bluuebunny/crossref_metadata_2025 huggingface dataset:
#15: Risk Factors of Infection related mortality in Pediatric Acute Myeloid Leukemia- Single Institute Experience: 2016–2018
Authors: Bayoumi Ahmed
Published: June 2021

Children with acute myeloid leukemia (AML) are at a particularly high risk for infectious complications related to the highly intensive chemotherapy. Infections leads to mortality and prolong hospitalization. The aim of the study is to evaluate the risk factors, infectious complications and assess outcome of febrile episodes during induction and consolidation chemotherapy courses in children with AML at the Pediatric Oncology Department, National Cancer Institute, Cairo University from January 2016 to December 2018.

Infectious complications were evaluated retrospectively in 621 febrile episodes. Mortality from gram negative bacteremia was 29.9%, in febrile episodes with multidrug resistant gram negative bacteremia: Mortality was 39.2 % in febrile episodes with multidrug resistant gram negative bacteremia and septic shock. Mortality was 71.8 % (p value <0.001). Mortality was high in early chemotherapy phase (intensive timing). Infection related mortality was 39%. In our institute there is epidemiological shift towards gram negative organisms.

Sepsis and septic shock are major causes of mortality during chemotherapy-induced neutropenia. Thus, awareness of the presenting characteristics and prompt management is most important. Improved management of sepsis during neutropenia may reduce the mortality of pediatric Acute myeloid leukemia. It is Important to trace the risk factors that may affect the outcome of febrile episodes.

Summary of Significant laboratory and clinical predictors of mortality Risk Factor Mortality p value Septic shock 55% <0.001 Septic shock with MDRO 72% Cardiac impairment/inotropic support 65.60% Presence Of Central venous line 18.30% Episode duration >18 days 20.50% Start of antimicrobial in relation to start of chemotherapy < 16 days 33% Episodes: Not in remission 15.60%

Risk factor Mortality p value CRP more than or equals 90 mg/l 24.4% Not significant ANC LESS THAN 500 29.9% 0.003 Hgb less than or equals to 7 g/dl 19.9% 0.633 Platelets less than 20000/cc 29.9% 0.299 Liver impairment (grades 3 and 4) 42.2% 0.025 Electrolyte imbalance (grades 3 and 4) 24.1% 0.003 Renal impairment 56.8% 0.025 Coagulopathy 41% <0.001
#14: Blastomycosis in 64 Wisconsin Children: Unanticipated Infection Risk and Severity in Urban Residents
Authors: Hall Jaimee M , Havens Peter L , Mitchell Errin A , De Vela Gabriel N , Titus Lauren L , Dasgupta Mahua , Simpson Pippa M , Kehl Sue C , Willoughby Rodney E , Henrickson Kelly J , Mitchell Michelle L , Huppler Anna R , Chusid Michael J
Published: June 2021

Background

Blastomycosis is an endemic mycosis of immunocompetent individuals, typically seen after exposure to wooded areas near rivers, lakes, and streams in rural locations, and often not considered a disease of urban environments. Disease can be isolated to lung, or disseminate to skin, bone, or central nervous system. Factors influencing disease acquisition and severity in children are unknown.

Methods

We analyzed acquisition risk factors and disease characteristics of blastomycosis in children treated at a tertiary care center from 1998–2018 to identify exposure source and measure disease severity, to identify cases without “typical exposure”, and to measure the effect of race on disease severity.

Results

Of 64 children, median age was 13.3 years, 72% were male, 38% resided in urban counties, and 50% had typical environmental exposure. Isolated pulmonary infection occurred in 33 (52%). The remaining children had evidence of dissemination including skin (N=13), bone (N=16; 7 clinically silent), and central nervous system (N=7; 3 clinically silent). Infection was moderate/severe in 19 (30%). Two children (3%) died. 79% of children with moderate/severe disease (p=0.008) and 71% of urban children (p=0.007) had no typical environmental exposure. Comparing children from urban counties to other residences, 63% versus 5% were black (p<0.001) and 71% versus 35% developed extrapulmonary dissemination (p=0.006). Moderate/severe disease occurred in 7/17 (42%) black and 12/47 (26%) children of other race (p=0.23).

Conclusions

Blastomycosis, endemic in urban children in the absence of typical exposure history, has frequent, sometimes clinically silent, extrapulmonary dissemination, with a trend toward more severe disease in black children.
#23: Investigation of Phosphomannomutase as an Antimalarial Drug Target
Authors: Frasse Philip , Goldberg Daniel , John Audrey Odom
Published: June 2021

Background

Malaria continues to pose an enormous economic and global health threat, killing over 200,000 people annually, primarily children under the age of 5. With the constant barrier of antimalarial resistance and the rise of delayed clearance by artemisinin, it is especially important to identify drug/target pairs that rapidly kill parasites. We study targetable metabolic pathways in the malaria parasite, Plasmodium falciparum, to guide such future drug development against this disease. In recent years, we have discovered that a large family of hydrolases, the Haloacid Dehalogenase (HAD) Superfamily of proteins, are implicated in regulating a variety of P. falciparum metabolic pathways, which can lead to dramatic changes in central carbon metabolism and drug resistance. We now turn our attention to a related HAD protein, the putative phosphomannomutase in these parasites, HAD5, responsible for the interconversion of mannose-6-phosphate and mannose-1-phosphate. This is an essential process for all stages of the parasite, and thus has potential as a broad antimalarial target. We examined the role of HAD5 in these parasites, and its potential to be chemically inhibited.

