bluuebunny/crossref_metadata_2025 huggingface dataset:
Anosmia in COVID-19: Mechanisms and Significance
Authors: Han Albert Y , Mukdad Laith , Long Jennifer L , Lopez Ivan A
Published: June 2020

The global pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains a challenge for prevention due to asymptomatic or paucisymptomatic patients. Anecdotal and preliminary evidence from multiple institutions shows that these patients present with a sudden onset of anosmia without rhinitis. We aim to review the pathophysiology of anosmia related to viral upper respiratory infections and the prognostic implications. Current evidence suggests that SARS-CoV-2-related anosmia may be a new viral syndrome specific to COVID-19 and can be mediated by intranasal inoculation of SARS-CoV-2 into the olfactory neural circuitry. The clinical course of neuroinvasion of SARS-CoV-2 is yet unclear; however, an extended follow-up of these patients to assess for neurological sequelae, including encephalitis, cerebrovascular accidents, and long-term neurodegenerative risk may be indicated.
Explaining Cross-National Variation in the Health Benefits of Tertiary Education: What Are the Roles of the Skills Gap and the Earnings Gap?
Authors: Fan Wen , Han Siqi
Published: June 2020

Recent studies have shown that the relationship between educational attainment and health varies across countries. To better understand the cross-national variation in the health benefits of higher education, we theorize and empirically examine two country-level factors—the skills gap and the earnings gap between adults with tertiary and intermediate education. We expect the skills gap and the earnings gap to moderate educational gradients in health through shaping information transparency and thus affecting labour market and marriage market opportunities, even though men and women may be affected in distinct ways. To test our hypotheses, we analyse a sample of 75,642 women and 68,004 men in 25 countries from the Programme for the International Assessment of Adult Competencies data. Multilevel linear regression models show that, for women but not men, the relationship between tertiary education and self-reported health is magnified in countries with a greater skills gap; for men but not women, the relationship between tertiary education and self-reported health is magnified in countries with a greater earnings gap. Combined, these results indicate that the educational system, the labour market, and the partner selection process cross-cut and amplify one another to shape the (re)production of health inequalities in gendered ways.
Lifetime Exposure to Conversion Therapy and Psychosocial Health Among Midlife and Older Adult Men Who Have Sex With Men
Authors: Meanley Steven , Haberlen Sabina A , Okafor Chukwuemeka N , Brown Andre , Brennan-Ing Mark , Ware Deanna , Egan James E , Teplin Linda A , Bolan Robert K , Friedman Mackey R , Plankey Michael W
Published: June 2020

Background and Objectives

Conversion therapies to minimize same-sex attractions are classified as a dangerous practice by numerous scientific institutions in the United States. These practices may contribute to poor long-term psychosocial health, thereby interrupting processes of healthy aging. Few studies have examined psychosocial differences between persons with and without prior experiences of conversion therapy. We assessed associations between prior conversion therapy experiences and psychosocial health among midlife and older men who have sex with men (MSM; age 40+ years).

Research Design and Methods

Participants included a multicity sample of MSM (N = 1,156) enrolled in the Multicenter AIDS Cohort Study who completed health surveys (2016–2019) as part of their biannual study visits. Using multivariable regressions, we investigated the associations of prior conversion therapy with current depressive symptoms, internalized homophobia, post-traumatic stress, and cumulative psychosocial conditions. Using a trait-level measure (e.g., life purpose and perseverance), we tested whether resilience moderated these associations.

Results

The full sample was predominantly non-Hispanic white with a mean age of 62.6 years. Fifteen percent of men (n = 171/1,156) reported prior conversion therapy. In multivariable models, men exposed to conversion therapy were more likely to have depressive symptoms and above-average internalized homophobia. Men exposed to conversion therapy had 2–2.5 times the odds of reporting 1 and ≥2 psychosocial conditions, respectively, compared with those who reported 0 conditions. Resilience did not moderate these associations.

Discussion and Implications

Conversion therapies are nonaffirming social stressors for MSM and may compromise critical psychosocial aspects of healthy aging among MSM.
A detailed image of the continent-borderland transition beneath Long Beach, California
Authors: Clayton Robert W
Published: June 2020

New crustal images beneath Long Beach, California show the region of the Inner Borderland to continent transition. The cross-sections are obtained from stacked autocorrelations of virtual sources generated from oil-industry data recorded in the city of Long Beach, CA. They show that the Moho is dipping at 65° and obliquely truncates an ∼10 km thick flat-lying lower crustal fabric. The Moho appears to be fault controlled and an integral part of the extrusion of the Catalina Schist that underlays the Inner Borderland. The basement interface has significant offsets of up to 2 km, none of which correspond to the mapped trace of the Newport–Inglewood Fault.
Do Epigenetic Changes Drive Corticosterone Responses to Alarm Cues in Larvae of an Invasive Amphibian?
Authors: Sarma Roshmi R , Edwards Richard J , Crino Ondi L , Eyck Harrison J F , Waters Paul D , Crossland Michael R , Shine Richard , Rollins Lee A
Published: June 2020

