bluuebunny/crossref_metadata_2025 huggingface dataset:
175Bleeding and cardiovascular risk of New Oral Anti-Coagulants (NOACs) versus warfarin in type 2 diabetes
Authors: Yu Dahai , Brown Julian , Simmons David
Published: September 2021

Background

New oral anticoagulants (NOACs) (vs warfarin) in the general population are associated with 34% less major bleeding events. We compared the risk of bleeding and cardiovascular disease (CVD) events between NOACs and warfarin in people with type 2 diabetes (T2DM).

Methods

Incident NOAC users (cases) and matched controls (incident warfarin users) with T2DM were identified from within 40 UK general practice records (1/4/2017-31/3/2018). Coarsened Exact Matching restricted the comparison to areas of sufficient overlap in characteristics (i-iv) and missingness. Entropy Balancing sequentially balanced NOAC and warfarin users on their distribution of (i) age, sex, general practice, first anticoagulant prescription year, diabetes duration, (ii) body mass index, systolic blood pressure, total cholesterol, HbA1c, (iii) bleeding/CVD history, (iv) treatment (Antiplatelet, Corticosteroids, statins, anti-hypertensives, anti-diabetes treatment number). Continuous covariates were balanced for mean, variance, and skewness. Pre-processing/balancing occurred without reference to outcomes. Multivariable logistic regression modelling estimated bleeding and CVD relative risks (RRs: incident non-elective hospitalisation within 12 months since first anticoagulant prescription), identified from linked hospitalisation data (Secondary Uses Service dataset), using entropy balancing weights from steps i-iv.

Results

The twelve month RRs of bleeding with NOAC (n = 967) vs matched/balanced warfarin (n = 911) were 0.94(0.62-1.45), 0.95(0.62-1.46), 0.98(0.65-1.48) and 0.98(0.67-1.43) through steps i-iv. CVD RR was increased with NOAC treatment through steps i-iv: 1.15(1.00-1.31), 1.22(1.06-1.39), 1.34(1.13-1.60) and 1.43(1.20-1.70).

Conclusion

Among T2DM patients, risk of bleeding among NOAC and warfarin incident users was similar. However, NOAC use significantly increased the risk of CVD events. Further external replication studies are warranted.
1487Biopolitics and Epidemiology during COVID-19 Pandemic
Authors: Zagozdzon Pawel
Published: September 2021

Focus of Presentation

During pandemic the social life has been transformed by new regimes of social distancing, face masks, and altered online education. The aim of this presentation is to review the recent philosophical concepts of biopolitics that bring an additional perspective to the COVID-19 pandemic.

Findings

The most important critical response was brought from the philosopher and cultural theorist Giorgio Agamben who in the book entitled “Where are we now? Epidemic as politics” evoked again, known from his previous writings, the figure of bare life. The epidemic restrictions have shown, that humanity no longer believes in anything but bare existence, to be preserved as such at any cost. There were no reliable risk-benefit analysis that took into account all other aspects of human condition except statistical data on positive test results or “asymptomatic illness”. The concepts of another Italian philosopher Roberto Esposito became more than relevant during pandemic. In his book entitled “Immmunitas: the Protection and Negation of Life” he assumes that the more we feel at risk of being infiltrated and infected by foreign elements, the more the life of the individual and society closes off within its protective boundaries, reminding us of the situations during lockdowns.

Conclusions/Implications

According to biopolitical interpretation of epidemic, the risk of infection can be considered as a “pretext” for ramping up political control on citizens.

Key messages

Epidemiologists should be aware what are the consequences of the decisions they recommended for governments when the social relations and the power structure are affected.
1300Associations between self-reported or measured anthropometric variables and cardiometabolic biomarkers in a Danish cohort
Authors: Zhang Jie , Olsen Anja , Halkjær Jytte , Petersen Kristina Elin Nielsen , Tjønneland Anne , Dahm Christina C
Published: September 2021

Background

It is easy and cost-effective to ask study participants to self-report height and weight and self-reported anthropometry is therefore widely used in epidemiological studies. However, it is questioned to what degree self-reported adiposity indices are a solid proxy of measured indices in terms of estimates of health outcomes. The current study aimed to quantify the agreement between self-reported and measured anthropometrics, including height, weight, body mass index (BMI), weight circumference (WC), and weight-to-height ratio (WHtR) in a contemporary cohort of adults, and to assess whether anthropometric indices misreporting yielded inaccurate estimates of associations with cardiometabolic biomarkers.

Methods

Self-reported and measured anthropometric variables were obtained from the Diet, Cancer, and Health-Next Generation Cohort (n = 39,514). Pearson correlations and Lin’s concordance correlations evaluated the correlation between self-report and measured anthropometrics. Misreporting in relation to age, sex and smoking status was investigated. Multivariable regression models and ROC analyses were used to assess the associations of cardiometabolic biomarkers with self-reported and measured general obesity and abdominal obesity.

Results

Self-reported height was overreported by 1.07 cm, weight was underreported by 0.32 kg on average, which led to self-reported BMI 0.42 kg/m2 lower than measured. Self-reported and measured height, weight, BMI, WC and WHtR were highly correlated (r = 0.98, 0.99, 0.98, 0.88, 0.86, respectively). Associations between self-reported indices and cardiometabolic biomarkers were comparable to associations assessed with measured anthropometrics.

