bluuebunny/crossref_metadata_2025 huggingface dataset:
Interspecific Hybridization and Island Colonization History, not Rarity, Most Strongly Affect the Genetic Diversity inDiospyrosa Clade of Mascarene-Endemic Trees
Authors: Linan Alexander G , Lowry Porter P , Miller Allison J , Schatz George E , Sevathian Jean Claude , Edwards Christine E
Published: February 2022

Many factors shape the genetic diversity of island-endemic trees, with important implications for conservation. Oceanic island-endemic lineages undergo an initial founding bottleneck during the colonization process and subsequently accumulate diversity following colonization. Moreover, many island endemics occur in small populations and are further threatened by anthropogenic factors that cause population declines, making them susceptible to losses in genetic diversity through genetic drift, inbreeding, and bottlenecks. However, life-history traits commonly found in trees, such as outcrossing mechanisms, long lifespans, and a propensity for interspecific hybridization, may help buffer against losses of genetic variation. To assess the relative importance of colonization history, rarity, and distribution in shaping genetic diversity of island-endemic trees, we conducted a comparative population genomic analysis of 13 species of Diospyros (Ebenaceae) endemic to the Mascarene Islands that differ in island colonization history, distribution, population size, and IUCN threat status. We genotyped 328 individuals across the islands using 2b-RADseq, compared genetic diversity both among and within species, and assessed patterns of genetic structure. Genetic diversity did not vary significantly by IUCN status, but we found that species that co-occur with others on the same intermediate-aged island (Mauritius) had much greater genetic diversity than those that occur solitarily on an island (Réunion and Rodrigues), likely because of greater interspecific hybridization among species with overlapping distributions and processes related to time since island colonization. Results presented here were used to determine priority localities for in situ and ex situ conservation efforts to maximize the genetic diversity of each Mascarene Diospyros species.
Donkey Anaphora in Non-Monotonic Environments
Authors: Denić Milica , Sudo Yasutada
Published: February 2022

Donkey anaphora in quantified sentences is ambiguous between an existential and a universal reading. The extent to which different readings are accessible depends on the quantifier, but how to model this dependence is debated (Kanazawa, 1994; Champollion et al. 2019). This study advances this debate by providing novel experimental data on the interpretation of donkey anaphora in sentences with non-monotonic quantifiers exactly 3 and all but one. We establish that while the existential reading of donkey anaphora is the preferred one with both exactly 3 and all but one, the universal reading is accessed more with all but one than with exactly 3. These results have important implications for both Kanazawa (1994) and Champollion et al. (2019) theories, as both need to be amended to fully capture the empirical picture.
Successful surgical management of intralobar pulmonary sequestration in Ghana
Authors: Okyere Isaac , Kwarteng Sandra Owusu , Bempah Atta Owusu , Okyere Perditer , Badu-Peprah Augustina , Brenu Samuel Gyasi
Published: February 2022

Pulmonary sequestration occurs when a portion of lung tissue receives its blood supply from an anomalous systemic artery. Three main presentations, intralobar, extralobar and communicating bronchopulmonary foregut malformations, have been described. It is the second most common congenital lung anomaly. The intralobar variant is the most common type seen in 75% of cases, especially in late childhood. Imaging of choice for diagnosis are computed tomography scan and magnetic resonance imaging. Management involves surgical resection with ligation of the aberrant blood supply via thoracotomy or thoracoscopy. Endovascular therapy with coil embolization of the aberrant anomalous systemic artery as a standard therapy or as a hybrid therapy is an option. We present our successful surgical management of an infant diagnosed prenatally with congenital lung abnormality and confirmed postnatally as intralobar pulmonary sequestration.
Ligation-assisted homologous recombination enables precise genome editing by deploying both MMEJ and HDR
Authors: Zhao Zhihan , Shang Peng , Sage Fanny , Geijsen Niels
Published: February 2022

CRISPR/Cas12a is a single effector nuclease that, like CRISPR/Cas9, has been harnessed for genome editing based on its ability to generate targeted DNA double strand breaks (DSBs). Unlike the blunt-ended DSB generated by Cas9, Cas12a generates sticky-ended DSB that could potentially aid precise genome editing, but this unique feature has thus far been underutilized. In the current study, we found that a short double-stranded DNA (dsDNA) repair template containing a sticky end that matched one of the Cas12a-generated DSB ends and a homologous arm sharing homology with the genomic region adjacent to the other end of the DSB enabled precise repair of the DSB and introduced a desired nucleotide substitution. We termed this strategy ‘Ligation-Assisted Homologous Recombination’ (LAHR). Compared to the single-stranded oligo deoxyribonucleotide (ssODN)-mediated homology directed repair (HDR), LAHR yields relatively high editing efficiency as demonstrated for both a reporter gene and endogenous genes. We found that both HDR and microhomology-mediated end joining (MMEJ) mechanisms are involved in the LAHR process. Our LAHR genome editing strategy, extends the repertoire of genome editing technologies and provides a broader understanding of the type and role of DNA repair mechanisms involved in genome editing.
Achromatic metasurfaces by dispersion customization for ultra-broadband acoustic beam engineering
Authors: Dong Hao-Wen , Shen Chen , Zhao Sheng-Dong , Qiu Weibao , Zheng Hairong , Zhang Chuanzeng , Cummer Steven A , Wang Yue-Sheng , Fang Daining , Cheng Li
Published: February 2022

