bluuebunny/crossref_metadata_2025 huggingface dataset:
450 EDUCATIONAL PROGRAMMES FOR FRAIL OLDER PEOPLE, THEIR FAMILIES, CARERS, AND HEALTH-CARE PROFESSIONALS: A SYSTEMATIC REVIEW
Authors: Viggars R J , Finney A , Panayiotou B
Published: June 2021

Introduction

With an ever-increasing, ageing population, there is inevitable increase in people living with frailty with a growing demand on the NHS in the UK. Healthcare policy emphasises holistic care and a multimorbid approach to meet these needs. Frailty is seen as a measurable, complex, fluid and variable state affected by a balance of resilience versus vulnerability across domains which impact on quality of life. The FCCF positions frailty as a LTC and suggests that a holistic and person-centred approach to education is required for people living with frailty, their families, carers and health care professionals. This is a systematic review of research studies providing educational programmes or initiatives to these groups and addresses whether the content and application will compliment and support the facilitation of the FCCF.

Methods

Following standardised methods and guidelines, electronic databases were searched. Two reviewers were involved in the research collection process, applying the inclusion and exclusion criteria. Quality appraisal tools were used to ensure robust quality assessment and then the findings were narratively synthesised.

Results

There was real heterogeneity of study design with variable quality according to the tools used. There was a paucity of high-quality evidence; (2 = high quality, 3 = low quality, 5 = medium quality). There were four thematic domains prominent from the synthesis: 1) Health Promotion (namely exercise and nutrition), 2) Empowerment, 3) Self-care, 4) Online platform delivery.

Conclusion

It is evident that educational programmes and initiatives are vital for the prevention and management of frailty. To be truly effective, such programmes must include a combination of health promotion, empowerment and self-care and be accessible to all target populations. Further work is needed to look at effective, accessible, sustainable delivery systems, including that of online digital platforms.
457 NUTRITION, SARCOPENIA AND FRAILTY
Authors: Du W
Published: June 2021

Many older people admitted to hospital are malnourished/at risk of malnourishment (30%), have swallowing problems (55%), are frail (25%), have sarcopenia (50%) or a combination of these. On admission to hospital frail older people are at significant risk of worsening nutritional status and prolonged hospital stay. Nutritional status should be identified, documented, food intake monitored and where appropriate they should be referred to the dietitian.

The question remains, do staff recognise that frail older people may not eat their food increasing their risk of poor nutrition and outcome.

Methods

Older people admitted to a ‘Frailty’ Ward were directly observed during lunchtime by WD. The Minimal Eating Observation Form –Version II (MEOF-II) was used to document how much they ate. Frailty status (CFS), presence of Sarcopenia (Sarc-F) and whether a referral to dietetics or speech and language therapy (SLT) was completed.

Results

39 patients were observed. Mean age was 82.38 years; median CFS 6 (3–8); median Sarc-F 4(0–9). Median MEOF II was 0 (0–5). Two patients were referred to dietetics and 4 to SLT. 7/40 (17,5%) were at high risk for undernutrition, a further 8/40(20%) were at moderate risk. 82% were severely frail, the remaining were mildly frail. 94% (16/17) exhibited sarcopenia. There was significant correlation between MEOF II and CFS (r = 0.4887, p = 0.00162); MEOFII and Sarc-F (r = 0.4395, p = 0.00512). There was correlation between CFS and Sarc-F (r = 0.80296, p < 0.00001). Only one (6%) was referred to the dietitian.

Conclusion

Frail older adults are often undernourished on admission to hospital. Nutritional intake is often poor with acute illness. Screening, observation and monitoring of nutritional intake should highlight concerns and needs for intervention. These study high lights that a significant number of older people are frail, fail to complete meals, are at significant risk of under nutrition, yet proactive intervention does not occur.
537 AGE, FRAILTY AND COMORBIDITY IN COVID-19 INPATIENTS 65 AND OLDER
Authors: Obiechina N , Michael A , Khan R R A , Ali M , Zainudin M , Mekala T , Doyle C-M , Nandi A
Published: June 2021

Introduction

Higher incidence of COVID-19 and poorer outcomes have been shown to be associated with age, frailty and comorbidity. Older people have more risk of severe COVID 19; hospitalization, ITU admission, ventilation and mortality.

Aim

To assess the correlation between age, frailty and comorbidity in COVID-19 inpatients 65 years and older.

Methods

A retrospective, cross-sectional analysis was carried out on COVID 19 inpatients 65 and older in a UK district general hospital. Patients with no microbiological evidence of COVID-19 and patients with incomplete data were excluded from the study. Demographic data, frailty score and comorbidity index were extracted from the electronic records of patients. SPSS 27 statistical software was used to perform descriptive analysis and linear regression coefficient.

Results

357 COVID-19 patients 65 and over were assessed; 207 males and 150 females. Mean age was 81.9 +/− 9.31. Frailty scores were measured using the Rockwood Clinical Frailty Scale (CFS) and comorbidity was calculated using the Charlson Comorbidity Index (CCI). There was positive correlation between age and Clinical Frailty Scale (r=. 436; p<. 001), between age and Charlson Comorbidity Index (r=. 448; p<. 001, and between frailty and comorbidity (r=. 429; p<. 001).

