bluuebunny/crossref_metadata_2025 huggingface dataset:
Puritan Women in Early America
Authors: Morris M. Michelle Jarrett
Published: September 2020

Puritan women could be found throughout early America, but the majority lived in New England. More is known about those who were white and of middling or elite rank, but Puritans could be found in all ranks of society, and some Native Americans and Africans converted to Christianity in response to Puritan missionary efforts as well. Puritan women’s lives were multifaceted. They were the backbone of the Puritan church and expert witnesses in court. They were economic partners in domestic economies, household managers, and could if necessary act in their husbands’ stead. Women were dispensers of charity and the workforce of military garrisons. As wives under coverture (a legal doctrine which placed wives’ legal and economic identities under their husbands’ control), they were expected to be submissive, but as mothers and mistresses, their role was to exercise authority. As members of earthly churches they were subordinate, but, as souls in the Church universal, they were equal before God.

Although many Puritan women shared basic roles, their experiences and the daily rhythms of their lives varied considerably. Age and life-cycle, as well as inequities of wealth, made some women mistresses and others servants. Married women’s work was focused primarily around food, clothing, and childcare, but geography and their husbands’ occupations shaped what women grew in their gardens and what food they foraged or bought, as well as which raw materials they had available for other types of domestic production. Aptitude and informal education led some women to become sought-after healers or midwives to whom other women turned in difficult times. Puritan women were part of both heterosocial and homosocial communities which might be sustaining or riddled with conflict. In extreme cases, social conflict might even lead to accusations of witchcraft. Often in those cases, both accused and accusers were Puritan women.
LGBTQ History and Movements in Brazil
Authors: Green James N.
Published: September 2020

An Lesbian, Gay, Bisexual, Trans, Queer (LGBTQ) movement emerged in the late 1970s during the Brazilian military dictatorship (1964–1985), as the country slowly moved toward democracy. The “Homosexual Movement,” as it was called at the time, along with feminist and black organizations that formed during the same period, fought for an end to discrimination, equality, and full rights. Since then, LGBTQ activists have challenged stereotypes about lesbians, gay men, and trans people and won some important victories, such as same-sex marriage, legal recognition of trans people’s rights to legalize their gender identity, and constitutional protection against hate speech, although discrimination and violence against LGBTQ people is still widespread. The movement challenged traditional Catholic Church notions of homosexuality as a sin, medico-legal discourses that considered same-sex and nontraditional gender performances as sicknesses, conservative political ideologies that privileged the heteronormative family, and sectors of the Left that considered homosexuality a product of “bourgeois decadence.” Built upon a long history of resistance to impositions of compulsory heterosexuality and normative gender roles, lesbians, gay men, and trans people formed diverse communities during the second half of the 20th century that offered important support networks. They also appropriated public spaces for dissident sexualities and gender performances. Carnival became a privileged site for subverting traditional gender roles. Gay activists pushed the government to change initial conservative policies dealing with HIV/AIDS, and Brazil became an international model for effectively combating the disease. Lesbians fought within the feminist movement for acceptance and against social norms that marginalized them. Trans people gained considerable respect and certain rights. The LGBTQ movement remains diverse in practice, composition, and ideologies. A recent reactionary backlash, which has united conservative Catholics, evangelical Christians, and right-wing political forces, is trying to undo the advances made since the late 1970s in favor of social toleration, respect, and equality.
Economic, Social, and Environmental Costs of the Waste-to-Energy Industry
Authors: Song Jinbo , Jin Lulu , Qian Chen , Sun Yan
Published: September 2020

With the upgrading of living standards and rapid urbanization around the globe, waste treatment has become a ubiquitous environmental issue. Increased waste generation and narrowed prospects for landfill and composting have brought strong growth prospects for the waste-to-energy (WtE) industry. WtE is considered an effective method for waste treatment because it can significantly reduce the land use and environmental pollutants caused by other methods and can generate energy by means of electricity or heat from the treatment of waste. However, there have been supportive and opposing opinions about WtE from the economic, environmental, and social perspectives. Whether WtE plants are the best option depends not only on associated investment and operating costs but also on the environmental and social costs (termed as external cost) as compared to other waste treatment options.

Economic costs are generally estimated by market price of materials, labor, and equipment. Social costs normally refer to health effects, transportation congestion, and environmental impacts, including the emission of gas and leachate. Qualitative and quantitative methods are proposed to assist in decision making on waste disposal alternatives. The qualitative method relies on the expert experience to rank waste treatment options, such as analytic hierarchy process and multicriteria decision model, while the quantitative method, such as life cycle assessment and social cost-benefit analysis, calculates the economic cost and monetizes the abstract external cost in the light of the historical data. The two methods offer different advantages and disadvantages, and thus cater to different conditions. In developed countries, along with the rapid development of WtE and the increase in available cost data, the estimation of the economic, environmental, and social costs is achievable, which promotes the popularization of quantitative method. In China and other developing countries, quantitative analysis is limited to the estimation of economic cost and the qualitative method is still dominated in the evaluation of environmental and social impacts due to the lack of cost data.
What About Fluency? Implicit vs. Explicit Training Affects Artificial Mini-Language Production
Authors: Lichtman Karen
Published: September 2020

