bluuebunny/crossref_metadata_2025 huggingface dataset:
Hip morphology in slipped capital femoral epiphysis
Authors: Galletta Claudia , Aprato Alessandro , Giachino Matteo , Marre’ Brunenghi Giorgio , Boero Silvio , Turchetto Luigino , Masse’ Alessandro
Published: September 2020

Several mechanical factors have been related to slipped capital femoral epiphysis (SCFE). Main aim of this study is to investigate the acetabular coverage and acetabular version in unilateral SCFE hips in order to detect a potential pincer-type deformity as predisposing factor; second, we compared those measurements either to the contralateral, uninvolved hips either to a matched healthy control population. A total of 85 patients treated for unilateral SCFE were retrospectively reviewed. The lateral center-edge angle (LCEA) and the Tönnis angle were used to assess acetabular coverage, whereas acetabular retroversion was defined by positive prominent ischial spine (PIS), cross-over sign (COS) and posterior wall sign (PWS). Angles and signs of the affected hips were compared to the contralateral hips and to a matched cohort undergoing an abdominal/pelvic computed tomography for nonorthopedic-related diseases. Affected and unaffected hips of patients with unilateral SCFE had similar morphology in terms of LCEA 28.7° vs. 28° (P = 0.4), Tönnis angle 9° vs. 9° (P = 0.1) and retroversion signs with concomitant rate of PWS and COS 57.6% vs. 50.5% (P = 0.4), PIS 56.4% vs. 49.4% (P = 0.4). Matched healthy controls vs. the affected hips showed a lower LCEA (P < 0.001) and higher Tönnis angle (P < 0.001) in conjunction with a lower incidence of acetabular retroversion: PWS and COS 40% vs. 57.6% (P = 0.01), PIS 43% vs. 56.4% (P = 0.07). A significant retroversion and increased overcoverage were observed in SCFE patients compared to matched healthy controls. In unilateral SCFE, the involved and uninvolved hips showed a substantial symmetry.
Clinical Application of a New Assessment Tool for Myelopathy Hand Using Virtual Reality
Authors: Su Xin-Jin , Hou Cang-Long , Shen Bei-Duo , Zhang Wei-Zhong , Wu De-Sheng , Li Quan , Shen Hong-Xing
Published: September 2020

Study Design.

A cross-sectional study.

Objective.

To assess the effectiveness of a new assessment tool, myelopathy-hand functional evaluation system (MFES), in evaluating the hand dysfunction of patients with cervical myelopathy in the 10-second grip-and-release test (10 second G-R test).

Summary of Background Data.

Clumsy fingers movement is a common symptom of myelopathy patients. Evaluating the impaired hand function can provide a strong basis in assessing the severity of myelopathy. Currently, no objective and effective evaluation method is widely accepted in clinical practice.

Methods.

MFES mainly consists of a pair of wise-gloves and a computer with software. One hundred and ninety-eight consecutive participants were asked to wear the wise-gloves and then perform 10 seconds G-R test. The movements of each finger were recorded by MFES and converted into waveforms. Relevant waveform parameters were measured and analyzed. The Japanese Orthopedics Association (JOA) scores of each patient were marked and the maximum spinal cord compression (MSCC) was measured on midsagittal T2-weighted magnetic resonance imaging (MRI).

Results.

Myelopathy patients had a lower number of G-R cycles and a longer time per cycle than healthy subjects. There were significant differences in adduction and abduction time in patients with JOA scores greater than 6, but not in healthy subjects and patients with JOA scores less than 6. The waveforms of ulnar three fingers in myelopathy patients were lower and wider than those in healthy individuals. The average ratio value of wave height to wave width (a/b) could quantitatively reflect such differences of waveforms. According to receiver operating characteristic (ROC) curve analysis, the optimal threshold value of the normal average ratio was more than 1.92. The average a/b value was correlated with the JOA scores of the motor function in the upper extremities (r = 0.842).

Conclusion.

MFES appears to be an objective and quantitative assessment tool for patients with cervical myelopathy.

Level of Evidence: 3
Biomedical Beliefs Explain the Clinical Decisions Made by Exercise-Based Practitioners for People With Chronic Low Back Pain
Authors: Gibbs Mitchell T. , Morrison Natalie M.V. , Marshall Paul W.M.
Published: September 2020

Study Design.

Cross-sectional survey.

Objective.

This study surveyed the attitudes and beliefs of physiotherapists and accredited exercise physiologists (AEP) toward chronic low back pain (CLBP), in Australia. The objective of this study was to investigate the effect of biomedical and biopsychosocial attitudes and beliefs toward CLBP on clinical decision making in exercise-based practitioners.

Summary of Background Data.

The attitudes and beliefs of AEPs toward CLBP have not been studied. Literature regarding physiotherapists suggests a biomedical approach leading to more conservative treatment and on occasion, treatment going against practice guidelines.

Methods.

Seventy five AEPs and 75 physiotherapists were surveyed using the pain attitudes and beliefs scale for physiotherapists, which consists of both a biomedical and biopsychosocial subscale. Clinical decision making was assessed using two patient vignettes.

Results.

AEPs held higher biomedical beliefs compared with physiotherapists. No between-group differences were observed on the biopsychosocial subscale. Indeed, biomedical attitudes and beliefs did explain clinical decision making with higher scores reflecting a more conservative approach. However, biomedical beliefs influenced decision making regardless of profession.

Conclusion.

