bluuebunny/crossref_metadata_2025 huggingface dataset:
INFLUENCE OF THE PERITUMORAL MATRIX ON COLON CANCER
Authors: Fernando Macías E , Rodriguez Uría R , Sanz Navarro S , Porrero Guerrero B , González del Rey Rodríguez M C , Vázquez Villa J F , Barneo Caragol C , Barneo Serra L
Published: May 2021

INTRODUCTION

Several publications have highlighted the importance of the peritumoral matrix in various epithelial tumors. Our team has pointed out the value of ColXIα1 in the stroma of breast, colon and pancreatic cancer. The possible prognostic factor of the stroma in colon cancer is debated. Our aim is to analyze the prognostic role of the stroma and ColXIα1 in colon adenocarcinoma.

MATERIAL AND METHODS

Samples of 189 patients with colon cancer were studied by image analysis. The matrix was stained with Gomori green trichrome and the CAFs with the mouse monoclonal anti-proColXIα1 antibody. The samples were evaluated with an optical microscope, obtaining data from the area stained with proColXIα1, the area stained with Gomori and the number of pro ColXIα1 positive cells. 35 Gb of images were analyzed with Image J-FIJI, which measures the number of cells and the total area of marked regions, and also quantifies the number and area of unlabeled cells. Statistical analysis by MedCalc v1o and SpSS v15.

RESULTS

Colon cancer stages (%): I, 13; II, 40; III, 29; IV, 18. Recurrences (%), 32; by stages: I, 0; II, 21; III, 44; IV, 86. Global survival: median, 28 months; S5, 33%. Total stromal cells, number of CAFs and its area: higher in early stages. Gomori area, smaller in early stages and in cases without recurrences.

CONCLUSIONS

The number of CAFs and the extension of the stromal area could have influence in the development of the cancer colon, and may be related to the prognosis of disease.
ASSESSMENT OF TECHNICAL ABILITIES IN ENDOSCOPIC SURGERY SIMULATED BY MEDICINE STUDENTS
Authors: Ibero Casadiego G P , Rodriguez Garcia J I , Garcia-Santos G , Mejia-Gil S C , Martinez Izquierdo G , Silva Cano D W , Merayo Alvarez M , Granero Trancon J E
Published: May 2021

INTRODUCTION

Simulation training has become a widely accepted educational tool for the development of technical skills in endoscopic surgery. The objective of this work was to evaluate bachelors who hold a Degree in Medicine in the execution of exercises carried out in both physical and virtual simulations.

MATERIAL AND METHODS

The descriptive study was carried out among 400 students (266 women and 134 men) in their third year of medicine studies between 2016 and 2019. The practises consisted of 11 hours of teaching, made of theory introduction, and exercise work in groups of 15-20 students on 4 workstations: LapSim, Pelvitrainer, Transanal Endoscopic Surgery (singleport) and Flexible Endoscopy. The execution time per individual exercise and in pairs is collected.

RESULTS

Individual exercises: the average execution time was: 277.0±117.8 sg, LapSim: 158.8± 66.44 sg and Pelvitrainer: 123.6±82.7sg. Couple exercises: the average execution time in Transanal Endoscopic Surgery was: 79.4±51.9 sg and Flexible Endoscopy: 53.56±34.4 sg. The analysis by gender showed that men performed better in LapSim with an average of 141.4 sg ± 52.2 in respect to women, 167.8 sg ± 71.1 (p < 0.05). In the rest of the exercises, no significant differences were shown.

CONCLUSIONS

Conducting simulated practises or studies for further development in the Degree is feasible, with objective evaluations of the skills acquired. The possibility of interacting in a controlled environment and with immediate feedback has made it possible to identify baseline differences by gender only in virtual simulation.
CHRONIC POSTOPERATIVE PAIN AFTER ANTERIOR INGUINAL HERNIA REPAIR
Authors: Arango Bravo A , Sosa Rodríguez V , Pérez Prudencio E , Soto Dopazo M , Nuño Iglesias C , Mateos Palacio C , Vazquez Presa E Mª , López-Mosquera Bayón E
Published: May 2021

INTRODUCTION

Chronic postoperative pain after inguinal hernia repair is one of the most prevalent sequel after inguinal hernioplasty.

MATERIAL AND METHODS

A retrospective descriptive study was done, studying 414 patients who underwent programmed anterior inguinal hernioplasty in our centre between 01/01/18 and 12/31/19. Laterality, the type of mesh used and fixation method are studied, as well as the appearance of early postoperative pain, at one month and after the third month. P < 0.05 is considered a statistically significant value.

RESULTS

Of 414 patients, 90.6% were male, with a mean age of 65.5 years. In 89.1% the surgery was unilateral and 8.7% was hernia recurrence. 46.1% presented pre-surgical pain. 10.4% presented pain in the first check-up and 1.9% chronic pain. In 81.4%, flat mesh was placed, fixing it with suture in 83.6%. Greater pain was observed in the first review in patients operated on for bilateral hernia (22%, p 0.006). No differences were found regarding age, sex or recurrent hernias. In bilateral hernias, recurrent hernias and hernioplasty with plug, more postoperative complications were observed with a p < 0.05. In those patients who present complications, postoperative pain was observed in the first review in 16% (p < 0,05).

