bluuebunny/crossref_metadata_2025 huggingface dataset:
Stereotactic Radiosurgery for Intracranial Noncavernous Sinus Benign Meningioma: International Stereotactic Radiosurgery Society Systematic Review, Meta-Analysis and Practice Guideline
Authors: Marchetti Marcello , Sahgal Arjun , De Salles Antonio A F , Levivier Marc , Ma Lijun , Paddick Ian , Pollock Bruce E , Regis Jean , Sheehan Jason , Suh John H , Yomo Shoji , Fariselli Laura
Published: April 2020

BACKGROUND

Stereotactic radiosurgery (SRS) for benign intracranial meningiomas is an established treatment.

OBJECTIVE

To summarize the literature and provide evidence-based practice guidelines on behalf of the International Stereotactic Radiosurgery Society (ISRS).

METHODS

Articles in English specific to SRS for benign intracranial meningioma, published from January 1964 to April 2018, were systematically reviewed. Three electronic databases, PubMed, EMBASE, and the Cochrane Central Register, were searched.

RESULTS

Out of the 2844 studies identified, 305 had a full text evaluation and 27 studies met the criteria to be included in this analysis. All but one were retrospective studies. The 10-yr local control (LC) rate ranged from 71% to 100%. The 10-yr progression-free-survival rate ranged from 55% to 97%. The prescription dose ranged typically between 12 and 15 Gy, delivered in a single fraction. Toxicity rate was generally low.

CONCLUSION

The current literature supporting SRS for benign intracranial meningioma lacks level I and II evidence. However, when summarizing the large number of level III studies, it is clear that SRS can be recommended as an effective evidence-based treatment option (recommendation level II) for grade 1 meningioma.
Pre-Employment MMPI-2 Measures and Later Psychological Injury-Related Absenteeism among Police Officers
Authors: Marshall Ruth E , Milligan-Saville Josie S , Steel Zachary , Bryant Richard A , Mitchell Philip B , Harvey Samuel B
Published: April 2020

Pre-employment screening to assess for psychological vulnerability is common in trauma-exposed occupations such as policing. However, the ability of such screening to predict those at increased risk of subsequent mental health problems has been questioned. The present study sought to investigate the ability of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) to predict absenteeism related to psychological injury in police officers. Pre-employment screening data from 1,399 sworn police officers was linked to organizational records. A total of 150 police officers who had taken at least 2 weeks’ sick leave with work-related mental health concerns were matched to 150 healthy controls. Conditional logistic regression was used to examine any association between MMPI-2 scales and psychological injury-related absenteeism. We found no evidence that elevations in the pre-employment MMPI-2 scores of police recruits were associated with an increased chance of future absenteeism as a result of psychological injury (P > 0.05). In addition, there was no evidence of an increased likelihood of psychological injury-related absenteeism among those with a higher number of positive pre-employment risk factors (P = 0.09). While the MMPI-2 may be able to predict different outcomes among police officers, it is important to note that based on these results, the MMPI-2, if used at pre-employment, is not able to predict later psychological injury-related absenteeism.
EXTREMELY LOW FREQUENCY ELECTROMAGNETIC FIELD EXPOSURE MEASUREMENT IN THE VICINITY OF WIND TURBINES
Authors: Alexias Aris , Kiouvrekis Yiannis , Tyrakis Charilaos , Alkhorayef Mohammed , Sulieman Abdelmoneim , Tsougos Ioannis , Theodorou Kiki , Kappas Constantin
Published: April 2020

Background

There is an exponential growth of public concern worldwide regarding the exposure to electromagnetic fields (EMF) generated by wind turbines. The high concern of the general population enhances the fact that EMF exposure remains a crucial issue that demands specific actions and reliable data to evaluate possible health hazards.

Materials and Methods

EMF exposure measurements were conducted in two wind farm (W/F) areas in Greece. The magnetic field strength concentrated in the proximity of 22 wind turbines (20 type of Gamesa Eolica Siemens of total power of 17 MW and 2 type of E53 Enercon, 800 KW each). Measurements were conducted using a Narda-NBM-550 basic unit (Narda Safety Test Solutions Company) using EHP-50F probe. The EMF exposure measurements were processed applying the weighted peak method (WPM), according to the 2013/35/EU Directive. WPM provides correction of the measured value of pulse signals, taking into account the phases of the various frequency components. The data were classified under two scenarios of EMF exposure: ‘high wind’ and ‘low wind’ conditions.

Results

The variation of the magnetic field strength was calculated between 1.13 and 1.42% (WPM). Measurements indicate that the intensity of the emitted magnetic field at the base of the wind turbines, in both high and low wind conditions, was relatively low (mean = 0.146 μT), while decreasing rapidly with increasing distance and reaching background values 6 m from the base.

