bluuebunny/crossref_metadata_2025 huggingface dataset:
Shuttleworth equation: A molecular simulations perspective
Authors: Di Pasquale Nicodemo , Davidchack Ruslan L.
Published: October 2020

Even though the study of interfacial phenomena can be traced back to Laplace and was given a solid thermodynamic foundation by Gibbs, it appears that some concepts and relations among them are still causing some confusion and debates in the literature, particularly for interfaces involving solids. In particular, the definitions of the concepts of interfacial tension, free energy, and stress and the relationships between them sometimes lack clarity, and some authors even question their validity. So far, the debates about these relationships, in particular the Shuttleworth equation, have taken place within the framework of classical thermodynamics. In this work, we are offering to look at these concepts within the framework of statistical mechanics, which can be readily tested in Molecular Dynamics (MD) simulations. For a simple one component system of particles interacting via the Lennard-Jones potential, we calculate by the cleaving method the excess free energy of a solid–vacuum interface (solid surface) for systems in different states of tangential strain and compare the results to the calculation of surface stress via the difference of normal and tangential forces at the surface. As a result, we demonstrate consistency, within the statistical uncertainty, of the thermodynamic and statistical mechanical definitions of surface free energy and surface stress and how they are expressed via interaction-dependent quantities in MD simulations.
Is it enough to use the traditional approach based on average values for basketball physical performance analysis?
Authors: Vázquez‐Guerrero Jairo , Garcia Franc
Published: October 2020

Understanding the most demanding scenarios of basketball match‐play can optimise training prescription. We established physical demand differences in total distance covered, distance covered at high‐speed running, distance covered at high‐intensity accelerations and decelerations, number of high‐speed running actions and number of high‐intensity accelerations comparing the traditional average method with the most demanding scenarios based on 1‐minute rolling averages. Physical demand parameters were analysed from 21 elite basketball players according to playing position during a friendly game via local positioning system microtechnology. The results showed that players covered a total distance of 141.3 m·min−1 (p < 0.001; ES = 7.80) and 25.4 m·min−1 (p < 0.001; ES = 4.52) at high‐speed running using rolling averages, compared to 66.3 and 3.2 m min−1, respectively, using the traditional average approach. These data represent a very large increase of 113.1% for total distance per minute and 686.4% for high‐speed running distance per minute, 252% for the number of high‐intensity accelerations and 290.5% for the number of high‐intensity decelerations, respectively, demonstrating the relevance of this novel approach. In conclusion, this investigation indicated that the traditional average method underestimates peak physical demands over a 1‐minute period during a basketball game. Thus, the average approach should be complemented by analysing the most demanding scenarios in order to have a better understanding of physical demands during basketball competition.
Reply to Comments on ‘Defining the electromagnetic potentials’
Authors: Davis A M
Published: October 2020

The two commentary articles by van Hees and Heras both reject the conclusions of our paper. Our response here shows that they address neither the issues we raised nor the reasons for our conclusions. Rather, they merely reiterate the ‘conventional approach’ as arguments against them.
Isospin dependence of the nuclear binding energy *
Authors: He Y. Q. , Ge J. K. , Fu G. J. , Jiang H.
Published: October 2020

In this paper, we study the symmetry energy and the Wigner energy in the binding energy formula for atomic nuclei. We simultaneously extract the

symmetry energy and Wigner energy coefficients using the double difference of "experimental" symmetry-Wigner energies, based on the binding energy data of nuclei with

. Our study of the triple difference formula and the "experimental" symmetry-Wigner energy suggests that the macroscopic isospin dependence of binding energies is explained well by the

symmetry energy and the Wigner energy, and further consideration of the

term in the binding energy formula does not substantially improve the calculation result.
Recurrent delirium over 12 months predicts dementia: results of the Delirium and Cognitive Impact in Dementia (DECIDE) study
Authors: Richardson Sarah J , Davis Daniel H J , Stephan Blossom C M , Robinson Louise , Brayne Carol , Barnes Linda E , Taylor John-Paul , Parker Stuart G , Allan Louise M
Published: October 2020

Background

Delirium is common, distressing and associated with poor outcomes. Previous studies investigating the impact of delirium on cognitive outcomes have been limited by incomplete ascertainment of baseline cognition or lack of prospective delirium assessments. This study quantified the association between delirium and cognitive function over time by prospectively ascertaining delirium in a cohort aged ≥ 65 years in whom baseline cognition had previously been established.

Methods

For 12 months, we assessed participants from the Cognitive Function and Ageing Study II-Newcastle for delirium daily during hospital admissions. At 1-year, we assessed cognitive decline and dementia in those with and without delirium. We evaluated the effect of delirium (including its duration and number of episodes) on cognitive function over time, independently of baseline cognition and illness severity.

Results

Eighty two of 205 participants recruited developed delirium in hospital (40%). One-year outcome data were available for 173 participants: 18 had a new dementia diagnosis, 38 had died. Delirium was associated with cognitive decline (−1.8 Mini-Mental State Examination points [95% CI –3.5 to –0.2]) and an increased risk of new dementia diagnosis at follow up (OR 8.8 [95% CI 1.9–41.4]). More than one episode and more days with delirium (>5 days) were associated with worse cognitive outcomes.

