bluuebunny/crossref_metadata_2025 huggingface dataset:
Langerhans Cell Histiocytosis Associated With Renal Cell Carcinoma Is a Neoplastic Process
Authors: Agaimy Abbas , Bonert Michael , Naqvi Asghar , Wang Chunjie , Trpkov Kiril , Dettmar Peer , Wintzer Hanns-Olof , Stoehr Robert , Hes Ondřej , Williamson Sean R. , Gibson Ian W. , Hartmann Arndt
Published: September 2020

Langerhans cell histiocytosis (LCH) is a rare histiocytic disorder composed of Langerhans cells admixed with reactive mononuclear and granulocytic cells, associated with prominent eosinophils. LCH is considered a neoplasm, driven in most cases by oncogenic RAS/RAF/MEK/ERK pathway mutations. The disease predominantly affects children. Urinary system involvement has rarely been reported in a multisystem disease setting. We describe 7 patients who presented with LCH occurring within (6 cases) or after (1 case) a resected clear cell (n=6) or clear cell papillary (n=1) renal cell carcinoma (RCC), identified prospectively in our routine and consultation files (2012 to 2019). The patients included 5 women and 2 men, with a median age of 54 years (range, 39 to 73 y), none with a history of LCH or LCH manifestations before the time of RCC diagnosis. The median size of the RCC was 3.5 cm (range, 1.8 to 8.3 cm). Treatment included partial (5 cases), or radical (2 cases) nephrectomy. All RCCs on gross examination showed at least focal cystic changes and were low grade (World Health Organization [WHO]/International Society of Urologic Pathologists [ISUP] grade 1 to 2). The LCH foci were detected as incidental histological finding within the resected RCC in all six cases and they were limited to few high-power fields (<2 mm2) in 5 of 6 cases, but in the sixth case, they occupied almost the entire clear cell papillary RCC (2 cm nodule). No LCH manifestations were detected in the normal kidney or in perinephric fat. The seventh patient developed LCH within inguinal deep soft tissue followed by systemic manifestations 6 years after clear cell RCC. Langerhans cell immunophenotype was supported by the reactivity for S-100, CD1a, and langerin and by the negative pankeratin. Successful pyrosequencing of microdissected LCH DNA revealed the V600E BRAF mutation in all 6 cases of LCH within RCC. To our knowledge, only 3 similar cases were published since 1980; the only case tested for BRAF mutation showed wild-type BRAF. This is the first study analyzing the morphologic and genetic features of a cohort of LCH associated with RCC. In our experience, these cases may be underrecognized in practice, or may erroneously be diagnosed as RCC dedifferentiation or high-grade sarcomatoid transformation. Finally, the detection of BRAF mutation further confirms that LCH in this setting is indeed a neoplasm, rather than a reactive lesion.
Secondary Involvement of the Uterine Cervix by Nongynecologic Neoplasms
Authors: Turashvili Gulisa , Samore Wesley R. , Oliva Esther , Ioffe Olga , Riddell Robert , Park Kay J. , Horn Lars-Christian
Published: September 2020

Secondary involvement of the uterine cervix by nongynecologic neoplasms is rare accounting for <2% of metastases to the gynecologic tract. This study aimed to analyze the clinicopathologic features of cervical involvement by nongynecologic malignancies. A total of 47 cases were identified including 39 (83%) carcinomas, 6 lymphomas (12.8%), and 2 (4.2%) cutaneous malignant melanomas. The most common primary site of origin among carcinomas was the gastrointestinal tract (27, 69.2%), followed by breast and urothelium (5 each, 12.8%), gallbladder, and lung (1 each, 2.6%). The gynecologic tract was involved at the presentation in 16 patients (34%), including 5 (10.6%) with the cervix being the first site, 7 (14.9%) with synchronous involvement of the cervix and other gynecologic sites, and 4 (8.5%) with the involvement of other gynecologic sites before the cervical presentation. Patients with lymphoma were younger compared with those with carcinoma (43.7 vs. >50.5) (P=0.01). Mean time to identification of cervical metastases was <1 year for gallbladder carcinoma, melanomas, and gastrointestinal signet ring cell carcinomas (P=0.03). Features that varied with different types of metastatic tumor included lymphovascular space invasion, depth of stromal invasion, growth pattern (glands lacking architectural complexity, cribriforming, solid), presence of goblet cells, and signet ring cells, degree of cytologic atypia, and overall findings mimicking a benign/noninvasive process (P≤0.027). Six tumors (12.8%) were initially misdiagnosed as cervical primary. Metastatic nongynecologic tumors can mimic primary in situ or invasive neoplasms in both ectocervix and endocervix. In patients with a known prior malignancy, the clinical history with ancillary studies and a high level of suspicion are crucial to ensure accurate diagnosis.
Pseudocarcinomatous Squamous Hyperplasia Involving Bone
Authors: Spasić Smiljana , Kryvenko Oleksandr N. , Kerr Darcy A. , Nielsen Gunnlaugur P. , Gomez-Fernandez Carmen , Rosenberg Andrew E.
Published: September 2020

Background:

Pseudocarcinomatous squamous hyperplasia (PSH) within the bone is uncommon and closely mimics well-differentiated squamous cell carcinoma (SCC). It arises from cutaneous or mucosal surfaces and grows directly into the bone. This study analyzes a large series of PSH and discusses the clinicopathologic features that facilitate its distinction from SCC.

Design:

Cases were identified from the surgical pathology files between 1985 and 2020.