Methods

Recombinant protein was generated and purified for enzymatic assays to determine HAD5 activity and test inhibitor potency against HAD5 compared to recombinant human orthologs, PMM1 and PMM2. In parallel, CRISPR/Cas9 was used to generate inducible knockdown parasite strains to demonstrate this gene’s essentiality and its role in parasite biology. Parasite growth was measured by flow cytometry and light microscopy. Immunofluorescence analysis (IFA) was used to track the parasite development on a molecular scale.

Results

Inhibition of HAD5 was achieved in biochemical assays, with an IC50 of 68µM in our most potent compound, representing roughly 10-fold increased potency against the parasite protein compared to human orthologs. In culture, knockdown of HAD5 leads to interrupted egress from and reinvasion into red blood cells, culminating in parasite death. In IFA-visualized parasites, reinvasion-facilitating proteins were no longer anchored to parasite surfaces, accounting for the inhibition of the parasite life cycle.

Conclusion

In the search for new antimalarial targets, identifying proteins that are essential across multiple parasite life-stages while being distinct from human orthologs is necessary to block parasite transmission, cure symptomatic infection, and minimize off-target effects. HAD5 is an essential protein in malaria parasites that is expressed throughout the parasite’s life cycle, and can be specifically targeted by inhibitors, giving it promise as a future drug target.
Autophagy complements metalloprotease FtsH6 in degrading plastid heat shock protein HSP21 during heat stress recovery
Authors: Sedaghatmehr Mastoureh , Thirumalaikumar Venkatesh P , Kamranfar Iman , Schulz Karina , Mueller-Roeber Bernd , Sampathkumar Arun , Balazadeh Salma
Published: June 2021

Moderate and temporary heat stresses prime plants to tolerate, and survive, a subsequent severe heat stress. Such acquired thermotolerance can be maintained for several days under normal growth conditions, and can create a heat stress memory. We recently demonstrated that plastid-localized small heat shock protein 21 (HSP21) is a key component of heat stress memory in Arabidopsis thaliana. A sustained high abundance of HSP21 during the heat stress recovery phase extends heat stress memory. The level of HSP21 is negatively controlled by plastid-localized metalloprotease FtsH6 during heat stress recovery. Here, we demonstrate that autophagy, a cellular recycling mechanism, exerts additional control over HSP21 degradation. Genetic and chemical disruption of both metalloprotease activity and autophagy trigger superior HSP21 accumulation, thereby improving memory. Furthermore, we provide evidence that autophagy cargo receptor ATG8-INTERACTING PROTEIN1 (ATI1) is associated with heat stress memory. ATI1 bodies co-localize with both autophagosomes and HSP21, and their abundance and transport to the vacuole increase during heat stress recovery. Together, our results provide new insights into the module for control of the regulation of heat stress memory, in which two distinct protein degradation pathways act in concert to degrade HSP21, thereby enabling cells to recover from the heat stress effect at the cost of reducing the heat stress memory.
On the Turing complexity of learning finite families of algebraic structures
Authors: Bazhenov Nikolay , San Mauro Luca
Published: June 2021

In previous work, we have combined computable structure theory and algorithmic learning theory to study which families of algebraic structures are learnable in the limit (up to isomorphism). In this paper, we measure the computational power that is needed to learn finite families of structures. In particular, we prove that, if a family of structures is both finite and learnable, then any oracle which computes the Halting set is able to achieve such a learning. On the other hand, we construct a pair of structures which is learnable but no computable learner can learn it.
Introduction
Authors: Bryan Craig J.
Published: June 2021

This introductory chapter provides an overview of suicide in the military, detailing the author’s experience in Iraq. The prevailing method for suicide prevention was limited by survival bias, a logical error wherein we focus on the people or things that survive some selection process while overlooking those who did not. This book challenges some of the core assumptions about suicide and typical practices that may not be so helpful or useful after all. It also presents alternative perspectives that implicate different approaches that may work better than prevailing methods. These alternative perspectives have been heavily influenced by the many suicidal individuals who have shared their experiences, trials, and triumphs.
The 90% Statistic
Authors: Bryan Craig J.
Published: June 2021

This chapter evaluates the centrality of mental illness in discussions of suicide and argues that the predominance of this perspective reflects confirmation bias, which is the tendency to search for and interpret information in a way that supports our beliefs and assumptions. Most people who are actively involved in suicide prevention learned that 90% of those who die by suicide were struggling with a mental illness at the time of their death. As a tool for diagnosing mental illness among individuals who cannot speak for themselves, however, the psychological autopsy method is vulnerable to confirmation bias. Instead of assuming that most or all individuals who die by suicide have a mental illness, a more balanced and accurate perspective would be that some individuals who die by suicide have a mental illness and some individuals who die by suicide do not. The chapter concludes that mental illness is only weakly correlated with suicidal behaviors and a much larger percentage of suicides than we may have traditionally recognized occur in the absence of mental illness.
Mentalization in transition
Authors: Duschinsky Robbie , Foster Sarah
Published: June 2021

