bluuebunny/crossref_metadata_2025 huggingface dataset:
Experiences of discrimination among people living with HIV in Serbia
Authors: Baros S , Bozinovic-Knezevic A
Published: October 2020

Background

Anti-discrimination regulation is a condition for reaching UNAIDS's “zero discrimination” target. In Serbia, there are laws that forbid discrimination and guarantee the confidentiality of health status. However, about 24% of people living with HIV (PLHIV) had experienced discrimination and most do not report the discrimination to the proper institutions.

Methods

We conducted qualitative research among PLHIV from December 2018-May 2019. We reached 43 persons, with five focus groups in the four cities where there were centers for HIV treatment. We transcribed and coded the interviews in Serbian and used thematic analysis to explore experiences of discrimination among PLHIV.

Results

PLHIV are aware of laws protecting the confidentiality of their HIV status and against discrimination. However, PLHIV do not believe implementation of those laws are appropriate. Most participants experienced discrimination in the health system and described that medical doctors demand to know their HIV status. This demand led to unequal treatment of PLHIV patients, and sometimes to non-consensual disclosure of one's HIV status to others. For employed PLHIV regular medical check-ups and eventual hospitalizations introduce an additional risk of discrimination. For sick leave requests by the law they have to submit documents with medical information to their employer and participants feared that HIV status will be a part of the documentation. Some participants described the loss of employment because of this disclosure. Majority of PLHIV fear further disclosure of their HIV status and additional discrimination if they follow complaint procedures.

Conclusions

Contradictory regulations increase the risk of discrimination of PLHIV. Anticipated stigma and fear of discrimination hinder the full attainment and respect for human rights by PHLIV. Harmonization of regulation and procedures of the anti-discrimination legislation is the first step to the “zero discrimination” target.
Applying “Acting Within Contexts” to intervention evaluation and equitable intervention design
Authors: Adam C
Published: October 2020

With the rise of chronic illness in the last century, notably diabetes, cardiovascular disease, and obesity, public health has worked to identify the causes of these diseases in order to develop effective interventions and improve population health. Research has shown that these chronic diseases are strongly linked to lifestyle-related risk factors such as smoking, poor eating habits, and physical inactivity. Based on this knowledge, public health interventions have focused on health information and education programs that target these lifestyle-related risk factors. However, these programs have been found to be ineffective because these lifestyle-related strategies do not take into account the contexts that influence behaviour change. This has been found to be particularly true for vulnerable populations who tend to live in contexts of poverty. We therefore asked: how do contexts of vulnerability influence the way people act in their daily lives? To address this question, findings from a qualitative project led to the development of the “Acting Within Contexts” framework. It is a system of five interrelated components (i.e. agency, resources, capacities, threats, and opportunities), which offers an analytical lens to better understand the influence of vulnerable contexts on how people carry out their daily actions.

This presentation will first propose an explanation of the limits of public health interventions that aim to change behaviours. Secondly, based on the two previous presentations, it will present how “Acting Within Contexts” can be used: 1) to develop a better understanding of contexts in which vulnerable populations live, based on how the five components interact in people's lives to either hinder or facilitate their access to health; and 2) to design interventions that will shift the focus away from lifestyle-related risk factors, and rather, towards targeting the five components that make up people's everyday contexts.
Immunization programs for hospital healthcare workers in Northern-Italy, can we do more?
Authors: Antinolfi F , Brunelli L , Malacarne F , Cocconi R , Brusaferro S
Published: October 2020

Background

Coverage for vaccine-preventable diseases (VPDs) among healthcare workers (HCWs) in Italy remains low, and WHO strongly recommends to tailor immunization programs to tackle hesitancy. Aim of the study was to investigate HCW-specific immunization programs within Friuli Venezia Giulia (FVG) Region in order to plan new common strategies.

Methods

In December 2019 we collected information about FVG hospitals and HCWs immunization programs conducted within each of them, including: number of HCWs employed, monitored VPDs, immunization assumption, vaccination strategies and refusers management.

Results

We obtained data from 7/7 hospitals, for a total of 12,557 employed HCWs (average 1,794; range 467-3,922); 2 hospitals are academic centers, while 2 are research institutions. All hospitals have immunization programs for measles, mumps, rubella; the majority for hepatitis B (6/7); 5 for diphtheria, tetanus, pertussis, chicken pox. Presumptive evidence of immunity is established when written vaccination documentation is available or in presence of laboratory evidence. HCWs immunization programs are responsibility of the occupational doctor in most hospitals (6/7). Vaccination promotion strategies include: mail or email personal invitation, training courses, video and notice display on hospital website, reminders. Most hospitals set up a dedicated vaccination service located in a hospital common area (4) or outside the hospital (2); one hospital also offered ward on-site vaccination. For airborne or droplets transmission diseases, refusers are asked to wear a mask during shift in 2 hospitals.

Conclusions

HCWs immunization programs in FVG Region are heterogeneous, and their specific effectiveness has to be studied yet. This study represents the first step in the process of FVG hospitals engagement in sharing effective actions in order to plan a new regional strategy for HWCs immunization.