Synopsis

The developmental environment can exert powerful effects on animal phenotype. Recently, epigenetic modifications have emerged as one mechanism that can modulate developmentally plastic responses to environmental variability. For example, the DNA methylation profile at promoters of hormone receptor genes can affect their expression and patterns of hormone release. Across taxonomic groups, epigenetic alterations have been linked to changes in glucocorticoid (GC) physiology. GCs are metabolic hormones that influence growth, development, transitions between life-history stages, and thus fitness. To date, relatively few studies have examined epigenetic effects on phenotypic traits in wild animals, especially in amphibians. Here, we examined the effects of exposure to predation threat (alarm cues) and experimentally manipulated DNA methylation on corticosterone (CORT) levels in tadpoles and metamorphs of the invasive cane toad (Rhinella marina). We included offspring of toads sampled from populations across the species’ Australian range. In these animals, exposure to chemical cues from injured conspecifics induces shifts in developmental trajectories, putatively as an adaptive response that lessens vulnerability to predation. We exposed tadpoles to these alarm cues, and measured changes in DNA methylation and CORT levels, both of which are mechanisms that have been implicated in the control of phenotypically plastic responses in tadpoles. To test the idea that DNA methylation drives shifts in GC physiology, we also experimentally manipulated methylation levels with the drug zebularine. We found differentially methylated regions (DMRs) between control tadpoles and their full-siblings exposed to alarm cues, zebularine, or both treatments. However, the effects of these manipulations on methylation patterns were weaker than clutch (e.g., genetic, maternal, etc.) effects. CORT levels were higher in larval cane toads exposed to alarm cues and zebularine. We found little evidence of changes in DNA methylation across the GC receptor gene (NR3C1) promoter region in response to alarm cue or zebularine exposure. In both alarm cue and zebularine-exposed individuals, we found differentially methylated DNA in the suppressor of cytokine signaling 3 gene (SOCS3), which may be involved in predator avoidance behavior. In total, our data reveal that alarm cues have significant impacts on tadpole physiology, but show only weak links between DNA methylation and CORT levels. We also identify genes containing DMRs in tadpoles exposed to alarm cues and zebularine, particularly in range-edge populations, that warrant further investigation.
Public procurement for innovation: firm-level evidence from Italy and Norway
Authors: Divella Marialuisa , Sterlacchini Alessandro
Published: June 2020

Controlling for factors affecting the participation in the procurement market, this article attempts to identify the main determinants of firms’ propensity to undertake innovative activities as part of public procurement contracts. The empirical analysis is carried out by using micro-data from two Community Innovation Surveys for Italian and Norwegian firms. We find that small- and medium-sized firms, as opposed to larger companies, have a lower capability to enter into the procurement market; however, once they succeed, they are equally capable of offering innovative solutions to public buyers. Another major result regards firms’ cooperation with universities and public research institutes, which seems to play a key role in order to facilitate firms’ involvement in public procurement for innovation. Although there are some differences in the estimated coefficients of explanatory variables, these results are consistent between Italy and Norway.
Clinical evaluation and diagnostic yield following evaluation of abnormal pulse detected using Apple Watch
Authors: Wyatt Kirk D , Poole Lisa R , Mullan Aidan F , Kopecky Stephen L , Heaton Heather A
Published: June 2020

Objective

The study sought to characterize the evaluation of patients who present following detection of an abnormal pulse using Apple Watch.

Materials and Methods

We conducted a retrospective review of patients evaluated for abnormal pulse detected using Apple Watch over a 4-month period.

Results

Among 264 included patients, clinical documentation for 41 (15.5%) explicitly noted an abnormal pulse alert. Preexisting atrial fibrillation was noted in 58 (22.0%). Most commonly performed testing included 12-lead echocardiography (n = 158; 59.8%), Holter monitor (n = 77; 29.2%), and chest x-ray (n = 64; 24.2%). A clinically actionable cardiovascular diagnosis of interest was established in only 30 (11.4%) patients, including 6 of 41 (15%) patients who received an explicit alert.

Discussion

False positive screening results may lead to overutilization of healthcare resources.

Conclusions

The Food and Drug Administration and Apple should consider the unintended consequences of widespread screening for asymptomatic (“silent”) atrial fibrillation and use of the Apple Watch abnormal pulse detection functionality by populations in whom the device has not been adequately studied.
Design and numerical investigation of an adaptive intramedullary nail with a novel interlocking mechanism
Authors: Bagheri Mohammad Ali , Rouhi Gholamreza
Published: June 2020