Conclusion

The results of the present study indicate that EMF levels are similar or even lower compared to those in urban areas and well below the national and international safety limits.
Sources and Resources‘The NHS … Should not be Condemned to the History Books’: Public Engagement as a Method in Social Histories of Medicine
Authors: Crane Jennifer
Published: April 2020

This article explores the public engagement work of the Cultural History of the National Health Service (NHS) project, conducted at the University of Warwick between 2016 and 2019 and aiming to explore the meanings attached to Britain’s NHS over its 70-year history. The article situates public engagement as a critical methodology for social historians of medicine, exploring how events deepened this project’s understandings of post-war welfare, childhood treatments and activist cultures. Through reflection on these themes, the article emphasises that public engagement can generate rich new forms of qualitative testimony, complementing archival documents; point us towards ‘hidden archives’; and challenge cultural visions of historical research as ‘condemning’ or ‘celebrating’ its subjects. Finally, the article provides critical reflection on the challenges of such work and argues that engagement around health makes visible the broader research challenges of emotional intensity, personal and professional boundaries, and the hierarchies ingrained in academic research.
Translating Trauma-Informed Principles into Social Work Practice
Authors: Levenson Jill
Published: April 2020

Trauma-informed social work is characterized by client-centered practices that facilitate trust, safety, respect, collaboration, hope, and shared power. Many agencies have adopted trauma-informed care (TIC) initiatives and many social workers are familiar with its basic principles, but it is challenging to infuse these ideals into real-world service delivery. This article offers 10 trauma-informed practices (TIPs) for translating TIC concepts into action by (a) conceptualizing client problems, strengths, and coping strategies through the trauma lens and (b) responding in ways that avoid inadvertently reinforcing clients’ feelings of vulnerability and disempowerment (re-traumatization). TIPs guide workers to consider trauma as an explanation for client problems, incorporate knowledge about trauma into service delivery, understand trauma symptoms, transform trauma narratives, and use the helping relationship as a tool for healing.
Longitudinal Differences in Human Hippocampal Connectivity During Episodic Memory Processing
Authors: Choi Kyuwan , Bagen Lisa , Robinson Linley , Umbach Gray , Rugg Michael , Lega Bradley
Published: April 2020

The question of longitudinal hippocampal functional specialization is critical to human episodic memory because an accurate understanding of this phenomenon would impact theories of mnemonic function and entail practical consequences for the clinical management of patients undergoing temporal lobe surgery. The implementation of the robotically assisted stereo electroencephalography technique for seizure mapping has provided our group with the opportunity to obtain recordings simultaneously from the anterior and posterior human hippocampus, allowing us to create an unparalleled data set of human subjects with simultaneous anterior and posterior hippocampal recordings along with several cortical regions. Using these data, we address several key questions governing functional hippocampal connectivity in human memory. First, we ask whether functional networks during episodic memory encoding and retrieval are significantly different for the anterior versus posterior hippocampus (PH). We also examine how connections differ across the 2–5 Hz versus 4–9 Hz theta frequency ranges, directly addressing the relative contribution of each of these separate bands in hippocampal–cortical interactions. While we report some overlapping connections, we observe evidence of distinct anterior versus posterior hippocampal networks during memory encoding related to frontal and parietal connectivity as well as hemispheric differences in aggregate connectivity. We frame these findings in light of the proposed AT/PM memory systems. We also observe distinct encoding versus retrieval connectivity patterns between anterior and posterior hippocampal networks, we find that overall connectivity is greater for the PH in the right hemisphere, and further that these networks significantly differ in terms of frontal and parietal connectivity. We place these findings in the context of existing theoretical treatments of human memory systems, especially the proposed AT/PM system. During memory retrieval, we observe significant differences between slow-theta (2–5 Hz) and fast-theta (4–9 Hz) connectivity between the cortex and hippocampus. Taken together, our findings describe mnemonically relevant functional connectivity differences along the longitudinal axis of the human hippocampus that will inform interpretation of models of hippocampal function that seek to integrate rodent and human data.
Sporangiospore Viability and Oospore Production in the Spinach Downy Mildew Pathogen, Peronospora effusa
Authors: Dhillon Braham , Feng Chunda , Villarroel-Zeballos Maria Isabel , Castroagudin Vanina Lilian , Bhattarai Gehendra , Klosterman Steven J. , Correll James C.
Published: April 2020

Downy mildew of spinach, caused by the obligate pathogen Peronospora effusa, remains the most important constraint in the major spinach production areas in the United States. This disease can potentially be initiated by asexual sporangiospores via “green bridges”, sexually derived oospores from seed or soil, or dormant mycelium. However, the relative importance of the various types of primary inoculum is not well known. The ability of P. effusa sporangiospores to withstand abiotic stress, such as desiccation, and remain viable during short- and long-distance dispersal and the ability of oospores to germinate and infect seedlings remain unclear. Thus, the primary objectives of this research were to evaluate the impact of desiccation on sporangiospore survival and infection efficiency and examine occurrence, production, and germination of oospores. Results indicate that desiccation significantly reduces sporangiospore viability as well as infection potential. Leaf wetness duration of 4 h was needed for disease establishment by spinach downy mildew sporangiospores. Oospores were observed in leaves of numerous commercial spinach cultivars grown in California in 2018 and Arizona in 2019. Frequency of occurrence varied between the two states-years. The presence of opposite mating types in spinach production areas in the United States was demonstrated by pairing isolates in controlled crosses and producing oospores on detached leaves as well as intact plants. Information from the study of variables that affect sporangiospore viability and oospore production will help in improving our understanding of the epidemiology of this important pathogen, which has implications for management of spinach downy mildew.
Polyketide Synthase Gene Expression in Relation to Chloromonilicin and Melanin Production in Monilinia fructicola
Authors: Yu Fang-Yi , Chiu Chiu-Min , Lee Yue-Zhi , Lee Shiow-Ju , Chou Chien-Ming , You Bang-Jau , Hsieh Dai-Keng , Lee Maw-Rong , Lee Miin-Huey , Bostock Richard M.
Published: April 2020