Metasurfaces, the ultra-thin media with extraordinary wavefront modulation ability, have shown great promise for many potential applications. However, most of the existing metasurfaces are limited by narrow-band and strong dispersive modulation, which complicates their real-world applications and, therefore require strict customized dispersion. To address this issue, we report a general methodology for generating ultra-broadband achromatic metasurfaces with prescribed ultra-broadband achromatic properties in a bottom-up inverse-design paradigm. We demonstrate three ultra-broadband functionalities, including acoustic beam deflection, focusing and levitation, with relative bandwidths of 93.3%, 120% and 118.9%, respectively. In addition, we reveal a relationship between broadband achromatic functionality and element dispersion. All metasurface elements have anisotropic and asymmetric geometries with multiple scatterers and local cavities that synthetically support internal resonances, bi-anisotropy and multiple scattering for ultra-broadband customized dispersion. Our study opens new horizons for ultra-broadband highly efficient achromatic functional devices, with promising extension to optical and elastic metamaterials.
Impact of Casirivimab-Imdevimab on Severe Acute Respiratory Syndrome Coronavirus 2 Delta Variant Nasopharyngeal Virus Load and Spike Quasispecies
Authors: Vellas Camille , Del Bello Arnaud , Gaube Geraldine , Tremeaux Pauline , Jeanne Nicolas , Ranger Noemie , Martin-Blondel Guillaume , Delobel Pierre , Kamar Nassim , Izopet Jacques
Published: February 2022

Background

The increasing use of monoclonal antibodies (mAbs) to treat coronavirus disease 2019 raises questions about their impact on the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mAb-resistant variants. We assessed the impact of Casirivimab-Imdevimab on SARS-CoV-2 mutations associated with reduced mAb activity in treated patients.

Methods

We measured the nasopharyngeal (NP) viral load and sequenced the haplotypes of spike gene of 50 patients infected with the SARS-CoV-2 delta variant and treated with Casirivimab-Imdevimab using single-molecule real-time sequencing.

Results

The NP SARS-CoV-2 viral load of patients treated with Casirivimab-Imdevimab decreased from 8.13 (interquartile range [IQR], 7.06–8.59) log10 copies/mL pretreatment to 3.67 (IQR, 3.07–5.15) log10 copies/mL 7 days later (P < .001). Of the 36 patients for whom follow-up timepoints Spike sequencing were available, none of the Spike mutations that reduced mAb activity were detected.

Conclusions

Casirivimab-Imdevimab is an effective treatment for patients infected with the SARS-CoV-2 delta variant. Despite selective pressure on SARS-CoV-2 Spike quasispecies, we detected no key mutations that reduced mAb activity in our patients.
The impact of police–community relations: Recruitment and retention concerns of local police agencies
Authors: Skaggs Sherry Lynn , Harris Chris , Montgomery Lauren
Published: February 2022

Recently, there has been a growing movement across the USA to defund police. Additionally, police agencies have faced a rapidly declining application pool. Fewer applicants combined with retention issues have led to staffing concerns and cultural impacts within departments. This study examines the recruitment and retention problems faced by a local police agency in response to struggles within police–community relations and calls to defund police nationwide. Three series of interviews were conducted among new hires in training, new hires post training, and voluntary departures. Findings from this study indicate three primary categories of themes effecting both recruitment and retention: support, operational standards and compensation, and transparency. Based on the findings, several policy implications should be considered to improve recruitment and retention within the department. These include developing a comprehensive website for candidates and current officers, adjusting personnel shift rotation, overhauling the Field Training Programme, and working to improve support.
Yukawa textures in modular symmetric vacuum of magnetized orbifold models
Authors: Kikuchi Shota , Kobayashi Tatsuo , Ogawa Yuya , Uchida Hikaru
Published: February 2022

We study quark mass matrices derived from magnetized $T^2/\mathbb {Z}_2$ orbifold models. Yukawa matrices at three modular fixed points, τ = i, e2πi/3, and i∞, are invariant under S-, ST-, and T-transformations. We study these invariances on the $T^2/\mathbb {Z}_2$ twisted orbifold. We find that Yukawa matrices have a kind of texture structure, although those at τ = i∞ are not realistic. We classify the Yukawa textures at τ = i and e2πi/3. Moreover we investigate the conditions such that the quark mass matrix constructed by Yukawa textures becomes approximately a rank-one matrix, which is favorable to lead to hierarchical masses between the third generation and the others. It is found that realistic quark mass matrices can be obtained around the S-invariant and ST-invariant vacua. As an illustrative example, we show the realization of the quark mass ratios and mixing based on Fritzch and Fritzch–Xing mass matrices.
The links of stress, substance use and socio-demographic factors with domestic violence during the Covid-19 pandemic in Portugal
Authors: Pérez Yilian M , Gama Ana , Pedro Ana R , de Carvalho Maria J L , Guerreiro Ana E , Duarte Vera , Quintas Jorge , Aguiar Pedro , Keygnaert Ines , Dias Sónia
Published: February 2022

Background

Lockdown, as a measure implemented to combat the coronavirus disease 2019 (COVID-19) pandemic, left many domestic violence (DV) victims trapped with their abusers. This study intends to explore the links between perceived stress, substance use and socio-demographic factors with DV experiences during COVID-19 pandemic in Portugal.

