bluuebunny/crossref_metadata_2025 huggingface dataset:
Service Providers’ Influence in Collaborative Governance Networks: Effectiveness in Reducing Chronic Homelessness
Authors: Mosley Jennifer E , Park Sunggeun
Published: May 2021

In fragmented policy areas, collaboration between government entities and nonprofit providers is thought to promote knowledge sharing and reinforce mutual accountability, hopefully improving performance. The popularity of this trend is matched only by the difficulties in actually meeting these multiplex goals. This is partly because there are both process (e.g., engagement and mutual learning) and outcome (e.g., effectiveness) goals that can work at cross-purposes. In this article, we use longitudinal data from a specific collaborative governance model—Housing and Urban Development (HUD) Homeless Continuums of Care (CoCs)—to investigate the relationship between meaningful inclusion of nonprofit service providers in the network and a valued outcome: reducing regional chronic homelessness. Specifically, we use structural equation modeling to assess the degree to which provider influence and local government support play mediating roles between network governance structure, growth in federal resource munificence, and reductions in chronic homeless. Combining HUD administrative data and data from a national survey of the population of CoCs (N = 313, 75% response rate), we find that while both (1) provider influence in decision-making and (2) federal funding growth are directly associated with reductions in chronic homelessness, provider influence also serves as an important mediator in the relationships between network governance structure, federal funding growth, and reductions in chronic homelessness. Qualitative case examples are then used to demonstrate how these trends are experienced in practice. Overall, we argue that collaborative governance can best improve client outcomes when it is truly collaborative and providers are given meaningful ways to engage with and influence the process.
Systematic Review: Diabetes Family Conflict in Young People With Type 1 Diabetes
Authors: Hickling Anna , Dingle Genevieve A , Barrett Helen L , Cobham Vanessa E
Published: May 2021

Objective

To investigate the relationships between diabetes-specific family conflict and health outcomes of young people with type 1 diabetes (T1D).

Methods

A systematic review was performed according to the PRISMA statement (registration number: CRD42020164988). PubMed, Embase, PsycNET, reference lists of included studies, and other relevant reviews were searched (1990–2020). Two independent reviewers screened titles, abstracts, and full-texts. Studies were included if they sampled young people with T1D (mean age between 14 and 25 years) and examined the relationship between diabetes-specific family conflict and the following outcomes: glycated hemoglobin (HbA1c), treatment adherence, blood glucose monitoring, depression, anxiety, quality of life, and/or well-being.

Results

A total of 20 studies met the predetermined inclusion criteria. Greater diabetes-specific family conflict was significantly related to higher HbA1c values in 17 studies. Seven studies reported a significant association between greater diabetes family conflict and suboptimal treatment adherence and/or less frequent blood glucose monitoring. However, significant relationships between conflict and HbA1c and/or treatment adherence were not found in four studies. Seven studies in total reported that greater diabetes family conflict was significantly related to poorer quality of life or well-being and greater depressive and/or anxiety symptoms in young people.

Conclusions

Diabetes-specific family conflict is associated with some adverse health outcomes for young people with T1D. However, more longitudinal studies of young people aged older than 16 years are needed. Screening for and addressing diabetes-specific family conflict is recommended, given the growing number of studies linking family conflict to various adverse health outcomes in young people with T1D.
Do Inattention/Hyperactivity and Motor Timing Predict Children’s Virtual Road-Crossing Performance?
Authors: Parr Morgan N D , Tang Hanxi , Mallaro Sophia R , Kearney Joseph K , Plumert Jodie M
Published: May 2021

Objective

The goal of this investigation was to examine how individual variation in inattention and hyperactivity is related to motor timing difficulties and whether children’s performance on simple laboratory timing tasks is related to their performance on a virtual road-crossing task using a head-mounted virtual reality display system.

Methods

Participants were a community sample of 92 9- to 11-year-old children. Parents completed questionnaires assessing their child’s inattention and hyperactivity. Children completed two simple motor timing tasks (duration discrimination and synchronization-continuation) and crossed roads with continuous traffic in a head-mounted VR system.

Results

Higher parent-reported inattention and hyperactivity predicted poorer performance in the duration discrimination and synchronization-continuation tasks, but not the virtual pedestrian road-crossing task. Children with higher tap onset asynchrony in the synchronization-continuation task had poorer timing of entry into the gap in the virtual pedestrian road-crossing task.

Conclusions

The findings provide further evidence that timing deficits are associated with individual differences in inattention and hyperactivity and that timing difficulties may be a risk factor for functional difficulties in everyday life.
Magnetic chemically peculiar stars investigated by the Solar Mass Ejection Imager
Authors: Paunzen E , Supíková J , Bernhard K , Hümmerich S , Prišegen M
Published: May 2021

