bluuebunny/crossref_metadata_2025 huggingface dataset:
Population-specific, recent positive selection signatures in cultivatedCucumis sativusL. (cucumber)
Authors: Lin Xinrui , Zhang Ning , Song Hongtao , Lin Kui , Pang Erli
Published: May 2022

Population-specific, positive selection promotes the diversity of populations and drives local adaptations in the population. However, little is known about population-specific, recent positive selection in the populations of cultivated cucumber (Cucumis sativus L.). Based on a genomic variation map of individuals worldwide, we implemented a Fisher’s combination method by combining 4 haplotype-based approaches: integrated haplotype score (iHS), number of segregating sites by length (nSL), cross-population extended haplotype homozygosity (XP-EHH), and Rsb. Overall, we detected 331, 2,147, and 3,772 population-specific, recent positive selective sites in the East Asian, Eurasian, and Xishuangbanna populations, respectively. Moreover, we found that these sites were related to processes for reproduction, response to abiotic and biotic stress, and regulation of developmental processes, indicating adaptations to their microenvironments. Meanwhile, the selective genes associated with traits of fruits were also observed, such as the gene related to the shorter fruit length in the Eurasian population and the gene controlling flesh thickness in the Xishuangbanna population. In addition, we noticed that soft sweeps were common in the East Asian and Xishuangbanna populations. Genes involved in hard or soft sweeps were related to developmental regulation and abiotic and biotic stress resistance. Our study offers a comprehensive candidate dataset of population-specific, selective signatures in cultivated cucumber populations. Our methods provide guidance for the analysis of population-specific, positive selection. These findings will help explore the biological mechanisms of adaptation and domestication of cucumber.
Futurology
Authors: Lucas Matt
Published: May 2022

Matt Lucas FBCS explores how to quit your job — in a way that benefits everyone.
Improving Software Quality in a Changing World
Authors: Cooper Martin
Published: May 2022

The world is becoming ever more reliant on code but how do we ensure software quality? A recent event hosted by the BCS Software Testing Specialist Group explored these issues and more, writes Martin Cooper MBCS.
A New Chapter for FBCS
Authors:   FBCS Update
Published: May 2022

Holly Porter, BCS Membership Director and Paul Martynenko FBCS, Chair of the BCS Registrations and Standards Committee, explain the new updates to BCS Fellowship.
Mentoring
Authors: Yetim Adem
Published: May 2022

Adem Yetim IntPE FIET FBCS, gives a glimpse of tomorrow’s job forecast.
Using the Cybersecurity Kill Chain for Attack and Defence
Authors: Cooper Martin
Published: May 2022

Professor Ali Al-Sherbaz and Dr Qublai Ali-Mirza from the University of Gloucestershire tell Martin Cooper MBCS how understanding the key phases of cyber attacks can keep an organisation safe.
Ukraine: The Cyber Battlefield
Authors: O’Connor Patrick
Published: May 2022

The Ukrainian conflict did not start with an invasion. gamified Patrick O’Connor CISSP CEH MBCS explores the many ‘trial runs’ of cyber attacks leading up to the physical war in Ukraine.
What is Digital Forensics?
Authors: Zargari Shahrzad
Published: May 2022

The definition of digital forensics is the process of uncovering and interpreting electronic data for use in a court of law, writes Shahrzad Zargari, Senior Lecturer and Course Leader in Cybersecurity with Forensics, after recently hosting the BCS webinar, Digital Forensics 101.
Cybersecurity
Authors: Ratnayake Deepthi
Published: May 2022

Dr Deepthi Ratnayake explains money mules and their role in cyber crime.
Social Media Analysis of Customer Emotions in Pizza Industry
Authors: Nasir Muhammad Umar , Rehmat Urva , Ahmad Imran
Published: May 2022

The paper, ’Social Media Analysis of Customer Emotions in Pizza Industry’ by Muhammad Umar Nasir, Urva Rehmat and Imran Ahmad, published in The Computer Journal (April 2022), looks at social media influence on UK pizza sales.
A triple star origin for T Pyx and other short-period recurrent novae
Authors: Knigge C , Toonen S , Boekholt T C N
Published: May 2022

Recurrent novae are star systems in which a massive white dwarf accretes material at such a high rate that it undergoes thermonuclear runaways every 1–100 yr. They are the only class of novae in which the white dwarf can grow in mass, making some of these systems strong Type Ia supernova progenitor candidates. Almost all known recurrent novae are long-period ($P_{\mathrm{orb}} \gtrsim 12\, \mathrm{h}$) binary systems in which the requisite mass supply rate can be provided by an evolved (sub-)giant donor star. However, at least two recurrent novae are short-period ($P_{\mathrm{orb}} \lesssim 3\, \mathrm{h}$) binaries in which mass transfer would normally be driven by gravitational radiation at rates three to four orders of magnitude smaller than required. Here, we show that the prototype of this class – T Pyxidis – has a distant proper motion companion and therefore likely evolved from a hierarchical triple star system. Triple evolution can naturally produce exotic compact binaries as a result of three-body dynamics, either by Kozai–Lidov eccentricity cycles in dynamically stable systems or via mass-loss-induced dynamical instabilities. By numerically evolving triple progenitors with physically reasonable parameters forward in time, we show explicitly that the inner binary can become so eccentric that mass transfer is triggered at periastron, driving the secondary out of thermal equilibrium. We suggest that short-period recurrent novae likely evolved via this extreme state, explaining their departure from standard binary evolution tracks.
Search for carbon-bearing compounds on low-albedo asteroids
Authors: Hromakina T , Barucci M A , Belskaya I , Fornasier S , Merlin F , Praet A , Poggiali G , Matsuoka M
Published: May 2022