Monilinia fructicola is a fungal pathogen of worldwide significance that causes brown rot of stone fruits. There are only few reports related to the production of biologically active polyketides by this pathogen. In this study, we examined an atypical M. fructicola strain TW5-4 that shows strong antimicrobial activity against various plant pathogens. TW5-4 also displays sparse growth in culture, low virulence, and higher levels of melanin compared with its albino mutant, TW5-4WM, and a wild-type strain Mf13-81. Antifungal compounds were extracted from TW5-4 and purified by thin-layer chromatography following visualization with an on-the-chromatogram inhibition assay. The principal antifungal compound was identified by linear ion trap mass spectrometry, high-resolution electro-spray ionization mass spectrometry, and proton nuclear magnetic resonance analyses as the polyketide chloromonilicin. Multiple M. fructicola polyketide synthase (PKS) sequences were then cloned by degenerate PCR and inverse PCR. Sequence analyses support presence of a 10-member PKS gene family in the M. fructicola genome. Analyses of PKS gene expression found no strong correlation between chloromonilicin production in culture and transcript levels of any of the PKS gene family members in mycelium of strains TW5-4, TW5-4WM, and Mf13-81. However, MfPKS12, a homolog of BcPKS12 involved in biosynthesis of 1,8-dihydroxynaphthalene (DHN)-melanin in Botrytis cinerea, was strongly expressed in mycelia of TW5-4 and Mf13-81. An MfPKS12-silenced mutant accumulated significantly less melanin in mycelia, had lower resistance to polyethylene glycol-induced osmotic stress, and displayed reduced virulence on nectarine fruit. The results suggest that DHN-melanin is required for tolerance to osmotic stress and full virulence in M. fructicola.
Identifying the Prescribing Physician in US Healthcare Claims Data
Authors: Der Jane S. , Brookhart M. Alan
Published: April 2020

Background:

Identifying the prescribing physician may be essential in studies that use health care claims databases but often there is no single consistent physician identifier (ID) available that spans an entire database and no standard methods have emerged to address this issue.

Methods:

Unique Drug Enforcement Administration (DEA) numbers (N=36,721) were identified from the pharmacy claims of a cohort of postmenopausal (55+) initiators of osteoporosis medications (2008–2011) in the United Healthcare database. The proportion of times a Provider ID appeared at least once on the outpatient medical service claims (OMSCs) in the 14 days before a new prescription (Rx) out of the total number of new Rxs for each DEA was calculated and the Provider ID with the highest proportion was considered the most likely match to the DEA. We used regression models to evaluate how characteristics of OMSCs (N=36,721) related to the probability that the provider would be the prescribing physician on a proximal pharmacy claim for each patient (N=20,058).

Results:

A total of 37,448,056 new Rxs and 132,135,673 OMSCs were associated with the DEAs. Family and general practitioner, hospitalist, and osteoporosis diagnoses were strong predictors of a match. Our models had sensitivities ranging from 81.9% to 82.8% and specificities ranging from 52.4% to 53.5%.

Conclusions:

Our algorithms were good at identifying matches for the prescribing physician according to our reference standard but may have included some false positives. Predicted probabilities from our models could be used in other databases where physician IDs are unavailable to help identify the prescriber.
A Novel Mutation in WAS Gene Causing a Phenotypic Presentation of Wiskott-Aldrich Syndrome: A Case Report
Authors: Ochfeld Elisa , Grayer Dannielle , Sharma Ruchika , Schneiderman Jennifer , Giordano Lisa , Makhija Melanie
Published: April 2020

Background:

Wiskott-Aldrich syndrome (WAS) is an X-linked disorder characterized by immunodeficiency, thrombocytopenia, and atopic dermatitis.

Observations:

This infant presented at birth with petechiae and bruising, with severe neonatal thrombocytopenia. Genetic testing for WAS revealed a variant of unknown significance hemizygous missense mutation in the WAS gene. This variant has not previously been reported. On the basis of the patient’s clinical course including bleeding, infection, abnormal immune evaluation, and dermatologic sequelae, he was diagnosed with WAS and underwent allogeneic hematopoietic stem cell transplantation.

