bluuebunny/crossref_metadata_2025 huggingface dataset:
Designing a long short-term network for short-term forecasting of global horizontal irradiance
Authors: Malakar Sourav , Goswami Saptarsi , Ganguli Bhaswati , Chakrabarti Amlan , Roy Sugata Sen , Boopathi K. , Rangaraj A. G.
Published: March 2021

Long short-term memory (LSTM) models based on specialized deep neural network-based architecture have emerged as an important model for forecasting time-series. However, the literature does not provide clear guidelines for design choices, which affect forecasting performance. Such choices include the need for pre-processing techniques such as deseasonalization, ordering of the input data, network size, batch size, and forecasting horizon. We detail this in the context of short-term forecasting of global horizontal irradiance, an accepted proxy for solar energy. Particularly, short-term forecasting is critical because the cloud conditions change at a sub-hourly having large impacts on incident solar radiation. We conduct an empirical investigation based on data from three solar stations from two climatic zones of India over two seasons. From an application perspective, it may be noted that despite the thrust given to solar energy generation in India, the literature contains few instances of robust studies across climatic zones and seasons. The model thus obtained subsequently outperformed three recent benchmark methods based on random forest, recurrent neural network, and LSTM, respectively, in terms of forecasting accuracy. Our findings underscore the importance of considering the temporal order of the data, lack of any discernible benefit from data pre-processing, the effect of making the LSTM model stateful. It is also found that the number of nodes in an LSTM network, as well as batch size, is influenced by the variability of the input data.
Generalized linear models for analyzing count data of rainfall occurrences
Authors: Sumi Sharmin Nahar , Sinha Narayan Chandra , Islam M. Ataharul
Published: March 2021

Having the adequate knowledge about the behavior of climatic variables on the occurrences of rainfall is needed to the country’s economists and agriculturists for saving the country’s people from the devastating natural hazards like flash flood, drought, heavy rainfall, etc. Therefore, the study has been taken initiative to identify the influence of climatic variables for the occurrences of rainfall. The study has been developed generalized linear models (GLMs) for Poisson distribution for weekly and fortnightly count data of daily rainfall occurrences for the summer and monsoon seasons for five regional rainfall stations of Bangladesh. For these models, minimum and maximum temperatures and relative humidity are considered as explanatory variables. For five regional rainfall stations, the model selection procedures AIC and BIC indicate that the GLMs for the Poisson distribution satisfactorily explain the influence of climatic variables for the fortnightly occurrences of rainfall in the summer and monsoon seasons. The GLMs for the summer season of fortnightly occurrences of rainfall indicate that if one unit of relative humidity increases, then the probability of rainy days will be increased by 12 percent in Feni station, 6 percent in Sylhet, Khulna and Rajshahi stations, and 7 percent in Dhaka station. Besides, the GLMs for the monsoon season of fortnightly occurrences of rainfall indicate that if one unit increases of minimum temperature, then the probability of rainy days will be increased by 22 percent, 19 percent, 24 percent, 17 percent and 19 percent in Feni, Sylhet, Khulna, Rajshahi and Dhaka stations, respectively. Further, maximum temperature indicates negative influence on the occurrences of rainfall for all the stations and seasons of the period. The study indicates that the relative humidity for summer season and minimum temperature for monsoon season play remarkable role for changing fortnightly occurrences of rainfall in all the regions of the country.
Adjustment of glacier geometries to future equilibrium line altitudes in the Shigar River Basin of Karakoram Range, Pakistan
Authors: Baig Siddique Ullah , Muneeb Fakhra
Published: March 2021

Pakistan’s Karakoram region has a large variety of glacier types. Equilibrium line altitude (ELA) of alpine or valley glaciers represents mass balance. Field observations for estimation of ELA of the majority of Karakoram’s glaciers are not available due to rugged glacier-covered terrains and lack of climatic data above 5000 masl. Therefore, we applied the hypsometrically controlled accumulation area ratio (AAR) and accumulation area balance ratio (AABR) methods for ELA estimation and glacier–climate reconstructions in the Shigar River Basin of the Karakoram region. Constrained by mountain topography, larger size and type of glaciers, several ranges of ELA are calculated and implemented for several ratios. Two parameters (ratio and interval) are provided to calculate AAR-ELAs between 0.4 and 0.8 with 0.05 interval and AABR-ELAs between 0.9 and 4.4 with 0.01 interval. By providing constant AAR (rather than constant glacier area), this approach adjusted glacier geometries (area) to future ELA variations. For constant AAR of 0.4–0.45, a 90-m ELA decrease from 5769 to 5679 m of Baltoro glacier adjusted its geometries by reducing ~ 5% area. The highest decrease of 140-m ELA of the same glacier is reported for constant AAR of 0.7–0.75, revealing a significant loss of 8% geometries. The projected geometry losses for all these glaciers are highly variable, with top-heavy glaciers (Biafo and Baltoro) projected to experience the major losses in glacier-ice area. It is concluded that the quality of ELAs is highly dependent on the reconstructed three-dimensional glacier surfaces.
Antioxidative study of polysaccharides extracted from red (Kappaphycus alvarezii), green (Kappaphycus striatus) and brown (Padina gymnospora) marine macroalgae/seaweed
Authors: Bhuyar Prakash , Sundararaju Sathyavathi , Rahim Mohd Hasbi Ab. , Unpaprom Yuwalee , Maniam Gaanty Pragas , Govindan Natanamurugaraj
Published: March 2021

