bluuebunny/crossref_metadata_2025 huggingface dataset:
Responding Effectively to Customer Feedback on Twitter: A Mixed Methods Study of Webcare Styles
Authors: Fuoli Matteo , Clarke Isobelle , Wiegand Viola , Ziezold Hendrik , Mahlberg Michaela
Published: August 2020

Social media offer an unprecedented opportunity for companies to interact more closely with customers and market their products and services. But social media also present reputational risks as negative word-of-mouth can spread more quickly and widely through these platforms than ever before. This study investigates how companies respond to customer complaints on Twitter. We propose an innovative mixed methods approach (i) to identify the key features that mark the styles used by a sample of companies in their replies to customers and (ii) to determine the most effective strategies for responding to complaints. Our results reveal that an affective style, expressed through devices such as stance markers, emphatics, and amplifiers, elicits the most positive response from complainants, regardless of the formality of the message. The study advances our understanding of the features and effects of corporate social media discourse. It also provides business communication practitioners with linguistically grounded insights that can inform the development of appropriate strategies for dealing with negative word-of-mouth online.
Genetic diversity and structure of the hedgehogsErinaceus europaeusandErinaceus roumanicus: evidence for ongoing hybridization in Eastern Europe
Authors: Zolotareva Katerina I , Belokon Mariana M , Belokon Yuri S , Rutovskaya Marina V , Hlyap Ludmila A , Starykov Vladimir P , Politov Dmitry V , Lebedev Vladimir S , Bannikova Anna A
Published: August 2020

Secondary contact zones between related species are key to understanding speciation mechanisms. The Central European sympatry zone of West European (Erinaceus europaeus) and northern white-breasted (Erinaceus roumanicus) hedgehogs is well studied, whereas data on the Eastern European sympatry zone are scarce. We examined the genetic variation in Russian populations using the mitochondrial Cytb gene, TTR intron 1 and 11 microsatellites to assess genetic variability and distribution patterns. In contrast to the Central European sympatry zone, we found evidence of ongoing hybridization between the two species in the sympatry zone of European Russia, where the proportion of individuals with mixed ancestry was c. 20%. Our data indicate bi-directional mtDNA introgression, but with a higher frequency of E. europaeus haplotypes in hybrids. The proportion of pure specimens with introgressed mitotypes is higher in E. roumanicus than in E. europaeus. Nuclear data showed the prevalence of the genetic contribution from E. roumanicus in admixed individuals. Demographic analyses indicated recent population growth in E. europaeus and little change in E. roumanicus, suggesting that E. europaeus colonized East Europe later than E. roumanicus.
Community Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 Disproportionately Affects the Latinx Population During Shelter-in-Place in San Francisco
Authors: Chamie Gabriel , Marquez Carina , Crawford Emily , Peng James , Petersen Maya , Schwab Daniel , Schwab Joshua , Martinez Jackie , Jones Diane , Black Douglas , Gandhi Monica , Kerkhoff Andrew D , Jain Vivek , Sergi Francesco , Jacobo Jon , Rojas Susana , Tulier-Laiwa Valerie , Gallardo-Brown Tracy , Appa Ayesha , Chiu Charles , Rodgers Mary , Hackett John ,   CLIAhub Consortium, Kistler Amy , Hao Samantha , Kamm Jack , Dynerman David , Batson Joshua , Greenhouse Bryan , DeRisi Joe , Havlir Diane V
Published: August 2020

Background

There is an urgent need to understand the dynamics and risk factors driving ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission during shelter-in-place mandates.

Methods

We offered SARS-CoV-2 reverse-transcription polymerase chain reaction (PCR) and antibody (Abbott ARCHITECT IgG) testing, regardless of symptoms, to all residents (aged ≥4 years) and workers in a San Francisco census tract (population: 5174) at outdoor, community-mobilized events over 4 days. We estimated SARS-CoV-2 point prevalence (PCR positive) and cumulative incidence (antibody or PCR positive) in the census tract and evaluated risk factors for recent (PCR positive/antibody negative) vs prior infection (antibody positive/PCR negative). SARS-CoV-2 genome recovery and phylogenetics were used to measure viral strain diversity, establish viral lineages present, and estimate number of introductions.

Results

We tested 3953 persons (40% Latinx; 41% White; 9% Asian/Pacific Islander; and 2% Black). Overall, 2.1% (83/3871) tested PCR positive: 95% were Latinx and 52% were asymptomatic when tested; 1.7% of census tract residents and 6.0% of workers (non–census tract residents) were PCR positive. Among 2598 tract residents, estimated point prevalence of PCR positives was 2.3% (95% confidence interval [CI], 1.2%–3.8%): 3.9% (95% CI, 2.0%–6.4%) among Latinx persons vs 0.2% (95% CI, .0–.4%) among non-Latinx persons. Estimated cumulative incidence among residents was 6.1% (95% CI, 4.0%–8.6%). Prior infections were 67% Latinx, 16% White, and 17% other ethnicities. Among recent infections, 96% were Latinx. Risk factors for recent infection were Latinx ethnicity, inability to shelter in place and maintain income, frontline service work, unemployment, and household income <$50 000/year. Five SARS-CoV-2 phylogenetic lineages were detected.

