulate the expression of the CACNA2D1 gene in laryngeal cancer cells. We detected the expressions of α2δ1 protein, microRNA-107, and CACNA2D1 in 40 pairs of laryngeal cancer tissues and adjacent normal tissues. Laryngeal squamous cell carcinoma cells, TU212 and TU686, were cultured and transfected in the blank control group, the agomiR negative control group, the agomiR-107 group, the antagomiR negative control group, or the antagomiR-107 group, and the dual-luciferase reporter assay was employed to assess the regulatory effect of microRNA-107 on CACNA2D1. Then, the effects of microRNA-107 on the biological function of laryngeal squamous cell carcinoma cells were detected by qRT-PCR, Western blot, MTT, cell migration/invasion assay, and cell colony-formation assay. Our data suggested that the protein level of α2δ1, encoded by CACNA2D1, in laryngeal carcinoma tissues was higher than that in adjacent normal tissues, while the expression of microRNA-107 was significantly decreased in laryngeal carcinoma tissues. The dual-luciferase reporter gene assay confirmed that microRNA-107 bound to the 3′-UTR two positions (202-209, 902-908) of CACNA2D1 mRNA. Moreover, the expression of CACNA2D1 and α2δ1 protein were significantly decreased in TU212 and TU686 cells transfected with microRNA-107 expression vectors (P < 0.05), and proliferation, clone formation, migration, and invasion of these cells were also reduced. Furthermore, after knocking down microRNA-107, exactly opposite results were obtained. Overexpression of microRNA-107 can inhibit the proliferation and invasion of laryngeal carcinoma cells in vitro.
A 10-Year Longitudinal Analysis of Protocol-Based Sepsis Management in a Philippine Tertiary ICU
Authors: Bumanglag Niña M. , San Juan Mari Des J. , Palo Jose Emmanuel M.
Published: November 2019

Objectives:

To compare the outcomes of sepsis management using protocol-based therapy versus non-protocolized care, assessed over 10 years.

Design:

Retrospective cohort study, analyzed longitudinally with risk-adjusted control charts, referenced against hospital- and unit-level programs or interventions.

Setting:

Private, tertiary teaching hospital ICU in the Philippines.

Patients:

Nine-hundred fifty adult patients (19 yr old or older) diagnosed with severe sepsis or septic shock, using 2001 consensus definitions, admitted to the ICU from September 2007 to August 2017.

Interventions:

Three iterations of a standard clinical pathway (including early antibiotics, prescribed fluid resuscitation, and hemodynamic management) versus concurrent non-protocolized care.

Measurements and Main Results:

Seven-hundred sixty patients were in the protocol-based care group versus 190 in the non-protocolized care group. Protocol-based management was associated with lower hospital mortality (28.4% vs 44.7%; p = 0.00) and ICU mortality (24.2% vs 31.6%; p = 0.038). There were no differences in ICU or hospital length-of-stay, mechanical ventilator days, or vasoactive days. Risk-Adjusted Cumulative Sum and Risk-Adjusted Exponentially Weighted Moving Average control charts showed that a survival advantage was achieved after 1 year and was sustained over the duration of the study.

Conclusions:

Protocol-based management was associated with sustained improvements in the survival of sepsis patients over 10 years in this hospital setting, after a run-in period of 1 year. Hospital- and unit-level interventions may have measurable impacts on the efficacy of sepsis clinical pathways.
Sepsis Immunometabolism: From Defining Sepsis to Understanding How Energy Production Affects Immune Response
Authors: Koutroulis Ioannis , Batabyal Rachael , McNamara Brittany , Ledda Matthew , Hoptay Claire , Freishtat Robert J.
Published: November 2019

Objectives:

This review will examine current definitions and trends in sepsis management as well pathophysiologic mechanisms in animal and ex vivo studies that correlate decreased energy production with deranged inflammatory response during the septic process.

Data Sources:

The latest articles in the literature that focus on the role of immunometabolism and associated mechanisms in sepsis were selected.

