bluuebunny/crossref_metadata_2025 huggingface dataset:
2. Introduction to Sources of Law and Court Structure
Authors: Thomas Mark , McGourlay Claire
Published: September 2020

Each Concentrate revision guide is packed with essential information, key cases, revision tips, exam Q&As, and more. This chapter introduces the various sources of law before proceeding onto a discussion of the courts of England and Wales. The courts of England and Wales can be divided into numerous different classifications. There are three different ways that courts may be classified: criminal and civil courts, trial and appellate courts, and superior and inferior courts. In England and Wales, there is often thought to be a stark divide between criminal and civil courts. Criminal courts deal with individuals who have ‘allegedly’ committed a criminal offence and it is the role of the arbiters of fact to determine the guilt or innocence of a defendant based on the evidence presented before them. On the other hand, civil courts deal primarily with the resolution of private disputes between individuals. Such disputes can include matters of contract law, personal injury, and family law. However, the jurisdiction of some courts is not limited to one area of law, but rather is approachable for both substantive areas of law.
4. Sources of Law II: Case Law
Authors: Thomas Mark , McGourlay Claire
Published: September 2020

Each Concentrate revision guide is packed with essential information, key cases, revision tips, exam Q&As, and more. This chapter focuses on case law, a major source of law providing for the interpretation of statutes and the application of law to particular circumstances. Case law, also known as the common law, is a set of judge-made rules that have either a binding or persuasive effect on future cases. Judge-made means that a member of the judiciary has decided a case in a certain way, which has led to the development of that particular piece of law. Certain courts are obliged to follow previous judgments, whereas other can ignore them due to their seniority. Indeed, the doctrine of precedent denotes a system of case law—binding or not—that a lower court may or may not have to follow. Whether precedent is binding is dependent on whether there is a statement of law, as opposed to fact, certain reasoning for that decision (known as ratio decidendi), and the decision of a superior court.
8. The Civil Justice System
Authors: Thomas Mark , McGourlay Claire
Published: September 2020

Each Concentrate revision guide is packed with essential information, key cases, revision tips, exam Q&As, and more. This chapter discusses the civil justice system. Civil justice is concerned with the private dispute between individuals in the absence of the state. It seeks to solve disputes before they have had a chance to enter the legal structure, through the use of alternative dispute resolution (ADR). Civil justice follows a similar pattern to its criminal counterpart; however, some of the procedural rules—specifically those relating to evidence—appear to be much more relaxed than in the criminal justice system. During the process of civil justice, a number of issues may arise which would bring the procedure to an end. These issues include ADR, through which parties may decide to settle the case at any point; default judgment, wherein judgment may be entered against a defendant at any point in the proceedings; and offers to settle, known as ‘Part 36 Offers’, in which an individual makes an offer to another without prejudice.
6. The leasehold estate
Authors: Sayles Victoria
Published: September 2020

Each Concentrate revision guide is packed with essential information, key cases, revision tips, exam Q&As, and more. Concentrates show you what to expect in a law exam, what examiners are looking for, and how to achieve extra marks. This chapter discusses the leasehold estate. A lease is one of the estates in land capable of being legal. Without both certainty of term and exclusive possession there can be no lease, although the presence of both does not necessarily mean that a lease exists. Formalities for the creation of a legal lease differ depending upon the duration of the lease. Where these formalities have not been met, an equitable lease may exist provided there is a valid contract capable of specific performance. An equitable lease is not as good as the legal equivalent. The most common types of leases are fixed term and periodic. The process of terminating a lease by forfeiture varies depending upon the type of covenant breached.
7. Covenants in leases
Authors: Sayles Victoria
Published: September 2020

Each Concentrate revision guide is packed with essential information, key cases, revision tips, exam Q&As, and more. Concentrates show you what to expect in a law exam, what examiners are looking for, and how to achieve extra marks. This chapter discusses leasehold covenants. Leasehold covenants are promises made between a landlord and his tenant, regulating the relationship between them and the way in which a leasehold estate is enjoyed. The covenants may be either express or implied. The nature and extent of liability imposed by express covenants will be a matter of negotiation between the parties. Implied covenants, which can occasionally be expressly excluded from the lease (where it is allowed), may impose burdens on either the landlord or the tenant. Covenants, whether express or implied, may be either positive (e.g. to repair) or negative (e.g. prohibiting change of use to the property). Covenants may be enforceable against successor owners of both the leasehold and reversionary interests.
2. Companies and Corporate Personality
Authors: Moore Imogen
Published: September 2020

The Concentrate Questions and Answers series offers the best preparation for tackling exam questions and coursework. Each book includes typical questions, suggested answers with commentary, illustrative diagrams, guidance on how to develop your answer, suggestions for further reading, and advice on exams and coursework. This chapter considers the main legal forms used for businesses in the UK—particularly sole traders, general partnerships, limited liability partnerships (LLPs), and companies (public and private). It then examines how registered companies limited by shares come into existence. On registration a company becomes a legal person, separate from its shareholders and directors. This chapter explores this ‘corporate personality’ and the popular topic of when the ‘veil of incorporation’ can be lifted or pierced by statute or the courts.
A demographic scaling model for estimating the total number of COVID-19 infections
Authors: Bohk-Ewald Christina , Dudel Christian , Myrskylä Mikko
Published: September 2020

Background

Understanding how widely COVID-19 has spread is critical information for monitoring the pandemic. The actual number of infections potentially exceeds the number of confirmed cases.

