bluuebunny/crossref_metadata_2025 huggingface dataset:
Feeling and thinking: can theories of human motivation explain how EHR design impacts clinician burnout?
Authors: Weir Charlene R , Taber Peter , Taft Teresa , Reese Thomas J , Jones Barbara , Del Fiol Guilherme
Published: October 2020

The psychology of motivation can help us understand the impact of electronic health records (EHRs) on clinician burnout both directly and indirectly. Informatics approaches to EHR usability tend to focus on the extrinsic motivation associated with successful completion of clearly defined tasks in clinical workflows. Intrinsic motivation, which includes the need for autonomy, sense-making, creativity, connectedness, and mastery is not well supported by current designs and workflows. This piece examines existing research on the importance of 3 psychological drives in relation to healthcare technology: goal-based decision-making, sense-making, and agency/autonomy. Because these motives are ubiquitous, foundational to human functioning, automatic, and unconscious, they may be overlooked in technological interventions. The results are increased cognitive load, emotional distress, and unfulfilling workplace environments. Ultimately, we hope to stimulate new research on EHR design focused on expanding functionality to support intrinsic motivation, which, in turn, would decrease burnout and improve care.
The θ–θ diagram: transforming pulsar scintillation spectra to coordinates on highly anisotropic interstellar scattering screens
Authors: Sprenger Tim , Wucknitz Olaf , Main Robert , Baker Daniel , Brisken Walter
Published: October 2020

We introduce a novel analysis technique for pulsar secondary spectra. The power spectrum of pulsar scintillation (referred to as the ‘secondary spectrum’) shows differential delays and Doppler shifts due to interference from multipath propagation through the interstellar medium. We develop a transformation that maps these observables to angular coordinates on a single thin screen of phase-changing material. This transformation is possible without degeneracies in the case of a one-dimensional distribution of images on this screen, which is often a successful description of the phenomenon. The double parabolic features of secondary spectra are transformed into parallel linear features, whose properties we describe in detail. Furthermore, we introduce methods to measure the curvature parameter and the field amplitude distribution of images by applying them to observations of PSR B0834+06. Finally, we extend this formalism to two-dimensional distributions of images on the interstellar screen.
Spectral signature of solar active region in millimetre and submillimetre wavelengths
Authors: Valle Silva J F , Giménez de Castro C G , Selhorst C L , Raulin J-P , Valio A
Published: October 2020

Active regions were observed with different instruments covering the spectral band from 17 to 405 GHz. The observations were made with the Nobeyama Radioheliograph (17 GHz), the Atacama Large Millimetre Array (107 and 238 GHz), and the Solar Submillimeter Telescope (212 and 405 GHz). A procedure was developed that allows the comparison between observations taken with telescopes of different operational characteristics and mainly of different spatial resolution. The brightness temperature and density flux spectra of several active regions corresponding to a different phase of its lifetime were obtained. The flux density invariably increases in all cases from 107 to 405 GHz and the mean spectral index is ∼2 showing that the dominant emission mechanism at submillimeter frequencies is still thermal. We show that Solar Submillimeter Telescope (SST) and Atacama Large Millimeter/submillimeter Array (ALMA) observations are compatible within the uncertainties, a result of great interest for future joint observations.
A multiwavelength study of the dual nuclei in Mrk 212
Authors: Rubinur K , Kharb P , Das M , Rahna P T , Honey M , Paswan A , Vaddi S , Murthy J
Published: October 2020

We present radio observations of the galaxy merger remnant Mrk 212 with the Karl G. Jansky Very Large Array (VLA) and the upgraded Giant Meter Radio Telescope (uGMRT). Mrk 212 has two previously known radio sources associated with the two optical nuclei, S1 and S2, with a projected separation of ∼6 kpc, making it a dual active galactic nuclei (AGN) candidate. Our new 15-GHz VLA observations reveal that S1 is a double radio source centred around the optical nucleus; its total extent is ∼750 pc its average 1.4−8.5 GHz spectral index is −0.81 ± 0.06. S1 therefore resembles a compact symmetric object. The 15-GHz VLA image identifies the radio source at S2 to be a compact core. Our radio observations therefore strongly support the presence of a dual AGN in Mrk 212. The optical emission line flux ratios obtained from the Himalayan Chandra Telescope (HCT) observations however, show that S1 and S2 both fall in the AGN + star formation (SF) region of the Baldwin, Philips and Terlevich (BPT) diagram. Weak AGN lying in the SF or AGN + SF intermediate regions in the BPT diagram have indeed been reported in the literature; our sources clearly fall in the same category. We find an extended radio structure in our newly reduced 8.5-GHz-VLA data, that is offset by ∼1 arcsec from the optical nucleus S2. New deep FUV and NUV observations with the Ultraviolet Imaging Telescope aboard AstroSat reveal SF knots around S2 as well as kpc-scale tidal tails; the SF knots around S2 coincide with the extended radio structure detected at 8.5 GHz. The radio spectral indices are consistent with SF. Any possible association with the AGN in S2 is unclear at this stage.
Customized optical mapping by CRISPR–Cas9 mediated DNA labeling with multiple sgRNAs
Authors: Abid Heba Z , Young Eleanor , McCaffrey Jennifer , Raseley Kaitlin , Varapula Dharma , Wang Hung-Yi , Piazza Danielle , Mell Joshua , Xiao Ming
Published: October 2020

