bluuebunny/crossref_metadata_2025 huggingface dataset:
Interactions between SARS-CoV-2 and influenza, and the impact of coinfection on disease severity: a test-negative design
Authors: Stowe Julia , Tessier Elise , Zhao H , Guy Rebecca , Muller-Pebody Berit , Zambon Maria , Andrews Nick , Ramsay Mary , Lopez Bernal Jamie
Published: April 2021

Background

The impact of SARS-CoV-2 alongside influenza is a major concern in the northern hemisphere as winter approaches.

Methods

Test data for influenza and SARS-CoV-2 from national surveillance systems between 20 January 2020 and 25 April 2020 were used to estimate influenza infection on the risk of SARS-CoV-2 infection. A test-negative design was used to assess the odds of SARS-CoV-2 in those who tested positive for influenza compared with those who tested negative. The severity of SARS-CoV-2 was also assessed using univariable and multivariable analyses.

Results

The risk of testing positive for SARS-CoV-2 was 58% lower among influenza-positive cases and patients with a coinfection had a risk of death of 5.92 (95% confidence interval: 3.21–10.91) times greater than among those with neither influenza nor SARS-CoV-2. The odds of ventilator use or death and intensive care unit admission or death were greatest among coinfected patients.

Conclusions

Coinfection of these viruses could have a significant impact on morbidity, mortality and health-service demand.
Validation of the VIRSeek SARS-CoV-2 Mplex Assay for Detection of SARS-CoV-2 on Stainless-Steel Surfaces: AOAC Performance Tested MethodSM 122006
Authors: Bleichner Laura , Bleicher Vera , Göhring Nadine , Kleiboeker Steven B
Published: April 2021

Background

The Eurofins GeneScan Technologies’ VIRSeek SARS-CoV-2 Mplex kit is a RT (reverse transcription) real-time polymerase chain reaction (RT-qPCR) assay for the detection of two targets on the N-gene (nucleocapsid) of SARS-CoV-2. An extraction control, that allows monitoring of the extraction procedure and PCR inhibition, is included.

Objective

In silico analysis and wet testing showed inclusivity and exclusivity of the assay. The complete workflow starting from surface swabbing (VIRSeek PATHOSwab kit), RNA extraction (VIRSeek RNAExtractor), RT-PCR (VIRSeek SARS-CoV-2 Mplex), and evaluation with FastFinder was validated in comparison to the CDC method for detection of SARS-CoV-2 on stainless steel.

Method

In silico analysis was performed by using the MFOLD online program. The matrix study was performed for stainless steel inoculated with SARS-CoV-2 isolated from the first documented US case of a traveler from Wuhan, China.

Results

For inclusivity, 15 764 sequences were analyzed and all mismatches (0.37% of the sequences had single mismatches) were considered non-critical. Cross reactivity for closely related viruses and background organisms was performed, resulting in correct exclusion of all. No significant differences were observed for the probability of detection (POD) study when comparing to the CDC method.

Conclusions

Results of the inclusivity and exclusivity study show that the assay is specific for detection of SARS-CoV-2. The POD study showed no statistically significant difference compared to the CDC reference method, results were identical for the uninoculated and the high level. For the fractional recovery level, the candidate method detected 9/17 samples leading to a POD of 0.47, the reference method detected 11/20 samples leading to a POD of 0.55.

Highlight

The complete workflow starting from swabbing of the surface (VIRSeek PATHOSwab kit), RNA extraction (VIRSeek RNAExtractor), RT-PCR (VIRSeek SARS CoV-2 Mplex) and evaluation with FastFinder was validated in comparison to the US Centers for Disease Control and Prevention method for detection of SARS-CoV-2 on Stainless Steel.
Squaring Things Up with R2: What It Is and What It Can (and Cannot) Tell You
Authors: Camirand Lemyre Félix , Chalifoux Kevin , Desharnais Brigitte , Mireault Pascal
Published: April 2021

The coefficient of correlation (r) and the coefficient of determination (R2 or r2) have long been used in analytical chemistry, bioanalysis and forensic toxicology as figures demonstrating linearity of the calibration data in method validation. We clarify here what these two figures are and why they should not be used for this purpose in the context of model fitting for prediction. R2 evaluates whether the data are better explained by the regression model used than by no model at all (i.e., a flat line of slope = 0 and intercept $\bar y$), and to what degree. Hopefully, in the context of calibration curves, the fact that a linear regression better explains the data than no model at all should not be a point of contention. Upon closer examination, a series of restrictions appear in the interpretation of these coefficients. They cannot indicate whether the dataset at hand is linear or not, because they assume that the regression model used is an adequate model for the data. For the same reason, they cannot disprove the existence of another functional relationship in the data. By definition, they are influenced by the variability of the data. The slope of the calibration curve will also change their value. Finally, when heteroscedastic data are analyzed, the coefficients will be influenced by calibration levels spacing within the dynamic range, unless a weighted version of the equations is used. With these considerations in mind, we suggest to stop using r and R2 as figures of merit to demonstrate linearity of calibration curves in method validations. Of course, this does not preclude their use in other contexts. Alternative paths for evaluation of linearity and calibration model validity are summarily presented.
A36 IMPACT OF DIGITAL HEALTH MONITORING IN THE MANAGEMENT OF INFLAMMATORY BOWEL DISEASE
Authors: Zhen J , Marshall J , Nguyen G C , Atreja A , Narula N
Published: April 2021

Background

Inflammatory bowel disease (IBD) affects over 270,000 Canadians and costs the healthcare system $1.28 billion dollars annually. With advancements in technology, a shift from the traditional ‘reactive’ approach to IBD management to a ‘proactive’ approach that integrates self-management strategies using digital health monitoring platforms could greatly benefit patient care.

