bluuebunny/crossref_metadata_2025 huggingface dataset:
Molecular Diagnosis of Pneumonia (Including Multiplex Panels)
Authors: Buchan Blake W , Armand-Lefevre Laurence , Anderson Neil
Published: August 2021

Background

Pneumonia is a common illness, accounting for a staggering amount of worldwide morbidity and mortality. The diagnosis of pneumonia is challenging given the variety of responsible pathogens. Diagnostic testing for bacterial pneumonia has traditionally relied on time-consuming culture-based methods, though recently multiplexed molecular approaches have been described. Multiplexed molecular assays for pneumonia have the potential to provide broad diagnostic information in a rapid timeframe. Much has yet to be learned about these assays regarding analytical performance, potential impact, and optimal implementation strategy.

Content

Herein we provide a summary of what is known and what has yet to be learned about multiplexed molecular pneumonia assays. We provide a comparison of the different commercially available assays and summarize the most current performance data for each. We further describe outcome data and lessons learned from those who have implemented these assays worldwide. Finally, based on the current state of performance and outcome data, we provide informed strategies and considerations for laboratories contemplating implementation.

Multiplexed molecular assays for the diagnosis of pneumonia boast high accuracy though the diagnostic information gained from these assays is inherently different from culture and must be interpreted in cultural context. Despite this, these assays can be powerful and effective diagnostic tools with a potential to positively impact patient care. The extent to which this is realized varies from setting to setting, though is dependent on thoughtful implementation and a focus on delivering clear, rapid, and actionable results that can be interpreted in the appropriate context.
Low coronary flow relative to myocardial mass predicts heart failure in symptomatic hypertensive patients with no obstructive coronary artery disease
Authors: Brown Jenifer M , Zhou Wunan , Weber Brittany , Divakaran Sanjay , Barrett Leanne , Bibbo Courtney F , Hainer Jon , Taqueti Viviany R , Dorbala Sharmila , Blankstein Ron , Di Carli Marcelo F
Published: August 2021

Aims

The transition from hypertension to heart failure (HF) remains poorly understood. We hypothesized that insufficient perfusion to match global metabolic demand, reflected by a low ratio of myocardial blood flow to global myocardial mass, may be a HF risk marker.

Methods and results

A retrospective cohort (n = 346) of patients with hypertension who underwent clinical positron emission tomography (PET) myocardial perfusion imaging for chest pain and/or dyspnoea at Brigham and Women’s Hospital (Boston, MA, USA) were studied. Patients without obstructive coronary artery disease by history or PET perfusion (summed stress score <3), HF, cardiomyopathy, or ejection fraction (EF) <40% were followed for HF hospitalization (primary outcome), all-cause death, and their composite. Myocardial blood flow, left ventricular (LV) mass, volumes, and EF were obtained from PET, and a ‘flow/mass ratio’ was determined as hyperaemic myocardial blood flow over LV mass indexed to body surface area. A lower flow/mass ratio was independently associated with larger end-diastolic (β = −0.44, P < 0.001) and end-systolic volume (β = −0.48, P < 0.001) and lower EF (β = 0.33, P < 0.001). A flow/mass ratio below the median was associated with an adjusted hazard ratio of 2.47 [95% confidence interval (CI) 1.24–4.93; P = 0.01] for HF hospitalization, 1.95 (95% CI 1.12–3.41; P = 0.02) for death, and 2.20 (95% CI 1.39–3.49; P < 0.001) for the composite.

Conclusion

An integrated physiological measure of insufficient myocardial perfusion to match global metabolic demand identifies subclinical hypertensive heart disease and elevated risk of HF and death in symptomatic patients with hypertension but without flow-limiting coronary artery disease.
Treatment and survival following in-hospital cardiac arrest: does patient ethnicity matter?
Authors: Agerström Jens , Carlsson Magnus , Bremer Anders , Herlitz Johan , Rawshani Araz , Årestedt Kristofer , Israelsson Johan
Published: August 2021

Aims

Previous research on racial/ethnic disparities in relation to cardiac arrest has mainly focused on black vs. white disparities in the USA. The great majority of these studies concerns out-of-hospital cardiac arrest (OHCA). The current nationwide registry study aims to explore whether there are ethnic differences in treatment and survival following in-hospital cardiac arrest (IHCA), examining possible disparities towards Middle Eastern and African minorities in a European context.

Methods and results

In this retrospective registry study, 24 217 patients from the IHCA part of the Swedish Registry of Cardiopulmonary Resuscitation were included. Data on patient ethnicity were obtained from Statistics Sweden. Regression analysis was performed to assess the impact of ethnicity on cardiopulmonary resuscitation (CPR) delay, CPR duration, survival immediately after CPR, and the medical team’s reported satisfaction with the treatment. Middle Eastern and African patients were not treated significantly different compared to Nordic patients when controlling for hospital, year, age, sex, socioeconomic status, comorbidity, aetiology, and initial heart rhythm. Interestingly, we find that Middle Eastern patients were more likely to survive than Nordic patients (odds ratio = 1.52).

