bluuebunny/crossref_metadata_2025 huggingface dataset:
Corneal endothelial wound healing after Descemet tear with a rho kinase inhibitor
Authors: Azhari Jamal , Patel Umangi , Vakharia Mitul
Published: March 2022

Introduction:

To the authors’ knowledge, this is the first report of Descemet tear postcataract surgery that was successfully treated with ripasudil hydrochloride hydrate.

Patient and Clinical Findings:

An 85-year-old pseudophakic man presented with blurry vision and mild photophobia in the left eye. Slitlamp biomicroscopy showed moderate corneal edema and a central Descemet tear from cataract surgery 7 years earlier.

Diagnosis, Intervention, and Outcomes:

The patient was treated for 1 month with prednisolone acetate 1% and sodium chloride 5% hyperosmotic ophthalmic solution with no clinical improvement. He declined surgical intervention and opted for medical management with ripasudil 0.4% ophthalmic solution, a rho kinase inhibitor. He applied it topically 4 times daily for 3 months, with improvement of corneal edema and corrected distance visual acuity. After discontinuation of ripasudil, his edema and vision worsened and then improved again after retreatment, showing a strong clinical response. 2 years after starting ripasudil therapy, the patient had continued to use ripasudil 3 times daily and reported worsened vision at lower doses.

Conclusions:

The use of topical ripasudil may be a viable medical intervention for corneal edema due to Descemet tear instead of surgery, although chronic use may be required.
Enthesopathy, a Cause for Persistent Peristomal Pain after Treatment with an Osseointegrated Bone-Anchor: A Retrospective Case Series
Authors: Kang Norbert Venantius , Woollard Alexander , Gupta Sanjay , Michno Dominika , Davison Eliza , Langley Beth
Published: March 2022

Introduction

After limb loss, many patients undergo treatment with an osseointegrated implant. Unfortunately, some develop persistent peristomal pain after surgery. This can be sufficiently severe to reduce the speed of their rehabilitation or may halt the process altogether. The pain may be due to an enthesopathy of the residual muscles. We describe the phenomenon and outcomes of treatment in a series of patients who underwent treatment with an osseointegrated prosthetic limb, bone-anchor.

Materials and Methods

Over 36 months, we followed 14 patients with symptoms consistent with enthesopathy. Thirteen had undergone treatment with a transfemoral bone-anchor and one underwent treatment with a transhumeral bone-anchor.

One patient had a bilateral transfemoral amputation. Analysis of the patients' ages, heights, weight at the time of surgery, length of residual femur, or preoperative dual-energy x-ray absorptiometry scans showed no correlation with the development of enthesopathy pain. Thirteen patients received steroid injections. Most received at least one injection of Adcortyl™ and bupivacaine. Patients were then encouraged to follow a program of physiotherapy to stretch out their enthesis, after injection.

Results

All patients experienced relief from their symptoms, but only two were rendered completely pain free. The remaining 11 patients gained sufficient control of their symptoms to allow them to continue daily use of their prosthesis with less difficulty or, where rehabilitation had been delayed or halted completely, to resume this process.

Conclusion

Enthesopathy seems to be a common phenomenon after bone-anchor surgery in individuals with transfemoral amputation. Steroid injections can help to relieve pain, allowing physiotherapy to be carried out. Patients undergoing treatment with a bone-anchor should be advised of the possibility of enthesopathy pain but can be reassured that there is a solution that works well in most cases.

Clinical Relevance

This article may be of benefit to clinicians who are struggling to manage patients with persistent peristomal pain after insertion of a bone-anchor. It may also encourage further research into measures for securing the soft tissues around the stoma for patients undergoing bone-anchor surgery.
Current Estimates of Cochlear Implant Utilization in the United States
Authors: Nassiri Ashley M. , Sorkin Donna L. , Carlson Matthew L.
Published: March 2022

Objective:

To present key data from a private marketing report that characterizes U.S. cochlear implant (CI) utilization, potential CI candidate and recipient population sizes, and CI market growth.

Patients:

Individuals who may benefit from CI and CI recipients in the United States.

Interventions:

Cochlear implantation.

Main outcome measures:

CI utilization, potential CI candidate and recipient population sizes, and CI market size and value.

Results:

As of 2015, a cumulative 170,252 people (240,056 devices) had undergone cochlear implantation in the United States. In the year 2015, approximately 30% of devices were implanted in bilateral CI patients, through simultaneous or sequential implantation. When considering traditional audiometric CI candidacy criteria (patients with severe to profound sensorineural hearing loss in the better hearing ear), utilization rates among the population who may benefit from CI approximated 12.7%. When considering expanded criteria including individuals with single-sided deafness or asymmetrical hearing loss (severe to profound hearing loss in the worse hearing ear), utilization rates approximated 2.1%. In 2015, there was a net increase of 20,093 individuals who may have benefited from CI who had not undergone CI, adding to the group of about 1.3 M untreated audiometric CI candidates who existed prior to that year. The CI market was valued at $450.8 M in 2015, with an average device selling price of $25,701 per device.

