bluuebunny/crossref_metadata_2025 huggingface dataset:
Interpreters’ perceived characteristics and perception of quality in interpreting
Authors: Cheung Andrew K. F.
Published: April 2020

This study examined the link between listeners’ perceptions of the quality of interpretation and their beliefs about the interpreter. Two groups of Mandarin-speaking participants were shown a video of a speech by President Obama being interpreted into Mandarin Chinese by a non-native Mandarin-speaking interpreter. The participants in one group were shown a photo of a Chinese-looking man alongside the video and those in the other group were shown a photo of a non-Chinese-looking man. The quantitative results showed that those who believed they were listening to a non-Chinese interpreter judged the interpretation more positively than those who believed they were listening to a Chinese interpreter. The qualitative results showed that the participants in the non-Chinese condition attributed the non-native features of the interpretation to the interpreter’s being a foreigner, and that they naturally used the language competence of non-native speakers as the standard of comparison. In this case, the participants’ perceptions of quality could also be explained by the interpreter’s perceived association with a highly esteemed group in China, and his ability to interpret into Chinese generated a sense of national self-esteem among the participants. Overall, the findings show that factors other than the features identifiable in an interpretation can influence the perception of quality of interpretation.
Language variation in university classrooms
Authors: Csomay Eniko , Wu Siew Mei
Published: April 2020

Corpus-based university classroom discourse studies found differences in teaching as it relates to language use: discourse organization, levels of instruction and interactivity, and disciplinary differences in participant talk. These practices were primarily reported on US-based classrooms, while scholars with different foci looked at British university classrooms as well. However, a comparison of how discourse is organized in university classrooms in varying geographical contexts is still missing. The present study provides lexico-grammatical analyses of classroom discourse at a South-East Asian university as associations are made to the communicative and pedagogical functions in the discourse structure of lectures, and comparisons are made to a corpus of university classroom discourse from the US. Findings show differences in language use and associated discourse organizational patterns within three disciplinary areas (Humanities, Natural Sciences, and Engineering) as they are delivered in the two geographical contexts. Implications are discussed for register, disciplinary, and discourse structure studies.
Regularity and variation in Japanese recipes
Authors: Kaneyasu Michiko , Kuhara Minako
Published: April 2020

This paper investigates the similarities and differences between three sub-registers of Japanese recipe texts: cookbook recipes, online commercial recipes written/edited by professionals, and online user-generated recipes. Past studies on Japanese recipes do not distinguish different sub-registers, and they tend to focus on a single feature. The present study of the sub-registers examines a group of frequently appearing linguistic features and uncovers functional links between observed features and situational characteristics. The comparative perspective contributes to a more comprehensive understanding of Japanese recipe language as well as universal and language-specific aspects of register variation. Shared traits among the three sub-registers are tied to the common topic of cooking and the central purpose of providing easy-to-follow food preparation instructions. Varied linguistic and textual features are motivated by different production circumstances, mediums, and relations among the participants. Professionally edited cookbook and online commercial recipes show a much higher uniformity in their grammatical features than unedited/self-edited user-generated recipes. Online sub-registers share a role of serving as a repository and reference center for numerous recipes and related information. Relationships among writers, readers, and other participants such as publishers and site organizers differ among all three sub-registers, resulting in some unique linguistic patterns.
A Dyadic Growth Modeling Approach for Examining Associations Between Weight Gain and Lung Function Decline
Authors: Cornelius Talea , Schwartz Joseph E , Balte Pallavi , Bhatt Surya P , Cassano Patricia A , Currow David , Jacobs David R , Johnson Miriam , Kalhan Ravi , Kronmal Richard , Loehr Laura , O’Connor George T , Smith Benjamin , White Wendy B , Yende Sachin , Oelsner Elizabeth C
Published: April 2020

The relationship between body weight and lung function is complex. Using a dyadic multilevel linear modeling approach, treating body mass index (BMI; weight (kg)/height (m)2) and lung function as paired, within-person outcomes, we tested the hypothesis that persons with more rapid increase in BMI exhibit more rapid decline in lung function, as measured by forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and their ratio (FEV1:FVC). Models included random intercepts and slopes and adjusted for sociodemographic and smoking-related factors. A sample of 9,115 adults with paired measurements of BMI and lung function taken at ≥3 visits were selected from a pooled set of 5 US population-based cohort studies (1983–2018; mean age at baseline = 46 years; median follow-up, 19 years). At age 46 years, average annual rates of change in BMI, FEV1, FVC, and FEV1:FVC ratio were 0.22 kg/m2/year, −25.50 mL/year, −21.99 mL/year, and −0.24%/year, respectively. Persons with steeper BMI increases had faster declines in FEV1 (r = −0.16) and FVC (r = −0.26) and slower declines in FEV1:FVC ratio (r = 0.11) (all P values < 0.0001). Results were similar in subgroup analyses. Residual correlations were negative (P < 0.0001), suggesting additional interdependence between BMI and lung function. Results show that greater rates of weight gain are associated with greater rates of lung function loss.
The self-styled ‘autonomy’ of international arbitration
Authors: Bermann George A
Published: April 2020

