bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparative Study of Performance Between Two Combined Ventilation Systems and Their Effect On Indoor Air Quality and Thermal Comfort Inside Office Rooms
Authors: Saheb Hussien Aziz , Mahdi Ala’a Abbas , Al-amir Qusay Rasheed
Published: March 2021

The most important problems that must be solved and improved in ventilation research are indoor air quality and thermal comfort. The Iraqi climate is characterized by being very hot and dry, so fresh cold air must be provided to the occupants of offices, factories, workshops and others to improve thermal comfort and increase their efficiency. This study focused on improving the quality of inhaled air by using two types of ventilation systems (mixing and displacement ventilation) in combined with a personal ventilation system. This study was a set of numerical tests that were conducted to predict the temperature distribution, air movement and speed inside a closed office room subject to the Iraqi climate in terms of weather conditions. This numerical study was carried out using (AIRPAK3.0.16) which is used to solve turbulence equations, Naiver stock, energy equations, and use of (FVM). A thermally isolated room was simulated with a personal ventilation system that supplies air at temperatures from 21 to 23 °C for case I (personal and mixing) and supplies air at a temperature from 18 to 20 °C for case II (personal and displacement) the air velocity for both cases was 0.6 m/s. It was found that there was a positive effect of the personal ventilation system in both cases, but its effect was more pronounced in the first case, through numerical calculations for each of the effectiveness of heat removal (εt) and air distribution performance index (ADPI), where (74.361) and (1.549) were found for the first case, and (68.321) and (1.71) for the second case.
An Experimental study of some Physical properties on Gallium Antimonide Nanocrystals
Authors: Majeed Saad , Al-Rawi Bilal K.
Published: March 2021

This study includes preparing Nano-thin films of gallium antimonide (GaSb) and study the physical properties of this films. These films are prepared by using a vacuum evaporation technique with pressure (10−6 Torr). They were deposited on glass substrates. After the preparation process, some of its optical and structural properties, such as (energy gap, optical absorption, AFM, SEM and XRD) were studied. By discussing the results, it was found that the prepared GaSb thin films have worthwhile structural and optical properties. These properties can be used in the preparation and manufacture of infrared devices, laser detectors and photoelectric applications. The distinguished obtained characteristics are of interest to a large number of researchers within the fields of semiconducting materials. The potential applications that could employ GaSb Nano-thin films in their work are infrared devices and wide range applications of detectors and photo electronics. For example, Li-Fi technology, which relies on visible light as a means of transmitting data instead of radio frequencies, in addition to it does not generate any radiation as in Wi-Fi, as it ultimately depends on visible light.
Morphology, Structure, and Optical Properties of ZnO nanorods/Eosin-y Grown via Microwave-assisted Hydrothermal Method
Authors: Rahma A J , Oleiwi H F , Khaleel S G , Mutter M M
Published: March 2021

Zinc Oxide (ZnO) was a highly attractive semiconductor material because it has a lot of properties such as non-toxic oxide, a friend of the environment, and stability for biological and biomedical applications. ZnO nanoparticle was deposited on the FTO substrates using sol-gel and spin-coating techniques and microwave-assisted hydrothermal methods were used to grow ZnO nanorods (ZNRs) from the seed layer. After that, the surface of ZNRs was modified using organic Eosin-y dye with different concentrations (0.5, 1, and 3) mM to enhance the surface of ZNRs. The XRD patterns of the as-synthesized ZNRs were indicated that the wurtzite hexagonal structure and the diameter of ZNRs will be increased after coated with Eosin-y and the surface becomes rough. The ZNRs/Eosin-y adsorbed more than 50% incident light and the electronic properties of ZNRs/1mM Eosin-y were studied using Photoluminescence (PL) spectrum and the results proved that 1 mM was the optimum concentration of Eosin-y dye that lead to increase the defects which could be enhanced the properties of ZNRs surface.
Composite Breast Remodeling After Implant Removal by Tissue Recruitment and Loops Fixation With Power-Assisted Liposuction and Lipofilling (PALLL)
Authors: Abboud Marwan H , Kapila Ayush K , Bogaert Svetlana , Abboud Nicolas M
Published: March 2021

Background

An increasing number of women wish breast implant removal whilst maintaining an acceptable projection and form were possible.

Objectives

The authors propose a technique to remodel the breast after implant removal utilizing internal suture loops to project the breast, recruit abdominal and axillary tissue cranially and medially, and provide a matrix for lipofilling.

Methods

A prospective analysis was performed of consecutive patients undergoing implant extraction followed by power-assisted liposuction loops and lipofilling. Patient characteristics were measured. The aesthetic results were evaluated by 2 independent raters. Patient-reported satisfaction was measured by standardized questionnaires.

Results

Implants in 52 patients with an average age of 55 and body mass index of 23.7 were extracted followed by breast remodeling. A total of 73% of patients had implants for aesthetic reasons, 41% were smokers, and 43% of the reconstruction cases received radiotherapy. A total of 28% had implant extraction for rupture, 58% for capsular contracture, and 14% due to pain and migration. The average volume of the implants removed was 292 cc, followed by an average lipofilling of 223 cc, yielding a ratio of 0.76 to 1. The average tissue recruited by loops was 82.5 cc. Independent raters measured 79% of results as good, 13% as acceptable, and 8% as requiring improvement; 80% of patients were satisfied to very satisfied.

