bluuebunny/crossref_metadata_2025 huggingface dataset:
Vector Fields and Automorphism Groups of Danielewski Surfaces
Authors: Leuenberger Matthias , Regeta Andriy
Published: July 2020

In this paper, we study the Lie algebra of vector fields ${\operatorname{Vec}}(\textrm{D}_p)$ of a smooth Danielewski surface $\textrm{D}_p$. We prove that the Lie subalgebra $\langle{\operatorname{LNV}}(\textrm{D}_p) \rangle$ of ${\operatorname{Vec}}(\textrm{D}_p)$ generated by locally nilpotent vector fields is simple. Moreover, if the two Lie algebras $\langle{\operatorname{LNV}}(\textrm{D}_p) \rangle$ and $\langle{\operatorname{LNV}}(\textrm{D}_q) \rangle$ of two Danielewski surfaces $\textrm{D}_p$ and $\textrm{D}_q$ are isomorphic, then the surfaces $\textrm{D}_p$ and $\textrm{D}_q$ are isomorphic. As an application we prove that the ind-groups ${\operatorname{Aut}}(\textrm{D}_p)$ and ${\operatorname{Aut}}(\textrm{D}_q)$ are isomorphic if and only if $\textrm{D}_p \simeq \textrm{D}_q$ as a variety. We also show that any automorphism of the ind-group ${\operatorname{Aut}}^\circ (\textrm{D}_p)$ is inner.
A Female Policy Premium? Agency Context and Women’s Leadership in the U.S. Federal Bureaucracy
Authors: Potter Rachel Augustine , Volden Craig
Published: July 2020

Although there are descriptive and substantive benefits associated with women serving in leadership posts in the bureaucracy, we ask whether there is a policy benefit associated with women’s leadership. Simply put, is there a policy premium to having women as bureaucratic leaders? We focus on agency rulemaking, a policymaking activity conducted by nearly all federal agencies. Across three presidential administrations, we find no evidence of an across-the-board premium associated with women’s leadership. However, our results are consistent with a conditional policy premium—wherein women leaders are particularly effective in advancing ambitious rules and in shepherding rules through to finalization—in agencies that have a working environment that is supportive of women and, to some extent, in agencies that focus on women’s issues. One key implication is that, rather than working to tear down “glass walls,” reformers would be better served by improving the workplace climate for women within agencies.
Quantifying temperature-equilibrium time using temperature analysis inside a Farmer ionization chamber
Authors: Fuse Hiraku , Fujisaki Tatsuya , Abe Shinji , Yasue Kenji , Oyama Satoshi
Published: July 2020

In this study, we propose a methodology for temperature determination of the temperature and pressure correction factor, PTP, by analyzing the temperature distribution of the modeled ionization chamber taking into account the thermal effect of a water phantom on neighboring materials in the process. Additionally, we present an appropriate temperature-equilibrium time for conducting measurements. The temporal response in the cavity is acquired at 20-s intervals using a Farmer ionization chamber and an electrometer. The initial temperature of the water phantom is 20–25°C with continuous heating/cooling. The temporal response is measured until temperature equilibrium is confirmed, specifically when a temperature difference of 1–5°C is observed between the ionization chamber and the water phantom. Using an ionization-chamber model, temperature distribution is simulated between 20 and 25°C with various parameters set to receive heating and cooling from surrounding media. The results suggest that the temporal response of the ionization chamber essentially coincides with the temperature change at the tip and middle; moreover, the predicted temperature change for temporal response and the simulated temperature of water are different by ~0.16°C at the tip and ~0.79°C at the bottom. Overall, the temperature-equilibration time for absorbed dosimetry is affected by two factors: the cavity wall and the stem side of the cavity; moreover, 400 s is required to obtain complete temperature equilibrium in the water phantom. This analytical study supports the experimental value obtained in previous research. Therefore, analytical representation of the temperature distribution in the ionization chamber is possible.
Recurrent acute pancreatitis caused by combined gastric and pancreatic duplications: value of preoperative CT and MRCP and conservative surgery
Authors: Hérin Edouard , Sauvanet Alain , Cros Jérome , Koulakian Hasmik , Lévy Philippe , Vullierme Marie Pierre
Published: July 2020

We present a series of patients with recurrent acute pancreatitis caused by a duplicated pancreatic head connected to a gastric duplication and successfully treated by conservative surgery. This retrospective study included consecutive adult patients referred to our institution for recurrent acute pancreatitis. All patients underwent a preoperative non-invasive imaging examination including contrast-enhanced computed tomography and magnetic resonance cholangiopancreatography (MRCP). The final diagnosis of this developmental anomaly was based on surgical and pathological examinations. The four patients in this study had the same typical imaging pattern including a duplicated duct. There was no recurrent acute pancreatitis after surgical treatment, which involved atypical resection of the duplicated pancreatic head and segmental gastric resection, without a Whipple procedure. The discovery of an accessory pancreatic head with a duct terminating in a cyst identified on MRCP in a patient with recurrent acute pancreatitis could suggest this rare and surgically treatable cause of acute pancreatitis.
Adenita: interactive 3D modelling and visualization of DNA nanostructures
Authors: de Llano Elisa , Miao Haichao , Ahmadi Yasaman , Wilson Amanda J , Beeby Morgan , Viola Ivan , Barisic Ivan
Published: July 2020

