bluuebunny/crossref_metadata_2025 huggingface dataset:
Bulky granulomatous disease resulting in constrictive tuberculous pericarditis requiring pericardiectomy: a case report
Authors: Barua Sumita , Phua Bernadette , Orr Yishay , Skinner Michael
Published: September 2020

Background 

We present a 23-year-old Nepalese migrant with mycobacterial tuberculosis (TB) pericarditis manifesting as effusive constrictive disease and subsequent rapid progression to constrictive pericarditis resulting from bulky granulomatous disease.

Case summary 

Following initial presumptive diagnosis of TB pericarditis based on presence of moderate pericardial effusion and positive polymerase chain reaction on concurrent pleural aspirate, the patient was managed with standard empiric therapy. Despite treatment, he developed progressive heart failure with New York Heart Association (NYHA) class III symptoms and had confirmation of constrictive physiology on simultaneous left and right heart catheterization. He underwent pericardiectomy 4 months after his initial diagnosis, with debridement of large necrotizing granulomas and an associated immediate improvement clinical improvement. He remains well at 6-month follow-up with no residual heart failure symptoms off diuretic therapy.

Discussion 

Tuberculous pericarditis accounts for 1–2% of presentations with TB infection, with progression to constrictive pericarditis in between 17 and 40% of cases. To date, pericardiectomy remains mainstay of treatment for constriction, albeit with high perioperative risk. In combination with anti-tuberculous therapy, prednisone and pericardiocentesis may reduce risk of progression to constriction, however, neither have shown mortality benefit. Our patient continued to progress, despite medical therapy and proceeded to pericardiectomy only 4 months after his initial diagnosis, with rapid improvement in symptoms, demonstrating the importance of close monitoring and revision of management strategy in these patients.
Catheter ablation or medical therapy to delay progression of atrial fibrillation: the randomized controlled atrial fibrillation progression trial (ATTEST)
Authors: Kuck Karl-Heinz , Lebedev Dmitry S , Mikhaylov Evgeny N , Romanov Alexander , Gellér László , Kalējs Oskars , Neumann Thomas , Davtyan Karapet , On Young Keun , Popov Sergey , Bongiorni Maria Grazia , Schlüter Michael , Willems Stephan , Ouyang Feifan
Published: September 2020

Aims

Delay of progression from paroxysmal to persistent atrial fibrillation (AF) is an important measure of long-term success of AF treatment. However, published data on the impact of catheter ablation on AF progression are limited. This study evaluates whether radiofrequency (RF) catheter ablation delays the progression of AF compared with antiarrhythmic drug (AAD) treatment using current AF management guidelines.

Methods

This prospective, randomized, controlled, two-arm, open-label trial was conducted at 29 hospitals and medical centres across 13 countries. Patients were randomized 1 : 1 to RF ablation or AAD treatment. The primary endpoint was the rate of persistent AF/atrial tachycardia (AT) at 3 years.

Results

After early study termination following slow enrolment, 255 (79%) of the planned 322 patients were enrolled (RF ablation, n = 128, AAD, n = 127); 36% of patients in the RF ablation group and 41% in the AAD group completed 3 years of follow-up. For the primary endpoint, the Kaplan–Meier estimate of the rate of persistent AF/AT at 3 years was significantly lower with RF ablation [2.4% (95% confidence interval (CI), 0.6–9.4%)] than with AAD therapy [17.5% (95% CI, 10.7–27.9%); one-sided P = 0.0009]. Patients ≥65 years were ∼4 times more likely to progress to persistent AF/AT than patients <65 years, suggesting RF ablation can delay disease progression [hazard ratio: 3.87 (95% CI, 0.88–17.00); P = 0.0727]. Primary adverse events were reported for eight patients in the RF ablation group.

Conclusions

Radiofrequency ablation is superior to guideline-directed AAD therapy in delaying the progression from paroxysmal to persistent AF.
Development of a narrow-band imaging classification to reduce the need for routine biopsies of gastric polyps
Authors: Asztalos Ivor B , Colling Caitlin A , Buchner Anna M , Chandrasekhara Vinay
Published: September 2020

Background

Most incidental gastric polyps identified during upper endoscopy are considered low-risk. However, current guidelines recommend sampling all gastric polyps for histopathologic analysis. We aimed to devise a simple narrow-band imaging (NBI) classification to reduce the need for routine biopsies of low-risk gastric polyps.

Methods

Pairs of NBI and white-light images were collected from 73 gastric polyps for which concurrent histopathologic diagnosis was available. A diagnostic accuracy cohort study was performed. Two blinded endoscopists independently analysed NBI features of each polyp for color, vessel pattern, surface pattern, and any combinations thereof to develop a classification scheme to differentiate low-risk polyps (fundic-gland or hyperplastic) from high-risk polyps (adenomatous or adenocarcinoma) and fundic-gland polyps (FGPs) from non-FGPs.

Results

An isolated lacy vessel pattern and a homogenous absence of surface pattern successfully differentiated low-risk from high-risk gastric polyps. Combining both descriptors into a single algorithm resulted in a negative predictive value (NPV) of 100% [95% confidence interval (CI): 100%–100%], positive predictive value (PPV) of 13.7% (95% CI: 2.6–24.8), sensitivity of 100% (95% CI: 100%–100%), and specificity of 53.7% (95% CI: 45.3%–62.0%) for high-risk polyps. This would reduce the number of polyps requiring biopsy by 50%, while still capturing all high-risk polyps. Regarding FGPs, using a rule not to biopsy polyps with isolated lacy vessels resulted in a 94.9% NPV (95% CI: 89.2%–100%), 63.2% PPV (95% CI: 47.2%–79.2%), 94.8% sensitivity (95% CI: 89.5%–100%), and 63.6% specificity (95% CI: 51.3%–76.0%) for non-FGPs.

