bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes of the human skin microbiota upon chronic exposure to polycyclic aromatic hydrocarbon pollutants
Authors: Leung Marcus H. Y. , Tong Xinzhao , Bastien Philippe , Guinot Florent , Tenenhaus Arthur , Appenzeller Brice M. R. , Betts Richard J. , Mezzache Sakina , Li Jing , Bourokba Nasrine , Breton Lionel , Clavaud Cécile , Lee Patrick K. H.
Published: June 2020

Background

Polycyclic aromatic hydrocarbons (PAHs) are of environmental and public health concerns and contribute to adverse skin attributes such as premature skin aging and pigmentary disorder. However, little information is available on the potential roles of chronic urban PAH pollutant exposure on the cutaneous microbiota. Given the roles of the skin microbiota have on healthy and undesirable skin phenotypes and the relationships between PAHs and skin properties, we hypothesize that exposure of PAHs may be associated with changes in the cutaneous microbiota. In this study, the skin microbiota of over two hundred Chinese individuals from two cities in China with varying exposure levels of PAHs were characterized by bacterial and fungal amplicon and shotgun metagenomics sequencing.

Results

Skin site and city were strong parameters in changing microbial communities and their assembly processes. Reductions of bacterial-fungal microbial network structural integrity and stability were associated with skin conditions (acne and dandruff). Multivariate analysis revealed associations between abundances of Propionibacterium and Malassezia with host properties and pollutant exposure levels. Shannon diversity increase was correlated to exposure levels of PAHs in a dose-dependent manner. Shotgun metagenomics analysis of samples (n = 32) from individuals of the lowest and highest exposure levels of PAHs further highlighted associations between the PAHs quantified and decrease in abundances of skin commensals and increase in oral bacteria. Functional analysis identified associations between levels of PAHs and abundance of microbial genes of metabolic and other pathways with potential importance in host-microbe interactions as well as degradation of aromatic compounds.

Conclusions

The results in this study demonstrated the changes in composition and functional capacities of the cutaneous microbiota associated with chronic exposure levels of PAHs. Findings from this study will aid the development of strategies to harness the microbiota in protecting the skin against pollutants.
Space use and relative habitat selection for immature green turtles within a Caribbean marine protected area
Authors: Griffin Lucas P. , Smith Brian J. , Cherkiss Michael S. , Crowder Andrew G. , Pollock Clayton G. , Hillis-Starr Zandy , Danylchuk Andy J. , Hart Kristen M.
Published: June 2020

Background

A better understanding of sea turtle spatial ecology is critical for the continued conservation of imperiled sea turtles and their habitats. For resource managers to develop the most effective conservation strategies, it is especially important to examine how turtles use and select for habitats within their developmental foraging grounds. Here, we examine the space use and relative habitat selection of immature green turtles (Chelonia mydas) using acoustic telemetry within the marine protected area, Buck Island Reef National Monument (BIRNM), St. Croix, United States Virgin Islands.

Results

Space use by turtles was concentrated on the southern side of Buck Island, but also extended to the northeast and northwest areas of the island, as indicated by minimum convex polygons (MCPs) and 99%, 95%, and 50% kernel density estimations (KDEs). On average space use for all categories was < 3 km2with mean KDE area overlap ranging from 41.9 to 67.7%. Cumulative monthly MCPs and their proportions to full MCPs began to stabilize 3 to 6 detection months after release, respectively. Resource selection functions (RSFs) were implemented using a generalized linear mixed effects model with turtle ID as the random effect. After model selection, the accuracy of the top model was 77.3% and showed relative habitat selection values were highest at shallow depths, for areas in close proximity to seagrass, and in reef zones for both day and night, and within lagoon zones at night. The top model was also extended to predict across BIRNM at both day and night.

Conclusion

More traditional acoustic telemetry analyses in combination with RSFs provide novel insights into animal space use and relative resource selection. Here, we demonstrated immature green turtles within the BIRNM have small, specific home ranges and core use areas with temporally varying relative selection strengths across habitat types. We conclude the BIRNM marine protected area is providing sufficient protection for immature green turtles, however, habitat protection could be focused in both areas of high space use and in locations where high relative selection values were determined. Ultimately, the methodologies and results presented here may help to design strategies to expand habitat protection for immature green turtles across their greater distribution.
Neurofibromatosis type 2 initially presenting as a preauricular mass: A case report
Authors: Lan Wei-Che , Aoh Yu , Chen Rui-Yun , Tien Hui-Chi , Lin Chia-Der
Published: June 2020

Neurofibromatosis type 2 (NF2) is a rare genetic disease involving multiple tumors of the central and peripheral nervous systems. Most patients with NF2 have bilateral vestibular schwannomas; nonvestibular schwannomas may also develop. While the majority of patients may present with hearing impairment, tinnitus, dizziness and balance disorders, some may present with cutaneous manifestations. We describe the case of a 20-year-old man who initially presented with a solitary subcutaneous painless nodule in the left preauricular area without any other symptoms. He received excisional biopsy for the preauricular mass and the pathologic diagnosis was schwannoma. Magnetic resonance imaging of brain and neck revealed multiple mass lesions over the bilateral cerebellopontine angle cisterns, extending to the bilateral internal auditory canals, bilateral cervical neuroforamens, cervical and upper thoracic spinal canals, and left posterior neck. The patient was diagnosed with NF2 according to the clinical criteria. He underwent gamma knife stereotactic radiosurgery for bilateral vestibular schwannomas and is now under regular monitoring.

