bluuebunny/crossref_metadata_2025 huggingface dataset:
Dissolution and Reprecipitation of Garnet during Eclogite-facies Metamorphism; Major and Trace Element Transfer during Atoll Garnet Formation
Authors: Kulhánek Jan , Faryad Shah Wali , Jedlicka Radim , Svojtka Martin
Published: September 2021

Garnet commonly accommodates high contents of Mn + Y + heavy rare earth elements (HREE) that follow Rayleigh fractionation during garnet early growth, with the exception of overstepping nucleation (late crystallization owing to reaction overstepping). Because of this, as the garnet porphyroblasts form mostly in equilibrium with the surrounding matrix, the concentration of these elements continuously decreases towards the porphyroblast rims. Yet rapid changes in the reaction progress of a rock during garnet growth, namely the resorption–dissolution of minerals with high concentrations of Y + REE, may create an anomaly or peak in the mantle or rim of garnet grains. In this study we present an example of the resorption of garnet cores and formation of atoll garnet textures in eclogite from the Krušné hory (in the Saxothuringian tectonic zone of the Bohemian Massif). Based on textural relations, we show that the atoll garnet grains in the studied rocks were formed during the prograde stage from blueschist- to eclogite-facies metamorphism. Preliminary observations showed that the full (non-atoll) garnet grains had compositionally different cores (interior, or garnet I) and rims (ring, or garnet II) that were separated by a Y + HREE + medium REE (MREE) concentration peak. The ring garnet II indicated an elevated concentration of Mn in comparison with the marginal parts of the interior garnet I. Therefore, minor elements that were less vulnerable to diffusion than major elements and strongly sensitive to the broad spectrum of geochemical processes, such as Y + REE, were used to track possible mineral reactions during the whole garnet growth path. Thermodynamic modelling indicated the formation of garnet by the breakdown of chlorite and lawsonite/zoisite, and peak-pressure phases were represented by garnet, omphacite, quartz, amphibole, rutile, and talc. To quantify the sources of high Mn concentrations in garnet II and of the Y + HREE + MREE sharp peaks, the sequences of mineral reactions and dissolution of garnet I leading to the formation of the atoll structure were investigated. In addition to thermodynamic modelling and pressure–temperature path constraints, mass-balance calculations of trace elements were also performed. The results combined with the observed compositional and textural relations indicate that the concentrations of Mn + Y + HREE + MREE in garnet II and the concentration peaks at the interface of the two garnet types were controlled by a complex mechanism that included the dissolution of garnet I during the formation of the atoll texture, stepwise growth of garnet during increasing pressure and temperature, and decomposition of phases with high concentrations of trace elements, such as zoisite/epidote or lawsonite.
The Corona-Eye: Exploring the risks of COVID-19 on fair assessments of impact for REF2021
Authors: Derrick Gemma E , Bayley Julie
Published: September 2021

This article assesses the risk of two COVID-19-related changes necessary for the expert review of the REF2021’s Impact criterion: the move from face to face (F2F) to virtual deliberation; and the changing research landscape caused by the COVID-19 crisis requiring an extension of deadlines, and accommodation of COVID-19-related mitigation. Peer review in its basic form requires expert debate, where dissenting opinions and non-verbal cues are absorbed into a group deliberative practice and therefore inform outcomes. With a move to deliberations in virtual settings, the most likely current outcome for REF2021 evaluations, the extent that negotiation dynamics necessary in F2F evaluations are diminished and how this limits panellists’ ability to sensitively assess COVID-19 mitigation statements is questioned. This article explores the nature of, and associated capabilities to undertake, complex decision-making in virtual settings around the Impact criterion as well the consequences of COVID-19 on normal Impact trajectories. It examines the risks these changes present for evaluation of the Impact criterion and provides recommendations to offset these risks to enhance discussion and safeguard the legitimacy of evaluation outcomes. This article is also relevant for evaluation processes of academic criteria that require both a shift to virtual, and/or guidance of how to sensitively assess the effect of COVID-19 on narratives of individual, group or organizational performance.
An Eight-Year Profile of Children with Influenza A(H1N1) in a Large Hospital in India
Authors: Ghosh Urmi , Bharathy R V Nirubhan , Prasad D Jayavelu Hariram , Moorthy Mahesh , Verghese Valsan Philip
Published: September 2021

As influenza virus A(H1N1) continues to circulate, reports from India have documented mainly respiratory involvement in children. This retrospective chart review of children at a medical college found that from August 2009 to July 2017, 855 children aged 3 months to 15 years had H1N1 influenza of whom 310 (36.3%) were admitted and 29 (9.4% admissions) died. In 2009–12, 76.5% patients presented in August–October but from 2015 to 2017, 89.3% came in January–March. The proportion of under-fives increased from 54.0% in 2009–10 to 77.7% in 2015–17. Among admitted children, 82.6% were under 5 years, 96.1% had respiratory symptoms and 11% had seizures. Six children had encephalopathy of whom four died; two survivors had severe neurological sequelae. Other features included gastroenteritis, otitis media, myositis and hepatitis. Complications included shock (10.7%) and acute respiratory distress syndrome (6.1%). Evidence of bacterial/fungal infection was present in 71 (22.9%). Oxygen was required by 123 children (39.7%), high-dependency/intensive care by 47 (15.2%), 17 (5.5%) received high-flow oxygen and 29 (9.4%) required mechanical ventilation. There were no significantly increased odds of needing intensive care or of dying in children with underlying diseases or among different age groups but those with underlying central nervous system (CNS) diseases had higher odds of needing high-dependency/intensive care [odds ratio (OR) 2.35, p = 0.046]. Significantly, children with CNS symptoms had nearly seven times higher odds of needing mechanical ventilation (OR 6.85, p < 0.001) and over three times higher odds of dying (OR 3.31, p = 0.009).

