bluuebunny/crossref_metadata_2025 huggingface dataset:
BiSulfite Bolt: A bisulfite sequencing analysis platform
Authors: Farrell Colin , Thompson Michael , Tosevska Anela , Oyetunde Adewale , Pellegrini Matteo
Published: May 2021

Background

Bisulfite sequencing is commonly used to measure DNA methylation. Processing bisulfite sequencing data is often challenging owing to the computational demands of mapping a low-complexity, asymmetrical library and the lack of a unified processing toolset to produce an analysis-ready methylation matrix from read alignments. To address these shortcomings, we have developed BiSulfite Bolt (BSBolt), a fast and scalable bisulfite sequencing analysis platform. BSBolt performs a pre-alignment sequencing read assessment step to improve efficiency when handling asymmetrical bisulfite sequencing libraries.

Findings

We evaluated BSBolt against simulated and real bisulfite sequencing libraries. We found that BSBolt provides accurate and fast bisulfite sequencing alignments and methylation calls. We also compared BSBolt to several existing bisulfite alignment tools and found BSBolt outperforms Bismark, BSSeeker2, BISCUIT, and BWA-Meth based on alignment accuracy and methylation calling accuracy.

Conclusion

BSBolt offers streamlined processing of bisulfite sequencing data through an integrated toolset that offers support for simulation, alignment, methylation calling, and data aggregation. BSBolt is implemented as a Python package and command line utility for flexibility when building informatics pipelines. BSBolt is available at https://github.com/NuttyLogic/BSBolt under an MIT license.
Representation theoretic patterns in multi-frequency class averaging for three-dimensional cryo-electron microscopy
Authors: Fan Yifeng , Gao Tingran , Zhao Zhizhen
Published: May 2021

We develop in this paper a novel intrinsic classification algorithm—multi-frequency class averaging (MFCA)—for classifying noisy projection images obtained from three-dimensional cryo-electron microscopy by the similarity among their viewing directions. This new algorithm leverages multiple irreducible representations of the unitary group to introduce additional redundancy into the representation of the optimal in-plane rotational alignment, extending and outperforming the existing class averaging algorithm that uses only a single representation. The formal algebraic model and representation theoretic patterns of the proposed MFCA algorithm extend the framework of Hadani and Singer to arbitrary irreducible representations of the unitary group. We conceptually establish the consistency and stability of MFCA by inspecting the spectral properties of a generalized local parallel transport operator through the lens of Wigner $D$-matrices. We demonstrate the efficacy of the proposed algorithm with numerical experiments.
AugIR Meets GestureCards: A Digital Sketching Environment for Gesture-Based Applications
Authors: Hesenius Marc , Kleffmann Markus , Gruhn Volker
Published: May 2021

To gain a common understanding of an application’s layouts, dialogs and interaction flows, development teams often sketch user interface (UI). Nowadays, they must also define multi-touch gestures, but tools for sketching UIs often lack support for custom gestures and typically just integrate a basic predefined gesture set, which might not suffice to specifically tailor the interaction to the desired use cases. Furthermore, sketching can be enhanced with digital means, but it remains unclear whether digital sketching is actually beneficial when designing gesture-based applications. We extended the AugIR, a digital sketching environment, with GestureCards, a hybrid gesture notation, to allow software engineers to define custom gestures when sketching UIs. We evaluated our approach in a user study contrasting digital and analog sketching of gesture-based UIs.
Magic and Politics: Conspirituality and COVID-19
Authors: Parmigiani Giovanna
Published: May 2021

Why do people find conspiracy theories attractive, convincing, or useful? In this article, I analyze conspirituality—that is, the relationships between New Age spirituality and conspiracy theories—in Italy during the COVID-19 lockdown. After distinguishing between conspiracy-believing and belief in conspiracies, I claim that conspiracy-believing could be understood as an aesthetic (sensory and artistic) practice. In doing so, I offer a novel interpretation on conspiracism that complements current scholarship while departing from the latter’s focus on the cognitive and emotional weaknesses of those who adopt conspiracy theories. By engaging with the thought of Jacques Rancière, in conversation with studies on contemporary Paganism and Western esotericism, I consider the adoption of conspiracy theories as an expression of dissensus by a community of sense that does not look only for visibility but, rather, wants to be fully acknowledged, recognized, and legitimized in their “participatory”—or “magical”—way of inhabiting the world.
A rare case of primary cutaneous diffuse large B-cell lymphoma, leg type, presenting as cellulitis: a case report
Authors: Huang Shih-Feng , Liu Wen-Chung
Published: May 2021

Primary cutaneous diffuse large B-cell lymphoma, leg type, accounts for only 4% of all cutaneous lymphomas and bears a worse prognosis than other cutaneous B-cell lymphomas. Diagnosis at an early stage may be difficult due to its nonspecific manifestations. We report an 88-year-old female who was brought to our emergency department due to two rapidly growing painful skin lesions with local redness and swelling on her right lower leg. We performed incisional biopsy of the two right lower leg skin lesions and sent the specimens for histopathological examination. The pathological examination was compatible with diffuse large B-cell lymphoma. Primary cutaneous diffuse large B-cell lymphoma, leg type, is a rare condition that can present as skin cellulitis, thereby misleading clinicians and resulting in delayed treatment. This diagnosis should be considered when assessing skin lesions.
Strigolactones regulate sepal senescence in Arabidopsis
Authors: Xu Xi , Jibran Rubina , Wang Yanting , Dong Lemeng , Flokova Kristyna , Esfandiari Azadeh , McLachlan Andrew R G , Heiser Axel , Sutherland-Smith Andrew J , Brummell David A , Bouwmeester Harro J , Dijkwel Paul P , Hunter Donald A
Published: May 2021

