bluuebunny/crossref_metadata_2025 huggingface dataset:
AstroSat soft X-ray observations of the symbiotic recurrent nova V3890 Sgr during its 2019 outburst
Authors: Singh K P , Girish V , Pavana M , Ness Jan-Uwe , Anupama G C , Orio M
Published: October 2020

Two long AstroSat Soft X-ray Telescope observations were taken of the third recorded outburst of the symbiotic recurrent nova V3890 Sgr. The first observing run, 8.1–9.9 d after the outburst, initially showed a stable intensity level with a hard X-ray spectrum that we attribute to shocks between the nova ejecta and the pre-existing stellar companion. On day 8.57, the first, weak, signs appeared of supersoft source (SSS) emission powered by residual burning on the surface of the white dwarf. The SSS emission was observed to be highly variable on time-scales of hours. After day 8.9, the SSS component was more stable and brighter. In the second observing run, on days 15.9–19.6 after the outburst, the SSS component was even brighter but still highly variable. The SSS emission was observed to fade significantly during days 16.8–17.8 followed by re-brightening. Meanwhile, the shock component was stable, leading to increase in hardness ratio during the period of fading. AstroSat and XMM–Newton observations have been used to study the spectral properties of V3890 Sgr to draw quantitative conclusions even if their drawback is model dependent. We used the xspec to fit spectral models of plasma emission, and the best fits are consistent with the elemental abundances being lower during the second observing run compared to the first for spectra ≥1 keV. The SSS emission is well fitted by non-local thermal equilibrium model atmosphere used for white dwarfs. The resulting spectral parameters, however, are subject to systematic uncertainties such as completeness of atomic data.
Wolf–Rayet stars in the Antennae unveiled by MUSE
Authors: Gómez-González V M A , Mayya Y D , Toalá J A , Arthur S J , Zaragoza-Cardiel J , Guerrero M A
Published: October 2020

We present the analysis of archival Very Large Telescope (VLT) Multi-Unit Spectroscopic Explorer (MUSE) observations of the interacting galaxies NGC 4038/39 (a.k.a. the Antennae) at a distance of 18.1 Mpc. Up to 38 young star-forming complexes with evident contribution from Wolf–Rayet (WR) stars are unveiled. We use publicly available templates of Galactic WR stars in conjunction with available photometric extinction measurements to quantify and classify the WR population in each star-forming region, on the basis of its nearly Solar oxygen abundance. The total estimated number of WR stars in the Antennae is 4053 ± 84, of which there are 2021 ± 60 WNL and 2032 ± 59 WC-types. Our analysis suggests a global WC to WN-type ratio of 1.01 ± 0.04, which is consistent with the predictions of the single star evolutionary scenario in the most recent bpass stellar population synthesis models.
Identifying resonances of the Galactic bar in Gaia DR2: I. Clues from action space
Authors: Trick Wilma H , Fragkoudi Francesca , Hunt Jason A S , Mackereth J Ted , White Simon D M
Published: October 2020

Action space synthesizes the orbital information of stars and is well suited to analyse the rich kinematic substructure of the disc in the second Gaia data release's radial velocity sample. We revisit the strong perturbation induced in the Milky Way disc by an m = 2 bar, using test particle simulations and the actions (JR, Lz, Jz) estimated in an axisymmetric potential. These make three useful diagnostics cleanly visible. (1) We use the well-known characteristic flip from outward to inward motion at the outer Lindblad resonance (OLR; l = +1, m = 2), which occurs along the axisymmetric resonance line (ARL) in (Lz, JR), to identify in the Gaia action data three candidates for the bar’s OLR and pattern speed Ωbar: 1.85Ω0, 1.20Ω0, and 1.63Ω0 (with ∼0.1Ω0 systematic uncertainty). The Gaia data is therefore consistent with both slow and fast bar models in the literature, but disagrees with recent measurements of ∼1.45Ω0. (2) For the first time, we demonstrate that bar resonances – especially the OLR – cause a gradient in vertical action 〈Jz〉 with Lz around the ARL via ‘Jz-sorting’ of stars. This could contribute to the observed coupling of 〈vR〉 and 〈|vz|〉 in the Galactic disc. (3) We confirm prior results that the behaviour of resonant orbits is well approximated by scattering and oscillation in (Lz, JR) along a slope ΔJR/ΔLz = l/m centred on the l:m ARL. Overall, we demonstrate that axisymmetrically estimated actions are a powerful diagnostic tool even in non-axisymmetric systems.
BIRTH of the COSMOS field: primordial and evolved density reconstructions during cosmic high noon
Authors: Ata Metin , Kitaura Francisco-Shu , Lee Khee-Gan , Lemaux Brian C , Kashino Daichi , Cucciati Olga , Hernández-Sánchez Mónica , Le Fèvre Oliver
Published: October 2020