Increasingly over the 2000s, Fonagy and colleagues became increasingly dissatisfied with their initial model, identifying that the concept of ‘mentalization’ was too absorptive and that they had placed too much weight on early childhood experiences and the role of disorganized attachment. Attempts to correct these problems led to a revised and more mature account of forms of mentalizing. In this chapter, we will trace these developments of the 2000s, paying particular attention to Fonagy and Luyten’s 2009 account of four dimensions of mentalizing. The chapter will close by attempting to discern the underpinning logic of the concept of mentalization across its diverse uses and definitions. A single synthesized definition will also be proposed.
Forms of non-mentalizing
Authors: Duschinsky Robbie , Foster Sarah
Published: June 2021

Fonagy and colleagues have described three forms of non-mentalizing: pretend mode, psychic equivalence, and teleological mode. Sometimes they have implied that these are just three kinds of non-mentalizing that they have happened to stumble upon, and that they have no particular importance beyond other forms of non-mentalizing, which could readily be identified. More frequently, however, pretend mode, psychic equivalence, and teleological mode are described definitively as ‘the’ forms of non-mentalizing. The characterization of the three modes of non-mentalizing by Fonagy and colleagues is among the most potentially insightful contributions of their work. Nonetheless, Fonagy and colleagues have not attempted to operationalize the specific modes of non-mentalizing, with the exception of hypermentalizing, leaving their reflections speculative and obstructing further development of the theory. This chapter will characterize the three modes of non-mentalizing. Finally, we will examine why it might be that no further forms have been identified in the past 20 years.
The wider social system
Authors: Duschinsky Robbie , Foster Sarah
Published: June 2021

Critics have alleged that in attempting to adapt to the individual-centric environment of contemporary health provision, mentalization-based therapy itself has been complicit with the atomization of society. Conversations with his colleague Peter Fuggle and Dickon Bevington at the Anna Freud Centre have also had a profound role in highlighting to Fonagy the importance of the wider social system around the individual. Pursuing these questions, this chapter begins by examining the growing attention to the social environment shown by Fonagy and colleagues, and especially their exploration of the role of friends and friendships for mentalization and epistemic trust. It will then examine the reflections and research by Fonagy and collaborators on public mental health. The researchers’ hopes regarding school-based prevention will be given particular attention, and the chapter will also show how this work has shaped Fonagy’s efforts as a policy influencer. Finally, the chapter will appraise the considerations offered by Fonagy and colleagues of the role of culture, in particular the issue of whether attention to cultural processes should be regarded as mentalizing, non-mentalizing or as not mentalizing, and whether organizations and societies can themselves be said to institutionalize cultures of mentalizing or non-mentalizing.
The characteristics of daughter waves emerging from colliding solitary waves in astrophysical plasma media
Authors: Abdikian A , Vasheghani Farahani S , Hussain S
Published: June 2021

The aim is to state the properties of ion acoustic solitary waves in course of collision and extract characteristics of the daughter wave in a magnetized electron–ion plasma. The magnetized plasma medium that is a constituent of white dwarfs and astrophysical plasmas that possesses relativistically degenerate electrons and thermal ions in the presence of a constant background magnetic field. The model is based on the extended Poincaré–Lighthill–Kuo (ePLK) method where a set of Korteweg–de Vries equations is obtained to show the phase shifts of colliding waves together with the amplitude and width of the born daughter solitary waves. The numerical results and presented figures regarding the amplitude and width of solitons provide a description of the influence of plasma parameters on soliton interactions, namely ion to electron temperature ratio (σi), ion cyclotron frequency (ωci), and angle between magnetic field and collision line (θ) together with their interplay in shaping the character of solitary waves. It is concluded that only rarefactive electrostatic non-linear waves are able to propagate in such plasma media. The daughter wave amplitude possesses a scaling behaviour regarding the impact angle. Interplay of the parameters on the phase shifts is presented. Ratio of amplitude and width of the daughter wave is directly proportional to the background field, the impact angle controls its maximum. It is observed that the magnetic field elevates ratio of the solitary wave amplitude to width leading it to a shorter life and hence interaction range with neighbouring sites.
C2H2···CO complex and its radiation-induced transformations: a building block for cold synthetic astrochemistry
Authors: Zasimov Pavel V , Ryazantsev Sergey V , Tyurin Daniil A , Feldman Vladimir I
Published: June 2021

In this work, we have examined the radiation-induced synthetic chemistry occurring in an astrochemically important C2H2–CO system at the molecular level using a matrix isolation approach. The 1:1 C2H2···CO intermolecular complex of linear structure was obtained in the solid low-temperature (5 K) noble gas matrices by deposition of the C2H2/CO/Ng (Ng = Ar, Kr, Xe) gaseous mixtures and characterized by Fourier-transform infrared spectroscopy. It was found that the X-ray radiolysis of the C2H2···CO complex resulted in formation of C3O (tricarbon monoxide), HCCCHO (propynal), c-H2C3O (cyclopropenone), H2CCCO (propadienone), and HC3O (oxoprorynyl radical). This means that the studied complex may be considered as the simplest building block (or minimal size of intermolecular reactor) for cold astrochemistry occurring in mixed interstellar ices. Remarkably, the discovered transformations of the complex actually represent synthetic routes leading to various C3 species, whereas the acetylenic C–H bond cleavage yielding ethynyl radical appears to be a minor process. Prolonged irradiation results in dehydrogenation, while the C3 skeleton is retained. The interpretation of the C2H2···CO radiolysis mechanism (possible reactions pathways) is provided based on the analysis of kinetic curves and matrix effect. Astrochemical implications of the results are discussed.
Detection of quasi-periodic oscillations in the long-term radio light curves of the blazar OT 081
Authors: Li Xiao-Pan , Cai Yan , Yang Hai-Tao , Luo Yu-Hui , Yan Yue , He Jia-Ying , Wang Li-Sha
Published: June 2021

