bluuebunny/crossref_metadata_2025 huggingface dataset:
Health-Related Quality of Life of Young People With and Without Chronic Conditions
Authors: Pinquart Martin
Published: June 2020

Objective

The aim of this meta-analysis was to compare levels of health-related quality of life (HRQOL) among children with and without chronic physical and/or sensory conditions, based on PedsQL 4.0 General Core Scales.

Methods

Studies were identified with electronic databases (CINAHL, PSYCINFO, MEDLINE, Google Scholar, PSYNDEX) and from the PedsQL website. We included controlled studies that compared PedsQL scores of children (mean age < 18 years) with and without chronic physical and/or sensory conditions and uncontrolled studies on children with chronic physical and/or sensory conditions from countries where data from peers without chronic conditions have been published. Random-effects meta-analyses were computed.

Results

In total, 1,231 studies fulfilled the inclusion criteria. There were large declines of the total and physical score as well as medium-sized declines of psychosocial health and its subscales, based on criteria of interpreting effect sizes by Cohen [Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159]. Children with cerebral palsy and spina bifida showed the largest declines across all scales, but significant declines emerged in all compared 29 chronic conditions. We identified moderating effects of duration of the chronic condition, rater, child gender, country, sociodemographic equivalence of the compared groups, type of control condition, and publication status.

Conclusions

Young people with chronic health conditions should be screened for HRQOL, and the profile across different domains should be preferred over the use of a sum score. Child self-reports are particularly relevant for assessing emotional and social functioning. Effective measures aimed at improving HRQOL are needed, especially if the chronic condition leads to severe declines of physical functioning.
Fixed places, shifting distances: remittance houses and migrants’ negotiation of home in Ecuador
Authors: Boccagni Paolo , Pérez Murcia Luis Eduardo
Published: June 2020

Many case studies on the rationale and purpose of transnational housing initiatives and so-called remittance houses have been published over the past two decades. Still missing, though, is a framework to illustrate the conceptual value of researching these buildings and their ways of mediating the relationships between movers and stayers. With a view to this, the article illustrates what remittance houses ‘do’ to narrow down the gaps that emerge—in space, time, status, and knowledge—between migrants and their communities of origin. As our fieldwork with Ecuadorian migrants in Europe and their left-behind counterparts shows, remittance houses are more than investments, or resources for migrants’ emotional attachment and dreams of return. They are also central to the negotiation of class, status and belonging, and to the very interplay between housing and home along the course of migration. As ‘agents’ in themselves, these houses shape the transnational connections between distant and disparate places, and the circulation of home-related ideas and practices across them. Over time, they embody a variety of meanings and expectations that, unlike the buildings, are far from fixed or immobile.
Clinical Use of the Automated Neuropsychological Assessment Metrics TBI-Mil Expanded Battery in Evaluating Concussion Recovery: A Retrospective Study
Authors: Porter Steven J , Johnson Dagny E
Published: June 2020

Introduction

This retrospective study evaluated the use of the Automated Neuropsychological Assessment Metrics (ANAM4) Expanded battery in a clinical setting to determine if the resolution of physiological symptoms, in the absence of neurocognitive assessment, was sufficient data in the return-to-duty (RTD) determination.

Materials and Methods

In this study, 508 U.S. Naval Academy midshipmen were diagnosed with concussion and prescribed a standard treatment protocol. As directed by the protocol, they were evaluated and tracked by medical providers until determined to have normal balance and to be asymptomatic at rest and with exertion. Upon the resolution of these physiological symptoms, the midshipmen were referred for neurocognitive (ANAM4) testing. When results indicated a return to neurocognitive baseline, a RTD determination was made.

Results

The analysis of data in this study indicated that RTD determinations based solely on the resolution of physiological symptoms would have resulted in 25.1% of the sample being returned to duty before neurocognitive recovery. Additional analysis of the ANAM4 reliable change index (RCI) data for each of the concussed patients revealed a pattern of scores that correlated with an expected length of recovery. Individuals with at least one RCI greater than or equal to −1.64 returned to neurocognitive baseline in 8.92 days, whereas individuals with 2 or more RCIs greater than or equal to −1.25 (but less than −1.64) returned to baseline in 5.78 days, and those with a difference in measured reaction times that were greater or equal to −1.25 returned to baseline in 3.20 days. Furthermore, findings indicated that female service members required additional time for the resolution of physical symptoms as compared to their male counterparts. The mean number of days from injury to being deemed symptoms free in males was approximately 14, as compared to females who were deemed symptom free in 21 days. This difference is statistically significant.

Conclusions

Findings of this investigation revealed three specific outcomes. First, a computerized neurocognitive assessment instrument should be used as an adjunct measure in evaluating the resolution of physiological symptoms following a concussive injury. Second, results revealed that based on the RCIs of postinjury ANAM4 assessments, it is possible to estimate the remaining recovery time needed for a return to neurocognitive baseline. Third, results of this analysis revealed that gender appears to be a factor in time between concussive injury and resolution of symptoms.
Transition From Military Prehospital Medicine to Civilian EMS
Authors: Westcott Sally , Walrath Benjamin , Miller Jeremy , Trumbull Melissa , Manifold Craig
Published: June 2020

Introduction

Currently, there is a disconnection between veteran military medics and the civilian Emergency Medical Services (EMS) workforce. This project aimed to characterize the rate of civilian certification among military medics, both active duty and retired, and identify perceived barriers to continuing a career in EMS after military separation.

