bluuebunny/crossref_metadata_2025 huggingface dataset:
Greater Prevalence of Mental Health Conditions in Septic Revision Total Knee Arthroplasty: A Call to Action
Authors: Anis Hiba K. , Warren Jared A. , Klika Alison K. , Navale Suparna M. , Zhou Guangjin , Barsoum Wael K. , Higuera Carlos A. , Piuzzi Nicolas S.
Published: July 2020

The purpose of this study was to compare the prevalence of mental health conditions among patients undergoing (1) primary total knee arthroplasty (pTKA), (2) septic revision total knee arthroplasty (rTKA), and (3) aseptic revision total knee arthroplasty (TKA). The State Inpatient Databases were queried for all TKAs from 2005 to 2014 yielding 563,144 patients. Patients were separated into the following cohorts: primary, septic revision, and aseptic revision. Diagnoses of any mental health condition and the following specific conditions were compared between the three cohorts: schizophrenia/delusion, bipolar disorder, depression/mood disorder, personality disorder, anxiety/somatic/dissociative disorder, eating disorders, attention deficit hyperactivity disorder/conduct/impulse control, alcohol abuse, and drug abuse. Throughout the study period, an increase in the prevalence of mental health conditions was observed in septic and aseptic revision patients. Overall, there was a significantly higher prevalence of mental health conditions in the septic revision cohort (22.7%) compared with the primary (17.8%, p < 0.001) and aseptic revision (20.0%, p < 0.001) cohorts. Specifically, septic revision TKA patients had a higher prevalence of depression (p < 0.001), alcohol abuse (p < 0.001), drug abuse (p < 0.001), schizophrenia (p = 0.0007), and bipolar disorder (p < 0.001), compared with primary TKA patients. Additionally, there was a significantly higher prevalence of depression (p < 0.001), alcohol abuse (p < 0.001), and drug abuse (p < 0.001) among septic revision patients compared with aseptic revision patients. Mental health conditions were significantly higher among septic revision patients. Alcohol and drug abuse were approximately twice as prevalent in septic revision patients compared with primary and aseptic revision patients. These findings should serve as a call to action for mental health support for patients suffering from PJI.
Effect of Isolated Medial Patellofemoral Ligament Reconstruction in Patellofemoral Instability Regardless of Predisposing Factors
Authors: Lee Jae Ik , Jaffar Mohd Shahrul Azuan , Choi Han Gyeol , Kim Tae Woo , Lee Yong Seuk
Published: July 2020

The purpose of this study was to evaluate the outcomes of isolated medial patellofemoral ligament (MPFL) reconstruction, regardless of the presence of predisposing factors. A total of 21 knees that underwent isolated MPFL reconstruction from March 2014 to August 2017 were included in this retrospective series. Radiographs of the series of the knee at flexion angles of 20, 40, and 60 degrees were acquired. The patellar position was evaluated using the patellar tilt angle, sulcus angle, congruence angle (CA), and Caton-Deschamps and Blackburne-Peel ratios. To evaluate the clinical outcome, the preoperative and postoperative International Knee Documentation Committee (IKDC) and Lysholm knee scoring scales were analyzed. To evaluate the postoperative outcomes based on the predisposing factors, the results were separately analyzed for each group. Regarding radiologic outcomes, 20-degree CA was significantly reduced from 10.37 ± 5.96° preoperatively to −0.94 ± 4.11° postoperatively (p = 0.001). In addition, regardless of the predisposing factors, delta values of pre- and postoperation of 20-degree CA were not significantly different in both groups. The IKDC score improved from 53.71 (range: 18–74) preoperatively to 94.71 (range: 86–100) at the last follow-up (p = 0.004), and the Lysholm score improved from 54.28 (range: 10–81) preoperatively to 94.14 (range: 86–100) at the last follow-up (p = 0.010). Isolated MPFL reconstruction provides a safe and effective treatment for patellofemoral instability, even in the presence of mild predisposing factors, such as trochlear dysplasia, increased patella height, increased TT–TG distance, or valgus alignment. This is a Level 4, case series study.
Giant Cell Tumor of Triquetrum: A Case Report with Literature Review
Authors: Ansari Mohammed T. , Digge Vijay K. , Mahmood Asjad
Published: July 2020

Background Giant cell tumor (GCT) of bone is a benign, aggressive tumor of bone and occurs commonly around the knee and distal radius. GCT of bone rarely occurs in hand. In hand, metacarpals are the most common site and there have been only a few case reports of GCT of the carpal bone. In hand, these tumors are very aggressive and these have a high tendency to recur after intralesional curettage. No long-term study is available for choosing an appropriate method of treatment for these tumors in hand.

Case Description Herein, we report a case of GCT of the bone involving triquetrum which was managed by excision of triquetrum and scaphoid bone. The reconstruction of the wrist was done through limited carpal fusion, by doing three corner fusion of the wrist. At 2 years after surgery, the patient was asymptomatic and radiographs revealed fusion of lunocapitate and lunohamate joints with no evidence of recurrence.

Literature review Current literature regarding GCT of triquetrum includes case reports that are reviewed in this report.

