bluuebunny/crossref_metadata_2025 huggingface dataset:
Health and Safety in Nail Salons: A Cross-Sectional Survey
Authors: Sanaat Sadaf , Holness D Linn , Arrandale Victoria H
Published: July 2020

Objectives

In recent years, nail salons have become more abundant than ever. The majority are small businesses, often employing immigrant women. Nail technicians have many exposures at work including chemical, biological, physical, and ergonomic hazards but few data exist on their symptoms or occupational health and safety practices, particularly in the Canadian context. The aim of this study was to learn about nail technicians, their work, and their health and safety practices.

Methods

Nail technicians were recruited from nail salons in Toronto, Ontario. Participants completed an anonymous survey with questions about demographics, work tasks, workplace health and safety practices, and symptoms (skin, respiratory, and musculoskeletal).

Results

A total of 155 nail technicians (95% female) participated in the survey. The majority of nail technicians performed manicures (99%) and pedicures (96%) and applied shellac polishes (86%). Only a third (34%) applied acrylic artificial nails. The reported use of personal protective equipment (PPE) was very high; 88% reported using a mask at work and 96% reporting using gloves. The most common symptoms reported by technicians were neck (44%) and back pain (38%). Skin and respiratory symptoms were less common with 6% of technicians reporting cough, 8% wheeze, and 5% a current rash. Technicians working over 30 h per week reported more neck pain (52 vs. 32%, P = 0.02). Technicians who reported using shellac polishes were more likely to report a runny nose (25 vs. 0%, P = 0.01).

Conclusions

Nail technicians in Toronto, Canada are experiencing work-related symptoms. Musculoskeletal symptoms were the most common symptoms reported. Much of the focus on nail salons and health has been on chemical exposures, but ergonomic hazards should not be overlooked. Efforts to increase knowledge and improve occupational health in nail salons should include information on multiple possible workplace hazards and how to reduce impacts of exposure.
Security Analysis of the First Certificateless Proxy Signature Scheme Against Malicious-But-Passive KGC Attacks
Authors: Lin Xi-Jun , Wang Qihui , Sun Lin , Yan Zhen , Liu Peishun
Published: July 2020

Recently, Yang et al. proposed the first certificateless proxy signature scheme against malicious-but-passive key generation center (MKGC) attacks. They proved that their scheme can resist the MKGC attacks in the standard model. In this paper, we point out that their scheme cannot achieve this security because the adversary can forge valid signatures.
DNA methylation reprogramming in medaka fish, a promising animal model for environmental epigenetics research
Authors: Wang Xuegeng , Bhandari Ramji K
Published: July 2020

DNA methylation is a major epigenetic modification that undergoes dramatic changes in two epigenetic reprogramming windows during development: first in preimplantation embryos and second in primordial germ cell (PGC) specification. In both windows, DNA methylation patterns are reprogrammed genome-wide, and the majority of inherited methylation marks are erased, generating cells with broad developmental potential. Recent studies reported that the reprogramming of genome methylation in medaka is similar to human and mouse, suggesting that medaka may serve as a suitable biomedical model for comparative studies focused on the epigenetic and transgenerational inheritance of phenotypic traits. In this mini review, we will discuss how somatic and germ cells in post-fertilization stage embryos are epigenetically reprogrammed in mammals and fishes with a particular focus on DNA methylation dynamics.
Comprehensive genome analysis and comparisons of the swine pathogen, Chlamydia suis reveals unique ORFs and candidate host-specificity factors
Authors: Dimond Zoe E , Hefty P Scott
Published: July 2020

Chlamydia suis, a ubiquitous swine pathogen, has the potential for zoonotic transmission to humans and often encodes for resistance to the primary treatment antibiotic, tetracycline. Because of this emerging threat, comparative genomics for swine isolate R19 with inter- and intra-species genomes was performed. A 1.094 Mb genome was determined through de novo assembly of Illumina high throughput sequencing reads. Annotation and subsystem analyses were conducted, revealing 986 putative genes (Chls_###) that are predominantly orthologs to other known Chlamydia genes. Subsequent comparative genomics revealed a high level of genomic synteny and overall sequence identity with other Chlamydia while 92 unique C. suis open reading frames were annotated. Direct comparison of Chlamydia-specific gene families that included the plasticity zone, inclusion membrane proteins, polymorphic membrane proteins and the major outer membrane protein, demonstrated high gene content identity with C. trachomatis and C. muridarum. These comparisons also identified diverse components that potentially could contribute to host-specificity. This study constitutes the first genome-wide comparative analysis for C. suis, generating a fully annotated reference genome. These studies will enable focused efforts on factors that provide key species specificity and adaptation to cognate hosts that are attributed to chlamydial infections, including humans.
Transcriptome-based drug repositioning for coronavirus disease 2019 (COVID-19)
Authors: Jia Zhilong , Song Xinyu , Shi Jinlong , Wang Weidong , He Kunlun
Published: July 2020

