bluuebunny/crossref_metadata_2025 huggingface dataset:
Elevated testosterone increases risk of hepatocellular carcinoma in men with chronic hepatitis B and diabetes mellitus
Authors: Yip Terry Cheuk‐Fung , Wong Grace Lai‐Hung , Chan Henry Lik‐Yuen , Tse Yee‐Kit , Liang Lilian Yan , Hui Vicki Wing‐Ki , Lee Hye Won , Lui Grace Chung‐Yan , Kong Alice Pik‐Shan , Wong Vincent Wai‐Sun
Published: April 2020

Background and Aim

Male sex is a risk factor for hepatocellular carcinoma (HCC). Diabetes mellitus (DM) is associated with a doubled risk of HCC in patients with chronic hepatitis B (CHB). We examined the relationship between serum total testosterone and HCC risk in male CHB patients with DM.

Methods

We performed a retrospective cohort study of male CHB patients with DM between 2000 and 2017 using a territory‐wide electronic health‐care database in Hong Kong. DM was defined by use of anti‐diabetic medications, hemoglobin A1c ≥ 6.5%, and/or fasting glucose ≥ 7 mmol/L in two measurements or ≥ 11.1 mmol/L in one measurement.

Results

Of 928 male CHB patients with DM, 83 (8.9%) developed HCC at a median (interquartile range) of 10.7 (6.1–14.6) years. Higher testosterone was associated with an elevated risk of HCC (adjusted hazard ratio [aHR] per 1 SD increase 1.23, 95% confidence interval [CI] 1.03–1.46, P = 0.024). The upper tertile of testosterone (aHR 1.86, 95% CI 1.02–3.39, P = 0.043), but not middle tertile (aHR 0.84, 95% CI 0.41–1.69 P = 0.620), was associated with a higher risk of HCC than the lower tertile. The cumulative incidence (95% CI) of HCC at 5, 10, and 15 years was 4.4% (2.5–7.2%), 12.4% (8.7–16.7%), and 19.1% (14.2–24.5%), respectively, in patients in the upper tertile of testosterone. By subgroup analysis, the association between testosterone and HCC was stronger in patients aged ≥ 50 years and those not receiving antiviral therapy.

Conclusion

Higher serum testosterone is associated with a higher incidence of HCC in male CHB patients with DM.
A Health System Response to COVID‐19 in Long‐Term Care and Post‐Acute Care: A Three‐Phase Approach
Authors: Kim Gina , Wang Mengru , Pan Hanh , H. Davidson Giana , Roxby Alison C. , Neukirch Jen , Lei Danna , Hawken‐Dennis Elicia , Simpson Louise , D. Ong Thuan
Published: April 2020

BACKGROUND

The Seattle, WA, area was ground zero for coronavirus disease 2019 (COVID‐19). Its initial emergence in a skilled nursing facility (SNF) not only highlighted the vulnerability of its patients and residents, but also the limited clinical support that led to national headlines. Furthermore, the coronavirus pandemic heightened the need for improved collaboration among healthcare organizations and local and state public health.

METHODS

The University of Washington Medicine's (UWM's) Post‐Acute Care (PAC) Network developed and implemented a three‐phase approach within its pre‐existing network of SNFs to help slow the spread of the disease, support local area SNFs from becoming overwhelmed when inundated with COVID‐19 cases or persons under investigation, and help decrease the burden on area hospitals, clinics, and emergency medical services.

RESULTS

Support of local area SNFs consisted of the following phases that were implemented at various times as COVID‐19 impacted each facility at different times. Initial Phase: This phase was designed to (1) optimize communication, (2) review infection control practices, and (3) create a centralized process to track and test the target population. Delayed Phase: The goals of the Delayed Phase were to slow the spread of the disease once it is present in the SNF by providing consistent education and reinforcing infection prevention and control practices to all staff. Surge Phase: This phase aimed to prepare facilities in response to an outbreak by deploying a "Drop Team" within 24 hours to the facility to expeditiously test patients and exposed employees, triage symptomatic patients, and coordinate care and supplies with local public health authorities.

CONCLUSIONS

The COVID‐19 Three‐Phase Response Plan provides a standardized model of care that may be implemented by other health systems and SNFs to help prepare and respond to COVID‐19. J Am Geriatr Soc 68:1155–1161, 2020.
Clients' Attributions of the Presenting Problem and the Therapeutic Alliance in Couple Therapy: Systemic Versus Intrapersonal Perspectives
Authors: Wu Qiong , McWey Lenore M. , Ledermann Thomas
Published: April 2020

The therapeutic alliance is central to couples' therapy success. The current study examined associations between couples' initial agreement and causal attributions of the presenting problem and changes in the therapeutic alliance. To test study hypotheses, 85 couples were recruited from a university training clinic focused on couple and family therapy. Couples completed an intake questionnaire concerning their attribution of the presenting problem, either as systemic or individual, and therapeutic alliance was assessed at the end of sessions 2–8. A dyadic multilevel model revealed that a disagreement in the couple's attributions of the problem (with one viewing it as systemic, the other as individual) was associated with a larger initial discrepancy in the couple's therapeutic alliance, as well as a decline in the discrepancy over time. Findings were discussed in the context of systemic family theory, with implications for improving assessment, treatment, and psychoeducation aimed toward couples in distress.
Relevance of diagnostic investigations in chronic inflammatory demyelinating poliradiculoneuropathy: Data from the Italian CIDP database
Authors: Liberatore Giuseppe , Manganelli Fiore , Cocito Dario , Fazio Raffaella , Briani Chiara , Filosto Massimiliano , Benedetti Luana , Antonini Giovanni , Cosentino Giuseppe , Jann Stefano , Mazzeo Anna , Cortese Andrea , Marfia Girolama Alessandra , Clerici Angelo Maurizio , Siciliano Gabriele , Carpo Marinella , Sabatelli Mario , Lauria Giuseppe , Rosso Tiziana , Nobile Orazio Eduardo ,   on the behalf of the Italian CIDP Database Study Group
Published: April 2020

