bluuebunny/crossref_metadata_2025 huggingface dataset:
Scientific publications in internal medicine and family medicine: a comparative cross-sectional study in Swiss university hospitals
Authors: Sebo Paul , de Lucia Sylvain , Vernaz Nathalie
Published: October 2020

Background

Family medicine is a relatively new academic medical discipline. We aimed to compare the main bibliometric indices of hospital-based senior physicians practicing internal medicine versus family medicine in Switzerland.

Methods

We conducted this cross-sectional study in March 2020. We selected all hospital-based senior physicians practicing internal medicine or family medicine in the six Swiss university hospitals. Using Web of Science, after removing from both groups of physicians the 5% with the highest number of publications, we extracted the number of publications, the number of publications per year, the number of citations, the number of citations per year, the number of citations per publication and the h-index. We compared the data between the two groups using negative binomial regressions and the proportion of physicians having at least one publication using chi-square tests.

Results

We included 349 physicians in the study (internal medicine: 51%, men: 51%). The median number of publications was three [interquartile range (IQR) = 18], the median number of citations was nine (IQR = 158) and the median h-index was one (IQR = 5). All bibliometric indices were similar in both groups, as was the proportion of physicians having at least one publication (family medicine: 87% versus 82%, P = 0.15).

Conclusions

We found no association between the bibliometric indices and the medical specialty. Further studies are needed to explore other important indicators of academic output, such as those more specifically assessing its quality and scientific importance.
Antecedents and Outcomes of Enrichment Among Working Family Caregivers of People With Dementia: A Longitudinal Analysis
Authors: Morimoto Hiroshi , Takebayashi Yoshitake
Published: October 2020

Objectives

Despite evidence of negative aspects of the work–caregiving interface (e.g., work–family conflict) among family caregivers of people with dementia (PWD), little is known about the positive aspects (e.g., enrichment). We examined antecedents and outcomes of family-to-work enrichment (FWE) and work-to-family enrichment (WFE) among working family caregivers of PWD. In terms of antecedents, we investigated whether factors that alleviated work–family conflict increased enrichment.

Method

We conducted a 3-wave 6-month-interval longitudinal online survey of Japanese working family caregivers of PWD (N = 747). We examined the mediational effects of WFE and FWE on associations between participants’ work resources (job control, supervisor support, co-worker support, and organizational support) and caregiving support and their well-being (psychological distress and quality of life). We also examined the moderating effect of caregiving self-efficacy on the relationships between caregiving support/caregiving demands and FWE.

Results

Our longitudinal analysis confirmed supervisor support had a positive effect on WFE. FWE had no significant longitudinal mediating effect on the association between caregiving support and well-being, and self-efficacy had no longitudinal moderating effect on FWE.

Discussion

Supervisor support is important for WFE, but greater enrichment does not necessarily improve family caregiver well-being. Caregiving experience (i.e., caregiving demands and caregiving support) has little effect on the work–caregiving interface. Policy makers should focus on supporting companies to create family-friendly work environments. More research is needed on factors that increase FWE and moderate the relationship between enrichment and working family caregivers’ well-being.
Cognition in Motion: Evidence for Intact Action Control With Healthy Aging
Authors: Ruitenberg Marit F L , Koppelmans Vincent
Published: October 2020

Objectives

Healthy aging is associated with impairments in motor functioning. Such functioning is not limited to the physical execution of actions, but also involves cognitive processes that allow for goal-directed behavior. The present study examined whether aging affects 2 of such cognitive components that control motor functioning, namely action planning and action adaptation, and whether age effects are associated across components.

Method

A group of 103 participants aged 18–82 years performed 2 tasks that have previously been linked to action planning and adaptation, respectively.

Results

Despite observations that aging was associated with slower and less accurate responses, Bayesian models showed evidence indicating that older age was not associated with poorer action planning and conflict adaptation.

Discussion

These findings challenge the view that healthy aging is associated with a general deficit in motor functioning and suggest that some cognitive aspects of motor control may be relatively spared.
Constitutional rights, horizontality, and the Ugandan Constitution: An example of emerging norms and practices in Africa
Authors: Chirwa Danwood M , Mbazira Christopher
Published: October 2020

The traditional view that only states have human rights obligations and, relatedly, that a constitution operates only vertically has been changing. In Uganda, as is the case in several other African countries, the Constitution expressly states that the rights and freedoms it recognizes must be respected, upheld, and promoted by all persons and organs of state, but the practical implications of this provision remain unexplored. So far, Ugandan courts have shown willingness to hold non-state actors directly responsible for violations of constitutional rights, although they are yet to use the language of horizontality expressly. Furthermore, Ugandan courts do not seem particularly troubled by the principle of subsidiarity which holds that statutory and common law remedies must be pursued first before recourse may be had to direct constitutional remedies. This has made it possible for litigants to bring direct constitutional suits against state and non-state actors in one action or to plead both constitutional provisions and statutory provisions, or direct and indirect horizontality, to enforce constitutional rights. This is a significant departure from the existing practice of constitutional horizontality in comparative constitutional law. In other respects, however, such as recognizing the duty to protect and applying the principle of third-party effect of constitutional rights, Uganda’s constitutional jurisprudence remains underdeveloped.
Dynamic Impact of Hormone Therapy on Laboratory Values in Transgender Patients over Time
Authors: Allen Amber N , Jiao Rhoda , Day Philip , Pagels Patti , Gimpel Nora , SoRelle Jeffrey A
Published: October 2020

Background

Known physiological changes occur while transgender patients are taking hormone therapy (HT). However, knowledge is limited about when laboratory values stabilize and if there are any long-term impacts, making it challenging for physicians to provide adequate gender-affirming care. We aim to analyze laboratory values with HT use over 5 years and after discontinuation of HT to define when values achieve stability.

