bluuebunny/crossref_metadata_2025 huggingface dataset:
Age-Based Characteristics of Pediatric Burn Injuries From Outdoor Recreational Fires
Authors: Trotter Zola , Foster Kevin , Khetarpal Shailesh , Sinha Madhumita
Published: May 2020

Accidental burns from outdoor recreational activities, such as campfires, bonfires, ceremonial fires, and firepits, are not uncommon; however, few studies describe the nature of such injuries in children. The objective of this study was to examine the age-based pattern of pediatric burn injuries from outdoor fires. Children and adolescents 0 to 18 years, admitted to the Burn Center between 2008 and 2018 with acute burn injuries from outdoor fires, were included in the current study. Demographic and clinical data were obtained from the burn injury database. Patients were categorized into three age groups: 0 to 5 years, 5 to 10 years, and 10 to 18 years. One hundred and sixty-seven children were included in the data analysis, the mean age of the cohort was 6.4 (SD ± 4.9) years, and the majority (66.5%) were males. More than half (52.1%) were less than 5 years of age, they commonly sustained hand burns and frequently required inpatient burn management. Burn severity varied between age groups, and the mean total burn surface area (TBSA) was significantly higher in adolescents (10.9%). Almost half the injuries (49.7%) resulted from a fall onto a campfire, bonfire, or a firepit. In this study, we found age-specific variation in the mechanism and pattern of burn injuries. Children at least 5 years and adolescents were least common victims of burns due to outdoor fires but suffered from more serious injuries with significantly higher TBSA involvement, longer intensive care unit, and ventilator days. Raising awareness among parents, caregivers, and children about outdoor fire safety is important for the prevention of such injuries.
Breast Imaging Second Opinion Consultation: A Single Institution’s Process of Improvement and Reform
Authors: Freiburg Luke , Bhole Sonya , Liko Hazizi Elona , Friedewald Sarah M
Published: May 2020

Objective

To review a single institution’s second opinion breast imaging process, data tracking, and metrics before and after implementing quality improvement changes and the effect on report turnaround time.

Methods

This Institutional Review Board approved retrospective quality improvement project was performed at a tertiary-care academic medical center and included patients 18 years or older who submitted their outside facility imaging for reinterpretation (any combination of mammography, breast ultrasonography, and/or magnetic resonance imaging performed within the last six months) with finalized second opinion reports between June 1, 2016, and July 17, 2017. Significant intradepartmental changes were implemented March 2017 with the goal to improve second opinion report turnaround time. Key metrics from 399 studies were analyzed before and after implemented changes. Two-sided Fisher’s exact test was used to assess the significance of results.

Results

After department interventions, the percentage of outside reports available at the time of surgical consultation improved from 82% (213/259) to 91% (127/140), an 11% improvement (P < 0.05). The average number of days from initial second opinion consultation to the availability of final report improved from 10.2 days to 9 days, a 12% improvement. Prior to the changes, the number of days it took a radiologist to complete a report varied from 1 to 4 days, but afterwards was consistently 1 day or less.

Conclusion

Implementation of second opinion intradepartmental changes demonstrated a significant improvement in report turnaround time and the number of finalized reports available at the time of surgical consultation. An efficient second opinion process is crucial to a breast imaging center, as it ultimately expedites patient surgical and oncological care.
Baseline Susceptibility of a Laboratory Strain of Northern Corn Rootworm, Diabrotica barberi (Coleoptera: Chrysomelidae) to Bacillus thuringiensis Traits in Seedling, Single Plant, and Diet-Toxicity Assays
Authors: Pereira Adriano E , Huynh Man P , Sethi Amit , Miles Ashley L , Wade French B , Ellersieck Mark R , Coudron Thomas A , Shelby Kent S , Hibbard Bruce E
Published: May 2020

The northern corn rootworm (NCR), Diabrotica barberi Smith & Lawrence, is an economic pest of maize in the U.S. Corn Belt. The objective of this study was to determine the baseline susceptibility of a laboratory NCR strain to Bt proteins eCry3.1Ab, mCry3A, Cry3Bb1, and Cry34/35Ab1 using seedling, single plant, and diet-toxicity assays. Plant assays were performed in greenhouse using corn hybrids expressing one of the Bt proteins and each respective near-isoline. Diet-toxicity assays, consisting of Bt proteins overlaid onto artificial diet were also conducted. In both plant assays, significantly more larvae survived Cry34/35Ab1-expressing corn compared with all other Bt-expressing corn, and larvae that survived eCry3.1Ab-expressing corn had significantly smaller head capsule widths compared with larvae that survived Cry34/35Ab1-expressing corn. In seedling assays, larvae surviving eCry3.1Ab-expressing corn also had significantly smaller head capsule widths compared with larvae that survived mCry3A-expressing corn. Additionally, larvae that survived mCry3A-expressing corn weighed significantly more than larvae surviving eCry3.1Ab- and Cry34/35Ab1-expressing corn. In single plant assays, no significant differences in larval dry weight was observed between any of the Bt-expressing corn. In diet assays, LC50s ranged from 0.14 (eCry3.1Ab) to 10.6 µg/cm2 (Cry34/35Ab1), EC50s ranged from 0.12 (Cry34/35Ab1) to 1.57 µg/cm2 (mCry3A), IC50s ranged from 0.08 (eCry3.1Ab) to 2.41 µg/cm2 (Cry34/35Ab1), and MIC50s ranged from 2.52 (eCry3.1Ab) to 14.2 µg/cm2 (mCry3A). These results establish the toxicity of four Bt proteins to a laboratory diapausing NCR strain established prior to the introduction of Bt traits and are important for monitoring resistance evolution in NCR field populations.
Asymptomatic colonic intussusception in ulcerative colitis: a case report
Authors: Tanabe Taro , Furukawa Satomi , Masuda Tomoyuki , Morimoto Koji , Yamana Tetsuo , Sahara Rikisaburo
Published: May 2020