DNA nanotechnology is a rapidly advancing field, which increasingly attracts interest in many different disciplines, such as medicine, biotechnology, physics and biocomputing. The increasing complexity of novel applications requires significant computational support for the design, modelling and analysis of DNA nanostructures. However, current in silico design tools have not been developed in view of these new applications and their requirements. Here, we present Adenita, a novel software tool for the modelling of DNA nanostructures in a user-friendly environment. A data model supporting different DNA nanostructure concepts (multilayer DNA origami, wireframe DNA origami, DNA tiles etc.) has been developed allowing the creation of new and the import of existing DNA nanostructures. In addition, the nanostructures can be modified and analysed on-the-fly using an intuitive toolset. The possibility to combine and re-use existing nanostructures as building blocks for the creation of new superstructures, the integration of alternative molecules (e.g. proteins, aptamers) during the design process, and the export option for oxDNA simulations are outstanding features of Adenita, which spearheads a new generation of DNA nanostructure modelling software. We showcase Adenita by re-using a large nanorod to create a new nanostructure through user interactions that employ different editors to modify the original nanorod.
Advances in nanomaterials for treatment of hypoxic tumor
Authors: Zou Mei-Zhen , Liu Wen-Long , Chen Han-Shi , Bai Xue-Feng , Gao Fan , Ye Jing-Jie , Cheng Han , Zhang Xian-Zheng
Published: July 2020

The hypoxic tumor microenvironment is characterized by disordered vasculature and rapid proliferation of tumors, resulting from tumor invasion, progression and metastasis. The hypoxic conditions restrict efficiency of tumor therapies, such as chemotherapy, radiotherapy, phototherapy and immunotherapy, leading to serious results of tumor recurrence and high mortality. Recently, research has concentrated on developing functional nanomaterials to treat hypoxic tumors. In this review, we categorize such nanomaterials into (i) nanomaterials that elevate oxygen levels in tumors for enhanced oxygen-dependent tumor therapy and (ii) nanomaterials with diminished oxygen dependence for hypoxic tumor therapy. To elevate oxygen levels in tumors, oxygen-carrying nanomaterials, oxygen-generating nanomaterials and oxygen-economizing nanomaterials can be used. To diminish oxygen dependence of nanomaterials for hypoxic tumor therapy, therapeutic gas-generating nanomaterials and radical-generating nanomaterials can be used. The biocompatibility and therapeutic efficacy of these nanomaterials are discussed.
The quality of e-fit notes issued in secondary care
Authors: Harrison S , Dorrington S , Parsons V , Shah S G S , Madan I
Published: July 2020

Background

Few data are available on the pattern of use of fit notes issued in secondary care settings.

Aims

To evaluate the pattern and quality of e-fit notes issued in an NHS Trust.

Methods

Anonymized data on patients admitted to Guy’s and St Thomas’ NHS Foundation Trust (London, UK) who had an e-fit note issued from 1 January to 31 August 2017 were analysed using descriptive statistical methods. Thematic analysis was used to group the free-text comments into distinct categories and themes.

Results

A total of 815 fit notes were issued during the study period. A total of 659 (81%) fit notes advised that patients were ‘not fit’ for work, whilst 156 (19%) advised that they ‘may be fit’ for work. The specialty with the highest proportion of patients assessed as may be fit was plastic surgery 46/104 (44%), whilst the lowest was ear, nose and throat surgery 0/57 (0%). The majority 151/156 (97%) of fit notes which advised that patients may be fit for work used the tick-box sections on the fit note to recommend work modifications. Of the free-text comments in section 4 of the ‘may be fit’ e-fit notes issued, 91/114 (80%) were related to the functional ability of patients.

Conclusions

Our study suggests that doctors in secondary care are more willing to use the ‘may be fit’ option on the fit note than primary care practitioners. Most fit notes, which advised that a patient may be fit for work, suggested workplace modifications.
Two Hundred Twenty-Six Consecutive Deep Brain Stimulation Electrodes Placed Using an “Asleep” Technique and the Neuro|MateTM Robot for the Treatment of Movement Disorders
Authors: Moran Catherine , Sarangmat Nagaraja , Gerard Carter S , Barua Neil , Ashida Reiko , Woolley Max , Pietrzyk Mariusz , Gill Steven S
Published: July 2020

BACKGROUND

Robotics in neurosurgery has demonstrated widening indications and rapid growth in recent years. Robotic precision and reproducibility are especially pertinent to the field of functional neurosurgery. Deep brain stimulation (DBS) requires accurate placement of electrodes in order to maximize efficacy and minimize side effects. In addition, asleep techniques demand clear target visualization and immediate on-table verification of accuracy.

OBJECTIVE

To describe the surgical technique of asleep DBS surgery using the Neuro|MateTM Robot (Renishaw plc, Wotton-under-Edge, United Kingdom) and examine the accuracy of DBS lead placement in the subthalamic nucleus (STN) for the treatment of movement disorders.

METHODS

A single-center retrospective review of 113 patients who underwent bilateral STN/Zona Incerta electrode placement was performed. Accuracy of implantation was assessed using 5 measurements, Euclidian distance, radial error, depth error, angular error, and shift error.

RESULTS

A total of 226 planned vs actual electrode placements were analyzed. The mean 3-dimensional vector error calculated for 226 trajectories was 0.78 +/− 0.37 mm. The mean radial displacement off planned trajectory was 0.6 +/− 0.33 mm. The mean depth error, angular error, and shift error was 0.4 +/− 0.35 mm, 0.4 degrees, and 0.3 mm, respectively.

