bluuebunny/crossref_metadata_2025 huggingface dataset:
Discourses of immigration and integration in German newspaper comments
Authors: Fuller Janet M.
Published: February 2019

This chapter employs a critical, constructivist theoretical perspective to address how online commenters on articles in the liberal newspaper Die Zeit characterize immigrants, integration, and German identity. While the formerly dominant ethnonational ideology about German identity is now in the minority, there is nonetheless a strong tendency to categorize and characterize immigrant background residents according to ethnonational and religious criteria. A hierarchy of immigrants has emerged, with a discourse that positions Muslims in general, and Turks in particular, as the unintegrated Other. Because Germanness is defined in opposition to Muslim practices, integration for such residents is impossible. However, the presence of competing discourses is significant; through voices that point out discrimination and view integration as a two-way process, social change may be enacted.
“They have lived in our street for six years now and still don’t speak a work [!] of English”
Authors: Musolff Andreas
Published: February 2019

Whilst sociolinguistic superdiversity is often viewed as an almost irreversible global development, there may be a question mark over whether the ‘mix of cultures’, which mass migration allegedly fosters, does in fact lead to an acceptance of multilingualism and/or multiculturalism in the respective societies. On the basis of public discourse data from press media and Internet forums, this paper explores popular attitudes the effects of mass immigration, which appear to express an endorsement of monolingual/monocultural societies. Using methods of argumentation theory, pragmatics and discourse-historical triangulation, the article argues that findings of a global rise in superdiversity as regards usage data need to be complemented by studies of divergent perception patterns at local/national levels.
Predicative possession in revived Cornish
Authors: Arbes Deborah
Published: February 2019

This study introduces the possessive schemas of revived Cornish. By means of a survey and interviews with 25 fluent speakers and a corpus study I identified several possessive schemas being employed for different purposes due to semantic and structural reasons. Possession splits, which are also attested for the other Brythonic languages (Stolz et al. 2008), occur for the distinction of temporary possession and the possession of illnesses. Furthermore, the speakers may be developing a new form to express the possession of abstract nouns by employing the short form of bos ‘to be’ and the preposition dhe ‘to’. For the development of this form the history of interrupted language transmission and the use of Cornish by New Speakers are relevant factors.
Predicative possession in Oghuz and Kipchak Turkic languages
Authors: Karakoç Birsel
Published: February 2019

This article studies syntactic, semantic and discursive properties of non-subordinate (main) clauses conveying possession in Oghuz and Kipchak Turkic languages. In Turkic, the concept of possession is typically encoded by clauses based on existential predicates. The language-specific and crosslinguistic properties of two predicate types, {bar} and {bol}, will be contrastively surveyed. As for the marking of possessor in clauses containing {bar}, three patterns will be described, one of which is a contact-induced structure restricted to Turkic varieties in Iran. As a multifunctional verb, {bol} can convey, among other things, dynamic or static possession. The results indicate that the clauses based on the static possession marker {bol} are more operative in Kipchak languages and in Turkmen (East Oghuz), than in West Oghuz languages. It will further be shown that the structures based on {bar} or the static marker {bol} typically exhibit discourse-related distribution in the respective languages.
A diachronic perspective on alienability splits in Icelandic attributive possession
Authors: Schuster Susanne
Published: February 2019

Icelandic makes use of different morphosyntactic patterns for different kinds of possessive relations both in predicative and attributive possession. The fact that this differentiation is at least partly motivated by the semantics of the possessum suggests an alienability split in the Icelandic possession system (Stolz 2008). There are various approaches to explain the formal distinctions in the system, one of them depending on grammaticalization processes. Following this approach, a diachronic perspective needs to be taken in order to understand how splits arise. Accordingly, this paper presents the results of a corpus-linguistic and frequency-based analysis of the attributive pronominal possessive system of Icelandic. The most significant finding to emerge is that splits in the possessive system do not only manifest in a different synchronic behaviour but also in different degrees of susceptibility to language-internal and/or contact-induced changes.
Grammatical relations in Mon
Authors: Jenny Mathias
Published: February 2019

This study investigates the relevance of the generalized semantic roles S, A, P, T, and G and whether there are constructions that treat subsets of these identically, defining Grammatical relations in Mon, (Austroasiatic). After establishing the notion of transitivity in Mon, the study looks at syntactic constructions that are cross-linguistically found to be relevant the selection of Grammatical Relations, including word order, case marking, control, reflexivization, among others. The results show that Mon exhibits identical treatment of S and A (‘Subject’) in most constructions, less prominently of P and T (‘Direct Object’), as well as a subset {P, G} in at least one construction. Grammatical Relations are found to be relevant for the description and analysis of Mon.
rAAV-based brain slice culture models of Alzheimer’s and Parkinson’s disease inclusion pathologies
Authors: Croft Cara L. , Cruz Pedro E. , Ryu Daniel H. , Ceballos-Diaz Carolina , Strang Kevin H. , Woody Brittany M. , Lin Wen-Lang , Deture Michael , Rodríguez-Lebrón Edgardo , Dickson Dennis W. , Chakrabarty Paramita , Levites Yona , Giasson Benoit I. , Golde Todd E.
Published: February 2019

