bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pork products associated with human infection caused by an emerging phylotype of hepatitis E virus in England and Wales
Authors: SAID B. , USDIN M. , WARBURTON F. , IJAZ S. , TEDDER R.S. , MORGAN D. 
Published: July 2017

SUMMARYSince 2010, human hepatitis E infections have increased in England and Wales. Most cases are locally acquired and caused by hepatitis E virus genotype 3 (HEV G3). HEV G3 is linked to the consumption of pork products. The increase is associated with the emergence of a new phylotype, HEV G3-group 2 (G3-2, also known as G3abcdhij). Sixty individuals with confirmed hepatitis E infection and no history of travel outside the UK were recruited: 19 were infected with HEV G3-group 1 (G3-1 or G3efg) and 41 with G3-2. Epidemiological data relating to usual shopping habits and consumption of ham and sausages were analysed together with typing data to identify any associations with HEV phylotype. Study participants who purchased ham and/or sausage from a major supermarket were more likely to have HEV G3-2 infection (Relative risks 1·85, P = 0·06, CI 0·97–3·53). The HEV G3-2 phylotype has not been detected in indigenous UK pigs and it is suggested that human infections could be the result of consumption of products made from pork originating outside the UK. This does not infer blame on the supermarket but the epidemiology of HEV is dynamic and reflects complex animal husbandry practices which need to be explored further.
Robotic astrobiology – prospects for enhancing scientific productivity of mars rover missions
Authors: Ellery A. A. 
Published: July 2017

AbstractRobotic astrobiology involves the remote projection of intelligent capabilities to planetary missions in the search for life, preferably with human-level intelligence. Planetary rovers would be true human surrogates capable of sophisticated decision-making to enhance their scientific productivity. We explore several key aspects of this capability: (i) visual texture analysis of rocks to enable their geological classification and so, astrobiological potential; (ii) serendipitous target acquisition whilst on the move; (iii) continuous extraction of regolith properties, including water ice whilst on the move; and (iv) deep learning-capable Bayesian net expert systems. Individually, these capabilities will provide enhanced scientific return for astrobiology missions, but together, they will provide full autonomous science capability.
Does being a Stranger make it Difficult to Cooperate?
Authors: Sariñana-González P. , Romero-Martínez Á. , Moya-Albiol L. 
Published: July 2017

AbstractCompetition and cooperation are two somewhat opposed strategies for interpersonal social interaction that help us to achieve both individual and shared goals. The main aim of this study was to explore which type of social interaction (cooperative or competitive) is more stressful in a face-to-face same-sex dyad in healthy young participants (n = 178), considering outcome obtained in these tasks (positive or negative) and sex as moderating variables, and performance of the task alone as a control condition. Salivary cortisol (Csal) was measured in one sample obtained before task and four obtained after the task (+0, +15, +30 and +45 minutes after). Anxiety-state was assessed before and immediately after the task. Participants who cooperated and obtained negative outcomes had higher Csal levels than those who worked alone with negative outcomes in all periods after the task (p = .008, ηp2 = .058 and p = .033, ηp2 = .031, respectively). Moreover, those who cooperated showed higher mean self-reported state anxiety levels than the rest of the participants (p = .013, ηp2 = .051 and p < .001, ηp2 = .530, respectively). Our study indicates that cooperation between strangers in face-to-face dyads is highly stressful, more so than competing or working alone. These results should be taken into account for understanding situations of social stress and can be generalized to situations in which subjects cooperate or must decide between cooperating and competing to attain a goal.
Turbulent transport coefficients in spherical wedge dynamo simulations of solar-like stars
Authors: Warnecke J. , Rheinhardt M. , Tuomisto S. , Käpylä P. J. , Käpylä M. J. , Brandenburg A. 
Published: July 2017