Conclusion

NF2 patients may present with an isolated solitary cutaneous schwannoma with no other associated clinical findings. Further assessment is thus warranted in young patients presenting with a peripheral schwannoma despite absence of other clinical findings.
Beyond the connoisseurship approach: creating a chronology in Hokusai prints using non-invasive techniques and multivariate data analysis
Authors: Vermeulen Marc , Burgio Lucia , Vandeperre Nathalie , Driscoll Elyse , Viljoen Madeleine , Woo Janie , Leona Marco
Published: June 2020

This study combines scientific and connoisseurship approaches to establish a production chronology of 141 woodblock prints from Katsushika Hokusai’s series Thirty-Six Views of Mount Fuji belonging to different cultural institutions in Europe and the United States. In order to create this chronology, the reflectance spectroscopy (FORS) signature of the indigo/Prussian blue mixture of the key-block printed outlines was measured and compared using multivariate data analysis. This approach yielded 9 clusters of prints, each one presenting slightly different FORS features, and therefore, different Prussian blue/indigo mixtures. The connoisseurship approach was then applied to impressions of the same print found across the 9 clusters. This allowed for arrangement of the clustered prints according to their production time, resulting in a comprehensive timeline for the 141 prints examined. To date, this work represents the only systematic study of such a large corpus of Japanese/Hokusai woodblock prints integrating chemical analysis and statistical treatment of data with careful visual examination of the prints. The result is a novel approach to creating a chronology for these objects. Our study easily differentiated between early nineteenth and early twentieth century prints as well as between various printing batches/clusters. Creating a chronology of such an important print series is also crucial to understand the evolution of artist and printing studio practices in late nineteenth-century Japan, a period of great economic and cultural changes.
Beyond content knowledge: transferable skills connected to experience as a peer-leader in a PLTL program and long-term impacts
Authors: Chase Anthony , S. Rao Anusha , Lakmala Prathima , Varma-Nelson Pratibha
Published: June 2020

Background

Being a successful peer-led team learning (PLTL) workshop leader involves developing content knowledge and workshop facilitation skills. These skills connected to being a peer leader, however, do not terminate at the end of one’s undergraduate program. In fact, many former peer leaders denote having been a peer leader on their LinkedIn profile. This study examines the transferable skills that former peer leaders identified as being valuable in their current positions. We conducted semi-structured interviews with former peer leaders from varying disciplines, universities, ages, and years since being a peer leader.

Results

Interview questions captured leadership experiences including successes and challenges of being peer leaders, roles and responsibilities, and specific transferable skills further developed by being peer leaders and how they are being utilized in the leaders’ current position.

Conclusion

Thematic analyses of these interviews indicate that former peer leaders recognize leadership skills, coping with many challenges (including not having the right answer), collaboration/teamwork skills, self-confidence, and problem-solving skills as being relevant and frequently used in their current work.
The dynamic evolution of compaction bands in highly porous carbonates: the role of local heterogeneity for nucleation and propagation
Authors: Chen Xiao , Roshan Hamid , Lv Adelina , Hu Manman , Regenauer-Lieb Klaus
Published: June 2020

The formation of compaction bands in porous brittle rocks such as sandstones and carbonates has a significant impact on the localization mechanisms preceding earth and planetary surface instabilities such as earthquakes, landslides, and plate boundary faults. The micromechanics underpinning the dynamics of the formation of compaction bands and its effect on alteration of pore fluid pathways are not yet fully understood. The current study seeks to understand the mechanical properties of compaction in highly porous carbonate at micro- and macro-scale using time-lapse triaxial experiments in an X-ray transparent flow and deformation cell. Images were obtained with increasing axial strain levels using X-ray computed tomography allowing mapping of the evolution of internal structures. In addition to the X-ray analysis, digital image correlation (DIC) was used to quantify the evolution of strain and precisely identify the nucleation mechanism of compaction bands and its dynamics. The effect of friction on the boundary platens was shown to be minimal as evidenced by shear strain obtained from DIC analysis. This comprehensive analysis allowed assessment of the role of heterogeneity for the initiation of compaction bands. Local regions with high porosity provide the initial seeds for discrete compaction followed by the nucleation of traveling waves that lead to diffuse growth of the compaction zone. This interesting phenomenon is expected to be a fundamental mode of compressional deformation in porous brittle media where discrete, often periodic, deformation bands are observed on compaction.
Do supplemental perches influence electrocution risk for diurnal raptors?
Authors: Sánchez Roberto , Sánchez Javier , Oria Javier , Guil Francisco
Published: June 2020

Background

Power lines are amongst the main causes of mortality for birds globally. Electrocution drives the population dynamics of several threatened species of raptors, at local and global scales. Among the many solutions that have been tested to minimize this threat are supplemental perches; however, their efficiency has rarely been assessed.