Materials and Methods

The National Association of Emergency Medical Technicians (EMTs) administered a 21-question online survey to participants. Individuals were recruited through the National Association of EMTs membership communications, Military Relations Committee members, and social media. All responses were anonymous and no identifiable information was collected. Survey questions were compiled and reported as a percentage of respondents. Free-text responses were categorized based on broad themes identified by the authors and are reported as a percentage of respondents.

Results

Results included 456 veteran and active duty respondents, of whom 304 (70.7%) had prehospital experience while in the military and 250 (58.1%) had emergency department experience. Over 60% of respondents participated in combat-related duty with 37% having at least 18 months of overseas deployment. Civilian EMT certification was held by 164 (36.7%) survey participants and 170 held paramedic certification (38.1%), while 65 (14.6%) held no EMS certification. There were 119 (28.1%) respondents who stated that they did not plan to work in civilian EMS. Top selected reasons for not pursuing civilian EMS careers included: pursuing a medical career that was not prehospital (28.5%), pay disparity (18.1%), and no interest in civilian prehospital medicine (16.4%). Write in responses indicated general frustration with maintaining certification and a desire for advanced certification (AEMT, paramedic) to be supplied by the military prior to transitioning to a civilian workforce as many respondents felt their military-endowed skills and experiences were better aligned with these advanced EMS licenses.

Conclusion

The majority of survey respondents held an EMS certification of some kind and suggests that recent efforts to supply military medics with civilian certifications have been largely successful. However, there is still a large portion that remains noncertified or expresses disinterest with entering the civilian workforce. Generally, many of those certified feel their military scope of practice exceeded civilian EMT certification and requested AEMT or paramedic licensure opportunities while still active duty military.
Magnetic fields from multiplicative chaos
Authors: Durrive Jean-Baptiste , Lesaffre Pierre , Ferrière Katia
Published: June 2020

An analytical model for fully developed three-dimensional incompressible turbulence was recently proposed in the hydrodynamics community, based on the concept of multiplicative chaos. It consists of a random field represented by means of a stochastic integral, which, with only a few parameters, shares many properties with experimental and numerical turbulence, including in particular energy transfer through scales (the cascade) and intermittency (non-Gaussianity) that is most conveniently controlled with a single parameter. Here, we propose three models extending this approach to magnetohydrodynamic turbulence. Our formulae provide physically motivated 3D models of a turbulent velocity field and magnetic field coupled together. Besides its theoretical value, this work is meant to provide a tool for observers: a dozen of physically meaningful free parameters enter the description, which is useful to characterize astrophysical data.
New empirical constraints on the cosmological evolution of gas and stars in galaxies
Authors: Padmanabhan Hamsa , Loeb Abraham
Published: June 2020

We combine the latest observationally motivated constraints on stellar properties in dark matter haloes, along with data-driven predictions for the atomic (H I) and molecular (H2) gas evolution in galaxies, to derive empirical relationships between the build-up of galactic components and their evolution over cosmic time. At high redshift (z ≳ 4), the frameworks imply that galaxies acquire their cold gas (both atomic and molecular) mostly by accretion, with the fraction of cold gas reaching about 20 per cent of the cosmic baryon fraction. We infer a strong dependence of the star formation rate on the H2 mass, suggesting a near-universal depletion time-scale of 0.1–1 Gyr in Milky Way-sized haloes (of masses 1012  M⊙ at z = 0). There is also evidence for a near-universality of the Kennicutt–Schmidt relation across redshifts, with very little dependence on stellar mass, if a constant conversion factor (αCO) of CO luminosity to molecular gas mass is assumed. Combining the atomic and molecular gas observations with the stellar build-up illustrates that galactic mass assembly in Milky Way-sized haloes proceeds from smooth accretion at high redshifts towards becoming merger-dominated at late times (z ≲ 0.6). Our results can be used to constrain numerical simulations of the dominant growth and accretion processes of galaxies over cosmic history.
Core magnetic field imprint in the non-radial oscillations of red giant stars
Authors: Gomes Pedro , Lopes Ilídio
Published: June 2020

Magnetic fields in red giant stars remain a poorly understood topic, particularly in what concerns their intensity in regions far below the surface. In this work, we propose that gravity-dominated mixed modes of high absolute radial order and low angular degree can be used to probe the magnetic field in their radiative cores. Using two poloidal, axisymmetric configurations for the field in the core and the classical perturbative approach, we derive an analytical expression for the magnetic frequency splitting of these oscillation modes. Considering three distinct red giant models, with masses of 1.3, 1.6, and 2.0 M⊙, we find that a field strength of 105 G is necessary in the core of these stars to induce a frequency splitting of the order of a μHz in dipole and quadrupole oscillation modes. Moreover, taking into account observational limits, we estimate that magnetic fields in the cores of red giants that do not present observable magnetic splittings cannot exceed 104 G. Given the general absence of observable splittings in the oscillation spectra of these stars, and assuming that present mode suppression mechanisms are not biased towards certain azimuthal orders and retain all peaks in each multiplet, our results lead us to conclude that internal fields with the considered configurations and strengths above 104 G are not prevalent in red giants.
Human OAS1 activation is highly dependent on both RNA sequence and context of activating RNA motifs
Authors: Schwartz Samantha L , Park Esther N , Vachon Virginia K , Danzy Shamika , Lowen Anice C , Conn Graeme L
Published: June 2020