Conclusions:

We report a novel mutation in the WAS gene that causes a phenotypic presentation of Wiskott-Aldrich Syndrome.
Chemotherapy-Induced Peripheral Neuropathy
Authors: Kanzawa-Lee Grace A.
Published: April 2020

Chemotherapy-induced peripheral neuropathy (CIPN) is an unsolved and potentially life-compromising problem for most patients receiving neurotoxic chemotherapy. It manifests with numbness, tingling, and possibly neuropathic pain and motor and autonomic symptoms. This review aims to provide an evidence synthesis that prepares nurses to comprehensively assess, provide supportive care for, and critically evaluate the literature on CIPN. The prevalence, significance, characteristics, mechanisms, and risk factors of CIPN will be discussed, as well as nursing-relevant evidence on the assessment, prevention, and management of CIPN. The importance of critical literature evaluation before clinical implementation to reduce physical and financial harms to patients will also be highlighted.
The Effect of Immediate Versus Delayed Port Access on 30-Day Infection Rate
Authors: Tancredi Tyler S. , Kissane Jennifer L. , Lynch Frank C. , Li Menghan , Kong Lan , Waybill Peter N.
Published: April 2020

This study compared the 30-day infection risk of chest ports accessed on the same day as placement and chest ports with delayed initial access. The aim was to evaluate a larger data set that provided evidence for the development of port access guidelines. A retrospective chart review of 3322 chest port placement procedures performed between October 15, 2003, and June 10, 2015, was conducted at the interventional radiology department of a single institution. Procedure notes and health records were reviewed to determine time of initial port access, evidence of infection within a 30-day window of port placement, and causal organism(s) of infection. The results demonstrated that 64 ports (1.93%) met infection criteria within 30 days of placement, including 30 of the 945 ports immediately accessed and 34 of the 2377 ports not immediately accessed (3.17% vs 1.43%; P < .005). Dual lumen devices had a statistically significant higher rate of infection compared with single lumen devices (P = .006). This study concluded that there is a statistically significant higher rate of infection if a port is accessed immediately versus when access is deferred to later than 24 hours after placement.
Review of the Association Between Number of Social Roles and Cardiovascular Disease: Graded or Threshold Effect?
Authors: Chin Brian , Cohen Sheldon
Published: April 2020

Objective

There is increasing evidence for an inverse association between the number of social roles (e.g., spouse, friend, and neighbor) we engage in and our risk of disease, especially cardiovascular disease (CVD). Two mechanistic models have been proposed to explain this association. The social integration model refers to a graded association where every additional social role is associated with an increase in resistance to disease. The social isolation model refers to a threshold effect where the lack of a minimal criterion number of roles increases risk of disease.

Methods

We conducted a systematic review of prospective studies examining the association between number of social roles and CVD risk.

Results

When we include all studies assessing number of social roles, irrespective of whether associations are attributable to graded effects (social integration) and threshold effects (social isolation) or cannot be determined by the data presented, those holding fewer social roles were found to be at greater risk of CVD incidence, CVD mortality (evidence stronger for men than women), and greater progression of disease (only for short [≤5 years] follow-ups). However, closer analyses indicate that the association between a greater number of social roles and decreased CVD incidence was attributable to graded effects among men but to both effects among women. In contrast, the association of number of social roles and disease progression was driven by threshold effects (social isolation) for both sexes, whereas mortality studies included evidence for both effects.

Conclusions

These results suggest underlying mechanisms linking social roles to different CVD outcomes.
Frailty transitions, inflammation, and mortality among persons aging with HIV infection and injection drug use
Authors: Piggott Damani A. , Bandeen-Roche Karen , Mehta Shruti H. , Brown Todd T. , Yang Huanle , Walston Jeremy D. , Leng Sean X. , Kirk Gregory D.
Published: April 2020

Objective:

Frailty is a critical aging-related syndrome marked by diminished physiologic reserve and heightened vulnerability to stress, predictive of major adverse clinical outcomes in HIV-infected and uninfected adults. Frailty is a dynamic state, yet little data exist on predictors and consequences of frailty transitions.

Design/methods:

Frailty was assessed semiannually among HIV-infected and uninfected persons with prior injection drug use using the five Fried phenotype domains. An inflammatory index score was constructed from IL-6 and soluble TNF-α receptor-1 data. Markov transition models assessed determinants of frailty transitions. Cox proportional hazards models estimated mortality risk.

Results:

Among 1353 AIDS Linked to the IntraVenous Experience participants with 9559 frailty transition assessments, 33% were HIV-infected. Younger age, higher education, employment, reduced comorbidity, HIV virologic suppression, elevated CD4+ nadir (>500 cells/μl) and absence of a prior AIDS diagnosis were significantly associated with both reduced frailty progression and greater frailty recovery. Each SD decrease in inflammatory index score was associated with decreased frailty progression [odds ratio 0.78; 95% confidence interval (CI), 0.65, 0.92] and increased frailty recovery (odds ratio 1.29; 95% CI, 1.08, 1.53). Being frail at one of two consecutive visits was associated with increased mortality, compared with maintenance of a nonfrail state. Being frail at both of two consecutive visits demonstrated the highest mortality risk (hazard ratio 3.23; 95% CI, 2.1, 4.96).