Conclusion

Overall, hospital staff do not appear to treat IHCA patients differently based on their ethnicity. Nevertheless, Middle Eastern patients are more likely to survive IHCA.
Development of a diagnostic model focusing on nutritional indicators for frailty classification in people with chronic heart failure
Authors: Gu Yiqin , Li Chaofeng , Yan Jing , Yin Guoping , Lu Guilan , Sha Li , Song Yan , Wang Yanyan
Published: August 2021

Aims

Frailty has a great impact on the quality of life of patients with chronic heart failure (CHF), which needs to be judged in time. To develop a diagnostic model based on nutritional indicators to judge the frailty status of patients with chronic heart failure (Frailty-CHF).

Methods and results

In the data collection part of this study, questionnaire method and biomedical measurement method were adopted. The trace elements in serum samples were detected by high performance liquid chromatography, chemiluminescence, and inductively coupled plasma mass spectrometry. We used Excel for data consolidation, and then imported the data into R software for modelling. Lasso method was used for variable screening, and Logistics regression fitting model was used after variables were determined. The internal validation of the model was completed by Bootstrap re-sampling. A total of 123 patients were included in this study. After variables’ screening, age, nutritional status-heart failure, New York Heart Association Functional Class (NYHA), micronutrients B12, Ca, folic acid, and Se were included in the model, the c statistic and Brier score of the original model were 0.9697 and 0.0685, respectively. After Bootstrap re-sampling adjustment, the c statistic and Brier score were 0.8503 and 0.1690.

Conclusion

In this study, a diagnostic model of age, nutritional status-heart failure, NYHA, the micronutrients B12, Ca, folic acid, and Se was established. It could help healthcare professionals better identify the frailty status in patients with CHF.
Exploring health coaching and mindfulness as levers for transformation in health: stakeholder perspectives
Authors: Gupta Rahul K , Mayhew Maureen , Woollard Robert , Gelb Karen
Published: August 2021

Background

Health coaching (HC) and mindfulness (MFN) are proven interventions for mobilizing patients’ inner resources and are slowly being integrated into public primary care. Since 2015 the medical community in Gibsons BC has integrated physician-led HC and MFN-based programs into team-based care. This exploratory study aimed to understand the mechanisms by which these rural programs helped both patients and clinicians, and to elicit priorities for future study in these fields.

Methods

Using a qualitative participant-engaged constructivist approach in focus groups and large-group graphic facilitation, we elicited perspectives from patients and their physicians during a 1-day event held in September 2018. Thematic analysis of transcripts using Nvivo identified emergent themes that were regularly reviewed with coresearchers, and member checked with participants via online videoconferences held at 6 weeks and 4 months postevent.

Results

We identified six main themes relating to the successful implementation of these programs: (i) accessibility and affordability, (ii) offering a toolbox of practical skills, (iii) providing attuned and openhearted care, (iv) generating hope and self-efficacy, (v) experiencing a shared humanity and connection, and (vi) addressing the health of the whole person.

Conclusion

These themes highlight critical qualities of HC and MFN programs when implemented in a Medicare system. Key features include reducing stigma around mental health through making programs physician-led and a natural part of primary care, enriching accessibility through public funding, and enhancing patient agency through cultivating embodied awareness, self-compassion, and interpersonal skills. These themes inform the next steps to support upscaling these programs to other communities.
The role of general practitioners in managing the COVID-19 pandemic in a private healthcare system
Authors: Cohidon Christine , El Hakmaoui Fatima , Senn Nicolas
Published: August 2021

Background

The canton of Vaud’s public health authorities, in Switzerland, invited general practitioners (GPs) to participate in managing suspected COVID-19 patients and continue caring for their non-COVID-19 patients. However, this course of action was not mandatory. The present study’s objective was to describe and understand how involved GPs were in dealing with the COVID-19 pandemic’s first wave.

Methods

This mixed-methods study combined a retrospective quantitative survey and a qualitative explanatory investigation. All of the canton’s GPs were invited to participate in the quantitative survey via an online questionnaire including sections on: specific organization regarding COVID-19 activities and suspected COVID-19 patients, activities relating to non-COVID-19 patients, consequences on the practice’s professional staff, and opinions about the public health authorities’ pandemic crisis management. The qualitative investigation involved interviews with 10 volunteer GPs.

Results

The participation rate was 41%. One third of GPs chose not to reorganize their practice for the specific management of suspected COVID-19 patients. The number of weekly activities and interventions decreased by over 50% at 44% of practices, mostly due to a lack of patients. Even in an extraordinary crisis, GPs maintained their choice of whether to become involved, as their private and independent status allowed them to do. However, those who chose to be involved felt frustrated that the public health authorities did not recognize them as major health providers in the management of the pandemic.

