bluuebunny/crossref_metadata_2025 huggingface dataset:
The Anatomy of the Frontal Process of the Maxilla in the Medial Wall of the Lacrimal Drainage System in East Asians
Authors: Chen Zhaoyue , Wang Peng , Du Lei , Wang Lan
Published: November 2020

Purpose:

To investigate the anatomical structure characteristics of the frontal process of the maxilla in the medial wall of the lacrimal drainage system for endoscopic dacryocystorhinostomy based on the cone-beam computed tomography images.

Methods:

One hundred eight sides of orbits were retrospectively evaluated in this study. The angulation and thickness of the frontal process of the maxilla in the medial wall of the lacrimal drainage system were measured and compared at 2 different levels: lacrimal sac level and nasolacrimal duct level. The vertical height between the 2 measurement levels was also measured. Data were compared between males and females.

Results:

The average angulation and thickness of the frontal process of the maxilla were found significantly larger at the lacrimal sac level than at the nasolacrimal duct level (83.1 ± 11.3° vs. 61.7 ± 10.9° and 2.7 ± 0.9 mm vs. 1.1 ± 0.4 mm) (p < 0.001). The vertical height between the 2 levels was significantly higher in males than in females (8.6 ± 1.8 mm vs. 7.8 ± 1.7 mm) (p = 0.015).

Conclusions:

We found the angulation and thickness of the frontal process of the maxilla in the medial wall of the lacrimal drainage system decreased from the upper to the lower level. Starting the osteotomy during endoscopic dacryocystorhinostomy might be easier and safer at the midpoint level of the maxillary line.
Expression Changes of Serum IL-1α, CCL2, and CXCL2 in Patients With Pemphigus
Authors: Mao Li-Dan , Zhang Yu , Liang Jun-Qin , Kang Xiao-Jing , Hu Feng-Xia , Jiang Fan-He
Published: November 2020

Objective:

This study was performed to explore the possible changes of the serum levels of the cytokines including interleukin 1α (IL-1 α), chemokine monocyte chemotactic protein 1 (also known as chemokine [C-C motif] ligand 2 [CCL2]), and C-X-C motif chemokine ligand 2 (CXCL2) in patients with pemphigus.

Methods:

The expression levels of IL-1 α, CCL2, and CXCL2 in the serum of 57 patients with pemphigus PV (including 42 patients in progressive stage and 15 patients in remission stage) and 31 healthy controls were examined by enzyme-linked immunosorbent assay. The indepent-samples t-test was used to compare the two groups. One-way analysis of variance was used for multiple-group comparisons, and the post-hoc least significant difference test was used to detect differences among multiple groups.

Results:

The serum expression levels of CCL2 and IL-1a were all significantly higher in the patients in progressive stage than in the controls ([2.69 ± 0.23] ng/mL vs. [2.55 ± 0.28] ng/mL, P = 0.043; [0.62 ± 0.27] ng/mL vs. [0.48 ± 0.23] ng/mL, P = 0.038, respectively). In addition, the serum expression level of CXCL2 was significantly higher in patients in progressive stage than in in the remission stage ([61.70 ± 46.38] ng/mL vs. [24.97 ± 18.46] ng/mL, P = 0.037). Sex, disease classification, disease severity, treatment, and mucosal involvement had no significant influence on the expression of IL-1 α, CCL2, or CXCL2 in the serum of patients groups and controls (all P > 0.05).

Conclusion:

IL-1 α, CCL2, and CXCL2 are heavily involved in the occurrence and development of pemphigus and may be related to the activity of the disease.
Role of Epigenetics in the Pathogenesis of Systemic Sclerosis
Authors: Liu Chao-Fan , Tang Jia-Xuan , Zhu Lu-Bing , Li Ming
Published: November 2020

Systemic sclerosis (SSc) is characterized by immune dysfunction, vasculopathy, chronic fibrosis of skin and internal organs with complex etiology. With the rapid development and the application in biomedicine of epigenetics, accumulating evidence has shown that epigenetics plays an important role in the pathogenesis of SSc. Environmental factors via epigenetics are needed to trigger and maintain for the disease in the subjects with genetic predisposition to SSc. The role of epigenetics in the pathogenesis of SSc includes hypermethylation of the promoter region of nitric oxide synthase and bone morphogenetic protein receptors II, up-regulation of histone deacetylases 4 and 5 expression, and down-regulation of miR-193b and miR-152 in endothelial cells inducing vascular dysfunction; DNA hypermethylation and hypoacetylation of histone H3 and H4 in Friend leukemia virus integration 1 and Kruppel-like factor 5 genes, and the abnormal expression of miR-29, miR-129-5p and miR-135b in fibroblasts causing excessive fibrosis; DNA hypomethylation in the promoter regions of CD11a and CD70 genes in CD4+T cells resulting in immune dysfunction. Studies on the role of epigenetics in SSc are of great significance for better understanding the pathogenic machanism of SSc, which is helpful to find new molecular targets for treating SSc, and consequently, improve the prognosis of SSc.
Knowledge and Attitudes Regarding Organ Transplantation Among Cyprus Residents
Authors: ASIMAKOPOULOU Evanthia , STYLIANOU Vaso , DIMITRAKOPOULOS Ioannis , ARGYRIADIS Alexandros , BELLOU–MYLONA Panagiota
Published: November 2020

Background

Organ transplantation was one of the greatest achievements of medical science during the 20th century. Knowledge, education, and culture all play prominent roles in transplantation because of the complexity of the process from donation to transplantation.

