bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and Clinical Significance of Metabolic Syndrome in Fibromyalgia Patients
Authors: Yahia Mohamed , Makboul Khaled , Ali Hany
Published: May 2021

Background and Objective Fibromyalgia syndrome (FMS) is a distressing clinical condition. Metabolic syndrome (MetS) is a biochemical and clinical condition characterised by visceral obesity, dyslipidaemia, hyperglycaemia and hypertension. The relation between the two conditions is rarely discussed. This study aimed to determine the prevalence of MetS in FMS patients and to uncover its association with the clinical severity of FMS.

Patients and Methods This cross-sectional study included 200 patients with newly diagnosed FMS. The diagnosis of FMS was established on the basis of the American College of Rheumatology (ACR) 2016 revised criteria. Patients were assessed using the validated Arabic version of Fibromyalgia Impact Questionnaire (FIQ). FMS severity was categorised according to FIQ scores into mild (≤45), moderate (>46 and≤65), and severe (>65).

Results The study included 200 FMS patients. They comprised 180 females (90.0%) and 20 males (10.0%). Among the studied patients, there were 96 patients (48.0%) who fulfilled the criteria of MetS diagnosis. A comparison between FMS patients with MetS and patients without MetS revealed a significantly higher Widespread Pain Index (WPI) [median (IQR): 12.0 (10.0–17.0) vs. 9.0 (6.0–11.0), p<0.001], a higher Symptoms Severity Scale (SSS) (10.5±1.04 vs. 8.1±1.8, p<0.001) and a higher FIQ (58.8±20.7 vs. 45.4±16.6) in patients with MetS. Patients with MetS had a significantly higher frequency of severe FMS (31.2 vs. 10.6%, p<0.001). Using binary logistic regression analysis, significant predictors of severe FMS included WPI, SSS and MetS in a univariate analysis. However, in a multivariate analysis, only WPI and SSS remained significant.

ConclusionsThis study found that MetS is prevalent in FMS patients and it may be associated with more severe forms of the disease.
A Series of Nontuberculous Mycobacterial Flexor Tenosynovitis Infections and Cost of Treatment
Authors: Aryee Jomar N.A. , Akinleye Sheriff D. , Ugwu-Oju Obinna C. , Moore Christopher C. , Freilich Aaron M.
Published: May 2021

Background Nontuberculous mycobacteria (NTM) are rare but potentially devastating causes of musculoskeletal infection and impairment in immunocompetent patients.

Purpose Given the sparse body of literature surrounding these infections, we describe a series of patients with and the cost of treatment of upper extremity NTM infections.

Patients and Methods In a retrospective review of seven patients with NTM infections of the upper extremity treated at a university hospital from 2010 to 2019, we assessed patient demographics, exposures, infection characteristics, management course, outcomes, and costs of treatment.

Results Insidious pain and swelling were the most common clinical manifestation of infection. Despite coupled surgical and medical management, recurrence was common. Two patients required amputation, and three others had lasting functional deficits. The most common pathogen was Mycobacterium avium complex (5 of 7). The estimated median charge related to management was $85,126 with a range from $8,361 to $1,66,229.

Conclusions The treatment of NTM infections is complex and expensive. Diagnosis is usually delayed, which further complicates the management of these patients who often suffer from lasting debilitation. Due to its potentially devastating course, NTM infection should be considered and tested for whenever flexor tenosynovitis is suspected. Regardless of initial presentation, our experience suggests that a protocol of serial surgical debridement immediately after tissue diagnosis is necessary for optimal outcomes. Furthermore, NTM infections require collaboration with infectious disease colleagues to guide antimicrobial regimens based on susceptibility testing and therapeutic drug monitoring for the recommended 6 to 12 months of therapy after the final operative debridement.

Level of Evidence This is a Level IV, case series study.
Joint Distraction for Thumb Carpometacarpal Osteoarthritis: 2-Year Follow-up Results of 20 Patients
Authors: Ottenhoff Janna S.E. , Spaans Anne J. , Braakenburg Assa , Teunis Teun , van Minnen L. Paul , Mink van der Molen Aebele B.
Published: May 2021

Background Joint distraction is a fairly new treatment for patients with symptomatic thumb carpometacarpal osteoarthritis (CMC1 OA). A previous pilot study of five patients showed that CMC1 joint distraction is technically feasible. The current study presents the results of CMC1 joint distraction in 20 patients with a 2-year follow-up period.

Purposes The primary study aim was to assess if patients with CMC1 OA have better physical function and less pain 2 years after CMC1 joint distraction. Second, we assessed the number of patients who achieved a minimal clinically important difference (MCID) in patient-reported outcome measures at each follow-up time point. Furthermore, this study sought differences on magnetic resonance imaging (MRI) of the CMC1 joint before and after distraction. Adverse events were noted and reported.

Methods Twenty patients (median age of 54 years) with symptomatic CMC1 OA and an established indication for a trapeziectomy were enrolled. An external distractor device was placed over the CMC1 joint and left in situ for 8 weeks. Disabilities of the Arm, Shoulder, and Hand (DASH) score, Michigan Hand Outcome Questionnaire (MHQ), visual analogue scale (VAS), and grip strength were recorded preoperatively and at 3, 6, 12, and 24 months postoperatively.

