bluuebunny/crossref_metadata_2025 huggingface dataset:
Synthesis of superficially modified Ce1−x(Zr + Y)xO2−δ
solid solutions and thermogravimetric analysis of their performance in the catalytic soot combustion
Authors: Téllez-Salazar W N , Fabián-Anguiano J A , Ovalle-Encinia O , Zeifert B H , Ezeta-Mejía A , Romero-Ibarra I C , Ortiz-Landeros J
Published: December 2020

In this work, solid solutions of general formula Ce1−x(Zr + Y)xO2−δ
were chemically synthesized through the so-called citrate-EDTA complexing method, wherein the doping cations Zr and Y were substituted in the ceria lattice with an equimolar amount of 0.05 ≤ x ≤ = 0.25. The ternary oxides were heat-treated, and those that showed the best textural properties were superficially impregnated with Fe2O3 particles by the thermal decomposition method using a metalorganic precursor. The X-ray diffraction results suggest that co-doping with Zr4+ and Y3+ promotes a slight distortion of the CeO2 cubic cell. Nevertheless, the fluorite cubic structure of the oxides remains stable after being exposed to heat treatments. Furthermore, using scanning electron microscopy and Raman techniques, the presence of deposited Fe2O3 and the formation of extrinsic vacancies in the materials could be corroborated. Finally, the oxides’ catalytic evaluation in the soot oxidation reaction was carried out using the thermogravimetry technique. The ternary oxide with cerium molar content equal to 0.9 and impregnated with Fe2O3 presented excellent catalytic behavior for soot oxidation. T10, T50, and T90 temperatures were 310, 383, and 416 °C, respectively.
Every exponential group supports a positive harmonic function
Authors: Amir Gideon , Kozma Gady
Published: December 2020

We prove that all groups of exponential growth support non-constant positive harmonic functions. In fact, our results hold in the more general case of strongly connected, finitely supported Markov chains invariant under some transitive group of automorphisms for which the directed balls grow exponentially.
Evaluation of an opioid risk mitigation initiative for veterans undergoing hip or knee arthroplasty at San Francisco Veterans Affairs Health Care System
Authors: Rife Tessa , Tat Christina , Malakootian Mahsa
Published: December 2020

Purpose

Guidelines recommend evaluating the risk of opioid-related adverse events prior to initiating opioid therapy. The orthopedic service at San Francisco Veterans Affairs Health Care System (SFVHCS) has not routinely used risk assessment tools such as the Stratification Tool for Opioid Risk Mitigation, prescription drug monitoring program data, and urine drug screening prior to opioid prescribing. A quality improvement project was conducted to evaluate the number of pharmacist-provided opioid risk mitigation recommendations implemented by orthopedic providers for patients who underwent total hip or knee arthroplasty at SFVHCS.

A pharmacist-led workflow for completing risk mitigation reviews was developed in collaboration with orthopedic providers, and urine drug screening was added to the preoperative laboratory testing protocol. The following recommendations were communicated via electronic medical record: limit postoperative opioids to a 7- or 14-day supply based on risk of suicide and/or overdose, offer naloxone and a medication disposal bag, and order a urine drug screen if not already completed. Risk reviews were completed for 75 patients. Among 64 patients with 2-month postdischarge data available, 88% (7 of 8) of 7-day and 79% (44 of 56) of 14-day opioid supply recommendations were implemented; 41% (26 of 59) of recommendations to issue a medication disposal bag, 17% (2 of 12) recommendations to order a missing urine drug screen, and 9% (5 of 55) of recommendations to offer naloxone were implemented.

Conclusion

Pharmacist-performed risk mitigation reviews paired with individualized recommendations led to high rates of orthopedic provider acceptance of limiting postdischarge opioid day supplies for patients who had total hip or knee arthroplasty. Alternative strategies may increase access to naloxone. Future research should examine the impact of risk mitigation tools in reducing prescribing of long-term opioid therapy and adverse events among orthopedic surgical patients.
Maternal environmental exposure to bisphenols and epigenome-wide DNA methylation in infant cord blood
Authors: McCabe Carolyn F , Padmanabhan Vasantha , Dolinoy Dana C , Domino Steven E , Jones Tamara R , Bakulski Kelly M , Goodrich Jaclyn M
Published: December 2020

Maternal prenatal exposures, including bisphenol A (BPA), are associated with offspring’s risk of disease later in life. Alterations in DNA methylation may be a mechanism through which altered prenatal conditions (e.g. maternal exposure to environmental toxicants) elicit this disease risk. In the Michigan Mother and Infant Pairs Cohort, maternal first-trimester urinary BPA, bisphenol F, and bisphenol S concentrations were tested for association with DNA methylation patterns in infant umbilical cord blood leukocytes (N = 69). We used the Illumina Infinium MethylationEPIC BeadChip to quantitatively evaluate DNA methylation across the epigenome; 822 020 probes passed pre-processing and quality checks. Single-site DNA methylation and bisphenol models were adjusted for infant sex, estimated cell-type proportions (determined using cell-type estimation algorithm), and batch as covariates. Thirty-eight CpG sites [false discovery rate (FDR) <0.05] were significantly associated with maternal BPA exposure. Increasing BPA concentrations were associated with lower DNA methylation at 87% of significant sites. BPA exposure associated DNA methylation sites were enriched for 38 pathways significant at FDR <0.05. The pathway or gene-set with the greatest odds of enrichment for differential methylation (FDR <0.05) was type I interferon receptor binding. This study provides a novel understanding of fetal response to maternal bisphenol exposure through epigenetic change.
The opioid-prescribing practices of Australian general practice registrars: an interview study
Authors: Prathivadi Pallavi , Barton Chris , Mazza Danielle
Published: December 2020

Background

Approximately half of the opioids prescribed by Australian GP and GP registrars are for chronic non-cancer pain—despite limited therapeutic benefit, and serious risks of harm. Understanding the factors driving non-evidence-based opioid prescribing may improve GP training and education.

