bluuebunny/crossref_metadata_2025 huggingface dataset:
The learning curve of video-assisted mediastinoscopic lymphadenectomy for staging of non-small-cell lung carcinoma
Authors: Daemen Jean H T , van den Broek Robert A M , Lozekoot Pieter W J , Maessen Jos G , Hulsewé Karel W E , Vissers Yvonne L J , de Loos Erik R
Published: July 2020

OBJECTIVES

The objective of this study was to define the learning process of video-assisted mediastinoscopic lymphadenectomy (VAMLA) by the assessment of consecutive procedural metrics.

METHODS

We conducted a single-centre retrospective observational study of all consecutive VAMLAs performed between 2011 and 2018 for the staging of non-small-cell lung carcinoma. Learning curves were assessed using non-risk adjusted cumulative observed minus expected (CUSUM) failure charts of complications. Boundary lines were defined by the acceptable and unacceptable complication rates of 4.5% and 15.0%. The Kruskal–Wallis test with post hoc analysis was used to assess trends in operation time and blood loss.

RESULTS

Two-hundred-thirty-six unique VAMLAs by 4 surgeons performing their first procedures were evaluated. CUSUM charts of surgeons A and B showed a typical learning curve with an initial incline, followed by a turning point towards lower complications rates after 16–17 cases, whereas surgeons C and D showed an average performance. The median time between consecutive VAMLAs was shorter for surgeons A and B (13.0 vs 28.5–38.0 days for surgeons C and D). Overcoming the learning curve, complication rates of surgeons A and B decreased from 19% to 3% and from 18% to 5%, respectively. Operation time and blood loss showed a significant improvement after, respectively, 81–100 and 61–80 procedures compared to the first 20 procedures.

CONCLUSIONS

VAMLA is a safe procedure to adopt and perform with acceptable complication rates from the first operation onward, regardless of the caseload. To overcome its learning curve, 16–17 cases are required, preferably at least 1 per 2 weeks.
Rethinking Transitional Justice in South Sudan: Critical Perspectives on Justice and Reconciliation
Authors: Akech Joseph Geng
Published: July 2020

The horrific violations committed in South Sudan’s civil war led to the establishment of mechanisms ensuring the prosecution of serious crimes and reconciliation within communities shattered by war. Through a peace deal, three mutually supportive but independent institutions of transitional justice were formed: The Commission for Truth, Reconciliation and Healing, The Hybrid Court for South Sudan and The Compensation and Reparation Authority. This article examines the extent to which these mechanisms can achieve their respective aims, and argues that prosecutions need to be implemented in an integrated manner alongside reconciliation and healing because of the massive scale of abuses and enormous number of perpetrators. The article further contends that their collaboration with local, indigenous justice mechanisms is crucial because of the latter’s extensive experience in facilitating accountability and reconciliation within divided communities in South Sudan. The article concludes that whilst a limited amnesty is inevitable, a blanket amnesty is counterproductive to the aims of transitional justice in post-conflict South Sudan. Further, the article cautions against the use of immunity, arguing that this would deny justice to victims and could lead to a rise in revenge or private retribution, lawlessness and impunity.
The Importance of Cellular Immunity in the Development of Vaccines and Therapeutics for COVID-19
Authors: Schlom Jeffrey , Donahue Renee N
Published: July 2020

It is important to develop vaccines that can also mediate T-cell responses to SARS-CoV-2 to limit severity of infections, and to analyze the cellular immunome in the use of anti-SARS-CoV-2 therapeutics.
Feeding a calf starter containing monensin alone or in combination with an oregano, and cobalt blend to Holstein calves
Authors: Wu Jianping , Guo Jinsheng , Liu Ting , Chen Hao , Bai Yan , Casper David P
Published: July 2020

Gut health is critically important for growing neonatal calves, and nutritional technologies are needed to prevent disease and stress challenges. Previous work feeding monensin (MON) in combination with an oregano, prebiotic, and cobalt-lactate (EOC) blend had demonstrated improved calf gut health and growth performance. The objective of this study was to evaluate the growth performance of calves fed MON and EOC alone or in combination. Eighty (80) newborn Holstein (37) female and (43) male calves were randomly assigned to one of four treatments arranged in a 2 × 2 factorial (MON and EOC). Treatments were: 1) Control: without MON or EOC added to the calf starter (CS); 2) MON: 50.8 mg/kg CS (Elanco, Greenfield, IN); 3) EOC: 44.1 mg/kg CS (Rum-A-Fresh, Ralco Inc. Marshall, MN); 4) MON + EOC: MON and EOC added to CS. Calves were fed colostrum followed by whole milk through weaning at 42 d, while CS was fed ad libitum through the 70-d experimental period. The MON by EOC interaction was found to be nonsignificant (P > 0.41) for growth performance. Calves fed without or with MON demonstrated similar (P > 0.70) body weight (BW; 68.7 and 68.9 kg without and with MON, respectively), while calves fed EOC demonstrated greater (P < 0.01) BW (67.3 and 70.4 kg without and with EOC, respectively) compared with calves fed without EOC. Calves fed a CS containing MON were similar (P > 0.47) in average daily gain (ADG; 0.88 and 0.91 kg/d) compared with calves fed without MON; however, feeding calves a CS with EOC increased (P < 0.01) ADG (0.84 and 0.95 kg/d) by 13% through the 70-d experimental period compared with calves not fed EOC. Frame measurements indicated that the greater ADG was due to increased (P < 0.10) frame growth for calves fed essential oils (EO) compared with calves fed without EO. A MON by EOC interaction (P < 0.01) for serum propionate concentration demonstrated calves fed MON + EOC and EOC were greater (P < 0.05) compared with calves fed Control, while calves fed MON were intermediate and different (P < 0.05). Feeding calves a CS with EOC increased (P < 0.04) immunoglobulin A, immunoglobulin G, and immunoglobulin M concentrations compared with calves fed without EOC. A MON by EOC interaction was detected (P < 0.01) for total tract starch digestibility for calves fed EOC or MON + EOC demonstrating greater (P < 0.05) starch digestibilities than Control-fed calves. These data demonstrate that EOC and MON fed in combination was not beneficial for enhancing the growth performance, but that calf growth performance can be improved with EOC compared with MON.
Exosomes derived from chronic lymphocytic leukaemia cells transfer miR-146a to induce the transition of mesenchymal stromal cells into cancer-associated fibroblasts
Authors: Yang Yanli , Li Jun , Geng Yinghua
Published: July 2020