This work presents the first comprehensive study of structure formation at the peak epoch of cosmic star formation over 1.4 ≤ z ≤ 3.6 in the Cosmic Evolution Survey (COSMOS) field, including the most massive high-redshift galaxy proto-clusters at that era. We apply the extended COSMIC BIRTH algorithm to account for a multitracer and multisurvey Bayesian analysis at Lagrangian initial cosmic times. Combining the data of five different spectroscopic redshift surveys (zCOSMOS-deep, VUDS, MOSDEF, ZFIRE, and FMOS–COSMOS), we show that the corresponding unbiased primordial density fields can be inferred, if a proper survey completeness computation from the parent photometric catalogues, and a precise treatment of the non-linear and non-local evolution on the light-cone is taken into account, including (i) gravitational matter displacements, (ii) peculiar velocities, and (iii) galaxy bias. The reconstructions reveal a holistic view on the known proto-clusters in the COSMOS field and the growth of the cosmic web towards lower redshifts. The inferred distant dark matter density fields concurrently with other probes like tomographic reconstructions of the intergalactic medium will explore the interplay of gas and dark matter and are ideally suited to study structure formation at high redshifts in the light of upcoming deep surveys.
Spherical isochrone models revisited
Authors: Dejonghe Herwig
Published: October 2020

A short derivation of all isochrone models using complex analysis.
The effects of star formation history in the SFR–M* relation of H ii galaxies
Authors: Lopes Amanda R , Telles Eduardo , Melnick Jorge
Published: October 2020

We discuss the implications of assuming different star formation histories (SFH) in the relation between star formation rate (SFR) and mass derived by the spectral energy distribution fitting (SED). Our analysis focuses on a sample of H ii galaxies, dwarf starburst galaxies spectroscopically selected through their strong narrow emission lines in SDSS DR13 at z < 0.4, cross-matched with photometric catalogues from GALEX, SDSS, UKIDSS, and WISE. We modelled and fitted the SEDs with the code CIGALE adopting different descriptions of SFH. By adding information from different independent studies, we find that H ii galaxies are best described by episodic SFHs including an old (10 Gyr), an intermediate age (100−1000 Myr) and a recent population with ages < 10 Myr. H ii galaxies agree with the SFR−M* relation from local star-forming galaxies, and only lie above such relation when the current SFR is adopted as opposed to the average over the entire SFH. The SFR−M* demonstrated not to be a good tool to provide additional information about the SFH of H ii galaxies, as different SFH present a similar behaviour with a spread of <0.1 dex.
Physical explanation for the galaxy distribution on the (λR, ε) and (V/σ, ε) diagrams or for the limit on orbital anisotropy
Authors: Wang Bitao , Cappellari Michele , Peng Yingjie
Published: October 2020

In the (λR, ε) and (V/σ, ε) diagrams for characterizing dynamical states, the fast-rotator galaxies (both early type and spirals) are distributed within a well-defined leaf-shaped envelope. This was explained as due to an upper limit to the orbital anisotropy increasing with galaxy intrinsic flattening. However, a physical explanation for this empirical trend was missing. Here, we construct Jeans Anisotropic Models (JAM), with either cylindrically or spherically aligned velocity ellipsoid (two extreme assumptions), and each with either spatially constant or variable anisotropy. We use JAM to build mock samples of axisymmetric galaxies, assuming on average an oblate shape for the velocity ellipsoid (as required to reproduce the rotation of real galaxies), and limiting the radial anisotropy β to the range allowed by physical solutions. We find that all four mock samples naturally predict the observed galaxy distribution on the (λR, ε) and (V/σ, ε) diagrams, without further assumptions. Given the similarity of the results from quite different models, we conclude that the empirical anisotropy upper limit in real galaxies, and the corresponding observed distributions in the (λR, ε) and (V/σ, ε) diagrams, are due to the lack of physical axisymmetric equilibrium solutions at high β anisotropy when the velocity ellipsoid is close to oblate.
Judicial-ENE and the ‘New Normal’
Authors: Islam Carl
Published: October 2020

The author’s premise is that in claims allocated to the multi-track, Judicial-Early Neutral Evaluation ('JENE') is the new normal. He discusses: the rationale; jurisdiction; and powers of the court to order JENE; its benefits; and the procedure. He concludes that, except where a claim involves the interests of minors and unborn beneficiaries, use of this case management tool is likely to become increasingly routine at the first case management conference where, for example, one party has proposed JENE, and the other has refused consent because he prefers mediation. Whereas mediation requires consent, JENE does not, and the court has the power at the first Case Management Conference to order a stay during which the parties must: (i) take stock and (ii) each carry out a reality check, i.e. before substantial costs are incurred in preparing for trial. Therefore, in an appropriate case, where a binary outcome on liability can open the door to settlement in relation to quantum, relief, and costs, JENE should be considered.
NaCl-altered oxygen flux profiles and H+-ATPase activity in roots of two contrasting poplar species
Authors: Ma Xiuying , Li Jinke , Deng Chen , Sun Jian , Liu Jian , Li Niya , Lu Yanjun , Wang Ruigang , Zhao Rui , Zhou Xiaoyang , Lu Cunfu , Chen Shaoliang
Published: October 2020

