bluuebunny/crossref_metadata_2025 huggingface dataset:
Novel genetic basis of resistance to Bt toxin Cry1Ac inHelicoverpa zea
Authors: Benowitz Kyle M , Allan Carson W , Degain Benjamin A , Li Xianchun , Fabrick Jeffrey A , Tabashnik Bruce E , Carrière Yves , Matzkin Luciano M
Published: March 2022

Crops genetically engineered to produce insecticidal proteins from the bacterium Bacillus thuringiensis have advanced pest management, but their benefits are diminished when pests evolve resistance. Elucidating the genetic basis of pest resistance to Bacillus thuringiensis toxins can improve resistance monitoring, resistance management, and the design of new insecticides. Here, we investigated the genetic basis of resistance to Bacillus thuringiensis toxin Cry1Ac in the lepidopteran Helicoverpa zea, one of the most damaging crop pests in the United States. To facilitate this research, we built the first chromosome-level genome assembly for this species, which has 31 chromosomes containing 375 Mb and 15,482 predicted proteins. Using a genome-wide association study, fine-scale mapping, and RNA-seq, we identified a 250-kb quantitative trait locus on chromosome 13 that was strongly associated with resistance in a strain of Helicoverpa zea that had been selected for resistance in the field and lab. The mutation in this quantitative trait locus contributed to but was not sufficient for resistance, which implies alleles in more than one gene contributed to resistance. This quantitative trait locus contains no genes with a previously reported role in resistance or susceptibility to Bacillus thuringiensis toxins. However, in resistant insects, this quantitative trait locus has a premature stop codon in a kinesin gene, which is a primary candidate as a mutation contributing to resistance. We found no changes in gene sequence or expression consistently associated with resistance for 11 genes previously implicated in lepidopteran resistance to Cry1Ac. Thus, the results reveal a novel and polygenic basis of resistance.
The facilitators and barriers to exercise in the Noongar Aboriginal population in Perth, Australia
Authors: Esgin Tuguy , Hersh Deborah , Rowley Kevin , Macniven Rona , Crouch Alan , Halaki Mark , Newton Robert
Published: March 2022

Indigenous Standpoint Theory forms the epistemological foundation for this study and methodological choices were made within this theoretical framework to ensure culturally responsive research processes that engaged the Indigenous agenda of self-determination and rights. The objectives of this research were to determine: (i) Indigenous perceptions of the facilitators and barriers to exercise; (ii) The potential feasibility and sustainability of an exercise intervention. In this context, Participatory Action Research methods were used to design the data-gathering instrument for the study—a questionnaire, co-designed with the Noongar Aboriginal community of Perth, Western Australia. This self-administered questionnaire, distributed to participants by email, post and manual delivery, sought to elicit the factors that impact uptake and retention of regular exercise activities. Questionnaire data included individual demographic detail and specific question responses on labelled 5 point Likert Scales. Specific question responses were tabulated by Likert Scale label category and the response distribution for each question was enumerated. Simple descriptive statistics (measures of central tendency and variance) were used to characterize the data set and the Chi squared test was used to evaluate frequency differences between males and females. A total of 133 participants (71 females) completed the questionnaire. The results indicated that people valued exercise. The most common barriers indicated by participants were exercising with an injury (63%), changing diet (58%), finding time to exercise every day (55%) and exercising the next day with pain from exercising the day before (54%). A larger proportion of males (34%) than females (24%) reported greater ease in finding time to exercise every day (p < 0.05). Facilitators mainly related to the potential social and community benefits of exercising with other people, preferably in small groups, and the importance of a culturally secure venue. These findings shed light on what a culturally secure exercise programme might involve for the Noongar community. As this may have implications for other Aboriginal and Torres Strait Islander and international First Nations’ Peoples, more focused research is needed on the place of traditional physical activities and the nature of culturally secure exercise programmes and spaces to enable wider application.
The fall and rise of industry participation in fisheries science – a European story
Authors: Mackinson Steven
Published: March 2022

Based on the Buckland Professor lecture for 2021–2022, this story uses a hypothetical sketch of how the relationship between the fishing industry and scientists evolved over the last century to provide a starting point for a personal account of changes in Science Industry Research Collaboration (SIRC). After a period in the doldrums, SIRC is burgeoning in debate and in practice. Focussing on experiences in the European arena, this story looks at why SIRC is gaining momentum, what is needed to make it useful and meaningful for those involved, and the reasons why there is hope that it is here to stay.
Estimating the long-term effects of mass screening for latent and active tuberculosis in the Marshall Islands
Authors: Ragonnet Romain , Williams Bridget M , Largen Angela , Nasa Joaquin , Jack Tom , Langinlur Mailynn K , Ko Eunyoung , Rahevar Kalpeshsinh , Islam Tauhid , Denholm Justin T , Marais Ben J , Marks Guy B , McBryde Emma S , Trauer James M
Published: March 2022

Background

Ambitious population-based screening programmes for latent and active tuberculosis (TB) were implemented in the Republic of the Marshall Islands in 2017 and 2018.

Methods

We used a transmission dynamic model of TB informed by local data to capture the Marshall Islands epidemic’s historical dynamics. We then used the model to project the future epidemic trajectory following the active screening interventions, as well as considering a counterfactual scenario with no intervention. We also simulated future scenarios including periodic interventions similar to those previously implemented, to assess their ability to reach the End TB Strategy targets and TB pre-elimination in the Marshall Islands.