Conclusions

The self-reported anthropometric indices were reliable when estimating associations with metabolic biomarkers.

Key messages

This study found overall agreement between self-reported and measured anthropometric variables.
1388Risk factors for chronic cough in adults: A systematic review and meta-analysis
Authors: Zhang Jingwen , Perret Jennifer , Chang Anne , Idrose Nur , Bui Dinh , Lowe Adrian , Abramson Michael , Haydn Walters E. , Lodge Caroline , Dharmage Shyamali
Published: September 2021

Background

Despite the challenges of diagnosing and managing adult patients with chronic cough, a systematic synthesis of evidence on aetiological risk factor is lacking.

Methods

We systematically searched PUBMED and EMBASE to synthesize the current evidence for longitudinal associations between various risk factors and chronic cough in the general adult population, following the meta-analysis of observation studies in epidemiology (MOOSE) guidelines. The Newcastle-Ottawa scale was used to assess the quality of the included studies. Fixed-effect meta-analysis was conducted where appropriate.

Results

Of 26 eligible articles, 16 domains of risk factors were assessed. There was consistent evidence that asthma (pooled adjusted OR (aOR) = 3.01; 95%CI: 2.33-3.70; I2=0%, number of articles (N)=3) and low education levels/socioeconomic status (SES) (pooled aOR=1.46; 95%CI: 1.20-1.72; I2=0%; N = 3) were associated with an increased risk of chronic cough after adjusting for smoking and other confounders. While continuous smoking was associated chronic cough (aOR =1.81; 95%CI: 1.36,2.26; I2=57%; N = 3), there was too little evidence to draw conclusions for occupational exposures, outdoor air pollution, early-life exposures, diet, snoring and other chronic conditions.

Conclusions

Asthma, persistent smoking and lower education/SES were associated with increased risk of chronic cough. Longitudinal associations between other factors frequently mentioned empirically need further investigation.

Key messages

Our systematic review found asthma, smoking and lower education to be associated with adult chronic cough. More longitudinal studies are needed to understand other potential risk factors for adult chronic cough.
1505Cost-effectiveness of guideline-based care for diabetes-related foot ulcers: using discrete event simulation in economic evaluation
Authors: Zhang Yuqi , Carter Hannah , Lazzarini Peter , Cramb Susanna , Pacella Rosana , Netten Jaap van , Cheng Qinglu , Derhy Patrick , Kinnear Ewan , McPhail Steven
Published: September 2021

Background

Implementation of guideline-based care for diabetes-related foot ulcers (DFU) in clinical practice is typically sub-optimal. We aimed to evaluate the cost-effectiveness of implementing different incremental increases in guideline-based care scenarios, compared with current practice, using discrete event simulation models.

Methods

The costs and effectiveness of current practice (identified as 30% receiving guideline-based care, remainder (70%) non-guideline-based care) were compared with seven hypothetical scenarios of implementing incremental increases in guideline-based care (40%, 50%, 60%, 70%, 80%, 90%, 100%) and evaluated using discrete event simulation models, including important events of disease history and parameterised by a large DFU cohort. Incremental cost-effectiveness ratio for each scenario was calculated and compared to willingness-to-pay of AUD28,000 per quality-adjusted life-years (QALY). Probability sensitivity analysis was conducted to incorporate parameter uncertainty by 2,000 random simulations.

Results

Under a three-year time-horizon, the seven scenarios (40%-100% guideline-based care) were estimated to incrementally save $901-$1843 (AUD 2020) and provide 0.017-0.056 more QALY per person, with all scenarios being cost-saving & more effective than current practice (30% guideline-based care). From probability sensitivity analyses we were increasingly confident (69.7%-89.8% confident) that implementing increased incremental scenarios (40%-100% guideline-based care) would be cost-effective compared with current practice (59.8%-73.4% confident).

Conclusions

All scenarios incrementally increasing guideline-based care were evaluated to be cost-saving and more effective than current practice according to this discrete event simulation modelling based on a large real-world cohort.

Key messages

Our findings support the cost-effectiveness of implementing any incremental increase in guideline-based care compared to current practice.
1390Utilisation of hospital Services during COVID 19 Pandemic in New Zealand
Authors: Zhang Zhi-ling (jim) , Jones Peter G
Published: September 2021

Background

Many factors have impacted the use of hospital services during the COVID-19 pandemic. This work described the volume and pattern changes of emergency department (ED) and inpatient admissions during earlier pandemic period in New Zealand in 2020.

Methods

ED and inpatient admissions during the pandemic period were compared with the figures and characteristics in the same time period in the previous years

Results

Over the period, ED and inpatient admissions decreased by 25 and 20 percent respectively. Remarkable declines of 41% in ED and 40% in inpatient were observed during the alert level 4 lockdown period. In the ED admissions, the degree of the decline was higher in less urgent presentations (triage levels 4 and 5), young patients (aged 0-24 years) and the patients without long term conditions. In the inpatient admissions, the degree of the decline was higher in the patients with lower level of inpatient clinical complexity, young patients and the admissions of respiratory diseases (especially influenza), viral infections, and injuries due to traffic and sport accident. In contrast, some hospitalisations increased during the period, including alcohol-related ED presentations, bacterial infections and injuries related to falls and assault occurred in home.