Study Selection:

The most relevant, original articles were included in the review.

Data Extraction:

All pertinent data for sepsis definitions as well as changes in immunometabolic pathways during the septic process was reviewed and assessed for inclusion in this article.

Data Synthesis:

Sepsis is a major cause of multiple organ dysfunction. It is the principal cause of death resulting from infection and one of the most expensive conditions treated in the United States. Despite current efforts to accurately define sepsis, novel treatments and highly trained providers, mortality rates for sepsis remain high, prompting a need for further investigation of underlying immunometabolic mechanisms to identify potential treatment targets. The definition of sepsis has shifted and changed in the past few decades due to poorly defined criteria, as well as unclear guidelines for providers with regards to management of severe sepsis and septic shock. The early identification of patients with a systemic inflammatory response that will progress to septic shock is critical since recent traditional therapeutic approaches, such as early goal-directed therapy, IV immunoglobulin, and anti–tumor necrosis factor-α antibodies have failed.

Conclusions:

There are no effective anti-sepsis drug therapies due to complex inflammatory and metabolic interactions. Further studies regarding the interface between innate immunity and metabolism should be investigated to effectively address septic patient mortality rates.
Family patterns of arterial stiffness across three generations in the Malmö Offspring Study
Authors: Rosberg Erik P. , Nilsson Peter M.
Published: November 2019

Background:

Central haemodynamics have in recent years emerged as a promising predictor of cardiovascular health and risk of cardiovascular disease (CVD). Central haemodynamics are affected early in the development of vascular aging and contributes to target organ damage. Carotid–femoral pulse wave velocity (c-f PWV), augmentation index (Aix) and central SBP (cSBP) are variables that reflect arterial stiffness and central haemodynamics.

Aim:

To study the association between patterns of central haemodynamics across three related generations focusing on c-f PWV.

Methods:

In all, 1131 participants from the Malmö Diet Cancer Study (MDCS) and Malmö Offspring Study (MOS) were included. c-f PWV was measured (Sphygmocor) in grandparents and in all offsprings. Correlation analyses of c-f PWV between offspring and c-f PWV in parents and grandparents were conducted. Parents and grandparents were stratified into quartiles by c-f PWV. Offspring c-f PWV means were compared with one-way ANOVA analyses. Multiple regression analyses were adjusted for age, sex, BMI, SBP and fasting glucose. Bonferroni corrections were used.

Results:

c-f PWV in offsprings was positively correlated with c-f PWV in parents (r = 0.26, P < 0.001) and in grandparents (r = 0.29, P < 0.001). Parents with high c-f PWV had offspring with significantly higher means of c-f PWV.

Conclusion:

A measure of aortic stiffness (c-f PWV) is positively correlated across three related generations in this population-based study.
Association of increased arterial stiffness with diastolic dysfunction in ischemic stroke patients: the Norwegian Stroke in the Young Study
Authors: Einarsen Eigir , Gerdts Eva , Waje-Andreassen Ulrike , Naess Halvor , Fromm Annette , Saeed Sahrai
Published: November 2019

Background:

Young and middle-aged ischemic stroke survivors have a high prevalence of hypertension, increased arterial stiffness and abnormal left ventricular (LV) geometry, which all are associated with the presence of LV diastolic dysfunction. However, the prevalence and covariates of diastolic dysfunction in these patients have not been reported.

Objectives:

To explore diastolic dysfunction in ischemic stroke patients aged 15–60 years included in the Norwegian Stroke in the Young Study.

Methods:

Data from 260 patients with acute ischemic stroke was analyzed. Diastolic dysfunction was assessed by combining transmitral peak early flow (E), early diastolic mitral annular velocity (e′), E/e′ ratio, left atrial volume index and peak tricuspid regurgitant jet velocity, following current European guidelines. Carotid–femoral pulse wave velocity at least 10 m/s by aplanation tonometry was defined as increased arterial stiffness.