Conclusion

In this derivation cohort study, NBI is helpful for differentiating between high-risk and low-risk gastric polyps, thereby reducing the need for routine sampling of low-risk polyps. These results need to be validated in a separate test population.
Effective use of online depression information and associated literacies among US college students
Authors: Gu Yulong , Kalibatseva Zornitsa , Song Xu
Published: September 2020

Mental health issues, such as depression, are rising among young people, who may benefit from online depression-related information. However, the competencies required to search for health information on the Internet and evaluate it before use may be poor among this population. This research aimed to investigate how college students use the Internet for solving problems in realistic case scenarios relevant to depression and to understand whether various literature-indicated literacies and factors may predict effective utilization of relevant online resources. We designed a web-based questionnaire survey including four depression-related case scenarios. A total of 218 undergraduate students who were enrolled in a Northeastern public US university were invited to participate in the survey in 2016, with 192 completed responses being included in this analysis (response rate = 88%; the participants’ median age = 20; 79% female). Approximately half of the participants (47%) answered the depression-related questions in the case scenarios with 90% or higher accuracy. In a multiple linear regression model, prior depression knowledge and eHealth information literacy significantly predicted the effective use of online depression information. However, medical literacy and critical health literacy were not significant predictors. A few additional demographic and experience related factors were positively associated with the effective Internet use (e.g. female, non-Hispanic, psychology or health science major and prior experience with depression). These findings identify a need for college students to develop domain-specific knowledge and literacies in order to facilitate effective use of online information about depression.
Reproductive outcomes of women aged 40 and older undergoing IVF with donor sperm
Authors: Bortoletto P , Willson S , Romanski P A , Davis O K , Rosenwaks Z
Published: September 2020

STUDY QUESTION

Do women ≥40 years old without a male partner who utilize donor sperm have the same reproductive outcomes as those who utilize their partner’s sperm?

SUMMARY ANSWER

After controlling for relevant confounders, women ≥40 years old using donor sperm for IVF have significantly higher odds of having a live birth compared to those utilizing their partner’s sperm.

WHAT IS KNOWN ALREADY

Women who are unpartnered or in same-sex relationships are by definition not infertile, but may choose to conceive using donor sperm. It is not known how IVF outcomes are affected with the use of donor sperm compared to women utilizing their partner’s sperm, particularly at very advanced maternal ages.

STUDY DESIGN, SIZE, DURATION

This is a retrospective cohort study conducted at a university-affiliated center of women undergoing IVF with fresh embryo transfer between 2008 and 2018.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Patients were divided into two groups based on the ejaculated sperm source utilized: donor or partner sperm. Live birth rate was the primary outcome. Pregnancy rate was the secondary outcome. Multivariable logistic regression was performed and adjusted for age, the developmental stage of the embryo, and the number of embryos transferred. Unadjusted odds ratio (OR) and adjusted OR (aOR) with 95% CI for pregnancy and live birth were estimated. Statistical significance was denoted by P < 0.05.

MAIN RESULTS AND THE ROLE OF CHANCE

A total of 3910 cycles in women ≥40 years old were analyzed, of which 307 utilized donor sperm and 3603 utilized their partner’s sperm to conceive. In the univariate analysis, patients utilizing donor sperm were found to have similar pregnancy rates as those utilizing partner sperm (41.0 vs 39.8%, OR: 0.95, 95% CI: 0.75–1.20). After adjusting for age, the number of embryos transferred and the developmental stage of the embryos, the model estimates did not vary (aOR: 1.22, 95% CI: 0.95–1.56). Similarly, the univariate analysis for live birth did not demonstrate a difference between groups (19.2 vs 17.8%, OR: 0.91, 95% CI: 0.67–1.22). However, after a similar adjustment was made for confounders, the use of donor sperm was associated with statistically significant increased odds of live birth (aOR: 1.38, 95% CI: 1.01–1.88).

LIMITATIONS, REASONS FOR CAUTION

As with any retrospective study, the potential for residual confounding exists, despite attempts to control for this with regression modeling.

WIDER IMPLICATIONS OF THE FINDINGS

Women ≥40 years old who are unpartnered or in same-sex relationships can be counseled that their odds of a live birth are slightly better than women in heterosexual relationships utilizing their partner’s sperm. These findings serve to further refine and individualize counseling on the expected IVF outcomes for women in this population.

STUDY FUNDING/COMPETING INTEREST(S)

No funding was sought for this study. The authors declare no competing interests.

TRIAL REGISTRATION NUMBER

N/A.
Potential limitations in COVID-19 machine learning due to data source variability: A case study in the nCov2019 dataset
Authors: Sáez Carlos , Romero Nekane , Conejero J Alberto , García-Gómez Juan M
Published: September 2020

Objective

The lack of representative coronavirus disease 2019 (COVID-19) data is a bottleneck for reliable and generalizable machine learning. Data sharing is insufficient without data quality, in which source variability plays an important role. We showcase and discuss potential biases from data source variability for COVID-19 machine learning.

Materials and Methods

We used the publicly available nCov2019 dataset, including patient-level data from several countries. We aimed to the discovery and classification of severity subgroups using symptoms and comorbidities.

