bluuebunny/crossref_metadata_2025 huggingface dataset:
Health-Related Difficulty in Internet Use Among Older Adults: Correlates and Mediation of Its Association With Quality of Life Through Social Support Networks
Authors: Ang Shannon , Lim Emily , Malhotra Rahul
Published: July 2020

Background and Objectives

Internet use is increasingly a necessity. However, older adults may not use the internet due to either nonhealth reasons (e.g., lack of digital literacy or internet access) or health-related reasons (e.g., visual impairment or movement difficulties). While researchers have studied internet use among older adults, most do not discriminate whether nonuse is due to health-related reasons or otherwise. We therefore examine the key correlates of health-related difficulty in internet use among older adults, and how it may affect the quality of life (QoL) through their perceived social support networks.

Research Design and Methods

Data were from a national survey of older Singaporeans (N = 3,966) conducted in 2016–2017. Multinomial logistic regression and mediation analysis were used to identify older adult subgroups more likely to experience health-related difficulty in internet use, and whether such difficulty affected older adults’ QoL through their social support networks.

Results

Those of male gender, of Malay ethnicity, with less education, and with more instrumental activity of daily living limitations were more likely to experience health-related difficulty in internet use. Social support networks mediated the relationship between health-related difficulty in internet use and QoL.

Discussion and Implications

Disparities in internet use are not just shaped by access or skill, but also health. Health-related difficulties in internet use are related to older adults’ social support networks and quality of life. As social connections become increasingly based around networked individuals due to technological advancements, more attention should be given to addressing these health-related difficulties.
The value of commercial fish size distribution recorded at haul by haul compared to trip by trip
Authors: Plet-Hansen Kristian S , Bastardie François , Ulrich Clara
Published: July 2020

Data from commercial fishing vessels may enhance the range of observations available for monitoring the marine environment. However, effort and catch data provide information on fish distribution with a bias due to spatial targeting and selectivity. Here, we measured the shortcomings of standard fishery-dependent data and advocate for the utilization of more precise datasets indirectly collected by the commercial fishery. Data from a Danish traceability system, which records size of commercial fish at the haul level, are held against the set-up of current eLog and sales slips’ data collected for the Danish fisheries. We showed that the most accurate mapping of the spatial distribution of catches per size group is not only possible through size records collected at the haul level but also by high resolution on fishing effort data. In Europe, the regulation to land all catches with a quota or minimum size limit, including unwanted, has increased the focus on avoidance and discards; we show the potential of such data sources to inform on fish abundance and distribution, especially of importance where fishery-dependent data are the only source of information.
Research on battery pack dynamic equalization technology with improved flying capacitor
Authors: Chen Huang
Published: July 2020

Aiming at the problem that the traditional flying capacitor equalization circuit has long equilibrium time and complicated structure, based on the in-depth study of the existing capacitor equalization method, this paper proposes a bidirectional DC-DC equalization circuit topology based on switch matrix. Structure, improve circuit switch network structure, reduce the number of switches and capacitors in the circuit, simplify the equalization structure, combined with the advantages of bidirectional DC-DC converters can be used in both directions, according to the difference between the average voltage of the battery pack and the voltage of each cell. Any two cells in the battery pack areused for equalization purposes. By establishing an experimental test platform verification, the results show that the topology can reduce the equalization time under the premise of simplifying the circuit structure when equalizing any two cells.
Evaluation of an Electrochemiluminescent SARS-CoV-2 Antibody Assay
Authors: Lau C S , Hoo S P , Yew S F , Ong S K , Lum L T , Heng P Y , Tan J G , Wong M S , Aw T C
Published: July 2020

Background

Little is known about the performance of the Roche novel severe acute respiratory syndrome coronavirus 2 antibody (anti-SARS-CoV-2) assay. We provide an extensive evaluation of this fully automated assay on Cobas e801/e602 immunoassay analyzers.

Methods

We assessed the linearity, precision, and throughput of the Roche anti-SARS-CoV-2 assay. Sensitivity was calculated from 349 SARS-CoV-2 polymerase chain reaction (PCR) positive samples; specificity was determined from 715 coronavirus disease 2019 (COVID-19)-naive samples. We examined cross-reactivity against other antibody positive samples [syphilis, rheumatoid factor (RF), antinuclear antibody (ANA), double-stranded DNA (ds-DNA), influenza, dengue, hepatitis B (HBV), hepatitis C (HCV)] and the anti-SARS-CoV-2 kinetics.

Results

The assay cut-off index (COI) was linear up to 90.8. The interassay precision was 2.9% for a negative control (COI = 0.1) and 5.1% for a positive control (COI = 3.0). Assay time is 18 min and results are available 1 min later; throughput for 300 samples was 76 min. Only 1 case positive for HBsAg tested falsely positive; specificity was 99.9%. The assay has a sensitivity of 97.1% 14 days after PCR positivity (POS) and 100% at ≥21 days POS; 48.2% of cases had anti-SARS-CoV-2 within 6 days POS. In 11 patients in whom serum was available prior to a positive antibody signal (COI ≥1.0) the interval between the last negative and first positive COI (time to “seroconversion”) on average is 3 days (range 1–6 days) and 4 more days (range 1–7) for the anti-SARS-CoV-2 to plateau.