Results:

Prevalent diastolic dysfunction was found in 20% of patients (13% with diastolic dysfunction grade 1 and 7% with diastolic dysfunction grades 2–3). Patients with diastolic dysfunction were older and more likely to have hypertension, overweight, increased arterial stiffness, higher LV mass and less percentage nightly reduction in mean blood pressure (BP) (all P < 0.001). In a multivariable logistic regression analysis, diastolic dysfunction was associated with increased arterial stiffness [odds ratio 2.86 (95% confidence interval 1.05–7.79), P < 0.05] independent of age more than 45 years, overweight, hypertension, night-time BP reduction and LV mass.

Conclusion:

Among young and middle-aged ischemic stroke survivors, diastolic dysfunction was found in 20%. The presence of diastolic dysfunction was associated with increased arterial stiffness independent of higher age, overweight, hypertension, night-time BP reduction and LV mass.
The role of insomnia in the association between posttraumatic stress disorder and hypertension
Authors: Gaffey Allison E. , Redeker Nancy S. , Rosman Lindsey , Mullington Janet M. , Brandt Cynthia A. , Haskell. Sally G. , Burg Matthew M.
Published: November 2019

Objective:

Posttraumatic stress disorder (PTSD) is associated with incident hypertension. Although this relationship is poorly understood, PTSD is also associated with insomnia symptoms, which increases the risk for hypertension. Whether insomnia contributes to PTSD-associated risk for hypertension is unknown.

Methods:

We examined self-report survey and electronic health record data from 1109 participants in the Women Veterans Cohort Study (mean age: 43.8 ± 10.9 years; 52% women, 81% White) to assess the cross-sectional associations between PTSD symptom severity, recent symptoms of insomnia, and hypertension, defined as self-reported treatment for high blood pressure in the last year. Structural equation modeling was used to examine whether insomnia symptoms mediate the association between PTSD and hypertension.

Results:

PTSD symptom severity was associated with hypertension (r = 0.09, P < 0.001). PTSD symptom severity and hypertension were each associated with the insomnia symptoms difficulty falling asleep, difficulty staying asleep, and worry/distress about sleep problems (PTSD: rs = 0.58--0.62, P <  0.001; hypertension: rs = 0.07--0.10, P <  0.001). A latent variable derived from those symptoms mediated 9% of the association between PTSD symptom severity and hypertension (P = 0.02).

Conclusion:

In this study of young and middle-aged Veterans, insomnia symptoms mediated the association between PTSD and hypertension. Difficulties falling asleep and maintaining sleep and related distress may be particularly deleterious for cardiovascular health in Veterans. Longitudinal data is required to further investigate the associations between PTSD, insomnia, and hypertension.
A Metaphor Analysis of Patients' With Chronic Conditions Experiences With Holistic Nurse Coaching
Authors: Delaney Colleen , Barrere Cynthia , Bark Linda
Published: November 2019

The purpose of this study was to examine metaphors used by patients with chronic conditions to describe their experience with holistic nurse coaching. A secondary analysis was conducted using Metaphor Identification Procedure to analyze the corpus of 112 pages of typed transcription. Five metaphors emerged: (1) taking personal power back like acquiring a new toolbox; (2) seeing health challenges from different angles like a duck pond race; (3) shifting perception of a chronic condition like a spider turned into a friend; (4) engaging in self-care like caring for a favorite plant; and (5) choosing to focus on the positive like a collage that changed from dark to light. Specific interventions can be developed to address each of these metaphors to help patients live well with chronic conditions.
Subclinical Inflammation of the Ocular Surface in Soft Contact Lens Wear
Authors: Saliman Noor Haziq , Morgan Philip B. , MacDonald Andrew S. , Maldonado-Codina Carole
Published: November 2019

Purpose:

To investigate the inflammatory response of the ocular surface with different soft contact lens (CL) replacement frequencies and materials.