Intussusception in adults is, especially with ulcerative colitis (UC), rare and only described in a few cases. Most adult patients with intussusception develop abdominal pain or other symptoms of bowel obstruction. This case describes an 18-year-old male with UC who treated with 5-aminosalycilicacid and underwent annual screening colonoscopies. Two attempts revealed that it was impossible to achieve total surveillance through the colonoscopy because multiple polyps were preventing the colonoscope from traversing the entire colon. Therefore, CT scan was performed and colonic intussusception was discovered incidentally, and the patient underwent elective laparoscopic total colectomy. To the best of our knowledge, this is the first reported case of asymptomatic intussusception in the adult patient with UC. When total surveillance colonoscopy fails to yield results, a CT may be advisable to pick up such an asymptomatic intussusception.
Global trends in air travel: implications for connectivity and resilience to infectious disease threats
Authors: Tuite Ashleigh R , Bhatia Deepit , Moineddin Rahim , Bogoch Isaac I , Watts Alexander G , Khan Kamran
Published: May 2020

Background

Increased connectivity via air travel can facilitate the geographic spread of infectious diseases. The number of travellers alone does not explain risk; passenger origin and destination will also influence risk of disease introduction and spread. We described trends in international air passenger numbers and connectivity between countries with different capacities to detect and respond to infectious disease threats.

Methods

We used the Fragile States Index (FSI) as an annual measure of country-level resilience and capacity to respond to infectious disease events. Countries are categorized as: Sustainable, Stable, Warning or Alert, in order of increasing fragility. We included data for 177 sovereign states for the years 2010 to 2019. Annual inbound and outbound international air passengers for each country were obtained for the same time period. We examined trends in FSI score, trends in worldwide air travel and the association between a state’s FSI score and air travel.

Results

Among countries included in the FSI rankings, the total number of outbound passengers increased from 0.865 billion to 1.58 billion between 2010 and 2019. Increasing fragility was associated with a decrease in travel volumes, with a 2.5% (95% CI: 2.0–3.1%) reduction in passengers per 1-unit increase in FSI score. Overall, travel between countries of different FSI categories either increased or remained stable.

Conclusions

The world’s connectivity via air travel has increased dramatically over the past decade. There has been notable growth in travel from Warning and Stable countries, which comprise more than three-quarters of international air travel passengers. These countries may have suboptimal capacity to detect and respond to infectious disease threats that emerge within their borders.
Should international medical electives to resource-poor countries continue during COVID-19?
Authors: McMaster David , Veremu Munashe , Jonas Kpanna M
Published: May 2020

Medical students on elective offer a workforce that may become essential when local healthcare services in resource-limited countries become overwhelmed. We argue they should not be cancelled, and instead should be offered on a voluntary basis to allow students the opportunity to support struggling health systems during the COVID-19 pandemic.
Child Maltreatment
Authors: Wang Claudia , Wong Daphne , Berkowitz Carol D.
Published: May 2020

Child abuse and neglect lead to significant morbidity and mortality in our vulnerable pediatric population. Primary care physicians are responsible for improving the care of children and reporting findings that are suspicious for child abuse and neglect. This chapter reviews the various types of child maltreatment, with a focus on identification, management, and treatment of child abuse and neglect. In addition to being able to identify child abuse, the questions also focus on recognition of medical diseases, disorders, or other mimickers resembling child abuse. The various types of child maltreatment covered include neglect; physical abuse (i.e., bruises, burns, fractures, abusive head trauma, abdominal trauma, Munchausen syndrome by proxy); sexual abuse; and psychological abuse.
Quick Facts
Authors: Kulkarni Deepa , Kamzan Audrey , Newcomer Charles A.
Published: May 2020

This chapter is intended for readers to quickly review topics within each content specification to consolidate information and refresh high-yield pearls in the days before taking the General Pediatric board certification exam. The exam often tests knowledge of common associations, and this chapter is meant to reinforce these frequently-tested associations. The information included in this section is mostly meant as a review of the preceding chapters, but may also be used as a stand-alone study tool. It includes memory aids and mnemonics to maximize retention.
Superfoods for Digestive Health
Authors: Gossard Crystal M. , Lipski Elizabeth
Published: May 2020

This chapter examines the gastrointestinal benefits associated with some therapeutic dietary approaches and specific functional foods for digestive health. Elimination diets, including the FODMAP diet, specific carbohydrate diet, 6-food elimination diet, and elemental diets, have all shown specific therapeutic benefit. Each of the various phytochemicals and zoochemicals (protective components from animals) has its unique physiological benefits. They are probiotics, prebiotics, fiber, omega-3 fatty acids and phospholipids, and bioactive peptides. This chapter will review each of these food bioactives in detail, listing the richest food sources and highlighting the effects these foods have on the health of the GI system. The chapter also describes how each bioactive food component supports and maintains the structure and function of the GI system, and provides an overview of how each nutrient targets the pathophysiology of GI disorders and disease. Therapeutic elimination diets, medical foods in GI health, and special dietary considerations are also outlined.
The Irritable Bowel Syndrome
Authors: Alammar Nuha , Mullin Gerard
Published: May 2020

The irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder characterized by chronic nonspecific abdominal pain with altered bowel movements in the absence of known organic disease. IBS is diagnosed by the Rome IV criteria for functional GI disorders. Although research has shown several factors that might be contributing to IBS pathophysiology, there is no specific cause for this disorder identified yet. There are four disease subtypes found in equal proportions: diarrhea, constipation, mixed, and undefined (IBS-U). IBS is a prevalent disorder that primary care physicians evaluate in the clinic. In this chapter, the authors review the epidemiology and updated research regarding its pathophysiology, diagnostics, and integrative therapeutic strategies.
Family Experiences of Psychiatric Services for their Relative with Intellectual and Developmental Disabilities
Authors: Chester Verity , James Neil , Rogers Ian , Grace Jackie , Alexander Regi
Published: May 2020

Accessing treatment for a relative with intellectual and/or developmental disabilities requiring assessment or treatment from services can be extremely difficult for families and carers. Adverse past experiences can significantly affect the development of trust and relationships with present services and professionals. Listening and acknowledging families’ past and present concerns, alongside providing transparent information and reassurance about their relatives’ care, provides a foundation for starting positive relationships. Families are valuable in helping clinicians understand their patients fully and this helps the recovery process. Services have a duty to work collaboratively with patients’ families, in order to improve treatment outcomes including quality of life. Occasionally, there may be concerns in relation to the patient being the victim of familial financial, emotional, physical, and/or sexual abuse. In such instances, safeguarding processes must be followed.
The spectral index of polarized diffuse Galactic emission between 30 and 44 GHz
Authors: Jew Luke , Grumitt R D P
Published: May 2020

We present an estimate of the polarized spectral index between the Planck 30 and 44 GHz surveys in 3.7° pixels. We use an objective reference prior that maximizes the impact of the data on the posterior and multiply this by a maximum entropy prior that includes information from observations in total intensity by assuming a polarization fraction. Our parametrization of the problem allows the reference prior to be easily determined and also provides a natural method of including prior information. The spectral index map is consistent with those found by others between surveys at similar frequencies. Across the entire sky we find an average spectral index of −2.99 ± 0.03(±1.12), where the first error term is the statistical uncertainty on the mean and the second error term (in parentheses) is the extra intrinsic scatter of the spectral index across the sky. We use a clustering algorithm to identify pixels with actual detections of the spectral index. The average spectral index in these pixels is −3.12 ± 0.03(±0.64) and then when also excluding pixels within 10° of the Galactic plane we find −2.92(±0.03). We find a statistically significant difference between the average spectral indices in the north and south Fermi bubbles. Only including pixels identified by the clustering algorithm, the average spectral index in the southern bubble is −3.00 ± 0.05(±0.35), which is similar to the average across the whole sky. In the northern bubble, we find a much harder average spectral index of −2.36 ± 0.09(±0.63). Therefore, if the bubbles are features in microwave polarization they are not symmetric about the Galactic plane.
ToxicoDB: an integrated database to mine and visualize large-scale toxicogenomic datasets
Authors: Nair Sisira Kadambat , Eeles Christopher , Ho Chantal , Beri Gangesh , Yoo Esther , Tkachuk Denis , Tang Amy , Nijrabi Parwaiz , Smirnov Petr , Seo Heewon , Jennen Danyel , Haibe-Kains Benjamin
Published: May 2020

In the past few decades, major initiatives have been launched around the world to address chemical safety testing. These efforts aim to innovate and improve the efficacy of existing methods with the long-term goal of developing new risk assessment paradigms. The transcriptomic and toxicological profiling of mammalian cells has resulted in the creation of multiple toxicogenomic datasets and corresponding tools for analysis. To enable easy access and analysis of these valuable toxicogenomic data, we have developed ToxicoDB (toxicodb.ca), a free and open cloud-based platform integrating data from large in vitro toxicogenomic studies, including gene expression profiles of primary human and rat hepatocytes treated with 231 potential toxicants. To efficiently mine these complex toxicogenomic data, ToxicoDB provides users with harmonized chemical annotations, time- and dose-dependent plots of compounds across datasets, as well as the toxicity-related pathway analysis. The data in ToxicoDB have been generated using our open-source R package, ToxicoGx (github.com/bhklab/ToxicoGx). Altogether, ToxicoDB provides a streamlined process for mining highly organized, curated, and accessible toxicogenomic data that can be ultimately applied to preclinical toxicity studies and further our understanding of adverse outcomes.
Neuro-oncology management during the COVID-19 pandemic with a focus on WHO grades III and IV gliomas
Authors: Bernhardt Denise , Wick Wolfgang , Weiss Stephanie E , Sahgal Arjun , Lo Simon S , Suh John H , Chang Eric L , Foote Matthew , Perry James , Meyer Bernhard , Vajkoczy Peter , Wen Patrick Y , Straube Christoph , Pigorsch Steffi , Wilkens Jan J , Combs Stephanie E
Published: May 2020

Background

Because of the increased risk in cancer patients of developing complications caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), physicians have to balance the competing risks of the negative impact of the pandemic and the primary tumor disease. In this consensus statement, an international group of experts present mitigation strategies and treatment guidance for patients suffering from high grade gliomas (HGGs) during the coronavirus disease 2019 (COVID-19) pandemic.