Clinical Relevance This case illustrates the successful treatment of GCT of triquetrum, which is a rare tumor. Three-corner fusion is a reliable and reproducible procedure that has been used for other arthritic conditions. The use of three corner fusion procedure can be extended to GCT of carpal bones. It has been a motion-preserving alternative to proximal row carpectomy.
Design of metamaterials permits separate control of currents
Authors: Patrick Chris
Published: July 2020

The design scheme uses concepts from thermodynamics and circuit theory to build metamaterials whose coupled thermal and electric currents can be independently controlled.
Thermoelectric transport control with metamaterial composites
Authors: Shi Wencong , Stedman Troy , Woods Lilia M.
Published: July 2020

The control of thermal and electric currents is important for many devices and applications. Being able to independently direct the two flows under simultaneous thermal and voltage gradients is, however, difficult when coupling via thermoelectric effects is present in the material. Here, we present a general computational scheme for the design of composites whose constituent materials follow a simple circuit theory of in-parallel and in-series connected transport properties capable of enhancing or inhibiting electric and thermal currents in a desired direction. We show that using the geometry of the flow, thermoelectric metamaterials for controlling currents can be designed using individual components. Controlling the thermoelectrically coupled electric and thermal currents in terms of different flow directions can be significantly optimized by exploring the dissimilarity of the transport properties of the different components.
Effective Attenuation Lengths for Different Quantitative Applications of X-ray Photoelectron Spectroscopy
Authors: Jablonski A. , Powell C. J.
Published: July 2020

The effective attenuation length (EAL) is a useful parameter in quantitative applications of x-ray photoelectron spectroscopy (XPS). This parameter is used in place of the inelastic mean free path (IMFP) in expressions for different XPS applications to correct those expressions for elastic scattering of the photoelectrons. We consider expressions used to determine (i) the thickness of an overlayer film on a planar substrate, (ii) the surface composition, (iii) the depth of a thin marker or delta layer, and (iv) the shell thickness of a core–shell nanoparticle. An EAL can be used for each of these applications. In general, the EAL depends on the particular defining equation as well as on the XPS configuration. Many attempts were made in the 1970s and 1980s to measure EALs for the determination of overlayer-film thicknesses, but there were often wide scatters in the reported results due to the difficulty in preparing uniform films with known thicknesses. We have therefore been motivated to calculate EALs for each application. The SRD 82 database from the National Institute of Standards and Technology (NIST) provides EALs for the measurement of overlayer-film thicknesses and of marker-layer depths. These EALs can be determined for photoelectron energies between 50 eV and 2 keV and for user-specified XPS configurations. We review EAL predictive equations for the determination of overlayer-film thicknesses on a planar substrate for XPS with unpolarized x rays and with linearly polarized x rays as well as an EAL predictive equation for quantitative analysis by XPS. These equations are simple analytical expressions that are valid for well-defined ranges of experimental conditions and for useful ranges of electron energies. We also point out that EALs for the determination of overlayer-film thicknesses can be derived from the simulated photoelectron intensities obtained from the NIST Database for the Simulation of Electron Spectra for Surface Analysis (SRD 100). Where possible, we make comparisons of the calculated EALs with illustrative experimental results. A key parameter in the EAL predictive equations is the so-called albedo, a useful measure of the strength of elastic-scattering effects in a material. The albedo is a simple function of the IMFP and the transport mean free path (TRMFP). We provide a tabulation of albedo and TRMFP values in the supplementary material for 41 elemental solids and 42 inorganic compounds for photoelectron energies between 50 eV and 30 keV. For other materials, albedo values can be determined from IMFP and TRMFP data available in the NIST SRD 82 and SRD 100 databases.
Sulfur regulation of boron doping and growth behavior for high-quality diamond in microwave plasma chemical vapor deposition
Authors: Liu D. Y. , Hao L. C. , Chen Z. A. , Zhao W. K. , Shen Y. , Bian Y. , Tang K. , Ye J. D. , Zhu S. M. , Zhang R. , Zheng Y. D. , Gu S. L.
Published: July 2020

In this work, sulfur addition has been employed on the boron-doped diamond growth process, and a significant regulation of the boron doping and the growth behavior has been realized by microwave plasma chemical vapor deposition. It is interesting to find that the sulfur incorporation will lead to an accordant evolution on the boron doping efficiency, hole mobility and concentration, crystal quality, surface morphology, and growth rate. In the presence of sulfur with appropriate dosage, for a boron-to-carbon ratio of only 2.5 ppm in gas phase during growth, a very high doping concentration of 1.2 × 1019 at/cm3 has been achieved, indicative of a very efficient boron doping. Besides, the hole mobility of the sample is 853 cm2/V s at 300 K, which is better than the state of the art for p-type doping in diamond. The regulation mechanism of the sulfur addition will be discussed from the point of view of sulfur-induced plasma change and possible B–S complex formation. This study may provide an effective way for high-quality p-type conductive diamond layer growth and further for the potential diamond-based opto-electronic device applications.
Quantum-enhanced stimulated emission detection for label-free microscopy
Authors: Triginer Garces Gil , Chrzanowski Helen M. , Daryanoosh Shakib , Thiel Valerian , Marchant Anna L. , Patel Raj B. , Humphreys Peter C. , Datta Animesh , Walmsley Ian A.
Published: July 2020