Results:

The 31 cases included 21 males, 9 females, 1 unknown sex; who were 20 to 87 years old (average: 59 y). Sites included mandible—17, maxilla—5, toes—4, and 1 case from finger, femur, tibia, ischium, and unknown. Fourteen patients had a history of SCC, 13 treated with resection and chemoradiation and developed infected osteoradionecrosis, 4—medication-related osteonecrosis, 3—peripheral vascular disease, and diabetes mellitus, 3—trauma, 3—osteomyelitis, 3—unknown, and 1—hematologic malignancy. All cases exhibited severe osteomyelitis and nests of reactive keratinizing squamous epithelium that matured towards the bone surface, lacked significant atypia, or mitotic activity but permeated the medullary cavity. Patients with previous SCC developed PSH after 2 months to 8 years (average: 4 y). Nineteen of 30 patients had follow-up (2 to 48 mo, average: 17 mo); 6 patients experienced repeated debridements over 2 months to 1 year; no patient developed SCC.

Conclusions:

PSH involving bone is infrequent, complicates severe osteomyelitis, and is often therapy related. The clinical findings are usually not concerning for malignancy, however, the histologic findings are an important diagnostic pitfall because they mimic SCC.
BRG1, INI1, and ARID1B Deficiency in Endometrial Carcinoma
Authors: Kihara Atsushi , Amano Yusuke , Matsubara Daisuke , Fukushima Noriyoshi , Fujiwara Hiroyuki , Niki Toshiro
Published: September 2020

Switch/sucrose nonfermenting complex subunits, such as BRG1, INI1, and ARID1B, are inactivated in a subset of endometrial undifferentiated carcinoma and dedifferentiated carcinoma (DC). Limited information is currently available on their prevalence in other subtypes or the nosological status of endometrial carcinoma with their deficiencies. This study immunohistochemically examined the expression status of BRG1, INI1, and ARID1B using 570 archived cases of endometrial carcinoma and carcinosarcoma resected at a single institution. We identified 1 BRG1-deficient undifferentiated carcinoma, 8 BRG1/INI1/ARID1B–deficient DC, and 3 BRG1-deficient clear-cell carcinomas. None of the cases of endometrioid and serous carcinomas or carcinosarcoma showed deficiencies of these subunits. We then compared 8 BRG1/INI1/ARID1B–deficient DC with 6 BRG1/INI1/ARID1B–intact DC and 28 carcinosarcomas, the latter of which was often confused with DC. Histologically, BRG1/INI1/ARID1B–intact and BRG1/INI1/ARID1B–deficient DC shared a monotonous solid appearance with rhabdoid and epithelioid cells and a myxoid stroma; however, abrupt keratinization and cell spindling was absent in BRG1/INI1/ARID1B–deficient tumors. The median overall survival of patients with BRG1/INI1/ARID1B–deficient DC was 3.8 months, which was worse than those with BRG1/INI1/ARID1B–intact DC (P=0.008) and with carcinosarcoma (P=0.004). BRG1/INI1/ARID1B–deficient DC may be a separate entity with an aggressive behavior to be distinguished from BRG1/INI1/ARID1B–intact DC and carcinosarcoma. Regarding clear-cell carcinoma (n=12), BRG1 deficiency appeared to be mutually exclusive with abnormal ARID1A, BRM, and p53 expression. Further studies are needed to clarify whether BRG1 deficiency plays a role in the pathogenesis of clear-cell carcinoma.
Corded and Hyalinized Endometrioid Adenocarcinoma (CHEC) of the Uterine Corpus are Characterized by CTNNB1 Mutations and Can Show Adverse Clinical Outcomes
Authors: Ladwig Nicholas R. , Umetsu Sarah E. , Zaloudek Charles , Rabban Joseph , Garg Karuna
Published: September 2020

Corded and hyalinized endometrioid adenocarcinoma (CHEC) is a morphologic variant of endometrioid adenocarcinoma that is typically low-grade [International Federation of Gynecology and Obstetrics (FIGO) grade 1–2]. CHEC exhibits a biphasic appearance with gland forming adenocarcinoma merging with a diffuse component with corded growth often in a hyalinized matrix; squamous differentiation is frequent and osteoid production can be seen. This morphologic appearance can invoke a large differential diagnosis including carcinosarcoma. CHEC is thought to be associated with good clinical outcome although the available data is sparse. We performed detailed clinical, morphologic, immunohistochemical, and molecular analyses on a cohort of 7 CHEC. Six cases exhibited features of classic low-grade CHEC while one case showed greater cytologic atypia (high-grade CHEC). Patient age ranged from 19 to 69 yr. Four patients presented at stage I, 2 at stage II, and 1 at stage III. All tumors demonstrated nuclear staining for beta-catenin and loss of E-cadherin in the corded and hyalinized component. There was relative loss of epithelial markers. Loss of PTEN and ARID1A was seen in 4 and 3 tumors, respectively, and 1 tumor displayed loss of MLH1 and PMS2. Next-generation sequencing revealed CTNNB1 and PI3K pathway mutations in all 7 cases with TP53 and RB1 alterations in the high-grade CHEC. Clinical follow-up was available for 6 patients; 2 died of disease (48 and 50 mo), 2 are alive with disease (both recurred at 13 mo), and 2 have no evidence of disease (13 and 77 mo). Our study shows that CHEC universally harbors CTNNB1 mutations with nuclear staining for beta-catenin, can rarely show high-grade cytology, and can be associated with adverse clinical outcomes.
Potentially Severe Incidents During Interhospital Transport of Critically Ill Patients, Frequently Occurring But Rarely Reported: A Prospective Study
Authors: Eiding Helge , Røise Olav , Kongsgaard Ulf E.
Published: September 2020

Objectives

The out-of-hospital environment can pose significant challenges to the quality and safety of interhospital transport of critically ill patients. Because we lack knowledge of the occurrence of incidents, their potential consequences, and whether they are actually reported, this study was initiated.