Methods

A cross-sectional study was carried out on a sample of 1062 participants over 16 years old, residing in Portugal. Data were collected through an online survey conducted between April and October 2020. The associations between potential factors and DV were investigated using bivariable analysis and multivariable logistic regression.

Results

The prevalence of DV reported was 13.75% (n = 146), disaggregated into psychological violence (13%, n = 138), sexual violence (1.0%, n = 11) and physical violence (0.9%, n = 10). Multivariable analyses confirmed that perceived financial difficulties (OR = 1.608; P = 0.019), use of medications to sleep or calm down (OR = 1.851; P = 0.002) and perceived stress (OR = 2.443; P = 0.003) were responsible for DV exposure during COVID-19 pandemic. Younger age (<25 years old) and consumption of alcohol were associated with a higher risk of DV victimization.

Conclusions

Interventions aimed at preventing and confronting DV are necessary within the strategies to combat COVID-19 in Portugal, especially aimed at groups in vulnerable situations, during and after the pandemic.
Robust neutralizing antibody response to SARS-CoV-2 mRNA vaccination in adolescents and young adults with childhood-onset rheumatic diseases
Authors: Yeo Joo Guan , Chia Wan Ni , Teh Kai Liang , Book Yun Xin , Hoh Sook Fun , Gao Xiaocong , Das Lena , Zhang Jinyan , Sutamam Nursyuhadah , Lim Amanda Jin Mei , Poh Su Li , Tay Shi Huan , Nay Yaung Katherine , Ong Xin Mei , Hazirah Sharifah Nur , Chua Camillus Jian Hui , Leong Jing Yao , Wang Lin-Fa , Albani Salvatore , Arkachaisri Thaschawee
Published: February 2022

Objectives

Immunogenicity to the SARS-CoV-2 mRNA vaccines in adolescents and young adults (AYA) with childhood-onset rheumatic diseases (cRD) is unknown. We aimed to evaluate the humoral immunogenicity and safety of the vaccines in our AYA with cRD.

Methods

A monocentric observational study with 159 AYA (50.3% female and 70.4% Chinese). Humoral immunogenicity was assessed at 2–3 and 4–6 weeks following first and second vaccination by cPass™ SARS-CoV-2 Neutralization Antibody Assay. Inhibition signal of ≥30% defined the cut-off for positive detection of the SARS-CoV-2 neutralizing antibodies. Vaccine safety and disease activity were assessed within 6 weeks after second vaccination.

Results

A total of 64.9% and 99.1% of 159 patients (median age: 16.9, IQR: 14.7–19.5) mounted positive SARS-CoV-2 neutralizing responses after first and second vaccination, respectively. Most patients (89.8%) had ≥90% inhibition signal after second vaccination. Methotrexate and mycophenolate mofetil increased the risk associated with negative cPass neutralization responses following the first vaccination. Holding both medications after each vaccination did not affect immunogenicity. There was no symptomatic COVID-19 infection. Local reaction remained the most common (23.3–25.2%) adverse event, without serious complication. Two and seven patients flared following the first and second vaccination, respectively. Subgroup analyses of the 12–18-year-old cohort did not show any differences in vaccine efficacy, predictors of poor response and general safety, but higher proportion of disease flares.

Conclusions

SARS-CoV-2 mRNA vaccines were efficacious after the two-dose regimen in almost all AYA with cRD without serious adverse event. The rate of disease flare observed is 4.4% after the second mRNA vaccine dose.
Patient Sex and Postoperative Outcomes after Inpatient Intraabdominal Surgery: A Population-based Retrospective Cohort Study
Authors: He Jennifer W. , Sun Louise Y. , Wijeysundera Duminda , Vogt Kelly , Jones Philip M.
Published: February 2022

Background

Intraabdominal surgeries are frequently performed procedures that lead to a high volume of unplanned readmissions and postoperative complications. Patient sex may be a determinant of adverse outcomes in this population, possibly due to differences in biology or care delivery, but it is understudied. The authors hypothesized that there would be no association between patient sex and the risk of postoperative adverse outcomes in intraabdominal surgery.

Methods

This retrospective, population-based cohort study involved adult inpatients aged 18 yr or older who underwent intraabdominal surgeries in Ontario, Canada, between April 2009 and March 2016. The authors studied the association of patient sex on the primary composite outcome of all-cause death, hospital readmission, or major postoperative complications, all within 30 postoperative days. Inverse probability of exposure weighting based on propensity scores (computed using demographic characteristics such as rural residence status and median neighborhood income quintile, common comorbidities, and surgery- and hospital-specific characteristics) was used to estimate the adjusted association of sex on outcomes.

Results

The cohort included 215,846 patients (52.3% female). The primary outcome was observed in 24,712 (21.9%) females and 25,486 (24.7%) males (unadjusted risk difference, 2.8% [95% CI, 2.5 to 3.2%]; P < 0.001). After adjustment, the association between the male sex and the primary outcome was not statistically significant (adjusted risk difference, −0.2% [95% CI, −0.5 to 0.2%]; P = 0.378).

Conclusions

In a large population of intraabdominal surgical patients, there was no differential risk between sexes in the composite outcome of all-cause death, hospital readmission, or major postoperative complications, all within 30 postoperative days.