Objective

To explore attitudes, beliefs, knowledge and self-reported factors influencing the opioid-prescribing decisions of Australian GP registrars.

Methods

Telephone interviews were undertaken with 20 GP registrars in 2018–19. Interviews were 30–60 minutes in duration, audio-recorded and de-identified. Braun and Clarke’s 6-phase framework was adopted for reflexive thematic analysis of data and managed using QSR NVivo software.

Results

Twenty registrars were recruited; 8 men and 12 women. Three themes were identified.

Support and supervision

Difficult chronic pain consultations negatively affected the registrar well-being. Registrars role modelled their supervisors’ opioid-prescribing practices, even if they perceived it to be unsafe.

Confidence

Registrars lacked confidence in initiating, prescribing and weaning opioids, recognizing drug-seeking behaviours and declining to prescribe—but felt confident in their knowledge of opioid pharmacology.

Safety

Registrars were aware of evidence-based prescribing recommendations and risk reduction strategies but struggled to translate this into practice.

Conclusions

Non-evidence-based opioid prescribing by Australian GP registrars is multifactorial. Emotionally difficult pain consultations, poor supervision and low prescriber confidence may contribute to unsafe prescribing. Improving registrar prescribing may require interventions to improve risk reduction, training in communication and role modelling by supervisors.
Testing of the foreshock hypothesis within an epidemic like description of seismicity
Authors: Petrillo G , Lippiello E
Published: December 2020

The epidemic type aftershock sequence (ETAS) model provides a good description of the post-seismic spatio-temporal clustering of seismicity and is also able to capture some features of the increase of seismic activity caused by foreshocks. Recent results, however, have shown that the number of foreshocks observed in instrumental catalogues is significantly much larger than the one predicted by the ETAS model. Here we show that it is possible to keep an epidemic description of post-seismic activity and, at the same time, to incorporate pre-seismic temporal clustering, related to foreshocks. Taking also into-account the short-term incompleteness of instrumental catalogues, we present a model which achieves very good description of the southern California seismicity both on the aftershock and on the foreshock side. Our results indicate that the existence of a preparatory phase anticipating main shocks represents the most plausible explanation for the occurrence of foreshocks.
Obturator hernia: a delayed diagnosis. A case report with literature review
Authors: Siddiqui Zohaib , Khalil Mohammed , Khalil Aoff , Saeed Shoaib
Published: December 2020

Obturator hernias are classically difficult to diagnose, have a high mortality and are an uncommon cause of intestinal obstruction. They are usually found in thin, elderly female patients. We present a case of a misdiagnosed 89-year-old female who presented to accident and emergency with a short history of abdominal pain. The diagnosis of an incarcerated obturator hernia was confirmed after re-discussion of computed tomography scan with the consultant radiologist in the morning. The patient underwent emergency laparotomy and the defect reduced. The patient recovered well post-operation; however; on the fourth day post-operation, the patient suffered a cardiac arrest. We report this case as a reminder to our health care colleagues to be mindful of elderly female patients who present with small bowel obstruction due to the high risk of mortality of this type of hernia.
Inelastic processes in copper–hydrogen collisions including fine-structure effects
Authors: Belyaev Andrey K , Yakovleva Svetlana A , Kraemer Wolfgang P
Published: December 2020

Inelastic processes in low-energy Cu + H and Cu+ + H− collisions, 306 partial processes in total, are investigated taking fine-structure effects into account. We use the asymptotic approach to model the adiabatic potentials and adapt a recently proposed method to include the copper fine structure. The nuclear dynamics is performed by the multichannel analytical approach and the Landau–Zener model. The rate coefficients are calculated for the temperature range of 1000–10 000 K. The largest rate coefficient is obtained for the mutual neutralization process Cu+ + H− → Cu(3d105s 2S1/2) + H with a value of $3.81 \times 10^{-8}\, {\rm cm}^3\,{\rm s^{-1}}$ at a temperature of 6000 K . It is shown that the practice to redistribute LS-coupling rate coefficients among fine-structure sublevels can give rates that deviate significantly from those calculated in the JJ-coupling scheme, that is with account for the fine-structure effects.
Middle aged γ-ray pulsar J1957+5033 in X-rays: pulsations, thermal emission, and nebula
Authors: Zyuzin D A , Karpova A V , Shibanov Y A , Potekhin A Y , Suleimanov V F
Published: December 2020

