bluuebunny/crossref_metadata_2025 huggingface dataset:
Training Experiences of Emergency Department Providers in the Recognition of Child Trafficking
Authors: Bechtel Kirsten , Passmore Sarah , Kondis Jamie , Walker Descartes Ingrid , Adewusi Adebimpe , Greenbaum Virginia
Published: August 2021

Objective

Trafficked children face challenges to obtaining appropriate health care that may be addressed by clinician training. We evaluated emergency department (ED) staff's training experiences regarding child trafficking and attitudes toward educational efforts to provide informed recommendations for improvement in the recognition and evaluation of trafficked children in the ED setting.

Methods

In this cross-sectional study of general and pediatric ED staff across 6 cities in the United States, participants completed a 25-question, online anonymous survey. Differences in proportions between categorical data were examined using χ2/Fisher exact tests. Differences in means were evaluated using Student t test and 1-way analysis of variance.

Results

The 484 participants included physicians (33.0%), nurses (27.4%), resident physicians (12.2%), and social workers (10.1%). Only 12.4% reported being very confident in recognizing child trafficking. Barriers to recognition included lack of awareness and training on child sex trafficking (37.4%, 58.3%) and labor trafficking (38.4%, 50.6%), sensitivity of the topic (44.4%), lack of institutional guidelines (29.8%) and social work coverage (26.0%), and the assumption that children will not disclose victimization (16.5%). Although 62.2% of the respondents had prior training in child sex trafficking, only 13.3% reported that it was adequate. Barriers to training included lack of easy access (82.5%), belief that prior training was adequate (13.3%), poor-quality curricula (5.1%), and low priority of topic (4.1%). Recommendations for training included a 1-hour module/webinar/lecture (43.1%), rounds (40.5%), written guidelines (9.8%), and individualized, case-based learning (6.6%).

Conclusions

We found that although most ED providers stated that they had prior training in the recognition of child trafficking, few expressed confidence in their ability to recognize and evaluate trafficked children. Barriers to education included a lack of awareness of and access to available curricula. Providers supported a variety of formats for further education. Strategies for improving educational access are discussed.
Differences in Placental Histology Between Zika Virus–infected Teenagers and Older Women
Authors: Santos Geovane R. , Pinto Clovis A.L. , Prudente Raphael C.S. , Witkin Steven S. , Arandes Antoni S. , Rodrigues Laura C. , Zatz Mayana , Massad Eduardo ,   Zika Consortium, Passos Saulo D.
Published: August 2021

In pregnant women, Zika virus (ZIKV) is associated with a congenital syndrome, most frequently involving damage to embryo brain formation and the development of microcephaly. The mechanism(s) by which ZIKV enters the maternal-fetal interface and is transmitted to the fetus remains incompletely determined. We sought to evaluate histologic changes in the placenta of ZIKV-infected pregnant women and to determine if this varied by maternal age. Placental samples were obtained from 66 women, 33 of whom were positive for ZIKV. Histologic evaluations were performed on 4 areas of the placenta: fetal surface, maternal surface, umbilical cord, and membranes. Samples were analyzed by the tissue microarray technique and tested for CD4, CD8, CD20, CD68, FOXP3, and cyclooxygenase-2 expression. Data were evaluated using Fisher exact test. ZIKV infection was more frequent in women less than 18 yr of age (9/11, 81.8%) than in women above 18 yr old (24/55, 43.6%) (P=0.0440). ZIKV detection was associated with neutrophilic chorioamnionitis (P=0.0332) and with septal (P=0.0244) and villous (P=0.0534) calcification. Hofbauer cell hyperplasia (P=0.0260) and cyclooxygenase-2 expression (P=0.0346) were more prevalent in ZIKV-positive women aged 18 yr and below than in the older ZIKV-positive women. ZIKV infection during pregnancy occurs more frequently in adolescents and induces higher rates of damage at the maternal-fetal interface than in older women.
Ovarian Metastasis by Gastric-type Endocervical Adenocarcinoma: A Clinicopathologic Description of 12 Cases
Authors: Lu Bingjian , Shi Haiyan , Shao Ying , Xu Junfen
Published: August 2021

Cervical gastric-type adenocarcinoma has a propensity for ovarian metastasis, but the clinicopathologic findings and possible routes of tumor spread have not been well characterized to date. To address these points, we reported 12 cervical gastric-type adenocarcinomas with ovarian metastases from a single institution. Seven patients with gastric-type adenocarcinoma had concurrent endometrial fallopian tube involvement, 5 of which showed tumors confined to the fallopian tube mucosa. Two of these 5 patients died of disease at 2 and 16 mo, and 1 recurred at 18 mo. In the remaining 5 patients, 3 had wide pelvic/peritoneal spread while the other 2 showed no evidence of uterine or tubal involvement. Among them, 1 died of disease at 94 mo, and another relapsed at 20 mo. Morphologically, ovarian tumors frequently had surface involvement consistent with metastasis, but also mimicked a primary tumor with a mixture of benign/borderline/intraepithelial carcinoma-like areas, as well as carcinoma with expansile or destructive stromal invasion. The tubal lesions were predominantly in the form of mucosal colonization without invasion of the underlying structures. Block p16 and high-risk human papillomavirus mRNA signals were not detected in cervical gastric-type adenocarcinomas and ovarian metastatic tumors. We conclude that fallopian tube spread may be associated with ovarian metastasis of cervical gastric-type adenocarcinomas that have bad clinical outcomes. Ovarian involvement may be a part of the aggressive nature of these tumors.
Psychometric Properties of the Safety Climate Survey in Austrian Acute Care: Factor Structure, Reliability, and Usability
Authors: Glarcher Manela , Kaiser Karin , Nestler Nadja , Kutschar Patrick
Published: August 2021

