bluuebunny/crossref_metadata_2025 huggingface dataset:
Deep reinforcement learning for tiled aperture beam combining in a simulated environment
Authors: Tünnermann Henrik , Shirakawa Akira
Published: November 2020

Coherent beam combining is a method for combining multiple emitters into one high power beam by means of relative phase stabilization. Usually, modulation or interferometric techniques are used to generate an error signal. This is relatively complicated and expensive. Especially in the case of tiled aperture combining the beam profile is usually monitored anyway. This beam profile should contain most of the information necessary for the stabilization as well but is usually not used because it is difficult to explicitly derive the correct actions from just the far-field image. Here we show that it is possible to derive a suitable control policy without any explicit modeling using deep reinforcement learning in a simulated environment.
Reckoning with Indigenous Solidarity
Authors: Suzack Cheryl
Published: November 2020

Solidarity with Indigenous land-based struggles, such as the #NoDAPL movement, reminds us that political affiliations cross racial lines, transcending aspects of tribal and national identity and community attachment. But does solidarity operate according to the politics of sameness, as in unwavering support for the political terrain demarcated by social justice struggles, or is there room among its many manifestations for opposition and challenge? The three books that comprise this review essay explore the tensions associated with enacting solidarity as they reflect on the social and cultural possibilities represented by Indigenous justice struggles. Their investments in examining the political stakes of solidarity—in the Oceti Sakowin’s resistance to the Dakota Access Pipeline Project, in Afrofuturist and Indigenous speculative fiction that traces the boundary between Black and Indigenous political formations, and in the tensions that exist among American Indian writing from the interwar and pre-civil rights era—help us to understand how Indigenous solidarity is connected to complex histories, settler-colonial relations, and systemic inequalities, as well as the political promise that social justice movements create.
Differing limb functions and their potential influence upon the diversification of the mustelid hindlimb skeleton
Authors: Kilbourne Brandon M
Published: November 2020

Though form-function relationships of the mammalian locomotor system have been investigated for over a century, recent models of trait evolution have hitherto been seldom used to identify likely evolutionary processes underlying the locomotor system’s morphological diversity. Using mustelids, an ecologically diverse carnivoran lineage, I investigated whether variation in hindlimb skeletal morphology functionally coincides with climbing, digging, swimming and generalized locomotor habits by using 15 linear traits of the femur, tibia, fibula, calcaneum and metatarsal III across 44 species in a principal component analysis. I subsequently fit different models of Brownian motion and adaptive trait diversification individually to each trait. Climbing, digging and swimming mustelids occupy distinct regions of phenotypic space characterized by differences in bone robustness. Models of adaptive and neutral evolution are, respectively, the best fits for long bone lengths and muscle in-levers, suggesting that different kinds of traits may be associated with different evolutionary processes. However, simulations based upon models of best fit reveal low statistical power to rank the models. Though differences in mustelid hindlimb skeletal morphology appear to coincide with locomotor habits, further study, with sampling expanded beyond the Mustelidae, is necessary to better understand to what degree adaptive evolution shapes morphological diversity of the locomotor system.
GPTs and growth: evidence on the technological adoption of electrical and electronic technologies in the 1920s
Authors: Petralia Sergio
Published: November 2020

The pervasive diffusion of electricity-related technologies at the beginning of the twentieth century has been studied extensively to understand the transformative potential of general purpose technologies (GPTs). Most of what we know, however, has been investigated in relation to the diffusion of their use. This article provides evidence on the county-level economic impact of the technological adoption of electrical and electronic (E&E) technologies in the 1920s in the United States (US). It focuses on measuring the impact of a GPT on technological adopters, i.e., those who are able to develop, transform, and complement it. It is shown that places with patenting activity in E&E technologies grew faster and paid higher wages than others between 1920 and 1930. This analysis required constructing a novel database identifying detailed geographical information for historical patent documents in the US since 1836, as well as developing a text-mining algorithm to identify E&E patents based on patent descriptions.
How Transitions in Dementia Care Trajectories Affect Health Problems in Partners: A Longitudinal Analysis With Linked Health and Administrative Data
Authors: van der Heide Iris , Heins Marianne J , van Hout Hein P J , Verheij Robert A , Francke Anneke L , Joling Karlijn J
Published: November 2020

Objectives

To evaluate whether the prevalence of health problems in cohabiting partners of people with dementia differs between the year before and the year after 3 transitions: the diagnosis of dementia, institutionalization, and the death of the person with dementia.

Methods

Individuals with dementia and their partners were identified on the basis of data in the electronic health records (EHRs) of 451 Dutch general practices. EHRs were also the data source on their health problems, which were linked to the Dutch population registry and health administration data with demographic characteristics, date of institutionalization, and date of death. Differences in the prevalence of 16 groups of health problems and of specific health problems in partners during the year before and the year after the 3 transitions were examined using a generalized estimating equation.

Results

About 1,110 partners of persons with dementia were identified. Problems related to the illness and/or loss of the person with dementia were significantly more prevalent in the year after the dementia diagnosis (32% vs. 17%) and in the year after the death of the person with dementia (59% vs. 41%) than in the years before. Unspecified health problems were more prevalent in the year after the diagnosis than in the year before (30% vs. 22%). After institutionalization, an increase was found in digestive problems and urological problems (30% vs. 18% and 24% vs. 17%).