CONCLUSIONS

Patients who underwent bilateral hernioplasty present more complications and greater postoperative pain in the first revision, but not after the third postoperative month. No differences were observed in chronic pain in primary vs recurrent hernias. Post-surgical complications are related to greater initial postoperative pain but not to chronic pain.
USEFULNESS OF BIODEGRADABLE STENT IN THE PREVENTION OF PANCREATIC FISTULA AFTER PANCREATIC SURGERY
Authors: Ferreras Martínez D , Gil Vázquez P , Egea Valenzuela J , Alberca de Las Parras F , Sánchez-Bueno F
Published: May 2021

INTRODUCTION

Postoperative pancreatic fistula (POPF) remains the most important cause of morbidity after cephalic pancreaticoduodenectomy (PD), affecting up to one third of cases.

The aim of this paper is to present a prospective single-center study with 16 patients undergoing PD in whom a biodegradable stent was placed, analyzing morbidity and mortality, the presence of POPF and the correct position and degradation time of the stent.

MATERIAL Y METHODS

A duct-to-mucosa end-to-side anastomosis was performed for the pancreaticojejunal anastomosis and the biodegradable stent (“Archimedes”, amg International GmbH, Germany) was placed from the pancreatic duct to the jejunum (Figure 1). The stent has a helical shape that facilitates the flow of pancreatic juice. POPF was defined as drainage fluid amylase value of > 5000 U/L on the first day after surgery.

RESULTS

Only one patient developed POPF in the postoperative period and it was successfully treated with interventional radiology drainage and somatostatin analogues. There was no mortality at 30 days after PD. An abdominal radiograph was performed to asses well-positioning of the stent on postoperative day 7. To evaluate the degradation after three months we used the CT scan. A complete degradation was defined as < 25% of stent length or stent fragments visible at CT. Completed degradation occurred after 3 months in all cases.

CONCLUSION

The use of resorbable internal pancreatic stent could be a valid alternative to prevent the development of pancreatic fistula after a pancreaticoduodenectomy.
Brain Dynamics Underlying Cognitive Flexibility Across the Lifespan
Authors: Kupis Lauren , Goodman Zachary T , Kornfeld Salome , Hoang Stephanie , Romero Celia , Dirks Bryce , Dehoney Joseph , Chang Catie , Spreng R Nathan , Nomi Jason S , Uddin Lucina Q
Published: May 2021

The neural mechanisms contributing to flexible cognition and behavior and how they change with development and aging are incompletely understood. The current study explored intrinsic brain dynamics across the lifespan using resting-state fMRI data (n = 601, 6–85 years) and examined the interactions between age and brain dynamics among three neurocognitive networks (midcingulo-insular network, M-CIN; medial frontoparietal network, M-FPN; and lateral frontoparietal network, L-FPN) in relation to behavioral measures of cognitive flexibility. Hierarchical multiple regression analysis revealed brain dynamics among a brain state characterized by co-activation of the L-FPN and M-FPN, and brain state transitions, moderated the relationship between quadratic effects of age and cognitive flexibility as measured by scores on the Delis-Kaplan Executive Function System (D-KEFS) test. Furthermore, simple slope analyses of significant interactions revealed children and older adults were more likely to exhibit brain dynamic patterns associated with poorer cognitive flexibility compared with younger adults. Our findings link changes in cognitive flexibility observed with age with the underlying brain dynamics supporting these changes. Preventative and intervention measures should prioritize targeting these networks with cognitive flexibility training to promote optimal outcomes across the lifespan.
Greater Neural Differentiation in the Ventral Visual Cortex Is Associated with Youthful Memory in Superaging
Authors: Katsumi Yuta , Andreano Joseph M , Barrett Lisa Feldman , Dickerson Bradford C , Touroutoglou Alexandra
Published: May 2021

Superagers are older adults who maintain youthful memory despite advanced age. Previous studies showed that superagers exhibit greater structural and intrinsic functional brain integrity, which contribute to their youthful memory. However, no studies, to date, have examined brain activity as superagers learn and remember novel information. Here, we analyzed functional magnetic resonance imaging data collected from 41 young and 40 older adults while they performed a paired associate visual recognition memory task. Superaging was defined as youthful performance on the long delay free recall of the California Verbal Learning Test. We assessed the fidelity of neural representations as participants encoded and later retrieved a series of word stimuli paired with a face or a scene image. Superagers, like young adults, exhibited more distinct neural representations in the fusiform gyrus and parahippocampal gyrus while viewing visual stimuli belonging to different categories (greater neural differentiation) and more similar category representations between encoding and retrieval (greater neural reinstatement), compared with typical older adults. Greater neural differentiation and reinstatement were associated with superior memory performance in all older adults. Given that the fidelity of cortical sensory processing depends on neural plasticity and is trainable, these mechanisms may be potential biomarkers for future interventions to promote successful aging.
Impact of Oral Metronidazole, Vancomycin, and Fidaxomicin on Host Shedding and Environmental Contamination With Clostridioides difficile
Authors: Turner Nicholas A , Warren Bobby G , Gergen-Teague Maria F , Addison Rachel M , Addison Bechtler , Rutala William A , Weber David J , Sexton Daniel J , Anderson Deverick J
Published: May 2021

Background

Shedding of Clostridioides difficile spores from infected individuals contaminates the hospital environment and contributes to infection transmission. We assessed whether antibiotic selection affects C. difficile shedding and contamination of the hospital environment.

Methods

In this prospective, unblinded, randomized controlled trial of hospitalized adults with C. difficile infection, patients were randomized 1:1:1 to receive fidaxomicin, oral vancomycin, or metronidazole. The primary outcome was change in environmental contamination rate during treatment. Secondary outcomes included stool shedding, total burden of contamination, and molecular relatedness of stool versus environmental C. difficile isolates.