Conclusion

This study illustrated the complexity and limitations of a primary care system based completely on private healthcare providers.
The N.C.Yeastract and CommunityYeastract databases to study gene and genomic transcription regulation in non-conventional yeasts
Authors: Godinho Cláudia P , Palma Margarida , Oliveira Jorge , Mota Marta N , Antunes Miguel , Teixeira Miguel C , Monteiro Pedro T , Sá-Correia Isabel
Published: August 2021

Responding to the recent interest of the yeast research community in non-Saccharomyces cerevisiae species of biotechnological relevance, the N.C.Yeastract (http://yeastract-plus.org/ncyeastract/) was associated to YEASTRACT + (http://yeastract-plus.org/). The YEASTRACT + portal is a curated repository of known regulatory associations between transcription factors (TFs) and target genes in yeasts. N.C.Yeastract gathers all published regulatory associations and TF-binding sites for Komagataellaphaffii (formerly Pichia pastoris), the oleaginous yeast Yarrowia lipolytica, the lactose fermenting species Kluyveromyces lactis and Kluyveromyces marxianus, and the remarkably weak acid-tolerant food spoilage yeast Zygosaccharomyces bailii. The objective of this review paper is to advertise the update of the existing information since the release of N.C.Yeastract in 2019, and to raise awareness in the community about its potential to help the day-to-day work on these species, exploring all the information available in the global YEASTRACT + portal. Using simple and widely used examples, a guided exploitation is offered for several tools: (i) inference of orthologous genes; (ii) search for putative TF binding sites and (iii) inter-species comparison of transcription regulatory networks and prediction of TF-regulated networks based on documented regulatory associations available in YEASTRACT + for well-studied species. The usage potentialities of the new CommunityYeastract platform by the yeast community are also discussed.
Role of Renal Sympathetic Nerve Activity in Volatile Anesthesia's Effect on Renal Excretory Function
Authors: Taavo Micael , Rundgren Mats , Frykholm Peter , Larsson Anders , Franzén Stephanie , Vargmar Karin , Valarcher Jean F , DiBona Gerald F , Frithiof Robert
Published: August 2021

Regulation of fluid balance is pivotal during surgery and anesthesia and affects patient morbidity, mortality, and hospital length of stay. Retention of sodium and water is known to occur during surgery but the mechanisms are poorly defined. In this study, we explore how the volatile anesthetic sevoflurane influences renal function by affecting renal sympathetic nerve activity (RSNA). Our results demonstrate that sevoflurane induces renal sodium and water retention during pediatric anesthesia in association with elevated plasma concentration of renin but not arginine–vasopressin. The mechanisms are further explored in conscious and anesthetized ewes where we show that RSNA is increased by sevoflurane compared with when conscious. This is accompanied by renal sodium and water retention and decreased renal blood flow (RBF). Finally, we demonstrate that renal denervation normalizes renal excretory function and improves RBF during sevoflurane anesthesia in sheep. Taken together, this study describes a novel role of the renal sympathetic nerves in regulating renal function and blood flow during sevoflurane anesthesia.
Causes and Consequences of Purifying Selection on SARS-CoV-2
Authors: Morales Atahualpa Castillo , Rice Alan M , Ho Alexander T , Mordstein Christine , Mühlhausen Stefanie , Watson Samir , Cano Laura , Young Bethan , Kudla Grzegorz , Hurst Laurence D
Published: August 2021

Owing to a lag between a deleterious mutation’s appearance and its selective removal, gold-standard methods for mutation rate estimation assume no meaningful loss of mutations between parents and offspring. Indeed, from analysis of closely related lineages, in SARS-CoV-2, the Ka/Ks ratio was previously estimated as 1.008, suggesting no within-host selection. By contrast, we find a higher number of observed SNPs at 4-fold degenerate sites than elsewhere and, allowing for the virus’s complex mutational and compositional biases, estimate that the mutation rate is at least 49–67% higher than would be estimated based on the rate of appearance of variants in sampled genomes. Given the high Ka/Ks one might assume that the majority of such intrahost selection is the purging of nonsense mutations. However, we estimate that selection against nonsense mutations accounts for only ∼10% of all the “missing” mutations. Instead, classical protein-level selective filters (against chemically disparate amino acids and those predicted to disrupt protein functionality) account for many missing mutations. It is less obvious why for an intracellular parasite, amino acid cost parameters, notably amino acid decay rate, is also significant. Perhaps most surprisingly, we also find evidence for real-time selection against synonymous mutations that move codon usage away from that of humans. We conclude that there is common intrahost selection on SARS-CoV-2 that acts on nonsense, missense, and possibly synonymous mutations. This has implications for methods of mutation rate estimation, for determining times to common ancestry and the potential for intrahost evolution including vaccine escape.
Patterns and mechanisms of sex ratio distortion in the Collaborative Cross mouse mapping population
Authors: Haines Brett A , Barradale Francesca , Dumont Beth L
Published: August 2021

In species with single-locus, chromosome-based mechanisms of sex determination, the laws of segregation predict an equal ratio of females to males at birth. Here, we show that departures from this Mendelian expectation are commonplace in the 8-way recombinant inbred Collaborative Cross (CC) mouse population. More than one-third of CC strains exhibit significant sex ratio distortion (SRD) at wean, with twice as many male-biased than female-biased strains. We show that these pervasive sex biases persist across multiple breeding environments, are stable over time, and are not mediated by random maternal effects. SRD exhibits a heritable component, but QTL mapping analyses fail to nominate any large effect loci. These findings, combined with the reported absence of sex ratio biases in the CC founder strains, suggest that SRD manifests from multilocus combinations of alleles only uncovered in recombined CC genomes. We explore several potential complex genetic mechanisms for SRD, including allelic interactions leading to sex-biased lethality, genetic sex reversal, chromosome drive mediated by sex-linked selfish elements, and incompatibilities between specific maternal and paternal genotypes. We show that no one mechanism offers a singular explanation for this population-wide SRD. Instead, our data present preliminary evidence for the action of distinct mechanisms of SRD at play in different strains. Taken together, our work exposes the pervasiveness of SRD in the CC population and nominates the CC as a powerful resource for investigating diverse genetic causes of biased sex chromosome transmission.
New insights on water storage dynamics in a mountainous catchment from superconducting gravimetry
Authors: Chaffaut Q , Hinderer J , Masson F , Viville D , Pasquet S , Boy J P , Bernard J D , Lesparre N , Pierret M C
Published: August 2021