Flower sepals are critical for flower development and vary greatly in life span depending on their function post-pollination. Very little is known about what controls sepal longevity. Using a sepal senescence mutant screen, we identified two Arabidopsis mutants with delayed senescence directly connecting strigolactones with senescence regulation in a novel floral context that hitherto has not been explored. The mutations were in the strigolactone biosynthetic gene MORE AXILLARY GROWTH1 (MAX1) and in the strigolactone receptor gene DWARF14 (AtD14). The mutation in AtD14 changed the catalytic Ser97 to Phe in the enzyme active site, which is the first mutation of its kind in planta. The lesion in MAX1 was in the haem–iron ligand signature of the cytochrome P450 protein, converting the highly conserved Gly469 to Arg, which was shown in a transient expression assay to substantially inhibit the activity of MAX1. The two mutations highlighted the importance of strigolactone activity for driving to completion senescence initiated both developmentally and in response to carbon-limiting stress, as has been found for the more well-known senescence-associated regulators ethylene and abscisic acid. Analysis of transcript abundance in excised inflorescences during an extended night suggested an intricate relationship among sugar starvation, senescence, and strigolactone biosynthesis and signalling.
The value of bone marrow biopsy for staging of patients with primary CNS lymphoma
Authors: Margold Michelle , Seidel Sabine , Kowalski Thomas , Ladigan-Badura Swetlana , Baraniskin Alexander , Schroers Roland , Frey Anna Verena , Schmidt-Wolf Ingo G H , Herrlinger Ulrich , Korfel Agnieszka , Schlegel Uwe
Published: May 2021

Background

In patients with presumed primary CNS lymphoma (PCNSL), a systemic manifestation is found only in a small minority. Although bone marrow biopsy (BMB) is recommended for staging, its diagnostic value is unclear.

Methods

A retrospective analysis of 392 patients with presumed PCNSL from 3 university hospitals and 33 patients with secondary CNS lymphoma (SCNSL) and initial CNS involvement from a multicenter Germany-wide prospective registry was performed.

Results

A BMB was performed and documented in 320/392 patients with presumed PCNSL; 23 had pathologic results. One harbored the same lymphoma in the brain and bone marrow (BM), 22 showed findings in BM discordant to the histology of brain lymphoma; n = 12 harbored a low-grade lymphoma in the BM, the other showed B-cell proliferation but no proof of lymphoma (n = 5), monoclonal B cells (n = 3), or abnormalities not B-cell-associated (n = 2). In the group of SCNSL with initial CNS manifestation, 32/33 patients underwent BMB; 7 were documented with bone marrow involvement (BMI); 1 had concordant results in the brain and BM with no other systemic manifestation. Six had additional systemic lymphoma manifestations apart from the brain and BM.

Conclusions

In only 2 out of 352 (0.6%) patients with CNS lymphoma (320 presumed PCNSL and 32 SCNSL), BMB had an impact on diagnosis and treatment. While collected in a selected cohort, these findings challenge the value of BMB as part of routine staging in presumed PCNSL.
A Novel Protocol for Reducing Intensive Care Utilization After Craniotomy
Authors: Pendharkar Arjun V , Shahin Maryam N , Awsare Sohun S , Ho Allen L , Wachira Christine , Clevinger Johnathan , Sigurdsson Sveinn , Lee Yohan , Wilson Alicia , Lu Amy C , Gephart Melanie Hayden
Published: May 2021

BACKGROUND

There is a growing body of evidence suggesting not all craniotomy patients require postoperative intensive care.

OBJECTIVE

To devise and implement a standardized protocol for craniotomy patients eligible to transition directly from the operating room to the ward—the Non-Intensive CarE (NICE) protocol.

METHODS

We preoperatively identified patients undergoing elective craniotomy for simple neurosurgical procedures with age <65 yr and American Society of Anesthesiologists (ASA) class of 1, 2 or 3. Postoperative eligibility was confirmed by the surgical and anesthesia teams. Upon arrival to the ward, patients were staffed with a neuroscience nurse for hourly neurological examinations for the first 8 h. Patient demographics, clinical characteristics, and outcomes were prospectively collected to evaluate the NICE protocol.

RESULTS

From February 2018 to 2019, 63 patients were included in the NICE protocol with a median age of 46 yr and 65% female predominance. Of the operations performed, 38.1% were microvascular decompressions, 31.7% were craniotomy for tumor, 15.9% were cavernous malformation resections, and 14.3% were Chiari decompressions. No patients required transfer to the intensive care unit (ICU). Median length of stay was 2 d. There was an 11.1% overall readmission rate within the median follow-up period of 48 d. Three patients (4.8%) required reoperation at time of readmission within the follow-up period (1 postoperative subdural hematoma, 2 cerebrospinal fluid leak repair). None of these complications could have been identified with a postoperative ICU stay.

CONCLUSION

In our pilot trial of the NICE protocol, no patients required postoperative transfer to the ICU.
Clinical Presentation and Multifactorial Pathogenesis of Necrotizing Enterocolitis in the Preterm Infant
Authors: Andrews Rachael E. , Coe Kristi L.
Published: May 2021

Background:

Necrotizing enterocolitis (NEC) is a serious infection of the bowel wall induced by multiple pathological factors, which include inflammation and tissue invasion with bacteria known to cause severe infections. NEC is now understood to be several disease processes under one umbrella. The most common form occurs in premature infants and can exert significant impacts to preterm morbidity and mortality.

Purpose:

This narrative review describes current knowledge of the clinical presentation and pathophysiology of NEC in premature infants.

