bluuebunny/crossref_metadata_2025 huggingface dataset:
Cladistic analysis ofParaphasma(Phasmatodea: Pseudophasmatidae) highlights the importance of the phallic organ for phasmid systematics
Authors: Chiquetto-Machado Pedro I , Cancello Eliana M
Published: January 2021

The internal male genitalia have been poorly investigated in Phasmatodea, remaining virtually unexplored in phylogenetic studies. Here we describe and illustrate the main phallic elements in several Neotropical stick insects, with emphasis on Paraphasma (Pseudophasmatidae), and present a phylogenetic analysis of this genus. The analysis included ten terminals in the ingroup and 18 in the outgroup, and was based on 32 characters of the phallic organ and 48 of external morphology. In order to compare these datasets in terms of phylogenetic signal and level of homoplasy, the consistency and retention indices of the cladogram were calculated separately for each of them, and partial analyses were also conducted using each dataset alone. The phylogenetic reconstruction revealed Paraphasma as polyphyletic and led us to propose a new, monotypic genus, Ecuadoriphasma gen. nov., three new combinations (Ecuadoriphasma cognatum, Paraphasma trianguliferum and Tithonophasma cancellatum) and place Oestrophora as a synonym of Paraphasma. Additionally, Olcyphides hopii and Paraphasma dentatum are synonymized with Paraphasma laterale. Both external and phallic characters were determinant for the topology obtained, and the latter were less homoplastic in the phylogenetic tree. Our results highlight the usefulness of phallic morphology for inferring phylogenetic relationships in Phasmatodea, especially among closely related genera and species.
Reemergence of Cylindrocladium Crown Rot of Roses in Florida
Authors: Iriarte Fanny B. , Paret Mathews L. , Da Silva Susannah
Published: January 2021

On April 2017, four out of 10,000 Double Knock Out Red roses were observed presenting partially wilted and chlorotic foliage in a commercial nursery in Gadsden Co., Florida. Closer examination of the plant crown revealed brown discoloration of the woody tissue. Under high temperature (85°F) and humidity (70%), shoots progressively turned chlorotic and necrotic, leading to plant death in 4 months. A rapid-growing fungus presenting orange-brown mycelium and abundant cylindrical spores was isolated from infected woody crown tissue. BLAST analysis of the resulting sequence (GenBank no. MT019606) of this pathogen had 100% identity to Calonectria cylindrospora β-tubulin gene (GenBank no. FJ918509.1). Koch’s postulates were conducted on healthy Double Knock Out roses. Two weeks after inoculation, shoots of inoculated plants turned progressively chlorotic and then necrotic, leading to plant death in 2 months. The same pathogen was reisolated from infected plant parts, which sequence also had 100% identity to C. cylindrospora β-tubulin gene (GenBank no. FJ918509.1). This pathogen is the same as one of three isolated from crown rot of roses back in 1994 and identified as Cylindrocladium scoparium (teleomorph: C. cylindrospora [Ellis & Everh.]). In this new occurrence, all infected plants were removed from the nursery, and no further infections were detected. This finding is important for commercial growers to be aware of the potential presence of this pathogen in their nurseries. Knowing the symptoms will help them recognize the disease and take action to prevent spread of the disease.
Sunflower Wilt Diseases: Charcoal Rot, Phialophora Yellows, and Verticillium Wilt
Authors: Ryley Malcolm , Gulya Thomas , Mathew Febina , Thompson Susan , Block Charles , Markell Samuel , Harveson Robert
Published: January 2021

This article describes three wilt diseases of sunflower (Helianthus annuus L.), charcoal rot, Phialophora yellows, and Verticillium wilt, caused by soilborne fungal pathogens that initiate infections through the roots. We provide information on methods and techniques for identifying and distinguishing these diseases with signs, symptoms, and biological characteristics described for each of the causal pathogens. Accurate diagnosis of diseases and knowledge of their causal agents on sunflower are critical steps for developing and recommending disease management strategies.
Methodology to evaluate changes in eating and body‐related attitudes, beliefs and behaviors among female graduate students in dietetics (1020.8)
Authors: Harris Cristen
Published: January 2021

Students may enter the dietetics field because of personal experience with disordered eating or body‐related issues and concerns. A graduate school education that leads to increased knowledge of nutrition may lead to healthier eating, body image and physical activity patterns in some students. The purpose of this study was to create a method for evaluating changes in eating and body‐related attitudes, beliefs and behaviors among graduate students in dietetics during their two‐year professional education. To retain the anonymity of each respondent, recruitment requests were e‐mailed to all graduate dietetic students for each data collection period, including a direct link to the study survey at baseline, at the end of respondents’ first academic year, and at the end of their second academic year. Respondents created confidential codes so responses from different time points could be compared. The 185‐item online survey, accessible to participants via REDCap™ software, consisted of several validated instruments. Information was obtained on demographics; dieting & weight history; eating behaviors; physical activity; orthorexia; cognitive restraint; dietary style & intake; intuitive eating; depression; and perceived stress. This method may be a valuable tool for dietetic educators who are in a unique position to address food‐ and body‐related issues held by students early in their professional training.
Risk of misdiagnosis and delayed diagnosis with COVID-19
Authors: Muhrer Jill C.
Published: January 2021