2′-5′-Oligoadenylate synthetases (OAS) are innate immune sensors of cytosolic double-stranded RNA (dsRNA) and play a critical role in limiting viral infection. dsRNA binding induces allosteric structural changes in OAS1 that reorganize its catalytic center to promote synthesis of 2′-5′-oligoadenylate and thus activation of endoribonuclease L. Specific RNA sequences and structural motifs can also enhance activation of OAS1 through currently undefined mechanisms. To better understand these drivers of OAS activation, we tested the impact of defined sequence changes within a short dsRNA that strongly activates OAS1. Both in vitro and in human A549 cells, appending a 3′-end single-stranded pyrimidine (3′-ssPy) can strongly enhance OAS1 activation or have no effect depending on its location, suggesting that other dsRNA features are necessary for correct presentation of the motif to OAS1. Consistent with this idea, we also find that the dsRNA binding position is dictated by an established consensus sequence (WWN9WG). Unexpectedly, however, not all sequences fitting this consensus activate OAS1 equivalently, with strong dependence on the identity of both partially conserved (W) and non-conserved (N9) residues. A picture thus emerges in which both specific RNA features and the context in which they are presented dictate the ability of short dsRNAs to activate OAS1.
CDK12 globally stimulates RNA polymerase II transcription elongation and carboxyl-terminal domain phosphorylation
Authors: Tellier Michael , Zaborowska Justyna , Caizzi Livia , Mohammad Eusra , Velychko Taras , Schwalb Björn , Ferrer-Vicens Ivan , Blears Daniel , Nojima Takayuki , Cramer Patrick , Murphy Shona
Published: June 2020

Cyclin-dependent kinase 12 (CDK12) phosphorylates the carboxyl-terminal domain (CTD) of RNA polymerase II (pol II) but its roles in transcription beyond the expression of DNA damage response genes remain unclear. Here, we have used TT-seq and mNET-seq to monitor the direct effects of rapid CDK12 inhibition on transcription activity and CTD phosphorylation in human cells. CDK12 inhibition causes a genome-wide defect in transcription elongation and a global reduction of CTD Ser2 and Ser5 phosphorylation. The elongation defect is explained by the loss of the elongation factors LEO1 and CDC73, part of PAF1 complex, and SPT6 from the newly-elongating pol II. Our results indicate that CDK12 is a general activator of pol II transcription elongation and indicate that it targets both Ser2 and Ser5 residues of the pol II CTD.
Variation in the life history strategy underlies functional diversity of tumors
Authors: Li Tao , Liu Jialin , Feng Jing , Liu Zhenzhen , Liu Sixue , Zhang Minjie , Zhang Yuezheng , Hou Yali , Wu Dafei , Li Chunyan , Chen Yongbin , Chen Hua , Lu Xuemei
Published: June 2020

Classical r- vs. K-selection theory describes the trade-offs between high reproductive output and competitiveness and guides research in evolutionary ecology. While its impact has waned in the recent past, cancer evolution may rekindle it. Herein, we impose r- or K-selection on cancer cell lines to obtain strongly proliferative r cells and highly competitive K cells to test ideas on life-history strategy evolution. RNA-seq indicates that the trade-offs are associated with distinct expression of genes involved in the cell cycle, adhesion, apoptosis, and contact inhibition. Both empirical observations and simulations based on an ecological competition model show that the trade-off between cell proliferation and competitiveness can evolve adaptively. When the r and K cells are mixed, they exhibit strikingly different spatial and temporal distributions. Due to this niche separation, the fitness of the entire tumor increases. The contrasting selective pressure may operate in a realistic ecological setting of actual tumors.
Food insecurity, gestational weight gain and gestational diabetes in the National Children’s Study, 2009–2014
Authors: Richards Megan , Weigel Margaret , Li Ming , Rosenberg Molly , Ludema Christina
Published: June 2020

Background

Household food insecurity (HFI) and gestational diabetes mellitus (GDM) are both common during pregnancy, yet it is unknown if these two factors are related. We aimed to determine the independent and joint associations between HFI, gestational weight gain (GWG) and GDM among pregnant women in the USA.

Methods

We used data from 592 women in the National Children’s Study, Initial Vanguard Study from 2009 to 2014. HFI was assessed using the Household Food Security Survey Module at the first study visit; GDM was assessed through questionnaires and medical chart review. Logistic regression models were used to investigate the exposures of HFI, GWG and their joint effect on GDM.

