bluuebunny/crossref_metadata_2025 huggingface dataset:
Reliability and Validity of Ultrasound Elastography for Evaluating Muscle Stiffness in Neurological Populations: A Systematic Review and Meta-Analysis
Authors: Miller Tiev , Ying Michael , Sau Lan Tsang Charlotte , Huang Meizhen , Pang Marco Y C
Published: October 2020

Objective

Ultrasound elastography is an emerging diagnostic technology used to investigate the biomechanical properties of the musculoskeletal system. The purpose of this study was to systematically review the psychometric properties of ultrasound elastography techniques for evaluating muscle stiffness in people with neurological conditions.

Methods

A systematic search of MEDLINE, EMBASE, CINAHL, and Cochrane Library databases was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Using software, reviewers independently screened citations for inclusion. Peer-reviewed studies that evaluated in vivo muscle stiffness in people with neurological conditions and reported relevant psychometric properties were considered for inclusion. Twenty-one articles were included for final review. Data relevant to measurement technique, site, and neurological condition were extracted. The Consensus-Based Standards for the Selection of Health Measurement Instruments checklist was used to rate the methodological quality of included studies. The level of evidence for specific measurement outcomes was determined using a best-evidence synthesis approach.

Results

Reliability varied across populations, ultrasound systems, and assessment conditions (ie, joint/body positions, active/passive muscle conditions, probe orientation), with most studies indicating moderate to good reliability (ICC = 0.5–0.9, n = 13). Meta-analysis results showed a good overall correlation across studies (r = 0.78, 95% confidence interval = 0.64–0.86), with no between-group difference based on population (Q1 = 0.00). Convergent validity was demonstrated by strong correlations between stiffness values and measures of spasticity (n = 5), functional motor recovery or impairment (n = 5), and grayscale or color histogram pixel intensities (n = 3). Discriminant or known-groups validity was also established for multiple studies and indicated either significant between-group differences in stiffness values (n = 12) or within-group differences between more and less affected limbs (n = 6). Responsiveness was observed in all intervention studies reporting posttreatment stiffness changes (n = 6).

Conclusions

Overall, ultrasound elastography techniques showed moderate reliability in evaluating in vivo muscle stiffness, good convergent validity with relevant clinical assessments, and good divergent validity in discriminating tissue changes within and between groups.

Impact

Ultrasound elastography has clinical utility in assessing muscle stiffness, monitoring its temporal changes, and measuring the response to intervention in people with neurological conditions.
Deficiency of protease-activated receptor (PAR) 1 and PAR2 exacerbates collagen-induced arthritis in mice via differing mechanisms
Authors: Xue Meilang , Lin Haiyan , Liang Hai Po Helena , McKelvey Kelly , Zhao Ruilong , March Lyn , Jackson Christopher
Published: October 2020

Objectives

Protease-activated receptor (PAR) 1 and PAR2 have been implicated in RA, however their exact role is unclear. Here, we detailed the mechanistic impact of these receptors on the onset and development of inflammatory arthritis in murine CIA and antigen-induced arthritis (AIA) models.

Methods

CIA or AIA was induced in PAR1 or PAR2 gene knockout (KO) and matched wild type mice. The onset and development of arthritis was monitored clinically and histologically. Immune cells, cytokines and MMPs were detected by ELISA, zymography, flow cytometry, western blot or immunohistochemistry.

Results

In CIA, PAR1KO and PAR2KO exacerbated arthritis, in opposition to their effects in AIA. These deficient mice had high plasma levels of IL-17, IFN-γ, TGF-β1 and MMP-13, and lower levels of TNF-α; T cells and B cells were higher in both KO spleen and thymus, and myeloid-derived suppressor cells were lower only in PAR1KO spleen, when compared with wild type cells. Th1, Th2 and Th17 cells were lower in PAR1KO spleens cells, whereas Th1 and Th2 cells were lower and Th17 cells higher in both KO thymus cells, when compared with wild type cells. PAR1KO synovial fibroblasts proliferated faster and produced the most abundant MMP-9 amongst three type cells in the control, lipopolysaccharides or TNF stimulated conditions.

Conclusion

This is the first study demonstrated that deficiency of PAR1 or PAR2 aggravates inflammatory arthritis in CIA. Furthermore, the protective functions of PAR1 and PAR2 in CIA likely occur via differing mechanisms involving immune cell differentiation and cytokines/MMPs.
UNCERTAINTY OF THERMOLUMINESCENCE AT LOW DOSE LEVELS: A MONTE-CARLO SIMULATION STUDY
Authors: Sadek A M
Published: October 2020

The purpose of the current work is to investigate the effect of the scatter data and the background noise level on the uncertainty of the thermoluminescence (TL) measurements. The Monte-Carlo (MC) algorithm has been used to simulate the scattering data and the background noise signal in TL glow-curve. Under the simulation and experimental parameters used in the present study, a new general criterion for the minimum measurable dose has been established. It has been found from the results that the TL measurements, using either the peak maximum or the peak integral, can be conducted with an uncertainty level $<\pm 10\%[2\sigma ]$ when the TL signal is at least 10 times greater than the background noise signal. It has also been found that the same criterion can be used for the evaluation of the kinetics parameters of the TL glow-peak using either the peak fitting or the peak shape methods.
Racial and Age Disparities in Licensing Rates among a Sample of Urban MSW Graduates
Authors: Senreich Evan , Dale Travis
Published: October 2020

