bluuebunny/crossref_metadata_2025 huggingface dataset:
Gauging oxygen risk and tolerance for the megafauna of the Southern California shelf based on in situ observation, species mobility, and seascape
Authors: Parnell P Ed , Levin Lisa A , Navarro Michael O
Published: April 2020

Oxygen decline poses increasing risks to global shelf communities. This study was conducted to measure species oxygen exposures in situ and to assess risks of low oxygen based on the hypothesis that species risk varies spatially and is dependent on the interaction of shelf oxygen dynamics with habitat pattern, species mobility, and tolerance to low oxygen. Here, we report concomitant observations of oxygen, depth, and habitat for the most common benthic and epibenthic megafauna on the southern California shelf (30–125 m). The study was conducted when oxygen concentrations were the lowest observed within the previous 30 years off southern California (2012–2014), yet hypoxic conditions (<1.42 ml l−1) were not observed. No significant oxygen exposure differences were observed among highly mobile, mobile, and sessile species due to the dynamic nature of the oxycline. Habitat affinities for the most abundant benthic megafauna (53 taxa) were discriminated among four different habitats. Highly mobile rockfish (Sebastidae) exhibited distributions suggesting less tolerance to low oxygen than most other taxa. Given the mosaic of consolidated and coarse-grained habitats that rockfish prefer, the onset of hypoxic conditions near the shelf break (∼90–120 m) would likely compress local rockfish populations into less favourable habitat in a non-linear fashion.
Hermite interpolation on the unit sphere and limits of Lagrange projectors
Authors: Van Manh Phung
Published: April 2020

We construct new Hermite and Lagrange interpolation schemes on the unit sphere in $\mathbb R^3$. We give Newton-type formulas for interpolation polynomials and use them to show that the Hermite projectors are the limits of Lagrange projectors when interpolation points coalesce.
Teledentistry in the diagnosis of oral lesions: A systematic review of the literature
Authors: Flores Anacláudia Pereira da Costa , Lazaro Samara Andreolla , Molina-Bastos Cynthia Goulart , Guattini Verônica Lucas de Oliveira , Umpierre Roberto Nunes , Gonçalves Marcelo Rodrigues , Carrard Vinicius Coelho
Published: April 2020

Objective

The purpose of this systematic review is to summarize information on the use of teledentistry in the diagnosis of oral lesions.

Materials and Methods

A systematic literature search conducted in August 2018 included articles published until December 2018 in 4 databases. Two reviewers evaluated the search results separately. If they were uncertain as to whether to include an article, a third reviewer made the final decision. Studies related to the diagnosis of oral lesions using teledentistry were included. The methodological quality of the studies was analyzed using the Quality Assessment of Studies of Diagnostic Accuracy.

Results

Eleven articles were included in the study. The selected articles were published between 1999 and 2018, predominantly in developing countries. The professionals acting as patient examiners are dental students and dentists, as well as other health professionals. Most of the patients evaluated in the studies were from rural populations or locations distant from large centers. The tools used to obtain patient data were smartphones, videoconference, email, questionnaires, histopathological exams, and telemedicine applications and systems. Most studies concluded that there is a high level of agreement between teledentistry and clinical consultation and that the use of this resource for diagnostic purposes can reduce costs and the travel time to consult a specialist personally. Nine of the 11 studies were of good quality.

Conclusions

Teledentistry has the potential to improve the care quality related to diagnosis and management of oral lesions, shortening distances between patients who need specialized diagnoses and specialists.
Regression-Based Expected Shortfall Backtesting
Authors: Bayer Sebastian , Dimitriadis Timo
Published: April 2020

This article introduces novel backtests for the risk measure Expected Shortfall (ES) following the testing idea of Mincer and Zarnowitz (1969). Estimating a regression model for the ES stand-alone is infeasible and thus, our tests are based on a joint regression model for the Value at Risk (VaR) and the ES, which allows for different test specifications. These ES backtests are the first which solely backtest the ES in the sense that they only require ES forecasts as input variables. As the tests are potentially subject to model misspecification, we provide asymptotic theory under misspecification for the underlying joint regression. We find that employing a misspecification robust covariance estimator substantially improves the tests’ performance. We compare our backtests to existing joint VaR and ES backtests and find that our tests outperform the existing alternatives throughout all considered simulations. In an empirical illustration, we apply our backtests to ES forecasts for 200 stocks of the S&P 500 index.
The legal and medical necessity of abortion care amid the COVID-19 pandemic
Authors: Donley Greer , Chen Beatrice A , Borrero Sonya
Published: April 2020

In response to the COVID-19 pandemic, states have ordered the cessation of non-essential healthcare. Unfortunately, many conservative states have sought to capitalize on those orders to halt abortion care. In this short paper, we argue that abortion should not fall under any state’s non-essential healthcare order. Major medical organizations recognize that abortion is essential healthcare that must be provided even in a pandemic, and the law recognizes abortion as a time-sensitive constitutional right. Finally, we examine the constitutional arguments as to why enforcing these orders against abortion providers should not stand constitutional scrutiny. We conclude that no public health purpose can be served by this application because abortion uses less scarce resources and involves fewer contacts with healthcare professionals than prenatal care and delivery assistance, which is continuing to be provided in this public health emergency.
Ultra wide field angiography documented peripheral retinal eovascularization as cause of vitreous hemorrhage after scleral buckle surgery#
Authors: Enghelberg Moises , Chalam K V
Published: April 2020