 

Lay summary

H1N1 Influenza (“swine flu”) emerged as a global pandemic in 2009 and continues to affect children all over the world. This review of records from a medical college hospital in southern India found that 855 children aged 3 months to 15 years came with H1N1 influenza over 8 years from August 2009 to July 2017. In 2009-12, over three-quarters of them presented in the rainy season but from 2015-17, almost 90% came in the winter and spring, suggesting a change in the seasonality of the outbreaks, which could impact the choice of dates for annual influenza vaccination. The proportion under 5 years of age increased from 54% in 2009-10 to 78% in 2015-17, suggesting possible immunity in children exposed to earlier outbreaks. Over a third of the children needed admission of whom almost 40% needed oxygen, one-sixth needed high-dependency/intensive care and 1 in 11 admitted children died, emphasizing the severity of this disease. While most children had respiratory symptoms, all organs of the body were affected; 11% of those admitted had seizures and 6 had encephalitis. Children admitted with central nervous system symptoms had an almost 7-fold higher risk of needing high-dependency/intensive care and an over 3-fold higher risk of dying.
Laparoscopic Versus Open Colorectal Surgery in the Emergency Setting
Authors: Warps Anne-Loes K. , Zwanenburg Emma S. , Dekker Jan Willem T. , Tollenaar Rob A.E.M. , Bemelman Willem A. , Hompes Roel , Tanis Pieter J. , de Groof Elisabeth J.
Published: September 2021

Objective:

This systematic review and meta-analysis aimed to compare published outcomes of patients undergoing laparoscopic versus open emergency colorectal surgery, with mortality as primary outcome.

Background:

In contrast to the elective setting, the value of laparoscopic emergency colorectal surgery remains unclear.

Methods:

PubMed, Embase, the Cochrane Library, and CINAHL were searched until January 6, 2021. Only comparative studies were included. Meta-analyses were performed using a random-effect model. The Cochrane Risk of Bias Tool and the Newcastle-Ottawa Scale were used for quality assessment.

Results:

Overall, 28 observational studies and 1 randomized controlled trial were included, comprising 7865 laparoscopy patients and 55,862 open surgery patients. Quality assessment revealed ‘good quality’ in 16 of 28 observational studies, and low to intermediate risk of bias for the randomized trial. Laparoscopy was associated with significantly lower postoperative mortality compared to open surgery (odds ratio [OR] 0.44; 95% confidence interval [CI], 0.35–0.54). Laparoscopy resulted in significantly less postoperative overall morbidity (OR, 0.53; 95% CI, 0.43–0.65), wound infection (OR, 0.63; 95% CI, 0.45–0.88), wound dehiscence (OR, 0.37; 95% CI, 0.18–0.77), ileus (OR, 0.68; 95% CI 0.51–0.91), pulmonary (OR, 0.43; 95% CI, 0.24–0.78) and cardiac complications (OR, 0.56; 95% CI, 0.35–0.90), and shorter length of stay. No meta-analyses were performed for long-term outcomes due to scarcity of data.

Conclusions:

The systematic review and meta-analysis suggest a benefit of laparoscopy for emergency colorectal surgery, with a lower risk of postoperative mortality and morbidity. However, the almost exclusive use of retrospective observational study designs with inherent biases should be taken into account.
Linear Association Between Hypoalbuminemia and Increased Risk of Acute Respiratory Distress Syndrome in Critically Ill Adults
Authors: McNeil J. Brennan , Jackson Karen E. , Wang Chunxue , Siew Edward D. , Vincz Andrew J. , Shaver Ciara M. , Bastarache Julie A. , Ware Lorraine B.
Published: September 2021

OBJECTIVES:

We hypothesized that low serum albumin would contribute to pulmonary edema formation, thereby independently increasing the risk of developing acute respiratory distress syndrome in critically ill patients.

DESIGN:

Retrospective analysis of prospective cohort.

SETTING:

Medical, surgical, and cardiovascular ICUs at Vanderbilt University Medical Center.

PATIENTS:

Patients (n = 993) with serum albumin measured for clinical reasons within 24 hours of study enrollment on ICU day 2 were included.

MEASUREMENTS AND MAIN RESULTS:

The primary outcome was presence of acute respiratory distress syndrome at any time during the first 4 days in the ICU, as defined by the Berlin definition. Secondary outcomes included ventilator-free days and ICU length of stay. In an unadjusted analysis, lower serum albumin levels were associated with a higher occurrence rate of acute respiratory distress syndrome (p < 0.001). In a multivariable analysis controlling for prespecified confounders, lower serum albumin was independently associated with an increased risk of acute respiratory distress syndrome (odds ratio, 1.48 per 1-g/dL decrease in albumin; 95% CI, 1.14–1.94; p = 0.004). Additionally, lower serum albumin was associated with increased mortality (odds ratio, 1.56 per 1-g/dL decrease in albumin; 95% CI, 1.19–2.04; p = 0.001), increased ICU length of stay (incidence rate ratio, 1.19; 95% CI, 1.15–1.23; p < 0.001), higher Sequential Organ Failure Assessment score (p < 0.001), and fewer ventilator-free days (incidence rate ratio, 1.21; 95% CI, 1.19–1.24; p < 0.001).