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New
Palliative Care Utilization Following Out-of-Hospital Cardiac Arrest in Pediatrics
Authors: Gouda Suzanne R. , Bohr Nicole L. , Hoehn K. Sarah
Published: February 2022

OBJECTIVES:

Pediatric out-of-hospital cardiac arrest (OHCA) is associated with significant morbidity and mortality. Pediatric palliative care (PPC) services could provide an integral component of the comprehensive care necessary for these patients and their families. The main objectives of this study are to examine the utilization of PPC following OHCA and compare the differences in characteristics between children who received PPC with those who did not.

DESIGN:

Retrospective cohort study.

SETTING:

An urban, tertiary PICU.

PATIENTS:

Children less than 21 years old admitted from October 2009 to October 2019 with an admitting diagnosis of OHCA and minimum PICU length of stay (LOS) of 48 hours.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Of the 283 patient charts reviewed, 118 patient encounters met inclusion criteria. Of those, 34 patients (28.8%) received a PPC consultation during hospitalization. Patients who received PPC had a longer PICU LOS (14.5 vs 4.0 d), a greater number of ventilator days (12.5 vs 4.0 d), and a larger proportion of do-not-resuscitate (DNR) statuses (41% vs 19%). When comparing the disposition of survivors, a greater proportion was discharged to rehab or nursing facilities (47% vs 28%), with no difference in mortality rates (53% vs 50%). In the multivariate logistic regression model, older age, longer LOS, and code status (DNR) were all associated with higher likelihood of PPC utilization. Data were analyzed using descriptive, Mann-Whitney U, and Fisher exact statistics.

CONCLUSIONS:

Our study demonstrates PPC services following OHCA are underutilized given the high degree of morbidity and mortality. The impact of automatic PPC consultation in all OHCA patients who survive beyond 48 hours should be explored further. Future studies are warranted to understand the benefits and barriers of PPC integration into standard postarrest care for patients and families.
Variability of Prognostic Communication in Critically Ill Neurologic Patients: A Pilot Multicenter Mixed-Methods Study
Authors: Ge Connie , Goss Adeline L. , Crawford Sybil , Goostrey Kelsey , Buddadhumaruk Praewpannarai , Shields Anne-Marie , Hough Catherine L. , Lo Bernard , Carson Shannon S. , Steingrub Jay , White Douglas B. , Muehlschlegel Susanne
Published: February 2022

IMPORTANCE:

Withdrawal-of-life-sustaining treatments (WOLST) rates vary widely among critically ill neurologic patients (CINPs) and cannot be solely attributed to patient and family characteristics. Research in general critical care has shown that clinicians prognosticate to families with high variability. Little is known about how clinicians disclose prognosis to families of CINPs, and whether any associations exist with WOLST.

OBJECTIVES:

Primary: to demonstrate feasibility of audio-recording clinician-family meetings for CINPs at multiple centers and characterize how clinicians communicate prognosis during these meetings. Secondary: to explore associations of 1) clinician, family, or patient characteristics with clinicians’ prognostication approaches and 2) prognostication approach and WOLST.

DESIGN, SETTING, AND PARTICIPANTS:

Forty-three audio-recorded clinician-family meetings during which prognosis was discussed from seven U.S. centers for 39 CINPs with 88 family members and 27 clinicians.

MAIN OUTCOMES AND MEASURES:

Two investigators qualitatively coded transcripts using inductive methods (inter-rater reliability > 80%) to characterize how clinicians prognosticate. We then applied univariate and multivariable multinomial and binomial logistic regression.

RESULTS:

Clinicians used four distinct prognostication approaches: Authoritative (21%; recommending treatments without discussing values and preferences); Informational (23%; disclosing just the prognosis without further discussions); advisory (42%; disclosing prognosis followed by discussion of values and preferences); and responsive (14%; eliciting values and preferences, then disclosing prognosis). Before adjustment, prognostication approach was associated with center (p < 0.001), clinician specialty (neurointensivists vs non-neurointensivists; p = 0.001), patient age (p = 0.08), diagnosis (p = 0.059), and meeting length (p = 0.03). After adjustment, only clinician specialty independently predicted prognostication approach (p = 0.027). WOLST decisions occurred in 41% of patients and were most common under the advisory approach (56%). WOLST was more likely in older patients (p = 0.059) and with more experienced clinicians (p = 0.07). Prognostication approach was not independently associated with WOLST (p = 0.198).

CONCLUSIONS AND RELEVANCE:

It is feasible to audio-record sensitive clinician-family meetings about CINPs in multiple ICUs. We found that clinicians prognosticate with high variability. Our data suggest that larger studies are warranted in CINPs to examine the role of clinicians’ variable prognostication in WOLST decisions.
Informatics Competency Measurement Instruments for Nursing Students
Authors: Raghunathan Kalpana , McKenna Lisa , Peddle Monica
Published: February 2022

