bluuebunny/crossref_metadata_2025 huggingface dataset:
Blood ketone measurement as a test for dietary compliance in cardiac sarcoid patients undergoing 18f-fluorodeoxyglucose positron emission tomography
Authors: Clarke S , Alves F , Martins N , Ahmed M , Sanchez L , Donovan J , Kouranos V , Wechalekar K
Published: July 2021

Funding Acknowledgements

Type of funding sources: None.

Background

Imaging with 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) is used as part of diagnosis and monitoring response to therapy in patients with cardiac sarcoidosis. In order to supress myocardial uptake of 18F-FDG patients prepare with a low carbohydrate diet followed by an 18-hour overnight fast. Failure to comply with the protocol results in diffuse myocardial 18F-FDG uptake which confounds diagnostic interpretation.

Purpose

To assess if point of care blood ketones could be used as a marker of dietary compliance and association with suppression of myocardial 18F-FDG uptake on PET scan.

Method

Patients (n = 26, 57 ± 4 years, 65% Male) from a single centre were instructed to follow standard preparation protocol prior to 18F-FDG PET/CT. After confirmation of dietary compliance, blood glucose and blood ketones were recorded using point of care devices. Images were graded based on the pattern of myocardial 18F-FDG uptake.

Results

There was no clear correlation between blood ketones in relation to dietary compliance or myocardial 18F-fluorodeoxyglucose uptake. In those with myocardial 18F-FDG uptake maximum standardized uptake value (SUV max) within the myocardium ranged from 2.3 to 9.8 (Mean 5.3) and ketone from 0.1 – 0.7 (normal <0.6).

Non-diabetic patients and those on steroids achieved adequate fasting glucose without significant rise in blood ketones. 60% of diabetic patients demonstrated mildly elevated ketones between 0.6-1.5mmol/L.

Conclusion

Current protocol with low carbohydrate diet and 18-hour fast achieves adequate quality of images in majority of patients, without significant change in blood ketones. Therefore, blood ketones cannot be used to confirm dietary compliance.  Diabetic patients on insulin may benefit from ketone measurement due to risk of diabetic ketoacidosis.
18F-FDGPET/CT improves diagnostic certainty over the modified Duke Criteria in blood culture negative infective endocarditis
Authors: Primus C , Bvekerwa I , Clay TA , Mccue M , Wong K , Uppal R , Ambekar S , Das S , Bhattacharyya S , Davies LC , Woldman S , Menezes L
Published: July 2021

Funding Acknowledgements

Type of funding sources: None.

Introduction

Diagnosis of blood culture negative infective endocarditis (BCNIE) is challenging, with positive microbiology key in the modified Duke Criteria (mDC). ESC IE Guidelines (2015) recommend the use of 18F-FDG PET/CT (PET) in cases where transoesophageal echocardiography (TOE) is equivocal and where cardiac implantable device-related IE (CIDRE) is suspected. We explored the role of PET to improve diagnostic certainty in the challenging cohort of BCNIE.

Methods

Retrospective review of all suspected BCNIE patients undergoing PET (10/2015 to 01/2021). Myocardial suppression technique was used in all cases, and studies were assessed for valve/device avidity. Patients were classified as definite/possible/rejected IE by mDC pre- and post-PET, with incremental benefit assessed by net reclassification index (NRI) versus actual diagnosis. Actual diagnosis was defined by Endocarditis Team consensus or surgical specimen (where available) at a minimum of 2-months following index admission.

Results

PET was performed in 110/807 (13.6%) cases overall. BCNIE prevalence was 18% across the total cohort, with 25/110 (22.7%) PET studies in BCNIE patients (male = 17, mean age 65). (p = 0.16 for PET in BCNIE compared to overall). PET was undertaken in 8 CIDRE, 9 native IE (NVE) and 10 prosthetic IE (PVE); 2-patients had suspected CIDRE + PVE. TOE was performed in all cases, and surgery was required in 8/25 patients. IE was confirmed in 44% of cases.

PET sensitivity, specificity, positive and negative predictive values were 73%, 93%, 89% and 81%, respectively. Addition of PET to the mDC improved re-classification to definite or rejected IE, with NRI 0.633 (positive NRI 0.3; negative 0.333), and added weight to the original mDC classification in 14/25 (56%) of cases.

Conclusion

PET improves diagnostic certainty when combined with mDC in the evaluation of patients with BCNIE across NVE, PVE and CIDRE.
A case report of transcatheter mitral valve repair in patient with severe acute mitral regurgitation, cardiogenic shock, and left atrial appendage thrombus as a rescue therapy: facing all enemies at once!
Authors: Alachkar Mhd Nawar , Schröder Jörg , Autschbach Rüdiger , Almalla Mohammad
Published: July 2021

Background

Transcatheter mitral valve repair (TMVR) in patients with severe acute mitral regurgitation (MR) and high surgical risk has been described. Moreover, the use of cerebral protection device (CPD) during TMVR in patients without evidence of intracardiac thrombus has been investigated. To the best of our knowledge, TMVR as a rescue therapy in a patient with acute ischaemic MR, cardiogenic shock, and left atrial appendage (LAA) thrombus with concurrent use of CPD has not been reported.