Malalignment is a common complication in the treatment of distal fractures of the tibia. Numerous efforts have been made to reduce the malalignment ratio. However, the reported cases with this disorder are still high. This study aimed at investigating an adaptive design of an intramedullary nail with a novel interlocking mechanism (AINIM), as an alternative for the customary nailing, in reducing malalignment ratio. A verified finite element model was employed to compare the performance of AINIM with the customary nail. The finite element model of the tibia follows the exact shape of the medullary canal, and nonhomogeneous material properties were assigned to the bone from bone ash density. It was assumed that the nails were implanted and interlocked in the tibia according to surgical protocols, and physiological-like loading was applied to finite element models. The results of this study showed that AINIM reduces the mean shear interfragmentary strains by about 30%, and the axial interfragmentary strain by 55%, also it increases the uniformity in the interfragmentary movements, compared to the customary nail. It was also found that AINIM caused a reduction of the stress on the nail by 60%, and an increase of 25% on the bone, compared to the customary nail. Moreover, average compressive principal strains in the tibia fixed by AINIM increased by 40% from 485 to 678 με, compared to the tibia fixed by the customary nailing method. The results of this work also showed that AINIM causes an increase in the contact area with the intramedullary canal, particularly at the fracture site, and it also escalates the magnitude of contact pressure. Results of this work indicate that, from the biomechanical standpoint, the adaptive nail, i.e. AINIM, with an innovative interlocking mechanism, compared to the customary nailing, can lessen intra- and post-operative malalignment occurrence, and it also mitigates the side effects of stress shielding, and thus better conserves neighboring bone density in a long period.
Study protocol for an International Prospective Observational Cohort Study for Optimal Bowel Resection Extent and Central Radicality for Colon Cancer (T-REX study)
Authors: Shiozawa Manabu , Ueno Hideki , Shiomi Akio , Kim Nan Kyu , Kim Jin Cheon , Tsarkov Petr , Grützmann Robert , Dulskas Audrius , Liang Jin-Tung , Samalavičius Narimantas , West Nick , Sugihara Kenichi
Published: June 2020

This is a prospective observational cohort study aiming to include 4000 patients with stages I to III colon cancer treated at 35 specialist institutions in Japan, South Korea, Germany, Russia, Lithuania and Taiwan. The anatomical distribution of lymph nodes and feeding arteries are investigated using surgical specimens according to pre-specified categorizing methods using intraoperative anatomical markings. Primary analyses are performed to identify the general principles of metastatic lymph node distribution in terms of its relation to the location of the primary tumor and feeding arteries. Secondary analyses will be used to estimate prognostic outcomes according to bowel resection length and central radicality and will be used to evaluate the quality of resected surgical specimens. Through in-depth lymph node mapping, standardized criteria for the definite area of ‘regional’ lymph node resection in routine surgical procedures can be identified, which is expected to contribute to international standardization in colon cancer surgery (ClinicalTrials.gov NCT02938481).
Legal and ethical implications of wastewater monitoring of SARS-CoV-2 for COVID-19 surveillance
Authors: Gable Lance , Ram Natalie , Ram Jeffrey L
Published: June 2020

Scientists have observed that molecular markers for COVID-19 can be detected in wastewater of infected communities both during an outbreak and, in some cases, before the first case is confirmed. The Centers for Disease Control and Prevention and other government entities are considering whether to add community surveillance through wastewater monitoring to assist in tracking disease prevalence and guiding public health responses to the COVID-19 pandemic. This scientific breakthrough may lead to many useful potential applications for tracking disease, intensifying testing, initiating social distancing or quarantines, and even lifting restrictions once a cessation of infection is detected and confirmed. Yet, new technologies developed in response to a public health crisis may raise difficult legal and ethical questions about how such technologies may impact both the public health and civil liberties of the population. This paper describes recent scientific evidence regarding COVID-19 detection in wastewater, identifying public health benefits that may result from this breakthrough, as well as the limitations of existing data. The paper then assesses the legal and ethical implications of implementing policy based on positive sewage signals. It concludes that the first step to implementing legal and ethical wastewater monitoring is to develop scientific understanding. Even if reliability and efficacy are established, limits on sample and data collection, use, and sharing must also be considered to prevent undermining privacy and autonomy in order to implement these public health strategies consistent with legal and ethical considerations.
Marr’s Tri-Level Framework Integrates Biological Explanation Across Communication Subfields
Authors: Huskey Richard , Bue Amelia Couture , Eden Allison , Grall Clare , Meshi Dar , Prena Kelsey , Schmälzle Ralf , Scholz Christin , Turner Benjamin O , Wilcox Shelby
Published: June 2020

In this special issue devoted to speaking across communication subfields, we introduce a domain general explanatory framework that integrates biological explanation with communication science and organizes our field around a shared explanatory empirical model. Specifically, we draw on David Marr’s classical framework, which subdivides the explanation of human behavior into three levels: computation (why), algorithm (what), and implementation (how). Prior theorizing and research in communication has primarily addressed Marr’s computational level (why), but has less frequently investigated algorithmic (what) or implementation (how all communication phenomena emerge from and rely on biological processes) explanations. Here, we introduce Marr’s framework and apply it to three research domains in communication science—audience research, persuasion, and social comparisons—to demonstrate what a unifying framework for explaining communication across the levels of why, what, and how can look like, and how Marr’s framework speaks to and receives input from all subfields of communication inquiry.
Dynamic Transactions Between News Frames and Sociopolitical Events: An Integrative, Hidden Markov Model Approach
Authors: Hopp Frederic R , Fisher Jacob T , Weber René
Published: June 2020

A central goal of news research is to understand the interplay between news coverage and sociopolitical events. Although a great deal of work has elucidated how events drive news coverage, and how in turn news coverage influences societal outcomes, integrative systems-level models of the reciprocal interchanges between these two processes are sparse. Herein, we present a macro-scale investigation of the dynamic transactions between news frames and events using Hidden Markov Models (HMMs), focusing on morally charged news frames and sociopolitical events. Using 3,501,141 news records discussing 504,759 unique events, we demonstrate that sequences of frames and events can be characterized in terms of “hidden states” containing distinct moral frame and event relationships, and that these “hidden states” can forecast future news frames and events. This work serves to construct a path toward the integrated study of the news-event cycle across multiple research domains.
Resection of a colonic mass following trauma: a diagnostic dilemma
Authors: Burchard Paul , Thomay Alan A
Published: June 2020