Conclusion

In COVID-19 inpatients 65 and older, there was positive correlation between age and Clinical Frailty Scale, between age and Charlson Comorbidity Index and between frailty and comorbidity. More studies are needed to explore the interaction between age, frailty and comorbidity and COVID 19 morbidity and mortality.
Double PIK3CA Alterations and Parallel Evolution in Colorectal Cancers
Authors: Lin Ming-Tseh , Zheng Gang , Rodriguez Erika , Tseng Li-Hui , Parini Vamsi , Xian Rena , Zou Ying , Gocke Christopher D , Eshleman James R
Published: June 2021

Objectives

To demonstrate clinicopathologic features and evaluate the clonality of double PIK3CA alterations in colorectal cancers (CRCs).

Methods

Clonality was examined in 13 CRCs with double PIK3CA alterations (1.7% of CRCs or 9.6% of PIK3CA-mutated CRCs). Multiregional analyses were performed to confirm subclonal PIK3CA alterations.

Results

PIK3CA alterations were detected within exon 9 (51%), exon 20 (23%), exon 1 (15%), and exon 7 (6.0%). CRCs with exon 7 alterations showed a significantly higher incidence of double PIK3CA alterations. Most double PIK3CA alterations consisted of a hotpsot alteration and an uncommon alteration; they were often clonal and present within a single tumor population. Multiregional analyses of CRCs with predicted subclonal double-alterations revealed multiclonal CRCs with divergent PIK3CA variant status originating from a common APC- and KRAS-mutated founder lineage of adenoma.

Conclusions

The findings supported multiclonal CRCs resulting from parallel evolution during the progression from adenoma to adenocarcinoma within the mitogen-activated protein kinase pathway, as previously demonstrated, or the mammalian target of rapamycin pathway. Further studies are warranted to elucidate clinical significance and potential targeted therapy for CRC patients with double PIK3CA alterations and impacts on clinical decision-making in patients with multiclonal CRCs harboring divergent PIK3CA mutational status.
PuffAligner: a fast, efficient and accurate aligner based on the Pufferfish index
Authors: Almodaresi Fatemeh , Zakeri Mohsen , Patro Rob
Published: June 2021

Motivation

Sequence alignment is one of the first steps in many modern genomic analyses, such as variant detection, transcript abundance estimation and metagenomic profiling. Unfortunately, it is often a computationally expensive procedure. As the quantity of data and wealth of different assays and applications continue to grow, the need for accurate and fast alignment tools that scale to large collections of reference sequences persists.

Results

In this article, we introduce PuffAligner, a fast, accurate and versatile aligner built on top of the Pufferfish index. PuffAligner is able to produce highly sensitive alignments, similar to those of Bowtie2, but much more quickly. While exhibiting similar speed to the ultrafast STAR aligner, PuffAligner requires considerably less memory to construct its index and align reads. PuffAligner strikes a desirable balance with respect to the time, space and accuracy tradeoffs made by different alignment tools and provides a promising foundation on which to test new alignment ideas over large collections of sequences.

Availability and implementation

All the data used for preparing the results of this paper can be found with 10.5281/zenodo.4902332. PuffAligner is a free and open-source software. It is implemented in C++14 and can be obtained from https://github.com/COMBINE-lab/pufferfish/tree/cigar-strings.

Supplementary information

Supplementary data are available at Bioinformatics online.
Induced pluripotent stem cell-derived motor neurons of CMT type 2 patients reveal progressive mitochondrial dysfunction
Authors: Van Lent Jonas , Verstraelen Peter , Asselbergh Bob , Adriaenssens Elias , Mateiu Ligia , Verbist Christophe , De Winter Vicky , Eggermont Kristel , Van Den Bosch Ludo , De Vos Winnok H , Timmerman Vincent
Published: June 2021

Axonal Charcot-Marie-Tooth neuropathies (CMT type 2) are caused by inherited mutations in various genes functioning in different pathways. The types of genes and multiplicity of mutations reflect the clinical and genetic heterogeneity in CMT2 disease, which complicates its diagnosis and has inhibited the development of therapies. Here, we used CMT2 patient-derived pluripotent stem cells (iPSCs) to identify common hallmarks of axonal degeneration shared by different CMT2 subtypes. We compared the cellular phenotypes of neurons differentiated from CMT2 patient iPSCs with those from healthy controls and a CRISPR/Cas9-corrected isogenic line. Our results demonstrated neurite network alterations along with extracellular electrophysiological abnormalities in the differentiated motor neurons. Progressive deficits in mitochondrial and lysosomal trafficking, as well as in mitochondrial morphology, were observed in all CMT2 patient lines. Differentiation of the same CMT2 iPSC lines into peripheral sensory neurons only gave rise to cellular phenotypes in subtypes with sensory involvement, supporting the notion that some gene mutations predominantly affect motor neurons. We revealed a common mitochondrial dysfunction in CMT2-derived motor neurons, supported by alterations in the expression pattern and oxidative phosphorylation, which could be recapitulated in the sciatic nerve tissue of a symptomatic mouse model. Inhibition of a dual leucine zipper kinase could partially ameliorate the mitochondrial disease phenotypes in CMT2 subtypes. Altogether, our data reveal shared cellular phenotypes across different CMT2 subtypes and suggests that targeting such common pathomechanisms could allow the development of a uniform treatment for CMT2.
Subcortical Contribution of Corticospinal Transmission during Visually Guided Switching Movements of the Arm
Authors: Suzuki Shinya , Nakajima Tsuyoshi , Irie Shun , Ariyasu Ryohei , Ohtsuka Hiroyuki , Komiyama Tomoyoshi , Ohki Yukari
Published: June 2021

