bluuebunny/crossref_metadata_2025 huggingface dataset:
The size and pervasiveness of Ly α–UV spatial offsets in star-forming galaxies at z ∼ 6
Authors: Lemaux B C , Fuller S , Bradač M , Pentericci L , Hoag A , Strait V , Treu T , Alvarez C , Bolan P , Gandhi P J , Huang K-H , Jones T , Mason C , Pelliccia D , Ribeiro B , Ryan R E , Schmidt K B , Vanzella E , Khusanova Y , Le Fèvre O , Guaita L , Hathi N P , Koekemoer A , Pforr J
Published: March 2021

We study the projected spatial offset between the ultraviolet continuum and Ly α emission for 65 lensed and unlensed galaxies in the Epoch of Reionization (5 ≤ z ≤ 7), the first such study at these redshifts, in order to understand the potential for these offsets to confuse estimates of the Ly α properties of galaxies observed in slit spectroscopy. While we find that ∼40 per cent of galaxies in our sample show significant projected spatial offsets ($|\Delta _{\rm {Ly}\alpha -\rm {UV}}|$), we find a relatively modest average projected offset of $|\widetilde{\Delta }_{\rm {Ly}\alpha -\rm {UV}}|$  = 0.61 ± 0.08 proper kpc for the entire sample. A small fraction of our sample, ∼10 per cent, exhibit offsets in excess of 2 proper kpc, with offsets seen up to ∼4 proper kpc, sizes that are considerably larger than the effective radii of typical galaxies at these redshifts. An internal comparison and a comparison to studies at lower redshift yielded no significant evidence of evolution of $|\Delta _{\rm {Ly}\alpha -\rm {UV}}|$ with redshift. In our sample, ultraviolet (UV)-bright galaxies ($\widetilde{L_{\mathrm{ UV}}}/L^{\ast }_{\mathrm{ UV}}=0.67$) showed offsets a factor of three greater than their fainter counterparts ($\widetilde{L_{\mathrm{ UV}}}/L^{\ast }_{\mathrm{ UV}}=0.10$), 0.89 ± 0.18 versus 0.27 ± 0.05 proper kpc, respectively. The presence of companion galaxies and early stage merging activity appeared to be unlikely causes of these offsets. Rather, these offsets appear consistent with a scenario in which internal anisotropic processes resulting from stellar feedback, which is stronger in UV-brighter galaxies, facilitate Ly α fluorescence and/or backscattering from nearby or outflowing gas. The reduction in the Ly α flux due to offsets was quantified. It was found that the differential loss of Ly α photons for galaxies with average offsets is not, if corrected for, a limiting factor for all but the narrowest slit widths (<0.4 arcsec). However, for the largest offsets, if they are mostly perpendicular to the slit major axis, slit losses were found to be extremely severe in cases where slit widths of ≤1 arcsec were employed, such as those planned for James Webb Space Telescope/NIRSpec observations.
Asymmetry in histone rotation in forced unwrapping and force quench rewrapping in a nucleosome
Authors: Reddy Govardhan , Thirumalai D
Published: March 2021

Single molecule pulling experiments have shown that DNA in the nucleosomes unwraps in two stages from the histone protein core (HPC). The first stage, attributed to the rupture of the outer DNA turn, occurs between 3 and 5 pNs, and is reversible. The inner DNA turn ruptures irreversibly at forces between 9 and 15 pNs (or higher) in the second stage. Molecular simulations using the Self-Organized Polymer model capture the experimental findings. The unwrapping of the outer DNA turn is independent of the pulling direction. The rupture of the DNA inner turn depends on the pulling direction and involves overcoming substantial energetic (most likely electrostatic in origin) and kinetic barriers. They arise because the mechanical force has to generate sufficient torque to rotate the HPC by 180°. On the other hand, during the rewrapping process, HPC rotation is stochastic, with force playing no role. The assembly of the outer DNA wrap upon force quench nearly coincides with the unwrapping process, confirming the reversibility of the outer turn rupture. The asymmetry in HPC rotation during unwrapping and rewrapping explains the observed hysteresis in the stretch-release cycles in experiments. We propose experiments to test the prediction that HPC rotation produces kinetic barriers in the unwrapping process.
Conscious perception and perceptual echoes: a binocular rivalry study
Authors: Luo Canhuang , VanRullen Rufin , Alamia Andrea
Published: March 2021

