bluuebunny/crossref_metadata_2025 huggingface dataset:
Recreational Fisheries
Authors: Hilborn Ray , Hilborn Ulrike
Published: November 2020

Are recreational fisheries fundamentally different from commercial fisheries?

The simple answer is yes, recreational fishing is very different from most commercial fisheries. Many more people participate, their catch and effort are harder to measure, and the overall objective of recreational fishing is often very...
Ecosystem Impacts of Fishing
Authors: Hilborn Ray , Hilborn Ulrike
Published: November 2020

How does overfishing affect ecosystems?

Early explorers’ accounts are full of wonder at the natural wealth of the New World and astonishment at the size of fish. Writing in 1615 about John Cabot’s voyage off Newfoundland, Peter Martyr said, “in the sea adjacent [he]...
The Status of Overfishing
Authors: Hilborn Ray , Hilborn Ulrike
Published: November 2020

Are the world’s stocks overfished?

The most authoritative assessment of the status of commercial fish stocks comes from FAO, the Food and Agriculture Organization of the United Nations. Every two years FAO publishes a report that summarizes the status of commercially important fish stocks....
Feminism and Reproductive Politics
Authors: Solinger Rickie
Published: November 2020

Why is feminism so important to reproductive politics, and vice versa, in the United States?

Over the course of American history, questions about female fertility have typically been dealt with in ways that eclipsed the interests of women, individually and as members of...
Nuclear Power
Authors: Goldemberg José
Published: November 2020

What is nuclear power?

Nuclear power is not based on mechanical energy (as is hydropower) or chemical energy (as is the burning of fossil fuels). Nuclear energy is created by the splitting of the nuclei of uranium atoms. This splitting releases a considerable amount...
Energy Efficiency
Authors: Goldemberg José
Published: November 2020

What are the existing technical solutions to the present energy system?

Existing technical solutions to the present energy system include higher efficiency, increased reliance on renewable sources, deployment of new energy technologies, and policies to accelerate the adoption of new technologies.

These solutions are...
Communism
Authors: Colton Timothy J.
Published: November 2020

Who were Lenin and the Bolsheviks?

“Revolutions,” ruminates the protagonist in Doctor Zhivago, Boris Pasternak’s tour de force about a physician-poet who outlasts the Russian Revolution, “are made by fanatical men of action with one-track minds, geniuses at confining themselves to a limited...
Transition Within the Transition
Authors: Colton Timothy J.
Published: November 2020

Who is Putin and what were his credentials to be leader?

A new president took it upon himself to craft a transition within Russia’s transition. The jury is out on whether it will make it to the level of the critical junctures of 1917 and...
Cybersecurity and Cyberwar
Authors: Singer Peter W. , Friedman Allan
Published: November 2020

Dependence on computers has had a transformative effect on human society. Cybernetics is now woven into the core functions of virtually every basic institution, including our oldest ones. War is one such institution, and the digital revolution’s impact on it has been profound. The American military, which has no peer, is almost completely reliant on high-tech computer systems. Given the Internet’s potential for full-spectrum surveillance and information disruption, the marshaling of computer networks represents the next stage of cyberwar. Indeed, it is upon us already. The recent Stuxnet episode, in which Israel fed a malignant computer virus into Iran’s nuclear facilities, is one such example. Penetration into US government computer systems by Chinese hackers-presumably sponsored by the Chinese government-is another. Together, they point to a new era in the evolution of human conflict. In Cybersecurity: What Everyone Needs to Know, noted experts Peter W. Singer and Allan Friedman lay out how the revolution in military cybernetics occurred and explain where it is headed. They begin with an explanation of what cyberspace is before moving on to discussions of how it can be exploited and why it is so hard to defend. Throughout, they discuss the latest developments in military and security technology. Singer and Friedman close with a discussion of how people and governments can protect themselves. In sum, Cybersecurity is the definitive account on the subject for the educated layman who wants to know more about the nature of war, conflict, and security in the twenty first century.
Invasive Species
Authors: Simberloff Daniel
Published: November 2020

Invasive species come in all sizes, from plant pathogens like the chestnut blight in eastern North America, to the red imported fire ant that has spread throughout the South, the predatory Indian mongoose now found in the Caribbean and Hawaii, and the huge Burmese python populating the Florida swamps. And while many invasive species are safe and even beneficial, the more harmful varieties cost the world economy billions of dollars annually, devastate agriculture, spread painful and even lethal diseases, and otherwise diminish our quality of life in myriad surprising ways. In Invasive Species: What Everyone Needs to Know, award-winning biologist Daniel Simberloff offers a wide-ranging and informative survey that sheds light on virtually every aspect of these biological invaders. Filled with case studies of an astonishing array of invasive species, the book covers such topics as how humans introduce these species-sometimes inadvertently, but often deliberately-the areas that have suffered the most biological invasions, the methods we use to keep our borders safe, the policies we currently have in place to manage these species, and future prospects for controlling their spread. An eminent ecologist, Simberloff analyzes the direct and indirect impacts of invasive species on various ecosystems, such as when non-native species out-compete native species for food or light, describes how invasive species (such as the Asian mosquito that is a vector for West Nile virus, itself an invasive species) transmit pathogens, and explains his acclaimed theory of "invasional meltdown" in which two or more introduced species combine to produce a far more devastating impact than any one of them would have caused alone. The book also discusses the more controversial issues surrounding invasive species and it concludes with suggested readings and a list of related web sites.
Magnitude, Geography, and Time Course of Invasions
Authors: Simberloff Daniel
Published: November 2020

How many introduced species become invasive?