Case summary

A 59-year-old female with subacute lateral myocardial infarction caused by subacute stent thrombosis after stent implantation in the left circumflex artery 3 weeks previously presented with acute heart failure due to acute severe MR at a peripheral hospital. The patient was transferred to our tertiary centre for operative mitral valve repair. Transoesophageal echocardiogram revealed the presence of LAA thrombus. During the admission, the patient developed an electrical storm and cardiogenic shock. Because of the extremely high surgical risk and the lack of other therapeutic options, the patient was treated with TMVR (MitraClip™, Abbott Structural Heart Devices, Santa Clara, CA, USA) with the use of CPD (Sentinel™; Boston scientific) as a rescue therapy. After the procedure, the clinical and haemodynamic conditions of the patient improved significantly, and she could be discharged home without any neurological sequelae.

Conclusion

TMVR with concurrent use of CPD as a rescue therapy may be considered in non-operable patients with cardiogenic shock caused by acute severe MR and evidence of LAA thrombus when no other therapy options are possible.
Efficacy and safety of dronedarone across age and sex subgroups: apost hocanalysis of the ATHENA study among patients with non-permanent atrial fibrillation/flutter
Authors: Curtis Anne B , Zeitler Emily P , Malik Aysha , Bogard Andrew , Bhattacharyya Nidhi , Stewart John , Hohnloser Stefan H
Published: July 2021

Aims

Age and sex may impact the efficacy of antiarrhythmic drugs on cardiovascular outcomes and arrhythmia recurrences in patients with atrial fibrillation (AF). We report on a post hoc analysis of the ATHENA study (NCT00174785), which examined cardiovascular outcomes in patients with non-permanent AF treated with dronedarone vs. placebo.

Methods and results

Efficacy and safety of dronedarone were assessed in patients according to age and sex. Baseline characteristics were comparable across subgroups, except for cardiovascular comorbidities, which were more frequent with increasing age. Dronedarone significantly reduced the risk of cardiovascular hospitalization or death due to any cause among patients 65–74 [n = 1830; hazard ratio (HR) 0.71, 95% confidence interval (CI) 0.60–0.83; P < 0.0001] and ≥75 (n = 1925; HR 0.75, 95% CI 0.65–0.88; P = 0.0002) years old and among males (n = 2459; HR 0.74, 95% CI 0.64–0.84; P < 0.00001) and females (n = 2169; HR 0.77, 95% CI 0.67–0.89; P = 0.0002); outcomes were similar for time to AF/AFL recurrence. Among patients aged <65 years (n = 873), cardiovascular hospitalization or death due to any cause with dronedarone vs. placebo was associated with an HR of 0.89 (95% CI 0.71–1.11; P = 0.3). The incidence of all treatment-emergent adverse events (TEAEs) and TEAEs leading to treatment discontinuation was comparable among males and females, and increased with increasing age.

Conclusions

These results support the use of dronedarone for the improvement of clinical outcomes among patients aged ≥65 years and regardless of sex.
Patient and clinician perspectives of factors that influence the delivery of alcohol brief interventions in Australian primary care: a qualitative descriptive study
Authors: Sturgiss Elizabeth , Lam Tina , Russell Grant , Ball Lauren , Gunatillaka Nilakshi , Barton Chris , Tam Chun Wah Michael , O’Donnell Renee , Chacko Elizabeth , Skouteris Helen , Mazza Danielle , Nielsen Suzanne
Published: July 2021

Background

Brief interventions (BIs) delivered in primary care can reduce harmful alcohol consumption. Yet, clinicians do not routinely offer BIs to reduce harmful alcohol use.

Objective

We explored the perspectives of clinicians and patients about the use of alcohol BIs during consultations in Australian primary care.

Methods

Semi-structured interviews and focus groups (face-to-face and virtual) were undertaken with 34 general practitioners, eight practice nurses and 17 patients. Field notes were made from audio-recordings and themes were identified using a descriptive qualitative approach with the field notes as the point of data analysis.

Results

Participants identified barriers within the consultation, practice setting and wider healthcare system plus across the community which reduce the delivery of BIs in primary care including: Australian drinking norms; inconsistent public health messaging around alcohol harm; primary care not recognized as a place to go for help; community stigma towards alcohol use; practice team culture towards preventive health, including systems for recording alcohol histories; limitations of clinical software and current patient resources.

Conclusion

Multiple layers of the healthcare system influence the use of BIs in primary care. Identified facilitators for embedding BIs in primary care included: (i) raising community and clinician awareness of the health harms of alcohol, (ii) reinforcing a primary care culture that promotes prevention and, (iii) supportive resources to facilitate discussion about alcohol use and strategies to reduce intake. Alcohol BIs in primary care could be further supported by community public health messages about alcohol use.
Contribution of crystal orientation and grain boundary compliance to low shear velocity observed near base of polar ice sheets
Authors: Sayers Colin M
Published: July 2021

Seismic shear wave velocity (S-velocity) shows a decrease towards the base of ice sheets in Antarctica and Greenland that is not accompanied by a corresponding decrease in compressional velocity (P-velocity). This decrease has been interpreted as arising from liquid water below the melting point (pre-melt water) at grain boundaries, but the lack of a corresponding decrease in P-velocity has not been explained. Representing grain boundaries as displacement discontinuities allows the change in P- and S-velocities to be written as functions of the normal and shear compliance of the grain boundaries. This allows the normal-to-shear compliance ratio of the grain boundaries to be constrained, and seismic anisotropy resulting from a partial orientation of grain boundaries to be estimated. This approach demonstrates that the observed reduction in S-velocity with no significant decrease in P-velocity near the base of ice sheets in Antarctica and Greenland can be explained by pre-melt water at small aperture grain boundaries. Such water may enable sliding along the grain boundaries and so may enhance creep of ice near the base of ice sheets. If stress state is anisotropic the aperture of water-containing grain boundaries may vary with azimuth, with the most open grain boundaries oriented with strikes perpendicular to least compressive stress. Microcracks and fractures may be treated also as displacement discontinuities and, together with oriented grain boundaries, may contribute to shear wave splitting as observed in West Antarctica in a fast-moving ice stream.
A novel zebrafish model for intermediate type spinal muscular atrophy demonstrates importance of Smn for maintenance of mature motor neurons
Authors: Tay Shermaine Huiping , Ellieyana Erna Nur , Le Yao , Sarusie Menachem Viktor , Grimm Clemens , Ohmer Jürgen , Mathuru Ajay S , Fischer Utz , Winkler Christoph
Published: July 2021

