bluuebunny/crossref_metadata_2025 huggingface dataset:
ALMA characterizes the dust temperature of z ∼ 5.5 star-forming galaxies
Authors: Faisst Andreas L , Fudamoto Yoshinobu , Oesch Pascal A , Scoville Nick , Riechers Dominik A , Pavesi Riccardo , Capak Peter
Published: August 2020

The infrared (IR) spectral energy distributions (SEDs) of main-sequence galaxies in the early Universe (z > 4) is currently unconstrained as IR continuum observations are time-consuming and not feasible for large samples. We present Atacama Large Millimetre Array Band 8 observations of four main-sequence galaxies at z ∼ 5.5 to study their IR SED shape in detail. Our continuum data (rest-frame 110 $\rm \mu m$, close to the peak of IR emission) allows us to constrain luminosity-weighted dust temperatures and total IR luminosities. With data at longer wavelengths, we measure for the first time the emissivity index at these redshifts to provide more robust estimates of molecular gas masses based on dust continuum. The Band 8 observations of three out of four galaxies can only be reconciled with optically thin emission redward of rest-frame $100\, {\rm \mu m}$. The derived dust peak temperatures at z ∼ 5.5 ($30\!-\!43\, {\rm K}$) are elevated compared to average local galaxies, however, $\sim 10\, {\rm K}$ below what would be predicted from an extrapolation of the trend at z < 4. This behaviour can be explained by decreasing dust abundance (or density) towards high redshifts, which would cause the IR SED at the peak to be more optically thin, making hot dust more visible to the external observer. From the $850{\hbox{-}}{\rm \mu m}$ dust continuum, we derive molecular gas masses between 1010 and $10^{11}\, {\rm M_{\odot }}$ and gas fractions (gas over total mass) of $30\!-\!80{{\ \rm per\ cent}}$ (gas depletion times of $100\!-\!220\, {\rm Myr}$). All in all, our results provide a first measured benchmark SED to interpret future millimetre observations of normal, main-sequence galaxies in the early Universe.
Using strong gravitational lensing to probe the post-reionization H i power spectrum
Authors: Arora Urvashi , Dutta Prasun
Published: August 2020

Probing statistical distribution of the neutral hydrogen (H i) using the redshifted 21-cm hyperfine-transition spectral line holds the key to understand the formation and evolution of the matter density in the Universe. The two-point statistics of the H i distribution can be estimated by measuring the power spectrum of the redshifted 21-cm signal using visibility correlation. A major challenge in this regard is that the expected signal is weak compared to the foreground contribution from the Galactic synchrotron emission and extragalactic point sources in the observing frequencies. In this work, we investigate the possibility of detecting the power spectrum of the redshifted 21-cm signal by using strong gravitational lensing of the galaxy clusters. This method has the advantage that it only enhances the H i signal and not the diffuse Galactic foreground. Based on four simple models of the cluster potentials, we show that the strong lenses at relatively lower redshifts with more than one dark matter halo significantly enhance the 21-cm signal from the post-reionization era. We discuss the merits and demerits of the method and the future studies required for further investigations.
Beyond moments: relativistic lattice Boltzmann methods for radiative transport in computational astrophysics
Authors: Weih L R , Gabbana A , Simeoni D , Rezzolla L , Succi S , Tripiccione R
Published: August 2020

We present a new method for the numerical solution of the radiative-transfer equation (RTE) in multidimensional scenarios commonly encountered in computational astrophysics. The method is based on the direct solution of the Boltzmann equation via an extension of the lattice Boltzmann (LB) equation and allows to model the evolution of the radiation field as it interacts with a background fluid, via absorption, emission, and scattering. As a first application of this method, we restrict our attention to a frequency independent (‘grey’) formulation within a special-relativistic framework, which can be employed also for classical computational astrophysics. For a number of standard tests that consider the performance of the method in optically thin, optically thick, and intermediate regimes with a static fluid, we show the ability of the LB method to produce accurate and convergent results matching the analytic solutions. We also contrast the LB method with commonly employed moment-based schemes for the solution of the RTE, such as the M1 scheme. In this way, we are able to highlight that the LB method provides the correct solution for both non-trivial free-streaming scenarios and the intermediate optical-depth regime, for which the M1 method either fails or provides inaccurate solutions. When coupling to a dynamical fluid, on the other hand, we present the first self-consistent solution of the RTE with LB methods within a relativistic-hydrodynamic scenario. Finally, we show that besides providing more accurate results in all regimes, the LB method features smaller or comparable computational costs compared to the M1 scheme.
Galaxy bias and σ8 from counts in cells from the SDSS main sample
Authors: Repp Andrew , Szapudi István
Published: August 2020

The counts-in-cells (CIC) galaxy probability distribution depends on both the dark matter clustering amplitude σ8 and the galaxy bias b. We present a theory for the CIC distribution based on a previous prescription of the underlying dark matter distribution and a linear volume transformation to redshift space. We show that, unlike the power spectrum, the CIC distribution breaks the degeneracy between σ8 and b on scales large enough that both bias and redshift distortions are still linear; thus, we obtain a simultaneous fit for both parameters. We first validate the technique on the Millennium Simulation and then apply it to the Sloan Digital Sky Survey main galaxy sample. We find σ8 = 0.92 ± .08 and $b = 1.39^{+.11}_{-.09}$ consistent with previous complementary results from redshift distortions and from Planck.
Locked nucleic acid building blocks as versatile tools for advanced G-quadruplex design
Authors: Haase Linn , Weisz Klaus
Published: August 2020

