bluuebunny/crossref_metadata_2025 huggingface dataset:
A practical phase field method for an elliptic surface PDE
Authors: Barrett John W , Deckelnick Klaus , Styles Vanessa
Published: July 2020

We consider a diffuse interface approach for solving an elliptic PDE on a given closed hypersurface. The method is based on a (bulk) finite element scheme employing numerical quadrature for the phase field function and hence is very easy to implement compared to other approaches. We estimate the error in natural norms in terms of the spatial grid size, the interface width and the order of the underlying quadrature rule. Numerical test calculations are presented, which confirm the form of the error bounds.
Global sensitivity-based modelling approach to identify suitable Eucalyptus traits for adaptation to climate variability and change
Authors: Elli Elvis Felipe , Huth Neil , Sentelhas Paulo Cesar , Carneiro Rafaela Lorenzato , Alvares Clayton Alcarde
Published: July 2020

Eucalyptus-breeding efforts have been made to identify clones of superior performance for growth and yield and how they will interact with global climate changes. This study performs a global sensitivity analysis for assessing the impact of genetic traits on Eucalyptus yield across contrasting environments in Brazil under present and future climate scenarios. The APSIM Next Generation Eucalyptus model was used to perform the simulations of stemwood biomass (t ha−1) for 7-year rotations across 23 locations in Brazil. Projections for the period from 2020 to 2049 using three global circulation models under intermediate (RCP4.5) and high (RCP8.5) greenhouse gas emission scenarios were performed. The Morris sensitivity method was used to perform a global sensitivity analysis to identify the influence of plant traits on stemwood biomass. Traits for radiation use efficiency, leaf partitioning, canopy light capture and fine root partitioning were the most important, impacting the Eucalyptus yield substantially in all environments under the present climate. Some of the traits targeted now by breeders for current climate will remain important under future climates. However, breeding should place a greater emphasis on photosynthetic temperature response for Eucalyptus in some regions. Global sensitivity analysis was found to be a powerful tool for identifying suitable Eucalyptus traits for adaptation to climate variability and change. This approach can improve breeding strategies by better understanding the gene × environment interactions for forest productivity.
Spatial clustering of cholera cases in the Kathmandu Valley: implications for a ring vaccination strategy
Authors: Roskosky Mellisa , Ali Mohammad , Upreti Shyam Raj , Sack David
Published: July 2020

Background

In mid-2016, a cholera outbreak occurred in Kathmandu Valley, Nepal. This retrospective study aims to determine if a reactive, ring vaccination strategy would have been useful in preventing cholera transmission during that outbreak.

Methods

Data on cholera cases were collected as part of hospital-based surveillance in the Kathmandu Valley in 2016. Global Positioning System (GPS) coordinates were obtained during household visits. Geographic clusters of cases were visually determined and tested statistically for clustering. Cluster size was determined based on the distribution of cases around the index case.

Results

GPS coordinates for 69 cases were analysed. Six geographic clusters were identified, all of which showed significant clustering of cases. Approximately 85% of cases within a cluster occurred more than 7 d after the index case. The median ring size was 1 km, with a population of 14 000 people.

Conclusions

Cholera cases were clustered in space and the majority of cases occurred over 1 week after the initial cases in the cluster, allowing for an opportunity to prevent transmission through the use of the vaccine soon after the initial case was identified. A ring vaccination strategy may be especially useful for large urban areas with recurrent seasonal outbreaks but where the specific locations for such outbreaks are not predictable.
The Value of Laboratory Information Augmenting a Managed Care Organization’s Comprehensive Diabetes Care Efforts in New Mexico
Authors: VanNess Richard , Swanson Kathleen , Robertson Virginia , Koenig Mark , Crossey Michael
Published: July 2020

Background

The National Committee on Quality Assurance’s Healthcare Effectiveness Data and Information Set on Comprehensive Diabetes Care requires patients with diabetes obtain a hemoglobin A1c (Hb A1c) and urine albumin-to-creatinine ratio (ACR) test every year. To improve these measures, managed care organizations (MCOs) rely on claim and prescription data to identify members for care management. TriCore Reference Laboratories collaborated with Blue Cross Blue Shield of New Mexico (BCBSNM) to determine if laboratory information would augment BCBSNM’s diabetes care management services.

Method

In January 2018, BCBSNM provided its Medicaid enrollment file to TriCore for identifying members and determining their diabetes status by evaluating their recent Hb A1c results. Of the 6,138 members with diabetes, a random sample of 600 was extracted, and half were provided to BCBSNM to perform care management from January 18 to May 1, 2018. Completion of Hb A1c and ACR were measured.

Results

Significantly more (P = 0.03) study group members (25%) than control group members (18%) received an Hb A1c test. The study group (14%) also received more ACR tests than the control group (9%; P = 0.07). We then calculated the monetary penalty to which New Mexico Medicaid MCOs are subject, leading to the identification of additional value ($3,693,000) that clinical laboratories provide beyond the cost per test.