Background

Hospitals are complex organizations with a potential for medical errors that can be influenced by safety culture. Safety climate, as measurable element of safety culture, illustrates the perception of safety-relevant aspects of health care staff at a certain time. The Safety Climate Survey is applied internationally to measure safety climate. However, psychometrics for the German version of the survey have yet not been evaluated. The aim of this study is to explore the factor structure, reliability, and potential usefulness of the Safety Climate Survey in Austrian acute care.

Methods

Cross-sectional surveys of physicians, therapists, and nurses/midwives were implemented. An exploratory factor analysis was carried out, both in total sample and split by 2 selected professions. After deriving a factor structure for both professions, internal consistency and scale means were calculated for the subscales. Finally, mean subscale differences between physicians and nurses/midwives were tested.

Results

Of 5160 eligible staff, 933 respondents participated. A 6-factor solution explaining 59.1% of total variance was identified. Comparison by profession illustrated that the factor structures and item loading patterns differ between physicians and nurses/midwives. To achieve an overarching solution, 5 items were excluded from consecutive subscale measures because of cross-loadings and contradictory factor loadings. Subscales demonstrated good to low internal consistency (α = 0.794–0.535). Significant mean differences between subscales of professions were found relating to 3 factors.

Conclusions

The German Safety Climate Survey measures safety climate multidimensionally rather than unidimensionally and demonstrated some limitations in factor structures and item loadings but overall had satisfactory reliability of the 6 subscales.
The Arcuate Eminence and Superior Semicircular Canal: Magnetic Resonance Imaging Study
Authors: Tsutsumi Satoshi , Ono Hideo , Ishii Hisato
Published: August 2021

Objective

The present study aimed to explore the relationship between the arcuate eminence (AE) and superior semicircular canal (SSC) using the constructive interference steady-state (CISS) sequence.

Patients and Methods

After conventional magnetic resonance imaging, a total of 71 patients underwent the CISS sequence in thin-sliced coronal sections.

Results

In all patients, the SSC was delineated on both sides. In contrast, the AE was identified only in 29 of 71 patients (40.8%) on both sides, varying in shape and relative location to the SSC in the mediolateral dimension. The shortest distance between the highest point of the SSC and middle fossa floor was 1.3 ± 1.1 mm on the right side and 1.3 ± 0.9 mm on the left with considerable variability. A dehiscent SSC with a distance less than 0.2 mm was found in 11.3% of 142 sides. On 22 sides (15.5%), the site on the middle fossa floor, reaching the SSC with the shortest distance (reference point) corresponded to the apex of the AE, equally on the right and left. On 36 sides (25.4%), the distance between the reference point and the apex of the AE was measured as 3.0 ± 1.1 mm on the 18 right sides and 3.7 ± 1.6 mm on the 18 left sides.

Conclusions

The relationship between AE and SSC is highly variable. Arcuate eminence was not a reliable landmark of the SSC. High-resolution CISS sequence is useful for exploring these structures.
The Past, Present, and Future (Liquid Biopsy) of Serum Tumor Markers in Lung Cancer: A Primer for the Radiologist
Authors: Vos Derek , Rao Sanjay , Pierce Jonathan D. , Smith Daniel A. , Tirumani Sree Harsha , Yoest Jennifer M. , Ramaiya Nikhil H.
Published: August 2021

Lung cancer continues to be a major cause of death throughout the world. The ability to both accurately diagnose lung cancer in its early stages and monitor response to treatment is essential to reducing the morbidity and mortality associated with the disease. Serum tumor markers have been identified as potential biomarkers that may aid in lung cancer diagnosis and surveillance. These markers, when combined with cross-sectional imaging, may result in more robust screening and surveillance protocols. The future role of serum tumor markers in lung cancer includes the advancement of “liquid biopsies,” in which peripheral blood samples are analyzed for tumor components without the need for a tissue biopsy.
Risk Stratification of Ductal Carcinoma In Situ and Texture Analysis of Contrast-Enhanced Breast Magnetic Resonance Imaging
Authors: Lee Eun Byul , Kim Sung Hun , Park Ga Eun , Lee Jeongmin , Kang Bong Joo
Published: August 2021

Objective

The aim of this study was to investigate whether texture analysis of contrast-enhanced T1 weighted images could predict risk of ductal carcinoma in situ (DCIS).

Methods

The study included 185 DCIS lesions that were classified as either low risk or non–low risk using surgical pathology records. All magnetic resonance imaging texture analyses were performed using postprocessing software, and texture-derived parameters were extracted.

