bluuebunny/crossref_metadata_2025 huggingface dataset:
Disease Control: How to Live with Infection
Authors: Foufopoulos Johannes , Wobeser Gary A. , McCallum Hamish
Published: April 2022

For many wildlife disease situations, it can be near impossible to eradicate the pathogen on anything other than a local scale. This can be due to a number of causes, including the lack of necessary epidemiological information, or, even if the information is available, a lack of resources or access to the animals. In these cases an alternative epidemiological goal is to reduce the harm caused by the pathogen, in part by reducing the transmission and intensity of infection. Transmission can be attenuated through environmental manipulations or culling. The latter approach, while often utilized, is often not as effective as expected and careful consideration is needed before using it. Host resistance and tolerance can be improved by reducing other stressors on the population, for example, via food supplementation. Vaccination, even if administered at levels insufficient to eliminate a disease, can help the host population persist in the face of infection. Lastly, more rarely used approaches include the use of probiotics and genetic management of either the host or vector populations.
Two and a half approaches to two-dimensional wave-packet interferometry
Authors: Cina Jeffrey A.
Published: April 2022

Fluorescence-detected wave-packet interferometry (WPI or whoopee) and four-wave-mixing approaches to optically phase-coherent two-dimensional electronic spectroscopy are analyzed and compared. It is noted that the former (whoopee) method does not depend on wave-vector matching within a macroscopic sample and can be applied to single-chromophore systems. A version of four-wave mixing using spectral interferometry is outlined. The ranges of interpulse delay within which each of several contributing wave-packet overlaps may take nonzero values are identified. Time-versus-time WPI interferograms for a model Hamiltonian are interpreted by using quasi-classical phase-space diagrams to identify conditions for non-negligible overlap between contributing multi-pulse nuclear wave packets. The effects of inhomogeneous broadening and optical dephasing are explored by including an additional, sluggish vibrational mode.
Does Homeownership Reduce Wealth Disparities for Low-Income and Minority Households?
Authors: Eldemire Ashleigh , Luchtenberg Kimberly F , Wynter Matthew M
Published: April 2022

We use the U.S. Department of Housing and Urban Development’s Housing Choice Voucher program as a setting to evaluate the interaction of homeownership and race on the wealth accumulation of low-income households. Using a within-treatment difference-in-differences framework, we establish that low-income households that receive assistance in owning a home experience increased wealth accumulation relative to their tenure as renters. These wealth gains are not present among low-income minority households. Our findings provide evidence that homeownership is a driver of wealth formation for low-income households and that homeownership does not inherently reduce racial disparities in wealth. (JEL G51, J15, R21).
Social Change through Financial Innovation: Evidence from Donor-Advised Funds
Authors: Grennan Jillian
Published: April 2022

I draw on new data to examine how donor-advised funds (DAFs), a fast-growing philanthropic option, relate to social progress. DAFs are distinguished by flexibility such as their ability to transform complex assets and separate the timing of tax breaks from giving decisions. While DAFs are often classified by their sponsor type, I introduce a new classification scheme that reflects their economic purpose, including the users targeted, style and features offered, and focus of grant making. This classification reveals that growth is fastest among DAFs that offer fintech tools, liquidity transformation, and grant making focused on diversity, equity, and inclusion. Conditional correlations show that DAFs with an innovative style of service distribute more grants to charities serving areas with high inequality, in times of greatest financial need, and with more efficient operations. (JEL D64, K34, L31, G23, J15, O35)
EEG frequency tagging evidence of social interaction recognition
Authors: Oomen Danna , Cracco Emiel , Brass Marcel , Wiersema Jan R
Published: April 2022

Previous neuroscience studies have provided important insights into the neural processing of third-party social interaction recognition. Unfortunately, however, the methods they used are limited by a high susceptibility to noise. Electroencephalogram (EEG) frequency tagging is a promising technique to overcome this limitation, as it is known for its high signal-to-noise ratio. So far, EEG frequency tagging has mainly been used with simplistic stimuli (e.g. faces), but more complex stimuli are needed to study social interaction recognition. It therefore remains unknown whether this technique could be exploited to study third-party social interaction recognition. To address this question, we first created and validated a wide variety of stimuli that depict social scenes with and without social interaction, after which we used these stimuli in an EEG frequency tagging experiment. As hypothesized, we found enhanced neural responses to social scenes with social interaction compared to social scenes without social interaction. This effect appeared laterally at occipitoparietal electrodes and strongest over the right hemisphere. Hence, we find that EEG frequency tagging can measure the process of inferring social interaction from varying contextual information. EEG frequency tagging is particularly valuable for research into populations that require a high signal-to-noise ratio like infants, young children and clinical populations.
Finding Joy in Social Work: Practical Strategies
Authors: Wolfer Terry A , Pooler David K , Graves Brian D
Published: April 2022

Based on the broaden-and-build theory of positive emotion, this article suggests that efforts by social workers to find joy in the profession may help them broaden their scope of attention, cognition, and action; build physical, intellectual, and social resources for future use; and increase resilience. This article explains Fredrickson’s broaden-and-build theory as a basis for exploring and seeking positivity and outlines several practical strategies that social workers or their leaders can adopt to promote joy and other positive emotions. The strategies can be implemented at individual or group levels in classrooms or agencies. Finally, this article considers how these strategies may contribute to social worker self-care, self-awareness, and ongoing growth and development.
Towards a unified doctrine of mistake?
Authors: Lee Rebecca
Published: April 2022