To become invasive, a nonnative species must first arrive and establish a population. It is difficult to determine how many species actually arrive, because many of these do not survive or, if they survive, often do not establish...
The Basics of Libertarianism
Authors: Brennan Jason
Published: November 2020

What is libertarianism?

Libertarianism is a political philosophy. Libertarians believe respect for individual liberty is the central requirement of justice. They believe human relationships should be based on mutual consent. Libertarians advocate a free society of cooperation, tolerance, and mutual respect.

Libertarianism holds that...
Basic Monetary Policy Objectives
Authors: Axilrod Stephen H.
Published: November 2020

What are the Fed’s basic objectives?

As noted in the preceding chapter, the goals set for monetary policy in the Federal Reserve Act are maximum employment, stable prices, and low, long-term interest rates. The Fed’s other very important objective, the maintenance of systemic stability...
The Fed’s Two Great Postwar Crises
Authors: Axilrod Stephen H.
Published: November 2020

In what ways are the two great postwar crises similar?

On the face of it, they are hardly similar at all. The first, the great inflation crisis encompassed the 1970s and the first part of the 1980s. It involved circumstances where market structure, surrounding...
The Socialists Strike Back, 2004–2011
Authors: Chislett William
Published: November 2020

Did the Socialists return to power because of the Islamic terrorist attack?

The Socialists under José Luis Rodríguez Zapatero won the election on March 14, 2004, three days after the Islamic terrorist attacks that killed 192 people in Madrid. They captured 11 million votes...
Introduction
Authors: Netanel Neil Weinstock
Published: November 2020

Copyright law was once an esoteric backwater, the special province of professional authors, publishers, and media companies. That’s no longer the case. In our age of social media and cloud storage, we have become a copying and sharing culture. In turn, copyright law now directly...
Fair Use
Authors: Netanel Neil Weinstock
Published: November 2020

Fair use is a longstanding, major exception to copyright owners’ exclusive rights. You do not infringe copyright if your copying of someone else’s work qualifies as fair use. I explained some fair use basics in Chapter I. Recall that to determine whether a...
The SLORC/SPDC Era (1988–Present): Continuation of Military Power
Authors: Steinberg David I.
Published: November 2020

The September 18, 1988, military transfer of power, in a sense a “coup by consent,” that produced the State Law and Order Restoration Council (SLORC) was designed to continue military control by alternative means. As war, according to Carl von Clausewitz, is nothing but the...
Metals
Authors: Weis Judith S.
Published: November 2020

What are the major sources of metal pollutants?

Metals are naturally occurring elements in the earth’s crust that can become contaminants when industrial activity concentrates them at higher than normal levels. Since they are elements, they cannot break down into anything else. Metals released...
Pesticides and Industrial Organic Chemicals
Authors: Weis Judith S.
Published: November 2020

What are the sources of pesticides to the marine environment?

Pesticides from agriculture, lawns, golf courses, and gardens wash into streams and rivers and ultimately down into estuaries. These chemicals are designed to kill agricultural pests (generally insects) on land. After being sprayed on...
Emerging Concerns
Authors: Weis Judith S.
Published: November 2020

What other types of contaminants are we beginning to learn about?

Contaminants of emerging concern (CECs) have been defined as any man-made or naturally occurring chemical or microorganism that is not generally monitored in the environment but has the potential to enter the environment...
Black Female Sexuality
Authors: Crooks Natasha , Singer Randi , Tluczek Audrey
Published: November 2020

Black females experience significant sexual health disparities. Intersectionality theory offers nurses a framework to address health disparities. Intersectionality theory examines how categorical identities of difference confer power or oppression, affect social interactions, and influence individuals' engagement with institutional structures. This secondary analysis of qualitative data details the damaging effects that power, oppression, and disadvantaged identities have on the sexual health of Black women. Twenty participants explained how the intersection of race, gender, age, education, and sexuality influences sexual health risk. Our expanded model of intersectionality theory emphasizes historical context with implications for research, practice, and education to promote health equity.
The Three-Step Theory of Suicide
Authors: Anderson Avery M. , Happ Mary Beth
Published: November 2020

Suicide is a public health crisis in the United States and around the world. Despite decades of research, prevention efforts have not substantially influenced suicide rates. Theoretical foundations for research are essential in building the science of suicide prevention. This article analyzes and evaluates the most recently published suicide theory based on an ideation-to-action framework, the Three-Step Theory of Suicide (3ST). This theory demonstrates significant scope and context as well as coherent content. Suggested theory improvements include enhanced clarity and directions for testability. Empirical evidence supports the merits of this theory, although further research is needed for population-specific application.
Components of Culturally Tailored Interventions
Authors: Im Eun-Ok , Chee Wonshik
Published: November 2020

The purpose of this article is to propose essential components of culturally tailored interventions through analyzing practical issues in 3 studies that tested culturally tailored interventions among Asian American women. Practical issues in the studies were analyzed using a content analysis according to the evaluation criteria for rigor in cross-cultural research. Seven essential components of culturally tailored interventions were identified through the analysis: (a) respecting cultural uniqueness; (b) understanding cultural contexts; (c) using cultural examples; (d) having flexibility; (e) adopting multiple languages; (f) having bilingual and/or culturally matched research team members; and (g) engaging community consultants and research participants. Key words: Asian, culture, intervention, issue, rigor
Lumbar Adding-on of the Thoracic Spine After Selective Fusion in Adolescent Idiopathic Scoliosis Lenke Types 1 and 2 Patients: A Critical Appraisal
Authors: Tan Jun-Hao , Hey Hwee Weng Dennis , Wong Gordon , Wong Hee-Kit , Lau Leok Lim
Published: November 2020

Study Design.

