bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploratory Case Study of Barriers and Facilitators Associated With the Pilot Implementation of a New Electronic Healthcare Record in the Military
Authors: Martin Megan B , Petros Michael , Welter Christina
Published: February 2021

Introduction

The Military Health System (MHS) overhauled its previous Electronic Health Records (EHRs) system. The MHS is in need of modernizing its healthcare system to improve patient safety and coordination of care between the MHS and Veterans Affairs. In 2015, the DoD awarded Cerner, Leidos, and Accenture a $4.3 billion EHR contract for a commercialized off-the-shelf system model to be used by more than 146,000 end users. This exploratory case study looked to access socio-technical barriers and facilitators to EHR implementation specifically in the military.

Materials and Methods

A document review served as the data source: implementation plans, evaluation reports, congressional reports, news articles, and relevant peer-reviewed literature. A series of a priori codes were developed, and emergent codes arose out of the thematic analysis process.

Results

There were several constructs that emerged from the analysis, placing emphasis on the uniqueness of EHR implementation in the MHS. The constructs of people, communication, and hardware and technical factors were strongly tied to EHR implementation. Additionally, medical readiness was identified in the analysis as a unique factor specific to the EHR implementation in the MHS.

Conclusion

This research identified three strategic recommendations for the MHS to consider: hire clinical informaticists, parallel EHR implementation, and enhance EHR training. This research also informed a Socio-Technical Leadership Framework for EHR Implementation to guide MHS leaders during health information technology implementation. Although significant health information technology changes may occur only once every few years, having issues during implementation impacts mission success, overall threatening the vital role that the MHS provides to national defense.
The Successful Use of Left-sided Stellate Ganglion Block in Patients That Fail to Respond to Right-sided Stellate Ganglion Block for the Treatment of Post-traumatic Stress Disorder Symptoms: A Retrospective Analysis of 205 Patients
Authors: Mulvaney Sean W , Lynch James H , Curtis Kamisha E , Ibrahim Tamara S
Published: February 2021

Introduction

Ultrasound-guided stellate ganglion block (SGB) is an injection of local anesthetic (8mL of 0.5% ropivacaine) in the neck to temporarily block the cervical sympathetic trunk which controls the body’s fight-or-flight response. This outpatient procedure takes less than thirty minutes and is immediately effective. Our goal was to determine if a left-sided stellate ganglion block is effective for treating posttraumatic stress disorder (PTSD) symptoms. While right-sided SGB has been extensively studied, left-sided SGB has not been formally evaluated for this indication.

Materials and Methods

Our hypothesis was that patients who fail to improve following a right-sided SGB will report significant improvement following a left-sided SGB. A retrospective chart review was conducted for patients who received SGB for PTSD symptoms between August 2019 and March 2020. All procedures were performed at an established musculoskeletal practice by the same anesthesia/pain fellowship-trained physician. Subjects included those who underwent a left-sided SGB (LSGB) only after non-response to a right-sided SGB (RSGB). Non-response was defined as less than 10 points of improvement on a PTSD Checklist (PCL-5).

Results

Out of 205 patients, 20 did not respond to an RSGB and were included in our analysis. Ten of these patients subsequently received an LSGB, and 90% responded favorably (PCL-5 mean improvement = 28.3 points).

Conclusions

Based on our sample of 205 patients receiving SGB for PTSD, we concluded that at least 4.4% did not respond to a right-sided SGB but did have a significant response to a left-sided SGB.
Formation of the largest galactic cores through binary scouring and gravitational wave recoil
Authors: Nasim Imran Tariq , Gualandris Alessia , Read Justin I , Antonini Fabio , Dehnen Walter , Delorme Maxime
Published: February 2021

Massive elliptical galaxies are typically observed to have central cores in their projected radial light profiles. Such cores have long been thought to form through ‘binary scouring’ as supermassive black holes (SMBHs), brought in through mergers, form a hard binary and eject stars from the galactic centre. However, the most massive cores, like the $\sim 3{\, \mathrm{kpc}}$ core in A2261-BCG, remain challenging to explain in this way. In this paper, we run a suite of dry galaxy merger simulations to explore three different scenarios for central core formation in massive elliptical galaxies: ‘binary scouring’, ‘tidal deposition’, and ‘gravitational wave (GW) induced recoil’. Using the griffin code, we self-consistently model the stars, dark matter, and SMBHs in our merging galaxies, following the SMBH dynamics through to the formation of a hard binary. We find that we can only explain the large surface brightness core of A2261-BCG with a combination of a major merger that produces a small $\sim 1{\, \mathrm{kpc}}$ core through binary scouring, followed by the subsequent GW recoil of its SMBH that acts to grow the core size. Key predictions of this scenario are an offset SMBH surrounded by a compact cluster of bound stars and a non-divergent central density profile. We show that the bright ‘knots’ observed in the core region of A2261-BCG are best explained as stalled perturbers resulting from minor mergers, though the brightest may also represent ejected SMBHs surrounded by a stellar cloak of bound stars.
Hidden in plain sight: a double-lined white dwarf binary 26 pc away and a distant cousin
Authors: Kilic Mukremin , Bédard A , Bergeron P
Published: February 2021

