bluuebunny/crossref_metadata_2025 huggingface dataset:
Simulations of M87 and Sgr A* imaging with the Millimetron Space Observatory on near-Earth orbits
Authors: Andrianov A S , Baryshev A M , Falcke H , Girin I A , de Graauw T , Kostenko V I , Kudriashov V , Ladygin V A , Likhachev S F , Roelofs F , Rudnitskiy A G , Shaykhutdinov A R , Shchekinov Y A , Shchurov M A
Published: September 2020

High-resolution imaging of supermassive black hole shadows is a direct way to verify the theory of general relativity under extreme gravity conditions. Very Long Baseline Interferometry (VLBI) observations at millimetre/submillimetre wavelengths can provide such angular resolution for the supermassive black holes located in Sgr A* and M87. Recent VLBI observations of M87 with the Event Horizon Telescope (EHT) have shown such capabilities. The maximum obtainable spatial resolution of the EHT is limited by the Earth's diameter and atmospheric phase variations. In order to improve the image resolution, longer baselines are required. The Radioastron space mission successfully demonstrated the capabilities of space–Earth VLBI with baselines much longer than the Earth's diameter. Millimetron is the next space mission of the Russian Space Agency and will operate at millimetre wavelengths. The nominal orbit of the observatory will be located around the Lagrangian L2 point of the Sun–Earth system. In order to optimize the VLBI mode, we consider a possible second stage of the mission that could use a near-Earth high elliptical orbit (HEO). In this paper, a set of near-Earth orbits is used for synthetic space–Earth VLBI observations of Sgr A* and M87 in a joint Millimetron and EHT configuration. General relativistic magnetohydrodynamic models for the supermassive black hole environments of Sgr A* and M87 are used for static and dynamic imaging simulations at 230 GHz. A comparison preformed between ground and space–Earth baselines demonstrates that joint observations with Millimetron and EHT significantly improve the image resolution and allow the EHT + Millimetron to obtain snapshot images of Sgr A*, probing the dynamics at fast time-scales.
DIGGER: exploring the functional role of alternative splicing in protein interactions
Authors: Louadi Zakaria , Yuan Kevin , Gress Alexander , Tsoy Olga , Kalinina Olga V , Baumbach Jan , Kacprowski Tim , List Markus
Published: September 2020

Alternative splicing plays a major role in regulating the functional repertoire of the proteome. However, isoform-specific effects to protein-protein interactions (PPIs) are usually overlooked, making it impossible to judge the functional role of individual exons on a systems biology level. We overcome this barrier by integrating protein-protein interactions, domain-domain interactions and residue-level interactions information to lift exon expression analysis to a network level. Our user-friendly database DIGGER is available at https://exbio.wzw.tum.de/digger and allows users to seamlessly switch between isoform and exon-centric views of the interactome and to extract sub-networks of relevant isoforms, making it an essential resource for studying mechanistic consequences of alternative splicing.
COVID-19: smoke testing of surgical mask and respirators
Authors: Douglas J D M , McLean N , Horsley C , Higgins G , Douglas C M , Robertson E
Published: September 2020

Background

Fluid Resistant Surgical Masks have been implemented in UK personal protective equipment (PPE) guidelines for COVID-19 for all care sites that do not include aerosol-generating procedures (AGPs). FFP3 masks are used in AGP areas. Concerns from the ENT and plastic surgery communities out with intensive care units have questioned this policy. Emerging evidence on cough clouds and health care worker deaths has suggested that a review is required.

Aims

To test the efficacy of Fluid Resistant Surgical Mask with and without adaptions for respiratory protection. To test the efficacy of FFP and FFP3 regarding fit testing and usage.

Methods

A smoke chamber test of 5 min to model an 8-h working shift of exposure while wearing UK guideline PPE using an inspiratory breathing mouthpiece under the mask. Photographic data were used for comparison.

Results

The Fluid Resistant Surgical Mask gave no protection to inhaled smoke particles. Modifications with tape and three mask layers gave slight benefit but were not considered practical. FFP3 gave complete protection to inhaled smoke but strap tension needs to be ‘just right’ to prevent facial trauma. Facial barrier creams are an infection risk.

Conclusions

Surgical masks give no protection to respirable particles. Emerging evidence on cough clouds and health care worker deaths suggests the implementation of a precautionary policy of FFP3 for all locations exposed to symptomatic or diagnosed COVID-19 patients. PPE fit testing and usage policy need to improve to include daily buddy checks for FFP3 users
Estimated prevalence and viral transmissibility in subjects with asymptomatic SARS-CoV-2 infections in Wuhan, China
Authors: Zhang Kang , Tong Weiwei , Wang Xinghuan , Lau Johnson Yiu-Nam
Published: September 2020

The role of subjects with asymptomatic SARS-CoV-2 infection in the current pandemic is not well-defined. Based on two different approaches to estimate the culminative attack rate (seroprevalence of antibodies against SARS-CoV-2, and a four compartment mathematical model) and the reported number of patients with COVID-19, the ratio of asymptomatic versus symptomatic SARS-CoV-2 infection was estimated to be 7 (95% CI: 2.8–12.4) in Wuhan, Hubei, China, the first epicenter of this pandemic, which has settled with no new cases. Together with detailed recording of the contact sources in a cohort of patients, and applying the estimations to an established mathematical model, the viral transmissibility of the subjects with asymptomatic SARS-CoV-2 infection is around 10% of that of the symptomatic patients (95% CI: 7.6%–12.3%). Public health measures/policies should address this important pool of infectious source in combat against this viral pandemic.
Neural correlates of integrated self and social processing
Authors: Finlayson-Short Laura , Davey Christopher G , Harrison Ben J
Published: September 2020