Results

Of 33 patients enrolled, 31 (94%) completed the study. Fidaxomicin (−0.36 log10 colony-forming units [CFUs]/d [95% confidence interval (CI), −.52 to −.19]; P < .01) and vancomycin (−0.17 log10 CFUs/d [−.34 to −.01]; P = .05) were associated with more rapid decline in C. difficile shedding than metronidazole (−0.01 log10 CFUs/d [95% CI, −.10 to .08). Both vancomycin (6.3% [95% CI, 4.7–8.3) and fidaxomicin (13.1% [10.7–15.9]) were associated with lower rates of environmental contamination than metronidazole (21.4% [18.0–25.2]). With specific modeling of within-subject change over time, fidaxomicin (adjusted odds ratio, 0.83 [95% CI, .70–.99]; P = .04) was associated with more rapid decline in environmental contamination than vancomycin or metronidazole. Overall, 207 of 233 environmental C. difficile isolates (88.8%) matched patient stool isolates by ribotyping, without significant difference by treatment.

Conclusions

Fidaxomicin, and to a lesser extent vancomycin, reduces C. difficile shedding and contamination of the hospital environment relative to metronidazole. Treatment choice may play a role in reducing healthcare-associated C. difficile transmission.

Clinical Trials Registration

NCT02057198.
Genetic and Epidemiologic Analyses of an Outbreak of Pneumocystis jirovecii Pneumonia Among Kidney Transplant Recipients in the United States
Authors: Azar Marwan M , Cohen Elizabeth , Ma Liang , Cissé Ousmane H , Gan Geliang , Deng Yanhong , Belfield Kristen , Asch William , Grant Matthew , Gleeson Shana , Koff Alan , Gaston David C , Topal Jeffrey , Curran Shelly , Kulkarni Sanjay , Kovacs Joseph A , Malinis Maricar
Published: May 2021

Background

Pneumocystis jirovecii is an opportunistic fungus that causes Pneumocystis pneumonia (PCP) in immunocompromised hosts. Over an 11-month period, we observed a rise in cases of PCP among kidney-transplant recipients (KTR), prompting an outbreak investigation.

Methods

Clinical and epidemiologic data were collected for KTR diagnosed with PCP between July 2019 and May 2020. Pneumocystis strain typing was performed using restriction fragment length polymorphism analyses and multilocus sequence typing in combination with next-generation sequencing. A transmission map was drawn, and a case-control analysis was performed to determine risk factors associated with PCP.

Results

Nineteen cases of PCP in KTR were diagnosed at a median of 79 months post-transplantation; 8 received monthly belatacept infusions. Baseline characteristics were similar for KTR on belatacept versus other regimens; the number of clinic visits was numerically higher for the belatacept group during the study period (median 7.5 vs 3). Molecular typing of respiratory specimens from 9 patients revealed coinfection with up to 7 P. jirovecii strains per patient. A transmission map suggested multiple clusters of interhuman transmission. In a case-control univariate analysis, belatacept, lower absolute lymphocyte count, non-White race, and more transplant clinic visits were associated with an increased risk of PCP. In multivariate and prediction power estimate analyses, frequent clinic visits was the strongest risk factor for PCP.

Conclusions

Increased clinic exposure appeared to facilitate multiple clusters of nosocomial PCP transmission among KTR. Belatacept was a risk factor for PCP, possibly by increasing clinic exposure through the need for frequent visits for monthly infusions.
Understanding the genetics of adult-onset dilated cardiomyopathy: what a clinician needs to know
Authors: Tayal Upasana , Ware James S , Lakdawala Neal K , Heymans Stephane , Prasad Sanjay K
Published: May 2021

There is increasing understanding of the genetic basis to dilated cardiomyopathy and in this review, we offer a practical primer for the practising clinician. We aim to help all clinicians involved in the care of patients with dilated cardiomyopathy to understand the clinical relevance of the genetic basis of dilated cardiomyopathy, introduce key genetic concepts, explain which patients and families may benefit from genetic testing, which genetic tests are commonly performed, how to interpret genetic results, and the clinical applications of results. We conclude by reviewing areas for future research in this dynamic field.
Impact of Cardiovascular Risk Factors in Adolescence, Young Adulthood, and Midlife on Late-Life Cognition: Study of Healthy Aging in African Americans
Authors: George Kristen M , Gilsanz Paola , Peterson Rachel L , Barnes Lisa L , DeCarli Charles S , Mayeda Elizabeth Rose , Mungas Dan M , Whitmer Rachel A
Published: May 2021

Background

Midlife cardiovascular risk factors (CVRFs) increase risk of dementia. Black Americans experience an elevated prevalence of CVRFs and dementia. However, little is known of how CVRFs prior to midlife affect late-life cognition. We examined CVRFs in adolescence, young adulthood, and midlife with late-life cognition in the Study of Healthy Aging in African Americans (STAR).

Method

STAR assesses cognitive aging among 764 Black Americans aged ≥50 (mean age = 69; SD = 9; range = 53–95). Participants’ body mass index, blood pressure, glucose, and total cholesterol were collected during Multiphasic Health Checkups (MHC; 1964–1985). At STAR baseline (2018–2019), executive function, verbal episodic memory, and semantic memory were measured using the Spanish and English Neuropsychological Assessment Scales. Linear regression models examined associations between CVRFs and cognition adjusting for demographics and years since MHC.