Methods

We performed a multicenter retrospective analysis of 126 transgender women (TW) and 91 transgender men (TM) at consecutive clinic visits. Labs included complete metabolic panel, complete blood count, lipids, and hormone levels and were monitored for 5 years. Absolute measurement and percentage change from baseline were calculated for each analyte value. We collected the laboratory studies described from patients off HT and the duration of discontinuation to determine the time to return to baseline levels.

Results

During HT, red blood cell (RBC; erythrocyte) indexes reach stable levels within 6 months (P < 0.001) and are unchanged long term. Some analytes such as HDL and platelets showed increases beyond the first year of HT in TW (P = 0.001 and P < 0.001, respectively). LDL and alanine aminotransferase increased beyond 1 year in TM (P < 0.005 and P < 0.001, respectively), whereas HDL decreased beyond 1 year (P < 0.001). Time for laboratory values to return to baseline occurred around 10 weeks.

Conclusions

Most analytes reach stable levels within 6 months (RBC and creatinine), whereas others change in the long term (LDL, HDL, platelets). This information can be used to guide physicians as they monitor their transgender patients in all stages of their progress through HT.
The Socialization of Young Children’s Empathy for Pain: The Role of Mother– and Father–Child Reminiscing
Authors: Pavlova Maria , Graham Susan A , Peterson Carole , Lund Tatiana , Kennedy Madison , Nania Cara , Noel Melanie
Published: October 2020

Objective

Empathy for pain allows one to recognize, understand, and respond to another person’s pain in a prosocial manner. Young children develop empathy for pain later than empathy for other negative emotions (e.g., sadness), which may be due to social learning. How parents reminisce with children about past painful events has been linked to children’s pain cognitions (e.g., memory) and broader socioemotional development. The present study examined how parent–child reminiscing about pain may be linked to children’s empathic behaviors toward another person’s pain.

Methods

One hundred and fourteen 4-year-old children (55% girls) and for each, one parent (51% fathers) completed a structured narrative elicitation task wherein they reminisced about a past painful autobiographical event for the child. Children were then observed responding in a lab-based empathy task wherein they witnessed a confederate pretending to hurt themselves. Children’s empathic behaviors and parent–child narratives about past painful events were coded using established coding schemes.

Results

Findings revealed that parents who used more neutral emotion language (e.g., How did you feel?) when discussing past painful events had children who exhibited more empathic concern in response to another’s pain. Similarly, children who used more explanations when reminiscing about past painful events displayed more empathic concern about another’s pain.

Conclusions

Findings highlight a key role of parent–child reminiscing about the past pain in the behavioral expression of empathy for pain in young children.
FANTOM enters 20th year: expansion of transcriptomic atlases and functional annotation of non-coding RNAs
Authors: Abugessaisa Imad , Ramilowski Jordan A , Lizio Marina , Severin Jesicca , Hasegawa Akira , Harshbarger Jayson , Kondo Atsushi , Noguchi Shuhei , Yip Chi Wai , Ooi Jasmine Li Ching , Tagami Michihira , Hori Fumi , Agrawal Saumya , Hon Chung Chau , Cardon Melissa , Ikeda Shuya , Ono Hiromasa , Bono Hidemasa , Kato Masaki , Hashimoto Kosuke , Bonetti Alessandro , Kato Masaki , Kobayashi Norio , Shin Jay , de Hoon Michiel , Hayashizaki Yoshihide , Carninci Piero , Kawaji Hideya , Kasukawa Takeya
Published: October 2020

The Functional ANnoTation Of the Mammalian genome (FANTOM) Consortium has continued to provide extensive resources in the pursuit of understanding the transcriptome, and transcriptional regulation, of mammalian genomes for the last 20 years. To share these resources with the research community, the FANTOM web-interfaces and databases are being regularly updated, enhanced and expanded with new data types. In recent years, the FANTOM Consortium's efforts have been mainly focused on creating new non-coding RNA datasets and resources. The existing FANTOM5 human and mouse miRNA atlas was supplemented with rat, dog, and chicken datasets. The sixth (latest) edition of the FANTOM project was launched to assess the function of human long non-coding RNAs (lncRNAs). From its creation until 2020, FANTOM6 has contributed to the research community a large dataset generated from the knock-down of 285 lncRNAs in human dermal fibroblasts; this is followed with extensive expression profiling and cellular phenotyping. Other updates to the FANTOM resource includes the reprocessing of the miRNA and promoter atlases of human, mouse and chicken with the latest reference genome assemblies. To facilitate the use and accessibility of all above resources we further enhanced FANTOM data viewers and web interfaces. The updated FANTOM web resource is publicly available at https://fantom.gsc.riken.jp/.
Comprehensive mapping of the human cytokine gene regulatory network
Authors: Santoso Clarissa S , Li Zhaorong , Lal Sneha , Yuan Samson , Gan Kok Ann , Agosto Luis M , Liu Xing , Pro Sebastian Carrasco , Sewell Jared A , Henderson Andrew , Atianand Maninjay K , Fuxman Bass Juan I
Published: October 2020