Forty-five U.S. states require social workers to pass an examination for entry-level MSW licensure, with all 50 states requiring it for clinical practice. All states use examinations created by the Association of Social Work Boards (ASWB) for this purpose. There has been concern that these exams may contribute to racial bias in social work licensing, as ASWB has historically not reported passing rates by demographic groups. In the present study, New York State licensing rates of over 5,000 graduates of three MSW programs of the City University of New York were analyzed according to race, gender, and age. Although passing rates on ASWB exams were not specifically examined, this study analyzed demographic disparities in licensure. In bivariate and multivariate analyses, White graduates had significantly higher rates of licensure than those who identified as Black, Latinx, Asian/Pacific Islander, mixed, or other. Furthermore, older Black and Latinx graduates had far lower rates of licensure than their younger counterparts. As a core value of social work is social justice, the results indicate the need for far more investigation into racial and age disparities in social work licensure.
An Australian view on a Trustee’s duty to account and to keep records and identify just what records should be kept and to discuss what are trust documents
Authors: Raphael David K L
Published: October 2020

This article reviews the law in England and Australia on the subject of a trustee’s duty to account and to keep appropriate records, and in that connection, what should be contained in a trustee’s minutes of deliberation and indeed what are, in fact, trust documents and the nature and extent of them. Related consideration is given to the ambit and extent of a beneficiary’s rights to information contained in trust documents. It should be noted that, where in this commentary the word “beneficiaries” is used, it is to be read as applying not merely those who are named as a beneficiary of the trust or who or which is a member of a class of beneficiaries but also as applying to all parties who are merely objects of a trust, i.e. those who can only benefit in consequence of the exercise of the trustee’s discretion. This application does not apply to the consideration and analysis of the law relating to inspection of trust documents, as will be abundantly clear later in this article. One other point must be made. This is that Australian unreported decisions and some reported decisions may not be readily available to UK readers. It is for this reason that certain lengthy extracts have been incorporated from some decisions as Annexures. Also in an article such as this, it makes sense to set out the extracts to assist in ease of absorption and comprehension.
Trade-offs between xylem water and carbohydrate storage among 24 coexisting subtropical understory shrub species spanning a spectrum of isohydry
Authors: Jiang Peipei , Meinzer Frederick C , Fu Xiaoli , Kou Liang , Dai Xiaoqin , Wang Huimin
Published: October 2020

Hydraulic capacitance and carbohydrate storage are two drought adaptation strategies of woody angiosperms. However, we currently lack information on their associations and how they are associated with species’ degree of isohydry. We measured total stem xylem nonstructural carbohydrate (NSC) concentration in the dry and wet seasons, xylem hydraulic capacitance, native leaf water potentials, pressure–volume curve parameters and photosynthetic performance in 24 woody understory species differing in their degree of isohydry. We found a trade-off between xylem water and carbohydrate storage both in storage capacitance and along a spectrum of isohydry. Species with higher hydraulic capacitance had lower native NSC storage. The less isohydric species tended to show greater NSC depletion in the dry season and have more drought-tolerant leaves. In contrast, the more isohydric species had higher hydraulic capacitance, which may enhance their drought avoidance capacity. In these species, leaf flushing in the wet season and higher photosynthetic rates in the dry season resulted in accumulation rather than depletion of NSC in the dry season. Our results provide new insights into the mechanisms through which xylem storage functions determine co-occurring species’ drought adaptation strategies and improve our capacity to predict community assembly processes under drought.
A Newborn with Brain-Eating Ameba Infection
Authors: Celik Yalcin , Arslankoylu Ali Ertuğ
Published: October 2020

Naegleria fowleriis a thermophilic free-living ameba that is found in warm, fresh water and causes primary amebic meningoencephalitis (PAM) in humans with high mortality rate. Here we report a case of newborn admitted with destructive clinical features of PAM after having bath with unchlorinated well water on a summer day.
Distinguishing Between the Impacts of Heat and Drought Stress on the Root Microbiome of Sorghum bicolor
Authors: Wipf Heidi M.-L. , Bùi Thảo-Nguyên , Coleman-Derr Devin
Published: October 2020

Water deficit and extreme temperatures regularly and considerably reduce crop productivity. Although several studies have explored the role of the plant microbiome in drought tolerance, it remains to be determined how the often co-occurring factor of heat conjunctly shapes plant–microbe interactions. In order to compare the roles that temperature and drought stress play in plant microbial recruitment, we conducted a growth chamber experiment with a series of temperatures (22, 30, and 38°C) and watering (drought versus watered) conditions in Sorghum bicolor, sampling soil mixtures and seedling roots at 7 and 21 days after initial stress initiation. We found that bacterial root communities had the lowest α diversity when under drought and at 38°C, and that temperature influenced the β diversity of soil mixture and root microbiomes to a greater extent than watering treatment. Additionally, we observed that the relative abundances of members of phylum Actinobacteria increased both under drought and, incrementally, with higher temperatures. Furthermore, unique Actinobacteria were indicator species of either temperature or watered conditions, and indicators of high temperature in watered conditions were predominantly in the phylum Actinobacteria. Together, these data suggest that heat and drought stress differentially affect microbiome assembly in significant ways and unique Actinobacteria are recruited under either stress. This work informs our understandings of how abiotic stresses jointly shape crop microbiomes, as well as highlights the need for additional work to describe what mechanisms may be involved in host-mediated microbial recruitment and adaptation under various stresses in field-based studies.

[Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Characterization of a New Nepovirus Infecting Grapevine
Authors: Al Rwahnih Maher , Alabi Olufemi J. , Hwang Min Sook , Tian Tongyan , Mollov Dimitre , Golino Deborah
Published: October 2020

In 2012, dormant canes of a proprietary wine grape (Vitis vinifera L.) accession were included in the collection of the University of California–Davis Foundation Plant Services. No virus-like symptoms were elicited when bud chips from propagated own-rooted canes of the accession were graft-inoculated onto a panel of biological indicators. However, chlorotic ringspot symptoms were observed on sap-inoculated Chenopodium amaranticolor Coste & A. Rein and C. quinoa Willd. plants, indicating the presence of a mechanically transmissible virus. Transmission electron microscopy of virus preparations from symptomatic C. quinoa revealed spherical, nonenveloped virions about 27 nm in diameter. Nepovirus-like haplotypes of sequence contigs were detected in both the source grape accession and symptomatic C. quinoa plants via high-throughput sequencing. A novel bipartite nepovirus-like genome was assembled from these contigs, and the termini of each RNA segment were verified by rapid amplification of complementary DNA ends assays. The RNA1 (7,186-nt) of the virus encodes a large polyprotein 1 of 231.1 kDa, and the RNA2 (4,460-nt) encodes a large polyprotein 2 of 148.9 kDa. Each of the polyadenylated RNA segments is flanked by 5′- (RNA1 = 156-nt; RNA2 = 170-nt) and 3′- (RNA1 = 834-nt; RNA2 = 261-nt) untranslated region sequences with >90% identities. Maximum likelihood phylogenetic analyses of the conserved Pro-Pol amino acid sequences revealed the clustering of the new virus within the genus Nepovirus of the family Secoviridae. Considering its biological and molecular characteristics, and based on current taxonomic criteria, we propose that the novel virus, named grapevine nepovirus A, be assigned to the genus Nepovirus.
Management of Acute Ischemic Stroke in the Interventional Neuroradiology Suite During the COVID-19 Pandemic: A Global Survey
Authors: Chowdhury Tumul , Rizk Abanoub A. , Daniels Abigail H. , Al Azazi Emad , Sharma Deepak , Venkatraghavan Lashmi
Published: October 2020

Background:

According to early reports, patients affected by coronavirus disease 2019 (COVID-19) are at an increased risk of developing cerebrovascular events, including acute ischemic stroke (AIS). The COVID-19 pandemic may also impose difficulties in managing AIS patients undergoing endovascular thrombectomy (EVT), as well as concerns for the safety of health care providers. This international global survey aims to gather and summarize information from tertiary care stroke centers on periprocedural pathways and endovascular management of AIS patients during the COVID-19 pandemic.

Methods:

A cross-sectional survey-based research questionnaire was sent to 259 tertiary care stroke centers with neurointerventional facilities worldwide.

Results:

We received 114 responses (response rate: 44%) from 25 different countries across all 5 continents. The number of AIS patients and EVT cases were reported to have decreased during the pandemic. Most participants reported conducting COVID-19 testing before (49%) or after the procedure (31%); 20% of centers did not test at all. Only 16% of participating centers reported using a negative pressure room for the thrombectomy procedure. Strikingly, 50% of participating centers reported no changes in the anesthetic management of AIS patients undergoing EVT during the pandemic.

Conclusions:

This global survey provides information on the challenges in managing AIS patients undergoing EVT during the COVID-19 pandemic. Its findings can be used to improve patient outcomes and the safety of the health care team worldwide.
Development and External Validation of an Online Clinical Prediction Model for Augmented Renal Clearance in Adult Mixed Critically Ill Patients: The Augmented Renal Clearance Predictor
Authors: Gijsen Matthias , Huang Chao-yuan , Flechet Marine , Van Daele Ruth , Declercq Peter , Debaveye Yves , Meersseman Philippe , Meyfroidt Geert , Wauters Joost , Spriet Isabel
Published: October 2020

Objectives:

Augmented renal clearance might lead to subtherapeutic plasma levels of drugs with predominant renal clearance. Early identification of augmented renal clearance remains challenging for the ICU physician. We developed and validated our augmented renal clearance predictor, a clinical prediction model for augmented renal clearance on the next day during ICU stay, and made it available via an online calculator. We compared its predictive performance with that of two existing models for augmented renal clearance.

Design:

Multicenter retrospective registry-based cohort study.

Setting:

Three Belgian tertiary care academic hospitals.

Patients:

Adult medical, surgical, and cardiac surgery ICU patients.

Interventions:

None.

Measurements and Main Results:

Development of the prediction model was based on clinical information available during ICU stay. Out of 33,258 ICU days, we found augmented renal clearance on 19.6% of all ICU days in the development cohort. We retained six clinical variables in our augmented renal clearance predictor: day from ICU admission, age, sex, serum creatinine, trauma, and cardiac surgery. We assessed performance by measuring discrimination, calibration, and net benefit. We externally validated the final model in a single-center population (n = 10,259 ICU days). External validation confirmed good performance with an area under the curve of 0.88 (95% CI 0.87–0.88) and a sensitivity and specificity of 84.1 (95% CI 82.5–85.7) and 76.3 (95% CI 75.4–77.2) at the default threshold probability of 0.2, respectively.

