bluuebunny/crossref_metadata_2025 huggingface dataset:
Electrical conductivity of melts: implications for conductivity anomalies in the Earth's mantle
Authors: Zhang Bao-Hua , Guo Xuan , Yoshino Takashi , Xia Qun-Ke
Published: April 2021

Magmatic liquids, including silicate and carbonate melts, are principal agents of mass and heat transfer in the Earth and terrestrial planets, and they play a crucial role in various geodynamic processes and in Earth's evolution. Electrical conductivity data of these melts elucidate the cause of electrical anomalies in Earth's interior and shed light on the melt structure. With the improvement in high-pressure experimental techniques and theoretical simulations, major progress has been made on this front in the past several decades. This review aims to summarize recent advances in experimental and theoretical studies on the electrical conductivity of silicate and carbonate melts of different compositions and volatile contents under high temperature and pressure. The electrical conductivity of silicate melts depends strongly on temperature, pressure, water content and the ratio of non-bridging oxygens to tetrahedral cations (NBO/T). By contrast, the electrical conductivity of carbonate melts exhibits a weak dependence on temperature and pressure due to their fully depolymerized structure. The electrical conductivity of carbonate melts is higher than that of silicate melts by at least two orders of magnitude. Water can increase electrical conductivity significantly and reduce the activation energy of silicate melts. Conversely, this effect is weak for carbonate melts. In addition, the replacement of alkali-earth elements (Ca2+ or Mg2+) with alkali elements causes a significant decrease in the electrical conductivity of carbonate melts. A distinct compensation trend is revealed for the electrical conductivity of silicate and carbonate melts under anhydrous and hydrous conditions. Several important applications of laboratory-based melt conductivity are introduced in order to understand the origin of high-conductivity anomalies in the Earth's mantle. Perspectives for future studies are also provided.
Critical Challenges and Creative Solutions for Quantifying Nicotine Vaping: Qualitative Reports From Young Adults
Authors: Yamaguchi Naosuke , Kechter Afton , Schiff Sara J , Braymiller Jessica L , Ceasar Rachel Carmen , Simpson Kelsey A , Bluthenthal Ricky N , Barrington-Trimis Jessica L
Published: April 2021

Introduction

Previous studies suggest that young adults who vape nicotine experience difficulty when answering survey items assessing the quantity of vaping. The current study asked young adults who vape to provide suggestions for improving the scientific measurement of vaping.

Aims and Methods

We conducted semi-structured qualitative interviews with 62 young adults who vape in Los Angeles, California between June 2018 and June 2019. We analyzed participants' responses to the following question: “What do you think is the best way for us to understand how much people vape?” using thematic content analysis.

Results

We identified two major themes: (1) challenges stemming from differences between the way researchers query about vaping and how individuals self-monitor vaping frequency, and (2) insights for future measurement of vaping. Participants reported that challenges of accurately quantifying vaping were due to inherently hard-to-answer questions (eg, puffs per day), lack of awareness of or not actively monitoring consumption of vaping products, or because vaping behaviors vary considerably between and within individuals over time, making “on-average” questions challenging. Participants discussed ideas for improving survey measures that could accurately assess vaping quantity, including querying about the type of device used, and frequency of replenishment of nicotine solutions.

Conclusions

Existing vaping behavior survey measures may not accurately capture the quantity of vaping as they differ from how (or if) participants track their own vaping consumption patterns. While continued research is needed to optimally refine survey measures on vaping consumption, future measures may better align with vapers' self-monitoring by including questions on device-type and replenishment frequency.

Implications

The present study provides insights regarding the variability that exists between vaping quantity measurements utilized by researchers and individuals who consume e-cigarettes. The qualitative data analyzed for this study support previous reports of difficulties faced by vapers when asked questions by researchers related to their vaping behavior. Furthermore, the present findings suggest the direction for the future development of accurate measurements of vaping frequency.
Folly and Improvised Rhyme in King Lear
Authors: Clark Molly
Published: April 2021

This article focuses on rhyme, specifically the extemporary rhyme that was a hallmark of early modern professional clowns and fools, and its contribution to the battle between sense and nonsense in King Lear. In the first half, I trace this rhyming tradition through Will Sommers, to Richard Tarlton, to Robert Armin, exploring the ‘rhyme and reason’ paradigm in this context, and considering the unique forms of interactive comedy that become possible when writers and performers exploit this technique. I pay particular attention to the dramatic potential of the ‘quip’: an improvised rhyming riposte for which Tarlton was famous, and which Armin picked up again onstage as well as in his own published writing. In the latter half of the article, I move on to consider the collaborative relationship between Armin and Shakespeare, focusing on King Lear. I argue that Shakespeare plays with the tradition of improvised fool rhymes, particularly the quip, when crafting the speech of Lear’s Fool and Poor Tom. Considering both characters, and also both versions (quarto and Folio), I argue that ‘improvisatory’ rhyme strikes a key note in the play, epitomizing nonsensical truth-telling in a world in which speaking and listening have a fraught relationship.
THE SINGLE PILL CONCEPT LEADS TO IMPROVED PERSISTENCE OF MEDICATION, CLINICAL OUTCOMES AND REDUCED ALL‐CAUSE MORTALITY IN HYPERTENSIVE PATIENTS – RESULTS FROM THE START PROJECT
Authors: Predel Hans-Georg , Weisser Burkhard , Wassmann Sven , Gillessen Anton , Blettenberg Jörg , Fournier Valérie , Noetel Andrea , Randerath Olaf , Böhm Michael , Schmieder Roland E.
Published: April 2021