Among international legal regimes, international arbitration has traditionally claimed for itself a remarkable degree of autonomy from other international regimes, an autonomy that enables it to enjoy a remarkable measure of self-determination. Its assertions of autonomy take a number of different forms and exhibit considerable resilience. Autonomy does allow international arbitration to develop in accordance with norms that are specific to it, but it also poses challenges that need, even for international arbitration’s own well-being, to be acknowledged and addressed.
Toward Improving Interventions Against Toxoplasmosis by Identifying Routes of Transmission Using Sporozoite-specific Serological Tools
Authors: Milne Gregory , Webster Joanne P , Walker Martin
Published: April 2020

Background

Horizontal transmission of Toxoplasma gondii occurs primarily via ingestion of environmental oocysts or consumption of undercooked/raw meat containing cyst-stage bradyzoites. The relative importance of these 2 transmission routes remains unclear. Oocyst infection can be distinguished from bradyzoite infection by identification of immunoglobulin G (IgG) antibodies against T. gondii embryogenesis-related protein (TgERP). These antibodies are, however, thought to persist for only 6–8 months in human sera, limiting the use of TgERP serology to only those patients recently exposed to T. gondii. Yet recent serological survey data indicate a more sustained persistence of anti-TgERP antibodies. Elucidating the duration of anti-TgERP IgG will help to determine whether TgERP serology has epidemiological utility for quantifying the relative importance of different routes of T. gondii transmission.

Methods

We developed a serocatalytic mathematical model to capture the change in seroprevalence of non-stage-specific IgG and anti-TgERP IgG antibodies with human age. The model was fitted to published datasets collected in an endemic region of Brazil to estimate the duration of anti-TgERP IgG antibodies, accounting for variable age–force of infection profiles and uncertainty in the diagnostic performance of TgERP serology.

Results

We found that anti-TgERP IgG persists for substantially longer than previously recognized, with estimates ranging from 8.3 to 41.1 years. The Brazilian datasets were consistent with oocysts being the predominant transmission route in these settings.

Conclusions

The longer than previously recognized duration of anti-TgERP antibodies indicates that anti-TgERP serology could be a useful tool for delineating T. gondii transmission routes in human populations. TgERP serology may therefore be an important epidemiological tool for informing the design of tailored, setting-specific public health information campaigns and interventions.
Affective practices in mid-18th-century German music-making: reflections on C. P. E. Bach’s advice to performers
Authors: Bania Maria , Skowroneck Tilman
Published: April 2020

Carl Philipp Emanuel Bach stated that a musical performer ‘must of necessity be able to transport himself into all of the affections that he wants to arouse in his listeners’. As famous as this passage is, it still raises questions. Did Bach mean that performers must arouse and feel all the shifting affections of the music within their own bodies, or was he using a metaphor here? Were composers supposed to feel the affections in their music while they composed it, as Bach suggested? Was this demand specific to Bach alone, or was it a stock recommendation given by many mid-18th-century German music writers? This article explores similar recommendations in historical sources and describes how Bach’s strategy might be enacted by performers. In an ideal empfindsam concert, the listener’s sympathetic response to the music would have been reinforced by the physical manifestations of the performer’s affective state.
The Natural Historian's Guide to the CT Galaxy: Step-by-Step Instructions for Preparing and Analyzing Computed Tomographic (CT) Data Using Cross-Platform, Open Access Software
Authors: Buser T J , Boyd O F , Cortés Á , Donatelli C M , Kolmann M A , Luparell J L , Pfeiffenberger J A , Sidlauskas B L , Summers A P
Published: April 2020

Synopsis

The decreasing cost of acquiring computed tomographic (CT) data has fueled a global effort to digitize the anatomy of museum specimens. This effort has produced a wealth of open access digital three-dimensional (3D) models of anatomy available to anyone with access to the Internet. The potential applications of these data are broad, ranging from 3D printing for purely educational purposes to the development of highly advanced biomechanical models of anatomical structures. However, while virtually anyone can access these digital data, relatively few have the training to easily derive a desirable product (e.g., a 3D visualization of an anatomical structure) from them. Here, we present a workflow based on free, open source, cross-platform software for processing CT data. We provide step-by-step instructions that start with acquiring CT data from a new reconstruction or an open access repository, and progress through visualizing, measuring, landmarking, and constructing digital 3D models of anatomical structures. We also include instructions for digital dissection, data reduction, and exporting data for use in downstream applications such as 3D printing. Finally, we provide Supplementary Videos and workflows that demonstrate how the workflow facilitates five specific applications: measuring functional traits associated with feeding, digitally isolating anatomical structures, isolating regions of interest using semi-automated segmentation, collecting data with simple visual tools, and reducing file size and converting file type of a 3D model.
Reporting, recording, and communication of COVID-19 cases in workplace: data protection as a moving target
Authors: Shabani Mahsa , Goffin Tom , Mertes Heidi
Published: April 2020