Whole-genome mapping technologies have been developed as a complementary tool to provide scaffolds for genome assembly and structural variation analysis (1,2). We recently introduced a novel DNA labeling strategy based on a CRISPR–Cas9 genome editing system, which can target any 20bp sequences. The labeling strategy is specifically useful in targeting repetitive sequences, and sequences not accessible to other labeling methods. In this report, we present customized mapping strategies that extend the applications of CRISPR–Cas9 DNA labeling. We first design a CRISPR–Cas9 labeling strategy to interrogate and differentiate the single allele differences in NGG protospacer adjacent motifs (PAM sequence). Combined with sequence motif labeling, we can pinpoint the single-base differences in highly conserved sequences. In the second strategy, we design mapping patterns across a genome by selecting sets of specific single-guide RNAs (sgRNAs) for labeling multiple loci of a genomic region or a whole genome. By developing and optimizing a single tube synthesis of multiple sgRNAs, we demonstrate the utility of CRISPR–Cas9 mapping with 162 sgRNAs targeting the 2Mb Haemophilus influenzae chromosome. These CRISPR–Cas9 mapping approaches could be particularly useful for applications in defining long-distance haplotypes and pinpointing the breakpoints in large structural variants in complex genomes and microbial mixtures.
gcType: a high-quality type strain genome database for microbial phylogenetic and functional research
Authors: Shi Wenyu , Sun Qinglan , Fan Guomei , Hideaki Sugawara , Moriya Ohkuma , Itoh Takashi , Zhou Yuguang , Cai Man , Kim Song-Gun , Lee Jung-Sook , Sedlacek Ivo , Arahal David R , Lucena Teresa , Kawasaki Hiroko , Evtushenko Lyudmila , Weir Bevan S , Alexander Sarah , Dénes Dlauchy , Tanasupawat Somboon , Eurwilaichitr Lily , Ingsriswang Supawadee , Gomez-Gil Bruno , Hazbón Manzour H , Riojas Marco A , Suwannachart Chatrudee , Yao Su , Vandamme Peter , Peng Fang , Chen Zenghui , Liu Dongmei , Sun Xiuqiang , Zhang Xinjiao , Zhou Yuanchun , Meng Zhen , Wu Linhuan , Ma Juncai
Published: October 2020

Taxonomic and functional research of microorganisms has increasingly relied upon genome-based data and methods. As the depository of the Global Catalogue of Microorganisms (GCM) 10K prokaryotic type strain sequencing project, Global Catalogue of Type Strain (gcType) has published 1049 type strain genomes sequenced by the GCM 10K project which are preserved in global culture collections with a valid published status. Additionally, the information provided through gcType includes >12 000 publicly available type strain genome sequences from GenBank incorporated using quality control criteria and standard data annotation pipelines to form a high-quality reference database. This database integrates type strain sequences with their phenotypic information to facilitate phenotypic and genotypic analyses. Multiple formats of cross-genome searches and interactive interfaces have allowed extensive exploration of the database's resources. In this study, we describe web-based data analysis pipelines for genomic analyses and genome-based taxonomy, which could serve as a one-stop platform for the identification of prokaryotic species. The number of type strain genomes that are published will continue to increase as the GCM 10K project increases its collaboration with culture collections worldwide. Data of this project is shared with the International Nucleotide Sequence Database Collaboration. Access to gcType is free at http://gctype.wdcm.org/.
Pilgrimage in Colonial Latin America
Authors: Palka Joel , Folch Ramon
Published: October 2020

Latin American pilgrimage shrines from pre-Columbian times to the present have been linked to prominent geographical features, including caves, springs, rivers, and mountains. These landscapes are associated with divine forces, whether indigenous or European, and have been ritualized or made sacred through the creation of shrines there. Some shrines for pilgrimage are mere altars, while others are large basilicas. The pilgrimage shrines located throughout Latin America contain religious architecture, icons, and materials, such as water or comestible clay, which are very important to devotees. Beliefs associated with pilgrimage in the New World often blend European, indigenous, and African cultural elements. Pilgrimage in colonial period Latin America has been marked by the occurrence of miracles at sanctuaries and has led to subsequent visits by large numbers of worshipers. Pilgrims come to these sanctuaries for curing, religious ritual, and to reaffirm their cultural identity. Importantly, pilgrimage behaviors and shrines in Latin America parallel those in many other societies around the world. Studies of pilgrimage in colonial period Latin America show how cultures and religious beliefs associated with shrines emerged in the region. Investigators have gleaned information on past Latin American pilgrimage from historic documents, oral histories, studies of material culture, and archaeology. Additional work in archaeology resulted in important insights on pilgrimage in Latin American during the colonial period, including indigenous and European origins for pilgrimage, the duration of shrine importance, and changes in the functions of sanctuaries. Archaeological research also illuminated the ceremonial behaviors at the sanctuaries and what social segments and ethnic groups used them over time. Much of the literature on pilgrimages and shrines in the colonial period focuses on Mexico, Central America (Mesoamerica), and the Andean and coastal regions of Peru. Many publications have come out in small venues in local presses in each country, which can be hard to access. This bibliography provides key sources for the study of Latin American pilgrimage, shrines, and religious iconography in the colonial period. It is an excellent source of information leading to primary sources and additional documents on the topics outlined here. Mostly works in English and Spanish are previewed.
Intergenerational Mobility in the Very Long Run: Florence 1427–2011
Authors: Barone Guglielmo , Mocetti Sauro
Published: October 2020