The concept of mistake permeates various areas of private law and performs a similar function in relieving errors in each. This article reviews the operation of the doctrine of mistake in different substantive areas of law, including contract, unjust enrichment and equity, and argues that the similarities in terms of the requirements for establishing a mistake and the role of assumption of risk in negating a mistake should not be overstated. It further argues that the distinction between gifts and bargains, as well as the proprietary consequences of equitable mistakes, makes it premature to postulate a unified doctrine of mistake.
Registering express trusts: a necessary clarification or step too far?
Authors: Brown Lloyd
Published: April 2022

This article analyses the changes that have been made to the registration of trusts with the HMRC’s Trust Registration Service. Ultimately the registration system has been greatly extended by new rules that were introduced on 6 October 2020. Following an outline of the new registration requirements, the article thereafter goes on to argue that the changes may greatly affect the number of people willing to become trustees. Furthermore, the inevitable privacy concerns for trustees are considered, as under the new system third parties will be able to apply to see the information contained on the register.
New Cherry-Adapted Plum Pox Virus Phylogroups Discovered in Russia
Authors: Chirkov Sergei , Sheveleva Anna , Gasanova Tatiana , Kwon Dmitry , Sharko Fedor , Osipov Gennady
Published: April 2022

Plum pox virus (PPV) is the most pathogenic virus of stone fruit crops worldwide. Unusual PPV isolates were discovered on sour cherry (Prunus cerasus L.) and steppe cherry (P. fruticosa Pall.) in the Republic of Tatarstan and the Middle Ural region, Russia. They induced typical sharka symptoms and tested positive for PPV by ELISA and RT-PCR, but were not detected by PCR using known strain-specific primers. Their complete genomes were determined using high-throughput sequencing. Phylogenetic analysis allocated new isolates to four clearly distinguished lineages (SC, TAT, Y, Tat-26) within a cluster of PPV cherry-adapted strains. The phylogroups SC and TAT had 84.5 to 86.9% average nucleotide identity to each other and strain CR, with which they comprised a common subcluster. Isolates from the Middle Ural region (group Y) were closer to strain C, sharing 96.9% identity. The fourth lineage is represented by the isolate Tat-26, which was a recombinant of strain CR and C isolates as major and minor parents, respectively. These results show that the genetic diversity of PPV is higher than thought and may contribute to a better understanding of the origin and evolution of cherry-adapted strains of the virus. P. fruticosa was reported as a new natural PPV host for the first time.
Infection Characteristics and Physical Prevention Strategy of Panax notoginseng Round Spot Disease Caused by Mycocentrospora acerina
Authors: Yang K. , Wang H. L. , Ye C. , Wang Z. H. , Ye K. H. , Zhang S. , Huang H. P. , Wei Z. X. , Zhu S. S. , Zhu Y. Y. , Guo L. W. , He X. H.
Published: April 2022

Panax notoginseng round spot disease (PRSD), caused by Mycocentrospora acerina, is the main leaf disease occurring in cultured P. notoginseng. Aiming to find a safe and efficient control method for PRSD, we studied the disease characteristics of PRSD and the optimal growth conditions of M. acerina and evaluated the efficacy of rain-shelter cultivation in PRSD control. Moreover, we described M. acerina based on morphological characterization and molecular analyses (ITS, ACT, LSU, and TEF-1α). The optimum temperature for M. acerina conidial germination was found to be 14 to 22°C. Furthermore, leaf surface wetness for at least 4 h is required for conidial germination, and conidia can successfully infect P. notoginseng when the leaf wetness lasts for more than 8 h. Additionally, rainwater splashing determines the conidial transfection distance, which is less than 2 m. Finally, our study revealed that rain-shelter cultivation is an effective and simple physical prevention strategy to control PRSD, with an average efficacy of up to 100%.
Detection of Xanthomonas translucens pv. undulosa, pv. translucens, and pv. secalis by Quantitative PCR
Authors: Sarkes Alian , Yang Yalong , Dijanovic Snezana , Fu Heting , Zahr Kher , Harding Michael W. , Feindel David , Feng Jie
Published: April 2022

A probe-based quantitative PCR (qPCR) protocol was developed for detection and evaluation of the wheat bacterial leaf streak pathogen Xanthomonas translucens pathovar (pv.) undulosa. The protocol can also detect X. translucens pv. translucens and X. translucens pv. secalis but can’t differentiate the three pathovars. When tested on nontarget DNA (i.e., from plant; bacteria other than X. translucens pv. undulosa, X. translucens pv. translucens, and X. translucens pv. secalis; and culture of microorganisms from wheat grains), the qPCR showed a high specificity. On purified X. translucens pv. undulosa DNA, the qPCR was more sensitive than a loop-mediated isothermal amplification assay. When DNA samples from a set of serial dilutions of X. translucens pv. undulosa cells were tested, the qPCR method could repeatedly generate quantification cycle (Cq) values from the dilutions containing ≥1,000 cells. Since 2 µl of the total 50 µl of DNA was used in one reaction, one qPCR reaction could detect the presence of the bacteria in samples containing as few as 40 bacterial cells. The qPCR could detect the bacteria from both infected grain and leaf tissues. For seed testing, a protocol for template preparation was standardized, which allowed one qPCR reaction to test DNA from the surface of one wheat grain. Thus, the qPCR system could detect X. translucens pv. undulosa, X. translucens pv. translucens, and/or X. translucens pv. secalis in samples where the bacteria had an average concentration of ≥40 cells per grain.
Taking Aim at the Injury Prevention Curriculum: Educating Residents on Talking to Patients About Firearm Injury
Authors: Mueller Kristen L. , Blomkalns Andra L. , Ranney Megan L.
Published: April 2022