Conclusions:

CI utilization rates remain low among individuals who meet audiometric criteria for CI. Although the annual proportion of CI recipients to new audiometric candidates has increased, the total population of untreated audiometric CI candidates continues to rise.
Misplaced Cochlear Implant Electrodes Outside the Cochlea: A Literature Review and Presentation of Radiological and Electrophysiological Findings
Authors: Cheung Linnea L. , Kong Jonathan , Chu Pui Yin , Sanli Halit , Walton Joanna , Birman Catherine S.
Published: March 2022

Hypothesis:

It is possible to detect when misplacement and malposition of the cochlear implant (CI) electrode array has occurred intraoperatively through different investigations. We aim to explore the literature surrounding cochlear implant misplacements and share our personal experience with such cases to formulate a quick-reference guide that may be able to help cochlear implant teams detect misplacements early.

Background:

Misplacement and malposition of a cochlear implant array can lead to poor hearing outcomes. Where misplacements go undetected during the primary surgery, patients may undergo further surgery to replace the implant array into the correct intracochlear position.

Methods:

Systematic literature review on cochlear implant misplacements and malpositions and a retrospective review of our program's cases in over 6,000 CI procedures.

Results:

Twenty-nine cases of CI misplacements are reported in the English literature. Sixteen cases of cochlear implant misplacements are reported from our institution with a rate of 0.28%. A further 12 cases of intracochlear malpositions are presented. The electrophysiological (CI electrically evoked auditory brainstem response, transimpedance matrix) and radiological (X-ray and computed tomography scan) findings from our experience are displayed in a tabulated quick-reference guide to show the possible characteristics of misplaced and malpositioned cochlear implant electrode arrays.

Conclusion:

Both intraoperative electrophysiological and radiological tests can show when the array has been misplaced or if there is an intracochlear malposition, to prompt timely intra-operative reinsertion to yield better outcomes for patients.
Inter and Intraobserver Agreement of the IOOG SAMEO ATO Classification for Tympanomastoid Surgery
Authors: Hickson Craig , Gao Chuanyu , Parsons Nicholas , Neumann Codruta
Published: March 2022

Introduction

In 2018 the International Otology Outcome Group (IOOG) introduced the stage of surgery, approach, mastoidectomy, external ear canal reconstruction, obliteration of mastoid cavity, access to middle ear, tympanic membrane, ossicular chain (SAMEO ATO) categorization framework for tympanomastoid surgery to develop a classification system that encompasses all aspects of surgical technique that are likely to influence the outcome of tympanomastoid surgery. To date there is no study that examines inter or intraobserver reliability of this classification system.

Objective

To assess inter and intraobserver reliability of the SAMEO ATO classification.

Study Design and Setting

Retrospective single center study.

Intervention

Two observers independently categorized 167 tympanomastoid surgeries using the SAMEO-ATO system to allow for interobserver analysis. Categorization was performed retrospectively from operation notes. Intraobserver reliability was evaluated for one observer.

Patients

One hundred sixty seven tympanomastoid surgeries performed by a single surgeon between 2018 and 2021.

Main Outcome Measure

Inter and intraobserver reliability calculated using Cohen’s kappa.

Results

Almost perfect interobserver agreement was seen for stage of surgery (S), approach (A), mastoidectomy (M), and ossicular chain (O) with kappa scores ranging from of 0.957 to 0.848.

Almost perfect intraobserver agreement was seen for approach (A), mastoidectomy (M), external ear reconstruction (E), obliteration of mastoid cavity (O), access to middle ear (A), and ossicular chain (O) with kappa ranging from 0.929 to 08.21.

Conclusion

The SAMEO ATO classification is a reliable system for recording surgical procedures. Given the complexity of the SAMEO ATO classification it is vital that those using it have a thorough knowledge of the classification.
Spanish-Speaking Caregivers' Perception of Emergency Physicians' Interpersonal and Communication Skills in a Pediatric Emergency Department
Authors: Russell Eric A. , Hsu Deborah , Camp Elizabeth A. , Soto-Ruiz Karina , Leaming-Van Zandt Katherine
Published: March 2022

Objectives

Medical communication is more than just the delivery of information; language differences between physicians and patients/caregivers create a challenge to providing effective care in the pediatric emergency department (ED). Overcoming this barrier is vital to providing high-quality care. We evaluated Spanish- versus English-speaking caregivers' perception of their pediatric ED physicians' interpersonal and communication skills. We also compared perceptions of Spanish- versus English-speaking caregivers who self-identified as Hispanic.

Methods

This study is a retrospective analysis of data from surveys administered in an urban, free-standing children's hospital ED. Surveys were administered in English and Spanish to pediatric patient caregivers. In person, video, and telephonic interpretations were available during patient encounters.

Results

There were 2542 (82.4%) surveys completed in English and 543 (17.6%) in Spanish. There were significant differences in demographic data of English versus Spanish survey respondents, including level of education, insurance status, and rates of nonpublic insurance. Spanish survey respondents rated their physicians' interpersonal skills lower than English survey respondents. There were 1455 (47%) surveys completed by the respondents who self-identified as Hispanic. Within this group, 928 (63.8%) respondents completed the survey in English and 527 (36.2%) in Spanish. Among this Hispanic population, the Spanish survey respondents rated their physicians' interpersonal and communication skills lower than English survey respondents. After adjusting for education level and insurance type, these differences persisted.