A 53-year-old Caucasian male presented with a 2-week history of abdominal distension, pain, nausea and lethargy. His symptoms began 1 day after an all-terrain vehicle accident during which he suffered blunt-force trauma to his mid-right abdomen. CT scan demonstrated abnormal thickening of the ascending colon and terminal ilium with surrounding inflammation within the retroperitoneum and colonic mesentery. Given his likely mechanism and symptomatic improvement, he was initially managed conservatively. However, he was readmitted with recurrence of symptoms, and a repeat CT scan demonstrated no interval improvement. An exploratory laparotomy was performed and a firm, fixed mass of the right-colon and colonic mesentery was found. Final histopathology of the mass revealed a diffuse lymphoid infiltrate with numerous mitotic figures and apoptotic cells. Immunohistochemical staining was positive for CD45, CD20, CD10, and BCL-6 and negative for CD3, TdT, and BCL-2, indicating a diagnosis of Burkitt lymphoma.
The nature of 500 micron risers I: SMA observations
Authors: Greenslade J , Clements D L , Petitpas G , Asboth V , Conley A , Pérez-Fournon I , Riechers D
Published: June 2020

We present SMA observations at resolutions from 0.35 to 3 arcsec of a sample of 34 candidate high redshift dusty star forming galaxies (DSFGs). These sources were selected from the HerMES Herschel survey catalogues to have SEDs rising from 250 to 350 to 500 μm, a population termed 500-risers. We detect counterparts to 24 of these sources, with four having two counterparts. We conclude that the remaining ten sources that lack detected counterparts are likely to have three or more associated sources which blend together to produce the observed Herschel source. We examine the role of lensing, which is predicted to dominate the brightest (F500 > 60 mJy) half of our sample. We find that while lensing plays a role, at least 35 per cent of the bright sources are likely to be multiple sources rather than the result of lensing. At fainter fluxes we find a blending rate comparable to, or greater than, the predicted 40 per cent. We determine far-IR luminosities and star formation rates for the non-multiple sources in our sample and conclude that, in the absence of strong lensing, our 500-risers are very luminous systems with LFIR > 1013 L⊙ and star formation rates >1000 M⊙ yr−1.
Merger rates in primordial black hole clusters without initial binaries
Authors: Korol Valeriya , Mandel Ilya , Miller M Coleman , Church Ross P , Davies Melvyn B
Published: June 2020

Primordial black holes formed through the collapse of cosmological density fluctuations have been hypothesized as contributors to the dark matter content of the Universe. At the same time, their mergers could contribute to the recently observed population of gravitational-wave sources. We investigate the scenario in which primordial black holes form binaries at late times in the Universe. Specifically, we re-examine the mergers of primordial black holes in small clusters of ∼30 objects in the absence of initial binaries. Binaries form dynamically through Newtonian gravitational interactions. These binaries act as heat sources for the cluster, increasing the cluster’s velocity dispersion, which inhibits direct mergers through gravitational-wave two-body captures. Meanwhile, three-body encounters of tight binaries are too rare to tighten binaries sufficiently to allow them to merge through gravitational-wave emission. We conclude that in the absence of initial binaries, merger rates of primordial black holes in the considered scenario are at least an order of magnitude lower than previously suggested, which makes gravitational-wave detections of such sources improbable.
Faraday rotation measures of Northern hemisphere pulsars using CHIME/Pulsar
Authors: Ng C , Pandhi A , Naidu A , Fonseca E , Kaspi V M , Masui K W , Mckinven R , Renard A , Scholz P , Stairs I H , Tendulkar S P , Vanderlinde K
Published: June 2020

Using commissioning data from the first year of operation of the Canadian Hydrogen Intensity Mapping Experiment’s (CHIME) Pulsar backend system, we conduct a systematic analysis of the Faraday Rotation Measure (RM) of the Northern hemisphere pulsars detected by CHIME. We present 55 new RMs as well as obtain improved RM uncertainties for 25 further pulsars. CHIME’s low observing frequency and wide bandwidth between 400 and 800 MHz contribute to the precision of our measurements, whereas the high cadence observation provides extremely high signal-to-noise co-added data. Our results represent a significant increase of the pulsar RM census, particularly regarding the Northern hemisphere. These new RMs are for sources that are located in the Galactic plane out to 10 kpc, as well as off the plane to a scale height of ∼16 kpc. This improved knowledge of the Faraday sky will contribute to future Galactic large-scale magnetic structure and ionosphere modelling.
Empirical completeness assessment of the Gaia DR2, Pan-STARRS 1, and ASAS-SN-II RR Lyrae catalogues
Authors: Mateu Cecilia , Holl Berry , De Ridder Joris , Rimoldini Lorenzo
Published: June 2020