We report the detection of quasi-periodic oscillations (QPOs) in the radio light curves at 4.8, 8, and 14.5 GHz of the blazar OT 081, by means of the Weighted Wavelet Z-transform (WWZ) and Lomb–Scargle periodogram (LSP) methods. The LSP diagrams and time-averaged WWZ powers demonstrate several significant claims of QPOs above the 4σ confidence level: QPOs of ∼850 and ∼1500 d in the 4.8-GHz light curve, ∼850, ∼1120, and ∼1540 d in the 8-GHz light curve, ∼850 and ∼1130 d in the 14.5-GHz light curve. The Keplerian orbit parameters in a binary black hole system have been estimated, assuming the QPO of ∼850 d appearing in all three wavebands is a real periodicity. Moreover, a pure geometrical scenario with blobs moving helically inside the jet provides another plausible explanation for the detected QPOs.
Development of a Quantitative Antigen Assay to Detect Coccidioidal Chitinase-1 (CTS1)
Authors: Grill Francisca J , Grys Thomas E , Grill Marie F , Roeder Alexa , Blair Janis E , Lake Douglas F
Published: June 2021

Background

Coccidioidomycosis is often diagnosed with a collection of tests that measure a patient’s ability to mount an immune response to the fungus (antibody-based diagnostics) utilizing fungal protein preparations. Here we present an antigen-based assay that detects and quantifies coccidioidal chitinase-1 (CTS1) in diagnostic antigen preparations with potential for use in human serum.

Methods

An inhibition-based enzyme-linked immunoassay (ELISA) was developed that utilizes a monoclonal antibody specific for coccidioidal CTS1. CTS1 was quantified in commercial antigen preparations using recombinant CTS1 as a standard. Sera from 192 individuals from an endemic area were tested which included 78 patients (40.6%) with proven or probable coccidioidomycosis.

Results

The quantity of CTS1 in diagnostic commercial antigen preparations from different suppliers varied. Temporal constraints of availability of different lots of commercial antigens does not allow for immediate comparison of lot-to-lot variability. Assay results from patient serum samples correlated with low- and high-titer serology from patients with a coccidioidomycosis diagnosis. Further analysis suggested that patient derived anti-CTS1 antibodies may overlap with the mouse monoclonal antibody used in the assay. This unexpected overlap in CTS1 binding suggests the assay can detect antigen, antibody, or both, which contributes to its high level of clinical sensitivity of 89.74% and specificity of 94.90%.

Conclusions

The CTS1 inhibition ELISA described in this report is a promising tool to aid in quality control of antigens used in the diagnosis of coccidioidomycosis. Further optimization is needed to harness its utility as a diagnostic tool to aid in diagnosis and disease monitoring of coccidioidomycosis.
Massive star formation in the Carina nebula complex and Gum 31. II. A cloud–cloud collision in Gum 31
Authors: Fujita Shinji , Sano Hidetoshi , Enokiya Rei , Hayashi Katsuhiro , Kohno Mikito , Tsuge Kisetsu , Tachihara Kengo , Nishimura Atsushi , Ohama Akio , Yamane Yumiko , Ohno Takahiro , Yamada Rin I , Fukui Yasuo
Published: June 2021

We present the results of analyses of the 12CO (J = 1–0), 13CO (J = 1–0), and 12CO (J = 2–1) emission data toward Gum 31. Three molecular clouds separated in velocity were detected at −25, −20, and −10 km s−1. The velocity structure of the molecular clouds in Gum 31 cannot be interpreted as an expanding motion. Two of them, the −25 km s−1 cloud and the −20 km s−1 cloud, are likely to be associated with Gum 31, because their 12CO (J = 2–1)$/$12CO (J = 1–0) intensity ratios are high. We found that these two clouds show the observational signatures of cloud–cloud collisions (CCCs): a complementary spatial distribution and a V-shaped structure (bridge features) in the position–velocity diagram. In addition, their morphology and velocity structures are very similar to the numerical simulations conducted by the previous studies. We propose a scenario that the −25 km s−1 cloud and the −20 km s−1 cloud collided and triggered the formation of the massive star system HD 92206 in Gum 31. This scenario can explain the offset of the stars from the center and the morphology of Gum 31 simultaneously. The timescale of the collision was estimated to be ∼1 Myr by using the ratio between the path length of the collision and the assumed velocity separation. This is consistent with that of the CCCs in the Carina Nebula Complex in our previous study.
Roles of IDM3 and SDJ1/2/3 in Establishment and/or Maintenance of DNA Methylation in Arabidopsis
Authors: Miao Wei , Dai Jie , Wang Yutong , Wang Qianqian , Lu Chong , La Yumei , Niu Jiayu , Tan Feng , Zhou Shaoxia , Wu Yufeng , Chen Huhui , La Honggui
Published: June 2021

