bluuebunny/crossref_metadata_2025 huggingface dataset:
Coagulation of inertial particles in supersonic turbulence
Authors: Li Xiang-Yu , Mattsson Lars
Published: February 2021

Coagulation driven by supersonic turbulence is primarily an astrophysical problem because coagulation processes on Earth are normally associated with incompressible fluid flows at low Mach numbers, while dust aggregation in the interstellar medium for instance is an example of the opposite regime. We study coagulation of inertial particles in compressible turbulence using high-resolution direct and shock-capturing numerical simulations with a wide range of Mach numbers from nearly incompressible to moderately supersonic. The particle dynamics is simulated by representative particles and the effects on the size distribution and coagulation rate due to increasing Mach number is explored. We show that the time evolution of particle size distribution mainly depends on the compressibility (Mach number). We find that the average coagulation kernel ⟨Cij⟩ scales linearly with the average Mach number ℳrms multiplied by the combined size of the colliding particles, that is, 〈Cij〉∼〈(ai+aj)3〉 ℳrmsτη−1, which is qualitatively consistent with expectations from analytical estimates. A quantitative correction 〈Cij〉∼〈(ai+aj)3〉(vp,rms/cs)τη−1 is proposed and can serve as a benchmark for future studies. We argue that the coagulation rate ⟨Rc⟩ is also enhanced by compressibility-induced compaction of particles.
Fortbildung und Co. – ins Netz gegangen
Authors: Bossenmayer Jörg
Published: February 2021

„Online“ wird immer beliebter. Auch im psychotherapeutischen Bereich nutzen immer mehr PatientInnen und TherapeutInnen die Beratung per Computer, wie die Vielzahl der im Internet aufrufbaren Beratungsangebote zeigt 1. Die Online-Beratung ist mittlerweile rechtlich gut in den Griff zu bekommen. Aber wie sieht es mit Online-Ausbildung, -Fortbildung und -Weiterbildung etc. aus? Dieser Beitrag versucht einige der Rechtsfragen zu klären, die in diesem Zusammenhang auftreten.
„Hören was (noch) nicht gesagt wird“ – Familientherapie als Settingvariante
Authors: Baumann Sebastian , Bürki Rainer , Hahlweg Kurt , Oestereich Cornelia , Richter Rainer
Published: February 2021

Familientherapie kommt als Settingvariante in allen Verfahren vor, auch wenn sie jeweils unterschiedlich häufig angewandt wird. Die Zugänge zur Familientherapie aus den vier Grundorientierungen werden mit ihren VertreterInnen in diesem Artikel beleuchtet, alle haben praktische Erfahrungen mit diesem Setting. Zu Corona-Zeiten findet ein solches Gespräch natürlich per Videotelefonie statt.
Aufsuchend? Ja sicher! – Wer keine Hoffnung hat, geht nicht zur Psychotherapie
Authors: Conen Marie-Luise
Published: February 2021

Aufsuchende Familientherapie fand in den USA ihren Weg in die Arbeit mit Familien zu Beginn der 1980er Jahre, bevor sie 1993 erstmals in Deutschland (Berlin) durchgeführt wurde 1. Seitdem hat aufsuchende Familientherapie ein großes Interesse unter Familientherapeuten und systemischen Therapeuten vor allem in der Kinder- und Jugendhilfe gefunden.
Angehörigenarbeit ist keine Familientherapie
Authors: Petereit-Zipfel Heike
Published: February 2021

Eine psychische Erkrankung geht nicht nur für die Betroffenen mit schwerwiegenden Belastungen einher, sondern hat auch weitreichende Konsequenzen für deren Familien. Die organisierte Angehörigenselbsthilfe ist somit eine wichtige Anlaufstelle. Gleichzeitig stellen sich bei einer Familientherapie spezielle Anforderungen an Familientherapeuten.
Familientherapie – Informationen und Hilfsangebote im Internet
Authors: Schieber Katharina
Published: February 2021

Im Netz lassen sich viele Informationen zum Thema Familientherapie finden: Für Therapeuten bieten die Fachgesellschaften, Fachkreise oder Fachzeitschriften eine gute Plattform, sich auszutauschen, fortzubilden oder berufspolitische Fragen zu klären. Für Hilfesuchende gibt es eine große Anzahl an Unterstützungsangeboten in Form von Therapeutensuchfunktionen oder direkt über eine Online-Beratung.
Histologic Findings of Choroidal Vasculopathy in Eyes Enucleated following Radiation Therapy for Uveal Melanoma: Radiation Choroidopathy
Authors: Platt Sean , Salomao Diva R. , Pulido Jose
Published: February 2021

Introduction Little has been published about the choroidal vascular changes that occur years after radiation exposure. The aim of this study was to review the histological changes observed in the choroidal vasculature following radiotherapy for uveal melanoma.

Methods Records from a single institution were retrospectively reviewed from June 7, 2007 to June 7, 2017; 101 patients with a diagnosis of uveal melanoma that underwent enucleation had their records reviewed. Out of these, a total of 26 eyes had undergone plaque brachytherapy prior to enucleation, which had been performed at a mean time of 7.2 years (range from 0 years to 30 years) after the initial plaque placement. A histopathologic analysis was conducted on all 26 eyes with special emphasis on the choroidal changes. Of these 26 eyes, 18 demonstrated evidence of radiation-induced vasculopathy.