RR Lyrae stars are an important and widely used tracer of the most ancient populations of our Galaxy, mainly due to their standard candle nature. The current availability of large-scale surveys of variable stars is allowing us to trace the structure of our entire Galaxy, even in previously inaccessible areas like the Galactic disc. In this work, we aim to provide an empirical assessment of the completeness of the three largest RR Lyrae catalogues available: Gaia DR2, PanSTARRS-1, and ASAS-SN-II. Using a joint probabilistic analysis of the three surveys we compute 2D and 3D completeness maps in each survey’s full magnitude range. At the bright end (G < 13), we find that ASAS-SN-II and Gaia are near 100 per cent complete in RRab at high latitude (|b| > 20°); ASAS-SN-II has the best completeness at low latitude for RRab and at all latitudes for RRc. At the faint end (G > 13), Gaia DR2 is the most complete catalogue for both RR Lyrae types, at any latitude, with median completeness rates of $95{{\ \rm per\ cent}}$ (RRab) and $\gt 85{{\ \rm per\ cent}}$ (RRc) outside the ecliptic plane (|β| > 25°). We confirm high and uniform completeness of PanSTARRS-1 RR Lyrae at 91 per cent (ab) and 82 per cent (c) down to G ∼ 18, and provide the first estimate of its completeness at low galactic latitude (|b| ≤ 20°) at estimated medians $65{{\ \rm per\ cent}}$ (ab) and $50\!-\!60{{\ \rm per\ cent}}$ (c). Our results are publicly available as 2D and 3D completeness maps, and as functions to evaluate each survey’s completeness versus distance or per line of sight.
Interspecific Gene Flow and the Evolution of Specialization in Black and White Rhinoceros
Authors: Moodley Yoshan , Westbury Michael V , Russo Isa-Rita M , Gopalakrishnan Shyam , Rakotoarivelo Andrinajoro , Olsen Remi-Andre , Prost Stefan , Tunstall Tate , Ryder Oliver A , Dalén Love , Bruford Michael W
Published: June 2020

Africa’s black (Diceros bicornis) and white (Ceratotherium simum) rhinoceros are closely related sister-taxa that evolved highly divergent obligate browsing and grazing feeding strategies. Although their precursor species Diceros praecox and Ceratotherium mauritanicum appear in the fossil record ∼5.2 Ma, by 4 Ma both were still mixed feeders, and were even spatiotemporally sympatric at several Pliocene sites in what is today Africa’s Rift Valley. Here, we ask whether or not D. praecox and C. mauritanicum were reproductively isolated when they came into Pliocene secondary contact. We sequenced and de novo assembled the first annotated black rhinoceros reference genome and compared it with available genomes of other black and white rhinoceros. We show that ancestral gene flow between D. praecox and C. mauritanicum ceased sometime between 3.3 and 4.1 Ma, despite conventional methods for the detection of gene flow from whole genome data returning false positive signatures of recent interspecific migration due to incomplete lineage sorting. We propose that ongoing Pliocene genetic exchange, for up to 2 My after initial divergence, could have potentially hindered the development of obligate feeding strategies until both species were fully reproductively isolated, but that the more severe and shifting paleoclimate of the early Pleistocene was likely the ultimate driver of ecological specialization in African rhinoceros.
State changes of the HORMA protein ASY1 are mediated by an interplay between its closure motif and PCH2
Authors: Yang Chao , Hu Bingyan , Portheine Stephan Michael , Chuenban Pichaporn , Schnittger Arp
Published: June 2020

HORMA domain-containing proteins (HORMADs) play an essential role in meiosis in many organisms. The meiotic HORMADs, including yeast Hop1, mouse HORMAD1 and HORMAD2, and Arabidopsis ASY1, assemble along chromosomes at early prophase and the closure motif at their C-termini has been hypothesized to be instrumental for this step by promoting HORMAD oligomerization. In late prophase, ASY1 and its homologs are progressively removed from synapsed chromosomes promoting chromosome synapsis and recombination. The conserved AAA+ ATPase PCH2/TRIP13 has been intensively studied for its role in removing HORMADs from synapsed chromosomes. In contrast, not much is known about how HORMADs are loaded onto chromosomes. Here, we reveal that the PCH2-mediated dissociation of the HORMA domain of ASY1 from its closure motif is important for the nuclear targeting and subsequent chromosomal loading of ASY1. This indicates that the promotion of ASY1 to an ‘unlocked’ state is a prerequisite for its nuclear localization and chromosomal assembly. Likewise, we find that the closure motif is also necessary for the removal of ASY1 by PCH2 later in prophase. Our work results in a unified new model for PCH2 and HORMADs function in meiosis and suggests a mechanism to contribute to unidirectionality in meiosis.
Regulation of alginate catabolism involves a GntR family repressor in the marine flavobacterium Zobellia galactanivorans DsijT
Authors: Dudek Magda , Dieudonné Anissa , Jouanneau Diane , Rochat Tatiana , Michel Gurvan , Sarels Benoit , Thomas François
Published: June 2020

