bluuebunny/crossref_metadata_2025 huggingface dataset:
Persistence of SARS-CoV-2 in the first trimester placenta leading to transplacental transmission and fetal demise from an asymptomatic mother
Authors: Shende Prajakta , Gaikwad Pradip , Gandhewar Manisha , Ukey Pawankumar , Bhide Anshul , Patel Vainav , Bhagat Sharad , Bhor Vikrant , Mahale Smita , Gajbhiye Rahul , Modi Deepak
Published: December 2020

Coronavirus disease 2019 (COVID-19) is caused by infection of the respiratory tract by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which survives in the tissues during the clinical course of infection but there is limited evidence on placental infection and vertical transmission of SARS-CoV-2. The impact of COVID-19 in first trimester pregnancy remains poorly understood. Moreover, how long SARS-CoV-2 can survive in placenta is unknown. Herein, we report a case of a pregnant woman in the first trimester who tested positive for SARS-CoV-2 at 8 weeks of gestation, although her clinical course was asymptomatic. At 13 weeks of gestation, her throat swab tested negative for SARS-CoV-2 but viral RNA was detected in the placenta, and the Spike (S) proteins (S1 and S2) were immunolocalized in cytotrophoblast and syncytiotrophoblast cells of the placental villi. Histologically, the villi were generally avascular with peri-villus fibrin deposition and in some areas the syncytiotrophoblast layer appeared lysed. The decidua also had fibrin deposition with extensive leukocyte infiltration suggestive of inflammation. The SARS-CoV-2 crossed the placental barrier, as the viral RNA was detected in the amniotic fluid and the S proteins were detected in the fetal membrane. Ultrasonography revealed extensively subcutaneous edema with pleural effusion suggestive of hydrops fetalis and the absence of cardiac activity indicated fetal demise. This is the first study to provide concrete evidence of persistent placental infection of SARS-CoV-2 and its congenital transmission is associated with hydrops fetalis and intrauterine fetal demise in early pregnancy.
Emergency surgical stent retrieval following stent dislodgement during ductal stenting for hybrid palliation
Authors: Tongut Aybala , Desai Manan , Peer Syed Murfad , Yerebakan Can
Published: December 2020

Stenting of the ductus arteriosus is part of the hybrid treatment of high-risk patients with hypoplastic left heart syndrome. Dislodgement of a ductal stent is a rare complication. We present challenges faced in successful surgical retrieval of a dislodged ductal stent in a high-risk infant undergoing hybrid palliation for hypoplastic left heart syndrome.
Seroprevalence of SARS-CoV-2 antibodies in over 6000 healthcare workers in Spain
Authors: Varona Jose F , Madurga Rodrigo , Peñalver Francisco , Abarca Elena , Almirall Cristina , Cruz Marta , Ramos Enrique , Castellano Vázquez Jose María
Published: December 2020

Background

Spain has one of the highest incidences of coronavirus disease 2019 (COVID-19) worldwide, so Spanish health care workers (HCW) are at high risk of exposure. Our objective was to determine severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody seroprevalence amongst HCW and factors associated with seropositivity.

Methods

A cross-sectional study evaluating 6190 workers (97.8% of the total workforce of a healthcare-system of 17 hospitals across four regions in Spain) was carried out between April and June 2020, by measuring immunoglobulin G (IgG)-SARS-CoV-2 antibody titres and related clinical data. Exposure risk was categorized as high (clinical environment; prolonged/direct contact with patients), moderate (clinical environment; non-intense/no patient contact) and low (non-clinical environment).

Results

A total of 6038 employees (mean age 43.8 years; 71% female) were included in the final analysis. A total of 662 (11.0%) were seropositive for IgG against SARS-CoV-2 (39.4% asymptomatic). Adding available PCR-testing, 713 (11.8%) employees showed evidence of previous SARS-CoV-2 infection. However, before antibody testing, 482 of them (67%) had no previous diagnosis of SARS-CoV-2-infection. Seroprevalence was higher in high- and moderate-risk exposure (12.1 and 11.4%, respectively) compared with low-grade risk subjects (7.2%), and in Madrid (13.8%) compared with Barcelona (7.6%) and Coruña (2.0%). High-risk [odds ratio (OR): 2.06; 95% confidence interval (CI): 1.63–2.62] and moderate-risk (OR: 1.77; 95% CI: 1.32–2.37) exposures were associated with positive IgG-SARS-CoV-2 antibodies after adjusting for region, age and sex. Higher antibody titres were observed in moderate–severe disease (median antibody-titre: 13.7 AU/mL) compared with mild (6.4 AU/mL) and asymptomatic (5.1 AU/mL) infection, and also in older (>60 years: 11.8 AU/mL) compared with younger (<30 years: 4.2 AU/mL) people.

Conclusions

Seroprevalence of IgG-SARS-CoV-2 antibodies in HCW is a little higher than in the general population and varies depending on regional COVID-19 incidence. The high rates of subclinical and previously undiagnosed infection observed in this study reinforce the utility of antibody screening. An occupational risk for SARS-CoV-2 infection related to working in a clinical environment was demonstrated in this HCW cohort.
The Burden of and Trends in Pelvic Inflammatory Disease in the United States, 2006–2016
Authors: Kreisel Kristen M , Llata Eloisa , Haderxhanaj Laura , Pearson William S , Tao Guoyu , Wiesenfeld Harold C , Torrone Elizabeth A
Published: December 2020

Background

Pelvic inflammatory disease (PID) is an infection of the upper genital tract that has important reproductive consequences to women. We describe the burden of and trends in PID among reproductive-aged women in the United States during 2006–2016.