Proper cytokine gene expression is essential in development, homeostasis and immune responses. Studies on the transcriptional control of cytokine genes have mostly focused on highly researched transcription factors (TFs) and cytokines, resulting in an incomplete portrait of cytokine gene regulation. Here, we used enhanced yeast one-hybrid (eY1H) assays to derive a comprehensive network comprising 1380 interactions between 265 TFs and 108 cytokine gene promoters. Our eY1H-derived network greatly expands the known repertoire of TF–cytokine gene interactions and the set of TFs known to regulate cytokine genes. We found an enrichment of nuclear receptors and confirmed their role in cytokine regulation in primary macrophages. Additionally, we used the eY1H-derived network as a framework to identify pairs of TFs that can be targeted with commercially-available drugs to synergistically modulate cytokine production. Finally, we integrated the eY1H data with single cell RNA-seq and phenotypic datasets to identify novel TF–cytokine regulatory axes in immune diseases and immune cell lineage development. Overall, the eY1H data provides a rich resource to study cytokine regulation in a variety of physiological and disease contexts.
Confined growth of ZIF-8 in dendritic mesoporous organosilica nanoparticles as bioregulators for enhanced mRNA delivery in vivo
Authors: Wang Yue , Song Hao , Liu Chao , Zhang Ye , Kong Yueqi , Tang Jie , Yang Yannan , Yu Chengzhong
Published: October 2020

Zeolitic imidazolate framework-8 (ZIF-8) and its composites have diverse applications. However, ZIF-8-based nanocomposites are mainly used as carriers in biomolecular delivery, with the functions of metal ions and ligands rarely used to modulate the biofunctions. In this work, dendritic mesoporous organosilica nanoparticles (DMONs) with tetrasulfide bond were used to confine ZIF-8 growth partially inside mesopores as a novel nanocomposite for mRNA delivery. Each component in the resultant DMONs-ZIF-8 contributed to mRNA delivery applications, including high loading benefitting from positively charged ZIF-8 and large mesopores of DMONs, endosomal escape promoted by the imidazole ring of ZIF-8, and long-term glutathione depletion mediated by both zinc ions and tetrasulfide bond. Combined together, DMONs-ZIF-8 demonstrated enhanced mRNA translation and better transfection efficiency than commercial products and toxic polymer-modified DMONs in vitro and in vivo.
The Communication of Metacognition for Social Strategy in Psychosis: An Exploratory Study
Authors: Hertz Uri , Bell Vaughan , Barnby Joseph M , McQuillin Andrew , Bahrami Bahador
Published: October 2020

Sharing privately held information, for example, one’s confidence in the likelihood of future events, can greatly help others make better decisions as well as promoting one’s reputation and social influence. Differences in metacognition on the one hand, and difficulties in social functioning and social cognition on the other, have been reported in people diagnosed with schizophrenia and bipolar disorder. However, despite clear relevance few studies have investigated the link between these abilities and psychosis. In this exploratory study, we compared individuals diagnosed with schizophrenia, bipolar disorder, and a group of unselected general population controls, in an online competitive advice-giving task. Participants gave advice to a client by making a probabilistic perceptual judgment. They could strategically adapt the advice confidence to gain influence over the client. Crucially, participants competed with a rival adviser to attract the client’s endorsement. We observe that participants diagnosed with schizophrenia displayed an overall overconfidence in their advice compared with other, bipolar, and unselected control groups, but did not differ in metacognitive efficiency from controls. Symptom-based analysis revealed that the social-influence effect was associated with the presence of delusions but not hallucinations or mood symptoms. These results suggest that the social communication of uncertainty should be further investigated in psychosis.
EU Values Are Law, after All: Enforcing EU Values through Systemic Infringement Actions by the European Commission and the Member States of the European Union
Authors: Scheppele Kim Lane , Kochenov Dimitry Vladimirovich , Grabowska-Moroz Barbara
Published: October 2020