Development

We develop a demographic scaling model to estimate COVID-19 infections, based on minimal data requirements: COVID-19-related deaths, infection fatality rates (IFRs), and life tables. As many countries lack IFR estimates, we scale them from a reference country based on remaining lifetime to better match the context in a target population with respect to age structure, health conditions and medical services. We introduce formulas to account for bias in input data and provide a heuristic to assess whether local seroprevalence estimates are representative for the total population.

Application

Across 10 countries with most reported COVID-19 deaths as of 23 July 2020, the number of infections is estimated to be three [95% prediction interval: 2–8] times the number of confirmed cases. Cross-country variation is high. The estimated number of infections is 5.3 million for the USA, 1.8 million for the UK, 1.4 million for France, and 0.4 million for Peru, or more than one, six, seven and more than one times the number of confirmed cases, respectively. Our central prevalence estimates for entire countries are markedly lower than most others based on local seroprevalence studies.

Conclusions

The national infection estimates indicate that the pandemic is far more widespread than the numbers of confirmed cases suggest. Some local seroprevalence estimates largely deviate from their corresponding national mean and are unlikely to be representative for the total population.
Steady states of thin film droplets on chemically heterogeneous substrates
Authors: Liu Weifan , Witelski Thomas P
Published: September 2020

We study steady-state thin films on chemically heterogeneous substrates of finite size, subject to no-flux boundary conditions. Based on the structure of the bifurcation diagram, we classify the 1D steady-state solutions that exist on such substrates into six different branches and develop asymptotic estimates for the steady states on each branch. Using perturbation expansions, we show that leading-order solutions provide good predictions of the steady-state thin films on stepwise-patterned substrates. We show how the analysis in one dimension can be extended to axisymmetric solutions. We also examine the influence of the wettability contrast of the substrate pattern on the linear stability of droplets and the time evolution for dewetting on small domains. Results are also applied to describe 2D droplets on hydrophilic square patches and striped regions used in microfluidic applications.
Ceftolozane/tazobactam exposure in critically ill patients undergoing continuous renal replacement therapy: a PK/PD approach to tailor dosing
Authors: Gatti Milo , Giannella Maddalena , Raschi Emanuel , Viale Pierluigi , De Ponti Fabrizio
Published: September 2020

Objectives

To investigate the influence of continuous renal replacement therapy (CRRT) intensity on the clearance of ceftolozane/tazobactam in critical care patients, and to evaluate if the reported doses would achieve an optimal pharmacokinetic/pharmacodynamic (PK/PD) target against Pseudomonas aeruginosa exhibiting different MICs.

Methods

The MEDLINE–PubMed database was searched from inception to January 2020 to retrieve observational studies or case reports investigating the PK behaviour of ceftolozane/tazobactam during CRRT. Relevant CRRT settings and PK variables were extracted, and the influence of CRRT intensity on ceftolozane/tazobactam total clearance (CLtot) was determined by simple linear regression. The optimal PK/PD target for the reported doses was deemed to be achieved when ceftolozane trough concentrations (Cmin) were above the MIC (less intensive target) or four times the MIC (intensive target) for P. aeruginosa.

Results

Data from six studies including 11 patients (mean age 56.6 years) were analysed. Mean blood flow rate and effluent flow rate were 161.8 mL/min and 2383.4 mL/h, respectively. Ceftolozane Cmin ranged from 25.8 to 79.4 mg/L. A significant correlation was found for ceftolozane CLtot and effluent flow rate (P = 0.027). The intensive PK/PD target was achieved by 100% and 50% of the reported doses for MIC, respectively, up to 4 and 8 mg/L.

Conclusions

A significant correlation between effluent flow rate and ceftolozane clearance during CRRT could be identified. Higher dosing regimens coupled with continuous/extended infusion may be required in the case of higher CRRT intensity, deep-seated infections or poorly susceptible isolates. Larger studies assessing ceftolozane PK in different CRRT settings are warranted.
Patterns of frequent user interactions in blogosphere
Authors: Rudek Krzysztof , Koźlak Jarosław
Published: September 2020

The aim of the paper is to identify and categorize frequent patterns describing interactions between users in social networks. We analyze a social network with relationships between users that evolve in time already identified. In our research, we discover patterns based on frequent interactions between groups of users. The patterns are described by the characteristics of these interactions, such as their reciprocity, or the relative difference between estimations of global influences of the users participating in the discussions. The modification of the apriori algorithms is applied as one of the methods for pattern identification. The analyzed social network is built using the data set containing data from the Polish blog website salon24, which concerns mostly socio-political issues.
ddPCR Analysis Reveals BRAF V600E Mutations Are Infrequent in Isolated Pituitary Langerhans Cell Histiocytosis Patients
Authors: Nellan Anandani , Bodlak Avery , Mirsky David M , Mulcahy Levy Jean , Garrington Timothy P , Foreman Nicholas K , Gilani Ahmed , Hayashi Masanori
Published: September 2020

