bluuebunny/crossref_metadata_2025 huggingface dataset:
Interplay of clear, demanding, and important goals on project performance in community–academic health partnerships
Authors: Chak Choiwai M. , Carminati Lara , Wilderom Celeste P. M.
Published: July 2021

Background

Community–academic health partnerships (CAHPs) have become increasingly common to bridge the knowledge-to-practice gap in health care. Because working in such partnerships can be excessively challenging, insights into the individual-level enablers of high performance will enable better management of CAHPs.

Purpose

Steered by the goal-setting theory, this study examined the relations between goal clarity, goal stress, goal importance, and their interactions on perceived project performance among individuals working in CAHPs’ constituting projects.

Methodology

Using a convergent mixed-method research design, online survey data were collected from 268 participants working in a variety of CAHP projects in three German-speaking countries. We tested the hypotheses using structural equation modeling, after which thematic analysis was carried out on the 209 open-ended responses.

Results

CAHP project performance was positively associated with goal clarity and negatively associated with goal stress. A three-way interaction analysis showed that when goal importance was high, the relationship between goal clarity and project performance remained positive regardless of the level of goal stress. The qualitative data corroborate this finding.

Conclusion

In CAHP projects, high goal importance offsets the negative effect of goal stress on project performance, indicating that workers who perceive the project goals as important can manage the stress associated with demanding goals better.

Practice Implications

To achieve high project performance in CAHPs, organizational and project leaders should (a) set clear project goals, (b) facilitate project workers in dealing with stress resulting from overly demanding goals, and (c) emphasize the importance of the project goals, especially when goal stress is high.
The organizational and environmental characteristics associated with hospitals’ use of intensivists
Authors: Liddle Bart , Weech-Maldonado Robert , Davlyatov Ganisher , O’Connor Stephen J. , Patrician Patricia , Hearld Larry R.
Published: July 2021

Background

As large numbers of coronavirus disease 2019 (COVID-19) patients were admitted to intensive care units (ICUs) in 2020 and 2021, the United States faced a shortage of critical care providers. Intensivists are physicians specializing in providing care in the ICU. Although studies have explored the clinical and financial benefits associated with the use of intensivists, little is known about the organizational and market factors associated with a hospital administrator’s strategic decision to use intensivists.

Purpose

The aim of this study was to use the resource dependence theory to better understand the organizational and market factors associated with a hospital administrator’s decision to use intensivists.

Methodology

The sample consisted of the national acute care hospitals (N = 4,986) for the period 2007–2017. The dependent variable was the number of full-time equivalent intensivists staffed in hospitals. The independent variables were organizational and market-level factors. A negative binomial regression model with state and year fixed effects, clustered at the hospital level, was used to examine the relationship between the use of intensivists and organizational and market factors.

Results

The results from the analyses show that administrators of larger, not-for-profit hospitals that operate in competitive urban markets with relatively high levels of munificence are more likely to utilize intensivists.

Practice Implications

When significant strains are placed on ICUs like what was experienced during the COVID-19 pandemic, it is imperative that hospital administrators understand how to best staff their ICUs. With a better understanding of the organizational and market factors associated with the use of intensivists, practitioners and policymakers alike can better understand how to strategically utilize intensivists in the ICU, especially in the face of a continuing pandemic.
Cognitive crafting and work engagement: A study among remote and frontline health care workers during the COVID-19 pandemic
Authors: Wijngaards Indy , Pronk Florie R. , Bakker Arnold B. , Burger Martijn J.
Published: July 2021

Background

The outbreak of COVID-19 has led to a profound change in the organization of work in the health care sector. As frontline health care workers are essential in battling the pandemic and their work is appreciated in society, we argue that health care workers who are forced to work from home are likely to perceive their jobs as less meaningful, which in turn may negatively affect their engagement at work. Cognitive crafting, or the altering of the perceptions one has about their tasks and relationships with the aim to enhance the meaningfulness of work, may be a fruitful cognitive strategy to counter the problems remote health care workers face.

Purpose

The primary purpose was to study the relationship between cognitive crafting, working from home (WFH), and work engagement.

Methodology

We collected cross-sectional survey data between May 7 and June 2, 2020, from a single hospital in the Netherlands (n = 278). The central hypothesis was tested using multiple regression analysis.

Results

The relationship between cognitive crafting and work engagement was moderated by WFH, such that the relationship is more positive for health care workers who work from home permanently since the start of the COVID-19 pandemic than for frontline workers and workers who work partially from home.

Conclusion

Our findings are consistent with previous research on cognitive crafting. We conclude that cognitive crafting is an interesting cognitive strategy to stay engaged for health care workers who are mandated into WFH.

Practice Implications

We advise organizations to provide remote workers virtual group trainings that promote cognitive crafting and expose them to testimonies of people who are positively affected by their work. More generally, we recommend organizations to engage in effective top-down work design and foster a climate for cognitive as well as behavioral job crafting strategies.
Prescribing Patterns of Amantadine During Pediatric Inpatient Rehabilitation After Traumatic Brain Injury: A Multicentered Retrospective Review From the Pediatric Brain Injury Consortium
Authors: McLaughlin Matthew J. , Caliendo Eric , Lowder Ryan , Watson William D. , Kurowski Brad , Baum Katherine T. , Blackwell Laura S. , Koterba Christine H. , Hoskinson Kristen R. , Tlustos Sarah J. , Zimmerman Kanecia O. , Shah Sudhin A. , Suskauer Stacy J.
Published: July 2021

Objectives:

To describe dosing practices for amantadine hydrochloride and related adverse effects among children and young adults with traumatic brain injury (TBI) admitted to pediatric inpatient rehabilitation units.

