bluuebunny/crossref_metadata_2025 huggingface dataset:
O3 Forming a novel trainee-led research collaborative during times of crisis: Lessons learned from the COVID:HAREM collaborative
Authors: Javanmard-Emamghissi Hannah ,   The COVID:HAREM Collaborative Group
Published: April 2021

Introduction

At the beginning of the COVID-19 pandemic, the effect it would have on our healthcare system was unknown. As a result, surgical guidelines shifted to recommend non-operative management despite uncertainty of its efficacy compared to standard operative management. Within general surgery, nowhere was this more relevant than with the management of appendicitis, the most common abdominal emergency worldwide. This novel research collaborative was set up during the COVID-19 pandemic to assess the outcomes of appendicitis patients managed with antibiotics compared to appendicectomy.

Methods

Without the time to obtain funding for the project, trainee-driven recruitment of sites was vital and used established trainee-led regional research networks and twitter (@Covidharem). Further backing was provided by surgical societies who published and promoted the study protocol on their platforms. The steering group used surgical networks and contacts to recruit sites who were not already involved and RedCap was used for data entry to allow for real time monitoring of data completion.

Results

In just twelve weeks, 471 individual collaborators were recruited from 101 sites across the United Kingdom and Ireland. The collaborative went from inception to 500 patients uploaded in 30 days. The collaborative to date has recruited nearly 3500 patients, published both the protocol and an interim analysis within 4 months, and hosted a highly successful webinar.

Conclusion

Quality research can be achieved in times of crisis, the key to successful projects is trainee driven and led, focussed “snapshots” that can be implemented rapidly during the dynamic environment of a crisis.
O7 SMILE: Sustaining Medical education In a Lockdown Environment Can free online access medical education be effective for the retention of long term knowledge acquisition?
Authors: Pascoe John , Foster Paul , Quddus Muntasha , Kosti Angeliki , Guest Francesca , Stevens Sian , Bamford Richard , Coulston James
Published: April 2021

Introduction

The 2020 coronavirus lockdown lead to medical educators finding new ways to teach. SMILE is a free online access medical education platform created by UK surgical trainees and a medical student that delivered 200 live lectures to students during lockdown, with up to 1500 students from every UK medical school as well as abroad. This study aims to demonstrate line education is an effective tool for knowledge retention.

Method

Students were invited to participate in three live sessions covering haematuria, bone infections/tumours and endocrine emergencies, in which students complete knowledge assessment over time .

Quiz-based polls using zoom were taken before and after each session. After two weeks and again at one month the same quiz questions were sent out to attendees of the lecture.

Results

312 students completed all 4 tests. In all three sessions average scores improved post lecture (haematuria 58%-85%; endocrine emergencies 48%-70%; osteomyelitis/bone tumours 40%-77%). At 2 weeks (H 86%; EE 78%; O/BT 75%) and 4 weeks (H 88%; EE 76%; O/BT 69%) scores remained high.

Conclusion

This study demonstrates that FOAMed is able to engage audiences in a unique way on a large scale with evidence of long-term knowledge retention.
O9 The Effects of Coronavirus (COVID-19) on operative and work-based assessment (WBA) activity on surgical training
Authors:   COVID-STAR collaborative research group, Clements Joshua
Published: April 2021

Background

COVID-19 has had a global impact on all aspects of healthcare including surgical teaching and training. The COVID-STAR qualitative study demonstrated a perceived negative impact of COVID-19 on numerous aspects of surgical training across all specialties and training grades. The aim of this study is to investigate how COVID-19 has affected operative case exposure and work-based assessments for surgeons in training.

Methods

Anonymized data has been sought from the Intercollegiate Surgical Curriculum Programme (ISCP) database for operations and work-based assessments in each specialty, involving surgical trainees on an approved training programme at defined Pre-COVID (16/03/19 – 11/05/19) and COVID (16/03/2020 – 11/05/20) timepoints. Primary outcome measures are the percentage (%) difference in WBA and operative activity between time points respectively. Differences in training activity between time periods will be tested using Pearson χ2 and Kruskal–Wallis tests for categorical and continuous variables respectively.

Results

This study has been approved by the ISCP Data Analysis, Audit and Research Group, and data will be managed in accordance with ISCP data governance. The hypothesis of this study is that COVID-19 has caused a reduction in the operative and WBA activity of trainees across all specialties.

Conclusion

This study seeks to quantify the impact of COVID-19 on operative training activity and completion of WBAs in clinical practice. This information will inform major stakeholders involved in optimising surgical training in the COVID-19 recovery phase.
V2 Evaluation of risk prediction models for postoperative pulmonary complications in adults undergoing major abdominal surgery: A systematic review and external validation study of the REspiratory COmplications after abdomiNal surgery (RECON) cohort
Authors:   STARSurg Collaborative, Kouli Omar
Published: April 2021

Background

Postoperative pulmonary complications (PPCs) following major abdominal surgery result in substantial morbidity and mortality, yet stratifying patients for risk-modifying interventions remains challenging. This study aimed to identify and externally validate PPC risk prediction models in an international, prospective cohort.

Methods

A systematic review was conducted to identify risk prediction models for PPC following abdominal surgery. External validation was performed using data from a prospective dataset of adult patients undergoing major abdominal surgery from January to April 2019 in the UK, Ireland and Australia. The primary outcome was identification of PPC within 30-days (StEP-COMPAC criteria definition). Model discrimination and diagnostic accuracy were compared.

