bluuebunny/crossref_metadata_2025 huggingface dataset:
Incidence of Hip Dysplasia Diagnosis in Young Patients With Hip Pain: A Geographic Population Cohort Analysis
Authors: LaPrade Matthew D. , Melugin Heath P. , Hale Rena F. , Leland Devin P. , Bernard Christopher D. , Sierra Rafael J. , Trousdale Robert T. , Levy Bruce A. , Krych Aaron J.
Published: March 2021

Background:

Hip dysplasia is a common source of hip pain and a known cause of early osteoarthritis of the hip.

Purpose:

To (1) define the population-based incidence of hip dysplasia diagnosis in young patients presenting with hip pain in a large geographically defined cohort, (2) analyze trends regarding presentation and diagnosis of hip dysplasia, and (3) report the rate and type of surgical interventions used to treat this population.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A geographic epidemiological database was queried to identify patients aged 14 to 50 years with hip pain between the years 2000 and 2016. Patient medical records were analyzed, and demographic, imaging, clinical, and treatment history were recorded. Incidence trends were examined by use of linear regression with confidence intervals for age and calendar year.

Results:

Overall, 1893 patients were included. Of these, 156 patients (196 hips) had a diagnosis of hip dysplasia. The incidence of hip dysplasia diagnosis in patients who reported hip pain was 12.7 per 100,000 person-years. Patients with dysplasia had a mean age of 26.7 ± 9.8 years, while the highest age-adjusted incidence occurred at age 14 to 18 years in both male and female patients. Female patients had double the age-adjusted incidence of male patients (cases per 100,000 person-years: 16.8 [95% CI, 13.9-19.7] vs 8.7 [95% CI, 6.6-10.8]; P < .01). Of the patients who underwent magnetic resonance imaging, 77% had imaging consistent with labral pathology. Patients were treated with physical therapy (67%), intra-articular steroid injection (29%), hip arthroscopy (10%), and periacetabular osteotomy (9%). The use of hip arthroscopy significantly increased over time ( P < .01), whereas the use of steroid injection and periacetabular osteotomy did not ( P < .28 and P < .08, respectively).

Conclusion:

The incidence of hip dysplasia diagnosis in patients presenting with hip pain was 12.7 per 100,000 person-years. Female patients had twice the age-adjusted incidence of male patients, and the highest age-adjusted incidence occurred in the age range of 14 to 18 years in both sexes. The use of hip arthroscopy to treat patients with hip dysplasia significantly increased over time.
Selections From the ABC 2020 Annual Conference, Online: Business Dress and Pajama Bottoms—My Favorite Assignment Goes Online
Authors: Whalen D. Joel
Published: March 2021

This article features 12 teaching innovations presented at the 2020 Association for Business Communication (ABC) annual international conference held online due to the global COVID-19 pandemic. Readers can explore the classroom methods designed to enhance students’ individual and career skills, critical thinking, teamwork, and report writing skills—many are designed to be taught online. This article is the first in a two-part series. The next article will appear in the September 2021 issue. Additional teaching materials—instructions to students, stimulus materials, slides, grading rubrics, frequently asked questions, and sample student projects—are posted on the ABC website: https://www.businesscommunication.org/page/assignments .
Susceptibility to Residual Inhibition Is Associated With Hearing Loss and Tinnitus Chronicity
Authors: Hu S. , Anschuetz L. , Hall D. A. , Caversaccio M. , Wimmer W.
Published: March 2021

Residual inhibition, that is, the temporary suppression of tinnitus loudness after acoustic stimulation, is a frequently observed phenomenon that may have prognostic value for clinical applications. However, it is unclear in which subjects residual inhibition is more likely and how stable the effect of inhibition is over multiple repetitions. The primary aim of this work was to evaluate the effect of hearing loss and tinnitus chronicity on residual inhibition susceptibility. The secondary aim was to investigate the short-term repeatability of residual inhibition. Residual inhibition was assessed in 74 tinnitus subjects with 60-second narrow-band noise stimuli in 10 consecutive trials. The subjects were assigned to groups according to their depth of suppression (substantial residual inhibition vs. comparator group). In addition, a categorization in normal hearing and hearing loss groups, related to the degree of hearing loss at the frequency corresponding to the tinnitus pitch, was made. Logistic regression was used to identify factors associated with susceptibility to residual inhibition. Repeatability of residual inhibition was assessed using mixed-effects ordinal regression including poststimulus time and repetitions as factors. Tinnitus chronicity was not associated with residual inhibition for subjects with hearing loss, while a statistically significant negative association between tinnitus chronicity and residual inhibition susceptibility was observed in normal hearing subjects (odds ratio: 0.63; p = .0076). Moreover, repeated states of suppression can be stably induced, reinforcing the use of residual inhibition for within-subject comparison studies.
Book review: Jeffrey W. Taliaferro, Defending Frenemies: Alliance Politics and Nuclear Non-proliferation in US Foreign Policy
Authors: Bano Saira
Published: March 2021

Jeffrey W. Taliaferro, Defending Frenemies: Alliance Politics and Nuclear Non-proliferation in US Foreign Policy. New York: Oxford University Press, 2019, 312 pp. ISBN: 978-0-190-93930-4.
Randomized Trial of Dilute Betadine Soak and Scrub for Orthopaedic Foot and Ankle Surgery
Authors: Bohl Daniel D. , Mehraban Nasima , Rossi David , Wakefield Connor , Lin Johnny L. , Lee Simon , Hamid Kamran S.
Published: March 2021

Category:

Lesser Toes; Midfoot/Forefoot; Other

Introduction/Purpose:

There is no consensus as to which skin antiseptic technique is most effective at reducing bacterial load prior to orthopaedic foot and ankle procedures. The purpose of this study is to determine if the addition of a dilute betadine soak and scrub to a standard preparation with alcohol and chlorhexidine decreases positive bacterial culture rates from the hallux nailfold.

