bluuebunny/crossref_metadata_2025 huggingface dataset:
A Multicenter Evaluation of Ceftolozane/Tazobactam Treatment Outcomes in Immunocompromised Patients With Multidrug-Resistant Pseudomonas aeruginosa Infections
Authors: Hart Delaney E , Gallagher Jason C , Puzniak Laura A , Hirsch Elizabeth B ,   C/T Alliance to deliver Real-world Evidence (CARE), Bandali Aiman , Beaulac Kirthana R , Bias Tiffany E , Biason Kenneth , Bland Christopher M , Boeser Kimberly , Chaudhry Saira , Claeys Kimberly C , Cubillos Ashley L , Dionne Brandon , Dixit Deepali , El-Beyrouty Claudine , Elabor Abdulrahman , Gancher Elizabeth , Guo Yi , Harrington Nicole , Heil Emily L , Hiles Jon , Jones Bruce M , King Madeline A , Lu Xiaoning , Mahoney Monica V , McCoy Dorothy , McCreary Erin K , Molnar Esther , Piche Ashley , Raddatz Janet K , Richards Lynette , Saraiya Nidhi , Satlin Michael J , Suh Jin , Virk Abinash , Vyas Nikunj M , Yu Daohai
Published: March 2021

Background

Real-world data assessing outcomes of immunocompromised patients treated with ceftolozane/tazobactam (C/T) are limited. This study evaluated treatment and clinical outcomes of immunocompromised patients receiving C/T for multidrug-resistant (MDR) Pseudomonas aeruginosa.

Methods

This was a 14-center retrospective cohort study of adult immunocompromised inpatients treated for ≥24 hours with C/T for MDR P. aeruginosa infections. Patients were defined as immunocompromised if they had a history of previous solid organ transplant (SOT), disease that increased susceptibility to infection, or received immunosuppressive therapies. The primary outcomes were all-cause 30-day mortality and clinical cure.

Results

Sixty-nine patients were included; 84% received immunosuppressive agents, 68% had a history of SOT, and 29% had diseases increasing susceptibility to infection. The mean patient age was 57 ± 14 years, and the median (interquartile range) patient Acute Physiology and Chronic Health Evaluation II and Charlson Comorbidity Index scores were 18 (13) and 5 (4), respectively, with 46% receiving intensive care unit care at C/T initiation. The most frequent infection sources were respiratory (56%) and wound (11%). All-cause 30-day mortality was 19% (n = 13), with clinical cure achieved in 47 (68%) patients. Clinical cure was numerically higher (75% vs 30%) in pneumonia patients who received 3-g pneumonia regimens vs 1.5-g regimens.

Conclusions

Of 69 immunocompromised patients treated with C/T for MDR P. aeruginosa, clinical cure was achieved in 68% and mortality was 19%, consistent with other reports on a cross-section of patient populations. C/T represents a promising agent for treatment of P. aeruginosa resistant to traditional antipseudomonal agents in this high-risk population.
Paralytic ileus in the neonate as a rare complication of maternal methadone treatment—a case report
Authors: Emery Joshua D , Samedi Veronica M , Bingham William T
Published: March 2021

Narcotic bowel syndrome is defined as worsening abdominal bloating and cramping with chronic opiate use, leading to paralytic ileus. This syndrome is common yet underreported in adults. However, there is no current evidence of such conditions in the newborn after exposure in utero to high doses of opiates. Our patient was a female indigenous preterm infant born to a mother on a high dose of methadone. On admission at the age of 12 h, she was found to have significant gastric distension. Initial abdominal X-ray showed a large gastric bubble with little evidence of rectal gas. Malrotation was suspected and surgical intervention was discussed. However, repeat abdominal X-ray, ultrasound and upper Gastrointestinal series were found to be normal and without acute findings. Thus, surgery was avoided. The gastric distension resolved spontaneously. She never required opiate therapy for neonatal abstinence syndrome. Given the pattern of gas seen on the initial abdominal X-ray and its spontaneous resolution after removal of maternal methadone, we suspect this baby had neonatal narcotic bowel syndrome. This has never been reported in the literature and is a unique finding. Given the lack of current reports, further observations for this syndrome should be conducted.
Outcome of Endoscope-Assisted Microvascular Decompression in Patients With Hemifacial Spasm Caused by Severe Indentation of the Brain Stem at the Pontomedullary Sulcus by the Posterior Inferior Cerebellar Artery
Authors: El Refaee Ehab , Fleck Steffen , Matthes Marc , Marx Sascha , Baldauf Joerg , Schroeder Henry W S
Published: March 2021

BACKGROUND

Microvascular decompression (MVD) is the most effective treatment option for hemifacial spasm (HFS). However, deeply located forms of compression would require proper identification to allow for adequate decompression.

OBJECTIVE

To describe the usefulness of endoscopic visualization in one of the most challenging compression patterns in HFS, where the posterior inferior cerebellar artery (PICA) loop is severely indenting the brain stem at the proximal root exit zone of facial nerve along the pontomedullary sulcus.

METHODS

Radiological and operative data were checked for all patients in whom severe indentation of the brainstem by PICA at pontomedullary sulcus was recorded and endoscope-assisted MVD was performed. Clinical correlation and outcome were analyzed.

RESULTS

A total of 58 patients with HFS were identified with radiological and surgical evidence proving brainstem indentation at the VII transitional zone. In 31 patients, PICA was the offending vessel to the facial nerve. In 3 patients, the PICA loop was mobilized under visualization of a 45° endoscope. A total of 31 patients had a mean follow-up duration of 52.1 mo. The mean duration between start of complaints and surgery was 7.2 yr. In the last follow-up, all patients had remarkable spasm improvement. A total of 5 patients had more than 90% disappearance of spasms and 26 patients experienced spasm-free outcome.