We analyse new XMM–Newton and archival Chandra observations of the middle-aged γ-ray radio-quiet pulsar J1957+5033. We detect, for the first time, X-ray pulsations with the pulsar spin period of the point-like source coinciding by position with the pulsar. This confirms the pulsar nature of the source. In the 0.15–0.5 keV band, there is a single pulse per period and the pulsed fraction is ≈18 ± 6 per cent. In this band, the pulsar spectrum is dominated by a thermal emission component that likely comes from the entire surface of the neutron star, while at higher energies (≳0.7 keV) it is described by a power law with the photon index Γ ≈ 1.6. We construct new hydrogen atmosphere models for neutron stars with dipole magnetic fields and non-uniform surface temperature distributions with relatively low effective temperatures. We use them in the spectral analysis and derive the pulsar average effective temperature of ≈(2–3) × 105 K. This makes J1957+5033 the coldest among all known thermally emitting neutron stars with ages below 1 Myr. Using the interstellar extinction–distance relation, we constrain the distance to the pulsar in the range of 0.1–1 kpc. We compare the obtained X-ray thermal luminosity with those for other neutron stars and various neutron star cooling models and set some constraints on the latter. We observe a faint trail-like feature, elongated ∼8 arcmin from J1957+5033. Its spectrum can be described by a power law with a photon index Γ = 1.9 ± 0.5 suggesting that it is likely a pulsar wind nebula powered by J1957+5033.
Using multichannel singular spectrum analysis to study galaxy dynamics
Authors: Weinberg Martin D , Petersen Michael S
Published: December 2020

N-body simulations provide most of our insight into the structure and evolution of galaxies, but our analyses of these are often heuristic and from simple statistics. We propose a method that discovers the dynamics in space and time together by finding the most correlated temporal signals in multiple time-series of basis-function expansion coefficients and any other data fields of interest. The method extracts the dominant trends in the spatial variation of the gravitational field along with any additional data fields through time. The mathematics of this method is known as multichannel singular spectrum analysis (M-SSA). In essence, M-SSA is a principal component analysis of the covariance of time-series replicates, each lagged successively by some interval. The dominant principal component (PC) represents the trend that contains the largest fraction of the correlated signal. The next PC is orthogonal to the first and contains the next largest fraction, and so on. Using a suite of previously analysed simulations, we find that M-SSA describes bar formation and evolution, including mode coupling and pattern-speed decay. We also analyse a new simulation tailored to study vertical oscillations of the bar using kinematic data. Additionally, and to our surprise, M-SSA uncovered some new dynamics in previously analysed simulations, underscoring the power of this new approach.
The thermal conductivity of the Earth's core and implications for its thermal and compositional evolution
Authors: Ohta Kenji , Hirose Kei
Published: December 2020

Determining the thermal conductivity of iron alloys at high pressures and temperatures are essential for understanding the thermal history and dynamics of the Earth's metallic cores. The authors summarize relevant high-pressure experiments using a diamond-anvil cell and discuss implications of high core conductivity for its thermal and compositional evolution.
Urine Lipoarabinomannan Testing for All HIV Patients Hospitalized in Medical Wards Identifies a Large Proportion of Patients With Tuberculosis at Risk of Death
Authors: Huerga Helena , Mathabire Rucker Sekai Chenai , Bastard Mathieu , Mpunga James , Amoros Quiles Isabel , Kabaghe Chimwemwe , Sannino Laura , Szumilin Elisabeth
Published: December 2020

Background

Diagnosing tuberculosis (TB), the leading cause of death in people with HIV, remains a challenge in resource-limited countries. We assessed TB diagnosis using a strategy that included systematic urine lipoarabinomannan (LAM) testing for all HIV patients hospitalized in medical wards and 6-month mortality according to LAM results.

Methods

This prospective, observational study included adult HIV patients hospitalized in the medical wards of a public district hospital in Malawi regardless of their TB symptoms or CD4 count. Each patient had a clinical examination, and Alere Determine TB-LAM, sputum microscopy, sputum GeneXpert MTB/RIF (Xpert), chest x-ray, and CD4 count were systematically requested.

Results

Among 387 inpatients, 54% had a CD4 <200 cells/µL, 64% had presumptive TB, and 90% had ≥1 TB symptom recorded in their medical file. LAM results were available for 99.0% of patients, microscopy for 62.8%, and Xpert for 60.7%. In total, 26.1% (100/383) had LAM-positive results, 48% (48/100) of which were grades 2–4. Any TB laboratory test result was positive in 30.8% (119/387). Among patients with no Xpert result, 28.5% (43/151) were LAM-positive. Cumulative 6-month mortality was 40.1% (151/377): 50.5% (49/97) in LAM-positives and 36.2% (100/276) in LAM-negatives (P = .013). In multivariable regression analyses, LAM-positive patients had a higher risk of mortality than LAM-negatives (adjusted odds ratio, 2.5; 95% CI, 1.1–5.8; P = .037).