Methods

We used data from 2 nationally representative probability surveys collecting self-reported PID history (National Health and Nutrition Examination Survey, National Survey of Family Growth); 5 datasets containing International Classification of Diseases, Ninth/Tenth Revision codes indicating diagnosed PID (Healthcare Utilization Project; National Hospital Ambulatory Medical Care Survey, emergency department component; National Ambulatory Medical Care Survey; National Disease Therapeutic Index; MarketScan); and data from a network of sexually transmitted infection (STI) clinics (Sexually Transmitted Disease Surveillance Network). Trends during 2006–2016 were estimated overall, by age group and, if available, race/ethnicity, region, and prior STIs.

Results

An estimated 2 million reproductive-aged women self-reported a history of PID. Three of 4 nationally representative data sources showed overall declines in a self-reported PID history, and PID emergency department and physician office visits, with small increases observed in nearly all data sources starting around 2015.

Conclusions

The burden of PID in the United States is high. Despite declines in burden over time, there is evidence of an increase in recent years.
Risk for Clostridioides difficile Infection Among Hospitalized Patients Associated With Multiple Healthcare Exposures Prior to Admission
Authors: Miller Aaron C , Sewell Daniel K , Segre Alberto M , Pemmaraju Sriram V , Polgreen Philip M
Published: December 2020

Background

Clostridioides difficile infection (CDI) is a common healthcare-associated infection and is often used as an indicator of hospital safety or quality. However, healthcare exposures occurring prior to hospitalization may increase risk for CDI. We conducted a case-control study comparing hospitalized patients with and without CDI to determine if healthcare exposures prior to hospitalization (ie, clinic visits, antibiotics, family members with CDI) were associated with increased risk for hospital-onset CDI, and how risk varied with time between exposure and hospitalization.

Methods

Records were collected from a large insurance-claims database from 2001 to 2017 for hospitalized adult patients. Prior healthcare exposures were identified using inpatient, outpatient, emergency department, and prescription drug claims; results were compared between various CDI case definitions.

Results

Hospitalized patients with CDI had significantly more frequent healthcare exposures prior to admission. Healthcare visits, antibiotic use, and family exposures were associated with greater likelihood of CDI during hospitalization. The degree of association diminished with time between exposure and hospitalization. Results were consistent across CDI case definitions.

Conclusions

Many different prior healthcare exposures appear to increase risk for CDI presenting during hospitalization. Moreover, patients with CDI typically have multiple exposures prior to admission, confounding the ability to attribute cases to a particular stay.
Patient and clinician experience with a rapidly implemented large-scale video consultation program during COVID-19
Authors: BARKAI Galia , GADOT Moran , AMIR Hadar , MENASHE Michal , SHVIMER-ROTHSCHILD Lilach , ZIMLICHMAN Eyal
Published: December 2020

Background

The coronavirus disease 2019 (COVID-19) pandemic has forced health-care providers to find creative ways to allow continuity of care in times of lockdown. Telemedicine enables provision of care when in-person visits are not possible. Sheba Medical Center made a rapid transition of outpatient clinics to video consultations (VC) during the first wave of COVID-19 in Israel.

Objective

Results of a survey of patient and clinician user experience with VC are reported.

Methods

Satisfaction surveys were sent by text messages to patients, clinicians who practice VC (users) and clinicians who do not practice VC (non-users). Questions referred to general satisfaction, ease of use, technical issues and medical and communication quality. Questions and scales were based on surveys used regularly in outpatient clinics of Sheba Medical Center.

Results

More than 1200 clinicians (physicians, psychologists, nurses, social workers, dietitians, speech therapists, genetic consultants and others) provided VC during the study period. Five hundred and forty patients, 162 clinicians who were users and 50 clinicians who were non-users completed the survey. High level of satisfaction was reported by 89.8% of patients and 37.7% of clinician users. Technical problems were experienced by 21% of patients and 80% of clinician users. Almost 70% of patients but only 23.5% of clinicians found the platform very simple to use. Over 90% of patients were very satisfied with clinician’s courtesy, expressed a high sense of trust, thought that clinician’s explanations and recommendations were clear and estimated that the clinician understood their problems and 86.5% of them would recommend VC to family and friends. Eighty-seven percent of clinician users recognize the benefit of VC for patients during the COVID-19 pandemic but only 68% supported continuation of the service after the pandemic.

Conclusion

Our study reports high levels of patient satisfaction from outpatient clinics VC during the COVID-19 pandemic. Lower levels of clinician satisfaction can mostly be attributed to technical and administrative challenges related to the newly implemented telemedicine platform. Our findings support the continued future use of VC as a means of providing patient-centered care. Future steps need to be taken to continuously improve the clinical and administrative application of telemedicine services.
Burkitt’s lymphoma: an unexpected cause of dental pain
Authors: Parker William D , Jones Keith
Published: December 2020

We would like to describe a case of Burkitt’s lymphoma in a 37-year-old lady, who initially presented to her General Dental Practitioner (GDP) complaining of pain and episodic numbness in the right lip and chin. The initial diagnosis was irreversible pulpitis of the lower right second molar (LR7) and despite having an extraction of the affected tooth her problems persisted. The patient also developed pain in the spine and limbs, accompanied by lethargy and weakness.