Self-referential and social processing are often engaged concurrently in naturalistic judgements and elicit activity in overlapping brain regions. We have termed this integrated processing ‘self-other referential processing’ and developed a task to measure its neural correlates. Ninety-eight healthy young people aged 16–25 (M = 21.5 years old, 67% female) completed our novel functional magnetic resonance imaging task. The task had two conditions, an active self-other referential processing condition in which participants rated how much they related to emotional faces and a control condition. Rating relatedness required thinking about oneself (self-referential processing) and drawing a comparison to an imagined other (social processing). Self-other referential processing elicited activity in the default mode network and social cognition system; most notably in the ‘core self’ regions of the medial prefrontal cortex and posterior cingulate cortex. Relatedness and emotional valence directly modulated activity in these core self areas, while emotional valence additionally modulated medial prefrontal cortex activity. This shows the key role of the medial prefrontal cortex in constructing the ‘social-affective self’. This may help to unify disparate models of medial prefrontal cortex function, demonstrating its role in coordinating multiple processes—self-referential, social and affective processing—to allow the self to exist in a complex social world.
Gender differences in nighttime sleep patterns and variability across the adult lifespan: a global-scale wearables study
Authors: Jonasdottir Sigga Svala , Minor Kelton , Lehmann Sune
Published: September 2020

Study Objectives

Previous research on sleep patterns across the lifespan have largely been limited to self-report measures and constrained to certain geographic regions. Using a global sleep dataset of in situ observations from wearable activity trackers, we examine how sleep duration, timing, misalignment, and variability develop with age and vary by gender and BMI for nonshift workers.

Methods

We analyze 11.14 million nights from 69,650 adult nonshift workers aged 19–67 from 47 countries. We use mixed effects models to examine age-related trends in naturalistic sleep patterns and assess gender and BMI differences in these trends while controlling for user and country-level variation.

Results

Our results confirm that sleep duration decreases, the prevalence of nighttime awakenings increases, while sleep onset and offset advance to become earlier with age. Although men tend to sleep less than women across the lifespan, nighttime awakenings are more prevalent for women, with the greatest disparity found from early to middle adulthood, a life stage associated with child-rearing. Sleep onset and duration variability are nearly fixed across the lifespan with higher values on weekends than weekdays. Sleep offset variability declines relatively rapidly through early adulthood until age 35–39, then plateaus on weekdays, but continues to decrease on weekends. The weekend–weekday contrast in sleep patterns changes as people age with small to negligible differences between genders.

Conclusions

A massive dataset generated by pervasive consumer wearable devices confirms age-related changes in sleep and affirms that there are both persistent and life-stage dependent differences in sleep patterns between genders.
Cognitive behavioral therapy for insomnia among young adults who are actively drinking: a randomized pilot trial
Authors: Miller Mary Beth , Deroche Chelsea B , Freeman Lindsey K , Park Chan Jeong , Hall Nicole A , Sahota Pradeep K , McCrae Christina S
Published: September 2020

Study Objectives

More than half of young adults at risk for alcohol-related harm report symptoms of insomnia. Insomnia symptoms, in turn, have been associated with alcohol-related problems. Yet one of the first-line treatments for insomnia (Cognitive Behavioral Therapy for Insomnia or CBT-I) has not been tested among individuals who are actively drinking. This study tested (1) the feasibility and short-term efficacy of CBT-I among binge-drinking young adults with insomnia and (2) improvement in insomnia as a predictor of improvement in alcohol use outcomes.

Methods

Young adults (ages 18–30 years, 75% female, 73% college students) who met criteria for Insomnia Disorder and reported 1+ binge drinking episode (4/5+ drinks for women/men) in the past month were randomly assigned to 5 weekly sessions of CBT-I (n = 28) or single-session sleep hygiene (SH, n = 28). All participants wore wrist actigraphy and completed daily sleep surveys for 7+ days at baseline, posttreatment, and 1-month follow-up.

Results

Of those randomized, 43 (77%) completed posttreatment (19 CBT-I, 24 SH) and 48 (86%) completed 1-month follow-up (23 CBT-I, 25 SH). CBT-I participants reported greater posttreatment decreases in insomnia severity than those in SH (56% vs. 32% reduction in symptoms). CBT-I did not have a direct effect on alcohol use outcomes; however, mediation models indicated that CBT-I influenced change in alcohol-related consequences indirectly through its influence on posttreatment insomnia severity.

Conclusions

CBT-I is a viable intervention among individuals who are actively drinking. Research examining improvement in insomnia as a mechanism for improvement in alcohol-related consequences is warranted.

Trial Registration

U.S. National Library of Medicine, https://clinicaltrials.gov/ct2/show/NCT03627832, registration #NCT03627832
Combined score based on arterial lactate, aspartate transaminase and prolonged capillary refill time is a useful diagnostic criterion for identifying severe dengue
Authors: Gupta Sarika , Mall Pranaya , Alam Areesha
Published: September 2020

Background

Taking into consideration, the variable performance of WHO’s dengue case definition and the magnitude of epidemics in India, a score based on clinical and laboratory parameters is required for the early identification of severe dengue.