In animal experiments, the indirect corticospinal tract (CST) system via cervical interneurons has been shown to mediate motor commands for online adjustment of visuomotor behaviors, such as target-reaching. However, it is still unclear whether the similar CST system functions to perform similar motor behaviors in humans. To clarify this, we investigated changes in motor-evoked potentials (MEPs) in the elbow muscles following transcranial magnetic stimulation, transcranial electrical stimulation, or cervicomedullary stimulation while participants executed target-reaching and switching movements. We found that the MEP, whether elicited cortically or subcortically, was modulated depending on the direction of the switching movements. MEP facilitation began around the onset of the switching activities in an agonist muscle. Furthermore, ulnar nerve-induced MEP facilitation, which could be mediated by presumed cervical interneuronal systems, also increased at the onset of MEP facilitation. In a patient with cortical hemianopsia who showed switching movements in the scotoma, the MEPs were facilitated just before the switching activities. Our findings suggested that CST excitation was flexibly tuned with the switching movement initiation, which could partly take place in the subcortical networks, including the presumed cervical interneuronal systems.
Evolution of a novel technology for gastroesophageal reflux disease: a safety perspective of magnetic sphincter augmentation
Authors: DeMarchi Janet , Schwiers Michael , Soberman Mark , Tokarski Allison
Published: June 2021

Magnetic sphincter augmentation using the LINX® device is a minimally invasive surgical option for patients with gastroesophageal reflux disease. An estimated 30,000 devices have been implanted worldwide. Device removals and erosion are identified risks. The objective of this analysis is to explore the procedure evolution with an emphasis on the removals and associated characteristics that may guide future clinical practice. The Manufacturer and User Facility Device Experience and Ethicon’s complaint databases were queried for all surgical device explants since January 2013. Device unit sales were used to determine the rates. The endpoint was based upon the time from implant to explant. Explant and erosion rates were calculated at yearly intervals and the Kaplan-Meier estimator was used to measure the time to explant. Chi-square analyses were used to investigate the risk of explant associated with the size, geography and implant year. Overall, 7-year cumulative risk of removal was 4.81% (95% Confidence Interval (CI) CI: 4.31–5.36%). The likelihood of removal was significantly related to the device size (P < 0.0001), with smaller sizes being more likely to be explanted. The primary reasons for device removal and relative percentages were dysphagia/odynophagia (47.9%), persistent gastroesophageal reflux disease (20.5%) and unknown/other (11.2%). Overall, the 7-year cumulative risk of erosion was 0.28% (95% CI: 0.17–0.46%). The average device size increased from 14.2 beads ± 1.0 in 2013 to 15.3 beads ± 1.2 in 2019 (P < 0.001). Surgical technique and perioperative management play an important role in the outcomes. Clinical practice changes since magnetic sphincter augmentation has been incorporated into clinical use are associated with improved outcomes and should be further characterized. Smaller device size is associated with increased removal and erosion rates.
Spatial Patterns of Canopy Disturbance and Shortleaf Pine in a Mixedwood Forest
Authors: Goode J Davis , Hart Justin L , Dey Daniel C , Torreano Scott J , Clark Stacy L
Published: June 2021

The spatial structure of forest ecosystems is dominated by the horizontal and vertical distribution of trees and their attributes across space. Canopy disturbance is a primary regulator of forest spatial structure. Although the importance of tree spatial pattern is widely acknowledged as it affects important ecosystem processes such as regeneration and recruitment into the overstory, quantitative reference spatial conditions to inform silvicultural systems are lacking. This is especially true for mixedwood forests, defined as those that contain hardwoods and softwoods in the canopy. We used data from a preexisting network of plots in a complex-stage mixedwood stand to investigate the influence of canopy disturbance on stand and neighborhood-scale spatial patterns. We reconstructed canopy disturbance history and linked detected stand-wide and gap-scale disturbance events to establishment and spatial patterns of shortleaf pine. The majority of shortleaf pine establishment coincided with stand-wide or gap-scale disturbance. Shortleaf pine was clustered at the stand scale but was randomly distributed at the neighborhood scale (i.e. five tree clusters), which was a legacy of the historical disturbance regime. These results may be used to improve natural disturbance-based silvicultural systems to restore and maintain mixedwood forests for enhanced resilience and provisioning of ecosystem goods and services.
Cellular Reprogramming and Immortality: Expression Profiling Reveals Putative Genes Involved in Turritopsis dohrnii’s Life Cycle Reversal
Authors: Matsumoto Yui , Miglietta Maria Pia
Published: June 2021