Results Two years after joint distraction, physical function and pain scores had improved significantly compared with baseline: DASH from 48 to 17, MHQ from 56 to 83, and VAS for pain from 50 to 18 mm. Fourteen of 19 patients (74%) reached an MCID in DASH and MHQ scores. One patient was not satisfied with treatment outcome and chose to proceed with a trapeziectomy 14 months after initial distraction therapy.

Conclusions This study demonstrates that CMC1 joint distraction can postpone more invasive surgical interventions (e.g., trapeziectomy) for at least 2 years. Larger comparative studies are needed to assess the value of CMC1 joint distraction in the treatment of CMC1 OA.

Level of Evidence This is a Level IV, prospective case series study.
Trends in Spontaneous and Medically Indicated Preterm Birth in Twins versus Singletons: A California Cohort 2007 to 2011
Authors: Ness Amen , Mayo Jonathan A. , El-Sayed Yasser Y. , Druzin Maurice L. , Stevenson David K. , Shaw Gary M.
Published: May 2021

Objective The study aimed to describe preterm birth (PTB) rates, subtypes, and risk factors in twins compared with singletons to better understand reasons for the decline in PTB rate between 2007 and 2011.

Study Design This was a retrospective population-based analysis using the California linked birth certificates and maternal-infant hospital discharge records from 2007 to 2011. The main outcomes were overall, spontaneous (following spontaneous labor or preterm premature rupture of membranes), and medically indicated PTB at various gestational age categories: <37, <32, and 34 to 36 weeks in twins and singletons.

Results Among the 2,290,973 singletons and 28,937 twin live births pairs included, overall PTB <37 weeks decreased by 8.46% (6.77–6.20%) in singletons and 7.17% (55.31–51.35%) in twins during the study period. In singletons, this was primarily due to a 24.91% decrease in medically indicated PTB with almost no change in spontaneous PTB, whereas in twins indicated PTB declined 7.02% and spontaneous PTB by 7.39%.

Conclusion Recent declines in PTB in singletons appear to be largely due to declines in indicated PTB, whereas both spontaneous and indicated PTB declined in twins.

Key Points
Channel geometry-dependent threshold voltage and transconductance degradation in gate-all-around nanosheet junctionless transistors
Authors: Jeon Dae-Young
Published: May 2021

The gate-all-around (GAA) nanosheet (NS) junctionless transistor (JLT) is an attractive candidate for advanced technology nodes in CMOS scaling. Here, the channel width-dependent transconductance (gm) degradation and threshold voltage (Vth) shift of GAA NS JLTs were investigated via numerical simulation. Compared to bulk neutral channels, a pronounced surface accumulation channel limited the overall electrical characteristics of GAA NS JLTs at narrow widths. Additionally, the variation in Vth of GAA NS JLTs was much smaller than that in tri-gate JLTs. Quantum mechanical effects in GAA NS JLTs with a very narrow width were also investigated.
A novel high current pulse activation method for proton exchange membrane fuel cell
Authors: Wang Dianlong , Ding Xinjian , Yang Daijun , Liang Zhimin , Wang Liwei
Published: May 2021

The performance of the proton exchange membrane fuel cell (PEMFC) is not the best when it is manufactured. It must be activated before it can be put into use. In this paper, a single-cell-based rapid activation method using high current pulses was proposed. The high current pulse activation method used the rectangular pulse current to discharge the PEMFC by adjusting the peak current, pulse period, pulse duty cycle, and cycle times. The polarization curve, electrochemical impedance spectroscopy, and cyclic voltammetry tests were carried out before and after each activation cycle. The results show that the performance of the PEMFC reaches the best state after the first activation cycle. The whole activation process only needs 1 h. The effectiveness of the high current pulse activation method is verified.
A non-equilibrium Alfvénic state of the Langevin system for single particles reproduces the linear relation between the cross helicity and the residual energy in the solar wind
Authors: Nariyuki Y.
Published: May 2021

As a minimal phenomenological model of unidirectional Alfvénic fluctuations in the solar wind, a non-equilibrium Alfvénic state (NAS) in the Langevin system for single particles is studied. The NAS is a nonequilibrium steady state of the Langevin system including both friction force and random force. It is shown that the overdamped Langevin system gives the NAS without the assumption of the monochromatic wave. The resultant NAS gives the relationship between the energy dissipation rate, the cross-helicity, and the residual energy with a single phenomenological parameter. It is shown that the energy dissipation rate can be evaluated using the non-equilibrium work, which satisfies the fluctuation dissipation-like relation.
Ce-doped LaCoO3 film as a promising gas sensor for ethanol
Authors: Wu Liang , Shi Xiang , Du Huiling , An Qunli , Li Zhuo , Xu Hang , Ran Hongpei
Published: May 2021

With increasing exposure to ethanol in various scenarios, including hand sanitizers that combat bacteria and viruses, energy-efficient miniaturized sensors capable of detecting excessive concentrations of ethanol are required in the fields of disinfection and chemical storage. Modified perovskite-type oxides with ABO3 structures are particularly attractive because they can be appropriately modified and have been used in heterogeneous catalysis and gas sensors. In this study, we designed and manufactured a novel thin-film-type LaCeCoO3 gas sensor using lithography technology and precursor-solution doping. The samples exhibited morphologies that contain randomly oriented nanostructures and short rods; the particle size was observed to decrease with Ce-addition. Room-temperature gas-sensing characterization studies revealed high reproducibility for the detection of ethanol. La0.96Ce0.04CoO3 exhibited superior stability and sensitivity, with a high impedance, |Z|, of ∼120 kΩ and a Δ|Z| of up to 77%, with response and recovery times of 16 and 8 s, respectively. This study provides a rational method for the development of LaCeCoO3 as a semiconducting material for ethanol gas-sensing applications.
Analyses of low-temperature transport and thermoelectric properties of polycrystalline undoped n-ZrNiSn
Authors: Kajikawa Yasutomo
Published: May 2021