Aims.We investigate dynamo action in global compressible solar-like convective dynamos in the framework of mean-field theory.Methods.We simulate a solar-type star in a wedge-shaped spherical shell, where the interplay between convection and rotation self-consistently drives a large-scale dynamo. To analyze the dynamo mechanism we apply the test-field method for azimuthally (φ) averaged fields to determine the 27 turbulent transport coefficients of the electromotive force, of which six are related to theαtensor. This method has previously been used either in simulations in Cartesian coordinates or in the geodynamo context and is applied here for the first time to fully compressible simulations of solar-like dynamos.Results.We find that theφφ-component of theαtensor does not follow the profile expected from that of kinetic helicity. The turbulent pumping velocities significantly alter the effective mean flows acting on the magnetic field and therefore challenge the flux transport dynamo concept. All coefficients are significantly affected by dynamically important magnetic fields. Quenching as well as enhancement are being observed. This leads to a modulation of the coefficients with the activity cycle. The temporal variations are found to be comparable to the time-averaged values and seem to be responsible for a nonlinear feedback on the magnetic field generation. Furthermore, we quantify the validity of the Parker-Yoshimura rule for the equatorward propagation of the mean magnetic field in the present case.
The Pellegrini–Stieda Lesion Dissected Historically
Authors: Somford Matthijs , Lorusso Lorenzo , Porro Alessandro , Loon Corné , Eygendaal Denise 
Published: July 2017

AbstractThe Pellegrini–Stieda lesion is a common finding on conventional X-rays. Whether it originates in the medial collateral ligament (MCL) of the knee or the medial head of the gastrocnemius muscle or another structure remains under debate. We discuss the difference in the articles by Pellegrini and Stieda and follow the vision on the origin of the lesion through time. A systematic research in PubMed/MEDLINE was conducted, identifying all articles on the Pellegrini–Stieda lesion and analyzing them for proposed origin of the lesion. The articles with their conclusion based on either finding during surgery or magnetic resonance imaging (MRI)/computed tomography were analyzed in more detail. Our PubMed/Medline search identified 4,997 articles. After exclusion of articles that were not on the Pellegrini–Stieda lesion and of doubles, 27 articles remained. By checking the references manually, 10 more articles were identified. Proposed origins were MCL, medial gastrocnemius, adductor magnus, vastus medialis, deep MCL, and superficial MCL. Although the MCL was most often coined as origin of the lesion (54% overall, 25% on MRI, and 57% during surgery), many cases remained undecided (50% on MRI) or no specific structure was found to be the origin (29% during surgery). There are diverse proposed origins of a calcification on the medial side of the knee. The eponymous term Pellegrini–Stieda lesion seems fitting, as it comprises two different thoughts on the origin of the lesion. MRI seems to be a noninvasive and quite accurate method for future research.
Relatively Loose Flexion Gap Improves Patient-Reported Clinical Scores in Cruciate-Retaining Total Knee Arthroplasty
Authors: Matsumoto Tomoyuki , Takayama Koji , Muratsu Hirotsugu , Ishida Kazunari , Hashimoto Shingo , Hayashi Shinya , Kuroda Ryosuke 
Published: July 2017

AbstractAlthough appropriate soft tissue balancing is well recognized as essential procedure in total knee arthroplasty (TKA), poor relationship between intraoperative soft tissue balance and physician-reported clinical outcomes was reported. Since physician-derived scores are reported to be poorly related to patient-reported scores, patient-derived outcome scales have received a great deal of attention and have become increasingly important. Thus, it should be clarified whether intraoperative soft tissue balance influences patient-reported clinical outcomes. Therefore, the purpose of this study was to investigate the relationship between intraoperative soft tissue balance and patient-reported clinical outcomes in TKA. A total of 35 TKAs were performed in patients with varus-type osteoarthritis, using the tibia first technique with a navigation system. Soft tissue balance (joint component gap and varus/valgus ligament balance) with femoral component placement and temporarily repaired patellofemoral joint were intraoperatively assessed with an offset-type tensor under 40 lb of joint distraction force. Measurements were performed at 0, 10, 30, 60, 90, and 120 degrees of knee flexion. Subjective clinical outcomes were assessed using the 2011 Knee Society score, which consists of objective knee indicators, patient satisfaction, patient expectations, and functional activities at the minimum 1-year follow-up. The relationship between each parameter in soft tissue balance and subjection clinical score was assessed using a simple linear regression model. Objective knee indicators, especially patient-reported symptoms, showed positive correlations with joint component gap difference of 90 to 0 and 120 to 0 degrees. Patient satisfaction and expectations also exhibited positive correlations with joint component gap difference of 90 to 0 and 120 to 0 degrees. There were no correlations among any parameters of soft tissue balance and functional activities. The other parameters, including varus/valgus ligament balance, showed no statistical correlations with clinical scores. In conclusion, intraoperative soft tissue balance influenced the postoperative clinical outcomes, where a relatively loose flexion gap resulted in higher scores for the parameters of pain, patient satisfaction, and patient expectations.
Component resolved diagnostics for hymenoptera venom allergy
Authors: Jakob Thilo , Müller Ulrich , Helbling Arthur , Spillner Edzard 
Published: July 2017