A hybrid-type G-quadruplex is modified with LNA (locked nucleic acid) and 2′-F-riboguanosine in various combinations at the two syn positions of its third antiparallel G-tract. LNA substitution in the central tetrad causes a complete rearrangement to either a V-loop or antiparallel structure, depending on further modifications at the 5′-neighboring site. In the two distinct structural contexts, LNA-induced stabilization is most effective compared to modifications with other G surrogates, highlighting a potential use of LNA residues for designing not only parallel but various more complex G4 structures. For instance, the conventional V-loop is a structural element strongly favored by an LNA modification at the V-loop 3′-end in contrast with an alternative V-loop, clearly distinguishable by altered conformational properties and base-backbone interactions as shown in a detailed analysis of V-loop structures.
Inference and multiscale model of epithelial-to-mesenchymal transition via single-cell transcriptomic data
Authors: Sha Yutong , Wang Shuxiong , Zhou Peijie , Nie Qing
Published: August 2020

Rapid growth of single-cell transcriptomic data provides unprecedented opportunities for close scrutinizing of dynamical cellular processes. Through investigating epithelial-to-mesenchymal transition (EMT), we develop an integrative tool that combines unsupervised learning of single-cell transcriptomic data and multiscale mathematical modeling to analyze transitions during cell fate decision. Our approach allows identification of individual cells making transition between all cell states, and inference of genes that drive transitions. Multiscale extractions of single-cell scale outputs naturally reveal intermediate cell states (ICS) and ICS-regulated transition trajectories, producing emergent population-scale models to be explored for design principles. Testing on the newly designed single-cell gene regulatory network model and applying to twelve published single-cell EMT datasets in cancer and embryogenesis, we uncover the roles of ICS on adaptation, noise attenuation, and transition efficiency in EMT, and reveal their trade-off relations. Overall, our unsupervised learning method is applicable to general single-cell transcriptomic datasets, and our integrative approach at single-cell resolution may be adopted for other cell fate transition systems beyond EMT.
Comprehensive classification of ABC ATPases and their functional radiation in nucleoprotein dynamics and biological conflict systems
Authors: Krishnan Arunkumar , Burroughs A Maxwell , Iyer Lakshminarayan M , Aravind L
Published: August 2020

ABC ATPases form one of the largest clades of P-loop NTPase fold enzymes that catalyze ATP-hydrolysis and utilize its free energy for a staggering range of functions from transport to nucleoprotein dynamics. Using sensitive sequence and structure analysis with comparative genomics, for the first time we provide a comprehensive classification of the ABC ATPase superfamily. ABC ATPases developed structural hallmarks that unambiguously distinguish them from other P-loop NTPases such as an alternative to arginine-finger-based catalysis. At least five and up to eight distinct clades of ABC ATPases are reconstructed as being present in the last universal common ancestor. They underwent distinct phases of structural innovation with the emergence of inserts constituting conserved binding interfaces for proteins or nucleic acids and the adoption of a unique dimeric toroidal configuration for DNA-threading. Specifically, several clades have also extensively radiated in counter-invader conflict systems where they serve as nodal nucleotide-dependent sensory and energetic components regulating a diversity of effectors (including some previously unrecognized) acting independently or together with restriction-modification systems. We present a unified mechanism for ABC ATPase function across disparate systems like RNA editing, translation, metabolism, DNA repair, and biological conflicts, and some unexpected recruitments, such as MutS ATPases in secondary metabolism.
Control over π-π stacking of heteroheptacene-based nonfullerene acceptors for 16% efficiency polymer solar cells
Authors: Ma Yunlong , Cai Dongdong , Wan Shuo , Yin Pan , Wang Pengsong , Lin Wenyuan , Zheng Qingdong
Published: August 2020

Nonfullerene acceptors are being investigated for use in polymer solar cells (PSCs), with their advantages of extending the absorption range, reducing the energy loss and therefore enhancing the power conversion efficiency (PCE). However, to further boost the PCE, mobilities of these nonfullerene acceptors should be improved. For nonfullerene acceptors, the π–π stacking distance between cofacially stacked molecules significantly affects their mobility. Here, we demonstrate a strategy to increase the mobility of heteroheptacene-based nonfullerene acceptors by reducing their π–π stacking distances via control over the bulkiness of lateral side chains. Incorporation of 2-butyloctyl substituents into the nonfullerene acceptor (M36) leads to an increased mobility with a reduced π–π stacking distance of 3.45 Å. Consequently, M36 affords an enhanced PCE of 16%, which is the highest among all acceptor-donor-acceptor-type nonfullerene acceptors to date. This strategy of control over the bulkiness of side chains on nonfullerene acceptors should aid the development of more efficient PSCs.
“Is a Bird in the Hand Worth 5 in the Bush?”: A Comparison of 3 Data-to-Care Referral Strategies on HIV Care Continuum Outcomes in San Francisco
Authors: Sachdev Darpun D , Mara Elise , Hughes Alison J , Antunez Erin , Kohn Robert , Cohen Stephanie , Scheer Susan
Published: August 2020

Background

Health departments utilize HIV surveillance data to identify people with HIV (PWH) who need re-linkage to HIV care as part of an approach known as Data to Care (D2C.) The most accurate, effective, and efficient method of identifying PWH for re-linkage is unknown.

