bluuebunny/crossref_metadata_2025 huggingface dataset:
Northward range extension for Durvillaea poha bull kelp: Response to tectonic disturbance?
Authors: Vaux Felix , Craw Dave , Fraser Ceridwen I. , Waters Jonathan M.
Published: May 2021

Understanding the forces that shape species distributions is increasingly important in a fast‐changing world. Although major disturbance events can adversely affect natural populations, they can also present new opportunities, for example by opening up habitat for colonization by other lineages. Following extensive geographic sampling, we use genomic data to infer a range extension following disturbance for an ecologically important intertidal macroalgal species. Specifically, we genotyped 288 southern bull kelp (Durvillaea) plants from 28 localities across central New Zealand. All specimens from the North Island were expected to be D. antarctica, but unexpectedly 10 samples from four sites were identified as D. poha. Extensive sampling from the northern South Island (105 samples at five locations) confirmed the absence of D. poha north of the Kaikōura Peninsula. The North Island specimens of D. poha therefore reveal a biogeographic disjunction, some 150 km northeast of the nearest (South Island) population of this species. Based on strong geographic correspondence between these North Island samples and historic disturbance, we infer that tectonic upheaval, particularly earthquake‐generated landslides, likely extirpated local D. antarctica and created an opportunity for a northward range expansion event by D. poha. Close phylogenomic relationships between this new North Island population and South Island samples support a geologically recent northward expansion, rather than a deeper evolutionary origin. These findings indicate the potential of large‐scale disturbances to facilitate sudden biogeographic range expansions, and they emphasize the ability of genomic analyses with fine‐scale sampling to reveal long‐lasting signatures of past disturbance, dispersal, and colonization.
The F3 phenomenon: Early‐career training breaks in medical training. A scoping review
Authors: Church Helen R. , Agius Steven J.
Published: May 2021

Background

Since 2017, more than 50% of UK doctors have undertaken a ‘Foundation 3 (F3) Year’ training break after completing their foundation programme (the first two years following graduation), rather than immediately enter specialty training. The reasons for, and consequences of, the growing F3 trend are largely unknown. This scoping review presents the current evidence and identifies future research in this field.

Methods

Following Arksey and O’Malley's guidelines, 12 databases and three UK‐based national postgraduate organisation websites were searched for articles published in English (final searches January 2020). Multiple search terms were used to capture articles relating to the ‘F3’ time‐period, including ‘post‐foundation’ or ‘pre‐specialty’ training. Title, abstract and full‐paper screening selected articles reporting any aspect of F3, including within a wider context (eg postgraduate training breaks), and then underwent mixed‐methods analysis.

Results

Of 4766 articles identified, 45 were included. All articles were published after 2009; 14/45 (31.1%) were published in 2019. 27 articles reported research, and the remainder were opinion/commentaries. Specific personal (including demographic), professional and organisational factors, particularly the UK postgraduate training structure, are associated with undertaking an F3. The majority of F3 training breaks last 1 year and involve working (clinically or non‐clinically) and/or travel. The decision to undertake an F3 is made either prior to or during foundation training. Evidence regarding the impact of F3 on health care service provision was limited but evenly balanced.

Conclusions

In summarising the existing F3 evidence, this review has highlighted important issues including health care workforce equality and diversity, training pathway inflexibility and the effect of negative early‐career experiences on subsequent career decisions. More research is needed to understand the financial impact of training breaks on health care service provision, how training programmes must adapt to retain more trainees and the long‐term effects of training breaks, such as F3, on subsequent career progression.
Optimization of electric bus scheduling considering stochastic volatilities in trip travel time and energy consumption
Authors: Bie Yiming , Ji Jinhua , Wang Xiangyu , Qu Xiaobo
Published: May 2021

This paper develops a vehicle scheduling method for the electric bus (EB) route considering stochastic volatilities in trip travel time and energy consumption. First, a model for estimating the trip energy consumption is proposed based on field‐collected data, and the probability distribution function of trip energy consumption considering the stochastic volatility is determined. Second, we propose the charging strategy to recharge buses during their idle times. The impacts of stochastic volatilities on the departure time, the idle time, the battery state of charge, and the energy consumption of each trip are analyzed. Third, an optimization model is built with the objectives of minimizing the expectation of delays in trip departure times, the summation of energy consumption expectations, and bus procurement costs. Finally, a real bus route is taken as an example to validate the proposed method. Results show that reasonable idle times can be generated by optimizing the scheduling plan, and it is helpful to stop the accumulation of stochastic volatilities. Collaboratively optimizing vehicle scheduling and charging plans can reduce the EB fleet and delay times while meeting the route operation needs.
The Relationship Between Utterance and Perceived Fluency: A Meta‐Analysis of Correlational Studies
Authors: SUZUKI SHUNGO , KORMOS JUDIT , UCHIHARA TAKUMI
Published: May 2021

