bluuebunny/crossref_metadata_2025 huggingface dataset:
Skin pH varies among bat species and seasons and between wild and captive bats
Authors: Vanderwolf Karen J , Kyle Christopher J , Faure Paul A , McAlpine Donald F , Davy Christina M
Published: November 2021

Skin is a key aspect of the immune system in the defence against pathogens. Skin pH regulates the activity of enzymes produced both by hosts and by microbes on host skin, thus implicating pH in disease susceptibility. Skin pH varies inter- and intra-specifically and is influenced by a variety of intrinsic and extrinsic variables. Increased skin alkalinity is associated with a predisposition to cutaneous infections in humans and dogs, and inter-specific and inter-individual variation in skin pH is implicated in differential susceptibility to some skin diseases. The cutaneous pH of bats has not been characterized but is postulated to play a role in susceptibility to white-nose syndrome (WNS), a fungal infection that has decimated several Nearctic bat species. We used non-invasive probes to measure the pH of bat flight membranes in five species with differing susceptibility to WNS. Skin pH ranged from 4.67 to 8.59 and varied among bat species, geographic locations, body parts, age classes, sexes and seasons. Wild Eptesicus fuscus were consistently more acidic than wild Myotis lucifugus, Myotis leibii and Perimyotis subflavus. Juvenile bats had more acidic skin than adults during maternity season but did not differ during swarming. Male M. lucifugus were more acidic than females during maternity season, yet this trend reversed during swarming. Bat skin was more acidic in summer compared to winter, a pattern also reported in humans. Skin pH was more acidic in captive than wild E. fuscus, suggesting environmental impacts on skin pH. The pH of roosting substrates affects skin pH in captive bats and may partially explain seasonal patterns in wild bats that use different roost types across seasons. Future research on the influence of pH on microbial pathogenic factors and skin barrier function may provide valuable insights on new therapeutic targets for treating bat skin conditions.
American Lyric, American Surveillance, and Claudia Rankine’sCitizen
Authors: Finberg Keegan Cook
Published: November 2021

This essay contends that Claudia Rankine’s Citizen: An American Lyric (2014) invites an overdue conversation between recent scholarship in lyric theory and writing on racial surveillance, including material on bias in artificial intelligence and disciplinary policing strategies. I argue that Citizen manipulates received structures of the lyric as both a racial and a carceral apparatus and compares those structures to contemporary forms of racial surveillance. Through the revelation of similarity in lyric and surveillance structures, Citizen illustrates a method of reading that exploits lyric history and form to suggest a reorientation of surveillance and a way of coping with its effects. I argue that this new American lyric is invested in participating in public life.
Long term trends in natriuretic peptide testing for heart failure in UK primary care: a cohort study
Authors: Roalfe Andrea K , Lay-Flurrie Sarah L , Ordóñez-Mena José M , Goyder Clare R , Jones Nicholas R , Hobbs F D Richard , Taylor Clare J
Published: November 2021

Aims

Heart failure (HF) is a malignant condition with poor outcomes and is often diagnosed on emergency hospital admission. Natriuretic peptide (NP) testing in primary care is recommended in international guidelines to facilitate timely diagnosis. We aimed to report contemporary trends in NP testing and subsequent HF diagnosis rates over time.

Methods and results

Cohort study using linked primary and secondary care data of adult (≥45 years) patients in England 2004–18 (n = 7 212 013, 48% male) to report trends in NP testing (over time, by age, sex, ethnicity, and socioeconomic status) and HF diagnosis rates. NP test rates increased from 0.25 per 1000 person-years [95% confidence interval (CI) 0.23–0.26] in 2004 to 16.88 per 1000 person-years (95% CI 16.73–17.03) in 2018, with a significant upward trend in 2010 following publication of national HF guidance. Women and different ethnic groups had similar test rates, and there was more NP testing in older and more socially deprived groups as expected. The HF detection rate was constant over the study period (around 10%) and the proportion of patients without NP testing prior to diagnosis remained high [99.6% (n = 13 484) in 2004 vs. 76.7% (n = 12 978) in 2017].

Conclusion

NP testing in primary care has increased over time, with no evidence of significant inequalities, but most patients with HF still do not have an NP test recorded prior to diagnosis. More NP testing in primary care may be needed to prevent hospitalization and facilitate HF diagnosis at an earlier, more treatable stage.
Efficacy of a short course of lung ultrasound for primary care physicians in the assessment of COVID-19-positive patients
Authors: Raiteri Alberto , Muratori Luca , Faggiano Chiara , Alvisi Margherita , Serio Ilaria , Piscaglia Fabio
Published: November 2021

Introduction

Lung ultrasound (LUS) has become the first diagnostic imaging approach to assess lung involvement in COVID-19. While LUS proved to be safe, reliable, and accurate, not many primary care physicians (PCP) are capable to employ this instrument in the first evaluation of COVID-19 outpatients. The aim of this study was to determine the effectiveness of a brief training program in LUS for PCP.

Methods

Italian local authorities promoted a training program in LUS for PCP engaged in COVID-19 outpatients’ evaluation. The course took place in a COVID-19 unit and included a hands-on practice on real COVID-19 patients. We conducted a qualitative and quantitative analysis of the results of the training program.