Methods:

Twenty soft CL wearers were required to wear 3 lens types: reusable Acuvue 2 (A2), reusable Acuvue Oasys (AO), and daily disposable Acuvue Oasys (AODD), for 1 week in random sequence in 1 eye with the nonlens-wearing eye acting as a control. Three methods were used to assess the subclinical response: tear cytokine evaluation, in vivo confocal microscopy (IVCM), and impression cytology.

Results:

Of 13 cytokines investigated, differences were observed only for IL-12p70, which was present in greater concentrations for A2 (interocular difference 8.8 pg/mL, 95% confidence interval 5.5–12.1) and AO (8.9 [5.7–12.1]) compared with AODD (3.7 [0.6–6.8]). For IVCM, corneal presumed dendritic cell density was lower for AODD (interocular difference 1.9 [−0.1 to 3.9] cells/mm2) than for both A2 (9.3 [7.2–11.4]) and AO (10.6 [8.6–12.6]). This trend was the same for the other 5 IVCM measures evaluated. The proportion of CD45+ cells in the bulbar conjunctiva was lower for AODD (0.6 [−0.3 to 1.5]%) compared with A2 (4.6 [3.7–5.6]) and AO (4.8 [3.9–5.8]). Similar findings were observed for cells in the upper lid margin.

Conclusions:

This work has demonstrated for the first time that daily disposable CL wear produces a minimal subclinical inflammatory response compared with no lens wear over 1 week. By contrast, this inflammatory response is upregulated with reusable lenses but appears to be similar between hydrogel and silicone hydrogel materials over this short time frame.
Descemet Stripping Only for a Chronic Descemet Detachment After Cataract Surgery
Authors: Hirabayashi Kristin E. , Mark David , Lau Jackson , Lin Charles C.
Published: November 2019

Purpose:

To describe a case of postsurgical corneal decompensation in a patient with Fuchs endothelial dystrophy with a sectoral Descemet detachment and corneal edema that was successfully managed with a targeted Descemet stripping only (DSO) procedure.

Methods:

This is a case report and review of the literature.

Results:

A female patient with Fuchs endothelial dystrophy presented with a 6-month history of a persistent sectoral Descemet membrane detachment after cataract surgery with overlying corneal edema. Specular microscopy demonstrated moderate cell dropout with a cell density of 929 cells/mm2 in the affected eye. Intracameral air injection was attempted without improvement, and a sectoral DSO procedure was performed. Netarsudil and prednisolone were used postoperatively, and she demonstrated gradual improvement with resolution of the edema by postoperative week 10 and a central endothelial cell density of 675 cells/mm2 by postoperative month 8.

Conclusions:

DSO is a viable therapy in certain cases of postsurgical corneal decompensation.
Detection of Wild-type Yellow Fever Virus in Breast Milk
Authors: Ribeiro Ana Freitas , Brasil Lucas Mendes Cunha de Resende , Prada Renato Martins , Nogueira Juliana Silva , Maeda Adriana Yurika , Sztajnbok Jaques
Published: November 2019

Yellow fever is an endemic disease in tropical areas in America and Africa. We report a case where the wild-type yellow fever virus was detected in a breast milk sample of a 33-year-old woman, from a rural area in the municipality of São Paulo, thus highlighting a potential risk for transmission of yellow fever virus through breast-feeding.
Quadrivalent Influenza Vaccine Prevents Illness and Reduces Healthcare Utilization Across Diverse Geographic Regions During Five Influenza Seasons
Authors: Dbaibo Ghassan , Amanullah Arshad , Claeys Carine , Izu Allen , Jain Varsha K. , Kosalaraksa Pope , Rivera Luis , Soni Jyoti , Yanni Emad , Zaman Khalequ , Acosta Beatriz , Ariza Miguel , Arroba Basanta Maria L. , Bavdekar Ashish , Carmona Alfonso , Cousin Luis , Danier Jasur , Diaz Adolfo , Diez-Domingo Javier , Dinleyici Ener C. , Faust Saul N. , Garcia-Sicilia Jose , Gomez-Go Grace D. , Gonzales Maria L. A. , Hacimustafaoglu Mustafa , Hughes Stephen M. , Jackowska Teresa , Kant Shashi , Lucero Marilla , Mares Bermudez Josep , Martinón-Torres Federico , Montellano May , Prymula Roman , Puthanakit Thanyawee , Ruzkova Renata , Sadowska-Krawczenko Iwona , Szymanski Henryk , Ulied Angels , Woo Wayne , Schuind Anne , Innis Bruce L.
Published: November 2019

