bluuebunny/crossref_metadata_2025 huggingface dataset:
Sex-specific relationships between face memory and the N170 component in event-related potentials
Authors: Nowparast Rostami Hadiseh , Hildebrandt Andrea , Sommer Werner
Published: April 2020

At the group level, women consistently perform better in face memory tasks than men and also show earlier and larger N170 components of event-related brain potentials (ERP), considered to indicate perceptual structural encoding of faces. Here we investigated sex differences in the relationship between the N170 and face memory performance in 152 men and 141 women at group mean and individual differences levels. ERPs and performance were measured in separate tasks, avoiding statistical dependency between the two. We confirmed previous findings about superior face memory in women and a—sex-independent—negative relationship between N170 latency and face memory. However, whereas in men, better face memory was related to larger N170 components, face memory in women was unrelated with the amplitude or latency of the N170. These data provide solid evidence that individual differences in face memory within men are at least partially related to more intense structural face encoding.
The German family foundation: concept, legal framework, and taxation
Authors: Haag Maximilian , Tischendorf Michael
Published: April 2020

Most German foundations serve the common good. Nevertheless, setting up a private foundation in Germany has proven to be a valuable instrument in private wealth management and estate planning. About 5% of all German foundations are the so-called family foundations with the purpose of serving the interests of one or more families. There are numerous possible areas of application, such as business succession, asset protection, estate planning, and/or use of tax advantages. This article is intended to describe the concept of the German family foundation, its establishment, constitution, and termination, as well as its taxation, in order to provide an overview of its advantages, disadvantages, and possible applications. The German non-profit foundation shall not be discussed.
Managing older patients with cancer
Authors: Robinson Lauren , Xavier Neena A.
Published: April 2020

With the growing population of adults over age 70 years, clinicians must know how to care appropriately for the increasing number of older patients with cancer. Although older adults have higher rates of surgical complications and chemotherapy-related toxicity, they should not be excluded from treatment opportunities based on age alone. Rather, patients should be assessed for fitness, or functional age, for a more accurate estimation of how they will tolerate treatment. This article discusses considerations clinicians should take into account when developing effective treatment plans that do not compromise quality of life for older patients with cancer.
Anticipating the management of Streptococcus agalactiae infective endocarditis
Authors: Schalla Gregory , Grant Michael
Published: April 2020

A patient who presented after falling out of bed had signs of right-sided stroke, which, after imaging, was suspicious for embolism with cardiac origin. Further investigation revealed a large aortic valve vegetation with mild aortic insufficiency, and the patient eventually developed heart failure requiring surgical intervention. Infective endocarditis is slowly becoming more prevalent, and clinicians should have a high index of suspicion when patients present with common complications of this disease, such as valvular dysfunction, heart failure, or stroke. Early diagnosis has been shown to reduce time to appropriate antibiotic treatment and definitive care, which can lead to better outcomes.
The Role of Nurses as Allies Against Racism and Discrimination
Authors: Weitzel Jennifer , Luebke Jeneile , Wesp Linda , Graf Maria Del Carmen , Ruiz Ashley , Dressel Anne , Mkandawire-Valhmu Lucy
Published: April 2020

The remnants of colonialism manifesting as structural violence, racism, and oppression continue to plague our society as evidenced by the persistence of health inequities, particularly for minority populations in the United States. As a profession bound by moral and ethical mandates, nursing must resist and deconstruct oppression in all its forms. Nurses, informed by critical race theory, intersectionality, and historical trauma, can become formidable allies with marginalized populations in the fight for social justice and health equity.
Spinal Surgery for Parkinson Disease With Camptocormia
Authors: Park Hyung-Youl , Ha Kee-Yong , Kim Young-Hoon , Oh In-Soo , Chang Dong-Gune , Kim Sang-Il , Jeon Woong-Ki , Kim Geon-U.
Published: April 2020

Study design:

A propensity score–matched cohort study.

Objective:

The objective of this study was to compare the radiologic and clinical outcomes of camptocormia in Parkinson disease (PD) with degenerative sagittal imbalance (DSI) patients.

Summary of Background Data:

Camptocormia in PD and DSI could be characterized by a dynamic deformity. However, no study has directly evaluated the outcomes of patients with camptocormia and DSI.

Methods:

Thirteen consecutive PD patients undergoing surgical correction for camptocormia were matched in a 1-to-2 format with 26 patients in the DSI group by propensity score–matching. Radiologic outcomes, including paravertebral muscle changes, and clinical outcomes were compared between the 2 groups. The rate of proximal junctional problems and reoperations were assessed.

Results:

PD patients with camptocormia had significantly greater preoperative coronal and sagittal malalignments (29.9 vs. 16.9 mm, P=0.019; 142.8 vs. 64.4 mm, P=0.0001, respectively) and weakness of paravertebral muscles compared with the DSI patients. Regarding the clinical outcomes, reoperations were significantly higher in the camptocormia group, compared with the DSI group (53.8% vs. 7.7%, P=0.001). Moreover, proximal junctional failure was developed in 8 patients in the camptocormia group, while 1 patient in the DSI group (61.5% vs. 3.8%, P=0.0001). In subgroup analysis, independent risk factors for the proximal junctional failure were the total fusion levels (hazard ratio=0.26, P=0.018) and the degree of fatty changes of the paravertebral muscles (hazard ratio=1.15, P=0.048).