Since the discovery of the spectral peculiarities of their prototype α2 Canum Venaticorum in 1897, the so-called ACV variables, which are comprised of several groups of chemically peculiar stars of the upper main sequence, have been the target of numerous photometric and spectroscopic studies. Especially for the brighter ACV variables, continuous observations over about a century are available, which are important to study long-term effects such as period changes or magnetic cycles in these objects. This work presents an analysis of 165 Ap/CP2 and He-weak/CP4 stars using light curves obtained by the Solar Mass Ejection Imager (SMEI) between the years 2003 and 2011. These data fill an important gap in observations for bright ACV variables between the Hipparcos and TESS satellite missions. Using specifically tailored data treatment and period search approaches, we find variability in the accuracy limit of the employed data in 84 objects. The derived periods are in excellent agreement with the literature; for one star, the here presented solution represents the first published period. We discuss the apparently constant stars and the corresponding level of non-variability. From an investigation of our target star sample in the Hertzsprung–Russell diagram, we deduce ages between 100 Myr and 1 Gyr for the majority of our sample stars. Our results support that the variable CP2/4 stars are in a more advanced evolutionary state and that He and Si peculiarities, preferentially found in the hotter, and thus more massive, CP stars, produce larger spots or spots of higher contrast.
Molecular line ratio diagnostics and gas kinematics in the AGN host Seyfert galaxy NGC 5033
Authors: Topal Selçuk
Published: May 2021

Multiple molecular lines are useful for studying the physical properties of multiphase star-forming gas in different types of galaxies. We probe the molecular gas throughout the disc of the spiral galaxy NGC 5033, hosting an active galactic nucleus (AGN), using multiple low-J CO lines [12CO(1–0, 2–1, 3–2 and 13CO(1–0, 2–1)] and dense gas tracers [HCN(1–0) and HCO+(1–0)]. First, we determine the ratios of the integrated intensity maps and the ratio of intensities in position velocity diagrams. Secondly, we obtain the ratios of CO lines and high-density tracers at the centre; and thirdly, we model these line ratios using a radiative transfer code. Line ratio diagnostics reveal that the south of the gaseous disc contains cooler gas than the northern part, and the centre hosts warmer and less tenuous gas with a similar dense gas fraction compared to most galaxies of similar type. Our model results mostly agree with the empirical ones in the sense that the central region of NGC 5033 harbours warmer gas than that in the centres of normal spirals and lenticulars without showing AGN activity. Finally, the beam-averaged total molecular gas mass and gas surface density along the galaxy’s major axis show a radial gradient, i.e. increasing from the outskirts up to the central region of size 1 kpc where there is a depression in both gas mass and surface density.
Optical spectral characterization of the gamma-ray blazars S4 0954+65, TXS 1515−273, and RX J0812.0+0237
Authors: González J Becerra , Acosta-Pulido J A , Boschin W , Clavero R , Otero-Santos J , Carballo-Bello J A , Domínguez-Palmero L
Published: May 2021

The study of gamma-ray blazars is usually hindered due to the lack of information on their redshifts and on their low-energy photon fields. This information is key to understand the effect on the gamma-ray absorption due to either extragalactic background light and/or intrinsic absorption and emission processes. All this information has also an impact on the determination of the location of the emitting region within the relativistic jets. In this work, a new optical spectroscopic characterization is presented for three gamma-ray blazars: S4 0954+65, TXS 1515−273, and RX J0812.0+0237. For all the three targets, the redshift determination is successful, and for the first time in the case of TXS 1515−273 and RX J0812.0+0237. Their classification as BL Lac type is confirmed based on these new optical spectra. For S4 0954+65 (z = 0.3694 ± 0.0011), an estimation on the disc, broad-line region, and torus luminosities is performed based on the observed optical emission lines. The results from this study are compatible with the nature of S4 0954+65 as a transitional blazar. In the case of TXS 1515−273 (z = 0.1281 ± 0.0004), although its optical spectrum is dominated by the continuum emission from the jet, applying the pPXF technique, the stellar population can be unveiled and is compatible with an old and metallic population. It is also the case of RX J0812.0+0237 (z = 0.1721 ± 0.0002). Moreover, this work confirms that the optical spectrum from RX J0812.0+0237 is compatible with an extreme blazar classification.
Secular dynamics of binaries in stellar clusters – III. Doubly averaged dynamics in the presence of general-relativistic precession
Authors: Hamilton Chris , Rafikov Roman R
Published: May 2021

Secular evolution of binaries driven by an external (tidal) potential is a classic astrophysical problem. Tidal perturbations can arise due to an external point mass, as in the Lidov–Kozai (LK) theory of hierarchical triples, or due to an extended stellar system (e.g. galaxy or globular cluster) in which the binary resides. For many applications, general-relativistic (GR) apsidal precession is important, and has been accounted for in some LK calculations. Here, we generalize and extend these studies by exploring in detail the effect of GR precession on (quadrupole-level) tidal evolution of binaries orbiting in arbitrary axisymmetric potentials (which includes LK theory as a special case). We study the (doubly averaged) orbital dynamics for arbitrary strengths of GR and binary initial conditions and uncover entirely new phase space morphologies with important implications for the binary orbital evolution. We also explore how GR precession affects secular evolution of binary orbital elements when the binary reaches high eccentricity (e → 1) and delineate several different dynamical regimes. Our results are applicable to a variety of astrophysical systems. In particular, they can be used to understand the high eccentricity behaviour of (cluster) tide-driven compact object mergers – i.e. LIGO/Virgo gravitational wave sources – for which GR effects are crucial.
Rosella: a mock catalogue from the P-Millennium simulation
Authors: Gaines Sasha , Norberg Peder , Cole Shaun
Published: May 2021