Conclusions

Language barriers have a meaningful impact on physician ability to communicate effectively in the pediatric ED. Improving physicians' ability to overcome this barrier is essential toward enriching patient outcomes and experience in the ED.
Multiple Symmetric Lipomatosis: Lipectomy for Madelung Collar
Authors: Duc Nguyen Quang , Lam Vu Ngoc , Thu Hai Le Thi , Nghia Nguyen Trong , Linh Le Diep
Published: March 2022

Multiple symmetric lipomatosis (MSL) is a rare disease associated with metabolic disorders and alcoholism. In this report, we describe the clinical outcome and surgical protocol for eight men with Madelung collar who underwent treatment in a craniofacial and plastic surgery facility in Hanoi, Vietnam, between May 2018 and December 2020. We discuss the patients' clinical symptoms, subclinical signs, epidemiology, magnetic resonance imaging, computerized tomography, surgical protocol, complications, and postoperative indicators that we collected and evaluated. Each patient underwent surgery in two stages (i.e., in supine and prone positions). We injected a tumescent solution 10 min before the incision. Two surgeons performed each operation simultaneously. After surgery, we followed the patients for 6–27 months. All of the patients had a history of long-time alcohol abuse and had associated comorbidities that included liver disease, blood disorders, restricted neck movement, and orthopnea. We did not have to open the trachea or transfuse blood during any of the surgical procedures. Postoperatively, all patients were satisfied with their functional results and aesthetic appearance. One patient experienced a recurrence of his MSL. We believe our surgical protocol provides optimal results for patients with MSL and Madelung collar.
Emotional Intelligence: Lessons Learned During a Pandemic
Authors: Izzarelli Jenn
Published: March 2022

Emotional intelligence (EI) is the level to which an individual is aware of, understands, and manages their emotional state. It also includes the level to which an individual is able to appreciate the emotional status of others. In 1995, Daniel Goleman's book, Emotional Intelligence, popularized the many theories and studies about EI. Since then, EI has transformed into a learned, applicable concept that can improve personal relationships and patients' experiences and lead to an increase in profitability for the aesthetic practitioner. The purpose of this article is to help the reader understand what EI is and how it can be applied in our everyday lives both personally and professionally. I also describe what I have learned about EI during the recent COVID-19 pandemic. I highlight the four components of EI that are the most crucial. These are self-awareness, self-management, social awareness, and relationship management.
Using a V–Y Advance Flap for Alar Rim Defect After Human Bite: A Case Report
Authors: Vicente-Pardo Andrea , Sanchez Garcia Alberto , Alonso Carpio Miriam , García Vilariño Elena
Published: March 2022

A human bite is a traumatic injury that often occurs in the recipient's nasal area. In this report, we describe the case of a 38-year-old man who was bitten by his roommate and sustained an alar rim defect. After reviewing the literature and professional recommendations for managing human bite wounds in the nasal area, we found both were unclear as to whether it is best to implement primary reconstruction or to defer reconstruction to a later date. We utilized a V–Y flap for secondary reconstruction in our patient.
Predictive Analytics Using Machine Learning to Identify ART Clients at Health System Level at Greatest Risk of Treatment Interruption in Mozambique and Nigeria
Authors: Stockman Jeni , Friedman Jonathan , Sundberg Johnna , Harris Emily , Bailey Lauren
Published: March 2022

Background:

A core objective of HIV/AIDS programming is keeping clients on treatment to improve their health outcomes and to limit spread. Machine learning and artificial intelligence can combine client, temporal, and locational attributes to identify which clients are at greatest risk of loss to follow-up (LTFU) and enable health providers to direct support interventions accordingly.

Setting:

The analysis was part of a project funded by U.S. President's Emergency Plan for AIDS Relief and United States Agency for International Development, Data for Implementation, and applied to data from publicly available sources (health facility data, geospatial data, and satellite imagery) and de-identified electronic medical record data on antiretroviral therapy clients in Nigeria and Mozambique.

Methods:

The project applied binary classification techniques using temporal cross-validation to predict the risk that patients would be LTFU. Classifiers included logistic regression, neural networks, and tree-based models.

Results:

Models showed strong predictive power in both settings. In Mozambique, the best-performing model, a Random Forest, achieved an area under the precision–recall curve of 0.65 compared against an underlying LTFU rate of 23%. In Nigeria, the best-performing model, a boosted tree, achieved an area under the precision–recall curve of 0.52 compared against an underlying LTFU rate of 27%.

Conclusions:

Machine-learned models outperformed current classification techniques and showed potential to better direct health worker resources toward patients at greatest risk of LTFU. Moreover, models performed equally across sex and age groups, supporting the model's generalizability and wider application.
Brief Report: Adolescent Girls Who Sell Sex in Zimbabwe: HIV Risk, Behaviours, and Service Engagement
Authors: Rice Brian , Machingura Fortunate , Maringwa Galven , Magutshwa Sitholubuhle , Kujeke Tatenda , Jamali Gracious , Busza Joanna , de Wit Mariken , Fearon Elizabeth , Hanisch Dagmar , Yekeye Raymond , Mugurungi Owen , Hargreaves James R. , Cowan Frances M.
Published: March 2022

Background:

To reduce HIV incidence among adolescent girls who sell sex (AGSS) in Zimbabwe, we need to better understand how vulnerabilities intersect with HIV infection and how those living with HIV engage in care.

