bluuebunny/crossref_metadata_2025 huggingface dataset:
Vertical stellar density distribution in a non-isothermal galactic disc
Authors: Sarkar Suchira , Jog Chanda J
Published: September 2020

The vertical density distribution of stars in a galactic disc is traditionally obtained by assuming an isothermal vertical velocity dispersion of stars. Recent observations from SDSS, LAMOST, RAVE, Gaia etc. show that this dispersion increases with height from the mid-plane. Here, we study the dynamical effect of such non-isothermal dispersion on the self-consistent vertical density distribution for the thin disc stars in the Galaxy, obtained by solving together the Poisson equation and the equation of hydrostatic equilibrium. We find that in the non-isothermal case the mid-plane density is lower and the scale height is higher than the corresponding values for the isothermal distribution, due to higher vertical pressure, hence the distribution is vertically more extended. The change is $\sim \! 35 {{\ \rm per\ cent}}$ at the solar radius for a stars-alone disc for the typical observed linear gradient of +6.7 km s−1 kpc−1 and becomes even higher with increasing radii and increasing gradients explored. The distribution shows a wing at high z, in agreement with observations, and is fitted well by a double $\operatorname{sech}^{2}$, which could be mis-interpreted as the existence of a second, thicker disc, specially in external galaxies. We also consider a more realistic disc consisting of gravitationally coupled stars and gas in the field of dark matter halo. The results show the same trend but the effect of non-isothermal dispersion is reduced due to the opposite, constraining effect of the gas and halo gravity. Further, the non-isothermal dispersion lowers the theoretical estimate of the total mid-plane density i.e. Oort limit value, by 16 per cent.
A Galactic dust devil: far-infrared observations of the Tornado supernova remnant candidate
Authors: Chawner H , Howard A D P , Gomez H L , Matsuura M , Priestley F , Barlow M J , De Looze I , Papageorgiou A , Marsh K , Smith M W L , Noriega-Crespo A , Rho J , Dunne L
Published: September 2020

We present complicated dust structures within multiple regions of the candidate supernova remnant (SNR) the ‘Tornado’ (G357.7–0.1) using observations with Spitzer and Herschel. We use point process mapping, ppmap, to investigate the distribution of dust in the Tornado at a resolution of 8 arcsec, compared to the native telescope beams of 5–36 arcsec. We find complex dust structures at multiple temperatures within both the head and the tail of the Tornado, ranging from 15 to 60 K. Cool dust in the head forms a shell, with some overlap with the radio emission, which envelopes warm dust at the X-ray peak. Akin to the terrestrial sandy whirlwinds known as ‘dust devils’, we find a large mass of dust contained within the Tornado. We derive a total dust mass for the Tornado head of 16.7 $\rm M_{\odot }$, assuming a dust absorption coefficient of κ300 = 0.56 $\rm m^2\, kg^{-1}$, which can be explained by interstellar material swept up by a SNR expanding in a dense region. The X-ray, infrared, and radio emission from the Tornado head indicate that this is a SNR. The origin of the tail is more unclear, although we propose that there is an X-ray binary embedded in the SNR, the outflow from which drives into the SNR shell. This interaction forms the helical tail structure in a similar manner to that of the SNR W50 and microquasar SS 433.
Velocity shift of Mg ii and Al iii broad absorption lines in quasar SDSS J134444.33+315007.6
Authors: Lu Wei-Jian , Lin Ying-Ru
Published: September 2020

We report, for the first time, a synchronized velocity shift of Mg ii and Al iii broad absorption lines (BALs) in quasar SDSS J134444.33+315007.6 (hereafter, J1344+3150). We found this quasar from a sample of 134 Mg ii BAL quasars with multi-epoch observations. This quasar contains three low-ionization BAL systems, the fastest of which at ${\sim} -17\, 000\, \rm km\, s^{-1}$ shows a kinematic shift of ${\sim} -1101$ and $\sim -1170\, \rm km\, s^{-1}$ in its Mg ii and Al iii ions, respectively, during a rest-frame time of about 3.21 yr. Meanwhile, this quasar also shows other various variation characteristics, including an obvious weakening in its continuum, a coordinated enhancement in multiple emission lines (Mg ii, C iii, and Al iii), and a coordinated enhancement in three Al iii absorption troughs. These variation characteristics convincingly indicate that the BAL outflows of J1344+3150 are under the influence from the background radiation energy. Thus, we infer that the velocity shift displayed in system A in the quasar J1344+3150 may indicate an actual line-of-sight acceleration of an outflow due to the radiation pressure from the central source.
A crucial test of the phantom closed cosmological model
Authors: Shirokov S I , Baryshev Yu V
Published: September 2020

We suggest a crucial direct-observational test for measuring distinction between the standard ΛCDM model and recently proposed phantom dark energy positive curvature cosmological model. The test is based on the fundamental distance–flux–redshift relation for general Friedmann models. It does not depend on the CMBR data, on the large-scale structure growth models, and also on the value of the Hubble constant H0. Our crucial test can be performed by future gamma-ray burst observations with THESEUS space mission and by using gravitational-wave standard siren observations with modern advanced LIGO–Virgo and also forthcoming LISA detectors.
R-chie: a web server and R package for visualizing cis and trans RNA–RNA, RNA–DNA and DNA–DNA interactions
Authors: Tsybulskyi Volodymyr , Mounir Mohamed , Meyer Irmtraud M
Published: September 2020