Conclusion

The Roche anti-SARS-CoV-2 assay shows excellent performance with minimal cross-reactivity from other viral and confounding antibodies. Antibody development and seroconversion appears quite early.
Representation of EHR data for predictive modeling: a comparison between UMLS and other terminologies
Authors: Rasmy Laila , Tiryaki Firat , Zhou Yujia , Xiang Yang , Tao Cui , Xu Hua , Zhi Degui
Published: July 2020

Objective

Predictive disease modeling using electronic health record data is a growing field. Although clinical data in their raw form can be used directly for predictive modeling, it is a common practice to map data to standard terminologies to facilitate data aggregation and reuse. There is, however, a lack of systematic investigation of how different representations could affect the performance of predictive models, especially in the context of machine learning and deep learning.

Materials and Methods

We projected the input diagnoses data in the Cerner HealthFacts database to Unified Medical Language System (UMLS) and 5 other terminologies, including CCS, CCSR, ICD-9, ICD-10, and PheWAS, and evaluated the prediction performances of these terminologies on 2 different tasks: the risk prediction of heart failure in diabetes patients and the risk prediction of pancreatic cancer. Two popular models were evaluated: logistic regression and a recurrent neural network.

Results

For logistic regression, using UMLS delivered the optimal area under the receiver operating characteristics (AUROC) results in both dengue hemorrhagic fever (81.15%) and pancreatic cancer (80.53%) tasks. For recurrent neural network, UMLS worked best for pancreatic cancer prediction (AUROC 82.24%), second only (AUROC 85.55%) to PheWAS (AUROC 85.87%) for dengue hemorrhagic fever prediction.

Discussion/Conclusion

In our experiments, terminologies with larger vocabularies and finer-grained representations were associated with better prediction performances. In particular, UMLS is consistently 1 of the best-performing ones. We believe that our work may help to inform better designs of predictive models, although further investigation is warranted.
A Rapid LC–MS-MS Method for the Quantitation of Antiepileptic Drugs in Urine
Authors: Feng Sheng , Bridgewater Brandi , Strickland Erin C , McIntire Gregory
Published: July 2020

Epilepsy is a common neurologic disease that requires treatment with one or more medications. Due to the polypharmaceutical treatments, potential side effects, and drug-drug interactions associated with these medications, therapeutic drug monitoring is important. Therapeutic drug monitoring is typically performed in blood due to established clinical ranges. While blood provides the benefit of determining clinical ranges, urine requires a less invasive collection method, which is attractive for medication monitoring. As urine does not typically have established clinical ranges, it has not become a preferred specimen for monitoring medication adherence. Thus, large urine clinical data sets are rarely published, making method development that addresses reasonable concentration ranges difficult. An initial method developed and validated in-house utilized a universal analytical range of 50–5,000 ng/mL for all antiepileptic drugs and metabolites of interest in this work, namely carbamazepine, carbamazepine-10,11-epoxide, eslicarbazepine, lamotrigine, levetiracetam, oxcarbazepine, phenytoin, 4-hydroxyphenytoin, and topiramate. This upper limit of the analytical range was too low leading to a repeat rate of 11.59% due to concentrations >5,000 ng/mL. Therefore, a new, fast liquid chromatography–tandem mass spectrometry (LC–MS-MS) method with a run time under 4 minutes was developed and validated for the simultaneous quantification of the previously mentioned nine antiepileptic drugs and their metabolites. Urine samples were prepared by solid-phase extraction and analyzed using a Phenomenex Phenyl-Hexyl column with an Agilent 6460 LC–MS-MS instrument system. During method development and validation, the analytical range was optimized for each drug to reduce repeat analysis due to concentrations above the linear range and for carryover. This reduced the average daily repeat rate for antiepileptic testing from 11.59% to 4.82%. After validation, this method was used to test and analyze patient specimens over the course of approximately one year. The resulting concentration data were curated to eliminate specimens that could indicate an individual was noncompliant with their therapy (i.e., positive for illicit drugs) and yielded between 20 and 1,700 concentration points from the patient specimens, depending on the analyte. The resulting raw quantitative urine data set is presented as preliminary reference ranges to assist with interpreting urine drug concentrations for the nine aforementioned antiepileptic medications and metabolites.
Microtremor HVSR analysis of heterogeneous shallow sedimentary structures at Pohang, South Korea
Authors: Kang Su Young , Kim Kwang-Hee , Chiu Jer-Ming , Liu Lanbo
Published: July 2020

We apply the single-station microtremor horizontal-to-vertical spectral ratio (HVSR) method to image the geometry of Pohang Basin, South Korea, which experienced the greatest earthquake damage in Korea during a series of anthropogenic earthquakes between November 2017 and February 2018. We collected and analysed the ambient seismic noise at 124 temporary stations. The resonance frequencies, which vary significantly across the area (0.35–19.86 Hz), were inverted to constrain the depth of the major impedance contrast, which is interpreted to be the sediment–bedrock interface beneath each station. The sedimentary layer thickness is generally thin in the north and thickens to the southern and central parts of the basin, where the depth to bedrock is up to 340 m. We compare the HVSR results with six borehole observations in the area, whose depth to bedrock ranges from 189 to 359 m. The sediment thicknesses obtained via the direct borehole measurements and HVSR method are comparable with each other. The resultant three-dimensional shape of the sedimentary basin provides crucial information for the microzonation of the Pohang area for seismic risk mitigation. It also provides a realistic initial velocity model for three-dimensional tomographic inversions to elucidate the detailed subsurface structure of the region.
Visualization of microstructural change affected by mechanical stimulation in tendon healing with a novel tensionless model
Authors: Oshima Junya , Sasaki Kaoru , Yamamoto Naoto , Kiyosawa Tomoharu , Sekido Mitsuru
Published: July 2020