CONCLUSION

This report details our institution's method for DBS lead placement in patients under general anaesthesia using anatomical targeting without microelectrode recordings or intraoperative test stimulation for the treatment of movement disorders. This is the largest reported dataset of accuracy results in DBS surgery performed asleep. This novel robot-assisted operative technique results in sub-millimeter accuracy in DBS electrode placement.
Supply and demand shocks in the COVID-19 pandemic: an industry and occupation perspective
Authors: del Rio-Chanona R Maria , Mealy Penny , Pichler Anton , Lafond François , Farmer J Doyne
Published: July 2020

We provide quantitative predictions of first-order supply and demand shocks for the US economy associated with the COVID-19 pandemic at the level of individual occupations and industries. To analyse the supply shock, we classify industries as essential or non-essential and construct a Remote Labour Index, which measures the ability of different occupations to work from home. Demand shocks are based on a study of the likely effect of a severe influenza epidemic developed by the US Congressional Budget Office. Compared to the pre-COVID period, these shocks would threaten around 20 per cent of the US economy’s GDP, jeopardize 23 per cent of jobs, and reduce total wage income by 16 per cent. At the industry level, sectors such as transport are likely to be output-constrained by demand shocks, while sectors relating to manufacturing, mining, and services are more likely to be constrained by supply shocks. Entertainment, restaurants, and tourism face large supply and demand shocks. At the occupation level, we show that high-wage occupations are relatively immune from adverse supply- and demand-side shocks, while low-wage occupations are much more vulnerable. We should emphasize that our results are only first-order shocks—we expect them to be substantially amplified by feedback effects in the production network.
Association of Padua prediction score with in-hospital prognosis in COVID-19 patients
Authors: Zeng D X , Xu J L , Mao Q X , Liu R , Zhang W Y , Qian H Y , Xu L
Published: July 2020

Background

Nearly 20% novel coronavirus disease 2019 (COVID-19) patients have abnormal coagulation function. Padua prediction score (PPS) is a validated tools for venous thromboembolism (VTE) risk assessment. However, its clinical value in COVID-19 patients’ evaluation was unclear.

Methods

We prospectively evaluated the VTE risk of COVID-19 patients using PPS. Demographic and clinical data were collected. Association of PPS with 28-day mortality was analyzed by multivariate logistic regression and Kaplan–Meier analysis.

Results

Two hundred and seventy-four continuous patients were enrolled, with total mortality of 17.2%. Patients in high PPS group, with significantly abnormal coagulation, have a higher levels of interleukin 6 (25.27 vs. 2.55 pg/ml, P < 0.001), prophylactic anticoagulation rate (60.7% vs. 6.5%, P < 0.001) and mortality (40.5% vs. 5.9%, P < 0.001) when compared with that in low PPS group. Critical patients showed higher PPS (6 vs. 2 score, P < 0.001) than that in severe patients. Multivariate logistic regression revealed the independent risk factors of in-hospital mortality included high PPS [odds ratio (OR): 7.35, 95% confidence interval (CI): 3.08–16.01], increased interleukin-6 (OR: 11.79, 95% CI: 5.45–26.20) and elevated d-dimer (OR: 4.65, 95% CI: 1.15–12.15). Kaplan–Meier analysis indicated patients with higher PPS had a significant survival disadvantage. Prophylactic anticoagulation in higher PPS patients shows a mild advantage of mortality but without statistical significance (37.1% vs. 45.7%, P = 0.42).

Conclusion

Higher PPS associated with in-hospital poor prognosis in COVID-19 patients. Prophylactic anticoagulation showed a mild advantage of mortality in COVID-19 patients with higher PPS, but it remain to need further investigation.
Association of altered folylpolyglutamate synthetase pre-mRNA splicing with methotrexate unresponsiveness in early rheumatoid arthritis
Authors: Muller Ittai B , Lin Marry , Lems Willem F , ter Wee Marieke M , Wojtuszkiewicz Anna , Nurmohamed Michael T , Cloos Jacqueline , Assaraf Yehuda G , Jansen Gerrit , de Jonge Robert
Published: July 2020

Objectives

An efficient pharmacological response to MTX treatment in RA patients relies on the retention and accumulation of intracellular MTX-polyglutamates catalysed by the enzyme folylpolyglutamate synthetase (FPGS). We recently identified a partial retention of FPGS intron 8 (8PR) as a prominent splice variant conferring FPGS dysfunction and decreased MTX polyglutamylation in acute lymphoblastic leukaemia. Here, we explored the association between FPGS 8PR levels and lack of MTX responsiveness in RA patients.

Methods

Thirty-six patients undergoing MTX treatment were enrolled from the Combinatie behandeling Reumatoide Artritis (COBRA)-light trial. RNA was isolated from blood samples at baseline, 13 weeks and 26 weeks of therapy, from patients in either COBRA-light (n = 21) or COBRA (n = 15) treatment arms. RT-qPCR analysis was used to assess RNA levels of FPGS 8PR over wild-type FPGS (8WT).

Results

In the COBRA-light treatment arm, higher baseline ratios of 8PR/8WT were significantly associated with higher 44-joint disease activity score (DAS44) at 13 and 26 weeks. Higher baseline ratios of 8PR/8WT also trended towards not obtaining low disease activity (DAS <1.6) and becoming a EULAR non-responder at 13 and 26 weeks. In the COBRA-treatment arm, a significant association was observed between high baseline 8PR/8WT ratios and higher DAS44 score at 26 weeks. Higher 8PR/8WT ratios were associated with non-response at week 26 based on both low disease activity and EULAR criteria.

Conclusion

This study is the first to associate alterations in FPGS pre-mRNA splicing levels with reduced responsiveness to MTX treatment in RA patients.