We describe an unusual case of ultra wide fluorescein angiography (UWFA) documented peripheral retinal neovascularization (NVE) with delayed vitreous hemorrhage after placement of an encircling scleral buckle (a common procedure for repair of retinal detachment). Anterior segment ischemia is a rare complication after scleral buckle surgery for the treatment of retinal detachment and results from altered choroidal flow through the impingement of the anterior and long posterior ciliary arteries. UWFA performed for the evaluation of vitreous hemorrhage confirmed ischemia anterior to the scleral buckle and consequential NVE. This case represents the utility of UWFA in evaluating and managing this exceptionally rare complication associated with a common procedure in the field of vitreoretinal surgery.
Severe snakebite envenomation revealed by an acute abdomen
Authors: Kassegne Iroukora , Mouzou Tabana Essohanam , Kanassoua Kokou , Dossouvi Tamegnon , Amouzou Yawod Efoé-Ga , Sakiye Aboza , Adabra Komlan , Alassani Fousseni , Amavi Ayi Kossigan , Tchangai Boyodi , Dosseh Ekoué David Joseph
Published: April 2020

Acute abdomens are common conditions, with many aetiologies in developing countries. Abdominal bleeding due to snake envenomation is an extremely rare aetiology. A 11-year-old girl was admitted for acute abdominal pains. She had a history of foot bite of unknown origin. Physical examination revealed palor and abdominal tenderness. At laparotomy, there were peritoneal and retroperitoneal diffuse hematomas. Laboratory studies revealed abnormal coagulation profile. Retroperitoneal and peritoneal hematomas’ diagnosis, by consumptive coagulopathy, due to snakebite envenomation, was made. Polyvalent antivenom administration permitted a normalization of coagulation profile, however, with persistent surgical site bleeding. Whole blood transfusion was administered with bleeding stop. Sudden abdominal pain, palor and signs of peritonism suggest an acute abdomen. However, abdominal bleeding due to snakebite envenomation should be considered, especially in child with unidentified bite history. Imaging modalities may helpful to confirm the abdominal bleeding. Antivenom is the mainstay of the treatment.
Repetition as Rebirth: A Sung Epitaph for Gautier De Coinci
Authors: Quinlan Meghan
Published: April 2020

The thirteenth-century prior and poet-musician Gautier de Coinci is known for his extravagant wordplay, which relies on the recursive patterning of verbal sound. This article considers Gautier’s penchant for sonic repetition in the light of the music that frames his book of miracles, focusing on the song Por mon chief reconforter, a chanson à refrain written in the voice of an aging Gautier coming to terms with his imminent death. The song’s exclusion from Frederic Koenig’s standard edition of the Miracles means it has received little scholarly attention, yet its earliest source is linked with Gautier’s original exemplar. The article examines how repeated musico-poetic forms—within the stanza, between stanzas, and in the more temporally extended repetition of contrafacture—interact with notions of temporality and mortality voiced in the song’s texts and contexts, suggesting that such structures reshape the experience of time into one that is less linear, and therefore less final.
Plasmoid formation in global GRMHD simulations and AGN flares
Authors: Nathanail Antonios , Fromm Christian M , Porth Oliver , Olivares Hector , Younsi Ziri , Mizuno Yosuke , Rezzolla Luciano
Published: April 2020

One of the main dissipation processes acting on all scales in relativistic jets is thought to be governed by magnetic reconnection. Such dissipation processes have been studied in idealized environments, such as reconnection layers, which evolve in merging islands and lead to the production of ‘plasmoids’, ultimately resulting in efficient particle acceleration. In accretion flows on to black holes, reconnection layers can be developed and destroyed rapidly during the turbulent evolution of the flow. We present a series of two-dimensional general-relativistic magnetohydrodynamic simulations of tori accreting on to rotating black holes focusing our attention on the formation and evolution of current sheets. Initially, the tori are endowed with a poloidal magnetic field having a multiloop structure along the radial direction and with an alternating polarity. During reconnection processes, plasmoids and plasmoid chains are developed leading to a flaring activity and hence to a variable electromagnetic luminosity. We describe the methods developed to track automatically the plasmoids that are generated and ejected during the simulation, contrasting the behaviour of multiloop initial data with that encountered in typical simulations of accreting black holes having initial dipolar field composed of one loop only. Finally, we discuss the implications that our results have on the variability to be expected in accreting supermassive black holes.
TESS photometry of extreme helium stars PV Tel and V821 Cen
Authors: Jeffery C Simon , Barentsen Geert , Handler Gerald
Published: April 2020

PV Tel variables are extreme helium (EHe) stars known to be intrinsic light and velocity variable on characteristic time-scales of 0.1–25 d. With two exceptions, they are best described as irregular. Light curves have invariably been obtained from single-site terrestrial observatories. We present Transiting Exoplanet Survey Satellite observations of two bright EHe stars, Popper’s star (V821 Cen) and Thackeray’s star (PV Tel). PV Tel is variable on time-scales previously reported. V821 Cen is proven to be variable for the first time. Neither light curve shows any evidence of underlying regularity. Implications are considered.
New Methods to Calculate Concordance Factors for Phylogenomic Datasets
Authors: Minh Bui Quang , Hahn Matthew W , Lanfear Robert
Published: April 2020