Langerhans cell histiocytosis (LCH) is an inflammatory myeloid neoplasia with a highly variable clinical presentation affecting people of all ages. Mutations in BRAF V600E are the most identifiable molecular alteration in LCH although its incidence in pediatric patients with isolated pituitary stalk involvement is not well described. Pediatric patients with LCH and isolated pituitary stalk involvement typically present with central diabetes insipidus. Diagnosis requires a transcranial biopsy which often yields scant tissue. We sought to determine the prevalence of BRAF V600E mutations in patients with isolated pituitary stalk LCH using digital droplet polymerase chain reaction because this method requires minimal tumor DNA. We identified 8 patients with isolated pituitary stalk thickening who underwent a biopsy at Children’s Hospital Colorado from January 2001 to December 2019, as well as 6 patients with systemic LCH diagnosed by biopsy in the same period as a comparison. Only one out of the 8 patients with isolated thickened pituitary stalk was found to have a detectable BRAF V600E mutation. Five out of the 6 patients with systemic LCH had a detectable BRAF V600E mutation. In our series, BRAF V600E mutations are rare in pediatric patients with LCH and isolated pituitary stalk involvement.
Post-trauma transmesocolic hernia: a case report
Authors: Salam Doaa Hussin , Al-Tarakji Mohannad , Alaieb Abubaker Ibrahim , Singh Rajvir , El-Menyar Ayman , Al-Thani Hassan , Zarour Ahmad , Ellabib Mohamed
Published: September 2020

The prevalence of transmesocolic hernias, a subtype of internal hernias (IHs), is generally low. Its clinical consequences, including strangulation, ischemia and even death, however, necessitate awareness. IHs are classified as congenital or acquired as resulting from surgery, trauma or intraperitoneal inflammation. This is a case of a 37-year-old male victim of a motor vehicle collision 1 month prior to the index admission. The trauma-related injuries were managed conservatively and then discharged home. The patient was re-admitted with a 2-day history of epigastric pain, vomiting and abdominal distension. A diagnosis of small bowel obstruction due to a transmesocolic hernia was made on CT and emergency laparotomy performed. The post-operative course was unremarkable. It is vital to consider transmesocolic hernias in trauma patients presenting with a picture of bowel obstruction even in the absence of prior surgery.
Caecal volvulus in an incisional hernia
Authors: Ting Ying Yang , Farfus Anthony , Trochsler Markus
Published: September 2020

Caecal volvulus represents 25–40% of all colonic volvulus. Symptoms include abdominal distension, constipation, nausea and vomiting where it may be intermittent. Abdominal X-rays and computed tomography (CTs) may help with diagnosis and recommended treatment is resection of mobile caecum. A 70-year old comorbid woman with previous open bariatric surgery and known incisional hernia presented with symptoms of bowel obstruction. CT showed caecal volvulus contained within the ventral hernia confirmed intra-operatively. Patient recovered well and was discharged on Day 6 of admission. This is the second case described in literature of a caecal volvulus occurring in an incisional hernia. The altered normal anatomy may have contributed to caecal mobility. Diagnosis of caecal volvulus can be challenging, more so in the presence of a more clinically apparent pathology. We present a second known case of caecal volvulus in a giant incisional hernia, where there were unique challenges to management.
Trypanosoma cruziinfection in Latin American pregnant women living outside endemic countries and frequency of congenital transmission: a systematic review and meta-analysis
Authors: Colombo Valeria , Giacomelli Andrea , Casazza Giovanni , Galimberti Laura , Bonazzetti Cecilia , Sabaini Federico , Ridolfo Anna Lisa , Antinori Spinello
Published: September 2020

Background

Chagas disease, as a consequence of globalization and immigration, is no more restricted to Central and Latin America. Therefore, congenital transmission represents a growing public health concern in non-endemic countries.

Methods

The aim of this study was to assess the prevalence of Trypanosoma cruzi infection in pregnant Latin American (LA) women living outside endemic countries and the rate of congenital transmission. Data were extracted from studies indexed in PubMed, Scopus, Embase, Lilacs and SciELO databases without language restriction. Two investigators independently collected data on study characteristics, diagnosis, prevalence of infection in pregnant women and congenital infection rate. The data were pooled using a random effects model.

Results

The search identified 1078 articles of which 29 were eligible regarding prevalence of T. cruzi infection among pregnant women and 1795 articles of which 32 were eligible regarding the congenital transmission rate. The estimated pooled prevalence of T. cruzi infection in LA pregnant women was 4.2% [95% confidence interval (CI): 3.0–5.5]. The prevalence of T. cruzi infection in pregnant women from Bolivia was 15.5% (95% CI: 11.7–19.7) and 0.5% (95% CI: 0.2–0.89) for those coming from all other LA countries. The estimated global rate of congenital transmission was 3.5% (95% CI: 2.5–4.5); excluding poor-quality studies, the rate of congenital transmission was 3.8% (95% CI: 2.4–5.1).