Methods Sixteen

international experts in the treatment of HGG contributed to this consensus-based practice recommendation, including neuro-oncologists, neurosurgeons, radiation oncologists, and a medical physicist. Generally, treatment of neuro-oncological patients cannot be significantly delayed and initiating therapy should not be outweighed by COVID-19. We present detailed interdisciplinary treatment strategies for molecular subgroups in 2 pandemic scenarios, a scale-up phase and a crisis phase.

Conclusion

This practice recommendation presents a pragmatic framework and consensus-based mitigation strategies for the treatment of HGG patients during the SARS-CoV-2 pandemic.
Iron deficiency, immunology, and colorectal cancer
Authors: Phipps Oliver , Brookes Matthew J , Al-Hassi Hafid O
Published: May 2020

Excessive gut luminal iron contributes to the initiation and progression of colorectal cancer. However, emerging evidence suggests that reduced iron intake and low systemic iron levels are also associated with the pathogenesis of colorectal cancer. This is important because patients with colorectal cancer often present with iron deficiency. Iron is necessary for appropriate immunological functions; hence, iron deficiency may hinder cancer immunosurveillance and potentially modify the tumor immune microenvironment, both of which may assist cancer development. This is supported by studies showing that patients with colorectal cancer with iron deficiency have inferior outcomes and reduced response to therapy. Here, we provide an overview of the immunological consequences of iron deficiency and suggest ensuring adequate iron therapy to limit these outcomes.
Endoscopic Third Ventriculostomy for Hydrocephalus Secondary to Extraventricular Obstruction in Thalamic Hemorrhage: A Case Series
Authors: Zeineddine Hussein A , Dono Antonio , Kitagawa Ryan , Savitz Sean I , Choi Huimahn Alex , Chang Tiffany R , Ballester Leomar Y , Esquenazi Yoshua
Published: May 2020

BACKGROUND

Intracranial hemorrhage carries significant morbidity and mortality, particularly if associated with hydrocephalus. Management of hydrocephalus includes temporary external ventricular drainage, with or without shunting. Thalamic location is an independent predictor of mortality and increases the likelihood of shunt dependence.

OBJECTIVE

To determine whether endoscopic third ventriculostomy (ETV) can avoid the need for shunt placement and expedite recovery.

METHODS

We prospectively identified thalamic intracranial hemorrhage patients who developed acute hydrocephalus requiring cerebrospinal fluid diversion by extraventricular drain placement from November 2017 to February 2019. Patients who failed an extraventricular drain clamping trial were then evaluated for eligibility for an ETV procedure. Patients who underwent ETV were then followed up for the development of hydrocephalus, need for shunting, and length of stay in the intensive care unit.

RESULTS

Eight patients (7 males, 1 female) were prospectively enrolled. All patients underwent an ETV successfully. None of the patients required shunting. ETV was performed despite the presence of other factors that would have prevented shunt placement, including fever, leukocytosis, and gastrostomy tube placement. Seven patients who underwent ETV were evaluated at 3-mo follow-up and did not require shunting.

CONCLUSION

ETV is a safe and effective technique for the management of hydrocephalus resulting from an extraventricular obstruction in thalamic hemorrhage. It can avoid the need for permanent shunting in this patient population. Larger studies should be conducted to validate and further analyze this intervention.
Access-Site Complications in Transfemoral Neuroendovascular Procedures: A Systematic Review of Incidence Rates and Management Strategies
Authors: Oneissi Mazen , Sweid Ahmad , Tjoumakaris Stavropoula , Hasan David , Gooch M Reid , Rosenwasser Robert H , Jabbour Pascal
Published: May 2020

BACKGROUND

The femoral artery is the most common access route for cerebral angiography and neurointerventional procedures. Complications of the transfemoral approach include groin hemorrhages and hematomas, retroperitoneal hematomas, pseudoaneurysms, arteriovenous fistulas, peripheral artery occlusions, femoral nerve injuries, and access-site infections. Incidence rates vary among different randomized and nonrandomized trials, and the literature lacks a comprehensive review of this subject.

OBJECTIVE

To gather data from 16 randomized clinical trials (RCT) and 17 nonrandomized cohort studies regarding femoral access-site complications for a review paper. We also briefly discuss management strategies for these complications based on the most recent literature.

METHODS

A PubMed indexed search for all neuroendovascular clinical trials, retrospective studies, and prospective studies that reported femoral artery access-site complications in neurointerventional procedures.

RESULTS

The overall access-site complication rate in RCTs is 5.13%, while in in non-RCTs, the rate is 2.78%. The most common complication in both groups is groin hematoma followed by access-site hemorrhage and femoral pseudoaneurysm. On the other hand, wound infection was the least common complication.