Retrospective cohort study.

Objective.

This study aimed to identify risk factors that predict lumbar curve adding-on in patients who had selective thoracic fusion.

Summary of Background Data.

Selective thoracic fusion offers deformity correction of Lenke 1 and 2 thoracic curves and maintains lumbar range of movement. However, some patients may develop postoperative lumbar adding-on.

Methods.

This study included patients 18 years or younger that underwent spinal instrumentation for Lenke 1 and 2 curves.

Results.

A total of 161 patients were included (147 females, 14 males). The mean age was 14.0 ± 2.1 years: 103 patients were Lenke 1, and 58 patients were Lenke 2 curves. Ninety-seven patients underwent posterior approach surgery, whereas 64 via anterior approach. In the posterior approach group, 79(81.4%) patients underwent selective fusion. Ten patients (6.2%) had lumbar curve adding-on, with nine females and one male. There were seven Lenke 1 and three Lenke 2 patients. All 10 patients were lumbar modifier (a), with 5 hypokyphotic patients. Selective fusion was done in nine patients. Lumbar adding-on was seen most commonly between 6 months to 1 year postoperative period (five patients). Two patients had adding-on because of incorrect distal fusion level, six were due to 1A-R curve, one due to the inadvertent fusion from the excessive long rod at the subjacent level. In multivariate analysis, hypokyphotic patients were at higher risk of lumbar adding-on (odds ratio = 9.2). Patients with Risser classification 0, 1, 2, 3 were also at higher risk of lumbar adding-on (odds ratio =6.1).

Conclusion.

The incidence of lumbar curve adding-on was 6.2%. Patients who were hypokyphotic and skeletally immature are nine times and six times more likely to have lumbar adding-on, respectively. This article examines adding-on in patients who had either anterior or posterior approach scoliosis surgeries, with follow-up stretching up to 10 years. This offers the rare opportunity to examine the natural history of the adding-on phenomenon.

Level of Evidence: 3
Changes in Low Back Muscle Activity and Spine Kinematics in Response to Smartphone Use During Walking
Authors: Choi Seobin , Kim Misol , Kim Eunjee , Shin Gwanseob
Published: November 2020

Study Design.

Within-subject design of an experimental study.

Objective.

The aim of this study was to determine the effects of smartphone use on the activity level of the lumbar erector spinae muscles and spine kinematics during walking.

Summary of Background Data.

Using a smartphone while walking makes the user hold the phone steady and look downward to interact with the phone. Walking with this non-natural posture of the head and the arms may alter the spine kinematics and increase the muscular load on the low back extensor muscles.

Methods.

Twenty healthy young individuals participated in the laboratory experiment. Each participant walked on a treadmill in five different conditions: normal walking without using a phone, conducting one-handed browsing while walking, two-handed texting while walking, walking with one arm bound, and walking with both arms bound. Spine kinematics variables and the myoelectric activity levels of the lumbar erector spinae muscles were quantified and compared between the five walking conditions.

Results.

Participants walked with significantly (P < 0.05) more thoracic kyphosis and lumbar lordosis when using a phone compared to when walking without using the phone. The median level of muscle activity was also 16.5% (browsing) to 31.8% (texting) greater for the two smartphone use conditions than for the normal walking condition, and the differences were significant (P < .05). Between the normal walking and the two bound arm walking conditions, no significant difference in the muscle activity was found.

Conclusion.

Study results show that the concurrent use of a smartphone while walking could pose a larger muscular load to the lumbar erector spinae muscles than that of normal walking. Habitual use of a smartphone while walking could be a risk factor for low back musculoskeletal problems.

Level of Evidence: N/A
DISRUPTION OF THE OUTER SEGMENTS OF THE PHOTORECEPTORS ON OPTICAL COHERENCE TOMOGRAPHY AS A FEATURE OF VITAMIN A DEFICIENCY
Authors: Jevnikar Kristina , Šuštar Maja , Kozjek Nada Rotovnik , Štrucl Ana M. , Markelj Špela , Hawlina Marko , Fakin Ana
Published: November 2020

Purpose:

To describe the optical coherence tomography features of vitamin A deficiency.

Methods:

Case series includes three male patients aged 50 to 66 years with vitamin A deficiency and visual symptoms ranging from 2 to 8 months. Examination included optical coherence tomography (OCT), fundus autofluorescence imaging, full-field electroretinography6 and laboratory work-up.

Results:

Patient 1 had inoperable pancreatic neuroendocrine tumor and presented with worsening nyctalopia. The electroretinography showed absent rod function 2 months after the onset of symptoms, followed by a decrease of the cone function eight months after the onset. Optical coherence tomography showed poorly distinguishable outer segments of the photoreceptors with the disappearance of the interdigitation zone. At that time, vitamin A deficiency along with several other deficiencies was confirmed. After the initiation of parenteral nutrition, a substantial improvement of the patient's overall well-being was noted and the OCT showed normalization of the retinal structure. Two other patients were diagnosed with vitamin A deficiency based on similar OCT features.