Results

A total of 32 PCP completed the training. About 100% of participants reported an increase in competence and confidence in the use of LUS after the training. Self-reported confidence in detecting major COVID-19 LUS abnormalities was high (B-lines 8/10, pleural abnormalities 6.5/10). B-lines were accurately identified with a reliability of 81%, with a sensitivity of 96%, and a negative predictive value of 98%. Trainees were some less accurate in detecting pleural abnormalities (reliability 63%) but with a high specificity (99%).

Conclusions

This study showed that a short training program, but comprising a hands-on practice, is capable to bring even almost novices to achieve a high overall accuracy and reliability in detecting lung involvement in COVID-19. This may result in a significant improvement of the performances of PCP involved in the first evaluation of COVID-19 cases in primary care facilities.
Building on open economy politics to understand the stalled EU–India trade negotiations
Authors: Curran Louise , Nadvi Khalid , Khorana Sangeeta
Published: November 2021

Global trade governance is increasingly characterized by a growing fragility in multilateral institutions and a preference for bilateral negotiations. The literature on such negotiations focuses primarily on successful agreements. Academic research on unsuccessful or stalled bilateral talks is limited, although better understanding of such outcomes may provide lessons for future negotiations. This article contributes to such understanding by proposing a revised open economy politics (OEP) framework, adapted to ‘second generation’ OEP analysis. Our framework highlights the multidirectional linkages between the trinity of interests, institutions and international interactions within trade negotiations, while adding the role of power and ideas to the analysis. We leverage our revised framework to explore why the European Union–India Free Trade Agreement (EUIFTA) negotiations stalled, thus providing insights as negotiators seek to revive them. Drawing on 45 semi-structured interviews conducted over a seven-year period in the EU and India, we examine what impact these different factors had on the progress of talks. Our results suggest that our revised OEP approach provides a multi-layered and integrated framework which enables us to better understand negotiating outcomes. Furthermore, our findings suggest that the shifting balance between emerging economies and developed economies as a result of the geopolitical (power) shifts and ideational change will affect future trade negotiations.
Rigidity of Compact Fuchsian Manifolds with Convex Boundary
Authors: Prosanov Roman
Published: November 2021

A compact Fuchsian manifold with boundary is a hyperbolic 3-manifold homeomorphic to $S_g \times [0; 1]$ such that the boundary component $S_g \times \{ 0\}$ is geodesic. We prove that a compact Fuchsian manifold with convex boundary is uniquely determined by the induced path metric on $S_g \times \{1\}$. We do not put further restrictions on the boundary except convexity.
An Equivariant Atiyah–Patodi–Singer Index Theorem for Proper Actions I: The Index Formula
Authors: Hochs Peter , Wang Bai-Ling , Wang Hang
Published: November 2021

Consider a proper, isometric action by a unimodular locally compact group $G$ on a Riemannian manifold $M$ with boundary, such that $M/G$ is compact. For an equivariant, elliptic operator $D$ on $M$, and an element $g \in G$, we define a numerical index ${\operatorname {index}}_g(D)$, in terms of a parametrix for $D$ and a trace associated to $g$. We prove an equivariant Atiyah–Patodi–Singer index theorem for this index. We first state general analytic conditions under which this theorem holds, and then show that these conditions are satisfied if $g=e$ is the identity element; if $G$ is a finitely generated, discrete group, and the conjugacy class of $g$ has polynomial growth; and if $G$ is a connected, linear, real semisimple Lie group, and $g$ is a semisimple element. In the classical case, where $M$ is compact and $G$ is trivial, our arguments reduce to a relatively short and simple proof of the original Atiyah–Patodi–Singer index theorem. In part II of this series, we prove that, under certain conditions, ${\operatorname {index}}_g(D)$ can be recovered from a $K$-theoretic index of $D$ via a trace defined by the orbital integral over the conjugacy class of $g$.
Bicarbonate modulates delafloxacin activity against MDRStaphylococcus aureusandPseudomonas aeruginosa
Authors: Holland Mische , Bjanes Elisabet , Nizet Victor , Dillon Nicholas
Published: November 2021

Objectives

To investigate the utility of recently approved delafloxacin and other fluoroquinolones against leading MDR bacterial pathogens under physiologically relevant conditions.

Methods

MIC and MBC assays were conducted for MDR strains of Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae in the standard antibiotic susceptibility testing medium CAMHB, amended Roswell-Park Memorial Institute tissue culture medium (RPMI+) or 20% fresh human whole blood. In vivo correlation of in vitro findings was performed in a murine P. aeruginosa pneumonia model. Mechanistic bases for the findings were explored by altering media conditions and with established fluoroquinolone accumulation assays.

Results

Fluoroquinolone MICs were increased in RPMI+ compared with CAMHB for all four MDR pathogens. Specifically, delafloxacin MICs were increased 32-fold versus MDR S. aureus and 8-fold versus MDR P. aeruginosa. MBC assays in 20% human whole blood and a murine MDR P. aeruginosa pneumonia model both confirmed that delafloxacin activity was reduced under physiological conditions. Bicarbonate (HCO3−), a key component of host physiology found in RPMI+ but absent from CAMHB, dictated delafloxacin susceptibility in CAMHB and RPMI+ by impairing its intracellular accumulation.