Previous studies had demonstrated that in Arabidopsis, IDM3 is involved in ROS1-mediated DNA demethylation pathway, and SUVH-SDJ complex functions as a DNA methylation reader complex for enhancing gene transcription, which presumably recruits ROS1 to the promoters of target genes for DNA demethylation. Here, our analyses, however, showed that the IDM3 and SDJ1/2/3, the components of the SUVH-SDJ complex, are implicated in establishing and/or maintaining DNA methylation as well through DDR (DRD1-DMS3-RDM1) complex. idm3-3 or sdj1/2/3 mutations led to genome-wide DNA hypomethylation, and both mutants shared a large number of common hypo-DMRs (Differentially Methylated Regions) with rdm1-4 and dms3-4, suggesting that IDM3 and SDJ1/2/3 help establish and/or maintain DNA methylation, mediated by RdDM pathway, at a subset of genomic regions largely through DDR complex. IDM3 is able to strongly interact with RDM1 and DMS3, but weakly with SDJ1 and SDJ3; SDJ1 and SDJ3 is capable of interacting separately with RDM1 and DMS3. Furthermore, comparisons of DNA methylation features in idm3-3 and sdj1/2/3 indicated that idm3-3 and sdj1/2/3 mutations make differential impacts on DNA methylation levels and patterns on a genome-wide scale, indicating that they are targeted to quite distinct genomic regions for aiding in DNA methylation. Further analyses on ChIP-seq data demonstrated that RDM1, DMS3 and NRPE1 are enriched in IDM3- and SDJ1/2/3-targted regions. Altogether, our results provide clear demonstration that IDM3 and SDJ1/2/3 play a part in establishing and/or maintaining DNA methylation of a group of genomic regions, through the DDR complex.
Dessins D’enfants and Some Holomorphic Structures on the Loch Ness Monster
Authors: Atarihuana Yasmina , García Juan , Hidalgo Rubén A , Quispe Saúl , Ramírez Maluendas Camilo
Published: June 2021

The theory of dessins d’enfants on compact Riemann surfaces, which are bipartite maps on compact orientable surfaces, are combinatorial objects used to study branched covers between compact Riemann surfaces and the absolute Galois group of the field of rational numbers. In this paper, we show how this theory is naturally extended to non-compact orientable surfaces and, in particular, we observe that the Loch Ness monster (LNM; the surface of infinite genus with exactly one end) admits infinitely many regular dessins d’enfants (either chiral or reflexive). In addition, we study different holomorphic structures on the LNM, which come from homology covers of compact Riemann surfaces, and infinite hyperelliptic and infinite superelliptic curves.
Can Individual Investors Beat the Market?
Authors: Coval Joshua D , Hirshleifer David , Shumway Tyler
Published: June 2021

We document persistent superior trading performance among a subset of individual investors. Investors classified in the top performance decile in the first half of our sample subsequently earn risk-adjusted returns of about 6% per year. These returns are not confined to stocks in which the investors are likely to have inside information, nor are they driven by illiquid stocks. Our results suggest that skilled individual investors exploit market inefficiencies (or perhaps conditional risk premiums) to earn abnormal profits, above and beyond any profits available from well-known strategies based on size, value, momentum, or earnings announcements. (JEL G11, G14, G40, G51)

Received: October 11, 2020 Editorial decision: January 4, 2021 Editor: Jeffrey Pontiff
Imbalance Between Prefronto-Thalamic and Sensorimotor-Thalamic Circuitries Associated with Working Memory Deficit in Schizophrenia
Authors: Wu Guowei , Palaniyappan Lena , Zhang Manqi , Yang Jie , Xi Chang , Liu Zhening , Xue Zhimin , Ouyang Xuan , Tao Haojuan , Zhang Jinqiang , Luo Qiang , Pu Weidan
Published: June 2021

Background

Thalamocortical circuit imbalance characterized by prefronto-thalamic hypoconnectivity and sensorimotor-thalamic hyperconnectivity has been consistently documented at rest in schizophrenia (SCZ). However, this thalamocortical imbalance has not been studied during task engagement to date, limiting our understanding of its role in cognitive dysfunction in schizophrenia.

Methods

Both n-back working memory (WM) task-fMRI and resting-state fMRI data were collected from 172 patients with SCZ and 103 healthy control subjects (HC). A replication sample with 49 SCZ and 48 HC was independently obtained. Sixteen thalamic subdivisions were employed as seeds for the analysis.

Results

During both task-performance and rest, SCZ showed thalamic hyperconnectivity with sensorimotor cortices, but hypoconnectivity with prefrontal-cerebellar regions relative to controls. Higher sensorimotor-thalamic connectivity and lower prefronto-thalamic connectivity both relate to poorer WM performance (lower task accuracy and longer response time) and difficulties in discriminating target from nontarget (lower d′ score) in n-back task. The prefronto-thalamic hypoconnectivity and sensorimotor-thalamic hyperconnectivity were anti-correlated both in SCZ and HCs; this anti-correlation was more pronounced with less cognitive demand (rest>0-back>2-back). These findings replicated well in the second sample. Finally, the hypo- and hyper-connectivity patterns during resting-state positively correlated with the hypo- and hyper-connectivity during 2-back task-state in SCZ respectively.