Maintaining mitochondrial respiration is crucial for proving ATP for H+ pumps to continuously exclude Na+ under salt stress. NaCl-altered O2 uptake, mitochondrial respiration and the relevance to H+-ATPase activity were investigated in two contrasting poplar species, Populus euphratica (salt-tolerant) and Populus popularis 35-44 (salt-sensitive). Compared with P. popularis, P. euphratica roots exhibited a greater capacity to extrude Na+ under NaCl stress (150 mM). The cytochemical analysis with Pb(NO3)2 staining revealed that P. euphratica root cells retained higher H+ hydrolysis activity than the salt-sensitive poplar during a long term (LT) of increasing salt stress (50–200 mM NaCl, 4 weeks). Long-sustained activation of proton pumps requires long-lasting supply of energy (adenosine triphosphate, ATP), which is delivered by aerobic respiration. Taking advantage of the vibrating-electrodes technology combined with the use of membrane-tipped, polarographic oxygen microelectrodes, the species, spatial and temporal differences in root O2 uptake were characterized under conditions of salt stress. Oxygen uptake upon NaCl shock (150 mM) was less declined in P. euphratica than in P. popularis, although the salt-induced transient kinetics were distinct from the drastic drop of O2 caused by hyperosmotic shock (255 mM mannitol). Short-term (ST) treatment (150 mM NaCl, 24 h) stimulated O2 influx in P. euphratica roots, and LT-treated P. euphratica displayed an increased O2 influx along the root axis, whereas O2 influx declined with increasing salinity in P. popularis roots. The spatial localization of O2 influxes revealed that the apical zone was more susceptible than the elongation region upon high NaCl (150, 200 mM) during ST and LT stress. Pharmacological experiments showed that the Na+ extrusion and H+-ATPase activity in salinized roots were correspondingly suppressed when O2 uptake was inhibited by a mitochondrial respiration inhibitor, NaN3. Therefore, we conclude that the stable mitochondrial respiration energized H+-ATPase of P. euphratica root cells for maintaining Na+ homeostasis under salt environments.
Prevalence of Linguatula sp., a food-borne zoonotic aberrant arthropod, in river buffaloes slaughtered at Tabriz slaughterhouse, Iran
Authors: Hajipour Nasser , Ketzis Jennifer , Hassanzadeh Parviz
Published: October 2020

Background

Canids and herbivores are the definitive and intermediate hosts of Linguatula sp., respectively.

Methods

Mesenteric lymph nodes (n=32 525) were randomly collected from 7585 buffaloes from July 2016 to July 2019 and examined macroscopically.

Results

Results showed that 388 (5.11%) buffaloes were infected. The intensity of infection was determined to be 3.07±0.07. Significant statistical association was identified between infection rate and age and sex. Although there were no significant differences in the infection rate over different seasons, the highest infection rate was observed in autumn.

Conclusions

These data highlight the importance of inspection at slaughter.
From Healthy Hearing to Healthy Living: A Holistic Approach
Authors: Campos Jennifer L. , Launer Stefan
Published: October 2020

The negative consequences of hearing loss go beyond difficulties with communication, having been identified as a major risk factor for injury and illness, social isolation, depression, overall quality of life, and mortality. Hearing loss affects the individual, their families and social network, the broader healthcare system, and the economy. Recognizing that there are multifactorial considerations associated with understanding and mitigating the consequences of hearing loss, great benefit is gained by taking an interdisciplinary, interprofessional, holistic approach to studying hearing loss in research and in developing holistic clinical strategies targeted at prevention, diagnosis, treatment, and social policy. Within the framework of this supplement focused on the role of ecological validity in hearing-related research and application, this article provides a general commentary on how ecological validity can be considered with a holistic perspective in mind. First, we consider how a holistic approach can be applied within clinical practice, how it can be applied to laboratory-based research to increase ecological validity, and how it can be applied to professional training and education within both research and clinical domains. Second, we discuss the associations between hearing loss and dementia as an example of how these holistic principles can be applied. The main goal of highlighting these approaches and principles is to motivate a change in the narrative about hearing loss from a focus in research and application on promoting healthy hearing, to a focus on living well.
Review of Self-Motion in the Context of Hearing and Hearing Device Research
Authors: Grimm Giso , Hendrikse Maartje M. E. , Hohmann Volker
Published: October 2020

The benefit from directional hearing devices predicted in the lab often differs from reported user experience, suggesting that laboratory findings lack ecological validity. This difference may be partly caused by differences in self-motion between the lab and real-life environments. This literature review aims to provide an overview of the methods used to measure and quantify self-motion, the test environments, and the measurement paradigms. Self-motion is the rotation and translation of the head and torso and movement of the eyes. Studies were considered which explicitly assessed or controlled self-motion within the scope of hearing and hearing device research. The methods and outcomes of the reviewed studies are compared and discussed in relation to ecological validity. The reviewed studies demonstrate interactions between hearing device benefit and self-motion, such as a decreased benefit from directional microphones due to a more natural head movement when the test environment and task include realistic complexity. Identified factors associated with these interactions include the presence of audiovisual cues in the environment, interaction with conversation partners, and the nature of the tasks being performed. This review indicates that although some aspects of the interactions between self-motion and hearing device benefit have been shown and many methods for assessment and analysis of self-motion are available, it is still unclear to what extent individual factors affect the ecological validity of the findings. Further research is required to relate lab-based measures of self-motion to the individual’s real-life hearing ability.
Objective Assessment of Speech Intelligibility in Crowded Public Spaces
Authors: Brungart Douglas S. , Barrett Mary E. , Cohen Julie I. , Fodor Calli , Yancey Calli M. , Gordon-Salant Sandra
Published: October 2020