The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) around the world has led to a pandemic with high morbidity and mortality. However, there are no effective drugs to prevent and treat the disease. Transcriptome-based drug repositioning, identifying new indications for old drugs, is a powerful tool for drug development. Using bronchoalveolar lavage fluid transcriptome data of COVID-19 patients, we found that the endocytosis and lysosome pathways are highly involved in the disease and that the regulation of genes involved in neutrophil degranulation was disrupted, suggesting an intense battle between SARS-CoV-2 and humans. Furthermore, we implemented a coexpression drug repositioning analysis, cogena, and identified two antiviral drugs (saquinavir and ribavirin) and several other candidate drugs (such as dinoprost, dipivefrine, dexamethasone and (-)-isoprenaline). Notably, the two antiviral drugs have also previously been identified using molecular docking methods, and ribavirin is a recommended drug in the diagnosis and treatment protocol for COVID pneumonia (trial version 5–7) published by the National Health Commission of the P.R. of China. Our study demonstrates the value of the cogena-based drug repositioning method for emerging infectious diseases, improves our understanding of SARS-CoV-2-induced disease, and provides potential drugs for the prevention and treatment of COVID-19 pneumonia.
Complete Genome of Roseobacter ponti DSM 106830T
Authors: Hollensteiner Jacqueline , Schneider Dominik , Poehlein Anja , Daniel Rolf
Published: July 2020

Members of the Roseobacter group are known for their different ecologically relevant metabolic traits and high abundance in many marine environments. This includes traits like carbon monoxide oxidation, sulfur oxidation, nitrogen oxidation, DMSP demethylation, denitrification, and production of bioactive compounds. Nevertheless, their role in the marine biogeochemical cycles remains to be elucidated. Roseobacter ponti DSM 106830T, also designated strain MM-7T (=KCTC 52469T =NBRC 112431T), is a novel type strain of the Roseobacter group, which was proposed as new Roseobacter species. It was isolated from seawater of the Yellow Sea in South Korea. We report the complete genome sequence of R. ponti DSM 106830T, which belongs to the family Rhodobacteraceae. The genome of R. ponti DSM 106830T comprises a single circular chromosome (3,861,689 bp) with a GC content of 60.52% and an additional circular plasmid (p1) of 100,942 bp with a GC content of 61.51%. The genome encodes 3,812 putative genes, including 3 rRNA, 42 tRNA, 1 tmRNA, and 3 ncRNA. The genome information was used to perform a phylogenetic analysis, which confirmed that the strain represents a new species. Moreover, the genome sequence enabled the investigation of the metabolic capabilities and versatility of R. ponti DSM 106830T. Finally, it provided insight into the high niche adaptation potential of Roseobacter group members.
The worse the better? Quantile treatment effects of a conditional cash transfer programme on mental health
Authors: Ohrnberger Julius , Fichera Eleonora , Sutton Matt , Anselmi Laura
Published: July 2020

Poor mental health is a pressing global health problem, with high prevalence among poor populations from low-income countries. Existing studies of conditional cash transfer (CCT) effects on mental health have found positive effects. However, there is a gap in the literature on population-wide effects of cash transfers on mental health and if and how these vary by the severity of mental illness. We use the Malawian Longitudinal Study of Family and Health containing 790 adult participants in the Malawi Incentive Programme, a year-long randomized controlled trial. We estimate average and distributional quantile treatment effects and we examine how these effects vary by gender, HIV status and usage of the cash transfer. We find that the cash transfer improves mental health on average by 0.1 of a standard deviation. The effect varies strongly along the mental health distribution, with a positive effect for individuals with worst mental health of about four times the size of the average effect. These improvements in mental health are associated with increases in consumption expenditures and expenditures related to economic productivity. Our results show that CCTs can improve adult mental health for the poor living in low-income countries, particularly those with the worst mental health.
Perceived physical fitness mediates the relationship between parental support and physical activity enjoyment in overweight and obese adolescents
Authors: De la Torre-Cruz Manuel J , Suárez-Manzano Sara , López-Serrano Sebastián , Ruiz-Ariza Alberto
Published: July 2020

The relationship between parental support and physical activity enjoyment appears to be mediated by individual-level factors. The aim of this study was to examine whether the relationship between perceived parental support and physical activity enjoyment is mediated by overweight and obese adolescents’ physical fitness, both subjectively and objectively assessed. A total of 163 participants (mean age =14.30 years, 55.8% boys) with an average body mass index of 28.97 kg/m2 took part in this study. Participants completed a questionnaire of parental influence regarding physical activity, a questionnaire of physical self-perception and several fitness tests (cardiorespiratory fitness, lower limbs muscular strength and flexibility) using the ALPHA-fitness battery. The results showed that relationship between perceived parental support and physical activity enjoyment is mediated by the overweight and obese adolescents’ perceived cardiorespiratory fitness and flexibility. We suggest to create educational guidelines for parents to increase the support and improve overweight and obese students’ positive perceived physical competence, in order to achieve a greater adherence to physical activity and greater physical activity enjoyment.
The mechanistic GEMMs of oncogenic histones
Authors: Lindroth Anders M , Park Yoon Jung , Matía Verónica , Squatrito Massimo
Published: July 2020