Results

The sphericity, compactness, and spherical disproportion were significantly different in the low-risk and non–low risk groups using the Van Nuys Prognostic Index (mean ± SD, 0.479 ± 0.189 vs 0.414 ± 0.176, 0.161 ± 0.159 vs 0.112 ± 0.134, and 2.569 ± 1.434 vs 2.934 ± 1.374, respectively; P < 0.05). In the univariate analyses, sphericity (odds ratio, 7.091; 95% confidence interval, 1.236–40.666; P = 0.028) and compactness (odds ratio, 9.267; 95% confidence interval, 1.125–76.360; P = 0.039) were significantly associated with a high probability of being low risk according to the Van Nuys Prognostic Index.

Conclusions

Whole-lesion texture analysis may be helpful in identifying patients classified as having low-risk DCIS before surgery.
Characteristic Features of Ear and Ear-Prints in Forensic Identification
Authors: Rani Deepika , Krishan Kewal , Sahani Ramesh , Shrestha Rijen , Kanchan Tanuj
Published: August 2021

Introduction and Objectives:

The human external ear is a morphologically perplexing structure with wide variations in its features across individuals. Advances in forensic science have established the use of morphological features and prints of different parts of the human body in establishing the identity of an individual. The present study aims to establish such an identification process by examining the use of comparative analysis of ear prints and ear photographs.

Methodology:

The study examined the morphological features of ear prints of 140 participants (71 males and 69 females) ranging in age from 18 to 25 years (with a mean age of 20.22 ± 1.77 years), recruited from a North Indian population. Prints of both the ears were recorded, using the inking method. The morphological features of the ear prints were compared with the photographs of the ear for their uniqueness and individualization using likelihood ratios.

Results:

The degree ofantihelix curvature demonstrated the highest correlation (98.57%) between the morphological features visible on the ear and the expressions of these features in an ear print. The impression of earlobes, Darwin tubercle, crus of the helix, and shape of the external ear showed accuracy between 70% and 90%, whereas correlations below 70% accuracy were recorded for the other features. The likelihood ratios for 12 parameters were reported to be more than 10x, representing that the identification made using these parameters was > 10 times more likely to be true identification as compared to false positives. Moreover, 5 parameters were found to show high sensitivity, with values greater than 3 standard deviations (0.997), with an additional 9 parameters found to have good sensitivity at values greater than 2 standard deviations (<0.95). Similarly, 2 parameters were found to show high specificity, with values greater than 3 standard deviations (0.997), with an additional 18 parameters found to have good sensitivity at values greater than 2 standard deviations (<0.95).

Conclusions:

Elevated features of the ear, such as helix, antihelix, antitragus, tragus, and inter-tragic notch; particularly the degree of antihelix curvature, are more easily impressed and identifiable on an ear print. The results support that ear prints may provide important clues to assist in establishing the identity of an individual if several morphological features are evaluated concurrently.
Acute intensive care unit resuscitation of severely injured trauma patients: Do we need a new strategy?
Authors: Beni Catherine E. , Arbabi Saman , Robinson Bryce R.H. , O’Keefe Grant E.
Published: August 2021

BACKGROUND

Unlike recent advances in blood product resuscitation, intravenous crystalloid (IVF) use after intensive care unit (ICU) admission in hemorrhagic shock has received less attention and current recommendations are based on limited evidence. To address this knowledge gap, we aimed to determine associations between IVF administration during acute ICU resuscitation and outcomes. We hypothesized that larger IVF volumes are associated with worse outcomes.

METHODS

We linked our trauma registry with electronic health record data (2012–2015) to identify adults with an initial lactate level of ≥4 mmol/L and documented lactate normalization (≤2 mmol/L), excluding those with isolated head Abbreviated Injury Scale score ≥3. We focused on the period from ICU admission to lactate normalization, analyzing duration, volume of IVF, and proportion of volume as 1-L boluses. We used linear regression to determine associations with ICU length of stay and duration of mechanical ventilation in survivors, and logistic regression to identify associations with acute kidney injury and home discharge while adjusting for important covariates.

RESULTS

We included 337 subjects. Median time to lactate normalization was 15 hours (interquartile range, 7–25 hours), and median IVF volume was 3.7 L (interquartile range, 1.5–6.4 L). The fourfold difference between the upper and lower quartiles of both duration and volume remained after stratifying by injury severity. Hourly volumes tapered over time but persistently aggregated at 0.5 and 1 L, with 167 subjects receiving at least one 0.5-L bolus for 6 hours after ICU admission. Administration of larger volumes was associated with longer ICU length of stay and duration of mechanical ventilation, as well as acute kidney injury.

CONCLUSION

There is substantial variation in volume administered during acute ICU resuscitation, both absolutely and temporally, despite accounting for injury severity. Administration of larger volumes during acute ICU resuscitation is associated with worse outcomes. There is an opportunity to improve outcomes by further investigating and standardizing this important phase of care.