In this work we aim to investigate the presence of absorption bands around 3.4 μm in the infrared spectra of primitive asteroids. We collected the published reflectance spectra of low-albedo asteroids from the literature and analyzed the 2.4-3.8 μm region using the same techniques. From the initial dataset of 92 asteroids, we restricted our analysis to 42 spectra of low-albedo asteroids with a good signal-to-noise (S/N) ratio and we found the absorption feature around 3.4 μm in the spectra of 16 objects. For objects that are classified by the 3 μm band into the ’rounded’, Ceres-like, and Europa-like groups, the depth of the 3.4 μm feature is strongly correlated with that of the 3 μm band. The majority of objects in our dataset not showing the 3.4 μm absorption band have lower S/N spectra and belong to Ch or Chg classes, while asteroids with a detected 3.4 μm bands mostly belong to C, B, and also P types. Additionally, asteroids with a detected 3.4 μm band tend to have a lower albedo, redder J-K colors, and more neutral U-V colors. We observe that the analyzed objects larger than ∼300 km in diameter show features due to carbon-bearing materials, which could be explained by their higher S/N ratio in our dataset. Finally, we found that the distributions of asteroids showing the 3.4 μm feature appear to be shifted towards larger distances from the Sun compared to those not showing this band.
The multifrequency angular power spectrum in parameter studies of the cosmic 21-cm signal
Authors: Mondal Rajesh , Mellema Garrelt , Murray Steven G , Greig Bradley
Published: May 2022

The light-cone effect breaks the periodicity and statistical homogeneity (ergodicity) along the line-of-sight direction of cosmological emission/absorption line surveys. The spherically averaged power spectrum (SAPS), which by definition assumes ergodicity and periodicity in all directions, can only quantify some of the second-order statistical information in the 3D light-cone signals, and therefore, gives a biased estimate of the true statistics. The multifrequency angular power spectrum (MAPS), by extracting more information from the data, does not rely on these assumptions. It is therefore better aligned with the properties of the signal. We have compared the performance of the MAPS and SAPS metrics for parameter estimation of a mock 3D light-cone observation of the 21-cm signal from the Epoch of Reionization. Our investigation is based on a simplified 3-parameter 21cmFAST model. We find that the MAPS produces parameter constraints, which are a factor of ∼2 more stringent than when the SAPS is used. The significance of this result does not change much even in the presence of instrumental noise expected for 128 h of SKA-Low observations. Our results therefore suggest that a parameter estimation framework based on the MAPS metric would yield superior results over one using the SAPS metric.
Connectome-based prediction of marital quality in husbands’ processing of spousal interactions
Authors: Ma Shan-Shan , Zhang Jin-Tao , Song Kun-Ru , Zhao Rui , Fang Ren-Hui , Wang Luo-Bin , Yao Shu-Ting , Hu Yi-Fan , Jiang Xin-Ying , Potenza Marc N , Fang Xiao-Yi
Published: May 2022

Marital quality may decrease during the early years of marriage. Establishing models predicting individualized marital quality may help develop timely and effective interventions to maintain or improve marital quality. Given that marital interactions have an important impact on marital well-being cross-sectionally and prospectively, neural responses during marital interactions may provide insight into neural bases underlying marital well-being. The current study applies connectome-based predictive modeling, a recently developed machine-learning approach, to functional magnetic resonance imaging (fMRI) data from both partners of 25 early-stage Chinese couples to examine whether an individual’s unique pattern of brain functional connectivity (FC) when responding to spousal interactive behaviors can reliably predict their own and their partners’ marital quality after 13 months. Results revealed that husbands’ FC involving multiple large networks, when responding to their spousal interactive behaviors, significantly predicted their own and their wives’ marital quality, and this predictability showed gender specificity. Brain connectivity patterns responding to general emotional stimuli and during the resting state were not significantly predictive. This study demonstrates that husbands’ differences in large-scale neural networks during marital interactions may contribute to their variability in marital quality and highlights gender-related differences. The findings lay a foundation for identifying reliable neuroimaging biomarkers for developing interventions for marital quality early in marriages.
Niche‐specific transcriptional reprogramming leads to pro‐angiogenic neutrophil specialization in colon cancer
Authors: Bui Triet M. , Yalom Lenore K. , Urbanczyk Jessica M. , Sumagin Ronen
Published: May 2022