The last decade’s progress unraveling the mutational landscape of all age groups of cancer has uncovered mutations in histones as vital contributors of tumorigenesis. Here we review three new aspects of oncogenic histones: first, the identification of additional histone mutations potentially contributing to cancer formation; second, tumors expressing histone mutations to study the crosstalk of post-translational modifications, and; third, development of sophisticated biological model systems to reproduce tumorigenesis. At the outset, we recapitulate the firstly discovered histone mutations in pediatric and adolescent tumors of the brain and bone, which still remain the most pronounced histone alterations in cancer. We branch out to discuss the ramifications of histone mutations, including novel ones, that stem from altered protein-protein interactions of cognate histone modifiers as well as the stability of the nucleosome. We close by discussing animal models of oncogenic histones that reproduce tumor formation molecularly and morphologically and the prospect of utilizing them for drug testing, leading to efficient treatment and cure of deadly cancers with histone mutations.
Pre-natal manifestation of systemic developmental abnormalities in spinal muscular atrophy
Authors: Motyl Anna A L , Faller Kiterie M E , Groen Ewout J N , Kline Rachel A , Eaton Samantha L , Ledahawsky Leire M , Chaytow Helena , Lamont Douglas J , Wishart Thomas M , Huang Yu-Ting , Gillingwater Thomas H
Published: July 2020

Spinal muscular atrophy (SMA) is a neuromuscular disease caused by mutations in survival motor neuron 1 (SMN1). SMN-restoring therapies have recently emerged; however, preclinical and clinical studies revealed a limited therapeutic time window and systemic aspects of the disease. This raises a fundamental question of whether SMA has presymptomatic, developmental components to disease pathogenesis. We have addressed this by combining micro-computed tomography (μCT) and comparative proteomics to examine systemic pre-symptomatic changes in a prenatal mouse model of SMA. Quantitative μCT analyses revealed that SMA embryos were significantly smaller than littermate controls, indicative of general developmental delay. More specifically, cardiac ventricles were smaller in SMA hearts, whilst liver and brain remained unaffected. In order to explore the molecular consequences of SMN depletion during development, we generated comprehensive, high-resolution, proteomic profiles of neuronal and non-neuronal organs in SMA mouse embryos. Significant molecular perturbations were observed in all organs examined, highlighting tissue-specific prenatal molecular phenotypes in SMA. Together, our data demonstrate considerable systemic changes at an early, presymptomatic stage in SMA mice, revealing a significant developmental component to SMA pathogenesis.
Revalidation of Ogyrides occidentalis (Ortmann, 1893) (Decapoda: Caridea: Ogyrididae) from Brazil based on morphological and mtDNA evidences
Authors: Terossi Mariana , Mantelatto Fernando L
Published: July 2020

The genus OgyridesStebbing, 1914 comprises 12 recognized species of small marine shrimps distributed in tropical and temperate waters worldwide. Ogyrides occidentalis (Ortmann, 1893), described for Brazil, was considered a junior synonym of Ogyrides alphaerostris (Kingsley, 1880). The aim of this study was to revalidate O. occidentalis from the Brazilian coast based on morphological and molecular data (16S gene), and to provide a redescription, illustrations and a comparison with congeners. As expected, O. occidentalis is close to O. alphaerostris but can be separated by molecular data, the proportional size of the second article of the antennular peduncle in relation to the third article (3–4 times as long as the former, and 2–2.5 times as long as the latter), and the size of the scaphocerite (not reaching the distal part of the second article of the antennular peduncle in O. occidentalis, while always reaching or sometimes overreaching the distal part of the second article of the antennular peduncle in O. alphaerostris). We also provided a table comparing key morphological characteristics of all known species of the genus, and discuss the validity of thelycum-like characters in the taxonomy of Ogyrides.
Evaluation of Flood Removal in Combination with Insecticide Seed Treatment for Rice Water Weevil (Coleoptera: Curculionidae) Larval Management in Rice
Authors: Kelly F R , Gore J , Cook D R , Catchot A L , Golden B R , Krutz L J , Crow W D , Towles T B , Bond J A
Published: July 2020

An experiment was conducted at the Delta Research and Extension Center in Stoneville, MS during 2017 and 2018 to determine whether removal of the flood is an economical method of control for rice water weevil, Lissorhoptrus oryzophilus Kuschel. This experiment compared a continuous flood production system to draining a rice field completely and reestablishing a flood for the remainder of the growing season. In addition, two insecticide seed treatments, thiamethoxam and chlorantraniliprole, were compared with an untreated control within each system. Rice water weevil densities were measured prior to draining at 3 wk after flood and again after the flood was reestablished in drained plots. Rice water weevil densities were greater in 2017 than 2018. Chlorantraniliprole at the predrainage and postdrainage sample timing reduced larval numbers compared with the untreated control. The plots where water was removed until soil cracking then re-flooded had significantly lower weevil populations than plots that were continuously flooded during 2018 only. Draining of plots resulted in lower yields in 2018, but not in 2017. Additionally, both of the insecticide seed treatments resulted in greater yields and economic returns than the untreated control. Draining of flooded rice when rice water weevil larvae were present did not provide a consistent benefit, and may result in yield and economic penalties. Insecticide seed treatments consistently provided greater yield benefits in flooded rice. Based on these results, draining of flooded rice is not recommended to manage rice water weevil and insecticide seed treatments should be used to minimize economic losses.
Screening of the Repellent Activity of 12 Essential Oils Against Adult German Cockroach (Dictyoptera: Blattellidae): Preparation of a Sustained Release Repellent Agent of Binary Oil-γ-CD and its Repellency in a Small Container
Authors: Huang Ke , Zhang Dan , Ren Jing-Jing , Dong Rui , Wu Hua
Published: July 2020