Aims

The purpose of this study was to investigate the effect of implementing the IBD health monitoring platform, HealthPROMISE, in clinical practice and to evaluate whether its use leads to better quality of care, improved health outcomes, and reduce resource consumption in patients with IBD.

Methods

IBD patients were recruited in gastroenterology clinics and asked to install the HealthPROMISE application onto their smartphones. Patient satisfaction, quality of care, quality of life, patient symptoms, and resource utilization metrics were collected throughout the study and sent directly to their healthcare teams. Patients with abnormal symptom/short inflammatory bowel disease questionnaire (SIBDQ) scores were flagged for their physicians to follow up with. After one-year, patient outcome metrics were compared to baseline values.

Results

Overall, out of 59 patients enrolled in the study, 32 patients (54%) logged into the application at least once during the study period. The number of IBD-related ER visits/hospitalizations in the year of use compared to the prior year demonstrated a significant decrease from 25% of patients (8/32) to 3% (1/32) (p=0.03). Patients also reported an increase in their understanding of the nature/causes of their condition after using the application (p=0.026). No significant changes were observed in the number of quality indicators met (p = 0.67) or in SIBDQ scores (p=0.48).

Conclusions

Given the significant burden of IBD, there is a need to develop effective management strategies. This study demonstrated that digital health monitoring platforms may aid in reducing the number of ER visits and hospitalizations in IBD patients. Future studies evaluating acceptability and costs with a larger sample size would help determine the feasibility and generalizability of widely implementing mobile health applications in the management of IBD.

Funding Agencies

CCC
Physical Activity, Weight, and Outcomes in Patients Receiving Chemotherapy for Metastatic Breast Cancer (C40502/Alliance)
Authors: Ligibel Jennifer A , Huebner Luke , Rugo Hope S , Burstein Harold J , Toppmeyer Debra L , Anders Carey K , Ma Cynthia , Barry William T , Suman Vera , Carey Lisa A , Partridge Ann H , Hudis Clifford A , Winer Eric P
Published: April 2021

Background

Obesity and inactivity are associated with increased risk of cancer-related and overall mortality in breast cancer, but there are few data in metastatic disease.

Methods

Cancer and Leukemia Group B 40502 was a randomized trial of first-line taxane-based chemotherapy for patients with metastatic breast cancer. Height and weight were collected at enrollment. After 299 patients enrolled, the study was amended to assess recreational physical activity (PA) at enrollment using the Nurses’ Health Study Exercise Questionnaire. Associations with progression-free survival (PFS) and overall survival (OS) were evaluated using stratified Cox modeling (strata included hormone receptor status, prior taxane, bevacizumab use, and treatment arm). All statistical tests were 2-sided.

Results

A total of 799 patients were enrolled, and at the time of data lock, median follow-up was 60 months. At enrollment, median age was 56.7 years, 73.1% of participants had hormone receptor–positive cancers, 42.6% had obesity, and 47.6% engaged in less than 3 metabolic equivalents of task (MET) hours of PA per week (<1 hour of moderate PA). Neither baseline body mass index nor PA was statistically significantly associated with PFS or OS, although there was a marginally statistically significant increase in PFS (hazard ratio = 0.83, 95% confidence interval = 0.79 to 1.02; P = .08) and OS (hazard ratio = 0.81, 95% confidence interval = 0.65 to 1.02; P = .07) in patients who reported PA greater than 9 MET hours per week vs 0-9 MET hours per week.

Conclusions

In a trial of first-line chemotherapy for metastatic breast cancer, rates of obesity and inactivity were high. There was no statistically significant relationship between body mass index and outcomes. More information is needed regarding the relationship between PA and outcomes.
Magnification bias in galaxy surveys with complex sample selection functions
Authors: von Wietersheim-Kramsta Maximilian , Joachimi Benjamin , van den Busch Jan Luca , Heymans Catherine , Hildebrandt Hendrik , Asgari Marika , Tr’oster Tilman , Unruh Sandra , Wright Angus H
Published: April 2021