The medical community recognizes that firearm injury is a public health problem. Yet we lack both the tools for and the implementation of evidence-based firearm injury screening and counseling techniques. One reason for these deficits is the lack of clinical training related to engaging patients in firearm injury risk reduction. In this issue, Rickert et al describe a pre–post evaluation of a 2-part firearm injury prevention training curriculum for first-year medical residents at a single academic medical center. Their manuscript serves an important, but still preliminary, step forward for the field of postgraduate medical education on firearm injury and its prevention. Important elements of this project and paper consist of the inclusion of multiple medical disciplines and the use of standardized patients to evaluate participants’ learning. This project also points to the need for further growth. We must commit to consistently and conscientiously framing injuries from guns not as “gun violence” but rather as “firearm injuries” to ensure that they are considered squarely in both the public health space and the clinical space. An ideal curriculum would also highlight the importance of trauma-informed care, cultural competency, and antiracist medical practice while countering implicit biases (e.g., toward gun owners, victims of firearm violence, perpetrators of violence). It should address barriers, as well as facilitators, to change. And most importantly, future educational work must evaluate the effect of these trainings on actual clinical practice—and, even better, the efficacy of education in changing behavior and patient-level outcomes.
Formal Reporting of Identity-Based Harassment at an Academic Medical Center: Incidence, Barriers, and Institutional Responses
Authors: Vargas Emily A. , Cortina Lilia M. , Settles Isis H. , Brassel Sheila T. , Perumalswami Chithra R. , Johnson Timothy R.B. , Jagsi Reshma
Published: April 2022

Purpose

To examine the incidence of, barriers to, and institutional responses to formal reporting of experiences of identity-based harassment at an academic medical center.

Method

The authors invited 4,545 faculty and medical trainees at the University of Michigan Medical School to participate in a 2018 survey about civility and respect. This analysis focused on respondents who indicated experiencing at least 1 form of identity-based harassment (sexual harassment, gender policing harassment, heterosexist harassment, racialized sexual harassment) within the past year, perpetrated by staff, students, and faculty or by patients and patients’ families. The authors assessed the incidence of formally reporting harassment to someone in authority, barriers to reporting, and institutional responses following reporting.

Results

Among the 1,288 (28.3%) respondents with usable data, 83.9% (n = 1,080) indicated experiencing harassment. Of the harassed individuals, 10.7% (114/1,067), including 13.1% (79/603) of cisgender women and 7.5% (35/464) of cisgender men, indicated they formally reported their harassment experiences. Among these reporters, 84.6% (66/78) of cisgender women and 71.9% (23/32) of cisgender men indicated experiencing positive institutional remedies. Many reporters indicated experiencing institutional minimization (42.9% [33/77] of cisgender women; 53.1% [17/32] of cisgender men) or retaliation (21.8% [17/78] of cisgender women; 43.8% [14/32] of cisgender men). Cisgender men were significantly more likely to indicate experiencing specific negative institutional responses, such as being considered a troublemaker (OR 3.56, 95% CI: 1.33–9.55). Among respondents who did not formally report harassment experiences, cisgender women were significantly more likely to cite concerns about institutional retaliation, such as being given an unfair performance evaluation or grade (OR 1.90, 95% CI: 1.33–2.70).

Conclusions

Most respondents who experienced harassment did not formally report it to anyone in authority. Many reporters faced institutional minimization and retaliation. These findings suggest a need to reshape institutional harassment prevention and response systems in academic medicine.
Differences in Quantitative Sensory Testing Outcomes Between Patients With Low Back Pain in Primary Care and Pain-free Controls
Authors: den Bandt Hester L. , Ickmans Kelly , Leemans Lynn , Nijs Jo , Voogt Lennard
Published: April 2022

Objectives:

Quantitative Sensory Testing (QST) is used to test somatosensory functioning in on people with chronic LBP in secondary/tertiary health care facilities. Studies using QST-testing on LBP populations in primary care are scarce. Central Sensitization Inventory (CSI) measures central sensitization (CS)-related symptoms and studies investigating the differences between QST-testing and participants with LBP with a positive and negative score on the CSI questionnaire are also rare. This case-control study investigates differences of an extensive QST-measurement between patients with acute, chronic LBP, and pain-free controls (PFCs) in primary care. Secondary aim is to investigate differences of an extensive QST-measurement between “CS” and “no-CS” group.

Materials and Methods:

Participants with LBP were recruited from November 2016 to October 2019. Demographic and clinical information was collected and a standardized QST protocol was taken. Data analysis involved determining differences between groups.