In response to concerns related to privacy in the context of coronavirus disease 2019 (COVID-19), recently European and national Data Protection Authorities (DPAs) issued guidelines and recommendations addressing a variety of issues related to the processing of personal data for preventive purposes. One of the recurring questions in these guidelines is related to the rights and responsibilities of employers and employees in reporting, recording, and communicating COVID-19 cases in workplace. National DPAs in some cases adopted different approaches regarding duties in reporting and communicating the COVID-19 cases; however, they unanimously stressed the importance of adopting privacy-preserving approaches to avoid raising concerns about surveillance and stigmatization. We stress that in view of the increasing use of new data collection and sharing tools such as ‘tracing and warning’ apps, the associated privacy-related risks should be evaluated on an ongoing manner. In addition, the intricacies of different settings where such apps may be used should be taken into consideration when assessing the associated risks and benefits.
Observational constraints on the multiphase nature of outflows using large spectroscopic surveys at z ∼ 0
Authors: Roberts-Borsani G W
Published: April 2020

Mass outflow rates and loading factors are typically used to infer the quenching potential of galactic-scale outflows. However, these generally rely on observations of a single gas phase that can severely underestimate the total ejected gas mass. To address this, we use observations of high mass (≥1010 M⊙), normal star-forming galaxies at z ∼ 0 from the MaNGA, xCOLD GASS, xGASS, and ALFALFA surveys and a stacking of Na d, Hα, CO(1–0), and H i 21 cm tracers with the aim of placing constraints on an average, total mass outflow rate, and loading factor. We find detections of outflows in both neutral and ionized gas tracers, with no detections in stacks of molecular or atomic gas emission. Modelling of the outflow components reveals velocities of |vNa d| = 131 km s−1 and |vHα| = 439 km s−1 and outflow rates of $\dot{M}_{\rm {Na\,\small{D}}}$ = 7.55 M⊙ yr−1 and $\dot{M}_{\text{H}\alpha }$ = 0.10 M⊙ yr−1 for neutral and ionized gas, respectively. Assuming a molecular/atomic outflow velocity of 200 km s−1, we derive upper limits of $\dot{M}_{\text{CO}}\lt 19.43$ M⊙ yr−1 and $\dot{M}_{\rm {H\,\small {I}}}\lt $ 26.72 M⊙ yr−1 for the molecular and atomic gas, respectively. Combining the detections and upper limits, we find average total outflow rates of $\dot{M}_{\text{tot}}\lesssim$27 M⊙ yr−1 and a loading factor of ηtot ≲ 6.39, with molecular gas likely contributing ≲72 per cent of the total mass outflow rate, and neutral and ionized gas contributing ∼28 and <1 per cent, respectively. Our results suggest that, to first order, a degree of quenching via ejective feedback could occur in normal galaxies when considering all gas phases, even in the absence of an active galactic nucleus.
RNase AM, a 5′ to 3′ exonuclease, matures the 5′ end of all three ribosomal RNAs in E. coli
Authors: Jain Chaitanya
Published: April 2020

Bacterial ribosomal RNAs (rRNAs) are transcribed as precursors and require processing by Ribonucleases (RNases) to generate mature and functional rRNAs. Although the initial steps of rRNA processing in Escherichia coli (E. coli) were described several decades ago, the enzymes responsible for the final steps of 5S and 23S rRNA 5′-end maturation have remained unknown. Here, I show that RNase AM, a recently identified 5′ to 3′ exonuclease, performs the last step of 5S rRNA 5′-end maturation. RNase AM was also found to generate the mature 5′ end of 23S rRNA, subsequent to a newly identified prior processing step. Additionally, RNase AM was found to mature the 5′ end of 16S rRNA, a reaction previously attributed to RNase G. These findings indicate a major role for RNase AM in cellular RNA metabolism and establish a biological role for the first 5′ to 3′ RNA exonuclease identified in E. coli.
High specificity and tight spatial restriction of self-biotinylation by DNA and RNA G-Quadruplexes complexed in vitro and in vivo with Heme
Authors: Lat Prince Kumar , Liu Kun , Kumar Dev N , Wong Kenneth K L , Verheyen Esther M , Sen Dipankar
Published: April 2020

Guanine-rich, single-stranded DNAs and RNAs that fold to G-quadruplexes (GQs) are able to complex tightly with heme and display strongly enhanced peroxidase activity. Phenolic compounds are particularly good substrates for these oxidative DNAzymes and ribozymes; we recently showed that the use of biotin-tyramide as substrate can lead to efficient GQ self-biotinylation. Such biotinylated GQs are amenable to polymerase chain reaction amplification and should be useful for a relatively non-perturbative investigation of GQs as well as GQ–heme complexes within living cells. Here, we report that in mixed solutions of GQ and duplex DNA in vitro, GQ biotinylation is specifically >104-fold that of the duplex, even in highly concentrated DNA gels; that a three-quartet GQ is tagged by up to four biotins, whose attachment occurs more or less uniformly along the GQ but doesn’t extend significantly into a duplex appended to the GQ. This self-biotinylation can be modulated or even abolished in the presence of strong GQ ligands that compete with heme. Finally, we report strong evidence for the successful use of this methodology for labeling DNA and RNA within live, freshly dissected Drosophila larval salivary glands.
Performance, heat tolerance response, and blood metabolites of water-restricted Xhosa goats supplemented with vitamin C1
Authors: Akinmoladun Oluwakamisi F , Fon Fabian N , Mpendulo Conference T , Okoh Omobola
Published: April 2020