Purpose

The aim of this research was to determine and analyze the knowledge and attitudes about organ donation and transplantation among the general population in Limassol, Cyprus.

Methods

A quantitative research approach was followed, and a questionnaire consisting of closed-ended questions was completed by adults from the general population in Limassol.

Results

One thousand two hundred adults out of the 1,346 adults who were contacted responded to the survey (response rate: 89%) and were included as participants. Of the participants, 93.4% (p < .05) considered organ donation to be lifesaving, 57% expressed interest (and 39.8% expressed disinterest) in becoming organ donors, 80.6% (p < .05) expressed awareness of there being a waiting list for people in need of organ transplantation, 50.4% agreed that brain death must be confirmed before organ removal for transplantation, and 47% recalled having been informed about organ donation through the media, with 31.5% stating that they had never been informed about organ donation.

Conclusions

The participants demonstrated limited awareness regarding the organ donation system in Cyprus. Furthermore, a significant percentage stated that they lacked a source for obtaining related information. The Cypriot society should be informed and encouraged to participate in organ donation to increase the rate of organ transplantation.
Helpfulness of Workplace Accommodations in Maintaining Health and Work Ability in Older Employees with Poor Health in Germany
Authors: Dettmann Marieke-Marie , Hasselhorn Hans Martin
Published: November 2020

Objective:

Supporting employees with health impairments to stay at work through workplace accommodation is a well-researched topic. However, research on workplace accommodations for older employees is lacking.

Methods:

Cross-sectional data from the German lidA cohort study in 2018 focusing on older employees who reported poor health (n = 421) was analyzed. A multiple logistic regression analysis was conducted to asses a potential association between the accommodation type and perceived helpfulness of workplace accommodations in older employees with poor health.

Results:

Changes in working times (OR 6.59), in work tasks (OR 3.50) and in the workplace (OR 2.57) were perceived as most helpful.

Conclusion:

The results indicate that workplace accommodations can be helpful in older employees with health impairments and that this is not by chance, but that the perceived effectiveness has determinants and can be influenced.
Stress Management and Resiliency Training for Healthcare Professionals
Authors: Dossett Michelle L. , Needles Emma W. , Nittoli Caroline E. , Mehta Darshan H.
Published: November 2020

Objective:

To assess the effects of a multi-modal resilience program, the Stress Management and Resiliency Training (SMART) Program, on healthcare professional well-being and job satisfaction.

Methods:

This pilot, mixed-methods, quality improvement, cohort study assessed perceived stress, physical and mental health, job satisfaction, burnout, and value of the curriculum to attendees.

Results:

Participants experienced a significant reduction in perceived stress (P < 0.001) and significant improvements in global mental health (P = 0.001), physical health (P = 0.045), and job satisfaction (P = 0.047). There was no significant improvement in burnout. Qualitative analysis of free text responses revealed appreciation for the skills taught, increased resiliency, and a positive impact on relationships.

Conclusions:

Delivering the SMART Program to healthcare professionals is feasible and may serve as a useful tool for reducing stress and increasing resilience.
Examining Common Characteristics Among Healthcare Personnel Positive for COVID-19 and the Effectiveness of Healthcare Personnel Mask Use in Preventing COVID-19 in a Large Health System in Central Michigan
Authors: Adawee Mohamed O. , Brum Renee E. , Ellsworth Lauretta J.
Published: November 2020

The aim of this quality improvement project was to survey commonalities among healthcare personnel (HCP) who tested positive for COVID-19 and to evaluate the effectiveness the organizational intervention to require HCP wear masks throughout their shift. Information regarding the 40 HCP who tested positive for COVID-19 between the dates of March 18, 2020 and May 13, 2020 were included in the analysis. Nurses (n = 9) made up the majority of HCP positive for COVID-19. The most common types of symptoms reported were cough (n = 26), headache (n = 20), and fever (n = 13). Fourteen days after the requirement for HCP across the organization to wear masks throughout their shift was implemented, a 67% reduction in positive tests among HCP involved in a workplace exposure was observed.
Genetic Variation Associated With Depressive Symptoms in Breast Cancer Patients
Authors: Bayer Samantha J. , Yang Gee Su , Lyon Debra E.
Published: November 2020

Background

Depressive symptoms are highly prevalent in breast cancer patients. These symptoms can contribute to lower treatment adherence, increased healthcare charges, and higher mortality rates. Growing evidence suggests that genetic variations may be associated with depressive symptom susceptibility.

Objective

To comprehensively review current findings on the association of genetic variations with depressive symptoms in breast cancer patients.

Methods

A literature search was conducted using keywords such as gene variation, single-nucleotide polymorphism, depression/depressive symptoms, and breast cancer. Four hundred articles were retrieved from PubMed, Web of Science, CINAHL, and PsycINFO, yielding 9 full-text, data-based articles. The study quality was assessed using the STrengthening the REporting of Genetic Association studies guideline.