Alpha rhythms (∼10Hz) in the human brain are classically associated with idling activities, being predominantly observed during quiet restfulness with closed eyes. However, recent studies demonstrated that alpha (∼10Hz) rhythms can directly relate to visual stimulation, resulting in oscillations, which can last for as long as one second. This alpha reverberation, dubbed perceptual echoes (PE), suggests that the visual system actively samples and processes visual information within the alpha-band frequency. Although PE have been linked to various visual functions, their underlying mechanisms and functional role are not completely understood. In this study, we investigated the relationship between conscious perception and the generation and the amplitude of PE. Specifically, we displayed two coloured Gabor patches with different orientations on opposite sides of the screen, and using a set of dichoptic mirrors, we induced a binocular rivalry between the two stimuli. We asked participants to continuously report which one of two Gabor patches they consciously perceived, while recording their EEG signals. Importantly, the luminance of each patch fluctuated randomly over time, generating random sequences from which we estimated two impulse-response functions (IRFs) reflecting the PE generated by the perceived (dominant) and non-perceived (suppressed) stimulus, respectively. We found that the alpha power of the PE generated by the consciously perceived stimulus was comparable with that of the PE generated during monocular vision (control condition) and higher than the PE induced by the suppressed stimulus. Moreover, confirming previous findings, we found that all PEs propagated as a travelling wave from posterior to frontal brain regions, irrespective of conscious perception. All in all our results demonstrate a correlation between conscious perception and PE, suggesting that the synchronization of neural activity plays an important role in visual sampling and conscious perception.
The Global Epidemiology of RSV in Community and Hospitalized Care: Findings From 15 Countries
Authors: Staadegaard Lisa , Caini Saverio , Wangchuk Sonam , Thapa Binay , de Almeida Walquiria Aparecida Ferreira , de Carvalho Felipe Cotrim , Njouom Richard , Fasce Rodrigo A , Bustos Patricia , Kyncl Jan , Novakova Ludmila , Caicedo Alfredo Bruno , de Mora Coloma Domenica Joseth , Meijer Adam , Hooiveld Mariëtte , Huang Sue , Wood Tim , Guiomar Raquel , Rodrigues Ana Paula , Danilenko Daria , Stolyarov Kirill , Lee Vernon Jian Ming , Ang Li Wei , Cohen Cheryl , Moyes Jocelyn , Larrauri Amparo , Delgado-Sanz Concepción , Le Mai Quynh , Hoang Phuong Vu Mai , Demont Clarisse , Bangert Mathieu , van Summeren Jojanneke , Dückers Michel , Paget John
Published: March 2021

Background

Respiratory syncytial virus (RSV) is one of the leading causes of acute respiratory tract infections. To optimize control strategies, a better understanding of the global epidemiology of RSV is critical. To this end, we initiated the Global Epidemiology of RSV in Hospitalized and Community care study (GERi).

Methods

Focal points from 44 countries were approached to join GERi and share detailed RSV surveillance data. Countries completed a questionnaire on the characteristics of their surveillance system.

Results

Fifteen countries provided granular surveillance data and information on their surveillance system. A median (interquartile range) of 1641 (552–2415) RSV cases per season were reported from 2000 and 2020. The majority (55%) of RSV cases occurred in the <1-year-olds, with 8% of cases reported in those aged ≥65 years. Hospitalized cases were younger than those in community care. We found no age difference between RSV subtypes and no clear pattern of dominant subtypes.