Methods

We evaluated referral and care continuum outcomes among PWH identified using 3 D2C referral strategies: health care providers, surveillance, and a combination list derived by matching an electronic medical record registry to HIV surveillance. PWH who were enrolled in the re-linkage intervention received short-term case management for up to 90 days. Relative risks and 95% confidence intervals were calculated to compare proportions of PWH retained and virally suppressed before and after re-linkage. Durable viral suppression was defined as having suppressed viral loads at all viral load measurements in the 12 months after re-linkage.

Results

After initial investigation, 233 (24%) of 954 referrals were located and enrolled in navigation. Although the numbers of surveillance and provider referrals were similar, 72% of enrolled PWH were identified by providers, 16% by surveillance, and 12% by combination list. Overall, retention and viral suppression improved, although relative increases in retention and viral suppression were only significant among individuals identified by surveillance or providers. Seventy percent of PWH who achieved viral suppression after the intervention remained durably virally suppressed.

Conclusions

PWH referred by providers were more likely to be located and enrolled in navigation than PWH identified by surveillance or combination lists. Overall, D2C re-linkage efforts improved retention, viral suppression, and durable viral suppression.
Transition to Transradial Access for Mechanical Thrombectomy—Lessons Learned and Comparison to Transfemoral Access in a Single-Center Case Series
Authors: Munich Stephan A , Vakharia Kunal , McPheeters Matthew J , Waqas Muhammad , Tso Michael K , Levy Elad I , Snyder Kenneth V , Siddiqui Adnan H , Davies Jason M
Published: August 2020

BACKGROUND

Trends in mechanical thrombectomy have emphasized larger bore aspiration catheters that may be difficult to deploy from a radial access point due to size constraints or need to obtain sheathless access. As such, many neurointerventionists are reticent to attempt thrombectomy through transradial access (TRA) for fear of worse outcomes.

OBJECTIVE

To explore whether mechanical thrombectomy could be achieved safely and effectively through the transradial route.

METHODS

We retrospectively analyzed the records of patients undergoing mechanical thrombectomy at our academic institute between January 2018 and January 2019, which corresponded to a time when we began to transition to TRA for neurointerventions, including mechanical thrombectomy. We compared the procedural details and clinical outcomes of patients undergoing mechanical thrombectomy using TRA with those using transfemoral access (TFA).

RESULTS

During the study period, 44 patients underwent mechanical thrombectomy with TRA and 129 with TFA. There was no statistically significant difference in door-to-access time, door-to-reperfusion time, or first-pass recanalization rate. There was no significant difference in modified Rankin Scale (mRS) score at discharge, mRS score at last follow-up, or length of stay. There were 7 access-site complications in the TFA group and none in the TRA group. One patient in the TRA group required crossover to TFA.

CONCLUSION

Mechanical thrombectomy can be performed safely and effectively from a TRA site without compromising recanalization times or rates. TRA has superior access-site complication profiles compared to TFA.
Who Am I? Who Are We? Exploring the Factors That Contribute to Work-Related Identities in Policing
Authors: Workman-Stark Angela L
Published: August 2020

Using social identity theory, this study examines the conditions under which police officers become attached (or not) to their organization and to their work, and whether one’s sex influences these relationships. Through an analysis of secondary survey data collected from a large Canadian police organization, the study found that fair treatment and psychological safety were significantly related to officers’ identification with their organization, and in turn, their work. The findings also demonstrated that when officers perceived their workplace as a masculinity contest, they were less likely to identify with their organization. Additionally, perceptions of a masculinity contest were associated with a greater likelihood that officers reported lower levels of psychological safety, and this effect was more significant for female officers. While women overall were no less likely than men to be attached to their organization or their occupational role, women who perceived their workplace as psychologically less safe reported lower levels of identification. The study also found that race and level within the organization may have a greater effect than sex on work-related identification. Overall, the study makes a significant contribution to the nascent literature on work-related identification and policing, as well as to the body of research on women in policing.
When Is Pure Bundling Optimal?
Authors: Haghpanah Nima , Hartline Jason
Published: August 2020

We study when pure bundling, i.e., offering only the grand bundle of all products, is optimal for a multi-product monopolist. Pure bundling is optimal if consumers with higher values for the grand bundle have higher relative values for smaller bundles compared to the grand bundle. Conversely, pure bundling is not optimal if consumers with higher values for the grand bundle have lower relative values. We prove the results by decomposing the problem into simpler ones in which types can be ranked according to their values for the grand bundle.
Epidural Analgesia During Childbirth and Postpartum Depressive Symptoms: A Population-Based Longitudinal Cohort Study
Authors: Eckerdal P. , Kollia N. , Karlsson L. , Skoog-Svanberg A. , Wikström A.K. , Högberg U. , Skalkidou A.
Published: August 2020

(Anesth Analg. 2020;130:615–624)