Results

Genetic polymorphisms in brain-derived neurotrophic factor (BDNF), interferon γ receptor 1 (IFNGR1), interleukin-6 (IL-6), tumor necrosis factor α (TNFA), and IL-1B were found to be associated with depressive symptoms among breast cancer patients. The role of serotonin transporter gene linked promotor region (5-HTTLPR) functional polymorphisms on depressive symptoms was inconclusive. The overall quality of reporting results and methods was medium.

Conclusions

This is the first review of genetic variations related to differences in levels of depressive symptoms among breast cancer patients. Genetic polymorphisms in inflammatory, neuronal system, and signal transduction pathways can influence the susceptibility. However, more research regarding this topic is needed to further clarify genetic risk factors.

Implications for Practice

Healthcare providers may determine patients at higher risk of developing depression and symptom outcomes if genetic biomarkers with good sensitivity/specificity are provided. This knowledge can potentially help the development of personalized treatment and decision making for those patients.
Are Physical Activity and Sedentary Behavior Associated With Cancer-Related Symptoms in Real Time?
Authors: Paxton Raheem J. , Bui Chuong , Fullwood Dottington , Daniel Danielle , Stolley Melinda , Oliver JoAnn S. , Wang Kun , Dubay John W.
Published: November 2020

Background

Few studies have examined the real-time and dynamic relationship between lifestyle behaviors and treatment-related symptoms.

Objective

The aim of this study was to examine the associations of daily physical activity and sedentary behavior with symptom burden, pain interference, and fatigue among patients who were undergoing active cancer treatment.

Methods

A total of 22 (mean age = 57 years; 73% women; 55% Black) cancer patients were recruited from a local hospital and reported a daily diary of physical activity, sedentary behavior, symptom burden, pain interference, and fatigue over 10 days. Adjusted mixed-effects models were used to examine all associations.

Results

Body mass index moderated the relationship between physical activity and symptom burden (γ = 0.06, P < .01) and physical activity and fatigue (γ = 0.09, P < .05). On days where physical activity was higher than average, symptom burden and fatigue scores were lower among patients who had lower body mass index values. Also, age moderated the relationship between sedentary behavior and symptom burden (γ = −0.04, P < .05); on days where patients sat more, symptom burden was lower among patients who were younger than the average age.

Conclusions

Overall, these data indicate that treatment-related symptoms vary daily within cancer patients and that physical activity may alleviate treatment-related symptoms for leaner patients. Larger samples and objective assessments of physical activity and sedentary behavior are needed to validate our results.

Implications for Practice

Oncology nurses may be in the best position to promote physical activity during treatment as a strategy to manage symptom burden.
Progress toward integrating Distress as the Sixth Vital Sign: a global snapshot of triumphs and tribulations in precision supportive care
Authors: Fradgley Elizabeth A. , Bultz Barry D. , Kelly Brian J. , Loscalzo Matthew J. , Grassi Luigi , Sitaram Brindha
Published: November 2020

Background:

The International Psycho-Oncology Society (IPOS) recognizes psychosocial cancer care as a universal human right. IPOS emphasized that distress should be measured as the 6th Vital Sign alongside temperature, blood pressure, pulse, respiratory rate, and pain. To date, >75 cancer care organizations and accreditation bodies have endorsed screening, monitoring, and treating the multifactorial symptoms of distress as an essential component to high-quality care. The degree to which this international commitment has translated into the integration of precision supportive care within clinical settings is unknown.

Methods:

Building upon a 2018 IPOS World Congress Symposium, this commentary provides 4 snapshots into the progress made toward integrating precision supportive care in India, Australia, Europe, and the United States. The commentary demonstrates the different approaches taken to develop screening practices or overcome barriers to comprehensive precision supportive care.

Results:

Although psychosocial cancer care is a universal right, service and patient barriers to implementation remain, such as: inadequate workforce distribution and service investment in psychosocial care; siloed teams and limited communication skills; and cultural challenges. Recurrent themes emerged which can be used to invigorate commitment to IPOS standards: ongoing capacity building of the international psycho-oncology community; supporting communication skills training and encouraging programmatic thinking within services; and advocating for ongoing investment in precision supportive care through evaluation and strong clinical leadership.

Conclusions:

In examining 4 unique settings, the commentary recognizes the geographic variation in health care resources and social contexts of cancer care alongside cultural perspectives on psychosocial distress, screening methods, and the value of precision supportive care.
The Psychological Impact of Cancer (PIC) Scale: development and comparative psychometric testing against the Mini-MAC Scale in UK and Australian cancer survivors
Authors: Hulbert-Williams Nicholas J. , Hulbert-Williams Lee , Whelen Liz , Mulcare Hunter
Published: November 2020

Background:

Clinicians and researchers make considerable use of both the Mental Adjustment to Cancer (MAC) Scale, and the shorter Mini-MAC, to measure psychological adjustment in cancer patients. The length of the scale is problematic when used clinically, and its psychometric properties have been criticized. This article presents two studies leading to the development of a novel scale, the Psychological Impact of Cancer (PIC) Scale, using items drawn from the MAC.