Conclusions

Standard in vitro antibiotic susceptibility testing conditions overpredicted the effectiveness of delafloxacin against MDR pathogens by failing to capture the role of the biological buffer HCO3− to impair delafloxacin accumulation. This work showcases limitations of our current antibiotic susceptibility testing paradigm and highlights the importance of understanding host microenvironmental conditions that impact true clinical efficacy.
Comparison of clinical features and outcomes of patients with leiomyosarcoma of bone and soft tissue: a population-based cohort study
Authors: Kobayashi Hiroshi , Zhang Liuzhe , Hirai Toshihide , Tsuda Yusuke , Ikegami Masachika , Tanaka Sakae
Published: November 2021

Background

Leiomyosarcoma commonly occurs in soft tissue but rarely in the bone. Whether leiomyosarcoma of bone and soft tissue have similar clinical characteristics and outcomes remains unknown.

Methods

This retrospective analysis was based on data from the Bone and Soft Tissue Tumor Registry in Japan. Patients with leiomyosarcoma of bone and soft tissue were enrolled. Overall survival and distant metastasis-free survival were estimated using the Kaplan–Meier method, and the Cox regression model was used to identify the prognostic factors.

Results

A total of 888 patients (60 leiomyosarcoma of bone and 828 leiomyosarcoma of soft tissue) were included in the study. Clinical characteristics were similar between the two groups, except for younger age in leiomyosarcoma of bone than in leiomyosarcoma of soft tissue (median 56 years vs. 66 years, P < 0.0001). To evaluate the prognostic factors and efficacy of adjuvant chemotherapy, data of localized and locally curative cases were extracted (total 572: 33 leiomyosarcoma of bone and 539 leiomyosarcoma of soft tissue). The 5-year overall survival rates of leiomyosarcoma of bone and soft tissue patients were similar (63.8% vs. 75.2%, P = 0.43); the 5-year distant metastasis-free survival tended to be worse in leiomyosarcoma of bone than in leiomyosarcoma of soft tissue (37.4% vs. 57.9%, P = 0.28). Larger tumor size (≥5 cm) and older age (≥65 years) correlated with poor overall survival in leiomyosarcoma of soft tissue patients. Adjuvant chemotherapy tended to prolong the overall survival of both leiomyosarcoma of bone (P = 0.11) and leiomyosarcoma of soft tissue patients with tumor size >10 cm (P = 0.06).

Conclusions

The clinical characteristics and outcomes of leiomyosarcoma of bone and soft tissue patients were similar. In localized cases, adjuvant chemotherapy may improve the survival of leiomyosarcoma of bone and soft tissue patients with large-size tumor.
May 3, 2005—An Epiphany
Authors: McQuellon Richard P.
Published: November 2021

Nell describes a very disruptive, boundary-violating visit from a nurse caregiver who interrupted a visit from a dear friend. She had a helpful discussion with the hospice chaplain, who tells her of God’s promise: You will not be alone at the end. It greatly comforts her. Being homebound has increased her sense of isolation and fear that she will die alone. She is managing her physical symptoms (i.e., shortness of breath and pain) as her body deteriorates. The tasks of daily living such as eating and toileting now take much of her time. I want to be useful to her since I have accompanied others on this road and seen bad deaths unfold as the body deteriorates. I want to help Nell avoid a painful death. She begins our conversation by describing the relief she experiences at night in dreams where she does not feel trapped in her bed. I am delighted to hear of her dream travels and to learn that our meetings are a welcome distraction from the fear that accompanies the slow deterioration of her body. I’m pleased that even when the topic is mortality, our conversations can be healing and surprised she describes them as fun.
Epidemiological Principles
Authors: Vaughan J Patrick , Victora Cesar , R Chowdhury A Mushtaque
Published: November 2021

This chapter reviews the basic epidemiological concepts and principles that are relevant for all primary health care workers. It describes patterns of disease frequency in populations and quantifies diseases, disability, and deaths with the use of health indicators. It measures causes and risk factors that influence disease frequency and the use of epidemiology in improving the effectiveness of health interventions in health services and public health programmes. Epidemiology is also essential for local health planning, management, and evaluation of these services at the district level.
Reporting and Surveillance Systems
Authors: Vaughan J Patrick , Victora Cesar , R Chowdhury A Mushtaque
Published: November 2021

Routine health information and surveillance systems collect and report information from the peripheral health facilities to the local district headquarters. Data are collected and recorded when people visit health facilities and later analysed and communicated to the Ministry of Health and other organizations. Data can also be collected using qualitative methods and surveys. District staff should know how to analyse and produce reliable local information. The Ministry of Health or national statistics bureau is usually responsible for collating this information for the whole country. A check list for reporting local health information is included.
Epidemiology and Health Planning
Authors: Vaughan J Patrick , Victora Cesar , R Chowdhury A Mushtaque
Published: November 2021

This chapter focuses on how local health teams can use epidemiology to help plan for health priorities and identify high-risk groups and to tackle inequalities. Using a systems approach epidemiology can help to strengthen primary health care and improve the delivery of district health services and programmes. These need to be delivered so people have high levels of access to high-quality services and programmes that also achieve high levels of population coverage.
ABC of Common Definitions and Terms
Authors: Vaughan J Patrick , Victora Cesar , R Chowdhury A Mushtaque
Published: November 2021

The definitions given in this chapter are valid for this publication but different definitions may be used in other contexts. They are based mainly on A Dictionary of Epidemiology (6th edn), edited for the International Epidemiological Association by Miquel Porta and published by Oxford University Press (2014).
Court
Authors: Smajdor Anna , Herring Jonathan , Wheeler Robert
Published: November 2021