Chronic lymphocytic leukaemia (CLL) is the most prevalent leukaemia and remains incurable. Mesenchymal stem cells (MSCs) can promote tumour progression by differentiating into cancer-associated fibroblasts (CAFs). However, the mechanisms by which tumour cells induce the transition of MSCs to CAFs are still largely undefined. Exosomes can regulate recipient cellular function by mediating intracellular communication. This study aimed to investigate whether CLL cells regulate the transition of bone marrow-derived MSCs (BM-MSCs) to CAFs via exosomal miR-146a delivery. The exosomes were isolated from CLL cell line MEC-1 (CLL-Exo) and then co-cultured with BM-MSCs. The expression of α-smooth muscle actin (α-SMA) and fibroblast-activated protein (FAP) were determined by immunofluorescence, quantitative real-time polymerase chain reaction and western blot. A luciferase reporter assay was performed to verify whether ubiquitin-specific peptidase 16 (USP16) was a target of miR-146a. CLL-Exo treatment up-regulated miR-146a and down-regulated expression of CAF markers (α-SMA and FAP) and USP16. The inducing effect of CLL-Exo on CAF marker expression was compromised when miR-146a expression was inhibited in CLL-Exo. USP16 was confirmed as a direct target of miR-146a and USP16 overexpression in BM-MSCs abrogated the CLL-Exo-mediated up-regulation of CAF markers. Collectively, CLL-Exo delivered miR-146a into BM-MSCs where miR-146a mediated transition of BM-MSCs into CAFs by targeting USP16.
Decline in Sublethal Effects of Bt Corn on Corn Earworm (Lepidoptera: Noctuidae) Linked to Increasing Levels of Resistance
Authors: Reay-Jones Francis P F , Bilbo Thomas R , Reisig Dominic D
Published: July 2020

As part of an ongoing longitudinal study in North and South Carolina, this study reports the recovery of Helicoverpa zea (Boddie) pupae in field trials with genetically engineered corn, Zea mays L., hybrids that produce insecticidal toxins from Bacillus thuringiensis (Bt) in 2017–2019. In total, 10,400 corn ears were collected, which led to 3,927 H. zea pupae (2,215 in South Carolina and 1,712 in North Carolina). Late-planted corn led to a 3.39-fold increase in recovery of pupae compared to early-planted corn. Bt corn expressing Cry1F + Cry1Ab and Cry1A.105 + Cry2Ab2 had 1.67-fold and 2.51-fold fewer pupae than non-Bt near-isolines, respectively. Only six pupae were recovered from the hybrid expressing Cry1F + Cry1Ab + Vip3Aa20. Averaged across trials, Bt corn expressing either Cry1A.105 + Cry2Ab2 or Cry1F + Cry1Ab significantly reduced pupal weight compared to non-Bt near-isolines in North and South Carolina. Combining our data with a previous study at the same locations (Bilbo et al. 2018), reduction in pupal weight between Bt and non-Bt near-isolines significantly declined from 2014 to 2019 for Cry1Ab + Cry1F in North and South Carolina. This decline in levels of a sublethal effect of Bt corn expressing Cry1Ab + Cry1F on H. zea at both locations is likely correlated with resistance development.
Cumulation Across Attitudes and Plural Projection
Authors: Schmitt Viola
Published: July 2020

This paper investigates cumulative readings of sentences in which some, but not all of the plural expressions have a de dicto reading, i.e. sentences where the lower plural is interpreted in the scope of an attitude verb like believe. I argue that such cases represent a problem for existing accounts of cumulativity, because the required cumulative relation cannot be formed. I then motivate and propose an alternative analysis where all plural expressions are interpreted in situ: I expand the ‘plural projection’ framework put forth by Haslinger & Schmitt (2018, 2019), Schmitt (2019), where embedded pluralities ‘project’ to the denotations of higher nodes in the sense that the latter reflect the part-structure of the former and where cumulativity is derived via a compositional rule in a step-by-step fashion. I show that if the denotations of the plurals with the de dicto construal are analyzed as pluralities of individual concepts, which project in the afore-mentioned sense to pluralities of propositions, the data can be explained straightforwardly. This proposal differs from treatments in terms of collective belief that don’t appeal to pluralities of propositions ( Pasternak 2018a, b), in that it (i) arguably generalizes to a larger number of examples and (ii) links grammatical plurality in the embedded clause to the availability of cumulative readings.
Mothers’ and Fathers’ Perspectives on the Causes of Their Child’s Disorder
Authors: Felnhofer Anna , Bussek Theresa , Goreis Andreas , Kafka Johanna X , König Dorothea , Klier Claudia , Zesch Heidi , Kothgassner Oswald D
Published: July 2020

Background

Parental beliefs about the cause of their child’s illness are thought to affect parents’ help-seeking behaviors, treatment decisions, and the child’s health outcomes. Yet, research on parental beliefs about disease causation is still scarce. While a small number of studies assesses parental cause attributions for singular disorders (e.g., neurodevelopmental disorders), no study has compared disorders with differing physical versus mental conditions or with mixed comorbidities in children and adolescents or their caregivers. Furthermore, most pediatric research suffers from a lack of data on fathers.