A deficiency in Survival Motor Neuron (SMN) protein results in motor neuron loss in spinal muscular atrophy (SMA) patients. Human SMN is encoded by SMN1 and SMN2 that differ by a single C6T transition in a splice regulatory region of exon 7. In SMN2, exon 7 is skipped leading to an unstable protein, which cannot compensate for SMN1 loss in SMA patients. The disease severity of human SMA (Types 1–4) depends on the levels of SMN protein, with intermediate levels leading to delayed disease onset and extended life expectancy in Type 2 patients. We used homology directed repair (HDR) to generate a zebrafish mutant with intermediate Smn levels, to mimic intermediate, hSMN2 dependent forms of SMA. In the obtained smnA6Tind27 mutant zebrafish, Smn protein formed oligomers but protein levels dropped significantly at juvenile stages. Motor neurons and neuromuscular junctions (NMJ) also formed normally initially but motor neuron loss and locomotor deficiencies became evident at 21 days. Subsequent muscle wasting and early adult lethality also phenocopied intermediate forms of human SMA. Together, our findings are consistent with the interpretation that Smn is required for neuromuscular maintenance, and establish the smnA6Tind27 zebrafish mutant as a novel model for intermediate types of SMA. As this mutant allows studying the effect of late Smn loss on motor neurons, neuromuscular junctions, and muscle at advanced stages of the disease, it will be a valuable resource for testing new drugs targeted towards treating intermediate forms of SMA.
EphA2 Is a Lung Epithelial Cell Receptor for Pneumocystis β-Glucans
Authors: Kottom Theodore J , Schaefbauer Kyle , Carmona Eva M , Limper Andrew H
Published: July 2021

Pneumocystis species interaction with myeloid cells is well known, especially in macrophages; however, how the organism binds to lung epithelial cells is incompletely understood. Ephrin type-A receptor 2 (EphA2) has been previously identified as a lung epithelial pattern recognition receptor that binds to fungal β-glucans. Herein, we also report that EphA2 can also bind Pneumocystis β-glucans, both in isolated forms and also on exposed surfaces of the organism. Furthermore, binding of Pneumocystis β-glucans resulted in phosphorylation of the EphA2 receptor, which has been shown to be important for downstream proinflammatory response. Indeed, we also show that interleukin 6 cytokine is significantly increased when lung epithelial cells are exposed to Pneumocystis β-glucans, and that this response could be blocked by preincubation with a specific antibody to EphA2. Our study presents another Pneumocystis lung epithelial cell receptor with implications for initial colonization and possible therapeutic intervention.
Do new housing units in your backyard raise your rents?
Authors: Li Xiaodi
Published: July 2021

There is a growing debate about whether new housing units increase rents for immediately surrounding apartments. Some argue new market-rate development produces a supply effect, which should alleviate the demand pressure on existing housing units and decrease their rents. Others contend that new development will attract high-income households and new amenities, generating an amenity effect and driving up rents. I contribute to this debate by estimating the impact of new high-rises on nearby residential rents, residential property sales prices and restaurant openings in New York City. To address the selection bias that developers are more likely to build new high-rises in fast-appreciating areas, I restrict the sample to residential properties near approved new high-rises and exploit the plausibly exogenous timing of completion conditional upon the timing of approval. I provide event study evidence that within 500 ft, for every 10% increase in the housing stock, rents decrease by 1%; and for every 10% increase in the condo stock, condo sales prices decrease by 0.9%. In addition, I show that new high-rises attract new restaurants, which is consistent with the hypothesis about amenity effects. However, I find that the supply effect dominates the amenity effect, causing net reductions in the rents and sales prices of nearby residential properties.
Analysis of Circulating Immune Biomarkers by Race in Men With Metastatic Castration-Resistant Prostate Cancer Treated With Sipuleucel-T
Authors: Hawley Jessica E , Pan Samuel , Kandadi Harini , Chaimowitz Matthew G , Sheikh Nadeem , Drake Charles G
Published: July 2021

Among racial subgroups, Black men have the highest prostate cancer–specific death rate, yet they also exhibit prolonged overall survival compared with White men when treated with standard therapies, including sipuleucel-T. Differential immune responses may play a role in these observations. We compared circulating immune markers from 54 men (18 Black and 36 White) with metastatic castrate-resistant prostate cancer who received sipuleucel-T and were enrolled on an immune monitoring registry. Markers included longitudinal serum cytokine concentrations, humoral responses, and cellular immunity from baseline until 52 weeks after sipuleucel-T administration. Black men had statistically significantly higher median concentrations of TH2-type (interleukin [IL]-4, IL-10, and IL-13) and inflammatory cytokines (IL-2, IL-12, and IL-6) compared with prostate-specific antigen-matched White men both at baseline and 52 weeks after sipuleucel-T (2-sided P < .05). No differences by race were seen in either the antigen-specific T-cell response or the humoral responses to the immunizing antigen PA2024 and select secondary antigens.
Flavonoids and saponins from Passiflora edulis f. edulis leaves (purple passion fruit) and its potential anti-inflammatory activity
Authors: Urrego Norman , Sepúlveda Paula , Aragón Marcela , Ramos Freddy A , Costa Geison M , Ospina Luis F , Castellanos Leonardo
Published: July 2021

Objectives

The objective of this work was to evaluate the anti-inflammatory activity of the aqueous extract, fractions and major compounds, which are isolated and identified from Passiflora edulis f. edulis (purple passion fruit) leaves extract.

