bluuebunny/crossref_metadata_2025 huggingface dataset:
Applied potential of task-free event-related paradigms for assessing neurocognitive functions in disorders of consciousness
Authors: Møller Marie Louise Holm , Højlund Andreas , Jensen Mads , Gansonre Christelle , Shtyrov Yury
Published: June 2020

Diagnosing patients with disorders of consciousness is immensely difficult and often results in misdiagnoses, which can have fatal consequences. Despite the severity of this well-known issue, a reliable assessment tool has not yet been developed and implemented in the clinic. The main aim of this focused review is to evaluate the various event-related potential paradigms, recorded using EEG, which may be used to improve the assessment of patients with disorders of consciousness; we also provide a brief comparison of these paradigms with other measures. Notably, most event-related potential studies on the topic have focused on testing a small set of components, or even just a single component. However, to be of practical use, we argue that an assessment should probe a range of cognitive and linguistic functions at once. We suggest a novel approach that combines a set of well-tested auditory event-related potential components: N100, mismatch negativity, P3a, N400, early left anterior negativity and lexical response enhancement. Combining these components in a single, task-free design will provide a multidimensional assessment of cognitive and linguistic processes, which may help physicians make a more precise diagnosis.
Color variation in signal crayfish Pacifastacus leniusculus
Authors: Sacchi Roberto , Cancian Stefania , Ghia Daniela , Fea Gianluca , Coladonato Alan
Published: June 2020

External coloration in animals depends on the interaction of several different factors including the genetics and epigenetics processes that underlie the color expression, the mechanisms of color perception, and the general mechanisms controlling color evolution and function. Among all, camouflages from predators and conspicuousness are of particular interest because pose animal to choose between opposite adjustment in coloration. The external coloration of crustaceans is mainly due to the accumulation of carotenoids in the exoskeleton and the epidermal layer, and the trade-off between camouflage and communication had led to a variety of responses, involving signal partitioning, spectral sensibility, changing coloration, or signaling behavior. Here, we used digital images to explore intrapopulation variability of the external coloration of Pacifastacus leniusculus among body regions within an individual and between sexes. We found that 1) ventral coloration of claws are more saturated and brilliant than upper parts, 2) males express a more saturated and brightness coloration than females, especially on the lower portion of claws, 3) color intensity and brightness increases with size differently in different body regions, and 4) brightness is more variable in males than in females. All the above patterns support the hypothesis that color in this species could be the result of a compromise between camouflage from predators and conspicuousness for communication. The results of this study suggest that carotenoid might have something to do with intraspecific communication and perform more complex functions than that of a simple pigment.
Pathways From Social Activities to Cognitive Functioning: The Role of Physical Activity and Mental Health
Authors: Cohn-Schwartz Ella
Published: June 2020

Background and Objectives

One of the greatest challenges of old age is the risk of cognitive decline. Engagement in social activities has been identified as a possible protective factor. However, it is not yet clear what are the mechanisms underlying this association. This study aims to elucidate the pathways through which social activities impact cognitive functioning, focusing on physical activity and mental health as possible mediators.

Research Design and Methods

The study utilized 3 waves of data—the fourth, fifth, and sixth waves of the Survey of Health, Ageing and Retirement in Europe, collected in 2011, 2013, and 2015, respectively. It focused on respondents aged 60 and older. Cognitive functioning was assessed via immediate recall, delayed recall, and fluency. Social activities were measured by volunteering and attending social clubs. Data were analyzed using a structural equation modeling approach.

Results

The results indicated a significant direct effect of social activities on cognitive functioning. That is, being socially active at baseline was related to better cognitive function 4 years later. The results also indicated the existence of indirect effects. Engaging in social activities was related to better mental health and more physical activities 2 years later, which were related to better subsequent cognitive performance.

Discussion and Implications

These findings highlight the mediating roles of physical activity and mental health in the effects of social activities on cognitive functioning. Understanding these mechanisms can help optimize social activity interventions to improve cognitive aging.
Broad-band study of high-synchrotron-peaked BL Lac object 1ES 1218+304
Authors: Sahakyan N
Published: June 2020

The origin of the multiwavelength emission from the high-synchrotron-peaked BL Lac 1ES 1218+304 is studied using the data from SwiftUVOT/XRT, NuSTAR, and Fermi-LAT. A detailed temporal and spectral analysis of the data observed during 2008–2020 in the  γ-ray (>100 MeV), X-ray (0.3–70 keV), and optical/UV bands is performed. The γ-ray spectrum is hard with a photon index of 1.71 ± 0.02 above 100 MeV. The SwiftUVOT/XRT data show a flux increase in the UV/optical and X-ray bands; the highest 0.3–3 keV X-ray flux was (1.13 ± 0.02) × 10−10 erg cm−2 s−1. In the 0.3–10 keV range, the averaged X-ray photon index is >2.0 which softens to 2.56 ± 0.028 in the 3–50 keV band. However, in some periods, the X-ray photon index became extremely hard (<1.8), indicating that the peak of the synchrotron component was above 1 keV, and so 1ES 1218+304 behaved like an extreme synchrotron BL Lac. The hardest X-ray photon index of 1ES 1218+304 was 1.60 ± 0.05 on MJD 58489. The time-averaged multiwavelength spectral energy distribution is modelled within a one-zone synchrotron self-Compton leptonic model using a broken power law and power law with an exponential cutoff electron energy distributions. The data are well explained when the electron energy distribution is $E_{\rm e}^{-2.1}$ extending up to γbr/cut ≃ (1.7 − 4.3) × 105, and the magnetic field is weak (B ∼ 1.5 × 10−2 G). By solving the kinetic equation for electron evolution in the emitting region, the obtained electron energy distributions are discussed considering particle injection, cooling, and escape.
ALMA observations of PSR B1259−63/LS 2883 in an inactive period: Variable circumstellar disk?
Authors: Fujita Yutaka , Nagai Hiroshi , Akahori Takuya , Kawachi Akiko , Okazaki Atsuo T
Published: June 2020