Robust neutrophil (PMN) tissue accumulation is an important clinical feature in active Ulcerative Colitis (UC) lesions and in colorectal cancer (CRC). Using murine colitis‐associated CRC model, we observed prominent and persistent PMN accumulation as the inflamed colon tissue progressed from colonic ulceration to CRC. Given the emerging evidence of PMN phenotypic and functional heterogeneity in homeostatic and pathologic conditions, we analyzed the transcriptomic landscape of these immune cells in blood and tissue during the transition from inflammatory ulceration to CRC. Principal component analysis effectively stratified neutrophils across different conditions into three discrete clusters that marked distinct spatial compartments of peripheral blood, inflamed colon tissue and the CRC tumor niche. Importantly, combinatory analyses of pathway overrepresentation, protein‐network mapping, and gene‐ontology scoring revealed a robust enrichment of biological pathways involved in vasculature development and angiogenesis uniquely in PMNs associated with the advanced CRC niche. These findings were validated in vivo as we found that temporary PMN depletion profoundly reduced tumor vascularity, vessel branching, and penetration depth of the tumor vessels. Moreover, we identified Spp1 (OPN) and Mmp14(MT1‐MMP) to be highly induced transcriptionally in PMNs as they left the circulation and entered the tumor niche, where Spp1 and Mmp14 directly promoted tumor angiogenesis. TCGA data mining and validation in UC/CRC patient cohorts further confirmed significant upregulation of Spp1 and Mmp14in high‐grade CRC, but not in UC patients. In conclusion, the current study identified a niche‐specific compartmentalization of PMN transcriptional programing, highlighting the novel PMN plasticity. Our findings further established the contribution of CRC‐associated PMNs via Spp1/Mmp14 activity to the formation of a complex tumor vasculature and subsequent neoplastic progression from inflammatory colitis to advanced CRC.
Regulation of endothelial DNA methylation by IL‐6 signaling
Authors: Bossardi Ramos Ramon , Martino Nina , Adam Alejandro P.
Published: May 2022

Interleukin 6 (IL‐6) is a major mediator of the septic cytokine storm. It activates the transcription factor STAT3, resulting in pathological vascular leakage, leukocyte adhesion, and coagulation cascade activation, leading to acute multiorgan dysfunction. Septic shock survivors have a high risk of developing post‐intensive care syndrome (PICS), a condition of chronic cardiovascular disease, cognitive impairment, and reduced overall survival. The causes for this syndrome are not fully understood. We hypothesize that acute STAT3‐mediated endotheliopathy promotes changes in the endothelial DNA methylation landscape, leading to the long‐lasting effects of PICS. To test this in vitro, HUVEC were treated with a combination of IL‐6 and sIL‐6Rα (IL‐6+R) or saline for 6h, 24h, or 72h, and DNA methylation was profiled using Infinium Methylation EPIC arrays after bisulfite conversion. Unbiased clustering showed a separation between treated and control cells only after 72h. 360 CpG sites were significantly modified (FDR‐adjusted p=<0.05). Of these, 329 CpG sites were hypomethylated and 31 were hypermethylated. Gene ontology analysis of the differentially methylated genes showed enrichment of pathways directly linked with the platelet and leukocyte interaction, cell proliferation and angiogenesis, and signaling. Consistent with the demethylation of the LAMP3 locus, a 72h treatment with IL‐6+R induced a dramatic increase in LAMP3 expression. The same treatment induced an inhibition of ADAM19 and MYO10 gene expression, consistent with their hypermethylation status. These changes were not associated with differences in the expression of DNA methyltransferases and TET enzymes. The IL‐6+R‐induced increase in LAMP3 expression was further increased in cells that had been previously treated with IL‐6+R for 72h and then incubated in the absence of IL‐6+R for another 96h, compared to saline‐treated cells, suggesting a long‐lasting effect of a prior IL‐6+R treatment via demethylation of the promoter. In contrast, SOCS3 expression (a gene directly activated by STAT3) was similar in cells that were pretreated with IL‐6+R or not. In summary, persistent activation of IL‐6 leads to endothelial DNA methylation changes and corresponding gene expression differences. These differences may regulate pathways that can be associated with reduced long‐term survival and prolonged organ damage as observed in PICS.
β‐catenin Overexpressing Hepatocytes Reduce Bile Stasis by Contributing to Cholangiocyte‐Like Phenotype in Murine Model of Intrahepatic Cholestasis
Authors: Goel Chhavi , Li Qin , Cornuet Pamela , Nejak‐Bowen Kari
Published: May 2022

Study Objective

To investigate the role of β‐catenin overexpression in hepatocytes (HC) in hepatocyte‐to‐biliary reprogramming during intrahepatic cholestasis.

Hypothesis

We previously reported that mice transgenic for Ser‐45 mutant β‐catenin (TG) show increased hepatocyte‐to‐biliary reprogramming after administration of the porphyrinogenic biliary toxin 3,5‐diethoxycarbonyl‐1,4‐dihydrocollidine (DDC) diet for 1 month. However, whether these cholangiocyte‐like hepatocytes fully convert into cholangiocytes (CC) or maintain an intermediate phenotype, remains unclear. We hypothesized that TG livers will have more HC‐derived CC than wild type and contribute to functional de novo biliary branches that will alleviate disease severity.

Methods

Age matched WT control (Con) and TG, both containing ROSA26‐stopflox/flox, were injected with AAV8‐TBG‐Cre to permanently label hepatocytes with EYFP and then fed 0.1% DDC diet for different time points ‐ 30d, 60d, 90d, 120d, 150d. Before sacrifice, bile flow analysis was measured for 1h to obtain flow rate and bile was collected. Liver histology and serum biochemistry were analyzed for fibrosis and parameters of injury. Porphyrin measurement was assessed in the liver tissues. Relative gene expression for bile transporter genes and immunofluorescence staining were performed to determine the expression of biliary markers.

