bluuebunny/crossref_metadata_2025 huggingface dataset:
Phylogeny Estimation Given Sequence Length Heterogeneity
Authors: Smirnov Vladimir , Warnow Tandy
Published: July 2020

Phylogeny estimation is a major step in many biological studies, and has many well known challenges. With the dropping cost of sequencing technologies, biologists now have increasingly large datasets available for use in phylogeny estimation. Here we address the challenge of estimating a tree given large datasets with a combination of full-length sequences and fragmentary sequences, which can arise due to a variety of reasons, including sample collection, sequencing technologies, and analytical pipelines. We compare two basic approaches: (1) computing an alignment on the full dataset and then computing a maximum likelihood tree on the alignment, or (2) constructing an alignment and tree on the full length sequences and then using phylogenetic placement to add the remaining sequences (which will generally be fragmentary) into the tree. We explore these two approaches on a range of simulated datasets, each with 1000 sequences and varying in rates of evolution, and two biological datasets. Our study shows some striking performance differences between methods, especially when there is substantial sequence length heterogeneity and high rates of evolution. We find in particular that using UPP to align sequences and RAxML to compute a tree on the alignment provides the best accuracy, substantially outperforming trees computed using phylogenetic placement methods. We also find that FastTree has poor accuracy on alignments containing fragmentary sequences. Overall, our study provides insights into the literature comparing different methods and pipelines for phylogenetic estimation, and suggests directions for future method development. [Phylogeny estimation, sequence length heterogeneity, phylogenetic placement.]
Ultraviolet light activates PMK-1/p38 MAPK signaling via MOM-4 and JKK-1 in Caenorhabditis elegans
Authors: Ma Jing , Jiang Xinghao , Yarui An , Danli Jin , Xiaodie Yin , Zhang Jian , Xu Ajing
Published: July 2020

P38 mitogen-activated protein kinase (p38 MAPK) plays an important role in innate immunity and is activated by ultraviolet (UV) radiation. However, the molecular mechanism underlying UV stress remains unclear. In this study, we reported that UV activated PMK-1/p38 MAPK signaling via JKK-1 and MOM-4 in Caenorhabditis elegans. In C. elegans, different UV radiation doses resulted in PMK-1 phosphorylation. However, pmk-1 mutants failed to demonstrate an altered survival time in response to UV when compared with wild-type worms. Further analysis showed that JKK-1, but not SEK-1 mutants, displayed impaired PMK-1 activation following UV irradiation, suggesting that JKK-1 is the upstream MAP2K for the activation of PMK-1 in C. elegans under UV stimulation. UV-induced activation of PMK-1 was markedly reduced in MOM-4, but not in NSY-1 and DLK-1 mutant worms, suggesting that MOM-4 is the upstream MAP3K regulator of PMK-1 activation in response to UV stress in C. elegans. Additionally, daf-16 mutants displayed a shorter lifespan under UV stress, but UV-induced activation of PMK-1 was not markedly reduced in daf-16 and age-1 mutant worms. Our results revealed the signaling pathway involved in PMK-1 activation in C. elegans in response to UV radiation.
Adult vernal keratoconjunctivitis
Authors: Di Zazzo Antonio , Bonini Stefano , Fernandes Merle
Published: July 2020

Purpose of review

Vernal keratoconjunctivitis (VKC) is a rare chronic self-limiting allergic inflammatory disease of the ocular surface mostly affecting young boys in their first decade of life. In the last few years a new clinical entity of VKC has been described: adult VKC. Two variants have been identified according to clinical onset: early (childhood VKC persisting beyond puberty) and late onset (arising de novo in adults) adult VKC. Several epidemiologic studies on VKC have been published from single tertiary centers but while the age distribution of VKC patients does show a small percentage of adults with the disease, detailed analysis on this small subset of adult VKC cases is lacking. In this review we describe pathogenesis, clinical features, diagnostic alternatives, and therapeutic alternatives of this highly invalidating disease.

Recent findings

Adult variants of VKC have same clinical manifestations of classic form, but show higher inflammatory response and increased risk of chronic fibrotic sequelae.

Adult VKC research could provide insights on the impact of sex hormones in the pathogenesis of allergic diseases and on the mechanisms of inflammation and fibrosis, which cause potentially vision threatening sequelae. The present review will highlight the recent developments in our understanding of this uncommon entity.
Gender Bias in Collaborative Medical Decision Making: Emergent Evidence
Authors: Helzer Erik G. , Myers Christopher G. , Fahim Christine , Sutcliffe Kathleen M. , Abernathy James H.
Published: July 2020

This initial, exploratory study on gender bias in collaborative medical decision making examined the degree to which physicians’ reliance on a team member’s patient care advice differs as a function of the gender of the advice giver. In 2018, 283 anesthesiologists read a brief, online clinical vignette and were randomly assigned to receive treatment advice from 1 of 8 possible sources (physician or nurse, man or woman, experienced or inexperienced). They then indicated their treatment decision, as well as the degree to which they relied upon the advice given.

The results revealed 2 patterns consistent with gender bias in participants’ advice taking. First, when treatment advice was delivered by an inexperienced physician, participants reported replying significantly more on the advice of a man versus a woman, F(1,61) = 4.24, P = .04. Second, participants’ reliance on the advice of the woman physician was a function of her experience, F(1,62) = 6.96, P = .01, whereas reliance on the advice of the man physician was not, F(1,60) = 0.21, P = .65.

