bluuebunny/crossref_metadata_2025 huggingface dataset:
Microbiologic Proof-Of-Concept: A Novel Device Combining UV Light And Ozone For Human Skin Antisepsis
Authors: Maris A , Jacobs J , Van Horn G , Stratton C W , Schmitz J
Published: October 2020

Introduction/Objective

Hand hygiene (HH) decreases healthcare-associated infections (HAI). Available products include alcohol-based gels, foams, wipes, and “gold-standard” hand-washing with soap and water. We tested an investigational device (HyLuxO3; GMI, LLC, patent pending) for antimicrobial effect (AME). HyLuxO3 was engineered to deliver UV-C light energy and high velocity O3 airflow to safely achieve human skin antisepsis within OSHA and EPA regulatory limits. Combined UV and O3 has yet to be evaluated for HH and may demonstrate synergistic AME.

Methods

HyLuxO3 was tested on LB agar to titrate device variables to ascertain intensities for optimal AME; later testing was performed on VITRO-SKIN (Florida Suncare Testing, Bunnell, FL), a human skin surrogate. ATCC strains of MRSA, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Candida albicans were used to test AME vs. vegetative microbes; Bacillus atrophaeus spores were used as a surrogate for C. difficile. Tested variables included time under device, [O3], airflow velocity, 222 and/or 254 nm UV light, sample distance from UV lamp, and UV beam width. Positive controls were used to calculate log-kill curves for AME.

Results

Similar results were seen on LB agar and VITRO-SKIN. >7 log-kill and >5 log-kill were acheived vs. vegetative microbes (<30 sec) and spores (60 sec), respectively, under optimized variables. Presence of UV light and sample distance from and time under the device were the most important variables. 254 nm UV had a significantly better AME than 222 nm; combining both UV lamps had a significant synergistic AME. The narrowest UV beam (2 mm) yielded the greatest AME (total energy input kept constant). Adding O3 to UV had a modest but significant synergistic effect; optimal [O3] was 0.3-0.8 ppm. Changing airflow velocity had no significant effect on AME.

Conclusion

HyLuxO3 is a novel device that achieves >7 log-kill vs. common pathogenic vegetative microbes and >5 log-kill vs. spores using combined UV light and [O3] safe for human skin antisepsis (and surface/fomite decontamination)- and- yields such impressive AME on faster timescales than those required by bleach/other chemical products unsuitable for human skin. Future studies on human hands (using many other microbes) will determine if HyLuxO3 meets regulatory and efficacy requirements for use in and beyond healthcare settings, especially with the specter of emerging respiratory viruses.
Multiple B-D Glucan and Cmv Test Ordering By Multiple Physicians – Analysis To Assess The Frequency Of Duplicate Test Orders
Authors: Fathima S , Gardner A R , Sohn A J , Benavides R
Published: October 2020

Introduction/Objective

In teaching hospitals, patients receive direct care from a succession of different physicians, each of whom may order diagnostic tests on the same patient resulting in multiple physicians unknowingly ordering the same test in the same time period, leading to overutilization. We examined the association of test-ordering by multiple physicians with duplication of two tests, Beta D-Glucan (BDG) and CMV Viral Load by PCR non blood, as aid for detection of fungal and cytomegaloviral infections, respectively

Methods

Retrospective medical records at Baylor University Medical Center, Dallas were examined in between 10/1/2019- 10/30/2019. A total 167 test orders were identified for CMV Viral Load non blood and BDG presence in blood. Each medical record was assessed for frequency of ordering along with the physicians who ordered them

Results

A total 167 tests were ordered in which, 120 times BDG was ordered and 52 times CMV was ordered.

Singleton orders were noted in 85(50%) instances of BDG & 30(17%) for CMV.Multiple test orders were 44 (25%) for BDG and 8 (4%) for CMV respectively. Both CMV and BDG were ordered together 57 times. The time stamps of multiple test orders in individual patients was assessed for instances of orders that were less than 3 days apart and analysis showed out of the 44 multiple test orders, 34% (15) test orders were ordered less than 3 days apart and 66%(29) tests were ordered more than 3 days apart for BDG. Upon chart review, most of these quickly successive orders were by different physicians. The estimated costs of the duplicate orders are 4334.0$ & 1104.16$ for BDG and CMV respectively.

Conclusion

CMV and BDG are commonly ordered on many patients. Analysis shows that many times, physicians order testing when the same test has been ordered very recently by a separate physician. Note that for both tests, retesting in less than three days is not normally indicated, however this happens often, especially for BDG. This is most likely due to difficulty in determining within the EHR what tests are drawn and “pending’ but not yet finalized and reported. With usage of prompts/ alerts in EMR that warn of existing “pending’ orders by another caregiver, the frequency of duplicate test ordering for the same patient may be reduced, in turn reducing the costs of healthcare.
Does PD-L1 Positivity in Inflammatory Cells Correlate with PD-L1 Expression in Tumor Cells in Colorectal Adenocarcinoma?
Authors: Broadwater D R , Williams G , Messersmith L , Brady R
Published: October 2020

Introduction/Objective

Drugs targeting the programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1) checkpoint is an important type of novel immunotherapy. These checkpoint inhibitors are being used in a wide variety of cancers, including colorectal carcinoma (CRC). PD-L1 expression on tumor cells in CRC is predictive of good response to checkpoint inhibitor therapies. PD-L1 expression on tumor infiltrating immune cells (TIIC) is increasingly observed and independently portends good prognosis. The relationship between PD-L1 positivity in TIIC and tumor cells is not well established. In this study, the relationship and correlation of PD-L1 positivity in TIIC and tumor cells were retrospectively reviewed.