Key messages

The investigation of effective strategies conducted in different FVG hospitals is essential for their scaling-up evaluation. A common regional plan for healthcare workers immunization is needed to tackle hesitancy and reduce infectious risk within hospitals.
“A room of our own”. Social media use amongst youth with immigrant background in Norway
Authors: Spjeldnæs I O , Agdal R
Published: October 2020

Background

Social media includes webpages, apps and digital games, where content can be created and shared, and participation in social networks is possible. It is known that social media impacts the lives of youth in a complex way. So far, little is known about how immigrant youth use social media and how that impacts their lives. The immigrant population is heterogeneous and complex, but overall, experiences a heavier burden of disease. In this study, we explored how immigrant youth use social media, and particularly how social media could contribute to health promotion.

Methods

We collaborated with non-governmental organisations to establish six focus group interviews that lasted for two hours each. The interviews were transcribed and analyzed by thematic content analysis.

Results

Immigrant youth met both barriers and benefits related to their background through their participation on social media. Barriers related to lack of knowledge about relevant social codes and to limited access due to negative social control. Benefits were the social interaction with people of similar identity. The youth navigated and carved rooms on social media to discuss topics like identity, social control, and to escape attributed identities and social control. They used several platforms established by immigrant youth and their organisations that contributed positively.

Conclusions

Social media represents arenas that serve as resources for immigrant youth. We found examples of use and platforms established by immigrant youth that can be incorporated into public health strategies. Yet, social media consists of social codes and structures, and unequal accessibility, like other social arenas. Such barriers can be addressed by providing more equal access to these social arenas.

Key messages

To youth with immigrant background in Norway, social media represents valuable arenas for health promotion. Social media signifies fruitful opportunities to navigate identities and social control.
Systematic review on multidisciplinarity and management of multimorbid chronic patients in hospital
Authors: Di Serafino F , Pascucci D , Sassano M , Di Pilla A , Carini E , Specchia M L , Ricciardi W , Damiani G
Published: October 2020

Multimorbidity requires that many physicians shift the focus of the care they provide towards the management of multiple chronic conditions such as heart diseases, diabetes, chronic obstructive pulmonary disease and mental illness. The aim of this systematic review is to summarize the scientific evidence on the effects of Multidisciplinary Teams (MDT) on chronic patients' management in hospital settings, evaluating outcomes, costs and workload.

Medline, Scopus and Ovid were queried for relevant articles using the Population-Intervention-Context-Outcome (PICO) model. Selected articles were assessed for quality and risk of bias using the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Data were analyzed using descriptive statistics, and comparison among comorbid patients with at least one mental illness versus those without was performed using Chi-square test (p < 0,05).

Out of 7332 records, 7 studies met the inclusion criteria and 85 indicators were identified: 52% improved significantly, 46% did not show any variation and 2% (nausea and delirium) worsened. In particular, in-hospital mortality was significantly reduced in 65% of the studies describing such indicator. The presence of a mental illness showed a statistically significant increase of length of stay (p < 0,05), hence related to a lower bed-day saving, while no statistically significant effect was observed on 30-day readmissions (p = 0,13). In addition, few studies highlighted that a higher workload leads to greater burn-out rates.

MDT meetings represent a fundamental step in a complex path care. They are useful to discuss clinical cases to define their diagnosis and to formulate shared treatment plans in order to deliver personalized treatment options and appropriate follow-up. These findings should stimulate decision makers to invest in the development of MDT and further research should be conducted to evaluate team efficacy.

Key messages

Successful management of chronic diseases can be enhanced by Multidisciplinary Teams. Caregivers can be involved in this relational process to ensure a better path care.
A participatory and systemic training approach for IPC improvement in Nigerian health facilities
Authors: Zocher U , Okwor T J , Dan-Nwafor C , Yahya D , Ita Ita O , Saleh M , Ogunniyi A , Ihekweazu C , Poggensee G
Published: October 2020

Background

Health care-associated infections (HAI) are one of the most common adverse events in care delivery and a major public health problem. A large percentage of HAI in hospitals are preventable through effective infection prevention and control (IPC) measures. IPC trainings for health care personnel based only on technical content do not lead to sustainable improvement of IPC standard precautions. To address this problem, the Nigeria Centre for Disease Control (NCDC) in collaboration with the Robert Koch Institute (RKI) developed a multimodal training approach to facilitate the transfer of IPC competences into working routine in Nigerian health facilities.

Objectives

The training should foster the ability of health care workers to act and communicate participatory, analyze IPC problems systemically and to develop and perform tailored IPC activities in their health facilities. It should empower health care workers to initiate and promote sustainable IPC improvement locally.