Discussion

Transitions during the dementia care trajectory, namely, the diagnosis, institutionalization, and death of the person with dementia, significantly affect the cohabiting partner’s health.
Lost and lonely: a qualitative study of women’s experiences of no embryo transfer owing to non-fertilization or poor embryo quality
Authors: Holter Herborg , Bergh Christina , Gejervall Ann-Louise
Published: November 2020

STUDY QUESTION

What are the experiences of women undergoing IVF who could not receive an embryo transfer because of failed fertilization or poor embryo development?

SUMMARY ANSWER

No embryo transfer because of failed embryo development is associated with considerable emotional suffering and the need for an early appointment with a physician to obtain information on what went wrong and new alternatives.

WHAT IS KNOWN ALREADY

The psychological and emotional impact of IVF treatments as experienced by IVF patients is well known, particularly following the failure to achieve pregnancy.

STUDY DESIGN, SIZE, DURATION

A qualitative study running from January 2018 to April 2019 was carried out at one public and one private IVF clinic. The invitation to participate was sent to women within 1 month after the cycle failed.

PARTICIPANTS/MATERIALS, SETTING, METHODS

The women undergoing IVF were diverse in terms of cause of infertility, age, number of previous cycles, country of birth and educational level. Nineteen of the 41 invited women who had experienced no embryo transfer because of non-fertilization or poor embryo development took part in a semi-structured interview. Data were analysed by thematic content analysis.

MAIN RESULTS AND THE ROLE OF CHANCE

The master theme was identified as: ‘Lost and lonely’ organized in two main themes ‘Experience of the event’ and ‘Perception of needs from healthcare providers’. Considerable emotional suffering was recognized after no embryo transfer. The need for support was expressed as to be offered an early appointment with a physician for information about what went wrong, looking at new alternatives and, for many women, providing information about counselling.

LIMITATIONS, REASONS FOR CAUTION

Only women participated, not partners. Of the women invited, 46% participated. Several declined to participate because of high levels of emotional stress.

WIDER IMPLICATIONS OF THE FINDINGS

Patients undergoing IVF and not achieving embryo transfer due to poor embryo development are a vulnerable group. They need early feedback concerning reasons for failure and future alternatives. They also require psychological support. This ought to be offered by IVF clinics.

STUDY FUNDING/COMPETING INTEREST(S)

The study was financed by grants from the Swedish state under the agreement between the Swedish government and the county councils, the ALF-agreement (ALFGBG-70940). It was also financed by the Local Research and Development Board for Gothenburg and Södra Bohuslän (VGFOUGSB-866771) and by Hjalmar Svensson’s research foundation (HJSV-2017012). None of the authors declares any conflicts of interest.

LARGE SCALE DATA

N/A.
Analysis of the Illicit Opioid U-48800 and Related Compounds by LC–MS-MS and Case Series of Fatalities Involving U-48800
Authors: Fogarty Melissa F , Mohr Amanda L A , Papsun Donna M , Logan Barry K
Published: November 2020

We report a method for the detection and quantitation of 12 drugs and 2 metabolites in the same structural class as the illicit mu-opioid agonist U-47700 in human whole blood. These substances are either known or suspected to be present as potential novel opioids in illicit drug markets. The general class of these drugs was developed in pharmaceutical research programs in the 1970s, but these drugs have recently become of concern for overdoses and death in opioid users in the USA and internationally. The scope of analysis included the following compounds: methylenedioxy U-47700, ethylenedioxy U-47700, ethylenedioxy U-51754, U-69593, U-47931E (bromadoline), U-47700, U-48800, U-49900, U-51754, U-50488, propyl U-47700 and isopropyl U-47700. Additionally, two metabolites N,N-didesmethyl U-47700 and desmethyl U-47700 were also included in the scope. Drugs were extracted from human whole blood using solid-phase extraction, and the extracts were analyzed by liquid chromatography--tandem mass spectrometry. The assay was validated with respect to bias, carryover, interference, within-run and between-run precision, and accuracy. Eight medicolegal death investigation cases that had screened positive for U-48800 by liquid chromatography--time-of-flight mass spectrometry were successfully confirmed and quantified using this method. The mean and median concentrations of U-48800 in these cases were 2.5 (±2.1) and 1.8 ng/mL, respectively, with a range of concentrations of 0.27–6.2 ng/mL. Case history information including the presence of other drugs in combination are described and discussed.
Monitoring the Resistance of the Beet Armyworm (Lepidoptera: Noctuidae) to Four Insecticides in Southern China from 2014 to 2018
Authors: Wang Pan , Yang Fan , Wang Yong , Zhou Li-Lin , Luo Hai-Bo , Zhang Shuai , Si Sheng-Yun
Published: November 2020