We examine intergenerational mobility in the very long run, across generations that are six centuries apart. We exploit a unique dataset containing detailed information at the individual level for all people living in the Italian city of Florence in 1427. These individuals have been associated, using their surnames, with their pseudo-descendants living in Florence in 2011. We find that long-run earnings elasticity is about 0.04; we also find an even stronger role for real wealth inheritance and evidence of persistence in belonging to certain elite occupations. Our results are confirmed when we account for the quality of the pseudo-links and when we address the potential selectivity bias behind the matching process. Finally, we frame our results within the existing evidence and argue that the quasi-immobility of preindustrial society and the existence of multigenerational effects might explain the long-lasting effects of ancestors’ socioeconomic status.
Medical emergency kits in ambulatory care clinics
Authors: Crimlisk Janet T. , Conlin Genevieve , Gendron Bryan J. , Bernard Sheilah A. , Medina Miguel , Guarino Richard
Published: October 2020

Implementation and staff perceptions of usability and feasibility
Building Longitudinal Relationships Into a Traditional Block Clerkship Model: A Mixed-Methods Study
Authors: Atalay Alev J. , Osman Nora Y. , Krupat Edward , Alexander Erik K.
Published: October 2020

Purpose

The authors describe the implementation of the novel Longitudinal Clinical Experiences with Patients (LCEP) curriculum, designed to integrate continuity and longitudinal patient relationships into a traditional block clerkship (BC), and present a mixed-methods analysis evaluating program effectiveness to assess its feasibility, value, and impact.

Method

This was a mixed-methods study of 54 Harvard Medical School students who participated in the LCEP during their core clerkship (third) year during the 2013–2014 academic year. Fifty-two students responded to an electronic survey about the patients they followed during the LCEP. Forty-two students completed confidential live interviews. Unique groups of 13–15 students were interviewed at 3 times during the year to assess students’ perceptions of the LCEP over time. The data were analyzed using a content analysis framework.

Results

On average, students followed 3.3 LCEP patients over the clerkship year. Ninety-four percent (n = 49/52) of students were able to follow 2 or more patients longitudinally. Most students met their longitudinal patient in the inpatient setting (71%, n = 37/52). Subsequent encounters were most often in the ambulatory setting. Students described scheduling logistics as key to the success or failure of the program. Many students described the challenges of competing priorities between their BC responsibilities and longitudinal opportunities. Students found the LCEP deepened their understanding of the patient experience, the health care system, and disease progression. Over the course of an academic year, an increased proportion of students (60%) highlighted understanding the patient experience as a core value obtained through the LCEP.

Conclusions

The LCEP was feasible and proved successful in promoting longitudinal patient relationships within a traditional BC model. Prioritizing the depth of experience with a smaller number of patients may reduce the barriers described by students. The results suggest that such a hybrid program promotes patient-centeredness.
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Antibodies at Delivery in Women, Partners, and Newborns
Authors: Egerup Pia , Fich Olsen Line , Christiansen Ann-Marie Hellerung , Westergaard David , Severinsen Elin Rosenbek , Hviid Kathrine Vauvert Römmelmayer , Kolte Astrid Marie , Boje Amalie Dyhrberg , Bertelsen Marie-Louise Mathilde Friis , Prætorius Lisbeth , Zedeler Anne , Nielsen Josefine Reinhardt , Bang Didi , Berntsen Sine , Ethelberg-Findsen Jeppe , Storm Ditte Marie , Bello-Rodríguez Judith , Ingham Andreas , Ollé-López Joaquim , Hoffmann Eva R. , Wilken-Jensen Charlotte , Krebs Lone , Jørgensen Finn Stener , Westh Henrik , Jørgensen Henrik Løvendahl , la Cour Freiesleben Nina , Nielsen Henriette Svarre
Published: October 2020

OBJECTIVE:

To investigate the frequency of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies in parturient women, their partners, and their newborns and the association of such antibodies with obstetric and neonatal outcomes.

METHODS:

From April 4 to July 3, 2020, in a single university hospital in Denmark, all parturient women and their partners were invited to participate in the study, along with their newborns. Participating women and partners had a pharyngeal swab and a blood sample taken at admission; immediately after delivery, a blood sample was drawn from the umbilical cord. The swabs were analyzed for SARS-CoV-2 RNA by polymerase chain reaction, and the blood samples were analyzed for SARS-CoV-2 antibodies. Full medical history and obstetric and neonatal information were available.

RESULTS:

A total of 1,313 parturient women (72.5.% of all women admitted for delivery at the hospital in the study period), 1,188 partners, and 1,206 newborns participated in the study. The adjusted serologic prevalence was 2.6% in women and 3.5% in partners. Seventeen newborns had SARS-CoV-2 immunoglobulin G (IgG) antibodies, and none had immunoglobulin M antibodies. No associations between SARS-CoV-2 antibodies and obstetric or neonatal complications were found (eg, preterm birth, preeclampsia, cesarean delivery, Apgar score, low birth weight, umbilical arterial pH, need for continuous positive airway pressure, or neonatal admission), but statistical power to detect such differences was low. Full serologic data from 1,051 families showed an absolute risk of maternal infection of 39% if the partner had antibodies.

CONCLUSION:

We found no association between SARS-CoV-2 infection and obstetric or neonatal complications. Sixty-seven percent of newborns delivered by mothers with antibodies had SARS-CoV-2 IgG antibodies. A limitation of our study is that we lacked statistical power to detect small but potentially meaningful differences between those with and without evidence of infection.
INTERVORTEX VENOUS ANASTOMOSIS IN Pachychoroid-RELATED DISORDERS
Authors: Spaide Richard F. , Ledesma-Gil Gerardo , Gemmy Cheung Chui Ming
Published: October 2020

Purpose:

To evaluate the choroidal vascular patterns of patients with pachychoroid-related diseases in eyes images with wide-field indocyanine green angiography.