Conclusions

Prevalence of Chagas disease among LA pregnant women living outside endemic countries is high, particularly in Bolivian women. The rate of vertical transmission of T. cruzi infection is similar to the rate reported in South and Central American countries.
Different Sources of Allelic Variation Drove Repeated Color Pattern Divergence in Cichlid Fishes
Authors: Urban Sabine , Nater Alexander , Meyer Axel , Kratochwil Claudius F
Published: September 2020

The adaptive radiations of East African cichlid fish in the Great Lakes Victoria, Malawi, and Tanganyika are well known for their diversity and repeatedly evolved phenotypes. Convergent evolution of melanic horizontal stripes has been linked to a single locus harboring the gene agouti-related peptide 2 (agrp2). However, where and when the causal variants underlying this trait evolved and how they drove phenotypic divergence remained unknown. To test the alternative hypotheses of standing genetic variation versus de novo mutations (independently originating in each radiation), we searched for shared signals of genomic divergence at the agrp2 locus. Although we discovered similar signatures of differentiation at the locus level, the haplotypes associated with stripe patterns are surprisingly different. In Lake Malawi, the highest associated alleles are located within and close to the 5′ untranslated region of agrp2 and likely evolved through recent de novo mutations. In the younger Lake Victoria radiation, stripes are associated with two intronic regions overlapping with a previously reported cis-regulatory interval. The origin of these segregating haplotypes predates the Lake Victoria radiation because they are also found in more basal riverine and Lake Kivu species. This suggests that both segregating haplotypes were present as standing genetic variation at the onset of the Lake Victoria adaptive radiation with its more than 500 species and drove phenotypic divergence within the species flock. Therefore, both new (Lake Malawi) and ancient (Lake Victoria) allelic variation at the same locus fueled rapid and convergent phenotypic evolution.
Evolution of a highly functional circular DNA aptamer in serum
Authors: Mao Yu , Gu Jimmy , Chang Dingran , Wang Lei , Yao Lili , Ma Qihui , Luo Zhaofeng , Qu Hao , Li Yingfu , Zheng Lei
Published: September 2020

Circular DNA aptamers are powerful candidates for therapeutic applications given their dramatically enhanced biostability. Herein we report the first effort to evolve circular DNA aptamers that bind a human protein directly in serum, a complex biofluid. Targeting human thrombin, this strategy has led to the discovery of a circular aptamer, named CTBA4T-B1, that exhibits very high binding affinity (with a dissociation constant of 19 pM), excellent anticoagulation activity (with the half maximal inhibitory concentration of 90 pM) and high stability (with a half-life of 8 h) in human serum, highlighting the advantage of performing aptamer selection directly in the environment where the application is intended. CTBA4T-B1 is predicted to adopt a unique structural fold with a central two-tiered guanine quadruplex capped by two long stem–loops. This structural arrangement differs from all known thrombin binding linear DNA aptamers, demonstrating the added advantage of evolving aptamers from circular DNA libraries. The method described here permits the derivation of circular DNA aptamers directly in biological fluids and could potentially be adapted to generate other types of aptamers for therapeutic applications.
Outpatient Parenteral Antimicrobial Therapy With Ceftolozane/Tazobactam via Continuous Infusion for Multidrug-Resistant Pseudomonas aeruginosa Osteomyelitis
Authors: Álvarez Otero Judith , Lamas Ferreiro Jose Luis , Sanjurjo Rivo Ana , de la Fuente Aguado Javier
Published: September 2020

We present a case of Pseudomonas aeruginosa osteomyelitis treated with surgery and antibiotic therapy with ceftolozane-tazobactam in continuous infusion at home using an elastomeric pump. We discuss the use of ceftolozane-tazobactam in continuous infusion administered at home as an effective alternative for the treatment of multidrug-resistant Pseudomonas aeruginosa osteomyelitis.
A Retrospective Cohort Study of Urgent Care Visits and Revisits for Headache/Migraine
Authors: Minen Mia , Zhou Kina , Lall Ramona , Friedman Benjamin W
Published: September 2020

Objective. Increasingly, patients are seeking same-day care at urgent care (UC) facilities. Little is known about the health care utilization patterns of patients who visit UC facilities for headache and migraine. We examined the frequency of headache and migraine visits and revisits at UC facilities. Methods. We conducted a retrospective cohort study of headache not otherwise specified (NOS) and migraine visits from 67 NYC UC facilities over an eight-month period. We report descriptive analyses, the frequency of headache NOS revisits, and the elapsed time to revisits. Results. There were 10,240 patients who visited UC facilities for headache NOS or migraine within the eight-month period. The majority of patients, 6,994 (68.3%), were female, and the mean age (SD) was 35.1 (15.0) years. Most (93.9%) patients (N = 9,613) lived within 60 miles of NYC; 5.5% (N = 564) had at least one revisit, and among re-visitors, there was an average (SD) of 2.2 (0.7) visits to UC facilities during the study period and an average time to revisit (SD) of 61.3 (55.2) days. Conclusions. In just eight months, there were >10,000 headache NOS and migraine visits to UC facilities in NYC, with half of revisits occurring within 90 days. Future work should examine headache management in UC facilities.
Development of a dual-phase xenon TPC with a quartz chamber for direct dark matter searches
Authors: Sato Kazufumi , Yamashita Masaki , Ichimura Koichi , Itow Yoshitaka , Kazama Shingo , Moriyama Shigetaka , Ozaki Kosuke , Suzuki Takumi , Yamazaki Rina
Published: September 2020