Conclusions

In resource-limited hospital medical wards with high TB prevalence, a diagnostic strategy including systematic urine LAM testing for all HIV patients is an easily implementable strategy that identifies a large proportion of patients with TB at risk of death.
When Selling Becomes Viral: Disruptions in Debt Markets in the COVID-19 Crisis and the Fed’s Response
Authors: Haddad Valentin , Moreira Alan , Muir Tyler
Published: December 2020

We document extreme disruption in debt markets during the COVID-19 crisis: a severe price crash accompanied by significant dislocations at the safer end of the credit spectrum. Investment-grade corporate bonds traded at a discount to credit default swaps; exchange-traded funds traded at a discount to net asset value, more so for safer bonds. The Federal Reserve’s announcement of corporate bond purchases caused these dislocations to disappear and prices to recover. These facts inform potential theories of the disruption. The best explanation is an acute liquidity need for specific bond investors, such as mutual funds, leading them to liquidate large positions.
Profiling severe acute respiratory syndrome coronavirus 2 and its relevance to otolaryngologic examinations during the coronavirus disease 2019 pandemic
Authors: Chan Catherine P.L. , Chan Jason Y.K.
Published: December 2020

Purpose of review

The WHO announced the coronavirus disease 2019 (COVID-19) outbreak as a pandemic in February 2020 with over 15 million confirmed cases of COVID-19 globally to date. Otolaryngologists are at a high risk of contracting COVID-19 during this pandemic if there is inadequate and improper personal protective equipment provision, as we are dealing with diseases of the upper-aerodigestive tract and routinely engaged in aerosol-generating procedures.

Recent findings

This article discusses the background and transmission route for severe acute respiratory syndrome coronavirus 2, its viral load and temporal profile as well as precaution guidelines in outpatient and operative setting in otorhinolaryngology.

As it is evident that COVID-19 can be transmitted at presymptomatic or asymptomatic period of infections, it is essential to practice ear, nose, and throat surgery with high vigilance in a safe and up-to-standard protection level during the pandemic. This article provides a summary for guidelines and recommendations in otorhinolaryngology.
Exploratory retrospective study of risk factors for thromboembolism treated with multi-kinase inhibitor pazopanib or lenvatinib
Authors: Nio Kenta , Tsuchihashi Kenji , Taguchi Keisuke , Yoshihiro Tomoyasu , Yamaguchi Kyoko , Ito Mamoru , Moriyama Shohei , Fukata Mitsuhiro , Fujiwara Toshifumi , Setsu Nokitaka , Endo Makoto , Matsumoto Yoshihiro , Nakashima Yasuharu , Wakasaki Takahiro , Yasumatsu Ryuji , Ariyama Hiroshi , Kusaba Hitoshi , Kishimoto Junji , Akashi Koichi , Baba Eishi
Published: December 2020

Tyrosine kinase inhibitors (TKI) work against various types of cancer by inhibiting angiogenic signaling. Little is understood about the incidence, characteristics, and risk factors associated with thromboembolism induced by TKI in routine clinical practice. We retrospectively analyzed data derived from 29 patients with thyroid cancer or soft tissue sarcoma (STS) treated with lenvatinib (n=10) and pazopanib (n=19). Eight (arterial n=4; venous n=4) thromboembolic events developed in 6 (20%) patients. Thromboembolisms occurred during a mean of 149 (range, 42–847) days from starting TKI. The primary disease progressed in all patients with thromboembolism. The overall survival durations of patients with and without improved thromboembolism were 572 [95% confidence interval (CI), 225– 918] and 176 (95% CI, 84–394) days, respectively, which did not significantly differ (P=0.33). Patients with and without improved thromboembolism survived after onset for 122 (95% CI, 71–173) versus 27 (95% CI, 21–42) days (P=0.049), which significantly differed. Univariate analysis and variate selection for multivariate analysis selected a history of thromboembolism as the most powerful risk factor for new thromboembolism. In summary, the frequency of thromboembolism in clinical practice was higher than that in previous clinical trials. Furthermore, a history of thromboembolism was a risk factor for the development of new thromboembolism in patients treated with TKI. Thromboembolism developed particularly as the primary disease progressed. Our findings require validation in a large-scale study.
Impact of nodal involvement on survival outcomes in chondrosarcoma: retrospective cohort analysis of Surveillance, Epidemiology, and End Results (SEER) database (2004–2015)
Authors: Cranmer Lee D. , Chau Bonny , Thompson Matthew J. , Loggers Elizabeth T. , Pollack Seth M. , Wagner Michael J. , Kim Teresa S. , Kim Edward Y. , Kane Gabrielle M. , Pavey Gabriel J.
Published: December 2020

Objectives:

Factors associated with nodal involvement in chondrosarcoma and outcomes based on treatment modality were analyzed using the Surveillance, Epidemiology, and End Results (SEER) database.

Methods:

Chondrosarcomas involving axial and appendicular parts of the body diagnosed from 2004 to 2015 were identified in SEER. Clinical, pathologic, and treatment parameters were compared with respect to nodal status at initial diagnosis by Fisher’s exact or Student’s t-test. Disease-specific survival (DSS) and overall survival (OS) were evaluated by Kaplan-Meier analyses, and by Cox regression models.

Results:

Synchronous regional nodal metastases were present in 1.3% of chondrosarcoma patients. Lymph node involvement was associated with primary tumor location in extraskeletal tissue and the pelvis, and with distant metastasis and larger primary tumor size at diagnosis. Patients with nodal involvement had 5-year DSS of 48% [95% confidence interval (CI): 28%–65%], versus 82% (95% CI: 80%–84%) for those without (log-rank P<0.001). 5-year OS with and without nodal involvement were 38% (95% CI: 21%–55%) and 73% (95% CI: 71%–75%), respectively (log-rank P<0.001). Surgical excision of nodes was associated with improved DSS and OS. Radiation and chemotherapy were not associated with improved DSS/OS.