Misdiagnosis and delayed diagnosis are common problems in healthcare and are typically related to patient, provider, and socioeconomic factors. A syndemics model of COVID-19 is used to analyze the synergistic relationship between diseases and influences that impact patients' living conditions and health. NPs can use this approach to promote patient safety and equitable healthcare.
Fractures of the Great Toe Proximal Phalanx: A Case Series and Review of the Literature
Authors: Dworkin Joshua D. , Harris Evan C. , Ryan Paul M.
Published: January 2021

Phalangeal fractures are the most common fractures seen in the foot, especially in the great toe. Acceptable angulations for fractures of the proximal phalanx are not known. To determine practice trends, a retrospective review of consecutive patients treated at a single institution from January 2011 to August 2014 was performed. All patients were skeletally mature with fractures to the diaphysis of the proximal phalanx with or without intra-articular extension. Outcomes from the medical record review included the type of treatment, radiographic alignment, and visual analog pain scores. Of the 12 patients reviewed, 4 sustained crush injuries and 8 sustained axial load injuries. Statistical analysis was done using Student’s t test for a normally distributed population. Nine of the 12 fractures were treated with manipulation, 7 were closed reduction and percutaneous pinning (CRPP), and 2 were isolated closed reduction without internal fixation. Two of the 9 patients with CRPP required additional surgery. The comparison between the sagittal plane angulation in the closed reduction cohort was 25 degrees compared with 42 degrees in the CRPP cohort (P=0.02). The final sagittal plane angulation comparison was not significant 12 versus 15 degrees (P=0.55). In the transverse plane, no statistical difference was seen between the 2 cohorts with an initial angulation of 8 degrees in the closed reduction cohort versus 13 degrees in the CRPP cohort (P=0.45). The final transverse angulation was symmetric with a mean of 4 degrees in each cohort (P=0.91). The patients in this review were more likely to be treated with operative intervention when initial angulation had a mean of 42 degrees in the sagittal plane. Patients with initial mean angulation of 25 degrees were more likely to be treated with a closed reduction. Final sagittal plane angulations of 12 to 15 degrees were associated with good outcomes. This series may help surgeons and patients in their shared decision making when faced with shaft fractures of the proximal phalanx.

Level of Evidence: Level IV—retrospective cohort study.
Direct Anterior Birmingham Hip Resurfacing: Surgical Technique
Authors: Lall Ajay C. , Annin Shawn , Diulus Samantha C. , Maldonado David R. , Ankem Hari K. , Domb Benjamin G.
Published: January 2021

Birmingham hip resurfacing (BHR) arthroplasty is an established alternative to total hip arthroplasty for end-stage osteoarthritis, specifically in the younger male patient population who wish to return to high-performance physical activity. Traditionally, this procedure has been performed via the posterolateral approach mainly due to the design of intraoperative equipment utilized for femoral component placement. In other words, no current intraoperative equipment has been designed to perform the BHR via any approach other than the posterolateral approach. Recent literature has shown numerous advantages to direct anterior approach arthroplasty, among total hip arthroplasty patients, such as shorter recovery times, less pain, and improved overall functional outcomes. This technique paper aims to highlight a step-by-step approach of achieving the benefits of direct anterior approach arthroplasty in the patients indicated for BHR. A novel guide-pin technique has been developed to account for lack of intraoperative equipment, with pearls and pitfalls explained in detail. We hope this technique will help to guide surgeons in performing the direct anterior BHR with safety and success thereby maximizing patient outcomes.
Trapeziectomy and All-Suture Anchor Suspensionplasty for Basal Joint Arthritis
Authors: Roebke Austin J. , Julka Abhishek
Published: January 2021

This article illustrates a technique for the treatment of thumb carpometacarpal arthritis via trapeziectomy with suture anchor suspensionplasty. The benefits of decreased operative time, simplicity, and decreased morbidity of the procedure are the highlights of this presentation of surgical technique and example case.
Incremental Propensity Score Effects for Time-fixed Exposures
Authors: Naimi Ashley I. , Rudolph Jacqueline E. , Kennedy Edward H. , Cartus Abigail , Kirkpatrick Sharon I. , Haas David M. , Simhan Hyagriv , Bodnar Lisa M.
Published: January 2021

When causal inference is of primary interest, a range of target parameters can be chosen to define the causal effect, such as average treatment effects (ATEs). However, ATEs may not always align with the research question at hand. Furthermore, the assumptions needed to interpret estimates as ATEs, such as exchangeability, consistency, and positivity, are often not met. Here, we present the incremental propensity score (PS) approach to quantify the effect of shifting each person’s exposure propensity by some predetermined amount. Compared with the ATE, incremental PS may better reflect the impact of certain policy interventions and do not require that positivity hold. Using the Nulliparous Pregnancy Outcomes Study: monitoring mothers-to-be (nuMoM2b), we quantified the relationship between total vegetable intake and the risk of preeclampsia and compared it to average treatment effect estimates. The ATE estimates suggested a reduction of between two and three preeclampsia cases per 100 pregnancies for consuming at least half a cup of vegetables per 1,000 kcal. However, positivity violations obfuscate the interpretation of these results. In contrast, shifting each woman’s exposure propensity by odds ratios ranging from 0.20 to 5.0 yielded no difference in the risk of preeclampsia. Our analyses show the utility of the incremental PS effects in addressing public health questions with fewer assumptions.
The role of chromosomal microarray and exome sequencing in prenatal diagnosis
Authors: Chau Matthew Hoi Kin , Choy Kwong Wai
Published: January 2021

Purpose of review

Advancements in technologies have revolutionized prenatal diagnosis. Chromosomal microarray analysis (CMA) became a proven method and was implemented to detect gains and losses of DNA and absence of heterozygosity across the genome. Next-generation sequencing technologies have brought opportunities and challenges to genetic testing. Exome sequencing detects single-nucleotide variants (SNVs) across the exome and its prenatal application is an emerging field. We reviewed the literature to define the role of CMA and exome sequencing in prenatal diagnosis.