Biomedical attitudes and beliefs regarding CLBP influence clinical decision making in exercise-based practitioners, regardless of profession. AEPs reported higher biomedical scores, suggesting more frequent choice of conservative care. Thus, patients may receive inconsistent care and advice from practitioners within the same field. Based on clinical practice guidelines and the positive associations on clinical decision making of the biopsychosocial model, it is necessary to understand how best to provide exercise-based practitioners with education on how to apply a biopsychosocial approach to CLBP.

Level of Evidence: 3
Trephine Technique for Iliac Crest Bone Graft Harvest
Authors: McLain Robert F. , Techy Fernando
Published: September 2020

Study Design.

Report of surgical technique and long-term outcome; review of prospectively gathered data and follow-up survey of patient cohort.

Objective.

The aim of this study was to review surgical technique for a trephine graft harvest technique and assess perioperative complications/pain, long-term outcome, and patient satisfaction after anterior iliac crest bone graft (ICBG) harvest for anterior cervical fusion.

Summary of Background Data.

Rates of complications and residual pain after ICBG harvest have reduced its utility as a source of autograft for spinal fusion. Less invasive options reduce morbidity, and trephine harvest is a simple technique, with low morbidity and perioperative and long-term pain. It has not been presented in the peer-reviewed spine literature, and the long-term experience has not been previously reported.

Methods.

Sixty-eight patients undergoing anterior cervical discectomy and fusion (ACDF), using allograft spacers, underwent ICBG harvest using a 3.5 mm trephine by a minimally invasive approach. Perioperative complications, pain incidence and Visual Analog Scale (VAS) were analyzed. Thirty consecutive patients were subsequently surveyed for long-term follow-up regarding pain, function, and satisfaction.

Results.

No perioperative (0–6 weeks) graft-site complications (infection, hematoma, fracture, wound dehiscence) occurred. There were no reoperations, and no treatment required for graft-site complaints. No patient reported clinically significant perioperative pain (>3/10). At long-term follow-up (mean 45 months) no patients reported pain >3/10 at their graft-site, and the mean VAS was 0.20/10. No patient was impaired by graft-site symptoms, and all were satisfied with their graft harvest.

Conclusion.

Trephine graft harvest minimizes soft tissue dissection, periosteal elevation, and cortical disruption. Outcome using this technique eliminated perioperative complications in this study group, and reduced pain in both perioperative and long-term assessments. Compared to historical outcomes, trephine harvest provides sufficient graft with comparable or improved results relative to other minimally invasive approaches, and significantly improved relative to traditional open techniques.

Level of Evidence: 4
Searching for the Responder, Unpacking the Physical Rehabilitation Needs of Critically Ill Adults
Authors: Jones Jennifer R. A. , Puthucheary Zudin , McDonald Luke A. , Denehy Linda , Berney Sue
Published: September 2020

Survivors of critical illness can experience persistent deficits in physical function and poor health-related quality of life and utilize significant health care resources. Short-term improvements in these outcomes have been reported following physical rehabilitation. Safety and feasibility of delivering physical rehabilitation are established; however, low physical activity levels are observed throughout the recovery of patients. We provide examples on how physical activity may be increased through interdisciplinary models of service delivery. Recently, however, there has been an emergence of large randomized controlled trials reporting no effect on long-term patient outcomes. In this review, we use a proposed theoretical construct to unpack the findings of 12 randomized controlled trials that delivered physical rehabilitation during the acute hospital stay. We describe the search for the responder according to modifiers of treatment effect for physical function, health-related quality of life, and health care utilization outcomes. In addition, we propose tailoring and timing physical rehabilitation interventions to patient subgroups that may respond differently based on their impairments and perpetuating factors that hinder recovery. We examine in detail the timing, components, and dosage of the trial intervention arms. We also describe facilitators and barriers to physical rehabilitation implementation and factors that are influential in recovery from critical illness. Through this theoretical construct, we anticipate that physical rehabilitation programs can be better tailored to the needs of survivors to deliver appropriate interventions to patients who derive greatest benefit optimally timed in their recovery trajectory.
Prevalence of Ocular Demodicosis in an Older Population and Its Association With Symptoms and Signs of Dry Eye
Authors: Cheng Anny Mansim , Hwang Jodi , Dermer Harrison , Galor Anat
Published: September 2020

Purpose:

To evaluate associations between Demodex and its symptoms and ocular surface parameters in individuals with dry eye (DE).

Methods:

A cross-sectional study of 119 individuals with DE symptoms or signs, grouped by the presence of ocular demodicosis, was performed. All individuals filled out questionnaires and underwent an ocular surface examination. Demographics, comorbidities, symptoms profiles, and ocular surface parameters were compared between the 2 groups. Multivariable regression analyses were used to determine which factors were associated with DE symptoms. Receiver operating curves analyses were performed to evaluate relationships between Demodex quantity and specific clinical phenotypes.

Results:

Demodex was highly prevalent in our population (68.9%) with average counts of 4.2 ± 3.9. Individuals with and without Demodex had comparable demographics. Overall, symptoms profiles were similar between individuals with and without Demodex using the Dry Eye Questionnaire 5 and Ocular Surface Disease Index. Individuals with Demodex, however, were more likely to report itching (58.5% vs. 35.1%, P = 0.03), with increasing frequency in those with higher Demodex counts. Individuals with Demodex also had more severe eyelid abnormalities [cylindrical dandruff (CD) and lid vascularity] and a more unstable tear film but similar tear production and corneal staining when compared with individuals without Demodex. Neither Demodex nor ocular surface findings related to DE symptoms in multivariable analyses. Receiver operating curves analysis revealed Demodex counts ≥2 maximized sensitivity and specificity for both itching (64.7% and 59.0%, respectively) and CD (80.4% and 60.4%, respectively).

