bluuebunny/crossref_metadata_2025 huggingface dataset:
Continental‐scale dynamics of avian influenza in U.S. waterfowl are driven by demography, migration, and temperature
Authors: Gorsich Erin E. , Webb Colleen T. , Merton Andrew A. , Hoeting Jennifer A. , Miller Ryan S. , Farnsworth Matthew L. , Swafford Seth R. , DeLiberto Thomas J. , Pedersen Kerri , Franklin Alan B. , McLean Robert G. , Wilson Kenneth R. , Doherty Paul F.
Published: October 2020

Emerging diseases of wildlife origin are increasingly spilling over into humans and domestic animals. Surveillance and risk assessments for transmission between these populations are informed by a mechanistic understanding of the pathogens in wildlife reservoirs. For avian influenza viruses (AIV), much observational and experimental work in wildlife has been conducted at local scales, yet fully understanding their spread and distribution requires assessing the mechanisms acting at both local, (e.g., intrinsic epidemic dynamics), and continental scales, (e.g., long‐distance migration). Here, we combined a large, continental‐scale data set on low pathogenic, Type A AIV in the United States with a novel network‐based application of bird banding/recovery data to investigate the migration‐based drivers of AIV and their relative importance compared to well‐characterized local drivers (e.g., demography, environmental persistence). We compared among regression models reflecting hypothesized ecological processes and evaluated their ability to predict AIV in space and time using within and out‐of‐sample validation. We found that predictors of AIV were associated with multiple mechanisms at local and continental scales. Hypotheses characterizing local epidemic dynamics were strongly supported, with age, the age‐specific aggregation of migratory birds in an area and temperature being the best predictors of infection. Hypotheses defining larger, network‐based features of the migration processes, such as clustering or between‐cluster mixing explained less variation but were also supported. Therefore, our results support a role for local processes in driving the continental distribution of AIV.
Keystone predation: trait‐based or driven by extrinsic processes? Assessment using a comparative‐experimental approach
Authors: Menge Bruce A. , Foley Melissa M. , Robart Matthew J. , Richmond Erin , Noble Mae , Chan Francis
Published: October 2020

Keystone predation can be a determinant of community structure, including species diversity, but factors underlying “keystoneness” have been minimally explored. Using the system in which the original keystone, the sea star Pisaster ochraceus, was discovered, we focused on two potential (but overlapping) determinants of keystoneness: intrinsic traits or state variables of the species (e.g., size, density), and extrinsic environmental parameters (e.g., prey productivity) that may provide conditions favorable for keystone predator evolution. Using a comparative‐experimental approach, with repeated field experiments at multiple sites across a variable coastal environment, we tested predation rates, or how quickly predators consumed prey, and predation effects, or community response to predator presence or absence. We tested five hypotheses: (H1) predation rates and effects will vary in space but not time; (H2) per population predation rates will vary primarily with individual traits and population variables; (HJHH3) per capita predation rates will vary only with individual traits; (H4) predation effects will vary with traits, variables, and external drivers; and (H5) as predicted by the keystone predation hypothesis, diversity will vary unimodally with predation pressure. As hypothesized, predation rates differed among sites but not over time (H1), and in caging exclusion experiments, predation effect varied with both intrinsic and extrinsic factors (H4). Unexpectedly, predation rates varied with both intrinsic and extrinsic (H2, per population), or only with extrinsic (H3, per capita) factors. Further, in large‐plot exclusion experiments, predation effect was most closely associated with individual traits (contra H4). Finally, taxon diversity varied unimodally with proxies of predation pressure (sessile prey abundance) and was sensitive to extrinsic factors (mussel growth, temperature, and upwelling, H5). Hence, keystoneness depended on predator individual traits, predator population variables, and environmental parameters. However, temporal differences in caging experiments suggested that environmental characteristics underlying prey dynamics may be preeminent. Compared to prior experiments, predation was weaker with low prey input compared to periods with high prey input. Collectively, our results suggest that keystone predator evolution depends on the coalescence of species‐specific characteristics, and environmental parameters favoring high prey productivity. Our approach may be a model for future studies exploring the generality of keystoneness.
Parasite intensity and the evolution of migratory behavior
Authors: Balstad Laurinne J. , Binning Sandra A. , Craft Meggan E. , Zuk Marlene , Shaw Allison K.
Published: October 2020

Migration can allow individuals to escape parasite infection, which can lead to a lower infection probability (prevalence) in a population and/or fewer parasites per individual (intensity). Because individuals with more parasites often have lower survival and/or fecundity, infection intensity shapes the life‐history trade‐offs determining when migration is favored as a strategy to escape infection. Yet, most theory relies on susceptible‐infected (SI) modeling frameworks, defining individuals as either healthy or infected, ignoring details of infection intensity. Here, we develop a novel modeling approach that captures infection intensity as a spectrum, and ask under what conditions migration evolves as function of how infection intensity changes over time. We show that relative timescales of migration and infection accumulation determine when migration is favored. We also find that population‐level heterogeneity in infection intensity can lead to partial migration, where less‐infected individuals migrate while more infected individuals remain resident. Our model is one of the first to consider how infection intensity can lead to migration. Our results frame migratory escape in light of infection intensity rather than prevalence, thus demonstrating that decreased infection intensity should be considered a benefit of migration, alongside other typical drivers of migration.
Reduced magnitude and shifted seasonality of CO2 sink by experimental warming in a coastal wetland
Authors: Sun Baoyu , Yan Liming , Jiang Ming , Li Xinge , Han Guangxuan , Xia Jianyang
Published: October 2020