Objective:

ESC/ESH guidelines for the treatment of arterial hypertension recommend to start treatment with a single pill combination (SP) of a renin–angiotensin–system (RAS) blocker with a diuretic or a calcium channel blocker to improve drug persistence, blood pressure (BP) control and to reduce cardiovascular events. Escalation should be a SP triple combination. We aimed to assess whether the SP concept is superior to identical free combinations (FC) in terms of clinical outcomes, including all-cause mortality.

Design and method:

This exploratory analysis of an anonymized claims dataset from patients with hypertension and cardiovascular disease captured in the database of the governmental health insurance company (German AOK PLUS) in the years 2012–2017. 57,998 Patients aged 18 years and older treated with SP or identical FC were followed up for at least 1 year. After 1:1-Propensity Score Matching (PSM) persistence (redemption of prescription with a lack > 60 days) and clinical outcomes were compared using non-parametric tests.

Results:

No significant differences in baseline characteristics were observed after PSM. Each group included 10,801 patients with valsartan/amlodipine, 1,026 with candesartan/amlodipine, 1,823 with amlodipine/valsartan/hydrochlorothiazide (HCT), and 15,349 with ramipril/amlodipine as SP or identical FC. Eight different clinical outcomes were compared for each combination. In 27 of 32 comparisons, significantly lower incidence rate ratios (IRR) were identified for SP, confirmed by time-to-event-analyses. In the largest group (ramipril/amlodipine, n = 15,349), a significantly lower risk for stroke (IRR = 0.75; 95% CI 0.627–0.886; p < 0.001), transitory ischemic attack (IRR = 0.69; 95% CI 0.496–0.963; p = 0.023), myocardial infarction (IRR = 0.62; 95% CI 0.493–0.784; p < 0.001), coronary artery disease (IRR = 0.58; 95% CI 0.462–0.723; p < 0.001), heart failure (IRR = 0.47; 95% CI 0.409–0.534; p < 0.001), all cause hospitalization (IRR = 0.67; 0.652–0.687; p < 0.001), cardiovascular hospitalization (IRR = 0.60; 95% CI 0.519–0.685; p < 0.001), and all-cause mortality (IRR = 0.53; 95% CI 0.463–0.596; p < 0.001) was observed for SP versus FC.

Conclusions:

These results strongly support the ESC/ESH guidelines recommending the use of a SP in favor of FC to improve cardiovascular outcomes including all-cause mortality.
Improved Recognition of Maternal Deaths Using Modern Data Analytics
Authors: Hollenbach Stefanie J. , Drennan Kathryn , Pressman Eva K. , Gray Lisa
Published: April 2021

OBJECTIVE:

To use a data-fusion approach to improve ascertainment of maternal deaths not detected with standard surveillance strategies.

METHODS:

We conducted a retrospective cohort study from the electronic health records of a tertiary medical center from 2011 to 2018. Cases of maternal death were identified in two ways: 1) using a standard medical informatics service query of hospital data and 2) using the TriNetX discovery tool as patients with a vital status of “deceased” and evidence of antecedent pregnancy exposure based on such factors as obstetric diagnostic codes or obstetric-related procedures. Potential cases of maternal death identified by the latter method underwent chart review to confirm timing of death compared with timing of last appreciable pregnancy, and to characterize the details of these deaths. The primary outcome was pregnancy-associated mortality during pregnancy or within the first postpartum year in the discovery cohort compared with the hospital-identified cohort. Secondary outcomes included causes of death and comorbidities.

RESULTS:

During the study period, the standard service query identified 23 maternal deaths. The discovery tool identified 18 additional patients confirmed on subsequent chart review to represent pregnancy-associated deaths, a 78% increase in ascertainment of which a greater proportion represented postpartum deaths. The majority (61%) of newly ascertained mortalities were related to cardiac causes or other medical comorbidities. Although many hospital-ascertained cases were associated with deaths after delivery of a living newborn, more deaths after early pregnancy loss or termination were identified through the discovery tool.

CONCLUSION:

Improved recognition of pregnancy-associated deaths can be achieved with modern data analytics.
Bladder Instillations With Triamcinolone Acetonide for Interstitial Cystitis–Bladder Pain Syndrome
Authors: Cardenas-Trowers Olivia O. , Abraham Alyce G. , Dotson Thomas K. , Houlette Brooke A. , Gaskins Jeremy T. , Francis Sean L.
Published: April 2021

OBJECTIVE:

To evaluate the utility of adding triamcinolone acetonide to a standard bladder instillation solution for treatment of interstitial cystitis–bladder pain syndrome.