CONCLUSION

Although severe indentation of brain stem implies morphological damage, outcome after MVD is excellent. A 45° endoscope is extremely helpful to identify compression down at the pontomedullary sulcus. Deeply located compression site can easily be missed with microscopic inspection alone.
Roadblocks faced by graphene in replacing graphite in large-scale applications
Authors: Owuor Peter Samora , Khan Abdullah , Leon Carlos Leon y , Ozden Sehmus , Priestley Rodney , Arnold Craig , Chopra Nitin , Tiwary Chandra Sekhar
Published: March 2021

Since its isolation by Geim and coworkers, graphene has received a lot of attention from the research community as well as industry. Interesting and groundbreaking research has been published on graphene showing excellent properties and a wide range of applications. It was thought that graphene could replace well-established applications currently being controlled by graphite. In this perspective, we review large-scale applications of graphite that we think graphene can replace. We also discuss niche applications that we think graphene can make inroads for large-scale applications.
Behind the Scenes: What is Parliamentary Performance and How Can We Measure It?
Authors: Schobess Richard
Published: March 2021

Although evaluations of members of parliaments’ (MPs) parliamentary work have gained increasing public popularity, the academic literature on the concept and measurement of parliamentary performance is surprisingly scarce. Most studies analysing (aspects of) MPs’ parliamentary performance focus on quantitative parliamentary activity indicators only, thereby neglecting the quality and effectiveness of parliamentary work, and the importance of less visible parliamentary activities. This article introduces a conceptual framework of parliamentary performance as well as a more encompassing measurement approach, and provides a first empirical test of theoretically expected underlying dimensions on 325 Belgian MPs. This study proposes an innovative method relying on the collective expertise of MPs through peer assessment while controlling for potential rater effects. I demonstrate that parliamentary performance cannot be captured by parliamentary activity indicators alone. Exploratory and confirmatory factor analyses show that apart from three factors of parliamentary activity, two more qualitative factors (content and policy-making effectiveness) can be identified. The results suggest that future evaluations of MPs’ parliamentary work may need to include more qualitative elements.
Importance of the description of light interception in crop growth models
Authors: Liu Shouyang , Baret Frédéric , Abichou Mariem , Manceau Loïc , Andrieu Bruno , Weiss Marie , Martre Pierre
Published: March 2021

Canopy light interception determines the amount of energy captured by a crop, and is thus critical to modeling crop growth and yield, and may substantially contribute to the prediction uncertainty of crop growth models (CGMs). We thus analyzed the canopy light interception models of the 26 wheat (Triticum aestivum) CGMs used by the Agricultural Model Intercomparison and Improvement Project (AgMIP). Twenty-one CGMs assume that the light extinction coefficient (K) is constant, varying from 0.37 to 0.80 depending on the model. The other models take into account the illumination conditions and assume either that all green surfaces in the canopy have the same inclination angle (θ) or that θ distribution follows a spherical distribution. These assumptions have not yet been evaluated due to a lack of experimental data. Therefore, we conducted a field experiment with five cultivars with contrasting leaf stature sown at normal and double row spacing, and analyzed θ distribution in the canopies from three-dimensional canopy reconstructions. In all the canopies, θ distribution was well represented by an ellipsoidal distribution. We thus carried out an intercomparison between the light interception models of the AgMIP–Wheat CGMs ensemble and a physically based K model with ellipsoidal leaf angle distribution and canopy clumping (KellC). Results showed that the KellC model outperformed current approaches under most illumination conditions and that the uncertainty in simulated wheat growth and final grain yield due to light models could be as high as 45%. Therefore, our results call for an overhaul of light interception models in CGMs.
Transport, functions, and interaction of calcium and manganese in plant organellar compartments
Authors: He Jie , Rössner Nico , Hoang Minh T T , Alejandro Santiago , Peiter Edgar
Published: March 2021

Calcium (Ca2+) and manganese (Mn2+) are essential elements for plants and have similar ionic radii and binding coordination. They are assigned specific functions within organelles, but share many transport mechanisms to cross organellar membranes. Despite their points of interaction, those elements are usually investigated and reviewed separately. This review takes them out of this isolation. It highlights our current mechanistic understanding and points to open questions of their functions, their transport, and their interplay in the endoplasmic reticulum (ER), vesicular compartments (Golgi apparatus, trans-Golgi network, pre-vacuolar compartment), vacuoles, chloroplasts, mitochondria, and peroxisomes. Complex processes demanding these cations, such as Mn2+-dependent glycosylation or systemic Ca2+ signaling, are covered in some detail if they have not been reviewed recently or if recent findings add to current models. The function of Ca2+ as signaling agent released from organelles into the cytosol and within the organelles themselves is a recurrent theme of this review, again keeping the interference by Mn2+ in mind. The involvement of organellar channels [e.g. glutamate receptor-likes (GLR), cyclic nucleotide-gated channels (CNGC), mitochondrial conductivity units (MCU), and two-pore channel1 (TPC1)], transporters (e.g. natural resistance-associated macrophage proteins (NRAMP), Ca2+ exchangers (CAX), metal tolerance proteins (MTP), and bivalent cation transporters (BICAT)], and pumps [autoinhibited Ca2+-ATPases (ACA) and ER Ca2+-ATPases (ECA)] in the import and export of organellar Ca2+ and Mn2+ is scrutinized, whereby current controversial issues are pointed out. Mechanisms in animals and yeast are taken into account where they may provide a blueprint for processes in plants, in particular, with respect to tunable molecular mechanisms of Ca2+ versus Mn2+ selectivity.
Acquiring Core Investigative Interviewing Skills in Police Academy Training
Authors: Mount David , Mazerolle Lorraine
Published: March 2021