After seeing multiple different practitioners, she was referred to her local Oral and Maxillofacial Surgery department. Cross-sectional imaging was requested and demonstrated disseminated malignancy. Histology following open trans-oral biopsy revealed a diagnosis of Burkitt’s lymphoma prompting an urgent haematology referral, and she successfully completed a chemotherapy regimen. This case highlights the importance of a thorough diagnostic process in the presence of persistent and/or atypical symptoms.
Leaf elongation response to blue light is mediated by stomatal-induced variations in transpiration in Festuca arundinacea
Authors: Barillot Romain , De Swaef Tom , Combes Didier , Durand Jean-Louis , Escobar-Gutiérrez Abraham J , Martre Pierre , Perrot Cédric , Roy Eric , Frak Elzbieta
Published: December 2020

Reduced blue light irradiance is known to enhance leaf elongation rate (LER) in grasses, but the mechanisms involved have not yet been elucidated. We investigated whether leaf elongation response to reduced blue light could be mediated by stomata-induced variations of plant transpiration. Two experiments were carried out on tall fescue in order to monitor LER and transpiration under reduced blue light irradiance. Additionally, LER dynamics were compared with those observed in the response to vapour pressure deficit (VPD)-induced variations of transpiration. Finally, we developed a model of water flow within a tiller to simulate the observed short-term response of LER to various transpiration regimes. LER dramatically increased in response to blue light reduction and then reached new steady states, which remained higher than the control. Reduced blue light triggered a simultaneous stomatal closure which induced an immediate decrease of leaf transpiration. The hydraulic model of leaf elongation accurately predicted the LER response to blue light and VPD, resulting from an increase in the growth-induced water potential gradient in the leaf growth zone. Our results suggest that the blue light signal is sensed by stomata of expanded leaves and transduced to the leaf growth zone through the hydraulic architecture of the tiller.
Inverse energy transfer in decaying, three-dimensional, non-helical magnetic turbulence due to magnetic reconnection
Authors: Bhat Pallavi , Zhou Muni , Loureiro Nuno F
Published: December 2020

It has been recently shown numerically that there exists an inverse transfer of magnetic energy in decaying, non-helical, magnetically dominated, magnetohydrodynamic turbulence in three dimensions (3D). We suggest that magnetic reconnection is the underlying physical mechanism responsible for this inverse transfer. In the two-dimensional (2D) case, the inverse transfer is easily inferred to be due to smaller magnetic islands merging to form larger ones via reconnection. We find that the scaling behaviour is similar between the 2D and 3D cases, i.e. the magnetic energy evolves as t−1, and the magnetic power spectrum follows a slope of k−2. We show that on normalizing time by the magnetic reconnection time-scale, the evolution curves of the magnetic field in systems with different Lundquist numbers collapse on to one another. Furthermore, transfer function plots show signatures of magnetic reconnection driving the inverse transfer. We also discuss the conserved quantities in the system and show that the behaviour of these quantities is similar between the 2D and 3D simulations, thus making the case that the dynamics in 3D could be approximately explained by what we understand in 2D. Lastly, we also conduct simulations where the magnetic field is subdominant to the flow. Here, too, we find an inverse transfer of magnetic energy in 3D. In these simulations, the magnetic energy evolves as t−1.4 and, interestingly, a dynamo effect is observed.
Effective temperatures of red supergiants estimated from line-depth ratios of iron lines in the YJ bands, 0.97-1.32μm
Authors: Taniguchi Daisuke , Matsunaga Noriyuki , Jian Mingjie , Kobayashi Naoto , Fukue Kei , Hamano Satoshi , Ikeda Yuji , Kawakita Hideyo , Kondo Sohei , Otsubo Shogo , Sameshima Hiroaki , Takenaka Keiichi , Yasui Chikako
Published: December 2020

Determining the effective temperatures (Teff) of red supergiants (RSGs) observationally is important in many fields of stellar physics and galactic astronomy, yet some significant difficulties remain as a result of the model uncertainty, which originates mainly in the extended atmospheres of RSGs. Here we propose a line-depth ratio (LDR) method in which we use only Fe i lines. As opposed to the conventional LDR method, in which lines of multiple species are involved, this LDR method is insensitive to surface gravity effects and is expected to circumvent the uncertainty originating in the upper atmosphere of RSGs. Therefore, the LDR–Teff relationships that we calibrated empirically with red giants can be directly applied to RSGs, although various differences between the two groups of objects, for example caused by 3D non-local thermodynamic equilibrium (non-LTE) effects, need to be kept in mind. Using the near-infrared YJ-band spectra of nine well-known solar-metallicity red giants observed with the WINERED high-resolution spectrograph, we selected 12 pairs of Fe i lines that were the least contaminated with other lines. After applying their LDR–Teff relation to 10 nearby RSGs, the resulting Teff with an internal precision of $30\!-\!70\, \mathrm{K}$ shows good agreement with previous observational results assuming 1D LTE and with the Geneva stellar evolution model. We found no evidence of significant systematic bias caused by various differences, including those in the size of the non-LTE effects, between red giants and RSGs, except for one line pair that we rejected because the non-LTE effects may be as large as $\sim \! 250\, \mathrm{K}$. Nevertheless, it is difficult to evaluate the systematic bias, and further study is required, for example including the 3D non-LTE calculations of all the lines involved.
Using Optical Spectroscopy to Map the Geometry and Structure of the Irradiated Accretion Discs in Low-mass X-ray Binaries: The Pilot-Study of MAXI J0637−430
Authors: Tetarenko B E , Shaw A W , Manrow E R , Charles P A , Miller J M , Russell T D , Tetarenko A J
Published: December 2020

