bluuebunny/crossref_metadata_2025 huggingface dataset:
Eliminating Structural Barriers: The Impact of Unrestricted Access on Hepatitis C Treatment Uptake Among People Living With Human Immunodeficiency Virus
Authors: Saeed Sahar , Strumpf Erin , Moodie Erica E M , Wong Leo , Cox Joseph , Walmsley Sharon , Tyndall Mark , Cooper Curtis , Conway Brian , Hull Mark , Martel-Laferriere Valerie , Gill John , Wong Alexander , Vachon Marie-Louise , Klein Marina B ,   Canadian Coinfection Cohort Study Investigators, Barrett Lisa , Cohen Jeff , Conway Brian , Cooper Curtis , Côté Pierre , Cox Joseph , Gill John , Haider Shariq , Hull Mark , Klein Marina , Montaner Julio , Moodie Erica , Pick Neora , Rachlis Anita , Rouleau Danielle , Sadr Aida , Sanche Steve , Sandre Roger , Tyndall Mark , Vachon Marie-Louise , Walmsley Sharon , Wong Alex , Saskatchewan M B K
Published: August 2019

Background

High costs of direct-acting antivirals (DAAs) have led health-care insurers to limit access worldwide. Using a natural experiment, we evaluated the impact of removing fibrosis stage restrictions on hepatitis C (HCV) treatment initiation rates among people living with human immunodeficiency virus (HIV), and then examined who was left to be treated.

Methods

Using data from the Canadian HIV-HCV Coinfection Cohort, we applied a difference-in-differences approach. Changes in treatment initiation rates following the removal of fibrosis stage restrictions were assessed using a negative binomial regression with generalized estimating equations. The policy change was then specifically assessed among people who inject drugs (PWID). We then identified the characteristics of participants who remained to be treated using a modified Poisson regression.

Results

Between 2010–2018, there were a total of 585 HCV initiations among 1130 eligible participants. After removing fibrosis stage restrictions, DAA initiations increased by 1.8-fold (95% confidence interval [CI] 1.3–2.4) controlling for time-invariant differences and secular trends. Among PWID the impact appeared even stronger, with an adjusted incidence rate ratio of 3.6 (95% CI 1.8–7.4). However, this increased treatment uptake was not sustained. At 1 year following universal access, treatment rates declined to 0.8 (95% CI .5–1.1). Marginalized participants (PWID and those of indigenous ethnicity) and those disengaged from care were more likely to remain HCV RNA positive.

Conclusions

After the removal of fibrosis restrictions, HCV treatment initiations nearly doubled immediately, but this treatment rate was not sustained. To meet the World Health Organization elimination targets, the minimization of structural barriers and adoption of tailored interventions are needed to engage and treat all vulnerable populations.
Weight Gain Associated With Integrase Stand Transfer Inhibitor Use in Women
Authors: Kerchberger Anne Marie , Sheth Anandi N , Angert Christine D , Mehta C Christina , Summers Nathan A , Ofotokun Ighovwerha , Gustafson Deborah , Weiser Sheri D , Sharma Anjali , Adimora Adaora A , French Audrey L , Augenbraun Michael , Cocohoba Jennifer , Kassaye Seble , Bolivar Hector , Govindarajulu Usha , Konkle-Parker Deborah , Golub Elizabeth T , Lahiri Cecile D
Published: August 2019

Background

Integrase strand-transfer inhibitor (INSTI)-based antiretroviral therapy (ART) is recommended for human immunodeficiency virus (HIV) management. Although studies have suggested associations between INSTIs and weight gain, women living with HIV (WLHIV) have been underrepresented in research. We evaluated the effect of switching or adding INSTIs among WLHIV.

Methods

Women enrolled in the Women’s Interagency HIV Study (WIHS) from 2006–2017 who switched to or added an INSTI to ART (SWAD group) were compared to women on non-INSTI ART (STAY group). Body weight, body mass index (BMI), percentage body fat (PBF), and waist, hip, arm, and thigh circumferences were measured 6–12 months before and 6–18 months after the INSTI switch/add in SWAD participants, with comparable measurement time points in STAY participants. Linear regression models compared changes over time by SWAD/STAY group, adjusted for age, race, WIHS site, education, income, smoking status, and baseline ART regimen.

Results

We followed 1118 women (234 SWAD and 884 STAY) for a mean of 2.0 years (+/− 0.1 standard deviation [SD]; mean age 48.8 years, SD +/− 8.8); 61% were Black. On average, compared to the STAY group, the SWAD group experienced mean greater increases of 2.1 kg in body weight, 0.8 kg/m2 in BMI, 1.4% in PBF, and 2.0, 1.9, 0.6, and 1.0 cm in waist, hip, arm, and thigh circumference, respectively (all P values < .05). No differences in magnitudes of these changes were observed by INSTI type.