Methods

Two different services in Norway were asked to self-report incidents after every interhospital transport of critically ill patients. Sampling lasted for 12 and 8 months, respectively. An expert group evaluated each incident for severity and demand for reporting into the hospital’s electronic incident reporting system. One year later, the hospital’s reporting system was scrutinized to determine the number of incidents actually reported.

Results

A total of 455 transports of critically ill patients were performed, resulting in 294 unique incidents reported: medical (15%), technical (25%), missing equipment (17%), and personal failures and communication difficulties (42%). Only 3 (1%) of the 294 unique incidents were actually reported in the hospital’s electronic incident reporting system. The experts were inconsistent in which incidents should have been reported and to what degree checklists, standard operating procedures, simulation, and training could have prevented the incidents.

Conclusions

This study of interhospital transports of critically ill patients reveals a very high number of incidents. Despite this fact, these incidents are severely underreported in the hospital’s electronic incident reporting system. This suggests that learning is lost and errors with predominant probability are repeated. These results emphasize the existing challenges in regard to the quality and safety of interhospital transport of critically ill patients.
Viral suppression rates in a safety-net HIV clinic in San Francisco destabilized during COVID-19
Authors: Spinelli Matthew A. , Hickey Matthew D. , Glidden David V. , Nguyen Janet Q. , Oskarsson Jon J. , Havlir Diane , Gandhi Monica
Published: September 2020

The COVID-19 pandemic is expected to hinder US End the HIV Epidemic goals. We evaluated viral suppression and retention-in-care before and after telemedicine was instituted, in response to shelter-in-place mandates, in a large, urban HIV clinic. The odds of viral nonsuppression were 31% higher postshelter-in-place (95% confidence interval = 1.08–1.53) in spite of stable retention-in-care and visit volume, with disproportionate impact on homeless individuals. Measures to counteract the effect of COVID-19 on HIV outcomes are urgently needed.
Immunological and virological efficacy of different antiretroviral regimens initiated during acute/recent HIV infection
Authors: Ambrosioni Juan , Farrera Júlia , de Lazzari Elisa , Nicolás David , Manzardo Christian , Hernández-Meneses Marta M. , Mosquera María M. , Ligero Carmen , Marcos María A. , Sánchez-Palomino Sonsoles , Fernández Emma , Plana Montserrat , Miró José M.
Published: September 2020

Objectives:

Antiretroviral treatment (ART) during acute/recent HIV infection decreases transmission and optimizes immune recovery but the optimal ART-regimen in this setting is unknown. The objectives were to analyze the virological efficacy, immunological reconstitution and tolerability of different ART-regimens at 3 years after starting ART during acute/recent HIV infection.

Design:

Retrospective cohort study of consecutive acutely/recently infected patients who started ART within 6 months postinfection.

Methods:

We compared regimens based on protease-inhibitors (N = 28), integrase-strand-transfer-inhibitors (InSTI, N = 87) and nonnucleoside-reverse-transcriptase-inhibitors (N = 22). Virological suppression (viral load <50 copies/ml), immune reconstitution (CD4+ T-cell count >900 cells/μl and CD4+/CD8+ ratio >1) and adverse events leading to ART discontinuation at 1 and 3 years were compared.

Results:

Baseline characteristics were comparable among groups. Overall viral suppression at 1 (96%) and 3 years (99%) was comparable in all ART regimens and, InSTI group, comparable for dolutegravir and elvitegravir within InSTIs. CD4+ T-cell counts at 1 year were comparable in all ART regimens. Overall proportion of patients reaching CD4+ cell count more than 900 cells/μl and CD4+/CD8+ ratio more than 1 was 36% and 40% and 46% and 63% at 1 and 3 years, respectively with no differences among ART regimens. Starting ART during the earliest Fiebig stages (I–V vs. VI) was associated with higher rates of CD4+ cell count more than 900 cells/μl at 3 years (P = 0.027). Discontinuation due to adverse events was more frequent with nonnucleoside-reverse-transcriptase-inhibitors compared with other ART classes.

Conclusion:

Viral suppression and immunological recovery were excellent, with no differences between ART regimens. Earlier ART initiation was associated with a higher proportion of long-term immunological recovery.
Development and Implementation of Augmented Reality Enhanced High-Fidelity Simulation for Recognition of Patient Decompensation
Authors: Zackoff Matthew W. , Cruse Bradley , Sahay Rashmi D. , Fei Lin , Saupe Jennifer , Schwartz Jerome , Klein Melissa , Geis Gary L. , Tegtmeyer Ken
Published: September 2020

Introduction

Simulation is a core aspect of training and assessment; however, simulation laboratories are limited in their ability to visually represent mental, respiratory, and perfusion status. Augmented reality (AR) represents a potential adjunct to address this gap.

Methods

A prospective, observational pilot of interprofessional simulation assessing a decompensating patient was conducted from April to June 2019. Teams completed 2 simulations: (1) traditional training (TT) using a manikin (Laerdal SimJunior) and (2) AR-enhanced training (ART) using a manikin plus an AR patient. The primary outcome was self-assessed effectiveness at the assessment of patient decompensation. Secondary outcomes were attitudes toward and adverse effects during the AR training.