The recurring transient outbursts in low-mass X-ray binaries (LMXBs) provide us with strong test-beds for constraining the poorly understood accretion process. While impossible to image directly, phase-resolved spectroscopy can provide a powerful diagnostic to study their highly complex, time-dependent accretion discs. We present an 8-month long multi-wavelength (UV, optical, X-ray) monitoring campaign of the new candidate black hole LMXB MAXI J0637−430 throughout its 2019/2020 outburst, using the Neil Gehrels Swift Observatory, as well as three quasi-simultaneous epochs of Gemini/GMOS optical spectroscopy. We find evidence for the existence of a correlation between the X-ray irradiation heating the accretion disc and the evolution of the He ii 4686 Å emission line profiles detected in the optical spectra. Our results demonstrate a connection between the line emitting regions and physical properties of the X-ray irradiation heating the discs during outburst cycles of LMXBs. Further, we are able to show that changes in the physical properties of the irradiation heating the disc in outburst can be imprinted within the H/He emission line profiles themselves in these systems.
Like Wings of a Bird: Functional Divergence and Complementarity between HLA-A and HLA-B Molecules
Authors: Di Da , Nunes Jose Manuel , Jiang Wei , Sanchez-Mazas Alicia
Published: December 2020

Human leukocyte antigen (HLA) genes are among the most polymorphic of our genome, as a likely consequence of balancing selection related to their central role in adaptive immunity. HLA-A and HLA-B genes were recently suggested to evolve through a model of joint divergent asymmetric selection conferring all human populations, including those with severe loss of diversity, an equivalent immune potential. However, the mechanisms by which these two genes might undergo joint evolution while displaying very distinct allelic profiles in populations are still unknown. To address this issue, we carried out extensive data analyses (among which factorial correspondence analysis and linear modeling) on 2,909 common and rare HLA-A, HLA-B, and HLA-C alleles and 200,000 simulated pathogenic peptides by taking into account sequence variation, predicted peptide-binding affinity and HLA allele frequencies in 123 populations worldwide. Our results show that HLA-A and HLA-B (but not HLA-C) molecules maintain considerable functional divergence in almost all populations, which likely plays an instrumental role in their immune defense. We also provide robust evidence of functional complementarity between HLA-A and HLA-B molecules, which display asymmetric relationships in terms of amino acid diversity at both inter- and intraprotein levels and in terms of promiscuous or fastidious peptide-binding specificities. Like two wings of a flying bird, the functional complementarity of HLA-A and HLA-B is a perfect example, in our genome, of duplicated genes sharing their capacity of assuming common vital functions while being submitted to complex and sometimes distinct environmental pressures.
A supernumerary designer chromosome for modular in vivo pathway assembly in Saccharomyces cerevisiae
Authors: Postma Eline D , Dashko Sofia , van Breemen Lars , Taylor Parkins Shannara K , van den Broek Marcel , Daran Jean-Marc , Daran-Lapujade Pascale
Published: December 2020

The construction of microbial cell factories for sustainable production of chemicals and pharmaceuticals requires extensive genome engineering. Using Saccharomyces cerevisiae, this study proposes synthetic neochromosomes as orthogonal expression platforms for rewiring native cellular processes and implementing new functionalities. Capitalizing the powerful homologous recombination capability of S. cerevisiae, modular neochromosomes of 50 and 100 kb were fully assembled de novo from up to 44 transcriptional-unit-sized fragments in a single transformation. These assemblies were remarkably efficient and faithful to their in silico design. Neochromosomes made of non-coding DNA were stably replicated and segregated irrespective of their size without affecting the physiology of their host. These non-coding neochromosomes were successfully used as landing pad and as exclusive expression platform for the essential glycolytic pathway. This work pushes the limit of DNA assembly in S. cerevisiae and paves the way for de novo designer chromosomes as modular genome engineering platforms in S. cerevisiae.
Arabidopsis mTERF9 protein promotes chloroplast ribosomal assembly and translation by establishing ribonucleoprotein interactions in vivo
Authors: Méteignier Louis-Valentin , Ghandour Rabea , Zimmerman Aude , Kuhn Lauriane , Meurer Jörg , Zoschke Reimo , Hammani Kamel
Published: December 2020

The mitochondrial transcription termination factor proteins are nuclear-encoded nucleic acid binders defined by degenerate tandem helical-repeats of ∼30 amino acids. They are found in metazoans and plants where they localize in organelles. In higher plants, the mTERF family comprises ∼30 members and several of these have been linked to plant development and response to abiotic stress. However, knowledge of the molecular basis underlying these physiological effects is scarce. We show that the Arabidopsis mTERF9 protein promotes the accumulation of the 16S and 23S rRNAs in chloroplasts, and interacts predominantly with the 16S rRNA in vivo and in vitro. Furthermore, mTERF9 is found in large complexes containing ribosomes and polysomes in chloroplasts. The comprehensive analysis of mTERF9 in vivo protein interactome identified many subunits of the 70S ribosome whose assembly is compromised in the null mterf9 mutant, putative ribosome biogenesis factors and CPN60 chaperonins. Protein interaction assays in yeast revealed that mTERF9 directly interact with these proteins. Our data demonstrate that mTERF9 integrates protein-protein and protein-RNA interactions to promote chloroplast ribosomal assembly and translation. Besides extending our knowledge of mTERF functional repertoire in plants, these findings provide an important insight into the chloroplast ribosome biogenesis.
Clinical features of acute kidney injury in patients receiving dabrafenib and trametinib
Authors: Seethapathy Harish , Lee Meghan D , Strohbehn Ian A , Efe Orhan , Rusibamayila Nifasha , Chute Donald F , Colvin Robert B , Rosales Ivy A , Fadden Riley M , Reynolds Kerry L , Sullivan Ryan J , Kaufman Howard L , Jhaveri Kenar D , Sise Meghan E
Published: December 2020

Background

Our objective was to characterize the incidence, risk factors and clinical features of acute kidney injury (AKI) in patients receiving dabrafenib and trametinib.