Results:

Data of 100 participants with LBP and 50 PFCs were analyzed. Heat pain thresholds, pressure pain threshold, and conditioned pain modulation local and remote were significantly moderately to relatively strongly affected by acute, chronic LBP and PFCs (P<0.001 to 0.001). Lumbar temporal summation was significantly moderately affected by acute, chronic LBP, and PFCs (P=0.001). Only pressure pain threshold showed significant difference between “CS” and “no-CS” group (P=0.001 to 0.002).

Discussion:

Signs of enhanced nociceptive processing and disturbed top-down nociceptive modulation are apparent in people with acute and chronic LBP in primary care. Results indicate existence of central mechanisms in LBP in primary care.
Persistent hand pain despite adequate immunosuppression? The distinct value of occupational therapy in the era of biologics
Authors: Minhas Deeba , Cagnoli Patricia , Dodge Carole
Published: April 2022

Purpose of review

Despite the tremendous advancement in the use of biologics, many patients with inflammatory arthritis do not achieve remission, and the risk of joint damage remains high. A multidimensional approach to treatment is essential. Joint disease in the hands and wrists may prevent patients from performing daily and valued life activities. This review will discuss the role of occupational therapists in inflammatory arthritis, recent updates on joint protection and assistive devices, as well as highlighting adjunctive treatment options for rheumatologists to help patients manage their symptoms.

Recent findings

This article describes the meaningful role of occupational therapy and assistive devices in improving the outcomes for patients with inflammatory arthritis. We describe orthoses, assistive devices and adjunctive therapies utilized in inflammatory arthritis. We provide evidence supporting joint protection and occupational therapy as ways to help with these diseases. A multidisciplinary approach including the entire healthcare provider team, including occupational therapists, is essential to providing individualized treatment focusing on maximizing mobility in each patient's daily routine.

Although larger studies are needed, assessment by hand-certified occupational therapists for instruction in joint protection techniques, assistive devices and customized orthoses and devices are important adjuncts to pharmacologic management in inflammatory arthritis.
The “Discoid Epiphysis”—An Uncommon Presentation of Legg-Calvé-Perthes Disease
Authors: Shah Hitesh , Singh Kumar A. , Joseph Benjamin
Published: April 2022

Background:

Among a cohort of 402 children with Legg-Calvé-Perthes disease (LCPD), 32 children presented with sclerosis and severe collapse of the entire femoral epiphysis that closely resembled a discus.

This study was undertaken to identify the characteristics of children with this form of a “discoid epiphysis,” compare them with typical LCPD and ascertain the radiologic outcome of their hips when the disease healed.

Methods:

Sequential radiographs of the children were studied to monitor disease evolution. Femoral epiphyseal extrusion was measured on the initial anteroposterior radiograph. Thirty-one of the 32 children were treated with a proximal femoral varus osteotomy and weight-bearing was deferred till the disease reached stage IIIb. The pattern of fragmentation of the epiphysis was noted and the Sphericity Deviation Score (SDS) was computed once the disease healed.

Results:

The mean age of children with a discoid epiphysis was 6.81±1.57 years at onset of symptoms while that of children with the typical presentation was 7.54±1.64 years (P<0.017). Perfusion magnetic resonance imaging scans of three children with a discoid epiphysis done in stage Ib of the disease showed that over 95% of the epiphysis was avascular. Femoral head extrusion was frequently present on the initial radiographs (mean Reimer’s migration index 27.08±8.7; range: 6.4 to 42.55).

In operated children with a discoid epiphysis, the disease evolved typically with fragmentation of the epiphysis followed by reconstitution. The height of the epiphysis was never restored; when the disease healed the mean epiphyseal height was 51.31±10.44% of the normal contralateral epiphysis as compared with 82.46±11.24% in children with typical LCPD (P<0.001).

The SDS at healing of operated children with a discoid epiphysis was 14.95±10.86 while the SDS for operated children without a discoid epiphysis was 9.77±11.7 (P<0.019). However, the SDS of children with typical onset LCPD who had Catterall IV involvement and Herring C collapse was 15.25±15.19 (P=0.49 NS).

Conclusion:

The outcome of treatment of children with a discoid epiphysis is comparable to that of children with typical onset LCPD with Catterall IV (whole-head involvement) and Herring C collapse of the lateral pillar. About a third of these children who undergo early surgical containment may have spherical heads when the disease heals.
A Qualitative Study to Understand the Cultural Factors That Influence Clinical Data Use for Continuing Professional Development
Authors: Wiljer David , Tavares Walter , Charow Rebecca , Williams Spencer , Campbell Craig , Davis Dave , Jeyakumar Tharshini , Mylopoulos Maria , Okrainec Allan , Silver Ivan , Sockalingam Sanjeev
Published: April 2022

Introduction:

The use of data to inform lifelong learning has become increasingly important in continuing professional development (CPD) practice. Despite the potential benefits of data-driven learning, our understanding of how physicians engage in data-informed learning activities, particularly for CPD, remains unclear and warrants further study. The purpose of this study was to explore how physicians perceive cultural factors (individual, organizational, and systemic) that influence the use of clinical data to inform lifelong learning and self-initiated CPD activities.

Methods:

This qualitative study is part of an explanatory sequential mixed-methods study examining data-informed learning. Participants were psychiatrists and general surgeons from Canada and the United States. Recruitment occurred between April 2019 and November 2019, and the authors conducted semistructured telephone interviews between May 2019 and November 2019. The authors performed thematic analysis using an iterative, inductive method of constant comparative analysis.