Nonlinear optical microscopy techniques have emerged as a set of successful tools for biological imaging. Stimulated emission microscopy belongs to a small subset of pump–probe techniques, which can image non-fluorescent samples without requiring fluorescent labeling. However, its sensitivity has been shown to be ultimately limited by the quantum fluctuations in the probe beam. We propose and experimentally implement sub-shot-noise limited stimulated emission microscopy by preparing the probe pulse in an intensity-squeezed state. This technique paves the way for imaging delicate biological samples that have no detectable fluorescence with sensitivity beyond standard quantum fluctuations.
Eulerian–Lagrangian simulation of inertial migration of particles in circular Couette flow
Authors: Li Heng , Ku Xiaoke , Lin Jianzhong
Published: July 2020

In this paper, the inertial migration of particles in circular Couette flow is numerically studied. The circular Couette configuration consists of two vertical concentric cylinders with the inner one rotating and the outer one being fixed. An Eulerian–Lagrangian computational fluid dynamics model is adopted, which treats the liquid phase as a continuum and tracks particles in the Lagrangian manner. Drag, lift, pressure gradient, added mass, viscous stress, gravitational, and buoyant forces are all considered for the particles. Inter-particle and particle–wall collisions are resolved by a soft-sphere model, and the lubrication force is also taken into account. The integrated two-phase model is verified by comparing the predicted equilibrium position of neutrally buoyant particles with the experimental data reported in the literature, and good agreement is obtained. Moreover, the effects of the drag model, lubrication force, Reynolds number (Re), and particle-to-fluid density ratio (ρp/ρf) are also investigated. The results show that the particles are more scattered and the equilibrium position is closer to the inner cylinder without the consideration of lubrication force. When Re increases from 60 to 90, the particle equilibrium position moves farther away from the inner cylinder, and the radial distribution of particles generally becomes less concentrated. In addition, as ρp/ρf decreases from 2 to 0.5, the particle equilibrium position moves closer to the inner cylinder, and in the limiting case, bubbles could accumulate preferentially along the inner cylinder in circular Couette flow.
Flapping dynamics of vertically clamped three-dimensional flexible flags in a Poiseuille flow
Authors: Chen Yujia , Ryu Jaeha , Liu Yingzheng , Sung Hyung Jin
Published: July 2020

The flapping dynamics of vertically clamped three-dimensional flags in a Poiseuille flow was studied numerically by using the immersed boundary method. First, the flapping dynamics of a single flag was explored for comparison. Two distinct flow modes were observed: a flapping mode and a deflected mode. In the flapping mode, periodic vortices shed from the flag are formed, leading to alternating upstroke and downstroke flapping motions induced by the hydrodynamic and restoring forces. In the deflected mode, the flag is initially deflected by the hydrodynamic force and reaches a stationary state; the hydrodynamic force is balanced by the restoring force. For tandem flags, when the gap distance is small, the flags behave as one single flag with a higher bending rigidity. When the gap distance is intermediate, the front flag deflects the oncoming flow away from the rear flag. The flapping motion of the front flag is significantly confined by the presence of the rear flag, which results in an attenuation of more than 50% in its flapping amplitude. When the distance is large, the impact of the rear flag on the upstream flow field is negligible, so the front flag exhibits a flapping amplitude and frequency that are similar to those of a single flag. The vortices shed from the front flag induce the formation downstream of a low pressure region, which results in active flapping in the rear flag with a strong amplitude. There are two vortices shed from the tandem flags in each flapping period. When they are far apart, the phase difference is linearly dependent on the gap distance.
Direct observation of multiple magnetic transitions in the La3NiGe2-type compounds
Authors: Zuo Shulan , Liu Jun , Qiao Kaiming , Zheng Xinqi , Zhang Ying , Zhao Tongyun , Hu Fengxia , Sun Jirong , Jiang Chengbao , Shen Baogen
Published: July 2020

By using Lorentz transmission electron microscopy, we show the real-space observation of magnetic domain structures in orthorhombic polycrystalline (Tb1−xGdx)3NiSi2 (x = 0, 0.4) compounds. The significant changes in magnetic domains related to multiple magnetic transitions were identified. A spin reorientation transition was further studied and a type of magnetic domain structure with two mutually perpendicular domain walls was observed, where the magnetic vortices and antivortices appeared as an array. This magnetic domain pattern evolves with temperature, which corresponds well to the spin reorientation transition and is related to the change in ferromagnetic and noncollinear magnetic components.
Coding metalens with helical-structured units for acoustic focusing and splitting
Authors: Li Weibai , Meng Fei , Huang Xiaodong
Published: July 2020

In this work, a helical structure with three spiral channels is employed to build the coding units of metalenses, which can provide high transmission efficiency with an arbitrary phase shift compared to air. The helical unit with the phase shift of π is used as logical unit 1, and the hollow tube filled with air is regarded as logical unit 0. By arranging these logical units in specific sequences, acoustic metalenses can achieve wave-field manipulation like acoustic focusing and splitting. The focusing efficiency as high as 41.5% is achieved. Meanwhile, the genetic algorithm is applied to seek the optimal arrangement of the bipartite units for 3D sound focusing. Simulations and experiments are conducted to demonstrate the proposed coding metalenses for molding the acoustic wave field in the desired manners.
Local flow at plate edge during water entry
Authors: Sun Shi-Yan , Wu G. X.
Published: July 2020