Cockroaches are important sanitary pests and very difficult to control worldwide. With public concern about traditional insecticides, cockroach control agents should be environmentally friendly, highly efficient, and economical. In this article, 12 essential oils were screened to test their repellent effect against Blattella germanica. To develop essential oils as repellent agents, the oils were further examined in binary synergistic combinations. Ilex chinensis Sims (Sapindales: Aquifoliaceae) oil, Lavandula spp (Tubiflorae: Labiatae) oil, and Elsholtzia ciliata (Thunb.) Hyland (Tubiflorae: Labiatae) oil showed excellent repellent activities with lower RD50 (repellency dose for 50% of treated adults) values of 218.634, 154.590, and 223.989 µg/cm2, respectively, compared to those of other oils and the positive control. The I. chinensis oil and E. ciliata oil (weight ratio of 1:1.41) combination also displayed a remarkable synergistic effect against B. germanica. Their cotoxicity coefficient was 214.4. The major chemical constituents in E. ciliata and I. chinensis oils were respectively 3,7-dimethyl-1, 6-octadien-3-ol and methyl salicylate. The binary oil mixtures were formulated as a sustained release agent with γ-CD. The optimal preparation should be an 8:1 ratio of γ-CD to oils, with a 1 h stirring time, 50°C stirring temperature, and 1:12 ratio of γ-CD to ddH2O. The results of this study suggest that sustained release of binary oil-γ-CD exhibited a prolonged repellent activity (10 h) against B. germanica. This sustained-release agent could be further investigated and developed as a novel repellent preparation.
Montana Native Entomopathogenic Nematode Species Against Limonius californicus (Coleoptera: Elateridae)
Authors: Sandhi Ramandeep Kaur , Shapiro-Ilan David , Reddy Gadi V P
Published: July 2020

Wireworms are destructive soil inhabiting polyphagous pests in the Pacific Northwest and Intermountain region of the United States. Continuously increasing wireworm populations and damage in small grain crops such as spring wheat in Northern Great Plains has become a challenge for growers. Due to unavailability of effective control measures, alternative methods, including biological control agents such as entomopathogenic nematodes (EPNs) are needed. Native/indigenous EPN species are expected to have better potential than exotic species to control the local insect pests. Two Montana native EPN species (Steinernema feltiae and Heterorhabditis bacteriophora) were tested against, Limonius californicus (Coleoptera: Elateridae) in laboratory and shade house studies. In the laboratory bioassay, two isolates of S. feltiae at the rate of 28,000 IJs/five larvae killed 48–50% of the insects within 4 wk. Heterorhabditis bacteriophora was not able to cause >30% L. californicus larval mortality. None of the two isolates of S. feltiae performed well against L. californicus when tested in different soil types. Similarly, two isolates of S. feltiae that were tested killed only 20–25% wireworms in a shade house trial that did not differ significantly from the control treatment. Four weeks after EPN treatment in the shade house trial, the percentage of wheat plant damage from L. californicus ranged from 30 to 40% in the presence of S. felitae, not differing statistically from control. These results suggest that S. felitae have limited potential in managing wireworm populations.
Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Febrile Neonates
Authors: Wardell Hanna , Campbell Jeffrey I , VanderPluym Christina , Dixit Avika
Published: July 2020

Most severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in pediatric patients are mild or asymptomatic. However, infants have emerged at higher risk of hospitalization and severe outcomes in pediatric coronavirus disease 2019 (COVID-19). We report a case series of 4 full-term neonates hospitalized with fever and found to have SARS-CoV-2 infection with a spectrum of illness severities. Two neonates required admission to the intensive care unit for respiratory insufficiency and end organ involvement. Half of the patients were found to have a coinfection. One neonate received antiviral therapy with remdesivir and is, to our knowledge, the youngest patient to receive this drug for COVID-19. All neonates had favorable outcomes.
Oncoplastic breast surgery technique for retroareolar breast cancer: a technical modification of the Grisotti flap in patients with short nipple to inferior mammary crease distance
Authors: Johnson Miguel , Cook Lorna , Rapisarda Fabio I , Betal Dibendu , Bonomi Riccardo
Published: July 2020

The introduction of breast conservation surgery together with advances in oncoplastic techniques has revolutionized the management of retroareolar breast tumours. Traditionally, cancers in this location were often managed with central excision and primary closure or mastectomy. More recently, oncoplastic breast-conserving techniques such as the Grisotti mammoplasty have been increasingly encouraged as an alternative option as it allows oncological safe margin resections while restoring cosmesis. The use of a Grisotti flap enables safe resection of a retroareolar tumour with concurrent reconstruction of the defect using a local rotational advancement dermoglandular flap allowing a satisfactory cosmetic result in term of contour and projection. This technique is often limited to those patients with sufficient native nipple-inferior mammary fold (IMF) distance to accommodate for some inevitable post-operative reduction in this distance. We describe a modification of the original description, such that satisfactory cosmetic outcome can be achieved, even in patients with a short nipple areolar complex to inframammary fold distance.
Absence of in-flight transmission of SARS-CoV-2 likely due to use of face masks on board
Authors: Nir-Paz Ran , Grotto Itamar , Strolov Israel , Salmon Asher , Mandelboim Michal , Mendelson Ella , Regev-Yochay Gili
Published: July 2020