Methods:

Retrospective study of wide-field indocyanine green angiographic images of patients with pachychoroid, peripapillary pachychoroid syndrome, central serous chorioretinopathy, and pachychoroid-associated neovascularization that were evaluated for anastomoses between vortex vein systems, which are ordinarily separated by a watershed zone.

Results:

There were 21 subjects with a mean age of 57.4 years and 15 were male. Among the 42 eyes evaluated, central serous chorioretinopathy was found in 24 eyes (57.1%), peripapillary pachychoroid syndrome in 5 (11.9%), pachychoroid associated neovascularization in 7 (16.7%), and pachychoroid in 6 (14.3%). Every eye showed anastomosis between the superonasal, superotemporal, and inferotemporal vortex vein systems. The inferonasal vortex vein system was less likely to demonstrate anastomosis except for peripapillary pachychoroid syndrome, which showed anastomosis in all eyes. The anastomotic connections were prominent in the central macula in the central serous chorioretinopathy and pachychoroid-associated neovascularization cases, and around the nerve in the peripapillary pachychoroid syndrome cases. Although the large choroidal veins were particularly prominent in the neovascular cases, the number was fewer in the macular region than in other pachychoroid-related diseases in this series. Compared with a control group of nine eyes, the inferotemporal–superotemporal–superonasal anastomotic connections were more common in the case group (P < 0.001) and inferonasal quadrant (P = 0.023 right eye; P = 0.01, left eye).

Conclusion:

Intervortex venous anastomosis is common in pachychoroid, central serous chorioretinopathy, peripapillary pachychoroid syndrome, and pachychoroid-associated neovascularization. This finding has important implications concerning pathogenesis and classification of disease.
Effect of interval between food intake and drug administration at fasting condition on the plasma concentrations of first-line anti-tuberculosis drugs in Chinese population
Authors: Wang Jun , Wang Jing , Du Yadong , Guo Ru , Han Xiqin , Wang Qingfeng , Pang Yu , Chu Naihui
Published: October 2020

We aimed to investigate the effect of interval between food intake and drug administration at fasting condition on the plasma concentrations of first-line anti- tuberculosis (TB) drugs in Chinese population. Newly diagnosed TB patients administered the anti-TB drugs under fasting conditions orally, and then had prepared breakfast at 30 minutes and 120 min after dosing, respectively. Blood sampling was also performed 120  minutes after dosing for the detection of C
max purpose. Overall, twenty-five participants were included in our analysis. The C
maxs of 30  minutes interval and 120  minutes interval were 21.8 ± 2.0 and 19.2 ± 2.0 μg/mL for rifampin, 1.6 ± 0.2 and 2.1 ± 0.2 μg/mL for isoniazid (INH), 1.5 ± 0.1and 1.5 ± 0.2 μg/mL for ethambutol (EMB), and 49.2 ± 3.7 and 41.5 ± 3.9 μg/mL for pyrazinamide, respectively. Statistical analysis revealed that there was no statistical difference between 2 groups. Additionally, 88.0% and 72.0% of the 25 participants at 2-hour interval group had peak concentrations less than the lower limit of the reference range for INH and EMB, respectively. The C
maxs of INH were 0.9 ± 0.4 μg/ml for rapid acetylator, which was significantly lower than those of intermediate (1.4 ± 1.0 μg/mL), and slow acetylator (2.5 ± 1.0 μg/mL), respectively (P < .01). In conclusion, our data demonstrate that early food intake at 30 minutes after drug administration had no significant influence on the plasma concentrations. In addition, a high proportion of patients receiving first-line anti-TB regimen fail to achieve the expected plasma drug ranges of INH and EMB (P > .05).
Accuracy of tumor size measurement on shear wave elastography (SWE)
Authors: Ko Kyung Hee , Jung Hae Kyoung , Park Ah Young , Koh Ji Eun , Jang Hyunkyung , Kim Yunju
Published: October 2020

The aim of this study is to investigate the accuracy of tumor size assessment by shear wave elastography (SWE) in invasive breast cancer and also evaluated histopathologic factors influencing the accuracy.

A total of 102 lesions of 102 women with breast cancers of which the size was 3 cm or smaller were included and retrospectively analyzed. Tumor size on B-mode ultrasound (US) and SWE were recorded and compared with the pathologic tumor size. If tumor size measurements compared to pathological size were within ±3 mm, they were considered as accurate. The relationship between the accuracy and histopathologic characteristics were evaluated.

The mean pathologic tumor size was 16.60 ± 6.12 mm. Tumor sizes on SWE were significantly different from pathologic sizes (18.00 ± 6.71 mm, P < 0.001). The accuracy of SWE (69.6%) was lower than that by B-mode US (74.5%). There was more size overestimation than underestimation (23.5% vs 6.9%) using SWE. Conversely, there was more size underestimation than overestimation (18.6% vs 6.9%) using B-mode US. The accuracy of SWE was associated with ER positivity (P = .004), PR positivity (P = .02), molecular subtype (P = .02), and histologic grade (P = .03). In the multivariate analysis, ER positivity (P = .002) and molecular subtype (P = .027) significantly influenced the accuracy of tumor size measurement by SWE.