We report Atacama Large Millimeter/submillimeter Array (ALMA) observations of the gamma-ray binary system containing the pulsar PSR B1259−63 orbiting around a massive star LS 2883 in an inactive period between the 2017 and 2021 periastron passages. We detected radio continuum emission from the binary system at 97 GHz (Band 3) and 343 GHz (Band 7). Compared with our previous ALMA observations performed soon after the 2017 periastron passage, the fluxes have decreased by a factor of six at 97 GHz and of two at 343 GHz. The flux at 343 GHz is large relative to that at 97 GHz and appears to be thermal emission from the circumstellar disk around LS 2883. The decrease of the 343 GHz flux may indicate that the disk has expanded and become partially optically thin since the disk is no longer affected by pulsar winds. The flux at 97 GHz is consistent with that expected from the pulsed emission from the pulsar, which indicates that the unpulsed emission that had been produced through pulsar-disk or pulsar-stellar wind interaction has disappeared. The image of the system is consistent with a point source and shows no sign of ejecta.
Combined influence of practice guidelines and prospective audit and feedback stewardship on antimicrobial treatment of community-acquired pneumonia and empyema in children: 2012 to 2016
Authors: Le Saux Nicole M A , Bowes Jennifer , Viel-Thériault Isabelle , Thampi Nisha , Blackburn Julie , Buba Melanie , Harrison Mary-Ann , Barrowman Nick
Published: June 2020

Background

Aminopenicillins are recommended empiric therapy for community-acquired pneumonia (CAP). The aim of the study was to assess treatment over a 5-year period after CAP guideline publication and introduction of an antimicrobial stewardship program (ASP).

Methods

Using ICD-10 discharge codes for pneumonia, children less than 18 years admitted to the Children’s Hospital of Eastern Ontario January 1, 2012 and December 31, 2016 were identified. Children ≥ 2 months with consolidation were included. One day of therapy (DOT) was one or more doses of an antimicrobial given for 1 day.

Results

Of 1,707 patients identified, 713 met inclusion criteria. Eighteen (2.5%) had bacteria identified by culture and 79 of 265 (29.8%) had Mycoplasma pneumoniae detected. Mean DOT/1,000 patient days of aminopenicillins/penicillin (AAP) increased by 18.1% per year (95% confidence interval [CI] −0.2, 39.9%) and decreased by 37.6% per year (95% CI −56.1, −11.3%) for second- and third-generation cephalosporins in the post-ASP period. The duration of discharge antimicrobials decreased. Of 74 (10.4%) patients who had pleural fluid drained, 35 (47.3%) received more than 5 days of AAP and ≤ 5 days of second-/third-generation cephalosporins with no difference in median length of stay nor mean duration of antimicrobials.

Conclusions

Implementation of CAP management guidelines followed by prospective audit and feedback stewardship was associated with a sustained decrease in the use of broad-spectrum antibiotics in childhood CAP. Use of AAP should also be strongly considered in patients with effusions (even if no pathogen is identified), as clinical outcome appears similar to patients treated with broad-spectrum antimicrobials.
Research progress on ecological protection technology of highway slope: status and challenges
Authors: Fu Hongyuan , Zha Huanyi , Zeng Ling , Chen Caiying , Jia Chuankun , Bian Hanbing
Published: June 2020

Slope protection has always been a major concern in highway construction and later operation. Ecological protection technology is widely used in highway slope, which takes into account functions of protection, ecology, and landscape. Ecological protection technology is mainly to improve the stability of the slope through the combination of supporting structure and plants, and vegetation restoration can reduce the negative impact of highway construction. In this paper, the latest research progress of ecological protection technology was first reviewed to identify the main construction process and types, which revealed the protection mechanism of ecological protection technology. The comprehensive benefits of ecological slope protection technology were analysed from the aspects of air, water circulation, landscape and biodiversity. It has found that ecological protection technology of highway slope mainly forms the atmosphere-plant-soil system. Ecological protection technology of highway slope improved the stability of the slope through the supporting structure and the anchoring effect of plant roots. And the restoration of the surface vegetation on the slope promoted the photosynthesis and transpiration of plants and purifies the air quality along the highway. Ecological protection technology of highway slope could quickly restore the ecological balance, overall landscape and biodiversity of the region.
Genetic recombination in fast-spreading coxsackievirus A6 variants: a potential role in evolution and pathogenicity
Authors: Song Yang , Zhang Yong , Han Zhenzhi , Xu Wen , Xiao Jinbo , Wang Xianjun , Wang Jianxing , Yang Jianfang , Yu Qiuli , Yu Deshan , Chen Jianhua , Huang Wei , Li Jie , Xie Tong , Lu Huanhuan , Ji Tianjiao , Yang Qian , Yan Dongmei , Zhu Shuangli , Xu Wenbo
Published: June 2020