The objective of our work was to report the clinical features and the relevance of diagnostic investigations in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). We retrospectively reviewed data from patients with a clinical diagnosis of CIDP included in a national database. Among the 500 included patients with a clinical diagnosis of CIDP, 437 patients (87%) fulfilled the European Federation of Neurological Societies and Peripheral Nerve Society criteria for CIDP (definite in 407, probable in 26, possible in four). In 352 patients (86%) motor nerve conduction abnormalities consistent with demyelination were sufficient for the diagnosis of definite CIDP. In 55 patients, this diagnosis required the addition of one or two (from probable or from possible CIDP, respectively) supportive tests, while in 20 cases they improved the diagnosis from possible to probable CIDP, seven patients did not change diagnosis. Considering these 85 patients, cerebrospinal fluid studies were performed in 79 cases (93%) upgrading the certainty of diagnosis in 59% of examined patients. Sensory nerve conduction studies (NCS) were performed in 85% of patients with an improvement of diagnosis in 32% of cases. Nerve biopsy and ultrasound and magnetic resonance imaging (US/MRI) exams resulted positive in about 40% of examined patients, but they were performed in few patients (7 patients and 16 patients, respectively). A response to the therapy was present in 84% of treated patients (n = 77), contributing to support the diagnosis in 40 patients in whom the other supportive criteria were not sufficient. In most patients with CIDP the diagnosis is possible solely with motor NCS while other investigations may help improving the diagnosis in a minority of patients.
Preliminary assessment of black soldier fly (Hermetia illucens) larval meal in the diet of African catfish (Clarias gariepinus): Impact on growth, body index, and hematological parameters
Authors: Adeoye Ayodeji A. , Akegbejo‐Samsons Yemi , Fawole Femi J. , Davies Simon J.
Published: April 2020

A study was conducted to evaluate the effect of black soldier fly (Hermetia illucens) larval meal (BSF) in practical diets of African catfish (Clarias gariepinus). Four diets were formulated to contain levels of fishmeal replacement at 0, 25, 50, and 100% with BSF. A total of 360 fingerlings (2.67 ± 0.0 g/fish) were randomly distributed into 12 tanks (30‐L capacity) containing 30 fish each and fed with the respective diet to apparent satiation. After 6 weeks of feeding, growth performance and nutrient utilization indices of the groups fed 25 and 50% BSF diets were not significantly different (p > .05) from the group fed the fishmeal‐based control diet. However, further increase in the replacement of fishmeal with BSF (100%) led to a significant (p < .05) reduction in the growth, feed intake, and protein efficiency ratio of the catfish, whereas body index and survival were not affected. The hematological parameters among the BSF fed groups showed no significant variation (p > .05) compared with the control group. From the current study, it was clear that fishmeal could be replaced with BSF up to 50% without affecting the growth performance, nutrient utilization, survival, and welfare of C. gariepinus fingerlings.
Attenuated effect of PNPLA3 on hepatic fibrosis by HSD17B13 in Japanese patients with non‐alcoholic fatty liver disease
Authors: Seko Yuya , Yamaguchi Kanji , Tochiki Nozomi , Yano Kota , Takahashi Aya , Okishio Shinya , Kataoka Seita , Okuda Keiichiroh , Umemura Atsushi , Moriguchi Michihisa , Tanaka Saiyu , Mori Kojiroh , Okanoue Takeshi , Itoh Yoshito
Published: April 2020

Background & Aims

PNPLA3 rs738409 has been associated with increased risks of fibrosis in patients with non‐alcoholic fatty liver disease (NAFLD). Recently, carriage of the rs6834314 G allele, which is in high linkage with rs72613567 of 17‐beta‐hydroxysteroid dehydrogenase 13 (HSD17B13), was reported to be associated with a reduced risk of liver injury in NAFLD patients. We estimated the impact of these genetic variants on hepatic fibrosis in Japanese patients with NAFLD.

Methods

We analysed the associations of these genetic variants with liver histology in 290 Japanese patients with biopsy‐proven NAFLD diagnosed during 2002‐2019. During follow‐up, 14 patients (4.8%) developed hepatocellular carcinoma.

Results

Prevalences of the PNPLA3 rs738409 genotypes were 0.17 for CC, 0.41 for CG, 0.42 for GG, and those for HSD17B13 rs6834314 were 0.54 for AA, 0.39 for AG and 0.07 for GG. There was no significant interaction between the PNPLA3 and HSD17B13 genotypes. Prevalences of advanced fibrosis according to PNPLA3/HSD17B13 genotypes were 0.16 for CC,CG/AG,GG, 0.20 for CC,CG/AA, 0.30 for GG/AG,GG and 0.37 for GG/AA. Multivariate analysis identified PNPLA3 GG as a predictor of advanced fibrosis (stage 3/4) in carriers of HSD17B13 AA (odds ratio 2.4, P = .041), but not HSD17B13 AG/GG (P = .776). The HSD17B13 genotype G was significantly associated with lower prevalences of severe inflammation and ballooning and tended to be associated with a higher prevalence of advanced steatosis.