Methods/Search Strategy:

A review of literature was conducted using key words in PubMed and CINAHL with preference for years 2015 to 2020.

Findings/Results:

Several converging and interrelated factors including characteristics of the premature intestinal mucosa, gut ischemia, dysregulation of the microbiome, enteral feeding, and genetics create an environment where NEC is more likely to occur.

Implications for Practice:

To recognize and diagnose NEC in preterm infants, an understanding of underlying factors that create an optimal environment for disease acquisition in premature infants is essential.

Implications for Research:

Prevention of NEC remains the most important strategy for decreasing morbidity and mortality. Multiple areas of potential study exist for NEC pathophysiology including those that consider how the factors discussed in this review are interrelated and how each particular pathway can be optimized to prevent the onset of NEC.
Mindfulness Effects in Obstetric and Gynecology Patients During the Coronavirus Disease 2019 (COVID-19) Pandemic
Authors: Smith Rachael B. , Mahnert Nichole D. , Foote Janet , Saunders Kelley T. , Mourad Jamal , Huberty Jennifer
Published: May 2021

OBJECTIVE:

To assess the effect of a consumer-based mobile meditation application (app) on wellness in outpatient obstetric and gynecology patients during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS:

We conducted a randomized controlled trial at a university outpatient clinic of obstetric and gynecology patients during the COVID-19 pandemic. Women were randomly assigned to the intervention group, who was prescribed a mobile meditation app for 30 days, or the control group, which received standard care. The primary outcome was self-reported perceived stress. Secondary outcomes included self-reported depression, anxiety, sleep disturbance, and satisfaction with the meditation app. A sample size of 80 participants (40 per group) was calculated to achieve 84% power to detect a 3-point difference in the primary outcome.

RESULTS:

From April to May 2020, 101 women were randomized in the study—50 in the meditation app group and 51 in the control group. Analysis was by intention-to-treat. Most characteristics were similar between groups. Perceived stress was significantly less in the intervention group at days 14 and 30 (mean difference 4.27, 95% CI 1.30–7.24, P=.005, d=0.69 and mean difference 4.28, 95% CI 1.68–6.88, P=.002, d=0.69, respectively). Self-reported depression and anxiety were significantly less in the intervention group at days 14 and 30 (depression: P=.002 and P=.04; anxiety: P=.01, and P=.04, respectively). Sleep disturbance was significantly less in the intervention group at days 14 and 30 (P=.001 and P=.02, respectively). More than 80% of those in the intervention group reported high satisfaction with the meditation app, and 93% reported that mindfulness meditation improved their stress.

CONCLUSION:

Outpatient obstetric and gynecology patients who used the prescribed consumer-based mobile meditation app during the COVID-19 pandemic had significant reductions in perceived stress, depression, anxiety, and sleep disturbance compared with standard care.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT04329533.
Outcomes of the First Pregnancy After Fertility-Sparing Surgery for Early-Stage Ovarian Cancer
Authors: Nitecki Roni , Clapp Mark A. , Fu Shuangshuang , Lamiman Kelly , Melamed Alexander , Brady Paula C. , Kaimal Anjali , del Carmen Marcela G. , Woodard Terri L. , Meyer Larissa A. , Giordano Sharon H. , Ramirez Pedro T. , Rauh-Hain J. Alejandro
Published: May 2021

OBJECTIVE:

To evaluate the outcomes of the first pregnancy after fertility-sparing surgery in patients treated for early-stage ovarian cancer.

METHODS:

We performed a retrospective study of women aged 18–45 years with a history of stage IA or IC ovarian cancer reported to the California Cancer Registry for the years 2000–2012. These data were linked to the 2000–2012 California Office of Statewide Health Planning and Development birth and discharge data sets to ascertain oncologic characteristics and obstetric outcomes. We included in the case group ovarian cancer patients who conceived at least 3 months after fertility-sparing surgery. The primary outcome was preterm birth, and only the first pregnancy after cancer diagnosis was considered. Secondary outcomes included small-for-gestational-age (SGA) neonates, neonatal morbidity (respiratory support within 72 hours after birth, hypoxic-ischemic encephalopathy, seizures, infection, meconium aspiration syndrome, birth trauma, and intracranial or subgaleal hemorrhage), and severe maternal morbidity as defined by the Centers for Disease Control and Prevention. Propensity scores were used to match women in a 1:2 ratio for the case group and the control group. Wald statistics and logistic regressions were used to evaluate outcomes.

RESULTS:

A total of 153 patients who conceived after fertility-sparing surgery were matched to 306 women in a control group. Histologic types included epithelial (55%), germ-cell (37%), and sex-cord stromal (7%). Treatment for ovarian cancer was not associated with preterm birth before 37 weeks of gestation (13.7% vs 11.4%; odds ratio [OR] 1.23, 95% CI 0.69–2.20), SGA neonates (birth weight less than the 10th percentile: 11.8% vs 12.7%; OR 0.91, 95% CI 0.50–1.66), severe maternal morbidity (2.6% vs 1.3%; OR 2.03, 95% CI 0.50–8.25), or neonatal morbidity (both 5.9% OR 1.00, 95% CI 0.44–2.28).

CONCLUSION:

Patients who conceived at least 3 months after surgery for early-stage ovarian cancer did not have an increased risk of adverse obstetric outcomes.
Cost Analysis and Outcomes of Endoscopic, Minimal Access and Open Pancreatic Necrosectomy
Authors: Saunders Rebecca , Hughes Faye E. , Evans Jonathan C. , Smart Howard L. , Ghaneh Paula , Ramesh Jayapal , Sutton Robert , Halloran Christopher M.
Published: May 2021

Objectives:

To assess both individual patient and institutional costs as well as outcomes in patients with pancreatic necrosis who underwent either endoscopic, minimal access or open pancreatic necrosectomy. These data can be used to evaluate clinical effectiveness with a view to informing local healthcare providers.