Results Of the 18 eyes, 10/18 (55%) had radiation retinopathy and 16/18 (89%) had radiation choroidal vasculopathy. One patient had a phthisical eye, and the choroid could not be evaluated because the characteristics of the vasculature could not be determined. Nine cases had vitreous hemorrhage (50%), all cases had radiation retinopathy, and 8/9 (89%) had radiation choroidopathy. Of the 16 cases with radiation choroidal vasculopathy, 3/16 (19%) had only intratumoral radiation choroidal vasculopathy, 3/16 (19%) had only extratumoral radiation choroidal vasculopathy, and, thus, 10/16 (32%) had both intratumoral and extratumoral radiation choroidal vasculopathy. In patients with radiation choroidal vasculopathy, 2/16 (13%) had hyalinization of the choroidal vessels. Another 3/16 (19%) cases with radiation choroidal vasculopathy had ectatic vessels. The other 11/16 (68%) had evidence of both hyalinization of the choroidal vessels as well as ectatic vessels in the
choroid. Histological evidence of radiation retinopathy and choroidopathy were seen in 69% of eyes enucleated after receiving radiation therapy, which, in some cases, also had vitreous hemorrhage. Polypoidal choroidal vasculopathy, choroidal neovascularization, and retinal choroidal anastomoses (RAP-type lesions) were seen in 12 of the 16 eyes (75%).

Discussion/Conclusion Irradiation of malignant tumors of the eye causes not only radiation retinopathy but also radiation choroidopathy. The role of radiation choroidopathy in the subsequent visual loss following radiotherapy and the role of anti-VEGF therapy needs to be recognized and distinguished from radiation retinopathy. Our data adds to the prior limited knowledge that radiation affects the choroid and can induce specific phenotypes similar to the clinical spectrum of CNV, PCV, and RAP.
High sensitivity of ROSE-supported ERCP-guided brushing for biliary strictures
Authors: Archibugi Livia , Mariani Alberto , Ciambriello Biagio , Petrone Maria Chiara , Rossi Gemma , Testoni Sabrina Gloria Giulia , Carlucci Michele , Aldrighetti Luca , Falconi Massimo , Balzano Gianpaolo , Doglioni Claudio , Capurso Gabriele , Arcidiacono Paolo Giorgio
Published: February 2021

Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) plays a major role in biliary strictures, with brushing being a cheap and fast method to acquire a cytological specimen, despite a sensitivity around 45 %. Rapid on-site evaluation (ROSE) is widely used for endoscopic ultrasound-acquired cytological specimen adequacy, improving its sensitivity and specificity. Nevertheless, no study has evaluated its role for ERCP-guided brushing. Our aim was to assess the diagnostic yield of ERCP-guided brushing of biliary strictures when supported by ROSE.

Patients and methods This was a retrospective single-center study that included patients undergoing ERCP-guided brush cytology supported by ROSE for biliary strictures. Recorded data included patient clinical-radiological and ERCP features. Final diagnosis was determined after surgery, intraductal biopsy or adequate follow-up. The diagnostic yield was calculated and a subgroup analysis for factors associated with false-negative or true-positive results was performed.

Results Two hundred six patients were included, 57.3 % males, median age 72 years, 77.2 % having extrahepatic biliary strictures. Of the patients, 99 % had an adequate sample at ROSE after a mean of 2.6 passages. The diagnostic yield was accuracy 83 %, sensitivity 74.6 %, and specificity 98 %, positive and negative predictive values 98 % and 71 % respectively, with an area under the curve of 0.86. A diagnosis of cholangiocarcinoma was significantly more frequent among true-positive cases (68 % vs 46.8 %; P = 0.04).

Conclusions This is the first study evaluating the use of ROSE as support for ERCP-guided brushing of biliary strictures, with a sensitivity far higher than those reported for brushing alone and at least comparable to those of more expensive and invasive techniques.
Yamamoto Neue Schädelakupunktur YNSA
Authors: Ogal Hans P.
Published: February 2021

Die Behandlung von Schmerzsymptomen und Einschränkungen des Bewegungssystems sind eine Domäne der Yamamoto Neue Schädelakupunktur (YNSA).

Der Autor stellt, aufbauend auf seinem 2018 erschienenen Artikel zu den Grundlagen der YNSA, bewährte Punkte bei Beschwerden des Bewegungsapparats vor. Ein Fall aus der Praxis zeigt beispielhaft das Vorgehen und die möglichen Erfolge.
Serum Selenium Levels in Glaucoma: a Pilot Study
Authors: Lucio Marianna , Fick Alexander , Michalke Bernhard , Laemmer Robert , Hosari Sami , Hohberger Bettina
Published: February 2021

Background Trace elements are assumed to be involved in glaucoma pathogenesis via changes in oxidative stress. Especially serum selenium (Se) has been linked to this
neurodegenerative disease. Serum Se levels differ between countries due to nutrition and ethnicity. It was the aim of the present study to investigate serum Se levels in primary open-angle
glaucoma (POAG) patients and controls in Germany and to consider potential age and gender effects.

Material and Methods The Se concentration of 39 serum samples (22 patients with POAG, 17 controls) were analyzed by inductively coupled plasma-sector field mass spectrometry
(ICP-sf-MS) in high resolution mode. Covariance and percentile regression were analyzed. Age and gender were defined as confounding factors and their different trends were investigated.
Moreover, age was examined across different quantiles of Se levels.

Results Total serum least-squares means (LS-means) Se levels were 132.02 µg/L (controls) and 134.86 µg/L (POAG). Total serum Se levels did not differ between the study groups
(p > 0.05). Significant age and gender effects of serum Se were observed. Quantile analysis showed that the 1st serum Se quantile decreased with increasing age in POAG patients in
contrast to controls. The odds ratios of the 1st serum Se were 1.3 (with 2nd quantile) and 1.3 (with 3rd quantile), respectively.