The objective of this study was to obtain a normative database of speech intelligibility data for young normal-hearing listeners communicating in public spaces. A total of 174 listeners participated in an interactive speech intelligibility task that required four-person groups to conduct a live version of the Modified Rhyme Test in noisy public spaces. The public spaces tested included a college library, a college cafeteria, a casual dining restaurant during lunch hour, and a crowded bar during happy hour. At the start of each trial, one of the participants was randomly selected as the talker, and a tablet computer was used to prompt them to say a word aloud from the Modified Rhyme Test. Then, the other three participants were required to select this word from one of six rhyming alternatives displayed on three other tablet computers. The tablet computers were also used to record the SPL at each listener location during and after the interval where the target talker was speaking. These SPL measurements were used to estimate the signal-to-noise ratio (SNR) in each trial of the experiment. As expected, the results show that speech intelligibility decreases, response time increases, and perceived difficulty increases as the background noise level increases. There was also a systematic decrease in SNR with increasing background noise, with SNR decreasing 0.44 dB for every 1 dB increase in ambient noise level above 60 dB. Overall, the results of this study have demonstrated how low-cost tablet computer-based data collection systems can be used to collect live-talker speech intelligibility data in real-world environments. We believe these techniques could be adapted for use in future studies focused on obtaining ecologically valid assessments of the effects of age, hearing impairment, amplification, and other factors on speech intelligibility performance in real-world environments.
Arrhythmias in Pregnancy
Authors: LINDLEY KATHRYN J. , JUDGE NANCY
Published: October 2020

The prevalence of arrhythmias in pregnant women are rising, particularly among women with a history of structural heart disease or prior arrhythmia. The physiological changes of pregnancy increase the risk of both benign and pathologic arrhythmias, with atrial fibrillation representing the most common pathologic arrhythmia. While bradyarrhythmias rarely require treatment during pregnancy, pharmacotherapy is frequently required for tachyarrhythmias. Electrophysiological procedures including cardioversions, ablations, and device placement are occasionally required during pregnancy and can be performed safely with proper precautions. This chapter will discuss the diagnosis and management of a broad array of cardiac arrhythmias that may be encountered in pregnant women.
AFP-L3 as a Prognostic Predictor of Recurrence in Hepatoblastoma: A Pilot Study
Authors: Kawahara Insu , Fukuzawa Hiroaki , Urushihara Naoto , Kosaka Yoshiyuki , Kuroda Yasuhiro , Fujieda Yuki , Takeuchi Yuki , Uemura Kotaro , Iwade Tamaki , Samejima Yoshitomo , Morita Keiichi , Maeda Kosaku
Published: October 2020

The α-fetoprotein (AFP) level is a sensitive biomarker of active hepatoblastoma (HB). This study aimed to clarify whether the Lens culinaris agglutinin A-reactive fraction of AFP (AFP-L3) after complete resection is a prognostic predictor of HB recurrence. Fourteen HB patients who underwent complete resection of HB were divided into the recurrence group (RG, n=4) and the non-recurrence group (NRG, n=10). The AFP level and AFP-L3 before and after radical surgery were compared between the 2 groups. There was no significant difference in AFP levels in the early postoperative period between the 2 groups (P=0.54), and AFP was not an early prognostic factor for HB recurrence. At 2 months after surgery, the AFP-L3 fell below the detection limit only in the NRG (7/10 cases) (NRG=70.0% vs. RG=0%, P=0.03). In addition, there were some cases of recurrence in those whose AFP level decreased to the normal range, but none in those whose AFP-L3 fell below the detection limit. In conclusion, the AFP-L3 decreased earlier than did the AFP level; thus, the AFP-L3 after complete resection may be a predictor for HB recurrence.
Complications of Central Venous Access Devices in Patients With Sickle Cell Disease and Thalassemia Major
Authors: Ordóñez Javier , del Cañizo Agustín , Beléndez Cristina , García-Morín Marina , Pérez-Egido Laura , Fanjul María , García-Casillas María A. , Cerdá Julio , Peláez David , Bardón Eduardo , de Agustín Juan C. , Cela Elena
Published: October 2020

Pediatric patients with sickle cell disease and thalassemia major present clinical characteristics that could lead to a higher incidence of central venous access devices–associated complications (CVAD-C). With the objective of analyzing the safety of the use of CVAD in these patients, a retrospective review including all pediatric patients with these pathologies who required the implantation of a CVAD between 2004 and 2019 was performed. In all, 54 patients with 100 CVAD (65 totally implantable venous access port with subcutaneous reservoir, 35 single-lumen or double-lumen partially tunneled catheter) were included. During 60,410 days at risk of suffering a CVAD-C, 55 complications (complication rate [CR]/1000 catheter-days at risk=0.91) were reported in 46 CVAD: 19 mechanicals (CR=0.32), 32 infectious (CR=0.53), and 4 thrombotic complications (CR=0.066). Incidence of mechanical and infectious complications was significantly higher in double-lumen partially tunneled catheter than in totally implantable venous access port with subcutaneous reservoir (P<0.001). Lower age at insertion was related with a higher incidence of any complication (odds ratio=0.88/y, P=0.02). Patients who required a stem cell transplantation (31 patients and 65 CVAD) had no significant higher incidences of CVAD-C. In conclusion, our study supports the safety of using CVAD in these patients, with a low incidence of infectious, thrombotic, and mechanical complications.
Haploidentical Stem Cell Transplant With Post-transplant Cyclophosphamide for Chediak-Higashi Syndrome: A Very Rare Case Report
Authors: Sachdev Mansi , Bansal Minakshi , Chakraborty Sohini , Hamal Sushma , Bhargava Rahul , Dua Vikas
Published: October 2020