Methods

We performed a retrospective cohort study examining the kidney outcomes of patients in a large healthcare system who received dabrafenib/trametinib between 2010 and 2019. The primary outcome was AKI, defined as a 1.5-fold increase in serum creatinine from baseline within a 12-month study period. AKI severity and etiology was determined for each case by chart review. Logistic regression was used to evaluate baseline predictors of AKI.

Results

A total of 199 patients who received dabrafenib in our healthcare system from 2010 to 2019 were included in the analysis. Forty-two patients (21%) experienced AKI within 12 months; 10 patients (5% of the total cohort, 24% of AKI patients) experienced AKI occurring during a dabrafenib/trametinib-induced febrile syndrome characterized by fever, chills, gastrointestinal symptoms and elevated liver enzymes. Preexisting liver disease was the only significant predictor of AKI in the cohort. One patient had biopsy-proven granulomatous acute interstitial nephritis that resolved with corticosteroids.

Conclusions

Oncologists and nephrologists should be aware that AKI is common after dabrafenib/trametinib and a substantial number of cases occur in the setting of treatment-induced pyrexia.
Prosthetic Finger Joint Infection Due to Aspergillus terreus
Authors: Kobayashi Takaaki , Lawler Ericka , Samra Hasan , Ford Bradley , Sekar Poorani
Published: December 2020

Fungal periprosthetic joint infections (PJIs) are rare but associated with significant mortality. We report a case of a finger PJI secondary to Aspergillus terreus in an immunocompetent patient with soil exposure, successfully treated with surgical debridement and voriconazole. Identification of A terreus is important because of intrinsic amphotericin B resistance.
Regional inequalities: causes and cures
Authors: Cörvers Frank , Mayhew Ken
Published: December 2020

Significant regional inequalities of income and wealth exist in every Western European country and in North America, but their extent varies from country to country. In both Europe and the US, it is generally thought that they tended to narrow from the early 1900s until about 1980, since when they have widened. This widening has become associated with the rise of populism, while the Covid-19 crisis has thrown regional disadvantage into sharp relief. This article discusses measurement issues, traces developments over time, and explores the social and economic consequences of regional disparities. It describes the evolution of regional policy, and in particular the move to more localized approaches in Europe, analysing their strengths and weaknesses.
Designing trials of Universal Basic Income for health impact: identifying interdisciplinary questions to address
Authors: Johnson Matthew Thomas , Johnson Elliott Aidan , Nettle Daniel , Pickett Kate E
Published: December 2020

Background

A large body of evidence indicates the importance of upstream determinants to health. Universal Basic Income (UBI) has been suggested as an upstream intervention capable of promoting health by affecting material, biopsychosocial and behavioural determinants. Calls are emerging across the political spectrum to introduce an emergency UBI to address socioeconomic insecurity. However, although existing studies indicate effects on health through cash transfers, UBI schemes have not previously been designed specifically to promote health.

Methods

In this article, we scope the existing literature to set out a set of interdisciplinary research challenges to address in designing a trial of the effectiveness of UBI as a population health measure.

Results

We present a theoretical model of impact that identifies three pathways to health impact, before identifying open questions related to regularity, size of payment, needs-based supplements, personality and behaviour, conditionality and duration.

Conclusions

These results set, for the first time, a set of research activities required in order to maximize health impact in UBI programmes.
Dissecting the clinical heterogeneity of adult-onset Still’s disease: results from a multi-dimensional characterization and stratification
Authors: Berardicurti Onorina , Conforti Alessandro , Iacono Daniela , Pantano Ilenia , Caso Francesco , Emmi Giacomo , Grembiale Rosa Daniela , Cantatore Francesco Paolo , Atzeni Fabiola , Perosa Federico , Scarpa Raffaele , Guggino Giuliana , Ciccia Francesco , Giacomelli Roberto , Cipriani Paola , Ruscitti Piero
Published: December 2020

Objectives

To stratify adult-onset Still’s disease (AOSD) patients in distinct clinical subsets to be differently managed, by using a multi-dimensional characterization.

Methods

AOSD patients were evaluated by using a hierarchical unsupervised cluster analysis comprising age, laboratory markers systemic score and outcomes. The squared Euclidean distances between each pair of patients were calculated and put into a distance matrix, which served as the input clustering algorithm. Derived clusters were descriptively analysed for any possible difference.