Background:

We evaluated an inactivated quadrivalent influenza vaccine (IIV4) in children 6–35 months of age in a phase III, observer-blind trial.

Methods:

The aim of this analysis was to estimate vaccine efficacy (VE) in preventing laboratory-confirmed influenza in each of 5 independent seasonal cohorts (2011−2014), as well as vaccine impact on healthcare utilization in 3 study regions (Europe/Mediterranean, Asia-Pacific and Central America). Healthy children were randomized 1:1 to IIV4 or control vaccines. VE was estimated against influenza confirmed by reverse transcription polymerase chain reaction on nasal swabs. Cultured isolates were characterized as antigenically matched/mismatched to vaccine strains.

Results:

The total vaccinated cohort included 12,018 children (N = 1777, 2526, 1564, 1501 and 4650 in cohorts 1−5, respectively). For reverse transcription polymerase chain reaction confirmed influenza of any severity (all strains combined), VE in cohorts 1−5 was 57.8%, 52.9%, 73.4%, 30.3% and 41.4%, respectively, with the lower limit of the 95% confidence interval >0 for all estimates. The proportion of vaccine match for all strains combined in each cohort was 0.9%, 79.3%, 72.5%, 24.1% and 28.6%, respectively. Antibiotic use associated with influenza illness was reduced with IIV4 by 71% in Europe, 36% in Asia Pacific and 59% in Central America.

Conclusions:

IIV4 prevented influenza in children 6−35 months of age in each of 5 separate influenza seasons in diverse geographical regions. A possible interaction between VE, degree of vaccine match and socioeconomic status was observed. The IIV4 attenuated the severity of breakthrough influenza illness and reduced healthcare utilization, particularly antibiotic use.
Earlier Antiretroviral Therapy Initiation and Decreasing Mortality Among HIV-infected Infants Initiating Antiretroviral Therapy Within 3 Months of Age in South Africa, 2006–2017
Authors: Iyun Victoria , Technau Karl-Gunter , Eley Brian , Rabie Helena , Boulle Andrew , Fatti Geoffrey , Egger Matthias , Tanser Frank , Wood Robin , Fairlie Lee , Cotton Mark F. , Davies Mary-Ann
Published: November 2019

Background:

Early infant diagnosis of HIV and antiretroviral therapy (ART) has been rapidly scaled-up. We aimed to examine the effect of expanded access to early ART on the characteristics and outcomes of infants initiating ART.

Methods:

From 9 cohorts within the International epidemiologic Databases to Evaluate AIDS-Southern Africa collaboration, we included infants with HIV initiating ART ≤3 months of age between 2006 and 2017. We described ART initiation characteristics and the probability of mortality, loss to follow-up (LTFU) and transfer out after 6 months on ART and assessed factors associated with mortality and LTFU.

Results:

A total of 1847 infants started ART at a median age of 60 days [interquartile range: 29–77] and CD4 percentage (%) of 27% (18%–38%). Across ART initiation calendar periods 2006–2009 to 2013–2017, ART initiation age decreased from 68 (53–81) to 45 days (7–71) (P < 0.001), median CD4% improved from 22% (15%–34%) to 32% (22–43) (P < 0.001) and the proportion with World Health Organization clinical disease stage 3 or 4 declined from 81.6% to 32.7% (P < 0.001). Overall, the 6-month mortality probability was 5.0% and LTFU was 20.4%. Mortality was 10.6% (95% confidence interval: 7.8%–14.4%) in 2006–2009 and 4.6% (3.1%–6.7%) in 2013–2017 (P < 0.001), with similar LTFU across calendar periods (P = 0.274). Pretreatment weight-for-age Z score <−2 was associated with higher mortality.