The beet armyworm Spodoptera exigua (Hübner) is a serious polyphagous pest that infests vegetable crops worldwide and has rapidly developed resistance due to its long-term exposure to insecticides. The current resistance statuses to four insecticides exhibited by three field populations of beet armyworms collected in southern China from 2014 to 2018 were investigated. Monitoring data from five consecutive years demonstrated that all three tested S. exigua populations developed extremely high resistance to chlorantraniliprole in 2018 (220.58- to 2,597.39-fold). Two populations (Baiyun and Fengxian) developed low to moderate resistance to spinosad, whereas the Huangpi population remained susceptible (except in 2014, with RR of 6.11-fold). The RR of the Fengxian and Baiyun populations to indoxacarb steadily increased over the years, whereas that of the Huangpi population increased relatively slowly. The Baiyun and Fengxian populations developed moderate to high resistance to indoxacarb and methoxyfenozide, whereas the Huangpi population exhibited susceptibility to low resistance (1.06- to 6.45-fold) to indoxacarb and susceptibility to moderate resistance (1.53- to 14.22-fold) to methoxyfenozide. These results suggest that chlorantraniliprole should not be employed to control this pest in southern China. Reduced use of indoxacarb and methoxyfenozide or the use of alternating insecticides with low levels of resistance is recommended. Spinosad remains an effective insecticide for the management of S. exigua. To avoid the rapid development of insecticide resistance, rotations of insecticides with low levels of resistance and different modes of action based on the resistance patterns of S. exigua should be performed in southern China.
Tolerance in Maize Landraces toDiabrotica speciosa(Coleoptera: Chrysomelidae) Larvae and Its Relationship to Plant Pigments, Compatible Osmolytes, and Vigor
Authors: Costa Eduardo Neves , Sardinha de Souza Bruno Henrique , Ribeiro Zulene Antônio , dos Santos Durvalina Maria Mathias , Boiça Arlindo Leal
Published: November 2020

The rootworm Diabrotica speciosa (Germar) is native to South America and causes severe economic losses to several crops due to root feeding and disease spread. In maize (Zea mays L.), losses in production come from larval rootworm attack on plant roots resulting in plant health problems, including stalk lodging. More options for controlling this pest are needed to create well balanced, integrated pest management programs for farmers in this region. Natural sources of tolerance in maize genotypes are important for maize breeding programs, and this study investigated the expression of tolerance in several Brazilian maize landraces to D. speciosa. Plant vigor and compounds associated with plant health, including chlorophylls, carotenoids, glycine betaine, and proline were assessed for each landrace. Five landraces and one maize cultivar were selected based on their levels of antibiosis-resistance to D. speciosa that were determined in a prior screening. The percent reduction in plant growth was used as the measure of tolerance. The landrace Azteca was classified as tolerant to D. speciosa larval feeding, displaying less reduction in plant matter despite having lower plant vigor. This landrace also had higher amounts of chlorophyl and carotenoid pigments, suggesting a positive correlation between tolerance to D. speciosa and higher contents of these photosynthetic pigments. The compatible osmolytes glycine betaine and proline do not seem to be associated with tolerance in maize landraces to D. speciosa larvae. Landrace Azteca seems promising for plant breeding, and repeated field studies are needed to confirm its suitability in maize integrated pest management.
The International Criminal Court versus the African Criminal Court
Authors: Martini Pauline
Published: November 2020

In 2014, the Assembly of the African Union amended the Statute of the prospective African Court of Justice and Human Rights (ACJHR) by the adoption of the Malabo Protocol. The Annex to the Protocol confers an extensive international criminal jurisdiction to the ACJHR’s International Criminal Law Section — often referred to as the African Criminal Court — which overlaps with the jurisdiction of the International Criminal Court (ICC). If the Protocol enters into force, the Courts will exercise concurrent jurisdiction over the same matters. Conflicts of jurisdiction would therefore arise should both Courts decide to exercise jurisdiction over the same situation or case. This article advocates for a remodelling of the principle of complementarity, enshrined in Article 17 of the Rome Statute and in Article 46H of the Annex to the Malabo Protocol, to solve these potential conflicts of jurisdiction. The arguments presented herein will be relevant to the relationship between the ICC and any regional criminal court which prosecutes international crimes that would take shape.
Fleas (Siphonaptera) Parasitizing Peridomestic and Indigenous Mammals in Panamá and Screening of Selected Fleas for Vector-Borne Bacterial Pathogens
Authors: Durden Lance A , Bermúdez Sergio , Vargas Géminis A , Sanjur Boris E , Gillen Laura , Brown Lisa D , Greiman Stephen E , Eremeeva Marina E
Published: November 2020

In total, 341 fleas belonging to 16 species were collected from 78 host mammals belonging to 10 species in Panamá from 2010 to 2016. The cat flea, Ctenocephalides felis (Bouché) predominated on domestic dogs and was also recorded from domestic cats, the raccoon, Procyon lotor (Linnaeus) and the common opossum, Didelphis marsupialis Linnaeus. The largest number of flea species (7) was recorded from D. marsupialis and the most common flea on that host was the ctenophthalmid, Adoratopsylla intermedia copha Jordan. One Oriental rat flea, Xenopsylla cheopis (Rothschild), was collected from D. marsupialis. Native rodents were parasitized by indigenous ceratophyllid, rhopalopsyllid, and stephanocircid fleas. The Mexican deermouse, Peromyscus mexicanus (Saussure), was parasitized by six species of ceratophyllids belonging to the mostly Central American genera, Baculomeris, Jellisonia, Kohlsia and Plusaetis. The long-tailed singing mouse, Scotinomys xerampelinus (Bangs), was parasitized by Plocopsylla scotinomi Tipton and Méndez, the only species of stephanocircid flea known from Central America. Twenty-six pools of extracted flea DNA representing 5 flea species (C. felis, Pulex echidnophagoides (Wagner), Pulex simulans Baker, A. intermedia copha, and P. scotinomi) and 79 individual fleas were all real-time polymerase chain reaction negative for Rickettsia felis, Rickettsia typhi, and Bartonella henselae.
Silencing of lncRNA XLOC_035088 Protects Middle Cerebral Artery Occlusion-Induced Ischemic Stroke by Notch1 Signaling
Authors: Chen Miao , Wang Feng , Wang Hairong
Published: November 2020