Conclusions

The authors propose implant extraction followed by power-assisted liposuction loops and lipofilling can provide footprint definition, sustained projection, and high patient satisfaction. Moreover, the recruitment of a vascularized adipo-cutaneous flap by loops allows a reduced ratio of fat grafting to implant volume.

Level of Evidence: 4
Clinicopathological and prognostic significance of programmed cell death ligand 1 expression in patients diagnosed with breast cancer: meta-analysis
Authors: Davey M G , Ryan É J , Davey M S , Lowery A J , Miller N , Kerin M J
Published: March 2021

Background

Uncertainty exists regarding the clinical relevance of programmed cell death ligand 1 (PD-L1) expression in breast cancer.

Methods

A systematic review was performed in accordance with PRISMA guidelines. Observational studies that compared high versus low expression of PD-L1 on breast cancer cells were identified. Log hazard ratios (HRs) for disease-free and overall survival and their standard errors were calculated from Kaplan–Meier curves or Cox regression analyses, and pooled using the inverse-variance method. Dichotomous variables were pooled as odds ratios (ORs) using the Mantel–Haenszel method.

Results

Sixty-five studies with 19 870 patients were included; 14 404 patients were classified as having low and 4975 high PD-L1 expression. High PD-L1 was associated with achieving a pathological complete response following neoadjuvant chemotherapy (OR 3.30, 95 per cent confidence interval 1.19 to 9.16; P < 0.01; I2 = 85 per cent). Low PD-L1 expression was associated with human epidermal growth factor receptor 2 (OR 3.98, 1.81 to 8.75; P < 0.001; I2 = 96 per cent) and luminal (OR 14.93, 6.46 to 34.51; P < 0.001; I2 = 99 per cent) breast cancer subtypes. Those with low PD-L1 had favourable overall survival rates (HR 1.30, 1.05 to 1.61; P = 0.02; I2 = 85 per cent).

Conclusion

Breast cancers with high PD-L1 expression are associated with aggressive clinicopathological and immunohistochemical characteristics and are more likely to achieve a pathological complete response following neoadjuvant chemotherapy. These breast cancers are, however, associated with worse overall survival outcomes.
Megasphaera in the Stool Microbiota Is Negatively Associated With Diarrheal Cryptosporidiosis
Authors: Carey Maureen A , Medlock Gregory L , Alam Masud , Kabir Mamun , Uddin Md Jashim , Nayak Uma , Papin Jason , Faruque A S G , Haque Rashidul , Petri William A , Gilchrist Carol A
Published: March 2021

Background

The protozoan parasites in the Cryptosporidium genus cause both acute diarrheal disease and subclinical (ie, nondiarrheal) disease. It is unclear if the microbiota can influence the manifestation of diarrhea during a Cryptosporidium infection.

Methods

To characterize the role of the gut microbiota in diarrheal cryptosporidiosis, the microbiome composition of both diarrheal and surveillance Cryptosporidium-positive fecal samples from 72 infants was evaluated using 16S ribosomal RNA gene sequencing. Additionally, the microbiome composition prior to infection was examined to test whether a preexisting microbiome profile could influence the Cryptosporidium infection phenotype.

Results

Fecal microbiome composition was associated with diarrheal symptoms at 2 timepoints. Megasphaera was significantly less abundant in diarrheal samples compared with subclinical samples at the time of Cryptosporidium detection (log2 [fold change] = –4.3; P = 10–10) and prior to infection (log2 [fold change] = –2.0; P = 10–4); this assigned sequence variant was detected in 8 children who had diarrhea and 30 children without diarrhea. Random forest classification also identified Megasphaera abundance in the pre- and postexposure microbiota as predictive of a subclinical infection.

Conclusions

Microbiome composition broadly, and specifically low Megasphaera abundance, was associated with diarrheal symptoms prior to and at the time of Cryptosporidium detection. This observation suggests that the gut microenvironment may play a role in determining the severity of a Cryptosporidium infection.

Clinical Trials Registration. NCT02764918.
Improved Sobolev Inequality Under Constraints
Authors: Hang Fengbo , Wang Xiaodong
Published: March 2021

We give a new proof of Aubin’s improvement of the Sobolev inequality on $ \mathbb{S}^{n}$ under the vanishing of 1st-order moments of the area element and generalize it to higher-order moments case. By careful study of an extremal problem on $\mathbb{S}^{n}$, we determine the constant explicitly in the 2nd-order moments case.
Assessment of the reliability of the IHI Global Trigger Tool: new perspectives from a Brazilian study
Authors: Moraes Sara Monteiro , Ferrari Teresa Cristina Abreu , Figueiredo Natália Mansur Pimentel , Almeida Thaís Novaes Costa , Sampaio Caio César Lôbo , Andrade Yane Cristine Pereira , Benedito Regina Oliveira , Beleigoli Alline Maria
Published: March 2021

Objective

To assess the reliability of the Institute for Healthcare Improvement's Global Trigger Tool (IHI-GTT) between nurses and medical students as primary reviewers to measure adverse events (AEs).

Design

Interrater reliability study.

Setting

A 500-bed general public hospital in Belo Horizonte, Brazil.

Participants

A randomly selected sample of 220 hospital admissions of adults (≥18 years) from Oct-Nov, 2016.

Intervention

Two 4th-5th year-medical students and two experienced nurses applied a Portuguese-translated version of the IHI-GTT to medical records. The role of medical reviewer was performed by two senior physicians specialists in Internal Medicine.