It has been challenging to produce ex vivo models of the inclusion pathologies that are hallmark pathologies of many neurodegenerative diseases. Using three-dimensional mouse brain slice cultures (BSCs), we have developed a paradigm that rapidly and robustly recapitulates mature neurofibrillary inclusion and Lewy body formation found in Alzheimer’s and Parkinson’s disease, respectively. This was achieved by transducing the BSCs with recombinant adeno-associated viruses (rAAVs) that express α-synuclein or variants of tau. Notably, the tauopathy BSC model enables screening of small molecule therapeutics and tracking of neurodegeneration. More generally, the rAAV BSC “toolkit” enables efficient transduction and transgene expression from neurons, microglia, astrocytes, and oligodendrocytes, alone or in combination, with transgene expression lasting for many months. These rAAV-based BSC models provide a cost-effective and facile alternative to in vivo studies, and in the future can become a widely adopted methodology to explore physiological and pathological mechanisms related to brain function and dysfunction.
Bilateral comparison of luminous flux (EURAMET.PR-K4.3)
Authors: Pons Alicia , Campos Joaquĺn , Sametoglu Ferhat
Published: February 2019

This report gives the result of a bilateral comparison of luminous flux between the Instituto de Óptica, IO-CSIC (Spain) and the Ulusal Metroloji Enstitüsü, TUBITAK UME (Turkey). This bilateral comparison is intended to link the TUBITAK UME realized lumen to the CCPR K4 reference value. The measurement artefacts were specially developed transfer standard lamps for luminous flux of the Polaron LF200W type.

The comparison and its protocol were approved by the CCPR and registered with KCDB with the comparison number: EURAMET.PR-K4.3.

KEY WORDS FOR SEARCH

Luminous flux, PR K4, Bilateral Comparison

Main text

To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/.

The final report has been peer-reviewed and approved for publication by the CCPR, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).
Antibody conjugation and formulation
Authors: Alves Nathan J
Published: February 2019

In an era where ultra-high antibody concentrations, high viscosities, low volumes, auto-injectors and long storage requirements are already complex problems with the current unconjugated monoclonal antibodies on the market, the formulation demands for antibody-drug conjugates (ADCs) are significant. Antibodies have historically been administered at relatively low concentrations through intravenous (IV) infusion due to their large size and the inability to formulate for oral delivery. Due to the high demands associated with IV infusion and the development of novel antibody targets and unique antibody conjugates, more accessible routes of administration such as intramuscular and subcutaneous are being explored. This review will summarize various site-specific and non-site-specific antibody conjugation techniques in the context of ADCs and the demands of formulation for high concentration clinical implementation.
Buccal Fat Pad Excision: Hydrodissection Technique
Authors: Valencia Luis C , Pérez Giovanny F , Kaplan Jordan , Fernández-Riera Ricardo
Published: February 2019

Background

Buccal fat pad (BFP) excision is a procedure in which the fat pad is extracted in order to achieve a more youthful appearance.

Objectives

The aim of this study was to describe an alternative technique that utilizes hydrodissection to extract the BFP.

Methods

This is a controlled, prospective, randomized clinical study involving 2 groups. Group A (n = 27) underwent BFP excision with hydrodissection, during which 15 mL of a vasoconstricting anesthetic solution was injected into the BFP. Group B (n = 27) underwent BFP excision, during which 3 mL of lidocaine 2% with epinephrine was injected. All procedures were performed by the same surgeon. Variables analyzed were surgical time, intraoperative bleeding, and postoperative pain directly following surgery 2 hours after the procedure, as well as maximum pain within 72 hours of surgery and complications. Postoperative care was standardized, and patient follow-up extended over a 6-month period.

Results

Pain scores for 54 patients were recorded on a visual analog scale (0–10). Mean ± standard deviation transoperative pain scores were 0.5 ± 0.8 for Group A and 1.3 ± 1.3 for Group B (P = 0.01); 2 hours postoperation the scores were 1.2 ± 0.7 for Group A and 2.6 ± 1 for Group B (P < 0.0001). Maximum pain occurred within 72 hours, and scored 1.6 ± 0.6 for Group A and 3.1 ± 1 for Group B (P < 0.0001). Mean operative time was 8:18 ± 0:47 minutes for Group A and 14:08 ± 2:28 minutes for Group B (P < 0.0001). There was a positive correlation between operative time and pain. Overall, 5.5% of patients suffered postoperative complications.

Conclusions

BFP excision by hydrodissection is an effective procedure that decreases surgical times by facilitating extraction of the BFP with less manipulation, thereby resulting in decreased postoperative pain and a more tolerable recovery.

Level of Evidence: 2
DeepAffinity: interpretable deep learning of compound–protein affinity through unified recurrent and convolutional neural networks
Authors: Karimi Mostafa , Wu Di , Wang Zhangyang , Shen Yang
Published: February 2019

Motivation

Drug discovery demands rapid quantification of compound–protein interaction (CPI). However, there is a lack of methods that can predict compound–protein affinity from sequences alone with high applicability, accuracy and interpretability.