Results

Cases from the 2 countries with the highest prevalence were divided into separate subgroups with distinct severity manifestations. This variability can reduce the representativeness of training data with respect the model target populations and increase model complexity at risk of overfitting.

Conclusions

Data source variability is a potential contributor to bias in distributed research networks. We call for systematic assessment and reporting of data source variability and data quality in COVID-19 data sharing, as key information for reliable and generalizable machine learning.
Encapsulated Papillary Carcinoma of the Breast: Imaging Features with Histopathologic Correlation
Authors: Bonnet Sarah E , Carter Gloria J , Berg Wendie A
Published: September 2020

Encapsulated papillary carcinoma (EPC) is a rare, clinically indolent breast malignancy most common in postmenopausal women. Absence of myoepithelial cells at the periphery is a characteristic feature. Mammographically, EPC typically presents as a mostly circumscribed, noncalcified, dense mass that can have focally indistinct margins when there is associated frank invasive carcinoma. Ultrasound shows a circumscribed solid or complex cystic and solid mass, and occasional hemorrhage in the cystic component may produce a fluid-debris level; the solid components typically show intense washout enhancement on MRI. Color Doppler may demonstrate a prominent vascular pedicle and blood flow within solid papillary fronds. Encapsulated papillary carcinoma can exist in pure form; however, EPC is often associated with conventional ductal carcinoma in-situ and/or invasive ductal carcinoma, no special type. Adjacent in-situ and invasive disease may be only focally present at the periphery of EPC and potentially unsampled at core-needle biopsy. In order to facilitate diagnosis, the mass wall should be included on core-needle biopsy, which will show absence of myoepithelial markers. Staging and prognosis are determined by any associated frankly invasive component, with usually excellent long-term survival and rare distant metastases.
Characteristics and Outcome of SARS-CoV-2 Infection in Cancer Patients
Authors: Basse Clémence , Diakite Sarah , Servois Vincent , Frelaut Maxime , Noret Aurélien , Bellesoeur Audrey , Moreau Pauline , Massiani Marie-Ange , Bouyer Anne-Sophie , Vuagnat Perrine , Malak Sandra , Bidard François-Clément , Vanjak Dominique , Kriegel Irène , Burnod Alexis , Bilger Geoffroy , Ramtohul Toulsie , Dhonneur Gilles , Bouleuc Carole , Cassoux Nathalie ,   Institut Curie COVID Group,, Paoletti Xavier , Bozec Laurence , Cottu Paul
Published: September 2020

Background

Concerns have emerged about the higher risk of fatal coronavirus disease 2019 (COVID-19) in cancer patients. In this article, we review the experience of a comprehensive cancer center.

Methods

A prospective registry was set up at Institut Curie at the beginning of the COVID-19 pandemic. All cancer patients with suspected or proven COVID-19 were entered and actively followed for 28 days.

Results

Among 9842 patients treated at Institut Curie between March 13 and May 1, 2020, 141 (1.4%) were diagnosed with COVID-19, based on reverse transcription polymerase chain reaction testing and/or computerized tomography scan. In line with our case mix, breast cancer (40.4%) was the most common tumor type, followed by hematological and lung malignancies. Patients with active cancer therapy or/and advanced cancer accounted for 87.9% and 68.9% of patients, respectively. At diagnosis, 78.7% of patients had COVID-19–related symptoms, with an extent of lung parenchyma involvement inferior to 50% in 95.8% of patients. Blood count variations and C-reactive protein elevation were the most common laboratory abnormalities. Antibiotics and antiviral agents were administered in 48.2% and 6.4% of patients, respectively. At the time of analysis, 26 patients (18.4%) have died from COVID-19, and 100 (70.9%) were cured. Independent prognostic factors at the time of COVID-19 diagnosis associated with death or intensive care unit admission were extent of COVID-19 pneumonia and decreased O2 saturation.

Conclusions

COVID-19 incidence and presentation in cancer patients appear to be very similar to those in the general population. The outcome of COVID-19 is primarily driven by the initial severity of infection rather than patient or cancer characteristics.
“It Takes a While to Get Used to”: The Costs of Redeeming Public Benefits
Authors: Barnes Carolyn Y
Published: September 2020

Scholars have examined how administrative burden creates barriers to accessing public benefits but have primarily focused on the challenges of claiming benefits. Less is known about the difficulties beneficiaries face when using public benefits, especially voucher-based public assistance programs. I argue that the costs of learning how to redeem benefits can discourage program use and undermine policy goals. To enrich the administrative burden framework, this study draws from a qualitative analysis of 43 participants in the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC) to develop a new subset of learning costs—redemption costs. I argue that two conditions: limited portability and reliance on third-party agents create redemption costs for beneficiaries. I apply these two conditions to two other voucher-based programs: the Housing Choice Voucher Program and the Child Care Subsidy. Examining redemption costs can help clarify when and where beneficiaries experience burdens, reasons behind discontinuity in program participation, and why public programs fail to meet objectives.
Recent advances in the regulation of plant immunity by S-nitrosylation
Authors: Lubega Jibril , Umbreen Saima , Loake Gary J
Published: September 2020

