bluuebunny/crossref_metadata_2025 huggingface dataset:
A MeerKAT survey of nearby nova-like cataclysmic variables
Authors: Hewitt D M , Pretorius M L , Woudt P A , Tremou E , Miller-Jones J C A , Knigge C , Castro Segura N , Williams D R A , Fender R P , Armstrong R , Groot P , Heywood I , Horesh A , van der Horst A J , Koerding E , McBride V A , Mooley K P , Rowlinson A , Stappers B , Wijers R A M J
Published: June 2020

We present the results of MeerKAT radio observations of 11 nearby nova-like cataclysmic variables (CVs). We have detected radio emission from IM Eri, RW Sex, V3885 Sgr, and V603 Aql. While RW Sex, V3885 Sgr, and V603 Aql had been previously detected, this is the first reported radio detection of IM Eri. Our observations have doubled the sample of non-magnetic CVs with sensitive radio data. We observe that at our radio detection limits, a specific optical luminosity ${\gtrsim}2.2\times 10^{18}\,$ erg s−1 Hz−1 (corresponding to MV ≲ 6.0) is required to produce a radio detection. We also observe that the X-ray and radio luminosities of our detected nova-like CVs are on an extension of the $L_X\propto L_R^{\sim 0.7}$ power law originally proposed for non-pulsating neutron star low-mass X-ray binaries. We find no other correlations between the radio emission and emission in other wavebands or any other system parameters for the existing sample of radio-detected non-magnetic CVs. We measure in-band (0.9–1.7 GHz) radio spectral indices that are consistent with reports from earlier work. Finally, we constructed broad spectral energy distributions for our sample from published multiwavelength data, and use them to place constraints on the mass transfer rates of these systems.
Pervasive Selection against MicroRNA Target Sites in Human Populations
Authors: Hatlen Andrea , Marco Antonio
Published: June 2020

MicroRNA target sites are often conserved during evolution and purifying selection to maintain such sites is expected. On the other hand, comparative analyses identified a paucity of microRNA target sites in coexpressed transcripts, and novel target sites can potentially be deleterious. We proposed that selection against novel target sites pervasive. The analysis of derived allele frequencies revealed that, when the derived allele is a target site, the proportion of nontarget sites is higher than expected, particularly for highly expressed microRNAs. Thus, new alleles generating novel microRNA target sites can be deleterious and selected against. When we analyzed ancestral target sites, the derived (nontarget) allele frequency does not show statistical support for microRNA target allele conservation. We investigated the joint effects of microRNA conservation and expression and found that selection against microRNA target sites depends mostly on the expression level of the microRNA. We identified microRNA target sites with relatively high levels of population differentiation. However, when we analyze separately target sites in which the target allele is ancestral to the population, the proportion of single-nucleotide polymorphisms with high Fst significantly increases. These findings support that population differentiation is more likely in target sites that are lost than in the gain of new target sites. Our results indicate that selection against novel microRNA target sites is prevalent and, although individual sites may have a weak selective pressure, the overall effect across untranslated regions is not negligible and should be accounted when studying the evolution of genomic sequences.
Gender, Power and Privilege in the Parliamentary Workplace
Authors: Erikson Josefina , Verge Tània
Published: June 2020

This introduction to the Special Section ‘Parliaments as workplaces: gendered approaches to the study of legislatures’ makes the case for revisiting the conditions under which male and female Members of Parliament (MPs) and staff carry out their parliamentary duties, thereby furthering the understanding of parliaments’ inner workings. It shows that adopting a workplace perspective grounded on feminist institutionalist analyses and gender organisational studies opens up new avenues for studying parliaments and the outcomes of political representation. The article then outlines how contributors to this Special Section deal with various aspects of the parliamentary workplace and concludes by highlighting the wider implications of this perspective for examining crucial questions of the parliamentary studies research agenda.
On the First Hochschild Cohomology of Cocommutative Hopf Algebras of Finite Representation Type
Authors: Chang Hao
Published: June 2020

Let $\mathscr{B}_0({\mathcal{G}})\subseteq k\,{\mathcal{G}}$ be the principal block algebra of the group algebra $k\,{\mathcal{G}}$ of an infinitesimal group scheme ${\mathcal{G}}$ over an algebraically closed field $k$ of characteristic ${\operatorname{char}}(k)=:p\geq 3$. We calculate the restricted Lie algebra structure of the first Hochschild cohomology ${\mathcal{L}}:={\operatorname{H}}^1(\mathscr{B}_0({\mathcal{G}}),\mathscr{B}_0({\mathcal{G}}))$ whenever $\mathscr{B}_0({\mathcal{G}})$ has finite representation type. As a consequence, we prove that the complexity of the trivial ${\mathcal{G}}$-module $k$ coincides with the maximal toral rank of ${\mathcal{L}}$.
COMPARISON OF EXPERIMENTAL AND NUMERICAL METHODS OF PATIENT DOSE ESTIMATIONS IN CT USING ANTHROPOMORPHIC MODELS
Authors: Fehrmann M L , Schegerer A , Werncke T , Schlattl H
Published: June 2020