Coastal wetlands have the highest carbon sequestration rate per unit area among all unmanaged natural ecosystems. However, how the magnitude and seasonality of the CO2 sink in coastal wetlands will respond to future climate warming remains unclear. Here, based on measurements of ecosystem CO2 fluxes in a field experiment in the Yellow River Delta, we found that experimental warming (i.e., a 2.4°C increase in soil temperature) reduced net ecosystem productivity (NEP) by 23.7% across two growing seasons of 2017–2018. Such a reduction in NEP resulted from the greater decrease in gross primary productivity (GPP) than ecosystem respiration (ER) under warming. The negative warming effect on NEP mainly occurred in summer (−43.9%) but not in autumn (+61.3%), leading to a shifted NEP seasonality under warming. Further analyses showed that the warming effects on ecosystem CO2 exchange were mainly controlled by soil salinity and its corresponding impacts on species composition. For example, warming increased soil salinity (+35.0%), reduced total aboveground biomass (−9.9%), and benefited the growth of plant species with high salt tolerance and late peak growth. To the best of our knowledge, this study provides the first experimental evidence on the reduced magnitude and shifted seasonality of CO2 exchange under climate warming in coastal wetlands. These findings underscore the high vulnerability of wetland CO2 sink in coastal regions under future climate change.
Research Progress and Future Perspectives on Rechargeable Na‐O2 and Na‐CO2 Batteries
Authors: Zheng Zhi , Wu Chang , Gu Qinfen , Konstantinov Konstantin , Wang Jiazhao
Published: October 2020

Rechargeable sodium–oxygen (Na‐O2) and sodium–carbon dioxide (Na‐CO2) batteries have attracted intensive research attention in recent years owing to their advantages of high theoretical energy density, modest cost, abundance of sodium resources, and promising potential for achieving real sodium–air batteries in large‐scale energy storage systems. Nevertheless, current research on Na‐O2 and Na‐CO2 batteries is facing enormous challenges, such as low energy efficiency and limited cycle life, which are restricting their progress at the initial stage. Therefore, understanding their working principles, and the chemical and electrochemical reactions of the electrodes is indispensable to achieve their practical application and even the goal of true sodium–air batteries. This review aims to provide an overview of the research developments and future perspectives on Na‐O2 and Na‐CO2 batteries, which include the major aspects, such as working mechanisms, air cathode materials design strategies, sodium anode protection, and electrolyte stability. Moreover, the remaining issues and future research directions are also thoroughly discussed and presented.
Precast concrete spreader‐walls to improve the reparability of RC frame buildings
Authors: Smith Joel W. , Sullivan Timothy J. , Nascimbene R.
Published: October 2020

Recent earthquakes have demonstrated that reinforced concrete (RC) frames, which form a beam‐sway mechanism, sustain damage to beams and floors that can be particularly difficult and costly to repair. This paper proposes a new structural system, which combines RC frames with precast concrete spreader‐walls. The spreader‐walls are fixed to frames with connections that allow them to pivot and are carefully arranged so that they distribute seismic deformation demands over the building height. This in turn allows the designer to force plastic hinges to occur at column ends without the risk of a soft‐story mechanism forming and without costly damage to beams and floors. Nonlinear time history analyses of two sets of 4‐, 8‐, and 12‐story buildings are conducted with and without the spreader‐walls. The analyses show that the system behaves as intended and has the potential to enhance the reparability of RC frame structures. To this end, experimental research is recommended to ensure that the proposed connection details behave as desired prior to their implementation in practice.
Can You Fish in a Pandemic? An Overview of Recreational Fishing Management Policies in North America During the COVID-19 Crisis
Authors: Paradis Yves , Bernatchez Simon , Lapointe Dominique , Cooke Steven J
Published: October 2020

Facing challenges of the COVID-19 pandemic, government agencies had to quickly react and provide guidelines for outdoor activities such as recreational fishing. Here we review information provided by provincial and state natural resource management agencies in North America during the March–April 2020 period to collate freshwater fishing regulations implemented during the pandemic. Among the 63 jurisdictions for which information was collected, 92% of jurisdictions kept the recreational fishing season open, asking anglers to practice social distancing at all times. Although recreational fishing was open in most jurisdictions, specific measures for anglers and for the fishing industry (e.g., fishing guides) were enforced to comply with public health rules. Some management agencies altered stocking practices, restricted fishing by non-residents, withdrew permits for competitive angling events, and instituted restrictions on the charter and guide industry. This overview of fishing regulations in North America in the context of a major pandemic provides fisheries managers a portrait of some measures taken by other jurisdictions.
A preliminary study on the quality of street vended foods around a university in Kunming, China
Authors: Zhang Xuechun , Li Yunqian , Sun Jian , Kan Huan , Wang Zhenxing , Xiang Ping
Published: October 2020