Methods:

In this prospective, randomized controlled trial, 242 subjects were randomized to one of two groups. The control group received only a standard skin antiseptic preparation with alcohol and chlorhexidine, while the intervention group received a three-minute dilute betadine soak and scrub followed by the standard preparation with alcohol and chlorohexidine (Figure 1). Immediately before skin incision, culture swabs were taken from the hallux nailfold of both groups.

Results:

Of the 257 subjects enrolled and randomized, 242 (94.2%) completed the study, satisfying the a priori sample size requirement of 242 subjects. There were no crossovers between groups. There were no differences in baseline characteristics between groups (p>0.05 for each). There was no difference in the bacterial growth rate between groups (26.8% growth in the intervention group versus 26.9% growth in the control group, p=0.991).

Conclusion:

The hallux nailfold is one of the most difficult to sterilize areas prior to orthopaedic foot and ankle surgery. This randomized controlled trail found no benefit to adding a three-minute dilute betadine soak and scrub to a standard skin preparation with alcohol and chlorohexidine.
Impact of COVID-19 on Pathology Presenting to a Foot and Ankle Clinic
Authors: Mehta Nabil , Hur Edward , Michalski Joseph , Fitch Ashlyn , Sayari Arash , Bohl Daniel D. , Holmes George B.
Published: March 2021

Category:

Other

Introduction/Purpose:

In our city, the COVID-19 pandemic led to a shelter-in-place ordinance, job loss, gym closures, and employees working from home. As a result, individuals adjusted their daily activities and exercise routines, potentially impacting the burden of foot and ankle disease. The purpose of the present study was to compare diagnoses made in an orthopaedic foot and ankle clinic during the months of the COVID-19 pandemic to diagnoses made during the same months of the previous year.

Methods:

A retrospective review of new patients presenting to our group of four fellowship-trained orthopaedic foot and ankle surgeons was performed. Patients in the COVID-19 group presented between March 22, 2020 (the beginning of our shelter-in- place ordinance) and July 1, 2020. Patients in the control group presented during the same period of the previous year. Final diagnosis was characterized. Chronicity was classified as acute (symptom duration <= 1 month) or chronic (symptom duration > 1 month). Diagnoses were classified as fractures (e.g. ankle fractures, foot fractures) or activity-related (e.g. plantar fasciitis, ankle sprain). Pearson Chi-squared tests were performed to assess for differences in patient presentations between the COVID-19 and control periods.

Results:

A total of 1,409 new patient visits were reviewed with 449 visits in the COVID-19 group and 960 visits in the control group. The COVID-19 group had a significantly higher proportion of ankle fractures (8.7% versus 5.4%; p=0.020) and stress fractures (4.2% versus 2.2%, p=0.031), but a smaller proportion of Achilles tendon ruptures (0.7% versus 2.5%; p=0.019). Similarly, the COVID-19 group had a higher proportion of acute injuries (35.4% versus 23.5%; p<0.001). No difference was seen between diagnoses classified as fractures or those classified as activity-related. Finally, the COVID-19 group had a higher proportion of acute activity-related injuries (16.0% versus 11.7%; p=0.023) and acute fractures (14.0% versus 8.4%; p=0.001), but a lower proportion of chronic activity-related injuries (22.5% versus 28.1%; p=0.025).

Conclusion:

The COVID-19 pandemic caused a marked shift in the pathology presenting to the orthopaedic foot and ankle clinic. There was an increase in ankle fractures, stress fractures, and acute injuries when compared to the previous year, and a decrease in Achilles tendon ruptures and chronic injuries. This shift may reflect both the adoption of different activities during the quarantine period and a reluctance to present to a medical environment for evaluation of non-urgent injuries.
Extensor Tendon Transfers for Treatment of Foot Drop in Charcot-Marie-Tooth Disease: A Biomechanical Evaluation
Authors: Michalski Max , An Tonya W. , Metzger Melodie F. , Nelson Trevor , Pfeffer Glenn B.
Published: March 2021

Category:

Midfoot/Forefoot; Ankle; Lesser Toes; Other

Introduction/Purpose:

Transfer of the Extensor hallucis longus (EHL) and extensor digitorum longus (EDL) tendons is an underutilized procedure for the treatment of drop foot in patients with Charcot-Marie-Tooth disease (CMT). Transfer of these tendons should be considered for augmentation of ankle dorsiflexion in the CMT population, regardless of the presence of clawed toes. The preferred site for tendon transfer, however, remains unknown. We hypothesized that EHL/EDL transfers will improve ankle dorsiflexion compared to the intact state but will produce similar motion at either the metatarsal necks or cuneiforms.