Recent finding

The application of exome sequencing in genetic diagnosis shows increased diagnostic yield and could be potentially implemented for prenatal diagnosis of fetuses with one or more ultrasound structural abnormalities or suspected monogenetic conditions. Although CMA is a gold standard for copy number variant (CNV) detection, large clinical cohort studies emphasized integrated CNV and SNV analyses for precise molecular diagnosis. Recent studies also suggest low-pass genome sequencing-based CNV detection can identify genome-wide imbalances at higher resolutions.

Data suggest exome sequencing for SNVs and CMA for CNV detection are the most effective approach for prenatal genetic diagnosis. Emerging evidences show genome sequencing has the potential to replace CMA and even exome sequencing to become a comprehensive genetic test in the clinical diagnostic laboratory.
Thalamic neurometabolite alterations in patients with knee osteoarthritis before and after total knee replacement
Authors: Weerasekera Akila , Morrissey Erin , Kim Minhae , Saha Atreyi , Lin Yang , Alshelh Zeynab , Torrado-Carvajal Angel , Albrecht Daniel , Akeju Oluwaseun , Kwon Young-Min , Bedair Hany , Chen Antonia F. , Napadow Vitaly , Schreiber Kristin , Ratai Eva-Maria , Edwards Robert R. , Loggia Marco L.
Published: January 2021

The weak association between disability levels and “peripheral” (ie, knee) findings suggests that central nervous system alterations may contribute to the pathophysiology of knee osteoarthritis (KOA). Here, we evaluated brain metabolite alterations in patients with KOA, before and after total knee arthroplasty (TKA), using 1H-magnetic resonance spectroscopy (MRS). Thirty-four presurgical patients with KOA and 13 healthy controls were scanned using a PRESS sequence (TE = 30 ms, TR = 1.7 seconds, voxel size = 15 × 15 × 15 mm). In addition, 13 patients were rescanned 4.1 ± 1.6 (mean ± SD) weeks post-TKA. When using creatine (Cr)-normalized levels, presurgical KOA patients demonstrated lower N-acetylaspartate (NAA) (P < 0.001), higher myoinositol (mIns) (P < 0.001), and lower Choline (Cho) (P < 0.05) than healthy controls. The mIns levels were positively correlated with pain severity scores (r = 0.37, P < 0.05). These effects reached statistical significance also using water-referenced concentrations, except for the Cho group differences (P ≥ 0.067). Post-TKA patients demonstrated an increase in NAA (P < 0.01), which returned to the levels of healthy controls (P > 0.05), irrespective of metric. In addition, patients demonstrated postsurgical increases in Cr-normalized (P < 0.001), but not water-referenced mIns, which were proportional to the NAA/Cr increases (r = 0.61, P < 0.05). Because mIns is commonly regarded as a glial marker, our results are suggestive of a possible dual role for neuroinflammation in KOA pain and post-TKA recovery. Moreover, the apparent postsurgical normalization of NAA, a putative marker of neuronal integrity, might implicate mitochondrial dysfunction, rather than neurodegenerative processes, as a plausible pathophysiological mechanism in KOA. More broadly, our results add to a growing body of literature suggesting that some pain-related brain alterations can be reversed after peripheral surgical treatment.
Research design considerations for randomized controlled trials of spinal cord stimulation for pain: Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials/Institute of Neuromodulation/International Neuromodulation Society recommendations
Authors: Katz Nathaniel , Dworkin Robert H. , North Richard , Thomson Simon , Eldabe Sam , Hayek Salim M. , Kopell Brian H. , Markman John , Rezai Ali , Taylor Rod S. , Turk Dennis C. , Buchser Eric , Fields Howard , Fiore Gregory , Ferguson McKenzie , Gewandter Jennifer , Hilker Chris , Jain Roshini , Leitner Angela , Loeser John , McNicol Ewan , Nurmikko Turo , Shipley Jane , Singh Rahul , Trescot Andrea , van Dongen Robert , Venkatesan Lalit
Published: January 2021