In conclusion, the accuracy of the tumor size measured with SWE was lower than that measured with B-mode US and SWE tends to overestimate the size. ER positivity and molecular subtype are significantly associated with the accuracy of SWE in tumor size assessment.
FOLFIRINOX for Recurrent Pancreatic Cancer After Pancreatic Resection
Authors: Morinaga Soichiro , Takita Morihito , Yoshizawa Atsuko , Kamei Keiko , Nakamori Shoji , Ishihara Shin , Kuramochi Hidekazu , Yokoyama Yukihiro , Uchiyama Takashi , Murohisa Gou , Ishigaki Marina , Todaka Akiko , Fukutomi Akira
Published: October 2020

Objectives

The multidrug regimen with fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) is widely used for recurrent pancreatic cancer after pancreatic resection. However, there are concerns about severe toxicities and poor tolerability of FOLFIRINOX in these patients because some suffer from surgery-associated malnutrition, weight loss, and diabetes mellitus. We evaluated the toxicity and tolerability of FOLFIRINOX in these patients.

Methods

This study was conducted as a secondary analysis of the Japan Adjuvant Study Group of Pancreatic Cancer 06 study, which was a multicenter observational study of FOLFIRINOX for pancreatic cancer in Japan. The toxicity and tolerability of FOLFIRINOX in recurrent disease correlated with those of both the locally advanced and the metastatic disease group.

Results

The major grades 3 and 4 toxicities observed in the recurrent and locally advanced or metastatic disease groups were neutropenia (68% vs 63%), febrile neutropenia (4% vs 15%, P = 0.007), thrombocytopenia (4% vs 3%), diarrhea (4% vs 8%), and sensory neuropathy (0% vs 2%). The dose modification and relative dose intensity did not differ markedly between the groups.

Conclusions

The toxicity and tolerability of FOLFIRINOX for recurrence after pancreatic resection were similar to those for locally advanced or metastatic disease with appropriate patient selection and dose modifications.
Treatment Strategies for the Optimal Management of Locally Advanced Pancreatic Adenocarcinoma With Curative Intent
Authors: Attard Joseph A. , Farrugia Alexia , Pathanki Adithya , Roberts Keith J. , Dasari Bobby , Isaac John , Ma Yuk Ting , Chatzizacharias Nikolaos A.
Published: October 2020

Historically, locally advanced pancreatic adenocarcinoma (LAPDAC) was considered a palliative condition. Advances in treatment have resulted in studies reporting survival after neoadjuvant treatment and surgery similar to earlier disease stages. However, there is no consensus on optimal LAPDAC management. Our aim was a systematic review of published evidence on LAPDAC treatment strategies with curative intent. Twenty-eight studies defining LAPDAC as per established criteria and reporting outcomes after neoadjuvant treatment with a view to resection were included. Primary outcomes were resection rate and proportion of curative resections. Secondary outcomes were postoperative mortality, progression-free survival, and overall survival. Neoadjuvant treatment varied significantly, most common being the combination of folinic acid, fluorouracil, irontecan, and oxaliplatin. Median percentage of patients proceeding to surgery after completion of neoadjuvant pathway was 33.5%. Median resection rate was 25%. Median R0 resection was 80% of resected patients. These outcomes ranged 0% to 100% across studies. Ninety-day postoperative mortality ranged from 0% to 5%. Median progression-free and overall survival for resected patients were 12.9 and 30 months, respectively, versus 13.2 months overall survival for unresected patients. In conclusion, although there is wide variability in reported LAPDAC resection rates post–neoadjuvant chemotherapy, retrospective data suggest that neoadjuvant treatment followed by surgery results in improved survival.
Low-Molecular–Weight Heparin Combined With Insulin Versus Insulin Alone in the Treatment of Hypertriglyceridemic Pancreatitis (LIHTGP Trial)
Authors: Yu Bingjun , He Wenhua , He Cong , Li Nianshuang , Li JiaRong , Zhu Yin , Chen Youxiang , Lu Nonghua
Published: October 2020

Objective

Currently, insulin and/or heparin/low-molecular–weight heparin (LMWH) serve as an early lipid-lowering treatment for hypertriglyceridemic pancreatitis (HTGP). However, whether the clinical prognosis of combining LMWH with insulin is superior to using insulin alone remains unknown. This trial will compare the clinical outcomes of LMWH with insulin and an insulin regimen for emergency lipid-lowering treatment in HTGP patients.

Methods

In total, 476 eligible participants will be recruited from 18 hospitals throughout China. Participants in the LMWH group will receive LMWH combined with insulin, whereas insulin alone will be administered to those in the insulin group. The patients will be followed up at 3 and 6 months after discharge. Adverse reactions will be evaluated by the safety monitoring committee. Safety outcomes and adverse events will also be recorded.

Results

The study is registered in the Chinese Clinical Trial Registry (No: ChiCTR1900023640). Recruitment will begin in August 2019 and will be completed in December 2021 (http://www.chictr.org.cn/index.aspx). No data are available now.

Conclusions

The trial will investigate the efficacy of using LMWH combined with insulin as an emergency lipid-lowering treatment in reducing new organ failure, mortality, hospital stays, and expenses compared using with insulin alone for patients with HTGP.
Variation in Pediatric Palliative Care Allocation Among Critically Ill Children in the United States*
Authors: O’Keefe Siobhán , Maddux Aline B. , Bennett Kimberly S. , Youngwerth Jeanie , Czaja Angela S.
Published: October 2020

OBJECTIVES:

The objectives are as follows: 1) estimate palliative care consult rates and trends among critically ill children and 2) characterize which children receive palliative care consults, including those meeting previously proposed ICU-specific palliative care screening criteria.