Conclusions:

The nodal disease is uncommon at presentation in chondrosarcoma. Greater clinical vigilance for regional nodal metastases may be warranted for those with specific risk factors, including extraskeletal or pelvic primary sites, myxoid, mesenchymal, or dedifferentiated histologies, and large size. Surgical excision of regional nodes is associated with improved DSS/OS. This analysis suggests a therapeutic effect of surgical treatment, rather than selection for favorable underlying biological factors.
Analysis of disease progression and prognosis in differentiated thyroid cancer with pulmonary metastases: a retrospective study
Authors: Iwasaki Hiroyuki , Toda Soji , Murayama Daisuke , Matsui Ai
Published: December 2020

Introduction:

Pulmonary metastasis originating from differentiated thyroid cancer is rare. Pulmonary metastasis generally progresses slowly and results in a relatively long prognosis when treated with radioactive iodine therapy and thyroid-stimulating hormone suppression therapy. However, some cases still result in death. Since 2015, lenvatinib administration for pulmonary metastases with disease progression has yielded satisfactory results.

Materials and methods:

Among the 798 patients with differentiated thyroid cancer treated at Kanagawa Cancer Center, Japan, between April 2015 and March 2020, 194 had distant metastasis. Of these 194 patients, 118 diagnosed with pulmonary metastasis had lesions that influence the prognosis. We retrospectively investigated the transition of the maximum diameter of pulmonary metastases, serum thyroglobulin, follow-up, and survival time.

Results:

We included 83 follow-up cases and 35 patients treated with lenvatinib. Considering that the disease progressed, 35 patients were treated with lenvatinib, and 4 died from cancer-specific disease. Treatment results were evaluated as progressive disease, stable disease, and partial response in 2, 11, and 22 patients, respectively.

Conclusions:

Among pulmonary metastases, no death occurred because of relatively slow disease progression up to a maximum diameter of 10 mm. However, when the size exceeded 15 mm, radioactive iodine treatment and thyroid-stimulating hormone suppression therapy did not work, and disease progression accelerated. As long as the lenvatinib treatment could be continued, the disease could be controlled satisfactorily. The patients who discontinued lenvatinib died from disease progression.
Evaluating reliability and validity of the modified radiographic union scale for tibia (mRUST) among North American and Tanzanian surgeons
Authors: Coburn Alexander , Shearer David , Albright Patrick , Ali Syed , Roberts Heather J. , Haonga Billy , Eliezer Edmund , Chu Kevin , Morshed Saam
Published: December 2020

Objectives:

To determine the international reliability and validity of the modified Radiographic Union Scale for Tibial fracture (mRUST) scoring method for open tibial shaft fractures based on ratings of radiographs by separate groups of North American and Tanzanian surgeons.

Methods:

Seven North American and 9 Tanzanian surgeons viewed 100 pairs of AP and lateral radiographs of open tibial shaft fractures obtained in Dar Es Salaam, Tanzania. The radiographs showed 25 patients’ fractures at 4 time points postfracture after treatment with either external fixation or intramedullary nailing. Surgeons evaluated each fracture using the mRUST scoring method and indicated their confidence that the fracture was healed on a scale from 1 to 10. Reliability of mRUST was determined using inter-rater agreement among North American and Tanzanian surgeons. Validity was determined via analysis of correlation between mRUST scores and EQ-5D-3L index scores at each time point postfracture.

Results:

mRUST scores demonstrated strong reliability overall (ICC = 0.64) as well as within each group of North American (ICC = 0.72) and Tanzanian (ICC = 0.69) surgeons. Reliability was stronger for external fixation than for intramedullary nailing cases. mRUST scores were significantly correlated with overall healing confidence at all time points and with quality of life at 6 months and 1 year postfracture. mRUST scores also correlated significantly with patients’ quality of life scores (EQ-5D index) at 6 months and 1 year postfracture.

Conclusion:

North American and Tanzanian surgeons exhibited strong agreement in rating open tibial shaft fractures. Using mRUST scores is a valid means of assessing radiographic healing of tibial fractures in austere environments like Tanzania.
Advancing the Evidence Base of Pediatric Physical Therapy: “Sincerely, From the Heart”
Authors: Bartlett Doreen J.
Published: December 2020

Purpose:

To share reflections on themes that have become important to me as a developing pediatric physical therapy researcher contributing to knowledge generation in our field.

Key Points:

The themes are: select strong mentors, assemble a research team with diverse perspectives and strengths, be family-centered, be rigorous in approaches to study design to match the research question, mentor the next generation, and engage in knowledge translation and exchange.

Conclusions:

I encourage everyone to reflect on who has been or could be your mentors or mentees, and on how you can be a part of an effective, family-centered research team, by encouraging a breadth of research designs to answer the many research questions that remain and by assisting in the implementation of knowledge to practice.