Main Outcome Measures

Ability to identify AEs was compared between pairs and against medical reviewer through percentage inter-examiner agreement and Kappa coefficient (K). Two outcomes -- “AE identification” and “category of harm” -- were evaluated according to two different denominators  -- “admissions” (the total number of admissions evaluated in the sample; reflects the presence or not of at least one AE in each admission) and “all possibilities of agreement” (obtained by adding each identified AE to the admissions without events; allows agreement assessment to be performed for each AE individually).

Results

Were identified 199 adverse events in 90 hospitalizations, with rates of 40.9% of admissions with AEs, 76.1 AEs/1,000 patient-days and 90.5 AEs/100 admissions. Comparing student–pair and nurse–pair, we found K = 0.76 (95% IC 0.62–0.88) and K = 0.17 (95% IC 0.06–0.27) for “AE identification” outcome and K = 0.28 (95% IC 0.01–0.55) and K = 0.46 (95% IC 0.28–0.64) for “category of harm” outcome to denominators “admission” and “all possibilities of agreement”, respectively. There was no significant difference between the performances of the different primary reviewers composed in any analyses.

Conclusion

IHI-GTT reliability varies considerably depending on the denominator used to calculate agreement. As the purpose of the tool is, in addition to measuring, promoting opportunities for quality of care improvement, the individual analysis of the AEs seems more appropriate. Further studies are needed to assess the implications of the slight agreement reached between primary reviewers on the test‘s overall accuracy. Moreover, advanced medical students may be considered for primary review in settings where unavailability of staff is a barrier to IHI-GTT adoption.
Identifying risk of opioid use disorder for patients taking opioid medications with deep learning
Authors: Dong Xinyu , Deng Jianyuan , Rashidian Sina , Abell-Hart Kayley , Hou Wei , Rosenthal Richard N , Saltz Mary , Saltz Joel H , Wang Fusheng
Published: March 2021

Objective

The United States is experiencing an opioid epidemic. In recent years, there were more than 10 million opioid misusers aged 12 years or older annually. Identifying patients at high risk of opioid use disorder (OUD) can help to make early clinical interventions to reduce the risk of OUD. Our goal is to develop and evaluate models to predict OUD for patients on opioid medications using electronic health records and deep learning methods. The resulting models help us to better understand OUD, providing new insights on the opioid epidemic. Further, these models provide a foundation for clinical tools to predict OUD before it occurs, permitting early interventions.

Methods

Electronic health records of patients who have been prescribed with medications containing active opioid ingredients were extracted from Cerner’s Health Facts database for encounters between January 1, 2008, and December 31, 2017. Long short-term memory models were applied to predict OUD risk based on five recent prior encounters before the target encounter and compared with logistic regression, random forest, decision tree, and dense neural network. Prediction performance was assessed using F1 score, precision, recall, and area under the receiver-operating characteristic curve.

Results

The long short-term memory (LSTM) model provided promising prediction results which outperformed other methods, with an F1 score of 0.8023 (about 0.016 higher than dense neural network (DNN)) and an area under the receiver-operating characteristic curve (AUROC) of 0.9369 (about 0.145 higher than DNN).

Conclusions

LSTM–based sequential deep learning models can accurately predict OUD using a patient’s history of electronic health records, with minimal prior domain knowledge. This tool has the potential to improve clinical decision support for early intervention and prevention to combat the opioid epidemic.
Potential interaction between autophagy and auxin during maize leaf senescence
Authors: Feng Xue , Liu Lili , Li Zhigang , Sun Fang , Wu Xiaoyuan , Hao Dongyun , Hao Huaiqing , Jing Hai-Chun
Published: March 2021

Leaf senescence is important for crop yield as delaying it can increase the average yield. In this study, population genetics and transcriptomic profiling were combined to dissect its genetic basis in maize. To do this, the progenies of an elite maize hybrid Jidan27 and its parental lines Si-287 (early senescence) and Si-144 (stay-green), as well as 173 maize inbred lines were used. We identified two novel loci and their candidate genes, Stg3 (ZmATG18b) and Stg7 (ZmGH3.8), which are predicted to be members of autophagy and auxin pathways, respectively. Genomic variations in the promoter regions of these two genes were detected, and four allelic combinations existed in the examined maize inbred lines. The Stg3Si-144/Stg7Si-144 allelic combination with lower ZmATG18b expression and higher ZmGH3.8 expression could distinctively delay leaf senescence, increase ear weight and the improved hybrid of NIL-Stg3Si-144/Stg7Si-144 × Si-144 significantly reduced ear weight loss under drought stress, while opposite effects were observed in the Stg3Si-287/Stg7Si-287 combination with a higher ZmATG18b expression and lower ZmGH3.8 expression. Thus, we identify a potential interaction between autophagy and auxin which could modulate the timing of maize leaf senescence.
Distinct plastid fructose bisphosphate aldolases function in photosynthetic and non-photosynthetic metabolism in Arabidopsis
Authors: Carrera Dániel Árpád , George Gavin M , Fischer-Stettler Michaela , Galbier Florian , Eicke Simona , Truernit Elisabeth , Streb Sebastian , Zeeman Samuel C
Published: March 2021