Conclusions

The high number of cases in the <1-year-olds indicates a need to focus prevention efforts in this group. The minimal differences between RSV subtypes and their co-circulation implies that prevention needs to target both subtypes. Importantly, there appears to be a lack of RSV surveillance data in the elderly.
GLAXO WELLCOME UK LTD v SANDOZ LTD
Authors:   Chancery Division
Published: March 2021

H1 Passing off – Asthma inhalers – Get-up – Use of the colour purple – Pre-trial review – Evidence – Witness statements – Admissibility – Expert evidence – Opinion evidence – Speculation – Argument – Commentary on third party documents
Ultraconserved Elements Improve the Resolution of Difficult Nodes within the Rapid Radiation of Neotropical Sigmodontine Rodents (Cricetidae: Sigmodontinae)
Authors: Parada Andrés , Hanson John , D’Eiía Guillermo
Published: March 2021

Sigmodontine rodents (Cricetidae, Sigmodontinae) represent the second largest muroid subfamily and the most species-rich group of New World mammals, encompassing above 410 living species and ca. 87 genera. Even with advances on the clarification of sigmodontine phylogenetic relationships that have been made recently, the phylogenetic relationships among the 12 main groups of genera (i.e., tribes) remain poorly resolved, in particular among those forming the large clade Oryzomyalia. This pattern has been interpreted as consequence of a rapid radiation upon the group entrance into South America. Here, we attempted to resolve phylogenetic relationships within Sigmodontinae using target capture and high-throughput sequencing of ultraconserved elements (UCEs). We enriched and sequenced UCEs for 56 individuals and collected data from four already available genomes. Analyses of distinct data sets, based on the capture of 4634 loci, resulted in a highly resolved phylogeny consistent across different methods. Coalescent species-tree-based approaches, concatenated matrices, and Bayesian analyses recovered similar topologies that were congruent at the resolution of difficult nodes. We recovered good support for the intertribal relationships within Oryzomyalia; for instance, the tribe Oryzomyini appears as the sister taxa of the remaining oryzomyalid tribes. The estimates of divergence times agree with the results of previous studies. We inferred the crown age of the sigmodontine rodents at the end of the Middle Miocene, while the main lineages of Oryzomyalia appear to have radiated in a short interval during the Late Miocene. Thus, the collection of a genomic-scale data set with a wide taxonomic sampling provided resolution for the first time of the relationships among the main lineages of Sigmodontinae. We expect the phylogeny presented here will become the backbone for future systematic and evolutionary studies of the group.[Coalescent; Muroidea; Oryzomyalia; phylogenomics; polytomy; Rodentia; Sigmodontalia; species tree; UCEs.]
The discovery, distribution, and diversity of DNA viruses associated withDrosophila melanogasterin Europe
Authors: Wallace Megan A , Coffman Kelsey A , Gilbert Clément , Ravindran Sanjana , Albery Gregory F , Abbott Jessica , Argyridou Eliza , Bellosta Paola , Betancourt Andrea J , Colinet Hervé , Eric Katarina , Glaser-Schmitt Amanda , Grath Sonja , Jelic Mihailo , Kankare Maaria , Kozeretska Iryna , Loeschcke Volker , Montchamp-Moreau Catherine , Ometto Lino , Onder Banu Sebnem , Orengo Dorcas J , Parsch John , Pascual Marta , Patenkovic Aleksandra , Puerma Eva , Ritchie Michael G , Rota-Stabelli Omar , Schou Mads Fristrup , Serga Svitlana V , Stamenkovic-Radak Marina , Tanaskovic Marija , Veselinovic Marija Savic , Vieira Jorge , Vieira Cristina P , Kapun Martin , Flatt Thomas , González Josefa , Staubach Fabian , Obbard Darren J
Published: March 2021

