bluuebunny/crossref_metadata_2025 huggingface dataset:
Adult malnutrition, nutritional interventions and outcomes in Singapore: a scoping review of local studies for the past 20 years
Authors: Wong Alvin , Huang Yingxiao , Sowa Przemyslaw M , Banks Merrilyn D , Bauer Judith D
Published: October 2020

Background:

There is currently no review published on the prevalence and incidence of malnutrition in Singapore across various populations, or what interventions or policies are in place for preventing/treating malnutrition.

Objectives:

This review aims to determine the: (a) incidence and prevalence of malnutrition in the community, and in acute, intermediate and long-term care facilities; (b) interventions implemented for screening, assessing and treating/preventing malnutrition; (c) specific clinical populations investigated for malnutrition or nutritional therapy; and (d) implications of malnutrition and effectiveness of treating malnutrition or using nutritional therapy in Singapore.

Methods:

A structured search strategy was applied to available electronic databases (MEDLINE/PubMed, EMBASE, CINAHL, the Cochrane Library and Google Scholar) using selected search terms, with additional reports and grey literature identified using iterative searches.

Results:

Forty-two articles were found, with the majority of research performed in the community and acute care settings. Malnutrition screening and assessment is the most common nutritional research performed in Singapore. Approximately 14.7% to 65.0% of acute care and 2.8% to 31.5% of community populations are found to be malnourished. Limited interventional and economic-related studies are available.

Conclusion:

Malnutrition rates in Singapore appear to be similar to other developed countries. Future studies will need to focus on nutritional intervention, cost-effectiveness analyses and specific populations such as the underprivileged, chronically ill and those dependent on nutritional support.
Visual Search Within a Limited Window Area: Scrolling Versus Moving Window
Authors: Fujii Yumiko , Morita Hiromi
Published: October 2020

Every day we perceive pictures on our mobile phones and scroll through images within a limited space. At present, however, visual perception via image scrolling is not well understood. This study investigated the nature of visual perception within a small window frame. It compared visual search efficiency using three modes: scrolling, moving-window, and free-viewing. The item number and stimulus size varied. Results showed variations in search efficiency depending on search mode. The slowest search occurred under the scrolling condition, followed by the moving-window condition, and the fastest search occurred under the no-window condition. For the scrolling condition, the response time increased the least sharply in proportion to item number but most sharply in proportion to the stimulus size compared to the other two conditions. Analysis of the trace of scan revealed frequent pauses interjected with small and fast stimulus shifts for the scrolling condition, but slow and continuous window movements interjected with a few pauses for the moving-window condition. We concluded that searching via scrolling was less efficient than searching via a moving-window, reflecting differences in dynamic properties of participants’ scan.
Delayed diagnosed Gradenigo’s syndrome associated with acute otitis media
Authors: Demir Berat , Abuzaid Ghazi , Ergenc Zeynep , Kepenekli Eda
Published: October 2020

Gradenigo’s syndrome presents as a triad of retroorbital pain, ipsilateral abducens palsy, and purulent otorrhea. If the otologic pathologies in Gradenigo’s syndrome go unnoticed, the condition could be misdiagnosed with neurological diseases because of retroorbital pain and abducens palsy. Treatment of Gradenigo’s syndrome remains controversial. Although some reports state that long-term antibiotic treatment is sufficient, we recommended that management ought to be guided on a case-by-case basis depending on patient and disease factors. Herein, we report a delayed diagnosed pediatric case of Gradenigo’s syndrome associated with acute otitis media that was treated with ventilation tube insertion.
Assessing solar geoengineering research funders: Insights from two US public deliberations
Authors: Nelson John P , Kaplan Leah , Tomblin David
Published: October 2020

Solar radiation management (SRM), a class of geoengineering methods aiming to alter the earth’s radiative energy balance, carries uncertain and potentially extensive social, ethical, and environmental consequences. For both normative and pragmatic reasons, actors interested in SRM research and implementation would do well to attend to public preferences and concerns regarding SRM work. But despite growing literature treating public perspectives on SRM governance, little is known about public perceptions or preferences regarding potential SRM research funders. Specific research funders could significantly affect both the varieties, scales, and aims of research performed and public responses to SRM research. Drawing from two deliberative public forums on SRM research involving 171 participants in total, this paper begins to fill this gap in the literature. Results reveal diverse and nuanced modes of participant reasoning regarding potential research funders. Among other criteria, participants evaluated funders according to perceived funding capabilities, motivations, and research competencies. Our results significantly expand knowledge on public views, preferences, and modes of reasoning regarding SRM research actors and funders.
Subarachnoid diverticulum associated with feline infectious peritonitis in a Siberian cat
Authors: Hoey Christopher , Nye George , Fadda Angela , Bradshaw Janet , Barker Emi N
Published: October 2020

Case summary

A 7-month-old Siberian cat was presented for investigation of acute onset multifocal neurological deficits. Neurological examination documented dull mental status and an ambulatory left hemiparesis. Serum biochemistry documented marked hyperglobulinaemia. MRI of the brain identified marked leptomeningeal contrast enhancement extending along the brainstem caudally to involve the cranial cervical spinal cord. MRI of the cervical spine further identified a subarachnoid diverticulum that extended from the level of the obex to the C2–C3 vertebrae. Cerebrospinal fluid quantitative RT-PCR was positive for the presence of feline coronavirus. Histopathology revealed pyogranulomatous meningitis and choroid plexitis, uveitis and nephritis.