Conclusion:

Disruption of the outer segments of the photoreceptors and the disappearance of the interdigitation zone on OCT may be helpful in recognition of vitamin A deficiency. Early detection and malnutrition evaluation are especially important in patients with a history of gastrointestinal disorders who may have several other underlying deficiencies. Treatment with either enteral or parenteral nutrition not only leads to resolution of visual symptoms but vastly improves their general condition and quality of life.
Virus Shedding in Patients With Hand, Foot and Mouth Disease Induced by EV71, CA16 or CA6
Authors: Duan Xiaoxia , Chen Zhenhua , Li Xianzhi , Yuan Ping , Long Lu
Published: November 2020

Background:

As the highly contagious hand, foot and mouth disease (HFMD) spreads rapidly among children, isolation is the most effective way to control its spread. However, studies on the duration of virus shedding of the HFMD-related enterovirus and a reasonable quarantine period for HFMD patients are inconsistent.

Methods:

We undertook a systematic review and meta-analysis evaluating the viral shedding of patients with HFMD caused by Enterovirus 71 (EV71) and coxsackievirus A16 (CVA16) and coxsackievirus A6.

Results:

A total of 17 observational studies evaluating 626 participants were included. In the first 5 weeks after onset, the pooled virus positive rate in specimens of EV71-related patients decreased from 0.79 (P < 0.001 for heterogeneity) to 0.38 (P < 0.001 for heterogeneity). The positive rate of CVA16 was reduced from 0.91 (P < 0.001 for heterogeneity) to 0.29 (P < 0.001 for heterogeneity). The positive rates of CVA16 and coxsackievirus A6 were approximately 50% in the third week after onset, while a 50% positive rate appeared in the fourth week in EV71 related cases.

Conclusions:

We found the positive rates of virus shedding were still high among the patients released from quarantine, and the duration of viral shedding was inconsistent among HFMD patients caused by different serotypes. Our findings provide comprehensive evidence for a possible flexible quarantine period according to the serotype.
Evaluating keratoconus progression prior to crosslinking: maximum keratometry vs the ABCD grading system
Authors: Vinciguerra Riccardo , Belin Michael W. , Borgia Alfredo , Piscopo Raffaele , Montericcio Alessio , Confalonieri Filippo , Legrottaglie Emanuela F. , Rosetta Pietro , Vinciguerra Paolo
Published: November 2020

Purpose:

To evaluate the correlation between changes in maximum keratometry (Kmax) and ABC values from the ABCD Progression Display (Pentacam) in progressive keratoconus (KC) and to evaluate whether the ABC changes were able to detect progression earlier than Kmax.

Setting:

Humanitas Clinical and Research Center, Rozzano, Milan, Italy.

Design:

Retrospective study.

Methods:

Kmax, ABC values, and thinnest point (ThCT) were recorded at the day of corneal crosslinking (CXL) (T0) and previous follow-up (T-1). In patients without earlier progression in Kmax, follow-up examination (T-2) was used to determine whether any of the ABC parameters reached statistical significance for progression.

Results:

Seventy-six eyes of 63 patients scheduled for CXL with documented progression (Kmax increase of >1.00 diopter) were included. There was a significant, albeit moderate, correlation between the change in Kmax between T0 and T-1 and the change in both A (ρ = 0.391) and B values (ρ = 0.339). There was no significant correlation between the change in Kmax between T0 and T-1 and the change in either C or ThCT. In patients with T-2 examinations, 16 (51.6%) of 31 patients showed a statistically significant change on the ABCD progression display that was not detected with Kmax.

Conclusions:

This study showed a significant, but moderate, correlation between the change in Kmax and the change in A and B values in progressive KC. Moreover, more than half of the cases showed documented progression earlier with the ABCD progression display than that detected by standard Kmax changes. This study suggests possible changes in progression criteria to allow for earlier intervention.
Child Trafficking Victims in Pediatric Surgical Environments
Authors: Peck Jessica L.
Published: November 2020

Human trafficking is a global human rights violation and emerging public health emergency. Child trafficking (CT), in particular, is both understudied and underreported. Despite the demonstrated need for skilled and knowledgeable health professional interventions, awareness across the continuum of care environments remains low. There is virtually no published scientific nursing literature exploring incidence and impact of CT specifically presenting in surgical settings, although survivor reports indicate an urgent and pressing need for it as victims may be hiding in plain sight within care environments. The purpose of this article is not to provide an exhaustive overview of the definitions, etiology, or means and purposes of CT but to draw attention of pediatric surgical nurses (PSNs) to consider how victims may be presenting for surgical care. PSNs need increased education, awareness, and tools to competently advocate for effective policy development and prioritized research efforts. PSNs should coordinate evidence-based, trauma-informed, and culturally responsive clinical actions in pediatric surgical care environments.
Population Health Content Within Professional Entry-Level Physical Therapist Education Programs
Authors: Domholdt Elizabeth , Giuffre Suzanne , Keehan Jane
Published: November 2020

Introduction.

Physical therapists can play an important role in improving the health of populations. However, little information exists about how physical therapists are prepared for population-based practice. The purpose of this study was to determine the current and desired coverage of population health concepts within entry-level physical therapist programs accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE). The Clinical Prevention and Population Health (CPPH) Curriculum Framework of the Association for Prevention Teaching and Research guided the study.

Methods.