Plastid metabolism is critical in both photoautotrophic and heterotrophic plant cells. In chloroplasts, fructose-1,6-bisphosphate aldolase (FBA) catalyses the formation of both fructose 1,6-bisphosphate and sedoheptulose 1,7-bisphosphate within the Calvin–Benson cycle. Three Arabidopsis genes, AtFBA1–AtFBA3, encode plastidial isoforms of FBA, but the contribution of each isoform is unknown. Phylogenetic analysis indicates that FBA1 and FBA2 derive from a recently duplicated gene, while FBA3 is a more ancient paralog. fba1 mutants are phenotypically indistinguishable from the wild type, while both fba2 and fba3 have reduced growth. We show that FBA2 is the major isoform in leaves, contributing most of the measurable activity. Partial redundancy with FBA1 allows both single mutants to survive, but combining both mutations is lethal, indicating a block of photoautotrophy. In contrast, FBA3 is expressed predominantly in heterotrophic tissues, especially the leaf and root vasculature, but not in the leaf mesophyll. We show that the loss of FBA3 affects plastidial glycolytic metabolism of the root, potentially limiting the biosynthesis of essential compounds such as amino acids. However, grafting experiments suggest that fba3 is dysfunctional in leaf phloem transport, and we suggest that a block in photoassimilate export from leaves causes the buildup of high carbohydrate concentrations and retarded growth.
Cis-regulation of the amino acid transporter genes ZmAAP2 and ZmLHT1 by ZmPHR1 transcription factors in maize ear under phosphate limitation
Authors: Wang Ruifeng , Zhong Yanting , Liu Xiaoting , Zhao Cheng , Zhao Jianyu , Li Mengfei , Ul Hassan Mahmood , Yang Bo , Li Dongdong , Liu Renyi , Li Xuexian
Published: March 2021

Phosphorus and nitrogen nutrition have profound and complicated innate connections; however, underlying molecular mechanisms are mostly elusive. PHR1 is a master phosphate signaling component, and whether it directly functions in phosphorus–nitrogen crosstalk remains a particularly interesting question. In maize, nitrogen limitation caused tip kernel abortion and ear shortening. By contrast, moderately low phosphate in the field reduced kernels across the ear, maintained ear elongation and significantly lowered concentrations of total free amino acids and soluble proteins 2 weeks after silking. Transcriptome profiling revealed significant enrichment and overall down-regulation of transport genes in ears under low phosphate. Importantly, 313 out of 847 differentially expressed genes harbored PHR1 binding sequences (P1BS) including those controlling amino acid/polyamine transport and metabolism. Specifically, both ZmAAP2 and ZmLHT1 are plasma membrane-localized broad-spectrum amino acid transporters, and ZmPHR1.1 and ZmPHR1.2 were able to bind to P1BS-containing ZmAAP2 and ZmLHT1 and down-regulate their expression in planta. Taken together, the results suggest that prevalence of P1BS elements enables ZmPHR1s to regulate a large number of low phosphate responsive genes. Further, consistent with reduced accumulation of free amino acids, ZmPHR1s down-regulate ZmAAP2 and ZmLHT1 expression as direct linkers of phosphorus and nitrogen nutrition independent of NIGT1 in maize ear under low phosphate.
Galactic merger implications for eccentric nuclear discs: a mechanism for disc alignment
Authors: Rodriguez Alexander , Generozov Aleksey , Madigan Ann-Marie
Published: March 2021

The nucleus of our nearest, large galactic neighbour, M31, contains an eccentric nuclear disc – a disc of stars on eccentric, apsidally aligned orbits around a supermassive black hole (SMBH). Previous studies of eccentric nuclear discs considered only an isolated disc, and did not study their dynamics under galaxy mergers (particularly a perturbing SMBH). Here, we present the first study of how eccentric discs are affected by a galactic merger. We perform N-body simulations to study the disc under a range of different possible SMBH initial conditions. A second SMBH in the disc always disrupts it, but more distant SMBHs can shut off differential precession and stabilize the disc. This results in a more aligned disc, nearly uniform eccentricity profile, and suppression of tidal disruption events compared to the isolated disc. We also discuss implications of our work for the presence of a secondary SMBH in M31.
Pushing automated morphological classifications to their limits with the Dark Energy Survey
Authors: Vega-Ferrero J , Domínguez Sánchez H , Bernardi M , Huertas-Company M , Morgan R , Margalef B , Aguena M , Allam S , Annis J , Avila S , Bacon D , Bertin E , Brooks D , Carnero Rosell A , Carrasco Kind M , Carretero J , Choi A , Conselice C , Costanzi M , da Costa L N , Pereira M E S , De Vicente J , Desai S , Ferrero I , Fosalba P , Frieman J , García-Bellido J , Gruen D , Gruendl R A , Gschwend J , Gutierrez G , Hartley W G , Hinton S R , Hollowood D L , Honscheid K , Hoyle B , Jarvis M , Kim A G , Kuehn K , Kuropatkin N , Lima M , Maia M A G , Menanteau F , Miquel R , Ogando R L C , Palmese A , Paz-Chinchón F , Plazas A A , Romer A K , Sanchez E , Scarpine V , Schubnell M , Serrano S , Sevilla-Noarbe I , Smith M , Suchyta E , Swanson M E C , Tarle G , Tarsitano F , To C , Tucker D L , Varga T N , Wilkinson R D
Published: March 2021