This chapter explains the procedure followed in criminal cases and civil cases. It explores the role of the Crown Prosecution Service in criminal prosecutions. It also considers the important role that expert witnesses can play in civil proceedings and what the expectations are of those who put themselves forward for that role.
Medical research
Authors: Smajdor Anna , Herring Jonathan , Wheeler Robert
Published: November 2021

This chapter discusses the legal and ethical issues related to medical research. It outlines international and national legal regulation. It discusses the important distinction between therapeutic and non-therapeutic research. The importance of consent and the protection of participants is highlighted.
Human Rights Act 1998 (European Convention on Human Rights)
Authors: Smajdor Anna , Herring Jonathan , Wheeler Robert
Published: November 2021

This chapter covers the Human Rights Act 1998 (European Convention on Human Rights) and includes topics on The Right to Protection from Torture, The Right to Life, Prohibition of slavery and forced labour, Right to liberty and security, Right to a Fair Trial, The Right Not to Suffer Punishment without Legal Authorisation, Right to respect for private and family life, The Right to Freedom of Thought, Conscience and Religion, The Right to Freedom of Expression, The Right to Freedom of Assembly and Association, The Right to Marry, and The Right to Protection from Discrimination.
Factors associated with Pneumocystis colonization and circulating genotypes in chronic obstructive pulmonary disease patients with acute exacerbation or at stable state and their homes
Authors: Gantois Nausicaa , Lesaffre Aymerick , Durand-Joly Isabelle , Bautin Nathalie , Le Rouzic Olivier , Nseir Saad , Reboux Gabriel , Scherer Emeline , Aliouat El Moukhtar , Fry Stéphanie , Gosset Philippe , Fréalle Emilie
Published: November 2021

Pneumocystis jirovecii colonization is frequent during chronic obstructive pulmonary disease (COPD) and patients constitute potential contributors to its interhuman circulation. However, the existence of an environmental reservoir cannot be excluded. We assessed the prevalence and factors associated with Pneumocystis colonization during COPD, and studied circulation between patients and their domestic environment. Pneumocystis molecular detection and mtLSU genotyping were performed in oro-pharyngeal washes (OPW) sampled in 58 patients with COPD acute exacerbation, and in indoor dust, sampled in patients’ homes using electrostatic dust collectors (EDCs). Lung and systemic inflammation was assessed. Pneumocystis carriage was evaluated in 28 patients after 18 months at stable state. Pneumocystis was detected in 11/58 OPWs during exacerbation (19.0%). Colonized patients presented a significantly lower body mass index, and higher serum IL-17 and CD62P. One patient presented positive detection of typable isolates in both OPW and EDC, with both isolates harboring mtLSU genotype 3. Pneumocystis genotype 1 was further detected in EDCs from three non-colonized patients and one colonized patient with non-typable isolate. Genotypes 1 and 2 were predominant in clinical isolates (both 42%), with genotype 3 representing 16% of isolates. Pneumocystis was detected in 3/28 patients at stable state (10.7%). These data suggest that Pneumocystis colonization could be facilitated by a lower BMI and be related to acute alteration of lung function during COPD exacerbation. It also suggests Th17 pathway and platelet activation could be involved in the anti-Pneumocystis response during colonization. Last, Pneumocystis detection in EDCs supports its potential persistence in indoor dust.

Lay Summary

Chronic obstructive pulmonary disease patients tend to be more frequently colonized by Pneumocystis during exacerbation (19.0%) than at stable state (10.7%). Factors associated with colonization include lower BMI, higher IL-17, and CD62P. Pneumocystis detection in patients’ dwellings suggests potential persistence in indoor dust.
A black hole detected in the young massive LMC cluster NGC 1850
Authors: Saracino S , Kamann S , Guarcello M G , Usher C , Bastian N , Cabrera-Ziri I , Gieles M , Dreizler S , Da Costa G S , Husser T-O , Hénault-Brunet V
Published: November 2021

We report on the detection of a black hole (NGC 1850 BH1) in the ∼100-Myr-old massive cluster NGC 1850 in the Large Magellanic Cloud. It is in a binary system with a main-sequence turn-off star (4.9 ± 0.4 M⊙), which is starting to fill its Roche lobe and is becoming distorted. Using 17 epochs of Very Large Telescope/Multi-Unit Spectroscopic Explorer observations, we detected radial velocity variations exceeding 300 km s−1 associated with the target star, linked to the ellipsoidal variations measured by the fourth phase of the Optical Gravitational Lensing Experiment in the optical bands. Under the assumption of a semidetached system, the simultaneous modelling of radial velocity and light curves constrains the orbital inclination of the binary to 38° ± 2°, resulting in a true mass of the unseen companion of $11.1_{-2.4}^{+2.1}\,{\rm M}_{\odot }$. This represents the first direct dynamical detection of a black hole in a young massive cluster, opening up the possibility of studying the initial mass function and the early dynamical evolution of such compact objects in high-density environments.
Sphenix: smoothed particle hydrodynamics for the next generation of galaxy formation simulations
Authors: Borrow Josh , Schaller Matthieu , Bower Richard G , Schaye Joop
Published: November 2021