Methods

For the isolation of the major compounds, reversed-phase chromatography and normal phase countercurrent chromatography were used. The separation was followed by thin layer chromatography and HPLC-DAD-ELSD. One-dimensional and two-dimensional NMR and ESI-TOF-MS/MS were used for structural elucidation. The anti-inflammatory activity was evaluated on a TPA multiple dose model of skin chronic inflammation in mice. Additionally, myeloperoxidase (MPO) and nitric oxide synthase (NOS) activity assays were performed as possible mechanisms of action studies.

Key findings and conclusions

The study of the butanolic fraction mainly showed the presence of saponins and flavonoids. Three minor flavonoids were detected; and three known saponins, cyclopassiflosides IX, XI and III were isolated and identified. This is the first unequivocal report of the presence of these compounds in P. edulis f. edulis leaves. The most favourable results of anti-inflammatory activity were obtained for the flavonoid-rich fraction. All the fractions and isolated compounds evaluated, presented high percentages of inhibition of nitric oxide synthase activity.
Wheat grain yield decreased over the past 35 years, but protein content did not change
Authors: Bloom Arnold J , Plant Richard E
Published: July 2021

The extent to which rising atmospheric CO2 concentration has already influenced food production and quality is uncertain. Here, we analyzed annual field trials of autumn-planted common wheat in California from 1985 to 2019, a period during which the global atmospheric CO2 concentration increased 19%. Even after accounting for other major factors (cultivar, location, degree-days, soil temperature, total water applied, nitrogen fertilization, and pathogen infestation), wheat grain yield and protein yield declined 13% over this period, but grain protein content did not change. These results suggest that exposure to gradual CO2 enrichment over the past 35 years has adversely affected wheat grain and protein yield, but not grain protein content.
The subtlety of Ly α photons: changing the expected range of the 21-cm signal
Authors: Reis Itamar , Fialkov Anastasia , Barkana Rennan
Published: July 2021

We present the evolution of the 21-cm signal from cosmic dawn and the epoch of reionization in an upgraded model including three subtle effects of Ly α radiation: Ly α heating, CMB heating (mediated by Ly α photons), and multiple scattering of Ly α photons. Taking these effects into account, we explore a wide range of astrophysical models and quantify the impact of these processes on the global 21-cm signal and its power spectrum. We find that Ly α heating raises the gas temperature by up to $\mathcal {O}(100)$ degrees (CMB heating adds a few more degrees) in models with weak X-ray heating, thus suppressing the predicted 21-cm signals. Varying the astrophysical parameters broadly in an attempt to cover the full plausible range of models, we find that in the upgraded model the absorption trough of the global signal reaches a lowest possible floor of −165 mK at redshifts z ≈ 15−19. This is in contrast with the predictions for a pure adiabatically cooling Universe, for which the deepest possible absorption is a monotonically decreasing function of cosmic time and is −178 mK at z = 19 and −216 mK at z = 15, dropping to even lower values at lower redshifts. With Ly α and CMB heating included we also observe a strong suppression in the low-redshift power spectra, with the maximum possible power (evaluated over the ensemble of models) attenuated by a factor of 6.6 at z = 9 and K = 0.1 Mpc−1. Finally, we find that at high redshifts corresponding to cosmic dawn, the multiple scattering of Ly α photons leads to an amplification of the power spectrum by a factor of ∼2−3 in all models.
The physical properties of γ-ray-quiet flat-spectrum radio quasars: why are they undetected by Fermi-LAT?
Authors: Deng Xue-Jiao , Xue Rui , Wang Ze-Rui , Xi Shao-Qiang , Xiao Hu-Bing , Du Lei-Ming , Xie Zhao-Hua
Published: July 2021

During a decade of operation of the Fermi-Large Area Telescope (LAT), thousands of blazars have been detected in the γ-ray band. However, there are still numbers of blazars that have not been detected in the γ-ray band. In this work, we focus on investigating why some flat-spectrum radio quasars (FSRQs) are undetected by Fermi-LAT. By cross-matching the Candidate Gamma-ray Blazars Survey catalogue with the Fourth Catalog of Active Galactic Nuclei Detected by the Fermi-LAT, we select 11 γ-ray-undetected (γ-ray-quiet) FSRQs as our sample and collect their quasi-simultaneous multiwavelength data. In the framework of the conventional one-zone leptonic model, we investigate their underlying physical properties and study the possibility that they are undetected in the γ-ray by modelling their quasi-simultaneous spectral energy distributions. In contrast to a smaller bulk Lorentz factor suggested by previous works, our results suggest that the dissipation region located relatively far away from the central super-massive black hole is more likely to be the reason why some γ-ray-quiet FSRQs are undetected by Fermi-LAT.
Machine learning application to detect light echoes around black holes
Authors: Chainakun P , Mankatwit N , Thongkonsing P , Young A J
Published: July 2021