Gravitational lensing magnification modifies the observed spatial distribution of galaxies and can severely bias cosmological probes of large-scale structure if not accurately modelled. Standard approaches to modelling this magnification bias may not be applicable in practice as many galaxy samples have complex, often implicit, selection functions. We propose and test a procedure to quantify the magnification bias induced in clustering and galaxy–galaxy lensing (GGL) signals in galaxy samples subject to a selection function beyond a simple flux limit. The method employs realistic mock data to calibrate an effective luminosity function slope, αobs, from observed galaxy counts that can then be used with the standard formalism. We demonstrate this method for two galaxy samples derived from the Baryon Oscillation Spectroscopic Survey (BOSS) in the redshift ranges 0.2 < z ≤ 0.5 and 0.5 < z ≤ 0.75, complemented by mock data built from the MICE2 simulation. We obtain αobs = 1.93 ± 0.05 and αobs = 2.62 ± 0.28 for the two BOSS samples. For BOSS-like lenses, we forecast a contribution of the magnification bias to the GGL signal between the multipole moments, ℓ, of 100 and 4600 with a cumulative signal-to-noise ratio between 0.1 and 1.1 for sources from the Kilo-Degree Survey (KiDS), between 0.4 and 2.0 for sources from the Hyper Suprime-Cam survey (HSC), and between 0.3 and 2.8 for ESA Euclid-like source samples. These contributions are significant enough to require explicit modelling in future analyses of these and similar surveys. Our code is publicly available within the MagBEt module (https://github.com/mwiet/MAGBET).
Fountains and storms: the effects of AGN feedback and mergers on the evolution of the intracluster medium in the romulusc simulation
Authors: Chadayammuri Urmila , Tremmel Michael , Nagai Daisuke , Babul Arif , Quinn Thomas
Published: April 2021

The intracluster medium (ICM) is a multiphase environment, dynamically regulated by active galactic nuclei (AGN), the motions of cluster galaxies, and mergers with other clusters or groups. AGN provide a central heating source capable of preventing runaway cooling flows and quenching star formation, but how they achieve this is still poorly understood. We investigate the effects of AGN feedback and mergers on the ICM using the high-resolution romulusc cosmological simulation of a 1014 M⊙ galaxy cluster. We demonstrate that AGN feedback regulates and quenches star formation in the brightest cluster galaxy gently, without any explosive episodes, and co-exists with a low entropy core with sub-Gyr cooling times. In contrast, the merger disrupts the ICM structure, heating the core and cutting off the supply of low-entropy, infalling gas that until then fuelled the AGN. We find that this removal of the low-entropy phase correlates with the ratio tcool / tff increasing above 30 in the core, matching observations that cooling gas is only found in clusters where this ratio is 5–30. Importantly, we find that evolution in the inner entropy profile and the ratio of cooling to free-fall time-scale are directly connected to the quenching of star formation in the BCG. This is in line with previous results from idealized simulations and confirmed here within a fully cosmological simulation for the first time.
IPC 2.0: prediction of isoelectric point and pKa dissociation constants
Authors: Kozlowski Lukasz Pawel
Published: April 2021

The isoelectric point is the pH at which a particular molecule is electrically neutral due to the equilibrium of positive and negative charges. In proteins and peptides, this depends on the dissociation constant (pKa) of charged groups of seven amino acids and NH+ and COO− groups at polypeptide termini. Information regarding isoelectric point and pKa is extensively used in two-dimensional gel electrophoresis (2D-PAGE), capillary isoelectric focusing (cIEF), crystallisation, and mass spectrometry. Therefore, there is a strong need for the in silico prediction of isoelectric point and pKa values. In this paper, I present Isoelectric Point Calculator 2.0 (IPC 2.0), a web server for the prediction of isoelectric points and pKa values using a mixture of deep learning and support vector regression models. The prediction accuracy (RMSD) of IPC 2.0 for proteins and peptides outperforms previous algorithms: 0.848 versus 0.868 and 0.222 versus 0.405, respectively. Moreover, the IPC 2.0 prediction of pKa using sequence information alone was better than the prediction from structure-based methods (0.576 versus 0.826) and a few folds faster. The IPC 2.0 webserver is freely available at www.ipc2-isoelectric-point.org
The Relationship Between Trauma Exposure and Adult Tobacco Use: Analysis of the National Epidemiologic Survey on Alcohol and Related Conditions (III)
Authors: Budenz Alexandra , Klein Amanda , Prutzman Yvonne
Published: April 2021

Introduction

Previous research has examined cigarette smoking in trauma exposed populations. However, the relationships between trauma exposure and use of other tobacco products (eg, cigars, e-cigarettes) and specific trauma exposure characteristics that may be associated with tobacco use are understudied.

Aims and Methods

Using the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (N = 36 151 adults), we conducted weighted bivariate analyses of tobacco use among participants with no trauma exposure, trauma exposure, and trauma exposure with post-traumatic stress disorder (trauma + PTSD), stratified by tobacco product use. We also performed weighted logistic regressions testing relationships between trauma exposure and tobacco use, controlling for behavioral health (BH) conditions (mood, anxiety, substance use, personality disorders) and sociodemographics.

Results

Approximately 44% of participants had experienced trauma; 6% experienced trauma + PTSD. Trauma exposed participants had a higher prevalence of tobacco use (30%––46% vs. 22%) and poly-tobacco use (34%––35% vs. 28%) than unexposed participants. Cigarettes were the most used tobacco product; trauma + PTSD (19%), and trauma (15%) participants had a higher prevalence of e-cigarette use than unexposed participants (11%). Trauma exposure was associated with current tobacco use (AOR = 1.36 trauma + PTSD; 1.23 trauma) (but not former use), particularly among participants exposed to violence/abuse (AOR = 1.23). Personality and substance use disorders were strongly associated with current and former tobacco use.