We present morphological classifications of ∼27 million galaxies from the Dark Energy Survey (DES) Data Release 1 (DR1) using a supervised deep learning algorithm. The classification scheme separates: (a) early-type galaxies (ETGs) from late-type galaxies (LTGs); and (b) face-on galaxies from edge-on. Our convolutional neural networks (CNNs) are trained on a small subset of DES objects with previously known classifications. These typically have mr ≲ 17.7 mag; we model fainter objects to mr < 21.5 mag by simulating what the brighter objects with well-determined classifications would look like if they were at higher redshifts. The CNNs reach 97 per cent accuracy to mr < 21.5 on their training sets, suggesting that they are able to recover features more accurately than the human eye. We then used the trained CNNs to classify the vast majority of the other DES images. The final catalogue comprises five independent CNN predictions for each classification scheme, helping to determine if the CNN predictions are robust or not. We obtain secure classifications for ∼87 per cent and 73 per cent of the catalogue for the ETG versus LTG and edge-on versus face-on models, respectively. Combining the two classifications (a) and (b) helps to increase the purity of the ETG sample and to identify edge-on lenticular galaxies (as ETGs with high ellipticity). Where a comparison is possible, our classifications correlate very well with Sérsic index (n), ellipticity (ϵ), and spectral type, even for the fainter galaxies. This is the largest multiband catalogue of automated galaxy morphologies to date.
MAYONNAISE: a morphological components analysis pipeline for circumstellar discs and exoplanets imaging in the near-infrared
Authors: Pairet Benoît , Cantalloube Faustine , Jacques Laurent
Published: March 2021

Imaging circumstellar discs in the near-infrared provides unprecedented information about the formation and evolution of planetary systems. However, current post-processing techniques for high-contrast imaging using ground-based telescopes have a limited sensitivity to extended signals and their morphology is often plagued with strong morphological distortions. Moreover, it is challenging to disentangle planetary signals from the disc when the two components are close or intertwined. We propose a pipeline that is capable of detecting a wide variety of discs and preserving their shapes and flux distributions. By construction, our approach separates planets from discs. After analysing the distortions induced by the current angular differential imaging (ADI) post-processing techniques, we establish a direct model of the different components constituting a temporal sequence of high-contrast images. In an inverse problem framework, we jointly estimate the starlight residuals and the potential extended sources and point sources hidden in the images, using low-complexity priors for each signal. To verify and estimate the performance of our approach, we tested it on VLT/SPHERE-IRDIS data, in which we injected synthetic discs and planets. We also applied our approach on observations containing real discs. Our technique makes it possible to detect discs from ADI data sets of a contrast above 3 × 10−6 with respect to the host star. As no specific shape of the discs is assumed, we are capable of extracting a wide diversity of discs, including face-on discs. The intensity distribution of the detected disc is accurately preserved and point sources are distinguished, even close to the disc.
The Genomic Architecture of Adaptation to Larval Malnutrition Points to a Trade-off with Adult Starvation Resistance in Drosophila
Authors: Kawecki Tadeusz J. , Erkosar Berra , Dupuis Cindy , Hollis Brian , Stillwell R. Craig , Kapun Martin
Published: March 2021

Periods of nutrient shortage impose strong selection on animal populations. Experimental studies of genetic adaptation to nutrient shortage largely focus on resistance to acute starvation at adult stage; it is not clear how conclusions drawn from these studies extrapolate to other forms of nutritional stress. We studied the genomic signature of adaptation to chronic juvenile malnutrition in six populations of Drosophila melanogaster evolved for 150 generations on an extremely nutrient-poor larval diet. Comparison with control populations evolved on standard food revealed repeatable genomic differentiation between the two set of population, involving >3,000 candidate SNPs forming >100 independently evolving clusters. The candidate genomic regions were enriched in genes implicated in hormone, carbohydrate, and lipid metabolism, including some with known effects on fitness-related life-history traits. Rather than being close to fixation, a substantial fraction of candidate SNPs segregated at intermediate allele frequencies in all malnutrition-adapted populations. This, together with patterns of among-population variation in allele frequencies and estimates of Tajima’s D, suggests that the poor diet results in balancing selection on some genomic regions. Our candidate genes for tolerance to larval malnutrition showed a high overlap with genes previously implicated in acute starvation resistance. However, adaptation to larval malnutrition in our study was associated with reduced tolerance to acute adult starvation. Thus, rather than reflecting synergy, the shared genomic architecture appears to mediate an evolutionary trade-off between tolerances to these two forms of nutritional stress.
Patient-reported factors influencing the choice of their kidney replacement treatment modality
Authors: de Jong Rianne W , Stel Vianda S , Rahmel Axel , Murphy Mark , Vanholder Raymond C , Massy Ziad A , Jager Kitty J
Published: March 2021

Background

Access to various kidney replacement therapy (KRT) modalities for patients with end-stage kidney disease differs substantially within Europe.

Methods

European adults on KRT filled out an online or paper-based survey about factors influencing and experiences with modality choice (e.g. information provision, decision-making and reasons for choice) between November 2017 and January 2019. We compared countries with low, middle and high gross domestic product (GDP).