Conclusions

In WLHIV, a switch to INSTI was associated with significant increases in body weight, body circumferences, and fat percentages, compared to non-INSTI ART. The metabolic and other health effects of these changes deserve further investigation.
Does spatial proximity raise firm productivity? Evidence from British manufacturing
Authors: Harris Richard , Moffat John , Evenhuis Emil , Martin Ron , Pike Andy , Sunley Peter
Published: August 2019

The UK’s economy is one of the most regionally imbalanced in Europe. The government’s recent industrial strategy discusses various means of addressing this, one of which is the strengthening of existing clusters. Using plant-level indices of spatial proximity derived from postcode district data, this article investigates the extent of spatial concentration and its impact on total factor productivity in advanced manufacturing sectors in Great Britain. The results from estimation of production functions indicate that, in most advanced manufacturing sectors, spatial concentration has a negative impact on productivity in small plants and a positive effect in larger plants. Large plants likely benefit more from knowledge spillovers due to their higher levels of absorptive capacity.
Aspects of reception: reading Goethe’s Iphigenie auf Tauris with Adorno, Fassbinder, and Jauss
Authors: Hamilton John T
Published: August 2019

In staging his Iphigenie auf Tauris, Johann Wolfgang Goethe stages reception itself. The story about a Mycenaean maiden who, exiled from her home in the South, was welcomed and sheltered by the barbarian people of the North, readily represents how the corpus of ancient Greek culture, detached from its native historical context, came to be received and curated by German artists, poets, and scholars, including, of course, by Goethe himself. If Goethe’s text is indeed understood as an allegory of reception, then subsequent readings of his Iphigenie should exhibit any number of ways in which reception itself has been formulated and assessed. The investigations here all turn on the issue of verbal aspect. By turning to key German interpretations of Goethe’s drama by Theodor Adorno, Rainer Werner Fassbinder, and Hans Robert Jauss, which emerged during the socially and politically tumultuous period of 1967–73, the present study aims to give a critical account of receptive paradigms — an account based on an investigation into the varied aspects that distinguish different historical receptions of reception.
Large-time behaviour of a family of finite volume schemes for boundary-driven convection–diffusion equations
Authors: Chainais-Hillairet Claire , Herda Maxime
Published: August 2019

We are interested in the large-time behaviour of solutions to finite volume discretizations of convection–diffusion equations or systems endowed with nonhomogeneous Dirichlet- and Neumann-type boundary conditions. Our results concern various linear and nonlinear models such as Fokker–Planck equations, porous media equations or drift–diffusion systems for semiconductors. For all of these models, some relative entropy principle is satisfied and implies exponential decay to the stationary state. In this paper we show that in the framework of finite volume schemes on orthogonal meshes, a large class of two-point monotone fluxes preserves this exponential decay of the discrete solution to the discrete steady state of the scheme. This includes for instance upwind and centred convections or Scharfetter–Gummel discretizations. We illustrate our theoretical results on several numerical test cases.
Elevated concentrations of crude glycerin in diets for beef cattle: feedlot performance, carcass traits, and ruminal metabolism1
Authors: Van Cleef Eric H C B , Uwituze Solange , Alvarado-Gilis Christian A , Miller Kevin A , Van Bibber-Krueger Cadra L , Aperce Celine C , Drouillard James S
Published: August 2019

Three experiments were conducted to evaluate the inclusion of crude glycerin (CG) in diets for beef cattle. In Exp. 1, 4 ruminally cannulated steers were fed diets with 0 or 15% CG (DM basis), to evaluate DM disappearance, VFA profiles, and gas production. There was a tendency for an interaction (P = 0.06) between diet fed to donor animals and substrate fed to in vitro system, and digestion was increased when CG was added to cultures with ruminal fluid from CG-fed animals. Total VFA were unaffected by diets or by substrate incubated. The CG increased production of propionate, butyrate, and valerate (P < 0.01) while the gas production was unaffected (P = 0.16). In Exp. 2, 24 crossbred heifers (334.4 ± 0.9 kg BW) were fed the same diets as Exp. 1, for 35 d. Fecal grab samples were collected 3 times daily on day 7, 21, and 35, to evaluate total tract digestibilities of DM, OM, and NDF. The CG improved digestibility of diet OM (P = 0.04), and DM followed a similar trend (P = 0.06), while the NDF digestibility was unaffected (P = 0.29). In Exp. 3, crossbred heifers (n = 374; 375.8 ± 36.1 kg BW) were used to evaluate feedlot performance and carcass traits when fed diets with 0, 7.5, or 15% CG, with or without added 0.3% salt. Heifers were assigned to 25 pens and were harvested on day 125. Removing salt from CG-based diets did not impact performance (P = 0.50). The CG did not influence average daily gain (P = 0.27), but decreased DM intake (P = 0.003), USDA Yield Grade (P = 0.01), and improved feed efficiency (P = 0.03), while tended to decrease USDA prime carcasses (P = 0.10). Carcass weight (P = 0.24), Longissimus muscle area (P = 0.63), and kidney, pelvic, heart fat (P = 0.59) were unaffected by CG. Twelfth-rib fat was less for heifers fed 15% CG without salt compared with the other treatments (P = 0.005), while marbling was less for heifers fed CG diets compared with the control-fed animals (linear, P = 0.004; quadratic, P = 0.02). In conclusion, GC can replace dry-rolled corn in diets for beef heifers when fed at 15% of diet DM, improving OM digestion, increasing ruminal propionate and butyrate without affecting greenhouse gas emissions. Feeding up to 15% CG improves feed efficiency but depresses marbling and tends to decrease Quality Grade. Removing supplemental salt from CG-diets has no impact on performance or carcass traits.
Company Worth Keeping: Personal Control and Preferences for Brand Leaders
Authors: Beck Joshua T , Rahinel Ryan , Bleier Alexander
Published: August 2019