Relevance and novel information

This article describes the first reported case of a subarachnoid diverticulum associated with feline infectious peritonitis.
Tweeting Along Partisan Lines: Identity-Motivated Elaboration and Presidential Debates
Authors: Jennings Freddie J. , Bramlett Josh C. , McKinney Mitchell S. , Hardy Molly M.
Published: October 2020

The influence of partisan identification infiltrates all aspects of a democracy. This study employs an innovative design to explore the presidential debate-viewing experience among young citizens. Data were collected from across the United States for all three 2016 presidential debates between Hillary Clinton and Donald Trump using pretest/posttest surveys and debate viewers’ Twitter posts. Examining Twitter expression as a form of political elaboration, the study employs a social identity theoretical perspective to better understand the process through which viewers form political attitudes. Applying the theory of identity-motivated elaboration (TIME) to presidential debates, the current research illuminates how partisan social identification changes the way viewers think about political issues and, resultantly, evaluate candidates and form political opinions. A strong partisan social identification results in greater identity-consistent elaboration and Twitter expression throughout one’s presidential debate viewing, which results in more biased candidate image evaluations and, subsequently, stronger preference for the in-party candidate.
Immune system changes during COVID-19 recovery play key role in determining disease severity
Authors: Fathi Farshid , Sami Ramin , Mozafarpoor Samaneh , Hafezi Hossein , Motedayyen Hossein , Arefnezhad Reza , Eskandari Nahid
Published: October 2020

Coronavirus disease 2019 (COVID-19), an acute respiratory infection, is largely associated with dysregulation and impairment of the immune system. This study investigated how the immune system changes were related to disease severity in COVID-19 patients. The frequencies of different immune cells and levels of pro- and anti-inflammatory cytokines in whole blood of participants were determined by flow cytometry and enzyme-linked immunosorbent assay, respectively. The values of other inflammatory agents were also studied. In the late recovery stage, unlike CD56high CD16+/− NK cells and monocytes, CD56low CD16+ NK cell numbers were increased ( P < 0.0001–0.05). Th1, Th2, and Th17 cell percentages were significantly lower in patients than healthy control ( P < 0.0001–0.05), while their frequencies were increased following disease recovery ( P < 0.0001–0.05). The numbers of Tregs, activated CD4+ T cells, and exhausted CD8+ T cells were significantly decreased during a recovery ( P < 0.0001–0.05). No significant change was observed in exhausted CD4+ T cell number during a recovery ( P > 0.05). B cell showed an increased percentage in patients compared to healthy subjects ( P < 0.0001–0.05), whereas its number was reduced following recovery ( P < 0.0001–0.05). IL-1α, IL-1β, IL-6, TNF-α, and IL-10 levels were significantly decreased in the late recovery stage ( P < 0.0001–0.05). However, TGF-β1 level was not significantly changed during the recovery ( P > 0.05). Lymphocyte numbers in patients were significantly decreased ( P < 0.001), unlike ESR value ( P < 0.001). Lymphocyte number was negatively correlated to ESR value and Th2 number ( P < 0.05), while its association with monocyte was significantly positive at the first day of recovery ( P < 0.05). The immune system changes during the disease recovery to improve and regulate immune responses and thereby may associate with the reduction in disease severity.
Intimate Partner Violence Experienced by Physicians
Authors: Reibling Ellen T. , Distelberg Brian , Guptill Mindi , Hernandez Barbara Couden
Published: October 2020

Purpose:

World Health Organization (WHO) defines intimate partner violence (IPV) as physical, sexual or psychological harm caused by an intimate partner or ex-partner. There are few studies describing interpersonal violence (IPV) among physicians. Our study describes IPV experienced by U.S. physicians.

Methods:

This was a multicenter survey administered to 4 physician groups in 2015 to 2016. In total 400 respondents returned survey results. Measures included current IPV, childhood abuse, mental health, professional role, and demographics.

Results:

IPV was reported by 24% of respondents. The most frequent abuses reported were: verbal (15%), physical (8%) followed by sexual abuse (4%) and stalking (4%). Logistic regression model found that IPV was more likely to be reported by older participants (aged 66–89), those who experienced childhood abuse, working less than full time, and had been diagnosed with a personality disorder. Women and Asian Americans reported slightly higher IPV rates.

Conclusions:

Our study has implications for both medical education and intervention development. Universal screening and education that addresses clinical implications when treating peers who experience IPV are needed. Workplace interventions that consider unique physician characteristics and experiences are needed, as well as programs that support sustained recovery. This is the first survey to our knowledge that confirms that physicians experience IPV at a rate consistent or higher than the national level. We developed a standardized instrument to assess IPV in male and female physicians at various career stages. We also identified significant predictors that should be included in IPV screening of potential physician victims.
Effect of Albumin Addition to Cardiopulmonary Bypass Prime on Outcomes in Children Undergoing Open-Heart Surgery (EACPO Study)—A Randomized Controlled Trial
Authors: Rauf Abdul , Joshi Reena K. , Aggarwal Neeraj , Agarwal Mridul , Kumar Manendra , Dinand Veronique , Joshi Raja
Published: October 2020

Background:

There is a paucity of literature regarding the association of high oncotic priming solutions for pediatric cardiopulmonary bypass (CPB) and outcomes, and no consensus exists regarding the composition of optimal CPB priming solution. This study aimed to examine the impact of high oncotic pressure priming by the addition of 20% human albumin on outcomes.