A great deal of research explores how implicit vs. explicit instruction affects second language learners’ grammatical accuracy, generally finding that explicit instruction increases accuracy. However, no research to date has examined the impact of implicit/explicit instruction on learners’ fluency. Additionally, nearly all the research has only tested adult learners, despite strong claims about the effects of age on implicit vs. explicit language learning. This study tests the impact of implicit or explicit training on children’s and adults’ performance with an artificial mini-language. After seven days of training, fluency, accuracy, and explicit knowledge were measured. Implicit groups became significantly more fluent than explicit groups. Adults were more accurate than children, but training condition did not significantly affect accuracy. Adults and explicit groups developed more explicit knowledge than children and implicit groups, with no interactions between age and training condition. This study is one of the first to show measurable benefits for implicit second language instruction over explicit instruction: both children and adults produce sentences more fluently after implicit instruction.
A Screening Method for Cyanide in Blood by Dimethoxytriazinyl Derivatization-GC/MS
Authors: Yamaguchi Akinori , Miyaguchi Hajime
Published: September 2020

A simple screening analysis of cyanide in blood has been developed, using 4-(4,6-dimethoxy-1,3,5-triazin-2-yl)-4-methylmorpholinium chloride (DMTMM). DMTMM, a convenient reagent for dehydrocondensation, converted cyanide to 2-cyano-4,6-dimethoxy-1,3,5-triazine, the dimethoxytriazinyl derivative of cyanide. This reaction proceeded in whole blood samples after treatment with trichloroacetic acid, and in basic aqueous solution samples. Sufficient sensitivity was observed by the method using gas chromatography/mass spectrometry. Intra- and inter-day repeated analyses (0.05, 0.1, 0.25, 1 and 5 μg/mL, n = 5) were performed and the accuracy and precision were within 20% for the lower limit of quantification (LLOQ) and within 15% for other concentrations. LLOQs for the aqueous solution and blood were 0.05 and 0.1 μg/mL, respectively, which are suitable for detecting cyanide poisoning. The limits of detection (signal-to-noise ratio ≥ 3) for aqueous solution and blood were 0.01 and 0.05 μg/mL, respectively. Interference from 13 other anions was tested and no false positive response was obtained, even in the case of thiocyanate, nitrite and nitrate, which are known to yield cyanide by acid treatment of blood. This method is practical because it uses readily available reagents and equipment and is sensitive enough for the rapid screening of cyanide poisoning in forensic and clinical toxicology.
Cardiac Troponin Composition Characterization after Non ST-Elevation Myocardial Infarction: Relation with Culprit Artery, Ischemic Time Window, and Severity of Injury
Authors: Damen Sander A J , Cramer Gilbert E , Dieker Hendrik-Jan , Gehlmann Helmut , Ophuis Ton J M Oude , Aengevaeren Wim R M , Fokkert Marion , Verheugt Freek W A , Suryapranata Harry , Wu Alan H , van Wijk Xander M R , Brouwer Marc A
Published: September 2020

Background

Troponin composition characterization has been implicated as a next step to differentiate among non-ST elevation myocardial infarction (NSTEMI) patients and improve distinction from other conditions with troponin release. We therefore studied coronary and peripheral troponin compositions in relation to clinical variables of NSTEMI patients.

Methods

Samples were obtained from the great cardiac vein (GCV), coronary sinus (CS), and peripheral circulation of 45 patients with NSTEMI. We measured total cTnI concentrations, and assessed both complex cTnI (binary cTnIC + all ternary cTnTIC forms), and large-size cTnTIC (full-size and partially truncated cTnTIC). Troponin compositions were studied in relation to culprit vessel localization (left anterior descending artery [LAD] or non-LAD), ischemic time window, and peak CK-MB value.

Results

Sampling occurred at a median of 25 hours after symptom onset. Of total peripheral cTnI, a median of 87[78-100]% consisted of complex cTnI; and 9[6-15]% was large-size cTnTIC. All concentrations (total, complex cTnI, and large-size cTnTIC) were significantly higher in the CS than in peripheral samples (P < 0.001). For LAD culprit patients, GCV concentrations were all significantly higher; in non-LAD culprit patients, CS concentrations were higher. Proportionally, more large-size cTnTIC was present in the earliest sampled patients and in those with the highest CK-MB peaks.

Conclusions

In coronary veins draining the infarct area, concentrations of both full-size and degraded troponin were higher than in the peripheral circulation. This finding, and the observed associations of troponin composition with the ischemic time window and the extent of sustained injury may contribute to future characterization of different disease states among NSTEMI patients.
Characterizing several properties of high-dimensional random Apollonian networks
Authors: Zhang Panpan
Published: September 2020

In this article, we investigate several properties of high-dimensional random Apollonian networks, including two types of degree profiles, the small-world effect (clustering property), sparsity and three distance-based metrics. The characterizations of the degree profiles are based on several rigorous mathematical and probabilistic methods, such as a two-dimensional mathematical induction, analytic combinatorics and Pólya urns, etc. The small-world property is uncovered by a well-developed measure—local clustering coefficient and the sparsity is assessed by a proposed Gini index. Finally, we look into three distance-based properties; they are total depth, diameter and Wiener index.
Pleural invasion, epidermal growth factor receptor mutation and carcinoembryonic antigen level affect pleural lavage cytology-positive status in non-small-cell lung cancer
Authors: Fujibayashi Yusuke , Ogawa Hiroyuki , Kitazume Mai , Nishikubo Megumi , Nishioka Yuki , Kimura Kenji , Tane Shinya , Kitamura Yoshitaka , Nishio Wataru
Published: September 2020

OBJECTIVES

Pleural invasion (pl) is strongly associated with the pleural lavage cytology (PLC) status. We analysed tumours with pl and evaluated the relationship between the PLC status and pl.