CONCLUSIONS:

Among adult ICU patients, lower serum albumin was independently associated with increased risk of acute respiratory distress syndrome after controlling for severity of illness and potential confounders. These findings support the hypothesis that low plasma oncotic pressure contributes to pulmonary edema formation in patients at risk for acute respiratory distress syndrome, independent of severity of illness.
Thyroid cancer incidence and trends by demographic and tumor characteristics in Oran, Algeria: 1993–2013, a population-based analysis
Authors: Boukheris Houda , Bachir Bouiadjra Noureddine
Published: September 2021

Objectives

Incidence rates of thyroid cancer have dramatically increased over recent decades in many countries, particularly the papillary histotype and microcarcinomas. We examined thyroid cancer incidence and trends by demographic and tumor characteristics based on 1443 patients with thyroid cancer diagnosed between 1993 and 2013 in Oran district, in Northwest Algeria.

Methods

All thyroid cancer cases were abstracted from medical records and pathology reports and classified according to the International Classification for Diseases in Oncology, third edition. Age-specific, age-standardized incidence rates per 100 000 person-years, and annual percent changes (APC) in the incidence were calculated.

Results

Age-standardized incidence was 11.7 per 100 000 for women and 2.0 per 100 000 for men. Thyroid cancer incidence increased over time significantly in women (APC: +3.72%; P < 0.05), mostly due to an increased incidence of the papillary histotype (APC: +5.48%; P < 0.05), and microcarcinomas (APC: +17.34%; P < 0.05). During the same time period, the incidence of follicular thyroid carcinomas decreased (APC: −3.74%; P < 0.05).

Conclusions

The results of our study showing an upward trend of thyroid cancer incidence driven largely by increases in the papillary histotype are consistent with previous studies. The higher increase has coincided with the introduction of fine needle aspiration and thyroid ultrasound in the 1990s, and may have led to overdiagnosis. However, the increased papillary-to-follicular ratio observed over time is possibly a late effect of iodine supplementation implemented in Algeria in 1967 to combat endemic goiter. Further larger-scale population-based research is needed to gain insight into thyroid cancer etiology.
The Impact of COVID-19 on Patients With Cancer
Authors: Rodriguez Gladys M. , Ferguson Jacqueline M. , Kurian Allison , Bondy Melissa , Patel Manali I.
Published: September 2021

Objectives:

The coronavirus disease 2019 (COVID-19) pandemic abruptly disrupted cancer care. The impact of these disruptions on patient experiences remain relatively understudied. The objective of this study was to assess patients’ perspectives regarding the impact of COVID-19 on their experiences, including their cancer care, emotional and mental health, and social determinants of health, and to evaluate whether these outcomes differed by cancer stage.

Materials and Methods:

We conducted a survey among adults with cancer across the United States from April 1, 2020 to August 26, 2020 using virtual snowball sampling strategy in collaboration with professional organizations, cancer care providers, and patient advocacy groups. We analyzed data using descriptive statistics, χ2 and t tests.

Results:

Three hundred twelve people with cancer participated and represented 38 states. The majority were non-Hispanic White (n=183; 58.7%) and female (n=177; 56.7%) with median age of 57 years. Ninety-one percent spoke English at home, 70.1% had health insurance, and 67% had access to home internet. Breast cancer was the most common diagnosis (n=67; 21.5%). Most had Stage 4 disease (n=80; 25.6%). Forty-six percent (n=145) experienced a change in their care due to COVID-19. Sixty percent (n=187) reported feeling very or extremely concerned that the pandemic would affect their cancer and disproportionately experienced among those with advanced cancer stages compared with earlier stages (P<0.001). Fifty-two percent (n=162) reported impact of COVID-19 on 1 or more aspects of social determinants of health with disproportionate impact among those with advanced cancer stages compared with earlier stages.

Conclusions:

COVID-19 impacted the care and well-being of patients with cancer and this impact was more pronounced among people with advanced cancer stages. Future work should consider tailored interventions to mitigate the impact of COVID-19 on patients with cancer.
Cardiovascular and Pulmonary Research: The Year (2020) in Review
Authors: Ricard Paul E. H. , McHugh Hannah F. , Ramsey Stephen
Published: September 2021

Practitioners need access to and the ability to openly discuss advances in practice and concepts as they apply to the practice of cardiovascular and pulmonary physical therapy (PT). Lack of accessibility to research literature, limited personal time, or insufficient knowledge to adequately review the breadth of literature published each year can hinder this process. This article provides a limited overview of cardiovascular and pulmonary research published in 2020 that the authors believe most important and relevant or speaks to the volume or trend of current topics in the clinical practice of cardiovascular and pulmonary PT. Each topic area is followed by brief overview of clinical relevance and was open to discussion with the participants present at the 2021 Combined Sections Meeting held virtually on February 24, 2021.
Recent clinical trials in atrial fibrillation
Authors: Flautt Thomas , Valderrábano Miguel
Published: September 2021

Purpose of review

Management of atrial fibrillation can be overwhelming with the amount of information and treatment options available today. This review discusses landmark and other clinically relevant trials published in the last 18 months.

Recent findings

There have been several recent key clinical trials and subanalyses in the field of atrial fibrillation. Early rhythm control with ablation or antiarrhythmic medications has upended the previous practice of rate control for patients with atrial fibrillation. Vein of Marshall alcohol ablation in combination with endocardial mitral annular ablation and a hybrid epicardial/endocardial approach has shown promising results in the fight against persistent atrial fibrillation. Early ablation with cryoballoon therapy vs. antiarrhythmic therapy gives further evidence for early ablation in patients with symptomatic paroxysmal atrial fibrillation.