Brand leaders possess tremendous agency, with the ability to shape a sweeping variety of outcomes. Does this fact confer psychological value to consumers? We posit that external conditions that undermine feelings of personal control cause consumers to affiliate more with brand leaders. This occurs because affiliating with such high-agency brands gives consumers a sense of personal agency and thereby restores feelings of control. An initial study using archival data from nearly 18,000 consumers reporting on over 1,200 brands documents real-world effects that are consistent with these propositions. Four follow-up experiments demonstrate the effect of low control on brand leader (vs. nonleader) purchase intentions using direct manipulations in controlled settings, capture the underlying process, and rule out alternative explanations. This research thus reveals that the psychology of personal control underlies a process that benefits brand leaders.
The Chemical Weapons Convention and the Contribution of the Organisation for the Prohibition of Chemical Weapons to Sustainable Development
Authors: Rajah Trevor Michael , Dawson Grant , Aylett Lydia
Published: August 2019

The concepts of disarmament, counter-terrorism, and sustainable development are interdependent and inextricably linked. In order to achieve the goals set out in the United Nations 2030 Agenda for Sustainable Development, states must abandon the competitive ‘arms culture’, cooperate to prevent violence by non-state actors, and divert resources towards peace and security. This article examines the past, present and future role of the Organisation for the Prohibition of Chemical Weapons (OPCW) in furthering sustainable development through disarmament and counter-terrorism. As the Organisation considers its future priorities and focuses on promoting the peaceful use of chemistry and preventing the re-emergence of chemical weapons, the links between peace, security, and development will continue to be of critical importance.
No proprietary protection for individual non-geographical components of protected geographical denominations, says AG Hogan
Authors: Contardi Magali
Published: August 2019

Opinion of Advocate General Hogan in Consorzio Tutela Aceto Balsamico di Modena v BALEMA GmbH, C-432/18, EU:C:2019:650
Alterations in pectoralis muscle cell characteristics after radiation of the human breast in situ
Authors: Wallner Christoph , Drysch Marius , Hahn Stephan A , Becerikli Mustafa , Puscz Fleming , Wagner Johannes Maximilian , Sacher Maxi , Sogorski Alexander , Dadras Mehran , Lehnhardt Marcus , Behr Björn
Published: August 2019

The life-time risk of being diagnosed with breast cancer is ~12%, hence breast cancer is by far the most common cancer among women. The multimodal treatment concept of breast cancer often intends radiation. The utilized ionizing radiation leads changes in the tissue resulting in tissue damage due to an alteration of molecular factors. The goal of this study was to identify the role of muscle-catabolic proteins after radiation of human pectoralis major muscles in situ. Tissue of the pectoralis major muscle was collected in 12 breast cancer patients after radiation (maximum 3 years after radiation) undergoing a deep inferior epigastric perforator free-flap breast reconstruction. At the same time, an intraindividual comparison to rectus abdominis muscle was carried out upon free-flap elevation. Immunological properties, cell proliferation, differentiation as well as the expression profile of the muscle tissue were investigated through immunohistological reactions, a DNA-microarray and histology. We found significantly increased neutrophil immigration in the radiated muscle tissue. At the same time, proteins responsible for muscular atrophy and apoptosis were significantly elevated in immunohistochemistry. A DNA microarray detected immunological upregulation and myo-differentiative disorders in radiated muscle tissue. This novel study investigating catabolism in radiated muscle in situ can serve as a basis for the treatment of radiation-accompanied muscle disorders.
Open Uruguay Round: strategy to overcome the challenges of frontier exploration
Authors: Blánquez Natalia , Ferro Santiago
Published: August 2019

Uruguayan geological basins imply a high exploratory risk and therefore present a frontier status. However, Latin America and West Africa are the regions in which exploratory activity has seen a remarkable increment, with major discoveries and significant investment in the last decade, and plenty of E&P opportunities nowadays. Within this context, The Uruguayan Government has recently approved a new bidding system for onshore and offshore areas, Open Uruguay Round, including very competitive features and contractual terms, after evaluating other countries’ petroleum fiscal regimes.
Butterfly Mimicry Polymorphisms Highlight Phylogenetic Limits of Gene Reuse in the Evolution of Diverse Adaptations
Authors: VanKuren Nicholas W , Massardo Darli , Nallu Sumitha , Kronforst Marcus R
Published: August 2019

Some genes have repeatedly been found to control diverse adaptations in a wide variety of organisms. Such gene reuse reveals not only the diversity of phenotypes these unique genes control but also the composition of developmental gene networks and the genetic routes available to and taken by organisms during adaptation. However, the causes of gene reuse remain unclear. A small number of large-effect Mendelian loci control a huge diversity of mimetic butterfly wing color patterns, but reasons for their reuse are difficult to identify because the genetic basis of mimicry has primarily been studied in two systems with correlated factors: female-limited Batesian mimicry in Papilio swallowtails (Papilionidae) and non-sex-limited Müllerian mimicry in Heliconius longwings (Nymphalidae). Here, we break the correlation between phylogenetic relationship and sex-limited mimicry by identifying loci controlling female-limited mimicry polymorphism Hypolimnas misippus (Nymphalidae) and non-sex-limited mimicry polymorphism in Papilio clytia (Papilionidae). The Papilio clytia polymorphism is controlled by the genome region containing the gene cortex, the classic P supergene in Heliconius numata, and loci controlling color pattern variation across Lepidoptera. In contrast, female-limited mimicry polymorphism in Hypolimnas misippus is associated with a locus not previously implicated in color patterning. Thus, although many species repeatedly converged on cortex and its neighboring genes over 120 My of evolution of diverse color patterns, female-limited mimicry polymorphisms each evolved using a different gene. Our results support conclusions that gene reuse occurs mainly within ∼10 My and highlight the puzzling diversity of genes controlling seemingly complex female-limited mimicry polymorphisms.
Migratory patterns, vertical distributions and diets of Abralia veranyi and Abraliopsis morisii (Cephalopoda: Enoploteuthidae) in the eastern North Atlantic
Authors: Guerra-Marrero Airam , Hernández-García Vicente , Sarmiento-Lezcano Airam , Jiménez-Alvarado David , Pino Angelo Santana-del , Castro José J
Published: August 2019