Conclusion:

Sustained, and to a lesser degree, intermittent frail states are associated with increased mortality. HIV virologic suppression with earlier antiretroviral therapy, reduced comorbidity, and reduced inflammation may prevent frailty progression and promote frailty recovery, consequently improving survival for persons aging with HIV and persons with prior injection drug use.
Who are the persons living with HIV who might refuse to participate in HIV cure-related clinical trials with treatment interruption?
Authors: Protiere Christel , Fiorentino Marion , Sow Abdourahmane , Préau Marie , Mora Marion , Fressard Lisa , Meyer Laurence , Lelièvre Jean-Daniel , Lambotte Olivier , Spire Bruno , Suzan-Monti Marie
Published: April 2020

Achieving a HIV cure has become a research priority. As any improvement of knowledge, which could help scientists design new HIV cure-related clinical trials (HCRCT) depends on the risks potential participants are willing to accept, it is important to understand who will agree or refuse to participate and in which proportions. By providing insights into factors associated with reluctance toward HCRCT participation, our results may help clinicians in patient recruitment.
What are the situational and behavioral factors associated with condomless anal sex without pre-exposure prophylaxis in MSM?
Authors: Di Ciaccio Marion , Sagaon-Teyssier Luis , Mimi Mohamed , Suzan-Monti Marie , Protiere Christel , Castro Daniela Rojas , Meyer Laurence , Tremblay Cécile , Chidiac Christian , Capitant Catherine , Préau Marie , Molina Jean-Michel , Spire Bruno
Published: April 2020

Objective:

This study aimed to identify situational and behavioral factors associated with condomless anal sex without on-demand PrEP in the open-label extension (OLE) study of the ANRS-IPERGAY trial.

Methods:

Univariable and multivariable modified Poisson regressions with a generalized estimating equation (GEE) were used. The attributable risk percentage for each explanatory variable and for condomless anal sex without PrEP was calculated.

Results:

In the OLE, 19% of anal intercourses were unprotected (i.e. no PrEP or condom). Of these, 85% were attributable to sexual intercourse with main partners and 47% with HIV-negative partners. The following factors were positively associated with condomless anal sex without PrEP: a depressive episode in the previous 12 months [aR (95% CI), P-value: 1.49 (1.02--2.17), 0.039], a higher number of sexual intercourses during the previous 4 weeks [1.01 [1.002--1.02], 0.014], and sexual intercourses under the influence of alcohol [1.45 (1.10--1.92), 0.008]. By contrast, condomless anal sex without PrEP was less frequent during sexual intercourses with known casual, unknown casual and multiple partners [0.20 (0.14--0.30), <0.001; 0.10 (0.05--0.20), <0.001; 0.11 (0.05--0.29), <0.001, respectively], as well as with HIV+ partners with an undetectable viral load and HIV+ partners with a detectable/unknown viral load or unknown serology status [0.57 (0.38--0.86), 0.007; 0.52 (0.32--0.87), 0.012, respectively].

Conclusion:

Choosing to have condomless anal sex without PrEP depends primarily on the sexual partner's characteristics (level of intimacy, serological status). This reflects a form of rationality in HIV risk management. However, our results raise questions about the true efficacy of managing HIV risk using this approach.
Radical Resection Versus Simple Cholecystectomy for Gallbladder Carcinoma: A Systematic Review and Meta-analysis
Authors: Liang Yu-Chuan , Li Shi-Gong , Wang Jin-Yan
Published: April 2020

Purpose:

The goal of this study was to review relevant randomized controlled trials or case-control studies to determine radical resection compared with simple cholecystectomy for gallbladder carcinoma.

Methods:

Using appropriate keywords, we identified relevant studies using PubMed, the Cochrane Library, and Embase. Key pertinent sources in the literature were also reviewed, and all articles published through September 2019 were considered for inclusion. For each study, we assessed odds ratios, mean difference, and 95% confidence interval (CI) to assess and synthesize outcomes.

Results:

We included 19 studies with a total of 1791 patients in the radical resection group and 3014 in the simple cholecystectomy group. Compared with simple cholecystectomy, radical resection significantly improved the 5-year disease-free survival rate [relative risk (RR): 1.36, 95% CI: 1.02-1.81], the 1-year overall survival (OS) rate (RR: 1.27, 95% CI: 1.04-1.54), and the 3-year OS rate (RR: 1.71, 95% CI: 1.02-2.85). However, there was no significant difference in the recurrence rate (RR: 1.04, 95% CI: 0.87-1.23), and in the 5-year OS rate (RR: 1.05, 95% CI: 0.92-1.19) between the 2 groups.

Conclusion:

Compared with simple cholecystectomy, radical resection has advantages in improving the 5-year disease-free survival rate, and the 1- and 3-year OS rate of gallbladder carcinoma patients.
Evolution From the U-shaped to Keyhole-shaped Mesh Configuration in the Repair of Paraesophageal and Recurrent Hiatal Hernia
Authors: Keville Sarah , Rabach Lauren , Saad Adham R. , Montera Beth , Velanovich Vic
Published: April 2020

Background:

Paraesophageal hernia (PEH) and recurrent hiatal hernia (RHH) are prone to recurrences. One adjunct used to reduce recurrences is mesh reinforcement. The optimal configuration is yet to be determined. We present our evolution from the U-shaped to the keyhole pattern.