Marine flavobacteria possess dedicated Polysaccharide Utilization Loci (PULs) enabling efficient degradation of a variety of algal polysaccharides. The expression of these PULs is tightly controlled by the presence of the substrate, yet details on the regulatory mechanisms are still lacking. The marine flavobacterium Zobellia galactanivorans DsijT digests many algal polysaccharides, including alginate from brown algae. Its complex Alginate Utilization System (AUS) comprises a PUL and several other loci. Here, we showed that the expression of the AUS is strongly and rapidly (<30 min) induced upon addition of alginate, leading to biphasic substrate utilization. Polymeric alginate is first degraded into smaller oligosaccharides that accumulate in the extracellular medium before being assimilated. We found that AusR, a GntR family protein encoded within the PUL, regulates alginate catabolism by repressing the transcription of most AUS genes. Based on our genetic, genomic, transcriptomic and biochemical results, we propose the first model of regulation for a PUL in marine bacteria. AusR binds to promoters of AUS genes via single, double or triple copies of operator. Upon addition of alginate, secreted enzymes expressed at a basal level catalyze the initial breakdown of the polymer. Metabolic intermediates produced during degradation act as effectors of AusR and inhibit the formation of AusR/DNA complexes, thus lifting transcriptional repression.
Coccidioidomycosis in Patients Treated With Ruxolitinib
Authors: Kusne Yael , Kimes Kathryn E , Feller Fionna F , Patron Roberto , Banacloche Juan Gea , Blair Janis E , Vikram Holenarasipur R , Ampel Neil M
Published: June 2020

We report 8 cases of coccidioidomycosis associated with ruxolitinib treatment. Among 135 patients living in the coccidioidal-endemic region receiving ruxolitinib, 5 cases were diagnosed after starting and 4 had extrathoracic dissemination. Periodic serological screening while on ruxolitinib is warranted for patients residing in the coccidioidal-endemic region.
SWEAT2 Study: Effectiveness of Trunk Training on Gait and Trunk Kinematics After Stroke: A Randomized Controlled Trial
Authors: Van Criekinge Tamaya , Hallemans Ann , Herssens Nolan , Lafosse Christophe , Claes Dirk , De Hertogh Willem , Truijen Steven , Saeys Wim
Published: June 2020

Objective

Trunk training after stroke is an effective method for improving mobility, yet underlying associations leading to the observed mobility carryover effects are unknown. The purposes of this study were to investigate the effectiveness of trunk training for gait and trunk kinematics and to find explanatory variables for the mobility carryover effects.

Methods

This study was an assessor-masked, randomized controlled trial. Participants received either additional trunk training (n = 19) or cognitive training (n = 20) after subacute stroke. Outcome measures were the Tinetti Performance-Oriented Mobility Assessment (POMA), the Trunk Impairment Scale, spatiotemporal gait parameters, center-of-mass excursions, and trunk and lower limb kinematics during walking. Multivariate analysis with post hoc analysis was performed to observe treatment effects. Correlation and an exploratory regression analysis were used to examine associations with the mobility carryover effects.

Results

Significant improvements after trunk training, compared with the findings for the control group, were found for the Trunk Impairment Scale, Tinetti POMA, walking speed, step length, step width, horizontal/vertical center-of-mass excursions, and trunk kinematics. No significant differences were observed in lower limb kinematics. Anteroposterior excursions of the trunk were associated with 30% of the variability in the mobility carryover effects.

Conclusions

Carryover effects of trunk control were present during ambulation. Decreased anteroposterior movements of the thorax were the main variable explaining higher scores on the Tinetti POMA Gait subscale. However, the implementation and generalizability of this treatment approach in a clinical setting are laborious and limited, necessitating further research.

Impact

Trunk training is an effective strategy for improving mobility after stroke. Regaining trunk control should be considered an important treatment goal early after stroke to adequately prepare patients for walking.
The Relationship Between Residents’ Perceptions of Residency Program Leadership Team Behaviors and Resident Burnout and Satisfaction
Authors: Dyrbye Liselotte N. , Leep Hunderfund Andrea N. , Winters Richard C. , Moeschler Susan M. , Vaa Stelling Brianna E. , Dozois Eric J. , Satele Daniel V. , West Colin P.
Published: June 2020

Purpose

To explore the relationship between residents’ perceptions of residency program leadership team behaviors and resident burnout and satisfaction.

Method

In February 2019, the authors surveyed all residents across the 77 graduate medical education training programs at Mayo Clinic’s multiple sites. Survey items measured residents’ perceptions of program director and associate program director behaviors (using a composite residency program leadership team score), resident burnout, and resident satisfaction with the program and organization. Multivariable logistic regression was performed to evaluate relationships between these variables at the individual resident (adjusting for age, sex, postgraduate training year, program location, and specialty) and program (including only programs with at least 5 respondents) levels.

Results

Of the 1,146 residents surveyed, 762 (66.5%) responded. At the individual resident level, higher composite leadership team scores were associated with lower emotional exhaustion and depersonalization and higher overall satisfaction with the residency program and organization (all P < .001). In adjusted logistic regression models, each 1-point gain in composite leadership team score was associated with 9% lower odds of burnout, 20% higher odds of program satisfaction, and 19% higher odds of satisfaction with the organization (all P < .001). At the residency program level, higher mean composite leadership team scores were associated with a lower rate of burnout (r = −0.35, P = .03) and higher program and organization satisfaction (r = 0.67 and 0.74, respectively, both P < .001).

Conclusions

The behaviors of residency program leadership teams influence residents’ burnout and satisfaction. Additional studies are needed to determine if leadership training results in improved resident well-being and satisfaction.
What Works? Processes of Change in a Transdiagnostic Exposure Treatment for Patients With Chronic Pain and Emotional Problems
Authors: Södermark Martin , Linton Steven J. , Hesser Hugo , Flink Ida , Gerdle Björn , Boersma Katja
Published: June 2020

Objectives:

We recently developed a transdiagnostic exposure treatment (the hybrid treatment) for chronic pain patients with concurrent emotional difficulties. This paper investigates the hypothesized treatment processes, specifically: (1) if changes on pain-related dysregulation (catastrophizing, fear-avoidance, and nonacceptance of pain) and general emotion dysregulation (difficulties to regulate a broad spectrum of emotional responses) mediate effects on outcomes; and (2) if mediation is more pronounced for patients who score higher on these processes pretreatment.

