bluuebunny/crossref_metadata_2025 huggingface dataset:
Lethal Effects of a Commercial Diatomaceous Earth Dust Product on Amblyomma americanum (Ixodida: Ixodidae) Larvae and Nymphs
Authors: Showler Allan T , Flores Nicole , Caesar Ryan M , Mitchel Robert D , Perez De León Adalberto A
Published: April 2020

With increasing development of resistance to conventional synthetic acaricides in economically and medically important ixodid species, interest in finding alternative control tactics has intensified. Laboratory bioassays were conducted, using the lone star tick, Amblyomma americanum (L.), as a model species, to assess the efficacy of a diatomaceous earth-based product, Deadzone, in comparison with a silica gel-based product, CimeXa. CimeXa is already known to be highly lethal against A. americanum larvae and nymphs. The two dust treatments were 100% effective against larvae and nymphs within 24 h after contact occurred by immersion in dry dusts and after crawling across a surface treated with the dry dusts. Contact by crawling on a dried aqueous film of the dusts, even at a concentration of 10%, was not as effective as exposure to the dusts in dry powder form. As has been demonstrated with CimeXa, it is likely that Deadzone will be capable of providing prophylactic protection of cattle from economically important one-host ixodids, such as the southern cattle fever tick, Rhipicephalus microplus (Canestrini), which vectors the causal agents of babesiosis. Diatomaceous earth can be stored indefinitely, will remain efficacious for as long as sufficient quantities remain on the substrate, it is a natural (organic) substance, and it might be amenable for limited use in environmentally protected habitats.
Summary From the First Kidney Cancer Research Summit, September 12–13, 2019: A Focus on Translational Research
Authors: Choueiri Toni K , Atkins Michael B , Bakouny Ziad , Carlo Maria I , Drake Charles G , Jonasch Eric , Kapur Payal , Lewis Bryan , Linehan W Marston , Mitchell Michael J , Pal Sumanta K , Pels Kevin , Poteat Susan , Rathmell W Kimryn , Rini Brian I , Signoretti Sabina , Tannir Nizar , Uzzo Robert , Wood Christopher G , Hammers Hans J
Published: April 2020

Kidney cancer is one of the 10 most common cancers both in the United States and worldwide. Until this year, there had not previously been a conference focused on translational studies in the broad and heterogeneous group of kidney cancers. Therefore, a group of researchers, clinicians, and patient advocates dedicated to renal cell carcinoma launched the Kidney Cancer Research Summit (KCRS) to spur collaboration and further therapeutic advances in these tumors. This commentary aims to summarize the oral presentations and serve as a record for future iterations of this meeting. The KCRS sessions addressed the tumor microenvironment, novel methods of drug delivery, single cell sequencing strategies, novel immune checkpoint blockade and cellular therapies, predictive biomarkers, and rare variants of kidney cancers. In addition, the meeting included 2 sessions to promote scientific mentoring and kidney cancer research collaborations. A subsequent KCRS will be planned for the fall of 2020.
Importance of starting points in heterogeneous environments: interactions between two clonal plants with contrasting spatial architectures
Authors: Xue Wei , Huang Lin , Yu Fei-Hai
Published: April 2020

Aims

Plants can benefit from heterogeneous environments via disproportionately increasing resource harvesting in resource-rich patches. Their initial growing positions with respect to resource patches may thus have important influences on their performance and relative competitive ability. Such impacts may differ between species with contrasting spatial architectures. However, the potential influence of initial growing positions in heterogeneous environment on plant growth and competition has largely been ignored.

Methods

We grew the phalanx plant Carex neurocarpa and the guerrilla plant Bolboschoenus planiculmis alone or in competition in a heterogeneous environment consisting of high- and low-nutrient soil patches. In treatments without competition, one ramet of each species was grown in either a high- or a low-nutrient patch in the heterogeneous environment. In treatments with competition, a ramet of the target species was grown in either a high- or a low-nutrient patch, and a ramet of the competitor species was grown in the same patch as the target species or an adjacent patch with a different nutrient level.

Important Findings

Without competition C. neurocarpa produced more biomass and ramets when initially grown in a high-nutrient patch than when initially grown in a low-nutrient patch. With competition, these differences disappeared. Consequently, competitive intensity on C. neurocarpa was higher when it initially grew in a high-nutrient patch than when it initially grew in a low-nutrient patch. These impacts were independent of the initial position of its competitor. By contrast, the initial positions of B. planiculmis did not influence its growth or competitive response. Therefore, in heterogeneous environments, initial growing positions of clonal plants may influence their performance in competition-free environments and may also affect their relative competitive ability, and these effects may depend on spatial architecture of the plants.
Different Kinds of Silence: Revisions of Villette and the ‘Reader’s Romance’
Authors: Hanks Lucy
Published: April 2020