Smoothed particle hydrodynamics (SPH) is a ubiquitous numerical method for solving the fluid equations, and is prized for its conservation properties, natural adaptivity, and simplicity. We introduce the Sphenix SPH scheme, which was designed with three key goals in mind: to work well with sub-grid physics modules that inject energy, be highly computationally efficient (both in terms of compute and memory), and to be Lagrangian. sphenix uses a Density-Energy equation of motion, along with a variable artificial viscosity and conduction, including limiters designed to work with common sub-grid models of galaxy formation. In particular, we present and test a novel limiter that prevents conduction across shocks, preventing spurious radiative losses in feedback events. Sphenix is shown to solve many difficult test problems for traditional SPH, including fluid mixing and vorticity conservation, and it is shown to produce convergent behaviour in all tests where this is appropriate. Crucially, we use the same parameters within sphenix for the various switches throughout, to demonstrate the performance of the scheme as it would be used in production simulations. sphenix is the new default scheme in the swift cosmological simulation code and is available open source.
Turbulent disc viscosity and the bifurcation of planet formation histories
Authors: Speedie Jessica , Pudritz Ralph E , Cridland A J , Meru Farzana , Booth Richard A
Published: November 2021

ALMA observations of dust ring/gap structures in a minority but growing sample of protoplanetary discs can be explained by the presence of planets at large disc radii – yet the origins of these planets remains debated. We perform planet formation simulations using a semi-analytic model of the HL Tau disc to follow the growth and migration of hundreds of planetary embryos initially distributed throughout the disc, assuming either a high or low turbulent α viscosity. We have discovered that there is a bifurcation in the migration history of forming planets as a consequence of varying the disc viscosity. In our high viscosity discs, inward migration prevails and yields compact planetary systems, tempered only by planet trapping at the water iceline around 5 au. In our lower viscosity models however, low mass planets can migrate outward to twice their initial orbital radii, driven by a radially extended region of strong outward-directed corotation torques located near the heat transition (where radiative heating of the disc by the star is comparable to viscous heating) – before eventually migrating inwards. We derive analytic expressions for the planet mass at which the corotation torque dominates, and find that this ‘corotation mass’ scales as Mp, corot ∼ α2/3. If disc winds dominate the corotation torque, the corotation mass scales linearly with wind strength. We propose that the observed bifurcation in disc demographics into a majority of compact dust discs and a minority of extended ring/gap systems is a consequence of a distribution of viscosity across the disc population.
H α-based star formation rates in and around z ∼ 0.5 EDisCS clusters
Authors: Cooper Jennifer R , Rudnick Gregory H , Brammer Gabriel G , Desjardins Tyler , Mann Justin L , Weiner Benjamin J , Aragón-Salamanca Alfonso , De Lucia Gabriella , Desai Vandana , Finn Rose A , Jablonka Pascale , Jaffé Yara L , Moustakas John , Spérone-Longin Damien , Teplitz Harry I , Vulcani Benedetta , Zaritsky Dennis
Published: November 2021

We investigate the role of environment on star formation rates (SFRs) of galaxies at various cosmic densities in well-studied clusters. We present the star-forming main sequence for 163 galaxies in four EDisCS clusters in the range 0.4 < z < 0.7. We use Hubble Space Telescope/Wide Field Camera 3 observations of the H α emission line to span three distinct local environments: the cluster core, infall region, and external field galaxies. The main sequence defined from our observations is consistent with other published H α distributions at similar redshifts but differs from those derived from star formation tracers such as 24 $\, \mu$m. We find that the Hα-derived SFRs for the 67 galaxies with stellar masses greater than the mass-completeness limit of M* > 109.75 M⊙ show little dependence on environment. At face value, the similarities in the SFR distributions in the three environments may indicate that the process of finally shutting down star formation is rapid, however, the depth of our data and size of our sample make it difficult to conclusively test this scenario. Despite having significant H α emission, 21 galaxies are classified as UVJ-quiescent and may represent a demonstration of the quenching of star formation caught in the act.
The formation of the Milky Way halo and its dwarf satellites: A NLTE–1D abundance analysis. V. The Sextans galaxy
Authors: Mashonkina L , Pakhomov Yu V , Sitnova T , Jablonka P , Yakovleva S A , Belyaev A K
Published: November 2021

We present a homogeneous set of accurate atmospheric parameters for a sample of eleven very metal-poor (−3.32 ≤ [Fe/H] ≤−2.61) stars in the Sextans dwarf spheroidal galaxy (dSph) and the non-local thermodynamic equilibrium (NLTE) abundances of, at least, seven chemical elements based on high-resolution UVES/VLT and HDS/Subaru spectra. For each star, its effective temperature and surface gravity were derived from the spectral energy distribution and the known distance, and the Fe abundance was obtained as the average from lines of Fe i and Fe ii. Based on abundances of Mg, Ca, and Ti, we show that all the investigated stars reveal α-enhancements of 0.4 dex to 0.2 dex, and there is a hint of a decline in α/Fe for [Fe/H] >−2.8. The Sextans stars are deficient in Ba. The new result is an extremely tight relation between Ba and Mg, suggesting their common origin in massive stars and Ba synthesis in the r-process events on the time-scales of standard supernovae. The exception is a C-enhanced star S 15-19 which is strongly enhanced in Ba. This star is unlikely to be a CEMP-s star because of low abundances of Sr and Y ([Y/Fe] <−1) that are produced in the s-process as efficiently as Ba and a non-detection of variation in the radial velocity. No distinctions from the Milky Way halo and the Sculptor and Ursa Minor dSphs were found in a history of early enrichment in Na and Ni, namely, the Sextans stars are deficient in Na and have close-to-solar Ni/Fe.
Modelling the water and carbon dioxide production rates of Comet 67P/Churyumov–Gerasimenko
Authors: Davidsson Björn J R , Samarasinha Nalin H , Farnocchia Davide , Gutiérrez Pedro J
Published: November 2021