The common methods for patient dose estimations in computed tomography (CT) are thermoluminescence dosemeter (TLD) measurements or the usage of software packages based on Monte Carlo simulations like CT-Expo or the newer CTVoxDos, which uses the ICRP Reference Adult Male (ICRP 110). Organ (OD) and effective doses of a CT protocol of the upper abdomen are compared. Compared to CTVoxDos, ODs inferred by TLD measurement using an anthropomorphic phantom differ by $\mathbf{(19\pm 16)\,\%}$ inside the primary radiation field, $\mathbf{(14\pm 2)\,\%}$ for partially primary irradiated organs and $\mathbf{(34\pm 38)\,\%}$ in the scattered radiation field. ODs estimated by CT-Expo show a mean deviation of $\mathbf{(16\pm 9)\,\%}$ (primary irradiated) and $\mathbf{(28\pm 31)\,\%}$ (scatter irradiated) from ODs estimated by CTVoxDos.
Demand for Information, Uncertainty, and the Response of U.S. Treasury Securities to News
Authors: Benamar Hedi , Foucault Thierry , Vega Clara
Published: June 2020

We use clickstream data to show that investors’ demand for information about macroeconomic factors affecting the path of future interest rates is a measure of their uncertainty about this path. In particular, an increase in information demand ahead of influential economic announcements affecting investors’ beliefs about future interest rates predicts a stronger reaction of U.S. Treasury note yields to these announcements, as it should if information demand positively covaries with uncertainty. This relationship does not vanish after using standard measures of uncertainty as predictors, suggesting that clickstream data contain unique information about investors’ uncertainty.
Hyperactive ACC-MDT Pathway Suppresses Prepulse Inhibition in Mice
Authors: Kim Yangsik , Noh Young Woo , Kim Kyungdeok , Kim Eunjoon
Published: June 2020

Altered prepulse inhibition (PPI) is an endophenotype associated with multiple brain disorders, including schizophrenia. Circuit mechanisms that regulate PPI have been suggested, but none has been demonstrated through direct manipulations. IRSp53 is an abundant excitatory postsynaptic scaffold implicated in schizophrenia, autism spectrum disorders, and attention-deficit/hyperactivity disorder. We found that mice lacking IRSp53 in cortical excitatory neurons display decreased PPI. IRSp53-mutant layer 6 cortical neurons in the anterior cingulate cortex (ACC) displayed decreased excitatory synaptic input but markedly increased neuronal excitability, which was associated with excessive excitatory synaptic input in downstream mediodorsal thalamic (MDT) neurons. Importantly, chemogenetic inhibition of mutant neurons projecting to MDT normalized the decreased PPI and increased excitatory synaptic input onto MDT neurons. In addition, chemogenetic activation of MDT-projecting layer 6 neurons in the ACC decreased PPI in wild-type mice. These results suggest that the hyperactive ACC-MDT pathway suppresses PPI in wild-type and IRSp53-mutant mice.
Patient Stratification Using Metabolomics to Address the Heterogeneity of Psychosis
Authors: MacDonald Kellie , Jiang Yuting , Krishnan Ankur , Sardaar Sameer , Qi Bill , Eleftheriadis Aristotelis , Glatt Stephen J , Joober Ridha , Mitchell John , Tabbane Karim , Trakadis Yannis
Published: June 2020

Psychosis is a symptomatic endpoint with many causes, complicating its pathophysiological characterization and treatment. Our study applies unsupervised clustering techniques to analyze metabolomic data, acquired using 2 different tandem mass spectrometry (MS-MS) methods, from an unselected group of 120 patients with psychosis. We performed an independent analysis of each of the 2 datasets generated, by both hierarchical clustering and k-means. This led to the identification of biochemically distinct groups of patients while reducing the potential biases from any single clustering method or datatype. Using our newly developed robust clustering method, which is based on patients consistently grouped together through different methods and datasets, a total of 20 clusters were ascertained and 78 patients (or 65% of the original cohort) were placed into these robust clusters. Medication exposure was not associated with cluster formation in our study. We highlighted metabolites that constitute nodes (cluster-specific metabolites) vs hubs (metabolites in a central, shared, pathway) for psychosis. For example, 4 recurring metabolites (spermine, C0, C2, and PC.aa.C38.6) were discovered to be significant in at least 8 clusters, which were identified by at least 3 different clustering approaches. Given these metabolites were affected across multiple biochemically different patient subgroups, they are expected to be important in the overall pathophysiology of psychosis. We demonstrate how knowledge about such hubs can lead to novel antipsychotic medications. Such pathways, and thus drug targets, would not have been possible to identify without patient stratification, as they are not shared by all patients, due to the heterogeneity of psychosis.
Coexpression analysis of a large-scale transcriptome identified a calmodulin-like protein regulating the development of adventitious roots in poplar
Authors: Xiao Zheng’ang , Zhang Yan , Liu Meifeng , Zhan Chang , Yang Xiaoqing , Nvsvrot Tashbek , Yan Zhaogui , Wang Nian
Published: June 2020