Conclusions

SARS-CoV-2 infections from diverse lineages continued circulating among low-income, Latinx persons unable to work from home and maintain income during San Francisco’s shelter-in-place ordinance.
Parameter interdependence of dynamic self-similar crack with distance-weakening friction
Authors: Hirano Shiro , Itou Hiromichi
Published: August 2020

In several analytical and numerical studies, the slip rate function and energy release rate for dynamic self-similar crack growth have been investigated, and the results obtained have contributed to a theoretical understanding and estimation of on-fault energetics. However, the relationships among physical parameters, including stress state, process zone size, rupture velocity, peak slip rate and energy release rate, are still unclear. Therefore, the aim of this study is to derive an analytical solution of the slip rate distribution of antiplane self-similar crack growth under distance-weakening friction that mimics slip-weakening friction. To satisfy the condition that the slip rate starts from zero at the rupture front, a trade-off relationship among rupture velocity, process zone size and breakdown stress-to-stress drop ratio is proposed. The peak slip rate, slip-weakening distance and fracture energy obtained using the proposed model provide a possible mechanism for the determination of the rupture velocity and the estimation of the fracture energy of the self-similar crack growth, based on the seismic observables.
Genetics and geography of leukocyte telomere length in sub-Saharan Africans
Authors: Hunt Steven C , Hansen Matthew E B , Verhulst Simon , McQuillan Michael A , Beggs William , Lai Tsung-Po , Mokone Gaonyadiwe G , Mpoloka Sununguko Wata , Meskel Dawit Wolde , Belay Gurja , Nyambo Thomas B , Abnet Christian C , Yeager Meredith , Chanock Stephen J , Province Michael A , Williams Scott M , Aviv Abraham , Tishkoff Sarah A
Published: August 2020

Leukocyte telomere length (LTL) might be causal in cardiovascular disease and major cancers. To elucidate the roles of genetics and geography in LTL variability across humans, we compared LTL measured in 1295 sub-Saharan Africans (SSAs) with 559 African–Americans (AAms) and 2464 European–Americans (EAms). LTL differed significantly across SSAs (P = 0.003), with the San from Botswana (with the oldest genomic ancestry) having the longest LTL and populations from Ethiopia having the shortest LTL. SSAs had significantly longer LTL than AAms [P = 6.5(e-16)] whose LTL was significantly longer than EAms [P = 2.5(e-7)]. Genetic variation in SSAs explained 52% of LTL variance versus 27% in AAms and 34% in EAms. Adjustment for genetic variation removed the LTL differences among SSAs. LTL genetic variation among SSAs, with the longest LTL in the San, supports the hypothesis that longer LTL was ancestral in humans. Identifying factors driving LTL variation in Africa may have important ramifications for LTL-associated diseases.
A sharp error estimate of piecewise polynomial collocation for nonlocal problems with weakly singular kernels
Authors: Chen Minghua , Qi Wenya , Shi Jiankang , Wu Jiming
Published: August 2020

As is well known, piecewise linear polynomial collocation (PLC) and piecewise quadratic polynomial collocation (PQC) are used to approximate the weakly singular integrals $$\begin{equation*}I(a,b,x) =\int^b_a \frac{u(y)}{|x-y|^\gamma}\textrm{d}y, \quad x \in (a,b),\quad 0< \gamma <1,\end{equation*}$$which have local truncation errors $\mathcal{O} (h^2 )$ and $\mathcal{O} (h^{4-\gamma } )$, respectively. Moreover, for Fredholm weakly singular integral equations of the second kind, i.e., $\lambda u(x)- I(a,b,x) =f(x)$, $\lambda \neq 0$, the global convergence rates are also $\mathcal{O} (h^2 )$ and $\mathcal{O} (h^{4-\gamma } )$ by PLC and PQC in Atkinson (2009, The Numerical Solution of Integral Equations of the Second Kind, Cambridge University Press). In this work we study the following nonlocal problems, which are similar to the above Fredholm integral equations: $$\begin{equation*}\int^b_a \frac{u(x)-u(y)}{|x-y|^\gamma}\textrm{d}y =f(x), \quad x \in (a,b),\quad 0< \gamma <1. \end{equation*}$$In the first part of this paper we prove that the weakly singular integrals $I(a,b,x)$ have optimal local truncation error $\mathcal{O}(h^4\eta _i^{-\gamma } )$ by PQC, where $\eta _i=\min \left \{x_i-a,b-x_i\right \}$ and $x_i$ coincides with an element junction point. Then the sharp global convergence orders $\mathcal{O}\left (h\right )$ and $\mathcal{O} (h^3)$ by PLC and PQC, respectively, are established for nonlocal problems. Finally, numerical experiments are shown to illustrate the effectiveness of the presented methods.
Selective Decay of Intact HIV-1 Proviral DNA on Antiretroviral Therapy
Authors: Gandhi Rajesh T , Cyktor Joshua C , Bosch Ronald J , Mar Hanna , Laird Gregory M , Martin Albine , Collier Ann C , Riddler Sharon A , Macatangay Bernard J , Rinaldo Charles R , Eron Joseph J , Siliciano Janet D , McMahon Deborah K , Mellors John W ,   AIDS Clinical Trials Group A5321 Team, Hogg Evelyn , LeBlanc Rebecca , Scello Christine , Palm David , Gandhi Monica , Fletcher Courtney , Podany Anthony , Aweeka Fran , Halvas Lou , Dragavon Joan , Joseph Jeymohan , Lagattuta Rose , Lin Leyi , Pederson Susan , Robertson Kevin , Rubin Leah , Smith Davey , Spudich Serena , Tsibris Athe
Published: August 2020

Background

HIV-1 proviruses persist in people on antiretroviral therapy (ART) but most are defective and do not constitute a replication-competent reservoir. The decay of infected cells carrying intact compared with defective HIV-1 proviruses has not been well defined in people on ART.

Methods

We separately quantified intact and defective proviruses, residual plasma viremia, and markers of inflammation and activation in people on long-term ART.