Methods:

All patients undergoing PEH/RHH repair with mesh between 2013 and 2019 were reviewed for demographic information, perioperative/intraoperative details, postoperative complications, and recurrences.

Results:

Of patients undergoing PEH/RHH repair between 2013 and 2019, 138 were repaired using mesh. Of these, 88 were repaired using the U-shaped configuration and 50 using the keyhole configuration. The U-shaped configuration was used for PEH in 72% and RHH in 28%, while the keyhole configuration was used for PEH in 66% and RHH in 34%. Thirty patients suffered postoperative complications, although there was no difference between the groups. Overall, 28 patients in the U-shaped configuration group (31.8%) had a recurrence of their hiatal hernia identified, compared with 7 patients (14.6%) in the keyhole group (P=0.039). The median time to last follow-up was 21 months (range: 1 to 85) in the U-shaped group and 8 months (range: 1 to 23) in the keyhole group. There was no difference in median time to recurrence, postoperative dysphagia, dilations, or strictures.

Conclusions:

The keyhole pattern mesh was not associated with a higher complication rate compared with the U-shape pattern. Although this study was not a direct comparison between the configurations, it does suggest that the keyhole pattern may lead to fewer recurrences.
Brilliant angle-independent structural colours preserved in weevil scales from the Swiss Pleistocene
Authors: McDonald Luke T. , Narayanan Suresh , Sandy Alec , Saranathan Vinodkumar , McNamara Maria E.
Published: April 2020

Extant weevils exhibit a remarkable colour palette that ranges from muted monochromatic tones to rainbow-like iridescence, with the most vibrant colours produced by three-dimensional photonic nanostructures housed within cuticular scales. Although the optical properties of these nanostructures are well understood, their evolutionary history is not fully resolved, in part due to a poor knowledge of their fossil record. Here, we report three-dimensional photonic nanostructures preserved in brightly coloured scales of two weevils, belonging to the genusPhyllobiusorPolydrusus, from the Pleistocene (16–10 ka) of Switzerland. The scales display vibrant blue, green and yellow hues that resemble those of extantPhyllobius/Polydrusus. Scanning electron microscopy and small-angle X-ray scattering analyses reveal that the subfossil scales possess a single-diamond photonic crystal nanostructure. In extantPhyllobius/Polydrusus, the near-angle-independent blue and green hues function primarily in crypsis. The preservation of far-field, angle-independent structural colours in the Swiss subfossil weevils and their likely function in substrate matching confirm the importance of investigating fossil and subfossil photonic nanostructures to understand the evolutionary origins and diversification of colours and associated behaviours (e.g. crypsis) in insects.
Discretization of the Bloch sphere, fractal invariant sets and Bell’s theorem
Authors: Palmer T. N.
Published: April 2020

An arbitrarily dense discretization of the Bloch sphere of complex Hilbert states is constructed, where points correspond to bit strings of fixed finite length. Number-theoretic properties of trigonometric functions (not part of the quantum-theoretic canon) are used to show that this constructive discretized representation incorporates many of the defining characteristics of quantum systems: completementarity, uncertainty relationships and (with a simple Cartesian product of discretized spheres) entanglement. Unlike Meyer’s earlier discretization of the Bloch Sphere, there are no orthonormal triples, hence the Kocken–Specker theorem is not nullified. A physical interpretation of points on the discretized Bloch sphere is given in terms of ensembles of trajectories on a dynamically invariant fractal set in state space, where states of physical reality correspond to points on the invariant set. This deterministic construction provides a new way to understand the violation of the Bell inequality without violating statistical independence or factorization, where these conditions are defined solely from states on the invariant set. In this finite representation, there is an upper limit to the number of qubits that can be entangled, a property with potential experimental consequences.
Calcium channel blocker amlodipine besylate is associated with reduced case fatality rate of COVID-19 patients with hypertension
Authors: Zhang Lei-Ke , Sun Yuan , Zeng Haolong , Peng Yudong , Jiang Xiaming , Shang Wei-Juan , Wu Yan , Li Shufen , Zhang Yu-Lan , Yang Liu , Chen Hongbo , Jin Runming , Liu Wei , Li Hao , Peng Ke , Xiao Gengfu
Published: April 2020

The coronavirus disease (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has now spread to more than 100 countries posing as a serious threat to the public health on a global scale. Patients with comorbidity such as hypertension suffer more severe infection with elevated case fatality rate. Development of effective anti-viral drug is in urgent need to treat COVID-19 patients. Here we report that calcium channel blockers (CCBs), a type of anti-hypertension drugs that are widely used in the clinics, can significantly inhibit the post-entry replication events of SARS-CoV-2 in vitro. Comparison with two other major types of anti-hypertension drugs, the angiotensin converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB), showed that only CCBs display significant anti-SARS-CoV-2 efficacy. Combined treatment with chloroquine and CCBs significantly enhanced the anti-SARS-CoV-2 efficacy. Retrospective clinical investigation of COVID-19 patients revealed that the CCB amlodipine besylate administration was associated with reduced case fatality rate of patients with hypertension. Results from this study suggest that CCB administration for COVID-19 patients with hypertension as the comorbidity might improve the disease outcome.
De-identifying Spanish medical texts - Named Entity Recognition applied to radiology reports
Authors: Pérez-Díez Irene , Pérez-Moraga Raúl , López-Cerdán Adolfo , Caparrós Redondo Marisa , Salinas-Serrano Jose-Maria , de la Iglesia-Vayá María
Published: April 2020