The temperature dependence data of the electrical conductivity σ(T), the Hall coefficient RH(T), the Seebeck coefficient S(T), and the Nernst coefficient Q(T) on a polycrystalline sample of undoped n-type ZrNiSn reported by Schrade et al. [J. Appl. Phys. 127(4), 045103 (2020)] have been analyzed in a model previously proposed, including both nearest-neighbor hopping and variable-range hopping in an impurity band. Through the simultaneous fits to the temperature dependence data of the four transport coefficients, the effective mass of electrons as well as the deformation potential is deduced together with the ionization energy of the donor level. The validity of the model is confirmed by applying it to the analysis of σ(T), RH(T), and S(T) on another polycrystalline sample of undoped n-type ZrNiSn reported by Hu et al. [ACS Appl. Mater. Interfaces 10(1), 864–872 (2018)].
RETRACTED ARTICLE: Evaluating creativity in contemporary dance: a consensual approach towards research on the practice in China
Authors: Wang Zheng
Published: May 2021

This study attempts to test a simple method of consensus assessment of contemporary dance, which allows a viewer to subconsciously assess the manifestation of creativity in contemporary dance. The sample is represented by 12 choreographers, 46 dancers and 123 spectators. The main analysis was carried out using the capabilities of the LAVAAN package; to determine the influence of the main studied categories (experience and knowledge), the correlation was checked using Cohen's kappa (value 0.82, high level of reliability). Analysis of variance was used to determine the difference in average ratings of videos with dance performances. The results show that a real-life dance experience is critical. The fact that raters have had some dance lessons or that they regularly watch dance videos does not affect the final score in assessing the creative component of the shown contemporary dance. Raters with dance choreography experience rated creativity higher.
Constant low‐to‐moderate mechanical asymmetries during a treadmill graded exercise test
Authors: Girard Olivier , Alsenoy Ken Van , Li Siu Nam , Ryu Joong Hyun , Peeling Peter
Published: May 2021

This study describes asymmetry in key mechanical variables during a treadmill‐based, running graded exercise test (GXT). Twenty‐one recreationally trained male runners completed a continuous, maximal GXT on an instrumented treadmill, starting at 9 km.h−1 with speed increases of +0.5 km.h−1 every 30 s, for the determination of ventilatory threshold (VT), respiratory compensation point (RCP), and maximal oxygen uptake (MAX). Ground reaction forces were recorded continuously and subsequently averaged from 10 consecutive steps corresponding to VT, RCP and MAX intensity stages (13.4 ± 1.2 km.h−1, 16.0 ± 1.6 km.h−1 and 18.2 ± 1.5 km.h−1, respectively). Asymmetry scores were assessed from the “symmetry angle” (SA) formulae, where a score of 0%/100% indicates perfect symmetry/asymmetry; these were then compared between the three intensity stages. There was no influence of exercise intensity on SA scores for any of the sixteen biomechanical variables (P > 0.222). The group mean SA scores did not exceed 1.5% for spatio‐temporal variables (contact time, aerial time, frequency and step length). There were larger mean SA scores for mean loading rate (3.7 ± 2.7%) and most spring‐mass model variables (vertical stiffness: 2.2 ± 1.6% and leg stiffness: 1.7 ± 1.4%). The SA scores were ∼1.0–3.5% for braking and propulsive phase durations, peak forces, and resulting impulses. Lower extremities behave similarly at submaximal and maximal intensities during GXT, indicating that runners maintained relatively even strides as intensity increased. However, practitioners must be careful not to infer the presence of asymmetry during GXT based on a single variable, given the lower SA scores for spatio‐temporal parameters.

Highlights

Our comprehensive list of sixteen mechanical variables provides a mechanical norm of expected asymmetry during treadmill graded exercise testing for recreationally trained runners.

The stride pattern across submaximal and maximal exercise intensities remains consistent between limbs, with mechanical asymmetries being more individual‐specific than intensity stage‐dependent.

Low to moderate asymmetry is a natural phenomenon in recreationally trained runners during treadmill graded exercise testing; notwithstanding, asymmetry scores appear inconsistent between mechanical parameters.
Multiplexed Workplace Measurements in Biogas Plants Reveal Compositional Changes in Aerosol Properties
Authors: Pöther Dierk-Christoph , Schneider Daniela , Prott Ulrich , Karmann Jörg , Klug Kerstin , Heubach Nancy , Hebisch Ralph , Jäckel Udo
Published: May 2021