Conclusions

Trauma exposure, PTSD, and experiences of violence/abuse are associated with current tobacco use. BH conditions may also play a role in current and former tobacco use. Recognizing and addressing trauma exposure and BH conditions among tobacco users may improve cessation rates in these populations.

Implications

This study contributes to research on tobacco use disparities in behavioral health populations by providing a comprehensive examination of tobacco use in trauma exposed individuals. Prior research has examined cigarette smoking, but not other tobacco product use in these populations. This study presents findings on multiple tobacco use behaviors (tobacco product, poly-tobacco use, cessation attempts) in trauma exposed populations and characteristics of trauma exposure (severity, type of traumatic event) associated with tobacco use. These findings underscore the importance of further examining the implications of trauma exposure for tobacco use and of screening and addressing trauma in cessation treatment.
Barn Owls select uncultivated habitats for hunting in a winegrape growing region of California
Authors: Castañeda Xerónimo A , Huysman Allison E , Johnson Matthew D
Published: April 2021

Large-scale conversion of uncultivated land to agriculture threatens wildlife and can diminish ecosystem services provided by nature. Understanding how wildlife provision ecosystem services may incentivize wildlife conservation in agricultural landscapes. Attracting Barn Owls (Tyto furcata) to nest on farms for pest management has been implemented worldwide but has not been evaluated in vineyard agroecosystems. Napa Valley, California, is a renowned winegrape growing region, and viticulturists encourage Barn Owl occupancy to help minimize damage from Botta’s pocket gophers (Thomomys bottae) and voles (Microtus spp.). This study modeled the use of habitats in space and time by hunting Barn Owls, providing information about their potential to provide the critical ecosystem service of pest consumption. We used global positioning system tags to track hunting owls and used a resource selection function to compare used and available habitats. We constructed the intensity of use and home range-movement maps using a time local convex hull analysis from location data. We found that Barn Owls selected uncultivated habitats when hunting, some of which were relatively rare on the landscape. Approximately, one-third of Barn Owl hunting locations occurred in vineyards, but this use was out of proportion to the availability of vineyards, which comprised 50% of the area around nest boxes. The owls’ use of vineyards increased with decreasing amount of selected uncultivated habitat in the landscape. However, as reported by a previous study, the occupancy of nest boxes in vineyards increases with uncultivated habitats nearby. Future research should model landscape composition to determine the amount of preferred habitat necessary to support occupancy as well as hunting in vineyards. A true test of pest management by Barn Owls awaits experimentation coupled with monitoring rodent populations.
Sensitivity of multiple vital rates for Ruffed Grouse in the Upper Great Lakes Region
Authors: Pollentier Christopher D , Hull Scott D , MacFarland David M
Published: April 2021

Effective management of wildlife requires a full understanding of population dynamics and knowledge of potential drivers that influence population growth. The Ruffed Grouse (Bonasa umbellus) is a popular upland game bird widely distributed across the northern United States and Canada that has experienced population declines within portions of its range in response to forest maturation and habitat loss. Although the species has been extensively studied, few efforts have been made to synthesize demographic data into a sensitivity analysis to guide management actions. We reviewed the literature and compiled Ruffed Grouse vital rates from 14 field studies conducted across four decades (1982−2018) within the Upper Great Lakes region of Michigan, Minnesota, and Wisconsin, USA. We parameterized a deterministic matrix model to evaluate population dynamics and conducted sensitivity analyses to identify vital rates projected to have the greatest influence on the finite rate of population change (λ). Our modeling effort projected a stable but highly variable annual rate of population change (λ = 1.01; 95% CI = 0.88–1.14) for Ruffed Grouse in the Upper Great Lakes region. Stochastic rates of population change derived from spring drumming surveys (λ = 1.01; 95% CI = 0.61–1.45) and Christmas Bird Count surveys (λ = 0.99; 95% CI = 0.62–1.76) of the corresponding regional population provided validation of stable trends over the same time period as our demographic model. Prospective elasticities and variance-scaled sensitivities suggested λ would be greatly influenced by components of reproductive performance: nesting success, chick survival, and post-fledging juvenile survival. Retrospective analysis indicated that much of the overall variability in λ and annual productivity was also attributed to annual variation in nesting success. Management of this species has often focused on fall and overwinter survival, but population projection models provided little evidence that survival was the predominant factor affecting population growth of Ruffed Grouse in this region. A suite of confounding factors and demographic processes that drive population trends can differ significantly across a species’ range. In the Upper Great Lakes region, management efforts aimed at maximizing reproductive success would likely have the greatest potential influence on Ruffed Grouse population growth. Other types of systematic, regional survey data can also be useful for validating population trends derived from demographic modeling studies.
Greater Sage-Grouse nest bowls buffer microclimate in a post-megafire landscape although effects on nest survival are marginal
Authors: Anthony Christopher R , Hagen Christian A , Dugger Katie M , Elmore R Dwayne
Published: April 2021