X-ray reverberation has become a powerful tool to probe the disc-corona geometry near black holes. Here, we develop machine learning (ML) models to extract the X-ray reverberation features imprinted in the power spectral density (PSD) of active galactic nucleus (AGN). The machine is trained using simulated PSDs in the form of a simple power-law encoded with the relativistic echo features. Dictionary learning and sparse coding algorithms are used for the PSD reconstruction, by transforming the noisy PSD to a representative sparse version. Then, the support vector machine is employed to extract the interpretable reverberation features from the reconstructed PSD that holds the information of the source height. The results show that the accuracy of predicting the source height, h, is genuinely high and the misclassification is only found when h > 15rg. When the test PSD has a bending power-law shape, which is completely new to the machine, the accuracy is still high. Therefore, the ML model does not require the intrinsic shape of the PSD to be determined in advance. By focusing on the PSD parameter space observed in real AGN data, classification for h ≤ 10rg can be determined with 100 per cent accuracy, even using a PSD in an energy band that contains a reflection flux as low as $10{{\ \rm per\ cent}}$ of the total flux. For h > 10rg, the data, if misclassified, will have small uncertainties of Δh ∼ 2–4rg. This work shows, as a proof of concept, that the ML technique could shape new methodological directions in the X-ray reverberation analysis.
Weak lensing scattering transform: dark energy and neutrino mass sensitivity
Authors: Cheng (程思浩) Sihao , Ménard Brice
Published: July 2021

As weak lensing surveys become deeper, they reveal more non-Gaussian aspects of the convergence field which can only be extracted using statistics beyond the power spectrum. In a companion paper, we showed that the scattering transform, a novel statistic borrowing mathematical concepts from convolutional neural networks, is a powerful tool for cosmological parameter estimation in the non-Gaussian regime. Here, we extend that analysis to explore its sensitivity to dark energy and neutrino mass parameters with weak lensing surveys. We first use image synthesis to show visually that, compared to the power spectrum and bispectrum, the scattering transform provides a better statistical vocabulary to characterize the perceptual properties of lensing mass maps. We then show that it is also better suited for parameter inference: (i) it provides higher sensitivity in the noiseless regime, and (ii) at the noise level of Rubin-like surveys, though the constraints are not significantly tighter than those of the bispectrum, the scattering coefficients have a more Gaussian sampling distribution, which is an important property for likelihood parametrization and accurate cosmological inference. We argue that the scattering coefficients are preferred statistics considering both constraining power and likelihood properties.
Searching water megamasers by using mid-infrared spectroscopy (I): Possible mid-infrared indicators
Authors: Lam Man I , Walcher C Jakob , Gao Feng , Yang Ming , Li Huan , Hao Lei
Published: July 2021

Water megamasers at 22 GHz with a gas disc configuration in galaxies provide the most precise measurements of supermassive black hole masses, as well as independent constraints on the Hubble constant in the nearby universe. The existence of other maser types, such as jet or outflow masers, represents another tracer for AGN science. However, the detection rate of water megamasers in galaxies is extremely low. Over 40 yr, only ∼ 160 galaxies are found to harbour maser emission, and ∼30 per cent of them show features in their maser emission that indicate a disc-like geometry. Therefore, increasing the detection rate of masers is a crucial task to allow expanding on maser studies. We present a comparison of mid-infrared spectroscopic data between a maser galaxy sample and a Seyfert 2 control sample. We find that maser galaxies show significant peculiarities in their mid-infrared spectra: (1) Maser galaxies tend to present stronger silicate absorption at τ9.7 $\mu\mathrm{ m}$ than the control sample, (2) PAH 11.3 $\mu$m emission in maser galaxies is much weaker than in the control sample, (3) spectral indices at 20–30 $\mu$m are steeper in maser galaxies than in the control sample and tend to be mid-infrared enhanced population. We conclude that there may be good indicators in mid-infrared and far-infrared which could differentiate maser and non-maser Seyfert 2 galaxies. Upcoming infrared facilities, such as the James Webb Space Telescope, may be able to exploit these and other useful criteria and tracers for water megamaser observations.
Non-equilibrium in the solar neighbourhood using dynamical modelling with Gaia DR2
Authors: Kipper Rain , Tenjes Peeter , Tempel Elmo , de Propris Roberto
Published: July 2021

Matter distribution models of the Milky Way galaxy are usually stationary, although there are known to be wave-like perturbations in the disc at ∼10 per cent level of the total density. Modelling of the overall acceleration field by allowing non-equilibrium is a complicated task. We must learn to distinguish whether density enhancements are persistent or not by their nature. In this paper, we elaborate our orbital arc method to include the effects of massless perturbations and non-stationarities in the modelling. The method is tested by modelling of simulation data and shown to be valid. We apply the method to the Gaia Data Release 2 (DR2) data within a region of ∼0.5 kpc from the Sun and confirm that acceleration field in the solar neighbourhood has a perturbed nature – the phase-space density along the orbits of stars grow in the order of $h\lesssim 5$ per cent per Myr due to non-stationarity. This result is a temporally local value and can be used only within the time frame of a few Myr. An attempt to pinpoint the origin of the perturbation shows that the stars having larger absolute angular momentum are the main carriers of the local perturbation. As they are faster than the average thin disc star, they are either originating further away and are close in their pericentre or they are perturbed locally by a fast comoving perturber, such as gas disc inhomogeneities.
A transmission hologram for slitless spectrophotometry on a convergent telescope beam. 1. Focus and resolution
Authors: Moniez M , Neveu J , Dagoret-Campagne S , Gentet Y , Le Guillou L ,   The LSST Dark Energy Science Collaboration, Bongard S , Copin Y , Coughlin M
Published: July 2021