We implement two measures for quantifying genealogical concordance in phylogenomic data sets: the gene concordance factor (gCF) and the novel site concordance factor (sCF). For every branch of a reference tree, gCF is defined as the percentage of “decisive” gene trees containing that branch. This measure is already in wide usage, but here we introduce a package that calculates it while accounting for variable taxon coverage among gene trees. sCF is a new measure defined as the percentage of decisive sites supporting a branch in the reference tree. gCF and sCF complement classical measures of branch support in phylogenetics by providing a full description of underlying disagreement among loci and sites. An easy to use implementation and tutorial is freely available in the IQ-TREE software package (http://www.iqtree.org/doc/Concordance-Factor, last accessed May 13, 2020).
Functional characterization of the human tRNA methyltransferases TRMT10A and TRMT10B
Authors: Vilardo Elisa , Amman Fabian , Toth Ursula , Kotter Annika , Helm Mark , Rossmanith Walter
Published: April 2020

The TRM10 family of methyltransferases is responsible for the N1-methylation of purines at position 9 of tRNAs in Archaea and Eukarya. The human genome encodes three TRM10-type enzymes, of which only the mitochondrial TRMT10C was previously characterized in detail, whereas the functional significance of the two presumably nuclear enzymes TRMT10A and TRMT10B remained unexplained. Here we show that TRMT10A is m1G9-specific and methylates a subset of nuclear-encoded tRNAs, whilst TRMT10B is the first m1A9-specific tRNA methyltransferase found in eukaryotes and is responsible for the modification of a single nuclear-encoded tRNA. Furthermore, we show that the lack of G9 methylation causes a decrease in the steady-state levels of the initiator tRNAiMet-CAT and an alteration in its further post-transcriptional modification. Our work finally clarifies the function of TRMT10A and TRMT10B in vivo and provides evidence that the loss of TRMT10A affects the pool of cytosolic tRNAs required for protein synthesis.
Assessment of Talaromyces Marneffei Infection of the Intestine in Three Patients and a Systematic Review of Case Reports
Authors: Pan Mianluan , Huang Jie , Qiu Ye , Zeng Wen , Li Zhangcheng , Tang Shudan , Wei Xuan , Zhang Jianquan
Published: April 2020

Background

Hematogenous dissemination of Talaromyces marneffei can result in multiorgan involvement (skin, lung, and reticuloendothelial system involvement); however, few studies have reported intestinal T marneffei infections. We investigated clinical features, management, and patient outcomes concerning Talaromyces-related intestinal infections.

Methods

Patients with Talaromycosis between August 2012 and April 2019 at The First Affiliated Hospital of Guangxi Medical University, China, were retrospectively analyzed. Patients presenting with intestinal Talaromycosis and endoscopy-confirmed diagnoses were investigated. We also undertook a systematic review of the relevant English and Chinese literature.

Results

Of 175 patients diagnosed with Talaromycosis, 33 presented with gastrointestinal symptoms, and 31 underwent stool cultures, 1 of which tested positive. Three patients had gastrointestinal symptoms and negative stool cultures, and endoscopic tissue biopsy confirmed a pathological diagnosis. A systematic review of 14 reports on human Talaromycosis identified an additional 16 patients. Fever, weight loss, and anemia were the most common symptoms, along with abdominal pain, diarrhea, and bloody stools. Abdominal computed tomography showed intestinal wall edema and thickening and/or abdominal lymphadenopathy. Endoscopy showed erosion, hyperemia, edema, and multiple intestinal mucosal ulcers. Of the 19 patients, 16 received antifungal therapy, 14 of whom recovered and 2 died. Three patients received no therapy and died.

Conclusions

Gastrointestinal disseminated Talaromycosis is not rare and can affect the stomach, duodenum, and colon, and may involve the entire digestive tract. Colon is the most common site. Endoscopy is needed for patients presenting with gastrointestinal symptoms in T marneffei-infected endemic areas. Systemic application of effective antifungal therapy can improve the prognosis.
Non-waivability in Labour Law
Authors: Davidov Guy
Published: April 2020

Non-waivability is considered a basic principle of labour law. In most cases, it is needed to protect employees against coerced waivers. But what if an employee genuinely wants to waive some labour right, for example in return for a higher salary? This article explains why non-waivability is generally justified even against the wishes of employees, for reasons of paternalism, harm to others and second-order justifications. At the same time, in some cases, there is room for intermediate solutions, which can be used to better respect the autonomy of employees and achieve additional benefits without undermining the goals of labour laws. The article employs this analysis to examine two concrete issues by way of example: waiving of ‘employee’ status and the individual opt-out from maximum weekly hours. In the latter context, while I critique the current law, I argue that some form of conditional waiver could be acceptable.
Investigation of contact binaries in the field of NGC 6811
Authors: Li Xu-Zhi , Liu Liang , Zhang Xu-Dong
Published: April 2020

Contact binary systems are very important for studying physical processes such as strong interactions between stars, mass transfer, and stellar merger. Further, the members of an open cluster have the same age, metal abundance, and interstellar extinction conditions. Therefore, we can conduct a comparative study on the different binary systems of the same open cluster. NGC 6811 is an observed intermediate-aged, slightly reddened open cluster in the Kepler field of view; we conducted a corresponding study on the contact binary systems in this cluster. We analyzed six suspected targets and found a total of five EW-type binary systems within a field of 40′ radius of the NGC 6811 cluster center. These targets were analyzed base on the Kepler data, and the corresponding system parameters were obtained by using the latest version of the Wilson–Devinney code. Further, we also used Gaia DR2 data and the cluster distance data to estimate the absolute parameters of these targets to determine whether they are members of the cluster. Finally, we determined that two targets (KIC 9470175 and KIC 9533706) are most likely cluster members; KIC 9957411 and KIC 9776718 are definitely not members of the cluster, just background stars.
Changes in Perceived Stress After Yoga, Physical Therapy, and Education Interventions for Chronic Low Back Pain: A Secondary Analysis of a Randomized Controlled Trial
Authors: Berlowitz Jonathan , Hall Daniel L , Joyce Christopher , Fredman Lisa , Sherman Karen J , Saper Robert B , Roseen Eric J
Published: April 2020