Results

At MHC, 36% of participants had 1 CVRF and 26% had ≥2. Twenty-two percent of participants were adolescents (age 12–20), 62% young adults (age 21–34), and 16% midlife adults (age 35–56). Overweight/obesity was not associated with cognition. Hypertension was associated with worse executive function (β [95% CI]: −0.14 [−0.28, −0.0003]) and verbal episodic memory (β [95% CI]: −0.22 [−0.37, −0.07]) compared to normotension. Diabetes was associated with worse executive function (β [95% CI]: −0.43 [−0.83, −0.03]). Having ≥2 CVRFs (vs 0) was associated with worse executive function (β [95% CI]: −0.19 [−0.34, −0.03]) and verbal episodic memory (β [95% CI]: −0.25 [−0.41, −0.08]). Adolescents with hypertension had lower late-life executive function compared to normotensive adolescents (β [95% CI]: −0.39 [−0.67, −0.11]). Young adulthood hypertension (β [95% CI]: −0.29 [−0.49, −0.09]) and midlife hyperlipidemia (β [95% CI]: −0.386 [−0.70, −0.02]) were associated with lower verbal episodic memory.

Conclusions

Among Black Americans, life-course CVRFs were associated with poorer executive function and verbal episodic memory emphasizing the importance of cardiovascular health on the aging brain.
Responsibility-sharing for pets in disasters: lessons for One Health promotion arising from disaster management challenges
Authors: Travers Cheryl , Rock Melanie , Degeling Chris
Published: May 2021

During disasters, the behaviour of pet owners and of pets themselves may compromise the ability of emergency responders to perform their duties safely. Furthermore, pet loss can have deleterious effects on personal and community recovery. To explore these issues and their implications for health promotion and disaster management practice, we conducted semi-structured interviews with 27 emergency responders in Australia, where disaster policy embraces shared responsibility yet does not acknowledge pets. We found that responders commit to being responsible for protecting human lives, especially members of their teams. Frontline emergency responders did not regard pets as their responsibility, yet decisions made with tragic consequences for pets exacted an emotional toll. Emergency managers consider community education as a pivotal strategy to support building people’s capacity to reduce their own risk in disasters. While important, we question whether this is sufficient given that human life is lived in more-than-human contexts. Reformulating the parameters of the Ottawa Charter for Health Promotion as ‘One Health Promotion’ may help to account for the intermeshed lives of people and pets, while acknowledging human priority in public policy and programming. To acknowledge the influence of people’s pets in disaster responses and recovery, we recommend five overlapping spheres of action: (i) integrate pets into disaster management practice and policy; (ii) create pet-friendly environments and related policies; (iii) engage community action in disaster management planning; (iv) develop personal skills by engaging owners in capacity building and (v) reorient health and emergency services toward a more-than-human approach.
A design of low-carbon architecture near water under self-circulation system using dead water effect
Authors: Li Yangluxi , Chen Lei
Published: May 2021

The purpose of this research is to design a self-circulation residence near Greenland using fully renewable energy and dead water effect. Special values in terms of commercial for Greenland lead to the increase of local population. Previous investigations mainly study the particular dead water effect phenomenon neglecting the utilization of this influence, which may provide energy for local residence. This research implements electromagnetic induction to design a power generation equipment and self-circulation system. Final results show that the designed device could successfully produce power using dead water effect occurring in Greenland. In addition, a building utilizing self-circulation system is also devised to achieve energy circulation. In conclusion, dead water effect could be used to generate electricity and some special places have the potential to realize energy circulation.
Human Papillomavirus Vaccines
Authors: Markowitz Lauri E , Schiller John T
Published: May 2021

Human papillomavirus (HPV) vaccines are among the most effective vaccines available, the first to prevent infection by a mucosatropic sexually transmitted infectious agent and to do so without specific induction of mucosal immunity. Currently available prophylactic HPV vaccines are based on virus-like particles that self-assemble spontaneously from the L1 major capsid protein. The first HPV vaccine was licensed in 2006. All vaccines target HPV-16 and HPV-18, types which cause the majority of HPV-attributable cancers. As of 2020, HPV vaccines had been introduced into national immunization programs in more than 100 countries. Vaccination polices have evolved; most programs target vaccination of young adolescent girls, with an increasing number also including boys. The efficacy and safety found in prelicensure trials have been confirmed by data from national immunization programs. The dramatic impact and effectiveness observed has stimulated interest in ambitious disease reduction goals.
Why the Sublime Is Aesthetic Awe
Authors: Clewis Robert R
Published: May 2021

This article focuses on the conceptual relationship between awe and the experience of the sublime. I argue that the experience of the sublime is best conceived as a species of awe, namely, as aesthetic awe. I support this conclusion by considering the prominent conceptual relations between awe and the experience of the sublime, showing that all of the options except the proposed one suffer from serious shortcomings. In maintaining that the experience of the sublime is best conceived as aesthetic awe, I draw from historical theories of the sublime as well as recent work in empirical psychology.
Evaluating Commutability of Control Materials in Three Nordic External Quality Assessment Schemes for Lipoproteins
Authors: Norling Anna , Bökman C Fredrik , Göransson Emma , Wande Birgitta , Pedersen Morten M , Berghäll Heidi , Svala Emilia
Published: May 2021

Background

The quality of control materials is crucial for evaluating external quality assessment (EQA) results. To detect method differences, the EQA material should behave the same as a patient sample, meaning the material must be commutable. Noncommutable materials may cause misinterpretations of EQA results. Here, we examined the commutability of EQA materials used in 3 Nordic EQA schemes for lipids.