The European Space Agency Rosetta/Philae mission to Comet 67P/Churyumov–Gerasimenko in 2014–2016 is the most complete and diverse investigation of a comet carried out thus far. Yet, many physical and chemical properties of the comet remain uncertain or unknown, and cometary activity is still not a well-understood phenomenon. We here attempt to place constraints on the nucleus abundances and sublimation front depths of H2O and CO2 ice, and to reconstruct how the nucleus evolved throughout the perihelion passage. We employ the thermophysical modelling code ‘Numerical Icy Minor Body evolUtion Simulator’, or nimbus, to search for conditions under which the observed H2O and CO2 production rates are simultaneously reproduced before and after perihelion. We find that the refractories to water–ice mass ratio of relatively pristine nucleus material is μ ≈ 1, that airfall material has μ ≈ 2, and that the molar abundance of CO2 relative H2O is near 30 per cent. The dust mantle thickness is typically $\lesssim 2\, \mathrm{cm}$. The average CO2 sublimation front depths near aphelion were $\sim 3.8\, \mathrm{m}$ and $\sim 1.9\, \mathrm{m}$ on the northern and southern hemispheres, respectively, but varied substantially with time. We propose that airfall material is subjected to substantial fragmentation and pulverization due to thermal fatigue during the aphelion passage. Sub-surface compaction of material due to CO2 activity near perihelion seems to have reduced the diffusivity in a measurable way.
LncRNA Hmrhl regulates expression of cancer related genes in chronic myelogenous leukemia through chromatin association
Authors: Choudhury Subhendu Roy , Dutta Sangeeta , Bhaduri Utsa , Rao Manchanahalli R Satyanarayana
Published: November 2021

Long non-coding RNA has emerged as a key regulator of myriad gene functions. One such lncRNA mrhl, reported by our group, was found to have important role in spermatogenesis and embryonic development in mouse. Recently, its human homolog, Hmrhl was shown to have differential expression in several type of cancers. In the present study, we further characterize molecular features of Hmrhl and gain insight into its functional role in leukemia by gene silencing and transcriptome-based studies. Results indicate its high expression in CML patient samples as well as in K562 cell line. Silencing experiments suggest role of Hmrhl in cell proliferation, migration & invasion. RNA-seq and ChiRP-seq data analysis further revealed its association with important biological processes, including perturbed expression of crucial TFs and cancer-related genes. Among them ZIC1, PDGRFβ and TP53 were identified as regulatory targets, with high possibility of triplex formation by Hmrhl at their promoter site. Further, overexpression of PDGRFβ in Hmrhl silenced cells resulted in rescue effect of cancer associated cellular phenotypes. In addition, we also found TAL-1 to be a potential regulator of Hmrhl expression in K562 cells. Thus, we hypothesize that Hmrhl lncRNA may play a significant role in the pathobiology of CML.
Clone decomposition based on mutation signatures provides novel insights into mutational processes
Authors: Matsutani Taro , Hamada Michiaki
Published: November 2021

Intra-tumor heterogeneity is a phenomenon in which mutation profiles differ from cell to cell within the same tumor and is observed in almost all tumors. Understanding intra-tumor heterogeneity is essential from the clinical perspective. Numerous methods have been developed to predict this phenomenon based on variant allele frequency. Among the methods, CloneSig models the variant allele frequency and mutation signatures simultaneously and provides an accurate clone decomposition. However, this method has limitations in terms of clone number selection and modeling. We propose SigTracer, a novel hierarchical Bayesian approach for analyzing intra-tumor heterogeneity based on mutation signatures to tackle these issues. We show that SigTracer predicts more reasonable clone decompositions than the existing methods against artificial data that mimic cancer genomes. We applied SigTracer to whole-genome sequences of blood cancer samples. The results were consistent with past findings that single base substitutions caused by a specific signature (previously reported as SBS9) related to the activation-induced cytidine deaminase intensively lie within immunoglobulin-coding regions for chronic lymphocytic leukemia samples. Furthermore, we showed that this signature mutates regions responsible for cell–cell adhesion. Accurate assignments of mutations to signatures by SigTracer can provide novel insights into signature origins and mutational processes.
A Randomized Controlled Trial of the Sources of Meaning Card Method: A New Meaning-Oriented Approach Predicts Depression, Anxiety, Pain Acceptance, and Crisis of Meaning in Patients with Chronic Pain
Authors: Böhmer Miriam C , la Cour Peter , Schnell Tatjana
Published: November 2021

Objective

Although considered the first-line psychological treatment for chronic pain, cognitive behavioral therapy has recently been criticized as being too limited, insufficient, and sometimes ineffective in the treatment of patients with chronic pain. Moreover, important existential perspectives are sparsely or not at all integrated into cognitive behavioral therapy. We therefore propose to complement chronic pain treatment with a meaning-based intervention, the Sources of Meaning Card Method (SoMeCaM). This study tested its efficacy.

Design

A randomized controlled trial was conducted with 42 patients with chronic pain. The trial compared an intervention group (standard care and participation in the SoMeCaM, a meaning-oriented approach) with a control group (standard care). We evaluated both groups at baseline and at 1 (t1) and 2 months (t2) after the intervention. The primary outcome assessed was pain acceptance, while depression, anxiety, pain intensity, pain medication, satisfaction with life, meaningfulness, and crisis of meaning were examined as secondary outcomes.