Spinal cord stimulation (SCS) is an interventional nonpharmacologic treatment used for chronic pain and other indications. Methods for evaluating the safety and efficacy of SCS have evolved from uncontrolled and retrospective studies to prospective randomized controlled trials (RCTs). Although randomization overcomes certain types of bias, additional challenges to the validity of RCTs of SCS include blinding, choice of control groups, nonspecific effects of treatment variables (eg, paresthesia, device programming and recharging, psychological support, and rehabilitative techniques), and safety considerations. To address these challenges, 3 professional societies (Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials, Institute of Neuromodulation, and International Neuromodulation Society) convened a meeting to develop consensus recommendations on the design, conduct, analysis, and interpretation of RCTs of SCS for chronic pain. This article summarizes the results of this meeting. Highlights of our recommendations include disclosing all funding source and potential conflicts; incorporating mechanistic objectives when possible; avoiding noninferiority designs without internal demonstration of assay sensitivity; achieving and documenting double-blinding whenever possible; documenting investigator and site experience; keeping all information provided to patients balanced with respect to expectation of benefit; disclosing all information provided to patients, including verbal scripts; using placebo/sham controls when possible; capturing a complete set of outcome assessments; accounting for ancillary pharmacologic and nonpharmacologic treatments in a clear manner; providing a complete description of intended and actual programming interactions; making a prospective ascertainment of SCS-specific safety outcomes; training patients and researchers on appropriate expectations, outcome assessments, and other key aspects of study performance; and providing transparent and complete reporting of results according to applicable reporting guidelines.
Drug-coated balloon treatment for nonsmall de-novo coronary artery disease: angiographic and clinical outcomes
Authors: Her Ae-Young , Yuan Song Lin , Jun Eun Jung , Bhak Youngjune , Kim Moo Hyun , Garg Scot , Kim Yong Hoon , Kun Liu , Hui Lin , Zhi Wang , Hao Jiang , Zhentao Shi , Qiang Tang , Shin Eun-Seok
Published: January 2021

Objectives

Although drug-coated balloons (DCBs) are established for de-novo lesions in small coronary arteries, the impact of DCB treatment according to the reference vessel diameter (RVD) remains poorly defined. This study aimed to evaluate the angiographic and long-term clinical outcomes of DCB treatment for de-novo coronary lesions according to RVD.

Methods and results

A total of 227 patients were retrospectively enrolled and stratified according to an RVD >2.5 mm [nonsmall vessel disease (NSVD) group, n = 100] and ≤2.5 mm [small vessel disease (SVD) group, n = 127]. The primary endpoint was late lumen loss (LLL) at a 6-month follow-up, and the secondary endpoint was target vessel failure (TVF, a composite of cardiac death, target vessel myocardial infarction, target vessel revascularization and target vessel thrombosis). The LLL among the 206 patients (90.8%) returning for scheduled angiography at 6 month was similar (NSVD, 0.03 ± 0.22 mm vs. SVD, 0.06 ± 0.25 mm; P = 0.384). TVF was also comparable in both groups at a median follow-up of 3.4 years (NSVD, 7.0 vs. SVD, 7.9 %; P = 0.596). At baseline, there were numerically more dissections in the SVD group compared to the NSVD group (47.2 vs. 35.0 %; P = 0.064); however, most of these had disappeared in both groups at a 6-month follow-up. In a multivariable analysis, the presence of dissection was not associated with LLL or TVF in either group.

Conclusions

The safety and efficacy of DCB treatment for de-novo coronary lesions, in terms of LLL and TVF, was unrelated to RVD.
A clinical prediction model to assess risk for pancreatic cancer among patients with prediabetes
Authors: Boursi Ben , Finkelman Brian , Giantonio Bruce J. , Haynes Kevin , Rustgi Anil K. , Rhim Andrew D. , Mamtani Ronac , Yang Yu-Xiao
Published: January 2021

Background

Early detection of pancreatic ductal adenocarcinoma (PDA) may improve survival. We previously developed a clinical prediction model among patients with new-onset diabetes to help identify PDAs 6 months prior to the clinical diagnosis of the cancer. We developed and internally validated a new model to predict PDA risk among those newly diagnosed with impaired fasting glucose (IFG).

Methods

We conducted a retrospective cohort study in The Health Improvement Network (THIN) (1995–2013) from the UK. Eligible study patients had newly diagnosed IFG during follow-up in THIN. The outcome was incident PDA diagnosed within 3 years of IFG diagnosis. Candidate predictors were factors associated with PDA, glucose metabolism or both.

Results

Among the 138 232 eligible patients with initial IFG diagnosis, 245 (0.2%) were diagnosed with PDA within 3 years. The median time from IFG diagnosis to clinical PDA diagnosis was 326 days (IQR 120–588). The final prediction model included age, BMI, proton pump inhibitor use, total cholesterol, low-density lipoprotein, alanine aminotransferase and alkaline phosphatase. The model achieved good discrimination [area under the curve 0.71 (95% CI, 0.67–0.75)] and calibration (Hosmer and Lemeshow goodness-of-fit test P > 0.05 in 17 of the 20 imputed data sets) with optimism of 0.0012662 (95% CI, −0.00932 to 0.0108771).

Conclusions

We developed and internally validated a sequential PDA prediction model based on clinical information routinely available at the initial appearance of IFG. If externally validated, this model could significantly extend our ability to detect PDAs at an earlier stage.
Reticuloendothelial activation correlates with disease severity and predicts mortality in severe alcoholic hepatitis
Authors: Vijayalekshmi Balakrishnan , Sharma Anand , Prabhu Savit B , Nair Sukesh C. , Mammen Joy , Goel Ashish , Zachariah Uday George , Dutta Amit Kumar , Balasubramanian Kunissery A , Elias Elwyn , Eapen Chundamannil E.
Published: January 2021

Background

Overactivation of reticuloendothelial cells lining liver sinusoids – Kupffer cells (macrophages) and sinusoidal endothelial cells – may narrow the sinusoidal lumen, impair perfusion in liver microcirculation and contribute to disease severity in alcoholic hepatitis.