Methods:

Double-blinded, randomized controlled study was done in the pediatric cardiac intensive care unit of a tertiary care hospital. Consecutive children with congenital heart diseases admitted for open-heart surgery were randomized into two groups, where the study group received an additional 20% albumin to conventional blood prime before CPB initiation.

Results:

We enrolled 39 children in the high oncotic prime (added albumin) group and 37 children in the conventional prime group. In the first 24-hour postoperative period, children in the albumin group had significantly lower occurrence of hypotension (28.2% vs 54%, P = .02), requirement of fluid boluses (25.6% vs 54%, P = .006), and lactate clearance time (6 vs 9 hours, P < .001). Albumin group also had significantly higher platelet count (×103/µL) at 24 hours (112 vs 91, P = .02). There was no significant difference in intra-CPB hemodynamic parameters and incidence of acute kidney injury. In subgroup analysis based on risk category, significantly decreased intensive care unit stay (4 vs 5 days, P = .04) and hospital stay (5 vs 7 days, P = .002) were found in the albumin group in low-risk category.

Conclusion:

High oncotic pressure CPB prime using albumin addition might be beneficial over conventional blood prime, and our study does provide a rationale for further studies.
Assessing Cut-off Points of Eosinophils, Nasal Polyp, and Lund-Mackay Scores to Predict Surgery in Nasal Polyposis: A Real-World Study
Authors: Virkkula P. , Penttilä E. , Vento S. I. , Myller J. , Koskinen A. , Hammarén-Malmi S. , Laulajainen-Hongisto A. , Hytönen M. , Lilja M. , Numminen J. , Sillanpää S. , Sahlman J. , Toppila-Salmi S.
Published: October 2020

Background

Developing tools to identify chronic rhinosinusitis with nasal polyps (CRSwNP) patients requiring surgical treatment would help clinicians treat patients more effectively. The aim of this retrospective cross-sectional study was to identify cut-off values ​​for eosinophil percentage, nasal polyps (NP), and Lund-Mackay (LM) scores that may predict the need for surgical treatment in Finnish CRSwNP patients.

Methods

Data of CRSwNP patients (N = 378) undergoing consultation for ESS in 2001–19 were used. Data was collected from patient records and Lund-Mackay scores were determined from sinus computed tomography scans. The percentage of eosinophils was microscopically evaluated from the polyp samples available (n = 81). Associations were analyzed by Mann Whitney U test, and cut-off values by the area under the receiver operating characteristic curve (AUROC).

Results

ESS was performed to 293 (77.5%) of patients. Polyp eosinophilia was associated significantly with ESS (p = 0.001), whereas peripheral blood eosinophil count, LM- score and endoscopic NP- score were not (p > 0.05). AUROC values (95% CI) for detecting those needing ESS were for polyp eosinophilia 0.71 (0.60–0.83), p = 0.001, for LM score 0.59 (0.50–0.67), p = 0.054; for NP score 0.56 (0.48–0.64), p = 0.17, and for blood eosinophil count 0.68 (0.46–0.90), p = 0.08. With the threshold value of polyp eosinophilia (>25%), the sensitivity and specificity were optimal for detecting the group needing ESS from the group not undergoing ESS. The cut-off value of blood eosinophil count (>0.26 × 109/L) had relatively good, yet statistically insignificant (underpowered), predictive potential. Moderate cut-off values were found for endoscopic LM score (≥14/24) and NP score (≥4/8).

Conclusions

Polyp eosinophilia (>25%) predicted ESS among Finnish hospital-level CRSwNP patients. A future challenge would be to find less invasive and cost-effective clinical factors predicting uncontrolled CRSwNP.
Group Acupuncture Therapy With Yoga Therapy for Chronic Neck, Low Back, and Osteoarthritis Pain in Safety Net Setting for an Underserved Population: Design and Rationale for a Feasibility Pilot
Authors: Nielsen Arya , Teets Ray , Moonaz Steffany , Anderson Belinda J , Walter Eve , Milanes Mirta , Mah Donna M , Diane McKee M , Kligler Benjamin
Published: October 2020

Chronic pain is prevalent in the United States, with impact on physical and psychological functioning as well as lost work productivity. Minority and lower socioeconomic populations have increased prevalence of chronic pain with less access to pain care, poorer outcomes, and higher risk of fatal opioid overdose. Acupuncture therapy is effective in treating chronic pain conditions including chronic low back pain, neck pain, shoulder pain, and knee pain from osteoarthritis. Acupuncture therapy, including group acupuncture, is feasible and effective, and specifically so for underserved and diverse populations at risk for health outcome disparities. Acupuncture therapy also encourages patient engagement and activation. As chronic pain improves, there is a natural progression to want and need to increase activity and movement recovery. Diverse movement approaches are important for improving range of motion, maintaining gains, strengthening, and promoting patient engagement and activation. Yoga therapy is an active therapy with proven benefit in musculoskeletal pain disorders and pain associated disability. The aim of this quasi-experimental pilot feasibility trial is to test the bundling of these 2 effective care options for chronic pain, to inform both the design for a larger randomized pragmatic effectiveness trial as well as implementation strategies across underserved settings.
The Learning Curve for Hip Arthroscopic Surgery: A Prospective Evaluation With 2-Year Outcomes in Patients With Femoroacetabular Impingement
Authors: You Jae S. , Flores Sergio E. , Friedman James M. , Lansdown Drew A. , Zhang Alan L.
Published: October 2020

Background:

The use of hip arthroscopic surgery in the treatment of femoroacetabular impingement (FAI) is increasing, but it is universally known as a technically demanding procedure with a “steep” learning curve. There are limited data investigating the correlation between surgeon experience and patient-reported outcomes (PROs) as well as procedure and traction times.