We present high-resolution spectroscopy of two nearby white dwarfs with inconsistent spectroscopic and parallax distances. The first one, PG 1632+177, is a 13th magnitude white dwarf only 25.6 pc away. Previous spectroscopic observations failed to detect any radial velocity changes in this star. Here, we show that PG 1632+177 is a 2.05-d period double-lined spectroscopic binary (SB2) containing a low-mass He-core white dwarf with a more-massive, likely CO-core white dwarf companion. After L 870−2, PG 1632+177 becomes the second closest SB2 white dwarf currently known. Our second target, WD 1534+503, is also an SB2 system with an orbital period of 0.71 d. For each system, we constrain the atmospheric parameters of both components through a composite model-atmosphere analysis. We also present a new set of non-local thermodynamic equilibrium (NLTE) synthetic spectra appropriate for modelling high-resolution observations of cool white dwarfs, and show that NLTE effects in the core of the H α line increase with decreasing effective temperature. We discuss the orbital period and mass distribution of SB2 and eclipsing double white dwarfs with orbital constraints, and demonstrate that the observed population is consistent with the predicted period distribution from the binary population synthesis models. The latter predict more massive CO + CO white dwarf binaries at short (<1 d) periods, as well as binaries with several day orbital periods; such systems are still waiting to be discovered in large numbers.
Angular momentum evolution can be predicted from cosmological initial conditions
Authors: Cadiou Corentin , Pontzen Andrew , Peiris Hiranya V
Published: February 2021

The angular momentum of dark matter haloes controls their spin magnitude and orientation, which in turn influences the galaxies therein. However, the process by which dark matter haloes acquire angular momentum is not fully understood; in particular, it is unclear whether angular momentum growth is stochastic. To address this question, we extend the genetic modification technique to allow control over the angular momentum of any region in the initial conditions. Using this technique to produce a sequence of modified simulations, we can then investigate whether changes to the angular momentum of a specified region in the evolved universe can be accurately predicted from changes in the initial conditions alone. We find that the angular momentum in regions with modified initial conditions can be predicted between 2 and 4 times more accurately than expected from applying tidal torque theory. This result is masked when analysing the angular momentum of haloes, because particles in the outskirts of haloes dominate the angular momentum budget. We conclude that the angular momentum of Lagrangian patches is highly predictable from the initial conditions, with apparent chaotic behaviour being driven by stochastic changes to the arbitrary boundary defining the halo.
Microlensing predictions: impact of Galactic disc dynamical models
Authors: Yang Hongjing , Mao Shude , Zang Weicheng , Zhang Xiangyu
Published: February 2021

Galactic model plays an important role in the microlensing field, not only for analyses of individual events but also for statistics of the ensemble of events. However, the Galactic models used in the field vary, and some are unrealistically simplified. Here, we tested three Galactic disc dynamic models; the first is a simple standard model that was widely used in this field, the second model considers the radial dependence of the velocity dispersion, and the last model employs the asymmetric drift in the disc velocity distribution. We found that for a typical lens mass $M_{\rm L}=0.5\, {\rm M}_\odot$, the two new dynamical models predict $\sim 16{{\ \rm per\ cent}}$ or $\sim 5{{\ \rm per\ cent}}$ less long-time-scale events (e.g. microlensing time-scale tE > 300 d) and $\sim 5{{\ \rm per\ cent}}$ and $\sim 3.5{{\ \rm per\ cent}}$ more short-time-scale events (tE < 3 d) than the standard model. Moreover, the microlensing event rate as a function of Einstein radius θE or microlensing parallax πE also shows some model dependence (a few per cent). The two new models also have an impact on the total microlensing event rate. This result will also to some degree affect the Bayesian analysis of individual events, but overall, the impact is small. However, we still recommend that modellers should be more careful when choosing the Galactic model, especially in statistical works involving Bayesian analyses of a large number of events. Additionally, we find the asymptotic power-law behaviours in both θE and πE distributions, and we provide a simple model to understand them.
Counts-in-cells of subhaloes in the IllustrisTNG simulations: the role of baryonic physics
Authors: Dantas Christine C
Published: February 2021

We present an analysis of the counts-in-cells (CiC) statistics of subhaloes in the publicly available IllustrisTNG cosmological simulations (TNG100-1, TNG100-3, and TNG300-3), considering their full and dark-only versions, in redshifts ranging from z = 0 to z = 5, and different cell sizes. We evaluated two CiC models: the gravitational quasi-equilibrium distribution (GQED) and the negative binomial distribution (NBD), both presenting good fits, with small detectable differences in the presence of baryons. Scaling and time dependencies of the best-fitting parameters showed similar trends compared with the literature. We derived a matter density-in-cells probability distribution function (PDF), associated with the GQED, which was compared to the PDF proposed by Uhlemann et al., for the IllustrisTNG 100-3-Dark run at z = 0. Our results indicate that the simplest gravithermodynamical assumptions of the GQED model hold in the presence of baryonic dissipation. Interestingly, the smoothed (density-in-cells) version of the GQED is also adequate for describing the dark matter one-point statistics of subhaloes and converges, to subpercentage levels (for an interval of parameters), to the Uhlemann et al. PDF in the high density range.
The auto- and cross-angular power spectrum of the Cas A supernova remnant in radio and X-ray
Authors: Saha Preetha , Bharadwaj Somnath , Chakravorty Susmita , Roy Nirupam , Choudhuri Samir , Günther Hans Moritz , Smith Randall K
Published: February 2021