Conclusions

The thalamocortical imbalance reflected by prefronto-thalamic hypoconnectivity and sensorimotor-thalamic hyperconnectivity is present both at rest and during task engagement in SCZ and relates to working memory performance. The frontal reduction, sensorimotor enhancement pattern of thalamocortical imbalance is a state-invariant feature of SCZ that affects a core cognitive function.
Europeanization, Democratization, and Backsliding: Trajectories and Framings of Gender Equality Institutions in Poland
Authors: Gaweda Barbara
Published: June 2021

This article investigates how democratic backsliding has affected Europeanizing gender equality institutions. It analyzes Polish public discourse on the Plenipotentiary for Equality, a policy agency that aims to promote gender equality and antidiscrimination. The article traces its framing and trajectories through European Union accession, until the ultraconservative and nationalist backlash in recent years. Post-2015, Polish governments have mainstreamed anti-gender equality rhetoric as a strategy to legitimize systemic changes and democratic backsliding. I demonstrate how discursive and institutional linkages between Europeanization, democratization, and gender equality allow not only progress, but can also lead to opportunity moments for democratic and equality backsliding.
Tax benefits of the asset management foundation and trust in Hungary
Authors: Menyhei Ákos
Published: June 2021

The tax treatment of the trust, the private foundation and the AMF is based on tax neutrality in Hungary, providing at least an equal and not burdensome treatment of these vehicles compared to any other alternative legal solutions. This treatment includes that the trustee and the foundation are treated as intermediaries from a tax and stamp duty perspective, with the outcome that the acquisition of the ownership of the transferred assets by the trustee or foundation does not trigger taxation. Moreover, asset owners are encouraged to use these vehicles as significant tax benefits that are provided in connection with the asset transfer, management and distribution.
Marker-Assisted Development and Evaluation of Monogenic Lines of Rice cv. Kaohsiung 145 Carrying Blast Resistance Genes
Authors: Chen Yi-Chia , Hu Chih-Chieh , Chang Fang-Yu , Chen Chieh-Yi , Chen Wei-Lun , Tung Chih-Wei , Shen Wei-Chiang , Wu Chih-Wen , Cheng An-Hsiu , Liao Dah-Jing , Liao Ching-Ying , Liu Li-yu D. , Chung Chia-Lin
Published: June 2021

Rice blast is a serious threat to global rice production. Large-scale and long-term cultivation of rice varieties with a single blast resistance gene usually leads to breakdown of resistance. To effectively control rice blast in Taiwan, marker-assisted backcrossing was conducted to develop monogenic lines carrying different blast resistance genes in the genetic background of an elite japonica rice cultivar, Kaohsiung 145 (KH145). Eleven International Rice Research Institute (IRRI)-bred blast-resistant lines (IRBLs) showing broad-spectrum resistance to local Pyricularia oryzae isolates were used as resistance donors. Sequencing analysis revealed that the recurrent parent, KH145, does not carry known resistance alleles at the target Pi2/9, Pik, Pita, and Ptr loci. For each IRBL × KH145 cross, we screened 21 to 370 (average of 108) plants per generation from the BC1F1 to BC3F1/BC4F1 generation. A total of 1,499 BC3F2/BC4F2 lines carrying homozygous resistance alleles were selected and self-crossed for four to six successive generations. The derived lines were also evaluated for background genotype using genotyping by sequencing, for blast resistance under artificial inoculation and natural infection conditions, and for agronomic performance in multiple field trials. In Chiayi and Taitung blast nurseries in 2018 to 2020, Pi2, Pi9, and Ptr conferred high resistance, Pi20 and Pik-h moderate resistance, and Pi1, Pi7, Pik-p, and Pik susceptibility to leaf blast; only Pi2, Pi9, and Ptr conferred effective resistance against panicle blast. The monogenic lines showed agronomic traits, yield, and grain quality similar to those of KH145, suggesting the potential of growing a mixture of lines to achieve durable resistance in the field.
Using Quality Improvement for Refining Program Materials for Exercise Promotion in Comprehensive Multiple Sclerosis Care
Authors: Fifolt Matthew , Richardson Emma V. , Barstow Elizabeth A. , Motl Robert W.
Published: June 2021

Introduction:

There is a gap between evidence-based knowledge of exercise benefits and the translation of these benefits among persons with multiple sclerosis within clinical practice. This study represents the second cycle of a Plan-Do-Study-Act ramp to assess and improve three exercise promotion practice models and a screening process for use by healthcare providers to bridge the knowledge–translation gap within comprehensive multiple sclerosis care.

Methods:

Using a quality improvement design, our research team created an online survey for evaluating program materials by healthcare providers (i.e., neurologists, nurses, physical therapists, and occupational therapists). Participants provided written comments and suggestions for improvement regarding roles and responsibilities and clarity and relatability of these tools within a real-world setting.

Results:

Healthcare providers submitted 13 suggestions for improvement. Responses informed four specific improvements regarding program materials (i.e., patient screening, current exercise behavior, referrals, and provider checklists), thereby prompting the research team to adapt and further test the change idea.

Conclusions:

This article provides a step forward in a line of research focused on developing a systems-based process for integrating exercise promotion as part of comprehensive multiple sclerosis care.
Evaluation and Management of Pediatric Concussion in the Acute Setting
Authors: Corwin Daniel J. , Grady Matthew F. , Master Christina L. , Joffe Mark D. , Zonfrillo Mark R.
Published: June 2021

Concussion, a type of mild traumatic brain injury, is a common injury encountered by providers caring for pediatric patients in the emergency department (ED) setting. Our understanding of the pathophysiologic basis for symptom and recovery trajectories for pediatric concussion continues to rapidly evolve. As this understanding changes, so do recommendations for optimal management of concussed youth. As more and more children present to EDs across the country for concussion, it is imperative that providers caring for children in these settings remain up-to-date with diagnostic recommendations and management techniques. This article will review the definition, epidemiology, pathophysiology, diagnosis, and management of pediatric concussion in the ED setting.
An Assessment Tool for Hand Surgical Education Needs and Capacity in Resource-Limited Settings
Authors: Huynh Kristine A. , Billig Jessica I. , Lalonde Donald H. , Chung Kevin C.
Published: June 2021

Background:

Hand surgeons have the potential to substantially decrease the surgical disability burden in the developing world through educator trips. The Lancet Commission supports contextually driven educator trips grounded in the needs of local hosts, yet few organizations perform a comprehensive assessment of learning interests or the hosting institutions’ surgical capacity before the trips.