Results

Six unique risk prediction models were eligible from 2819 records. These were validated across 11,591 patients, with an overall PPC rate of 7.8% (n = 903). The Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score provided the best discrimination (AUC: 0.709 (95% CI: 0.692-0.727), yet no risk prediction model demonstrated good discrimination (AUC >0.7).

Conclusion

The risk of PPC for patients following major abdominal surgery in the pre-covid era is not well described by existing prediction tools. New prediction tools are required to account for additional variation introduced for patients affected by SARS-CoV-2 infection.
V5 Preoperative nasopharyngeal swab testing and postoperative pulmonary complications in patients undergoing elective surgery during the SARS-CoV-2 pandemic
Authors:   COVIDSurg Collaborative
Published: April 2021

Background

Surgical services are preparing to scale up in areas affected by COVID-19. This study aimed to evaluate the association between preoperative SARS-CoV-2 testing and postoperative pulmonary complications in patients undergoing elective cancer surgery.

Methods

This international cohort study included adult patients undergoing elective surgery for cancer in areas affected by SARS-CoV-2 up to 19 April 2020. Patients suspected of SARS-CoV-2 infection before operation were excluded. The primary outcome measure was postoperative pulmonary complications at 30 days after surgery. Preoperative testing strategies were adjusted for confounding using mixed-effects models.

Results

Of 8784 patients (432 hospitals, 53 countries), 2303 patients (26.2 per cent) underwent preoperative testing: 1458 (16.6 per cent) had a swab test, 521 (5.9 per cent) CT only, and 324 (3.7 per cent) swab and CT. Pulmonary complications occurred in 3.9 per cent, whereas SARS-CoV-2 infection was confirmed in 2.6 per cent. After risk adjustment, having at least one negative preoperative nasopharyngeal swab test (adjusted odds ratio 0.68, 95 per cent confidence interval 0.68 to 0.98; P = 0.040) was associated with a lower rate of pulmonary complications. Swab testing was beneficial before major surgery and in areas with a high 14-day SARS-CoV-2 case notification rate, but not before minor surgery or in low-risk areas. To prevent one pulmonary complication, the number needed to swab test before major or minor surgery was 18 and 48 respectively in high-risk areas, and 73 and 387 in low-risk areas.

Conclusion

Preoperative nasopharyngeal swab testing was beneficial before major surgery and in high SARS-CoV-2 risk areas. There was no proven benefit of swab testing before minor surgery in low-risk areas.
V8 Reporting of governance and ethical considerations in innovative surgical procedures – a systematic review
Authors: Zucker Benjamin , Lawrence Ruby M , Baker Will , Scroggie Darren , Jones Conor , Blencowe Natalie S ,   RoboSurg Collaborative
Published: April 2021

Introduction

The process of innovation in the field of surgery has largely resulted in improved patient outcomes. However, the uncertainty around the potential benefits and harms of innovative procedures mean that both research governance and ethics are important considerations for those who innovate. Though the need for ethical approval is standardised, other patient safeguards are surgeon and procedure dependent, such as the information provided during the consent procedure. It is currently unknown how ethical considerations in innovative surgery have been reported. This systematic review aims to evaluate the reporting of governance arrangements and ethical safeguards applied to innovative surgical procedures, using a case study of robotic upper gastrointestinal surgery.

Methods

The RoboSurg collaboration is conducting a set of systematic reviews to evaluate reports of innovative robotic surgical procedures including: pancreatectomies, gastrectomies, Roux-en-Y gastric bypasses, oesophagectomies, liver resections, cholecystectomies and anti-reflux operations. Databases were searched in April 2020 using relevant search terms including ‘oesophagectomy’ and ‘robotics’. Data extracted include details of approvals from Institutional Review Boards, ethics committees and clinical effectiveness groups, a priori study registration, and patient consent.

Results

Interim results for the reporting of governance arrangements and ethical safeguards from studies detailing robotic oesophagectomies will be presented. The search yielded 1908 abstracts for screening, of which 101 were included. The proportion of studies reporting on each ethical safeguard for patients undergoing this innovative procedure will be described and summarised.

Conclusion

This review will evaluate how governance and ethical safeguards in studies of innovative surgical procedures have been reported.
V10 The role of surgical trainees in recruiting to multicentre RCTs: an example from the Sunflower Study
Authors: Huppler Lucy , Staight Sarah , Urbonas Tomas , Johnston Judith , Tryliskyy Yegor , Jacob Manoj , Collingwood Jane , Jepson Marcus , Pathak Samir ,   Natalie Blencowe on behalf of the Sunflower Study
Published: April 2021

Background

The Sunflower Study aims to compare the effectiveness of expectant management and MRCP prior to laparoscopic cholecystectomy (LC) in patients at low or moderate risk of common bile duct stones. This is the largest surgical randomised controlled trial (RCT) in the UK and a secondary aim is to describe trainees’ contributions.

Methods

Participants are randomised to receive expectant management or MRCP in a 2:1 ratio. Over 13,500 patients from more than 50 UK hospitals are required over five years. Trainees’ contributions are documented as follows: total number signed up to the study; number enrolled in the NIHR associate PI scheme; and the number of patients approached and recruited. The proportion of ‘emergency’ and ‘elective’ patients recruited was also recorded.