Results

In total, 7820 patients [mean age 59 years, 56% male, 63% on centre haemodialysis (CHD)] from 38 countries participated. Twenty-five percent had received no information on the different modalities, and only 23% received information >12 months before KRT initiation. Patients were not informed about home haemodialysis (HHD) (42%) and comprehensive conservative management (33%). Besides nephrologists, nurses more frequently provided information in high-GDP countries, whereas physicians other than nephrologists did so in low-GDP countries. Patients from low-GDP countries reported later information provision, less information about other modalities than CHD and lower satisfaction with information. The majority of modality decisions were made involving both patient and nephrologist. Patients reported subjective (e.g. quality of life and fears) and objective reasons (e.g. costs and availability of treatments) for modality choice. Patients had good experiences with all modalities, but experiences were better for HHD and kidney transplantation and in middle- and high-GDP countries.

Conclusion

Our results suggest European differences in patient-reported factors influencing KRT modality choice, possibly caused by disparities in availability of KRT modalities, different healthcare systems and varying patient preferences. Availability of home dialysis and kidney transplantation should be optimized.
When expressions of faith in the Philippines becomes a potential COVID-19 ‘superspreader’
Authors: Canete Jonathan James O
Published: March 2021

The Filipino people are known for their strong religious faith. Even in the midst of the most trying moments of their collective history their faith remains steadfast. The isolation brought by the COVID-19 pandemic did not stop the Filipino Catholic faithful from expressing their faith but made it stronger. Allowed by the government to attend Church celebrations, the Filipino Catholic devotee flocked in the Quiapo Church just to attend the feast of the Black Nazarene and had a chance to hold its image with a firm conviction that the grace of God could protect them from the pandemic. However, the local medical experts called their devotion, in this time of crisis, as a ‘superspreader’, a sign not of hope but of despair.
Characteristics of patients with difficult-to-treat rheumatoid arthritis in clinical practice
Authors: Takanashi Satoshi , Kaneko Yuko , Takeuchi Tsutomu
Published: March 2021

Objectives

The aim of this study was to investigate the clinical characteristics of patients with difficult-to-treat RA (D2T RA) and the usefulness of switching to drugs with different modes of action in real-world.

Methods

We reviewed all consecutive patients with RA treated at Keio University Hospital between 2016 and 2017 with a definition of D2T RA. We analysed clinical characteristics and evaluated the usefulness of changing drugs according to mode of action.

Results

Among 1709 patients with RA, 173 (10.1%) were D2T RA. The reason for the D2T RA was multi-drug resistance in 59 patients (34.1%), comorbidity in 17 (9.8%), and socio-economic reasons in 97 (56.1%). The multi-drug-resistance group had significantly higher tender joint count and evaluator global assessment than the other groups, despite receiving the most intensive treatment. The comorbidity group showed a significantly older age and higher rheumatic disease comorbidity index. Although changing the drug to another with a different mode of action was useful, the proportion of patients who achieved remission or low disease activity decreased as the number of switches increased.

Conclusion

Of the patients with RA, 10.1% were still difficult to treat in clinical practice, despite intensive treatment. Their characteristics were distinct by the reasons of D2T RA, which suggests the need for a personalized approach to D2T RA.
The use and context of the term ‘multimorbidity’ in rheumatoid arthritis: a systematic literature review
Authors: Dey Mrinalini , Busby Amanda , Elwell Helen , Pratt Arthur , Young Adam , Isaacs John , Nikiphorou Elena
Published: March 2021

This systematic literature review aimed to analyse terms describing coexisting conditions in the RA literature, informing the need for an operationalized definition of multimorbidity. Articles discussing RA with multimorbidity, published 1946 until August 2020, were identified. The primary outcome was the use and/or definition of ‘multimorbidity’ in RA. Information extracted included terms defining coexisting conditions, the use of a comorbidity/multimorbidity score and the use of ‘index disease’ to describe RA (more applicable to comorbidity than multimorbidity).

Thirty-nine articles were included. Eight articles used the term ‘multimorbidity’, 18 used ‘comorbidity’ and 12 used both terms, 7 synonymously. One used no term. Fourteen articles fully defined the term. The number of co-existing conditions described in included studies was one-121. Twelve articles used a comorbidity/multimorbidity score. Four articles described RA as the ‘index disease’. Our results demonstrate inconsistent use of the term multimorbidity. Improved assessment of multimorbidity is indicated in RA patients, including an operationalized use and definition.
Hyperactivity is a Core Endophenotype of Elevated Neuregulin-1 Signaling in Embryonic Glutamatergic Networks
Authors: Götze Tilmann , Soto-Bernardini Maria Clara , Zhang Mingyue , Mießner Hendrik , Linhoff Lisa , Brzózka Magdalena M , Velanac Viktorija , Dullin Christian , Ramos-Gomes Fernanda , Peng Maja , Husseini Hümeyra , Schifferdecker Eva , Fledrich Robert , Sereda Michael W , Willig Katrin , Alves Frauke , Rossner Moritz J , Nave Klaus-Armin , Zhang Weiqi , Schwab Markus H
Published: March 2021