The scientific exploitation of the Dark Energy Spectroscopic Instrument Bright Galaxy Survey (DESI BGS) data requires the construction of mocks with galaxy population properties closely mimicking those of the actual DESI BGS targets. We create a high-fidelity mock galaxy catalogue, including information about galaxies and their host dark matter subhaloes. The mock catalogue uses subhalo abundance matching with scatter to populate the P-Millennium N-body simulation with galaxies at the median BGS redshift of ∼0.2, using formation redshift information to assign 0.1(g − r) rest-frame colours. The mock provides information about r-band absolute magnitudes, 0.1(g − r) rest-frame colours, and 3D positions and velocities of a complete sample of DESI BGS galaxies in a volume of (542 Mpc h−1)3, as well as the masses of host dark matter haloes. This P-Millennium DESI BGS mock catalogue is ideally suited for the tuning of approximate mocks unable to resolve subhaloes that DESI BGS galaxies reside in, to test for systematics in analysis pipelines and to interpret (non-cosmological focused) DESI BGS analysis.
The first measurement of the quasar lifetime distribution
Authors: Khrykin Ilya S , Hennawi Joseph F , Worseck Gábor , Davies Frederick B
Published: May 2021

Understanding the growth of the supermassive black holes (SMBH) powering luminous quasars, their co-evolution with host galaxies, and impact on the surrounding intergalactic medium (IGM) depends sensitively on the duration of quasar accretion episodes. Unfortunately, this time-scale, known as the quasar lifetime, tQ, is still uncertain by orders of magnitude ($t_{\rm Q} \simeq 0.01\, {\rm Myr} - 1\, {\rm Gyr}$). However, the extent of the He ii Ly α proximity zones in the absorption spectra of zqso ∼ 3–4 quasars constitutes a unique probe, providing sensitivity to lifetimes up to ∼30 Myr. Our recent analysis of 22 archival Hubble Space Telescope He ii proximity zone spectra reveals a surprisingly broad range of emission time-scales, indicating that some quasars turned on ≲1 Myr ago, whereas others have been shining for ≳30 Myr. Determining the underlying quasar lifetime distribution (QLD) from proximity zone measurements is a challenging task owing to: (1) the limited sensitivity of individual measurements; (2) random sampling of the quasar light curves; (3) density fluctuations in the quasar environment; and (4) the inhomogeneous ionization state of He ii in a reionizing IGM. We combine a seminumerical He ii reionization model, hydrodynamical simulations post-processed with ionizing radiative transfer, and a novel statistical framework to infer the QLD from an ensemble of proximity zone measurements. Assuming a lognormal QLD, we infer a mean $\langle {\rm log}_{10}(t_{\rm Q} / {\rm Myr})\rangle = 0.22^{+0.22}_{-0.25}$ and standard deviation $\sigma _{{\rm log}_{10}t_{\rm Q}} = 0.80^{+0.37}_{-0.27}$. Our results allow us to estimate the probability of detecting very young quasars with tQ ≤ 0.1 Myr from their proximity zone sizes yielding $p ({\le}0.1\, {\rm Myr}) = 0.19^{+0.11}_{-0.09}$, which is broadly consistent with recent determination at z ∼ 6.
eVITTA: a web-based visualization and inference toolbox for transcriptome analysis
Authors: Cheng Xuanjin , Yan Junran , Liu Yongxing , Wang Jiahe , Taubert Stefan
Published: May 2021

Transcriptome profiling is essential for gene regulation studies in development and disease. Current web-based tools enable functional characterization of transcriptome data, but most are restricted to applying gene-list-based methods to single datasets, inefficient in leveraging up-to-date and species-specific information, and limited in their visualization options. Additionally, there is no systematic way to explore data stored in the largest transcriptome repository, NCBI GEO. To fill these gaps, we have developed eVITTA (easy Visualization and Inference Toolbox for Transcriptome Analysis; https://tau.cmmt.ubc.ca/eVITTA/). eVITTA provides modules for analysis and exploration of studies published in NCBI GEO (easyGEO), detailed molecular- and systems-level functional profiling (easyGSEA), and customizable comparisons among experimental groups (easyVizR). We tested eVITTA on transcriptomes of SARS-CoV-2 infected human nasopharyngeal swab samples, and identified a downregulation of olfactory signal transducers, in line with the clinical presentation of anosmia in COVID-19 patients. We also analyzed transcriptomes of Caenorhabditis elegans worms with disrupted S-adenosylmethionine metabolism, confirming activation of innate immune responses and feedback induction of one-carbon cycle genes. Collectively, eVITTA streamlines complex computational workflows into an accessible interface, thus filling the gap of an end-to-end platform capable of capturing both broad and granular changes in human and model organism transcriptomes.
Functional characterization of RebL1 highlights the evolutionary conservation of oncogenic activities of the RBBP4/7 orthologue in Tetrahymena thermophila
Authors: Nabeel-Shah Syed , Garg Jyoti , Saettone Alejandro , Ashraf Kanwal , Lee Hyunmin , Wahab Suzanne , Ahmed Nujhat , Fine Jacob , Derynck Joanna , Pu Shuye , Ponce Marcelo , Marcon Edyta , Zhang Zhaolei , Greenblatt Jack F , Pearlman Ronald E , Lambert Jean-Philippe , Fillingham Jeffrey
Published: May 2021