Temperature at fine spatial scales is an important driver of nest site selection for many avian species during the breeding season and can influence nest success. Sagebrush (Artemisia spp.) communities have areas with high levels of vegetation heterogeneity and high thermal variation; however, fire removes vegetation that provides protection from predators and extreme environmental conditions. To examine the influence of microclimates on Greater Sage-Grouse (Centrocercus urophasianus) nest site selection and nest success in a fire-affected landscape, we measured black bulb temperature (Tbb) and vegetation attributes (e.g., visual obstruction) at 3 spatial scales (i.e. nest bowl, microsite, and landscape) in unburned and burned areas. Nest bowls exhibited greater buffering of Tbb than both nearby microsites and the broader landscape. Notably, nest bowls were warmer in cold temperatures, and cooler in hot temperatures, than nearby microsites and the broader landscape, regardless of burn stage. Nest survival (NS) was higher for nests in unburned areas compared to nests in burned areas (unburned NS = 0.43, 95% confidence interval [CI]: 0.33–0.54; burned NS = 0.24, 95% CI: 0.10–0.46). The amount of bare ground was negatively associated with NS, but effects diminished as the amount of bare ground reached low levels. Shrub height and visual obstruction were positively associated with NS during the entire study period, whereas minimum Tbb had a weaker effect. Our findings demonstrate that thermoregulatory selection by Greater Sage-Grouse at nest sites had marginal effects on their NS. However, given that increases in vegetation structure (e.g., shrub height) provide thermal refuge and increase NS, vegetation remnants or regeneration in a post-fire landscape could be critical to Greater Sage-Grouse nesting ecology.
Beyond refueling: Investigating the diversity of functions of migratory stopover events
Authors: Linscott Jennifer A , Senner Nathan R
Published: April 2021

Stopovers comprise a significant proportion of the time that many birds spend migrating, and researchers have long relied on these events to define and classify broader migratory strategies. Analyses of stopovers often assume that individuals stop primarily or exclusively in order to replenish energy stores, but other non-fueling behaviors have also been described during stopover events and can influence stopover incidence and duration. Here, we discuss the growing demand for understanding these non-fueling behaviors and for restoring the inherent behavioral complexity to stopover events. We begin by describing how light-weight tracking technologies allow researchers to follow individuals along their entire migratory journeys, capturing stopovers that controvert the traditional stop–refuel–resume paradigm. We then discuss 5 well-identified non-fueling behaviors—recovering, sleeping, waiting, information gathering, and social interactions—and examine how including these behaviors can alter interpretations of individual movement paths. Finally, we outline emerging directions for identifying these behaviors and look to larger implications for population management and site conservation along migratory flyways.
Female and male song exhibit both parallel and divergent patterns of cultural evolution: A long-term study of song structure and diversity in tropical wrens
Authors: Graham Brendan A , Heath Daniel D , Mennill Daniel J
Published: April 2021

Animal culture changes over time through processes that include drift, immigration, selection, and innovation. Cultural change has been particularly well-studied for animal vocalizations, especially for the vocalizations of male animals in the temperate zone. Here we examine the cultural change in the vocalizations of tropical Rufous-and-white Wrens (Thryophilus rufalbus), quantifying temporal variation in song structure, song type diversity, and population-level distribution of song types in both males and females. We use data from 10 microsatellite loci to quantify patterns of immigration and neutral genetic differentiation over time, to investigate whether cultural diversity changes with rates of immigration. Based on 11 yr of data, we show that the spectro-temporal features of several widely-used persistent song types maintain a relatively high level of consistency for both males and females, whereas the distribution and frequency of particular song types change over time for both sexes. Males and females exhibit comparable levels of cultural diversity (i.e. the diversity of song types across the population), although females exhibit greater rates of cultural change over time. We found that female changes in cultural diversity increased when immigration is high, whereas male cultural diversity did not change with immigration. Our study is the first long-term study to explore cultural evolution for both male and female birds and suggests that cultural patterns exhibit notable differences between the sexes.
High-intensity flight feather molt and comparative molt ecology of warblers of eastern North America
Authors: Mumme Ronald L , Mulvihill Robert S , Norman David
Published: April 2021

Rapid high-intensity molt of flight feathers occurs in many bird species and can have several detrimental consequences, including reductions in flight capabilities, foraging performance, parental care, and plumage quality. Many migratory New World warblers (family Parulidae) are known to have intense remigial molt, and recent work has suggested that simultaneous replacement of the rectrices may be widespread in the family as well. However, the phylogenetic distribution of simultaneous rectrix molt, and high-intensity flight feather molt more generally, has not been systematically investigated in warblers. We addressed this issue by examining flight feather molt in 13 species, representing 7 different warbler genera, at Powdermill Avian Research Center in southwestern Pennsylvania, USA. All 13 species replaced their 12 rectrices simultaneously, with the onset of rectrix molt occurring in the early-middle stages of high-intensity primary molt. As expected, single-brooded early migrants molted earlier than double-brooded species whose nesting activities extend into late summer. However, our finding that late-molting species replaced their primaries more slowly and less intensively than early molting species was unexpected, as late-molting species are widely hypothesized to be under stronger migration-related time constraints. This surprising result appears to be at least partially explained by a positive association between the pace of molt and daylength; shorter late-summer days may mandate reduced daily food intake, lower molt intensity, and a slower pace of molt. In comparison to other passerines, flight feather molt in warblers of eastern North America is extraordinarily intense; at its peak, individuals are simultaneously replacing 50–67% of their 48 flight feathers (all 12 rectrices and 6–10 remiges on each wing) for 2–3 weeks or more. Because molt of this intensity is likely to present numerous challenges for flight, avoiding predators, foraging, and parental care, the period of flight feather molt for warblers constitutes a highly demanding phase of their annual cycle.
Ecological and evolutionary significance of molt in lowland Neotropical landbirds
Authors: Wolfe Jared D , Terrill Ryan S , Johnson Erik I , Powell Luke L , Brandt Ryder T
Published: April 2021