Methods

A retrospective observational study of children (aged ≤12 y) presenting with dengue, defined as per the WHO 2009 classification and NS1 antigen/IgM ELISA positivity, was conducted at a tertiary care hospital from 2013 to 2015. Clinical laboratory parameters were compared between severe/non-severe dengue using univariate and multivariate analysis. Areas under receiver operating characteristic curves (AUROCs), sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were obtained for independent and composite markers.

Results

Of 135 dengue patients, 46 (34.1%) had non-severe dengue and 89 (65.9%) had severe dengue. Logistic regression determined prolonged capillary refill time (CRT), lactate ≥2.9 mmol/L and serum aspartate transaminase (AST) ≥135 IU/L as predictive for severe dengue. AUROCs of lactate, AST and combined score incorporating AST, lactate and prolonged CRT for identifying severity were 7.55, 7.23 and 8.5, respectively. The combined score cut-off ≥1 had 87.6% sensitivity, 65.2% specificity, 83% PPV and 73.2% NPV. The combined score cut-off ≥3 had 100% specificity and 100% PPV.  However, AST >135 IU/L and lactate >2.9 mmol/L together had 97.8% specificity and 97.1% PPV for identifying severity.

Conclusions

The presence of either ‘prolonged capillary refill time with one deranged biochemical parameter’ or ‘both deranged biochemical parameters’ is nearly 100% specific for severity of dengue.
Development of Boscalid Resistance in Botrytis cinerea and an Efficient Strategy for Resistance Management
Authors: Cui Kaidi , He Leiming , Li Tongtong , Mu Wei , Liu Feng
Published: September 2020

Among succinate dehydrogenase inhibitors, only boscalid has been registered in China for controlling gray mold. In Shandong Province of China, it has been more than a decade since the first use of boscalid to control gray mold. In the current study, we monitored the resistance development process of Botrytis cinerea to boscalid, identified the mutation types that occurred in boscalid-resistant isolates, and proposed an original application technique to delay resistance development. A total of 720 B. cinerea isolates collected from tomato and cucumber in Shandong Province from 2014 to 2019 were determined to be sensitive to boscalid. The results showed that the sensitivity of the B. cinerea isolates to boscalid declined gradually over time, with a mean half maximal effective concentration of 0.3 ± 0.02 mg/liter in 2014 and 6.39 ± 1.66 mg/liter in 2019. The proportion of resistant isolates quickly increased from 0.81% in 2014 to 28.97% in 2019. Mutations of P225F, N230I, H272Y, and H272R in the SdhB subunit were responsible for boscalid resistance. Four concurrent mutations (G85A, I93V, M158V, and V168I) in the SdhC subunit were first discovered in Shandong Province, but they did not affect the level of boscalid resistance. Interestingly, this study found that the fruit dipping application, a precise topical application technique, could delay the development of boscalid resistance. Therefore, this application technique provides a new method for resistance management of B. cinerea.
Nonimmune mechanisms in idiopathic inflammatory myopathies
Authors: Loredo Martinez Marta , Zampieri Sandra , Franco Chiara , Ghirardello Anna , Doria Andrea , Gatto Mariele
Published: September 2020

Purpose of review

This review encompasses the main novelties regarding nonimmune mechanisms implicated in the pathogenesis of idiopathic inflammatory myopathies (IIM).

Recent findings

In recent years, growing data support a role for endoplasmic-reticulum (ER) stress as a propagator of muscular damage, together with the release of interferon type I and reactive oxygen species in hypoxemic muscle fibers. Other studies evaluating the relationship between autophagy and Toll-like receptors (TLRs) in IIM subtypes have shown increased TLR3 and TLR4 expression in fibers of IIM patients and colocalization with LC3, an autophagy marker, submitting autophagy as a likely player in IIM pathogenesis. Most novel evidences concern the potential role of denervation of the neuromuscular junction in IIM, possibly connected to hyperexpression of MHC-I, and trafficking of extracellular vesicles, which may represent a connection between nonimmune and immune-mediated mechanisms of muscle inflammation and damage.

Nonimmune mechanisms contribute to the pathogenesis of IIM, likely cooperating with immune-mediated inflammation. Consistent data were released for ER stress, autophagy, mitochondrial dysfunction and hypoxia; in addition to, neuromuscular denervation and extracellular vesicles have been proposed as thoughtful links between muscle inflammation, damage and atrophy. Further understanding of nonimmune abnormalities and potential reversible pathways is needed to improve the management of IIM.
Chromium Metal Ion Release During Instrumented Spinal Surgery in Children
Authors: Cundy Peter J. , Antoniou Georgia , Mascarhenas Annika , Freeman Brian J.C. , Cundy William J.
Published: September 2020

Study Design.

Prospective 2-year study with operative sampling and in-vitro analysis of chromium ions following spinal surgery in children.

Objectives.

To measure metal ion levels at preoperative, intraoperative, and postoperative times to determine patterns of metal ion release during instrumented spinal surgery.

Summary of Background Data.

Raised serum metal ion levels are reported following instrumented spinal fusion in adolescent idiopathic scoliosis. The authors noted raised chromium levels in patients receiving implants that did not contain chromium. This prompted further work to establish the source. The electrosurgery tips used were discovered to contain 17% chromium.