The rapid development in technology and medications to treat atrial fibrillation, prevent stroke and improve quality of life for patients has created a vast amount of information for physicians to process. The present review will focus on the recent (within 2 years) clinical trials in atrial fibrillation and the impact they may have on your practice.
Identification of the Obstetric Factors Increasing Tendency to Smoking Cessation During Pregnancy
Authors: Avcibay Vurgec Burcu
Published: September 2021

Introduction

Cigarette, one of the various forms of tobacco, is the most commonly used tobacco product in Turkey and in the world. Cigarette has several negative effects on general health and is a major problem in the pregnancy period. This study aims to identify pregnancy-related factors that affect the tendency to smoking cessation and their effect levels in pregnant women who continue to smoke during pregnancy.

Method

The sample of this descriptive and cross-sectional study was 430 pregnant women who smoked. Data were collected through an original interview form and face-to-face interviews. Data analysis was performed using chi-square, independent t test, and multiple logistic regression model in terms of demographic, obstetric, maternal, and fetal features.

Results

The average number of cigarettes smoked before pregnancy was 13.28 ± 8.62, whereas the average number of cigarettes smoked during pregnancy was 6.60 ± 7.64. The tendency to decrease smoking increases 2.8 times (OR = 2.825, 95% CI [1.631, 4.895]) with the number of pregnancies and approximately 2 times in case of a planned pregnancy (OR = 1.946, 95% CI [1.076, 3.520]). The frequency of having prenatal visits showed a weak but significant relationship with the number of abortuses and the number of living children.

Conclusions

Developing a risk map in line with the findings of the study and considering the obstetric features of smoking women could enable to hypothesize about the types of behaviors in smoking in the following processes of pregnancy. With the precautions to be taken, the negative effects of smoking on maternal and fetal health could be prevented or minimized.
Rubicon
deficiency exacerbates fasting-induced hepatic steatosis
Authors: Dong Fan , Hu Xiao-Wen , Zhang Shasha , He Fan , Naz Amber , He Lin , Zhu Hongxin
Published: September 2021

Objective:

Rubicon is an inhibitory interacting protein of the autophagy-related protein Uvrag. We previously showed that
Rubicon
deficiency promotes autophagic flux
in vivo
and that autophagy can degrade lipid droplets. This study aimed to investigate the effects of Rubicon deficiency on fasting-induced hepatic steatosis.

Methods:

Two-month-old wild-type (WT) and
Rubicon
-deficient mice were subjected to feeding or fasting for 24 hours to induce hepatic steatosis. The distribution of liver lipid droplets was revealed by oil red O staining. Hepatic and plasma triglyceride, non-esterified fatty acid (NEFA), and cholesterol levels were detected using commercially available kits. Real-time reverse transcriptasepolymerase chain reaction was performed to analyze the mRNA expression of genes related to lipid metabolism in the liver. Western blot was conducted to assess autophagy-related protein levels in the liver. The animal experiments were approved by the Institutional Animal Care and Use Committee at Shanghai Jiao Tong University, China.

Results:

We showed that under fasting conditions,
Rubicon
-deficient mice had more lipid droplets in the liver than WT controls. Consistent with these results, the hepatic triglyceride, NEFA, and cholesterol levels in fasted
Rubicon
-deficient mice were significantly higher than those of fasted WT controls. The levels of
SREBP-1
, a key regulator of lipid synthesis, were significantly lower in livers from fasted WT mice than those of fed WT mice. However, the decrease in
SREBP-1
in fasted mice was attenuated by
Rubicon
deficiency. Western blot analysis demonstrated that the fasting-induced increase in autophagic flux was amplified by
Rubicon
deficiency. Finally, we showed that
Rubicon
deficiency in mice led to elevated plasma triglyceride and NEFA acid levels under fasting conditions.

Conclusion:

Rubicon
deficiency exacerbates fasting-induced hepatic steatosis in mice.
The feasibility and efficacy of catheterizable stoma's in adults
Authors: Beels Elodie , Thiruchelvam Nikesh , Van der Aa Frank
Published: September 2021

Purpose of review

A continent vesicostomy represents a useful alternative for adult patients with impaired bladder emptying who are unable to perform clean intermittent (self-) catheterization through the urethra. In a pediatric setting, there exists a vast experience in these procedures. But experience with continent catheterizable vesicostomies is less abundant in adult patients. We want to give an overview and discuss recent literature about catheterizable conduits in the adult population.

Recent findings

Adult patients who undergo continent vesicostomy comprise a diverse cohort. Because of this very heterogeneous population, it can be difficult to make an objective analysis and draw conclusions on both the success rate and complication rate of these diversions. We will discuss short- and long-term surgical outcomes and changes in quality of life after the procedure in these patients.

A continent vesicostomy is a valuable and durable reconstructive technique for adult patients with impaired bladder emptying. Surgery can be challenging and a better knowledge of complications can help with patient counseling. In the future we hope that minimally invasive surgery will decrease the morbidity of such surgery and hopefully also improve functional outcomes and diminish the complication rate.
Toxin‐Producing Klebsiella oxytoca in Healthy Infants
Authors: Greimel Theresa M. , Stampfer Laura , Leitner Eva , Kienesberger Sabine , Zechner Ellen L. , Bozic Michael , Wagner Gabriel E. , Unterhauser Katrin , Kitsera Maksym , Hauer Almuthe C. , Gorkiewicz Gregor , Wurm Philipp , Valitutti Francesco , Högenauer Christoph , Hoffmann Karl Martin
Published: September 2021

Objectives:

Klebsiella oxytoca is a gastrointestinal pathobiont with the potential to produce the toxins tilivalline and tilimycin, which cause antibiotic‐associated hemorrhagic colitis. Overgrowth of toxigenic K oxytoca has recently been implicated in necrotizing enterocolitis. K oxytoca colonizes 2–9% of healthy adults, however, there is no systematic data on colonization in healthy children. We investigated K oxytoca colonization and its toxigenic properties in healthy infants.