Methods:

Eight fresh-frozen cadaveric specimens transected at the mid-tibia were mounted into a specialized jig with the ankle held in 20 degrees of plantarflexion. The EHL and EDL tendons were isolated and connected to linear actuators with suture. Diodes secured on the 1st metatarsal, 5th metatarsal and tibia provided optical data for tibiopedal position in 3-dimensions. After preloading, the tendons were tested at 25%, 50%, 75% and 100% of maximal physiologic force for the EHL and EDL muscles, individually and combined.

Results:

Transfers to metatarsal and cuneiform locations significantly improved ankle dorsiflexion compared to the intact state. No difference was observed between these transfer sites. Following transfer, only 25% of maximal force by combined EHL and EDL was required to achieve a neutral foot position.

Conclusion:

Transfer of the long toe extensors, into either the metatarsals or cuneiforms, significantly increases dorsiflexion of the ankle. Transfer should be considered for augmentation of dorsiflexion in the CMT population, regardless of the presence of clawed toes. This study supports tendon transfers into the cuneiforms, which involves less time, fewer steps and easier tendon balancing without compromising dorsiflexion power.
Accessibility of the Metatarsal Head Comparing Distraction and Plantarflexion in a 2-Portal Technique for First Metatarsophalangeal (MTP 1) Joint Arthroscopy
Authors: Willegger Madeleine , Czerny Katharina , Hirtler Lena
Published: March 2021

Category:

Arthroscopy; Midfoot/Forefoot

Introduction/Purpose:

Arthroscopic treatment of osteochondral lesion of the first metatarsophalangeal (MTP1) joint is an established procedure. Non-invasive distraction is most commonly applied when a dorsal 2-portal technique is used. Alternatively, plantarflexion can be utilized. In order to compare the arthroscopic reachability of the first metatarsal head, a laboratory study in anatomical specimens was performed.

Methods:

Twenty matched pairs (n=40) of fresh-frozen lower leg specimens were obtained and randomly assigned into two groups, a distraction (DIS) and a plantarflexion (PF) group, respectively. A standard 2-portal approach (dorsolateral and dorsomedial portals) with a 1.9mm 30° scope was used. The arthroscopic accessibility of the first metatarsal head was evaluated using chondral picks. Markings at the metatarsal heads were made intraoperatively and measured after exarticulation.

Results:

In the DIS group the mean accessible area was 58.03%, while the accessible area in the PF group was 55.93%. Though there is a small difference between the two groups, this difference was not statistically significant (p=0.51). Range of motion of the MTP 1 joint did not affect reachability. In one specimen (2.5%) the dorsomedial hallucal nerve was injured during arthroscopy.

Conclusion:

Access to the MTP1-joint for the treatment of osteochondral lesions is similar using distraction or plantarflexion during arthroscopy. The plantarflexion technique has the advantage of less surgical equipment needed. The dorsomedial hallucal nerve is at danger at the medial portal.
Characterization and statistical modeling of glycosylation changes in sickle cell disease
Authors: Ashwood Heather E. , Ashwood Christopher , Schmidt Anna P. , Gundry Rebekah L. , Hoffmeister Karin M. , Anani Waseem Q.
Published: March 2021

Sickle cell disease is an inherited genetic disorder that causes anemia, pain crises, organ infarction, and infections in 13 million people worldwide. Previous studies have revealed changes in sialic acid levels associated with red blood cell sickling and showed that stressed red blood cells bare surface-exposed clustered terminal mannose structures mediating hemolysis, but detailed glycan structures and anti-glycan antibodies in sickle cell disease remain understudied. Here, we compiled results obtained through lectin arrays, glycan arrays, and mass spectrometry to interrogate red blood cell glycoproteins and glycan-binding proteins found in the plasma of healthy individuals and patients with sickle cell disease and sickle cell trait. Lectin arrays and mass spectrometry revealed an increase in α2,6 sialylation and a decrease in α2,3 sialylation and blood group antigens displayed on red blood cells. Increased binding of proteins to immunogenic asialo and sialyl core 1, Lewis A, and Lewis Y structures was observed in plasma from patients with sickle cell disease, suggesting a heightened anti-glycan immune response. Data modeling affirmed glycan expression and plasma protein binding changes in sickle cell disease but additionally revealed further changes in ABO blood group expression. Our data provide detailed insights into glycan changes associated with sickle cell disease and refer glycans as potential therapeutic targets.
Nicotine upregulates ACE2 expression and increases competence for SARS-CoV-2 in human pneumocytes
Authors: Maggi Fabrizio , Rosellini Alfredo , Spezia Pietro Giorgio , Focosi Daniele , Macera Lisa , Lai Michele , Pistello Mauro , de Iure Antonio , Tomino Carlo , Bonassi Stefano , Russo Patrizia
Published: March 2021

The coronavirus disease 2019 (COVID-19) pandemic has a variable degree of severity according to underlying comorbidities and life-style. Several research groups have reported an association between cigarette smoking and increased severity of COVID-19. The exact mechanism of action is largely unclear.

We exposed low angiotensin-converting enzyme 2 (ACE2)-expressing human pulmonary adenocarcinoma A549 epithelial cells to nicotine and assessed ACE2 expression at different times. We further used the nicotine-exposed cells in a virus neutralisation assay.

Nicotine exposure induces rapid and long-lasting increases in gene and protein expression of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) receptor ACE2, which in turn translates into increased competence for SARS-CoV-2 replication and cytopathic effect.