Methods

197 sections of CRC from 33 cases (mean of 6 sections/case) with heterogeneous expression of PD-L1 on tumor cells were stained for PD-L1 with immunohistochemistry. None of the patients had received neo-adjuvant therapy. The presence of tumor cells and immune cells with positive PD-L1 expression was noted for each section.

Results

Immune cells were positive in 79% of the sections examined. TIIC were positive in 56% of the sections examined. A Cohen’s correlation study showed correlation between tumor cells and TIIC in 77% of the cases (k=0.51, moderate agreement). There was at least one section with PD-L1 positive TIIC in 97% of cases.

Conclusion

This study shows that PD-L1 is expressed in TIIC in the vast majority of CRC cases designated PD-L1 positive and that PD-L1 is positive in TIIC at a higher rate than in tumor cells. The moderate correlation is interesting, perhaps suggesting that if TIIC are noted to be positive for PD-L1 and tumor cells are not, additional sections of tumor should be stained.
Mycoplasma Genitalium And Streptococcus Agalactiae Colonization In Pregnant Women: An Emerging Relationship
Authors: Hummel K , Dunn J , Muldrew K , Gogia S , Kravitz E , Johnson E , Berra A , Stafford I , Martin I , Munson E
Published: October 2020

Introduction/Objective

Mycoplasma genitalium has been identified as an emerging sexually transmitted infection (STI) causing cervicitis, pelvic inflammatory disease and other gynecologic pathology. The prevalence of M. genitalium in pregnant women has not been determined, nor has frequency of co-infection with Streptococcus agalactiae (GBS). Neonatal sepsis caused by GBS is associated with black race and young maternal age with approximately 10%-30% of pregnant women colonized. The aim of this retrospective study was to investigate the possible association between M. genitalium infection and colonization with GBS in a large cohort of pregnant women from a tertiary care center in Houston, Texas.

Methods

Remnant endocervical samples collected from pregnant women attending clinics at the Baylor College of Medicine between September 2019 and December 2019 were screened for M. genitalium by transcription mediated amplification (Hologic, Inc. Marlborough, MA). Demographic, STI co-infection [Human papillomavirus (types 16,18), Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, and Herpes simplex virus], and GBS status data were recorded. Fisher’s exact test was performed for statistical analysis.

Results

719 total samples were collected and tested for M. genitalium. Of these, 41 (5.7%) were positive. The mean age of infected women was younger than noninfected women (24.9 vs. 28.1 years respectively p = 0.0004). More black women (34.2%) were infected with M. genitalium compared to white (14.6%) or other (51.2%) (p = 0.0003).

Rates of GBS colonization was significantly higher among women infected with M. genitalium compared to women who tested negative (58.3% vs. 16.1% respectively p = 0.002) and increased compared to national reported rates of GBS colonization. M. genitalium also showed a significant association with T. vaginalis (p=0.03), but no other STI co- infections studied.

Conclusion

Our data demonstrates that infection with M. genitalium may be associated with persistent GBS colonization. Further prospective studies are needed to further elucidate this relationship.
Returning the Blood and Saving the Supply, the Veteran Affairs Medical Center (VAMC) Experience
Authors: Petersen J M , Jhala D
Published: October 2020

Introduction/Objective

Blood conservation techniques such as perioperative autologous cell salvage (PACS) can reduce patient usage and exposure to allogeneic blood products during surgery. As all blood transfusions carry risk and cost, the avoidance of transfusion through PACS represents an opportunity to reduce risk of allogeneic transfusion related reactions or complications and reduce costs from blood product utilization. Although the benefits of PACS has been documented in the literature, quality assurance demonstrations of the blood volume returned to veteran patients undergoing surgeries with a high likelihood of significant blood loss are sparse; thus, we present the quality assurance study of PACS usage in a VAMC.

Methods

Quality assurance documentation from the American Red Cross (ARC) that provides autologous cell salvage services at the VAMC were examined from February 2017 to August 2018, for a total of 17 months examined. The procedure, estimated blood loss, and volume returned was documented as part of a quality assurance/improvement project. The volume returned was compared to the typical RBC volume (~250 mL) within a packed red blood cell volume (~350 mL).

Results

A total of 44 procedures took place corresponding usage of PACS. Of these 44 procedures, 15 had no estimated blood loss, and an additional 10 had too little estimated blood loss (<250 mL) for blood volume to be returned. Among the procedures with blood loss, an average of 864 mL of blood was lost (1230 mL when the low blood loss cases are excluded) with an average volume returned of 511 mL or the approximate equivalent of 2 units of RBCs when utilized. Two cases with significant estimated blood loss (5400 mL and 4850 mL) had 2250 mL and 2125 mL or about the equivalent of 9 RBC units each. The total volume returned to all patients was 9700 mL, or the equivalent RBC volume of 38-39 RBC units.