The ability of a police officer to elicit case-relevant information from a witness, victim, or suspect of a crime is a fundamental component of policing capability. The skills required to conduct an effective interview are not innate requiring police officers to be formally trained. The structural design, teaching, and assessment methods employed in the delivery of investigative interviewing training are assumed to directly impact a trainee’s level of engagement and level of interviewing knowledge and skills acquired. This paper uses a qualitative case study approach to observe how core investigative interviewing skills are acquired through formal training. Our findings suggest a relationship between the adult learning construct adopted, the levels of learner engagement generated, and the achievement of desired learning outcomes. Our findings will inform future designs of investigative interviewing training that seek to maximize both learning outcomes and returns on resource investments.
Differential Diagnosis and Treatment in a Patient With Posterior Upper Thoracic Pain
Authors: Fruth Stacie J
Published: March 2021

Background and Purpose. Determining the source of a patient's pain in the upper thoracic region can be difficult. Costovertebral (CV) and costotransverse (CT) joint hypomobility and active trigger points (TrPs) are possible sources of upper thoracic pain. This case report describes the clinical decision-making process for a patient with posterior upper thoracic pain. Case Description. The patient had a 4-month history of pain; limited cervical, trunk, and shoulder active range of motion; limited and painful mobility of the right CV /CT joints of ribs 3 through 6; and periscapular TrPs. Interventions included CV / CT joint mobilizations, TrP release, and flexibility and postural exercises. Outcomes. The patient reported intermittent mild discomfort after 7 physical therapy sessions. Examination findings were normal, and he was able to resume all preinjury activities. Discussion. This case suggests that CV /CT mobilizations and active TrP release may have been beneficial in reducing pain and restoring function in this patient. [Fruth SJ. Differential diagnosis and treatment in a patient with posterior upper thoracic pain. Phys Ther. 2006;86:254-268.]
Predicting relapse in anti-neutrophil cytoplasmic antibody-associated vasculitis: a Systematic review and meta-analysis
Authors: King Catherine , Druce Katie L , Nightingale Peter , Kay Ellen , Basu Neil , Salama Alan D , Harper Lorraine
Published: March 2021

Objectives

Relapses affect 30–50% of patients with ANCA-associated vasculitis (AAV) over 5 years, necessitating long-term treatment. Although there have been studies looking at predictors of relapse in AAV, this research has yet to translate clinically into guidance on tailored therapy. The aim of this systematic review was to identify and meta-analyse existing risk factors from the literature and produce a model to calculate individualised patient risk of relapse.

Method

A search strategy was developed to include all studies identifying predictors of AAV relapse using multivariate analysis. Individual risk factors were extracted and pooled hazard ratios (HRs) calculated. A model to predict the time to first relapse based on identified risk factors was tested retrospectively using a cohort of patients with AAV.

Results

The review of 2674 abstracts identified 117 papers for full text review, with 16 eligible for inclusion. Pooled HRs were calculated from significant risk factors, including anti-PR3 ANCA positivity [HR 1.69 (95% CI 1.46, 1.94)], cardiovascular involvement [HR 1.78 (95% CI 1.26, 2.53)], creatinine >200 µmol/l (relative to creatinine ≤100) [HR 0.39 (95% CI 0.22, 0.69)] and creatinine 101–200 µmol/l [HR 0.81 (95% CI 0.77, 0.85)]. Using data from 182 AAV patients to validate the model gave a C-statistic of 0.61.

Conclusion

Anti-PR3 ANCA positivity, lower serum creatinine and cardiovascular system involvement are all associated with an increased risk of relapse, and a combination of these risk factors can be used to predict the individualised risk of relapse. In order to produce a clinically useful model to stratify risk, we need to identify more risk factors, with a focus on robust biomarkers.
Dynamics of Research and Strategic Trading
Authors: Banerjee Snehal , Breon-Drish Bradyn
Published: March 2021

We study how dynamic research affects information acquisition in financial markets. In our strategic trading model, the trader performs costly research to generate private information but does not always succeed. Optimal research activity responds to market conditions and generates novel implications. First, more frequent public disclosures can “crowd in” private information acquisition, increase price informativeness, and harm liquidity, instead of “leveling the playing field.” Second, observed research activity does not necessarily imply that traders are better informed. Finally, improvements in research effectiveness or higher market participation by uninformed investors can simultaneously increase price informativeness and liquidity.
Treatment strategies and safety of rechallenge in the setting of immune checkpoint inhibitors-related myositis: a national multicentre study
Authors: Weill Amandine , Delyon Julie , Descamps Vincent , Deschamps Lydia , Dinulescu Monica , Dupuy Alain , Célérier Philippe , Nardin Charlee , Aubin François , Le Corre Yannick , Heidelberger Valentine , Maubec Eve , Malissen Nausicaa , Longvert Christine , Machet Laurent , Gounant Valérie , Brosseau Solenne , Bonniaud Bertille , Jeudy Géraldine , Psimaras Dimitri , Doucet Ludovic , Lebbe Céleste , Zalcman Gérard , De Masson Adèle , Baroudjian Barouyr , Leonard-Louis Sarah , Hervier Baptiste , Brunet-Possenti Florence
Published: March 2021

Objectives

The occurrence of immune-related myositis (irM) is increasing, yet there are no therapeutic guidelines. We sought to analyse the current therapeutic strategies of irM and evaluate the outcomes of immune checkpoint inhibitors (ICIs) rechallenge.