These findings show that nicotine worsens SARS-CoV-2 pulmonary infection and have implications for public health policies.
Spatiotemporal heterogeneity and its determinants of COVID-19 transmission in typical labor export provinces of China
Authors: Wang Li , Xu Chengdong , Wang Jinfeng , Qiao Jiajun , Yan Mingtao , Zhu Qiankun
Published: March 2021

Background

Previous studies have indicated that the risk of infectious disease spread is greatest in locations where a population has massive and convenient access to the epicenter of an outbreak. However, the spatiotemporal variations and risk determinants of COVID-19 in typical labor export regions of China remain unclear. Understanding the geographical distribution of the disease and the socio-economic factors affecting its transmission is critical for disease prevention and control.

Methods

A total of 2152 COVID-19 cases were reported from January 21 to February 24, 2020 across the 34 cities in Henan and Anhui. A Bayesian spatiotemporal hierarchy model was used to detect the spatiotemporal variations of the risk posed by COVID-19, and the GeoDetector q statistic was used to evaluate the determinant power of the potential influence factors.

Results

The risk posed by COVID-19 showed geographical spatiotemporal heterogeneity. Temporally, there was an outbreak period and control period. Spatially, there were high-risk regions and low-risk regions. The high-risk regions were mainly in the southwest areas adjacent to Hubei and cities that served as economic and traffic hubs, while the low-risk regions were mainly in western Henan and eastern Anhui, far away from the epicenter. The accessibility, local economic conditions, and medical infrastructure of Wuhan in Hubei province all played an important role in the spatiotemporal heterogeneity of COVID-19 transmission. The results indicated that the q statistics of the per capita GDP and the proportion of primary industry GDP were 0.47 and 0.47, respectively. The q statistic of the population flow from Wuhan was 0.33. In particular, the results showed that the q statistics for the interaction effects between population density and urbanization, population flow from Wuhan, per capita GDP, and the number of doctors were all greater than 0.8.

Conclusions

COVID-19 showed significant spatiotemporal heterogeneity in the labor export regions of China. The high-risk regions were mainly located in areas adjacent to the epicenter as well as in big cities that served as traffic hubs. Population access to the epicenter, as well as local economic and medical conditions, played an important role in the interactive effects of the disease transmission.
Value of gadoxetic acid-enhanced MRI for microvascular invasion of small hepatocellular carcinoma: a retrospective study
Authors: Zhou Meng , Shan Dan , Zhang Chunhui , Nie Jianhua , Wang Guangyu , Zhang Yanqiao , Zhou Yang , Zheng Tongsen
Published: March 2021

Background

The objective of this study was to analyze the accuracy of gadolinium–ethoxybenzyl–diethylenetriamine penta–acetic acid enhanced magnetic resonance imaging (Gd–EOB–DTPA–MRI) for predicting microvascular invasion (MVI) in patients with small hepatocellular carcinoma (sHCC) preoperatively.

Methods

A total of 60 sHCC patients performed with preoperative Gd–EOB–DTPA–MRI in the Harbin Medical University Cancer Hospital from October 2018 to October 2019 were involved in the study. Univariate and multivariate analyses were performed by chi–square test and logistic regression analysis. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of Gd–EOB–DTPA–MRI were performed by receiver operating characteristic (ROC) curves.

Results

Univariate analysis indicated that alanine aminotransferase (≥ 39.00U/L), poorly differentiated pathology, and imaging features including grim enhancement, capsule enhancement, arterial halo sign and hepatobiliary features (tumor highly uptake, halo sign, spicule sign and brush sign) were associated with the occurrence of MVI (p < 0.05). Multivariate analysis revealed that rim enhancement and hepatobiliary spicule sign were independent predictors of MVI (p < 0.05). The area under the ROC curve was 0.917 (95% confidence interval 0.838–0.996), and the sensitivity was 94.74%.

Conclusions

The morphologies of hepatobiliary phase imaging, especially the spicule sign, showed high accuracy in diagnosing MVI of sHCC. Rim enhancement played a significant role in diagnosing MVI of sHCC.
Age-specific definition of low anti-Mullerian hormone and associated pregnancy outcome in women undergoing IVF treatment
Authors: Zhao Depeng , Fan Jing , Wang Ping , Jiang Xuan , Yao Jilong , Li Xuemei
Published: March 2021

Background

The age-specific definition of low anti-müllerian hormone (AMH) is lacking. This study aims to define an age-specific reference for low AMH and to evaluate the associated outcome in women undergoing IVF treatment.

Methods

A retrospective study was performed in women receiving IVF treatment at the Shenzhen maternity and child healthcare hospital between September 2016 and September 2018. We excluded cases without AMH concentration. Polynomial least-squares regression was used to estimate the age-specific reference ranges for AMH after log-transformed. The age-specific 10th centile was defined as the threshold of low AMH concentration.

Results

A total of 909 patients were analyzed in this study. The age-specific reference ranges for AMH were established using linear regression model and resulted in an age-specific equation for mean: mean of LnAMH = (− 0.085 × age) + 3.722 (ng/ml, in unit). Women with AMH level higher than 10th centile had favorable outcomes in ovarian stimulation compared to those with low AMH level. In patients younger than 35 years, the rates of clinical pregnancy per transfer and ongoing pregnancy per transfer in the subgroup with AMH level higher than 10th centile were significantly higher than that in the subgroup of low AMH level, 57% versus 31.3% p = 0.003 and 51.9% versus 21.9% p = 0.001, respectively.