Methods:

We sampled stool of healthy infants and determined K oxytoca colonization using stool culture and PCR (pehX). Toxin in stool was measured with HPLC/high‐resolution mass spectrometry. K oxytoca isolates were typed using multi‐locus sequence typing (MLST) and K oxytoca toxin PCR (npsA/B). Cytotoxin production of isolates was analyzed by MTT assay.

Results:

K oxytoca was detected in 30 of 61 infants (49%) using stool culture and in 45 of 61 (73%) using PCR (pehX). Toxin marker PCR (npsA/B) was positive in 66% of stool samples positive for K oxytoca PCR. Stool toxin levels were too low for quantitation but traces of tilivalline were detected. Contrarily, 49% of K oxytoca isolates demonstrated toxicity in the MTT assay. MLST revealed 36 distinct sequence types affiliated with all known K oxytoca sequence type clusters (A, B1 and B2).

Conclusions:

More than 70% of healthy infants were colonized with K oxytoca. Toxin quantities in stool of colonized healthy infants were below detection level, yet half of the isolates produced toxin in vitro demonstrating their pathobiont potential. The high occurrence of toxigenic K oxytoca in healthy infants has to be considered for future disease association studies.
The Effect of Yes-Associated Protein on the Interaction Between the MEK/Extracellular Signal-Regulated Kinase and Hippo Pathways in Osteoblasts Co-Cultured With Fibroblast Growth Factor Receptor 2-Mutated Dura Cells
Authors: Dong Xinhang , Zhang Mingzi , Li Chengcheng , Lai Chenzhi , Song Guodong , Jin Xiaolei
Published: September 2021

Background:

C342Y (Cys342Tyr) point mutation of FGFR2 (fibroblast growth factor receptor 2) is closely associated with the pathogenesis of Crouzon syndrome. The dura mater plays an important role in mediating the closure of cranial sutures. However, the underlying mechanisms of these pathological processes have been rarely investigated. in this study, the authors analyzed the effects of dura cells with FGFR2 mutations on the biological function of osteoblasts.

Methods:

Dura cells and cranial osteoblasts from C57BL/6 mice were extracted and cultured. C342Y-FGFR2 mutant constructs were established via lentivirus and applied to infect dura cells. A co-cultured trans-well system with dura cells and osteoblasts was established. Three experimental groups were set up: oste group, Oste + Dura-vector group, and Oste + Dura-C342Y group. The expression levels of key factors in MEK (Mitogen-activated protein kinase kinase, MAPKK)/extracellular signal-regulated kinase (ERK) and Hippo pathway were detected by western blot and RT-qPCR (Real Time Quantitative PCR). Finally, a rescue experiment was carried out with small interference RUA.

Results:

The proliferation level of osteoblasts in Oste + Dura- C342Y group was significantly up-regulated. Our studies indicated that the activation of MEK/ERK pathway in Oste + Dura-C342Y group could inhibit the Hippo pathway, lead to down-regulation of large tumor suppressor 1 and promote the activation and nuclear localization of yes-associated protein, and the results of rescue experiments showed a reverse expression trend, further confirming the effects of C342Y-FGFR2 mutation in dura cells on osteoblasts and its potential mechanism.

Conclusions:

This study suggested that the C342Y-FGFR2 mutation in dura cells could promote osteoblastic proliferation, and shown the crosstalk between MEK/ERK and Hippo pathways. As the regulatory machinery center, yes-associated protein might play a bridging role in these pathways, and might influence the pathogenesis of craniosynostosis by activating downstream transcriptional factors.
Parent and Patient Reported Outcomes for Head Shape in Children Undergoing Surgery for Single Suture Synostosis
Authors: Dalton Louise J. , Kiani Shahida , Judge Andrew , Wall Steven , Johnson David
Published: September 2021

Assessing outcomes following surgery for single suture craniosynostosis is important to ensure minimum standards are being met, but also to compare results using different surgical techniques and treatment protocols. What constitutes an “outcome” and how this is measured remains a challenge, particularly when assessment should include consideration of aesthetic, functional, and psychological domains.

The Oxford Craniofacial Unit has initiated routine collection of parents’ and patients’ ratings of 2 factors that are closely associated with psychological adjustment; how noticeable the child's headshape is and how much this bothers the parent and/or child. A brief Surgical Outcome Questionnaire is completed by parents and children (over 7 years) at their outpatient appointment; parents are also asked to rate the extent to which they feel surgery made a difference to their child's headshape.

Data are presented for 519 parents and 248 children with single suture craniosynostosis who attended the Oxford Craniofacial Unit in 2018 and 2019; this represents over 80% of patients seen in the clinic indicating the questionnaire is acceptable for families and the potential for rapid, relevant data on a continuous basis. Analysis of the data is presented to demonstrate the utility of the Surgical Outcome Questionnaire in exploring the views of both parents and patients of the noticeability and level of concern about the child's headshape for different age groups and diagnoses.