DESIGN:

Retrospective cohort.

SETTING:

Fifty-two United States children’s hospitals participating in the Pediatric Health Information Systems database.

PATIENTS:

Hospitalized children with nonneonatal ICU admissions from 2007 to 2018.

MEASUREMENTS AND MAIN RESULTS:

The primary outcome was palliative care consultation, as identified by the palliative care International Classification of Disease code. Patient characteristics and outcomes were compared between those with and without palliative care. We used a mixed-effects multivariable model to estimate the independent association between the palliative care and patient characteristics accounting for institution and subject clustering. Hospitalizations were categorized into three mutually exclusive groups for comparative analyses: 1) meeting ICU-specific palliative care criteria, 2) presence of a complex chronic condition not in ICU-specific palliative care criteria, or 3) not meeting ICU-specific palliative care or complex chronic condition criteria. Rates and trends of palliative care consultation were estimated including variation among institutions and variation among subcategories of ICU-specific palliative care criteria. The study cohort included 740,890 subjects with 1,024,666 hospitalizations. About 1.36% of hospitalizations had a palliative care consultation. Palliative care consult was independently associated with older age, female sex, government insurance, inhospital mortality, and ICU-specific palliative care or complex chronic condition criteria. Among the hospitalizations, 30% met ICU-specific palliative care criteria, 40% complex chronic condition criteria, and 30% neither. ICU-specific palliative care patients received more mechanical ventilation and cardiopulmonary resuscitation, had longer hospital and ICU lengths of stay, and had higher inhospital mortality (p < 0.001). Palliative care utilization increased over the study period with considerable variation between the institutions especially in the ICU-specific palliative care cohort and its subgroups.

CONCLUSIONS:

Palliative care consultation for critically ill children in the United States is low. Palliative care utilization is increasing but considerable variation exists across institutions, suggesting inequity in palliative care allocation among this vulnerable population. Future studies should evaluate factors influencing allocation of palliative care among critically ill children in the United States and the drivers of differences between the institutional practices.
Coastal sharks supply the global shark fin trade
Authors: Van Houtan Kyle S. , Gagné Tyler O. , Reygondeau Gabriel , Tanaka Kisei R. , Palumbi Stephen R. , Jorgensen Salvador J.
Published: October 2020

Progress in global shark conservation has been limited by constraints to understanding the species composition and geographic origins of the shark fin trade. Previous assessments that relied on earlier genetic techniques and official trade records focused on abundant pelagic species traded between Europe and Asia. Here, we combine recent advances in DNA barcoding and species distribution modelling to identify the species and source the geographic origin of fins sold at market. Derived models of species environmental niches indicated that shark fishing effort is concentrated within Exclusive Economic Zones, mostly in coastal Australia, Indonesia, the United States, Brazil, Mexico and Japan. By coupling two distinct tools, barcoding and niche modelling, our results provide new insights for monitoring and enforcement. They suggest stronger local controls of coastal fishing may help regulate the unsustainable global trade in shark fins.
A case of long-term herbivory: specialized feeding trace on
Parrotia
(Hamamelidaceae) plant species
Authors: Adroit Benjamin , Zhuang Xin , Wappler Torsten , Terral Jean-Frederic , Wang Bo
Published: October 2020

Interactions between plants and insects evolved during millions of years of coevolution and maintain the trophic balance of terrestrial ecosystems. Documenting insect damage types (DT) on fossil leaves is essential for understanding the evolution of plant–insect interactions and for understanding the effects of major environmental changes on ecosystem structure. However, research focusing on palaeoherbivory is still sparse and only a tiny fraction of fossil leaf collections have been analysed. This study documents a type of insect damage found exclusively on the leaves of
Parrotia
species (Hamamelidaceae). This DT was identified on
Parrotia
leaves from Willershausen (Germany, Pliocene) and from Shanwang (China, Miocene) and on their respective endemic modern relatives:
Parrotia perisca
in the Hyrcanian forests (Iran) and
Parrotia subaequalis
in the Yixing forest (China). Our study demonstrates that this insect DT persisted over at least 15 Myr spanning eastern Asia to western Europe. Against expectations, more examples of this type of herbivory were identified on the fossil leaves than on the modern examples. This mismatch may suggest a decline of this specialized plant–insect interaction owing to the contraction of
Parrotia
populations in Eurasia during the late Cenozoic. However, the continuous presence of this DT demonstrates a robust and long-term plant–herbivore association, and provides new evidence for a shared biogeographic history of the two host plants.
Boundary-layer effects on electromagnetic and acoustic extraordinary transmission through narrow slits
Authors: Brandão Rodolfo , Holley Jacob R. , Schnitzer Ory
Published: October 2020

We study the problem of resonant extraordinary transmission of electromagnetic and acoustic waves through subwavelength slits in an infinite plate, whose thickness is close to a half-multiple of the wavelength. We build on the matched-asymptotics analysis of Holley & Schnitzer (2019
Wave Motion
91
, 102381 (doi:10.1016/j.wavemoti.2019.102381)), who considered a single-slit system assuming an idealized formulation where dissipation is neglected and the electromagnetic and acoustic problems are analogous. We here extend that theory to include thin dissipative boundary layers associated with finite conductivity of the plate in the electromagnetic problem and viscous and thermal effects in the acoustic problem, considering both single-slit and slit-array configurations. By considering a distinguished boundary-layer scaling where dissipative and diffractive effects are comparable, we develop accurate analytical approximations that are generally valid near resonance; the electromagnetic–acoustic analogy is preserved up to a single parameter that is provided explicitly for both scenarios. The theory is shown to be in excellent agreement with GHz-microwave and kHz-acoustic experiments in the literature.
Reynolds stress anisotropy in flow over two-dimensional rigid dunes
Authors: Dey Subhasish , Paul Prianka , Ali Sk Zeeshan , Padhi Ellora
Published: October 2020