Poplars are important woody plants, and the ability to form adventitious roots (ARs) is the key factor for their cultivation because most poplars are propagated by cloning. In previous studies, Ca2+ was confirmed to regulate AR formation in poplar. In this study, wild-type poplar cuttings grown in 1.0 mM Ca2+ solution showed the best visible performance of AR development. Coexpression analysis of a large-scale RNA-Seq transcriptome was conducted to identify Ca2+-related genes that regulate AR development in poplar. A total of 15 coexpression modules (CMs) were identified, and two CMs showed high association with AR development. Functional analysis identified a number of biological pathways, including ‘oxidation-reduction process’, ‘response to biotic stimulus’ and ‘metabolic process’, in tissues of AR development. The Ca2+-related pathway was specifically selected, and its regulation in poplar AR development was predicted. A Ca2+ sensor, PdeCML23-1, which is a member of the calmodulin-like protein (CML) family, was found to promote AR development by phenotypic assay of overexpressed PdeCML23-1 transgenic lines at various growing conditions. By measuring cytosolic Ca2+ in AR tips, PdeCML23-1 seemed to play a role in decreasing cytosolic Ca2+ concentration. Additionally, the expression profiles of some genes and phytohormone indole acetic acid (IAA) were also changed in the overexpressed PdeCML23-1 transgenic lines. According to this study, we were able to provide a global view of gene regulation for poplar AR development. Moreover, we also observed the regulation of cytosolic Ca2+ concentration by PdeCML23-1, and this regulation was involved in AR development in poplar. We also predicted that PdeCML23-1 possibly regulates AR development by modulating IAA content in poplar.
Even Experts Can Be Fooled: Reliability of Clinical Examination for Diagnosing Hip Dislocations in Newborns
Authors: Harper Philip , Joseph Brijil M. , Clarke Nicholas M.P. , Herrera-Soto Jose , Sankar Wudbhav N. , Schaeffer Emily K. , Mulpuri Kishore , Aarvold Alexander
Published: June 2020

Background:

The aim of this study was to assess the accuracy of clinical screening examination in newborns with dislocated hips compared with ultrasound scan (USS).

Methods:

Newborns, up to 3 months of age, with confirmed hip dislocations on USS were prospectively enrolled in a multinational observational study. Data from 2010 to 2016 were reviewed to determine pretreatment clinical examination findings of the treating orthopaedic surgeon as well as baseline ultrasound indices of developmental dysplasia of the hip (DDH). All infants had been referred to specialist centres with expertise in DDH, due to abnormal birth examination or risk factor.

Results:

The median age of the study population was 2.3 weeks and 84% of patients were female. Of the total 515 USS-confirmed dislocated hips included in the study, 71 (13.8%) were incorrectly felt to be reduced on clinical examination by the treating orthopaedist (P<0.001). Full hip abduction was documented in 106 hips. Of the hips correctly identified as dislocated, 322 hips were further analyzed based on clinical reducibility. Thirty-three of 322 (10.2%) were incorrectly thought to be reducible when in fact they were irreducible or vice versa.

Conclusions:

Expert examiners missed a significant number of frankly dislocated hips on clinical examination and their ability to classify hips based on clinical reducibility was only moderately accurate. This study provides evidence that, even in experienced hands, physical examination findings in DDH are often too subtle to elicit clinically in the first few months of life. This may explain the persistent and measurable rate of late presenting dislocations in countries with screening programmes reliant on clinical examination.

Level of Evidence:

Level 1—testing of previously developed diagnostic criteria in series of consecutive patients (with universally applied reference “gold” standard).
Correction of Recurrent Equinus Deformity in Surgically Treated Clubfeet by Anterior Distal Tibial Hemiepiphysiodesis
Authors: Ebert Nicola , Ballhause Tobias M. , Babin Kornelia , Schelling Katrin , Stiel Norbert , Stuecker Ralf , Spiro Alexander S.
Published: June 2020

Background:

Residual or recurrent equinus deformity is a common problem in surgically treated clubfeet. This deformity may occur due to soft tissue–related reasons or due to bony deformity. An increased anterior distal tibial angle (ADTA) was previously found in 48% of the operated clubfeet. This study aimed to determine the efficacy and safety of anterior distal tibial hemiepiphysiodesis (ADTE) in the treatment of recurrent equinus deformity in patients with an increased ADTA.

Methods:

Eighteen children (23 feet) treated by ADTE to correct recurrent equinus deformity in surgically treated clubfeet were included in this retrospective, single-center study. ADTE using 8 plates was performed in children with an increased ADTA (>82 degrees) and inability to dorsiflex the ankle (≤0 degree of dorsiflexion). The mean patient age was 11.3 years (range: 10.2 to 12.9 y). All patients had completed treatment with implant removal after an average of 20.3 months (range: 9 to 37 mo).

Results:

The mean preoperative ankle dorsiflexion significantly improved from −3.3 degrees (range: −20 to –0 degrees) to 6.1 degrees (range: −15 to 10 degrees) at the time of 8-plate removal (correction rate: 9.4 degrees; P<0.0001). The ADTA was a mean of 87.5 degrees (range: 83 to 110 degrees) before surgery and significantly improved to 75.8 degrees (range: 63 to 106 degrees) at the time of implant removal (correction rate: 11.7 degrees; P<0.0001). Average follow-up was 43.9 months (range: 10 to 76 mo). Follow-up examinations were continued in 11 patients (13 feet) after implant removal. Changes of ankle dorsiflexion (mean: −2.5 degrees) and ADTA (mean: 3.6 degrees) occurred in this group.

Conclusions:

ADTE was safe and effective in the treatment of recurrent equinus deformity in surgically treated clubfeet with increased ADTA. Deterioration of ankle dorsiflexion and ADTA occurred after implant removal in some cases. The results of this study have to be analyzed with caution due to the limited number of included patients and its retrospective nature.