The shell type supernova remnant (SNR) Cas A exhibits structures at nearly all angular scales. Previous studies show the angular power spectrum (Cℓ) of the radio emission to be a broken power law, consistent with MHD turbulence. The break has been identified with the transition from 2D to 3D turbulence at the angular scale corresponding to the shell thickness. Alternatively, this can also be explained as 2D inverse cascade driven by energy injection from knot–shock interactions. Here we present Cℓ measured from archival VLA 5-GHz (C band) data, and Chandra X-ray data in the energy ranges ${\rm A}=0.6{-}1.0$ and ${\rm B} =4.2{-}6.0 \,{\rm keV}$, both of which are continuum dominated. The different emissions all trace fluctuations in the underlying plasma and possibly also the magnetic field, and we expect them to be correlated. We quantify this using the cross-Cℓ between the different emissions. We find that X-ray B is strongly correlated with both radio and X-ray A; however, X-ray A is only very weakly correlated with radio. This supports a picture where X-ray A is predominantly thermal bremsstrahlung, whereas X-ray B is a composite of thermal bremsstrahlung and non-thermal synchrotron emission. The various Cℓ measured here, all show a broken power-law behaviour. However, the slopes are typically shallower than those in radio and the position of the break also corresponds to smaller angular scales. These findings provide observational inputs regarding the nature of turbulence and the emission mechanisms in Cas A.
Dimensional Characterization of the Human Lumbar Interlaminar Space as a Guide for Safe Application of Minimally Invasive Dilators
Authors: Lehrman Jennifer N , Mulholland Celene B , de Andrada Pereira Bernardo , Sawa Anna G U , Kelly Brian P , Tumialán Luis M
Published: February 2021

BACKGROUND

The risk of interlaminar passage of a dilator into the lumbar spinal canal in minimally invasive approaches is currently unknown. Among anthropometric data reported in the medical literature, there is no cadaveric report of the interlaminar dimensions of the lumbar spine.

OBJECTIVE

To report the lumbar interlaminar dimensions in neutral, flexion, and extension postures.

METHODS

A total of 8 spines were sectioned into lumbar segments. Digitized coordinate data defining the locations and movements of chosen anatomic points on the laminar edges at a given spinal level were used to measure changes in the opening dimensions during static neutral posture and flexion-extension movements. Interlaminar dimensions were averaged and categorized for each vertebral level and spinal posture.

RESULTS

The mean interlaminar distance increased from neutral posture to flexion across all vertebral levels. The mean interlaminar distances in the neutral posture ranged from 12.21 mm (L5-S1) to 14.88 mm (L1-L2). In flexion, the range was from 17.15 mm (L5-S1) to 18.50 mm (L4-L5). These measurements are greater than the first several diameters of dilators in all minimally invasive dilator sets.

CONCLUSION

The precise measurements of the lumbar interlaminar space are valuable to minimally invasive spine surgeons for the dilatation phase of the operation. The risk of interlaminar passage of a minimally invasive dilator is greatest in flexion with dilators that have a diameter of 16 mm or less. There is considerably less risk of interlaminar passage in patients positioned on an extended Jackson table.
Bayesian Basics and the Scientific Hypothesis
Authors: Alger Bradley E.
Published: February 2021

This chapter covers the basics of Bayesian statistics, emphasizing the conceptual framework for Bayes’ Theorem. It works through several iterations of the theorem to demonstrate how the same equation is applied in different circumstances, from constructing and updating models to parameter evaluation, to try to establish an intuitive feel for it. The chapter also covers the philosophical underpinnings of Bayesianism and compares them with the frequentist perspective described in Chapter 5. It addresses the question of whether Bayesians are inductivists. Finally, the chapter shows how the Bayesian procedures of model selection and comparison can be pressed into service to allow Bayesian methods to be used in hypothesis testing in essentially the same way that various p-tests are used in the frequentist hypothesis testing framework.
What Scientists Think About Scientific Thinking
Authors: Alger Bradley E.
Published: February 2021

This chapter reports original data from two surveys conducted to find out how scientists view the hypothesis and related concepts. One was an online survey of hundreds of members of biological research societies. The scientists reported on their knowledge of and training in the use of the hypothesis, their views about hypothesis testing as compared with other modes of conducting science, such as Discovery Science, open-ended questioning, and Big Data methods. Respondents estimated how the various scientific modes influenced their work and how much they relied on each one. Most respondents,70% of them, reported having received little or no training in scientific thinking; however, 90% felt confident about their thinking skills. Nevertheless, more than 90% felt that formal training in this area would be helpful. The great majority relied on hypotheses in their research work. The second survey, analyzed all (more than 150) neuroscience research papers that appeared sequentially in top journals during 2015 to determine how the papers were structured, particularly with respect to the hypothesis. Only 33% of the papers had an explicitly stated hypothesis, whereas, in 45%, the hypothesis was “implicit.” A minor, though notable, fraction of the papers misused the term “hypothesis.” The results are germane to several topics covered in the remainder of the book.
Conclusion
Authors: Berry Craig
Published: February 2021