Chediak-Higashi syndrome is a rare immunodeficiency disorder for which hematopoietic stem cell transplant (HSCT) is the only curative treatment option. HSCT only corrects the hematologic and immunologic manifestations of the disease but neurologic complications may still progress after transplant. Haploidentical HSCT (haplo-HSCT) has evolved as a feasible alternative for patients with primary immunodeficiency. More recently, there has been use of haplo-HSCT with post-transplant cyclophosphamide. However, only 4 cases of Chediak-Higashi syndrome have been reported using this approach. Here, the authors describe a case of a 17-month-old boy who was successfully treated by haplo-HSCT with reduced-toxicity conditioning (fludarabine/treosulfan/melphalan) and post-transplant cyclophosphamide.
Affecting Length of Stay in Well-appearing Febrile Infants
Authors: Mier Madeline , Antoon James W. , Sefcovic Sarah , Awatramani Seema , Kreppel Andrew , Smith Sara Boblick
Published: October 2020

Introduction:

The management of infants under 2 months of age presenting with fever has perplexed pediatricians for decades. The University of Illinois at Chicago was selected as one of the primary sites for the REVISE (Reducing Variation in Infant Sepsis Evaluations) study through the American Academy of Pediatrics. Our primary objective was to decrease the length of stay (LOS) for well-appearing febrile infants by 20% over 8 months from December 2016 to August 2017.

Methods:

We introduced the use of a decision support smartphone application to providers caring for febrile infants. Monthly retrospective chart review of patients 7–59 days old with fever seen in the emergency department or the inpatient setting was performed from September 2015 to August 2016 for baseline data, from December 2016 to August 2017 for intervention data, and from September 2017 to December 2018 for surveillance data.

Results:

A total of 1013 patients of ages 7–59 days seen in the emergency department or inpatient unit between September 2015 to December 2018 were screened for study inclusion. Forty-one febrile, well-appearing infants of ages 7–59 days met inclusion criteria. During the baseline period, there was a mean LOS of 48 hours. Intervention and surveillance data did not change the mean from baseline.

Conclusions:

Infants with a negative diagnostic evaluation for urinary tract infection, bacteremia, or meningitis drove our LOS. Further study is needed to affect the LOS in febrile infants with diagnoses of urinary tract infection, bacteremia, or meningitis.
Microbotulinum: A Quantitative Evaluation of Aesthetic Skin Improvement in 62 Patients
Authors: Diaspro Alberto , Calvisi Lucia , Manzoni Veronica , Sito Giuseppe
Published: October 2020

Background:

Microbotulinum refers to the systematic injection of tiny blebs of diluted botulinum toxin at repeated intervals into the skin. This targets the superficial fibers of the facial muscles, and weakens their insertion into the undersurface of the skin, which is responsible for the fine lines and wrinkles on the face. The authors present a pilot study based on quantitative evaluation, by means of a skin-scanning technology, of the aesthetic improvement of skin texture, microroughness, and enlarged pore size in a patient group treated with microbotulinum injections for cosmetic purposes.

Methods:

The treatment was performed using a 32-gauge needle to deliver injections on a regular 1-cm grid from the forehead to the cheek and down to the jawline.

Results:

Sixty of the 62 patients completed the study. All analyzed parameters improved significantly (p < 0.0001) at 90 days with respect to the pretreatment time point (skin texture, −1.93 ± 0.51; microroughness, −2.48 ± 0.79; and pore diameter, 2.1 ± 0.43). Best results have been obtained in patients aged between 42.7 and 46.8 years, and standard deviation calculation allows us to recommend it in patients aged between 36.5 and 53 years.

Conclusions:

The results of this pilot study suggest that intradermal botulinum toxin injection, or so-called microbotulinum, is a safe and effective method to treat skin flaws. Because of the high satisfaction rate among both physicians and patients, further studies are indeed mandatory to determine the optimal number of units needed for a longer and lasting effect with this particular novel dilution.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Aesthetic Augmentation Phalloplasty: A Systematic Review of Techniques and Outcomes
Authors: Vyas Krishna S. , Abu-Ghname Amjed , Banuelos Joseph , Morrison Shane D. , Manrique Oscar
Published: October 2020

Background:

Aesthetic augmentation phalloplasty is a set of procedures aimed at increasing penile length and/or girth; many of these procedures are investigational. This systematic review set out to summarize available literature on these procedures in patients with normal penile anatomy.

Methods:

A systematic review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The MEDLINE/PubMed, Scopus, and Cochrane Databases were used to identify articles on aesthetic augmentation phalloplasty in cis-gender men without penile deformity from 1990 to 2018. Data on outcomes, complications, and patient-reported satisfaction were collected.

Results:

Sixteen articles, involving 1192 patients, met our inclusion criteria. Mean age ranged from 23 to 44 years, and follow-up time ranged from 6 to 48 months. The quality of the studies was poor regarding methodology for patient selection and outcomes reporting. Surgical interventions included suspensory ligament incision, grafting, flaps, and penile disassembly. Augmentation was performed for length only in 16 percent of patients, girth only in 70.6 percent, and combined in 13.4 percent. Length gain ranged from 8 to 83 percent in the flaccid state and 12 to 53 percent in the erect state. Girth gain ranged from 16 to 56 percent in the flaccid state and 19 to 30 percent in the erect state. The pooled complication rate was 14.6 percent, with those undergoing combined augmentation having the highest complication rate. Patients were generally satisfied; reported satisfaction rates ranged from 50 to 100 percent.