Assessing the spatial and temporal heterogeneity in subsurface water storage has strong societal and environmental implications, as it is key to assess the water availability for the ecosystem and society. This challenge is especially significant in mountainous areas, where the local population totally depends on springwater as a freshwater resource, while water storage dynamics is complex to evaluate because it exhibits spatiotemporal heterogeneities on all scales as a result of the topography. In this study, we compare the water balance of a headwater granitic catchment (CWB) with water storage changes assessed from in situ continuous gravity monitoring using an iGrav superconducting gravimeter (SGWSC) located at the summit of the catchment. We show that SGWSC and CWB exhibit a similar annual cycle, although they deviate in the months following winter peak flow events. We investigate the reasons for these discrepancies using a tank model adjusted to the SG signal. This shows that during these events, the effective discharge in the SG footprint area is much lower than the catchment streamflow. We attribute this difference in the drainage term to a lower contribution of the upper part of the catchment to the generation of peak flow, compared to the lower part.
Accuracy of Liver-Type Fatty Acid-Binding Protein in Predicting Acute Kidney Injury: A Meta-Analysis
Authors: Chiang Ting-Hui , Yo Chia-Hung , Lee Gin Hoong , Mathew Amy , Sugaya Takeshi , Li Wen-Yi , Lee Chien-Chang
Published: August 2021

Background

Liver-type fatty acid–binding protein (L-FABP) is a promising biomarker for the early prediction of acute kidney injury (AKI). However, the clinical utility of L-FABP in different populations or settings remains unclear. We present a meta-analysis of studies evaluating the performance of L-FABP in AKI prediction.

Methods

We performed a literature search in MEDLINE, EMBASE, and Cochrane library, using search terms “acute kidney injury” and “L-FABP.” Studies investigating the performance characteristics of L-FABP for the early diagnosis of AKI were included. Data about patient characteristics, diagnostic criteria of AKI, quantitative data required for construction of a 2 × 2 table (number of participants, sensitivity, specificity, and case number), study settings, and outcomes were extracted. The bivariable model was applied to calculate the estimated sensitivity and specificity of L-FABP. A summary ROC curve was created by plotting the true-positive rate against the false-positive rate at various cutoff values from different studies.

Results

We found 27 studies reporting measurement of urine (n = 25 studies) or plasma (n = 2 studies) L-FABP. Overall, the estimated sensitivity was 0.74 (95% CI: 0.69–0.80) and specificity was 0.78 (95% CI: 0.71–0.83). L-FABP demonstrated a stable area under the ROC of 0.82 (95% CI: 0.79–0.85) in variable clinical settings including intensive care unit, surgery, and contrast-induced AKI. In subgroup analysis excluding pediatric and post radiocontrast exposure cohorts, L-FABP had comparative diagnostic performance with neutrophil gelatinase associated lipocalin (NGAL).

Conclusions

Despite broad prevalence, L-FABP is a clinically useful marker with moderate accuracy in variable clinical settings as demonstrated in our subgroup analysis. Except for pediatric patients and those post-radiocontrast exposure, L-FABP has comparable discriminative capability as NGAL.
Polygenic Basis and the Role of Genome Duplication in Adaptation to Similar Selective Environments
Authors: Campbell Matthew A , Anderson Eric C , Garza John Carlos , Pearse Devon E
Published: August 2021

Genetic changes underlying adaptation vary greatly in terms of complexity and, within the same species, genetic responses to similar selective pressures may or may not be the same. We examine both complex (supergene) and simple (SNP) genetic variants occurring in populations of rainbow trout (Oncorhynchus mykiss) independently isolated from ocean access and compared them to each other and to an anadromous below-barrier population representing their ancestral source to search for signatures of both parallel and nonparallel adaptation. All landlocked populations displayed an increased frequency of a large inversion on chromosome Omy05, while 3 of the 4 populations exhibited elevated frequencies of another inversion located on chromosome Omy20. In addition, we identified numerous regions outside these 2 inversions that also show significant shifts in allele frequencies consistent with adaptive evolution. However, there was little concordance among above-barrier populations in these specific genomic regions under selection. In part, the lack of concordance appears to arise from ancestral autopolyploidy in rainbow trout that provides duplicate genomic regions of similar functional composition for selection to act upon. Thus, while selection acting on landlocked populations universally favors the resident ecotype, outside of the major chromosomal inversions, the resulting genetic changes are largely distinct among populations. Our results indicate that selection on standing genetic variation is likely the primary mode of rapid adaptation, and that both supergene complexes and individual loci contribute to adaptive evolution, further highlighting the diversity of adaptive genomic variation involved in complex phenotypic evolution.
Moso bamboo and Japanese cedar seedlings differently affected soil N2O emissions
Authors: Fang Haifu , Gao Yu , Zhang Qiang , Ma Lili , Wang Baihui , Shad Nasir , Deng Wenping , Liu Xiaojun , Liu Yuanqiu , Zhang Ling
Published: August 2021