Digital transformation in healthcare impacts curricula preparation and work readiness of future health professionals. Informatics capabilities are essential practice attributes. Therefore, measurement of these competencies is important as students transition from education to practice. This rapid review, conducted according to Cochrane and World Health Organization guidelines, examined validity and reliability measurements of existing instruments used to self-assess nursing informatics competencies. MEDLINE, CINAHL, EMBASE, and PubMed databases were searched. Empirical studies with the primary aim of measuring informatics competencies reporting psychometric assessment were included. Methodological quality appraisal involved predetermined criteria based on COnsensus-based Standards for the selection of health Measurement INstruments taxonomy. Data extraction and critical appraisal of six studies from four countries identified five instruments. Study characteristics, constructs measured, population, instrument type, and psychometric properties of interest were examined. There were some similarities and differences with instrumentation. Two important measurement properties, content validity and reliability, were underreported. Gaps in key measurement properties were identified, which require further research. Selection of a practical evaluative instrument to implement should also consider the constructs measured, and practicality and feasibility of the instrument for its suitability in different settings. A larger investigation comparing more informatics competency assessment instruments is necessary for an exhaustive analysis.
Excessive gestational weight gain in early pregnancy and insufficient gestational weight gain in middle pregnancy increased risk of gestational diabetes mellitus
Authors: Yin Aiqi , Tian Fuying , Wu Xiaoxia , Chen Yixuan , Liu Kan , Tong Jianing , Guan Xiaonian , Zhang Huafan , Wu Linlin , Niu Jianmin
Published: February 2022

Background:

Gestational weight gain (GWG) is associated with the risk of gestational diabetes mellitus (GDM). However, the effect of weight gain in different trimesters on the risk of GDM is unclear. This study aimed to evaluate the effect of GWG on GDM during different trimesters.

Methods:

A birth cohort study was conducted from 2017 to 2020 in Shenzhen, China. In total, 51,205 participants were included comprising two models (early pregnancy model and middle pregnancy model). Gestational weight (kg) was measured at each prenatal clinical visit using a standardized weight scale. Logistic regression analysis was used to assess the risk of GDM. Interaction analysis and mediation effect analysis were performed in the middle pregnancy model.

Results:

In the early pregnancy model, the risk of GDM was 0.858 times lower (95% confidence interval [CI]: 0.786, 0.937) with insufficient GWG (iGWG) and 1.201 times higher (95% CI: 1.097, 1.316) with excessive GWG after adjustment. In the middle pregnancy model, the risk of GDM associated with iGWG increased 1.595 times (95% CI: 1.418, 1.794) after adjustment; for excessive GWG, no significant difference was found (P = 0.223). Interaction analysis showed no interaction between GWG in early pregnancy (GWG-E) and GWG in middle pregnancy (GWG-M) (F = 1.268; P = 0.280). The mediation effect analysis indicated that GWG-M plays a partial mediating role, with an effect proportion of 14.9%.

Conclusions:

eGWG-E and iGWG-M are associated with an increased risk of GDM. Strict control of weight gain in early pregnancy is needed, and sufficient nutrition should be provided in middle pregnancy.
A Case of Probable Multifocal Motor Neuropathy With Clinical Stability for Ten Years After a Single Treatment of Rituximab
Authors: Gonzalez Natalia L. , Juel Vern C. , Živković Saša A.
Published: February 2022

Multifocal motor neuropathy is a rare, immune-mediated motor neuropathy with asymmetric, often debilitating progressive weakness. The efficacy of intravenous immunoglobulin in this disease is well established; however, the response typically wanes over time. No other agent has shown similar therapeutic efficacy. We describe a case of anti-ganglioside GM1 IgM-positive multifocal motor neuropathy with typical incomplete and diminishing response to intravenous immunoglobulin over time. Sixteen years after symptom onset, rituximab was administered at 2 g/m2 over 2 weeks. No significant progression of disease has occurred over the following 10 years despite no additional treatments, including intravenous immunoglobulin, being given. Only case reports and small, mostly uncontrolled studies have reported the use of rituximab in multifocal motor neuropathy with mixed results. However, given its potential benefits and lack of an established second-line agent, treatment with rituximab may be considered in select patients with refractory multifocal motor neuropathy.
Multiple Cranial Nerve Enhancement in Guillain–Barre Syndrome With Clinicoradiological Dissociation
Authors: Kesav Praveen , John Seby , Dogar Mohammad A. , Al-Sharif Khalid , Hussain Zulfiqar
Published: February 2022

Guillain-Barre Syndrome (GBS) is an acute inflammatory polyradiculoneuropathy which can lead to rapid neuromuscular respiratory failure, with an estimated annual incidence of 1-2 per 100,000 person-years. Even though cranial nerve involvement is known to occur in GBS, radiological correlation on neuroimaging studies are less frequently reported in pediatric population. We hereby report the case of a 14-year-old boy with acute motor axonal neuropathy variant of GBS, who had extensive contrast enhancement of multiple cranial nerves on Magnetic Resonance Imaging brain, associated with clinicoradiological dissociation on presentation.
The P value plot does not provide evidence against air pollution hazards
Authors: Hicks Daniel J.
Published: February 2022

Background:

A number of papers by Young and collaborators have criticized epidemiological studies and meta-analyses of air pollution hazards using a graphical method that the authors call a P value plot, claiming to find zero effects, heterogeneity, and P hacking. However, the P value plot method has not been validated in a peer-reviewed publication. The aim of this study was to investigate the statistical and evidentiary properties of this method.

Methods:

A simulation was developed to create studies and meta-analyses with known real effects

, integrating two quantifiable conceptions of evidence from the philosophy of science literature. The simulation and analysis is publicly available and automatically reproduced.

Results:

In this simulation, the plot did not provide evidence for heterogeneity or P hacking with respect to any condition. Under the right conditions, the plot can provide evidence of zero effects; but these conditions are not satisfied in any actual use by Young and collaborators.