The idea of a hermetic quartz chamber in a dual-phase xenon time projection chamber (TPC) has the potential to improve the detector sensitivity for direct dark matter searches in the future. A major challenge facing TPC detectors in future dark matter experiments will be the reduction of the internal background such as $^{222}$Rn and the deterioration of the ionization signal due to electronegative impurities. The hermetic quartz chamber can isolate the TPC’s sensitive volume from external interference and is thus expected to prevent contamination caused by radioactive and electronegative impurities, which originate from the outer detector materials. At the Kamioka Observatory in Japan, we have developed a TPC with a quartz chamber that contains a ⌀$ 48 \times 58$ mm volume of liquid xenon. At this development stage, we have not aimed for perfect hermeticity of the quartz chamber. Our aim here is twofold: first, to demonstrate via the use of a calibration source that the presence of quartz materials in the TPC does not impact its operation; and second, to perform quantitative measurements of the TPC’s characteristics. We successfully measured electron drift velocities of 1.2–1.7 mm/$\mu$s in liquid xenon under electric fields ranging from 75–384 V/cm, and also observed small S2 signals produced by a single ionized electron with a light yield of 16.5 $\pm$ 0.5 PE. These results were consistent with the expected values; therefore, our demonstrations provide a proof of principle for TPCs incorporating a quartz chamber.
Multi-host dispersal of known and novel carnivore amdoparvoviruses
Authors: Canuti Marta , McDonald Emily , Graham Stephanie M , Rodrigues Bruce , Bouchard Émilie , Neville Richard , Pitcher Mac , Whitney Hugh G , Marshall H Dawn , Lang Andrew S
Published: September 2020

Amdoparvoviruses (family Parvoviridae) are ssDNA viruses that cause an immune complex-mediated wasting syndrome in carnivores. They are multi-host pathogens and cross-species infection is facilitated by the fact that viral entry is mediated by cellular Fc receptors recognizing antibody-coated viruses. We developed a pan-amdoparvovirus PCR and screened tissue samples from 666 wild carnivores (families Felidae, Canidae, and Mustelidae) from Newfoundland or Labrador (Canada) and molecularly characterized the identified strains. Fifty-four out of 666 (8.1%) animals were amdoparvovirus-positive. Infection rate was the highest in American mink (34/47, 72.3%), followed by foxes (Arctic and red foxes, 13/311, 4.2%), lynx (2/58, 3.5%), and American martens (5/156, 3.4%). No virus was detected in samples from 87 coyotes and 17 ermines. Viruses from Newfoundland were classified as Aleutian mink disease virus (AMDV). Mink harvested near AMDV-affected fur farms had higher prevalence (24/24, 100%) than other mink (10/23, 43.5%; P < 0.001) and their viruses were phylogenetically closely related to those from farms, while most viruses from other mink were in other clades. Strains from three foxes and two lynx were highly related to mink strains. This proves that farms disperse AMDV that subsequently spreads among wild mink (maintenance host) and transmits to other spillover carnivore hosts. In Labrador two novel viruses were identified, Labrador amdoparvovirus 1 (LaAV-1) found in foxes (9/261, 3.5%) and martens (5/156, 3.4%), and LaAV-2 found in one fox (0.4%). LaAV-1 fulfills all requirements to be classified as a novel species. LaAV-1 was most similar to viruses of mink and skunks (AMDV and skunk amdoparvovirus (SKAV)) while LaAV-2 was more closely related to other viruses infecting canids. LaAV-1 capsid proteins were almost indistinguishable from those of AMDV in some regions, suggesting that LaAV-1 could be a virus of mustelids that can infect foxes. While intensive farming practices provide occasions for inter-species transmission in farms, niche overlap or predation could explain cross-species transmission in the wild, but competition among sympatric species reduces the chances of direct contacts, making this an infrequent event. Pan-amdoparvovirus detection methods in wide epidemiological investigations can play a crucial role in defining amdoparvoviral ecology and evolution and discovering novel viruses.
Genome Analysis of Erwinia amylovora Strains Responsible for a Fire Blight Outbreak in Korea
Authors: Song Ju Yeon , Yun Yeo Hong , Kim Gi-Don , Kim Seong Hwan , Lee Seong-Jin , Kim Jihyun F.
Published: September 2020

Erwinia amylovora is a plant-pathogenic bacterium that causes fire blight disease in Rosaceae plants. Since fire blight is highly contagious and results in serious losses once introduced, it is regulated as a quarantine disease. Recently, for the first time in East Asia, fire blight emerged in Korea with strains of E. amylovora being isolated from lesions of infected trees. Five of those strains were selected and subjected to whole-genome shotgun sequencing. Each strain had two circular replicons, a 3.8-Mb chromosome and a 28-kb plasmid. The genome sequences were compared with those of other E. amylovora strains isolated from different hosts or geographical regions. Genome synteny was analyzed and sequence variations including nucleotide substitutions, inversions, insertions, and deletions were detected. Analysis of the population genomic structure revealed that the five strains form a distinct structural group. Phylogenomic analysis was performed to infer the evolutionary relationships among E. amylovora strains, which indicated that the Korean isolates, all descended from a common ancestor, are closely related to a lineage of North American strains. These results provide useful information for understanding the genomic dynamics of E. amylovora strains including those in Korea, developing genetic markers for surveillance of the pathogen or diagnosis of the disease, and eventually developing measures to eradicate it.
Marfan syndrome in children: correlation between musculoskeletal features and cardiac Z-score
Authors: De Maio Fernando , Pisano Calogera , Caterini Alessandro , Bertoldo Fabio , Ruvolo Giovanni , Farsetti Pasquale
Published: September 2020