This article presents an alternative reading of Lucy Snowe’s silences in Charlotte Brontë’s Villette. Instead of interpreting silence as submission or antagonistic ‘evasions’, I suggest that it operates as a productive mode. This is emphasized by Brontë’s markings and excisions on the fair copy manuscript. Revisions render parts of the text intentionally ambiguous; I provide extended close readings of the manuscript that demonstrate how Lucy Snowe makes the fact that she has withheld something explicit to the reader. Villette draws attention to its own composition and reception to such an extent that it is the very act of non-narration – and the way it engages the reader – that produces meaning. Approaching this through the lens of the romance plot addresses some of the overtly unnarratable aspects of female selfhood in the mid-nineteenth century. As a female autobiographer, Lucy Snowe makes her struggle to express her sexuality explicit. Brontë crafts this self-reflexivity to form a relationship with the reader that is akin to Bakhtin’s description of the ‘activating reader’. It is only the act of reading, he suggests, that makes discourse possible. However, revisions show how Brontë attempts to influence the types of meaning that are gleaned by the reader; the ‘reader’s romance’ clarifies how she suggestively places the onus on the reader to resolve their expectations about the narrative’s events for themselves. This narrative mode allows the protagonist to reclaim power and use the very means of her oppression as a mode of meaning production.
PaACL silencing accelerates flower senescence and changes the proteome to maintain metabolic homeostasis in Petunia hybrida
Authors: Zhao Huina , Zhong Shiwei , Sang Lina , Zhang Xinyou , Chen Zeyu , Wei’s Qian , Chen Guoju , Liu Juanxu , Yu Yixun
Published: April 2020

Cytosolic acetyl-CoA is an intermediate of the synthesis of most secondary metabolites and the source of acetyl for protein acetylation. The formation of cytosolic acetyl-CoA from citrate is catalysed by ATP-citrate lyase (ACL). However, the function of ACL in global metabolite synthesis and global protein acetylation is not well known. Here, four genes, PaACLA1, PaACLA2, PaACLB1, and PaACLB2, which encode the ACLA and ACLB subunits of ACL in Petunia axillaris, were identified as the same sequences in Petunia hybrida ‘Ultra’. Silencing of PaACLA1-A2 and PaACLB1-B2 led to abnormal leaf and flower development, reduced total anthocyanin content, and accelerated flower senescence in petunia ‘Ultra’. Metabolome and acetylome analysis revealed that PaACLB1-B2 silencing increased the content of many downstream metabolites of acetyl-CoA metabolism and the levels of acetylation of many proteins in petunia corollas. Mechanistically, the metabolic stress induced by reduction of acetyl-CoA in PaACL-silenced petunia corollas caused global and specific changes in the transcriptome, the proteome, and the acetylome, with the effect of maintaining metabolic homeostasis. In addition, the global proteome and acetylome were negatively correlated under acetyl-CoA deficiency. Together, our results suggest that ACL acts as an important metabolic regulator that maintains metabolic homeostasis by promoting changes in the transcriptome, proteome. and acetylome.
Verification of 20 Mathematical Formulas for Discriminating Between Iron Deficiency Anemia and Thalassemia Trait in Microcytic Anemia
Authors: Hoffmann Johannes J M L , Urrechaga Eloísa
Published: April 2020

Background

Currently, more than 45 mathematical formulas based on simple red blood cell (RBC) parameters have been proposed for differentiating between iron deficiency and thalassemia in microcytic anemia, of which 20 are relatively new and have not been thoroughly independently verified. The study goal was to verify these 20 new formulas and to identify which RBC parameters have a decisive impact on the performance of those formulas.

Methods

A database containing laboratory and diagnostic data from 2788 subject individuals with microcytic anemia was used for assessing performance by receiver operating characteristic (ROC) analysis.

Results

The new Index26 had excellent performance, equivalent to the Green and King, Jayabose, and Janel formulas previously identified in the literature. The discriminant power of nearly all newer formulas was lower in our study than that claimed by the original authors. We discovered that a well-performing formula requires mean cell volume (MCV), RBC distribution width (RDW), and RBC measurements, whereas hemoglobin measurements appeared not to be essential.

Conclusions

Only the new Index26 performed at a level comparable to the very strongest established formulas. All other new formulas had lower performance than was claimed in the original publications, underscoring that independent verification of new formulas is indispensable.
K2 Ultracool Dwarfs Survey – VI. White light superflares observed on an L5 dwarf and flare rates of L dwarfs
Authors: Paudel R R , Gizis J E , Mullan D J , Schmidt S J , Burgasser A J , Williams P K G
Published: April 2020

$Kepler\, K2$ long cadence data are used to study white light flares in a sample of 45 L dwarfs. We identified 11 flares on 9 L dwarfs with equivalent durations of (1.3–198) h and total (UV/optical/IR) energies of ≥0.9 × 1032 erg. Two superflares with energies of >1033 erg were detected on an L5 dwarf (VVV BD001): this is the coolest object so far on which flares have been identified. The larger superflare on this L5 dwarf has an energy of 4.6 × 1034 erg and an amplitude of >300 times the photospheric level: so far, this is the largest amplitude flare detected by the Kepler/K2 mission. The next coolest star on which we identified a flare was an L2 dwarf: 2MASS J08585891+1804463. Combining the energies of all the flares which we have identified on 9 L dwarfs with the total observation time which was dedicated by Kepler to all 45 L dwarfs, we construct a composite flare frequency distribution (FFD). The FFD slope is quite shallow (−0.51 ± 0.17), consistent with earlier results reported by Paudel et al. for one particular L0 dwarf, for which the FFD slope was found to be −0.34. Using the composite FFD, we predict that, in early- and mid-L dwarfs, a superflare of energy 1033 erg occurs every 2.4 yr and a superflare of energy 1034 erg occurs every 7.9 yr. Analysis of our L dwarf flares suggests that magnetic fields of ≥0.13–1.3 kG are present on the stellar surface: such fields could suppress Type II radio bursts.
A joint SZ–X-ray–optical analysis of the dynamical state of 288 massive galaxy clusters
Authors: Zenteno A , Hernández-Lang D , Klein M , Vergara Cervantes C , Hollowood D L , Bhargava S , Palmese A , Strazzullo V , Romer A K , Mohr J J , Jeltema T , Saro A , Lidman C , Gruen D , Ojeda V , Katzenberger A , Aguena M , Allam S , Avila S , Bayliss M , Bertin E , Brooks D , Buckley-Geer E , Burke D L , Capasso R , Carnero Rosell A , Carrasco Kind M , Carretero J , Castander F J , Costanzi M , da Costa L N , De Vicente J , Desai S , Diehl H T , Doel P , Eifler T F , Evrard A E , Flaugher B , Floyd B , Fosalba P , Frieman J , García-Bellido J , Gerdes D W , Gonzalez J R , Gruendl R A , Gschwend J , Gutierrez G , Hartley W G , Hinton S R , Honscheid K , James D J , Kuehn K , Lahav O , Lima M , McDonald M , Maia M A G , March M , Melchior P , Menanteau F , Miquel R , Ogando R L C , Paz-Chinchón F , Plazas A A , Roodman A , Rykoff E S , Sanchez E , Scarpine V , Schubnell M , Serrano S , Sevilla-Noarbe I , Smith M , Soares-Santos M , Suchyta E , Swanson M E C , Tarle G , Thomas D , Varga T N , Walker A R , Wilkinson R D ,   (DES Collaboration)
Published: April 2020