Results

Among participants, 20.1% were marginally food secure or food insecure and 7.4% were diagnosed with GDM. The elevated unadjusted association between HFI and GDM was attenuated after adjustment (aOR: 1.12; 95%CI: 0.47, 2.66). There was an elevated risk of GDM associated with inadequate GWG, (aOR: 2.42; 95%CI: 0.97, 6.00), but results were imprecise. There were no statistically significant associations in the joint exposure analysis.

Conclusion

The relationship between HFI and GDM is mostly explained by other covariates, but there is some evidence that inadequate GWG is a possible risk factor for GDM.
Private Foundations and EU beneficial ownership registers: towards full disclosure to the general public?
Authors: Panico Paolo
Published: June 2020

Directive (EU) 2015/849, known as the “4th AML Directive”, introduced an obligation on all EU Member States to create and maintain registers of the beneficial owners of their companies and trusts. Prior to such measures coming into force in most member states, Directive (EU) 2018/843, known as the “5th AML Directive”, further introduced some significant changes to the functioning of such registers and, in particular, to the access to their information.

This article considers the impact of the rules introduced under the 5th AML Directive on private foundations. After a brief analysis of the relevant provisions in the Directive, it focuses on three member states in particular: Austria, Malta, and Belgium.
Vaping-related lung injury
Authors: Perkins Amanda
Published: June 2020

Nurses can help slow the growth of unsafe e-cigarette use through education and support.
Living with chronic illness
Authors: Pullen Richard L.
Published: June 2020

Chronic diseases are a global pandemic related to changing demographics and longer life expectancy.
Program Evaluation of the Research in Academic Pediatrics Initiative on Diversity (RAPID): Impact on Career Development and Professional Society Diversity
Authors: Flores Glenn , Mendoza Fernando , Brimacombe Michael B. , Frazier Willie
Published: June 2020

Purpose

Despite a demographic surge in U.S. minority children, pediatric workforce diversity has failed to keep pace. The study aim was to evaluate the Research in Academic Pediatrics Initiative on Diversity (RAPID), a research-education program aimed at recruiting, retaining, and professionally advancing diverse early-career faculty in general pediatrics who are pursuing research careers.

Method

RAPID includes the following components: small research grants, mentoring by nationally renowned senior investigators, mentoring and networking at an annual breakfast, an annual career-development conference, and monthly mentoring conference calls. Outcomes data from the first 5 years (2012–2017) of RAPID were analyzed. Data sources were Academic Pediatric Association (APA) membership data and postconference, baseline, and end-of-program/follow-up surveys. Outcome measures included mentoring quality, presentations, publications, subsequent grants, impact on career success, conference ratings, and APA membership diversity.

Results

For the 10 Scholars from the first 4 cohorts, mean scores were 4.5 (5 = strongly agree) for RAPID fostering mentoring, developing research skills, and helping Scholars feel more comfortable as underrepresented minority (URM) faculty; 78% delivered platform or poster presentations on their project. They published 56 total articles and received a mean of 2.5 subsequent grants. Their mean score for RAPID “advancing my career by facilitating promotion or getting a job” was 4.6. The first 4 RAPID Conferences were highly rated (mean scores = 4.2–4.8) and brought in 33 additional URM young investigators. Pre-RAPID, URM APA membership stagnated at 6%–7% for 5 years. In RAPID’s first year, URM APA membership rose to 8%, then to 10% by 2017 (43% increase; P < .001).

Conclusions

RAPID Scholars generated multiple presentations and publications. RAPID mentoring and Conferences were highly rated. RAPID was associated with career advancement and increased professional society diversity. RAPID could serve as a national model for enhancing URM career development and professional society diversity.
Early Goal-directed Therapy During Endovascular Coiling Procedures Following Aneurysmal Subarachnoid Hemorrhage: A Pilot Prospective Randomized Controlled Study
Authors: Chui Jason , Craen Rosemary , Dy-Valdez Christine , Alamri Rizq , Boulton Mel , Pandey Sachin , Herrick Ian
Published: June 2020

Background:

Maintenance of euvolemia and cerebral perfusion are recommended for the prevention of cerebral vasospasm after aneurysmal subarachnoid hemorrhage (aSAH). We conducted a pilot randomized controlled study to assess the feasibility and efficacy of goal-directed therapy (GDT) to correct fluid and hemodynamic derangements during endovascular coiling in patients with aSAH.

Methods:

This study was conducted between November 2015 and February 2019 at a single tertiary center in Canada. Adult patients with aSAH within 5 days of aneurysm rupture were randomly assigned to receive either GDT or standard therapy during endovascular coiling. The incidence of dehydration at presentation and the efficacy of GDT were evaluated.

Results:

Forty patients were allocated to receive GDT (n=21) or standard therapy (n=19). Sixty percent of all patients were found to have dehydration before the coiling procedure commenced. Compared with standard therapy, GDT reduced the duration of intraoperative hypovolemia (mean difference 37.6 [95% confidence interval, 6.2-37.4] min, P=0.006) and low cardiac index (mean difference 30.7 [95% confidence interval, 9.5-56.9] min, P=0.035). There were no differences between the 2 treatment groups with respect to the incidence of vasospasm, stroke, death, and other complications up to postoperative day 90.