Moso bamboo expansions into Japanese cedar forests are common. The expansion effects on soil nitrous oxide (N2O) emissions have not been thoroughly understood, and the underlying microbial mechanisms remain unclear. We studied bacterial and fungal contribution to soil N2O emissions under moso bamboo or Japanese cedar by applying bacterial or fungal inhibitors using streptomycin and iprodione, respectively. Soil N2O emissions were measured and the relative contribution of bacteria and fungi to soil N2O emissions was calculated. N2O emission from soil with moso bamboo was significantly higher than under Japanese cedar. Compared with control, bacterial or fungal inhibitor or their combination decreased N2O emissions, indicating substantial contribution of microbial activities to N2O emissions. However, the relative contribution of bacteria and fungi to N2O emissions was not affected by plants. Soil organic carbon, total and ammonium nitrogen were lower in soil under moso bamboo than Japanese cedar, suggesting faster microbial decomposition under moso bamboo. Fungal inhibitor and plants interactively affected soil pH, total phosphorus and ammonium nitrogen, while bacterial inhibitor and plants interactively affected total nitrogen, indicating substantial dependence of effects by microbial communities on plant species. Moso bamboo and Japanese cedar differed in their effects on soil N2O emissions with higher emissions under moso bamboo. Stimulation of N2O emission under moso bamboo might occur due to higher nitrogen mineralization and subsequent denitrification induced by high root exudation. These results highlight the need to consider the effect of species shifts on N2O emissions in forests.
Evaluation of overtime phenotypic variation of yeasts in chronic vulvovaginal candidosis cases
Authors: Faria-Gonçalves Paula , Gaspar Carlos , Oliveira Ana Sofia , Palmeira-de-Oliveira Rita , Gonçalves Teresa , Martinez-de-Oliveira José , Palmeira-de-Oliveira Ana , Rolo Joana
Published: August 2021

Chronic vulvovaginal candidosis results either from reinfection or from the ability of Candida spp. to persist in the vulva and/or vagina. Persistence is usually associated with increased antifungal (mainly azoles) resistance rates, which can explain treatment failure, and/or increased expression of virulence factors by Candida spp. The aim of this study was to assess the mechanisms leading to Candida spp persistence, by studying sequential isolates from women with chronic vulvovaginal candidosis, focusing on strains genotypes, azole resistance, and ability to form biofilms along the period of clinical evaluation. The strains were identified at species level by automated analysis of biochemical profiles and molecular typing evaluated by polymorphic DNA analysis. The capacity to form biofilm was assessed with a microtiter plate assay. Fluconazole susceptibility was determined by the microdilution broth assay at both pH 7 (following the recommended guideline) and pH 4.5 (as representative of vaginal pH). We studied samples from 17 clinically recurrent cases. In 53% of the chronic cases there were two or more isolates that had a phylogenetic relationship while the remaining (47%) were caused by different species. In those cases where related strains were involved in recurrence, we verified an increase in MIC at pH 7 and also an increased capacity to form biofilms over time. Significant correlation between these two parameters was observed only in cases caused by C. glabrata, evidencing the importance of these two factors to enhance persistence in the vaginal mucosa for this particular species.
Physical characterization of equal-mass binary near-Earth asteroid 2017 YE5: a possible dormant Jupiter-family comet
Authors: Monteiro F , Rondón E , Lazzaro D , Oey J , Evangelista-Santana M , Arcoverde P , De Cicco M , Silva-Cabrera J S , Rodrigues T , Santos L B T
Published: August 2021

Photometric observations of the nearly equal-mass binary near-Earth asteroid 2017 YE5 were carried out at the Observatório Astronômico do Sertão de Itaparica (OASI, Brazil) and at the Blue Mountains Observatory (BMO, Australia) between 2018 July and August, shortly after it made a close approach to Earth in 2018 June. These observations allowed to determine an orbital period of the system in good agreement with the result of the radar observations. Our results also indicate that the 2017 YE5 system is not fully locked in a synchronous spin–orbit resonance, as there is a possible asynchronous component or tumbling rotator in the system. Additional data obtained at the Observatorio Astronómico Nacional de San Pedro Mártir (OAN-SPM, Mexico) in 2018 August allowed to derive the colour indices and the low-resolution spectrum, which indicate that the object has a very reddish surface similar to the outer Solar system objetcs. This is consistent with a dark albedo of about 3 per cent, derived from an effective diameter of the combined components and an absolute magnitude of 19.2. Infrared data obtained at the NASA’s Infrared Telescope Facility exhibit a thermal emission in the 2.5 $\mu$m range for which a low albedo of 2–4 per cent was adjusted by applying a thermal model. Regarding to the taxonomic classification, we found that the 2017 YE5 is a D-type in the Bus-DeMeo taxonomy. Therefore, according to our results and considering that the 2017 YE5 system has a typical comet orbit (TJ = 2.87), we suggest that it is a dormant Jupiter-family binary comet.
Radio constraint on outflows from tidal disruption events
Authors: Matsumoto Tatsuya , Piran Tsvi
Published: August 2021