Setting:

Eight pediatric acute inpatient rehabilitation units located throughout the United States comprising the Pediatric Brain Injury Consortium.

Participants:

Two-hundred thirty-four children and young adults aged 2 months to 21 years with TBI.

Design:

Retrospective data revie.

Main Outcome Measures:

Demographic variables associated with the use of amantadine, amantadine dose, and reported adverse effects.

Results:

Forty-nine patients (21%) aged 0.9 to 20 years received amantadine during inpatient rehabilitation. Forty-five percent of patients admitted to inpatient rehabilitation with a disorder of consciousness (DoC) were treated with amantadine, while 14% of children admitted with higher levels of functioning received amantadine. Children with DoC who were not treated with amantadine were younger than those with DoC who received amantadine (median 3.0 vs 11.6 years, P = .008). Recorded doses of amantadine ranged from 0.7 to 13.5 mg/kg/d; the highest total daily dose was 400 mg/d. Adverse effects were reported in 8 patients (16%); nausea/abdominal discomfort and agitation were most common, each reported in 3 patients. The highest reported dose without an adverse effect was 10.1 mg/kg/d.

Conclusion:

During pediatric inpatient rehabilitation, amantadine was prescribed to children across a range of ages and injury severity and was most commonly prescribed to older children with DoC. Dosing varied widely, with weight-based dosing for younger/smaller children at both lower and higher doses than what had been previously reported. Prospective studies are needed to characterize the safety and tolerability of higher amantadine doses and optimize amantadine dosing parameters for children with TBI.
The Effect of Written and Video Discharge Instructions After Mild Traumatic Brain Injury on Healthcare Costs and Productivity Costs
Authors: Hoek Amber E. , Geraerds A. J. L. M. , Rood Pleunie P. M. , Joosten Marieke , Dippel Diederik W. J. , van Beeck Ed F. , van den Hengel Leandra , Dijkstra Björn , Papathanasiou Dafni , van Rijssel Daphne , van den Hamer Maaike , Schuit Stephanie C. E. , Burdorf Alex , Haagsma Juanita A. , Polinder Suzanne
Published: July 2021

Objective:

To compare healthcare and productivity costs between patients with mild traumatic brain injury (mTBI) who received verbal discharge instructions only and patients who received an additional flyer with or without video instructions.

Setting:

Emergency departments (EDs) of 6 hospitals in the Netherlands.

Participants:

In total, 1155 adult patients with mTBI (384 with verbal instructions; 771 with additional flyer with or without video instructions) were included.

Design:

Cost study with comparison between usual care and intervention.

Methods:

Medical and productivity costs up to 3 months after presentation at the ED were compared between mTBI patients with usual care and mTBI patients who received the intervention.

Results:

Mean medical costs per mTBI patient were slightly higher for the verbal instructions–only cohort (€337 vs €315), whereas mean productivity costs were significantly higher for the flyer/video cohort (€1625 vs €899). Higher productivity costs were associated with higher working age, injury severity, and postconcussion symptoms.

Conclusion:

This study showed that the implementation of flyer (and video) discharge instructions for patients with mTBI who present at the ED increased reports of postconcussion symptoms and reduced medical costs, whereas productivity costs were found to be higher for the working population in the first 3 months after the sustained head injury.
The Impact of Night-time Emergency Department Presentation on Upper Gastrointestinal Hemorrhage Outcomes
Authors: Alayo Quazim A. , Oyenuga Abayomi O. , Adejumo Adeyinka C. , Pottathil Vijay , Grewal Damanpreet , Okafor Philip N.
Published: July 2021

Goals:

The aim was to investigate the impact of night-time emergency department (ED) presentation on outcomes of patients admitted for acute upper gastrointestinal hemorrhage (UGIH).

Background:

The relationship between time of ED presentation and outcomes of gastrointestinal hemorrhage is unclear.

Study:

Using the 2016 and 2017 Florida State Inpatient Databases which provide times of ED arrival, we identified and categorized adults hospitalized for UGIH to daytime (07:00 to 18:59 h) and night-time (19:00 to 06:59 h) based on the time of ED presentation. We matched both groups with propensity scores, and assessed their clinical outcomes including all-cause in-hospital mortality, in-hospital endoscopy utilization, length of stay (LOS), total hospitalization costs, and 30-day all-cause readmission rates.

Results:

Of the identified 38,114 patients with UGIH, 89.4% (n=34,068) had acute nonvariceal hemorrhage (ANVH), while 10.6% (n=4046) had acute variceal hemorrhage (AVH). Compared with daytime patients, ANVH patients admitted at night-time had higher odds of in-hospital mortality (odds ratio: 1.32; 95% confidence interval: 1.06-1.60), lower odds of in-patient endoscopy (odds ratio: 0.83; 95% confidence interval: 0.77-0.90), higher total hospital costs ($9911 vs. $9545, P<0.016), but similar LOS and readmission rates. Night-time AVH patients had a shorter LOS (5.4 vs. 5.8 d, P=0.045) but similar mortality rates, endoscopic utilization, total hospitalization costs, and readmission rates as daytime patients.