Results

Comparisons within and between groups showed significant treatment effects at t1. Higher increases in pain acceptance and decreases in anxiety, depression, and crisis of meaning were observed in the intervention group. Improvements in pain acceptance and anxiety persisted until t2, when pain intensity was also lower. Effect sizes at t2 were medium to large.

Conclusion

Our preliminary work demonstrates the importance of the existential perspective in chronic pain therapy.
Correlation Made Simple: Applications to Salience and Regret Theory
Authors: Lanzani Giacomo
Published: November 2021

I offer an axiomatization of risk models where the choices of the decision maker are correlation sensitive. By extending the techniques of conjoint measurement to the nondeterministic case, I show that transitivity is the von Neumann-Morgenstern axiom that has to be relaxed to allow for these richer patterns of behavior. To illustrate the advantages of the modeling choice, we provide a simple axiomatization for the salience theory model in our general framework. This approach leads to clear comparison to popular preexisting models, such as regret and reference dependence, and allows one to single out the ordering property as the feature that brings salience theory outside the prospect theory realm.
The first cave associated genus of Berothidae (Insecta: Neuroptera), and a new interpretation of the subfamily Cyrenoberothinae
Authors: Machado Renato Jose Pires , Martins Caleb Califre , Aspöck Horst , De Miranda Tavares Leon Gustavo , Aspöck Ulrike
Published: November 2021

A new genus of Berothidae (Neuroptera), Speleoberotha gen. nov., with two new species from Brazil, Speleoberotha mineira sp. nov. and Speleoberotha palomae sp. nov., are herein presented. These are the first cave-associated species of Berothidae ever recorded. The new genus shares some characters with the two extant genera of the subfamily Cyrenoberothinae, Cyrenoberotha and Manselliberotha, and other characters are shared with three fossil genera, Microberotha, Protoberotha and Sibelliberotha. This intermediate nature of the new genus was reinforced by the phylogenetic analyses presented here, which recovered Speleoberotha gen. nov. as sister to Sibelliberotha but closely associated with the extant Cyrenoberothinae. In this sense, a new concept of the subfamily Cyrenoberothinae is presented here, now including Speleoberotha gen. nov. and the three fossil genera together with Cyrenoberotha and Manselliberotha. We discuss the biogeographical history of the new concept of Cyrenoberothinae, suggesting that the clade originated in Gondwana. We also provide an identification key for the genera of Cyrenoberothinae.
Postoperative Pain and Opioid Dose Requirements in Patients on Sublingual Buprenorphine
Authors: Komatsu Ryu , Nash Michael , Peperzak Katherin A. , Wu Jiang , Dinges Emily M. , Bollag Laurent A.
Published: November 2021

Objective:

To test the hypothesis that patients who continued buprenorphine postoperatively experience less severe pain and require a smaller dose of opioids than those who discontinued buprenorphine.

Materials and Methods:

This is a retrospective cohort study of surgical patients who were on buprenorphine preoperatively. Using our previous study’s data as pilot data, we selected the covariates to be included in 2 regression models with postoperative time-weighted average pain score and opioid dose requirements in morphine milligram equivalents during 48 hours after surgery as the outcomes. Both contained preoperative daily buprenorphine dose, whether buprenorphine was continued postoperatively, and the preoperative daily dose-by-postoperative continuation interaction as predictors. Precision variables were identified by exhaustive search of perioperative parameters with the exposure variables (preoperative daily dose, postoperative continuation, and their interaction) included in the regression model. The model selected by using the pilot data was estimated again using the new data extracted for this study to make inference about the effect of the 2 exposures (postoperative buprenorphine continuation and preoperative daily buprenorphine dose) and their interaction on the outcomes.

Results:

Continuing buprenorphine was associated with a 1.3-point lower time-weighted average pain score than discontinuing (95% confidence interval, 0.39-2.21; P=0.005) but was not associated with a difference in opioid dose requirements (P=0.48).

Discussion:

Continuing buprenorphine was associated with lower postoperative pain levels than discontinuing. Our results were primarily driven by patients on lower buprenorphine dose as only 22% of patients were on daily doses of 24 mg or above.
Study Groups and POSNA: A Review of Podium Presentations From 2006 to 2020
Authors: Mulvey Hillary E. , Johnson Mitchell A. , Parambath Andrew , Shah Apurva S. , Anari Jason B.
Published: November 2021

Background:

Study groups are multicenter collaborations aimed at improving orthopaedic decision-making through higher-powered, more generalizable studies. New research is disseminated through peer-reviewed literature and academic meetings, including the Pediatric Orthopaedic Society of North America (POSNA) annual meeting, which brings together academic and medical professionals in pediatric orthopaedics. The goal of this study was to identify patterns in podium presentations (PP) at the POSNA annual meeting resulting from multicenter study groups during a 15-year period.

Methods:

A total of 2065 PP from the 2006 to 2020 POSNA annual meetings were identified. The abstracts of each PP were reviewed to determine if they resulted from a multicenter study group and for characteristics including subspecialty focus. PP from 2006 to 2018 were further reviewed for publication in academic journals. Pearson correlation was used to assess change in the number of PP resulting from study groups overtime. Univariate analysis was used to compare characteristics of PP based on study group involvement (significance P<0.05).