Conclusions:

PD patients undergoing spinal surgery for camptocormia had global malalignment and higher rates of complications compared with DSI patients. Patients should be appropriately counseled regarding the increased risk of operative complications and closely followed for incipient failure.
Deciphering skin re-pigmentation patterns in vitiligo: an update on the cellular and molecular events involved
Authors: Lei Tie-Chi , Hearing Vincent J.
Published: April 2020

Current treatment of vitiligo is still a great challenge, since most cases of vitiligo have variable re-pigmentation outcomes due to their unpredictable responses to existing therapeutic regimens. There is an urgent need to identify this re-pigmentation process and to develop novel therapies. This review illustrates the most current research and latest understanding of vitiligo skin re-pigmentation and related regulatory mechanisms. Literature was collected from PubMed until January 2020, using the search terms including “vitiligo,” “re-pigmentation,” “phototherapy,” “narrow-band ultraviolet B, ” “excimer,” “fractional carbon dioxide laser,” and “melanocyte stem cells.” Literature was mainly derived from English articles. Article type was not limited. Emerging evidence suggests that patients with vitiligo present various re-pigmentation patterns following ultraviolet B phototherapy, which relies on different cell reservoirs from the perilesional margins and/or from uninvolved hair follicles to replenish functional melanocytes that are lost in vitiliginous skin. The following events are likely to be involved in this re-pigmentation process, including: 1) changes in the paracrine secretion and distribution of transforming growth factor-β1 in the bulge area and in the epidermis; 2) the enhanced transfer of dermal pro-melanogenic growth factors to the epidermis; and 3) the induction of a C-X-C motif chemokine ligand (CXCL) 12-enriched micro-environment that efficiently recruits CXCR4- or CXCR7-positive melanocytes. Ongoing studies on the cellular and molecular events underlying vitiligo re-pigmentation will help design new therapeutic strategies to improve treatment outcomes.
Hemoglobin structure at higher levels of hemoglobin A1C in type 2 diabetes and associated complications
Authors: Andleeb Farah , Hafeezullah  , Atiq Atia , Atiq Maria
Published: April 2020

Background:

Fourier transform infrared (FTIR) spectroscopy technique has not been used as a diagnostic tool for diabetes in clinical practice. This study was linked to structural changes in hemoglobin (Hb) in type 2 diabetes patients at higher levels of HbA1C using FTIR spectroscopy.

Methods:

Fifty-three diabetic patients from the Bahawal Victoria Hospital, Bahawalpur, Pakistan were categorized as group A (6% < HbA1C < 7%; n = 25) and group B (HbA1C ≥9%; n = 28). Another group (group N) of twenty blood samples was taken from healthy people from the Islamia University Bahawalpur, Pakistan. Data from all groups were collected from January 1, 2018 to March 31, 2019. The structure of Hb was studied by FTIR spectroscopy and impact of glucose on the fine structure of HbA1C was estimated.

Results:

Hb secondary structure erythrocyte parameters were altered by changing glucose concentrations. From FTIR spectra of all three groups it was found that Hb structure was slightly altered in group A, but significantly changed in group B (P < 0.05). There was an increase in β-sheet structure and a reduction in α-helix structure at elevated levels of HbA1C (group B) in type 2 diabetes.

Conclusion:

We suggest that higher level of glycation reflected by increased HbA1C might be a contributing factor to structural changes in Hb in type 2 diabetic patients. FTIR spectroscopy can be a novel technique to find pathogenesis in type 2 diabetes.
EARLY AND LATE MACULAR CHANGES AFTER THE INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE FOR A FULL-THICKNESS MACULAR HOLE
Authors: Tsui Mei-Chi , Yang Chung-May
Published: April 2020

Purpose:

To describe the anatomic evolution of full-thickness macular hole closure after the inverted internal limiting membrane (ILM) flap technique.

Methods:

A retrospective review of 39 eyes (38 patients) with a full-thickness macular hole treated with the inverted ILM flap technique was performed. Ophthalmic examinations and imaging were performed preoperatively and postoperatively.

Results:

Macular changes in the early postoperative period included flap closure (15.4%), U-shaped closure (17.9%), V-shaped closure (33.3%), W-shaped closure (28.2%), gap closure (2.6%), and gap open (2.6%). Flap closure was associated with low myopia and shorter axial length (P < 0.05). Two types of flap closure were observed. Type 1 was characterized by gap opening with an ILM cap, followed by a thickened ILM band drawing the edges of the macular hole closer with subsequent external limiting membrane formation; Type 2 was characterized by gap closure with an ILM cap, followed by gliotic proliferation filling the gap. Flap closure configuration disappeared within 4 months postoperatively. At the last follow-up, foveal contours were U-shaped closure (25.6%), V-shaped closure (35.9%), W-shaped closure (35.9%), and gap open (2.6%).