LEVEL OF EVIDENCE

Therapeutic/care management, level IV.
Neuromuscular rehabilitation – what to do?
Authors: Mandarakas Melissa R. , Young Peter , Burns Joshua
Published: August 2021

Purpose of review

Rehabilitation for patients with neuromuscular disorders (NMDs) has undisputed health benefits and is potentially therapeutic for targeting impairments, improving quality of life, and enabling activities of daily living. Whilst rehabilitation is commonly prescribed, unequivocal evidence and disease-related guidelines are lacking. This review highlights recent studies of exercise, assistive devices, respiratory management and manual therapy and stretching for patients with NMDs.

Recent findings

Randomised controlled trials of neuromuscular rehabilitation are scant, often underpowered and lack a control group. Recent case studies, clinical trials and cohort studies support rehabilitative therapies such as exercise, respiratory muscle training, assistive devices, and manual therapy and stretching, to provide systemic health benefits, with the possibility to retain or improve function. No evidence of overwork weakness or muscle damage have been reported in exercise trials, and rehabilitative exercise programs in many cases lead to positive psychosocial impacts. Tele-rehab is an emerging area of interest, as a response to the COVID-19 pandemic.

Robust evidence for the benefits of neuromuscular rehabilitation is lacking, and clinical trial quality can be improved. Tele-rehab is a tantalising development to improve access to neuromuscular rehabilitation in both metropolitan and remote settings during and beyond the COVID-19 pandemic.
Dysregulation of energy homeostasis in amyotrophic lateral sclerosis
Authors: Guillot Simon J. , Bolborea Matei , Dupuis Luc
Published: August 2021

Purpose of review

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease targeting upper and lower motor neurons, inexorably leading to an early death. Defects in energy metabolism have been associated with ALS, including weight loss, increased energy expenditure, decreased body fat mass and increased use of lipid nutrients at the expense of carbohydrates. We review here recent findings on impaired energy metabolism in ALS, and its clinical importance.

Recent findings

Hypothalamic atrophy, as well as alterations in hypothalamic peptides controlling energy metabolism, have been associated with metabolic derangements. Recent studies showed that mutations causing familial ALS impact various metabolic pathways, in particular mitochondrial function, and lipid and carbohydrate metabolism, which could underlie these metabolic defects in patients. Importantly, slowing weight loss, through high caloric diets, is a promising therapeutic strategy, and early clinical trials indicated that it might improve survival in at least a subset of patients. More research is needed to improve these therapeutic strategies, define pharmacological options, and refine the population of ALS patients that would benefit from these approaches.

Dysfunctional energy homeostasis is a major feature of ALS clinical picture and emerges as a potential therapeutic target.
Advances in the genetic classification of amyotrophic lateral sclerosis
Authors: Cooper-Knock Johnathan , Harvey Calum , Zhang Sai , Moll Tobias , Timpanaro Ilia Sarah , Kenna Kevin P. , Iacoangeli Alfredo , Veldink Jan H.
Published: August 2021

Purpose of review

Amyotrophic lateral sclerosis (ALS) is an archetypal complex disease wherein disease risk and severity are, for the majority of patients, the product of interaction between multiple genetic and environmental factors. We are in a period of unprecedented discovery with new large-scale genome-wide association study (GWAS) and accelerating discovery of risk genes. However, much of the observed heritability of ALS is undiscovered and we are not yet approaching elucidation of the total genetic architecture, which will be necessary for comprehensive disease subclassification.

Recent findings

We summarize recent developments and discuss the future. New machine learning models will help to address nonlinear genetic interactions. Statistical power for genetic discovery may be boosted by reducing the search-space using cell-specific epigenetic profiles and expanding our scope to include genetically correlated phenotypes. Structural variation, somatic heterogeneity and consideration of environmental modifiers represent significant challenges which will require integration of multiple technologies and a multidisciplinary approach, including clinicians, geneticists and pathologists.

The move away from fully penetrant Mendelian risk genes necessitates new experimental designs and new standards for validation. The challenges are significant, but the potential reward for successful disease subclassification is large-scale and effective personalized medicine.
Efficacy and Safety of Intranasal Dexmedetomidine During Recovery From Sevoflurane Anesthesia in Children: A Systematic Review and Meta-analysis
Authors: Xu Chengfeng , Zhang Yanyuan , Zhang Taomei , Wu Duozhi , Zhang Kexian
Published: August 2021

Background

Intranasal drip of dexmedetomidine in children with sevoflurane anesthesia can reduce anesthesia and restlessness. However, there is still some controversy. We conducted a meta-analysis to explore the effect of intranasal infusion of dexmedetomidine on the quality of recovery during the recovery period, to provide certain guidance for clinical application.

Methods

Web of Science, PubMed, Embase, and the Cochrane Library were used for literature search. Systematic reviews were based on PRISMA (the Preferred Reporting Items for Systematic Reviews and Meta-Analysis).