Characteristics of turbulence anisotropy in flow over two-dimensional rigid dunes are analysed. The Reynolds stress anisotropy is envisaged from the perspective of the stress ellipsoid shape. The spatial evolutions of the anisotropic invariant map (AIM), anisotropic invariant function, eigenvalues of the scaled Reynolds stress tensor and eccentricities of the stress ellipsoid are investigated at various streamwise distances along the vertical. The data plots reveal that the oblate spheroid axisymmetric turbulence appears near the top of the crest, whereas the prolate spheroid axisymmetric turbulence dominates near the free surface. At the dune trough, the axisymmetric contraction to the oblate spheroid diminishes, as the vertical distance below the crest increases. At the reattachment point and one-third of the stoss-side, the oblate spheroid axisymmetric turbulence formed below the crest appears to be more contracted, as the vertical distance increases. The AIMs suggest that the turbulence anisotropy up to edge of the boundary layer follows a looping pattern. As the streamwise distance increases, the turbulence anisotropy at the edge of the boundary layer approaches the plane-strain limit up to two-thirds of the stoss-side, intersecting the plane-strain limit at the top of the crest and thereafter moving towards the oblate spheroid axisymmetric turbulence.
Proposal to reclassify Lactobacillus zhaodongensis, Lactobacillus zeae, Lactobacillus argentoratensis and Lactobacillus buchneri subsp. silagei as Lacticaseibacillus zhaodongensis comb. nov., Lacticaseibacillus zeae comb. nov., Lactiplantibacillus argentoratensis comb. nov. and Lentilactobacillus buchneri subsp. silagei comb. nov., respectively and Apilactobacillus kosoi as a later heterotypic synonym of Apilactobacillus micheneri
Authors: Liu Dan Dan , Gu Chun Tao
Published: October 2020

Recently, the members of the genus

Lactobacillus

have been reclassified by Zheng et al. At the same time,

Lactobacillus buchneri

subsp.

silagei

,

Lactobacillus zhaodongensis

,

Lactobacillus argentoratensis

and

Lactobacillus zeae

have been successively and validly published, and

Lactobacillus kosoi

has also been reclassified. In the present study, all these species and subspecies were re-evaluated by 16S rRNA gene sequence analysis or a combination of 16S rRNA gene sequence analysis and phylogenomic treeing. On the basis of the results presented here, we propose to reclassify

Lactobacillus zhaodongensis

,

Lactobacillus zeae

,

Lactobacillus argentoratensis

and

Lactobacillus buchneri

subsp.

silagei

as Lacticaseibacillus zhaodongensis comb. nov., Lacticaseibacillus zeae comb. nov., Lactiplantibacillus argentoratensis comb. nov. and

Lentilactobacillus buchneri

subsp. silagei comb. nov., respectively and

Apilactobacillus kosoi

as a later heterotypic synonym of

Apilactobacillus micheneri

.
Evaluation of a Modified Early Warning Score (MEWS) adjusted for COVID-19 patients (CEWS) to identify risk of ICU admission or death
Authors: Smid Linda , Osman Lano , Arend Sandra M. , de Groot Stefanie , de Boer Mark G.J.
Published: October 2020

The commonly used Modified Early Warning score (MEWS) may poorly predict deterioration in COVID-19 patients. Therefore, an adjusted MEWS for COVID-19 patients (CEWS) was constructed. CEWS exceeded MEWS at all time points and impending death or intensive care unit (ICU) admission was strongly correlated with a persistently high CEWS.
Life Expectancy and Voting Patterns in the 2020 U.S. Presidential Election
Authors: Curtis Lesley H. , Hoffman Molly N. , Califf Robert M. , Hammill Bradley G.
Published: October 2020

Introduction

In the 2016 U.S. Presidential election, voters in communities with recent stagnation or decline in life expectancy were more likely to vote for the Republican candidate than in prior Presidential elections. We aimed to assess the association between change in life expectancy and voting patterns in the 2020 Presidential election.

Methods

With data on county-level life expectancy from the Institute for Health Metrics and Evaluation and voting data from GitHub, we used weighted multivariable linear regression to estimate the association between the change in life expectancy from 1980 to 2014 and the proportion of votes for the Republican candidate in the 2020 Presidential election.

Results

Among 3,110 U.S counties and Washington, D.C., change in life expectancy at the county level was negatively associated with Republican share of the vote in the 2020 Presidential election (parameter estimate −7.2, 95% confidence interval, −7.8 to −6.6). With the inclusion of state, sociodemographic, and economic variables in the model, the association was attenuated (parameter estimate −0.8; 95% CI, −1.5 to −0.2).