Water restriction in small ruminants is usually accompanied by a drop in feed intake, body weight, and disturbances in the normal internal milieu. However, attempts to lessen the burden of water stress with vitamin C (VC) supplementation have been greeted with conflicting reports. Therefore, this experiment was conducted to evaluate the effect of single and/or multiple VC supplementations in water-restricted Xhosa goats by evaluating their performance, heat tolerance, and blood metabolites. In total, 42 does, 12 mo old and with an average weight of 15.92 ± 2.12 kg were evaluated for 75 d. The does were distributed according to a complete randomized design into seven groups of six comparable animals: W0, without water restriction (control); W70, water restriction of 70% of ad libitum water intake (WI); W50, water restriction of 50% ad libitum WI; W70+, water restriction of 70% of ad libitum WI plus 3 g VC daily; W50+, water restriction 50% of ad libitum WI plus 3 g VC daily; W70++, water restriction of 70% of ad libitum WI plus 3 g VC and extra 5 g VC given every eighth day; and W50++, water restriction of 50% of ad libitum WI plus 3 g VC and extra 5 g VC given every eighth day. Goats under the W50 group were the most affected (P < 0.05) and the effect was more pronounced in their body condition scores (BCs). Weight loss due to water restriction was reduced by VC supplementation in treated groups. Changes in body thermal gradient, rectal temperature, cholesterol, and bilirubin were similar (P > 0.05) across the various experimental groups. The attenuation effect of VC was significant (P < 0.05) in responses to respiratory rate, Na+, K+, Mg2+, Cl−, Ca2+, and urea. Supplementation of VC (either single or multiple) did not significantly (P > 0.05) improve the effect of water restriction on BCs, FAMACHA, glucose, globulin, alanine aminotransferase, and high-density lipoprotein. The additive effect of multiple VC significantly influenced (P < 0.05) Na+ and Mg2+. Limited WI affects growth and other physiological parameters in Xhosa goats. However, supplementation of VC may be beneficial at modulating the stressful stimuli imposed by water stress.
New Liberalism and the City of London: Reassessing Empire, Finance, and Politics in Francis Hirst’s Economist, 1906–16
Authors: Zevin Alexander
Published: April 2020

The influence of the City of London on British politics has been a focus of controversy among historians. Likewise, the ‘death of liberal England’, during the years in which Liberals governed in the run-up to the First World War. The Economist, as the City’s leading liberal weekly, allows us to explore the connection between these themes, in ways that challenge scholarly assumptions about both. Under Francis Hirst, its editor and an influential New Liberal thinker in his own right, The Economist acted as a bridge between the realms of finance capital and political practice, at just the moment that a serious conflict appeared to divide them—over the new taxes and social reform measures in the People’s Budget of 1909–10. This article deploys Hirst and his tenure at The Economist—including his ejection in 1916 for supporting a negotiated peace during the First World War—to argue that finance and politics were deeply intertwined in liberal understandings of free trade, empire, and social reform by the turn of the twentieth century; in addition, it suggests that the conflicts that emerged at this time, over the interests of the City and how and if these were compatible with other economic, social, or political aims or actors, prefigured later, better-known clashes that have recurred in Britain down to the present.
Phyloanatomic characterization of the distinct T cell and monocyte contributions to the peripheral blood HIV population within the host
Authors: RifeMagalis Brittany , Strickland Samantha L , Shank Stephen D , Autissier Patrick , Schuetz Alexandra , Sithinamsuwan Pasiri , Lerdlum Sukalaya , Fletcher James L K , de Souza Mark , Ananworanich Jintanat , Valcour Victor ,   The Search007 Study Group, Williams Kenneth C , Kosakovsky Pond Sergei L , RattoKim Silvia , Salemi Marco
Published: April 2020

Human immunodeficiency virus (HIV) is a rapidly evolving virus, allowing its genetic sequence to act as a fingerprint for epidemiological processes among, as well as within, individual infected hosts. Though primarily infecting the CD4+ T-cell population, HIV can also be found in monocytes, an immune cell population that differs in several aspects from the canonical T-cell viral target. Using single genome viral sequencing and statistical phylogenetic inference, we investigated the viral RNA diversity and relative contribution of each of these immune cell types to the viral population within the peripheral blood. Results provide evidence of an increased prevalence of circulating monocytes harboring virus in individuals with high viral load in the absence of suppressive antiretroviral therapy. Bayesian phyloanatomic analysis of three of these individuals demonstrated a measurable role for these cells, but not the circulating T-cell population, as a source of cell-free virus in the plasma, supporting the hypothesis that these cells can act as an additional conduit of virus spread.
Productivity and Health: Physical Activity as a Measure of Effort
Authors: Akogun Oladele , Dillon Andrew , Friedman Jed , Prasann Ashesh , Serneels Pieter
Published: April 2020

This paper examines the relationship between physical activity and individual productivity among agricultural workers paid on a piece-rate basis. In the context studied, physical activity has a clear correspondence with worker effort. Agricultural workers’ physical activity is directly observed from accelerometer data and is robustly associated with their daily productivity. In addition the impact of a health intervention, which provides malaria testing and treatment, on physical activity and productivity, indicates that the increased daily productivity of workers who are offered this program is explained by worker effort reallocation from low-intensity to high-intensity work within a fixed time period. This demonstrates, in settings when individual productivity is observed, that physical activity measures can help disentangle productivity effects due to effort. When productivity is unobserved, physical activity measures may proxy for individual productivity in physically demanding tasks. The challenges and limitations of physical activity measurement using accelerometers is discussed including their potential use for alternative contexts and the importance of field and data analysis protocols.
Dromaeosaurid crania demonstrate the progressive loss of facial pneumaticity in coelurosaurian dinosaurs
Authors: Brownstein Chase Doran
Published: April 2020