Conclusions:

A high proportion of aSAH patients presented at the coiling procedure with dehydration and a low cardiac output state; these derangements were more likely to be corrected if the GDT algorithm was used. Compared with standard therapy, use of the GDT algorithm resulted in earlier recognition and more consistent treatment of dehydration and hemodynamic derangement during endovascular coiling.
The Application of Henna (Lawsonia inermis) in Orthopedics
Authors: Arora Sumit , Thora Ankit , Sural Sumit , Dhal Anil
Published: June 2020

Background:

Many orthopedic procedures require skin marking as part of preoperative planning. The markings obtained from commercially available permanent pens may fade away after vigorous skin preparation before surgery. We describe the use of Henna (Lawsonia inermis) paste as a durable, readily available, and cost-effective material for preoperative skin marker in various orthopedic surgeries.

Patients and Methods:

We performed a retrospective review of prospectively collected data of 50 cases with various indications of preoperative localization of skin incision and divided them in 2 groups: Group A (n=25) were the patients where Henna was to be used as marker and group B (n=25) were the ones where permanent skin marking pen was decided to be used for the purpose of skin marking. The groups were compared for the instances of mark fading after bathing, after scrubbing of surgical part, the need for intraoperative fluoroscopy, and complications because of marking substance.

Results:

Of the 25 cases where henna was used for markings (group A), none had fading of mark after routine bath with soap on the morning of surgery (0 of applicable 11) or after surgical scrubbing (0 of 25). However, for the permanent marker (group B), 3 patients (of applicable 6) had fading of mark beyond recognition after routine bath with soap and additional 10 cases (of applicable 22) had fading of mark beyond recognition after surgical scrubbing (P<0.05). Four cases (of applicable 23) from group A still required intraoperative fluoroscopy, whereas this figure was 15 (of 25 cases) for group B (P<0.05). There was no suggestion of rash/allergy/wound infection in either group.

Conclusions:

Henna paste may reliably be used in various orthopedic procedures like foreign body removal, vertebral-level identification, nail dynamization, marking growth plate in children, identification of sequestrum in nondischarging chronic osteomyelitis, and marking the course of blood vessels in tumor surgery.
Effects of the COVID-19 Pandemic on the Management of Patients With ST-elevation Myocardial Infarction in a Tertiary Cardiovascular Center
Authors: Firouzi Ata , Baay Mohammadreza , Mazayanimonfared Azadeh , Pouraliakbar Hamidreza , Sadeghipour Parham , Noohi Feridoun , Maleki Majid , Peighambari Mohamad Mehdi , Kiavar Majid , Abdi Seifollah , Maadani Mohsen , Shakerian Farshad , Zahedmehr Ali , Kiani Reza , Alemzadeh-Ansari Mohammad Javad , Rashidinejad Alireza , Hosseini Zahra
Published: June 2020

Background:

In the Coronavirus Disease 2019 (COVID-19) pandemic, the appropriate reperfusion strategy in patients with ST-segment elevation myocardial infarction (STEMI) is unclear.

Methods:

This retrospective single-center study consecutively enrolled patients who presented with STEMI and scheduled for primary percutaneous coronary intervention (PPCI) during the outbreak of COVID-19. Due to the delay in the reporting of the polymerase chain reaction test results, our postprocedural triage regarding COVID-19, followed by the isolation strategy, was based on lung computerized tomography scan results.

Results:

Forty-eight patients with STEMI referred to our center. PPCI was done for 44 (91%) of these patients. The mean symptom-to-device time was 490.93 ± 454.608 minutes, and the mean first medical contact-to-device time was and 154.12 ± 36.27 minutes. Nine (18%) patients with STEMI were diagnosed as having typical/indeterminate features indicating COVID-19 involvement. During hospitalization, 1 (2.0%) patient died of cardiogenic shock. The study population was followed for 35.9 ± 12.7 days. Two patients expired in another centers due to COVID-19. No cardiac catheterization laboratory staff members were infected by COVID-19 during the study period.

Conclusions:

Our small report indicates that by taking the recommended safety measures and using appropriate PPE, we can continue PPCI as the main reperfusion strategy safely and effectively.
The Influence and Treatment of the Intestinal Microbiome on Child Respiratory Diseases
Authors: Zhang Chuanxin , Huang Junlin , Ren Yifan , Zhu Shenghong , Yin Fangxue , Zhu Yixin
Published: June 2020

The intestinal microbiome has a great influence on human health through its close interaction with the human body, including growth, development, maturation, immunity, and anti-aging. Numerous studies have reported that the intestinal microbiome is related to the pathogenesis, diagnosis, and treatment of diseases. Variable clinical interventions, such as prebiotics and probiotics have been widely used to cure people. However, probiotics might suffer from viability issues. Therefore, new technologies are being exploited to solve these problems. In this review, we describe the correlation between the intestinal microbiome and children respiratory diseases, present therapies based on microecological theory, and introduce some new technologies aimed to improve the efficacy of microbiological therapies.
Progressive Decline of the Glomerular Filtration Rate in HIV-infected Children Treated With Tenofovir Disoproxil Fumarate-based Regimens in West and Central Africa
Authors: Diack Aminata , Yonaba Caroline , Coulibaly Aba , Ouedraogo Sylvie , Penda Ida , Bukuru Hélène , Folquet Madeleine , Tanoh Eboua François , Sylla Mariam , Blanche Stéphane , Tejiokem Mathurin ,   on behalf of the Enfants VIH Afrique network
Published: June 2020