Conclusions

The changes in hospitalisation utilisation are likely associated with the changes in people’s behaviour in seeking health services, in behaviours of health risk or protective factors, and the changes in healthcare provided to the population during the period.

Key messages

The results provide insights for further assessment of health needs and health services.
Mining long-COVID symptoms from Reddit: characterizing post-COVID syndrome from patient reports
Authors: Sarker Abeed , Ge Yao
Published: September 2021

Our objective was to mine Reddit to discover long-COVID symptoms self-reported by users, compare symptom distributions across studies, and create a symptom lexicon. We retrieved posts from the /r/covidlonghaulers subreddit and extracted symptoms via approximate matching using an expanded meta-lexicon. We mapped the extracted symptoms to standard concept IDs, compared their distributions with those reported in recent literature and analyzed their distributions over time. From 42 995 posts by 4249 users, we identified 1744 users who expressed at least 1 symptom. The most frequently reported long-COVID symptoms were mental health-related symptoms (55.2%), fatigue (51.2%), general ache/pain (48.4%), brain fog/confusion (32.8%), and dyspnea (28.9%) among users reporting at least 1 symptom. Comparison with recent literature revealed a large variance in reported symptoms across studies. Temporal analysis showed several persistent symptoms up to 15 months after infection. The spectrum of symptoms identified from Reddit may provide early insights about long-COVID.
Effects of Bacillus subtilis on jejunal integrity, redox status, and microbial composition of intrauterine growth restriction suckling piglets
Authors: Yun Yang , Ji Shuli , Yu Ge , Jia Peilu , Niu Yu , Zhang Hao , Zhang Xin , Wang Tian , Zhang Lili
Published: September 2021

The present study used intrauterine growth restriction (IUGR) piglets as an animal model to determine the effect of Bacillus subtilis on intestinal integrity, antioxidant capacity, and microbiota in the jejunum of suckling piglets. In total, 8 normal birth weight (NBW) newborn piglets (1.62 ± 0.10 kg) and 16 newborn IUGR piglets (0.90 ± 0.08 kg) were selected and assigned to three groups. Piglets were orally gavaged with 10-mL sterile saline (NBW and IUGR groups), and IUGR piglets were orally gavaged with 10-mL/d bacterial fluid (B. subtilis diluted in sterile saline, gavage in the dose of 2 × 109 colony-forming units per kg of body weight; IBS group; n = 8). IUGR induced jejunal barrier dysfunction and redox status imbalance of piglets, and changed the abundances of bacteria in the jejunum. Treatment with B. subtilis increased (P < 0.05) the ratio of villus height to crypt depth (VH/CD) in the jejunum, decreased (P < 0.05) the plasma diamine oxidase (DAO) activity, and enhanced (P < 0.05) the gene expressions of zonula occludens-1 (ZO-1), occludin, and claudin-1 in the jejunum of IUGR piglets. Treatment with B. subtilis decreased (P < 0.05) the concentration of protein carbonyl (PC) and increased (P < 0.05) the activities of catalase (CAT) and total superoxide dismutase (T-SOD) in the jejunum of IUGR piglets. Treatment with B. subtilis also increased (P < 0.05) gene expressions of superoxide dismutase 1 (SOD1), CAT, and nuclear factor erythroid 2-related factor (Nrf2), as well as the protein expressions of heme oxygenase-1 (HO-1), SOD1, and Nrf2 in the jejunum of IUGR piglets. Treatment with B. subtilis also improved the abundances and the community structure of bacteria in the jejunum of IUGR piglets. These results suggested that IUGR damaged the jejunal barrier function and antioxidant capacity of suckling piglets, and altered the abundances of bacteria in the jejunum. Treatment with B. subtilis improved the intestinal integrity and antioxidant capacity while also improved the abundances and structure of bacteria in the jejunum of suckling piglets.
Discovery of a young pre-intermediate polar
Authors: Wilson David J , Toloza Odette , Landstreet John D , Gänsicke Boris T , Drake Jeremy J , Hermes J J , Koester Detlev
Published: September 2021

We present the discovery of a magnetic field on the white dwarf component in the detached post-common envelope binary (PCEB) CC Cet. Magnetic white dwarfs in detached PCEBs are extremely rare, in contrast to the high incidence of magnetism in single white dwarfs and cataclysmic variables. We find Zeeman-split absorption lines in both ultraviolet Hubble Space Telescope (HST) spectra and archival optical spectra of CC Cet. Model fits to the lines return a mean magnetic field strength of 〈|B|〉 ≈ 600–700 kG. Differences in the best-fitting magnetic field strength between two separate HST observations and the high $v\, \sin \, i$ of the lines indicate that the white dwarf is rotating with a period ∼0.5 h, and that the magnetic field is not axisymmetric about the spin axis. The magnetic field strength and rotation period are consistent with those observed among the intermediate polar class of cataclysmic variable, and we compute stellar evolution models that predict CC Cet will evolve into an intermediate polar in 7–17 Gyr. Among the small number of known PCEBs containing a confirmed magnetic white dwarf, CC Cet is the hottest (and thus youngest), with the weakest field strength, and cannot have formed via the recently proposed crystallization/spin-up scenario. In addition to the magnetic field measurements, we update the atmospheric parameters of the CC Cet white dwarf via model spectra fits to the HST data and provide a refined orbital period and ephemeris from TESS photometry.
Flow directions of low-energy ions in and around the diamagnetic cavity of comet 67P
Authors: Bergman Sofia , Stenberg Wieser Gabriella , Wieser Martin , Nilsson Hans , Vigren Erik , Beth Arnaud , Masunaga Kei , Eriksson Anders
Published: September 2021