Conclusions:

Patients arriving in the ED at night-time with ANVH had worse outcomes (mortality, hospitalization costs, and endoscopy utilization) compared with daytime patients. However, those with AVH had comparable outcomes irrespective of ED arrival time.
Showcasing Nursing Leadership and Contributions to a University's COVID-19 Student Contact Tracing Process
Authors: Jones Pam , Walker Jessica , Kleinpell Ruth , George Andrea , Norman Linda
Published: July 2021

The COVID-19 pandemic was an unprecedented event that impacted every segment of healthcare, including universities preparing healthcare professionals. Instituting processes to coordinate student return to campus and ongoing COVID-19 testing and contract tracing challenged university campuses, but also brought opportunities for collaboration. This article reports on the experiences of one nonprofit private higher education university in management of the COVID-19 testing and contact tracing that were led by school of nursing faculty and nursing leadership.
Unusual Variants of Teratoma Involving the Gynecologic Tract
Authors: Guido Luiz P. , Camacho Felipe , Freire Rochelle , Pinto Andre
Published: July 2021

Teratomas are tumors of germ cell origin, and in the female genital tract are subclassified as immature or mature based on the presence or absence, respectively, of immature elements. Somatic tumors may also develop in association with teratomas, and most commonly include thyroid tumors, carcinoids and carcinomas. We report herein 2 rare forms of gynecologic teratomas: 1 case of immature teratoma of the uterus and 1 case of a benign follicular hamartoma arising in association with mature cystic teratoma of the ovary.
Improving Delivery of Care through Standardized Monitoring in Children with Eosinophilic Esophagitis
Authors: Shukla-Udawatta Monica , Russo John , Gunderman Lauren , Pearlstein Haley , Wood Eric , Boyle Brendan , Erwin Elizabeth
Published: July 2021

Introduction:

Eosinophilic esophagitis (EoE) is a chronic, antigen-driven disorder for which endoscopic monitoring and multidisciplinary care are recommended to achieve histologic remission. The EoE team at our large academic center developed a quality improvement (QI) initiative aimed to reduce variability in monitoring. This QI project focused on completing 3 process metrics within 6 months of diagnosis: (1) outpatient follow-up with a gastroenterologist; (2) referral to an allergist; and (3) Follow-up esophagogastroduodenoscopy (EGD).

Methods:

In January 2015, our QI team developed a registry of newly diagnosed EoE patients and maintained ongoing, weekly tracking of the process measures. Interventions to increase the completion of the process metrics included educational sessions, proactive reminders to providers, and targeted communications with patient families. Missed opportunities were evaluated by more in-depth chart review and categorized as provider- or patient-driven.

Results:

We tracked 6-month process metrics from 2015 through 2018. During this interval, follow-up visit rates in GI improved from 77% to 86%, and the percentage of referrals placed to allergy increased from 65% to 77%. The percentage of patients completing a repeat EGD improved from 33% to 61%. Among patients without a repeated EGD, nearly 70% of those missed opportunities were provider-driven.

Conclusions:

In patients newly diagnosed with EoE, QI interventions, including patient registry development, implementation of a local standard of care, and creating a patient tracking system, improved adherence with national EoE monitoring guidelines.
Rare Brain Metastasis in Parotid Adenoid Cystic Carcinoma Detected on 68Ga-PSMA PET/CT
Authors: Datta Gupta Shreya , Arora Geetanjali , Kumar Deepak , Seith Bhalla Ashu , Sikka Kapil , Shamim Shamim A.
Published: July 2021

We present the case of a 45-year-old woman with known adenoid cystic carcinoma of the right parotid gland, postexcision and postoperative radiation therapy. She was followed up on 18F-FDG PET/CT, which revealed minimal local residual disease and bilateral lung nodules, for which chemotherapy was initiated. Postchemotherapy, 18F-FDG PET/CT showed residual lung metastases. As a part of ongoing project, 68Ga-PSMA PET/CT done revealed additional focal uptake in the right cerebellum, missed on FDG PET/CT. The brain lesion was confirmed upon MRI.
Sentinel Lymph Node Biopsy in Prostate Cancer Using the SENSEI® Drop-In Gamma Probe
Authors: Abascal Junquera Jose Maria , Mestre-Fusco Antoni , Grootendorst Maarten Ruben , Vidal-Sicart Sergi , Fumado Lluis
Published: July 2021

Minimally invasive surgery in the form of laparoscopic and robot-assisted procedures has been widely adopted in the field of prostate cancer. When performing minimally invasive radioguided surgery, conventional rigid laparoscopic gamma probes have limited maneuverability and control due to their form factor, which may hinder detection of radiotracer-avid lesions in anatomically challenging areas. A drop-in gamma probe has been developed to address these limitations. Our group report on the first clinical use of this probe (SENSEI®) as part of an ongoing prospective, international, multicenter clinical trial in primary prostate cancer patients undergoing 99mTc-nanocolloid sentinel lymph node biopsy.
Vesicoureteral Reflux in Nonfunctioning Renal Allograft Incidentally Detected in a Posttransplant 99mTc-DTPA Scan
Authors: Qutbi Mohsen
Published: July 2021