Results

TG mice showed significantly increased bile flow rate as compared to Con mice after 150d of DDC diet. Liver histology and porphyrin measurement analysis showed significantly less porphyrin accumulation in TG as compared to the Con. Analysis of bile homeostasis and transport genes demonstrated comparable levels of expression in TG and Con mice suggesting a possible mechanism by which HC contribute to bile duct formation and thus, increase bile flow rate observed in TG. HC‐derived ducts positive for both EYFP and Sox9 were observed more frequently in TG mice compared to Con. Nevertheless, serum biochemistry did not show any differences in hepatic and biliary injury in these groups.

Conclusions

Mice with β‐catenin overexpressing HC showed significantly improved bile flow rate and reduced porphyrin accumulation in response to the biliary toxin DDC. Using HC fate‐tracing, we observed increased biliary cell markers in TG hepatocytes that is suggestive of the mechanism of enhanced bile flow. Further studies would be focused on assessing the functional comparison of these HC‐derived CC to native CC and evaluate if β‐catenin overexpression mediates similar biliary reprogramming in response to short‐term DDC diet.
First Description of Different Neutrophil Populations in the Mucosa of the Female Genital Tract Identified by Spatial Transcriptomics
Authors: Carrillo‐Salinas Francisco J. , Parthasarathy Ragav S. , Moreno de Lara Laura , Borchers Anna , Werner Alexandra E. , Rodriguez‐Garcia Marta
Published: May 2022

Women worldwide acquire the human immunodeficiency virus (HIV) mainly through sexual contact. The female genital tract (FGT) has a unique mucosal surface that combines reproductive function with host defense against incoming pathogens, with a complex array of local immune defenses coordinated to protect against viral infections, including HIV. The first line of defense is formed by the epithelial cell barrier, mucus and secreted immune mediators. In addition, neutrophil recruitment to the genital mucosa is essential to maintain homeostasis, reproductive function and, as first responders against an insult, fight pathogens. We hypothesize that different populations of neutrophils exist within the FGT mucosa to play distinct roles in homeostasis and defense. To gain insight into neutrophil distribution and function within FGT tissues, we performed immunofluorescent staining of human endocervical and ectocervical tissue sections using neutrophil elastase antibody. Neutrophils were found concentrated towards the mucosal surface, positioned close to or within the epithelium, and also scattered throughout the tissue. Using spatial transcriptomics, neutrophils were selected in regions of interest (ROIs) with a segmentation mask and RNA extracted for sequencing. Whole transcriptome analysis segregated the transcriptional profiles of subepithelial and tissue‐scattered neutrophils and detected differential gene expression based on tissue location. Interestingly, epithelium‐associated neutrophil transcripts were enriched for pathways characteristic of defense (i.e., “Antimicrobial peptides”, “Neutrophil degranulation”, “Chemokine receptors bind chemokines”, among others). In addition, epithelium‐associated neutrophils showed an upregulation of CD16 and CD62L measured by flow cytometry, which indicates an activated state and could be associated to microbiota‐neutrophil interactions and protection of the very first layer of mucosal tissue.

For the first time, we describe different populations of neutrophils within the mucosal FGT and set foundation for mucosal immunity research, with potential for development of therapeutic interventions against sexually transmitted infections, including HIV.
Inflammation and Hypoxia May Underlie Neuronal Death in Brain of SARS‐CoV‐2 Infected Non‐Human Primates
Authors: Mayer Meredith , Rutkai Ibolya , Hellmers Linh , Ning Bo , Huang Zhen , Monjure Christopher , Maness Nicholas J. , Russell‐Lodrigue Kasi , Hu Tony Y. , Roy Chad , Blair Robert , Bohm Rudolf , Doyle‐Meyers Lara , Rappaport Jay , Fischer Tracy
Published: May 2022

Neuropathological complications are frequently observed in SARS‐CoV‐2 infection and brain autopsies from human subjects who died from COVID‐19 have revealed significant pathology, including wide‐spread neuroinflammation, hypoxic‐ischemic injury, and microhemorrhages. To begin to understand the neuropathogenesis of SARS‐CoV‐2 infection, we investigated brain from infected non‐human primates (NHP)s for pathological changes consistent with that seen among humans. Eight aged NHPs were inoculated with the 2019‐nCoV/USA‐WA1/2020 strain of SARS‐CoV‐2 via a multi‐route mucosal or aerosol challenge. Hematoxylin and eosin (H&E) and immunohistochemistry (IHC) staining was done on seven brain regions to elucidate general pathology, microhemorrhages, platelet derived thrombi, neuronal apoptosis, microglia and astrocyte morphology, hypoxia, and virus present. Similar to humans, pathology was variable but included wide‐spread neuroinflammation, nodular lesions, neuronal degeneration, and microhemorrhages. Neuronal degeneration was most often seen in the cerebellum and brainstem of infected animals. Neuronal death was confirmed through FluorJade C and cleaved (active) caspase 3 IHC, which showed foci of positivity, particularly among Purkinje cells of the cerebellum. Importantly, this was seen among infected animals that did not develop severe respiratory disease. Hypoxia inducible factor‐1α (HIF‐1α) was observed at a higher intensity around the vasculature within deep brain regions of the infected animals. Microhemorrhages were prevalent among all animals but were less frequently associated with platelet derived thrombi in the infected animals, as compared to mock‐infected controls. Sparse virus was detected in brain endothelial cells but did not associate with the severity of CNS injury. Increased HIF‐1α suggests that brain hypoxia may promote neuronal degeneration within infected brain. Wide‐spread neuroinflammation may also contribute to neuronal injury/death and neurological manifestations seen in the context of infection.
Dexmedetomidine and Other Analgosedatives Alter Pupil Characteristics in Critically Ill Patients
Authors: Chan Wang Pong , Prescott Brenton R. , Barra Megan E. , Chung David Y. , Kim Ivy S. , Saglam Hanife , Hutch Meghan R. , Shin Min , Zafar Sahar F. , Benjamin Emelia J. , Smirnakis Stelios M. , Dupuis Josée , Greer David M. , Ong Charlene J.
Published: May 2022