Objective

Perceived stress and musculoskeletal pain are common, especially in low-income populations. Studies evaluating treatments to reduce stress in patients with chronic pain are lacking. We aimed to quantify the effect of two evidence-based interventions for chronic low back pain (cLBP), yoga and physical therapy (PT), on perceived stress in adults with cLBP.

Methods

We used data from an assessor-blinded, parallel-group randomized controlled trial, which recruited predominantly low-income and racially diverse adults with cLBP. Participants (N = 320) were randomly assigned to 12 weeks of yoga, PT, or back pain education. We compared changes in the 10-item Perceived Stress Scale (PSS-10) from baseline to 12- and 52-week follow-up among yoga and PT participants with those receiving education. Subanalyses were conducted for participants with elevated pre-intervention perceived stress (PSS-10 score ≥17). We conducted sensitivity analyses using various imputation methods to account for potential biases in our estimates due to missing data.

Results

Among 248 participants (mean age = 46.4 years, 80% nonwhite) completing all three surveys, yoga and PT showed greater reductions in PSS-10 scores compared with education at 12 weeks (mean between-group difference = −2.6, 95% confidence interval [CI] = −4.5 to −0.66, and mean between-group difference = −2.4, 95% CI = −4.4 to −0.48, respectively). This effect was stronger among participants with elevated pre-intervention perceived stress. Between-group effects had attenuated by 52 weeks. Results were similar in sensitivity analyses.

Conclusions

Yoga and PT were more effective than back pain education for reducing perceived stress among low-income adults with cLBP.
The Impact of Childhood Trauma, Hallucinations, and Emotional Reactivity on Delusional Ideation
Authors: Wright Abigail C , Coman Drew , Deng Wisteria , Farabaugh Amy , Terechina Olga , Cather Corinne , Fava Maurizio , Holt Daphne J
Published: April 2020

Background

A large body of evidence has demonstrated that childhood trauma increases the risk for developing a psychotic disorder. However, the path by which psychotic symptoms develop following trauma is still debated. Emotional reactivity, a tendency to experience more intense and enduring emotional responses, and hallucinations are sequelae of childhood trauma that may predict the emergence of delusional ideation. This study aimed to examine evidence for this hypothesis in a college student sample.

Methods

Self-report measures were used to cross-sectionally assess childhood trauma (Childhood Trauma Questionnaire), delusional ideation (Peters et al Delusions Inventory), hallucinations (Launay-Slade Hallucinations Scale), and emotional reactivity (Emotion Reactivity Scale) in 1703 US college students.

Results

Hallucinations and emotional reactivity fully mediated the relationship between childhood trauma and delusional ideation, after controlling for covariates (gender, age, levels of current stress, stressful life events, and resilience).

Discussion

These results suggest that hallucinations and emotional reactivity associated with childhood trauma may represent quantifiable targets for early intervention.
Tracking parallel adaptation of shell morphology through geological times in the land snail genusPupilla(Gastropoda: Stylommatophora: Pupillidae)
Authors: Haase Martin , Meng Stefan , Horsák Michal
Published: April 2020

Changing environmental conditions force species either to disperse or to adapt locally either genetically or via phenotypic plasticity. Although limits of plasticity can be experimentally tested, the predictability of genetic adaptation is restricted due to its stochastic nature. Nevertheless, our understanding of evolutionary adaptation has been improving in particular through studies of parallel adaptation. Based on molecular phylogenetic inferences and morphological investigations of both recent and fossil shells we tracked the morphological changes in three land snails, Pupilla alpicola, Pupilla loessica and Pupilla muscorum. These species differ in habitat requirements as well as historical and extant distributions with P. alpicola and P. loessica being more similar to each other than to P. muscorum. Therefore, we hypothesized, that the three species reacted independently and individually to the conditions changing throughout the Pleistocene, but expected that changes within P. alpicola and P. loessica would be more similar compared to P. muscorum. Indeed, intraspecific shell shape differences across time were similar in P. alpicola and P. loessica, suggesting that similar niche shifts have led to similar transformations in parallel. In contrast, extant P. muscorum populations were practically identical in shape to their ancestors. They have probably tracked their ecological niches through time.
Draft Genome Sequence Resource for Blumeriella jaapii, the Cherry Leaf Spot Pathogen
Authors: Peng Jingyu , Rojas J. Alejandro , Sang Hyunkyu , Proffer Tyre J. , Outwater Cory A. , Vilgalys Rytas , Sundin George W.
Published: April 2020

Blumeriella jaapii is the causal agent of cherry leaf spot (CLS), the most important disease of tart cherry in the Midwestern United States. Infection of leaves by B. jaapii leads to premature defoliation, which places trees at heightened risk of winter injury and death. Current management of CLS relies primarily on the application of three important fungicide classes, quinone outside inhibitors, sterol demethylation inhibitors, and succinate dehydrogenase inhibitors. Here, we present the first high-quality genome of B. jaapii through a hybrid assembly of PacBio long reads and Illumina short reads. The assembled draft genome of B. jaapii is 47.4 Mb and consists of 95 contigs with a N50 value of 1.5 Mb. The genomic information of B. jaapii, representing the most complete sequenced genome of the family Dermateaceae (Ascomycota) to date, provides a valuable resource for identifying fungicide resistance mechanisms of this pathogen and expands our knowledge of the phytopathogenic fungi in this family.
Evidence-Based Cesarean Section for Universal Use in China: The “Stark (Misgav Ladach) Method”
Authors: Stark Michael
Published: April 2020

There are many ways to perform cesarean section, with many methods developing from local traditions. Following a 3-year study process, a modified, evidence-based method has been developed, which is now in use in many countries.