We report in this paper the test of a plane holographic optical element to be used as an aberration-corrected grating for a slitless spectrograph, inserted in a convergent telescope beam. Our long-term objective is the optimization of a specific hologram to switch the auxiliary telescope imager of the Vera Rubin Observatory into an accurate slitless spectrograph, dedicated to the atmospheric transmission measurement. We present and discuss here the promising results of tests performed with prototype holograms at the CTIO $0.9\,$m telescope during a run of 17 nights in 2017 May–June. After their on-sky geometrical characterization, the performances of the holograms as aberration-balanced dispersive optical elements have been established by analysing spectra obtained from spectrophotometric standard stars and narrow-band emitter planetary nebulae. Thanks to their additional optical function, our holographic disperser prototypes allow us to produce significantly better focused spectra within the full visible wavelength domain $[370,1050]\,$nm than a regular grating, which suffers from strong defocusing and aberrations when used in similar conditions. We show that the resolution of our slitless on-axis spectrograph equipped with the hologram approaches its theoretical performance. While estimating the benefits of a hologram for the spectrum resolution, the roadmap to produce a competitive holographic element for the Vera Rubin Observatory auxiliary telescope has been established.
TDRD3 promotes DHX9 chromatin recruitment and R-loop resolution
Authors: Yuan Wei , Al-Hadid Qais , Wang Zhihao , Shen Lei , Cho Hyejin , Wu Xiwei , Yang Yanzhong
Published: July 2021

R-loops, which consist of a DNA/RNA hybrid and a displaced single-stranded DNA (ssDNA), are increasingly recognized as critical regulators of chromatin biology. R-loops are particularly enriched at gene promoters, where they play important roles in regulating gene expression. However, the molecular mechanisms that control promoter-associated R-loops remain unclear. The epigenetic ‘reader’ Tudor domain-containing protein 3 (TDRD3), which recognizes methylarginine marks on histones and on the C-terminal domain of RNA polymerase II, was previously shown to recruit DNA topoisomerase 3B (TOP3B) to relax negatively supercoiled DNA and prevent R-loop formation. Here, we further characterize the function of TDRD3 in R-loop metabolism and introduce the DExH-box helicase 9 (DHX9) as a novel interaction partner of the TDRD3/TOP3B complex. TDRD3 directly interacts with DHX9 via its Tudor domain. This interaction is important for recruiting DHX9 to target gene promoters, where it resolves R-loops in a helicase activity-dependent manner to facilitate gene expression. Additionally, TDRD3 also stimulates the helicase activity of DHX9. This stimulation relies on the OB-fold of TDRD3, which likely binds the ssDNA in the R-loop structure. Thus, DHX9 functions together with TOP3B to suppress promoter-associated R-loops. Collectively, these findings reveal new functions of TDRD3 and provide important mechanistic insights into the regulation of R-loop metabolism.
Difference in the Clinical Outcome of Bloodstream Infections Caused by Klebsiella aerogenes and Enterobacter cloacae Complex
Authors: Jeon Minji , Huh Kyungmin , Ko Jae-Hoon , Cho Sun Young , Huh Hee Jae , Lee Nam Yong , Kang Cheol-In , Chung Doo Ryeon , Peck Kyong Ran
Published: July 2021

Background

The difference in clinical outcomes between Klebsiella aerogenes (formerly Enterobacter aerogenes) bacteremia (KAB) and Enterobacter cloacae complex bacteremia (ECB) is controversial.

Methods

We compared the clinical outcomes of patients with KAB and ECB and examined the risk factors associated with mortality. We conducted a retrospective case-control study of hospitalized patients with monobacterial KAB and ECB between January 2011 and June 2020. The primary outcome measure was 30-day all-cause mortality. Multiple logistic regression and propensity-score (PS) matching were used to identify independent risk factors for mortality. The models included demographic characteristics, comorbidities, recent healthcare contact, patient status at the onset of bacteremia, and severity of infection as covariates.

Results

A total of 282 patients with KAB or ECB were included, among whom 194 patients were selected after PS matching. The 30-day all-cause mortality rate was higher in the ECB group than in the KAB group (24.1% vs 10.6%, P = .003). In a multivariable model, ECB was an independent risk factor for 30-day mortality in both overall and PS-matched cohorts (adjusted odds ratio, 3.528; 95% confidence interval, 1.614–7.714; P = .002). Stay in the intensive care unit at the onset of bacteremia and higher Pitt bacteremia score were found to be independent risk factors for 30-day mortality.