Materials and Methods:

Structural equation modeling for longitudinal data using the full intention-to-treat sample was used to test whether proposed variables mediated the effect of the hybrid treatment (n=58) compared with a guided internet-delivered pain management treatment based on cognitive-behavioral principles (n=57) on pain interference and depressive symptoms at the 9-month follow-up. To make full use of the multiple process measures collected in the trial, we modeled mediators as 2 continuous latent variables: pain-related dysregulation and general emotion dysregulation.

Results:

Reduced pain-related dysregulation mediated the effects of treatment on both outcomes, whereas reduced general emotion dysregulation mediated the effects on depressive symptoms only. In the hybrid treatment, the mediated effect was more pronounced for participants who scored higher on pain-related dysregulation pretreatment relative to those who scored lower.

Discussion:

Our findings provide initial support for the transdiagnostic theoretical underpinnings of the hybrid treatment model. Using a hybrid treatment approach that centers on teaching patients emotion-regulation skills before commencing broad exposure successfully influenced both pain-related dysregulation and general emotion dysregulation, which in turn was associated with better treatment outcomes. It appears central to address these processes in pain patients with comorbid emotional problems, especially among patients scoring high on measures of catastrophizing, fear-avoidance, and nonacceptance of pain.
Surgical Approach and Internal Fixation Techniques for Intra-Articular Distal Humerus Fracture With Coronal Shear Capitellar Fracture
Authors: Chang Andy L. , Dieterich James D. , DiPrinzio Eliseo V. , Kim Jaehon M.
Published: June 2020

Intra-articular distal humerus fractures with an associated coronal shear capitellar fragment present a challenge for stable internal fixation. Adequate visualization and fixation of the capitellar shear fragment are difficult to achieve with conventional exposures, including the olecranon osteotomy. The capitellar fragment often translates anterior and proximally and is challenging to visualize with intact soft tissue attachments from a posterior approach. We describe a surgical exposure that releases the lateral ulnar collateral ligament in addition to an olecranon osteotomy to allow complete visualization of the entire articular surface. In contrast to an isolated capitellar fracture, the column stability and the posterior cortex are frequently disrupted with distal humerus fractures. Depending on the comminution of the posterior cortex, a supplemental posterolateral plate or headless compression screws can provide fixation to the coronal fracture plane. The lateral ulnar collateral ligament is repaired at the conclusion of fracture stabilization through a bone tunnel or to the plate to restore lateral stability. Despite the release of the ligament and additional soft tissue stripping, there were no cases of elbow instability or avascular necrosis in our case series of 9 patients.
Intramedullary Headless Screw Fixation for Metacarpal Fractures
Authors: Sellers Thomas R. , Lewis Jesse T. , Smith Carson , Nydick Jason A.
Published: June 2020

Multiple techniques have been proposed for metacarpal fracture fixation, including percutaneous Kirschner-wires, interfragmentary screws, plate and screw constructs, intramedullary (IM) nails, and cannulated IM headless screws. Each of these treatment options has its proposed advantages and disadvantages, and there remains no consensus on the optimal mode of treatment. We describe a technique of retrograde IM headless screw fixation for extra-articular metacarpal fractures.
Increase in Central Venous Pressure During Passive Leg Raising Cannot Detect Preload Unresponsiveness
Authors: Hamzaoui Olfa , Gouëzel Corentin , Jozwiak Mathieu , Millereux Maude , Sztrymf Benjamin , Prat Dominique , Jacobs Frederic , Monnet Xavier , Trouiller Pierre , Teboul Jean-Louis
Published: June 2020

Objective:

By analogy with the classical central venous pressure rules to assess a fluid challenge, we hypothesized that an increase in central venous pressure greater than or equal to 5 cm H2O (i.e., 4 mm Hg) during passive leg raising can predict preload unresponsiveness diagnosed by the absence of increase in velocity-time integral of the left ventricular outflow tract greater than or equal to 10% during the test (negative passive leg raising test).

Design and Settings:

Velocity-time integral was measured by transthoracic echocardiography. Central venous pressure and velocity-time integral were measured before and during passive leg raising.

Patients:

Critically ill patients for whom the physician decided to test preload responsiveness by passive leg raising were prospectively included.

Measurement and Main Results:

Fifty-seven set of measurements were performed in 50 patients. Preload unresponsiveness (negative passive leg raising test) was observed in 32 cases. The changes in central venous pressure during passive leg raising did not differ between positive passive leg raising cases (positive passive leg raising test) and negative passive leg raising test cases (3 ± 2 vs 3 ± 2 mm Hg, respectively) and thus did not predict preload unresponsiveness (area under the receiver-operating characteristic curve of 0.59). An increase in central venous pressure greater than or equal to 4 mm Hg during passive leg raising was observed in 10 cases of positive passive leg raising test and in 11 cases of negative passive leg raising test. Taking an increase in central venous pressure greater than or equal to 3 or greater than or equal to 5 mm Hg rather than greater than or equal to 4 mm Hg during passive leg raising did not better allow one to identify negative passive leg raising test.