Conclusions:

Demodex is highly prevalent in an older population with DE. Symptom of itching and CD were the findings most specific for Demodex.
Landmarks for dual biological therapy in inflammatory bowel disease: lesson from two case reports of vedolizumab in combination with ustekinumab
Authors: Biscaglia Giuseppe , Piazzolla Mariano , Cocomazzi Francesco , Melchionda Gennaro , De Cata Angelo , Bossa Fabrizio , Palmieri Orazio , Andriulli Angelo
Published: September 2020

Inflammatory bowel disease (IBD) is a chronic and disabling disorder. Severity of IBD is prominent among refractory with patients with concomitant immune-mediated disorders. Among those patients, dual biological therapy (DBT) has been suggested as an alternative approach to spare steroids and avoid surgery. However, pieces of evidence on clinical outcomes among patients receiving DBT are still limited. We present two cases of IBD patients, with dermatological comorbidity, treated with a combination of vedolizumab and ustekinumab, identifying possible landmarks to address therapeutic choice. No patient experienced adverse events in the follow-up period and both obtained complete clinical remission. DBT may be an effective approach to consider in selected patients with refractory IBD with concomitant severe immune-mediated diseases taking into account medical history of the patient, presence, and type of concomitant extraintestinal manifestations, safety profile of selected DBT, licensed therapeutic indications, and costs.
Epidemiological approximation of the enteric manifestation and possible fecal–oral transmission in COVID-19: a preliminary systematic review
Authors: Pamplona Javier , Solano Rubén , Soler Cristina , Sabat Miriam
Published: September 2020

The recent appearance of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has led to the publication of the first evidence on gastrointestinal symptoms (GIS), the possible enteric involvement of the virus and the detection of RNA in stool, with its possible implication in the fecal–oral transmission of coronavirus disease 2019 (COVID-19). We aimed to conduct a systematic review to describe the epidemiological scientific evidence on GIS, enteric involvement and fecal excretion of SARS-CoV-2 viral RNA and to discuss the possible fecal–oral transmission pathway of COVID-19.
From terminal ileitis to Crohn’s disease: how capsule endoscopy is crucial to diagnosis
Authors: Freitas Marta , Cúrdia Gonçalves Tiago , Boal Carvalho Pedro , Dias de Castro Francisca , Rosa Bruno , João Moreira Maria , Cotter José
Published: September 2020

Background and aims

Terminal ileitis is a common condition and may be associated with a wide variety of diseases, mostly Crohn’s disease. Although small bowel capsule endoscopy (SBCE) is a valuable diagnostic tool for small-bowel diseases, data regarding its diagnostic impact on isolated terminal ileitis are sparse. The aim of this study was to evaluate the diagnostic value of SBCE for isolated terminal ileitis detected during ileocolonoscopy and to assess predictive factors for Crohn’s disease diagnosis.

Methods

This is a retrospective study including consecutive patients undergoing SBCE after diagnosis of terminal ileitis without colonic mucosal abnormalities on ileocolonoscopy between January 2016 and September 2019.

Results

This included 102 patients with isolated terminal ileitis on ileocolonoscopy. Positive findings on SBCE were found in 82.4% of patients. After performing SBCE, 61.8% of patients had a final diagnosis, being Crohn’s disease the most common (34.3%), followed by NSAIDs enteropathy (12.7%). Extraintestinal manifestations (P = 0.003), weight loss (P = 0.02), abnormal imaging (P = 0.04) and positive SBCE findings (P = 0.001) were independently associated with Crohn’s disease diagnosis. Regarding SBCE, presence of proximal small-bowel disease (P = 0.02), diffuse findings (P = 0.002) and moderate to severe inflammatory activity (Lewis score ≥ 790) (P < 0.001) were independently associated with Crohn’s disease diagnosis.

Conclusion

SBCE is a valuable tool that should be systematically used in patients with isolated terminal ileitis on ileocolonoscopy, since it revealed a high diagnostic yield, supporting a definite diagnosis in almost two-thirds of patients, and Crohn’s disease diagnosis in approximately one-third of patients. A diagnosis of Crohn’s disease should be considered when a patient with terminal ileitis on ileocolonoscopy shows proximal involvement, diffuse findings and/or moderate to severe inflammatory activity on SBCE.
Detachable string magnetically controlled capsule endoscopy for complete observation of the upper gastrointestinal tract
Authors: Xiu Hui , Lu Yanyan , Liu Xishuang , Liu Fuguo , Zhang Lingyu , Zhao Chengye , Sun Xueguo
Published: September 2020

Background

Wireless magnetically controlled capsule endoscopy (WMCCE) was feasible, well tolerated, highly acceptable, and had high consistency in diagnosis of gastric diseases with esophagogastroduodenoscopy (EGD). But WMCCE is not suitable for inspection of the esophagus. We developed detachable string magnetically controlled capsule endoscopy (DS-MCCE) to observe gastroesophageal diseases.

Methods

A total of 60 volunteers were enrolled. Thirty participants underwent DS-MCCE, and the other 30 underwent WMCCE. The primary outcome measures included swallowing time, esophageal transit time, the whole examination time, grade of air-bubble interference on esophageal, gastric preparation, visualization of Z-line and gastric mucosa, and discomfort scores.