The abdomen incision is based on the Joel-Cohen incision, the peritoneum is opened by repeated stretching, and the uterus is opened transversely after pushing the bladder down.

After delivery the uterus is sutured with one layer using a large needle, and the abdomen is closed with only two layers, fascia and skin.

This method was subject to scores of studies, with all upholding its superiority over traditional methods. As a result, the “Stark (Misgav Ladach) method” is recommended to become a standard procedure across China.
Issues Meriting Further Study in Preventing Mother-to-Infant Transmission of Hepatitis B by Antiviral Therapy During Pregnancy
Authors: Zhou Yi-Hua
Published: April 2020

Mother-to-infant transmission of hepatitis B virus (HBV) is a main cause of chronic HBV infection. Maternal high HBV DNA level or positive hepatitis B e antigen (HBeAg) is the major risk factor for the transmission. With recommended passive and active immunoprophylaxis, the transmission occurs in nearly 0 and 4–12% of infants born to HBV-infected mothers with negative and positive HBeAg, respectively. Therefore, pregnant women with negative HBeAg appear not requiring antiviral therapy to prevent mother-to-infant transmission of HBV. Recent studies demonstrated that oral antivirals (lamivudine, telbivudine, or tenofovir) in pregnant women with high viral load or positive HBeAg, starting from 28–32 weeks of gestation, together with neonatal immunoprophylaxis, can almost completely prevent the transmission, indicating that it does not require antiviral therapy before 28 weeks of gestation. Accumulated evidence showed that the antivirals may be stopped upon delivery, and the infants may receive breast feeding after birth. However, these issues, as well as HBV DNA threshold for antiviral therapy during pregnancy, optimal timing for start and discontinuation of antivirals, and the drug safety of fetuses/infants, require further investigations to optimize the antiviral therapy during pregnancy. The proof of safety of fetal exposure to antivirals needs more evidence, which can be achieved from the real-world data analysis.
Elimination of Mother-to-child Transmission of Syphilis: Challenge and Solution
Authors: Fan Shang-Rong , Wang Ai-Ling , Wang Lin-Hong
Published: April 2020

Congenital syphilis (CS) is a significant public health problem worldwide. The majority of cases of CS are caused by in utero transmission. The World Health Organization launched the global elimination of CS initiative with the goal of reducing mother-to-child transmission of syphilis. The risk for CS is mainly related to three factors: (1) high maternal prevalence, (2) low coverage of antenatal care services, and (3) treatment failure. The long-acting penicillin preparations such as benzathine penicillin G are the preferred therapies for maternal syphilis. There are several challenges in preventing CS from both pregnant women and their health care providers. These problems include that prenatal care lack or delay, syphilis management flaws from health care providers, lacks of basic information, and awareness about maternal syphilis and CS by public. Many efforts have been made to solve the problems. These include that dual elimination of mother-to-child transmission (EMTCT) of both human immunodeficiency virus (HIV) and syphilis or triple EMTCT of HIV, syphilis and hepatitis B, World Health Organization country validation of EMTCT of syphilis and HIV, set up a CS case review board and a National Day to combat syphilis and CS.
Elastogram: Physics, Clinical Applications, and Risks
Authors: Lu Jing , Chen Min , Chen Qiong-Hua , Wu Qin , Jiang Jin-Na , Leung Tak-Yeung
Published: April 2020

The tissue stiffness is always an interesting issue to clinicians. Traditionally, it is assessed by the manual palpation, and this now can be measured by the ultrasound-based elastography. The basic physics is based on Young's modulus through the Hooke's law: E= S/e, where the Young's modulus (E) equals to the stress applied to the object (S) divided by the generated strain (e). With the rapid advancement of technology, the elastography has evolved from quasi-static elastography (ie, strain elastography) to dynamic elastography (i,e, shear wave elastography). The key differentiation of these two categories roots in the stimuli applied, namely mechanical or acoustic radiation force, and the response of the soft tissue. The strain elastography requires the operator to compress and decompress the tissue manually and the motion of the tissue during the stimuli is tracked to calculate the strain to reflect the tissue stiffness. While strain elastography is operator-dependent, shear wave elastography is not. Using shear wave elastography, the tissue is stimulated by the acoustic radiation force which can generate shear wave traveling through the tissue transversely. The shear wave propagation speed (V

s
) is related to the shear modulus (μ) of the medium: μ = ρV

s

2, where ρ is the density of the tissue and assumed to be a constant as 1000 kg/m3. In the incompressible biological tissue, the Young's modulus is approximately three times the shear modulus (E≈3 μ). So the quantitative measurements of the tissue stiffness can be attained by shear wave elastography. The clinical application of elastography and its diagnostic capability has been extended. The knowledge of the basic physics of the various type of elastography facilitates the effective use of elastography. This review presented the clinical application and the risks of different types of elastography.
Maternal-Fetal Medicine in China
Authors: Zheng Thomas Q. , Yang Hui-Xia
Published: April 2020