Conclusions:

Enhancement procedures are controversial and investigational. Data point to inconsistent methodology when reporting penile dimensions, outcomes, and patient satisfaction. Despite the reportedly high satisfaction rates, patients should be counseled regarding high complication rates. Best-practice guidelines will be critical to achieve safe and reliable outcomes.
Facial Shape, Size, and Gender
Authors: Lambros Val , Amos Gideon
Published: October 2020

Traditional ways of visualizing the differences between male and female faces are often based on single-subject exemplars or artist depictions of hypermasculine and hyperfeminine faces. By equalizing the sizes of male and female facial averages, the authors analyzed the influences of intrinsic shape and size on the architecture of the face.
Viral Meningitis
Authors: Freer Sarah , House David Thomas , Hallman Melanie Gibbons
Published: October 2020

Meningitis is a significant viral, bacterial, or fungal infection of the meninges that cover and protect the brain and the spinal cord. Symptoms of meningitis may present rapidly or develop gradually over a period of days, manifesting with common prodromal flu-like symptoms of headache, photophobia, fever, nuchal rigidity, myalgias, and fatigue. Character and significance of symptoms vary by patient age. Symptoms of infection may improve spontaneously or worsen, becoming potentially lethal. Early recognition and treatment of meningitis are crucial to prevent morbidity and mortality. The case reviewed in this article focuses on viral meningitis in a pediatric patient that may be unrecognized or underreported because of indistinct symptoms. Epidemiology, pathophysiology, presentation, assessment techniques, diagnostics, clinical management, and health promotion relevant to viral meningitis are presented.
Rapid Assessment of Adults With Traumatic Brain Injuries
Authors: Colio Pedro Alonso
Published: October 2020

The aim of this evidence-based project was to improve the medical screening process, enhance medical decision-making, and standardize the utilization of an adult traumatic brain injury (TBI) neuroimaging guideline among advanced practice providers (APPs) in an urban emergency department (ED). Neuroimaging, specifically computed tomography (CT), helps identify life-threatening intracranial injuries when clinically appropriate. The literature supports the utilization of neuroimaging guidelines, clinical examinations, and provider expertise when identifying the need for a head CT scan. Although head CT scans are clinically useful, they increase health care costs and pose potential cancer risks from radiation exposure. Eight APPs (i.e., nurse practitioners, physician assistants) were trained in the American College of Emergency Physicians' (ACEP's) TBI clinical guideline with one-on-one education. Preintervention, retrospective, baseline data were collected for a period of 4 months (n = 152). Three months of postintervention data were collected to assess adherence to the guideline (n = 132), including physicians' charts that were reviewed as a comparison. The findings demonstrated a statistically significant reduction in head CT scans that did not meet ACEP criteria among APPs after training (p = 0.010). The results of this project suggest improved medical decision-making among APPs, avoidance of unnecessary costs, and a reduction in radiation exposure for patients. This project could be easily replicated in other ED settings using the ACEP TBI guideline as part of their standardized procedures, clinical policies, or protocols.
The impact of COVID-19 on Long Term Care Facilities (LTCFs) of an Italian Province: a cohort study and a retrospective analysis of observed vs. expected mortality
Authors: Tramarin Andrea , Gennaro Nicola , Dal Grande Giancarlo , Bragagnolo Luciana , Carta Maria Rosa , Giavarina Davide , Pascarella Michela , Rassu Mario , Matteazzi Antonio , Stopazzolo Giampaolo
Published: October 2020

In Italy, as in other countries, Long Term Care Facilities (LTCFs) have seen a disproportionally high number of deaths during the COVID-19 pandemic. The Veneto region was one of the first areas of the country where the virus spread rapidly particularly in the LTCFs. As it became evident that LTCs were the epicenter of the pandemic, health authorities of the Vicenza province adopted a plan, which included an epidemiological investigation in a case study facility (CSF) and a retrospective analysis to estimate the impact of COVID-19 in terms of mortality. Combining retrospective data and a prospective cohort study in the CSF we provided a tentative estimate of the impact of COVID-19 on LTCFs. We found an age-gradient in all variables explored. An observed mortality higher 60% than 2019 was found in those LTCF reporting COVID-19 cases. Our findings suggest the need to adopt and maintain strict mitigation measures in LTCFs in the future dynamics of the epidemic.
Viral dynamics of acute SARS-CoV-2 infection
Authors: Kissler Stephen M. , Fauver Joseph R. , Mack Christina , Olesen Scott W. , Tai Caroline , Shiue Kristin Y. , Kalinich Chaney C. , Jednak Sarah , Ott Isabel M. , Vogels Chantal B.F. , Wohlgemuth Jay , Weisberger James , DiFiori John , Anderson Deverick J. , Mancell Jimmie , Ho David D. , Grubaugh Nathan D. , Grad Yonatan H.
Published: October 2020

Background

SARS-CoV-2 infections are characterized by viral proliferation and clearance phases and can be followed by low-level persistent viral RNA shedding. The dynamics of viral RNA concentration, particularly in the early stages of infection, can inform clinical measures and interventions such as test-based screening.