The street vended foods (SVF) are very popular in China, particularly in highly adolescents populated regions such as schools. Food quality is a critical global issue, but there are few studies describe the quality assessment of SVF. In this study, the quality of SVF around a university in Kunming was evaluated, including the microbial quality, proximate composition, oil quality, and heavy metal content. Microbial results showed that the aerobic plate count (APC) and Escherichia coli (E. coli) counts ranged from 1.94 to 7.43 log CFU/g or ml, and 0.53 to 1.48 log CFU/g or ml, respectively. A portion of fried snack samples exceed the standard limit of acid value (AV) and peroxide value (POV), and the same result was observed in carbonyl group value (CGV), thiobarbituric acid (TBA) value, viscosity, and conductivity. The proximate composition of the fried snack samples varied widely, while the fat content was generally higher. The heavy metal analysis showed most samples met the safety standards, with the content of 12–51, 1–19, 12–73, and 11–88 μg/kg for As, Hg, Cd, and Pb, respectively. In conclusion, although the overall results of this study were satisfying, more attention should be given to the quality of SVF. Consequently, there is a need for additional measures to protect consumers, particularly young adults in college, from foodborne disease.
Feeding practice, energy, and nutrient intake adequacy among children aged 6–23 months in Southern Ethiopia: a community based cross‐sectional study
Authors: Feyisa Beshadu Bedada , Tefera Gosaye Mekonen , Endris Bilal Shukur , Asayehu Tamene Taye , Gebreyesus Seifu Hagos
Published: October 2020

After 6 months, children require increased food and nutrient intake from complementary food for their growth and development. However, quantitative data on macro and micronutrient intakes from complementary food is limited. Thus, this study is designed to identify the adequacy of energy and micronutrient intake from complementary foods among children aged 6–23 months and to characterize current feeding practice in Southern Ethiopia. A community‐based cross‐sectional study was conducted from February to March 2016. Simple random sampling was used to recruit 190 mothers/primary caregivers of children aged 6–23 months. A repeated interactive multiple‐pass 24‐hr recall survey was used to assess' food and nutrient intake of children. Complementary food was low in animal sources, fruits, and vegetables. Most of the children (94.7%) consume grain, roots, and tubers. Vitamin A‐rich fruits and vegetables are consumed by 71 (37.8%) children. Very few (1.6%) children consume iron‐fortified food. Median protein intake exceeds the estimated requirement from complementary food. Except for vitamin B2 and B6, intake of energy and micronutrient were below world health organization (WHO) recommendations among children aged 9–23 months. In conclusion, infant and young child feeding practices in Butajira district did not conform to recommendations. Intake of energy and micronutrient from complementary food among children aged 6–23 months in Butajira district was inadequate. Consumption of a diverse diet by including animal source food (ASF) such as poultry, organ meat, chicken liver, beef, fruits, and vegetables is needed to fill the nutrient intake gap among the study participant.
Not All Regional Public Universities Strive for Prestige: Examining and Strengthening Mission‐Centeredness Within a Vital Sector
Authors: Orphan Cecilia M.
Published: October 2020

A dominant narrative exists that all regional public universities (RPUs) are striving for prestige and, if given the chance, would readily abandon their missions of facilitating educational access for marginalized students and increase admissions selectivity to privilege elite students. As a result of this dominant narrative, RPUs are largely depicted as being unsure of and uncommitted to their missions. This chapter tests this dominant narrative by examining research and media reporting about the sector. The chapter argues that some indicators of prestige‐seeking have been inappropriately applied to RPUs and that assumptions have been made about the entire sector based on the behaviors of a few institutions. Research demonstrating far more mission‐centeredness in the sector than the dominant narrative suggests is also shared. The chapter concludes with recommendations for policymakers, the media, and RPU administrators to help them counter the dominant narrative while strengthening the sector's mission‐centeredness.
A Well in the Desert: Regional Public Universities as Teaching‐Supportive Institutions
Authors: Campbell Corbin M.
Published: October 2020

Teaching quality is a crucial, yet under‐valued, component of a quality institution. This study draws upon a multi‐institutional study of college teaching, the College Educational Quality (CEQ) study to examine the teaching practices and the culture of support for teaching at one Regional Public University that was included in the broader CEQ study. Through faculty surveys, student surveys, and classroom observations of forty‐one courses, this study found that the Regional Public Universities (RPUs) demonstrated characteristics of a Teaching‐Supportive Institution. In particular, faculty reported a high motivation for teaching, peer faculty support for teaching, and institutional reward structures that focus on teaching. At the same time, faculty were less likely to report engaging in specific teaching development experiences. The conclusion of this chapter discusses implications for RPUs and the faculty who teach at RPUs.
Outpacing Expectations: Battling the Misconceptions of Regional Public Historically Black Colleges and Universities
Authors: Commodore Felecia , Njoku Nadrea R.
Published: October 2020