Trial registration

ISRCTN55552928.
A revision of pipistrelle-like bats (Mammalia: Chiroptera: Vespertilionidae) in East Africa with the description of new genera and species
Authors: Monadjem Ara , Demos Terrence C , Dalton Desire L , Webala Paul W , Musila Simon , Kerbis Peterhans Julian C , Patterson Bruce D
Published: July 2020

Vespertilionidae (class Mammalia) constitutes the largest family of bats, with ~500 described species. Nonetheless, the systematic relationships within this family are poorly known, especially among the pipistrelle-like bats of the tribes Vespertilionini and Pipistrellini. Perhaps as a result of their drab pelage and lack of obvious morphological characters, the genus and species limits of pipistrelle-like bats remain poorly resolved, particularly in Africa, where more than one-fifth of all vesper bat species occur. Further exacerbating the problem is the accelerating description of new species within these groups. In this study, we attempt to resolve the systematic relationships among the pipistrelle-like bats of sub-Saharan Africa and Madagascar and provide a more stable framework for future systematic efforts. Our systematic inferences are based on extensive genetic and morphological sampling of > 400 individuals covering all named genera and the majority of described African pipistrelle-like bat species, focusing on previously unstudied samples of East African bats. Our study corroborates previous work by identifying three African genera in Pipistrellini (Pipistrellus, Scotoecus and Vansonia), none of which is endemic to Africa. However, the situation is more complex in Vespertilionini. With broad taxonomic sampling, we confirm that the genus Neoromicia is paraphyletic, a situation that we resolve by assigning the species of Neoromicia to four genera. Neoromicia is here restricted to Neoromicia zuluensis and allied taxa. Some erstwhile Neoromicia species are transferred into an expanded Laephotis, which now includes both long-eared and short-eared forms. We also erect two new genera, one comprising a group of mostly forest-associated species (many of which have white wings) and the other for the genetically and morphologically unique banana bat. All four of these genera, as recognized here, are genetically distinct, have distinctive bacular morphologies and can be grouped by cranial morphometrics. We also demonstrate that the genus Nycticeinops, until now considered monospecific, includes both Afropipistrellus and the recently named Parahypsugo, thus representing the fifth African genus in Vespertilionini. A sixth genus, Hypsugo, is mostly extra-limital to sub-Saharan Africa. Finally, we describe three new species of pipistrelle-like bats from Kenya and Uganda, uncovered during the course of systematic bat surveys in the region. Such surveys are greatly needed across tropical Africa to uncover further bat diversity.
One size does not fit all
Authors: Kloss Katherine A. , Funnell Martha M. , Piatt Gretchen A. , Nwankwo Robin
Published: July 2020

Several nutrition strategies and eating patterns can help support self-management among persons with diabetes. This article details the effectiveness of popular eating patterns and nutrition strategies, as well as the role of nurses in facilitating informed patient choices and decisions.
Just-in-Time Training in a Tertiary Referral Hospital During the COVID-19 Pandemic in Italy
Authors: Ragazzoni Luca , Barco Ambra , Echeverri Lina , Conti Andrea , Linty Monica , Caviglia Marta , Merlo Federico , Martini Daniela , Pirisi Alessandro , Weinstein Eric , Barone-Adesi Francesco , Della Corte Francesco
Published: July 2020

The COVID-19 pandemic is threatening health systems worldwide, requiring extraordinary efforts to contain the virus and prepare health care systems for unprecedented situations. In this context, the entire health care workforce must be properly trained to guarantee an effective response. Just-in-time training has been an efficient solution for rapidly equipping health care workers with new knowledge, skills, and attitudes during emergencies; thus, it could also be an effective training technique in the context of the response to the COVID-19 pandemic. Because of the unexpected magnitude of this health crisis, the health care workforce must be trained in 2 areas: (1) basic infection prevention and control, including public health skills that are the core of population-based health management and (2) disaster medicine principles, such as surge capacity, allocation of scarce resources, triage, and the ethical dilemmas of rationing medical care. This Perspective reports how just-in-time training concepts and methods were applied in a tertiary referral hospital in March 2020, during the COVID-19 pandemic in Northern Italy, one of the hardest hit places in the world.

The COVID-19 just-in-time training was designed to provide hospital staff with the competencies they need to work proficiently and safely inside the hospital, including an understanding of the working principles and standard operating procedures in place and the correct use of personal protective equipment. Moreover, this training was intended to address the basic principles of disaster medicine applied to the COVID-19 pandemic. Such training was essential in enabling staff to rapidly attain competencies that most of them lacked because disaster medicine and global health are not included in the curricula of Italian medical and nursing schools. Although a formal evaluation was not performed, this is a useful example of how to create just-in-time training in a large hospital during a crisis of an unprecedented scale.
Kocher–Langenbeck Approach for Posterior Wall Acetabular Fractures
Authors: Cosgrove Christopher T. , Berkes Marschall B. , McAndrew Christopher M. , Miller Anna N.
Published: July 2020

Adequate surgical exposure is necessary for anatomical reduction and fixation of posterior wall acetabular fractures. This video demonstrates the Kocher–Langenbeck approach to the posterior acetabulum, as well as operative indications, surgical reduction and fixation techniques, and outcomes for posterior wall acetabular fractures.
Correction of Lateral Tibial Plateau Malunion
Authors: Probe Robert A. , Britten Tyler
Published: July 2020