Conclusions

In our study, mortality was significantly higher in patients with ECB than in those with KAB. Further studies are warranted to clarify the virulence mechanisms of E cloacae complex.
Pricing Implications of Covariances and Spreads in Currency Markets
Authors: Maurer Thomas , Tô Thuy-Duong , Tran Ngoc-Khanh
Published: July 2021

We introduce a covariance and spread (i.e., exchange rate forward discount) adjusted carry factor that prices the cross-section of FX market returns, where many other single- and multifactor models fail. Both the covariance matrix of exchange rate growths and forward discounts contain important information for pricing that is not captured by well-known factors. The time-varying conditional covariance matrix and forward discounts forecast future realized currency returns. (JEL F31, F37, G12, G15, G17)
Treatment strategies for Sjögren’s syndrome with childhood onset: a systematic review of the literature
Authors: Doolan Georgia , Faizal Nor Mohd , Foley Charlene , Al-Obaidi Muthana , Jury Elizabeth C , Price Elizabeth , Ramanan Athimalaipet V , Lieberman Scott M , Ciurtin Coziana
Published: July 2021

Objectives

SS with childhood onset is a rare autoimmune disease characterized by heterogeneous presentation. The lack of validated classification criteria makes it challenging to diagnose. Evidence-based guidelines for treatment of juvenile SS are not available due to the rarity of disease and the paucity of research in this patient population. This systematic review aims to summarize and appraise the current literature focused on pharmacological strategies for management of SS with childhood onset.

Methods

PubMed and MEDLINE/Scopus databases up to December 2020 were screened for suitable reports highlighting pharmacological treatment of SS with childhood onset using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 reporting checklist. Animal studies were excluded.

Results

A total of 43 studies (34 case reports, 8 mini case series and 1 pilot study) were eligible for analysis. The studies retrieved included girls in 88% (120/137) of cases and had very low confidence levels. HCQ was prescribed for parotid swelling, as well as in association with MTX and NSAIDs in patients with arthritis and arthralgia. Corticosteroids such as long courses of oral prednisone and i.v. methylprednisolone were commonly prescribed for children with severe disease presentations. Rituximab was mainly indicated for mucosa-associated lymphoid tissue lymphoma and renal and nervous system complications. Other conventional DMARDs were prescribed in selected cases with extraglandular manifestations.

Conclusion

Various therapies are used for the management of juvenile SS and are prescribed based on expert clinician’s opinion. There are currently no good-quality studies that allow clinical recommendations for treatment of SS with childhood onset.
How Efficacious Are Antipsychotic Drugs for Schizophrenia? An Interpretation Based on 13 Effect Size Indices
Authors: Leucht Stefan , Siafis Spyridon , Engel Rolf R , Schneider-Thoma Johannes , Bighelli Irene , Cipriani Andrea , Furukawa Toshi A , Davis John M
Published: July 2021

Background

The magnitude of the superiority of antipsychotics over placebo is debated. One reason is that the effect-size index which is usually used in meta-analyses is in standard deviation units. Many other indices, some of which are more intuitive, exist.

Methods

We explain the formulae, advantages, and limitations of 13 effect-size indices: Mean Difference (MD), Standardized-Mean-Difference (SMD), Correlation Coefficient, Ratio-of-Means (RoM, endpoint and change data), Improvement Fraction (IF), Drug-Response Fraction (DRF), Minimally-Clinically-Important-Difference-Units (MCIDU), Number-Needed-to-Treat-derived from SMD (NNT), Odds Ratio (OR), Relative Risk (RR), and Risk Difference (RD) derived from SMD, Drug-response and Placebo-response in percent. We applied these indices to meta-analyses comparing antipsychotic drugs with placebo for acute schizophrenia.

Results

The difference of all antipsychotics pooled vs placebo (105 trials with 22741 participants) was: MD 9.4 (95% CI 8.4,10.2) PANSS points, SMD 0.47 (0.42,0.51), Correlation coefficient 0.23 (0.21,0.25), RoM endpoint 0.83 (0.81,0.85), RoM change 1.94 (1.84,2.02), IF (%) 49 (46,51), DRF (%) 94 (84,102), MCIDU 0.63 (0.56,0.68), NNT 5 (5,6), OR 2.34 (2.14, 2.52), RR 1.67 (1.59,1.73), RD 20% (18–22), and 50% (48, 52) improved on drug compared to 30% on placebo. Results of individual drugs compared to placebo are presented, as well.

Conclusions

Taken together these indices show a substantial, but not a large superiority of antipsychotics compared to placebo. The general chronicity of the patients in the trials must be considered. Future meta-analyses should report other effect size indices in addition to the Standardized-Mean-Difference, in particular percentage responders in the drug and placebo groups. They can be easily derived and would enhance the interpretation of research findings.
Co-occurring Deficits in Clinical and Cognitive Insight in Prolonged Schizophrenia-Spectrum Disorders: Relationship to Metacognitive Deficits
Authors: Mervis Joshua E , Bonfils Kelsey A , Cooper Samuel E , Wiesepape Courtney , Lysaker Paul H
Published: July 2021

People diagnosed with schizophrenia have been broadly observed to experience deficits in clinical and cognitive insight; however, less is understood about how these deficits are related. One possibility is that these deficits co-occur among people when other deficits in cognition are present, such as in executive function, social cognition, and metacognition, which may either promote the development of both forms of poor insight or allow one to negatively influence the other. To explore this possibility, we conducted a cluster analysis using assessments of clinical and cognitive insight among 95 adults with a schizophrenia spectrum disorder. As predicted, this analysis yielded a group with concurrently poor clinical and cognitive insight (n = 36). Additional groups were found with concurrently good clinical and cognitive insight (n = 28) and poor clinical insight and good cognitive insight (n = 31). Groups were then compared on assessments of executive function, social cognition, and metacognition. The group with concurrently lower levels of cognitive and clinical insight had significantly poorer metacognition relative to the other groups. In particular, they tended to form more fragmented and less integrated ideas about themselves and others. No differences were found for executive function or social cognition. The result may suggest that while clinical and cognitive insight is partially orthogonal phenomena, relatively lower levels of metacognition, or difficulties forming integrated ideas about oneself and others, maybe a condition leading to the confluence of lower clinical and cognitive insight. Interventions targeting metacognition may be of particular use for this group.
Improving Phylogenies Based on Average Nucleotide Identity, Incorporating Saturation Correction and Nonparametric Bootstrap Support
Authors: Gosselin Sophia , Fullmer Matthew S , Feng Yutian , Gogarten Johann Peter
Published: July 2021