Results

Sunflower has been open since February 2019 and 48 centres are currently participating. A total of 104 trainees have been actively involved and 34 are/have been enrolled in the associate PI scheme. To date, 3992 patients have been screened, by trainees (n = 719,18%), consultants (n = 439,11%) and research nurses (n = 2214,71%). 1996 patients have been recruited, 359(18%) of which by trainees, 319(16%) consultants and 1318(66%) research nurses. Of the recruited patients, 423 (21%) presented as emergencies, recruited by trainees (n = 169,40%), consultants (n = 59,14%) and research nurses (n = 195,46%).

Conclusions

Trainees have an important role to play in recruiting patients to multicentre surgical RCTs, in particular in emergency settings, which can help improve studies’ generalisability. The associate PI scheme seems to provide an extra incentive for trainees to be involved in an RCT.
Malaria Infection Is Common and Associated With Perinatal Mortality and Preterm Delivery Despite Widespread Use of Chemoprevention in Mali: An Observational Study 2010 to 2014
Authors: Mahamar Almahamoudou , Andemel Naissem , Swihart Bruce , Sidibe Youssoufa , Gaoussou Santara , Barry Amadou , Traore Moussa , Attaher Oumar , Dembele Adama B , Diarra Bacary S , Keita Sekouba , Dicko Alassane , Duffy Patrick E , Fried Michal
Published: April 2021

Background

In malaria-endemic areas, pregnant women and especially first-time mothers are more susceptible to Plasmodium falciparum. Malaria diagnosis is often missed during pregnancy, because many women with placental malaria remain asymptomatic or have submicroscopic parasitemia, masking the association between malaria and pregnancy outcomes. Severe maternal anemia and low birthweight deliveries are well-established sequelae, but few studies have confirmed the relationship between malaria infection and severe outcomes like perinatal mortality in high transmission zones.

Methods

Pregnant women of any gestational age enrolled at antenatal clinic into a longitudinal cohort study in Ouelessebougou, Mali, an area of high seasonal malaria transmission. Follow-up visits included scheduled and unscheduled visits throughout pregnancy. Blood smear microscopy and polymerase chain reaction (PCR) analysis were employed to detect both microscopic and submicroscopic infections, respectively. Intermittent preventative treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) was documented and prompt treatment regardless of symptoms given upon malaria diagnosis.

Results

Of the 1850 women followed through delivery, 72.6% of women received 2 or more IPTp-SP doses, 67.2% of women experienced at least 1 infection between enrollment up to and including delivery. Malaria infection increased the risks of stillbirth (adjusted hazard ratio [aHR] 3.87, 95% confidence interval [CI]: 1.18–12.71) and preterm delivery (aHR 2.41, 95% CI: 1.35–4.29) in primigravidae, and early neonatal death (death within 7 days) in secundigravidae and multigravidae (aHR 6.30, 95% CI: 1.41–28.15).

Conclusions

Malaria treatment after diagnosis, alongside IPTp-SP, is insufficient to prevent malaria-related stillbirth, early neonatal death and preterm delivery (PTD). Although IPTp-SP was beneficial in Mali during the study period, new tools are needed to improve pregnancy outcomes.

Clinical Trials Registration

NCT01168271.
Cardiovascular RNA markers and artificial intelligence may improve COVID-19 outcome: a position paper from the EU-CardioRNA COST Action CA17129
Authors: Badimon Lina , Robinson Emma L , Jusic Amela , Carpusca Irina , deWindt Leon J , Emanueli Costanza , Ferdinandy Péter , Gu Wei , Gyöngyösi Mariann , Hackl Matthias , Karaduzovic-Hadziabdic Kanita , Lustrek Mitja , Martelli Fabio , Nham Eric , Potočnjak Ines , Satagopam Venkata , Schneider Reinhard , Thum Thomas , Devaux Yvan
Published: April 2021

The coronavirus disease 2019 (COVID-19) pandemic has been as unprecedented as unexpected, affecting more than 105 million people worldwide as of 8 February 2020 and causing more than 2.3 million deaths according to the World Health Organization (WHO). Not only affecting the lungs but also provoking acute respiratory distress, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is able to infect multiple cell types including cardiac and vascular cells. Hence a significant proportion of infected patients develop cardiac events, such as arrhythmias and heart failure. Patients with cardiovascular comorbidities are at highest risk of cardiac death. To face the pandemic and limit its burden, health authorities have launched several fast-track calls for research projects aiming to develop rapid strategies to combat the disease, as well as longer-term projects to prepare for the future. Biomarkers have the possibility to aid in clinical decision-making and tailoring healthcare in order to improve patient quality of life. The biomarker potential of circulating RNAs has been recognized in several disease conditions, including cardiovascular disease. RNA biomarkers may be useful in the current COVID-19 situation. The discovery, validation, and marketing of novel biomarkers, including RNA biomarkers, require multi-centre studies by large and interdisciplinary collaborative networks, involving both the academia and the industry. Here, members of the EU-CardioRNA COST Action CA17129 summarize the current knowledge about the strain that COVID-19 places on the cardiovascular system and discuss how RNA biomarkers can aid to limit this burden. They present the benefits and challenges of the discovery of novel RNA biomarkers, the need for networking efforts, and the added value of artificial intelligence to achieve reliable advances.
Colonic Strictures in Inflammatory Bowel Disease: Epidemiology, Complications, and Management
Authors: Fumery Mathurin , Yzet Clara , Chatelain Denis , Yzet Thierry , Brazier Franck , LeMouel Jean-Philippe , Laharie David , Sabbagh Charles
Published: April 2021