Conclusions:

Augmented renal clearance on the next day can be predicted with good performance during ICU stay, using routinely collected clinical information that is readily available at bedside. Our augmented renal clearance predictor is available at www.arcpredictor.com.
Adjustable 6-0 polypropylene flanged technique for scleral fixation, part 2: repositioning of subluxated IOLs
Authors: Assia Ehud I. , Wong John X.H.
Published: October 2020

Purpose:

To describe the technique of modified adjustable flange scleral fixation using 6-0 polypropylene sutures for repositioning of subluxated intraocular lenses (IOLs).

Setting:

Center for Applied Eye Research, Meir Medical Center, and the Ein-Tal Eye Center, Israel.

Design:

Case series.

Methods:

Subluxated capsular-fixated posterior chamber IOLs are secured to the sclera using 6-0 polypropylene sutures looped around the IOL haptics. This method can be performed for any type of IOL: hydrophobic, hydrophilic, silicone, or poly(methyl methacrylate); 1-piece or 3-piece; and with either closed-loop or open-loop haptics. It can also be used in conjunction with capsular stabilizing devices.

Results:

In the 18 cases performed, successful repositioning with stable and central fixation of the IOLs was achieved. One eye required a repeated surgery due to suture slippage. The eyes recovered relatively quickly with noted quiescence as early as 1 week postoperatively. Patients did not complain of ocular irritation from the subconjunctival flange up to the 6-month follow-up period. In 1 case, a flange was exposed postoperatively but the patient refused additional intervention and developed intraocular infection 7 months postoperatively.

Conclusions:

The adjustable 6-0 polypropylene flanged technique for IOL repositioning and scleral fixation was a relatively quick and simple method for management of subluxated IOLs. Complete coverage of the flange by conjunctiva and Tenon layer must be confirmed at the end of surgery.
Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic
Authors: Spatz Diane Lynn , Froh Elizabeth B.
Published: October 2020

For new families giving birth in a hospital setting, the COVID-19 pandemic has presented numerous challenges to their birth, breastfeeding, and postpartum experiences. We present experiences of three first-time, healthy mothers and their babies, as they gave birth in the hospital and were breastfeeding during the start of the pandemic in Philadelphia, PA. Each case is framed in the mother's prenatal goals, infant feeding intentions, birth, breastfeeding, and postpartum experiences. Shared concerns and experiences among the three participants are described in five key areas: 1) Recommendations changing every day, 2) Guilt, concern, and stress, 3) In-person versus telehealth visits, 4) Missing time with family and friends, and 5) Silver linings. Through these mothers' experiences, nurses and other health care providers can learn from their perceptions and events and proactively work to ensure we provide sound anticipatory guidance, enhance our communication, and improve provision of evidence-based lactation care and support.
Tenofovir alafenamide vs. tenofovir disoproxil fumarate: an updated meta-analysis of 14 894 patients across 14 trials
Authors: Pilkington Victoria , Hughes Sophie L. , Pepperrell Toby , McCann Kaitlyn , Gotham Dzintars , Pozniak Anton L. , Hill Andrew
Published: October 2020

Background:

Both tenofovir disoproxil fumarate (TDF)/emtricitabine and tenofovir alafenamide (TAF)/emtricitabine demonstrate excellent efficacy and safety overall, but concerns remain over specific changes in markers of bone and renal function. Lower plasma tenofovir concentrations are seen with TAF and in unboosted regimens. We assess TAF vs. TDF safety with and without booster coformulation.

Methods:

A previous systematic review was updated with recent clinical trials. TAF vs. TDF efficacy and safety were compared in boosted and unboosted subgroups. Efficacy was measured by viral suppression. Key safety endpoints included all adverse events, serious adverse events, Grades 3–4 adverse events and adverse event discontinuation. Further specific renal and bone markers were also assessed.

Results:

A total of 14 clinical trials comparing TDF and TAF regimens were identified. A significant difference (P = 0.0004) in efficacy was shown in the boosted subgroup in favour of TAF, but no difference was seen in the unboosted subgroup. There were no significant differences between TAF and TDF for any of the key safety endpoints analysed. No differences were seen for the bone markers analysed. No difference was found for renal tubular events. There was a difference in risk for discontinuation due to renal adverse events when boosted (P = 0.03), but none when unboosted.

Conclusion:

Across all main safety endpoints, no differences between TAF and TDF are seen. Boosted TDF regimens were associated with lesser comparative efficacy than boosted TAF and a higher risk of renal event discontinuation. However, modern antiretroviral regimens are more commonly unboosted. This study finds no difference in efficacy or safety in unboosted TAF vs. TDF.
Changes in weight and BMI with first-line doravirine-based therapy
Authors: Orkin Chloe , Elion Richard , Thompson Melanie , Rockstroh Juergen K. , Alvarez Bognar Fernando , Xu Zhi J. , Hwang Carey , Sklar Peter , Martin Elizabeth A.
Published: October 2020

Objective:

To evaluate changes in weight and BMI in adults with HIV-1 at 1 and 2 years after starting an antiretroviral regimen that included doravirine, ritonavir-boosted darunavir, or efavirenz.

Design:

Post-hoc analysis of pooled data from three randomized controlled trials.

Methods:

We evaluated weight change from baseline, weight gain at least 10%, and increase in BMI after 48 and 96 weeks of treatment with doravirine, ritonavir-boosted darunavir, or efavirenz-based regimens. Risk factors for weight gain and metabolic outcomes associated with weight gain were also examined.