Anaerobic digestion is an emerging technology producing energy from renewable resources or food waste. Exposure screenings, comprising hazardous substances and biological agents, at different workplaces are necessary for a comprehensive overview of potential hazards in order to assess the risk of employees in biogas plants. In order to analyse these parameters, workplace measurements were conducted in seven full-scale anaerobic digesters. Personal and stationary sampling was performed for inhalable and respirable particles, volatile organic compounds, ammonia, hydrogen sulphide, carbon monoxide, and carbon dioxide. Furthermore, concentrations of the total cell count, endotoxins, and fungi—down to species level—were determined in comparison to windward air. Sequencing of the 16S rRNA genes was utilized for the determination of the bacterial composition inside the biogas plants. Measurements of hazardous substances show hardly values reaching the specific occupational exposure limit value, except ammonia. An approximate 5-fold increase in the median of the total cell count, 15-fold in endotoxins, and 4-fold in fungi was monitored in the biogas plants compared with windward air. Specifying the comparison to selected workplaces showed the highest concentrations of these parameters for workplaces related to delivery and cleaning. Strikingly, the fungal composition drastically changed between windward air and burdened workplaces with an increase of Aspergillus species up to 250-fold and Penicillium species up to 400-fold. Sequence analyses of 16S rRNA genes revealed that many workplaces are dominated by the order of Bacillales or Lactobacillales, but many sequences were not assignable to known bacteria. Although significant changes inside the biogas plant compared with windward air were identified, that increase does not suggest stricter occupational safety measures at least when applying German policies. However, exposure to biological agents revealed wide ranges and specific workplace measurements should be conducted for risk assessment.
Hybrid Implant and Grafted Fat Breast Augmentation: Designing the Pathway to a Future With Breasts Free of Silicone Breast Implants
Authors: Sforza Marcos , Spear Scott
Published: May 2021

Background

Fat grafting in breast augmentation surgery is becoming increasingly popular, allowing surgeons to fill the gaps that implant augmentation alone cannot. However, one of the current issues surrounding fat grafting is the lack of standardization.

Objectives

The objective of this study was to validate and summarize expert-based advice to help plastic surgeons better understand the benefits of utilizing fat grating to reduce implant size in their surgical planning.

Methods

This was a prospective study of fat grafting in 56 patients who underwent fat transfer together with silicone breast implants. A 3-dimensional planning system was used to plan the procedure and also to analyze the fat retention and resorption rates. Pictures served as a basis for a questionnaire in which both patients and physicians were asked to rate their satisfaction.

Results

Patients reported a satisfaction rate of “excellent” in 83.3% of cases and “good” in 16.7%. Physician satisfaction was rated as “excellent” in 84.5% of cases, “good” in 13.3%, and “fair” in 4.2% of cases. The mean fat volume grafted per breast was 113.63 mL. The mean absorption rate was 4.53%.

Conclusions

The procedure presented consistent and reproducible results. Hybrid breast augmentation can help design a pathway for a future with breasts free of silicone. This information is particularly relevant for women who have their first breast augmentation at an early age and will probably have 2 to 5 additional surgeries in their lifetime due to the nature of current silicone breast technology.

Level of Evidence: 4
Bipolar Fractional Radiofrequency Treatment of Suprapatellar Skin Assessment Using Noninvasive Devices and Microbiopsy
Authors: Kislevitz Mikaela , Lu Karen B , Wamsley Christine E , Parsa Shyon , Hoopman John E , Kenkel Jeffrey M , Akgul Yucel
Published: May 2021

Background

Noninvasive treatments for skin tightening are gaining popularity. However, no studies have assessed bipolar fractional radiofrequency treatment on suprapatellar skin.

Objectives

The purpose of this study was to evaluate the efficacy of bipolar fractional radiofrequency treatment on suprapatellar skin.

Methods

Twenty patients received 1 bilateral suprapatellar bipolar fractional radiofrequency treatment. They returned 7 days, 3 weeks, 3 months, and 6 months posttreatment. Noninvasive measurements were obtained at each visit, including high-resolution ultrasonography, optical coherence tomography, transepidermal water loss and skin elasticity. Microbiopsies were collected in the treatment area for histologic and gene expression analyses. Three clinicians completed photographic evaluations comparing texture and laxity at baseline vs 6 months posttreatment.

Results

Fifteen subjects completed all 6 visits. Both transepidermal water loss and dermal-epidermal junction roughness were increased at 3 weeks and 3 months posttreatment. Both attenuation coefficient and stiffness were increased significantly at 3 and 6 months posttreatment. Blood flow 0.5 mm below the surface and expression of epidermal hyaluronic acid and inflammatory genes IL-1b and IL-6 were significantly higher at 7 days posttreatment compared with pretreatment and 3 months posttreatment. There were no statistically significant changes in collagen- or elastin-related genes and proteins at 7 days or 3 months posttreatment. An improvement in texture and laxity was observed at 6 months posttreatment in 17.7% and 24.4% of photographs, respectively.

Conclusions

Radiofrequency treatment by microneedling of suprapatellar skin shows limited effects in decreasing skin laxity and improving skin appearance. At a molecular level, the treatment resulted in lower elastin and hyaluronic acid levels and increased dermal-epidermal junction roughness based on histology and optical coherence tomography imaging.

Level of Evidence: 4
Cross-Cultural Evaluation of the Dutch FACE-Q Rhinoplasty Questionnaires Using Rasch Analysis
Authors: Declau Frank , Pingnet Laura , Verkest Valérie , Hansen Tina
Published: May 2021

Background

The English version of the FACE-Q rhinoplasty module, developed according to Rasch measurement theory, has recently been translated into Dutch. Before conclusions can be drawn from the Dutch version, this translation must also fit the item analysis by the Rasch model.

Objectives

The primary aim of this study was to evaluate cross-cultural equivalence between the Dutch and English versions of the FACE-Q rhinoplasty module by applying Rasch methodology.