To gather insight on the genetic network of cell reprogramming and reverse development in a nonmodel cnidarian system, we produced and annotated a transcriptome of the hydrozoan Turritopsis dohrnii, whose medusae respond to damage or senescence by metamorphosing into a juvenile stage (the polyp), briefly passing through an intermediate and uncharacterized stage (the cyst), where cellular transdifferentiation occurs. We conducted sequential and pairwise differential gene expression (DGE) analyses of the major life cycle stages involved in the ontogenetic reversal of T. dohrnii. Our DGE analyses of sequential stages of T. dohrnii’s life cycle stages show that novel and characterized genes associated with aging/lifespan, regulation of transposable elements, DNA repair, and damage response, and Ubiquitin-related processes, among others, were enriched in the cyst stage. Our pairwise DGE analyses show that, when compared with the colonial polyp, the medusa is enriched with genes involved in membrane transport, the nervous system, components of the mesoglea, and muscle contraction, whereas genes involved in chitin metabolism and the formation of the primary germ layers are suppressed. The colonial polyp and reversed polyp (from cyst) show significant differences in gene expression. The reversed polyp is enriched with genes involved in processes such as chromatin remodeling and organization, matrix metalloproteinases, and embryonic development whereas suppressing genes involved in RAC G-protein signaling pathways. In summary, we identify genetic networks potentially involved in the reverse development of T. dohrnii and produce a transcriptome profile of all its life cycle stages, and paving the way for its use as a system for research on cell reprogramming.
WormPaths: Caenorhabditis elegans metabolic pathway annotation and visualization
Authors: Walker Melissa D , Giese Gabrielle E , Holdorf Amy D , Bhattacharya Sushila , Diot Cédric , García-González Aurian P , Horowitz Brent B , Lee Yong-Uk , Leland Thomas , Li Xuhang , Mirza Zeynep , Na Huimin , Nanda Shivani , Ponomarova Olga , Zhang Hefei , Zhang Jingyan , Yilmaz L Safak , Walhout Albertha J M
Published: June 2021

In our group, we aim to understand metabolism in the nematode Caenorhabditis elegans and its relationships with gene expression, physiology, and the response to therapeutic drugs. Visualization of the metabolic pathways that comprise the metabolic network is extremely useful for interpreting a wide variety of experiments. Detailed annotated metabolic pathway maps for C. elegans are mostly limited to pan-organismal maps, many with incomplete or inaccurate pathway and enzyme annotations. Here, we present WormPaths, which is composed of two parts: (1) the careful manual annotation of metabolic genes into pathways, categories, and levels, and (2) 62 pathway maps that include metabolites, metabolite structures, genes, reactions, and pathway connections between maps. These maps are available on the WormFlux website. We show that WormPaths provides easy-to-navigate maps and that the different levels in WormPaths can be used for metabolic pathway enrichment analysis of transcriptomic data. In the future, we envision further developing these maps to be more interactive, analogous to road maps that are available on mobile devices.
Staying Connected: Alternative Transportation Use, Neighborhoods, and Social Participation Among Older Americans
Authors: Latham-Mintus Kenzie , Manierre Matthew , Miller Keith
Published: June 2021

Background and Objectives

A wealth of empirical evidence documents improved health among older adults who participate in social activities. Alternative transportation can serve as a bridge linking older adults to social activities and improving person–environment fit.

Research Design and Methods

Using Waves 1–8 of the National Health and Aging Trends Study, this research examines whether alternative transportation use is associated with participation in diverse social activities among a sample of Medicare beneficiaries aged 65 or older. Additionally, this research explores whether the effect of transportation use varies across neighborhood environments. We analyzed individual trajectories of participation in social activities by estimating 2-level growth curve models.

Results

The use of public transportation, paratransit, getting a ride, or walking/using wheelchair/scooter to get places was associated with participating in more types of social activities. Respondents who used alternative transportation had less steep declines in participation. The effect of getting rides and using paratransit services was more pronounced among respondents living in disordered neighborhoods.

Discussion and Implications

This research underscores the importance of alternative transportation use and the neighborhood context for participation among older adults. Age-friendly initiatives aimed at fostering greater community engagement should think broadly about the role of multiple forms of transportation.
Trends in socio-economic, sex and geographic disparities in childhood underweight in Mauritania: evidence from Multiple Indicator Cluster Surveys (2007–2015)
Authors: Shibre Gebretsadik , Zegeye Betregiorgis , Ahinkorah Bright Opoku , Seidu Abdul-Aziz , Ameyaw Edward Kwabena , Keetile Mpho , Yaya Sanni
Published: June 2021

Background

Underweight is one of the largest contributors to child morbidity and mortality and is considered to be the largest contributor to the global burden of diseases in low-and middle-income countries. In Mauritania, where one-fifth of children are underweight, there is a dearth of evidence on socio-economic, sex and geographic disparities in childhood underweight. As a result, this study aimed at investigating the socio-economic, sex and geographic disparities in childhood underweight in Mauritania.

Methods

Using the World Health Organization's (WHO) Health Equity Assessment Toolkit (HEAT) software, data from the Mauritania Multiple Indicator Cluster Surveys (MICSs) conducted between 2007 and 2015 were analysed. Childhood underweight was disaggregated by five equity stratifiers: education, wealth, residence, region and sex. In addition, absolute and relative inequality measures, namely difference (D), population attributable risk (PAR), ratio (R) and population attributable fraction (PAF) were calculated to understand inequalities from wider perspectives. Corresponding 95% confidence intervals (CIs) were computed to measure statistical significance.

Results

Substantial absolute and relative socio-economic, sex and geographic disparities in underweight were observed from 2007 to 2015. Children from the poorest households (PAR=−12.66 [95% CI −14.15 to −11.16]), those whose mothers were uneducated (PAF=−9.11 [95% CI −13.41 to −4.81]), those whose mothers were rural residents (R=1.52 [95% CI 1.37 to 1.68]), residents of HodhCharghy (PAF=−66.51 [95% CI −79.25 to −53.76]) and males (D=4.30 [95% CI 2.09 to 6.52]) experienced a higher burden of underweight. Education-related disparities decreased from 2007 to 2015. The urban–rural gap in underweight similarly decreased over time with the different measures showing slightly different reductions. Wealth-driven disparities decreased marginally from 2011 to 2015. The sex-based and regional disparities increased, at least on average, over the 8-y intersurvey period.