Drosophila melanogaster is an important model for antiviral immunity in arthropods, but very few DNA viruses have been described from the family Drosophilidae. This deficiency limits our opportunity to use natural host-pathogen combinations in experimental studies, and may bias our understanding of the Drosophila virome. Here, we report fourteen DNA viruses detected in a metagenomic analysis of 6668 pool-sequenced Drosophila, sampled from forty-seven European locations between 2014 and 2016. These include three new nudiviruses, a new and divergent entomopoxvirus, a virus related to Leptopilina boulardi filamentous virus, and a virus related to Musca domestica salivary gland hypertrophy virus. We also find an endogenous genomic copy of galbut virus, a double-stranded RNA partitivirus, segregating at very low frequency. Remarkably, we find that Drosophila Vesanto virus, a small DNA virus previously described as a bidnavirus, may be composed of up to twelve segments and thus represent a new lineage of segmented DNA viruses. Two of the DNA viruses, Drosophila Kallithea nudivirus and Drosophila Vesanto virus are relatively common, found in 2 per cent or more of wild flies. The others are rare, with many likely to be represented by a single infected fly. We find that virus prevalence in Europe reflects the prevalence seen in publicly available datasets, with Drosophila Kallithea nudivirus and Drosophila Vesanto virus the only ones commonly detectable in public data from wild-caught flies and large population cages, and the other viruses being rare or absent. These analyses suggest that DNA viruses are at lower prevalence than RNA viruses in D.melanogaster, and may be less likely to persist in laboratory cultures. Our findings go some way to redressing an earlier bias toward RNA virus studies in Drosophila, and lay the foundation needed to harness the power of Drosophila as a model system for the study of DNA viruses.
Examining Use of Dual Point Temperature Display in Servo-Control With Early Preterm Infants
Authors: Dail Robin B. , Tavakoli Abbas S. , Moseley Sherry L. , Bergstedt Victoria B. , Kuehn Devon , Chang Weili
Published: March 2021

Background:

Previously, we recorded periods of time with foot higher than abdominal temperatures in association with infection in preterm infants. Monitoring dual temperatures may be an important tool to assess infant instability. Currently, incubators cannot measure and display dual temperatures in servo-control mode.

Purpose:

To examine the usability of GE Healthcare's Giraffe OmniBed with research software to measure, display, and record dual temperatures, and their differences while in servo-control. In addition, nurses' perceptions of the use and display of dual temperatures and differences were evaluated.

Methods:

A multiple-case, mixed-methods design. Abdominal and foot temperatures were measured, displayed, and stored for 28 days for 14 preterm infants. Nurses were surveyed for satisfaction and preferences with the dual temperature display. Nurses noted abnormal temperature differences and infant condition in bedside journals.

Results:

Study infants were 26 to 31 weeks of gestational age and 670 to 1410 g. Abdominal, foot, and the abdominal-foot temperature difference was measured, recorded, and downloaded successfully in all infants over all days. Nurses liked using dual temperature display with the abdominal-foot temperature difference. Surveys indicated preferences for larger displays and alarms for abnormal values. Thermal instability, stimulation, and thermistor detachment were associated with abnormal thermal gradients. Two exemplar cases are presented.

Implications for Practice:

Monitoring dual temperatures adds information to the clinical assessment.

Implications for Research:

Studies are needed to examine relationships between abnormal thermal gradients and infections, infant stability, and nursing care along with the underlying physiologic mechanisms. Studies are needed for wireless dual temperature monitoring.
Decreasing Complete Blood Count Clotting Rates
Authors: Giddens Emily
Published: March 2021

Background:

In premature and critically ill infants, a complete blood count (CBC) is commonly collected via the heel-stick method, which is preferred because of the ongoing requirements to preserve intravenous sites. However, because of sample clotting, these specimens are often rejected, leading to unnecessary repeat heel sticks, painful stimuli, and increased costs.

Purpose:

The purpose of this quality improvement project was to decrease the rate of clotted CBC samples obtained from neonates admitted in the neonatal intensive care unit.

Methods:

The RE-AIM translation model, which stands for Reach, Effectiveness, Adoption, Implementation, and Maintenance, was adopted to decrease the rate of clotted CBC samples through staff education, randomized audits of the staff's heel-stick technique, and the development and implementation of a standardized capillary blood sampling protocol. The primary outcome measure was the rate of clotted CBC samples, which was defined as the proportion of clotted CBC samples.