Purpose:

To prospectively evaluate the relationship between surgeon experience and PROs after hip arthroscopic surgery for the treatment of FAI.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

A total of 190 patients undergoing primary hip arthroscopic surgery for FAI were prospectively enrolled during a sports medicine fellowship–trained surgeon’s first 36 months of practice. A radiographic evaluation as well as PRO surveys including the 12-Item Short Form Health Survey (SF-12), the modified Harris Hip Score (mHHS), and the Hip disability and Osteoarthritis Outcome Score (HOOS) were administered preoperatively and at 2 years postoperatively. Logistic regression as well as analysis of variance was performed to evaluate for correlations between surgical experience and PROs, procedure time, and traction time.

Results:

Of the 190 patients, 168 (88%; mean age, 35.3 ± 9.6 years; mean body mass index, 25.07 ± 3.98) completed a 2-year follow-up and were included for analysis. The mean procedure time was 91.5 ± 23.9 minutes, and the mean traction time was 54.0 ± 17.7 minutes. Patients demonstrated significant improvements at 2 years after surgery for all PRO scores (mHHS, HOOS, and SF-12 physical component summary; P < .001), except the SF-12 mental component summary, which had no change ( P = .43). The procedure time significantly decreased after 70 cases, while the traction time continued to decrease until 110 cases ( R 2 = 0.99; P < .0001). There was no correlation between increasing case volume and 2-year PRO scores ( P > .2 for mHHS, HOOS, and SF-12). There was also no difference with increasing case volume and amount of improvement from preoperative to 2-year postoperative PRO scores for the SF-12 and HOOS. Case volume did not affect the complication rate, as this cohort experienced 4 minor cases of neurapraxia.

Conclusion:

Surgical efficiency in hip arthroscopic surgery for the treatment of FAI was maximized after 110 cases in this cohort. However, significant PRO improvements can be achieved early in a surgeon’s practice prior to maximizing surgical efficiency.
Pediatric and Adolescent Shoulder Instability: Does Insurance Status Predict Delays in Care, Outcomes, and Complication Rate?
Authors: Hung Nicole J. , Darevsky David M. , Pandya Nirav K.
Published: October 2020

Background:

Recurrent shoulder instability results from overuse injuries that are often associated with athletic activity. Timely diagnosis and treatment are necessary to prevent further dislocations and secondary joint damage. In pediatric and adolescent patients, insurance status is a potential barrier to accessing timely care that has not yet been explored.

Purpose:

To examine the effect of insurance status on access to clinical consultation, surgical intervention, and surgical outcome of pediatric and adolescent patients with recurrent shoulder instability.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

We conducted a retrospective review of pediatric and adolescent patients who were treated at a single tertiary children’s hospital for recurrent shoulder instability between 2011 and 2017. Patients were sorted into private and public insurance cohorts. Dates of injury, consultation, and surgery were recorded. Number of previous dislocations, magnetic resonance imaging (MRI) results, surgical findings, and postoperative complications were also noted. Delays in care were compared between the cohorts. The presence of isolated anterior versus complex labral pathology as well as bony involvement at the time of surgery was recorded. The incidences of labral pathology and secondary bony injury were then compared between the 2 cohorts. Postoperative notes were reviewed to compare rates of repeat dislocation and repeat surgery.

Results:

A total of 37 patients had public insurance, while 18 patients had private insurance. Privately insured patients were evaluated nearly 5 times faster than were publicly insured patients ( P < .001), and they obtained MRI scans over 4 times faster than did publicly insured patients ( P < .001). Publicly insured patients were twice as likely to have secondary bony injuries ( P = .016). Postoperatively, a significantly greater number (24.3%) of publicly insured patients experienced redislocation versus the complete absence of redislocation in the privately insured patients ( P = .022).

Conclusion:

Public insurance status affected access to care and was correlated with the development of secondary bony injury and a higher rate of postoperative dislocations. Clinicians should practice with increased awareness of how public insurance status can significantly affect patient outcomes by delaying access to care—particularly if delays lead to increased patient morbidity and health care costs.
Testing Basic Assumptions Reveals When (Not) to Expect Mindset and Belonging Interventions to Succeed
Authors: McPartlan Peter , Solanki Sabrina , Xu Di , Sato Brian
Published: October 2020