Conclusion:

The P value plot does not provide evidence to support the skeptical claims about air pollution hazards made by Young and collaborators.
Discovery of Third Possible Ion Generating Source in 4π Plasma Focus Device Space
Authors: Sohrabi Mehdi
Published: February 2022

Discovery of a possible third source of ion generation in 4π Plasma Focus Device (PFD) space is reported. Unexpected observation of dense ion tracks, called “On Shadow Ion Tracks” (OSIT), on the “ion cathode shadows” (ICS) was discovered. These ions were formed on panorama mega-size cylindrical polycarbonate ion image detectors placed behind the cathodes in the PFD space on PFD wall, where no ion tracks are expected to exist. Such unexpected ion tracks were observed when different gases were used, in particular hydrogen, deuterium, and helium. An ICS is formed on the detector when each cathode shadows and removes all ions bombarding it from the “anode top” and “anode cathodes assembly.” Such ion tracks forming the OSITs seem to be generated not from the “anode top” and “a node cathodes assembly” but also from a third possible ion source in PFD space bombarding the detector.
SAFETY AND THERAPEUTIC EFFECTS OF ORALLY ADMINISTERED AKST4290 IN NEWLY DIAGNOSED NEOVASCULAR AGE-RELATED MACULAR DEGENERATION
Authors: Stewart Michael W. , Garg Seema , Newman Erin M. , Jeffords Elizabeth , Konopińska Joanna , Jackson Sam , Sikorski Bartosz L. , Rawner Esther S.
Published: February 2022

Purpose:

To evaluate the safety and therapeutic effects of orally administered AKST4290 (formerly BI 144807 and ALK4290) in treatment-naive patients with neovascular age-related macular degeneration.

Methods:

In this prospective, multicenter, open-label Phase 2a pilot clinical study, 30 patients with newly diagnosed neovascular age-related macular degeneration self-administered AKST4290 (400 mg) orally twice daily for 6 weeks. Patients were examined weekly for safety, to measure best-corrected visual acuity (BCVA), and to perform exploratory morphologic assessments. The primary endpoint was the mean change in BCVA from baseline to end of treatment, and the secondary endpoint was safety. Exploratory endpoints investigated potential changes in macular morphology.

Results:

Mean BCVA improved by +7.0 letters (95% CI, 2.2–11.7); 24 patients (82.8%) had stable or improved BCVA, with 6 (20.7%) gaining ≥15 letters. No patients experienced severe or serious adverse events.

Conclusion:

In this 6-week study, AKST4290 treatment was associated with improved BCVA scores in patients with treatment-naive neovascular age-related macular degeneration. All adverse events were mild or moderate in severity and no safety issues were identified. Treatment of neovascular age-related macular degeneration with AKST4290 warrants further investigation in randomized, placebo-controlled trials.
Sapovirus, Norovirus and Rotavirus Detections in Stool Samples of Hospitalized Finnish Children With and Without Acute Gastroenteritis
Authors: Pitkänen Oskari , Markkula Jukka , Hemming-Harlo Maria
Published: February 2022

Background:

Sapovirus, norovirus and rotavirus are major causes of childhood acute gastroenteritis (AGE) globally. Asymptomatic infections of these viruses have not been extensively studied.

Aim:

To examine the prevalence and the genetic variations of sapovirus, norovirus and rotavirus in children with and without symptoms of AGE.

Methods:

We collected 999 stool samples from children under 16 years old from September 2009 to August 2011 at Tampere University Hospital, Finland. In total 442 children (44%) had symptoms of AGE and 557 patients (56%) had acute respiratory tract infection (ARTI) only. Samples were examined for sapovirus, norovirus and rotavirus using reverse transcription-polymerase chain reaction and the positive amplicons were sequenced.

Results:

Totally 54% and 14% of the patients in AGE and ARTI groups, respectively, tested positive. All viruses were more frequently detected in AGE patients than in ARTI patients (norovirus, 25% vs. 7.2%, respectively; rotavirus, 24% vs. 6.1%; sapovirus, 5.2% vs. 1.4%). In ARTI patients, the cases were seen most frequently during the first two years of life. Norovirus was the most detected pathogen in both groups with genogroup GII covering ≥97% of norovirus strains. Sapovirus was mostly detected in children under 18 months old without predominating genotype. Rotavirus was often detected after recent rotavirus vaccination and 18% and 88% of the strains were rotavirus vaccine-derived in AGE and ARTI groups, respectively.

Conclusions:

We showed that the most common viruses causing gastroenteritis in children may be found in the stools of an asymptomatic carrier which may function as a potential reservoir for AGE.
Psychometric Testing of the Newly Developed Competence Scale for Clinical Nurses
Authors: KAO Chia-Chan , CHAO Hsiu-Ling , LIU Yi-Hui , PAN I-Ju , YANG Li-Hui , CHEN Wan-I
Published: February 2022

Background

Nursing competence is an essential element in ensuring high-quality nursing care and positive patient outcomes. Valid and reliable assessment tools for assessing nurse competence are needed to help nurse supervisors measure whether nurses are performing their job well and to provide a baseline for improving the competences of nurses.

Purpose

This study was designed to develop and psychometrically validate the Competence Scale for Clinical Nurses (CSCN).

Methods

The CSCN was developed in three steps: (a) generalize assessment items from nursing competence-related scales and a review of the relevant literature, (b) determine the content validity of the developed scale, and (c) psychometrically test the developed scale. Five hundred nurses were recruited from a medical center in southern Taiwan. Exploratory and confirmatory factor analyses were executed to analyze construct validity and internal consistency reliability.