The local flow near the edge of a horizontal plate impacting a flat liquid surface is investigated through velocity potential flow theory. The inner solution is matched with the outer solution. The far field of the inner solution is assumed to be far away from the other edge of the plate, and thus, its effect can be neglected. The effects of surface tension, viscous friction, and gravity are accounted for in the fully nonlinear dynamic boundary condition on the free surface. When one of these effects is dominant and the other two can be ignored, it is then possible to use self-similar variables to describe the local flow if the entry speed varies with time in a corresponding manner. Detailed results for various self-similar solutions are provided, and the relative importance of the Weber number, Reynolds number, and Froude number is investigated. Simulations are also undertaken for general non-similar flow, and the comparison with the experimental data is also made.
Build me up to break me down: frothed spawn in the sandpaper frog, Lechriodus fletcheri, is formed by female parents and later broken down by their offspring
Authors: Gould John
Published: July 2020

Several genera of anuran amphibians deposit their eggs within mucous secretions that have been aerated by the parents to produce a foam or bubble spawn body. This is a dynamic medium for embryo development given that it gradually breaks down over time, and one that has been hypothesised to serve a variety of purposes including protecting embryos from external stresses, such as suboptimal temperatures, desiccation and predation. In this study, I provide additional details of bubble spawn production in the sandpaper frog, Lechriodus fletcheri. Field and laboratory observations showed that females aerate spawn while in inguinal amplexus, using flanged fingers to transport air bubbles into the mucous. While the frothed spawn is initially resistant to breakdown, it gradually loses bubbles and flattens out into a film. This temporal shift in structure is likely to be adaptive, as the resultant increase in surface area allows embryos to come in direct contact with the open water, which may accommodate their increased oxygen demands or ease extrication from the mass. I provide evidence that this process is controlled by the residing embryos, given that spawn in the absence of embryos does not break down, highlighting the ability of offspring to modify their immediate environment even before hatching occurs to ensure conditions remain suitable for their changing needs.
The sealing properties of magnetorheological fluids under quasi-static tensile
Authors: Zheng Ji-Nan , Li Yu-Zheng , Chen Chen , Chen Shu-Mei
Published: July 2020

In order to study the influences of sealing gap on the seal of magnetorheological fluids (MRF), the quasi-static tensile tests along the direction of magnetic field have been carried out by using a commercial plate-plate rheometer. Based on the experimental results, the relationships among the height of sealing gap, magnetic field intensity, particle concentration and the sealing properties of MRF are discussed. The analysis results show that the sealing performances of MRF will deteriorate with the increase of sealing gap, especially when the MRF is exposed to a strong magnetic field. This is probably due to the fact that the material properties of MRF become more similar to the solid with the rise of magnetic field, which makes the sealing layer more brittle and prone to leakage. The tensile process in low magnetic field can be divided into the forming of seal region, stable seal, leak and balanced-pressure four stages, in which the stable seal stage shows that the MRF has certain self-healing ability of seal. Furthermore, both the initial compressive strength and the sealing stability of MRF can be significantly improved by increasing the volume fraction of MRF. Finally, a theoretical model for calculating the burst pressure of MRF seal is proposed according to the theory of magnetic dipole. The description of the relationship between various influencing factors and the sealing characteristics of MRF by this model is consistent with the experimental results, which indicates that the model has favorable instructing value in the practical engineering application.
Character Adaptations: Recurrence and Return
Authors: Strong Jeremy
Published: July 2020

This paper examines recurring character storytelling as the most prodigiously successful tradition in fiction of the last two hundred years. James Fenimore Cooper’s Leatherstocking Tales and Honoré de Balzac’s La Comédie humaine are proposed as significant precursors that embody two dominant trends within recurring character storytelling: the central protagonist series and the populous storyworld. The foundations of recurring character storytelling are traced in a range of determinants including: increasing literacy and the rise of popular genres; modes of serial publication; and the development and enforcement of copyright law. Finally, focusing upon the central protagonist variant, the age and aging of recurring characters are discussed as a necessary consideration for the makers and adapters of such series. Several are analysed, including James Bond, Sharpe, the Morse franchise, and Midsomer Murders, to illuminate how makers handle chronology, the passage of time, and related issues in adaptation. As part of an assessment of the ‘affordances’ of recurring character fictions, nostalgia and familiarity are discussed as significant dimensions of the experience they furnish.
Review of 189 Consecutive Female Genital Skin and Mucosal Biopsies Submitted to an Academic Dermatopathology Practice
Authors: Joehlin-Price Amy S , Mully Thaddeus W
Published: July 2020

Objectives

To describe consecutive vulvar biopsy cases and to create an educational template for pathology trainees and practicing pathologists.

Methods

We reviewed 189 consecutive biopsies from the female genital area skin and mucosa. We classified them based on etiologies and examined limited clinical information.

Results

We classified diagnoses as squamous intraepithelial neoplasia (21.5%), melanocytic neoplasia (17.9%), lichenoid dermatoses (15.9%), nonlichenoid dermatoses (11.3%), infectious (6.2%), reparative (4.6%), or miscellaneous (22.6%). The miscellaneous diagnoses included common entities (polyps and cysts) and rarer entities (calcinosis cutis, adnexal neoplasms, or basal cell carcinoma) and nonspecific descriptive diagnoses. Clinicians most often included the actual diagnosis in their differential for melanocytic lesions (83%) and least often for inflammatory lesions (32%). However, some cases included a clinical description without a differential diagnosis (14%) or no helpful clinical information (4%). The distribution of whether correct diagnoses were included in the clinical differential was similar between submitting physicians and midlevel providers.