Hand, foot, and mouth disease (HFMD) is a common global epidemic. From 2008 onwards, many HFMD outbreaks caused by coxsackievirus A6 (CV-A6) have been reported worldwide. Since 2013, with a dramatically increasing number of CV-A6-related HFMD cases, CV-A6 has become the predominant HFMD pathogen in mainland China. Phylogenetic analysis based on the VP1 capsid gene revealed that subtype D3 dominated the CV-A6 outbreaks. Here, we performed a large-scale (near) full-length genetic analysis of global and Chinese CV-A6 variants, including 158 newly sequenced samples collected extensively in mainland China between 2010 and 2018. During the global transmission of subtype D3 of CV-A6, the noncapsid gene continued recombining, giving rise to a series of viable recombinant hybrids designated evolutionary lineages, and each lineage displayed internal consistency in both genetic and epidemiological features. The emergence of lineage –A since 2005 has triggered CV-A6 outbreaks worldwide, with a rate of evolution estimated at 4.17 × 10−3 substitutions site-1 year−1 based on a large number of monophyletic open reading frame sequences, and created a series of lineages chronologically through varied noncapsid recombination events. In mainland China, lineage –A has generated another two novel widespread lineages (–J and –L) through recombination within the enterovirus A gene pool, with robust estimates of occurrence time. Lineage –A, –J, and –L infections presented dissimilar clinical manifestations, indicating that the conservation of the CV-A6 capsid gene resulted in high transmissibility, but the lineage-specific noncapsid gene might influence pathogenicity. Potentially important amino acid substitutions were further predicted among CV-A6 variants. The evolutionary phenomenon of noncapsid polymorphism within the same subtype observed in CV-A6 was uncommon in other leading HFMD pathogens; such frequent recombination happened in fast-spreading CV-A6, indicating that the recovery of deleterious genomes may still be ongoing within CV-A6 quasispecies. CV-A6-related HFMD outbreaks have caused a significant public health burden and pose a great threat to children’s health; therefore, further surveillance is greatly needed to understand the full genetic diversity of CV-A6 in mainland China.
XI The Eighteenth Century
Authors: Lyons-McFarland Michelle , Glover Danni , Scott Robert , Distel Kristin M
Published: June 2020

This chapter has four sections: 1 General and Prose; 2 The Novel; 3. Poetry; 4. Drama. Section 1 is by Michelle Lyons-McFarland; section 2 is by Danni Glover; section 3 is by Robert Scott; section 4 is by Kristin M. Distel
Stress in the Clinical Learning Environment: Perceptions of First-Year Finnish Nursing Students
Authors: Bhurtun Hanish , Saaranen Terhi , Estola Matti , Turunen Hannele
Published: June 2020

AIM

The aim of the study was to examine how first-year Finnish nursing students perceive stress and the coping strategies they use in the clinical learning environment.

BACKGROUND

Stress from the clinical learning environment is a recurrent problem in nursing education. This topic has not been explored in the Finnish context.

METHOD

This is a cross-sectional study using data from 189 first-year nursing students. Students completed the Perceived Stress Scale and Coping Behavior Inventory; t-tests and Pearson correlation analyses were performed.

RESULTS

Our sample rarely experienced stress, with a mean stress score of 1.07 (SD = 0.49). A commonly reported stressor was lack of professional knowledge and skills (M = 1.49, SD = 0.82). Transference was the most common coping strategy.

CONCLUSION

Our findings may help nursing teachers understand stressors in the clinical learning environment and support their students to use effective coping strategies, such as problem-solving and optimistic attitudes.
Nonoperating room anesthesia for children
Authors: Shih Grace , Bailey Philip D.
Published: June 2020

Purpose of review

Nonoperating room anesthesia (NORA) cases performed in pediatric patients have increased over the past decade. It is imperative for the anesthesia provider to be familiar with the nuances of this environment and the myriad of cases to ensure delivery of safe and efficient care.

Recent findings

Though case volume has increased, sedative agents have largely remained unchanged. NORA sites must meet the same operating room standards and expectations of anesthesia established by the American Society of Anesthesiologists. Despite the increasing NORA volume and efforts to instill a similar culture of safety as the operating room complex, NORA cases present challenges with limited resources and access to the patient, highlighting the need for resident and fellow training to include NORA experiences.

Experience working in the NORA environment helps provide, maintain, and improve the cognitive fitness and resilience that an anesthesiologist needs to tackle the complexities from the variety of NORA cases and locations. Patient factors aside, procedural considerations can affect the anesthetic plan, so understanding the nuances of the procedure helps the anesthesia provider provide safe and efficient care.
The anesthesiologist and global climate change: an ethical obligation to act
Authors: Van Norman Gail A. , Jackson Stephen
Published: June 2020

Purpose of review

Pollution and global warming/climate change contribute to one-quarter of all deaths worldwide. Global healthcare as a whole is the world's fifth largest emitter of greenhouse gases, and anesthetic gases, intravenous agents and supplies contribute significantly to the overall problem. It is the ethical obligation of all anesthesiologists to minimize the harmful impact of anesthesia practice on environmental sustainability.