Conclusions

The burden of underweight was significantly higher among children from disadvantaged subpopulations, those with uneducated and poorest/poor mothers, those living in rural areas and those living in HodhCharghy. Special nutrition intervention and efforts focused on these deprived subpopulations are required to reduce childhood morbidity and mortality associated with underweight and help achieve the Sustainable Development Goals.
Alain Crosnier’s role in modern carcinology: exploration, international collaboration, and taxonomy
Authors: Richer de Forges Bertrand , Ahyong Shane T , Castro Peter , Chan Tin-Yam , Clark Paul F , Lemaitre Rafael , Macpherson Enrique , Ng Peter K L , Poore Gary C B , Poupin Joseph , Tavares Marcos
Published: June 2021

The French carcinologist and oceanographer Alain Crosnier (1930–2021) had a most influential role in modern carcinology. This tribute reviews his contributions to organising oceanographic expeditions; expanding collections of specimens, particularly from the deep sea; and supporting international collaboration for taxonomic investigations of the rich collections of material obtained from these expeditions. His expertise and enthusiasm also extended to the publication of the results of these investigations.
Rumors of Insurgency and Assassination in the Ixcán, Guatemala
Authors: Foss Sarah
Published: June 2021

In the late 1960s, landless campesinos partnered with the Maryknoll Catholic order to form a colony and cooperative in the lowland jungles of northern Guatemala. The Ixcán Grande colony became profitable and fell in line with state development and agrarian policies. Yet by the mid-1970s, this dramatically changed when the colony began experiencing increased government repression as Guatemala’s ongoing civil war escalated. After Father William Woods, the colony’s priest, died in a mysterious plane crash in 1976, multiple accounts of that fateful day circulated: the official version recorded it as an accident while unofficial versions maintained that the military-state had assassinated him. This event shaped the relationship between Ixcán residents and the state from that moment on and continues to influence historical memory in the present. This article first explores the circulation of rumors of insurgency, leading to the Ixcán Grande project’s reputation as an unstable, dangerous space. Then, it examines the competing historical narratives surrounding Father Woods’s death. Finally, it links rumor creation and utilization with historical memory, ending with a brief conclusion about the utility—and the necessity—of giving proper attention to rumors as archival traces.
Assessment of Dermal and Inhalation Exposure to Permethrin During Field Treatment of Military Uniforms
Authors: Jensen Lynnea , Schaal N Cody , English James , Dunford James , Stubner Alex H
Published: June 2021

Introduction

Permethrin is a common pesticide spray-applied to civilian clothing and military uniforms for protection against biting arthropods in an effort to reduce risks to arthropod-borne diseases. During mass clothing spray events, exposure is possible through the dermal, inhalation, and ingestion routes. The potentially exposed population during a spray event includes the pesticide applicator(s) and working party (personnel who handle clothing/uniforms by positioning on the ground, flipping, and removing after spraying is complete). Previous investigation is limited regarding permethrin exposure via multiple routes of entry. Additionally, most exposure assessments are limited to pesticide applicators rather than working party that support applicator personnel. The purpose of this investigation was to conduct a multi-route exposure assessment for all personnel normally participating in mass permethrin military uniform treatments.

Materials and Methods

The protocol and Informed Consent Document were approved by the Uniformed Services University of the Health Sciences (USUHS) Institutional Review Board (IRB) before fieldwork initiation (IRB number: USUHS.2019-032). Sampling occurred during routine spray events performed by 14 U.S. Navy personnel (3 applicators and 11 working party) over 2 days. Personal exposures were measured with dermal sampling, and airborne concentrations were measured with area air sampling. Permethrin area air sampling and analysis were conducted using OSHA Versatile Sampler-2 sampling media (n = 36). Dermal exposure was measured using dosimeter gloves (n = 26) and a dermal patch (n = 26) worn by study participants.

Results

All air samples were reported below the 0.4 µg limit of quantification. Glove sample results ranged from 45 to 120,000 µg and patch results ranged from 0.57 to 45 µg. A repeated-measures ANOVA showed non-statistically significant differences in dermal concentrations (P-value = .8340) between the applicators and working party in patches and gloves.

Conclusions

Results suggest dermal contact is the primary route of exposure compared to inhalation when mass spraying clothing with permethrin. Similar dermal exposures between these two occupations may necessitate reconsidering risk assessment procedures, training and personal protective equipment (PPE) requirements for mass spray uniform treatments. Specifically, while PPE requirements for applicators are highly regulated by the Armed Forces Pest Management Board and include items such as Tyvek suits, chemical protective gloves, and air-purifying respirators, PPE was not regulated for working party personnel before this investigation.
The Impact of Combat Ocular Trauma and Traumatic Brain Injury on Vision- and Health-Related Quality of Life Among U.S. Military Casualties
Authors: Sia Rose K , Ryan Denise S , Brooks Daniel I , Kagemann Janice M , Bower Kraig S , French Louis M , Justin Grant A , Colyer Marcus H
Published: June 2021

Purpose

The purpose of this study was to assess visual and health-related quality of life (QOL) among U.S. military service members who sustained combat ocular trauma (COT) with or without associated traumatic brain injury (TBI).

Methods

This was a single-center, prospective observational study of U.S. service members (n = 88) with COT who were treated at Walter Reed National Military Medical Center. Participants completed the National Eye Institute Visual Function Questionnaire (VFQ-25) at enrollment and at follow-up (>1 year) and supplemental surveys: Neurobehavioral Symptom Inventory, the Medical Outcomes 36-item Short Form Survey (SF-36), and Mayo-Portland Adaptability Inventory.