Since the majority of a tendon’s dry weight is collagen fibers, tendon healing consists mainly of collagen repair and observing three-dimensional networks of collagen fibers with scanning electron microscopy (SEM) is optimal for investigating this process. In this report, a cell-maceration/SEM method was used to investigate extrasynovial tendon (unwrapped tendon in synovial tissue such as the tendon sheath) healing of an injured Achilles tendon in a rat model. In addition, since mechanical stimulation is important for tendon healing, a novel, tensionless, rat lower leg tendon injury model was established and verified by visualizing the structural change of collagen fibers under tensionless conditions by SEM. This new model was created by transplanting the leg of a rat with a tendon laceration to the back, removing mechanical stimulation. We then compared the process of tendon healing with and without tension using SEM. Under tension, collagen at the tendon stump shows axial alignment and repair that subsequently demarcates the paratenon (connective tissue on the surface of an extrasynovial tendon) border. In contrast, under tensionless conditions, the collagen remains randomly arranged. Our findings demonstrate that mechanical stimulation contributes to axial arrangement and reinforces the importance of tendon tension in wound healing.
Music Therapy Private Practice in the United States: Updated Financial and Marketing Recommendations
Authors: Wilhelm Kyle , Knight Andrew
Published: July 2020

More and more music therapists in the United States are entering into private practice. For a private practice to survive, a therapist must make sound financial and marketing decisions that can have wide-ranging implications on the success of the business. Clear and current recommendations from music therapists in private practice can help those wanting to go into private practice as well as those already in private practice. The purpose of this study was to identify a current descriptive profile of music therapists in private practice in the United States as well as marketing and financial recommendations. In addition, comparing this survey with previous surveys can reveal possible trends in the field. Music therapists (N = 745) who self-identified as being self-employed or in private practice were sent a survey designed by the researchers. A total of 193 respondents returned the survey revealing that current therapists in private practice are better educated and value the internet and social media for marketing and session implementation more than respondents of previous surveys. Respondents recommend that music therapists in private practice continually learn by taking business classes and consulting with business experts; diversify funding sources, service options, and populations served; and connect with music therapists and nonmusic therapists in the community.
Comparison of Serum Free and Bioavailable 25-Hydroxyvitamin D Levels in Alzheimer’s Disease and Healthy Control Patients
Authors: Ertilav Esra , Barcin Nur Ebru , Ozdem Sebahat
Published: July 2020

Objective

Many studies have investigated lower 25-hydroxyvitamin D (25[OH]D) levels in patients with Alzheimer’s disease (AD) compared with those in control patients. In the present study, we aimed to evaluate serum free and bioavailable 25(OH)D levels in patients with AD and in healthy control patients.

Methods

The AD group consisted of 85 patients aged >60 years who were diagnosed with possible AD according to National Institute on Aging-Alzheimer’s Association criteria and 85 healthy control patients. Serum levels of total 1,25-dihydroxyvitamin D, total 25(OH)D, vitamin D binding protein (VDBP), parathormone, calcium, phosphorus and albumin, free 25(OH)D, bioavailable 25(OH)D, and the bioavailable 25(OH)D/total 25(OH)D ratio were compared in both groups.

Results

Total 25(OH)D, free 25(OH)D, bioavailable 25(OH)D, and the bioavailable 25(OH)D/total 25(OH)D ratio were significantly lower (P <.001, P <.001, P <.001, P <.05, respectively) in the AD group, whereas the VDBP level was significantly higher (P <.05) in the AD than in the control group.

Conclusion

Free and bioavailable 25(OH)D detected at lower levels in patients with AD limit the target central effects of 25(OH)D; this result suggests that reduced levels of the active free form of vitamin D may be a risk factor for AD and dementia.
Magnetar outburst and spin-down glitch
Authors: Tong H , Huang L
Published: July 2020

The outburst and spin-down glitch of magnetars are modelled from the magnetospheric point of view. We try to discuss the following four questions: (1) Which pulsar on the period and period-derivative diagram are more likely to show magnetar outburst? (2) Which outburst will make the glitch that triggered the outburst to become a spin-down glitch? (3) Can we model the outburst and spin-down glitch in PSR J1119−6127 simultaneously? (4) Why the torque variation is delayed compared with the peak of the X-ray luminosity in 1E 1048.1−5937 and PSR J1119−6127? It is found that both the global and local twisted magnetic field will affect the radiation and timing behaviours of magnetars. Especially, the delay of torque variations may due to the combined effect of increasing twist in the j-bundle and untwisting of the global magnetosphere. A toy model is built for magnetar outburst and torque variations. It can catch the general trend of magnetar outburst: decaying flux, shrinking hotspot, and torque variations.
Jet–ISM interactions near the microquasars GRS 1758−258 and 1E 1740.7−2942
Authors: Tetarenko A J , Rosolowsky E W , Miller-Jones J C A , Sivakoff G R
Published: July 2020