The neuregulin 1 (NRG1) ErbB4 module is at the core of an “at risk” signaling pathway in schizophrenia. Several human studies suggest hyperstimulation of NRG1-ErbB4 signaling as a plausible pathomechanism; however, little is known about the significance of stage-, brain area-, or neural cell type-specific NRG1-ErbB4 hyperactivity for disease-relevant brain endophenotypes. To address these spatiotemporal aspects, we generated transgenic mice for Cre recombinase-mediated overexpression of cystein-rich domain (CRD) NRG1, the most prominent NRG1 isoform in the brain. A comparison of “brain-wide” vs cell type-specific CRD-NRG1 overexpressing mice revealed that pathogenic CRD-NRG1 signals for ventricular enlargement and neuroinflammation originate outside glutamatergic neurons and suggests a subcortical function of CRD-NRG1 in the control of body weight. Embryonic onset of CRD-NRG1 in glutamatergic cortical networks resulted in reduced inhibitory neurotransmission and locomotor hyperactivity. Our findings identify ventricular enlargement and locomotor hyperactivity, 2 main endophenotypes of schizophrenia, as specific consequences of spatiotemporally distinct expression profiles of hyperactivated CRD-NRG1 signaling.
Fronto-Temporal Disconnection Within the Presence Hallucination Network in Psychotic Patients With Passivity Experiences
Authors: Stripeikyte Giedre , Potheegadoo Jevita , Progin Pierre , Rognini Giulio , Blondiaux Eva , Salomon Roy , Griffa Alessandra , Hagmann Patric , Faivre Nathan , Do Kim Q , Conus Philippe , Blanke Olaf
Published: March 2021

Psychosis, characterized by hallucinations and delusions, is a common feature of psychiatric disease, especially schizophrenia. One prominent theory posits that psychosis is driven by abnormal sensorimotor predictions leading to the misattribution of self-related events. This misattribution has been linked to passivity experiences (PE), such as loss of agency and, more recently, to presence hallucinations (PH), defined as the conscious experience of the presence of an alien agent while no person is actually present. PH has been observed in schizophrenia, Parkinson’s disease, and neurological patients with brain lesions and, recently, the brain mechanisms of PH (PH-network) have been determined comprising bilateral posterior middle temporal gyrus (pMTG), inferior frontal gyrus (IFG), and ventral premotor cortex (vPMC). Given that the experience of an alien agent is a common feature of PE, we here analyzed the functional connectivity within the PH-network in psychotic patients with (N = 39) vs without PE (N = 26). We observed reduced fronto-temporal functional connectivity in patients with PE compared to patients without PE between the right pMTG and the right and left IFG of the PH-network. Moreover, when seeding from these altered regions, we observed specific alterations with brain regions commonly linked to auditory-verbal hallucinations (such as Heschl’s gyrus). The present connectivity findings within the PH-network extend the disconnection hypothesis for hallucinations to the specific case of PH and associates the PH-network with key brain regions for frequent psychotic symptoms such as auditory-verbal hallucinations, showing that PH are relevant to the study of the brain mechanisms of psychosis and PE.
Cognitive Predictors of Social and Occupational Functioning in Early Psychosis: A Systematic Review and Meta-analysis of Cross-Sectional and Longitudinal Data
Authors: Cowman Megan , Holleran Laurena , Lonergan Edgar , O’Connor Karen , Birchwood Max , Donohoe Gary
Published: March 2021

Many individuals with early psychosis experience impairments in social and occupational function. Identification of modifiable predictors of function such as cognitive performance has the potential to inform effective treatments. Our aim was to estimate the strength of the relationship between psychosocial function in early psychosis and different domains of cognitive and social cognitive performance. We conducted a systematic review and meta-analysis of peer-reviewed, cross-sectional, and longitudinal studies examining cognitive predictors of psychosocial function. Literature searches were conducted in PsycINFO, PubMed, and reference lists of relevant articles to identify studies for inclusion. Of the 2565 identified, 46 studies comprising 3767 participants met inclusion criteria. Separate meta-analyses were conducted for 9 cognitive domains. Pearson correlation values between cognitive variables and function were extracted. All cognitive domains were related to psychosocial function both cross-sectionally and longitudinally. Importantly, these associations remained significant even after the effects of symptom severity, duration of untreated psychosis, and length of illness were accounted for. Overall, general cognitive ability and social cognition were most strongly associated with both concurrent and long-term function. Associations demonstrated medium effect sizes. These findings suggest that treatments targeting cognitive deficits, in particular those focusing on social cognition, are likely to be important for improving functional outcomes in early psychosis.
Identification of Fungal Species Associated with Crown and Root Rots of Wheat and Evaluation of Plant Reactions to the Pathogens in North Dakota
Authors: Shrestha Subidhya , Poudel Roshan Sharma , Zhong Shaobin
Published: March 2021

Common root rot (CRR) and crown rot (CR), caused by Bipolaris sorokiniana and Fusarium species, respectively, can cause significant yield losses in cereal crops. To assess the prevalence, incidence, and severity of these diseases in North Dakota, wheat samples were collected from spring wheat fields across the state in 2012, 2013, and 2014. Based on subcrown internode symptoms, a greater incidence and severity of CRR was observed in 2012 (warm and dry year) than in 2013 and 2014. Also, the Northwestern Glaciated Plains and Northwestern Great Plains ecoregions showed greater CRR incidence and severity compared with the Northern Glaciated Plains and Lake Agassiz Plains ecoregions in the state. B. sorokiniana and Fusarium species, including Fusarium acuminatum, Fusarium avenaceum, Fusarium culmorum, Fusarium graminearum, Fusarium equiseti, Fusarium pseudograminearum, Fusarium oxysporum, Fusarium redolens, Fusarium sporotrichioides, and Fusarium solani were isolated and identified from the root and crown tissues of the wheat samples. B. sorokiniana was isolated more frequently than other fungal species in all sampled years and ecoregions of North Dakota. F. acuminatum, F. avenaceum, F. culmorum, F. equiseti, F. graminearum, F. pseudograminearum, and F. redolens were pathogenic causing infections on seedlings of the two wheat genotypes (ND652 and Alsen), whereas isolates of F. oxysporum and F. solani were nonpathogenic and considered as secondary invaders associated with the root and CR diseases. Evaluation of some spring wheat genotypes for reactions to one B. sorokiniana isolate at seedling and adult plant stages, and one F. culmorum isolate at the seedling stage, indicated that susceptibility to these pathogens varied among different wheat genotypes tested. This study provides useful information on fungal species associated with CRR and CR of wheat in North Dakota and on resistant/susceptible reactions of some spring wheat lines to the different fungal isolates evaluated.
Collaborative Testing: An Opportunity for Student‐centered Feedback and Peer Learning
Authors: Terrell Mark
Published: March 2021