Level of Evidence:

Level IV—retrospective case series.
Four-in-one Extensor Realignment for the Treatment of Obligatory or Fixed, Lateral Patellar Instability in Skeletally Immature Knee
Authors: Danino Baruch , Deliberato David , Abousamra Oussama , Singh Satbir , Klingele Kevin
Published: June 2020

Background:

Congenital (fixed) and obligatory (habitual) patellar dislocations in children are a complex clinical and surgical challenge. Numerous individual surgical techniques have been described. This study aims to assess results, patient satisfaction, and complications after a combined Roux-Goldthwait procedure, vastus medialis obliquus advancement, Galeazzi procedure, and extensive, lateral release (4-in-1 extensor realignment) in the skeletally immature knee with obligatory, or fixed lateral patellar instability.

Methods:

Records of children with congenital fixed or obligatory patellar instability, who underwent the 4-in-1 procedure at a single institution, were reviewed. Clinical results included ability and time for the return to activities of daily living (ADL) and sport, recurrent instability and/or dislocation, and necessity of long-term bracing. Continued pain was assessed by the Kujala Score. Complications including infection, recurrent instability, and the necessity for secondary procedures were recorded.

Results:

A total of 34 patients (46 knees) mean age 10.3±2.4 years, underwent the 4-in-1 procedure with a mean postoperative follow-up of 51.6±31.5 (range, 12 to 146) months. Sixteen patients (22 knees) responded to a phone interview and questionnaire. All 16 patients returned to ADL in a mean time of 10.3±2.4 weeks. Ninety-one percent returned to sport in a mean time of 23.1±15.5 weeks. Long-term bracing was required for 6 knees after the surgery. The mean Kujala Score was 93.0±5.2 (range, 83 to 100). Complications included 6 of 34 patients (18%) with recurrent instability at the latest follow-up and 2 with superficial wound infection.

Conclusions:

Patients with obligatory or fixed lateral, patellar instability who undergo the 4-in-1 procedure have good short-term results with low complication rates. Return to ADL and sporting activity with minimal pain can be expected, usually without the need for long-term bracing. The 4-in-1 procedure is a viable option for skeletally immature patients with obligatory or fixed, lateral patellar instability.

Level of Evidence:

Level IV—Therapeutic study.
Review of Viral Testing (Polymerase Chain Reaction) and Antibody/Serology Testing for Severe Acute Respiratory Syndrome-Coronavirus-2 for the Intensivist
Authors: Motley Michael P. , Bennett-Guerrero Elliott , Fries Bettina C. , Spitzer Eric D.
Published: June 2020

Objective:

As the severe acute respiratory syndrome-coronavirus-2 pandemic develops, assays to detect the virus and infection caused by it are needed for diagnosis and management. To describe to clinicians how each assay is performed, what each assay detects, and the benefits and limitations of each assay.

Data Sources:

Published literature and internet.

Study Selection:

As well done, relevant and recent as possible.

Data Extraction:

Sources were read to extract data from them.

Data Synthesis:

Was synthesized by all coauthors.

Conclusions:

Available assays test for current or previous severe acute respiratory syndrome-coronavirus-2 infection. Nucleic acid assays such as quantitative, or real-time, polymerase chain reaction and loop-mediated isothermal amplification are ideal for acute diagnosis with polymerase chain reaction testing remaining the “gold standard” to diagnose acute infection by severe acute respiratory syndrome-coronavirus-2, specifically the presence of viral RNA. Assays that detect serum antibodies can theoretically diagnose both acute and remote infection but require time for the patient to develop immunity and may detect nonspecific antibodies. Antibody assays that quantitatively measure neutralizing antibodies are needed to test efficacy of convalescent plasma therapy but are more specialized.
Encephalitis in a Patient With Melanoma Treated With Immune Checkpoint Inhibitors: Case Presentation and Review of the Literature
Authors: Gkoufa Aikaterini , Gogas Helen , Diamantopoulos Panagiotis T. , Ziogas Dimitrios C. , Psichogiou Mina
Published: June 2020

After the approval of immune checkpoint inhibitors for the treatment of many solid tumors, a new class of adverse events was recognized through the augmented activation of T cells, known as immune-related toxicities (immune-related adverse events). Encephalitis as an immune-mediated phenomenon is extremely rare, but potentially fatal, and questions remain with regard to its optimal management. Herein, we describe a patient with metastatic melanoma who developed autoimmune encephalitis following treatment with nivolumab plus ipilimumab and present the data concerning clinical features, diagnostic procedure, and therapeutic management of neurological immune-related adverse events. Early recognition and management, and high doses of immunosuppressive agents are the proposed essential strategies for patients’ recovery. As immune-related toxicities may represent a clinical biomarker for cancer response to immune checkpoint inhibitors, these adverse events should promptly be managed to ensure that patients will experience the benefits of cancer immunotherapy.
Effectiveness and Safety of Reirradiation With Stereotactic Ablative Radiotherapy of Lung Cancer After a First Course of Thoracic Radiation
Authors: Viani Gustavo A. , Arruda Caio V. , De Fendi Ligia I.
Published: June 2020

Objective:

The effectiveness and safety of reirradiation with stereotactic ablative radiotherapy (re-SABR) in patients with recurrence after a previous course of radiation are limited to small series. We carried out a meta-analysis to summarize existing data and identify trends in overall survival (OS), local control (LC), and toxicity after re-SABR in patients with recurrence of lung cancer.

Materials and Methods:

Eligible studies were identified on Medline, Embase, the Cochrane Library, and the proceedings of annual meetings through June 2019. We followed the PRISMA and MOOSE guidelines. A meta-regression analysis was carried out to assess whether there is a relationship between moderator variables and outcomes. A P-value<0.05 was considered significant.