Objective

Hence, the objective of the current study was to test for possible differences in mothers’ and fathers’ perceptions about the etiology of their child’s illness.

Methods

Forty-two parent couples (overall N = 84) whose child had been diagnosed either with Attention Deficit Hyperactivity-Disorder (ADHD) or Autism Spectrum Disorder (ASD) (category “neurodevelopmental disorder”) or with a primary physical illness and a comorbid mental disorder, e.g. depression (category “psychosomatic disorder”) were asked to rate possible causes of their child’s illness using a modified version of the revised Illness Perception Questionnaire (IPQ) Cause scale.

Results

A two-way ANOVA showed that psychosomatic disorders were significantly more strongly attributed to be caused by medical and environmental stressors than neurodevelopmental disorders. A significant parent × illness category interaction revealed that this effect was more pronounced in fathers.

Conclusions

By providing first insights into parental beliefs about the etiology of their children’s neurodevelopmental versus psychosomatic disorders, this study paves ground for future research and tailored counseling of affected families.
Intrathoracic sleeve gastrectomy migration with gastric volvulus treated with laparoscopic repair and conversion to gastric bypass
Authors: Alwatari Yahya , Roriz-Silva Renato , Bolckmans Roel , Campos Guilherme M
Published: July 2020

A 43 years old female with laparoscopic sleeve gastrectomy (SG) and an ‘anterior’ hiatal hernia repair 11 years ago, presented with 3 years history dysphagia and heartburn. Upper gastrointestinal barium showed an almost complete intrathoracic migration of the SG with a partial organoaxial volvulus. Upper endoscopy revealed a 10 cm hiatal hernia with grade B esophagitis. Laparoscopic revision surgery with reduction of the gastric sleeve, standard posterior hiatal hernia repair, resection of the narrowed remnant of the SG and conversion to a gastric bypass was performed. No postoperative complications occurred. The patient is asymptomatic at 2 years of follow-up. We present the technical standards for the management and discuss the suspected pathophysiology of this rare but challenging condition.
Patterns of illness and injury on Antarctic research cruises, 2004–2019: a descriptive analysis
Authors: Visser Jenny T
Published: July 2020

Background

Before the impact of the coronavirus disease 2019 pandemic, cruise travel had experienced exponential growth in the preceding decade. Travel medicine practitioners were increasingly called upon to provide pre-cruise travel advice and medical clearance. Demand for these services will return at some time in the future.

Methods

The clinical conditions seen in those presenting for care on six small-vessel scientific cruises to Antarctica were analysed.

Results

Personnel presented on 196 occasions resulting in 257 consultations (when initial plus all follow-up consultations were included). Personnel presented with a clinical condition at a rate of 17.9 per 1000 person-days at sea. The total consultation rate was 23.5 per 1000 person-days at sea. Injury accounted for 24% of all presentations at a rate of 4.3 per 1000 person-days at sea. Dermatological, soft tissue and musculoskeletal, general malaise and motion sickness were the four most common presentations.

Conclusions

Pre-cruise advice for travellers planning small-vessel cruises to polar regions needs to include skin care, prevention and management of sea sickness and how to reduce the risk of injury. Those providing medical care on such cruises should be prepared to manage a wide range of clinical presentations.
Rational coordination with no communication or conventions
Authors: Goranko Valentin , Kuusisto Antti , Rönnholm Raine
Published: July 2020

We study pure coordination games where in every outcome, all players have identical payoffs, ‘win’ or ‘lose’. We identify and discuss a range of ‘purely rational principles’ guiding the reasoning of rational players in such games and compare the classes of coordination games that can be solved by such players with no preplay communication or conventions. We observe that it is highly nontrivial to delineate a boundary between purely rational principles and other decision methods, such as conventions, for solving such coordination games.
The Patterns and Associated Cost of Serologic Testing for Helicobacter pylori in the U.S. Military Health System
Authors: Pak Kevin , Junga Zachary , Mertz Andrew , Singla Manish
Published: July 2020

Introduction

Helicobacter pylori (H. pylori) infection affects about half of the world’s population and can lead to multiple complications if left untreated. Testing for H. pylori infection in appropriate patients with prompt treatment followed by the testing of eradication is the standard of care in the United States. Active Duty Service members (ADSMs) in the U.S. military are a unique patient population that may be at higher risk for acquiring H. pylori infection given frequent deployments to developing countries. Noninvasive diagnostic strategies include the urea breath test, the stool antigen test, and serologic testing, which include H. pylori immunoglobulin M (IgM), immunoglobulin A (IgA), and immunoglobulin G (IgG) antibodies. Among noninvasive methods, the least sensitive is serology, and although there is clinical utility in testing for H. pylori IgG antibodies, H. pylori IgA or IgM antibodies have limited clinical utility. Despite this, H. pylori IgA and IgM antibodies are still widely ordered across the Military Health System.