Methods

We designed 43 transects in 4 districts in mainland Portugal to gather data from birds perching on pylons with or without supplemental perches. From 2015 to 2018, transects were surveyed by car at least once. We analyzed the factors driving the use of these supplemental perches, and we analyzed if there were differences in the perceived risk (calculated from measurements and not from field surveys) depending on whether the perching was on pylons with or without supplemental perches.

Results

We recorded 548 perches of 14 species. Weather conditions seemed to play a role in birds’ choice of pylons with supplemental perches versus pylons without supplemental perches. Models also indicated a strong influence of observational conditions. The use of models showed us an important specific effect in the selection of supplemental perches where available: there are some species with a greater tendency to perch on supplemental perches, even when they use both pylons with and without supplemental perches. For most of the analyzed species and species groups, perceived risk was higher in pylons without supplemental perches compared to pylons with supplemental perches, but there were differences between species.

Conclusions

Supplemental perches may be a useful and efficient tool for mitigating raptor electrocution. However, there are many influential factors affecting their success, and their effectiveness with different species groups is not homogeneous. Some studies show higher electrocution rates for certain species and devices and thus, their efficacy must be validated. We propose a two-step validation process, first in controlled conditions and then in the field. A common protocol should be established to enable comparisons between studies.
Aberrant methylation-mediated downregulation of lncRNA CCND2 AS1 promotes cell proliferation in cervical cancer
Authors: Zhao Chengcheng , Liu Jian , Wu Huazhang , Hu Jiaojiao , Chen Jianquan , Chen Jie , Qiao Fengchang
Published: June 2020

Background

Long non-coding RNA (lncRNA) plays an important role in tumorigenesis. The lncRNA CCND2 AS1 has been shown to be involved in the growth of several tumors; however, its role in cervical cancer has not been elucidated. This study aimed to explore the expression, function, and underlying mechanism of action of CCND2 AS1 in cervical cancer. Expression of CCND2 AS1 was examined in cervical cancer and adjacent normal cervical tissues by quantitative real-time polymerase chain reaction (qRT-PCR) and by bioinformatic analysis of data from the Gene Expression Profiling Interactive Analysis (GEPIA) database. The function of CCND2 AS1 was investigated by overexpressing or silencing CCND2 AS1 in HeLa and SiHa cervical cancer cells followed by in vitro and in vivo analyses. Methylation-specific PCR (MSP) and bisulfite genomic sequencing (BGS) were used to detect CCND2 AS1 promoter methylation status in cervical cancer cells.

Results

CCND2 AS1 expression was lower in cervical cancer compared with normal cervical tissues, and the level was significantly correlated with the patient age and tumor size. CCND2 AS1 overexpression inhibited the proliferation and cell cycle progression of HeLa cells in vitro and/or in vivo, whereas CCND2 AS1 silencing had the opposite effects. CCND2 AS1 expression was elevated after treatment of cervical cancer cells with the DNA methyltransferase inhibitor 5′-azacytidine (5′-Aza), and this was mediated, at least in part, via reduced CpG methylation at the CCND2 AS1 promoter.

Conclusion

CCND2 AS1 expression is downregulated in cervical cancer, potentially through increased CCND2 AS1 promoter methylation, and the upregulation of CCND2 AS1 expression inhibited tumor growth. These data suggest that CCND2 AS1 could be a diagnostic marker and potential therapeutic target for cervical cancer.
Post-transplant indolent T cell lymphoproliferative disorder in living donor liver transplantation: a case report
Authors: Goto Ryoichi , Kawamura Norio , Watanabe Masaaki , Koshizuka Yasuyuki , Shiratori Souichi , Ara Momoko , Honda Shohei , Mitsuhashi Tomoko , Matsuno Yoshihiro , Shimamura Tsuyoshi , Taketomi Akinobu
Published: June 2020

Background

Post-transplant lymphoproliferative disorder (PTLD) of T cell type has been rarely reported. Accurate diagnosis of this life-threatening rare form of PTLD is important for the treatment strategy.

Case presentation

A 7-year-old boy had severe diarrhea and weight loss progressively at 7 years post-living donor liver transplantation (LDLT) for biliary atresia. Endoscopy in the gastrointestinal (GI) tract revealed multiple erosions and ulcer lesions with prominent intraepithelial lymphocytosis in the duodenum and terminal ileum. Immunohistochemical examination demonstrated that these accumulated lymphocytes mainly comprised small- to medium-sized T cells expressing CD3, CD4, CD5, CD7, and CD103, but lacking CD8, CD56, and Epstein-Barr virus-encoded small RNAs. In addition, T cell receptor β gene rearrangement was detected by polymerase chain reaction analysis. Comprehensively, the lesions were best interpreted as post-transplant indolent T cell lymphoproliferative disorder (LPD) of the intestine. Clinical remission was achieved by reducing the immunosuppressant.

Conclusion

A rarely reported indolent type of T cell LPD in post-LDLT was diagnosed by direct inspection and histological investigation. Although the histological classification and therapeutic strategy for post-transplant indolent T cell LPD have not been established, reducing immunosuppression allowed complete remission in our case. To prevent the incidence of PTLD and de novo malignancy, developing a methodology to set a proper dose of immunosuppressant is required.
Evaluation of the usefulness of EQ-5D as a patient-reported outcome measure using the Paretian classification of health change among patients with chronic heart failure
Authors: Jonsson Åsa , Orwelius Lotti , Dahlstrom Ulf , Kristenson Margareta
Published: June 2020

Purpose

The aim of this study was to evaluate the usefulness of EQ-5D as a patient-reported outcome measure using different analytical methods. Especially we used the Paretian Classification of Health Change, to see if this gave better information compared to measures that are more traditional. For the evaluation we used data from patients with chronic heart failure (HF).