The concluding chapter summarizes the book’s main arguments, distilling its implications for how we understand pensions provision, and specifically its relationship to the wider financialization process, capitalist organization, and generational change. It also reflects more explicitly on some of the book’s implicit themes, such as the implications of pensions individualization for women and low earners, and industrial relations. Crucially, this chapter also offers a programme of reforms to overcome pensions imperilment in the United Kingdom, encompassing: expanded coverage for workplace pensions and employer contributions; new forms of state-managed provision in relation to annuities; increasing the state pension’s generosity over time; abolishing pensions tax relief as it currently exists; nationalizing residual defined benefit provision in order to capitalize a new public pension; and establishing transparent processes for aligning retirement ages with demographic change.
Hypertension across the lifespan
Authors: Esquibel Karen A. , Moore Amy , Hilliard Tara C. , Bruce Kellie , Mello Inola
Published: February 2021

How can nurses facilitate cardiovascular care for our young patient population?
What is vestibular weakness?
Authors: Pullen Richard L.
Published: February 2021

Patients with this balance disorder require an interprofessional team to promote safety and quality of life.
Traits of the resilient nurse
Authors: Moore Amy , Thal Wendy
Published: February 2021

The road to emotional resilience is often difficult, but it's through this process of overcoming or adapting that we grow.
Analysis of Health Care Personnel's Attitudes Toward Complementary and Alternative Medicine and Life Satisfaction due to COVID-19 Pandemic
Authors: Teke Neslihan , Özer Zülfünaz , Bahçecioğlu Turan Gülcan
Published: February 2021

This study was conducted to analyze health care personnel's attitudes toward traditional and complementary medicine (TCM) and life satisfaction due to coronavirus disease-2019 (COVID-19) pandemic. This cross-sectional descriptive study was conducted between April 2 and 9, 2020. The Questionnaire form was sent to health care personnel online. A total of 560 individuals who answered the questionnaires were included in the study. The data were collected by using the Personal Information Form, Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ), and Life Satisfaction Scale (LSS). Average age of the participants was 30.88 ± 7.68 years, 82.5% were male, and 65.5% were working as nurses. It was found that 45.5% of the participants used TCM methods for COVID-19 during the last month; 48.7% of the health care personnel stated that they used TCM methods to strengthen their immune system. The HCAMQ total average score was 27.96 ± 5.49; the holistic health subdimension total average score was 9.59 ± 3.04; the complementary and alternative medicine subdimension total average score was 18.37 ± 3.58; and the LSS total average score was 20.78 ± 6.32. A positive weak statistically significant association was found between the HCAMQ and complementary and alternative medicine subdimension and the LSS (P < .05). Participants had moderately positive attitudes toward TCM and life satisfaction. As the participants' positive attitudes toward TCM increased, their life satisfaction was also found to increase.
Impact of Citrus Essential Oil Diffusion on Health Care Staff's Stress Levels
Authors: Reynolds Staci S. , Hodges Elyse , Tang Jessica , Dahnke Deborah , Thomesen Emily M.
Published: February 2021

Essential oil diffusion can decrease stress. In one hospital, citrus essential oils were diffused over 6 weeks. Staff completed surveys of their stress levels before and after diffusion. Staff did not report a significant reduction in stress; however, there was an increase in feeling “relaxed.”
Online Training and Self-assessment in the Histopathologic Classification of Endocervical Adenocarcinoma and Diagnosis of Pattern of Invasion: Evaluation of Participant Performance
Authors: Park Kay J. , Cabrero Isabel A. , Fadare Oluwole , Hoang Lynn , Kiyokawa Takako , Oliva Esther , Parra-Herran Carlos , Rabban Joseph T. , Roma Andres , Singh Naveena , Soslow Robert , Stolnicu Simona , Huvila Jutta , Leung Samuel , Gilks C. Blake
Published: February 2021

Histopathologic classification of endocervical adenocarcinomas (EAC) has recently changed, with the new system based on human papillomavirus (HPV)-related morphologic features being incorporated into the 5th edition of the WHO Blue Book (Classification of Tumours of the Female Genital Tract). There has also been the introduction of a pattern-based classification system to assess invasion in HPV-associated (HPVA) endocervical adenocarcinomas that stratifies tumors into 3 groups with different prognoses. To facilitate the introduction of these changes into routine clinical practice, websites with training sets and test sets of scanned whole slide images were designed to improve diagnostic performance in histotype classification of endocervical adenocarcinoma based on the International Endocervical Adenocarcinoma Criteria and Classification (IECC) and assessment of Silva pattern of invasion in HPVA endocervical adenocarcinomas. We report on the diagnostic results of those who have participated thus far in these educational websites. Our goal was to identify areas where diagnostic performance was suboptimal and future educational efforts could be directed. There was very good ability to distinguish HPVA from HPV-independent adenocarcinomas within the WHO/IECC classification, with some challenges in the diagnosis of HPV-independent subtypes, especially mesonephric carcinoma. Diagnosis of HPVA subtypes was not consistent. For the Silva classification, the main challenge was related to distinction between pattern A and pattern B, with a tendency for participants to overdiagnose pattern B invasion. These observations can serve as the basis for more targeted efforts to improve diagnostic performance.
Tumor Staging of Endocervical Adenocarcinoma: Recommendations From the International Society of Gynecological Pathologists
Authors: Park Kay J. , Roma Andres , Singh Naveena , Gilks C. Blake , Oliva Esther , Abu-Rustum Nadeem , Ramirez Pedro T. , McCluggage W. Glenn
Published: February 2021