Conclusion

PACS is a procedure that can rapidly provide large quantities of autologous blood in surgeries with significant risk of bleeding. Blood salvage avoids or reduces the risks of allogeneic blood transfusion and reduces cost to the transfusion service as the autologous blood loss would not need to be replaced with allogeneic blood transfusions. PACS in the VAMC returned significant blood volumes to patients undergoing procedures with high risk of blood loss, therefore reducing allogeneic blood transfusion requirements in the veteran population.
What’s in a Name? Comparative Analysis of Laboratory Test Naming Guidelines as Applied to Common Confusing Test Names
Authors: Garnett E , Consortium T , Singh I , Jackson B , Wang J , Procop G , Bierl C
Published: October 2020

Introduction/Objective

Laboratory test names frequently do not enable easy understandability or promote correct test utilization, which leads to difficulty for providers in finding the correct test and results in unnecessary cost and medical errors. Laboratory test names are also largely unstandardized and are not named by a consistent set of conventions. To address these issues, the TRUU-Lab (Test Renaming for Understanding & Utilization) initiative aims to generate a consensus test naming guideline for better human understandability of laboratory test names. These studies address the first aim of the TRUU-Lab initiative: to identify root causes and challenges in understanding and using laboratory test names.

Methods

We conducted survey studies to capture the most problematic laboratory test names, then performed analysis of these names to identify aspects of these names that led to confusion among providers. A subset of these test names were used to evaluate five existing laboratory test naming guidelines (LOINC, ONC TigerTeam, Pan- Canadian iEHR Viewer Name, Standards for Pathology Informatics (Australia), and ARUP Laboratories internal style guides) for their ability to produce understandable test names.

Results

274 survey responses yielded ~100 unique laboratory tests cited as confusing, and highlighted substantial diversity both in the names of these tests between institutions and in respondent opinion on the best alternative names. The top 10 most commonly-cited tests yielded ≥ 3 unique names, and the top 2 tests (Vitamin D and anti- factor Xa) yielded ≥ 10 unique names. Post-survey analysis identified eight characteristics associated with poor understandability of a test name, including ambiguity, abbreviations, homophones, multiple indications for a single test, proprietary names, synonyms, truncation, and “panels” where components are obfuscated. Existing guidelines produced highly variable names given the same prompt, and varied in their ability to avoid pitfalls associated with poor understandability.

Conclusion

These studies highlight aspects of existing laboratory test names that lead to confusion among ordering providers, and identify the inability of existing laboratory test naming practices to adequately address these issues. Efforts are ongoing within TRUU-Lab to use these results to inform novel laboratory test naming guidelines to promote universal human understandability.
Anti-IH Related Hemolytic Reaction in a Sickle Cell Patient and Further Management While Avoiding Transfusion
Authors: Yurtsever N , Wilson-Sandberg K , Dikeman J , Louie J , Fomani K
Published: October 2020

Introduction/Objective

H antigen is a precursor for A and B antigens and is mostly converted except for the O blood group, which has the highest amount of H antigen. I is present on all adult RBCs. Anti-IH is usually an IgM antibody active at cold temperatures, and rarely demonstrates a wide thermal amplitude and can cause a significant hemolytic transfusion reaction.

Methods

Data was collected from patient information and transfusion management systems.

Results

38 year old female with sickle cell disease presented to the emergency room with dizziness, tachypnea and Hgb: 5.9 g/dl Hct:19.1%. Upon further review, patient chart showed that she had received an emergency RBC exchange transfusion 21 days prior to this admission for acute chest syndrome. She was B positive. The units for RBC exchange consisted of 5 group B and 1 group O units and an additional 1 group O unit later. All RBC units were matched for her phenotype; Rh, K, Duffy & Kidd, except anti-S which was ruled out. At the time of discharge, Hgb was 9.3 g/dl and Hct was 27.7%. The drop in Hgb between discharge and the present admission prompted a suspicion for delayed hemolytic reaction/hyperhemolysis. The sample sent to the local Reference Laboratory came back as follows: DAT/Coombs Positive, DAT C3 positive; positive for cold auto-anti-IH antibody. A thermal amplitude test indicated that the anti-IH was reactive at 30 C and therefore had the potential to be of clinical significance. Her Hgb continued to drop and 3 days later Hb=3.7 g/dl with instructions not to transfuse unless clinically emergent. With treatment of IVIG and steroids, reducing further blood draws and monitoring the patient for clinical symptoms only, her Hgb/Hct started to rise and the patient was discharged 4 days later with Hgb: 6.4 g/dl, and no symptoms of anemia.

Conclusion

Our case study is important in two ways: Firstly, it raises awareness of the severity of a cold autoantibody, i.e. anti-IH, with a wide thermal amplitude. Specifically, in this case, our attempt to provide phenotypically similar RBCs resulted in the destruction of all the type O donor cells as well as some of the B donor cells. Secondly, even with Hgb counts as low as 3.7, treating the patient and not the number proved to be better clinical practice. In conclusion, a good monitoring protocol for sickle cell patients is required to transfuse less and avoid serious complications.
A Rare Case of Autoimmune Hemolytic Anemia Caused by Warm-reacting IgM-class Antibodies Associated with Mycoplasma Pneumoniae Infection
Authors: Abdelmonem M , Wasim H , Abdelmonem M
Published: October 2020

Introduction/Objective

Warm autoantibodies are usually IgG-class and/or IgA-class immunoglobulins. may be classified as agglutinins or hemolysins, which may be incomplete or complete, depending on in vitro serology; they almost always bind complement. Autoimmune hemolytic anemia with only warm IgM autoantibodies is extremely rare.