METHODS

We retrospectively reviewed 428 surgically treated patients who had been diagnosed with non-small-cell lung cancer with pl and had their PLC status examined between 2000 and 2016. We investigated the influence of a PLC-positive status on the prognosis and searched for the factors predictive of a PLC-positive status.

RESULTS

Seventy-eight (18%) patients were PLC positive. The recurrence-free survival of PLC-positive patients was significantly worse than that of PLC-negative patients in pl1 and pl2, but not in pl3 (5-year recurrence-free survival rate, PLC positive versus PLC negative: pl1, 22.0% vs 60.0%, P = 0.002; pl2, 30.4% vs 59.7%, P = 0.015; pl3, 50.0% vs 59.6%, P = 0.427). A multivariable analysis showed that the degree of pl (pl2–3 versus pl1) [odds ratio (OR) 5.34, P < 0.001] was an independent predictive factor for PLC positivity. Epidermal growth factor receptor (EGFR) mutation positivity (OR 5.48, P = 0.042) and carcinoembryonic antigen (CEA) ≥5 ng/ml (OR 3.78, P = 0.042) were associated with a PLC-positive status in patients with pl2–3. We found that the PLC-positive rate in patients with pl2–3 was 35.6%; however, if the tumour was EGFR mutation positive and had CEA ≥5 ng/ml, the PLC-positive rate increased to 77%.

CONCLUSIONS

If a tumour was suspected of being pl2–3 and had EGFR mutation positivity and CEA ≥5 ng/ml, the PLC-positive rate was extremely high.

Clinical trial registration number

Hyogo Cancer Center, G-138.
Lifestyle, metabolism and environmental adaptation inLactococcus lactis
Authors: Kleerebezem Michiel , Bachmann Herwig , van Pelt-KleinJan Eunice , Douwenga Sieze , Smid Eddy J , Teusink Bas , van Mastrigt Oscar
Published: September 2020

Lactococcus lactis serves as a paradigm organism for the lactic acid bacteria (LAB). Extensive research into the molecular biology, metabolism and physiology of several model strains of this species has been fundamental for our understanding of the LAB. Genomic studies have provided new insights into the species L. lactis, including the resolution of the genetic basis of its subspecies division, as well as the control mechanisms involved in the fine-tuning of growth rate and energy metabolism. In addition, it has enabled novel approaches to study lactococcal lifestyle adaptations to the dairy application environment, including its adjustment to near-zero growth rates that are particularly relevant in the context of cheese ripening. This review highlights various insights in these areas and exemplifies the strength of combining experimental evolution with functional genomics and bacterial physiology research to expand our fundamental understanding of the L. lactis lifestyle under different environmental conditions.
Quasi-reliable estimates of effective sample size
Authors: Fang Youhan , Cao Yudong , Skeel Robert D
Published: September 2020

The efficiency of a Markov chain Monte Carlo algorithm for estimating the mean of a function of interest might be measured by the cost of generating one independent sample, or equivalently, the total cost divided by the effective sample size, defined in terms of the integrated autocorrelation time. To ensure the reliability of such an estimate, it is suggested that there be an adequate sampling of state space— to the extent that this can be determined from the available samples. A sufficient condition for adequate sampling is derived in terms of the supremum of all possible integrated autocorrelation times, which leads to a more stringent condition for adequate sampling than that simply obtained from integrated autocorrelation times for functions of interest. A method for estimating the supremum of all integrated autocorrelation times, based on approximation in a finite-dimensional subspace, is derived and evaluated empirically.
Stokes Matrices for Confluent Hypergeometric Equations
Authors: Hien Marco
Published: September 2020

We apply the method of [7] to compute the Stokes matrices of non-resonant confluent hypergeometric differential equations. We discuss the ambiguity of the presentation of the Stokes matrices regarding different choices. The results rely on an explicit description of the perverse sheaf associated to the non-confluent regular singular hypergeometric system arising via Fourier–Laplace transform. We give assumptions on the parameter such that the Stokes matrices have rational or real values. Under some more restrictive conditions, the Stokes matrices had been computed by Duval–Mitschi before. We compare our results with their formulae in the unramified case.
Accelerated Extraction and Analysis of Ethyl Glucuronide in Hair by Means of Pressurized Liquid Extraction Followed by Liquid Chromatography–Tandem Mass Spectrometry Determination
Authors: Vincenti Flaminia , Montesano Camilla , Oliva Eleonora , Fanti Federico , Vincenti Marco , Salomone Alberto , Compagnone Dario , Curini Roberta , Sergi Manuel
Published: September 2020