Purpose of review
Component-resolved diagnostics makes use of defined allergen molecules to analyse IgE-mediated sensitizations at a molecular level. Here, we review recent studies on the use of component-resolved diagnostics in the field of Hymenoptera venom allergy (HVA) and discuss its benefits and limitations.

Recent findings
Component resolution in HVA has moved from single molecules to panels of allergens. Detection of specific immunoglobulin E (sIgE) to marker and cross-reactive venom allergens has been reported to facilitate the discrimination between primary sensitization and cross-reactivity and thus, to provide a better rationale for prescribing venom immunotherapy (VIT), particularly in patients sensitized to both honeybee and vespid venom. Characterization of IgE reactivity to a broad panel of venom allergens has allowed the identification of different sensitization profiles that in honeybee venom allergy were associated with increased risks for side effects or treatment failure of VIT. In contrast, component resolution so far has failed to provide reliable markers for the discrimination of sensitizations to venoms of different members of Vespidae.

Summary
Component-resolved diagnostics allows a better understanding of the complexity of sensitization and cross-reactivities in HVA. In addition, the enhanced resolution and precision may allow identification of biomarkers, which can be used for risk stratification in VIT. Knowledge about the molecular composition of different therapeutic preparations may enable the selection of appropriate preparations for VIT according to individual sensitization profiles, an approach consistent with the goals of personalized medicine.
Clonidine Increases the Likelihood That Abstinence Can Withstand Unstructured Time in Buprenorphine-maintained Outpatients
Authors: Kowalczyk William J. , Bertz Jeremiah W. , Moran Landhing M. , Phillips Karran A , Ghitza Udi E. , Epstein David H. , Preston Kenzie L. 
Published: July 2017

Objective:
In a clinical trial examining daily clonidine as an adjunct to buprenorphine treatment for opioid dependence, we found that clonidine increased opioid abstinence and decoupled stress from craving. From a personalized-medicine perspective, the next step is to identify people for whom clonidine would be beneficial. To that end, using data from the same clinical trial, we examined the associations of daily-life activities with treatment success.

Methods:
Outpatients (N = 118) received clonidine (0.3 mg/d) or placebo during 18 weeks of buprenorphine treatment. Participants carried a smartphone that randomly prompted them 4 times per day to report their moods and activities. Using generalized linear mixed models, we assessed the likelihoods of different types of daily activity as a function of clonidine versus placebo, days of longest continuous opioid abstinence, and their interaction.

Results:
Participants in the buprenorphine-only (buprenorphine plus placebo) control group who engaged in more responsibilities (work and child/elder care) had longer streaks of abstinence, whereas those who engaged in more unstructured-time activities had shorter streaks of abstinence. Conversely, for participants in the buprenorphine-plus-clonidine group, longer streaks of abstinence were associated with higher frequencies of activities associated with “unstructured” time.

Conclusions:
The study replicates findings that engaging in responsibilities is related to positive treatment outcomes in standard opioid agonist therapy. The pattern of results also suggests that clonidine helped participants engage in unstructured-time activities with less risk of craving or use than they might otherwise have had.
Pharmacokinetics and Bioavailability of Inhaled Esketamine in Healthy Volunteers
Authors: Jonkman Kelly , Duma Andreas , Olofsen Erik , Henthorn Thomas , van Velzen Monique , Mooren René , Siebers Liesbeth , van den Beukel Jojanneke , Aarts Leon , Niesters Marieke , Dahan Albert 
Published: July 2017

Abstract

Background
Esketamine is traditionally administered via intravenous or intramuscular routes. In this study we developed a pharmacokinetic model of inhalation of nebulized esketamine with special emphasis on pulmonary absorption and bioavailability.