In this case study, we investigated the effectiveness of growth mindset and social belonging interventions in a college setting with large numbers of traditionally underrepresented groups (n = 1,091). In doing so, we highlight the characteristics of the students in our study that are important for determining whether we should expect such interventions to be effective for diverse higher education populations. Correlational analyses revealed no evidence that growth mindset or social belonging were barriers to academic success among targeted subgroups in our sample. Additionally, we found no evidence that underrepresented minority, first-generation, or low-income students substantially endorsed fixed mindset or belonging uncertainty measures at baseline. We discuss benefits of testing basic assumptions for interpreting null results, including choosing the most appropriate interventions, accurately identifying subgroups who face psychological barriers to academic success, and establishing “redundancy thresholds” at which messages do not need to be reinforced by interventions.
Snehagram Model of an Applied Psychosocial Intervention Approach Among Adolescents Living with HIV/AIDS: A Blueprint
Authors: Sudhesh N. T. , Sreenath K. , Gupta Sahen , Nair Devika , Avnit
Published: October 2020

We present the Snehagram model, an applied psychosocial intervention for adolescents living with HIV/AIDS (ALWH), delivered through service learning (SL). The model is a synthesised blueprint of the ongoing intervention adopting a multi-component structure, addressing the overall development of ALWH through the integration of educational support, psychological interventions and research. Intervention outcomes include psychosocial skills, mental health and holistic education using research- and evidence-based practice to support ALWH with skills needed for re-integration and functioning in society post intra-community residence. The SL delivery framework parallelly benefits student trainees and the community, resulting in active participation via experiential learning and professional development. This unique approach to resource utilisation also makes it a viable and sustainable model in developing countries where resources are limited.
Development of the optimal touchscreen interface for patients with scleroderma
Authors: Moroncini Gianluca , Brunzini Agnese , Papetti Alessandra , Filippini Emanuele , Maurizi Valentina , Cesaretti Giulia , Gesuita Rosaria , Gabrielli Armando , Germani Michele
Published: October 2020

Impaired hand function is a major contributor to overall disability and reduced health-related quality of life in scleroderma patients. A relevant issue concerns interaction of scleroderma subjects with touchscreen interfaces. This study aims at investigating this problem assessing scleroderma patients’ performance with a novel, aptly designed, touchscreen application in order to identify critical items of touchscreen technology which may impair or facilitate the use by scleroderma subjects. Eighty scleroderma patients performed this novel application including three games, each of which tested a different gesture: tapping, dragging/dropping, and pinching-to-zoom. Eighty healthy subjects without hand impairments were recruited as controls. Scleroderma patients performed worse than healthy users in each game, and statistically significant negatively impacting items were identified. In the second phase of the study, the 10 worst touchscreen performers within the scleroderma cohort were recruited for a physio-rehabilitation trial based on the daily use at home of a modified version of the software application downloaded into the personal devices of patients. The results of this study allow introduction of guidelines to design accessible touchscreen interfaces for subjects with scleroderma and suggest that touchscreen technology may be included in self-administered physio-rehabilitation programs for scleroderma hand.
Treatment and Outcomes for Cutaneous Periauricular Basal Cell Carcinoma: A 16‐Year Institutional Experience
Authors: Peters Mallory , Smith Joshua D. , Kovatch Kevin J. , McLean Scott , Durham Alison B. , Basura Gregory
Published: October 2020

Objective

To report a single institutional experience with the surgical management of cutaneous periauricular basal cell carcinoma.

Study Design

Retrospective chart review.

Setting

Tertiary academic center.

Methods

Retrospective chart review of 71 patients diagnosed with periauricular basal cell carcinoma managed surgically from 2000 to 2016. Data were analyzed with descriptive statistics.

Results

The median age at diagnosis was 73.0 years (interquartile range, 13.0). Of all lesions, 2.8% (n = 2) were preauricular, 80.3% (n = 57) auricular, and 16.9% (n=12) postauricular. Auricular subsites included conchal bowl (36.6%, n = 26), helix (21.1%, n = 15), antihelix (1.4%, n = 1), peritragus (5.6%, n = 4), triangular fossa (1.4%, n = 1), external auditory canal (2.8%, n = 2), and lobule skin (1.4%, n = 1). Surgical approach included wide local excision (80.3%, n = 57), partial auriculectomy (8.5%, n = 6), and total auriculectomy or other combinations of surgical methods (11.3%, n = 8). Due to aggressive pathology, 3 cases required concurrent parotidectomy, neck dissection, ear canal sleeve resection, or mastoidectomy. In sum, 52.1% (n = 37) of cases had clear margins on first pass in the operating room; 25.4% (n = 18) required further resection; and 12.7% (n = 9) demonstrated final positive/overturned margins read as negative from the frozen sections. Reconstruction included full‐thickness (25.4%, n = 18) or superficial‐thickness (29.6%, n = 21) skin grafts and local flap reconstruction (25.4%, n = 18), while 5.6% (n = 4) required combinations of free flap and/or other reconstruction techniques; 14.1% (n = 10) did not undergo formal reconstruction.

Conclusion

Periauricular basal cell carcinoma occurs in anatomically diverse locations in and around the ear, and multiple surgical methods are required for successful treatment.
Real-world efficacy of the Hydrus microstent in Black and Afro-Latinx patients with glaucoma: a retrospective study
Authors: Laroche Daniel , Nkrumah Gideon , Ng Chester
Published: October 2020

Purpose:

The purpose was to determine the real-world efficacy of phacoemulsification cataract surgery and Hydrus microstent in Black and Afro-Latinx patients with glaucoma.