Dinosaurs are notable for their extensive skeletal pneumaticity, a feature that may have helped facilitate the development of various ‘extreme’ body plans in this group. Despite its relevance to understanding the evolution of the avian body plan, this feature has only been described in detail for a few non-avian dinosaurs, and cranial pneumaticity outside the braincase remains poorly documented. I describe facial pneumatic features in members of the Dromaeosauridae, a clade of hypercarnivorous dinosaurs closely allied to birds. Variation in the pneumaticity of the nasals and jugals, the position and shape of the pneumatic fenestrae of the maxilla and the border of the antorbital fossa shows that facial pneumaticity differed substantially among closely related dromaeosaurids and other bird-like dinosaurs. Ancestral state reconstructions of facial pneumaticity in coelurosaurs suggest a complex evolutionary history for these features. Surprisingly, the general trend along the path towards birds was the loss or reduction of superficial pneumatic features on the snout and cheek. Some facial pneumatic features seem to have evolved secondarily in some derived bird-like forms. The results show superficial facial pneumaticity did not increase in coelurosaurs and emphasize the complexity of the evolution of pneumatization in the lineage leading to birds.
Quantifying Mobility in the ICU: Comparison of Electronic Health Record Documentation and Accelerometer-Based Sensors to Clinician-Annotated Video
Authors: Fazio Sarina , Doroy Amy , Da Marto Natalie , Taylor Sandra , Anderson Nicholas , Young Heather M. , Adams Jason Y.
Published: April 2020

Objectives:

To compare the accuracy of electronic health record clinician documentation and accelerometer-based sensors with a gold standard dataset derived from clinician-annotated video to quantify early mobility activities in adult ICU patients.

Design:

Prospective, observational study.

Setting:

Medical ICU at an academic hospital.

Patients:

Adult ICU patients (n = 30) were each continuously monitored over a median of 24.4 hours, yielding 711.5 hours of video, electronic health record, and sensor data.

Interventions:

None.

Measurements and Main Results:

Electronic health record documentation estimated ambulation (intraclass correlation coefficient, 0.89; 95% CI, 0.78–0.95), sitting out-of-bed (intraclass correlation coefficient, 0.85; 95% CI, 0.72–0.93), and turning events (intraclass correlation coefficient, 0.87; 95% CI, 0.75–0.94) with excellent agreement but underestimated the number of standing, transferring, and pregait activities performed per patient. The accelerometer-based sensor had excellent agreement with video annotation for estimating duration of time spent supine (intraclass correlation coefficient, 0.99; CI, 0.97–0.99) and sitting/standing upright (intraclass correlation coefficient, 0.92; CI, 0.82–0.96) but overestimated ambulation time.

Conclusions:

Our results show that electronic health record documentation and sensor-based technologies accurately capture distinct but complimentary metrics for ICU mobility measurement. Innovations in artifact detection, standardization of clinically relevant mobility definitions, and electronic health record documentation enhancements may enable further use of these technologies to drive critical care research and technology leveraged data-driven ICU models of care.
Lumbopelvic motor control function between patients with chronic low back pain and healthy controls: a useful distinguishing tool
Authors: Jung Sung-hoon , Hwang Ui-jae , Ahn Sun-hee , Kim Hyun-a , Kim Jun-hee , Kwon Oh-yun
Published: April 2020

Although lumbopelvic stability exercise improves lumbopelvic motor control function in patients with chronic low back pain (CLBP), the difference in lumbopelvic motor control function between the patients with CLBP and the healthy controls is unclear. The purpose of this study was to compare lumbopelvic motor control function between patients with CLBP and healthy controls and to determine the prevalence of CLBP according to core stability function.

For this study, 278 participants were recruited, including patients with CLBP (n = 137) and healthy controls (n = 141). The participants performed a core stability function test and were classified to either the low or high core stability function group according to their core stability function for CLBP prevalence analysis.

Lumbopelvic motor control was significantly higher in the healthy controls than in patients with CLBP. Of the patients in the low lumbopelvic motor control function group, 65.9% had CLBP, whereas 36.8% of the patients in the high lumbopelvic motor control function group had CLBP. Lumbopelvic motor control function demonstrated a significant difference between the patients with CLBP and the healthy controls. The lumbopelvic motor control function test was demonstrated to be an effective diagnostic tool for distinguishing CLBP. This information can be applied in assessments and interventions for CLBP in clinical settings.
Three dimensional finite element analysis used to study the influence of the stress and strain of the operative and adjacent segments through different foraminnoplasty technique in the PELD
Authors: Xie YiZhou , Wang Xinling , Jian Qiang , Fan Xiaohong , Yu Yang , Gu Dangwei , Wu WeiDong
Published: April 2020

Introduction:

Percutaneous endoscopic lumbar disectomy (PELD) is one of the most popular minimally invasive techniques of spinal surgery in recent years. At present, there are 2 main surgical approaches in PELD: foraminal approach and interlaminar approach. What's more, foraminoplasty is a necessary step for both approaches. However, there are few biomechanical studies on the formation of different parts of the intervertebral foramen. The aim of this study is to explore the effects of different foraminoplasty methods on the biomechanics of the corresponding and adjacent segments of the lumbar through a 3-dimensional finite element model analysis.