Aim

The aim of the article was to assess reticuloendothelial activation in patients with severe alcoholic hepatitis (SAH).

Methods

In SAH patients, we prospectively studied baseline reticuloendothelial activation markers [serum ferritin, sCD163 and plasma von Willebrand factor (VWF) antigen] and Macrophage Activation Syndrome (MAS) criteria, correlated them with disease severity scores [model for end-stage liver disease (MELD) and Sequential Organ Failure Assessment (SOFA) scores] and analyzed their ability to predict survival over a 90-day follow-up period.

Results

A total of 50 SAH patients [45 (37–49) years, median (interquartile range), 49 males, discriminant function, 76.2 (54.5–106.6); MELD score, 30 (26.2–36)] were studied. 41 SAH patients (82%) had ferritin >500 ng/mL, and all (100%) had markedly raised sCD163 and VWF levels. The median sCD163 level was 10-fold higher than healthy controls and the median VWF level was 5-fold above the upper limit of normal. In total, 37 SAH patients (74%) met MAS criteria. Reticuloendothelial activation markers correlated with MELD and SOFA scores (P < 0.05). VWF was an independent marker to predict mortality in SAH [adjusted hazard ratio, 1.002 (1.000–1.004)].

Conclusions

The reticuloendothelial system was markedly activated and correlated with disease severity scores in SAH patients.VWF predicted short-term mortality independent of MELD and sCD163. Further larger multicentric studies are needed to validate these findings.
Increased prevalence of irritable bowel syndrome in migraine patients: a systematic review and meta-analysis
Authors: Wongtrakul Wasit , Charoenngam Nipith , Ungprasert Patompong
Published: January 2021

Objective

Even though evidence showing increased prevalence of irritable bowel syndrome (IBS) among migraine patients exists, it has not been well-established and the magnitude of association varies substantially across the studies. This study aimed to comprehensively compare the prevalence of IBS among migraineurs versus nonmigraineurs using the systematic review and the meta-analysis technique.

Methods

Two authors independently conducted a literature search in MEDLINE, EMBASE and Google Scholar database up to April 2020. The eligible study must consist of two groups of participants, migraineurs and nonmigraineurs, and report the prevalence of IBS in both groups. Alternatively, an eligible study may report the odds ratio (OR) with a 95% confidence interval (CI) of the association between migraine and IBS. Point estimates and standard errors from each eligible study were combined together using the generic inverse variance method of DerSimonian and Laird.

Results

Of the 2531 articles identified from the three databases, 11 studies with a total of 28 336 migraineurs and 1 535 758 nonmigraineurs met the selection criteria and were included into the meta-analysis. The pooled analysis found that migraineurs had a significantly higher prevalence of IBS than nonmigraineurs with the pooled OR of 2.49 (95% CI, 2.22–2.78; I
2, 42%). The funnel plot was asymmetric and suggested the presence of publication bias.

Conclusion

A significantly increased prevalence of IBS among patients with migraine was demonstrated in this study.
Review article: safety of new biologic agents for inflammatory bowel disease in the liver
Authors: Magrì Salvatore , Chessa Luchino , Demurtas Mauro , Cabras Francesco , Mocci Giammarco
Published: January 2021

New biologic agents (vedolizumab, ustekinumab and tofacitinib) represent an effective treatment for inflammatory bowel diseases and have been recently approved. However, with a rapidly evolving complement of advanced targeted therapies, new concerns about their potentially undesirable effects on liver function emerge. In particular, little is known about safety data in patients with hepatitis B virus, hepatitis C virus chronic infections, cirrhosis and in transplanted patients who are accumulating. In addition, these new agents have also been associated with drug-induced liver injury. Limited data on the efficacy of vedolizumab in patients with primary sclerosing cholangitis are also available.

This article reviews available data about hepatic safety concerns in patients receiving vedolizumab, ustekinumab and tofacitinib with and without preexistent hepatic diseases.
Ureteropelvic junction obstruction: diagnosis and management
Authors: Vemulakonda Vijaya M.
Published: January 2021

Purpose of review

Ureteropelvic junction obstruction (UPJO) is the most common cause of prenatally diagnosed hydronephrosis. Although associated with obstruction of the kidney, the natural history is variable, ranging from spontaneous resolution to progressive loss of function over the first few years of life. As a result, the optimal evaluation strategy and indications for treatment have not been well defined. The purpose of this article is to review recent literature focused on the prenatal and postnatal evaluation of infants with prenatally diagnosed hydronephrosis suspicious for UPJO.

Recent findings

Recent studies have focused on the effect of the urinary tract dilation (UTD) ultrasound classification system, as well as use of magnetic resonance imaging both prenatally and postnatally to stratify the risk of infants with prenatally diagnosed hydronephrosis to develop renal impairment or undergo surgery. Additionally, urinary biomarkers have been identified as a potential noninvasive alternative to diuretic renography in identifying infants with clinically significant UPJO.