Ischemic stroke represents one of the leading causes of mortality worldwide and especially in developing countries. It is crucial for finding effective therapeutic targets that protect the brain against ischemic injury. Long noncoding RNAs (lncRNAs) have emerged as major regulators of neurological diseases, and clarifying their roles in cerebral ischemic injury may provide novel targets for the treatment of ischemic stroke. We aimed to investigate the role of lncRNA-XLOC_035088 in middle cerebral artery occlusion (MCAO)-induced rat brain injury and oxygen-glucose deprivation (OGD)-reperfusion treated hippocampal neurons. In our findings, we found that XLOC_035088 expression was significantly upregulated in OGD-reperfusion treated hippocampal neurons and in different brain regions of MCAO-treated rats. XLOC_035088 silencing protected against MCAO-induced ischemic brain injury in vivo and OGD-induced hippocampal neuronal apoptosis in vitro. Intrahippocampal silencing of XLOC_035088 significantly decreased brain XLOC_035088 expression, reduced brain infarct size, and improved neurological function through inhibiting NOTCH1 following derepression of presenilin 2 (PSEN2). Taken together, this study provides evidence that the lncRNA XLOC_035088/PSEN2/Notch1 axis is involved in the pathogenesis of ischemic brain injury, and presents a promising therapeutic route for ischemic stroke.
Losing oceans: The effects of composition on the thermal component of impact-driven atmospheric loss
Authors: Biersteker John B , Schlichting Hilke E
Published: November 2020

The formation of the Solar system’s terrestrial planets concluded with a period of giant impacts. Previous works examining the volatile loss caused by the impact shock in the moon-forming impact find atmospheric losses of at most 20–30 per cent and essentially no loss of oceans. However, giant impacts also result in thermal heating, which can lead to significant atmospheric escape via a Parker-type wind. Here we show that H2O and other high-mean molecular weight outgassed species can be efficiently lost through this thermal wind if present in a hydrogen-dominated atmosphere, substantially altering the final volatile inventory of terrestrial planets. We demonstrate that a giant impact during terrestrial planet formation can remove several Earth oceans’ worth of H2O, and other heavier volatile species, together with a primordial hydrogen-dominated atmosphere. These results may offer an explanation for the observed depletion in Earth’s light noble gas budget and for its depleted xenon inventory, which suggest that Earth underwent significant atmospheric loss by the end of its accretion. Because planetary embryos are massive enough to accrete primordial hydrogen envelopes and because giant impacts are stochastic and occur concurrently with other early atmospheric evolutionary processes, our results suggest a wide diversity in terrestrial planet volatile budgets.
Bayesian calibration of the mixing length parameter αML and of the helium-to-metal enrichment ratio ΔY/ΔZ with open clusters: the Hyades test-bed
Authors: Tognelli E , Dell’Omodarme M , Valle G , Prada Moroni P G , Degl’Innocenti S
Published: November 2020

We tested the capability of a Bayesian procedure to calibrate both the helium abundance and the mixing length parameter (αML), using precise photometric data for main-sequence (MS) stars in a cluster with negligible reddening and well-determined distance. The method has been applied first to a mock data set generated to mimic Hyades MS stars and then to the real Hyades cluster. We tested the impact on the results of varying the number of stars in the sample, the photometric errors, and the estimated [Fe/H]. The analysis of the synthetic data set shows that αML is recovered with a very good precision in all the analysed cases (with an error of few percent), while [Fe/H] and the helium-to-metal enrichment ratio ΔY/ΔZ are more problematic. If spectroscopic determinations of [Fe/H] are not available and thus [Fe/H] has to be recovered alongside with ΔY/ΔZ and αML, the well-known degeneracy between [Fe/H]–ΔY/ΔZ-αML could result in a large uncertainty on the recovered parameters, depending on the portion of the MS used for the analysis. On the other hand, the prior knowledge of an accurate [Fe/H] value puts a strong constraint on the models, leading to a more precise parameters recovery. Using the current set of pisa models, the most recent [Fe/H] value and the Gaia photometry and parallaxes for the Hyades cluster, we obtained the average values <αML> = 2.01 ± 0.05 and <ΔY/ΔZ> = 2.03 ± 0.33, sensitively reducing the uncertainty in these important parameters.
Genetic Architecture and Fitness of Bacterial Interspecies Hybrids
Authors: Bartke Katrin , Garoff Linnéa , Huseby Douglas L , Brandis Gerrit , Hughes Diarmaid
Published: November 2020