The slow-paced life history of many Neotropical birds (e.g., high survival and low fecundity) is hypothesized to increase lifetime fitness through investments in self-maintenance over reproduction relative to their temperate counterparts. Molt is a key investment in self-maintenance and is readily shaped by environmental conditions. As such, variation in molt strategies may be a key mechanism underlying life-history trade-offs and adaptation to new environments. Here, we review molt strategies from a diversity of lowland Neotropical landbirds and examine how variation in molt strategies, characterized by differences in molt insertions, timing, extent, and duration contribute to life-history variation and adaptation to diverse ecological conditions. In addition to our synthesis, we present a case study to examine the relationship between home range size and duration of the definitive prebasic molt of a well-studied subset of Amazonian landbirds. Our results suggest a connection between prolonged molt duration and larger home range size of small-to-medium-sized Amazonian landbirds. Our aims were to identify key gaps in our knowledge of Neotropical bird molt, to stimulate further comparative studies into the evolution of molt strategies, and to highlight how variation in molt strategies may be a key mechanism underlying life-history variation across latitudes.
Factors influencing care-seeking behaviour for mental illness in India: a situational analysis in Tamil Nadu
Authors: Jani Anant , Ravishankar Sindhu , Kumar Naresh , Vimitha J , Shah Soleil , Pari Anees , Ramasubramaniam C
Published: April 2021

Background

The contribution of mental illness to the total burden of disease in India nearly doubled from 1990 to 2017, increasing from 2.5% of the total disability-adjusted life years in 1990 to 4.7% in 2017. Despite efforts by the Indian government, a treatment gap of 75–85%, with heterogeneity across multiple dimensions, exists across India. We conducted a qualitative study in Tamil Nadu, India, to better understand the contextual factors affecting the care-seeking behaviour for mental illness.

Methods

Qualitative methods, including semi-structured interviews and focus groups (FGs), were conducted with stakeholders involved in the mental health care pathway in Tamil Nadu. Ten semi-structured interviews and five FGs were conducted and analysed using an inductive approach to identify codes, using Dedoose v7, related to the emerging themes and categories.

Results

Our analyses identified three key areas that influence care-seeking: views on what causes and/or constitutes mental illness, stigma and discrimination associated with mental illness and broader factors influencing decision-making.

Conclusions

The specific contextual factors identified by our study can be used to design and implement approaches that can help to address some of the issues that influence the care-seeking behaviour and manifest in the treatment gaps seen in Tamil Nadu and in India, more generally.
Institutional Investors and Infrastructure Investing
Authors: Andonov Aleksandar , Kräussl Roman , Rauh Joshua
Published: April 2021

Institutional investors expect infrastructure to deliver long-term stable returns but gain exposure to infrastructure predominantly through finite-horizon closed private funds. The cash flows delivered by infrastructure funds display similar volatility and cyclicality as other private equity investments, and their performance similarly depends on quick deal exits. Despite weak risk-adjusted performance and failure to match the supposed characteristics of infrastructure assets, closed funds have received more commitments over time, particularly from public investors. Public institutional investors perform worse than private institutional investors. ESG preferences and regulations explain 25$\%$–40$\%$ of their increased allocation to infrastructure and 30$\%$ of their underperformance.
Flexor digitorum superficialis muscular activity is more reliable than mentalis muscular activity for rapid eye movement sleep without atonia quantification: A study of interrater reliability for artifact correction in the context of semiautomated scoring of rapid eye movement sleep without atonia
Authors: Cesari Matteo , Heidbreder Anna , Bergmann Melanie , Holzknecht Evi , Högl Birgit , Stefani Ambra
Published: April 2021

Study Objectives

To evaluate interrater reliability for artifact correction in the context of semiautomated quantification of rapid eye movement (REM) sleep without atonia (RWA) in the mentalis and flexor digitorum superficialis (FDS) muscles.

Methods

We included video-polysomnographies of 14 subjects with apnea–hypopnea index in REM sleep (AHIREM) < 15/h and 11 subjects with AHIREM ≥ 15/h. Eight subjects had isolated REM sleep behavior disorder. A validated algorithm (www.osg.be) automatically scored phasic and “any” EMG activity in the mentalis muscle, and phasic EMG activity in the FDS muscles. Four independent expert scorers performed artifact correction according to the SINBAR (Sleep Innsbruck Barcelona) recommendations. Interrater reliability for artifact correction was computed with B-statistics. The variability across scorers of four RWA indices (phasic mentalis, “any” mentalis, phasic FDS and SINBAR—i.e. “any” mentalis and/or phasic FDS–EMG activity indices) was computed. With Friedman tests, we compared B-statistics obtained for mentalis and FDS muscles, and the variability of the RWA indices. Influence of AHIREM and REM sleep behavior disorder (RBD) diagnosis on the RWA indices variability was evaluated with linear regressions.