Conclusions

In Japanese patients with NAFLD, carriage of the HSD17B13 rs6834314 G allele attenuated the effect of the PNPLA3 rs738409 GG genotype on advanced hepatic fibrosis.
RENAISSANCE HUMANISM AND PHILOSOPHY AS A WAY OF LIFE
Authors: Sellars John
Published: April 2020

A long‐established view has deprecated Renaissance humanists as primarily literary figures with little serious interest in philosophy. More recently it has been proposed that the idea of philosophy as a way of life offers a useful framework with which to reassess their philosophical standing. This proposal has faced some criticism, however. By looking again at the work of three important figures from the period, this essay defends the claim that at least some thinkers during the Renaissance did see philosophy as a way of life, while also acknowledging the force of reservations made by recent critics.
SETTING LIMITS TO PRACTICAL REFLECTION
Authors: Sommavilla Vitor
Published: April 2020

According to a tradition going back to Socrates, one should thoroughly examine the grounds of one’s judgments before settling on what one has reason to do or believe. According to contemporary metaethical constructivism, assumed in this essay, reflective scrutiny is also central to assessing a judgment’s claim to justification. This essay argues against the injunctions to thoroughly examine oneself and seek ultimate reasons for one’s normative judgments. In other words, the essay argues against the ideal of the philosophical way of life. It shows that in most cases one does not have reason to question the practical conclusion of one’s initial deliberation. It is only under very limited conditions, specified in the essay, that one is justified in engaging in further reflection. Furthermore, the essay argues that if one does go for full self‐examination, the consequences are most likely to be bad for oneself, given one’s practical interests.
Introduction
Authors: Ambury James M. , Irani Tushar , Wallace Kathleen
Published: April 2020

This is an Introduction to the special issue of Metaphilosophy entitled Philosophy as a Way of Life, giving a brief account of the genesis of the project, an overview of the topic, and a summary of the topics covered in the issue.
Quantifying the sharing of foliar fungal pathogens by the invasive plant Ageratina adenophora and its neighbours
Authors: Chen Lin , Zhou Jie , Zeng Tian , Miao Yi‐Fang , Mei Liang , Yao Guang‐Bo , Fang Kai , Dong Xing‐Fan , Sha Tao , Yang Ming‐Zhi , Li Tao , Zhao Zhi‐Wei , Zhang Han‐Bo
Published: April 2020

Local pathogens can accumulate as asymptomatic endophytes, making it difficult to detect the impacts of invasive species as propagators of disease in the invaded range.

We used the invasive plant Ageratina adenophora to assess such accumulation. We intensively collected foliar fungal endophytes and leaf spot pathogens of A. adenophora and co‐occurring neighbours and performed an inoculation experiment to evaluate their pathogenicity and host range.

Ageratina adenophora harboured diverse necrotrophic pathogens; its communities of endophytes and leaf spot pathogens were different in composition and shared only a small number of fungal species. In the pathogen communities of local plant hosts, 21% of the operational taxonomic units (OTUs), representing 50% of strains, also occurred as leaf spot pathogens and/or endophytes of A. adenophora. The local pathogen community was more similar to the endophytes than to the pathogens of A. adenophora. The inoculation experiment showed that local pathogens could infect A. adenophora leaves asymptomatically and that local plant hosts were susceptible to both A. adenophora endophytes and pathogens.

Ageratina adenophora is a highly competent host for local pathogens, and its asymptomatic latent pathogens are fungi primarily shared with local neighbours. This poses challenges for understanding the long‐term ecological consequences of plant invasion.
CARMIL2‐related immunodeficiency manifesting with photosensitivity
Authors: Shayegan Leila H. , Garzon Maria C. , Morel Kimberly D. , Borlack Rachel , Vuguin Patricia M. , Margolis Kara G. , Demirdag Yesim Y. , Pereira Elaine M. , Lauren Christine T.
Published: April 2020

We report a case of a newly recognized primary immunodeficiency due to biallelic mutations in CARMIL2 manifesting as an actinic prurigo‐like photodermatitis, allergic diathesis and recurrent infections in a child. We present this case to highlight a rare phenotype seen in this T‐cell immunodeficiency and provide an overview of other dermatologic manifestations among published reports of this condition.
Preterm birth, unplanned hospital contact, and mortality in infants born to teenage mothers in five countries: An administrative data cohort study
Authors: Harron Katie , Verfuerden Maximiliane , Ibiebele Ibinabo , Liu Can , Kopp Alex , Guttmann Astrid , Ford Jane , van der Meulen Jan , Hjern Anders , Gilbert Ruth
Published: April 2020

Background

Young maternal age is associated with lower birthweight and higher rates of preterm birth and childhood hospitalisations. Internationally, teen pregnancy rates vary widely, reflecting differences in social, welfare, and health care factors in different cultural contexts.

Objectives

To determine whether the increased risk of adverse infant outcomes among teenage mothers varies by country, reflecting different national teenage birth rates and country‐specific social/welfare policies, in Scotland (higher teenage pregnancy rates), England, New South Wales (NSW; Australia), Ontario (Canada), and Sweden (lower rates).

Methods

We used administrative hospital data capturing 3 002 749 singleton births surviving to postnatal discharge between 2010 and 2014 (2008‐2012 for Sweden). We compared preterm birth (24‐36 weeks’ gestation), mortality within 12 months of postnatal discharge, unplanned hospital admissions, and emergency department visits within 12 months of postnatal discharge, for infants born to mothers aged 15‐19, 20‐24, 25‐29, and 30‐34 years.