Interactions between biological entities are key to understanding their potential functional roles. Three fields of research have recently made particular progress: the investigation of transRNA–RNA and RNA–DNA transcriptome interactions and of trans DNA–DNA genome interactions. We now have both experimental and computational methods for examining these interactions in vivo and on a transcriptome- and genome-wide scale, respectively. Often, key insights can be gained by visually inspecting figures that manage to combine different sources of evidence and quantitative information. We here present R-chie, a web server and R package for visualizing cis and transRNA–RNA, RNA–DNA and DNA–DNA interactions. For this, we have completely revised and significantly extended an earlier version of R-chie (1) which was initially introduced for visualizing RNA secondary structure features. The new R-chie offers a range of unique features for visualizing cis and transRNA–RNA, RNA–DNA and DNA–DNA interactions. Particularly note-worthy features include the ability to incorporate evolutionary information, e.g. multiple-sequence alignments, to compare two alternative sets of information and to incorporate detailed, quantitative information. R-chie is readily available via a web server as well as a corresponding R package called R4RNA which can be used to run the software locally.
Integrating information in the brain’s EM field: the cemi field theory of consciousness
Authors: McFadden Johnjoe
Published: September 2020

A key aspect of consciousness is that it represents bound or integrated information, prompting an increasing conviction that the physical substrate of consciousness must be capable of encoding integrated information in the brain. However, as Ralph Landauer insisted, ‘information is physical’ so integrated information must be physically integrated. I argue here that nearly all examples of so-called ‘integrated information’, including neuronal information processing and conventional computing, are only temporally integrated in the sense that outputs are correlated with multiple inputs: the information integration is implemented in time, rather than space, and thereby cannot correspond to physically integrated information. I point out that only energy fields are capable of integrating information in space. I describe the conscious electromagnetic information (cemi) field theory which has proposed that consciousness is physically integrated, and causally active, information encoded in the brain’s global electromagnetic (EM) field. I here extend the theory to argue that consciousness implements algorithms in space, rather than time, within the brain’s EM field. I describe how the cemi field theory accounts for most observed features of consciousness and describe recent experimental support for the theory. I also describe several untested predictions of the theory and discuss its implications for the design of artificial consciousness. The cemi field theory proposes a scientific dualism that is rooted in the difference between matter and energy, rather than matter and spirit.
Ten-Year Outcomes of 1- and 2-Level Cervical Disc Arthroplasty From the Mobi-C Investigational Device Exemption Clinical Trial
Authors: Kim Kee , Hoffman Greg , Bae Hyun , Redmond Andy , Hisey Michael , Nunley Pierce , Jackson Robert , Tahernia David , Araghi Ali
Published: September 2020

BACKGROUND

Short- and mid-term studies have shown the effectiveness of cervical disc arthroplasty (CDA) to treat cervical disc degeneration.

OBJECTIVE

To report the 10-yr outcomes of a multicenter experience with cervical arthroplasty for 1- and 2-level pathology.

METHODS

This was a prospective study of patients treated with CDA at 1 or 2 contiguous levels using the Mobi-C® Cervical Disc (Zimmer Biomet). Following completion of the 7-yr Food and Drug Administration postapproval study, follow-up continued to 10 yr for consenting patients at 9 high-enrolling centers. Clinical and radiographic endpoints were collected out to 10 yr.

RESULTS

At 10 yr, patients continued to have significant improvement over baseline Neck Disability Index (NDI), neck and arm pain, neurologic function, and segmental range of motion (ROM). NDI and pain outcomes at 10 yr were significantly improved from 7 yr. Segmental and global ROM and sagittal alignment also were maintained from 7 to 10 yr. Clinically relevant adjacent segment pathology was not significantly different between 7 and 10 yr. The incidence of motion restricting heterotopic ossification at 10 yr was not significantly different from 7 yr for 1-level (30.7% vs 29.6%) or 2-level (41.7% vs 39.2%) patients. Only 2 subsequent surgeries were reported after 7 yr.

CONCLUSION

Our results through 10 yr were comparable to 7-yr outcomes, demonstrating that CDA with Mobi-C continues to be a safe and effective surgical treatment for patients with 1- or 2-level cervical degenerative disc disease.
Discordance Between Radiologic Findings and Molecular Testing in Patients With Underlying Hematologic Malignancy and Coronavirus Disease 2019
Authors: Raja Mohammed , Natori Yoichiro , Chandorkar Aditya , Camargo Jose F , Simkins Jacques , Andrews David , Bradley Terrence , Watts Justin , Komanduri Krishna , Morris Michele I , Fishman Joel E
Published: September 2020

Severe acute respiratory syndrome coronavirus 2 is associated with severe disease in patients with hematologic malignancy. We report a series of patients with underlying hematologic malignancy and coronavirus disease of 2019 with discrepancy between radiographic findings and molecular testing. Initial chest x-ray findings should raise suspicion in immunosuppressed patients with typical clinical presentation even with negative initial testing.
18F-FDG PET/CT contribution to tuberculous vertebral osteomyelitis diagnosis: a case report
Authors: Manika Katerina , Kipourou Maria , Georga Stamata , Faniadou Eleni , Pilianidis Georgios , Arsos Georgios , Kioumis Ioannis
Published: September 2020