A cross-sectional study of 358 HIV-1-infected children and adolescents living in Sub-Saharan Africa treated with tenofovir disoproxil fumarate-based regimens for a median of 1.5 interquartile range [0.6–3.1 years] showed a loss of glomerular filtration rate estimated to be 0.41 mL/min/1.73 m2 per month of treatment. In contrast, there was no decrease depending on the duration of the previous antiretroviral treatment.
Premature ovarian insufficiency: clinical orientations for genetic testing and genetic counseling
Authors: Barros Francisco , Carvalho Filipa , Barros Alberto , Dória Sofia
Published: June 2020

Premature ovarian insufficiency (POI) is a heterogeneous disorder diagnosed in women before 40 years old and describes a wide range of impaired ovarian function, from diminished ovarian reserve to premature ovarian failure. Genetic etiology accounts for 20% to 25% of patients. The evidence that POI can be isolated (nonsyndromic) or part of a pleiotropic genetic syndrome highlights its high heterogeneous etiology. Chromosomal abnormalities as a cause of POI have a prevalence of 10% to 13%, being 45,X complement the most common cytogenetic cause of primary amenorrhea and mosaicism with a 45,X cell line more frequently associated with secondary amenorrhea. Other X chromosome aberrations include deletions, duplications, balanced, and unbalanced X-autosome rearrangements involving the critical region for the POI phenotype (Xq13-Xq21 to Xq23-Xq27).

The identification of 2 or more pathogenic variants in distinct genes argues in favor of a polygenic origin for POI. Hundreds of pathogenic variants (including mitochondrial) have been involved in POI etiology mainly with key roles in biological processes in the ovary, such as meiosis and DNA damage repair mechanism, homologous recombination, follicular development, granulosa cell differentiation and proliferation, and ovulation.

The most common single gene cause for POI is the premutation for FMR1 gene (associated with fragile X syndrome) with alleles ranging from about 55 to about 200 CGG trinucleotide repeats. POI occurs in 20% of women with this premutation. As females with premutation or full mutation alleles are also at risk of having affected children, their genetic counseling should include the indication for prenatal diagnosis or preimplantation genetic testing after intracytoplasmic sperm injection and trophectoderm biopsy.

In conclusion, in clinical practice high-resolution karyotype and FMR1 gene molecular study should be performed as first-tier tests in the assessment of POI. In addition, array Comparative Genomic Hybridization or specific next generation sequencing panels should be considered to identify chromosomal deletions/duplications under karyotype resolution or other pathogenic variants in specific genes associated with POI. This is particularly important in patients with first- or second-degree relatives also affected with POI, improving their reproductive and genetic counseling.
Nurses' Experiences of “Being Swamped” in the Clinical Setting and Association with Adherence to AWHONN Nurse Staffing Guidelines
Authors: Roth Cheryl , Brewer Melanie A. , Bay R. Curtis , Gosselin Kevin P.
Published: June 2020

Purpose:

Being swamped is defined as “when you are so overwhelmed with what is occurring that you are unable to focus on the most important thing.” The purpose of this study was to explore the experience of being swamped in the clinical setting among nurses who are members of the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) and the relationship of the level of being swamped to adherence to the AWHONN (2010) nurse staffing guidelines.

Study Design and Methods:

A 25-item survey was sent to ~21,000 AWHONN members by email in the Fall of 2018. It was completed by 1,198 members, representing 49 states and the District of Columbia. Questions explored timing and causes of being swamped, its effect on health care team members and patients, what helps when a nurse feels swamped, and nurses' reports of their hospital following the AWHONN nurse staffing guidelines.

Results:

Twenty-eight percent of nurses reported being swamped daily or multiple times per day. Situations that contribute to being swamped include assignments that are too heavy, interruptions, critical patient situations, and mistakes made by others that nurses are expected to catch and fix. Teamwork and someone stepping in to help without being asked were identified as most helpful when a nurse feels swamped. Nurses practicing in hospitals following the AWHONN nurse staffing guidelines always or most of the time reported less frequency of being swamped as compared with those in hospitals that followed the guidelines some of the time, or rarely (p < 0.001).