We use imaging from the first three years of the Dark Energy Survey to characterize the dynamical state of 288 galaxy clusters at 0.1 ≲ z ≲ 0.9 detected in the South Pole Telescope (SPT) Sunyaev–Zeldovich (SZ) effect survey (SPT-SZ). We examine spatial offsets between the position of the brightest cluster galaxy (BCG) and the centre of the gas distribution as traced by the SPT-SZ centroid and by the X-ray centroid/peak position from Chandra and XMM data. We show that the radial distribution of offsets provides no evidence that SPT SZ-selected cluster samples include a higher fraction of mergers than X-ray-selected cluster samples. We use the offsets to classify the dynamical state of the clusters, selecting the 43 most disturbed clusters, with half of those at z ≳ 0.5, a region seldom explored previously. We find that Schechter function fits to the galaxy population in disturbed clusters and relaxed clusters differ at z > 0.55 but not at lower redshifts. Disturbed clusters at z > 0.55 have steeper faint-end slopes and brighter characteristic magnitudes. Within the same redshift range, we find that the BCGs in relaxed clusters tend to be brighter than the BCGs in disturbed samples, while in agreement in the lower redshift bin. Possible explanations includes a higher merger rate, and a more efficient dynamical friction at high redshift. The red-sequence population is less affected by the cluster dynamical state than the general galaxy population.
MetaPhOrs 2.0: integrative, phylogeny-based inference of orthology and paralogy across the tree of life
Authors: Chorostecki Uciel , Molina Manuel , Pryszcz Leszek P , Gabaldón Toni
Published: April 2020

Inferring homology relationships across genes in different species is a central task in comparative genomics. Therefore, a large number of resources and methods have been developed over the years. Some public databases include phylogenetic trees of homologous gene families which can be used to further differentiate homology relationships into orthology and paralogy. MetaPhOrs is a web server that integrates phylogenetic information from different sources to provide orthology and paralogy relationships based on a common phylogeny-based predictive algorithm and associated with a consistency-based confidence score. Here we describe the latest version of the web server which includes major new implementations and provides orthology and paralogy relationships derived from ∼8.2 million gene family trees—from 13 different source repositories across ∼4000 species with sequenced genomes. MetaPhOrs server is freely available, without registration, at http://orthology.phylomedb.org/
DNA flowerstructure co-localizes with human pathogens in infected macrophages
Authors: Franch Oskar , Gutiérrez-Corbo Camino , Domínguez-Asenjo Bárbara , Boesen Thomas , Jensen Pia Bomholt , Nejsum Lene N , Keller Josephine Geertsen , Nielsen Simon Pagaard , Singh Prakruti R , Jha Rajiv Kumar , Nagaraja Valakunja , Balaña-Fouce Rafael , Ho Yi-Ping , Reguera Rosa María , Knudsen Birgitta Ruth
Published: April 2020

Herein, we characterize the cellular uptake of a DNA structure generated by rolling circle DNA amplification. The structure, termed nanoflower, was fluorescently labeled by incorporation of ATTO488-dUTP allowing the intracellular localization to be followed. The nanoflower had a hydrodynamic diameter of approximately 300 nanometer and was non-toxic for all mammalian cell lines tested. It was internalized specifically by mammalian macrophages by phagocytosis within a few hours resulting in specific compartmentalization in phagolysosomes. Maximum uptake was observed after eight hours and the nanoflower remained stable in the phagolysosomes with a half-life of 12 h. Interestingly, the nanoflower co-localized with both Mycobacterium tuberculosis and Leishmania infantum within infected macrophages although these pathogens escape lysosomal degradation by affecting the phagocytotic pathway in very different manners. These results suggest an intriguing and overlooked potential application of DNA structures in targeted treatment of infectious diseases such as tuberculosis and leishmaniasis that are caused by pathogens that escape the human immune system by modifying macrophage biology.
CausalMGM: an interactive web-based causal discovery tool
Authors: Ge Xiaoyu , Raghu Vineet K , Chrysanthis Panos K , Benos Panayiotis V
Published: April 2020