Methods:

The authors adapted the Personnel, Infrastructure, Procedures, Equipment, and Supplies questionnaire, which was modified from the World Health Organization’s validated Tool for Situational Analysis to Assess Emergency and Essential Surgical Care. The authors revised each aspect of the questionnaire to reflect items pertinent to upper extremity surgery and hand trauma care. They added sections to gauge self-identified learning needs, local disease burden, operative resources, and current practices. The tool was distributed by means of Qualtrics; descriptive statistics were used to summarize data. The authors analyzed the data for all participants and performed two subgroup analyses to examine variation by regions and countries.

Results:

The authors received 338 responses from 27 countries. There was wide variability in local surgical disease burden, learning interests, and skill level of upper extremity procedures. Although learners were most interested in learning tendon transfers and microsurgical techniques, the majority did not have adequate infrastructure at their institution to sustain capacity for microvascular procedures.

Conclusions:

Needs assessments can gauge how best to provide education during short-term visiting educator trips and optimize its impact in resource-limited settings. Understanding the needs, learning interests, and availability of resources of local learners is imperative to creating a sustainable global surgical workforce.
Plastic Surgery amidst the Pandemic: The New York University Experience at the Epicenter of the COVID-19 Crisis
Authors: Berman Zoe P. , Diep Gustave K. , Alfonso Allyson R. , Ramly Elie P. , Bluebond-Langner Rachel , Bernstein G. Leslie , Rodriguez Eduardo D.
Published: June 2021

The coronavirus disease of 2019 pandemic became a global threat in a matter of weeks, with its future implications yet to be defined. New York City was swiftly declared the epicenter of the pandemic in the United States as case numbers grew exponentially in a matter of days, quickly threatening to overwhelm the capacity of the health care system. This burgeoning crisis led practitioners across specialties to adapt and mobilize rapidly. Plastic surgeons and trainees within the New York University Langone Health system faced uncertainty in terms of future practice, in addition to immediate and long-term effects on undergraduate and graduate medical education. The administration remained vigilant and adaptive, enacting departmental policies prioritizing safety and productivity, with early deployment of faculty for clinical support at the front lines. The authors anticipate that this pandemic will have far-reaching effects on the future of plastic surgery education, trends in the pursuit of elective surgical procedures, and considerable consequences for certain research endeavors. Undoubtedly, there will be substantial impact on the physical and mental well-being of health care practitioners across specialties. Coordinated efforts and clear lines of communication between the Department of Plastic Surgery and its faculty and trainees allowed a concerted effort toward the immediate challenge of tempering the spread of coronavirus disease of 2019 and preserving structure and throughput for education and research. Adaptation and creativity have ultimately allowed for early rebooting of in-person clinical and surgical practice. The authors present their coordinated efforts and lessons gleaned from their experience to inform their community’s preparedness as this formidable challenge evolves.
Striae Distensae: Scars without Wounds
Authors: Borrelli Mimi R. , Griffin Michelle , Ngaage Ledibabari Mildred , Longaker Michael T. , Lorenz H. Peter
Published: June 2021

Striae distensae, or stretch marks, are common linear lesions of atrophic skin characterized histologically by epidermal atrophy, absent rete ridges, and alterations in connective tissue architecture. Hormonal excess, mechanical stress, and genetic predisposition are all associated with striae distensae, but their exact pathogenesis remains unknown. Despite a multitude of options, no single treatment has yet proven effective. In this article, the authors describe an up-to-date overview of striae distensae in terms of their etiology, pathophysiology, and therapeutic options. Further research is required to better elucidate their pathophysiology and to develop targeted effective treatments.
Donor and Recipient Matching in Facial Vascularized Composite Allotransplantation: A Closer Look at the Donor Pool
Authors: Kauke Martin , Haug Valentin , Obed Doha , Diehm Yannick , Tchiloemba Bianief , Safi Ali-Farid , Pomahac Bohdan
Published: June 2021

Background:

Identifying a donor for facial vascularized composite allotransplant recipients can be a lengthy, emotionally challenging process. Little is known about the relative distribution of key donor characteristics among potential donors. Data on actual wait times of patients are limited, making it difficult to estimate wait times for future recipients.

Methods:

The authors retrospectively reviewed charts of nine facial vascularized composite allotransplant patients and provide data on transplant wait times and patient characteristics. In addition, they analyzed the United Network for Organ Sharing database of dead organ donors. After excluding donors with high-risk characteristics (e.g., active cancer or risk factors for blood-borne disease transmission), the authors calculated the distribution of relevant donor-recipient matching criteria (i.e., ethnicity, body mass index, age, ABO blood group, cytomegalovirus, Epstein-Barr virus, hepatitis C virus) among 65,201 potential donors.