Often Historically Black Colleges and Universities (HBCUs) are viewed and discussed through a deficit‐laden lens. In reality, HBCUs—many of which are regional public universities (RPUs)—not only carry a lion's share of the education of Black students but also contribute greatly to the social mobility, economic impact, and increased access to marginalized populations within their respective states. In this chapter, using the foundation of the United Negro College Fund (UNCF) “Punching Above Their Weight” report findings, the authors explore four state cases to highlight how HBCU RPUs are overlooked in broader RPU discussions regarding their unique contributions to access and degree attainment. This chapter will review research and popular press on HBCU RPUs to give insight into how they are uniquely contributing to state higher education goals while navigating funding disparities. Moreover, this review—coupled with our insights for research, practice, and funding—will give a broader view of these institutions’ contributions for both students and the regions they serve.
Conclusion: Appraising Asset‐Based Themes for Policy and Practice
Authors: Warshaw Jarrett B. , McClure Kevin R. , DeMonbrun Matt
Published: October 2020

This chapter presents four central themes that are distilled from the volume. First, regional public universities (RPUs) are mission‐centered as access‐ and teaching‐oriented and civically engaged institutions. Second, no matter how RPUs are sampled and classified, they are at the center of college access and equity. Third, RPUs deploy lean resources to shoulder a strong share of undergraduate education in the 4‐year sector, displaying some long‐term financial ingenuity and resilience. Fourth, campus leaders have the power to shape and tell the story of the “positive core” of what RPUs are and do well in enriching the lives of their students and communities. These themes suggest that RPUs are positioning, based on strengths, to adapt to significant challenges in their external environments. Public and institutional policies may enhance RPUs and their unique contributions by rewarding these campuses for serving the broader public and economic good.
Systematic review of postoperative therapy for resected squamous cell carcinoma of the head and neck: Executive summary of the American Radium Society appropriate use criteria
Authors: Margalit Danielle N. , Sacco Assuntina G. , Cooper Jay S. , Ridge John A. , Bakst Richard L. , Beadle Beth M. , Beitler Jonathan J. , Chang Steven S. , Chen Allen M. , Galloway Tom J. , Koyfman Shlomo A. , Mita Carol , Robbins Jared R. , Tsai C. Jillian , Truong Minh T. , Yom Sue S. , Siddiqui Farzan
Published: October 2020

Background

The aims of this systematic review are to (a) evaluate the current literature on the impact of postoperative therapy for resected squamous cell carcinoma of the head and neck (SCCHN) on oncologic and non‐oncologic outcomes and (b) identify the optimal evidence‐based postoperative therapy recommendations for commonly encountered clinical scenarios.

Methods

An analysis of the medical literature from peer‐reviewed journals was conducted using the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) guideline. Prospective studies and methodology‐based systematic reviews and meta‐analyses of postoperative therapy for SCCHN were identified by searching Medline (OVID) and EMBASE (Elsevier) using controlled vocabulary terms (ie, National Library of Medicine Medical Subject Headings [MeSH], EMTREE). Study screening and selection was performed with Covidence software and full‐text review. The RAND/UCLA appropriateness method was used by the expert panel to rate the appropriate use of postoperative therapy, and the modified Delphi method was used to come to consensus.

Results

A total of 5660 studies were identified and screened using the title and abstract, leading to 201 studies assessed for relevance using full‐text review. After limitation to the eligibility criteria, 101 studies from 1977 to 2020 were identified, including 77 with oncologic endpoints and 24 with function and quality of life endpoints. All studies reported staging prior to the implementation of American Joint Committee on Cancer (AJCC‐8).

Conclusions

Prospective clinical studies and systematic reviews identified through the PRISMA systematic review provided good evidence for consensus statements regarding the appropriate use of postoperative therapy for resected SCCHN. Further research is needed in domains where consensus by the expert panel could not be achieved for the appropriateness of specific postoperative therapeutic interventions.
Application of Artificial Intelligence for the Diagnosis and Treatment of Liver Diseases
Authors: Ahn Joseph C. , Connell Alistair , Simonetto Douglas A. , Hughes Cian , Shah Vijay H.
Published: October 2020

Modern medical care produces large volumes of multimodal patient data, which many clinicians struggle to process and synthesize into actionable knowledge. In recent years, artificial intelligence (AI) has emerged as an effective tool in this regard. The field of hepatology is no exception, with a growing number of studies published that apply AI techniques to the diagnosis and treatment of liver diseases. These have included machine‐learning algorithms (such as regression models, Bayesian networks, and support vector machines) to predict disease progression, the presence of complications, and mortality; deep‐learning algorithms to enable rapid, automated interpretation of radiologic and pathologic images; and natural‐language processing to extract clinically meaningful concepts from vast quantities of unstructured data in electronic health records. This review article will provide a comprehensive overview of hepatology‐focused AI research, discuss some of the barriers to clinical implementation and adoption, and suggest future directions for the field.
The V‐Y gluteal fold advancement flap: Outcomes following radical surgery for vulvar malignancies
Authors: Giannini Andrea , Di Donato Violante , D’Oria Ottavia , Schiavi Michele Carlo , May James , Benedetti Panici Pierluigi , Congiu Mario Antonio
Published: October 2020

Objective

To evaluate the feasibility and complication rate of the V‐Y gluteal fold flap in surgery for vulvar cancer.