Medical texts such as radiology reports or electronic health records are a powerful source of data for researchers. Anonymization methods must be developed to de-identify documents containing personal information from both patients and medical staff. Although currently there are several anonymization strategies for the English language, they are also language-dependent. Here, we introduce a named entity recognition strategy for Spanish medical texts, translatable to other languages. We tested 4 neural networks on our radiology reports dataset, achieving a recall of 97.18% of the identifying entities. Along-side, we developed a randomization algorithm to substitute the detected entities with new ones from the same category, making it virtually impossible to differentiate real data from synthetic data. The three best architectures were tested with the MEDDOCAN challenge dataset of electronic health records as an external test, achieving a recall of 69.18%. The strategy proposed, combining named entity recognition tasks with randomization of entities, is suitable for Spanish radiology reports. It does not require a big training corpus, thus it can be easily extended to other languages and medical texts, such as electronic health records.
Chasing the ghost of infection past: identifying thresholds of change during the COVID-19 infection in Spain
Authors: Santamaría Luis , Hortal Joaquín
Published: April 2020

COVID-19 pandemic has spread worldwide rapidly from its first outbreak in China, with different impacts depending on the age and social structure of the populations, and the measures taken by each government. Within Europe, the first countries to be strongly affected have been Italy and Spain. In Spain, infection has expanded in highly populated areas, resulting in one of the largest nationwide bursts so far by early April. We analyze the evolution of the growth curve of the epidemic in both the whole of Spain, Madrid Autonomous Region (the second largest conurbation in Europe), and Catalonia (which includes Spain’s second largest city), based on the cumulative numbers of reported cases and deaths. We conducted segmented, poisson regressions on log-transformed data to identify changes in the slope of these curves and/or sudden shifts in the number of cases (i.e. changes in the intercept) at fitted breaking points, and compared their results with a timeline including both key events of the epidemic and containment measures taken by the national and regional governments. Results were largely consistent in the six curves analyzed (reported infections and deaths for Spain, Madrid and Catalonia, respectively), showing three major clusters of shifts in slopes (growth rates) on March 13-19, March 23-29 and April 1-5 that resulted in 33-71% reductions of slope, and originated in infections on March 3-9, 13-19 and 22-26; as well as a decrease in the infection rate following the strengthened lockdown of 29-30 April, only for Madrid and Catalonia. Small upward shifts in the progress of the disease in Madrid were not associated with significant increases in the intercept of the curve, and seem related with unevenness in case reporting; but they did so in Spain and Catalonia, where they were probably associated to specific events of group infection in Vitoria and to the onset of the outbreak in Catalonia. These results evidence an early deceleration in the spread of COVID-19 coinciding with personal hygiene and social distancing recommendations, as well as the general awareness of the population; and a second, stronger decrease when harder isolation measures were enforced. The combination of these two inflection points seemingly led to the start of the contention of the disease outbreak by early April, the limit of our time series. This highlights the importance of adopting public health strategies that include disseminating basic knowledge on personal hygiene and reduced social contact at the onset of the epidemic, and the importance of early enforcement of hard confinement measures for its subsequent contention.
Viral Mutations as a Possible Mechanism of Hidden Immunization and Containment of a Pandemia
Authors: Dimaschko Juri , Podolsky Victor
Published: April 2020

An impact of viral mutations on the extent of an epidemic is examined. A mechanism of immunization of the population via spread of weakly mutated strain as a natural factor terminating the epidemic is indicated. An epidemic model which details this mechanism is proposed.
Forecasting the scale of the COVID-19 epidemic in Kenya
Authors: Brand Samuel P. C. , Aziza Rabia , Kombe Ivy K. , Agoti Charles N. , Hilton Joe , Rock Kat S. , Parisi Andrea , Nokes D. James , Keeling Matt J. , Barasa Edwine W.
Published: April 2020

Background

The first COVID-19 case in Kenya was confirmed on March 13th, 2020. Here, we provide forecasts for the potential incidence rate, and magnitude, of a COVID-19 epidemic in Kenya based on the observed growth rate and age distribution of confirmed COVID-19 cases observed in China, whilst accounting for the demographic and geographic dissimilarities between China and Kenya.

Methods

We developed a modelling framework to simulate SARS-CoV-2 transmission in Kenya, KenyaCoV. KenyaCoV was used to simulate SARS-CoV-2 transmission both within, and between, different Kenyan regions and age groups. KenyaCoV was parameterized using a combination of human mobility data between the defined regions, the recent 2019 Kenyan census, and estimates of age group social interaction rates specific to Kenya. Key epidemiological characteristics such as the basic reproductive number and the age-specific rate of developing COVID-19 symptoms after infection with SARS-CoV-2, were adapted for the Kenyan setting from a combination of published estimates and analysis of the age distribution of cases observed in the Chinese outbreak.