Results

Initial and follow-up VFQ-25 showed a statistically significant increase in median scores for near activities (initial: 75.0, follow-up 83.3; P = .004) and peripheral vision (initial: 50.0, follow-up: 75.0; P = .009) and in composite scores (initial: 79.5, follow-up: 79.8; P = .022). Comparing those who did (n = 78) and did not (n = 8) have a TBI history, there were no significant differences in median change in VFQ-25 composite scores (with TBI: 2.3 vs. no TBI: 10.7; P = .179). Participants with a TBI history had a significantly lower median SF-36 General Health score (with TBI: 67.5 vs. no TBI: 92.5; P = .009)

Conclusions

Vision-related QOL of COT patients is generally good in the long term. However, those with both COT and a history of TBI conditions showed significantly worse functioning in several domains than those without TBI. As TBI is a common finding in COT, this association is an important factor impacting this population’s overall clinical presentation and daily functions.
Rare events of a peculiar thermonuclear supernova that precedes a core-collapse supernova
Authors: Bear Ealeal , Soker Noam
Published: June 2021

We study stellar binary evolution that leads to the formation of a white dwarf (WD) that explodes in a thermonuclear supernova at the termination of a common envelope evolution (CEE) shortly before the core of its companion explodes as a core-collapse supernova (CCSN). The CCSN explosion of the core, which is the remnant of a red supergiant (RSG) star, might take place few months to several years after the explosion of the WD as a thermonuclear supernova, i.e. a Type Ia peculiar supernova (peculiar SN Ia). Using the evolutionary code mesa-binary, we simulate the evolution of binary systems with stars of initial masses of $6\!-\!7.5\, {\rm M}_\odot$. The more massive star, the primary, transfers mass to the secondary star and leaves a CO WD remnant. The secondary becomes massive enough to end in a CCSN. As the secondary evolves to the RSG phase, it engulfs the WD and the system experiences a CEE that ends with a WD–core binary system at an orbital separation of af ≃ 1–5 R⊙. Our simulations show that the core explodes as a CCSN at $t_{\rm CEE-CCSN} \simeq 3000 \!-\! 10^5 {~\rm yr}$ after the CEE. We assume that if the WD accretes helium-rich gas from the core it might explode as an SN Ia in the frame of the double detonation scenario for SNe Ia and peculiar SNe Ia. We predict the very rare occurrence of a peculiar SN Ia followed within months to years by a CCSN.
Time Course of Neutralizing Antibody in Health Care Workers With Mild or Asymptomatic COVID-19 Infection
Authors: Vicenti Ilaria , Gatti Francesca , Scaggiante Renzo , Boccuto Adele , Modolo Eliana , Zago Daniela , Basso Monica , Dragoni Filippo , Bartolini Niccolo’ , Zazzi Maurizio , Parisi Saverio Giuseppe
Published: June 2021

We describe the time course of neutralizing antibody (NtAb) titer in a cohort of health care workers with mild or asymptomatic severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection. NtAb levels decreased over time; however, serum neutralizing activity remained detectable after a median of 7 months from SARS-CoV-2 diagnosis in the majority of cases.
Anti-Severe Acute Respiratory Syndrome Coronavirus 2 Immunoglobulin G Antibody Seroprevalence Among Truck Drivers and Assistants in Kenya
Authors: Kagucia E Wangeci , Gitonga John N , Kalu Catherine , Ochomo Eric , Ochieng Benard , Kuya Nickline , Karani Angela , Nyagwange James , Karia Boniface , Mugo Daisy , Karanja Henry K , Tuju James , Mutiso Agnes , Maroko Hosea , Okubi Lucy , Maitha Eric , Ajuck Hossan , Mukabi David , Moracha Wycliffe , Bulimu David , Andanje Nelson , Aman Rashid , Mwangangi Mercy , Amoth Patrick , Kasera Kadondi , Ng’ang’a Wangari , Nyaguara Amek , Voller Shirine , Otiende Mark , Bottomley Christian , Agoti Charles N , Ochola-Oyier Lynette I , Adetifa Ifedayo M O , Etyang Anthony O , Gallagher Katherine E , Uyoga Sophie , Barasa Edwine , Bejon Philip , Tsofa Benjamin , Agweyu Ambrose , Warimwe George M , Scott J Anthony G ,   The Magarini Sub-County TDA SARS-CoV-2 Serosurveillance Team, The Busia County TDA SARS-CoV-2 Serosurveillance Team
Published: June 2021

In October 2020, anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G seroprevalence among truck drivers and their assistants (TDA) in Kenya was 42.3%, higher than among healthcare workers and blood donors. Truck drivers and their assistants transport essential supplies during the coronavirus disease 2019 pandemic, placing them at increased risk of being infected and of transmitting SARS-CoV-2 over a wide geographical area.
Effect of Monoclonal Antibody Treatment on Clinical Outcomes in Ambulatory Patients With Coronavirus Disease 2019
Authors: Anderson Blake , Smith Zirka , Edupuganti Srilatha , Yan Xiaobo , Masi Christopher M , Wu Henry M
Published: June 2021