These findings suggest women physicians, relative to men, may encounter additional hurdles to performing their jobs, especially at early stages in their careers. These hurdles are rooted in psychological biases of others, rather than objective features of cases or treatment settings. Cultural stereotypes may shape physicians’ information use and decision-making processes (and hinder collaboration), even in contexts that appear to have little to do with social category membership. The authors recommend institutions adopt policies and practices encouraging equal attention to advice, regardless of the source, to help ensure advice taking is a function of information quality rather than the attributes of the advice giver. Such policies and practices may help surface and implement diverse expert perspectives in collaborative medical decision making, promoting better and more effective patient care.
What Is Finite Element Analysis?
Authors: Welch-Phillips Adanna , Gibbons Denys , Ahern Daniel P. , Butler Joseph S.
Published: July 2020

Finite element analysis is a computational technique to predict how different materials will react when a range of forces are applied. In the field of orthopedics, this technique has predominantly been used for implant design and testing. As the technology improves, increasing clinical applications are being developed, offering promise in the areas of surgical planning and the opportunity to tailor implants to individual patient characteristics. This article introduces the various preclinical mechanical tests available, as well as providing a brief overview of the finite element analysis technology.
Derangement of Arginine and Related Amino Acids in Children Undergoing Surgery for Congenital Heart Disease With Cardiopulmonary Bypass
Authors: Navaei Amir H. , Shekerdemian Lara S. , Mohammad Mahmoud A. , Coss-Bu Jorge A. , Bastero Patricia , Ettinger Nicholas A. , Orellana Renan , Fernandes Caraciolo J. , Marini Juan C.
Published: July 2020

Objectives:

Arginine is a conditionally essential amino acid, the precursor for nitric oxide and a key factor in cell proliferation, protein synthesis, and energy metabolism. When there is increased demand in the setting of inflammation, ischemia-reperfusion injury, and organ dysfunction, endogenous arginine production falls short, and external supplementation may be necessary. The goal of this study was to assess changes in concentrations of plasma arginine, citrulline, ornithine, glutamine, and plasma arginase in infants and children undergoing surgery for congenital heart disease with cardiopulmonary bypass.

Design:

Prospective observational study.

Setting:

The study was conducted in the Heart Center at Texas Children’s Hospital.

Subjects:

Children undergoing surgery for congenital heart disease with cardiopulmonary bypass.

Interventions:

None.

Measurements and Main Results:

Serial perioperative blood samples were collected for quantification of amino acids, arginase, nitric oxide metabolites, and markers of organ function (lactate, Pao
2/Fio
2 ratio, and creatinine clearance). Thirty children (18 males) were included in the study; median (interquartile range) age 0.5 years (0.3–0.9 yr). The mean ± sd for plasma amino acid concentrations before cardiopulmonary bypass: arginine 62 ± 20 µmol/L, citrulline 24 ± 6 µmol/L, ornithine 53 ± 32 µmol/L, and glutamine 591 ± 126 µmol/L. Arginine concentration was decreased within the first 24 hours (43 ± 15 µmol/L; p = 0.004), citrulline and glutamine concentrations decreased over the first 48 hours (11 ± 4 µmol/L; p < 0.001 and 493 ± 131 µmol/L; p = 0.019, respectively) and were associated with an increase in arginase (3.8 ± 3 µg/mL; p < 0.05). There was an increase in Vasoactive-Inotropic Score (5.9 ± 19 vs 0.5 ± 2; p < 0.001), decrease in creatinine clearance (76 ± 24 vs 93 ± 31; p = 0.002), and Pao
2/Fio
2 ratio (243 ± 138 vs 374 ± 200; p = 0.007) comparing to baseline.

Conclusions:

A widely variable degree of arginine, citrulline, and glutamine depletion occurs in children after surgery for congenital heart disease. These findings were associated with increased arginase and coincide with some of the markers of organ perfusion.
Digital Quantification of Melanocytic Density in Resection Margins of Lentigo Maligna Using SOX10 Versus Hematoxylin–Eosin Staining
Authors: Siarov Jan , Neittaanmäki Noora , Mölne Johan , Gillstedt Martin , Paoli John
Published: July 2020

Lentigo maligna (LM) represents an overgrowth of atypical melanocytes at the dermal–epidermal junction of chronically sun-damaged skin. The presence of LM on sun-damaged skin poses a diagnostic challenge because the solar-induced melanocytic hyperplasia makes it difficult to assess the LM margins. Melanocytic density can be used to discriminate sun-damaged skin from LM. The aim of this study was to quantify the melanocytic density at the surgical margins of scanned whole-slide images of LM comparing sections stained with H&E and SOX10. Twenty-six surgically excised LM diagnosed at the Department of Pathology at Sahlgrenska University Hospital were collected. The slides that contained the closest surgical margin or harbored the highest density of melanocytes at the margin were selected for serial sectioning using H&E and SOX10. Whole-slide imaging at ×40 magnification was used, and a circular field with a diameter of 0.5 mm at the surgical margin was superimposed on the image. Five blinded pathologists reviewed the slides in a randomized order. In the majority of the cases (24/26), the pathologists identified more melanocytes on the SOX10 slides than those on the H&E slides. On average, 2.5 times more melanocytes were counted using SOX10 compared with H&E (P < 0.05). Furthermore, the average group SD on the H&E slides was 4.12 compared with 2.83 on the SOX10 slides (P = 0.004). Thus, the use of SOX10 staining leads to higher melanocytic density counts compared with H&E staining when assessing the surgical margins of LM. The use of SOX10 staining also significantly decreased the interobserver variability between pathologists.
Development and performance testing of the low-cost, 3D-printed, smartphone-compatible ‘Tansen Videolaryngoscope’ vs. Pentax-AWS videolaryngoscope vs. direct Macintosh laryngoscope
Authors: Lambert Christopher T. , John Stephen C. , John Anna V.
Published: July 2020