Conclusion The serum Se level of the German cohort was almost half of those of the published US cohort (glaucoma 209.11 ng/mL; control 194.45 ng/mL). Age and gender effects were
observed; the serum Se level increased with age in women (controls and POAG), however, Se levels decreased with age in men (controls and POAG).
Gelenkbeschwerden homöopathisch behandeln
Authors: Boeddrich Ute
Published: February 2021

In diesem Artikel sollen von Arthritis bis Osteoporose einige bewährte Indikationen mit homöopathischen Mitteln bei häufigen Gelenkbeschwerden beschrieben werden. Entsprechende Leitsymptome und Modalitäten führen zu den passenden Medikamenten. Erwähnt werden auch einige sinnvolle andere bekannte Maßnahmen, die Erleichterung bringen können, ebenso pflanzliche Hilfen, Vitamine und orthomolekulare Substanzen.
Use of suction during endoscopic ultrasound-guided fine needle biopsy of solid pancreatic lesions with a Franseen-tip needle: a pilot comparative trial
Authors: Costa-Moreira Pedro , Vilas-Boas Filipe , Martins Diana , Moutinho-Ribeiro Pedro , Lopes Susana , Lopes Joanne , Barroca Helena , Macedo Guilherme
Published: February 2021

Background and study aims The utility of suction during endoscopic ultrasound (EUS) fine-needle biopsy (FNB) using Franseen-tip needle remains unclear and has not been evaluated in randomized trials. We designed a randomized crossover trial to compare the diagnostic yield during EUS-FNB using a 22G Franseen-tip needle, with and without standard suction.

Patients and methods Consecutive patients undergoing EUS-guided sampling of solid pancreatic lesions were recruited. A minimum of two passes were performed for each case: one with 20-mL syringe suction (S+) and another without (S–). The order of passes was randomized and the pathologist blinded. The endpoints were the diagnostic yield and the impact of blood contamination in the diagnosis.

Results Fifty consecutive patients were enrolled. The overall diagnostic accuracy was 84 %. A diagnosis of malignancy was obtained in 70 samples: 36 in the S+group and 34 in the S–group. A statistically significant difference was seen in the diagnostic accuracy (S+: 78 % vs. S–: 72 %, P < 0.01) and blood contamination (S+: 68 %; S–: 44 %, P < 0.01). The sensitivity, specificity, negative likelihood ratio and positive likelihood ratio for S+vs. S–samples were 76.6 % vs. 73.9 %, 100 % vs. 100 % and 0.23 vs. 0.26, NA vs NA, respectively. A negative impact of blood contamination in the overall diagnostic yield wasn’t seen, even in samples where suction was used (OR 0.36, P = 0.15)

Conclusions We found a higher diagnostic yield with the use of suction. It was associated with a higher degree of sample blood contamination that did not affect the diagnostic performance.
Interobserver agreement of the Paris and simplified classifications of superficial colonic lesions: a Western study
Authors: Cocomazzi Francesco , Gentile Marco , Perri Francesco , Merla Antonio , Bossa Fabrizio , Piazzolla Mariano , Ippolito Antonio , Terracciano Fulvia , Giuliani Arcangela Patrizia , Cubisino Rossella , Marra Antonella , Carparelli Sonia , Mileti Alessia , Paolillo Rosa , Fontana Andrea , Copetti Massimiliano , Di Leo Alfredo , Andriulli Angelo
Published: February 2021

Background and study aims The Paris classification of superficial colonic lesions has been widely adopted, but a simplified description that subgroups the shape into pedunculated, sessile/flat and depressed lesions has been proposed recently. The aim of this study was to evaluate the accuracy and inter-rater agreement among 13 Western endoscopists for the two classification systems.

Methods Seventy video clips of superficial colonic lesions were classified according to the two classifications, and their size estimated. The interobserver agreement for each classification was assessed using both Cohen k and AC1 statistics. Accuracy was taken as the concordance between the standard morphology definition and that made by participants. Sensitivity analyses investigated agreement between trainees (T) and staff members (SM), simple or mixed lesions, distinct lesion phenotypes, and for laterally spreading tumors (LSTs).

Results Overall, the interobserver agreement for the Paris classification was substantial (κ = 0.61; AC1 = 0.66), with 79.3 % accuracy. Between SM and T, the values were superimposable. For size estimation, the agreement was 0.48 by the κ-value, and 0.50 by AC1. For single or mixed lesions, κ-values were 0.60 and 0.43, respectively; corresponding AC1 values were 0.68 and 0.57. Evaluating the several different polyp subtypes separately, agreement differed significantly when analyzed by the k-statistics (0.08–0.12) or the AC1 statistics (0.59–0.71). Analyses of LSTs provided a κ-value of 0.50 and an AC1 score of 0.62, with 77.6 % accuracy. The simplified classification outperformed the Paris classification: κ = 0.68, AC1 = 0.82, accuracy = 91.6 %.

Conclusions Agreement is often measured with Cohen’s κ, but we documented higher levels of agreement when analyzed with the AC1 statistic. The level of agreement was substantial for the Paris classification, and almost perfect for the simplified system.
„Einfache“ Neuraltherapie bei Gelenkschmerzen – Fallbeispiele aus der Praxis
Authors: Gündling Peter W.
Published: February 2021

Die Neuraltherapie oder therapeutische Lokalanästhesie ist ein schmerz- und regulationstherapeutisches Verfahren, das bei nahezu allen in der Praxis vorkommenden Schmerzformen mit Erfolg angewendet werden kann. Dennoch kann sie die ursächliche Therapie nur begleiten, z. B. wird man bei Personen mit Rückenschmerzen, die am Computer arbeiten und nicht zusätzlich regelmäßig Bewegungs- und Dehnungsübungen machen, keine dauerhaften Erfolge erzielen.