The measurement of ethyl glucuronide (EtG) in hair is an established practice to evaluate alcohol consumption habits of the donors; nevertheless, analytical variability has shown to be an important factor to be considered: measured EtG values can vary significantly as a consequence of analyte washout during decontamination, pulverization of samples, extraction solvent and incubation temperature. In the present study, we described a new method for automated hair decontamination and EtG extraction from the inner core of the hair by using pressurized liquid extraction (PLE), followed by solid-phase extraction (SPE) cleanup; validation was performed according to SWGTOX guidelines. The extraction efficiency of the new method was evaluated by comparing the results with those obtained by a validated and ISO/IEC 17025:2005 accredited method; an average positive difference of + 32% was observed when the extraction was performed by PLE. The effect of hair pulverization was also studied, and a good correlation between cut and milled hair was observed, implying that PLE allowed a highly efficient extraction of EtG from the inner keratin core of the hair, no matter if it has been cut or pulverized. Finally, to verify the results, paired aliquots of 27 real hair samples were analyzed with both PLE and a protocol optimized by design-of-experiment strategies planned to maximize the extraction yield; in this case, a comparable efficiency was observed, suggesting that exhaustive EtG extraction was obtained with both approaches. This finding opens new perspectives in the eligible protocols devoted to hair EtG analysis, in terms of speed, automation and reproducibility.
Against Normative Defeat
Authors: Nottelmann Nikolaj
Published: September 2020

Several epistemologists have advanced the idea that a subject’s epistemic status can be weakened by evidence she does not possess but should have possessed, or, alternatively, by beliefs or doubts she should have had under her evidential circumstances but does not have. This alleged phenomenon is known as normative defeat and its adherents have typically reported intuitions that it obtains under mundane circumstances. Some epistemologists have analyzed normative defeat in terms of breached epistemic obligations, while others have preferred an analysis in terms of cognitive malfunctioning. No matter which analysis one prefers, I here argue that - given plausible psychological and epistemological assumptions - if the normative defeat phenomenon were real it would be more bizarre than is generally recognized. I conclude that alleged cases of normatively defeated knowledge or epistemic justification are better analyzed as cases of lucky or undeserved knowledge or epistemic justification.
Efficient DNA double-strand break formation at single or multiple defined sites in theSaccharomyces cerevisiaegenome
Authors: Gnügge Robert , Symington Lorraine S
Published: September 2020

DNA double-strand breaks (DSBs) are common genome lesions that threaten genome stability and cell survival. Cells use sophisticated repair machineries to detect and heal DSBs. To study DSB repair pathways and associated factors, inducible site-specific endonucleases have proven to be fundamental tools. In Saccharomyces cerevisiae, galactose-inducible rare-cutting endonucleases are commonly used to create a single DSB at a unique cleavage site. Galactose induction requires cell cultivation in suboptimal growth media, which is tedious especially when working with slow growing DSB repair mutants. Moreover, endonucleases that simultaneously create DSBs in multiple defined and unique loci of the yeast genome are not available, hindering studies of DSB repair in different genomic regions and chromatin contexts. Here, we present new tools to overcome these limitations. We employ a heterologous media-independent induction system to express the yeast HO endonuclease or bacterial restriction enzymes for single or multiple DSB formation, respectively. The systems facilitate tightly controlled and efficient DSB formation at defined genomic sites and will be valuable tools to study DSB repair at a local and genome-wide scale.
Coming of Age
Authors: Sisk Cheryl L. , Romeo Russell D.
Published: September 2020

The purpose of this book is to explore the neurobiology and psychobiology underlying puberty and adolescence. It tells the story of how contemporary neuroscience has come to make significant contributions to the understanding of a developmental period that used to be the sole purview of developmental psychologists and pediatric endocrinologists. The authors presume the reader will have a general understanding of the basic principles of neuroscience and psychology and have written this book to serve as an appropriate text for an upper-level undergraduate seminar or graduate course designed to probe puberty and adolescence more deeply from a psychobiological perspective. Topics covered in specific chapters include timing and regulation of reproductive maturation (puberty), mechanisms of adolescent brain development in laboratory animals and humans, neural underpinnings of higher risk-taking and impulsive behavior in adolescents, hormonal programming of social behaviors during adolescence, and effects of stress and drugs on the adolescent brain. The book ends with the authors’ perspective on some of the big questions about the adolescent brain and behavior that remain to be answered.
BC Cassiopeiae: First detection of IW Andromedae-type phenomenon among post-eruption novae
Authors: Kato Taichi , Kojiguchi Naoto
Published: September 2020

IW And-type dwarf novae are a recently recognized group of cataclysmic variables which are characterized by a sequence of brightening from a standstill-like phase with damping oscillations often followed by a deep dip. We found that the supposed classical nova BC Cas which erupted in 1929 experienced a state of an IW And-type dwarf nova in 2018, 89 yr after the eruption. This finding suggests that a high mass-transfer rate following the nova eruption is associated with the IW And-type phenomenon. The mass of the white dwarf inferred from the decline rate of the nova is considerably higher than the average mass of the white dwarfs in cataclysmic variables, and these massive white dwarfs may be responsible for the manifestation of the IW And-type phenomenon.
Efficacy of early prone or lateral positioning in patients with severe COVID-19: a single-center prospective cohort
Authors: Ni Zhong , Wang Kaige , Wang Ting , Ni Yuenan , Huang Wei , Zhu Ping , Fan Tao , Wang Ye , Wang Bo , Deng Jun , Qian Zhicheng , Liu Jiasheng , Cai Wenhao , Xu Shanling , Du Yu , Wang Gang , Liang Zongan , Li Weimin , Luo Jianfei , Luo Fengming , Liu Dan
Published: September 2020

Background

Position intervention has been shown to improve oxygenation, but its role in non-invasively ventilated patients with severe COVID-19 has not been assessed. The objective of this study was to investigate the efficacy of early position intervention on non-invasively ventilated patients with severe COVID-19.