S-nitrosylation, the addition of a nitric oxide (NO) moiety to a reactive protein cysteine (Cys) thiol, to form a protein S-nitrosothiol (SNO), is emerging as a key regulatory post-translational modification (PTM) to control the plant immune response. NO also S-nitrosylates the antioxidant tripeptide, glutathione, to form S-nitrosoglutathione (GSNO), both a storage reservoir of NO bioactivity and a natural NO donor. GSNO and, by extension, S-nitrosylation, are controlled by GSNO reductase1 (GSNOR1). The emerging data suggest that GSNOR1 itself is a target of NO-mediated S-nitrosylation, which subsequently controls its selective autophagy, regulating cellular protein SNO levels. Recent findings also suggest that S-nitrosylation may be deployed by pathogen-challenged host cells to counteract the effect of delivered microbial effector proteins that promote pathogenesis and by the pathogens themselves to augment virulence. Significantly, it also appears that S-nitrosylation may regulate plant immune functions by controlling SUMOylation, a peptide-based PTM. In this context, global SUMOylation is regulated by S-nitrosylation of SUMO conjugating enzyme 1 (SCE1) at Cys139. This redox-based PTM has also been shown to control the function of a key zinc finger transcriptional regulator during the establishment of plant immunity. Here, we provide an update of these recent advances.
The Discourse of Dignity in the Charlie Gard, Alfie Evans and Isaiah Haastrup Cases
Authors: Jonas Monique , Ryan Samantha
Published: September 2020

There are competing accounts of dignity and no agreement about how to adjudicate between them, but this does not prevent dignity from playing an important role in the law. In fact, this very multiplicity enables dignity to perform a range of functions, both explicit and implicit, intended and unintended. Its ‘open character’ allows dignity to serve as a locus of agreement, but it can also silence debate and limit speaker control of how their statements are received and interpreted. This paper considers dignity’s roles in recent English court judgments relating to withdrawal of ventilation and associated care from three unresponsive, paralysed infants: Charlie Gard, Alfie Evans, and Isaiah Haastrup. It presents a critical discourse analysis focusing on the judgments of first instance in relation to these infants. It argues that a range of conceptions of dignity are operationalised, serving four functions: to express esteem; to establish a hierarchy of credibility; to justify a best interests judgment, and to socialise that judgment. The overall effect is that dignity serves to compel acceptance of, rather than providing reasons to support, a best interests judgment. While recognising the value of unspecified invocations of dignity, we voice a warning about its potential to stifle debate and legitimise and enforce existing power relations.
Evidence from APOGEE for the presence of a major building block of the halo buried in the inner Galaxy
Authors: Horta Danny , Schiavon Ricardo P , Mackereth J Ted , Pfeffer Joel , Mason Andrew C , Kisku Shobhit , Fragkoudi Francesca , Allende Prieto Carlos , Cunha Katia , Hasselquist Sten , Holtzman Jon , Majewski Steven R , Nataf David , O’Connell Robert W , Schultheis Mathias , Smith Verne V
Published: September 2020

We report evidence from APOGEE for the presence of a new metal-poor stellar structure located within ∼4 kpc of the Galactic Centre. Characterized by a chemical composition resembling those of low-mass satellites of the Milky Way, this new inner Galaxy structure (IGS) seems to be chemically and dynamically detached from more metal-rich populations in the inner Galaxy. We conjecture that this structure is associated with an accretion event that likely occurred in the early life of the Milky Way. Comparing the mean elemental abundances of this structure with predictions from cosmological numerical simulations, we estimate that the progenitor system had a stellar mass of ∼5 × 108 M⊙, or approximately twice the mass of the recently discovered Gaia-Enceladus/Sausage system. We find that the accreted:in situ ratio within our metal-poor ([Fe/H] < –0.8) bulge sample is somewhere between 1:3 and 1:2, confirming predictions of cosmological numerical simulations by various groups.
Testing the evolution of correlations between supermassive black holes and their host galaxies using eight strongly lensed quasars
Authors: Ding Xuheng , Treu Tommaso , Birrer Simon , Agnello Adriano , Sluse Dominique , Fassnacht Chris , Auger Matthew W , Wong Kenneth C , Suyu Sherry H , Morishita Takahiro , Rusu Cristian E , Galan Aymeric
Published: September 2020

One of the main challenges in using high-redshift active galactic nuclei (AGNs) to study the correlations between the mass of a supermassive black hole ($\mathcal {M}_{\rm BH}$) and the properties of its active host galaxy is instrumental resolution. Strong lensing magnification effectively increases instrumental resolution and thus helps to address this challenge. In this work, we study eight strongly lensed AGNs with deep Hubble Space Telescope imaging, using the lens modelling code lenstronomy to reconstruct the image of the source. Using the reconstructed brightness of the host galaxy, we infer the host galaxy stellar mass based on stellar population models. $\mathcal {M}_{\rm BH}$ are estimated from broad emission lines using standard methods. Our results are in good agreement with recent work based on non-lensed AGNs, demonstrating the potential of using strongly lensed AGNs to extend the study of the correlations to higher redshifts. At the moment, the sample size of lensed AGNs is small and thus they provide mostly a consistency check on systematic errors related to resolution for non-lensed AGNs. However, the number of known lensed AGNs is expected to increase dramatically in the next few years, through dedicated searches in ground- and space-based wide-field surveys, and they may become a key diagnostic of black holes and galaxy co-evolution.
A revisit of PSR J1909−3744 with 15-yr high-precision timing
Authors: Liu K , Guillemot L , Istrate A G , Shao L , Tauris T M , Wex N , Antoniadis J , Chalumeau A , Cognard I , Desvignes G , Freire P C C , Kehl M S , Theureau G
Published: September 2020