Sterile and fresh tissues of three marine macroalgae red, green and brown (Kappaphycus alvarezii, Kappaphycus striatusandPadina gymnospora) collected from Malaysia east costal seas were compared for the antioxidants and polysaccharide composition of sugars as well as the active components. Results obtained showed that polysaccharides isolated fromKappaphycus alvarezii, Kappaphycus striatusandPadina gymnospora) can be used as a source of natural antioxidant compounds as they possess antioxidant potential in which thePadina gymnosporashowed 15.56 ± 0.12 mg/mL to be the best antioxidants among all the polysaccharides studied. The hot water extraction method is effective in isolating polysaccharides from studied seaweeds. The GC–MS analysis revealed that there is presence of chemical compounds such as furfural was 25.53% inKappaphycus alvareziiand 21.04% inKappaphycus striatusalsoPadina gymnosporaincorporates n- Hexadecanoic acid about 26.31% in seaweed polysaccharides that contribute to their antioxidant activities. Further studies can be done on determining the seaweed species that are available abundantly with the best source of natural antioxidant compounds.
Mutation Profile in BCR-ABL1-Negative Myeloproliferative Neoplasms
Authors: Maddali Madhavi , Kulkarni Uday Prakash , Ravindra Niveditha , Arunachalam Arun Kumar , Venkatraman Arvind , Lionel Sharon , Manipadam Marie Therese , Devasia Anup J. , Korula Anu , Fouzia N.A. , Abraham Aby , Srivastava Alok , George Biju , Balasubramanian Poonkuzhali , Mathews Vikram
Published: March 2021

Objective/Background:

Recurrent somatic mutations in the JAK2, calreticulin (CALR), and the MPL genes are described as drivers of BCR-ABL1-negative myeloproliferative neoplasms (MPN) that includes polycythemia vera (PV), essential thrombocytosis (ET), primary myelofibrosis (PMF), and MPN unclassified (MPN-U).

Methods:

We describe the mutation profile and clinical features of MPN cases diagnosed at a tertiary care center. JAK2V617F and MPL (S505/W515) mutations were screened by allele-specific polymerase chain reaction, while CALR exon 9 and JAK2 exon 12 mutations were screened by fragment analysis/Sanger sequencing. Among the 1,570 patients tested for these mutations during the study period, 407 were classified as MPN with a diagnosis of PV, ET, PMF, and MPN-U seen in 30%, 17%, 36%, and 17%, respectively, screened.

Results:

Similar to previous reports from Asian countries, the incidence of PMF was the highest among the classic MPN. JAK2V617F mutation was detected in 90% of PV, 38% of ET, 48% of PMF, and 65% of MPN-U. JAK2 exon 12 mutations were seen in 5.7% of PV and 1.4% of PMF. CALR exon 9 mutations were seen in 33% of ET, 33% of PMF, and 12% of MPN-U. MPL mutations were detected in 2.8%, 2.7%, and 2.9% of ET, PMF, and MPN-U, respectively. Fifteen % of PMF, 26% of ET, and 22% of MPN-U were triple negative.

Conclusion:

There was a significantly higher incidence of CALR mutation in PMF and ET cases. Our study highlights the challenges in the diagnosis of JAK2-negative PV and the need for harmonization of criteria for the same.
Equity in global surgical care: A commentary
Authors: Khan Sadaf , Urooba Amna
Published: March 2021

Highlights
Outcomes of Complex Gastrointestinal Cancer Resection at US News & World Report Top-Ranked vs Non-Ranked Hospitals
Authors: Tay Erika , Gambhir Sahil , Stopenski Stephen , Hohmann Samuel , Smith Brian R. , Daly Shaun , Hinojosa Marcelo W. , Nguyen Ninh T.
Published: March 2021

BACKGROUND:

The US News & World Report (USNWR) annual ranking of the best hospitals for gastroenterology and gastrointestinal surgery offers direction to patients and healthcare providers, especially for recommendations on complex medical and surgical gastrointestinal (GI) conditions. The objective of this study was to examine the outcomes of complex GI cancer resections performed at USNWR top-ranked, compared to non-ranked, hospitals.

STUDY DESIGN:

Using the Vizient database, data for patients who underwent esophagectomy, gastrectomy, and pancreatectomy for malignancy between January and December 2018 were reviewed. Perioperative outcomes were analyzed according to USNWR rank status. Primary outcome was in-hospital mortality. Secondary outcomes include length of stay, mortality index (observed-to-expected mortality ratio), rate of serious complication, and cost. Secondary analysis was performed for outcomes of patients who developed serious complications.