Results

We developed a participatory training approach which focusses on the relational and organizational dimension of IPC. It addresses the human and infrastructural factors for IPC compliance in daily working routine. A variety of training methods offers practice tools in communication, systemic thinking and team work, and allows experiencing a participatory attitude. The training program consists of two face to face workshops and an interjacent field project. 28 Health care workers of 14 health facilities in Lagos State participated the first implementation of the training program in 2018. The training evaluation showed the high relevance of the training to the HCW. The field projects showed that the participants could apply the participatory approach for IPC improvement.

Conclusions

A participatory and systemic approach for IPC trainings enables health care workers to take action for IPC improvement locally.

Key messages

We developed and implemented a participatory training approach that addresses the relational and organizational dimension of IPC. Health care workers took tailored actions for IPC improvement locally.
Organization and activities of school health services among EU countries
Authors: Michaud Pierre-André , Vervoort Johanna P M , Visser Annemieke , Baltag Valentina , Reijneveld Sijmen A , Kocken Paul L , Jansen Danielle
Published: October 2020

Background

School health services (SHS) can be defined as health services provided to enrol pupils by health professionals and/or allied professions. The aim of this study was to explore the current state of the governance, organization and workforce of SHS and their provision of preventive activities in European countries.

Methods

Observational study. Data were collected as part of the Horizon 2020-funded project ‘Models of Child Health Appraised’. Only 1 expert from each of the 30 included European countries answered a closed-items questionnaire during the years 2017 and 2018.

Results

All countries (except Spain and the Czech Republic, which do not have formal SHS) provided school-based individual screening and health-enhancing measures. The majority performed height, weight, vision and hearing checks; some integrated other assessments of limited evidence-based effectiveness. Most countries also delivered health education and promotion activities in areas, such as sexual health, substance use and healthy nutrition. Almost all countries seemed to suffer from a shortage of school health professionals; moreover, many of these professionals had no specific training in the area of school health and prevention.

Conclusions

Many EU countries need better administrative and legal support. They should promote evidence-based screening procedures and should hire and train more school health professionals. Overall, they need to adapt to the evolving health priorities of pupils, adopt a more holistic paradigm and extend their activities beyond traditional screening or vaccination procedures.
Composition of soil bacterial and fungal communities in relation to vegetation composition and soil characteristics along an altitudinal gradient
Authors: Bayranvand Mohammad , Akbarinia Moslem , Salehi Jouzani Gholamreza , Gharechahi Javad , Kooch Yahya , Baldrian Petr
Published: October 2020

The objective of the present study was to evaluate how altitudinal gradients shape the composition of soil bacterial and fungal communities, humus forms and soil properties across six altitude levels in Hyrcanian forests. Soil microbiomes were characterized by sequencing amplicons of selected molecular markers. Soil chemistry and plant mycorrhizal type were the two dominant factors explaining variations in bacterial and fungal diversity, respectively. The lowest altitude level had more favorable conditions for the formation of mull humus and exhibited higher N and Ca contents. These conditions were also associated with a higher proportion of Betaproteobacteria, Acidimicrobia, Acidobacteria and Nitrospirae. Low soil and forest floor quality as well as lower bacterial and fungal diversity characterized higher altitude levels, along with a high proportion of shared bacterial (Thermoleophilia, Actinobacteria and Bacilli) and fungal (Eurotiomycetes and Mortierellomycota) taxa. Beech-dominated sites showed moderate soil quality and high bacterial (Alphaproteobacteria, Acidobacteria, Planctomycetes and Bacteroidetes) and fungal (Basidiomycota) diversity. Particularly, the Basidiomycota were well represented in pure beech forests at an altitude of 1500 m. In fertile and nitrogen rich soils with neutral pH, soil quality decreased along the altitudinal gradient, indicating that microbial diversity and forest floor decomposition were likely constrained by climatic conditions.
The influence of small states: how Bhutan succeeds in influencing global sustainability governance
Authors: Theys Sarina , Rietig Katharina
Published: October 2020

How do small states succeed in influencing global policies? Traditional International Relations theories highlight the vulnerability and limited capacity of small states and suggest that the scope for these states to influence global policies is limited. However, recent literature on small states in global governance has challenged this view. Studies have found that in the context of international organizations, participation in coalitions and favourable decision-making structures, among others, contribute to explaining the influence of small states in global governance. While these factors are indeed relevant, they only partly explain how small states are able to influence global policies. Drawing on in-depth qualitative research exploring the influence of small states, this article advances understandings of how small states can influence global governance and international negotiations. Focusing on one small state, the article analyses how Bhutan, through policy entrepreneur Jigme Y. Thinley, challenged fundamental ideas about what constitutes development by placing happiness on the global agenda. We contribute unique data on the influence of Bhutan and an analytical framework on the influence of small states, outlining a process of how small states can influence global policy despite their structural weaknesses. The framework consists of an attribute in the form of policy entrepreneur(s) who speak and act on behalf of the state, four strategies comprising the marketing of the state, venue shopping, facilitating learning and coalition networks, and two framework conditions, including windows of opportunity and a conducive decision-making process.
Multinational security coalitions and the limits of middle power activism in the Middle East: the Saudi case
Authors: Miller Rory , Cardaun Sarah
Published: October 2020