Conclusion

Clinical laboratories play a critical role in healthcare, and this article demonstrates an approach for laboratories to collaborate with MCOs in their care management efforts. In addition, we calculate the value of this novel collaboration, which may play an integral role in laboratories’ pursuit of value-based care.
Prognostic impact of the number of lateral pelvic lymph node metastases on rectal cancer
Authors: Ozawa Heita , Nakanishi Hiroki , Sakamoto Junichi , Suzuki Yoshiyuki , Fujita Shin
Published: July 2020

Background

This study aimed to clarify the number of lateral pelvic lymph node metastases of colorectal cancer for which prognosis could be improved by dissection.

Methods

We analysed the data of 30 patients with lateral pelvic lymph node metastases of rectal cancer that underwent a total mesorectal excision with lateral pelvic lymph node dissection at our institute from 1986 to 2016. We performed survival analysis on the number of lateral pelvic lymph node metastases in each of these patients and identified an optimal cut-off point of the number of lateral pelvic lymph node metastases that would predict recurrence-free survival using the receiver operating characteristic curves and an Akaike information criterion value.

Results

The 5-year recurrence-free survival and overall survival of patients with one or two lateral pelvic lymph node metastases were significantly better than that of those with three or more (5-year recurrence-free survival, 63.3 vs. 0.0%, respectively; hazard ratio, 0.23; 95% CI, 0.07–0.72; P = 0.0124) (5-year overall survival, 68.2 vs. 15.6%, respectively; hazard ratio, 0.29; 95% CI, 0.09–0.92; P = 0.0300). All of the metastatic lateral pelvic lymph nodes in the group with one or two lateral pelvic lymph node metastases were restricted to the internal iliac artery or obturator nerve regions.

Conclusions

The cut-off number of lateral pelvic lymph node metastases in the internal iliac artery or obturator nerve regions of colorectal cancer cases in whom prognosis was improved by lateral pelvic lymph node dissection was 2; patients who had <3 lateral pelvic lymph node metastases had better prognoses than those with ≥3 lateral pelvic lymph node metastases.
Traumatic thoracolumbar fracture–dislocation in an infant: surgical management using posterior thoracolumbar instrumentation
Authors: Alkhaibary Ali , Khairy Sami , Alshaya Wael
Published: July 2020

Spinal fracture–dislocation in the infantile population is a rare phenomenon, and its surgical management remains poorly discussed in the literature. This article reports a case of traumatic fracture–dislocation in an infant by outlining the surgical management and extensively reviewing the literature. An 8-month-old girl was involved in a motor vehicle accident and was ejected from the car through the windshield. Radiological imaging demonstrated a complete spinal cord injury at the level of T10 and a three-column fracture of T12-L1, with an evidence of kyphosis measuring 47° at the fracture site. Posterior thoracolumbar instrumentation, using the posterior cervical fixation set, was successfully performed. In experienced neurosurgical centers, posterior thoracolumbar instrumentation can be safely performed in infants with traumatic thoracolumbar fracture–dislocation. This allows for the correction of the kyphotic deformity, facilitation of the rehabilitation course and improvement in the health-related quality of life.
A challenging case of a chyle leak following axillary lymph node clearance
Authors: Wong Joshua , Farkas Nicholas , Monib Sherif , Thomson Simon
Published: July 2020

Chyle leak following axillary lymph node clearance is a rarely reported complication. We present a case of chylous leakage following axillary lymph node clearance, which was diagnosed on clinical grounds. Surgical re-exploration was undertaken due to ongoing high output. However, the chylous leak recurred post-operatively, if at a lower rate. The patient was subsequently managed successfully with conservative measures, primarily utilizing regular aspiration and compression bandaging to the axilla.
Machine Learning for Occupation Coding—A Comparison Study
Authors: Schierholz Malte , Schonlau Matthias
Published: July 2020

Asking people about their occupation is common practice in surveys and censuses around the world. The answers are typically recorded in textual form and subsequently assigned (coded) to categories, which have been defined in official occupational classifications. While this coding step is often done manually, substituting it with more automated workflows has been a longstanding goal, promising reduced data-processing costs and accelerated publication of key statistics. Although numerous researchers have developed different algorithms for automated occupation coding, the algorithms have rarely been compared with each other or tested on different data sets. We fill this gap by comparing some of the most promising algorithms found in the literature and testing them on five data sets from Germany. The first two algorithms we test exemplify a common practice in which answers are coded automatically according to a predefined list of job titles. Statistical learning algorithms—that is, regularized multinomial regression, tree boosting, or algorithms developed specifically for occupation coding (algorithms three to six)—can improve upon algorithms one and two, but only if a sufficient number of training observations from previous surveys is available. The best results are obtained by merging the list of job titles with coded answers from previous surveys before using this combined training data for statistical learning (algorithm 7). However, the differences between the algorithms are often small compared to the large variation found across different data sets, which we ascribe to systematic differences in the way the data were coded in the first place. Such differences complicate the application of statistical learning, which risks perpetuating questionable coding decisions from the training data to the future.
The Transformation to Health for All in Correctional Care: Shifting Mindset to End Collusion
Authors: Hayden James , Huth Charles
Published: July 2020