Methods:

Study 1 used standard item-reduction techniques to shorten the Mini-MAC in a sample of 160 cancer patients of mixed diagnosis, recruited an average 46 days post-diagnosis. This resulted in a 12-item scale with a 4-factor structure, similar to that derived from a 2012 re-analysis of the Mini-MAC. Study 2 presents confirmatory factor analysis (CFA) of this new measure and tests its construct validity and test–retest reliability in a sample of 183 mixed cancer survivors.

Results:

This study indicated that the shorter scale performed well on CFA indicators (RMSEA = .083; ECVI = .923; PNFI = .604; AGFI = .857) and tests of internal consistency (all >.623), and comparable concurrent validity with longer versions. The 4 factors were labeled cognitive distress, cognitive avoidance, emotional distress, and fighting spirit.

Conclusions:

Given its shorter length and acceptable psychometrics, the PIC offers a useful clinical and research tool to assess the psychological impact of cancer. Psychometric properties of one subscale (fighting spirit) remain poor, but no worse than in the original scale; directions for further development of the scale are described.
Psychological distress in newly diagnosed breast cancer patients: an observational study comparing those at high risk of hereditary cancer with those of unknown risk
Authors: Wevers Marijke R. , Schou-Bredal Inger , Verhoef Senno , Bleiker Eveline M.A. , Hahn Daniela E.E. , Brouwer Titia , Kieffer Jacobien M. , Ausems Margreet G.E.M. , Aaronson Neil K.
Published: November 2020

Background:

We compared levels of psychological distress of newly diagnosed breast cancer patients who knew they were at heightened risk of carrying a BRCA1/2 mutation (HRBC) (eg, because of young age at diagnosis and/or a positive family history) with breast cancer patients who were not assessed for their risk (unknown risk breast cancer, or URBC).

Methods:

We administered the Hospital Anxiety and Depression Scale (HADS) to a sample of 238 Dutch HRBC patients and 165 Norwegian URBC patients within 3 weeks of breast cancer diagnosis, prior to primary surgery. We compared HADS scores between these groups, and identified variables associated with those scores.

Results:

The HRBC patients reported significantly more symptoms of depression than URBC patients (P < .001, effect size = .40). The percentage of women with a suspected or probable (HADS depression score ≥8) and a probable diagnosis of depression (HADS depression score ≥11) was 29% versus 12% (P = .001) and 15% versus 5% (P = .01) in the HRBC and URBC groups, respectively. There were no significant group differences in HADS anxiety scores. In the HRBC sample, having children and psychological problems in the year before breast cancer diagnosis were associated significantly with both depression and anxiety following the diagnosis of breast cancer.

Conclusions:

Shortly after diagnosis, high hereditary-risk breast cancer patients report significantly higher levels of clinically relevant depressive symptoms as compared to breast cancer patients not assessed for their risk. Screening for psychological distress among high-risk breast cancer patients could facilitate timely referral to appropriate psychosocial services.
Online psychological self-management intervention for testicular cancer survivors (e-TC 2.0): promising acceptability and preliminary efficacy, but limited feasibility
Authors: Smith Allan ‘Ben’ , Rincones Orlando , Heiniger Louise , Grimison Peter , Tran Ben , Stockler Martin R. , Toner Guy , Cohen Beth , Olver Ian , Klein Britt , McJannett Margaret , Butow Phyllis
Published: November 2020

Background:

Testicular cancer (TC) survivors experience greater psychological morbidity than the general population. Two-thirds of TC survivors report unmet supportive care needs regarding issues such as fear of cancer recurrence (FCR), but many are reluctant/unable to seek face-to-face help. This study prospectively assessed the feasibility, acceptability, and preliminary efficacy of an interactive web-based self-management intervention (e-TC 2.0) in reducing borderline/clinical levels of anxiety, depression, and/or FCR among TC survivors.

Methods:

TC survivors who had completed treatment were recruited to this single-arm phase I trial through clinicians and online advertisements. Consenting participants completed baseline questionnaires, had 12 weeks’ access to e-TC 2.0, then completed post-intervention questionnaires. Feasibility was determined by the proportion of e-TC 2.0 completed (website usage data). Acceptability was assessed with purpose-designed satisfaction measures. Preliminary efficacy was indicated by changes in anxiety/depression (HADS), distress (thermometer), and FCR (Fear of Cancer Recurrence Inventory-Short Form).

Results:

Thirty-nine participants started the intervention; 48% completed the first module, but only 20% completed all modules. Mean participant age was 37.1 years; mean time since diagnosis was 3.6 years. Mean acceptability scores were > 8/10. Mean unmet needs, distress, FCR, anxiety, and depression levels decreased after the intervention, as did the proportion of participants above clinical cut-offs.

Conclusions:

e-TC 2.0 is the first web-based resource for TC survivors with borderline/clinical levels of anxiety, depression, and/or FCR. Although engagement with e-TC 2.0 was somewhat limited, website users reported high levels of satisfaction and reductions in psychological morbidity and unmet needs. e-TC 2.0 may be a useful adjunct to traditional face-to-face health professional support for TC survivors.
Exploring the Survivorship Experiences and Preferences for Survivorship Care Following Testicular Cancer: A Mixed Methods Study
Authors: Petrella Anika R. , Sabiston Catherine M. , O’Rourke Roxy H. , Santa Mina Daniel , Matthew Andrew G.
Published: November 2020

Background:

Men with testicular cancer are an understudied subgroup of survivors due to a lack of engagement in supportive care research and usual care despite reporting unmet support care needs. The present study aimed to explore the survivorship experience of men with testicular cancer, as well as survivors’ attitudes toward, and preferences for, sport-based supportive care programming.