Clinical Relevance:

Outcomes for children and families receiving pediatric physical therapy services are enhanced through the use of evidence-based knowledge.
Dermal Shift Umbilical Reconstruction: An Innovative and Simple Technique
Authors: Yousif N. John , Venditto Chelsea , Matloub Hani S.
Published: December 2020

Umbilical reconstruction is a procedure with widespread indications in the setting of congenital or postsurgical loss. Reconstruction of the umbilicus when no remnant of the natural umbilicus is present is also called neoumbilicoplasty. Numerous neoumbilicoplasty techniques have been published, including cartilage grafts, full-thickness skin grafts, and multiflap reconstruction. No consensus has been reached regarding an optimal technique, and many procedures involve complicated designs with small flaps that are difficult to reproduce or explain. The authors divide patients into three types depending on the thickness of the adipose layer of the abdomen. With appropriate patient selection and minor variations depending on patient type, the technique can be applied to all patients. The umbilicus is marked in the appropriate position. Local anesthesia is infiltrated, and the area beneath the skin is defatted. The dermis is then applied to the underlying fascia with a superior shift. The authors describe the technique and its variations and present one illustrative case with additional supplemental digital content. The authors have gone through a progression of techniques to find a simple surgical method yielding consistently reproducible results with minimal complexity, limited morbidity, and an aesthetic final outcome. The authors believe that the technique described here achieves those goals. It can be performed under local anesthetic and with a simple occlusive dressing so that the patient can go on with most of his or her daily activities. There is no scar to suggest a surgical procedure, and patients are extremely happy with the aesthetic outcomes.
Anticholestatic Effect of Bardoxolone Methyl on Hepatic Ischemia-reperfusion Injury in Rats
Authors: Kim Joohyun , Hagen Catherine E. , Kumar Suresh N. , Park Jong-In , Zimmerman Michael A. , Hong Johnny C.
Published: December 2020

Background.

Cholestasis is a sign of hepatic ischemia-reperfusion injury (IRI), which is caused by the dysfunction of hepatocyte membrane transporters (HMTs). As transcriptional regulation of HMTs during oxidative stress is mediated by nuclear factor erythroid 2-related factor 2, we hypothesized that bardoxolone methyl (BARD), a nuclear factor erythroid 2-related factor 2 activator, can mitigate cholestasis associated with hepatic IRI.

Methods.

BARD (2 mg/kg) or the vehicle was intravenously administered into rats immediately before sham surgery, 60 min of ischemia (IR60), or 90 min of ischemia (IR90); tissue and blood samples were collected after 24 h to determine the effect on key surrogate markers of bile metabolism and expression of HMT genes (Mrp (multidrug resistance-associated protein) 2, bile salt export pump, Mrp3, sodium-taurocholate cotransporter, and organic anion-transporting polypeptide 1).

Results.

Significantly decreased serum bile acids were detected upon BARD administration in the IR60 group but not in the IR90 group. Hepatic tissue analyses revealed that BARD administration increased mRNA levels of Mrp2 and Mrp3 in the IR60 group, and it decreased those of bile salt export pump in the IR90 group. Protein levels of multidrug resistance–associated protein 2, multidrug resistance–associated protein 3, and sodium-taurocholate cotransporter were higher in the IR90 group relative to those in the sham or IR60 groups, wherein the difference was notable only when BARD was administered. Immunohistochemical and morphometric analyses showed that the area of expression for multidrug resistance–associated protein 2 and for sodium-taurocholate cotransporter was larger in the viable tissues than in the necrotic area, and the area for multidrug resistance–associated protein 3 was smaller; these differences were notable upon BARD administration.

Conclusions.

BARD may have the potential to change HMT regulation to mitigate cholestasis in hepatic IRI.
Unimpaired perception of relative depth from perspective cues in strabismus
Authors: Zlatkute Giedre , de la Bastida Vanessa Charlotte Sagnay , Vishwanath Dhanraj
Published: December 2020

Strabismus is a relatively common ophthalmological condition where the coordination of eye muscles to binocularly fixate a single point in space is impaired. This leads to deficits in vision and particularly in three-dimensional (3D) space perception. The exact nature of the deficits in 3D perception is poorly understood as much of understanding has relied on anecdotal reports or conjecture. Here, we investigated, for the first time, the perception of relative depth comparing strabismic and typically developed binocular observers. Specifically, we assessed the susceptibility to the depth cue of perspective convergence as well as the capacity to use this cue to make accurate judgements of relative depth. Susceptibility was measured by examining a 3D bias in making two-dimensional (2D) interval equidistance judgements and accuracy was measured by examining 3D interval equidistance judgements. We tested both monocular and binocular viewing of images of perspective scenes under two different psychophysical methods: two-alternative forced-choice (2AFC) and the method of adjustment. The biasing effect of perspective information on the 2D judgements (3D cue susceptibility) was highly significant and comparable for both subject groups in both the psychophysical tasks (allps < 0.001) with no statistically significant difference found between the two groups. Both groups showed an underestimation in the 3D task with no significant difference between the group's judgements in the 2AFC task, but a small statistically significant difference (ratio difference of approx. 10%,p= 0.016) in the method of adjustment task. A small but significant effect of viewing condition (monocular versus binocular) was revealed only in the non-strabismic group (ratio difference of approx. 6%,p= 0.002). Our results show that both the automatic susceptibility to, and accuracy in the use of, the perspective convergence cue in strabismus is largely comparable to that found in typically developed binocular vision, and have implications on the nature of the encoding of depth in the human visual system.
Roughing it: terrain is crucial in identifying novel translocation sites for the vulnerable brush-tailed rock-wallaby (Petrogale pencillata)
Authors: Morris Shane D. , Johnson Christopher N. , Brook Barry W.
Published: December 2020