Conclusion:

Two types of flap closure were observed in the early postoperative period. Several patterns of the foveal contour were observed in the late period. The presence of the ILM flap predicts eventual hole closure. These findings require confirmation and further elucidation of their possible clinical significance.
Inhibiting MLL1-WDR5 interaction ameliorates neuropathic allodynia by attenuating histone H3 lysine 4 trimethylation-dependent spinal mGluR5 transcription
Authors: Lin Tzer-Bin , Lai Cheng-Yuan , Hsieh Ming-Chun , Ho Yu-Cheng , Wang Hsueh-Hsiao , Yang Po-Sheng , Cheng Jen-Kun , Chen Gin-Den , Ng Soo-Cheen , Peng Hsien-Yu
Published: April 2020

Mixed lineage leukemia 1 (MLL1)-mediated histone H3 lysine 4 trimethylation (H3K4me3) of a subset of genes has been linked to the transcriptional activation critical for synaptic plasticity, but its potential contribution to neuropathic allodynia development remains poorly explored. Here, we show that MLL1, which is induced in dorsal horn neuron after spinal nerve ligation (SNL), is responsible for mechanical allodynia and increased H3K4me3 at metabotropic glutamate receptor subtype 5 (mGluR5) promoter. Moreover, SNL induced WD (Trp-Asp) repeat domain 5 subunit (WDR5) expression as well as the MLL1-WDR5 interaction accompany with H3K4me3 enrichment and transcription of mGluR5 gene in the dorsal horn in neuropathic allodynia progression. Conversely, WDR5-0103, a novel inhibitor of the MLL1-WDR5 interaction, reversed SNL-induced allodynia and inhibited SNL-enhanced mGluR5 transcription/expression as well as MLL1, WDR5, and H3K4me3 at the mGluR5 promoter in the dorsal horn. Furthermore, disrupting the expression of MLL1 or WDR5 using small interfering RNA attenuated mechanical allodynia and reversed protein transcription/expression and complex localizing at mGluR5 promoter in the dorsal horn induced by SNL. This finding revealed that MLL1-WDR5 complex integrity regulates MLL1 and WDR5 recruitment to H3K4me3 enrichment at mGluR5 promoter in the dorsal horn underlying neuropathic allodynia. Collectively, our findings indicated that SNL enhances the MLL1-WDR5 complex, which facilitates MLL1 and WDR5 recruitment to H3K4me3 enrichment at mGluR5 promoter in spinal plasticity contributing to neuropathic allodynia pathogenesis.
The Graphical Index of Pain: a new web-based method for high-throughput screening of pain
Authors: Steingrímsdóttir Ólöf Anna , Engdahl Bo , Hansson Per , Stubhaug Audun , Nielsen Christopher Sivert
Published: April 2020

This article is the first to present the Graphical Index of Pain (GRIP), a new user-friendly web-based method for high-throughput screening of pain. The long-term goal of the method is to improve global standardization of pain measurements. GRIP consists of a hierarchical body map with 10 first-tier body regions, and a second tier with multiple pain loci (167 among men, 168 among women), which provides detailed information about pain location and distribution. Follow-up questions for first-tier regions include the following pain characteristics: onset, episode frequency, episode duration (including constant pain), intensity, bothering, depth of pain, and effects on sleep and daily activities. The first implementation of GRIP was in the Tromsø Study (2015-2016), a population-based study of adults aged 40 to 99 years. In total, 21,083 individuals participated in the study, and 96% (n = 20,263; age 40-96 years) completed GRIP. Pain intensity at first-tier regions and pain location and distribution at second-tier regions are in this article presented by sex-stratified customized heat maps showing large sex difference. Mean time to mark the first- and second-tier regions was 74 seconds. In conclusion, GRIP allows for high-resolution assessment and presentation of pain location and distribution with minimal use of time.
The International Society of Urological Pathology Consultation on Molecular Pathology of Urogenital Cancer
Authors: van der Kwast Theodorus H. , Egevad Lars , Kristiansen Glen , Grignon David J.
Published: April 2020

The 2019 Consultation Conference on the molecular pathology of urogenital cancers was organized by the International Society of Urological Pathology (ISUP) to have an understanding of the current use of molecular-genetic markers and to make recommendations on their application in prostate, bladder, renal, testicular, and penile cancer. This brief introductory article describes the organization of this conference and provides its rationale and main findings.
Pediatric Extracorporeal Cardiopulmonary Resuscitation: A Systematic Review*
Authors: Esangbedo Ivie D. , Brunetti Marissa A. , Campbell Frank M. , Lasa Javier J.
Published: April 2020

Objectives:

This systematic review aims to summarize the body of available literature on pediatric extracorporeal cardiopulmonary resuscitation in order to delineate current utilization, practices, and outcomes, while highlighting gaps in current knowledge.

Data Sources:

PubMed, Embase, Scopus, Cochrane Library, and ClinicalTrials.gov databases.

Study Selection:

We searched for peer-reviewed original research publications on pediatric extracorporeal cardiopulmonary resuscitation (patients < 18 yr old) and were inclusive of all publication years.

Data Extraction:

Our systematic review used the structured Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. Our initial literature search was performed on February 11, 2019, with an updated search performed on August 28, 2019. Three physician reviewers independently assessed the retrieved studies to determine inclusion in the systematic review synthesis. Using selected search terms, a total of 4,095 publications were retrieved, of which 96 were included in the final synthesis. Risk of bias in included studies was assessed using the Risk of Bias in Non-Randomized Studies of Interventions-I tool.