Background:

Intervention for infected pancreatic necrosis is associated with a high morbidity, mortality, and long hospital stays. Minimal access surgical step-up approaches have been the gold standard of care; however, endoscopic approaches are now offered preferentially.

Methods:

All patients undergoing endoscopic (EN), minimal access retroperitoneal (MARPN), and open (OPN) necrosectomy at a single institution from April 2015 to March 2017 were included. Patients were selected for intervention based on morphology and position of the necrosis and on clinical factors. Patient-level costing systems were used to determine inpatient and outpatient costs.

Results:

Eighty-six patients were included: 38 underwent EN, 35 MARPN, and 13 OPN. Preoperative APACHEII was 6 versus 9 versus 9 (P = 0.017) and CRP 107 versus 204 versus 278 (P = 0.012), respectively. Postoperative stay was 19 days for EN versus 41 for MARPN versus 42 for OPN (P = 0.007). Complications occurred in 68.4%, 68.6%, and 46.2% (P = 0.298), whereas mortality was 10.5%, 22.9%, and 15.4% (P = 0.379), respectively. Mean total cost was £31,364 for EN, £52,770 for MARPN (P = 0.008), and £60,346 for OPN. Ward and critical care costs for EN were lower than for MARPN (ward: £9430 vs £14,033, P = 0.024; critical care: £5317 vs £16,648, P = 0.056).

Conclusions:

EN was at least as safe and effective as MARPN and OPN and was associated with markedly reduced hospital stay and cost, although some markers of disease severity were higher in patients undergoing MARPN and OPN. These results support EN as the preferred approach to necrosectomy, but hybrid utilization of all available techniques remains integral to optimal outcomes.
Female-Specific Susceptibility Locus in BOC and SEC16B are Associated with Adolescent Idiopathic Scoliosis
Authors: Dai Zhicheng , Wang Yuwen , Wu Zhichong , Feng Zhenhua , Sun Xu , Qiu Yong , Cheng Jack Chun-Yiu , Xu Leilei , Zhu Zezhang
Published: May 2021

Study Design.

A genetic case-control study.

Objectives.

To investigate whether the variants in BOC, SEC16B, and SH2D1B are sex-specifically and functionally associated with the susceptibility of adolescent idiopathic scoliosis (AIS) in Chinese Han population.

Summary of Background Data.

A recent genome-wide association study identified three female-specific susceptibility loci of AIS in Japanese population. However, the association of these genes with AIS in other populations remains unclear. Further investigation of the functional role of the three genes was warranted.

Methods.

SNPs rs73235136, rs545608, and rs142502288 were genotyped in 1599 AIS patients and 2985 controls. Paraspinal muscle collected from 40 AIS and 30 lumber disc herniation patients during surgical interventions was used for gene expression analysis. The difference regarding genotype and allele frequency between patients and controls was analyzed by chi-square analysis. Expression of BOC and SEC16B was compared between AIS and lumber disc herniation patients by the Student t test. Pearson correlation analysis was performed to evaluate the relationship between gene expression level and clinical phenotypes.

Results.

SNPs rs73235136 of BOC and rs545608 of SEC16B were found to be remarkably associated with AIS only in females. Allele C of rs73235136 and allele G of rs545608 could significantly add to the risk of female AIS patients, with an odds ratio of 1.087 and 1.033, respectively. However, there was no significant difference between the male patients and controls regarding genotype or allele frequency of rs73235136 and rs545608. No polymorphism at rs142502288 was detected in either patients or controls, and all the subjects had genotype of AA. Moreover, tissue expression of BOC and SEC16B was significantly lower in AIS patients compared with controls. BOC expression was positively associated with bone mineral contents, and expression of SEC16B was negatively correlated with curve severity in AIS patients.

Conclusion.

Female-specific variants in BOC and SEC16B were associated with AIS. Expression of BOC and SEC16B was significantly lower in AIS patients. The role of BOC and SEC16B in the development of AIS is worthy of further investigation.

Level of Evidence: 3
Facilitated Umbilical Positioning in Abdominoplasty Using the 15/10 Rule and the “Flap Flipping” Technique
Authors: Rysin Roman , Wolf Yoram
Published: May 2021

First described by Gaudet and Morestin, abdominoplasty with umbilical preservation dates as far back as 1905. Navel position was described on the transverse axis by Rohrich, and on the median longitudinal axis, by Vernon, Baroudi and Pitanguy. The aim of this article is to validate the 15/10 rule of umbilical positioning in abdominoplasty with the “flap flipping” technique, as an intraoperative aid to simplify umbilical repositioning. Between October 2019 and March 2020, 18 consecutive patients underwent full abdominoplasty, using the 15/10 rule for umbilical positioning. Patients’ average age was 47.9, with body mass index 27.5 kg/m2 and height 1.63 m. An “expected zone” of umbilical position was delineated by 2 horizontal lines, 15 cm from the bra line and 10 cm from the pubic level. The umbilicus was accurately positioned by using the flap flipping technique before closure of the inferior abdominal incision line. It was then examined to determine whether the umbilicus was situated in the expected zone. In 14 of 18 patients, intraoperative and postoperative measurements of umbilical position were in the expected zone. An average 15.19 cm was measured between the bra line and the new umbilical positioning, and 12.02 cm from the new umbilicus to the pubic inferior suture line. We find that the 15/10 rule of umbilical positioning with the flap flipping technique is an important, intuitive, and easy-to-use guide for precise umbilical positioning in abdominoplasty.
FOVEAL DISPLACEMENT IN EYES WITH EPIRETINAL MEMBRANE AFTER VITRECTOMY AND MEMBRANE PEELING
Authors: Tung Hsiao-Fan , Chen Yi-Ling , Tung Hsiao-Yu , Tung Hsiao-Wei , Chen San-Ni
Published: May 2021

Purpose:

To investigate the foveal movement in eyes with epiretinal membrane after vitrectomy and membrane peeling.