Retinoblastoma-binding proteins 4 and 7 (RBBP4 and RBBP7) are two highly homologous human histone chaperones. They function in epigenetic regulation as subunits of multiple chromatin-related complexes and have been implicated in numerous cancers. Due to their overlapping functions, our understanding of RBBP4 and 7, particularly outside of Opisthokonts, has remained limited. Here, we report that in the ciliate protozoan Tetrahymena thermophila a single orthologue of human RBBP4 and 7 proteins, RebL1, physically interacts with histone H4 and functions in multiple epigenetic regulatory pathways. Functional proteomics identified conserved functional links for Tetrahymena RebL1 protein as well as human RBBP4 and 7. We found that putative subunits of multiple chromatin-related complexes including CAF1, Hat1, Rpd3, and MuvB, co-purified with RebL1 during Tetrahymena growth and conjugation. Iterative proteomics analyses revealed that the cell cycle regulatory MuvB-complex in Tetrahymena is composed of at least five subunits including evolutionarily conserved Lin54, Lin9 and RebL1 proteins. Genome-wide analyses indicated that RebL1 and Lin54 (Anqa1) bind within genic and intergenic regions. Moreover, Anqa1 targets primarily promoter regions suggesting a role for Tetrahymena MuvB in transcription regulation. RebL1 depletion inhibited cellular growth and reduced the expression levels of Anqa1 and Lin9. Consistent with observations in glioblastoma tumors, RebL1 depletion suppressed DNA repair protein Rad51 in Tetrahymena, thus underscoring the evolutionarily conserved functions of RBBP4/7 proteins. Our results suggest the essentiality of RebL1 functions in multiple epigenetic regulatory complexes in which it impacts transcription regulation and cellular viability.
Renal dysfunction and podocyturia in pre-eclampsia may be explained by increased urinary VEGF
Authors: Valsecchi Luca , Galdini Alessandro , Gabellini Daniela , Dell’Antonio Giacomo , Galbiati Silvia , Fanecco Andrea , Viganò Ilaria , Smid Maddalena , Bernardi Rosa , Maestroni Silvia , Baelde Hans J , Zerbini Gianpaolo
Published: May 2021

Background

Pre-eclampsia has a major impact on renal function as shown by the development of proteinuria and podocyturia. How the systemic, soluble Fms-like tyrosine kinase-1 (sFlt-1)-driven inhibition of vascular endothelial growth factor (VEGF) activity detected in pre-eclampsia directly affects renal function remains unknown. The aim of the study was to clarify whether a non-canonical, renal-centred escape from VEGF inhibition in the case of pre-eclamptic pregnancy might have a direct impact on renal function.

Methods

We evaluated plasma and urinary VEGF and placental growth factor (PlGF), plasma sFlt-1 and carbonic anhydrase IX (CAIX), albuminuria and podocyturia in 18 women with uncomplicated pregnancy, 21 with pre-eclampsia and 18 non-pregnant. The three groups were matched for age and the pregnant groups also for gestational age at enrolment.

Results

Plasma VEGF was reduced in uncomplicated (P = 0.001) and pre-eclamptic (P = 0.0003) pregnancies when compared with controls. In uncomplicated pregnancy, the dysfunction was balanced by an increase (P = 0.009) of plasma PlGF. Increased (P = 0.0001) plasma CAIX in pre-eclampsia was in line with hypoxia. Pre-eclampsia resulted in a paradoxical increase (P = 0.0004) of urinary excretion of VEGF. Urinary concentrations of VEGF and podocytes were correlated to each other (r2 = 0.48, P < 0.0005) but also to plasma sFlt-1 (r2 = 0.56, P < 0.0001 and r2 = 0.23, P = 0.03, respectively).

Conclusions

In the case of pre-eclampsia, the systemic VEGF inhibition leads the kidney, possibly the podocyte, to increase the VEGF synthesis. The mechanisms leading to local VEGF overproduction or the overproduced VEGF itself are reasonably involved in the pathogenesis of podocyturia and, as a consequence, renal dysfunction in pre-eclampsia.
Professional and Ethical Issues in United States Acute Care Physical Therapists Treating Patients With COVID-19: Stress, Walls, and Uncertainty
Authors: Ditwiler Rebecca E , Swisher Laura L , Hardwick Dustin D
Published: May 2021

Objective

To the authors' knowledge, no peer-reviewed research has explored professional and ethical issues encountered by physical therapists in treating patients with COVID-19. The purpose of this study was to explore the experiences of physical therapists regarding the professional and ethical issues they encountered during the COVID-19 pandemic.

Methods

The current study used reflexive thematic analysis, a qualitative research design developed by Braun and Clarke, to analyze individual interviews.

Results

Analysis of the coded interviews produced 6 primary themes (uncertainty, physical therapist’s role, ethical dilemmas and moral distress, emotions, providing care and working conditions, and management and leadership influence) and associated subthemes.

Conclusion

Physical therapists reported numerous professional and ethical issues across the individual, organizational, and societal realms during the COVID-19 pandemic. This study highlights the need for education and resources to prepare physical therapists for professional and ethical issues encountered during pandemics. Specifically, there is a need to define the physical therapist’s role in pandemics and prepare physical therapy personnel for dealing with ethical issues, stress, uncertainty, and organizational changes associated with pandemics. Ethical guidelines would support organizations in delineating fair processes for triage and allocation of scarce resources for acute care physical therapy during health care emergencies.