Materials and Methods

In order to determine how frequently this testing is being ordered and the associated cost, we conducted a retrospective cross-sectional study of H. pylori serologic testing utilization in the MHS from October 2015 to September 2018 in adult patients using the MHS Data Repository. All H. pylori IgM, IgA, and IgG antibodies, H. pylori stool antigen tests, and H. pylori urea breath tests were queried during this time period across all ADSMs, retirees, and ADSM dependents for all adults. Cost information was obtained from LabCorp, and the institutional price used for cost analysis was the same throughout all military treatment facilities in the Department of Defense (DOD).

Results

We discovered that over a 3-yr period, 1,916 H. pylori IgA and 2,492 IgM antibodies were ordered. In total, the DOD spent close to $400,000 on antibody-based testing for H. pylori not accounting for indirect associated costs like personnel, supplies, repeat testing, as well as the costs of delayed diagnosis and associated complications.

Conclusion

H. pylori IgM and IgA have limited clinical utility, are inaccurate, and are costly to maintain, especially when more accurate alternative tests are available. Based on our analysis, we strongly recommend the removal of the H. pylori IgA and IgM serologic tests throughout the DOD in order to improve the efficiency and quality of care for patients suspected of having an H. pylori infection. Further research is needed to determine how these tests are ordered, how providers are responding to the results of the serologic tests, and if noninvasive testing is being ordered appropriately.
AT2018kzr: the merger of an oxygen–neon white dwarf and a neutron star or black hole
Authors: Gillanders J H , Sim S A , Smartt S J
Published: July 2020

We present detailed spectroscopic analysis of the extraordinarily fast-evolving transient AT2018kzr. The transient’s observed light curve showed a rapid decline rate, comparable to the kilonova AT2017gfo. We calculate a self-consistent sequence of radiative transfer models (using tardis) and determine that the ejecta material is dominated by intermediate-mass elements (O, Mg, and Si), with a photospheric velocity of ∼12 000–14 500 $\rm {km}\, s^{-1}$. The early spectra have the unusual combination of being blue but dominated by strong Fe ii and Fe iii absorption features. We show that this combination is only possible with a high Fe content (3.5 per cent). This implies a high Fe/(Ni+Co) ratio. Given the short time from the transient’s proposed explosion epoch, the Fe cannot be 56Fe resulting from the decay of radioactive 56Ni synthesized in the explosion. Instead, we propose that this is stable 54Fe, and that the transient is unusually rich in this isotope. We further identify an additional, high-velocity component of ejecta material at ∼20 000–26 000 $\rm {km}\, s^{-1}$, which is mildly asymmetric and detectable through the Ca ii near-infrared triplet. We discuss our findings with reference to a range of plausible progenitor systems and compare with published theoretical work. We conclude that AT2018kzr is most likely the result of a merger between an ONe white dwarf and a neutron star or black hole. As such, it would be the second plausible candidate with a good spectral sequence for the electromagnetic counterpart of a compact binary merger, after AT2017gfo.
On using dipolar modes to constrain the helium glitch in red giant stars
Authors: Dréau G , Cunha M S , Vrard M , Avelino P P
Published: July 2020

The space-borne missions CoRoT and Kepler have revealed numerous mixed modes in red giant stars. These modes carry a wealth of information about red giant cores, but are of limited use when constraining rapid structural variations in their envelopes. This limitation can be circumvented if we have access to the frequencies of the pure acoustic dipolar modes in red giants, i.e. the dipole modes that would exist in the absence of coupling between gravity and acoustic waves. We present a pilot study aimed at evaluating the implications of using these pure acoustic mode frequencies in seismic studies of the helium structural variation in red giants. The study is based on artificial seismic data for a red giant branch stellar model, bracketing seven acoustic dipole radial orders around νmax. The pure acoustic dipole-mode frequencies are derived from a fit to the mixed-mode period spacings and then used to compute the pure acoustic dipole-mode second differences. The pure acoustic dipole-mode second differences inferred through this procedure follow the same oscillatory function as the radial-mode second differences. The additional constraints brought by the dipolar modes allow us to adopt a more complete description of the glitch signature when performing the fit to the second differences. The amplitude of the glitch retrieved from this fit is 15${{\ \rm per\ cent}}$ smaller than that from the fit based on the radial modes alone. Also, we find that thanks to the additional constraints, a bias in the inferred glitch location, found when adopting the simpler description of the glitch, is avoided.
3D structure of the H ii region Sh2-235 from tunable-filter optical observations
Authors: Kirsanova M S , Boley P A , Moiseev A V , Wiebe D S , Uklein R I
Published: July 2020

We present observations of the H α, H β, [S ii] λλ6716, 6731 and [N ii] λ6583 emission lines in the galactic H ii region Sh2-235 with the Mapper of Narrow Galaxy Lines (MaNGaL), a tunable filter at the 1-m telescope of the Special Astrophysical Observatory of the Russian Academy of Sciences. We show that the H ii region is obscured by neutral material with AV ≈ 2−4 mag. The area with the highest AV is situated to the south-west from the ionizing star and coincides with a maximum detected electron density of ≳300 cm−3. The combination of these results with archive AKARI far-infrared data allows us to estimate the contribution of the front and rear walls to the total column density of neutral material in S235 and explain the 3D structure of the region. The H ii region consist of a denser, more compact portion deeply embedded in the neutral medium and the less dense and obscured gas. The front and rear walls of the H ii region are inhomogeneous, with the material in the rear wall having a higher column density. We find a two-sided photodissociation region in the dense clump S235 East 1, illuminated by a UV field with G0 = 50−70 and 200 Habing units in the western and eastern parts, respectively.
Battle of the Sex Chromosomes: Competition between X and Y Chromosome-Encoded Proteins for Partner Interaction and Chromatin Occupancy Drives Multicopy Gene Expression and Evolution in Muroid Rodents
Authors: Moretti Charlotte , Blanco Mélina , Ialy-Radio Côme , Serrentino Maria-Elisabetta , Gobé Clara , Friedman Robin , Battail Christophe , Leduc Marjorie , Ward Monika A , Vaiman Daniel , Tores Frederic , Cocquet Julie
Published: July 2020