Recent findings

Focused programs encouraging judicious selection of the use of anesthetic gas agents has been shown to reduce CO2 equivalent emissions by 64%, with significant cost savings. Good gas flow management reduces nonscavenged anesthetic gas significantly, and has been shown to decrease the consumption of volatile anesthetic agent by about one-fifth. New devices may allow for recapture, reclamation and recycling of waste anesthetic gases. For propofol, a nonbiodegradable, environmentally toxic agent, simply changing the size of vials on formulary has been shown to reduce wasted agent by 90%.

The 5 R's of waste minimization in the operating room (OR) (Reduce, Reuse, Recycle, Rethink and Research) have proven benefit in reducing the environmental impact of the practice of anesthesiology, as well as in reducing costs.
Intubation outside of the operating room: new challenges and opportunities in COVID-19 era
Authors: Lee Delice Weishan , Ma Martin , Parotto Matteo , Wąsowicz Marcin
Published: June 2020

Purpose of review

Airway management in patients outside the operating room is associated with increased difficulties and risks, and the setting of the COVID-19 global pandemic adds another layer of complexity. Therefore, endotracheal intubation (ETT) of a patient who is presumptive COVID-19 or COVID-19 positive presents an additional challenge to an anesthesiologist. The aim of this review is to summarize the important principles of airway management outside of the operating room during the COVID-19 pandemic.

Recent findings

Several professional societies have formulated guidelines on airway management COVID-19 suspect and proven patients. Additionally, anesthesiologists working in hospitals treating many infected patients have developed specialized teams responsible for airway management outside the operating room. These documents and protocols focus on the importance of wearing personal protective equipment and the skills of the providers responsible for securing the airway. Staff safety is always a priority when performing ETT outside operating room.

The COVID-19 pandemic redefined the management of patients requiring aerosol generating procedures (droplet and airborne precautions). ETT is one of them and anesthesiologists are experts in performing airway management. Although the operating room is a highly controlled environment, airway management outside of this setting is not always the easiest task.
Prognostic value of free triiodothyronine in patients with dilated cardiomyopathy
Authors: Zhao Hong-Yan , Sun Ling , Zhu Ye-Qian , Chen Qiu-Shi , Zhu Wen-Wu , Toorabally Mohammad Bilaal , Chen Xin-Guang , Zhang Feng-Xiang
Published: June 2020

Background

The association between free triiodothyronine (FT3) and long-term prognosis in dilated cardiomyopathy (DCM) patients has not been evaluated. The purpose of this study was to determine whether the level of FT3 could provide prognostic value in patients with DCM.

Methods

Data of consecutive patients diagnosed with DCM were collected from October 2009 to December 2014. FT3 was measured by fluoroimmunoassay. Other biochemical markers, such as free thyroxin (FT4), thyroid-stimulating hormone, red blood cell, hemoglobin, blood urea nitrogen, and serum creatinine, were tested at the same time. Follow-up was performed every 3 months. The primary endpoint was all-cause mortality. Pearson analysis was used to evaluate the correlation of FT3 and other lab metrics with DCM patients’ prognosis. The association of long-term mortality in DCM and FT3 was compared using Cox hazards model.

Results

Data of 176 patients diagnosed with DCM were collected. Of them, 24 patients missed FT3 values and six patients were lost to follow-up. Altogether, data of 146 patients were analyzed. During the median follow-up time of 79.9 (53.5–159.6) months, nine patients lost, 61 patients died (non-survival group), and 85 patients survived (survival group). FT3 was significantly lower in non-survival group than that in survival group (3.65 ± 0.83 pmol/L vs. 4.36 ± 1.91 pmol/L; P = 0.003). FT3 also showed a significantly positive correlation with red blood cell and hemoglobin, negatively correlated with age, blood urea nitrogen and serum creatinine (P < 0.05), respectively. Patients in the group of lower FT3 levels (FT3 ≤3.49 pmol/L) suffered from a higher risk of all-cause mortality (P for log-rank = 0.001). In multivariate Cox regression analysis, FT3 level was significantly associated with all-cause mortality (hazard ratio: 0.70, 95% confidence interval 0.52–0.95, P for trend = 0.021).

Conclusion

Low levels of FT3 were associated with increased all-cause mortality in patients with DCM.
RECURRENCE OF IDIOPATHIC EPIRETINAL MEMBRANE AND ITS PREDISPOSING FACTORS
Authors: Ahn Seong Joon , Woo Se Joon , Park Kyu Hyung
Published: June 2020

Purpose:

To evaluate the incidence and clinical course of recurrent epiretinal membrane (ERM) after ERM surgery and to identify predisposing optical coherence tomography (OCT) findings for the recurrence.

Methods:

Postoperative ERM recurrence, defined as reappearance of the membrane after its removal or regrowth of the remnant membrane, was investigated in 301 eyes with idiopathic ERM followed up for more than 6 months after macular surgery by fundus photographs and spectral-domain OCT. The incidences of recurrent ERM and its associated clinical characteristics were assessed. Preceding OCT findings in the area subsequently showing recurrent ERM were evaluated at early postoperative periods.

Results:

Among the 301 eyes that underwent ERM peeling, 119 (39.5%) and 86 (28.6%) showed ERM recurrence on OCT images and biomicroscopic examination/fundus photographs, respectively, during the follow-up period (average: 18.1 months). Neighboring remnant membrane and hyperreflective dots on the retinal surface at 1 week after the surgery and postoperative inner retinal wrinkling persisting for ≥1 month were predisposing OCT findings for ERM recurrence, with an odds ratio of 6.48 (95% confidence interval, 3.51–12.0), 3.48 (95% confidence interval, 1.81–6.70), and 6.11 (95% confidence interval, 3.30–11.3), respectively (all P < 0.001).