Methods

Rasch analysis performed with Winsteps (Beaverton, OR) was used to evaluate the Dutch version of the FACE-Q nose and nostrils scales with data from a prospective consecutive cohort of 100 Dutch-speaking septorhinoplasty patients. New Dutch-related conversion tables were constructed for the FACE-Q nose and nostrils scales and compared to the original ones. Psychometric cross-validation was performed by receiver operating characteristics (ROC) analysis.

Results

Both questionnaires adequately met the requirement of invariance. Within an acceptable range, some issues with item and person fit were found, as well as some local item dependency and differential item functioning. However, comparison of the Dutch- and English-related conversion tables by ROC analysis demonstrated identical results for the FACE-Q nose and nostrils scales.

Conclusions

Item analysis by the Rasch model on the data of a Dutch-speaking population proved the conceptual correspondence with the original English version.
Disparate origins for endemic bird taxa from the ‘Gondwana Rainforests’ of Central Eastern Australia
Authors: Mitchell Kieren J , Hugall Andrew F , Heiniger Holly , Joseph Leo , Oliver Paul M
Published: May 2021

Subtropical and temperate rainforests of Central Eastern Australia are some of the largest remaining fragments of their kind globally. The biota of these rainforests appears to comprise two broad biogeographical elements: a more ancient (Miocene or older) and typically upland temperate (‘Gondwanan’) element and a younger (Plio-Pleistocene) lowland tropical element. We present the first phylogenetic synthesis of the spatiotemporal origins for the eight bird taxa endemic to Central Eastern Australian Rainforests. At least five of these eight focal taxa show Plio-Pleistocene divergences from their respective northern sister taxa, consistent with origins driven by recent expansion and contraction of lowland rainforest. In contrast, two more strictly upland species, the rufous scrub-bird (Atrichornis rufescens) and the logrunner (Orthonyx temminckii), diverged from their nearest living relatives during the Miocene, suggesting potentially longer histories of persistence and more temperate origins. Finally, we did not recover reciprocal monophyly in mitogenomes from the two extant lyrebirds, Albert’s lyrebird (Menura alberti) and the superb lyrebird (Menura novaehollandiae). The disparate divergence ages recovered among all eight taxa are consistent with the biota of the Central Eastern Australian Rainforests comprising isolates either of younger age and tropical lowland origins or of older age and temperate upland origins.
Handel’s harpsichords revisited Part I: Handel and Ruckers harpsichords
Authors: Holman Peter
Published: May 2021

The harpsichords supposedly owned or played by Handel have long been the subject of scholarly enquiry, in recent years mainly to try to match their compasses and disposition to his solo music, a strategy also used, for instance, with instruments associated with J. S. Bach and Mozart. Similarly, Grant O’Brien, John Koster and others have tried to determine how Ruckers-family instruments might have been used to play early 17th-century keyboard music.

In these two articles I will survey the plucked keyboard instruments that have been associated with Handel from the composer’s time to the present. The focus in Part I is on three surviving Ruckers harpsichords that were promoted as ‘Handel’s harpsichord’ in the 18th and 19th centuries. A good deal of new information about them has come to light as the result of the recent projects to digitize newspapers, journals and other 18th- and 19th-century documents. This has enabled me to trace their provenance in greater detail than before, and to place them in the context of the process of importing, modernizing and circulating instruments by the Ruckers-Couchet family of Antwerp in 18th-century England. Evidence has also come to light of three more Ruckers instruments said to have been owned and used by Handel or his followers, making six in all, helping us to understand how they were used and why they might have preferred these obsolete instruments to the larger and more modern ones by London makers such as Shudi and Kirkman.
Should ceftriaxone-resistant Enterobacterales be tested for ESBLs? A PRO/CON debate
Authors: Villegas Maria Virginia , Esparza German , Reyes Jinnethe
Published: May 2021

ESBLs are a group of plasmid-mediated, diverse, complex and rapidly evolving enzymes that pose a therapeutic challenge today in hospital- and community-acquired infections. Thirty-six years after the first report, diagnostic and therapeutic approaches for ESBLs are still the subject of controversy. Detection of these enzymes is recommended for epidemiological purposes and facilitates targeted therapy, necessary for antimicrobial stewardship. On the other hand, ESBLs are not confined to specific species, phenotypic detection methods have pitfalls, and concerns exist about the accuracy of antimicrobial susceptibility testing systems to rely on MIC values for cephalosporins and β-lactam combination agents. In this issue, we present a PRO/CON debate on ESBL testing for ceftriaxone-non-susceptible Enterobacterales.
Social and environmental correlates of rat complaints in Chicago
Authors: Sánchez Cecilia A , Rios María Jazmín , Murray Maureen H
Published: May 2021