In the present note, a case with rising serum creatinine shortly posttransplantation was referred for 99mTc-DTPA scan. The previous nonfunctioning renal allograft in the left hemipelvis showed no finding during dynamic phase of scan and filling phase of bladder but revealed a high-grade vesicoureteral reflux (VUR) in postvoid image, which can be responsible, partly, for the patient’s present and prior symptoms.
A Striking Case of Perfusion-Metabolism “Flip-Flop” in a Patient With Left Anterior Descending Artery Total Occlusion
Authors: Juweid Malik E. , Doudeen Rahma M. , Alkhawaldeh Khaled
Published: July 2021

A 57-year-old man diagnosed with left anterior descending artery chronic total occlusion underwent rest gated 99mTc-MIBI scan showing moderately to markedly decreased perfusion with abnormal wall motion in the apex, anterior, anteroseptal, and apical anterolateral walls. 18F-FDG PET showed a “flip-flop” phenomenon with markedly increased FDG uptake in the hypoperfused regions and absent/markedly decreased uptake in the normally perfused, normokinetic myocardium, presumably due to the predominant use of free fatty acids under normoxic conditions. After coronary artery bypass grafting, left ventricular motion normalized except for surgery-related paradoxical septal motion and the left ventricular ejection fraction improved from 52% to 68%.
Invasive Fungal Infection in COVID-19–Recovered Patient Detected on 18F-FDG–Labeled Leukocytes PET/CT Scan
Authors: Manda Divya , Sen Ishita , Thakral Parul , Das Subha Shankar , CB Virupakshappa , Malik Dharmender
Published: July 2021

Occurrence of invasive fungal infections has gained significant attention during recent times in patients with COVID-19. Patients with severe form of COVID-19, such as those treated in the intensive care unit with prolonged steroid use, are particularly vulnerable to secondary bacterial and fungal infections. Disseminated systemic mycosis is a life-threatening condition, especially in immunocompromised patients. Here, we report a case of a recovered severe COVID-19 patient, who presented with persistent fever. 18F-FDG–labeled leukocyte scan revealed focal accumulation of radiotracer in the small intestine and right lung lower lobe. Subsequently, performed biopsy revealed mucormycosis.
Barriers and Resources to Cleft Lip and Palate Speech Services Globally: A Descriptive Study
Authors: Baigorri Miriam , Crowley Catherine J. , Sommer Chelsea L. , Moya-Galé Gemma
Published: July 2021

Background:

Although a number of international cleft organizations and cleft professionals in low- and middle-income countries (LMICs) have built and supported comprehensive cleft care and speech therapy models to address the shortage of speech services in LMICs, the specific speech needs of individuals with cleft lip and palate (CLP) in such countries remain unknown. The objective of this study was to evaluate the barriers to accessing speech services for patients with CLP as well as the resources and models of speech services that are currently available for individuals with CLP in LMICs, with the goal of better understanding the needs of this population.

Methods:

Qualitative and quantitative methods consisted of Smile Train partner surveys that were distributed June 25th to July 31st, 2018 worldwide. Surveys were distributed through Smile Train's online medical database, Smile Train Express, which every Smile Train partner uses to report their Smile Train sponsored treatment outcomes. A total of 658 Smile Train partners responded to the surveys. Respondents included surgeons, speech therapists, orthodontists, administrators and nurses who represented non-governmental organizations, hospitals (private or public), hospital groups, and private clinics.

Results:

Results indicated that lack of resources, including access to local speech providers and language materials, as well as financial constraints such as patient travel and speech treatment costs, are the most commonly reported barriers to accessing speech services across all geographic regions surveyed.

Conclusions:

Improving access to CLP speech services in LMICs may require strategies that address lack of speech providers, language materials, and financial constraints.
Managing Bilateral Oro-Sino-Orbital Fistulae in the Setting of Bilateral Tessier IV Clefts
Authors: Pontell Matthew E. , Barahimi Behin , Golinko Michael S.
Published: July 2021

The number IV orofacial cleft is extremely rare, and reports on long-term outcomes are limited. Here we present the management of a child born with bilateral Tessier number IV clefts and microphthalmia, who developed bilateral oro-sino-orbital fistulae. He presented 8 years after his index procedure with persistent ocular drainage and radiographic evidence of bilateral oro-sino-orbital fistulae. His globes maintained light perception, and in order to protect them from chemical reflux he underwent fistula obliteration with demineralized bone matrix and acellular dermal matrix. His orbits were reconstructed by Imre and conjunctival flaps. In the presence of marginally functioning globes, the importance of timely intervention is critical in order to preserve residual ocular function. Light perception vision assists in the maintenance of circadian rhythm and physiologic functions that are critical to the developing pediatric patient. This case also emphasizes the importance of a multi-disciplinary team in the correction of complex craniofacial deformities.
Alar Rim Triangular Flap for Congenital Nasal Cleft Repair in Pediatric Patients
Authors: Yu Bao-Fu , Wei Shu-Yi , Dai Chuan-Chang , Wei Jiao
Published: July 2021

Background:

According to Tessier classification, number 1 and number 2 craniofacial clefts involve the nasal ala. Congenital nasal cleft is not common and is difficult for reconstruction. Notches in the medial one-third of either nasal ala are typical manifestations in these patients. Herein, we introduce a alar rim triangular flap, which is indeed a local flap, for the treatment of isolated nasal cleft due to congenital deformities in pediatric patients.