We report on a high-precision timing analysis and an astrophysical study of the binary millisecond pulsar, PSR J1909−3744, motivated by the accumulation of data with well improved quality over the past decade. Using 15 yr of observations with the Nançay Radio Telescope, we achieve a timing precision of approximately 100 ns. We verify our timing results by using both broad-band and sub-band template matching methods to create the pulse time-of-arrivals. Compared with previous studies, we improve the measurement precision of secular changes in orbital period and projected semimajor axis. We show that these variations are both dominated by the relative motion between the pulsar system and the Solar system barycentre. Additionally, we identified four possible solutions to the ascending node of the pulsar orbit, and measured a precise kinetic distance of the system. Using our timing measurements and published optical observations, we investigate the binary history of this system using the stellar evolution code mesa, and discuss solutions based on detailed WD cooling at the edge of the WD age dichotomy paradigm. We determine the 3D velocity of the system and show that it has been undergoing a highly eccentric orbit around the centre of our Galaxy. Furthermore, we set up a constraint over dipolar gravitational radiation with the system, which is complementary to previous studies given the mass of the pulsar. We also obtain a new limit on the parametrized post-Newtonian parameter, $\left| \hat\alpha_1 \right|$ < 2.1 × 10−5 at 95 per cent confidence level, which is fractionally better than previous best published value and achieved with a more concrete method.
The GOGREEN and GCLASS surveys: first data release
Authors: Balogh Michael L , van der Burg Remco F J , Muzzin Adam , Rudnick Gregory , Wilson Gillian , Webb Kristi , Biviano Andrea , Boak Kevin , Cerulo Pierluigi , Chan Jeffrey , Cooper M C , Gilbank David G , Gwyn Stephen , Lidman Chris , Matharu Jasleen , McGee Sean L , Old Lyndsay , Pintos-Castro Irene , Reeves Andrew M M , Shipley Heath , Vulcani Benedetta , Yee Howard K C , Alonso M Victoria , Bellhouse Callum , Cooke Kevin C , Davidson Anna , De Lucia Gabriella , Demarco Ricardo , Drakos Nicole , Fillingham Sean P , Finoguenov Alexis , Forrest Ben , Golledge Caelan , Jablonka Pascale , Lambas Garcia Diego , McNab Karen , Muriel Hernan , Nantais Julie B , Noble Allison , Parker Laura C , Petter Grayson , Poggianti Bianca M , Townsend Melinda , Valotto Carlos , Webb Tracy , Zaritsky Dennis
Published: September 2020

We present the first public data release of the GOGREEN (Gemini Observations of Galaxies in Rich Early Environments) and GCLASS (Gemini CLuster Astrophysics Spectroscopic Survey) surveys of galaxies in dense environments, spanning a redshift range 0.8 < z < 1.5. The surveys consist of deep, multiwavelength photometry and extensive Gemini GMOS spectroscopy of galaxies in 26 overdense systems ranging in halo mass from small groups to the most massive clusters. The objective of both projects was primarily to understand how the evolution of galaxies is affected by their environment, and to determine the physical processes that lead to the quenching of star formation. There was an emphasis on obtaining unbiased spectroscopy over a wide stellar mass range (M ≳ 2 × 1010 M⊙), throughout and beyond the cluster virialized regions. The final spectroscopic sample includes 2771 unique objects, of which 2257 have reliable spectroscopic redshifts. Of these, 1704 have redshifts in the range 0.8 < z < 1.5, and nearly 800 are confirmed cluster members. Imaging spans the full optical and near-infrared wavelength range, at depths comparable to the UltraVISTA survey, and includes Hubble Space Telescope/Wide Field Camera 3 F160W (GOGREEN) and F140W (GCLASS). This data release includes fully reduced images and spectra, with catalogues of advanced data products including redshifts, line strengths, star formation rates, stellar masses, and rest-frame colours. Here, we present an overview of the data, including an analysis of the spectroscopic completeness and redshift quality.
A bright, high rotation-measure FRB that skewers the M33 halo
Authors: Connor L , van Leeuwen J , Oostrum L C , Petroff E , Maan Y , Adams E A K , Attema J J , Bast J E , Boersma O M , Dénes H , Gardenier D W , Hargreaves J E , Kooistra E , Pastor-Marazuela I , Schulz R , Sclocco A , Smits R , Straal S M , van der Schuur D , Vohl D , Adebahr B , de Blok W J G , van Cappellen W A , Coolen A H W M , Damstra S , van Diepen G N J , Frank B S , Hess K M , Hut B , Kutkin A , Loose G Marcel , Lucero D M , Mika Á , Moss V A , Mulder H , Oosterloo T A , Ruiter M , Vedantham H , Vermaas N J , Wijnholds S J , Ziemke J
Published: September 2020

We report the detection of a bright fast radio burst, FRB 191108, with Apertif on the Westerbork Synthesis Radio Telescope. The interferometer allows us to localize the FRB to a narrow 5 arcsec × 7 arcmin ellipse by employing both multibeam information within the Apertif phased-array feed beam pattern, and across different tied-array beams. The resulting sightline passes close to Local Group galaxy M33, with an impact parameter of only 18 kpc with respect to the core. It also traverses the much larger circumgalactic medium (CGM) of M31, the Andromeda Galaxy. We find that the shared plasma of the Local Group galaxies could contribute ∼10 per cent of its dispersion measure of 588 pc cm−3. FRB 191108 has a Faraday rotation measure (RM) of +474 $\pm \, 3$ rad m−2, which is too large to be explained by either the Milky Way or the intergalactic medium. Based on the more moderate RMs of other extragalactic sources that traverse the halo of M33, we conclude that the dense magnetized plasma resides in the host galaxy. The FRB exhibits frequency structure on two scales, one that is consistent with quenched Galactic scintillation and broader spectral structure with Δν ≈ 40 MHz. If the latter is due to scattering in the shared M33/M31 CGM, our results constrain the Local Group plasma environment. We found no accompanying persistent radio sources in the Apertif imaging survey data.
Nanopore sequencing of native adeno-associated virus (AAV) single-stranded DNA using a transposase-based rapid protocol
Authors: Radukic Marco T , Brandt David , Haak Markus , Müller Kristian M , Kalinowski Jörn
Published: September 2020