Results

Interrater reliability for artifact correction was higher in the FDS than in the mentalis muscle (p < 0.001). Phasic FDS activity was minimally affected by artifacts. Accordingly, the phasic FDS EMG activity index had the lowest variability across scorers (p < 0.001). Variability across scorers of the RWA indices including the mentalis muscle increased with AHIREM and was independent from RBD diagnosis.

Conclusions

Due to the consistently found low number of artifacts, phasic FDS activity is a reliable measure of RWA.
Wheat oral immunotherapy
Authors: Leeds Stephanie , Liu Elise G. , Nowak-Wegrzyn Anna
Published: April 2021

Purpose of review

The prevalence of food allergy is increasing on a global scale, and therefore increased attention is being paid to specific food allergy epidemiology and management. There has been a large amount of progress made in the last decade on human trials of wheat oral immunotherapy (WOIT).

Recent findings

To date, there has been one multicenter, double-blind, randomized controlled trial of WOIT, one randomized, noncontrolled trial of WOIT, and several smaller, nonrandomized clinical trials of WOIT. WOIT trials are generally limited by smaller sample sizes, affecting the demographic skew of evaluated patients. In addition, there is minimal standardization of efficacy and safety outcomes between trial protocols, making head-to-head comparison challenging. However, some common themes emerge. The majority of WOIT regimens result in successful desensitization, and success is more likely with higher maintenance dosing for longer periods of time. Limited studies have looked at sustained unresponsiveness in WOIT. WOIT can induce allergic reactions, including anaphylaxis, but more severe reactions often have an associated augmenting factor, such as exercise. Lower maintenance doses likely are associated with less severe reactions, and food modification and/or adjunct therapeutics may also decrease the risk of reactions.

WOIT trials are ongoing and will optimize updosing protocols and maintenance doses to improve efficacy and safety.
Diagnosing Fractures of the Distal Tibial Articular Surface in Tibia Shaft Fractures: Is Computed Tomography Always Necessary?
Authors: Behlmer Richard J. , Simske Natasha M. , Graf Ryan M. , Kliethermes Stephanie A. , Lang Gerald J. , Whiting Paul S.
Published: April 2021

Objectives:

To identify the incidence of distal articular fractures in a series of distal third tibia shaft fractures and to report the utility of both computed tomography (CT) scans and Radiographic Investigation of the Distal Extension of Fractures into the Articular Surface of the Tibia (RIDEFAST) ratios for identification of articular involvement.

Design:

Retrospective cohort.

Setting:

Level 1 trauma center.

Patients:

Four hundred seventeen patients with distal third tibia shaft fractures were included in the study.

Intervention:

Intramedullary nail or plate fixation.

Main Outcome Measures:

Type of articular fracture, time of diagnosis, and RIDEFAST ratios.

Results:

One hundred one of the 417 distal third fractures (24%) had a fracture of the distal tibia articular surface. Of these 101 fractures, 41 (41%) represented an extension of the primary fracture line and 60 (59%) were separate malleolar fractures. Of the 101 articular fractures, 95 (94%) were identified preoperatively and 6 (6%) were identified intraoperatively. Of the 95 fractures identified preoperatively, 87 (92%) were identified on plain radiographs and 8 (8%) by CT scan. Thirty-five preoperative CT scans were performed on distal third tibia shaft fractures in search of an intra-articular fracture. In 27 patients (77%), no articular fracture was present, representing an overall yield of 23% among CT scans performed to rule out an articular fracture in distal third tibia shaft fractures. RIDEFAST ratios for all 101 distal tibia shaft fractures with articular involvement and 100 fractures with no articular involvement were not significantly different (P > 0.05) using both coronal and sagittal plane measurements.

Conclusions:

CT scans performed on distal third tibia shaft fractures in search of articular fractures had a low yield (23%). Widespread use of CT scan to diagnose fractures of the distal tibia articular surface in the setting of distal tibia shaft fractures does not seem warranted. No statistically significant differences in RIDEFAST ratios were found between fractures with and without articular involvement, indicating that more work is necessary before RIDEFAST can be used to reliably rule out articular involvement in this setting.

Level of Evidence:

Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.
An Improved Technique for Medial Malleolar Osteotomy
Authors: Shah Rajiv , Geevarughese Nikku Mathew , Shah Shivam
Published: April 2021

The medial malleolar osteotomy has been a time-tested technique to approach the medial and anterior aspects of the talus for cases of talus fractures and the osteochondral lesions of the talus. The precision of osteotomy, safety to the inherent articular cartilage, and maintenance of vascularity to the talus are prime concerns of the procedure, failing which instability, early ankle osteoarthritis, or avascular necrosis of the talus become inevitable. Here we describe a couple of modifications to decrease the chances of such complications.