Methods:

In 2017, we conducted social mapping in 4 locations in Zimbabwe and recruited girls aged 16–19 years who sell sex, using respondent-driven sampling or census sampling methods. Participants completed a questionnaire and provided finger prick blood samples for HIV antibody testing.

Results:

Of 605 AGSS recruited, 74.4% considered themselves sex workers, 24.4% reported experiencing violence in the past year, 91.7% were not in school, and 83.8% had less than a complete secondary education. Prevalence of HIV increased steeply from 2.1% among those aged 16 years to 26.9% among those aged 19 years; overall, 20.2% of AGSS were HIV-positive. In the multivariate analysis, age, education, marital status, and violence from a client were associated with HIV. Among the 605 AGSS, 86.3% had ever tested for HIV, with 64.1% having tested in the past 6 months. Among AGSS living with HIV, half (50.8%) were aware of their status, among whom 83.9% reported taking antiretroviral therapy.

Conclusion:

The steep rise in HIV prevalence among those aged between 16 and 19 years suggests the window to engage with AGSS before HIV acquisition is short. To accelerate reductions in incidence among AGSS, intensified combination prevention strategies that address structural factors and tailor services to the needs of AGSS are required, particularly ensuring girls enroll and remain in school.
68Ga-FAPI and 18F-FDG PET/CT Findings in a Patient With Pancreatic Tuberculosis Mimicking Malignant Tumor
Authors: Sun Rui , Huang Zhanwen , Wei Jing , Zeng Chengrun , Chen XiaoLiang
Published: March 2022

We report the case of a 24-year-old man who presented with abdominal pain and jaundice. 18F-FDG and 68Ga-FAPI PET/CT showed increased radioactivity in the region of the pancreatic head, which suggested malignant tumor. However, postoperative pathological finding demonstrated the presence of tuberculosis. This case documents that the pancreatic tuberculosis may cause FAPI uptake, and nuclear medicine physician evaluating 68Ga-FAPI imaging should be aware of this potential pitfall.
Prehospital activation of a coordinated multidisciplinary hospital response in preparation for patients with severe hemorrhage: A statewide data linkage study of the New South Wales “Code Crimson” pathway
Authors: Partyka Christopher , Miller Matthew , Johnson Tamara , Burns Brian , Fogg Toby , Sarrami Pooria , Singh Hardeep , Dee Kelly , Dinh Michael
Published: March 2022

BACKGROUND

Hemorrhage is a leading cause of preventable death in trauma. Prehospital medical teams can streamline access to massive transfusion and definitive hemorrhage control by alerting in-hospital trauma teams of suspected life-threatening bleeding in unstable patients. This study reports the initial experience of an Australian “Code Crimson” (CC) pathway facilitating early multidisciplinary care for these patients.

METHODS

This data-linkage study combined prehospital databases with a trauma registry of patients with an Injury Severity Score greater than 12 between 2017 and 2019. Four groups were created; prehospital CC activation with and without in-hospital links and patients with inpatient treatment consistent with CC, without one being activated. Diagnostic accuracy was estimated using capture-recapture methodology to replace the missing cell (no prehospital CC and Injury Severity Score < 12).

RESULTS

Of 72 prehospital CC patients, 50 were linked with hospital data. Of 154 potentially missed patients, 42 had a prehospital link. Most CC patients were young men who sustained blunt trauma and required more prehospital interventions than non-CC patients. Code Crimson patients had more multisystem trauma, especially complex thoracic injuries (80%), while missed CC patients more frequently had single organ injuries (59%). Code Crimson patients required fewer hemorrhage control procedures (60% vs. 86%). Lower mortality was observed in CC patients despite greater hospital and intensive care unit length of stay. Despite a low sensitivity (0.49; 95% confidence interval [CI], 0.38–0.61) and good specificity (0.92; 95% CI, 0.86–0.96), the positive likelihood ratio was acceptable (6.42; 95% CI, 3.30–12.48).

CONCLUSION

The initiation of a statewide CC process was highly specific for the need for hemorrhage control intervention in hospital, but further work is required to improve the sensitivity of prehospital activation. Patients who had a CC activation sustained more multisystem trauma but had lower mortality than those who did not. These results guide measures to improve this pathway.

LEVEL OF EVIDENCE

Therapeutic/Care Management; Level IV.
Epidemicity of cholera spread and the fate of infection control measures
Authors: Trevisin Cristiano , Lemaitre Joseph C. , Mari Lorenzo , Pasetto Damiano , Gatto Marino , Rinaldo Andrea
Published: March 2022