BACKGROUND

While videolaryngoscopes help in the management of difficult airways, they remain too expensive for those with limited resources. We have developed a robust, re-usable, low-cost videolaryngoscope at United Mission Hospital Tansen, Nepal, by combining a smartphone-compatible endoscope capable of capturing still and video images with a three dimensional-printed, channelled, hyperangulated blade. The computer-aided design file for the videolaryngoscope blade was emailed and printed in London before evaluation of its performance on a difficult airway manikin.

OBJECTIVE

To benchmark the intubation performance of the Tansen Videolaryngoscope (TVL) in a ‘difficult airway’ manikin (SimMan3G, tongue fully inflated, neck stiff), against a commercially available videolaryngoscope and a conventional Macintosh laryngoscope.

DESIGN

A manikin study.

SETTING AND PARTICIPANTS

Forty-three experienced videolaryngoscope users in two London teaching hospitals.

INTERVENTION AND OUTCOME

Primary outcome: Intubation success rate. Secondary outcomes: grade of laryngeal view, median time to intubation and intubator-rated ‘ease of use’.

RESULTS

Our device was equivalent to Pentax-AWS and superior to Macintosh laryngoscope (TVL vs. Pentax-AWS vs. Macintosh) in overall intubation success rate (88 vs. 98 vs. 67%, P < 0.05); grade of view (median Cormack-Lehane grade 1 vs. 1 vs. 3, P < 0.01); median time to intubation (17.5 vs. 15.5 vs. 27 s, P < 0.01). In subjective ‘ease of use’ scores, Pentax-AWS was superior to the TVL, which was superior to Macintosh laryngoscope (Likert-type 1 to 5 scale: 4 vs. 4 vs. 1, P < 0.00001).

CONCLUSION

In this manikin simulation of a difficult airway, the ‘TVL’ was superior to the Macintosh laryngoscope, and noninferior to the Pentax-AWS videolaryngoscope in intubation success rate, grade of laryngeal view and time to intubation. Participants found the Pentax device easier to use, and their feedback has given us valuable insights for improving our device. The TVL is well suited to settings in which resources are limited, being inexpensive, simple and re-usable.
A Case of IgG4-Related Ophthalmic Disease With Coronary Arteritis
Authors: Suimon Yuka , Kase Satoru , Shimoyama Shuhei , Ishida Susumu
Published: July 2020

IgG4-related disease (IgG4-RD) is a fibro-inflammatory condition characterized by lymphoplasmacytic infiltrates rich in IgG4-positive plasma cells, often with elevated serum IgG4. Multiple organs may be affected. Coronary arteritis may be one form of fatal involvement in IgG4-RD. IgG4-RD can manifest as periocular lesions, called IgG4-related ophthalmic disease (IgG4-ROD). Here, the authors describe a patient with asymptomatic coronary arteritis detected after the diagnosis of IgG4-ROD. A 58-year-old male complained of eyelid swelling and diplopia without systemic symptoms. Swelling of bilateral lacrimal glands and infraorbital nerves, high serum IgG4 levels, and histopathology of lacrimal gland tissue fulfilled diagnostic criteria for IgG4-ROD. After diagnosis, systemic and coronary CT showed coronary lesions and coronary artery stenosis. After prednisolone at 40 mg/day was administered, swelling of the lacrimal glands, diplopia, and coronary lesions improved. This case emphasizes the importance of systemic screening, even if initial symptoms are solely associated with periocular regions.
Assessment of the duration of surgery and patient turnover after the incorporation of a standardized intracameral combination of mydriatics and anesthetics for cataract surgery
Authors: Ben Hadj Salah Wassim , Rousseau Antoine , M'garrech Mohamed , Best Anne Laurence , Barreau Emmanuel , Labetoulle Marc
Published: July 2020

Purpose:

To evaluate changes in clinical outcomes, duration, and workflow of cataract surgery, before and after the introduction of a commercially available intracameral combination of 2 mydriatics (phenylephrine, tropicamide) and 1 anesthetic (lidocaine) (ICMA).

Setting:

Service d'Ophtalmologie, Hôpital Bicêtre, Université Paris Sud., Le Kremlin-Bicêtre, France.

Design:

Retrospective chart review.

Methods:

Three series of patients who underwent cataract surgery were grouped according to when they had surgery: just before ICMA was approved (early 2016, Series I); just after implementation of ICMA as the standard procedure for surgery (late 2016, Series II); and 21 months after using ICMA routinely for surgery (2018, Series III). Data were collected on patient turnover during the day of surgery and surgical outcomes.