Although compliance with the founding values is presumed in its law, the Union is now confronted with persistent disregard of these values in two Member States. If it ceases to be a union of Rule-of-Law-abiding democracies, the European Union (EU) is unthinkable. Purely political mechanisms to safeguard the Rule of Law, such as those in Article 7 Treaty of European Union (TEU), do not work. Worse still, their existence has disguised the fact that the violations of the values of Article 2 TEU are also violations of EU law. The legal mechanisms tried thus far, however, do not work either. The fundamental jurisprudence on judicial independence and irremovability under Article 19(1) TEU is a good start, but it has been unable to change the situation on the ground. Despite ten years of EU attempts at reining in Rule of Law violations and even as backsliding Member States have lost cases at the Court of Justice, illiberal regimes inside the EU have become more consolidated: the EU has been losing through winning. More creative work is needed to find ways to enforce the values of Article 2 TEU more effectively. Taking this insight, we propose to turn the EU into a militant democracy, able to defend its basic principles, by using the traditional tools for the enforcement of EU law in a novel manner. We demonstrate how the familiar infringement actions—both under Article 258 and 259 TFEU—can be adapted as instruments for enforcing EU values by bundling a set of specific violations into a single general infringement action to show how a pattern of unlawful activity rises to the level of being a systemic violation. A systemic violation, because of its general and pervasive nature, in itself threatens basic values above and beyond violations of individual provisions of the acquis. Certified by the Court of Justice, a systemic violation of EU law should call for systemic compliance that would require the Member State to undo the effects of its attacks on the values of Article 2. The use of Article 260 Treaty on the Functioning of the EU (TFEU) to deduct fines from EU funds due to be received by the troubled Member State would provide additional incentives for systemic compliance. We illustrate this proposed militant democratic structure by explaining and critiquing what the Commission and Court together have done to reign in the governments of Hungary and Poland so far and then showing how they can do better.
Illumina Sequencing of 18S/16S rRNA Reveals Microbial Community Composition, Diversity, and Potential Pathogens in 17 Turfgrass Seeds
Authors: Ban Li-Ping , Li Jin-Dong , Yan Min , Gao Yu-Hao , Zhang Jin-Jin , Moural Timothy W. , Zhu Fang , Wang Xue-Min
Published: October 2020

The increasing need for turfgrass seeds is coupled with the high risk of dangerous microbial pathogens being transmitted through the domestic and international trade of seeds. Concerns continue to be raised about seed safety and quality. Here, we show that next-generation sequencing (NGS) of DNA represents an effective and reliable tactic to monitor the microbial communities within turfgrass seeds. A comparison of DNA sequence data with reference databases revealed the presence of 26 different fungal orders. Among them, serious plant disease pathogens such as Bipolaris sorokiniana, Boeremia exigua, Claviceps purpurea, and Rhizoctonia zeae were detected. Seedborne bacteria, including Erwinia persicina and Acidovorax avenae, were identified from different bacterial orders. Our study indicated that the traditional culturing method and the NGS approach for pathogen identification complement each other. The reliability of culturing and NGS methods was further validated by PCR with specific primers. The combination of these different techniques ensures maximum sensitivity and specificity for turfgrass seed pathogen testing assay.
Screening for Susceptibility of Macadamia to Euwallacea fornicatus and its Fungal Symbiont Fusarium euwallaceae
Authors: Twiddy D. , Fell S. , de Beer Z. W. , Fourie G.
Published: October 2020

The polyphagous shothole borer (Euwallacea fornicatus, PSHB), an ambrosia beetle, with its fungal symbiont, Fusarium euwallaceae, is responsible for Fusarium dieback (FD) in a wide range of woody hosts. In 2019, the first suspected case of E. fornicatus was reported in macadamia in South Africa. The aims of this study were to confirm the E. fornicatus report and thereafter to assess the susceptibility of commercially planted macadamia cultivars to FD caused by F. euwallaceae. The identities of the beetle and associated fungal symbionts were confirmed by means of DNA sequence analysis of the 28S ribosomal large subunit gene for beetles and the internal transcribed spacer region for fungi. Isolates identified as Fusarium species were further characterized by phylogenetic analysis of the translation elongation factor 1α and the β-tubulin gene regions. Thereafter, Koch’s postulates regarding F. euwallaceae were fulfilled on a mature Macadamia integrifolia tree planted at the experimental farm of the University of Pretoria. In order to determine susceptibility against FD, additional cultivar screening was conducted on nine commercially planted cultivars by means of pathogenicity trials using sterilized or inoculated toothpicks inserted into detached branches. Detached branch inoculations showed no significant lesion development six weeks post inoculation, except for cultivar 816. The restricted growth of F. euwallaceae observed in macadamia tissues therefore suggests that macadamia may not be a suitable host for F. euwallaceae and that the threat of FD in macadamia in the event of E. fornicatus infestation is less than for other E. fornicatus hosts. Future work on beetle attraction to macadamia is recommended for a more comprehensive understanding of the interaction between E. fornicatus and its fungal symbionts and macadamia.
Using telehealth for diabetes self-management in underserved populations
Authors: Ju Hsiao-Hui
Published: October 2020

Diabetes self-management is a complex process and central to well-being of patients with this chronic disorder. A patient-centered telehealth program may potentially meet needs of those in underserved populations to reduce socioeconomic disparities. Achieving this goal requires a focused concentration on health behaviors and practices of individuals in underserved populations.
Asymptomatic cryptococcal antigenemia in HIV-infected patients: a review of recent studies
Authors: Xu Xiao-Lei , Zhao Ting , Harypursat Vijay , Lu Yan-Qiu , Li Yan , Chen Yao-Kai
Published: October 2020

The prevalence of asymptomatic cryptococcal antigenemia (ACA) in human immunodeficiency virus (HIV) infected individuals has been observed to be elevated. The prevalence of ACA ranges from 1.3% to 13%, with different rates of prevalence in various regions of the world. We reviewed studies conducted internationally, and also referred to two established expert consensus guideline documents published in China, and we have concluded that Chinese HIV-infected patients should undergo cryptococcal antigen screening when CD4+ T-cell counts fall below 200 cells/μL and that the recommended treatment regimen for these patients follow current World Health Organization guidelines, although it is likely that this recommendation may change in the future. Early screening and optimized preemptive treatment for ACA is likely to help decrease the incidence of cryptococcosis, and is lifesaving. Further studies are warranted to explore issues related to the optimal management of ACA.
Modern Management of High-risk Soft Tissue Sarcoma With Neoadjuvant Chemoradiation
Authors: Byun David J. , Katz Leah M. , Xiao Julie , Rapp Timothy B. , Paoluzzi Luca , Rosen Gerald , Schiff Peter B.
Published: October 2020

Objective:

Neoadjuvant chemoradiation (NA-CRT), followed by resection of high-risk soft tissue sarcoma (STS), may offer good disease control and toxicity outcomes. We report on a single institution’s modern NA-CRT experience.