Methods

A 91-year-old Caucasian male with hypertension presented with non-productive cough for two weeks, associated with shortness of breath and fatigue. He has a paste history of medical history of high degree AV block with sick sinus syndrome and bradycardia.

Results

He had blood pressure of 111/53 and heart rate of 50. Laboratory investigations showed leukocytes count of 7, Hemoglobin level of 5.6 g/dl, hematocrit level of 15.5%, platelets count of 267, total bilirubin of 5.6 mg/dL, direct bilirubin of 0.7 mg/dL, and lactate dehydrogenase (LDH) of 372 U/L and IgM titer for Mycoplasma pneumoniae was 1493 units/mL (Ref < 770). He was transfused four units of packed red blood cells as emergency release due to a positive antibody screen. His hemoglobin level increased from 5.6 g/dL to 7.2 g/dL then it decreased from 8.2 g/dL to 5.6 g/dL the next two days. Direct antiglobulin test was 3+ positive for C3d and Negative for IgG. He finished a 7-day course of antibiotic treatment. The results the Cold-agglutinin titer and thermal amplitude test were suggestive of an IgM warm autoantibody and a cold agglutinin of a moderate titer. The results exclude a diagnosis of cold agglutinin syndrome.

Conclusion

Mycoplasma pneumonia is mainly associated with cold agglutinin syndrome but it is very rare to be associated with WAIHA. WAIHA with a DAT positive for C3 only is relatively rare with an incidence ranging between 6% and 13% and can have a clinical picture ranging from mild to severe anemia. Severe symptomatic hemolysis can be treated with Rituximab, cytotoxic agents or plasmapheresis.
A Case of Recurrent Acute Pain Transfusion Reactions Due to Platelet Transfusion
Authors: Robertson-Patera J , Lu W
Published: October 2020

Introduction/Objective

Transfusion of blood components is one of the most common medical procedures with transfusion reactions being the greatest associated risk. Acute pain transfusion reaction (APTR) is one such under- recognized and under-reported risk, likely due to scarcity of literature and lack of criteria for diagnosis.

Methods

A literature review was performed using PubMed to search for the keywords: “acute pain transfusion reaction”. This searched revealed two articles, from which one abstract and a book chapter were also identified.

Results

A 58-year-old female with chronic myeloid leukemia and pre-existing pain received 44 leukoreduced irradiated blood components [7 pooled platelets, 17 apheresis platelets, 20 red blood cells (RBCs)] over two months. Four platelet (one pooled, three apheresis) transfusions resulted in chest and lower back pain starting an average of 15 minutes after initiation of transfusion and resolving following cessation of transfusion. Laboratory evaluations were negative for hemolysis. Despite the patient’s history of pain, these reactions were most consistent with APTRs.

APTRs are rare, most often associated with leukoreduced RBCs and characterized by severe pain in the abdomen, back, flank, or proximal extremities typically occurring within 30 minutes of starting transfusion and abating within 30 minutes following cessation of transfusion. All of our patient’s reported reactions occurred in association with leukoreduced platelets. These reactions may be associated with the leukoreduction, but reports of APTR appeared when leukoreduction became standard practice. Therefore, the etiology remains unknown.

Conclusion

This case aids in the argument that APTR is a complication of transfusion, despite the absence of a clear etiology or diagnostic criteria. Additional research and improved surveillance are necessary to elucidate potential etiology and improve patient care by identifying prevention and treatment options. A diagnostic criterion would aid efforts to harmonize reporting in the United States and collect the hemovigilance data required to improve transfusion outcomes.
Parental Socioeconomic Status and Autism Spectrum Disorder in Offspring: A Population-Based Cohort Study in Taiwan
Authors: Yu Tsung , Lien Yueh-Ju , Liang Fu-Wen , Kuo Pao-Lin
Published: October 2020

Studies from the United States have shown increasing incidence of autism spectrum disorder (ASD) with increasing socioeconomic status (SES), whereas in Scandinavian countries, no such relation was identified. We investigated how ASD risk in offspring varied according to parental SES in Taiwan, where there is universal health care. Through linking birth reporting data and data from Taiwan’s national health insurance program, we studied 706,111 singleton births from 2004 to 2007 and followed them until 2015. Parental SES was determined by monthly salary at the time of childbirth, and child neuropsychiatric outcomes were defined using International Classification of Diseases codes. We identified 7,323 ASD cases and 7,438 intellectual disability (ID) cases; 17% of ASD cases had co-occurring ID. In multivariable Cox regression analysis, higher SES was independently associated with higher risk of ASD after we took into account urbanization levels, child sex, parental age, and other covariates. By contrast, higher SES was independently associated with lower risk of ID. Besides the SES disparity in ASD case ascertainment and in the access to health care, findings from Taiwan suggest that other social, environmental, biological, and immunological factors linked with parental SES levels may contribute to the positive relation of SES and ASD risk.
A genome-wide association study to identify candidate genes for erectile dysfunction
Authors: Kazemi Elham , Zargooshi Javaad , Kaboudi Marzieh , Heidari Parviz , Kahrizi Danial , Mahaki Behzad , Mohammadian Youkhabeh , Khazaei Habibolah , Ahmed Kawsar
Published: October 2020