Although continued work is needed to develop clear guidelines for evaluation and treatment and to better define long-term outcomes, these studies offer novel approaches to improve the care of these patients.
Percutaneous nephrolithotomy with suction: is this the future?
Authors: Liu Yang , Zhu Wei , Zeng Guohua
Published: January 2021

Purpose of review

The armamentarium of percutaneous nephrolithotomy (PCNL) and the strategy to perform the procedure is constantly evolving. The innovation and development in techniques lead to further miniaturization in PCNL devices and change the lithotripsy and stone removal strategy. Suctioning in PCNL offers urologist a new conception in renal stone management. The present review evaluates the latest results on efficacy, safety and feasibility of suctioning PCNL techniques.

Recent findings

Recent literature reported the outcomes of different suctioning PCNL techniques. Most of these studies demonstrated good efficacy when comparing conventional PCNL. Suctioning PCNL improving the lithotripsy efficiency to enhance the stone-free rate (SFR) and reducing renal pelvic pressure to attenuate postoperative infectious complications. The advantage of suction also helps overcome the limitation of potentially higher intrarenal pressure and prolonged operative time in Mini-PCNL.

PCNL with suctioning represents a valuable new tool in the armamentarium of modern endourologists. This innovative approach can offer improved safety and efficacy with lower complications rates and higher cost effectiveness than the traditional PCNL technique.
Incisional Hernia Incidence, Repair Techniques, and Outcomes Based on 1600 Consecutive Patients Receiving Abdominally Based Autologous Breast Reconstruction
Authors: Rhemtulla Irfan A. , Mauch Jaclyn T. , McCarty E. Berryhill , Broach Robyn B. , Serletti Joseph M. , Kovach Stephen J.
Published: January 2021

Background

As the number of postmastectomy patients who receive abdominally based autologous breast reconstruction (ABABR) increases, the frequency of unique paramedian incisional hernias (IHs) at the donor site is increasing as well. We assessed incidence, repair techniques, and outcomes to determine the optimal treatment for this morbid condition.

Methods

A total of 1600 consecutive patients who underwent ABABR at the University of Pennsylvania between January 1, 2009, and August 31, 2016, were retrospectively identified. Preoperative and operative information was collected for these patients. Incisional hernia incidence was determined by flap type and donor site closure technique. Repair techniques and postoperative outcomes for all patients receiving IH repair (IHR) after ABABR at our institution were also determined. Univariate and multivariate analyses were conducted.

Results

The incidence of IH after ABABR in our health system was 3.6% (n = 61). Fifteen additional patients were referred from outside hospitals for a total of 76 patients who received IHR. At the time of IHR, mesh was used in 79% (n = 60) of cases (13 biologic and 47 synthetic), with synthetics having significantly lower recurrent IH incidence (10.6% vs 38.5%, P = 0.017) when compared with biologics. Mesh position did not have any statistically significant effect on outcomes; however, sublay mesh position had zero adverse outcomes.

Conclusions

Mesh should be used in all cases when possible. Although retrorectus repair with mesh is optimal, this plane is often nonexistent or too scarred in after ABABR. Thus, intraperitoneal underlay mesh with primary fascial closure or primary closure with onlay mesh placement should then be considered.
Two-Stage, Prepectoral Breast Reconstruction
Authors: Kumbla Pallavi Archana , Ananthasekar Shivani , Denney Brad David
Published: January 2021

Goals

Prepectoral breast reconstruction is seeing a resurgence in popularity as advances in breast oncology and breast reconstruction continue to occur. This study seeks to describe a simple, reproducible method for prepectoral breast reconstruction and analyzes patient demographics and outcomes after the first stage of prepectoral breast reconstruction.

Methods

After institutional review board approval was obtained, a retrospective chart review was performed to identify patients who underwent 2-stage prepectoral reconstruction by the senior author from January 2019 to February 2020. Patient demographics including body mass index, nicotine use, diabetes mellitus, neoadjuvant chemotherapy, and adjuvant radiation were analyzed. Type of mastectomy (nipple vs skin sparing), unilateral versus bilateral reconstruction, and use of intraoperative angiography were also assessed. Complications including excision of ischemic skin, delayed mastectomy flap ischemia, seroma, hematoma, axillary cellulitis, expander infection, and reconstructive failure were analyzed. χ2 Analysis was used to identify any association between the above demographics and infection, and P values were generated with a statistical significance being denoted by a P < 0.05.

Results

One hundred five breast reconstructions were included in this study. A statistically significant association was found between nicotine use, diabetes mellitus, excision of ischemic skin, and expander infection. No significant association was found between other demographics and infection risk. Expander infection occurred in 2.86% of all reconstructions with an overall reconstructive failure rate of 2.86%.

Conclusions

This study demonstrates that our technique is reproducible and can be used for all types of mastectomies and incisions. Our data analysis demonstrates that this is a reliable method of breast reconstruction if performed correctly in the properly selected patient. Future studies will assess outcomes following the second stage of reconstruction.
Long-term (18 Years) Results of Patients With Long-segment Barrett Esophagus Submitted to Acid Suppression-duodenal Diversion Operation
Authors: Csendes Attila , Orellana Omar , Figueroa Manuel , Lanzarini Enrique
Published: January 2021

Objective:

To determine late results of AS-DD procedure in long-segment (LSBE) and extralong-segment BE (ELSBE) using subjective and objective measurements to ascertain the histological impact over intestinal metaplasia (IM) and progression to EAC.

Summary of Background Data:

Barrett esophagus (BE) is a known precursor of esophageal adenocarcinoma (EAC), and Nissen fundoplication has proven to be unable to stop mixed reflux among them. Our group proposed a surgical procedure that handles pathophysiological changes responsible for BE.