Results

The screening activities conducted in 2017 and 2018 were estimated to have reduced TB incidence and mortality by around one-third in 2020, and are predicted to achieve the End TB Strategy milestone of 50% incidence reduction by 2025 compared with 2015. Screening interventions had a considerably greater impact when latent TB screening and treatment were included, compared with active case finding alone. Such combined programmes implemented at the national level could achieve TB pre-elimination around 2040 if repeated every 2 years.

Conclusions

Our model suggests that it would be possible to achieve TB pre-elimination by 2040 in the Marshall Islands through frequent repetition of the same interventions as those already implemented in the country. It also highlights the importance of including latent infection testing in active screening activities.
Increasing serotonin concentrations alter calcium metabolism in periparturient dairy goats
Authors: Zhang ZhiFei , Du Wei , Liu WenYi , Wong Braden T , Zheng HuiLing
Published: March 2022

Due to the large amounts of calcium transferred to milk from mammary glands, periparturient dairy goats face challenges with calcium metabolism disorder and hypocalcemia. Serotonin (5-hydroxytryptamine, 5-HT), the product of 5-hydroxy-l-tryptophan (5-HTP) catalyzed by tryptophan hydroxylase 1, is a multifunctional monoamine thought to be a homeostatic regulator of the animal. The objective of the current study was to investigate the effects and underlying mechanisms of intramuscular 5-HTP injections on calcium homeostasis in the goat mammary glands. In the in vivo experiment, 30 multiparous Guanzhong dairy goats were randomly assigned to 2 groups, one group was injected with 5-HTP intramuscularly and the other group was injected with normal saline. From the first 10 d of the expected date for delivery, 5-HTP or saline was injected into goats through the shoulder muscle every morning before feeding, with a dose of 1 mg/kg per body weight. In the in vitro experiment, goat mammary epithelial cells (GMEC) were treated with 100 μM 5-HT for the evaluation of 5-HT in calcium transportation. The results demonstrated that 5-HTP treatment had no effect on the basic composition of colostrum (P > 0.05) but increased the serum 5-HT concentrations on days −5, −4, −3, and 5 relative to parturition (P < 0.05). The 5-HTP injection group had greater serum calcium concentration on day 4 and greater serum parathyroid hormone-related protein (PTHrP) on days −5, −4, −1, 3, 4, and 5 compared with the saline injection group (P < 0.05). It was further confirmed that 5-HT could increase intracellular calcium levels by increasing PTHrP and decreasing plasma membrane Ca2+-ATPases1 (PMCA1) in GMEC (P < 0.05). In conclusion, 5-HTP treatment in multiparous goats during the transition period from pregnancy to lactation is a feasible way to protect goats from calcium metabolism disorder.
Are amphipodsOrchestia grillus(Bosc, 1802) (Amphipoda: Talitridae) infected with the trematodeLevinseniella byrdi(Heard, 1968) drawn to the light?
Authors: Johnson David S
Published: March 2022

A parasite can change its host’s behavior in spectacular ways. When the saltmarsh amphipod Orchestia grillus (Bosc, 1802) is infected with the trematode Levinseniella byrdi (Heard, 1968) it is bright orange and is found in the open unlike uninfected individuals. I tested the hypothesis that infected amphipods are found in the open because L. byrdi reverses their innate photophobia. During daytime treatments and when placed in a dark chamber, 0% of the uninfected and 20% of the infected amphipods, on average, moved to the light chamber after 30 minutes. When placed in a light chamber, 91% of the uninfected and 53% of the infected amphipods, on average, went to the dark side after 30 minutes. These results clearly indicate that O. grillus is normally photophobic, but not drawn to light when infected with L. byrdi. Instead, L. byrdi appears to neutralize the amphipod’s photophobia. Uninfected O. grillus are typically found under vegetation. I hypothesize that O. grillus with L. byrdi infections wander into open, unvegetated habitats randomly. In addition, 94% of infected amphipods could be touched by a finger in the field suggesting they can be easily caught by predators. Levinseniella byrdi infects at least three other amphipod hosts, Chelorchestia forceps (Smith & Heard, 2001), Uhlorchestia spartinophila (Bousfield & Heard, 1986), and U. uhleri (Shoemaker, 1930). The parasite-manipulation hypothesis suggests that the parasite-induced changes (conspicuous body color and neutralized light response) are adaptive for L. byrdi to make amphipod hosts more susceptible to bird predators, the definitive hosts. This hypothesis remains to be tested.
De novo cloning and functional characterization of potassium channel genes and proteins in the crayfish Astacus leptodactylus (Eschscholtz, 1823) (Decapoda: Astacidea: Astacidae)
Authors: Ergin Bora , Saglam Berk , Taskiran Ekim Z , Bastug Turgut , Purali Nuhan
Published: March 2022