The flow direction of low-energy ions around comet 67P/Churyumov–Gerasimenko has previously been difficult to constrain due to the influence of the spacecraft potential. The Ion Composition Analyzer of the Rosetta Plasma Consortium (RPC-ICA) on Rosetta measured the distribution function of positive ions with energies down to just a few eV/q throughout the escort phase of the mission. Unfortunately, the substantial negative spacecraft potential distorted the directional information of the low-energy data. In this work, we present the flow directions of low-energy ions around comet 67P, corrected for the spacecraft potential using Particle-In-Cell simulation results. We focus on the region in and around the diamagnetic cavity, where low-energy ions are especially important for the dynamics. We separate between slightly accelerated ‘burst’ features and a more constant ‘band’ of low-energy ions visible in the data. The ‘bursts’ are flowing radially outwards from the nucleus with an antisunward component while the ‘band’ is predominantly streaming back towards the comet. This provides evidence of counter-streaming ions, which has implications for the overall expansion velocity of the ions. The backstreaming ions are present also at times when the diamagnetic cavity was not detected, indicating that the process accelerating the ions back towards the comet is not connected to the cavity boundary.
Detailed elemental abundances of binary stars: searching for signatures of planet formation and atomic diffusion
Authors: Liu (刘凡) Fan , Bitsch Bertram , Asplund Martin , Liu (刘倍贝) Bei-Bei , Murphy Michael T , Yong David , Ting (丁源森) Yuan-Sen , Feltzing Sofia
Published: September 2021

Binary star systems are assumed to be co-natal and coeval, and thus to have identical chemical composition. In this work, we aim to test the hypothesis that there is a connection between observed element abundance patterns and the formation of planets using binary stars. Moreover, we also want to test how atomic diffusion might influence the observed abundance patterns. We conduct a strictly line-by-line differential chemical abundance analysis of seven binary systems. Stellar atmospheric parameters and elemental abundances are obtained with extremely high precision (<3.5 per cent) using the high-quality spectra from Very Large Telescope/ultraviolet–visual Echelle spectrograph and Keck/high-resolution Echelle spectrometer. We find that four of seven binary systems show subtle abundance differences (0.01–0.03 dex) without clear correlations with the condensation temperature, including two planet-hosting pairs. The other three binary systems exhibit similar degree of abundance differences correlating with the condensation temperature. We do not find any clear relation between the abundance differences and the occurrence of known planets in our systems. Instead, the overall abundance offsets observed in the binary systems (four of seven) could be due to the effects of atomic diffusion. Although giant planet formation does not necessarily imprint chemical signatures on to the host star, the differences in the observed abundance trends with condensation temperature, on the other hand, are likely associated with diverse histories of planet formation (e.g. formation location). Furthermore, we find a weak correlation between abundance differences and binary separation, which may provide a new constraint on the formation of binary systems.
Winds aloft over three water bodies influence spring stopover distributions of migrating birds along the Gulf of Mexico coast
Authors: Clipp Hannah L , Buler Jeffrey J , Smolinsky Jaclyn A , Horton Kyle G , Farnsworth Andrew , Cohen Emily B
Published: September 2021

Migrating birds contend with dynamic wind conditions that ultimately influence most aspects of their migration, from broad-scale movements to individual decisions about where to rest and refuel. We used weather surveillance radar data to measure spring stopover distributions of northward migrating birds along the northern Gulf of Mexico coast and found a strong influence of winds over nonadjacent water bodies, the Caribbean Sea and Atlantic Ocean, along with the contiguous Gulf of Mexico. Specifically, we quantified the relative influence of meridional (north–south) and zonal (west–east) wind components over the 3 water bodies on weekly spring stopover densities along western, central, and eastern regions of the northern Gulf of Mexico coast. Winds over the Caribbean Sea and Atlantic Ocean were just as, or more, influential than winds over the Gulf of Mexico, with the highest stopover densities in the central and eastern regions of the coast following the fastest winds from the east over the Caribbean Sea. In contrast, stopover density along the western region of the coast was most influenced by winds over the Gulf of Mexico, with the highest densities following winds from the south. Our results elucidate the important role of wind conditions over multiple water bodies on region-wide stopover distributions and complement tracking data showing Nearctic–Neotropical birds flying nonstop from South America to the northern Gulf of Mexico coast. Smaller-bodied birds may be particularly sensitive to prevailing wind conditions during nonstop flights over water, with probable orientation and energetic consequences that shape subsequent terrestrial stopover distributions. In the future, the changing climate is likely to alter wind conditions associated with migration, so birds that employ nonstop over-water flight strategies may face growing challenges.
Contemporary biomedical engineering perspective on volitional evolution for human radiotolerance enhancement beyond low-earth orbit
Authors: Borg Alexander M , Baker John E
Published: September 2021