Methods:

We established a normal 3-dimensional finite element mode of L3 to L5, simulated lumbar percutaneous endoscopy by doing cylindrical excision of bone whose diameter was 7.5 mm on the L5 superior articular process and the L4 inferior articular process, respectively, so that we obtained 3 models: the first one was normal lumbar model, the second one was the L4 inferior articular process shaped model, and the third one was the L5 superior articular process shaped model. We compared the biomechanics of the intervertebral disc of L3/4 and L4/5 when they were in the states of forward flexion, backward extension, left and right flexion, and left and right rotation on specific loading condition.

Discussion:

If the outcomes indicate the trial is feasible and there is evidence that one of the foraminoplasty technique may make few differences in biomechanics of corresponding lumbar intervertebral disc, we will proceed to a definitive trial to test the best way to foraminplasty, which could make biomechanical influence as little as possible.

Trial Registration: Chinese Clinical Trial Registry, ChiCTR1900026973. Registered on September 27, 2019.
The first reported case of Beaulieu-Boycott-Innes syndrome caused by two novel mutations in THOC6 gene in a Chinese infant
Authors: Zhang Qiang , Chen Shaoke , Qin Zailong , Zheng Haiyang , Fan Xin
Published: April 2020

Rationale:

This case report expands the mutation and phenotypic spectra of Beaulieu-Boycott-Innes syndrome (BBIS), and will be valuable for mutation-based pre- and post-natal screening of BBIS when conducting a genetic diagnosis.

Patient concerns:

A 4-year old boy from Guilin City, Guangxi Zhuang Autonomous Region, China, was referred to our clinic for clarification of his diagnosis because he showed moderate intellectual disability.

Diagnosis:

Two novel compound heterozygous mutations of THOC6, c.664T>C (p.Trp222Arg) and c.945+1 G>A were identified in this patient by whole exome sequencing. The two mutations were evaluated as pathogenic and likely pathogenic respectively according to the American College of Medical Genetics guidelines. This is the first case displaying the BBIS phenotype reported in the Chinese population. These two mutations have not been reported previously.

Interventions:

Symptomatic treatment and rehabilitation training for patients.

Outcomes:

The genetic cause of the disease was identified. The family received scientific genetic counseling.

Lessons:

BBIS is a rare syndromic autosomal recessive disease with intellectual disability and it is normally difficult for clinicians to recognize it. Whole exome sequencing is an efficient way to identify the gene which causes a particular disease in patients.
Misplacement of the tunnel hemodialysis catheter through the left jugular vein to the azygos vein
Authors: Cao Dan , Shen Zhaonan , Gui Qiaoqiao , He Yun
Published: April 2020

Rationale:

The percutaneous catheterization of central veins is widely applied in patients with end-stage renal diseases as a permanent vascular access. To our knowledge, inadvertent placement of a hemodialysis catheter into the azygos vein through the left internal jugular vein is not described.

Patient concerns:

A 72-year-old female patient was admitted to the hospital for replacement of another new tunneled hemodialysis catheter due to poor flow in the left internal jugular vein tunneled catheter during hemodialysis.

Diagnosis:

The catheter tip was incorrectly positioned into the azygos vein as confirmed by conventional anteroposterior and lateral chest radiographs.

Interventions:

The catheter was removed and replaced under Digital Subtraction Angiography.

Outcomes:

The catheter tip was finally placed in the proper position.

Lessions:

The insertion of central vein catheterization is not always in suitable position especially through left jugular vein in hemodialysis patients. DSA technology should be performed to confirm the correct position of the tip and to ensure good blood flow.
Early stage Acute B lymphocytic leukemia presenting with symptoms of ankylosing spondylitis (AS)
Authors: Liu Wei , Chen Guangfeng , Xu Bing , Sun Suping , Tian Jingzhen , Zhang Yingying
Published: April 2020

Rationale:

Acute lymphoblastic leukemia (ALL) has acute and severe onset characterized by fever, moderate to severe anemia, bone and joint pain, and sternal tenderness. It is easy to be misdiagnosed as rheumatic disease when joint pain is the first symptom.

Patient concerns:

A male Han, 18 years of age was admitted on July 15th, 2016 for multi-joint swelling and pain with intermittent fever for half a year which had aggravated in the last 10 days.

Diagnosis:

Based on symptoms, imaging, family history, and blood tests, he was first diagnosed with ankylosing spondylitis, but he was refractory to treatment. Bone marrow biopsy then revealed acute B-lymphoblastic leukemia (possibility Pro-B-ALL).

Interventions:

The patient was transferred to the hematology department on July 23rd, 2016 for chemotherapy.

Outcomes:

No joint pain occurred during follow-up, which ended on November 4th, 2018.