Results

Among 40 participants tested longitudinally from a median of 7.1 years to 12 years after ART initiation, intact provirus levels declined significantly over time (median half-life, 7.1 years; 95% confidence interval [CI], 3.9–18), whereas defective provirus levels did not decrease. The median half-life of total HIV-1 DNA was 41.6 years (95% CI, 13.6–75). The proportion of all proviruses that were intact diminished over time on ART, from about 10% at the first on-ART time point to about 5% at the last. Intact provirus levels on ART correlated with total HIV-1 DNA and residual plasma viremia, but there was no evidence for associations between intact provirus levels and inflammation or immune activation.

Conclusions

Cells containing intact, replication-competent proviruses are selectively lost during suppressive ART. Defining the mechanisms involved should inform strategies to accelerate HIV-1 reservoir depletion.
Supporting global antimicrobial stewardship: antibiotic prophylaxis for the prevention of surgical site infection in low- and middle-income countries (LMICs): a scoping review and meta-analysis
Authors: Cooper Lesley , Sneddon Jacqueline , Afriyie Daniel Kwame , Sefah Israel A , Kurdi Amanj , Godman Brian , Seaton R Andrew
Published: August 2020

Background

The Scottish Antimicrobial Prescribing Group is supporting two hospitals in Ghana to develop antimicrobial stewardship. Early intelligence gathering suggested that surgical prophylaxis was suboptimal. We reviewed the evidence for use of surgical prophylaxis to prevent surgical site infections (SSIs) in low- and middle-income countries (LMICs) to inform this work.

Methods

MEDLINE, Embase, Cochrane, CINAHL and Google Scholar were searched from inception to 17 February 2020 for trials, audits, guidelines and systematic reviews in English. Grey literature, websites and reference lists of included studies were searched. Randomized clinical trials reporting incidence of SSI following Caesarean section were included in two meta-analyses. Narrative analysis of studies that explored behaviours and attitudes was conducted.

Results

This review included 51 studies related to SSI and timing of antibiotic prophylaxis in LMICs. Incidence of SSI is higher in LMICs, infection surveillance data are poor and there is a lack of local guidelines for antibiotic prophylaxis. Education to improve appropriate antibiotic prophylaxis is associated with reduction of SSI in LMICs. The random-effects pooled mean risk ratio of SSI in Caesarean section was 0.77 (95% CI: 0.51–1.17) for pre-incision versus post-incision prophylaxis and 0.89 (95% CI: 0.55–1.14) for short versus long duration. Reduction in cost and nurse time was reported in shorter-duration surgical antibiotic prophylaxis.

Conclusions

There is scope for improvement, but interventions must include local context and address strongly held beliefs. Establishment of local multidisciplinary teams will promote ownership and sustainability of change.
Liver resection for metastatic thyroid carcinoma. Case report and literature review
Authors: Sánchez-Garavito Jesús Emiliano , Sanchez-Garcia Jorge , Olsen Daniel , Shorti Rami M , Lopez-Verdugo Fidel , Rodriguez-Davalos Manuel I
Published: August 2020

Liver resection for metastatic cancer has become the standard of care for specific groups of patients, including noncolorectal non-neuroendocrine liver metastases (NCNNELM). Liver metastasis from differentiated thyroid carcinoma is considered rare, with an approximated frequency of 0.5%. We present a case of metastatic papillary thyroid carcinoma (PTC) to the liver and literature review. Herein, we report a 72-year-old male that underwent formal left hepatectomy for 4.4 cm metastatic PTC generating left bile duct obstruction. Two months after, presented with multiple small lesions within the hepatic parenchyma and diffuse ductal dilatation of the right biliary system. Therefore, treated with a percutaneous biliary drain placement without complications. In a patient diagnosed with initial Stage II PTC, undergoing total thyroidectomy 10 years before presenting to the clinic. Bearing over a decade of treatments for local and distal recurrences. We believe approaching strategies for this specific disease should be developed to establish standard management.
Orthopedic Surgery and Flight Surgery: Income Differences Between the Navy Health Professions Scholarship Program and Civilian Orthopedic Surgery
Authors: Goodrich Eric , Goodrich Richard P
Published: August 2020

Introduction

The purpose of this study to analyze the financial impact of choosing a civilian or military orthopedic surgery career. It will examine the most common scenarios to become an orthopedic surgeon in the Navy Health Professions Scholarship Program to include becoming a flight surgeon. To the authors’ knowledge, there is no peer-reviewed literature that financially analyzes the most common scenarios for a Navy Health Professions Scholarship Program scholarship recipient to become an orthopedic surgeon.

Materials and Methods

Salaries for Navy orthopedic surgeons, residents, and flight surgeons were recorded using the 2020 Defense Finance and Accounting Service pay tables and Navy Fiscal Year 2019 Medical Corps Special Pay Guidance. The median income of civilian orthopedic surgeons was recorded using Salary.com. The present value (PV) and future value (FV) were calculated using the Consumer Price Index-U and average Department of Defense pay increases over the past 20 years. Six common scenarios were utilized to calculate the PV and FV of civilian compared to Navy orthopedic surgeons.

Results

The two highest earning net FVs among all Navy scenarios were those surgeons who kept their Navy tour to 5 years or less (flight surgeon tour/separate or civilian deferment/separate). The civilian throughout scenario had the highest net FV of $19,974,673 after retiring at the age of 65. Flight surgeon tour/separate and civilian deferment/separate scenarios only made $843,751 and $1,401,630 less respectively than a pure civilian career due to the tax shelter afforded by the military pay. All Navy retirement scenarios to include Navy throughout, civilian deferment/Navy throughout, flight surgeon tour/Navy throughout resulted in a net FV less than $17,700,000. Civilian residency/deferment and retiring in the Navy had the worst net FV among all scenarios.