METHODS:

This was a single-center, randomized, double-blind trial that compared symptom response in women with interstitial cystitis–bladder pain syndrome who underwent six bladder instillations with triamcinolone acetonide or six instillations without. All instillation solutions contained heparin, viscous lidocaine, sodium bicarbonate, and bupivacaine. The primary outcome was the change in interstitial cystitis–bladder pain syndrome symptoms from the first to sixth bladder instillation between groups based on the total OLS (O'Leary-Sant Questionnaire) score. Assuming a 4.03-point or larger difference in the mean total OLS score from the first to sixth bladder instillation as compared between the groups, 64 participants were needed to show a significant difference with 80% power at the 0.05 significance level.

RESULTS:

From January 2019 to October 2020, 90 women were enrolled—45 per group; 71 (79%) completed all six bladder instillations. Randomization resulted in groups with similar characteristics. There was no difference between groups in the primary outcome (bladder instillation with triamcinolone acetonide: mean OLS change −6.7 points, 95% CI 4.6–8.8 and bladder instillation without triamcinolone acetonide: mean OLS change −5.8 points, 95% CI 3.4–8.1; P=.31). Women in both groups had improvement in their interstitial cystitis–bladder pain syndrome symptoms as indicated by a decrease in the total OLS score from the first to sixth bladder instillation.

CONCLUSION:

The addition of triamcinolone acetonide to a standard bladder instillation solution does not improve symptoms associated with interstitial cystitis–bladder pain syndrome.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT03463915.
Current co-morbidities burden in patients living with HIV in low- and middle-income countries
Authors: Ponatshego Ponego Lloyd , Youssouf Nabila Farah , Mosepele Mosepele
Published: April 2021

Purpose of review

The present review aims to decipher common co-morbidities faced by people living with HIV in low- to middle-income countries, and in particular the sub-Saharan region, which hosts the majority of the HIV burden worldwide.

Recent findings

Well-controlled chronic HIV disease is strongly associated with an increased risk of developing cardiovascular disease. This is partly due to the natural aging process, however recent studies show that using antiretroviral therapy as well as the HIV disease itself may be predisposing factors to the development of cardiovascular diseases, creating a new burden for healthcare facilities in the region. Furthermore, newly completed studies assessing inflammation marker albuminuria and age-related syndrome frailty have been found in a higher prevalence than in non-HIV infected people, with increased morbidity and mortality.

As antiretroviral medication continues to be well supplied in the region and well tolerated by patients living with HIV, this group is now reckoning with cardiovascular ailments faced by all ageing population therefore there is a need for cardiovascular care systems to be better integrated within the existing, well-performing HIV care systems to address this burden.
Frailty: the current challenge for aging people with HIV
Authors: Falutz Julian , Brañas Fátima , Erlandson Kristine M.
Published: April 2021

Purpose of review

Older adults account for the majority of people with HIV (PWH) in high-income countries and have increasingly complex clinical profiles related to premature aging. Frailty is an important geriatric syndrome affecting a minority of PHW. Frailty negatively affects PHW's clinical status and quality of life. This review will update care providers on the current state of frailty that limits the healthspan of PWH.

Recent findings

Ongoing low-level HIV replication in treated PWH leads to immune activation and chronic inflammation contributing to the destabilization of normally autoregulated physiologic systems in response to environmental and biologic challenges characteristic of frailty. Understanding these underlying mechanisms will determine potential intervention options. Potentially reversible risk factors that promote progression to and reversion from the dynamic state of frailty are being studied and will help prevent frailty. Simple assessment tools and treatment strategies for frailty are being adapted for aging PWH.

Insight into underlying biologic mechanisms and adapting proven geriatric principles of interdisciplinary care will inform the healthy aging of PWH.
Virtual Reality as a Nonpharmacological Strategy in Pediatric Pain Control During Procedures With Needle Use
Authors: Pestana-Santos Marcia , Santos Daniela , Pinto Jéssica , Nunes Sara , Lomba Lurdes
Published: April 2021

Introduction

Needle procedures can be very painful for children and generate stress and anxiety. Virtual reality (VR) has been used to enhance a child's distraction for pain control during these procedures. This study aims to identify the advantages and limitations of VR used for pain control in procedures using needles in pediatrics.

Methods

Studies were limited to children aged 4–18 years undergoing a procedure involving needles and the use of VR with goggles, headset, or helmet. A comprehensive search strategy using CINAHL Complete, MedicLatina, Medline Complete, B-on, LILACS, and SciELO databases was undertaken to find relevant studies published from January 2015 to April 2020. The retained studies included experimental and quasi-experimental, randomized controlled trials and nonrandomized controlled trials as well as prospective and retrospective studies.

Results

The search yielded 80 articles. Of these, six articles met the inclusion criteria. Advantages found with the use of VR were (a) decrease of pain; (b) improvement of communication; (c) increased probability of success in performing the procedures; (d) reduction of anxiety, stress, distress, and fear; (e) easier handling of equipment; (f) almost complete isolation of external noise; and (g) low cost, lightness, and ease of transportation. Disadvantages reported were goggles' size and annoyance from repeated play and the occasional side effect of nausea.