Materials and Methods:

Delay to surgical resection, resection margin status, extent of necrosis, tumor cell viability, presence of hyalinization, positron emission tomography (PET)/computed tomography data, and treatment toxicities were collected. Using the Kaplan-Meier survival analysis, 5-year overall survival, disease-free survival, distant metastasis-free survival, and local control (LC) were estimated. Clinicopathologic features and PET/computed tomography avidity changes were assessed for their potential predictive impact using the log-rank test.

Results:

From 2011 to 2018, 37 consecutive cases of localized high-risk STS were identified. Twenty-nine patients underwent ifosfamide-based NA-CRT to a median dose of 50 Gy before en bloc resection. At a median follow-up of 40.3 months, estimated 5-year overall survival was 86.1%, disease-free survival 70.2%, distant metastasis-free survival 75.2%, and LC 86.7%. Following NA-CRT, a median reduction of 54.7% was observed in tumor PET avidity; once resected, median tumor necrosis of 60.0% with no viable tumor cells was detected in 13.8% of the cases. Posttreatment resection margins were negative in all patients, with 27.6% having a margin of ≤1 mm. Delays of over 6 weeks following the end of radiation treatment to surgical resection occurred in 20.7% cases and was suggestive of inferior LC (92.8% vs. 68.6%, P=0.025).

Conclusions:

This single-institution series of NA-CRT demonstrates favorable disease control. Delay in surgical resection was associated with inferior LC, a finding that deserves further evaluation in a larger cohort.

Level of Evidence:

Level III—retrospective cohort study.
Methods and Influencing Factors for the Simple and Rapid Identification of Depleted Uranium Weapon Use under Battlefield Conditions
Authors: Yu Tao , Yin Ya-Ru , Lu Bing-Hui , Yang Lu-Xun , Liu Jing , Ren Jiong , Yang Zhang-You , Hao Yu-Hui , Wang Wei-Dong , Li Rong
Published: October 2020

The purpose of this paper is to explore how to rapidly and easily identify depleted uranium (DU) samples under battlefield conditions and to study the factors that influence their measurement. The air-absorbed dose rate and surface contamination levels for DU samples of 2–330 g were measured using a patrol instrument and portable energy spectrometer. The results were analyzed in accordance with IAEA standards for judging radioactive substances. The energy spectra of 5-g quantities of DU samples were analyzed using a high-purity germanium gamma spectrometer, and the uranium content of 100 mg DU samples was determined with an inductively coupled plasma mass spectrometer to clarify the type and composition of the uranium. The same batches of DU samples were identified using a portable gamma-ray spectrometer. We added 0–5 g environmental soil powders at different proportions. After sealing, the spectra were collected with a detection distance of 1–5 cm for 10 min. The activities of 238U and 235U nuclides in the samples were detected with an NaI(TI) scintillation detector. The 238U and 235U mass abundances in samples were calculated from measured specific activities. The sample was determined to contain DU if the 235U to 238U ratio was below 0.00723. It is found that for detecting DU materials with a low activity, surface contamination level measurements are more effective than calculating the air-absorbed external irradiation dose rate. Hence, for low-activity samples suspected to be radioactive, a radiometer with a high sensitivity for surface contamination is recommended, and the optimal measurement distance is 1–3 cm. Under all detection conditions, 238U can be identified using a portable gamma spectrometer, whereas 235U can only be detected under certain conditions. If these nuclides can be detected simultaneously, a 235U to 238U ratio of below 0.00723 indicates the presence of DU. The main factors affecting this identification include the sample mass, sample purity, measurement distance, and measurement time. For the rapid identification of DU with a portable gamma-ray spectrometer, the mass of uranium in the sample must be more than 1 g, the measuring distance needs to be less than 1 cm, and the measuring time must be 1–10 min. It is feasible to use a portable gamma-ray spectrometer to rapidly identify the types and composition of nuclides in DU samples. The detection of 235U activity is a precondition for the identification of DU.
Genetic Characterization of Streptococcus pyogenes emm89 Strains Isolated in Japan From 2011 to 2019
Authors: Hirose Yujiro , Yamaguchi Masaya , Takemoto Norihiko , Miyoshi-Akiyama Tohru , Sumitomo Tomoko , Nakata Masanobu , Ikebe Tadayoshi , Hanada Tomoki , Yamaguchi Takahiro , Kawahara Ryuji , Okuno Rumi , Otsuka Hitoshi , Matsumoto Yuko , Terashima Yuji , Kazawa Yu , Nakanishi Noriko , Uchida Kaoru , Akiyama Yumi , Iwabuchi Kaori , Nakagawa Chikara , Yamamoto Kazunari , Nizet Victor , Kawabata Shigetada
Published: October 2020