Conclusions

It was found that the shorter tours in the Navy had a higher net FV than those who made the Navy a career in orthopedic surgery. Flight surgery is a rewarding operational experience with among the highest net FV among Navy scenarios and is only slightly less than the net FV of a pure civilian career. However, it can be more difficult to apply for civilian orthopedic surgery after serving a flight surgeon tour. Lastly, the net FV was very similar between a civilian orthopedic surgeon career and the shorter tours served in the Navy. Factors such as higher civilian income with associated loan repayment/signing bonuses makes the civilian orthopedic surgery route the best financial option. This study will help those medical students considering a military versus a civilian career in orthopedic surgery and aid in Department of Defense recruitment/retention.
Insights into the planetary dynamics of HD 206893 with ALMA
Authors: Marino S , Zurlo A , Faramaz V , Milli J , Henning Th , Kennedy G M , Matrà L , Pérez S , Delorme P , Cieza L A , Hughes A M
Published: August 2020

Radial substructure in the form of rings and gaps has been shown to be ubiquitous among protoplanetary discs. This could be the case in exo-Kuiper belts as well, and evidence for this is emerging. In this paper, we present ALMA observations of the debris/planetesimal disc surrounding HD 206893, a system that also hosts two massive companions at 2 and 11 au. Our observations reveal a disc extending from 30 to 180 au, split by a 27 au wide gap centred at 74 au, and no dust surrounding the reddened brown dwarf (BD) at 11 au. The gap width suggests the presence of a 0.9MJup planet at 74 au, which would be the third companion in this system. Using previous astrometry of the BD, combined with our derived disc orientation as a prior, we were able to better constrain its orbit finding it is likely eccentric ($0.14^{+0.05}_{-0.04}$). For the innermost companion, we used radial velocity, proper motion anomaly, and stability considerations to show its mass and semimajor axis are likely in the ranges 4–100MJup and 1.4–4.5 au. These three companions will interact on secular time-scales and perturb the orbits of planetesimals, stirring the disc and potentially truncating it to its current extent via secular resonances. Finally, the presence of a gap in this system adds to the growing evidence that gaps could be common in wide exo-Kuiper belts. Out of six wide debris discs observed with ALMA with enough resolution, four to five show radial substructure in the form of gaps.
The Blanco DECam bulge survey. I. The survey description and early results
Authors: Rich R Michael , Johnson Christian I , Young Michael , Simion Iulia T , Clarkson William I , Pilachowski Catherine , Michael Scott , Kunder Andrea , Katherina Vivas A , Koch Andreas , Marchetti Tommaso , Ibata Rodrigo , Martin Nicolas , Robin Annie C , Lagarde Nadége , Collins Michelle , Ivezić Željko , de Propris Roberto , Shen Juntai , Gerhard Ortwin , Soto Mario
Published: August 2020

The Blanco Dark Energy Camera (DECam) Bulge survey is a Vera Rubin Observatory (LSST) pathfinder imaging survey, spanning ∼200 deg2 of the Southern Galactic bulge, −2° < b < −13° and −11° < l < +11°. We have employed the CTIO-4 m telescope and the DECam to image a contiguous ∼200 deg2 region of the relatively less reddened Southern Galactic bulge, in SDSS u  + Pan-STARRSgrizy. Optical photometry with its large colour baseline will be used to investigate the age and metallicity distributions of the major structures of the bulge. Included in the survey footprint are 26 globular clusters imaged in all passbands. Over much of the bulge, we have Gaia DR2 matching astrometry to i ∼ 18, deep enough to reach the faint end of the red clump. This paper provides the background, scientific case, and description of the survey. We present an array of new reddening-corrected colour–magnitude diagrams that span the extent of Southern Galactic bulge. We argue that a population of massive stars in the blue loop evolutionary phase, proposed to lie in the bulge, are instead at ∼2 kpc from the Sun and likely red clump giants in the old disc. A bright red clump near (l, b) = (+ 8°, −4°) may be a feature in the foreground disc, or related to the long bar reported in earlier work. We also report the first map of the blue horizontal branch population spanning the Blanco DECam Bulge Survey field of regard, and our data do not confirm the reality of a number of proposed globular clusters in the bulge.
Understanding biases in measurements of molecular cloud kinematics using line emission
Authors: Yuan (原) Yuxuan (宇轩) , Krumholz Mark R , Burkhart Blakesley
Published: August 2020

Molecular line observations using a variety of tracers are often used to investigate the kinematic structure of molecular clouds. However, measurements of cloud velocity dispersions with different lines, even in the same region, often yield inconsistent results. The reasons for this disagreement are not entirely clear, since molecular line observations are subject to a number of biases. In this paper, we untangle and investigate various factors that drive linewidth measurement biases by constructing synthetic position–position–velocity cubes for a variety of tracers from a suite of self-gravitating magnetohydrodynamic simulations of molecular clouds. We compare linewidths derived from synthetic observations of these data cubes to the true values in the simulations. We find that differences in linewidth as measured by different tracers are driven by a combination of density-dependent excitation, whereby tracers that are sensitive to higher densities sample smaller regions with smaller velocity dispersions, opacity broadening, especially for highly optically thick tracers such as CO, and finite resolution and sensitivity, which suppress the wings of emission lines. We find that, at fixed signal-to-noise ratio, three commonly used tracers, the J = 4 → 3 line of CO, the J = 1 → 0 line of C18O, and the (1,1) inversion transition of NH3, generally offer the best compromise between these competing biases, and produce estimates of the velocity dispersion that reflect the true kinematics of a molecular cloud to an accuracy of $\approx 10{{\ \rm per\ cent}}$ regardless of the cloud magnetic field strengths, evolutionary state, or orientations of the line of sight relative to the magnetic field. Tracers excited primarily in gas denser than that traced by NH3 tend to underestimate the true velocity dispersion by $\approx 20{{\ \rm per\ cent}}$ on average, while low-density tracers that are highly optically thick tend to have biases of comparable size in the opposite direction.
A Neurosurgeon's Guide to Cognitive Dysfunction in Adult Glioma
Authors: Morshed Ramin A , Young Jacob S , Kroliczek Arlena A , Berger Mitchel S , Brang David , Hervey-Jumper Shawn L
Published: August 2020