The fate of ongoing infectious disease outbreaks is predicted through reproduction numbers, defining the long-term establishment of the infection, and epidemicity indices, tackling the reactivity of the infectious pool to new contagions. Prognostic metrics of unfolding outbreaks are of particular importance when designing adaptive emergency interventions facing real-time assimilation of epidemiological evidence. Our aim here is twofold. First, we propose a novel form of the epidemicity index for the characterization of cholera epidemics in spatial models of disease spread. Second, we examine in hindsight the survey of infections, treatments and containment measures carried out for the now extinct 2010–2019 Haiti cholera outbreak, to suggest that magnitude and timing of non-pharmaceutical and vaccination interventions imply epidemiological responses recapped by the evolution of epidemicity indices. Achieving negative epidemicity greatly accelerates fading of infections and thus proves a worthwhile target of containment measures. We also show that, in our model, effective reproduction numbers and epidemicity indices are explicitly related. Therefore, providing an upper bound to the effective reproduction number (significantly lower than the unit threshold) warrants negative epidemicity and, in turn, a rapidly fading outbreak preventing coalescence of sparse local sub-threshold flare-ups.
Snail regulates Hippo signalling-mediated cell proliferation and tissue growth in
Drosophila
Authors: Ding Xiang , Li Zhuojie , Peng Kai , Zou Rui , Wu Chenxi , Lin Gufa , Li Wenzhe , Xue Lei
Published: March 2022

Snail (Sna) plays a pivotal role in epithelia-mesenchymal transition and cancer metastasis, yet its functions in normal tissue development remain elusive. Here, using
Drosophila
as a model organism, we identified Sna as an essential regulator of Hippo signalling-mediated cell proliferation and tissue growth. First, Sna is necessary and sufficient for impaired Hippo signalling-induced cell proliferation and tissue overgrowth. Second, Sna is necessary and sufficient for the expression of Hippo pathway target genes. Third, genetic epistasis data indicate Sna acts downstream of Yki in the Hippo signalling. Finally, Sna is physiologically required for tissue growth in normal development. Mechanistically, Yki activates the transcription of
sna
, whose protein product binds to Scalloped (Sd) and promotes Sd-dependent cell proliferation. Thus, this study uncovered a previously unknown physiological function of Sna in normal tissue development and revealed the underlying mechanism by which Sna modulates Hippo signalling-mediated cell proliferation and tissue growth.
A novel approach to the functional classification of retinal ganglion cells
Authors: Hilgen Gerrit , Kartsaki Evgenia , Kartysh Viktoriia , Cessac Bruno , Sernagor Evelyne
Published: March 2022

Retinal neurons are remarkedly diverse based on structure, function and genetic identity. Classifying these cells is a challenging task, requiring multimodal methodology. Here, we introduce a novel approach for retinal ganglion cell (RGC) classification, based on pharmacogenetics combined with immunohistochemistry and large-scale retinal electrophysiology. Our novel strategy allows grouping of cells sharing gene expression and understanding how these cell classes respond to basic and complex visual scenes. Our approach consists of several consecutive steps. First, the spike firing frequency is increased in RGCs co-expressing a certain gene (
Scnn1a
or
Grik4
) using excitatory DREADDs (designer receptors exclusively activated by designer drugs) in order to single out activity originating specifically from these cells. Their spike location is then combined with
post hoc
immunostaining, to unequivocally characterize their anatomical and functional features. We grouped these isolated RGCs into multiple clusters based on spike train similarities. Using this novel approach, we were able to extend the pre-existing list of Grik4-expressing RGC types to a total of eight and, for the first time, we provide a phenotypical description of 13 Scnn1a-expressing RGCs. The insights and methods gained here can guide not only RGC classification but neuronal classification challenges in other brain regions as well.
Duration invariance and intensity dependence of the human circadian system phase shifting response to brief light flashes
Authors: Joyce Daniel S. , Spitschan Manuel , Zeitzer Jamie M.
Published: March 2022

The melanopsin-containing intrinsically photosensitive retinal ganglion cells (ipRGCs) are characterized by a delayed off-time following the cessation of light stimulation. Here, we exploited this unusual physiologic property to characterize the exquisite sensitivity of the human circadian system to flashed light. In a 34 h in-laboratory between-subjects design, we examined phase shifting in response to variable-intensity (3–9500 photopic lux) flashes at fixed duration (2 ms;
n
= 28 participants) and variable-duration (10 µs–10 s) flashes at fixed intensity (2000 photopic lux;
n
= 31 participants). Acute melatonin suppression, objective alertness and subjective sleepiness during the flash sequence were also assessed. We find a dose–response relationship between flash intensity and circadian phase shift, with an indication of a possible threshold-like behaviour. We find a slight parametric relationship between flash duration and circadian phase shift. Consistent with prior studies, we observe no dose–response relationship to either flash intensity or duration and the acute impact of light on melatonin suppression, objective alertness or subjective sleepiness. Our findings are consistent with circadian responses to a sequence of flashes being mediated by rod or cone photoreceptors via ipRGC integration.
Long-distance dispersal of pigeons and doves generated new ecological opportunities for host-switching and adaptive radiation by their parasites
Authors: Boyd Bret M. , Nguyen Nam-Phuong , Allen Julie M. , Waterhouse Robert M. , Vo Kyle B. , Sweet Andrew D. , Clayton Dale H. , Bush Sarah E. , Shapiro Michael D. , Johnson Kevin P.
Published: March 2022