We compared rates of emergency department visits or hospitalizations among ambulatory coronavirus disease 2019 (COVID-19) patients treated with monoclonal antibody (mAb) therapy (n = 305) vs untreated patients (n = 6354). Treatment was associated with decreased encounters within 30 days (adjusted odds ratio, 0.23 [95% confidence interval, .15–.36]). Our findings support treatment of acute COVID-19 with mAbs.
Measurable Selections: A Bridge Between Large Cardinals and Scientific Applications?
Authors: Burgess John P
Published: June 2021

There is no prospect of discovering measurable cardinals by radio astronomy, but this does not mean that higher set theory is entirely irrelevant to applied mathematics broadly construed. By way of example, the bearing of some celebrated descriptive-set-theoretic consequences of large cardinals on measurable-selection theory, a body of results originating with a key lemma in von Neumann’s work on the mathematical foundations of quantum theory, and further developed in connection with problems of mathematical economics, will be considered from a philosophical point of view.
Myositis specific antibodies are associated with isolated anti-Ro-52 associated interstitial lung disease
Authors: Shao Chi , Sun Yuxin , Huang Hui , Zhang Zeyu , Pan Ruili , Xu Kai , Zhang Xin , Zhang Ying , Xu Zuojun
Published: June 2021

Objectives

Anti-Ro-52 antibody positivity might be associated with the presence of interstitial lung disease (ILD) among patients with autoimmune features. However, the clinical significance of isolated anti-Ro-52 positivity (i.e. the presence of anti-Ro-52 antibodies but the absence of anti-Ro-60 antibodies; anti-Ro-52+Ro-60−) in patients with ILD is not clear.

Methods

This is a prospective and observational study of Chinese ILD patients with isolated anti-Ro-52 positivity. According to their myositis specific antibody (MSA) status, patients were split into groups, and their clinical and radiological features were compared.

Results

Of the 158 enrolled patients with ILD and isolated anti-Ro-52 positivity (isolated anti-Ro-52-ILD), there were 130 patients with a positive MSA status and 28 patients with a negative MSA status. Anti-synthetase antibodies (ASAs) were found in 61.5% of patients with MSA+-ILD, and anti-melanoma differentiation associated protein 5 (anti-MDA-5) antibodies were found in the remaining 38.5% of patients. The anti-nuclear antibody (ANA) pattern was associated with ASA and anti-MDA-5 positivity (x2 = 70.7, P < 0.001; Cramer’s value 0.47, P < 0.001): ANA negativity was associated with anti-MDA-5 positivity, and cytoplasmic ANA positivity was associated with ASA positivity. There were statistically significant differences in the high-resolution CT patterns between patients with isolated anti-Ro-52 positivity with different MSA statuses (x2 = 29.8, P < 0.001; Cramer’s value 0.31, P < 0.001): OP pattern was more common in patients with anti-MDA-5 antibodies than in those without anti-MDA-5 antibodies.

Conclusions

Patients with isolated anti-Ro-52-ILD showed high positivity of MSA. Isolated anti-Ro-52 positivity with cytoplasmic ANA positivity was strongly associated with ASA+-ILD, while ANA negativity was associated with anti-MDA-5+-ILD.
Dose response of biochar and wood vinegar on in vitro batch culture ruminal fermentation using contrasting feed substrates
Authors: O’Reilly Grace Celia , Huo Yuxin , Meale Sarah Jade , Chaves Alex V
Published: June 2021

Within Australia, approximately 6.4% of total greenhouse gas emissions are from animal methane (CH4) derived from enteric fermentation. Mitigation of ruminant CH4 is a key concept in support of sustainable agriculture production; dietary manipulations a viable strategy to lower CH4 release during enteric fermentation. In order to determine the effects of dose response of biochar and wood vinegar supplementation on fermentation parameters and CH4 production, this study utilized in vitro batch culture incubations. It is hypothesized that the addition of either biochar or wood vinegar will successfully reduce enteric CH4 emissions without negative modification of other fermentation parameters. Three feed substrates (vegetable mixed ration, maize silage, and winter pasture) were separated into treatments containing either biochar at 0%, 0.5%, 1%, 2%, and 4% DM replacing substrate (w/w basis), or wood vinegar at 0%, 0.25%, 0.5%, 1%, and 2% into incubation media volume (v/v). At 6, 12, and 24 hours after inoculation, total gas volume, and methane (CH4 %) were measured. Volatile fatty acid (VFA) concentrations, media pH, and in vitro dry matter digestibility were measured at 24 hours. Biochar at various dosages had no effect (P > 0.05) on fermentation characteristics other than decreased in vitro dry matter digestibility (IVDMD; P = 0.01) at 2% and 4% (DM basis) inclusion. Similar to biochar, dose response of wood vinegar had no effect on in vitro fermentation characteristics. However, feed substrate had major effects on all fermentation parameters (P = 0.01) where winter pasture > vegetable mixed ration > maize silage for all recorded fermentation characteristics. Biochar and wood vinegar supplementation were ineffectual in mitigating CH4 production or modifying fermentation characteristics, thus rejecting the initial hypothesis. These results suggest the use of biochar is not an effective tool for methane mitigation in ruminant livestock and infers that studies previously reporting success must better define the systemic mechanisms responsible for the reduction in CH4.
Electronic Family History Screening Tool for Detection of Inherited Cancer Risk
Authors: Le Amy , Valice Emily , Kobelka Christine , Janes Kristen , Hoodfar Elizabeth , Powell C. Bethan
Published: June 2021