Results

Twenty-one simulation sessions included 84 participants in headsets. Participants reported improved ability to assess the patient's mental status, respiratory status, and perfusion status (all P < 0.0001) during ART in comparison to TT. Similar findings were noted for recognition of hypoxemia, shock, apnea, and decompensation (all P ≤ 0.0003) but not for recognition of cardiac arrest (P = 0.06). Most participants agreed or strongly agreed that ART accurately depicted a decompensating patient (89%), reinforced key components of the patient assessment (88%), and will impact how they care for patients (68%). Augmented reality–enhanced training was rated more effective than manikin training and standardized patients and equally as effective as bedside teaching.

Conclusions

This novel application of AR to enhance the realism of manikin simulation demonstrated improvement in self-assessed recognition of patient decompensation. Augmented reality may represent a viable modality for increasing the clinical impact of training.
A Simulation-Based Failure Mode Analysis of SARS-CoV-2 Infection Control and Prevention in Emergency Departments
Authors: Balmaks Reinis , Grāmatniece Alise , Vilde Aija , Ļuļļa Mārtiņš , Dumpis Uga , Gross Isabel Theresia , Šlēziņa Ieva
Published: September 2020

Background

Severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2, the causative agent of coronavirus disease 2019 (COVID-19)] outbreak has been declared a global pandemic by the World Health Organization. The COVID-19 pandemic has highlighted problems of sustainable infection prevention and control measures worldwide, particularly the emerging issues with an insufficient supply of personal protective equipment. The aim of this study was to provide an action plan for mitigation of occupational hazards and nosocomial spread of SARS-CoV-2 through a failure mode analysis based on observations during in situ simulations.

Methods

A multicenter, cross-sectional, observational, simulation-based study was performed in Latvia from March 2 to 26, 2020. This study was conducted at 7 hospitals affiliated with Riga Stradiņš University. The presentation of a COVID-19 patient was simulated with an in situ simulations, followed by a structured debrief. Healthcare Failure Modes and Effects Analysis is a tool for conducting a systematic, proactive analysis of a process in which harm may occur. We used Healthcare Failure Modes and Effects Analysis to analyze performance gaps and systemic issues.

Results

A total of 67 healthcare workers from 7 hospitals participated in the study (range = 4–17). A total of 32 observed failure modes were rated using a risk matrix. Twenty-seven failure modes (84.4%) were classified as either medium or high risk or were single-point weaknesses, hence evaluated for action type and action; 11 (40.7%) were related to organizational, 11 (40.7%) to individual, and 5 (18.5%) to environmental factors.

Conclusions

Simulation-based failure mode analysis helped us identify the risks related to the preparedness of the healthcare workers and emergency departments for the COVID-19 pandemic in Latvia. We believe that this approach can be implemented to assess and maintain readiness for the outbreaks of emerging infectious diseases in the future.
Ultra-mini Percutaneous Hepatolithotomy in Patients With Large and Multiple Hepatolithiasis
Authors: Öztürk Ahmet , Sönmez Mehmet Giray , Bakdik Süleyman , Ecer Gökhan , Altinkaya Nurullah , Ataseven Hüseyin , Aksoy Faruk
Published: September 2020

Background:

In this study, we applied the ultra-mini percutaneous hepatolithotomy (UM-PHL) technique on hepatolithiasis patients with multiple and large stones on which other minimally invasive methods failed, and our aim was to report its results, sharing in series for the first time.

Materials and Methods:

Preoperative and postoperative data, laboratory parameters, radiologic findings, and preoperative and postoperative details were recorded for a total of 14 patients for whom the UM-PHL technique was applied between April 2017 and December 2019. As all patients had multiple stones and extreme stone load and had bile duct surgery, they did not have a normal anatomy. All patients were radiologically confirmed to have had preprocedural magnetic retrograde cholangiopancreatography.

Results:

Operation duration of the patients was 137.6±44.9 minutes, while intraoperative blood loss was 69.2±24.9 mL, drainage catheter removal time was 2.85±0.86 days, and the hospitalization time was 4.28±2.55 days. Intraoperative balloon dilation was applied to enlarge the stricture area in 5 patients (35.7%). On the basis of the Clavien-Dindo classification, grade 2 complication was observed in 2 patients (14.2%) due to postoperative cholangitis. Patients were followed up for an average of 15 months, and nonsymptomatic radiologic stone recurrence was detected in the 12th month control of 1 patient (7.1%).

Conclusion:

The UM-PHL technique is a successful method that facilitates stone clearance by providing minimal dilatation through percutaneous intervention and by using instruments with small diameter, and it can safely be applied with its low complication level, low recurrence ratio, and short hospitalization time.
Using Digital Ethnography to Understand the Experience of Women With Pelvic Organ Prolapse
Authors: Gonzalez Gabriela , Vaculik Kristina , Khalil Carine , Zektser Yuliya , Arnold Corey , Almario Christopher V. , Spiegel Brennan M.R. , Anger Jennifer T.
Published: September 2020

Objective

To characterize the decision-making process and illness experience of women with pelvic organ prolapse (POP) using large-scale social media analysis.

Methods

Digital ethnographic analysis of online posts identified through data mining was performed. Grounded theory methodology was applied to 200 posts via traditional hand coding. To supplement our qualitative approach, we applied a Latent Dirichlet Allocation probabilistic topic modeling process to review the entire data set of identified posts to ensure thematic saturation.