Results

The esophageal time (222.53 ± 107.53 s vs. 49.50 ± 34.90 s, P < 0.001) and the whole examination time (26.53 ± 6.33 min vs. 15.97±4.90 min, P < 0.001) in DS-MCCE group were longer than in WMCCE group. DS-MCCE had a significantly better visualization of Z-line visualization. Visualization of the gastric mucosa was assessed as good in 24 (80%) participants for DS-MCCE and 26 (86.6%) for WMCCE, moderate in 6 (20%) with DS-MCCE as compared with 4 (13.3%) with WMCCE. The visualization of gastric cardia for DS-MCCE was better than for WMCCE (100 vs 80%, P = 0.024). The visualization of gastric angle, antrum, and pylorus in DS-MCCE group was not as good as in WMCCE group (80 vs. 100%, 80 vs. 100%, 83.3 vs. 100%, P = 0.024).

Conclusions

DS-MCCE is feasible and well tolerated in the diagnosis of gastroesophageal diseases. For people who cannot stand conventional EGD or with contraindication of EGD, DS-MCCE may be an excellent alternative screening modality.
Severe Cloverleaf Skull Deformity in c.1061C>G (p.Ser354Cys) Mutated Fibroblast Growth Factor Receptor 2 Gene in Crouzon Syndrome
Authors: Chaisrisawadisuk Sarut , Hammam Elie , Molloy Cindy J. , Barnett Christopher , Anderson Peter J. , Moore Mark H.
Published: September 2020

Cloverleaf skull deformity (CSD), or Kleeblattschädel, is a condition with severe and unpatterned multisuture craniosynostosis, resulting in a trilobar-shaped skull. This deformity mainly comprises a cranio-orbito-facial malformation that leads to a spectrum of multidisciplinary issues. Several syndromes are associated with CSD, such as Crouzon syndrome (CS). Here, we report the case of an infant with CS and the pathogenic c.1061C>G (p.Ser354Cys) variant of the fibroblast growth factor receptor 2 (FGFR2) gene. The child presented with the severe form of CSD despite having a normal, mid-trimester, sonographic scan.
A Compact Surgical Robot System for Craniomaxillofacial Surgery and its Preliminary Study
Authors: Xu Cheng , Lin Li , Zhou Chaozheng , Xie Le
Published: September 2020

Craniomaxillofacial surgery has the characteristics of complex anatomical structure, narrow surgical field, and easy damage to nerves, blood vessels, and other structures. Compared with the traditional bare-hand operation, robot-assisted craniofacial surgery is expected to achieve a more stable and accurate surgical operation. So we have developed a robot-assisted craniofacial surgery system. A compact mechanism design was adopted for the robot system, integrates with visual and force perception modules. The motion analysis and working space analysis are carried out on the mechanical structure. The binocular vision module is integrated and the robot hand-eye calibration process was completed. The target tracking method based on staple is used to achieve tracking and monitoring of the target area. A distributed robot control system based on CAN bus technology is designed, and a position-based visual servo control method is adopted. Then the precision test of the robot system prototype and the drilling experiment of the 3D printed mandible model were carried out. The average pixel error of the vision module is 0.15 pixels. Based on the staple tracking method, the average center error rate of the image is 0.3175 mm, and the overlap rate is 88.76%. The drilling experiment of the mandible model showed that the average entrance position error is 1.76 ± 0.36 mm, the average target position error is 1.62 ± 0.27 mm, and the angle error is 5.36 ± 0.31 degrees. The designed craniofacial robot system can better assist surgeons to complete the mandibular osteotomy.
Assessment of Alternative Personal Protective Equipment by Emergency Department Personnel During the SARS-CoV-2 Pandemic
Authors: Shavit Danielle , Feldman Oren , Hussein Khetam , Meir Michal , Miller Asaf , Gutgold Amichai , Idelman Ravit , Kvatinsky Noa , Cohen Daniel M. , Shavit Itai
Published: September 2020

Summary Statement

Shortage of personal protective equipment (PPE) for frontline healthcare workers managing the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is a major, global challenge. In this pilot study, we describe a simulation-based method for evaluating the suitability and acceptability of an alternative biological isolation garment (BIG, a gown or a suit) for clinical use by emergency department (ED) personnel. Using a high-fidelity simulator, participants provided airway management according to the SARS-CoV-2 protocol. A nonvisible fluorescent marker was used as a surrogate marker of contamination. We assessed ultraviolet light visualization of the fluorescent marker after doffing and satisfaction with donning, use during simulation, and doffing. We found that after doffing, markers were not visualized on any of the participants and that the median satisfaction scores of the alternative and standard BIG (sBIG) were 4 [interquartile range (IQR) = 1–5] and 4 (IQR = 2–4), respectively. The results suggest the suitability and acceptability of the alternative BIG (aBIG) for use by ED personnel.
Peripheral vascular endothelial growth factor changes after transcranial magnetic stimulation in treatment-resistant depression
Authors: Fukuda Andrew M. , Hindley Lauren E. , Kang Jee Won Diane , Tirrell Eric , Tyrka Audrey R. , Ayala Alfred , Carpenter Linda L.
Published: September 2020

Objectives

To determine if vascular endothelial growth factor (VEGF) changes with transcranial magnetic stimulation (TMS) in treatment-resistant major depressive disorder (MDD).