Abralia veranyi and Abraliopsis morisii were the most abundant cephalopods caught during epipelagic and mesopelagic surveys off the Canary Islands and accounted for 26% and 35% of the cephalopod catch, respectively. Diel vertical migration patterns were observed in both species. At night, A. veranyi was recorded at depths as shallow as 38–90 m, whereas Abraliopsis morisii occurred at depths of 98–219 m. As individuals grow in mantle length, their diet changes substantially. Abraliopsis morisii showed ontogenetic shifts at 22.9 mm and 35.3 mm dorsal mantle length (DML), while A. veranyi showed ontogenetic shifts at 20.5 mm and 30.9 mm DML. Prior to the first ontogenic shift, both species fed mainly on copepods and mysids. After this shift they fed on larger prey, such as decapods and fish; the diets of larger individuals also contained cephalopods.
A Novel Augmented-Reality-Based Surgical Navigation System for Spine Surgery in a Hybrid Operating Room: Design, Workflow, and Clinical Applications
Authors: Edström Erik , Burström Gustav , Nachabe Rami , Gerdhem Paul , Elmi Terander Adrian
Published: August 2019

BACKGROUND

Treatment of several spine disorders requires placement of pedicle screws. Detailed 3-dimensional (3D) anatomic information facilitates this process and improves accuracy.

OBJECTIVE

To present a workflow for a novel augmented-reality-based surgical navigation (ARSN) system installed in a hybrid operating room for anatomy visualization and instrument guidance during pedicle screw placement.

METHODS

The workflow includes surgical exposure, imaging, automatic creation of a 3D model, and pedicle screw path planning for instrument guidance during surgery as well as the actual screw placement, spinal fixation, and wound closure and intraoperative verification of the treatment results. Special focus was given to process integration and minimization of overhead time. Efforts were made to manage staff radiation exposure avoiding the need for lead aprons. Time was kept throughout the procedure and subdivided to reflect key steps. The navigation workflow was validated in a trial with 20 cases requiring pedicle screw placement (13/20 scoliosis).

RESULTS

Navigated interventions were performed with a median total time of 379 min per procedure (range 232-548 min for 4-24 implanted pedicle screws).

The total procedure time was subdivided into surgical exposure (28%), cone beam computed tomography imaging and 3D segmentation (2%), software planning (6%), navigated surgery for screw placement (17%) and non-navigated instrumentation, wound closure, etc (47%).

CONCLUSION

Intraoperative imaging and preparation for surgical navigation totaled 8% of the surgical time. Consequently, ARSN can routinely be used to perform highly accurate surgery potentially decreasing the risk for complications and revision surgery while minimizing radiation exposure to the staff.
The Impact of Critical Incidents and Workload on Functioning in the Private Life of Police Officers: Does Weakened Mental Health Act as a Mediator?
Authors: (Heilwine) Bakker A H M , (Marc) Van Veldhoven M J P M , (Anthony) Gaillard A W K , (Margot) Feenstra M
Published: August 2019

This study examined the disintegrating effects of critical incidents (Cri) and workload (WL) on the mental health status (MHS) and private life tasks of 166 police officers. In addition, it investigated whether diminished MHS mediated the impact of Cri and WL on private life tasks. This mediation effect was based on the work–home resources model of Brummelhuis and Bakker (2012). The respondents were police officers functioning in the front line, experiencing Cri and working in urban areas. We investigated the effects on the following five private life tasks: ‘social life, maintaining mental health, household and finance, giving meaning, and maintaining positivity’. The results showed that Cri only had a negative effect on ‘maintaining positivity’. Respondents reporting more Cri had a lower MHS, which in turn had a direct effect on the functioning in all private life tasks except ‘social life’. When mediated by MHS, Cri were associated with less effective functioning in all private life tasks except for ‘social life’. Thus, the effects of Cri on functioning in private life tasks (except social life) were larger for respondents with a low MHS. The largest effects were found for ‘maintaining mental health (MMH) and maintaining positivity’. In the WL model, no significant indirect effects were found on life tasks.
LOCALIZATION OF IONIZING RADIATION SOURCES VIA AN AUTONOMOUS ROBOTIC SYSTEM
Authors: Lazna Tomas , Fisera Ota , Kares Jaroslav , Zalud Ludek
Published: August 2019

The article discusses an autonomous and flexible robotic system for radiation monitoring. The detection part of the system comprises two NaI(Tl) scintillation detectors: one of these is collimated to allow directionally sensitive measurements and the other is used to calculate the dose rate and provides sufficient sensitivity. Special algorithms for autonomous operation of an unmanned ground vehicle were developed, utilizing radiation characteristics acquired by the implemented detection system. The system was designed to operate in three modes: radiation mapping, localization of discrete sources and inspection of a region of interest. All of the modes were verified experimentally. In the localization mode, the time required to localize ionizing radiation sources was reduced by half compared to the field mapping mode exploiting parallel trajectories; the localization accuracy remained the same. In the inspection mode, the desired functionality was achieved, and the changes in the sources arrangement were detected reliably in the experiments.
Transition of Substance-Induced, Brief, and Atypical Psychoses to Schizophrenia: A Systematic Review and Meta-analysis
Authors: Murrie Benjamin , Lappin Julia , Large Matthew , Sara Grant
Published: August 2019