Conclusions

Delirium increases risk of future cognitive decline and dementia, independent of illness severity and baseline cognition, with more episodes associated with worse cognitive outcomes. Given that delirium has been shown to be preventable in some cases, we propose that delirium is a potentially modifiable risk factor for dementia.
Role of environmental filtering and functional traits for species coexistence in a harsh tropical montane ecosystem
Authors: Tameirão Lucas B S , Caminha-Paiva Dario , Negreiros Daniel , Veloso Maria Das Dores M , Berbara Ricardo L L , Dias Luiz Eduardo , Pierce Simon , Fernandes G Wilson
Published: October 2020

Environmental filtering and niche differentiation are often invoked to explain species coexistence at local scales. The ironstone campo rupestre of Brazil provides a biodiverse natural experiment in which edaphic gradients represent filters to test the hypothesis that plant community functional composition, despite converging on extreme stress tolerance, exhibits a co-structure with environmental parameters. At the Serra do Rola-Moça State Park, soil physico-chemical parameters were characterized alongside community-weighted mean plant functional traits and Grime’s competitor, stress-tolerator and ruderal strategies for species at each sampling site. In general, species exhibited a high degree of stress tolerance (between 72.6% and 100%), while ruderalism was 0% for all species. Soil nutrients related to plant metabolism (e.g. P, Ca, Mg) were associated with the stress-tolerant strategy and with traits involved in the leaf economics and size spectra. Despite a major edaphic filter selecting stress tolerance, fine-scale microhabitat variability represented by soil parameters related to fertility (i.e. P, Ca, Mg) and water retention capacity (i.e. clay content) was associated with subtle variation in ecological strategies and functional traits of species in the ironstone campo rupestre.
Through convergence and governance: embedding empowerment in community development interventions
Authors: Kumar Shubham , Kumar Deepak , Sengupta Keya , Giri Tapas Kumar
Published: October 2020

To achieve social justice, equality, and quality of life under the concerted efforts deliberated for community development, countries engage in a range of interventions focusing on participation, capacity building, and sustainability. In this study, we examine two specific characteristics of livelihood interventions, development and empowerment; their relationship; and impact on community well-being. The findings suggest that while outcomes related to development and empowerment processes have a positive but meagre impact on community well-being, there is lack of continuum between them and the relationship is conditioned by convergence and governance. Further, insights from interviews also suggest that though there are institutional voids, challenging changing context, and variations in the way mobilization and participation are employed, those that will integrate good governance and strong convergence can deliver better outcomes.
Predictors of Virological Failure and Time to Viral Suppression of First-Line Integrase Inhibitor–Based Antiretroviral Treatment
Authors: Pyngottu Ashima , Scherrer Alexandra U , Kouyos Roger , Huber Michael , Hirsch Hans , Perreau Matthieu , Yerly Sabine , Calmy Alexandra , Cavassini Matthias , Stöckle Marcel , Furrer Hansjakob , Vernazza Pietro , Bernasconi Enos , Günthard Huldrych F ,   Swiss HIV Cohort Study, Aebi-Popp K , Anagnostopoulos A , Battegay M , Bernasconi E , Böni J , Braun D L , Bucher H C , Calmy A , Cavassini M , Ciuffi A , Dollenmaier G , Egger M , Elzi L , Fehr J , Fellay J , Furrer H , Fux C A , Günthard H F , Haerry D , Hasse B , Hirsch H H , Hoffmann M , Hösli I , Huber M , Kahlert C R , Kaiser L , Keiser O , Klimkait T , Kouyos R D , Kovari H , Ledergerber B , Martinetti G , Martinez de Tejada B , Marzolini C , Metzner K J , Müller N , Nicca D , Paioni P , Pantaleo G , Perreau M , Rauch A , Rudin C , Scherrer A U , Schmid P , Speck R , Stöckle M , Tarr P , Trkola A , Vernazza P , Wandeler G , Weber R , Yerly S
Published: October 2020

Background

Integrase strand transfer inhibitors (InSTIs) are recommended for first-line treatment of persons with human immunodeficiency virus (HIV). We identified risk factors, including baseline minor InSTI resistance mutations, for treatment failure of InSTI-based regimens.

Methods

We studied time-to-treatment failure and time to viral suppression among 1419 drug-naive patients in the Swiss HIV Cohort Study. We performed Cox regression models adjusted for demographic factors, baseline HIV RNA/CD4 cell counts, AIDS-defining events, and the type of InSTI. In 646 patients with a baseline genotypic resistance test of the integrase, we studied the impact of minor integrase resistance mutations.

Results

We observed 121 virological failures during 18 447 person-years of follow-up. A baseline viral load ≥100 000 copies/mL (multivariable hazard ratio [mHR], 2.2; 95% confidence interval [CI], 1.3–3.6) and an AIDS-defining event (mHR, 1.8; 95% CI. 1.1–3.0) were associated with treatment failure. CD4 counts between 200 and 500 cells/µL (mHR, 0.5; 95% CI, .3–.8) and >500 cells/µL (mHR, 0.4; 95% CI, .2–.7) were protective. Time to suppression was shorter in lower viral load strata (mHR, 0.7; 95% CI, .6–.8) and in dolutegravir-based therapy (mHR, 1.2; 95% CI, 1.0–1.4). Minor resistance mutations were found at baseline in 104 of 646 (16%) patients with no effect on treatment outcome.