Next-generation sequencing of single-stranded DNA (ssDNA) enables transgene characterization of gene therapy vectors such as adeno-associated virus (AAV), but current library generation uses complicated and potentially biased second-strand synthesis. We report that libraries for nanopore sequencing of ssDNA can be conveniently created without second-strand synthesis using a transposase-based protocol. We show for bacteriophage M13 ssDNA that the MuA transposase has unexpected residual activity on ssDNA, explained in part by transposase action on transient double-stranded hairpins. In case of AAV, library creation is additionally aided by genome hybridization. We demonstrate the power of direct sequencing combined with nanopore long reads by characterizing AAV vector transgenes. Sequencing yielded reads up to full genome length, including GC-rich inverted terminal repeats. Unlike short-read techniques, single reads covered genome-genome and genome-contaminant fusions and other recombination events, whilst additionally providing information on epigenetic methylation. Single-nucleotide variants across the transgene cassette were revealed and secondary genome packaging signals were readily identified. Moreover, comparison of sequence abundance with quantitative polymerase chain reaction results demonstrated the technique's future potential for quantification of DNA impurities in AAV vector stocks. The findings promote direct nanopore sequencing as a fast and versatile platform for ssDNA characterization, such as AAV ssDNA in research and clinical settings.
Trends in survival and treatment of SEGA: National Cancer Database Analysis
Authors: Ryoo James S , Khalid Syed I , Chaker Anisse N , Behbahani Mandana , Nunna Ravi S , Mehta Ankit I
Published: September 2020

Background

SEGA is a rare, slow-growing CNS neoplasm that has historically been treated by surgical resection. However, the advent of a mammalian target of rapamycin complex-1 inhibitor, everolimus, has shown promising results in recent clinical trials. We sought to provide an analysis of epidemiological and survival risk factors in this rare tumor entity, while comparing trends in surgical management before and after introduction of everolimus in SEGAs.

Methods

Patients with SEGA were queried from the National Cancer Database between 2004 and 2015. Standard statistical analysis was conducted to assess variables associated with the odds of performing surgery and survival, while controlling for confounding variables.

Results

A total of 460 patients were diagnosed with SEGA. Multivariable analysis of survival demonstrated that increased age was associated with decreased survival (HR, 1.05; P < .0001). Multivariable analysis of surgery showed increased age (odds ratio [OR], 1.02, P = .04) and tumor size 20 mm or larger (OR, 9.52-16.75, P < .0001 for all) to be associated with higher odds of performing surgery. The use of radiotherapy (OR, 0.12, P = .008) or chemotherapy (OR, 0.21, P = .008) was associated with lower odds of surgery. A comparison of surgical rates between 2004 and 2010 and 2011 and 2015 was found to be significantly different, with a lower rate of surgery seen after 2011 (60.63% vs 48.06%, P = .007).

Conclusion

Our analysis of SEGAs demonstrated that age was the only variable affecting overall survival. Surgical resection was performed in older patients with larger tumors (> 20 mm) as a primary mode of treatment, without chemoradiotherapy. Expectedly, rates of surgical resection were found to have decreased since 2011, after FDA approval of everolimus for SEGA treatment.
Systematic review of the incidence and risk factors for cerebral vasculopathy and stroke after cranial proton and photon radiation for childhood brain tumors
Authors: Bavle Abhishek , Srinivasan Anand , Choudhry Farooq , Anderson Michael , Confer Michael , Simpson Hilarie , Gavula Theresa , Thompson J Spencer , Clifton Shari , Gross Naina L , McNall-Knapp Rene
Published: September 2020

Background

The aim of our study is to determine the incidence, timing, and risk factors for cerebral vasculopathy after cranial proton and photon radiation for pediatric brain tumors.

Methods

We performed a single-institution retrospective review of a cohort of children treated with proton radiation for brain tumors. MRA and/or MRI were reviewed for evidence of cerebral vascular stenosis and infarcts. Twenty-one similar studies (17 photon, 4 proton) were identified by systematic literature review.

Results

For 81 patients with median follow-up of 3 years, the rates of overall and severe vasculopathy were 9.9% and 6.2% respectively, occurring a median of 2 years post radiation. Dose to optic chiasm greater than 45 Gy and suprasellar location were significant risk factors. Results were consistent with 4 prior proton studies (752 patients) that reported incidence of 5% to 6.7%, 1.5 to 3 years post radiation. With significantly longer follow-up (3.7-19 years), 9 studies (1108 patients) with traditional photon radiation reported a higher rate (6.3%-20%) and longer time to vasculopathy (2-28 years). Significant risk factors were neurofibromatosis type 1 (NF-1; rate 7.6%-60%) and suprasellar tumors (9%-20%). In 10 studies with photon radiation (1708 patients), the stroke rate was 2% to 18.8% (2.3-24 years post radiation).