Methods

We conducted a nationwide retrospective study between April 2018 and March 2020 including irM without myocardial involvement. Depending on the presence of cutaneous signs or unusual histopathological features, patients were classified into two groups: typical or atypical irM. Therapeutic strategies were analysed in both groups. The modalities and outcomes of ICI rechallenge were reviewed.

Results

Among the 20 patients, 16 presented typical irM. Regardless of severity, most typical irM were treated with steroid monotherapy (n = 14/16) and all had a complete response within ≤3 weeks. The efficacy of oral steroids for non-severe typical irM (n = 10) was the same with low-dose (≤0.5 mg/kg/day) or high-dose (1 mg/kg/day). Severe typical irM were successfully treated with intravenous methylprednisolone. Atypical irM (n = 4) had a less favourable evolution, including one irM-related death, and required heavy immunosuppression. ICIs were safely reintroduced in nine patients presenting a moderate (n = 6) or a severe (n = 3) irM.

Conclusion

Our data highlight that steroid monotherapy is an effective treatment for typical irM, either with prednisone or with intravenous methylprednisone pulses depending on the severity. The identification of unusual features is important in determining the initial therapeutic strategy. The outcomes of rechallenged patients are in favour of a safe reintroduction of ICI following symptom resolution and creatin kinase (CK) normalization in moderate and severe forms of irM.
What is the incidence of methotrexate or leflunomide discontinuation related to cytopenia, liver enzyme elevation or kidney function decline?
Authors: Nakafero Georgina , Grainge Matthew J , Card Tim , Mallen Christian D , Zhang Weiya , Doherty Michael , Taal Maarten W , Aithal Guruprasad P , Abhishek Abhishek
Published: March 2021

Objectives

To examine incidence of treatment changes due to abnormal blood-test results and, to explore rates of treatment changes due to liver, kidney and haematological blood-test abnormalities in autoimmune rheumatic diseases (AIRD) treated with low-dose MTX or LEF.

Methods

Data for people with AIRDs prescribed MTX or LEF were extracted from the Clinical Practice Research Datalink. Participants were followed-up from first prescription of MTX or LEF in primary care. Primary outcome of interest was drug discontinuation, defined as a prescription gap of ≥90 days following an abnormal (or severely abnormal) blood-test result. Dose reduction was examined between consecutive prescriptions. Incidence rates per 1000 person-years were calculated.

Results

15, 670 and 2,689 participants contributing 46, 571 and 4,558 person-years follow-up were included in MTX and LEF cohorts, respectively. The incidence of MTX and LEF discontinuation with abnormal (severely abnormal) blood-test was 42.24 (6.16) and 106.53 (9.42)/1000 person-years in year 1, and 22.44 (2.84) and 31.69 (4.40)/1000 person years, respectively, thereafter. The cumulative incidence of MTX and LEF discontinuation with abnormal (severely abnormal) blood tests was 1 in 24 (1 in 169), 1 in 9 (1 in 106) at 1 year; and 1 in 45 (1 in 352), 1 in 32 (1 in 227) per-year, respectively, thereafter. Raised liver enzymes were the commonest abnormality associated with drug discontinuation. MTX and LEF dose reduction incidence were comparable in year 1, however, thereafter MTX dose was reduced more often than LEF [16.60 (95% CI 13.05, 21.13) vs 8.10 (95% CI 4.97, 13.20)/1000 person-years].

Conclusion

MTX and LEF were discontinued for blood-test abnormalities after year 1 of treatment, however, discontinuations for severely abnormal results were uncommon.
Effects of ractopamine hydrochloride on nutrient digestibility and nitrogen excretion of finishing beef cattle
Authors: Harsh Bailey N , Klatt Brady J , Volk Mareah J , Green-Miller Angela R , McCann Joshua C
Published: March 2021

The objective was to quantify the effects of the beta-adrenergic agonist (β-AA) ractopamine hydrochloride (Actogain, Zoetis, Parsippany, NJ) on nitrogen excretion and nutrient digestibility in feedlot cattle. In experiment 1, 12 Simmental × Angus steers were blocked by bodyweight (531 ± 16 kg) and used in a randomized complete block design. Dietary treatments included: 1) a control without β-AA (CON) or 2) 400 mg/steer/d ractopamine hydrochloride (RAC) for 35 d before slaughter. Diets contained (DM basis) 55% dry-rolled corn, 20% corn silage, 15% modified wet distillers grains with soluble, and 10% supplement. For each block, total collection of feed, orts, feces, and urine were conducted for two 5 d sampling periods during week 2 and 4 of RAC supplementation. No interaction (P > 0.21) between treatment and collection period was observed for any parameter evaluated. Dietary treatment had no effect (P = 0.51) on DMI, but RAC had decreased fecal DM output (P = 0.04) compared with CON. Thus, RAC had greater apparent total tract DM digestibility (77.2 vs. 73.5%; P < 0.01), N digestibility (72.4 vs. 69.4%; P = 0.01), and NDF digestibility (65.6 vs. 60.2%; P < 0.01) than CON. Although treatment did not affect nitrogen intake (P = 0.52), RAC tended to reduce total nitrogen excretion (113.3 vs. 126.7 g/d; P = 0.10) compared with CON due to a tendency for decreased fecal nitrogen output (53.9 vs. 61.3 g/d; P = 0.10). However, dietary treatment had no effect (P = 0.53) on urinary nitrogen output or percentage of urinary nitrogen excreted as urea (P = 0.28). Experiment 2 was an in vitro experiment conducted to validate the effects of RAC on nutrient digestibility using Simmental × Angus heifers (451 ± 50 kg). Rumen fluid was collected individually by stomach tube from CON- (n = 9) and RAC-fed (n = 10) heifers to inoculate bottles containing a CON or RAC-containing substrate in a split–plot design. No interaction between rumen fluid source and in vitro substrate was observed. Greater IVDMD (P = 0.01) was observed in rumen fluid from RAC-fed heifers compared with rumen fluid from CON-fed heifers. The inclusion of RAC in the in vitro substrate increased IVDMD (P < 0.01). Overall, feeding RAC increased microbial digestion of the dry-rolled corn-based finishing diet to increase total tract dry mater digestion by 5% and reduce nitrogen excretion by 10.6% in the 35 d period prior to slaughter.
Evaluation of an herbal therapy to alleviate acute pain and stress of disbudded dairy calves under organic management1
Authors: Phillips Hannah N , Heins Bradley J
Published: March 2021