Methods
Three increasing doses of inhaled esketamine (dose escalation from 25 to 100 mg) were applied followed by a single intravenous dose (20 mg) in 19 healthy volunteers using a nebulizer system and arterial concentrations of esketamine and esnorketamine were obtained. A multicompartmental pharmacokinetic model was developed using population nonlinear mixed-effects analyses.

Results
The pharmacokinetic model consisted of three esketamine, two esnorketamine disposition and three metabolism compartments. The inhalation data were best described by adding two absorption pathways, an immediate and a slower pathway, with rate constant 0.05 ± 0.01 min–1 (median ± SE of the estimate). The amount of esketamine inhaled was reduced due to dose-independent and dose-dependent reduced bioavailability. The former was 70% ± 5%, and the latter was described by a sigmoid EMAX model characterized by the plasma concentration at which absorption was impaired by 50% (406 ± 46 ng/ml). Over the concentration range tested, up to 50% of inhaled esketamine is lost due to the reduced dose-independent and dose-dependent bioavailability.

Conclusions
We successfully modeled the inhalation of nebulized esketamine in healthy volunteers. Nebulized esketamine is inhaled with a substantial reduction in bioavailability. Although the reduction in dose-independent bioavailability is best explained by retention of drug and particle exhalation, the reduction in dose-dependent bioavailability is probably due to sedation-related loss of drug into the air.
Recent clinical trials in idiopathic inflammatory myopathies
Authors: Leclair Valérie , Lundberg Ingrid E. 
Published: July 2017

Purpose of reviewIdiopathic inflammatory myopathies (IIMs) are complex multisystemic autoimmune diseases. Glucocorticoids remain the cornerstone of treatment in IIM, and the benefit of additional immunosuppressors is still debated. A limited number of controlled clinical trials have been available to support treatment guidelines, but in the last year, several clinical trials have been published. In this review, the highlights of recently published and on-going clinical trials in IIM will be summarized and discussed.Recent findingsPost hoc analyses of a large randomized controlled trial (RCT) suggested new predictive factors of response to rituximab in refractory IIM individuals. An international collaboration enabled the completion of a large RCT in early juvenile dermatomyositis that will orient first-line treatment in that population. New approaches are showing encouraging results in inclusion body myositis.SummaryRecent advances in molecular mechanisms underlying IIM pathogenesis and the development of novel targeted therapies have influenced recent and on-going clinical research.
Quick Sequential Organ Failure Assessment and Systemic Inflammatory Response Syndrome Criteria as Predictors of Critical Care Intervention Among Patients With Suspected Infection*
Authors: Moskowitz Ari , Patel Parth V. , Grossestreuer Anne V. , Chase Maureen , Shapiro Nathan I. , Berg Katherine , Cocchi Michael N. , Holmberg Mathias J. , Donnino Michael W. 
Published: July 2017

Objectives:
The Sepsis III clinical criteria for the diagnosis of sepsis rely on scores derived to predict inhospital mortality. In this study, we introduce the novel outcome of “received critical care intervention” and investigate the related predictive performance of both the quick Sequential Organ Failure Assessment and the Systemic Inflammatory Response Syndrome criteria.

Design:
This was a single-center, retrospective analysis of electronic health records.

Setting:
Tertiary care hospital in the United States.

Patients:
Patients with suspected infection who presented to the emergency department and were admitted to the hospital between January 2010 and December 2014.

Interventions:
Systemic Inflammatory Response Syndrome and quick Sequential Organ Failure Assessment scores were calculated, and their relationships to the receipt of critical care intervention and inhospital mortality were determined.

Measurement and Main Results:
A total of 24,164 patients were included of whom 6,693 (27.7%) were admitted to an ICU within 48 hours; 4,453 (66.5%) patients admitted to the ICU received a critical care intervention. Among those with quick Sequential Organ Failure Assessment less than 2, 13.4% received a critical care intervention and 3.5% died compared with 48.2% and 13.4%, respectively, for quick Sequential Organ Failure Assessment greater than or equal to 2. The area under the receiver operating characteristic was similar whether quick Sequential Organ Failure Assessment was used to predict receipt of critical care intervention or inhospital mortality (0.74 [95% CI, 0.73–0.74] vs 0.71 [0.69–0.72]). The area under the receiver operating characteristic of Systemic Inflammatory Response Syndrome for critical care intervention (0.69) and mortality (0.66) was lower than that for quick Sequential Organ Failure Assessment (p < 0.001 for both outcomes). The sensitivity of quick Sequential Organ Failure Assessment for predicting critical care intervention was 38%.