Listener‐based judgements of fluency play an important role in second language (L2) communication contexts and in L2 assessment. Accordingly, our meta‐analysis examined the relationship between different aspects of utterance fluency and listener‐based judgements of perceived fluency by analyzing primary studies reporting correlation coefficients between objective measures of temporal features and subjective ratings of fluency. We analyzed 263 effect sizes from 22 studies (N = 335–746) to calculate the mean effect sizes of the links between utterance and perceived fluency. We also investigated the moderator effects of 11 methodological factors—such as speech stimuli, listeners’ background, rating procedure, and computation of utterance fluency measures—on the relationship between utterance and perceived fluency. Perceived fluency was strongly associated with speed and pause frequency, r = |.59–.62|; moderately with pause duration, r = |.46|; and weakly with repair fluency, r = |.20|; while composite measures showed the strongest effect sizes, r = |.72–.76|. Moderator analyses revealed that the utterance–perceived fluency link is influenced by methodological variables related to how speech samples are prepared for listeners’ judgements and how listeners’ attention is directed in evaluations of fluency. These findings suggest future directions for L2 fluency research and implications for language assessment.
The hop downy mildew pathogen Pseudoperonospora humuli
Authors: Purayannur Savithri , Gent David H. , Miles Timothy D. , Radišek Sebastjan , Quesada‐Ocampo Lina M.
Published: May 2021

Pseudoperonospora humuli is an obligate biotrophic oomycete that causes downy mildew, one of the most devastating diseases of cultivated hop, Humulus lupulus. Downy mildew occurs in all production areas of the crop in the Northern Hemisphere and Argentina. The pathogen overwinters in hop crowns and roots, and causes considerable crop loss. Downy mildew is managed by sanitation practices, planting of resistant cultivars, and fungicide applications. However, the scarcity of sources of host resistance and fungicide resistance in pathogen populations complicates disease management. This review summarizes the current knowledge on the symptoms of the disease, life cycle, virulence factors, and management of hop downy mildew, including various forecasting systems available in the world. Additionally, recent developments in genomics and effector discovery, and the future prospects of using such resources in successful disease management are also discussed.

Taxonomy

Class: Oomycota; Order: Peronosporales; Family: Peronosporaceae; Genus: Pseudoperonospora; Species: Pseudoperonospora humuli.

Disease symptoms

The disease is characterized by systemically infected chlorotic shoots called “spikes". Leaf symptoms and signs include angular chlorotic lesions and profuse sporulation on the abaxial side of the leaf. Under severe disease pressure, dark brown discolouration or lesions are observed on cones. Infected crowns have brown to black streaks when cut open. Cultivars highly susceptible to crown rot may die at this phase of the disease cycle without producing shoots. However, foliar symptoms may not be present on plants with systemically infected root systems.

Infection process

Pathogen mycelium overwinters in buds and crowns, and emerges on infected shoots in spring. Profuse sporulation occurs on infected tissues and sporangia are released and dispersed by air currents. Under favourable conditions, sporangia germinate and produce biflagellate zoospores that infect healthy tissue, thus perpetuating the infection cycle. Though oospores are produced in infected tissues, their role in the infection cycle is not defined.

Control

Downy mildew on hop is managed by a combination of sanitation practices and timely fungicide applications. Forecasting systems are used to time fungicide applications for successful management of the disease.

Useful Websites

https://content.ces.ncsu.edu/hop‐downy‐mildew (North Carolina State University disease factsheet), https://www.canr.msu.edu/resources/michigan‐hop‐management‐guide (Michigan Hop Management Guide), http://uspest.org/risk/models (Oregon State University Integrated Plant Protection Center degree‐day model for hop downy mildew), https://www.usahops.org/cabinet/data/Field‐Guide.pdf (Field Guide for Integrated Pest Management in Hops).
New thinking for filth fly control: residual, non‐chemical wall spray from volcanic glass
Authors: Chen K. , Deguenon J. M. , Cave G. , Denning S. S. , Reiskind M. H. , Watson D. W. , Stewart D. A. , Gittins D. , Zheng Y. , Liu X. , Mouhamadou C. S. , Roe R. M.
Published: May 2021

Filth flies are of medical and veterinary importance because of the transfer of disease organisms to animals and humans. The traditional control methods include the use of chemical insecticides. A novel mechanical insecticide made from volcanic glass and originally developed to control mosquitoes (Imergard™ WP; ImG) was investigated for control of adult grey flesh flies, Sarcophaga bullata (Parker), secondary screwworms, Cochliomyia macellaria (F.), and house flies, Musca domestica L. In a modified WHO cone test device, the time to 50% mortality (LT50) when applied at 5 g/m2 (tested at 30 °C and 50% relative humidity (rH)) was 7.1, 4.3 and 3.2 h, respectively. When knockdown was included, the LT50s were 5.5, 1.5 and 2.8 h, respectively. Application rates of 1.25 and greater g/m2 had the shortest LT50s. The time to the LT50 increased for M. domestica as rH increased, but ImG was still active at the highest rH tested of 70%. Scanning electron micrographs showed ImG was present on all body parts, unlike that for mosquitoes where it was found mostly on the lower legs. These first studies on the use of Imergard WP against flies suggest this could be an alternative method for filth fly control.
Fungaemia due to rare yeasts in paediatric intensive care units: A prospective study
Authors: Kaur Harsimran , Singh Shreya , Rudramurthy Shivaprakash Mandya , Jayashree Muralidharan , Peters Nitin James , Ray Pallab , Samujh Ram , Ghosh Anup , Chakrabarti Arunaloke
Published: May 2021

Background

Considering the emergence of fungaemia due to rare yeasts at our centre, we performed a systematic epidemiologic study on fungaemia due to rare yeast.