This article examines Saudi Arabia's decision in recent years to use novel and hitherto unexplored informal alliance formats, which we term multinational security coalitions (MSCs). This development was initiated by the new Saudi political leadership under King Salman and Crown Prince Mohammad bin Salman, who have a much greater inclination to pursue proactive foreign and security policies than their predecessors. However, it will be highlighted that beyond the priorities of individual personalities, this shift in Saudi Arabia's behaviour occurred against the backdrop of significant changes in the existing security environment, including the perceived withdrawal of the United States from the security affairs of the region during the presidency of Barack Obama, and crucially also Saudi Arabia's frustration over the failure of the Gulf Cooperation Council (GCC) to develop into a viable security mechanism. The article begins with the introduction of the key ideas relating to institutional design, the conceptual framework for this study. Section two outlines the most important reasons for Saudi Arabia's choice of the MSC format. The third section examines the strengths of the MSC format—especially informality, the resulting low entry-thresholds and the low risk of entrapment—that provided Saudi Arabia with partial and temporary success in recruiting coalition partners and thus bolstering its leadership role. The final section demonstrates, however, that ultimately MSCs are not a panacea. The informality of MSCs that makes it easy for the pivotal state to assemble a coalition also makes it hard for it to forge, and enforce, a common vision.
Three lumps of coal: doing fisheries research in Lowestoft in the 1940s
Authors: Holt Sidney J
Published: October 2020

Following graduation from the University of Reading in 1946, I was offered a job as a “Naturalist” at the Lowestoft Fisheries Laboratory. I learned to appreciate Michael Graham, the director, and was incredibly lucky to have such a man as my first boss and mentor. During my few months working alone before Ray Beverton returned from Cambridge, I put together the simple yield equation in the form in which it was eventually published, and produced most of the theorems that you may see in Parts I and II of Beverton and Holt (On the Dynamics of Exploited Fish Populations. Her Majesty’s Stationery Office, UK. 533 pp.). When Ray returned, we began to work seriously together in 1947–1950 to complete the substantive work on the book. The three lumps of coal was the fuel brought daily into our office in an annex to the main laboratory to keep us warm while working. Before leaving Lowestoft in 1950 for the Nature Conservancy, considerable time was devoted to publishing papers and “diversions” such as attending/speaking at conferences and international negotiations, as well as research on possible effects on fish of low-level radioactive wastes from a nuclear power plant. In late 1953, I resigned from the Nature Conservancy and accepted a position with the UN’s Food and Agriculture Organization in Rome.
Combinatorics of Orbit Configuration Spaces
Authors: Bibby Christin , Gadish Nir
Published: October 2020

From a group action on a space, define a variant of the configuration space by insisting that no two points inhabit the same orbit. When the action is almost free, this “orbit configuration space” is the complement of an arrangement of subvarieties inside the Cartesian product, and we use this structure to study its topology. We give an abstract combinatorial description of its poset of layers (connected components of intersections from the arrangement), which turns out to be of much independent interest as a generalization of partition and Dowling lattices. The close relationship to these classical posets is then exploited to give explicit cohomological calculations.
Immunization Against Poliomyelitis and the Challenges to Worldwide Poliomyelitis Eradication
Authors: Modlin John F , Bandyopadhyay Ananda S , Sutter Roland
Published: October 2020

Both inactivated poliovirus vaccine (IPV) and oral poliovirus vaccine (OPV) have contributed to the rapid disappearance of paralytic poliomyelitis from developed countries despite possessing different vaccine properties. Due to cost, ease of use, and other properties, the Expanded Programme on Immunization added OPV to the routine infant immunization schedule for low-income countries in 1974, but variable vaccine uptake and impaired immune responses due to poor sanitation limited the impact. Following launch of the Global Polio Eradication Initiative in 1988, poliomyelitis incidence has been reduced by >99% and types 2 and 3 wild polioviruses are now eradicated, but progress against type 1 polioviruses which are now confined to Afghanistan and Pakistan has slowed due to insecurity, poor access, and other problems. A strategic, globally coordinated replacement of trivalent OPV with bivalent 1, 3 OPV in 2016 reduced the incidence of vaccine-associated paralytic poliomyelitis (VAPP) but allowed the escape of type 2 vaccine–derived polioviruses (VDPV2) in areas with low immunization rates and use of monovalent OPV2 in response seeded new VDPV2 outbreaks and reestablishment of type 2 endemicity. A novel, more genetically stable type 2 OPV vaccine is undergoing clinical evaluation and may soon be deployed prevent or reduce VDPV2 emergences.
P2X receptor agonist enhances tumor-specific CTL responses through CD70+ DC-mediated Th17 induction
Authors: Yamamoto Shinya , Matsuo Kazuhiko , Sakai Sho , Mishima Itsuki , Hara Yuta , Oiso Naoki , Kawada Akira , Yoshie Osamu , Nakayama Takashi
Published: October 2020