CONCLUSION

The transfemoral approach in neuroendovascular procedures holds risk for several complications. This review will allow further studies to compare access-site complications between the transfemoral approach and other alternative access sites, mainly the transradial approach, which is gaining a lot of interest nowadays.
Linguistic Conventionalism and the Truth-Contrast Thesis
Authors: Nyseth Fredrik
Published: May 2020

According to linguistic conventionalism, necessities are to be explained in terms of the conventionally adopted rules that govern the use of linguistic expressions. A number of influential arguments against this view concerns the ‘Truth-Contrast Thesis’. This is the claim that necessary truths are fundamentally different from contingent ones since they are not made true by ‘the (worldly) facts’. Instead, they are supposed to be something like ‘true in virtue of meaning’. This thesis is widely held to be a core commitment of the conventionalist position, and the view is frequently rejected on the grounds that this thesis is untenable. I argue that this line of reasoning is mistaken. While the thesis should be rejected (although not for the reasons often given), it is not, I argue, entailed by linguistic conventionalism – nor was it invariably accepted by the paradigmatic conventionalists.
Phase-Amplitude Markers of Synchrony and Noise: A Resting-State and TMS-EEG Study of Schizophrenia
Authors: Freche Dominik , Naim-Feil Jodie , Hess Shmuel , Peled Avraham , Grinshpoon Alexander , Moses Elisha , Levit-Binnun Nava
Published: May 2020

The electroencephalogram (EEG) of schizophrenia patients is known to exhibit a reduction of signal-to-noise ratio and of phase locking, as well as a facilitation of excitability, in response to a variety of external stimuli. Here, we demonstrate these effects in transcranial magnetic stimulation (TMS)-evoked potentials and in the resting-state EEG. To ensure veracity, we used 3 weekly sessions and analyzed both resting-state and TMS-EEG data. For the TMS responses, our analysis verifies known results. For the resting state, we introduce the methodology of mean-normalized variation to the EEG analysis (quartile-based coefficient of variation), which allows for a comparison of narrow-band EEG amplitude fluctuations to narrow-band Gaussian noise. This reveals that amplitude fluctuations in the delta, alpha, and beta bands of healthy controls are different from those in schizophrenia patients, on time scales of tens of seconds. We conclude that the EEG-measured cortical activity patterns of schizophrenia patients are more similar to noise, both in alpha- and beta-resting state and in TMS responses. Our results suggest that the ability of neuronal populations to form stable, locally, and temporally correlated activity is reduced in schizophrenia, a conclusion, that is, in accord with previous experiments on TMS-EEG and on resting-state EEG.
Acute Encephalopathy with Biphasic Seizures and Late Reduced Diffusion Associated with Dengue Infection in a Child
Authors: Kumar Manokaran Ranjith , Mahalingam Harshavardhan , Shankaranarayanan Shubha , Sowmya Devaram , Venkat Ramanan Padmasani
Published: May 2020

Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is a clinico-radiological syndrome in children secondary to viral or bacterial infections. The causes include viral (influenza, human herpes virus-6, adenovirus, rota) as well as bacterial infections. However, AESD with dengue infection has not been reported earlier. Here, we present an infant with dengue infection and AESD which recovered completely following treatment with intravenous human immunoglobulin therapy. A 9-month-old girl presented with seizures following fever and loose stools. Seizures recurred after 2 days of seizure-free interval. Cerebrospinal fluid analysis was not contributory. Dengue infection was confirmed by lab tests. Magnetic resonance imaging brain after the second seizure revealed diffusion restriction involving the bilateral frontal and parietal white matter, both hemispheres with a typical central perisylvian sparing lesion suggestive of AESD. This case report expands the reported spectrum of neurological manifestations of dengue infection.
Corruption as a Self-Reinforcing Trap: Implications for Reform Strategy
Authors: Stephenson Matthew C
Published: May 2020

Corruption is widely believed to be a self-reinforcing phenomenon, in the sense that the incentive to engage in corrupt acts increases as corruption becomes more widespread. Some argue that corruption's self-reinforcing property necessarily implies that incremental anticorruption reforms cannot be effective, and that the only way to escape a high-corruption equilibrium “trap” is through a so-called “big bang” or “big push.” However, corruption's self-reinforcing property does not logically entail the necessity of a big bang approach to reform. Indeed, corruption's self-reinforcing property may strengthen the case for pursuing sustained, cumulative incremental reforms. While there may be other reasons to prefer a big bang approach to an incremental approach, this conclusion cannot be grounded solely or primarily on corruption's self-reinforcing character.
Genome Sequence Data of the Soybean Pathogen Stagonosporopsis vannaccii: A Resource for Studies on Didymellaceae Evolution
Authors: Cafà Giovanni , Boufleur Thaís Regina , Linhares de Castro Renata Rebellato , Massola Nelson Sidnei , Baroncelli Riccardo
Published: May 2020

The genus Stagonosporopsis is classified within the Didymellaceae family and has around 40 associated species. Among them, several species are important plant pathogens responsible for significant losses in economically important crops worldwide. Stagonosporopsis vannaccii is a newly described species pathogenic to soybean. Here, we present the draft whole-genome sequence, gene prediction, and annotation of S. vannaccii isolate LFN0148 (also known as IMI 507030). To our knowledge, this is the first genome sequenced of this species and represents a new useful source for future research on fungal comparative genomics studies.
Efficacy of Conventional Fungicides for Downy Mildew in Field-Grown Sweet Basil in the United States
Authors: McGrath Margaret Tuttle
Published: May 2020