Although epidural analgesia (EDA) offers effective pain relief during childbirth, no evidence exists to substantiate an improved sense of control, nor an overall satisfaction with the childbirth experience. In addition, its risks in regard to postpartum depression (PPD) remain unclear. As PPD can have a 19% prevalence (depending on cultural and geographical distribution), identifying common and easily modifiable factors could contribute to clinical recommendations concerning pain relief during childbirth. This study aimed to investigate the relationship between EDA and PPD, with the hypothesis that undergoing EDA during childbirth would be associated with a lower risk of PPD.
Analgesia Use Among 984 Women With Preeclampsia: A Retrospective Observational Single-center Study
Authors: Beilin Y. , Katz D.J.
Published: August 2020

(J Clin Anesth. 2020;62:109741)

Preeclampsia is a multisystem disease that affects the coagulation system and platelets of 3% to 5% of all patients, and accounts for 16% of all prenatal thrombocytopenia cases. Routine neuraxial analgesia/anesthesia procedures carry a risk of the patient developing a spinal epidural hematoma, which is problematic for parturients with coagulation disorders. While health administrative bodies have advised that care providers consider platelet count before neuraxial anesthesia placement in preeclamptic patients, there is currently no agreed-upon minimum platelet count considered safe for a neuraxial anesthetic procedure. Beilin and colleagues conducted this study of preeclamptic patients to measure the frequency of platelet count <100,000 mm3, as well as to observe the percentage decrease in platelet count during the 72-hour period before delivery.
How Women Are Treated During Facility-Based Childbirth in Four Countries: A Cross-Sectional Study With Labor Observations and Community-based Surveys
Authors: Bohren M.A. , Mehrtash H. , Fawole B. , Maung T.M. , Balde M.D. , Maya E. , Thwin S.S. , Aderoba A.K. , Vogel J.P. , Irinyenikan T.A. , Adeyanju A.O. , Mon N.O. , Adu-Bonsaffoh K. , Landoulsi S. , Guure C. , Adanu R. , Diallo B.A. , Gülmezoglu A.M. , Soumah A.-M. , Sall A.O. , Tunçalp Ö.
Published: August 2020

(Lancet. 2019;394:1750–1763)

While quality of obstetric care has been examined in low- and middle-income countries, including life-saving interventions and health outcomes, maternal experience is often left out of these evaluations. There is established evidence across the world of mistreatment during childbirth, including physical and verbal abuse, nonconsent for procedures performed, and discrimination. Previous studies on this mistreatment have varied widely in their methods, including location, timing and populations, presenting challenges in making cross-study comparisons. The current investigators aimed to develop tools for collecting data on the burden of mistreatment which can be compared across contexts. The study consisted of formative and measurement phases. The formative phase involved systematic reviews and qualitative research conducted in Nigeria, Ghana, Guinea, and Myanmar. Data from this phase informed the measurement phase, which included both continuous observations during labor and community-based postpartum surveys to measure the prevalence of mistreatment during childbirth in those countries. This article reported only on the measurement phase of the study.
Physiological and Psychological Stress Responses to Labor and Delivery as Expressed by Salivary Cortisol: A Prospective Study
Authors: Miller N. , Asali A.A. , Agassi-Zaitler M. , Neumark E. , Eisenberg M.M. , Hadi E. , Elbaz M. , Pasternak Y. , Fishman A. , Biron-Shental T.
Published: August 2020

(Am J Obstet Gynecol. 2019;221:351.e1–351.e7)

Pregnant women experience both physiological stress and psychological stress during labor and delivery, but research is limited on measurement of stress levels during labor. Previous studies on physiological stress during labor have found a significant increase of total and free plasma cortisol concentrations; this increase is considered to be crucial for helping labor progression and promoting maternal and fetal well-being. While there are few studies on psychological stress during labor, researchers found epidural anesthesia helps alleviate women’s anxiety. In addition, postpartum stress levels can affect breastfeeding duration and health care service usage. The objective of this prospective, observational study was to accurately record the levels of physiological and psychological stress during labor to determine their effect on obstetric and neonatal outcomes.
Are Peripartum Stress-Dose Steroids Necessary?
Authors: Sylvester-Armstrong K.R. , Duff P. , Genç M.R.
Published: August 2020

(Obstet Gynecol. 2020;135:522–525)

The practice of administering stress-dose steroids for all corticosteroid-treated patients undergoing vaginal or cesarean delivery has been in place since the 1950s, despite the inconsistencies in the research that recommends this tradition. Present-day studies, such as a 2014 study by Zaghiyan and colleagues, indicate that perioperative corticosteroids do not have a measurable effect on a patient’s risk of hemodynamic instability. Sylvester-Armstrong and colleagues have examined a number of studies related to steroid administration to assert that stress-dose steroids are unnecessary for labor and delivery and the aforementioned practice should be retired.
A Comparison of Spinal Anesthesia Versus Monitored Anesthesia Care With Local Anesthesia in Minimally Invasive Fetal Surgery
Authors: Ferschl M.B. , Feiner J. , Vu L. , Smith D. , Rollins M.D.
Published: August 2020

(Anesth Analg. 2020;130:409–415)