Conclusion:

Incidence of ERM recurrence varies depending on the definition used for the recurrence. Optical coherence tomography examination may be useful for the prediction and sensitive detection of recurrent ERM.
CENTRAL RETINAL VEIN OCCLUSION IN YOUNG PATIENTS
Authors: Eah Kyu Sang , Kim You Na , Park Yu Jeong , Lee Joo Yong , Kim June-Gone , Yoon Young Hee , Kim Yoon Jeon
Published: June 2020

Purpose:

To investigate the clinical characteristics and prognostic factors of young patients with central retinal vein occlusion (CRVO).

Methods:

This retrospective cohort study involved treatment-naïve patients with CRVO. Medical records regarding basic demographics, predisposing factors, ocular characteristics, and treatments were reviewed and compared according to age at CRVO onset.

Results:

We enrolled 263 patients, of whom 69 were younger patients. Younger patients had higher prevalence of nontraditional risk factors including physical or psychological stress (P = 0.032), hematologic abnormalities (P = 0.003), and better visual acuity at baseline and last visit (all P < 0.001) and were unlikely to undergo intravitreal injections (47.8 vs. 68.6%, P < 0.001) during follow-up. Younger patients had higher prevalence of paracentral acute middle maculopathy (28.1 vs. 4.7%, P < 0.001). Older age (odds ratio = 1.165, P = 0.028), male sex (odds ratio = 7.074, P = 0.034), coexisting renal disease (odds ratio = 7.845, P = 0.050), and poor baseline visual acuity (odds ratio = 16.069, P = 0.002) were significant risk factors for poor visual outcomes in young CRVO patients.

Conclusion:

Younger CRVO patients had a milder clinical course with fewer treatments and were more likely to have nontraditional risk factors than older patients.
NOVEL METHOD FOR IMAGE AVERAGING OF OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IMAGES
Authors: Spaide Richard F. , Ledesma-Gil Gerardo
Published: June 2020

Purpose:

To develop a method of averaging optical coherence tomography (OCT) angiography to improve visualization of choriocapillaris structure.

Methods:

A stack of OCT angiographic data from vascular layers were placed into the red-green-blue channels of a conventional digital color image. The superficial plexus was placed in the blue channel, choriocapillaris in the green, and deep vascular plexus in the red channel. The red-green-blue images derived from nine separate OCT angiographic scans were registered using an automatic registration sequence and the images were averaged. The averaged red-green-blue image was then split into the three averaged component layers. The technique is flexible and any vascular layer, such as macular neovascularization, can be used as well.

Results:

The utility of the imaging method was demonstrated by showing the imaging of two different diseases. A patient with a history of familial amyloidosis, hypertension, kidney failure, kidney transplantation, and prednisone use, followed by central serous chorioretinopathy treated by photodynamic therapy. She had alterations in retinal pigment epithelial pigmentation and widespread abnormalities of autofluorescence. She showed remarkably decreased vascular density and vessel configuration of her choriocapillaris. A patient with pseudoxanthoma elasticum with subretinal drusenoid deposits at an early age also showed marked decreased choriocapillaris density and vascular configuration. These findings were compared with healthy controls of similar age with no abnormalities.

Conclusion:

The detailed method is capable of averaging choriocapillaris OCT angiographic images using a simple automatic method. Image averaging offers opportunity to improve the noisy OCT angiographic images such that actual vascular structure is visible.
Mulitmodal Corneal Imaging of Genetically Confirmed Keratitis–Ichthyosis–Deafness Syndrome
Authors: Lee Lenis Tamara , Zhang Wenlin , Shibayama Vivian , Al-Hashimi Saba , Aldave Anthony J. , Deng Sophie X. , Fung Simon S. M.
Published: June 2020

Background:

Keratitis–ichthyosis–deafness (KID) syndrome is characterized by a congenital triad of keratitis, ichthyosis, and deafness, and is most commonly associated with mutations in the gap junction protein beta 2 gene (GJB2) on chromosome 13q11-q12.

Methods:

Multimodal anterior segment imaging and genetic testing were used to supplement clinical examination findings in the diagnosis and management of a 12-year-old boy with suspected KID syndrome.

Results:

The patient presented with hearing loss, ichthyosis of the face and extremities, and corneal scarring and keratinization. The corneal limbal stem cell population was found to be normal on in vivo confocal microscopy, whereas the basal epithelium of the cornea demonstrated scarring and areas of cellular loss. Screening of GJB2 revealed a presumed pathogenic heterozygous missense mutation, c.148G>A, confirming the diagnosis of KID syndrome.

Conclusions:

Multimodal imaging including in vivo confocal microscopy suggests that dysfunctional corneal basal epithelium maturation might contribute to the pathophysiology of keratopathy in KID syndrome.
Assessing effector T cells in type 1 diabetes
Authors: Arif Sefina , Pujol-Autonell Irma , Eichmann Martin
Published: June 2020

Purpose of review

The role of T cells specific for islet autoantigens is proven in pathogenesis of type 1 diabetes. Recently, there has been rapid expansion in the number of T-cell subsets identified, this has coincided with an increase in the repertoire of reported islet antigens mainly through the discovery of novel epitopes. A discussion of how these marry together is now warranted and timely.