Tuberculous vertebral osteomyelitis (TVO) is an extrapulmonary tuberculosis form characterized by difficulty and delay in diagnosis. PET/CT is a valuable, well-established tool in the diagnostic workup of cancer and fever of unknown origin, which is increasingly appreciated in the management of infectious diseases. We report a TVO case where PET/CT had a valuable contribution towards diagnosis and monitoring of treatment response, highlighting its advantages and future perspectives when dealing with infectious diseases.
Homozygous familial hypercholesterolemia with an update on cholesterol management
Authors: Velvet Anju J J , Soran Handrean , Clarke Bernard , Motwani Manish , Ordoubadi Farzin F , Daniels Matthew J
Published: September 2020

Familial hypercholesterolemia (FH) is an autosomal dominant condition that increases the risk of premature cardiovascular disease. Despite advances in treatment, it remains under detected and under treated. As an inherited condition, it poses a risk to the patient and family members. Most cases are due to defective low-density lipoprotein receptor (LDLR) activity. Heterozygous mutations are common (1:250–1:300). Homozygous FH is very rare (2–3 in a million), with higher circulating cholesterol levels and a poorer cardiovascular prognosis. We present the management of a case of homozygous hypercholesterolemia due to homozygous LDLR mutation. The patient subsequently developed severe coronary artery and aortic valve disease despite aggressive lipid-lowering therapy. We review advanced lipid management options that include lipoprotein apheresis, Proprotein Convertase Subtilisin/Kexin type 9 inhibition, and the microsomal triglyceride transfer protein inhibitor lomitapide.
Revising a diagnosis of functional neurological disorder—a case report
Authors: Berry Alex J , Wiethoff Sarah
Published: September 2020

We report a case of a 62-year-old female diagnosed with functional neurological disorder (FND), where the diagnosis was eventually revised to progressive supranuclear palsy 3 years after symptom onset. FND is a commonly encountered condition and can be diagnosed with a considerable degree of confidence in most cases. FND is associated with significant functional impairment and may occur alongside other neurological disorders, and there is now a growing evidence base for symptom-specific FND treatments. Charting clinical progression of symptoms and serial neuroimaging were useful in refining the diagnosis in this case. Alhough the diagnosis was ultimately revised to a neurodegenerative disorder, a degree of functional overlay likely remained present. The case highlights the importance of recognizing and avoiding diagnostic overshadowing in those with FND.
An unusual headache: CSF negative APML relapse in the brain
Authors: Quinn Thomas , Jain Manish , Lee Ming-Te
Published: September 2020

Acute Promyelocytic Leukaemia (APML) is a subtype of Acute Myeloid Leukaemia (AML), responsible for around 10% of cases of the disease in adults. Extra medullary disease (EMD) occurs infrequently in APML, but where EMD does occur, the central nervous system is one of the most commonly infiltrated sites. Our case describes a man in his 40s undergoing post-therapy surveillance for APML who presented to follow-up clinic with a headache, which was ultimately found to be caused by a tumour comprised of APML cells. His case presented a diagnostic challenge due to the benign appearances of the lesion on initial computed tomography brain imaging and the non-diagnostic cerebrospinal fluid analysis. The diagnostic difficulties described in our case emphasizes that clinicians working with APML patients must approach new neurological symptoms with a high degree of suspicion to prevent diagnostic delay.
Dermatopathia pigmentosa reticularis with beard alopecia: first report from Syria
Authors: Elias Lama , Bleidy Rahaf , Hasan Foz , Romeah Abdalhalem , Houreih Mohammad Adib
Published: September 2020

Dermatopathia pigmentosa reticularis (DPR) is a rare disorder with characteristic triad of generalized reticulate hyperpigmentation, noncicatricial alopecia and onychodystrophy. We report the first case from Syria with classical features of the triad along with hyperhidrosis and adermatoglyphia. Based on previous studies this case is distinguished by the location of alopecia on the beard which is not reported before and distinctive histopathological features were found on the biopsy.
Primary vaginal leiomyosarcoma: case report of a rare gynaecological malignancy and diagnostic challenge in a resource-constraint setting
Authors: Okunowo Adeyemi A , Ugwu Aloy O , Owie Emmanuel , Kolawole Habibat F , Adebayo Luqman A , Kusamotu Olaniyi A , Kuku Jubril O , Soibi-Harry Adaiah P , Ohazurike Ephraim O , Banjo Adekunbiola A F
Published: September 2020

Primary vaginal leiomyosarcoma (VLMS) is an extremely rare variant of primary vaginal cancers with very poor prognosis irrespective of the stage at presentation and the type of treatment received. It is easily recurrent and has a high propensity for haematogenous spread especially to the lungs. We present the case of a 34-year-old Para 1 + 1 (1 alive) woman with recurrent vaginal mass of 8 years duration after two surgical excisions without histological evaluation. She had examination under anaesthesia and a wide local excision of the vaginal mass. Histological examination of the mass revealed poorly differentiated VLMS with positive surgical margins and she was commenced on adjuvant chemo-radiation. Histological evaluation remains the hallmark for diagnosing rare malignancies like VLMS, which unfortunately is not a standard practice in some resource-constraint settings.
Teleology
Authors: McDonough Jeffrey K.
Published: September 2020