The most common minimally invasive fetal surgeries are selective fetoscopic laser photocoagulation to treat twin-to-twin transfusion syndrome and radiofrequency ablation using twin-reversed arterial perfusion sequence. The anesthetic techniques for these surgeries have evolved from general endotracheal anesthesia to spinal anesthesia with or without intravenous sedation in the United States, though in some other countries local anesthesia infiltration is used. This study aimed to compare spinal anesthesia and local anesthesia with or without sedation in these 2 surgeries in terms of safety and efficacy.
Ropivacaine Activates Multiple Proapoptotic and Inflammatory Signaling Pathways That Might Subsume to Trigger Epidural-related Maternal Fever
Authors: Wohlrab P. , Boehme S. , Kaun C. , Wojta J. , Spittler A. , Saleh L. , Knöfler M. , Markstaller K. , Klein K.U. , Tretter V.
Published: August 2020

(Anesth Analg. 2020;130:321–331)

Epidural-related maternal fever (ERMF), which is associated with perinatal mortality and neonatal morbidity, occurs in up to 20% of laboring women receiving epidural analgesia. Epidural analgesia has been suspected to cause maternal fever by signaling the release of proinflammatory endogenous pyrogens. In previous studies, antibiotics did not decrease the incidence of ERMF. This study compared the effects on inflammation of ropivacaine with lidocaine in human umbilical vein endothelial cells (HUVECs) and human first trimester placental trophoblasts (TBs). The study also investigated the impact of dexamethasone, an anti-inflammatory corticosteroid.
Does Programmed Intermittent Epidural Bolus Improve Childbirth Conditions of Nulliparous Women Compared With Patient-controlled Epidural Analgesia? A Multicentre, Randomized, Controlled, Triple-blind Study
Authors: Morau E. , Jaillet M. , Storme B. , Nogue E. , Bonnin M. , Chassard D. , Benhamou D. , Nagot N. , Dadure C.
Published: August 2020

(Eur J Anaesthesiol. 2019;36:755–762)

Currently about 80% of deliveries in France involve an epidural for labor analgesia. Epidural rates and programs have changed over time, but various authors have found that a programmed intermittent epidural bolus (PIEB) plus patient-controlled epidural analgesia (PCEA) demand dosing strategy for maintenance of labor analgesia decreased the rate of instrumental vaginal delivery, lessened anesthetic drug consumption and increased maternal satisfaction scores compared with a continuous background infusion+PCEA. This study aimed to investigate whether the use of a modern PIEB pump improved the mechanics of the second stage of labor compared with a conventional epidural analgesia technique.
Endometrial Ablation or Resection Versus Levonorgestrel Intra-uterine System for the Treatment of Women With Heavy Menstrual Bleeding and a Normal Uterine Cavity: A Systematic Review With Meta-analysis
Authors: Bergeron Catherine , Laberge Philippe Y. , Boutin Amélie , Thériault Marie-Anne , Valcourt Florence , Lemyre Madeleine , Maheux-Lacroix Sarah
Published: August 2020

(Abstracted from Hum Reprod Update 2020;26:302–311)

One of the most common gynecological conditions, abnormal uterine bleeding (AUB), affects approximately 30% of women throughout their reproductive lifetime. Abnormal uterine bleeding has a significant impact on quality of life and sexual function.
Profitability of Large Pharmaceutical Companies Compared With Other Large Public Companies
Authors: Ledley Fred D. , McCoy Sarah Shonka , Vaughan Gregory , Cleary Ekaterina Galkina
Published: August 2020

(Abstracted from JAMA 2020;323(9):834–843)

Virtually all of the US Food and Drug Administration–approved medications in the United States were developed by for-profit companies, thus demonstrating the importance of these corporations in providing medicine to the public. Understanding both drug costs and company profits is vital to creating evidence-based policies that balance the cost of medicine with the industry's ability to innovate.
Placental Growth Factor Predicts Time to Delivery in Women With Signs or Symptoms of Early Preterm Preeclampsia: A Prospective Multicenter Study
Authors: Barton John R. , Woelkers Doug A. , Newman Roger B. , Combs C. Andrew , How Helen Y. , Boggess Kim A. , Martin James N. , Kupfer Kenneth , Sibai Baha M.
Published: August 2020

(Abstracted from Am J Obstet Gynecol 2020;222:259.e1–259.e11)

Preeclampsia is a complex and heterogeneous disease, with much of the associated neonatal morbidity related to issues of prematurity incurred from preterm delivery. While there has been robust association between altered concentrations of angiogenic factors, including placental growth factor (PlGF), and clinically recognized preeclampsia, the temporal relationship between these factors and the time to delivery (TTD) in women with suspected preeclampsia at less than 35 weeks of gestation has not been clarified.
Timing of Delivery in Women With Diabetes: A Population-Based Study
Authors: Metcalfe Amy , Hutcheon Jennifer A. , Sabr Yasser , Lyons Janet , Burrows Jason , Donovan Lois E. , Joseph K. S.
Published: August 2020

(Abstracted from Acta Obstet Gynecol Scand 2020;99:341–349)

Pregestational and gestational diabetes have been associated with an increased risk of neonatal morbidity and mortality, including higher rates of macrosomia, shoulder dystocia, and other birth injuries. While it has been hypothesized that delivery at earlier term gestation may reduce the risk of neonatal complications associated with diabetes in pregnancy, there have been very few studies to examine the timing of delivery among women with diabetes.
Screening for Hepatitis C Virus Infection in Adolescents and Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force
Authors: Chou Roger , Dana Tracy , Fu Rongwei , Zakher Bernadette , Wagner Jesse , Ramirez Shaun , Grusing Sara , Jou Janice H.
Published: August 2020