Sechs Fälle aus der Praxis des Autors illustrieren exemplarisch das Vorgehen und die möglichen Behandlungserfolge bei unterschiedlich lokalisierten Gelenkschmerzen.
Evaluation of Clinical Outcome in Traumatic Facial Nerve Paralysis
Authors: Shankar Abhijit , George Shibu , Somaraj Satheesh
Published: February 2021

Introduction The facial nerve is the most commonly paralyzed nerve in the human body, resulting in far-reaching functional, aesthetic and emotional concerns to the patient.

Objective Evaluation of the clinical outcome of 47 patients with traumatic facial nerve paralyses, with respect to clinical recovery and audiological sequelae.

Methods A descriptive longitudinal study was conducted over 24 months between January 2017 and December 2018 at a tertiary center with detailed clinical, topodiagnostic, audiometric and radiological evaluation and regular follow-up after discharge.

Results Road traffic accidents constituted 82.98% of the trauma cases, out of which 76.60% were found to be under the influence of alcohol.

Delayed facial paralysis was observed in 76.60% cases. Temporal bone fracture was reported in 89.36%, with otic capsule (OC) sparing fractures forming 91.49% of the cases. Topologically, the injury was mostly at the suprachordal region around the second genu. The majority of the patients (65%) attained full recovery of facial nerve function with conservative medical management. Audiometrically, 77.27% of the patients had hearing loss at the time of presentation, of which 64.71% were conductive in nature; 51.22% attained normal hearing at follow-up visits.

Conclusion Early initiation of steroid therapy, concurrent eye care and physiotherapy are the cornerstones in the management of traumatic facial nerve paralysis.
Association of Single Nucleotide Polymorphisms on Locus 18q21.1 in the Etiology of Nonsyndromic Cleft Lip Palate (NSCLP) in Indian Multiplex Families
Authors: Neela Praveen Kumar , Reddy Gosla Srinivas , Husain Akhter , Mohan Vasavi , Thumoju Sravya , BV Rajeshwari
Published: February 2021

Background Cleft lip palate (CLP) is a common congenital anomaly with multifactorial etiology. Many polymorphisms at different loci on multiple chromosomes were reported to be involved in its etiology. Genetic research on a single multigenerational American family reported 18q21.1 locus as a high-risk locus for nonsyndromic CLP (NSCLP). However, its association in multiple multiplex families and Indian population is not analyzed for its association in NSCLP.

Aim This study was aimed to evaluate whether high-risk single nucleotide polymorphisms (SNPs) on chromosome 18q21.1 are involved in the etiology of NSCLP in multiplex Indian families.

Materials and Methods Twenty multigenerational families affected by NSCLP were selected for the study after following inclusion and exclusion criteria. Genomic DNA was isolated from the affected and unaffected members of these 20 multiplex families and sent for genetic analysis. High-risk polymorphisms, such as rs6507872 and rs8091995 of CTIF, rs17715416, rs17713847 and rs183559995 of MYO5B, rs78950893 of SMAD7, rs1450425 of LOXHD1, and rs6507992 of SKA1 candidate genes on the 18q21.1 locus, were analyzed. SNP genotyping was done using the MassARRAY method. Statistical analysis of the genomic data was done by PLINK.

Results Polymorphisms followed the Hardy–Weinberg equilibrium. In the allelic association, all the polymorphisms had a p-value more than 0.05. The odds ratio was not more than 1.6 for all the SNPs.

Conclusion High-risk polymorphisms, such as rs6507872 and rs8091995 of CTIF, rs17715416, rs17713847 and rs183559995 of MYO5B, rs78950893 of SMAD7, rs1450425 of LOXHD1, and rs6507992 of SKA1 in the locus 18q21.1, are not associated with NSCLP in Indian multiplex families.
Variant in CACNA1G as a Possible Genetic Modifier of Neonatal Epilepsy in an Infant with a De Novo SCN2A Mutation
Authors: Nieto-Barcelo Juan Jose , Gonzalez Montes Noelia , Gonzalo Alonso Isabel , Martinez Francisco , Aparisi Maria Jose , Martinez-Matilla Marina , Marco Hernandez Ana Victoria , Tomás Vila Miguel
Published: February 2021

Mutations in SCN2A genes have been described in patients with epilepsy, finding a large phenotypic variability, from benign familial epilepsy to epileptic encephalopathy. To explain this variability, it was proposed the existence of dominant modifier alleles at one or more loci that contribute to determine the severity of the epilepsy phenotype. One example of modifier factor may be the CACNA1G gene, as proved in animal models. We present a 6-day-old male newborn with recurrent seizures in which a mutation in the SCN2A gene is observed, in addition to a variant in CACNA1G gene. Our patient suffered in the first days of life myoclonic seizures, with pathologic intercritical electroencephalogram pattern, requiring multiple drugs to achieve adequate control of them. During the next weeks, the patient progressively improved until complete remission at the second month of life, being possible to withdraw the antiepileptic treatment. We propose that the variant in CACNA1G gene could have acted as a modifier of the epilepsy syndrome produced by the mutation in SCN2A gene in our patient.
Occupational Outcomes and Revision Rates for Medial Unicondylar Knee Arthroplasty in U.S. Military Servicemembers
Authors: Rodriguez Marina , Heida Ken , Rider Danielle E. , Goodman Gens P. , Waterman Brian R. , Belmont Philip J.
Published: February 2021