A primary objective of the National Aeronautics and Space Administration (NASA) is expansion of humankind’s presence outside low-Earth orbit, culminating in permanent interplanetary travel and habitation. Having no inherent means of physiological detection or protection against ionizing radiation, humans incur capricious risk when journeying beyond low-Earth orbit for long periods. NASA has made large investments to analyze pathologies from space radiation exposure, emphasizing the importance of characterizing radiation’s physiological effects. Because natural evolution would require many generations to confer resistance against space radiation, immediately pragmatic approaches should be considered. Volitional evolution, defined as humans steering their own heredity, may inevitably retrofit the genome to mitigate resultant pathologies from space radiation exposure. Recently, uniquely radioprotective genes have been identified, conferring local or systemic radiotolerance when overexpressed in vitro and in vivo. Aiding in this process, the CRISPR/Cas9 technique is an inexpensive and reproducible instrument capable of making limited additions and deletions to the genome. Although cohorts can be identified and engineered to protect against radiation, alternative and supplemental strategies should be seriously considered. Advanced propulsion and mild synthetic torpor are perhaps the most likely to be integrated. Interfacing artificial intelligence with genetic engineering using predefined boundary conditions may enable the computational modeling of otherwise overly complex biological networks. The ethical context and boundaries of introducing genetically pioneered humans are considered.
Fluctuations in Arousal Correlate with Neural Activity in the Human Thalamus
Authors: Iidaka Tetsuya
Published: September 2021

The neural basis of consciousness has been explored in humans and animals; however, the exact nature of consciousness remains elusive. In this study, we aimed to elucidate which brain regions are relevant to arousal in humans. Simultaneous recordings of brain activity and eye-tracking were conducted in 20 healthy human participants. Brain activity was measured by resting-state functional magnetic resonance imaging with a multiband acquisition protocol. The subjective levels of arousal were investigated based on the degree of eyelid closure that was recorded using a near-infrared eye camera within the scanner. The results showed that the participants were in an aroused state for 79% of the scan time, and the bilateral thalami were significantly associated with the arousal condition. Among the major thalamic subnuclei, the mediodorsal nucleus (MD) showed greater involvement in arousal when compared with other subnuclei. A receiver operating characteristic analysis with leave-one-out crossvalidation conducted using template-based brain activity and arousal-level data from eye-tracking showed that, in most participants, thalamic activity significantly predicted the subjective levels of arousal. These results indicate a significant role of the thalamus, and in particular, the MD, which has rich connectivity with the prefrontal cortices and the limbic system in human consciousness.
‘The Violet Killer’—Successful Treatment of an Infant with Chromobacterium violaceum Sepsis
Authors: Mohammed Jawad M , Sajana T M , Raj Reshma , Rachana Babu A , Paul George , Pillai P Rajappan
Published: September 2021

Chromobacterium violaceum, a facultative anaerobic proteobacterium, is isolated from water and soil in tropical areas and has been implicated in infections like septicemia, visceral abscesses, skin and soft tissue infections, meningitis and diarrhea. Chromobacterium violaceum sepsis, a rarely reported phenomenon has a very high mortality rate. Here, we report a unique case of Chromobacterium sepsis in an infant. A 48-day-old baby boy was referred to our institution with h/o fever, loose stools and reduced activity. He was intubated and referred to us in septic shock. Radiological investigations revealed multiple abscesses in the liver, spleen and kidneys. The infant was successfully treated with trimethoprim-sulfamethoxazole and ciprofloxacin.
Ancient viral integrations in marsupials: a potential antiviral defence
Authors: Harding Emma F , Russo Alice G , Yan Grace J H , Waters Paul D , White Peter A
Published: September 2021

Marsupial viruses are understudied compared to their eutherian mammal counterparts, although they may pose severe threats to vulnerable marsupial populations. Genomic viral integrations, termed ‘endogenous viral elements’ (EVEs), could protect the host from infection. It is widely known past viral infections and EVEs play an active role in antiviral defence in invertebrates and plants. This study aimed to characterise actively transcribed EVEs in Australian marsupial species, because they may play an integral role in cellular defence against viruses. This study screened publicly available RNA sequencing data sets (n = 35) and characterised 200 viral transcripts from thirteen Australian marsupial species. Of the 200 transcripts, 188 originated from either Bornaviridae, Filoviridae, or Parvoviridae EVEs. The other twelve transcripts were from putative active infections from members of the Herpesviridae and Anelloviridae, and Hepadnaviridae. EVE transcripts (n = 188) were mapped to marsupial genomes (where available, n = 5/13) to identify the genomic insertion sites. Of the 188 transcripts, 117 mapped to 39 EVEs within the koala, bare-nosed wombat, tammar wallaby, brushtail possum, and Tasmanian devil genomes. The remaining eight animals had no available genome (transcripts n = 71). Every marsupial has Bornaviridae, Filoviridae, and Parvoviridae EVEs, a trend widely observed in eutherian mammals. Whilst eutherian bornavirus EVEs are predominantly nucleoprotein-derived, marsupial bornavirus EVEs demonstrate a surprising replicase gene bias. We predicted these widely distributed EVEs were conserved within marsupials from ancient germline integrations, as many were over 65 million years old. One bornavirus replicase EVE, present in six marsupial genomes, was estimated to be 160 million years old, predating the American–Australian marsupial split. We considered transcription of these EVEs through small non-coding RNA as an ancient viral defence. Consistent with this, in koala small RNA sequence data sets, we detected Bornaviridae replicase and Filoviridae nucleoprotein produced small RNA. These were enriched in testis tissue, suggesting they could protect marsupials from vertically transmitted viral integrations.
Etiology of Septoria Leaf Spot of Pistachio in Southern Spain
Authors: López-Moral Ana , Agustí-Brisach Carlos , Raya María del Carmen , Lovera María , Trapero Carlos , Arquero Octavio , Trapero Antonio
Published: September 2021