Integration of a conjugative plasmid into a bacterial chromosome can promote the transfer of chromosomal DNA to other bacteria. Intraspecies chromosomal conjugation is believed responsible for creating the global pathogens Klebsiella pneumoniae ST258 and Escherichia coli ST1193. Interspecies conjugation is also possible but little is known about the genetic architecture or fitness of such hybrids. To study this, we generated by conjugation 14 hybrids of E. coli and Salmonella enterica. These species belong to different genera, diverged from a common ancestor >100 Ma, and share a conserved order of orthologous genes with ∼15% nucleotide divergence. Genomic analysis revealed that all but one hybrid had acquired a contiguous segment of donor E. coli DNA, replacing a homologous region of recipient Salmonella chromosome, and ranging in size from ∼100 to >4,000 kb. Recombination joints occurred in sequences with higher-than-average nucleotide identity. Most hybrid strains suffered a large reduction in growth rate, but the magnitude of this cost did not correlate with the length of foreign DNA. Compensatory evolution to ameliorate the cost of low-fitness hybrids pointed towards disruption of complex genetic networks as a cause. Most interestingly, 4 of the 14 hybrids, in which from 45% to 90% of the Salmonella chromosome was replaced with E. coli DNA, showed no significant reduction in growth fitness. These data suggest that the barriers to creating high-fitness interspecies hybrids may be significantly lower than generally appreciated with implications for the creation of novel species.
Tirant Stealthily Invaded NaturalDrosophila melanogasterPopulations during the Last Century
Authors: Schwarz Florian , Wierzbicki Filip , Senti Kirsten-André , Kofler Robert
Published: November 2020

It was long thought that solely three different transposable elements (TEs)—the I-element, the P-element, and hobo—invaded natural Drosophila melanogaster populations within the last century. By sequencing the “living fossils” of Drosophila research, that is, D. melanogaster strains sampled from natural populations at different time points, we show that a fourth TE, Tirant, invaded D. melanogaster populations during the past century. Tirant likely spread in D. melanogaster populations around 1938, followed by the I-element, hobo, and, lastly, the P-element. In addition to the recent insertions of the canonical Tirant, D. melanogaster strains harbor degraded Tirant sequences in the heterochromatin which are likely due to an ancient invasion, likely predating the split of D. melanogaster and D. simulans. These degraded insertions produce distinct piRNAs that were unable to prevent the novel Tirant invasion. In contrast to the I-element, P-element, and hobo, we did not find that Tirant induces any hybrid dysgenesis symptoms. This absence of apparent phenotypic effects may explain the late discovery of the Tirant invasion. Recent Tirant insertions were found in all investigated natural populations. Populations from Tasmania carry distinct Tirant sequences, likely due to a founder effect. By investigating the TE composition of natural populations and strains sampled at different time points, insertion site polymorphisms, piRNAs, and phenotypic effects, we provide a comprehensive study of a natural TE invasion.
Benchmark dose analysis of multiple genotoxicity endpoints in gpt delta mice exposed to aristolochic acid I
Authors: Chen Ruixue , You Xinyue , Cao Yiyi , Masumura Kenichi , Ando Tomoko , Hamada Shuichi , Horibata Katsuyoshi , Wan Jingjing , Xi Jing , Zhang Xinyu , Honma Masamitsu , Luan Yang
Published: November 2020

As the carcinogenic risk of herbs containing aristolochic acids (AAs) is a global health issue, quantitative evaluation of toxicity is needed for the regulatory decision-making and risk assessment of AAs. In this study, we selected AA I (AAI), the most abundant and representative compound in AAs, to treat transgenic gpt delta mice at six gradient doses ranging from 0.125 to 4 mg/kg/day for 28 days. AAI-DNA adduct frequencies and gpt gene mutation frequencies (MFs) in the kidney, as well as Pig-a gene MFs and micronucleated reticulocytes (MN-RETs) frequencies in peripheral blood, were monitored. The dose–response (DR) relationship data for these in vivo genotoxicity endpoints were quantitatively evaluated using an advanced benchmark dose (BMD) approach with different critical effect sizes (CESs; i.e., BMD5, BMD10, BMD50 and BMD100). The results showed that the AAI-DNA adduct frequencies, gpt MFs and the MN-RETs presented good DR relationship to the administrated doses, and the corresponding BMDL100 (the lower 90% confidence interval of the BMD100) values were 0.017, 0.509 and 3.9 mg/kg/day, respectively. No positive responses were observed in the Pig-a MFs due to bone marrow suppression caused by AAI. Overall, we quantitatively evaluated the genotoxicity of AAI at low doses for multiple endpoints for the first time. Comparisons of BMD100 values across different endpoints provide a basis for the risk assessment and regulatory decision-making of AAs and are also valuable for understanding the genotoxicity mechanism of AAs.
Factors Associated With Pregnancy and Perinatal Outcomes in Female Neurosurgeons: A Cross-Sectional Study
Authors: Parker Samantha L , Conner Christopher R , Mata Douglas A , Zima Laura A , Chen Amber , McCormack Ryan , Bindal Shivani , Stark Jessica R
Published: November 2020