Some people who experience substance-induced psychosis later develop an enduring psychotic disorder such as schizophrenia. This study examines the proportion of people with substance-induced psychoses who transition to schizophrenia, compares this to other brief and atypical psychoses, and examines moderators of this risk. A search of MEDLINE, PsychINFO, and Embase identified 50 eligible studies, providing 79 estimates of transition to schizophrenia among 40 783 people, including 25 studies providing 43 substance-specific estimates in 34 244 people. The pooled proportion of transition from substance-induced psychosis to schizophrenia was 25% (95% CI 18%–35%), compared with 36% (95% CI 30%–43%) for brief, atypical and not otherwise specified psychoses. Type of substance was the primary predictor of transition from drug-induced psychosis to schizophrenia, with highest rates associated with cannabis (6 studies, 34%, CI 25%–46%), hallucinogens (3 studies, 26%, CI 14%–43%) and amphetamines (5 studies, 22%, CI 14%–34%). Lower rates were reported for opioid (12%), alcohol (10%) and sedative (9%) induced psychoses. Transition rates were slightly lower in older cohorts but were not affected by sex, country of the study, hospital or community location, urban or rural setting, diagnostic methods, or duration of follow-up. Substance-induced psychoses associated with cannabis, hallucinogens, and amphetamines have a substantial risk of transition to schizophrenia and should be a focus for assertive psychiatric intervention.
FNTC (UK) Limited and BBCB Limited v Page and others
Authors: Rimmer John
Published: August 2019

Trusts are often used in commercial and property contexts, offering flexibility and overcoming technical difficulties with complex ownership. Holiday timeshare schemes have used trusts for many years, but little analysis appears to have been made of the use of trusts in their structures—timeshare buyers will not generally instruct lawyers to scrutinise their purchase. When they are analysed, surprisingly, different views can be taken of the most fundamental aspects of them. If documents do not anticipate mishaps, difficult questions arise about where losses lie. An assumption that trust property will bear all expenses and liabilities falling on a structure may be ill-founded. Even where those acting on behalf of timeshare club members have made the same wrong assumptions, they may not be prevented from denying that the members are, in fact, liable at all.
Unforeseen diversity of quails (Galliformes: Phasianidae: Coturnix) in oceanic islands provided by the fossil record of Macaronesia
Authors: Rando Juan C , Alcover Josep A , Pieper Harald , Olson Storrs L , Hernández C Nayra , López-Jurado L Felipe
Published: August 2019

The original bird fauna of most oceanic islands has been affected by recent extinction processes associated with human arrival and its subsequent impacts. In the volcanic Macaronesian archipelagos (Azores, Madeira, Selvagens, Canary Islands and Cape Verde), in the North Atlantic, the Late Quaternary fossil record indicates that there was formerly a higher avian diversity, including a high number of now extinct endemic species. This assemblage of extinct birds includes endemic insular quails (Galliformes: Phasianidae). In this study, we describe three newly discovered extinct species of quails, two of which inhabited the archipelago of Madeira (Coturnix lignorum sp. nov. from Madeira Island and Coturnix alabrevis sp. nov. from Porto Santo Island) and one from Cape Verde (Coturnix centensis sp. nov.). The fossil record also indicates the presence of additional species of extinct endemic quails on other Macaronesian islands. These birds plus the extinct Canary Island quail (Coturnix gomerae) indicate a high former endemic diversity of this genus in Macaronesia, a feature unique among oceanic archipelagos. Anatomical traits show that the new taxa were flightless ground dwellers, making them vulnerable to human interference, with their extinction being linked to human arrival and subsequent habitat alterations and the introduction of invasive species.
Ferric Uptake Regulator (FurA) is Required forAcidovorax citrulliVirulence on Watermelon
Authors: Liu Jun , Tian Yanli , Zhao Yuqiang , Zeng Rong , Chen Baohui , Hu Baishi , Walcott Ron R.
Published: August 2019

Acidovorax citrulli is the causal agent of bacterial fruit blotch, a serious threat to commercial watermelon and melon crop production worldwide. Ferric uptake regulator (Fur) is a global transcription factor that affects a number of virulence-related functions in phytopathogenic bacteria; however, the role of furA has not been determined for A. citrulli. Hence, we constructed an furA deletion mutant and a corresponding complement in the background of A. citrulli strain xlj12 to investigate the role of the gene in siderophore production, concentration of intracellular Fe2+, bacterial sensitivity to hydrogen peroxide, biofilm formation, swimming motility, hypersensitive response induction, and virulence on melon seedlings. The A. citrulli furA deletion mutant displayed increased siderophore production, intracellular Fe2+concentration, and increased sensitivity to hydrogen peroxide. In contrast, biofilm formation, swimming motility, and virulence on melon seedlings were significantly reduced in the furA mutant. As expected, complementation of the furA deletion mutant restored all phenotypes to wild-type levels. In accordance with the phenotypic results, the expression levels of bfrA and bfrB that encode bacterioferritin, sodB that encodes iron/manganese superoxide dismutase, fliS that encodes a flagellar protein, hrcN that encodes the type III secretion system (T3SS) ATPase, and hrcC that encodes the T3SS outer membrane ring protein were significantly downregulated in the A. citrulli furA deletion mutant. In addition, the expression of feo-related genes and feoA and feoB was significantly upregulated in the furA mutant. Overall, these results indicated that, in A. citrulli, FurA contributes to the regulation of the iron balance system, and affects a variety of virulence-related traits.
Intravenous Propofol Versus Volatile Anesthetics For Stroke Endovascular Thrombectomy
Authors: Diprose William K. , Wang Michael T.M. , Campbell Doug , Sutcliffe James A. , McFetridge Andrew , Chiou Daniel , Lai Joshua , Barber P. Alan
Published: August 2019

Background:

The choice of anesthetic technique for ischemic stroke patients undergoing endovascular thrombectomy is controversial. Intravenous propofol and volatile inhalational general anesthetic agents have differing effects on cerebral hemodynamics, which may affect ischemic brain tissue and clinical outcome. We compared outcomes in patients undergoing endovascular thrombectomy with general anesthesia who were treated with propofol or volatile agents.