Conclusions

Factors associated with treatment failure on InSTI-based first-line regimen remained similar to those of older treatments, in particular high viral load and low CD4 counts.
Do you have time to take a walk together? Private and joint time within the household
Authors: Browning Martin , Donni Olivier , Gørtz Mette
Published: October 2020

We develop a theoretical model for the intra-household allocation of time and consumption that distinguishes between partners’ joint and private leisure. Estimating the model using time-use data leads to five findings. First, the intra-household expenditure distribution correlates with relative wages, consistent with the collective model. Second, men put relatively more weight on private expenditure and composite leisure. Third, joint and private leisure are imperfect substitutes. Fourth, joint and private leisure are independent of the wage distribution, suggesting that togetherness does not substitute for economic factors. Fifth, higher female wages imply higher childcare hours for women, but lower for men.
The golden age of mercenaries
Authors: Leeson Peter T , Piano Ennio E
Published: October 2020

Between the mid-thirteenth and mid-fifteenth centuries, Italian city-states abandoned citizen militaries for militaries composed of mercenaries: foreign soldiers for hire. So dramatic was the switch that this epoch has been called “the golden age of mercenaries,” and so treacherous did the mercenaries prove that Niccolò Machiavelli would later denounce them as “useless and dangerous.” Italian rulers knew of mercenaries’ infamous reputation when they hired them. To explain the puzzling fact that rulers hired mercenaries anyway, we develop a theory of military composition in which political circumstance constrains ruler choice. Comparative analysis of Venice and Florence provides evidence for our explanation.
Infrastructure and Chinese power
Authors: Ho Selina
Published: October 2020

China's increasing material capabilities stand at the heart of the US–China power transition debate. The focus on material power reflects a realist definition of power based on the possession of resources. However, material capabilities do not necessarily translate into influence and do not always determine outcomes. Non-material power matters at least as much as material capabilities. This article argues that China under President Xi Jinping views power differently from previous generations of Chinese leaders. While material power remains important, Xi has paid greater attention to strengthening Chinese non-material power, in particular structural power and discursive power. This article examines Chinese structural and discursive power, the third and fourth faces of power, through the lens of Xi's mega-infrastructure vision, the Belt and Road Initiative (BRI). It argues that power, both material and non-material, is embedded in infrastructure. Specifically, the article uses case-studies of Chinese construction of high-speed railways in Laos and Indonesia to illustrate the effects of Chinese structural and discursive power. Based on field work and in-depth interviews, the cases show that China is relatively successful in wielding structural and discursive power in Laos and Indonesia, despite the differences in the two countries’ political systems, and economic and population sizes. Chinese domination, however, does not mean that subordinate states do not have agency. For instance, there is resistance against the narrative of a pre-eminent Chinese civilization in Chinese discourse, as the Indonesia case demonstrates. Exploring the different facets of Chinese power is critical for a proper understanding of how China strives to shape the structure and discourse of the global order.
Randomized phase II study of chemoradiotherapy with versus without induction chemotherapy for locally advanced pancreatic cancer: Japan Clinical Oncology Group trial, JCOG1106
Authors: Ioka Tatsuya , Furuse Junji , Fukutomi Akira , Mizusawa Junki , Nakamura Satoaki , Hiraoka Nobuyoshi , Ito Yoshinori , Katayama Hiroshi , Ueno Makoto , Ikeda Masafumi , Sugimori Kazuya , Okano Naohiro , Shimizu Kyoko , Yanagimoto Hiroaki , Okusaka Takuji , Ozaka Masato , Todaka Akiko , Nakamori Shoji , Tobimatsu Kazutoshi , Sata Naohiro , Kawashima Yohei , Hosokawa Ayumu , Yamaguchi Taketo , Miyakawa Hiroyuki , Hara Hiroki , Mizuno Nobumasa , Ishii Hiroshi ,   Hepatobiliary and Pancreatic Oncology Group (HBPOG) of Japan Clinical Oncology Group (JCOG)
Published: October 2020

Background

Chemoradiotherapy is a treatment option for locally advanced pancreatic cancer. However, the efficacy of induction chemotherapy prior to chemoradiotherapy is uncertain. The aim of this randomized, multicentre phase II study is to evaluate the efficacy and safety of chemoradiotherapy with and without induction chemotherapy to determine the significance of induction chemotherapy.

Methods

Patients with locally advanced pancreatic cancer were randomly assigned to the chemoradiotherapy arm (Arm A) or induction chemotherapy followed by the chemoradiotherapy arm (Arm B). Patients in Arm A underwent radiotherapy with concurrent S-1. Patients in Arm B received induction gemcitabine for 12 weeks, and thereafter, only patients with controlled disease underwent the same chemoradiotherapy as Arm A. After chemoradiotherapy, gemcitabine was continued until disease progression or unacceptable toxicity in both arms. The primary endpoint was overall survival.

Results

Amongst 102 patients enrolled, 100 were eligible for efficacy assessment. The probability of survival was greater in Arm B in the first 12 months, but the trend was reversed in the following periods (1-year survival 66.7 vs. 69.3%, 2-year survival 36.9 vs. 18.9%). The hazard ratio was 1.255 (95% confidence interval 0.816–1.930) in favour of Arm A. Gastrointestinal toxicity was slightly more frequent and three treatment-related deaths occurred in Arm A.