Cognitive decline is common among patients with low- and high-grade glioma and can significantly impact quality of life. Although cognitive outcomes have been studied after therapeutic interventions such as surgery and radiation, it is important to understand the impact of the disease process itself prior to any interventions. Neurocognitive domains of interest in this disease context include intellectual function and premorbid ability, executive function, learning and memory, attention, language function, processing speed, visuospatial function, motor function, and emotional function. Here, we review oncologic factors associated with more neurocognitive impairment, key neurocognitive tasks relevant to glioma patient assessment, as well as the relevance of the human neural connectome in understanding cognitive dysfunction in glioma patients. A contextual understanding of glioma-functional network disruption and its impact on cognition is critical in the surgical management of eloquent area tumors.
Diffusion and catalyst efficiency in hierarchical zeolite catalysts
Authors: Peng Peng , Gao Xiong-Hou , Yan Zi-Feng , Mintova Svetlana
Published: August 2020

The preparation of hierarchical zeolites with reduced diffusion limitation and enhanced catalyst efficiency has become a vital focus in the field of zeolites and porous materials chemistry within the past decades. This review will focus on the diffusion and catalyst efficiency of hierarchical zeolites and industrial catalysts. The benefits of diffusion and catalyst efficiency at two levels of hierarchies (zeolitic component level and industrial catalyst level) from a chemical reaction engineering point of view will be analysed. At zeolitic component level, three types of mesopores based on the strategies applied toward enhancing the catalyst effectiveness factor are presented: (i) ‘functional mesopores’ (raising effective diffusivity); (ii) ‘auxiliary mesopores’ (decreasing diffusion length); and (iii) ‘integrated mesopores’ (a combination thereof). At industrial catalyst level, location and interconnectivity among the constitutive components are revealed. The hierarchical pore interconnectivity in multi-component zeolite based industrial catalysts is exemplified by fluid catalytic cracking and bi-functional hydroisomerization catalysts. The rational design of industrial zeolite catalysts at both hierarchical zeolitic component and catalyst body levels can be fully comprehended using the advanced in situ and/or operando spectroscopic, microscopic and diffraction techniques.
Enhanced Surveillance for Histoplasmosis—9 States, 2018–2019
Authors: Benedict Kaitlin , McCracken Stephanie , Signs Kimberly , Ireland Malia , Amburgey Victoria , Serrano Jose Antonio , Christophe Natalie , Gibbons-Burgener Suzanne , Hallyburton Sara , Warren Kimberly A , Keyser Metobo Alison , Odom Racheal , Groenewold Matthew R , Jackson Brendan R
Published: August 2020

Background

Histoplasmosis is often described as the most common endemic mycosis in the United States, but much remains unknown about its epidemiology among the general population.

Methods

We conducted enhanced surveillance in 9 states during 2018–2019 by identifying cases through routine surveillance and interviewing 301 patients about their clinical features and exposures.

Results

Before being tested for histoplasmosis, 60% saw a health care provider ≥3 times, and 53% received antibacterial medication. The median time from seeking health care to diagnosis (range) was 23 (0–269) days. Forty-nine percent were hospitalized, and 69% said that histoplasmosis interfered with their daily activities (median [range], 56 [2–3960] days). Possible exposures included handling plants (48%) and bird or bat droppings (24%); 22% reported no specific exposures. Only 15% had heard of histoplasmosis before their illness.

Conclusions

Histoplasmosis can be severe and prolonged. Additional educational efforts to increase public and provider awareness and reduce delays in diagnosis are needed.
Using Therapeutic Drug Monitoring to Treat KPC-Producing Klebsiella pneumoniae Central Nervous System Infection With Ceftazidime/Avibactam
Authors: Yasmin Mohamad , Hanrahan Jennifer , Marshall Steven , Lodise Thomas P , Chen Liang , Perez Federico , Kreiswirth Barry , Bonomo Robert A
Published: August 2020

This report describes the treatment of Klebsiella pneumoniae carbapenemase (KPC)–3–producing multidrug-resistant K. pneumoniae with ceftazidime/avibactam (CAZ-AVI) in a patient who developed postneurosurgical meningitis and bacteremia. Therapeutic drug monitoring of cerebrospinal fluid and blood samples demonstrated CAZ-AVI concentration levels 20-fold greater than the minimum inhibitory concentration in the first 60 minutes postinfusion, providing evidence for the utility of CAZ-AVI in treating KPC–Klebsiella pneumoniae central nervous system infections.
Care Work and the Family in Catholic Reformation Tuscany
Authors: Maglaque Erin
Published: August 2020