High-throughput sequencing and the availability of large online data repositories (e.g. The Cancer Genome Atlas and Trans-Omics for Precision Medicine) have the potential to revolutionize systems biology by enabling researchers to study interactions between data from different modalities (i.e. genetic, genomic, clinical, behavioral, etc.). Currently, data mining and statistical approaches are confined to identifying correlates in these datasets, but researchers are often interested in identifying cause-and-effect relationships. Causal discovery methods were developed to infer such cause-and-effect relationships from observational data. Though these algorithms have had demonstrated successes in several biomedical applications, they are difficult to use for non-experts. So, there is a need for web-based tools to make causal discovery methods accessible. Here, we present CausalMGM (http://causalmgm.org/), the first web-based causal discovery tool that enables researchers to find cause-and-effect relationships from observational data. Web-based CausalMGM consists of three data analysis tools: (i) feature selection and clustering; (ii) automated identification of cause-and-effect relationships via a graphical model; and (iii) interactive visualization of the learned causal (directed) graph. We demonstrate how CausalMGM enables an end-to-end exploratory analysis of biomedical datasets, giving researchers a clearer picture of its capabilities.
Neurologically Devastating Intraparenchymal Hemorrhage in COVID-19 Patients on Extracorporeal Membrane Oxygenation: A Case Series
Authors: Heman-Ackah Sabrina M , Su YouRong Sophie , Spadola Michael , Petrov Dmitriy , Chen H Isaac , Schuster James , Lucas Timothy
Published: April 2020

BACKGROUND AND IMPORTANCE

Extracorporeal membrane oxygenation (ECMO) represents a life-saving therapy in cases of refractory hypoxia and has been utilized in patients suffering from the most severe forms of coronavirus disease 2019 (COVID-19). A strikingly high mortality rate of 94% was described in early reports of patients with COVID-19 transitioned to ECMO. Later case reports and series demonstrating successful recovery from COVID-19 after ECMO have revived interest in this therapeutic modality, including the recent approval of ECMO for COVID-19 patients by the Food and Drug Administration (FDA). Here, we present the first reports of devastating intracranial hemorrhage as a complication of veno-venous (VV) ECMO in two COVID-19 patients.

CLINICAL PRESENTATION

We performed a retrospective analysis of 2 cases of devastating intracranial hemorrhage in patients on VV-ECMO for the treatment of COVID-19. Collected data included clinical history, laboratory results, treatment, and review of all available imaging. Both patients demonstrated activated partial thromboplastin times (aPTT) within an appropriate therapeutic range. No risk factors that clearly predicted likelihood of this complication were identified.

CONCLUSION

Understanding the complications of ECMO in this cohort and developing therapeutic algorithms to aid in optimal patient selection will be critical in the limited resource setting experienced as a result of global pandemic. We propose the use of head computed tomography (CT) to identify devastating neurological complications as early as possible, aiding in the resource allocation of ECMO machines to the most appropriately selected patients.
Smoking, Smoking Cessation, and Progression of Chronic Kidney Disease: Results From KNOW-CKD Study
Authors: Lee Sangmi , Kang Shinchan , Joo Young Su , Lee Changhyun , Nam Ki Heon , Yun Hae-Ryong , Park Jung Tak , Chang Tae Ik , Yoo Tae-Hyun , Kim Soo Wan , Oh Kook-Hwan , Kim Yeong Hoon , Park Sue K , Kang Shin-Wook , Choi Kyu Hun , Ahn Curie , Han Seung Hyeok
Published: April 2020

Introduction

In patients with chronic kidney disease (CKD), studies investigating the association between smoking and deterioration of kidney function are scarce.

Aims and Methods

We analyzed data for 1,951 patients with an estimated glomerular filtration rate (eGFR) ≥15 mL/min/1.73 m2 enrolled in the KoreaN cohort study for Outcome in patients With Chronic Kidney Disease (KNOW-CKD) from 2011 to 2016. Patients were categorized by smoking load. Primary outcome was a composite of a ≥50% reduction in eGFR, initiation of dialysis, or kidney transplantation.

Results

There were 967 never-smokers and 369, 276, and 339 smokers who smoked <15, 15 to 29, ≥30 pack-years, respectively. During a mean follow-up of 3.0 years, the incidence rates (95% confidence interval [CI]) of the primary outcome were 54.3 (46.4–63.5), 46.9 (35.9–61.4), 69.2 (52.9–90.6), and 76.3 (60.7–96.0) events per 1,000 person-yr in never-, <15, 15 to 29, and ≥30 pack-year smokers. In cause-specific hazard model after adjustment of confounding factors, smokers were associated with 1.09 (0.73–1.63), 1.48 (1.00–2.18), and 1.94 (1.35–2.77) fold increased risk (95% CI) of primary outcome in <15, 15–29, and ≥30 pack-year smokers compared with never-smokers. The association of longer smoking duration with higher risk of CKD progression was evident particularly in patients with eGFR < 45 mL/min/1.73 m2 and proteinuria ≥ 1.0 g/g. In contrast, the risk of adverse kidney outcome decreased with longer smoking-free periods among former-smokers.

Conclusions

These findings suggest potentially harmful effects of the degree of exposure to smoking on the progression of CKD.