Conclusions

This study suggested that the chemoradiotherapy using S-1 alone had more promising efficacy with longer-term survival, compared with induction gemcitabine followed by chemoradiotherapy for locally advanced pancreatic cancer.

Clinical trial registration

The study was registered at the UMIN Clinical Trials Registry as UMIN000006811.
Early-Life Body Adiposity and the Breast Tumor Transcriptome
Authors: Wang Jun , Peng Cheng , Guranich Catherine , Heng Yujing J , Baker Gabrielle M , Rubadue Christopher A , Glass Kimberly , Eliassen A Heather , Tamimi Rulla M , Polyak Kornelia , Hankinson Susan
Published: October 2020

Background

Cumulative epidemiologic evidence has shown that early-life adiposity is strongly inversely associated with breast cancer risk throughout life, independent of adult obesity. However, the molecular mechanisms remain poorly understood.

Methods

We assessed the association of early-life adiposity, defined as self-reported body size during ages 10-20 years from a validated 9-level pictogram, with the transcriptome of breast tumor (N = 835) and tumor-adjacent histologically normal tissue (N = 663) in the Nurses’ Health Study. We conducted multivariable linear regression analysis to identify differentially expressed genes in tumor and tumor-adjacent tissue, respectively. Molecular pathway analysis using Hallmark gene sets (N = 50) was further performed to gain biological insights. Analysis was stratified by tumor estrogen receptor (ER) protein expression status (n = 673 for ER+ and 162 for ER− tumors).

Results

No gene was statistically significantly differentially expressed by early-life body size after multiple comparison adjustment. However, pathway analysis revealed several statistically significantly (false discovery rate < 0.05) upregulated or downregulated gene sets. In stratified analyses by tumor ER status, larger body size during ages 10-20 years was associated with decreased cellular proliferation pathways, including MYC target genes, in both ER+ and ER− tumors. In ER+ tumors, larger body size was also associated with upregulation in genes involved in TNFα/NFkB signaling. In ER− tumors, larger body size was additionally associated with downregulation in genes involved in interferon α and interferon γ immune response and Phosphatidylinositol 3-kinase (PI3K)/AKT/mammalian target of rapamycin (mTOR) signaling; the INFγ response pathway was also downregulated in ER− tumor-adjacent tissue, though at borderline statistical significance (false discovery rate = 0.1).

Conclusions

These findings provide new insights into the biological and pathological underpinnings of the early-life adiposity and breast cancer association.
Racial and Ethnic Variation in PSA Testing and Prostate Cancer Incidence Following the 2012 USPSTF Recommendation
Authors: Kensler Kevin H , Pernar Claire H , Mahal Brandon A , Nguyen Paul L , Trinh Quoc-Dien , Kibel Adam S , Rebbeck Timothy R
Published: October 2020

Background

The 2012 US Preventive Services Task Force recommendation against routine prostate-specific antigen (PSA) testing led to a decrease in prostate cancer screening, but the heterogeneity of its impact by race and ethnicity remains unclear.

Methods

The proportion of 40- to 74-year-old men who self-reported receiving a routine PSA test in the past year was estimated in the Behavioral Risk Factor Surveillance System (2012-2018). Odds ratios (ORs) of undergoing screening by race and ethnicity were estimated, adjusting for healthcare–related factors. Prostate cancer incidence rates and rate ratios (IRRs) by race and ethnicity were estimated using Surveillance, Epidemiology, and End Results registry data (2004-2017).

Results

PSA testing frequencies were 32.3% (95% confidence interval [CI] = 31.7% to 32.8%) among non-Hispanic White (NHW), 30.3% (95% CI = 28.3% to 32.3%) among non-Hispanic Black (NHB), 21.8% (95% CI = 19.9% to 23.7%) among Hispanic, and 17.7% (95% CI = 14.1% to 21.3%) among Asian and Pacific Islander men in 2012. The absolute screening frequency declined by 9.5% from 2012 to 2018, with a larger decline among NHB (11.6%) than NHW men (9.3%). The relative annual decrease was greater among NHB (OR = 0.86, 95% CI = 0.84 to 0.88) than NHW men (OR = 0.89, 95% CI = 0.89 to 0.90; Pheterogeneity = .005), driven by a larger decline among NHB men ages 40-54 years. The NHB to NHW IRR for total prostate cancer increased from 1.73 (95% CI = 1.69 to 1.76) in 2011 to 1.87 (95% CI = 1.83 to 1.92) in 2012 and has remained elevated, driven by differences in localized tumor incidence. Metastatic disease incidence is rising across all racial and ethnic groups.

Conclusions

The frequency of prostate cancer screening varies by race and ethnicity, and there was a modestly steeper decline in PSA testing among younger NHB men relative to NHW men since 2012. The NHB to NHW IRR for localized prostate cancer modestly increased following 2012.
The magnetic early B-type stars – IV. Breakout or leakage? H α emission as a diagnostic of plasma transport in centrifugal magnetospheres
Authors: Shultz M E , Owocki S , Rivinius Th , Wade G A , Neiner C , Alecian E , Kochukhov O , Bohlender D , ud-Doula A , Landstreet J D , Sikora J , David-Uraz A , Petit V , Cerrahoğlu P , Fine R , Henson G ,   MiMeS and BinaMIcS Collaborations
Published: October 2020