Septoria leaf spot (SLS) is the most prevalent disease of pistachio (Pistacia vera L.) in Spain. To elucidate its etiology, 22 samples of pistachio leaves showing SLS symptoms were collected mainly from 1993 to 2018 across southern Spain. Affected leaves from terebinth (P. terebinthus) were also collected for comparative purposes. Six Septoria-like isolates were recovered from pistachio leaves. They were identified as S. pistaciarum by sequencing internal transcribed spacers, partial RNA polymerase II second largest subunit locus, and 28S ribosomal RNA genes. The phenotypic characteristics of conidia and colonies were evaluated, confirming the identity of S. pistaciarum. Conidia were solitary, hyaline, and straight to curved. Large differences in length were observed between conidia from leaf samples, with those from terebinth being slightly larger than those from pistachio. Colonies showed slow mycelial growth on potato dextrose agar (PDA). The effect of temperature on conidial germination and mycelial growth was evaluated in vitro on PDA. For both characters, the optimum temperature was approximately 19 to 20°C. Eight culture media were tested, with oatmeal agar and Spezieller Nährstoffarmer agar showing the highest mycelial growth and pistachio leaf agar (PLA) showing the highest sporulation. A specific culture medium integrating lyophilized-powdered pistachio leaves into diluted PDA improved sporulation compared with PLA. Pathogenicity tests were conducted by inoculating detached and in planta pistachio and terebinth leaflets with conidial suspensions. Typical symptoms of SLS and cirri of S. pistaciarum developed at 10 and 21 days after inoculation, respectively, in both hosts. To our knowledge, this is the first report of S. pistaciarum causing SLS in pistachio and terebinth in Spain.
Rapid Detection of Carbapenemase-producing Enterobacteriaceae From Blood Culture Bottles of Known CPE Carriers
Authors: Kriger Or , Shatzman-Steuerman Rachel , Smollan Gillian , Belausov Natasha , Sarkisian Gayane , Amit Sharon
Published: September 2021

We used a rapid antigen test for the detection of carbapenemases directly from positive blood culture bottles of pediatric hemato-oncologic patients, known carriers of carbapenemase-producing enterobacteriaceae. Resistance mechanism was detected within 15 minutes of observing Gram-negative bacilli from a positive bottle, leading to treatment modification. This simple-to-use, inexpensive assay shortens the interval between empiric to tailored antimicrobial therapy.
Cortical mechanisms of visual hypersensitivity in women at risk for chronic pelvic pain
Authors: Kmiecik Matthew J. , Tu Frank F. , Silton Rebecca L. , Dillane Katlyn E. , Roth Genevieve E. , Harte Steven E. , Hellman Kevin M.
Published: September 2021

Increased sensory sensitivity across non-nociceptive modalities is a common symptom of chronic pain conditions and is associated with chronic pain development. Providing a better understanding of the brain–behavior relationships that underlie multimodal hypersensitivity (MMH) may clarify the role of MMH in the development of chronic pain. We studied sensory hypersensitivity in a cohort of women (n = 147) who had diary confirmation of menstrual status and were enriched with risk factors for chronic pelvic pain, such as dysmenorrhea and increased bladder sensitivity. We administered 2 experimental tasks to evaluate the cross-modal relationship between visual and visceral sensitivity. Visual sensitivity was probed by presenting participants with a periodic pattern-reversal checkerboard stimulus presented across 5 brightness intensities during electroencephalography recording. Self-reported visual unpleasantness ratings for each brightness intensity were simultaneously assessed. Visceral sensitivity was evaluated with an experimental bladder-filling task associated with early clinical symptoms of chronic pelvic pain. Visually evoked cortical activity increased with brightness intensity across the entire scalp, especially at occipital electrode sites. Visual stimulation–induced unpleasantness was associated with provoked bladder pain and evoked primary visual cortex activity. However, the relationship between unpleasantness and cortical activity was moderated by provoked bladder pain. These results demonstrate that activity in the primary visual cortex is not greater in individuals with greater visceral sensitivity. We hypothesize that downstream interpretation or integration of this signal is amplified in individuals with visceral hypersensitivity. Future studies aimed at reducing MMH in chronic pain conditions should prioritize targeting of cortical mechanisms responsible for aberrant downstream sensory integration.
Becoming an Expert Home Health Nurse
Authors: Hinck Susan M.
Published: September 2021