Extracellular ATP is known to promote Th17 cell differentiation in the intestinal lamina propria by stimulating CD70+CD11clow dendritic cells (DCs) via P2X receptors (P2XRs). Recent studies have also shown that Th17 cells enhance antitumor immunity by directly promoting proliferation of cytotoxic T lymphocytes (CTLs). These finding led us to test a P2XR agonist, αβ-methylene ATP (αβ-ATP), as a mucosal vaccine adjuvant to promote CTL responses through Th17 induction. We demonstrated that (i) CD70+CD11clow DCs were present in the nasal lamina propria and expressed P2X1R, P2X2R and P2X4R; (ii) CD70+CD11clow DCs isolated from the nasal lamina propria enhanced Th17 cell differentiation of cocultured splenic CD4+ T cells upon stimulation with αβ-ATP; (iii) mice intranasally immunized with ovalbumin (OVA) and αβ-ATP had increased OVA-specific Th17 cells and CTLs in the nasal lamina propria and regional lymph nodes; (iv) mice intranasally immunized with OVA and αβ-ATP also had elevated resistance to E.G7-OVA tumor growth compared with those intranasally immunized with OVA alone; (v) suramin, a broad-range inhibitor of P2 receptors, suppressed the increases of OVA-specific Th17 cells and CTLs in mice intranasally immunized with OVA and αβ-ATP; and (vi) suramin also abrogated the enhanced antitumor immunity of mice intranasally immunized with OVA and αβ-ATP against E.G7-OVA. Collectively, αβ-ATP may be a promising mucosal adjuvant that promotes antigen-specific CTL responses via CD70+CD11clow DC-mediated Th17 induction.
The Enduring Legacy of the Dodd-Frank Act’s Derivatives Reforms
Authors: Tarbert Heath P
Published: October 2020

Despite the shortcomings of the Dodd-Frank Act, this article argues that the two parts most relevant to derivatives—Titles VII and VIII—are likely to endure. Title VII, which covers the trading of derivatives, especially swaps, generally strikes the right balance between preserving the vibrancy of the US derivatives markets and mitigating risk to market participants and the US financial system. While Title VII’s consolidation of much of the credit risk management function in central counterparties (CCPs) itself poses a systemic risk, this article contends nonetheless that Title VII addresses this risk by giving the Commodity Futures Trading Commission (CFTC) the power to mitigate it through regulations that implement the ‘core principles’ applicable to CCPs. This oversight is complemented by Title VIII, which provides enhanced supervision of systemically important CCPs. The Dodd-Frank Act’s approach to derivatives will endure, it is argued, so long as policymakers understand the interrelationship between Titles VII and VIII. This article focuses on that relationship and closes with a brief discussion of some of the work the CFTC is undertaking to bring finality to the statutory framework created by Titles VII and VIII.
Ghosts of a Structured Past: Impacts of Ancestral Patterns of Isolation-by-Distance on Divergence-Time Estimation
Authors: Hancock Zachary B , Blackmon Heath
Published: October 2020

Isolation-by-distance is a widespread pattern in nature that describes the reduction of genetic correlation between subpopulations with increased geographic distance. In the population ancestral to modern sister species, this pattern may hypothetically inflate population divergence time estimation due to allele frequency differences in subpopulations at the ends of the ancestral population. In this study, we analyze the relationship between the time to the most recent common ancestor and the population divergence time when the ancestral population model is a linear stepping-stone. Using coalescent simulations, we compare the coalescent time to the population divergence time for various ratios of the divergence time over the population size. Next, we simulate whole genomes to obtain single nucleotide polymorphisms (SNPs), and use the Bayesian coalescent program SNAPP to estimate divergence times. We find that as the rate of migration between neighboring demes decreases, the coalescent time becomes significantly greater than the population divergence time when sampled from end demes. Divergence-time overestimation in SNAPP becomes severe when the divergence-to-population size ratio < 10 and migration is low. Finally, we demonstrate the impact of ancestral isolation-by-distance on divergence-time estimation using an empirical dataset of squamates (Tropidurus) endemic to Brazil. We conclude that studies estimating divergence times should be cognizant of the potential ancestral population structure in an explicitly spatial context or risk dramatically overestimating the timing of population splits.
News and Idiosyncratic Volatility: The Public Information Processing Hypothesis*
Authors: Engle Robert F , Hansen Martin Klint , Karagozoglu Ahmet K , Lunde Asger
Published: October 2020

Motivated by the recent availability of extensive electronic news databases and advent of new empirical methods, there has been renewed interest in investigating the impact of financial news on market outcomes for individual stocks. We develop the information processing hypothesis of return volatility to investigate the relation between firm-specific news and volatility. We propose a novel dynamic econometric specification and test it using time series regressions employing a machine learning model selection procedure. Our empirical results are based on a comprehensive dataset comprised of more than 3 million news items for a sample of 28 large U.S. companies. Our proposed econometric specification for firm-specific return volatility is a simple mixture model with two components: public information and private processing of public information. The public information processing component is defined by the contemporaneous relation with public information and volatility, while the private processing of public information component is specified as a general autoregressive process corresponding to the sequential price discovery mechanism of investors as additional information, previously not publicly available, is generated and incorporated into prices. Our results show that changes in return volatility are related to public information arrival and that including indicators of public information arrival explains on average 26% (9–65%) of changes in firm-specific return volatility.
Torsion of a mucocele of the veriform appendix: report of a case
Authors: Knol M E , de Leede E M , van Beurden A
Published: October 2020