Adaptive radiation is an important mechanism of organismal diversification and can be triggered by new ecological opportunities. Although poorly studied in this regard, parasites are an ideal group in which to study adaptive radiations because of their close associations with host species. Both experimental and comparative studies suggest that the ectoparasitic wing lice of pigeons and doves have adaptively radiated, leading to differences in body size and overall coloration. Here, we show that long-distance dispersal by dove hosts was central to parasite diversification because it provided new ecological opportunities for parasites to speciate after host-switching. We further show that among extant parasite lineages host-switching decreased over time, with cospeciation becoming the more dominant mode of parasite speciation. Taken together, our results suggest that host dispersal, followed by host-switching, provided novel ecological opportunities that facilitated adaptive radiation by parasites.
An intermediate crocodylian linking two extant gharials from the Bronze Age of China and its human-induced extinction
Authors: Iijima Masaya , Qiao Yu , Lin Wenbin , Peng Youjie , Yoneda Minoru , Liu Jun
Published: March 2022

A solid phylogenetic framework is the basis of biological studies, yet higher level relationships are still unresolved in some major vertebrate lineages. One such group is Crocodylia, where the branching pattern of three major families (Alligatoridae, Crocodylidae and Gavialidae) has been disputed over decades due to the uncertain relationship of two slender-snouted lineages, gavialines and tomistomines. Here, we report a bizarre crocodylian from the Bronze Age of China, which shows a mosaic of gavialine and tomistomine features across the skeleton, rendering support to their sister taxon relationship as molecular works have consistently postulated. Gavialine characters of the new Chinese crocodylian include a novel configuration of the pterygoid bulla, a vocal structure known in mature male Indian gharials. Extinct gavialines have repeatedly evolved potentially male-only acoustic apparatus of various shapes, illuminating the deep history of sexual selection on acoustic signalling in a slender-snouted group of crocodylians. Lastly, a cutmark analysis combined with accelerator mass spectrometry (AMS) radiocarbon dating of bone remains demonstrated that two individuals from Shang and Zhou dynasties in Guangdong, China, suffered head injuries and decapitation. Archaeological evidence together with historical accounts suggests the human-induced extinction of this unique crocodylian only a few hundred years ago.
Necrotizing fasciitis in neonate by Lichtheimia ramosa : A case study
Authors: William Ashish , Kaur Ravinder , Rawat Deepti , Kandir Neelam S. S. , Sharma Akanksha
Published: March 2022

Zygomycetes have been known to cause life-threatening infections in humans which are often difficult to treat. We present a rare case of cutaneous mucormycosis in a premature neonate admitted with neonatal sepsis and necrotizing fasciitis. He was diagnosed with Lichtheimia ramosa infection and managed surgically along with Amphotericin B. Low birth weight, prematurity, respiratory distress, administration of corticosteroid and broad spectrum antibiotics were identified as the potential risk factors in this case which had led to the fungal infection. Early diagnosis and prompt management is critical in prevention of morbidity and mortality associated with the disease.
ICTV Virus Taxonomy Profile: Adenoviridae 2022
Authors: Benkő Mária , Aoki Koki , Arnberg Niklas , Davison Andrew J. , Echavarría Marcela , Hess Michael , Jones Morris S. , Kaján Győző L. , Kajon Adriana E. , Mittal Suresh K. , Podgorski Iva I. , San Martín Carmen , Wadell Göran , Watanabe Hidemi , Harrach Balázs ,   ICTV Report Consortium
Published: March 2022

The family Adenoviridae includes non-enveloped viruses with linear dsDNA genomes of 25–48 kb and medium-sized icosahedral capsids. Adenoviruses have been discovered in vertebrates from fish to humans. The family is divided into six genera, each of which is more common in certain animal groups. The outcome of infection may vary from subclinical to lethal disease. This is a summary of the ICTV Report on the family Adenoviridae, which is available at ictv.global/report/adenoviridae.
Mining for Health: A Comparison of Word Embedding Methods for Analysis of EHRs Data
Authors: Getzen Emily , Ruan Yucheng , Ungar Lyle , Long Qi
Published: March 2022

Electronic health records (EHRs), routinely collected as part of healthcare delivery, offer great promise for advancing precision health. At the same time, they present significant analytical challenges. In EHRs, data for individual patients are collected at irregular time intervals and with varying frequencies; they include both structured and unstructured data. Advanced statistical and machine learning methods have been developed to tackle these challenges, for example, for predicting diagnoses earlier and more accurately. One powerful tool for extracting useful information from EHRs data is word embedding algorithms, which represent words as vectors of real numbers that capture the words’ semantic and syntactic similarities. Learning embeddings can be viewed as automated feature engineering, producing features that can be used for predictive modeling of medical events. Methods such as Word2Vec, BERT, FastText, ELMo, and GloVe have been developed for word embedding, but there has been little work on re-purposing these algorithms for the analysis of structured medical data. Our work seeks to fill this important gap. We extended word embedding methods to embed (structured) medical codes from a patient’s entire medical history, and used the resultant embeddings to build prediction models for diseases. We assessed the performance of multiple embedding methods in terms of predictive accuracy and computation time using the Medical Information Mart for Intensive Care (MIMIC) database. We found that using Word2Vec, Fast-Text, and GloVe algorithms yield comparable models, while more recent contextual embeddings provide marginal further improvement. Our results provide insights and guidance to practitioners regarding the use of word embedding methods for the analysis of EHR data.
Intentions and willingness to engage in risky driving behaviour among high school adolescents: evaluating the bstreetsmart road safety program
Authors: Sharwood LN , Martiniuk A , Sarrami P , Seggie J , Wilson S , Hsu J , Burns B , Logan D.B.
Published: March 2022

Objective

investigate the impact of a road-safety program on adolescent willingness to engage in risky behaviour as probationary drivers, adjusted for covariates of interest.