Family history screening to identify individuals at increased risk for hereditary cancers could be a powerful strategy to prevent cancer but is used inconsistently in primary care. The objective was to improve identification of women with at-risk family histories using a point-of-care family history screening tool administered on an electronic tablet device during well-woman appointments. A total of 288 women were invited to participate and 136 women (47.2%) completed the electronic family history screening tool. Significantly more women were identified and referred to the genetics department with the electronic family history screening tool than the standard-of-care paper questionnaire (11.8% versus 0.8%, P < 0.001). There were no statistically significant differences in the proportion of referred women who were evaluated by the genetic counselors, and no pathogenic variants were found with either family history screening method. Implementing innovative self-reporting tools may improve inherited cancer risk detection.
Discharge Disposition and Clinical Outcomes After Spine Surgery
Authors: Minetos Paul D. , Canseco Jose A. , Karamian Brian A. , Bowles Daniel R. , Bhatt Amy H. , Semenza Nicholas C. , Murphy Hamadi , Kaye I. David , Woods Barrett I. , Rihn Jeffrey A. , Kurd Mark F. , Anderson D. Greg , Hilibrand Alan S. , Kepler Christopher K. , Vaccaro Alexander R. , Schroeder Gregory D.
Published: June 2021

Objective:

Spinal decompression with or without fusion is one of the most commonly performed procedures in spine surgery. However, there is limited evidence on the effect of discharge environment on outcomes after surgery. The purpose of this study is to identify the effects of discharge disposition setting on clinical outcomes after spine surgery.

Methods:

Patients who underwent lumbar decompression, lumbar decompression and fusion, or posterior cervical decompression and fusion surgery were retrospectively identified. All clinical and demographic data were obtained from electronic health records. Surgical outcomes included wound complications, revision surgery, “30-day” readmission (0–30 d), and “90-day” readmission (31–90 d). Discharge disposition was stratified into home/self-care, acute inpatient rehabilitation, and subacute rehabilitation. Patient-reported outcome measures including VAS Back, VAS Leg, VAS Neck, VAS Arm, PCS-12 and MCS-12, ODI, and NDI were compared between patient discharge disposition settings using the Mann–Whitney U test. Pearson’s chi-square analysis was used to assess for differences in wound complications, revision surgery, 30-day readmission, or 90-day readmission rates. Multivariate logistic regression incorporating age, sex, body mass index (BMI), Charlson Comorbidity Index (CCI), and discharge disposition was used to determine independent predictors of wound complications.

Results:

A total of 637 patients were included in the study. A significant difference (P = 0.03) was found in wound complication based on discharge disposition, with subacute disposition having the highest proportion of wound complications (6.1%) and home disposition having the lowest (1.5%). There were no significant differences in the rates of revision surgery, 30-day readmission, or 90-day readmission between groups. Subacute rehabilitation (odds ratio: 3.67, P = 0.047) and CCI (odds ratio 1.49, P = 0.01) were independent predictors of wound complications. Significant improvement in PROMs was seen across all postacute discharge dispositions. Baseline (P = 0.02) and postoperative (P = 0.02) ODI were significantly higher among patients discharged to an acute facility (49.4 and 32.0, respectively) compared to home (42.2 and 20.0) or subacute (47.4 and 28.4) environments.

Conclusion:

Subacute rehabilitation disposition and CCI are independent predictors of wound complications after spinal decompression surgery. Patients undergoing spine surgery have similar readmission and revision rates and experience similar clinical improvement across all postacute discharge dispositions.
CE: Assessing Back Pain in Patients Presenting to the ED
Authors: Carman Margaret J.
Published: June 2021

Although back pain is common, most often benign, and generally resolves in a few days with self-care, nonspecific low back pain that does not resolve with self-care and prompts patients to seek treatment in an ED may result from a serious underlying pathology. In this article, the first in a series on clinical red flags—indicators that can be used in the clinical setting to screen for an elevated risk of severe underlying conditions—the author considers back pain manifestations that may signal the presence of a debilitating or even fatal disease process. Detecting such red flags and communicating their presence to the attending provider can facilitate appropriate diagnosis and management.
Reappearance of Neurological Deficits in Pathologic Brain: Are Sedatives and Opioids Culprits? A Systematic Review
Authors: Rizk Abanoub Aziz , Venkatraghavan Lashmi , Shankar Jai J.S. , Schaller Bernhard , Chowdhury Tumul
Published: June 2021

Following a brain insult, focal neurological deficits may develop. Despite resolution of these deficits with time, the subsequent administration of sedative medications and opioids may lead to recrudescence of previous neurological deficits. Therefore, the present systematic review aims to explore the role of different sedatives and opioid analgesics at reproducing focal neurological deficits in patients with previous brain insults undergoing surgery. Our PRISMA compliant systematic review covering the literature from 1990 to 2020 showed a consistent reoccurrence of neurological deficits following administration of benzodiazepines and opioids across 12 studies. It appears that in all studies, the manifestations were transient and affected mostly middle-aged patients (45 to 67 y of age). In addition, benzodiazepines and opioid antagonism by naloxone and flumazenil reverses the unmasking of prior neurological deficits. In contrast, it is not clear based on our study whether the unmasking or worsening of neurological deficits occurs following recent injuries or an older brain insult, although for most patients it appears to be the former. Future studies are needed to elucidate the mechanisms involved in unmasking prior deficits and/or extension of prior injuries by sedative and opioid analgesics. This review will aid in developing prospective studies on individual sedative medications and their effects on unmasking neurological deficits in patients with multiple brain pathologies.