Urban rats are widely distributed pests that have negative effects on public health and property. It is crucial to understand their distribution to inform control efforts and address drivers of rat presence. Analysing public rat complaints can help assess urban rat distribution and identify factors supporting rat populations. Both social and environmental factors could promote rat complaints and must be integrated to understand rat distributions. We analysed rat complaints made between 2011 and 2017 in Chicago, a city with growing rat problems and stark wealth inequality. We examined whether rat complaints at the census tract level are associated with factors that could influence rat abundance, rats’ visibility to humans, and the likelihood of people making a complaint. Complaints were significantly positively correlated with anthropogenic factors hypothesized to promote rat abundance (restaurants, older buildings, garbage complaints, and dog waste complaints) or rat visibility (building construction/demolition activity), and factors hypothesized to increase the likelihood of complaining (human population density, more owner-occupied homes); we also found that complaints were highest in the summer. Our results suggest that conflicts between residents and rats are mainly driven by seasonal variation in rat abundance and human activity and could be mitigated with strategies such as securing food waste from residential and commercial sources. Accounting for social factors such as population density, construction and demolition activity, and home ownership versus rental can also help cities more accurately predict blocks at higher risk of rat conflicts.
ALMA 13CO(J = 1–0) observations of NGC 604 in M33: physical properties of molecular clouds
Authors: Phiri S P , Kirk J M , Ward-Thompson D , Sansom A E , Bendo G J
Published: May 2021

We present Atacama Large Millimeter/submillimeter Array (ALMA) observations of 13CO(J = 1–0) line and 104 GHz continuum emission from NGC 604, a giant H ii region (GHR) in the nearby spiral galaxy M33. Our high spatial resolution images (3.2 arcsec × 2.4 arcsec, corresponding to 13 × 10 pc physical scale) allow us to detect 15 molecular clouds. We find spatial offsets between the 13CO and 104 GHz continuum emission and also detect continuum emission near the centre of the GHR. The identified molecular clouds have sizes ranging from 5–21 pc, linewidths of 0.3–3.0 km s−1 and luminosity-derived masses of (0.4–80.5) × 103 M⊙. These molecular clouds are in near virial equilibrium, with a spearman correlation coefficient of 0.98. The linewidth–size relationship for these clouds is offset from the corresponding relations for the Milky Way and for NGC 300, although this may be an artefact of the dendrogram process.
Glioma-associated microglia/macrophages augment tumorigenicity in canine astrocytoma, a naturally occurring model of human glioma
Authors: Toedebusch Ryan , Grodzki Ana Cristina , Dickinson Peter J , Woolard Kevin , Vinson Nicole , Sturges Beverly , Snyder John , Li Chai-Fei , Nagasaka Ori , Consales Blaire , Vernau Karen , Knipe Marguerite , Murthy Vishal , Lein Pamela J , Toedebusch Christine M
Published: May 2021

Background

Glioma-associated microglia/macrophages (GAMs) markedly influence glioma progression. Under the influence of transforming growth factor beta (TGFB), GAMs are polarized toward a tumor-supportive phenotype. However, neither therapeutic targeting of GAM recruitment nor TGFB signaling demonstrated efficacy in glioma patients despite efficacy in preclinical models, underscoring the need for a comprehensive understanding of the TGFB/GAM axis. Spontaneously occurring canine gliomas share many features with human glioma and provide a complementary translational animal model for further study. Given the importance of GAM and TGFB in human glioma, the aims of this study were to further define the GAM-associated molecular profile and the relevance of TGFB signaling in canine glioma that may serve as the basis for future translational studies.

Methods

GAM morphometry, levels of GAM-associated molecules, and the canonical TGFB signaling axis were compared in archived samples of canine astrocytomas versus normal canine brain. Furthermore, the effect of TGFB on the malignant phenotype of canine astrocytoma cells was evaluated.

Results

GAMs diffusely infiltrated canine astrocytomas. GAM density was increased in high-grade tumors that correlated with a pro-tumorigenic molecular signature and upregulation of the canonical TGFB signaling axis. Moreover, TGFB1 enhanced the migration of canine astrocytoma cells in vitro.

Conclusions

Canine astrocytomas share a similar GAM-associated immune landscape with human adult glioma. Our data also support a contributing role for TGFB1 signaling in the malignant phenotype of canine astrocytoma. These data further support naturally occurring canine glioma as a valid model for the investigation of GAM-associated therapeutic strategies for human malignant glioma.
Rejuvenation remodels transcriptional network to improve rhizogenesis in mature Juglans tree
Authors: Song Xiaobo , Liu Hao , Bu Dechao , Xu Huzhi , Ma Qingguo , Pei Dong
Published: May 2021

Adventitious rooting of walnut species (Juglans L.) is known to be rather difficult, especially for mature trees. The adventitious root formation (ARF) capacities of mature trees can be significantly improved by rejuvenation. However, the underlying gene regulatory networks (GRNs) of rejuvenation remain largely unknown. To characterize such regulatory networks, we carried out the transcriptomic study using RNA samples of the cambia and peripheral tissues on the bottom of rejuvenated and mature walnut (Juglans hindsii × J. regia) cuttings during the ARF. The RNA sequencing data suggested that zeatin biosynthesis, energy metabolism and substance metabolism were activated by rejuvenation, whereas photosynthesis, fatty acid biosynthesis and the synthesis pathways for secondary metabolites were inhibited. The inter- and intra-module GRNs were constructed using differentially expressed genes. We identified 35 hub genes involved in five modules associated with ARF. Among these hub genes, particularly, beta-glucosidase-like (BGLs) family members involved in auxin metabolism were overexpressed at the early stage of the ARF. Furthermore, BGL12 from the cuttings of Juglans was overexpressed in Populus alba × P. glandulosa. Accelerated ARF and increased number of ARs were observed in the transgenic poplars. These results provide a high-resolution atlas of gene activity during ARF and help to uncover the regulatory modules associated with the ARF promoted by rejuvenation.
Cranial skeletogenesis of one of the largest amphibians, Andrias japonicus, provides insight into ontogenetic adaptations for feeding in salamanders
Authors: Ishikawa Kaoru , Taguchi Yuki , Kobayashi Ryomei , Anzai Wataru , Hayashi Toshinori , Tokita Masayoshi
Published: May 2021