Results:

CBC clotted sample rates decreased by 27%, resulting in a cost saving of $1136, and overall CBC rejection rates decreased by 23%.

Implications for Practice:

All hospital units should provide staff with an evidence-based resource, recurrent education, and evaluation of skills to avoid unnecessary repeat heel sticks and prevent increased pain sensitivity, social hypervigilance, and avoidance behavior in early infancy.

Implications for Research:

Future efforts should focus on the long-term benefits of routine education and its effects on clotted sample rates and whether samples drawn by laboratory phlebotomy staff versus registered nurses/patient care technicians result in disproportionate rejection rates.
Risk Factors Associated With Long-term Feeding Problems in Preterm Infants
Authors: Fucile Sandra , Samdup Dawa , MacFarlane Vanessa , Sinclair McKenzie A.
Published: March 2021

Background:

Infants who are born preterm are at a high risk of encountering feeding problems.

Purpose:

The aim of this scoping review is to identify risk factors associated with feeding problems that persist beyond infancy in children (aged 1-6 years) who were born preterm (<37 weeks' gestation).

Methods:

To perform this scoping review, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework was applied. To be included in this study, articles had to be published in peer-reviewed journals, had an empirical study design, examined feeding problems relating to the child's feeding ability or refusal to eat certain texture of foods, and assessed risk factors (age, weight, and medical conditions) associated with long-term feeding problems in children who were born preterm.

Results:

After abstract and full-text screening, a total of 9 articles meeting the inclusion criteria were included in this study. Findings from this study identified that gestational age and birth weight are significant risk factors and that sex, duration of mechanical ventilation, and length of tube feedings are potential risk factors.

Implications for Practice:

This study confirms that younger and smaller infants are at a high risk of encountering oral feeding difficulties and early interventions services should be focused on these preterm infants.

Implications for Research:

Evaluation of timing and intensity (dose) of early interventions strategies should be investigated to provide more targeted and effective interventions for younger and smaller preterm infants.
Rib-based Distraction Device Implantation Before Age 3 Associated With Higher Unplanned Rate of Return to the Operating Room
Authors: Johnson Mitchell A. , Lott Carina , Qiu Catherine , Galagedera Nirupa , Flynn John M. , Cahill Patrick J. , Anari Jason B.
Published: March 2021

Background:

Surgical treatment of early-onset scoliosis (EOS) with rib-based implants such as the vertical expandable prosthetic titanium rib (VEPTR) is associated with a high rate of complications including surgical site infection, skin breakdown, and implant migration. Many of these complications warrant the need for unplanned reoperations, increasing the burden on an already vulnerable patient population, and introducing the further risk of infection. To provide insight into the risks of early intervention, we investigate the relationship between initial device implantation before the age of 3 and the rate of unplanned reoperation.

Methods:

A retrospective review was performed of all patients at a single institution who had undergone VEPTR insertion for EOS with at least a 2-year follow-up from 2007 to 2016. Patients were stratified into the case-cohort (0 to 2 y of age) or the comparison cohort (3 to 10 y of age) based on age at the time of device implantation. Multivariate regression accounting for age and scoliosis etiology was performed to identify factors predictive of unplanned reoperation.

Results:

A total of 137 of 185 patients treated with VEPTR were identified with 76 (56%) undergoing at least 1 unplanned reoperation during the study time period. There were 68 and 69 patients in the age 0- to 2-year and 3- to 10-year cohorts, respectively. Patients aged 0 to 2 years underwent a higher number of total procedures compared with those aged 3 to 10 (13.1±6.5 vs. 10.6±4.8, P=0.032). A significant difference was found in the rate of unplanned reoperation between the 2 cohorts with 44 (65%) patients aged 0 to 2 and 32 (46%) patients aged 3 to 10 undergoing at least 1 unplanned reoperation (P=0.031). Binary logistic multivariate regression accounting for age and scoliosis etiology demonstrated that patients aged 0 to 2 had a significantly greater odds of undergoing an unplanned reoperation (odds ratio=3.050; 95% confidence interval: 1.285-7.241; P=0.011) compared with patients aged 3 to 10 years.