We investigated the correlation between the musculoskeletal features and the cardiovascular anomalies in pediatric patients affected by Marfan syndrome, in order to identify possible orthopedic deformities that could be a warning sign for severe aortic dilatation. Moreover, we analyzed the role of the orthopedic aspects in the early diagnosis of the disease in a pediatric population. Seventy-two patients from 3 to 14 years of age, underwent interdisciplinary evaluation that included an orthopedic and cardiological examination. At the orthopedic examination, we analyzed the musculoskeletal features included in the systemic score of the revised Ghent criteria. Cardiological evaluation included a transthoracic echocardiography with definition of the cardiac Z-score, which is an index that evaluates aortic diameter. A statistical analysis was performed. We identified a statistically significant correlation between the presence of pectus excavatum and cardiac Z-score ≥3 (P = 0.022). Clinically, this data means that pectus excavatum is frequently observed in patients with larger aortic root diameter. On the contrary, no statistically significant correlation was found between the other investigated musculoskeletal features and a pathological Z-score. In the pediatric population, the diagnosis of Marfan syndrome remains difficult because many clinical manifestations are age-dependent and the Ghent criteria, usually used for adults, are not reliable in children. Our results show that the presence of pectus excavatum could help in the early identification of patients at greater risk of developing possibly fatal aortic disease. However, it is always indicated to screen all patients with Marfan syndrome for cardiac abnormalities, even in absence of pectus excavatum.
Outcomes of distally un-threaded screw fixation of slipped capital femoral epiphysis at skeletal maturity: a matched cohort study
Authors: Mills Henry , Flowers Mark J. , Agrawal Yuvraj , Nicolaou Nicolas
Published: September 2020

The most common treatment for slipped capital femoral epiphysis worldwide is in situ fixation with a threaded screw. Un-threaded screws are designed to prevent slip progression without hindering residual growth of the proximal femur. This study aimed to compare growth, remodelling and long-term outcomes after fixation with un-threaded screws and a matched cohort of patients treated with a standard screw. Six patients (nine hips) treated with un-threaded screws and 16 patients (21 hips) treated with standard screws matched for age, skeletal maturity, sex and Southwick angle were recruited. Clinical records were reviewed for patient demographics, medical history and complications. Radiographs were reviewed for residual growth and time to physeal closure. Growth velocity was calculated. Absence of cam deformity signified complete remodelling. Clinical assessment was graded from excellent to poor and patient-reported outcomes were recorded. There was significantly more growth recorded in the un-threaded screw group in femoral neck length (7.6 mm, P = 0.003), articulo-lesser trochanter distance (5.3 mm, P = 0.028), pin-joint ratio (7.439%, P = 0.006) and pin-physis ratio (8.244%, P = 0.001). The probability of revision operations due to ongoing growth was higher in this group (risk ratio: 6.57, P = 0.0008). Time to physeal closure was not significantly different, but growth velocity was significantly higher in the un-threaded group. The lower probability of cam deformity was not significant. Functional and clinical results were not significantly different at average 11.2 years’ follow-up. Un-threaded screws allow for significantly more growth than standard threaded screws. The un-threaded screw could not be recommended due to the higher re-operation rates, without any proven benefit.
Development of a method to produce a valid and reliable foot mask for plantar pressure evaluation in children with clubfoot
Authors: Wallace Juanita , White Hank , Augsburger Sam , Walker Janet
Published: September 2020

The purposes of this article are to describe common masking inaccuracies, provide a standard methodology for correcting inaccuracies, and report intra/interclinician reliability when novice and experts mask foot pressures for children with clubfoot. Foot pressures from 26 children (ages 2.6–12.9 years) with unilateral clubfoot were utilized. Three raters were used for intra/interclinician reliability: one expert masker with 8 years of experience and two novice maskers. For children with unilateral clubfoot, automated masking was inaccurate in 4% of trials on the unaffected side and 24% of trails on the affected side. Novice and expert maskers report good–excellent reliability (interclass correlation coefficient range 0.61–1.0) when identifying and correcting inaccurate masks. To obtain accurate and reliable foot pressure data, it is recommended to first utilize an automasking technique and apply manual editing. This is the first study to present a standard methodology for foot pressure mask editing, the first to present the incidence of mask inaccuracies and the first to present foot pressure masking reliability in children with clubfoot.
Periacetabular triple osteotomy by single anterior approach for children under 6-years-old with severe acetabular deficiency: prevention of retroversion and anterior impingement
Authors: Najdi Hassan , Mouarbes Danny , Karnib Soha , Dimassi Ahmad
Published: September 2020