Conclusions:
Emergency department patients with suspected infection and low quick Sequential Organ Failure Assessment scores frequently receive critical care interventions. The misclassification of these patients as “low risk,” in combination with the low sensitivity of quick Sequential Organ Failure Assessment greater than or equal to 2, may diminish the clinical utility of the quick Sequential Organ Failure Assessment score for patients with suspected infection in the emergency department.
Elderly patients with multiple myeloma: towards a frailty approach?
Authors: Zweegman Sonja , Engelhardt Monika , Larocca Alessandra 
Published: July 2017

Purpose of review
To describe how to better identify frail multiple myeloma patients and to treat them appropriately.

Recent findings
Proteasome inhibitors, such as bortezomib, carfilzomib, and ixazomib, and immunomodulatory agents (IMiDs), such as thalidomide, lenalidomide, and pomalidomide, have significantly improved the outcome of multiple myeloma patients in the last decade. However, both in clinical trials and in daily clinical practice, elderly multiple myeloma patients have shown lesser benefit. This is mainly due to less stringent use of proteasome inhibitors and IMiDs, increased toxicity, and subsequent early discontinuation of therapy in elderly.

Summary
Multiple myeloma typically affects elderly patients. Approximately one-third of patients are older than 75 years at diagnosis. Moreover, at least 30% are frail, both due to disease-related symptoms and (age-related) decline in physical capacity, presence of comorbidities, frailty, polypharmacy, nutritional status, and cognitive impairment. Treatment regimens that are investigated in clinical trials for transplant-ineligible patients have largely been investigated in fit, rather than frail patients, the latter being typically excluded or highly underrepresented therein. Data on the feasibility and efficacy of current standards of care are therefore lacking in frail patients. Preliminary data suggest a higher toxicity and discontinuation rate, loss of efficacy, and impaired quality of life in frail patients. Geriatric assessment helps to identify frail patients according to their functional and cognitive status. Both the International Myeloma Working Group (IMWG)-frailty index and Revised Myeloma Comorbidity Index constitute recently proposed algorithms that easily identify intermediate-fit and frail patients. Ongoing and future clinical trials, specifically designed for frail patients, will hopefully define frailty-directed treatment selection.
Bullous Erythema Nodosum Leprosum as the First Manifestation of Multibacillary Leprosy: A Rare Phenomenon
Authors: Bakshi Neha , Rao Seema , Batra Rohit 
Published: July 2017

Abstract:
Erythema nodosum leprosum (ENL) may uncommonly present before treatment in patients with multibacillary leprosy. Atypical manifestations are known in ENL and may be clinically misleading. Such wide variations in the clinical presentation of leprosy in reaction make histopathology an important tool for supporting clinical diagnosis. We report bullous ENL presenting as the first manifestation of leprosy in a 30-year-old Indian man diagnosed using histopathology.
Metastatic Cutaneous Paraganglioma: A Case Report and Review of the Literature
Authors: de Leon Dianne , Walton Kara , Sokumbi Olayemi 
Published: July 2017

Abstract:
Paragangliomas are rare neoplasms that arise from chromaffin cells of the sympathetic and parasympathetic nervous system. These tumors are often cured by surgical resection but the risk for metastatic disease exists, particularly for extra-adrenal paragangliomas. The behavior of these tumors is unpredictable, and clinical and histopathological features associated with malignancy have not been determined. The most common sites of metastases include local and distant lymph nodes, bone, liver, and lung. Cutaneous metastases are exceedingly rare with only 2 reported cases, both of which presented on the scalp. Here we describe a 78-year-old woman with cutaneous metastatic paraganglioma presenting as a forehead nodule, which developed 15 years after her initial diagnosis of paraganglioma.