Application of fungicides has been the main management practice for Peronospora belbahrii, which is the most important pathogen of sweet basil in the United States. Six replicated experiments were conducted between 2010 and 2016 with field-grown basil of a susceptible cultivar exposed to naturally occurring wind-dispersed sporangiospores of P. belbahrii to evaluate conventional fungicides registered for basil downy mildew in the United States and in development for this use. This project revealed the importance for successful management of using a preventive fungicide application schedule, maintaining a 7-day application interval, and using application equipment designed to provide thorough spray coverage to plants (drop nozzles). Fungicide efficacy was assessed based on incidence of symptomatic leaves rather than disease severity, which is stringent but realistic because there is zero tolerance for disease on fresh-market herbs. Most fungicides were tested as the formulated product marketed in the United States. Oxathiapiprolin was tested as experimental formulations. Its trade name is Orondis. Overall best control was achieved in 2016. Excellent control (99% based on AUDPC values) was obtained with four fungicide programs with oxathiapiprolin, Revus, and ProPhyt, indicating this combination of chemistry was more important than specific timing for each fungicide. Ranman applied in alternation with Revus plus K-Phite was not quite as effective (89% control); this treatment was ineffective in 2015 when the 7-day spray interval was not maintained. Best treatment in 2015 was Quadris applied in alternation with Revus plus oxathiapiprolin for two of three Revus applications. Two different alternations of these fungicides also were effective. But Quadris alternated with Revus was ineffective. When tested singly, the most effective fungicides in 2013 (listed in order based on AUDPC values) were Zampro, Revus, oxathiapiprolin, and Ranman. ProPhyt was effective in 2013 but not in 2012, when another phosphorous acid fungicide, K-Phite, also was ineffective. Only oxathiapiprolin and Zampro were effective in the 2012 experiment; Revus and Ranman were ineffective. Presidio was ineffective both years. Based on the results from this study, Orondis is the most effective fungicide among those evaluated for managing basil downy mildew, and Zampro is second. Neither were labeled for this use on field-grown basil as of June 2020. Ranman applied in alternation with Revus plus K-Phite, a commonly recommended program of labeled fungicides, provided very good control.
Monitoring Ectotrophic Root-Infecting Fungi Associated with Bermudagrass Putting Green Roots Using Quantitative Multiplex Assays
Authors: Bronzato-Badial Aline , King Jonas , Tomaso-Peterson Maria
Published: May 2020

Bermudagrass decline (BD) is a destructive root rot disease of hybrid bermudagrass putting greens in the southeastern United States. Previous studies reported a single ectotrophic root-infecting (ERI) fungus, Gaeumannomyces graminis, associated with BD. Recently, three novel ERI fungi, Gaeumannomyces sp., Magnaporthiopsis cynodontis, and Candidacolonium cynodontis, have also been associated with BD. Current diagnostic methods for identification can be inconclusive and inaccurate for distinguishing these ERI fungal species. Here, we present the development and application of novel real-time PCR assays designed to detect four selected ERI fungi associated with BD. The distribution of these ERI fungi in hybrid bermudagrass samples collected from putting greens and fairways throughout the southeastern United States was also assessed. In addition, we established a reliable and rapid protocol to simultaneously detect these selected fungi directly from bermudagrass root tissue. The limit of detection for each assay was as low as 1 pg/µl of DNA per reaction, proving the sensitivity of the method to detect low quantities of fungal DNA when present in bermudagrass roots. The presence of the selected ERI fungi was detected in 36 of 37 bermudagrass root samples, with one fungus having a wider distribution among the samples tested and two fungi with greater DNA quantities when compared with the bermudagrass roots. The novel assays provide a reliable method for accurate detection of the four selected ERI fungi. The acute sensitivity of each assay makes it a viable tool for early detection of ERI fungi in hybrid bermudagrass roots.
Relationship of Pink Pigmentation in Rose Petals and Botrytis cinerea
Authors: Muñoz Melissa , Faust James E. , Bridges William C. , Schnabel Guido
Published: May 2020

Pink pigmentation on rose (Rosa × hybrida) petals in the form of round spots or irregular-shaped discoloration has been associated with Botrytis cinerea infection, but scientific evidence has been lacking to support this hypothesis. The unfounded association between pink pigmentation and Botrytis blight has been sufficient to warrant rejection of international shipments during inspection at the ports of entry. The objective of this research was to evaluate the relationship between pink pigmentation symptoms on rose petals and B. cinerea infection. Four shipments of ‘Vendela’ and ‘Brighton’ roses were received from a commercial grower. Intact rose flowers and detached petals were assessed separately, and symptom development and Botrytis blight incidence were evaluated. In addition, tissue pieces with and without pink pigmentation were placed in culture media to determine the frequency of B. cinerea isolation. Results showed that Botrytis blight incidence in whole flowers and petals of cut roses with and without pink pigmentations was not significantly different. B. cinerea was not isolated more frequently from pink-pigmented tissue compared with tissues lacking pink pigmentation. These results show that pink pigmentation in the form of round spots or irregular-shaped discoloration along the petal margins is not associated with B. cinerea infections.
Atrial Flutter—Unique Arrhythmia in Neonatal Population, Presentation of 3 Cases
Authors: Kędziora Piotr , Stasiak Aleksandra
Published: May 2020

Background:

Atrial flutter (AFL) is an uncommon arrhythmia in the pediatric population. It is defined as fast ordered atrial depolarization (about 250-500 beats/min). It occurs mainly in children with congenital heart defects; however, it may also manifest in fetuses and infants with an anatomically healthy heart. In neonates, AFL is most often revealed within the first 2 days after birth.