Bottom Line Up Front: Prison, for most incarcerated persons, can be a harsh and oftentimes dehumanizing environment. The U.S. criminal justice system has become more punitive than rehabilitative since the 1970s. In a reversal of this trend, newly passed legislation has charged prisons with preparing incarcerated persons for reentry into society, reducing recidivism, and providing rehabilitation programs targeting individual needs and risk. At the same time, prison staff delivering these services are faced with the challenge of burn-out, fatigue, depression, PTSD, suicide, and substance abuse at higher rates than individuals in other professions. To sustainably deliver the newly mandated prison-based services with an emphasis on the health and wellbeing of both the staff and the incarcerated population, prisons and the criminal justice system must change dramatically. The key to accomplishing this change is a foundational shift in mindset, from a self-focused “inward mindset” to an in impact-focused “outward mindset.” The purpose of this article is to hypothesize the potential for increased safety, security, and human wellbeing when a prison culture adopts an outward mindset.
Military Protein Intake Related to Strength and Fat Mass Independent of Energy Intake
Authors: Ross Jeremy A , Thomas D Travis , Winters Joshua D , Royer Scott D , Halagarda Christopher J , Sheppard Ryan , Abt John , Heebner Nicholas R
Published: July 2020

Introduction

Kinetic military units operate in austere training environments and deprivation not commonly experienced by competitive athletes. Nutritional strategies to protect against decrements in performance and potential injury risk may differ for these two groups. A cross sectional analysis was conducted to determine energy and macronutrient characteristics associated with performance metrics.

Materials and Methods

78 male subjects (age: 28.4 ± 6.0 years, height: 178.3 ± 6.7 cm, mass: 84.3 ± 9.4 kg, 8.5 ± 5.8 years of service) assigned to Marine Corps Forces Special Operations Command completed a 1-day performance assessment. Body mass, lean body mass, fat mass (FM), aerobic capacity (VO2max), lactate inflection point (LT), anaerobic power, anaerobic capacity, knee flexion strength, knee extension strength, peak knee flexion strength, and peak knee extension strength outcome values were recorded. Dietary intake was collected using automated self-administered 24-hour dietary recall (ASA24). Performance assessment scores were compared with macronutrient intake and controlled for energy intake using analysis of covariance.

Results

Differences in knee flexion strength, knee extension strength, peak knee flexion strength, and peak knee extension strength were significant across low (LPRO), medium (MPRO), and high (HPRO) protein intake groups (p < 0.05) with LPRO performance metrics significantly lower than both MPRO and HPRO and MPRO significantly lower than HPRO. FM was significantly higher in LPRO than MPRO or HPRO (p < 0.05). Low carbohydrate intake (LCHO) was associated with greater body mass and FM compared with high (HCHO) (p < 0.05). There was no association between fat intake and any variable.

Conclusions

Increases in protein intake may have beneficial performance effects independent of total energy intake, while moderate increases in carbohydrate intake may not be sufficient to enhance physical performance in a special operations population.
Direct Peritoneal Resuscitation Improves Survival in a Murine Model of Combined Hemorrhage and Burn Injury
Authors: Jung Andrew D , Friend Lou Ann , Stevens-Topie Sabre , Schuster Rebecca , Lentsch Alex B , Gavitt Brian , Caldwell Charles C , Pritts Timothy A
Published: July 2020

Introduction

Combined burn injury and hemorrhagic shock are a common cause of injury in wounded warfighters. Current protocols for resuscitation for isolated burn injury and isolated hemorrhagic shock are well defined, but the optimal strategy for combined injury is not fully established. Direct peritoneal resuscitation (DPR) has been shown to improve survival in rats after hemorrhagic shock, but its role in a combined burn/hemorrhage injury is unknown. We hypothesized that DPR would improve survival in mice subjected to combined burn injury and hemorrhage.

Materials and Methods

Male C57/BL6J mice aged 8 weeks were subjected to a 7-second 30% total body surface area scald in a 90°C water bath. Following the scald, mice received DPR with 1.5 mL normal saline or 1.5 mL peritoneal dialysis solution (Delflex). Control mice received no peritoneal solution. Mice underwent a controlled hemorrhage shock via femoral artery cannulation to a systolic blood pressure of 25 mm Hg for 30 minutes. Mice were then resuscitated to a target blood pressure with either lactated Ringer’s (LR) or a 1:1 ratio of packed red blood cells (pRBCs) and fresh frozen plasma (FFP). Mice were observed for 24 hours following injury.

Results

Median survival time for mice with no DPR was 1.47 hours in combination with intravascular LR resuscitation and 2.08 hours with 1:1 pRBC:FFP. Median survival time significantly improved with the addition of intraperitoneal normal saline or Delflex. Mice that received DPR followed by 1:1 pRBC:FFP required less intravascular volume than mice that received DPR with LR, pRBC:FFP alone, and LR alone. Intraperitoneal Delflex was associated with higher levels of tumor necrosis factor alpha and macrophage inflammatory protein 1 alpha and lower levels of interleukin 10 and intestinal fatty acid binding protein. Intraperitoneal normal saline resulted in less lung injury 1 hour postresuscitation, but increased to similar severity of Delflex at 4 hours.