Results

There were 3451 posts by 2088 unique users from 117 websites worldwide that were identified via social media data mining. We found that the anonymity of online forums allowed for information and support exchange among women with POP. Our analysis revealed that the exchange of online information aids in the decision-making process and, in some instances, appears to be the primary source of information. There was confusion about the anatomical and surgical complexities of prolapse. Our study also identified misconceptions, perceived risk factors, prevention methods, and management recommendations that were discussed online.

Conclusions

This large-scale online community-based analysis demonstrated the utility of social media to better understand women’s experiences with POP. Thematic findings highlighted essential concerns and challenges involved in the surgical decision-making process and the understating of the anatomical complexity of sector defects, specifically to cystocele, rectocele, State specific defects.
Operationalizing Postdischarge Recovery From Laparoscopic Sacrocolpopexy for the Preoperative Consultative Visit
Authors: Heit Michael , Carpenter Janet S. , Chen Chen X. , Rand Kevin L.
Published: September 2020

Objective

The objective was to establish a threshold for postdischarge surgical recovery from laparoscopic sacrocolpopexy for the preoperative consultative visit to answer the “what is my recovery time?” question.

Methods

Study participants (N = 171) with stage 2 or worse pelvic organ prolapse undergoing laparoscopic sacrocolpopexy who completed postoperative surveys at 4 time points. Postdischarge Surgical Recovery 13 (PSR13) scores were anchored to a Global Surgical Recovery (GSR) tool (if 100% recovery is back to your usual health, what percentage of recovery are you now?). Weighted mean PSR13 scores were calculated as a sum of the products variable when patients considered themselves 80 to less than 85, 85 to less than 90, 90 to less than 95, or 95 to 100 percent recovered on the GSR tool. The percentage of study participants recovered at postdischarge day 7, 14, 42, and 90 was calculated based on a comparison between the GSR scores and weighted mean PSR13 scores.

Results

A PSR13 score of 80 or greater, corresponding to 85% or greater recovery, was seen in 55.6% (42 days) and 50.9% (90 days) of study participants, respectively, establishing this numeric threshold as representing “significant” postdischarge recovery after laparoscopic sacrocolpopexy. At 14 days after discharge, only 16.4% of the study population achieved this PSR13 score.

Conclusions

Most study subjects were “significantly” recovered at 42 days after laparoscopic sacrocolpopexy using a PSR13 score of 80 or greater as a numeric threshold. There is a need to determine the population percentage of recovered study subjects at 30, 60, and beyond 90 days from laparoscopic sacrocolpopexy.
Composite Outcomes After Posterior Colporrhaphy With and Without Biologic Graft Augmentation
Authors: Winkelman William D. , Macharia Annliz , Bharadwa Sonya , Bharadwaj Maheetha , Hacker Michele R. , Rosenblatt Peter L.
Published: September 2020

Objectives

To compare subjective and objective failure after posterior colporrhaphy with and without biologic graft augmentation.

Methods

We conducted a retrospective chart review and telephone survey of patients who underwent a posterior colporrhaphy with and without biologic graft augmentation from 2005 to 2019. Patients who underwent a sacrocolpopexy, uterosacral ligament suspensions, or anterior sacrospinous ligament fixation were excluded. We determined objective, subjective, and composite failure rates.

Results

Although 137 patients met eligibility criteria, 56 did not have valid contact information and, therefore, were excluded from the study. Of the 81 with valid contact information, 67 (83%) agreed to participate. There were 24 (36%) who had a native tissue repair and 43 (64%) who had biologic graft augmentation. Median telephone follow-up was 73 months (interquartile range [IQR], 36–117). Objective failure was similar for the biologic graft (37%) and the native tissue (42%) groups (P = 0.72). Subjective failure was twice as likely among the biologic graft group (60%) compared with the native tissue group (33%, P = 0.03). Patients with a biologic graft reported a median Pelvic Floor Distress Inventory-Short Form 20 improvement of 31 (IQR, 8–33), while those with a native tissue repair reported a median improvement of 45 (IQR, 4–46). Overall, 78% were satisfied, 85% would recommend the procedure, and 84% reported symptomatic improvement. Reoperation occurred for 15% of patients.

Conclusion(s)

Although biologic graft-augmented posterior colporrhaphy may be a safe and effective treatment option, the use of biologic grafts in the posterior compartment does not appear to confer a significant long-term benefit to traditional posterior colporrhaphy.
Are affective factors related to individual differences in facial expression recognition?
Authors: Alharbi Sarah A. H. , Button Katherine , Zhang Lingshan , O'Shea Kieran J. , Fasolt Vanessa , Lee Anthony J. , DeBruine Lisa M. , Jones Benedict C.
Published: September 2020