Results

We present a seamless integration of domain knowledges and learning-based approaches. Under novel representations of structurally annotated protein sequences, a semi-supervised deep learning model that unifies recurrent and convolutional neural networks has been proposed to exploit both unlabeled and labeled data, for jointly encoding molecular representations and predicting affinities. Our representations and models outperform conventional options in achieving relative error in IC50 within 5-fold for test cases and 20-fold for protein classes not included for training. Performances for new protein classes with few labeled data are further improved by transfer learning. Furthermore, separate and joint attention mechanisms are developed and embedded to our model to add to its interpretability, as illustrated in case studies for predicting and explaining selective drug–target interactions. Lastly, alternative representations using protein sequences or compound graphs and a unified RNN/GCNN-CNN model using graph CNN (GCNN) are also explored to reveal algorithmic challenges ahead.

Availability and implementation

Data and source codes are available at https://github.com/Shen-Lab/DeepAffinity.

Supplementary information

Supplementary data are available at Bioinformatics online.
BioKEEN: a library for learning and evaluating biological knowledge graph embeddings
Authors: Ali Mehdi , Hoyt Charles Tapley , Domingo-Fernández Daniel , Lehmann Jens , Jabeen Hajira
Published: February 2019

Knowledge graph embeddings (KGEs) have received significant attention in other domains due to their ability to predict links and create dense representations for graphs’ nodes and edges. However, the software ecosystem for their application to bioinformatics remains limited and inaccessible for users without expertise in programing and machine learning. Therefore, we developed BioKEEN (Biological KnowlEdge EmbeddiNgs) and PyKEEN (Python KnowlEdge EmbeddiNgs) to facilitate their easy use through an interactive command line interface. Finally, we present a case study in which we used a novel biological pathway mapping resource to predict links that represent pathway crosstalks and hierarchies.

Availability and implementation

BioKEEN and PyKEEN are open source Python packages publicly available under the MIT License at https://github.com/SmartDataAnalytics/BioKEEN and https://github.com/SmartDataAnalytics/PyKEEN

Supplementary information

Supplementary data are available at Bioinformatics online.
Gp49B is a pathogenic marker for auto-antibody-producing plasma cells in lupus-prone BXSB/Yaamice
Authors: Wong Yi Li , Su Mei-Tzu , Sugahara-Tobinai Akiko , Itoi So , Kezuka Dai , Endo Shota , Inui Masanori , Takai Toshiyuki
Published: February 2019

AbstractImmune homeostasis is critically regulated by the balance between activating and inhibitory receptors expressed on various immune cells such as T and B lymphocytes, and myeloid cells. The inhibitory receptors play a fundamental role in the immune checkpoint pathway, thus maintaining peripheral tolerance. We recently found that expression of leukocyte immunoglobulin-like receptor (LILR)B4, an inhibitory member of the human LILR family, is augmented in auto-antibody-producing plasmablasts/plasma cells of systemic lupus erythematosus (SLE) patients. However, the mechanism behind the ‘paradoxical’ up-regulation of this inhibitory receptor upon pathogenic antibody-secreting cells is yet to be known. To this end, in this study, we examined if glycoprotein 49B (gp49B), the murine counterpart of human LILRB4, is also elevated in auto-antibody-producing cells in several SLE mouse models, and tried to clarify the underlying mechanism. We found that gp49B is expressed on plasma cells of lupus-prone models but not of healthy C57BL/6 mice, and the level was positively correlated to the anti-double-stranded DNA IgG titer in serum. Gp49B genetic deletion, however, did not abolish the serum auto-antibodies or fully ameliorate the lethal glomerulonephritis, indicating that gp49B is not the sole regulator of lupus but a pathogenic element in the disease. We conclude that the elevated expression of this inhibitory receptor on pathogenic plasma cells was also relevant upon the murine SLE model. The mechanism of gp49B underlying the disease progression in lupus-prone mice has been discussed.
A Microsatellite Multiplex Assay for Profiling Pig DNA in Mosquito Bloodmeals
Authors: Keven John B , Walker Edward D , Venta Patrick J
Published: February 2019

Genetic profiling has been used to link mosquito bloodmeals to the individual humans, but this analysis has not been done for other mammalian bloodmeals. In this study, we describe a microsatellite-based method for identifying individual pigs in mosquito bloodmeals based on their unique multilocus genotypes. Eleven tetranucleotide microsatellites and a sex-specific marker were selected based on Smith-Waterman DNA sequence alignment scores from the reference genome and primers were designed with features that reduce primer dimers, promote complete adenylation, and enable fluorescent labeling of amplicons. A multiplex polymerase chain reaction (PCR) assay was optimized and validated by analyzing DNA of individual pigs from several nuclear families and breeds before it was used to analyze genomic DNA of pig-derived mosquito bloodmeals from villages of Papua New Guinea. Population analysis of the nuclear families showed high expected and observed heterozygosity. The probability of observing two unrelated or sibling individuals sharing the same genotype at a single microsatellite locus or a combination of loci was vanishingly low. Samples had unique genotypes and gender was accurately predicted. Analysis of 129 pig bloodmeals identified 19 unique genotypes, which varied greatly in frequency in the mosquito bloodmeal samples. The high allelic diversity of the microsatellite loci and low probability of false attribution of identity show that this genotyping method reliably distinguishes distantly and closely related pigs and can be used to identify individual pigs from genotyped mosquito bloodmeals.
Through The Looking Glass
Authors: Brown Richard H.
Published: February 2019