Data Synthesis:

There were no randomized controlled trials of extracorporeal cardiopulmonary resuscitation use in pediatrics. A vast majority of pediatric extracorporeal cardiopulmonary resuscitation publications were single-center retrospective studies reporting outcomes after in-hospital cardiac arrest. Most pediatric extracorporeal cardiopulmonary resuscitation use in published literature is in cardiac patients. Survival to hospital discharge after extracorporeal cardiopulmonary resuscitation for pediatric in-hospital cardiac arrest ranged from 8% to 80% in included studies, and there was an association with improved outcomes in cardiac patients. Thirty-one studies reported neurologic outcomes after extracorporeal cardiopulmonary resuscitation, of which only six were prospective follow-up studies. We summarize the available literature on: determination of candidacy, timing of activation of extracorporeal cardiopulmonary resuscitation, staffing/logistics, cannulation strategies, outcomes, and the use of simulation for training.

Conclusions:

This review highlights gaps in our understanding of best practices for pediatric extracorporeal cardiopulmonary resuscitation. We summarize current studies available and provide a framework for the development of future studies.
Three-Dimensionally–Printed Hand Surgical Simulator for Resident Training
Authors: Farrell Daniel A. , Miller Travis J. , Chambers Justin R. , Joseph Vinitha A. , McClellan W. Thomas
Published: April 2020

Reduced work hours and funding have fueled an increase in simulation-based training for plastic and orthopedic surgery residency programs. Unfortunately, certain simulation training can fail to enhance surgical skills because of availability, cost, or low fidelity. There is a growing interest among training programs for a cost-effective surgical simulator to improve basic skills and muscle memory of residents. The authors developed a three-dimensionally–printed, malleable, and anatomically accurate hand surgery simulator from a computed tomographic scan of an adult male subject. The bone matrix was specifically designed to provide proprioceptive feedback to hone drilling skills used in fracture repair and arthrodesis. The silicone soft-tissue covering provides excellent malleability to dissect and perform fracture-reducing maneuvers. Three-dimensional printing of “fracture bridges” allows the design of on-demand polyfracture models so the trainee can practice multiple types and locations of repairs as skills progress. To summarize, the authors’ hand simulator is an anatomical, low-cost, multiprocedure tool that can be used to improve the muscle memory and basic surgery skills of residents in training.
The Value of Ultrasonography in Assessing Fetal Lung Maturity
Authors: Tang Yan , Jin Xiao-dan , Xu Lin , Deng Ying , Chang Zhe , Li Qing , Peng Xiang-Lian
Published: April 2020

Objective

To establish the normal parameters of fetal lung development at different gestational ages and to study their correlation with gestational age, thereby providing clinicians with a noninvasive method for assessing fetal lung maturity.

Methods

Two hundred eight cases with pregnancy of 22 to 39 weeks plus 6 days were divided into 18 groups according to gestational age. Ultrasound Doppler was used to measure the relevant parameters of fetal pulmonary development, including right pulmonary left and right diameter, right pulmonary upper and lower diameter, right pulmonary anterior and posterior diameter, right pulmonary area, thoracic area, inner diameter of fetal main pulmonary artery, and Doppler velocity curve parameters of main pulmonary artery: systolic acceleration time (AT), ejection time (ET), AT/ET.

Results

This study establishes normal parameters of lung development at different gestational weeks, draws scatter plots, correlation, and regression analysis of fetal main pulmonary artery AT, ET, AT/ET, and gestational weeks; selects the optimal equation; and analyzes the correlation among right pulmonary left and right diameter, right pulmonary upper and lower diameter, right pulmonary anterior and posterior diameter, right lung diameter, right lung area, thoracic area, and gestational weeks; and draw growth curve. The diameter of main pulmonary artery, AT, and AT/ET increased with the increase of gestational age and were positively correlated with gestational age (r = 0.948, 0.875, 0.810; P = 0.012). Ejection time had no correlation with gestational weeks. There were significant differences in the diameter of main pulmonary artery, AT, AT/ET between different gestational weeks (F = 240.67, 41.137, 23.067; P = 0.024); left and right diameter of right lung, anterior and posterior diameter of right lung, upper and lower diameter of right lung, chest area and right lung area were positively correlated with gestational weeks, and there were significant differences between different gestational weeks (F = 190.85, 105.74, 34.97, 172.33, 35.33, P = 0.018).

Conclusions

Ultrasound Doppler can be used as a noninvasive detecting equipment to evaluate the growth of fetal lung, thus providing a basis for the evaluation of fetal lung maturity.
Guns, scalpels, and sutures: The cost of gunshot wounds in children and adolescents
Authors: Phillips Ryan , Shahi Niti , Bensard Denis , Meier Maxene , Shirek Gabrielle , Goldsmith Adam , Recicar John , Haasz Maya , Schroeppel Thomas , Moulton Steven
Published: April 2020

BACKGROUND

Firearm injuries are the second leading cause of death among US children. While injury prevention has been shown to be effective for blunt mechanisms of injury, the rising incidence of accidental gunshot wounds, school shootings, and interpersonal gun violence suggests otherwise for firearm-related injuries. The purpose of the study is to describe the incidence, injury severity, and institutional costs of pediatric gun-related injuries in Colorado.

METHODS

Pediatric patients (≤18 years), who sustained firearm injuries between 2008 and 2018, were identified from the trauma registries of three pediatric trauma centers in Colorado. Patients were stratified based on age: those younger than 14 years were defined as children and those 15 years to 18 years as adolescents.