Results

Four AOSD patients clusters were identified. Disease onset in cluster 1 was characterized by fever (100%), skin rash (92%) and arthritis (83%), with the highest ferritin levels [mean (S.D.) 14 724  (6837) ng/ml]. In cluster 2, the onset was characterized by fever (100%), arthritis (100%) and liver involvement (90%), together with the highest CRP levels [288.10  (46.01) mg/l]. The patients in cluster 3 presented with fever (100%), myalgia (96%) and sore throat (92%). The highest systemic score values [8.88  (1.70)] and the highest mortality rate (54.2%) defined cluster 3. Fever (100%) and arthritis (90%) were the symptoms at the onset in cluster 4, which was characterized by the lowest ferritin and CRP levels [1457  (1298) ng/ml and 54.98  (48.67) mg/l, respectively].

Conclusion

Four distinct phenotypic subgroups in AOSD could be suggested, possibly associated with different genetic background and pathogenic mechanisms. Our results could provide the basis for a precision medicine approach in AOSD in an attempt to find a clinical and laboratory multidimensional stratification and characterization, which would drive a tailored therapeutic approach in these patients.
About the model law for the CIS member states “On fiduciary management of property and trust”
Authors: Rudokvas Anton
Published: December 2020

On 22 November 2019, the Interparliamentary Assembly of the Commonwealth of Independent States adopted a model law for the CIS member states “On fiduciary management of property and trusts”. Its section on fiduciary management of property was inspired in a very high degree by innovative ideas of Professor M. Lupoi on such a functional surrogate device of “trusts” as the construction of “affidamento fiduciario”, already absorbed in the legislation of the Republic of San Marino and implemented in practice in Italy due to the principle of the freedom of contract. The section on trusts contains also some borrowings from foreign experience.
A Novel Disease of Mung Bean, Phytophthora Stem Rot Caused by a New Forma Specialis of Phytophthora vignae
Authors: Sun Feifei , Sun Suli , Yang Yong , Zhou Bin , Duan Canxing , Shan Weixing , Zhu Zhendong
Published: December 2020

An emerging soilborne disease resembling Phytophthora stem rot was observed on mung bean plants grown in Anhui, China. To identify the causal agent, diseased plants and soil samples from 13 fields were collected to isolate the pathogen. Twenty-two Phytophthora isolates were recovered from the samples and detailed identification was conducted. Based on morphological and molecular characterizations, all of the isolates were consistently identified as P. vignae. Phylogenetic analysis using eight nuclear loci sequences of the internal transcribed spacer region, rRNA gene large subunit, a partial sequence of the β-tubulin gene, translation elongation factor 1α, 60S ribosomal protein L10, the enolase gene, heat shock protein 90, and triose phosphate isomerase/glyceraldehyde-3-phosphate dehydrogenase and a mitochondrial locus cytochrome c oxidase subunit I revealed that the mung bean isolates grouped in the same clade as P. vignae and its two formae speciales, P. vignae f. sp. adzukicola and P. vignae f. sp. vignae. A host specificity test showed that the mung bean isolates of P. vignae were pathogenic toward mung bean with a much stronger virulence and toward adzuki bean with a relatively weak virulence, but they were nonpathogenic to the other tested legume crops, including soybean, cowpea, pea, common bean, faba bean, and chickpea. The host range of mung bean isolates significantly differs from those of P. vignae f. sp. adzukicola and P. vignae f. sp. vignae based on our results and on previous studies. Thus, the pathogen causing Phytophthora stem rot of mung bean is proposed as a new forma specialis of P. vignae, designated as P. vignae f. sp. mungcola.
The Genome Sequence of the Citrus Melanose PathogenDiaporthe citriand Two Citrus-RelatedDiaportheSpecies
Authors: Gai Yunpeng , Xiong Tao , Xiao Xiaoe , Li Pudong , Zeng Yating , Li Lei , Riely Brendan K. , Li Hongye
Published: December 2020

Melanose disease is one the most widely distributed and economically important fungal diseases of citrus worldwide. The causative agent is the filamentous fungus Diaporthe citri (syn. Phomopsis citri). Here, we report the genome assemblies of three strains of D. citri, namely strains ZJUD2, ZJUD14, and Q7, which were generated using a combination of PacBio Sequel long-read and Illumina paired-end sequencing data. The assembled genomes of D. citri ranged from 52.06 to 63.61 Mb in genome size, containing 15,977 to 16,622 protein-coding genes. We also sequenced and annotated the genome sequences of two citrus-related Diaporthe species, D. citriasiana and D. citrichinensis. In addition, a database for citrus-related Diaporthe genomes was established to provide a public platform to access genome sequences, genome annotation and comparative genomics data of these Diaporthe species. The described genome sequences and the citrus-related Diaporthe genomes database provide a useful resource for the study of fungal biology, pathogen−host interaction, molecular diagnostic marker development, and population genomic analyses of Diaporthe species. The database will be updated regularly when the genomes of newly isolated Diaporthe species are sequenced. The citrus-related Diaporthe genomes database is freely available for nonprofit use at zjudata.com/blast/diaporthe.php .
Clinical and Economic Impact of Wound Care Using a Polyurethane Foam Multilayer Dressing
Authors: Tiscar-González Verónica , Menor-Rodríguez Maria José , Rabadán-Sainz Carlos , Fraile-Bravo Mercedes ,   The Life Group, Styche Tim , Valenzuela-Ocaña Francisco José , Muñoz-García Leticia
Published: December 2020

OBJECTIVE

To study the impact of a newly introduced dressing on efficiency and quality of care in routine clinical practice in a Spanish community setting.

DESIGN AND SETTING

An ambispective multicenter observational study was conducted in 24 primary care centers and 6 nursing homes in 4 different Spanish regions. The study was carried out between November 2017 and March 2019.