Current knowledge about the molecular properties of the crustacean ion channels is rather limited even if crustaceans have been widely used as a model in neuroscience. We cloned for the first time two different potassium channel genes from the freshwater crayfish Astacus leptodactylus (Eschscholtz, 1823), one of the genes functionally expressed in the Xenopus oocytes. The open-reading frames of the genes were 1,203 and 3,447 bp, respectively. The nucleic acid sequence of the genes and associated proteins were similar to those of a typical potassium channel. BLAST analyses indicated that one of the cloned genes had a substantial similarity to an inward-rectifier potassium channel whereas the other gene was similar to a high-conductance-KCa type potassium channel reported in related species. Transmembrane topology and three-dimensional structure of the coded proteins were calculated and functional regions of the channel proteins responsible for ion selectivity, voltage sensing, gating, and calcium binding were identified. One of the cloned channel genes has been expressed in the Xenopus oocytes. Analysis of the expressed potassium currents confirmed that the cloned gene was coding a typical Kir-type potassium channel with ATP sensitivity.
Final report on plasma ctDNA T790M monitoring during EGFR-TKI treatment in patients with EGFR mutant non-small cell lung cancer (JP-CLEAR trial)
Authors: Naka Go , Yokoyama Takuma , Usui Kazuhiro , Ishida Hiroo , Kishi Kazuma , Uemura Kohei , Ohashi Yasuo , Kunitoh Hideo
Published: March 2022

Osimertinib is active against T790M-positive epidermal growth factor receptor mutant non-small cell lung cancer. We enrolled 122 sensitive epidermal growth factor receptor mutant non-small cell lung cancer patients who were planned to receive or were receiving first-/second-generation epidermal growth factor receptor tyrosine kinase inhibitors without disease progression and monitored plasma T790M every 1–2 months using the cobas® EGFR Mutation Test v2. We previously reported the concordance between T790M status in plasma and tissue. This is the final report on the sensitivity of plasma T790M and the efficacy of sequential osimertinib. The sensitivity was 21.1% (95% confidence interval: 6.1–45.6%). The best overall response was 25.0% (95% confidence interval: 9.8–46.7) in the plasma T790M-positive group and 28.6% (95% confidence interval: 8.4–58.1) in the plasma T790M-negative but tissue T790M-positive group. Median progression-free survival was 7.9 months (95% confidence interval: 4.7–17.5) for the former and 4.4 months (95% confidence interval: 3.0–N.E.) for the latter, with no statistically significant difference (P = 0.74).
Forest Contracting Businesses in the US Southwest: Current Profile and Workforce Training Needs
Authors: Vaughan Damon , Edgeley Catrin , Han Han-Sup
Published: March 2022

We surveyed forestry contractors in three sectors (logging, mastication, and trucking) across the states of Arizona, New Mexico, and Colorado. Our survey sought to gather current demographic and background information on contractors as well as establish how a forest operations training center might address their employee training needs. Most of the businesses surveyed were small, with owner ages tending to be high (over 50) but employee ages much lower (under 40). Finding skilled workers was identified as the greatest barrier to success by the respondents, underscoring the need for more training opportunities. The majority of respondents (86%) did not have access to any external training programs. Survey results indicated a high demand for training programs for forestry contractors in the Southwest, which could play a vital role for the region to achieve landscape-scale forest restoration goals.
Spatial patterns and determinants of Moraceae richness in China
Authors: Wang Hua-Feng , Xu Xiaoting , Cheng Xia-Lan , Liu Yunpeng , Luo Ao , Lyu Tong , Wang Wen-Long , Nizamani Mir Muhammad , Wang Zhiheng
Published: March 2022

Understanding large-scale patterns of biodiversity and their drivers remains central in ecology. Many hypotheses have been proposed, including hydrothermal dynamic hypothesis, tropical niche conservatism hypothesis, Janzen’s hypothesis and a combination model containing energy, water, seasonality and habitat heterogeneity. Yet, their relative contributions to groups with different lifeforms and range sizes remain controversial, which have limited our ability to understand the general mechanisms underlying species richness patterns. Here we evaluated how lifeforms and species range sizes influenced the relative contributions of these three hypotheses to species richness patterns of a tropical family Moraceae. The distribution data of Moraceae species at a spatial resolution of 50 km × 50 km and their lifeforms (i.e. shrubs, small trees and large trees) were compiled. The species richness patterns were estimated for the entire family, different life forms and species with different range sizes separately. The effects of environmental variables on species richness were analyzed, and relative contributions of different hypotheses were evaluated across life forms and species range size groups. The species richness patterns were consistent across different species groups and the species richness was the highest in Sichuan, Guangzhou and Hainan provinces, making these provinces the hotspots of this family. Climate seasonality is the primary factor in determining richness variation of Moraceae. The best combination model gave the largest explanatory power for Moraceae species richness across each group of range size and life forms followed by the hydrothermal dynamic hypothesis, Janzen’s hypothesis and tropical niche conservatism hypothesis. All these models has a large shared effects but a low independent effect (< 5%), except rare species. These findings suggest unique patterns and mechanisms underlying rare species richness and provide a theoretical basis for protection of the Moraceae species in China.
Turbulent magnetic fields in merging clusters: a case study of Abell 2146
Authors: Chadayammuri Urmila , ZuHone John , Nulsen Paul , Nagai Daisuke , Russell Helen
Published: March 2022