Translocations—the movement of species from one place to another—are likely to become more common as conservation attempts to protect small isolated populations from threats posed by extreme events such as bushfires. The recent Australian mega-fires burnt almost 40% of the habitat of the brush-tailed rock-wallaby (Petrogale pencillata), a threatened species whose distribution is already restricted, primarily due to predation by invasive species. This chronic threat of over-predation, coupled with the possible extinction of the genetically distinct southern population (approx. 40 individuals in the wild), makes this species a candidate for a conservation translocation. Here, we use species distribution models to identify translocation sites for the brush-tailed rock-wallaby. Our models exhibited high predictive accuracy, and show that terrain roughness, a surrogate for predator refugia, is the most important variable. Tasmania, which currently has no rock-wallabies, showed high suitability and is fox-free, making it a promising candidate site. We outline our argument for the trial translocation of rock-wallaby to Maria Island, located off Tasmania's eastern coast. This research offers a transparent assessment of the translocation potential of a threatened species, which can be adapted to other taxa and systems.
Face coverings and respiratory tract droplet dispersion
Authors: Bandiera Lucia , Pavar Geethanjali , Pisetta Gabriele , Otomo Shuji , Mangano Enzo , Seckl Jonathan R. , Digard Paul , Molinari Emanuela , Menolascina Filippo , Viola Ignazio Maria
Published: December 2020

Respiratory droplets are the primary transmission route for SARS-CoV-2, a principle which drives social distancing guidelines. Evidence suggests that virus transmission can be reduced by face coverings, but robust evidence for how mask usage might affect safe distancing parameters is lacking. Accordingly, we set out to quantify the effects of face coverings on respiratory tract droplet deposition. We tested an anatomically realistic manikin head which ejected fluorescent droplets of water and human volunteers, in speaking and coughing conditions without a face covering, or with a surgical mask or a single-layer cotton face covering. We quantified the number of droplets in flight using laser sheet illumination and UV-light for those that had landed at table height at up to 2 m. For human volunteers, expiratory droplets were caught on a microscope slide 5 cm from the mouth. Whether manikin or human, wearing a face covering decreased the number of projected droplets by less than 1000-fold. We estimated that a person standing 2 m from someone coughing without a mask is exposed to over 10 000 times more respiratory droplets than from someone standing 0.5 m away wearing a basic single-layer mask. Our results indicate that face coverings show consistent efficacy at blocking respiratory droplets and thus provide an opportunity to moderate social distancing policies. However, the methodologies we employed mostly detect larger (non-aerosol) sized droplets. If the aerosol transmission is later determined to be a significant driver of infection, then our findings may overestimate the effectiveness of face coverings.
Experimental evaluation of spectral efficiency from a circular array antenna producing a Laguerre–Gauss mode
Authors: Allen Ben , Drysdale Timothy D. , Stevens Chris
Published: December 2020

We present the four-dimensional volumetric electromagnetic field measurements (
x
,
y
,
z
and frequency) of the complex radiated field produced by an 8-element circular antenna array. The array is designed to produce a Laguerre–Gauss (LG) mode
l
= +1 over the frequency range of 9–10 GHz. We evaluate our findings in terms of far-field LG mode purity and spectral efficiency in terms of the quadrature amplitude modulation (QAM) modulation scheme that can be supported. The application of LG modes in radio systems is as a means of multiplexing several data streams onto the same frequency, polarization and time slot, thus making a highly spectrally efficient transmission system or enhancing radar systems by means of exploiting mode behaviour as an additional degree of freedom. Our results show that for the circular antenna array, we find that mode purity is sufficient to support binary phase shift keying or quadrature phase shift keying modulation over a 0.3 GHz bandwidth, which corresponds to a spectral efficiency of 1.5 b s
−1
Hz
−1
per mode. Closer to the antennas' design frequency, 256QAM modulation may be supported over a 0.05 GHz band, and which corresponds to a spectral efficiency of 11 b s
−1
Hz
−1
per mode. We anticipate the practical insights provided in this paper contribute to the successful design of such systems.
Numerical models for assessing the risk of leaflet thrombosis post-transcatheter aortic valve-in-valve implantation
Authors: Plitman Mayo Romina , Yaakobovich Halit , Finkelstein Ariel , Shadden Shawn C. , Marom Gil
Published: December 2020