Results:

The authors interviewed 28 physicians: 17 psychiatrists (61%) and 11 general surgeons (39%). Three major themes emerged from the continuous, iterative analysis of interview transcripts: (1) a strong relationship between data and trust, (2) a team-based approach to data-informed learning for practice improvement, and (3) a need for organizational support and advocacy to put data into practice.

Conclusion:

Building trust, taking a team-based approach, and engaging multiple stakeholders, such as data specialists and organizational leadership, may significantly improve the use of data-informed learning. The results are situated in the existing literature, and opportunities for future research are summarized.
Three-dimensional measurements on the mandible of patients with hemifacial microsomia
Authors: Wang Meng , Gui Lai
Published: April 2022

Background:

Hemifacial microsomia (HFM), which involves multiple sites with different levels of severity, is the second most common congenital craniofacial deformity after cleft lip and palate. However, three-dimensional (3D) measurements of mandibular deformities have not yet been studied in detail. The objective of this study is to investigate the method of 3D measurements of mandibular deformities in HFM patients.

Methods:

A total of 48 HFM patients were included in this study. All clinical treatment for patients was performed in the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences at Peking Union Medical College from June 2006 to June 2020. The patients’ 3D computerized tomography scan data were processed using medical imaging software, following four iterative steps: 3D reconstruction, mirroring, differential analysis, and partition.

Results:

The characteristics of the mandibular bone in HFM patients are mainly presented as follows: (1) compared to the normal side, the part of the bone body that extends from the ascending ramus to the pogonion (Po-NB) is analyzed using a dynamic process: less fullness-fullness-more fullness; (2) absences were frequently observed among the angular zones, that is, the height of the ascending ramus is deficient.

Conclusions:

HFM is a complicated condition with numerous variations in clinical presentation. We employed both 3D image reconstruction and computerization image processing techniques to investigate asymmetrical mandibular deformity in HFM patients in detail and with great accuracy. This will be of great use to clinicians for disease management.
Let Me Spell It Out: The Impact of Microaggression on the Health Care Professional
Authors: Valdez Purnima , Kendrick-Allwood Salathiel , Williams Traci S. , Spinks-Franklin Adiaha , Nyp Sarah S.
Published: April 2022

CASE:

Rachel is a 10-year-old White girl with attention-deficit/hyperactivity disorder and a history of trauma who presented for evaluation by Dr. Narayanaswamy, a developmental-behavioral pediatrician. A pediatric resident observed the visit with permission from Rachel's parents.

During the visit, Dr. Narayanaswamy spoke to Rachel's case manager over the phone to advocate for a trauma-based day treatment program at her school. At the end of the call, the case manager asked the physician for her full name. Dr. Narayanaswamy responded with her name and asked the case manager, “Would you like me to spell it?” At that time, Rachel's father began to laugh, shook his head, and incredulously remarked, “Ugh, yeah you need to spell it.” Dr. Narayanaswamy ignored the comment and completed the phone call.

After the visit, Dr. Narayanaswamy explained to the resident that the father's derisive laughter was a microaggression. The resident appreciated the observation and, after a pause, asked why she chose not to defend herself when the microaggression occurred. Dr. Narayanaswamy reflected that she had refrained from responding to Rachel's father over concern that he would retaliate by providing low ratings on the postvisit patient satisfaction survey sent to all patients who received care at the institution. The granular survey results, comprising ratings in each survey subheading category for each clinician, are made public to members of her division each quarter, and low ratings are scrutinized by the leadership. Dr. Narayanaswamy thought it unfortunate that she felt inhibited in her response because this deprived the resident of observing ways to address microaggressions during an encounter, deprived herself the opportunity to respond directly to Rachel's father, and deprived Rachel from an instructive moment about racial empathy.

Dr. Narayanaswamy wrote a letter about the incident to the chief of clinical affairs to inquire what recourse clinicians had in these situations and whether certain patient encounters could be flagged to prevent the postvisit patient survey from being automatically sent. The chief responded that the incident was unfortunate and praised Dr. Narayanaswamy's restraint and professionalism but denied her request to have postvisit surveys blocked for certain encounters. He shared that if a clinician were to be dissatisfied with a visit satisfaction rating, the clinician could petition for a review, and a committee would subsequently determine whether the review could be removed.

How can health care professionals respond to microaggressions while maintaining a therapeutic alliance with the patient/family members and how can institutions support health care professionals in this endeavor?
Therapeutic Drug Monitoring of Long-Acting Injectable Antipsychotics as a Predictor of Relapse in Schizophrenia Spectrum Disorders: A 1-Year Pilot Study
Authors: D'Anna Giulio , Rotella Francesco , Santarelli Gabriele , Scannerini Silvia , Fanelli Alessandra , Ricca Valdo , Ballerini Andrea
Published: April 2022

Background:

Long-acting injectable antipsychotics (LAIs) have been shown to reduce acute episodes of schizophrenia spectrum disorders (SSDs). However, breakthrough relapses are frequent, possibly because of underdosing in clinical practice. In this framework, the advantages of therapeutic drug monitoring (TDM) may be overlooked. This study explored the association of low steady-state LAI levels with a higher risk of relapse in SSDs, despite the use of a licensed posology.