Results

The scale-content validity index was .87, as determined by five experts. Two thirds (63.29%) of the variance was explained by three factors: basic care skills (nine items), being dedicated to work (five items), and patient-centered and ethical considerations (four items). A second-order confirmatory factor analysis indicated that the data fit the model well. The Cronbach's alpha coefficients for each of the three factors and the total scale were .84–.91.

Conclusions/Implications for Practice

The 18-item CSCN is a feasible and time-efficient tool for assessing competence in clinical nurses. Nursing supervisors may use this tool to explore nurses' competency and routinely track the effect of continuing education on competence. Continuous evaluation of nurses' clinical-based competence using the CSCN is recommended.
Role of ATP-dependent chromatin remodelers in hematopoietic stem and progenitor cell maintenance
Authors: Tu Zhaowei , Zheng Yi
Published: February 2022

Purpose of review

ATP-dependent chromatin remodeling factors utilize energy from ATP hydrolysis to modulate DNA-histone structures and regulate gene transcription. They are essential during hematopoiesis and for hematopoietic stem and progenitor cell (HSPC) function. This review discusses the recently unveiled roles of these chromatin remodelers in HSPC regulation, with an emphasis on the mechanism of chromodomain helicase DNA-binding (CHD) family members.

Recent findings

Recent studies of ATP-dependent chromatin remodelers have revealed that individual CHD family members engage in distinct mechanisms in regulating HSPC cell fate. For example, CHD8 is required for HSPC survival by restricting both P53 transcriptional activity and protein stability in steady state hematopoiesis while the related CHD7 physically interacts with RUNX family transcription factor 1 (RUNX1) and suppresses RUNX1-induced expansion of HSPCs during blood development. Moreover, other CHD subfamily members such as CHD1/CHD2 and CHD3/CHD4, as well as the switch/sucrose non-fermentable, imitation SWI, and SWI2/SNF2 related (SWR) families of chromatin modulators, have also been found important for HSPC maintenance by distinct mechanisms.

The expanding knowledge of ATP-dependent chromatin remodelers in hematopoiesis illustrates their respective critical roles in HSPC maintenance including the regulation of HSPC differentiation, survival, and self-renewal. Further studies are warranted to elucidate how different chromatin remodeling complexes are integrated in various HSPC cell fate decisions during steady-state and stress hematopoiesis.
Meningeal Lymphatic vasculature in health and disease
Authors: Busch Nisha , O’Reilly Liam , Louveau Antoine
Published: February 2022

Purpose of review

The recent (re)discovery of the meningeal lymphatic has brought a new player in brain neurophysiology. This review highlights the state of the current research on the meningeal lymphatic vasculature, from its specific physiology to its increasing implication in normal and pathological brain function.

Recent findings

Growing evidence are emerging about the uniqueness of the meningeal lymphatic vasculature and its implication in multiple neurological and neurotraumatic disorders.

These studies are highlighting a new and unexpected role for the lymphatic vasculature in brain function and a potential new therapeutic target for neurological disorders.
Clinical and pathologic characteristics to select patients for focal therapy or partial gland ablation of nonmetastatic prostate cancer
Authors: Jaipuria Jiten , Ahmed Hashim U.
Published: February 2022

Purpose of review

Focal therapy or partial gland ablation for nonmetastatic prostate cancer is gaining popularity not just as an alternative to active surveillance, but as an acceptable alternative to whole gland therapy in appropriate cases. This review summarizes recent evidence to help select patients for optimal outcomes.

Recent findings

Recommendations by expert panels have become less conservative with each meeting. As experience with older modalities for focal therapy grows, newer modalities continue to be introduced. We are now in a position to offer personalized treatment pathway considering nuances of each focal therapy modality.

The ideal case for focal therapy should be an MRI visible significant lesion (PIRADS score ≥ 3), with a positive biopsy for significant cancer (Gleason grade group 2–3) in the corresponding targeted biopsy area, and insignificant or absent disease in the nontarget random biopsy areas. Multifocal disease can also be selectively treated. Salvage focal ablation is an attractive treatment option for radio-recurrent or index focal therapy failure cases.
The Correlation Between Radiotherapy and Patients' Fear of Cancer Recurrence
Authors: Zheng Mimi , Wan Hongwei , Zhu Yu , Xiang Lina
Published: February 2022

The purpose of this review was to explore the correlation between patients' fear of cancer recurrence (FCR) and radiotherapy. National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database, SinoMed, PubMed, Web of Science, EBSCO-CINAHL, Cochrane Library, and Ovid Embase were searched to identify relevant studies. Thirty-five eligible studies were included in the systematic review, and 22 of them were included in further meta-analysis. The results of the meta-analysis showed that the level of patients' FCR was positively correlated with radiotherapy, but the correlation was weak (overall r = 0.075; 95% confidence interval [CI], 0.046-0.103; P = .000). In terms of subgroup analysis based on cancer site (breast cancer vs other types of cancer), the breast cancer group (r = 0.086; 95% CI, 0.027-0.143; P = .004), the mixed-type group (r = 0.073; 95% CI, 0.033-0.112; P = .000), and the other-type group (r = 0.071; 95% CI, 0.015-0.126; P = .013) have a positive correlation with radiotherapy. Patients' FCR positively correlated with the receipt of radiotherapy. However, because of the variability among the studies, the results have limitations. Therefore, longitudinal studies are needed to verify the trajectory of FCR over radiation therapy.
Diagnostic Value of the Electroencephalogram and Cerebrospinal Fluid in Viral Encephalitis
Authors: Chen Jian-Hua , Wu Jie , Yang Xiao-Yan , Li Jing , Huang Nan-Qu , Shi Shang-Peng , Feng Fei , Li Qin , Yu Chang-Yin , Luo Yong
Published: February 2022

Background:

Electroencephalogram (EEG) and cerebrospinal fluid (CSF) are widely used in the clinical diagnosis of viral encephalitis (VE), but their value in the diagnosis of VE and the detection rate of abnormal indicators need to be further supported by more clinical data.