Using flights was severely affected during the COVID19 pandemic. We describe a 14 hours flight of 11 passengers and 4 crew members in which 2 positive SARS-COV-2 were on board. No new viral acquisitions found in this flight, probably due to the use of masks.
Examining Racial Disparities in Diabetes Readmissions in the United States Military Health System
Authors: Frankel Dianne , Banaag Amanda , Madsen Cathaleen , Koehlmoos Tracey
Published: July 2020

Introduction

Diabetes is one of the most common chronic conditions in the United States and has a cost burden over $120 billion per year. Readmissions following hospitalization for diabetes are common, particularly in minority patients, who experience greater rates of complications and lower quality healthcare compared to white patients. This study examines disparities in diabetes-related readmissions in the Military Health System, a universally insured, population of 9.5 million beneficiaries, who may receive care from military (direct care) or civilian (purchased care) facilities.

Methods

The study identified a population of 7,605 adult diabetic patients admitted to the hospital in 2014. Diagnostic codes were used to identify hospital readmissions, and logistic regression was used to analyze associations among race, beneficiary status, patient or sponsor’s rank, and readmissions at 30, 60, and 90 days.

Results

A total of 239 direct care patients and 545 purchased care patients were included in our analyses. After adjusting for age and sex, we found no significant difference in readmission rates for black versus white patients; however, we found a statistically significant increase in the likelihood for readmission of Native American/Alaskan Native patients compared to white patients, which persisted in direct care at 60 days (adjusted odds ratio [AOR] 11.51, 95% CI 1.11–119.41) and 90 days (AOR 18.42, 95% CI 1.78–190.73), and in purchased care at 90 days (AOR 4.54, 95% CI 1.31–15.74).

Conclusion

Our findings suggest that universal access to healthcare alleviates disparities for black patients, while Native America/Alaskan Native populations may still be at risk of disparities associated with readmissions among diabetic patients in both the closed direct care system and the civilian fee for service purchased care system.
CRISPR/Cas9 treatment causes extended TP53-dependent cell cycle arrest in human cells
Authors: Geisinger Jonathan M , Stearns Tim
Published: July 2020

While the mechanism of CRISPR/Cas9 cleavage is understood, the basis for the large variation in mutant recovery for a given target sequence between cell lines is much less clear. We hypothesized that this variation may be due to differences in how the DNA damage response affects cell cycle progression. We used incorporation of EdU as a marker of cell cycle progression to analyze the response of several human cell lines to CRISPR/Cas9 treatment with a single guide directed to a unique locus. Cell lines with functionally wild-type TP53 exhibited higher levels of cell cycle arrest compared to lines without. Chemical inhibition of TP53 protein combined with TP53 and RB1 transcript silencing alleviated induced arrest in TP53+/+ cells. Using dCas9, we determined this arrest is driven in part by Cas9 binding to DNA. Additionally, wild-type Cas9 induced fewer 53BP1 foci in TP53+/+ cells compared to TP53−/− cells and DD-Cas9, suggesting that differences in break sensing are responsible for cell cycle arrest variation. We conclude that CRISPR/Cas9 treatment induces a cell cycle arrest dependent on functional TP53 as well as Cas9 DNA binding and cleavage. Our findings suggest that transient inhibition of TP53 may increase genome editing recovery in primary and TP53+/+ cell lines.
Genome-wide analysis of high-risk primary brain cancer pedigrees identifies PDXDC1 as a candidate brain cancer predisposition gene
Authors: Cannon-Albright Lisa A , Farnham James M , Stevens Jeffrey , Teerlink Craig C , Palmer Cheryl A , Rowe Kerry , Cessna Melissa H , Blumenthal Deborah T
Published: July 2020

Background

There is evidence for an inherited contribution to primary brain cancer. Linkage analysis of high-risk brain cancer pedigrees has identified candidate regions of interest in which brain cancer predisposition genes are likely to reside.

Methods

Genome-wide linkage analysis was performed in a unique set of 11 informative, extended, high-risk primary brain cancer pedigrees identified in a population genealogy database, which include from 2 to 6 sampled, related primary brain cancer cases. Access to formalin-fixed paraffin embedded tissue samples archived in a biorepository allowed analysis of extended pedigrees.

Results

Individual high-risk pedigrees were singly informative for linkage at multiple regions. Suggestive evidence for linkage was observed on chromosomes 2, 3, 14, and 16. The chromosome 16 region in particular contains a promising candidate gene, pyridoxal-dependent decarboxylase domain-containing 1 (PDXDC1), with prior evidence for involvement with glioblastoma from other previously reported experimental settings, and contains the lead single nucleotide polymorphism (rs3198697) from the linkage analysis of the chromosome 16 region.