Discussion

VR is considered an interactive digital therapeutic toy used with positive effects in clinical practice. As children become calmer, VR can also reduce nursing stress and improve communication between children and nurses.
Estimating Prevalence of Hepatitis B Virus Coinfection Among Adults With Tuberculosis
Authors: Wong Robert J. , Hubbard Ashley , Bagley Laurie , Shiau Rita , Chitnis Amit S.
Published: April 2021

Background:

While patients with hepatitis B virus (HBV) infection and tuberculosis (TB) have similar risk factors, little is known regarding the prevalence of HBV and TB coinfection. We aim to evaluate the prevalence of HBV among patients with TB across world regions.

Methods:

We systematically reviewed the literature using PubMed from inception through September 1, 2019, to identify studies that provided data to calculate HBV coinfection prevalence among adults with TB infection. Prevalence estimates of HBV coinfection among TB patients were stratified by world regions and calculated using meta-analyses with random-effects models.

Results:

A total of 36 studies met inclusion criteria (4 from the Africa region, 6 from the Americas region, 5 from the Eastern Mediterranean region, 2 from European region, 6 from Southeast Asia region, and 13 from the Western Pacific region). On meta-analysis, overall pooled HBV coinfection prevalence among TB patients was 7.1%, but varied by world region. Region-specific pooled HBV prevalence among TB patients was highest in Africa region [11.4%, 95% confidence interval (CI): 3.45-19.31] and Western Pacific region (10.8%, 95% CI: 8.68-12.84), and was lowest in the Americas (2.2%, 95% CI: 0.78-3.53). Sensitivity analyses yielded similar HBV prevalence estimates across world regions.

Conclusions:

In this meta-analysis, we observed HBV coinfection prevalence among TB patients to be 38% to 450% higher than published estimates from the Polaris group of region-specific overall HBV prevalence. Timely identification of HBV infection among TB patients will improve patient outcomes by allowing for closer clinical monitoring and management, which may reduce the risk of liver dysfunction and liver failure related to TB treatment.
Artificial Intelligence and Early Detection of Pancreatic Cancer
Authors: Kenner Barbara , Chari Suresh T. , Kelsen David , Klimstra David S. , Pandol Stephen J. , Rosenthal Michael , Rustgi Anil K. , Taylor James A. , Yala Adam , Abul-Husn Noura , Andersen Dana K. , Bernstein David , Brunak Søren , Canto Marcia Irene , Eldar Yonina C. , Fishman Elliot K. , Fleshman Julie , Go Vay Liang W. , Holt Jane M. , Field Bruce , Goldberg Ann , Hoos William , Iacobuzio-Donahue Christine , Li Debiao , Lidgard Graham , Maitra Anirban , Matrisian Lynn M. , Poblete Sung , Rothschild Laura , Sander Chris , Schwartz Lawrence H. , Shalit Uri , Srivastava Sudhir , Wolpin Brian
Published: April 2021

Despite considerable research efforts, pancreatic cancer is associated with a dire prognosis and a 5-year survival rate of only 10%. Early symptoms of the disease are mostly nonspecific. The premise of improved survival through early detection is that more individuals will benefit from potentially curative treatment. Artificial intelligence (AI) methodology has emerged as a successful tool for risk stratification and identification in general health care. In response to the maturity of AI, Kenner Family Research Fund conducted the 2020 AI and Early Detection of Pancreatic Cancer Virtual Summit (www.pdac-virtualsummit.org) in conjunction with the American Pancreatic Association, with a focus on the potential of AI to advance early detection efforts in this disease. This comprehensive presummit article was prepared based on information provided by each of the interdisciplinary participants on one of the 5 following topics: Progress, Problems, and Prospects for Early Detection; AI and Machine Learning; AI and Pancreatic Cancer—Current Efforts; Collaborative Opportunities; and Moving Forward—Reflections from Government, Industry, and Advocacy. The outcome from the robust Summit conversations, to be presented in a future white paper, indicate that significant progress must be the result of strategic collaboration among investigators and institutions from multidisciplinary backgrounds, supported by committed funders.
Impact of Antidepressant Prescriptions on Suicidal Behavior in Times of Severe Financial Strain
Authors: Sacchi Valentina , Mattei Giorgio , Musetti Laura , Galeazzi Gian Maria
Published: April 2021

This descriptive study observes the relationship between antidepressant prescriptions and the suicide rate in Italy in the 2000s to the mid-2010s, which includes a period of severe economic crisis. The observation period was from 2000 to 2015. Suicide and unemployment rates disaggregated by age and sex were collected from the Italian Institute of Statistics. Statistical analyses were performed using correlations between suicide rates and the defined daily dose, with reference to selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), and other types of antidepressants. Fixed-effects panel regressions were also run. Increases in SSRIs prescriptions were associated with decreases in suicide rates among both men and women. However, when the analyses were adjusted for the rate of growth of the unemployment rate and for gross domestic product, the associations were weaker. The potential protective factor of SSRIs with respect to suicidal behavior may be reduced by severe recessions, especially when unemployment increases.
Impact of COVID-19–Related Social Distancing on Delivery of Intensive Case Management
Authors: Rosenheck Robert , Johnson Barbara , Deegan Debbie , Stefanovics Elina
Published: April 2021