RESULTS:

There were 3,054 complex GI cancer resections performed at 42 top-ranked hospitals vs 3,608 resections performed at 198 non-ranked hospitals. The mean annual case volume was 73 cases at top-ranked hospitals compared to 18 cases at non-ranked hospitals. Compared with non-ranked hospitals, top-ranked hospitals had lower in-hospital mortality (0.96% vs 2.26%, respectively, p < 0.001) and lower mortality index (0.71 vs 1.53, respectively). There were no significant differences in length of stay, rate of serious complications, or direct cost between groups. In patients who developed serious morbidity, top-ranked hospitals had a lower mortality compared with non-ranked hospitals (8.2% vs 16.8%, respectively, p < 0.01).

CONCLUSIONS:

Within the context of complex GI cancer resection, USNWR top-ranked hospitals performed a 4-fold higher case volume and were associated with improved outcomes. Patients with complex GI-related malignancies may benefit from seeking surgical care at high-volume regional USNWR top-ranked hospitals.
Lateral Seismic Anisotropy Variations Record Interaction Between Tibetan Mantle Flow and Plume‐Strengthened Yangtze Craton
Authors: Li Wei , Chen Yun , Liang Xiaofeng , Xu Yi‐Gang
Published: March 2021

The southeastern Tibetan Plateau experienced intense Cenozoic shortening and extrusion along the western Yangtze Craton, SW China, where the Permian Emeishan flood basalts were emplaced. Seismic anisotropy along a dense E–W‐trending linear seismic array across the west Yunnan is determined by shear‐wave splitting analysis to characterize the deformation associated with these processes. Interestingly, a strong N–S‐oriented anisotropic zone collocated with the Eocene–Oligocene potassic magmatism is observed between two weak anisotropic zones in the Three‐River Orogenic Zone and the western Yangtze Craton, respectively. The lateral anisotropy variation and distinct upper mantle structures collectively suggest that the western most Yangtze Craton, strengthened by the Permian mantle plume, acted as a rigid barrier to divert the Cenozoic Tibetan mantle flow into the Three‐River Orogenic Zone. Consequently, the western edge of the Yangtze Craton has been partially eroded and its anisotropic orientation was realigned to the direction of the mantle flow. This observation indicates that both the remodeled anisotropy in the lithosphere and the dynamic flow in the asthenosphere contribute to the mantle anisotropy at the lateral lithosphere‐asthenosphere transition, which is usually hard to seismologically resolve from the vertical lithosphere‐asthenosphere boundary.
Enhanced Climate Response to Ozone Depletion From Ozone‐Circulation Coupling
Authors: Lin Pu , Ming Yi
Published: March 2021

The effect of stratospheric ozone depletion is simulated in GFDL AM4 model with three ozone schemes: Prescribing monthly zonal mean ozone concentration, full interactive stratospheric chemistry, and a simplified linear ozone chemistry scheme but with full dynamical interactions. While similar amounts of ozone loss are simulated by the three schemes, the two interactive ozone schemes produce significantly stronger stratospheric cooling than the prescribed one. We find that this temperature difference is driven by the dynamical responses to ozone depletion. In particular, the existence of ozone hole leads to strong ozone eddies that are in‐phase with the temperature eddies. The coherence between ozone and temperature anomalies leads to a weaker radiative damping as ozone absorbs shortwave radiation that compensates for the longwave cooling. As a result, less wave dissipates at the lower stratosphere, leading to a weaker descending and dynamical heating over the polar lower stratosphere, and hence a stronger net cooling there. The covariance between ozone and temperature is largely suppressed when ozone is prescribed as monthly zonal mean time series, as is the reduction in the radiative damping following ozone depletion. With much lower computational cost, the simplified ozone scheme is capable of producing similar magnitude of ozone loss and the consequent dynamical responses to those simulated by the full chemistry.
AQP2 as a target of lycopene protects against atrazine-induced renal ionic homeostasis disturbance
Authors: Guo Jian-Ying , Lin Jia , Huang Yue-Qiang , Talukder Milton , Yu Lei , Li Jin-Long
Published: March 2021

This study shows that atrazine exposure can lead to nephrotoxicity by interfering with ion homeostasis. Lycopene maintains ion homeostasis by regulating the expression of AQPs and the activity of ATPase, and antagonizes the nephrotoxicity induced by atrazine.
Iodine-catalyzed thioallylation of indoles using Bunte salts prepared from Baylis–Hillman bromides
Authors: Gupta Prince Kumar , Yadav Arvind Kumar , Sharma Anup Kumar , Singh Krishna Nand
Published: March 2021

Iodine-catalyzed regioselective thioallylation of indoles has been accomplished using Bunte salts prepared from Baylis–Hillman bromides.
Mitochondrial genome stability in human: understanding the role of DNA repair pathways
Authors: Dahal Sumedha , Raghavan Sathees C.
Published: March 2021

Mitochondria are semiautonomous organelles in eukaryotic cells and possess their own genome that replicates independently. Mitochondria play a major role in oxidative phosphorylation due to which its genome is frequently exposed to oxidative stress. Factors including ionizing radiation, radiomimetic drugs and replication fork stalling can also result in different types of mutations in mitochondrial DNA (mtDNA) leading to genome fragility. Mitochondria from myopathies, dystonia, cancer patient samples show frequent mtDNA mutations such as point mutations, insertions and large-scale deletions that could account for mitochondria-associated disease pathogenesis. The mechanism by which such mutations arise following exposure to various DNA-damaging agents is not well understood. One of the well-studied repair pathways in mitochondria is base excision repair. Other repair pathways such as mismatch repair, homologous recombination and microhomology-mediated end joining have also been reported. Interestingly, nucleotide excision repair and classical nonhomologous DNA end joining are not detected in mitochondria. In this review, we summarize the potential causes of mitochondrial genome fragility, their implications as well as various DNA repair pathways that operate in mitochondria.
C‐CNNLoc: Constrained CNN for robust indoor localization with building boundary
Authors: Oh Y. , Noh H.‐M. , Shin W.
Published: March 2021