Implications

Among patients with CKD, there has been lack of studies on the association between smoking and CKD progression and studies to date have yielded conflicting results. In this prospective cohort study involving Korean CKD patients, smoking was associated with significantly higher risk of worsening kidney function. Furthermore, the risk of adverse kidney outcome was incrementally higher as smoking pack-years were higher. As the duration of smoking cessation increased, the hazard ratios for adverse kidney outcome were attenuated, suggesting that quitting smoking may be a modifiable factor to delay CKD progression.
Development of an antimicrobial peptide-loaded mineralized collagen bone scaffold for infective bone defect repair
Authors: He Yuzhu , Jin Yahui , Ying Xiaoxia , Wu Qiong , Yao Shenglian , Li Yuanyuan , Liu Huiying , Ma Guowu , Wang Xiumei
Published: April 2020

The repair of infective bone defects is a great challenge in clinical work. It is of vital importance to develop a kind of bone scaffold with good osteogenic properties and long-term antibacterial activity for local anti-infection and bone regeneration. A porous mineralized collagen (MC) scaffold containing poly(d,l-lactide-co-glycolic acid) (PLGA) microspheres loaded with two antibacterial synthetic peptides, Pac-525 or KSL-W was developed and characterized via scanning electron microscopy (SEM), porosity measurement, swelling and mechanical tests. The results showed that the MC scaffold embedded with smooth and compact PLGA microspheres had a positive effect on cell growth and also had antibacterial properties. Through toxicity analysis, cell morphology and proliferation analysis and alkaline phosphatase evaluation, the antibacterial scaffolds showed excellent biocompatibility and osteogenic activity. The antibacterial property evaluated with Staphylococcus aureus and Escherichia coli suggested that the sustained release of Pac-525 or KSL-W from the scaffolds could inhibit the bacterial growth aforementioned in the long term. Our results suggest that the antimicrobial peptides-loaded MC bone scaffold has good antibacterial and osteogenic activities, thus providing a great promise for the treatment of infective bone defects.
Investor Protection and Capital Fragility: Evidence from Hedge Funds around the World
Authors: Aragon George O , Nanda Vikram , Zhao Haibei
Published: April 2020

We find that capital flows to hedge funds in different countries are influenced by the strength and the enforcement of investor protection laws. Hedge funds located in weak investor protection countries exhibit greater sensitivity of investor outflow to poor performance, relative to funds in countries with strong protection. Furthermore, weak investor protection is associated with fund managers engaging in greater returns management. Our findings suggest that in countries with weaker investor protection, poor fund performance exposes investors to a greater risk of fraud and legal jeopardy, thus triggering a larger outflow of capital.
The Rise and Fall of the Tahrir Repertoire: Theorizing Temporality, Trajectory, and Failure
Authors: Said Atef
Published: April 2020

This article examines how and why the strategy of occupying Tahrir Square went from being the central mode of action and defining image of the Egyptian Revolution of 2011 to an ineffective strategy read by many as symbolic of the revolution’s ultimate failure during the transitional period of 2011–2012. This question speaks to a lacuna in the literature on repertoires, specifically a lack of attention to their temporality and the lessons to be learned from their failure. I propose a framework that examines the trajectory of repertoires and traces their 1) meaning; 2) internal composition; 3) relationality vis-à-vis the regime in relation to which the repertoire is practiced; and 4) temporal momentum. Using this framework, I chart the rise and fall of the Tahrir repertoire in a very short period: from February 12, 2011, to December 5, 2012. The article draws on ethnographic, qualitative, and historical data collected over three research trips taken between February 4, 2011, and January 7, 2015.
A procolophonid reptile from the Lower Triassic of Australia
Authors: Hamley Tim , Cisneros Juan C , Damiani Ross
Published: April 2020

A new procolophonid reptile from the Lower Triassic Arcadia Formation of Queensland, Australia is described on the basis of abundant cranial and postcranial remains. Eomurruna yurrgensis gen. & sp. nov. is the first parareptile from Australia, being represented by more than 40 specimens from which a detailed description of the osteology is made. The most characteristic feature of Eo. yurrgensis is the presence of six to eight blunted, monocuspid maxillary teeth that are circular in basal cross-section. The new Australian taxon features an interdigitated tooth-occlusion system that represents an intermediate functional stage between the primitive procolophonoid pattern, without apparent tooth-to-tooth contact, and the crown-to-crown occlusion system characteristic of the horned procolophonids. Its dentition suggests good capabilities of oral processing and shows instances of replacement. A phylogenetic analysis suggests that the new taxon occupies a relatively basal position within the Procolophonidae. The taxonomic status of the procolophonoid species ‘Owenetta’ kitchingorum and Saurodektes rogersorum from South Africa and ‘Eumetabolodon’ dongshengensis from China is reassessed. The new genus Youngetta gen. nov. and the new combinations Saurodektes kitchingorumcomb. nov. and Youngetta dongshengensiscomb. nov. are here proposed.
Preterm Delivery Prediction Using Phosphorylated Insulin-Like Growth Factor in Rural Kenya [OP01-1A]
Authors: Shirazian Taraneh , Gilligan Lisa , K'Ouma Matete Thomas
Published: April 2020

INTRODUCTION:

To evaluate the feasibility and accuracy of a test analyzing for the presence of phosphorylated insulin-like growth factor binding protein-1 (pIGFBP-1), in predicting preterm delivery in asymptomatic women in the rural Kenya.

METHODS:

This was a prospective cohort study conducted by Saving Mothers from 2013-2019. Asymptomatic women presenting for routine prenatal care in West Pokot, Kenya were enrolled. Pregnant women were recruited prior to 24 weeks and offered the opportunity to return at 28-32 weeks gestation to obtain the phosphorylated insulin-like growth factor binding protein-1 (pIGFBP-1) assay. Dating was established by last menstrual period and confirmed by ultrasound. Patients who tested positive received betamethasone, and were referred to the maternity waiting home. Outcome data was collected after delivery and sensitivity, specificity, positive and negative predictive values were reported for the test.

RESULTS:

669 women were recruited. 469 returned for the second visit to receive the test, and presently 370 have complete data for analysis. 180 tested positive for preterm birth risk, 143 of whom delivered prior to 37 weeks gestation (Positive Predictive Value = 79.4%). 190 tested negative, 176 of whom delivered after 37 weeks (Negative Predictive Value = 92.6%). Sensitivity for the test was 91.0%. Specificity was 82.6%.