Through the Looking Glass examines John Cage’s interactions and collaborations with avant-garde and experimental filmmakers, and in turn seeks out the implications of the audiovisual experience for the overall aesthetic surrounding Cage’s career. As the commercially dominant media form in the 20th century, cinema transformed the way listeners were introduced to and consumed music. Cage’s quest to redefine music, intentionality, and expression reflects the similar transformation of music within the larger audiovisual experience of sound film. This study covers a wide variety of topics, ranging from Cage’s father, John Cage Sr.’s patents in infrared and military technology during World War II, theories of dance aesthetics, film and television theory, visual music, information technology, copyright, and the postwar position of the American Neo-Avant-Garde. This volume examines key moments in Cage’s career in which cinema either informed or transformed his position on the nature of sound, music, expression, and the ontology of the musical artwork. The examples point to moments of rupture within Cage’s own consideration of the musical artwork, pointing to new-found collision points that have a significant and heretofore unacknowledged role in Cage’s notions of the audiovisual experience and the medium-specific ontology of a work of art.
Soilborne Inoculum Density and Environmental Parameters Influence the Development of Pythium Stunt Caused by Pythium tracheiphilum in Head Lettuce Crops
Authors: Sauvageau Andréanne , Gravel Valérie , Van der Heyden Hervé
Published: February 2019

In Quebec muck soils, Pythium stunt (Pythium tracheiphilum Matta) is responsible for important yield losses in head lettuce crops each year, which can reach up to 50% in certain cases. Despite the significance of the disease, factors influencing its development remain poorly documented, and no disease risk indicators are available, which makes the development of management strategies difficult. Hence, growers systematically use chemical fungicides throughout the growing season to reduce crop losses. However, it is known that soilborne disease incidence or severity may be influenced by soil inoculum density and environmental parameters. Therefore, the objectives of this study were to investigate the influence of inoculum density on lettuce growth under controlled conditions and evaluate the influence of soil inoculum density, air temperature, relative humidity, and rainfall on disease incidence under field conditions. In particular, this study aims to develop accurate predictors for Pythium stunt incidence. Results showed that, under controlled environment, thresholds of inoculum density of 97 and 46 propagules per gram of dry soil were needed to reduce lettuce dry weight by one-half for cultivars Estival and Prestige, respectively. These results were confirmed under field conditions, where a soil inoculum density >132 propagules per gram of dry soil combined with air temperatures <18°C for the first 2 weeks and rain accumulation >64 mm for the first 3 weeks after transplanting accurately predicted disease incidence 79% of the time. These relationships improve understanding of seasonal Pythium stunt development and will provide useful tools to develop sustainable management strategies.
Genera Acremonium and Sarocladium Cause Brown Spot on Bagged Apple Fruit in China
Authors: Hou Y. M. , Zhang X. , Zhang N. N. , Naklumpa W. , Zhao W. Y. , Liang X. F. , Zhang R. , Sun G. Y. , Gleason M. L.
Published: February 2019

Apple fruit spot disease has caused serious economic losses for years in China since the widespread application of fruit bagging in production. Although the three genera Trichothecium, Alternaria, and Acremonium have been reported to be the causal agents, studies on the disease etiology and pathogen biology are still sparse. Here, we report characterization of eight fungal isolates from lesions on 126 symptomatic fruit samples collected in Shaanxi Province, China. Pathogenicity of the isolates was assessed. DNA sequences were obtained at four loci, including D1/D2 domains of the large-subunit nrRNA gene, internal transcribed spacer regions 1 and 2, 5.8S nrDAN gene, a fragment of the actin gene, and a fragment of the β-tubulin. Based on phylogenetic analysis and morphological features, three new species were found: Acremonium mali, Sarocladium liquanensis, and Sarocladium mali. In addition, we made the first report of Sarocladium terricola as a plant pathogen. Temperature and moisture significantly affected in vitro conidial germination of five Acremonium-like species, and their impact on infection of apple fruit was tested using Acremonium sclerotigenum. Conidia of five species germinated from 15 to 35°C in free water; four of the species had optimum temperature around 25°C, whereas conidia of S. terricola had an optimum temperature of 30°C. Conidial germination rate increased as relative humidity (RH) increased. The five isolates had relatively high conidial germination rates at RH > 97%, with a significant decline at 95% RH. Incidence of infection also increased in proportion to RH. In free water, conidial germination was relatively unaffected by temperature.
Dexmedetomidine as a Part of General Anesthesia for Cesarean Delivery in Patients With Preeclampsia: A Randomized Double-blinded Trial
Authors: Eskandr A.M. , Metwally A.A. , Ahmed A.A. , Elfeky E.M. , Eldesoky I.M. , Obada M.A. , Abd-Elmegid O.A.
Published: February 2019

(Eur J Anaesthesiol. 2018;35:372–378)

In patients with preeclampsia, endotracheal intubation during the induction of general anesthesia causes stimulation of the sympathetic nervous system and catecholamine release, leading to maternal hypertension and tachycardia that could contribute to maternal and neonatal complications. A variety of sedative and opioid drugs have been used in an attempt to blunt this stress response during endotracheal intubation. However, these drugs cross the uteroplacental barrier, and may affect the fetus. Therefore, the search for a drug that has minimal placental transfer to the fetus while also inhibiting the stress response to intubation has led to increasing use of α2 adrenergic agonists such as dexmedetomidine. The current randomized, double-blind, controlled study investigated the use of 2 different doses of dexmedetomidine (0.4 and 0.6 μg/kg) as part of a general anesthetic for patients with preeclampsia undergoing cesarean delivery. The effects of dexmedetomidine on the intubation-related stress response, intraoperative hemodynamics, postoperative analgesia, and fetal outcome were assessed.
Diagnostic Accuracy of Magnetic Resonance Imaging in Detecting the Severity of Abnormal Invasive Placenta: A Systematic Review and Meta-Analysis
Authors: Familiari A. , Liberati M. , Lim P. , Pagani G. , Cali G. , Buca D. , Manzoli L. , Flacco M.E. , Scambia G. , D’antonio F.
Published: February 2019