Methods

We used prospective longitudinal RT-qPCR testing to measure the viral RNA trajectories for 68 individuals during the resumption of the 2019-20 National Basketball Association season. For 46 individuals with acute infections, we inferred the peak viral concentration and the duration of the viral proliferation and clearance phases.

Findings

According to our mathematical model, we found that viral RNA concentrations peaked an average of 3.3 days (95% credible interval [2.5, 4.2]) after first possible detectability at a cycle threshold value of 22.3 [20.5, 23.9]. The viral clearance phase lasted longer for symptomatic individuals (10.9 days [7.9, 14.4]) than for asymptomatic individuals (7.8 days [6.1, 9.7]). A second test within 2 days after an initial positive PCR substantially improves certainty about a patient’s infection phase. The effective sensitivity of a test intended to identify infectious individuals declines substantially with test turnaround time.

Conclusions

SARS-CoV-2 viral concentrations peak rapidly regardless of symptoms. Sequential tests can help reveal a patient’s progress through infection stages. Frequent rapid-turnaround testing is needed to effectively screen individuals before they become infectious.
Early use of nitazoxanide in mild Covid-19 disease: randomized, placebo-controlled trial
Authors: Rocco Patricia R. M. , Silva Pedro L. , Cruz Fernanda F. , Junior Marco Antonio C. M. , Tierno Paulo F. G. M. M. , Moura Marcos A. , De Oliveira Luís Frederico G. , Lima Cristiano C. , Dos Santos Ezequiel A. , Junior Walter F. , Fernandes Ana Paula S. M. , Franchini Kleber G. , Magri Erick , de Moraes Nara F. , Gonçalves José Mário J. , Carbonieri Melanie N. , Dos Santos Ivonise S. , Paes Natália F. , Maciel Paula V. M. , Rocha Raissa P. , de Carvalho Alex F. , Alves Pedro Augusto , Modena José Luiz P. , Cordeiro Artur T. , Trivella Daniela B. B. , Marques Rafael E. , Luiz Ronir R. , Pelosi Paolo , Lapa e Silva Jose Roberto
Published: October 2020

The antiparasitic drug nitazoxanide is widely available and exerts broad-spectrum antiviral activity in vitro. However, there is no evidence of its impact on SARS-CoV-2 infection.

In a multicenter, randomized, double-blind, placebo-controlled trial, adult patients who presented up to 3 days after onset of Covid-19 symptoms (dry cough, fever, and/or fatigue) were enrolled. After confirmation of SARS-CoV2 infection by RT-PCR on nasopharyngeal swab, patients were randomized 1:1 to receive either nitazoxanide (500 mg) or placebo, TID, for 5 days. The primary outcome was complete resolution of symptoms. Secondary outcomes were viral load, general laboratory tests, serum biomarkers of inflammation, and hospitalization rate. Adverse events were also assessed.

From June 8 to August 20, 2020, 1,575 patients were screened. Of these, 392 (198 placebo, 194 nitazoxanide) were analyzed. Median time from symptom onset to first dose of study drug was 5 (4-5) days. At the 5-day study visit, symptom resolution did not differ between the nitazoxanide and placebo arms. However, at the 1-week follow-up, 78% in the nitazoxanide arm and 57% in the placebo arm reported complete resolution of symptoms (p=0.048). Swabs collected were negative for SARS-CoV-2 in 29.9% of patients in the nitazoxanide arm versus 18.2% in the placebo arm (p=0.009). Viral load was also reduced after nitazoxanide compared to placebo (p=0.006). No serious adverse events were observed.

In patients with mild Covid-19, symptom resolution did not differ between the nitazoxanide and placebo groups after 5 days of therapy. However, early nitazoxanide therapy was safe and reduced viral load significantly.

Take home message

This was the first study to evaluate the effect of early nitazoxanide therapy in mild Covid-19. Nitazoxanide did not accelerate symptom resolution after 5 days of therapy; however, reduced viral load significantly with no serious adverse events.
Age, wound size and position of injury – dependent vascular regeneration assay in growing leaves
Authors: Radhakrishnan Dhanya , Shanmukhan Anju Pallipurath , Kareem Abdul , Mathew Mabel Maria , Varaparambathu Vijina , Aiyaz Mohammed , Radha Raji Krishna , Mekala Krishnaprashanth Ramesh , Shaji Anil , Prasad Kalika
Published: October 2020

Background

Recurring damage to aerial organs of plants necessitates their prompt repair, particularly their vasculature. While vascular regeneration assay in aerial plant parts such as stem and inflorescence stalk are well established, those on leaf vasculature remained unexplored. Recently we established a new vascular regeneration assay in growing leaf and discovered the underlying molecular mechanism.

Results

Here we describe the detailed stepwise method of incision and the regeneration assay used for studying the leaf vascular regeneration. By using a combination of micro-surgical perturbations, brightfield microscopy and other experimental approaches, our new findings show that the regeneration efficiency decreases with aging of the leaf, and increases with the nearness of the wound towards the proximal end of the leaf.