Neurosurgery is male dominated with women representing only 12% of residents and 5% of practicing neurosurgeons. The conflicting demands of training versus pregnancy and motherhood are significant deterrents to women entering the field. We examined pregnancy incidence and timing, perinatal complications, and the perceived career impact of motherhood on female neurosurgeons using an anonymous survey of 643 training, practicing, and retired female neurosurgeons from the United States. Among 260 respondents, 50.8% (132/260) reported pregnancies, with an average age at first pregnancy that was significantly higher than the national average (32.1 vs 26.3 yr). In all, 40.1% (53/132) of respondents reported perinatal complications in at least one of their pregnancies. Only 25% (33/132) of respondents noted designated program maternity allowances. The most significant challenges associated with being a mother and neurosurgeon reported were issues relating to work/life balance, “mommy guilt,” and sleep deprivation. A majority of respondents, 70.1% (82/116), reported fear of backlash from co-residents, partners, and staff, as well as hindered career advancement related to childbearing. Female neurosurgeons face challenges surrounding family planning different from those faced by male practitioners. Higher perinatal and fetal complications, backlash from colleagues, and demanding workload are significant issues. Progress requires institutional support and mentorship for women to create a more diverse field of practitioners.
A Pilot Randomized Clinical Trial of Remote Varenicline Sampling to Promote Treatment Engagement and Smoking Cessation
Authors: Carpenter Matthew J , Gray Kevin M , Wahlquist Amy E , Cropsey Karen , Saladin Michael E , Froeliger Brett , Smith Tracy T , Toll Benjamin A , Dahne Jennifer
Published: November 2020

Introduction

Medication sampling is a clinically useful tool to engage smokers in the quitting process. Whether varenicline is suitable for sampling purposes is unclear. The purpose of this study was to examine the feasibility, uptake, and preliminary outcomes of varenicline sampling.

Methods

Smokers (N = 99), both motivated to quit and not, were recruited and randomized to varenicline sampling versus not, with 12 week follow-up. The intervention consisted of mailing one-time samples of varenicline (lasting 2–4 wks), with minimally suggestive guidance on use.

Results

Uptake of varenicline was strong, at 2 weeks (54% any use, 66% daily use) and 4 weeks (38%, 46%), with 58% of medication users seeking additional medication. Most users followed conventional titration patterns, self-titrating from 0.5 mg to 2 mg. Relative to control, varenicline sampling increased motivation (p = 0.006) and confidence to quit (p = 0.02), and decreased cigarette smoking (p = 0.02). Smokers receiving varenicline samples were significantly more likely to achieve 50% reduction in cigarettes per day (CPD), both immediately following the sampling exercise (Adjusted Odds Ratio [AOR] = 4.12; 95% CI: 1.39 to 12.17) and at final follow-up (AOR = 4.50; 95% CI: 1.56 to 13.01). Though cessation outcomes were not statistically significant, there was a 1.5 to 3-fold increase in quit attempts and abstinence from varenicline sampling throughout follow-up. These outcomes were comparable among smokers motivated to quit and not.

Conclusions

Unguided, user-driven sampling of varenicline sampling is a concrete behavioral exercise that is feasible to do and seems to suggest clinical utility. Sampling is a pragmatic clinical approach to engage more smokers in quitting.

Implications

Use of evidence-based pharmacotherapies for smoking cessation is low. Medication sampling is a pragmatic behavioral exercise that allows smokers to experience the benefits of using them, while promoting positive downstream effects towards quitting. While previous studies have shown that nicotine replacement therapy (NRT) sampling is viable and effective, whether this extends to varenicline is unclear. Results from this trial demonstrate that varenicline sampling is feasible, safe, and suggestive of clinically important steps toward quitting, deserving of a larger trial.

Clinical Trial Registration

NCT #03742154.
Use of injectable collagen in partial-thickness tears of the supraspinatus tendon: a case report
Authors: Corrado Bruno , Bonini Ilenia , Alessio Chirico Vincenzo , Rosano Nicola , Gisonni Pietro
Published: November 2020

Management of partial-thickness rotator cuff tears is actually controversial. We treated a patient with a partial-thickness tear of the supraspinatus tendon by a series of four type I porcine collagen ultrasound-guided injections, at weekly intervals. At the same time the patient underwent physical therapy, consisting of motor re-education and proprioceptive exercises. The patient was assessed before the treatment and up to 18 months after the last injection by the Constant–Murley score, the Disability of Arm, Shoulder and Hand questionnaire and ultrasonography. Shoulder pain and functional limitation progressively improved and they almost completely disappeared at the last follow-up. Ultrasonography showed a gradual healing of the partial-thickness tear and a regeneration of the tendon structure. This is the first study on ultrasound-guided injections of type I porcine collagen for the treatment of partial-thickness rotator cuff tears. Future research should confirm the excellent result achieved in this case report.
Percutaneous Peripheral Nerve Stimulation of the Medial Branch Nerves for the Treatment of Chronic Axial Back Pain in Patients After Radiofrequency Ablation
Authors: Deer Timothy R , Gilmore Christopher A , Desai Mehul J , Li Sean , DePalma Michael J , Hopkins Thomas J , Burgher Abram H , Spinner David A , Cohen Steven P , McGee Meredith J , Boggs Joseph W
Published: November 2020

Objective

Lumbar radiofrequency ablation is a commonly used intervention for chronic back pain. However, the pain typically returns, and though retreatment may be successful, the procedure involves destruction of the medial branch nerves, which denervates the multifidus. Repeated procedures typically have diminishing returns, which can lead to opioid use, surgery, or implantation of permanent neuromodulation systems. The objective of this report is to demonstrate the potential use of percutaneous peripheral nerve stimulation (PNS) as a minimally invasive, nondestructive, motor-sparing alternative to repeat radiofrequency ablation and more invasive surgical procedures.

Design

Prospective, multicenter trial.