(Acta Obstet Gynecol Scand. 2018;97:507–520)

As cesarean delivery rates have increased in many countries, a marked rise in the prevalence of abnormal invasive placenta (AIP) has also occurred. Accurate prenatal diagnosis of AIP can significantly reduce maternal morbidity associated with this disorder by allowing for preoperative planning of obstetric and anesthetic management. Ultrasound is considered the primary tool to diagnose AIP; but in cases where ultrasound examination is inconclusive, prenatal magnetic resonance imaging (MRI) may be performed. The current authors have previously found MRI to have good diagnostic accuracy for identifying AIP based on a systematic review and meta-analysis. This systematic review and meta-analysis was undertaken with the primary aim of evaluating the diagnostic accuracy of prenatal MRI for detecting the severity of AIP, as determined by the depth and topography of placental invasion, in women with risk factors for AIP. The secondary goal of the study was to evaluate individual MRI signs for their predictive accuracy is assessing AIP severity.
Maternal and Neonatal Outcomes After Bariatric Surgery: A Systematic Review and Meta-Analysis: Do the Benefits Outweigh the Risks?
Authors: Kwong W. , Tomlinson G. , Feig D.S.
Published: February 2019

(Am J Obstet Gynecol. 2018;218(6):573–580)

As obesity rates rise, rates of pregnant women who are overweight or obese have increased. Obesity is associated with adverse obstetric and neonatal outcomes, including gestational hypertension, gestational diabetes, preeclampsia, and increased risk of cesarean delivery. Weight loss before pregnancy is recommended to prevent these risks. With an increase in the number of reproductive-age women undergoing bariatric surgery, this study aimed to evaluate the benefits and risks of bariatric surgery on obstetric and neonatal outcomes.
Improving Anesthesia Safety in Low-resource Settings
Authors: Khan F.A. , Merry A.F.
Published: February 2019

(Anesth Analg. 2018;126(4):1312–1320)

Over the last century, anesthesia safety has improved significantly in high-income countries (HICs) of the world but has not done the same in low-income countries (LICs), due to characteristics like poor infrastructure and shortages of anesthesia providers, essential drugs, equipment and supplies. In the present article, the authors argued that further disregard of this global anesthesia crisis could result in failure to achieve the full potential of LIC populations. In order to address this issue, the authors provided a high-level overview of some of the relevant challenges and discussed current and potential initiatives at global, regional, national, and local levels. The authors believe that understanding how such systems work is essential to achieving sustainable, widespread improvement globally for safety in anesthesia.
Impact of Epidural Analgesia on Cesarean and Operative Vaginal Delivery Rates Classified by the Ten Groups Classification System
Authors: Lucovnik M. , Blajic I. , Verdenik I. , Mirkovic T. , Stopar Pintaric T.
Published: February 2019

(Int J Obstet Anesth. 2018;34:37–41)

Although epidural analgesia (EA) is widely used for pain relief during labor and delivery, there has been controversy over its impact on labor outcomes. The available evidence has not shown an increase in cesarean delivery rates associated with EA. However, some studies have found an association between EA rates and rates of assisted vaginal delivery. The Ten Group Classification System (TGCS) is used to assess all perinatal events and outcomes according to the obstetric characteristics of women in labor, such as singleton or multiple pregnancy; nulliparous, multiparous, or multiparous with a previous cesarean delivery; cephalic, breech presentation or other malpresentation; spontaneous or induced labor; and term or preterm births. This system has been endorsed by the World Health Organization and is used when analyzing various obstetric outcomes. It has not yet been used, though, to analyze the effects of EA on obstetric outcomes. The objective of this study was to use TGCS to evaluate potential associations between EA and cesarean and assisted vaginal delivery rates, according to the TGCS groups.
Severe Primary Autoimmune Thrombocytopenia in Pregnancy: A National Cohort Study
Authors: Care A. , Pavord S. , Knight M. , Alfirevic Z.
Published: February 2019

(BJOG. 2018;125:604–612)

Primary autoimmune thrombocytopenia (ITP) is an acquired autoimmune disease that is commonly detected in women of reproductive age. ITP is a hemorrhagic disorder characterized by a decrease in platelet count that can carry an increased risk of bleeding. ITP has been reported to occur in 1 in 1000 to 1 in 10,000 pregnancies, but determining the incidence of severe ITP is challenging due to the rarity of the disorder, changing diagnostic criteria, and difficulty determining the cause of thrombocytopenia. The authors hypothesized the risks of maternal and neonatal morbidity and mortality would be elevated in parturients with ITP. This study aimed to determine the incidence of severe ITP in pregnancy in the United Kingdom, as well as current management strategies and maternal and fetal outcomes.
Metformin Exposure in First Trimester of Pregnancy and Risk of All or Specific Congenital Anomalies: Exploratory Case-control Study
Authors: Given J.E. , Loane M. , Garne E. , Addor M.C. , Bakker M. , Bertaut-Nativel B. , Gatt M. , Klungsoyr K. , Lelong N. , Morgan M. , Neville A.J. , Pierini A. , Rissmann A. , Dolk H.
Published: February 2019