Conclusions

Understanding squamous and melanocytic pathology and the various lichenoid and other inflammatory diagnoses is critical for signing out female genital tract skin pathology. The cases examined in this report can serve as an educational template for trainees and practicing pathologists.
NCBI Taxonomy: a comprehensive update on curation, resources and tools
Authors: Schoch Conrad L , Ciufo Stacy , Domrachev Mikhail , Hotton Carol L , Kannan Sivakumar , Khovanskaya Rogneda , Leipe Detlef , Mcveigh Richard , O’Neill Kathleen , Robbertse Barbara , Sharma Shobha , Soussov Vladimir , Sullivan John P , Sun Lu , Turner Seán , Karsch-Mizrachi Ilene
Published: July 2020

The National Center for Biotechnology Information (NCBI) Taxonomy includes organism names and classifications for every sequence in the nucleotide and protein sequence databases of the International Nucleotide Sequence Database Collaboration. Since the last review of this resource in 2012, it has undergone several improvements. Most notable is the shift from a single SQL database to a series of linked databases tied to a framework of data called NameBank. This means that relations among data elements can be adjusted in more detail, resulting in expanded annotation of synonyms, the ability to flag names with specific nomenclatural properties, enhanced tracking of publications tied to names and improved annotation of scientific authorities and types. Additionally, practices utilized by NCBI Taxonomy curators specific to major taxonomic groups are described, terms peculiar to NCBI Taxonomy are explained, external resources are acknowledged and updates to tools and other resources are documented.

Database URL: https://www.ncbi.nlm.nih.gov/taxonomy
Long-term experience with the one-and-a-half ventricle repair for simple and complex congenital heart defects
Authors: Cabrelle Giulio , Castaldi Biagio , Vedovelli Luca , Gregori Dario , Vida Vladimiro L , Padalino Massimo A
Published: July 2020

OBJECTIVES

The one-and-a-half ventricle repair (1.5VR) is a surgical alternative to Fontan circulation or high-risk biventricular repair in patients with complex congenital heart disease (CHD) with a hypoplastic right ventricle (RV). We report our 25 years of experience to evaluate whether the degree of anatomical complexity of the CHD can affect long-term outcomes.

METHODS

This is a retrospective study including patients undergoing 1.5VR between 1994 and 2018. Clinical records and operative reports were reviewed. Follow-up data were collected from all survivors at the last evaluation or by phone contact.

RESULTS

Twenty-nine patients underwent 1.5VR [median age: 3.5 years, interquartile range (IQR) 0.8–7.8]. Fifteen patients had ‘simple’ (i.e. confined to right heart lesions) anatomical characteristics (48.3%); the median tricuspid valve annulus z-score was −3.5 (IQR −6.2 to +3.6). There were no operative deaths. The median hospital stay was 21 days (IQR 10–33), with postoperative complications in 21 patients (75.8%). At a median follow-up of 13.2 years (IQR 3.2–25.6 years; completeness 96.6%), there were 3 late deaths. There was no significant difference in survival and in freedom from adverse events between simple and complex anatomy groups. However, stress test findings showed a tendency towards a higher maximum oxygen uptake in the simple group (P = 0.055).

CONCLUSIONS

The 1.5VR strategy is an effective low-risk surgical option for patients with CHD with hypoplastic RV. When it is planned from birth, late outcomes can be satisfactory. In our experience, the presence of associated major cardiac anomalies was not associated with either worse early or long-term outcomes and functional status.
Molecular tumor classification using DNA methylome analysis
Authors: Sill Martin , Plass Christoph , Pfister Stefan M , Lipka Daniel B
Published: July 2020

Tumor classifiers based on molecular patterns promise to define and reliably classify tumor entities. The high tissue- and cell type-specificity of DNA methylation, as well as its high stability, makes DNA methylation an ideal choice for the development of tumor classifiers. Herein, we review existing tumor classifiers using DNA methylome analysis and will provide an overview on their emerging impact on cancer classification, the detection of novel cancer subentities and patient stratification with a focus on brain tumors, sarcomas and hematopoietic malignancies. Furthermore, we provide an outlook on the enormous potential of DNA methylome analysis to complement classical histopathological and genetic diagnostics, including the emerging field of epigenomic analysis in liquid biopsies.
Identifying psychiatric diagnostic errors with the Safer Dx Instrument
Authors: Fletcher Terri L , Helm Ashley , Vaghani Viralkumar , Kunik Mark E , Stanley Melinda A , Singh Hardeep
Published: July 2020

Objective

Diagnostic errors in psychiatry are understudied partly because they are difficult to measure. The current study aimed to adapt and test the Safer Dx Instrument, a structured tool to review electronic health records (EHR) for errors in medical diagnoses, to evaluate errors in anxiety diagnoses to improve measurement of psychiatric diagnostic errors.

Design

The iterative adaptation process included a review of the revised Safer Dx-Mental Health Instrument by mental health providers to ensure content and face validity and review by a psychometrician to ensure methodologic validity and pilot testing of the revised instrument.

Settings

None.

Participants

Pilot testing was conducted on 128 records of patients diagnosed with anxiety in integrated primary care mental health clinics. Cases with anxiety diagnoses documented in progress notes but not included as a diagnosis for the encounter (n = 25) were excluded.

Intervention(s)

None.

Main Outcome Measure(s)

None.