Conclusions

After a combined burn injury and hemorrhage, DPR leads to increased survival in mice. Survival was similar with the use of normal saline or Delflex. DPR with normal saline reduced the inflammatory response seen with Delflex and delayed the progression of acute lung injury. DPR may be a valuable strategy in the treatment of patients with combined burn injury and hemorrhage.
Remeasurement of Solar Observing Optical Network sunspot areas
Authors: Meadows P J
Published: July 2020

The United States Air Force solar observing optical network (SOON) sunspot areas have been reported by several researchers over many years to be underestimated by as much as 50 per cent. Here, the areas of sunspots from scanned SOON disc drawings have been accurately remeasured for a period of two months from 2014 October and November – this being near the peak of Solar Cycle 24 and which includes the largest sunspot group of that cycle. The remeasured sunspot areas are now comparable with areas in sunspot catalogues.
The Theory and Applications of Measuring Broad-Range and Chromosome-Wide Recombination Rate from Allele Frequency Decay around a Selected Locus
Authors: Wei Kevin H -C , Mantha Aditya , Bachtrog Doris
Published: July 2020

Recombination is the exchange of genetic material between homologous chromosomes via physical crossovers. High-throughput sequencing approaches detect crossovers genome wide to produce recombination rate maps but are difficult to scale as they require large numbers of recombinants individually sequenced. We present a simple and scalable pooled-sequencing approach to experimentally infer near chromosome-wide recombination rates by taking advantage of non-Mendelian allele frequency generated from a fitness differential at a locus under selection. As more crossovers decouple the selected locus from distal loci, the distorted allele frequency attenuates distally toward Mendelian and can be used to estimate the genetic distance. Here, we use marker selection to generate distorted allele frequency and theoretically derive the mathematical relationships between allele frequency attenuation, genetic distance, and recombination rate in marker-selected pools. We implemented nonlinear curve-fitting methods that robustly estimate the allele frequency decay from batch sequencing of pooled individuals and derive chromosome-wide genetic distance and recombination rates. Empirically, we show that marker-selected pools closely recapitulate genetic distances inferred from scoring recombinants. Using this method, we generated novel recombination rate maps of three wild-derived strains of Drosophila melanogaster, which strongly correlate with previous measurements. Moreover, we show that this approach can be extended to estimate chromosome-wide crossover interference with reciprocal marker selection and discuss how it can be applied in the absence of visible markers. Altogether, we find that our method is a simple and cost-effective approach to generate chromosome-wide recombination rate maps requiring only one or two libraries.
The Rise of the Parish Welfare State in England,
c
.1600–1800*
Authors: Waddell Brodie
Published: July 2020

The world’s first nationwide, publicly funded welfare system emerged and solidified in England over the course of the seventeenth and eighteenth centuries. Its influence on society and economy during this period was profound, but this article is the first attempt to determine the scale of its impact by examining the amount of money annually spent on relief across the whole period. Drawing on data from 184 widely dispersed parishes over more than two centuries and a new estimate for spending in c.1600, it shows that poor relief experienced alternating phases of rapid expansion, relative stability and occasionally outright retrenchment. Levels of redistribution were pushed higher by both ‘supply’ and ‘demand’ factors. Specifically, trends in relief spending are compared to other indices such as population, economic expansion, central government revenues, labourers’ wages and inflation to show how the growth of poor relief related to wider demographic and economic changes. Such comparisons make it possible to think more clearly about causation: how much of the growth in spending can be attributed to such developments? While law, demography, inflation and other well-attested factors certainly contributed to the rise of this early modern welfare system, the poor themselves may well have played an important role.
Sortase mutants with improved protein thermostability and enzymatic activity obtained by consensus design
Authors: Wójcik Magdalena , Vázquez Torres Susana , Quax Wim J , Boersma Ykelien L
Published: July 2020

Staphylococcus aureus sortase A (SaSrtA) is an enzyme that anchors proteins to the cell surface of Gram-positive bacteria. During the transpeptidation reaction performed by SaSrtA, proteins containing an N-terminal glycine can be covalently linked to another protein with a C-terminal LPXTG motif (X being any amino acid). Since the sortase reaction can be performed in vitro as well, it has found many applications in biotechnology. Although sortase-mediated ligation has many advantages, SaSrtA is limited by its low enzymatic activity and dependence on Ca2+. In our study, we evaluated the thermodynamic stability of the SaSrtA wild type and found the enzyme to be stable. We applied consensus analysis to further improve the enzyme’s stability while at the same time enhancing the enzyme’s activity. As a result, we found thermodynamically improved, more active and Ca2+-independent mutants. We envision that these new variants can be applied in conjugation reactions in low Ca2+ environments.
Obstructive sleep apnea and Alzheimer’s disease-related cerebrospinal fluid biomarkers in mild cognitive impairment
Authors: Díaz-Román Mónica , Pulopulos Matias M , Baquero Miguel , Salvador Alicia , Cuevas Ana , Ferrer Inés , Ciopat Oana , Gómez Enriqueta
Published: July 2020