Results

A total of 14 articles and 1123 patients were included. The results of the meta-analysis showed that the incidence of emergence agitation [risk ratio (RR), 0.32; 95% confidence interval (CI), 0.20–0.50; P < 0.0001], satisfactory sedation at parent separation (RR, 1.41; 95% CI, 1.031–93; P = 0.034), incidence of nausea and vomiting (RR, 0.41; 95% CI, 0.21–0.78; P = 0.007), and incidence of laryngospasm (RR, 0.23; 95% CI, 0.08–0.65; P = 0.006) of the intranasal dexmedetomidine group were different compared with the control group. However, the satisfactory sedation at mask induction in the intranasal dexmedetomidine group (RR, 1.16; 95% CI, 0.87–1.54; P = 0.319), postanesthesia care unit (PACU) stay time (standardized mean deviation, 0.51; 95% CI, −0.11 to 1.12; P = 0.107), and extubation time (standardized mean deviation, 1.64; 95% CI, −1.07 to 4.35; P = 0.235) were not statistically significant compared with those of the control group.

Conclusion

Intranasal dexmedetomidine anesthesia with sevoflurane in children can reduce the incidence of emergence agitation, provide more satisfactory sedation when the parents are separated, reduce the incidence of nausea and vomiting, and reduce the incidence of laryngospasm. In addition, the 2 μg/kg dose of dexmedetomidine may be the best dose for clinical application.
X-ray nanotomography and electron backscatter diffraction demonstrate the crystalline, heterogeneous and impermeable nature of conodont white matter
Authors: Atakul-Özdemir Ayse , Warren Xander , Martin Peter G. , Guizar-Sicairos Manuel , Holler Mirko , Marone Federica , Martínez-Pérez Carlos , Donoghue Philip C. J.
Published: August 2021

Conodont elements, microfossil remains of extinct primitive vertebrates, are commonly exploited as mineral archives of ocean chemistry, yielding fundamental insights into the palaeotemperature and chemical composition of past oceans. Geochemical assays have been traditionally focused on the so-called lamellar and white matter crown tissues; however, the porosity and crystallographic nature of the white matter and its inferred permeability are disputed, raising concerns over its suitability as a geochemical archive. Here, we constrain the characteristics of this tissue and address conflicting interpretations using ptychographic X-ray-computed tomography (PXCT), pore network analysis, synchrotron radiation X-ray tomographic microscopy (srXTM) and electron back-scatter diffraction (EBSD). PXCT and pore network analyses based on these data reveal that while white matter is extremely porous, the pores are unconnected, rendering this tissue closed to postmortem fluid percolation. EBSD analyses demonstrate that white matter is crystalline and comprised of a single crystal typically tens of micrometres in dimensions. Combined with evidence that conodont elements grow episodically, these data suggest that white matter, which comprises the denticles of conodont elements, grows syntactically, indicating that individual crystals are time heterogeneous. Together these data provide support for the interpretation of conodont white matter as a closed geochemical system and, therefore, its utility of the conodont fossil record as a historical archive of Palaeozoic and Early Mesozoic ocean chemistry.
The impacts of past, present and future ocean chemistry on predatory planktonic snails
Authors: Wall-Palmer Deborah , Mekkes Lisette , Ramos-Silva Paula , Dämmer Linda K. , Goetze Erica , Bakker Karel , Duijm Elza , Peijnenburg Katja T. C. A.
Published: August 2021

The atlantid heteropods represent the only predatory, aragonite shelled zooplankton. Atlantid shell production is likely to be sensitive to ocean acidification (OA), and yet we know little about their mechanisms of calcification, or their response to changing ocean chemistry. Here, we present the first study into calcification and gene expression effects of short-term OA exposure on juvenile atlantids across three pH scenarios: mid-1960s, ambient and 2050 conditions. Calcification and gene expression indicate a distinct response to each treatment. Shell extension and shell volume were reduced from the mid-1960s to ambient conditions, suggesting that calcification is already limited in today's South Atlantic. However, shell extension increased from ambient to 2050 conditions. Genes involved in protein synthesis were consistently upregulated, whereas genes involved in organismal development were downregulated with decreasing pH. Biomineralization genes were upregulated in the mid-1960s and 2050 conditions, suggesting that any deviation from ambient carbonate chemistry causes stress, resulting in rapid shell growth. We conclude that atlantid calcification is likely to be negatively affected by future OA. However, we also found that plentiful food increased shell extension and shell thickness, and so synergistic factors are likely to impact the resilience of atlantids in an acidifying ocean.
Modelling COVID-19 outbreaks in USA with distinct testing, lockdown speed and fatigue rates
Authors: Macdonald J. C. , Browne C. , Gulbudak H.
Published: August 2021

Each state in the USA exhibited a unique response to the COVID-19 outbreak, along with variable levels of testing, leading to different actual case burdens in the country. In this study, viaper capitatesting dependent ascertainment rates, along with case and death data, we fit a minimal epidemic model for each state. We estimate infection-level responsive lockdown/self-quarantine entry and exit rates (representing government and behavioural reaction), along with the true number of cases as of 31 May 2020. Ultimately, we provide error-corrected estimates for commonly used metrics such as infection fatality ratio and overall case ascertainment for all 55 states and territories considered, along with the USA in aggregate, in order to correlate outbreak severity with first wave intervention attributes and suggest potential management strategies for future outbreaks. We observe a theoretically predicted inverse proportionality relation between outbreak size and lockdown rate, with scale dependent on the underlying reproduction number and simulations suggesting a critical population quarantine ‘half-life’ of 30 days independent of other model parameters.
Social cognition in refugee children: an experimental cross-sectional study of emotional processing with Syrian families in Turkish communities
Authors: Gredebäck Gustaf , Haas Sara , Hall Jonathan , Pollak Seth , Karakus Dogukan Cansin , Lindskog Marcus
Published: August 2021