Objectives

We undertook the present prospective observational study to explore the epidemiological features and clinical characteristics of fungaemia due to rare yeasts in paediatric ICUs at our centre.

Methods

The successive yeasts isolated from blood at our PICUs during December 2017 through March 2019 were identified by molecular methods. Fungaemia due to yeasts other than C. albicans, C. tropicalis, C. glabrata, C. krusei and C. parapsilosis was categorised as rare yeasts. Antifungal susceptibility testing of the yeast isolates was performed as per clinical and laboratory standards institute (CLSI) guidelines. We also compared different clinical parameters of fungaemia due to common versus rare yeasts, and rare yeasts in neonates versus non‐neonates.

Results

During the study period, 212 yeast isolates were obtained from 159 patients at PICUs of our hospital, and 127 isolates from 98 patients (61.6%) were categorised as rare yeasts. Neonates acquired fungaemia significantly earlier after ICU admission than non‐neonates (median:4 vs 6 days; p = .005). Regarding epidemiology study of rare yeast fungaemia, Wickerhamomyces anomalus (43.8%) and Candida utilis (40.8%) were common isolates; surgical intervention and gastrointestinal disease were significantly associated; overall, azole, echinocandin and amphotericin B resistance was at 9.1%, 1.02% and 1.02%, respectively; overall mortality was 65.3%.

Conclusions

The emergence of rare yeasts especially W. anomalus and C. utilis causing fungaemia in our children demands urgent attention to control the spread.
Effects of electromagnetic fields on neuronal ion channels: a systematic review
Authors: Bertagna Federico , Lewis Rebecca , Silva S. Ravi P. , McFadden Johnjoe , Jeevaratnam Kamalan
Published: May 2021

Many aspects of chemistry and biology are mediated by electromagnetic field (EMF) interactions. The central nervous system (CNS) is particularly sensitive to EMF stimuli. Studies have explored the direct effect of different EMFs on the electrical properties of neurons in the last two decades, particularly focusing on the role of voltage‐gated ion channels (VGCs). This work aims to systematically review published evidence in the last two decades detailing the effects of EMFs on neuronal ion channels as per the PRISM guidelines. Following a predetermined exclusion and inclusion criteria, 22 papers were included after searches on three online databases. Changes in calcium homeostasis, attributable to the voltage‐gated calcium channels, were found to be the most commonly reported result of EMF exposure. EMF effects on the neuronal landscape appear to be diverse and greatly dependent on parameters, such as the field's frequency, exposure time, and intrinsic properties of the irradiated tissue, such as the expression of VGCs. Here, we systematically clarify how neuronal ion channels are particularly affected and differentially modulated by EMFs at multiple levels, such as gating dynamics, ion conductance, concentration in the membrane, and gene and protein expression. Ion channels represent a major transducer for EMF‐related effects on the CNS.
International Effects of Euro Area Forward Guidance*
Authors: Böck Maximilian , Feldkircher Martin , Siklos Pierre L.
Published: May 2021

In this paper, we investigate the international effects of euro rate forward guidance (FG) and compare them to spillovers from a conventional monetary policy shock (MP). We identify the forward guidance shock via a combination of zero and sign restrictions that use the relationship between expectations and observed data and additionally draw on insights from recent event studies using high‐frequency data. To address potential time variation, we use a fully flexible approach that allows to handle both drifts in residual variances and the structural coefficients. Our results show that both shocks lead to considerable international effects on output growth, inflation and equity returns. Moreover, we find that effects are stronger during the period of the global financial crisis, which is particularly true for the FG shock. This implies that monetary policy is generally not hindered in affecting the real economy by the zero lower bound. Also, shocks to expectations can have real domestic effects with international consequences.
Computer vision syndrome in presbyopic digital device workers and progressive lens design
Authors: Sánchez‐Brau Mar , Domenech‐Amigot Begoña , Brocal‐Fernández Francisco , Seguí‐Crespo Mar
Published: May 2021

Purpose

To estimate the prevalence of computer vision syndrome (CVS) in presbyopic digital device workers using two ophthalmic progressive lens designs during the working day, and to analyse the association of CVS with sociodemographic, occupational, digital device exposure and refractive factors.

Methods

This time series, quasi‐experimental design study included 69 presbyopic digital device workers (age range: 46–69 years; mean ± SD = 54.7 ± 5.0). All used desktop computers at their workplace. Progressive addition lenses (PALs) and occupational lenses were used for three months each. CVS was measured with the CVS‐Q© questionnaire before intervention (baseline) and at 1 week, 1 month and 3 months after wearing the lenses. A multivariate logistic regression model was used to identify the factors that were associated with an improved CVS‐Q© score.

Results

37.7% of the subjects were female and 78.3% were ametropes; 65.2% had advanced presbyopia. 56.2% used digital devices at work >6 h day−1. The prevalence of CVS at baseline, after wearing PALs for three months and after three months of occupational lens wear was 68.1%, 33.3% and 18.8%, respectively. The mean CVS‐Q© score was lower with occupational lenses than with PALs (p = 0.001). 40.6% of the digital device workers improved their CVS‐Q© score ≥2 points with the occupational lenses. Ametropes were less likely than emmetropes to improve with occupational lenses (OR = 0.27, p = 0.05). 89.8% of the sample workers were satisfied or very satisfied with the occupational lenses and 71% were similarly satisfied with the PALs. 73.9% chose the occupational lenses as their first choice of lens for digital device use, compared with 17.4% for PALs.