Conclusion

Women with AMH lower than age-specific 10th centile had significantly unfavorable outcomes after IVF treatment. The age-specific 10th centile of AMH concentration may be useful to predict the outcome of IVF treatment.
Evaluation of percutaneous transcatheter embolization for pulmonary arteriovenous malformations
Authors: Wu ZhengZhong , Lin JunQing , Yang WeiZhu , Jiang Na , Huang Ning , Clavijo Leonardo C.
Published: March 2021

Background

The purpose of this study was to assess the safety and efficacy of percutaneous transcatheter embolization (TCE) for the treatment of pulmonary arteriovenous malformations (PAVMs).

Methods

Forty-three consecutive patients (n = 17 males; n = 26 females) with 72 untreated PAVMs underwent coil and/or plug embolization between January 2010 and February 2018. The mean patient age was 42 ± 14 years (range 19–71 years). The median size of the feeding artery was 7.9 ± 2.9 mm (range 3.5–14.0 mm). The arterial blood gas level and cardiac function of all patients were analysed. The technical success rate, recanalization rate, and complications were evaluated. Computed tomography angiography (CTA) examinations were scheduled for 12 months after treatment and every 2–4 years thereafter.

Results

Twenty-five PAVMs were treated with coils alone, twenty-one were treated with plugs alone, and twenty-six were treated with both coils and plugs. The technical success rate was 100%. There were no complications during operation. However, one patient (2.3%) had pulmonary thrombosis and embolism post-operation. The patients’ pre-operative and post-operative PaO2 and SaO2 levels were significantly different (p < 0.01). A comparison of the New York Heart Association (NYHA) grade before and after embolization in all patients showed a significant decrease in the post-operative grade (p < 0.01). The 72 PAVMs were divided into three groups (coils only group [n = 25], plugs only group [n = 21], and coils/plugs combined group [n = 26]). After 12 months of follow-up, there were seven reperfusion PAVMs in the coil group, seven reperfusion PAVMs in the plug group, and 1 reperfusion PAVM in the combined group. There were significant differences between the two groups and the combined group.

Conclusion

Percutaneous TCE is safe and effective for the treatment of PAVMs. A combination of coils and vascular plugs may be useful for preventing recanalization after the embolization of PAVMs.
Hyperthermia in a pediatric patient with neuroblastoma during anesthesia: a case report
Authors: Wang Chuan , Xin Wenqiong , Ji Yi
Published: March 2021

Background

Neuroblastoma is the most common malignant extracranial solid tumor in pediatrics patients. Intraoperative hyperthermia is extremely rare in patients with neuroblastoma and can cause a series of complications. Here, we represent a case of neuroblastoma accompanied by hyperthermia during anesthesia, and propose a rational explanation and management options.

Case presentation

The patient had gait disturbance and sitting-related pain without fever. Magnetic resonance imaging revealed a soft tissue mass located in the right posterior mediastinum, paravertebral space and canalis vertebralis. Serum tumor marker screening showed that the patient had increased epinephrine, norepinephrine and neuron specific enolase levels, with an increased 24 hour urine vanillylmandelic acid level. Intraspinal tumor resection was conducted. The temperature of the patient rapidly arose to 40.1 °C over 10 minutes when waiting for tracheal extubation. The arterial gas analysis results indicated malignant hyperthermia was less likely, and dantrolene was not administered. Physical cooling methods were used, and the temperature dropped to 38.6 ℃. The trachea was successfully extubated. Histological results confirmed the diagnosis of neuroblastoma.

Conclusions

Hyperthermia during anesthesia is a serious adverse event. Catecholamines secreted from neuroblatoma cells can lead to hypermetabolism and hyperthermia. Surgeons and anesthesiologists should be aware of the possibility of hyperthermia in patients with neuroblastoma.
Excess mortality for care home residents during the first 23 weeks of the COVID-19 pandemic in England: a national cohort study
Authors: Morciano Marcello , Stokes Jonathan , Kontopantelis Evangelos , Hall Ian , Turner Alex J.
Published: March 2021

Background

To estimate excess mortality for care home residents during the COVID-19 pandemic in England, exploring associations with care home characteristics.

Methods

Daily number of deaths in all residential and nursing homes in England notified to the Care Quality Commission (CQC) from 1 January 2017 to 7 August 2020. Care home-level data linked with CQC care home register to identify home characteristics: client type (over 65s/children and adults), ownership status (for-profit/not-for-profit; branded/independent) and size (small/medium/large). Excess deaths computed as the difference between observed and predicted deaths using local authority fixed-effect Poisson regressions on pre-pandemic data. Fixed-effect logistic regressions were used to model odds of experiencing COVID-19 suspected/confirmed deaths.