Methods:

Forty-eight clinically stable outpatients with SSD underwent LAI-TDM using liquid chromatography–mass spectrometry for routine observational purposes. Baseline anamnestic, pharmacological, and psychometric evaluations compared subjects with “under-range” versus “in-range” LAI serum levels; between-group comparisons for different LAI treatments were also performed. A binary logistic regression explored which baseline factors (age, sex, previous hospitalizations, psychopathology, specific LAI treatment, and underrange serum levels) predicted relapse during the next 12 months.

Results:

Baseline comparisons did not show significant between-group differences, except for a higher percentage of underrange values in individuals receiving olanzapine pamoate. A total of 10 patients (20.8%) relapsed during the follow-up; only underrange LAI levels predicted the event (odds ratio 0.03, 95% confidence interval 0.01–0.36; P = 0.005).

Conclusions:

Even if relapse remains as a multifactorial event, LAI-TDM may identify subjects at risk for this negative outcome, thus optimizing antipsychotic maintenance treatment in the context of precision medicine. The finding of underrange LAI plasma levels in real-world practice should prompt adequate monitoring of clinically stable outpatients to identify the early signs of psychopathological deterioration.
Intestinal Inflammation is Significantly Associated With Length Faltering in Preterm Infants at Neonatal Intensive Care Unit Discharge
Authors: Thai Julie D. , Cherkerzian Sara , Filatava Evgenia J. , Luu Ngan , Yamamoto Hidemi S. , Fichorova Raina N. , Belfort Mandy B. , Gregory Katherine E.
Published: April 2022

Objective:

The aim of the study was to assess intestinal inflammatory measures, urinary intestinal fatty acid‐binding protein (IFABP), and fecal calprotectin (FC) by gestational age (GA) and postmenstrual age (PMA) and determine the association between intestinal inflammation and growth in preterm infants from birth to hospital discharge. We hypothesized that intestinal inflammation is associated with adverse growth in preterm infants.

Methods:

We assayed repeated measures of IFABP and FC in 72 hospitalized preterm infants (<34 weeks’ gestation). We calculated weight and length z scores at birth and discharge using the Fenton growth reference. Associations between mean IFABP or FC, growth z scores at discharge, and growth faltering (weight or length z score difference <−0.8 from birth to discharge) were assessed using mixed linear and logistic regression models, adjusted for intrafamilial correlation and potential confounders: GA, sex, birth z score, race/ethnicity, and maternal age.

Results:

Mean IFABP was greater among infants born at earlier GA and decreased with increasing PMA. Mean FC did not vary by GA or PMA. Higher mean IFABP and FC were associated with lower discharge growth z scores and greater likelihood of growth faltering significant only for mean IFABP and discharge length z score (β = −0.353, 95% confidence interval [CI]: −0.704 to −0.002) and mean IFABP and length faltering (odds ratio [OR] 1.99, P = 0.018).

Conclusions:

Intestinal inflammation, measured by IFABP, was associated with lower length z scores and length faltering at discharge. Interventions to prevent intestinal inflammation may improve linear growth among preterm infants.
Incomplete Third Nerve Palsy Due to a Carotid-Cavernous Fistula
Authors: Chan Chung Charles , Wen David Wei , Chew Tricia Li Ting , See Siew Ju
Published: April 2022

Introduction:

The approach to oculomotor nerve palsies involves the exclusion of compressive, infective, inflammatory, or ischemic lesions. Dural arteriovenous fistulae, including carotid-cavernous fistulae (CCF), are known causes of third nerve palsy. However, diagnosis can sometimes be delayed or missed due to the various clinical presentations. CCF remains a rare but treatable cause of third nerve palsy.

Case Report:

A 63-year-old Chinese female presented to our unit with gradual onset horizontal diplopia. Clinical examination revealed a partial left oculomotor nerve palsy without congestive eye symptoms. A cerebral angiogram revealed a left indirect CCF supplied by the inferolateral trunk of the left internal carotid artery. She underwent successful transvenous embolization. She improved postprocedure and was discharged well on day 10 of her admission. She was reviewed at 2 months follow-up and had recovered completely.

Conclusion:

Our case is a classic description of a CCF with posterior drainage into the inferior petrosal sinus. We hope this case and a review of the literature can serve as a reminder to clinicians of the varied presentations of CCF. We believe this case adds value to the clinicians in contributing to their diagnostic process and to our interventional colleagues in highlighting a case with a successful postembolization outcome.
Case report: unique failure of a Synthes TFNA fenestrated lag screw in a peritrochanteric nonunion
Authors: Smidt Kevin P. , Perry Kevin J. , Andre Lincoln K. , Chauvin Brad J. , Kautz Steve , Massey Patrick A. , Barton R. Shane
Published: April 2022

Background:

Intertrochanteric femur fractures are a common orthopaedic injury that are often treated surgically. Cephalomedullary nails (CMN) are frequently the implant of choice for intertrochanteric femur fractures, resulting in low complication rates. Implant failure is a rare but reported complication. Common locations of failure include the proximal nail aperture, distal screw holes, and implant shaft. In this case report, we describe a CMN failure pattern through fenestrated cephalic screw holes.