Conclusions

Computer vision syndrome is reduced in presbyopic desktop computer workers wearing occupational lenses compared with PALs, especially in emmetropes.
Salmonella Osteomyelitis in Adults: A Systematic Review
Authors: Huang Zi‐da , Wang Chao‐xin , Shi Teng‐bin , Wu Bai‐jian , Chen Yang , Li Wen‐bo , Fang Xin‐Yu , Zhang Wen‐Ming
Published: May 2021

The aim of this systematic review was to characterize the clinical features of adults with Salmonella osteomyelitis and summarize diagnosis and treatment methods to provide guidance for clinicians. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. We conducted a literature search in the PubMed, EMBASE, and Cochrane Library databases. Article screening and data extraction were performed by two reviewers individually. All the included studies were independently evaluated by two reviewers using the Methodological Index for Non‐Randomized Studies (MINORS) criteria. A total of 67 articles published between 1970 and 2019 were selected, which include 69 patients with an average age of 47.5 years (range, 18–79).The majority of cases (47.76%) occurred in immunocompetent adults without common risk factors. Aspiration and biopsy cultures were all positive in Salmonella osteomyelitis patients who underwent aspiration or biopsy. All infections were monomicrobial, and a total of 12 different serotypes were identified. The three most commonly reported Salmonella serotypes were Salmonella typhi (19 cases), Salmonella typhimurium (12 cases), and Salmonella enteritidis (11 cases). Only 12 of the 67 cases in our data (17.91%) had diarrhea symptoms, and 44 of the 67 cases (65.67%) had fever symptoms. Fifty‐nine of the 67 cases (88.06%) had local inflammatory manifestations, such as erythema, swelling, and tenderness in the affected area. The commonly reported involved sites were the vertebrae, femur, and tibia. Antibiotic therapy alone was utilized in 30 cases, and 24 patients (80.00%) were eventually cured. In total, 75.68% of patients achieved satisfactory results after treatment with surgery and antibiotics. Third‐generation cephalosporins were most commonly utilized, and antibiotic treatment was administered for an average of 11.3 weeks (95%CI, 8.31–14.37 weeks). Salmonella osteomyelitis should be considered in patients without any common risk factors. Aspiration or biopsy can facilitate the identification of pathogens to guide antibiotic choice. Empirical therapy with a third‐generation cephalosporin is recommended until the susceptibility of the strain is determined.
Arthroscopic Internal Drainage with Cyst Wall Resection and Arthroscopic Internal Drainage with Cyst Wall Preservation to Treat Unicameral Popliteal Cysts: A Retrospective Case–Control Study
Authors: Zhang Min , Li Hao , Wang Hao‐hao , Xi Gang , Li Ya‐kun , Zhao Bin
Published: May 2021

Objective

To compare the clinical efficacy and safety of arthroscopic internal drainage for the treatment of unicameral popliteal cysts with or without cyst wall resection.

Methods

This was a retrospective case–control study of 73 patients diagnosed with unicameral popliteal cysts from January 2012 to January 2019 who received arthroscopic treatment. The study included 38 cases with cyst wall resection (CWR group) and 35 cases with cyst wall preservation (CWP group). The CWR group consisted of 14 men and 24 women with an average age of 51.8 years, while the CWP group consisted of 13 men and 22 women with an average age of 52.0 years. All patients were examined for intra‐articular lesions and communicating ports by magnetic resonance imaging (MRI) prior to surgery, and recurrence of cysts was evaluated at the last follow‐up examination. Rauschning and Lindgren grade (R–L grade) and Lysholm score were used to evaluate clinical outcomes. In addition, operation time and complications were recorded.

Results

The average length of follow‐up was 24.2 months (range, 16 to 32 months). There were no considerable differences in age, gender, cyst size, Lysholm score, R–L grade and concomitant intra‐articular cases between the CWR group and CWP group prior to surgery (P > 0.05). The last follow‐up MRI scans showed that in the CWR group, the cyst disappeared in 25 cases and shrunk in 13 cases. In the CWP group, the cyst disappeared in 22 cases, shrunk in 12 cases and persisted in one case. There was no obvious difference in recurrence rate between the two groups (0% vs 2.9%, P = 0.899). At the last follow‐up, there were no differences in the R–L grade (P = 0.630) and Lysholm score (88.3 ± 5.6 points vs 90.1 ± 3.8 points, P = 0.071) between the two groups. Compared with the CWP group, operation time was significantly prolonged in the CWR group (38.3 ± 3.1 min vs 58.3 ± 4.4 min, P < 0.05). In the CWR group, three cases occurred fluid infiltration under the gastrocnemius muscle, which improved after pressure bandaging and cold compress. In another three cases, hematoma was found. The incidence of complications in the CWR group was markedly higher than that in the CWP group (15.8% vs 0%, P < 0.05). During the follow‐up period, none of the patients developed serious complications such as neurovascular injury, deep venous thrombosis, or infection.