Results

Up to 7 August 2020, there were 29,542 (95% CI 25,176 to 33,908) excess deaths in all care homes. Excess deaths represented 6.5% (95% CI 5.5 to 7.4%) of all care home beds, higher in nursing (8.4%) than residential (4.6%) homes. 64.7% (95% CI 56.4 to 76.0%) of the excess deaths were confirmed/suspected COVID-19. Almost all excess deaths were recorded in the quarter (27.4%) of homes with any COVID-19 fatalities. The odds of experiencing COVID-19 attributable deaths were higher in homes providing nursing services (OR 1.8, 95% CI 1.6 to 2.0), to older people and/or with dementia (OR 5.5, 95% CI 4.4 to 6.8), amongst larger (vs. small) homes (OR 13.3, 95% CI 11.5 to 15.4) and belonging to a large provider/brand (OR 1.2, 95% CI 1.1 to 1.3). There was no significant association with for-profit status of providers.

Conclusions

To limit excess mortality, policy should be targeted at care homes to minimise the risk of ingress of disease and limit subsequent transmission. Our findings provide specific characteristic targets for further research on mechanisms and policy priority.
Efficacy of lotilaner (Credelio™) against experimentally induced infestations of the adult cat flea, Ctenocephalides felis, and flea eggs following oral administration to cats
Authors: Paarlberg Tandy , Karadzovska Daniela , Helbig Rainer
Published: March 2021

Background

Credelio™ (lotilaner; Elanco) is indicated for the treatment of flea and tick infestations on cats at a recommended lotilaner dose rate of 6–24 mg/kg. This study evaluated the efficacy and safety of lotilaner following a single oral administration to cats for the treatment and prevention of adult Ctenocephalides felis fleas and flea egg production under laboratory conditions.

Methods

Two treatment groups of ten cats each were used in this study. One group was treated with lotilaner at a dose rate of 6−9 mg/kg on Day 0 and the other group served as the control group. Each cat was infested with 100 unfed adult fleas on days –1, 6, 13, 20 and 29. At 24 h post-treatment or post-infestation, each cat was combed to remove and count adult live fleas. At each time point, flea eggs were also collected and counted from under each cat cage.

Results

Following a single oral administration of lotilaner at a minimum dose rate of 6 mg/kg (range 6.00−8.57 mg/kg), the lotilaner group displayed 100%, 100%, 99.9%, 99.9% and 99.8% efficacy against adult live flea counts as compared to the control group on Days 1, 7, 14, 21 and 30, respectively. At each time point, adult flea counts from the lotilaner-treated cats were significantly lower (P < 0.0001) than from the control group. A mean flea egg count of 22.6 in the lotilaner-treated cats (compared to 441.7 in the control animals) was observed 24 h post-treatment. No eggs were present from any of the treated cats on Days 7, 14 and 30 and a single egg was detected on a single treated cat on Day 21. One adverse event (regurgitated food) was observed during the study in one treated cat approximately 1 h after dosing.

Conclusions

Lotilaner was well tolerated; only one adverse event was observed in the treated group. Virtually all adult fleas were killed within 24 h post-treatment or post-infestation in cats treated with a single dose of lotilaner as compared to the control group, thus significantly reducing the number of flea eggs being produced for 30 days after treatment.

Graphical Abstract
Neutron: an attention-based neural decompiler
Authors: Liang Ruigang , Cao Ying , Hu Peiwei , Chen Kai
Published: March 2021

Decompilation aims to analyze and transform low-level program language (PL) codes such as binary code or assembly code to obtain an equivalent high-level PL. Decompilation plays a vital role in the cyberspace security fields such as software vulnerability discovery and analysis, malicious code detection and analysis, and software engineering fields such as source code analysis, optimization, and cross-language cross-operating system migration. Unfortunately, the existing decompilers mainly rely on experts to write rules, which leads to bottlenecks such as low scalability, development difficulties, and long cycles. The generated high-level PL codes often violate the code writing specifications. Further, their readability is still relatively low. The problems mentioned above hinder the efficiency of advanced applications (e.g., vulnerability discovery) based on decompiled high-level PL codes.In this paper, we propose a decompilation approach based on the attention-based neural machine translation (NMT) mechanism, which converts low-level PL into high-level PL while acquiring legibility and keeping functionally similar. To compensate for the information asymmetry between the low-level and high-level PL, a translation method based on basic operations of low-level PL is designed. This method improves the generalization of the NMT model and captures the translation rules between PLs more accurately and efficiently. Besides, we implement a neural decompilation framework called Neutron. The evaluation of two practical applications shows that Neutron’s average program accuracy is 96.96%, which is better than the traditional NMT model.
The ECM as a driver of heart development and repair
Authors: Derrick Christopher J. , Noël Emily S.
Published: March 2021

The developing heart is formed of two tissue layers separated by an extracellular matrix (ECM) that provides chemical and physical signals to cardiac cells. While deposition of specific ECM components creates matrix diversity, the cardiac ECM is also dynamic, with modification and degradation playing important roles in ECM maturation and function. In this Review, we discuss the spatiotemporal changes in ECM composition during cardiac development that support distinct aspects of heart morphogenesis. We highlight conserved requirements for specific ECM components in human cardiac development, and discuss emerging evidence of a central role for the ECM in promoting heart regeneration.
DNAJB chaperones suppress destabilised protein aggregation via a region distinct from that used to inhibit amyloidogenesis
Authors: McMahon Shannon , Bergink Steven , Kampinga Harm H. , Ecroyd Heath
Published: March 2021