Results:

The study population comprised of 51, 47, and 51 patients in Series I, II, and III respectively. There were no statistical differences between series in the mean change in corrected distance visual acuity from preoperatively to 1 month postoperatively and in complications (P > .05, all comparisons). The mean duration of surgery was significantly shorter in Series III and II, compared with Series I (13.18 ± 4.05 and 13.62 ± 5.26 vs 15.82 ± 6.01 minutes; P = .023 and P = .041, respectively). The mean patient rotation was statistically significantly shorter in Series III compared with Series I (41.50 ± 8.31 vs 47.79 ± 14.66 minutes, respectively; P = .028).

Conclusions:

Implementing ICMA as a routine procedure in cataract surgery resulted in similar vision and safety outcomes than the usual topical eyedrop regimen, while significantly reducing the total surgery and rotation times. Hence, patient turnover during the surgical session was optimized while maintaining safety and efficacy of the procedure.
Identifying oxidized lipid mediators as prognostic biomarkers of chronic posttraumatic headache
Authors: Domenichiello Anthony F. , Jensen Jennifer R. , Zamora Daisy , Horowitz Mark , Yuan Zhi-Xin , Faurot Keturah , Mann J. Douglas , Mannes Andrew J. , Ramsden Christopher E.
Published: July 2020

Chronic posttraumatic headache (PTH) is among the most common and disabling sequelae of traumatic brain injury (TBI). Current PTH treatments are often only partially effective and have problematic side effects. We previously showed in a small randomized trial of patients with chronic nontraumatic headaches that manipulation of dietary fatty acids decreased headache frequency, severity, and pain medication use. Pain reduction was associated with alterations in oxylipins derived from n-3 and n-6 fatty acids, suggesting that oxylipins could potentially mediate clinical pain reduction. The objective of this study was to investigate whether circulating oxylipins measured in the acute setting after TBI could serve as prognostic biomarkers for developing chronic PTH. Participants enrolled in the Traumatic Head Injury Neuroimaging Classification Protocol provided serum within 3 days of TBI and were followed up at 90 days postinjury with a neurobehavioral symptom inventory (NSI) and satisfaction with life survey. Liquid chromatography-tandem mass spectrometry methods profiled 39 oxylipins derived from n-3 docosahexaenoic acid (DHA), and n-6 arachidonic acid and linoleic acid. Statistical analyses assessed the association of oxylipins with headache severity (primary outcome, measured by headache question on NSI) as well as associations between oxylipins and total NSI or satisfaction with life survey scores. Among oxylipins, 4-hydroxy-DHA and 19,20-epoxy-docosapentaenoate (DHA derivatives) were inversely associated with headache severity, and 11-hydroxy-9-epoxy-octadecenoate (a linoleic acid derivative) was positively associated with headache severity. These findings support a potential for DHA-derived oxylipins as prognostic biomarkers for development of chronic PTH.
Person-Centered Care, Job Stress, and Quality of Life Among Long-Term Care Nursing Staff
Authors: CHANG HeeKyung , GIL Chorong , KIM Hyejin , BEA Hanju
Published: July 2020

Background

Although it has been established that person-centered care is an essential aspect in long-term care facilities, the relationship between person-centered care and job stress among nursing staff and the effect of this relationship on their quality of life are not clear.

Purpose

This study aims to investigate correlations among job stress, quality of life, and person-centered care of nurses as well as factors affecting the person-centered care abilities of nursing staff working at long-term care hospitals.

Methods

Nursing staff (N = 183) in three long-term care hospitals in South Korea completed a questionnaire on job stress, quality of life, and person-centered care. Data were analyzed using the SPSS 22.0 program for descriptive statistics, using an independent t test, a one-way analysis of variance, Pearson's correlation coefficient, and multiple stepwise regression analyses.

Results

Significant factors found to be associated with person-centered care included the quality of life (r = .411, p < .001) and job stress (r = −.305, p < .001) of the participant. The regression model with job stress and quality of life as predictor variables accounted for 29.2% of the variance in person-centered care.

Conclusions/Implications for Practice

Higher quality of life and lower job stress were found to increase the person-centered care abilities of nurses in long-term care facilities.
The Symptom Experience and Self-management Strategies of Women Undergoing Cervical Cancer Treatment
Authors: Christiansen Mille Guldager , Piil Karin , Jarden Mary
Published: July 2020

Background

Cervical cancer treatment modalities, such as surgery, chemotherapy, radiation, and brachytherapy, often result in short- and long-term adverse effects such as nausea, fatigue, and sexual dysfunction. Chemotherapy and radiation are typically provided on an outpatient basis, requiring women to be more active in self-managing their symptoms at home.

Objective

The aim of this study was to explore how women with cervical cancer experience symptoms and manage daily life during treatment.

Methods

Individual interviews with 10 women diagnosed with cervical cancer and undergoing curative concurrent chemotherapy and radiation were carried out. Data analysis was conducted using a phenomenological-hermeneutic perspective, inspired by Ricoeur.

Results

Three themes were identified based on the interviews: (1) new life perspectives, (2) suffering in silence, and (3) enhanced symptom self-management strategies.

Conclusion

Diagnosis and treatment create an opportunity for the women to critically reflect on their lives and to develop new life perspectives. During treatment, a mental transformation involving the use of various individual social, mental, and physical coping strategies allowed the women to manage their daily lives. This enabled self-management strategies, resulting in maintaining a sense of normalcy, trying to defy the adverse effects, and prioritizing themselves, their families, and the treatment.