Methods

Individuals with a return of chronic axial pain after radiofrequency ablation underwent implantation of percutaneous PNS leads targeting the medial branch nerves. Stimulation was delivered for up to 60 days, after which the leads were removed. Participants were followed up to 5 months after the start of PNS. Outcomes included pain intensity, disability, and pain interference.

Results

Highly clinically significant (≥50%) reductions in average pain intensity were reported by a majority of participants (67%, n = 10/15) after 2 months with PNS, and a majority experienced clinically significant improvements in functional outcomes, as measured by disability (87%, n = 13/15) and pain interference (80%, n = 12/15). Five months after PNS, 93% (n = 14/15) reported clinically meaningful improvement in one or more outcome measures, and a majority experienced clinically meaningful improvements in all three outcomes (i.e., pain intensity, disability, and pain interference).

Conclusions

Percutaneous PNS has the potential to shift the pain management paradigm by providing an effective, nondestructive, motor-sparing neuromodulation treatment.
A reconciling hypothesis centred on brain-derived neurotrophic factor to explain neuropsychiatric manifestations in rheumatoid arthritis
Authors: Pedard Martin , Quirié Aurore , Tessier Anne , Garnier Philippe , Totoson Perle , Demougeot Céline , Marie Christine
Published: November 2020

Rheumatoid arthritis (RA) is an autoimmune chronic inflammatory disease characterized by synovitis leading to joint destruction, pain and disability. Despite efficient antirheumatic drugs, neuropsychiatric troubles including depression and cognitive dysfunction are common in RA but the underlying mechanisms are unclear. However, converging evidence strongly suggests that deficit in brain-derived neurotrophic factor (BDNF) signalling contributes to impaired cognition and depression. Therefore, this review summarizes the current knowledge on BDNF in RA, proposes possible mechanisms linking RA and brain BDNF deficiency including neuroinflammation, cerebral endothelial dysfunction and sedentary behaviour, and discusses neuromuscular electrical stimulation as an attractive therapeutic option.
WOOF AND BREW LTD’S TRADE MARK APPLICATION
Authors:   Appointed Person (Trade Marks)
Published: November 2020

H1 Trade Marks – Opposition proceedings – PAWSECCO – Edible pet treats – Pet beverages – Whether use in the UK prohibited by any enactment or provision of EU law – Protected denominations of origin – PROSECCO – Scope of protection – Assessing evocation – Surrounding context – Circumstances suggestion visual and phonetic similarities not fortuitous – Freedom of speech – Parody defences – Appeal to Appointed Person
Comparative Performance of Popular Methods for Hybrid Detection using Genomic Data
Authors: Kong Sungsik , Kubatko Laura S
Published: November 2020

Interspecific hybridization is an important evolutionary phenomenon that generates genetic variability in a population and fosters species diversity in nature. The availability of large genome scale data sets has revolutionized hybridization studies to shift from the observation of the presence or absence of hybrids to the investigation of the genomic constitution of hybrids and their genome-specific evolutionary dynamics. Although a handful of methods have been proposed in an attempt to identify hybrids, accurate detection of hybridization from genomic data remains a challenging task. In addition to methods that infer phylogenetic networks or that utilize pairwise divergence, site pattern frequency based and population genetic clustering approaches are popularly used in practice, though the performance of these methods under different hybridization scenarios has not been extensively examined. Here, we use simulated data to comparatively evaluate the performance of four tools that are commonly used to infer hybridization events: the site pattern frequency based methods HyDe and the $D$-statistic (i.e., the ABBA-BABA test) and the population clustering approaches structure and ADMIXTURE. We consider single hybridization scenarios that vary in the time of hybridization and the amount of incomplete lineage sorting (ILS) for different proportions of parental contributions ($\gamma$); introgressive hybridization; multiple hybridization scenarios; and a mixture of ancestral and recent hybridization scenarios. We focus on the statistical power to detect hybridization and the false discovery rate (FDR) for comparisons of the $D$-statistic and HyDe, and the accuracy of the estimates of $\gamma$ as measured by the mean squared error for HyDe, structure, and ADMIXTURE. Both HyDe and the $D$-statistic are powerful for detecting hybridization in all scenarios except those with high ILS, although the $D$-statistic often has an unacceptably high FDR. The estimates of $\gamma$ in HyDe are impressively robust and accurate whereas structure and ADMIXTURE sometimes fail to identify hybrids, particularly when the proportional parental contributions are asymmetric (i.e., when $\gamma$ is close to 0). Moreover, the posterior distribution estimated using structure exhibits multimodality in many scenarios, making interpretation difficult. Our results provide guidance in selecting appropriate methods for identifying hybrid populations from genomic data. [ABBA-BABA test; ADMIXTURE; hybridization; HyDe; introgression; Patterson’s $D$-statistic; Structure.]
Barriers, facilitators, and interventions for medication adherence across chronic conditions with the highest non-adherence rates: a scoping review with recommendations for intervention development
Authors: Konstantinou Pinelopi , Kassianos Angelos P , Georgiou Giοrgos , Panayides Andreas , Papageorgiou Alexia , Almas Ioannis , Wozniak Greta , Karekla Maria
Published: November 2020