RESULTS

Our cohort (n = 308) was predominantly male (87%), with a median age of 14 years. The overall mortality rate was 11% (34/308), with significantly fewer children (5%) dying from their injuries when compared with adolescents (14%; p = 0.04). Sixty-five (21%) patients required blood product transfusions, with 23 (7.4%) patients receiving a massive transfusion. Overall, 52% (161/308) required a major operation, with 15% undergoing an exploratory laparotomy. One third (4/13) of the patients who had a thoracotomy in the emergency department survived to hospital discharge. Overall, 14.0% of patients had psychiatric follow-up at both 30 days and 1 year. The readmission rate for complications was 11.6% at 30 days and 14% at 1 year. The total cost of care for all pediatric firearm-related injuries was approximately US $26 million.

CONCLUSION

The survivors of pediatric firearm injuries experience high operative and readmission rates, sustain long-term morbidities, and suffer from mental health sequelae. Combining these factors with the economic impact of these injuries highlights the immense burden of disease. This burden may be palliated by a multipronged approach, which includes the development and dissemination of injury prevention strategies and better follow-up care for these patients.

LEVEL OF EVIDENCE

Epidemiological, Level III.
A Retrospective Analysis for Risk Factors and Early Prognosis of Delayed Withdrawal Extracorporeal Membrane Oxygenation After Lung Transplantation
Authors: Minqiang Liu , Xiaoshan Li , Bo Xu , Guilong Wang , Zhengfeng Gu , Dong Wei , Jingyu Chen , Qiang Wu , Chunxiao Hu
Published: April 2020

Background.

Extracorporeal membrane oxygenation (ECMO) is widely used for cardiopulmonary assistance during lung transplantation (LTx). However, the optimal timing for ECMO removal remains controversial. This study aimed to evaluate the risk factors and early prognosis of delayed withdrawal ECMO after LTx.

Methods.

Two hundred sixty-seven patients who underwent LTx supported by ECMO were included in this study. Based on whether or not ECMO was completely stopped in the operating room, patients were divided into early ECMO withdrawal group (group E, 107 cases) and delayed withdrawal group (group D, 160 cases). Perioperative data of the donors and recipients, including the suspected risk factors for delayed removal of ECMO, postoperative complications, and hospital survival rate, were retrospectively analyzed.

Results.

Preoperative New York Heart Association cardiac function for recipients and mechanical ventilation time for donors were independent risk factors for delayed weaning of ECMO in veno-arterial ECMO patients. Compared with group E, the odds of postoperative pulmonary infection, primary graft dysfunction, renal dysfunction, blood transfusion volume, and mechanical ventilation time were significantly higher in group D (all P < 0.05). Delayed withdrawal ECMO was decisive factor for early postoperative death, as the risk of early postoperative death in group D was 1.99 (95% confidence interval, 1.13-3.54) times as that in the group E.

Conclusions.

During the period of LTx, New York Heart Association grade III/IV for recipients and mechanical ventilation time ≥5 days for donors are suggestive of delayed veno-arterial ECMO removal, and clinicians should minimize the postoperative bypass time of ECMO when conditions permit.
River capture in the middle reaches of the palaeo-Yarlung Zangbo River
Authors: Liu Yong , Wang Yunsheng , Wei Liangshuai , Shen Tong , Shu Qinfeng , Huang Anbang , Jia Yi
Published: April 2020

There are 51 tributaries in the middle reaches of the Yarlung Zangbo River (YZR), and the confluences of 87% of the tributaries west of Jiacha Gorge are high-angle or perpendicular, reflecting the anomalous development of these tributaries. In this paper, field investigation and digital elevation model (DEM) methods were used to analyse the causes of this anomalous phenomenon, and it was found that there was a watershed in the area of the Jiacha Gorge. The palaeo-YZR west of the Jiacha Gorge flowed westward before the early Pleistocene into the Zada, Zhongba, Jilong and Gamba–Dingri palaeolakes, which featured a large amount of total accommodation space in the western Qinghai–Tibet Plateau; thus, this river was a continental river. With the intensification of the collision between the Indian plate and the Eurasian plate, the Qinghai–Tibet Plateau experienced rapid uplift and formed a landscape with high elevations in the west and lower elevations in the east, promoting the headward erosion of the eastward-flowing river. During the early Pleistocene, the river east of the Jiacha Gorge crossed the watershed and captured the palaeo-YZR, causing a reversal in the flow direction of the palaeo-YZR.
Damselfishes alleviate the impacts of sediments on host corals
Authors: Chase T. J. , Pratchett M. S. , McWilliam M. J. , Hein M. Y. , Tebbett S. B. , Hoogenboom M. O.
Published: April 2020