We present Atacama Large Millimeter/Sub-millimeter Array observations of the candidate jet–ISM interaction zones near the black hole X-ray binaries GRS 1758−258 and 1E 1740.7−2942. Using these data, we map the molecular line emission in the regions, detecting emission from the HCN [J = 1−0], HCO+ [J = 1−0], SiO [J = 2−1], CS [J = 2−1], 13CO [J = 1−0], C18O [J = 1−0], HNCO [J = 40,4−30,3], HNCO [J = 50,5−40,4], and CH3OH [J = 21,1−11,0] molecular transitions. Through examining the morphological, spectral, and kinematic properties of this emission, we identify molecular structures that may trace jet-driven cavities in the gas surrounding these systems. Our results from the GRS 1758−258 region in particular, are consistent with recent work, which postulated the presence of a jet-blown cocoon structure in deep radio continuum maps of the region. Using these newly discovered molecular structures as calorimeters, we estimate the time averaged jet power from these systems, finding $(1.1{\!-\!}5.7)\times 10^{36}{\rm erg\, s}^{-1}$ over 0.12−0.31 Myr for GRS 1758−258 and $(0.7{\!-\!}3.5)\times 10^{37}{\rm erg\, s}^{-1}$ over 0.10−0.26 Myr for 1E 1740.7−2942. Additionally, the spectral line characteristics of the detected emission place these molecular structures in the central molecular zone of our Galaxy, thereby constraining the distances to the black hole X-ray binaries to be 8.0 ± 1.0 kpc. Overall, our analysis solidifies the diagnostic capacity of molecular lines, and highlights how astro-chemistry can both identify jet–ISM interaction zones and probe jet feedback from Galactic X-ray binaries.
Constraints on the spin-pole orientation, jet morphology, and rotation of interstellar comet 2I/Borisov with deep HST imaging
Authors: Bolin Bryce T , Lisse Carey M
Published: July 2020

We present high resolution, deep imaging of interstellar comet 2I/Borisov taken with the Hubble Space Telescope/Wide Field Camera 3 (HST/WFC3) on 2019 December 8 UTC and 2020 January 27 UTC (HST GO 16040, PI: Bolin) before and after its perihelion passage in combination with HST/WFC3 images taken on 2019 October 12 UTC and 2019 November 16 UTC (HST GO/DD 16009, PI: Jewitt) before its outburst and fragmentation of 2020 March, thus observing the comet in a relatively undisrupted state. We locate 1–2 arcsec long (2000–3000 km projected length) jet-like structures near the optocentre of 2I that appear to change position angles from epoch to epoch. With the assumption that the jet is located near the rotational pole supported by its stationary appearance on ∼10–100 h time frames in HST images, we determine that 2I’s pole points near α = 322 ± 10° and δ = 37 ± 10° (λ = 341° and β  = 48°) and may be in a simple rotation state. Additionally, we find evidence for possible periodicity in the HST time-series light curve on the time-scale of ∼5.3 h with a small amplitude of ∼0.05 mag implying a lower limit on its b/a ratio of ∼1.5 unlike the large ∼2 mag light curve observed for 1I/‘Oumuamua. However, these small light-curve variations may not be the result of the rotation of 2I’s nucleus due to its dust-dominated light-scattering cross-section. Therefore, uniquely constraining the pre-Solar system encounter, pre-outburst rotation state of 2I may not be possible even with the resolution and sensitivity provided by HST observations.
Alkaline exospheres of exoplanet systems: evaporative transmission spectra
Authors: Gebek Andrea , Oza Apurva V
Published: July 2020

Hydrostatic equilibrium is an excellent approximation for the dense layers of planetary atmospheres, where it has been canonically used to interpret transmission spectra of exoplanets. Here, we exploit the ability of high-resolution spectrographs to probe tenuous layers of sodium and potassium gas due to their formidable absorption cross-sections. We present an atmosphere–exosphere degeneracy between optically thick and optically thin mediums, raising the question of whether hydrostatic equilibrium is appropriate for Na i lines observed at exoplanets. To this end we simulate three non-hydrostatic, evaporative, density profiles: (i) escaping, (ii) exomoon, and (iii) torus to examine their imprint on an alkaline exosphere in transmission. By analysing an evaporative curve of growth, we find that equivalent widths of $W_{\mathrm{Na D2}} \sim 1{\!-\!} 10\, \mathrm{m\mathring{\rm A}}$ are naturally driven by evaporation rates ∼103−105 kg s−1 of pure atomic Na. To break the degeneracy between atmospheric and exospheric absorption, we find that if the line ratio is D2/D1 ≳ 1.2 the gas is optically thin on average roughly indicating a non-hydrostatic structure of the atmosphere/exosphere. We show this is the case for Na i observations at hot Jupiters WASP-49b and HD189733b and also simulate their K i spectra. Lastly, motivated by the slew of metal detections at ultra-hot Jupiters, we suggest a toroidal atmosphere at WASP-76b and WASP-121b is consistent with the Na i data at present.
RW Aur B: a modest UX Ori-type companion of the famous primary
Authors: Dodin A , Lamzin S , Petrov P , Safonov B , Takami M , Tatarnikov A
Published: July 2020