Kelvin–Helmholtz instabilities (KHI) along contact discontinuities in galaxy clusters have been used to constrain the strength of magnetic fields in galaxy clusters, following the assumption that, as magnetic field lines drape around the interface between the cold and hot phases, their magnetic tension resists the growth of perturbations. This has been observed in simulations of rigid objects moving through magnetized media and sloshing galaxy clusters, and then applied in interpreting observations of merger cold fronts. Using a suite of magnetohydrodynamic (MHD) simulations of binary cluster mergers, we show that even magnetic field strengths stronger than yet observed (β = Pth/PB = 50) show visible KHI features. This is because our initial magnetic field is tangled, producing Alfvén waves and associated velocity fluctuations in the intracluster medium (ICM); stronger initial fields therefore seed larger fluctuations, so that even a reduced growth rate due to magnetic tension produces a significant KHI. The net result is that a stronger initial magnetic field produces more dramatic fluctuations in surface brightness and temperature, not the other way around. We show that this is hard to distinguish from the evolution of turbulent perturbations of the same initial magnitude. Therefore, in order to use observations of KHI in the ICM to infer magnetic field strengths by comparing to idealized simulations, the perturbations that seed the KHI must be well understood and (if possible) carefully controlled.
Fast radio bursts as probes of feedback from active galactic nuclei
Authors: Batten Adam J , Duffy Alan R , Flynn Chris , Gupta Vivek , Ryan-Weber Emma , Wijers Nastasha
Published: March 2022

Fast radio bursts (FRBs) are a promising tool for studying the low-density universe as their dispersion measures (DM) are extremely sensitive probes of electron column density. Active galactic nuclei (AGN) inject energy into the intergalactic medium, affecting the DM and their scatter. To determine the effectiveness of FRBs as a probe of AGN feedback, we analysed three different AGN models from the EAGLE simulation series. We measured the mean DM–redshift relation, and the scatter around it, using 2.56 × 108 sightlines at 131 redshift (z) bins between 0 ≤ z ≤ 3. While the DM–redshift relation itself is highly robust against different AGN feedback models, significant differences are detected in the scatter around the mean: weaker feedback leads to more scatter. We find that ∼104 localized FRBs are needed to discriminate between the scatter in standard feedback and stronger, more intermittent feedback models. The number of FRBs required is dependent on the redshift distribution of the detected population. A lognormal redshift distribution at z = 0.5 requires approximately 50 per cent fewer localized FRBs than a distribution centred at z = 1. With the Square Kilometre Array expected to detect >103 FRBs per day, in the future, FRBs will be able to provide constraints on AGN feedback.
Comparable efficacy of denosumab and romosozumab in patients with rheumatoid arthritis receiving glucocorticoid administration
Authors: Kobayakawa Tomonori , Miyazaki Akiko , Kanayama Yasuhide , Hirano Yuji , Takahashi Jun , Suzuki Takako , Nakamura Yukio
Published: March 2022

Objectives

Romosozumab is a newly released and widely known molecular-targeted drug for severe osteoporosis treatment with comparable effectiveness to denosumab. However, there have been no reports discussing the efficacy of those treatments for rheumatoid arthritis (RA) patients, especially those receiving glucocorticoids. This retrospective observational registry study compared the efficacy of 12-month treatment of denosumab and romosozumab in RA patients under the influence of glucocorticoid intake.

Methods

Following propensity score matching, 36 patients each in the denosumab and romosozumab groups were analysed in this study. Drug effectiveness was evaluated by measuring bone mineral density (BMD) at the lumbar spine, total hip, and femoral neck at baseline, 6 and 12 months as well as alterations in P1NP, TRACP-5b, and simplified disease activity index (SDAI). The occurrence of adverse events and new fractures was also assessed.

Results

At 12 months of treatment, BMD at the lumbar spine was increased by 7.5% in the denosumab group and 8.7% in the romosozumab group, which were both significantly and comparably elevated over baseline. At the total hip and femoral neck, romosozumab tended to exhibit favourable efficacy to increase BMD versus denosumab. Both P1NP and TRACP-5b were significantly lower in the denosumab group as compared with the baseline. Conversely in the romosozumab group, P1NP was increased over baseline, while TRACP-5b was decreased. Regarding SDAI alterations, both the romosozumab and denosumab groups exhibited comparable improvements in RA disease activity over time during treatment. Recorded adverse events and new fractures during treatment were few and minor in both groups.

Conclusions

Romosozumab exhibited comparable efficacy to denosumab for increasing BMD even under the influence of glucocorticoids for treating RA. Both drugs may be therefore suitable for managing osteoporosis in patients with RA and glucocorticoid intake.
Safe surgery for glioblastoma: Recent advances and modern challenges
Authors: Gerritsen Jasper Kees Wim , Broekman Marike Lianne Daphne , De Vleeschouwer Steven , Schucht Philippe , Nahed Brian Vala , Berger Mitchel Stuart , Vincent Arnaud Jean Pierre Edouard
Published: March 2022

One of the major challenges during glioblastoma surgery is balancing between maximizing extent of resection and preventing neurological deficits. Several surgical techniques and adjuncts have been developed to help identify eloquent areas both preoperatively (fMRI, nTMS, MEG, DTI) and intraoperatively (imaging (ultrasound, iMRI), electrostimulation (mapping), cerebral perfusion measurements (fUS)), and visualization (5-ALA, fluoresceine)). In this review, we give an update of the state-of-the-art management of both primary and recurrent glioblastomas. We will review the latest surgical advances, challenges, and approaches that define the onco-neurosurgical practice in a contemporary setting and give an overview of the current prospective scientific efforts.
Bound states in the continuum based on the total internal reflection of Bloch waves
Authors: Hu Peng , Xie Chongwu , Song Qianju , Chen Ang , Xiang Hong , Han Dezhuan , Zi Jian
Published: March 2022