Methods:

A retrospective review of 85 eyes with epiretinal membrane treated with vitrectomy, membrane peeling, and internal limiting membrane removal. Using a self-designed computer program to compare the preoperative and postoperative images of optical coherence tomography to measure the amount of foveal movement. Analyze the relationships between foveal displacement, preoperative and postoperative best-corrected visual acuity, central foveal thickness, and the stage of epiretinal membrane.

Results:

Most of the fovea were nasally shifted. More movement happened in the first month and almost finished in the first year. The greater degree of foveal displacement was correlated with poorer initial visual acuity and thicker central foveal thickness. In considering with the ectopic inner foveal layer staging of epiretinal membrane by structural optical coherence tomography, the foveal realignment is greatest in Stage 4 (394.47 ± 171.44 µm), followed by Stage 1 (251.21 ± 135.40 µm), Stage 2 (235.70 ± 147.51 µm), and Stage 3 (219.86 ± 117.91 µm) at the postoperative 1 month.

Conclusion:

Most eyes of epiretinal membrane had the foveal moved nasally after membrane peeling and internal limiting membrane peeling. The larger amount of foveal movement was correlated with poorer initial best-corrected visual acuity. Dystopia fovea may be another factor affecting visual acuity in addition to other biomarkers in optical coherence tomography.
Child Sexual Assault Nurse Examinations and Prosecutorial Decisions to Accept or Reject Cases of Child Sexual Abuse
Authors: Bracewell Tammy E. , Greenwood Lynn M.
Published: May 2021

Introduction

Prosecution of child sexual abuse (CSA) cases provides safety for communities and justice for victims. Prosecutorial decisions are multifactorial and include the presence of a structured coordinated community response to outcries and access to skilled healthcare providers. This study examines the impact forensic nurse sexual assault examinations (SAEs) have on prosecution in a population of children seen at a child advocacy center (CAC).

Methods

The authors examined case data from 553 cases of reported CSA, seen by a forensic nurse in a CAC.

Results

Statistical analysis focused on prosecution decisions with and without SAE, with and without physical findings. Logistic regression determined prosecution occurred more often when SAE had been conducted (p = 0.026, OR = 1.732, 95% CI [1.068, 2.808]), regardless of examination findings.

Limitations

The limitations include a single location for data and the multifactorial reasons for prosecution of cases.

Discussion

The multifactorial elements contributing to prosecutorial decisions are diverse. The formalized approaches in CACs historically show increased prosecution. Teasing out the impact of an SAE in a CAC may be reflective of positive CAC approaches. Regardless, a statistically significant finding of association uniquely with the SAE, with or without findings, implies more studies are needed to support the role of the forensic nurse in successful prosecutions of CSA cases.
Opioid-Prescribing Practices Between Total Knee and Hip Arthroplasty in an Outpatient Versus Inpatient Setting
Authors: Nouraee Cyrus M. , McGaver Rebecca Stone , Schaefer Jacob J. , O'Neill Owen R. , Anseth Scott D. , Lehman-Lane Justina , Uzlik Rachel M. , Giveans M. Russell
Published: May 2021

Despite trends showing increases in the utilization of outpatient (OP) ambulatory surgery centers (ASCs) and decreases in the utilization of inpatient (IP) facilities for total knee arthroplasty (TKA) and total hip arthroplasty (THA), little is known about opioid prescribing for these procedures between each setting. This study evaluated differences in opioid prescribing and consumption between OP ASC and IP settings for elective TKA and THA surgeries over a 1-year period. Data collection also included pain and satisfaction of pain control postsurgery. In an OP ASC, analysis revealed a significant decrease in pills prescribed (p < .001, p < .001) and consumed (p < .001, p < .001) for TKA and THA, respectively. There was a significant decrease in the morphine equivalence units prescribed (p < .001, p < .001) and consumed (p < .001, p < .001) for TKA and THA, respectively. For TKA, pain was significantly lower (p = .018) and satisfaction of pain control was significantly higher (p = .007). For THA, pain (p = .374) and satisfaction of pain control (p = .173) were similar between the settings. Benefits of performing these surgeries in an OP ASC setting are patients having similar or lower levels of pain and having similar or higher satisfaction of pain control. Patients are also prescribed and consume less opioids. This has important implications for healthcare systems.
Prevalence of Elevated Blood Pressure and Risk Factors for Hypertension in College Athletes
Authors: Petek Bradley J. , Drezner Jonathan A. , Harmon Kimberly G.
Published: May 2021

Objective:

To compare the prevalence and risk factors for hypertension (HTN) in college athletes using the new (≥130/80 mm Hg) versus prior (≥140/90 mm Hg) US hypertension guidelines.

Design:

Retrospective cohort study.

Setting:

Eleven Pacific-12 Conference institutions.

Participants:

Of the 8602 athletes enrolled in the primary study, 4977 (57.9%) met inclusion criteria. Athletes were included in the study if age <30 and blood pressure (BP), baseline demographics (age, weight, height, sex, and race), and primary sport were available.

Independent Variables:

Age, sex, race, height, weight, body mass index, and primary sport.