Methods:

The authors conducted a retrospective cohort study including 10 consecutive pediatric patients undergoing this surgery. This alar rim triangular flap including 2 triangles was existing nasal tissue near the cleft. The alar rim defect was covered through local tissue re-arrangement. The authors reviewed the photographs and clinical medical notes of these patients carefully. Self-reported satisfactions of patients (or children's parents) with the scar morphology and correction effect of this procedure were evaluated as well at postoperative every follow-up.

Results:

All the cases were followed up regularly, and the average follow-up time was 22 months (ranged from 13–38 months). All the nasal clefts were reconstructed successfully. The alar rim triangular flap survived with no flap loss. The wound created by this procedure healed primarily. No alar retraction, nasal obstruction or step-off deformities were observed during postoperative follow-up. There were no patients unsatisfied with the outcome of the scar morphology and correction effect of this operation.

Conclusions:

The newly designed alar rim triangular flap in this study can be an alternative treatment for correcting isolated congenital nasal cleft with optimal clinical outcome.

Level of evidence:

Level 4.
Contemporary Review on Craniectomy and Cranioplasty; Part 1: Decompressive Craniectomy
Authors: Hatamleh Muhanad M.
Published: July 2021

This paper aims to review clinical benefits of decompressive craniectomy (DC) in both adult and paediatric populations; its indications and factors contributing to its postoperative success. The Glasgow Outcome Scale and the Modified Rankin Scale are the most commonly used scales to assess the long-term outcome in patients post DC. In adult traumatic brain injury patients, 2 randomized clinical trials were carried out; DECRA (Decompressive Craniectomy in Diffuse Traumatic Brain Injury) and RESCUEicp (Randomised Evaluation of Surgery with Craniectomy for Uncontrollable Elevation of inter cranial pressure) employing collectively 555 patients. Despite the differences in these trials, their initial results affirm DC can lead to reduced mortality and more favorable outcomes. In ischemic stroke adult patients, different clinical trials of HAMLET (Dutch trial of Hemicraniectomy after middle cerebral artery infarction with life-threatening Edema), DESTINY (German trial of Decompressive Surgery for the treatment of Malignant Infarct of the Middle Cerebral Artery), and DECIMAL (French trial of Decompressive Craniectomy in Malignant Middle Cerebral Artery Infarcts) suggested that DC improves survival compared with best medical management, but with an increased proportion of treated individuals surviving with moderate or severe disability. With regard to the size of bone to be removed, the larger the defect the better the results with a minimum diameter of 11 to 12 cm of bone flap. Cranioplasty timing varies and ranges from 6 weeks to more than 12 months post DC, depending on completion of medical treatment, clinical recovery, resolution of any infection, and an evaluation of soft tissues at the defect site.
Identifying Predictors of Airway Complications During Conscious Sedation Procedures
Authors: Bray Rosemary , Knapp Herschel
Published: July 2021

Conscious sedation procedures are complicated by unanticipated airway compromise and obstruction. The STOP-Bang questionnaire (University of Toronto, 2012) is a validated obstructive sleep apnea screening questionnaire used as a preprocedure evaluation tool to assess a patient's risk for obstructive sleep apnea. The purpose of this study was to determine whether risk factors for obstructive sleep apnea, using the STOP-Bang questionnaire, could predict procedural airway complications in 152 endoscopy patients following conscious sedation. Logistic regression analysis revealed that a STOP-Bang score of greater than 5 (high risk) predicted a 10% change in heart rate (p = .021), apnea (p = .038), and arousal-relieved airway obstruction (p = .023). Every point of increase in body mass index predicted a 10% change in heart rate (p = .046), a drop in oxygen saturation (p = .002), apnea (p = .003), and 1.212 times the odds of requiring arousal-relieved airway obstruction (p = .002). An intermediate-risk STOP-Bang score (3–4) positively correlated to abnormal carbon dioxide values during the procedure (p = .015). These findings concur with existing literature on the topic and translate to clinical considerations of procedural monitoring protocols for patients with a high probability for airway complications during conscious sedation.
Power laws in the Roman Empire: a survival analysis
Authors: Ramos P. L. , Costa L. F. , Louzada F. , Rodrigues F. A.
Published: July 2021

The Roman Empire shaped western civilization, and many Roman principles are embodied in modern institutions. Although its political institutions proved both resilient and adaptable, allowing it to incorporate diverse populations, the Empire suffered from many conflicts. Indeed, most emperors died violently, from assassination, suicide or in battle. These conflicts produced patterns in the length of time that can be identified by statistical analysis. In this paper, we study the underlying patterns associated with the reign of the Roman emperors by using statistical tools of survival data analysis. We consider all the 175 Roman emperors and propose a new power-law model with change points to predict the time-to-violent-death of the Roman emperors. This model encompasses data in the presence of censoring and long-term survivors, providing more accurate predictions than previous models. Our results show that power-law distributions can also occur in survival data, as verified in other data types from natural and artificial systems, reinforcing the ubiquity of power-law distributions. The generality of our approach paves the way to further related investigations not only in other ancient civilizations but also in applications in engineering and medicine.
Classification of bi-Hamiltonian pairs extended by isometries
Authors: Pavlov Maxim V. , Vergallo Pierandrea , Vitolo Raffaele
Published: July 2021