Methods

The study was designed according to the procedures recommended for assessing commutability by the International Federation of Clinical Chemistry and Laboratory Medicine. Commutability was assessed based on the difference in bias between a control material (CM) and clinical samples (CS) consisting of human plasma using 2 different measurement procedures (MPs). Measurands: LDL-cholesterol (LDL-C), total cholesterol (TC), HDL-cholesterol (HDL-C), and triglycerides (TG). Four CMs (CM1–4) were assessed for commutability by using 40 CS and 3 MPs (Abbott Architect, Roche Cobas, and Siemens Atellica).

Results

Unmodified native CMs (CM1 and CM3), stored at −80 °C, were commutable for all included measurands, except for LDL-C that was indeterminate, when comparing MPs pairwise. Modified CM2 was noncommutable for HDL-C, LDL-C, non-HDL-C, and LDL-C calculations. Unmodified native CM4, stored at −20°C, was noncommutable for LDL-C.

Conclusions

Unmodified serum samples stored at −80 °C were commutable for lipids on the evaluated MPs, and therefore suitable as CMs in EQA schemes. Moreover, the study demonstrated that minor modifications of samples may lead to noncommutability.
TechQuity is an imperative for health and technology business: Let’s work together to achieve it
Authors: Clark Cheryl R , Akdas Yasemin , Wilkins Consuelo H , Rhee Kyu , Johnson Kevin B , Bates David W , Dankwa-Mullan Irene
Published: May 2021

Open discussions of social justice and health inequities may be an uncommon focus within information technology science, business, and health care delivery partnerships. However, the COVID-19 pandemic—which disproportionately affected Black, indigenous, and people of color—has reinforced the need to examine and define roles that technology partners should play to lead anti-racism efforts through our work. In our perspective piece, we describe the imperative to prioritize TechQuity—equity and social justice as a technology business strategy—through collaborating in partnerships that focus on eliminating racial and social inequities.
Edge-to-edge repair of the systolic anterior motion of mitral valve and cardiac myectomy of the abnormally positioned papillary muscles in an infant with COL4A1 mutation
Authors: Miyairi Satoshi , Takeyoshi Daisuke , Ishikawa Natsuya , Kamiya Hiroyuki
Published: May 2021

Surgical treatment is challenging in pediatric patients with left ventricular outflow tract (LVOT) stenosis (LVOTS). We herein present the case of a 2-year-old male patient with porencephaly who was diagnosed with LVOTS accompanied by moderate mitral valve regurgitation (MR) with systolic anterior motion (SAM). Edge-to-edge mitral valve reconstruction and myectomy of the abnormal cardiac muscle were performed, with an uneventful postoperative course. LVOT myectomy and edge-to-edge mitral valve repair may be considered as a safe and acceptable approach with good clinical outcomes in pediatric patients with LVOTS accompanied by MR with SAM.
Concealed gallbladder perforation: a rare case report
Authors: Suleiman Jamil , Mremi Alex , Tarmohamed Murad , Sadiq Adnan , Lodhia Jay
Published: May 2021

Acute acalculous cholecystitis remains an elusive clinical diagnosis possibly due to complex clinical setting in which this entity develops, lack of large prospective controlled trials that evaluate various diagnostic modalities, thus dependence on a small database for clinical decision making. Concealed gallbladder perforation is rare. Herein, we report an 82-year-old female who presented with a right upper quadrant pain and features of local peritonitis. Abdominal ultrasound was suggestive of cholecystitis while computed tomography (CT) scan reported a perforated gallbladder with pericholecystic fluid collection. The patient underwent successful cholecystectomy; and intra-operatively, similar findings as those reported on imaging were seen. Unfortunately, she succumbed shortly post-operatively due to pulmonary embolism. Our report highlights the importance CT scan in patients with vague abdominal symptoms followed by sudden resolution. It also reminds the importance of considering the diagnosis of concealed gallbladder perforation as a differential in patients with peritonitis, as it may be missed by routine radiological investigations.
Multiwavelength investigation of the candidate Galactic PeVatron MGRO J1908+06
Authors: Crestan S , Giuliani A , Mereghetti S , Sidoli L , Pintore F , La Palombara N
Published: May 2021

The candidate PeVatron MGRO J1908+06, which shows a hard spectrum beyond 100 TeV, is one of the most peculiar γ-ray sources in the Galactic plane. Its complex morphology and some possible counterparts spatially related with the very high energy (VHE) emission region, preclude to distinguish between a hadronic and leptonic nature of the γ-ray emission. In this paper, we illustrate a new multiwavelength analysis of MGRO J1908+06, with the aim to shed light on its nature and the origin of its ultra-high-energy emission. We performed an analysis of the 12CO and 13CO molecular line emission demonstrating the presence of dense molecular clouds spatially correlated with the source region. We also analysed 12 yr of Fermi-Large Area Telescope (LAT) data between 10 GeV and 1 TeV finding a counterpart with a hard spectrum (Γ ∼ 1.6). Our reanalysis of XMM–Newton data allowed us to put a more stringent constraint on the X-ray flux from this source. We demonstrate that a single accelerator cannot explain the whole set of multiwavelength data, regardless of whether it accelerates protons or electrons, but a two-zone model is needed to explain the emission from MGRO J1908+06. The VHE emission seems most likely the superposition of a TeV pulsar wind nebula powered by PSR J1907+0602, in the southern region, and of the interaction between the supernova remnant G40.5−0.5 and the molecular clouds, in the northern region.
The impact of magnetic fields on cosmological galaxy mergers – I. Reshaping gas and stellar discs
Authors: Whittingham Joseph , Sparre Martin , Pfrommer Christoph , Pakmor Rüdiger
Published: May 2021