Methods

We compared results of EQ-5D at baseline and at 1 year’s follow up for HF patients with preserved or reduced ejection fraction (EF), HFpEF (EF > 50%, n = 930) and HFrEF (EF < 40%, n = 3831) using individual patient data from the Swedish Heart Failure Registry. Statistical analysis included EQ-5D index and proportions for all five dimensions of the EQ-5D. In addition, we also used the Paretian classification of Health Change to judge overall improvements (improved in at least one dimension and not worsened in any other dimension) or worsening (vice versa) in EQ-5D profiles.

Results

Mean EQ-5D index showed minor changes at the one-year follow-up, likewise in both groups. The proportions reporting moderate, or severe, problems increased for all five dimensions of the EQ-5D in the HFpEF group. In the HFrEF group this was seen only for three dimensions, with no change for “anxiety/depression” and reduction of problems for “usual activities “. The Paretian classification showed that 24% (n = 200) of the HFpEF group and 34% (n = 1059) of the HFrEF group reported overall improvement while 43% (n = 355) and 39% (n = 1212) respectively reported overall worsening. Multiple logistic regressions showed different patterns of determinants e.g. that treatment in a cardiology clinic only affected overall health outcome in the HFrEF group.

Conclusion

The usefulness of EQ-5D is dependent on the analytical method used. While the index showed minor differences between groups, analyses of specific dimensions showed different patterns of change in the two groups with better prognosis for the HFrEF group. The Paretian classification of Health Change could further identify subgroups that showed overall improvements or overall worsening. This method can therefore help to identify needs for more tailored interventions in health services.
Olanzapine in the treatment of anorexia nervosa: a systematic review
Authors: Çöpür Sidar , Çöpür Mazlum
Published: June 2020

Anorexia nervosa, with the highest mortality rate among psychiatric diseases, is characterized by low body mass index, fear of weight gain, and disturbed body image. Even though multiple drugs have been proposed for the treatment of anorexia nervosa, current treatment modalities include nutritional support and psychotherapy. In this study, our aim is to analyze the efficiency and possible adverse effects of olanzapine, an atypical anti-psychotic drug, in the treatment of anorexia nervosa. The studies investigating the efficiency and possible adverse effects of olanzapine in anorexia nervosa have been searched by using 3 databases (Embase, PubMed, and Cochrane Library). DerSimonian-Laird random effects meta-analyses have been used in the statistical analysis. Effect of olanzapine treatment in accordance with the duration and dosage of drug have been analyzed by the determination of 95% confidence intervals (p value < 0.05 is considered as statistically significant). Despite the presence of some contradictory studies, olanzapine treatment has been found beneficial in anorexia nervosa. In addition, analysis reveals that statistically significant beneficial effect of olanzapine treatment is used at high doses and for short duration. Possible side effects include neuroleptic malignant syndrome, hypoglycemia, and heart block in patients suffering from anorexia nervosa. Even though there is obvious need for more comprehensive further studies, current literature favors olanzapine treatment. The efficiency of olanzapine is considered to be related to changes in dopaminergic and serotonergic system in anorexic patients both in terms of neurotransmitter levels and receptor activity.
Phytochemical and molecular analyses of some Coleus cultivars cultivated in Egypt
Authors: Shoaib Rashad M. , Ali Sami I. , Metwally Sami A. , Ibrahim Mohamed M. , Aboud Kamal A.
Published: June 2020

Background

Coleus(familyLamiaceae) is a popular garden ornamental plant known for its bright-colored foliage. The effective role of different plant growth regulators have been widely reported in plant cultivars (Singh A and Prasad SM Int. J. Sci. Eng. Appl. Sci. 2 (1): 1-10, (2016)). Kinetin has received great interest due to its richness in bioactive phytochemicals including polyphenolic compounds with its antioxidant activity. Molecular markers have been very helpful in enhancing our understanding of genome structure and function. In our study, we investigated the effect of three treatments of kinetin on the phytochemical contents of fiveColeuscultivars and molecular characterization by ISSR markers.

Results

The studied cultivars ofColeusrevealed adequate amounts of pigments chlorophyll a (Cha), chlorophyll b (Chb), and total carotenoids (Carot) as well as phytochemical ingredients including total carbohydrates (Carb), total phenolic (TP), total flavonoids (TF), and total tannins (TT). Finger paint cultivar (C5) revealed the highest values (0.266, 10.853, 11.648, and 6.722 mg/g) of Carb, TP, and TT, respectively, while the highest contents (11.814 and 11.648 mg/g) of TF were identified in Beckwhites gem species (C2) and finger paint cultivar (C5), respectively. Inter-simple sequence repeat (ISSR) marker analysis was performed on the samples with 5 primer pairs. These bands were identified as 21 polymorphic and 18 monomorphic ones with 53.8% polymorphism. Ten unique bands were identified in the resulted ISSR profile.