Rapidly rotating early-type stars with strong magnetic fields frequently show H α emission originating in centrifugal magnetospheres (CMs), circumstellar structures in which centrifugal support due to magnetically enforced corotation of the magnetically confined plasma enables it to accumulate to high densities. It is not currently known whether the CM plasma escapes via centrifugal breakout (CB), or by an unidentified leakage mechanism. We have conducted the first comprehensive examination of the H α emission properties of all stars currently known to display CM-pattern emission. We find that the onset of emission is dependent primarily on the area of the CM, which can be predicted simply by the value BK of the magnetic field at the Kepler corotation radius RK. Emission strength is strongly sensitive to both CM area and BK. Emission onset and strength are not dependent on effective temperature, luminosity, or mass-loss rate. These results all favour a CB scenario; however, the lack of intrinsic variability in any CM diagnostics indicates that CB must be an essentially continuous process, i.e. it effectively acts as a leakage mechanism. We also show that the emission profile shapes are approximately scale-invariant, i.e. they are broadly similar across a wide range of emission strengths and stellar parameters. While the radius of maximum emission correlates closely as expected to RK, it is always larger, contradicting models that predict that emission should peak at RK.
Simulating the interstellar medium of galaxies with radiative transfer, non-equilibrium thermochemistry, and dust
Authors: Kannan Rahul , Marinacci Federico , Vogelsberger Mark , Sales Laura V , Torrey Paul , Springel Volker , Hernquist Lars
Published: October 2020

We present a novel framework to self-consistently model the effects of radiation fields, dust physics, and molecular chemistry (H2) in the interstellar medium (ISM) of galaxies. The model combines a state-of-the-art radiation hydrodynamics module with a H  and He  non-equilibrium thermochemistry module that accounts for H2 coupled to an empirical dust formation and destruction model, all integrated into the new stellar feedback framework SMUGGLE. We test this model on high-resolution isolated Milky-Way (MW) simulations. We show that the effect of radiation feedback on galactic star formation rates is quite modest in low gas surface density galaxies like the MW. The multiphase structure of the ISM, however, is highly dependent on the strength of the interstellar radiation field. We are also able to predict the distribution of H2, that allow us to match the molecular Kennicutt–Schmidt (KS) relation, without calibrating for it. We show that the dust distribution is a complex function of density, temperature, and ionization state of the gas. Our model is also able to match the observed dust temperature distribution in the ISM. Our state-of-the-art model is well-suited for performing next-generation cosmological galaxy formation simulations, which will be able to predict a wide range of resolved (∼10 pc) properties of galaxies.
Mocking faint black holes during reionization
Authors: Eide Marius B , Ciardi Benedetta , Feng Yu , Di Matteo Tiziana
Published: October 2020

To investigate the potential abundance and impact of nuclear black holes (BHs) during reionization, we generate a neural network that estimates their masses and accretion rates by training it on 23 properties of galaxies harbouring them at z = 6 in the cosmological hydrodynamical simulation MassiveBlack-II. We then populate all galaxies in the simulation from z = 18 to 5 with BHs from this network. As the network allows to robustly extrapolate to BH masses below those of the BH seeds, we predict a population of faint BHs with a turnover-free luminosity function, while retaining the bright (and observed) BHs, and together they predict a Universe in which intergalactic hydrogen is $15{{\ \rm per\ cent}}$ ionized at z = 6 for a clumping factor of 5. Faint BHs may play a stronger role in H reionization without violating any observational constraints. This is expected to have an impact also on pre-heating and pre-ionization, which is relevant to observations of the 21-cm line from neutral H. We also find that BHs grow more efficiently at higher z, but mainly follow a redshift-independent galaxy–BH relation. We provide a power law parametrization of the hydrogen ionizing emissivity of BHs.
Genomes OnLine Database (GOLD) v.8: overview and updates
Authors: Mukherjee Supratim , Stamatis Dimitri , Bertsch Jon , Ovchinnikova Galina , Sundaramurthi Jagadish Chandrabose , Lee Janey , Kandimalla Mahathi , Chen I-Min A , Kyrpides Nikos C , Reddy T B K
Published: October 2020

The Genomes OnLine Database (GOLD) (https://gold.jgi.doe.gov/) is a manually curated, daily updated collection of genome projects and their metadata accumulated from around the world. The current version of the database includes over 1.17 million entries organized broadly into Studies (45 770), Organisms (387 382) or Biosamples (101 207), Sequencing Projects (355 364) and Analysis Projects (283 481). These four levels contain over 600 metadata fields, which includes 76 controlled vocabulary (CV) tables containing 3873 terms. GOLD provides an interactive web user interface for browsing and searching by a wide range of project and metadata fields. Users can enter details about their own projects in GOLD, which acts as a gatekeeper to ensure that metadata is accurately documented before submitting sequence information to the Integrated Microbial Genomes (IMG) system for analysis. In order to maintain a reference dataset for use by members of the scientific community, GOLD also imports projects from public repositories such as GenBank and SRA. The current status of the database, along with recent updates and improvements are described in this manuscript.
Low Bladder Compliance in Women: A Clinical Overview
Authors: Arunachalam Divya , Heit Michael
Published: October 2020

(Abstracted from Female Pelvic Med Reconstr Surg 2020;26:263–269)