Methods

Serum from a naturalistic population of 15 patients with MDD was collected at baseline and after standard TMS treatment. VEGF concentration was determined via ELISA. Inventory of Depressive Symptomatology Self Report and Patient Health Questionnaire were used as a measure of depression symptom severity, clinical response and remission. Mann–Whitney U and Kendall’s Tau Correlation were used for continuous variables.

Results

VEGF increased from pre- to post-TMS (+30.3%) in remitters whereas VEGF decreased in non-remitters (−9.87%) (P < 0.05). This same pattern was observed when comparing mean %change in VEGF between responders (+14.7%) and non-responders (−14.9%) (P = 0.054). Correlation was present between change in VEGF concentration (baseline to post) and change in Inventory of Depressive Symptomatology-Self Report at Tx30 (r = −0.371, P < 0.054), reflecting greater increases in VEGF linked to greater improvement in depressive symptoms following the standard 6-week course of TMS.

Conclusion

Patients with a successful treatment with TMS had significantly greater increase in VEGF from baseline to after treatment compared to non-responders/non-remitters and a larger increase in VEGF was associated with greater improvement in depressive symptoms after TMS. This is the first report examining VEGF levels in depressed patients receiving TMS. This study provides correlative data supporting further investigation into VEGF’s role as an important mediator in the processes underpinning TMS’ antidepressant effects and as a potential biomarker of clinical outcomes.
MicroED structure of lipid-embedded mammalian mitochondrial voltage dependent anion channel
Authors: Martynowycz Michael W. , Khan Farha , Hattne Johan , Abramson Jeff , Gonen Tamir
Published: September 2020

A near-atomic resolution structure of the mouse voltage dependent anion channel (mVDAC) is determined by combining cryogenic focused ion-beam (FIB) milling and microcrystal electron diffraction (MicroED). The crystals were grown in a viscous modified bicelle suspension which limited their size and made them unsuitable for conventional X-ray crystallography. Individual thin, plate-like crystals were identified using scanning electron microscopy (SEM) and focused ion-beam (FIB) imaging at high magnification. Three crystals were milled into thin lamellae. MicroED data were collected from each lamellae and merged to increase completeness. Unmodelled densities were observed between protein monomers, suggesting the presence of lipids that likely mediate crystal contacts. This work demonstrates the utility of milling membrane protein microcrystals grown in viscous media using a focused ion-beam for subsequent structure determination by MicroED for samples that are not otherwise tractable by other crystallographic methods. To our knowledge, the structure presented here is the first of a membrane protein crystallized in a lipid matrix and solved by MicroED.
Chronic lithium treatment alters the excitatory/inhibitory balance of synaptic networks and reduces mGluR5-PKC signaling
Authors: Khayachi A. , Ase A. R. , Liao C. , Kamesh A. , Kuhlmann N. , Schorova L. , Chaumette B. , Dion P. , Alda M. , Séguéla P. , Rouleau G.A. , Milnerwood A. J.
Published: September 2020

Bipolar disorder (BD) is characterized by cyclical alternations between mania and depression, often comorbid with psychosis, and suicide. The mood stabilizer lithium, compared to other medications, is the most efficient treatment for prevention of manic and depressive episodes. The pathophysiology of BD, and lithium’s mode of action, are yet to be fully understood. Evidence suggests a change in the balance of excitatory/inhibitory activity, favouring excitation in BD. Here, we sought to establish a holistic appreciation of the neuronal consequences of lithium exposure in mouse cortical neurons and identify underlying mechanisms. We found that chronic (but not acute) lithium treatment significantly reduced intracellular calcium flux, specifically through the activation of the metabotropic glutamatergic receptor mGluR5. This was associated with altered phosphorylation of PKC and GSK3 kinases, reduced neuronal excitability, and several alterations to synapse function. Consequently, lithium treatment shifts the excitatory/inhibitory balance in the network toward inhibition. Together, the results revealed how lithium dampens neuronal excitability and glutamatergic network activity, which are predicted to be overactive in the manic phase of BD. Our working model of lithium action enables the development of targeted strategies to restore the balance of overactive networks, mimicking the therapeutic benefits of lithium, but with reduced toxicity.
The stem loop 2 motif is a site of vulnerability for SARS-CoV-2
Authors: Lulla Valeria , Wandel Michal P. , Bandyra Katarzyna J. , Ulferts Rachel , Wu Mary , Dendooven Tom , Yang Xiaofei , Doyle Nicole , Oerum Stephanie , Beale Rupert , O’Rourke Sara M. , Randow Felix , Maier Helena J. , Scott William , Ding Yiliang , Firth Andrew E. , Bloznelyte Kotryna , Luisi Ben F.
Published: September 2020

RNA structural elements occur in numerous single stranded (+)-sense RNA viruses. The stemloop 2 motif (s2m) is one such element with an unusually high degree of sequence conservation, being found in the 3’ UTR in the genomes of many astroviruses, some picornaviruses and noroviruses, and a variety of coronaviruses, including SARS-CoV and SARS-CoV-2. The evolutionary conservation and its occurrence in all viral subgenomic transcripts implicates a key role of s2m in the viral infection cycle. Our findings indicate that the element, while stably folded, can nonetheless be invaded and remodelled spontaneously by antisense oligonucleotides (ASOs) that initiate pairing in exposed loops and trigger efficient sequence-specific RNA cleavage in reporter assays. ASOs also act to inhibit replication in an astrovirus replicon model system in a sequence-specific, dose-dependent manner and inhibit SARS-CoV-2 infection in cell culture. Our results thus permit us to suggest that the s2m element is a site of vulnerability readily targeted by ASOs, which show promise as anti-viral agents.
Experimental warming reduces gut prokaryotic diversity, survival and thermal tolerance of the eastern subterranean termite,Reticulitermes flavipes(Kollar)
Authors: Arango Rachel A. , Schoville Sean D. , Currie Cameron R. , Carlos-Shanley Camila
Published: September 2020