Teleology is the belief that some things happen, or exist, for the sake of other things. It is the belief that, for example, eyes are for seeing and gills are for breathing. It is the belief that people go to the cinema in order to see films and that salmon swim upstream in order to spawn. The core idea of teleology is thus intuitive enough. Nonetheless, difficult questions arise as we dig deeper into the concept. Is teleology intrinsic or extrinsic—that is, is teleology inherent in its subjects or is it imposed on them from the outside? Does teleology necessarily involve intentionality—that is, does teleology necessarily involve a subject’s cognizing some end, goal, or purpose? What is the scope of teleology—is the concept of teleology, for example, applicable to elements and animals, or only to rational beings? Finally, is teleology explanatory? When we say that salmon swim upstream in order to spawn, have we explained why they swim upstream? When we say that eyes are for seeing, have we explained why we have eyes? This volume explores the development of the concept of teleology from ancient times to the present. It begins in the golden age of ancient Greece with Plato and Aristotle, winds its way through Islamic, Latin, and Jewish medieval traditions, passes into treatments by leading figures of the scientific revolution, and European Enlightenment, and finishes with current debates in contemporary philosophy of biology. Chapter discussions of key figures, traditions, and contexts are enlivened and contextualized by a series of intermittent reflections on the implications of teleology in medicine, art, poetry and music.
Towards a dynamic disequilibrium theory with randomness
Authors: Guzman Martin , Stiglitz Joseph E
Published: September 2020

The 2008 Global Financial Crisis, and the myriad other crises confronting economies around the world, exposed the inadequacies of the Dynamic Stochastic General Equilibrium models. These models not only hadn’t predicted the crisis, its occurrence was completely outside of their framework. The framework assumes there are no macroeconomic inconsistencies—all plans are realized, all budget constraints honoured. But after each instance in which that assumption is proved wrong, say in a crisis, the DSGE models assume that kind of event won’t happen again. By contrast, our framework explains why these inconsistencies arise and investigates the consequences, shows how large changes in the aggregate demand could trigger inconsistencies, explains the origins of such changes, and explains why decentralized market forces may be disequilibrating. We identify the crucial departures from the Arrow–Debreu assumptions underlying our results. We analyse the policy implications of this alternative theory, which typically are distinctly different from those of the standard model.
What Are DPT Program Practices and Attitudes Related to Population Health, Prevention, Health Promotion, and Wellness? Results of a National Survey
Authors: Rethorn Zachary D , Maxwell Jessica L , Bezner Janet R , Davenport Todd E , Bradford Elissa H , Ingman Mary Sue , Magnusson Dawn M
Published: September 2020

Objective

Noncommunicable diseases have increased in prevalence and are now responsible for the majority of the burden of disease. Aligning entry-level (professional) physical therapist education with these changing societal needs may position physical therapists to best address them. However, no comprehensive understanding of the practices and attitudes related to population health, prevention, health promotion, and wellness (PHPW) content among accredited US professional doctor of physical therapy (DPT) programs has been established. This study aims to identify practices and attitudes related to PHPW content among accredited US DPT programs.

Methods

A mixed-methods cross-sectional design using an electronic survey was utilized. Program directors of each accredited DPT program were identified using an official Commission on Accreditation in Physical Therapy Education list and invited to ascertain the perceived importance of PHPW, describe the delivery of PHPW content, and identify factors that influence inclusion of PHPW content in US DPT programs.

Results

Individuals from 49% of 208 invited programs responded. Nearly all programs reported teaching prevention (96.1%), health promotion (95.1%), and wellness content (98.0%), while fewer reported teaching population health (78.4%). However, only 15% of PHPW topics were covered in depth. Facilitators and barriers to the delivery of PHPW content were reciprocal and included faculty with PHPW expertise, logistical flexibility and support, and the perceived importance of PHPW content.

Conclusions

The majority of US DPT programs are teaching PHPW content. Lack of trained faculty and lack of professional competencies hinder further integration of PHPW content into curricula.

Impact

The findings of this study highlight avenues for additional research to determine professional PHPW competencies and additional educational needs for faculty members.
Peripheral blood mononuclear cells are hypomethylated in active rheumatoid arthritis and methylation correlates with disease activity
Authors: Liebold Ilka , Grützkau Andreas , Göckeritz Anika , Gerl Velia , Lindquist Randall , Feist Eugen , Zänker Michael , Häupl Thomas , Poddubnyy Denis , Zernicke Jan , Smiljanovic Biljana , Alexander Tobias , Burmester Gerd R , Gay Steffen , Stuhlmüller Bruno
Published: September 2020

Objective

Epigenetic modifications are dynamic and influence cellular disease activity. The aim of this study was to investigate global DNA methylation in peripheral blood mononuclear cells (PBMCs) of RA patients to clarify whether global DNA methylation pattern testing might be useful in monitoring disease activity as well as the response to therapeutics.

Methods

Flow cytometric measurement of 5-methyl-cytosine (5′-mC) was established using the cell line U937. In the subsequent prospective study, 62 blood samples were investigated, including 17 healthy donors and 45 RA patients at baseline and after 3 months of treatment with methotrexate, the IL-6 receptor inhibitor sarilumab, and Janus kinase inhibitors. Methylation status was assessed with an anti-5′-mC antibody and analysed in PBMCs and CD4+, CD8+, CD14+ and CD19+ subsets. Signal intensities of 5′-mC were correlated with 28-joint DASs with ESR and CRP (DAS28-ESR and DAS28-CRP).