Social distancing due to COVID-19 may adversely impact treatment of adults with serious mental illness, especially those receiving intensive forms of community-based care, in part through weakening of the therapeutic alliance. Veterans and staff at a Veterans Affair (VA) medical center were surveyed 3 months after social distancing disrupted usual service delivery in intensive community-based treatment programs. Veterans (n = 105) and staff (n = 112) gave similar multi-item ratings of service delivery after social distancing, which involved far less face-to-face contact and more telephone contact than usual and rated their therapeutic alliances and clinical status similarly as “not as good” on average than before social distancing. Self-reported decline in therapeutic alliance was associated with parallel decline in clinical status indicators. Both veterans and staff indicated clear preference for return to face-to-face service delivery after the pandemic with some telehealth included.
The Population-Level Effect of Screening for Mycoplasma genitalium on Antimicrobial Resistance: A Quasi-Experimental Study
Authors: Kenyon Chris , De Baetselier Irith , Vanbaelen Thibaut , Buyze Jozefien , Florence Eric
Published: April 2021

Background

No studies have evaluated the utility and risks of screening for Mycoplasma genitalium in men who have sex with men taking preexposure prophylaxis (PrEP). We made use of a quasi-experimental design to evaluate the effect of screening for M. genitalium in a demonstration PrEP cohort with 3-monthly follow-up.

Methods

We compared the proportion of PrEP participants with M. genitalium clearance, the duration of persistence, proportion with incident symptoms, the incidence of fluoroquinolone and macrolide resistance, and the proportion of noncleared infections with resistance-associated mutations between 2 groups: those in whom the first episode of M. genitalium was treated and those in whom it was not treated.

Results

M. genitalium was detected in 70 of 179 individuals. The first episode of infection was treated in 46 individuals. Treatment was not significantly associated with the incidence of symptomatic infections or the acquisition of genotypic resistance. Treatment was associated with a higher probability of clearance of infection but at the expense of increasing the proportion of remaining infections that were resistant. In the nontreated group, the infections that did not clear were less likely to be fluoroquinolone resistant (1/6 [16.7%]) than those that did clear (4/4 [100%]; P = 0.048). In contrast, in the treated group, there was no significant difference in the proportion of fluoroquinolone resistance between the infections that persisted and cleared.

Conclusions

If screening and treatment increase the ratio of resistant to susceptible M. genitalium in a population, then this could play a role in the spread of antimicrobial resistance.
Evidence-Based Approach to Timing of Nerve Surgery
Authors: MacKay Brendan J. , Cox Cameron T. , Valerio Ian L. , Greenberg Jeffrey A. , Buncke Gregory M. , Evans Peter J. , Mercer Deana M. , McKee Desirae M. , Ducic Ivica
Published: April 2021

Events causing acute stress to the health care system, such as the COVID-19 pandemic, place clinical decisions under increased scrutiny. The priority and timing of surgical procedures are critically evaluated under these conditions, yet the optimal timing of procedures is a key consideration in any clinical setting. There is currently no single article consolidating a large body of current evidence on timing of nerve surgery. MEDLINE and EMBASE databases were systematically reviewed for clinical data on nerve repair and reconstruction to define the current understanding of timing and other factors affecting outcomes. Special attention was given to sensory, mixed/motor, nerve compression syndromes, and nerve pain. The data presented in this review may assist surgeons in making sound, evidence-based clinical decisions regarding timing of nerve surgery.
Fibroadipose Vascular Anomaly of the Upper Extremity
Authors: Strübing Felix , Sadick Maliha , Porubsky Stefan , Harhaus Leila , Bigdeli Amir , Kneser Ulrich
Published: April 2021

Alomari and colleagues described in 2014 for the first time a distinct combination of vascular malformation, fibrofatty muscular infiltration and contracture which was termed fibroadipose vascular anomaly (FAVA) (J Pediatr Orthoped 34, 109–117 (2014). So far only few publications (J Pediatr Orthoped (2014) 34, 109–117; J Hand Surg (2020). 45, 68.e1, 68.e13; Ann Vasc Dis (2014) 7, 316–319; Pediatr Radiol 46, 1179–1186 (2016)) concerning this newly described disease have been published, covering only a limited number of cases. We present a case of a 19-year-old male patient suffering from a FAVA of the proximal forearm with a severe contracture of the infiltrated flexor musculature. Upon surgery, we observed infiltration of the ulnar nerve. We were able to successfully resect the vascular malformation. Secondary tendon transfer was performed after extensive resection of the flexor musculature.