The objective of this experiment was to evaluate a herbal therapy used in place of standard synthetic analgesia to mitigate disbudding pain of dairy calves. For this experiment, 54 calves were randomly assigned to one of three treatments: 1) local anesthetic lidocaine given as a cornual nerve block before cautery disbudding (AD); 2) sham disbudding (SD); or 3) herbal tincture (Dull It, Dr. Paul’s Lab, Mazomanie, WI) composed of white willow (Salix alba L.) bark, St. John’s wort (Hypericum perforatum L.), chamomile (Matricaria recutita L.), arnica (Arnica montana L.), and fennel (Foeniculum vulgare Mill.) administered orally before and after cautery disbudding (TD). Behaviors were assessed during disbudding, and behaviors and blood plasma cortisol concentrations were assessed following disbudding. Tail wag, head movement, forcing ahead, and kick rates recorded during disbudding were similar among treatments. When averaged across the 360-min observation period following disbudding, injury-directed behavioral rates of head jerks, head shakes, horn bud scratches, and head rubs were greater (P ≤ 0.03) for calves in the AD group than calves in the SD group, calves in the TD group had greater (P < 0.01) horn bud scratch and head rub rates compared to calves in the SD group, and calves in the AD group had a greater (P < 0.01) horn bud scratch rate than calves in the TD group. Calves in the AD group took 1.6 [95% confidence interval (CI) = 1.0 to 2.4, P = 0.03] times longer to lie down after disbudding compared to calves in the TD group. Serum cortisol concentrations were greater (P ≤ 0.01) for calves in the TD group compared to calves in the SD group at 10, 30, and 90 min after disbudding. At 30 min after disbudding, calves in the AD group had 5.8 ng/mL (95% CI = −1.1 to 12.7 ng/mL, P = 0.02) greater serum cortisol compared to calves in the SD group, while calves in the TD group had 14.3 ng/mL (95% CI = 1.5 to 27.1 ng/mL, P < 0.01) greater serum cortisol than calves in the AD group. In conclusion, neither the local anesthetic lidocaine nor the orally administered herbal tincture attenuated both acute injury-directed behaviors and blood plasma cortisol concentrations in disbudded calves, and the tincture was clearly less effective at mitigating cortisol; therefore, additional analgesic may be required to properly manage disbudding pain effectively.
Effects of voluntary removal of ractopamine hydrochloride (Optaflexx) on live performance and carcass characteristics of beef steers
Authors: Rincker Phillip J , Allen Janet B , Edmonds Matt , Brown Michael S , Kube John C
Published: March 2021

There is a lack of consistency across the globe in how countries establish tissue ractopamine residue limits and which residue limits are applied to various tissues, particularly for edible noncarcass tissues. Therefore, some U.S. beef slaughter organizations have recommended a 48-h voluntary removal of ractopamine before slaughter to meet residue requirements of specific export countries and maintain international trade. Our objective was to assess the impact of voluntary removal of ractopamine hydrochloride (Optaflexx; Elanco, Greenfield, IN) up to 8 d before slaughter on growth performance and carcass characteristics. Crossbred beef steers (60 pens of 10 animals/pen) with an initial shrunk body weight (BW) of 611.8 ± 10 kg SEM were fed one of six treatments over 42 d. Treatments included a control that did not receive ractopamine, on-label use of ractopamine (0-d withdrawal), and 2, 4, 6, or 8 d of voluntary removal of ractopamine from feed before slaughter. The start of ractopamine feeding (30.1 mg/kg of diet dry matter for 32 d) was staggered, so that blocks could be slaughtered on the same day. Dry matter intake was decreased by 0.5 kg/d when ractopamine was fed with a 0-d withdrawal (P = 0.04) compared with the control, but was not altered (P = 0.56) as the duration of ractopamine removal increased from 0 to 8 d. Final BW, total BW gain, and average daily BW gain were increased by feeding ractopamine with a 0-d withdrawal (P = 0.09) compared with the control, but these variables decreased in a linear manner (P = 0.10) as the duration of removal increased from 0 to 8 d. Gain efficiency was improved by 15% (P < 0.01) by feeding ractopamine with a 0-d withdrawal compared with the control, and gain efficiency decreased linearly (P = 0.06) as the duration of ractopamine removal increased. Approximately 2/3 of the increase in gain efficiency remained after 8 d of removal. Hot carcass weight was increased by 6 kg (P = 0.02) by feeding ractopamine with a 0-d withdrawal compared to the control. Measured carcass characteristics were not altered by ractopamine feeding or by removal before slaughter (P ≥ 0.24). The consequences of voluntary removal of ractopamine up to 8 d before slaughter were a linear decrease in live BW gain (0.64 kg/d), poorer gain efficiency, and numerically lighter carcass weight.
COVID-19 pandemic response behaviors: a Singapore experience of the “circuit breaker”
Authors: Chew Han Shi Jocelyn , Chng Samuel
Published: March 2021