To enable accurate and reliable indoor localization in a multi‐building environment, a novel constrained convolutional neural network (CNN)‐based indoor localization system (C‐CNNLoc) is proposed using WiFi fingerprinting approach. The proposed network has a sequential structure that firstly classifies a building, followed by estimating the user's location coordinate within the pre‐detected building. Furthermore, the location accuracy is improved by introducing a new loss function that incorporates a penalty term associated with the building boundary. Experimental results illustrate that the proposed method outperforms the existing solutions on the average distance error. The gain comes from that the approach tailored to a multi‐building indoor localization with the sequential structure is prone to successfully correct outliers, that is, predicted location coordinates that lie outside the buildings.
Current Concepts on the Pathogenesis of Peri-implantitis: A Narrative Review
Authors: Fragkioudakis Ioannis , Tseleki Georgia , Doufexi Aikaterini-Elisavet , Sakellari Dimitra
Published: March 2021

As implant treatment has been integrated in contemporary dental practice, complications with the forms of peri-implant mucositis and peri-implantitis have also increased in prevalence. Peri-implantitis is the more severe biological complication and is defined as an inflammatory disease affecting peri-implant tissues resulting in bone and eventually implant loss. In addition, the treatment of peri-implantitis has currently become a substantial global economic burden. In the current study, a search was conducted in several electronic databases using specific keywords relevant to the article’s main topic. An increasing number of scientific reports have investigated the etiopathology of peri-implant diseases, focusing mainly on peri-implantitis. Microbial biofilm consists an important etiological factor of peri-implant pathology analogous to periodontal diseases. Although several data confirm that peri-implant infections are dominated by gram-negative bacteria, similar to periodontal infections, there is evidence that some cases may harbor a distinct microbiota, including opportunistic microorganisms and/or uncultivable species. Additionally, data support that several parameters, such as genetic predisposition of individual patients, occlusal overload, and local factors such as titanium particles and excess cement, may be implicated in peri-implantitis pathogenesis. Simultaneously, the release of titanium metal particles and their biological consequences or the presence of excess cement in the adjacent peri-implant tissues have also been suggested as factors that contribute to peri-implant pathology. A specific line of research also indicates the role of foreign body response to implant installation. This narrative review aims to discuss the current concepts of etiopathogenetic factors implicated in peri-implantitis.
Continuing Education through COVID-19 Crisis in the United Kingdom: A Swiss Trainee Abroad
Authors: Zientara Alicja
Published: March 2021

The work has been awarded in July 2020 with the “Special Swiss Young Cardiac Surgeon Award 2020” by the Swiss Society of Cardiac Surgery (Schweizerische Gesellschaft für Herz- und thorakale Gefässchirurgie [SGHC-SSCC]) and reflects a personal perspective from a Swiss trainee experiencing the novel coronavirus disease 2019 (COVID-19) pandemic during her fellowship in London.
Management of a Residual VSD 60 Years after One of the First Operations Worldwide
Authors: Hegazy Yasser Yehia , Koriem Mohamed , Keshk-Hegazy Noha Samir , Sodian Ralf
Published: March 2021

Background Although surgical closure of ventricular septal defect (VSD) is the gold standard treatment, patients are subjected to deterioration in the following decades. We will present here the first case in literature surviving 60 years after surgical VSD closure with a residual VSD and presenting again for surgery.

Case Description A 68-year-old male patient who underwent surgical closure of a perimembranous VSD in Berlin in 1959. Postoperatively, a small residual VSD was noticed, which was well tolerated over six decades. He presented 60 years postoperatively with severe aortic regurgitation, tricuspid regurgitation, and moderate mitral regurgitation.
Evaluating Knowledge Regarding Cervical Cancer and Its Screening among Woman in Rural India
Authors: Khanna Divya
Published: March 2021

Context Cervical cancer is the most common cancer among rural women of India. However, awareness of cancer of the uterine cervix and its screening coverage among the general population of India remains insufficient.

Aims The study aims to assess awareness of cervical cancer and its screening among women attending a rural health care center in northern India and determine factors associated with satisfactory knowledge.

Settings and Design A cross-sectional observational study was done among women attending a rural secondary health care center from Uttar Pradesh, India.

Materials and Methods A total of 1088 women aged ≥30 years were interviewed using a pretested schedule. Data were collected for biosocial, reproductive, sexual, and personal habits of participants and their partners. Scoring for knowledge related to cervical cancer and its screening was done.