Method

bstreetsmart is a road-safety program delivered to around 25,000 adolescent students annually in New South Wales. Using a smart phone-based app, student and teacher participation incentives, students were surveyed before and after program attendance. Mixed methods linear regression analysed pre-post modified Behaviour of Young Novice Driver (BYNDS_M) scores.

Results

2360 and 1260 students completed pre- and post-event surveys respectively. Post-event BYNDS_M scores were around 3 points lower than pre-event scores (−2.99, 95%CI - 3.418 to -2.466), indicating reduced intention to engage in risky driving behaviours. Covariates associated with higher stated intentions of risky driving were exposure to risky driving as a passenger (1.21, 95% CI 0.622-2.011), identifying as non-binary gender (20.8, 95% CI 8.795 to 40.852), adjusting for other predictors.

Conclusions

Trauma-informed, reality-based injury prevention programs are effective in changing short term stated intentions to engage in risky driving, among a pre-independent driving student population. The adolescent novice driver age group is historically challenging to engage, and injury prevention action must be multi-pronged to address the many factors influencing their behaviour.

What is already known on this topic

Road traffic injuries are the leading cause of death for adolescents in most developed countries globally. Injury prevention action must be multi-pronged to address the many factors influencing their behaviour

What this study adds

The bstreetsmart injury prevention intervention which incorporates trauma informed, CBT influence and reality-based road safety information to around 25,000 students annually, showed significant short-term impact on the stated willingness of the study population to engage in risky driving behaviour when obtaining their probationary licence. Adolescents are strongly influenced by examples of risky road behaviours among their closest adult drivers.

How this study might affect research, practice, or policy

Interventions such as bstreetsmart hold a positive place in the multi-pronged approach needed to address the difficult issue of novice drivers.
DIAGNOSTIC ACCURACY OF NON-INVASIVE DETECTION OF SARS-COV-2 INFECTION BY CANINE OLFACTION
Authors: Grandjean Dominique , Elie Caroline , Gallet Capucine , Julien Clotilde , Roger Vinciane , Desquilbet Loïc , Alvergnat Guillaume , Delarue Séverine , Gabassi Audrey , Minier Marine , Choupeaux Laure , Kerneis Solen , Delaugerre Constance , Le Goff Jérôme , Treluyer Jean-Marc
Published: March 2022

BACKGROUND

Throughout the COVID-19 pandemic, testing individuals remains a key action. One approach to rapid testing is to consider the olfactory capacities of trained detection dogs.

METHODS

Prospective cohort study in two community COVID-19 screening centers. Two nasopharyngeal swabs (NPS), one saliva and one sweat samples were simultaneously collected. The dog handlers (and the dogs…) were blinded with regards to the Covid status. The diagnostic accuracy of non-invasive detection of SARS-CoV-2 infection by canine olfaction was assessed as compared to nasopharyngeal RT-PCR as the reference standard, saliva RT-PCR and nasopharyngeal antigen testing.

RESULTS

335 ambulatory adults (143 symptomatic and 192 asymptomatic) were included. Overall, 109/335 participants tested positive on nasopharyngeal RT-PCR either in symptomatic (78/143) or in asymptomatic participants (31/192). The overall sensitivity of canine detection was 97% (95% CI, 92 to 99) and even reached 100% (95% CI, 89 to 100) in asymptomatic individuals compared to NPS RT-PCR. The specificity was 91% (95% CI, 72 to 91), reaching 94% (95% CI, 90 to 97) for asymptomatic individuals. The sensitivity of canine detection was higher than that of nasopharyngeal antigen testing (97% CI: 91 to 99 versus 84% CI: 74 to 90, p=0.006), but the specificity was lower (90% CI: 84 to 95 versus 97% CI: 93 to 99, p=0.016).

CONCLUSIONS

Non-invasive detection of SARS-CoV-2 infection by canine olfaction could be one alternative to NPS RT-PCR when it is necessary to obtain a result very quickly according to the same indications as antigenic tests in the context of mass screening.
Hetero-bivalent Nanobodies Provide Broad-spectrum Protection against SARS-CoV-2 Variants of Concern including Omicron
Authors: Ma Huan , Zhang Xinghai , Zheng Peiyi , Dube Peter H. , Zeng Weihong , Chen Shaohong , Yang Yunru , Wu Yan , Zhou Junhui , Hu Xiaowen , Xiang Yan , Zhang Huajun , Chiu Sandra , Jin Tengchuan
Published: March 2022