The management of colorectal stricture complicating inflammatory bowel disease [IBD] remains a challenging condition. Stricture raises concern about neoplastic complications, which cannot be fully ruled out by negative endoscopic biopsies. Also, impassable strictures restrict the endoscopic monitoring of upstream disease activity and dysplasia. Surgery remains the ‘gold standard’ treatment for colonic strictures but is associated with high morbidity. Over the past few decades, our therapeutic arsenal for IBD has been reinforced by biologics and therapeutic endoscopy. Few studies have focused on colonic strictures, and so current therapeutic strategies are based on a low level of evidence and applied by analogy with the treatment of ileal strictures. With a view to facilitating the decision making process in clinical practice, we reviewed the literature on the epidemiology, natural history, and management of colonic strictures in IBD.
Efficiency and outcome quality of Herbst-Multibracket appliance therapy in Class II:2 patients
Authors: Bock Niko Christian , Killat Sophia , Ruf Sabine
Published: April 2021

Objectives

The aim of this retrospective investigation was to generate representative data on the efficiency and outcome quality of Class II:2 Herbst-Multibracket appliance (Herbst-MBA) treatment.

Subjects and methods

All Class II:2 patients who had started Herbst-MBA treatment at the study centre since 1986 were included. Study casts from before treatment, after Herbst-MBA treatment, and (if available) after ≥24 months of follow-up were evaluated using standard occlusal variables, the Peer Assessment Rating (PAR)-Index, and the Ahlgren-Scale.

Results

During treatment, the pre-treatment PAR score was reduced from 23.6 ± 7.66 to 5.6 ± 3.85 (n = 192); during the follow-up period, a slight increase to 6.0 ± 3.60 occurred (n = 127). The percentage of patients who could be assigned to the PAR category ‘greatly improved’ was 30% after treatment and 33% after follow-up; only 1%, respectively, 2% had to be assigned to the category ‘worse/no different’. The outcome ratings according to the Ahlgren-Scale revealed 20% excellent, 32% good, 46% acceptable, and 2% unsuccessful results.

Limitations

Retrospective study design with follow-up data not available from all subjects and no data from untreated controls.

Conclusions

Herbst-MBA is an efficient treatment approach in orthodontic care of Class II:2 malocclusions. High-quality results (mean/median PAR score: 5.6/5.0) with very good short-term stability (2.2 years’ follow-up) were achieved. Unfortunately, no appropriate control group or groups, where other treatment approaches had been applied, exist.
Inhibitors of DNA topoisomerases I and II applied to Candida dubliniensis reduce growth, viability, the generation of petite mutants and toxicity, while acting synergistically with fluconazole
Authors: Tagle-Olmedo Tania , Andrade-Pavón Dulce , Martínez-Gamboa Areli , Gómez-García Omar , García-Sierra Francisco , Hernández-Rodríguez César , Villa-Tanaca Lourdes
Published: April 2021

The increasing resistance of Candida species to azoles emphasizes the urgent need for new antifungal agents with novel mechanisms of action. The aim of this study was to examine the effect of three DNA topoisomerase inhibitors of plant origin (camptothecin, etoposide and curcumin) on the growth of Candida dubliniensis. The phylogenetic analysis showed a close relationship between the topoisomerase enzymes of C. dubliniensis and Candida albicans. The alignment of the amino acid sequences of topoisomerase I and II of yeasts and humans evidenced conserved domains. The docking study revealed affinity of the test compounds for the active site of topoisomerase I and II in C. dubliniensis. Curcumin and camptothecin demonstrated a stronger in vitro antifungal effect than the reference drugs (fluconazole and itraconazole). Significant synergistic activity between the topoisomerase inhibitors and fluconazole at the highest concentration (750 µM) was observed. Fluconazole induced the petite phenotype to a greater degree than the topoisomerase inhibitors, indicating a tendency to generate resistance. Lower toxicity was found for such inhibitors versus reference drugs on Galleria mellonella larva. The topoisomerase inhibitors exhibited promising antifungal activity, and the DNA topoisomerase enzymes of C. dubliniensis proved to be an excellent model for evaluating new antifungal compounds.
Population Genomics of the Maize PathogenUstilago maydis: Demographic History and Role of Virulence Clusters in Adaptation
Authors: Schweizer Gabriel , Haider Muhammad Bilal , Barroso Gustavo V , Rössel Nicole , Münch Karin , Kahmann Regine , Dutheil Julien Y
Published: April 2021

The tight interaction between pathogens and their hosts results in reciprocal selective forces that impact the genetic diversity of the interacting species. The footprints of this selection differ between pathosystems because of distinct life-history traits, demographic histories, or genome architectures. Here, we studied the genome-wide patterns of genetic diversity of 22 isolates of the causative agent of the corn smut disease, Ustilago maydis, originating from five locations in Mexico, the presumed center of origin of this species. In this species, many genes encoding secreted effector proteins reside in so-called virulence clusters in the genome, an arrangement that is so far not found in other filamentous plant pathogens. Using a combination of population genomic statistical analyses, we assessed the geographical, historical, and genome-wide variation of genetic diversity in this fungal pathogen.