Methods

From June 2015 to June 2018, 62 patients surgically treated for vulvar cancer were included in the study. Twenty‐three (37.1%) underwent plastic reconstructive surgery with V‐Y advancement flaps.

Results

The mean surgical time was longer for patients undergoing V‐Y flap surgery. The margins were positive in six patients (9.7%), close (<8 mm) in 10 (16.1%), and adequate (>8 mm) in 46 (74.2%). Six (9.7%) patients had dehiscence and two (3.2%) patients suffered from necrosis. In patients undergoing V‐Y flap reconstruction, two (8.7%) had a wound dehiscence, no patients had necrosis. In patients undergoing direct closure, four (10.3%) had wound dehiscence and two (5.1%) had necrosis.

Conclusions

V‐Y gluteal fold advancement technique is a safe procedure, performed in a single surgical session with minimal increase in surgical time and low wound healing complications. Use of this technique was correlated with an increased rate of adequate surgical margins (<8 mm) and reduced need for adjuvant radiotherapy.
Perinatal death audit and classification of stillbirths in two provinces in Papua New Guinea: A retrospective analysis
Authors: Vallely Lisa M. , Smith Rachel , Bolnga John W. , Babona Delly , Riddell Michaela A. , Mengi Alice , Au Lucy , Polomon Cherolyn , Vogel Joshua P. , Pomat William S. , Vallely Andrew J , Homer Caroline S.E.
Published: October 2020

Objective

To undertake a retrospective perinatal death audit and assessment of avoidable factors associated with stillbirths among a cohort of women in two provinces in Papua New Guinea.

Methods

We used data from an ongoing cluster‐randomized crossover trial in 10 sites among 4600 women in Papua New Guinea (from 2017 to date). The overarching aim is to improve birth outcomes. All stillbirths from July 2017 to January 2020 were identified. The Perinatal Problem Identification Program was used to analyze each stillbirth and review associated avoidable factors.

Results

There were 59 stillbirths among 2558 births (23 per 1000 births); 68% (40/59) were classified “fresh” and 32% as “macerated”. Perinatal cause of death was identified for 63% (37/59): 30% (11/37) were due to intrapartum asphyxia and traumatic breech birth and 19% (7/37) were the result of pre‐eclampsia. At least one avoidable factor was identified for 95% (56/59) of stillbirths. Patient‐associated factors included lack of response to reduced fetal movements and delay in seeking care during labor. Health personnel‐associated factors included poor intrapartum care, late diagnosis of breech presentation, and prolonged second stage with no intervention.

Conclusion

Factors associated with stillbirths in this setting could be avoided through a package of interventions at both the community and health‐facility levels.
Impact of group prenatal care on key prenatal services and educational topics in Malawi and Tanzania
Authors: Liese Kylea L. , Kapito Esnath , Chirwa Ellen , Liu Li , Mei Xiaohan , Norr Kathleen F. , Patil Crystal L.
Published: October 2020

Objective

To examine whether group prenatal care (PNC) increased key services and educational topics women reported receiving, compared with individual PNC in Malawi and Tanzania.

Methods

Data come from a previously published randomized trial (n=218) and were collected using self‐report surveys. Late pregnancy surveys asked whether women received all seven services and all 13 topics during PNC. Controlling for sociodemographics, country, and PNC attendance, multivariate logistic regression used forward selection to produce a final model showing predictors of receipt of all key services and topics.

Results

In multivariate logistic regression, women in group PNC were 2.49 times more likely to receive all seven services than those in individual care (95% confidence interval [CI] 1.78–3.48) and 5.25 times more likely to have received all 13 topics (95% CI 2.62–10.52).

Conclusion

This study provides strong evidence that group PNC meets the clinical standard of care for providing basic clinical services and perinatal education for pregnant women in sub‐Saharan Africa. The greater number of basic PNC services and educational topics may provide one explanatory mechanism for how group PNC achieves its impact on maternal and neonatal outcomes.

ClinicalTrials.gov: NCT03673709, NCT02999334.
Assessing risk factors for severe forms of COVID‐19 in a pregnant population: A clinical series from Lombardy, Italy
Authors: Di Martino Daniela , Chiaffarino Francesca , Patanè Luisa , Prefumo Federico , Vergani Patrizia , Ornaghi Sara , Savasi Valeria , Spinillo Arsenio , Cromi Antonella , D’Ambrosi Francesco , Tassis Beatrice , Iurlaro Enrico , Parazzini Fabio , Ferrazzi Enrico
Published: October 2020

In 250 pregnant women with either asymptomatic, non‐severe, or severe SARS‐CoV‐2 infection, obesity turned out to be the main determinant of severe COVID‐19 illness.
Multiple sclerosis identification in brainMRIimages using wavelet convolutional neural networks
Authors: Alijamaat Ali , NikravanShalmani Alireza , Bayat Peyman
Published: October 2020