Mutualisms play a critical role in ecological communities; however, the importance and prevalence of mutualistic associations can be modified by external stressors. On coral reefs, elevated sediment deposition can be a major stressor reducing the health of corals and reef resilience. Here, we investigated the influence of severe sedimentation on the mutualistic relationship between small damselfishes (
Pomacentrus moluccensis
and
Dascyllus aruanus
) and their coral host (
Pocillopora damicornis
). In an aquarium experiment, corals were exposed to sedimentation rates of approximately 100 mg cm
−2
d
−1
, with and without fishes present, to test whether: (i) fishes influence the accumulation of sediments on coral hosts, and (ii) fishes moderate partial colony mortality and/or coral tissue condition. Colonies with fishes accumulated much less sediment compared with colonies without fishes, and this effect was strongest for colonies with
D. aruanus
(fivefold less sediment than controls) as opposed to
P. moluccensis
(twofold less sediment than controls). Colonies with symbiont fishes also had up to 10-fold less sediment-induced partial mortality, as well as higher chlorophyll and protein concentrations. These results demonstrate that fish mutualisms vary in the strength of their benefits, and indicate that some mutualistic or facilitative interactions might become more important for species health and resilience at high-stress levels.
Comments on open string with ‘massive’ boundary term
Authors: Tseytlin Arkady A.
Published: April 2020

We discuss possible definition of open string path integral in the presence of additional boundary couplings corresponding to the presence of masses at the ends of the string. These couplings are not conformally invariant implying that as in a non-critical string case one is to integrate over the one-dimensional metric or reparametrizations of the boundary. We compute the partition function on the disc in the presence of an additional constant gauge field background and comment on the structure of the corresponding scattering amplitudes.
Characterisation of buried blast loading
Authors: Clarke Sam , Rigby Sam , Fay Steve , Barr Andrew , Tyas Andy , Gant Matt , Elgy Ian
Published: April 2020

While it is well known that detonation of shallow-buried high explosive charges generally results in above-surface loading which is greatly amplified compared with the same detonation in air, uncertainty persists as to the mechanisms leading to this effect. The work presented in this paper is a systematic investigation into the mechanisms of load transfer in buried blast events. This paper details the results from a parametric study into the mechanisms and magnitudes of load transfer following a shallow-buried explosion, where spatial and temporal load distributions are directly measured on a rigid surface using an array of Hopkinson pressure bars. In particular, the investigation has looked at the influence of both geometrical confinement and geotechnical conditions on the loading. The parametric study was separated into four main threads: the influence of physical confinement; gravimetric moisture content; stand-off distance and depth of burial; and soil material/particle size distribution. This study allows a direct observation of the contributions of each of these distinct parameters, and in particular the ability to discern how each parameter influences the temporal form and spatial distribution of the loading.
Displacement ventilation: a viable ventilation strategy for makeshift hospitals and public buildings to contain Covid-19 and other airborne diseases
Authors: Bhagat Rajesh K. , Linden P. F.
Published: April 2020

The SARS-CoV-2 virus has so far infected more than 2.4 million people around the world, and its impact is being felt by all. Patients with airborne diseases such as Covid-19 should ideally be treated in negative pressure isolation rooms. However, due to the overwhelming demand for hospital beds, patients are being treated in general wards, hospital corridors, and makeshift hospitals. Adequate building ventilation in hospitals and public spaces is a crucial factor to contain the disease1,2, to exit the current lockdown situation, and reduce the chance of subsequent waves of outbreaks. Lu et al. 3 reported an air-conditioner induced Covid-19 outbreak, by an asymptomatic patient, in a restaurant in Guangzhou, China, which exposes our vulnerability to future outbreaks linked to ventilation in public spaces. We demonstrate that displacement ventilation (either mechanical or natural ventilation), where air intakes are at low level and extracts are at high level, is a viable alternative to negative pressure isolation rooms, which are often not available on site in hospital wards and makeshift hospitals. Displacement ventilation produces negative pressure at the occupant level, which draws fresh air from outdoor, and positive pressure near the ceiling, which expels the hot and contaminated air out. We acknowledge that, in both developed and developing countries, many modern large structures lack the openings required for natural ventilation. This lack of openings can be supplemented by installing extract fans. We provide guidelines for such mechanically assisted-naturally ventilated makeshift hospitals, and public spaces such as supermarkets and essential public buildings.
Development and testing of a game-based digital intervention for working memory training in autism spectrum disorder
Authors: Wagle Surbhit , Ghosh Arka , Karthic P , Ghosh Akriti , Pervaiz Tarana , Kapoor Rashmi , Patil Koumudi , Gupta Nitin
Published: April 2020

Autism spectrum disorder (ASD) is prevalent globally, yet it lacks cost-effective treatment approaches. Deficits in executive functions occur frequently in autism spectrum disorder and present a target for intervention. Here we report the design and development of five smartphone-based games for training working memory in autistic children. These open-source games, available free of cost to the community, were designed to match the behavioral preferences and sensorimotor abilities of autistic kids. We then conducted a preliminary trial to test the effectiveness of a month-long intervention using these games. Although we did not see a significant change in the working memory of all children with a month-long training, children who performed better on the games also showed more improvement in their working memory, suggesting that a longer intervention with the games might be useful in improving working memory. Using a Hindi translation of the Autism Treatment Evaluation Checklist (ATEC), we also tested the far transfer of the training in reducing autistic symptoms. We found no significant change in the autistic symptoms after the intervention. Further, there was no correlation between the change in the working memory and the change in the autistic symptoms.
Comparison of SARS-CoV-2 Exit Strategies Building Blocks
Authors: Barkan Elad , Shilo Smadar , Talmor-Barkan Yeela
Published: April 2020