Transmission distorters (TDs) are genetic elements that favor their own transmission to the detriments of others. Slx/Slxl1 (Sycp3-like-X-linked and Slx-like1) and Sly (Sycp3-like-Y-linked) are TDs, which have been coamplified on the X and Y chromosomes of Mus species. They are involved in an intragenomic conflict in which each favors its own transmission, resulting in sex ratio distortion of the progeny when Slx/Slxl1 versus Sly copy number is unbalanced. They are specifically expressed in male postmeiotic gametes (spermatids) and have opposite effects on gene expression: Sly knockdown leads to the upregulation of hundreds of spermatid-expressed genes, whereas Slx/Slxl1-deficiency downregulates them. When both Slx/Slxl1 and Sly are knocked down, sex ratio distortion and gene deregulation are corrected. Slx/Slxl1 and Sly are, therefore, in competition but the molecular mechanism remains unknown. By comparing their chromatin-binding profiles and protein partners, we show that SLX/SLXL1 and SLY proteins compete for interaction with H3K4me3-reader SSTY1 (Spermiogenesis-specific-transcript-on-the-Y1) at the promoter of thousands of genes to drive their expression, and that the opposite effect they have on gene expression is mediated by different abilities to recruit SMRT/N-Cor transcriptional complex. Their target genes are predominantly spermatid-specific multicopy genes encoded by the sex chromosomes and the autosomal Speer/Takusan. Many of them have coamplified with not only Slx/Slxl1/Sly but also Ssty during muroid rodent evolution. Overall, we identify Ssty as a key element of the X versus Y intragenomic conflict, which may have influenced gene content and hybrid sterility beyond Mus lineage since Ssty amplification on the Y predated that of Slx/Slxl1/Sly.
Analysis of accessible chromatin landscape in the inner cell mass and trophectoderm of human blastocysts
Authors: Yang Min , Tao Xin , Titus Shiny , Zhao Tianhua , Scott Richard T , Seli Emre
Published: July 2020

Early embryonic development is characterized by drastic changes in chromatin structure that affects the accessibility of the chromatin. In human, the chromosome reorganization and its involvement in the first linage segregation are poorly characterized due to the difficulties in obtaining human embryonic material and limitation on low input technologies. In this study, we aimed to explore the chromatin remodeling pattern in human preimplantation embryos and gain insight into the epigenetic regulation of inner cell mass (ICM) and trophectoderm (TE) differentiation. We optimized ATAC-seq (an assay for transposase-accessible chromatin using sequencing) to analyze the chromatin accessibility landscape for low DNA input. Sixteen preimplantation human blastocysts frozen on Day 6 were used. Our data showed that ATAC peak distributions of the promoter regions (<1 kb) and distal regions versus other regions were significantly different between ICM versus TE samples (P < 0.01). We detected that a higher percentage of accessible binding loci were located within 1 kb of the transcription start site in ICM compared to TE (P < 0.01). However, a higher percentage of accessible regions was detected in the distal region of TE compared to ICM (P < 0.01). In addition, eight differential peaks with a false discovery rate <0.05 between ICM and TE were detected. This is the first study to compare the landscape of the accessible chromatin between ICM and TE of human preimplantation embryos, which unveiled chromatin-level epigenetic regulation of cell lineage specification in early embryo development.
Developing an endogenous quorum-sensing based CRISPRi circuit for autonomous and tunable dynamic regulation of multiple targets in Streptomyces
Authors: Tian Jinzhong , Yang Gaohua , Gu Yang , Sun Xinqiang , Lu Yinhua , Jiang Weihong
Published: July 2020

Quorum-sensing (QS) mediated dynamic regulation has emerged as an effective strategy for optimizing product titers in microbes. However, these QS-based circuits are often created on heterologous systems and require careful tuning via a tedious testing/optimization process. This hampers their application in industrial microbes. Here, we design a novel QS circuit by directly integrating an endogenous QS system with CRISPRi (named EQCi) in the industrial rapamycin-producing strain Streptomyces rapamycinicus. EQCi combines the advantages of both the QS system and CRISPRi to enable tunable, autonomous, and dynamic regulation of multiple targets simultaneously. Using EQCi, we separately downregulate three key nodes in essential pathways to divert metabolic flux towards rapamycin biosynthesis and significantly increase its titers. Further application of EQCi to simultaneously regulate these three key nodes with fine-tuned repression strength boosts the rapamycin titer by ∼660%, achieving the highest reported titer (1836 ± 191 mg/l). Notably, compared to static engineering strategies, which result in growth arrest and suboptimal rapamycin titers, EQCi-based regulation substantially promotes rapamycin titers without affecting cell growth, indicating that it can achieve a trade-off between essential pathways and product synthesis. Collectively, this study provides a convenient and effective strategy for strain improvement and shows potential for application in other industrial microorganisms.
Ependymoma and Chordoma
Authors: Levine Adrian B , Wong Derek , Fatehi Mostafa , Yip Stephen
Published: July 2020