Medication non-adherence (MNA) constitutes a complex health problem contributing to increased economic burden and poor health outcomes. The Medication Adherence Model (MAM) supports that numerous processes are involved in medication adherence (MA). Based on the MAM and guidelines of the World Health Organization (WHO), this scoping review aimed to identify the barriers and facilitators associated with MA, and the behavioral health interventions and techniques among chronic conditions presenting with high non-adherence rates (asthma, cancer, diabetes, epilepsy, HIV/AIDS, and hypertension). PubMed, PsycINFO, and Scopus databases were screened, and 243 studies were included. A mixed methods approach was used to collate the evidence and interpret findings. The most commonly reported barriers to MA across conditions were younger age, low education, low income, high medication cost, side effects, patient beliefs/perceptions, comorbidities, and poor patient–provider communication. Additionally, digitally delivered interventions including components such as medication and condition education, motivational interviewing (MI), and reinforcement and motivational messages led to improvements in MA. This review highlights the importance of administrating multicomponent interventions digitally and personalized to the patients’ individual needs and characteristics, responding to the adherence barriers faced. This is the first review examining and synthesizing evidence on barriers and facilitators to MA and behavioral health interventions used for improving MA across chronic conditions with the highest non-adherence rates and providing recommendations to researchers and clinicians. Stakeholders are called to explore methods overcoming barriers identified and developing effective multicomponent interventions that can reduce the high rates of MNA.
An unusual artery causing an unusual stroke
Authors: Balbi Alanna M. , Henry Kathryn A. , Van Sant Amanda A. , Maier Jessica L. , Eygnor Jessica K. , Jacoby Jeanne L.
Published: November 2020

Bilateral thalamic infarctions are uncommon and often lead to more severe and long-lasting symptoms than unilateral thalamic infarctions. This article describes a patient with bilateral thalamic infarction caused by occlusion in the artery of Percheron, an anatomic variant thought to be present in 4% to 12% of the population.
Entrustable Professional Activities (EPAs) for Global Health
Authors: Steeb David R. , Brock Tina P. , Dascanio Sarah A. , Drain Paul K. , Squires Allison , Thumm Melissa , Tittle Robin , Haines Stuart T.
Published: November 2020

Purpose

As global health education and training shift toward competency-based approaches, academic institutions and organizations must define appropriate assessment strategies for use across health professions. The authors aim to develop entrustable professional activities (EPAs) for global health to apply across academic and workplace settings.

Method

In 2019, the authors invited 55 global health experts from medicine, nursing, pharmacy, and public health to participate in a multiround, online Delphi process; 30 (55%) agreed. Experts averaged 17 years of global health experience, and 12 (40%) were from low- to middle-income countries. In round one, participants listed essential global health activities. The authors used in vivo coding for round one responses to develop initial EPA statements. In subsequent rounds, participants used 5-point Likert-type scales to evaluate EPA statements for importance and relevance to global health across health professions. The authors elevated statements that were rated 4 (important/relevant to most) or 5 (very important/relevant to all) by a minimum of 70% of participants (decided a priori) to the final round, during which participants evaluated whether each statement represented an observable unit of work that could be assigned to a trainee. Descriptive statistics were used for quantitative data analysis. The authors used participant comments to categorize EPA statements into role domains.

Results

Twenty-two EPA statements reached at least 70% consensus. The authors categorized these into 5 role domains: partnership developer, capacity builder, data analyzer, equity advocate, and health promoter. Statements in the equity advocate and partnership developer domains had the highest agreement for importance and relevance. Several statements achieved 100% agreement as a unit of work but achieved lower levels of agreement regarding their observability.

Conclusions

EPAs for global health may be useful to academic institutions and other organizations to guide the assessment of trainees within education and training programs across health professions.
Cybersecurity Challenges and the Academic Health Center: An Interactive Tabletop Simulation for Executives
Authors: Maggio Lauren A. , Dameff Christian , Kanter Steven L. , Woods Beau , Tully Jeffrey
Published: November 2020

Problem

Academic health centers (AHCs) face cybersecurity vulnerabilities that have potential costs to an institution’s finances, reputation, and ability to deliver care. Yet many AHC executives may not have sufficient knowledge of the potential impact of cyberattacks on institutional missions such as clinical care, research, and education. Improved cybersecurity awareness and education are areas of opportunity for many AHCs.

Approach

The authors developed and facilitated a tabletop cybersecurity simulation at an international conference for AHC leaders in September 2019 to raise awareness of cybersecurity issues and threats and to provide a forum for discussions of concerns specific to CEOs and C-suite–level executives. The 3.5-hour interactive simulation used an evolving, 3-phase case study describing a hypothetical cyberattack on an AHC with a ransomware demand. The approximately 70 participants, from AHCs spanning 25 states and 11 countries, worked in teams and discussed how they would react if they held roles similar to their real-life positions. The authors provide the full scenario as a resource.

Outcomes

The exercise was well received by the participants. In the postsession debrief, many participants noted that cybersecurity preparedness had not received the level of institutional attention given to threats such as epidemics or natural disasters. Significant variance in teams’ courses of action during the simulation highlighted a lack of consensus with regard to foundational decisions. Participants identified this as an area that could be remedied by the development of guidelines or protocols.

Next Steps

As health care cybersecurity challenges persist or grow in magnitude, AHCs will have increased opportunities to lead in the development of best practices for preparedness and response. AHCs are well positioned to work with clinicians, security professionals, regulators, law enforcement, and other stakeholders to develop tools and protocols to improve health care cybersecurity and better protect patients.