Conclusion:

Overall, EOS patients aged 0 to 2 at initial VEPTR implantation are up to 3 times higher risk of undergoing an unplanned reoperation compared with those aged 3 to 10.

Level of Evidence:

Level III.
Trends and Complications in Spinopelvic Fixation for Deformity for Spinal Surgeons in Early Independent Practice
Authors: Yeung Caleb M. , Schoenfeld Andrew J. , Lightsey Harry M. , Kang James D. , Makhni Melvin C.
Published: March 2021

Study Design:

Retrospective case series study.

Objective:

Evaluate trends and complications following posterior spinal instrumented fusion for deformity with/without pelvic fixation using the American Board of Orthopaedic Surgery Part II Oral Examination Candidate Case List data from 2008 to 2017.

Summary of Background Data:

Complication rates for cases with pelvic fixation are widely reported in spine deformity literature but are typically derived from practices of senior surgeons. As surgical experience and clinical volume are shown to decrease complication rates, spine surgeons newly in practice may have higher risks of such events.

Materials and Methods:

Surgical cases submitted by candidates taking the American Board of Orthopaedic Surgery Part II Oral Examination between 2008 and 2017 with a self-designated sub-specialty of spine surgery were retrospectively reviewed. Mortality, readmission/reoperation data, and complications as reported by candidates were tracked over time. Bivariate testing and multivariable Poisson analyses, respectively, were used to assess complication rates and time-related trends.

Results:

A total of 37,539 cases were submitted between 2008 and 2017. Four hundred sixty-one cases (1.2%) were for deformity; of these, 60 cases included pelvic fixation (13% of deformity cases). For all deformity cases, we noted medical, surgical, and overall complication rates to be 17%, 22.3%, and 31.5%. Multivariable analyses demonstrated no difference in surgical/overall complication rates between spinopelvic and nonspinopelvic instrumented groups, but showed a consistently low number of cases using spinopelvic fixation over time.

Conclusions:

Newly practicing spinal surgeons consistently performed low numbers of deformity cases with relatively high complication rates which remained stable over time.
Perspectives in pathomics in head and neck cancer
Authors: Classe Marion , Lerousseau Marvin , Scoazec Jean-Yves , Deutsch Eric
Published: March 2021

Purpose of review

Pathology is the cornerstone of cancer care. Pathomics, which represents the use of artificial intelligence in digital pathology, is an emerging and promising field that will revolutionize medical and surgical pathology in the coming years. This review provides an overview of pathomics, its current and future applications and its most relevant applications in Head and Neck cancer care.

Recent findings

The number of studies investigating the use of artificial intelligence in pathology is rapidly growing, especially as the utilization of deep learning has shown great potential with Whole Slide Images. Even though numerous steps still remain before its clinical use, Pathomics has been used for varied applications comprising of computer-assisted diagnosis, molecular anomalies prediction, tumor microenvironment and biomarker identification as well as prognosis evaluation. The majority of studies were performed on the most frequent cancers, notably breast, prostate, and lung. Interesting results were also found in Head and Neck cancers.

Even if its use in Head and Neck cancer care is still low, Pathomics is a powerful tool to improve diagnosis, identify prognostic factors and new biomarkers. Important challenges lie ahead before its use in a clinical practice, notably the lack of information on how AI makes its decisions, the slow deployment of digital pathology, and the need for extensively validated data in order to obtain authorities approval. Regardless, pathomics will most likely improve pathology in general, including Head and Neck cancer care in the coming years.
Patient Portal Use by Adults With Heart Failure
Authors: Kallmerten Pamela S. , Chia Lichun Rebecca , Jakub Karen , Turk Melanie T.
Published: March 2021