Clinical Implications:

Being swamped is a common phenomenon among AWHONN members responding to the survey. The reported incidence of being swamped daily is significantly associated with the extent to which hospitals follow the AWHONN nurse staffing guidelines. Nurse leaders, hospital administrators, and staff nurses must work together to identify and initiate timely, feasible nurse staffing solutions that support the safety of patients and nurses.
Gen2EpiGUI: User-Friendly Pipeline for Analyzing Whole-Genome Sequencing Data for Epidemiological Studies of Neisseria gonorrhoeae
Authors: Singh Reema , Yarmovich Trevor , Kusalik Anthony , Dillon Jo-Anne R.
Published: June 2020

We have developed a graphical user interface for our Gen2Epi computational pipeline named Gen2EpiGUI. A total of 594 published whole-genome sequence datasets of Neisseria gonorrhoeae were used to validate the program. Gen2Epi facilitates an understandable analysis of N. gonorrhoeae whole-genome sequence data for users with limited bioinformatics skills.
Persistent Verrucous Plaques in an HIV-Positive Patient With Secondary and Neurosyphilis
Authors: Thanyathorn Nuchanatanon , Pravit Asawanonda , Chanat Kumtornrut
Published: June 2020

A 23-year-old HIV-positive woman presented with persistent yellowish verrucous plaques on both ankles, which had been present for 2 years, and blurred vision, which had persisted for 1 month. Serological tests confirmed a syphilis diagnosis. Her condition improved after systemic penicillin treatment, with no topical treatment except petrolatum ointment.
An Evaluation of Syndromic Surveillance–Related Practices Among Selected State and Local Health Agencies
Authors: Romano Sebastian , Yusuf Hussain , Davis Cassandra , Thomas Mathew J. , Grigorescu Violanda
Published: June 2020

Context:

Syndromic surveillance consists of the systematic collection and use of near real-time data about health-related events for situational awareness and public health action. As syndromic surveillance programs continue to adopt new technologies and expand, it is valuable to evaluate these syndromic surveillance systems and practices to ensure that they meet public health needs.

Objective:

This assessment's aim is to provide recent information about syndromic surveillance systems and practice characteristics among a group of state and local health departments.

Design/Setting:

Information was obtained between November 2017 and June 2018 through a telephone survey using an Office of Management and Budget–approved standardized data collection tool. Participants were syndromic surveillance staff from each of 31 state and local health departments participating in the National Syndromic Surveillance Program funded by the Centers for Disease Control and Prevention. Questions included jurisdictional experience, data sources and analysis systems used, syndromic system data processing characteristics, data quality verification procedures, and surveillance activities conducted with syndromic data.

Measures:

Practice-specific information such as types of systems and data sources used for syndromic surveillance, data quality monitoring, and uses of data for public health situational awareness (eg, investigating occurrences of or trends in diseases).

Results:

The survey analysis revealed a wide range of experiences with syndromic surveillance. Participants reported the receipt of data daily or more frequently. Emergency department data were the primary data source; however, other data sources are being integrated into these systems. All health departments routinely monitored data quality. Syndromes of highest priority across the respondents for health events monitoring were influenza-like illness and drug-related syndromes. However, a wide variety of syndromes were reported as priorities across the health departments.

Conclusion:

Overall, syndromic surveillance was relevantly integrated into the public health surveillance infrastructure. The near real-time nature of the data and its flexibility to monitor different types of health-related issues make it especially useful for public health practitioners. Despite these advances, syndromic surveillance capacity, locally and nationally, must continue to evolve and progress should be monitored to ensure that syndromic surveillance systems and data are optimally able to meet jurisdictional needs.
Prospective Quality-of-Life Outcomes after Facial Feminization Surgery: An International Multicenter Study
Authors: Morrison Shane D. , Capitán-Cañadas Fermín , Sánchez-García Anabel , Ludwig David C. , Massie Jonathan P. , Nolan Ian T. , Swanson Marco , Rodríguez-Conesa Marina , Friedrich Jeffrey B. , Cederna Paul S. , Bellinga Raúl J. , Simon Daniel , Capitán Luis , Satterwhite Thomas
Published: June 2020

Background:

No data exist on the prospective outcomes of facial feminization surgery. This study set out to determine the effects of facial feminization surgery on quality-of-life outcomes for gender-diverse patients.

Methods:

A prospective, international, multicenter, cohort study with adult gender-diverse patients with gender dysphoria was undertaken. Facial feminization outcome score was calculated preoperatively and postoperatively (1-week to 1-month and >6 months). Photogrammetric cephalometries were measured at the same time points. Self-perceived preoperative masculinity and femininity were recorded. Externally rated gender appearance (scale of 1 to 5, with 1 being most feminine) and general aesthetics (scale of 1 to 10, with 10 being very good) for 10 facial feminization surgery patients were compared with those of five cisgender controls. Univariate linear regression analyses were used to predict outcomes from facial feminization surgery.

Results:

Sixty-six consecutive patients were enrolled. Patients noted that their brows, jaws, and chins were the most masculine aspects of their faces (54.5 percent, 33.3 percent, and 30.3 percent, respectively). Median facial feminization outcome score increased from 47.2 preoperatively to 80.6 at 6 months or more postoperatively (p < 0.0001). Mean satisfaction was excellent (3.0 at both 1-month and ≥6-month follow-up; p = 0.46). Cephalometric values were significantly more feminine after surgery. Gender appearance was feminine to very feminine (1.83 ± 0.96) and general aesthetics were good (6.09 ± 2.01) but different from those of cisgender women controls (1.25 ± 0.49 and 7.63 ± 1.82, respectively; p < 0.001 for each).