The obstetric issues and management styles in China are different from that in Western countries. Chinese medical education, residency training, obstetric care structure, and management of common obstetric complications are briefly reviewed and compared to the United States. Maternal-fetal medicine (MFM) is rapidly developing in China, but the development of MFM may not follow the same trajectory as in the West. Understanding the difference between China and the West may facilitate communication and foster mutual development.
Prevention of Perinatal Group B Streptococcus Infections
Authors: Fan Shang-Rong , Tasneem Umber , Liu Xiao-Ping , Yan Shao-Mei
Published: April 2020

Group B streptococcus (GBS) is a leading cause of neonatal infection. Maternal vaginal-rectal colonization with GBS during the intrapartum period is a prerequisite for GBS early-onset disease (EOD). The obstetric measures for effective prevention of GBS EOD include universal prenatal screening by vaginal-rectal culture, correct specimen collection and processing, appropriate implementation of intrapartum antibiotic prophylaxis, and coordination with pediatric care providers. It is now recommended to universal screen GBS between 360/7 and 376/7 weeks of gestation and to identify groups of women who are eligible for intravenous intrapartum antibiotic prophylaxis as a means of preventing GBS EOD.
Bautype: Capsule and Lipopolysaccharide Serotype Prediction for Acinetobacter baumannii Genome
Authors: Hua Xiaoting , Liang Qian , Fang Li , He Jintao , Wang Meixia , Hong Wenjie , Leptihn Sebastian , Wang Hengliang , Yu Yunsong , Chen Huan
Published: April 2020

Acinetobacter baumannii has three clusters of genes for polysaccharide synthesis. Capsular polysaccharides and lipopolysaccharides are major virulence determinants in many Gram-negative bacteria, and play key roles in the overall fitness and virulence in A. baumannii, meanwhile poly-beta-1-6-N-acetylglucosamine was critical for biofilm formation. A variety of studies have been conducted which focused on the surveillance of antimicrobial resistance genes and clones in A. baumannii. However, a tool to perform serotype prediction in A. baumannii is still lacking. Here we present Bautype, a tool for whole genome sequencing-based K and O locus typing in A. baumannii. Using Bautype, users can upload and analyze the genome assembled in a web browser, with the results being displayed in a tabular or graphical format. We demonstrated the high accuracy of predicting K and O locus diversity using Bautype when analyzing more than 3000 A. baumannii genomes. Using our software, we were able to analyze K and O locus diversity among 593 genomes belonging to ST208 (3 K and 8 O). These diverse loci can serve as epidemiological markers for Multi-drug Resistance (MDR) strain subtyping. We also identified 45 novel O locus types. Our findings highlight the importance in monitoring the capsule type and LOS of A. baumannii strains for which Bautype is a tailored clinical software. Bautype is available at http://BauType.net.
Erosive Adenomatosis of the Nipple Masquerading as Paget's Disease: A Case Report
Authors: Guo Qin , Ji Jin , Tan Cheng , Zhang Qi , Feng Su-Ying
Published: April 2020

Introduction:

Erosive adenomatosis of the nipple is a rare benign lesion involving nipple which can be easily misdiagnosed as more ominous entities such as Pagets disease. Here we reported a case of erosive adenomatosis on the nipple masquerading as paget's disease.

Case presentation:

A 21-year-old woman presented with a 6-year history of breast erythema involving her left nipple with tenderness and mild itching. The nipple appeared rough and thickened with areas of erosion and fissuring. Physical examination of other areas of breast as well as imaging studies including ultrasound and mammography showed no abnormalities. The histological examination reveal adiagnosis of erosive adenomatosis of nipple (EAN). The patient was treated by a simple surgical excision without complications and recurrence during 9-month follow-up.

Discussion:

In the early stage, it can mimic eczema, but in the later stage, more serious diagnosis such as Pagets disease should be differential. It is diagnosed by histopathological examination. Surgical excision is an optimal choice for treament with or without plastic reconstruction.

Conclusion:

EAN should be considered in the diagnosis of erythema and erosion lesions involving nipple. The gold standard for diagnosis is histopathological examination. A prompt and correct diagnosis of EAN can avoid both unnecessary over treatment and patients emotional stress.
Bowen's Disease on the Left Fifth Finger Successfully Treated with Photodynamic Therapy: A Case Report
Authors: Wu Wei-Hong , Al-Muriesh Maher , Deng Xiao-Hong , Huang Chang-Zheng
Published: April 2020

Introduction:

Bowen's disease is a squamous cell carcinoma in situ. It is more common on the head and neck, less common on the nail units in which it usually involves the second to fourth fingers of both hands. Here, we report a case of Bowen's disease involving the left fifth finger of a 78-year-old Chinese woman.

Case presentation:

The patient was treated with nine sessions of topical 5-aminolevulinic acid-photodynamic therapy (5-ALA-PDT), with a one-week interval between sessions. The 5-ALA cream was applied to the lesion and the region surrounding its marginal diameter by 0.5cm. After 3-4hours, the lesion was irradiated with 635 ± 10nm red light at an intensity of 80mw/cm2 for 20minutes. An excellent result with a topical 5-ALA-PDT was reached.