Heart failure is a chronic condition affecting many with an emphasis on self-management to improve outcomes and decrease the cost of care. A potential strategy to improve the self-management of heart failure includes the use of a patient portal. The purpose of this integrative review is to synthesize what is known about patient portal use by adults with heart failure to identify contributing factors for use and areas for future research. Within the three zones of the Health Information Technology Acceptance Model, predominant themes contributing to patient portal use were identified. Within the health zone, the predominant themes were physical and mental health, quality of life, and social interaction. Within the information zone, the predominant themes included knowledge about heart failure and self-care, information sharing, and communication. Within the technology zone, the predominant themes include the barriers and facilitators of patient portal use and overall usability. Overall, the patient perceptions of the patient portal can lead to the acceptance and use of the technology that can enhance self-management. Healthcare providers should partner with adults with heart failure to maximize the features of the patient portal to support self-management.
Poor Parental Supervision Associated With Traumatic Brain Injury and Reactive Aggression in Young Offenders
Authors: Kent Hope , Williams W. Huw , Hinder Darren , Meadham Hannah , Hodges Emma , Agarwalla Vedika , Hogarth Lee , Mewse Avril J.
Published: March 2021

Objective:

To establish whether poor parental supervision is associated with head injury and self-reported reactive aggression (ie, aggression in response to perceived provocation or threat) in adolescents in a Young Offender's Institute, by examining correlations between these variables. Understanding this population is important, as they are at a key pivotal age for intervention to prevent lifelong reoffending.

Methods:

Ninety-six male participants aged 16 to 18 years were recruited from a UK Young Offender's Institute. Self-report measures of remembered parenting, reactive aggression, and head injury history were administered during individual interviews.

Results:

Seventy-four percent of participants reported having experienced a lifetime traumatic brain injury (TBI), and 46% of participants reported experiencing at least 1 TBI leading to a loss of consciousness (LOC). We found that poor parental supervision, length of LOC following TBI, and self-reported reactive aggression were all positively correlated.

Conclusions:

Findings show that there are correlational relationships between poor parental supervision, length of LOC following lifetime TBI, and higher levels of self-reported reactive aggression. This suggests there may be pathways resulting from poor parental supervision leading to both TBI with LOC, and reactive aggression. We advocate for future research with longitudinal designs and larger samples to examine the nature of these interactions, and to establish whether poor parental supervision is a prospective risk factor for more TBIs leading to LOC, and reactive aggression. This is key to understanding whether parenting interventions could help to reduce the disabling effects of TBI in adolescents, and help to prevent contact with the law.
B-SCAN ULTRASONOGRAPHY OF VITREOUS DYNAMICS DURING INTRAVITREAL ADMINISTRATION OF ANTIANGIOGENICS
Authors: Sánchez-Martínez Daniel , Sánchez-López Sara , Sellés-Navarro Inmaculada
Published: March 2021

Purpose:

To study the distribution of angiogenesis inhibitors (anti-Vascular Endothelial Growth Factor) injected into the vitreous cavity by means of simultaneous ultrasonography.

Methods:

Three hundred and thirty-two B-scan ultrasound sequences of 121 eyes from 95 patients were recorded simultaneously to the intravitreal anti-Vascular Endothelial Growth Factor administration. The dynamics of the injected substance and the presence of reflux were studied, associating them with the presence/absence of total posterior vitreous detachment.

Results:

Three well-defined patterns were distinguished. Pattern A: the medication penetrates the vitreous in a linear manner until reaching the retina (3.6%, n = 12). Pattern B: the medication adopts a globular shape and then moves down reaching the retrohyaloid space (37%, n = 123). Pattern C: the medication remains in a globular form (54%, n = 180). The pattern was not identified in 17 (5.1%) injections. Pattern A was only observed in vitrectomized eyes. The reflux (7.8%) was exclusive in eyes showing a C pattern. A relationship (P < 0.001) was observed between the presence/absence of total posterior vitreous detachment, the patterns, and the presence of reflux.