The International Federation of Gynecology and Obstetrics (FIGO) updated its staging system for cervical cancer in 2018 with changes that affect size criteria for early stage disease, as well as including pathology and radiology in addition to clinical assessment to be used in staging. Lymph node involvement was also included in the staging system. In early stage disease, pathologic findings are crucial in determining stage, which in turn determine treatment and prognosis for the patient. Therefore, it is imperative that there are unified and consistent methods and recommendations for assessing and reporting pathologic parameters for accurate staging. We describe the changes in the revised FIGO staging scheme and discuss controversial issues in cervical cancer staging from a pathologic perspective. We also provide practical recommendations regarding these parameters based on literature review and/or expert opinion/consensus.
Generalized tessellations of superellipitcal voids in low porosity architected materials for stress mitigation
Authors: Leng Jiazhen , Xu Hang , Schaenzer Megan , Quan Pham Minh , Bourgeois Genevieve , Shanian Ali , Pasini Damiano
Published: February 2021

Stress concentration is a crucial source of mechanical failure in structural elements, especially those embedding voids. This paper examines periodic porous materials with porosity lower than 5%. We investigate their stress distribution under planar multiaxial loading, and presents a family of geometrically optimized void shapes for stress mitigation. We adopt a generalized description for both void geometry and planar tessellation patterns that can handle single and multiple voids of arbitrary void shape at a generic angle. The role of void shape evolution from diamond to rectellipse on the stress-distribution is captured at the edge of voids in a representative volume element (RVE) made of non-equal length periodic vectors. Theoretical derivations, numerical simulations along with experimental validation of the strain field in thermoplastic polymer samples fabricated by laser cutting unveil the role of geometric parameters, e.g. superellipse order, aspect ratio and rotation angle, that minimize stress peak and ameliorate stress distribution around voids. This work extends and complements classical theory by providing fundamental insights into the role that tessellation, void shape and inclination play in the stress distribution of low-porosity architected materials, thus introducing essential guidelines of broad application for stress-minimization and failure mitigation in diverse sectors.
f
-distance of knotoids and protein structure
Authors: barbensi Agnese , Goundaroulis Dimos
Published: February 2021

Recent studies classify the topology of proteins by analysing the distribution of their projections using knotoids. The approximation of this distribution depends on the number of projection directions that are sampled. Here, we investigate the relation between knotoids differing only by small perturbations of the direction of projection. Since such knotoids are connected by at most a single forbidden move, we characterize forbidden moves in terms of equivariant band attachment between strongly invertible knots and of strand passages between
θ
-curves. This allows for the determination of the optimal sample size needed to produce a well-approximated knotoid distribution. Based on that and on topological properties of the distribution, we probe the depth of knotted proteins with the trefoil as the predominant knot type without using subchain analysis.
Tuna robotics: hydrodynamics of rapid linear accelerations
Authors: Thandiackal Robin , White Carl H. , Bart-Smith Hilary , Lauder George V.
Published: February 2021

Fish routinely accelerate during locomotor manoeuvres, yet little is known about the dynamics of acceleration performance. Thunniform fish use their lunate caudal fin to generate lift-based thrust during steady swimming, but the lift is limited during acceleration from rest because required oncoming flows are slow. To investigate what other thrust-generating mechanisms occur during this behaviour, we used the robotic system termed Tunabot Flex, which is a research platform featuring yellowfin tuna-inspired body and tail profiles. We generated linear accelerations from rest of various magnitudes (maximum acceleration of

3.22
 

m

 

s

−
2

at

11.6
 

Hz

tail beat frequency) and recorded instantaneous electrical power consumption. Using particle image velocimetry data, we quantified body kinematics and flow patterns to then compute surface pressures, thrust forces and mechanical power output along the body through time. We found that the head generates net drag and that the posterior body generates significant thrust, which reveals an additional propulsion mechanism to the lift-based caudal fin in this thunniform swimmer during linear accelerations from rest. Studying fish acceleration performance with an experimental platform capable of simultaneously measuring electrical power consumption, kinematics, fluid flow and mechanical power output provides a new opportunity to understand unsteady locomotor behaviours in both fishes and bioinspired aquatic robotic systems.
Evolutionary biomechanics: hard tissues and soft evidence?
Authors: Broyde Sarah , Dempsey Matthew , Wang Linjie , Cox Philip G. , Fagan Michael , Bates Karl T.
Published: February 2021

Biomechanical modelling is a powerful tool for quantifying the evolution of functional performance in extinct animals to understand key anatomical innovations and selective pressures driving major evolutionary radiations. However, the fossil record is composed predominantly of hard parts, forcing palaeontologists to reconstruct soft tissue properties in such models. Rarely are these reconstruction approaches validated on extant animals, despite soft tissue properties being highly determinant of functional performance. The extent to which soft tissue reconstructions and biomechanical models accurately predict quantitative or even qualitative patterns in macroevolutionary studies is therefore unknown. Here, we modelled the masticatory system in extant rodents to objectively test the ability of current muscle reconstruction methods to correctly identify quantitative and qualitative differences between macroevolutionary morphotypes. Baseline models generated using measured soft tissue properties yielded differences in muscle proportions, bite force, and bone stress expected between extant sciuromorph, myomorph, and hystricomorph rodents. However, predictions from models generated using reconstruction methods typically used in fossil studies varied widely from high levels of quantitative accuracy to a failure to correctly capture even relative differences between macroevolutionary morphotypes. Our novel experiment emphasizes that correctly reconstructing even qualitative differences between taxa in a macroevolutionary radiation is challenging using current methods. Future studies of fossil taxa should incorporate systematic assessments of reconstruction error into their hypothesis testing and, moreover, seek to expand primary datasets on muscle properties in extant taxa to better inform soft tissue reconstructions in macroevolutionary studies.
Two-Round Ca2+transient in papillae by mechanical stimulation induces metamorphosis in the ascidianCiona intestinalistype A
Authors: Wakai Maiki K. , Nakamura Mitsuru J. , Sawai Satoshi , Hotta Kohji , Oka Kotaro
Published: February 2021