Methods.

Chromium, cobalt, and titanium levels were measured before, during, and after surgery in serum and local intraoperative fluid samples in 11 children undergoing posterior instrumentation for scoliosis. Administered drugs, cell-saver fluids, and intraoperative fluids, both local and intravenous, were investigated to exclude these as sources of chromium ions. An in-vitro study was also performed to elucidate sources of intraoperative chromium ions.

Results.

High chromium levels were detected in all samples from the wound irrigation fluid prior to insertion of metal implants. Immediate postoperative chromium serum ion levels were also elevated and returned to baseline by day 30. In-vitro sampling of fluids from test models using electrosurgery revealed high levels of chromium ions

Conclusion.

This finding of high chromium metal ion concentrations in intraoperative and early postoperative samples provides evidence of chromium release during the dissection phase of spinal surgery. This challenges existing beliefs that metal ion release occurs solely due to implants and now implicates the electrosurgery electrode tips as a source of raised chromium ion levels. Thorough irrigation of the operative site after the dissection phase of surgery to both dilute and reduce the intraoperative chromium ion load is suggested. Alternative electrosurgery electrode tips or other methods to coagulate during surgery could be considered.

Level of Evidence: 2
Risk Factors Associated With Development of Urinary Retention Following Posterior Lumbar Spinal Fusion: Special Attention to the Use of Glycopyrrolate in Anesthesia Reversal
Authors: Mormol Jeremy D. , Basques Bryce A. , Harada Garrett K. , Louie Philip K. , Alter Kevin , Goldberg Edward , Colman Matthew W. , An Howard S.
Published: September 2020

Study Design.

The study is designed as a retrospective cohort study.

Objective.

The aim of this study was to identify modifiable and nonmodifiable risk factors of postoperative urinary retention in spine surgery patients.

Summary of Background Data.

Postoperative urinary retention is a common complication in patients undergoing operative procedures requiring anesthesia. Current studies have shown significant risk factors for postoperative urinary retention, but most are nonmodifiable and subsequently of limited usefulness in preventing this complication. Several new studies have shown possible modifiable risk factors, but current data are inconsistent in terms of their statistical significance.

Methods.

A total of 814 consecutive patients who underwent open posterior lumbar laminectomy and fusion were included in the retrospective cohort study. Pre, intra-, and postoperative characteristics were collected in all patients to identify risk factors for postoperative urinary retention.

Results.

Glycopyrrolate use (odds ratio [OR] 2.60; P = 0.001), decreased body mass index (OR 0.96; P = 0.018), previous diagnosis of benign prostate hyperplasia (OR 3.34; P ≤ 0.001), and postoperative urinary tract infection (OR 5.60, P = 0.005) were associated with postoperative urinary retention. Previous history of lumbar spine surgery (OR 0.55; P = 0.019) was associated with decreased rates of postoperative urinary retention.

Conclusion.

Glycopyrrolate use, benign prostate hyperplasia, and postoperative urinary tract infection were independent risk factors for postoperative urinary retention. The use of glycopyrrolate is a potentially modifiable risk factor for postoperative urinary retention.

Level of Evidence: 3
Effect of Multimodal Drugs Infiltration on Postoperative Pain in Split Laminectomy of Lumbar Spine
Authors: Kraiwattanapong Chaiwat , Arnuntasupakul Vanlapa , Kantawan Rungthiwa , Woratanarat Patarawan , Keorochana Gun , Langsanam Nantida
Published: September 2020

Study Design.

A randomized, double-blinded controlled trial.

Objective.

This study tested the effect of single-dose wound infiltration with multiple drugs for pain management after lumbar spine surgery.

Summary of Background Data.

Patients undergoing spine surgery often experience severe pain especially in early postoperative period. We hypothesized that intraoperative wound infiltration with multiple drugs would improve outcomes in lumbar spine surgery.

Methods.

Fifty-two patients who underwent one to two levels of spinous process splitting laminectomy of lumbar spine, were randomized into two groups. Infiltration group received intraoperative wound infiltration of local anesthetics, morphine sulfate, epinephrine, and nonsteroidal anti-inflammatory drugs at the end of surgery, and received patient-controlled analgesia (PCA) postoperatively. The control group received only PCA postoperatively. The primary outcome measures were amount of morphine consumption and visual analogue scale (VAS) for pain. The secondary outcome measures were Oswestry Disability Index (ODI), Roland-Morris Low Back Pain and Disability Questionnaire (RMDQ), patient satisfaction, length of hospital stay, and side effects.

Results.

A total of 49 patients (23 patients for local infiltration group, and 26 patients for control group) were analyzed. There were statistically significant [P < 0.001, the effect size −5.0, 95% CI (−6.1, −3.9)] less morphine consumptions in the local infiltration group than the control group during the first 12 hours, 12 to 24 hours, and 24 to 48 hours after surgery. The VAS of postoperative pain reported by patients at rest and during motion was significantly lower in the local infiltration group than the control group at all assessment times (P < 0.001). The effect size of VAS of postoperative pain at rest and during motion were −2.0, 95% CI (−2.5, −1.4) and −2.0, 95% CI (−2.6, −1.4) respectively. ODI and RMDQ at 2 week and 3 month follow-ups in both groups had significant improvement from baseline (P < 0.001). No significant differences were found between groups (P = 0.262 for ODI and P = 0.296 for RMDQ). There were no significant differences of patient satisfaction, length of stay, and side effects between both groups (P = 0.256, P = 0.262, P = 0.145 respectively).