Conclusion

For unicameral popliteal cysts, arthroscopic internal drainage combined with resection of the cyst wall did not further improve the clinical outcomes or reduce the recurrence rate, while prolonging the operation time and increasing the possibility of complications.
Unilateral Limited Laminectomy for Debridement to Treat Localized Short‐Segment Lumbosacral Spinal Tuberculosis: A Retrospective Case Series
Authors: Li Miao , Huang Jianjun , Chen Jinbiao , Liu Shaohua , Deng Zhansheng , Hu Jianzhong , Cao Yong , Wu Tianding
Published: May 2021

Objective

This study aimed to investigate the clinical effects of surgically treating lumbosacral tuberculosis with a modified posterior unilateral limited laminectomy method for debridement.

Methods

This retrospective study enrolled a total of 26 patients who were administered in our institution from January 2010 to December 2016, diagnosed with lumbosacral tuberculosis at the L5/S1 level, and underwent one‐stage posterior unilateral limited laminectomy as surgical treatment for debridement, allograft of cortical bone grafting, and fixation. The erythrocyte sedimentation rate (ESR), C‐reactive protein (CRP) level, visual analog scale (VAS) score, Oswestry Disability Index (ODI), and lumbosacral angle (LA, Cobb's method) were statistically compared, and the American Spinal Injury Association Impairment (ASIA) Scale was compared between the preoperative and postoperative time points to evaluate the clinical outcomes.

Results

All 26 patients were observed during the follow‐up period, and the mean follow‐up time was 1.3 ± 0.42 years. The mean age was 56 ± 7.4 years old. The average operation time was 118.1 ± 17.5 min, and the mean bleeding volume was 513.0 ± 79.6 mL. There were no intraoperative complications or tuberculous sinus, and two cases experienced hypostatic pneumonia during hospitalization, which resolved with responsive antibiotics and symptomatic supportive treatment. At the final follow‐up, there was no recurrence of tuberculosis, and the ESR (11.8 ± 1.8 mm/h) and CRP (3.0 ± 1.0 mg/L) levels in all patients had returned to normal. The patients with neurologic deficits had improved, and the mean ODI was 79.9 ± 10.6 (87–62) preoperatively and significantly decreased to 20.5 ± 5.7 (11–29) at the final follow‐up (P < 0.01). ASIA scale scores were improved by 1~2 grades at the last follow‐up. The patients' pain levels were significantly alleviated; the mean VAS score declined to 1.2 ± 0.4 (0–2.5) at the final follow‐up compared to 7.5 ± 1.6 (6.5–8.5) preoperatively (P < 0.01). All patients achieved bony graft fusion at an average time of 6.8 ± 1.2 months. Physiological lumbar lordosis was significantly improved, and the mean LA before operation was 17.6° ± 2.1°, which was significantly different from the postoperative LA (29.3° ± 7.4°, P < 0.01) at the final follow up. The LA (27.1° ± 5.5°, P = 0.15) slightly rebounded but without significance compared to the postoperative level.

Conclusion

Only posterior approach by unilateral limited laminectomy for debridement could be served as an effective and safe method to treat short‐segment lumbosacral tuberculosis without extensive anterior sacral and gravitation abscesses.
Treatment of Degenerative Lumbar Scoliosis with Oblique Lumbar Interbody Fusion in Conjunction with Unilateral Pedicle Screw Fixation via the Wiltse Approach
Authors: Yang Shu‐long , Liu Xiao‐yin , Ma Rong , Zhang Jian‐qun , Liang Si‐min , Chen Zhen , Pan Zong , Ma Zong‐jun , Ding Xiao‐li , Kang Yi , Wang Zhi‐qiang , Ge Zhao‐hui
Published: May 2021

Objective

To evaluate the clinical outcomes of oblique lumbar interbody fusion (OLIF) in conjunction with unilateral pedicle screw fixation (UPSF) via the Wiltse approach in treating degenerative lumbar scoliosis (DLS).

Methods

The article is a retrospective analysis. Twelve patients with DLS who underwent combined OLIF and UPSF between July 2017 and December 2018 were included. The study included 2 male and 10 female patients, with a mean age at the time of the operation of 67.2 ± 9.1 years. The surgical characteristics and complications were evaluated. The clinical and radiological data such as the correction of deformity, coronal and sagittal profile were analyzed.

Results

The mean follow‐up time of the study was 26.8 ± 1.8 months. At the final follow‐up, all patients who underwent combined OLIF and UPSF achieved statistically significant improvements in coronal Cobb angle (from 19.6° ± 4.8° to 6.9° ± 3.8°, P < 0.01), distance between the C7 plumb line and central sacral vertebral line (from 2.5 ± 1.7 cm to 0.9 ± 0.6 cm, P < 0.01), sagittal vertebral axis (from 4.3 ± 4.3 cm to 1.5 ± 1.0 cm, P = 0.03), lumbar lordosis (from 29.4° ± 8.6° to 40.8° ± 5.8°, P < 0.01), pelvic tilt (from 27.6° ± 10.8° to 18.3° ± 7.0°, P < 0.01), pelvic incidence‐lumbar lordosis mismatch (from 23.3° ± 10.5° to 11.9° ± 8.4°, P < 0.01), and cross‐sectional area of the dural sac (from 87.33 ± 39.41 mm2 to 124.70 ± 39.26 mm2, P < 0.01). The visual analogue score for back and leg pain and Oswestry Disability Index of all patients significantly improved postoperatively (P < 0.01). One case of lumbar plexus injury was found after surgery. During the follow‐up period, one patient had cage subsidence. A fusion rate of 100% and good positioning of the pedicle screws were achieved in all patients at the final follow‐up.