Implications for Practice

Women with cervical cancer undergoing oncological treatment need more specific and detailed information about the course of treatment, symptom management, adverse effects, and psychological reactions to better manage their daily lives. Healthcare professionals play a crucial role in supporting and guiding the women and in ensuring optimal symptom management.
Emergency Preparedness Competencies Among Nurses
Authors: McNeill Charleen , Adams Lavonne , Heagele Tara , Swanson Melvin , Alfred Danita
Published: July 2020

OBJECTIVE

The aim of this study was to examine current levels of self-reported professional emergency preparedness competence among nurses. In addition, relationships between nurse professional emergency preparedness competence, personal preparation for a disaster, and perceived likelihood of reporting to work after a disaster are examined.

BACKGROUND

Evidence suggests wide gaps in nurses' familiarity with the dimensions of professional emergency preparedness competence and their likelihood to report, potentially impacting human life after a disaster.

METHODS

An exploratory, cross-sectional survey design was used with a sample of 186 RNs and licensed practical nurses.

RESULTS

Results indicate significant weaknesses in nurses' professional emergency preparedness competence. There are positive correlations between likelihood to report, personal preparedness, and professional emergency preparedness competence.

CONCLUSIONS

Nurses across the United States lack sufficient competence in professional emergency preparedness. Results demonstrate the need to improve the education of nurses to meet the demands of populations in urgent situations. Action items nurse administrators can take are provided.
Photogrammetric Analysis of Eyebrow and Eyelid Dimensions in Indian American Adults
Authors: Sadacharan Chakravarthy Marx , Packirisamy Vasanthakumar
Published: July 2020

In cosmetic surgery, knowledge of the average dimensions of periorbital features based on gender and ethnicity is essential to improve the patient appearance and maintain the ethnicity. The aim the study was to establish gender-specific periorbital anthropometric and anthroposcopic data for Indian Americans (IA) and to assess the statistically ethnic differences by comparing with published data of Malaysian Indians (MI). Evaluation of periorbital features was done on the standardized frontal photographs of 400 IA, aged 18 to 26 years. The measured values were evaluated by an independent t-test. Sexual dimorphism was found in all 15 measurements. The eyebrow height, combined height of the orbit and eyebrow, eyebrow apex inclination, apex to lateral canthus distance, medial end of brow to medial canthus distance, lateral end of brow to lateral canthus distance; pretarsal skin height, palpebral fissure height, palpebral fissure inclination (PFI), and medial canthus tilt were significantly greater in female than the males. In males, eyebrow apex hairline distance, apex to lateral limbus distance, eyebrow apex angle (EAA), lower eyelid height, and interpupillary distance was significantly greater than the females. Significant ethnic difference was found between IA and MI for eyebrow height, apex to lateral limbus distance, EAA, palpebral fissure height, and PFI in male group. In female group, EAA, medial canthus tilt, and PFI were significantly greater in MI. Four types of epicanthus were observed and the brow apex between lateral limbus and lateral canthus was the most common position. The generated normative data may be useful during diagnosis and treatment planning.
Use of Kinesiography to Assess Mandibular Function Following Segmental Resection and Microvascular Reconstruction
Authors: Venturi Giulio , Defila Luca , Battaglia Salvatore , Cicciù Marco , Crimi Salvatore , Bianchi Aberto , Marchetti Claudio , Tarsitano Achille
Published: July 2020

Mandibular reconstruction has attained adequate morphological outcomes. However, some patients encounter difficulties in oral function and limited mandibular movements. An objective: evaluation has seldom featured actual kinetic measurements after mandibular reconstruction.

Thirty patients who underwent mandibular reconstruction using bony free flap were enrolled in the study. Twenty-two patients were recruited after surgery and compared to a control group of 8 healthy subjects; 8 patients underwent both pre and postoperative evaluations. For each patient, a kinesiographic scan was obtained, recording maximum mouth opening, maximal laterality, and maximal protrusion.

All postoperative kinesiographic evaluations were performed at least 6 months after surgery to ensure complete healing. In the first group of 22 patients, all measured movements were less than those of healthy controls, in particular maximum mouth opening. In the second study group (pre and postoperative evaluation), the postsurgical values did not achieve the control ones, but were no less than the preoperative values, granting adequate functional outcomes.

The kinesiograph appears useful for objectively recording the functional outcomes in patients who have undergone mandibular reconstruction. The postoperative jaw movements were acceptable, ensuring a sufficient functional recovery.
Development and Validation of a Vaginal Anterior Repair Simulation Model for Surgical Training
Authors: O’Meara Amanda , Ramaseshan Aparna S. , O’Sullivan David M. , Tunitsky-Bitton Elena
Published: July 2020

Objective

The aims of this study were to design and to validate a surgical simulation model for vaginal anterior colporrhaphy.

Methods

Obstetrics and gynecology residents were divided into two groups: “novice” and “advanced.” “Expert” group comprised female pelvic medicine and reconstructive surgery (FPMRS) fellows and faculty. All subjects were recorded performing anterior colporrhaphy using the simulation model. Deidentified, silent videos of recorded performances were evaluated by a blinded reviewer using the Objective Structured Assessment of Technical Skills (OSATS) and a procedure-specific assessment, based on the American Board of Obstetrics and Gynecology milestone evaluation. Analysis of variance was used for statistical comparisons.