(BMJ. 2018;361:k2477)

Metformin is a commonly used drug for the treatment of type 2 diabetes. It has also been used in women with polycystic ovary syndrome to improve insulin sensitivity. Since 2008 the drug has been recommended for use in pregnancy in the United Kingdom for women with type 2 diabetes or gestational diabetes. However, its use in pregnancy remains controversial as it affects stem cell function and concerns have been raised about potential teratogenic effects. Animal studies and meta-analyses in humans have not provided evidence of increased risk for congenital anomalies. However, one cohort study involving 392 women did report an increased risk of congenital anomalies in women taking metformin for diabetes, but no increased risk was found when the drug was being taken for other indications. This led those investigators to conclude the increased risk of anomalies was related to the patients’ diabetes and not the exposure to metformin. In contrast, it has also been suggested that metformin could decrease the risk of congenital anomalies in parturients with diabetes by improving glycemic control. This current study aimed to investigate the effect of first trimester metformin exposure on all or specific congenital anomalies by using a European database.
Do Time of Birth, Unit Volume and Staff Seniority Affect Neonatal Outcome in Deliveries at ≥34+0 Weeks of Gestation?
Authors: Reif P. , Pichler G. , Griesbacher A. , Lehner G. , Schöll W. , Lang U. , Hofmann H. , Ulrich D.
Published: February 2019

(BJOG. 2018;125:884–891)

While women can go into labor at any time, most maternity units are better staffed during daytime working hours. A higher incidence of adverse events has been associated with out-of-hours periods in some studies, but this relationship was not confirmed in others. This study aimed to evaluate whether unit volume, time of birth, and staff seniority during delivery were associated with adverse neonatal outcomes in a province in Austria. The study hypothesized that out-of-hours-deliveries and deliveries at units with fewer deliveries would be associated with an increased risk of adverse outcomes, and also hypothesized that deliveries attended by junior staff and midwives would have better outcomes when compared with deliveries attended by senior staff, as senior staff are likely to be involved in complicated pregnancies and deliveries.
Accuracy of Second Trimester Prediction of Preterm Preeclampsia by 3 Different Screening Algorithms
Authors: Al-Amin A. , Rolnik D.L. , Black C. , White A. , Stolarek C. , Brennecke S. , da Silva Costa F.
Published: February 2019

(Aust N Z J Obstet Gynaecol. 2018;58:192–196)

Preeclampsia (PE) is a major risk factor for maternal and perinatal morbidity and mortality. Thus, early screening in the first trimester to identify patients at high risk for PE allows the initiation of early preventive measures, such as low-dose aspirin therapy begun before 16 weeks gestation. Many women, though, do not have their first prenatal visit until after 16 weeks, and identifying high-risk patients in the second trimester can still be beneficial, especially for identifying early signs of PE and providing timely treatment. Currently, the National Institute for Health and Clinical Excellence (NICE) in the United Kingdom has guidelines for identifying at risk women using maternal demographics and medical history. Likewise in the United States, the American College of Obstetricians and Gynecologists (ACOG) have recommendations for screening that uses demographics and medical history to define those women considered at high risk for PE. In contrast, the Fetal Medicine Foundation (FMF) has published an algorithm for identifying women at risk for early PE that includes measurement of mean arterial pressure and uterine artery Doppler pulsatility index in addition to medical history. This prospective nonintervention study aimed to compare the efficacy of these three screening methods used during the second trimester to predict the occurrence of PE.
Effect of Ibuprofen Versus Acetaminophen on Postpartum Hypertension in Preeclampsia With Severe Features: A Double-masked, Randomized Controlled Trial
Authors: Blue N.R. , Murray-Krezan C. , Drake-Lavelle S. , Weinberg D. , Holbrook B.D. , Katukuri V.R. , Leeman L. , Mozurkewich E.L.
Published: February 2019

(Am J Obstet Gynecol. 2018;218:616.e1–e8)

Hypertensive disorders of pregnancy contribute to maternal morbidity and mortality. Women with hypertension are at increased risk for cesarean delivery. The American College of Obstetricians and Gynecologists suggests avoiding the use of nonsteroidal antiinflammatory drugs (NSAIDS) in women with preeclampsia as they have been shown to increase blood pressure in nonpregnant adults. The purpose of this study was to evaluate the effect of ibuprofen compared with acetminophen on blood pressure control in the postpartum period in women diagnosed with preeclampsia with severe features. They hypothesized that NSAIDs would adversely affect postpartum blood pressure control in women with preeclampsia with severe features.
Sequencing of Circulating Cell-free DNA During Pregnancy
Authors: Bianchi D.W. , Chiu R.W.K.
Published: February 2019

(N Engl J Med. 2018;379:464–473)