Marine invertebrate larvae are known to begin metamorphosis in response to environmentally derived cues. However, little is known about the relationships between the perception of such cues and internal signalling for metamorphosis. To elucidate the mechanism underlying the initiation of metamorphosis in the ascidian,Ciona intestinalistype A (Ciona robusta), we artificially induced ascidian metamorphosis and investigated Ca2+dynamics from pre- to post-metamorphosis. Ca2+transients were observed and consisted of two temporally distinct phases with different durations before tail regression which is the early event of metamorphosis. In the first phase, Phase I, the Ca2+transient in the papillae (adhesive organ of the anterior trunk) was coupled with the Ca2+transient in dorsally localized cells and endoderm cells just after mechanical stimulation. The Ca2+transients in Phase I were also observed when applying only short stimulation. In the second phase, Phase II, the Ca2+transient in papillae was observed again and lasted for approximately 5–11 min just after the Ca2+transient in Phase I continued for a few minutes. The impaired papillae byFoxg-knockdown failed to induce the second Ca2+transient in Phase II and tail regression. In Phase II, a wave-like Ca2+propagation was also observed across the entire epidermis. Our results indicate that the papillae sense a mechanical cue and two-round Ca2+transients in papillae transmits the internal metamorphic signals to different tissues, which subsequently induces tail regression. Our study will help elucidate the internal mechanism of metamorphosis in marine invertebrate larvae in response to environmental cues.
Associations of DMT therapies with COVID-19 severity in multiple sclerosis
Authors: Simpson-Yap Steve , De Brouwer Edward , Kalincik Tomas , Rijke Nick , Hillert Jan , Walton Clare , Edan Gilles , Moreau Yves , Spelman Tim , Geys Lotte , Parciak Tina , Gautrais Clément , Lazovski Nikola , Pirmani Ashkan , Ardeshirdavani Amin , Forsberg Lars , Glaser Anna , McBurney Robert , Schmidt Hollie , Bergmann Arnfin , Braune Stefan , Stahmann Alexander , Middleton Rodden , Salter Amber , Fox Robert J. , van der Walt Anneke , Butzkueven Helmut , Al-Roughani Raed , Ozakbas Serkan , Rojas Juan I , van der Mei Ingrid , Nag Nupur , Ivanov Rumen , do Olival Guilherme Sciascia , Dias Alice Estavo , Magyari Melinda , Guimarães Brum Doralina , Mendes Maria Fernanda , Alonso Ricardo , Nicholas Richard , Bauer Johana , Chertcoff Anibal , Zabalza Ana , Arrambide Georgina , Fidao Alexander , Comi Giancarlo , Peeters Liesbet M.
Published: February 2021

Background

People with multiple sclerosis (MS) are a vulnerable group for severe COVID-19, particularly those taking immunosuppressive disease-modifying therapies (DMTs). We examined the characteristics of COVID-19 severity in an international sample of people with MS.

Methods

Data from 12 data-sources in 28 countries were aggregated. Demographic and clinical covariates were queried, alongside COVID-19 clinical severity outcomes, hospitalisation, admission to ICU, requiring artificial ventilation, and death. Characteristics of outcomes were assessed in patients with suspected/confirmed COVID-19 using multilevel mixed-effects logistic regression.

Results

657 (28.1%) with suspected and 1,683 (61.9%) with confirmed COVID-19 were analysed. Older age, progressive MS-phenotype, and higher disability were associated with worse COVID-19 outcomes. Compared to dimethyl fumarate, ocrelizumab and rituximab were associated with hospitalisation (aOR=1.56,95%CI=1.01-2.41; aOR=2.43,95%CI=1.48-4.02) and ICU admission (aOR=2.30,95%CI=0.98-5.39; aOR=3.93,95%CI=1.56-9.89), though only rituximab was associated with higher risk of artificial ventilation (aOR=4.00,95%CI=1.54-10.39). Compared to pooled other DMTs, ocrelizumab and rituximab were associated with hospitalisation (aOR=1.75,95%CI=1.29-2.38; aOR=2.76,95%CI=1.87-4.07) and ICU admission (aOR=2.55,95%CI=1.49-4.36; aOR=4.32,95%CI=2.27-8.23) but only rituximab with artificial ventilation (aOR=6.15,95%CI=3.09-12.27). Compared to natalizumab, ocrelizumab and rituximab were associated with hospitalisation (aOR=1.86,95%CI=1.13-3.07; aOR=2.88,95%CI=1.68-4.92) and ICU admission (aOR=2.13,95%CI=0.85-5.35; aOR=3.23,95%CI=1.17-8.91), but only rituximab with ventilation (aOR=5.52,95%CI=1.71-17.84). Importantly, associations persisted on restriction to confirmed COVID-19 cases. No associations were observed between DMTs and death.