Conclusion

OLIF in conjunction with UPSF is a safe and effective minimally invasive procedure for correcting both coronal and sagittal deformities, as it results in an improved quality of life in patients with DLS.
Imaging Evaluation of Fat Infiltration in Paraspinal Muscles on MRI: A Systematic Review with a Focus on Methodology
Authors: Han Gengyu , Jiang Yu , Zhang Bo , Gong Chunjie , Li Weishi
Published: May 2021

Purpose

Numerous studies have applied a variety of methods to assess paraspinal muscle degeneration. However, the methodological differences in imaging evaluation may lead to imprecise or inconsistent results. This article aimed to provide a pragmatic summary review of the current imaging modalities, measurement protocols, and imaging parameters in the evaluation of paraspinal muscle fat infiltration (FI) in MRI studies.

Methods

Web of Science, EMBASE, and PubMed were searched from January 2005 to March 2020 to identify studies that examined the FI of paraspinal muscles on MRI among patients with lumbar degenerative diseases.

Results

Intramyocellular lipids measured by magnetic resonance spectroscopy and FI measured by chemical‐shift MRI were both correlated to low back pain and several degenerative lumbar diseases, whereas results on the relationship between FI and degenerative lumbar pathologies using conventional MRI were conflicting. Multi‐segment measurement of FI at the lesion segment and adjacent segments could be a prognostic indicator for lumbar surgery. Most studies adopted the center of the intervertebral disc or endplate as the level of slice to evaluate the FI. Compared with visual semiquantitative assessment, quantitative parameters appeared to be precise for eliminating individual or modality differences. It has been demonstrated that fat CSA/total CSA (based on area) and muscle–fat index (based on signal intensity) as quantitative FI parameters are associated with multiple lumbar diseases and clinical outcomes after surgery.

Conclusion

Having a good command of the methodology of paraspinal muscle FI on MRI was effective for diagnosis and prognosis in clinical practice.
Decreasing Thickness of Partial Lateral Trochlear Cartilage in Patients with Patellar Instability
Authors: Fan Chongyi , Li Ming , Yang Guangmin , Feng Xunkai , Wang Fei
Published: May 2021

Objective

To explore morphological characteristics of patellofemoral joint surface of patients with patellar instability by adopting the MRI‐based method.

Methods

A retrospective analysis was performed from March 2016 to January 2020 to assess morphological characteristics of the patellofemoral joint surface by Magnetic Resonance Imaging (MRI) scanning knees of 30 patients (24 females, six males) with patellar instability and trochlear dysplasia and knees of 30 subjects from a randomly selected control group (25 females, five males). The control group was matched as per age and sex. All participants had undergone MRI scans in the supine position and keep knees in or near full extension. Six parts were measured in total, including thickness of trochlear cartilage, thickness of patella cartilage, cartilaginous sulcus angle, cartilaginous Wiberg angle, contact range and frequency and distributions of the mean difference measurement of the femoral trochlea, to evaluate the difference of trochlear and patellar morphology between the patient group and the control group. The threshold for statistical significance was set at P < 0.05.

Results

There were significant differences in four values between the two groups (P < 0.05). The cartilage thickness two‐third along the lateral condyle in the patient group was significantly lower than that in the control group (LCT2,1.80 ± 0.37 vs 2.06 ± 0.52, 1.92 ± 0.36 vs 2.17 ± 0.50), but there was no significant difference in other sites. There was no significant difference in patella thickness between the patient group and the control group. The cartilaginous sulcus angle in the patient group was larger than that in the control group (157.90 ± 6.64 vs 142.23 ± 3.95, P < 0.001), but there was no significant difference in cartilaginous Wiberg angle. The patient group had a larger initial contact ratio (59.47 ± 6.13 vs 46.50 ± 3.67, P < 0.001), and a smaller contact range (16.55 ± 4.14 vs 27.55 ± 4.09, P < 0.001). The deepest part of the intercondylar suclus appears more often in the lateral of the deepest part of the osseous concavity of the femoral trochlea. Among the patient group, 18 cases (60%) were found with the deepest part of the intercondylar suclus lateral to the deepest point of the osseous concavity of the femoral trochlea while among the control group only 4 cases (13.33%) were found. The distribution of trochlear dysplasia of Dejour grades was type B (n = 22), type C (n = 5), and type D (n = 3).

Conclusion

Thickness of partial lateral trochlear cartilage decreases in patients with patellar instability and the trochlear cartilage develops abnormal morphological characteristics. Moreover, it also suggests that MRI can be used to further present the morphology of cartilage for the convenience of surgical planning.
Discrepancies in persons with dementia, family members, and physician perspectives of dementia treatment: a descriptive study
Authors: Maki Yohko , Ohashi Wataru , Hattori Hideyuki , Suzuki Takao
Published: May 2021

Background

This study aims to reconsider diagnostic approaches to dementia where pharmacological approaches are not available to reverse the pathological changes caused by dementia.