Methods:

Using a concurrent mixed methods approach, semistructured interviews with a convenient sample of testicular cancer survivors (n = 11) were conducted, along with a cross-sectional survey (n = 135) completed during routine oncology visits.

Results:

Inductive thematic analysis of qualitative data resulted in three core themes labeled “the developmental disruption," “the connectedness conflict," and “the way back to normal." Based on the descriptive analysis of survey data and qualitative feedback, testicular cancer survivors indicated preferences for sport-based supportive care programming that is offered outside of the hospital, in the evening, include a strength training component, and embedded psychoeducation throughout addressing common survivorship concerns related to physical health (eg, fertility and fatigue), managing emotions (eg, anxiety and low mood), and getting back on track.

Conclusions:

Findings from this study provide a foundation for the development of a gender-sensitized supportive care program tailored to the survivorship profile of men with testicular cancer.
Seminal Vesicle Urinary Reflux After TURP Mimicking Vesicular Invasion From Prostate Cancer on 18F-Choline PET/CT
Authors: Sollaku Saadi , Casciani Emanuele , De Angelis Cristina , Frantellizzi Viviana , Gualdi Gianfranco
Published: November 2020

Seminal vesicles are paired secretory glands located posterior to the bladder in men that produce seminal fluid to maintain sperm. Seminal vesicle reflux into the prostatic ducts may be associated with prostatitis in older patients or may represent a very rare complication of transurethral prostate resection in patients with prostatic cancer. This condition is frequently accidentally diagnosed on excretory urography and/or retrograde urethrogram. Clinical presentation includes pain, fever, recurrent epididymitis-prostatitis, and post void dribbling.
Comparison Between Human Amniotic/Chorionic Membrane and Cryopreserved Allografts in the Treatment of Genital Burns
Authors: Puyana Salomon , Ruiz Samuel , Elkbuli Adel , Bernal Eileen , McKenney Mark , Young Elizabeth , Lim Rizal , Askari Morad , Mir Haaris
Published: November 2020

Background

Genital burns have devastating effects on patient and have been classified by the American Burn Association as major burn injury. The management of these injuries continues to challenge reconstructive surgeons. Cryopreserved skin allografts have been successfully used to manage partial-thickness skin burns; however, dehydrated human amniotic/chorionic membrane (DHACM) represents novel technology. Dehydrated human amniotic/chorionic membrane outcomes have not been sufficiently studied to guide its use on genital burns. The objective of this study was to report on the outcomes of dehydrated amniotic membrane as a biologic skin dressing on genital burns injury compared with cryopreserved allografts.

Methods

Retrospective review of data collected from our institutional burn registry from 2012 to 2017. The study population included patients with partial-thickness genital burns admitted between 2012 and 2017 treated with either dehydrated human amniotic/chorionic membrane or cryopreserved allografts. Demographic characteristics and outcome measures were compared between the 2 groups.

Results

Thirty patients with genital burns who received DHACM skin and cryopreserved allografts were included in the analysis. The mean age for the DHACM group was 27.6 years compared with 33.5 years for the cryopreserved group. The mean total body surface area was 3.8% in the DHACM group compared with 7.2% in the cryopreserved group (P = non-significant (ns)). The mean injury severity score was not significantly different between groups. Patients receiving cadaveric allografts had a higher number of skin substitute surgical reapplications as compared with the DHACM group (28% vs 0%, P ≤ 0.05). All patients who received DHACM skin substitutes healed by 2 weeks postoperative compared with 76% of patients who received cryopreserved skin allografts (P = 0.03, χ2).

Conclusions

Dehydrated amniotic membrane skin substitutes are a safe alternative in the treatment of genital burns. Its use achieves comparable benefits with no major significant difference in terms of complication, supporting the safety of amniotic membrane to treat genital burns.
Age- and Sex-Related Morphometric Changes and Asymmetry in the Orbito-Zygomatic Region
Authors: Erdoğan Kübra , Tatlisumak Ertuğrul , Ovali Gülgün Yilmaz , Pabuşçu Yüksel , Tarhan Serdar
Published: November 2020

The aims of this study were to obtain cephalometric data of orbito-zygomatic skeleton using CT axial images and to determine the presence of sexual dimorphism, normal range of facial asymmetry, and the age-related changes.

This study used data from 315 CT scan series of skeletally normal subjects (159 males and 156 females) between the ages of 18 to 90. Two different levels of axial sections were used. In total, 11 measurements were performed and 5 of them were bilateral.

The mean values and standard deviations were calculated. Gender and age related changes and asymmetry degree were investigated.