Program directors at CAPTE-accredited physical therapist education program were invited to participate in an online survey. Sixty-three of 237 program directors (27%) responded.

Results.

Program directors agreed that 22 of 23 CPPH domains should be included in entry-level physical therapist education programs, although only 9 of these domains had at least moderate coverage within current curriculums. The largest gaps between current and desired coverage were for occupational health, population health informatics, counseling for behavioral change, global health issues, and organization of clinical and public health systems.

Discussion and Conclusion.

The CPPH Framework may be a useful tool for physical therapy faculty to use when incorporating population health into their curriculums. The identified gaps between current and desired coverage may be a useful place to start curriculum development efforts. Similarities between responses to this survey and those in a companion study of occupational therapist programs suggests that it may be useful for faculty from physical therapist and occupational therapist programs to collaborate in curriculum development efforts related to population health.
Rapid Administration of Ketamine for Abscess Drainage in Children—A Dose Finding Study
Authors: Chinta Sri S. , Schrock Charles R. , McAllister John D. , Jaffe David M. , Liu Jingxia , Kennedy Robert M.
Published: November 2020

Study Objective

To estimate the minimum dose and total sedation time of rapidly infused ketamine that achieves 3 to 5 minutes of effective sedation in children undergoing abscess incision and drainage in the emergency department.

Methods

The Up-Down method was used to estimate the dose of intravenous ketamine infused over 5 seconds or less that provided effective sedation in 50% (ED50) and 95% (ED95) for healthy children aged 2 to 5 years and 6 to 11 years undergoing abscess incision and drainage. None were pretreated with opioids. Three investigators blinded to ketamine dose independently graded sedation effectiveness by viewing a video recording of the first 5 minutes of sedation. Recovery was determined when patients reached a Modified Aldrete score of 10.

Results

We enrolled 20 children in each age group. The estimated ED50 was 0.9 and 0.6 mg/kg for the 2 to 5 years and 6 to 11 years' groups and the estimated ED95 was 1.1 mg/kg for both groups. The median time to full recovery for the 2 groups was 20.5 and 17.5 minutes when only 1 dose of ketamine was administered and 27.5 and 35 minutes when additional doses of ketamine were administered. No participants experienced serious adverse events.

Conclusions

We estimated ED50 and ED95 for rapidly infused ketamine for 2 age groups undergoing abscess incision and drainage. Further studies are needed to get a more precise estimate of ED95. The total sedation time with this technique in the abscess group was shorter than most previous studies and is consistent with our previous observations in patients undergoing fracture reduction.
Local and Topical Anesthetics for Pediatric Patients in the Emergency Department
Authors: Mace Sharon E. , Whiteman Paula , Avarello Jahn T. , Ojo Aderonke , Rose Emily , Valente Jonathan , Joseph Madeline
Published: November 2020

Painful diagnostic and therapeutic procedures are common in the emergency department. Adequately treating pain, including the pain of procedures is an essential component of the practice of emergency medicine. Pain management is also part of the core competency for emergency medicine residencies and pediatric emergency medicine fellowships. There are many benefits to providing local and/or topical anesthesia before performing a medical procedure, including better patient and family satisfaction and increased procedural success rates. Local and topical anesthetics when used appropriately, generally, have few, if any, systemic side effects, such as hypotension or respiratory depression, which is an advantage over procedural sedation. Use of local and topical anesthetics can do much toward alleviating the pain and anxiety of pediatric patients undergoing procedures in the emergency department.
Statin exposure and risk of cancer in people with and without HIV infection
Authors: Bedimo Roger J. , Park Lesley S. , Shebl Fatima M. , Sigel Keith , Rentsch Christopher T. , Crothers Kristina , Rodriguez-Barradas Maria C. , Goetz Matthew Bidwell , Butt Adeel A. , Brown Sheldon T. , Gibert Cynthia , Justice Amy C. , Tate Janet P.
Published: November 2020

Objective:

To determine whether statin exposure is associated with decreased cancer and mortality risk among persons with HIV (PWH) and uninfected persons. Statins appear to have immunomodulatory and anti-inflammatory effects and may reduce cancer risk, particularly among PWH as they experience chronic inflammation and immune activation.

Design:

Propensity score-matched cohort of statin-exposed and unexposed patients from 2002 to 2017 in the Veterans Aging Cohort Study (VACS), a large cohort with cancer registry linkage and detailed pharmacy data.

Methods:

We calculated Cox regression hazard ratios (HRs) and 95% confidence intervals (CI) associated with statin use for all cancers, microbial cancers (associated with bacterial or oncovirus coinfection), nonmicrobial cancers, and mortality.

Results:

:The propensity score-matched sample (N = 47 940) included 23 970 statin initiators (31% PWH). Incident cancers were diagnosed in 1160 PWH and 2116 uninfected patients. Death was reported in 1667 (7.0%) statin-exposed, and 2215 (9.2%) unexposed patients. Statin use was associated with 24% decreased risk of microbial-associated cancers (hazard ratio 0.76; 95% CI 0.69–0.85), but was not associated with nonmicrobial cancer risk (hazard ratio 1.00; 95% CI 0.92–1.09). Statin use was associated with 33% lower risk of death overall (hazard ratio 0.67; 95% CI 0.63–0.72). Results were similar in analyses stratified by HIV status, except for non-Hodgkin lymphoma where statin use was associated with reduced risk (hazard ratio 0.56; 95% CI 0.38–0.83) for PWH, but not for uninfected (P interaction = 0.012).