Results

Compared to births to women aged 30‐34 years, risks of adverse outcomes among teenage mothers were higher in all countries, but the magnitude of effects was not related to country‐specific rates of teenage births. Teenage mothers had between 1.2% (95% confidence interval [CI] 0.7, 1.7, Sweden) and 2.0% (95% CI 1.4, 2.5, NSW) more preterm births, and between 9.8 (95% CI 7.2, 12.4, England) and 19.7 (95% CI 8.7, 30.6, Scotland) more deaths per 10 000 infants, compared with mothers aged 30‐34. Between 6.4% (95% CI 5.5, 7.4, NSW) and 25.4% (95% CI 24.7, 26.1, Ontario), more infants born to teenage mothers had unplanned hospital contacts compared with those born to mothers aged 30‐34.

Conclusions

Regardless of country, infants born to teenage mothers had universally worse outcomes than those born to older mothers. This excess risk did not vary by national rates of livebirths to teenage mothers. Current mechanisms to support teenage mothers have not eliminated maternal age‐related disparities in infant outcomes; further strategies to mitigate excess risk in all countries are needed.
A qualitative study of nurses’ perspective about the impact of end‐of‐life communication on the goal of end‐of‐life care in nursing home
Authors: Gonella Silvia , Basso Ines , Clari Marco , Dimonte Valerio , Di Giulio Paola
Published: April 2020

Background

With a growing nursing home population suffering from chronic progressive illnesses and evolving patterns of comorbidities, end‐of‐life communication takes on a critical role to enable healthcare professionals to gather information about the resident’s wishes for care at the end‐of‐life and organise the care plan accordingly.

Aim

To explore nurses’ perspective about the process by which end‐of‐life communication impacts on the goal of end‐of‐life care in nursing home residents.

Design

A qualitative descriptive research design based on thematic analysis was performed. Fourteen nurses involved in the care of residents during their last week of life were recruited across 13 Italian nursing homes and accounted for 34 semi‐structured interviews. A combined approach of analysis that incorporated a data‐driven inductive approach and a theory‐driven one was adopted.

Results

Twelve themes described how end‐of‐life communication may contribute to adjust the care plan in nursing home according to the nurses’ perspective. Five antecedents (i.e. life crisis or transitions, patient‐centered environment, arising the question of possible dying, quality of relationships and culture of care) influenced the establishment and quality of communication, and five attributes depicted the characteristics and potential mechanisms of end‐of‐life communication (i.e. healthcare professional‐resident and healthcare professional‐family carers communication, knowledge of family carers’ preferences, knowledge of residents’ preferences, family carers and residents understanding, and shared decision‐making), while curative‐oriented and palliative‐oriented care goals emerged as consequences.

Conclusion

This study provides insight into the nursing perspective of end‐of‐life communication between healthcare professionals and bereaved family carers of nursing home residents. Several factors influenced the occurrence and quality of end‐of‐life communication, which contributed to the transition towards palliative‐oriented care by using and improving knowledge about family cares’ and resident’s preferences for end‐of‐life care, promoting family carers and residents understanding about prognosis and treatments available, and fostering shared decision‐making.
Beyond slash‐and‐burn: The roles of human activities, altered hydrology and fuels in peat fires in Central Kalimantan, Indonesia
Authors: Goldstein Jenny E. , Graham Laura , Ansori Sofyan , Vetrita Yenni , Thomas Andri , Applegate Grahame , Vayda Andrew P. , Saharjo Bambang H. , Cochrane Mark A.
Published: April 2020

Near‐annual landscape‐scale fires in Indonesia's peatlands have caused severe air pollution, economic losses, and health impacts for millions of Southeast Asia residents. While the extent of fires across the peatland surface has been widely attributed to widespread peatland drainage for plantation agriculture, fires that transition from surface into sub‐surface soil‐based fires are the source of the most dangerous air pollution. Yet the mechanisms by which this transition occurs have rarely been considered, particularly in diversely managed landscapes. Integrating physical geography methods, including active fire scene evaluations and hydrological monitoring, with qualitative methods such as retrospective fire scene evaluations and semi‐structured interviews, this article discusses how and why sub‐surface peat fire transition occurs in an intensively altered peatland ecosystem in Indonesia's Central Kalimantan province. We demonstrate that variable water table levels and flammable surface vegetation (fire fuels) are co‐produced socio‐political and biophysical phenomena that enable the conditions in which surface fire is likely to transition into peat fire and increase landscape vulnerability to ongoing, uncontrollable annual fires. This localized understanding of peat fire transition counters normative causal narratives of tropical fire such as ‘slash‐and‐burn’, with implications for the management of new fire regimes in inhabited landscapes.
The use of 4F‐PCC to correct direct oral anticoagulant‐induced coagulopathy: An observational analysis
Authors: Zheng Yan , Tormey Christopher A.
Published: April 2020

Background

With the approval of four‐factor prothrombin complex concentrate (4F‐PCC, Kcentra) for the reversal of vitamin K antagonist‐associated bleeding in the United States, it has become a relatively common practice for 4F‐PCC to be used in an “off‐label” fashion to correct coagulopathy caused by direct oral anticoagulants (DOACs). However, the efficacy and safety of 4F‐PCC have not been well studied in this scenario.

Materials and Methods

We performed a retrospective observational study on the off‐label use of 4F‐PCC for reversing bleeding associated with DOACs in a level 1 trauma centre between November 2014 and February 2017. International normalised ratio (INR) and Hgb prior to and post 4F‐PCC infusion, clinical outcome and thromboembolic events within 24 hours and 45 days of 4F‐PCC administration were collected.

Results

We identified 24 patients on DOACs who received 4F‐PCC for severe haemorrhage and emergent surgeries. Most patients showed improved haemorrhage as demonstrated by stabilised intracranial haemorrhage sizes and/or by steady Hgb levels. No thromboembolic event was identified within 24 hours of 4F‐PCC administration. However, 16.7% patients (4/24) experienced thromboembolic events 2 to 45 days after receiving 4F‐PCC.