FAVA presents a differential diagnosis in patients with solid growth of the upper or lower extremity and contracture of the involved extremity. We conclude that patients suffering from FAVA of the upper extremity should be referred to a center specialized in oncologic extremity surgery and reconstructive hand and microsurgery.
Does the Use of Intraoperative Angiography Reduce the Incidence of Postoperative Wound and Flap Complications in Complex Lower Extremity Oncologic Reconstruction?
Authors: Kapadia Kailash , Dalena Maragaret , Cavanaugh Zachary , Ayyala Haripriya , Ippolito Joesph , Beebe Kathleen , Benevenia Joseph , Lee Edward S.
Published: April 2021

Introduction

Intraoperative laser angiography via indocyanine green (ICG) has become a valuable tool in objectively assessing tissue perfusion in reconstructive procedures. Studies have demonstrated the utility of ICG angiography (ICGA) for decreasing both mastectomy skin flap necrosis and wound healing complications in abdominal wall reconstruction. This tool has not been studied in lower extremity oncologic reconstruction. The objective of this study was to compare postoperative complications in lower extremity oncologic reconstruction managed with or without laser-assisted ICGA.

Methods

A retrospective chart review was performed of patients undergoing complex lower extremity oncologic reconstruction at a single institution between 2000 and 2018. Patient information regarding demographics, comorbidities, operative procedures, and postoperative complications was analyzed.

Results

Sixty-one patients were identified in our study. As some patients underwent multiple reconstructive surgeries, a total of 76 reconstructive procedures were analyzed. Patients with plastic surgery reconstruction using ICGA (n = 36) were compared with those without, non-ICGA (n = 40). No significant differences in age, sex, smoking status, chemotherapy, or radiation history were identified between cohorts. The total number of postoperative complications did not statistically differ between cohorts. There was no statistically significant difference in the number of required reoperation because of a postoperative complication between the ICGA and non-ICGA groups (0.44 vs 0.4).

Conclusions

The incidence of postoperative wound complications after complex lower extremity oncologic reconstruction remains high. The findings of our study suggest that clinical judgment of flap and soft tissue viability, as compared with ICGA, may lead to comparable operative outcomes and be more cost-effective. Long-term follow-up and prospective studies are needed to further investigate this trend.
The Addition of a Nerve Transfer to the Treatment of Peroneal Neuropathy Secondary to Intraneural Ganglion
Authors: Winter Jessica , Zhang Yiyang , Clark Tod A. , Giuffre Jennifer L.
Published: April 2021

Peroneal intraneural ganglia are rare, and their management is controversial. Presently, the accepted treatment of intraneural ganglia is decompression and ligation of the articular nerve branch. Although this treatment prevents recurrence of the ganglia, the resultant motor deficit of foot drop in the case of intraneural peroneal ganglia is unsatisfying. Foot drop is classically treated with splinting or tendon transfers to the foot. We have recently published a case report of a peroneal intraneural ganglion treated by transferring a motor nerve branch of flexor hallucis longus into a nerve branch of tibialis anterior muscle in addition to articular nerve branch ligation and decompression of the intraneural ganglion to restore the patient's ability to dorsiflex. We have since performed this procedure on 4 additional patients with appropriate follow-up. Depending on the initial onset of foot drop and time to surgery, nerve transfer from flexor hallucis longus to anterior tibialis nerve branch may be considered as an adjunct to decompression and articular nerve branch ligation for the treatment of symptomatic peroneal intraneural ganglion.
Silver diamine fluoride and oral health-related quality of life: A network meta-analysis
Authors: Ruff Ryan Richard , Whittemore Rachel , Grochecki Martyna , Bateson Jillian , Barry-Godin Tamarinda
Published: April 2021

Objective

Silver diamine fluoride (SDF) is an effective non-surgical treatment for dental caries which may also impact oral health-related quality of life (OHRQoL). The objective of this study was to conduct a network meta-analysis of SDF versus other standard of care therapies on OHRQoL.

Data Sources

Studies published in PubMed/MEDLINE, Scopus, or Web of Science through March 2021 with no date or language restrictions.

Study Selection

Any randomized controlled trial, cohort, or case-control study that included silver diamine fluoride as either a single or combinative treatment for dental caries and a quantitatively measured outcome for oral health-related quality of life was included.

Data Extraction and Synthesis

Potentially eligible studies were screened by two independent reviewers trained in conducting systematic reviews. Studies meeting inclusion criteria underwent a full-text review with data being extracted using a standardized form, including publication details, study methodology, outcomes, assessors, and sample information. Studies underwent a risk of bias assessment and quality of evidence evaluation. Quantitative synthesis was performed using network meta-analysis.

Main Outcome(s) and Measure(s)

Oral health-related quality of life.

Results

19 articles were returned following search strategies. Following screening, ten studies were evaluated for full-text eligibility and five were retained for meta-analyses. Studies included in quantitative synthesis were classified as a high degree of evidence, suggesting estimated effects are similar to true effects. Direct and indirect estimates from network meta-analysis indicated that OHRQoL in children was not significantly different when treated with SDF versus atraumatic restorations (d = 0.02, 95% CI = -0.32, 0.36) or placebo (d = 0.03, 95% CI = -0.16, 0.22).