The Surgical Outcome Questionnaire provides a novel method of collecting routine data for patients across their craniofacial care pathway, using variables which are relevant and meaningful for patients and parents.
Use of Buried Guide Needle to Fix Inferior Eyelid Orbital Septum Fat for Tear Trough Depression Filling
Authors: Gu Cong-Min , Zhou Chuan-De , Chen Wen , Guo Shi-Wei , Zhang Jia-Qi , Xu Li-Si , Yang Ming-Yong
Published: September 2021

Fat fixation is a key step in filling tear trough depression with inferior eyelid orbital septum fat. The ideal position for inferior eyelid fat fixation is to cross the tear trough ligament causing tear trough depression and the orbicularis retaining ligament, with the distal end fixed at the farthest end of the dissected lacuna deep down the inferior orbicularis oculi muscle. Traditional suturing is difficult in the deep narrow lacunae, but a buried guide needle can be used to suture and fix the fat in the deepest lacuna. In this study, 264 patients who underwent tear trough filling using a buried guide needle to fix the released inferior eyelid orbital septum fat from 2017 to 2020 were followed up. The preoperative and postoperative imaging findings were compared to evaluate the effectiveness of the operation and postoperative complications. The inferior eyelid bulging, loose skin, and tear trough depression significantly improved than that before the operation. None of the patients had any severe complications, such as inferior eyelid ectropion, lagophthalmos, scar hyperplasia, and diplopia, in the long term (6 months) postoperatively. Five patients showed mild eyelid-eyeball separation and recovered in 1 month. Four patients had diplopia, and 3 patients had chemosis; all recovered in 7 days. The tear trough depression was not corrected completely in 2 patients. The operation showed satisfactory results in the improvement of tear trough depression in addition to alleviation of inferior eyelid bulging and loose inferior eyelid skin that is caused by the traditional inferior eyelid pouch removal.
Addressing Surgical Care Disparities: Residents’ Involvement in Global Mission Trips
Authors: Kambhampati Praneeth V. , Mitchell David , Rajesh Aashish , Deptula Peter L. , Asaad Malke
Published: September 2021

Humanitarian mission trips have been organized by several residency programs and organizations to cater to surgical care in underdeveloped countries. While there is cross-talk on the existence of such opportunities, there is a paucity of guidance to residents on participation in such trips, their benefits, and the myriad of intangibles to consider while planning to pursue such opportunities. Through this article, the authors highlight the background and utility of humanitarian surgical missions and summarize the clinical and surgical experiences that these trips offer for residents choosing to embark on these altruistic journeys.
Longitudinal Trends in 30-Day Mortality Between Multi-Site and Single-Site Surgeons
Authors: Tsai Thomas C. , Bryan Ava Ferguson , Zheng Jie , Haas Susan , Orav E. John , Benjamin Evan
Published: September 2021

Background:

Quality leaders are concerned that creation of multi-hospital health systems may lead to surgeons traveling to and from distant hospitals and thus to more fragmented surgical care and worse outcomes for their patients. Despite this concern, little empirical data exist on outcomes of multi-site versus single-site surgeons.

Methods:

Using national Medicare data, we assessed trends in the number of multi-site vs. single-site surgeons from 2011 to 2016. We performed a multivariable regression analysis to compare overall 30-day mortality differences, stratified by system and rural status, and examined trends over time.

Results:

The number of multi-site surgeons and the percentage of multi-site surgeons per hospital decreased over time (24.2%–19.0%; 44.3%–41.8%). Overall, multi-site surgeons had lower 30-day mortality than single-site surgeons (2.24% vs 2.50%, P < 0.01). When stratified by system status, multi-site surgeons performed better in-system (2.47% vs 2.58%, P < 0.01); by rural status, multi-site surgeons had lower mortality in non-rural hospitals (2.42% vs 2.51%, P < 0.01). The statistically significant but small mortality advantage of multi-site versus single-site surgeons decreased over time, such that by 2016 there was no difference in outcomes between multi-site and single-site surgeons.

Conclusion:

For the majority of study years, multi-site surgeons had lower 30-day mortality than single-site surgeons, but this trend narrowed until outcomes were equivalent by 2016. Surgeons operating at multiple hospitals can provide surgical care to patients without any evidence of increased mortality.
Electroconvulsive Therapy in Canada During the First Wave of COVID-19
Authors: Demchenko Ilya , Blumberger Daniel M. , Flint Alastair J. , Anderson Melanie , Daskalakis Zafiris J. , Foley Karen , Karkouti Keyvan , Kennedy Sidney H. , Ladha Karim S. , Robertson Jamie , Vaisman Alon , Koczerginski David , Parikh Sagar V. , Bhat Venkat
Published: September 2021

Objectives

The COVID-19 pandemic has disrupted the provision of essential and potentially life-saving procedural treatments such as electroconvulsive therapy (ECT). We surveyed ECT providers across Canada to understand how the first wave of the pandemic affected ECT delivery between mid-March 2020 and mid-May 2020.

Methods

The survey was administered to ECT team members and decision makers at 107 Canadian health care centers with a focus on 5 domains: operations, decision-making, hospital resources, ECT procedure, and patient impact. Responses were obtained from 72 institutions, and collected answers were used to derive representative responses reflecting the situation at each ECT center. For specific domains, responses were split into 2 databases representing the perspective of psychiatrists (n = 67 centers) and anesthesiologists (n = 24 centers).

Results

Provision of ECT decreased in 64% centers and was completely suspended in 27% of centers after the onset of the pandemic. Outpatient and maintenance ECT were more affected than inpatient and acute ECT. Programs reported a high level of collaboration between psychiatry and hospital leadership (59%) but a limited input from clinical ethicists (18%). Decisions were mostly made ad hoc leading to variability across institutions in adopted resource allocation, physical location of ECT delivery, and triaging frameworks. The majority of centers considered ECT to be aerosol-generating and incorporated changes to airway management.