Invasive infection caused by Streptococcus pyogenes emm89 strains has been increasing in several countries linked to a recently emergent clade of emm89 strains, designated clade 3. In Japan, the features of emm89 S. pyogenes strains, such as clade classification, remains unknown. In this study, we collected emm89 strains isolated from both streptococcal toxic shock syndrome (STSS) (89 STSS isolates) and noninvasive infections (72 non-STSS isolates) in Japan from 2011 to 2019, and conducted whole-genome sequencing and comparative analysis, which resulted in classification of a large majority into clade 3 regardless of disease severity. In addition, invasive disease-associated factors were found among emm89 strains, including mutations of control of virulence sensor, and absence of the hylP1 gene encoding hyaluronidase. These findings provide new insights into genetic features of emm89 strains.
Noninvasive Detection of Active Microcalcification in an Occlusive Peripheral Vascular Aneurysm Using 18F-NaF PET/CT Imaging
Authors: Eisert Susan Natalie , Chou Ting-Heng , Bobbey Adam J. , Go Michael R. , Stacy Mitchel R.
Published: October 2020

A 65-year-old man with an occluded popliteal artery aneurysm and calf claudication underwent PET/CT imaging with 18F-NaF to assess the status of active microcalcification in the aneurysm site and additional lower extremity arteries. CT imaging revealed macrocalcification of the aneurysm that colocalized with elevated retention of 18F-NaF on PET images. PET/CT detected additional distal arterial sites with focal uptake of 18F-NaF that did not coincide with CT-detectable macrocalcification. This report highlights a case of active microcalcification in an occlusive peripheral aneurysm using PET/CT. PET/CT may provide molecular insight into the remodeling of lower extremity aneurysms and atherosclerotic lesions.
Craniofacial Trauma Due to Stone-pelting – Patterns of Injury and Management
Authors: Arya Saurabh , Jose Anson , Rangan N. Mohan
Published: October 2020

Aim:

The aims of the study were to elucidate the pattern of stone-pelting induced cranio-facial injuries and to document soft and hard tissue injuries, their management, and complications.

Methods:

A retrospective descriptive study was conducted using a sample of patients reporting to our department in the years 2015 to 2020. Cranio-facial injuries were assessed for soft and hard tissue injuries, including tissue loss, and corresponding management. Follow up ranged from 18 ± 6 months. & A standardized surgical regime was followed for patient management, which included primary survey, debridement of wounds, and routine primary repair of soft tissue. Bony defect reconstruction was performed by open reduction and internal fixation. Cranial bone was used as split calvarial graft in postcraniectomy cranioplasty procedures, which were performed after 6 months. Local flaps were used for the reconstruction of soft tissue defects.

Results:

Being a military hospital, majority of cases fell in the 20 to 30 age group with a male preponderance. The etiology in all cases was stone-pelting. Among cranio-facial injuries, cranial vault injuries and mid-face injuries (71%) were most prevalent, mandibular fractures (24%) and remaining were soft tissue injuries (5%). & Frontal & parietal bone injuries were seen in 23.6% cases (n = 9) and orbito-zygomatic complex injuries were seen in (36.8%) cases (n = 14). Isolated blow-out fractures were seen in 4 patients of our series. 52.6% of patients of our series suffered associated soft tissue injuries to the head, face, and neck region. The most common cause of injury was due to the direct impact of stone hitting the mid-face/cranial vault and the most common pattern of injury was gross comminution of the skeleton. & 2 patients suffered ocular injuries that required management and 6 patients of our series who suffered head injuries to the cranium required a secondary cranioplasty procedure (n = 4) &The most commonly used technique for treatment was open reduction internal fixation, which was used in 89% of patients. Soft-tissue injuries overall occurred most frequently on the forehead, nose, lips, and chin which was managed by primary suturing.

Conclusions:

Cranial vault injuries & orbito-zygomatic complex fractures are most commonly seen in patients with stone-pelting injuries. Early management of such injuries improves outcomes in terms of function and restitution of preinjury skeleton structure. The most common patterns seen is gross comminution to the cranio-facial skeleton that can be treated with immediate primary wound repair after meticulous wound debridement and open reduction and internal fixation. Importance of stone-pelting as a cause of craniofacial injuries is highlighted as it leads to significant disruption of craniofacial skeleton.
Safe at the Plate: Acute Assessment and Management of Baseball-Related Craniofacial Injuries by On-Field Personnel
Authors: Sprau Annelise C. , Slavin Benjamin R. , Pierrot Randall G. , Weber Lee E. , Figueroa Javier M. , Jagid Jonathan R. , Thaller Seth R.
Published: October 2020

Introduction:

Long regarded as “America's Past Time”, over 8.6 million children partake in organized and recreational baseball. Although improved equipment has reduced contemporary injury rates, nearly half of pediatric baseball injuries requiring hospitalization are due to craniofacial trauma. Sideline personnel at the youth levels, often without advanced medical training, frequently act as first-responders in instances of acute craniofacial injury.