This article examines the care work undertaken by wet-nurses employed by Florence’s foundling hospital, the Spedale degli Innocenti. Left in a basin outside the Innocenti, infants were nursed for a few days in the hospital before being assigned to the homes of wet-nurses living in the villages and remote sharecropped farms of rural Tuscany. Some wet-nurses committed ‘fraud’ — so labelled by the institution — by contriving to receive a wage for wet-nursing their own infants, covertly exchanging the infant delegated to them by the hospital in return for their own. Their ‘fraud’ allows us to challenge assumptions by both historians and feminist economists concerning commercialization and measurement of women’s work; historians might more critically reflect on the systems of monitoring and auditing women’s work that gave rise to our archives. Finally, by receiving a wage for mothering, these wet-nurses allow us to perceive the historical contingency of our most deeply naturalized assumptions about the nature of work and the family. Wet-nursing fraud reveals that definitions of work were always predicated upon concomitant definitions of the family.
Immunity to measles in Italian children and adolescents: a persistent problem in view of measles elimination
Authors: Marchi Serena , Monti Martina , Viviani Simonetta , Remarque Edmond J , Esposito Susanna , Principi Nicola , Ruggiero Luca , Montomoli Emanuele , Trombetta Claudia Maria
Published: August 2020

Background

Despite efforts to increase coverage by two doses of measles vaccine in Italy, measles continues to circulate, with over 13 000 cases of disease since 2013. This study aimed to evaluate immunity to measles in Italian children and adolescents.

Methods

A total of 378 serum samples from subjects aged 9 months–18 years were collected in Northern, Central and Southern regions of Italy between 2012 and 2016. Specific IgG antibodies against measles were measured by a commercial ELISA kit.

Results

The frequency of IgG-positive samples ranged from 10.5% in infants under 1 year to 98.3% in children aged 6–7 years. The frequency of IgG was 72.2% in subjects aged 1–2 years, 85.6% in those aged 3–5 years and 88.3 and 86.8% in those aged 8–10 and 11–18 years, respectively. In Northern Italy, IgG prevalence was consistent with data on vaccination coverage, whereas some differences were observed in samples from subjects aged more than 8 years in Central and Southern Italy.

Conclusions

Our findings confirm that a large proportion of children and adolescents in Italy are still susceptible to measles. While data on first- and second-dose measles vaccination are essential, they are not sufficient to identify susceptible population cohorts to be targeted by vaccination.
Professional Migration, Occupational Challenge, and Mental Health: Medical Practitioners in New Zealand, 1850–1890s
Authors: Tomkins Alannah , Coleborne Catharine
Published: August 2020

Australasian colonies were promoted as ‘lands of opportunity’ for British medical practitioners of the Victorian period, but once there doctors often found that any problems they faced had travelled with them. Furthermore, the act of migration could add to personal difficulty. This article builds on existing work about the challenges confronting doctors in England, and on the potential of asylum records to address the consequences of migration, to consider the experiences of men who chose to move round the globe. It concerns practitioners’ turbulent careers in New Zealand, with an emphasis on their poor mental health and suicide. Official and personal sources are used to evaluate the impact of professional drivers, and the consequences for medical men. It concludes that migration did not mitigate professional stresses and instead induced or exacerbated personal crisis. The visibility of alcohol-related distress is particularly marked in contrast to evidence for practitioners in England.
Anthropometric, Biochemical, and Food Consumption Parameters are Associated with Venous Leg Ulcer Area and Duration
Authors: Melo Paulla G. , Mota João F. , Nunes Cynthia A. B. , Amaral Kelle V. A. , Coelho Alexandre S. G. , Bachion Maria M.
Published: August 2020

OBJECTIVE

To describe the dietary habits and anthropometric and biochemical parameters of patients with active venous leg ulcers and to verify the association of these variables with wound duration and area.

DESIGN, SETTING, AND PARTICIPANTS

A cross-sectional study conducted with 33 participants diagnosed with venous leg ulcers in outpatient care.

MAIN OUTCOME MEASURES

Socioeconomic data, anthropometric parameters, biochemical parameters, food consumption, and wound characteristics were analyzed by an interprofessional team.

MAIN RESULTS

Participants were an average of 58 ± 13 years, 57.6% women, 84.8% overweight, and had a median wound duration of 10 months (range, 1–192 months) and an average wound area of 5 cm2 (range, 0.22–61.1 cm2). Diets were typically hypocaloric and hypoproteic, with a low amount of vitamin A and magnesium. Wound duration was negatively associated with polyunsaturated fat intake (P = .032), whereas wound area was significantly associated with lipid intake (P = .002) and C-reactive protein (P = .040).

CONCLUSIONS

Patients with active venous leg ulcers were overweight (leading to systemic inflammation) and had low consumption of calories, protein, and micronutrients that could support cicatrization. Wound area was associated with a high-fat diet, whereas wound duration was negatively associated with polyunsaturated fat intake.
Failure to achieve castrate level of serum testosterone during luteinizing hormone-releasing hormone agonist therapy in a patient with prostate cancer
Authors: Koh Yoko , Kawashima Atsunari , Ujike Takeshi , Nagahara Akira , Fujita Kazutoshi , Kiuchi Hiroshi , Imamura Ryoichi , Miyagawa Yasushi , Nonomura Norio , Uemura Motohide
Published: August 2020