Main Outcome Measures:

Elevated BP of ≥130/80 mm Hg and/or ≥140/90 mm Hg.

Results:

Normal BP (<130/80) was present in 3214 (64.6%) athletes and 1763 (35.4%) had BP ≥ 130/80, including 460 (9.2%) with BP ≥ 140/90. Male athletes had a higher prevalence of BP ≥ 130/80 (46.7% vs 21.5%; P < 0.001) and BP ≥ 140/90 (14.2% vs 3.1%; P < 0.001) compared to female athletes. Independent risk factors from multivariate analyses for BP ≥ 130/80 included: older age (odds ratio [OR] = 1.05, 95% confidence interval [CI] 1.00-1.11, P = 0.04), male sex (OR = 1.97, 95% CI 1.65-2.35, P < 0.001), heavier weight (OR = 1.03, 95% CI 1.02-1.03, P < 0.001), and baseball as the primary sport (OR = 1.47, 95% CI 1.14-1.90, P < 0.01). Independent risk factors for BP ≥ 140/90 mm Hg included: male sex (OR = 3.54, 95% CI 2.55-4.97, P < 0.001) and heavier weight (OR = 1.03, 95% CI 1.02-1.04, P < 0.001).

Conclusions:

In a large, diverse cohort of matriculating college athletes from multiple institutions, over one-third presented with elevated BP ≥ 130/80 mm Hg, which was more common in older male athletes with larger body size and baseball players.
Successful urethral reconstruction with scrotal skin island flap and pudendal thigh flap for urethral stricture and urethrocutaneous fistula
Authors: Li Chiao-Ching , Tang Shou-Hung , Li Chiao-Zhu , Wang Chih-Hsin , Wu Sheng-Tang , Cha Tai-Lung , Meng En , Kao Chien-Chang
Published: May 2021

Introduction:

One of the complications following transurethral resection of the prostate is urethral stricture formation. There are several treatment methods for urethral obstructions, such as urethral dilation with urethral sounds, direct vision internal urethrotomy with a cold knife or laser, and urethral reconstruction. However, urethrocutaneous fistulae, periurethral and scrotal abscesses are complications that result from urethral dilation and direct vision internal urethrotomy.

Patient concerns:

A 66-year-old male patient complained of difficulty in voiding for 3 years accompanied by urinary frequency and incomplete emptying. He had no underlying chronic diseases. He underwent transurethral resection of the prostate, however, urinary frequency and a weak urine stream persisted for 2 weeks.

Diagnoses:

According to physical examination and cystoscopy, the patient was diagnosed with urethrocutaneous fistula and urethral stricture.

Interventions:

Initially, urethral sounding and direct vision internal urethrotomy were performed, however, complications such as urethrocutaneous fistula, periurethral and scrotal abscesses occurred. Urethral reconstruction was performed as a two staged procedure involving urethral fistulectomy, cutaneous urethrotomy, debridement and suprapubic cystostomy in the first stage followed by reconstruction using scrotal skin island and pudendal thigh flaps six months later.

Outcomes:

Improved voiding and no wound dehiscence were observed on postoperative day 56. After a follow-up period of 2 years, there was no evidence of urinary retention nor incomplete emptying. However, there was minimal residual paresthesia from the medial thigh to the left hemi-scrotal skin.

Conclusion:

Urethral reconstruction with scrotal skin island and pudendal thigh flaps can be a successful treatment method owing to abundant blood supply and less skin tension.
Content validity of the Brief and Comprehensive ICF Core Sets for common disabling conditions in a developing country
Authors: Pathak Anupa , Abbott Haxby J , Sharma Saurab , Ribeiro Daniel Cury , Heinemann Allen W.
Published: May 2021

The International Classification of Functioning, Disability and Health (ICF) features associated tools, the Brief and Comprehensive ICF Core Sets. These are designed to be universally applicable, but have limited evidence of content validity (i.e. comprehensiveness and relevance) in low income, non-Western countries. In this cross-sectional study, we aimed to assess the content validity of the ICF Core Sets in Nepal. We interviewed 161 participants with stroke, spinal cord injury (SCI), chronic obstructive pulmonary disease (COPD), and musculoskeletal conditions and asked them to identify activities they had difficulty performing due to their health condition. We mapped 544 participant responses to the ICF and assessed if these ICF categories were represented in the respective ICF core sets. The Comprehensive Core Sets for stroke, COPD, SCI, and musculoskeletal conditions contained more items identified by participants than the respective Brief Core Sets (e.g., 89% vs. 26% in stroke). Among ICF categories that represented at least 5% of participants’ responses, the Brief Core Sets covered 40%–71% of participants’ responses whereas the Comprehensive Core Sets covered 67%–100% of responses. This is the first study to evaluate the content validity of the ICF Brief and Comprehensive core sets in Nepali individuals with stroke, SCI, MSK conditions, and COPD. The Comprehensive Core Sets for stroke, COPD, and SCI have adequate content validity for use in clinical practice and research in Nepal; the Brief Core Sets may not adequately meet local and individual needs unless supplemented with additional ICF categories.
Preceptor Practice
Authors: Harper Mary G. , Ulrich Beth , Whiteside Dawn , Warren Joan Insalaco , MacDonald Ryan
Published: May 2021

In 2020, the Association for Nursing Professional Development commissioned a national preceptor practice analysis study using the Ulrich Precepting Model to identify the roles, knowledge, and activities essential to preceptor practice. In a survey of 3,623 preceptors, the model’s seven preceptor roles and their associated domains of knowledge and practice were validated. Findings indicate that nursing professional development practitioners should provide preceptors with initial role preparation in addition to ongoing education.
The Effect of Abdominal Anatomy on the Measurement of Bone Mineral Density With Dual-Energy X-Ray Absorptiometry
Authors: Başaloğlu Can , Güngör Özlem , Balcı Ali
Published: May 2021

Objective

This study aimed to assess the effects of abdominal fat content and anatomical changes on the measurement of bone mineral density using dual-energy X-ray absorptiometry (DXA).