OBJECTIVES:

In critically ill patients with neurologic disease, pupil examination abnormalities can signify evolving intracranial pathology. Analgesic and sedative medications (analgosedatives) target pupillary pathways, but it remains unknown how analgosedatives alter pupil findings in the clinical care setting. We assessed dexmedetomidine and other analgosedative associations with pupil reactivity and size in a heterogeneous cohort of critically ill patients with acute intracranial pathology.

DESIGN:

Retrospective cohort study.

SETTING:

Two neurologic ICUs between 2016 and 2018.

PATIENTS:

Critically ill adult patients with pupil measurements within 60 minutes of analgosedative administration. Patients with a history of intrinsic retinal pathology, extracranial injury, inaccessible brain imaging, or no Glasgow Coma Scale (GCS) data were excluded.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

We used mixed-effects linear regression accounting for intrapatient correlations and adjusting for sex, age, GCS score, radiographic mass effect, medication confounders, and ambient light. We tested the association between an initiation or increased IV infusion of dexmedetomidine and pupil reactivity (Neurologic Pupil Index [NPi]) and resting pupil size (mm) obtained using NeurOptics NPi—200 (NeurOptics, Irvine, CA) pupillometer. Of our 221 patients with 9,897 pupil observations (median age, 60 [interquartile range, 50–68]; 59% male), 37 patients (166 pupil observations) were exposed to dexmedetomidine. Dexmedetomidine was associated with higher average NPi (β = 0.18 per 1 unit increase in rank-normalized NPi ± 0.04; p < 0.001) and smaller pupil size (β = –0.25 ± 0.05; p < 0.001). Exploratory analyses revealed that acetaminophen was associated with higher average NPi (β = 0.04 ± 0.02; p = 0.02) and that most IV infusion analgosedatives including propofol, fentanyl, and midazolam were associated with smaller pupil size.

CONCLUSIONS:

Dexmedetomidine is associated with higher pupil reactivity (high NPi) and smaller pupil size in a cohort of critically ill patients with neurologic injury. Familiarity with expected pupil changes following analgosedative administration is important for accurate interpretation of pupil examination findings, facilitating optimal management of patients with acute intracranial pathology.
Implementing a Care Plan System in a Community Hospital Electronic Health Record
Authors: Russell Cynthia K. , McNeill Margaret
Published: May 2022

Nursing care plans, the result of the nursing process, are important because they guide quality patient care, define the nurse's role in patient treatment, and support patient specific nursing interventions. Nurse leaders at a community hospital identified that 70% of hospitalized patients shared the same three nursing problems and three-day resolution target dates. This quality improvement project involved the implementation of a nursing care plan system within the organization's existing electronic health record platform that supported the development of individualized plans. The implementation included a) integration of care plan activities into the nursing workflow, b) adoption of a standardized nursing language to provide structure nursing care plan data capture and reporting, c) configuration of the electronic health record to recommend patient data-driven care plan problems based on nursing assessment documentation; and d) trended care plan data to identify problem patterns within the patient population. A postimplementation audit indicated a 130% improvement in achieving individualized care plans within 24 hours of admission.
Improving Active Collaborative Clinical Learning Through a Mobile Application for Undergraduate Nursing Students
Authors: Lee Hyejung , Kim Chanhee , Kim Hyoyeong , Kim Jinsook , Kang Myungsuk
Published: May 2022

Innovative teaching and learning strategies in pediatric clinical education are needed to ensure that learning outcomes are achieved efficiently and to improve students' satisfaction with the learning process. We developed a mobile application to enhance the clinical learning of nursing students during pediatric clinical practice and explored the participants' perceptions of the learning method. A mixed-method design and an online survey were used to assess participants' perceived achievement of learning objectives and satisfaction with the clinical practicum. Focus groups explored the participants' experience of using the application. The overall achievement of learning outcomes was 4.1 out of 5, and participants reported high satisfaction with the clinical practicum using the mobile application. Qualitative analysis of the transcripts revealed four major themes: (1) facilitation of collaborative learning through real-time interactions and communication; (2) engagement in active learning through an application; (3) a useful tool for enhancing critical thinking; and (4) the “curate's egg” nature of the application. The mobile application can be incorporated into the clinical education of nursing students to promote self-regulated learning and collaboration with faculty. Clear guidance on how to use the application in a clinical environment should be provided to students and preceptors to achieve better learning outcomes.
Direct Oral Anticoagulants Versus Vitamin K Antagonists for the Treatment of Left Ventricular Thrombus: An Updated Meta-Analysis of Cohort Studies and Randomized Controlled Trials
Authors: Chen Yanming , Zhu Mei , Wang Kai , Xu Qiang , Ma Jing
Published: May 2022