Recent findings

In this review, we will discuss the autoreactivity against neo-epitopes. We then explore the growing array of T-cell subsets for both CD4+ T cells, including follicular and peripheral T helper cells, and CD8+ T cells, discussing evolution from naïve to exhausted phenotypes. Finally, we detail how subsets correlate with disease stage and loss of β-cell function and are impacted by immunotherapy.

The expanding list of T-cell subsets may be potentially encouraging in terms of elucidating disease mechanisms and have a role as biomarkers for disease progression. Furthermore, T-cell subsets can be used in stratifying patients for clinical trials and for monitoring immunotherapy outcomes. However, the definition of subsets needs to be refined in order to ensure that there is a uniform approach in designating T-cell subset attributes that is globally applied.
Update on evidence in craniomaxillofacial surgery
Authors: Arnold Mark , Tatum Sherard
Published: June 2020

Purpose of review

Evidence-based medicine underpins clinical practice. Ideally, our clinical decision-making stems from systematic reviews of randomized controlled trials. However, in practice, this is not often the case, and we must instead rely on the best available evidence.

Recent findings

We review the history of evidence-based research, the development of the levels of evidence, and the relationship of evidence and bias present in craniomaxillofacial surgery. We also discuss the recent trends in CMF publications and identify areas for improvement.

Because of inherent challenges, the quality of evidence in craniomaxillofacial surgery lags behind other surgical and medical specialties. However, over recent years this has improved significantly, with better reporting of data and a higher rate of randomized controlled trials.
A Morphologic and Immunohistochemical Comparison of Nuclear β-Catenin Expressing Testicular Sertoli Cell Tumors and Pancreatic Solid Pseudopapillary Neoplasms Supporting Their Continued Separate Classification
Authors: Kao Chia-Sui , Ulbright Thomas M.
Published: June 2020

Some recent reports suggested that many Sertoli cell tumors, not otherwise specified (SCTs-NOS) of the testis were analogs of the solid pseudopapillary neoplasm (SPN) of the pancreas. One of the most relied on pieces of information for this assertion was the shared occurrence in both neoplasms of exon 3 mutations of the CTNNB1 gene, which was reflected by nuclear β-catenin expression. We, therefore, compared the morphologic and immunohistochemical features of 18 SCTs-NOS with strong, diffuse nuclear β-catenin expression with 16 SPNs that also showed such positivity. Although there were clear similarities in the light microscopic features of these neoplasms, there were also significant differences that included, in SCT-NOS and SPN, respectively: hollow tubules (53% vs. 0%), sheet-like growth (44% vs. 94%), circumscription (79% vs. 25%), corded or trabecular patterns (81% vs. 31%), formation of papillae or pseudopapillae (24% vs. 69%), growth in nests or clusters (94% vs. 50%), perivascular pseudorosettes (13% vs. 56%), and rhabdoid cytology (6% vs. 50%). Commonly shared morphologic features included signet-ring cells, pale or foamy cytoplasm, myxoid stroma, cyst formation, perivascular hyalinization, and globular or band-like basement membrane deposits. On immunohistochemical study, sex cord markers were frequently positive in SCTs-NOS (steroidogenic factor-1—94%; FOXL2—87%; SOX9—69%; calretinin—60%; Wilms tumor-1—38%; inhibin—29%) whereas all of these markers were negative in the SPNs. We conclude that even though SCT-NOS and SPN share some morphologic features and nuclear immunoreactivity for β-catenin, there remain differences, both morphologically and immunohistochemically, between these neoplasms to the degree that SCT-NOS should not be equated with pancreatic SPN.
Complex Dentoalveolar Fractures: Main Clinical Variables Description and Analysis
Authors: Fernández-Ferro Martín , Fernández-Sanromán Jacinto , Costas-López Alberto , López-Betancourt Annahys , Casañas-Villalba Natalia , López-Fernández Pablo
Published: June 2020

Aims and Objectives:

To analyze and evaluate clinical features that define complex dentoalveolar trauma.

Materials and Methods:

Forty-five patients, with a mean age of 36.1 years, were included in the study; most patients were male (82.2%). The main clinical features defining dentoalveolar fractures were evaluated, including the status of the tooth, alveolar socket and adjacent soft tissues and their relationships with tooth loss. The relationship between splinting and tooth loss was also studied. The data were analyzed using descriptive and statistical methods.

Results:

A significant relationship was observed between the different clinical variables and tooth loss, in particular the status of the alveolar socket as the most relevant clinical factor; there was also a significant relationship between splinting and tooth loss, as this was the main protective factor.