(Abstracted from JAMA 2020;323(10):976–992)

From 2013 to 2016, approximately 1.4 million people in the United States had active infection of hepatitis C virus (HCV). It is estimated that people born between 1945 and 1965 make up approximately three-quarters of HCV infections.
New guidance on the regulation of allergen products: key aspects and outcomes
Authors: Bonertz Andreas , Mahler Vera , Vieths Stefan
Published: August 2020

Purpose of review

Key aspects and outcomes from the recently published guidance on the regulation of allergen products are summarized.

Recent findings

A new regulatory guideline has been published to enhance harmonized national approaches on the regulation of allergen products and thereby strengthen the availability of high-quality products across the European Union (EU). As the guideline was developed, critical aspects for allergen products regulation were identified and are discussed in the document, including recommendations on the regulatory procedures to be applied for diagnostics, allergen immunotherapy products and named-patient products.

The new guidance is expected to provide clarifications on and support harmonization of the regulation of allergen products in the EU.
Curriculum Changes and Trends 2010–2020: A Focused National Review Using the AAMC Curriculum Inventory and the LCME Annual Medical School Questionnaire Part II
Authors: Blood Angela D. , Farnan Jeanne M. , Fitz-William Walter
Published: August 2020

Medical school curricula have evolved from 2010 to 2020. Numerous pressures and influences affect medical school curricula, including those from external sources, academic medical institutions, clinical teaching faculty, and undergraduate medical students. Using data from the AAMC Curriculum Inventory and the LCME Annual Medical School Questionnaire Part II, the nature of curriculum change is illuminated. Most medical schools are undertaking curriculum change, both in small cycles of continuous quality improvement and through significant change to curricular structure and content. Four topic areas are explored: cost consciousness, guns and firearms, nutrition, and opioids and addiction medicine. The authors examine how these topic areas are taught and assessed, where in the curriculum they are located, and how much time is dedicated to them in relation to the curriculum as a whole. When examining instructional methods overall, notable findings include (1) the decrease of lecture, although lecture remains the most used instructional method, (2) the increase of collaborative instructional methods, (3) the decrease of laboratory, and (4) the prevalence of clinical instructional methods in academic levels 3 and 4. Regarding assessment methods overall, notable findings include (1) the recent change of the USMLE Step 1 examination to a pass/fail reporting system, (2) a modest increase in narrative assessment, (3) the decline of practical labs, and (4) the predominance of institutionally developed written/computer-based examinations and participation. Among instructional and assessment methods, the most used methods tend to cluster by academic level. It is critical that faculty development evolves alongside curricula. Continued diversity in the use of instructional and assessment methods is necessary to adequately prepare tomorrow’s physicians. Future research into the life cycle of a curriculum, as well optional curriculum content, is warranted.
Innovation Reports: Successes and Limitations for Promoting Innovation in Medical Education
Authors: Beck Jimmy B. , DeVilbiss Mary Beth , Carline Jan D. , McDaniel Corrie E. , Durning Steven J.
Published: August 2020

In 2013, Academic Medicine introduced a new article type, Innovation Reports, with the intent to promote innovation by providing a forum for publishing promising new ideas at an early stage of development. In this article, the authors examine Innovation Reports as a means for promoting innovation within the medical education community.

The authors undertook a 2-part analysis. In July 2018, they examined submission data, Altmetric scores, and citations for the first 5 years of the feature. To explore authors’ perceptions of the impact of publishing an Innovation Report, in October 2018, they conducted a web-based survey of corresponding authors.

Between October 2013 and May 2018, 920 manuscripts were submitted under the Innovation Report category, of which 335 were sent for review and 151 were published (16% overall acceptance rate). The mean citation rate for the published Innovation Reports was 4.3 (range 0–47). The mean Altmetric Attention Score was 14.3 (range 0–441). An Altmetric score of 14 places an article in the top 20% of articles published in Academic Medicine.

The 151 published Innovation Reports had 148 unique corresponding authors, of whom 85 (57%) responded to the survey. Almost all respondents (n = 82; 96%) reported that publishing an Innovation Report promoted their individual career growth. For many corresponding authors, the publication of early ideas in an Innovation Report appeared to be an end point rather than a springboard for further development and innovation, as only 14 (16%) reported publication of a subsequent related study.

Reflecting on the successes and limitations of Innovation Reports over the first 5 years, the authors suggest that soliciting input from more stakeholders and being explicit about the goals of this article type would help inform how Innovation Reports should evolve in the future so they can better launch creative thought and spur innovation.
Prospects of molecular hydrogen in perioperative neuroprotection from basic research to clinical application
Authors: Wang Zhen , Wang Guolin , Xie Keliang
Published: August 2020

Purpose of review

The current systematic review summarizes recent, basic clinical achievements regarding the neuroprotective effects of molecular hydrogen in distinct central nervous system conditions.