Level of Evidence: Diagnostic Level V. See Instructions for Authors for a complete description of levels of evidence.
Family history of esophageal cancer modifies the association of serum lipids and malignant esophageal lesions: a nested case-control study from the “Endoscopic Screening for Esophageal Cancer in China” trial
Authors: Wang Min-Min , Guo Chuan-Hai , Li Feng-Lei , Xu Rui-Ping , Liu Zhen , Pan Ya-Qi , Liu Fang-Fang , Liu Ying , Cai Hong , Liu Meng-Fei , He Zhong-Hu , Ke Yang
Published: April 2021

Background:

The association of lipids and cancer has varied greatly among different cancer types, lipid components and study populations. This study is aimed to investigate the association of serum lipids and the risk of malignant lesions in esophageal squamous epithelium.

Methods:

In the “Endoscopic Screening for Esophageal Cancer in China” (ESECC) trial, serum samples were collected and tested for total cholesterol (TC), triglycerides, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol at the time of subject enrollment. Cases were defined as malignant esophageal lesions identified by baseline endoscopic examination or by follow-up to May 31, 2018. Controls were randomly selected using incidence density sampling in the same cohort. Conditional logistic models were applied to identify the association of serum lipids and the risk of malignant esophageal lesions. Effect modification was evaluated by testing interaction terms of the factor under assessment and these serum lipid indicators.

Results:

No consistent association between serum lipid levels and esophageal malignant lesions were found in a pooled analysis of 211 cases and 2101 controls. For individuals with a family history of esophageal cancer (EC), high TC, and LDL-C were associated with a significantly increased risk of having malignant lesions (odds ratio [OR]High vs. Low TC = 2.22, 95% confidence interval [CI]: 1.14–4.35; ORHigh vs. Low LDL-C = 1.93, 95% CI: 1.01–3.65). However, a negative association was observed in participants without an EC family history (ORHigh vs. Low TC = 0.69, 95% CI: 0.48–0.98, P
interaction = 0.002; ORHigh vs. Low LDL-C = 0.50, 95% CI: 0.34–0.76, P
interaction < 0.001).

Conclusions:

In this study, we found that the association of serum lipids and malignant esophageal lesions might be modified by EC family history. The stratified analysis would be crucial for population-based studies investigating the association of serum lipids and cancer. The mechanism by which a family history of EC modifies this association warrants further investigation.
Quantifying the Effect of Spectacle Frame Dimensions on Wind-Induced Ocular Plane Evaporation Using an in Vitro Model
Authors: Huynh Cassandra B. , Ngo William
Published: April 2021

Purpose:

To quantify the effect of spectacle frame dimensions on wind-induced ocular plane evaporation.

Methods:

A drop of 0.5 μL water was pipetted onto an eye of a mannequin head. The face was fitted with a spectacle frame. A fan positioned 10 cm away directed air (185 CFM) toward the face and the time required for the drop to evaporate was recorded. This procedure was repeated with 31 different frames to obtain evaporation times for various eye sizes, vertical heights, vertex distances, temperature, and humidity. This was also repeated 30 times without spectacle wear to obtain evaporation times for various temperature and humidity conditions.

Results:

Spectacle wear increased evaporation times compared with nonspectacle wear, in both high (>35%) and low humidity (<30%) conditions (both P<0.01). Humidity was correlated with evaporation time, regardless of spectacle and nonspectacle wear (both P<0.01). Evaporation time did not correlate with spectacle eye size, vertical height, or vertex distance (all P≥0.21).

Conclusion:

This study showed that spectacle wear guarded against wind-induced evaporation at the ocular plane compared with nonspectacle wear. However, once spectacles were worn, eye size, vertical height, and vertex distance were not correlated with evaporation times. Humidity drove evaporation independent of spectacle wear.
Exploring a Nursing Home-Specific, Interdisciplinary, Function-Focused, Communicative Framework Based on Situation, Background, Assessment, and Recommendation
Authors: PARK Min Sun , LEE Su Jung , CHOI Young Rim , CHANG Sung Ok
Published: April 2021

Background

Improved methods of communication are needed among professionals in related fields to address the increasing complexity of clinical situations and various levels of functioning experienced by older adults who live in nursing homes.

Purpose

The purpose of this study was to explore function-focused clinical communication among nurses and providers based on the Situation, Background, Assessment, Recommendation (SBAR) approach toward interdisciplinary collaboration to maintain function among nursing home residents and to identify the characteristics of SBAR flows in nursing homes.

Methods

Detailed interviews with 28 interdisciplinary professionals working in four nursing homes were conducted. Directed qualitative content analysis was used to identify the internal attributes of SBAR-based communication. Case analysis was conducted to identify SBAR flows.

Results

Four themes emerged as key factors for function-focused interdisciplinary staff communication in nursing homes. Effective nursing care to maintain function among nursing home residents requires accurate awareness of abnormal circumstances. Knowledge of assessment and resident background are needed to address situations requiring intervention and identify the problems underlying a resident's current state. The optimal therapeutic environment is created by sharing roles and tasks among practitioners through referrals.

Twelve generalized situations requiring function-focused communication (i.e., dislocation of body line because of joint contracture, change in walking, difficulty of moving because of pain, difficulty in eating, fever, change in sleep pattern, change in excretion pattern, change in weight, change in condition, change in problematic behavior, decrease in cognitive function, and change in relationships) and the related nurse-centered SBAR pathways were identified.

Conclusions/Implications for Practice

These results represent a first prototype for developing practical communication guidelines for nursing-home-specific function-focused care and provide new insights into the interdisciplinary approach.