The ability of a normally functioning bladder to accommodate large volumes of urine is termed bladder compliance. Both the viscoelastic properties of the bladder wall and neural responses influence bladder storage.
An Approach to Integrating Exome Sequencing for Fetal Structural Anomalies Into Clinical Practice
Authors: Vora Neeta L. , Gilmore Kelly , Brandt Alicia , Gustafson Chelsea , Strande Natasha , Ramkissoon Lori , Hardisty Emily , Foreman Ann Katherine M. , Wilhelmsen Kirk , Owen Phillips , Weck Karen E. , Berg Jonathan S. , Powell Cynthia M. , Powell Bradford C.
Published: October 2020

(Abstracted from Genet Med 2020;22(5):954–961)

Prenatal ultrasound, karyotype, and microarray have become routine tools for the diagnosis of structural anomalies of the fetus. Gene panels are increasingly used as well, although the relatively limited prenatal information that is available regarding fetal phenotypes can make it difficult to choose the appropriate gene panel.
Associations Between Maternal Antenatal Corticosteroid Treatment and Mental and Behavioral Disorders in Children
Authors: Räikkönen Katri , Gissler Mika , Kajantie Eero
Published: October 2020

(Abstracted from JAMA 2020;323(19):1924–1933)

Antenatal corticosteroid therapy is the standard of care when birth is imminent before 34 weeks' gestation. In preterm infants, this therapy has been shown to reduce the risk of a number of complications including respiratory distress syndrome and intraventricular hemorrhage.
Prevention of Stillbirth: Impact of Two-Stage Screening for Vasa Previa
Authors: Zhang W. , Geris S. , Beta J. , Ramadan G. , Nicolaides K. H. , Akolekar R.
Published: October 2020

(Abstracted from Ultrasound Obstet Gynecol 2020;55:605–612)

Undiagnosed cases of vasa previa, the presence of fetal blood vessels unsupported by the placenta or umbilical cord, may pose a higher risk of stillbirth and neonatal mortality and morbidity. Prenatal screening and early diagnosis via ultrasound, which have been found to have high accuracy and low false-positive rates, may help to reduce this risk.
Term Complications and Subsequent Risk of Preterm Birth: Registry-Based Study
Authors: Kvalvik Liv G. , Wilcox Allen J. , Skjærven Rolv , Østbye Truls , Harmon Quaker E.
Published: October 2020

(Abstracted from BMJ 2020;369:m1007)

Preterm birth in a previous pregnancy is associated with future preterm delivery. This suggests that underlying factors may play a role in an individual's pregnancies.
Influence of three different anesthesia protocols on aged rat brain: a resting-state functional magnetic resonance imaging study
Authors: Liu Yang , Fu Hui-Qun , Wu Yan , Du Zun-Shu , Li Bo-Ran , Gao Xin , Lin Guan-Wen , Yang Shu-Yi , Wang Tian-Long
Published: October 2020

Background

Resting-state functional magnetic resonance imaging (rs-fMRI) is a promising method for the study of brain function. Typically, rs-fMRI is performed on anesthetized animals. Although different functional connectivity (FC) in various anesthetics on whole brain have been studied, few studies have focused on different FC in the aged brain. Here, we measured FC under three commonly used anesthesia methods and analyzed data to determine if the FC in whole brain analysis were similar among groups.

Methods

Twenty-four male aged Wistar rats were randomly divided into three groups (n = 8 in each group). Anesthesia was performed under either isoflurane (ISO), combined ISO + dexmedetomidine (DEX) or α-chloralose (AC) according to the groups. Data of rs-fMRI was analyzed by FC in a voxel-wise way. Differences in the FC maps between the groups were analyzed by one-way analysis of variance and post hoc two-sample t tests.

Results

Compared with ISO + DEX anesthesia, ISO anesthesia caused increased FC in posterior brain and decreased FC in the middle brain of the aged rat. AC anesthesia caused global suppression as no increase in FC was observed.

Conclusion

ISO could be used as a substitute for ISO + DEX in rat default mode network studies if the left temporal association cortex is not considered important.
Should Fetal Growth Charts Be References or Standards?
Authors: Hutcheon Jennifer A. , Liauw Jessica
Published: October 2020

Background:

Fetal growth standards (prescriptive charts derived from low-risk pregnancies) are theoretically better tools to monitor fetal growth than conventional references. We examined how modifying chart inclusion criteria influenced the resulting curves.

Methods:

We summarized estimated fetal weight (EFW) distributions from a hospital’s routine 32-week ultrasound in all nonanomalous singleton fetuses (reference) and in those without maternal–fetal conditions affecting fetal growth (standard). We calculated EFWs for the 3rd, 5th, 10th, and 50th percentiles, and the proportion of fetuses each chart classified as small for gestational age.

Results:

Of 2309 fetuses in our reference, 690 (30%) met the standard’s inclusion criteria. There were no meaningful differences between the EFW distributions of the reference and standard curves (50th percentile: 1989 g reference vs. 1968 g standard; 10th percentile: 1711 g reference vs. 1710 g standard), or the proportion of small for gestational age fetuses (both 9.9%).

Conclusions:

In our study, there was little practical difference between a fetal growth reference and standard for detecting small infants.
The placenta as the window to congenital heart disease
Authors: Cohen Jordan A. , Rychik Jack , Savla Jill J.
Published: October 2020

Purpose of review

There is an increasing recognition that structural abnormalities and functional changes in the placenta can have deleterious effects on the development of the fetal heart. This article reviews the role of the placenta and the potential impact of placental insufficiency on fetuses with congenital heart disease.