CONCLUSION:

The pIGFBP-1 point of care test is effective in predicting risk for preterm birth in asymptomatic women in rural Kenya. This allows for risk-stratification in low resource settings. Proper intervention may optimize utilization of scarce resources and improve maternal and child health.
Vaginal Cleansing and Azithromycin at Cesarean Delivery; A Quality Improvement Study [OP01-1C]
Authors: Quist-Nelson Johanna Rachel , Gomez Julie , Felder Laura , Di Mascio Daniele , Eckler Rebecca , Posencheg Michael
Published: April 2020

INTRODUCTION:

The objective was to assess the stepwise implementation of pre-operative vaginal cleansing and intravenous (IV) azithromycin on the rate of surgical site infection (SSI) for women who undergo cesarean delivery (CD) intrapartum or after rupture of membranes.

METHODS:

This was a quality improvement study comparing 3 groups: 1). 12 months of pre-intervention; 2). 14 months of vaginal cleaning as infection prophylaxis; 3). 16 months of both vaginal cleansing and azithromycin IV as infection prophylaxis. The primary outcome, which was analyzed by control charts, was the rate of SSI as defined by the Center for Disease Control and Prevention (CDC). This study was IRB approved.

RESULTS:

There were 1,033 patients included from the 3 study periods. The total rate of SSI rate decreased from 22% to 12.5% after implementing vaginal cleansing. Special cause variation was seen with an 8-point shift starting 4 months after implementation of vaginal cleansing. This decrease was sustained during the following 26 months. Adding azithromycin IV did not significantly further lower the rate of SSI. When examined separately, deep SSI (P=.009) and endometritis (P=.001) significantly decreased in the post-intervention periods. Pre-operative vaginal cleansing compliance rose to 74%, and then further increased to 85% 1 year after implementation. Azithromycin IV compliance rose to 75%.

CONCLUSION:

In this quality improvement study, implementation of vaginal cleansing decreased the SSI rate by 43%, from 22% prior to either intervention to 12.5% after addition of vaginal cleansing. The addition of azithromycin IV did not result in any further change in SSI rate.
Does Robot Assistance for Benign Hysterectomy Increase the Risk of Trendelenburg Position-Related Complications? [OP02-3B]
Authors: Mandelbaum Rachel S. , Chang Erica , Matsuzaki Shinya , Im Dwight , Klar Maximilian , Matsuo Koji
Published: April 2020

INTRODUCTION:

Recent studies have suggested that prolonged Trendelenburg positioning during robotic-assisted total laparoscopic hysterectomy (RA-TLH) may lead to fluid shifts and resulting pulmonary, airway, head and neck, and cranial complications, however national statistics are lacking. This study examined Trendelenburg position-related complications by hysterectomy approach for benign gynecological disease.

METHODS:

A population-based retrospective study utilizing the National Inpatient Sample was conducted to examine total hysterectomy for benign gynecologic disease from 2008-2015. Trendelenburg position-related complications were compared between RA-TLH (n=59,061), conventional TLH (C-TLH, n=58,864), and total abdominal hysterectomy (TAH, n=791,320). Pairwise propensity score inverse probability of treatment weighting (PS-IPTW) with a generalized estimating equation was used to estimate odds ratios (OR) and 95% confidence intervals (CI). A classification tree model was used to examine factors contributing to complications.

RESULTS:

In the PS-IPTW model, RA-TLH was not associated with increased risk of Trendelenburg position-related complications compared to C-TLH (4.5% versus 4.5%, OR 0.99, 95% CI 0.87-1.13, P=0.871) or TAH (4.5% versus 4.7%, 0.96, 95% CI 0.87-1.06, P=0.420). Charlson Comorbidity Index (CCI) and age were most strongly associated with Trendelenburg position-related complications; women ≥80 years with a CCI of ≥4 had a disproportionally high incidence (49.1%). Moreover, Trendelenburg position-related complications were the most predictive of inpatient death following hysterectomy in the whole cohort; mortality rate was 4.9% in patients with a CCI of ≥4 at rural hospitals.

CONCLUSION:

RA-TLH is not associated with an increased risk of Trendelenburg position-related complications. However, older age and higher comorbidity are two key risk factors for these complications and confer high mortality risk.
Evaluation of Ovarian Perfusion With Indocyanine Green Dye (ICG) in Patients With Suspected Adnexal Torsion [OP02-4B]
Authors: Nicholson Kaitlin , Urh Anze , Schwartz Benjamin , Holubyeva Anastasiya , LaPier Zoe , Cisneros-Camacho Ana
Published: April 2020

INTRODUCTION:

The aim of this study is to assess the safety and feasibility of Indocyanine Green (ICG) dye in patients with adnexal torsion. Our hypothesis is that the use of ICG dye will aid in the surgical determination of tissue viability, ultimately preventing the resection of salvageable ovaries.

METHODS:

An IRB approved pilot study is currently enrolling patients 18-45 years old with suspected adnexal torsion in a multicentered tertiary care hospital setting. During laparoscopy, the involved adnexa is untwisted and ICG dye is injected intravenously. The untwisted ovary is then observed. Adnexal tissue demonstrating perfusion is preserved and patients are followed postoperatively with anti-Mullerian hormone level and ultrasound. Non-perfused tissue is resected and histologically evaluated for necrosis.