Mergers play an important role in galaxy evolution. In particular, major mergers are able to have a transformative effect on galaxy morphology. In this paper, we investigate the role of magnetic fields in gas-rich major mergers. To this end, we run a series of high-resolution magnetohydrodynamic (MHD) zoom-in simulations with the moving-mesh code arepo and compare the outcome with hydrodynamic simulations run from the same initial conditions. This is the first time that the effect of magnetic fields in major mergers has been investigated in a cosmologically consistent manner. In contrast to previous non-cosmological simulations, we find that the inclusion of magnetic fields has a substantial impact on the production of the merger remnant. Whilst magnetic fields do not strongly affect global properties, such as the star formation history, they are able to significantly influence structural properties. Indeed, MHD simulations consistently form remnants with extended discs and well-developed spiral structure, whilst hydrodynamic simulations form more compact remnants that display distinctive ring morphology. We support this work with a resolution study and show that whilst global properties are broadly converged across resolution and physics models, morphological differences only develop given sufficient resolution. We argue that this is due to the more efficient excitement of a small-scale dynamo in higher resolution simulations, resulting in a more strongly amplified field that is better able to influence gas dynamics.
MaNGA galaxy properties – I. An extensive optical, mid-infrared photometric, and environmental catalogue
Authors: Arora Nikhil , Stone Connor , Courteau Stéphane , Jarrett Thomas H
Published: May 2021

We present an extensive catalogue of non-parametric structural properties derived from optical and mid-infrared imaging for 4585 galaxies from the MaNGA survey. DESI and Wide-field Infrared Survey Explorer (WISE) imaging are used to extract surface brightness profiles in the g, r, z, W1, W2 photometric bands. Our optical photometry takes advantage of the automated algorithm autoprof and probes surface brightnesses that typically reach below 29 mag arcsec−2 in the r-band, while our WISE photometry achieves 28 mag arcsec−2 in the W1-band. Neighbour density measures and central/satellite classifications are also provided for a large subsample of the MaNGA galaxies. Highlights of our analysis of galaxy light profiles include (i) an extensive comparison of galaxian structural properties that illustrates the robustness of non-parametric extraction of light profiles over parametric methods; (ii) the ubiquity of bimodal structural properties, suggesting the existence of galaxy families in multiple dimensions; and (iii) an appreciation that structural properties measured relative to total light, regardless of the fractional levels, are uncertain. We study galaxy scaling relations based on photometric parameters, and present detailed comparisons with literature and theory. Salient features of this analysis include the near-constancy of the slope and scatter of the size–luminosity and size–stellar mass relations for late-type galaxies with wavelength, and the saturation of central surface density, measured within 1 kpc, for elliptical galaxies with $M_* \gt 10.7\, {\rm M}_{\odot }$ (corresponding to $\Sigma _1 \simeq 10^{10}\, {\rm M}_{\odot }\, {\rm kpc}^{-2}$). The multiband photometry, environmental parameters, and structural scaling relations presented are useful constraints for stellar population and galaxy formation models.
A high-rate foreground of sub-second flares from geosynchronous satellites
Authors: Nir Guy , Ofek Eran O , Ben-Ami Sagi , Segev Noam , Polishook David , Manulis Ilan
Published: May 2021

The Weizmann Fast Astronomical Survey Telescope is a 55 cm optical survey telescope with a high-cadence (25 Hz) monitoring of the sky over a wide field of view (≈7 deg2). The high frame rate allows detection of sub-second transients over multiple images. We present a sample of ∼0.1–0.3 s duration flares detected in an untargeted survey for such transients. We show that most, if not all of them, are glints of sunlight reflected off geosynchronous and graveyard orbit satellites. The flares we detect have a typical magnitude of 9–11, which translates to ∼14–16th magnitude if diluted by a 30 s exposure time. We estimate the rate of events brighter than ∼11 mag to be of the order of 30–40 events per day per deg2, for declinations between −20° and +10°, not including the declination corresponding to the geostationary belt directly above the equator, where the rate can be higher. We show that such glints are common in large area surveys (e.g. Zwicky Transient Facility and Legacy Survey of Space and Time), and that some of them have a point-like appearance, confounding searches for fast transients such as fast radio burst counterparts and gamma-ray bursts (GRBs). By observing in the direction of the Earth’s shadow, we are able to put an upper limit on the rate of fast astrophysical transients of 0.052 deg−2 day−1 (95 per cent confidence limit) for events brighter than 11 mag. We also suggest that the single image, high declination flare observed in coincidence with the GN-z11 galaxy and assumed to be a GRB, is also consistent with such a satellite glint.
Peculiar-velocity cosmology with Types Ia and II supernovae
Authors: Stahl Benjamin E , de Jaeger Thomas , Boruah Supranta S , Zheng WeiKang , Filippenko Alexei V , Hudson Michael J
Published: May 2021