Results:

Twenty observational studies with a total of 595 patients treated were included. The 2-year OS and LC were 0.54 (95% confidence interval [CI]: 0.48-0.61) and 0.73 (95% CI: 0.66-0.80), respectively. The rate of any toxicity grade ≥3 was 0.098 (95% CI: 0.06-13.6), with 9 grade 5 toxicity (1.5%). In the meta-regression, the re-SABR dose (P=0.028), tumor size (P=0.031), and time to recurrence (P=0.018) showed an association with survival. For LC, the re-SABR dose (P=0.034) and tumor size (P=0.040) were statistically significant. Any toxicity grade ≥3 showed a relationship with the cumulative dose (P=0.024). Cumulative dose ≤145 versus >145 Gy2 had 3% versus 15% (P=0.013) of any grade ≥3 toxicity.

Conclusions:

Re-SABR produces satisfactory LC and OS rates with an acceptable rate of toxicity. The balancing between the re-SABR dose and the tumor location has the potential to reduce severe and fatal toxicity.
Short-term reproducibility of ambulatory blood pressure measurements: a systematic review and meta-analysis of 35 observational studies
Authors: Bo Yacong , Kwok Kin-On , Chung Vincent Chi-Ho , Yu Chun-Pong , Tsoi Kelvin Kam-Fai , Wong Samuel Yeung-Shan , Lee Eric Kam-Pui
Published: June 2020

Objective:

A systematic review on the reproducibility of ambulatory blood pressure measurements (ABPM) has not yet been conducted. This meta-analysis compared 24-h/daytime/night-time SBP and DBP mean values and SBP/DBP nocturnal dipping status from ABPMs in participants with or without hypertension.

Methods:

Ovid MEDLINE, EMBASE, and CINAHL Complete databases were searched for articles published before 3 May 2019. Eligible studies reporting a 24-h ABPM repeated at least once within 1 month were included. The mean daytime/night-time/24-h BP values, percentage of nocturnal dipping, and proportion of nondippers were compared between the first and second day of measurements, and the proportion of participants with inconsistent dipping status were estimated using a random effect model.

Results:

Population-based analysis found a 0–1.1 mmHg difference between the first and second ABPM for 24-h/daytime/night-time SBP and DBP and 0–0.5% for percentage of SBP/DBP nocturnal dipping. The proportion of non-dippers was not different between the first and second ABPM. Intra-individual analysis found that the 95% limit of agreements (LOA) for SBP/DBP were wide and the 95% LOA for daytime SBP, common reference to diagnose hypertension, ranged −16.7 to 18.4 mmHg. Similarly, 32% of participants had inconsistent nocturnal dipping status.

Conclusion:

ABPM had excellent reproducibility at the population level, favouring its application for research purposes; but reproducibility of intra-individual BP values and dipping status from a 24-h ABPM was limited. The available evidence was limited by the lack of high-quality studies and lack of studies in non-Western populations.
The Influence of Ultrasound Ciliary Plasty on Corneal Parameters
Authors: Bolek Bartłomiej , Wylęgała Adam , Wylęgała Edward
Published: June 2020

Précis:

The ultrasound ciliary plasty (UCP) procedure affects corneal parameters, although the effect is transient. Ultrasound energy affects the sclera, leading to induced astigmatism. The area of energy application correlates with the astigmatism axis.

Purpose:

To assess the postoperative corneal topography for 1 year after UCP.

Materials and Methods:

In total, 78 patients with primary and secondary refractory glaucoma were enrolled in the study. The primary outcome measures were the corneal parameters obtained with anterior segment swept-source optical coherence tomography. Intraocular pressure, number of antiglaucoma medications, and best-corrected logMAR visual acuities were analyzed as secondary outcome measures. Measurements were performed preoperatively and at 1 week, and 1, 3, 6, and 12 months postoperatively. A total of 39 patients (39 eyes) completed the follow-up period of 12 months.

Results:

There was a significant difference in the anterior/posterior steep/flat keratometry and anterior/posterior astigmatism values immediately after UCP. However, 3 months postoperatively these parameters returned to their initial values and there were no significant differences noted. The mean±SD values of anterior astigmatism preoperatively and at 1 week, and 1, 3, 6, and 12 months postoperatively were 1.12±0.66 D, 2.17±0.91 D (P<0.001), 2.05±0.93 D (P<0.001), 1.55±0.75 D (P=0.004), 1.31±0.70 D (P=0.024), and 1.20±0.73 D (P=0.406), respectively. The astigmatism axis tended to approach 90 degrees meridian with a significant difference 1 week postoperatively. Central and minimal corneal thickness remained unchanged, whereas the intraocular pressure and the number of antiglaucoma medications decreased significantly.

Conclusions:

UCP influenced the corneal topography parameters in the immediate postoperative period; however, with time, all parameters returned to their initial values.
Facilitators of Self-Initiated HIV Testing Among Youths: A Qualitative Study
Authors: ADEBAYO Oluwamuyiwa Winifred , DE SANTIS Joseph P. , GATTAMORTA Karina A. , VILLEGAS Natalia Andrea
Published: June 2020

Background

Youth experience disparities in HIV infection but have significantly low rates of HIV testing that lead to late diagnoses, increased transmission rates, and adverse health outcomes. There is limited knowledge regarding self-initiated HIV testing, which is a promising strategy for improving testing rates among youth.

Purpose

This study aimed to identify the facilitators of self-initiated HIV testing among youth.