We report evidence of two partially admixed subpopulations that are only loosely associated with geographic origin. Using the multiple sequentially Markov coalescent model, we inferred the demographic history of the two pathogen subpopulations over the last 0.5 Myr. We show that both populations experienced a recent strong bottleneck starting around 10,000 years ago, coinciding with the assumed time of maize domestication. Although the genome average genetic diversity is low compared with other fungal pathogens, we estimated that the rate of nonsynonymous adaptive substitutions is three times higher in genes located within virulence clusters compared with nonclustered genes, including nonclustered effector genes. These results highlight the role that these singular genomic regions play in the evolution of this pathogen.
The rec8 gene of Schizosaccharomyces pombe is involved in linear element formation, chromosome pairing and sister-chromatid cohesion during meiosis.
Authors: Molnar M , Bähler J , Sipiczki M , Kohli J
Published: April 2021

The fission yeast Schizosaccharomyces pombe does not form tripartite synaptonemal complexes during meiotic prophase, but axial core-like structures (linear elements). To probe the relationship between meiotic recombination and the structure, pairing, and segregation of meiotic chromosomes, we genetically and cytologically characterized the rec8-110 mutant, which is partially deficient in meiotic recombination. The pattern of spore viability indicates that chromosome segregation is affected in the mutant. A detailed segregational analysis in the rec8-110 mutant revealed more spores disomic for chromosome III than in a wild-type strain. Aberrant segregations are caused by precocious segregation of sister chromatids at meiosis I, rather than by nondisjunction as a consequence of lack of crossovers. In situ hybridization further showed that the sister chromatids are separated prematurely during meiotic prophase. Moreover, the mutant forms aberrant linear elements and shows a shortened meiotic prophase. Meiotic chromosome pairing in interstitial and centromeric regions is strongly impaired in rec8-110, whereas the chromosome ends are less deficient in pairing. We propose that the rec8 gene encodes a protein required for linear element formation and that the different phenotypes of rec8-110 reflect direct and indirect consequences of the absence of regular linear elements.
A Microsatellite Linkage Map of Rainbow Trout (Oncorhynchus mykiss) Characterized by Large Sex-Specific Differences in Recombination Rates
Authors: Sakamoto Takashi , Danzmann Roy G , Gharbi Karim , Howard Pamela , Ozaki Akiyuki , Khoo Sok Kean , Woram Rachael A , Okamoto Nobuaki , Ferguson Moira M , Holm Lars-Erik , Guyomard René , Hoyheim Bjorn
Published: April 2021

We constructed a genetic linkage map for a tetraploid derivative species, the rainbow trout (Oncorhynchus mykiss), using 191 microsatellite, 3 RAPD, 7 ESMP, and 7 allozyme markers in three backcross families. The linkage map consists of 29 linkage groups with potential arm displacements in the female map due to male-specific pseudolinkage arrangements. Synteny of duplicated microsatellite markers was used to identify and confirm some previously reported pseudolinkage arrangements based upon allozyme markers. Fifteen centromeric regions (20 chromosome arms) were identified with a half-tetrad analysis using gynogenetic diploids. Female map length is ~10 M, but this is a large underestimate as many genotyped segments remain unassigned at a LOD threshold of 3.0. Extreme differences in female:male map distances were observed (ratio F:M, 3.25:1). Females had much lower recombination rates (0.14:1) in telomeric regions than males, while recombination rates were much higher in females within regions proximal to the centromere (F:M, 10:1). Quadrivalent formations that appear almost exclusively in males are postulated to account for the observed differences.
Perceiving Dynamic Emotions Expressed Simultaneously in the Face and Body Minimizes Perceptual Differences Between Young and Older Adults
Authors: Abo Foul Yasmin , Eitan Renana , Mortillaro Marcello , Aviezer Hillel
Published: April 2021

Objectives

It is commonly argued that older adults show difficulties in standardized tasks of emotional expression perception, yet most previous works relied on classic sets of static, decontextualized, and stereotypical facial expressions. In real life, facial expressions are dynamic and embedded in a rich context, 2 key factors that may aid emotion perception. Specifically, body language provides important affective cues that may disambiguate facial movements.

Method

We compared emotion perception of dynamic faces, bodies, and their combination in a sample of older (age 60–83, n = 126) and young (age 18–30, n = 124) adults. We used the Geneva Multimodal Emotion Portrayals set, which includes a full view of expressers’ faces and bodies, displaying a diverse range of positive and negative emotions, portrayed dynamically and holistically in a nonstereotypical, unconstrained manner. Critically, we digitally manipulated the dynamic cue such that perceivers viewed isolated faces (without bodies), isolated bodies (without faces), or faces with bodies.

Results

Older adults showed better perception of positive and negative dynamic facial expressions, while young adults showed better perception of positive isolated dynamic bodily expressions. Importantly, emotion perception of faces with bodies was comparable across ages.