Case:

A 70-year-old female sustained an OTA 31A-2.2 peritrochanteric fracture during a motor vehicle collision. She was treated the following day with a Synthes Trochanteric Fixation Nail—Advanced CMN utilizing a fenestrated cephalic screw. There were no intraoperative complications. She was made non-weight bearing for 8 weeks after the procedure due to ipsilateral foot fractures. At 6 months follow-up she was noted to have a delayed union. 11 months postoperatively she suffered a ground level fall and the cephalic lag screw failed through its fenestrations, resulting in varus collapse of her fracture at the femoral neck. The patient then underwent nail extraction and salvage total hip arthroplasty.

Conclusion:

Cephalomedullary nail implant failure is presented with implant fracture propagation through a fenestrated cephalic screw. Cephalomedullary lag screw failure is rare and can be difficult to manage. It is important to monitor new implants for unique failure mechanisms.
Health Care Disparities in Surgical Management of Pelvic Organ Prolapse: A Contemporary Nationwide Analysis
Authors: Yadav Ghanshyam S. , Rutledge Emily C. , Nisar Tariq , Xu Jiaqiong , Rozycki Sarah K. , Muir Tristi , Antosh Danielle D.
Published: April 2022

Objectives

Our objective was to compare the rate of native tissue repair (NTR) versus sacrocolpopexy (SCP) and reconstructive (RECON) versus obliterative repair (OBR) for the treatment of pelvic organ prolapse (POP), evaluating for health care disparities based on race, socioeconomic, and geographic factors.

Methods

The National Inpatient Sample database was queried for patients older than 18 years undergoing POP surgery from 2008 to 2018. Baseline demographics, comorbidity index, socioeconomic, and hospital variables were extracted. The weighted t test, Wilcoxon test, and χ2 test were used to compare the rate of (1) NTR versus SCP and (2) RECON vs OBR. Multivariate weighted logistic regression was used to compare while controlling for confounders. Reference groups were White race, Medicare patients, northeast region, small hospital size, and rural location.

Results

Of 71,262 patients, 67,382 (94.6%) underwent RECON. Patients undergoing OBR were older and had a higher comorbidity score. Multivariate analysis showed the following: (1) Black, Hispanic, and other races; (2) Medicaid patients; (3) patients at urban teaching hospitals are less likely to receive RECON. Patients in the midwest were more likely to receive RECON. Among 68,401 patients, 23,808 (34.8%), and 44,593 (65.19%) underwent SCP and NTR, respectively. Hysterectomy was more common in the NTR group. Multivariate analysis showed the following:(1) Black, Hispanic, and “other” races; (2) uninsured and Medicaid patients; (3) patients in the midwest, south, and west were at higher odds of receiving NTR. Patients in large and urban hospitals were less likely to undergo NTR.

Conclusions

Racial, socioeconomic, and geographic disparities exist in surgical management for POP warranting further study to seek to eliminate these disparities.
Unravelling insect declines: can space replace time?
Authors: Blüthgen Nico , Staab Michael , Achury Rafael , Weisser Wolfgang W.
Published: April 2022

Temporal trends in insect numbers vary across studies and habitats, but drivers are poorly understood. Suitable long-term data are scant and biased, and interpretations of trends remain controversial. By contrast, there is substantial quantitative evidence for drivers of spatial variation. From observational and experimental studies, we have gained a profound understanding ofwhereinsect abundance and diversity is higher—and identified underlying environmental conditions, resource change and disturbances. We thus propose an increased consideration of spatial evidence in studying the causes of insect decline. This is because for most time series available today, the number of sites and thus statistical power strongly exceed the number of years studied. Comparisons across sites allow quantifying insect population risks, impacts of land use, habitat destruction, restoration or management, and stressors such as chemical and light pollution, pesticides, mowing or harvesting, climatic extremes or biological invasions. Notably, drivers may not have to change in intensity to have long-term effects on populations, e.g. annually repeated disturbances or mortality risks such as those arising from agricultural practices. Space-for-time substitution has been controversially debated. However, evidence from well-replicated spatial data can inform on urgent actions required to halt or reverse declines—to be implemented in space.
A shared future: chemistry's engagement is essential for resilience of people and planet
Authors: Mehta Goverdhan , Cornell Sarah E. , Krief Alain , Hopf Henning , Matlin Stephen A.
Published: April 2022

Strengthening resilience—elasticity or adaptive capacity—is essential in responding to the wide range of natural hazards and anthropogenic changes humanity faces. Chemistry's roles in resilience are explored for the first time, with its technical capacities set in the wider contexts of cross-disciplinary working and the intersecting worlds of science, society and policy. The roles are framed by chemistry's contributions to the sustainability of people and planet, examined via the human security framework's four material aspects of food, health, economic and environmental security. As the science of transformation of matter, chemistry is deeply involved in these material aspects and in their interfacing with human security's three societal and governance aspects of personal, community and political security. Ultimately, strengthening resilience requires making choices about the present use of resources as a hedge against future hazards and adverse events, with these choices being co-determined by technical capacities and social and political will. It is argued that, to intensify its contributions to resilience, chemistry needs to take action along at least three major lines: (i) taking an integrative approach to the field of ‘chemistry and resilience’; (ii) rethinking how the chemical industry operates; and (iii) engaging more with society and policy-makers.
Oca2targeting using CRISPR/Cas9 in the Malawi cichlidAstatotilapia calliptera
Authors: Clark Bethan , Elkin Joel , Marconi Aleksandra , Turner George F. , Smith Alan M. , Joyce Domino , Miska Eric A. , Juntti Scott A. , Santos M. Emília
Published: April 2022