A photonic-crystal slab can support bound states in the continuum (BICs) that have infinite lifetimes but are embedded into the continuous spectrum of optical modes in free space. The formation of BICs requires a total internal reflection (TIR) condition at both interfaces between the slab and the free space. Here, we show that the TIR of Bloch waves can be directly obtained based on the generalized Fresnel equations proposed. If each of these Bloch waves picks up a phase with integer multiples of 2π for traveling a round trip, light can be perfectly guided in the slab, namely forming a BIC. A BIC solver with low computational complexity and fast convergence speed is developed, which can also work efficiently at high frequencies beyond the diffraction limit where multiple radiation channels exist. Two examples of multi-channel BICs are shown and their topological nature in momentum space is also revealed. Both can be attributed to the coincidence of the topological charges of far-field radiations from different radiation channels. The concept of the generalized TIR and the TIR-based BIC solver developed offer highly effective approaches for explorations of BICs that could have many potential applications in guided-wave optics and enhanced light–matter interactions.
Smokers Increasingly Motivated and Able to Quit as Smoking Prevalence Falls: Umbrella and Systematic Review of Evidence Relevant to the “Hardening Hypothesis,” Considering Transcendence of Manufactured Doubt
Authors: Harris Miranda , Martin Melonie , Yazidjoglou Amelia , Ford Laura , Lucas Robyn M , Newman Eryn , Banks Emily
Published: March 2022

Introduction

The “hardening hypothesis” proposes that as the prevalence of smoking in a population declines, there will be a “hardening” of the remaining smoker population. This review examines the evidence regarding smokers’ motivation, dependence, and quitting behavior as smoking prevalence declines, to assess whether population “hardening” (decreasing propensity to quit) or “softening” (the converse) is occurring.

Methods

MEDLINE, PsychINFO, Scopus, Web of Science, and Cochrane Library were searched to July 2019, using terms related to smoking and hardening, for reviews and large, population-based repeat cross-sectional studies. There were additional searches of reference lists and citations of key research articles. Two reviewers screened half the titles and abstracts each, and two reviewers screened full texts independently using tested criteria. Four reviewers independently and systematically extracted data from eligible publications, with one reviewer per study, checked by another reviewer.

Results

Of 265 titles identified, three reviews and ten repeat cross-sectional studies were included. Reviews concluded that hardening has not occurred among the general smoking population over time. Among repeated cross-sectional studies, five examined motivation, nine examined dependence, five examined hardcore smoking, and two examined quit outcomes. All but one study found a lack of hardening. Most found softening within the smoking population, consistent across hardening indicators, definitions, countries (and tobacco control environments), and time periods examined.

Conclusions

Tobacco control reduces smoking prevalence and fosters a smoking population more amenable to evidence-based interventions. Based on the weight of the available evidence, the “hardening hypothesis” should be rejected and the reality of softening accepted.

Implications

This umbrella review and systematic review provides a critical consideration of evidence from epidemiology and psychology and other fields regarding the “hardening hypothesis”—a persistent myth undermining tobacco control. It reaches the conclusion that the sum-total of the worldwide evidence indicates either “softening” of the smoking population, or a lack of hardening. Hence, tobacco control reduces smoking prevalence and fosters a smoking population more amenable to evidence-based interventions. The review indicates that the time has come to take active steps to combat the myth of hardening and to replace it with the reality of “softening.”
Immediate Hypersensitivity to Fluoroquinolones:  A Cohort Assessing Cross-Reactivity
Authors: Azimi Sara F , Mainella Vincent , Jeffres Meghan N
Published: March 2022

Background

Fluoroquinolones are the second-most prescribed antimicrobial and are frequently associated with causing hypersensitivity reactions. Existing evidence regarding cross-reactivity of fluoroquinolones is limited, offering clinicians little guidance in understanding the implications of selecting an in-class alternative among patients with histories of allergic reactions to fluoroquinolones. The aim of this study was to compare the frequency of immediate hypersensitivity reactions to ciprofloxacin, levofloxacin, and/or moxifloxacin among patients with a history of immediate hypersensitivity to a different fluoroquinolone.

Methods

This retrospective chart review included adult patients with a history of an immediate hypersensitivity reaction to ciprofloxacin, levofloxacin, and/or moxifloxacin and a documented prescription for a different fluoroquinolone. The primary outcome was documentation of a hypersensitivity reaction upon second fluoroquinolone exposure.

Results

A total of 321 cases met inclusion criteria. Of these cases, 2.5% experienced an immediate hypersensitivity reaction after second fluoroquinolone exposure to ciprofloxacin, levofloxacin, and/or moxifloxacin. Within the ciprofloxacin, levofloxacin, and moxifloxacin index allergy cohorts, the frequency of cross-reactivity was 2.5%, 2.0%, and 5.3%, respectively.