The aim of this article is to classify pairs of the first-order Hamiltonian operators of Dubrovin–Novikov type such that one of them has a non-local part defined by an isometry of its leading coefficient. An example of such a bi-Hamiltonian pair was recently found for the constant astigmatism equation. We obtain a classification in the case of two dependent variables, and a significant new example with three dependent variables that is an extension of a hydrodynamic-type system obtained from a particular solution of the Witten–Dijkgraaf–Verlinde–Verlinde equations.
The skin crawls, the stomach turns: ectoparasites and pathogens elicit distinct defensive responses in humans
Authors: Kupfer Tom R. , Fessler Daniel M. T. , Wu Bozhi , Hwang Tiffany , Sparks Adam Maxwell , Alas Sonia , Samore Theodore , Lal Vedika , Sakhamuru Tanvi P. , Holbrook Colin
Published: July 2021

Disgust has long been viewed as a primary motivator of defensive responses to threats posed by both microscopic pathogens and macroscopic ectoparasites. Although disgust can defend effectively against pathogens encountered through ingestion or incidental contact, it offers limited protection against ectoparasites, which actively pursue a host and attach to its surface. Humans might, therefore, possess a distinct ectoparasite defence system—including cutaneous sensory mechanisms and grooming behaviours—functionally suited to guard the body's surface. In two US studies and one in China, participants (
N
= 1079) viewed a range of ectoparasite- and pathogen-relevant video stimuli and reported their feelings, physiological sensations, and behavioural motivations. Participants reported more surface-guarding responses towards ectoparasite stimuli than towards pathogen stimuli, and more ingestion/contamination-reduction responses towards pathogen stimuli than towards ectoparasite stimuli. Like other species, humans appear to possess evolved psychobehavioural ectoparasite defence mechanisms that are distinct from pathogen defence mechanisms.
Genomic regions associated with adaptation to predation in
Daphnia
often include members of expanded gene families
Authors: Zhang Xiuping , Blair David , Wolinska Justyna , Ma Xiaolin , Yang Wenwu , Hu Wei , Yin Mingbo
Published: July 2021

Predation has been a major driver of the evolution of prey species, which consequently develop antipredator adaptations. However, little is known about the genetic basis underpinning the adaptation of prey to intensive predation. Here, we describe a high-quality chromosome-level genome assembly (approx. 145 Mb, scaffold N50 11.45 Mb) of
Daphnia mitsukuri
, a primary forage for many fish species. Transcriptional profiling of
D. mitsukuri
exposed to fish kairomone revealed that this cladoceran responds to predation risk through regulating activities of Wnt signalling, cuticle pattern formation, cell cycle regulation and anti-apoptosis pathways. Genes differentially expressed in response to predation risk are more likely to be members of expanded families. Our results suggest that expansions of multiple gene families associated with chemoreception and vision allow
Daphnia
to enhance detection of predation risk, and that expansions of those associated with detoxification and cuticle formation allow
Daphnia
to mount an efficient response to perceived predation risk. This study increases our understanding of the molecular basis of prey defences, being important evolutionary adaptations playing a stabilizing role in community dynamics.
Devonian agglutinated polychaete tubes: all in all it's just another grain in the wall
Authors: Becker-Kerber Bruno , Horodyski Rodrigo Scalise , del Mouro Lucas , Sedorko Daniel , Lehn Ilana , Sanchez Dario Ferreira , Fournier Jérôme , Mazurier Arnaud , El Albani Abderrazak
Published: July 2021

Biomineralized and organic metazoan tubular skeletons are by far the most common in the fossil record. However, several groups of organisms are also able to agglutinate particles to construct more rigid structures. Here we present a novel type of agglutinated tube from the austral and endemic palaeobiota of the Malvinokaffric realm (Devonian, Brazil). This fossil is characterized by an agglutinated tube made of silt-sized particles forming an unusual flanged morphology that is not known from the fossil record. Besides being able to select specific particles, these organisms probably lived partially buried and were detritus/suspension feeders. Comparisons across different modern groups show that these fossils are strongly similar to tubes made by polychaetes, specifically from the family Maldanidae. If this interpretation is correct, then an early divergence of the Sedentaria clade may have occurred before the Devonian.
Pollinators and plant nurseries: how irrigation and pesticide treatment of native ornamental plants impact solitary bees
Authors: Cecala Jacob M. , Wilson Rankin Erin E.
Published: July 2021