Conclusion:

In both PWH and uninfected, statin exposure was associated with lower risk of microbial, but not nonmicrobial cancer incidence, and with decreased mortality.
Ultrasound Contrast
Authors: Klibanov Alexander L.
Published: November 2020

Gas-filled microbubbles are currently in clinical use as blood pool contrast agents for ultrasound imaging. The goal of this review is to discuss the trends and issues related to these relatively unusual intravascular materials, which are not small molecules per se, not polymers, not even nanoparticles, but larger micrometer size structures, compressible, flexible, elastic, and deformable. The intent is to connect current research and initial studies from 2 to 3 decades ago, tied to gas exchange between the bubbles and surrounding biological medium, in the following areas of focus: (1) parameters of microbubble movement in relation to vasculature specifics; (2) gas uptake and loss from the bubbles in the vasculature; (3) adhesion of microbubbles to target receptors in the vasculature; and (4) microbubble interaction with the surrounding vessels and tissues during insonation.

Microbubbles are generally safe and require orders of magnitude lower material doses than x-ray and magnetic resonance imaging contrast agents. Application of microbubbles will soon extend beyond blood pool contrast and tissue perfusion imaging. Microbubbles can probe molecular and cellular biomarkers of disease by targeted contrast ultrasound imaging. This approach is now in clinical trials, for example, with the aim to detect and delineate tumor nodes in prostate, breast, and ovarian cancer. Imaging of inflammation, ischemia-reperfusion injury, and ischemic memory is also feasible. More importantly, intravascular microbubbles can be used for local deposition of focused ultrasound energy to enhance drug and gene delivery to cells and tissues, across endothelial barrier, especially blood-brain barrier.

Overall, microbubble behavior, stability and in vivo lifetime, bioeffects upon the action of ultrasound and resulting enhancement of drug and gene delivery, as well as targeted imaging are critically dependent on the events of gas exchange between the bubbles and surrounding media, as outlined in this review.
Liver Abscess With High 18F-FDG Uptake and No 18F-Fluorothymidine Uptake
Authors: Fujimoto Kengo , Norikane Takashi , Mitamura Katsuya , Yamamoto Yuka , Okano Keiichi , Suzuki Yasuyuki , Nishiyama Yoshihiro
Published: November 2020

18F-FDG accumulates not only in malignant lesions but also in infectious and inflammatory ones. 3′-deoxy-3′-18F-fluorothymidine (FLT) has been investigated as a promising PET tracer for evaluating tumor proliferating activity. We report a case of liver abscess during therapy of pancreatic cancer that underwent FDG PET/CT and FLT PET/CT studies. Although FDG PET/CT demonstrated several regions of increased uptake in the liver, FLT PET/CT showed no increased uptake in the liver.
Increased Uptake of 68Ga-Pentixafor in Thymic Rebound After Chemotherapy in a Patient With Multiple Myeloma
Authors: Pan Qingqing , Luo Yaping , Cao Xinxin , Li Jian
Published: November 2020

A 38-year-old man with newly diagnosed multiple myeloma underwent 68Ga-pentixafor PET/CT for baseline assessment. 68Ga-pentixafor PET/CT demonstrated multiple focal bone and bone marrow lesions with intense radioactivity. After 9 cycles of chemotherapy against multiple myeloma, the patient experienced serologically complete remission of myeloma. Consistently, the follow-up 68Ga-pentixafor PET/CT for PET response showed significantly reduced uptake in the previously chemokine receptor 4–positive bone lesions. However, intense and homogeneous uptake of 68Ga-pentixafor was noted in the thymus with a smooth contour and slightly increased density, which is possibly caused by thymic hyperplasia after chemotherapy.
Focal Liver 18F-FDG Uptake in a Patient Who Underwent Thrombolysis for Brachiocephalic and Subclavian Thrombosis
Authors: Huot Daneault Alexis , Le Blanc Richard , Voyer Nathalie , Turcotte Éric , Rousseau Etienne
Published: November 2020

A 19-year-old woman presented with a primary mediastinal B-cell lymphoma invading the superior vena cava with associated thrombosis of the left brachiocephalic and subclavian vein. She underwent thrombolysis followed by chemotherapy. The midtreatment 18F-FDG PET/CT demonstrated important regression of the primary mediastinal B-cell lymphoma, but showed intense focal hepatic uptake in segment IV, without a corresponding lesion on ultrasonography, non–contrast-enhanced low-dose CT, and MRI. This focal uptake disappeared on a subsequent 18F-FDG PET/CT study when the radiotracer was injected in the foot, suggesting an anomalous venous return pathway that persisted despite thrombolysis.
Malakoplakia Presenting as a Mass in the Transplanted Kidney
Authors: Kalimuthu Lokeshwaran Madurai , Ora Manish , Nazar Aftab Hasan , Gambhir Sanjay
Published: November 2020

Malakoplakia is a rare inflammatory condition that can affect many organ systems, including the genitourinary tract. It is associated with impaired immune function. Isolated renal parenchymal involvement has been reported in very few cases. Urinary tract and digestive malakoplakia have been reported in transplant recipients, but the involvement of transplant itself is rare. Variable clinical manifestations and nonspecific radiological appearance make the diagnosis difficult. The differential diagnosis includes infective etiologies and malignancy. We report a case of renal allograft malakoplakia, mimicking as a malignancy on 18F-FDG PET/CT.
Orthognathic Surgery in Cleidocranial Dysplasia
Authors: Pourtaheri Navid , Allam Omar , Chandler Ludmila , Steinbacher Derek M.
Published: November 2020