Conclusions

Using the largest cohort of people with MS and COVID-19 available, we demonstrated consistent associations of rituximab with increased risk of hospitalisation, ICU admission, and requiring artificial ventilation, and ocrelizumab with hospitalisation and ICU admission, suggesting their use may be a risk factor for more severe COVID-19.
Impact of Binge Drinking During College on Resting State Functional Connectivity
Authors: Tong Tien T. , Vaidya Jatin G. , Kramer John R. , Kuperman Samuel , Langbehn Douglas R. , O’Leary Daniel S.
Published: February 2021

Aim

The current study aimed to examine the longitudinal effects of standard binge drinking (4+/5+ drinks for females/males in 2 hours) and extreme binge drinking (8+/10+ drinks for females/males in 2 hours) on resting state functional connectivity.

Method

119 college students with distinct alcohol bingeing patterns (35 non-bingeing controls, 44 standard bingers, and 40 extreme bingers) were recruited to ensure variability in bingeing frequency. Resting state fMRI scans were obtained at time 1 when participants were college freshmen and sophomores and again approximately two years later. On four occasions during the 2-year period between scans, participants reported monthly standard and extreme binge drinking for the past 6 months. Association between bingeing and change in functional connectivity was studied using both network-level and edge-level analysis. Network connectivity was calculated by aggregating multiple edges (a functional connection between any two brain regions) affiliated with the same network. The network-level analysis used mixed-effects models to assess the association between standard/extreme binge drinking and change in network connectivity, focusing on canonical networks often implicated in substance misuse. On the other hand, the edge-level analysis tested the relationship between bingeing and change in whole-brain connectivity edges using connectome-based predictive modeling (CPM).

Results

For network-level analysis, higher standard bingeing was associated with a decrease in connectivity between Default Mode Network-Ventral Attention Network (DMN-VAN) from time 1 to time 2, controlling for the initial binge groups at time 1, longitudinal network changes, in-scanner motion and other demographic covariates. For edge-level analysis, the CPM failed to identify a generalizable predictive model of cumulative standard/extreme bingeing from change in connectivity edges.

Conclusions

Our findings suggest that binge drinking is associated with abnormality in networks implicated in attention allocation and self-focused processes, which, in turn, have been implicated in rumination, craving, and relapse. More extensive alterations in functional connectivity might be observed with heavier or longer binge drinking pattern.
Deep learning models for COVID-19 chest x-ray classification: Preventing shortcut learning using feature disentanglement
Authors: Robinson Caleb , Trivedi Anusua , Blazes Marian , Ortiz Anthony , Desbiens Jocelyn , Gupta Sunil , Dodhia Rahul , Bhatraju Pavan K. , Liles W. Conrad , Lee Aaron , Kalpathy-Cramer Jayashree , Ferres Juan M. Lavista
Published: February 2021

In response to the COVID-19 global pandemic, recent research has proposed creating deep learning based models that use chest radiographs (CXRs) in a variety of clinical tasks to help manage the crisis. However, the size of existing datasets of CXRs from COVID-19+ patients are relatively small, and researchers often pool CXR data from multiple sources, for example, using different x-ray machines in various patient populations under different clinical scenarios. Deep learning models trained on such datasets have been shown to overfit to erroneous features instead of learning pulmonary characteristics – a phenomenon known as shortcut learning. We propose adding feature disentanglement to the training process, forcing the models to identify pulmonary features from the images while penalizing them for learning features that can discriminate between the original datasets that the images come from. We find that models trained in this way indeed have better generalization performance on unseen data; in the best case we found that it improved AUC by 0.13 on held out data. We further find that this outperforms masking out non-lung parts of the CXRs and performing histogram equalization, both of which are recently proposed methods for removing biases in CXR datasets.
Evaluation of the Knowledge of University Students in the Health Area About Sexually Transmitted Infections: A Cross-Sectional Study
Authors: Filho Carlos Izaias Sartorão , Neto Carlos Izaias Sartorão , Guazelli Carla Fabiana Souza , Avello Camila Rodrigues , Rodrigues Ivana Geraldeli Neiva , Alvarez Luana Durante , de Souza Reis Fabiana Vieira Duarte , Patrícia Fagundes Vanessa , Takano Luiz , Prudêncio Caroline Baldini , Barbosa Angélica Mércia Pascon , Rudge Marilza Vieira Cunha
Published: February 2021

Introduction

Sexually transmitted infections (STI) have consequences that negatively affect the population’s quality of life and health. Young adults are susceptible to low access to preventive measures and a greater risk behavior risk. The objective was to evaluate and compare STI’ Knowledge in university students from health courses, a public institution, and a private institution of higher education in Brazil.

Methods

a cross-sectional study conducted in 2019 in Brazil at the FEMA School of Medicine in Assis-SP and the University of the State of São Paulo (UNESP) in Marília in the courses of Physiotherapy, Speech Therapy, and Occupational Therapy, in undergraduate students, over 18 years of age, through a self-applied questionnaire translated and adapted to the Brazilian Portuguese from the STD-KQ – Transmitted Disease Knowledge Questionnaire.