We consider and compare various exit strategy building blocks and key measures to mitigate the current SARS-CoV-2 pandemic, some already proposed as well as improvements we suggest. Our comparison is based on a computerized simulation integrating accumulated SARS-CoV-2 epidemiological knowledge. Our results stress the importance of immediate on-symptom isolation of suspected cases and household members, and the beneficial effects of prompt testing capacity. Our findings expose significant epidemic-suppression differences among strategies with seemingly similar economic cost stressing the importance of not just the portion of population and business that is released, but also the pattern. The most effective building blocks are the ones that integrate several base strategies - they allow to release large portions of the population while still achieving diminishing viral spread. However, it may come with a price on somewhat more complex schemes. For example, our simulations indicate that a personal isolation of 4 days once every two weeks, for example a long weekend (Fri-Mon) self-isolation once every two weeks, while protecting the 5% most sensitive population would reduce R well below 1 even if ten percent of the population do not follow it. This kind of integrated strategy can be either voluntary or mandatory and enforced. We further simulate the contrasting approach of a stratified population release in a hope to achieve herd immunity, which for the time being seems inferior to other suggested building blocks. Knowing the tradeoff between building blocks could help optimize exit strategies to be more effective and suitable for a particular area or country, while maximizing human life as well as economic value. Given our results, we believe that pandemic can be controlled within a reasonable amount of time and at a reasonable socio-economic burden.
Wisconsin April 2020 Election Not Associated with Increase in COVID-19 Infection Rates
Authors: Berry Andrew C. , Mulekar Madhuri S. , Berry Bruce B.
Published: April 2020

Background

Wisconsin (WI) held a primary election in the midst of the COVID-19 pandemic. Live voting at polls was allowed despite concern over increasing the spread of COVID-19. In addition to 1.1 million absentee ballots cast, 453,222 persons voted live. The purpose of our study was to determine if an increase in COVID-19 activity was associated with the election.

Methods

Using the voting age population for the United States (US), WI, and its 3 largest counties, and daily new COVID-19 case reports from various COVID-19 web-based dashboards, daily new case rates were calculated. With election day April 7, the incubation period included April 12-21. The new case activity in the rest of the US was compared with the Wisconsin activity during the incubation period.

Results

WI daily new case rates were lower than those of the rest of the US for the 10-day period before the election and remained lower during the post exposure incubation period. The ratio of Wisconsin new case rates to US new case rates was 0.34 WI: 1 US for the 10 days leading up to the election and declined to 0.28 WI: 1 US for the 10-day post-incubation period after the election. Similar analysis for Milwaukee county showed a pre-election ratio of 1.02 Milwaukee: 1 US and after the election the ratio was 0.63 Milwaukee: 1 US. Dane county had a pre-election ratio of 0.21 Dane: 1 US case, and it fell to 0.13 Dane: 1 US after the election. Waukesha county had a pre-election ratio of 0.27 Waukesha: 1 US case and that fell to 0.19 Waukesha: 1 US after the election.

Conclusions

There was no increase in COVID-19 new case daily rates observed for Wisconsin or its 3 largest counties following the election on April 7, 2020, as compared to the US, during the post-incubation interval period.
Pharmacokinetic bases of the hydroxychloroquine response in COVID-19: implications for therapy and prevention
Authors: Tarek Mohammad , Savarino Andrea
Published: April 2020

Chloroquine/hydroxychloroquine has recently been the subject of intense debate in regard to its potential antiviral activity against SARS-Cov-2, the etiological agent of COVID-19. Some report possible curative effects, others do not. In order to shed some light on this rather controversial topic, we used mathematical modelling to simulate possible scenarios of response to hydroxychloroquine in COVID-19 patients. Our computer-aided simulations show that hydroxychloroquine may have an impact on the amplitude of the viral load peak but that viral clearance is not significantly accelerated if the drug is not administered early enough (i.e. when viral loads range from 1 to 1,000 copies/mL). Although some authors had used the trough plasma concentrations or the theoretical drug distribution in the lung to model the effect of chloroquine/hydroxychloroquine on COVID-19, the theoretical drug response based on the trough whole blood concentrations of the drug agreed well with the results of the clinical trials so far reported. Moreover, the effects of chloroquine/hydroxychloroquine could be fully explained when taking into account also the capacity of this drug to raise cell-mediated responses against the productively SARS-Cov-2-infected cells. On the whole, the present study suggests that chloroquine/hydroxychloroquine has a narrow therapeutic window, which overlaps with the highest tolerated doses. These considerations may have implications for development of anti-COVID-19 combination therapies and prevention strategies.
LONG-TERM MORPHOLOGICAL CHANGES IN THE HUMAN CORNEA LAYERS
Authors: Goedert Merry Elizabeth , Lucca Micheline Borges , Beltrão Medeiros Felipe , da Glória Silva Maria , Soares Renata Oliveira , Rezende Gustavo Lara , Catai Chalita Maria Regina , Souza Kückelhaus Selma Aparecida
Published: April 2020

Purpose

To describe and compare the morphology of the corneal layers from adults and aging individuals.

Methods

The study was conducted with normal corneas (n = 15) of predominantly male individuals grouped into two classes (group I: < 40 years; group II: ≥ 40 years). To describe and to compare the corneas, the thickness of the layers, the integrity of the stromal lamellae and the endothelial lesions, SEM images of the central and peripheral regions of each cornea were quantified.