Conclusions

Pedigrees with a statistical excess of primary brain cancers have been identified in a unique genealogy resource representing the homogeneous Utah population. Genome-wide linkage analysis of these pedigrees has identified a potential candidate predisposition gene, as well as multiple candidate regions that could harbor predisposition loci, and for which further analysis is suggested.
Artificial intelligence neuropathologist for glioma classification using deep learning on hematoxylin and eosin stained slide images and molecular markers
Authors: Jin Lei , Shi Feng , Chun Qiuping , Chen Hong , Ma Yixin , Wu Shuai , Hameed N U Farrukh , Mei Chunming , Lu Junfeng , Zhang Jun , Aibaidula Abudumijiti , Shen Dinggang , Wu Jinsong
Published: July 2020

Background

Pathological diagnosis of glioma subtypes is essential for treatment planning and prognosis. Standard histological diagnosis of glioma is based on postoperative hematoxylin and eosin stained slides by neuropathologists. With advancing artificial intelligence (AI), the aim of this study was to determine whether deep learning can be applied to glioma classification.

Methods

A neuropathological diagnostic platform is designed comprising a slide scanner and deep convolutional neural networks (CNNs) to classify 5 major histological subtypes of glioma to assist pathologists. The CNNs were trained and verified on over 79 990 histological patch images from 267 patients. A logical algorithm is used when molecular profiles are available.

Results

A new model of the squeeze-and-excitation block DenseNet with weighted cross-entropy (named SD-Net_WCE) is developed for the glioma classification task, which learns the recognizable features of glioma histology CNN-based independent diagnostic testing on data from 56 patients with 17 262 histological patch images demonstrated patch level accuracy of 86.5% and patient level accuracy of 87.5%. Histopathological classifications could be further amplified to integrated neuropathological diagnosis by 2 molecular markers (isocitrate dehydrogenase and 1p/19q).

Conclusion

The model is capable of solving multiple classification tasks and can satisfactorily classify glioma subtypes. The system provides a novel aid for the integrated neuropathological diagnostic workflow of glioma.
COVID-19 and public-sector capacity
Authors: Mazzucato Mariana , Kattel Rainer
Published: July 2020

The paper argues that to govern a pandemic, governments require dynamic capabilities and capacity—too often missing. These include capacity to adapt and learn; capacity to align public services and citizen needs; capacity to govern resilient production systems; and capacity to govern data and digital platforms.
Patterns of Genetic Diversification in the Invasive Hybrid Plant Pathogen Phytophthora × alni and Its Parental Species P. uniformis
Authors: Mizeriene Goda , Cerny Karel , Zyka Vladimir , Bakonyi József , Nagy Zoltán Árpád , Oliva Jonas , Redondo Miguel Angel , Corcobado Tamara , Martín-García Jorge , Prospero Simone
Published: July 2020

In pathogenic fungi and oomycetes, interspecific hybridization may lead to the formation of new species having a greater impact on natural ecosystems than the parental species. From the early 1990s, a severe alder (Alnus spp.) decline due to an unknown Phytophthora species was observed in several European countries. Genetic analyses revealed that the disease was caused by the triploid hybrid P. × alni, which originated in Europe from the hybridization of P. uniformis and P. × multiformis. Here, we investigated the population structure of P. × alni (158 isolates) and P. uniformis (85 isolates) in several European countries using microsatellite markers. Our analyses confirmed the genetic structure previously observed in other European populations, with P. uniformis populations consisting of at most two multilocus genotypes (MLGs) and P. × alni populations dominated by MLG Pxa-1. The genetic structure of P. × alni populations in the Czech Republic, Hungary and Sweden seemed to reflect the physical isolation of river systems. Most rare P. × alni MLGs showed a loss of heterozygosity (LOH) at one or a few microsatellite loci compared with other MLGs. This LOH may allow a stabilization within the P. × alni genome or a rapid adaptation to stress situations. Alternatively, alleles may be lost because of random genetic drift in small, isolated populations, with no effect on fitness of P. × alni. Additional studies would be necessary to confirm these patterns of population diversification and to better understand the factors driving it.
Cirrhosis
Authors: Casler Kelly , Chaney Amanda
Published: July 2020

The NP's role in managing cirrhosis is increasing due to the growing prevalence of the disease. The purpose of this article is to review the pathophysiology, diagnosis, and management of patients with cirrhosis with an emphasis on interdisciplinary collaboration and evidence-based practice. Cirrhosis complications are also discussed.
Risk of major cardiovascular and cerebrovascular complications after elective surgery in patients with sleep-disordered breathing
Authors: Chaudhry Rabail , Suen Colin , Mubashir Talha , Wong Jean , Ryan Clodagh M. , Mokhlesi Babak , Chung Frances
Published: July 2020

BACKGROUND

There is limited and conflicting data on whether sleep-disordered breathing (SDB) is associated with postoperative major cardiovascular and cerebrovascular events (MACCE), and mortality.

OBJECTIVES

To determine whether SDB is associated with increased risks of MACCE, mortality and length of hospital stay.

DESIGN

Retrospective cohort analysis from the Nationwide Inpatient Sample.

SETTING

Adults who underwent elective abdominal, orthopaedic, prostatic, gynaecological, thoracic, transplant, vascular or cardiac surgery in the United States of America between 2011 and 2014.

PATIENTS

The study cohort included 1813 974 surgical patients, of whom 185 615 (10.2%) had SDB. Emergency or urgent surgical procedures were excluded.

MAIN OUTCOME MEASURES

The incidences of MACCE, respiratory and vascular complications, in-hospital mortality and mean length of hospital stay were stratified by SDB. Linear and logistic regression models were constructed to determine the independent association between SDB and outcomes of interest.