The aim of this study was to perform periacetabular triple osteotomy (PATO) in children under 6-years-old with severe acetabular deficiency aiming to obtain important correction and avoid excessive pressure on epiphysis, anterior overcorrection and acetabular retroversion. This is a retrospective study of 29 PATO using single anterior approach in 24 patients under 6-years-old with dysplasia of the hip. Clinical examination and radiographic evaluation were done pre-op, post-op and at last follow-up. Computed tomography (CT) scan was obtained, comparing operated hip to contro-lateral normal hip. Clinical examination of the operated hip, at the last follow-up, showed a normal range of motion with nonsignificant difference when compared to normal hip. All hips were classified as Wicart A, and all activities were allowed. Radiographically, X-ray revealed improvement of all parameters postoperatively, with nonsignificant change compared to the last follow-up. CT-2D axial analysis demonstrated the absence of acetabular retroversion with good anterior and posterior coverage. CT-3D imaging comparing the anterior acetabular inclination, anterolateral and posterolateral inclination angles of operated hip and normal hip showed comparable results. Patients less than 6 years with severe acetabular deficiency could benefit from PATO. Performing osteotomies close to joint gave important acetabular fragment freedom, allowing an important correction. Appropriate manoeuver of reorientation avoided anterior overcorrection and acetabular retroversion, responsible for early pain and osteoarthritis. Age should not be the only criteria to choose the type of osteotomy. Level of evidence: level IV.
Temporary epiphysiodesis in adolescent patients with ulnocarpal impaction syndrome: a preliminary case series of seven wrists
Authors: Scheider Philipp , Ganger Rudolf , Farr Sebastian
Published: September 2020

Adolescents with ulnar positive variance can develop ulnocarpal symptoms due to ulnocarpal impaction syndrome. Common treatment methods are conservative therapy, distal ulna epiphysiodesis or eventually ulnar shortening osteotomy. The aim of this preliminary case series was to investigate a recently described, new therapeutic approach using a reversible, temporary epiphysiodesis technique, following the principles of guided growth. Seven cases with the diagnosis of a painful ulnar positive variance, which underwent a temporary epiphysiodesis, were retrospectively evaluated. These cases consisted of four individual patients who received an intraoperatively customized plate fixation to slow down growth. The following parameters were collected: diagnosis, age at surgery, age at explantation, growth plate status at explantation, ulnar variance before and after surgery, complications and any clinical and radiological abnormalities. The radiological measurements of ulnar variance were performed according to the Gelbermann method. The seven investigated cases (average age at surgery 12.4 years; average age at explantation 14.7 years), in which a temporary epiphysiodesis was performed, showed an average ulnar variance of +3.9 mm (range: from +1.9 mm to +6.1 mm) before the start of therapy. After explantation, an average ulnar variance of +0.1 mm (range: from –3.2 mm to +5.0 mm) was observed, which corresponds to an average reduction/improvement of –3.8 mm (range: from –0.5 mm to –9.3 mm). The ulnocarpal wrist complaints were significantly reduced after the intervention. One case needed a secondary ulnar shortening osteotomy. The described method of a temporary, reversible epiphysiodesis is an elegant, less invasive technique to correct the ulnar positive variance without irreversibly closing the growth plate. In case of therapy failure, a secondary ulna shortening osteotomy is still possible.
Guiding Principles for the Conduct of Observational Critical Care Research for Coronavirus Disease 2019 Pandemics and Beyond: The Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study Registry
Authors: Walkey Allan J. , Sheldrick R. Christopher , Kashyap Rahul , Kumar Vishakha K. , Boman Karen , Bolesta Scott , Zampieri Fernando G. , Bansal Vikas , Harhay Michael O. , Gajic Ognjen
Published: September 2020

Objectives:

Use of observational data to inform the response and care of patients during a pandemic faces unique challenges.

Design:

The Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study COVID 2019 Registry Core data and research methodology team convened over virtual meetings throughout March to June 2020 to determine best practice goals for development of a pandemic disease registry to support rapid data collection and analysis.

Setting:

International, multi-center registry of hospitalized patients.

Patients:

None.

Interventions:

None.

Measurements and Main Results:

Large-scale observational data collection requires: 1) quality assurance and harmonization across many sites; 2) a transparent process for selecting from among many potential research questions; 3) the use of best practices in design of descriptive, predictive, and inferential studies; (4) innovative approaches to characterize random error in the setting of constantly updated data; (5) rapid peer-review and reporting; and (6) transitions from a focus on discovery to implementation. Herein, we describe the guiding principles to best practices and suggestions for innovations to study design and reporting within the coronavirus disease 2019 Viral Infection and Respiratory Illness Universal Study pandemic registry.

Conclusions:

Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study coronavirus disease 2019 registry sought to develop and implement prespecified best practices combined with grassroots efforts from clinical sites worldwide in order to develop clinically useful knowledge in response to a pandemic.
PREOPERATIVE ANATOMICAL FEATURES ASSOCIATED WITH IMPROVED SURGICAL OUTCOMES FOR STAGE 5 RETINOPATHY OF PREMATURITY
Authors: Ozsaygili Cemal , Ozdek Sengul , Ozmen Mehmet C. , Atalay Hatice T. , Yeter Duygu Y.
Published: September 2020

Purpose:

To describe preoperative anatomical features of Stage 5 retinopathy of prematurity with results of surgery and patient-related and surgery-related factors affecting postoperative success.

Methods:

Forty eyes of 33 infants who underwent vitrectomy with lensectomy or lens-sparing vitrectomy for Stage 5 retinopathy of prematurity were enrolled. Stage 5 cases were divided into different groups according to their preoperative anatomical features as follows: A: for eyes with ophthalmoscopically observable total retinal detachment; B: for eyes with total leucocoria associated with funnel retinal detachment; and C: for eyes with very shallow anterior chamber and corneal opacity. Only A and B eyes underwent surgery. The effect of the presence of vascular dilation and tortuosity, preoperative treatment status, surgically induced posterior hyaloid detachment, and sparing the lens on anatomical and functional results was evaluated.