Methods

This was a single-center, prospective observational study in consecutive patients with severe COVID-19 managed in a provisional ICU at Renmin Hospital of Wuhan University from 31 January to 15 February 2020. Patients with chest CT showing exudation or consolidation in bilateral peripheral and posterior parts of the lungs were included. Early position intervention (prone or lateral) was commenced for > 4 hours daily for 10 days in these patients, while others received standard care.

Results

The baseline parameters were comparable between the position intervention group (n = 17) and the standard care group (n = 35). Position intervention was well-tolerated and increased cumulative adjusted mean difference of SpO2/FiO2 (409, 95% CI 86 to 733) and ROX index (26, 95% CI 9 to 43) with decreased Borg scale (−9, 95% CI −15 to −3) during the first 7 days. It also facilitated absorption of lung lesions and reduced the proportion of patients with high National Early Warning Score 2 (≥ 7) on days 7 and 14, with a trend toward faster clinical improvement. Virus shedding and length of hospital stay were comparable between the two groups.

Conclusions

This study provides the first evidence for improved oxygenation and lung lesion absorption using early position intervention in non-invasively ventilated patients with severe COVID-19, and warrants further randomized trials.
Universality in COVID-19 spread in view of the Gompertz function
Authors: Ohnishi Akira , Namekawa Yusuke , Fukui Tokuro
Published: September 2020

We demonstrate that universal scaling behavior is observed in the current coronavirus (SARS-CoV-2) spread, the COVID-19 pandemic, in various countries. We analyze the numbers of infected people who tested positive (cases) in 11 selected countries (Japan, USA, Russia, Brazil, China, Italy, Indonesia, Spain, South Korea, UK, and Sweden). By using a double exponential function called the Gompertz function, $f_\mathrm{G}(x)=\exp(-e^{-x})$, the number of cases is well described as $N(t)=N_0 f_\mathrm{G}(\gamma(t-t_0))$, where $N_0$, $\gamma$, and $t_0$ are the final number of cases, the damping rate of the infection probability, and the peak time of the daily number of new cases, $dN(t)/dt$, respectively. The scaled data of cases in most of the analyzed countries are found to collapse onto a common scaling function $f_\mathrm{G}(x)$ with $x=\gamma(t-t_0)$ being the scaling variable in the range of $f_\mathrm{G}(x)\pm 0.05$. The recently proposed indicator, the so-called $K$ value, the increasing rate of cases in one week, is also found to show universal behavior. The mechanism for the Gompertz function to appear is discussed from the time dependence of the produced pion numbers in nucleus–nucleus collisions, which is also found to be described by the Gompertz function.
STUDY ON RADON CONCENTRATION VARIATION DURING SUBWAY CONSTRUCTION
Authors: Tan Bo , Yang Guangyuan , Fu Shuhui , Xu Cheng
Published: September 2020

The high radon concentration in the underground space of the subway station during construction often endangers the health of workers. Subway station project No. 16 in Beijing, while under construction, was selected as the main measuring point, a year’s monitoring data was obtained to analyse the change of radon concentration. It was found that the concentration of radon was basically within the range of 5 ~ 500 Bq/m3 and showing a low level in the morning and a high level at noon, and presents the seasonal rule, compared with other seasons, the summer radiation is stronger. Furthermore, among the different measuring points, the radon concentration of the heading roadway is the highest, and the construction level of the station hall is the lowest. According to the comprehensive analysis, the concentration of radon during the construction of the subway station is mainly affected by the ambient temperature and air mobility.
Complementary approaches to problem solving in healthcare and public health: implementation science and human-centered design
Authors: Chen Elizabeth , Neta Gila , Roberts Megan C
Published: September 2020

Complementary approaches to problem solving in healthcare and public health: implementation science and human-centered design”: Combining implementation science and human-centered design approaches is novel and these complementary approaches can be applied together to optimize the integration of evidence-based practices within clinical and public health settings.
Prevalence and risk factors of Hantavirus infection in patients undergoing hemodialysis in Khartoum, Sudan, in 2019: a cross-sectional study
Authors: Abbas Azza A , Ali Hiba A A , Alagib Mohamed A , Salih Huda F S , Elkhidir Isam M , El Hussein Abdel Rahim M , Enan Khalid A
Published: September 2020

Background

Hantaviruses are enveloped negative sense RNA viruses that cause hemorrhagic fever with renal syndrome. This study aimed to identify the prevalence of Hantavirus IgG antibodies and possible risk factors for Hantaviruses infections among end-stage renal disease (ESRD) patients attending the Dr Salma dialysis center in Sudan.