Statistical Analysis Used Descriptive statistics were calculated. Chi-square test was applied to detect the significant difference in distribution of bio-socio-demographic variables with knowledge score. Statistically significant variables were subjected to multinomial logistic regression. Unadjusted and adjusted odds ratios with 95% confidence interval were calculated as odds of having poor cervical cancer awareness. p < 0.05 was considered statistically significant.

Results Most participants knew about cervical cancer as a type of cancer in women. Very few knew about symptoms, risk factors, and screening of the disease. Illiteracy and multiple sexual contacts were significant predictors of awareness.

Conclusions The study demonstrates a lack of awareness in women regarding cervical cancer and its prevention, especially among those women who belonged to weaker sections of the society, because of illiteracy and poor socioeconomic status. Lack of awareness is a potential limiting step for a woman to seek cervical cancer screening. Multipronged strategies are needed to improve the level of cervical cancer awareness among women.
Pediatric Metastatic Crohn's Disease
Authors: Oliveira Amanda Trindade de , Oliveira Raissa Albuquerque Calais de , Meyer Matheus Matta Machado Duque Estrada , Silva Ilson Geraldo da , Massahud Matheus Duarte
Published: March 2021

Crohn's disease (CD) is a chronic, relapsing, idiopathic condition, characterized by granulomatous, transmural inflammation of the gastrointestinal tract, which can affect its entire length, from mouth to anus. Metastatic Crohn's disease (MCD) is a rare form of skin involvement and is defined by skin lesions without contiguity with the gastrointestinal tract. A 9-year-old patient presented with gastrointestinal complaints and gross skin lesions in the vulva and perianal region. The diagnosis of Crohn's disease was made when the patient was 11 years old, after being evaluated by the colorectal surgeon. Treatment was started with a “top-down” approach, with a sustained response for four years. Afterwards, there was a relapse of the skin disease in previously normal areas, without overt symptoms. Treatment consisted of steroids and local infiltration of infliximab, without improvement. A year later, there was a rapid progression of the skin lesions, and the drug changed to adalimumab, also without response and worsening of the skin lesions. The patient was admitted to the hospital and intravenous steroids were initiated, along with surgical debridement of the lesions. After some improvement, ustekinumab was initiated with satisfactory response. Pediatric MCD has an important impact on the patient's quality of life, with influences on growth and social development.
Assessment of Quality Indexes in Colonoscopy in the Coloproctology Service of a Tertiary Private Hospital in Southern Brazil
Authors: Pinto Rafael Castilho , Seabra Marcela Krug , Cunha Aline Andrea da , Pagano Cassia Garcia Moraes , Mussnich Heloisa Guedes
Published: March 2021

Background Colorectal cancer (CRC) is the third most common cancer among men, and the second among women worldwide. In Brazil, the incidence and mortality of CRC continues to increase. In colonoscopies, adenoma detection rates (ADRs) higher than 25% are associated linearly with better outcomes and lower rates of interval cancer.

Objective To assess the colonoscopy quality indexes.

Methods This is a cross-sectional retrospective study in which anatomopathological data and data regarding the colonoscopies were collected from the patient records of Hospital Moinhos de Vento, in Southern Brazil. The exams were performed by doctors from the Colorectal Service from June to August 2015.

Results A total of 430 exams were included. Most patients were women (60.9% [262]), with a mean age of 56.96 years. The cecal intubation rate was of 96.7% (416). The quality of the bowel preparation was excellent or good in 92.95% (396) of the cases. The average time of removal of the colonoscope in normal exams was of 6.15 minutes. Polyps were detected in 201 patients (46.7%), and adenomas, in 125 patients (29.1%); 12 patients (2.8%) had advanced adenomas, and 6 (2.3%) had malignant neoplasms. The proximal serrated lesion detection rate (PSLDR) was of 6.7% (29). The prevalence ratio (PR) of adenomas among men was 1.78 times greater than in women (95% confidence interval [95%CI]: 1.16–2.75). The PR of adenomas among people aged 50 years or older was 2.41 times that of those under 50 years of age (95%CI: 1.43–4.06).

Conclusion The data obtained are in line with international quality criteria in colonoscopy. More studies are needed to assess the ADR in the Brazilian population.
Anatomical Step-by-Step Dissection of Complex Skull Base Approaches for Trainees: Surgical Anatomy of the Middle Fossa Approaches and Anterior Petrosectomy, Surgical Principles, and Illustrative Cases
Authors: Salgado-Lopez Laura , Perry Avital , Graffeo Christopher S. , Carlstrom Lucas P. , Leonel Luciano C.P.C. , Driscoll Colin L.W. , Link Michael J. , Peris-Celda Maria
Published: March 2021

Introduction The middle fossa (MF) approaches encompass a group of versatile surgical accesses to pathologies in the MF, internal auditory canal (IAC), and superomedial aspect of the posterior fossa. Although many descriptions of the MF approaches have been published, a practical surgical guide that allows an easy understanding for Skull Base trainees is needed.

Methods Three formalin-fixed, colored-injected specimens were dissected under microscopic magnification (six sides). A MF craniotomy followed by IAC drilling was performed on three sides, and anterior petrosectomy (AP) was performed in the remaining three sides. The anatomical dissection was documented in stepwise three-dimensional photographic images. Following dissection, representative case applications were reviewed.