Conclusions

Electroconvulsive therapy services in Canada were markedly disrupted by the COVID-19 pandemic. The variability in decision-making across centers warrants the development of a rational approach toward offering ECT in pandemic contexts.
Massilia rhizosphaerae sp. nov., a rice-associated rhizobacterium with antibacterial activity against Ralstonia solanacearum
Authors: Li Chenxu , Cao Peng , Du Chuanjiao , Zhang Xue , Bing Hui , Li Lei , Sun Peng , Xiang Wensheng , Zhao Junwei , Wang Xiangjing
Published: September 2021

A novel rhizobacterium, designated strain NEAU-GH312T, with antibacterial activity against

Ralstonia solanacearum

was isolated from rhizosphere soil of rice (Heilongjiang Province, PR China) and characterized with a polyphasic approach. Cells of strain NEAU-GH312T were Gram-stain-negative, aerobic, non-spore-forming, motile with peritrichous flagella and rod-shaped. Colonies were light orange, convex and semi-translucent on Reasoner's 2A (R2A) agar after 2 days of incubation at 28 °C. Growth was observed on R2A agar at 10–40 °C, pH 4.0–8.0 and with 0–5 % (w/v) NaCl. The respiratory quinone was ubiquinone Q-8. The major cellular fatty acids of strain NEAU-GH312T were C16 : 1
 ω7c and/or C16 : 1
 ω6c, C16 : 0 and C18 : 1
 ω7c and/or C18 : 1
 ω6c. The main polar lipids were phosphatidylglycerol, phosphatidylethanolamine and diphosphatidylglycerol. Phylogenetic analyses confirmed the well-supported affiliation of strain NEAU-GH312T within the genus

Massilia

, close to the type strains of

Massilia arvi

THG-RS2OT (98.7 %),

Massilia norwichensis

NS9T (98.7 %) and

Massilia kyonggiensis

TSA1T (98.6 %). Strain NEAU-GH312T had a genome size of 6.68 Mb and an average DNA G+C content of 66.3 mol%. Based on the genotypic, phenotypic and chemotaxonomic data obtained in this study, strain NEAU-GH312T could be classified as representative of a novel species of the genus

Massilia

, for which the name Massilia rhizosphaerae sp. nov. is proposed, with strain NEAU-GH312T (=DSM 109722T=CCTCC AB 2019142T) as the type strain.
Tobacco 21: Retailer Perceptions, Experiences, and Challenges Before and After a New Minimum Legal Sales Age Law in Maryland
Authors: Walsh Candace , Biblow Alanna , Charles John , Madden Patrick , Berkowitz Dawn , Jallah Nikardi , Moncrief Dana
Published: September 2021

Objectives

By raising the legal age of sale from 18 to 21 years old, Tobacco 21 laws (T21) are reshaping the tobacco landscape in the United States. In 2019, Maryland became the 13th state to adopt T21. This study is among the first to examine the perception, awareness, and ease of compliance of T21 among tobacco retailers through a two-wave survey conducted pre-T21 and post-T21.

Design

Surveys were conducted among the state’s more than 6,000 registered retailers prior to the state’s T21 law going into effect and eight months later after T21 had been enacted. The pre-T21 and post-T21 survey instruments measured retailer awareness, support, and perceived ability to comply with T21, current tobacco practices, revenue from tobacco products, and challenges faced in compliance. 414 retailers completed the pre-T21 survey and 360 completed the post-T21 survey. The final survey data was weighted to reflect the geographic distributions of licensed tobacco retailers in Maryland.

Results

There was no significant difference in retailer awareness, support and challenges comparing pre and post T21. One notable caveat is lack of consumer knowledge about T21, resulting in retailers being responsible for educating customers.

Conclusions

The evaluation of T21 and impact to retailers is a valuable tool in determining the law’s success and barriers to implementation. Results support the idea that T21 laws have had a minor impact on how retailers conduct their business. As a result of the communication and materials provided by the state, retailers largely understand the law and how to adhere to guidelines.
Effects of polygenic risk for suicide attempt and risky behavior on brain structure in young people with familial risk of bipolar disorder
Authors: Overs Bronwyn J. , Roberts Gloria , Ridgway Kate , Toma Claudio , Hadzi-Pavlovic Dusan , Wilcox Holly C. , Hulvershorn Leslie A. , Nurnberger John I. , Schofield Peter R. , Mitchell Philip B. , Fullerton Janice M.
Published: September 2021

Aims

Bipolar Disorder (BD) is associated with a 20-30 fold increased suicide risk compared to the general population. First-degree relatives of BD patients show inflated rates of psychopathology including suicidal behaviors. As reliable biomarkers of suicide attempts (SA) are lacking, we examined associations between suicide-related polygenic risk scores (PRS) – a quantitative index of genomic risk – and variability in brain structures implicated in SA.

Methods

Participants (n=206; aged 12-30 years) were unrelated individuals of European ancestry and comprised three groups: 41 BD cases, 96 BD relatives (‘high-risk’), and 69 controls. Genotyping employed PsychArray, followed by imputation. Three PRS were computed using genome-wide association data for SA in BD (SA-in-BD), SA in Major Depressive Disorder (SA-in-MDD) [Mullins et al., 2019], and risky behavior [Karlsson Linnér et al., 2019]. Structural MRI processing employed FreeSurfer v5.3.0. General linear models were constructed using 32 regions-of-interest identified from suicide neuroimaging literature, with false-discovery-rate correction.