Method

Thirty youths aged 18–24 years were recruited to participate in a qualitative descriptive study. Potential participants were recruited from a combination of HIV testing sites, including community testing events, a community-based organization, an adolescent health clinic, and a college campus. A demographic and sexual history questionnaire and audio-recorded interviews were used to collect data. Transcribed interviews were analyzed using qualitative content analysis.

Results

Salient themes and subthemes that explain the study findings are as follows: testing within the context of a sexual relationship (e.g., infidelity), support and influence from social relationships (e.g., family support), taking the initiative for health (e.g., signs and symptoms of infection), HIV testing preferences (e.g., free testing), and HIV testing experiences (e.g., provision of other health services).

Conclusions

The findings of this study advance scholarly understanding regarding the predictors of self-initiated testing and provide critical information necessary to further improve evidence-based nursing clinical practice and develop public health nursing interventions that target self-initiated HIV testing. Encouraging self-initiated HIV testing is an effective approach to increasing testing rates and, consequently, preventing new HIV transmissions in this vulnerable population.
Asymptomatic Right Atrial Thrombosis After Acute Lymphoblastic Leukemia Treatment
Authors: Jarvis Kirsten B. , Andersson Nadine G. , Giertz Mia , Järvelä Liisa , Lindinger Olle , Långström Satu , Niinimäki Riitta , Palmu Sauli , Trakymiene Sonata S. , Tuckuviene Ruta , Vepsäläinen Kaisa , Ranta Susanna , Frisk Tony
Published: June 2020

Right atrial thrombosis is a rare, but potentially serious complication of acute lymphoblastic leukemia treatment. We conducted a retrospective multicenter study to assess the incidence, treatment, and outcome of asymptomatic right atrial thrombosis detected at routine echocardiography of children after acute lymphoblastic leukemia treatment in the Nordic and Baltic countries. Eleven (2.7%, 95% confidence interval, 1.4-4.9) of 406 patients had asymptomatic right atrial thrombosis, ranging from 10 to 25 mm at detection. Three patients were treated with anticoagulation. None of the thromboses affected cardiac function, and they showed neither sign of progress nor spontaneous or treatment-related regress at follow-up.
Multimodal Therapy Including Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Can Result in Long-term Disease-free Survival in Pediatric Desmoplastic Small Round Cell Tumor With Extraperitoneal Disease
Authors: Xiao Jerry , Browning Meghen B. , Boyd Kevin P. , Suchi Mariko , Turaga Kiran K. , Firat Selim Y. , Mortland Leslie J. , Lal Dave R.
Published: June 2020

Desmoplastic small round cell tumor is a rare sarcoma with 5-year overall survival of 15%. An 8-year-old female presented with diffuse abdominal/pelvic desmoplastic small round cell tumor including numerous liver metastasis. She underwent neoadjuvant chemotherapy followed by cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Residual disease was found shortly after CRS/HIPEC which was resected, followed by whole abdomen/pelvic radiation and autologous hematopoietic cell transplant. Previous papers have reported dismal survival in patients with liver metastasis and residual disease arguing against CRS/HIPEC. Our patient remains disease-free over 6 years after completing therapy indicating long-term survival is achievable with aggressive multimodal therapy.
NUT Carcinoma Without Upfront Surgical Resection: A Case Report
Authors: Leeman Rachel , Pinkney Kerice , Bradley Julie A. , Ruiz Robert , DuBois Steven G. , French Christopher , Trucco Matteo
Published: June 2020

Nuclear protein in testis carcinoma is a rare and highly aggressive carcinoma associated with a 70% mortality rate 1 year from diagnosis and a median survival of only 6.5 months. No established treatment protocol exists, although some success has been achieved using a multimodal approach including early surgical resection and adjuvant chemotherapy and radiation. Prior studies have not demonstrated successful treatment in the absence of upfront surgical resection. We describe the first reported case of a patient with unresectable nuclear protein in testis carcinoma treated successfully with definitive chemotherapy using the Scandinavian Sarcoma Group IX Protocol and concurrent radiation therapy, but without surgical resection.
An Integrative Review of Brain-Derived Neurotrophic Factor and Serious Cardiovascular Conditions
Authors: Halloway Shannon , Jung Miyeon , Yeh An-Yun , Liu Jia , McAdams Ellen , Barley Maddison , Dorsey Susan G. , Pressler Susan J.
Published: June 2020

Background

There is emerging evidence that supports a role for brain-derived neurotrophic factor (BDNF) in the risk and presence of serious cardiovascular conditions. However, few existing literature reviews methodically describe empirical findings regarding this relationship.

Objectives

The purpose of this integrative review was to (a) evaluate BDNF (serum/plasma BDNF levels,BDNFVal66Met genotype) among humans at risk for or with serious cardiovascular conditions and (b) investigate the relationship between BDNF and risk/presence of serious cardiovascular conditions in humans.

Methods

An integrative review was conducted. Articles in English included human subjects, a measure of BDNF levels orBDNFgene, serious cardiovascular conditions, and quantitative data analyses. The search resulted in 475 unique titles, with the final sample including 35 articles representing 30 studies. Articles that received “good” or “fair” ratings (n= 31) using the National Heart, Lung, and Blood Institute Study Quality Assessment Tools were included for synthesis.