Impact

The COVID-19 pandemic has produced significant changes in health care and physical therapist practice. This study reports results of the first, to our knowledge, research study focusing on professional and ethical issues experienced by physical therapists in acute care during the COVID-19 pandemic. As the United States faces an unprecedented spike in COVID-19 cases and deaths, results of this study may contribute to physical therapists’ preparation for and response to professional and ethical issues encountered in acute care during the pandemic.
Occurrence of Canker and Wood Rot Pathogens on Stone Fruit Propagation Material and Nursery Trees in the Western Cape of South Africa
Authors: van der Merwe Rhona , Halleen Francois , van Dyk Meagan , Jacobs Vernon Guy , Mostert Lizel
Published: May 2021

Dieback and canker of young stone fruit trees can cause suboptimal growth and even death under severe conditions. One source of inoculum of canker pathogens could be through nursery trees harboring latent infections that would not be visible to inspections done according to the deciduous fruit scheme. The objectives of this study were to identify the canker and wood rot fungal pathogens present in nursery stone fruit trees as well as in propagation material and to evaluate their pathogenicity. Isolations were made from scion and rootstock propagation material and from certified nursery stone fruit trees. The plant material sampled did not have any external symptoms. The certified nursery trees when cross-sectioned displayed brown discoloration from the pruning wound, the bud union, and often the crown. Fungal species isolated were identified by sequencing of the relevant barcoding genes and phylogenetic analyses thereof. Canker- and wood rot-associated fungi were identified. Buds used for budding had low levels of infection, with 1.2% of dormant buds infected and 0.4% of green buds infected. The dormant rootstock shoots had a canker pathogen incidence of 6.2% before they were planted in the nursery fields and increased inasmuch as the ungrafted, rooted rootstock plants had 11.1% infection with canker and wood rot pathogens. Out of 1,080 nursery trees, the canker- and wood rot-associated fungi infected 21.8% of trees. The canker-causing pathogens that were isolated the most were Cadophora luteo-olivacea and Diplodia seriata. A low incidence of wood rot fungi was found, with only 1.5% of nursery trees infected. In total, 26 new reports of fungal species on stone fruit in South Africa were made. Of these, 22 have not been found on stone fruit worldwide. The pathogenicity trials’ results confirmed the pathogenic status of these newly reported species. All of the isolates tested formed lesions significantly longer than the control, 4 months after wound inoculation of 2-year-old shoots of two plum orchards. Lasiodiplodia theobromae was the most virulent species on both plum cultivars. The results of this research showed that nursery stone fruit trees and propagation material can harbor latent infections. Different management practices need to be evaluated to prevent these infections to ensure healthier stone fruit nursery trees.
Highly Sensitive and Rapid Detection of Citrus Huanglongbing Pathogen (‘Candidatus Liberibacter asiaticus’) Using Cas12a-Based Methods
Authors: Wheatley Matthew S. , Duan Yong-Ping , Yang Yinong
Published: May 2021

Citrus huanglongbing (HLB) or greening is one of the most devastating diseases of citrus worldwide. Sensitive detection of its causal agent, ‘Candidatus Liberibacter asiaticus’ (CLas), is critical for early diagnosis and successful management of HLB. However, current nucleic acid–based detection methods are often insufficient for the early detection of CLas from asymptomatic tissue and unsuitable for high-throughput and field-deployable diagnosis of HLB. Here we report the development of the Cas12a-based DNA endonuclease-targeted CRISPR trans reporter (DETECTR) assay for highly specific and sensitive detection of CLas nucleic acids from infected samples. The DETECTR assay, which targets the five-copy nrdB gene specific to CLas, couples isothermal amplification with Cas12a transcleavage of a fluorescent reporter oligonucleotide and enables detection of CLas nucleic acids at the attomolar level. The DETECTR assay was capable of specifically detecting the presence of CLas across different infected citrus, periwinkle, and psyllid samples and shown to be compatible with lateral flow assay technology for potential field-deployable diagnosis. The improvements in detection sensitivity and flexibility of the DETECTR technology position the assay as a potentially suitable tool for early detection of CLas in infected regions.
Management of Vancouver B2 Periprosthetic Femoral Fractures, Revision Total Hip Arthroplasty Versus Open Reduction and Internal Fixation: A Systematic Review and Meta-Analysis
Authors: Lewis Daniel P. , Tarrant Seth M. , Cornford Lachlan , Balogh Zsolt J.
Published: May 2021

Objective:

To identify and analyze the current evidence for the use of open reduction and internal fixation (ORIF) constructs compared with conventional revision total hip arthroplasty (rTHA) for the management of Vancouver B2 periprosthetic femoral fractures (PFFs).

Data Sources:

A systematic literature search of the MEDLINE, CINAHL, and EMBASE databases was conducted. Prospective and retrospective studies were eligible. No limitation was placed on publication date, with only articles printed in English eligible.

Study Selection:

Included studies were retrospective studies comparing ORIF and rTHA for the management of Vancouver B2 PFFs.

Data Extraction:

The primary outcome was the overall complication rate. Other outcomes included as rate of dislocation, revision operation, refracture, infection, nonunion, and subsidence/loosening. Twenty-four studies were included totaling 1621 patients, of which 331 were treated with ORIF and 1280 with rTHA.