Conclusion

These results suggested that the effect of kinetin treatments stimulates secondary metabolites production. Also, ISSR marker is helpful for possible distinguishing, identifying, characterizing, and selection processing ofColeuscultivars.
Graduate teaching assistants: sharing epistemic agency with non-science majors in the biology laboratory
Authors: McFadden Justin Robert , Fuselier Linda
Published: June 2020

In teaching laboratories, scientific reasoning and argumentation are often taught in concert so students are provided opportunities to formulate a more nuanced understanding of science-as-practice and science as a social epistemology. Given recent calls to attend to the social aspects of science, we used Critical Contextual Empiricism, a social epistemology of science, as a framework for examining what features of a scientific community emerge in the introductory biology lab. In a case study of six graduate teaching assistants (GTAs), we explored how GTAs encouraged epistemic agency that encouraged their student’s efforts at knowledge construction in a community by collecting multiple data sources (e.g. audio recordings, students written work, focus group interviews) over a four-week sequence. Data analysis strategies were inductive, as a series of initial and focused coding were applied to select exchanges garnered from within the lab. Comparative analysis identified common occurrences across each respective case, which then revealed three overarching themes. We intended for GTAs to readily encourage epistemic agency to their students so insights regarding the social nature of knowledge production could be experienced and discussed. When epistemic shifts did occur, GTAs executed discursive moves targeting students’ experimental design practices (e.g. defining the dependent variable). Conversely, student’s efforts were also de-legitimized as GTAs provided specific directives to follow when challenges emerged for students. Finally, GTAs struggled to create a genuine community that modeled exemplary science-as-practice in the lab. Implications discuss how GTAs likely require more targeted support if community-driven learning is going to be successful in these uniquely challenging settings. Finally, working with non-science majors adds an additional layer of importance here given these lab-based experiences are limited and understanding the community’s role in generating scientific knowledge is a key component of being scientifically literate.
What Is the Impact of the Ebola Virus Disease Outbreak on Cancer Management in Guinea?
Authors: Traore Bangaly , Kourouma Mamady , Bah Malick , Keita Mamady
Published: June 2020

PURPOSE

To assess the impact of the Ebola virus disease outbreak (EVDO) on cancer management at the surgical oncology unit of Donka National Hospital.

METHODS

This was a retrospective and comparative analysis of cancer consultation and care data before (2012-2013), during (2014-2015), and after (2016-2017) the EVDO. The number of cancer occurrences, referral mode, origin, main activities (consultations, surgery, chemotherapy), and access of radiotherapy were analyzed. The Mann-Whitney U test with independent samples used was considered as significant if P was ≤ .05.

RESULTS

From 2012 to 2017, 4,977 patients were admitted, including 2,254 with cancer. The variations observed were a decrease in consultations by 2.3% during the EVDO versus an increase by 46.9% after the outbreak ( P < .001). We found decreases of 0.7% and 12.5% during and increases of 253.8% and 15.4% after the EVDO from level 1 and 2 and from level 3 health facilities, respectively ( P < .001). A total of 251 surgeries were performed, and 1,463 received chemotherapy. There was 5.2% more chemotherapy use during and 33.7% more after the EVDO ( P < .001). The number of surgeries increased by 35.8% and decreased by 40.0% during and after the EVDO, respectively ( P < .001). We evacuated 36 patients for radiotherapy, which reflected a decrease of 42.1% and 45.5% during and after the EVDO ( P < .001).

CONCLUSION

Cancer management slowed down during the EVDO. This change requires organization of the fight against cancer through the institutionalization and decentralization of its management.
Dual Challenge of Cancer and COVID-19: Impact on Health Care and Socioeconomic Systems in Asia Pacific
Authors: De Guzman Roselle , Malik Monica
Published: June 2020

Coronavirus or COVID-19 is caused by severe acute respiratory syndrome coronavirus 2. The COVID-19 pandemic has resulted in social and economic disruption throughout the entire world. Each country is being challenged. Although much of the world’s focus has been on the rapid spread in Italy, Spain, and the United States, the potential impact on the world’s poor, a majority of whom are living in Asia, could be devastating. Asia has the world’s most densely populated cities, and its developing countries are facing challenges in their socioeconomic and health care systems. COVID-19 is quickly overwhelming the fragile and overstretched health systems of low- and low- to middle-income countries. With its aging population having chronic diseases and the growing burden of cancer, Asia is facing the dual challenge of controlling the spread of COVID-19 and at the same time providing and maintaining cancer care.
Nonsurgical Management of Oligozoospermia
Authors: Choy Jeremy T , Amory John K
Published: June 2020

Male infertility secondary to oligozoospermia is surprisingly common. Although a majority of cases are idiopathic, oligozoospermia can be caused by endocrine dysfunction, anatomic abnormalities, medications, or environmental exposures. The work-up includes excluding reversible factors such as hormonal deficiency, medication effects, and retrograde ejaculation and identifying any underlying genetic syndrome and treating reversible medical causes. If no reversible cause is found, appropriate referrals to urology and assisted reproductive technology should be initiated. Lastly, clinicians should be aware of and respond to the psychological and general health ramifications of a diagnosis of oligozoospermia as part of the comprehensive care of men and couples struggling with a diagnosis of infertility.
Cancellation of Elective Surgery and Intensive Care Unit Capacity in New York State: A Retrospective Cohort Analysis
Authors: Poeran Jashvant , Zhong Haoyan , Wilson Lauren , Liu Jiabin , Memtsoudis Stavros G.
Published: June 2020

BACKGROUND:

In response to the coronavirus disease 2019 (COVID-19) pandemic, New York State ordered the suspension of all elective surgeries to increase intensive care unit (ICU) bed capacity. Yet the potential impact of suspending elective surgery on ICU bed capacity is unclear.