Results

Of 103 records meeting the inclusion criteria, 62 likely involved a diagnostic error (42 from use of unspecified anxiety diagnosis when a specific anxiety diagnosis was warranted; 20 from use of unspecified anxiety diagnosis when anxiety symptoms were either undocumented or documented but not severe enough to warrant diagnosis). Reviewer agreement on presence/absence of errors was 88% (κ = 0.71).

Conclusion

The revised Safer Dx-Mental Health Instrument has a high reliability for detecting anxiety-related diagnostic errors and deserves testing in additional psychiatric populations and clinical settings.
Evaluation of standardized automated rapid antimicrobial susceptibility testing of Enterobacterales-containing blood cultures: a proof-of-principle study
Authors: Mancini Stefano , Bodendoerfer Elias , Kolensnik-Goldmann Natalia , Herren Sebastian , Röthlin Kim , Courvalin Patrice , Böttger Erik C
Published: July 2020

Background

Rapid antimicrobial susceptibility testing (RAST) of bacteria causing bloodstream infections is critical for implementation of appropriate antibiotic regimens.

Objectives

We have established a procedure to prepare standardized bacterial inocula for Enterobacterales-containing clinical blood cultures and assessed antimicrobial susceptibility testing (AST) data generated with the WASPLabTM automated reading system.

Methods

A total of 258 blood cultures containing Enterobacterales were examined. Bacteria were enumerated by flow cytometry using the UF-4000 system and adjusted to an inoculum of 106 cfu/mL. Disc diffusion plates were automatically streaked, incubated for 6, 8 and 18 h and imaged using the fully automated WASPLabTM system. Growth inhibition zones were compared with those obtained with inocula prepared from primary subcultures following the EUCAST standard method. Due to time-dependent variations of the inhibition zone diameters, early AST readings were interpreted using time-adjusted tentative breakpoints and areas of technical uncertainty.

Results and conclusions

Inhibition zones obtained after 18 h incubation using an inoculum of 106 cfu/mL prepared directly from blood cultures were highly concordant with those of the EUCAST standard method based on primary subcultures, with categorical agreement (CA) of 95.8%. After 6 and 8 h incubation, 89.5% and 93.0% of the isolates produced interpretable results, respectively, with CA of >98.5% and very low numbers of clinical categorization errors for both the 6 h and 8 h readings. Overall, with the standardized and automated RAST method, consistent AST data from blood cultures containing Enterobacterales can be generated after 6–8 h of incubation and subsequently confirmed by standard reading of the same plate after 18 h.
Present status of support for adolescent and young adult cancer patients in member hospitals of Japanese Association of Clinical Cancer Centers
Authors: Nakayama Hideki , Toh Yasushi , Fujishita Manami , Nakagama Hitoshi
Published: July 2020

Background

the proportion of adolescent and young adult cancer patients is relatively small, but they require age-specific support. We conducted a survey on the present status of support for adolescent and young adult cancer patients in the Japanese Association of Clinical Cancer Centers.

Methods

in December 2018, the primary questionnaires were sent to 32 hospitals of Japanese Association of Clinical Cancer Centers regarding support for adolescent and young adult cancer patients. Secondary questionnaires were sent to doctors, nurses and medical social workers in 24 hospitals for the implementation rates of information provision and consultation on 17 unmet needs identified in the study by the Ministry of Health, Labour and Welfare, Japan.

Results

there were marked differences in support for adolescent and young adult cancer patients among hospitals. Only one hospital facilitated an adolescent and young adult department and ward. Thirteen hospitals cooperated with the paediatric cancer designated hospitals. A learning support for high school-aged patients was provided in 15 hospitals. Adolescent and young adult support teams were active in seven hospitals and staff training sessions were held in eight hospitals. Many hospitals had referrals for fertility preservation. The rates of information provision and consultation for more than 70% of adolescent and young adult patients showed statistically significant differences among the medical professions in most of the 17 items.

Conclusions

support systems and activities for adolescent and young adult cancer patients vary extremely across hospitals. Information provision and consultation for unmet needs are still insufficient. Therefore, sharing information and experiences is required to enhance the support for adolescent and young adult cancer patients.
Comparison of Acellular Solutions for Ex-situ Perfusion of Amputated Limbs
Authors: Haug Valentin , Kollar Branislav , Endo Yori , Kadakia Nikita , Veeramani Anamika , Kauke Martin , Tchiloemba Bianief , Klasek Robin , Pomahac Bohdan
Published: July 2020

Introduction

Hypothermic ex-situ machine perfusion (MP) has been shown to be a promising alternative to static cold storage (SCS) for preservation of solid organs for transplantation and vascularized composite allotransplantation. Perfusion with blood-based perfusion solutions in austere environments is problematic due to their need for appropriate storage and short shelf life, making it impractical for military and emergency use. Acellular perfusion has been shown to be effective, but the ideal perfusate solution for MP of amputated limbs is yet to be determined. The purpose of this study is to evaluate the efficacy of alternative perfusate solutions, such as dextran-enriched Phoxilium, Steen, and Phoxilium in ex-vivo hypothermic MP of amputated limbs in a porcine model.