Methods

A questionnaire survey was conducted with 524 physicians specialising in dementia management in Aichi, Japan, with 163 (31.1%) valid responses. The survey gathered information on the perceived merits and demerits of the early diagnosis of dementia and the priorities in treating those with mild cognitive impairment (MCI), mild dementia, and moderate or advanced dementia. In the interview survey, 27 outpatients with mild Alzheimer's disease (76.2 ± 7.6 years old; Mini‐Mental State Examination score 23.3 ± 2.7 points; 21 women, six men) and 24 family members (12 spouses, 12 children) were asked about their priorities in treatment.

Results

A total of 61.3% of physicians answered that persons with dementia having more time to accept the diagnosis is a merit of early diagnosis, while 61.3% answered that the possibility of causing anxiety was a demerit. Around 45% of the physicians chose the option ‘maintaining cognitive function’ as the first priority in cases of MCI and mild dementia, while 39.3% considered it the last priority in moderate or advanced cases. About 22.2% of persons with dementia and 37.5% of their families assigned the highest priority to ‘maintaining cognitive function’, whereas 37.0% of persons with dementia prioritised ‘maintaining quality of life for them and their families’.

Conclusions

Although it is important to build therapeutic alliances among persons with dementia, their families, and physicians by sharing a common perspective for better treatment of dementia, this study suggested that the three parties do not always share the same vision. Future research is needed to determine how to build therapeutic alliances for better approaches to dementia, especially to ensure that timely diagnosis is beneficial for persons with dementia and their families.
New methods for oscillation analyses push new theories of discrete cognition
Authors: Lundqvist Mikael , Wutz Andreas
Published: May 2021

Classical ways of analyzing neural time series data has led to static views on cognition, in which the cognitive processes are linked to sustained neural activity and interpreted as stationary states. The core analytical focus was on slow power modulations of neural oscillations averaged across many experimental trials. Whereas this custom analytical approach reduces the complexity and increases the signal‐to‐noise ratio, it may disregard or even remove important aspects of the underlying neural dynamics. Novel analysis methods investigate the instantaneous frequency and phase of neural oscillations and relate them to the precisely controlled timing of brief successive sensory stimuli. This enables to capture how cognitive processes unfold in discrete windows within and across oscillatory cycles. Moreover, several recent studies analyze the oscillatory power modulations on single experimental trials. They suggest that the power modulations are packed into discrete bursts of activity, which occur at different rates and times, and with different durations from trial‐to‐trial. Here, we review the current work that made use of these methodological advances for neural oscillations. These novel analysis perspectives emphasize that cognitive processes occur in discrete time windows, instead of sustained, stationary states. Evidence for discretization was observed for the entire range of cognitive functions from perception and attention to working memory, goal‐directed thought and motor actions, as well as throughout the entire cortical hierarchy and in subcortical regions. These empirical observations create demand for new psychological theories and computational models of cognition in the brain, which integrate its discrete temporal dynamics.
Power transitions and the rise of the regulatory state: Global market governance in flux
Authors: Lavenex Sandra , Serrano Omar , Büthe Tim
Published: May 2021

This special issue examines the consequences of the ongoing power transition in the world economy for global regulatory regimes, especially the variation in rising powers' transition from rule‐takers to rule‐makers in global markets. This introductory article presents the analytical framework for better understanding those consequences, the Power Transition Theory of Global Economic Governance (PTT‐GEG), which extends the scope of traditional power transition theory to conflict and cooperation in the international political economy and global regulatory governance. PTT‐GEG emphasizes variation in the institutional strength of the regulatory state as the key conduit through which the growing market size of the emergent economies gives their governments leverage in global regulatory regimes. Whether or not a particular rising power, for a particular regulatory issue, invests its resources in building a strong regulatory state, however, is a political choice, requiring an analysis of the interplay of domestic and international politics that fuels or inhibits the creation of regulatory capacity and capability. PTT‐GEG further emphasizes variation in the extent to which rising powers' substantive, policy‐specific preferences diverge from the established powers' preferences as enshrined in the regulatory status quo. Divergence should not be assumed as given. Distinct combinations of these two variables yield, for each regulatory regime, distinct theoretical expectations about how the power transition in the world economy will affect global economic governance, helping us identify the conditions under which rule‐takers will become regime‐transforming rule‐makers, regime‐undermining rule‐breakers, resentful rule‐fakers, or regime‐strengthening rule‐promoters, as well as the conditions under which they remain weakly regime‐supporting rule‐takers.
Demystifying the modernized European data protection regime: Cross‐disciplinary insights from legal and regulatory governance scholarship
Authors: Yeung Karen , Bygrave Lee A.
Published: May 2021