Erectile dysfunction (ED) can be caused by different diseases and controlled by several genetic networks. In this study, to identify the genes related to ED, the expression profiles of normal and ED samples were investigated by the Gene Expression Omnibus (GEO) database. Seventeen genes were identified as associated genes with ED. The protein and nucleic acid sequences of selected genes were retrieved from the UCSC database. Selected genes were diverse according to their physicochemical properties and functions. Category function revealed that selected genes are involved in pathways related to humans some diseases. Furthermore, based on protein interactions, genes associated with the insulin pathway had the greatest interaction with the studied genes. To identify the common cis-regulatory elements, the promoter site of the selected genes was retrieved from the UCSC database. The Gapped Local Alignment of Motifs tool was used for finding common conserved motifs into the promoter site of selected genes. Besides, INSR protein as an insulin receptor precursor showed a high potential site for posttranslation modifications, including phosphorylation and N-glycosylation. Also, in this study, two Guanine-Cytosine (GC)-rich regions were identified as conserved motifs in the upstream of studied genes which can be involved in regulating the expression of genes associated with ED. Also, the conserved binding site of miR-29-3p that is involved in various cancers was observed in the 3′ untranslated region of genes associated with ED. Our study introduced new genes associated with ED, which can be good candidates for further analyzing related to human ED.
The Functional Foundations of Episodic Memory Remain Stable Throughout the Lifespan
Authors: Vidal-Piñeiro Didac , Sneve Markus H , Amlien Inge K , Grydeland Håkon , Mowinckel Athanasia M , Roe James M , Sørensen Øystein , Nyberg Lars H , Walhovd Kristine B , Fjell Anders M
Published: October 2020

It has been suggested that specific forms of cognition in older age rely largely on late-life specific mechanisms. Here instead, we tested using task-fMRI (n = 540, age 6–82 years) whether the functional foundations of successful episodic memory encoding adhere to a principle of lifespan continuity, shaped by developmental, structural, and evolutionary influences. We clustered regions of the cerebral cortex according to the shape of the lifespan trajectory of memory activity in each region so that regions showing the same pattern were clustered together. The results revealed that lifespan trajectories of memory encoding function showed a continuity through life but no evidence of age-specific mechanisms such as compensatory patterns. Encoding activity was related to general cognitive abilities and variations of grey matter as captured by a multi-modal independent component analysis, variables reflecting core aspects of cognitive and structural change throughout the lifespan. Furthermore, memory encoding activity aligned to fundamental aspects of brain organization, such as large-scale connectivity and evolutionary cortical expansion gradients. Altogether, we provide novel support for a perspective on memory aging in which maintenance and decay of episodic memory in older age needs to be understood from a comprehensive life-long perspective rather than as a late-life phenomenon only.
Determination of PAH Benzo[a]anthracene, Chrysene, Benzo[b]flouranthene and Benzo[a]pyrene in Hydro Alcoholic Herbal Extracts with Fluorescence Detector Using Solid-Phase Extraction
Authors: Benny Antony Merina , Benny Antony , Aravind E S
Published: October 2020

An appropriate purification and quantification method has been developed for polycyclic aromatic hydrocarbons (PAH) in hydro alcoholic herbal extracts. For this, Bacopa monnieri, Camellia sinensis, Withania somnifera and Andrographis paniculata samples were extracted with modified solid-phase extraction (SPE) and the PAH were quantified using liquid chromatography coupled to fluorescence detector. Purification of herbal extract using hexane and acetone in the ratio of 1:1 followed by treatment with QuEChERS salt (6 g MgSO4 and 1.5 g sodium acetate) improved the recovery rate of PAH. Silica SPE, which accomplishes solvent exchange to hexane by cleanup method, was developed to reduce the matrix effect and quality of the result obtained was increased. The developed method can be used for regular monitoring and analysis of PAH in natural extracts so as to prevent contamination.
Hurricane effects on climate-adaptive silviculture treatments to longleaf pine woodland in southwestern Georgia, USA
Authors: Bigelow Seth W , Looney Christopher E , Cannon Jeffery B
Published: October 2020

The Adaptive Silviculture for Climate Change (ASCC) network tests silvicultural treatments to promote ‘resistance’ or ‘resilience’ to climate change or speed ‘transition’ to new forest types. Based on projected increases in air temperatures and within-season dry periods in southeastern USA, we installed resistance, resilience and transition treatments involving species selection and varied intensities of density reduction, plus an untreated control, in mixed longleaf pine-hardwood woodland in southwest Georgia USA. Within a year of treatment a tropical cyclone, Hurricane Michael, exposed the site to the unforeseen climatic stress of >44-m s−1 winds. We measured inventory plots post-cyclone and compared the data to pre-storm and pre-treatment values. We analysed stand density index (metric SDI, species maximum value = 1000), stand complexity index (SCI), composition and individual tree characteristics. The ASCC treatments decreased both SDI (from 220 to 124 in the transition treatment) and SCI. The cyclone did not greatly decrease SDI (mean decrease 4.5 per cent) and decreased SCI only in the Controls. Xeric hardwoods were more prone to damage than other functional groups, and ordination showed that the cyclone shifted species composition to greater longleaf pine dominance. Taller trees were more likely to be damaged, except in the resilience treatment, which had a relatively large representation of shorter, more easily damaged xeric hardwoods. The open canopy of the longleaf-hardwood woodland, only 22 per cent of maximum SDI before treatment, evidently fostered wind-firmness, thereby limiting the destructive effect of the cyclone. The sensitivity of xeric hardwoods to hurricane damage suggests that there may be a trade-off between wind tolerance and drought tolerance among functional groups. Maintaining a mixture of drought and wind-resistant species, as in the resilience treatments, may provide broader insurance against multiple climate change impacts in longleaf pine and other forested systems dominated by a single foundation species.
The common EU approach to personal data and cybersecurity regulation
Authors: Mantelero Alessandro , Vaciago Giuseppe , Samantha Esposito Maria , Monte Nicole
Published: October 2020