METHODS:

We retrospectively reviewed 5 years of New York State data on ICU usage. Descriptions of ICU utilization and mechanical ventilation were stratified by admission type (elective surgery, emergent/urgent/trauma surgery, and medical admissions) and by geographic location (New York metropolitan region versus the rest of New York State). Data are presented as absolute numbers and percentages and all adult and pediatric ICU patients were included.

RESULTS:

Overall, ICU admissions in New York State were seen in 10.1% of all hospitalizations (n = 1,232,986/n = 12,251,617) and remained stable over a 5-year period from 2011 to 2015. Among n = 1,232,986 ICU stays, sources of ICU admission included elective surgery (13.4%, n = 165,365), emergent/urgent admissions/trauma surgery (28.0%, n = 345,094), and medical admissions (58.6%, n = 722,527). Ventilator utilization was seen in 26.3% (n = 323,789/n = 1232,986) of all ICU patients of which 6.4% (n = 20,652), 32.8% (n = 106,186), and 60.8% (n = 196,951) was for patients from elective, emergent, and medical admissions, respectively. New York City holds the majority of ICU bed capacity (70.0%; n = 2496/n = 3566) in New York State.

CONCLUSIONS:

Patients undergoing elective surgery comprised a small fraction of ICU bed and mechanical ventilation use in New York State. Suspension of elective surgeries in response to the COVID-19 pandemic may thus have a minor impact on ICU capacity when compared to other sources of ICU admission such as emergent/urgent admissions/trauma surgery and medical admissions. More study is needed to better understand how best to maximize ICU capacity for pandemics requiring heavy use of critical care resources.
“Sound, Substantial Flesh and Blood”
Authors: Mullen Lisa
Published: June 2020

The shocking defamiliarization of the everyday that took place during World War II created a crisis in modernist aesthetics. This crisis emerges both in Eliot’s anguished meditation on time, space, and infinity in “East Coker,” and in Powell and Pressburger’s playful satire about an aging soldier. The curious parallels between these two works are articulated through the figure of the failing human body; in both poem and film, flesh becomes the avatar of a modernist sensorium that struggles to conjoin the perceiving subject with a fugitive and unreliable object world. Specifically, the medicalized body becomes the metaphorical locus of a profound epistemological unease, and the interventionist apparatuses of medicine and of cinema become folded into a more general problematic of style. Whereas Eliot’s poem repeatedly breaks the frame of classical rhyme, meter, and structure in order to express disquiet with the mechanics of the corporeal, Powell’s camera insists that we look steadily at the bodies of his lead actors—one aging before our eyes, one remaining eternally and impossibly the same—as they are worked on by the trickery of cinema, and to marvel at (rather than being repulsed by) the persistence of their intransigent materiality. A new poetics permits the consolation of aesthetic mediation, between the inaccessible metaphysical ideal and the baffling entanglements of human time.
Ten Years of Messaging about the Affordable Care Act in Advertising and News Media: Lessons for Policy and Politics
Authors: Gollust Sarah E. , Fowler Erika Franklin , Niederdeppe Jeff
Published: June 2020

Messaging about the Affordable Care Act (ACA) has seemingly produced a variety of outcomes: millions of Americans gained access to health insurance, yet much of the US public remains confused about major components of the law, and there remain stark and persistent political divides in support of the law. Our analysis of the volume and content of ACA-related media (including both ads and news) helps explain these phenomena, with three conclusions. First, the information environment around the ACA has been complex and competitive, with messaging originating from diverse sponsors with multiple objectives. Second, partisan cues in news and political ads are abundant, likely contributing to the crystallized politically polarized opinion about the law. Third, partisan discussions of the ACA in political ads have shifted in volume, direction, and tone over the decade, presenting divergent views regarding which party is accountable for the law's successes (or failures). We offer evidence for each of these conclusions from longitudinal analyses of the volume and content of ACA messaging, also referencing studies that have linked these messages to attitudes and behavior. We conclude with implications for health communication, political science, and the future outlook for health reform.
A Look Under the Hood: Regulatory Policy Making and the Affordable Care Act
Authors: Haeder Simon F. , Yackee Susan Webb
Published: June 2020