Materials and Methods

The bone mineral density measurements were performed with quantitative computed tomography for patients who underwent DXA and abdominal CT on the same day. The effects of abdominal fat content and anatomic changes on the results of DXA were assessed.

Results

Of the 43 patients, 88.3% were women, 11.7% were men, and the mean age was 55.6 years (range, 32–72). There was a significant relationship between the error in the measurement of T-scores with DXA and osteophytic new bone formation (P = 0.011). There were significant relationships between the error in detecting osteoporosis with DXA and osteophytic new bone formation, facet joint degeneration, and aortic calcification (P < 0.05).

Conclusions

Abdominal fat content does not significantly affect T-scores. However, DXA can give false-negative results in detecting osteoporosis, especially in patients with osteophyte new bone formation, facet joint degeneration, and aortic calcifications, all conditions primarily in elderly patients. In these cases, it is more appropriate to use quantitative computed tomography instead of DXA.
Clinical, Radiographic, Pathologic Characterization and Survival Outcomes of Nuclear Protein of the Testis Carcinoma
Authors: Virarkar Mayur , Mallery Marcelle , Saleh Mohammed , Ramani Nisha S. , Morani Ajaykumar C. , Bhosale Priya
Published: May 2021

Introduction

Nuclear protein of the testis (NUT) carcinoma (formerly NUT midline carcinoma) is an aggressive tumor with characteristic BRD4-NUTM1 translocation and a poor prognosis. The primary objective of this study was to describe the clinical and radiologic features, treatment response, and survival of NUT carcinoma (NC).

Materials and Methods

This retrospective single-center study was based on the review of medical records of NC patients with a specific genetic rearrangement or positive anti-NUT nuclear staining. Overall survival (OS) was analyzed according to primary tumor location.

Results

This series of 22 patients had a mean age of 36.27 ± 2.68 years with 68% women and 32% men. The median age at diagnosis was 34 years (range, 17–55 years). The primary tumor was located in the chest (n = 12/22; 55%), head and neck (n = 9/22; 40%), and 1 patient had a renal tumor. About 68% (n = 15/22) patients presented with regional lymph nodal involvement and 77% (n = 17/22) had distant metastases. All the bone metastases were lytic (100%) with mixed lytic and sclerotic metastases in 5 patients. Only 18% (n = 4/22) of the patients showed response to treatment, with progression in the remaining 18 patients. The median OS was 7 months. The OS was significantly (P = 0.024) more in patients with primary head and neck NC (n = 9; OS, 16 months) versus those with pulmonary and other locations (n = 13; OS, 6 months).

Conclusions

Nuclear protein of the testis carcinoma is an aggressive disease refractory to conventional therapy. Imaging with the complementary use of computed tomography, magnetic resonance imaging, and positron emission tomography/computed tomography is important for staging, guiding management, assessing the treatment response, and surveillance.
Rapid multi-generational acclimation of coralline algal reproductive structures to ocean acidification
Authors: Moore B. , Comeau S. , Bekaert M. , Cossais A. , Purdy A. , Larcombe E. , Puerzer F. , McCulloch M. T. , Cornwall C. E.
Published: May 2021

The future of coral reef ecosystems is under threat because vital reef-accreting species such as coralline algae are highly susceptible to ocean acidification. Although ocean acidification is known to reduce coralline algal growth rates, its direct effects on the development of coralline algal reproductive structures (conceptacles) is largely unknown. Furthermore, the long-term, multi-generational response of coralline algae to ocean acidification is extremely understudied. Here, we investigate how mean pH, pH variability and the pH regime experienced in their natural habitat affect coralline algal conceptacle abundance and size across six generations of exposure. We show that second-generation coralline algae exposed to ocean acidification treatments had conceptacle abundances 60% lower than those kept in present-day conditions, suggesting that conceptacle development is initially highly sensitive to ocean acidification. However, this negative effect of ocean acidification on conceptacle abundance disappears after three generations of exposure. Moreover, we show that this transgenerational acclimation of conceptacle development is not facilitated by a trade-off with reduced investment in growth, as higher conceptacle abundances are associated with crusts with faster growth rates. These results indicate that the potential reproductive output of coralline algae may be sustained under future ocean acidification.
Quantitative assessment of tarsal morphology illuminates locomotor behaviour in Palaeocene mammals following the end-Cretaceous mass extinction
Authors: Shelley Sarah L. , Brusatte Stephen L. , Williamson Thomas E.
Published: May 2021

Mammals exhibit vast ecological diversity, including a panoply of locomotor behaviours. The foundations of this diversity were established in the Mesozoic, but it was only after the end-Cretaceous mass extinction that mammals began to increase in body size, diversify into many new species and establish the extant orders. Little is known about the palaeobiology of the mammals that diversified immediately after the extinction during the Palaeocene, which are often perceived as ‘archaic’ precursors to extant orders. Here, we investigate the locomotor ecology of Palaeocene mammals using multivariate and disparity analyses. We show that tarsal measurements can be used to infer locomotor mode in extant mammals, and then demonstrate that Palaeocene mammals occupy distinctive regions of tarsal morphospace relative to Cretaceous and extant therian mammals, that is distinguished by their morphological robustness. We find that many Palaeocene species exhibit tarsal morphologies most comparable with morphologies of extant ground-dwelling mammals. Disparity analyses indicate that Palaeocene mammals attained similar morphospace diversity to the extant sample. Our results show that mammals underwent a post-extinction adaptive radiation in tarsal morphology relating to locomotor behaviour by combining a basic eutherian bauplan with anatomical specializations to attain considerable ecomorphological diversity.
The evolution of monogamy is associated with reversals from male to female bias in the survival cost of parasitism
Authors: Wittman Tyler N. , Cox Robert M.
Published: May 2021