Understanding the effects of environmental disturbances on the health and physiology of insects is crucial in predicting the impact of climate change on their distribution, abundance, and ecology. As microbial symbionts have been shown to play an integral role in a diversity of functions within the insect host, research examining how organisms adapt to environmental fluctuations should include their associated microbiota. Previous studies have shown that temperature affects the diversity of protists in termite gut, but less is known about the bacterial symbionts. In this study, subterranean termites (Reticulitermes flavipes(Kollar)) were exposed to three different temperature treatments characterized as low (15 °C), medium (27 °C), and high (35 °C). Results showed low temperature exposed termites had significantly lower CTmin and significantly higher SCP values compared to termites from medium or high temperature groups. This suggests that pre-exposure to cold allowed termites to stay active longer in decreasing temperatures but caused termites to freeze at higher temperatures. High temperature exposure had the most deleterious effects on termites with a significant reduction in termite survival as well as reduced ability to withstand cold stress. The microbial community of high temperature exposed termites showed a reduction in bacterial richness and decreased relative abundance of Spirochaetes, Elusimicrobia, and methanogenic Euryarchaeota. Our results indicate a potential link between gut bacterial symbionts and termite’s physiological response to environmental changes and highlight the need to consider microbial symbionts in studies relating to insect thermosensitivity.
Selling Together: The Benefits of Cooperatives to Women Honey Producers in Ethiopia
Authors: Serra Renata , Davidson Kelly A.
Published: September 2020

Smallholder farmers in developing countries encounter multiple barriers in access to inputs and technology, which prevent them from reaping the benefits from market participation. Women farmers face additional constraints due to gender norms that further limit their engagement in productive activities. While collective action has been shown to improve access to markets and economic outcomes for farmers overall, the evidence on the effects of cooperative membership for women smallholders remains limited. We investigate empirically the economic benefits of collective action for women farmers in the honey sector in Ethiopia. Relying on a rich data set on women honey producers, both cooperative members and non‐members, we evaluate the effects of belonging to a cooperative on three outcome variables through coarsened exact matching and regression analysis. Our results indicate that cooperative membership significantly increases the market price and the production quantity and, while the average effect on the share of product marketed is statistically insignificant, significant differences emerge for women with given characteristics. These results are shown to be robust to a number of tests that address biases from selection on observables and unobservables. An analysis of the heterogeneous effects of household membership in multiple groups finds that membership of self‐help groups or farmer associations amplifies the positive outcomes from belonging to a formal cooperative. Finally, qualitative findings derived from the same communities indicate self‐reported improvements in agency and self‐esteem among women members, thus reinforcing the importance of the quantitative findings.
Electrophysiological priming effects confirm that the extrastriate symmetry network is not gated by luminance polarity
Authors: Makin Alexis D. J. , Piovesan Andrea , Tyson‐Carr John , Rampone Giulia , Derpsch Yiovanna , Bertamini Marco
Published: September 2020

It is known that the extrastriate cortex is activated by visual symmetry. This activation generates an ERP component called the Sustained Posterior Negativity (SPN). SPN amplitude increases (i.e., becomes more negative) with repeated presentations. We exploited this SPN priming effect to test whether the extrastriate symmetry response is gated by element luminance polarity. On each trial, participants observed three stimuli (patterns of dots) in rapid succession (500 ms. with 200 ms. gaps). The patterns were either symmetrical or random. The dot elements were either black or white on a grey background. The triplet sequences either showed repeated luminance (black > black > black, or white > white > white) or changing luminance (black > white > black, or white > black > white). As predicted, SPN priming was comparable in repeated and changing luminance conditions. Therefore, symmetry with black elements is not processed independently from symmetry with white elements. Source waveform analysis confirmed that this priming happened within the extrastriate symmetry network. We conclude that the network pools information across luminance polarity channels.
Sarcoptic mange severity is associated with reduced genomic variation and evidence of selection in Yellowstone National Park wolves (Canis lupus)
Authors: DeCandia Alexandra L. , Schrom Edward C. , Brandell Ellen E. , Stahler Daniel R. , vonHoldt Bridgett M.
Published: September 2020

Population genetic theory posits that molecular variation buffers against disease risk. Although this “monoculture effect” is well supported in agricultural settings, its applicability to wildlife populations remains in question. In the present study, we examined the genomics underlying individual‐level disease severity and population‐level consequences of sarcoptic mange infection in a wild population of canids. Using gray wolves (Canis lupus) reintroduced to Yellowstone National Park (YNP) as our focal system, we leveraged 25 years of observational data and biobanked blood and tissue to genotype 76,859 loci in over 400 wolves. At the individual level, we reported an inverse relationship between host genomic variation and infection severity. We additionally identified 410 loci significantly associated with mange severity, with annotations related to inflammation, immunity, and skin barrier integrity and disorders. We contextualized results within environmental, demographic, and behavioral variables, and confirmed that genetic variation was predictive of infection severity. At the population level, we reported decreased genome‐wide variation since the initial gray wolf reintroduction event and identified evidence of selection acting against alleles associated with mange infection severity. We concluded that genomic variation plays an important role in disease severity in YNP wolves. This role scales from individual to population levels, and includes patterns of genome‐wide variation in support of the monoculture effect and specific loci associated with the complex mange phenotype. Results yielded system‐specific insights, while also highlighting the relevance of genomic analyses to wildlife disease ecology, evolution, and conservation.
Inter‐shift handoff: Changes over a 6‐year interval
Authors: Gu Xiuzhu , Itoh Kenji
Published: September 2020

Aims

To capture inter‐shift handoff changes over a 6‐year interval and to verify whether the handoff supporting system and aids (e.g., guidelines, training, and protocols) and environment really affect handoff performance.