Multiple sclerosis (MS) is a degenerative disease of the covering around the nerves in the central nervous system. It damages the immune cells and causes small lesions in the patient's brain. Automated image recognition techniques can be employed for increasing the accuracy of detection. The use of convolutional neural networks (CNN) is the most common deep learning method for detecting lesions in image. Due to the specific features of MS lesions, the use of spectral features especially multiresolution enables the highlighting of images lesions and leads to a more accurate diagnosis. In the present study, the Haar wavelet transform was applied to make use of the spectral information. The proposed method is a combination of the two‐dimensional discrete Haar wavelet transform and the CNN network. Experiments on the image data of 38 patients and 20 healthy individuals revealed accuracy, precision, and sensitivity of 99.05%, 98.43%, and 99.14%, respectively.
Nonlinear effects of government spending shocks in the USA: Evidence from state‐level data
Authors: Mumtaz Haroon , Sunder‐Plassmann Laura
Published: October 2020

This paper uses state‐level data to estimate the effect of government spending shocks during expansions and recessions. By employing a mixed‐frequency framework, we are able to include a long span of annual state‐level government spending data in our nonlinear quarterly panel VAR model. We find evidence that for the average state the fiscal multiplier is larger during recessions. However, there is substantial heterogeneity across the cross‐section. The degree of nonlinearity in the effect of spending shocks is larger in states that are subject to a higher degree of financial frictions. In contrast, states with a prevalence of manufacturing, mining and agricultural industries tend to have multipliers that are more similar across business cycle phases.
LV‐GAN: A deep learning approach for limited‐view optoacoustic imaging based on hybrid datasets
Authors: Lu Tong , Chen Tingting , Gao Feng , Sun Biao , Ntziachristos Vasilis , Li Jiao
Published: October 2020

The optoacoustic imaging (OAI) methods are rapidly evolving for resolving optical contrast in medical imaging applications. In practice, measurement strategies are commonly implemented under limited‐view conditions due to oversized image objectives or system design limitations. Data acquired by limited‐view detection may impart artifacts and distortions in reconstructed optoacoustic (OA) images. We propose a hybrid data‐driven deep learning approach based on generative adversarial network (GAN), termed as LV‐GAN, to efficiently recover high quality images from limited‐view OA images. Trained on both simulation and experiment data, LV‐GAN is found capable of achieving high recovery accuracy even under limited detection angles less than 60°. The feasibility of LV‐GAN for artifact removal in biological applications was validated by ex vivo experiments based on two different OAI systems, suggesting high potential of a ubiquitous use of LV‐GAN to optimize image quality or system design for different scanners and application scenarios.
Identification of Cytochrome b‐245, beta‐chain gene mutations, and clinical presentations in Iranian patients with X‐linked chronic granulomatous disease
Authors: Heydari Atefeh , Abolnezhadian Farhad , Sadeghi‐Shabestari Mahnaz , Saberi Alihossein , Shamsizadeh Ahmad , Ghadiri Ata A. , Ghandil Pegah
Published: October 2020

Background

X‐linked chronic granulomatous disease (X‐CGD) is an immunodeficiency disorder caused by defects in the gp91phox subunit that leads to life‐threatening infections. We aimed to identify CYBB gene mutations and study clinical phenotypes in Iranian patients with probable X‐CGD.

Methods

We studied four unrelated Iranian patients with probable X‐CGD and their families recruited in several years. We isolated genomic DNA from whole blood and performed Sanger sequencing in the CYBB gene's coding and flanking regions. We also performed pathogenicity predictions using in silico tools.

Results

We detected four different mutations, including a novel insertion mutation in exon 5 (p.Ile117AsnfsX6), in the patient. Bioinformatics analysis confirmed the pathogenic effect of this mutation. We predicted protein modeling and demonstrated lost functional domains. The patient with the insertion mutation presented pneumonia and acute sinusitis during his life. We also detected three other known nonsense mutations (p.Arg157Ter, p.Arg226Ter, and p.Trp424Ter) in the CYBB gene. The patient with p.Arg157Ter developed lymphadenitis and pneumonia. Moreover, the patient with inflammatory bowel disease showed p.Arg226Ter and the patient with tuberculosis presented p.Trp424Ter. We detected different clinical features in the patients compared to other Iranian patients with the same mutations.

Conclusion

Our results expand the genetic database of patients with X‐CGD from Iran and make it much easier and faster to identify patients with X‐CGD. Our results also help to detect carriers and enable prenatal diagnosis in high‐risk families as a cost‐effective strategy.
A practice‐based evidence investigation of God representations in spiritually integrated psychotherapies
Authors: Currier Joseph M. , McDermott Ryon C. , Stevens Laura T. , Isaak Steven L. , Davis Edward B. , Hollingsworth William‐Glenn L. , Archer Glenn D. , Stefurak Tres
Published: October 2020

Objective

This practice‐based evidence study examined trajectories of God representations and psychological distress among Christians participating in spiritually integrated psychotherapies (SIPs).

Methods

In total, 17 clinicians practicing SIPs in a mid‐sized city on the US Gulf Coast implemented session‐to‐session assessments of these outcomes with 158 clients over a 4‐month period and also reported their use of specific spiritual interventions after each session (e.g., affirmed client's divine worth).

Results

Multivariate growth modeling revealed clients' psychological distress decreased over the study period whereas authoritarian God representations increased and benevolent God representations remained stable. In addition, clients who increased in benevolent representations of God had a greater likelihood of experiencing alleviation of psychological distress.