Conclusion

Our data showed that 4F‐PCC was relatively efficient in correcting DOAC‐induced coagulopathy. We did notice that 16.7% of patients experienced some form of thromboembolic events in the days‐to‐weeks after 4F‐PCC administration, although the imputability of 4F‐PCC in these processes (vs their underlying disease) is difficult to determine. Additional prospective studies would be warranted to further evaluate the safety of 4F‐PCC for this off‐label indication.
Three‐dimensional genetic networks among seed oil‐related traits, metabolites and genes reveal the genetic foundations of oil synthesis in soybean
Authors: Liu Jin‐Yang , Li Pei , Zhang Ya‐Wen , Zuo Jian‐Fang , Li Guo , Han Xu , Dunwell Jim M. , Zhang Yuan‐Ming
Published: April 2020

Although the biochemical and genetic basis of lipid metabolism is clear in Arabidopsis, there is limited information concerning the relevant genes in Glycine max (soybean). To address this issue, we constructed three‐dimensional genetic networks using six seed oil‐related traits, 52 lipid metabolism‐related metabolites and 54 294 SNPs in 286 soybean accessions in total. As a result, 284 and 279 candidate genes were found to be significantly associated with seed oil‐related traits and metabolites by phenotypic and metabolic genome‐wide association studies and multi‐omics analyses, respectively. Using minimax concave penalty (MCP) and smoothly clipped absolute deviation (SCAD) analyses, six seed oil‐related traits were found to be significantly related to 31 metabolites. Among the above candidate genes, 36 genes were found to be associated with oil synthesis (27 genes), amino acid synthesis (four genes) and the tricarboxylic acid (TCA) cycle (five genes), and four genes (GmFATB1a, GmPDAT, GmPLDα1 and GmDAGAT1) are already known to be related to oil synthesis. Using this information, 133 three‐dimensional genetic networks were constructed, 24 of which are known, e.g. pyruvate–GmPDAT–GmFATA2–oil content. Using these networks, GmPDAT, GmAGT and GmACP4 reveal the genetic relationships between pyruvate and the three major nutrients, and GmPDAT, GmZF351 and GmPgs1 reveal the genetic relationships between amino acids and seed oil content. In addition, GmCds1, along with average temperature in July and the rainfall from June to September, influence seed oil content across years. This study provides a new approach for the construction of three‐dimensional genetic networks and reveals new information for soybean seed oil improvement and the identification of gene function.
Equine pythiosis in Egypt: clinicopathological findings, detection, identification and genotyping of Pythium insidiosum
Authors: Tartor Yasmine H. , Hamad Mohamed H. , Abouzeid Nasser Z. , El‐Belkemy Farouk A.
Published: April 2020

Background

Equine pythiosis is an emerging, devastating disease that is hard to treat. The tumour‐like nodular skin masses grow rapidly and the outcome is generally fatal, and thus early diagnosis and intervention are important.

Objectives

(i) To highlight the clinical, histological and haematological findings in pythiosis, and (ii) to evaluate the efficacy of direct sample multiplex‐PCR targeting the single nucleotide polymorphisms within the ribosomal DNA region for detection and genotyping of Pythium insidiosum.

Animals

Two hundred and twenty horses including 204 Arabian and 16 draft horses were surveyed.

Methods

Case series study diagnosis was based on clinical, pathological and haematological findings typical of P. insidiosum infection, culture identification, immunohistochemical investigation and direct sample PCR.

Results

The affected horses (24 of 220, 10.91%) presented with unifocal or multiple lesions on the abdomen, limbs, chest, face and mammary gland. Cases commonly had a history of access to stagnant water, ponds and intentionally flooded rice fields. Most were pregnant mares (58.33%). Histopathology revealed granulomatous reaction, blood vessel endotheliosis, heavy infiltration of eosinophils in the dermal layer, multifocal necrosis and Splendore–Hoeppli phenomenon. Unlike direct microscopy (50%) and culture (91.6%), multiplex‐PCR assay identified P. insidiosum (Clade II) in all tested samples. To the best of the authors knowledge, this is the first study determining a clade of P. insidiosum causing equine pythiosis in Egypt.

Conclusions and clinical importance

Direct sample multiplex‐PCR assay is a potential tool for the early and rapid diagnosis of equine pythiosis. It overcomes limitations associated with morphological identification and provides a definitive diagnosis.
Reducing the red blood cell transfusion threshold from 8·0 g/dl to 7·0 g/dl in acute myeloid leukaemia patients undergoing induction chemotherapy reduces transfusion rates without adversely affecting patient outcome
Authors: Ballo Olivier , Fleckenstein Philine , Eladly Fagr , Kreisel Eva‐Maria , Stratmann Jan , Seifried Erhard , Müller Markus , Serve Hubert , Bug Gesine , Bonig Halvard , Brandts Christian H. , Finkelmeier Fabian
Published: April 2020

Background and Objectives

Red blood cell (RBC) transfusions are needed by almost every acute myeloid leukaemia (AML) patient undergoing induction chemotherapy and constitute a cornerstone in supportive measures for cancer patients in general. Randomized controlled trials have shown non‐inferiority or even superiority of restrictive transfusion guidelines over liberal transfusion guidelines in specific clinical situations outside of medical oncology. In this study, we analysed whether more restrictive RBC transfusion reduces blood use without affecting hard outcomes.

Materials and Methods

A total of 352 AML patients diagnosed between 2007 and 2018 and undergoing intensive induction chemotherapy were included in this retrospective analysis. In the less restrictive transfusion group, patients received RBC transfusion for haemoglobin levels below 8 g/dl (2007–2014). In the restrictive transfusion group, patients received RBC transfusion for haemoglobin levels below 7 g/dl (2016–2018). Liberal transfusion triggers were never endorsed.