More than 5.6 million people have fled Syria since 2011, about half of them children. These children grow up with parents that often suffer from war-related mental health problems. In this study, we assess emotional processing abilities of 6–18 year-old children growing up in families that have fled from Syria and reside in Turkish communities (100 families, 394 individuals). We demonstrate that mothers', but not fathers’, post-traumatic stress (PTS) impacts children's emotional processing abilities. A 4% reduction of mothers' PTS was equivalent to 1 year of development in children, even when controlling for parents’ traumatic experiences. Making a small investment in increased mental health of refugee mothers might have a positive impact on the lives of their children.
Confined La
2
O
3
particles in mesoporous carbon material for enhanced phosphate adsorption
Authors: Ju Xiaoqiu , Cui He , Liu Tao , Sun Yabing , Zheng Shourong , Qu Xiaolei
Published: August 2021

Novel phosphate adsorbents with confined La
2
O
3
inside mesoporous carbon were fabricated by the solid-state grinding method using pristine mesoporous carbon material CMK-3 (PCMK-3) and oxidized CMK-3 (OCMK-3) as the matrixes (denoted as La
2
O
3
@PCMK-3 and La
2
O
3
@OCMK-3). Compared with pure La
2
O
3
, La
2
O
3
@PCMK-3 and La
2
O
3
@OCMK-3 exhibited higher normalized phosphate adsorption capacity, indicative of efficient loading of La
2
O
3
inside the mesopores of the carbon materials. Furthermore, La
2
O
3
loading led to substantially enhanced phosphate adsorption. The adsorption capacities of La
2
O
3
@OCMK-3 samples were higher than those of La
2
O
3
@PCMK-3 samples, possibly owing to the oxygen-containing groups forming in OCMK-3 during HNO
3
oxidation, which enhanced the dispersion of La
2
O
3
in the mesopores of OCMK-3. The adsorption capacities of La
2
O
3
@PCMK-3 and La
2
O
3
@OCMK-3 increased with the La
2
O
3
loading amount. Phosphate adsorption onto La
2
O
3
(14.7)@PCMK-3 followed the pseudo-second-order kinetics with respect to correlation coefficient values (larger than 0.99). As pH increased from 3.4 to 12.0, the phosphate adsorption amounts of La
2
O
3
(14.7)@PCMK-3 and La
2
O
3
(15.7)@OCMK-3 decreased from 37.64 mg g
−1
and 37.08 mg g
−1
to 21.92 mg g
−1
and 14.18 mg g
−1
, respectively. Additionally, La
2
O
3
@PCMK-3 showed higher adsorption selectivity towards phosphate than coexisting Cl
−
,

NO

3
−

and

SO

4

2
−

. The adsorbent La
2
O
3
(14.7)@PCMK-3 remained stable after five regeneration cycles.
Nothing in evolution makes sense except in the light of parasitism: evolution of complex replication strategies
Authors: Hickinbotham Simon J. , Stepney Susan , Hogeweg Paulien
Published: August 2021

Parasitism emerges readily in models and laboratory experiments of RNA world and would lead to extinction unless prevented by compartmentalization or spatial patterning. Modelling replication as an active computational process opens up many degrees of freedom that are exploited to meet environmental challenges, and to modify the evolutionary process itself. Here, we use automata chemistry models and spatial RNA-world models to study the emergence of parasitism and the complexity that evolves in response. The system is initialized with a hand-designed replicator that copies other replicators with a small chance of point mutation. Almost immediately, short parasites arise; these are copied more quickly, and so have an evolutionary advantage. The replicators also become shorter, and so are replicated faster; they evolve a mechanism to slow down replication, which reduces the difference of replication rate of replicators and parasites. They also evolve explicit mechanisms to discriminate copies of self from parasites; these mechanisms become increasingly complex. New parasite species continually arise from mutated replicators, rather than from evolving parasite lineages. Evolution itself evolves, e.g. by effectively increasing point mutation rates, and by generating novel emergent mutational operators. Thus, parasitism drives the evolution of complex replicators and complex ecosystems.
Aqueous dispersion and tuning surface charges of polytetrafluoroethylene particles by bioinspired polydopamine–polyethyleneimine coating via one-step method
Authors: Grewal Manjit Singh , Abe Hiroya , Matsuo Yasutaka , Yabu Hiroshi
Published: August 2021

We propose a surface modification of poorly dispersive polytetrafluoroethylene (PTFE) particles via bioinspired polydopamine–polyethyleneimine (PDA–PEI) which conferred PTFE particles a uniform dispersion in aqueous medium. With increasing dopamine concentration in the reaction solution, dispersity of PTFE particles improved and the surface charges of particles changed from negative to positive due to an increase of surface coverage of PDA–PEI layers. Simplicity of the method here outlines an attractive route for surface modification of inert surfaces useful for large-scale applications.
Flexible use of a dynamic energy landscape buffers a marine predator against extreme climate variability
Authors: Carroll Gemma , Brodie Stephanie , Whitlock Rebecca , Ganong James , Bograd Steven J. , Hazen Elliott , Block Barbara A.
Published: August 2021