Ependymoma and chordoma are 2 tumors that occur throughout the craniospinal axis, and for which the extent of neurosurgical resection has a key prognostic role. Both tumors have distinctive pathologic features, yet can present significant diagnostic challenges to pathologists in cases without classical histology. The molecular understanding of ependymoma has had significant advances in the past decade, with the identification of 9 molecular groups with significant prognostic and clinical implications, while a comprehensive study of chordoma further emphasized the key role of brachyury overexpression in its pathogenesis. In this review, we discuss the pathogenesis, radiology and gross pathology, histology, and molecular features of these 2 tumors, as well as active research into targeted therapies, with an emphasis on practical diagnostic challenges, and the use of immunohistochemical and molecular tests in routine diagnostic practice.
Occupational low-dose irradiation and cancer risk among medical radiation workers
Authors: Chartier H , Fassier P , Leuraud K , Jacob S , Baudin C , Laurier D , Bernier M-O
Published: July 2020

Background

Medical workers are the largest group of workers occupationally exposed to low doses of ionizing radiation (IR) worldwide.

Aims

This review presents all the cohorts of medical workers exposed in the world and summarizes cancer risks associated with radiation exposure in this population.

Methods

Epidemiological studies on health professionals exposed to IR published from 1975 to 2019 were reviewed. Strength of evidence was assessed according to the modified Royal College of General Practitioners three-star system.

Results

Among the 16 epidemiological studies focusing on cancers from 11 cohorts among medical staff exposed to radiation, higher risks of cancer were observed for pre-1950 exposure and for medical workers who performed fluoroscopically guided interventional procedures or radionuclides procedures compared to those who did not. However, strength of evidence supporting the associations remains moderate as several methodological limits including the lack of dosimetry data, lifestyle factors and recent updates may obscure the link between medical occupational exposure and cancer occurrence.

Conclusions

Excess risk of cancer is suspected for high and former exposures. The more highly exposed professions, i.e. interventional physicians and nuclear medicine workers, should be monitored carefully. Collaborative projects aiming to increase the quantity and quality of information of the studied populations would be a key point
Petrogenesis and Lu–Hf Dating of (Ultra)Mafic Rocks from the Kutná Hora Crystalline Complex: Implications for the Devonian Evolution of the Bohemian Massif
Authors: Ackerman Lukáš , Kotková Jana , Čopjaková Renata , Sláma Jiří , Trubač Jakub , Dillingerová Veronika
Published: July 2020

The Lu–Hf isotope system and Sr–Nd–Hf–Os isotope systematics of mantle rocks are capable of unravelling the early processes in collision belts, especially in a hot subduction context where the Sm–Nd and U–Pb systems in crustal rocks are prone to resetting owing to high temperatures and interaction with melts during exhumation. To improve models of the Devonian–Carboniferous evolution of the Bohemian Massif, we investigated in detail mafic and ultramafic rocks (eclogite, pyroxenite, and peridotite) from the ultrahigh-pressure and ultrahigh-temperature Kutná Hora Crystalline Complex (KHCC: Úhrov, Bečváry, Doubrava, and Spačice localities). Petrography, multiphase solid inclusions, major and trace element compositions of rocks and minerals, and radiogenic isotopic data document contrasting sources and protoliths as well as effects of subduction-related processes for these rocks. The Úhrov peridotite has a depleted composition corresponding to the suboceanic asthenospheric mantle, whereas Bečváry and Doubrava peridotites represent lithospheric mantle that underwent melt refertilization by basaltic and SiO2-undersaturated melts, respectively. Multiphase solid inclusions enclosed in garnet from Úhrov and Bečváry peridotites represent trapped H2O ± CO2-bearing metasomatizing agents and Fe–Ti-rich melts. The KHCC eclogites either formed by high-pressure crystal accumulation from mantle-derived basaltic melts (Úhrov) or represent a fragment of mid-ocean ridge basalt-like gabbroic cumulate (Spačice) and crustal-derived material (Doubrava) both metamorphosed at high P–T conditions. The Lu–Hf age of 395 ± 23 Ma obtained for the Úhrov peridotite reflects garnet growth related to burial of the asthenospheric mantle during subduction of the oceanic slab. By contrast, Spačice and Doubrava eclogites yield younger Lu–Hf ages of ∼350 and 330 Ma, respectively, representing mixed ages as demonstrated by the strong granulite-facies overprint and trace element zoning in garnet grains. We propose a refined model for the Early Variscan evolution of the Bohemian Massif starting with the subduction of the oceanic crust (Saxothuringian ocean) and associated oceanic asthenospheric mantle (Úhrov) beneath the Teplá–Barrandian at ≥380 Ma, which was responsible for melt refertilization of the associated mantle wedge (Bečváry, Doubrava). This was followed by continental subduction (∼370–360 Ma?) accompanied by the oceanic slab break-off and incorporation of the upwelling asthenospheric mantle into the Moldanubian lithospheric mantle and subsequent coeval exhumation of mantle and crustal rocks at ∼350–330 Ma.
Psychological burden of healthcare professionals in Germany during the acute phase of the COVID-19 pandemic: differences and similarities in the international context
Authors: Skoda Eva-Maria , Teufel Martin , Stang Andreas , Jöckel Karl-Heinz , Junne Florian , Weismüller Benjamin , Hetkamp Madeleine , Musche Venja , Kohler Hannah , Dörrie Nora , Schweda Adam , Bäuerle Alexander
Published: July 2020

Background

Healthcare professionals (HPs) are the key figures to keep up the healthcare system during the COVID-19 pandemic and thus are one of the most vulnerable groups in this. To this point, the extent of this psychological burden, especially in Europe and Germany, remains unclear. This is the first study investigating German HPs after the COVID-19 outbreak.