Methods:

This prospective study included 127 LSBE and ELSBE subjects submitted to clinical and functional analyses. They were presented to selective vagotomy, fundoplication, partial gastrectomy with Roux-en-Y reconstruction. The changes in IM were determined in both groups.

Results:

Follow-up was completed at a mean of 18 years in 81% of the cases. Visick I-II scores were seen in 88% of LSBE and 65% in ELSBE (P < 0.01). There was significant healing of erosive esophagitis and esophageal peptic ulcers, and strictures were resolved in 71%. There was 38% of IM regression in LSBE. Two cases in each group progressed to EAC at a mean of 15 years. Pathologic acid reflux was abolished in 91% and duodenal in 100%. There was a regression of low-grade dysplasia to IM in 80%.

Conclusions:

AS-DD permanently eliminates pathologic refluxate to the esophagus. The progression to HGD/EAC is lower compared to medical treatment, with an 8-fold reduction in LSBE and 2.2-fold in ELSBE. AS-DD seems to influence IM behaviors, and it is a tool that could reduce and delay progression to EAC.
Power Training in Older Adults With Hip Osteoarthritis and Total Hip Arthroplasty
Authors: Chui Kevin K. , Tudini Frank , Corkery Marie B. , Yen Sheng-Che
Published: January 2021

Exercise is often recommended as part of the conservative management of hip osteoarthritis (OA) and total hip arthroplasty (THA) in older adults. The purpose of this review is to summarize recent evidence on power training in these populations. Clinical practice guidelines, systematic reviews, and randomized clinical trials on hip OA and THA in older adults frequently recommend exercise; however, the optimal exercise type, duration, frequency, and intensity remain unknown. There is a lack of studies that specifically examined the effects of power training on these populations. Additional research on the effects of power training on patients with hip OA and THA is therefore warranted.
Exercise for the prevention and treatment of neurocognitive disorders: new evidence and clinical recommendations
Authors: Chan Wai Chi , Lee Allen T.C. , Lam Linda C.W.
Published: January 2021

Purpose of review

As current pharmacological treatments of dementia have only modest effects, nonpharmacological treatments like exercise interventions have attracted much research interest. This review summarizes recent evidence regarding the efficacy of exercise in preventing and treating neurocognitive disorders.

Recent findings

Recent evidence suggests that exercise may prevent cognitive impairment in older adults with normal cognition. Besides, it may slow down the deterioration in older adults who have mild cognitive impairment (MCI) and dementia. But inconsistent findings have been reported, and larger randomized controlled trials are required to confirm its treatment value. This article also reviews existing evidence-based clinical guidelines advising on the optimal format and intensity of exercise interventions for older adults with different cognitive functions.

There is a growing body of evidence supporting the cognitive benefits of exercise for older adults with normal cognition, MCI, and dementia. Exercise is a relatively safe and low-cost lifestyle intervention and should be recommended for older adults to prevent dementia and treat cognitive impairment. However, as the factors affecting the efficacy of exercise in improving cognition are complex, exercise prescription should be individually tailored.
Reconstructing cranial evolution in an extinct hominin
Authors: Baab Karen L.
Published: January 2021

Homo erectusis the first hominin species with a truly cosmopolitan distribution and resembles recent humans in its broad spatial distribution. The microevolutionary events associated with dispersal and local adaptation may have produced similar population structure in both species. Understanding the evolutionary population dynamics ofH. erectushas larger implications for the emergence of laterHomolineages in the Middle Pleistocene. Quantitative genetics models provide a means of interrogating aspects of long-standingH. erectuspopulation history narratives. For the current study, cranial fossils were sorted into six major palaeodemes from sites across Africa and Asia spanning 1.8–0.1 Ma. Three-dimensional shape data from the occipital and frontal bones were used to compare intraspecific variation and test evolutionary hypotheses. Results indicate thatH. erectushad higher individual and group variation thanHomo sapiens, probably reflecting different levels of genetic diversity and population history in these spatially disperse species. This study also revealed distinct evolutionary histories for frontal and occipital bone shape inH. erectus, with a larger role for natural selection in the former. One scenario consistent with these findings is climate-driven facial adaptation inH. erectus, which is reflected in the frontal bone through integration with the orbits.
Wing serial homologues and the diversification of insect outgrowths: insights from the pupae of scarab beetles
Authors: Hu Yonggang , Moczek Armin P.
Published: January 2021

Modification of serially homologous structures is a common avenue towards functional innovation in developmental evolution, yet ancestral affinities among serial homologues may be obscured as structure-specific modifications accumulate over time. We sought to assess the degree of homology to wings of three types of body wall projections commonly observed in scarab beetles: (i) the dorsomedial support structures found on the second and third thoracic segments of pupae, (ii) the abdominal support structures found bilaterally in most abdominal segments of pupae, and (iii) the prothoracic horns which depending on species and sex may be restricted to pupae or also found in adults. We functionally investigated 14 genes within, as well as two genes outside, the canonical wing gene regulatory network to compare and contrast their role in the formation of each of the three presumed wing serial homologues. We found 11 of 14 wing genes to be functionally required for the proper formation of lateral and dorsal support structures, respectively, and nine for the formation of prothoracic horns. At the same time, we document multiple instances of divergence in gene function across our focal structures. Collectively, our results support the hypothesis that dorsal and lateral support structures as well as prothoracic horns share a developmental origin with insect wings. Our findings suggest that the morphological and underlying gene regulatory diversification of wing serial homologues across species, life stages and segments has contributed significantly to the extraordinary diversity of arthropod appendages and outgrowths.
Genome-based reclassification of Amycolatopsis eurytherma as a later heterotypic synonym of Amycolatopsis thermoflava
Authors: Singh Priya , Hira Princy , Rawat Charu Dogra , Lal Rup , Sood Utkarsh
Published: January 2021

The present study was carried out to clarify the taxonomic assignment of two closely related

Amycolatopsis

species. Genomic information for 48 type strains was available at the time of conducting this analysis. Our analysis showed that two species, viz.