The results of open reduction and internal fixation for tibial plateau fractures are generally favorable when articular morphology and stability are restored. When these goals of treatment are not achieved, limited function often results. The patient presented in this video complained of pain and an inability to resume his previous work. Evaluation suggested that root causes of these difficulties included widening of the plateau, significant depression of the articular surface, resultant valgus instability, and a displaced nonfunctioning lateral meniscus. This video demonstrates the planning and correction of a long-standing intraarticular malunion of a lateral tibial plateau fracture.
Bridge Plating for Comminuted Ulna Fractures
Authors: Swentik Andrew G. , Neiman Rafael
Published: July 2020

Highly comminuted fractures of the forearm are challenging for orthopaedic surgeons to manage because of the functional importance of anatomic restoration of alignment while obtaining sufficient fixation. The use of spanning plate fixation to stabilize comminuted ulna shaft fractures allows the patient early range of motion, whereas maintaining appropriate alignment and maximizing the patient's chances for a good outcome. This video demonstrates a technique for treating a highly comminuted open forearm fracture using spanning or bridge plating techniques.
Displaced Radial Shaft Fracture: The Dorsal (Thompson) Approach to the Forearm
Authors: Shields Charlotte N. , Egol Kenneth A.
Published: July 2020

This video demonstrates a displaced radial shaft fracture repaired through a dorsal (Thompson) approach to the forearm. The patient is an 18-year-old man who sustained a left elbow dislocation and ipsilateral radial shaft fracture (OTA/AO: 22-B2) while playing basketball. The patient underwent a closed reduction of the elbow joint and was indicated for operative repair of the radius. Ultimate fixation included a compression plate and nonlocking screws through a dorsal approach to the radius. Anatomic reduction and stable fixation was obtained. The posterior interosseus nerve was identified and protected throughout the procedure. A dorsal (Thompson) approach to a radial shaft fracture is advantageous for fractures involving the proximal and middle-third of the radius. This approach can also be used when there is soft tissue damage (open wounds) on the dorsal aspect, which require debridement.
Surgical Correction of Finger Malrotation Secondary to Proximal Phalanx Malunions
Authors: Roebke Austin J. , Goyal Kanu S.
Published: July 2020

Proximal phalanx malunions resulting in malrotation can be functionally limiting to patients. Surgical correction allows for improvement in range of motion, function, and cosmesis. This video demonstrates surgical correction of finger malrotation secondary to a proximal phalanx malunion.
Triceps-Sparing Total Elbow Arthroplasty for Distal Humerus Fracture: The Lateral Paraolecranon Approach
Authors: Amini Michael H.
Published: July 2020

Distal humerus fractures in the elderly are a difficult problem to treat. Open reduction internal fixation has a high rate of complications, particularly because osteopenia compromises what is already tenuous fixation in a metaphyseal fracture. Total elbow arthroplasty is a more predictable outcome and easier recovery for these patients. However, most surgeons perform a low volume of total elbow arthroplasty. In addition, traditional exposure requires detachment of the triceps tendon. The lateral paraolecranon approach maintains the central tendon attachment to the olecranon while still facilitating relative ease of the procedure. Patients are allowed full active use of the triceps postoperatively, which is very helpful for polytrauma patients and those who are already dependent on assistive devices for ambulation.
Techniques for Reduction and Fixation of the Sternoclavicular Joint
Authors: Bonyun Marissa , Nauth Aaron
Published: July 2020

This video demonstrates the relevant anatomy, approach, and surgical techniques for reduction and fixation of the sternoclavicular joint in both the acute and chronic settings. Fixation techniques demonstrated include transosseous suture fixation, figure-of-eight autograft/allograft fixation, and transarticular plating. A step-by-step guide is provided with demonstration video on cadaveric specimens for each technique, along with a case example that demonstrates acute reduction and fixation of a posterior sternoclavicular joint dislocation.
The Production of Antibiotic Cement Beads
Authors: Darnley James E. , Petersen Kyle A. , Siesel Craig , Miller Eric T.
Published: July 2020

The use of antibiotic beads in open fracture cases can lead to decreased rates of infection and surgeon production is associated with significant time and cost savings. This video demonstrates production of antibiotic impregnated polymethylmethacrylate beads used in the setting of a grade IIIB open tibial shaft fracture.
Intramedullary Nail for a Distal Tibia Fracture
Authors: Schaffer Nathaniel E. , Wilson Jenna L. , Yee Michael A. , Hake Mark E.
Published: July 2020

Extraarticular fractures of the distal tibia have historically been treated with open reduction and fixation with plates and screws. This technique requires a more extensive dissection and comes with a higher risk of wound complications than intramedullary nail fixation. This article and the accompanying video demonstrate the use of closed reduction and suprapatellar nail fixation appropriate for the treatment of most extraarticular distal tibial fractures. A variety of treatment decisions are discussed, including the nail insertion method, fixation of associated fibular fractures, and postoperative immobilization.
Ankle Arthrodesis Through an Anterior Approach
Authors: Lindsey Benjamin B. , Hundal Rajbir , Bakshi Neil K. , Holmes James R. , Talusan Paul G. , Walton David M.
Published: July 2020

Ankle arthritis occurs primarily because of trauma and has a huge impact on patient's quality of life. Ankle arthrodesis is indicated for patients with end-stage ankle arthritis who fail conservative management. High rates of fusion can be achieved through an anterior approach. This video demonstrates an ankle arthrodesis using an anterior approach to the ankle in a patient with posttraumatic ankle arthritis.
Juxtaglomerular Cell Tumor of Kidney in Pregnancy: A Rare Case Report
Authors: Gadgil Nitin Maheshvar , Padmanabhan Anitha , Acharya Prapti
Published: July 2020