Along with the learning process, assessment is considered an important component of an educational setting. Assessment plays a significant role in helping students learn when it is interweaved with learning and instruction instead of being postponed at the end of a unit or course. As knowledge construction necessitates higher order thinking, new forms of assessment are required. Consequently, a social constructivist model of learning was used to develop structured peer‐group lecture exams to test the hypothesis that lecture exams can be used as a formative learning tool during assessment practices. Each semester, two of four unit exams were taken by students using individual effort only and the other two exams were completed in a combined format: individually first and then immediately retaking the same exam using small group discussions; a final comprehensive exam was completed individually. Performance on the collaborative unit exams was higher (P < 0.001) than on the individual‐effort exams of the same semester. Mean final comprehensive exam scores increased (P < 0.01) compared to previous semesters that did not use collaborative testing. Performance on unit sections of the comprehensive final exam that were associated with the collaborative testing technique earlier in the semester was higher (P < 0.01) than units on the final that did not use it. Student perceptions rated collaborative testing as positive and indicated that discussions during exams were very helpful toward their mastery of course content. These results suggest that adding a formative learning component to traditional examinations allows students to actually learn from the assessment event itself by providing immediate feedback in identifying concept errors, to monitor their personal learning progress, and to further direct their learning process.
Development and Validation of a Community Assessment Survey for Diverse Rural Family Caregivers of People With Alzheimer Disease and Related Dementias
Authors: McCarthy Michael J. , Lee-Regalado Hustead Morgan , Bacon Rachel , Garcia Y. Evie , Dunn Dorothy J. , Williamson Heather J. , Baldwin Julie
Published: March 2021

Many individuals with Alzheimer disease and related dementias receive care from family members and friends. Rurality adds increased complexity to care, especially for diverse caregivers. This study details the development and content validation process for a community assessment survey for rural white, Latinx, and American Indian/Alaska Native Alzheimer disease and related dementias caregivers. Foundational survey items were based upon instruments validated with diverse rural caregivers. A modified Delphi process (2 rounds) was used to refine items. The process concluded when 75%+ of experts agreed that the survey was (1) inclusive of different cultural groups; (2) respectful of cultural values and norms; (3) comprehensive with respect to needs, assets, and resources, and (4) relevant to the experiences of diverse rural caregivers. Round 1 of the process (N = 9 panelists) resulted in the elimination of 2 survey sections, a greater focus on issues including transportation and roles of extended family members, and the inclusion of open-ended questions. Round 2 (N = 6 panelists) resulted in further improvements, particularly to the sections about cultural customs, beliefs, and traditions and interactions with health care and other providers. Benefits of the process included raising awareness about rural caregiving issues and maximizing data quality. Challenges included honoring the diversity of respondents' opinions and balancing research rigor with community utility. This community assessment survey may help researchers better understand the needs and culturally–based strengths of diverse rural family caregivers.
Does General Anesthesia Compared With Conscious Sedation Result in Better Outcomes in Acute Stroke Patients Undergoing Endovascular Therapy?
Authors: Howard Levi W. , Demaerschalk Bart M. , Chong Brian W. , Bendok Bernard R. , Gritsch David , Marks Lisa A. , Wingerchuk Dean M. , O’Carroll Cumara B.
Published: March 2021

Background:

There is considerable controversy surrounding the optimal use of sedation in patients with acute ischemic stroke undergoing mechanical thrombectomy. Several retrospective studies have favored conscious sedation (CS) over general anesthesia (GA) in terms of functional outcomes and mortality. Recent data from randomized controlled trials has challenged this view.

Objective:

The aim was to critically assess current evidence regarding the use of CS versus GA in mechanical thrombectomy for acute ischemic stroke.

Methods:

The objective was addressed through the development of a critically appraised topic that included a clinical scenario, structured question, literature search strategy, critical appraisal, assessment of results, evidence summary, commentary, and bottom-line conclusions. Participants included consultant and resident neurologists, a medical librarian, clinical epidemiologists, and content experts in the field of vascular neurology, vascular neurosurgery, and interventional neuroradiology.

Results:

A randomized controlled trial was selected for critical appraisal. This trial compared 128 patients with acute ischemic stroke and large vessel occlusion from a single center (Aarhus University Hospital, Denmark), 65 of whom received GA and 63 received CS. No significant difference was detected for the primary outcome of volume of infarct growth. The rate of successful thrombectomy and favorable clinical outcomes for the GA arm was significantly higher in the intention-to-treat analysis.

Conclusions:

GA does not result in worse tissue outcomes or worse clinical outcomes when compared with CS in acute stroke patients with large vessel occlusion undergoing mechanical thrombectomy.