The Affordable Care Act (ACA) was signed into law a decade ago. Partisanship has limited the number of statutory changes, leaving the law mostly unchanged across the past 10 years. However, the ACA delegated vast powers to the executive branch, which opened the door for significant regulatory policy-making activities (also called “rulemaking”). We collected data on all regulatory actions related to the Affordable Care Act that have been taken since its passage to provide the first exploratory analyses of both the public law itself and the ensuing rulemaking activities. We also provide illustrative examples of two controversial issues: short-term limited-duration insurance plans and contraceptive coverage for women. Despite relative statutory stasis, regulatory actions have continued to shape the implementation of the Affordable Care Act. Both the Obama and Trump administrations have taken advantage of a vast delegation of policy-making power. Importantly, regulatory policy making holds the potential to yield significant changes depending on the policy goals of the presidential administration. Scholars, policy makers, and the public are well-advised to pay attention to ACA-related rulemaking activities. Moreover, “quasi-rulemaking” (i.e., the use of agency guidance as a policy tool) remains largely unexplored but could indicate an even greater regulatory enterprise than illustrated here.
Why Did the ACA Co-Op Program Fail? Lessons for the Health Reform Debate
Authors: Sparer Michael S. , Brown Lawrence D.
Published: June 2020

The ACA created a new type of nonprofit health insurance entity, the “Consumer Operated and Oriented Plan” (“co-op”). Most of the newly created co-ops soon lost money, and only 4 of the original 23 remain. We interviewed key stakeholders and conducted in-depth case studies of 3 of these co-ops. We discovered that politicians and regulators made it unlikely the program could succeed, that most of the co-ops did not have the management capacity to overcome these political obstacles, and that even those with good managers lacked the needed fiscal resilience. We also considered lessons suggested for those proposing a newly created “public option.” The main one is that a successful public option requires a supportive political environment, strong management, and significant fiscal capacity, none of which comes easily. A better route may be a quasi-public option in which the government subcontracts the operation of its newly created plan to a private firm. Although it is uncertain whether federal regulators have the capacity to hold such private for-profit firms accountable, pragmatism suggests that a combination of public-sector regulation and private-sector implementation may be the most direct path toward a US version of affordable universal coverage.
The Potential and Realized Impact of the Affordable Care Act on Health Equity
Authors: Lantz Paula M. , Rosenbaum Sara
Published: June 2020

The Affordable Care Act (ACA) was designed with multiple goals in mind, including a reduction in social disparities in health care and health status. This was to be accomplished through some novel provisions and a significant infusion of resources into long-standing public programs with an existing track record related to health equity. In this article, we discuss seven ACA provisions with regard to their intended and realized impact on social inequalities in health, focusing primarily on socioeconomic and racial/ethnic disparities. Arriving at its 10th anniversary, there is significant evidence that the ACA has reduced social disparities in key health care outcomes, including insurance coverage, health care access, and the use of primary care. In addition, the ACA has had a significant impact on the volume/range of services offered and the financial security of community health centers, and through section 1557, the ACA broadened the civil rights landscape in which the health care system operates. Less clear is how the ACA has contributed to improved health outcomes and health equity. Extant evidence suggests that the part of the ACA that has had the greatest impact on social disparities in health outcomes—including preterm births and mortality—is the Medicaid expansion.
SIX1 and SIX4 homeoproteins regulate PAX7+ progenitor cell properties during fetal epaxial myogenesis
Authors: Wurmser Maud , Chaverot Nathalie , Madani Rouba , Sakai Hiroshi , Negroni Elisa , Demignon Josiane , Saint-Pierre Benjamin , Mouly Vincent , Amthor Helge , Tapscott Stephen , Birchmeier Carmen , Tajbakhsh Shahragim , Le Grand Fabien , Sotiropoulos Athanassia , Maire Pascal
Published: June 2020

Pax7 expression marks stem cells in developing skeletal muscles and adult satellite cells during homeostasis and muscle regeneration. The genetic determinants that control the entrance into the myogenic program and the appearance of PAX7+ cells during embryogenesis are poorly understood. SIX homeoproteins are encoded by the Sine oculis homeobox related Six1-Six6 genes in vertebrates. Six1, Six2, Six4 and Six5 are expressed in the muscle lineage. Here we tested the hypothesis that Six1 and Six4 could participate in the genesis of myogenic stem cells. We show that fewer PAX7+ cells occupy a satellite cell position between the myofiber and its associated basal lamina in Six1 and Six4 (s1s4KO) at E18. However, PAX7+ cells are detected in remaining muscle masses present in the epaxial region of the double mutant embryos and are able to divide and contribute to muscle growth. To further characterize the properties of s1s4KO PAX7+ cells, we analyzed their transcriptome and tested their properties after transplantation in adult regenerating tibialis anterior (TA) muscle. Mutant stem cells form hypotrophic myofibers that are not innervated but retain the ability to self-renew.
Sensory regulated Wnt production from neurons helps make organ development robust to environmental changes in C. elegans
Authors: Modzelewska Katarzyna , Brown Louise , Culotti Joseph , Moghal Nadeem
Published: June 2020