Materials and methods

Amputated forelimbs from Yorkshire pigs (n = 8) were preserved either in SCS (n = 2) at 4°C for 12 hours or machine-perfused at 10°C for 12 hours with oxygenated perfusion solutions (n = 6) at a constant flow rate. The perfusates used include modified Steen-solution, Phoxilium (PHOX), or Phoxilium enriched with dextran-40 (PHODEX). The perfusate was exchanged after 1 and 6 hours of perfusion. Machine data were recorded continuously. Perfusate samples for clinical chemistry, blood gas analysis, and muscle biopsies were procured at specific timepoints and subsequently analyzed. In this semi in-vivo study, limb replantation has not been performed.

Results

After amputation, every limb was successfully transferred and connected to our perfusion device. The mean total ischemia time was 77.5 ± 5.24 minutes. The temperature of the perfusion solution was maintained at 10.18 ± 2.01°C, and perfusion pressure at 24.48 ± 10.72 mmHg. Limb weight increased by 3% in the SCS group, 36% in the PHODEX group, 25% in the Steen group, and 58% in the PHOX group after 12 hours. This increase was significant in the PHOX group compared with the SCS group. All perfusion groups showed a pressure increase of 10.99 mmHg over time due to edema. The levels of HIF-1a decreased over time in all groups except the Steen and the PHODEX group. The biomarkers of muscle injury in the perfusate samples, such as creatine kinase and lactate-dehydrogenase, showed a significant difference between groups, with highest values in the PHODEX group. No significant differences were found in the results of the blood gas analysis.

Conclusion

With the exception of significantly higher levels of creatine kinase and lactate dehydrogenase, MP with dextran-enriched Phoxilium provides similar results as that of the commercially available perfusates such as Steen, without the need for cold storage, and at circa 5% of the cost of the Steen solution. Further large-scale replantation studies are necessary to evaluate the efficacy of dextran-enriched Phoxilium as an alternate perfusate solution.
One-point probability distribution function from spherical collapse: early dark energy versus ΛCDM
Authors: Mandal Ankush , Nadkarni-Ghosh Sharvari
Published: July 2020

We compute the one-point probability distribution function (PDF) of an initially Gaussian dark matter density field using spherical collapse (SC). We compare the results to other forms available in the literature and also compare the PDFs in the Λ-cold dark matter model with an early dark energy (EDE) model. We find that the skewed lognormal distribution provides the best fit to the non-linear PDF from SC for both cosmologies, from a = 0.1 to 1 and for scales characterized by the comoving width of the Gaussian: σG = 0.5, 1, and 2. To elucidate the effect of cosmology, we examine the linear and non-linear growth rates through test cases. For overdensities, when the two models have the same initial density contrast, the differences due to cosmology are amplified in the non-linear regime, whereas, if the two models have the same linear density contrast today, then the differences in cosmology are damped in the non-linear regime. This behaviour is in contrast with voids, where the non-linear growth becomes ‘self-regulatory’ and is less sensitive to cosmology and initial conditions. To compare the PDFs, we examine the difference of the PDFs and evolution of the width of the PDF. The trends with scale and redshift are as expected. A tertiary aim of this paper was to check if the fitting form for the non-linear density–velocity divergence relation, derived for constant equation of state (w) models by Nadkarni-Ghosh holds for the EDE model. We find that it does with an accuracy of 4 per cent, thus increasing its range of validity.
The dichotomy of atmospheric escape in AU Mic b
Authors: Carolan S , Vidotto A A , Plavchan P , Villarreal D’Angelo C , Hazra G
Published: July 2020

Here, we study the dichotomy of the escaping atmosphere of the newly discovered close-in exoplanet AU Microscopii (AU Mic) b. On one hand, the high extreme-ultraviolet stellar flux is expected to cause a strong atmospheric escape in AU Mic b. On the other hand, the wind of this young star is believed to be very strong, which could reduce or even inhibit the planet’s atmospheric escape. AU Mic is thought to have a wind mass-loss rate that is up to 1000 times larger than the solar wind mass-loss rate ($\dot{\mathrm{ M}}_\odot$). To investigate this dichotomy, we perform 3D hydrodynamics simulations of the stellar wind–planetary atmosphere interactions in the AU Mic system and predict the synthetic Ly α transits of AU Mic b. We systematically vary the stellar wind mass-loss rate from a ‘no wind’ scenario to up to a stellar wind with a mass-loss rate of $1000~\dot{\mathrm{ M}}_\odot$. We find that, as the stellar wind becomes stronger, the planetary evaporation rate decreases from 6.5 × 1010  g s−1 to half this value. With a stronger stellar wind, the atmosphere is forced to occupy a smaller volume, affecting transit signatures. Our predicted Ly α absorption drops from $\sim 20{{\ \rm per\ cent}}$ in the case of ‘no wind’ to barely any Ly α absorption in the extreme stellar wind scenario. Future Ly α transits could therefore place constraints not only on the evaporation rate of AU Mic b, but also on the mass-loss rate of its host star.
Quantitative, super-resolution localization of small RNAs with sRNA-PAINT
Authors: Huang Kun , Demirci Feray , Batish Mona , Treible Wayne , Meyers Blake C , Caplan Jeffrey L
Published: July 2020