Conclusion:

The 1621 patients included comprised a mixture of different fracture patterns, prostheses, and patient comorbidities. The overall complication rate for ORIF was 24% versus 18% for rTHA (P = 0.13). The results demonstrate that rTHA has a similar revision rate to ORIF in PFFs with a loose femoral component and adequate bone stock. ORIF was superior to rTHA in prevention of postoperative dislocation; however, there was no difference between other complications. This review suggests a potential role of both ORIF and rTHA in the management of Vancouver B2 PFFs.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Clinical and Functional Outcomes Following Modified Intervastus Approach
Authors: Sartawi Muthana , Rahman Hafizur , Kohlmann James
Published: May 2021

Background:

The modified intervastus (MIV) approach is a new muscle and tendon sparing approach to the knee that is easy to perform and compatible with more extensile approaches such as a quadriceps snip. The study reports the clinical and functional outcomes of patients undergoing total knee arthroplasty (TKA) using the MIV approach. These results will be compared with published results of TKA done utilizing the subvastus approach.

Methods:

A total of 84 patients underwent TKA using the MIV approach from 2017 to 2019. Clinical and functional outcomes were assessed by recording the knee injury and osteoarthritis outcomes score, visual analog scale for pain, and knee range of motion (ROM). Outcome data was collected preoperatively, on the day of surgery, and postoperatively at 2, 6 weeks, 3, 6 months, 1, and 2 years. Paired sample t tests were conducted to assess the statistical significance observed in the outcomes between different time intervals.

Results:

All patients were able to walk on the day of surgery. The knee ROM increased significantly by 2 weeks after surgery (9.36%) and a net improvement for knee ROM of 37.89% was observed by the end of 2 years (P<0.001). Knee injury and osteoarthritis outcomes score improved by 226.35% and visual analog scale for pain decreased by 82.34% following 2 years of surgery (Ps<0.001).

Conclusion:

The study reports impressive clinical and functional outcomes using the MIV approach. The approach is safe and affords adequate exposure for the majority of primary TKA cases.
Exploring the Experiences of Families of Latino Children Newly Diagnosed With Autism Spectrum Disorder
Authors: Coffield Caroline N. , Spitalnik Deborah M. , Harris Jill F. , Jimenez Manuel E.
Published: May 2021

Objective:

Understanding families' experiences from their initial developmental concerns through the first several months after autism spectrum disorder (ASD) diagnosis might help explain persistent disparities in age of diagnosis for low-income Latino children and those whose parents speak a primary language other than English. We explored these experiences among Latino parents of children recently diagnosed with ASD to develop a richer understanding of this critical juncture.

Method:

We conducted semistructured interviews with Latino parents of children diagnosed with ASD in the previous 3 months who were receiving follow-up care through a large, hospital-based outpatient practice. Interviews were recorded, transcribed verbatim, translated, and analyzed using an iterative process.

Results:

Twenty parents participated in a semistructured interview approximately 3 months after their child was diagnosed with ASD. All respondents were female and Latina, 90% spoke Spanish, and 95% of children received Medicaid. We identified the following 3 themes from their experiences: (1) When parents first shared their concerns about their child's development with professionals, they felt unheard. (2) Parents were surprised that the diagnostic process for ASD relied on parental description of child development and behavior and observation of the child, not on medical tests. (3) Receiving an ASD diagnosis was a life-altering event for parents, and how that diagnosis was communicated by clinicians had a significant impact on families.

Conclusion:

Parents of young Latino children identified several barriers throughout the process of ASD identification and diagnosis that have important implications for improving clinician communication with families.
The dual role of ferroptosis in pancreatic cancer: a narrative review
Authors: Tang Daolin , Chen Xin , Comish Paul B. , Kang Rui
Published: May 2021

Pancreatic ductal adenocarcinoma is the main cause of cancer-related mortality, with a lack of effective treatments and overall survival rates far lower than other solid cancers. This clinical challenge is related to late diagnosis as well as primary or acquired resistance to therapy-induced apoptosis. Targeting nonapoptotic cell death pathways may provide alternative therapeutic strategies to overcome drug resistance. In particular, recent studies have suggested that ferroptosis, a type of iron-dependent nonapoptotic cell death, is a promising target for pancreatic ductal adenocarcinoma. Ferroptosis can be triggered by inhibiting or activating the redox or iron metabolism-related pathways, mediated by extrinsic/membrane transports (e.g., solute carrier family 7 member 11) or intrinsic/enzymes (e.g., glutathione peroxidase 4). Although the exact effector molecule remains obscure, reactive oxygen species-induced lipid peroxidation and subsequent plasma membrane damage appears to play a central role in mediating ferroptotic death. While treatment-induced ferroptosis is beneficial to suppress tumor growth, inflammation-related immunosuppression caused by ferroptotic damage may promote the occurrence of pancreatic ductal adenocarcinoma. In this review, we outline the latest knowledge about the regulation and function of ferroptosis in pancreatic tumorigenesis and therapy.
Nonabducent Cranial Neuropathies in Cerebral Venous Sinus Thrombosis
Authors: Nagaraja Nandakumar , Sabu Sibiya
Published: May 2021

Introduction:

Cerebral venous sinus thrombosis (CVST) can rarely present with cranial neuropathies other than abducent nerve palsy. The authors report a case and review the literature for nonabducent cranial neuropathies in CVST.

Case Report:

A 22-year-old woman with a history of oral contraceptive use developed right-sided headache, blurred vision, and dizziness for 4 days. Magnetic resonance venogram showed complete thrombosis of the right transverse sinus, sigmoid sinus, and internal jugular vein, and partial thrombosis of the superior sagittal sinus, left transverse sinus, and superior part of the left internal jugular vein. Hypercoagulable workup revealed heterozygous factor V Leiden mutation. About 2 weeks after symptom onset, she developed right facial droop and left eye ptosis. Examination revealed bilateral papilledema, partial left ptosis, complete right abducent, and right peripheral facial palsies. Acetazolamide 250 mg 2 times per day was initiated for the treatment of headache. Three days after starting acetazolamide left ptosis, right facial and abducent palsies improved that continued to get better with only slight deficits at discharge 4 weeks from symptom onset. Follow-up computed tomography venogram on day 24 showed partial recanalization of CVST.