Results

462/700 students participated (66.66%) 18-46 years of age (mean 21.46 years, +/− 3.61), 99 men and 363 women. In the private institution, 262/340 (77.06%), and in the public institution, 200/360 (55.55%). The mean age was 22.21 (+/− 4.21) years among men and 21.25 (+/− 3.41) years among women. The mean percentage of the 28 test questions’ correct answers was 52.07%. The average number of correct responses per student was 17.49 out of 28 possible, 62% (+/− 4.97). The distribution between the groups was normal. In the multiple linear regression model for the percentage of correct answers, adjusted for the confounding variables, the intercept was 55.2. The students of the private institution answered 19,655 questions more than the public one (P<.001), and for each semester of graduation, the students answered 1,628 more questions (P<.001). There were no relevant differences regarding the gender and age of the students.

Conclusion

there are gaps in STI knowledge among university students in the health area. The students of the first semesters of the courses, and, in particular, students from a public educational institution, had a significantly lower performance of the right in the questionnaire applied. Thus, actions to promote STI knowledge and preventive attitudes are necessary among university students.
SearcHPV: a novel approach to identify and assemble human papillomavirus-host genomic integration events in cancer
Authors: Pinatti Lisa M. , Gu Wenjin , Wang Yifan , El Hossiny Ahmed , Bhangale Apurva D. , Brummel Collin V. , Carey Thomas E. , Mills Ryan E. , Brenner J. Chad
Published: February 2021

Background

Human papillomavirus (HPV) is a well-established driver of malignant transformation in a number of sites including head and neck, cervical, vulvar, anorectal and penile squamous cell carcinomas; however, the impact of HPV integration into the host human genome on this process remains largely unresolved. This is due to the technical challenge of identifying HPV integration sites, which includes limitations of existing informatics approaches to discover viral-host breakpoints from low read coverage sequencing data.

Methods

To overcome this limitation, we developed a new HPV detection pipeline called SearcHPV based on targeted capture technology and applied the algorithm to targeted capture data. We performed an integrated analysis of SearcHPV-defined breakpoints with genome-wide linked read sequencing to identify potential HPV-related structural variations.

Results

Through analysis of HPV+ models, we show that SearcHPV detects HPV-host integration sites with a higher sensitivity and specificity than two other commonly used HPV detection callers. SearcHPV uncovered HPV integration sites adjacent to known cancer-related genes includingTP63andMYC, as well as near regions of large structural variation. We further validated the junction contig assembly feature of SearcHPV, which helped to accurately identify viral-host junction breakpoint sequences. We found that viral integration occurred through a variety of DNA repair mechanisms including non-homologous end joining, alternative end joining and microhomology mediated repair.

Conclusions

In summary, we show that SearcHPV is a new optimized tool for the accurate detection of HPV-human integration sites from targeted capture DNA sequencing data.
Animal soundscapes reveal key markers of Amazon forest degradation from fire and logging
Authors: Rappaport Danielle I. , Swain Anshuman , Fagan William F. , Dubayah Ralph , Morton Douglas C.
Published: February 2021

Safeguarding tropical forest biodiversity requires solutions for monitoring ecosystem composition over time. In the Amazon, logging and fire reduce forest carbon stocks and alter tree species diversity, but the long-term consequences for wildlife remain unclear, especially for lesser-known taxa. Here, we combined data from multi-day acoustic surveys, airborne lidar, and satellite timeseries covering logged and burned forests (n=39) in the southern Brazilian Amazon to identify acoustic markers of degradation. Our findings contradict theoretical expectations from the Acoustic Niche Hypothesis that animal communities in more degraded habitats occupy fewer ‘acoustic niches.’ Instead, we found that habitat structure (e.g., aboveground biomass) was not a consistent proxy for biodiversity based on divergent patterns of acoustic space occupancy (ASO) in logged and burned forests. Full 24-hr soundscapes highlighted a stark and sustained reorganization in community structure after multiple fires; animal communication networks were quieter, more homogenous, and less acoustically integrated in forests burned multiple times than in logged or once-burned forests. These findings demonstrate strong biodiversity co-benefits from protecting Amazon forests from recurrent fire activity. By contrast, soundscape changes after logging were subtle and more consistent with community recovery than reassembly. In both logged and burned forests, insects were the dominant acoustic markers of degradation, particularly during midday and nighttime hours that are not typically sampled by traditional field surveys of biodiversity. The acoustic fingerprints of degradation history were conserved across replicate recording locations at each site, indicating that soundscapes offer a robust, taxonomically inclusive solution for tracking changes in community composition over time.

Significance Statement

Fire and logging reduce the carbon stored in Amazon forests, but little is known about how human degradation alters animal communities. We recorded thousands of hours of ecosystem sounds to investigate animal community assembly and the associations between biodiversity and biomass following Amazon forest degradation over time. 24-hr patterns of acoustic activity differed between logged and burned forests, and we observed large and sustained breakpoints in community structure after multiple burns. Soundscape differences among degraded forests were clearest during insect-dominated hours rarely sampled in field studies of biodiversity. These findings demonstrate that acoustic monitoring holds promise for routine biodiversity accounting, even by non-experts, to capture a holistic measure of animal communities in degraded tropical forests and benchmark change over time.