Mean values of measurements except left medial orbital wall length, right and left medial orbital wall protrusion, right and left lateral orbital wall angle were significantly larger in males for all age groups. Majority of the measurements was formed by the individuals with larger right side. Similar tendencies were observed for craniofacial asymmetry in both sexes and in different age groups. There were no significant craniofacial asymmetries between age and gender groups in terms of the cephalometric measurements. Mid-interorbital distance had a negative correlation (r = –0.11 and P = 0.043) and interzygomatic buttress distance had a positive correlation (r = 0.15 and P = 0.005) with age.

Morphological properties such as sexual dimorphism, symmetry, age related changes are important parameters especially for plastic surgery discipline. The authors hope the data can be helpful in diagnosis and surgical treatment of craniofacial diseases, estimating the prognosis and preparation of the facial prosthesis.
Orbital Hypertelorism Correction With Inverted-U Osteotomy: Indications and Advantages
Authors: Huang Qinghua , Yang Bin , Li Binghang , Ma Hengyuan
Published: November 2020

This study aimed to explore the clinical effects of inverted-U osteotomy in correcting orbital hypertelorism and to further explore its indications and advantages; 4 patients with orbital hypertelorism and premature closure of unilateral coronal suture underwent inverted-U osteotomy. The interorbital distance was measured using three-dimensional digital technology pre- and postoperatively. Virtual preoperative planning and three-dimensional cutting guide were used to minimize surgical risk and increase the precision of periorbital osteotomy. The procedure was successfully performed on 4 patients; the average orbital medial wall distance was reduced from 34.9 mm to 23.1 mm. Inverted-U osteotomy is a modified surgical method especially applicable to orbital hypertelorism with premature closure of unilateral coronal suture. Advantages include less surgical trauma, a shorter operative time, and better correction results.
Association of Premature Menopause With Risk of Abdominal Aortic Aneurysm in the Women’s Health Initiative
Authors: Chou Elizabeth L. , Pettinger Mary , Haring Bernhard , Allison Matthew A. , Mell Matthew W. , Hlatky Mark A. , Wactawski-Wende Jean , Wild Robert A. , Shadyab Aladdin H. , Wallace Robert B. , Snetselaar Linda G. , Madsen Tracy E. , Eagleton Matthew J. , Conrad Mark F. , Liu Simin
Published: November 2020

Objective:

To determine if premature menopause and early menarche are associated with increased risk of AAA, and to explore potential effect modification by smoking history.

Summary of Background Data:

Despite worse outcomes for women with AAA, no studies have prospectively examined sex-specific risk factors, such as premature menopause and early menarche, with risk of AAA in a large, ethnically diverse cohort of women.

Methods:

This was a post-hoc analysis of Women’s Health Initiative participants who were beneficiaries of Medicare Parts A&B fee-for-service. AAA cases and interventions were identified from claims data. Follow-up period included Medicare coverage until death, end of follow-up or end of coverage inclusive of 2017.

Results:

Of 101,119 participants included in the analysis, the mean age was 63 years and median follow-up was 11.3 years. Just under 10,000 (9.4%) women experienced premature menopause and 22,240 (22%) experienced early men-arche. Women with premature menopause were more likely to be overweight, Black, have >20 pack years of smoking, history of cardiovascular disease, hypertension, and early menarche. During 1,091,840 person-years of follow-up, 1125 women were diagnosed with AAA, 134 had premature menopause (11.9%), 93 underwent surgical intervention and 45 (48%) required intervention for ruptured AAA. Premature menopause was associated with increased risk of AAA [hazard ratio 1.37 (1.14, 1.66)], but the association was no longer significant after multivariable adjustment for demographics and cardiovascular disease risk factors. Amongst women with ≥20 pack year smoking history (n = 19,286), 2148 (11.1%) had premature menopause, which was associated with greater risk of AAA in all models [hazard ratio 1.63 (1.24, 2.23)]. Early menarche was not associated with increased risk of AAA.

Conclusions:

This study finds that premature menopause may be an important risk factor for AAA in women with significant smoking history. There was no significant association between premature menopause and risk of AAA amongst women who have never smoked. These results suggest an opportunity to develop strategies for better screening, risk reduction and stratification, and outcome improvement in the comprehensive vascular care of women.
A Risk Model of Admitting Patients With Silent SARS-CoV-2 Infection to Surgery and Development of Severe Postoperative Outcomes and Death
Authors: Soreide Kjetil , Yaqub Sheraz , Hallet Julie , Kvaløy Jan Terje , Kleppe Tore Selland
Published: November 2020

Objective:

To model the risk of admitting silent COVID-19-infected patients to surgery with subsequent risk of severe pulmonary complications and mortality.

Summary Background Data:

With millions of operations cancelled during the COVID-19 pandemic, pressure is mounting to reopen and increase surgical activity. The risk of admitting patients who have silent SARS-Cov-2 infection to surgery is not well investigated, but surgery on patients with COVID-19 is associated with poor outcomes. We aimed to model the risk of operating on nonsymptomatic infected individuals and associated risk of perioperative adverse outcomes and death.

Methods:

We developed 2 sets of models to evaluate the risk of admitting silent COVID-19-infected patients to surgery. A static model let the underlying infection rate (R rate) and the gross population-rate of surgery vary. In a stochastic model, the dynamics of the COVID-19 prevalence and a fixed population-rate of surgery was considered. We generated uncertainty intervals (UIs) for our estimates by running low and high scenarios using the lower and upper 90% uncertainty limits. The modelling was applied for high-income regions (eg, United Kingdom (UK), USA (US) and European Union without UK (EU27), and for the World (WORLD) based on the WHO standard population.