Radio flares from tidal disruption events (TDEs) are generally interpreted as synchrotron emission arising from the interaction of an outflow with the surrounding circumnuclear medium (CNM). We generalize the common equipartition analysis to be applicable in cases lacking a clear spectral peak or even with just an upper limit. We show that, for detected events, there is a lower limit on the combination of the outflow’s velocity v and solid angle Ω, ≃vΩa (with a ≃ 0.5). Considering several possible outflow components accompanying TDEs, we find that: isotropic outflows such as disc winds with $v\sim 10^4\, \rm km\, s^{-1}$ and Ω = 4π can easily produce the observed flares; the bow shock of the unbound debris has a wedge-like geometry and it must be geometrically thick with Ω ≳ 1. A fraction of its mass (≳0.01 M⊙) has to move at $v \gtrsim 2 \times 10^4\, \rm km\, s^{-1}$; Conical Newtonian outflows such as jets can also be a radio source but both their velocity and the CNM density should be larger than those of isotropic winds by a factor of ∼(Ω/4π)−0.5. Our limits on the CNM densities are typically 30–100 times larger than those found by previous analysis that ignored non-relativistic electrons. We also find that late (a few years after the TDE) radio upper limits rule out energetic, ${\sim}10^{51\!-\!52}\, \rm erg$, relativistic jets like the one observed in TDE Sw J1644+57, implying that such jets are rare.
Phylogenomic Analysis of Velvet Worms (Onychophora) Uncovers an Evolutionary Radiation in the Neotropics
Authors: Baker Caitlin M , Buckman-Young Rebecca S , Costa Cristiano S , Giribet Gonzalo
Published: August 2021

Onychophora (“velvet worms”) are charismatic soil invertebrates known for their status as a “living fossil,” their phylogenetic affiliation to arthropods, and their distinctive biogeographic patterns. However, several aspects of their internal phylogenetic relationships remain unresolved, limiting our understanding of the group’s evolutionary history, particularly with regard to changes in reproductive mode and dispersal ability. To address these gaps, we used RNA sequencing and phylogenomic analysis of transcriptomes to reconstruct the evolutionary relationships and infer divergence times within the phylum. We recovered a fully resolved and well-supported phylogeny for the circum-Antarctic family Peripatopsidae, which retains signals of Gondwanan vicariance and showcases the evolutionary lability of reproductive mode in the family. Within the Neotropical clade of Peripatidae, though, we found that amino acid-translated sequence data masked nearly all phylogenetic signal, resulting in highly unstable and poorly supported relationships. Analyses using nucleotide sequence data were able to resolve many more relationships, though we still saw discordant phylogenetic signal between genes, probably indicative of a rapid, mid-Cretaceous radiation in the group. Finally, we hypothesize that the unique reproductive mode of placentotrophic viviparity found in all Neotropical peripatids may have facilitated the multiple inferred instances of over-water dispersal and establishment on oceanic islands.
Permanent Cerebrospinal Fluid Diversion in Adults With Posterior Fossa Tumors: Incidence and Predictors
Authors: Saad Hassan , Bray David P , McMahon J Tanner , Philbrick Brandon D , Dawoud Reem A , Douglas J Miller , Adeagbo Segun , Yarmoska Steven K , Agam Matthew , Chow Jocelyn , Pradilla Gustavo , Olson Jeffrey J , Alawieh Ali , Hoang Kimberly
Published: August 2021

BACKGROUND

Posterior fossa tumors (PFTs) can cause hydrocephalus. Hydrocephalus can persist despite resection of PFTs in a subset of patients requiring permanent cerebrospinal fluid (CSF) diversion. Characteristics of this patient subset are not well defined.

OBJECTIVE

To define preoperative and postoperative variables that predict the need for postoperative CSF diversion in adult patients with PFTs.

METHODS

We surveyed the CNS (Central Nervous System) Tumor Outcomes Registry at Emory (CTORE) for patients who underwent PFT resection at 3 tertiary-care centers between 2006 and 2019. Demographic, radiographic, perioperative, and dispositional data were analyzed using univariate and multivariate models.

RESULTS

We included 617 patients undergoing PFT resection for intra-axial (57%) or extra-axial (43%) lesions. Gross total resection was achieved in 62% of resections. Approximately 13% of patients required permanent CSF diversion/shunting. Only 31.5% of patients who required pre- or intraop external ventricular drain (EVD) placement needed permanent CSF diversion. On logistic regression, size, transependymal flow, use of perioperative EVD, postoperative intraventricular hemorrhage (IVH), and surgical complications were predictors of permanent CSF diversion. Preoperative tumor size was only independent predictor of postoperative shunting in patients with subtotal resection. In patients with intra-axial tumors, transependymal flow (P = .014), postoperative IVH (P = .001), surgical complications (P = .013), and extent of resection (P = .03) predicted need for shunting. In extra-axial tumors, surgical complications were the major predictor (P = .022).