Identifying genetic loci underlying trait variation provides insights into the mechanisms of diversification, but demonstrating causality and characterizing the role of genetic loci requires testing candidate gene function, often in non-model species. Here we establish CRISPR/Cas9 editing inAstatotilapia calliptera, a generalist cichlid of the remarkably diverse Lake Malawi radiation. By targeting the geneoca2required for melanin synthesis in other vertebrate species, we show efficient editing and germline transmission. Gene edits include indels in the coding region, probably a result of non-homologous end joining, and a large deletion in the 3′ untranslated region due to homology-directed repair. We find thatoca2knock-outA. callipteralack melanin, which may be useful for developmental imaging in embryos and studying colour pattern formation in adults. AsA. callipteraresembles the presumed generalist ancestor of the Lake Malawi cichlid radiation, establishing genome editing in this species will facilitate investigating speciation, adaptation and trait diversification in this textbook radiation.
Re-contacting biobank participants: lessons from a pilot study within FinnGen
Authors: Rodosthenous Rodosthenis S. , Niemi Mari E.K. , Kallio Lila , Perälä Merja , Terho Perttu , Knopp Theresa , Punkka Eero , Makkonen Enni M. , Nurmi Paula , Mäkelä Johanna , Wihuri Pauli , Hautalahti Marco , Moffatt Corianna , Martini Paolo , Germine Laura , Mäkelä Viola A. , Karhunen Oona A. , Lahti Jari , Hiekkalinna Tero S. , Jyrhämä Tero , Shen Huei-Yi ,   FinnGen, Runz Heiko , Palotie Aarno , Perola Markus , Ganna Andrea
Published: April 2022

Background

Biobank studies are well suited to identify novel disease risk factors. However, these studies often offer limited insights into participants’ lifestyle, behavioral, or cognitive characteristics, among others. FinnGen is a nation-wide biobank project in Finland and one of the largest in the world that has successfully linked genetic and register-based information for 259,578 individuals (N=500,000 by 2023); however, it lacks cognitive, behavioral, and lifestyle measurements.

Methods

We conducted a pilot study to evaluate the feasibility of obtaining cognitive, behavioral, and lifestyle information by re-contacting 5,995 participants from three FinnGen-participating Biobanks. We created an online portal to allow participants to securely log-in, provide consent, and access the study survey tools.

Results

The overall participation rate was 18.6% (23.1% among individuals aged 18-69). A second reminder letter yielded an additional 9.7% participation rate in those who did not respond to the first invitation. Re-contacting participants via an online healthcare portal yielded lower participation than re-contacting via physical letter. The completion rate of questionnaire and cognitive tests was high (92% and 85%, respectively), and measurements were overall reliable among participants. For example, the correlation (r) between self-reported body mass index and that collected by the biobanks was 0.92.

Conclusions

In summary, this pilot suggests that re-contacting FinnGen participants with the goal to collect a wide range of cognitive, behavioral and lifestyle information without additional engagement, results in a low participation rate, but with reliable data. We suggest that such information be collected at enrollment, if possible, rather than via post-hoc re-contacting.
Duration of COVID-19 mRNA Vaccine Effectiveness against Severe Disease
Authors: Bansal Devendra , Abdulmajeed Jazeel , Yassin Esraa , Al-Shamali Maha H M A , Albayat Soha S A , Himatt Sayed M , Cyprian Farhan S , Chivese Tawanda , Mundodan Jesha M A , Khogali Hayat , Baaboura Rekayahouda , Kaleeckal Anvar H , Kandy Mujeeb C , Latif Ali Nizar , Al-Kuwari Mohamed G , Al-Romaihi Hamad Eid , Khal Abdullatif Al , Bertollini Roberto , Al-Thani Mohamed H , Farag Elmobashar , Doi Suhail A R
Published: April 2022

Background

Waning immunity following administration of mRNA based COVID-19 vaccines remains a concern for many health systems. We undertook a study of SARS-CoV-2 infections, with and without requirement for intensive care to shed more light on the duration of vaccine effectiveness for protection against the need for intensive care.

Methods

We used a matched case-control study design with the study base being all individuals with first infection with SARS-CoV-2 reported in the State of Qatar between 1 Jan 2021 and 20 Feb 2022. Cases were those requiring intensive care while controls were those who recovered without need for intensive care. Vaccine effectiveness against requiring intensive care and number needed to vaccinate (NNV) to prevent one more case of COVID-19 requiring intensive care were computed for the mRNA (BNT162b2 / mRNA-1273) vaccines.

Results

Vaccine effectiveness against requiring intensive care was 59% (95% confidence interval [CI], 50 to 76) between the first and second dose and strengthened to 89% (95% CI, 85 to 92) between the second dose and 4 months post the second dose in persons who received a primary course of the vaccine. There was no waning of vaccine effectiveness in the period from 4 to 12 months after the second dose.

Conclusions

This study demonstrates that vaccine effectiveness against requiring intensive care remains robust till at least 12 months after the second dose of mRNA based vaccines.