Whole-genome comparisons based on average nucleotide identities (ANI) and the genome-to-genome distance calculator have risen to prominence in rapidly classifying prokaryotic taxa using whole-genome sequences. Some implementations have even been proposed as a new standard in species classification and have become a common technique for papers describing newly sequenced genomes. However, attempts to apply whole-genome divergence data to the delineation of higher taxonomic units and to phylogenetic inference have had difficulty matching those produced by more complex phylogenetic methods. We present a novel method for generating statistically supported phylogenies of archaeal and bacterial groups using a combined ANI and alignment fraction-based metric. For the test cases to which we applied the developed approach, we obtained results comparable with other methodologies up to at least the family level. The developed method uses nonparametric bootstrapping to gauge support for inferred groups. This method offers the opportunity to make use of whole-genome comparison data, that is already being generated, to quickly produce phylogenies including support for inferred groups. Additionally, the developed ANI methodology can assist the classification of higher taxonomic groups.[Average nucleotide identity (ANI); genome evolution; prokaryotic species delineation; taxonomy.]
Peripunctal Mass Lesions: Clinicopathological Analysis and Surgical Outcomes—A Multicentric Series
Authors: Nair Akshay Gopinathan , Mukherjee Bipasha , Kamal Saurabh , Singh Swati , Alam Md. Shahid , Nisar Sonam Poonam , Koka Kirthi , Gopinathan Indumati
Published: July 2021

Purpose:

To report the epidemiology, histopathological spectrum, and surgical outcomes of peripunctal mass lesions.

Methods:

Multicentric retrospective case series involving 6 centers in India. All cases of peripunctal masses with histopathological diagnoses and minimum follow up of 3 months were included. Demographic data, clinical photographs, objective assessments of clinical improvement were assessed before and after treatment.

Results:

A total of 50 patients were included. The mean age was 46.4 years (range: 12–76 years). The mean duration of complaints was 27.4 months (range: 1–120 months) and mean follow-up period after surgery was 15.8 months (range: 3–120 months). The most common presenting complaints were a mass lesion/cosmetic concern (82%), followed by epiphora (48%) and foreign body sensation (16%). The most common lesion was melanocytic nevus (19/50; 38%), followed by squamous papilloma (8/50; 16%), hidrocystoma (7/50; 14%), and epidermoid cyst (7/50; 14%). Three cases of malignant tumors were diagnosed: 2 cases of sebaceous gland carcinoma and 1 case of squamous cell carcinoma. In all, 21 of 50 (42%) cases underwent excision with the placement of a Mini-Monoka stent, whereas the remaining 29 cases underwent only excision. At final follow up, a healed punctal opening was visible in 46 of 50 (92%) of the cases; 2 (4%) cases had a slit-like punctum and in 1 case (2%), a stenosed punctum was visible. However, only 1 case (2%) reported epiphora at follow up.

Conclusions:

Peripunctal masses are largely benign and present most commonly on the lower eyelid. Melanocytic nevus is the most common peripunctal mass lesion. In the series, stent placement did not play a significant role in the functional outcome.
Real-world incidence of monofocal toric intraocular lens repositioning: analysis of the American Academy of Ophthalmology IRIS Registry
Authors: Kramer Brent A. , Berdahl John , Gu Xiaolin , Merchea Mohinder
Published: July 2021

Purpose:

To determine the 12-month incidence of reoperation to realign 2 commercially available types of implanted monofocal toric acrylic intraocular lenses (IOLs).

Setting:

American Academy of Ophthalmology IRIS (Intelligent Research in Sight) Registry.

Design:

Registry retrospective study.

Methods:

Eyes that underwent cataract extraction and were implanted with a TECNIS or AcrySof monofocal toric IOL in 2016 and 2017 were identified. The rate of reoperation for IOL realignment (Current Procedural Terminology code 66825) within 365 days of implantation was determined for each IOL group. Risk factors for repositioning were evaluated using logistic regression modeling.

Results:

A total of 6482 eyes were implanted with a monofocal toric IOL, including 2013 (31.06%) with a TECNIS and 4469 (68.94%) with an AcrySof IOL. During the first postoperative year, 87 (1.3%) eyes underwent surgical IOL repositioning. The incidence of repositioning was significantly higher (P < .0001) for TECNIS-implanted (3.1%, 62/2013) than for AcrySof-implanted (0.6%, 25/4469) eyes (odds ratio [OR] 5.6; 95% CI, 3.5-8.9). Younger age (OR 0.76; 95% CI, 0.67-0.86 per 5-year increase) was associated with a higher risk for IOL repositioning.

Conclusions:

Real-world analysis of U.S. patients in the IRIS Registry revealed that the rate of surgical IOL repositioning was 5 times higher in eyes implanted with TECNIS than with AcrySof monofocal toric IOLs for astigmatic correction at the time of cataract surgery. These findings should be considered when selecting a toric IOL for correction of astigmatism in cataract patients, particularly in younger patients with a higher risk for misalignment requiring repositioning.