RESULTS

The incidences of MACCE [25.3 vs. 19.8%, odds ratio (OR) 1.20, P < 0.001] and respiratory complications (11.75 vs. 8.0%, OR 1.43, P < 0.001) were significantly higher in patients with SDB than in those without SDB. SDB was associated with higher rates of atrial fibrillation (14.7 vs. 10.8%, P < 0.001), other arrhythmias (6.0 vs. 5.4%, P < 0.001) and congestive heart failure (9.8 vs. 7.1%, P < 0.001). SDB patients had a lower rate of myocardial infarction (3.1 vs. 3.4%, OR 0.69, P < 0.001), lower mortality (0.6 vs. 1.3%, P < 0.001) and shorter length of hospital stay (4.8 vs. 5.2 days, P < 0.001).

CONCLUSION

SDB was associated with increased risks of MACCE, and respiratory and vascular complications, but had a lower incidence of in-hospital mortality and shorter length of hospital stay.
Scleral Suture Fixation of Dislocated Posterior Chamber Intraocular Lens: Modification for Tapered Haptics
Authors: Echegaray Jose J. , Smiddy William E.
Published: July 2020

Purpose:

To present a surgical modification to a previously published technique that allows repositioning and scleral fixation of one-piece acrylic intraocular lenses with tapered haptics.

Methods:

A retrospective review of three consecutive cases.

Results:

Our technique modification enables repositioning using scleral suture fixation of one-piece intraocular lenses with tapered haptics by looping the haptic at its proximal, notched junction to the optic with the polypropylene suture. The suture knot is internalized which effectively suspends the intraocular lens and allows for better adjustment of the intraocular lens centration. Two cases were endocapsular dislocations; the third case was dislocated extracapsularly due through a posterior capsule rupture. All showed adequate lens centration at 3 months of follow-up. One case had suffered a vitreous hemorrhage a month postoperatively that is clearing.

Conclusion:

Repositioning using scleral fixation of one-piece intraocular lenses with tapered haptics is possible with a minor technique modification. This offers an alternative to intraocular lens exchange.
Associations Between Complementary and Alternative Medicine and Health Care Expenditures Among Adults With Chronic Back Pain
Authors: Olaisen R. Henry
Published: July 2020

Background:

Although complementary and alternative medicine (CAM) has been associated with reduced morbidity among adults with chronic back pain, less is known about the association between CAM use and health care expenditures.

Objectives:

The objective of this study was to first estimate health care expenditures of adult CAM users and nonusers with chronic back pain and then assess CAM’s influence on health care expenditures.

Research Design:

This was an ambidirectional cohort study.

Data:

Linked National Health Interview Survey (2012) and Medical Expenditure Panel Survey (2013–2014).

Measures:

CAM use was defined as 3 or more visits to a practitioner in the 12 months before the National Health Interview Survey interview. Covariates included age, sex, race-ethnicity, and body mass index. The outcome was annual health care expenditures (overall and within 8 categories, including office-based visits and prescription medication).

Analyses:

Survey-weighted, covariate adjusted predicted marginal means models were applied to quantify health care expenditures. Survey-weighted, covariate adjusted linear and logistic regression models were used to investigate CAM’s influence on expenditures, and the Z mediation test statistic was applied to quantify the independent effects of CAM.

Results:

Overall, health care expenditures were significantly lower among CAM users with chronic back pain compared with non-CAM users for both 2013 and 2014: $8402 versus $9851 for 2013; $7748 versus $10,227 in 2014, annual differences of −$1499 (95% confidence interval: −$1701 to −$1197) and −$2479 (95% confidence interval: −$2696 to −$2262), respectively (P<0.001). Adult CAM users also had significantly lower prescription medication as well as outpatient expenses (P<0.001). CAM use was identified as a partial mediator to health care expenditures.

Conclusion:

CAM use is associated with lower overall health care expenditures, driven primarily by lower prescription and outpatient expenditures, among adults with chronic back pain in the United States.
Did the Affordable Care Act Decrease Veteran Enrollment in the Veterans Health Administration?
Authors: Silva Abigail , Tarlov Elizabeth , Gonzalez Beverly , Smith Bridget M. , French Dustin D. , Hogan Timothy P. , Jordan Neil , Huo Zhiping , Martinez Rachael N. , Ippolito Dolores , Stroupe Kevin T.
Published: July 2020

Background:

Provisions of the Affordable Care Act (ACA) provided nonelderly individuals, including Veterans, with additional health care coverage options. This may impact enrollment for health care through the Veterans Health Administration (VHA). National enrollment data was used to: (1) compare characteristics of enrollees at 3 time points in relation to the implementation of ACA insurance provisions (2012); and (2) examine enrollment trends.

Methods:

The study population included a 10% sample of Veterans under age 65 who were VHA enrollees between January 2012 and September 2015. Demographic and baseline characteristics were compared between 3 enrollment groups: pre-2012, pre-ACA (2012–2013), and post-ACA (2014–2015). Using an interrupted time series approach, we employed pooled logistic regression to assess trends in new VHA enrollment, overall, and by select enrollee characteristics.