We report the failure to achieve castrate level of serum testosterone during luteinizing hormone-releasing hormone agonist therapy in a patient with prostate cancer. A 76-year-old man was admitted to our hospital for evaluation of an elevated serum prostate specific antigen (PSA) level (191.10 ng/ml) in August 2011. He was diagnosed with T3aN0M1b prostate adenocarcinoma. A combined androgen blockade using luteinizing hormone-releasing hormone agonist (the 1-month depot of leuprorelin acetate) and antiandrogen was administered. Due to liver dysfunction, antiandrogens, both bicalutamide and flutamide, were stopped. The 1-month depot was switched to the 3-month depot in May 2013, but the patient complained of induration and abscess at the infection site. Leuprorelin acetate was replaced by goserelin acetate. Because no adverse event appeared after injection of the 1-month depot of goserelin acetate, the 3-month depot was administered in October 2013. The PSA level increased gradually, and the testosterone level was greater than 50 ng/dl, that is, above castrate range. The 3-month depot of both leuprorelin acetate and goserelin acetate was not effective for this patient. For this reason, the 1-month depot of leuprorelin acetate was started resulting in a rapid decrease in PSA and testosterone levels. Thereafter, androgen depriving therapy could be continued. Androgen deprivation therapy is the standard treatment for patients with advanced prostate cancer and luteinizing hormone-releasing hormone aims to suppress serum testosterone to castrate range. We recommend assessing the serum testosterone levels during luteinizing hormone-releasing hormone agonist therapy for monitoring treatment efficacy and verifying progression when the PSA level increases.
The kappa-opioid receptor agonist, nalfurafine, blocks acquisition of oxycodone self-administration and oxycodone’s conditioned rewarding effects in male rats
Authors: Zamarripa C. Austin , Patel Tilak R. , Williams B. Cole , Pareek Tanya , Schrock Hayley M. , Prisinzano Thomas E. , Freeman Kevin B.
Published: August 2020

Mu-opioid receptor (MOR) agonists are highly efficacious for the treatment of pain but have significant abuse liability. Recently, we reported that nalfurafine, when combined with oxycodone at a certain ratio, reduced the reinforcing effects of oxycodone in rats while producing additive antinociceptive effects. Questions remain, however, including if the combination will function as a reinforcer in drug-naïve rats, and if the combination produces aversive effects that could explain nalfurafine’s ability to reduce oxycodone self-administration? In the present study, we investigated nalfurafine’s ability to reduce acquisition of oxycodone self-administration when the two were self-administered as a mixture in drug-naïve rats and nalfurafine’s ability to attenuate a conditioned place preference (CPP) induced by oxycodone. In the self-administration study, male Sprague–Dawley rats self-administered intravenous injections of oxycodone (0.056 mg/kg/injection), an oxycodone/nalfurafine combination (0.056/0.0032 mg/kg/injection), or saline under fixed-ratio schedules of reinforcement for 20 days to compare rates of acquisition of drug taking. In the CPP assay, male Sprague–Dawley rats received subcutaneous injections of either saline, oxycodone (3.2 mg/kg), nalfurafine (0.18 mg/kg), or an oxycodone/nalfurafine combination at the same ratio used in the self-administration study (3.2 mg/kg/0.18 mg/kg). All subjects self-administering oxycodone alone met acquisition criteria. However, only 13% of subjects self-administering oxycodone/nalfurafine met criteria, and no subjects acquired self-administration of saline. Oxycodone, but not nalfurafine alone or the oxycodone/nalfurafine combination, produced rewarding effects in rats in the CPP test. These findings suggest that the combination of oxycodone and nalfurafine will be less habit forming in opioid-naïve patients than oxycodone alone.
Left Ventricular Geometry in COPD Patients
Authors: Heubel Alessandro Domingues , Roscani Meliza Goi , Kabbach Erika Zavaglia , Agnoleto Aline Galvão , Camargo Patrícia Faria , dos Santos Polliana Batista , Borghi-Silva Audrey , Mendes Renata Gonçalves
Published: August 2020

Purpose:

Chronic obstructive pulmonary disease (COPD) and abnormalities of left ventricular (LV) geometry often coexist. This study aimed to verify whether LV geometry is associated with airflow obstruction, functional capacity, and grip strength in COPD patients.

Methods:

Thirty-seven COPD patients (GOLD II, III, and IV) were allocated to three groups according to LV geometry as assessed by transthoracic echocardiography: normal (n = 13), concentric LV remodeling (n = 8), and concentric LV hypertrophy (LVH) (n = 16). Lung function was assessed using spirometry. The Duke Activity Status Index (DASI) was used to estimate functional capacity, and grip strength measurement was performed using a hydraulic hand dynamometer.

Results:

The concentric LVH group presented lower DASI scores (P = .045) and grip strength (P = .006) when compared with the normal group. Correlations analysis showed the following: relative wall thickness negatively correlated with forced expiratory volume in the first second (r = −0.380; P = .025) and DASI score (r = −0.387, P = .018); LV mass index negatively correlated with grip strength (r = −0.363, P = .038).

Conclusions:

In COPD patients, LV geometry is associated with airflow limitation, functional capacity, and grip strength. Specifically, concentric LV remodeling is associated with increased airflow limitation and decreased functional capacity whereas increased LV mass is associated with decreased grip strength.
Cardiac Rehabilitation Is Associated With Improved Physical Function in Frail Older Adults With Cardiovascular Disease
Authors: Lutz Andrew H. , Delligatti Amanda , Allsup Kelly , Afilalo Jonathan , Forman Daniel E.
Published: August 2020

Purpose:

Frailty is highly prevalent among older adults with cardiovascular disease (CVD) and is associated with greater than 2-fold risk for morbidity and mortality, independent of age and comorbidities. Many candidates are not referred to cardiac rehabilitation (CR) under the assumption that they are too frail to benefit. We hypothesized that CR is associated with similar benefits for frail adults as for intermediate-frail and nonfrail adults.