Methods:

A retrospective noncomparative single-center study of 76 Black and Afro-Latinx patients with glaucoma who underwent phacoemulsification cataract surgery and Hydrus microstent placement for treatment of glaucoma at single practice. Investigated parameters were intraocular pressure (IOP), number of medications, mean deviation on visual field test, and visual acuity. Patients were also subgrouped into mild, moderate, and advance glaucoma for further analysis.

Results:

We reviewed a total of 76 patients who had 6 months of follow up in the study. The mean number of medications decreased significantly from 2.6 ± 1.5 preoperatively to 0.72 ± 1.4 in 6 months ( p < 0.0010), while IOP decreased from 14.7 ± 3.7 to 13.9 ± 4.3 ( p = 0.25). At 6 months, 55 patients (74%) of all patients were medication free ( n = 27, 84.4% mild glaucoma; n = 17, 70.8% moderate glaucoma; n = 10, 50% advance glaucoma). There was significant improvement in visual acuity ( p < 0.00010) and stabilization of mean deviation on visual field test (baseline −9.2; 6 months −9.1; p = 0.22). The most common adverse effect was a transient IOP spike and transient corneal edema ( n = 6, 7.9%; n = 6, 7.9%, respectively) with spontaneous resolution in all cases. No sight-threatening complications were reported at 6 months.

Conclusion/clinical relevance:

This 6-month retrospective study demonstrated the efficacy of phacoemulsification cataract surgery and Hydrus microstent in reducing the medication burden while maintaining lower IOP in Black and Afro-Latinx patients with glaucoma.
E-Cadherin, NFATC3, and PLP2 Are Differentially Methylated in Multiple Cancers
Authors: Lotesto Mary J , Wallace Christopher J , Raimondi Stacey L
Published: October 2020

It is well documented that cancer cells have abnormal methylation patterns often caused by faulty methylating machinery. Specifically, E-cadherin, NFATC3, and PLP2 are 3 genes known to be aberrantly methylated in cancer cells. These genes are well documented for their role in signaling pathways involved with cell proliferation, adhesion, migration, and other signs of tumor progression. Therefore, changes in gene expression of CDH1, NFATC3, and PLP2 due to aberrant methylation can lead to profound changes in cellular function and tumor formation. In order to ensure that previous in vitro and in vivo methylation studies match what is observed in the clinic, we utilized a bioinformatics approach to complete an extensive analysis of methylation patterns of these 3 genes, analyzing over 5000 patient samples, across all cancers for which both normal and tumor tissues were available. Specifically, we analyzed overall and site-specific methylation patterns, at CpG islands and shores, of all 3 genes across 14 cancer types. Furthermore, we compared these methylation levels in normal and tumor samples of both matched and unmatched patient samples in order to determine any differences between groups. Finally, we examined whether an aberrant DNA methyltransferase, DNMT3B7, known to be expressed in cancer cells and to alter methylation patterns in vitro correlated with altered overall and site-specific methylation of CDH1, NFATC3, and PLP2 in these patient samples. Our results indicate that methylation patterns of CDH1 and NFATC3 were unexpectedly varied across tumors, contrary to previous studies performed in vitro, while PLP2 showed the expected hypomethylation pattern in tumor tissues. We also observed some correlation between DNMT3B7 expression and methylation patterns of these genes, but patterns were inconsistent. Taken together, these results emphasize the necessity for in vivo and patient studies rather than a complete reliance on in vitro data and provide multiple areas of future research.
Thunderbayite, TlAg3Au3Sb7S6, a new gold-bearing mineral from the Hemlo gold deposit, Marathon, Ontario, Canada
Authors: Bindi Luca , Roberts Andrew C.
Published: October 2020

Thunderbayite (IMA2020–042), ideally TlAg3Au3Sb7S6, is a new mineral from the Hemlo gold deposit, Marathon, Ontario, Canada. It occurs as very rare anhedral rims up to 70 μm across in contact with aurostibite and associated spatially with stibarsen, biagioniite and native gold in a calcite matrix. Thunderbayite is opaque with a metallic lustre and shows a black streak. In reflected light, thunderbayite is weakly bireflectant and faintly pleochroic from grey–blue to slightly greenish grey–blue. Under crossed polars, it is weakly anisotropic with bluish to light-blue rotation tints. Internal reflections are absent. Reflectance percentages for the four Commission on Ore Mineralogy wavelengths (Rmin, Rmax) are: 37.9, 38.4 (471.1 nm); 35.3, 36.0 (548.3 nm); 33.9, 34.4 (586.6 nm); and 32.0, 32.5 (652.3 nm), respectively. A mean of five electron-microprobe analyses gave Ag 14.91(16), Au 27.40(22), Tl 9.37(9), Sb 39.80(34) and S 8.61(7), for a total of 100.09 wt.%, corresponding, on the basis of a total of 20 atoms, to Tl1.00Ag3.01Au3.03Sb7.12S5.84. Thunderbayite is triclinic, space group P1, with a = 8.0882(5), b = 7.8492(5), c = 20.078(1) Å, α = 92.518(5), β = 93.739(5), γ = 90.028(6)°, V = 1270.73(9) Å3 and Z = 2. The five strongest powder-diffraction lines [d in Å (I/I0) (hkl)] are: 4.04 (100) (200); 3.92 (80) (020); 2.815 (50) (220/$\bar{2}$20); 2.566 (45) ($\bar{1}$17); and 2.727 (40) (0$\bar{1}$7). The crystal structure [R1 = 0.0220 for 5521 reflections with I > 2σ(I)] can be considered as a strongly deformed pyrite-type structure with several metal–metal bonds. Thunderbayite shows close similarities with criddleite, TlAg2Au3Sb10S10, from an optical, chemical and structural point of view. The new mineral is named for the Thunder Bay district, Ontario, in which the Hemlo gold deposit is located.
Using optimal control to understand complex metabolic pathways
Authors: Tsiantis Nikolaos , Banga Julio R.
Published: October 2020