Disturbances to protein homeostasis (proteostasis) can lead to protein aggregation and inclusion formation, processes associated with a variety of neurodegenerative disorders. DNAJB proteins are molecular chaperones that have been identified as potent suppressors of disease-related protein aggregation. In this work, a destabilised isoform of firefly luciferase (R188Q/R261Q Fluc; termed FlucDM) was overexpressed in cells to assess the capacity of DNAJBs to inhibit inclusion formation. Co-expression of all DNAJB proteins tested significantly inhibited the intracellular aggregation of FlucDM. Moreover, we show that DNAJB proteins suppress aggregation by supporting the Hsp70 (HSPA)-dependent degradation of FlucDM via the proteasome. The serine-rich stretch in DNAJB6 and DNAJB8, essential for preventing fibrillar aggregation, is not involved in the suppression of FlucDM inclusion formation. Conversely, deletion of the C-terminal TTK-LKS motif in DNAJB6 and DNAJB8, a region not required to suppress polyglutamine aggregation, abolished the ability to inhibit inclusion formation by FlucDM. Thus, our data suggest that DNAJB6 and DNAJB8 possess two distinct regions for binding substrates, one that is responsible for binding β-hairpins that form during amyloid formation and another that interacts with exposed hydrophobic patches in aggregation-prone clients.

This article has an associated First Person interview with the first author of the paper.
Na+/H+ exchangers differentially contribute to midgut fluid sodium and proton concentration in the sea urchin larva
Authors: Petersen Inga , Chang William W. J. , Hu Marian Y.
Published: March 2021

Regulation of ionic composition and pH is a requisite of all digestive systems in the animal kingdom. Larval stages of the marine superphylum Ambulacraria, including echinoderms and hemichordates, were demonstrated to have highly alkaline conditions in their midgut with the underlying epithelial transport mechanisms being largely unknown. Using ion-selective microelectrodes, the present study demonstrated that pluteus larvae of the purple sea urchin have highly alkaline pH (pH ∼9) and low [Na+] (∼120 mmol l−1) in their midgut fluids, compared with the ionic composition of the surrounding seawater. We pharmacologically investigated the role of Na+/H+ exchangers (NHE) in intracellular pH regulation and midgut proton and sodium maintenance using the NHE inhibitor 5-(n-ethyl-n-isopropyl)amiloride (EIPA). Basolateral EIPA application decreased midgut pH while luminal application via micro-injections increased midgut [Na+], without affecting pH. Immunohistochemical analysis demonstrated a luminal localization of NHE-2 (SpSlc9a2) in the midgut epithelium. Specific knockdown of spslc9a2 using Vivo-Morpholinos led to an increase in midgut [Na+] without affecting pH. Acute acidification experiments in combination with quantitative PCR analysis and measurements of midgut pH and [Na+] identified two other NHE isoforms, Spslc9a7 and SpSlc9a8, which potentially contribute to the regulation of [Na+] and pH in midgut fluids. This work provides new insights into ion regulatory mechanisms in the midgut epithelium of sea urchin larvae. The involvement of NHEs in regulating pH and Na+ balance in midgut fluids shows conserved features of insect and vertebrate digestive systems and may contribute to the ability of sea urchin larvae to cope with changes in seawater pH.
Thirst and drinking in North American watersnakes (Nerodia spp.)
Authors: Edwards Matthew , Sheehy Coleman M. , Fedler Matthew T. , Lillywhite Harvey B.
Published: March 2021

We quantified drinking behavior in three species of North American watersnakes: Nerodia clarkii, which is a marine or brackish water amphibious species, and Nerodiafasciata and Nerodiataxispilota, both freshwater amphibious species. All three species have relatively small and similar thresholds of dehydration (TH, approximately −4% loss of body mass) that elicit thirst and drinking of fresh water. These species have higher thirst sensitivity than several species of hydrophiine and laticaudine sea snakes, which are characterized by much lower TH (greater dehydration, −9% to <−20%). Nerodia clarkii, which is often found in coastal oceanic water, refused to drink seawater, but drank fresh water when dehydrated. In separate trials involving dehydration of N. clarkii and N. fasciata that were concurrently fed fish at regular intervals, snakes eventually refused to eat at TH of approximately −12% of original body mass, but resumed eating after they were allowed to drink fresh water and rehydrate. The drinking behaviors of Nerodia corroborate previous data on the importance of fresh water for drinking, and they complement growing evidence that dietary water does not itself mitigate dehydration in snakes. These new data increase understanding of water relationships in the context of evolutionary transitions from land to sea, and they emphasize the importance of fresh water resources in the conservation of coastal and marine species of reptiles.
Health economic analyses of latent tuberculosis infection screening and preventive treatment among people living with HIV in lower tuberculosis incidence settings: a systematic review
Authors: Baggaley Rebecca F. , Vegvari Carolin , Dimala Christian A. , Lipman Marc , Miller Robert F. , Brown James , Degtyareva Svetlana , White Helena A. , Hollingsworth T. Déirdre , Pareek Manish
Published: March 2021

Introduction:In lower tuberculosis (TB) incidence countries (<100 cases/100,000/year), screening and preventive treatment (PT) for latent TB infection (LTBI) among people living with HIV (PLWH) is often recommended, yet guidelines advising which groups to prioritise for screening can be contradictory and implementation patchy. Evidence of LTBI screening cost-effectiveness may improve uptake and health outcomes at reasonable cost.