CONCLUSION

Our study demonstrates that presence of preoperative hydrocephalus in patients with PFT does not necessarily entail the need for permanent CSF diversion. We report the major predictive factors for needing permanent CSF diversion.
Ketogenic diet with medium‐chain triglycerides restores skeletal muscle function and pathology in a rat model of Duchenne muscular dystrophy
Authors: Fujikura Yuri , Sugihara Hidetoshi , Hatakeyama Masaki , Oishi Katsutaka , Yamanouchi Keitaro
Published: August 2021

Duchenne muscular dystrophy (DMD) is an intractable genetic disease associated with progressive skeletal muscle weakness and degeneration. Recently, it was reported that intraperitoneal injections of ketone bodies partially ameliorated muscular dystrophy by increasing satellite cell (SC) proliferation. Here, we evaluated whether a ketogenic diet (KD) with medium‐chain triglycerides (MCT‐KD) could alter genetically mutated DMD in model rats. We found that the MCT‐KD significantly increased muscle strength and fiber diameter in these rats. The MCT‐KD significantly suppressed the key features of DMD, namely, muscle necrosis, inflammation, and subsequent fibrosis. Immunocytochemical analysis revealed that the MCT‐KD promoted the proliferation of muscle SCs, suggesting enhanced muscle regeneration. The muscle strength of DMD model rats fed with MCT‐KD was significantly improved even at the age of 9 months. Our findings suggested that the MCT‐KD ameliorates muscular dystrophy by inhibiting myonecrosis and promoting the proliferation of muscle SCs. As far as we can ascertain, this is the first study to apply a functional diet as therapy for DMD in experimental animals. Further studies are needed to elucidate the underlying mechanisms of the MCT‐KD‐induced improvement of DMD.
Student Nurse Knowledge of and Attitudes Toward Pressure Injury Prevention: How Sufficient Is Undergraduate Education?
Authors: Kara Hava , Arikan Fatma , Kahyaoglu Ali
Published: August 2021

OBJECTIVES

To assess the knowledge and attitudes of student nurses regarding evidence-based guidelines for preventing pressure injuries.

METHODS

This study used a descriptive research design. The participants included second-, third-, and fourth-year nursing students completing their bachelor’s degrees at a faculty of nursing in Turkey. Data collection forms consisted of a student nurse information form, the Pressure Ulcer Prevention Knowledge Assessment Instrument, and the Attitude Towards Pressure Ulcer Prevention Instrument.

RESULTS

The overall mean score for knowledge was 49.9% (11.7/26). The highest scores for the instrument’s subthemes were for nutrition (72%), and the lowest were for etiology and development (40.1%). The overall mean attitude score was 42.20 ± 2.40, although a statistically significant difference among grades was found (P < .001). The highest mean scores showed agreement among students that pressure injury prevention should be a priority (10.50 ± 1.43). A significant difference was found in the competence subscale according to the number of dressing changes observed and sense of competence in pressure injury care (P = .003). A weak but statistically significant positive relationship was found between knowledge and attitude scores (r = 0.158; 95% confidence interval, .040–.269; P < .001).

CONCLUSIONS

This study revealed that certain revisions are needed in the nursing curriculum to improve the knowledge and attitudes of nursing students toward the prevention and care of pressure injuries. More details should be covered in the classroom and laboratories through simulation or clinical practice for improved management of pressure injuries.
The Reverdin Graft: The Forgotten Skin Transplant
Authors: Brekelmans Wouter , Leijnen Michiel , Borger van de Burg Boudewijn L. S. , Hoencamp Rigo
Published: August 2021

This article describes a series of four patients for whom a Reverdin graft was performed. The Reverdin graft, also known as a pinch graft, is a method to promote epithelialization for superficial wounds. The intervention is minimally invasive with a short learning curve. The procedure and its advantages and disadvantages are discussed in this case series. This pinch graft is a widely accepted, minimally invasive intervention to accelerate the epithelialization of wounds.
Incidence and Risk Factors for Surgical Site Infection following Emergency Cesarean Section: A Retrospective Case-Control Study
Authors: Ousey Karen , Blackburn Joanna , Stephenson John , Southern Tom
Published: August 2021

OBJECTIVE

To assess the incidence, risk, and associated factors that contribute to an acquired surgical site infection (SSI) after emergency cesarean section (CS).

METHODS

This retrospective case-control study was conducted in an acute district general hospital in England with 206 patients (101 SSI patients and 105 non-SSI patients) who had an emergency CS in 2017. Grade of surgeon, smoking status, preoperative vaginal swab status (positive or negative), diabetes status, age, body mass index, membrane rupture to delivery interval, and length of surgery were recorded. Risk factors were identified using simple and multiple logistic regression.

RESULTS

Body mass index was significantly associated with SSI (odds ratio, 1.17; 95% confidence interval, 1.11 to 1.24; P < .001). Further, substantive nonsignificant associations were recorded between SSI and patient age and vaginal swab status.