Several sector-specific studies on EU data protection and cybersecurity frameworks can be found in the literature, but their differing legal domains has hindered the development of a common analysis of the different sets of provisions from a business perspective. This article sets out to bridge this gap, providing a systematic review and a cross-cutting operational analysis of the main legal instruments that constitute the common European approach to personal data and cybersecurity regulation for the business sector. We aim to demonstrate the existence of a core of common principles and procedural approaches referring to specific cybersecurity and data security technologies. Analysis reveals a coordinated regulatory model based on five pillars: risk-based approach, by-design approach, reporting obligations, resilience and certification schemes. We also highlight the relationship between the main directives and regulations.
A Multiancestry Sex-Stratified Genome-Wide Association Study of Spontaneous Clearance of Hepatitis C Virus
Authors: Vergara Candelaria , Valencia Ana , Thio Chloe L , Goedert James J , Mangia Alessandra , Piazzolla Valeria , Johnson Eric , Kral Alex H , O’Brien Thomas R , Mehta Shruti H , Kirk Gregory D , Kim Arthur Y , Lauer Georg M , Chung Raymond T , Cox Andrea L , Peters Marion G , Khakoo Salim I , Alric Laurent , Cramp Matthew E , Donfield Sharyne M , Edlin Brian R , Busch Michael P , Alexander Graeme , Rosen Hugo R , Murphy Edward L , Wojcik Genevieve L , Taub Margaret A , Thomas David L , Duggal Priya
Published: October 2020

Background

Spontaneous clearance of acute hepatitis C virus (HCV) infection is more common in women than in men, independent of known risk factors.

Methods

To identify sex-specific genetic loci, we studied 4423 HCV-infected individuals (2903 male, 1520 female) of European, African, and Hispanic ancestry. We performed autosomal, and X chromosome sex-stratified and combined association analyses in each ancestry group.

Results

A male-specific region near the adenosine diphosphate–ribosylation factor–like 5B (ARL5B) gene was identified. Individuals with the C allele of rs76398191 were about 30% more likely to have chronic HCV infection than individuals with the T allele (OR, 0.69; P = 1.98 × 10−07), and this was not seen in females. The ARL5B gene encodes an interferon-stimulated gene that inhibits immune response to double-stranded RNA viruses. We also identified suggestive associations near septin 6 and ribosomal protein L39 genes on the X chromosome. In box sexes, allele G of rs12852885 was associated with a 40% increase in HCV clearance compared with the A allele (OR, 1.4; P = 2.46 × 10−06). Septin 6 facilitates HCV replication via interaction with the HCV NS5b protein, and ribosomal protein L39 acts as an HCV core interactor.

Conclusions

These novel gene associations support differential mechanisms of HCV clearance between the sexes and provide biological targets for treatment or vaccine development.
On the Effect of Age on the Transmission of SARS-CoV-2 in Households, Schools, and the Community
Authors: Goldstein Edward , Lipsitch Marc , Cevik Muge
Published: October 2020

Background

There is limited information on the effect of age on the transmission of SARS-CoV-2 infection in different settings.

Methods

We reviewed published studies/data on detection of SARS-CoV-2 infection in contacts of COVID-19 cases, serological studies, and studies of infections in schools.

Results

Compared to younger/middle-aged adults, susceptibility to infection for children younger than 10 years is estimated to be significantly lower, while estimated susceptibility to infection in adults older than 60 years is higher. Serological studies suggest that younger adults (particularly those younger than 35 years) often have high cumulative incidence of SARS-CoV-2 infection in the community. There is some evidence that given limited control measures, SARS-CoV-2 may spread robustly in secondary/high schools, and to a lesser degree in primary schools, with class size possibly affecting that spread. There is also evidence of more limited spread in schools when some mitigation measures are implemented. Several potential biases that may affect these studies are discussed.

Conclusions

Mitigation measures should be implemented when opening schools, particularly secondary/high schools. Efforts should be undertaken to diminish mixing in younger adults, particularly individuals aged 18–35 years, to mitigate the spread of the epidemic in the community.
Racial Capitalism, Islamophobia, and Austerity
Authors: Ali Nadya , Whitham Ben
Published: October 2020

Explorations of Islamophobia or anti-Muslim racism predominantly focus on issues of security policy and media representations, set against the backdrop of the global “War on Terror.” This scholarship explores the racialization of Muslim populations across different global contexts, including the UK, Europe, the United States, and China. However, Islamophobia has also been articulated through concerns about the economy, jobs, public services, and national debt in times of austerity. Narratives have emerged around Muslim families in the UK receiving “excessive” welfare benefits, preferential access to social housing, and pressuring public services through “breeding.” This article offers a new way of thinking about the links between Islamophobia and austerity through an engagement with the literature on racial capitalism. The article shows how constructions of Muslim populations as the “undeserving poor” are central to the intersectional racialized and gendered disentitlements of austerity. The analysis draws on the findings from twelve interviews and a six-person focus group with Muslim subjects based in London to illustrate the political economy of austerity Islamophobia.
Intrapuparial Age Estimation of Forensically Important Dohrniphora cornuta (Diptera: Phoridae)
Authors: Feng Dian-Xing , Wu Jing , Sun Da-Peng
Published: October 2020