Methods:

Retrospective analysis of CVD patients who completed a phase II CR program. Patients classified as frail by meeting ≥2 frailty criteria and intermediate-frail by meeting 1 criterion, including 6-min walk distance (6MWD) <300 m, gait speed ≤0.65 m/sec or 0.76 m/sec normalized to height and sex, tandem stand <10 sec, Timed Up & Go (TUG) <15 sec, and weak hand grip strength per Fried criteria. Changes within and between groups were compared before and after completion of CR.

Results:

We evaluated 243 patients; 75 were classified as frail, 70 as intermediate-frail, and 98 as nonfrail. Each group improved in all measures of frailty except for tandem stand. There were no significant differences in pre- to post-CR measures for 6MWD, gait speed, tandem stand, or hand grip strength between groups. Frail patients showed greater improvement in TUG than the other groups (P = .007).

Conclusion:

Among frail patients, CR was associated with improvements in multiple domains of physical function. Gains achieved by frail adults were similar to or greater than those achieved by intermediate-frail and nonfrail patients. These data provide strong rationale for referring all eligible patients to CR, including frail patients. Those who are most physically impaired may derive gains that have proportionally greater ramifications.
Impact of COVID-19 Pandemic on Physical Activity in Patients With Implantable Cardioverter-Defibrillators
Authors: Sassone Biagio , Mandini Simona , Grazzi Giovanni , Mazzoni Gianni , Myers Jonathan , Pasanisi Giovanni
Published: August 2020

Purpose:

The coronavirus disease-2019 (COVID-19) pandemic has been spreading rapidly worldwide since late January 2020. The strict lockdown strategy prompted by the Italian government, to hamper severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) spreading, has reduced the possibility of performing either outdoor or gym physical activity (PA). This study investigated and quantified the reduction of PA in patients with automatic implantable cardioverter-defibrillators (ICDs) for primary prevention of sudden death.

Methods:

Daily PA of 24 patients was estimated by processing recorded data from ICD-embedded accelerometric sensors used by the rate-responsive pacing systems.

Results:

During the forced 40-d in-home confinement, a mean 25% reduction of PA was observed as compared with the 40-d confinement-free period (1.2 ± 0.3 vs 1.6 ± 0.5 hr/d, respectively, P = .0001).

Conclusions:

This objective quantification of the impact of the COVID-19 pandemic on PA determined by an ICD device showed an abrupt and statistically significant reduction of PA in primary prevention ICD patients, during the in-home confinement quarantine. To counteract the deleterious effects of physical inactivity during the COVID-19 outbreak, patients should be encouraged to perform indoor exercise-based personalized rehabilitative programs.
MULTIPLE INTRAVITREAL INJECTIONS DO NOT CAUSE ANTERIOR SCLERAL THINNING
Authors: Schwartz Shulamit , Reinhertz Noa , Neudorfer Meira , Loewenstein Anat , Iglicki Matias , Zur Dinah
Published: August 2020

Purpose:

To evaluate possible changes in anterior scleral thickness and structure and changes in the anterior segment in eyes receiving multiple intravitreal injections using ultrasound biomicroscopy imaging.

Methods:

Prospective, interventional, nonrandomized, cross-sectional study. Both eyes from 33 patients previously treated at least by 15 intravitreal injections in one eye only for retinal diseases were included. Intravitreal injections were performed by ophthalmologists using an aseptic standardized procedure. Ultrasound biomicroscopy examination was performed in all eyes, and scleral thickness was measured at the pars plana in four quadrants. Anterior chamber depth and ciliary body size were measured. Scleral thickness in the study eye was compared with the fellow eye. Secondary outcome measures were 1) anterior chamber depth; 2) ciliary body size; 3) scleral qualitative changes in the study eye compared with the fellow eye and 4) risk factors for scleral thinning.

Results:

There was no statistically significant difference in scleral thickness between the study and fellow eyes when comparing each quadrant between the two eyes (P = 0.86 superotemporal; P = 0.76 superonasal; P = 0.72 inferonasal; P = 0.55 inferotemporal). Scleral thickness was neither related to the number of injections nor to the duration of treatment in the treated eye.

Conclusion:

Multiple intravitreal injections do not impact scleral thickness in a clinical practice using different injection sites.
SQUARE GRID DEFORMATION ANALYSIS OF THE MACULA AND POSTOPERATIVE METAMORPHOPSIA AFTER MACULAR HOLE SURGERY
Authors: Park Sun Ho , Park Keun Heung , Kim Hwa Yeong , Lee Jae Jung , Kwon Han Jo , Park Sung Who , Byon Ik Soo , Lee Ji Eun
Published: August 2020

Purpose:

To investigate the correlation between postoperative metamorphopsia and macular deformation after macular hole surgery.

Methods:

This study included 28 eyes of 28 patients who underwent vitrectomy and internal limiting membrane removal for an idiopathic macular hole. The retinal vasculatures were compared between preoperative and postoperative photographs, and postoperative deformation of the macula was assessed as deformation of the square grid. The displacement of each node was measured, and deformation of the grid was calculated as differences in the coordinates of the adjacent nodes. These parameters were analyzed to find correlation with metamorphopsia measured using the M-charts after 6 postoperative months.

Results:

The average deformations in the vertical and horizontal lines of the grid were 94.29 μm and 49.72 μm, respectively. Perifoveal deformation was significantly greater than parafoveal deformation (P = 0.001∼0.019). The multiple regression analysis demonstrated that the vertical M-score correlated with superior perifoveal deformation of the vertical line on the fovea (P = 0.036), and the horizontal M-score correlated with temporal perifoveal deformation of the horizontal line on the fovea (P = 0.032).

Conclusion:

The parafoveal tissue was displaced with the fovea concurrently after internal limiting membrane removal in macular hole surgery causing perifoveal deformation, which correlated with postoperative metamorphopsia.