Evidence that affective factors (e.g. anxiety, depression, affect) are significantly related to individual differences in emotion recognition is mixed. Palermo
et al
. (Palermo
et al
. 2018
J. Exp. Psychol. Hum. Percept. Perform.
44
, 503–517) reported that individuals who scored lower in anxiety performed significantly better on two measures of facial-expression recognition (emotion-matching and emotion-labelling tasks), but not a third measure (the multimodal emotion recognition test). By contrast, facial-expression recognition was not significantly correlated with measures of depression, positive or negative affect, empathy, or autistic-like traits. Because the range of affective factors considered in this study and its use of multiple expression-recognition tasks mean that it is a relatively comprehensive investigation of the role of affective factors in facial expression recognition, we carried out a direct replication. In common with Palermo
et al
. (Palermo
et al
. 2018
J. Exp. Psychol. Hum. Percept. Perform.
44
, 503–517), scores on the DASS anxiety subscale negatively predicted performance on the emotion recognition tasks across multiple analyses, although these correlations were only consistently significant for performance on the emotion-labelling task. However, and by contrast with Palermo
et al
. (Palermo
et al
. 2018
J. Exp. Psychol. Hum. Percept. Perform.
44
, 503–517), other affective factors (e.g. those related to empathy) often also significantly predicted emotion-recognition performance. Collectively, these results support the proposal that affective factors predict individual differences in emotion recognition, but that these correlations are not necessarily specific to measures of general anxiety, such as the DASS anxiety subscale.
Differences between and within individuals, and subprocesses of face cognition: implications for theory, research and personnel selection
Authors: Fysh Matthew C. , Stacchi Lisa , Ramon Meike
Published: September 2020

Recent investigations of individual differences have demonstrated striking variability in performance both
within
the same subprocess in face cognition (e.g. face perception), but also
between
two different subprocesses (i.e. face
perception
versus face
recognition
) that are assessed using different tasks (face
matching
versus face
memory
). Such differences between and within individuals between and within laboratory tests raise practical challenges. This applies in particular to the development of screening tests for the selection of personnel in real-world settings where faces are routinely processed, such as at passport control. The aim of this study, therefore, was to examine the performance profiles of individuals within and across two different subprocesses of face cognition: face perception and face recognition. To this end, 146 individuals completed four different tests of face matching—one novel tool for assessing proficiency in face perception, as well as three established measures—and two benchmark tests of face memory probing face recognition. In addition to correlational analyses, we further scrutinized individual performance profiles of the highest and lowest performing observers identified
per test
, as well as
across all tests
. Overall, a number of correlations emerged between tests. However, there was limited evidence at the individual level to suggest that high proficiency in one test generalized to other tests measuring the same subprocess, as well as those that measured a different subprocess. Beyond emphasizing the need to honour inter-individual differences through careful
multivariate
assessment in the laboratory, our findings have real-world implications: combinations of tests that most accurately map the task(s) and processes of interest are required for personnel selection.
Towards a reliable measure of motor working memory: revisiting Wu and Coulson's (2014) movement span task
Authors: Nicoladis Elena , Gagnon Rielle
Published: September 2020

Some researchers have argued that motor working memory is relatively independent from visuospatial working memory and underlies the learning and processing of motor tasks, like gesture comprehension. To allow systematic testing of these claims, Wu & Coulson 2014
Psychol. Sci.
26
, 1717–1727. (
doi:10.1177/0956797615597671
) proposed a novel measure of motor working memory, the movement span task. Some studies have reported that the movement span task has a high degree of validity. The purpose of the present study was to attempt to replicate Wu & Coulson 2014
Psychol. Sci.
26
, 1717–1727. (
doi:10.1177/0956797615597671
) in the following ways: (1) the high correlation between movement span and movement recall scores and (2) the lack of correlation between the movement span task on the one hand and visuospatial and verbal working memory on the other. In the present study, we found a high correlation between the movement span and recall scores as well as most measures of visuospatial memory. However, the size of these correlations was similar to that reported by Wu and Coulson, suggesting that the significance may be related to sample size. In other words, motor working memory may be weakly related to visuospatial memory. By contrast, there were weak correlations between the movement span task and verbal memory. In sum, we found the same pattern of results observed by Wu & Coulson 2014, 1717–1727. (
doi:10.1177/0956797615597671
).
Is either direct photolysis or photocatalysed H-shift of peroxyl radicals a competitive pathway in the troposphere?
Authors: Valiev Rashid R. , Kurten Theo
Published: September 2020

Peroxyl radicals (RO

O
.

) are key intermediates in atmospheric chemistry, with relatively long lifetimes compared to most other radical species. In this study, we use multireference quantum chemical methods to investigate whether photolysis can compete with well-established RO

O
.

sink reactions. We assume that the photolysis channel is always RO

O
.

+ h
ν
=> RO + O(
3
P). Our results show that the maximal value of the cross-section for this channel is
σ
= 1.3 × 10
−18
cm
2
at 240 nm for five atmospherically representative peroxyl radicals: CH
3
O

O
.

, C(O)HCH
2
O

O
.

, CH
3
CH
2
O

O
.

, HC(O)O

O
.

and CH
3
C(O)O

O
.

. These values agree with experiments to within a factor of 2. The rate constant of photolysis in the troposphere is around 10
−5
s
−1
for all five RO

O
.

. As the lifetime of peroxyl radicals in the troposphere is typically less than 100 s, photolysis is thus not a competitive process. Furthermore, we investigate whether or not electronic excitation to the first excited state (D
1
) by infrared radiation can facilitate various H-shift reactions, leading, for example, in the case of CH
3
O

O
.

to formation of

O
.