Results:

Mean (and median) weight changes were similar for doravirine [1.7 (1.0) kg] and ritonavir-boosted darunavir [1.4 (0.6) kg] and were lower for efavirenz [0.6 (0.0) kg] at week 48 but were similar across all treatment groups at week 96 [2.4 (1.5), 1.8 (0.7), and 1.6 (1.0) kg, respectively]. No significant differences between treatment groups were found in the proportion of participants with at least 10% weight gain or the proportion with BMI class increase at either time point. Low CD4+ T-cell count and high HIV-1 RNA at baseline were associated with at least 10% weight gain and BMI class increase at both timepoints, but treatment group, age, sex, and race were not.

Conclusion:

Weight gains over 96 weeks were low in all treatment groups and were similar to the average yearly change in adults without HIV-1. Significant weight gain and BMI class increase were similar across the treatment groups and were predicted by low baseline CD4+ T-cell count and high baseline HIV-1 RNA.
What is the Treatment Role of Transpapillary Cholecystostomy for Delayed Cholecystectomy in the Coexistence of Acute Cholecystitis and Cholangitis
Authors: Gumusoglu Alpen Y. , Kabuli Hamit A. , Kones Osman , Karabulut Mehmet , Akbulut Sezer , Akarsu Cevher , Peker Kivanc D. , Adas Gokhan
Published: October 2020

Introduction:

This study aims to investigate the role of main bile duct drainage and gallbladder transpapillary drainage in the treatment of patients who diagnosed with acute cholecystitis and acute cholangitis because of choledocholithiasis.

Materials and Methods:

Patients who were admitted to the hospital with the diagnosis of acute cholecystitis between January 2018 and December 2019, have hyperbilirubinemia in their laboratory tests, and who were diagnosed with choledochal stone by magnetic resonance imaging and magnetic resonance cholangiopancreatography imaging because of the findings of cholangitis were included in this study. These patients underwent endoscopic retrograde cholangiopancreatography (ERCP) and choledochus stone extraction procedure and gallbladder drainage with the transpapillary pigtail. The demographic data, success rates, and complications of the patients were evaluated.

Results:

A total of 19 patients were included in the study. Choledochus was cannulated in all patients, but gallbladder drainage could not be achieved in 2 patients. These 2 patients were recorded under the unsuccessful method use. Although 2 patients could not be operated because of high comorbidity (American Society of Anesthesiologists IV), they underwent percutaneous cholecystostomy because of the development of cholecystitis arising from an obstruction in the pigtail catheter in the 11th and 12th weeks. Treatments of the remaining 15 patients and subsequent cholecystectomy procedures were successful. The mean age of the patients was 54.52 years. Of the patients, 9 were female and 6 were male. In the 6th week of follow-up, 15 patients underwent laparoscopic cholecystectomy with ERCP 1 day after removal of the stent and pigtail catheter.

Conclusions:

Transpapillary cholecystectomy with ERCP is a successful method of treatment in patients with acute cholecystitis with the symptoms of cholangitis because of choledochal stone.
An Analysis of Free-hand Targeting in Laparoscopic Liver Microwave Ablation
Authors: Li Pengpeng , Erten Ozgun , Akbulut Serkan , Gokceimam Mehmet , Berber Eren
Published: October 2020

Background:

Recently, new technologies have been developed for antenna placement in laparoscopic liver tumor ablation (LLTA). At this point, it is important to analyze the efficacy of free-hand targeting to identify deficiencies and opportunities for improvement.

Methods:

This was an institutional review board-approved retrospective study. Video recordings of 30 consecutive patients with 77 lesions who underwent LLTA were reviewed. Tumor-specific anatomic and targeting-related parameters were analyzed using χ2, t test, and regression analyses.

Results:

Neuroendocrine metastasis was the dominant tumor type, with median tumor size 1.4 cm (range, 0.5 to 5.2). In total, 41 (53%) tumors were superficial and 36 (47%) deep. In 68 lesions (88%), an optimal targeting was achieved with first attempt, without a need for repositioning; whereas 9 lesions (12%) required repositioning of antenna. For 37% (15/41) of superficial and 56% (20/36) of deep lesions, a straight avascular needle trajectory was not present, requiring steering of the antenna around vascular and biliary structures. All procedures were completed laparoscopically without bleeding or biliary complications. Local treatment recurrence rate in follow-up was 10% (n=8).

Conclusions:

This study shows that in experienced hands, LLTA through free-hand technique is safe and efficacious, providing an accurate targeting with the first pass in 90% of tumors. Although newer technology is being developed to guide less-experienced surgeons in needle targeting, it should be kept in mind that a straight trajectory is not available for 1/3 of superficial and half of deep lesions. Hence, ablation surgeons need to develop free-hand skills to avoid possible hemorrhagic and biliary complications in LLTA.
Combined head and abdominal blunt trauma in the hemodynamically unstable patient: What takes priority?
Authors: Jakob Dominik A. , Benjamin Elizabeth R. , Cho Jayun , Demetriades Demetrios
Published: October 2020

BACKGROUND

The management of hypotensive patients with severe combined head and abdominal trauma is challenging, regarding the need, timing, and sequence of craniotomy or laparotomy. The purpose of the present study was to determine whether rare situations requiring craniotomy prior to laparotomy can be identified on admission with simple clinical parameters. We hypothesized that hypotension is rarely associated with the need of a combined procedure, especially in patients with mildly depressed consciousness.