Conclusions:

Marked increase in central venous pressure during passive leg raising cannot identify negative passive leg raising test cases and thus preload unresponsiveness. Measurements of cardiac output (or its surrogates) during passive leg raising are, thus, mandatory to appropriately interpret this test.
Central Venous-to-Arterial Pco 2 Difference and Central Venous Oxygen Saturation in the Detection of Extubation Failure in Critically Ill Patients*
Authors: Mallat Jihad , Baghdadi Fawzi Ali , Mohammad Usman , Lemyze Malcolm , Temime Johanna , Tronchon Laurent , Thevenin Didier , Fischer Marc-Olivier
Published: June 2020

Objectives:

To evaluate the ability of central venous-to-arterial carbon dioxide pressure difference, central venous oxygen saturation, and the combination of these two parameters to detect extubation failure in critically ill patients.

Design:

Multicentric, prospective, observational study.

Setting:

Three ICUs.

Patients:

All patients who received mechanical ventilation for more than 48 hours and tolerated spontaneous breathing trials with a T-piece for 60 minutes.

Interventions:

Extubation after successful spontaneous breathing trials. Extubation failure was defined as the need for mechanical ventilation within 48 hours.

Measurements and Main Results:

The oxygen delivery index, oxygen consumption index, central venous oxygen saturation, central venous-to-arterial carbon dioxide pressure difference, and oxygen extraction were measured immediately before spontaneous breathing trials and at 60 minutes after spontaneous breathing trials initiation. Seventy-five patients were enrolled, and extubation failure was noted in 18 (24%) patients. Oxygen consumption index increased significantly during spontaneous breathing trials in the failure group. Oxygen delivery index increased in both success and failure groups. Oxygen extraction increased in the failure group (p = 0.005) and decreased in the success group (p = 0.001). Central venous oxygen saturation decreased in the failure group and increased in the success group (p = 0.014). ΔPco2
value increased in the extubation failure group and decreased in the success group (p = 0.002). Changes in ΔPco2
(Δ – ΔPCO2) and central venous oxygen saturation (ΔScvO2) during spontaneous breathing trials were independently associated with extubation failure (odds ratio, 1.02; 95% CI, 1.01–1.05; p = 0.006, and odds ratio, 0.84; 95% CI, 0.70–0.95; p = 0.02, respectively). Δ – ΔPCO2 and central venous oxygen saturation could predict extubation failure with areas under the curve of 0.865 and 0.856, respectively; however, their combined areas under the curve was better at 0.940.

Conclusions:

We found that Δ – ΔPco
2 and central venous oxygen saturation, during spontaneous breathing trials, were independent predictors of weaning outcomes. Combination analysis of both parameters enhanced their diagnostic performance and provided excellent predictability in extubation failure detection in critically ill patients.
ACR-ACNM-ASTRO-SNMMI Practice Parameter for the Performance of Therapy With Radium-223
Authors: Hurwitz Mark , Buscombe John R. , Jacene Heather A. , Klitzke Alan K. , Lamonica Dominick , Lu Yang , Pryma Daniel A. , Rohren Eric M. , Speer Tod W. , Subramaniam Rathan M. , Thompson Holly M. , Tomblyn Michael B. , Wong William W. , Xiao Ying , Banks Kevin P. , Brown Richard K.J.
Published: June 2020

Aim/Objectives/Background:

The goal of therapy with unsealed radiopharmaceutical sources is to provide either cure or significant prolongation of disease-specific survival, and effective reduction and/or prevention of adverse disease-related symptoms or untoward events while minimizing treatment-associated side effects and complications. Radium-223 dichloride (radium-223) is an alpha particle–emitting isotope used for targeted bone therapy. This practice parameter is intended to guide appropriately trained and licensed physicians performing therapy with radium-223. Such therapy requires close cooperation and communication between the physicians who are responsible for the clinical management of the patient and those who administer radiopharmaceutical therapy and manage the attendant side effects. Adherence to this parameter should help to maximize the efficacious use of radium-223, maintain safe conditions, and ensure compliance with applicable regulations.

Methods:

This practice parameter was developed according to the process described on the American College of Radiology (ACR) website (“The Process for Developing ACR Practice Parameters and Technical Standards,” www.acr.org/ClinicalResources/Practice-Parameters-and-Technical-Standards) by the Committee on Practice Parameters of the ACR Commission on Radiation Oncology in collaboration with the American College of Nuclear Medicine (ACNM), the American Society for Radiation Oncology (ASTRO), and the Society of Nuclear Medicine and Molecular Imaging (SNMMI). All these societies contributed to the development of the practice parameter and approved the final document.

Results:

This practice parameter addresses the many factors which contribute to appropriate, safe, and effective clinical use of radium-223. Topics addressed include qualifications and responsibilities of personnel, specifications of patient examination and treatment; documentation, radiation safety, quality control/improvement, infection control, and patient education.

Conclusions:

This practice parameter is intended as a tool to guide clinical use of radium-223 with the goal of facilitating safe and effective medical care based on current knowledge, available resources and patient needs. The sole purpose of this document is to assist practitioners in achieving this objective.