Dohrniphora cornuta (Bigot) is a forensically important phorid fly indoors and in burial environments. The determination of a minimum postmortem interval (PMImin) often relies on the determination of the age of the immatures. Although the larval development data of D. cornuta under different temperatures has been established, the intrapuparial stage which lasts for about half of the total immature development is scarce. In this study, we investigated the key morphological changes during intrapuparial development at constant temperatures (15, 18, 21, 24, 27, 30, 33, and 36°C), with an aim to estimate the intrapuparial age of D. cornuta. Puparia were sampled at 12-h (24, 27, 30, and 33°C), 24-h (18 and 21°C), and 48-h (15°C) intervals. The morphological developments within the puparium were analyzed using a stereomicroscope after the puparium was removed. The average minimum duration of intrapuparial stage was inversely related to temperature, ranging from 184.79 ± 3.00 h at 30°C to 1102.86 ± 25.55 h at 15°C for female, and 197.40 ± 4.12 h at 30°C to 1175.33 ± 18.55 h at 15°C for male. It did not develop at 36°C. Some morphological traits that changed during development within the puparium could be used as age markers. According to these changes, the intrapuparial stage of D. cornuta was divided into nine stages which could be used for both sexes. This study provides relatively systematic development data of D. cornuta intrapuparial for the estimation of PMImin in forensic entomology.
Toxic Effects of Fine Plant Powder Impregnated With Avermectins on Mosquito Larvae and Nontarget Aquatic Invertebrates
Authors: Belevich Olga , Yurchenko Yury , Alekseev Alexander , Kotina Oxana , Odeyanko Vyacheslav , Tsentalovich Yury , Yanshole Lyudmila , Kryukov Vadim , Danilov Victor , Glupov Victor
Published: October 2020

The toxic effects of an avermectin-impregnated fine plant powder (AIFP) against larval Aedes aegypti L. (Diptera: Culicidae), Culex modestus Ficalbi (Diptera: Culicidae), and Anopheles messeae Falleroni (Diptera: Culicidae), as well as selected nontarget aquatic invertebrates, were studied under laboratory conditions. The possibility of trophic transfer of avermectins (AVMs) through the food chain and their toxic effects on predaceous species fed AIFP-treated mosquito larvae was also evaluated. Among mosquitoes, Anopheles messeae were the most sensitive to AIFP, while Cx. modestus exhibited the least sensitivity to this formulation. Among nontarget aquatic invertebrates, the greatest toxicity of AIFP was observed for benthic species (larval Chironomus sp. Meigen (Diptera: Chironomidae), whereas predators (dragonflies, water beetles, and water bugs) exhibited the lowest AIFP sensitivity. AIFP sensitivity of the clam shrimp Lynceus brachyurus O. F. Muller (Diplostraca: Lynceidae), the phantom midge Chaoborus crystallinus De Geer (Diptera: Chaoboridae), and the mayfly Caenis robusta Eaton (Ephemeroptera: Caenidae) was intermediate and similar to the sensitivity of the mosquito Cx. modestus. However, these nontarget species were more resistant than An. messeae and Ae. aegypti. Solid-phase extraction of mosquito larvae treated with AIFP and subsequent high-performance liquid chromatography (HPLC) analysis of the extracts revealed an AVM concentration of up to 2.1 ± 0.3 μg/g. Feeding the creeping water bug Ilyocoris cimicoides L. (Hemiptera: Naucoridae) on the AIFP-treated mosquito larvae resulted in 51% mortality of the predaceous species. But no toxicity was observed for Aeshna mixta Latreille (Odonata: Aeshnidae) dragonfly larvae fed those mosquito larvae. The results of this work showed that this AVM formulation can be effective against mosquito larvae.
Cicero's Rhetorical Works
Authors: May James M.
Published: October 2020