Results:

The median wait time for a transplant was 4 months (range, 1 day to 17 months). The large majority of United Network for Organ Sharing–recorded deaths from disease were white (63 percent) and male (58 percent). Female donors of black, Hispanic, or Asian descent are underrepresented, with 7, 5, and 1 percent of all recorded deaths from disease, respectively. Potential donors show cytomegalovirus and Epstein-Barr virus seropositivity of 65 and 95 percent, respectively. The number of annual hepatitis C–positive donors increased over time.

Conclusions:

Actual facial vascularized composite allotransplant wait times vary considerably. Although most patients experience acceptable wait times, some with underrepresented characteristics exceed acceptable levels. Cytomegalovirus-seropositive donors present a large portion of the donor pool, and exclusion for seronegative patients may increase wait time. Hepatitis C–seropositive donors may constitute a donor pool for underrepresented patient groups in the future.
Revisiting Primary Otoplasty: Surgical Approach to the Prominent Ear
Authors: Savetsky Ira L. , Cohen Joshua M. , Avashia Yash J. , Byrd H. Steve
Published: June 2021

Prominent ears and other ear deformities are some of the most common congenital deformities of the head, affecting over 10 percent of the general population. In 2018, more than 10,000 otoplasties were performed in the United States, with over one-third performed on men. The goal of primary otoplasty is creation of a normal-appearing ear without evidence of surgical intervention. This article and video detail the authors’ preferred technique for the treatment of prominent ears. This novel method allows for reduction of a hypertrophic concha and obtuse conchoscaphal angle, as well as creation of an adequate antihelical fold.
Is Digital Animation Superior to Text Resources for Facial Transplantation Education? A Randomized Controlled Trial
Authors: Wolfe Erin M. , Alfonso Allyson R. , Diep Gustave K. , Berman Zoe P. , Mills Emily C. , Park Jenn J. , Hoffman Alexandra F. , Felsenheld Julia H. , Ramly Elie P. , Rodriguez Eduardo D.
Published: June 2021

Background:

Facial transplantation is a complex surgical procedure that requires education of medical professionals, patients, and the general public. The objective of this randomized controlled trial was to compare the educational efficacy of facial transplantation digital animation versus text resources for teaching medical students a complex surgical procedure and its applicable anatomical and surgical principles.

Methods:

Medical student volunteers were recruited and prospectively randomized to an animation or a text group. Students completed preintervention and postintervention assessments of confidence and knowledge of head and neck anatomy and facial transplantation. Student Evaluations of Educational Quality survey assessed student satisfaction with both tools following study crossover. Knowledge assessment was developed using National Board of Medical Examiners guidelines and content validated by four experts. The Cohen d statistic was used to measure the effect size of each intervention.

Results:

Thirty-six students were assigned randomly to the animation group (n = 19) or the text (n = 17) group. Postintervention analysis demonstrated significantly higher performance scores in the animation group compared to the text group (p = 0.029). The animation group had a larger effect size (Cohen d = 1.96 versus 1.27). Only students in the animation group reported significantly improved confidence in head and neck anatomy after the intervention (p = 0.002). Both groups demonstrated significantly increased postintervention confidence in knowledge of facial transplantation (p < 0.001). Satisfaction scores revealed that students significantly favored the animation resource (p < 0.001).

Conclusions:

Animation can be an effective tool for facial transplantation education and results in improved student knowledge, confidence, and satisfaction compared to text resources. Facial transplantation can also be used as an educational framework for teaching medical students anatomical and surgical principles.
The Transition to Microsurgical Technique for Hepatic Artery Reconstruction in Pediatric Liver Transplantation
Authors: Nickel Kevin J. , Staples John , Meeberg Glenda , Kwan Peter O. , Gilmour Susan , Bigam David L. , Dajani Khaled , Shapiro A. M. James , Kneteman Norman M. , Ladak Adil
Published: June 2021

Background:

Hepatic artery thrombosis represents a potentially fatal complication following liver transplantation. Rates of hepatic artery thrombosis are significantly higher in children, with mortality reported up to 80 percent. Microsurgical anastomosis has been shown to decrease the rate of hepatic artery thrombosis and now represents the standard of care at the authors’ institution. In this article, the authors present the largest study of its type directly comparing rates of hepatic artery thrombosis with and without microsurgical reconstruction of the hepatic artery.

Methods:

All pediatric patients who underwent primary orthotopic liver transplantation between 1989 and 2018 were included. Patients were divided into two cohorts: standard anastomosis with loupes, and microsurgical anastomosis under the operating microscope. The authors’ primary outcome was the rate of hepatic artery thrombosis. Secondary outcomes were graft survival, patient survival, retransplantation rate, requirement for intraoperative blood products, and length of stay.

Results:

Two hundred thirty-one children met criteria for inclusion. One hundred eighty cases were performed with loupe magnification and 51 cases were performed under the microscope. The hepatic artery thrombosis rate was lower, but not significantly so (p = 0.114), in the microsurgical group [n = 1 (2.0 percent)] compared with the standard cohort [n = 15 (8.3 percent)]. Survival analysis revealed a significant increase in graft survival with microsurgical anastomosis (p = 0.020), but not patient survival (p = 0.196). The retransplantation rate was significantly lower with microsurgical anastomosis (p = 0.021).

Conclusions:

Microsurgical anastomosis was associated with a clinically important decrease in hepatic artery thrombosis compared with standard loupe anastomosis. The graft survival rate was significantly higher in the microsurgical cohort, with a reduced retransplantation rate at 1 year. On this basis, the authors recommend microsurgical hepatic artery anastomosis in cases of pediatric liver transplantation. 

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.