Results

Thirty-seven participants included 13 novices, 18 advanced residents, and six experts. The experts scored significantly higher than both resident groups in each of the domains of the OSATS and the procedure assessment. The mean OSATS score for experts was 32.30 (±6.06) (maximum, 35); novice, 17.15 (±5.84); and advanced, 21.11 (±5.61) (P = 0.001). The experts’ scores for the procedure assessment (maximum, 25) was 23.00 (±3.95); novice, 10.62 (±4.70); and advanced, 14.33 (±4.73) (P < 0.001). The two trainee groups did not differ significantly in their overall performance. Most trainees (29 [94%]) evaluated the model as a useful tool in learning this procedure.

Conclusions

This low-fidelity model can be constructed easily using common materials. The model cost is $43.92 with reusable components ($11 per use). Higher scores by experts versus trainees confirm construct validity of this model. It may serve as a valuable simulation tool allowing trainees to improve their surgical technique for anterior colporrhaphy.
Laparoscopic Cerclage Sacrohysteropexy: Comparing a Novel Technique for Sacrohysteropexy to Traditional Supracervical Hysterectomy and Sacrocervicopexy
Authors: Armstrong Katherine L. , Modest Anna M. , Rosenblatt Peter L.
Published: July 2020

Objective

The objective of this study was to compare outcomes of laparoscopic cerclage sacrohysteropexy (LCSH), a novel technique used to perform sacrohysteropexy, which requires significantly less suturing and knot tying, to traditional laparoscopic supracervical hysterectomy (LSH) with sacrocervicopexy for the treatment of uterine prolapse.

Methods

This is a retrospective cohort study of all patients who underwent LCSH between March 3, 2016, and October 30, 2018, and patients who underwent LSH with sacrocervicopexy between September 1, 2013, and October 30, 2018. Medical records were reviewed to obtain information on baseline demographics, preoperative pelvic organ prolapse quantification (POP-Q), baseline Pelvic Floor Distress Inventory score, and intraoperative and postoperative outcomes. Apical failure was defined as descent of the cervix beyond the midvagina (C > −TVL/2). Subjective failure was defined as reporting of bulge symptoms, reoperation, or use of a vaginal pessary.

Results

Seventy-seven patients who underwent the LCSH procedure and 88 who underwent LSH with sacrocervicopexy were identified. Baseline demographic data were similar between the 2 groups. Operating time was significantly decreased in the LCSH group with median time of 129 minutes (interquartile range, 121–153) versus 199 minutes (interquartile range, 178.5–222.5; P < 0.001) in the traditional cohort. Six weeks after surgery, patients had equivalent POP-Q examinations and Pelvic Floor Distress Inventory scores. At 6 months after surgery, patients similarly had no significant difference in POP-Q examination or scores on standardized questionnaires between the 2 groups. There were no mesh or suture erosions noted in either cohort at any time point.

Conclusions

Laparoscopic cerclage sacrohysteropexy is a novel variation of traditional sacrohysteropexy and an alternative to LSH with sacrocervicopexy that minimizes the dissection and suturing required. This procedure appears to offer equivalent anatomic and subjective outcomes to traditional LSH with sacrocervicopexy with significantly decreased intraoperative time.
Place and causes of acute cardiovascular mortality during the COVID19 pandemic: retrospective cohort study of 580,972 deaths in England and Wales, 2014 to 2020
Authors: Wu Jianhua , Mamas Mamas A , Mohamed Mohamed , Kwok Chun Shing , Roebuck Chris , Humberstone Ben , Denwood Tom , Luescher Tom , de Belder Mark A , Deanfield John E , Gale Chris P
Published: July 2020

Importance

The COVID-19 pandemic has resulted in a decline in admissions with cardiovascular (CV) emergencies. The fatal consequences of this are unknown.

Objectives

To describe the place and causes of acute CV death during the COVID-19 pandemic.

Design

Retrospective nationwide cohort.

Setting

England and Wales.

Participants

All adult (age ≥18 years) acute CV deaths (n=580,972) between 1st January 2014 and 2nd June 2020.

Exposure

The COVID-19 pandemic (defined as from the onset of the first COVID-19 death in England on 2nd March 2020).

Main outcomes

Place (hospital, care home, home) and acute CV events directly contributing to death as stated on the first part of the Medical Certificate of Cause of Death.

Results

After 2nd March 2020, there were 22,820 acute CV deaths of which 5.7% related to COVID-19, and an excess acute CV mortality of 1752 (+8%) compared with the expected daily deaths in the same period. Deaths in the community accounted for nearly half of all deaths during this period. Care homes had the greatest increase in excess acute CV deaths (1065, +40%), followed by deaths at home (1728, +34%) and in hospital (57, +0%). The most frequent cause of acute CV death during this period was stroke (8,290, 36.3%), followed by acute coronary syndrome (ACS) (5,532, 24.2%), heart failure (5,280, 23.1%), pulmonary embolism (2,067, 9.1%) and cardiac arrest (1,037, 4.5%). Deep vein thrombosis had the greatest increase in cause of excess acute CV death (18, +25%), followed pulmonary embolism (340, +19%) and stroke (782, +10%). The greatest cause of excess CV death in care homes was stroke (700, +48%), compared with cardiac arrest (80, +56%) at home, and pulmonary embolism (126, +14%) and cardiogenic shock (41, +14%) in hospital.