Juxtaglomerular cell tumor is a rare renal neoplasm with fewer than 100 cases reported in literature, of which 7 cases were diagnosed during pregnancy. This tumor is generally seen in young adults with female preponderance. Patients generally present with hypertension, hyperaldosteronism, and hypokalemia secondary to renin secretion by the tumor cells. When the tumor occurs during pregnancy, the hypertension is often presumed to be pregnancy-induced hypertension and results in fetal loss. We report the case of a 21-year-old woman who presented with hypertension in the first trimester of pregnancy, which was attributed to and treated as pregnancy-induced hypertension. Routine ultrasonography of abdomen in the fourth month revealed a right renal mass. Patient underwent preterm delivery in the seventh month, and the infant did not survive, and subsequently after 1 month, a partial nephrectomy was performed. The diagnosis of juxtaglomerular cell tumor was confirmed by light microscopy. The tumor was positive for CD34 and vimentin. Electron microscopy showed the characteristic rhomboid renin granules in the cytoplasm of the tumor cells.
Grossing Issues in Ovarian and Fallopian Tube Pathology
Authors: Kulumani Mahadevan Lakshmi Shree , Park Byoung Uk , Yeh I-Tien
Published: July 2020

Ovaries and fallopian tubes are often removed for treatment of various benign and malignant gynecological conditions including prophylactic resections in high-risk patients. Meticulous grossing techniques are essential for staging, prognostication, and accurate diagnosis. We conducted a comprehensive review of published literature on methods for grossing pelvic adnexal specimens, including standard textbooks and grossing manuals, supplemented by a limited review of grossing protocols from academic institutions. This review addresses common issues encountered during the grossing of ovarian and fallopian tube specimens.
A Case Report of Capecitabine-Associated Bowel Inflammation With a Novel Mutation of the DPYD Gene
Authors: Schlager Lukas , Wöran Katharina , Luhn Helena , Stift Anton , Harpain Felix
Published: July 2020

Capecitabine is a fluoropyrimidine used in chemotherapeutic regiments in patients with colorectal cancer. Diarrhea and hand-foot syndrome are common adverse effects of capecitabine treatment in patients with colorectal cancer,
1,2
whereas steatohepatitis is rather uncommon. In this case report, we present the case of a patient with colon cancer receiving adjuvant capecitabine treatment and suffering from severe therapy-refractory diarrhea, hand-foot syndrome, and steatosis hepatis caused by a novel mutation of the DPYD gene and a swelling of the bowel, which presented as an unusually early relapse tumor.
Comparable Outcomes Between Unrelated and Haploidentical Stem Cell Transplantation in Adult Patients With Severe Aplastic Anemia
Authors: Park Sung-Soo , Min Gi June , Park Silvia , Lee Sung-Eun , Yoon Jae-Ho , Shin Seung Hwan , Cho Byung-Sik , Eom Ki-Seong , Kim Yoo-Jin , Lee Seok , Min Chang-Ki , Kim Hee-Je , Cho Seok-Goo , Lee Jong Wook
Published: July 2020

Background.

Regarding patients with severe aplastic anemia (SAA) who fail immunosuppressive therapy and lack an HLA-matched sibling donor (MSD), the best alternative donor including unrelated (URD) and haploidentical (HAPLO) donors for allogeneic stem cell transplantation (SCT) remains to be established.

Methods.

We analyzed the comprehensive outcomes of 153 consecutive adult SAA patients treated with SCT from alternative donors: 73 HLA-well matched (8/8) URDs (WM-URDs), 34 mismatched (6-7/8) URDs (MM-URDs), and 46 HAPLOs.

Results.

Neutrophil/platelet engraftments were achieved at a median of 11/15 days for WM-URDs, 13/16.5 days for MM-URDs, and 12/14 days for HAPLOs, respectively. The 3-year overall survival (OS), failure-free survival, cumulative incidence of graft-failure, and transplant-related mortality were statistically not different among the 3 groups: 90.3%, 87.5%, 2.7%, and 9.8% for WM-URDs; 85.3%, 81.7%, 0%, and 14.7% for MM-URDs, and 84.4%, 82.3%, 6.5%, and 11.2% for HAPLOs, respectively. The rates of other complications, including graft-versus-host disease, cytomegalovirus DNAemia, hemorrhagic cystitis, invasive fungal disease, secondary malignancies, and sinusoidal obstruction syndrome, were also statistically not different. Subgroup analysis of the MM-URD group showed that the 3-year OS of patients receiving SCTs from 6/8-URDs were worse than those receiving SCTs from 7/8-URDs (75.0% versus 94.4%, P = 0.26).

Conclusions.

There was no significant difference in the SCT outcomes with WM-URDs, MM-URDs, or HAPLO donors. The clinician can make the best choice among these alternative donor sources based on the host/donor features and the urgency of the need for SCT. However, the selection of 6/8-URDs should be avoided due to inferior survival outcomes.
Dickeya poaceiphila sp. nov., a plant-pathogenic bacterium isolated from sugar cane (Saccharum officinarum)
Authors: Hugouvieux-Cotte-Pattat Nicole , Brochier-Armanet Céline , Flandrois Jean-Pierre , Reverchon Sylvie
Published: July 2020

The genus

Dickeya

is an important group of plant pathogens that currently comprises 10 recognized species. Although most

Dickeya

isolates originated from infected cultivated plants, they are also isolated from water. The genomic sequence of the Australian strain NCPPB 569T clearly established its separation from the previously characterized