Preventive health behaviors such as hand hygiene are crucial amidst pandemics like COVID-19 but reports on nonadherence persist. This could be due to the lack of Consideration of Future Consequences (CFC), a cognitive-motivational construct known to improve health-related behaviors. Therefore, we examined the relationship between CFC and five behaviors—mask-wearing, social distancing, hand hygiene, excessive necessities buying, and COVID-19 information searching using an internet-based Singapore-wide survey conducted from April 20 to May 4, 2020. Behavioral differences 2 weeks before and after the state-wide confinement were examined using paired t-tests. Relationships between CFC and COVID-19 behaviors were examined using regression analyses adjusted for depression and anxiety. Participants were regrouped into three categories—increased behavior performance, maintained high performance, and maintained low performance where mean differences were analysed using MANOVA. Three hundred and thirty-six participants completed the survey (mean age, SD = 32.9 years [SD = 12.6]; 38.7% males). CFCfuture predicted mask wearing (B = 0.16; p < .05), social distancing (B = 0.0.19; p < .01), hand hygiene (B = 0.17; p < .01), and information searching (B = 0.21; p < .001). CFCimmediate predicted hand hygiene (B = 0.09; p < .05), excessive necessities buying (B = 0.07; p < .05) and information searching (B = 0.08; p < .05). Anxiety predicted excessive buying (B = 0.08; p < .05) and hand hygiene (B = 0.13; p < .01). Post-hoc test showed significantly higher CFCfuture (p < .01) in participants who increased and maintained high behavioral performance.
Local Water Quality, Diarrheal Disease, and the Unintended Consequences of Soda Taxes
Authors: Gutierrez Emilio , Rubli Adrian
Published: March 2021

Could taxing sugar-sweetened beverages in areas where clean water is unavailable lead to increases in diarrheal disease? An excise tax introduced in Mexico in 2014 led to a significant 6.6 percent increase in gastrointestinal disease rates in areas lacking safe drinking water throughout the first year of the tax, with evidence of a diminishing impact in the second year. Suggestive evidence of a differential increase in the consumption of bottled water by households without access to safe water two years post-tax provides a potential explanation for this declining pattern. The costs implied by these results are small, particularly compared to tax revenues and the potential public health benefits. However, these findings inform the need for accompanying soda taxes with policy interventions that guarantee safe drinking water for vulnerable populations.
Vaginal Hysterectomy Rates Before and After Implementation of a Multiple-Tier Intervention
Authors: Crouss Tess , Sharma Shefali , Smith Devon , Hunter Krystal , Perry Robin , Lipetskaia Lioudmila
Published: March 2021

OBJECTIVE:

To assess a multiple-tier intervention to increase vaginal hysterectomy rates.

METHODS:

We performed a cohort study assessing hysterectomy performance before and after implementation of a multiple-tier intervention to increase vaginal hysterectomy rates at a single tertiary care medical center. This intervention involved resident and attending education and simulation, professional development, design of a clinical pathway to assist in hysterectomy decision making, and development of a surgical mentorship program.

RESULTS:

Data from 698 hysterectomies (253 preintervention and 445 postintervention) were included. The preintervention time period extended from January 1, 2016, to December 31, 2017 (24 months), and the postintervention period from January 1, 2018, to February 28, 2020 (26 months). The intervention was implemented over the month of December 2017 but was not complete until January 1, 2018. The preintervention and postintervention cohorts were similar in most demographic and clinical aspects. Postintervention, the proportion of vaginal hysterectomies was higher (26.5% vs 5.5%, odds ratio 6.2, 95% CI 3.52–11.35), including in those performed for reasons other than prolapse (6.8% vs 0%, P<.001). Logistic regression revealed that prolapse, uterine weight less than 250 g, and surgery during the postintervention cohort were significantly associated with vaginal hysterectomy. Operative complications did not differ significantly by hysterectomy type.

CONCLUSION:

Implementation of a multiple-tier intervention was associated with an increase in vaginal hysterectomies.
Cochrane Review Summaries—April 2021
Authors: Cohen Megan , Edelman Alison , Bellussi Federica , Berghella Vincenzo , Haas David M.
Published: March 2021

In this month's issue, the journal continues to bring new insights from Cochrane Systematic Reviews to the readers of Obstetrics & Gynecology. This month, we highlight the use of self-administered medication for abortion, antibiotic use during operative vaginal delivery, and timing of labor induction. The summaries are published below. The complete references with hyperlinks are listed in Box 1.
Long-Term Outcomes in Complex Abdominal Wall Reconstruction Repaired With Absorbable Biologic Polymer Scaffold (Poly-4-Hydroxybutyrate)
Authors: Buell Joseph F. , Flaris Alexandros N. , Raju Sukreet , Hauch Adam , Darden Michael , Parker Geoff G.
Published: March 2021

Introduction:

After promising early outcomes in the use of absorbable biologic mesh for complex abdominal wall reconstruction, significant criticism has been raised over the longevity of these repairs after its 2-year resorption profile.