The purpose of this article is to discuss the five levels of skill acquisition (novice, advanced beginner, competent, proficient, and expert) developed by Patricia Benner and colleagues, within the unique context of home health nursing. Descriptions of practice at each level are provided and can help nurses have reasonable expectations of performance. Recommendations are made for competence-based clinical support programs such as orientation, mentoring, and clinical ladders that identify, measure, and reward clinical knowledge and skill.
Antimicrobial Resistance and Antimicrobial Stewardship in Home Healthcare
Authors: Mohammed Shafii , Gorski Lisa
Published: September 2021

Antimicrobial resistance, the ability of microbes to become resistant to known antimicrobial medications, is a growing and serious global health concern. There are growing numbers of publications about efforts to educate nurses about antimicrobial resistance, and efforts to involve nurses in antimicrobial stewardship in acute and long-term care settings; however, this has not been the case in home care. Home care organizations are required to address infection control and surveillance, including patient, family, and staff education. Home care nurses play an important role in identifying infections, performing cultures, and teaching patients and families. This article provides an overview of antimicrobial resistance and antimicrobial stewardship and provides antimicrobial stewardship actions for home care nurses and agencies. In the interest of public health, home care agencies and nurses can, and should, educate themselves and patients about antimicrobial resistance and employ antimicrobial stewardship strategies.
Lessons on Life and Death
Authors: Gee Emily , Yates Julia
Published: September 2021

The death of a patient can be a significant event for professional caregivers. Yet, little attention is paid to the emotional toll this can exert on carers, nor the support they need to cope during this time. The purpose of this study was to explore the experiences of home carers following the death of a patient. Qualitative data collected through individual semistructured interviews with six United Kingdom home carers were analyzed using interpretative phenomenological analysis. A central aspect was the merging of carers' personal and professional losses. Three key themes were: (1) there are no boundaries to loss, (2) coping actions, and (3) a new understanding of life and death. These conversations gave carers a space to share their experiences of grief as well as lessons on their own life and mortality. Learning from these experiences will highlight the complexity of carers' loss and possible sources of support.
Case Report: Atypical Presentation of Neuroretinitis in a Middle-aged Woman with Pre-existing Maculopathy
Authors: Yadav Sandhya , Kumawat Devesh , Afroz Khan Shama , Patel Siddharth , Samanta Ramanuj
Published: September 2021

SIGNIFICANCE

Neuroretinitis classically presents with sudden vision loss, disc edema, and macular star formation. However, the classical triad may not always be seen, especially in the case of a pre-existing macular disorder. A thorough clinical examination may still clinch the appropriate diagnosis and prevent unwarranted treatment.

PURPOSE

This study aimed to report a case of neuroretinitis in an adult woman with pre-existing type 2 macular telangiectasia where the classical pattern of exudation could not be seen.

CASE REPORT

A 48-year-old woman, type 2 diabetic and hypertensive, presented with sudden painless blurring of vision in the right eye for the past 1 week. Macula in both eyes had loss of transparency and intraretinal crystalline deposits and pigments. The right eye had hyperemic edematous disc with peripapillary retinal hemorrhages and hard exudates. Color vision was grossly abnormal, and a centrocecal scotoma was noted on visual field analysis in the right eye. After a normal systemic evaluation, a diagnosis of right eye neuroretinitis and coexistent bilateral type 2 macular telangiectasia (nonproliferative type) was made. Unilateral painless visual loss, severe dyschromatopsia, and peripapillary hard exudates pointed to the correct diagnosis of neuroretinitis. Observation was advised, and visual acuity improved spontaneously. The disc edema resolved with consequent optic atrophy.

CONCLUSIONS

Absence of the classical “macular star” appearance does not refute the diagnosis of neuroretinitis when pre-existing maculopathy is present.
Topical Review: Bibliometric Analysis of the Emerging Field of Myopia Management
Authors: Efron Nathan , Morgan Philip B. , Jones Lyndon W. , Nichols Jason J.
Published: September 2021

SIGNIFICANCE

Identification of the most impactful articles, authors, institutions, countries, and journals in myopia management provides a useful baseline reference for clinicians, researchers, and funding agencies in respect of this emerging field.

This work aims to assemble publication metrics for myopia management to identify the most impactful articles, authors, institutions, countries, and journals in this emerging field of research. A search of the titles of articles was undertaken on the Scopus database to identify myopia management–related articles. The 25 most highly cited articles were determined from the total list of 1064 articles found. Rank-order lists by count were assembled for the top 25 in each of four categories: authors, institutions, countries, and journals. A subject-specific myopia management–related h-index (h
MM-index) was derived for the entire field, in addition to each of the four categories, to serve as measures of impact in the field. Top 15 lists were generated for each category ranked by hMM-index and tabulated for consideration. An article by Christine Wildsoet and colleagues, describing choroidal and scleral mechanisms of compensation for spectacle lenses in chicks, has generated the most citations (412); Earl Smith is the most impactful author (h
MM = 19); the University of Houston produces the most impactful articles (h
MM = 31); the United States is the most highly ranked country (h
MM = 60); and Optometry and Vision Science is the most impactful journal. Although still in its infancy, myopia management is a topic of emerging interest in the clinical and scientific ophthalmic literature. Impactful authors, institutions, countries, and journals are identified. Optometry is revealed as the leading profession in relation to the publication of myopia management–related articles.
Risk and Benefit Evaluation: Application of Multiphase Computed Tomography Angiography in Mechanical Thrombectomy for Patients With Acute Ischemic Stroke
Authors: Yu Xiang , Pan Jingjiang , Zhao Xiaoying , Yu Xianfeng , Liu Bin
Published: September 2021

Objective

The objective of this study was to evaluate the collateral circulation in patients with acute ischemic stroke (AIS) by multiphase computed tomography angiography (mCTA) and explore its application value in the risk and benefit assessment after thrombectomy.