This article critically examines fundamental aspects of the recently reformed European regime for protection of personal data, focusing on the General Data Protection Regulation (GDPR) adopted by the European Union (EU) in 2016. Although the GDPR is now a central concern for many organizations across multiple sectors, many complain that it is arcane, confusing, and complex. By combining knowledge from two disciplinary perspectives – from regulatory governance scholarship, on the one hand, with legal scholarship from the fields of data protection law, constitutional law, and fundamental rights, on the other hand – this article seeks to “demystify” the key elements of the regime's architecture and approach in light of the significant uncertainties concerning the nature of its requirements. In particular, this article examines the tension between the regime's pronounced “risk‐based” approach to compliance and its basic objective of safeguarding fundamental rights, and the challenges facing data protection authorities in providing timely clarifications of the regime's norms. We argue that, despite its complex and arcane character and continuing uncertainty about the precise scope of its requirements, the regime is an innovative hybrid with a significant degree of in‐built “future‐proofing” that should help render it more resistant to being rapidly overtaken or outpaced by organizational–technological developments. The secondary aim of this article is to demonstrate how academic insights from two distinct but related disciplinary perspectives – legal scholarship and regulatory governance studies – offer a potentially fruitful approach to enrich understandings of the European data protection regime in particular, and of the mechanics, efficacy, and legitimacy of regulatory governance regimes more generally.
Exploring Risks of Human Challenge Trials For COVID‐19
Authors: Manheim David , Wiȩcek Witold , Schmit Virginia , Morrison Josh ,   1Day Sooner Research Team
Published: May 2021

Human challenge trials (HCTs) are a potential method to accelerate development of vaccines and therapeutics. However, HCTs for COVID‐19 pose ethical and practical challenges, in part due to the unclear and developing risks. In this article , we introduce an interactive model for exploring some risks of a severe acute respiratory syndrome coronavirus‐2 (SARS‐COV‐2) dosing study, a prerequisite for any COVID‐19 challenge trials. The risk estimates we use are based on a Bayesian evidence synthesis model which can incorporate new data on infection fatality risks (IFRs) to patients, and infer rates of hospitalization. The model estimates individual risk, which we then extrapolate to overall mortality and hospitalization risk in a dosing study. We provide a web tool to explore risk under different study designs. Based on the Bayesian model, IFR for someone between 20 and 30 years of age is 15.1 in 100,000, with a 95% uncertainty interval from 11.8 to 19.2, while risk of hospitalization is 130 per 100,000 (100–160). However, risk will be reduced in an HCT via screening for comorbidities, selecting lower‐risk population, and providing treatment. Accounting for this with stronger assumptions, we project the fatality risk to be as low as 2.5 per 100,000 (1.6–3.9) and the hospitalization risk to be 22.0 per 100,000 (14.0–33.7). We therefore find a 50‐person dosing trial has a 99.74% (99.8–99.9%) chance of no fatalities, and a 98.9% (98.3–99.3%) probability of no cases requiring hospitalization.
FVE promotes RNA‐directed DNA methylation by facilitating the association of RNA polymerase V with chromatin
Authors: Zhou Jin‐Xing , Du Ping , Liu Zhang‐Wei , Feng Chao , Cai Xue‐Wei , He Xin‐Jian
Published: May 2021

Association of RNA polymerase V (Pol V) with chromatin is a critical step for RNA‐ directed DNA methylation (RdDM) in plants. Although the methylated DNA‐binding proteins SUVH2 and SUVH9 and the chromatin remodeler‐containing complex DRD1‐DMS3‐RDM1 are known to be required for the association of Pol V with chromatin, the molecular mechanisms underlying the association of Pol V with different chromatin environments remain largely unknown. Here we found that SUVH9 interacts with FVE, a homolog of the mammalian retinoblastoma‐associated protein, which has been previously identified as a shared subunit of the histone deacetylase complex and the polycomb‐type histone H3K27 trimethyltransferase complex. We demonstrated that FVE facilitates the association of Pol V with chromatin and thus contributes to DNA methylation at a substantial subset of RdDM target loci. Compared with FVE‐independent RdDM target loci, FVE‐dependent RdDM target loci are more abundant in gene‐rich chromosome arms than in pericentromeric heterochromatin regions. This study contributes to our understanding of how the association of Pol V with chromatin is regulated in different chromatin environments.
A fluorometric erythrophagocytosis assay using differentiated monocytic THP‐1 cells to assess the clinical significance of antibodies to red blood cells
Authors: Balola Abdelwahab Hassan Ahmed , Mayer Beate , Bartolmäs Thilo , Salama Abdulgabar
Published: May 2021

Background and Objectives

The significance of antibodies to red blood cells (RBCs) is variable and cannot be predicted solely by serological testing. A flow cytometry‐based erythrophagocytosis assay was established using phorbol 12‐myristate 13‐acetate (PMA)‐treated THP‐1 cells and RBCs labelled with PKH26 to assess allo‐ and autoantibodies to RBCs.

Materials and Methods

THP‐1 cells were differentiated into macrophage‐like cells by treatment with PMA. RBC samples coated with alloantibodies or autoantibodies were obtained from 16 patients with autoimmune haemolytic anaemia of warm type (wAIHA) as well as from five pregnant women with warm autoantibodies. RBCs from healthy blood donors were used as controls. RBCs were labelled with the red lipophilic fluorescent dye PKH26 and incubated with PMA‐treated THP‐1 cells. After removal of nonadherent RBCs by washing and haemolysis of adherent RBCs, erythrophagocytosis was quantified by flow cytometry.

Results

We observed significant phagocytosis of RBCs coated with clinically relevant alloantibodies (i.e. anti‐D and anti‐K) or autoantibodies from patients with active wAIHA, but not of those coated with alloantibodies (anti‐Ch) or autoantibodies from patients and pregnant women without haemolysis.

Conclusion

The flow cytometry‐based erythrophagocytosis test described here is quantitative, highly reliable, and may be helpful for the assessment of the clinical significance of antibodies to RBCs.