Methods:

In this study, routine laboratory testing, biochemical examinations of cerebrospinal fluid (CSF) and EEG characteristics were performed in patients with VE to guide the diagnosis and treatment of VE in clinical settings. A total of 330 patients with VE were enrolled in the Department of Neurology of the Third Affiliated Hospital of Zunyi Medical University from January 1, 2015 to January 30, 2020. EEG, routine testing and assessment of biochemical indicators of CSF were performed within 10 days after admission, and the results were analyzed by paired χ2 test to compare the diagnostic value of EEG and CSF for VE.

Results:

In 330 cases of VE, 283 cases (85.76%) had abnormal EEG, and 189 cases (57.27%) had abnormal CSF indicators. The incidence of EEG abnormalities was higher than that of CSF indicators, and the difference was statistically significant (P<0.05).

Conclusions:

Both the EEG and CSF analysis are valuable indicators in the diagnosis of VE patients. Compared with the CSF examination, the EEG examination had a better diagnostic efficacy for the diagnosis of VE. In addition, a normal EEG or a normal CSF level cannot exclude VE, and it is still necessary to develop new diagnostic indicators to cover all viral encephalitides.
Repetitive Transcranial Magnetic Stimulation and Transcranial Direct Current Stimulation as Treatment of Poststroke Depression
Authors: Shen Yiting , Cai Zhengyun , Liu Furong , Zhang Zhihui , Ni Guangxia
Published: February 2022

Background:

Previous studies showed that the application of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) during stroke rehabilitation improve the depression symptoms in poststroke depression (PSD). However, some studies showed inconsistent results. The study was designed to make a meta-analysis to evaluate the effect of noninvasive brain stimulation (tDCS and rTMS) on PSD.

Methods:

Articles published before July 2021 were searched in databases: PubMed, Web of Science, and Google Scholar. STATA 12.0 software was utilized to make meta-analysis. We extracted or calculated mean values and SD of reduction or increase rate of depression-related scales. Standardized mean difference (SMD) and 95% confidence intervals (CIs) were calculated as effect size.

Results:

The study showed increased immediate and long-term improvement in depression in rTMS group compared with sham rTMS group after treatment with random-effects models (immediate: SMD=4.92, 95% CI=2.69-7.15, I
2=95.2%, P-value for Q test <0.001; long term: SMD=7.21, 95% CI=3.50-10.92, I
2=93.9%, P-value for Q test <0.001). Meta-analysis showed increased substantially immediate improvement in depression in tDCS group compared with sham tDCS group with a random effect model (SMD=5.30, 95% CI=1.30-9.30, I
2=97.3%, P-value for Q test <0.001).

Conclusions:

rTMS and tDCS were demonstrated to be effective and safe treatment techniques for PSD. More large-scale studies were essential to explore the effect of rTMS with different frequencies and tDCS on PSD.
Analysis of the Failure of Removal of the Urinary Catheter for Patients With Intracerebral Hemorrhage Postoperatively
Authors: Zhou E. , He Jin-Ai , Liu Ling , Wang Jing , Ding Wei-Long
Published: February 2022

Background:

We conducted this study to assess the value of clinically relevant data for predicting the failure of removing urinary catheters among patients with intracerebral hemorrhage postoperatively.

Materials and Methods:

We retrospectively analyzed the medical records of all patients with intracerebral hemorrhage who underwent surgery for removal of intracerebral hematoma between January 2014 and December 2019, all of whom retained their urinary catheter. The patients were classified into 2 groups. Group A included patients who underwent successful removal of the catheter while group B included patients who underwent a failed removal. Univariate analysis was performed to determine the relationship between the failure of catheter removal and the patients’ preoperative clinical characteristics. Independent prognostic predictors were identified using multivariate analyses.

Results:

The site of intracerebral hematoma (P=0.004), volume of hematoma (P<0.001), intraventricular hemorrhage (P<0.001), admitted Glasgow Coma Scale (GCS) (P<0.001), GCS before urinary catheter removal (P<0.001), smoking (P=0.011), herniation (P<0.001), urine protein (P=0.013), creatinine (P=0.037), and timing of urinary catheter removal (P<0.001) were significantly different among the 2 groups. Multiple logistical regression analysis indicated that GCS before urinary catheter removal (odds ratio=1.171; 95% confidence interval=1.050-1.306; P=0.005) and timing for urinary catheter removal (odds ratio=0.962; 95% confidence interval=0.944-0.981; P<0.001) were associated with failure of urinary catheter removal.

Conclusions:

This study demonstrated that GCS before urinary catheter removal and the timing of urinary catheter removal are independent factors associated with failure of urinary catheter removal among patients with intracerebral hemorrhage.