Conclusions:

Tooth loss prognosis following complex dentoalveolar trauma is related to the clinical features of the fracture, particularly the status of the alveolar socket and the possibility of using splinting as treatment.
Therapeutic Potential of B-1a Cells in COVID-19
Authors: Aziz Monowar , Brenner Max , Wang Ping
Published: June 2020

Coronavirus disease 2019 (COVID-19) is a life-threatening respiratory illness caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Its clinical presentation can vary from the asymptomatic state to acute respiratory distress syndrome (ARDS) and multi-organ dysfunction. Due to our insufficient understanding of its pathophysiology and lack of effective treatment, the morbidity and mortality of severe COVID-19 patients are high. Patients with COVID-19 develop ARDS fueled by exaggerated neutrophil influx into the lungs and cytokine storm. B-1a cells represent a unique subpopulation of B lymphocytes critical for circulating natural antibodies, innate immunity, and immunoregulation. These cells spontaneously produce natural IgM, interleukin (IL)-10, and granulocyte-monocyte colony stimulating factor (GM-CSF). Natural IgM neutralizes viruses and opsonizes bacteria, IL-10 attenuates the cytokine storm, and GM-CSF induces IgM production by B-1a cells in an autocrine manner. Indeed, B-1a cells have been shown to ameliorate influenza virus infection, sepsis, and pneumonia, all of which are similar to COVID-19. The recent discovery of B-1a cells in humans further reinforces their potentially critical role in the immune response against SARS-CoV-2 and their anticipated translational applications against viral and microbial infections. Given that B-1a cells protect against ARDS via immunoglobulin production and the anti-COVID-19 effects of convalescent plasma treatment, we recommend that studies be conducted to further examine the role of B-1a cells in the pathogenesis of COVID-19 and explore their therapeutic potential to treat COVID-19 patients.
Stepwise construction of dynamic microscale concentration gradients around hydrogel-encapsulated cells in a microfluidic perfusion culture device
Authors: Yamahira Shinya , Satoh Taku , Yanagawa Fumiki , Tamura Masato , Takagi Toshiyuki , Nakatani Eri , Kusama Yuta , Sumaru Kimio , Sugiura Shinji , Kanamori Toshiyuki
Published: June 2020

Inside living organisms, concentration gradients dynamically change over time as biological processes progress. Therefore, methods to construct dynamic microscale concentration gradients in a spatially controlled manner are needed to provide more realistic research environments. Here, we report a novel method for the construction of dynamic microscale concentration gradients in a stepwise manner around cells in micropatterned hydrogel. In our method, cells are encapsulated in a photodegradable hydrogel formed inside a microfluidic perfusion culture device, and perfusion microchannels are then fabricated in the hydrogel by micropatterned photodegradation. The cells in the micropatterned hydrogel can then be cultured by perfusing culture medium through the fabricated microchannels. By using this method, we demonstrate the simultaneous construction of two dynamic concentration gradients, which allowed us to expose the cells encapsulated in the hydrogel to a dynamic microenvironment.
Green and efficient three-component synthesis of 4H-pyran catalysed by CuFe
2
O
4
@starch as a magnetically recyclable bionanocatalyst
Authors: Kamalzare Maryam , Bayat Mohammad , Maleki Ali
Published: June 2020

The development of simple, practical and inexpensive catalysis systems using natural materials is one of the main goals of pharmaceutical chemistry as well as green chemistry. Owing to the ability of easy separation of nanocatalyst, those goals could be approached by applying heterogeneous bionanocatalyst in combination with magnetic nanoparticles. Starch is one of the most abundant natural polymers; therefore, preparing bionanocatalyst from starch is very valuable as starch is largely available and inexpensive. An ecologically benign and efficacious heterogeneous nanocatalyst was prepared based on a biopolymer, and its attributes and morphology were specified by using Fourier transform infrared spectra, scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), X-ray diffraction (XRD), thermal analysis and vibrating sample magnetometer measurements; followed by studying catalytic behaviour of bionanocomposite in a multicomponent reaction to synthesize of 4H-pyran derivatives. 4H-pyran is extremely valuable in pharmaceutical chemistry, and the development of methods for synthesis of different derivatives of 4H-pyran is momentous. Revealing environmentally benign nature, mild condition, easy work-up, low cost and non-toxicity are some of the advantages of this protocol. Besides, the bionanocomposite was recovered using an external magnetic bar and could be re-used at least six times with no further decrease in its catalytic activity.
Big dairy data to unravel effects of environmental, physiological and morphological factors on milk production of mountain-pastured Braunvieh cows
Authors: Duruz Solange , Vajana Elia , Burren Alexander , Flury Christine , Joost Stéphane
Published: June 2020

The transhumance system, which consists in moving animals to high mountain pastures during summer, plays a considerable role in preserving both local biodiversity and traditions, as well as protecting against natural hazard. In cows, particularly, milk production is observed to decline as a response to food shortage and climatic stress, leading to atypical lactation curves that are barely described by current lactation models. Here, we relied on 5 million monthly milk records from over 200 000 Braunvieh and Original Braunvieh cows to devise a new model accounting for transhumance, and test the influence of environmental, physiological and morphological factors on cattle productivity. Counter to expectations, environmental conditions in the mountain showed a globally limited impact on milk production during transhumance, with cows in favourable conditions producing only 10% more compared with cows living in detrimental conditions, and with precipitation in spring and altitude revealing to be the most production-affecting variables. Conversely, physiological factors such as lactation number and pregnancy stage presented an important impact over the whole lactation cycle with 20% difference in milk production, and alter the way animals respond to transhumance. Finally, the considered morphological factors (cow height and foot angle) presented a smaller impact during the whole lactation cycle (10% difference in milk production). The present findings help to anticipate the effect of climate change and to identify problematic environmental conditions by comparing their impact with the effect of factors that are known to influence lactation.
The Human Fragile X Mental Retardation Protein Inhibits the Elongation Step of Translation through its RGG and C-terminal domains
Authors: Athar Youssi M. , Joseph Simpson
Published: June 2020