Conclusion:

A systematic review identified 26 patients from 21 articles with nonabducent cranial neuropathies. Seven patients had lower motor neuron facial palsy, 13 patients had hearing loss or vertigo with vestibulocochlear involvement, and 6 patients had other mixed cranial nerve palsies with CVST. They are usually associated with transverse sinus and/or sigmoid sinus thrombosis. They have a good prognosis with improvement and complete resolution of cranial neuropathies in most cases usually in 1 month.
Concurrent Stroke and Myocardial Infarction After Mild COVID-19 Infection
Authors: Ruiz-Ares Gerardo , Jimenez-Valero Santiago , Fernández-Prieto Andrés , Arbas-Redondo Emilio , Díaz-Pollán Beatriz , Navia Pedro , Meras Pablo , Alonso de Leciñana Maria , de Donebún Jorge R.P. , Rigual Ricardo , Fuentes Blanca , Díez-Tejedor Exuperio
Published: May 2021

Introduction:

The concurrency of both, acute stroke and acute myocardial infarction in normal conditions, outside the pandemic is rare. Coagulopathy has been associated with the inflammatory phase of coronavirus disease (COVID-19) and might be involved in this concurrency.

Cases Report:

We describe 2 patients with previous mild or no symptoms of COVID-19, admitted for acute stroke with recent/simultaneous myocardial infarction in whom admission polymerase chain reaction was negative but serologic testing diagnosed COVID-19. In these patients, concurrent stroke and myocardial infarction could have been promoted by COVID-19 infection. Management and evolution are detailed, and their contacts to confirm the COVID-19 infection. Pathogenic analysis of possible hypercoagulation state is described suggesting the hypothesis of endothelial dysfunction as the strongest mechanism involved in thrombus formation after the acute phase of COVID-19 infection.

Conclusions:

Our experience with these cases suggests that patients with mild symptoms can also present thromboembolic complications once the acute phase of COVID-19 infection has passed.
Aβ-related Angiitis (ABRA)—A Rare Paraneoplastic Cause of Cerebral Vasculitis in a Young Patient
Authors: Rill Constantin , Scheerer Lukas , Iorgu Ana-Maria , Bonmann Eckhard
Published: May 2021

Introduction:

Aβ-related angiitis (ABRA) is a very rare disease entity with combined features of cerebral amyloid angiopathy and primary angiitis of the CNS. However, the pathogenesis has not been conclusively described yet. Interestingly though, a possible paraneoplastic origin has been reported in the past. ABRA leads to severe encephalopathy with a broad spectrum of unspecific neurological symptoms and usually occurs in older patients. Because of the response to immunological treatment, it is important to confirm the diagnosis as fast as possible. Unfortunately, the pathway to a definite diagnosis is often complicated and prolonged.

Case Report:

Here, we describe a 48-year-old-female patient presenting headache, behavioral changes as well as subacute fatigue and epileptic seizures in the recent past. The initial neuroradiological examination demonstrated extended lesions in the left hemisphere compatible with an inflammatory or neoplastic disease. After extensive investigations, initially without a definite result, we finally validated the diagnosis of ABRA by brain biopsy. Shortly afterwards a routine check-up revealed an invasive mammary carcinoma. Owing to a mandatory mastectomy and chemotherapy, an immunosuppressive therapy was not implemented.

Conclusions:

The reported case demonstrates our diagnostic approach and the clinical difficulties in validating a rare cause of encephalopathy in a young patient with nonspecific clinical and neuroradiological findings. Because of the possibility of an effective treatment, it is important to consider ABRA in the differential diagnosis especially when blood tests, analysis of cerebrospinal fluid, and angiography show normal results. Since a paraneoplastic genesis is presumed, a search for an underlying tumor disease should be considered.
Prevalence of postamputation pain and its subtypes: a meta-analysis with meta-regression
Authors: Schwingler Paul M. , Moman Rajat N. , Hunt Christy , Ashmore Zachary , Ogletree Sandra P. , Uvodich Mason E. , Murad M. Hassan , Hooten W. Michael
Published: May 2021

Introduction:

The inconsistent use of standardized approaches for classifying postamputation pain (PAP) has been a barrier to establishing its prevalence.

Objectives:

The primary objective of this systematic review and meta-analysis is to determine the prevalence of nontraumatic lower-extremity PAP using an established taxonomy. The secondary objective is to determine the prevalence of PAP subtypes, including phantom limb pain and residual limb pain (RLP).

Methods:

An a priori protocol was registered, and a database search was conducted by a reference librarian. Randomized trials and uncontrolled studies were eligible for inclusion. The risk of bias was assessed using a tool developed for uncontrolled studies. A total of 2679 studies were screened, and 13 studies met inclusion criteria (n = 1063).