Conclusions

Our data suggest that patients with a history of immediate hypersensitivity reaction to ciprofloxacin, levofloxacin, and/or moxifloxacin are at low risk of experiencing a cross-reaction when exposed to a different fluoroquinolone. Avoidance of all fluoroquinolones in this patient population may not be warranted.
Late Cretaceous Metamorphism and Anatexis of the Gangdese Magmatic Arc, South Tibet: Implications for Thickening and Differentiation of Juvenile Crust
Authors: Ding Huixia , Zhang Zeming , Palin Richard M , Kohn Matthew J , Niu Zhixiang , Chen Yanfei , Qin Shengkai , Jiang Yuanyuan , Li Wentan
Published: March 2022

Magmatic arcs are the primary sites of growth of post-Archean continental crust; however, the mechanisms and processes for transforming primary arc crust into mature continental crust are subject to disagreement. We conducted a detailed petrologic and geochronological study on mafic and felsic migmatites from the eastern Gangdese magmatic arc, which is typical of continental arcs worldwide. The studied mafic migmatites contain amphibole, garnet, plagioclase, epidote, white mica, quartz, rutile and ilmenite in melanosomes, and plagioclase, garnet, epidote, amphibole, white mica, and quartz in leucosomes. The leucosomes occur as diffuse patches, concordant bands, or concordant and discordant networks and veins in the melanosomes. The migmatites have protolith ages between ~157 and ~86–87 Ma, and metamorphic ages of ~83–87 Ma and underwent high-pressure granulite-facies metamorphism at peak P–T conditions of ~850–880°C and 15–17 kbar. Heating, burial, and associated partial melting preceded near-isobaric cooling with residual melt crystallization. Significant melt (>16 wt.%) generated during heating and loading had a granitic composition. Compositional comparison to low-grade meta-gabbros implies that any extracted melt had adakitic affinities (high Sr/Y and highly fractionated REE patterns). The eastern Gangdese magmatic arc experienced crustal thickening during Late Cretaceous late-stage evolution of the arc due to magma loading and tectonic shortening and thrusting of the arc crust. Crustal thickening and chemical differentiation of the Gangdese arc occurred during late subduction of the Neo-Tethys, prior to the India–Asia collision. Metamorphism nearly completely erased all prior igneous mineralogy and mineral chemistry, and consequent partial melting represents a potential source for Late Cretaceous granitoids of the upper arc crust. Although prior studies demonstrate the significance of fractional crystallization, deep-seated metamorphic processes largely drove chemical differentiation to produce mature continental crust in the Gangdese arc during the late Cretaceous.
Small is beautiful: climate-change science as if people mattered
Authors: Rodrigues Regina R , Shepherd Theodore G
Published: March 2022

There is a widely accepted gap between the production and use of climate information. It is also widely accepted that at least part of the reason for this situation lies in the challenge of bridging between what may be characterized as ‘‘top-down’’ approaches to climate information on the global scale, and local decision contexts, which necessarily take a ‘‘bottom-up’’ perspective, in which climate change is just one factor among many to consider. We here reflect on the insights provided in a different context—that of economics—by E.F. Schumacher in his celebrated book Small is Beautiful (1973), to see what light they might shed on this challenge, with a focus on climate-change science for adaptation. Schumacher asked how economics might look if it was structured “as if people mattered”. We ask the same question of climate-change science, and find many parallels. One is the need to grapple with the complexity of local situations, which can be addressed by expressing climate knowledge in a conditional form. A second is the importance of simplicity when dealing with deep uncertainty, which can be addressed through the use of physical climate storylines. A third is the need to empower local communities to make sense of their own situation, which can be addressed by developing ‘‘intermediate technologies’’ that build trust and transparency. Much of climate-change science is necessarily big science. We argue that in order to make climate information useable for adaptation, it is also necessary to discover the beauty of smallness.
Are Perineal Massage and Instrument-Assisted Perineal Stretching With Short Protocol Effective for Increasing Pelvic Floor Muscle Extensibility? A Randomized Controlled Trial
Authors: Cabral Alana Leandro , de Freitas Síssi Sisconeto , Pinto Rogério de Melo Costa , Resende Ana Paula Magalhães , Pereira-Baldon Vanessa Santos
Published: March 2022

Objective

The purpose of this study was to compare (1) the effects of the instrument-assisted perineal stretching technique with different application protocols in combination with perineal massage and (2) the effects of the isolated techniques on the extensibility and strength of the pelvic floor muscles (PFMs).

Methods

A randomized controlled clinical trial with parallel randomization, assessor blinding, and concealed allocation was conducted in the Campus Physical Education at the Federal University of Uberlândia in Brazil. Ninety-six pregnant women (18–40 years of age) were allocated into 4 groups: perineal massage (PnM) group (PnM protocol for 10 minutes); instrument-assisted perineal stretching with a long static protocol for 15 minutes [IStrLS group]); PnM + IStrLS group (both techniques applied in the 2 previous groups); and PnM + IStrSR group (the same techniques as used in the PnM + IStrLS group but with a short repeated protocol; 4 sets lasting 30 seconds each). Eight interventions were performed in all 4 groups twice weekly (beginning at the 34th gestational week). The primary outcome was PFM extensibility, assessed using vaginal dilator circumference, and the secondary outcome was PFM strength, assessed using vaginal manometry.

Results

For the PFM extensibility variable, a significant main effect of time (F2,88 = 87.951) and group (F3,88 = 7.193) was found. Tukey post hoc test results showed that the PnM + IStrSR group presented greater extensibility than the PnM and IStrLS groups. The PnM group showed increased PFM strength after 8 sessions compared with the other groups.

Conclusions

Women who were pregnant and received the combination of perineal massage and instrument-assisted perineal stretching with short repeated application had a greater increase in PFM extensibility than perineal massage and instrument-assisted perineal stretching alone.