Discussion

Dynamic emotion perception in young and older adults may be more similar than previously assumed, especially when the task is more realistic and ecological. Our results emphasize the importance of contextualized and ecological tasks in emotion perception across ages.
Ectopic expression of CGG-repeats alters ovarian response to gonadotropins and leads to infertility in a murine FMR1 premutation model
Authors: Shelly Katharine E , Candelaria Nicholes R , Li Ziyi , Allen Emily G , Jin Peng , Nelson David L
Published: April 2021

Women heterozygous for an expansion of CGG repeats in the 5’UTR of FMR1 risk developing fragile X-associated primary ovarian insufficiency (FXPOI) and/or tremor and ataxia syndrome (FXTAS). We show that expanded CGGs, independent of FMR1, are sufficient to drive ovarian insufficiency and that expression of CGG-containing mRNAs alone or in conjunction with a polyglycine-containing peptide translated from these RNAs contribute to dysfunction. Heterozygous females from two mouse lines expressing either CGG RNA-only (RNA-only) or CGG RNA and the polyglycine product FMRpolyG (FMRpolyG+RNA) were used to assess ovarian function in aging animals. The expression of FMRpolyG+RNA led to early cessation of breeding, ovulation and transcriptomic changes affecting cholesterol and steroid hormone biosynthesis. Females expressing CGG RNA-only did not exhibit decreased progeny during natural breeding, but their ovarian transcriptomes were enriched for alterations in cholesterol and lipid biosynthesis. The enrichment of CGG RNA-only ovaries for differentially expressed genes related to cholesterol processing provided a link to the ovarian cysts observed in both CGG-expressing lines. Early changes in transcriptome profiles led us to measure ovarian function in prepubertal females that revealed deficiencies in ovulatory responses to gonadotropins. These include impairments in cumulus expansion and resumption of oocyte meiosis, as well as reduced ovulated oocyte number. Cumulatively, we demonstrated the sufficiency of ectopically expressed CGG repeats to lead to ovarian insufficiency and that co-expression of CGG-RNA and FMRpolyG lead to premature cessation of breeding. However, the expression of CGG RNA-alone was sufficient to lead to ovarian dysfunction by impairing responses to hormonal stimulation.
Percutaneous major aortopulmonary collateral artery banding using a covered stent in an infant
Authors: Nagatomo Yusaku , Nagata Hazumu , Yamamura Kenichiro , Ohga Shouichi
Published: April 2021

We report a 6-month-old infant with pulmonary atresia with ventricular septal defect who was successfully treated with a novel technique of percutaneous major aortopulmonary collateral artery (MAPCA) banding with a covered stent. He suffered from heart failure due to a residual MAPCA of 4.5 mm in diameter. A covered stent tied with 2 5–0 size nylon threads was successfully deployed into the MAPCA in a dumbbell shape with a banding diameter of 2.8 mm. Banding covered stent implantation is a useful method to reduce the pulmonary blood flow in patients with MAPCA, which could be a less-invasive alternative to surgery.
Apramycin resistance in epidemic carbapenem-resistant Klebsiella pneumoniae ST258 strains
Authors: Hao Mingju , Schuyler Jessica , Zhang Haifang , Shashkina Elena , Du Hong , Fouts Derrick E , Satlin Michael , Kreiswirth Barry N , Chen Liang
Published: April 2021

Background

Recent studies indicated that the monosubstituted deoxystreptamine aminoglycoside apramycin is a potent antibiotic against a wide range of MDR Gram-negative pathogens.

Objectives

To evaluate the in vitro activity of apramycin against carbapenem-resistant Klebsiella pneumoniae (CRKp) isolates from New York and New Jersey, and to explore mechanisms of apramycin resistance.

Methods

Apramycin MICs were determined by broth microdilution for 155 CRKp bloodstream isolates collected from 2013 to 2018. MLST STs, wzi capsular types and apramycin resistance gene aac(3’)-IV were examined by PCR and Sanger sequencing. Selected isolates were further characterized by conjugation experiments and WGS.

Results

Apramycin MIC50/90 values were 8 and >128 mg/L for CRKp isolates, which are much higher than previously reported. Twenty-four isolates (15.5%) were apramycin resistant (MIC ≥64 mg/L) and they were all from the K. pneumoniae ST258 background. The 24 apramycin-resistant K. pneumoniae ST258 strains belonged to six different capsular types and 91.7% of them harboured the apramycin resistance gene aac(3’)-IV. Sequencing analysis showed that different ST258 capsular type strains shared a common non-conjugative IncR plasmid, co-harbouring aac(3’)-IV and blaKPC. A novel IncR and IncX3 cointegrate plasmid, p59494-RX116.1, was also identified in an ST258 strain, demonstrating how apramycin resistance can be spread from a non-conjugative plasmid through cointegration.

Conclusions

We described a high apramycin resistance rate in clinical CRKp isolates in the New York/New Jersey region, mainly among the epidemic K. pneumoniae ST258 strains. The high resistance rate in an epidemic K. pneumoniae clone raises concern regarding the further optimization and development of apramycin and apramycin-like antibiotics.
Building a Life in Australia: Young Hazara Men and the Journey to ‘Adulthood’
Authors: Neve Amy
Published: April 2021

Young Hazara men who entered Australia as unaccompanied minors have insecure futures. While this insecurity of pathways and opportunities is in some ways similar to that of other young people in Australia, the challenges and opportunities that unaccompanied minors face as refugee youth mean that their experiences of growing-up also have unique characteristics. The journey to adult life is still shaped by the core dimensions of employment, education, housing, and family relationships. However, for the young Hazara men who participated in this study, they are also sites of disruption and adaption. Their experiences suggest a desire to fulfil these goals within social structures that actively prevent their achievement. Drawing on interviews and ethnographic fieldwork, this article investigates the challenges and strategies of young asylum seekers during a period in their lives in which the transition to adult life intersects with the process of settlement. This research contributes to the growing literature that represents experiences of young adults in the wake of global diversity and social change.
Efficacy of one-dose intramuscular rabies vaccine as pre-exposure prophylaxis in travellers
Authors: Mills Deborah J , Lau Colleen L , Mills Christine , Furuya-Kanamori Luis
Published: April 2021

Background

Current guidelines for rabies pre-exposure prophylaxis (PrEP) recommend multiple vaccine doses. Travellers sometimes present for pre-travel consultation with insufficient time to complete standard PrEP schedules. We investigated the efficacy of one-dose intramuscular (IM) vaccine in priming the immune system (as PrEP) by measuring antibody response to simulated post-exposure prophylaxis (PEP).