Conclusion:

Facial feminization achieved improved quality of life, feminized cephalometries, feminine gender appearance, good overall aesthetics, and high satisfaction that were present at 1 month and stable at more than 6 months.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Slowing the Spread and Minimizing the Impact of COVID-19: Lessons from the Past and Recommendations for the Plastic Surgeon
Authors: MacKenzie Ethan L. , Poore Samuel O.
Published: June 2020

Background:

Coronavirus disease 2019 (COVID-19), a novel coronavirus originating in December of 2019 in Wuhan, People’s Republic of China, has spread rapidly throughout the globe over 3 months. On March 11, 2020, the World Health Organization declared COVID-19 a global pandemic. COVID-19 represents a nearly unprecedented threat to both the public health and the durability of our health care systems and will profoundly affect the field of plastic and reconstructive surgery. The objective of this article is to provide a natural history of COVID-19—including virology, epidemiology, and transmission patterns—and a guide for plastic surgeons regarding patient and resource management.

Methods:

The authors reviewed existing literature regarding COVID-19, both primary research and secondary reviews, by means of PubMed queries, and recommendations from relevant professional organizations (e.g., American College of Surgeons and American Society of Plastic Surgeons). The literature and recommendations were summarized to provide a specific guide for plastic surgeons.

Results:

Internationally, over 5.7 million cases and 357,000 deaths from COVID-19 have been reported at the time of writing. No pharmacologic treatments have been identified, but epidemiologic strategies were identified to prevent viral spread, preserve health care resources, and protect patients and surgeons globally. Specific recommendations for plastic and reconstructive surgeons include postponing elective cases and transitioning to telecommunication platforms for patient consultations and education.

Conclusions:

COVID-19 represents a nearly unprecedented threat to the public health and the durability of health care systems in the contemporary era. Although plastic and reconstructive surgery may seem relatively remote from the pandemic in direct patient care and exposure, our field can significantly enhance health care resource management.
Performance gains with Compute Unified Device Architecture-enabled eddy current correction for diffusion MRI.
Authors: Maller Jerome J. , Grieve Stuart M. , Vogrin Simon J. , Welton Thomas
Published: June 2020

Correcting for eddy currents, movement-induced distortion and gradient inhomogeneities is imperative when processing diffusion MRI (dMRI) data, but is highly computing resource-intensive. Recently, Compute Unified Device Architecture (CUDA) was implemented for the widely-used eddy-correction software, ‘eddy’, which reduces processing time and allows more comprehensive correction. We investigated processing speed, performance and compatibility of CUDA-enabled eddy-current correction processing compared to commonly-used non-CUDA implementations. Four representative dMRI datasets from the Human Connectome Project, Alzheimer’s Disease Neuroimaging Initiative and Chronic Diseases Connectome Project were processed on high-specification and regular workstations through three different configurations of ‘eddy’. Processing times and graphics processing unit (GPU) resources used were monitored and compared. Using CUDA reduced the ‘eddy’ processing time by a factor of up to five. The CUDA slice-to-volume correction method was also faster than non-CUDA eddy except when datasets were large. We make a series of recommendations for eddy configuration and hardware. We suggest that users of eddy-correction software for dMRI processing utilise CUDA and take advantage of the slice-to-volume correction option. We recommend that users run eddy on computers with at least 32GB motherboard random access memory (RAM), and a graphics card with at least 4.5GB RAM and 3750 cores to optimise processing time.
Bacillus pasinlerensis sp. nov., a thermophilic bacterium isolated from a hot spring in Turkey
Authors: Baltaci Mustafa Ozkan , Ay Hilal , Akbulut Sumeyya , Adiguzel Gulsah , Albayrak Seyda , Omeroglu Mehmet Akif , Ozkan Hakan , Taskin Mesut , Adiguzel Ahmet
Published: June 2020

A Gram-reaction-positive, endospore-forming bacterium, designated strain P1T, was isolated from water samples collected from Pasinler Hot Spring and characterized using a polyphasic approach to clarify its taxonomic position. Strain P1T was found to have chemotaxonomic and morphological characteristics consistent with its classification in the genus

Bacillus

. The strain shared the highest 16S rRNA gene sequence identity values with

Bacillus thermolactis

R-6488T (97.6 %) and

Bacillus kokeshiiformis

MO-04T (97.2 %) and formed a distinct clade with both type strains in the phylogenetic trees based on 16S rRNA gene sequences. Strain P1T could grow optimally at 55 °C and in the presence of 2 % NaCl. The organism was found to contain meso-diaminopimelic acid as the diagnostic diamino acid in the cell-wall peptidoglycan. The major polar lipids were diphosphatidylglycerol and phosphatidylglycerol. The predominant menaquinone was determined to be MK-7. The major cellular fatty acids were identified as iso-C15 : 0, iso-C17 : 0 and anteiso-C17 : 0. Based upon the consensus of phenotypic and phylogenetic analyses, strain P1T represents a novel species of the genus

Bacillus

, for which the name Bacillus pasinlerensis sp. nov. is proposed. The type strain is P1T (=DSM 107529T=CECT 9885T=NCCB 100674T).