Conclusion.

Intraoperative wound infiltration with multimodal drugs reduced postoperative morphine consumption, decreased pain score with no increased side effects.

Level of Evidence: 1
Correlations and Age-Related Changes of Cervical Sagittal Parameters in Adults Without Symptoms of Cervical Spinal Disease
Authors: Hu Liu , Lv Yongman , Lin Yang
Published: September 2020

Study Design.

Retrospective study.

Objective.

To determine the correlations and age-related changes of cervical sagittal parameters in adults without obvious cervical spinal disease.

Summary of Background Data.

Cervical sagittal parameters play essential roles in the pathogenesis and therapy of cervical spinal diseases. However, few studies have investigated the correlations and age-related changes of cervical sagittal parameters.

Methods.

The enrolled participants were divided into three age groups and their cervical sagittal parameters were collected. Correlations and age-related changes of these parameters were analyzed.

Results.

Significant differences in the C2–C7 angle, center of gravity of the head–C7 sagittal vertical axis (CGH–C7 SVA), C2–C7 SVA, neck tilt (NT), and thoracic inlet angle (TIA) were found among the three age groups. Pearson correlation analysis showed positive correlations between the C0–C2 angle and CGH–C7 SVA, C0–C2 angle and C2–C7 SVA, C2–C7 angle and T1 slope, C2–C7 angle and TIA, CGH–C7 SVA and C2–C7 SVA, C2–C7 SVA and T1 slope, T1 slope and TIA, and NT and TIA as well as negative correlations between the C0–C2 angle and C2–C7 angle, C2–C7 angle and CGH–C7 SVA, and C2–C7 angle and C2–C7 SVA. Paired t tests showed significant changes in the C2–C7 angle in groups I and II, and in the CGH–C7 SVA and C2–C7 SVA in all age groups with increasing age.

Conclusion.

The results indicate that cross correlations exist between different cervical sagittal parameters in adults without symptoms of cervical spinal disease, and the lower cervical curvature and SVA change obviously with increasing age.

Level of Evidence: 3
Disaster Nursing
Authors: Weeks Maranatha
Published: September 2020

National and global disasters require immense resources, including nurses. Personal, professional, and spiritual preparation is strongly recommended for healthcare workers who desire to serve in disaster settings. Most nurses are underprepared for this role; options for preparation are described along with the ministry of nursing and spiritual care that expresses God's heart of mercy and care for hurting and desperate people.
Setting up a Research Poster During COVID-19 Lockdown
Authors: Kazmierczak Thomas , Bistany Belle
Published: September 2020

Students at a Christian nursing school faced unanticipated challenges in preparing and presenting research projects during the COVID-19 pandemic. Students and faculty rapidly adapted to a virtual environment and overcame obstacles to complete and present their work. The students demonstrated resilience and additional learning outcomes as a result of the enforced virtual experience.
Comparison of 24-2 Faster, Fast, and Standard Programs of Swedish Interactive Threshold Algorithm of Humphrey Field Analyzer for Perimetry in Patients With Manifest and Suspect Glaucoma
Authors: Thulasidas Mithun , Patyal Sagarika
Published: September 2020

Précis:

Swedish Interactive Threshold Algorithm (SITA) Faster (SFR) saves considerable test time but needs further amendments for considering it to be an accurate test that can replace SITA Fast (SF) or SITA Standard (SS).

Purpose:

To compare visual field results obtained using SFR, SF, and SS programs in patients with manifest and suspect glaucoma.

Materials and Methods:

In this cross-sectional observational study involving manifest patients with glaucoma and glaucoma suspects, perimetric outcomes of SFR, SF, and SS were compared. Outcomes included test time, mean deviation, pattern standard deviation (PSD), Visual Field Index (VFI), foveal threshold, number of points depressed at P<5%, P<2%, P<1%, and P<0.5% on PSD probability plot, individual threshold test points, glaucoma hemifield test, and grade of field defect.

Results:

Seventy eyes of 70 patients were included in this study. SFR test times averaged 36.1% shorter than SF and 60.7% shorter than SS (P<0.001). Mean deviation values were lower with SFR compared with both SF and SS (Δ=1.5, P<0.001). Mean PSD and VFI showed no significant differences between the algorithms. The mean foveal threshold was higher for SFR compared with SF (Δ=1.6, P<0.001) and SS (Δ=2.1, P<0.001). The number of points depressed at P<0.5% was lesser in SFR than in both SF and SS (P=0.002). Bland-Altman plots showed that considerable variability existed between the algorithms.

Conclusion:

SFR provides benefits in test time and shows similar VFI compared with SF and SS. However, the detection of early cases with SFR is questionable and few modifications are needed in the future to improve its accuracy. SF and SS gave almost similar results. The algorithms cannot be used interchangeably for the same patient on different test sessions.
Comparison of Peripapillary Choroidal Microvasculature Dropout in Primary Open-angle, Primary Angle-closure, and Pseudoexfoliation Glaucoma
Authors: Jo Youn Hye , Sung Kyung Rim , Shin Joong Won
Published: September 2020

Precis:

The prevalence of choroidal microvascular dropout (CMvD) was significantly higher in primary open-angle glaucoma (POAG) than primary angle-closure glaucoma (PACG) or pseudoexfoliation glaucoma (PXG) in the early stage. However, in the advanced stage, it did not differ among the 3 groups.