This study evaluates return to work and revision rates for medial unicondylar knee arthroplasty (UKA) in a high-demand military cohort. Patient demographic and clinical variables were isolated from the medical records of active-duty military servicemembers with at least 2 years of postoperative follow-up and correlated with return to work, medial UKA survivorship, and perioperative complications. The medial UKA annual revision rate was calculated as the percentage of implants revised per observed component year. A total of 39 servicemembers underwent 46 primary medial UKAs (32 unilateral and 7 bilateral) with a mean follow-up of 3.9 (2.0–6.6) years. At a minimum of 2 years postoperatively, 33 (85%) servicemembers returned to military service or successfully completed their service obligation. Older servicemembers (odds ratio [OR] = 0.67; 95% confidence interval [CI]: 0.45, 0.99) had a significantly decreased OR for knee-related medical separation. Nine servicemembers (20%) had conversion to TKA at an average of 2.4 (range, 0.6–5.6) years with a medial UKA annual revision rate of 5%. When compared with Navy/Air Force, Army/Marine servicemembers had an increased TKA conversion rate (OR = 5.40; 95% CI: 1.13, 25.81). Older age decreased the likelihood of medical separation and Army/Marines service was the sole risk factor associated with conversion to TKA. The level of evidence is IV, therapeutic case series.
Use of Fenoldopam in Children with Congenital Heart Disease to Decrease Fluid Balance: A Retrospective, Descriptive Study and Insights into Predictors of Decreased Fluid Balance
Authors: Rausa Jacqueline , Loomba Rohit S. , Dorsey Vincent , Chandra Priya , Penk Jamie S. , Flores Saul , Villarreal Enrique G. , Goldstein Stuart L.
Published: February 2021

This retrospective study aimed to determine if fenoldopam is associated with a decrease in fluid balance and to define the factors that may promote this in children with a history of congenital heart disease at the cardiac intensive care unit (CICU). Patients cared from January 2014 to December 2018 in the CICU were reviewed, and those on fenoldopam infusion were identified. Patient cohort data included demographics, clinical information, laboratory results, hemodynamic and urine output measurements, and information regarding fenoldopam infusion were compared between those with and without decrease in fluid balance. Forty-six patients were identified. Patients received a starting dose of fenoldopam of 0.2 mcg/kg/h, a maximum dose of 0.3 mcg/kg/h, and duration of 64 hours. Over the 4-hour study period, statistically significant change was noted in systolic pressure (decrease of 5.4%; p < 0.001), diastolic pressure (decrease of 3.5%; p = 0.01), fluid balance, and urine output (decrease of 1.3%; p = 0.027). In the cohort, 34 patients (74%) had a decrease in fluid balance, 18 (39%) had an increase in urine output, and 25 (54%) had a decrease in fluid input after the initiation of fenoldopam. Patients that had a decrease in fluid balance tended to have a higher blood urea nitrogen level at the time of fenoldopam initiation. Fenoldopam was associated with decrease in fluid balance and fluid input, but not associated with an increase in urine output. The identification of factors that can decrease fluid balance may help identify those patients who can be benefited with this treatment.
Comparing the biogeochemical functioning of two arid subtropical coastal lagoons: the effect of wastewater discharges
Authors: Medina-Galván Julio , Osuna-Martínez Carmen Cristina , Padilla-Arredondo Gustavo , Frías-Espericueta Martín Gabriel , Barraza-Guardado Ramón Héctor , Arreola-Lizárraga José Alfredo
Published: February 2021

Nutrient flux, net metabolism, and N
2
fixation and denitrification processes were estimated and compared in two semi-arid subtropical coastal lagoons in the Gulf of California: El Soldado (ES), where no wastewater is discharged, and El Rancho (ER), where shrimp farm effluents are regularly discharged. Biogeochemical processes were evaluated with the LOICZ model. Flushing time was <2 days in both systems. Nutrient fluxes were higher in ER than in ES and both systems acted as nutrient sinks for most of the year. ER showed a larger nutrient flow rate in the summer and autumn due to the input of shrimp-farm effluents. Nitrogen fluxes increased in both ER and ES in the winter in response to the increased nutrient supply from coastal upwellings. ER and ES both showed autotrophic metabolism and N
2
fixation in the spring, autumn, and winter, but heterotrophic metabolism and denitrification in the summer. Denitrification dominated in ER (−2.21 mmol m
2
day
−1
) and values were higher than those estimated in ES (−0.45 mmol m
2
day
−1
). The comparative analysis between ES and ER evidenced the significant changes in its biogeochemical performance caused by the input of anthropogenic nutrients, and can orient the environmental management of coastal lagoons.
Cognitive-Behavioral Interventions Targeting Alcohol or Other Drug Use and Co-Occurring Mental Health Disorders: A Meta-Analysis
Authors: Mehta Kahini , Hoadley Ariel , Ray Lara A , Kiluk Brian D , Carroll Kathleen M , Magill Molly
Published: February 2021

Aims

This meta-analysis reviewed 15 clinical trials (18 study sites/arms), examining the efficacy of an integrated cognitive-behavioral intervention (CBI) delivered to individuals with an alcohol or other drug use disorder and a co-occurring mental health disorder (AOD/MHD). Outcomes were alcohol or other drug use and mental health symptoms at post-treatment through follow-up.

Methods

The inverse-variance weighted effect size was calculated for each study and pooled under random effects assumptions.

Results

Integrated CBI showed a small effect size for AOD (g = 0.188, P = 0.061; I2 = 86%, τ2 = 0.126, k = 18) and MHD (g = 0.169, P = 0.024; I2 = 58%, τ2 = 0.052, k = 18) outcomes, although only MHD outcomes were statistically significant. Analysis by subgroup suggested that effect magnitude varied by type of contrast condition (integrated CBI + usual care vs. usual care only; integrated CBI vs. a single-disorder intervention), follow-up time point (post-treatment vs. 3–6 months) and primary AOD/MHD diagnosis, although these sub-groups often contained significant residual heterogeneity. In a series of mixed effects, meta-regression models, demographic factors were non-significant predictors of between-study heterogeneity. For AOD outcomes, greater effects were observed in higher quality studies, but study quality was not related to effect size variability for MHD outcomes.