METHODS

National Trauma Data Bank study, including adult blunt trauma patients with combined severe head (Abbreviated Injury Scale score, ≥ 3) and abdominal injury (Abbreviated Injury Scale score, ≥ 3). Data collection included demographic and clinical characteristics, laparotomy, and craniotomy within 24 hours of admission, types of intracranial pathologies, survival, and hospital stay. Multivariate regression analysis was used to determine factors predictive for the need of both operative procedures.

RESULTS

Of 25,585 patients with severe combined head and abdominal trauma, 8,744 (34.2%) needed only laparotomy, 534 (2.1%) only craniotomy, and 394 (1.5%) required both procedures within 24 hours of admission. In the subgroup of 4,667 hypotensive patients, 2,421 (51.9%) underwent only laparotomy, 54 (1.2%) only craniotomy, and 79 (1.7%) both procedures within 24 hours of admission. Only 5 (0.7%) of 711 hypotensive patients with Glasgow Coma Scale (GCS) score above 8 who required a laparotomy also needed a craniotomy. Among clinical parameters available on patient’s arrival, GCS score of 7 to 8 was independently associated with the highest need for craniotomy in hypotensive patients requiring laparotomy (odds ratio, 7.94; p = 0.004).

CONCLUSION

The need for craniotomy in patients with severe combined head and abdominal injury requiring exploratory laparotomy is very low. In hypotensive patients requiring laparotomy, GCS score of 7 to 8 was an independent predictor of the need for craniotomy. In hemodynamically unstable patients with a GCS score greater than 8, it may be safer to proceed with a laparotomy first and address the head with a computed tomography scan at a later stage.

LEVEL OF EVIDENCE

Therapeutic, Level IV.
Long-term shifts in the colony size structure of coral populations along the Great Barrier Reef
Authors: Dietzel Andreas , Bode Michael , Connolly Sean R. , Hughes Terry P.
Published: October 2020

The age or size structure of a population has a marked influence on its demography and reproductive capacity. While declines in coral cover are well documented, concomitant shifts in the size-frequency distribution of coral colonies are rarely measured at large spatial scales. Here, we document major shifts in the colony size structure of coral populations along the 2300 km length of the Great Barrier Reef relative to historical baselines (1995/1996). Coral colony abundances on reef crests and slopes have declined sharply across all colony size classes and in all coral taxa compared to historical baselines. Declines were particularly pronounced in the northern and central regions of the Great Barrier Reef, following mass coral bleaching in 2016 and 2017. The relative abundances of large colonies remained relatively stable, but this apparent stability masks steep declines in absolute abundance. The potential for recovery of older fecund corals is uncertain given the increasing frequency and intensity of disturbance events. The systematic decline in smaller colonies across regions, habitats and taxa, suggests that a decline in recruitment has further eroded the recovery potential and resilience of coral populations.
Plant-virus-insect tritrophic interactions: insights into the functions of geminivirus virion-sense strand genes
Authors: Vinoth Kumar R. , Shivaprasad P. V.
Published: October 2020

The genome of the plant-infecting viruses in the family Geminiviridae is composed of one or two circular single stranded DNA of approximately 2.7–5.2 kb in length. These viruses have emerged as the most devastating pathogen infecting a large number of crops and weeds across the continents. They code for fewer open reading frames (ORFs) through the generation of overlapping transcripts derived from the bidirectional viral promoters. Members of geminiviruses code for up to four ORFs in the virion-sense strand, and their gene expression is regulated by variouscis-elements located at their promoters in the intergenic region. These viral proteins perform multiple functions at every stage of the viral life cycle such as virus transport, insect-mediated virus transmission and suppression of host defence. They impede the host's multi-layered antiviral mechanisms including gene silencing (at transcriptional and post-transcriptional levels) and hypersensitive response. This review summarizes the essential role of virion-sense strand encoded proteins in transport of viral genomes within and between plant cells, countering defence in hosts (both plants and the insects), and also in the ubiquitous role in vector-mediated transmission. We highlight the significance of their pro-viral activities in manipulating host-derived innate immune responses and the interaction with whitefly-derived proteins. We also discuss the current knowledge on virus replication and transcription within the insect body.
Postcopulatory sexual selection and the evolution of shape complexity in the carnivoran baculum
Authors: Brassey Charlotte A. , Behnsen Julia , Gardiner James D.
Published: October 2020

The baculum is an enigmatic bone within the mammalian glans penis, and the driving forces behind its often bizarre shape have captivated evolutionary biologists for over a century. Hypotheses for the function of the baculum include aiding in intromission, stimulating females and assisting with prolonged mating. Previous attempts to test these hypotheses have focused on the gross size of the baculum and have failed to reach a consensus. We conducted three-dimensional imaging and apply a new method to quantify three-dimensional shape complexity in the carnivoran baculum. We show that socially monogamous species are evolving towards complex-shaped bacula, whereas group-living species are evolving towards simple bacula. Overall three-dimensional baculum shape complexity is not related to relative testes mass, but tip complexity is higher in induced ovulators and species engaging in prolonged copulation. Our study provides evidence of postcopulatory sexual selection pressures driving three-dimensional shape complexity in the carnivore baculum.
Octopamine and dopamine mediate waggle dance following and information use in honeybees
Authors: Linn Melissa , Glaser Simone M. , Peng Tianfei , Grüter Christoph
Published: October 2020