Purpose:

The purpose of this study was to compare the prevalence of peripapillary CMvD in POAG, PACG, and PXG.

Materials and Methods:

The presence of peripapillary CMvD was identified using optical coherence tomography angiography (AngioVue/RTVue-XR) imaging of the choroid in 186 eyes from 186 subjects [age and visual field (VF) mean deviation (MD) matched; 62 POAG, 62 PACG, and 62 PXG eyes]. Prevalence of CMvD was compared among glaucoma types in early and moderate to advanced disease, as divided by VF MD (−6 dB). The association between glaucoma type and presence of CMvD was evaluated using logistic regression analysis.

Results:

Prevalence of CMvD was significantly different between glaucoma types in early-stage disease (PACG 7.5%, PXG 25%, and POAG 46.3%, P<0.001), but it did not differ between glaucoma types in eyes with moderate to advanced disease (PACG 59.1%, PXG 68.2%, and POAG 81%; P=0.331). After adjusting for age, sex, the β-zone peripapillary atrophy/disc ratio, and glaucoma severity (VF MD), the CMvD odds ratio was 7.50 times greater in POAG than in PACG (P=0.001).

Conclusions:

CMvD was more common in POAG relative to both PACG and PXG, especially in early-stage disease. This finding suggested a role for ischemic injury in the pathogenesis of POAG.
The Relationship Between Melanin and Glaucoma: A Case-control Study
Authors: Giorgis Abeba T. , Alsoudi Amer F. , Alemu Abiye M. , Tadesse Tesfaye , Gemida Jibat , Taye Kalekirstos , Zeru Mhretab , Moe Caitlin A. , Stamper Robert L. , Keenan Jeremy D.
Published: September 2020

Précis:

In a case-control study, skin pigmentation was not statistically significantly different when comparing glaucoma patients to those without glaucoma.

Purpose:

Darker skin color has been implicated as a risk factor for glaucoma based on previous studies’ subjective assessments of skin pigmentation. This study used objective measurements to determine whether cutaneous pigmentation is a risk factor for glaucoma.

Methods:

This case-control study was conducted at Menelik II Tertiary Referral Hospital in Addis Ababa, Ethiopia. Patients aged 40 years or older from the glaucoma clinic who were being scheduled for trabeculectomy were enrolled as cases and age-matched patients without glaucoma from other clinics at Menelik II Tertiary Referral Hospital were enrolled as controls. A Dermacatch device was used to capture melanin measurements in triplicate from the inner arm of each participant. The exposure variable of interest was the median of the triplicate skin melanin measurements, in arbitrary units. The outcome of interest was presence of glaucoma.

Results:

Agreement between the triplicate inner arm melanin measurements was high, with an intraclass correlation of 0.99 (95% confidence interval, 0.98-0.99). Mean melanin values were 704 units (SD 94) in 76 cases and 694 units (SD 93) in 152 controls. Melanin was not statistically significantly associated with glaucoma after adjusting for sex and season of measurement (ie, dry vs. rainy), with an odds ratio of 1.15 (95% confidence interval, 0.59-2.24) per 100 units of inner arm melanin.

Conclusion:

This study failed to find a significant association between skin pigmentation and glaucoma using an objective and reproducible assessment of pigmentation.
A systematic review of animal models and sex as a variable in itch research
Authors: Wheeler Joshua J. , Allen-Moyer Katherine N. , Davis John M. , Mishra Santosh K.
Published: September 2020

Introduction:

Pruritus (or itch) research has gained momentum in the last decades and use of animal models to study itch behavior are a vital part of the research. Recent studies have found that many fields using animal models, including neuroscience, are predisposed toward using male animals in preclinical research. To address sex bias in animal research, the National Institutes of Health (NIH) began requiring researchers to include sex as a variable beginning in June 2015. Here, we test whether researchers studying itch are biased toward using males in preclinical research.

Methods:

The NIH’s PubMed database was searched for primary research articles written between August 2007 and December 2018 using the words “Itch” and “Pruritus.” The following information was extracted from articles fitting our inclusion criteria: type of itch (acute or chronic), the animal model and the sex of the animals used, and whether researchers considered sex as a variable. z-Tests, binomial tests, and the Cochran-Armitage test for trend were used to explore relationships between animal models and the usage of both sexes.

Results:

We found 5.3%±1.2% of papers in a given year used 1 of our 4 animal models. Mice were the most frequently used animal model, followed by rats, nonhuman primates, and dogs. Overall, researchers used male animals regardless of the animal model used. In preclinical research conducted on both male and female animals, sex was not considered a variable in a majority of these studies. Finally, since 2015, there has not been a change in the usage of male or female mice. Briefly, the incidence of papers utilizing both sexes has not changed.

Discussion:

We have found that itch researchers have a bias towards males in animal research. This bias has not changed since the NIH’s mandate to include sex as a variable in preclinical research.
Postoperative Opioid Filling Patterns in Women Undergoing Midurethral Sling Placement
Authors: Feroz Rehan T. , Boyd Sarah S. , Schaefer Eric W. , Swailes Alexa L. , Long Jaime B.
Published: September 2020

Objective

To evaluate postoperative opioid filling patterns for patients undergoing isolated midurethral sling placement.