Conclusions:

Infants with HIV are starting ART younger and healthier with associated declines in mortality. However, the risk of mortality remained undesirably high in recent years. Focused interventions are needed to optimize the benefits of earlier diagnosis and treatment.
A Pharmacoepidemiologic Study of the Safety and Effectiveness of Clindamycin in Infants
Authors: Greenberg Rachel G. , Wu Huali , Maharaj Anil , Cohen-Wolkowiez Michael , Tomashek Kay M. , Osborn Blaire L. , Clark Reese H. , Walter Emmanuel B.
Published: November 2019

Background:

Despite the absence of adequate safety or efficacy data, clindamycin is widely prescribed in the neonatal intensive care unit. We evaluated the association between clindamycin exposure and adverse events, as well as antibiotic effectiveness in infants.

Methods:

This was a retrospective cohort study of infants receiving clindamycin before postnatal day 121 who were discharged from a Pediatrix Medical Group neonatal intensive care unit (1997–2015). Using a previously developed pharmacokinetic model, we performed simulations to predict clindamycin exposure based on available dosing data. We used multivariable logistic regression to evaluate the association between clindamycin exposure and safety outcomes during and after clindamycin therapy. We reported the proportion of infants with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and clearance of MRSA bacteremia.

Results:

A total of 4089 infants received clindamycin at a median (25th–75th percentile) dose of 15 mg/kg/d (12–16). Clearance increased with older gestational age. Infants with the highest total clindamycin exposure had marginally increased odds of necrotizing enterocolitis within 7 days (adjusted odds ratio = 1.95 [1.04–3.63]), but exposure was not associated with death, sepsis, seizures, intestinal perforation or intestinal strictures. Of 25 infants who had MRSA bacteremia, 19 (76%) cleared the infection by the end of the clindamycin course.

Conclusions:

Higher clindamycin exposure was not associated with increased odds of death or nonlaboratory adverse events. The use of pharmacokinetic models combined with available electronic health record data offers a valuable, cost-effective approach to analyzing the safety and effectiveness of drugs in infants when large-scale trials are not feasible.
Performance of a Sensor to Monitor Socket Fit: Comparison With Practitioner Clinical Assessment
Authors: Larsen Brian G. , Allyn Katheryn J. , Ciol Marcia A. , Sanders Joan E.
Published: November 2019

Introduction

A sensor that detects changes in prosthetic socket fit before they manifest clinically may be helpful towards rehabilitation after limb amputation.

Materials and Methods

Participants with transtibial amputation walked on a treadmill wearing a motor-driven, cabled-panel adjustable socket. Socket volume was slowly adjusted away from the neutral socket volume (panels flush). The percent socket volume change at which the practitioner, using visual assessment, first noted fit issues was compared with the percent socket volume change at which the sensor first detected a measurable change in fit.

Results

The median percent socket volume change at which the sensor first detected a measurable socket enlargement (0.50%) was significantly less than both the median percent socket volume change at which the research practitioner first noted a change in fit (1.69%) (P = 0.008) and the median percent socket volume change at which the participant would normally add a sock (2.30%) (P = 0.005). During socket reduction, the practitioner noted a change in fit before the participant would normally remove a sock in only 2 of 10 participants. The median percent socket volume change at which the sensor first detected a measurable socket reduction (−0.44%) was significantly smaller in absolute value than the median percent socket volume change at which the participant would normally remove a sock (−2.76%) (P = 0.005).

Conclusions

The sensor detected controlled socket fit changes before the research practitioner in this study. A next step will be to determine if the sensor detects unforced socket fit changes, and changes in user free-living environments.