Results

The retrieved articles were largely nonexperimental, with sample sizes ranging from 20 to 5,510 participants. Overall, BDNF levels were lower in patients with chronic heart failure and stroke, but higher in patients with unstable angina and recent myocardial infarction. Lower BDNF levels were associated with higher incidence of cardiovascular events in patients with a prior history of serious cardiovascular conditions and decreased cardiovascular risk in healthy samples. ForBDNFgenotype, on average, 36.3% of participants had Met alleles. The frequency of theBDNFMet allele varied across race/ethnicity and cardiovascular conditions and in terms of association with serious cardiovascular condition incidence/risk.

Discussion

These findings indicate an emerging area of science. Future investigation is needed on serious cardiovascular condition phenotypes in relationship to BDNF in the same study conditions. Results also suggest for use of standardized BDNF measurement across studies and additional investigation in cardiovascular inflammatory processes that affect BDNF. Moreover, within specific populations, the frequency of Met alleles may be too low to be detected in sample sizes normally found in these types of studies.
Economic Analysis of Brief Motivational Intervention Following Trauma Related to Drugs and Alcohol
Authors: Cordovilla-Guardia Sergio , Ortega-Ortega Marta , Epstein David , Fernández-Mondéjar Enrique , Vilar-López Raquel
Published: June 2020

Background

Very few studies have conducted an economic assessment of brief motivational intervention (BMI) in patients experiencing traumatic injuries related to alcohol and/or substance use. Furthermore, findings concerning the potential long-term economic benefits of BMI applied in nursing are promising but very scarce.

Objective

The purpose of this study was to analyze the costs and benefits associated with the application of a BMI program by nursing staff to patients hospitalized for trauma related to substance use.

Methods

An analysis of costs and benefits was conducted in a nonrandomized study of a retrospective cohort of patients. An intervention and follow-up (of 10–52 months) of patients between 16 and 70 years of age admitted for traumatic injuries in University Hospital of Granada were carried out with a cohort of 294 patients (intervention = 162 vs. no intervention = 132) between 2011 and 2016. The National Health Service’s perspective on the use of medical resources and the costs associated with intervention and recidivism was considered. A cost analysis with a 5-year time frame and a subsequent analysis of sensitivity were conducted.

Results

Direct medical costs associated with trauma recidivism were significantly lower in patients who received BMI, as compared to patients who did not receive it, €751.82 per patient (95% CI €13.15 to €1,490.48) in the first year. The cost–benefit ratio of €74.92 at 4 years reflects National Health Service savings for each euro invested in BMI.

Discussion

The implementation of BMI programs in nursing care may be profitable from an economic standpoint, justifying the inclusion of these programs in hospitals both because of their efficacy and the potential savings incurred by the health system. This study addresses the lack of evidence regarding the economic implications linked to the effectiveness of the intervention to reduce substance use and trauma recidivism. Results identify BMI delivered in hospitals by nurses as a technique that offers the potential for reducing costs linked to trauma recidivism. The research has important practical implications for hospital nurses and doctors.
Epstein-Barr Virus-negative Marginal Zone Lymphoma as an Uncommon Form of Monomorphic Posttransplant Lymphoproliferative Disorder
Authors: Galera Pallavi , Flavin Richard , Savage Natasha M. , Saksena Annapurna , Gong Shunyou , Wang Huan-You , Swan Niall , Xi Liqiang , Raffeld Mark , Pittaluga Stefania , Jaffe Elaine S.
Published: June 2020

Monomorphic posttransplant lymphoproliferative disorders have been defined as lymphoid or plasmacytic proliferations that fulfill criteria for one of the B-cell or T/NK-cell neoplasms recognized in immunocompetent hosts in the current WHO Classification. Low-grade B-cell neoplasms have historically been excluded from this category, although rare reports of marginal zone lymphoma (MZL) have been described. We report 9 cases of posttransplant Epstein-Barr virus-negative MZL, all arising in solid organ transplant recipients (4 renal, 3 liver, 1 cardiac, and 1 liver, pancreas, and small bowel). Seven were extranodal MZL of mucosa-associated lymphoid tissue type, all of which had gastrointestinal involvement (4 colon, 1 duodenum, 1 stomach, and 1 oropharynx/base of tongue). Notably, the preferential involvement of intestine distinguishes posttransplant extranodal MZL from sporadic cases. Immunoglobulin light-chain restriction was seen in all cases, with polymerase chain reaction showing a monoclonal pattern in 7 of 8 cases with successful amplification of polymerase chain reaction products. A clonally unrelated recurrence was seen in one case. Next-generation sequencing identified recurrent mutations previously reported in MZL in 3/5 cases. MZL was diagnosed at least 1 year after solid organ transplant (median time to presentation, 84 mo; range, 13 to 108 mo). The median age was 44 (range, 9 to 73 y); the male: female ratio was 5:4. The mean follow-up was 33.4 months, with an indolent clinical course observed. A subset responded to reduction in immunosuppression and anti-CD20 therapy alone. These data support the designation of Epstein-Barr virus-negative MZL as an uncommon form of monomorphic posttransplant lymphoproliferative disorders.
Benefits of Patient/Caregiver Engagement in Adverse Drug Reaction Reporting Compared With Other Sources of Reporting in the Inpatient Setting: A Systematic Review
Authors: Prakasam Dhanuvarshini , Wong Adrian L. , Smithburger Pamela L. , Buckley Mitchell S. , Kane-Gill Sandra L.
Published: June 2020

Objectives

Clinicians learn from prior adverse events through pharmacovigilance allowing for improved medication safety in the medication use process; therefore, adverse drug reaction (ADR) reporting needs to be maximized. This systematic review was conducted to determine whether engaging patients/caregivers in ADR reporting during a patient’s hospitalization provides further information about ADRs not obtained from traditional sources of reporting (i.e., voluntary reporting, medical record review).