Methodology

This was a cross-sectional study in which 91 ESRD patients and 30 healthy plasma samples were screened for Hantavirus IgG antibodies using ELISA. A questionnaire containing sociodemographics, history of rat exposure and clinical data information was filled in by each ESRD patient.

Results

In this study, 9 out of 91 ESRD patients (9.9%) tested positive for Hantaviruses antibodies (IgG) while none of the 30 healthy plasma samples showed seropositivity. There was no statistically significant association between age, gender, educational level and rat exposure and Hantavirus infection in ESRD patients (p>0.05)

Conclusion

This study is the first to be conducted in Sudan regarding Hantaviruses and ESRD. The prevalence of Hantavirus antibodies among ESRD patients is high compared with findings reported in the literature from studies conducted on the same group of patients. It points to an interesting question as to whether Hantaviruses have an association with ESRD but further studies are needed before drawing any conclusions.
Morphological phylogeny and review of the generic classification of Colletinae (Hymenoptera: Colletidae)
Authors: Ferrari Rafael R , Packer Laurence
Published: September 2020

The bee subfamily Colletinae includes 542 species, the vast majority of which (518 spp.) belong to Colletes. The generic placement of the remaining 24 species has been controversial, resulting in several classifications being proposed. Despite several recently published molecular phylogenies of Colletinae, it remains unknown (1) what morphological synapomorphies support the recognized genera, (2) in which direction some relevant functional traits (e.g. basitibial plate) have evolved and (3) whether morphology supports the available molecular data. Herein, we provide a morphological phylogeny of Colletinae, which was constructed through parsimony analyses of 186 characters. In total, 50 ingroup species were included representing all major lineages of Colletes (29 spp.), plus all but three of the non-Colletes species of Colletinae (21 spp.). Trees were estimated through equal weights and extended implied weighting. Both provide strong support for the monophyly of Colletinae and indicate that the subfamily is defined by four unique synapomorphies. Our results also confirm recent phylogenetic hypotheses showing that Colletinae can be subdivided into two major clades: one comprising the reciprocally monophyletic Mourecotelles and Xanthocotelles; the other includes Colletes plus Hemicotelles, which are also reciprocally monophyletic. We also provide a fully illustrated key to facilitate generic identification of the Colletinae.
Implementation and maintenance of an established clinical decision support tool algorithm: challenges and recommendations from a prospective cohort study
Authors: Padley Michelle , Madden Tyler , Kothari Parin , Hall Jacob , Pate Matthew J. , Brown Todd
Published: September 2020

Background:

Computerized clinical decision support systems (CDSS) offer predictive statistical measurements of patient outcomes to clinicians using amalgamated data.

Methods:

The focus of this study was to investigate the usability and reliability of an established CDSS at a pilot site in the management of surgical patients with lumbar degenerative spondylolisthesis, and to assemble recommendations in order to implement a CDSS at other organizations.

Results:

Physicians reported that in 100% of patients, the clinical decision support tool algorithm (CDSTA) could help discuss surgical options. In 78% of patients, physicians agreed that it could help make the decision to recommend surgery. Physicians agreed with the CDSTA outcome predictions in 96% of patients.

Conclusions:

Various challenges were identified concerning CDSTA usability, and the main stumbling point was communication between the clinical and information technology staff who developed the CDSTA, demonstrated through technical language barriers, CDSTA backend updating delays, and reluctance of clinicians and staff to adapt to the CDSTA in addition to the typical daily workflow. The most significant lesson was maintaining open lines of dialogue between the developer and pilot site to allow for seamless CDSS integration into a practice and minimal technical downtime.
Braces Designed Using CAD/CAM Combined or Not With Finite Element Modeling Lead to Effective Treatment and Quality of Life After 2 Years
Authors: Guy Aymeric , Labelle Hubert , Barchi Soraya , Audet-Duchesne Elisabeth , Cobetto Nikita , Parent Stefan , Raison Maxime , Aubin Carl-Éric
Published: September 2020

Study Design.

Single-center prospective randomized controlled trial.

Objective.

The aim of this study was to assess the computer-aided design/manufacturing (CAD/CAM) brace design approach, with and without added finite element modeling (FEM) simulations, after 2 years in terms of clinical outcomes, 3D correction, compliance, and quality of life (QoL).

Summary of Background Data..

Previous studies demonstrated that braces designed using a combination of CAD/CAM and FEM induced promising in-brace corrections, were lighter, thinner, and covered less trunk surface. Yet, their long-term impact on treatment quality has not been evaluated.

Methods.

One-hundred twenty adolescent idiopathic scoliosis patients were recruited following Scoliosis Research Society standardized criteria for brace treatment; 61 patients in the first subgroup (CAD) were given braces designed using CAD/CAM; 59 in the second subgroup (CAD-FEM) received braces additionally simulated and refined using a patient-specific FEM built from 3D reconstructions of the spine, rib cage and pelvis. Main thoracic (MT) and thoraco-lumbar/lumbar (TL/L) Cobb angles, sagittal curves, and apical rotations were compared at the initial visit and after 2 years. Patient compliance and QoL were tracked respectively by using embedded temperature sensors and SRS-22r questionnaires.

Results.