The secondary of the famous young binary RW Aur is much less studied than the primary. To rectify this shortcoming, we present here the results of UBVRIJHK photometric, VRI polarimetric and optical spectral observations of RW Aur B. The star demonstrates chaotic brightness variations in the optical band, with irregular, short (∼1-d) dimmings with an amplitude ΔV up to 1.3 mag. The dimmings are accompanied by an increase in the linear polarization (up to 3 per cent in the I band), presumably as a result of the scattering of stellar radiation by dust in the circumstellar disc, which means that RW Aur B can be classified as a UX Ori-type star. We conclude that the observed excess emission at λ ≲ 0.45 μm and longwards of ~2 μm as well as the variability of fluxes and profiles of the H i, He i and Na i D emission lines are due to the accretion process. At the same time, emission components of Ca ii lines indicate that RW Aur B has a powerful chromosphere. Assuming solar elemental abundances, we find the following parameters for the star: Teff = 4100–4200 K, AV = 0.6 ± 0.1 (out of the dimming events), L* ≈ 0.6 ${\rm L}_\odot ,\, R_* \approx 1.5$ ${\rm R}_\odot ,\, M\approx 0.85$ M$_\odot ,\, \dot{M}_{\rm acc}\lt 5\times 10^{-9}$ M⊙ yr−1. Finally, we discuss possible reasons for the different levels of accretion activity of the RW Aur binary components and present arguments in favour of the fact that the components are gravitationally bound.
Linear and non-linear tidal oscillations and mode identification in the eccentric binary system KIC 3858884
Authors: Manzoori Davood
Published: July 2020

The phoebe code was used to analyse the Kepler light-curve and to estimate the physical and geometrical parameters of a rare pulsating binary system, KIC 3858884. The analysis indicated that the system is composed of two detached and very similar main-sequence A-type stars, in a highly eccentric orbit with e = 0.47. After disentangling the binarity effect, the residual data were subjected to Fourier frequency decomposition using period04 software. The resulting frequency spectrum consists of two moderately high-amplitude nearby frequencies, F1 = 7.232199 d−1 and $F2=7.472889\, \mathrm{d}^{-1}$, which were attributed to δ Scuti-type pulsations. In addition, 18 frequencies were identified that were exact harmonics of the orbital frequency $f_{\rm orb}= 0.038533\, \mathrm{d}^{-1}$, and also 53 anharmonics. However, it was found that many of these anharmonic frequencies coupled together non-linearly to give harmonic modes of pulsation. Furthermore, some existing theoretical models of the tidal oscillations were numerically verified in general binary systems through estimations of various modal characteristics, for example mode quantum numbers ${n, l, m,}$ energies Ei, threshold energies Ei,th, damping rates γi, growth rates Γi and stability criteria, etc. The evolution of the stars in the binary system was compared with some similar single pulsating stars on the Hertzsprung–Russell diagram and it was concluded that the evolution of a single star is more rapid. Finally, the observed rate of apsidal line displacement was estimated through eclipse timing variation analysis as Uobs  = 74745.2 ± 2566 yr. This was compared with the theoretically calculated rate of the line of apsides motion, UTheo  = 73588 ± 2298 yr, and found to be in good agreement within errors, hence verifying general relativity theory once again.
An extensive spectroscopic time series of three Wolf–Rayet stars – II. A search for wind asymmetries in the dust-forming WC7 binary WR137
Authors: St-Louis N , Piaulet C , Richardson N D , Shenar T , Moffat A F J , Eversberg T , Hill G M , Gauza B , Knapen J H , Kubát J , Kubátová B , Sablowski D P , Simón-Díaz S , Bolduan F , Dias F M , Dubreuil P , Fuchs D , Garrel T , Grutzeck G , Hunger T , Küsters D , Langenbrink M , Leadbeater R , Li D , Lopez A , Mauclaire B , Moldenhawer T , Potter M , dos Santos E M , Schanne L , Schmidt J , Sieske H , Strachan J , Stinner E , Stinner P , Stober B , Strandbaek K , Syder T , Verilhac D , Waldschläger U , Weiss D , Wendt A
Published: July 2020

We present the results of a 4-month, spectroscopic campaign of the Wolf–Rayet dust-making binary, WR137. We detect only small-amplitude random variability in the C iii λ5696 emission line and its integrated quantities (radial velocity, equivalent width, skewness, and kurtosis) that can be explained by stochastic clumps in the wind of the WC star. We find no evidence of large-scale periodic variations often associated with Corotating Interaction Regions that could have explained the observed intrinsic continuum polarization of this star. Our moderately high-resolution and high signal-to-noise average Keck spectrum shows narrow double-peak emission profiles in the H α, H β, H γ, He ii λ6678, and He ii λ5876 lines. These peaks have a stable blue-to-red intensity ratio with a mean of 0.997 and a root mean square of 0.004 commensurate with the noise level; no variability is found during the entire observing period. We suggest that these profiles arise in a decretion disc around the O9 companion, which is thus an O9e star. The characteristics of the profiles are compatible with those of other Be/Oe stars. The presence of this disc can explain the constant component of the continuum polarization of this system, for which the angle is perpendicular to the plane of the orbit, implying that the rotation axis of the O9e star is aligned with that of the orbit. It remains to be explained why the disc is so stable within the strong ultraviolet radiation field of the O star. We present a binary evolutionary scenario that is compatible with the current stellar and system parameters.
The Human Face of Naturalism: Putnam and Diamond on Religious Belief and the “Gulfs between Us”
Authors: Miguens Sofia
Published: July 2020