Impact

The combination of perineal massage and instrument-assisted perineal stretching techniques with a short, repeated protocol led to better PFM extensibility results than the application of the techniques alone in women who were pregnant.

Lay summary

Pregnant women can benefit from intervention using the combination of perineal massage and instrument-assisted perineal stretching techniques with a short, repeated protocol.
DESIGN, COMMISSIONING AND OPERATION OF PROGRAMMABLE DRAINAGE SYSTEM FOR PET-CT: AN OPTIMIZED APPROACH TO PROTECT PERSONNEL AND ENVIRONMENT IN NUCLEAR MEDICINE FACILITIES
Authors: Elashmawy Mostafa M
Published: March 2022

Nuclear medicine facilities are considered one of the most important practices associated with potential radiological risks to personnel and the environment due to the significant amounts of solid and liquid radioactive waste generated from these facilities. Whenever possible and applicable, the licensee shall apply the most up-to-date technological advances to ensure that such radioactive waste is safely discharged to the public sewage. To date, there is no specific technical safety requirement endorsed by regulatory body in Egypt regarding drainage system design for nuclear medicine facilities. This paper discusses the design, commissioning and operation of a programmable drainage system in a Positron Emission Tomography/Computed Tomography (PET-CT) unit for collecting and draining sewage contaminated with the radioactive isotope 18F. The system operates automatically without the need for human intervention. The system has been tested using clean water and found to be working efficiently in accordance with the design parameters. The proposed system concept can be applied in other nuclear medicine facilities after scaling it up/down according to all radionuclides in use and the expected volume of associated radioactive waste. Based on the system’s demonstrated performance, regulatory bodies are highly recommended to embrace such approach as a safety requirement to assist the licensees in complying with the safety standards during the planning and construction of PET-CT facilities.
Birth of the Russian Patient: Somatic Modes of Attention and the Embodied Self in a Mid-Eighteenth-Century Russian Diary
Authors: Pirogovskaya Maria
Published: March 2022

Research into the history of doctor–patient relations or into the sick person’s perspective on treatment and prophylaxis never ceases to enrich or even undermine existing theoretical approaches to the experience of illness. Ego-documents created by ‘sick-men’ in early modern Europe demonstrate complex patient behaviour that resembled neither the active ‘patient–consumer’ of the post-war period nor the ideal type of the passive ‘patient–sufferer’ of the nineteenth century. This article contributes to the scholarly discussion on illness experience, the history of the body and subjectivity by analysing unique eighteenth-century sources from the Russian archives. A comparative analysis of the self-account of a sick-person during the early period of the dissemination of learned medicine in imperial Russia reveals both expertise and personal reflection, and the role both ego-documents and printed calendars play in shaping self-observation skills.
An explorative digital tool as a pathway to meaning: the case of the inflection point
Authors: Kouropatov Anatoli , Ovodenko Regina
Published: March 2022

The learning of calculus concepts is considered challenging for students. This claim is actual for calculus in general and for specific concepts in particular. In this paper, we focus on the concept of the inflection point. We argue that one of the roots of this problem is the lack of a useful and productive meaning of the concept—the understanding of the inflection point as the point where the behaviour of a curve (graph of function) changes in relation to the tangent line. With the purpose of helping students to construct this meaning we developed a specific digital tool: a teaching unit based on the interactive diagrams framework. Does this tool help students to achieve this meaning (i.e., to construct and consolidate new knowledge)? To answer this question, we conducted an empirical feasibility experiment (in the form of a case study with two first-year students from the Industrial Engineering College) and analysed the gathered data using the framework of abstraction in context as the theoretical and methodological basis. Our findings show that the designed tool (the interactive digital teaching unit) has potential for helping students to make the above-mentioned meaning for this mathematical concept and can serve as a useful basis to continue the investigation of designing tools that support the meaning-making of advanced mathematical concepts.
Critical Care in Obstetrics: A Strategy for Addressing Maternal Mortality
Authors: Padilla C. , Markwei M. , Easter S.R. , Fox K.A. , Shamshirsaz A.A. , Foley M.R.
Published: March 2022

(Am J Obstet Gynecol. 2021;224:567–573)

Given a 200% increase from 1993 to 2014 of severe maternal morbidity, it is imperative to look for mechanisms to decrease risk and possible associated maternal deaths. For the estimated 1 to 3 percent of all obstetrical patients who require intensive care unit (ICU) level care, best outcomes are achieved when a collaborative care model utilizing intensivists and maternal fetal medicine (MFM) specialists is possible. However, with an increasingly more complicated obstetrical population and no concomitant rise in MFM specialists there is an important role for broadening the skill sets for health care providers and resources for facilities that are lacking in advanced care. The authors suggest that using evidence-based tools for patient risk stratification, rapid diagnosis of life-threatening conditions, access to consultation by critical care specialists and better education regarding critical care for all obstetrical providers would lead to less maternal morbidity and mortality. The focus of the authors’ clinical opinion was to evaluate the best screening tools for high risk obstetrical patients as well as advocating for more critical care resource accessibility on Labor and Delivery.
Liver and Biliary Disease of Pregnancy and Anesthetic Implications: A Review
Authors: Hansen J.D. , Perri R.E. , Riess M.L.
Published: March 2022

(Anesth Analg. 2021;133:80–92)