Results The MF approach provides direct access to the MF structures and IAC. The AP provides excellent access to the superomedial aspect of the posterior fossa. Key common steps include: positioning and skin incision; scalp and muscle flaps; burr holes; craniotomy flap elevation; dural dissection along the petrous ridge; division of the middle meningeal artery; and exposure of the greater superficial petrosal nerve, tegmen tympani, and V3. Then, to approach the IAC: superior IAC drilling, and longitudinal dura opening. The area drilled in the AP approach forms a pentagon limited by the petrous internal carotid artery, cochlea, IAC, petrous ridge, and lateral border of V3.

Conclusion The MF approaches are challenging. Operatively oriented skull base dissections provide a crucial foundation for learning these techniques. We describe comprehensive step-by-step approaches intended to develop familiarity in the cadaver laboratory and facilitate understanding of their potential for skull base disorders. Basic surgical principles are described to help in the operating room as well as illustrative cases.
Normal Values and Associated Factors in High-resolution Anorectal Manometry in Healthy Vietnamese Adults
Authors: Anh Nguyen Ngoc , Tung Le Dinh , Khoa Ngo Xuan , Cuong Le Manh , Hung Nguyen Xuan , Hang Nguyen Thi Thu , Khanh Pham Phuc , Huy Nguyen Van , Kien Vu Duy
Published: March 2021

Introduction The present study aims to identify normal high-resolution anorectal manometry (HRAM) values and related factors in healthy Vietnamese adults.

Methods The present cross-sectional study was conducted at the Viet Duc hospital, Hanoi, Vietnam, during April and May 2019. Healthy volunteers were recruited to participate in the study. Anorectal measurement values from the digestive tract, including pressure, were recorded.

Results A total of 76 healthy volunteers were recruited. The mean functional anal canal length was 4.2 ± 0.5 cm, while the mean anal high-pressure zone length was 3.4 ± 0.5 cm. The mean defecation index was 1.4 ± 0.8, with values ranging from 0.3 to 5.0. The mean threshold volume to elicit the rectoanal inhibitory reflex (RAIR) was 18.1 mL. The mean rectal sensation values were 32.4 mL, 81.6 mL, and 159 mL for first sensation, desire to defecate, and urge to defecate, respectively. Dyssynergic patterns occurred in ∼ 50% of the study participants and included mainly types I (27.6%) and III (14.6%). There were significant differences between male and female patients in terms of maximum anal squeeze pressure, maximum anal cough pressure, maximum anal strain pressure, maximum rectal cough pressure, and maximum rectal strain pressure (all p < 0.01).

Conclusions The present study establishes normal HRAM values in healthy Vietnamese adults, particularly regarding normal values of anorectal pressure and rectal sensation. Further studies that include larger sample sizes should be conducted to further confirm the constants and their relationships.
The making of “deep language” in the Philippines
Authors: Osborne Dana
Published: March 2021

This analysis interrogates one of the most highly recognizable, but little understood metalinguistic descriptors of
language in the contemporary Philippine linguistic scene: the concept of “deep language.” Here, “deep language” is explored as a complex,
polysemous term generally used to describe homegrown conceptualizations of “pure” forms of Philippine-type languages and speakers. The
contemporary understanding of “deep language” in the Philippines is theorized to have been informed by a complex combination of folk and
academic discourses that have percolated throughout shared ideologies and conceptualizations of language since national independence at mid-20th
century. The metric of “depth” in the analysis of language is shown to function centrally as a conceptual metaphor that enables everyday
speakers to theorize person-types and the passage of time in a folk chronotope reckoned through the sign of language.
Spontaneous classroom engagement facilitating development of L2 pragmatic competence
Authors: Van Dyke Angelina , Acton William R.
Published: March 2021

The question of how to teach toward social, cultural and linguistic L2 pragmatic competence has raised serious challenges (Kasper, 1997). This is more the case for spoken rather than written discourse. As can be expected, the underlying pragmatic implications of spontaneous face-to-face communication naturally constrains the interactional scope and its potential pedagogical application. To address this issue, this naturalistic study explores two key potential contributors to the development of oral pragmatic competence: meta-pragmatic classroom conversational discourse and the course framework supporting that kind of relatively spontaneous interaction. An English for Academic Purposes (EAP) course provided fluency practice protocols, instruction in pragmatic categories, analysis of conversational data and “live” in-class intervention, focusing on meaning and alternate expressions and forms. Those interventions were designed to enhance learners’ ability to self-assess, monitor and expand their interactional repertoires. Part of a larger research project examining principles of pragmatics applied in EAP instruction, this study focuses on data from spontaneous classroom interactions situated within the integrated instructional framework of the course. Results present a range of strategies employed by the instructor consistent with current theoretical models of factors or pedagogical interventions that facilitate development of pragmatic competence.
Models to inform neutralizing antibody therapy strategies during pandemics: the case of SARS-CoV-2
Authors: Guttieres Donovan , Sinskey Anthony J , Springs Stacy L
Published: March 2021

Background

Neutralizing antibodies (nAbs) against SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) can play an important role in reducing impacts of the COVID-19 pandemic, complementing ongoing public health efforts such as diagnostics and vaccination. Rapidly designing, manufacturing and distributing nAbs requires significant planning across the product value chain and an understanding of the opportunities, challenges and risks throughout.