A key conservation goal in agroecosystems is to understand how management practices may affect beneficial species, such as pollinators. Currently, broad gaps exist in our knowledge as to how horticultural management practices, such as irrigation level, might influence bee reproduction, particularly for solitary bees. Despite the extensive use of ornamental plants by bees, especially little is known about how irrigation level may interact with insecticides, like water-soluble neonicotinoids, to influence floral rewards and bee reproduction. We designed a two-factor field cage experiment in which we rearedMegachile rotundata(Fabricius) (Hymenoptera: Megachilidae) on containerized ornamental plants grown under two different irrigation levels and imidacloprid treatments (30% label rate dosage of a nursery formulation or an untreated control). Lower irrigation was associated with modest decreases in nectar volume and floral abundance in untreated plants, whereas irrigation did not affect plants treated with imidacloprid. Furthermore, higher irrigation decreased the amount of imidacloprid entering nectar. Imidacloprid application strongly reduced bee foraging activity and reproduction, and higher irrigation did not offset any negative effects on bees. Our study emphasizes the impact of a nursery neonicotinoid formulation on solitary bee foraging and reproduction, while highlighting interactions between irrigation level and neonicotinoid application in containerized plants themselves.
Combined computational and cellular screening identifies synergistic inhibition of SARS-CoV-2 by lenvatinib and remdesivir
Authors: Pohl Marie O. , Busnadiego Idoia , Marrafino Francesco , Wiedmer Lars , Hunziker Annika , Fernbach Sonja , Glas Irina , Moroz-Omori Elena V. , Hale Benjamin G. , Caflisch Amedeo , Stertz Silke
Published: July 2021

Rapid repurposing of existing drugs as new therapeutics for COVID-19 has been an important strategy in the management of disease severity during the ongoing SARS-CoV-2 pandemic. Here, we used high-throughput docking to screen 6000 compounds within the DrugBank library for their potential to bind and inhibit the SARS-CoV-2 3 CL main protease, a chymotrypsin-like enzyme that is essential for viral replication. For 19 candidate hits, parallel in vitro fluorescence-based protease-inhibition assays and Vero-CCL81 cell-based SARS-CoV-2 replication-inhibition assays were performed. One hit, diclazuril (an investigational anti-protozoal compound), was validated as a SARS-CoV-2 3 CL main protease inhibitor in vitro (IC50 value of 29 µM) and modestly inhibited SARS-CoV-2 replication in Vero-CCL81 cells. Another hit, lenvatinib (approved for use in humans as an anti-cancer treatment), could not be validated as a SARS-CoV-2 3 CL main protease inhibitor in vitro, but serendipitously exhibited a striking functional synergy with the approved nucleoside analogue remdesivir to inhibit SARS-CoV-2 replication, albeit this was specific to Vero-CCL81 cells. Lenvatinib is a broadly-acting host receptor tyrosine kinase (RTK) inhibitor, but the synergistic effect with remdesivir was not observed with other approved RTK inhibitors (such as pazopanib or sunitinib), suggesting that the mechanism-of-action is independent of host RTKs. Furthermore, time-of-addition studies revealed that lenvatinib/remdesivir synergy probably targets SARS-CoV-2 replication subsequent to host-cell entry. Our work shows that combining computational and cellular screening is a means to identify existing drugs with repurposing potential as antiviral compounds. Future studies could be aimed at understanding and optimizing the lenvatinib/remdesivir synergistic mechanism as a therapeutic option.
Phylogenomic disentangling of the Bifidobacterium longum subsp. infantis taxon
Authors: Tarracchini Chiara , Milani Christian , Lugli Gabriele Andrea , Mancabelli Leonardo , Fontana Federico , Alessandri Giulia , Longhi Giulia , Anzalone Rosaria , Viappiani Alice , Turroni Francesca , van Sinderen Douwe , Ventura Marco
Published: July 2021

Members of the

Bifidobacterium longum

species have been shown to possess adaptive abilities to allow colonization of different mammalian hosts, including humans, primates and domesticated mammalian species, such as dogs, horses, cattle and pigs. To date, three subspecies have formally been recognized to belong to this bifidobacterial taxon, i.e.

B. longum

subsp.

longum

,

B. longum

subsp.

infantis

and

B. longum

subsp.

suis

. Although

B. longum

subsp.

longum

is widely distributed in the human gut irrespective of host age,

B. longum

subsp.

infantis

appears to play a significant role as a prominent member of the gut microbiota of breast-fed infants. Nevertheless, despite the considerable scientific relevance of these taxa and the vast body of genomic data now available, an accurate dissection of the genetic features that comprehensively characterize the

B. longum

species and its subspecies is still missing. In the current study, we employed 261 publicly available

B. longum

genome sequences, combined with those of 11 new isolates, to investigate genomic diversity of this taxon through comparative genomic and phylogenomic approaches. These analyses allowed us to highlight a remarkable intra-species genetic and physiological diversity. Notably, characterization of the genome content of members of

B. longum

subsp.

infantis

subspecies suggested that this taxon may have acquired genetic features for increased competitiveness in the gut environment of suckling hosts. Furthermore, specific

B. longum

subsp.

infantis

genomic features appear to be responsible for enhanced horizontal gene transfer (HGT) occurrences, underpinning an intriguing dedication toward acquisition of foreign DNA by HGT events.
The role of l-arabinose metabolism for Escherichia coli O157:H7 in edible plants
Authors: Crozier Louise , Marshall Jacqueline , Holmes Ashleigh , Wright Kathryn Mary , Rossez Yannick , Merget Bernhard , Humphris Sonia , Toth Ian , Jackson Robert Wilson , Holden Nicola Jean
Published: July 2021

Arabinose is a major plant aldopentose in the form of arabinans complexed in cell wall polysaccharides or glycoproteins (AGP), but comparatively rare as a monosaccharide. l-arabinose is an important bacterial metabolite, accessed by pectolytic micro-organisms such as