Results:

The proportion of PP resulting from study groups increased from 2.2% (n=2) in 2006 to 9.4% in 2020 (n=16) (R
2=0.519, P=0.002). Of the PP resulting from study groups, 52.9% focused on spine, 26.5% on hip, 2.9% on sports, and 2.0% on trauma. This is compared with a distribution of 16.7% (P<0.001) spine, 15.9% (P=0.005) hip, 9.5% (P=0.026) sports, and 14.6% (P<0.001) trauma focus of PP not from study groups. There was no difference in publication rate of PP resulting from study groups compared with those that were not (69.1% vs. 66.2%, P=0.621).

Conclusions:

In the 15-year period from 2006 to 2020, there was a nearly 5-fold increase in the proportion of POSNA PP resulting from study groups. Spine surgery is disproportionately supported by study groups, suggesting that there is an opportunity to establish new study groups across the breadth of pediatric orthopaedics.

Level of Evidence:

Level V.
How Do We Best Educate Our Patients’ Caregivers? Comparing the Efficacy of Print Versus Media-based Education Materials in Peripheral Nerve Catheter and Pain Pump Education
Authors: Parikh Harin B. , Gagliardi Alexia G. , Carry Patrick M. , Albright Jay C. , Mandler Tessa N.
Published: November 2021

Background:

Media-based educational materials (EMs) are becoming prominent. The purpose of this study was to compare print versus media-based EMs given to caregivers of pediatric and young adult patients undergoing surgery. We aimed to see whether print or media-based EMs lead to greater caregiver satisfaction, comfort, and preparedness for outpatient peripheral nerve catheter and pain pump management. We also assessed caregiver preference for EM modality.

Hypothesis:

We hypothesized that media-based EMs would demonstrate greater overall efficacy and thus generate higher caregiver preference.

Study Design:

Randomized control trial.

Methods:

After IRB approval, clinicaltrials.gov registration (17-0638), and informed consent, caregivers were randomized to either media or print-based EM groups. Caregivers reviewed their assigned EM and completed a standardized assessment of their comprehension. We assessed caregiver satisfaction, preparedness, and comfort level with the content on a 5-point Likert scale. On postoperative days 1 to 2, caregivers reported satisfaction, comfort, and preference for EM modality. An intent-to-treat analysis was used to compare the 2 groups.

Results:

From our final cohort of 135 caregivers, we found no difference [P>0.05] in satisfaction, comfort level, level of preparedness, or discharge readiness scores between groups. After the caregivers were given both EMs, they were evenly split in their preference for print (49.6%) versus video (50.4%) based methods.

Conclusions:

We did not detect a significant difference in caregiver preference or feelings of preparedness between groups. Interestingly, a significant proportion of caregivers (25%) did not feel comfortable managing the peripheral nerve catheter and its pain pump at home. Future studies should work to improve caregiver comfort with educational content before patient discharge.

Clinical Relevance:

Providers and institutions should feel comfortable providing both print and media-based patient and caregiver education. Caregiver education may be best suited based on caregiver preference of one EM modality versus the other.

Level of Evidence:

Level I.
Advanced Age Does Not Impact Outcomes After 1-level or 2-level Lateral Lumbar Interbody Fusion
Authors: Wadhwa Harsh , Oquendo Yousi A. , Tigchelaar Seth S. , Warren Shay I. , Koltsov Jayme C.B. , Desai Atman , Veeravagu Anand , Alamin Todd F. , Ratliff John K. , Hu Serena S. , Cheng Ivan
Published: November 2021

Study Design:

This was a retrospective comparative study.

Objective:

The objective of this study was to assess the effect of increased age on perioperative and postoperative complication rates, reoperation rates, and patient-reported pain and disability scores after lateral lumbar interbody fusion (LLIF).

Summary of Background Data:

LLIF was developed to minimize soft tissue trauma and reduce the risk of vascular injury; however, there is little evidence regarding the effect of advanced age on outcomes of LLIF.

Methods:

Patients who underwent LLIF from 2009 to 2019 at one institution with a minimum 6-month follow-up were retrospectively reviewed. Patients less than 18 years old with musculoskeletal tumor or trauma were excluded. The primary outcome was the preoperative to postoperative change in the Numeric Pain Rating Scale (NPRS) for back pain. Operative time, estimated blood loss, length of stay, perioperative and 90-day complications, unplanned readmissions, reoperations, and change in Oswestry Disability Index were also evaluated. Relationships with age were assessed both with age as a continuous variable and segmenting by age below 70 versus 70+.

Results:

In total, 279 patients were included. The median age was 65±13 years and 159 (57%) were female. Age was not related to improvements in back NPRS and Oswestry Disability Index. Operative time, estimated blood loss, length of stay, perioperative and 90-day complications, unplanned readmissions, reoperations, and radiographic fusion rate also were not related to age. After multivariable risk adjustment, increasing age was associated with greater improvements in back NPRS. The decrease in back NPRS was 0.68 (95% confidence interval: 0.14, 1.22; P=0.014) points greater for every 10-year increase in age. Age was not associated with rates of complication, readmission, or reoperation.

Conclusions:

LLIF is a safe and effective procedure in the elderly population. Advanced age is associated with larger improvements in preoperative back pain. Surgeons should consider the benefits of LLIF and other minimally invasive techniques when evaluating elderly candidates for lumbar fusion.

Level of Evidence:

Level III.