Skeletal development in salamanders is greatly influenced by their complex life history. Although the relationship between skull development and life history has been investigated in a variety of salamander species, few studies have compared skull development among lineages. Here, we describe the cranial skeletogenesis of the Japanese giant salamander, Andrias japonicus (family Cryptobranchidae), for the first time. To conduct interspecific comparisons, we also describe the cranial skeletogenesis of Hynobius nebulosus (Hynobiidae), Pleurodeles waltl (Salamandridae) and Ambystoma mexicanum (Ambystomatidae). Our comparative analyses reveal interspecific differences in cranial skeletogenesis, particularly in the timing of the onset of ossification, the direction of ossification (e.g. from anterior to posterior) and the ossification pattern of the hyobranchial skeleton. The early onset of jaw ossification, posterior extension of the maxilla and posterolateral inclination of the squamosal in An. japonicus might be adaptations that allow An. japonicus to gulp feed, primarily using the suction force generated by opening the mouth wide, while also supplementing that force by depressing the hyobranchial skeleton. Multivariate regression of skull shape on log10-transformed centroid size revealed that the unique skull shape of adult and subadult An. japonicus forms through hypermorphosis.
The Potential of Gaseous Chlorine Dioxide for the Control of Citrus Postharvest Stem-End Rot Caused by Lasiodiplodia theobromae
Authors: Zhong Tian , Zhang Jiuxu , Sun Xiuxiu , Kou Jingjing , Zhang Zhike , Bai Jinhe , Ritenour Mark A.
Published: May 2021

The focus of this study was to develop technologies using chlorine dioxide (ClO2) gas to control postharvest stem-end rot of citrus caused by Lasiodiplodia theobromae. Mycelial growth of L. theobromae on potato dextrose agar (PDA) plugs was completely inhibited by a 24-h ClO2 exposure provided by 0.5 g of solid ClO2 generating granular mixture in a 7.7-liter sealed container. In vivo experiments were conducted on artificially inoculated Tango and naturally infected U.S. Early Pride mandarins. When ClO2 treatments were initiated 0 to 6 h after inoculation, decay development was significantly reduced as compared with the control, and higher ClO2 doses were more effective. A ClO2 treatment (using 3 g of generating mixture per 7.7-liter sealed container) administered 0 h after inoculation resulted in 17.6% Diplodia stem-end rot incidence compared with 95.6% in the control, whereas the same treatment administered 24 h after inoculation was much less effective, resulting in 63.0% incidence compared with 85.4% in the control. Diplodia stem-end rot incidence of naturally infected fruit after using 6 or 9 g of generating mixture per 24-liter sealed box was 23.8 or 25.7%, respectively, compared with 47.9% for control fruit. The ClO2 treatments had no negative effects on fruit quality characteristics including weight loss, firmness, puncture resistance, titratable acids (TAs), total soluble solids (TSSs), and rind color. Albedo pH at wounds was significantly reduced from 6.0 to 4.8 by the ClO2 treatments, whereas undamaged albedo remained at 5.8. In addition, no visible physiologic defects, such as peel browning and bleaching, were observed on ClO2-treated fruit. These results indicate that ClO2 gas has the potential to be developed as a component of an integrated citrus postharvest decay control system to minimize fruit losses.
Central pain modulatory mechanisms of attentional analgesia are preserved in fibromyalgia
Authors: Oliva Valeria , Gregory Robert , Brooks Jonathan C.W. , Pickering Anthony E.
Published: May 2021

Fibromyalgia is a prevalent pain condition that is associated with cognitive impairments including in attention, memory, and executive processing. It has been proposed that fibromyalgia may be caused by altered central pain processing characterised by a loss of endogenous pain modulation. We tested whether attentional analgesia, where cognitive engagement diminishes pain percept, was attenuated in patients with fibromyalgia (n = 20) compared with matched healthy controls (n = 20). An individually calibrated, attentional analgesia paradigm with a 2 × 2 factorial design was used with brain and brainstem-focussed functional magnetic resonance imaging. Patients with fibromyalgia had both lower heat pain thresholds and speeds in a visual attention task. When this was taken into account for both attentional task and thermal stimulation, both groups exhibited an equivalent degree of attentional analgesia. Functional magnetic resonance imaging analysis showed similar patterns of activation in the main effects of pain and attention in the brain and brainstem (with the sole exceptions of increased activation in the control group in the frontopolar cortex and the ipsilateral locus coeruleus). The attentional analgesic effect correlated with activity in the periaqueductal gray and rostral ventromedial medulla. These findings indicate that patients with fibromyalgia can engage the descending pain modulatory system if the attentional task and noxious stimulus intensity are appropriately titrated.
Implementation of an educational program for pancreaticoduodenectomy in a university hospital: a retrospective observational study
Authors: Satoi Sohei , Yamamoto Tomohisa , Yamaki So , Hirooka Satoshi , Hashimoto Daisuke , Sakaguchi Tatsuma , Ryota Hironori , Yui Rintaro , Sakuramoto Kazuto , Matsushima Hideyuki , Yanagimoto Hiroaki , Toyokawa Hideyoshi , Michiura Taku , Inoue Kentaro , Sekimoto Mitsugu
Published: May 2021

Objective:

No ideal training system exists for pancreaticoduodenectomy (PD). We developed an educational system that uses an objective structured assessment of technical skills.