Results

The total thickness of the cornea was largest in the periphery only for group I. The Bowman, Descemet and endothelium layers of group I were thicker at the periphery of the corneas than their respective central regions, while for group II, this difference was observed only in the Bowman layer. Comparison between groups showed that the Bowman layer was thicker (central region), while the Descemet membrane and endothelium were thinner in group II; A greater number of endothelial lesions in both regions of the corneas was observed in group II, but no difference in the total number of interlamellar slits.

Conclusions

The morphological changes observed in group II could be related to the reduction in the pool of stem cell of limbus and, despite the corneas being from healthy individuals, these changes could compromise the success of transplantation. Our results point to an update of corneal uptake protocols and they may aid in the refractive surgeries interventions in individuals from different age groups.
Potential Role of Personal Protective Equipment Use in the Protection Against COVID-19 Infection Among Health Care Workers
Authors: Wang Wei , Min Yuan-Zeng , Yang Chun-Mei , Hong Hai-Ou , Xue Tian , Gao Yong , Jin Tengchuan , Lu Zhao-Hui , Zhang Liang-Ming , Zheng Xueying , Luo Sihui , Bao Wei , Weng Jian-Ping
Published: April 2020

The coronavirus disease 2019 (COVID-19) pandemic has posed a major challenge for protecting health care workers (HCWs) against the infection. Use of personal protective equipment (PPE) in health care workplace is recommended as a high priority. In order to investigate the relationship between PPE use and the number of COVID-19 cases among HCWs, we conducted a molecular epidemiological study among 142 HCWs who were dispatched from Hefei to work in Wuhan and 284 HCWs who remained in Hefei, China; both provided care for patients with COVID-19. Nucleic acid testing and SARS-CoV-2 specific antibody (IgM, IgG, IgA) detection were performed to confirm SARS-CoV-2 infection among those HCWs. We also extracted publicly released data on daily number of COVID-19 cases among HCWs, daily number of HCWs who were dispatched to Hubei province since January 24, and daily production of PPE in China and daily demand and supply of PPE in Hubei province. Our laboratory testing confirmed that none of the 142 HCWs who were dispatched to work in Wuhan and 284 HCWs who remained in Hefei were infected by SARS-CoV-2. Consistent with these findings, as of April 15, 2020, none of the 42,600 HCWs who were successively dispatched to Hubei province since January 24, 2020 was reported to have COVID-19. These HCWs were provided with adequate supply of PPE as committed by their original institutions or provinces. In contrast, during the early phase of COVID-19 epidemic in Hubei province, a substantial shortage of PPE and an increasing number of COVID-19 infection among HCWs were reported. With the continuing increase in domestic production of PPE in China, the PPE supply started to meet and then exceed the demand. This coincided with a subsequent reduction in the number of reported COVID-19 cases among HCWs. In conclusion, our findings indicate that COVID-19 infection among HCWs could be completely prevented. Appropriate and adequate PPE might play a crucial role in protecting HCWs against COVID-19 infection.
Estimation of SARS-CoV-2 infection fatality rate by real-time antibody screening of blood donors
Authors: Erikstrup Christian , Hother Christoffer Egeberg , Vestager Pedersen Ole Birger , Mølbak Kåre , Skov Robert Leo , Holm Dorte Kinggaard , Sækmose Susanne , Nilsson Anna Christine , Brooks Patrick Terrence , Kjærgaard Boldsen Jens , Mikkelsen Christina , Gybel-Brask Mikkel , Sørensen Erik , Dinh Khoa Manh , Mikkelsen Susan , Møller Bjarne Kuno , Haunstrup Thure , Harritshøj Lene , Jensen Bitten Aagaard , Hjalgrim Henrik , Lillevang Søren Thue , Ullum Henrik
Published: April 2020

Background

The pandemic due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has tremendous consequences for our societies. Knowledge of the seroprevalence of SARS-CoV-2 is needed to accurately monitor the spread of the epidemic and also to calculate the infection fatality rate (IFR). These measures may help the authorities to make informed decisions and adjust the current societal interventions. Blood donors comprise approximately 4.7% of the similarly aged population of Denmark and blood is donated in all areas of the country. The objective of this study was to perform real-time seroprevalence surveying among blood donors as a tool to estimate previous SARS-CoV-2 infections and the population based IFR.

Methods

All Danish blood donors aged 17-69 years giving blood April 6 to 17 were tested for SARS-CoV-2 immunoglobulin M and G antibodies using a commercial lateral flow test. Antibody status was compared between areas and an estimate of the IFR was calculated. The seroprevalence was adjusted for assay sensitivity and specificity taking the uncertainties of the test validation into account when reporting the 95% confidence intervals (CI).

Results

The first 9,496 blood donors were tested and a combined adjusted seroprevalence of 1.7% (CI: 0.9-2.3) was calculated. The seroprevalence differed across areas. Using available data on fatalities and population numbers a combined IFR in patients younger than 70 is estimated at 82 per 100,000 (CI: 59-154) infections.

Conclusions

The IFR was estimated to be slightly lower than previously reported from other countries not using seroprevalence data. The IFR, including only individuals with no comorbidity, is likely several fold lower than the current estimate. This may have implications for risk mitigation. We have initiated real-time nationwide anti-SARS-CoV-2 seroprevalence surveying of blood donations as a tool in monitoring the epidemic.