Conclusions

Childhood brain tumor survivors need screening for vasculopathy after cranial radiation, especially with higher dose to optic chiasm, NF-1, and suprasellar tumors. Prospective studies are needed to identify risk groups, and ideal modality and timing, for screening of this toxicity.
Effects of universal masking on Massachusetts healthcare workers’ COVID-19 incidence
Authors: Lan F-Y , Christophi C A , Buley J , Iliaki E , Bruno-Murtha L A , Sayah A J , Kales S N
Published: September 2020

Background

Healthcare workers (HCWs) and other essential workers are at risk of occupational infection during the COVID-19 pandemic. Several infection control strategies have been implemented. Evidence shows that universal masking can mitigate COVID-19 infection, though existing research is limited by secular trend bias.

Aims

To investigate the effect of hospital universal masking on COVID-19 incidence among HCWs compared to the general population.

Methods

We compared the 7-day average incidence rates between a Massachusetts (USA) healthcare system and Massachusetts residents statewide. The study period was from 17 March (the date of first incident case in the healthcare system) to 6 May (the date Massachusetts implemented public masking). The healthcare system implemented universal masking on 26 March, we allotted a 5-day lag for effect onset and peak COVID-19 incidence in Massachusetts was 20 April. Thus, we categorized 17–31 March as the pre-intervention phase, 1–20 April the intervention phase and 21 April to 6 May the epidemic decline phase. Temporal incidence trends (i.e. 7-day average slopes) were compared using standardized coefficients from linear regression models.

Results

The standardized coefficients were similar between the healthcare system and the state in both the pre-intervention and epidemic decline phases. During the intervention phase, the healthcare system’s epidemic slope became negative (standardized β: −0.68, 95% CI: −1.06 to −0.31), while Massachusetts’ slope remained positive (standardized β: 0.99, 95% CI: 0.94 to 1.05).

Conclusions

Universal masking was associated with a decreasing COVID-19 incidence trend among HCWs, while the infection rate continued to rise in the surrounding community.
Intrathecal Drug Delivery System: A Pain Management Option for Refractory Cancer-Related Pain
Authors: Wanderman Robalee L , Hagedorn Jonathan M
Published: September 2020

Cancer-related pain is progressive and therefore requires a stepwise approach to management, such as the World Health Organization’s Pain Ladder. This approach calls for increasingly strong pain medications in addition to interventional options for patients with medication-refractory pain or intolerable medication side effects. Here, we discuss a case involving cancer-related pain which ultimately required intrathecal drug delivery system placement for optimal pain management.
Comparison of Freshly Isolated Adipose Tissue-derived Stromal Vascular Fraction and Bone Marrow Cells in a Posterolateral Lumbar Spinal Fusion Model
Authors: Perdomo-Pantoja Alexander , Holmes Christina , Cottrill Ethan , Rindone Alexandra N. , Ishida Wataru , Taylor Maritza , Tomberlin Colson , Lo Sheng-fu L. , Grayson Warren L. , Witham Timothy F.
Published: September 2020

Study Design.

Rat posterolateral lumbar fusion model.

Objective.

The aim of this study was to compare the efficacy of freshly isolated adipose tissue-derived stromal vascular fraction (A-SVF) and bone marrow cells (BMCs) cells in achieving spinal fusion in a rat model.

Summary of Background Data.

Adipose tissue-derived stromal cells (ASCs) offer advantages as a clinical cell source compared to bone marrow-derived stromal cells (BMSCs), including larger available tissue volumes and reduced donor site morbidity. While pre-clinical studies have shown that ex vivo expanded ASCs can be successfully used in spinal fusion, the use of A-SVF cells better allows for clinical translation.

Methods.

A-SVF cells were isolated from the inguinal fat pads, whereas BMCs were isolated from the long bones of syngeneic 6- to 8-week-old Lewis rats and combined with Vitoss (Stryker) bone graft substitute for subsequent transplantation. Posterolateral spinal fusion surgery at L4-L5 was performed on 36 female Lewis rats divided into three experimental groups: Vitoss bone graft substitute only (VO group); Vitoss + 2.5 × 106 A-SVF cells/side; and, Vitoss + 2.5 × 106 BMCs/side. Fusion was assessed 8 weeks post-surgery via manual palpation, micro-computed tomography (μCT) imaging, and histology.

Results.

μCT imaging analyses revealed that fusion volumes and μCT fusion scores in the A-SVF group were significantly higher than in the VO group; however, they were not significantly different between the A-SVF group and the BMC group. The average manual palpation score was highest in the A-SVF group compared with the BMC and VO groups. Fusion masses arising from cell-seeded implants yielded better bone quality than nonseeded bone graft substitute.

Conclusion.

In a rat model, A-SVF cells yielded a comparable fusion mass volume and radiographic rate of fusion to BMCs when combined with a clinical-grade bone graft substitute. These results suggest the feasibility of using freshly isolated A-SVF cells in spinal fusion procedures.

Level of Evidence: N/A
Excess Pneumonia Mortality During a 2014–2015 Legionnaires’ Disease Outbreak in Genesee County, Michigan
Authors: Nelson Kristin N. , Binney Zachary O. , Chamberlain Allison T.
Published: September 2020

Background:

From June 2014 to October 2015, the Michigan Department of Health and Human Services reported an outbreak of 90 cases of Legionnaires’ disease, including 10 deaths, in Genesee County, Michigan. As Legionnaires’ disease is not routinely tested for as a cause of community-acquired pneumonia, we hypothesized that the size of the outbreak was underestimated.