Leaflet thrombosis has been suggested as the reason for the reduced leaflet motion in cases of hypoattenuated leaflet thickening of bioprosthetic aortic valves. This work aimed to estimate the risk of leaflet thrombosis in two post-valve-in-valve (ViV) configurations, using five different numerical approaches. Realistic ViV configurations were calculated by modelling the deployments of the latest version of transcatheter aortic valve devices (Medtronic Evolut PRO, Edwards SAPIEN 3) in the surgical Sorin Mitroflow. Computational fluid dynamics simulations of blood flow followed the dry models. Lagrangian and Eulerian measures of near-wall stagnation were implemented by particle and concentration tracking, respectively, to estimate the thrombogenicity and to predict the risk locations. Most of the numerical approaches indicate a higher leaflet thrombosis risk in the Edwards SAPIEN 3 device because of its intra-annular implantation. The Eulerian approaches estimated high-risk locations in agreement with the wall sheer stress (WSS) separation points. On the other hand, the Lagrangian approaches predicted high-risk locations at the proximal regions of the leaflets matching the low WSS magnitude regions of both transcatheter aortic valve implantation models and reported clinical and experimental data. The proposed methods can help optimizing future designs of transcatheter aortic valves with minimal thrombotic risks.
Determining the serotype composition of mixed samples of pneumococcus using whole-genome sequencing
Authors: Knight James R. , Dunne Eileen M. , Mulholland E. Kim , Saha Sudipta , Satzke Catherine , Tothpal Adrienn , Weinberger Daniel M.
Published: December 2020

Serotyping of

Streptococcus pneumoniae

is a critical tool in the surveillance of the pathogen and in the development and evaluation of vaccines. Whole-genome DNA sequencing and analysis is becoming increasingly common and is an effective method for pneumococcal serotype identification of pure isolates. However, because of the complexities of the pneumococcal capsular loci, current analysis software requires samples to be pure (or nearly pure) and only contain a single pneumococcal serotype. We introduce a new software tool called SeroCall, which can identify and quantitate the serotypes present in samples, even when several serotypes are present. The sample preparation, library preparation and sequencing follow standard laboratory protocols. The software runs as fast as or faster than existing identification tools on typical computing servers and is freely available under an open source licence at https://github.com/knightjimr/serocall. Using samples with known concentrations of different serotypes as well as blinded samples, we were able to accurately quantify the abundance of different serotypes of pneumococcus in mixed cultures, with 100 % accuracy for detecting the major serotype and up to 86 % accuracy for detecting minor serotypes. We were also able to track changes in serotype frequency over time in an experimental setting. This approach could be applied in both epidemiological field studies of pneumococcal colonization and experimental laboratory studies, and could provide a cheaper and more efficient method for serotyping than alternative approaches.
SARS-CoV-2 neutralizing antibodies; longevity, breadth, and evasion by emerging viral variants
Authors: Tea Fiona , Stella Alberto Ospina , Aggarwal Anupriya , Darley David Ross , Pilli Deepti , Vitale Daniele , Merheb Vera , Lee Fiona X. Z. , Cunningham Philip , Walker Gregory J. , Brown David A. , Rawlinson William D. , Isaacs Sonia R. , Mathivanan Vennila , Hoffman Markus , Pöhlmann Stefan , Dwyer Dominic E. , Rockett Rebeca , Sintchenko Vitali , Hoad Veronica C. , Irving David O. , Dore Gregory J. , Gosbell Iain B. , Kelleher Anthony D. , Matthews Gail V. , Brilot Fabienne , Turville Stuart G
Published: December 2020

The SARS-CoV-2 antibody neutralization response and its evasion by emerging viral variants are unknown. Antibody immunoreactivity against SARS-CoV-2 antigens and Spike variants, inhibition of Spike-driven virus-cell fusion, and infectious SARS-CoV-2 neutralization were characterized in 807 serial samples from 233 RT-PCR-confirmed COVID-19 individuals with detailed demographics and followed up to seven months. A broad and sustained polyantigenic immunoreactivity against SARS-CoV-2 Spike, Membrane, and Nucleocapsid proteins, along with high viral neutralization were associated with COVID-19 severity. A subgroup of ‘high responders’ maintained high neutralizing responses over time, representing ideal convalescent plasma therapy donors. Antibodies generated against SARS-CoV-2 during the first COVID-19 wave had reduced immunoreactivity and neutralization potency to emerging Spike variants. Accurate monitoring of SARS-CoV-2 antibody responses would be essential for selection of optimal plasma donors and vaccine monitoring and design.

One Sentence Summary

Neutralizing antibody responses to SARS-CoV-2 are sustained, associated with COVID19 severity, and evaded by emerging viral variants
The auditory Mismatch Negativity reflects accelerated aging in adults with Down’s Syndrome
Authors: Avancini Chiara , Jennings Sally , Chennu Srivas , Noreika Valdas , Le April , Bekinschtein Tristan , Walpert Madeleine , Clare Isabel , Holland Anthony , Zaman Shahid , Ring Howard
Published: December 2020

Down’s Syndrome (DS) is associated with premature and accelerated ageing and a propensity for early-onset Alzheimer’s disease (AD). The early symptoms of dementia in people with DS may reflect frontal lobe vulnerability to amyloid deposition. The Mismatch Negativity (MMN) is a frontocentral component elicited by auditory violations of expected sensory input and it reflects sensory memory and automatic attention switching. In the typically developing (TD) population, the MMN response has been found to decrease with age. In the cross-sectional phase of this study the MMN was used to investigate the premature neurological ageing hypothesis of DS. In the longitudinal phase, we evaluated the MMN as a potential predictor of cognitive decline. The study found that age predicted MMN amplitude in DS but not in those who are TD, showing that the MMN reflects accelerated ageing in DS. However, a follow-up of 34 adults with DS found that neither amplitude nor latency of the MMN predicted cognitive decline one year later.