Marcus Tullius Cicero (106–43 bce) rose to prominence in the state during the final decades of the Roman Republic. Blessed with a goodly measure of natural ability, an extraordinary amount of self-discipline, and a remarkably broad and deep education not only in rhetoric but also in philosophy and the other noble arts, Cicero employed his oratorical skill to establish himself in the courts and on the Rostra as Rome’s finest orator. He was elected to the state’s chief political offices at the youngest possible age, and during the final months of his consulship (63 bce), he foiled a plot by L. Sergius Catilina to overthrow the government. His decisive action in that affair was the source of great glory and pride in having saved the state, but also of great pain and heartache, for some five years later he was forced into exile for his part in the summary execution of Catilinarian co-conspirators who were also Roman citizens. Following his return to Rome, he found himself at loggerheads with members of the so-called “First Triumvirate,” a situation that resulted for him in something like a forced retirement from political activity. A decade later, in the wake of Julius Caesar’s victory in the civil war and subsequent dictatorship, Cicero was placed in a similar situation. During both these occasions (namely, the mid-50s and mid-40s bce), he channeled his energies in the direction of his other great love, i.e., contemplation, study, and writing. Remarkably, these two periods saw him produce nearly a score of treatises, including his most important and influential rhetorical writings, wherein he enunciated his deeply-held conviction that eloquent speech (coupled with reason) was a chief civilizing factor in human society—a glue that binds and builds well-ordered communities when employed responsibly by its most expert practitioners. Following the assassination of Caesar and the emergence of Marcus Antonius as a force who appeared to be aiming to secure his own dictatorial powers, Cicero once again took up the mantle of the Republic, hoping for its restoration. He opposed Antonius and his actions by writing and delivering to the Senate and people a series of speeches known as the Philippics. But on the brink of success, young Caesar Octavianus allied himself with Antonius, and Cicero’s name found a prominent place on the list of those proscribed: his head and hands, severed by Antonius’s henchmen, were gruesomely displayed on the speaker’s platform in the Roman forum. See the separate Oxford Bibliographies article in Classics Cicero for a general and more comprehensive bibliography of Cicero and his other works. Other Oxford Bibliographies articles that may be of interest include Greek Rhetoric, Latin Rhetoric, and Rhetoric.
Baoshan
Authors: Adamek Wendi
Published: October 2020

Baoshan 寶山 (Treasure Mountain) is a Buddhist site in the Taihang 太行 mountain range in Henan 河南 Province; it includes neighboring Lanfengshan 嵐峰山 (Misty Peak Mountain). It is a network of cave-shrines, devotional and memorial inscriptions, reliquary niches with portrait-statues, and references to buildings and restorations. Most notably, the memorial inscriptions on Lanfengshan are the single largest extant in situ collection of records of medieval Chinese Buddhist nuns. It is claimed that Baoshan was first marked as a Buddhist place by the monk Daoping 道憑 (b. 488–d. 559). Daoping’s disciple Lingyu 靈裕 (b. 518–d. 605) won imperial recognition for the site and probably led the design and construction of the main cave-shrine. Both monks belonged to the southern branch of the Dilun 地論 (Stages treatise) lineage that began in the Northern Qi 北齊 (550–577) capital of Ye 鄴. Two rock-cut cave shrines on Baoshan and Lanfengshan constitute the devotional foci of the site, and a restored temple stands in the valley between them, in what is believed to be its original location. The site’s main cave-shrine Dazhusheng 大住聖 (Great Abiding Holy Ones) is located midway up Baoshan and about five hundred meters west and further up the valley from the restored temple. Mortuary niches for monks and laymen fan out on several levels above the cave to the east and west. An earlier, smaller cave attributed to Daoping was renamed Daliusheng 大留聖 (Great Remaining Holy Ones), establishing correspondence with Dazhusheng. It is situated partway up Langfengshan, overlooking the lower part of the valley. Mortuary niches for nuns and laywomen are carved into cliff-faces above, below, and to the east of the cave. In Lingyu’s Xu gaoseng zhuan續高僧傳 (Continued biographies of eminent monks) biography, it is said that the temple in the valley between the peaks was designated Lingquansi 靈泉寺 (Ling’s Spring/Numinous Spring Temple) in 591 by Emperor Wen of the Sui. This was meant to honor Lingyu, who that year conferred precepts on the imperial household. One of Lingyu’s disciples, the eminent monk Huixiu 慧休 (b. 547–d. 646), also had a formative influence at the site.
Internalism and Externalism in Epistemology
Authors: Engel Mylan
Published: October 2020

The internalism/externalism distinction in epistemology applies to both theories of justification and theories of knowledge. The distinction is most clearly defined for theories of justification. An internalist theory of epistemic justification is any theory that maintains that epistemic justifiedness is exclusively a function of states internal to the cognizer. Externalism is the denial of internalism. Thus, an externalist theory is any theory that maintains that epistemic justifiedness is at least partly a function of states or factors external to the cognizer, i.e., states or factors outside the cognizer’s ken. There is no unified agreement among internalists as to which internal states are epistemically relevant, and different internalisms emerge based on the subset of internal states deemed relevant. (See Internalism and Justification for details.) Internalists typically maintain that justification is a normative notion in the belief-guiding/regulative sense. Internalists also typically maintain that one can tell whether one is justified in believing p simply by reflecting on one’s internal evidence for p. The central internalist intuition, as highlighted by the New Evil Demon Problem is this: There can be no difference in justification without a difference in epistemically relevant internal states. Externalism is motivated by the intuition that epistemic justification must be conceptually connected to truth such that the conditions that make a belief justified also make it objectively probable. Externalists are also typically motivated by the view that children and animals can form justified beliefs, while failing to satisfy the internalist’s intellectualist requirements for justification. The dominant externalist theory of justification is process reliabilism, a simplified version of which holds that a belief is justified iff it’s produced by a reliable process. There is less canonical agreement when it comes to applying the internalist/externalist distinction to theories of knowledge. In one sense, every plausible epistemology is an externalist theory because every plausible epistemology requires an externalist truth condition and an externalist Gettier-blocking fillip. However, in another widely used sense, “externalist” theories of knowledge are theories that replace the internalist justification condition with either an externalist justification condition or some other externalist constraint (such as a causal or modal constraint); while “internalist” theories of knowledge hold that internalist justification is necessary for knowledge and also typically hold that no other kind of justification is needed for knowledge, though they do incorporate some sort of externalist constraint to handle the Gettier problem.