Methods

A systems framework comprised of four critical components is presented to aid in developing effective end-to-end nAbs strategies in the context of a pandemic: (1) product design and optimization, (2) epidemiology, (3) demand and (4) supply. Quantitative models are used to estimate product demand using available epidemiological data, simulate biomanufacturing operations from typical bioprocess parameters and calculate antibody production costs to meet clinical needs under various realistic scenarios.

Results

In a US-based case study during the 9-month period from March 15 to December 15, 2020, the projected number of SARS-CoV-2 infections was 15.73 million. The estimated product volume needed to meet therapeutic demand for the maximum number of clinically eligible patients ranged between 6.3 and 31.5 tons for 0.5 and 2.5 g dose sizes, respectively. The relative production scale and cost needed to meet demand are calculated for different centralized and distributed manufacturing scenarios.

Conclusions

Meeting demand for anti-SARS-CoV-2 nAbs requires significant manufacturing capacity and planning for appropriate administration in clinical settings. MIT Center for Biomedical Innovation’s data-driven tools presented can help inform time-critical decisions by providing insight into important operational and policy considerations for making nAbs broadly accessible, while considering time and resource constraints.
Identification of Molecular Alterations Challenging Initial Pathologic Classification in Cases of Clinician-Initiated Next-Generation Sequencing Testing
Authors: Cho Joseph H , Charnot-Katsikas Angela , Segal Jeremy , Pytel Peter
Published: March 2021

Objectives

Large gene panel next-generation sequencing (NGS) is a powerful tool capable of generating predictive data on cancer prognosis and response to specific therapeutic interventions. The utility of large panel NGS data on tumor classification, however, may be underappreciated because of a workflow that often circumvents the surgical pathologist. We sought to describe cases in which NGS data lead to an unanticipated change in tumor classification and to discuss current workflow practices of NGS testing that limit its use as a diagnostic adjunct.

Methods

We performed a retrospective review to identify cases in which NGS testing uncovered data that led to a revision of the initial pathologic diagnosis that an outside or in-house pathologist had made.

Results

Nine cases are presented in which NGS data provided insights that led to a revision of the original pathologic diagnosis. Distinctive molecular signatures, mutational signatures, fusions, or identification of viral sequencing provided the critical evidence on which these tumors were reclassified.

Conclusions

The current workflow of NGS testing should always include the surgical pathologist as an active partner to ensure that the molecular results are fully reflected in the final diagnosis. In some instances, active participation by the surgical pathologist may require amendment of previously issued pathology reports.
Pathology Residency Open-House Events: A Novel Marketing Paradigm
Authors: Salah Haneen T , Mirza Kamran M
Published: March 2021

Objectives

Due to the continued impact of coronovirus 2019 (COVID-19), residency programs were advised to offer virtual interviews in place of traditional in-person interviews for the 2021 match recruitment season. As a result, many pathology residency programs offered preinterview virtual open-house events to meet prospective applicants before the interview season. This article aims to understand applicants’ perspective on those events during the residency recruitment season of 2020 to 2021.

Methods

We performed a cross-sectional survey-based study involving 95 pathology residency applicants.

Results

Our results demonstrated that applicants generally have a positive perception of open house events; 91% found virtual open-house events beneficial, 63.2% attended open-house events for programs they were not considering applying to. Considering the high number of offered virtual open house events, 17% of applicants felt overwhelmed by attendance and 30% felt obligated to attend.

Conclusions

This brief report demonstrates the generally positive impact of these events.
Divergence in floral scent and morphology, but not thermogenic traits, associated with pollinator shift in two brood-site-mimicking Typhonium (Araceae) species
Authors: Sayers Thomas D J , Johnson Kim L , Steinbauer Martin J , Farnier Kevin , Miller Rebecca E
Published: March 2021

Background

Flowers which imitate insect oviposition sites probably represent the most widespread form of floral mimicry, exhibit the most diverse floral signals and are visited by two of the most speciose and advanced taxa of insect – beetles and flies. Detailed comparative studies on brood-site mimics pollinated exclusively by each of these insect orders are lacking, limiting our understanding of floral trait adaptation to different pollinator groups in these deceptive systems.

Methods

Two closely related and apparent brood-site mimics, Typhonium angustilobum and T. wilbertii (Araceae) observed to trap these distinct beetle and fly pollinator groups were used to investigate potential divergence in floral signals and traits most likely to occur under pollinator-mediated selection. Trapped pollinators were identified and their relative abundances enumerated, and thermogenic, visual and chemical signals and morphological traits were examined using thermocouples and quantitative reverse transcription–PCR, reflectance, gas chromatography–mass spectrometry, floral measurements and microscopy.

Key Results

Typhonium angustilobum and T. wilbertii were functionally specialized to trap saprophagous Coleoptera and Diptera, respectively. Both species shared similar colour and thermogenic traits, and contained two highly homologous AOX genes (AOX1a and AOX1b) most expressed in the thermogenic tissue and stage (unlike pUCP). Scent during the pistillate stage differed markedly – T. angustilobum emitted a complex blend of sesquiterpenes, and T. wilbertii, a dung mimic, emitted high relative amounts of skatole, p-cresol and irregular terpenes. The species differed significantly in floral morphology related to trapping mechanisms.