Long-term survival of an animal species depends on development being robust to environmental variations and climate changes. We used C. elegans to study how mechanisms that sense environmental changes trigger adaptive responses that ensure animals develop properly. In water, the nervous system induces an adaptive response that reinforces vulval development through an unknown backup signal for vulval induction. This response involves the heterotrimeric G-protein EGL-30//Gαq acting in motor neurons. It also requires body-wall muscle, which is excited by EGL-30-stimulated synaptic transmission, suggesting a behavioral function of neurons induces backup signal production from muscle. We now report that increased acetylcholine during liquid growth activates an EGL-30-Rho pathway, distinct from the synaptic transmission pathway, that increases Wnt production from motor neurons. We also provide evidence that this neuronal Wnt contributes to EGL-30-stimulated vulval development, with muscle producing a parallel developmental signal. As diverse sensory modalities stimulate motor neurons via acetylcholine, this mechanism enables broad sensory perception to enhance Wnt-dependent development. Thus, sensory perception improves animal fitness by activating distinct neuronal functions that trigger adaptive changes in both behavior and developmental processes.
PP2A­-B55γ counteracts Cdk1 and regulates proper spindle orientation through the cortical dynein adaptor NuMA
Authors: Keshri Riya , Rajeevan Ashwathi , Kotak Sachin
Published: June 2020

Proper orientation of the mitotic spindle is critical for accurate development and morphogenesis. In human cells, spindle orientation is regulated by the evolutionarily conserved protein NuMA, which interacts with dynein and enriches it at the cell cortex. Pulling forces generated by cortical dynein orient the mitotic spindle. Cdk1-mediated phosphorylation of NuMA at threonine 2055 (T2055) negatively regulates its cortical localization. Thus, only NuMA not phosphorylated at T2055 localizes at the cell cortex. However, the identity and the mechanism of action of the phosphatase complex involved in T2055 dephosphorylation remains elusive. Here, we characterized the PPP2CA-B55γ (PPP2R2C)–PPP2R1B complex that counteracts Cdk1 to orchestrate cortical NuMA for proper spindle orientation. In vitro reconstitution experiments revealed that this complex is sufficient for T2055 dephosphorylation. Importantly, we identified polybasic residues in NuMA that are critical for T2055 dephosphorylation, and for maintaining appropriate cortical NuMA levels for accurate spindle elongation. Furthermore, we found that Cdk1-mediated phosphorylation and PP2A-B55γ-mediated dephosphorylation at T2055 are reversible events. Altogether, this study uncovers a novel mechanism by which Cdk1 and its counteracting PP2A-B55γ complex orchestrate spatiotemporal levels of cortical force generators for flawless mitosis.
Effects of a local auxiliary protein on the two-dimensional affinity of a TCR–peptide MHC interaction
Authors: Junghans Victoria , Chouliara Manto , Santos Ana Mafalda , Hatherley Deborah , Petersen Jan , Dam Tommy , Svensson Lena M. , Rossjohn Jamie , Davis Simon J. , Jönsson Peter
Published: June 2020

The affinity of T-cell receptors (TCRs) for major histocompatibility complex molecules (MHCs) presenting cognate antigens likely determines whether T cells initiate immune responses, or not. There exist few measurements of two-dimensional (2D) TCR–MHC interactions, and the effect of auxiliary proteins on binding is unexplored. Here, Jurkat T-cells expressing the MHC molecule HLA-DQ8-glia-α1 and the ligand of an adhesion protein (rat CD2) were allowed to bind supported lipid bilayers (SLBs) presenting fluorescently labelled L3-12 TCR and rat CD2, allowing measurements of binding unconfounded by cell signaling effects or co-receptor binding. The 2D Kd for L3-12 TCR binding to HLA-DQ8-glia-α1, of 14±5 molecules/μm2 (mean±s.d.), was only marginally influenced by including CD2 up to ∼200 bound molecules/μm2 but higher CD2 densities reduced the affinity up to 1.9-fold. Cell–SLB contact size increased steadily with ligand density without affecting binding for contacts at up to ∼20% of total cell area, but beyond this lamellipodia appeared, giving an apparent increase in bound receptors of up to 50%. Our findings show how parameters other than the specific protein–protein interaction can influence binding behavior at cell–cell contacts.
Neuronal MT1-MMP mediates ECM clearance and Lrp4 cleavage for agrin deposition and signaling in presynaptic development
Authors: Oentaryo Marilyn Janice , Tse Anna Chung-Kwan , Lee Chi Wai
Published: June 2020

Agrin is a crucial factor that induces postsynaptic differentiation at neuromuscular junctions (NMJs), but how secreted agrin is locally deposited in the context of extracellular matrix (ECM) environment and its function in presynaptic differentiation remain largely unclear. Here, we report that the proteolytic activity of neuronal membrane-type 1 matrix metalloproteinase (MT1-MMP; also known as MMP14) facilitates agrin deposition and signaling during presynaptic development at NMJs. Firstly, agrin deposition along axons exhibits a time-dependent increase in cultured neurons that requires MMP-mediated focal ECM degradation. Next, local agrin stimulation induces the clustering of mitochondria and synaptic vesicles, two well-known presynaptic markers, and regulates vesicular trafficking and surface insertion of MT1-MMP. MMP inhibitor or MT1-MMP knockdown suppresses agrin-induced presynaptic differentiation, which can be rescued by treatment with the ectodomain of low-density lipoprotein receptor-related protein 4 (Lrp4). Finally, neuronal MT1-MMP knockdown inhibits agrin deposition and nerve-induced acetylcholine receptor clustering in nerve-muscle co-cultures and affects synaptic structures at Xenopus NMJs in vivo. Collectively, our results demonstrate a previously unappreciated role of agrin, as well as dual functions of neuronal MT1-MMP proteolytic activity in orchestrating agrin deposition and signaling, in presynaptic development.