We present the Democratic Samples of Supernovae (DSS), a compilation of 775 low-redshift Type Ia and II supernovae (SNe Ia and II), of which 137 SN Ia distances are derived via the newly developed snapshot distance method. Using the objects in the DSS as tracers of the peculiar-velocity field, we compare against the corresponding reconstruction from the 2M++ galaxy redshift survey. Our analysis – which takes special care to properly weight each DSS subcatalogue and cross-calibrate the relative distance scales between them – results in a measurement of the cosmological parameter combination $f\sigma _8 = 0.390_{-0.022}^{+0.022}$ as well as an external bulk flow velocity of $195_{-23}^{+22}$ km s−1 in the direction $(\ell , b) = (292_{-7}^{+7}, -6_{-4}^{+5})$ deg, which originates from beyond the 2M++ reconstruction. Similarly, we find a bulk flow of $245_{-31}^{+32}$ km s−1 towards $(\ell , b) = (294_{-7}^{+7}, 3_{-5}^{+6})$ deg on a scale of $\sim 30\, h^{-1}$ Mpc if we ignore the reconstructed peculiar-velocity field altogether. Our constraint on fσ8 – the tightest derived from SNe to date (considering only statistical error bars), and the only one to utilize SNe II – is broadly consistent with other results from the literature. We intend for our data accumulation and treatment techniques to become the prototype for future studies that will exploit the unprecedented data volume from upcoming wide-field surveys.
Long-term neuropsychological outcomes of survivors of young childhood brain tumors treated on the Head Start II protocol
Authors: Levitch Cara F , Malkin Benjamin , Latella Lauren , Guerry Whitney , Gardner Sharon L , Finlay Jonathan L , Sands Stephen A
Published: May 2021

Background

The Head Start treatment protocols have focused on curing young children with brain tumors while avoiding or delaying radiotherapy through using a combination of high-dose, marrow-ablative chemotherapy and autologous hematopoietic cell transplantation (AuHCT). Late effects data from treatment on the Head Start II (HS II) protocol have previously been published for short-term follow-up (STF) at a mean of 39.7 months post-diagnosis. The current study examines long-term follow-up (LTF) outcomes from the same cohort.

Methods

Eighteen HS II patients diagnosed with malignant brain tumors <10 years of age at diagnosis completed a neurocognitive battery and parents completed psychological questionnaires at a mean of 104.7 months’ post-diagnosis.

Results

There was no significant change in Full Scale IQ at LTF compared to baseline or STF. Similarly, most domains had no significant change from STF, including verbal IQ, performance IQ, academics, receptive language, learning/memory, visual-motor integration, and externalizing behaviors. Internalizing behaviors increased slightly at LTF. Clinically, most domains were within the average range, except for low average mathematics and receptive language. Additionally, performance did not significantly differ by age at diagnosis or time since diagnosis. Of note, children treated with high-dose methotrexate for disseminated disease or atypical teratoid/rhabdoid tumor displayed worse neurocognitive outcomes.

Conclusions

These results extend prior findings of relative stability in intellectual functioning for a LTF period. Ultimately, this study supports that treatment strategies for avoiding or delaying radiotherapy using high-dose, marrow-ablative chemotherapy and AuHCT may decrease the risk of neurocognitive and social-emotional declines in young pediatric brain tumor survivors.
Global Risk in Long-Term Sovereign Debt
Authors: Borri Nicola , Shakhnov Kirill
Published: May 2021

This paper focuses on emerging market government bonds issued in local currency with different maturities. Foreign investors face interest rate, currency, and credit risks. We consider the entire term structure of carry trade returns and find that, while the default premium does not contribute to carry trade strategies, the contribution of interest rate risk, captured by the term premium, is large and increases with maturity. We introduce default risk in an otherwise standard affine model; we show that the volatility of the permanent component of the SDFs must be different across emerging markets in order to match these stylized facts. (JEL F31, F34, G15)

Received September 9, 2019; editorial decision March 25, 2021 by Editor: Nikolai Roussanov. Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Unicolumnar Pin Fixation of Type III Supracondylar Humeral Fractures Is Associated With Over 3 Times Higher Odds of Lost Reduction
Authors: Jenkins Sarah M. , Mehlman Charles T. , Denning Jaime Rice
Published: May 2021

Objectives:

To compare the rate of lost reduction between 2 groups of non–age-segregated type III supracondylar humeral fracture patients: a unicolumnar versus bicolumnar fixation group.

Design:

Retrospective cohort study.

Setting:

Pediatric Academic Trauma Center.

Patients:

We identified 257 patients with type III supracondylar humerus fractures from surgical billing records over a 5-year period. There were 183 patients identified with bicolumnar fixation (71.2%) and 74 patients identified with unicolumnar fixation (28.8%).

Intervention:

Closed reduction percutaneous pinning of the distal humerus.

Main Outcome Measures:

The primary outcome measure was difference in rate of lost reduction between patients with bicolumnar (lateral and medial column) and unicolumnar (lateral column only) fixation (Fig. 1). The reduction and fixation at the time of fluoroscopy was assessed using the Baumann angle, Gordon index, and anterior humeral line. Loss of reduction was assessed at time of healing, defined by a Baumann angle change ≥10 degrees and Gordon index of ≥50% (Fig. 2).

Results:

There were 183 patients with bicolumnar fixation and 74 patients with unicolumnar fixation included in the study (average age 5.8 years; range, 2–14 years). The rate of lost reduction in patients with bicolumnar fixation was 6.01% (11/183), whereas 17.57% (13/74) of patients with unicolumnar fixation experienced lost reduction. These rates were significantly different (P = 0.008) with a 3.3 times higher odds (95% confidence interval = 1.3–8.6) of lost reduction with unicolumnar fixation.