H and CH
2
O or HO

O
.

and CH
2
products. While the activation barriers for H-shifts in the D
1
state may be lower than in the ground state (D
0
), we find that H-shifts are unlikely to be competitive with decay back to the D
0
state through internal conversion, as this has a rate of the order of 10
13
s
−1
for all studied systems.
Biosynthesis, characterization and anti-dengue vector activity of silver nanoparticles prepared from
Azadirachta indica
and
Citrullus colocynthis
Authors: Rasool Shafqat , Raza Muhammad Akram , Manzoor Farkhanda , Kanwal Zakia , Riaz Saira , Iqbal Muhammad Javaid , Naseem Shahzad
Published: September 2020

We report here biosynthesis of silver nanoparticles (AgNPs) using aqueous extracts of (i)
Azadirachta indica
leaves and (ii)
Citrullus colocynthis
fruit and their larvicidal activity against
Aedes aegypti.
The UV–Vis spectroscopy absorption peaks occurred in the range of 412–416 nm for
A. indica
AgNPs and 416–431 nm for
C. colocynthis
AgNPs indicating the silver nature of prepared colloidal samples. The scanning electron microscopy examination revealed the spherical morphology of both types of NPs with average size of 17 ± 4 nm (
A. indica
AgNPs) and 26 ± 5 nm (
C. colocynthis
AgNPs). The X-ray diffraction pattern confirmed the face-centred cubic (FCC) structure with crystallite size of 11 ± 1 nm (
A. indica
AgNPs) and 15 ± 1 nm (
C. colocynthis
AgNPs) while characteristic peaks appearing in Fourier transform infrared spectroscopy analysis indicated the attachment of different biomolecules on AgNPs. The larvicidal activity at different concentrations of synthesized AgNPs (1–20 mg l
−1
) and extracts (0.5–1.5%) against
Aedes aegypti
was examined for 24 h. A concentration-dependent larvicidal potential of both types of AgNPs was observed. The LC
50
values were found to be 0.3 and 1.25 mg l
−1
for
C. colocynthis
AgNPs and
A. indica
AgNPs, respectively. However, both extracts did not exhibit any notable larvicidal activity.
Synthesis and
in vitro
anticancer activities of substituted
N
-(4′-nitrophenyl)-
l
-prolinamides
Authors: Osinubi Adejoke , Izunobi Josephat , Bao Xiaoguang , Asekun Olayinka , Kong Jiehong , Gui Chunshan , Familoni Oluwole
Published: September 2020

Prolinamides are present in secondary metabolites and have wide-ranging biological properties as well as antimicrobial and cytotoxic activities.
N
-(4′-substituted phenyl)-

l

-prolinamides
4a
–
4w
were synthesized in two steps, starting from the condensation of
p
-fluoronitrobenzene
1a
–
1b
with

l

-proline
2a
–
2b
, under aqueous–alcoholic basic conditions to afford
N
-aryl-

l

-prolines
3a
–
3c
, which underwent amidation via a two-stage, one-pot reaction involving SOCl
2
and amines, to furnish

l

-prolinamides in 20–80% yield. The cytotoxicities of
4a
–
4w
against four human carcinoma cell lines (SGC7901, HCT-116, HepG2 and A549) were evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay; with good tumour inhibitory activities (79.50 ± 1.24%–50.04 ± 1.45%) against HepG2.
4a
exhibited the best anti-tumour activity against A549 with percentage cell inhibition of 95.41 ± 0.67% at 100 µM. Likewise,
4s
(70.13 ± 3.41%) and
4u
(83.36 ± 1.70%) displayed stronger antineoplastic potencies against A549 than the standard, 5-fluorouracil (64.29 ± 2.09%), whereas
4a
(93.33 ± 1.36%) and
4u
(81.29 ± 2.32%) outperformed the reference (81.20 ± 0.08%) against HCT-116. SGC7901 showed lower percentage cell viabilities with
4u
(8.02 ± 1.54%) and
4w
(27.27 ± 2.38%). These results underscore the antiproliferative efficacies of

l

-prolinamides while exposing
4a
and
4u
as promising broad-spectrum anti-cancer agents. Structure-activity relationship studies are discussed.
Review of smoothed particle hydrodynamics: towards converged Lagrangian flow modelling
Authors: Lind Steven J. , Rogers Benedict D. , Stansby Peter K.
Published: September 2020

This paper presents a review of the progress of smoothed particle hydrodynamics (SPH) towards high-order converged simulations. As a mesh-free Lagrangian method suitable for complex flows with interfaces and multiple phases, SPH has developed considerably in the past decade. While original applications were in astrophysics, early engineering applications showed the versatility and robustness of the method without emphasis on accuracy and convergence. The early method was of weakly compressible form resulting in noisy pressures due to spurious pressure waves. This was effectively removed in the incompressible (divergence-free) form which followed; since then the weakly compressible form has been advanced, reducing pressure noise. Now numerical convergence studies are standard. While the method is computationally demanding on conventional processors, it is well suited to parallel processing on massively parallel computing and graphics processing units. Applications are diverse and encompass wave–structure interaction, geophysical flows due to landslides, nuclear sludge flows, welding, gearbox flows and many others. In the state of the art, convergence is typically between the first- and second-order theoretical limits. Recent advances are improving convergence to fourth order (and higher) and these will also be outlined. This can be necessary to resolve multi-scale aspects of turbulent flow.
Personality differences in the selection of dynamic refugia have demographic consequences for a winter-adapted bird
Authors: Shipley Amy A. , Cruz Jennyffer , Zuckerberg Benjamin
Published: September 2020