CONCLUSIONS

Body mass index was the only significant risk factor for the development of an SSI after emergency CS, possibly because of the impact of excessive adipose tissue on the immune system and reduced effectiveness of antibiotics. Diabetes status, patient age, and preoperative vaginal swab status were not significantly associated with SSI. Improved guidelines and strategies for managing at-risk patients would enable clinicians to reduce the risk of SSI development. The importance of wound management including frequent wound cleaning, appropriate dressings, dressing changes, and education is highlighted. Future research on larger samples should be conducted to validate these findings.
Evolution in the Acute Management of Open Fracture Treatment? Part 2
Authors: Sagi H. Claude , Patzakis Michael J.
Published: August 2021

Introduction:

In the first installment of this two-part series, we explored the history of open fracture treatment focusing primarily on bacteriology and antibiotic selection/stewardship. In this follow-up segment, we will analyze and summarize the other aspects of open fracture care such as time to debridement, pulsatile lavage, and open wound management (including time to closure)—finishing with summative statements and recommendations based on the current most up-to-date literature.

Level of Evidence:

Therapeutic Level V. See Instructions for Authors for a complete description of levels of evidence.
Distal Radioulnar Joint, Distal Ulna Injury, and Lunate Facet Considerations in Distal Radius Fractures
Authors: Rubio Francisco
Published: August 2021

Injuries to the distal aspect of the ulna and the distal radioulnar joint (DRUJ) commonly occur concurrently with distal radius fractures. These fractures may also involve the sigmoid notch of the lunate facet of the radius. Each of these structures merits consideration when managing ulnar-sided injuries associated with distal radius fractures. Improper management of distal radioulnar complex injuries may result in limited wrist motion, persistent DRUJ instability, and pain despite successful fracture union. The distal ulna is the keystone of the distal radioulnar articulation. An understanding of the components of the distal radioulnar complex and methods to manage injuries of each of these components contributes to improved functional outcomes by restoring this keystone effect. The classification of distal radioulnar injuries discussed herein provides a framework for understanding the disruption of the ligamentous stabilizers of the DRUJ and identifying residual distal radioulnar instability after fracture fixation. Proper treatment of residual DRUJ instability will restore stability and minimize persistent functional impairment.
Components of Health-Related Quality of Life Most Affected Following Pediatric Critical Illness
Authors: Killien Elizabeth Y. , Rivara Frederick P. , Dervan Leslie A. , Smith Mallory B. , Watson R. Scott
Published: August 2021

OBJECTIVES:

To evaluate which individual elements of health-related quality of life contribute most to decline in overall health-related quality of life status following pediatric critical care.

DESIGN:

Retrospective cohort study.

SETTING:

Seattle Children’s Hospital.

PATIENTS:

ICU patients age 1 month to 18 years admitted between December 2011 and February 2017.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

We assessed health-relatedquality of life decline from baseline to postdischarge (median, 6 wk) and determined the individual items of the Pediatric Quality of Life Inventory Infant Scales (< 2 yr) and Generic Core Scales (2–18 yr) with the highest prevalence of decline. We used multivariable regression to estimate the risk of decline in each of seven thematic categories by patient age, baseline health status, diagnosis, Pediatric Risk of Mortality score, and ICU length of stay. Decline from baseline health-related quality of life occurred in 22.5% of 539 patients. Items most commonly affected for infants less than 2 years were primarily emotional (cranky/crying, sleep, and self-soothing). Children 2–18 years most commonly experienced declines in physical functioning (play/exercise, lifting, and pain). Across the entire cohort, declines in categories of energy (31.5%), activity (31.0%), sleep (28.0%), and fear (24.7%) were most commonly endorsed. Risk of decline in each category varied with patient age, medical complexity, and diagnosis.

CONCLUSIONS:

Deconditioning, sleep, fear, and pain are important targets for intervention to improve health-related quality of life outcomes for critically ill children.
Comprehensive characterization of pharmacogenetic variants in TPMT and NUDT15 in children with acute lymphoblastic leukemia
Authors: Moriyama Takaya , Yang Wenjian , Smith Colton , Pui Ching-Hon , Evans William E. , Relling Mary V. , Bhatia Smita , Yang Jun J.
Published: August 2021

Thiopurines [e.g. 6-mercaptopurine (6MP)] are essential for the cure of acute lymphoblastic leukemia (ALL) but can cause dose-limiting hematopoietic toxicity. Germline variants in drug-metabolizing enzyme genes TPMT and NUDT15 have been linked to the risk of thiopurine toxicity. However, the full spectrum of genetic polymorphism in these genes and their impact on the pharmacological effects of thiopurines remain unclear. Herein, we comprehensively sequenced the TPMT and NUDT15 genes in 685 children with ALL from the Children’s Oncology Group AALL03N1 trial and evaluated their association with 6MP dose intensity. We identified 6 and 5 coding variants in TPMT and NUDT15 respectively, confirming the association at known pharmacogenetic variants. Importantly, we discovered a novel gain-of-function noncoding variants in TPMT associated with increased 6MP tolerance (rs12199316), with independent validation in 380 patients from the St. Jude Total Therapy XV protocol. Located adjacent to a regulatory DNA element, this intergenic variant was strongly associated TPMT transcription, with the variant allele linked to higher expression (P = 2.6 × 10−9). For NUDT15, one noncoding common variant, rs73189762, was identified as potentially related to 6MP intolerance. Collectively, we described pharmacogenetic variants in TPMT and NUDT15 associated with thiopurine sensitivity, providing further insights for implementing pharmacogenetics-based thiopurine individualization.