Honeybees can be directed to profitable food sources by following waggle dances performed by other bees. Followers can often choose between using this social information or relying on memories about food sources they have visited in the past, so-called private information. While the circumstances that favour the use of either social or private information have received considerable attention, still little is known about the neurophysiological basis of information use. We hypothesized that octopamine and dopamine, two biogenic amines with important functions in reward signalling and learning, affect dance use in honeybees. We orally administered octopamine and dopamine when bees collected food at artificial feeders and tested if this affected interest in dance information about a new food source. We predicted that octopamine reduces interest in dances and strengthens private information use via an increase in the perceived value of the previously exploited resource. Since dopamine has been shown to lower reward perception, we expected it to act in the opposite direction. Octopamine-treated foragers indeed followed 32% fewer dances than control bees and increased the use of private information. Conversely, dopamine-treated bees followed dances 15% longer than control bees, but surprisingly did not use social information more. Overall, our results suggest that biogenic amine signalling affects interactions among dancers and dance followers and, thus, information flow about high-quality food sources.
Rufibacter hautae sp. nov., a red-pigmented bacterium from freshwater lake sediment, and proposal of Rufibacter quisquiliarum as a latter heterotypic synonym of Rufibacter ruber
Authors: Zhou Jia , Ma Wen-Wen , Qu Jian-Hang , Li Hai-Feng , Yang Bang-Bang , Qu Ling-Bo , Wang Lin-Feng
Published: October 2020

A taxonomic identification using a polyphasic approach was performed on strain NBS58-1T, which was isolated from the interfacial sediment of Taihu Lake in China. Strain NBS58-1T was Gram-stain-negative, aerobic, non-spore-forming and catalase-positive. Phylogenetic analyses based on 16S rRNA gene and three housekeeping genes (rpoB, gyrB and dnaK) sequences supported the position that strain NBS58-1T should be classified within the genus

Rufibacter

. The 16S rRNA gene sequence of strain NBS58-1T possessed the highest similarity to

Rufibacter sediminis

H-1T (96.60 %), followed by

Rufibacter glacialis

MDT1-10-3T (96.17 %). And the ANI value between strain NBS58-1T and

R. glacialis

MDT1-10-3T was 79.3 %. The respiratory quinone was menaquinone 7 (MK-7). The major cellular fatty acids comprised iso-C15 : 0 and summed feature 3. Phosphatidylethanolamine, two unidentified phospholipids and four unidentified lipids were the main polar lipids. The genomic DNA G+C content was 51.3 mol%. Based on phenotypic features and phylogenetic position, a novel species with the name Rufibacter hautae sp. nov. is proposed. The type strain is NBS58-1T=(KACC 21309T=MCCC 1K04037T). We also proposed

Rufibacter quisquiliarum

as a latter heterotypic synonym of

Rufibacter ruber

.
Pseudarthrobacter psychrotolerans sp. nov., a cold-adapted bacterium isolated from Antarctic soil
Authors: Shin Yoonjae , Lee Byoung-Hee , Lee Ki-Eun , Park Woojun
Published: October 2020

A novel cold-tolerant bacterium, designated strain YJ56T, was isolated from Antarctic soil collected from the Cape Burk area. Phylogenetic analysis through 16S rRNA gene sequence similarity revealed that strain YJ56T was most closely related to the genus

Pseudarthrobacter

, including

Pseudarthrobacter oxydans

DSM 20119T (99.06 % similarity),

Pseudarthrobacter polychromogenes

DSM 20136T (98.98 %) and

Pseudarthrobacter sulfonivorans

ALLT (98.76 %). The genome size (5.2 Mbp) of strain YJ56T was the largest among all the published genomes of

Pseudarthrobacter

type strains (4.2–5.0 Mbp). The genomic G+C content of strain YJ56T (64.7 mol%) was found to be consistent with those of other

Pseudarthrobacter

strains (62.0–71.0 mol%). The average nucleotide identity and average amino acid identity values between strain YJ56T and

P. sulfonivorans

ALLT were estimated at 84.1 and 84.2 %, respectively. The digital DNA–DNA hybridization value between the two strains was calculated to be 28.0 %. This rod-shaped and obligate aerobic strain exhibited no swimming or swarming motility. It had catalase activity but no oxidase activity. Cells grew at 4–28 °C (optimum, 13 °C) and pH 5.0–11.0 (optimum, pH 7.0) and with 0–6.0 % (w/v) NaCl (optimum, 0%) in Reasoner's 2A medium. MK-9 (H2) was the sole menaquinone. Two-dimensional TLC results revealed that the primary polar lipids were diphosphatidylglycerol, phosphatidylglycerol, two glycolipids and phosphatidylinositol. Fatty acid methyl ester analysis showed that anteiso-C15 : 0, anteiso-C17 : 0, iso-C15 : 0, C16 : 0 and iso-C16 : 0 were the major cellular fatty acids in strain YJ56T. Based on phenotypic and genotypic characteristics, strain YJ56T represents a novel species of the genus

Pseudarthrobacter

, and thus the name Pseudarthrobacter psychrotolerans sp. nov is proposed. The type strain is YJ56T (=JCM 33881T=KACC 21510T).
ICTV Virus Taxonomy Profile: Metaviridae
Authors: Llorens Carlos , Soriano Beatriz , Krupovic Mart ,   ICTV Report Consortium
Published: October 2020