Small RNAs are non-coding RNAs that play important roles in the lives of both animals and plants. They are 21- to 24-nt in length and ∼10 nm in size. Their small size and high diversity have made it challenging to develop detection methods that have sufficient resolution and specificity to multiplex and quantify. We created a method, sRNA-PAINT, for the detection of small RNAs with 20 nm resolution by combining the super-resolution method, DNA-based points accumulation in nanoscale topography (DNA-PAINT), and the specificity of locked nucleic acid (LNA) probes for the in situ detection of multiple small RNAs. The method relies on designing probes to target small RNAs that combine DNA oligonucleotides (oligos) for PAINT with LNA-containing oligos for hybridization; therefore, we developed an online tool called ‘Vetting & Analysis of RNA for in situ Hybridization probes’ (VARNISH) for probe design. Our method utilizes advances in DNA-PAINT methodologies, including qPAINT for quantification, and Exchange-PAINT for multiplexing. We demonstrated these capabilities of sRNA-PAINT by detecting and quantifying small RNAs in different cell layers of early developmental stage maize anthers that are important for male sexual reproduction.
CODEL: phase III study of RT, RT + TMZ, or TMZ for newly diagnosed 1p/19q codeleted oligodendroglioma. Analysis from the initial study design
Authors: Jaeckle Kurt A , Ballman Karla V , van den Bent Martin , Giannini Caterina , Galanis Evanthia , Brown Paul D , Jenkins Robert B , Cairncross J Gregory , Wick Wolfgang , Weller Michael , Aldape Kenneth D , Dixon Jesse G , Anderson S Keith , Cerhan Jane H , Wefel Jeffrey S , Klein Martin , Grossman Stuart A , Schiff David , Raizer Jeffrey J , Dhermain Frederick , Nordstrom Donald G , Flynn Patrick J , Vogelbaum Michael A
Published: July 2020

Background

We report the analysis involving patients treated on the initial CODEL design.

Methods

Adults (>18) with newly diagnosed 1p/19q World Health Organization (WHO) grade III oligodendroglioma were randomized to radiotherapy (RT; 5940 centigray ) alone (arm A); RT with concomitant and adjuvant temozolomide (TMZ) (arm B); or TMZ alone (arm C). Primary endpoint was overall survival (OS), arm A versus B. Secondary comparisons were performed for OS and progression-free survival (PFS), comparing pooled RT arms versus TMZ-alone arm.

Results

Thirty-six patients were randomized equally. At median follow-up of 7.5 years, 83.3% (10/12) TMZ-alone patients progressed, versus 37.5% (9/24) on the RT arms. PFS was significantly shorter in TMZ-alone patients compared with RT patients (hazard ratio [HR] = 3.12; 95% CI: 1.26, 7.69; P = 0.014). Death from disease progression occurred in 3/12 (25%) of TMZ-alone patients and 4/24 (16.7%) on the RT arms. OS did not statistically differ between arms (comparison underpowered). After adjustment for isocitrate dehydrogenase (IDH) status (mutated/wildtype) in a Cox regression model utilizing IDH and RT treatment status as covariables (arm C vs pooled arms A + B), PFS remained shorter for patients not receiving RT (HR = 3.33; 95% CI: 1.31, 8.45; P = 0.011), but not OS ((HR = 2.78; 95% CI: 0.58, 13.22, P = 0.20). Grade 3+ adverse events occurred in 25%, 42%, and 33% of patients (arms A, B, and C). There were no differences between arms in neurocognitive decline comparing baseline to 3 months.

Conclusions

TMZ-alone patients experienced significantly shorter PFS than patients treated on the RT arms. The ongoing CODEL trial has been redesigned to compare RT + PCV versus RT + TMZ.
Improved catalytic activity and stability of cellobiohydrolase (Cel6A) from the Aspergillus fumigatus by rational design
Authors: Dodda Subba Reddy , Sarkar Nibedita , Jain Piyush , Aikat Kaustav , Mukhopadhyay Sudit S
Published: July 2020

Cheap production of glucose is the current challenge for the production of cheap bioethanol. Ideal protein engineering approaches are required for improving the efficiency of the members of the cellulase, the enzyme complex involved in the saccharification process of cellulose. An attempt was made to improve the efficiency of the cellobiohydrolase (Cel6A), the important member of the cellulase isolated from Aspergillus fumigatus (AfCel6A). Structure-based variants of AfCel6A were designed. Amino acids surrounding the catalytic site and conserved residues in the cellulose-binding domain were targeted (N449V, N168G, Y50W and W24YW32Y). I mutant 3 server was used to identify the potential variants based on the free energy values (∆∆G). In silico structural analyses and molecular dynamics simulations evaluated the potentiality of the variants for increasing thermostability and catalytic activity of Cel6A. Further enzyme studies with purified protein identified the N449V is highly thermo stable (60°C) and pH tolerant (pH 5–7). Kinetic studies with Avicel determined that substrate affinity of N449V (Km =0.90 ± 0.02) is higher than the wild type (1.17 ± 0.04) and the catalytic efficiency (Kcat/Km) of N449V is ~2-fold higher than wild type. All these results suggested that our strategy for the development of recombinant enzyme is a right approach for protein engineering.
Does Option Trading Have a Pervasive Impact on Underlying Stock Prices?
Authors: Ni Sophie X , Pearson Neil D , Poteshman Allen M , White Joshua
Published: July 2020

The question of whether and to what extent option trading affects underlying stock prices has been of interest to researchers since exchange-based options trading began in 1973. Recent research presents evidence of an informational channel through which option trading affects stock prices by showing that option market makers’ stock trades to hedge new options positions cause the information reflected in option trading to be impounded into underlying equity prices. This paper provides evidence of a noninformational channel through which option market maker hedge rebalancing affects stock return volatility and the probability of large stock price moves.