Conclusions

The current meta-analysis shows a small and variable effect for integrated CBI with the most promising effect sizes observed for integrated CBI compared with a single disorder intervention (typically an AOD-only intervention) for follow-up outcomes, and for interventions targeting alcohol use and/or post-traumatic stress disorder. Given the clinical and methodological variability within the sample, results should be considered a preliminary, but important step forward in our understanding of treatment for co-occurring AOD/MHD.
More for less: predicting and maximizing genomic variant discovery via Bayesian nonparametrics
Authors: Masoero Lorenzo , Camerlenghi Federico , Favaro Stefano , Broderick Tamara
Published: February 2021

While the cost of sequencing genomes has decreased dramatically in recent years, this expense often remains nontrivial. Under a fixed budget, scientists face a natural trade-off between quantity and quality: spending resources to sequence a greater number of genomes or spending resources to sequence genomes with increased accuracy. Our goal is to find the optimal allocation of resources between quantity and quality. Optimizing resource allocation promises to reveal as many new variations in the genome as possible. We introduce a Bayesian nonparametric methodology to predict the number of new variants in a follow-up study based on a pilot study. When experimental conditions are kept constant between the pilot and follow-up, we find that our prediction is competitive with the best existing methods. Unlike current methods, though, our new method allows practitioners to change experimental conditions between the pilot and the follow-up. We demonstrate how this distinction allows our method to be used for more realistic predictions and for optimal allocation of a fixed budget between quality and quantity. We validate our method on cancer and human genomics data.
Multilayer network analyses as a toolkit for measuring social structure
Authors: Finn Kelly R
Published: February 2021

The formalization of multilayer networks allows for new ways to measure sociality in complex social systems, including groups of animals. The same mathematical representation and methods are widely applicable across fields and study systems, and a network can represent drastically different types of data. As such, in order to apply analyses and interpret the results in a meaningful way the researcher must have a deep understanding of what their network is representing and what parts of it are being measured by a given analysis. Multilayer social networks can represent social structure with more detail than is often present in single layer networks, including multiple “types” of individuals, interactions, or relationships, and the extent to which these types are interdependent. Multilayer networks can also encompass a wider range of social scales, which can help overcome complications that are inherent to measuring sociality. In this paper, I dissect multilayer networks into the parts that correspond to different components of social structures. I then discuss common pitfalls to avoid across different stages of multilayer network analyses—some novel and some that always exist in social network analysis but are magnified in multi-layer representations. This paper serves as a primer for building a customized toolkit of multilayer network analyses, to probe components of social structure in animal social systems.
Case report: Recovery after large intramyocardial dissecting haematoma of the ventricular septum—a rare complication of myocardial infarction
Authors: Lovasz David , Camboni Daniele , Zeller Judith , Schmid Christof
Published: February 2021

Background

Intramyocardial dissecting haematoma is a rare and potentially life-threatening complication of myocardial infarction (MI). Only a few isolated cases have been reported so far.

Case summary

We report the case of a patient with a large, obstructing intramyocardial haematoma of the ventricular septum following MI due to plaque rupture of the right coronary artery (RCA) and following successful coronary intervention. The clinically inapparent haematoma was discovered during routine echocardiography and confirmed by both computed tomography (CT) and magnetic resonance imaging (MRI). With non-surgical treatment, the patient remained clinically stable. Repeated echocardiography showed gradual regression of the haematoma. Follow-up echocardiography 3 months after the initial diagnosis demonstrated no evidence of septal haematoma.

Discussion

This report suggests that even large intramyocardial haematoma may recede without operative intervention. Echocardiography, CT, and MRI are all helpful in quantifying the size of the haematoma. The appropriate management should be patient-oriented, depending on clinical stability and progression of the haematoma. Conservative treatment in clinically stable patients suffering from septal haematoma following MI and coronary intervention can be a feasible option.
Successful emergent transcatheter aortic valve implantation and left ventricular unloading by Impella in a patient with severe aortic stenosis who experienced cardiogenic shock after primary percutaneous coronary intervention for ST-elevation myocardial infarction: a case report
Authors: Konami Yutaka , Sakamoto Tomohiro , Suzuyama Hiroto , Unoki Takashi
Published: February 2021

Background

Determining the treatment strategy for cardiogenic shock following ST-elevation myocardial infarction in a patient with severe aortic stenosis remains challenging and is a matter of debate.

Case summary

An 84-year-old man with chest pain was transferred to our institute and subsequently diagnosed with ST-elevation myocardial infarction and Killip class III heart failure. The patient was intubated, and urgent coronary angiography revealed severe tandem stenosis from the proximal to mid-left anterior descending coronary artery. We performed a primary percutaneous coronary intervention (PCI) and deployed drug-eluting stents from the left main trunk to mid-left anterior descending coronary artery. Although the procedure was successful, the patient went into cardiogenic shock a few hours later. Transthoracic echocardiography revealed low cardiac function and severe aortic stenosis. We decided to perform transcatheter aortic valve implantation using a self-expandable valve, followed by the insertion of a left ventricular assist device. The combination of procedures achieved haemodynamic stability.