Methods:

An IRB-approved survey was distributed nationally to target field personnel working at youth, high school, collegiate, and professional baseball levels. Survey items included: comfort in assessing subtypes of acute craniofacial trauma (loss of consciousness (LOC), skull injury, orbital injury, nasal injury, and dental injury) via Likert scale, years of medical training, presence of an emergency action plan (EAP), and access to higher level care from emergency medical services (EMS) or a nearby hospital.

Results:

When comparing the amateur and professional cohorts, the respondents from professional teams were significantly more confident in assessing LOC (P = 0.001), skull injury (P < 0.001), orbital injury (P < 0.001), nasal injury (P < 0.001), and dental injury (P < 0.001). The professional teams had significantly more years of first aid training (P < 0.0001) and were significantly more likely to have an EAP (P < 0.0001). Professional teams also had a significantly higher average of reported craniofacial incidents (P = 0.0279).

Conclusion:

The authors identified a significant disparity in comfort level between amateur and professional baseball field personnel for identifying and managing acute craniofacial trauma. Based on these findings, the authors were able to develop a rudimentary tool for on-field personnel to effectively assess and manage craniofacial injuries.
Association of Medical Students' Stress and Coping Skills With Simulation Performance
Authors: Anton Nicholas E. , Rendina Megan A. , Hennings Julie M. , Stambro Ryan , Stanton-Maxey Katie J. , Stefanidis Dimitrios
Published: October 2020

Introduction

Medical students are vulnerable to experience stress, as they are routinely confronted with stressors. Acute stress can reduce students' performance on examinations, and chronic stress can contribute to cognitive disorders. Conversely, stress coping skills can reduce trainees' anxiety. Thus, stress coping skills may help students manage stress effectively and better maintain clinical performance. The goal of this study was to assess the relationship between medical students' stress, workload, stress coping skills, performance-enhancing mental skills, and clinical performance during a simulated clinical scenario.

Methods

During their surgery clerkship rotation, third-year medical students participated in a simulated scenario designed to assess their ability to care for an acutely ill surgical patient. Participants' physiological stress was assessed using heart rate (HR) monitors during the simulation, their perceived stress using the State-Trait Anxiety Inventory, and workload using the NASA–Task Load Index immediately after. Clinical performance was assessed using a global rating scale. Stress coping skills were also assessed. The relationship between performance, stress level, workload, and coping skills was examined.

Results

Forty-one third-year medical students voluntarily participated in the study. Participants' clinical performance was negatively correlated with perceived stress and workload during the scenario (P < 0.05). A stepwise linear regression model revealed that higher HR was the main predictor of poorer clinical performance (P < 0.05).

Conclusions

In this study, medical students' HR was associated with poorer performance during a simulated clinical scenario. Adaptive stress coping skills may allow medical students to manage stressful situations and better maintain performance.
The Impact of Telemedicine Adoption on a Multidisciplinary Bariatric Surgery Practice During the COVID-19 Pandemic
Authors: Brown Andrew M. , Ardila-Gatas Jessica , Yuan Victoria , Devas Nina , Docimo Salvatore , Spaniolas Konstaninos , Pryor Aurora D.
Published: October 2020

Objective:

This study aims to show how full-time telemedicine adoption has impacted patient visit volume and attendance in a comprehensive metabolic and weight loss center.

Summary Background Data:

Elective surgical practices have been profoundly impacted by the global COVID-19 pandemic, leading to a rapid increase in the utilization of telemedicine. The abrupt initiation of audio-video telehealth visits for all providers of a multidisciplinary clinic on March 19th 2020 provided unique circumstances to assess the impact of telemedicine.

Methods:

Data from the clinical booking system (new patient and follow-up visits) for all clinical provider types of the multidisciplinary metabolic center from the pre-telehealth, post-telehealth, and a 2019 comparative period were retrospectively reviewed and compared. The primary outcome is the change in patient visit volume for all clinical providers from before to after the initiation of telemedicine for both new patient, and follow-up visits.

Results:

There were a total of 506 visits (162 new patient visits, and 344 follow-ups) in the pre-telehealth period, versus 413 visits (77 new patient visits, and 336 follow-ups) during the post-telehealth period. After telehealth implementation, new visits for surgeons decreased by 75%. Although follow-up visits decreased by 55.06% for surgeons, there was an increase by 27.36% for advanced practitioners. When surgeons were separated from other practitioners, their follow-up visit rate decrease by 55.06%, compared to a 16.08% increase for the group of all other practitioners (P < 0.0001). Dietitians experienced higher rates of absenteeism with new patient visits (10.00% vs 31.42%, P = 0.0128), whereas bariatricians experienced a decrease in follow-up visit absenteeism (33.33% vs 0%, P = 0.0093).