Background

Optimality principles have been used to explain the structure and behavior of living matter at different levels of organization, from basic phenomena at the molecular level, up to complex dynamics in whole populations. Most of these studies have assumed a single-criteria approach. Such optimality principles have been justified from an evolutionary perspective. In the context of the cell, previous studies have shown how dynamics of gene expression in small metabolic models can be explained assuming that cells have developed optimal adaptation strategies. Most of these works have considered rather simplified representations, such as small linear pathways, or reduced networks with a single branching point, and a single objective for the optimality criteria.

Results

Here we consider the extension of this approach to more realistic scenarios, i.e. biochemical pathways of arbitrary size and structure. We first show that exploiting optimality principles for these networks poses great challenges due to the complexity of the associated optimal control problems. Second, in order to surmount such challenges, we present a computational framework which has been designed with scalability and efficiency in mind, including mechanisms to avoid the most common pitfalls. Third, we illustrate its performance with several case studies considering the central carbon metabolism ofS. cerevisiaeandB. subtilis. In particular, we consider metabolic dynamics during nutrient shift experiments.

Conclusions

We show how multi-objective optimal control can be used to predict temporal profiles of enzyme activation and metabolite concentrations in complex metabolic pathways. Further, we also show how to consider general cost/benefit trade-offs. In this study we have considered metabolic pathways, but this computational framework can also be applied to analyze the dynamics of other complex pathways, such as signal transduction or gene regulatory networks.
Comprehensive transcriptomic analysis provides new insights into the mechanism of ray floret morphogenesis in chrysanthemum
Authors: Pu Ya , Huang He , Wen Xiaohui , Lu Chenfei , Zhang Bohan , Gu Xueqi , Qi Shuai , Fan Guangxun , Wang Wenkui , Dai Silan
Published: October 2020

Background

The ray floret shapes referred to as petal types on the chrysanthemum (Chrysanthemum × morifolium Ramat.) capitulum is extremely abundant, which is one of the most important ornamental traits of chrysanthemum. However, the regulatory mechanisms of different ray floret shapes are still unknown. C. vestitum is a major origin species of cultivated chrysanthemum and has flat, spoon, and tubular type of ray florets which are the three basic petal types of chrysanthemum. Therefore, it is an ideal model material for studying ray floret morphogenesis in chrysanthemum. Here, using morphological, gene expression and transcriptomic analyses of different ray floret types of C. vestitum, we explored the developmental processes and underlying regulatory networks of ray florets.

Results

The formation of the flat type was due to stagnation of its dorsal petal primordium, while the petal primordium of the tubular type had an intact ring shape. Morphological differences between the two ray floret types occurred during the initial stage with vigorous cell division. Analysis of genes related to flower development showed that CYCLOIDEA genes, including CYC2b, CYC2d, CYC2e, and CYC2f, were differentially expressed in different ray floret types, while the transcriptional levels of others, such as MADS-box genes, were not significantly different. Hormone-related genes, including SMALL AUXIN UPREGULATED RNA (SAUR), GRETCHEN HAGEN3 (GH3), GIBBERELLIN 2-BETA-DIOXYGENASE 1 (GA2OX1) and APETALA2/ETHYLENE RESPONSIVE FACTOR (AP2/ERF), were identified from 1532 differentially expressed genes (DEGs) in pairwise comparisons among the flat, spoon, and tubular types, with significantly higher expression in the tubular type than that in the flat type and potential involvement in the morphogenesis of different ray floret types.

Conclusions

Our findings, together with the gene interactional relationships reported for Arabidopsis thaliana, suggest that hormone-related genes are highly expressed in the tubular type, promoting petal cell division and leading to the formation of a complete ring of the petal primordium. These results provide novel insights into the morphological variation of ray floret of chrysanthemum.
Unlocking the efficiency of genomics laboratories with robotic liquid-handling
Authors: Tegally Houriiyah , San James Emmanuel , Giandhari Jennifer , de Oliveira Tulio
Published: October 2020

In research and clinical genomics laboratories today, sample preparation is the bottleneck of experiments, particularly when it comes to high-throughput next generation sequencing (NGS). More genomics laboratories are now considering liquid-handling automation to make the sequencing workflow more efficient and cost effective. The question remains as to its suitability and return on investment. A number of points need to be carefully considered before introducing robots into biological laboratories. Here, we describe the state-of-the-art technology of both sophisticated and do-it-yourself (DIY) robotic liquid-handlers and provide a practical review of the motivation, implications and requirements of laboratory automation for genome sequencing experiments.
Hydrogen sulfide negatively regulates cd-induced cell death in cucumber (Cucumis sativus L) root tip cells
Authors: Luo Shilei , Tang Zhongqi , Yu Jihua , Liao Weibiao , Xie Jianming , Lv Jian , Feng Zhi , Dawuda Mohammed Mujitaba
Published: October 2020

Background

Hydrogen sulfide (H2S) is a gas signal molecule involved in regulating plants tolerance to heavy metals stress. In this study, we investigated the role of H2S in cadmium-(Cd-) induced cell death of root tips of cucumber seedlings.