Pectobacterium atrosepticum

via pectin and hemicellulose degrading enzymes. However, not all plant-associated microbes encode cell-wall-degrading enzymes, yet can metabolize l-arabinose, raising questions about their use of and access to the glycan in plants. Therefore, we examined l-arabinose metabolism in the food-borne pathogen

Escherichia coli

O157:H7 (isolate Sakai) during its colonization of plants. l-arabinose metabolism (araBA) and transport (araF) genes were activated at 18 °C in vitro by l-arabinose and expressed over prolonged periods in planta. Although deletion of araBAD did not impact the colonization ability of

E. coli

O157:H7 (Sakai) on spinach and lettuce plants (both associated with STEC outbreaks), araA was induced on exposure to spinach cell-wall polysaccharides. Furthermore, debranched and arabinan oligosaccharides induced ara metabolism gene expression in vitro, and stimulated modest proliferation, while immobilized pectin did not. Thus,

E. coli

O157:H7 (Sakai) can utilize pectin/AGP-derived l-arabinose as a metabolite. Furthermore, it differs fundamentally in ara gene organization, transport and regulation from the related pectinolytic species

P. atrosepticum

, reflective of distinct plant-associated lifestyles.
Dalbavancin in real life: Economic impact of prescription timing in French hospitals
Authors: Béraud Guillaume , Maupetit Jean-Claude , Darras Audric , Vimont Alexandre , Blachier Martin
Published: July 2021

Synopsis

Objectives

The extended half-life of dalbavancin justifies a once-a-week dosing schedule and is supposed to favour early discharge. These advantages may therefore compensate for the cost of dalbavancin. We aimed to assess the real-life budget impact of dalbavancin through its impact on the length of stay in French hospitals.

Methods

A multicentre cohort based on the French registry of dalbavancin use in 2019 was compared to the French national discharge summary database. Lengths of stay and budget impact related to the infection type, the time of introduction of dalbavancin, the type of catheter and patient subgroups were assessed. An early switch was defined when dalbavancin was administered as the first or second treatment and within less than 11 days of hospitalization.

Results

One hundred seventy-nine patients were identified in the registry, and 154 were included in our study. Dalbavancin is mostly used for bone and joint infections, infective endocarditis and acute bacterial skin and skin structure infections. When compared to the data for similar patients in the national database, the length of stay was almost always shorter for patients treated with dalbavancin. The budget impact for dalbavancin was heterogeneous but frequently generated savings. Early switching was associated with savings (or lesser costs). Patients who required a deep venous catheter and those with the most severe patients benefited the most from dalbavancin.

Conclusions

Our study confirms that dalbavancin is associated with early discharge, which can offset its cost and generate savings. The greatest benefit is achieved with an early switch.
SARS-CoV-2 Antibody Response in Patients Undergoing Kidney Transplantation
Authors: Lubetzky Michelle , Sukhu Ashley , Zhao Zhen , Rand Sophie , Sharma Vijay , Sultan Samuel , Kapur Zoe , Albakry Shady , Hauser Nataliya , Marku-Podvorica Jehona , Craig-Schapiro Rebecca , Lee John R. , Salinas Thalia , Aull Meredith , Kapur Sandip , Cushing Melissa , Dadhania Darshana M.
Published: July 2021

The response of the immune system to COVID-19 in end stage kidney disease patients who undergo kidney transplantation has yet to be described. We report data on 72 patients who underwent SARS-CoV-2 antibody testing both before and after kidney transplantation and were followed for a median of 186 days (range 83, 277). Of the 25 patients with a positive antibody test at the time of transplant, 17 (68%) remained positive after transplantation. Patients were significantly more likely to have a persistently positive test if they reported a symptomatic COVID-19 infection prior to transplant (p=0.01). SARS-CoV-2 IgG index values were measured in a subset of kidney transplant recipients and compared to wait -listed dialysis patients. These assays demonstrated a more significant decline in IgG (58% versus 14% p = 0.008) in transplant recipients when compared to dialysis patients tested during the same time period. Additional analysis of the quality of the immune response measuring the binding of SARS-CoV-2 antibodies to the receptor-binding domain (RBD binding), the antibody neutralizing capability, and the antibody avidity demonstrated a more pronounced effect when comparing pre-transplant values to post-induction therapy/post transplant values. The attenuated IgG response seen in transplant patients compared to dialysis patients after induction therapy requires further study. These data have important implications for post-transplant management of vaccinated dialysis patients.
Information silos distort biomedical research
Authors: Rodriguez-Esteban Raul
Published: July 2021

Information silos have been an oft-maligned feature of scientific research for introducing a bias towards knowledge that is produced within a scientist’s own community. The vastness of the scientific literature has been commonly blamed for this phenomenon, despite recent improvements in information retrieval and text mining. Its actual negative impact on scientific progress, however, has never been quantified. This analysis attempts to do so by exploring its effects on biomedical discovery, particularly in the discovery of relations between diseases, genes and chemical compounds. Results indicate that the probability that two scientific facts will enable the discovery of a new fact depends on how far apart these two facts were published within the scientific landscape. In particular, the probability decreases exponentially with the citation distance. Thus, the direction of scientific progress is distorted based on the location in which each scientific fact is published, representing a path-dependent bias in which originally closely-located discoveries drive the sequence of future discoveries. To counter this bias, scientists should open the scope of their scientific work with modern computational approaches.