Methods:Our systematic review assessed cost-effectiveness estimates of LTBI screening/PT strategies among PLWH in lower TB incidence countries to identify model-driving inputs and methodological differences. Databases were searched 1980-2020. Studies including health economic evaluation of LTBI screening of PLWH in lower TB incidence countries (<100 cases/100,000/year) were included. Study quality was assessed using the CHEERS checklist.

Results:Of 2,644 articles screened, nine studies were included. Cost-effectiveness estimates of LTBI screening/PT for PLWH varied widely, with universal screening/PT found highly cost-effective by some studies, while only targeting to high-risk groups (such as those from mid/high TB incidence countries) deemed cost-effective by others. Cost-effectiveness of strategies screening all PLWH from studies published in the past five years varied from US$2828 to US$144,929/quality-adjusted life-year gained (2018 prices). Study quality varied, with inconsistent reporting of methods and results limiting comparability of studies. Cost-effectiveness varied markedly by screening guideline, with British HIV Association guidelines more cost-effective than NICE guidelines in the UK.

Discussion:Cost-effectiveness studies of LTBI screening/PT for PLWH in lower TB incidence settings are scarce, with large variations in methods and assumptions used, target populations and screening/PT strategies evaluated. The limited evidence suggests LTBI screening/PT may be cost-effective for some PLWH groups but further research is required, particularly on strategies targeting screening/PT to PLWH at higher risk. Standardisation of model descriptions and results reporting could facilitate reliable comparisons between studies, particularly to identify those factors driving the wide disparity between cost-effectiveness estimates.

Registration:PROSPEROCRD42020166338(18/03/2020).
Crime, punishment, and death: Reading finitude and the self in David Malouf’s ‘The Conversations at Curlow Creek’
Authors: Thakur Chinmaya Lal
Published: March 2021

The present paper reads David Malouf’s 1996 novel The Conversations at Curlow Creek as portraying a vivid and realistic picture of events relating to crime and punishment in colonial Australia in the early nineteenth century. The depiction of death penalty accorded to the bushranger Daniel Carney under the supervision of the Irish sheriff Michael Adair in New South Wales thus resonates with numerous historical accounts of incidents that actually happened. The novel, however, does more than only provide accurate historical representation as it also presents Adair as having undergone a rather dramatic transformation in the process of conversing with Carney before the latter’s execution. The paper, drawing on the views of the German philosopher Martin Heidegger, argues that a realization of inevitable mortality, of facing certain death characterizes this change in Adair’s nature and worldview. It concludes by suggesting that Adair’s acceptance of his finitude intimates of a way of being in the world that not only subverts procedures of administering punishment to convicts in colonial Australia but also indicates the limits of polarized identity politics that shapes the country in the present times.
Blue noise coding for a coherent x-ray diffraction imaging
system
Authors: Fang Zhen , Ma Xu , Restrepo Carlos , Arce Gonzalo R.
Published: March 2021

Coded x-ray diffraction imaging (CXRDI) is an emerging computational
imaging approach that aims to solve the phase retrieval problem in
x-ray crystallography based on the intensity measurements of encoded
diffraction patterns. Boolean coding masks (BCMs) with complementary
structures have been used to modulate the diffraction pattern in
CXRDI. However, the optimal spatial distribution of BCMs still remains
an open problem to be studied in depth. Based on the spectral
initialization criterion, we provide a theoretical proof for the
premise that the optimal complementary BCMs should obey the blue noise
distribution in the sense of mathematical expectation. In addition,
the benefits of the blue noise coding strategy are assessed by a set
of simulations, where better reconstruction quality is observed
compared to the random BCMs and other complementary BCMs.
Hierarchical registration of laser point clouds between airborne and
vehicle-borne data considering building eave attributes
Authors: Guo Yadong , Wang Xiankun , Su Dianpeng , Yang Fanlin , Li Guoyu , Qi Chao
Published: March 2021

Laser point cloud registration is a key step in multisource laser
scanning data fusion and application. Aimed at the problems of fewer
overlapping regional features and the influence of building eaves on
registration accuracy, a hierarchical registration algorithm of laser
point clouds that considers building eave attributes is proposed in
this paper. After extracting the building feature points of airborne
and vehicle-borne light detection and ranging data, the similarity
measurement model is constructed to carry out coarse registration
based on pseudo-conjugate points. To obtain the feature points of the
potential eaves (FPPE), the building contour lines of the
vehicle-borne data are extended using the direction prediction
algorithm. The FPPE data are regarded as the search set, in which the
iterative closest point (ICP) algorithm is employed to match the true
conjugate points between the airborne laser scanning data and
vehicle-borne laser scanning data. The ICP algorithm is used again to
complete the fine registration. To evaluate the registration
performance, the developed method was applied to the data processing
near Shandong University of Science and Technology, Qingdao, China.
The experimental results showed that the FPPE dataset can effectively
address the coarse registration accuracy effects on the convergence of
the iterative ICP. Before considering eave attributes, the mean
registration errors (MREs) of the proposed method in the

x
o
z

plane,

y
o
z

plane, and

x
o
y

plane are 0.318, 0.96, and 0.786 m,
respectively. After considering eave attributes, the MREs decrease to
0.129, 0.187, and 0.169 m, respectively. The developed method can
effectively improve the registration accuracy of the laser point
clouds, which not only solves the problem of matching true conjugate
points under the effects of the eaves but also avoids converging to a
local minimum due to ICP’s poor coarse registration.