Lessons:

ALL may present with symptoms suggestive of rheumatic diseases like ankylosing spondylitis. Physicians should be aware of this possibility, especially in young patients.
Confidence and Competence in Palliative Care
Authors: Rotter Briana , Braband Barb
Published: April 2020

Nurses spend more time with seriously and terminally ill patients across the continuum of care than other health professionals, yet nursing students lack adequate palliative care education and experience when they transition to practice. In response to the American Association of Colleges of Nursing CARES competencies for enhanced preparation in palliative care, the End-of-Life Nursing Education Consortium developed modules for undergraduate programs. Nursing students' life experiences and their prior involvement with death and dying situations shape their potential achievement of end-of-life learning outcomes. The purpose of this study was to explore traditional and nontraditional students' perspectives and outcomes of their lived experiences in response to the End-of-Life Nursing Education Consortium modules and current palliative care program curriculum. Following university institutional review board approval, the phenomenological qualitative study included 2 focus groups of traditional and transfer students. Thematic data analysis revealed 4 primary themes with differences noted between groups in response to these themes: (1) witnessing suffering and death, (2) building courage and competence, (3) conversation challenges, and (4) curriculum issues and recommendations. Implications for future palliative care education indicate opportunities to better support students through expanded simulations and debriefing sessions, integrated roles for clinical faculty and preceptors, and interdisciplinary team collaboration opportunities across settings.
Face Lift Using Dual Deep Tissue Support
Authors: Yang Doo Byung , Yang Jung Hak , Kim So Young
Published: April 2020

Background:

Utilizing the concept of Barton's high superficial musculo-aponeurotic system (SMAS) technique, the authors performed the more extensive skin-attached SMAS/platysma flap elevation and the ‘dual deep tissue support’ technique involving multiple plications of the parotid-masseteric fascia, repositioning of the SMAS, and platysma muscle. Our aim was to demonstrate a specific surgical procedure for face and neck lift and offer its pitfalls and outcomes.

Methods:

This study included 83 patients aged between 54 and 73 years. The pre- and 10-month postoperative photographs of all patients were used to assess the extent of the nasolabial folds, the labiomental fold, and the cervical band (platysma band). Each patient's subjective aesthetic satisfaction was also evaluated.

Results:

At 3 and 6 months postoperatively, 94% (n = 3) of patients achieved “minimal” and “mild” nasolabial folds. Most patients (89.1%, n = 74) were satisfied with their outcomes. Two minor hematomas (2.4%) occurred locally over the temporal or retro-auricular area. No incidence of skin flap necrosis or permanent facial nerve injury was observed.

Conclusions:

Our extensive skin-attached SMAS/platysma flap elevation with dual deep tissue support, both by multiple parotic masseteric plication and SMAS/platysma repositioning, provided not only the definite lifting effect in the immediate postoperative period, but also resulted in long-lasting lifting outcomes without remission.

Level of evidence:

IV.
Closure of the Nasal and Buccal Layers in V-Y Pushback Palatoplasty: Use of a Spring Carrier
Authors: Hwang Kun , Lee Se Il
Published: April 2020

The aim of this paper is to re-introduce Kilner and Calnan's technique of closing the nasal and buccal layers in V-Y pushback palatoplasty by using the spring carrier on the mouth gag.

After flap elevation and dissection, the first suture is inserted through the nasal layer of the mucosa at the level of the posterior border of the hard palate. This 3–0 stitch is left untied until later. The nasal layer is approximated by inserting a series of 4–0 sutures so that the knots can be tied on the mucosal surface inside the nose. All sutures are inserted before any are tied. The sutures are inserted consecutively, moving from the hard palate region toward the uvula. The sutures may be held on the spring suture carrier attached to the mouth gag; they should be covered by a damp swab. When all sutures have been inserted, they are then tied firmly with three knots, working from behind to forward, and cut short by the surgeon. The buccal layer is closed starting from the uvula and moving toward the hard palate. A series of interrupted mattress sutures are inserted to unite the mucosa and the velar muscles. The inserted sutures are tied before the next stitch. They may be cut by the assistant, leaving 3 to 4 mm beyond the knot.

In this technique, the untied sutures could be arranged well on the spring suture carrier attached to the mouth gag. When covered by a damp swab, the catgut sutures did not dry up.
Correlation Between Lacrimal Syringing Test and Dacryoscintigraphy in Patients With Epiphora
Authors: Kim Seungheon , Yang Sungwon , Park Jinhwan , Lee Hwa , Baek Sehyun
Published: April 2020

The purpose of this study was to evaluate the correlation between the lacrimal syringing test (LST) and dacryoscintigraphy (DSG) in patients with epiphora. The authors retrospectively reviewed the clinical records of patients who underwent both LST and DSG from March 2016 to February 2018. From this, 636 eyes of 336 patients with a mean age of 61.20 ± 11.93 years (range, 22–86 years) were included. The concordance rate between LST and DSG was 43.7% (278 eyes). The sensitivity of DSG was 68.78%, and specificity was 30.99%. Factors of age and sex were analyzed in terms of concordance. The authors categorized age into 2 groups of younger and older than 65 years. Only sex was found to affect the results, with a much higher concordance rate in the female group than the male group. The lack of correlation between the tests indicates that the LST and DSG methods are complementary to each other. There is no single reliable method for testing patency of the lacrimal drainage system. Therefore, physicians should refer to these tests as complementary in a clinic setting.
Analysis of Prognostic Factors for the Indirect Traumatic Optic Neuropathy Underwent Endoscopic Transnasal Optic Canal Decompression
Authors: Lin Jingquan , Hu Wanglu , Wu Qun , Yi Jianhua , Liu Zhihai , Zhou Guangju , Ma Feiqiang , Zhang Jianmin , Yan Wei
Published: April 2020

Objective:

This study aimed to investigate the clinical outcomes of endoscopic transnasal optic canal decompression (ETOCD) for patients with indirect traumatic optic neuropathy (TON) and identify the relevant prognostic factors.