Conclusions

Evidence from the literature consistently shows no discernible impact on OHRQoL across various non-surgical treatments for dental caries. Overall oral health-related quality of life may increase regardless of treatment protocol due to treatment of the underlying disease. Concerns over the staining of dental decay and oral mucosa resulting from treatment with silver diamine fluoride do not seem to affect OHRQoL.
Continuous monitoring of SARS-CoV-2 RNA in urban wastewater from Porto, Portugal: sampling and analysis protocols
Authors: Tomasino Maria Paola , Semedo Miguel , Vieira Pedro , Ferraz Elza , Rocha Adelaide , Carvalho Maria F. , Magalhães Catarina , Mucha Ana P.
Published: April 2021

Research on the emerging COVID-19 pandemic is demonstrating that wastewater infrastructures can be used as public health observatories of virus circulation in human communities. Important efforts are being organized worldwide to implement sewage-based surveillance of SARS-CoV-2 that can be used for preventive or early warning purposes, informing preparedness and response measures. However, its successful implementation requires important and iterative methodological improvements, as well as the establishment of standardized methods. The aim of this study was to develop a continuous monitoring protocol for SARS-CoV-2 in wastewater, that could be used to model virus circulation within the communities, complementing the current clinical surveillance. Specific objectives included (1) optimization and validation of a sensitive method for virus quantification; (2) monitoring the time-evolution of SARS-CoV-2 in wastewater from two wastewater treatment plants (WWTPs) in the city of Porto, Portugal. Untreated wastewater samples were collected weekly from the two WWTPs between May 2020 and March 2021, encompassing two COVID-19 incidence peaks in the region (mid-November 2020 and mid-January 2021). In the first stage of this study, we compared, optimized and selected a sampling and analysis protocol that included RNA virus concentration through centrifugation, RNA extraction from both liquid and solid fractions and quantification by reverse transcription quantitative PCR (RT-qPCR). In the second stage, we used the selected methodology to track SARS-CoV-2 in the collected wastewater over time. SARS-CoV-2 RNA was detected in 39 and 37 out of 48 liquid and solid fraction samples of untreated wastewater, respectively. The copy numbers varied throughout the study between 0 and 0.15 copies/ng RNA and a good fit was observed between the SARS-CoV-2 RNA concentration in the untreated wastewater and the COVID-19 temporal trends in the study region. In agreement with the recent literature, the results from this study support the use of wastewater-based surveillance to complement clinical testing and evaluate temporal and spatial trends of the current pandemic.
Correcting Covid-19 PCR Prevalence for False Positives in the Presence of Vaccination Immunity
Authors: Halem Michael
Published: April 2021

Since the first analysis was published on 7 April 2021 the PCR test positivity rate has dropped significantly below the then estimated false positive rate (FPR) of 1.16% using the exponential decay to FPR model. Therefore, the estimate has been rejected and a new model was developed.

Using the ONS infection survey’s assumption (PCR FPR rate below 0.1%) the new model splits the test time series data into two periods based on a change in transmissibility that coincides with the reopening of England schools on 8 March. The new model provides for two base levels of exponential decay (for each period’s transmissibility) combined with a single decay rate increase dependent on vaccination.

Because the FPR is relatively insignificant compared to current PCR test positives, it cannot be statistically separated using currently available England epidemic time series data by the non-linear least squares estimation technique. Therefore, the FPR factor is temporarily dropped in the least squares regression.

The new model is stable in that it reasonably predicts through the most current available data (25 April) the future test prevalence using parameters estimated with 29 March data. Thus far, the estimate parameters remain within their original confidence intervals as successive days are added to the time series. Of potential usefulness is the current estimate for change in decay rate per mean vaccination rate, currently estimated at approximately 10.7% (CI: 8.8% - 12.6%). The estimate should be used with caution as other unforeseen factors could cause the model to misestimate.
Millennial-scale change on a Caribbean reef system that experiences hypoxia
Authors: Figuerola Blanca , Grossman Ethan L. , Lucey Noelle , Leonard Nicole D. , O’Dea Aaron
Published: April 2021

Coastal hypoxia has become an increasingly acknowledged threat to coral reefs that is potentially intensifying because of increased input of anthropogenic nutrients. Almirante Bay (Caribbean Panama) is a semi-enclosed system that experiences hypoxia in deeper waters which occasionally expand into shallow coral reefs, suffocating most aerobic benthic life. To explore the long-term history of reefs in the bay we extracted reef matrix cores from two reefs that today experience contrasting patterns of oxygenation. We constructed a 1800-year-long record of gastropod assemblages and isotope compositions from six U-Th chronologically-constrained reef matrix cores. We extracted two cores from each reef at 3 m water depth and two additional cores from a deeper part (4.8 m) of the hypoxia-exposed reef. Results show that the deeper part of the hypoxic reef slowed in growth and stopped accreting approximately 1500 years BP while the shallow part of the reef continued to accrete to the present day, in agreement with a model of expanding hypoxia at this time. Our proxy-based approach suggests that differences among these palaeoindicators in the two reefs may have been driven by an increase in hypoxia via eutrophication caused by either natural changes or human impacts. Similar patterns of increasing herbivores and decreasing carbon isotope values occurred in the shallow part of the hypoxic reef during the last few decades. This suggests that hypoxia may be expanding to depths as shallow as 3 m and that shallow reefs are experiencing greater risk due to increased human activity.
Sex and Gender Considerations in Reporting Guidelines of Health Research: A Systematic Review
Authors: Gogovor Amédé , Zomahoun Hervé Tchala Vignon , Ekanmian Giraud , Adisso Évèhouénou Lionel , Tardif Alèxe Deom , Khadhraoui Lobna , Rheault Nathalie , Moher David , Légaré France
Published: April 2021

Background

Despite growing recognition of the importance of sex and gender considerations in health research, they are rarely integrated into research design and reporting. We sought to assess the integration of sex, as a biological attribute and gender as a socially constructed identity in published reporting guidelines.