Results

A total of 268 (76·1%) and 84 (23·9%) AML patients fell into the less restrictive and restrictive transfusion groups, respectively. The less restrictive transfusion group had 1 g/dl higher mean haemoglobin levels, received their first RBC transfusions earlier and needed 1·5 more units of RBC during the hospital stay of induction chemotherapy. Febrile episodes, C‐reactive protein levels, admission to the intensive care unit, length of hospital stay as well as response and survival rates did not differ between the two cohorts.

Conclusion

From our retrospective analysis, we conclude that a more restrictive transfusion trigger does not affect important outcomes of AML patients. The opportunity to test possible effects of the more severe anaemia in the restrictive transfusion group on quality of life was missed.
Impact of long‐term storage of plasma and cell‐free DNA on measured DNA quantity and fetal fraction
Authors: Clausen Frederik Banch , Barrett Angela N. , Advani Henna V. , Choolani Mahesh , Dziegiel Morten Hanefeld
Published: April 2020

Background and objective

Optimal sample storage conditions are essential for non‐invasive prenatal testing of cell‐free fetal and total DNA. We investigated the effect of long‐term storage of plasma samples and extracted cfDNA using qPCR.

Materials and methods

Fetal and total cfDNA yield and fetal fraction were calculated before and after storage of plasma for 0–6 years at −25°C. Dilution experiments were performed to investigate PCR inhibition. Extraction with or without proteinase K was used to examine protein dissociation. Storage of extracted cfDNA was investigated by testing aliquots immediately, and after 18 months and 3 years of storage at −25°C.

Results

We observed a marked increase in the levels of amplifiable fetal and total DNA in plasma stored for 2‐3 years, and fetal fraction was slightly decreased after 3 years of storage. cfDNA detection was independent of proteinase K during DNA extraction in plasma samples stored >2 years, indicating a loss of proteins from DNA over time, which was likely to account for the observed increase in DNA yields. Measured fetal and total DNA quantities, as well as fetal fraction, increased in stored, extracted cfDNA.

Conclusion

Fetal and total cell‐free DNA is readily detectable in plasma after long‐term storage at −25°C. However, substantial variation in measured DNA quantities and fetal fraction means caution may be required when using stored plasma and extracted cfDNA for test development or validation purposes.
Platelet immunology from the inside out
Authors: Semple John W. , Kapur Rick
Published: April 2020

Platelets are the critical cellular mediators of hemostasis; however, many studies have now suggested that these tiny offspring of megakaryocytes can also perform multiple immune‐like functions that significantly affect both innate and adaptive immunity. For example, like whole blood, platelets can mediate transfusion‐related immunomodulation (TRIM) and it appears that activated platelets are more immunoregulatory that their resting counterparts. In addition, platelets express and secrete a wide variety of critical immune molecules such as TGF‐β, CD40/CD40L and MHC class I molecules. This allows platelets to directly influence adaptive immune mechanisms and a variety of immune disease processes. It has also been demonstrated that both platelets and megakaryocytes can process and present both foreign and self‐antigens to CD8+ T cells. This manuscript will highlight several non‐haemostatic attributes of platelets that deservedly categorize them as integral players in immunity.
Effects of Cyclic Loading and Time-Recovery on Microstructure and Mechanical Properties of Particle-Binder Composites
Authors: Agarwal Ankit , Gonzalez Marcial
Published: April 2020

We propose a systematic experimental procedure and quantitative analyses to investigate the effect of cyclic loading, and time-recovery, or aging, on the mechanical properties and microstructure of particle-binder composites. Specifically, we study three compositions that differ in aluminum content from the mock sugar formulation of plastic-bonded explosive PBXN-109. Cast cylindrical specimens are subjected to high-amplitude quasi-static cyclic compressive loading, before and after a 4-week time-recovery period, and their microstructures are analyzed using micro-computed tomography (CT). For quantitative analysis, we develop a procedure for identifying the spatial distribution of primary components of the formulation, including pore space, from micro-CT images. The study shows that the stress–strain response is highly nonlinear, without a distinct yield point, and exhibits hysteresis and cyclic stress softening, or Mullins effect, with cyclic stabilization. Specimens without aluminum exhibit considerable gain in stiffness and strength after the time-recovery or aging period, owing to the development of increased sucrose particle–particle interactions during the first cyclic loading. In contrast, specimens with aluminum micro-sized powder exhibit permanent loss of stiffness and strength, owing to large ductile plastic flow and irrecoverable damage. Further insight from micro-CT analysis is gained by observing that, for all compositions, the majority of microstructural changes occur near the specimen core. Specifically, affine radial deformation of the soft and debonded binder, as it is compressed by the non-affine longitudinal motion of stiffer sucrose crystals, is observed in the formulation without aluminum, whereas non-affine rearrangement of the binder toward the specimen core, and affine radial flow of sucrose particles away from the core due to ductile macroscopic deformation of the specimen, is observed in the formulations with aluminum content.
Micro-level Clearance Punching on NGO Electrical Steel
Authors: Fang Zhenglong , Nagato Keisuke , Shimura Tomohito , Murakami Masato , Nakao Masayuki
Published: April 2020