Mucocele of the appendix refers to an appendix that is distended by mucus and transformed in a mucus-filled sac. Appendicular torsion is rare. Primary and secondary forms of appendicular torsion are known. Our patient presented to the emergency department with complaints mimicking acute appendicitis. Imaging with computed tomography and ultrasound showed a cystic lesion most likely originating from the right ovary. The veriform appendix was located close to this lesion and seemed to be distended. During diagnostic laparoscopy, a torsion of the veriform appendix due to a mucocele was found and an appendectomy was performed. Histopathological analysis confirmed the diagnosis. Torsion of the vermiform appendix is most often diagnosed intra-operatively. Pre-operative radiologic imaging is often not useful in the detection of appendicular abnormalities other than acute appendicitis. The treatment consists of detorsion and appendectomy.
Situation Aspect, (UN)Boundedness and The Participial Periphrastic Construction in Biblical Hebrew
Authors: Carver Daniel E , Cook Edward M
Published: October 2020

This paper provides a comprehensive and uniform description that accounts for the use of all the participial periphrastic constructions in Biblical Hebrew and calls into question the claim that a second (‘preterite’) function of the construction was developed in Late Biblical Hebrew. We define the syntagm and give criteria for distinguishing true participial periphrastic constructions from superficially similar constructions. We then show that close attention to situation aspect and (un)boundedess provides a unified and sound account of every occurrence of the syntagm in the Hebrew Bible. We conclude that, unless the situation is bounded by an adverbial phrase, every participial periphrastic construction is unbounded which semantically distinguishes the construction from wayyiqtol.
Lyme borreliosis
Authors: Krause Andreas , Fingerle Volker
Published: October 2020

Lyme borreliosis (LB) is a multisystem infectious disease caused by the tick-borne spirochete Borrelia burgdorferi. The most frequent clinical manifestations include erythema migrans, meningoplyneuritis, and arthritis. Diagnosis of LB is made on clinical grounds and usually supported by a positive serology. Early diagnosis and treatment almost always leads to a rapid healing of the disease. However, in disseminated manifestations gradual remission of symptoms may take several weeks to months. In rare cases, the pathogen can persist for many years, causing acrodermatitis chronica atrophicans, chronic neuroborreliosis of the central nervous system, or Lyme arthritis. Moreover, the infection may induce a persisting immunopathological response, resulting in ‘antibiotic-resistant’ Lyme arthritis. However, even these chronic manifestations usually slowly regress after thorough antibiotic and symptomatic therapy, although in part with irreversible organ defects.
Fungal arthritis
Authors: Kemper Carol A. , Deresinski Stanley C.
Published: October 2020

Fungal infections of the musculoskeletal system are uncommon and diagnosis is often delayed. Infection is more common in the immunocompromised patient. The most important infections are due to candida species, Histoplasmosis capsulatum, Blastomycosis dermatiditis, and Coccidioides immitis. Amphotericin B remains the initial therapeutic agent of choice for many serious fungal infections, especially for those who are severely immunosuppressed, have life-threatening or central nervous system disease, or who have failed azole therapy.
Polymyositis and dermatomyositis
Authors: Chinoy Hector , Lilleker James B.
Published: October 2020

Polymyositis (PM), dermatomyositis (DM), and inclusion body myositis (IBM) form part of the idiopathic inflammatory myopathies (IIM), a heterogeneous group of rare autoimmune diseases characterized by an acquired proximal muscle weakness, raised muscle enzymes (including creatine kinase), inflammatory cell infiltrates in muscle biopsy tissue, electrophysiological abnormalities, and presence of circulating myositis-specific/myositis-associated autoantibodies. The underlying aetiology of IIM is poorly understood, but likely involves interactions between environmental and genetic risk factors. Myositis may also manifest in association with other connective tissue disorders. The predominant clinical presentation of IIM is skeletal muscle weakness, but many extramuscular features can also occur. Access to good neuropathological support is essential in securing an accurate IIM diagnosis and excluding non-inflammatory myopathies which can mimic IIM. Antibody testing can help define IIM clinical subtypes, including cancer-associated myositis, predict prognosis, and help in optimizing treatment decisions. MRI can help to differentiate disease activity from irreversible damage, and for detecting treatment-induced interval changes. Therapeutic effectiveness of new and existing treatments (where the evidence base remains poor) depends on making a prompt diagnosis and initiating early and appropriately aggressive treatment to prevent establishment of muscle damage. This chapter attempts to summarize the salient features of IIM and update the reader about currently used diagnostics and treatment paradigms in this rare and understudied disease.
Hypermobility syndromes
Authors: Hakim Alan J. , Grahame Rodney
Published: October 2020