Optimal surgical correction of the craniofacial manifestations of cleidocranial dysplasia (CCD) has not been established due to the rarity of the condition. A 27-year-old female with CCD is presented. She underwent virtual surgical planning (VSP) followed by LeFort-I disimpaction, bone grafting, bilateral sagittal-split osteotomy, genioplasty, submental lipectomy, and targeted facial fat grafting. The patient necessitated 15-mm of vertical maxillary disimpaction centrally, stabilized with wide maxillary plates and interpositional allogenic fibula grafts. Six-month postoperative examination demonstrated improved appearance and functional symptoms. Skeletal relationships were normalized on computed tomography (CT) and there was minimal change between immediate and 6-month postoperative CT measurements, demonstrating a stable result. Orthognathic surgery used to establish dentofacial harmony in patients with CCD can test the extremes of single-stage facial skeletal expansion. Use of VSP, wide maxillary plates, and interpositional bone grafts can help optimize maxillary expansion and stability, while concurrent fat redistribution optimizes facial aesthetics.
Anatomical and Volumetric Analysis of the Sphenoid Sinus by Semiautomatic Segmentation of Cone Beam Computed Tomography
Authors: Lentzen Max-Philipp , Zirk Matthias , Riekert Maximilian , Buller Johannes , Kreppel Matthias
Published: November 2020

This investigation was performed to analyze and evaluate anatomical and volumetric data of the sphenoid sinus by semiautomatic segmentation of cone beam computed tomography (CBCT) datasets.

This analysis was carried out on cone beam computed tomography images of 100 patients. By using the discretionary software “ITK-Snap”, the volumetric investigation of 197 sphenoid sinuses was conducted. The statistical analyses were carried out by using the paired and independent Studentt-test. In addition, thePearsonschi-square test was performed.PvaluesP < 0.05 were considered significant.

The volumetric mean was 4.438 ± 2.434 cm3for the right and 4.809 ± 3.000 for the left side. Results did not indicate statistically significant differences according to the side, irrespective of gender (P > 0.05). The further investigation of differences between male and female patients did assess significant results (P < 0.05), males (10.477 ± 3.851 cm3) present a larger total sinus volume than females (8.219 ± 3.574 cm3). In accordance to patients‘ age (median 54 years), smaller volumes were related to younger patients and larger volumes to older ones. But, no statistically significant results in accordance to age could be detected (χ2 = 1.258;P > 0.05).

Endoscopic sinus surgery of the vulnerable and intricate anatomy of the sphenoid sinus requires an explicit knowledge and orientation about the anatomical variations such as septums and volumetric capacity. Concerning this matter, semiautomatic segmentation of CBCT images can aid the surgeon in preoperative planning. Our investigation shows that a small sinus volume, that is, affecting female patients and a complex sinus anatomy by the occurrence of a septum, especially located close to neurovascular structures could essentially aggravate endoscopic sphenoid sinus surgery. In this regard, volumetric analysis of the sphenoid sinus by CBCT images can provide presurgical information and facilitates an individualized treatment.
Development of a protocol for detection of SARS-CoV-2 in sputum and endotracheal aspirates using Cepheid Xpert Xpress SARS-CoV-2
Authors: Malczynski Michael , Rezaeian Saba , Rios Javier , Dirnberger Laura , Polanco Wanda , Zembower Teresa , Qi Chao
Published: November 2020

Sputum and endotracheal aspirates (ETs) are not among the vendor-approved specimens for the Cepheid Xpert SARS-CoV-2 assay. However, they are the common lower respiratory tract specimens submitted for laboratory diagnosis. Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in lower respiratory tract samples is required for the discharge of patients from coronavirus disease (COVID) units at some institutions. We developed a protocol used for testing unliquified viscous sputum or tracheal aspirate with the Cepheid Xpert SARS-CoV-2 assay.
Unification of the M/ORF3-related proteins points to a diversified role for ion conductance in pathogenesis of coronaviruses and other nidoviruses
Authors: Tan Yongjun , Schneider Theresa , Shukla Prakash K. , Chandrasekharan Mahesh B. , Aravind L , Zhang Dapeng
Published: November 2020

The new coronavirus, SARS-CoV-2, responsible for the COVID-19 pandemic has emphasized the need for a better understanding of the evolution of virus-host conflicts. ORF3a in both SARS-CoV-1 and SARS-CoV-2 are ion channels (viroporins) and involved in virion assembly and membrane budding. Using sensitive profile-based homology detection methods, we unify the SARS-CoV ORF3a family with several families of viral proteins, including ORF5 from MERS-CoVs, proteins from beta-CoVs (ORF3c), alpha-CoVs (ORF3b), most importantly, the Matrix (M) proteins from CoVs, and more distant homologs from other nidoviruses. By sequence analysis and structural modeling, we show that these viral families utilize specific conserved polar residues to constitute an ion-conducting pore in the membrane. We reconstruct the evolutionary history of these families, objectively establish the common origin of the M proteins of CoVs and Toroviruses. We show that the divergent ORF3a/ORF3b/ORF5 families represent a duplication stemming from the M protein in alpha- and beta-CoVs. By phyletic profiling of major structural components of primary nidoviruses, we present a model for their role in virion assembly of CoVs, ToroVs and Arteriviruses. The unification of diverse M/ORF3 ion channel families in a wide range of nidoviruses, especially the typical M protein in CoVs, reveal a conserved, previously under-appreciated role of ion channels in virion assembly, membrane fusion and budding. We show that the M and ORF3 are under differential evolutionary pressures; in contrast to the slow evolution of M as core structural component, the CoV-ORF3 clade is under selection for diversification, which indicates it is likely at the interface with host molecules and/or immune attack.