Methods

Patients undergoing midurethral sling placement from 2005 to 2016 were identified in the Truven Health MarketScan database. We determined whether sling placement was an isolated procedure or performed in conjunction with other benign gynecologic procedures. All outpatient prescription drug claims for opioids were extracted from 28 days before surgery to 28 days after surgery. We identified the number of prescriptions filled and calculated morphine milligram equivalents (MMEs) in the allotted perioperative windows. The proportion of patients with opioid prescription claims and cumulative MMEs were compared for multiple versus isolated procedures using χ2 and Wilcoxon tests, respectively.

Results

The cohort included 153,631 patients, with 79,069 (51.5%) having an isolated procedure and 74,562 (48.5%) having multiple benign procedures. Seventy-two percent of the patients undergoing isolated midurethral sling placement received at least 1 opioid prescription in the study period compared with 79% of those undergoing combined procedures (P < 0.001). The median cumulative MMEs for isolated midurethral sling and midurethral sling + multiple procedures were 150 and 225 MMEs, respectively (P < 0.001). Across the years under study, the proportion of patients filling opioid prescription claims increased, but the median cumulative MME was unchanged.

Conclusions

Patients undergoing isolated midurethral sling placement filled a median of 150 cumulative MMEs, and the proportion of patients filling perioperative opioid prescriptions increased over the study period.
Patient Preferences and Knowledge Regarding Hysterectomy: A Study from the Fellows’ Pelvic Research Network (FPRN)®
Authors: Jacobs Kristin M. , Hokenstad Erik D. , Park Beau Y. , Hamner Jennifer J. , Shannon Megan B. , Zigman Jessica S. , Pilkinton Marjorie L. , Mahal Amandeep S. , Sheyn David D. , Elmer-Lyon Caroline G. , Korbly Nicole B. , Sung Vivian W.
Published: September 2020

Objective

The purpose of this study was to describe preference for and knowledge of hysterectomy routes in women presenting to urogynecology/gynecology clinics throughout the United States and to determine association with health literacy. Our primary aim was preference for hysterectomy route, and secondary aims were knowledge of basic pelvic structures and function, knowledge of various hysterectomy routes, and baseline health literacy level.

Methods

This multicenter, cross-sectional study was conducted through the Fellows’ Pelvic Research Network. Patients’ preference and knowledge for hysterectomy routes were assessed at initial presentation to the urogynecology/gynecology clinic with an anonymous, voluntary, self-administered questionnaire along with a validated health literacy test (Medical Term Recognition Test).

Results

Two hundred four women participated. Forty-five percent of patients were unsure which hysterectomy modality they would choose. Of patients who selected a preferred modality, 50% selected laparoscopic and 33% selected vaginal. Patients indicated that safety was considered highest priority when selecting route. The mean score for “knowledge about gynecology/hysterectomy” was 68%, with the high literacy group scoring higher compared with the low health literacy group (70% vs 60.1%, P = 0.01). More than 50% of patients incorrectly answered knowledge questions related to vaginal hysterectomy. Majority of the respondents had high health literacy (79.4%).

Conclusions

Patients prefer laparoscopic hysterectomy approach, although have limited understanding of vaginal hysterectomy. Higher health literacy levels are associated with increased knowledge of gynecology and hysterectomy routes, but were not found to influence patient preference for hysterectomy route. Overall, patients have limited knowledge of vaginal hysterectomy.
Dramatic decrease of surgical emergencies during COVID-19 outbreak
Authors: Rausei Stefano , Ferrara Francesco , Zurleni Tommaso , Frattini Francesco , Chiara Osvaldo , Pietrabissa Andrea , Sarro Giuliano ,   for Italian Association of Hospital Surgeons, and Collected Data Contributors
Published: September 2020

BACKGROUND

During the coronavirus disease 2019 (COVID-19) outbreak, a general decrease in surgical activity was observed. There is perception that this phenomenon has involved also surgical emergency, but no extensive data have been presented to date. The aim of this study was to analyze the real number of admissions and procedures for emergency surgical disease during COVID-19 pandemic.

METHODS

This is a multicenter study including 18 general surgery units performing emergency surgery in hospitals of the “Red Zone” in Lombardy. Data about admissions from emergency department and surgical emergency procedures performed during March 2019 and March 2020 were collected in an online database. Additional data were collected according to the different indications for surgical treatment. The primary outcomes were the overall rate of admissions for emergent surgical disease and the overall rate of emergency surgical procedures in the study periods. The secondary outcome was the overall surgical rates (among all the diagnosed surgical diseases).

RESULTS

Emergency surgical admissions and surgical operations significantly decreased with a fall in value of 45% (p < 0.001) and 41% (p = 0.001), respectively. This reduction was confirmed by the analysis according to different surgical indications, with the exceptions of admissions and operations for gastrointestinal bleeding and operations for abdominal trauma. The overall ratio between surgical procedures and diseases was not significantly different (54% vs. 63%; p = 0.619). This ratio was significantly different only for bowel obstruction and for gastrointestinal perforation.

CONCLUSIONS

It seems correct to consider “true” the dramatic decrease of surgical problems during COVID-19 outbreak, despite any therapeutic strategies and logistic difficulties.