Previous studies have demonstrated that sleep-breathing disorders, and especially obstructive sleep apnea (OSA), can be observed in patients with a higher risk of progression to Alzheimer’s disease (AD). Recent evidence indicates that cerebrospinal fluid (CSF) AD-biomarkers are associated with OSA. In this study, we investigated these associations in a sample of patients with mild cognitive impairment (MCI), a condition that is considered the first clinical phase of AD, when patients showed biomarkers consistent with AD pathology. A total of 57 patients (mean age = 66.19; SD = 7.13) with MCI were included in the study. An overnight polysomnography recording was used to assess objective sleep parameters (i.e. apnea/hypopnea index [AHI], total sleep time, sleep efficiency, sleep latency, arousal index, awakening, stage 1, 2, and slow-wave sleep and rapid eye movement sleep, periodic limb movement index, O2 saturation during sleep, and percentage of time O2 saturation <90%). Phosphorylated-tau (P-tau), total-tau (T-tau), and amyloid-beta 42 (Aβ42) were measured in CSF. Unadjusted correlation analyses showed that a higher AHI (reflecting higher OSA severity) was related to higher P-tau and T-tau (both results remained significant after Bonferroni correction, p = 0.001). Importantly, these associations were observed even after adjusting for potential confounders (i.e. age, sex, body mass index, sleep medication, smoking, hypertension, and heart disease). Although more research is needed to establish a causal link, our findings provide evidence that OSA could be related to the pathophysiological mechanisms involved in neurodegeneration in MCI patients.
Outcomes at 18 mo of 37 noma (cancrum oris) cases surgically treated at the Noma Children's Hospital, Sokoto, Nigeria
Authors: Farley Elise S , Amirtharajah Mohana , Winters Ryan D , Taiwo Abdurrazaq O , Oyemakinde Modupe J , Fotso Adolphe , Torhee Linda A , Mehta Ushma C , Bil Karla A , Lenglet Annick D
Published: July 2020

Background

Noma is a rapidly progressing infection of the oral cavity frequently resulting in severe facial disfigurement. We present a case series of noma patients surgically treated in northwest Nigeria.

Methods

A retrospective analysis of routinely collected data (demographics, diagnosis and surgical procedures undergone) and in-person follow-up assessments (anthropometry, mouth opening and quality of life measurements) were conducted with patients who had surgery >6 mo prior to data collection.

Results

Of the 37 patients included, 21 (56.8%) were male and 22 (62.9%) were aged >6 y. The median number of months between last surgery and follow-up was 18 (IQR 13, 25) mo. At admission, the most severely affected anatomical area was the outer cheek (n = 9; 36.0% of patients had lost between 26% and 50%). The most frequent surgical procedures were the deltopectoral flap (n = 16; 43.2%) and trismus release (n = 12; 32.4%). For the eight trismus-release patients where mouth opening was documented at admission, all had a mouth opening of 0–20 mm at follow-up. All patients reported that the surgery had improved their quality of life.

Conclusions

Following their last surgical intervention, noma patients do experience some improvements in their quality of life, but debilitating long-term sequelae persist.
Genomic epidemiology and evolutionary dynamics of respiratory syncytial virus group B in Kilifi, Kenya, 2015–17
Authors: Kamau Everlyn , Otieno James R , Murunga Nickson , Oketch John W , Ngoi Joyce M , de Laurent Zaydah R , Mwema Anthony , Nyiro Joyce U , Agoti Charles N , Nokes D James
Published: July 2020

Respiratory syncytial virus (RSV) circulates worldwide, occurring seasonally in communities, and is a leading cause of acute respiratory illness in young children. There is paucity of genomic data from purposively sampled populations by which to investigate evolutionary dynamics and transmission patterns of RSV. Here we present an analysis of 295 RSV group B (RSVB) genomes from Kilifi, coastal Kenya, sampled from individuals seeking outpatient care in nine health facilities across a defined geographical area (∼890 km2), over two RSV epidemics between 2015 and 2017. RSVB diversity was characterized by multiple virus introductions into the area and co-circulation of distinct genetic clusters, which transmitted and diversified locally with varying frequency. Increase in relative genetic diversity paralleled seasonal virus incidence. Importantly, we identified a cluster of viruses that emerged in the 2016/17 epidemic, carrying distinct amino-acid signatures including a novel nonsynonymous change (K68Q) in antigenic site ∅ in the Fusion protein. RSVB diversity was additionally marked by signature nonsynonymous substitutions that were unique to particular genomic clusters, some under diversifying selection. Our findings provide insights into recent evolutionary and epidemiological behaviors of RSVB, and highlight possible emergence of a novel antigenic variant, which has implications on current prophylactic strategies in development.
Survey and Identification of Date Palm Pathogens and Indigenous Biocontrol Agents
Authors: Nishad Resna , Ahmed Talaat A.
Published: July 2020

Fungal diseases are considered a major threat to plant growth and productivity. However, some beneficial fungi growing in the same environment protect plants from various pathogens, either by secreting antifungal metabolites or by stimulating the host immune defense mechanism. Date palms are susceptible to several fungal pathogens. Nevertheless, information on the pathogenic fungal distribution in date palm fields across different seasons is limited, especially that from Qatar. Therefore, the current study’s aim was to evaluate the pathogenic and beneficial fungal diversity and distribution, including the endophytic fungi from the date palm tissues and root-associated soil fungi, during different seasons, for the identification of indigenous biocontrol agents. Our results showed that the highest number of fungal species was isolated in fall and spring, and pathogenic fungi were isolated mainly in spring. This is the first report that in Qatar, Neodeightonia phoenicum and Thielaviopsis punctulata cause date palm root rot disease, Fusarium brachygibbosum and Fusarium equiseti cause date palm wilting, and N. phoenicum causes diplodia disease in date palm offshoots. The combinations of the fungi that did not frequently occur together in date palm rhizosphere soil were investigated to identify indigenous biocontrol agents. Based on the results, we determined that Trichoderma harzianum and Trichoderma longibrachiatum are effective antagonistic fungi against T. punctulata, N. phoenicum, F. brachygibbosum, and Fusarium solani, qualifying them as potential biocontrol agents. Antagonistic activity of endophytic fungi against the pathogens was tested; except for Ulocladium chartarum, no endophytic fungi showed antagonistic activity against the tested pathogens.