Methods:

Consecutive endovascular thrombectomy patients treated using general anesthesia were identified from our prospective database. Baseline patient characteristics, anesthetic agent, and clinical outcomes were recorded. Functional independence at 3 months was defined as a modified Rankin Scale of 0 to 2.

Results:

There were 313 patients (182 [58.1%] men; mean±SD age, 64.7±15.9 y; 257 [82%] anterior circulation), of whom 254 (81%) received volatile inhalational (desflurane or sevoflurane), and 59 (19%) received intravenous propofol general anesthesia. Patients with propofol anesthesia had more ischemic heart disease, higher baseline National Institutes of Health Stroke Scale scores, more basilar artery occlusion, and were less likely to be treated with intravenous thrombolysis. Multivariable logistic regression analysis showed that propofol anesthesia was associated with improved functional independence at 3 months (odds ratio=2.65; 95% confidence interval, 1.14-6.22; P=0.03) and a nonsignificant trend toward reduced 3-month mortality (odds ratio=0.37; 95% CI, 0.12-1.10; P=0.07).

Conclusion:

In stroke patients undergoing endovascular thrombectomy treated using general anesthesia, there may be a differential effect between intravenous propofol and volatile inhalational agents. These results should be considered hypothesis-generating and be tested in future randomized controlled trials.
Rapid Recovery With Plasma Exchange in Acute Motor Axonal Neuropathy With Reversible Conduction Failure
Authors: Burford Matthew , Chou Chris A. , Sommerville Richard B. , Bucelli Robert C.
Published: August 2019

Characterization of Guillain–Barré syndrome (GBS) subtypes has become increasingly complicated with the recognition of paranodal dysfunction and reversible conduction failure (RCF) in acute motor axonal neuropathy. We describe 2 cases of seronegative acute motor axonal neuropathy with RCF with a rapid onset of severe quadriplegia. Treatment with plasma exchange was associated with rapid clinical and electrophysiological response on serial examinations. Increased recognition of RCF may lead to improved characterization of GBS subtypes and may play a role in determining future treatment options in GBS.
Cannabis Legalization in Canada: The Public Health Approach We Did Not Get
Authors: DeVillaer Michael
Published: August 2019

Objectives:

The reader will understand the successes and shortfalls of the government's stated intention to take “a public health approach” to cannabis legalization.

Method:

Aspects of a public health approach to cannabis legalization were identified from the drug policy literature and from advice provided to government by health policy organizations. These aspects were compared to the output of federal legislation to identify successes and shortfalls.

Results:

Public health input had some influence on legislation. However, the legislation compromised a public health approach on critical issues such as industry models, minimum age for use, product promotion practices, product types, consumer protection, and holding industry accountable to regulatory provisions.

Conclusions:

Cannabis legalization can be improved to better reflect a public health priority. Given that legalization will be a process and not a solitary event, this article will be relevant to

Objectifs:

Le lecteur comprendra les succès et les faiblesses de l’intention déclarée du gouvernement d’adopter une «approche de santé publique» en matière de légalisation du cannabis.

Méthode:

Les aspects d’une approche de santé publique en matière de légalisation du cannabis ont été identifiés à partir de la littérature sur les politiques en matière de drogue et des conseils fournis au gouvernement par les organisations responsables des politiques de santé. Ces aspects ont été comparés aux résultats de la législation fédérale pour identifier les succès et les lacunes.

Résultats:

L’apport de la santé publique a eu une influence sur la législation. Cependant, la législation compromettait une approche de santé publique sur des questions critiques telles que les modèles industriels, l’âge minimum d’utilisation, les pratiques de promotion des produits, les types de produits, la protection des consommateurs et la responsabilisation de l’industrie vis-à-vis des dispositions réglementaires.

Conclusions:

La légalisation du cannabis peut être améliorée pour mieux refléter une priorité de santé publique. Étant donné que la légalisation sera un processus et non un événement isolé, cet article sera pertinent pour: les fournisseurs de soins de santé et les autorités de santé publique qui souhaitent plaider auprès des divers ordres de gouvernement afin d’atténuer les méfaits, et auditoires internationaux observant l’expérience canadienne.
Early Gross Motor Development Among Brazilian Children with Microcephaly Born Right After Zika Virus Infection Outbreak
Authors: A. Ventura Paloma , C. Lage Maria-Lúcia , L. de Carvalho Alessandra , S. Fernandes Adriana , B. Taguchi Tânia , Nascimento-Carvalho Cristiana M.
Published: August 2019

Objective:

To assess the gross motor development of children with presumed congenital Zika virus (ZIKV) infection over the first 2 years of their lives.