Results

Compared with healthy individuals, PBMCs of RA patients showed a significant global DNA hypomethylation. Signal intensities of 5′-mC correlated with transcription levels of DNMT1, DNMT3B and MTR genes involved in methylation processes. Using flow cytometry, significant good correlations and linear regression values were achieved in RA patients between global methylation levels and DAS28-ESR values for PBMCs (r = −0.55, P = 0.002), lymphocytes (r = −0.57, P = 0.001), CD4+ (r = −0.57, P = 0.001), CD8+ (r = −0.54, P = 0.001), CD14+ (r = −0.49, P = 0.008) and CD19+ (r = −0.52, P = 0.004) cells.

Conclusions

The degree of global DNA methylation was found to be associated with disease activity. Based on this novel approach, the degree of global methylation is a promising biomarker for therapy monitoring and the prediction of therapy outcome in inflammatory diseases.
ETF Arbitrage, Non-Fundamental Demand, and Return Predictability*
Authors: Brown David C , Davies Shaun William , Ringgenberg Matthew C
Published: September 2020

Non-fundamental demand shocks have significant effects on asset prices, but observing these shocks is challenging. We use the exchange-traded fund (ETF) primary market to study non-fundamental demand. Unique to the ETF market, specialized arbitrageurs called authorized participants correct violations of the law of one price between an ETF and its underlying assets by creating or redeeming ETF shares. We show theoretically and empirically that creation and redemption activities (ETF flows) provide signals of non-fundamental demand shocks. A portfolio that is short high-flow ETFs and long low-flow ETFs earns excess returns of 1.1–2.0% per month, consistent with non-fundamental demand distorting asset prices away from fundamental values. Moreover, we show non-fundamental demand imposes non-trivial costs on investors, leading to underperformance.
UNATTACHED 212PB FRACTION IN THE WORKER’S BREATHING ZONE AT HIGH THORON CONCENTRATIONS
Authors: Zhukovsky Michael , Vasyanovich Maksim , Onishchenko Aleksandra
Published: September 2020

Classical aerosol physics predicts that it is impossible to observe noticeable values of the unattached fraction of decay products of thoron at typical concentrations of aerosol particles. The experimental data have shown that the unattached fraction of the thoron decay products in a monazite storage facility is in the range 0.3–0.6. This effect is caused by local increase in air exchange near the inlet of the sampling device at high 220Rn concentrations. It was found that a dynamic shift between the unattached and attached thoron decay products is also observed in the worker’s breathing zone at a high concentration of thoron. The 212Pb unattached fraction in worker’s breathing zone was ~0.4. It demonstrates that when evaluating inhalation exposure to the products of the decay of thoron, it is necessary to take into account the increase of the 212Pb unattached fraction in the worker’s breathing zone.
THE INFLUENCE OF THE EQUILIBRIUM FACTOR ON THE ESTIMATED ANNUAL EFFECTIVE DOSE FROM INHALED RADON DECAY PRODUCTS IN SELECTED WORKPLACES
Authors: Otahal Petr P S , Burian Ivo , Fialova Eliska , Vosahlik Josef
Published: September 2020

Measurements of activity concentration of radon gas and radon decay products were carried out in several workplaces including schools, radium spas, swimming pools, water treatment plants, caves and former mines. Based on these measurements, annual effective doses to workers were estimated and values of the equilibrium factor, F, were calculated. This paper describes the different approaches used to estimate the annual effective dose based on the dose coefficients recommended by the International Commission on Radiological Protection. Using the measured F values as opposed to the default F value of 0.4 changed the doses by about 5–95% depending mainly upon the ventilation conditions of the workplace.
Metabolites from Wild Potato Inhibit Virulence Factors of the Soft Rot and Blackleg Pathogen Pectobacterium brasiliense
Authors: Joshi Janak R. , Yao Linxing , Charkowski Amy O. , Heuberger Adam L.
Published: September 2020

Potato (Solanum tuberosum L.) is the primary vegetable crop consumed worldwide and is largely affected by bacterial pathogens that can cause soft rot and blackleg disease. Recently, resistance to these diseases has been identified in the wild potato S. chacoense, and the mechanism of resistance is unknown. Here, it was hypothesized that S. chacoense stems or tubers have unique chemistry that confers resistance to the pathogen Pectobacterium brasiliense through bactericidal, bacteriostatic, or antivirulence activity. Stem and tuber metabolite extracts were collected from S. chacoense and tested for effects on Pectobacterium bacterial multiplication rates, and activity and expression of known exoenzymes and virulence genes using S. tuberosum extracts as a comparative control. Comparatively, the S. chacoense extracts did not affect bacterial multiplication rate; however, they did reduce pectinase, cellulase, and protease activities. The chemical extracts were profiled using a bioassay-guided fractionation, and a nontargeted metabolomics comparison of S. chacoense and S. tuberosum stems and tubers was performed. The data showed that selected alkaloids, phenolic amines, phenols, amines, and peptides are integrative chemical sources of resistance against the bacteria.

[Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Effectiveness of the Wheat Blast Resistance Gene Rmg8 in Bangladesh Suggested by Distribution of an AVR-Rmg8 Allele in the Pyricularia oryzae Population
Authors: Horo Jemal Tola , Asuke Soichiro , Vy Trinh Thi Phuong , Tosa Yukio
Published: September 2020

Wheat blast caused by the Triticum pathotype of Pyricularia oryzae was first reported in 1985 in Brazil and recently spread to Bangladesh. We tested whether Rmg8 and RmgGR119, recently identified resistance genes, were effective against Bangladeshi isolates of the pathogen. Common wheat accessions carrying Rmg8 alone (IL191) or both Rmg8 and RmgGR119 (GR119) were inoculated with Brazilian isolates (Br48, Br5, and Br116.5) and Bangladeshi isolates (T-108 and T-109). Br48, T-108, and T-109 carried the eI type of AVR-Rmg8 (the avirulence gene corresponding to Rmg8) while Br5 and Br116.5 carried its variants, eII and eII’ types, respectively. Detached primary leaves of IL191 and GR119 were resistant to all isolates at 25°C. At a higher temperature (28°C), their resistance was still effective against the eI carriers but was reduced to a low level against the eII/eII’ carriers. A survey of databases and sequence analyses revealed that all Bangladeshi isolates carried the eI type which induced a higher level of resistance than the eII/eII’ types. The resistance of IL191 (Rmg8/−) to the eI carriers was maintained even at the heading stage and at the higher temperature. In addition, GR119 (Rmg8/RmgGR119) displayed higher levels of resistance than IL191 at this stage. These results suggest that Rmg8 combined with RmgGR119 will be useful in breeding for resistance against wheat blast in Bangladesh.
Chromosomal Abnormalities Detected by Karyotyping and Microarray Analysis in Twins With Structural Anomalies
Authors: Li L. , He Z. , Huang X. , Lin S. , Wu J. , Huang L. , Wan Y. , Fang Q.
Published: September 2020

(Abstracted from Ultrasound Obstet Gynecol 2020;55:502–509)

Structural anomalies are frequently detected by prenatal ultrasound, and understanding the cause of such anomalies is important for genetic counseling and prenatal management. Chromosomal microarray analysis (CMA) has been shown to increase the rate of genetic diagnosis compared with karyotyping.
Hospital-based Buprenorphine Micro-dose Initiation
Authors: Weimer Melissa B. , Guerra Michael , Morrow Gina , Adams Kathleen
Published: September 2020

Buprenorphine induction can be challenging for patients with chronic pain or patients who are unable to cease opioids for sufficient time to prevent precipitated opioid withdrawal. In the outpatient setting, low-dose buprenorphine induction strategies have been described to avoid these barriers; however, these strategies are not generalizable to the hospital setting where specific medication regulations may apply. We report a novel strategy for hospital-based low-dose buprenorphine initiation that facilitates transition from full opioid agonists to buprenorphine.
The Concept of Pain Inventory (COPI)
Authors: Pate Joshua W. , Simons Laura E. , Hancock Mark J. , Hush Julia M. , Noblet Tim , Pounder Meg , Pacey Verity
Published: September 2020

Objectives:

Clinical guidelines recommend that health care providers assist children to understand their experience of persistent pain, with pain science education a key component of clinical management in pediatric pain clinics. Currently, no tool exists to assess a child’s concept of pain. The aim of this study was to develop such a tool and to evaluate its psychometric properties.

Methods:

After a rigorous process to generate items, assess content validity, evaluate readability and understandability, and pretest items, a cohort of 124 children (aged 8 to 12 y) independently completed the measure on 2 occasions, along with additional measures of pain, function, and pain-related distress.

Results:

The resulting unidimensional 14-item Concept of Pain Inventory (COPI) had acceptable internal consistency (α= 0.78) and moderate test-retest reliability (intraclass correlation coefficient (3,1) = 0.55; 95% CI, 0.37-0.68). Higher COPI scores reflect greater alignment with contemporary pain science. COPI scores were inversely correlated with pain intensity and functional disability, but unrelated to pain catastrophizing and pain-related fear. At 1 to 2 months’ follow-up, baseline COPI scores were inversely correlated with clinical variables of functional disability and pain intensity.

Discussion:

These results support the COPI as a brief, psychometrically sound tool to assess a child’s concept of pain. Clinically, this tool may facilitate individualized pain science education to target identified conceptual “gaps” or misconceptions and to evaluate the effectiveness of pain science education in children. Further research examining its efficacy and impact is warranted.
Progress of antibiotic-loaded bone cement in joint arthroplasty
Authors: Xu Yi-Ming , Peng Hui-Ming , Feng Bin , Weng Xi-Sheng
Published: September 2020

Bone cement, consisting of polymethyl methacrylate, is a bioinert material used for prothesis fixation in joint arthroplasty. To treat orthopedic infections, such as periprosthetic joint infection, antibiotic-loaded bone cement (ALBC) was introduced into clinical practice. Recent studies have revealed the limitations of the antibacterial effect of ALBC. Moreover, with the increase in high infection risk patients and highly resistant microbes, more researches and modification of ALBC are required. This paper reviewed latest findings about ALBC for most popular and destructive pathogens, summarized the influence of antibiotic kind, drug dosage, application method, and environment towards characteristic of ALBC. Subsequently, new cement additives and clinical applications of ALBC in joint arthroplasty were also discussed.
Effect of Cystatin C on Vancomycin Clearance Estimation in Critically Ill Children Using a Population Pharmacokinetic Modeling Approach
Authors: Downes Kevin J. , Zane Nicole R. , Zuppa Athena F.
Published: September 2020

Background:

Vancomycin is eliminated by glomerular filtration, but current approaches to estimate kidney function in children are unreliable. The authors sought to compare the suitability of cystatin C (CysC)-based glomerular filtration rate equations with the most commonly used creatinine-based equation, bedside Schwartz, to estimate vancomycin clearance (CL).