Hypermobility-related syndromes constitute a family of heritable disorders of connective tissue (HDCT) that derive from abnormalities affecting genes that encode for the connective tissue matrix proteins such as collagen, fibrillin, and tenascin. They range from such commonplace though poorly recognized conditions such as hypermobility spectrum disorder (HSD), formerly within the joint hypermobility syndrome (JHS), to the better-known, if rarer, eponymous syndromes such as the Marfan syndrome (MFS), Loeys–Dietz syndrome, and the different types of the Ehlers-Danlos syndrome (EDS). The more common presentations are with skin pathology (bruising, scaring), joint or spinal and/or muscle pain and instability with vulnerability to injury and chronic widespread pain, cardiac valve pathologies, and in MFS and vascular EDS, in particular, arterial dilatation with the risk of dissection and rupture. The hypermobile variant of EDS and HSD are further complicated by cardiovascular autonomic dysfunction such as orthostatic intolerance, palpitations, and syncope, and the recently described and commonly encountered pan-gastrointestinal dysmotility. The latter can manifest as gastro-oesophageal reflux, gastroparesis, slow-transit constipation, or rectal evacuatory dysfunction with rectal intussusception. In addition, HDCT are associated with bladder and uterine problems as a consequence of pelvic floor weakness. Such multisystemic conditions need to be managed by a multidisciplinary team able to draw on medical, surgical, physical, and psychological interventions by appropriately experienced specialists and therapists. This chapter introduces the reader to the epidemiology, genetics, classification, and clinical presentation of HSD, EDS, and MFS. It also describes the key investigations required to support a diagnosis and assess complications of an HDCT, as well as the multidisciplinary approach to management.
Detection of subtilisin 3 and 6 in skin biopsies of cattle with clinically manifested bovine ringworm
Authors: Lindenhahn Jakob , Bartosch Theresa , Baumbach Christina-Marie , Suchowski Marcel , Kacza Johannes , Schrödl Wieland , Michler Jule K
Published: October 2020

Trichophyton (T.) verrucosum is a highly pathogenic dermatophyte causing zoonotic bovine ringworm that is transmissible to humans. The virulence factors subtilisin (Sub)3 and Sub6 are discussed to contribute to disease manifestation but no protein expression study is available for T. verrucosum. We used customized antibodies (against Trichophyton-species, Sub3 and Sub6) to examine skin biopsies of infected cattle via immunofluorescence stainings. Both virulence factors Sub3 and 6 were solely expressed by conidia and not only found in epidermal but also in dermal and hair structures. The anti-T-antibody reliably detected the fungus and proved more sensitive compared to histological stains.

Lay Summary

We examined the zoonotic dermatophyte Trichophyton (T.) verrucosum in bovine skin and studied two important virulence factors called subtilisin (Sub)3 and Sub6 that T. verrucosum produces and secretes using immunolabeling.
High resolution parameter study of the vertical shear instability
Authors: Manger Natascha , Klahr Hubert , Kley Wilhelm , Flock Mario
Published: October 2020

Theoretical models of protoplanetary discs have shown the vertical shear instability (VSI) to be a prime candidate to explain turbulence in the dead zone of the disc. However, simulations of the VSI have yet to show consistent levels of key disc turbulence parameters like the stress-to-pressure ratio α. We aim to reconcile these different values by performing a parameter study on the VSI with focus on the disc density gradient p and aspect ratio h = H/R. We use full 2π 3D simulations of the disc for chosen set of both parameters. All simulations are evolved for 1000 reference orbits, at a resolution of 18 cells per h. We find that the saturated stress-to-pressure ratio in our simulations is dependent on the disc aspect ratio with a strong scaling of α∝h2.6, in contrast to the traditional α model, where viscosity scales as ν∝αh2 with a constant α. We also observe consistent formation of large scale vortices across all investigated parameters. The vortices show uniformly aspect ratios of χ ≈ 10 and radial widths of approximately 1.5H. With our findings we can reconcile the different values reported for the stress-to-pressure ratio from both isothermal and full radiation hydrodynamics models, and show long-term evolution effects of the VSI that could aide in the formation of planetesimals.
Constraining models of the pulsar wind nebula in SNR G0.9+0.1 via simulation of its detection properties using the Cherenkov Telescope Array
Authors: Fiori M , Zampieri L , Burtovoi A , Caraveo P , Tibaldo L
Published: October 2020