Conclusion

Counties with a less positive trajectory in life expectancy were more likely to vote for Republican candidates in the 2020 U.S. Presidential election, but the association was mediated by demographic, social and economic factors.
The energy balance theory: an unsatisfactory model of body composition fluctuations
Authors: Arencibia-Albite Francisco , Manninen Anssi H.
Published: October 2020

Differential weight and fat losses under isocaloric diets of distinct macronutrient composition are well-documented findings in obesity research.1-6 Such data are considered a result of inadequate methodology as it disagree with the energy balance theory.7 A recent mathematical analysis of this paradigm has found, however, serious analytical contradictions in its foundations.8 As an alternative, a mass balance model was proposed to explain the aforesaid body composition alterations. Here, we expand on this observation by contrasting both models. We show that mass balance explains a wide range of fending experiments including those concurring with the energy balance principle. The latter, however, is less flexible and results in poor forecasts in settings consistent with mass balance. The energy balance theory is thus an unsatisfactory model of body composition changes. Consequently, by shifting to a mass balance paradigm of obesity a much deeper understanding of this disease may follow in the near future.
Physical properties of the cytoplasm modulate the rates of microtubule polymerization and depolymerization
Authors: Molines Arthur T. , Lemière Joël , Gazzola Morgan , Steinmark Emilie I. , Edrington Claire H. , Hsu Chieh-Ting (Jimmy) , Suhling Klaus , Goshima Gohta , Holt Liam J. , Thery Manuel , Brouhard Gary. J. , Chang Fred
Published: October 2020

The cytoplasm is a crowded, visco-elastic environment whose physical properties change according to physiological or developmental states. How the physical properties of the cytoplasm impact cellular functionsin vivoremain poorly understood. Here, we probed the effects of cytoplasmic concentration on microtubules by applying osmotic shifts to fission yeast, moss, and mammalian cells. We show that both the rates of microtubule polymerization and depolymerization scale linearly and inversely with cytoplasmic concentration; an increase in cytoplasmic concentration decreases the rates of microtubule polymerization and depolymerization proportionally, while a decrease in cytoplasmic concentration leads to the opposite. Numerous lines of evidence indicate that these effects are due to changes in cytoplasmic viscosity rather than cellular stress responses or macromolecular crowdingper se. We reconstituted these effects on microtubulesin vitroby tuning viscosity. Our findings indicate that, even in normal conditions, the viscosity of cytoplasm modulates the reactions underlying microtubule dynamic behaviors.
Clonal propagation history shapes the intra-cultivar genetic diversity in ‘Malbec’ grapevines
Authors: Calderón Luciano , Mauri Nuria , Muñoz Claudio , Carbonell-Bejerano Pablo , Bree Laura , Sola Cristobal , Gomez-Talquenca Sebastian , Royo Carolina , Ibáñez Javier , Martinez-Zapater Jose Miguel , Lijavetzky Diego
Published: October 2020

Grapevine (Vitis viniferaL.) cultivars are clonally propagated to preserve their varietal attributes. However, novel genetic variation still accumulates due to somatic mutations. Aiming to study the potential impact of clonal propagation history on grapevines intra-cultivar genetic diversity, we have focused on ‘Malbec’. This cultivar is appreciated for red wines elaboration, it was originated in Southwestern France and introduced into Argentina during the 1850s. Here, we generated whole-genome resequencing data for four ‘Malbec’ clones with different historical backgrounds. A stringent variant calling procedure was established to identify reliable clonal polymorphisms, additionally corroborated by Sanger sequencing. This analysis retrieved 941 single nucleotide variants (SNVs), occurring among the analyzed clones. Based on a set of validated SNVs, a genotyping experiment was custom-designed to survey ‘Malbec’ genetic diversity. We successfully genotyped 214 samples and identified 14 different clonal genotypes, that clustered into two genetically divergent groups. Group-Ar was driven by clones with a long history of clonal propagation in Argentina, while Group-Fr was driven by clones that have longer remained in Europe. Findings show the ability of such approaches for clonal genotypes identification in grapevines. In particular, we provide evidence on how human actions may have shaped ‘Malbec’ extant genetic diversity pattern.
Availability of Medications Used for Puberty Induction and Maintenance in Adolescents with Hypogonadism in the Arab Region
Authors: Deeb Asma , AlSaffar Hussain , Hamza Rasha Tarif , Habeb Abdelhadi
Published: October 2020

Purpose

Inducing puberty in hypogonadal patients enables achieving normal final adult height, healthy bone mass accrual and improves fertility potential. Reliable availability and access to medicines remain a challenge around the world, particularly in low income countries. We aim to study the availability/access to medications used for inducing and maintaining puberty in centers within the Arab region.

Patients and Methods

A cross-sectional survey was conducted using a link to an online questionnaire which was emailed to paediatric endocrinologists in the Arab region. The questionnaire consisted of three questions related to availability of various forms of sex hormones.

Results

99 physicians from 16 countries participated in the study. The commonest available form of estrogen was conjugated estrogen (29% of centers) followed by ethinylestradiol in 26%. Depot estradiol was available in 11centers while topical estrogen preparations of gel and patches were available in 6 and 10 centers respectively. Medroxy progesterone was available in 26% of the centers followed by noresthisterone (24%). The combined forms of oral and transdermal patches of estrogen/progestorne were available in 35 and 9% of centers. Intramuscular testosterone (Sustanon) was the most commonly available preparation of testosterone followed by the depot injection (Nebido), oral testosterone and testosterone gel and cream.

Conclusions

We report the first availability data of medications used for puberty induction and maintenance in paediatric hypogonadism in the Arab region. Recommended preparations for this purpose are not widely available. Creating essential list of medications used in paediatric endocrinology disorders might improve availability, access and consequently practice.