Methods and Findings

We conducted a systematic review of published reporting guidelines listed on the EQUATOR website (www.equator-nework.org) from inception until December 2018. We selected all reporting guidelines (original and extensions) listed on the EQUATOR library. We used EndNote Citation Software to build a database of the statement of each guideline identified as ‘full bibliographic reference’ and retrieved the full texts. Reviewers independently extracted the data from the checklist/abstract/main text of guidelines. Data were analyzed using descriptive statistics and narrative synthesis. A total of 407 reporting guidelines were included; they were published between 1995 and 2018. Of the 407 guidelines, 159 (39%) mentioned “sex” and/or “gender” in the checklist/abstract/main text. Of these, 90 (22.1%) mentioned only “sex”, and 91 (22.4%) mentioned only “gender”. In the checklist of the reporting guidelines (n = 363), “sex” and “gender” were mentioned in 50 (13.8%) and 39 (10.7%), respectively. Only one reporting guideline met the three criteria of correct use of sex and gender concepts. Trends in the use of sex and gender in the checklists showed that the use of “sex” only started in 2003, while “gender” has been used since 1996.

Conclusions

We assessed the integration of sex and gender considerations in reporting guidelines based on the use of sex- and gender-related words. Our findings showed a low use and integration of sex and gender concepts in reporting guidelines. Authors of reporting guidelines should reduce this gap for a better use of research knowledge.

Registration:PROSPERO no. CRD42019136491.
A fully adapted headstage for electrophysiological experiments with custom and scalable electrode arrays to record widely distributed brain regions
Authors: Mourão Flávio Afonso Gonçalves , de Oliveira Guarnieri Leonardo , Júnior Paulo Aparecido Amaral , Carvalho Vinícius Rezende , Mendes Eduardo Mazoni Andrade Marçal , Moraes Márcio Flávio Dutra
Published: April 2021

Electrophysiological recordings lead amongst the techniques that aim to investigate the dynamics of neural activity sampled from large neural ensembles. However, the financial costs associated with the state-of-the-art technology used to manufacture probes and multi-channel recording systems make these experiments virtually inaccessible to small laboratories, especially if located in developing countries. Here, we describe a new method for implanting several tungsten electrode arrays, widely distributed over the brain. Moreover, we designed a headstage system, using the Intan®RHD2000 chipset, associated with a connector (replacing the expensive commercial Omnetics connector), that allows the usage of disposable and cheap cranial implants. Our results showed high-quality multichannel recording in freely moving animals (detecting local field, evoked responses and unit activities) and robust mechanical connections ensuring long-term continuous recordings. Our project represents an open source and inexpensive alternative to develop customized extracellular records from multiple brain regions.
Mechanism of LolCDE as a molecular extruder of bacterial triacylated lipoproteins
Authors: Sharma Stuti , Zhou Ruoyu , Wan Li , Song KangKang , Xu Chen , Li Yanyan , Liao Maofu
Published: April 2021

Present in all bacteria, lipoproteins are central in bacterial growth and antibiotic resistance. These proteins use lipid acyl chains attached to the N-terminal cysteine residue to anchor on the outer surface of cytoplasmic membrane. In Gram-negative bacteria, many lipoproteins are transported to the outer membrane (OM), a process dependent on the ATP-binding cassette (ABC) transporter LolCDE which extracts the OM-targeted lipoproteins from the cytoplasmic membrane for subsequent trafficking across the periplasm. Lipid-anchored proteins pose a unique challenge for transport machinery as they have both hydrophobic lipid moieties and soluble protein component, and the underlying mechanism is poorly understood. Here we determined the cryo-EM structures of nanodisc-embedded LolCDE in the nucleotide-free and nucleotide-bound states at 3.8-Å and 3.5-Å resolution, respectively. The structural analyses, together with biochemical and mutagenesis studies, uncover how LolCDE specifically recognizes its substrate by establishing multiple interactions with the lipid and N-terminal peptide moieties of the lipoprotein, and identify the amide-linked acyl chain as the key element for LolCDE interaction. Upon nucleotide binding, the transmembrane helices and the periplasmic domains of LolCDE undergo large-scale, asymmetric movements, resulting in extrusion of the captured lipoprotein. Comparison of LolCDE and MacB reveals the conserved mechanism of type VII ABC transporters and emphasizes the unique properties of LolCDE as a molecule extruder of triacylated lipoproteins.