PATIENTS AND INTERVENTION

A total of 128 wounds in 94 patients (primary care, n = 79; nursing home, n = 15) were analyzed before and 4 weeks after switching to the study dressing.

OUTCOME MEASURES

Frequency of dressing changes; secondary outcomes were change in the mean wound area and weekly cost and patient and provider satisfaction.

MAIN RESULTS

The mean number of dressing changes was significantly reduced with the study dressing from 3.14 ± 1.77 changes per week to 1.66 ± 0.87 (P < .001), a 47.1% reduction in frequency. Wound area significantly reduced from 9.90 ± 19.62 cm2 to 7.10 ± 24.33 cm2. In addition, a 58.7% reduction in weekly costs was achieved with the intervention. Patients and providers agreed that their satisfaction with wound care improved.

CONCLUSIONS

The use of the study dressing in routine clinical practice could lead to a major improvement in both efficiency and quality of wound care. Its use could reduce wound care-related costs through improvements in healing and a reduced frequency of dressing changes. It also enhanced the wound care experience from the perspective of both patients and providers.
Postoperative delirium – treatment and prevention
Authors: Duning Thomas , Ilting-Reuke Katharina , Beckhuis Mara , Oswald Daniel
Published: December 2020

Purpose of review

Postoperative delirium (POD) is one of the most severe complications after surgery.

The consequences are dramatic: longer hospitalization, a doubling of mortality and almost all cases develop permanent, yet subtle, cognitive deficits specific to everyday life. Actually, no global guideline with standardized concepts of management exists. Advances in prevention, diagnosis and treatment can improve recognition and risk stratification of delirium and its consequences.

Recent findings

Management of POD is a multiprofessional approach and consists of different parts: First, the detection of high-risk patients with a validated tool, preventive nonpharmacological concepts and an intraoperative anesthetic management plan that is individualized to the older patient (e.g. avoiding large swings in blood pressure, vigilance in maintaining normothermia, ensuring adequate analgesia and monitoring of anesthetic depth). In addition to preventive standards, treatment and diagnostic concepts must also be available, both pharmaceutical and nonpharmacological.

Not every POD can be prevented. It is important to detect patients with high risk for POD and have standardized concepts of management. The most important predisposing risk factors are a higher age, preexisting cognitive deficits, multimorbidity and an associated prodelirious polypharmacy. In view of demographic change, the implementation of multidisciplinary approaches to pharmacological and nonpharmacological POD management is highly recommended.
Prevent deterioration and long-term ventilation: intensive care following thoracic surgery
Authors: Kalbhenn Johannes
Published: December 2020

Purpose of review

Patients with indication for lung surgery besides the pulmonary pathology often suffer from independent comorbidities affecting several other organ systems. Preventing patients from harmful complications due to decompensation of underlying organ insufficiencies perioperatively is pivotal. This review draws attention to the peri- and postoperative responsibility of the anaesthetist and intensivist to prevent patients undergoing lung surgery deterioration.

Recent findings

During the last decades we had to accept that ‘traditional’ intensive care medicine implying deep sedation, controlled ventilation, liberal fluid therapy, and broad-spectrum antimicrobial therapy because of several side-effects resulted in prolongation of hospital length of stay and a decline in quality of life. Modern therapy therefore should focus on the convalescence of the patient and earliest possible reintegration in the ‘life-before.’ Avoidance of sedative and anticholinergic drugs, early extubation, prophylactic noninvasive ventilation and high-flow nasal oxygen therapy, early mobilization, well-adjusted fluid balance and reasonable use of antibiotics are the keystones of success.

A perioperative interprofessional approach and a change in paradigms are the prerequisites to improve outcome and provide treatment for elder and comorbid patients with an indication for thoracic surgery.
Immunopathogenesis of skin injury in systemic lupus erythematosus
Authors: Hile Grace A. , Kahlenberg J. Michelle
Published: December 2020

Purpose of review

Skin injury is the most common clinical manifestation of SLE and is disfiguring, difficult to treat, and incompletely understood. We provide an overview of recently published articles covering the immunopathogenesis of skin injury in SLE

Recent findings

Skin of SLE has an inherent susceptibility to apoptosis, the cause of which may be multifactorial. Chronic IFN overexpression leads to barrier disruption, infiltration of inflammatory cells, cytokine production, and release of autoantigens and autoantibody production that result in skin injury. Ultraviolet light is the most important CLE trigger and amplifies this process leading to skin inflammation and potentially systemic disease flares.

The pathogenesis of skin injury in CLE is complex but recent studies highlight the importance of mechanisms driving dysregulated epidermal cell death likely influenced by genetic risk factors, environmental triggers (UV light), and cytotoxic cells and cellular signaling.
Range of motion following percutaneous fixation of pediatric supracondylar humerus fracture is independent of anterior osseous fragment resorption
Authors: Silverstein Rachel S. , Meltsakos Christopher P. , Dedhia Nicket , Lynch Brian C. , Lucas Paul A. , Asprinio David E. , Cristofaro Robert L.
Published: December 2020