[Formula: see text] Copyright © 2020 The Author(s). This is an open access article distributed under the CC BY 4.0 International license .
The Use of Physical Therapy ICU Assessments to Predict Discharge Home
Authors: Tymkew Heidi , Norris Traci , Arroyo Cassandra , Schallom Marilyn
Published: July 2020

Objectives:

To establish cutoff values for making recommendations for discharge to the home setting using standardized physical therapy assessments.

Design:

Retrospective study.

Setting:

Five ICUs at a large academic medical center.

Patients:

1,203 ICU patients.

Intervention:

None.

Measurements and Main Results:

The Functional Status Score for the ICU and the ICU Mobility Scale were collected during the initial physical therapy assessment, at ICU discharge, and prior to hospital discharge. The Activity Measure for Post-Acute Care—Inpatient Mobility Short Form “6 clicks” was only collected during the initial physical therapy assessment. Receiver Operating Characteristic curves were used to determine a potential cutoff value for discharge home. The Receiver Operating Characteristic was adjusted for ICU and hospital length of stay along with mobility status prior to hospital admission. Cutoff values were then determined by using Youden’s Index. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated based on these cut off values. The Functional Status Score for the ICU at ICU discharge was the best predictor of a discharge to the home setting in patients who had an ICU admission. The area under the curve for the Functional Status Score for the ICU at ICU discharge was 0.80. A Functional Status Score for the ICU score at ICU discharge of 19 or higher predicted discharge to home with a sensitivity of 82.9% and specificity of 73.6%

Conclusions:

The Functional Status Score for the ICU at ICU discharge provided the best accuracy for making a timely recommendation for discharge home in patients who had an ICU admission.
Patient-Reported Outcome Measures in Colon and Rectal Surgery: A Systematic Review and Quality Assessment
Authors: Hawkins Alexander T. , Rothman Russell L. , Geiger Timothy M. , Canedo Juan R. , Edwards-Hollingsworth Kamren , LaNeve David C. , Penson David F.
Published: July 2020

BACKGROUND:

There is growing interest in using patient-reported outcome measures to support value-based care in colorectal surgery. To draw valid conclusions regarding patient-reported outcomes data, measures with robust measurement properties are required.

OBJECTIVE:

The purpose of this study was to assess the use and quality of patient-reported outcome measures in colorectal surgery.

DATA SOURCES:

Three major databases were searched for studies using patient-reported outcome measures in the context of colorectal surgery.

STUDY SELECTION:

Articles that used patient-reported outcome measures as outcome for colorectal surgical intervention in a comparative effectiveness analysis were included. Exclusion criteria included articles older than 11 years, non-English language, age <18 years, fewer than 40 patients, case reports, review articles, and studies without comparison.

MAIN OUTCOME MEASURES:

This was a quality assessment using a previously reported checklist of psychometric properties.

RESULTS:

From 2007 to 2018, 368 studies were deemed to meet inclusion criteria. These studies used 165 distinct patient-reported outcome measures. Thirty were used 5 or more times and were selected for quality assessment. Overall, the measures were generally high quality, with 21 (70%) scoring ≥14 on an 18-point scale. Notable weaknesses included management of missing data (14%) and description of literacy level (0%).

LIMITATIONS:

The study was limited by its use of original articles for quality assessment. Measures were selected for quality analysis based on frequency of use rather than other factors, such as impact of the article or number of patients in the study.

CONCLUSIONS:

Patient-reported outcome measures are widely used in colorectal research. There was a wide range of measures available, and many were used only once. The most frequently used measures are generally high quality, but a majority lack details on how to deal with missing data and information on literacy levels. As the use of patient-reported outcome measures to assess colorectal surgical intervention increases, researchers and practitioners need to become more knowledgeable about the measures available and their quality.
What do Spanish men know about menopause?
Authors: Fasero Maria , Mainar Laura B. , Campo Leyre R. , Delgado David Varillas , Coronado Pluvio J.
Published: July 2020

Objective:

The aim of this study is to evaluate the level of knowledge men have about menopause and to analyze whether sociodemographic aspects influence this knowledge.

Methods:

A total of 560 consecutive surveys were collected during 2019. Surveys were completed by men anonymously, voluntarily, and without incentives. A maximum score of 45 points was considered for the knowledge analysis.

Results:

The mean age was 49.13 ± 11.1 years. The most frequent source of information to obtain knowledge about menopause was friends (61.4%). The mean of the questionnaire score was 20.69 ± 6.1 (R: 0-45). The most frequent symptoms associated with menopause were hot flashes and vaginal dryness (93.7%; 48%) and the best-known treatment to improve vaginal health was lubricants at 69.5%. The most common treatment men knew for improving menopause symptoms was menopause hormone treatment; however, 27.9% of men thought there is no treatment for menopause. Differences were found between ages in numbers and grades (P = 0.032). Men with a higher level of education had significantly more knowledge than those with primary school education (P = 0.016). Differences were shown in men who obtained information from healthcare staff with respect to other sources (P < 0.001).