Methods:

This retrospective observational study was conducted using the data of consecutive trainees and patients who underwent PD from 2007 to 2013 in Kansai Medical University Hospital. The total score on the task checklist (21 parameters) for measuring technical performance during PD by self assessment and instructor assessment was compared between junior (JN) and hepatobiliary pancreatic (HBP) trainees at a university hospital. Surgical outcomes of 303 PDs (2007–2013) were also compared among JN trainees, HBP trainees, and instructors, and the present position of the trainees was investigated. This study was approved by the institutional review board of Kansai Medical University on May 26, 2020.

Results:

The self-assessment score on the task checklist was significantly higher for the HBP trainees than for the JN trainees on all parts of PD (P < .001). The discrepancy between self-assessment and instructor assessment improved in 3 JN trainees after experience with the first 5 PDs. Although total score curves rose to the right in the JN group, scores in the HBP group were stable, at 70 or higher, which correlated with the instructor assessment. The 90-day and 30-day mortality rates were 1.6% and 0.3%, respectively. Mortality and morbidity after PD did not differ between the JN and HBP trainees or between the instructors and the trainees. Four of 10 trainees became board-certified expert surgeons of the Japanese Society of Hepatobiliary Pancreatic Surgery.

Conclusion:

These results indicated good construct validity of the task checklist system. This program was safely and effectively implemented in terms of surgical outcomes and final outcomes of trainees becoming board-certified expert surgeons.
Clinical Diagnosis of Central Vertigo in Patients With Dizziness in Emergency Practice
Authors: Umibe Akiko , Kitahara Tadashi , Aoki Satoshi , Suzuki Yumi , Tochigi Kosuke , Miyashita Keisuke , Ihara Kanako , Inoue Yukari , Anazawa Utaro , Akiyoshi Ryohei , Nishijima Yoshikata , Omura Kazuhiro , Tanaka Yasuhiro
Published: May 2021

Background:

Life-threatening diseases should be promptly identified to provide appropriate medical care for emergency outpatients experiencing dizziness. However, dizziness is associated with various medical conditions; thus, a definitive diagnosis is challenging. To accurately diagnose vertigo in an emergency outpatient, we conducted a survey on the need to identify vertigo patients in the current outpatient departments.

Materials and Methods:

The participants included 509 patients who visited the outpatient department at our hospital from February 2014 to May 2017. Overall, 12 characteristics were retrospectively extracted from the patients’ medical records: age, sex, visit method, medical history (diabetes, hypertension, cardiac, or cerebrovascular disease), dizziness history, vertigo characteristics, concomitant symptoms, systolic blood pressure, nystagmus, imaging history, diagnosis, and hospitalization department. Univariate and multivariate analyses were performed to identify factors related to central vertigo.

Results:

The diagnosis of central vertigo was confirmed when intracranial lesions were detected through imaging. In multivariate analysis, the presence/absence of a history of headache and cardiovascular disease were significantly correlated with central vertigo (P=0.002 and 0.006, respectively), with odds ratios of 5.18 and 4.38, respectively.

Conclusions:

To avoid missing central dizziness in a patient, diagnostic abilities should be improved by including careful interviews and confirmation of the presence/absence of accompanying symptoms. Furthermore, collaboration with neurology and neurosurgery departments is important for improving the diagnosis in suspected cases.
Effect of metronidazole on vaginal microbiota associated with asymptomatic bacterial vaginosis
Authors: Ruiz-Perez Daniel , Coudray Makella S. , Colbert Brett , Krupp Karl , Kumari Hansi , Stebliankin Vitalii , Mathee Kalai , Cook Robert L. , Schwebke Jane , Narasimhan Giri , Madhivanan Purnima
Published: May 2021

Vaginal dysbiosis-induced by an overgrowth of anaerobic bacteria is referred to as bacterial vaginosis (BV). The dysbiosis is associated with an increased risk for acquisition of sexually transmitted infections. Women with symptomatic BV are treated with oral metronidazole (MET), but its effectiveness remains to be elucidated. This study used whole-genome sequencing (WGS) to determine the changes in the microbiota among women treated with MET. WGS was conducted on DNA obtained from 20 vaginal swabs collected at four time points over 12 months from five randomly selected African American (AA) women. The baseline visit included all women who were diagnosed with asymptomatic BV and were untreated. All subjects were tested subsequently once every 2 months and received a course of MET for each BV episode during the 12 months. The BV status was classified according to Nugent scores (NSs) of vaginal smears. The microbial and resistome profiles were analysed along with the sociodemographic metadata. Despite treatment, none of the five participants reverted to normal vaginal flora — two were consistently positive for BV, and the rest experienced episodic cases of BV. WGS analyses showed

Gardnerella

spp. as the most abundant organism. After treatment with MET, there was an observed decline of

Lactobacillus

and

Prevotella

species. One participant had a healthy vaginal microbiota based on NS at one follow-up time point. Resistance genes including tetM and lscA were detected. Though limited in subjects, this study shows specific microbiota changes with treatment, presence of many resistant genes in their microbiota, and recurrence and persistence of BV despite MET treatment. Thus, MET may not be an effective treatment option for asymptomatic BV, and whole metagenome sequence would better inform the choice of antibiotics.