Conclusions:

Although new patient visit volume fell across the board, follow-up visits increased for certain nonsurgical providers. This provides a template for adoption of a multidisciplinary telehealth clinic in a post-pandemic world.
Efficient production of few-layer black phosphorus by liquid-phase exfoliation
Authors: Tiouitchi Ghassane , Ali Mustapha Ait , Benyoussef Abdelilah , Hamedoun Mohammed , Lachgar Abdessadek , Kara Abdelkader , Ennaoui Ahmed , Mahmoud Abdelfattah , Boschini Frederic , Oughaddou Hamid , El Moutaouakil Amine , El Kenz Abdellah , Mounkachi Omar
Published: October 2020

Phosphorene is a new two-dimensional material that has recently attracted much attention owing to its fascinating electrical, optical, thermal and chemical properties. Here, we report on high-quality exfoliation of black phosphorus nanosheets, with controllable size produced in large quantities by liquid-phase exfoliation using
N
-methyl-2-pyrrolidone (NMP) as a solvent under ambient conditions. The as-synthesized few layers show a great potential for solar energy conversion based on the optical results shown in this work.
Understanding gambling behaviour and risk attitudes using cryptocurrency-based casino blockchain data
Authors: Meng Jonathan , Fu Feng
Published: October 2020

The statistical concept of gambler’s ruin suggests that gambling has a large amount of risk. Nevertheless, gambling at casinos and gambling on the Internet are both hugely popular activities. In recent years, both prospect theory and laboratory-controlled experiments have been used to improve our understanding of risk attitudes associated with gambling. Despite theoretical progress, collecting real-life gambling data, which is essential to validate predictions and experimental findings, remains a challenge. To address this issue, we collect publicly available betting data from a
DApp
(decentralized application) on the Ethereum blockchain, which instantly publishes the outcome of every single bet (consisting of each bet’s timestamp, wager, probability of winning, userID and profit). This online casino is a simple dice game that allows gamblers to tune their own winning probabilities. Thus the dataset is well suited for studying gambling strategies and the complex dynamic of risk attitudes involved in betting decisions. We analyse the dataset through the lens of current probability-theoretic models and discover empirical examples of gambling systems. Our results shed light on understanding the role of risk preferences in human financial behaviour and decision-makings beyond gambling.
Improved phase-field models of melting and dissolution in multi-component flows
Authors: Hester Eric W. , Couston Louis-Alexandre , Favier Benjamin , Burns Keaton J. , Vasil Geoffrey M.
Published: October 2020

We develop and analyse the first second-order phase-field model to combine melting and dissolution in multi-component flows. This provides a simple and accurate way to simulate challenging phase-change problems in existing codes. Phase-field models simplify computation by describing separate regions using a smoothed phase field. The phase field eliminates the need for complicated discretizations that track the moving phase boundary. However, standard phase-field models are only first-order accurate. They often incur an error proportional to the thickness of the diffuse interface. We eliminate this dominant error by developing a general framework for asymptotic analysis of diffuse-interface methods in arbitrary geometries. With this framework, we can consistently unify previous second-order phase-field models of melting and dissolution and the volume-penalty method for fluid–solid interaction. We finally validate second-order convergence of our model in two comprehensive benchmark problems using the open-source spectral code Dedalus.
Sex-specific variation in the use of vertical habitat by a resident Antarctic top predator
Authors: Photopoulou Theoni , Heerah Karine , Pohle Jennifer , Boehme Lars
Published: October 2020

Patterns of habitat use are commonly studied in horizontal space, but this does not capture the four-dimensional nature of ocean habitats (space, depth, and time). Deep-diving marine animals encounter varying oceanographic conditions, particularly at the poles, where there is strong seasonal variation in vertical ocean structuring. This dimension of space use is hidden if we only consider horizontal movement. To identify different diving behaviours and usage patterns of vertically distributed habitat, we use hidden Markov models fitted to telemetry data from an air-breathing top predator, the Weddell seal, in the Weddell Sea, Antarctica. We present evidence of overlapping use of high-density, continental shelf water masses by both sexes, as well as important differences in their preferences for oceanographic conditions. Males spend more time in the unique high-salinity shelf water masses found at depth, while females also venture off the continental shelf and visit warmer, shallower water masses. Both sexes exhibit a diurnal pattern in diving behaviour (deep in the day, shallow at night) that persists from austral autumn into winter. The differences in habitat use in this resident, sexually monomorphic Antarctic top predator suggest a different set of needs and constraints operating at the intraspecific level, not driven by body size.
The biophysical basis of thermal tolerance in fish eggs
Authors: Martin Benjamin T. , Dudley Peter N. , Kashef Neosha S. , Stafford David M. , Reeder William J. , Tonina Daniele , Del Rio Annelise M. , Scott Foott J. , Danner Eric M.
Published: October 2020

A warming climate poses a fundamental problem for embryos that develop within eggs because their demand for oxygen (O
2
) increases much more rapidly with temperature than their capacity for supply, which is constrained by diffusion across the egg surface. Thus, as temperatures rise, eggs may experience O
2
limitation due to an imbalance between O
2
supply and demand. Here, we formulate a mathematical model of O
2
limitation and experimentally test whether this mechanism underlies the upper thermal tolerance in large aquatic eggs. Using Chinook salmon (
Oncorhynchus tshawytscha
) as a model system, we show that the thermal tolerance of eggs varies systematically with features of the organism and environment. Importantly, this variation can be precisely predicted by the degree to which these features shift the balance between O
2
supply and demand. Equipped with this mechanistic understanding, we predict and experimentally confirm that the thermal tolerance of these embryos in their natural habitat is substantially lower than expected from laboratory experiments performed under normoxia. More broadly, our biophysical model of O
2
limitation provides a mechanistic explanation for the elevated thermal sensitivity of fish embryos relative to other life stages, global patterns in egg size and the extreme fecundity of large teleosts.