Forty-four patients with CAD-FEM braces and 50 with CAD braces completed the study. Average in-brace correction was 9° MT (8° CAD-FEM, 10° CAD, P = 0.054) and 12° TL/L (same for both subgroups, P = 0.91). Out-of-brace 2-year progression from initial deformity was <4° for all 3D measurements. Sixty-six percent of all cases (30 CAD-FEM, 35 CAD) met the ≤5° curve progression criterion, 83% (38 CAD-FEM, 43 CAD) stayed <45°, and 6% (5 CAD-FEM, 1 CAD) underwent fusion surgery. 3D correction, compliance, and QoL were not significantly different between both subgroups (P > 0.05).

Conclusion.

After 2 years, patients with braces designed using CAD/CAM with/without FEM had satisfying clinical outcomes (compared to the BrAIST study), 3D corrections, compliance and QoL. A more comprehensive optimization of brace treatment remains to be accomplished.

Level of Evidence: 2
Novel Nomograms as Aids for Predicting Recurrence and Survival in Chordoma Patients
Authors: Meng Tong , Huang Runzhi , Hu Peng , Yin Huabin , Lin Shaojian , Qiao Suchi , Wang Renkai , Wang Jing , Cai Zhengdong , Huang Zongqiang , Cheng Liming , Song Dianwen
Published: September 2020

Study Design.

A retrospective data analysis was performed.

Objective.

The aim of this study is to explore the significant prognostic factors and propose new nomograms to facilitate clinical decision-making.

Summary of Background Data.

Chordoma is a rare bone tumor. The clinical features and optimal therapeutic strategies are still uncertain.

Methods.

Chordoma patients treated in four medical centers of mainland China before January 2015 were included. The predictors for local relapse-free survival (LRFS) and overall survival (OS) were identified by the Lasso regression and Cox proportional hazards regression model. Then the nomograms were developed. Their discrimination, calibration, and accuracy were evaluated by the C-index, calibration curve, and receiver operating characteristic curve (ROC), respectively.

Results.

A total of 341 patients were identified and full prognostic variable data were available for 276 patients. A total of 179 patients (64.9%) experienced recurrence and 122 patients (44.2%) died of all causes with a median follow-up time of 57.5 (range, 1–325) months. We identified recurrence-relevant factors of tumor size, tumor location, histology subtype and resection method, and death-relevant factors of tumor size, tumor location, resection method, complication, and postoperative recurrence. The constructed LRFS and OS nomograms showed good calibration and discriminative ability (C index 0.79 and 0.76, respectively). The ROCs suggested decent prediction ability with the 5-year area under curve (AUC) value of 0.868 and 0.786, respectively.

Conclusion.

Based on the multicenter case series of chordoma with a relative long follow-up, we proposed two nomograms to predict the prognosis on the basis of recurrence- and death-relevant factors. These findings could be referenced in the clinical decision-making process and provide additional prognostic information for risk stratification.

Level of Evidence: 4
Sports-related Cervical Spine Fracture and Spinal Cord Injury
Authors: Alas Haddy , Pierce Katherine E. , Brown Avery , Bortz Cole , Naessig Sara , Ahmad Waleed , Moses Michael J. , O’Connell Brooke , Maglaras Constance , Diebo Bassel G. , Paulino Carl B. , Buckland Aaron J. , Passias Peter G.
Published: September 2020

Study Design.

Retrospective cohort study.

Objective.

Assess trends in sports-related cervical spine trauma using a pediatric inpatient database.

Summary of Background Data.

Injuries sustained from sports participation may include cervical spine trauma such as fractures and spinal cord injury (SCI). Large database studies analyzing sports-related cervical trauma in the pediatric population are currently lacking.

Methods.

The Kid Inpatient Database was queried for patients with external causes of injury secondary to sports-related activities from 2003 to 2012. Patients were further grouped for cervical spine injury (CSI) type, including C1–4 and C5–7 fracture with/without spinal cord injury (SCI), dislocation, and SCI without radiographic abnormality (SCIWORA). Patients were grouped by age into children (4–9), pre-adolescents (Pre, 10–13), and adolescents (14–17). Kruskall-Wallis tests with post-hoc Mann-Whitney U's identified differences in CSI type across age groups and sport type. Logistic regression found predictors of TBI and specific cervical injuries.

Results.

A total of 38,539 patients were identified (12.76 years, 24.5% F). Adolescents had the highest rate of sports injuries per year (P < 0.001). Adolescents had the highest rate of any type of CSI, including C1–4 and C5–7 fracture with and without SCI, dislocation, and SCIWORA (all P < 0.001). Adolescence increased odds for C1-4 fracture w/o SCI 3.18×, C1-4 fx w/ SCI by 7.57×, C5-7 fx w/o SCI 4.11×, C5-7 w/SCI 3.63×, cervical dislocation 1.7×, and cervical SCIWORA 2.75×, all P < 0.05. Football injuries rose from 5.83% in 2009 to 9.14% in 2012 (P < 0.001), and were associated with more SCIWORA (1.6% vs. 1.0%, P = 0.012), and football injuries increased odds of SCI by 1.56×. Concurrent TBI was highest in adolescents at 58.4% (pre: 26.6%, child: 4.9%, P < 0.001), and SCIWORA was a significant predictor for concurrent TBI across all sports (odds ratio: 2.35 [1.77–3.11], P < 0.001).

Conclusion.