Animal migrations track predictable seasonal patterns of resource availability and suitable thermal habitat. As climate change alters this ‘energy landscape’, some migratory species may struggle to adapt. We examined how climate variability influences movements, thermal habitat selection and energy intake by juvenile Pacific bluefin tuna (
Thunnus orientalis
) during seasonal foraging migrations in the California Current. We tracked 242 tuna across 15 years (2002–2016) with high-resolution archival tags, estimating their daily energy intake via abdominal warming associated with digestion (the ‘heat increment of feeding’). The poleward extent of foraging migrations was flexible in response to climate variability, allowing tuna to track poleward displacements of thermal habitat where their standard metabolic rates were minimized. During a marine heatwave that saw temperature anomalies of up to +2.5°C in the California Current, spatially explicit energy intake by tuna was approximately 15% lower than average. However, by shifting their mean seasonal migration approximately 900 km poleward, tuna remained in waters within their optimal temperature range and increased their energy intake. Our findings illustrate how tradeoffs between physiology and prey availability structure migration in a highly mobile vertebrate, and suggest that flexible migration strategies can buffer animals against energetic costs associated with climate variability and change.
Adaptive shifts underlie the divergence in wing morphology in bombycoid moths
Authors: Aiello Brett R. , Tan Milton , Bin Sikandar Usama , Alvey Alexis J. , Bhinderwala Burhanuddin , Kimball Katalina C. , Barber Jesse R. , Hamilton Chris A. , Kawahara Akito Y. , Sponberg Simon
Published: August 2021

The evolution of flapping flight is linked to the prolific success of insects. Across Insecta, wing morphology diversified, strongly impacting aerodynamic performance. In the presence of ecological opportunity, discrete adaptive shifts and early bursts are two processes hypothesized to give rise to exceptional morphological diversification. Here, we use the sister-families Sphingidae and Saturniidae to answer how the evolution of aerodynamically important traits is linked to clade divergence and through what process(es) these traits evolve. Many agile Sphingidae evolved hover feeding behaviours, while adult Saturniidae lack functional mouth parts and rely on a fixed energy budget as adults. We find that Sphingidae underwent an adaptive shift in wing morphology coincident with life history and behaviour divergence, evolving small high aspect ratio wings advantageous for power reduction that can be moved at high frequencies, beneficial for flight control. By contrast, Saturniidae, which do not feed as adults, evolved large wings and morphology which surprisingly does not reduce aerodynamic power, but could contribute to their erratic flight behaviour, aiding in predator avoidance. We suggest that after the evolution of flapping flight, diversification of wing morphology can be potentiated by adaptative shifts, shaping the diversity of wing morphology across insects.
Kin-mediated plasticity in alternative reproductive tactics
Authors: Lymbery Samuel J. , Tomkins Joseph L. , Buzatto Bruno A. , Hosken David J.
Published: August 2021

Conditional strategies occur when the relative fitness pay-off from expressing a given phenotype is contingent upon environmental circumstances. This conditional strategy model underlies cases of alternative reproductive tactics, in which individuals of one sex employ different means to obtain reproduction. How kin structure affects the expression of alternative reproductive tactics remains unexplored. We address this using the miteRhizoglyphus echinopus, in which large males develop into aggressive ‘fighters’ and small males develop into non-aggressive ‘scramblers.’ Because only fighters kill their rivals, they should incur a greater indirect fitness cost when competing with their relatives, and thus fighter expression could be reduced in the presence of relatives. We raised mites in full-sibling or mixed-sibship groups and found that fighters were more common at higher body weights in full-sibling groups, not less common as we predicted (small individuals were almost exclusively scramblers in both treatments). This result could be explained if relatedness and cue variability are interpreted signals of population density, since fighters are more common at low densities in this species. Alternatively, our results may indicate that males compete more intensely with relatives in this species. We provide the first evidence of kin-mediated plasticity in the expression of alternative reproductive tactics.
What happened? Do preschool children and capuchin monkeys spontaneously use visual traces to locate a reward?
Authors: Civelek Zeynep , Völter Christoph J. , Seed Amanda M.
Published: August 2021

The ability to infer unseen causes from evidence is argued to emerge early in development and to be uniquely human. We explored whether preschoolers and capuchin monkeys could locate a reward based on the physical traces left following a hidden event. Preschoolers and capuchin monkeys were presented with two cups covered with foil. Behind a barrier, an experimenter (E) punctured the foil coverings one at a time, revealing the cups with one cover broken after the first event and both covers broken after the second. One event involved hiding a reward, the other event was performed with a stick (order counterbalanced). Preschoolers and, with additional experience, monkeys could connect the traces to the objects used in the puncturing events to find the reward. Reversing the order of events perturbed the performance of 3-year olds and capuchins, while 4-year-old children performed above chance when the order of events was reversed from the first trial. Capuchins performed significantly better on the ripped foil task than they did on an arbitrary test in which the covers were not ripped but rather replaced with a differently patterned cover. We conclude that by 4 years of age children spontaneously reason backwards from evidence to deduce its cause.
Human biomechanics perspective on robotics for gait assistance: challenges and potential solutions
Authors: Wu Amy R.
Published: August 2021