SNR G0.9+0.1 is a well-known source in the direction of the Galactic Centre composed by a Supernova Remnant (SNR) and a Pulsar Wind Nebula (PWN) in the core. We investigate the potential of the future Cherenkov Telescope Array (CTA), simulating observations of SNR G0.9 + 0.1. We studied the spatial and spectral properties of this source and estimated the systematic errors of these measurements. The source will be resolved if the very high-energy emission region is bigger than ∼0.65′. It will also be possible to distinguish between different spectral models and calculate the cutoff energy. The systematic errors are dominated by the Instrument Response Function instrumental uncertainties, especially at low energies. We computed the evolution of a young PWN inside an SNR using a one-zone time-dependent leptonic model. We applied the model to the simulated CTA data and found that it will be possible to accurately measure the cutoff energy of the γ-ray spectrum. Fitting of the multiwavelength spectrum will allow us to constrain also the magnetization of the PWN. Conversely, a pure power-law spectrum would rule out this model. Finally, we checked the impact of the spectral shape and the energy density of the Inter-Stellar Radiation Fields on the estimate of the parameters of the PWN, finding that they are not significantly affected.
Small-scale star formation as revealed by VVVX galactic cluster candidates
Authors: Borissova J , Kurtev R , Amarinho N , Alonso-García J , Ramírez Alegría S , Bernal S , Medina N , Chené A-N , Ivanov V D , Lucas P W , Minniti D
Published: October 2020

We report a search and analysis of obscured cluster candidates in the ‘VISTA Variables in the Via Lactea eXtended (VVVX)’ ESO Public Survey area encompassing the region between 229${_{.}^{\circ}}$4 < l < 295${_{.}^{\circ}}$2 and −4${_{.}^{\circ}}$3 < b < 4${_{.}^{\circ}}$4 of the southern Galactic disc. We discover and propose 88 new clusters. We improve the completeness of the embedded cluster population in this region, adding small size (linear diameters of 0.2–1.4 pc) and relatively far objects (heliocentric distance between 2 and 4 kpc) to existing catalogues. Nine candidates are proposed to be older open cluster candidates. Three of them (VVVX CL 204,  CL 207, CL  208) have sufficient numbers of well-resolved stellar members to allow us to determine some basic cluster parameters. We confirm their nature as older, low-mass open clusters. Photometric analysis of 15 known clusters shows that they have ages above 20 Myr, and masses below 2000 M⊙: in general, their proper motions follow the motion of the disc. We outline some groups of clusters, most probably formed within the same dust complex. Broadly, our candidates follow the network of filamentary structure in the remaining dust. Thus, in this part of the southern disc of the Galaxy, we have found recent star formation, producing small size and young clusters, in addition to the well-known, massive young clusters, including NGC 3603, Westerlund 2, and the Carina Nebula Complex.
Discovery of Ongoing Selective Sweeps withinAnophelesMosquito Populations Using Deep Learning
Authors: Xue Alexander T , Schrider Daniel R , Kern Andrew D ,   Ag1000g Consortium, della Torre Alessandra , Kern Andrew , Caputo Beniamino , Kabula Bilali , White Bradley , Godfray Charles , Edi Constant , Wilding Craig , Neafsey Dan , Schrider Daniel , Conway David , Weetman David , Ayala Diego , Kwiatkowski Dominic , Sharakhov Igor , Midega Janet , Xu Jiannong (John) , Pinto João , Essandoh John , Matowo Johnson , Vernick Ken , Djogbenou Luc S , Coulibaly Mamadou , Lawniczak Mara , Donnelly Martin , Hahn Matthew , Fontaine Michaël , Riehle Michelle , Besansky Nora , Cornejo Omar , McCann Robert , O’Loughlin Sam , Robert Vincent , Xue Alexander , Miles Alistair , Clarkson Chris , Battey CJ , Champion Cody , Labbe Frederic , Bottà Giordano , Adrion Jeffrey , Nelson Joel , Harding Nick , Wang Richard , Small Scott T , Redmond Seth , Antão Tiago
Published: October 2020

Identification of partial sweeps, which include both hard and soft sweeps that have not currently reached fixation, provides crucial information about ongoing evolutionary responses. To this end, we introduce partialS/HIC, a deep learning method to discover selective sweeps from population genomic data. partialS/HIC uses a convolutional neural network for image processing, which is trained with a large suite of summary statistics derived from coalescent simulations incorporating population-specific history, to distinguish between completed versus partial sweeps, hard versus soft sweeps, and regions directly affected by selection versus those merely linked to nearby selective sweeps. We perform several simulation experiments under various demographic scenarios to demonstrate partialS/HIC’s performance, which exhibits excellent resolution for detecting partial sweeps. We also apply our classifier to whole genomes from eight mosquito populations sampled across sub-Saharan Africa by the Anopheles gambiae 1000 Genomes Consortium, elucidating both continent-wide patterns as well as sweeps unique to specific geographic regions. These populations have experienced intense insecticide exposure over the past two decades, and we observe a strong overrepresentation of sweeps at insecticide resistance loci. Our analysis thus provides a list of candidate adaptive loci that may be relevant to mosquito control efforts. More broadly, our supervised machine learning approach introduces a method to distinguish between completed and partial sweeps, as well as between hard and soft sweeps, under a variety of demographic scenarios. As whole-genome data rapidly accumulate for a greater diversity of organisms, partialS/HIC addresses an increasing demand for useful selection scan tools that can track in-progress evolutionary dynamics.