Design

A non‐experimental cross‐sectional research design. Data from the 2017 and 2011 surveys were used for comparisons.

Methods

A questionnaire survey was conducted among nursing staff in 31 general hospitals in 2017 and 4,282 staff responses were collected from inpatient wards such as internal medicine and surgery, the intensive care unit, emergency department and operating room. These were compared with the 1,182 responses collected in the previous 2011 survey.

Results

Changes in the 6‐year interval included the introduction of handoff guidelines and increased provision of training. The handoff approach changed significantly and relied more on electronic systems, especially in inpatient wards. However, there was no significant improvement in interruptions. Information transfer improvement was limited and only observed in the surgery wards. Significant correlations verified that in hospitals where nursing staff more positively evaluated the effectiveness of the guidelines, faced fewer interruptions and had more time, handoff performance was better overall, and a higher frequency of sufficient information transfer was evident.

Conclusion

Although the inter‐shift handoff supporting system had great changes, improvement of information transfer occurred only in the surgery wards and was limited. It was verified that more effective handoff guidelines and a better handoff environment contributed significantly to improving inter‐shift handoff performance.

Impact

This study addressed the question as to whether inter‐shift handoffs have really improved. The answer is yes, but in a limited way. Based on the survey results and handoff practices in Japanese hospitals, a mixed approach (verbal, written, technological) is suggested for inter‐shift handoffs. In addition, it is important to improve the current handoff procedures, guidelines and training.
Prevalence and prognosis of the 2018 vs 2008 AHA definitions of apparent treatment‐resistant hypertension in high‐risk hypertension patients
Authors: Chun Kyeong‐Hyeon , Lee Chan Joo , Oh Jaewon , Lee Sang‐Hak , Kang Seok‐Min , Kario Kazuomi , Park Sungha
Published: September 2020

Resistant hypertension was defined according to the 2008 scientific statement as office blood pressure ≥ 140/90 mm Hg and the 2018 scientific statement as office blood pressure ≥ 130/80 mm Hg. We investigated the prognostic significance of lowered blood pressure threshold for defining resistant hypertension in the 2018 American Heart Association scientific statement compared with that in the 2008 scientific statement. The participants of this prospective cohort were enrolled from December 2013 to November 2018. Major adverse cardiovascular events (MACEs) were defined as a composite of cardiovascular death, non‐fatal myocardial infarction, non‐fatal stroke, and heart failure hospitalization. Renal event was defined as a ≥ 50% decline in estimated glomerular filtration rate or progression to end‐stage renal disease. A total of 206 patients among 2018 (10.2%) were diagnosed with resistant hypertension by the previous definition (≥140/90 mm Hg), and 276 patients among 2011 (13.7%) were diagnosed with resistant hypertension by the updated definition (≥130/80 mm Hg). During a median follow‐up of 4.5 years, 33 MACEs (3.7 per 1000 patient‐years) and 164 renal events (19.9 per 1000 patient‐years) occurred in the study population. Treatment‐resistant hypertension groups had a higher incidence rate of MACEs and renal events than the control groups. In multivariate Cox proportional hazards regression analysis, resistant hypertension by both definitions was significantly associated with increased risk of MACE and renal event. Both the previous and updated definitions of resistant hypertension were significant predictors of MACEs and renal events. This finding supports the adoption of the updated criteria for resistant hypertension in clinical practice.
Brain structural trajectories in youth at familial risk for schizophrenia or bipolar disorder according to development of psychosis spectrum symptoms
Authors: Sugranyes Gisela , de la Serna Elena , Ilzarbe Daniel , Pariente Jose Carlos , Borras Roger , Romero Soledad , Rosa Mireia , Baeza Inmaculada , Moreno Maria Dolores , Bernardo Miguel , Vieta Eduard , Castro‐Fornieles Josefina
Published: September 2020

Background

The evaluation of child and adolescent offspring of patients with schizophrenia (SzO) or bipolar disorder (BpO) may help understand changes taking place in the brain in individuals at heightened risk for disease during a key developmental period.

Methods

One hundred twenty‐eight individuals (33 SzO and 46 BpO, considered jointly as ‘Familial High Risk’ (FHR), and 49 controls) aged 6–17 years underwent clinical, cognitive and neuroimaging assessment at baseline, 2‐ and 4‐year follow‐up. Twenty FHR participants (11 SzO and 9 BpO) developed psychotic spectrum symptoms during follow‐up, while 59 FHR participants did not. Magnetic resonance imaging was performed on a 3Tesla scanner; cortical surface reconstruction was applied to measure cortical thickness, surface area and grey matter volume.