Conclusions and relevance

The COVID-19 pandemic has resulted in an inflation in acute CV deaths above that expected for the time of year, nearly half of which occurred in the community. The most common cause of acute CV death was stroke followed by acute coronary syndrome and heart failure. This is key information to optimise messaging to the public and enable health resource planning.
Characterization of the SARS-CoV-2 outbreak in the State of Qatar, February 28-April 18, 2020
Authors: Al Kuwari Hanan M , Abdul Rahim Hanan F , Abu Raddad Laith J , Abou-Samra Abdul-Badi , Al Kanaani Zaina , Al Khal Abdullatif , Al Kuwari Einas , Al Marri Salih , Al Masalmani Muna , Al Romaihi Hamad Eid , Al Thani Sheikh M , Coyle Peter , Latif Ali N , Owen Robert , Bertollini Roberto , Butt Adeel A
Published: July 2020

Objective
To define the epidemiologic curve of COVID-19 in Qatar, determine factors associated with severe or critical illness, and study the temporal relation between public health measures and case finding

Design
Epidemiologic investigation

Setting and Participants
All confirmed COVID-19 cases in the State of Qatar between February 28 and April 18, 2020

Main Outcome Measures
Number of total and daily new COVID-19 infections; demographic characteristics and comorbidity burden and severity of infection; factors associated with severe or critical illness

Results
Between February 28 and April 18, 2020 (11:00AM local time), 5,685 cases of COVID-19 were identified. Mean age (SD) was 35.8(12.0) years, 88.9% were male and 8.7% were Qatari nationals. Overall, 83.6% had no concomitant comorbidity, and 3.0% had 3 or more comorbidities. The overwhelming majority (90.9%) were asymptomatic or with minimal symptoms, with 2.0% having severe or critical illness. Presence of hypertension or diabetes were associated with a higher risk of severe or critical illness. Seven deaths were observed during the time interval studied. The epidemiologic curve indicated two distinct patterns of infection, a larger cluster among expatriate craft and manual workers, and a smaller one among Qatari nationals returning from abroad during the epidemic.

Conclusion
COVID-19 infections in Qatar started in two distinct clusters, but then became more widespread in the population through community transmission. Infections were mostly asymptomatic or with minimal symptoms and associated with very low mortality. Severe/critical illness was associated with presence of hypertension or diabetes.
Utrametric diffusion model for spread of covid-19 in socially clustered population: Can herd immunity be approached in Sweden?
Authors: Khrennikov Andrei
Published: July 2020

We present a new mathematical model of disease spread reflecting specialties of covid-19 epidemic by elevating the role social clustering of population. The model can be used to explain slower approaching herd immunity in Sweden, than it was predicted by a variety of other mathematical models; see graphs Fig. 2. The hierarchic structure of social clusters is mathematically modeled with ultrametric spaces having treelike geometry. To simplify mathematics, we consider homogeneous trees withp-branches leaving each vertex. Such trees are endowed with algebraic structure, thep-adic number fields. We apply theory of thep-adic diffusion equation to describe coronavirus’ spread in hierarchically clustered population. This equation has applications to statistical physics and microbiology for modelingdynamics on energy landscapes. To move from one social cluster (valley) to another, the virus (its carrier) should cross a social barrier between them. The magnitude of a barrier depends on the number of social hierarchy’s levels composing this barrier. As the most appropriate for the recent situation in Sweden, we considerlinearly increasing barriers. This structure matches with mild regulations in Sweden. The virus spreads rather easily inside a social cluster (say working collective), but jumps to other clusters are constrained by social barriers. This behavior matches with the covid-19 epidemic, with its cluster spreading structure. Our model differs crucially from the standard mathematical models of spread of disease, such as the SIR-model. We present socio-medical specialties of the covid-19 epidemic supporting our purely diffusional model.
Graduate students significantly more concerned than undergraduates about returning to campus in the era of COVID-19
Authors: Ebell Mark H. , Bierema Laura , Haines Lauren
Published: July 2020

Introduction

As students return to colleges and universities in the fall of 2020, it is important to understand their perception of risk and their desire for in person versus online learning, which may differ between undergraduate and graduate students.

Methods

We anonymously surveyed 212 undergraduate and 134 graduate students in the College of Public Health, and 94 graduate students in the College of Education in late June, 2020. We asked them Likert style questions regarding their comfort returning to campus and their preferred learning strategies once back. We compared “Strongly agree/Agree” with “Neutral/Disagree/Strongly disagree” using a chi-square test.

Results

Graduate students were significantly less likely to look forward to being on campus (38.3% doctoral vs 40.6% master’s vs 77.7% undergraduate, p < 0.001), more likely to perceive themselves as high risk (43.3% doctoral vs 40.0% masters vs 17.5% undergraduate, p < 0.001), and were more likely to prefer all classwork online (66.7% doctoral vs 44.6% master’s vs 20.8% undergraduate, p < 0.001). Graduate students were also less likely to prefer to be in the classroom as much as possible in the fall (59.2% doctoral vs 67.7% master’s vs 74.5% undergraduate, p < 0.001). Most were not concerned about their ability to conduct research. Students generally supported wearing of facemasks indoors.