Methods:

Seventy-seven children were assessed at the median ages of 11, 18, and 24 months, using the evaluative instrument Gross Motor Function Measure (GMFM-66). At the third assessment, the children with diagnoses of cerebral palsy (CP) were classified by severity through the Gross Motor Function Classification System (GMFCS) and stratified by topography indicating the predominantly affected limbs. With these instruments in combination and using the motor development curves as reference, the rate of development and functional ability were estimated.

Results:

At 2 years of age, all children had the diagnosis of CP. Seventy-four (96.1%) presented gross motor skills similar to those of children aged 4 months or younger, according to the World Health Organization's standard. The GMFM-66 median score among the 73 (94.8%) children with quadriplegia and GMFCS level V showed significant change between 11 and 18 months (p < 0.001) and between 11 and 24 months (p < 0.001). No significant difference (p = 0.076) was found between 18 and 24 months.

Conclusion:

Despite showing some gross motor progress during the initial 18 months of life, these children with presumed congenital ZIKV infection and CP experienced severe motor impairment by 2 years of age. According to the motor development curves, these children with quadriplegia have probably already reached about 90% of their motor development potential.
Salpingectomy to reduce risk of ovarian cancer in women at average risk
Authors: Arruda Jaime
Published: August 2019

Ovarian cancer is a common gynecologic malignancy with a poor prognosis and a lack of screening for women at average risk. Focus has therefore shifted toward strategies for risk-reducing surgery to prevent the development of ovarian cancer. This Practice Pearl describes the evidence supporting opportunistic salpingectomy at the time of hysterectomy or tubal sterilization as a strategy to reduce the risk of ovarian cancer, the risks and benefits associated with the procedure, and the methods used.
REGIONAL DENSITIES OF RETINAL CAPILLARIES AND RETINAL SENSITIVITIES AFTER MACULAR HOLE SURGERY WITH INTERNAL LIMITING MEMBRANE PEELING
Authors: Baba Takayuki , Kakisu Masato , Nizawa Tomohiro , Oshitari Toshiyuki , Yamamoto Shuichi
Published: August 2019

Purpose:

To measure the vascular density (VD) of the retinal capillary plexuses by optical coherence tomography angiography (OCTA) after surgery for an idiopathic macular hole.

Methods:

Retrospective, observational case series.Sixteen eyes of 16 patients with an idiopathic macular hole underwent vitrectomy with internal limiting membrane peeling. The VDs of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were determined by OCTA, and the retinal sensitivity (RS) and the inner retinal thickness (IRT) were measured before, and at 3, 6, and 12 months after the surgery. The VD, RS, and IRT were measured at the four parafoveal quadrants.

Results:

The mean age was 68.9 years. The VDs of the SCP and DCP were significantly correlated with the RS and IRT at 12 months postoperatively (all P < 0.001 for both SCP and DCP). The VDs of the SCP and DCP were higher, the RS more sensitive, and the IRT thicker in the nasal than the temporal quadrant at 12 months (P < 0.001, <0.001, =0.009, <0.001, respectively).

Conclusion:

The significant correlation between the VDs of the SCP and DCP and the RS and IRT may be due to the nasal shift of the posterior retina.
SURGICAL OUTCOMES OF MYOPIC TRACTION MACULOPATHY ACCORDING TO THE INTERNATIONAL PHOTOGRAPHIC CLASSIFICATION FOR MYOPIC MACULOPATHY
Authors: Lee Kyung Sik , Lee Jihei Sara , Koh Hyoung Jun
Published: August 2019

Purpose:

To compare treatment results of myopic traction maculopathy according to the international photographic classification for myopic maculopathy.

Methods:

This was a retrospective, single-surgeon–based, observational case series of 35 consecutive eyes that underwent vitrectomy for myopic traction maculopathy. Eyes were classified into nonpathologic myopia (PM) (n = 15) and PM (n = 20) groups. Main outcome measures constituted best-corrected visual acuity (BCVA) and anatomical change.

Results:

The mean follow-up was 32.03 ± 6.85 months. Axial length correlated with myopic maculopathy category (rho = 0.6836, P < 0.001). In the total group, BCVA improved from 20/61 to 20/36 (P = 0.001). In the subgroup, BCVA improved from 20/41 to 20/22 in the non-PM group (P = 0.002), whereas from 20/82 to 20/52 in the PM group (P = 0.048). Postoperative BCVA of the PM group was inferior to that of the non-PM group (P = 0.002) and the PM group was more likely to have postoperative BCVA <20/30 (odds ratio, 17.3; 95% CI, 2.6–325.0; P = 0.012). Two cases of macular hole retinal detachment occurred after surgery in the PM group.

Conclusion:

Because there are limited benefits of vitrectomy in myopic traction maculopathy accompanied by PM, careful consideration would be necessary when determining surgery. Optical coherence tomography should not be used alone in determining vitrectomy because myopic traction maculopathy can also have PM defined mainly by fundus photographs.
SUCCESSFUL SURGICAL TREATMENT OF MACULA-INVOLVING DEGENERATIVE RETINOSCHISIS BY VITRECTOMY AND DRAINAGE OF THE SCHISIS CAVITY
Authors: Desjarlais Eric B. , Garza Philip S. , Johnson Mark W. , Jayasundera Thiran
Published: August 2019

Purpose:

To demonstrate the potential for visual recovery after surgery for early foveal involvement by progressive degenerative retinoschisis.

Methods:

Surgical case report.