For overwintering species, individuals' ability to find refugia from inclement weather and predators probably confers strong fitness benefits. How animals use their environment can be mediated by their personality (e.g. risk-taking), but does personality mediate how overwintering species select refugia? Snow cover is a dynamic winter characteristic that can influence crypsis or provide below-the-snow refugia. We explored how wintering ruffed grouse (Bonasa umbellus) selected snow roosting sites, a behaviour that reduces stress and cold exposure. We linked selection for approximately 700 roosts with survival of 42 grouse, and showed that grouse generally selected deeper snow and warmer areas. Grouse found in shallow snow were less likely to survive winter. However, individuals that selected deep snow improved their survival, suggesting that demographic consequences of selecting winter refugia are mediated by differences in personality.Our study provides a crucial, and seldom addressed, link between personality in resource selection and resulting demographic consequences.
Food web complexity weakens size-based constraints on the pyramids of life
Authors: Woodson C. B. , Schramski J. R. , Joye S. B.
Published: September 2020

Marine ecosystems are generally expected to have bottom-heavy trophic structure (more plants than animals) due to size-based constraints arising from increased metabolic requirements and inefficient energy transfer. However, size-based (allometric) approaches are often limited to confined trophic-level windows where energy transfer is predicted by size alone and are constrained to a balance between bottom-up and top-down control at steady state. In real food webs, energy flow is more complex and imbalances in top-down and bottom-up processes can also shape trophic structure. We expand the size-based theory to account for complex food webs and show that moderate levels of food web connectance allow for inverted trophic structure more often than predicted, especially in marine ecosystems. Trophic structure inversion occurs due to the incorporation of complex energy pathways and top-down effects on ecosystems. Our results suggest that marine ecosystems should be top-heavy, and observed bottom-heavy trophic structure may be a result of human defaunation of the ocean that has been more extreme than presently recognized.
Cellular bicarbonate accumulation and vesicular proton transport promote calcification in the sea urchin larva
Authors: Hu Marian Y. , Petersen Inga , Chang William Weijen , Blurton Christine , Stumpp Meike
Published: September 2020

The sea urchin embryo develops a calcitic endoskeleton through intracellular formation of amorphous calcium carbonate (ACC). Intracellular precipitation of ACC, requiresHCO3−/CO32−concentrating as well as proton export mechanisms to promote calcification. These processes are of fundamental importance in biological mineralization, but remain largely unexplored. Here, we demonstrate that the calcifying primary mesenchyme cells (PMCs) use Na+/H+-exchange (NHE) mechanisms to control cellular pH homeostasis during maintenance of the skeleton. During skeleton re-calcification, pHiof PMCs is increased accompanied by substantial elevation in intracellular[HCO3−]mediated by theNa+/HCO3−cotransporter Sp_Slc4a10. However, PMCs lower their pHiregulatory capacities associated with a reduction in NHE activity. Live-cell imaging using green fluorescent protein reporter constructs in combination with intravesicular pH measurements demonstrated alkaline and acidic populations of vesicles in PMCs and extensive trafficking of largeV-type H+-ATPase (VHA)-rich acidic vesicles in blastocoelar filopodial cells. Pharmacological and gene expression analyses underline a central role of the VHA isoformsSp_ATP6V0a1,Sp_ATP6V01_1andSp_ATPa1-4for the process of skeleton re-calcification. These results highlight novel pH regulatory strategies in calcifying cells of a marine species with important implications for our understanding of the mineralization process in times of rapid changes in oceanic pH.
Predicting the recombination potential of severe acute respiratory syndrome coronavirus 2 and Middle East respiratory syndrome coronavirus
Authors: Banerjee Arinjay , Doxey Andrew C. , Tremblay Benjamin J.-M. , Mansfield Michael J. , Subudhi Sonu , Hirota Jeremy A. , Miller Matthew S. , McArthur Andrew G. , Mubareka Samira , Mossman Karen
Published: September 2020

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) recently emerged to cause widespread infections in humans. SARS-CoV-2 infections have been reported in the Kingdom of Saudi Arabia, where Middle East respiratory syndrome coronavirus (MERS-CoV) causes seasonal outbreaks with a case fatality rate of ~37 %. Here we show that there exists a theoretical possibility of future recombination events between SARS-CoV-2 and MERS-CoV RNA. Through computational analyses, we have identified homologous genomic regions within the ORF1ab and S genes that could facilitate recombination, and have analysed co-expression patterns of the cellular receptors for SARS-CoV-2 and MERS-CoV, ACE2 and DPP4, respectively, to identify human anatomical sites that could facilitate co-infection. Furthermore, we have investigated the likely susceptibility of various animal species to MERS-CoV and SARS-CoV-2 infection by comparing known virus spike protein–receptor interacting residues. In conclusion, we suggest that a recombination between SARS-CoV-2 and MERS-CoV RNA is possible and urge public health laboratories in high-risk areas to develop diagnostic capability for the detection of recombined coronaviruses in patient samples.
The TACTIC experience: establishing an international, interdisciplinary network to tackle antimicrobial resistance
Authors: Al-Hassan Leena , Roemer-Mahler Anne , Price James , Islam Jasmin , El-Mahallawy Hadir , Higgins Paul G. , Hussein Amira F. A. , Roca Ignasi , Newport Melanie
Published: September 2020

Antimicrobial resistance (AMR) is a major global health threat that requires an interdisciplinary international approach to address. In response to calls from policymakers and funders alike, a growing number of research networks on AMR have been created with this approach in mind. However, there are many challenges facing researchers in establishing such networks and research projects. In this article, we share our experience of establishing the network ‘TACTIC: Tackling AMR Challenges through Translational Interdisciplinary Collaborations’. Although presented with many challenges both scientific and logistical, the network has underpinned productive interaction between biomedical and social scientists from several countries and fostered true collaboration in an educative, stimulating and sustainable way that forms a platform for important research on AMR.