Hilary Putnam and Cora Diamond both wrote on Wittgenstein’s Three Lectures on Religious Belief. They did it quite differently; my ultimate aim in this article is to explore this difference. Putnam’s view of religion is largely a view of ethical life; I look thus into his writings on ethics and his proposals to face the relativist menace therein. Still, in his incursions into philosophy of religion, describing religious experience through authors such as Rosenzweig, Buber, or Levinas, Putnam deals with what Diamond calls, after Wittgenstein, “the gulfs between us.” Such gulfs, and the threat of relativism they bring, need to be accounted for. With that purpose in mind I complement Putnam’s reading of the Three Lectures with Diamond’s own reading.
Clinical Pearls and Methods for Intraoperative Motor Mapping
Authors: Rossi Marco , Sciortino Tommaso , Conti Nibali Marco , Gay Lorenzo , Viganò Luca , Puglisi Guglielmo , Leonetti Antonella , Howells Henrietta , Fornia Luca , Cerri Gabriella , Riva Marco , Bello Lorenzo
Published: July 2020

Resection of brain tumors involving motor areas and pathways requires the identification and preservation of various cortical and subcortical structures involved in motor control at the time of the procedure, in order to maintain the patient's full motor capacities. The use of brain mapping techniques has now been integrated into clinical practice for many years, as they help the surgeon to identify the neural structures involved in motor functions. A common definition of motor function, as well as knowledge of its neural organization, has been continuously evolving, underlining the need for implementing intraoperative strategies at the time of the procedure. Similarly, mapping strategies have been subjected to continuous changes, enhancing the likelihood of preservation of full motor capacities. As a general rule, the motor mapping strategy should be as flexible as possible and adapted strictly to the individual patient and clinical context of the tumor. In this work, we present an overview of current knowledge of motor organization, indications for motor mapping, available motor mapping, and monitoring strategies, as well as their advantages and limitations. The use of motor mapping improves resection and outcomes in patients harboring tumors involving motor areas and pathways, and should be considered the gold standard in the resection of this type of tumor.
Vape Shop Owners/Managers’ Opinions About FDA Regulation of E-Cigarettes
Authors: Berg Carla J , Barker Dianne C , Sussman Steve , Getachew Betelihem , Pulvers Kim , Wagener Theodore L , Hayes Rashelle B , Henriksen Lisa
Published: July 2020

Introduction

In the United States, prominent sources of vaping products are specialty vape shops, which are subject to Food and Drug Administration (FDA) regulation. This study interviewed vape shop owners/managers to assess: (1) reasons for entering into or engaging in vape shop retail; (2) personnel training, particularly with regard to FDA and state regulations; and (3) how existing regulations are perceived and the anticipated impact of future regulation.

Aims and Methods

The current study involved phone–based semi-structured interviews of 45 vape shop owners/managers in six metropolitan statistical areas (Atlanta, Boston, Minneapolis, Oklahoma City, San Diego, and Seattle) during Summer 2018 as FDA regulations regarding minimum age verification, bans on product sampling, and health warnings (among others) were first being implemented.

Results

Vape shop owners/managers reported: (1) entering the industry with positive intentions for their customers, (2) training their personnel to adhere to regulations and provide good customer service, and (3) significant concerns about the impact of FDA regulations. With regard to the latter, participants reported mistrust of the intentions of the FDA regulations, financial implications of the regulations (particularly for small businesses), difficulty understanding and interpreting the regulations, insufficient evidence to support the regulations, negative impact on customer service, negative impact on product offerings and product innovation/advancement, and negative implications of flavor bans and/or restrictions on sale of flavors.

Conclusions

These findings indicate the complexities in implementing tobacco regulations, particularly from the perspective of the vape shop industry. Current findings should inform future regulatory actions and efforts to assess compliance with regulations.

Implications

Current and impending FDA regulation of vaping products present a critical period for examining regulatory impact on the vape shop industry. Current results indicated that many vape shop owners/managers reporting positive intentions for engaging in the vaping product industry and in training vape shop personnel to adhere to regulations. However, the majority reported concerns about FDA regulation and other state/local regulations that could have negative implications for their industry. Particular concerns include difficulty understanding the regulations due to complexity, vagueness, and changes in language and/or interpretation over time. These issues have implications for compliance that must be addressed.
Cirq® Robotic Assistance for Minimally Invasive C1-C2 Posterior Instrumentation: Report on Feasibility and Safety
Authors: Farah Kaissar , Meyer Mikael , Prost Solene , Dufour Henry , Blondel Benjamin , Fuentes Stephane
Published: July 2020

BACKGROUND

Accurate screw placement remains very challenging especially in the upper cervical spine.

OBJECTIVE

To present our first experience of a percutaneous posterior C1-C2 fixation for a traumatic fracture.

METHODS

This is a case report of a non-neurological patient, harboring a type II odontoid fracture. She underwent a posterior percutaneous fixation using Cirq® Robotic Assistance coupled to the AIRO® intraoperative computed tomography (iCT)-scan and BrainLab® navigation system (all by BrainLab AG). Routine CT was performed on postoperative day 2 to evaluate pedicle screw placement. The effective dose was calculated.

RESULTS

The C1-C2 posterior percutaneous fixation was performed with cannulated VERTEX® Reconstruction System (Medtronic). Overall, 4 screws were placed. All of them were rated as acceptable (100%). Radiation dose received by the patient was 4.13 mSv. Radiation dose received by the surgical staff was 0 mSv. Postoperative course was excellent.