Adolescent athletes had the highest rates of upper/lower cervical fracture, dislocation, and SCIWORA. Adolescence and SCIWORA were significant predictors of concurrent TBI across sports. The increased prevalence of CSI with age sheds light on the growing concern for youth sports played at a competitive level, and supports recently updated regulations aimed at decreasing youth athletic injuries.

Level of Evidence: 3
Cardiometabolic Profiles and Change in Neighborhood Food and Built Environment Among Older Adults
Authors: Shiba Koichiro , Hanazato Masamichi , Aida Jun , Kondo Katsunori , Arcaya Mariana , James Peter , Kawachi Ichiro
Published: September 2020

Background:

The association between neighborhood environment and health may be biased due to confounding by residential self-selection. The displacement of disaster victims can act as a natural experiment that exposes residents to neighborhood environments they did not select, allowing for the study of neighborhood effects on health.

Methods:

We leveraged data from a cohort of older adults 65 years of age or older living in Iwanuma, Japan, located 80 km west of the 2011 Great East Japan Earthquake and Tsunami. Surveys were conducted 7 months before the disaster, as well as 2.5 and 5.5 years afterward, and linked with medical records. We classified each individual’s type of exposure to neighborhood environment based on proximity to local food and recreation destinations and walkability.

Results:

Fixed-effect models indicated that change in the exposure type from low to high urban density was associated with increased body mass index (0.46 kg/m2; 95% confidence interval [CI] = 0.20, 0.73), waist circumference (1.8 cm; 95% CI = 0.56, 3.0), low-density lipoprotein cholesterol (11 mg/dl; 95% CI = 5.0, 17), and decreased high-density lipoprotein cholesterol (−3.1 mg/dl; 95% CI = −5.0, −1.3). We observed similar trends when we analyzed only the individuals who experienced postdisaster relocation to temporary homes.

Conclusions:

Increased proximity to food outlets was simultaneously correlated with greater walkability and accessibility to recreational destinations; however, any protective association of physical activity-promoting built environment appeared to be offset by proximity to unhealthy food outlets, especially fast-food restaurants and bars.
LONGITUDINAL ELLIPSOID ZONE DYNAMICS AFTER MACULAR HOLE REPAIR IN THE DISCOVER STUDY
Authors: Sevgi Duriye Damla , Yee Philina S. , Srivastava Sunil K. , Le Thuy K. , Abraham Joseph R. , Reese Jamie , Ehlers Justis P.
Published: September 2020

Purpose:

To evaluate association of the baseline macular hole (MH) geometric features and longitudinal ellipsoid zone integrity with the visual acuity outcome after surgical repair.

Methods:

This was a post-hoc analysis of eyes in the DISCOVER study undergoing vitrectomy repair for MH. Anatomical and functional data were collected through one year postoperatively. An automated retinal layer segmentation platform was used for the assessment of outer retinal metrics and volumetric reconstruction of MH. Association of longitudinal ellipsoid zone features and baseline MH height, width, and volume with VA outcomes were investigated.

Results:

Eighty-four eyes with MH were included. The mean baseline VA was 20 of 114 and increased to 20 of 45 (P < 0.001) at postoperative Month 12 (N = 45). Successful MH closure was achieved in 98.8% of cases. Ellipsoid zone integrity metrics significantly improved from baseline (P = 0.002) and postoperative Month 1 (P < 0.001) to post-operative Month 12. Ellipsoid zone metrics independently correlated with VA at all follow-up visits (P < 0.05). Increased baseline MH width and volume negatively correlated with the VA at postoperative Month 12 (P < 0.001). Preoperative VA and EZ integrity on optical coherence tomography were predictors for postoperative VA.

Conclusion:

Baseline MH volumetric parameters and EZ parameters were associated with VA outcomes after repair.
VARYING OPTICAL COHERENCE TOMOGRAPHY APPEARANCE OF THE INNER CHOROID WITH AGE
Authors: Spaide Richard F. , Ledesma-Gil Gerardo , Mullins Robert F.
Published: September 2020

Purpose:

To investigate the reflectivity of the structural optical coherence tomography images of the inner choroid as it relates to potential structural composition.

Methods:

The reflectivity of slab images 29 to 49 µm and 45 to 65 µm below the retinal pigment epithelium, obtained with the Zeiss Plex Elite 9000, was evaluated. The mean and SD of a group of subjects with no ocular disorders were determined. Binarization of the images was performed and a threshold level established at the mean plus one SD for each slab depth. The proportion of area binarized was evaluated with generalized estimating equations. Representative histologic images obtained from autopsy donors were stained with Masson's trichrome, a staining method helpful in evaluating collagen and ground substance of tissue.

Results:

There were 67 eyes of 38 subjects with a mean age of 44.5 (range 22–82) years. Using generalized estimating equations, age was found to be a significant predictor for the proportion of binarized pixels in both the 29 to 49 µm (P = 0.034) and the 45 to 65 µm (P < 0.001) slabs. The histologic specimens illustrated the loss of ground substance with increasing compaction of collagen fibers in the choroidal stroma with advancing age.

Conclusion:

The reflectivity from the inner choroid is not uniform and changes with age. As suggested by the histologic specimens, we propose the optical coherence tomography reflectance from the inner choroid is related, in part, to the packing density of collagen fibers present there.