Dickeya

species. The average nucleotide identity and digital DNA–DNA hybridization values obtained by comparing strain NCPPB 569T with strains of characterized

Dickeya

species were lower than 87 and 32 %, respectively, supporting the delineation of a new species. The name Dickeya poaceiphila sp. nov. is proposed for this taxon with the type strain NCPPB 569T (=CFBP 8731T). Two other strains isolated in Australia, CFBP 1537 and CFBP 2040, also belong to this species. Phenotypic and genomic comparisons enabled the identification of traits distinguishing D. poaceiphila isolates from strains of other

Dickeya

species.
Evaluation of Viasure SARS-CoV-2 RT-qPCR kit (CerTest Biotec) using CDC FDA EUA RT-qPCR kit as a gold standard
Authors: Freire-Paspuel Byron , Vega-Mariño Patricio , Velez Alberto , Castillo Paulina , Cruz Marilyn , Perez Franklin , Garcia-Bereguiain Miguel Angel
Published: July 2020

Background

Several RT-qPCR kits are available for SARS-CoV-2 diagnosis, some of them with Emergency Use Authorization (EUA) by FDA, but most of them lacking of proper evaluation studies due to covid19 emergency.

Objective

We evaluated Viasure RT-qPCR kit (CerTest Biotec, Spain) for SARS-CoV-2 diagnosis using CDC FDA EUA kit as gold standard.

Results

Although we found the lack of RNA quality control probe as the main limitation for Viasure kit, the sensitivity was up to 97.5% and specificity was 100%.

Conclusions

Viasure RT-qPCR kit is a reliable tool for SARS-CoV-2 diagnosis but improvement of an alternative RT-qPCR reaction for RNA extraction quality control as RNaseP is recommended.
High frequency of cerebrospinal fluid autoantibodies in COVID-19 patients with neurological symptoms
Authors: Franke Christiana , Ferse Caroline , Kreye Jakob , Reincke S Momsen , Sanchez-Sendin Elisa , Rocco Andrea , Steinbrenner Mirja , Angermair Stefan , Treskatsch Sascha , Zickler Daniel , Eckardt Kai-Uwe , Dersch Rick , Hosp Jonas , Audebert Heinrich J. , Endres Matthias , Ploner Christoph J. , Prüss Harald
Published: July 2020

COVID-19 intensive care patients occasionally develop neurological symptoms. The absence of SARS-CoV-2 in most cerebrospinal fluid (CSF) samples suggests the involvement of further mechanisms including autoimmunity. We therefore determined whether anti-neuronal or anti-glial autoantibodies are present in eleven consecutive severely ill COVID-19 patients presenting with unexplained neurological symptoms. These included myoclonus, cranial nerve involvement, oculomotor disturbance, delirium, dystonia and epileptic seizures. Most patients showed signs of CSF inflammation and increased levels of neurofilament light chain. All patients had anti-neuronal autoantibodies in serum or CSF when assessing a large panel of autoantibodies against intracellular and surface antigens relevant for central nervous system diseases using cell-based assays and indirect immunofluorescence on murine brain sections. Antigens included proteins well-established in clinical routine, such as Yo or NMDA receptor, but also a variety of specific undetermined epitopes on brain sections. These included vessel endothelium, astrocytic proteins and neuropil of basal ganglia, hippocampus or olfactory bulb. The high frequency of autoantibodies targeting the brain in the absence of other explanations suggests a causal relationship to clinical symptoms, in particular to hyperexcitability (myoclonus, seizures). While several underlying autoantigens still await identification in future studies, presence of autoantibodies may explain some aspects of multi-organ disease in COVID-19 and can guide immunotherapy in selected cases.
Heterogeneity in SIR epidemics modeling: superspreaders
Authors: Szapudi Istvan
Published: July 2020

Deterministic epidemic models, such as the Susceptible-Infected-Recovered (SIR) model, are immensely useful even if they lack the nuance and complexity of social contacts at the heart of network science modeling. Here we present a simple modification of the SIR equations to include the heterogeneity of social connection networks. A typical power-law model of social interactions from network science reproduces the observation that individuals with a high number of contacts, “hubs” or “superspreaders”, can become the primary conduits for transmission. Conversely, once the tail of the distribution is saturated, herd immunity sets in at a smaller overall recovered fraction than in the analogous SIR model. The new dynamical equations suggest that cutting off the tail of the social connection distribution, i.e., stopping superspreaders, is an efficient non-pharmaceutical intervention to slow the spread of a pandemic, such as COVID-19.
Characterization of longitudinal transformation of T2-hyperintensity in oligodendroglioma
Authors: Heiland Dieter H. , Ohle Robin , Cipriani Debora , Franco Pamela , Delev Daniel , Behriger Simon P. , Kellner Elias , Petrova Gergana , Neidert Nicolas , Mader Irina , Fariña Nuñez Mateo , Urbach Horst , Sankowski Roman , Beck Jürgen , Schnell Oliver
Published: July 2020

Background

Oligodendroglioma (ODG) are CNS resistant tumors characterized by their unique molecular signature, namely a combined deletion of 1p and 19q simultaneously to an IDH1/2 mutation. These tumors have a more favorable clinical outcome compared to other gliomas and a long-time survival that ranges between 10-20 years. However, during the course of the disease, multiple recurrences occur and the optimal treatment at each stage of the disease remains unclear. Here we report a retrospective longitudinal observation study of 836 MRI examinations in 44 ODG patients.