Left ventricular thrombi (LVTs) increase the risk of stroke, systemic embolism, and subsequent death. Current guidelines recommend vitamin K antagonists (VKAs) as first-line treatment for LVT. Direct oral anticoagulants (DOACs) are increasingly used as alternatives to warfarin for the treatment of LVT. However, the efficacy and safety of DOACs versus VKAs remain controversial. Thus, we conducted an updated meta-analysis of DOACs versus VKAs for LVT treatment. We systematically searched PubMed, Embase, ClinicalTrials, and Cochrane Library databases for relevant articles published before December 11, 2021. The relative risks (RRs) with 95% confidence intervals (CIs) were calculated for each study. The meta-analysis included 12 cohort studies and 3 randomized controlled trials with a total of 2334 patients. We found that DOACs had a lower risk of clinically significant bleeding than VKAs (RR = 0.6; 95% CI, 0.39 to 0.90; P = 0.01; I2 = 0%). There was no difference in LVT resolution (RR = 1.01; 95% CI, 0.93 to 1.09; P = 0.48; I2 = 0%), stroke and/or systematic embolic events (RR = 0.87; 95% CI, 0.11 to 1.55; P = 0.2; I2 = 30%), and all-cause mortality (RR = 0.9; 95% CI, 0.58 to 1.4; P = 0.65; I2 = 0%). Overall, DOACs are noninferior to warfarin in LVT treatment but have a lower risk of clinically significant bleeding. This suggests that DOACs might be better alternatives to warfarin for LVT treatment.
Infection Rate Comparison during Transition from Hospital to Office WALANT Enabled by Virtual Reality
Authors: Oakes Tannur C. , Wong Karren C. , Schank Kyle J. , Haan Pam , Bray Stephanie M. , Clarkson James H. W.
Published: May 2022

Background:

We transitioned our hand practice from the operating room (OR) to our office-based procedure room (OPR) to offer wide-awake, local anesthesia, no tourniquet (WALANT). We have established that using wide-awake virtual reality improves patient comfort and anxiety during wide-awake procedures and helps facilitate our patients’ choice of venue. We aimed to assess the effect of this transition on infection rates for procedures performed by a single surgeon in the OR versus the OPR.

Methods:

A retrospective chart review was performed on a single surgeon’s adult patients who underwent elective and closed traumatic upper limb surgeries. A surgical site infection was defined as superficial or deep, based on clinical examination conducted by the surgeon, and was treated with antibiotics within a 4-week postoperative window.

Results:

From August 2017 to August 2019, 538 (216 OR and 322 OPR) consecutive cases met inclusion criteria. There were six (2.78%) superficial infections and zero deep space infections in the OR cohort compared with four (1.24%) superficial and zero deep space infections in the OPR cohort with no statistical significance. Two-thirds of cases were converted to WALANT and delivered in the office.

Conclusions:

This narrative study concurs with the current literature that WALANT in the office setting is as safe as the hospital OR-based procedures for selected elective cases. By transitioning suitable cases from the OR to the OPR, a surgeon’s overall infection rate should not change.
Uterus didelphys complicated with endometrial carcinoma
Authors: Chen Liang , Zhang Fang , Ma Yue-bing , Chen Jin-long
Published: May 2022

Rationale:

The incidence of uterine malformations is low (4%–7%). Currently, the National Comprehensive Cancer Network clinical practice guidelines in oncology recommend minimally invasive surgery for early endometrial cancer. Minimally invasive surgery for the treatment of uterine didelphys with endometrial cancer is rare due to the large size of the uterus. To date, only 2 such patients have been reported to have undergone laparoscopy. Whether such patients can be treated with minimally invasive surgery needs to be further explored.

Patient concerns:

A 40-year-old woman with uterine didelphys was hospitalized for menorrhagia in the past 2 months.

Diagnosis:

Endometrial adenocarcinoma was found in both the uterus and cervix using fractional dilation and curettage.

Interventions:

The patient underwent laparoscopic surgery. Postoperative adjuvant radiotherapy and chemotherapy were administered.

Outcomes:

There was no sign of recurrence during routine follow-up.

Lessons:

The use of a uterine manipulator to lift either side of the uterus could help to expose the narrow ipsilateral para-uterine field. It is difficult to remove the uterus entirely through the vagina, making it necessary to select appropriate cases wherein screening is performed to check if the vagina is loose, and the uterus is of appropriate size. Minimally invasive surgery may be feasible for suitable patients.
Correlations between COMT polymorphism and brain structure and cognition in elderly subjects
Authors: Cha Eunsil , Ahn Hyun Jung , Kang Wonil , Jung Kwang-Ik , Ohn Suk Hoon , Bashir Shahid , Yoo Woo-Kyoung
Published: May 2022

The catechol-O-methyltransferase (COMT) gene has been noted to play an important role in individual variations in the aging process. We investigated whether COMT polymorphism could influence cognition related to white matter networks. More specifically, we examined whether methionine (Met) allele loading is associated with better individual cognitive performance. Thirty-four healthy elderly participants were recruited; each participant's COMT genotype was determined, and Korean version of Montreal Cognitive Assessment scores and a diffusion tensor image were obtained for all participants. The Met carrier group showed significantly lower mean diffusivity, axial diffusivity, and radial diffusivity values for the right hippocampus, thalamus, uncinate fasciculus, and left caudate nucleus than the valine homozygote group. The Met carrier group also scored higher for executive function and attention on the Korean version of Montreal Cognitive Assessment. Based on these results, we can assume that the COMT Met allele has a protective effect on cognitive decline contributing to individual differences in cognitive function in late life period.
Prognostic significance of conventional and volumetric PET parameters with and without partial volume correction in the assessment of head and neck squamous cell carcinoma
Authors: Zirakchian Zadeh Mahdi , Asadollahi Shadi , Kaghazchi Fatemeh , Raynor William Y. , Mehdizadeh Seraj Siavash , Werner Thomas J. , Seierstad Therese , Korostoff Jonathan , Swisher-McClure Samuel , Alavi Abass , Revheim Mona-Elisabeth
Published: May 2022