Non-grain-oriented electrical steel lamination is a critical component for the magnetic core. Punching such steel sheet with a large shear region, a low burr and small rollover is required to ensure accuracy. Densely packed grain deformation and plastic strain near cut surface are generally accompanied which detrimentally influence magnetic properties. In this study, micro-clearance (CL: 1 and 5 µm) punching of electrical silicon steel was conducted to investigate the influences of punching speed, micro-clearance, and counterforce on dimensional accuracy and microstructural changes. Electron backscatter diffraction analysis was performed to investigate the microstructural characteristics and detailed texture of specimens produced by shear speeds of 100, 260, and 600 mm/s with and without applied counterforce. Rollover height was found to be significantly reduced at a shear speed of 260 mm/s with applied counterforce under 1 µm clearance punching. The applications of counterforce and higher speed both significantly increased grain deformation, although the dimensional accuracy was improved. Grain conditions and the quality of cut surface were compared for different punching conditions to advance the understanding on the correlations between dimensional accuracy, grain deformation, and plastic strain.
Discussion “Investigation of Double Diffusive Natural Convection in Presence of Gray Gas Radiation Within a Square Cavity Using Multiple Relaxation Time Lattice Boltzmann Method,” [Moufekkir, F., Moussaoui, M. A., Mezrhab, A., Fontaine, J. P., Bouzidi, M., ASME J. Heat Transfer, 2013, 135(10), p. 102701]
Authors: Pantokratoras Asterios
Published: April 2020

Some errors exist in the above paper.
A New Thermodynamic and Heat Transfer Model for Nanolubricants and Refrigerant Heat Transfer Processes in Smooth Copper Tubes
Authors: Deokar Pratik S. , Cremaschi Lorenzo , Bigi Andrea A. M.
Published: April 2020

In air conditioning systems, lubricating oil leaves the compressor and circulates through the other system components. This lubricant acts as a contaminant affecting heat transfer in heat exchangers. The literature indicated that mixtures of refrigerants and nanolubricants, that is, nanoparticles dispersed in the lubricant oils, have potentials to augment heat transfer exchange effectiveness. However, the nanoparticle mechanisms leading to such heat transfer changes are still unclear and not well included in the models. In this work, an existing single-phase forced flow convective heat transfer model, originally developed for water-based nanofluids, was modified to include the effects of diffusion and mass balance of different shape nanoparticles within the laminar sublayer and turbulent layer of the flow. A new physics-based superposition heat transfer model for saturated two-phase flow boiling of refrigerant and nanolubricants was also developed by integrating the modified forced flow convective heat transfer model and a semi-empirical pool boiling model for nanolubricants. The new model included the several physical effects that influenced heat transfer, such as slip mechanisms at the nanoparticles and base fluid interface and its influence on the laminar sublayer thickness, momentum transfer from the nanoparticles to the growing bubbles, and formation of lubricant excess concentration at the tube surface and its influence on bubble growth and tube wetting. The new model was validated for single-phase convective heat transfer and two-phase flow boiling of refrigerant R410A with two nanolubricants, having nonspherical ZnO nanoparticles and spherical Al2O3 nanoparticles.
Regulation of the error-prone DNA polymerase Polκ by oncogenic signaling and its contribution to drug resistance
Authors: Temprine Kelsey , Campbell Nathaniel R. , Huang Richard , Langdon Erin M. , Simon-Vermot Theresa , Mehta Krisha , Clapp Averill , Chipman Mollie , White Richard M
Published: April 2020

DNA polymerase κ mediates drug resistance in tumor cells through a mechanism that could be independent of mutagenesis.
Antifungal Susceptibility Testing: Current Approaches
Authors: Berkow Elizabeth L. , Lockhart Shawn R. , Ostrosky-Zeichner Luis
Published: April 2020

Although not as ubiquitous as antibacterial susceptibility testing, antifungal susceptibility testing (AFST) is a tool of increasing importance in clinical microbiology laboratories. The goal of AFST is to reliably produce MIC values that may be used to guide patient therapy, inform epidemiological studies, and track rates of antifungal drug resistance. There are three methods that have been standardized by standards development organizations: broth dilution, disk diffusion, and azole agar screening for
Aspergillus
.
Bioavailability Based on the Gut Microbiota: a New Perspective
Authors: Zhang Feng , He Fang , Li Li , Guo Lichun , Zhang Bin , Yu Shuhuai , Zhao Wei
Published: April 2020

The substantial discrepancy between the strong effects of functional foods and various drugs, especially traditional Chinese medicines (TCMs), and the poor bioavailability of these substances remains a perplexing problem. Understanding the gut microbiota, which acts as an effective bioreactor in the human intestinal tract, provides an opportunity for the redefinition of bioavailability. Here, we discuss four different pathways associated with the role of the gut microbiota in the transformation of parent compounds to beneficial or detrimental small molecules, which can enter the body’s circulatory system and be available to target cells, tissues, and organs.
Cross-Feeding between Members of
Thauera
spp. and
Rhodococcus
spp. Drives Quinoline-Denitrifying Degradation in a Hypoxic Bioreactor
Authors: Wu Xinxin , Wu Xiaogang , Li Ji , Wu Qiaoyu , Ma Yiming , Sui Weikang , Zhao Liping , Zhang Xiaojun
Published: April 2020

We experimentally verified that the second most abundant taxon,
Rhodococcus
, played a role in degrading quinoline to 2-hydroxyquinoline, while the most abundant taxon,
Thauera
, degraded 2-hydroxyquinoline. Metabolites from
Thauera
further served to provide metabolites for
Rhodococcus
. Hence, an ecological guild composed of two isolates was assembled, revealing the different roles that keystone organisms play in the microbial community. This report, to the best of our knowledge, is the first on cross-feeding between the initial quinoline degrader and a second bacterium. Specifically, the quinoline degrader (
Rhodococcus
) did not benefit metabolically from quinoline degradation to 2-hydroxyquinoline but instead benefited from the metabolites produced by the second bacterium (
Thauera
) when
Thauera
degraded the 2-hydroxyquinoline. These results could be a significant step forward in the elucidation of the microbial mechanism underlying quinoline-denitrifying degradation.
Traumatic arteriovenous fistula with serious haemodynamic repercussions: endovascular treatment
Authors: Raymundo Selma Regina de Oliveira , Leite Roana Lacerda Tavares , Reis Luiz Fernando , Russeff Gleison Juliano da Silva
Published: April 2020