Methods:

This prospective observational study enrolled critically ill patients (2–18 years) receiving intravenous vancomycin at the Children's Hospital of Philadelphia during December 2015–November 2017. Vancomycin levels were collected during clinical care and at 3 times during a single dosing interval. Plasma CysC was measured within 24 hours before intravenous vancomycin (baseline) initiation or immediately after enrollment and along with the third pharmacokinetic sample. Nonlinear mixed effects modeling was performed using NONMEM software. Covariate selection was used to test model fit with inclusion of the estimated glomerular filtration rate (eGFR) on CL using bedside Schwartz versus various published CysC-based equations.

Results:

In total, 83 vancomycin levels were obtained from 20 children. The median age was 12.7 years; 6 patients were women. A 1-compartment model best described the data; CL was allometrically scaled to 0.75. During covariate selection, inclusion of the eGFR calculated using a CysC-based equation significantly improved model fit [reduction in objective function value (OFV) range: −17.191 to −18.704] than bedside Schwartz (∆OFV −12.820). Including the full age spectrum equation, an eGFR equation based on both creatinine and CysC, led to the largest OFV reduction (−22.913); female sex was also a significant covariate of CL in the model. Final model pharmacokinetic indices were CL = 0.29 L/h/kg0.75 and volume of distribution = 0.48 L/kg.

Conclusions:

CysC-based equations help better estimate vancomycin CL than bedside Schwartz in critically ill children.
Population Pharmacokinetic Models of Antituberculosis Drugs in Patients: A Systematic Critical Review
Authors: Otalvaro Julian D. , Hernandez Alher M. , Rodriguez Carlos A. , Zuluaga Andres F.
Published: September 2020

Background:

Tuberculosis (TB) remains one of the most important infectious diseases. Population pharmacokinetic (pop-PK) models are widely used to individualize dosing regimens of several antibiotics, but their application in anti-TB drug studies is scant. The aim of this study was to provide an insight regarding the status of pop-PK for these drugs and to compare results obtained through both parametric and nonparametric approaches to design precise dosage regimens.

Methods:

First, a systematic approach was implemented, searching in PubMed and Google Scholar. Articles that did not include human patients, that lacked an explicit structural model, that analyzed drugs inactive against M. tuberculosis, or were without full-text access, were excluded. Second, the PK parameters were summarized and categorized as parametric versus nonparametric results. Third, a Monte Carlo simulation was performed in Pmetrics using the results of both groups, and an error term was built to describe the imprecision of each PK modeling approach.

Results:

Thirty-three articles reporting at least 1 pop-PK model of 19 anti-TB drug were found; 46 different models including PK parameter estimates and their relevant covariates were also reported. Only 9 models were based on nonparametric approaches. Rifampin was the drug most studied, but only using parametric approaches. The simulations showed that nonparametric approaches improve the error term compared with parametric approaches.

Conclusions:

More and better models, ideally using nonparametric approaches linked with clear pharmacodynamic goals, are required to optimize anti-TB drug dosing, as recommended in the WHO End TB strategy.
Onset of the climacteric phase by the mid-forties associated with impaired insulin sensitivity: a birth cohort study
Authors: Savukoski Susanna M. , Suvanto Eila T. J. , Auvinen Juha P. , Pesonen Paula R. O. , Keinänen-Kiukaanniemi Sirkka M. , Puukka Katri S. , Ebeling Tapani , Niinimäki Maarit J.
Published: September 2020

Objective:

To investigate whether the early-onset menopausal transition is associated with deteriorated glucose tolerance in women in their mid-forties.

Methods:

A cross-sectional analysis of a cohort study including 2,632 women of the Northern Finland Birth Cohort 1966. The participants were divided into two groups by their menstrual history and follicle-stimulating hormone values at age 46: climacteric and preclimacteric women. Glucose and insulin parameters, as well as mathematical indices derived from them to evaluate insulin sensitivity, were compared between the groups. The results were adjusted for measured body mass index and smoking. The possible effect of hormone therapy was investigated in subanalyses excluding hormone therapy users.

Results:

Climacteric women (n = 379) were more often current smokers at age 46 (P = 0.008), and their body mass indices increased more from 31 to 46 years (P = 0.013), compared to preclimacteric women (n = 2,253). In a multivariable generalized linear model, being climacteric at age 46 was associated with several findings suggesting decreased insulin sensitivity: increased glycated hemoglobin (P < 0.001), 2-hour oral glucose tolerance test 30- and 60-minute insulin (P = 0.040 and 0.006, respectively), and area under the insulin curve (P = 0.005). Being climacteric also was associated with a decreased the McAuley (P = 0.024) and Belfiore indices (P = 0.027) and glucose tolerance test 60-minute glucose (P = 0.015). In subanalyses excluding hormone therapy users (n = 94), the results did not change significantly.

Conclusions:

Earlier onset of climacteric transition is associated with impaired insulin sensitivity in middle-aged women.