Background

The optimal quantification of PET in assessment of head and neck squamous cell carcinoma (HNSCC) is still under development. The effect of partial volume correction (PVC) on the evaluation of survival in the HNSCC patients has not been investigated yet.

Methodology

Pretreatment 18F-FDG-PET/CT scans of a selected group of 57 patients with advanced stage HNSCC were collected. Conventional (SUVmean and SUVmax) and volumetric [total lesion glycolysis (TLG) and metabolic tumor volume (MTV)] PET metrics were calculated. The ROVER software (ABX GmbH, Radeberg, Germany) automatically applied PVC to the PET metrics. Cox proportional hazards regression model calculated hazard ratio (HR) for assessment of predictive parameters of progression-free survival (PFS).

Results

In multivariate Cox regression analysis, including age, gender, race, human papillomavirus status, and stage, the only significant predictors of PFS were the volumetric PET parameters (TLG: HR, 1.003; 95% CI, 1.001–1.005; P = 0.02), pvcTLG (HR, 1.002; 95% CI, 1.001–1.004; P = 0.01) and MTV (HR, 1.050; 95% CI, 1.024–1.077; P < 0.01). The partial volume-corrected values were significantly higher than the noncorrected values (Wilcoxon sign test; P < 0.05). However, there was not a statistically significant difference between the nonpartial volume corrected and partial volume-corrected PET metrics for assessment of PFS.

Conclusion

Volumetric PET metrics were predictors of PFS in Cox regression analysis. Applying PVC could not significantly improve the accuracy of PET metrics for assessment of PFS.
Usefulness of 18F-FDG PET/computed tomography in differentiating between subacute and chronic aortic dissection: initial investigation
Authors: Higashigawa Takatoshi , Ichikawa Yasutaka , Chino Shuji , Nakajima Ken , Ouchi Takafumi , Kato Hiroaki , Hirano Koji , Tokui Toshiya , Kato Noriyuki , Sakuma Hajime
Published: May 2022

Objectives

In the selection of thoracic endovascular repair for aortic dissection (AD), it is important to distinguish between the subacute and chronic phases, but there is no reliable way to distinguish between them in patients with unknown onset of AD. The purpose of this study was to assess the diagnostic performance of 2-[18F] fluoro-2-deoxy-d-glucose (18F-FDG)-PET/computed tomography (PET/CT) for discriminating subacute AD from chronic AD.

Methods

Thirteen patients with AD who were medically treated and followed up for 6 months were studied. 18F-FDG PET/CT images were obtained for each patient in the subacute phase (the first scan) and at 6 months (the second scan) after the onset. Target-to-background ratio (TBR) was measured as the maximum standardized uptake value (SUV) in the dissected aortic wall divided by blood pool SUV.

Results

TBR was significantly higher in the first scan (mean ± SD, 1.97 ± 0.32) than in the second scan (1.69 ± 0.29, P = 0.007). The area under the receiver operating characteristic curve of TBR for discriminating subacute AD from chronic AD was 0.76. With a threshold of 1.74, the TBR showed the sensitivity, specificity, and positive and negative predictive value of 85%, 69%, 73%, and 82%, respectively, for the discrimination of subacute AD from chronic AD.

Conclusion

Metabolic assessment of dissected aortic wall by 18F-FDG PET/CT is useful in differentiating between subacute and chronic AD and can provide important information in determining the appropriate indication for treatment for patients with AD of unknown onset.
Addressing Cultural Competency and Primary Palliative Care Needs in Community Health Nursing Education
Authors: Dudley Nancy , Rauch Lisa , Adelman Toby , Canham Daryl
Published: May 2022

To meet the primary palliative care needs of older adults, especially the underserved and those of color, a qualitative descriptive study was conducted among nursing students (n = 34) in community health nursing whose clinical rotations included independent living facilities for low-income populations. Two themes were identified that influence student nurse confidence and self-efficacy in initiating conversations with seriously ill clients and assessing their primary palliative care needs: (1) emotional assessment skills and cultural competency and (2) an assessment guide to primary palliative care needs that provides structure and guidance to conduct such conversations. Two major categories were identified that influence student nurse confidence and self-efficacy in initiating conversations with seriously ill clients: (1) educational needs and desired experience and (2) cultural impact. Two major categories were identified that facilitated the assessment of primary palliative care needs: (1) a guide that provided structure and guidance in initiating and conducting conversations about serious illness and (2) insight into the primary palliative care needs of clients in the community.
Pediatric Softball Injuries Presenting to Emergency Departments
Authors: Lee Alexander , Farooqi Ali S. , Talwar Divya , Maguire Kathleen J.
Published: May 2022

Introduction

This study sought to characterize the mechanisms of injury responsible for common softball-related injuries in recent years.