RESULTS:

Eleven patients with suspected adnexal torsion were enrolled, of which eight had surgically confirmed torsion. Six women demonstrated perfusion with the use of ICG dye even though three of these patients had minimal or no flow on preoperative ultrasound. The remaining 2/8 patients with confirmed torsion failed to demonstrate perfusion with the ICG dye and oophorectomies were performed. One of these patients had confirmed histologic necrosis. There have been no adverse events.

CONCLUSION:

The use of intravenous ICG dye appears to be a safe and valuable adjunct in the surgical management of adnexal torsion. This may be particularly helpful in patients with diminished adnexal perfusion on preoperative ultrasound. Further research is recommended to determine the generalized role of ICG dye in patients with adnexal torsion.
Impact of Retained Cystoscopy Fluid Following Laparoscopic/Robotic Hysterectomy: A Randomized Controlled Trial [OP02-5B]
Authors: Smith Rachael , Mahnert Nichole D. , Hu Chengcheng , Steck-Bayat Kayvahn , Stone Ashley , Mourad Jamal
Published: April 2020

INTRODUCTION:

Spontaneous voiding is an important postoperative milestone following hysterectomy. We investigated the impact of retained cystoscopy fluid following laparoscopic and robotic hysterectomy with universal cystoscopy on time to spontaneous void and patient satisfaction.

METHODS:

This was an IRB approved, single-blind, randomized, controlled trial from October 2018 to October 2019 comparing 200-mL retained cystoscopy fluid and complete bladder emptying following laparoscopic and robotic hysterectomy for benign indications, excluding prolapse and incontinence. The primary outcome was time to spontaneous void. Secondary outcomes were urinary retention rates, length of stay, bladder discomfort, and patient satisfaction. A sample size of 120 was calculated to achieve 80% power (alpha = .05) to detect a 57 minute difference in time to spontaneous void.

RESULTS:

A total of 120 patients were randomized (59 in the retained fluid arm, 61 in the empty arm). There were no differences in baseline demographics or surgery characteristics between groups. There was an apparent although not statistically significant difference in time to spontaneous void (143 minutes vs 168 minutes, P=.20). Urinary retention rates and length of stay did not differ (13.6% vs 8.2%, P=.51 and 199 minutes vs 214 minutes, P=.40). There was no difference in postoperative bladder discomfort and patient satisfaction.

CONCLUSION:

Retained cystoscopy fluid following laparoscopic and robotic hysterectomy did not significantly impact time to spontaneous void, urinary retention, length of stay, bladder discomfort, and patient satisfaction. Despite no differences, recovery nurses feel patients void faster with retained fluid. Our next step will be to perform a qualitative study of recovery nurse perceptions.
Assessing Hepatitis C Among Perinatal Women Undergoing Treatment for Opioid Use Disorder in Kentucky [03A]
Authors: Winter Kathleen , Adekunle Deborah , Harp Kathi , Barnhart Sheila , Critchfield Agatha
Published: April 2020

INTRODUCTION:

HCV infection among women of child-bearing age in Kentucky is among the highest in the nation. Many women with opioid use disorders (OUD) are unaware of their HCV status and do not receive follow-up treatment for themselves or their infant.

METHODS:

Our IRB-approved cohort study evaluated HCV prevalence among pregnant and early parenting women receiving outpatient medication-assisted treatment for OUD. After informed consent, anti-HCV positive patients completed a survey and interview to assess HCV knowledge, perception of risk, and barriers to antiviral treatment.

RESULTS:

Of 129 clients, 76 (59%) had HCV antibodies and 52 (40%) had detectable HCV RNA; most were genotypes 1 or 3. Of the 63 eligible, 45 (71%) participated; 6 (14%) women were unaware of their current HCV infection status. Most (82%) were diagnosed with HCV prior to their most recent pregnancy and 55% were diagnosed >2 years prior; 28% had no knowledge of perinatal HCV transmission risk. Most (75%) reported that HCV treatment was important, however only 3 (7%) had received direct acting antiviral treatment; all achieved sustained virologic response. Perceived barriers included severe side effects and cost; nearly all were uninformed about Medicaid eligibility. One-third did not know anyone with prior HCV treatment.

CONCLUSION:

HCV prevalence in this cohort was high; despite prenatal testing, not all clients were aware of their status. Women were uninformed about perinatal transmission risk, and HCV treatment efficacy, protocols, and side effects. HCV testing and counseling is important for pregnant women even if a client has been previously diagnosed with HCV.
Association Between Preterm Birth and Chronic Toxoplasma gondii Infection in Latina Women [04A]
Authors: Ranaweera Indira , Ozorio Dutra Samia Valeria , Yoo Ji Yoon , Louis-Jacques Adetola , Duffy Allyson , Groer Maureen
Published: April 2020

INTRODUCTION:

Chronic Toxoplasma gondii infects up to one-third of the world's population. Latina women have a higher rate of infection with more virulent serotypes. While acute infection can cause devastating effects in pregnancy, chronic infection had not been considered to have pathological effects. Our objective is to investigate the association between preterm birth and chronic T. gondii infection in Latina women.

METHODS:

We evaluated 178 Latina women for T. gondii status and followed them through pregnancy and up to 6 weeks postpartum. Demographic information, obstetric histories, pregnancy outcomes, and blood samples were obtained. T. gondii IgG positivity signified chronic exposure. We performed descriptive analyses, chi-square, and Student t-test.