Clinical Findings:

In this case report, we present 3 neonates without complex congenital heart defects with AFL, along with the description of the course, diagnostic and therapeutic processes depending on the clinical condition of a child, and response to treatment.

Primary Diagnosis:

Symptoms in this group of patients are nonspecific, that is, tachypnea, unwillingness to eat, and fatigue while feeding. The diagnostic process included thorough electro- and echocardiographic assessments. Each child was treated individually due to a different cause of arrhythmia and comorbidities.

Interventions:

Invasive (electrical cardioversion) and pharmacological methods were used in treatment to achieve conversion to sinus rhythm.

Outcomes:

One patient required electrical cardioversion, one was treated with amiodarone and digoxin, and one infant received amiodarone. All children achieved conversion to sinus rhythm.

Practice Recommendations:

During the follow-up, each child maintained sinus rhythm, which shows that in the neonatal group, it is a unique, but well-controlled, arrhythmia once conversion to sinus rhythm is achieved.
Dysmenorrhea and Endometriosis: Diagnosis and Management in Adolescents
Authors: HEWITT GERI
Published: May 2020

Dysmenorrhea is common in adolescents. Most have primary dysmenorrhea and respond to empiric treatment with nonsteroidal anti-inflammatory drugs and/or hormonal therapies. Infrequently, patients have persistent symptoms requiring further evaluation including a pelvic examination, ultrasonography, and/or diagnostic laparoscopy. The most common cause of secondary dysmenorrhea in adolescents is endometriosis. Endometriosis is an estrogen-dependent, inflammatory condition with no surgical or medical cure. Treatment is individualized and typically includes surgical diagnosis with resection and/or ablation limited to visible lesions followed by hormonal suppressive therapy in an attempt to relieve symptoms, limit disease progression, and protect fertility. Multidisciplinary attention to comorbidities and pain management as well as patient education and support are important.
Two-Year Outcomes of the New Low-cost Nonvalved Aurolab Aqueous Drainage Implant in Refractory Glaucoma
Authors: Ray Vanita Pathak , Rao Divya P.
Published: May 2020

Purpose:

This study aimed to report the 2-year surgical outcomes in terms of efficacy and safety of the relatively new, indigenously manufactured, low-cost nonvalved drainage device Aurolab Aqueous Drainage Implant (AADI) in the management of refractory glaucomas in the Indian population.

Methods:

A retrospective review of consecutive patients older than 12 years, who underwent nonvalved glaucoma drainage device surgery via AADI, was performed by a single fellowship-trained surgeon, between January 2014 and January 2018, who had at least 12 months of documented postoperative follow-up.

Outcome Measures:

Primary—intraocular pressure (IOP).

Secondary—number of antiglaucoma medication (AGM), LogMAR best-corrected visual acuity and complications.

Complete success was defined as IOP ≥5 and ≤21 mm Hg; qualified success was defined as fulfilling the above criteria with the use of AGM. Failure was defined as the inability to fulfill the IOP criteria, loss of perception of light, explantation, or any additional glaucoma surgery.

Results:

A total of 48 eyes of 46 patients were included with a median follow-up of 24 months (quartile 1=16, quartile 3=31.25; interquartile range=15.25) (mean=24.9 mo; SD=10.1). The IOP and number of AGM required was significantly lower at every timepoint postoperatively (P<0.001). The median LogMAR best-corrected visual acuity remained unchanged (P=0.307). Complications occurred in 21 patients (43.7%); some eyes had >1 complication. Complete success was seen in 56.3%; overall success was 87.5%.

Conclusions:

The safety and efficacy of the new nonvalved glaucoma drainage device, AADI, remain in its second year after implantation. Still further follow-up is recommended, as it has the ability to breach the cost barrier in newly industrialized nations worldwide
Acute Angle Closure Following Implantable Collamer Lens for Myopia
Authors: Strungaru M. Hermina , González Rodríguez Johanna , Weisbrod Daniel J. , Tayfour Fouad , Buys Yvonne M.
Published: May 2020

We report a case of acute angle closure with significantly elevated intraocular pressure 9 hours after implantation of a phakic intraocular lens for high myopia.
Diffuse Hypermetabolic Bone Marrow Infiltration in Severe Primary Hyperoxaluria on FDG PET
Authors: Tonnelet David , Benali Khadija , Rasmussen Camille , Goulenok Tiphaine , Piekarski Eve
Published: May 2020

A 24-year-old man, with type 1 primary hyperoxaluria (diagnosed at age 20 years after repeated renal lithiasis, due to a I244T mutation frequently encountered in Mediterranean countries) complicated by end-stage renal failure requiring dialysis, was admitted for pancytopenia, refractory to erythropoietin injections. On clinical examination, he presented a hepatosplenomegaly without palpable adenopathy. 18F-FDG PET/CT revealed intense and diffuse bone marrow uptake in the axial skeleton and preferential long bone metaphyseal uptake. Bone marrow aspiration showed Gaucher-like cells infiltration due to oxalate accumulation in macrophages, leading to the diagnosis of bone marrow involvement by primary hyperoxaluria.
Differences in 18F-FDG Uptake and Expression of Glucose Transporter Between 2 Distinct Subtypes of Mass-Forming Intrahepatic Cholangiocarcinomas
Authors: Kozaka Kazuto , Kobayashi Satoshi , Takamura Hiroyuki , Sato Yasunori , Kitao Azusa , Inoue Dai , Yoneda Norihide , Tajima Hidehiro , Kinuya Seigo , Harada Kenichi , Ohta Tetsuo , Koda Wataru , Matsui Osamu , Gabata Toshifumi
Published: May 2020