Video Summary:
http://links.lww.com/MENO/A648.
Transbronchial Cryobiopsy in Interstitial Lung Diseases
Authors: Avasarala Sameer K. , Wells Athol U. , Colby Thomas V. , Maldonado Fabien
Published: September 2020

Interstitial lung diseases are a heterogenous group of disorders that are often difficult to diagnose precisely. Clinical, laboratory, radiographic, and histologic information may be needed to arrive at the correct diagnosis. The multidisciplinary discussion has been proven to be useful in this patient group. Transbronchial cryobiopsy has become a popular method for obtaining tissue samples. Over the course of the last decade, there has been a significant amount of research assessing the feasibility, safety, and diagnostic endpoints of transbronchial cryobiopsy in patients with interstitial lung disease. Data continues to mount to support its use, which has been reflected in guidelines and expert panel reports. Patient selection, procedural performance, and appropriate specimen handling are critical factors for success. A coordinated approach by pulmonologists with expertise in interstitial lung diseases, interventional pulmonologists, and thoracic pathologists is essential. In this evidence-based narrative review, we address transbronchial cryobiopsies from these three distinct perspectives. In addition, the current literature was used to address nine common procedural questions.
Impact of a Best Practice Prevention Bundle on Central Line-associated Bloodstream Infection (CLABSI) Rates and Outcomes in Pediatric Hematology, Oncology, and Hematopoietic Cell Transplantation Patients in Inpatient and Ambulatory Settings
Authors: Ardura Monica I. , Bibart Mindy J. , Mayer Lauren C. , Guinipero Terri , Stanek Joseph , Olshefski Randal S. , Auletta Jeffery J.
Published: September 2020

Background:

Pediatric hematology, oncology, and hematopoietic cell transplantation (HCT) patients are at increased risk for bloodstream infections. The authors sought to evaluate the influence of a standardized best practice central venous catheter (CVC) maintenance bundle on the burden of and risk factors for mucosal barrier injury (MBI) and non-MBI central line-associated bloodstream infections (CLABSIs) across a common inpatient and ambulatory continuum in this high-risk population.

Methods:

A retrospective cohort study of patients with underlying malignancy, hematologic disorders, and HCT recipients with a CVC in place at the time of CLABSI diagnosis in both inpatient and ambulatory settings from January 1, 2012 to December 31, 2016. Descriptive, nonparametric statistics were used to describe patient characteristics and outcomes. Logistic regression analyses were applied to identify potential risk factors for inpatient versus ambulatory and MBI versus non-MBI CLABSI.

Results:

During the 5-year period, 118 of 808 (14.6%) patients had 159 laboratory-confirmed CLABSIs for ambulatory and inpatient CLABSI rates of 0.27 CLABSI/1000 and 2.2 CLABSI/1000 CVC days, respectively. CLABSI occurred more frequently in hospitalized patients after HCT and with underlying leukemia, most frequently caused by Gram-negative bacteria. MBI CLABSI accounted for 42% of all CLABSI with a 3-fold higher risk in hospitalized patients. Having multiple CVC or a CVC that was not a port independently associated with higher CLABSI risk.

Conclusions:

In our cohort, non-MBI CLABSI continued to account for the majority of CLABSI. CVC type is independently associated with higher overall CLABSI risk. Further studies are needed to reliably define additional prevention strategies when CLABSI maintenance bundles elements are optimized in this high-risk population.
Predictors of State-Level Stay-at-Home Orders in the United States and Their Association With Mobility of Residents
Authors: Gigliotti Philip , Martin Erika G.
Published: September 2020

Objective:

To evaluate predictors of stay-at-home order adoption among US states, as well as associations between order enactment and residents' mobility.

Design:

We assess associations between state characteristics and adoption timing. We also assess associations between enactment and aggregate state-level measures of residents' mobility (Google COVID-19 Community Mobility Reports).

Setting:

The United States.

Participants:

Adoption population: 50 US states and District of Columbia. Mobility population: state residents using devices with GPS tracking accessible by Google.

Intervention and Exposures:

State characteristics: COVID-19 diagnoses per capita, 2016 Trump vote share, Republican governor, Medicaid expansion status, hospital beds per capita, public health funding per capita, state and local tax revenue per capita, median household income, population, percent residents 65 years or older, and percent urban residents. Mobility exposure: indicator of order enactment by March 29, 2020 (date of mobility data collection).

Main Outcome Measures:

Order adoption timing: days since adoption of first order. Mobility: changes in mobility to 6 locations from February 6 to March 29, 2020.

Results:

In bivariate models, order adoption was associated with COVID-19 diagnoses (hazard ratio [HR] = 1.01; 95% confidence interval [CI], 1.00 to 1.01), Republican governor (HR = 0.24; 95% CI, 0.13 to 0.44), Medicaid expansion (HR = 2.50; 95% CI, 1.40 to 4.48), and hospital capacity (HR = 0.43; 95% CI, 0.26 to 0.70), consistent with findings in the multivariate models. Order enactment was positively associated with time at home (beta (B) = 1.31; 95% CI, 0.35 to 2.28) and negatively associated with time at retail and recreation (B = −7.17; 95% CI, −10.89 to −3.46) and grocery and pharmacy (B = −8.28; 95% CI, −11.97 to −4.59) locations. Trump vote share was associated with increased mobility for 4 of 6 mobility measures.

Conclusions and Relevance:

While politics influenced order adoption, public health considerations were equally influential. While orders were associated with decreased mobility, political ideology was associated with increased mobility under social distancing policies.