CONCLUSION

Posterior percutaneous fixation using Cirq® Robotic Assistance coupled with iCT navigation system is a major innovation that can improve pedicle screw positioning's accuracy with acceptable patient radiation and reduced surgical team exposure.
Intraoperative Neurophysiology for Optimization of Percutaneous Spinothalamic Cordotomy for Intractable Cancer Pain
Authors: Sapir Yechiam , Korn Akiva , Bitan-Talmor Yifat , Vendrov Irina , Berger Assaf , Shofty Ben , Zegerman Alexander , Strauss Ido
Published: July 2020

BACKGROUND

Percutaneous ablation of the cervical spinothalamic tract (STT) remains a therapeutic remedy for intractable cancer pain. However, it is accompanied by the risk of collateral damage to essential spinal cord circuitry, including the corticospinal tract (CST). Recent studies describe threshold-based mapping of the CST with the objective of motor bundle preservation during intramedullary spinal cord and supratentorial surgery.

OBJECTIVE

To assess the possibility that application of spinal cord mapping using intraoperative neuromonitoring in percutaneous cordotomy procedures may aid in minimizing iatrogenic motor tract injury.

METHODS

We retrospectively reviewed the files of 11 patients who underwent percutaneous cervical cordotomy for intractable oncological pain. We performed quantitative electromyogram (EMG) recordings to stimulation of the ablation needle prior to the STT-ablative stage. We compared evoked motor and sensory electrical thresholds, and the electrical span between them as a reliable method to confirm safe electrode location inside the STT.

RESULTS

Quantified EMG data were collected in 11 patients suffering from intractable cancer pain. The threshold range for evoking motor activity was 0.3 to 1.2 V. Stimulation artifacts were detected from trapezius muscles even at the lowest stimulation intensity, while thenar muscles were found to be maximally sensitive and specific. The minimal stimulation intensity difference between the motor and the sensory threshold, set as “Δ-threshold,” was 0.26 V, with no new motor deficit at 3 days or 1 month postoperatively.

CONCLUSION

Selective STT ablation is an effective procedure for treating intractable pain. It can be aided by quantitative evoked EMG recordings, with tailored parameters and thresholds.
Risk Factors for Wire Fracture or Tethering in Deep Brain Stimulation: A 15-Year Experience
Authors: Mackel Charles E , Papavassiliou Efstathios , Alterman Ron L
Published: July 2020

BACKGROUND

In deep brain stimulation (DBS), tunneled lead and extension wires connect the implantable pulse generator to the subcortical electrode, but circuit discontinuity and wire revision compromise a significant portion of treatments.

OBJECTIVE

To identify factors predisposing to fracture or tethering of the lead or extension wire in patients undergoing DBS.

METHOD

Retrospective review of wire-related complications was performed in a consecutive series of patients treated with DBS at a tertiary academic medical center over 15 yr.

RESULTS

A total of 275 patients had 513 extension wires implanted or revised. There were 258 extensions of 40 cm implanted with a postauricular connector (50.3%), 229 extensions of 60 cm with a parietal connector (44.6%), and 26 extensions 40 cm with a parietal connector (5.1%). In total, 26 lead or extension wires (5.1%) were replaced for fracture. Fracture rates for 60 cm extensions with a parietal connector, 40 cm wires with a postauricular connector, and 40 cm extensions with a parietal connector were 0.2, 1.4, and 12.9 fractures per 100 wire-years, significantly different on log-rank test. Total 16 (89%) 40 cm extension wires with a postauricular connector had fracture implicating the lead wire. Tethering occurred only in patients with 60 cm extensions with parietal connectors (1.14 tetherings per 100 wire-years). Reoperation rate correlated with younger age, dystonia, and target in the GPI.

CONCLUSION

The 40 cm extensions with parietal connectors have the highest fracture risk and should be avoided. Postauricular connectors risk lead wire fracture and should be employed cautiously. The 60 cm parietal wires may reduce fracture risk but increase tethering risk.
Massive star formation in the Carina nebula complex and Gum 31. I. the Carina nebula complex
Authors: Fujita Shinji , Sano Hidetoshi , Enokiya Rei , Hayashi Katsuhiro , Kohno Mikito , Tsuge Kisetsu , Tachihara Kengo , Nishimura Atsushi , Ohama Akio , Yamane Yumiko , Ohno Takahiro , Yamada Rin , Fukui Yasuo
Published: July 2020

Herein, we present results from observations of the 12CO (J = 1–0), 13CO (J = 1–0), and 12CO (J = 2–1) emission lines toward the Carina nebula complex (CNC) obtained with the Mopra and NANTEN2 telescopes. We focused on massive-star-forming regions associated with the CNC including the three star clusters Tr 14, Tr 15, and Tr 16, and the isolated WR-star HD 92740. We found that the molecular clouds in the CNC are separated into mainly four clouds at velocities −27, −20, −14, and −8 km s−1. Their masses are 0.7 × 104 M⊙, 5.0 × 104 M⊙, 1.6 × 104 M⊙, and 0.7 × 104 M⊙, respectively. Most are likely associated with the star clusters, because of their high 12CO (J = 2–1)/12CO (J = 1–0) intensity ratios and their correspondence to the Spitzer 8 μm distributions. In addition, these clouds show the observational signatures of cloud–cloud collisions. In particular, there is a V-shaped structure in the position–velocity diagram and a complementary spatial distribution between the −20 km s−1 cloud and the −14 km s−1 cloud. Furthermore, we found that SiO emission, which is a tracer of a shocked molecular gas, is enhanced between the colliding clouds by using ALMA archive data. Based on these observational signatures, we propose a scenario wherein the formation of massive stars in the clusters was triggered by a collision between the two clouds. By using the path length of the collision and the assumed velocity separation, we estimate the timescale of the collision to be ∼1 Myr. This is comparable to the ages of the clusters estimated in previous studies.
Ethical Advice for an Intensive Care Triage Protocol in the COVID-19 Pandemic: Lessons Learned from The Netherlands
Authors: Verweij Marcel , van de Vathorst Suzanne , Schermer Maartje , Willems Dick , de Vries Martine
Published: July 2020