Purpose

Recently, intrahepatic cholangiocarcinoma (iCCA) has been classified into small duct cholangiocarcinoma (SDC) and large duct cholangiocarcinoma (LDC) according to the origin of the biliary tree. Although the usefulness of 18F-FDG PET/CT in iCCA is well known, there are no reports evaluating differences in accumulation of 18F-FDG according to the recently described iCCA subtypes. The aim of this study was therefore to assess 18F-FDG accumulation and the expression of glucose transporters in SDC and LDC.

Methods

Our institutional review board approved this retrospective study and waived the requirement for informed consent. Fourteen consecutive surgically resected mass-forming iCCA (7 SDCs, 23 ± 6.7 mm; 7 LDCs, 44 ± 26 mm) were enrolled. The SUVmax on 18F-FDG PET/CT and the expression of glucose transporter 1 (Glut-1), Glut-2, hexokinase 2 (HK2), and glucose-6-phosphatase by immunohistochemistry were evaluated and compared between SDC and LDC.

Results

The SUVmax in SDC was significantly lower than that in LDC (3.2 ± 0.8 vs 7.6 ± 3.2, P < 0.01). The staining scores of Glut-1 and HK2 were significantly lower in SDC than in LDC (0 vs 3 ± 1.4, P = 0.0034; 1.6 ± 1.1 vs 3.4 ± 1.1, P = 0.014, respectively). Expression levels of Glut-2 and glucose-6-phosphatase were variable and did not show a significant difference between SDC and LDC. Overall survival was significantly worse in LDC than in SDC (P = 0.01).

Conclusions

18F-FDG accumulation and Glut-1 and HK2 expression were significantly higher in LDC than in SDC. A low-glycolytic feature may be one of the characteristic findings of SDC.
Evaluation of Turkish social distancing measures on the spread of COVID-19
Authors: Civcir İrfan
Published: May 2020

The coronavirus disease (COVID-19) affecting across the globe. The government of different countries has adopted various policies to contain this epidemic and the most common were social distancing and lockdown. We use a simple log-linear model with intercept and trend break to evaluate whether the measures are effective preventing/slowing down the spread of the disease in Turkey. We estimate the model parameters from the Johns Hopkins University (2020) epidemic data between 15th March and 16th April 2020. Our analysis revealed that the measures can slow down the outbreak. We can reduce the epidemic size and prolong the time to arrive at the epidemic peak by seriously following the measures suggested by the authorities.
Population vulnerability to COVID-19 in Europe: a burden of disease analysis
Authors: Wyper Grant MA , Assunção Ricardo MA , Cuschieri Sarah , Devleeschauwer Brecht , Fletcher Eilidh , Haagsma Juanita A , Hilderink Henk , Idavain Jane , Lesnik Tina , Lippe Elena Von der , Majdan Marek , Milicevic Milena S , Pallari Elena , Peñalvo José L , Pires Sara M , Plaß Dietrich , Santos João V , Stockton Diane L , Thomsen Sofie T , Grant Ian
Published: May 2020

Background

Evidence has emerged showing that elderly people and those with pre-existing chronic health conditions may be at higher risk of developing severe health consequences from COVID-19. In Europe, this is of particular relevance with ageing populations living with non-communicable diseases, multi-morbidity and frailty. Published estimates of Years Lived with Disability (YLD) from the Global Burden of Disease (GBD) study help to characterise the extent of these effects. Our aim was to identify the countries across Europe that have populations at highest risk from COVID-19 by using estimates of population age structure and YLD for health conditions linked to severe illness from COVID-19.

Methods

Population and YLD estimates from GBD 2017 were extracted for 45 countries in Europe. YLD was restricted to a list of specific health conditions associated with being at risk of developing severe consequences from COVID-19 based on guidance from the United Kingdom Government. This guidance also identified individuals aged 70 years and above as being at higher risk of developing severe health consequences. Study outcomes were defined as: (i) proportion of population aged 70 years and above; and (ii) rate of YLD for COVID-19 for vulnerable health conditions across all ages. Bivariate groupings were established for each outcome and combined to establish overall population-level vulnerability.

Results

Countries with the highest proportions of elderly residents were Italy, Greece, Germany, Portugal and Finland. When assessments of population-level YLD rates for COVID-19 vulnerable health conditions were made the highest rates were observed for Bulgaria, Czech Republic, Croatia, Hungary and Bosnia and Herzegovina. A bivariate analysis indicated that the countries at high-risk across both measures of vulnerability were: Bulgaria; Portugal; Latvia; Lithuania; Greece; Germany; Estonia; and Sweden.

Conclusion

Routine estimates of population structures and non-fatal burden of disease measures can be usefully combined to create composite indicators of vulnerability for rapid assessments, in this case to severe health consequences from COVID-19. Countries with available results for sub-national regions within their country, or national burden of disease studies that also use sub-national levels for burden quantifications, should consider using non-fatal burden of disease estimates to estimate geographical vulnerability to COVID-19.