Recent findings

Perioperative neuroprotection remains a major topic of clinical anesthesia. Various gaseous molecules have previously been explored as a feasible therapeutic option in neurological disorders. Among them, molecular hydrogen, which has emerged as a novel and potential therapy for perioperative neuroprotection, has received much attention.

Fundamental and clinical evidence supports the antioxidant, antiinflammation, antiapoptosis and mitochondrial protective effects of hydrogen in the pathophysiology of nervous system diseases. The clinically preventive and therapeutic effects of hydrogen on different neural diseases, however, remain uncertain, and the lack of support by large randomized controlled trials has delayed its clinical application.
Ketamine: a versatile tool for anesthesia and analgesia
Authors: Barrett William , Buxhoeveden Michael , Dhillon Sabrina
Published: August 2020

Purpose of review

Ketamine has been used for decades for a variety of indications. Beyond the historical benefits and effects of ketamine, newer developments have occurred worthy of an update. This review will discuss common uses and indications for ketamine in the perioperative setting, as well as highlight newer indications in recent years.

Recent findings

Multiple studies have examined the use of ketamine in a variety of environments, as ketamine has become more popular in emergency rooms and ICUs. Ketamine may be particularly beneficial in management of burn patients, who often require multiple procedures over the course of their treatment. Ketamine's role in the ongoing opioid crisis has been of particular interest, with multiple studies evaluating its potential role in managing both acute and chronic pain conditions. Ongoing studies examining the role of ketamine in treatment of depressions show promise as well.

Ketamine is regaining popularity in the field of anesthesia and beyond. New studies provide insight on the many indications and use that anesthesia providers may encounter during their perioperative care of patients. Ongoing research is needed to further elucidate ketamine's effects on the management of psychiatric conditions and potential indications for ketamine metabolites.
Policies to Improve Substance Use Disorder Treatment With Telehealth During the COVID-19 Pandemic and Beyond
Authors: Drake Coleman , Yu Jiani , Lurie Nicole , Kraemer Kevin , Polsky Daniel , Chaiyachati Krisda H.
Published: August 2020

The COVID-19 pandemic has created an urgent need to expand access to substance use disorder (SUD) treatment through telehealth. A more permanent adoption of tele-SUD treatment options could positively alter the future of SUD treatment. We identify four steps that will help to ensure a broader transition to telehealth will be successful in improving the health outcomes of patients with SUDs. These steps are: (1) investing in telehealth infrastructure to enable health care providers and patients to use telehealth; (2) training and equipping providers to provide SUD treatment through telehealth; (3) providing patients with the financial and social support, hardware, and training necessary to use telehealth; (4) making temporary changes to telehealth law and regulation permanent. We believe these 4 steps will be critical to initiating SUD treatment for many persons that have yet to receive it, and for preserving SUD treatment continuity for millions of other patients both during and after the pandemic.
A Maternal-Administered Multimodal Neonatal Bundle in Hospitalized Very Preterm Infants
Authors: Letzkus Lisa , Alonzo Corrie , Connaughton Elizabeth , Kelly Nancy , Zanelli Santina
Published: August 2020

Background:

Premature infants are at an increased risk for developing cerebral palsy (CP). Evidence-based strategies designed to promote healthy brain development and facilitate adaptation after brain injury in infants still admitted to the neonatal intensive care unit (NICU) represent a novel approach that may lead to improved long-term outcomes.

Purpose:

To investigate the feasibility of a maternal-administered early intervention bundle in very preterm infants prior to NICU discharge.

Methods:

A pilot trial evaluating a maternal-administered NICU-based bundle of interventions in preterm infants (≤32 weeks' gestational age and/or ≤1500 g birth weight). The impact of the bundle on short-term developmental outcomes of infants, as well as maternal stress, anxiety, and depression, is evaluated.

Results:

The intervention bundle was implemented in 11 mother–infant dyads (including 1 set of twins) for a median of 8 weeks and was overall well received. Vocal soothing, scent exchange, and comforting touch were feasible, performed at or above the predetermined goal of 71% of the time (5/7 days), while kangaroo care and infant massage were not. Maternal stress, anxiety, and depression were decreased during the study time.

Implications to Practice:

A neonatal multimodal intervention bundle provided by mothers is feasible.

Implications to Research:

Additional randomized controlled studies are needed to determine whether this type of bundled interventions can (1) improve the neurodevelopmental outcomes of participating infants and (2) improve long-term parental outcomes, including decreased burden of anxiety and depression, as well as improved attachment and optimal patterns of social interaction.
Neonatal Intensive Care Unit Admission Temperatures of Infants 1500 g or More
Authors: Apanovitch Audrey R. , McGrath Jacqueline M. , McGlothen-Bell Kelly , Briere Carrie-Ellen
Published: August 2020

Background:

Smaller preterm infants often receive extra attention with implementation of additional thermoregulation interventions in the delivery room. Yet, these bundles of interventions have largely remained understudied in larger infants.

Purpose:

The purpose of this study was to evaluate initial (or admission) temperatures of infants born weighing 1500 g or more with diagnoses requiring admission to the neonatal intensive care unit (NICU).

Methods:

Retrospective medical record review of 388 infants weighing 1500 g or more admitted to the NICU between January 2016 and June 2017.