Methods

This review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A literature search was conducted from January 2018 to June 2019 in PubMed, CINAHL, and Embase. Studies were included if they were (i) conducted in the inpatient setting, (ii) surveyed patients/caregivers, (iii) compared patient/caregiver reporting with another source of reporting, and (iv) evaluated ADRs. Studies completed in an outpatient setting or nursing home were excluded.

Results

A total of 11 studies were included. Sources of ADR information from patient/caregiver were obtained through interviews, surveys, questionnaires, or open-ended responses. Patient reporting was compared with medical record reports (7 articles) and health care professional reporting (4 articles). Approximately 11% to 35% of ADRs reported from patients were not identified through voluntary reporting by health care professionals, and 5.6% to 66% of ADRs obtained from patient reporting were not provided in the medical record.

Conclusions

Patients/caregivers are important sources of safety information to improve system and practice of medication use that may not be recorded by other surveillance methods. Administrators and clinicians need to determine the best approach to integrate patients/caregivers into routine reporting for optimal engagement.
Evaluation of Protective Properties of Commercially Available Medical Helmets: Are Medical Helmets Protective?
Authors: Barrett Blake , Peterson Matthew J. , Phillips Sam L. , Lloyd John , Cowan Linda , Friedman Yvonne , Ramaiah Padmaja , Neily Julia , Bulat Tatjana
Published: June 2020

Objectives

The aims of the study were to evaluate and to compare protective properties of commercially available medical helmets for a set of standardized head injury risk measures.

Methods

Eleven helmet types were evaluated to represent the variety of commercially available medical helmet designs and manufacturers. A test mannequin and sensor apparatus were used to simulate a backward-standing fall. The head/neck size, mass, and “standing” height of the mannequin (5′9″) were representative of a 50th percentile male. A triaxial array was placed at the head center of mass to position 3 linear accelerometers and 3 angular rate sensors. Data were collected for 5 single trials for each helmet, as well as 5 repeated trials. Five trials were also collected with no helmet scenarios. Three head injury risk measures were examined (linear acceleration, angular acceleration, and head injury criterion). Data were analyzed by clinical cutoff thresholds and continuous values.

Results

Helmets varied in their performance across head injury risk measures. All helmets provided higher levels of protection compared with no helmet scenarios. No helmets were protective for subdural hematoma (measured by angular acceleration). All helmets lost protective properties with repeated falls. Results for skull fracture risk were inconsistent between linear acceleration and head injury criterion injury risk measures.

Conclusions

No helmets were protective across all head injury risk measures. Medical helmets may reduce some fall injury severity but may not prevent all types of head injury. All helmets exhibited worsening of protective properties with repeated falls. We recommend medical helmets be replaced after each fall incident where the helmet impacts another surface.
Mobility and its sensitivity to fitness differences determine consumer–resource distributions
Authors: Jiao Jing , Riotte-Lambert Louise , Pilyugin Sergei S. , Gil Michael A. , Osenberg Craig W.
Published: June 2020

An animal's movement rate (mobility) and its ability to perceive fitness gradients (fitness sensitivity) determine how well it can exploit resources. Previous models have examined mobility and fitness sensitivity separately and found that mobility, modelled as random movement, prevents animals from staying in high-quality patches, leading to a departure from an ideal free distribution (IFD). However, empirical work shows that animals with higher mobility can more effectively collect environmental information and better sense patch quality, especially when the environment is frequently changed by human activities. Here, we model, for the first time, this positive correlation between mobility and fitness sensitivity and measure its consequences for the populations of a consumer and its resource. In the absence of consumer demography, mobility alone had no effect on system equilibria, but a positive correlation between mobility and fitness sensitivity could produce an IFD. In the presence of consumer demography, lower levels of mobility prevented the system from approaching an IFD due to the mixing of consumers between patches. However, when positively correlated with fitness sensitivity, high mobility led to an IFD. Our study demonstrates that the expected covariation of animal movement attributes can drive broadly theorized consumer–resource patterns across space and time and could underlie the role of consumers in driving spatial heterogeneity in resource abundance.
Projections of coral cover and habitat change on turbid reefs under future sea-level rise
Authors: Morgan Kyle M. , Perry Chris T. , Arthur Rudy , Williams Hywel T. P. , Smithers Scott G.
Published: June 2020

Global sea-level rise (SLR) is projected to increase water depths above coral reefs. Although the impacts of climate disturbance events on coral cover and three-dimensional complexity are well documented, knowledge of how higher sea levels will influence future reef habitat extent and bioconstruction is limited. Here, we use 31 reef cores, coupled with detailed benthic ecological data, from turbid reefs on the central Great Barrier Reef, Australia, to model broad-scale changes in reef habitat following adjustments to reef geomorphology under different SLR scenarios. Model outputs show that modest increases in relative water depth above reefs (Representative Concentration Pathway (RCP) 4.5) over the next 100 years will increase the spatial extent of habitats with low coral cover and generic diversity. More severe SLR (RCP8.5) will completely submerge reef flats and move reef slope coral communities below the euphotic depth, despite the high vertical accretion rates that characterize these reefs. Our findings suggest adverse future trajectories associated with high emission climate scenarios which could threaten turbid reefs globally and their capacity to act as coral refugia from climate change.