At the height of the COVID-19 crisis in the Netherlands a shortness of intensive care beds was looming. Dutch professional medical organizations asked a group of ethicists for assistance in drafting guidelines and criteria for selection of patients for intensive care (IC) treatment in case of absolute scarcity, when medical selection criteria would no longer suffice. This article describes the Dutch context, the process of drafting the advice and reflects on the role of ethicists and lessons learned. We argue that timely interaction between clinical and ethical expertise is necessary since the distinction between medical and non-medical considerations is not as clearcut as sometimes assumed. Furthermore, pragmatic considerations related to the specifics of an epidemic are of importance, for example, in relation to prioritizing health care workers. As a consequence, any protocol already present before the pandemic would need alterations to fit the current situation. The ‘fair innings’ criterion we proposed, rephrased as an argument of intergenerational solidarity, was considered reasonable by professionals as well as patient organizations. While it is desirable to draft ethical guidelines in ‘peacetime’ as a matter of pandemic preparedness, the pressure of an actual crisis facilitates decision-making, although it will also complicate a more democratic approach.
Transcranial Doppler Evaluation of the Cerebral Vasculature in Women Patients who Have Migraine with Aura
Authors: Petrušić Igor , Podgorac Ana , Radojičić Aleksandra , Zidverc-Trajković Jasna
Published: July 2020

Background

Previous studies suggest that increased cerebrovascular reactivity might be a feature of patients who have migraine with aura (MwA). The correlation between the clinical presentation of migraine with aura and transcranial Doppler parameters remains unclear.

Objective

The main aim of this study was to explore cerebral blood flow, vascular resistance, and cerebrovascular reactivity in women MwA. Also, the relationships between hemodynamic conditions and aura characteristics are examined.

Design

Cross-sectional study.

Setting

Headache Center, Neurology Clinic, Clinical Center of Serbia.

Subjects

Fifty-four women MwA and 49 healthy controls (HCs).

Methods

Transcranial Doppler sonography examination was used to determine blood flow mean velocity (MV) and pulsatility index (PI), as well as breath-holding index (BHI), in 15 arterial segments comprising the circle of Willis.

Results

A total of 54 women MwA and 49 HCs were studied. The PIs of all segments of the left and right middle cerebral arteries and the left and right anterior cerebral arteries were significantly higher in MwA with regards to HCs. Also, both the left and right BHIs were significantly higher in MwA than HCs. In addition, MVs of the right vertebral artery and the first segment of the basilar artery were significantly lower in MwA than HCs. Longer duration of migraine aura showed a weak negative correlation with the PI of the left posterior cerebral artery.

Conclusions

Our findings suggest increased vessel pulsatility, abnormal cerebrovascular reactivity, and decreased cerebral blood flow velocity in several arterial segments of the Willis circle in women MwA.
Identifying Multisite Chronic Pain with Electronic Health Records Data
Authors: Von Korff Michael , DeBar Lynn L , Deyo Richard A , Mayhew Meghan , Kerns Robert D , Goulet Joseph L , Brandt Cynthia
Published: July 2020

Background

Multisite chronic pain (MSCP) is associated with increased chronic pain impact, but methods for identifying MSCP for epidemiological research have not been evaluated.

Objective

We assessed the validity of identifying MSCP using electronic health care data compared with survey questionnaires.

Methods

Stratified random samples of adults served by Kaiser Permanente Northwest and Washington (N = 2,059) were drawn for a survey, oversampling persons with frequent use of health care for pain. MSCP and single-site chronic pain were identified by two methods, with electronic health care data and with self-report of common chronic pain conditions by survey questionnaire. Analyses were weighted to adjust for stratified sampling.

Results

MSCP was somewhat less common when ascertained by electronic health records (14.7% weighted prevalence) than by survey questionnaire (25.9% weighted prevalence). Agreement of the two MSCP classifications was low (kappa agreement statistic of 0.21). Ascertainment of MSCP with electronic health records was 30.9% sensitive, 91.0% specific, and had a positive predictive value of 54.5% relative to MSCP identified by self-report as the standard. After adjusting for age and gender, patients with MSCP identified by either electronic health records or self-report showed higher levels of pain-related disability, pain severity, depressive symptoms, and long-term opioid use than persons with single-site chronic pain identified by the same method.

Conclusions

Identification of MSCP with electronic health care data was insufficiently accurate to be used as a surrogate or screener for MSCP identified by self-report, but both methods identified persons with heightened chronic pain impact.
Potential role of hypovitaminosis D and vitamin D supplementation during COVID-19 pandemic
Authors: Verdoia M , De Luca G
Published: July 2020

Vitamin D deficiency is a pandemic disorder affecting over 1 billion of subjects worldwide and displaying a broad spectrum of implications on cardiovascular and inflammatory disorders. Since the initial reports of the association between hypovitaminosis D and COVID-19, Vitamin D has been pointed as a potentially interesting treatment for SARS-CoV-2 infection. We provide an overview on the current status of vitamin D deficiency, the mechanisms of action of vitamin D and the current literature on the topic, with a special focus on the potential implications for COVID-19 pandemic.