Conclusion

These findings affirm the potential efficacy of SIPs and cultural importance of belief in a benevolent deity as a source of strength, identity, and potential healing among Christians clients who prefer a spiritually integrated approach in psychotherapy.
Orofacial pain education in dentistry: A path to improving patient care and reducing the population burden of chronic pain
Authors: Costa Yuri M. , De Koninck Beatrice P. , Elsaraj Sherif M. , Exposto Fernando G. , Herrero Babiloni Alberto , Kapos Flavia P. , Sharma Sonia , Shimada Akiko
Published: October 2020

Dentists stand in an optimal position to prevent and manage patients suffering from chronic orofacial pain (OFP) disorders, such as temporomandibular disorders, burning mouth syndrome, trigeminal neuralgia, persistent idiopathic dentoalveolar pain, among others. However, there are consistent reports highlighting a lack of knowledge and confidence in diagnosing and treating OFP among dental students, recent graduates, and trained dentists, which leads to misdiagnosis, unnecessary costs, delay in appropriate care and possible harm to patients. Education in OFP is necessary to improve the quality of general dental care and reduce individual and societal burden of chronic pain through prevention and improved quality of life for OFP patients. Our aims are to emphasize the goals of OFP education, to identify barriers for its implementation, and to suggest possible avenues to improve OFP education in general, postgraduate, and continuing dental education levels, including proposed minimum OFP competencies for all dentists. Moreover, patient perspectives are also incorporated, including a testimony from a person with OFP. General dentists, OFP experts, educators, researchers, patients, and policy makers need to combine efforts in order to successfully address the urgent need for quality OFP education.
Evaluating co‐created patient‐facing materials to increase understanding of genetic test results
Authors: Dwyer Andrew A. , Au Margaret G. , Smith Neil , Plummer Lacey , Lippincott Margaret F. , Balasubramanian Ravikumar , Seminara Stephanie B.
Published: October 2020

Patients often have difficulty understanding genetic test reports. Technical language and jargon can impede comprehension and limit patients using results to act on findings. One potential way to improve patient understanding of genetic test reports is to provide patient‐facing materials. This study aimed to examine understandability and actionability of co‐created patient‐facing materials for genetic test results in a research context. We combined interprofessional perspectives and patient engagement to co‐create patient‐facing materials for patients undergoing research genetic testing for congenital hypogonadotropic hypogonadism (Kallmann syndrome). The iterative development process was guided by principles of health literacy and human‐centered design (i.e., design thinking). Readability was assessed using eight validated algorithms. Patients and parents evaluated materials using a web‐based survey. The gold standard Patient Education Materials Assessment Tool for print materials (PEMAT‐P) was employed to measure understandability (content, style, use of numbers, organization, design, use of visual aids) and actionability. PEMAT‐P scores >80% were considered high quality. Results were analyzed descriptively and correlations performed to identify relationships between education/health literacy and PEMAT‐P ratings. A consensus score of eight algorithms indicated the materials were an 8th–9th grade reading level. Our findings are consistent with the U.S. Department of Health and Human Services ‘average difficulty’ classification (i.e., 7th–9th grade). In total, 61 patients/parents evaluated the materials. ‘Visual Aids’ received the lowest mean PEMAT‐P rating (89%). All other parameters scored 90%–97%. PEMAT‐P scores did not differ according to educational attainment (less than college vs. college or more, p = 0.28). Participants with adequate health literacy were more likely to approve of the ‘organization’ of information (p < 0.05). Respondents with low health literacy had more favorable views of ‘visual aids’ (p < 0.01). Involving patients in a co‐creation process can produce high‐quality patient‐facing materials that are easier to understand.
A case of urgent colonoscopic hemostasis of a cecal hemorrhagic ulceration in a patient receiving heparin for COVID‐19 coagulopathy
Authors: Yoshida Naohisa , Hirose Ryohei , Watanabe Makoto , Yamazaki Masaski , Hashimoto Satoru , Matsubara Shin , Kasamatsu Yu , Fujita Naohisa , Rani Rafiz Abdul , Dohi Osamu , Inoue Ken , Naito Yuji , Itoh Yoshito
Published: October 2020

COVID‐19 rarely causes lower gastrointestinal bleeding even though its RNA has been detected in patient's stool. Urgent colonoscopy in a COVID‐19 patient with massive bloody stool requires various procedural and equipment considerations. Here, we present a case of colonoscopic hemostasis of a cecal hemorrhagic ulceration in a patient on heparin for COVID‐19 coagulopathy. We also share various management methods for the prevention of COVID‐19 contamination. A 71‐year‐old man was diagnosed with COVID‐19 pneumonia and subsequently underwent hemodiafiltration. Heparin was initiated for COVID‐19 coagulopathy. At day 42, the patient experienced 2000 mL of bloody stool. An operator performed urgent colonoscopy with three assistants in a negative‐pressure room with full personal protective equipment. A hemorrhagic ulceration was detected at the cecum, and endoscopic hemostasis was performed. Immunohistochemistry was positive for cytomegalovirus. Postprocedure, the endoscopic systems were thoroughly cleaned, and specific measures for endoscope reprocessing and disinfection were performed to prevent contamination with COVID‐19.
The skin of birds' feet: Morphological adaptations of the plantar surface
Authors: Höfling Elizabeth , Abourachid Anick
Published: October 2020