Discussion

It is difficult to treat cardiogenic shock that develops in patients with severe aortic stenosis and ST-elevation myocardial infarction. This case report demonstrates that combined transcatheter aortic valve replacement using a self-expanding valve and left ventricular assist device placement can be safe and effective after a primary PCI.
The master regulator MAT1-1-1 of fungal mating binds to its targets via a conserved motif in the human pathogen Aspergillus fumigatus
Authors: Ramšak Barbara , Markau Jessica , Pazen Tobias , Dahlmann Tim A , Krappmann Sven , Kück Ulrich
Published: February 2021

Mating-type transcription factors are master regulators of sexually related signal transduction pathways in fungi; however, their recognition of specific DNA sequences from target genes is widely undetermined. Here, we identified and characterized the DNA-binding sequence of the MAT1-1-1 alpha-box domain transcription factor from the human pathogen Aspergillus fumigatus. In order to explore MAT1-1-1 DNA-binding targets, we used the previously reported MAT1-1-1 binding motif from Penicillium chrysogenum, in a bioinformatics approach. We identified 18 A. fumigatus genes carrying the MAT1.1 sequence in their upstream region, among them genes for the α-pheromone precursor (PpgA), G-protein-coupled pheromone receptor (PreA), and for TomA, an unidentified protein. To validate our prediction further, quantification of transcript levels showed a decrease in expression of ppgA, tomA, and others in a MAT1-1 deletion strain. For a functional analysis of the binding sites, truncated variants of the A. fumigatus MAT1-1-1 gene were introduced into Escherichia coli for heterologous expression. The yield of recombinant protein was further optimized for the AfMAT1-1-178–235 variant that harbors an extended alpha-box domain. AfMAT1-1-178–235 bound to a subset of the most strongly upregulated genes: ppgA, preA, and tomA. The DNA-binding specificity was confirmed by testing mutated binding sequences, as well as performing competition experiments with specific and non-specific sequences. Finally, equilibrium dissociation constants of 1.83 ± 0.1 and 1.45 ± 0.26 µM were determined for AfMAT1-1-178–235 and fusion protein GST-AfMAT1-1-178–235. Collectively, these findings provide further insights into AfMAT1-1-1-mediated gene expression and imply that alpha-box domain regulators from other members of Eurotiales control fungal development in a conserved manner.
Intestinal lamina propria macrophages upregulate interleukin-10 mRNA in response to signals from commensal bacteria recognized by MGL1/CD301a
Authors: Kurashina Ryosuke , Denda-Nagai Kaori , Saba Kengo , Hisai Tomoko , Hara Hiromitsu , Irimura Tatsuro
Published: February 2021

Ligand-induced cellular signaling involved in interleukin 10 (IL-10) production by lamina propria macrophages (LPMs) during their interactions with commensal bacteria is not clearly understood. We previously showed, using mice lacking a C-type lectin MGL1/CD301a, that this molecule on colonic LPMs plays an important role in the induction of IL-10 upon interaction with commensal bacteria, Streptococcus sp.

In the present report, we show that the physical engagement of MGL1/CD301a on LPMs with in-situ isolated Streptococcus sp. bacteria leads to IL-10 messenger RNA (mRNA) induction. Spleen tyrosine kinase (Syk), caspase recruitment domain 9 (CARD9) and extracellular signal-regulated kinase (ERK), but not NF-κB pathway, are shown to be indispensable for IL-10 mRNA induction after stimulation with heat-killed Streptococcus sp. Guanidine hydrochloride treatment of Streptococcus sp., which is known to extract bacterial cell surface glycan-rich components, abolished bacterial binding to recombinant MGL1/CD301a. The extract contained materials which bound rMGL1 in ELISA and appeared to induce IL-10 mRNA expression in LPMs in vitro. Lectin blotting showed that the extract contained glycoproteins that are considered as putative ligands for MGL1. Some human commensal Lactobacillus species also induced IL-10 mRNA expression by colonic LPMs in vitro, which depends on the presence of MGL1/CD301a and CARD9. The present results are the first to show that MGL1/CD301a acts as a signal transducer during colonic host–microbe interactions.
Association of oral contraceptives and tubal ligation with risk of early natural menopause
Authors: Langton C R , Whitcomb B W , Purdue-Smithe A C , Sievert L L , Hankinson S E , Manson J E , Rosner B A , Bertone-Johnson E R
Published: February 2021

STUDY QUESTION

What is the association of oral contraceptives (OCs) and tubal ligation (TL) with early natural menopause?

SUMMARY ANSWER

We did not observe an association of OC use with risk of early natural menopause; however, TL was associated with a modestly higher risk.

WHAT IS KNOWN ALREADY

OCs manipulate hormone levels, prevent ovulation, and may modify the rate of follicular atresia, while TL may disrupt the blood supply to the ovaries. These mechanisms may be associated with risk of early menopause, a condition associated with increased risk of cardiovascular disease and other adverse health outcomes.

STUDY DESIGN, SIZE, DURATION

We examined the association of OC use and TL with natural menopause before the age of 45 years in a population-based study within the prospective Nurses’ Health Study II (NHSII) cohort. Participants were followed from 1989 to 2017 and response rates were 85-90% for each cycle.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Participants included 106 633 NHSII members who were premenopausal and aged 25-42 years at baseline. Use, duration and type of OC, and TL were measured at baseline and every 2 years. Menopause status and age were assessed every 2 years. Follow-up continued until early menopause, age 45 years, hysterectomy, oophorectomy, death, cancer diagnosis, or loss to follow-up. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% CIs adjusted for lifestyle, dietary, and reproductive factors.