Sequence analysis of cell-free DNA (cfDNA) in screenings for fetal chromosome abnormalities is a success story of modern genomic medicine. In this review, the authors discussed lessons learned from the widespread clinical and biotechnological implementation of this test, ethical and legal concerns, and the future of cfDNA sequencing.
Infant Outcome After Complete Uterine Rupture
Authors: Al-Zirqi I. , Daltveit A.K. , Vangen S.
Published: February 2019

(Am J Obstet Gynecol. 2018;219:109.e1–e8)

Although rare, complete uterine rupture is often associated with catastrophic maternal and neonatal outcomes. Studies on complete uterine rupture are limited, in part because most studies do not differentiate between complete and partial rupture, or only include ruptures of scarred uteri. This study used population-based data in Norway to explore risk factors of poor neonatal outcomes after complete uterine rupture.
Neuraxial Anesthesia During Cesarean Delivery for Placenta Previa With Suspected Morbidly Adherent Placenta: A Retrospective Analysis
Authors: Markley J.C. , Farber M.K. , Perlman N.C. , Carusi D.A.
Published: February 2019

(Anesth Analg. 2018;127:930–938)

The coincident state of placenta previa and morbidly adherent placenta (MAP) is associated with an increased risk of complications for women during delivery. Cesarean deliveries (CDs) with placenta previa and MAP are thereby often performed under general anesthesia (GA), as GA can facilitate large-volume resuscitation while avoiding sympathectomy-induced hypotension, an uncontrolled airway, and an indwelling catheter in conjunction with an altered coagulation state. The authors of the present study reported a single-center retrospective analysis of the mode of anesthesia for cases of nonemergent CD with placenta previa and suspected MAP and identified risk factors for nonelective conversion from neuraxial anesthesia (NA) to GA.
Defining Trainee Competence: Value Is in the Eye of the Stakeholder
Authors: Yarris Lalena M.
Published: February 2019

In this issue of Academic Medicine, Lundsgaard and colleagues present “Embracing Multiple Stakeholder Perspectives in Defining Trainee Competence,” a qualitative exploration of how various stakeholders contribute to the understanding of trainee competence. Drawing on stakeholder theory from business management, the authors of that report explore how the perceptions of key stakeholders (leaders/administrators, nurses/nurse practitioners, trainees, and patients) either confirm, enhance, or complicate the picture of competence that emerges from the perspectives of senior physician supervisors.

In this Invited Commentary, the author considers the potential effects of applying stakeholder theory to educational assessment and elaborates on Lundsgaard and colleagues’ findings that additional stakeholder perceptions may be redundant in some instances and present conflicting understandings of competence in others. She also emphasizes the importance of a process of defining competence, and ultimately developing assessment programs, that includes measuring and illuminating conflicting perceptions of what constitutes competence. Finally, the author considers potential applications of Lundsgaard and colleagues’ results for educators and assessors with comprehensive assessment programs already in place.

There are limitations and risks to applying a conceptual framework that aims to increase value for a company to the training of physicians. However, with thoughtful application, incorporating multiple stakeholders into instrument development and workplace-based assessment may provide educators with a more nuanced picture of competence that incorporates the values of those ultimately impacted by trainee performance.
Posttraumatic Stress Symptoms Mediate the Effects of Trauma Exposure on Clinical Indicators of Central Sensitization in Patients With Chronic Pain
Authors: McKernan Lindsey C. , Johnson Benjamin N. , Crofford Leslie J. , Lumley Mark A. , Bruehl Stephen , Cheavens Jennifer S.
Published: February 2019

Objective:

Evidence supports high rates of co-occurrence of posttraumatic stress disorder (PTSD) and chronic pain disorders involving central sensitization (CS). The nature of this relationship, however, remains relatively unexplored. In this study, we aimed to (1) assess how both trauma exposure and current PTSD symptoms are related to clinical manifestations of CS, and (2) test whether PTSD symptoms explain the relationship between trauma exposure and CS. Because experiential avoidance has been shown to impact the relationship between trauma and health outcomes, we (3) explored experiential avoidance as a possible mediator or moderator of the trauma-CS relationship.

Methods:

A sample of 202 adult patients (79% female) with chronic pain completed validated self-report measures of trauma exposure, current PTSD symptoms, experiential avoidance, and 3 manifestations of CS: widespread pain, greater pain severity, and polysomatic symptom reporting. We used path analysis and multivariate regression to assess our study aims.

Results:

Both trauma exposure and PTSD symptoms were significantly associated with all 3 clinical indicators of CS. PTSD symptoms partially explained the relationship between trauma exposure and widespread pain, pain intensity, and polysomatic symptoms. Experiential avoidance did not mediate or moderate the trauma-CS relationship.