Discussion:

PDT involves the application of a combination of a photosensitizing drug and light to cause selective damage to the target tissue. PDT is more appropriate than surgical excision for lesions located in sites with poor healing ability.

Conclusion:

PDT appears to be effective, safe and has a better cosmetic outcome in the treatment of Bowen's disease of the finger unit.
Lichen Striatus With Nail Involvement: Two Case Reports
Authors: Liu Zhen-Ru , Zhou Yuan , Liu Meng-Xi , Wang Xiao-Qing , Wang Da-Guang
Published: April 2020

Introduction:

Lichen striatus (LS) is a benign, self-limiting, linear inflammatory skin disease that was rarely reported. Here we report two cases of nail involvement in children with LS.

Case presentation:

Two children was referred to our hospital with asymptomatic linear eruption and nail dystrophy. Histopathological examination revealed epidermal hyperkeratosis, infiltration of inflammatory cells around the adnexal region, hyperpigmentation in the rete ridges, and focal liquefactive degeneration of the basal layer.

Discussion:

There is no specific treatment for nail LS. Without treatment, LS can resolve spontaneously over a period of time. Topical steroid treatment can improve symptoms and shorten the duration of the disease. It is important for clinicians to distinguish LS from other linear diseases, which may lead to unnecessary treatment and surgical intervention.

Conclusion:

The appearance of nail and skin lesions is importance of clinical features in making the diagnosis of nail LS, and also distinguish to other linear and nail diseases.
Chinese Experts Consensus on Biologic Therapy for Psoriasis#
Authors: Chen Ai-Jun , Gao Xing-Hua , Gu Heng , Gu Jun , Hao Fei , Jiang Xian , Jin Hong-Zhong , Kang Xiao-Jing , Li Cheng-Xin , Li Yu-Zhen , Liu Xiao-Ming , Shi Yu-Ling , Sun Qing , Wang Gang , Yang Bin , Zhang Jun-Ling , Zhang Xi-Bao , Zhang Xue-Jun , Zhao Yi , Zheng Min
Published: April 2020

Biologic drugs have been increasingly used in the treatment of psoriasis and are especially favorable for severe, recalcitrant, and special-type cases. Therefore, appropriate, effective, and safe use of biologic drugs has drawn attention from dermatologists. For this purpose, Chinese experts majoring in psoriasis analyzed domestic and international research data, summarized current clinical experiences, investigated features of Chinese patients with psoriasis, and finally formulated the present consensus, which provides detailed guidances to clinicians in terms of the principles and methods of the application of biologics, the efficacy and safety profile, patient screening and monitoring, main adverse events and corresponding solutions, and precautions for special patient populations.
Chinese Experts Consensus on Pre-examination and Triage in Dermatology Clinics during the COVID-19 Outbreak#
Authors: Ma Lin , Wang Gang , Mu Qi-Ri , Ran Yu-Ping , Liu Quan-Zhong , Xiao Sheng-Xiang , Zhang Xue-Jun , Zhang Jian-Zhong , Zhang Fu-Ren , He Li , Chen Ai-Jun , Chen Xiang , Zheng Jie , Yang Rong-Ya , Yao Zhi-Rong , Tu Ping , Li Yu-Zhen , Gao Xing-Hua , Xu Jin-Hua , Gu Heng , Cheng Bo , Lai Wei , Lu Qian-Jin
Published: April 2020

The SARS-CoV-2 infection has brought a great challenge in prevention and control of the national epidemic of coronavirus disease 2019 (COVID-19) in China. During the COVID-19 epidemic, properly carrying out pre-examination and triage for patients with skin lesions and fever has become a practical problem encountered in hospitals for skin diseases and dermatology clinics in general hospitals. Some of the carriers of the SARS-CoV-2 and patients with COVID-19 in the early stage may not present with any symptoms of COVID-19, while certain other skin diseases can also cause fever. Therefore, to properly deal with the patients presenting at dermatology clinics, the Chinese Society of Dermatology organized experts to formulate principles and procedures for the pre-examination and triage of patients at dermatology clinics during the COVID-19 epidemic.
The Immune Function of Keratinocytes in Anti-Pathogen Infection in the Skin
Authors: Wang Jia-Ning , Li Min
Published: April 2020

Keratinocytes, located in the outer part of human skin, are the main epidermal cell type and play an essential role in skins defense against infection. Besides creating a physical barrier between the environment and the internal body, keratinocytes exert powerful immune function in anti-pathogen infection in the skin. At the recognition stage, pattern recognition receptors (PRRs) expressed by keratinocytes sense pathogen-associated molecular patterns (PAMPs) existing in pathogens. Toll like receptors (TLRs) are the most important PRRs in keratinocytes. Other PRRs such as dectin-1 and nucleotide-binding oligomerization domain (NOD)-like receptors (NLRs) are also found to participate in this process. Activated PRRs enhance the secretion of cytokines, chemokines and the production of antimicrobial peptides (AMPs). Proinflammatory cytokines tumor necrosis factor-α, interleukin (IL)-1α, IL-6, IL-1β and IL-18, chemokines (C-X-Cmotif) ligand (CXCL) 1, CXCL2, CCL20, CCL2 and IL-8, AMPs human β-defensin (HBD) 2, HBD3 and LL37 are the main molecules expressed in this procedure. Thymic stromal lymphopoietin (TSLP), IL-36γ, IL-17 family member IL-17C and anti-inflammatory cytokine IL-10 can also be secreted. Some molecules produced by keratinocytes such as ribonuclease 5 and 7, S100 proteins own antimicrobial properties. Keratinocytes defense responses can be regulated by internal and external factors. This review summarizes recent advances on the innate immune function of keratinocytes against infection, promoting the finding of a new direction for avoiding severe skin infection as well as the potential treatment of keratinocyte-associated inflammatory dermatosis.
The dynamics of Covid-19: weather, demographics and infection timeline
Authors: Pedrosa Renato H. L.
Published: April 2020