Results:

Thirty-five percentage of the eyes were in Group A and 65% were in Group B. The mean follow-up was 30.6 months (12–68). Anatomical success was 55.5% for Group A and 15.4% for Group B (P: 0.047), and functional success was 33.3% for Group A and 7.7% for Group B at the third year (P: 0.125). The presence of vascular dilation and tortuosity and postoperative vitreous hemorrhage were found to have negative effects; preoperative treatment and surgical induction of posterior hyaloid detachment were found to have positive effects on anatomical and functional results.

Conclusion:

Surgery for ophthalmoscopically observable retinopathy of prematurity–associated retinal detachment resulted in better anatomical and functional outcomes, and the results are even better in eyes with preoperative treatment, lens-sparing vitrectomy, and surgically induced posterior hyaloid detachment.
Helicobacter pylori Infection of the Gastric Mucosa and Ocular Adnexa—Lack of Association With Ocular Adnexal Lymphoma
Authors: Kalin-Hajdu Evan , Bernier-Turmel Félix , Frost Éric , Labbé Annie-Claude , Couture Simon , Wong Jamie , Boulos Patrick R , Codère François , Hardy Isabelle
Published: September 2020

Purpose:

Helicobacter pylori could theoretically induce ocular adnexal lymphoma (OAL) via 2 mechanisms: the first is that of infection within the ocular adnexa and the second is that of infection within the gastric mucosa, leading to the malignant transformation of lymphocytes that migrate to the ocular adnexa, forming a primary “ectopic” cancer. This study investigated if an association exists between gastric H. pylori or ocular adnexal H. pylori and OAL.

Methods:

Prospective case-control study including cases with OAL and controls with nonlymphomatous pathologies. Gastric H. pylori infection was assessed via serologic antibody testing. Ocular adnexal infection was assessed via polymerase chain reaction testing for H. pylori and Chlamydia psittaci within ocular adnexal samples.

Results:

Seventy-two patients were enrolled, of whom 18 had lymphoma and 54 nonlymphomatous pathologies. H. pylori antibodies were present in 5 cases (28%) and 18 controls (33%) (95% CI, 0.24%–2.50%, p = 0.78). All ocular adnexal specimens were negative for H. pylori and C. psittaci infection. The only relevant statistically significant difference between cases and controls was a history of gastric ulcer (95% CI, 1.23%–44.80%, p = 0.03).

Conclusions:

In the study’s population, infection of gastric mucosa with H. pylori does not appear to influence the development of OAL. Also, H. pylori or C. psittaci infection within the ocular adnexa does not appear to influence the development of OAL. In the study’s practice, authors do not recommend antibiotic administration or routine gastroscopy for patients with OAL. The authors do recommend referral of OAL patients with gastric symptoms to a gastroenterologist.
Femtosecond laser–assisted big bubble for deep anterior lamellar keratoplasty
Authors: Gogri Pratik Y. , Bore Millicent C. , Rips Aaron G.T. , Reddy Jagadesh C. , Rostov Audrey T. , Vaddavalli Pravin K.
Published: September 2020

Purpose:

To assess the utility of a femtosecond laser–assisted stromal channel to assist the creation of a big bubble (BB) for deep anterior lamellar keratoplasty (DALK) surgery in cadaveric corneas.

Setting:

L V Prasad Eye Institute, Hyderabad, India.

Design:

Experimental study.

Methods:

An attempt to create a BB was made on 10 donor pairs of human cadaveric corneoscleral tissues. The 20 corneas were split into 2 groups: Group A underwent femtosecond laser pretreatment and Group B had conventional manual deep lamellar technique. Laser pretreatment was performed using the VisuMax femtosecond laser system to create a stromal channel using the intracorneal ring segment treatment module for direct insertion of the 27-gauge air cannula for pneumodissection at a predetermined depth.

Results:

Of the 20 corneas studied, type 1 BB was achieved in 9 of 10 corneas in Group A and in 7 of 10 corneas in Group B. One cornea from Group A had a combined type 1 and 2 BB, whereas no BB was achieved in 1 cornea.

Conclusions:

Creation of an intrastromal channel using a femtosecond laser at a predetermined depth seemed to be a promising option to increase the chances of achieving a BB when compared with the conventional air injection technique of BB DALK.
Cutaneous Manifestations of Rheumatoid Arthritis
Authors: Cabling Marven Gerel
Published: September 2020

Rheumatoid arthritis is a chronic systemic autoimmune inflammatory arthritis with various extra-articular manifestations. In this first series examining the cutaneous manifestation of rheumatic diseases, we will discuss the most common dermatologic findings in patients with rheumatoid arthritis. Cutaneous lesions are the most common extra-articular findings. Rheumatoid nodules, accelerated rheumatoid nodulosis, and rheumatoid vasculitis are found especially in those with long-standing rheumatoid-factor-positive disease. Several neutrophilic dermatoses such as pyoderma gangrenosum, rheumatoid neutrophilic dermatoses, and Sweet's syndrome are also seen in association with rheumatoid arthritis. Patients may also present with various cutaneous adverse effects related to their arthritis therapy. It is important to recognize these dermatologic manifestations to better understand the underlying disease process, thus optimizing therapy and patient care.