Results:

Both models provided concerning rates of perioperative risk over a 24-months period. For the US, the modelled rates were 92,000 (UI 68,000–124,000) pulmonary complications and almost 30,000 deaths (UI 22,000–40·000), respectively; for Europe, some 131,000 patients (UI 97,000–178,000) with pulmonary complications and close to 47,000 deaths (UI 34,000–63,000) were modelled. For the UK, the model suggested a median daily number of operations on silently infected ranging between 25 and 90, accumulating about 18,700 (UI 13,700–25,300) perioperative pulmonary complications and 6400 (UI 4600–8600) deaths. In high-income regions combined, we estimated around 259,000 (UI 191,000–351,000) pulmonary complications and 89,000 deaths (UI 65,000–120,000). For the WORLD, even low surgery rates estimated a global number of 1.2 million pulmonary complications and 350,000 deaths.

Conclusions:

The model highlights a considerable risk of admitting patients with silent COVID-19 to surgery with an associated risk for adverse perioperative outcomes and deaths. Strategies to avoid excessive complications and deaths after surgery during the pandemic are needed.
Estimating the Effects of Individual Nurses on ICU Outcomes
Authors: Brossette Stephen E. , Zheng Ning , Wong Daisy Y. , Hymel Patrick A.
Published: November 2020

A better understanding of the effects of nursing on clinical outcomes could be used to improve the safety, efficacy, and efficiency of inpatient care. However, measuring the performance of individual nurses is complicated by the non-random assignment of nurses to patients, a process that is confounded by unobserved patient, management, workforce, and institutional factors. Using the MIMIC-III ICU database, we estimate the effects of individual registered nurses (RNs) on the probability of acute kidney injury (AKI) in the ICU. We control for significant unobserved heterogeneity by exploiting panel data with 12-hour fixed effects, and use a linear probability model to estimate the near-term marginal effects of individual RN assignments. Among 270 ICU RNs, we find 15 excess high-side outliers, and 4 excess low-side outliers. We estimate that in one twelve-hour work shift, each high-side RN outlier increases the probability of AKI by about 4 percentage points, and in 25 work shifts, causes about one additional AKI. Conversely, each low-side outlier prevents about one AKI in 50 work shifts. Given the fine-grained nature of the fixed effects employed, we believe that the estimated individual nursing effects are approximately causal. We discuss our contribution to the literature and identify potential use cases for clinical deployment.
Discovering subgenomes of octoploid strawberry with repetitive sequences
Authors: Session Adam , Rokhsar Daniel
Published: November 2020

Although its sequence was recently determined in a genomictour de force,{Edger 2019} the ancestry of the cultivated octoploid strawberryFragariaxananassaremains controversial.{Liston 2020; Edger 2020} Polyploids that arise by hybridization generally have chromosome sets, or subgenomes, of distinct ancestry.{Stebbins 1947; Garsmeur 2014} The conventional method for partitioning a polyploid genome into its constituent subgenomes relies on establishing phylogenetic relationships between protein-coding genes of the polyploid and its extant diploid relatives,{Edger 2018-sub} but this approach has not led to a consensus for cultivated strawberry.{Liston 2020; Edger 2020} Here we resolve this controversy using a complementary strategy that focuses on the chromosomal distribution of transposable elements and depends only on the octoploid sequence itself.{Session 2016; Mitros 2020} Our method independently confirms the consensus that two of the four subgenomes derived from the diploid lineages ofF. vescaandF. iinumae.{Tennessen 2014; Edger 2019} For the remaining two subgenomes, however, we find a statistically well-supported partitioning that differs from ref. {Edger 2019} and other work (reviewed in {Hardigan 2020}). We also provide evidence for a shared allohexaploid intermediate and suggest a neutral explanation for the “dominance” of theF. vesca-related subgenome.
From local spectral species to global spectral communities: a benchmark for ecosystem diversity estimate by remote sensing
Authors: Rocchini Duccio , Salvatori Nicole , Beierkuhnlein Carl , Chiarucci Alessandro , de Boissieu Florian , Förster Michael , Garzon-Lopez Carol X. , Gillespie Thomas W. , Hauffe Heidi C. , He Kate S. , Kleinschmit Birgit , Lenoir Jonathan , Malavasi Marco , Moudrý Vítězslav , Nagendra Harini , Payne Davnah , Šímová Petra , Torresani Michele , Wegmann Martin , Féret Jean-Baptiste
Published: November 2020