Conclusions:

There is a statistically significant increase in the rate of supracondylar fracture loss of reduction for patients with unicolumnar fixation when compared with bicolumnar fixation.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Spitz Melanoma of Childhood With A Novel Promoter Hijacking Anaplastic Lymphoma Kinase (C2orf42-ALK) Rearrangement
Authors: Frederico Ingrid K. S. , Mesbah Ardakani Nima , Ryan Annie L. , Cowley Mark J. , Wood Benjamin A.
Published: May 2021

We present the case of a prepubescent man of African descent who developed a spitzoid melanocytic proliferation showing evidence of a novel promoter hijacking ALK-C2orf42 rearrangement, with atypical histology, clinically apparent metastatic disease, and abnormal cytogenetic findings, representing a rare genuine case of “Spitz melanoma of childhood.” As our understanding of the distinct molecular biology of different tumors traditionally grouped as spitzoid melanocytic lesions evolves, it is becoming increasingly apparent that this group encompasses morphologically and genetically distinct entities. Accurate classification with detailed molecular analysis and prolonged clinical follow-up is essential to allow meaningful conclusions regarding prognostication and prediction of response to therapy.
Cutaneous Pseudolymphoma With Langerhans Cell Hyperplasia—A Rare Case With Clinical Presentation Mimicking Malignancy and Potential Diagnostic Pitfall
Authors: Ye Cian-Hao , Chen Chih-Jung , Chang Kung-Chao , Wu Yu-Hung , Chen Mei-Ling , Chiu Tsu-Man
Published: May 2021

We describe a rare case of cutaneous pseudolymphoma with Langerhans cell hyperplasia. An 84-year-old female patient presented with erythematous and pernicious-looking plaques on her scalp that had been present for months. Histologically, lymphoid follicles consisting of mixed-type lymphocytes and Langerhans cells were aggregated focally. The diagnosis was verified by several immunohistochemical stains and by clinical evaluation. Skin lesions were steadily resolved with low-dose corticosteroid and hydroxychloroquine.
Clinical and Histopathologic Characteristics of Metastatic and Locally Advanced Cutaneous Basal Cell Carcinomas
Authors: Baker Laura X. , Grilletta Erica , Zwerner Jeffrey P. , Boyd Alan S. , Wheless Lee
Published: May 2021

Locally advanced or metastatic basal cell carcinomas (laBCCs or mBCCs) are rare, with few case series providing information on their epidemiology. We aimed to describe the clinical and histologic features of locally advanced and metastatic basal cell carcinomas. Forty cases of laBCC or mBCC were identified by searching Vanderbilt's database from 1984 to January 2019. A retrospective chart review was performed. Pathology slides were available for 23 cases (13 mBCCs and 10 laBCCs). Twenty-one of 23 cases were Clark level IV or V, with a mean depth of invasion of >7 mm for both types. The mean mitotic rate was 4.4 mitoses/mm2 for laBCCs and 3.3 mitoses/mm2 for mBCCs. Ulceration was identified in 7 laBCC and 8 mBCC cases. Perineural invasion was present in 2 laBCC and 6 mBCC cases, with 3 mBCCs invading nerves >0.1 mm. Of 13 mBCC cases, histologic subtypes included infiltrative (n = 9), nodular (n = 7), morpheaform (n = 4), and superficial (n = 2), with multiple patterns present in some specimens. 10 of 13 patients with mBCC had local recurrence before metastasis. In summary, we identified several potential markers of high-risk BCC, including perineural invasion, deep invasion, elevated mitotic rate, and local recurrence of the primary tumor.
Simulation-Based Interpretation of Therapeutically Monitored Cabozantinib Plasma Concentration in Advanced Adrenocortical Carcinoma with Hemodialysis
Authors: Zimmermann Sebastian , Kurlbaum Max , Mayer Stefanie , Fassnacht Martin , Kroiss Matthias , Scherf-Clavel Oliver
Published: May 2021

Background:

Adrenocortical carcinoma is an orphan but aggressive malignancy with limited treatment options. Cabozantinib (CAB), a tyrosine kinase inhibitor, has emerged as a new potential treatment. However, no data are available on whether and how CAB can be administered to patients undergoing hemodialysis.

Methods:

An liquid chromatography with tandem mass spectrometry detection method was developed and validated according to the European Medicines Agency and United States Food and Drug Administration guidelines for bioanalytical method validation. The samples were prepared using protein precipitation and online solid-phase extraction. The method was applied to clinical samples of an adrenocortical carcinoma patient receiving CAB treatment (80 mg daily). During the 10 days of observation, the patient received periodic hemodialysis on 7 days. Pharmacokinetic (PK) simulations were performed using Bayesian forecasting according to an existing population PK model for CAB.

Results:

Based on the PK simulation, a mean plasma trough concentration of 1375 ng/mL [90% prediction interval (PI), 601–2602 ng/mL] in the steady state at a daily dose of 80 mg was expected for CAB. However, an individual simulation involving the measured plasma levels of the patient resulted in a mean trough concentration of 348 ng/mL (90% PI, 278–430 ng/mL). The model based on individual PK parameters estimated accessible plasma levels of 521, 625, and 834 ng/mL by dose adjustment to 100, 120, and 160 mg, respectively.

Conclusions:

After establishing an liquid chromatography with tandem mass spectrometry detection method for therapeutic drug monitoring of CAB, our analyses involving a single patient undergoing hemodialysis indicated that higher than expected doses of CAB were required to achieve reasonable plasma concentrations. Our study demonstrates the usefulness of therapeutic drug monitoring for the evaluation of “new” drugs in patients with renal impairment.