Fragile X mental retardation protein (FMRP) is an RNA-binding protein that regulates the translation of numerous mRNAs in neurons. The precise mechanism of translational regulation by FMRP is unknown. Some studies have indicated that FMRP inhibits the initiation step of translation, whereas other studies have indicated that the elongation step of translation is inhibited by FMRP. To determine whether FMRP inhibits the initiation or the elongation step of protein synthesis, we investigated m7G-cap-dependent and IRES-driven, cap-independent translation of several reporter mRNAs in vitro. Our results show that FMRP inhibits both m7G-cap-dependent and cap-independent translation to similar degrees, indicating that the elongation step of translation is inhibited by FMRP. Additionally, we dissected the RNA-binding domains of hFMRP to determine the essential domains for inhibiting translation. We show that the RGG domain, together with the C-terminal domain (CTD), is sufficient to inhibit translation while the KH domains do not inhibit mRNA translation. However, the region between the RGG domain and the KH2 domain may contribute as NT-hFMRP shows more potent inhibition than the RGG-CTD tail alone. Interestingly, we see a correlation between ribosome binding and translation inhibition, suggesting the RGG-CTD tail of hFMRP may anchor FMRP to the ribosome during translation inhibition.
Sex differences in bile acid homeostasis and excretion underlie the disparity in liver cancer incidence between males and females
Authors: Patton Megan E. , Kelekar Sherwin , Taylor Lauren J. , Dean Angela E. , Zuo Qianying , Thakare Rhishikesh N , Lee Sung Hwan , Gentry Emily , Panitchpakdi Morgan , Dorrestein Pieter , Alnouti Yazen , Madak-Erdogan Zeynep , Lee Ju-Seog , Finegold Milton J. , Anakk Sayeepriyadarshini
Published: June 2020

Hepatocellular carcinoma (HCC), the most common liver cancer, exhibits a higher incidence in males. Here, we report that mice lacking the bile acid regulators, Farnesoid X Receptor (FXR) and Small Heterodimer Partner (SHP), recapitulate the sex difference in liver cancer risk. Since few therapeutic options are available, we focused on understanding the intrinsic protection afforded to female livers. Transcriptomic analysis in control and FXR and SHP double knockout livers identified female-specific changes in metabolism, including amino acids, lipids and steroids. We examined if the obtained transcriptomic signatures correlate with the survival outcomes for HCC patients to assess the translational potential of this murine HCC model. Gene signature that is unique to the knockout females correspond with low-grade tumors and better survival. Ovariectomy blunts the metabolic changes in female livers and promotes tumorigenesis that, intriguingly, coincides with increases in serum bile acid (BA) levels. Despite similar genetics, we found higher serum BA concentrations in males, whereas female knockout mice excreted more BAs. Decreasing enterohepatic BA recirculation using cholestyramine, an FDA-approved resin, dramatically reduced the liver cancer burden in male mice. Overall, we reveal that sex-specific BA metabolism leading to lower circulating BA concentration protects female livers from developing cancer. Thus, targeting BA excretion may be a promising therapeutic strategy against HCC.

Significance

We show that female-specific gene profiles identified inFxr-/-,Shp-/-double knockout (DKO) mice correlate with better outcomes for HCC patients and uncover sex difference in circulation and excretion of bile acid. Overall, we demonstrate that increasing (ovariectomy or chemical injury) or decreasing (pharmacologically with FDA approved resin) serum bile acids, not hepatic bile acids, promoted or alleviated liver cancer burden.
Vaporized H2O2 decontamination against surrogate viruses for the reuse of N95 respirators in the COVID-19 emergency
Authors: Oral Ebru , Wannomae Keith K. , Connolly Rachel L. , Gardecki Joseph A. , Leung Hui Min , Muratoglu Orhun K. , Durkin John , Jones Ralph , Collins Cassidy , Gjore Julian , Budzilowicz Amanda , Jaber Tareq
Published: June 2020

Decontamination of N95 respirators has become critical to alleviate PPE shortages for healthcare workers in the current COVID-19 emergency. The factors that are considered for the effective reuse of these masks are the fit, filter efficiency and decontamination/disinfection level both for SARS-CoV-2, which is the causative virus for COVID-19, and for other organisms of concern in the hospital environment such as Staphylococcus aureus or Clostridium difficile.

In its guidance entitled ‘Recommendations for Sponsors Requesting EUAs for Decontamination and Bioburden Reduction Systems for Surgical Masks and Respirators During the Coronavirus Disease 2019 (COVID19) Public Health Emergency’ (May 2020)[1], the FDA recommends a 6-log10 reduction in either the most resistant bacterial spores for the system or in a mycobacterium species to authorize the use of a decontamination method of N95 respirators for single or multiple users. While the goal is primarily inactivation against SARS-CoV-2, testing of decontamination methods against the virus may not always be available. For decontamination methods considered for only single users, the recommendation is a 6-log10 reduction in the infective virus concentration of 3 non-enveloped viruses or in the concentration of two Gram (+) and two Gram (-) bacteria. Based on these recommendations, we explored the efficacy of vaporized H2O2 (VHP) treatment of N95 respirators against surrogate viruses covering a wide range of disinfection resistance for emergency decontamination and reuse to alleviate PPE shortages for healthcare workers in the COVID-19 emergency.