LEVEL OF EVIDENCE

Epidemiological, level III.
New species in Aspergillus section Usti and an overview of Aspergillus section Cavernicolarum
Authors: Sun Bing Da , Houbraken Jos , Frisvad Jens C. , Jiang Xian Zhi , Chen Amanda Juan , Samson Robert A.
Published: September 2020

AspergillussectionsUstiandCavernicolarumare accommodated in the subgenusNidulantes. In the present study, a polyphasic approach using morphology and multi-gene phylogeny was applied to investigate the taxonomy of these two sections. Based on the phylogenetic analysis,AspergillussectionUstiincludes 25 species, which can be assigned to four series:Calidousti,Deflecti,MonodiorumandUsti. Aspergillus sigarelliis newly described in this section and this species was isolated from a cigarette from PR China and belongs to seriesCalidousti. It is clearly distinct from other members in this series based on ITS,BenA,CaMandRPB2sequences.AspergillussectionUstimembers likeA. calidoustusandA. granulosusare important opportunistic pathogens, it is speculative that more pathogenetic species will be found by using polyphasic taxonomy approaches.AspergillussectionCavernicolarumincludes five species, the growth rates on agar media and size and ornamentation of conidia are important characters for differentiating species in sectionCavernicolarum.
Halomonas pellis sp. nov., a moderately halophilic bacterium isolated from wetsalted hides
Authors: Li Xiaoguang , Gan Longzhan , Hu Mengyao , Wang Shiting , Tian Yongqiang , Shi Bi
Published: September 2020

A Gram-stain-negative, moderately halophilic strain, designated strain L5T, was isolated from wetsalted hides collected from Chengdu, south-west PR China. The cells were motile, facultative aerobic, short rod-shaped and non-endospore-forming. Growth of strain L5T occurred at pH 6–10 (optimum, pH 8), 10–45 °C (optimum, 30 °C) and in the presence of 1–17 % (w/v) NaCl (optimum, 10 %). Results of phylogenetic analyses based on 16S rRNA, gyrB and rpoD gene sequences and its genome revealed that strain L5T belonged to the genus

Halomonas

. Strain L5T was found to be most closely related to the type strains of

Halomonas saliphila

,

Halomonas lactosivorans

,

Halomonas kenyensis

,

Halomonas daqingensis

and

Halomonas desiderata

(98.8, 98.6, 98.3, 97.9 and 97.4 % 16S rRNA gene sequence similarity, respectively). The draft genome was approximately 4.2 Mb in size with a G+C content of 63.5 mol%. The average nucleotide identity (ANI) and digital DNA–DNA hybridization values among strain L5T and the selected

Halomonas

species were 83.3–88.9 % (ANIm), 71.1–87.3 % (ANIb) and 20.2–34.6 %, which are below the recommended cutoff values. Major fatty acids were C16 : 0, C16 : 1
 ω7c, C18 : 1
 ω7c and C19 : 0 cyclo ω8c and the predominant ubiquinone was Q-9, with minor ubiquinone Q-8 also present. The phospholipid profile consisted of diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, phosphatidylcholine, four unidentified aminophospholipids and three unidentified phospholipids. Based on the mentioned polyphasic taxonomic evidence, strain L5T represents a novel species within the genus

Halomonas

, for which Halomonas pellis sp. nov. is proposed. The type strain is L5T (=CGMCC 1.17335T=KCTC 72573T).
Roseomonas bella sp. nov., isolated from lake sediment
Authors: Zhang Jin-Yu , Jiang Xiao-Bing , Zhu Di , Wang Xiao-Man , Du Zong-Jun , Mu Da-Shuai
Published: September 2020

A Gram-stain-negative, non-motile, coccus-shaped, catalase- and oxidase-positive, facultatively anaerobic and pink-pigmented bacterium, designated strain CQN31T, was isolated from sediment of Changqiaohai Lake, Yunnan Province, China. Growth occurred at 4–45 °C (optimum, 37 °C), at pH 6.5–9.5 (optimum, pH 8.0) and with 0–1 % (w/v) NaCl (optimum, 0 %). C18 : 1ω7c/C18 : 1ω6cand C16 : 0were the predominant fatty acids. Phosphatidylcholine (PC), phosphatidylethanolamine (PE), phosphatidylglycerol (PG), diphosphatidylglycerol (DPG), phosphatidyldimethylethanolamine (PME) and one unidentified aminolipid (AL) were the major polar lipids. The G+C content of the genomic DNA was 71.5 %. 16S rRNA gene sequence comparisons indicated that strain CQN31Tshared 96.8 % similarity withRoseomonas wooponensisJCM 19527Tand 95.9 % withR. terricolaEM0302T. Digital DNA–DNA hybridization values between strain CQN31TandRoseomonas stagniDSM 19981T,R. roseaDSM 14916TandR. mucosaNCTC 13291Twere 21.0, 19.4 and 19.8 %, respectively. Average amino acid identity and average nucleotide identity values between strain CQN31TandR. stagniDSM 19981T,R. roseaDSM 14916TandR. mucosaNCTC 13291Twere 73.7, 63.4 and 61.9 %, and 79.2, 77.1 and 77.5%, respectively. Distinct morphological, physiological and genotypic differences from previously described taxa support the classification of strain CQN31Tas a representative of a novel species in the genusRoseomonas, for which the nameRoseomonas bellasp. nov. is proposed. The type strain is CQN31T(=KCTC 62447T=MCCC 1H00309T).