Conclusions:

Our findings suggest that trauma exposure is linked to elevated clinical markers of CS but a critical factor in this relationship is the mediating effect of current PTSD symptoms.
Synthetic glycoscapes: addressing the structural and functional complexity of the glycocalyx
Authors: Purcell Sean C. , Godula Kamil
Published: February 2019

The glycocalyx is an information-dense network of biomacromolecules extensively modified through glycosylation that populates the cellular boundary. The glycocalyx regulates biological events ranging from cellular protection and adhesion to signalling and differentiation. Owing to the characteristically weak interactions between individual glycans and their protein binding partners, multivalency of glycan presentation is required for the high-avidity interactions needed to trigger cellular responses. As such, biological recognition at the glycocalyx interface is determined by both the structure of glycans that are present as well as their spatial distribution. While genetic and biochemical approaches have proven powerful in controlling glycan composition, modulating the three-dimensional complexity of the cell-surface ‘glycoscape’ at the sub-micrometre scale remains a considerable challenge in the field. This focused review highlights recent advances in glycocalyx engineering using synthetic nanoscale glycomaterials, which allows for controlled
de novo
assembly of complexity with precision not accessible with traditional molecular biology tools. We discuss several exciting new studies in the field that demonstrate the power of precision glycocalyx editing in living cells in revealing and controlling the complex mechanisms by which the glycocalyx regulates biological processes.
Paenibacillus zeisoli sp. nov., isolated from maize-cultivated soil artificially contaminated with cadmium
Authors: Chen Zhaojin , Ouyang Wenkai , Chen Yan , Tian Wei , Sun Leni
Published: February 2019

A Gram-stain-negative, rod-shaped, motile bacterial strain, designated 3-5-3T, was isolated from maize-cultivated soil artificially contaminated with cadmium, in Nanyang, Henan Province, China. Strain 3-5-3T was oxidase- and catalase-positive. Phylogenetic analysis based on 16S rRNA gene sequences indicated that strain 3-5-3T was affiliated with the genus

Paenibacillus

and most closely related to

Paenibacillus anaericanus

MH2T (96.5 % similarity). The average nucleotide identity and digital DNA–DNA hybridization values between 3-5-3T and the closely related species ranged 69.4–84.5 % and 18.1–18.4 %. The genomic G+C content was 53.8 mol%. Anteiso-C15 : 0 was the major fatty acid and MK-7 was the only menaquinone. The diamino acid in the cell-wall peptidoglycan contains meso-diaminopimelic acid. The polar lipid profile contained diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, phosphatidylmethylethanolamine, two unidentified glycolipids, two unidentified aminolipids, one unidentified phospholipid, one unidentified phosphoaminolipid and six unidentified lipids. On the basis of the results obtained in this study, strain 3-5-3T is considered to represent a novel species of the genus

Paenibacillus

, for which the name

Paenibacillus
zei soli sp. nov. is proposed. The type strain is 3-5-3T (=CGMCC 1.13686T=KCTC 33998T).
Brain tissue properties and morphometry assessment after chronic complete spinal cord injury
Authors: Hug Andreas , Bernini Adriano , Wang Haili , Lutti Antoine , Jende Johann M.E. , Böttinger Markus , Weber Marc-André , Weidner Norbert , Lang Simone
Published: February 2019

There is much controversy about the potential impact of spinal cord injury (SCI) on brain’s anatomy and function, which is mirrored in the substantial divergence of findings between animal models and human imaging studies. Given recent advances in quantitative magnetic resonance imaging (MRI) we sought to tackle the unresolved question about the link between the presumed injury associated volume differences and underlying brain tissue property changes in a cohort of chronic complete SCI patients. Using the established computational anatomy methods of voxel-based morphometry (VBM) and voxel-based quantification (VBQ) we performed statistical analyses of grey matter volume and parameter maps indicative for brain’s myelin, iron and free tissue water content in complete SCI patients (n=14) and healthy individuals (n=14). Our whole-brain analysis showed significant white matter volume loss in the rostral and dorsal part of the spinal cord consistent with Wallerian degeneration of proprioceptive axons in the lemniscal tract in SCI subjects, which correlated with spinal cord atrophy assessed with quantification of the spinal cord cross-sectional area at cervical level. The latter finding suggests that Wallerian degeneration of the lemniscal tract represents a main contributor to the observed spinal cord atrophy, which is highly consistent with preclinical ultrastructural/histological evidence of remote changes in the central nervous system secondary to SCI. Structural changes in the brain representing remote changes in the course of chronic SCI could not be confirmed with conventional VBM or VBQ statistical analysis. Whether and how MRI based brain morphometry and brain tissue property analysis will inform clinical decision making and clinical trial outcomes in spinal cord medicine remains to be determined.
Nuclear hormone receptor NHR-49 shapes immuno-metabolic response ofCaenorhabditis elegans to Enterococcus faecalisinfection
Authors: Dasgupta Madhumanti , Shashikanth Meghana , Bojanala Nagagireesh , Gupta Anjali , Javed Salil , Singh Varsha
Published: February 2019

Immune responses to pathogenic microbes include activation of resistance and tolerance mechanisms in the host both of which are energetically expensive. In this study, we show thatC. elegansexposed to Gram positive bacteriaEnterococcus faecalisandStaphylococcus aureus, rapidly utilizes lipid droplets, the major energy reserve in the nematode. Feeding onE. faecaliscauses developmental arrest inC. eleganslarvae and growth arrest in adults, pointing to starvation response. We find that nematode’s early response to infection entails upregulation of 25 genes involved in lipid hydrolysis and downregulation of 13 lipid synthesis genes as early as 8 hours following exposure. We also show that lipid droplets play a protective role inC. elegansduring infection. NHR-49, a PPARα ortholog, is required forE. faecalisinduced beta-oxidation of fatty acids and immune effector production. It regulates an immunometabolic axis required for survival of the nematode onE. faecalis.Our findings reveal a facet of nutritional immunity wherein lipid droplet homeostasis plays a central role in nematode microbe interactions.