The skin of the foot provides the interface between the bird and the substrate. The foot morphology involves the bone shape and the integument that is in contact with the substrate. The podotheca is a layer of keratinized epidermis forming scales that extends from the tarsometatarsus to the toe extremities. It varies in size, shape, amount of overlap and interacts with the degree of fusion of the toes (syndactyly). A study of toe shape and the podotheca provides insights on the adaptations of perching birds. Our analysis is based on micro‐CT scans and scanning electron microscopy images of 21 species from 17 families, and includes examples with different orientations of the toes: zygodactyl (toes II and III forward), anisodactyl (toes II, III, and IV forward), and heterodactyl (toes III and IV forward). We show that in these three groups, the skin forms part of a perching adaptation that involves syndactyly to different degrees. However, syndactyly does not occur in Psittacidae that use their toes also for food manipulation. The syndactyly increases the sole surface and may reinforce adherence with the substrate. Scale shape and toe orientation are involved in functional adaptations to perch. Thus, both bone and skin features combine to form a pincer‐like foot.
Large colloidal probes for atomic force microscopy: Fabrication and calibration issues
Authors: Chighizola Matteo , Puricelli Luca , Bellon Ludovic , Podestà Alessandro
Published: October 2020

Atomic force microscopy (AFM) is a powerful tool to investigate interaction forces at the micro and nanoscale. Cantilever stiffness, dimensions and geometry of the tip can be chosen according to the requirements of the specific application, in terms of spatial resolution and force sensitivity. Colloidal probes (CPs), obtained by attaching a spherical particle to a tipless (TL) cantilever, offer several advantages for accurate force measurements: tunable and well‐characterisable radius; higher averaging capabilities (at the expense of spatial resolution) and sensitivity to weak interactions; a well‐defined interaction geometry (sphere on flat), which allows accurate and reliable data fitting by means of analytical models. The dynamics of standard AFM probes has been widely investigated, and protocols have been developed for the calibration of the cantilever spring constant. Nevertheless, the dynamics of CPs, and in particular of large CPs, with radius well above 10 μm and mass comparable, or larger, than the cantilever mass, is at present still poorly characterized. Here we describe the fabrication and calibration of (large) CPs. We describe and discuss the peculiar dynamical behaviour of CPs, and present an alternative protocol for the accurate calibration of the spring constant.
Quantification of Myelinated Nerve Fraction and Degeneration in Spinal Cord Neuropil by SHIFT MRI
Authors: Wolfe Tatiana , Hoffman Kristopher , Hogan Matthew K. , Salazar Betsy , Tang Xiufeng , Chaboub Lesley , Quini Caio C. , Lu Zhong‐Lin , Horner Philip J.
Published: October 2020

Background

Neurodegeneration is a complex cellular process linked to prompt changes in myelin integrity and gradual neuron loss. Current imaging techniques offer estimations of myelin volumes in lesions/remyelinated areas but are limited to detect subtle injury.

Purpose

To investigate whether measurements detected by a signal hierarchically isolated as a function of time‐to‐echo (SHIFT) MRI technique can determine changes in myelin integrity and fiber axolemma.

Study Type

Prospective animal model.

Animal Model

Surgically demyelinated spinal cord (SC) injury model in rodents (n = 6).

Field Strength/Sequence

Gradient‐echo spin‐echo at 3T.

Assessment

Multicompartment T2 relaxations were computed by SHIFT MRI in 75‐microns‐resolution images of the SC injury penumbra region 2 weeks post‐trauma. G‐ratio and axolemma delamination were assessed by transmission electron microscopy (TEM) in intact and injured samples. SC myelinated nerve fraction was computed by SHIFT MRI prospectively and assessed histologically.

Statistical Tests

Relations between SHIFT‐isolated T2‐components and TEM measurements were studied using linear regression and t‐tests. Pearson's correlation and significance were computed to determine the SHIFT's sensitivity to detect myelinated fibers ratio in gray matter. Regularized least‐squares‐based ranking analysis was employed to determine SHIFT MRI's ability to discern intact and injured myelinated nerves.

Results

Biexponential signals isolated by SHIFT MRI for intact vs. lesion penumbra exhibited changes in T2, shifting from intermediate components (25 ± 2 msec) to long (43 ± 11 msec) in white matter, and similarly in gray matter regions‐of‐interest (31 ± 2 to 46 ± 16 msec). These changes correlated highly with TEM g‐ratio and axon delamination measurements (P < 0.05). Changes in short T2 components were observed but not statistically significant (8.5 ± 0.5 to 7 ± 3 msec, P = 0.445, and 4.0 ± 0.9 to 7 ± 3 msec, P = 0.075, respectively). SHIFT MRI's ability to detect myelinated fibers within gray matter was confirmed (P < 0.001).

Data Conclusion

Changes detected by SHIFT MRI are associated with abnormal intermembrane spaces formed upon mild injury, directly correlated with early neuro integrity loss.

Level of Evidence 1

Technical Efficacy Stage 2