Methods:

This is the long-term (5-year) follow-up analysis of our initial experience with the absorbable polymer scaffold poly-4-hydroxybutyrate (P4HB) mesh compared with a consecutive contiguous group treated with porcine cadaveric mesh for complex abdominal wall reconstructions. Our clinical analysis was performed using Stata 14.2 and Excel 16.16.23.

Results:

After a 5-year follow-up period, the P4HB group (n = 31) experienced lower rates of reherniation (12.9% vs 38.1%; P = 0.017) compared with the porcine cadaveric mesh group (n = 42). The median interval in months to recurrent herniation was similar between groups (24.3 vs 20.8; P = 0.700). Multivariate logistic regression analysis on long-term outcomes identified smoking (P = 0.004), African American race (P = 0.004), and the use of cadaveric grafts (P = 0.003) as risks for complication while smoking (P = 0.034) and the use of cadaveric grafts (P = 0.014) were identified as risks for recurrence. The long-term cost analysis showed that P4HB had a $10,595 per case costs savings over porcine cadaveric mesh.

Conclusions:

Our study identified the superior outcomes in clinical performance and a value-based benefit of absorbable biologic P4HB scaffold persisted after the 2-year resorption timeframe. Data analysis also confirmed the use of porcine cadaveric grafts independently contributed to the incidence of complications and recurrences.
Evaluation of true point of care molecular assay using fingerstick capillary whole blood for diagnosis of hepatitis C infection
Authors: Agarwal Reshu , Gupta Ekta , Kumar Guresh , Singh Keshaw Kumar , Sharma Manoj Kumar
Published: March 2021

At present, the available point of care (POC) molecular assays for hepatitis C are not considered as true POC due to sample collection and processing requiring minimal laboratory infrastructure. A new POC Xpert HCV VL Fingerstick (Xpert FS) precludes such requirements where specimen collected by simple fingerstick can be loaded directly into the test cartridge with results available within 60 min. The present study compared the performance of this assay for HCV RNA quantitation using both capillary whole blood (CWB) and venous whole blood (VWB) with plasma HCV RNA performed on Abbott Real Time HCV PCR. CWB via fingerstick and VWB via venipuncture collected from serologically confirmed HCV-infected participants were loaded into Xpert HCV VL WB for viral load estimation. Simultaneously Abbott Real Time HCV PCR assay was also performed using plasma (reference method). Among the enrolled participants (n=157), the mean age was 46.22±14.79 years and 63 % were male. HCV RNA was detected in 100 cases (63.7 %), median 5.69 (IQR: 5.00–6.32)log10IU ml−1 on the reference method. Xpert FS showed 100 % sensitivity and specificity using both CWB and VWB. The median viral loads detected in CWB and VWB were 5.52 (IQR: 4.59–6.15) and 5.48 (IQR: 4.61–6.07)log10IU ml−1, respectively. Xpert FS offers potential as true POC enabling accurate diagnosis in a single patient visit to the health-care facility, hence may reduce the number of dropouts with a confirmed diagnosis. However, further real-time studies with larger sample size are warranted.
Chronic cluster headache: a study of the telencephalic and cerebellar cortical thickness
Authors: Demichelis Greta , Pinardi Chiara , Giani Luca , Medina Jean Paul , Gianeri Ruben , Bruzzone Maria Grazia , Becker Benjiamin , Proietti Alberto , Leone Massimo , Chiapparini Luisa , Ferraro Stefania , Nigri Anna
Published: March 2021

Previous studies on brain morphological alterations in chronic cluster headache revealed inconsistent findings. The present cross-sectional explorative study determined telencephalic and cerebellar cortex thickness alterations in a relatively wide sample of chronic cluster headache patients (n=28) in relation to matched healthy individuals. The combination of two highly robust state-of-the-art approaches for thickness estimation (Freesurfer and CERES) with an unbiased functional characterization of the abnormal regions, revealed two main results. First, chronic cluster headache patients show cortical thinning in the right middle cingulate cortex and the left posterior insula. This indicates abnormalities in key-regions of pain processing areas, in particular in regions belonging to the spino-thalamic-cortical tract and primarily involved in the sensory-motor aspects of nociception. Second, chronic cluster headache patients present cortical thinning in the left anterior superior temporal sulcus and the left collateral/lingual sulcus, suggesting neuroplastic maladaptations in areas possibly involved in social cognition, which may promote psychiatric comorbidity, frequently observed in these patients.
Determining the risk of developing symptomatic covid-19 infection after attending hospital for radiological examinations: controlled cohort study
Authors: Evangelou Nikos , Vaughan Sian , Hibbert Aimee , Morgan Paul S , Backx Matthijs , Berry Louise , Card Tim , Tallantyre Emma
Published: March 2021

OBJECTIVE

To determine whether brief attendance for outpatient radiological investigations is associated with increased risk of clinically significant coronavirus disease 2019 (covid-19) infection.

DESIGN

Observational cohort study with a historical control.

SETTING

2 large UK University Hospitals located in Nottingham and Cardiff.

PARTICIPANTS

All 47,340 patients who attended an outpatient radiology appointment at Nottingham University Hospitals and University Hospital of Wales during the first wave of the pandemic in 2020, and 70,655 patients that comprised the control cohort who attended for outpatient radiology the same period in 2019.