Major abdominal arteriovenous fistula (AVF) is a rare clinical condition defined as an abnormal communication between the aorta or iliac arteries and the inferior vena cava or the iliac or renal veins. Penetrating trauma, including iatrogenic injuries, accounts for less than 20% of these AVFs. Endovascular techniques were useful in the management of vascular lesions. The authors report the case of a patient with high-output heart failure and high-flow AVF between the left external iliac artery and the left external iliac vein manifested 17 years after a gunshot wound. Endovascular approach was satisfactorily performed with the implantation of a septal occlusion device to interrupt abnormal vascular communication and preserve artery and vein patency. There were improvement of symptoms and control images showed arteriovenous communication closure.
Mixed neuroendocrine-non-neuroendocrine neoplasms (MiNEN) of pancreas: a rare entity—worth to note
Authors: Varshney Bharti , Bharti Jyotsna Naresh , Varshney Vaibhav Kumar , Yadav Taruna
Published: April 2020

Mixed adenocarcinoma with neuroendocrine tumour of pancreas has been reported infrequently and consists of both epithelial and neuroendocrine component. We encountered an 81-year-old male patient who presented with clinical features of painful progressive jaundice for 1 month. Contrast-enhanced CT abdomen reported a mass in the pancreatic head with dilated common bile duct and pancreatic duct. He underwent pancreatoduodenectomy and histopathological examination revealed two different tumours: ductal adenocarcinoma admixed with neuroendocrine tumour of pancreas. He received adjuvant chemotherapy, and at the end of 1-year follow-up, he has no recurrence. Here, we reported this rare malignancy of pancreas for which pancreatoduodenectomy was done and diagnosed on histopathology with immunohistochemistry.
Morphological characteristics of parapapillary atrophy and subsequent visual field progression in primary open-angle glaucoma
Authors: Ha Ahnul , Kim Yong Woo , Lee Jinho , Bak Eunoo , Han Young Soo , Kim Young Kook , Park Ki Ho , Jeoung Jin Wook
Published: April 2020

Background/Aims

To investigate the associations between the morphological characteristics of beta-zone parapapillary atrophy (β-zone PPA) and subsequent visual field (VF) progression in eyes with primary open-angle glaucoma (POAG).

Methods

One hundred and twenty-one POAG eyes with β-zone PPA along with 48 normal eyes with β-zone PPA were included. β-zone PPA area was calculated based on the PPA pixel area/optic-disc pixel area ratio and the optical coherence tomography (OCT)-measured disc area. β-zone PPA margin irregularity was quantified as a function of both area (A) and perimeter (P, calculated as 1/(4πA/P²)). VF progression was defined using standard automated perimetry’s guided progression analysis software.

Results

Of the 121 POAG eyes, 49 (40.5%) showed VF progression during the 10.1±1.9 years of follow-up. The baseline β-zone PPA area was similar among the three groups (Progressors, Non-progressors and Controls, p=0.995). However, the β-zone PPA irregularity index was significantly higher in the Progressors (p<0.001). The cumulative probability of VF progression was greater in the higher PPA irregularity index group (p<0.001, log-rank test). A Cox proportional hazards model showed the significant influences of optic disc haemorrhage (HR: 2.661, p=0.034) and higher baseline PPA irregularity index (HR: 1.455, p=0.007) on subsequent progression.

Conclusions

In POAG eyes, baseline β-zone PPA margin regularity was significantly associated with subsequent VF progression. Irregular margin of β-zone PPA might be the mark of vulnerability in the parapapillary area to further glaucomatous damage.
Correlation of ocular rigidity with intraocular pressure spike after intravitreal injection of bevacizumab in exudative retinal disease
Authors: Sayah Diane N , Szigiato Andrei-Alexandru , Mazzaferri Javier , Descovich Denise , Duval Renaud , Rezende Flavio A , Costantino Santiago , Lesk Mark R
Published: April 2020

Background/aims

To evaluate the non-invasive measurement of ocular rigidity (OR), an important biomechanical property of the eye, as a predictor of intraocular pressure (IOP) elevation after anti-vascular endothelial growth factor (anti-VEGF) intravitreal injection (IVI).

Methods

Subjects requiring IVI of anti-VEGF for a pre-existing retinal condition were enrolled in this prospective cross-sectional study. OR was assessed in 18 eyes of 18 participants by measurement of pulsatile choroidal volume change using video-rate optical coherence tomography, and pulsatile IOP change using dynamic contour tonometry. IOP was measured using Tono-Pen XL before and immediately following the injection and was correlated with OR.

Results

The average increase in IOP following IVI was 19±9 mm Hg, with a range of 7–33 mm Hg. The Spearman correlation coefficient between OR and IOP elevation following IVI was 0.796 (p<0.001), showing higher IOP elevation in more rigid eyes. A regression line was also calculated to predict the IOP spike based on the OR coefficient, such that IOP spike=664.17 mm Hg·µL×OR + 4.59 mm Hg.

Conclusion

This study shows a strong positive correlation between OR and acute IOP elevation following IVI. These findings indicate that the non-invasive measurement of OR could be an effective tool in identifying patients at risk of IOP spikes following IVI.