In the light of unprecedented change in global biodiversity, real-time and accurate ecosystem and biodiversity assessments are becoming increasingly essential. Nevertheless, estimation of biodiversity using ecological field data can be difficult for several reasons. For instance, for very large areas, it is challenging to collect data that provide reliable information. Some of these restrictions in Earth observation can be avoided through the use of remote sensing approaches. Various studies have estimated biodiversity on the basis of the Spectral Variation Hypothesis (SVH). According to this hypothesis, spectral heterogeneity over the different pixel units of a spatial grid reflects a higher niche heterogeneity, allowing more organisms to coexist. Recently, the spectral species concept has been derived, following the consideration that spectral heterogeneity at a landscape scale corresponds to a combination of subspaces sharing a similar spectral signature. With the use of high resolution remote sensing data, on a local scale, these subspaces can be identified as separate spectral entities, the so called “spectral species”. Our approach extends this concept over wide spatial extents and to a higher level of biological organization. We applied this method to MODIS imagery data across Europe. Obviously, in this case, a spectral species identified by MODIS is not associated to a single plant species in the field but rather to a species assemblage, habitat, or ecosystem. Based on such spectral information, we propose a straightforward method to deriveα- (local relative abundance and richness of spectral species) andβ-diversity (turnover of spectral species) maps over wide geographical areas.
MarkovHC: Markov hierarchical clustering for the topological structure of high-dimensional single-cell omics data
Authors: Wang Zhenyi , Zhong Yanjie , Ye Zhaofeng , Zeng Lang , Chen Yang , Shi Minglei , Qian Minping , Zhang Michael Q.
Published: November 2020

Distinguishing cell types and cell states is one of the fundamental questions in single-cell studies. Meanwhile, exploring the lineage relations among cells and finding the path and critical points in the cell fate transition are also of great importance.

Existing unsupervised clustering methods and lineage trajectory reconstruction methods often face several challenges such as clustering data of arbitrary shapes, tracking precise trajectories and identifying critical points. Certain adaptive landscape approach1–3, which constructs a pseudo-energy landscape of the dynamical system, may be used to explore such problems. Thus, we propose Markov hierarchical clustering algorithm (MarkovHC), which reconstructs multi-scale pseudo-energy landscape by exploiting underlying metastability structure in an exponentially perturbed Markov chain4. A Markov process describes the random walk of a hypothetically traveling cell in the corresponding pseudo-energy landscape over possible gene expression states. Technically, MarkovHC integrates the tasks of cell classification, trajectory reconstruction, and critical point identification in a single theoretical framework consistent with topological data analysis (TDA)5.

In addition to the algorithm development and simulation tests, we also applied MarkovHC to diverse types of real biological data: single-cell RNA-Seq data, cytometry data, and single-cell ATAC-Seq data. Remarkably, when applying to single-cell RNA-Seq data of human ESC derived progenitor cells6, MarkovHC not only could successfully identify known cell types, but also discover new cell types and stages. In addition, when using MarkovHC to analyze single-cell RNA-Seq data of human preimplantation embryos in early development7, the hierarchical structure of the lineage trajectories was faithfully reconstituted. Furthermore, the critical points representing important stage transitions had also been identified by MarkovHC from early gastric cancer data8.

In summary, these results demonstrate that MarkovHC is a powerful tool based on rigorous metastability theory to explore hierarchical structures of biological data, to identify a cell sub-population (basin) and a critical point (stage transition), and to track a lineage trajectory (differentiation path).

Highlights

MarkovHC explores the topology hierarchy in high-dimensional data.

MarkovHC can find clusters (basins) and cores (attractors) of clusters in different scales.

The trajectory of state transition (transition paths) and critical points in the process of state transition (critical points) among clusters can be tracked.

MarkovHC can be applied on diverse types of single-cell omics data.
Tracking tau fibrillogenesis and consequent primary phagocytosis of neurons mediated by microglia in a living tauopathy model
Authors: Takuwa Hiroyuki , Orihara Asumi , Takado Yuhei , Urushihata Takuya , Shimojo Masafumi , Ishikawa Ai , Takahashi Manami , Barron Anna M. , Ono Maiko , Maeda Jun , Masamoto Kazuto , Akatsu Hiroyasu , Tolkovsky Aviva M. , Ji Bin , Tomita Yutaka , Ito Hiroshi , Zhang Ming-Rong , Goedert Michel , Spillantini Maria Grazia , Lee Virginia M. -Y. , Trojanowski John Q. , Maehara Taketoshi , Suhara Tetsuya , Sahara Naruhiko , Higuchi Makoto
Published: November 2020

Fibrillary tau pathologies have been implicated in Alzheimer’s and allied neurodegenerative diseases, while mechanisms by which neurons bearing tau tangles die remain enigmatic. To address this issue, we pursued tau and related key pathologies macroscopically by PET and MRI and microscopically by intravital two-photon laser optics. Time-course macroscopic assays of tau transgenic mice demonstrated intimate associations of tau deposition and increase of an inflammatory microglial marker, translocator protein (TSPO), with regional brain atrophy. Longitudinal microscopy of these mice revealed a rapid turnover of tau lesions resulting from continuous generation of new tau aggregates followed by loss of neurons and their fibrillar contents. This technology also allowed the capturing of the disappearance of tangle-bearing neurons several days after being engulfed by activated microglia. Notably, a therapeutic TSPO ligand profoundly suppressed the mobility and phagocytotic activity of microglia and improved neuronal survival in this model, supporting the involvement of primary phagocytosis of viable neurons by microglia in tau-primed neuronal death. Finally, partial depletion of microglia revealed roles of immune factors, MFG-E8 and C1q, as ‘eat-me’ signals for an immediate attraction of phagocytic microglia towards the elimination of tangle-loaded neurons.