Results:

A total of 429,833 enrollees were identified. Compared with pre-ACA enrollees, post-ACA enrollees were more likely to be older, have a service-connected disability, live further away from a VHA medical center, but less likely to use primary care within 6 months. The post-ACA quarterly trend in the odds of being a new enrollee was 3% lower (95% confidence interval: 0.96, 0.98) as compared with the pre-ACA trend. This decline was consistent across sex, geography, (all but 1) priority group, and state Medicaid-expansion subgroups.

Conclusions:

The ACA appears to have contributed to a decline in new VHA enrollment. In addition, the profile of newer enrollees differs from that of pre-ACA enrollees. The VHA must continue to monitor trends in demand in order to continue delivering high-quality, efficient care.
Emergency Medicaid Acquisition Through the Affordable Care Act
Authors: Tran Linda D. , Knowlton Lisa M. , Wagner Todd H.
Published: July 2020

Background:

Hospital Presumptive Eligibility (HPE) is a national policy stemming from the Affordable Care Act that allows qualified hospitals, working with state officials, to enroll eligible patients for temporary Medicaid coverage. Although all states are required to operate an HPE program, hospital participation is elective and variable. It is unclear which hospitals choose to participate in HPE and how participation affects hospital utilization and revenue.

Objective:

We examined hospital factors associated with HPE participation in the state of California and assessed pre and post changes in hospital revenue and utilization for HPE and non-HPE hospitals.

Research Design:

We performed a logistic regression to identify hospital attributes associated with HPE participation. We then used a difference in differences methodology with a hospital fixed effect to test whether HPE enrollment was associated with changes in annual revenues by payer source, uncompensated care costs, outpatient visits, and/or discharges.

Results:

Three quarters (76%) of qualified hospitals elected to participate in HPE by the end of 2018. Hospitals with 100 or more beds had over 10 times greater odds of participating in HPE compared with smaller hospitals. Hospitals that did not provide outpatient care were significantly less likely to participate. Among hospitals included in trend analyses, enrollment in HPE was associated with increased annual net patient Medicaid revenue and decreased uncompensated care charges. We predicted that HPE enrollment was associated with an average of 9.7% (95% confidence interval: 3.4%–16.4%) increase in annual net patient Medicaid revenue. As of 2018, ∼33,000 adults and children were enrolled in California’s HPE program per month.

Conclusion:

Hospital enrollment in the HPE program shifted costs from uncompensated care to Medicaid.
Use of sleeve gastrectomy in adolescents and young adults with severe obesity
Authors: Singhal Vibha , Youssef Soundos , Misra Madhusmita
Published: July 2020

Purpose of review

The prevalence of pediatric obesity and its associated complications is increasing around the world. Treatment of obesity is challenging and metabolic and bariatric surgery (MBS) is currently the most effective treatment for this condition. At this time, vertical sleeve gastrectomy (VSG) is the most commonly performed bariatric procedure in adolescents. However, knowledge regarding the efficacy, safety, and durability of VSG in adolescents is still evolving. This review summarizes the most recent updates in the field of MBS particularly VSG in adolescents.

Recent findings

MBS is recommended to treat moderate to severe obesity, especially when complicated by comorbidities. The use of VSG for weight loss is increasing among adolescents and produces similar weight loss at five years in both adolescents and adults. The physiologic mechanisms causing weight loss after VSG are multifactorial and still being investigated. The complication rate after VSG ranges between 0 and 17.5%.

VSG appears to be a well-tolerated and effective procedure in adolescents. However, it continues to be underutilized despite the increasing prevalence of moderate to severe obesity in adolescents. It is thus important to educate providers regarding its benefits and safety profile.
Do we need to go beyond a purely behavioral approach? A response to Woodcock and Blackwell
Authors: Tincani Matt , Travers Jason , Dowdy Art
Published: July 2020

In their recent review, ‘Psychological treatment strategies for challenging behaviours in neurodevelopmental disorders: what lies beyond a purely behavioural approach?’ Woodcock and Blackwell discuss supposed deficiencies in applied behavior analysis (ABA) and positive behavior support (PBS) to address challenging behavior. This commentary highlights problems with Woodcock and Blackwell's critique based on substantial evidence that behavioral approaches including ABA and PBS are often the best available solution for individuals with neurodevelopmental disorders who display challenging behavior.
Gut instincts: vitamin D/vitamin D receptor and microbiome in neurodevelopment disorders
Authors: Ogbu Destiny , Xia Eric , Sun Jun
Published: July 2020

The gut microbiome regulates a relationship with the brain known as the gut–microbiota–brain (GMB) axis. This interaction is influenced by immune cells, microbial metabolites and neurotransmitters. Recent findings show gut dysbiosis is prevalent in autism spectrum disorder (ASD) as well as attention deficit hyperactivity disorder (ADHD). There are previously established negative correlations among vitamin D, vitamin D receptor (VDR) levels and severity of ASD as well as ADHD. Both vitamin D and VDR are known to regulate homeostasis in the brain and the intestinal microbiome. This review summarizes the growing relationship between vitamin D/VDR signalling and the GMB axis in ASD and ADHD. We focus on current publications and summarize the progress of GMB in neurodevelopmental disorders, describe effects and mechanisms of vitamin D/VDR in regulating the microbiome and synoptically highlight the potential applications of targeting vitamin D/VDR signalling in neurodevelopment disorders.