Methods

We quantified the volume of T2-hyperintensity to compute growth behavior in dependence of different treatment modalities, using various computational models.

Results

The identified growth pattern revealed dynamic changes, which were found to be patient-specific an did not correlate with clinical parameter or therapeutic interventions. Further, we showed that, surgical resection is beneficial for overall survival regardless the WHO grad or timepoint of surgery. To improve overall survival, an extent of resection above 50% is required. Multiple resections do not generally improve overall survival, except a greater extent of resection than in previous surgeries was achieved.

Conclusions

Our data aids to improve the interpretation of MRI images in clinical practice.
Recurrent selection with glufosinate at low rates reduces the susceptibility of aLolium perennessp.multiflorumpopulation to glufosinate
Authors: Matzrafi Maor , Morran Sarah , Jasieniuk Marie
Published: July 2020

Repeated applications of herbicides at the labelled rates have often resulted in the selection and evolution of herbicide-resistant weeds capable of surviving the labelled and higher rates in subsequent generations. However, the evolutionary outcomes of recurrent herbicide selection at low rates are far less understood. In this study of an herbicide-susceptible population ofLolium perennessp.multiflorum, we assessed the potential for low glufosinate rates to select for reduced susceptibility to the herbicide, and cross-resistance to herbicides with other modes of action. Reduced susceptibility to glufosinate was detected in progeny in comparison with the parental population following three rounds of selection at low glufosinate rates. Differences were mainly observed at the 0.5X, 0.75X, and 1X rates. Comparing the parental susceptible population and progeny from the second and third selection cycle, the percentage of surviving plants increased to values of LD50(1.31 and 1.16, respectively) and LD90(1.36 and 1.26, respectively). When treated with three alternative herbicides (glyphosate, paraquat, and sethoxydim), no plants of either the parental or successive progeny populations survived treatment with 0.75X or higher rates of these herbicides. The results of this study provide clear evidence that reduced susceptibility to glufosinate can evolve in weed populations following repeated applications of glufosinate at low herbicide rates. However, the magnitude of increases in resistance levels over three generations of recurrent low-rate glufosinate selection observed is relatively low compared with higher levels of resistance observed in response to low-rate selection with other herbicides (three fold and more).
Dynamic RNA 3’ uridylation and guanylation during mitosis
Authors: Liu Yusheng , Nie Hu , Lu Falong
Published: July 2020

The successful cell division involves highly regulated transcriptional and post-transcriptional control. Some of the cell cycle related genes are periodically expressed, while most of the genes show relatively stable steady state transcript level throughout the mitotic cell cycle (Bertoli et al., 2013; Park et al., 2016). Previous TAIL-seq analysis of S phase and M phase poly(A) tail information showed that less than 2% genes showed more than 2-fold change in their poly(A) tail length (Chang et al., 2014; Park et al., 2016). In addition, the changes in poly(A) tail length between these two stages showed minimal impact on the translation of the genes as long as the poly(A) tails were longer than 20 nt. Therefore, the significance of poly(A) tail dynamics during the cell cycle remains unknown. Here, by re-analyzing the S phase and M phase TAIL-seq data, we uncovered an interesting global dynamics of RNA poly(A) tails in terms of their terminal modifications, implying global RNA regulation between mitotic cell cycles through poly(A) tail terminal modifications.
Functional analysis of the fatty acid and alcohol metabolism ofPseudomonas putidausing RB-TnSeq
Authors: Thompson Mitchell G. , Incha Matthew R. , Pearson Allison N. , Schmidt Matthias , Sharpless William A. , Eiben Christopher B. , Cruz-Morales Pablo , Blake-Hedges Jacquelyn M. , Liu Yuzhong , Adams Catharine A. , Haushalter Robert W. , Krishna Rohith N. , Lichtner Patrick , Blank Lars M. , Mukhopadhyay Aindrila , Deutschbauer Adam M. , Shih Patrick M. , Keasling Jay D.
Published: July 2020

With its ability to catabolize a wide variety of carbon sources and a growing engineering toolkit,Pseudomonas putidaKT2440 is emerging as an important chassis organism for metabolic engineering. Despite advances in our understanding of this organism, many gaps remain in our knowledge of the genetic basis of its metabolic capabilities. These gaps are particularly noticeable in our understanding of both fatty acid and alcohol catabolism, where many paralogs putatively coding for similar enzymes co-exist making biochemical assignment via sequence homology difficult. To rapidly assign function to the enzymes responsible for these metabolisms, we leveraged Random Barcode Transposon Sequencing (RB-TnSeq). Global fitness analyses of transposon libraries grown on 13 fatty acids and 10 alcohols produced strong phenotypes for hundreds of genes. Fitness data from mutant pools grown on varying chain length fatty acids indicated specific enzyme substrate preferences, and enabled us to hypothesize that DUF1302/DUF1329 family proteins potentially function as esterases. From the data we also postulate catabolic routes for the two biogasoline molecules isoprenol and isopentanol, which are catabolized via leucine metabolism after initial oxidation and activation with CoA. Because fatty acids and alcohols may serve as both feedstocks or final products of metabolic engineering efforts, the fitness data presented here will help guide future genomic modifications towards higher titers, rates, and yields.

IMPORTANCE

To engineer novel metabolic pathways intoP. putida, a comprehensive understanding of the genetic basis of its versatile metabolism is essential. Here we provide functional evidence for the putative roles of hundreds of genes involved in the fatty acid and alcohol metabolism of this bacterium. These data provide a framework facilitating precise genetic changes to prevent product degradation and channel the flux of specific pathway intermediates as desired.