Technological advancements in robotic devices have the potential to transform human mobility through gait assistance. However, the integration of physical hardware and software control algorithms with users to assist with impaired gait poses several challenges, such as allowing the user to adopt a variety of gaits and the process for evaluating the efficacy and performance of these assistive devices. Here, I discuss some of the challenges in the development of assistive devices and the use of biomechanical concepts and tools for control and test validation. Several potential solutions are proposed through the case study of one project that aimed to provide gait assistance for individuals with a spinal cord injury. Further challenges and future directions are discussed, with emphasis that diverse perspectives and approaches in gait assistance will accelerate engineering solutions towards regaining mobility.
Persistent viremia in an immunocompetent patient with inherited chromosomally integrated HHV-6B
Authors: Obeid Michele , Gakhal Inderdeep , McDonald Philip J.
Published: August 2021

Human herpesvirus-6 (HHV-6), the virus which causes roseola, has traditionally been associated with benign and self-limited childhood illness. However, HHV-6 establishes lifelong latency and can reactivate in immunocompromised adult patients. In about 1% of cases, it integrates into the human genome as inherited chromosomally integrated HHV-6 (iciHHV-6). We report the case of a 70-year-old man presenting with altered mental status and agitation. His infectious workup revealed a cerebrospinal fluid sample positive for HHV-6 with virus detectable in the blood as well. He was subsequently treated with ganciclovir. HHV-6 viremia (DNAemia) persisted, and the antiviral medications were switched to foscarnet under the assumption of treatment failure due to drug resistance. After several admissions to the hospital for the same complaint, and after noticing that DNAemia persisted despite adequate treatment for HHV-6, infectious disease specialists ordered testing for chromosomally integrated virus. Test results confirmed the presence of iciHHV-6, explaining his consistently elevated serum viral load. Primary HHV-6 infection in adults causes a transient increase in viral load with resolution and clearance after a few weeks while iciHHV-6 is characterized by persistent detection of viral DNA at a high copy number. Individuals with iciHHV-6 can develop HHV-6 disease and are at increased risk for active viral replication when treated with immunosuppressive medications, but only mRNA testing, which is not widely available can differentiate between latent and active infection. This makes the decision to treat challenging in this patient population. When faced with a positive HHV-6 DNA result in the setting of equivocal symptoms, clinicians should consider the possibility of chromosomally integrated virus rather than drug-resistant virus in order to reduce exposure to potentially toxic antiviral medications.
Hydroxychloroquine Prophylaxis against Coronavirus Disease-19: Practice Outcomes among Health-Care Workers
Authors: Bhatt Parloop , Patel Vishva , Shah Prachi , Parikh Keyur
Published: August 2021

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a rapidly emerging virus responsible for the ongoing Covid-19 pandemic with no known effective prophylaxis. We investigated whether hydroxychloroquine(HCQ) could prevent SARS CoV-2 in healthcare workers(HCW) at high-risk of exposure.

Method

This voluntary observational study for the prevention and treatment of COVID-19 was conducted at a tertiary care center, from 12th June to 12th October 2020(total 16 weeks). All consented asymptomatic HCW’s of CIMS hospital were administered 400 mg HCQ twice a day on day one followed by 400 mg once weekly to be taken with meals up to 16 weeks. Data collected included OPD registration, risk assessment, medical and family history (related to COVID), physical examination and vitals, pulse oximetry, ECG (pre and post HCQ), drug adherence, side effects, adverse drug reactions.

Result

The study enrolled 927 full-time, hospital-based HCWs ((including doctors, nurses, paramedical, lab technicians, sanitary workers and others), of whom 731(78.85%) initially started HCQ while 196 (21.14%) did not volunteer. The median age and weight of the study population was 27.5 years and 69.5 kg respectively. No major associated co-morbidities were present in these HCW’s. There was an increased trend towards non adherence to HCQ with each proceeding week more so after week 11. Of the 731 HCW’s taking HCQ a total of 167(22.8%) tested COVID positive at different intervals of time as against 30 HCW (15.3%) out of 196 not taking HCQ. The rate of COVID-19 positive was statistically significantly higher in the HCW’s taking HCQ (p=0.0220; 95% CI: 1.14% to 12.94%), as compared to those not on HCQ. Thus HCQ was not prophylactically effective against COVID 19 infection. No participants in this study experienced grade 3 or 4 adverse events. No significant difference in the median of ECG changes in QTc between pre and post HCQ administration of 46 HCW’s was observed.

Conclusions

This clinical study did not detect a reduction in SARS CoV-2 transmission with prophylactic administration of 400 mg/HCQ in HCW’s. All participants who did contract SARSCoV-2 were either asymptomatic or had mild disease courses with full recoveries. All adverse events were self-limiting and no serious cardiovascular events were reported with use of HCQ. In the absence of robust data, it seems premature to recommend HCQ as a prophylactic panacea for COVID-19.