MAIN RESULTS AND THE ROLE OF CHANCE

Over 1.6 million person-years, 2579 members of the analytic cohort experienced early natural menopause. In multivariable models, the duration, timing, and type of OC use were not associated with risk of early menopause. For example, compared with women who never used OCs, those reporting 120+ months of OC use had an HR for early menopause of 1.01 (95% CI, 0.87-1.17; P for trend=0.71). TL was associated with increased risk of early menopause (HR = 1.17, 95% CI, 1.06-1.28).

LIMITATIONS, REASONS FOR CAUTION

Our study population is homogenous with respect to race and ethnicity. Additional evaluation of these relations in more diverse populations is important.

WIDER IMPLICATIONS OF THE FINDINGS

To our knowledge, this is the largest study examining the association of OC use and TL with early natural menopause to date. While TL was associated with a modest higher risk of early menopause, our findings do not support any material hazard or benefit for the use of OCs.

STUDY FUNDING/COMPETING INTEREST(S)

The study was sponsored by UO1CA176726 and R01HD078517 from the National Institutes of Health and Department of Health and Human Services. The work was supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. The authors have no competing interests to report.

TRIAL REGISTRATION NUMBER

N/A
Alumni Assessments of Soft Skill Formation in an Extended Simulation
Authors: Moore Joel , Loh Sharmaine
Published: February 2021

Existing research indicates that participation in simulations contributes to the development of key soft skills, but has tended to rely on contemporaneous self-evaluations. In this paper, we evaluated the degree to which early career professionals who had previously completed an extended simulation class felt that the experience had contributed to the development of soft skills that they used in their professional lives. Survey, interview, and focus group data all show that working professionals in various fields felt that the dynamic nature of the extended simulation contributed to the development of several categories of soft skills and made a strong impact on their careers.
The Presence of Nucleated Red Blood Cells as an Indicator for Increased Mortality and Morbidity in Burn Patients
Authors: Jenkins Phillip M , Al Daoud Fadi , Mercer Leo , Scholten Donald , Wong Kristoffer , Perinjelil Vinu , Majeske Karl , Cranford James , Elian Ghaith , Nigam Tina , Carto Chase A , Sachwani-Daswani Gul R
Published: February 2021

Nucleated red blood cells (NRBCs) have been studied in critically ill and injured patients as a predictor of increased in-hospital mortality and poor clinical outcomes. While prior studies have demonstrated the prognostic power of NRBCs in the critical patient, there has been a paucity of literature available describing their value as a prognostic indicator in the severely burned patient. This retrospective observational study was conducted from 2012 to 2017. Inclusion criteria for this study included all burn patients with total body surface area > 10% who were aged ≥ 15 years. Demographic and clinical data were collected from the electronic medical record system. Data analysis consisted of descriptive and comparative analysis using SPSS. Two hundred and nineteen patients (17.5%) met inclusion criteria with 51 (23.3%) patients positive for NRBCs. The presence of NRBCs had an increased mortality rate with an odds ratio of 6.0 (P = .001; 2.5, 14.5); was more likely to appear in older patients (P < .001); and was associated with increased hospital length of stay (P < .001), injury severity scores (P < .001), and complications. The presence of NRBCs even at the low concentrations reported in our study showed a 6-fold increase in the rate of mortality. With the current improvements in burn care leading to higher survival rates, the need to improve upon the numerous models that have been developed to predict mortality in severe burn patients is clear given the significantly increased risk of death that the presence of NRBCs portends.
Skin Malignancy in the Military: A Number Needed to Biopsy Analysis
Authors: Yong James , Raiciulescu Sorana , Coffman Marcedes , Meyerle Jon
Published: February 2021

Introduction

Skin malignancy has increased in prevalence over the last 15 years and effective diagnosis is required for adequate treatment. Retrospective data analysis of skin biopsy data has shown correlation between various independent variables, but no studies have been shown to directly assess skin malignancy risks for military personnel. Assessing correlation could lead to more effective, targeted screening programs that could lead to decreased mortality from skin malignancies. We present a 1-year analysis of the number needed to biopsy (NNB) to detect skin cancer and analysis of military-specific risk factors in a military dermatology training program. The present study aims to (1) compare skin biopsy yields to civilian institutions and patient populations and (2) determine significance of exposure variables including age, gender, military beneficiary status, branch of service, and military rank.

Materials and Methods

We performed a retrospective observational study over 1 year by identifying all skin biopsies performed in the Walter Reed National Military Medical Center dermatology clinic from August 2015 to July 2016. Utilizing the pathology reports, we manually excluded biopsies performed for the purpose of ruling out inflammatory/immunologic conditions or cosmeses and focused only on encounters performed to rule out basal cell carcinoma, squamous cell carcinoma, or melanoma. We decided to exclude malignant diagnoses that were exceedingly rare or could mimic inflammatory conditions, such as cutaneous T-cell lymphoma. For uncertain diagnoses with vague context per pathology report, previous office clinic notes and pre-biopsy differential were referenced and included only if melanoma or non-melanoma skin cancer (NMSC) diagnosis was the intended indication.

Results

A total of 3,098 biopsies were included in the study, diagnostic for 1,084 total skin malignancy and 54 melanoma diagnoses. Melanoma comprised 4.98% of all skin malignancy diagnosed. The NNB for all skin malignancy was 2.86 (95% CI 2.76-2.96) and NNB for melanoma and NMSC was 20.93 (95% CI 19.70-22.15) and 1.91 (95% CI 1.83-2.00), respectively. Patient age, gender, and military rank significantly impacted NNB values (P < .001).

Conclusions

The proportion of melanoma skin cancers is notably increased in our population compared to published population statistics with comparable total biopsy yields. Skin biopsy for purpose of screening for malignancy should be performed in the military population and consideration should be made for gender, age, and rank. Our findings can further expand on military risk factors for skin cancer and aid in further multivariant modeling.