Recent findings

The fetal heart and the placenta are directly linked because they develop concurrently with shared regulatory and signaling pathways. Placental disease is more common in pregnancies carrying a fetus with congenital heart disease and the fetal response to placental insufficiency may lead to the postnatal persistence of cardiac remodeling. The mechanisms underlying this placental–fetal axis of interaction potentially include genetic factors, oxidative stress, chronic hypoxia, and/or angiogenic imbalance.

The maternal–placental–fetal circulation is critical to advancing our understanding of congenital heart disease. We must first expand our ability to detect, image, and quantify placental insufficiency and dysfunction in utero. Elucidating the modifiable factors involved in these pathways is an exciting opportunity for future research, which may enable us to improve outcomes in patients with congenital heart disease.
Systemic Hypertension in Pediatric Veno-Venous Extracorporeal Membrane Oxygenation
Authors: Rabinowitz Edon J. , McGregor Kailyn , O’Connor Nicole R. , Neumayr Tara M. , Said Ahmed S.
Published: October 2020

Systemic hypertension (HTN) is a recognized complication of veno-venous (VV) extracorporeal membrane oxygenation (ECMO) in children. We sought to determine the prevalence and associated features of HTN in a retrospective cohort of children (>1 year old) supported with VV ECMO from January 2015 to July 2019 at our institution. Patient and ECMO-related characteristics were reviewed, including intensive care unit (ICU) length of stay (LOS), ECMO duration, corticosteroids and nephrotoxic medication exposure, acute kidney injury (AKI), overall fluid balance, and transfusion data. We analyzed 23 children (43% female) with a median age of 8.5 years (interquartile range [IQR] = 4–14.5). Median ICU LOS was 26 days (IQR = 15–47) with a median ECMO duration of 288 hours (IQR = 106–378) and a mortality rate of 35%. HTN was diagnosed in 87% subjects at a median of 25 ECMO hours (IQR = 9–54) of whom 55% were hypertensive >50% of their ECMO duration. AKI and fluid overload were documented in >50% of cohort. All but two subjects received at least one nephrotoxic medication, and nearly all received corticosteroids. Our data demonstrate that HTN is present in a preponderance of children supported with VV ECMO and appears within the first 3 days of cannulation. Underlying etiology is likely multifactorial.
The Magnet® Site Visit: Going Virtual in Response to COVID-19
Authors: Curto Christine , Martin Deborah Maust
Published: October 2020

The coronavirus disease (COVID-19) pandemic has been a source of disruption, unexpected illness, stress, and adversity for people, worldwide. As the reality of the COVID-19 pandemic unfolded in early 2020, many healthcare organizations found themselves in the midst of their Magnet
®
appraisals—just short of the 3rd appraisal phase, the Site Visit Phase. In response, the Magnet Recognition Program
®
devised strategies to maintain the integrity of the appraisal process, despite the turbulence associated with the unexpected changes that healthcare organizations were confronting while contending with the impact of COVID-19. In this month's Magnet® Perspectives column, we explore how the virtual site visit has provided healthcare organizations with the opportunity to complete this phase of their appraisal process while addressing the safety and well-being of the organization's staff as well as that of the Magnet appraisers.
Craniosynostosis: Clinical Presentation, Genetics, and Prenatal Diagnosis
Authors: Brah Tara Kaur , Thind Ravneet , Abel David E.
Published: October 2020

Importance

Craniosynostosis is a fetal condition caused by premature closure of the cranial sutures. Through provider awareness, we can raise suspicion in high-risk individuals, increase prenatal detection, optimize genetic testing, perform appropriate antenatal surveillance and delivery planning, and allow for a comprehensive, multidisciplinary approach to treatment.

Objective

The aim of this study was to review what is currently known regarding the genetics, pathophysiology, diagnosis, and treatment of craniosynostosis for the obstetric care provider.

Evidence Acquisition

A comprehensive literature review was performed using the PubMed database with the search term “craniosynostosis.” The search was limited to the English language.

Results

A total of 220 articles were identified, and a total of 53 were used in completion of this article. The results highlight the multiple factors involved with abnormal suture formation, including various genetic factors. Although rare at this time, prenatal detection can allow families to prepare and practitioners to provide appropriate clinical treatment. Both 3-dimensional sonography and magnetic resonance imaging have been identified as modalities to aid in detection for high-risk individuals. Early referral allows for less-invasive surgical outcomes with lower complication rates.

Conclusions and Relevance

Familiarity with craniosynostosis among obstetric providers can improve patient counseling, prenatal detection rates, and appropriate antepartum, intrapartum, and postpartum counseling.

Target Audience

Obstetricians and gynecologists, family physicians

Learning Objectives

After participating in this CME activity, physicians should be better able to identify the various craniosynostosis syndromes and their genetic basis; describe the role of ultrasound and magnetic resonance imaging with respect to prenatal diagnosis; and summarize clinical management aims, including early referral and establishment of a multidisciplinary team.
Diagnosis and Management of Ectopic Pregnancy: A Comparative Review of Major National Guidelines
Authors: Tsakiridis Ioannis , Giouleka Sonia , Mamopoulos Apostolos , Athanasiadis Apostolos , Dagklis Themistoklis
Published: October 2020

Importance

Ectopic pregnancies (EPs) represent a severe early pregnancy complication that is associated with increased risks of maternal morbidity and mortality. Over the years, there has been a significant reduction in the mortality from this complication by improving the diagnostic tools and the treatment options.