The objective of this study was to understand postoperative resorption of the anterior osseous fragment following closed reduction and percutaneous pinning (CRPP) of pediatric supracondylar humerus fractures and its effect on final range of motion (ROM). Eighty-six patients that underwent CRPP had sagittal and or axial plane deformities resulting in an anterior fragment. Humerocapitellar angle (HCA), anterior humeral line (AHL) and angle of rotation (AoR) were measured. A total of 11 (12.8%) patients failed to resorb the anterior fragment, 10 (90.9%) had satisfactory ROM. HCA initially was acceptable in 40 (46.5%) patients, and 37 (92.5%) demonstrated acceptable ROM. Final HCA was acceptable in 44 (51.2%) patients and 42 (95.4%) had acceptable final ROM. AHL was in the anterior third of the capitellum in 35 (40.6%) patients and 33 (94.3%) had acceptable ROM. Final AHL was in the anterior third of the capitellum in 43 (50.0%) patients and 41 (95.3%) had acceptable final ROM. No difference was found between acceptable ROM and HCA or AHL at either follow-up. Sixty-five and 21 patients had an AoR of 0° and between 23 and 36°, respectively. A total of 59 (90.7%) patients with an AoR of 0°, and 18 (85.7%) patients with an AoR of 23–36° displayed acceptable ROM. A total of 57 (87.7%) patients with an AoR of 0° and 18 (85.7%) with an AoR of 23–36° resorbed the anterior fragment. No association was found between rotational deformity and postoperative ROM or fragment resorption. Postoperative sagittal and axial plane alignment, HCA, AHL, AoR and resorption of the anterior osseous fragment does not correlate with final ROM.
Results after treatment of congenital radioulnar synostosis: a systematic review and pooled data analysis
Authors: Barik Sitanshu , Farr Sebastian , Gallone Giovanni , Zarantonello Paola , Trisolino Giovanni , Di Gennaro Giovanni L.
Published: December 2020

Congenital radioulnar synostosis (CRUS) is one of the most common congenital disorders affecting the elbow and forearm, with the forearm being fixed in a range of positions usually varying from neutral rotation to severe pronation. The aim of this study, apart from a systematic review of all surgical procedures described for CRUS, is to derive any correlation between various influencing factors, outcomes and complications. This review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses format by an electronic literature search of Ovid, MEDLINE and the Cochrane Library databases. Grading was according to the Newcastle-Ottawa scale and the Modified Coleman Methodology Score. Demographic data, surgical procedures, outcomes and complications were analyzed. Outcome data were pooled to establish means and ranges across all studies. Spearman correlations were performed. A total of 23 articles, showing a poor overall study quality (all Level of Evidence IV), met the inclusion criteria. A total of 374 forearms with a mean age of 6.7 years (2.0–18.8) were analyzed. Derotational surgeries were more commonly performed (91%) than motion-preserving surgeries (9%). The mean deformity improved from 64.8° pronation (−75° to 110°) to a mean of 2.8° pronation (−50° to 80°). In total, 17.9% of patients presented with complications. A significant correlation was noted between age and major complications, proximal osteotomies and complications, and postoperative loss of reduction and double level osteotomies as the primary treatment modality. Most of the complications occurred above the threshold of 65–70° of correction and in children 7 years and above. Surgery is essential to improve the quality of life of children with CRUS. However, each type of surgery is associated with complications, along with the respective hardware being used in rotation osteotomies. Caution is, nevertheless, warranted in interpreting these results in view of the inherent limitations of the included studies.
Translation, Cross-cultural Adaptation and Psychometric Evaluation of the Hausa Roland-Morris Disability Questionnaire in Mixed Rural and Urban Nigerian Populations with Low Back Pain
Authors: Raheem Sarafadeen , Ibrahim Aminu A. , Ganiyu Sokunbi O. , Faruk Abdulmanaf U. , Akindele Mukadas O.
Published: December 2020

Study Design.

Cross-cultural adaptation and cross-sectional study.

Objective.

The aim of this study was to translate and cross-culturally adapt the Roland-Morris Disability Questionnaire (RMDQ) into Hausa language, and evaluate its psychometric properties in mixed rural and urban populations with low back pain (LBP).

Summary of Background Data.

The RMDQ is one of the most commonly used and recommended condition-specific measures of disability related to LBP. However, no formal adapted and validated Hausa version exists at the time our study was initiated.

Methods.

The Hausa version of the RMDQ (Hausa-RMDQ) was developed according to established guidelines. Psychometric properties were evaluated in 125 patients with LBP recruited from rural and urban Nigerian clinics. Internal consistency (Cronbach's α), test–retest reliability using Intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimal detectable change (MDC), and limits of agreement using Bland-Altman plots were calculated to evaluate reliability. Using Spearman's correlation for a priori hypotheses, the Hausa-RMDQ was correlated with Oswestry Disability Index (ODI) to evaluate concurrent validity, Numerical Pain Rating Scale (NPRS) to evaluate convergent validity, and age, educational level, and occupational status to evaluate divergent validity. Reliability and validity analyses were also conducted separately for rural and urban subgroups.

Results.

The Hausa-RMDQ had no major translation problems. The questionnaire had adequate internal consistency (α = 0.70), test–retest reliability (ICC = 0.79), minimal SEM (1.30) and MDC (3.60), and good agreement between test–retest values. The Hausa-RMDQ had a strong correlation with ODI (rho = 0.59), a moderate correlation with NPRS (rho = 0.46), and a null correlation with age, educational level, and occupational status (P > 0.05), thus confirming all the (5:5) a priori hypotheses constructed. These reliability and validity results were also replicated in the rural and urban subgroups.

Conclusion.

The Hausa-RMDQ was successfully developed and proved to be a reliable and valid measure of functional disability in Hausa culture. This questionnaire is recommended for future clinical and scientific research purposes.

Level of Evidence: 3