Methods

We performed an online-based cross-sectional study after the COVID-19 outbreak in Germany (10–31 March 2020). In total, 2224 HPs (physicians n = 492, nursing staff n = 1511, paramedics n = 221) and 10 639 non-healthcare professionals (nHPs) were assessed including generalized anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-2), current health status (EQ-5D-3L), COVID-19-related fear, subjective level of information regarding COVID-19.

Results

HPs showed less generalized anxiety, depression and COVID-19-related fear and higher health status and subjective level of information regarding COVID-19 than the nHPs. Within the HP groups, nursing staff were the most psychologically burdened. Subjective levels of information regarding COVID-19 correlated negatively with generalized anxiety levels across all groups. Among HPs, nursing staff showed the highest and paramedics the lowest generalized anxiety levels.

Conclusions

In the context of COVID-19, German HPs seem to be less psychological burdened than nHPs, and also less burdened compared with existing international data.
Immunity passports to travel during the COVID-19 pandemic: controversies and public health risks
Authors: Liew Chee H , Flaherty Gerard T
Published: July 2020

As countries emerge from pandemic lockdown, many countries are relaxing international travel restrictions. Commercially available serologic tests for anti-SARS-CoV-2 antibodies are being performed. The concept of an ‘immunity passport’ has gained popularity, whereby evidence of SARS-CoV-2 antibody production would signal immunity to reinfection. For an immunity certificate to be validated for travel purposes, it should meet certain criteria. The introduction of such certificates faces multiple challenges. While there may be a future role for immunity passports in limited circumstances in the event that a protective vaccine becomes freely available, for now at least the risks of such an approach outweigh the perceived benefits.
The presentation, diagnosis and management of non-traumatic wrist pain: an evaluation of current practice in secondary care in the UK NHS
Authors:   The MOWP study group:, Dean Benjamin J F , Carr Andrew , Trickett Ryan W , Kluzek Stefan , Riley Nicholas , Bretherton Christopher P , Wilson Melanie K , Hayton Mike J , Rupani Neal R , Hsieh Ching Cheng Daniel , Clifton Laura J , Dacombe Peter , Milnes Lydia K , Jayasuriya Raveen L , George Harvey A , Das Rishi , Mayne Alistair , Brown Matthew T , Lipscombe Stephen J , Eastwood Gillian L , Unsworth Richard M , Wright Lucie J , As-Sultany Mohammed , Dean Benjamin J F , Carr Andrew , Trickett Ryan W , Kluzek Stefan , Riley Nicholas , Bretherton Christopher P , Wilson Melanie K , Hayton Mike J , Rupani Neal R , Hsieh Ching Cheng Daniel , Clifton Laura J , Dacombe Peter , Milnes Lydia K , Jayasuriya Raveen L , George Harvey A , Das Rishi , Mayne Alistair , Brown Matthew T , Lipscombe Stephen J , Eastwood Gillian L , Unsworth Richard M , Wright Lucie J , As-Sultany Mohammed
Published: July 2020

Objectives

The study aims were to assess the burden of non-traumatic wrist pain in terms of numbers of referrals to secondary care and to characterize how patients present, are diagnosed and are managed in secondary care in the UK National Health Service.

Methods

Ten consecutive patients presenting with non-traumatic wrist pain were identified retrospectively at each of 16 participating hospitals, and data were extracted for 12 months after the initial referral.

Results

The 160 patients consisted of 100 females and 60 males with a median age of 49 years, accounting for ∼13% of all new hand/wrist referrals. The dominant wrist was affected in 60% of cases, and the mean symptom duration was 13.3 months. Diagnoses were grouped as follows: OA (31%), tendinopathy (13%), ganglion (14%), ulnar sided pain (17%) and other (25%). The OA group was significantly older than other groups, and other groups contained a predominance of females. The non-surgical interventions, in decreasing frequency of usage, were as follows: CS injections (39%), physiotherapy (32%), splint (31%) and analgesics (12%). Of those who underwent surgery, all patients had previously received non-surgical treatment, but 42% had undergone only one non-surgical intervention.

Conclusions

Non-traumatic wrist pain represents a significant burden to secondary care both in terms of new patient referrals and in terms of investigation, follow-up and treatment. Those presenting with OA are more likely to be older and male, whereas those presenting with other diagnoses are more likely to be younger and female.
Tradeoff Theory and Leverage Dynamics of High-Frequency Debt Issuers*
Authors: Eckbo B Espen , Kisser Michael
Published: July 2020

We test whether high-frequency net-debt issuers (HFIs)—public industrial companies with relatively low issuance costs and high debt-financing benefits—manage leverage toward long-run targets. Our answer is they do not: (1) the leverage–profitability correlation is negative even in quarters with leverage rebalancing; (2) the speed-of-adjustment to target leverage deviations is no higher for HFIs than for low-frequency net-debt issuers; and (3) under-leveraged HFIs do not speed up rebalancing activity in significant investment periods. Thus, even in the subset of firms most likely to follow dynamic trade-off theory, the theory does not appear to hold.
Hard Times: Routine Schedule Unpredictability and Material Hardship among Service Sector Workers
Authors: Schneider Daniel , Harknett Kristen
Published: July 2020