Following Delta, Omicron variant triggered a new wave of SARS-CoV-2 infection globally, adaptive evolution of the virus may not stop, the development of broad-spectrum antivirals is still urgent. We previously developed two hetero-bivalent nanobodies with potent neutralization against original WT SARS-CoV-2, termed aRBD-2-5 and aRBD-2-7, by fusing aRBD-2 with aRBD-5 or aRBD-7, respectively. Here, we resolved crystal structures of these nanobodies in complex with RBD, and found the epitope of aRBD-2 differs from that of aRBD-5, aRBD-7. aRBD-2 binds to a conserved epitope which renders its binding activity to all variants of concern (VOCs) including Omicron. Interestingly, although monovalent aRBD-5 and aRBD-7 lost binding to some variants, they effectively improved the overall affinity when transformed into the hetero-bivalent form after being fused with aRBD-2. Consistent with the high binding affinities, aRBD-2-5-Fc and aRBD-2-7-Fc exhibited ultra-potent neutralization to all five VOCs; particularly, aRBD-2-5-Fc neutralized authentic virus of Beta, Delta and Omicron with the IC50of 5.98∼9.65 ng/mL or 54.3∼87.6 pM. Importantly, aRBD-2-5-Fc providedin vivoprophylactic protection for mice against WT and mouse-adapted SARS-CoV-2, and provided full protection against Omicron in hamster model when administrated either prophylactically or therapeutically. Taken together, we found a conserved epitope on RBD, and hetero-bivalent nanobodies had increased affinity for VOCs over its monovalent form, and provided potent and broad-spectrum protection bothin vitroandin vivoagainst all tested major variants, and potentially future emerging variants. Our strategy provides a new solution in the development of therapeutic antibodies for COVID-19 caused by newly emergent VOCs.
Gender and financial performance in SMEs in emerging economies
Authors: Espinosa-Méndez Christian , Inostroza Correa Alejandra
Published: March 2022

Purpose

The purpose of this paper is to investigate how chief executive officer (CEO) gender relates to financial performance in small and medium enterprises (SMEs) in a Latin American emerging economy like Chile.

Design/methodology/approach

The authors apply a questionnaire on a sample of 188 SMEs in Chile in 2017. The authors apply multiple ordinary least squares regression models to test the effects of CEO gender on SME performance using the industry location indicators to account for unobserved heterogeneity in the sample. As a robustness test the authors use hierarchical regression analysis.

Findings

The authors find a positive relationship between the presence of female CEOs and firm performance. Then, when probing whether the sociodemographic characteristics of the CEO are related to firm performance or moderate the gender-performance relationship, the authors do not find statistically significant evidence that these types of characteristics affect the performance of SMEs.

Originality/value

To the best of the authors’ knowledge, the present study is the first to investigate the relationship between CEO gender and financial performance of SMEs in an emerging Latin American economy. The study contributes to the general literature by reporting comparable evidence with studies in developed economies.
Governance for global health: the role of Nordic countries
Authors: Ibragimova Irina
Published: March 2022

Purpose

Global health challenges and threats could be confronted by collaborative efforts of international community. Governance for global health is a set of formal and informal processes, operating beyond state boundaries, and refers to institutions and mechanisms established at the national, regional and international levels. Nordic countries demonstrated a long-standing commitment to development assistance for health (DAH), and more recently to governance for global health. Governance for global health tools could be used effectively to achieve collective solutions for the maintenance and promotion of health as a common good, could ensure accountability and transparency, and reconcile the interests of different actors on the international and national levels. The aim of this paper is to provide an overview of tools and approaches in support of eight sub-functions of governance for global health applied by the Nordic countries. This will help international audience to compare those mechanisms with similar mechanisms that are available or planned in their countries and regions, and may benefit policy scholars and practitioners.

Design/methodology/approach

This study uses qualitative review of research literature, policy documents and information available from institutional websites related to the governance of global health in four Nordic countries. In total, 50 selected publications were analyzed using framework synthesis, mapping all findings to 8 dimensions (sub-functions) of governance for global health and related tools.

Findings

Review reveals which tools are available, how they have been applied by the Nordic countries and influenced all domains (sub-functions) of governance for global health at different levels: national governments, agencies and networks; bilateral and multilateral partnerships; inter-governmental institutions and international health-related organizations. Common trends and approaches in governance for global health have been formulated.

Originality/value

This study is unique in relation to the prior literature as it looks at the role of Nordic countries in the governance for global health system through the lens of tools applied in support to its sub-functions.
Analysis of factors affecting dysfunctional audit behavior in Malaysia
Authors: Johari Razana Juhaida , Mohd Hairudin Nurul Afifah , Dawood Ayub Khan
Published: March 2022

Purpose

The financial scandals in Malaysia have caused auditors to be convicted of such failure and led to the claims that they were involved in dysfunctional audit behavior. The incidences have worsened the profession’s credibility and deteriorated the public confidence on the profession. This study aims to examine the influence of professional skills, independence, work experience, time budget pressure on dysfunctional audit behavior.

Design/methodology/approach

This study collected primary data based on a questionnaire survey among audit firms in the Klang Valley area and registered with Malaysian Institutes of Accountants.

Findings

The findings from a survey conducted on 130 Malaysian auditors proved that time budget pressure is significantly influenced the dysfunctional audit behavior. However, this study did not support the relationship between professional skills, independence, work experience and dysfunctional audit behavior.

Originality/value

This study contributed to the researchers, auditors as well as educators in further understanding the factors that might influence the dysfunctional audit behavior. The findings are expected to help in improving the auditors’ credibility and uphold the public confidence on the auditing profession.