IMPORTANCE

Coronaviruses (CoVs) have become a major threat to human welfare as the causative agents of several severe infectious diseases, namely Severe Acute Respiratory Syndrome (SARS), Middle Eastern Respiratory Syndrome (MERS), and the recently emerging human coronavirus disease 2019 (COVID-19). The rapid spread, severity of these diseases, as well as the potential re-emergence of other CoV-associated diseases have imposed a strong need for a thorough understanding of function and evolution of these CoVs. By utilizing robust domain-centric computational strategies, we have established homologous relationships between many divergent families of CoV proteins, including SARS-CoV/SARS-CoV-2 ORF3a, MERS-CoV ORF5, proteins from both beta-CoVs (ORF3c) and alpha-CoVs (ORF3b), the typical CoV Matrix proteins, and many distant homologs from other nidoviruses. We present evidence that they are active ion channel proteins, and the Cov-specific ORF3 clade proteins are under selection for rapid diversification, suggesting they might have been involved in interfering host molecules and/or immune attack.
The Treatment of Clear Cell Ovarian Cancer with the Poly(ADP- Ribose) Polymerase (PARP1) Inhibitors (AG14361,Veliparib,Olaparib) as Chemosensitizers
Authors: de Soto Joseph Angel
Published: November 2020

Introduction

Most of those who get ovarian cancer will die from this cancer. Of the major types of ovarian cancer clear cell carcinoma is the most aggressive and chemoresistant type of epithelial ovarian cancer. Here the sensitivity of clear cell ovarian carcinoma to poly adenosine diphosphate [ADP-ribose] polymerase (PARP) inhibitors is tested.

Methodology

Ovarian cancer cell lines were treated with the PARP inhibitors AG14361, Veliparib, or Olaparib alone or in combination with cisplatin, carboplatinum, doxorubicin, 5-fluorouracil (5-FU), gemcitabine and paclitaxel for 72 hours. The IC50 concentrations were calculated. Each experiment was replicated 10 times.

Results

As single agents the PARP inhibition of ovarian cancer among serous, endometroid and clear cell ovarian cancer cell lines was similar. Clear cell ovarian cancer seemed particularly susceptible to chemo-sensitization by PARP inhibitors with paclitaxel, 5-FU, carboplatin, doxorubicin and/or cisplatin. Antagonism was seen with gemcitabine.

Conclusion

PARP inhibitors are exceptional chemosensitizers of clear cell ovarian cancer to treatment with most standard chemotherapy agents.
Enzyme catalysis prior to aromatic residues: reverse engineering of a dephosphoCoA kinase
Authors: Makarov Mikhail , Meng Jingwei , Tretyachenko Vyacheslav , Srb Pavel , Březinová Anna , Giacobelli Valerio Guido , Bednárová Lucie , Vondrášek Jiří , Dunker A. Keith , Hlouchová Klára
Published: November 2020

It is well-known that the large diversity of protein functions and structures is derived from the broad spectrum of physicochemical properties of the 20 canonical amino acids. According to the generally accepted hypothesis, protein evolution was continuously associated with enrichment of this alphabet, increasing stability, specificity and spectrum of catalytic functions. Aromatic amino acids are considered the latest addition to genetic code.

The main objective of this study was to test whether enzymatic catalysis can spare the aromatic amino acids (aromatics) by determining the effect of amino acid alphabet reduction on structure and function of dephospho-CoA kinase (DPCK). We designed two mutant variants of a putative DPCK fromAquifex aeolicusby substituting (i) Tyr, Phe and Trp or (ii) all aromatics (including His), i.e. ∼10% of the total sequence. Their structural characterization indicates that removal of aromatic amino acids may support rich secondary structure content although inevitably impairs a firm globular arrangement. Both variants still possess ATPase activity, although with 150-300 times lower efficiency in comparison with the wild-type phosphotransferase activity. The transfer of the phosphate group to the dephospho-CoA substrate is however heavily uncoupled and only one of the variants is still able to perform the reaction.

Here we provide support to the hypothesis that proteins in the early stages of life could support at least some enzymatic activities, despite lower efficiencies resulting from the lack of a firm hydrophobic core. Based on the presented data we hypothesize that further protein scaffolding role may be provided by ligands upon binding.

Significance

All extant proteins rely on the standard coded amino acid alphabet. However, early proteins lacked some of these amino acids that were incorporated into the genetic code only after the evolution of their respective metabolic pathways, aromatic amino acids being among the last additions. This is intriguing because of their crucial role in hydrophobic core packing, indispensable for enzyme catalysis.

We designed two aromatics-less variants of a highly conserved enzyme from the CoA synthesis pathway, capable of enzyme catalysis and showing significant ordering upon substrate binding. To our knowledge, this is the first example of enzyme catalysis in complete absence of aromatic amino acids and presents a possible mechanism of how aromatics-less enzymes could potentially support an early biosphere.