Results:

A 79-year-old woman was monitored over 4 years for degenerative retinoschisis in the inferotemporal periphery of both eyes. Over the course of follow-up, visual acuity in the left eye decreased from 20/40 to 20/100, concurrent with extension of the schisis cavity into the macula. Macular involvement was confirmed on optical coherence tomography imaging, and there was no rhegmatogenous retinal detachment. The patient elected to undergo 25-gauge pars plana vitrectomy and drainage of the schisis cavity. Eleven weeks after surgery, the macula remained attached, and the uncorrected visual acuity was 20/30. Fundus examination and spectral domain optical coherence tomography confirmed ongoing resolution of the macula-involving retinoschisis.

Conclusion:

Bullous degenerative retinoschisis is believed to result in an absolute scotoma that is not surgically correctable. Our patient's excellent visual recovery suggests that the synaptic integrity of the macular outer plexiform layer can be preserved and a permanent scotoma avoided if early macular involvement by progressive degenerative retinoschisis is surgically repaired.
Influence of Corneal Topographic Parameters in the Decentration of Orthokeratology
Authors: Gu Tianpu , Gong Boteng , Lu Daqian , Lin Weiping , Li Na , He Qing , Wei Ruihua
Published: August 2019

Objective:

To investigate the lens decentration (LD) of orthokeratology (ortho-k) and the association between pretreatment corneal topographic parameters and LD of the ortho-k.

Methods:

Fifty right eyes of 50 myopes wearing ortho-k lenses were included in the prospective study. Corneal topography was conducted pretreatment to get topographic corneal parameters, including flat-K (K1); steep-K (K2); corneal astigmatism (CA), CA at 0 to 3 mm (3 mm-CA), 3 to 5 mm (5 mm-CA), 5 to 7 mm (7 mm-CA); surface asymmetry index (SAI); surface regularity index; the curvature of best-fit sphere; the diameter of cornea (DC); the distance from the corneal center to the corneal vertex (CCCV); flat eccentricity (E1), steep eccentricity (E2), and E1/E2(E ratio); and the corneal curvature differences between the nasal and temporal quadrants at 0 to 3 mm (3 mm-Knt), and the corneal curvature differences between the superior and inferior quadrants at 0 to 3 mm (3 mm-Ksi), 5 mm-Knt(at 3–5 mm), 5 mm-Ksi(at 3–5 mm), 7 mm-Knt(at 5–7 mm), and 7 mm-Ksi(at 5–7 mm). The relationship between these cornea topographic parameters and LD of the ortho-k was tested using stepwise multiple linear regression models.

Results:

The mean magnitude of LD was 0.51±0.23 mm (0.06–1.03 mm). According to the stepwise analysis, 4 factors were associated with the overall LD (P<0.01): SAI (β=0.252), CCCV (β=0.539), 5 mm-CA (β=−0.268), and 3 mm-Ksi(β=−0.374); 5 factors were associated with the horizontal LD (P<0.01): DC (β=0.205), CCCV (β=0.881), 3 mm-CA (β=−0.217), 5 mm-Knt(β=0.15), and 3 mm-Ksi(β=−0.18); and 3 factors were associated with the vertical LD (P<0.01): SAI (β=0.542), 5 mm-CA (β=−0.188), and 3 mm-Ksi(β=−0.213).

Conclusion:

Lens decentration is most common, but in most cases, the amount of LD is moderate and acceptable. The magnitude of LD can be predetermined by topographic corneal parameters. Surface asymmetry index, CCCV, 5 mm-Knt, and 3 mm-Ksimay be more preferable parameters in terms of the assessment of LD of ortho-k.
A Case of Nocardia farcinica Keratitis in a Pediatric Contact Lens Wearer
Authors: Verner Aimee , Durrani Asad , Kowalski Regis P. , Jhanji Vishal
Published: August 2019

Purpose:

To report a case of Nocardia farcinica keratitis in a pediatric contact lens wearer.

Methods:

Case report and literature review.

Results:

A pediatric contact lens wearer was initially misdiagnosed with a poorly healing corneal abrasion after swimming with his contact lenses. On examination at our center, he was found to have a 2.5 by 2.5 mm corneal infiltrate with feathery margins. Microbiology revealed N. farcinica keratitis, which was treated with topical amikacin. The patient returned to his baseline visual acuity after treatment.

Conclusions:

Nocardia keratitis can be misdiagnosed because of its low prevalence, especially in young patients. Prompt diagnosis is important for proper management in these cases. The infection resolved in our patient with prompt diagnosis and treatment with topical amikacin eye drops.
The Probable Mechanism of Traumatic Angle Recession and Cyclodialysis
Authors: Pujari Amar , Selvan Harathy , Behera Aswini Kumar , Gagrani Meghal , Kapoor Saloni , Dada Tanuj
Published: August 2019

During blunt ocular trauma, the anteroposterior compressive forces confronted lead to consequent equatorial expansion of the globe. This may result in ciliary body trauma, typically manifesting as angle recession or cyclodialysis. The authors hypothesize that a likely asymmetric contraction between the longitudinal and circular ciliary fibers, and an intrinsic weak “oblique buffer zone” creates a plane of separation between the 2, resulting in angle recession. When stronger forces are met with, the equatorial expansion of the sclera may outperform the ability of the ciliary body to follow it, and the taut longitudinal ciliary fibers may subsequently disinsert from the scleral spur causing cyclodialysis. In addition to this, the routinely thought dismembering aqueous jets directed toward the angle may also accentuate ciliary body trauma. Therefore, the vivid distractive external forces along with the complex ciliary muscle anatomy and differential functionality may play a crucial role in causation of post-traumatic angle recession and cyclodialysis.