Results:

The sources of risk of bias included selection bias and, to a lesser extent, whether the outcome was adequately ascertained. Two studies reported the prevalence of PAP and the pooled prevalence was 61% (95% confidence interval [CI], 33%–86%) with high heterogeneity (I2 = 93%). Thirteen studies reported the prevalence of phantom limb pain and the pooled prevalence was 53% (95% CI, 40%–66%) with high heterogeneity (I2 = 93%). Eight studies reported the prevalence of RLP and the pooled prevalence was 32% (95% CI 24%–41%) with high heterogeneity (I2 = 76%). Clinical subtypes of RLP were not reported.

Conclusions:

The prevalence of PAP is high in patients with nontraumatic lower-extremity amputations. Ongoing research that uses a taxonomy for PAP is needed to fully delineate the prevalence of PAP subtypes.
Combination of Crossbar and Let-Down Techniques for Dorsal Hump and Septal Correction in Rhinoplasty
Authors: Öztürk Güncel
Published: May 2021

Rhinoplasty is one of the most common and challenging surgeries in aesthetic plastic surgery. Among rhinoplasty operations, dorsal hump reduction and septal deviation surgeries are quite common. In the present research, the author describes new approaches in which let-down and crossbar techniques are used in patients with simultaneous dorsal hump and septal deviation deformations. The records of the patients were accessed from a private practice. According to the inclusion and exclusion criteria, 36 patients were included. Two approaches were defined according to patients' needs. Patients were evaluated using the “Rhinoplasty Outcome Evaluation” (ROE) questionnaire before and 12 months after surgery. The follow-up periods ranged between 14 and 21 months. The ROE scores ranged between 80 and 100 points after 1 year. The initial median ROE score was 55.5, and it increased to 90.5 points at 12 months after surgery (P < 0.001). Patient satisfaction was excellent for 90% of the included patients. The present research is the first to demonstrate the successful results of the combination of crossbar and let-down techniques in patients with septal deviation and nasal hump. Plastic surgeons will be able to solve these challenging problems without relapse with the combination of crossbar and let-down techniques.
Microbe Profile: Aeromonas salmonicida: an opportunistic pathogen with multiple personalities
Authors: Charette Steve J.
Published: May 2021

The bacterial species

Aeromonas salmonicida

is a fish pathogen. Feared by fish farmers everywhere on Earth over the past century, this species has turned out to be more diverse than initially suspected. While some psychrophilic subspecies cannot grow at temperatures above 25 °C or 30 °C, other mesophilic strains growing up to 37 °C and above are now characterized. Adding to the surprising diversity of this species, some of the mesophilic strains infect mammals and birds. The remarkable diversity is explained in part by the presence of numerous mobile genetic elements, which sculpt and modify the genome of the various strains of this species.
Preliminary Immunogenicity of a Pan-COVID-19 T Cell Vaccine in HLA-A*02:01 Mice
Authors: Carter Brandon , Chen Jinjin , Kaseke Clarety , Dimitrakakis Alexander , Gaiha Gaurav D. , Xu Qiaobing , Gifford David K.
Published: May 2021

New strains of SARS-CoV-2 have emerged, including B.1.351 and P.1, that demonstrate increased transmissibility and the potential of rendering current SARS-CoV-2 vaccines less effective. A concern is that existing SARS-CoV-2 spike subunit vaccines produce neutralizing antibodies to three dimensional spike epitopes that are subject to change during viral drift. Here we provide an initial report on the hypothesis that adaptive T cell based immunity may provide a path for a pan-COVID-19 vaccine that is resilient to viral drift. T cell based adaptive immunity can be based on short peptide sequences selected from the viral proteome that are less subject to drift, and can utilize multiple such epitopes to provide redundancy in the event of drift. We find that SARS-CoV-2 peptides contained in a mRNA-LNP T cell vaccine for SARS-CoV-2 are immunogenic in mice transgenic for the human HLA-A*02:01 gene. We plan to test the efficacy of this vaccine with SARS-CoV-2 B.1.351 challenge trials with HLA-A*02:01 mice.
Convergent antibody responses to the SARS-CoV-2 spike protein in convalescent and vaccinated individuals
Authors: Chen Elaine C. , Gilchuk Pavlo , Zost Seth J. , Suryadevara Naveenchandra , Winkler Emma S. , Cabel Carly R. , Binshtein Elad , Sutton Rachel E. , Rodriguez Jessica , Day Samuel , Myers Luke , Trivette Andrew , Williams Jazmean K. , Davidson Edgar , Li Shuaizhi , Doranz Benjamin J. , Campos Samuel K. , Carnahan Robert H. , Thorne Curtis A. , Diamond Michael S. , Crowe James E.
Published: May 2021

Unrelated individuals can produce genetically similar clones of antibodies, known as public clonotypes, which have been seen in responses to different infectious diseases as well as healthy individuals. Here we identify 37 public clonotypes in memory B cells from convalescent survivors of SARS-CoV-2 infection or in plasmablasts from an individual after vaccination with mRNA-encoded spike protein. We identified 29 public clonotypes, including clones recognizing the receptor-binding domain (RBD) in the spike protein S1 subunit (including a neutralizing, ACE2-blocking clone that protectsin vivo), and others recognizing non-RBD epitopes that bound the heptad repeat 1 region of the S2 domain. Germline-revertant forms of some public clonotypes bound efficiently to spike protein, suggesting these common germline-encoded antibodies are preconfigured for avid recognition. Identification of large numbers of public clonotypes provides insight into the molecular basis of efficacy of SARS-CoV-2 vaccines and sheds light on the immune pressures driving the selection of common viral escape mutants.