Liver and biliary diseases complicate approximately 3% of pregnancies and influence anesthesia care. This review aims to help clinicians identify and treat liver dysfunction in parturients; review disease processes and their differential diagnoses in the context of pregnancy; and highlight the effects of liver and biliary disease on anesthetic care of parturients.
mRNA Covid-19 Vaccines in Pregnant Women
Authors: Riley L.E.
Published: March 2022

(N Engl J Med. 2021;384:2342–2343)

Pregnant women were not included in initial trials for the Moderna and Pfizer-BioNTech messenger RNA (mRNA) vaccines for coronavirus disease 2019 (Covid-19), but were among the first persons eligible to receive the vaccines under an Emergency Use Authorization.
Pregnant Women With Substance Use Disorders: The Harm Associated With Punitive Approaches
Authors: Haffajee R.L. , Faherty L.J. , Zivin K.
Published: March 2022

(N Engl J Med. 2021;384:2364–2367)

In the United States, a plan has been issued to reduce maternal mortality. An estimated 8.2% of pregnancy-related deaths involve substance use disorders (SUDs), as reported in a 2017 study. Between 2006 and 2017, the proportion of pregnancies in women with SUDs rose from 3.6% to 7.4%.
Evidence From New York: Perinatal Insurance Expansions as a Lever to Address Maternal Morbidity
Authors: Admon L.K. , Daw J.R.
Published: March 2022

(Anesth Analg. 2021;133:338–339)

Severe maternal morbidity (SMM), which has been increasing in the United States, is an unexpected labor complication that can cause devastating maternal and neonatal outcomes. SMM especially impacts low-income and racial/ethnic groups. A study by Guglielminotti et al found the 2014 New York State Medicaid expansion was significantly associated with decreased SMM, especially for low-income women.
Point-of-Care Lung Ultrasound Pattern in Healthy Parturients: Prevalence of Pulmonary Interstitial Syndrome Following Vaginal Delivery, Elective and Unplanned Intrapartum Cesarean Delivery
Authors: Macias P. , Wilson J.G. , Austin N.S. , Guo N. , Carvalho B. , Ortner C.M.
Published: March 2022

(Anesth Analg. 2021;133:739–746. doi: 10.1213/ANE.0000000000005464)

The risk of pulmonary edema for parturient women increases near term, and factors during and post labor lead to even greater risk of pulmonary edema in the early postpartum period. Lung ultrasound (LUS) is a tool that helps to diagnose pulmonary edema earlier. Data on the effect of labor and early postpartum fluid shifts and hormonal changes on the occurrence of pulmonary interstitial syndrome is unknown. This exploratory study seeks to estimate the prevalence of pulmonary interstitial syndrome following vaginal delivery (VD), elective cesarean delivery (eCD), and unplanned intrapartum cesarean delivery (uCD). Secondary aims of the study include finding associations between positive lung regions found on lung ultrasound and several variables (eg, mode of delivery, duration) and estimating the prevalence of positive lung regions.
Major Adverse Cardiovascular Events and Anaesthetic Management in Pregnant Women in Cardiac Disease: A Retrospective, Single-center Study
Authors: Roue M. , Lung B. , Bourgeois-Moine A. , Montravers P. , Kantor E.
Published: March 2022

(Br J Anaesth. 2021;127:e8–e10. doi: 10.1016/j.bja.2021.03.032. Epub May 7, 2021)

Pregnancies in women with cardiac disease are on the rise in Western countries, in part due to older maternal ages, an increase in cardiovascular risk factors, and advances in care for patients with congenital heart disease. Cardiovascular disease is associated with increased risk of maternal morbidity and mortality. Cardiovascular issues are the leading cause of maternal death during pregnancy in the United States, representing more than a quarter of cases. Managing care for pregnant patients with cardiovascular disease or cardiovascular physiological adaptations in pregnancy can be challenging for anesthesiologists, and there are few recent data to guide them.
Cardiovascular Severe Maternal Morbidity in Pregnant and Postpartum Women: Development and Internal Validation of Risk Prediction Models
Authors: Malhamé I. , Danilack V.A. , Raker C.A. , Hardy E.J. , Spalding H. , Bouvier B.A. , Hurlburt H. , Vrees R. , Savitz D.A. , Mehta N.
Published: March 2022

(BJOG. 2021;128:922–932. doi: 10.1111/1471-0528.16512. Epub November 4, 2020)

Cardiovascular diseases are a leading cause of maternal mortality. Severe maternal morbidity can drastically reduce quality of life, increase hospital lengths of stay, adversely impact finances, and lead to maternal mortality. Thus, it is critical to identify women at high risk for cardiovascular severe maternal morbidity (CSMM) during pregnancy and postpartum and develop strategies to mitigate its adverse effects. This study aims to create and validate risk prediction models so high-risk women can be more accurately identified.
Pregnancy-specific Continuous Reference Intervals for Haematology Parameters from an Australian Dataset: A Step Toward Dynamic Continuous Reference Intervals
Authors: Markus C. , Flores C. , Saxon B. , Osborn K.
Published: March 2022

(Aust N Z J Obstet Gynaecol. 2021;61:223–231)

Reference intervals (RIs) in pregnancy are usually only reported in terms of trimesters or for specific weeks gestational age. RIs are also usually treated in a static manner, while pediatric growth charts and now fetal growth charts use smoothed centile curves to detect growth issues. This study aimed to derive continuous centile curves for 6 hematological parameters in pregnancy and compare the indirect RIs from those curves to previously published direct RIs.