Methods:

Seventy-two indirect TON patients who underwent ETOCD surgery from August 2017 to May 2019 were analyzed retrospectively. The pairedt-test was used to compare the visual acuity (VA) before and after ETOCD, and multiple linear regression analysis was used to distinguish the potential prognostic factors.

Results:

Among the patients analyzed, postoperative VA (−2.87 ± 0.19) was significantly higher than the preoperative VA (−3.92 ± 0.13) (P < 0.05). Multiple linear regression analysis models showed that poor initial VA and longer time to surgery were independent risk factors for VA prognosis (P < 0.05), but surgical time alone was significantly associated with the improvement degree of visual acuity (IDVA) (P < 0.05). Optic canal fracture, orbital fracture, and hemorrhage within the ethmoid and/or sphenoid sinus were not significantly correlated with IDVA and VA prognosis (P > 0.05).

Conclusions:

ETOCD surgery could salvage VA impairment in patients with indirect TON. A better initial VA indicates better final VA outcomes after surgery. Additionally, shorter time to surgery implies better VA prognosis and higher IDVA.
Association of Surgical Resident Wellness With Medical Errors and Patient Outcomes
Authors: Hewitt Daniel Brock , Ellis Ryan J. , Chung Jeanette W. , Cheung Elaine O. , Moskowitz Judith T. , Huang Reiping , Merkow Ryan P. , Yang Anthony D. , Hu Yue-Yung , Cohen Mark E. , Ko Clifford Y. , Hoyt David B. , Bilimoria Karl Y.
Published: April 2020

Objectives:

The aims of this study were to: (1) measure the prevalence of self-reported medical error among general surgery trainees, (2) assess the association between general surgery resident wellness (ie, burnout and poor psychiatric well-being) and self-reported medical error, and (3) examine the association between program-level wellness and objectively measured patient outcomes.

Summary of Background Data:

Poor wellness is prevalent among surgical trainees but the impact on medical error and objective patient outcomes (eg, morbidity or mortality) is unclear as existing studies are limited to physician and patient self-report of events and errors, small cohorts, or examine few outcomes.

Methods:

A cross-sectional survey was administered immediately following the January 2017 American Board of Surgery In-training Examination to clinically active general surgery residents to assess resident wellness and self-reported error. Postoperative patient outcomes were ascertained using a validated national clinical data registry. Associations were examined using multivariable logistic regression models.

Results:

Over a 6-month period, 22.5% of residents reported committing a near miss medical error, and 6.9% reported committing a harmful medical error. Residents were more likely to report a harmful medical error if they reported frequent burnout symptoms [odds ratio 2.71 (95% confidence interval 2.16–3.41)] or poor psychiatric well-being [odds ratio 2.36 (95% confidence interval 1.92–2.90)]. However, there were no significant associations between program-level resident wellness and any of the independently, objectively measured postoperative American College of Surgeons National Surgical Quality improvement Program outcomes examined.

Conclusions:

Although surgical residents with poor wellness were more likely to self-report a harmful medical error, there was not a higher rate of objectively reported outcomes for surgical patients treated at hospitals with higher rates of burnout or poor psychiatric well-being.
Interferon-α2b treatment for COVID-19
Authors: Zhou Qiong , Chen Virginia , Shannon Casey P. , Wei Xiao-Shan , Xiang Xuan , Wang Xu , Wang Zi-Hao , Tebbutt Scott J. , Kollmann Tobias R. , Fish Eleanor N.
Published: April 2020

Background

The global pandemic of COVID-19 cases caused by infection with SARS-CoV-2 is ongoing, with no approved antiviral intervention. We describe here the effects of treatment with interferon-α2b in a cohort of confirmed COVID-19 cases in Wuhan, China.

Methods

In this retrospective study, 77 adults hospitalized with confirmed COVID-19 were treated with either nebulized IFN-α2b (5mU b.i.d.), arbidol (200mg t.i.d.) or a combination of IFN-α2b plus arbidol. Serial SARS-CoV-2 testing along with hematological measurements, including cell counts and blood biochemistry, serum cytokine levels, temperature and blood oxygen saturation levels were recorded for each patient during their hospital stay.

Results

Treatment with IFN-α2b with or without arbidol significantly reduced the duration of detectable virus in the upper respiratory tract and in parallel reduced duration of elevated blood levels for the inflammatory markers IL-6 and CRP.

Conclusion

These findings suggest that IFN-α2b should be further investigated as a therapy in COVID-19 cases.