Conclusions

Functional specialization and pollinator divergence were not associated with differences in anthesis rhythm and floral thermogenic or visual signals between species, but with significant differences in floral scent and morphological features, suggesting that these floral traits are critical for the attraction and filtering of beetle or fly pollinators in these two brood-site mimics.
Letter to the Editor: Significant mutation enrichment in inverted repeat sites of new SARS-CoV-2 strains
Authors: Bartas Martin , Goswami Pratik , Lexa Matej , Červeň Jiří , Volná Adriana , Fojta Miroslav , Brázda Václav , Pečinka Petr
Published: March 2021

In a recently published paper, we have found that SARS-CoV-2 hot-spot mutations are significantly associated with inverted repeat loci and CG dinucleotides. However, fast-spreading strains with new mutations (so-called mink farm mutations, England mutations and Japan mutations) have been recently described. We used the new datasets to check the positioning of mutation sites in genomes of the new SARS-CoV-2 strains. Using an open-access Palindrome analyzer tool, we found mutations in these new strains to be significantly enriched in inverted repeat loci.
Deep grey matter injury in multiple sclerosis: a NAIMS consensus statement
Authors: Ontaneda Daniel , Raza Praneeta C , Mahajan Kedar R , Arnold Douglas L , Dwyer Michael G , Gauthier Susan A , Greve Douglas N , Harrison Daniel M , Henry Roland G , Li David K B , Mainero Caterina , Moore Wayne , Narayanan Sridar , Oh Jiwon , Patel Raihaan , Pelletier Daniel , Rauscher Alexander , Rooney William D , Sicotte Nancy L , Tam Roger , Reich Daniel S , Azevedo Christina J ,   the North American Imaging in Multiple Sclerosis Cooperative (NAIMS)
Published: March 2021

Although multiple sclerosis has traditionally been considered a white matter disease, extensive research documents the presence and importance of grey matter injury including cortical and deep regions. The deep grey matter exhibits a broad range of pathology and is uniquely suited to study the mechanisms and clinical relevance of tissue injury in multiple sclerosis using magnetic resonance techniques. Deep grey matter injury has been associated with clinical and cognitive disability. Recently, MRI characterization of deep grey matter properties, such as thalamic volume, have been tested as potential clinical trial end points associated with neurodegenerative aspects of multiple sclerosis. Given this emerging area of interest and its potential clinical trial relevance, the North American Imaging in Multiple Sclerosis (NAIMS) Cooperative held a workshop and reached consensus on imaging topics related to deep grey matter. Herein, we review current knowledge regarding deep grey matter injury in multiple sclerosis from an imaging perspective, including insights from histopathology, image acquisition and post-processing for deep grey matter. We discuss the clinical relevance of deep grey matter injury and specific regions of interest within the deep grey matter. We highlight unanswered questions and propose future directions, with the aim of focusing research priorities towards better methods, analysis, and interpretation of results.
Bi-allelic loss of function variants in COX20 gene cause autosomal recessive sensory neuronopathy
Authors: Dong Hai-Lin , Ma Yin , Yu Hao , Wei Qiao , Li Jia-Qi , Liu Gong-Lu , Li Hong-Fu , Chen Lei , Chen Dian-Fu , Bai Ge , Wu Zhi-Ying
Published: March 2021

Sensory neuronopathies are a rare and distinct subgroup of peripheral neuropathies, characterized by degeneration of the dorsal root ganglia neurons. About 50% of sensory neuronopathies are idiopathic and genetic causes remain to be clarified. Through a combination of homozygosity mapping and whole exome sequencing, we linked an autosomal recessive sensory neuronopathy to pathogenic variants in the COX20 gene. We identified eight unrelated families from the eastern Chinese population carrying a founder variant c.41A>G (p.Lys14Arg) within COX20 in either a homozygous or compound heterozygous state. All patients displayed sensory ataxia with a decrease in non-length-dependent sensory potentials. COX20 encodes a key transmembrane protein implicated in the assembly of mitochondrial complex IV. We showed that COX20 variants lead to reduction of COX20 protein in patient’s fibroblasts and transfected cell lines, consistent with a loss-of-function mechanism. Knockdown of COX20 expression in ND7/23 sensory neuron cells resulted in complex IV deficiency and perturbed assembly of complex IV, which subsequently compromised cell spare respiratory capacity and reduced cell proliferation under metabolic stress. Consistent with mitochondrial dysfunction in knockdown cells, reduced complex IV assembly, enzyme activity and oxygen consumption rate were also found in patients’ fibroblasts. We speculated that the mechanism of COX20 was similar to other causative genes (e.g. SURF1, COX6A1, COA3 and SCO2) for peripheral neuropathies, all of which are functionally important in the structure and assembly of complex IV. Our study identifies a novel causative gene for the autosomal recessive sensory neuronopathy, whose vital function in complex IV and high expression in the proprioceptive sensory neuron further underlines loss of COX20 contributing to mitochondrial bioenergetic dysfunction as a mechanism in peripheral sensory neuron disease.