MAIN OUTCOME MEASURES

The risk of developing clinically significant covid-19 infection within 28-days of attending a radiological examination. Covid-19 infection rates for the 2020 cohort were compared against a control group who attended in 2019.

RESULTS

84 positive SARS-CoV-2 tests were temporally associated with 47,340 radiological examinations across two hospitals in 2020. This low infection rate was higher than the 2019 control cohort; OR 2.507 (1.766 – 3.559) and equates to an approximate 1 positive covid-19 infection per 1000 radiology investigations.

CONCLUSIONS

Our data suggests that attending hospitals for outpatient radiological investigations during the pandemic is associated with a very small absolute risk of acquiring clinically significant covid-19 infection. It is unlikely that this risk is directly attributable to radiology attendance, considering the reasons leading individuals to attend hospitals during the pandemic, the true attributable risk will likely be even lower.

TRIAL REGISTRATION

ClinicalTrials.govNCT04544176
Polygenic risk scores for psychiatric, inflammatory, and cardio-metabolic traits and diseases highlight possible genetic overlaps with suicide attempt and treatment-emergent suicidal ideation
Authors: Fanelli Giuseppe , Sokolowski Marcus , Wasserman Danuta ,   European College of Neuropsychopharmacology (ECNP) Network on Suicide Research and Prevention, Kasper Siegfried , Zohar Joseph , Souery Daniel , Montgomery Stuart , Albani Diego , Forloni Gianluigi , Ferentinos Panagiotis , Rujescu Dan , Mendlewicz Julien , Ronchi Diana De , Serretti Alessandro , Fabbri Chiara
Published: March 2021

Suicide is the second leading cause of death among young people. Genetics may contribute to suicidal phenotypes and their co-occurrence in other psychiatric and medical conditions. Our study aimed to investigate the association of polygenic risk scores (PRSs) for 22 psychiatric, inflammatory, and cardio-metabolic traits and diseases with suicide attempt (SA) or treatment-worsening/emergent suicidal ideation (TWESI).

PRSs were computed based on summary statistics of genome-wide association studies. Regression analyses were performed between PRSs and SA or TWESI in four clinical cohorts, including up to 3,834 individuals, and results were meta-analyzed across samples. Stratified genetic covariance analyses were performed to investigate the biology underlying cross-phenotype PRS associations. After Bonferroni correction, PRS for major depressive disorder (MDD) was positively associated with SA (p=1.7e-4). Nominal associations were shown between PRSs for coronary artery disease (CAD) (p=4.6e-3) or loneliness (p=0.009) and SA, PRSs for MDD or CAD and TWESI (p=0.033 and p=0.032, respectively). Genetic covariance between MDD and SA was shown in 35 gene sets related to drugs having anti-suicidal effects.

A higher genetic liability for MDD may underlie a higher risk of SA. Further, but milder, possible modulatory factors are genetic risk for loneliness and CAD.
Evolutionary dynamics of the OR gene repertoire in teleost fishes: evidence of an association with changes in olfactory epithelium shape
Authors: Policarpo Maxime , Bemis Katherine E , Tyler James C , Metcalfe Cushla J , Laurenti Patrick , Sandoz Jean-Christophe , Rétaux Sylvie , Casane Didier
Published: March 2021

Teleost fishes perceive their environment through a range of sensory modalities, among which olfaction often plays an important role. Richness of the olfactory repertoire depends on the diversity of receptors coded by homologous genes classified into four families: OR, TAAR, VR1 and VR2. Herein, we focus on the OR gene repertoire. While independent large contractions of the OR gene repertoire associated with ecological transitions have been found in mammals, little is known about the diversity of the OR gene repertoire and its evolution within teleost fishes, a group that includes more than 34,000 living species. We analyzed genomes of 163 species representing diversity in this large group. We found a large range of variation in the number of functional OR genes, from 15 inSyngnathus typhleandMola mola, to 429 inMastacembelus armatus. The number of OR genes was higher in species with an extensively folded olfactory epithelium, that is, for example, when a multi-lamellar rosette was present in the olfactory organ. Moreover, the number of lamellae was correlated with the richness of the OR gene repertoire. While a slow and balanced birth-and-death process generally drives evolution of the OR gene repertoire, we inferred several episodes of high rates of gene loss, sometimes followed by large gains in the number of OR genes. These gains coincide with morphological changes of the olfactory organ and suggest a strong functional association between changes in the morphology and the evolution of the OR gene repertoire.
Mapping of Whole-Brain Resting-State Networks with Half-Millimetre Resolution
Authors: Yun Seong Dae , Pais-Roldán Patricia , Palomero-Gallagher Nicola , Shah N. Jon
Published: March 2021

Resting-state fMRI has been used in numerous studies to map networks in the brain that employ spatially disparate regions. However, attempts to map networks with high spatial resolution have been hampered by conflicting technical demands and associated problems. Results from recent fMRI studies have shown that spatial resolution remains around 0.7 × 0.7 × 0.7 mm3, with only partial brain coverage. This work presents a novel fMRI method, TR-external EPI with keyhole (TR-external EPIK), which can provide a nominal spatial resolution of 0.51 × 0.51 × 1.00 mm3(0.26 mm3voxel) with whole-brain coverage. TR-external EPIK enabled the identification of various resting-state networks distributed throughout the brain from a single fMRI session, with mapping fidelity onto the grey matter at 7T. The high-resolution functional image further revealed mesoscale anatomical structures, such as small cerebral vessels and the internal granular layer of the cortex within the postcentral gyrus.