Conclusions:

The level of knowledge in men in this sample is limited. Differences were found between ages, level of education, and sources of information. No differences were found between public and private hospitals. Teaching of this knowledge should be carried out by trained personnel, preferably healthcare staff.
Simple Bimanual Technique of Internal Limiting Membrane Retrieval
Authors: Agarwal Pulak , Venkatesh Pradeep , Kumar Vinod
Published: July 2020

Purpose:

To describe a novel technique of internal limiting membrane retrieval.

Methods:

A 25-gauge vitrectomy was performed in all patients. After internal limiting membrane (ILM) peeling (after brilliant blue dye staining), the ILM was held with the forceps in the midvitreous cavity and a 25-gauge cannula mounted on a 2 mL of balanced salt solution–filled syringe was introduced. When the tip of the cannula made contact with the ILM, mild suction was applied, and the ILM was retrieved in the syringe.

Results:

Internal limiting membrane retrieval was successful in the all the patients attempted.

Conclusion:

To conclude, bimanual technique of membranous tissue removal using a soft tip cannula under direct visualization is a safe and efficient technique that makes membrane retrieval a predictable process.
The Efficacy and Safety of Hemospray for the Management of Gastrointestinal Bleeding
Authors: Ofosu Andrew , Ramai Daryl , John Febin , Mohan Babu P. , Dhindsa Banreet , Antoine Gaelle , Hajiyeva Gulara , Alatevi Eric M. , Ofori Emmanuel , Dhaliwal Amaninder S. , Gaduputi Vinaya , Gurram Krishna C. , Reddy Madhavi , McDonough Stephanie , Adler Douglas G.
Published: July 2020

Goals/Background:

Hemospray is a new hemostatic powder recently approved for endoscopic hemostasis in gastrointestinal (GI) bleeding. Data are limited in terms of its clinical outcomes, and its role in the treatment algorithm of GI bleeds. We conducted a systematic review and meta-analysis to study the clinical performance of Hemospray in the management of GI bleeding.

Study:

We searched multiple databases from inception through March 2019 to identify studies that reported on the clinical outcomes of Hemospray in GI bleeding. The primary outcome was pooled rates of clinical success after the application of Hemospray in GI bleeding. The secondary outcomes were pooled rebleeding rates and adverse events after use of Hemospray.

Results:

A total of 19 studies, 814 patients, of which 212 patients were treated with Hemospray as monotherapy, and 602 patients were treated with Hemospray with conventional hemostatic techniques. Overall pooled clinical success after the application of Hemospray was 92% [95% confidence interval (95% CI), 87%-96%; I
2=70.4%]. Overall pooled early rebleeding rates after application of Hemospray was 20% (95% CI, 16%-26%; I
2=54%). Overall pooled delayed rebleeding rates after the application of Hemospray was 23% (95% CI, 16%-31%; I
2=34.9%). There was no statistical difference in clinical success (RR, 1.02; 95% CI, 0.96-1.08; P=0.34) and early rebleeding (RR, 0.89; 95% CI, 0.75-1.07; P=0.214) in studies that compared the use of Hemospray as monotherapy versus combination therapy with conventional therapy.

Conclusions:

Hemospray is highly effective in achieving immediate hemostasis in gastrointestinal bleeding. However, due to significantly high rebleeding rates, Hemospray is not suited for definitive long-term therapy.
Early Performance of Hospital Value-based Purchasing Program in Medicare
Authors: Hong Young-Rock , Nguyen Oliver , Yadav Sandhya , Etzold Emma , Song Jihee , Duncan R. Paul , Turner Kea
Published: July 2020

Background:

Under the Affordable Care Act, the Centers for Medicare and Medicaid Services has greatly expanded inpatient fee-for-value programs including the Hospital Value-based Purchasing (HVBP) program. Existing evidence from the HVBP program is mixed. There is a need for a systematic review of the HVBP program to inform discussions on how to improve the program’s effectiveness.

Objective:

To review and summarize studies that evaluated the HVBP program’s impact on clinical processes, patient satisfaction, costs and outcomes, or assessed hospital characteristics associated with performance on the program.

Design:

We searched the MEDLINE/PubMed, Scopus, ProQuest database for literature published between January 2013 and July 2019 using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.

Results:

Of 988 studies reviewed, 33 studies that met the selection criteria were included. A small group of studies (n=7) evaluated the impact of the HVBP program, and no impact on processes or patient outcomes was reported. None of the included studies evaluated the effect of HVBP program on health care costs. Other studies (n=28) evaluated the hospital characteristics associated with HVBP performance, suggesting that safety-net hospitals reportedly performed worse on several quality and cost measures. Other hospital characteristics’ associations with performance were unclear.