Result:

In total, 42.5% of infants weighing 1500 g or more were admitted hypothermic (<36.5°C), 54.4% with a normothermic temperature, and 2.8% were hyperthermic. Of those infants admitted hypothermic, 30.4% had an admission temperature ranging from 36°C to 36.4°C and 12.1% had an admission temperature of less than 36°C. When compared with infants weighing less than 1500 g, who were born at the same institution and received extra thermal support interventions, there was a statistically significant difference (P < .001) between admission temperatures where infants less than 1500 g were slightly warmer (36.8°C vs 36.5°C).

Implications for Practice:

Ongoing admission temperature monitoring of all infants requiring NICU admission regardless of birth weight or admission diagnosis is important if we are going to provide the best support to decrease mortality and morbidity for this high-risk population.

Implications for Research:

While this study examined short-term outcomes, effects on long-term outcomes were not addressed. Findings could be used to design targeted interventions to support thermal regulation for all high-risk infants.

Conclusion:

Neonates admitted to the NICU weighing 1500 g or more are at high risk for developing hypothermia, similar to smaller preterm infants.
Prediction of the Functional Status of the Cochlear Nerve in Individual Cochlear Implant Users Using Machine Learning and Electrophysiological Measures
Authors: Skidmore Jeffrey , Xu Lei , Chao Xiuhua , Riggs William J. , Pellittieri Angela , Vaughan Chloe , Ning Xia , Wang Ruijie , Luo Jianfen , He Shuman
Published: August 2020

Objectives:

This study aimed to create an objective predictive model for assessing the functional status of the cochlear nerve (CN) in individual cochlear implant (CI) users.

Design:

Study participants included 23 children with cochlear nerve deficiency (CND), 29 children with normal-sized CNs (NSCNs), and 20 adults with various etiologies of hearing loss. Eight participants were bilateral CI users and were tested in both ears. As a result, a total of 80 ears were tested in this study. All participants used Cochlear Nucleus CIs in their test ears. For each participant, the CN refractory recovery function and input/output (I/O) function were measured using electrophysiological measures of the electrically evoked compound action potential (eCAP) at three electrode sites across the electrode array. Refractory recovery time constants were estimated using statistical modeling with an exponential decay function. Slopes of I/O functions were estimated using linear regression. The eCAP parameters used as input variables in the predictive model were absolute refractory recovery time estimated based on the refractory recovery function, eCAP threshold, slope of the eCAP I/O function, and negative-peak (i.e., N1) latency. The output variable of the predictive model was CN index, an indicator for the functional status of the CN. Predictive models were created by performing linear regression, support vector machine regression, and logistic regression with eCAP parameters from children with CND and the children with NSCNs. One-way analysis of variance with post hoc analysis with Tukey’s honest significant difference criterion was used to compare study variables among study groups.

Results:

All three machine learning algorithms created two distinct distributions of CN indices for children with CND and children with NSCNs. Variations in CN index when calculated using different machine learning techniques were observed for adult CI users. Regardless of these variations, CN indices calculated using all three techniques in adult CI users were significantly correlated with Consonant–Nucleus–Consonant word and AzBio sentence scores measured in quiet. The five oldest CI users had smaller CN indices than the five youngest CI users in this study.

Conclusions:

The functional status of the CN for individual CI users was estimated by our newly developed analytical models. Model predictions of CN function for individual adult CI users were positively and significantly correlated with speech perception performance. The models presented in this study may be useful for understanding and/or predicting CI outcomes for individual patients.
Cortical Tracking of Speech in Delta Band Relates to Individual Differences in Speech in Noise Comprehension in Older Adults
Authors: McHaney Jacie R. , Gnanateja G. Nike , Smayda Kirsten E. , Zinszer Benjamin D. , Chandrasekaran Bharath
Published: August 2020

Objectives:

Understanding speech in adverse listening environments is challenging for older adults. Individual differences in pure tone averages and working memory are known to be critical indicators of speech in noise comprehension. Recent studies have suggested that tracking of the speech envelope in cortical oscillations <8 Hz may be an important mechanism related to speech comprehension by segmenting speech into words and phrases (delta, 1 to 4 Hz) or phonemes and syllables (theta, 4 to 8 Hz). The purpose of this study was to investigate the extent to which individual differences in pure tone averages, working memory, and cortical tracking of the speech envelope relate to speech in noise comprehension in older adults.

Design:

Cortical tracking of continuous speech was assessed using electroencephalography in older adults (60 to 80 years). Participants listened to speech in quiet and in the presence of noise (time-reversed speech) and answered comprehension questions. Participants completed Forward Digit Span and Backward Digit Span as measures of working memory, and pure tone averages were collected. An index of reduction in noise (RIN) was calculated by normalizing the difference between raw cortical tracking in quiet and in noise.

Results:

Comprehension question performance was greater for speech in quiet than for speech in noise. The relationship between RIN and speech in noise comprehension was assessed while controlling for the effects of individual differences in pure tone averages and working memory. Delta band RIN correlated with speech in noise comprehension, while theta band RIN did not.

Conclusions:

Cortical tracking by delta oscillations is robust to the effects of noise. These findings demonstrate that the magnitude of delta band RIN relates to individual differences in speech in noise comprehension in older adults. Delta band RIN may serve as a neural metric of speech in noise comprehension beyond the effects of pure tone averages and working memory.