We study the effects of temperature, absolute humidity, population density and when country/U.S. state reached 100 cases on early pace of Covid-19 expansion, for all 50 U.S. states and 110 countries with enough data. For U.S. states, weather variables show opposite effects when compared to the case of countries: higher temperature or absolute humidity imply faster early outbreak. The higher the population density or the earlier the date when state reached 100th case, the faster the pace of outbreak. When all variables are considered, only population density and the timeline variable show statistical significance. Discounting the effect of the timeline variable, we obtain an estimate for the initial growth rate of Covid-19, which can be also used to estimate the basic reproduction number for a region, in terms of population density. This has policy implications regarding how to control the pace of Covid-10 outbreak in a particular area, and we discuss some of them. In the case of countries, for which we did not have demographic information, weather variables lose statistical significance once the timeline variable is added. Relaxing CI requirements, absolute humidity contributes mildly to the reduction of growth rate of cases for the countries studied. Our results suggest that population density should be employed as a control variable and that analysis should have a local character, for subregions and countries separately, in studies involving the dynamics of Covid-19 and similar infectious diseases.
In silicoIdentification and Functional Characterization of Conserved miRNAs in Fibre Biogenesis CropCorchorus capsularis
Authors: Hasan Mahmudul , Ahmed Milad , Ahmed Foeaz , Ahmed Jamil , Nazneen Akhand Mst Rubaiat , Azim Kazi Faizul , Shukur Imran Md. Abdus , Hoque Syeda Farjana
Published: April 2020

Corchorus capsularis, commonly known as jute occupies the leading position in the production of natural fibre and fibre based products alongside lower environmental threat. Nowadays, the study of lignin biosynthesis pathways with other molecular basis of fibres formation are being more focused for its economic perspective. Small noncoding ∼21 to 24 nt nucleotides long microRNAs play significant roles in regulating the gene expression as well as different functions in cellular growth and development. Here, the study adopted a comprehensive in silico approach to identify and characterize the conserved miRNAs in the genome of C. capsularis including specific gene targets involved in the crucial cellular process. Expressed Sequence Tags (ESTs) based homology search of 3350 known miRNAs of dicotyledons were allowed against 763 non-redundant ESTs of jute genome resulted in the prediction of 5 potential miRNA candidates belonging five different miRNA families (miR1536, miR9567-3p, miR4391, miR11300, and miR8689). The putative miRNAs were 18 nucleotide length, within a range of -0.49 to -1.56 MFEI values and 55% to 61% of (A+U) content of their correspondence pre-miRNAs. A total of 1052 gene targets of putative miRNAs were identified and their functions were extensively analyzed. Most of the gene targets were involved in plant growth, cell cycle regulation, organelle synthesis, developmental process and environmental responses. The five gene targets, namely, NAC Domain Containing Protein, WRKY DNA binding protein, 3-dehydroquinate synthase, S-adenosyl-L-Met–dependent methyl transferase and Vascular-related NAC-Domain were found to be involved in the lignin biosynthesis, phenylpropanoid pathways and secondary wall formation which could play significant roles in the overall fibre biogenesis. The characterization of conserved miRNAs and their functional annotation of specific gene targets might enhance the more miRNA discovery, strengthening the complete understanding of miRNAs association in the cellular basis of lignin biosynthesis towards the production of high standard jute products.
A national landscaping survey of critical care services in hospitals accredited for training in a lower-middle income country: Pakistan
Authors: Hashmi Madiha , Taqi Arshad , Memon Muhammad Iqbal , Ali Syed Muneeb , Khaskheli Saleh , Sheharyar Muhammad , Hayat Muhammad , Shiekh Mohiuddin , Kodippily Chamira , Gamage Dilanthi , Dondorp Arjen M , Haniffa Rashan , Beane Abi
Published: April 2020

Purpose

To describe the extent and variation of critical care services in Pakistan

Materials and methods

A cross-sectional survey was conducted in all CCUs recognised for postgraduate training to determine administration, infrastructure, equipment, staffing, and training.

Results

There were 220 CCUs registered for training, providing 2166 CCU beds and 1473 ventilators. Regional distribution of CCU beds per 100,000 population ranged from 1.0 in Sindh to none in Gilgit Baltistan (median 0.7). A senior clinician trained in critical care was available in 19 (12.1%) of units, giving a ratio of one trained intensivist for every 82 CCU beds and 0.009 trained intensivists per 100,000 population. One to one nurse to bed ratio during the day was available in 84 (53.5%) of units, dropping to 75 (47.8%) at night. Availability of 1:1 nursing also varied between provinces, ranging from 56.5% in Punjab compared to 0% in Azad Jamu Kashmir. All CCUs had basic infrastructure (electricity, running water, piped oxygen) and basic equipment (electronic monitoring and infusion pumps).

Conclusion

Pakistan, a lower middle-income country has an established network of critical care facilities with access to basic equipment, but inequalities in its distribution. Investment in critical care training for doctors and nurses is needed.