Methods

Clinical and imaging parameters of AIS patients who underwent thrombectomy were consecutively collected. The 90-day modified Rankin Scale (mRS) score was used as the standard for evaluating the recovery of neurological functions. The receiver operating characteristic curve and correlation analysis were used to evaluate the diagnostic efficacy of collateral circulation in the clinical outcomes at 90 days and the correlation with symptomatic intracerebral hemorrhage (sICH), respectively.

Results

Thirty of 58 AIS patients (51.7%) had favorable functional recovery (90-day mRS score, ≤2). Significant differences were observed in age, time from symptom onset to groin puncture, National Institutes of Health Stroke Scale score at admission and 24 hours after thrombectomy, mRS score at discharge, collateral circulation score, and target mismatch between the favorable and unfavorable groups (P < 0.05). The diagnostic efficacy of mCTA collateral score (area under the curve, 0.697; 95% confidence interval, 0.563–0.831) was similar to that of computed tomography perfusion target mismatch (area under the curve, 0.740; 95% confidence interval, 0.609–0.872) (DeLong test, P = 0.575). The collateral circulation score was significantly negatively correlated with sICH (ρ = −0.607, P < 0.001). Patients with sICH had lower collateral circulation scores and higher 90-day mRS scores (P < 0.05).

Conclusions

The mCTA collateral score has good application value in the risk and benefit evaluation after mechanical thrombectomy, and it is well suited for routine emergency assessment of AIS patients.
Clinical Characterization of Atypical Primary Progressive Aphasia in a 3-Year Longitudinal Study: A Case Report
Authors: Basilico Stefania , Ciricugno Andrea , Gelosa Giorgio , Magnani Francesca G. , Mosca Lorena , Popescu Cristina , Garibotto Valentina , Sberna Maurizio , Paulesu Eraldo , Bottini Gabriella
Published: September 2021

The logopenic variant of primary progressive aphasia (lvPPA) is the most recent variant of primary progressive aphasia (PPA) to be identified; thus far, it has been poorly investigated. Despite being typically associated with Alzheimer disease (AD), lvPPA has recently been linked to frontotemporal lobe degeneration (FTLD), with distinctive cognitive and neural features that are worthy of further investigation. Here, we describe the neuropsychological and linguistic profile, as well as cerebral abnormalities, of an individual exhibiting PPA and carrying a pathogenetic variant in the GRN gene, from a 3-year longitudinal perspective. The individual’s initial profile resembled lvPPA because it was characterized by word-finding difficulties and phonological errors in spontaneous speech in addition to sentence repetition and phonological short-term memory impairments. The individual’s structural and metabolic imaging data demonstrated left temporal and bilateral frontal atrophy and hypometabolism, respectively. On follow-up, as the pathology progressed, dysprosody, stereotypical speech patterns, agrammatism, and orofacial apraxia appeared, suggesting an overlap with the nonfluent variant of PPA (nfvPPA). Severe sentence comprehension impairment also became evident. Our longitudinal and multidisciplinary diagnostic approach allowed us to better characterize the progression of a GRN-positive lvPPA profile, providing neuropsychological and imaging indicators that might be helpful to improve classification between different PPA variants and to address a nosological issue. Finally, we discuss the importance of early diagnosis of PPA given the possible overlap between different PPA variants during the progression of the pathology.
High-resolution microbiome analysis enabled by linking of 16S rRNA gene sequences with adjacent genomic contexts
Authors: Kapustina Žana , Medžiūnė Justina , Alzbutas Gediminas , Rokaitis Irmantas , Matjošaitis Karolis , Mackevičius Gytis , Žeimytė Simona , Karpus Laurynas , Lubys Arvydas
Published: September 2021

Sequence-based characterization of bacterial communities has long been a hostage of limitations of both 16S rRNA gene and whole metagenome sequencing. Neither approach is universally applicable, and the main efforts to resolve constraints have been devoted to improvement of computational prediction tools. Here, we present semi-targeted 16S rRNA sequencing (st16S-seq), a method designed for sequencing V1–V2 regions of the 16S rRNA gene along with the genomic locus upstream of the gene. By in silico analysis of 13 570 bacterial genome assemblies, we show that genome-linked 16S rRNA sequencing is superior to individual hypervariable regions or full-length gene sequences in terms of classification accuracy and identification of gene copy numbers. Using mock communities and soil samples we experimentally validate st16S-seq and benchmark it against the established microbial classification techniques. We show that st16S-seq delivers accurate estimation of 16S rRNA gene copy numbers, enables taxonomic resolution at the species level and closely approximates community structures obtainable by whole metagenome sequencing.