Amycolatopsis eurytherma

Kim et al. 2002 and

Amycolatopsis thermoflava

Chun et al. 1999, are conspecific. The 16S rRNA gene sequences of the two species possess 98.85 % sequence similarity. Further, whole-genome comparisons showed that

A. eurytherma

DSM 44348T and

A. thermoflava

N1165T shared 98.75 % average nucleotide identity, 98.63 % average amino acid identity and 87.8 % digital DNA–DNA hybridization values. These values exceed the threshold values for bacterial species delineation, indicating that they belong to the same species. Further, the phylogenomic analysis based on the core genome of the strains under study confirmed that

A. eurytherma

DSM 44348T and

A. thermoflava

N1165T formed a monophyletic clade. Based on this evidence we propose the reclassification of

Amycolatopsis eurytherma

Kim et al. 2002 as a later heterotypic synonym of

Amycolatopsis thermoflava

Chun et al. 1999.
Optimal Size of COVID-19 Testing Pools
Authors: Cohen Jon
Published: January 2021

This research note investigates the optimal size of pools for pooled, COVID-19 testing when positive pools will be followed up by individual tests of pool members. Formulae for the optimum are derived and provided. The analysis indicates that

optimal pool sizes are unlikely to exceed about 20 individuals in realistic situations,

optimal pool size is influenced by prevalence in the population and the extent to which infection is clustered within the population, and,

pools are most efficiently comprised of people with homogeneous risk, with heterogeneity across pools.
Origin of HIV/AIDS and Vaccine Failure: Simulation of the Role of the Adjuvant Activation Hypothesis
Authors: Grassi H.C. , Andrades E.D.J. , Andrades-Grassi V.J.
Published: January 2021

Human Immunodeficiency Virus (HIV) is the etiological agent for Acquired Immunodeficiency Syndrome (AIDS). It is possible that vaccine failure could be related to the events involved at the origin of HIV/AIDS. In this work the role of the adjuvant activation hypothesis on the origin and on the failure of vaccines, as well as other effects is evaluated by means of a simulation using a mathematical analysis, differential equations and an Excel spreadsheet. The results show that the adjuvant activation alters the viral load and the cellular and humoral Immune Response. Under certain conditions it was possible to show how the adjuvant activation could have promoted the origin of the HIV/AIDS pandemic and also, as a consequence of the SIV adaptation to human beings at the origin, the failure of present day vaccine trials. Other effects such as Immunotolerance and Antibody Dependent Enhancement (ADE) were shown. This study provides a means to examine other effectors in order to suggest therapeutic alternatives. In this case passive immunization in combination with anti-retroviral therapy showed an acceptable adaptation to the conditions tested. It is concluded that the methodological strategy of this work may be useful for the analysis of the adjuvant activation hypothesis as well as other effects, interactions and new proposals, such as thermodynamics of HIV infections.
Ecological correlates of reproductive status in a guild of Afrotropical understory trees
Authors: Drager Andrea P. , Weylandt Michael , Chuyong George , Kenfack David , Thomas Duncan W. , Dunham Amy E.
Published: January 2021

The relative abundance patterns of tropical trees have been of interest since the expeditions of Alfred Russel Wallace, but little is known about how differences in relative abundance relate to reproductive patterns. Flowering is resource-dependent and fitness differences as well as differences in the quality of the abiotic and biotic neighborhood may contribute to the variation in reproductive status responsible for population-level flowering patterns. This variation determines the density and distance between flowering conspecifics and may alter relative abundance extremes among species during reproduction, factors known to influence pollination success. We collected flowering status data for a guild of twenty-three co-occurring tree species that flower in the understory of the Korup Forest Dynamics Plot in Cameroon. We examined how the occurrence and location of reproductive events were related to spatial patterns of adult abundance, focal tree size, neighborhood crowding, and habitat, while accounting for the influence of shared ancestry. Across species, the probability of flowering was higher for individuals of rarer species and for larger individuals but was unrelated to neighborhood crowding or habitat differences. Relative abundance extremes were reduced when only flowering individuals were considered, leading to a negative relationship between plot abundance and flowering probability at the species level that was not structured by shared ancestry. Spatially, flowering conspecifics tended to be overdispersed relative to all adult conspecifics. Rare species are predicted to suffer Allee effects or reduced fitness due to the difficulty of finding mates at low densities and frequencies. Here, however, rare species appear to maximize the size of their mate pool, compared to abundant species. If this partial ‘leveling of the playing field’ during reproduction is typical, it has consequences for our understanding of biodiversity maintenance and species coexistence in tropical forests.