Results

The results showed that the application of 200 μM Cd caused cell death, increased the content of reactive oxygen species (ROS), chromatin condensation, the release of Cytochrome c (Cyt c) from mitochondria and activated caspase-3-like protease. Pretreatment of seedlings with 100 μM sodium hydrogen sulfide (NaHS, a H2S donor) effectively alleviated the growth inhibition and reduced cell death of root tips caused by Cd stress. Additionally, NaHS + Cd treatment could decrease the ROS level and enhanced antioxidant enzyme activity. Pretreatment with NaHS also inhibited the release of Cyt c from the mitochondria, the opening of the mitochondrial permeability transition pore (MPTP), and the activity of caspase-3-like protease in the root tips of cucumber seedling under Cd stress.

Conclusion

H2S inhibited Cd-induced cell death in cucumber root tips by reducing ROS accumulation, activating the antioxidant system, inhibiting mitochondrial Cyt c release and reducing the opening of the MPTP. The results suggest that H2S is a negative regulator of Cd-induced cell death in the root tips of cucumber seedling.
The effect of revascularization on mortality and risk of ventricular arrhythmia in patients with ischemic cardiomyopathy
Authors: Alkharaza Ahmad , Al-Harbi Mousa , El-sokkari Ihab , Doucette Steve , MacIntyre Ciorsti , Gray Christopher , Abdelwahab Amir , Sapp John L. , Gardner Martin , Parkash Ratika
Published: October 2020

Background

There is clear evidence that patients with prior myocardial infarction and a reduced ejection fraction benefit from implantation of a cardioverter-defibrillator (ICD). It is unclear whether this benefit is altered by whether or not revascularization is performed prior to ICD implantation.

Methods

This was a retrospective cohort study following patients who underwent ICD implantation from 2002 to 2014. Patients with ischemic cardiomyopathy and either primary or secondary prevention ICDs were selected for inclusion. Using the electronic medical record, cardiac catheterization data, revascularization status (percutaneous coronary intervention or coronary bypass surgery) were recorded. The outcomes were mortality and ventricular arrhythmia.

Results

There were 606 patients included in the analysis. The mean age was 66.3 ± 10.1 years, 11.9% were women, and the mean LVEF was 30.5 ± 12.0, 58.9% had a primary indication for ICD, 82.0% of the cohort had undergone coronary catheterization prior to ICD implantation. In the overall cohort, there were fewer mortality and ventricular arrhythmia events in patients who had undergone prior revascularization. In patients who had an ICD for secondary prevention, revascularization was associated with a decrease in mortality (HR 0.46, 95% CI (0.24, 0.85) p = 0.015), and a trend towards fewer ventricular arrhythmia (HR 0.62, 95% CI (0.38, 1.00) p = 0.051). There was no association between death or ventricular arrhythmia with revascularization in patients with primary prevention ICDs.

Conclusion

Revascularization may be beneficial in preventing recurrent ventricular arrhythmia, and should be considered as adjunctive therapy to ICD implantation to improve cardiovascular outcomes.
Selenium supplementation in patients with peripartum cardiomyopathy: a proof-of-concept trial
Authors: Karaye Kamilu M. , Sa’idu Hadiza , Balarabe Suleiman A. , Ishaq Naser A. , Sanni Bushra , Abubakar Haruna , Mohammed Baba Lawan , Abdulsalam Tijjani , Tukur Jamilu , Mohammed Idris Y.
Published: October 2020

Background

We studied the efficacy and safety of selenium supplementation in patients who had peripartum cardiomyopathy (PPCM) and selenium deficiency.

Methods

We randomly assigned 100 PPCM patients with left ventricular ejection fraction (LVEF) < 45% and selenium deficiency (< 70 μg/L) to receive either oral Selenium (L-selenomethionine) 200 μg/day for 3 months or nothing, in addition to recommended therapy, in an open-label randomised trial. The primary outcome was a composite of persistence of heart failure (HF) symptoms, unrecovered LV systolic function (LVEF < 55%) or death from any cause.

Results

Over a median of 19 months, the primary outcome occurred in 36 of 46 patients (78.3%) in the selenium group and in 43 of 54 patients (79.6%) in the control group (hazard ratio [HR] 0.69; 95% confidence interval [CI] 0.43–1.09; p = 0.113). Persistence of HF symptoms occurred in 18 patients (39.1%) in the selenium group and in 37 patients (68.5%) in the control group (HR 0.53; 95% CI 0.30–0.93; p = 0.006). LVEF < 55% occurred in 33 patients (71.7%) in the selenium group and in 38 patients (70.4%) in the control group (HR 0.91; 95% CI 0.57–1.45; p = 0.944). Death from any cause occurred in 3 patients (6.5%) in the selenium group and in 9 patients (16.7%) in the control group (HR 0.37; 95% CI 0.10–1.37; p = 0.137).

Conclusions

In this study, selenium supplementation did not reduce the risk of the primary outcome, but it significantly reduced HF symptoms, and there was a trend towards a reduction of all-cause mortality.

Clinical trial registration

ClinicalTrials.gov Identifier: NCT03081949.