RESULTS:

There were complete data on 157 Latina women. Thirty-three (21.0%) were T. gondii IgG positive and 124 (79.0%) were T. gondii IgG negative. Among T. gondii positive women, 9 (27.3%) delivered preterm as compared to 15 (12.1%) of T. gondii negative women. There was a significant difference when comparing the frequency of preterm birth in T. gondii IgG positive and T. gondii IgG negative mothers (phi coefficient=.172, P<.031). The mean gestational age of delivery was 36.9 weeks (SD±3.98) for seropositive mothers and 38.1 weeks (SD±2.96) for seronegative mothers (t(155)=1.931, P=.055).

CONCLUSION:

T. gondii IgG seropositivity was associated with a higher likelihood of preterm delivery in Latina women. Further studies are needed to examine the impact of chronic T. gondii infection on pregnancy outcomes.
Expedited Partner Therapy and Its Impact on Chlamydia and Gonorrhea Rates in LA County Hospitals [08A]
Authors: Chang Emily , Nguyen Brian T. , Mitchell Evelyn , Jeffrey Nicholas , Long Minica
Published: April 2020

INTRODUCTION:

Rising rates of gonorrhea (GC) and chlamydia (CT) in Los Angeles County may be related to the inadequate notification/treatment of sexual partners, leading to cycles of treatment and reinfection. Expedited partner therapy (EPT) is a proposed solution that provides prescriptions/antibiotics directly to an affected patient's partner without a separate visit. EPT is approved in California for GC/CT treatment; however its distribution varies, warranting an examination of factors influencing partner notification and EPT distribution.

METHODS:

Institutional Review Board approval was obtained. Patients with positive GC/CT lab results from 1/2015 to 6/2017 were identified from LA County hospital electronic medical records. Documentation of the need to treat the patient's partner and/or EPT provision was identified, along with possible associated factors, e.g. the patient demographics, as well as the provider's specialty and training level. Descriptive statistics and bivariate comparisons identified correlations between receipt of EPT and possible factors.

RESULTS:

Of 319 GC/CT diagnoses, only 7.5% had EPT documented. More diagnoses occurred among female than male patients (63.6% vs. 36.4%) with males being less likely to be offered EPT (0.9% vs. 11.3%, P<.01). Patient age, race, and marital status were not associated with receiving EPT. Most diagnoses (60.2%) occurred in the emergency department, but those patients were least likely to receive EPT (3.7%, P<.01). Gynecologists were most likely to provide EPT (37.8%, P<.01).

CONCLUSION:

EPT was rarely offered to patients diagnosed with GC/CT, with provision least likely among male patients and in the emergency department setting. Gender-based and structural barriers may underlie low rates of EPT provision.
Limited Postpartum Versus 24-Hour Antibiotic Dosing Regimens Following Intrapartum Chorioamnionitis [11A]
Authors: Hood Keren , Ulfers Alexander , Mersch Michelle , Cuadra German , Stevenson Robert , Martingano Daniel
Published: April 2020

INTRODUCTION:

The objective of this study was to determine if limited postpartum dosing versus (LPD) 24-hour dosing treatment regimens for endometritis prophylaxis following deliveries complicated by intrapartum chorioamnionitis (IC) provides greater effectiveness.

METHODS:

We conducted a prospective observational cohort study and followed all women receiving treatment for IC. All patients diagnosed with IC received IV gentamicin and IV ampicillin. Those who required a cesarean delivery additionally received IV clindamycin. Those in the LPD group received an additional dose of ampicillin (and clindamycin if cesarean delivery) while the 24-hour dosing group were continued on the scheduled antibiotics for 24 hours. Appropriate IRB approval was obtained. The primary outcome was treatment failure defined by persistent fever and fundal tenderness requiring continuation of antibiotics and ascribing a diagnosis of postpartum endometritis.

RESULTS:

The study included 206 patients, where 120 patients received 24-hour dosing of antibiotics postpartum and 86 received LPD. Baseline characteristics were not significantly different. Rates of endometritis were noted to be less in the 24-hour dosing group (15.8% versus 29.1%, P=.022) with a 46% decreased risk of developing endometritis (RR 0.54, 95% CI 0.3–0.99, P=.46). After adjusting for perceived confounders, this decreased risk was no longer statistically significant.

CONCLUSION:

In this prospective study, either dosing strategy appears to have equivalent efficacy of endometritis prophylaxis after adjusted analysis. Given the lack of superiority of either regimen, each dosing approach remains reasonable with the LTD favored to limit overuse of antibiotics and combat resistance.
Percutaneous Exposure Incidents in U.S. Obstetrics and Gynecology Residents [12A]
Authors: Garrett Alison
Published: April 2020

INTRODUCTION:

To examine the self-reported incidence of percutaneous exposure incidents (PEIs) as well as injury reporting trends among U.S. Obstetrics and Gynecology residents.

METHODS:

IRB approval was obtained. This voluntary survey was distributed to all ACGME-accredited OB/GYN residency program leadership with instructions to forward to all residents in their programs. The online survey was IRB approved and open for responses from May-June 2019. Descriptive statistics were gathered, and variables were evaluated for significance by chi-square analysis.

RESULTS:

Among the 441 residents who responded, 355 (81%) reported ever experiencing a PEI. Sharps injuries were sustained by 321 (73%), and mucous membrane exposures (MMEs) were sustained by 255 (58%). By the final year of training, 96% of residents experienced at least one sharps injury, and 71% reported at least one MME. Most residents (258, 72%) did not reported an injury in the past. The most common reasons for not reporting included that the patient was perceived to be at low risk for infection (32%), the process was too cumbersome (24%), or the resident was too busy (12%).

CONCLUSION:

OBGYN residents experience a high rate of PEIs but infrequently report these injuries. Efforts to prevent PEIs are of utmost importance. Increased reporting of these injuries is needed to optimize post-exposure prophylaxis administration.