Results

We find that if person-to-person transmission becomes established within Kenya, identifying the role of subclinical, and therefore largely undetected, infected individuals is critical to predicting and containing a very significant epidemic. Depending on the transmission scenario our reproductive number estimates for Kenya range from 1.78 (95% CI 1.44 −2.14) to 3.46 (95% CI 2.81-4.17). In scenarios where asymptomatic infected individuals are transmitting significantly, we expect a rapidly growing epidemic which cannot be contained only by case isolation. In these scenarios, there is potential for a very high percentage of the population becoming infected (median estimates: >80% over six months), and a significant epidemic of symptomatic COVID-19 cases. Exceptional social distancing measures can slow transmission, flattening the epidemic curve, but the risk of epidemic rebound after lifting restrictions is predicted to be high.
Histology-based average template of the marmoset cortex with probabilistic localization of cytoarchitectural areas
Authors: Majka Piotr , Bednarek Sylwia , Chan Jonathan M. , Jermakow Natalia , Liu Cirong , Saworska Gabriela , Worthy Katrina H. , Silva Afonso C. , Wójcik Daniel K. , Rosa Marcello G.P.
Published: April 2020

The rapid adoption of marmosets in neuroscience has created a demand for three dimensional (3D) atlases of the brain of this species to facilitate data integration in a common reference space. We report on a new open access template of the marmoset cortex (the Nencki–Monash, or NM template), representing a morphological average of 20 brains of young adult individuals, obtained by 3D reconstructions generated from Nissl-stained serial sections. The method used to generate the template takes into account morphological features of the individual brains, as well as the borders of clearly defined cytoarchitectural areas. This has resulted in a resource which allows direct estimates of the most likely coordinates of each cortical area, as well as quantification of the margins of error involved in assigning voxels to areas, and preserves quantitative information about the laminar structure of the cortex. We provide spatial transformations between the NM and other available marmoset brain templates, thus enabling integration with magnetic resonance imaging (MRI) and tracer-based connectivity data. The NM template combines some of the main advantages of histology-based atlases (e.g. information about the cytoarchitectural structure) with features more commonly associated with MRI-based templates (isotropic nature of the dataset, and probabilistic analyses). The underlying workflow may be found useful in the future development of brain atlases that incorporate information about the variability of areas in species for which it may be impractical to ensure homogeneity of the sample in terms of age, sex and genetic background.

Graphical abstract

Highlights

A 3D template of the marmoset cortex representing the average of 20 individuals.

The template is based on Nissl stain and preserves information about cortical layers.

Probabilistic mapping of areas, cortical thickness, and layer intensity profiles.

Includes spatial transformations to other marmoset brain atlases.

Abbreviations

For a list of areas and their abbreviations see Table S2.
Melanocortin-1 receptor (MC1R) genotypes do not correlate with size in two cohorts of medium-to-giant congenital melanocytic nevi
Authors: Calbet-Llopart Neus , Pascini-Garrigos Mirella , Tell-Martí Gemma , Potrony Miriam , da Silva Vanessa Martins , Barreiro Alicia , Puig Susana , Captier Guillaume , James Isabelle , Degardin Nathalie , Carrera Cristina , Malvehy Josep , Etchevers Heather C. , Puig-Butillé Joan Anton
Published: April 2020

Congenital melanocytic nevi (CMN) are cutaneous malformations whose prevalence is inversely correlated with projected adult size. CMN are caused by somatic mutations, but epidemiological studies suggest that germline genetic factors may influence CMN development. In CMN patients from the U.K., genetic variants in the MC1R gene, such as p.V92M and loss-of-function variants, have been previously associated with larger CMN. We analyzed the association of MC1R variants with CMN characteristics in 113 medium-to-giant CMN patients from Spain and from a distinct cohort of 53 patients from France, Norway, Canada and the U.S. These cohorts were similar at the clinical and phenotypical level, except for the number of nevi per patient. We found that the p.V92M or loss-of-function MC1R variants either alone or in combination did not correlate with CMN size, in contrast to the U.K. CMN patients. An additional case-control analysis with 259 unaffected Spanish individuals, showed a higher frequency of MC1R compound heterozygous or homozygous variant genotypes in Spanish CMN patients compared to the control population (15.9% vs. 9.3%; P=0.075). Altogether, this study suggests that MC1R variants are not associated with CMN size in these non-U.K. cohorts. Additional studies are required to define the potential role of MC1R as a risk factor in CMN development.

SIGNIFICANCE

Congenital melanocytic nevi (CMN) are common pigmented lesions that originate during prenatal life, without clear evidence of a genetic predisposition. To date, limited data exist regarding the role of the MC1R gene, a key regulator of human pigmentation, in the development of the class of rarer CMN that are greater than 10 cm diameter at projected adult size and associated with increased morbidity or mortality risks. This study provides data from a large set of such CMN patients to support the hypothesis that MC1R could be involved in the development of these types of lesions, but at the same time discounting its influence on the size of CMN across distinct populations. Improving our understanding of genetic susceptibility to rare types of CMN is necessary to determine whether routine germline genotyping is relevant in clinical practice.