Methods

The National Electronic Injury Surveillance System database was queried for all pediatric softball-related injuries presenting to participating US emergency departments from 2010 to 2019. Patients were classified by age as children (7–12 years), adolescents (13–18 years), or young adults (19–21 years). The case narrative of each injury was used to establish the mechanism of injury: hit by bat, hit by ball, sliding into base, collision with another player, catching, running, and throwing. Statistical weights provided by the Consumer Product Safety Commission were used to produce national injury estimates.

Results

There were an estimated 511,117 pediatric softball injuries presenting to the emergency department over the study period, with a mean patient age of 14.3 years (95% confidence interval [CI], 14.1–14.4 years). The head/neck was the most commonly affected body part, making up 30.2% of cases (95% CI, 28.2%–32.2%). Injuries to the head/neck were most often caused by being hit by the ball (78.4%; 95% CI, 76.4%–80.3%) and most commonly resulted in a superficial injury (36.9%), internal injury (22.2%), or concussion (16.3%). Foot/ankle injuries were most frequently caused by sliding into base (51.5%; 95% CI, 47.0%–55.2%) and typically resulted in a sprain/strain (65.5%). The most frequent causes of shoulder/elbow injuries were being hit by the ball (33.3%; 95% CI, 28.6%–38.3%) and throwing the ball (27.6%; 95% CI, 22.8%–32.9%). These resulted most frequently in a sprain or strain (39.5%), followed by a superficial injury (28.2%). The proportion of softball injuries affecting the shoulder and elbow and the lower extremities increased with athlete age, whereas the proportion of injuries affecting the remainder of the upper extremities decreased with athlete age.

Conclusion

Being hit by the ball was the most common mechanism of injury, especially in the head/neck region, and shoulder/elbow injuries increase with athlete age. Coaches and leagues may consider mandating helmets for infielders and pitch counts for pitchers, especially among adolescent athletes.
Carriage prevalence and genomic epidemiology of Staphylococcus aureus among Native American children and adults in the Southwestern USA
Authors: Cella Eleonora , Sutcliffe Catherine G. , Tso Carol , Paul Ella , Ritchie Nina , Colelay Janene , Denny Estar , Grant Lindsay R. , Weatherholtz Robert C. , Hammitt Laura L. , Azarian Taj
Published: May 2022

Native American individuals in the Southwestern USA experience a higher burden of invasive

Staphylococcus aureus

disease than the general population. However, little is known about

S. aureus

carriage in these communities. A cross-sectional study was conducted to determine the carriage prevalence, risk factors and genomic epidemiology of

S. aureus

among Native American children (<5 years, n=121) and adults (≥18 years, n=167) in the Southwestern USA. Short- and long-read sequencing data were generated using Illumina and Oxford Nanopore Technology platforms to produce high-quality hybrid assemblies, and antibiotic-resistance, virulence and pangenome analyses were performed.

S. aureus

carriage prevalence was 20.7 % among children, 30.2 % among adults 18–64 years and 16.7 % among adults ≥65 years. Risk factors among adults included recent surgery, prior

S. aureus

infection among household members, and recent use of gyms or locker rooms by household members. No risk factors were identified among children. The bacterial population structure was dominated by clonal complex 1 (CC1) (21.1 %), CC5 (22.2 %) and CC8 (22.2 %). Isolates from children and adults were intermixed throughout the phylogeny. While the

S. aureus

population was diverse, the carriage prevalence was comparable to that in the general USA population. Genomic and risk-factor data suggest household, community and healthcare transmission are important components of the local epidemiology.
Core-, pan- and accessory genome analyses of Clostridium neonatale: insights into genetic diversity
Authors: Mesa Victoria , Monot Marc , Ferraris Laurent , Popoff Michel , Mazuet Christelle , Barbut Frederic , Delannoy Johanne , Dupuy Bruno , Butel Marie-Jose , Aires Julio
Published: May 2022

Clostridium neonatale

is a potential opportunistic pathogen recovered from faecal samples in cases of necrotizing enterocolitis (NEC), a gastrointestinal disease affecting preterm neonates. Although the

C. neonatale

species description and name validation were published in 2018, comparative genomics are lacking. In the present study, we provide the closed genome assembly of the

C. neonatale

ATCC BAA-265T (=250.09) reference strain with a manually curated functional annotation of the coding sequences. Pan-, core- and accessory genome analyses were performed using the complete 250.09 genome (4.7 Mb), three new assemblies (4.6–5.6 Mb), and five publicly available draft genome assemblies (4.6–4.7 Mb). The

C. neonatale

pan-genome contains 6840 genes, while the core-genome has 3387 genes. Pan-genome analysis revealed an ‘open’ state and genomic diversity. The strain-specific gene families ranged from five to 742 genes. Multiple mobile genetic elements were predicted, including a total of 201 genomic islands, 13 insertion sequence families, one CRISPR-Cas type I-B system and 15 predicted intact prophage signatures. Primary virulence classes including offensive, defensive, regulation of virulence-associated genes and non-specific virulence factors were identified. The presence of a tet(W/N/W) gene encoding a tetracycline resistance ribosomal protection protein and a 23S rRNA methyltransferase ermQ gene were identified in two different strains. Together, our results revealed a genetic diversity and plasticity of

C. neonatale

genomes and provide a comprehensive view of this species genomic features, paving the way for the characterization of its biological capabilities.