Methods:

We used Centers for Disease Control and Prevention (CDC) Wide-ranging ONline Data for Epidemiologic Research data to compare pneumonia mortality in Genesee to similar counties from 2011 to 2017. We used data from the Genesee County Vital Records Division to assess geographic overlap of pneumonia mortality with reported Legionnaires disease cases by census tract.

Results:

We estimated 70.0 excess pneumonia deaths (90% uncertainty interval: 36–103) in Genesee County during the outbreak. Areas of high pneumonia mortality overlapped with those with high Legionnaires’ disease incidence.

Conclusions:

These findings are consistent with the hypothesis that the Legionnaires’ disease outbreak was larger than reported. Earlier outbreak detection and response may have facilitated identification of additional cases.
Orbital Involvement by Biphenotypic Sinonasal Sarcoma With a Literature Review
Authors: Hanbazazh Mehenaz , Jakobiec Frederick A. , Curtin Hugh D. , Lefebvre Daniel R.
Published: September 2020

Purpose:

To document a case of a biphenotypic sinonasal sarcoma that impinged on the orbit via a tumor-induced mucocele and review the previous literature devoted to this condition.

Methods:

A clinicopathologic case report with detailed histopathologic, immunohistochemical, and radiological studies with tabulations of previously reported cases and immunohistochemical stains for ruling out mimicking lesions.

Results:

A biphenotypic sinonasal sarcoma arose from the ethmoid sinus in a middle-aged man. The tumor induced a mucocele that bowed the medial orbital lamina papyracea into the orbit and caused diplopia and mild proptosis. The biopsy’s dual positivity for S100 and smooth muscle actin together with positive paired box 3 immunohistochemical staining established the diagnosis of biphenotypic sinonasal sarcoma.

Conclusion:

Biphenotypic sinonasal sarcoma, which can involve the orbit in 25% of cases, is a rare head and neck malignancy that has only recently been described. Biphenotypic sinonasal sarcoma is a low-grade, locally aggressive, nonmetastasizing sarcoma displaying both neural and muscle differentiation. It is further characterized by rearrangements of the PAX3 gene with multiple fusion partners, most commonly MAML3 (Mastermind like transcriptional coactivator 3). It occurs predominantly in middle-aged women and exclusively in the sinonasal tract. However, it can spread throughout the central facial structures to invade the brain if not detected early. Ophthalmologists should be aware of this new entity to avoid delays in diagnosis and treatment. The previous literature devoted to this condition was reviewed and analyzed for clinical, radiological, histopathological, and immunohistochemical features. In circumstances where molecular testing is not available, paired box 3 immunohistochemical staining can be used as an alternative diagnostic marker. The current case is most unusual because the orbital findings were induced by a mucocele caused by the tumor that obstructed the sinus ostium. This produced diplopia without direct tumor invasion into the orbital fat.
In vivo evaluation of a 1-piece foldable sutureless intrascleral fixation intraocular lens using ultrasound biomicroscopy and anterior segment OCT
Authors: Mularoni Alessandro , Imburgia Aurelio , Forlini Matteo , Rania Laura , Possati Giovanna Linda
Published: September 2020

Purpose:

To evaluate the optic plate and haptics of a specially designed sutureless intrascleral-fixated intraocular lens (IOL) using ultrasound biomicroscopy and anterior segment optical coherence tomography (AS-OCT).

Setting:

Department of Ophthalmology, San Marino Hospital, Republic of San Marino.

Design:

Retrospective observational case series.

Methods:

Eyes that underwent intrascleral fixation with IOL implantation (Carlevale) were included. Preoperative and postoperative refractive outcomes were reported. Optic plate tilt and haptics position were assessed with ultrasound biomicroscopy, whereas intrascleral plug depth and conformation were evaluated with AS-OCT.

Results:

The study comprised 10 aphakic eyes. Postoperative visual acuity improved in all patients. At postoperative month 3, 3 eyes (30%) had a vertical tilt of more than 100 μm, whereas no horizontal tilt was observed in any patient. The mean vertical intraocular tilt was 0.19 ± 0.22 mm. Of 20 haptics, 13 (65%) passed through the ciliary sulcus, 4 (20%) posterior to the ciliary body, and 3 (15%) through the ciliary body. AS-OCT scans showed a mean intrascleral plug depth of 247.20 ± 62.82 μm in the nasal sector and 265.50 ± 30.11 μm in the temporal sector, with adequate integration of the T-shaped plugs in the scleral tissue.

Conclusions:

This secondary IOL showed good intraocular stability and safe haptics fixation, making it suitable for the intrascleral fixation technique. The specific foldable design results in a low predisposition to optic plate tilt and haptic torsion. In long eyes, the sulcus-to-sulcus distance should be carefully evaluated preoperatively because the flexible structure of the IOL could be subjected to excessive stretching.
Correcting optic capture with 2 flanged 6-0 sutures after intrascleral haptic fixation with ViscoNeedling
Authors: Mascarenhas Menna Barreto Vicente , Mascarenhas Menna Barreto Carlos , Kern Menna Barreto Pedro , Kern Menna Barreto Roberta
Published: September 2020

A 6-0 polypropylene suture was introduced in the eye through an ophthalmic viscosurgical device syringe in a completely closed system. The procedure was used to correct optic capture of the intraocular lens by the pupil after 2 cases of Yamane technique.