American policymakers have long focused on work as a key means to improve economic wellbeing. Yet, work has become increasingly precarious and polarized. This precarity is manifest in low wages but also in unstable and unpredictable work schedules that often vary significantly week to week with little advance notice. We draw on new survey data from The Shift Project on 37,263 hourly retail and food service workers in the United States. We assess the association between routine unpredictability in work schedules and household material hardship. Using both cross-sectional models and panel models, we find that workers who receive shorter advanced notice, those who work on-call, those who experience last minute shift cancellation and timing changes, and those with more volatile work hours are more likely to experience hunger, residential, medical, and utility hardships as well as more overall hardship. Just-in-time work schedules afford employers a great deal of flexibility but at a heavy cost to workers’ economic security.
Fusarium Hardlock Associated With Lygus lineolaris (Hemiptera: Miridae) Injury in Southeastern Cotton
Authors: Dorman Seth J. , Opoku Joseph , Mehl Hillary L. , Taylor Sally V.
Published: July 2020

The tarnished plant bug, Lygus lineolaris (Palisot de Beauvois), is an important insect pest in cotton that feeds on reproductive fruit, contributing to yield loss. Economically damaging infestations of L. lineolaris have doubled in Virginia since 2013. Escalation of L. lineolaris abundance may increase Fusarium hardlock disease observed in this region, compounding economic losses. Research has linked Fusarium hardlock with fungal species Fusarium verticillioides and F. proliferatum. Field and greenhouse experiments were performed to investigate (i) Fusarium hardlock occurrence in field plots managed and unmanaged for L. lineolaris, (ii) severity of F. verticillioides infection of cotton bolls with and without the presence of L. lineolaris feeding in a greenhouse setting, and (iii) Fusarium species composition and prevalence within field-collected L. lineolaris and cotton lint with and without insect feeding injury and hardlock symptoms present. Nearly twice the amount of hardlock (i.e., proportion of hardlocked locules) occurred in field-collected bolls with L. lineolaris feeding symptoms (0.40 ± 0.02) compared with bolls without (0.21 ± 0.01). Based on real-time quantitative PCR, cotton bolls exposed to F. verticillioides inoculum and caged with L. lineolaris adults had greater levels of F. verticillioides DNA compared with untreated bolls. F. proliferatum, F. verticillioides, and F. fujikuroi were isolated from field-collected L. lineolaris and hardlocked cotton lint at harvest. These findings suggest that the presence of L. lineolaris is associated with an increased risk of Fusarium hardlock in Southeastern cotton, and both should be carefully managed using timely insecticide applications and cultural control practices to minimize yield loss.
The In Vitro and In Planta Interspecies Interactions Among Rice-Pathogenic Burkholderia Species
Authors: Kim Namgyu , Mannaa Mohamed , Kim Juyun , Ra Ji-Eun , Kim Sang-Min , Lee Chaeyeong , Lee Hyun-Hee , Seo Young-Su
Published: July 2020

Burkholderia glumae, B. plantarii, and B. gladioli are responsible for serious diseases in rice crops and co-occurrence among them has been reported. In this study, in vitro assays revealed antagonistic activity among these organisms, with B. gladioli demonstrating strong inhibition of B. glumae and B. plantarii. Strains of B. glumae and B. plantarii that express green fluorescent protein were constructed and used for cocultivation assays with B. gladioli, which confirmed the strong inhibitory activity of B. gladioli. Cell-free supernatants from each species were tested against cultures of counterpart species to evaluate the potential to inhibit bacterial growth. To investigate the inhibitory activity of B. gladioli on B. glumae and B. plantarii in rice, rice plant assays were performed and quantitative PCR (qPCR) assays were developed for in planta bacterial quantification. The results indicated that coinoculation with B. gladioli leads to significantly reduced disease severity and colonization of rice tissues compared with single inoculation with B. glumae or B. plantarii. This study demonstrates the interactions among three rice-pathogenic Burkholderia species and strong antagonistic activity of B. gladioli in vitro and in planta. The qPCR assays developed here could be applied for accurate quantification of these organisms from in planta samples in future studies.
The ABCs of atrial fibrillation
Authors: El Hussein Mohamed Toufic , Kilfoil Lauren
Published: July 2020

This article provides an outline of the diagnosis and pathogenesis of atrial fibrillation. It introduces a mnemonic for atrial fibrillation treatment guidelines based on recent evidence. Mnemonics use has been associated with improved learning and task organization.1 Articles using mnemonics to inform clinical practice have been well-received and implemented.2,3
Fetal Transient Skin Edema in Two Pregnant Women With Coronavirus Disease 2019 (COVID-19)
Authors: Garcia-Manau Pablo , Garcia-Ruiz Itziar , Rodo Carlota , Sulleiro Elena , Maiz Nerea , Catalan Marina , Fernández-Hidalgo Nuria , Balcells Joan , Antón Andrés , Carreras Elena , Suy Anna
Published: July 2020

BACKGROUND:

The risk of vertical transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains unknown. Positive reverse-transcription polymerase chain reaction (RT-PCR) test results for SARS-CoV-2 infection in neonates and placental tissue have been reported, and immunoglobulin M antibodies have been detected in neonates born to mothers with infection.

CASES:

The first case is a woman at 22 3/7 weeks of gestation with coronavirus disease 2019 (COVID-19) who was admitted to the intensive care unit. In the second case, the patient remained at home with mild symptoms, starting at 20 weeks of gestation. In both cases, fetal skin edema was observed on ultrasound examination while maternal SARS-COV-2 RT-PCR test results were positive and resolved when maternal SARS-COV-2 RT-PCR test results became negative. The RT-PCR test result for SARS-CoV-2 in amniotic fluid was negative in both cases. The two pregnancies are ongoing and uneventful.

CONCLUSION:

Transient fetal skin edema noted in these two patients with COVID-19 in the second trimester may represent results of fetal infection or altered fetal physiology due to maternal disease or may be unrelated to the maternal illness.