Conclusions:

Our findings suggest that the current HVBP does not lead to meaningful improvements in quality of care or patient outcomes and may negatively affect safety-net hospitals. More rigorous and comprehensive adjustment is needed for more valid hospital comparisons.
Fetal surgery and neonatal ICU admissions
Authors: Vaughn Alyssa , Reynolds Regina , Zenge Jeanne , Marwan Ahmed I.
Published: July 2020

Purpose of review

Fetal intervention is a dynamic field with wide-reaching implications on neonatal ICU admissions and the care of neonates with congenital anomalies. The aim of this review is to summarize recent advancements in fetal surgery and provide a broad understanding of how these topics interrelate.

Recent findings

Advancements in prenatal imaging and diagnosis have dramatically expanded the indications for fetal intervention. Most recently, there has been a large focus on evaluating minimally invasive strategies of fetal intervention, notably fetoscopic surgery, and the use of stem cells for fetal treatment of myelomeningocele. With the advances in fetal intervention, neonatal care has adapted to the needs of these various patients to help improve the outcomes of this unique population.

Fetal intevention relies on a multidisciplinary team from prenatal imaging and maternal fetal medicine to fetal surgery and postnatal subspecialty care, particuarly neonatology. Fetal intervention uniquely involves two patients, both mother and fetus, and therefore, has unique risks and considerations, particularly in the advancement of the field. As the number of conditions suited to fetal intervention grows, awareness and advancement of the postnatal intensive care necessary for these patients are essential.
Long-acting reversible contraception side effect management
Authors: Edwards Alexandra J. , DiVasta Amy D. , Pitts Sarah
Published: July 2020

Purpose of review

Long-acting reversible contraception (LARC) is increasingly used by adolescents and young adults (AYAs). Subsequent to LARC insertion, AYAs are presenting to their primary care providers with LARC concerns. This article seeks to equip primary care clinicians with the tools necessary to assess and manage common LARC-associated side effects.

Recent findings

Side effects are common with progestin-only LARC, and can precipitate early discontinuation of an otherwise effective, low-maintenance form of contraception. Abnormal uterine bleeding, pelvic pain, acne, and weight change are often cited as progestin-only LARC side effects, yet the causes are poorly understood despite extensive research. While most side effects improve with time, therapeutic interventions are available for patients with undesirable side effects that prefer medical management. Research emphasizes the importance of proper patient counseling and clinical follow-up.

Counseling remains essential in the management of LARC-associated side effects. However, options are available to temporarily mitigate such side effects and increase LARC satisfaction. While these therapeutic options are prescribed based on expert opinion, such regimens remain inadequately studied in AYA populations.
HIV and organ transplantation
Authors: Lee Ingi , Blumberg Emily
Published: July 2020

Purpose of review

This review summarizes the advances that have occurred over the past 2 years in organ transplantation in the setting of HIV.

Recent findings

Although HIV+ organ transplantation is both safe and effective, recent studies show that HIV+ patients continue to experience barriers to transplantation. In the United States, the HOPE Act is not only expected to increase the donor pool for HIV+ transplant candidates, but to also allow for the use of donors with false-positive HIV+ tests, which had previously been banned under the US National Organ Transplant Act. More effective HCV treatment, increased experience with heart and lung transplantation and the potential for increased organ availability with the inclusion of HIV+ organ donors have provided for significant advances in the care of these patients.

There continues to be progress in the field of organ transplantation in persons living with HIV. Future efforts should continue aiming to limit barriers to transplantation and improving the understanding of immunologic derangements seen in transplant recipients with HIV infection.
Brief Report: Using Behavioral Economics to Increase HIV Knowledge and Testing Among Latinx Sexual Minority Men and Transgender Women: A Quasi-Experimental Pilot Study
Authors: MacCarthy Sarah , Wagner Zachary , Barreras Joanna L. , Kim Alice , Menodza-Graf Alexandra C. , Giguere Rebecca , Carballo-Dieguez Alex , Linnemayr Sebastian
Published: July 2020

Objective:

To determine how weekly text messages and small incentives impact HIV knowledge and frequency of HIV testing among Latinx sexual minority men (LSMM) and transgender women (LTGW).

Design:

Prospectively randomized participants into 2 intervention arms compared with a nonrandomized comparison group.

Setting:

Bienestar, a primarily Latinx focused HIV service provider located across Los Angeles County.

Subjects, Participants:

Two hundred eighteen participants self-identifying as LSMM or LTGW, HIV negative, having regular mobile phone access, ≥18 years, and fluent in English or Spanish.

Intervention:

The “information only” (IO) group received text messages with HIV prevention information. The “information plus” (IP) group additionally could win incentives by answering weekly quiz questions correctly and testing for HIV once every 3 months. We followed participants for 12 months.

Main Outcome Measure(s):

HIV knowledge and frequency of HIV testing.

Results:

We found no effect on HIV knowledge in the IO group but a statistically significant improvement in the IP group (79.2%–88.1%; P = 0.007). The frequency of HIV testing was higher in both intervention groups relative to the comparison group: On average, 22.0% of IO participants and 24.9% of IP participants tested at a Bienestar site within a given 3-month period, compared with 13.0% in the comparison group. This represents unadjusted relative risk ratios of 1.69 for the IO group (95% CI: 1.25 to 2.1; P < 0.01) and 1.91 for the IP group (95% CI: 1.51 to 2.31; P < 0.01), respectively.

Conclusions:

This study demonstrates that a simple, low-cost intervention may help increase HIV testing frequency among LSMM and LTGW, 2 groups at high HIV risk.