Conclusions

There are important differences in perception of risk and desire for online versus in-person learning between undergraduate and graduate students. Faculty and administrators must acknowledge and address these differences as they prepare for return to campus in the fall.
Retrieving the configuration of grain boundary structure in polycrystalline materials by extraordinary X-ray reflection analysis
Authors: Aarão-Rodrigues Lorena , Isaac Augusta , Figueiredo Roberto B. , Malachias Angelo
Published: July 2020

The development of materials is strongly related to our capability of understanding thermal, mechanical and chemical processing on the nanoscale. Unravelling the interface structure is crucial for opening new regimes in property–performance space. Interface arrangements have been characterized by statistically limited microscopy techniques. In this work, a large-angular-range detector was used for synchrotron diffraction measurements on commercially pure Mg. Long acquisitions allowed the retrieval of preferred interface configurations through the observation of extraordinary diffraction peaks located close to the Mg 102, 200, 204 and 300 fundamental reflections. A kinematical simulation scanning possible interface structures established the correspondence of the non-bulk peaks to the interfacial organization of atoms that may be responsible for their appearance. Simulated interfaces were probed for a wide range of angular displacements with respect to the main cleavage planes. The results indicate configurations that allow the observation of X-ray diffraction, representing a long-range-ordered pattern of atomic distributions in Mg. The introduced methodology allows for nondestructive monitoring of systems that undergo processes that modify grain sizes and grain-interface orientation.
Investigation of cotton fabric composites as a natural radar-absorbing material
Authors: Ayan Muhammet Çağrı , Kiriş Serap , Yapici Ahmet , Karaaslan Muharrem , Akgöl Oğuzhan , Altıntaş Olcay , Ünal Emin
Published: July 2020

Purpose

The purpose of this paper is to investigate cotton fabric behavior that is exposed to radar waves between selected operation frequencies as an alternative radar-absorbing material (RAM) response. Cotton fabric biocomposite materials were compared with carbon fabric composite materials, which are good absorbers, in terms of mechanical and electromagnetic (EM) properties for that purpose.

Design/methodology/approach

The laminated composite plates were manufactured by using a vacuum infusion process. The EM tests were experimentally performed with a vector network analyzer to measure reflection, transmission and absorption ability of cotton fabric, carbon fabric and cotton–carbon fabric (side by side) composite plates between 3 and 18 GHz. The tensile and low-velocity impact tests were carried out to compare the mechanical properties of cotton fabric and carbon fabric composite plates. A scanning electron microscope was used for viewing the topographical features of fracture surfaces.

Findings

The cotton fabric composite plate exhibits low mechanical values, but it gives higher EM wave absorption values than the carbon fabric composite plate in certain frequency ranges. Comparing the EM absorption properties of the combination of cotton and carbon composites with those of the carbon composite alone, it appears that the cotton–carbon combination can be considered as a better absorber than the carbon composite in a frequency range from 12 to 18 GHz at Ku band.

Originality/value

This paper shows how cotton, which is a natural and easily supplied low-cost raw material, can be evaluated as a RAM.
Close knit: using consumption communities to overcome loneliness
Authors: O Sullivan Máire , Richardson Brendan
Published: July 2020

Purpose

This paper aims to highlight the role of consumption communities as a self-help support group to ameliorate loneliness. The authors suggest that the self-help element of consumption communities has been overlooked because of a focus on communities pursuing hegemonic masculinity. Instead, the authors focus on a female-led and – dominated consumption community.

Design/methodology/approach

A longitudinal ethnography was undertaken with the aim of understanding consumer behaviour in a “hyper-feminine” environment. Participant observation, depth interviews and netnography were carried out over five years within the Knitting community, focussing on an Irish Stitch ‘n’ Bitch group.

Findings

A dimension of consumption communities has been overlooked in the extant literature; this female-led and -dominated community functions as a self-help support group used as a “treatment” for loneliness. It also demonstrates all the characteristics of a support group.

Research limitations/implications

This study offers a framework with which new studies of community consumption can be examined or existing studies can be re-examined, through rather than cases of loneliness and self-help support groups.

Practical implications

Marketers have an opportunity to build supportive consumption communities that provide a safe space for support where commerce and brand-building can also occur. Groups aimed at ameliorating loneliness may wish to consider integration of the consumption community model.

Originality/value

Calls have been made for a reconceptualisation of consumption communities as current typologies seem inadequate. This paper responds with a critical examination through the lens of the self-help support group, while also taking steps towards resolving the gender imbalance in the consumption community literature. The paper explores loneliness, a previously underexamined motivator for consumption community membership.
RepGrid: a new way of identifying and assessing teaching competency
Authors: Srivastava Praveen Kumar , Gupta Manish , Jaiswal Bhavna
Published: July 2020

Purpose

This study illustrates the use of the repertory grid in identifying and assessing effective teaching competencies.

Design/methodology/approach

The data were collected from two subsamples that consist of business management students and engineering students. The systematic repertory grid (RepGrid) method was performed to identify broad effective teaching competencies.

Findings

Broad effective teaching competencies found in the study include teaching approach, behavioral orientation, subject expertise, and communication skills among others.

Research limitations/implications

Interestingly, the responses of the subsamples differ in the competencies identified and the weights assigned to a particular competency. Further, the results indicate the importance of having a “context” and thereby challenge the concept of generic teaching competencies.

Practical implications

The universities are encouraged to use RepGrid technique to assess effective teaching competencies of their faculty members.

Originality/value

The techniques for developing teaching competency models by some prior studies have several inherent flaws including the efficiency and effectiveness of data collection. The study takes forward the suggestions of scholars to use a rigorous technique, repertory grid, to overcome several of these flaws to a large extent.