Results

SA-in-MDD and SA-in-BD PRS negatively predicted parahippocampal thickness, with the latter association modified by group membership. SA-in-BD and Risky Behavior PRS inversely predicted rostral and caudal anterior cingulate structure, respectively, with the latter effect driven by the ‘high-risk’ group. SA-in-MDD and SA-in-BD PRS positively predicted cuneus structure, irrespective of group.

Conclusions

This study demonstrated associations between PRS for suicide-related phenotypes and structural variability in brain regions implicated in SA. Future exploration of extended PRS, in conjunction with a range of biological, phenotypic, environmental and experiential data in high-risk populations, may inform predictive models for suicidal behaviors.
Media Exposure and the Social Determinants of Health Insurance Coverage in Ethiopia 2011-2016
Authors: Olatunji Eniola A. , Maredia Sanam , Freeman Natalie , Nguyen Allen , Washburn David J
Published: September 2021

Background

In a push for universal health coverage, Ethiopia introduced two insurance schemes in 2010. Yet coverage rates remain very low. To encourage greater adoption, policymakers require a better understanding of who chooses to enroll and which promotional efforts are most effective in encouraging enrollment.

Objective

Using nationally representative Demographic and Health Surveys, this research assessed the social determinants of health insurance coverage, including media exposure, in Ethiopia from 2011-2016.

Methods

This research analyzed health insurance coverage and other sociodemographic and media exposure variables using multivariable logistic regression model.

Results

Health insurance coverage increased 3.30 times from 1.48% in 2011 to 4.89% in 2016. In both years, coverage was associated with higher education, older age, higher wealth levels, and exposure to newspaper and television. Compared to those with no exposure to newspaper, those with newspaper exposure at least once a week were 1.80 times (2011) and 1.86 times (2016) more likely to be insured. Similar results were obtained for television exposure.

Conclusion

Initiatives that target the poor and less educated will be necessary if Ethiopia is to achieve universal health coverage. This research suggests that, to date, newspaper and television mediums have been effective promotion mechanisms for growing enrollment.
Detection of malignant peripheral nerve sheath tumors in patients with neurofibromatosis using aneuploidy and mutation identification in plasma
Authors: Mattox Austin K. , Douville Christopher , Silliman Natalie , Ptak Janine , Dobbyn Lisa , Schaefer Joy , Popoli Maria , Blair Cherie , Judge Kathy , Pollard Kai , Pratilas Christine , Blakeley Jaishri , Rodriguez Fausto , Belzberg Allan , Bettegowda Chetan
Published: September 2021

Malignant peripheral nerve sheath tumors (MPNST) are the deadliest cancer that arises in individuals diagnosed with neurofibromatosis and account for nearly 5% of the 15,000 soft tissue sarcomas diagnosed in the United States each year. Comprised of neoplastic Schwann cells, primary risk factors for developing MPNST include existing plexiform neurofibromas (PN), prior radiotherapy treatment, and expansive germline mutations involving the entire NF1 gene and surrounding genes. PN develop in nearly 30-50% of patients with NF1 and most often grow rapidly in the first decade of life. One of the most important aspects of clinical care for NF1 patients is monitoring PN for signs of malignant transformation to MPNST that occurs in 10-15% of patients.

We perform aneuploidy analysis on ctDNA from 883 ostensibly healthy individuals and 28 patients with neurofibromas, including 7 patients with benign neurofibroma, 9 patients with PN and 12 patients with MPNST. Overall sensitivity for detecting MPNST using genome wide aneuploidy scoring was 33%, and analysis of sub-chromosomal copy number alterations (CNAs) improved sensitivity to 50% while retaining a high specificity of 97%. In addition, we performed mutation analysis on plasma cfDNA for a subset of patients and identified mutations in NF1, NF2, RB1, TP53BP2, and GOLGA2. Given the high throughput and relatively low sequencing coverage required by our assay, liquid biopsy represents a promising technology to identify incipient MPNST.
SARS-CoV-2 serology across scales: a framework for unbiased seroprevalence estimation incorporating antibody kinetics and epidemic recency
Authors: Takahashi Saki , Peluso Michael J. , Hakim Jill , Turcios Keirstinne , Janson Owen , Routledge Isobel , Busch Michael P. , Hoh Rebecca , Tai Viva , Kelly J. Daniel , Martin Jeffrey N. , Deeks Steven G. , Henrich Timothy J. , Greenhouse Bryan , Rodríguez-Barraquer Isabel
Published: September 2021

Serosurveys are a key resource for measuring SARS-CoV-2 cumulative incidence. A growing body of evidence suggests that asymptomatic and mild infections (together making up over 95% of all infections) are associated with lower antibody titers than severe infections. Antibody levels also peak a few weeks after infection and decay gradually. We developed a statistical approach to produce adjusted estimates of seroprevalence from raw serosurvey results that account for these sources of spectrum bias. We incorporate data on antibody responses on multiple assays from a post-infection longitudinal cohort, along with epidemic time series to account for the timing of a serosurvey relative to how recently individuals may have been infected. We applied this method to produce adjusted seroprevalence estimates from five large-scale SARS-CoV-2 serosurveys across different settings and study designs. We identify substantial differences between reported and adjusted estimates of over two-fold in the results of some surveys, and provide a tool for practitioners to generate adjusted estimates with pre-set or custom parameter values. While unprecedented efforts have been launched to generate SARS-CoV-2 seroprevalence estimates over this past year, interpretation of results from these studies requires properly accounting for both population-level epidemiologic context and individual-level immune dynamics.