The extent to which parasites reduce host survival should depend upon how hosts balance trade-offs between reproduction and survival. For example, parasites are predicted to impose greater survival costs under polygynous or promiscuous mating systems in which competition for mates favours increased reproductive investment, particularly in males. We provide, to our knowledge, the first comparative test of the hypothesis that the mating system of the host is an important determinant of (i) the extent to which parasites reduce survival, and (ii) the extent to which males and females differ in the survival cost of parasitism. Using meta-analysis of 85 published estimates of the survival cost of parasitism from 72 studies of 64 species representing diverse animal lineages, we show that parasites impose a mean 3.5-fold increase in the odds of mortality on their hosts. Although this survival cost does not differ significantly across monogamous, polygynous and promiscuous mating systems, females incur a greater survival cost than males in monogamous species, whereas males incur a greater survival cost than females in polygynous and promiscuous species. Our results support the idea that mating systems shape the relative extent to which males and females invest in reproduction at the expense of defence against parasites.
Adaptations to light contribute to the ecological niches and evolution of the terrestrial avifauna
Authors: Ausprey Ian J.
Published: May 2021

The role of light in structuring the ecological niche remains a frontier in understanding how vertebrate communities assemble and respond to global change. For birds, eyes represent the primary external anatomical structure specifically evolved to interpret light, yet eye morphology remains understudied compared to movement and dietary traits. Here, I use Stanley Ritland's unpublished measurements of transverse eye diameter from preserved specimens to explore the ecological and phylogenetic drivers of eye morphology for a third of terrestrial avian diversity (
N
= 2777 species). Species with larger eyes specialized in darker understory and forested habitats, foraging manoeuvres and prey items requiring long-distance optical resolution and were more likely to occur in tropical latitudes. When compared to dietary and movement traits, eye size was a top predictor for habitat, foraging manoeuvre, diet and latitude, adding 8–28% more explanatory power. Eye size was phylogenetically conserved (
λ
= 0.90), with phylogeny explaining 61% of eye size variation. I suggest that light has contributed to the evolution and assembly of global vertebrate communities and that eye size provides a useful predictor to assess community response to global change.
Travel-driven emergence and spread of SARS-CoV-2 lineage B.1.620 with multiple VOC-like mutations and deletions in Europe
Authors: Dudas Gytis , Hong Samuel L. , Potter Barney , Calvignac-Spencer Sébastien , Niatou-Singa Frédéric S. , Tombolomako Thais B. , Fuh-Neba Terence , Vickos Ulrich , Ulrich Markus , Leendertz Fabian H. , Khan Kamran , Watts Alexander , Olendraitė Ingrida , Snijder Joost , Wijnant Kim N. , Bonvin Alexandre M.J.J. , Martres Pascale , Behillil Sylvie , Ayouba Ahidjo , Maidadi Martin Foudi , Djomsi Dowbiss Meta , Godwe Celestin , Butel Christelle , Šimaitis Aistis , Gabrielaitė Miglė , Katėnaitė Monika , Norvilas Rimvydas , Raugaitė Ligita , Jonikas Rimvydas , Nasvytienė Inga , Žemeckienė Živilė , Gečys Dovydas , Tamušauskaitė Kamilė , Norkienė Milda , Vasiliūnaitė Emilija , Žiogienė Danguolė , Timinskas Albertas , Šukys Marius , Šarauskas Mantas , Alzbutas Gediminas , Juozapaitė Dovilė , Naumovas Daniel , Pautienius Arnoldas , Vitkauskienė Astra , Ugenskienė Rasa , Gedvilaitė Alma , Čereškevičius Darius , Lesauskaitė Vaiva , Žemaitis Lukas , Griškevičius Laimonas , Baele Guy
Published: May 2021

Many high-income countries have met the SARS-CoV-2 pandemic with overwhelming sequencing resources and have identified numerous distinct lineages, including some with notably altered biology. Over a year into the pandemic following unprecedented reductions in worldwide human mobility, distinct introduced lineages of SARS-CoV-2 without sequenced antecedents are increasingly discovered in high-income countries as a result of ongoing SARS-CoV-2 genomic surveillance initiatives. We here describe one such SARS-CoV-2 lineage, carrying many mutations and deletions in the spike protein shared with widespread variants of concern (VOCs), including E484K, S477N and deletions HV69Δ, Y144Δ, and LLA241/243Δ. This lineage – designated B.1.620 – is known to circulate in Lithuania and has now been found in several European states, but also in increasing numbers in central Africa owing to important recent increases in genome sequencing efforts on the continent. We provide evidence of likely ongoing local transmission of B.1.620 in Lithuania, France, Germany, Spain, Belgium and the Central African Republic. We describe the suite of mutations this lineage carries, its potential to be resistant to neutralising antibodies, travel histories for a subset of the European cases, and evidence of local B.1.620 transmission in Europe. We make a case for the likely Central African origin of this lineage by providing travel records as well as the outcomes of carefully crafted phylogenetic and phylogeographic inference methodologies, the latter of which is able to exploit individual travel histories recorded for infected travellers having entered different European countries.