Methods

A quasi-experimental pre–post intervention clinical trial was conducted at a specialist travel clinic in Australia. Adults (≥18 years) without a history of rabies vaccination were included. At Visit 1, seronegative status was confirmed and one dose of 0.5 ml IM rabies vaccine (Verorab®) administered. At Visit 2 (≥60 days after Visit 1), serology was repeated and a simulated PEP dose (0.5 ml IM) given on this day and again 3 days later (Visit 3). Serology was repeated at Visit 4 (7 days after Visit 2).

Results

A total of 94 antibody-negative participants were included (<50 years [n = 50]; ≥50 years [n = 44]). At Visit 2, 38.0 and 31.8% of participants aged <50 and ≥50 years were antibody-positive (≥0.5 EU/ml). At Visit 4, all participants were antibody-positive; 82.0 and 47.7% of participants aged <50 and ≥50 years had antibody levels >4 EU/ml, respectively.

Conclusions

One-dose IM vaccine was effective as PrEP for priming the immune system in both age groups, resulting in rapid development of antibodies 7 days after commencing simulated PEP. If there is insufficient time to complete a standard PrEP schedule, one-dose IM could be considered as an alternative schedule for short trips, rather than not offering travellers any doses at all.

Clinical trials registration: ACTRN12619000946112.
Between Love and Misogamy: Changing Perceptions of Marriage among German Jews, 1750–1800
Authors: Naimark-Goldberg Natalie
Published: April 2021

Marriage is a central and binding institution of Jewish life. However, as a historical construct, it was never a static, immutable structure. This article focuses on the changing attitudes towards marriage among German Jews in the second half of the eighteenth century. It discusses how rational considerations external to the couple’s personal needs and desires started losing ground, while its function as a framework for emotional and erotic satisfaction intensified. As marriage was increasingly perceived in terms of self-fulfilment, many pursued happiness through matrimony, embracing the new idea of the love marriage. Although this idea developed from contemporary trends in non-Jewish society, maskilic authors used Jewish sources to maintain this position, trying to present it as consistent with tradition rather than as a break from it. The emergence of a romantic discourse was not the only transformation in the perception of marriage. The individualism that impelled the notion of a love marriage led to another type of discourse among Jewish women and men: the discourse against marriage. Using the perspectives of continuity and change, the article seeks to discern the role that Judaism and Jewish sources played in discourses about misogamy and the modernization of the traditional institution of marriage.
sMILES: a library of semi-empirical MILES stellar spectra with variable [α/Fe] abundances
Authors: Knowles Adam T , Sansom A E , Allende Prieto C , Vazdekis A
Published: April 2021

We present a new library of semi-empirical stellar spectra that is based on the empirical Medium resolution Isaac Newton Library of Empirical Spectra (MILES) library. A new, high-resolution library of theoretical stellar spectra is generated that is specifically designed for use in stellar population studies. We test these models across their full wavelength range against other model libraries and find reasonable agreement in their predictions of spectral changes due to atmospheric α-element variations, known as differential corrections. We also test the models against the MILES and MaStar libraries of empirical stellar spectra and also find reasonable agreements, as expected from previous work. We then use the abundance pattern predictions of the new theoretical stellar spectra to differentially correct MILES spectra to create semi-empirical MILES (sMILES) star spectra with abundance patterns that differ from those present in the Milky Way. The final result is five families of 801 sMILES stars with [α/Fe] abundances ranging from −0.20 to 0.60 dex at MILES resolution (FWHM = $2.5\,$Å) and wavelength coverage ($3540.5\!-\!7409.6\,$Å). We make the sMILES library publicly available.
New X-ray observations of the hot subdwarf binary HD 49798/RX J0648.0–4418
Authors: Mereghetti S , Pintore F , Rauch T , La Palombara N , Esposito P , Geier S , Pelisoli I , Rigoselli M , Schaffenroth V , Tiengo A
Published: April 2021

HD 49798/RX J0648.0–4418 is the only confirmed X-ray binary in which the mass donor is a hot subdwarf star of O spectral type and, most likely, it contains a massive white dwarf (1.28 ± 0.05 M⊙) with a very fast spin period of 13.2 s. Here, we report the results of new XMM–Newton pointings of this peculiar binary, carried out in 2018 and in 2020, together with a reanalysis of all the previous observations. The new data indicate that the compact object is still spinning-up at a steady rate of (−2.17 ± 0.01) × 10−15 s s−1, consistent with its interpretation in terms of a young contracting white dwarf. Comparison of observations obtained at similar orbital phases, far from the ecplise, shows evidence for long-term variability of the hard (>0.5 keV) spectral component at a level of ∼(70 ± 20) per cent, suggesting the presence of time-dependent inhomogeneities in the weak stellar wind of the HD 49798 subdwarf. To investigate better the soft spectral component that dominates the X-ray flux from this system, we computed a theoretical model for the thermal emission expected from an atmosphere with element abundances and surface gravity appropriate for this massive white dwarf. This model gives a best fit with effective temperature of Teff = 2.25 × 105 K and an emitting area with a radius of ∼1600 km, larger than that found with blackbody fits. This model also predicts a contribution of the pulsed emission from the white dwarf in the optical band significantly larger than previously thought and possibly relevant for optical variability studies of this system.
A revised SALT2 surface for fitting Type Ia supernova light curves
Authors: Taylor G , Lidman C , Tucker B E , Brout D , Hinton S R , Kessler R
Published: April 2021