Objective

The aim of this study was to review and compare the recommendations from published guidelines on this potentially fatal condition.

Evidence Acquisition

A descriptive review of guidelines from the Royal College of Obstetricians and Gynaecologists, the Royal College of Physicians of Ireland, the Society of Obstetricians and Gynaecologists of Canada, the American College of Obstetricians and Gynecologists, and the National Institute for Health and Care Excellence on EP was carried out.

Results

All the guidelines point out the crucial role of sonography in the prompt diagnosis of EP and describe similar sonographic findings. There is a consensus on the indications and contraindications to the use of methotrexate, the post-treatment surveillance, and the criteria of expectant management. The indications for a surgical approach are not well established, although the Royal College of Obstetricians and Gynaecologists, the Royal College of Physicians of Ireland, the American College of Obstetricians and Gynecologists, and the National Institute for Health and Care Excellence agree that a laparoscopy is preferred to laparotomy for hemodynamically stable patients. The latter is considered a better option only in emergency conditions. However, there is controversy in the recommended methotrexate protocols and the evaluation of β-human chorionic gonadotrophin and progesterone levels.

Conclusions

It is of paramount importance to build consistent international protocols, so as to help clinicians all over the world diagnose EPs in the most timely and accurate way and subsequently treat them effectively as a nonurgent medical condition, with the intention to lower the mortality and morbidity rate.

Target Audience

Obstetricians and gynecologists, family physicians.

Learning Objectives

After participating in this activity, the learner should be better able to explain all aspects of the diagnosis of tubal and nontubal EPs; identify the indications and contraindications to expectant, medical, or surgical management of EPs; and describe the appropriate management options for EPs.
Randomized Trial of Lactin-V to Prevent Recurrence of Bacterial Vaginosis
Authors: Cohen Craig R. , Wierzbicki Michael R. , French Audrey L. , Morris Sheldon , Newmann Sara , Reno Hilary , Green Lauri , Miller Steve , Powell Jonathan , Parks Thomas , Hemmerling Anke
Published: October 2020

(Abstracted from N Engl J Med 2020;382:1906–1915)

Worldwide, 15% to 50% of women of reproductive age have bacterial vaginosis (BV) and are treated with an antibiotic agent. Within 3 months after treatment, the infection recurs in 20% to 75% of women.
Association of Gestational Age at Birth With Risk of Perinatal Mortality and Special Educational Need Among Twins
Authors: Murray Sarah , MacKay Daniel , Stock Sarah , Pell Jill , Norman Jane
Published: October 2020

(Abstracted from JAMA Pediatr 2020;174(5):437–445)

Twin pregnancies are associated with higher rates of perinatal mortality and neonatal death and approximately 15% of admissions to neonatal and special care baby units. Current literature and policies are unclear on the ideal timing of birth for twins to optimize short-term clinical outcomes and long-term childhood outcomes, such as special education needs (SENs).
A Critical Assessment of Postneoadjuvant Therapy Pancreatic Cancer Regression Grading Schemes With a Proposal for a Novel Approach
Authors: Chou Angela , Ahadi Mahsa , Arena Jennifer , Sioson Loretta , Sheen Amy , Fuchs Talia L. , Pavlakis Nick , Clarke Stephen , Kneebone Andrew , Hruby George , Sahni Sumit , Mittal Anubhav , Samra Jaswinder , Gill Anthony J.
Published: October 2020

Currently, there is no consensus on the optimal tumor response score (TRS) system to assess regression in pancreatic cancers resected after neoadjuvant therapy. We developed a novel TRS (Royal North Shore [RNS] system) based on estimating the percentage of tumor bed occupied by viable cancer and categorized into 3 tiers: grade 1 (≤10%), grade 2 (11% to 75%), and grade 3 (>75%). We assessed 147 resected carcinomas with this and other TRS systems (College of American Pathologists [CAP], MD Anderson Cancer Center [MDACC], and Evans). The 3-tiered RNS system predicted median survival after surgery for grades 1, 2, and 3 of 54, 23, and 9 months, respectively (P<0.05). The CAP, MDACC, and Evans systems also predicted survival (P<0.05) but less consistently. The median survival for MDACC and CAP grade 0 (complete regression) was less than MDACC grade 1 and CAP grades 1 and 2. There was no difference in survival between CAP grades 2 and 3 (P=0.960), Evans grades 1 and 2a (P=0.395), and Evans grades 2a and 2b (P=0.587). Interobserver concordance was weak for CAP (κ=0.431), moderate for MDACC (κ=0.691), minimal for Evans (κ=0.307), and moderate to strong for RNS (κ=0.632 to 0.84). Of age, sex, size, stage, grade, perineural and vascular invasion, extrapancreatic extension, margin status, and RNS score, only RNS score, vascular invasion, and extrapancreatic extension predicted survival in univariate analysis. Only extrapancreatic extension (P=0.034) and RNS score (P<0.0001) remained significant in multivariate analysis. We conclude that the RNS system is a reproducible and powerful predictor of survival after resection for pancreatic cancers treated with neoadjuvant therapy and should be investigated in larger cohorts.