Metaviridae is a family of retrotransposons and reverse-transcribing viruses with long terminal repeats belonging to the order Ortervirales. Members of the genera Errantivirus and Metavirus include, respectively, Saccharomyces cerevisiae Ty3 virus and its Gypsy-like relatives in drosophilids. This is a summary of the International Committee on Taxonomy of Viruses (ICTV) Report on the family Metaviridae, which is available at ictv.global/report/metaviridae.
Whole-genome sequencing to investigate two concurrent outbreaks of Salmonella Enteritidis in South Africa, 2018
Authors: Smith Anthony M. , Tau Nomsa P. , Ngomane Hlengiwe M. , Sekwadi Phuti , Ramalwa Ntsieni , Moodley Krishnee , Govind Chetna , Khan Shameema , Archary Moherndran , Thomas Juno
Published: October 2020

Salmonella enterica

serotype Enteritidis (

Salmonella

Enteritidis) is a major cause of foodborne disease outbreaks worldwide. In 2018, two concurrent outbreaks of

Salmonella

Enteritidis gastroenteritis in one district of South Africa were investigated. We describe the use of whole-genome sequencing (WGS) analysis of bacterial isolates to assist with the investigation of these outbreaks. Outbreak A affected children (n=27) attending a day-care centre, while outbreak B affected adults (n=16) who ate breakfast at the same restaurant.

Salmonella

Enteritidis was isolated from stool samples in both outbreaks (four children in outbreak A; 12 restaurant customers and three restaurant food-handlers in outbreak B). In outbreak B,

Salmonella

Enteritidis was isolated from three food retention samples (raw chicken egg, hollandaise sauce and rocket-herb). Available isolates from both outbreaks (n=13) were investigated using WGS analysis. Sequencing data for isolates were analysed at the EnteroBase web-based platform and included core-genome multi-locus sequence typing (cgMLST). Isolates with epidemiological links to the restaurant (n=10) and day-care centre (n=3), were shown by cgMLST to be highly genetically related, with no more than five allele differences when comparing one isolate against another. On food history, eggs and hollandaise sauce were the common food items consumed by ill restaurant customers. Unfortunately,

Salmonella

Enteritidis isolated from the egg and hollandaise sauce were not available for WGS analysis. Our investigation concluded that the two concurrent outbreaks were caused by a highly related strain of

Salmonella

Enteritidis, suggesting the possibility of a common contaminated food source, of which contaminated eggs are strongly implicated.
Duration of Supplemental Oxygen Requirement and Predictors in Severe COVID-19 Patients in Ethiopia: A Survival Analysis
Authors: Leulseged Tigist W. , Hassen Ishmael S. , Edo Mesay G. , Abebe Daniel S. , Maru Endalkachew H. , Zewde Wuletaw C. , Chamiso Nigat W. , Jagema Tariku B.
Published: October 2020

Background

With the rising number of new cases of COVID-19, understanding the oxygen requirement of severe patients assists in identifying at risk groups and in making an informed decision on building hospitals capacity in terms of oxygen facility arrangement. Therefore, the study aimed to estimate time to getting off supplemental oxygen therapy and identify predictors among COVID-19 patients admitted to Millennium COVID-19 Care Center in Ethiopia.

Methods

A prospective observational study was conducted among 244 consecutively admitted COVID-19 patients from July to September, 2020. Kaplan Meier plots, median survival times and Log-rank test were used to describe the data and compare survival distribution between groups. Cox proportional hazard survival model was used to identify determinants of time to getting off supplemental oxygen therapy, where hazard ratio (HR), P-value and 95%CI for HR were used for testing significance and interpretation of results.

Results

Median time to getting off supplemental oxygen therapy among the studied population was 6 days (IQR, 4.3-20.0). Factors that affect time to getting off supplemental oxygen therapy were age group (AHR=0.52,95%CI=0.32,0.84, p-value=0.008 for ≥70 years) and shortness of breath (AHR=0.71,95%CI=0.52,0.96, p-value=0.026).

Conclusions

Average duration of supplemental oxygen therapy requirement among COVID-19 patients was 6 days and being 70 years and older and having shortness of breath were found to be associated with prolonged duration of supplemental oxygen therapy requirement. This result can be used as a guide in planning institutional resource allocation and patient management to provide a well-equipped care to prevent complications and death from the disease.
The Statistical Monitoring by Adaptive RMSTD Tests: an efficient, informative, and customizable method for the complete internal quality control intended for low-frequent sampling of control measures
Authors: Beier Christian
Published: October 2020

Two control mechanisms are relevant to perform an internal quality assurance: a permissible limit LSMC applied to single measures of control samples and a retrospective statistical analysis to detect increased imprecision and baseline drifts. A common statistical metric is the root mean square (total) deviation (RMSD/RMSTD). To focus on recent changes under low-frequent sampling conditions, the monitored amount of retrospective data is usually very small. Unfortunately, the calculated RMSTD of a small data set with n<50 samples has a significant statistical uncertainty that needs to be considered in adequate limit definitions. In particular, the minimum reasonable limit LRMSTD(n), applied to the RMSTD of a series of n samples, decreases from LSMC (e.g., 2.33*standard_deviation+bias) for n=1 towards Ltrue_RMSTD for n→∞ (long-term statistics). Two mathematical approaches were derived to reliably estimate an optimal function to adjust LRMSTD(n) to small sample sizes.

This knowledge led to the development of a new quality-control method: the Statistical Monitoring by Adaptive RMSTD Tests (SMART). SMART requires just one mandatory limit (either LSMC or Ltrue_RMSTD) per analyte. By definition of up to 7 possible alert levels, SMART can early recognize and evaluate both the significance of a single outlier and establishing critical trends or shifts in recent SMC data. SMART is intended to efficiently monitor and evaluate small amounts of control data.