Results

FHR participants who developed psychotic spectrum symptoms over time showed greater time‐related mean cortical thinning than those who did not and than controls. By subgroups, this effect was present in both BpO and SzO in the occipital cortex. At baseline, FHR participants who developed psychotic spectrum symptoms over time had smaller total surface area and grey matter volume than those who did not and than controls. Over time, all FHR participants showed less longitudinal decrease in surface area than controls. In those who developed psychotic spectrum symptoms over time, this effect was driven by BpO, while in those who did not, this was due to SzO, who also showed less grey matter volume reduction.

Conclusion

The emergence of psychotic spectrum symptoms in FHR was indexed by smaller cross‐sectional surface area and progressive cortical thinning. Relative preservation of surface area over time may signal different processes according to familial risk. These findings lay the foundation for future studies aimed at stratification of FHR youth.
Exclusive predation of sea turtle hatchlings by juvenile blacktip reef sharks Carcharhinus melanopterus at a turtle nesting site in Malaysia
Authors: Bashir Zalina , Abdullah Maizah M. , Ghaffar Mazlan Abd. , Rusli Mohd Uzair
Published: September 2020

This study reports the discovery of the exclusive predation of sea turtle hatchlings by several juvenile blacktip reef sharks (Carcharhinus melanopterus) in Chagar Hutang bay on Redang Island, Malaysia, in the South China Sea. Three dead specimens of C. melanopterus were retrieved from ghost nets, and the entire digestive tracts of these sharks solely contained the partially digested bodies of sea turtle hatchlings, with no evidence of the remains of any other prey. Thus, juvenile C. melanopterus may opportunistically feed primarily on turtle hatchlings during times when hatchling abundance is high.
Netherton syndrome: Temporary response to dupilumab
Authors: Aktas Meryem , Salman Andac , Apti Sengun Ozlem , Comert Ozer Elif , Hosgoren Tekin Selcen , Akin Cakici Ozlem , Demir Gizem , Ergun Tulin
Published: September 2020

Netherton syndrome (NS) is an orphan disease characterized by congenital ichthyosis, hair abnormalities, and atopy, with limited treatment options. We achieved temporary improvement only during the initial 6 weeks of treatment with dupilumab, which differs from the sustained improvement observed in 2 other recently published cases. Although the clinical presentation of atopy and increased pre‐allergic cytokines in NS patients suggest that dupilumab may be beneficial, larger studies are required.
Elevated temperature and waterlogging decrease cottonseed quality by altering the accumulation and distribution of carbohydrates, oil and protein
Authors: Xu Bingjie , Chen Yinglong , Wang Haimiao , Zhao Wenqing , Zhou Zhiguo
Published: September 2020

Soil waterlogging and high‐temperature events have occurred simultaneously in recent years in the Yangtze River basin cotton belt region of China, negatively affecting the development and quality of cottonseed. This study investigated the effects of the combination of elevated temperature (ET) (34.1/29.0°C) and waterlogging (3 or 6 days) on the accumulation and distribution of oil, protein and carbohydrates in cottonseed during flowering and boll development. The results showed that ET resulted in greater decreases in cottonseed biomass under waterlogging than under control conditions. The combination of waterlogging and ET significantly limited the accumulation of carbohydrates and oil contents. However, ET promoted protein accumulation and compensated for the negative effects of 3‐day waterlogging on the final protein content. The combined ET and 6‐day waterlogging significantly decreased the final contents of oil and protein by limiting carbon flux and NADPH supply because of the decreased activities of phosphoenolpyruvate carboxylase (PEPC, EC 4.1.1.31) and glucose‐6‐phosphate dehydrogenase (G6PDH, EC 1.1.1.49). The PEPC activity was correlated more with protein content than oil content. In addition, simultaneous exposure to waterlogging and ET resulted in lower unsaturated fatty acid/saturated fatty acid ratios and essential amino acid/non‐essential amino acid ratios than did exposure to the individual factors alone. These findings could provide the theoretical support for the prospective assessment of effects of high temperature and waterlogging stresses on cotton production under climate change, and they can help to develop effective techniques in cotton cultivation.
THERMAL, DYNAMIC MECHANICAL ANALYSIS AND MECHANICAL PROPERTIES OF POLYBUTYLENE TEREPHTHALATE/POLYETHYLENE TEREPHTHALATE BLENDS
Authors: Ahmad Saidi Muhammad Akmal , Hassan Azman , Wahit Mat Uzir , Jau Choy Lai , Anuar Hazleen
Published: September 2020

Differential scanning calorimetry (DSC), dynamic mechanical analysis (DMA) and mechanical tests were conducted to characterize the properties of polybutylene terephthalate/polyethylene terephthalate (PBT/PET) blends. PBT and PET were blended at different PBT/PET ratios (80/20, 60/40, 40/60, 20/80) via twin screw extruder prior to injection molding. DSC characterization showed a single glass transition temperature for all PBT/PET blends indicating that the miscibility occurred in the amorphous region. From DMA results, loss modulus and tan δ also showed a single peak for all PBT/PET blends, confirming the DSC results. At room temperature, PBT/PET 20/80 has the highest storage modulus followed by PBT/PET 80/20 blend. PET has higher tensile strength, flexural strength, Young’s and flexural modulus than PBT but lower in elongation at break and impact strength. PBT/PET 80/20 blend has the highest tensile strength, flexural strength, elongation at break, and impact strength compared to other PBT/PET blends. PBT/PET 80/20 blend can be suggested as an optimum formulation with balanced mechanical properties in terms of stiffness and toughness.