Conclusion

This easy-to-master vascular regeneration assay is an efficient and rapid method to study the mechanism of vascular regeneration in growing leaves. It can be readily adapted for other plant species and can be combined with cellular and molecular biology techniques.
TruSight Oncology 500: Enabling Comprehensive Genomic Profiling and Biomarker Reporting with Targeted Sequencing
Authors: Zhao Chen , Jiang Tingting , Hyun Ju Jin , Zhang Shile , Tao Jenhan , Fu Yao , Lococo Jenn , Dockter Janel , Pawlowski Traci , Bilke Sven
Published: October 2020

Background

As knowledge of mechanisms that drive the development of cancer grows, there has been corresponding growth in therapies specific to a mechanism. While these therapies show improvements in patient outcomes, they can be expensive and are effective only for a subset of patients. These treatments drive interest in research focused on the assignment of cancer therapies based on aberrations in individual genes or biomarkers that assess the broader mutational landscape, including microsatellite instability (MSI) and tumor mutational burden (TMB).

Methods

Here we describe the TruSight™ Oncology 500 (TSO500; Research Use Only) bioinformatics workflow. This tumor-only approach leverages the next-generation sequencing-based assay TSO500 to enable high fidelity determination of DNA variants across 523 cancer-relevant genes, as well as MSI status and TMB in formalin-fixed paraffin-embedded (FFPE) samples.

Results

The TSO500 bioinformatic workflow integrates unique molecular identifier (UMI)-based error correction and a dual approach variant filtering strategy that combines statistical modeling of error rates and database annotations to achieve detection of variants with allele frequency approaching 5% with 99.9998% per base specificity and 99% sensitivity in FFPE samples representing a variety of tumor types. TMB determined using the tumor-only workflow of TSO500 correlated well with tumor-normal (N =170, adjustedR2=0.9945) and whole-exome sequencing (N=108, adjustedR2=0.933). Similarly, MSI status determined by TSO500 showed agreement (N=106, 98% agreement) with a MSI-PCR assay.

Conclusion

TSO500 is an accurate tumor-only workflow that enables researchers to systematically characterize tumors and identify the next generation of clinical biomarkers.
Evaluation of gene knock-outs by CRISPR as potential targets for the genetic engineering of the mosquitoCulex quinquefasciatus
Authors: Feng Xuechun , Kambic Lukas , Nishimoto Jared H.K. , Reed Floyd A. , Denton Jai A. , Sutton Jolene T. , Gantz Valentino M.
Published: October 2020

Culex quinquefasciatusmosquitoes are a globally widespread vector of several human and animal pathogens. Their biology and behavior allow them to thrive in proximity to urban areas, rendering them a constant public health threat. Their mixed bird/mammal feeding behavior further offers a vehicle for zoonotic pathogens transmission to people, and separately, poses a threat to the conservation of insular birds. The advent of CRISPR has led to the development of novel technologies for the genetic engineering of wild mosquito populations, yet research inCulex quinquefasciatushas been lagging compared to other disease vectors. Here we use this tool to disrupt a set of five pigmentation genes inCulex quinquefasciatusthat, when altered, lead to visible, homozygous-viable phenotypes. We further validate this approach in separate laboratories and in two distinct strains ofCulex quinquefasciatusthat are relevant to potential future public health and bird conservation applications. We generate a double-mutant line, demonstrating the possibility of sequentially combining multiple such mutations in a single individual. Lastly, we target two loci,doublesexin the sex-determination pathway andproboscipediaa hox gene, demonstrating the flexibility of these methods applied to novel targets. Our work provides a platform of seven validated loci that could be used for targeted mutagenesis inCulex quinquefasciatusand the future development of genetic suppression strategies for this species. Furthermore, the mutant lines generated here could have widespread utility to the research community using this model organism, as they could be used as targets for transgene delivery, where a copy of the disrupted gene could be included as an easily-scored transgenesis marker.
Precursor processing by SBT3.8 and phytosulfokine signaling contribute to drought stress tolerance in Arabidopsis
Authors: Stührwohldt Nils , Bühler Eric , Sauter Margret , Schaller Andreas
Published: October 2020

Increasing drought stress poses a severe threat to agricultural productivity. Plants, however, evolved numerous mechanisms to cope with such environmental stress. Here we report that the stress-induced production of a peptide signal contributes to stress tolerance. The expression of phytosulfokine (PSK) peptide precursor genes, and transcripts of three subtilisin-like serine proteases, SBT1.4, SBT3.7 and SBT3.8 were found to be up-regulated in response to osmotic stress. Stress symptoms were enhanced insbt3.8loss-of-function mutants and could be alleviated by PSK treatment. Osmotic stress tolerance was improved in plants overexpression the precursor of PSK1 (proPSK1) orSBT3.8resulting in higher fresh weight and improved lateral root development in the transgenic compared to wild-type plants. We further showed that SBT3.8 is involved in the biogenesis of the bioactive PSK peptide. ProPSK1 was cleaved by SBT3.8 at the C-terminus of the PSK pentapeptide. Processing by SBT3.8 depended on the aspartic acid residue adjacent to the cleavage site. ProPSK1 processing was impaired in thesbt3.8mutant. The data suggest that increased expression in response to osmotic stress followed by the post-translational processing of proPSK1 by SBT3.8 leads to the production of PSK as a peptide signal for stress mitigation.

Highlight

The expression of phytosulfokine precursor genes and processing by the subtilase SBT3.8 are upregulated in response to osmotic stress for improved drought tolerance in Arabidopsis.