We present a revised Spectral Adaptive Light Curve Template (SALT2) surface (SALT2-2021) for fitting the light curves of Type Ia supernovae (SNe Ia), which incorporates new measurements of zero-point calibration offsets and Milky Way extinction. The most notable change in the new surface occurs in the UV region. This new surface alters the distance measurements of SNe Ia, which can be used to investigate the nature of dark energy by probing the expansion history of the Universe. Using the revised SALT2 surface on public data from the first 3 yr of the Dark Energy Survey Supernova Program (combined with an external low-z SNe Ia sample) and combining with cosmic microwave background constraints, we find a change in the dark energy equation-of-state parameter, Δw = 0.015 ± 0.004. This result highlights the continued importance of controlling and reducing systematic uncertainties, particularly with the next generation of supernova analyses aiming to improve constraints on dark energy properties.
Correlation between optical and γ-ray flux variations in BL Lacs
Authors: Rajput Bhoomika , Shah Zahir , Stalin C S , Sahayanathan S , Rakshit Suvendu
Published: April 2021

We report here results of the analysis of correlated flux variations between the optical and GeV γ-ray bands in three bright BL Lac objects, namely AO 0235+164, OJ 287, and PKS 2155−304. This was based on the analysis of about 10 yr of data from the Fermi Gamma-ray Space Telescope covering the period between 2008 August 8 and 2018 August 8 along with optical data covering the same period. For all the sources, during the flares analysed in this work, the optical and γ-ray flux variations are found to be closely correlated. From broad-band spectral energy distribution modelling of different epochs in these sources using the one-zone leptonic emission model, we found that the optical–ultraviolet emission is dominated by synchrotron emission from the jet. The γ-ray emission in the low synchrotron peaked sources AO 0235+164 and OJ 287 is found to be well fitted with external Compton (EC) component, while the γ-ray emission in the high synchrotron peaked source PKS 2155−304 is well fitted with synchrotron self-Compton component. Further, we note that the γ-ray emission during the high-flux state of AO 0235+164 (epochs A and B) requires seed photons from both the dusty torus and broad-line region, while the γ-ray emission in OJ 287 and during epochs C and D of AO 0235+164 can be modelled by EC scattering of infrared photons from the torus.
Explaining the extended GeV gamma-ray emission adjacent to HESS J1825-137
Authors: Collins T , Rowell G , Mitchell A M W , Voisin F , Fukui Y , Sano H , Alsulami R , Einecke S
Published: April 2021

HESS J1825-137 is one of the most powerful and luminous TeV gamma-ray pulsar wind nebulae (PWN). To the south of HESS J1825-137, Fermi-LAT observation revealed a new region of GeV gamma-ray emission with three apparent peaks (termed here, GeV-ABC). This study presents interstellar medium (ISM) data and spectral energy distribution (SED) modelling towards the GeV emission to understand the underlying particle acceleration. We considered several particle accelerator scenarios – the PWN associated with HESS J1825-137, the progenitor SNR also associated with HESS J1825-137, plus the gamma-ray binary system LS 5039. It was found that the progenitor SNR of HESS J1825-137 has insufficient energetics to account for all GeV emission. GeV-ABC may be a reflection of an earlier epoch in the history of the PWN associated with HESS 1825-137, assuming fast diffusion perhaps including advection. LS 5039 cannot meet the required energetics to be the source of particle acceleration. A combination of HESS J1825-137 and LS 5039 could be plausible sources.
Extracting the 21 cm EoR signal using MWA drift scan data
Authors: Patwa Akash Kumar , Sethi Shiv , Dwarakanath K S
Published: April 2021

The detection of redshifted hyperfine line of neutral hydrogen (H i) is the most promising probe of the epoch of reionization (EoR). We report an analysis of 55 h of Murchison Widefield Array (MWA) phase II drift scan EoR data. The data correspond to a central frequency $\nu _0 = 154.24 \, \rm MHz$ (z ≃ 8.2 for the redshifted H i hyperfine line) and bandwidth $B = 10.24 \, \rm MHz$. As one expects greater system stability in a drift scan, we test the system stability by comparing the extracted power spectra from data with noise simulations and show that the power spectra for the cleanest data behave as thermal noise. We compute the H i power spectrum as a function of time in one and two dimensions. The best upper limit on the 1D power spectrum are: $\Delta ^2(k) \simeq (1000~\rm mK)^2$ at k ≃ 0.2h Mpc−1 and at k ≃ 1h Mpc−1. The cleanest modes, which might be the most suited for obtaining the optimal signal to noise, correspond to k ≳ 1h Mpc−1. We also study the time-dependence of the foreground-dominated modes in a drift scan and compare with the expected behaviour.