Conclusion:

This study document for the first time the behavior of antiangiogenic medication injected into the vitreous cavity and how its distribution and the presence of reflux is conditioned by the previous state of the vitreous body.
Late Onset Interface Calcium Deposition After Laser In Situ Keratomileusis
Authors: Chen Angela C. , Pelsor Nathaniel P. , Wang Kaidi , Glasgow Ben J. , Aldave Anthony J.
Published: March 2021

Purpose:

The purpose of this study was to report a novel clinical entity characterized by bilateral calcium deposits in the flap interface after uncomplicated laser in situ keratomileusis (LASIK).

Methods:

Slit-lamp examination, anterior segment optical coherence tomography imaging, and histopathologic analysis of an interface opacity were performed to characterize and identify the origin of the interface opacities.

Results:

Two unrelated healthy young men who underwent LASIK in both eyes at 20 (case 1) and 44 (case 2) years of age were diagnosed with bilateral, white anterior stromal opacities 5 years after LASIK surgery. Slit-lamp examination and anterior segment optical coherence tomography imaging demonstrated that the opacities were located at the level of the LASIK interface in both eyes of both cases, with most of the opacities located at the temporal edge of the flap in each eye of case 2. An opacity from case 2 demonstrated birefringence using polarization microscopy and staining with Alizarin red, indicative of calcium deposition. The serum calcium level was borderline elevated in case 1 and within normal limits in case 2.

Conclusions:

Intrastromal calcium deposition can occur after LASIK surgery, with the deposits resembling dystrophic deposits located in the LASIK flap interface in individuals with granular corneal dystrophy type 2. Because the etiology and management of calcific and dystrophic interface deposition after LASIK are distinct, it is important for clinicians to differentiate the 2 entities based on the examination, diagnostic imaging, and, if necessary, molecular genetic analysis.
Stenotrophomonas maltophilia-Associated Dacryocystitis in Leukemia-Infiltrated Lacrimal Sacs: Case and Review of Literature
Authors: Habib Matthew , Saunders Peter J. , Rubinstein Tal J.
Published: March 2021

A 91-year-old female with a history of chronic lymphocytic leukemia developed recurrent bouts of bilateral dacryocystitis. She underwent incision and drainage of the lacrimal sac with culture demonstrating the rare bacteria Stenotrophomonas maltophilia. She underwent subsequent dacryocystectomy with biopsy revealing bilateral involvement of chronic lymphocytic leukemia in the lacrimal sac. Stenotrophomonas maltophilia has been associated with immune suppression and is rarely seen in dacryocystitis. Local and/or systemic immune deregulation or suppression may play a role in lacrimal sac infection with this bacterium in some patients.
The “Quiet TED”—A Special Subgroup of Thyroid Eye Disease
Authors: Iñiguez-Ariza Nicole M. , Sharma Anu , Garrity James A. , Stan Marius N.
Published: March 2021

Purpose:

Thyroid eye disease (TED) or Graves’ orbitopathy starts with an active inflammatory stage (active disease) followed by resolution of inflammation and progression to a fibrotic, inactive stage. In our practice, we have encountered cases that have not had active disease despite presence of fibrotic sequelae and disease progression. We aim to delineate the clinical characteristic of this unique group of patients.

Methods:

We conducted a single-center (Mayo Clinic Rochester) retrospective chart review of TED patients who throughout the course of their disease had only evidence for inactive TED, defined as clinical activity score <3.

Results:

Median age in the cohort (n = 19) was 54 years (IQR 47–61). 58% had a prior diagnosis of Graves’ disease (GD) before referral. 80% (n = 15) were euthyroid at the time of TED onset (median thyroid-stimulating hormone 1.7 mIU/L). The most common finding was diplopia (100%, n = 19) followed by proptosis (63%, n = 12). Interestingly the disease was asymmetric in 42% of cases. Overall median clinical activity score on presentation was 1 (IQR 0-1). Severity wise, 85% (n = 16) of patients were classified as moderate-to-severe during follow up. Orbital decompression was performed in only 1 case, while extraocular muscle surgery was performed in 13 cases.

Conclusions:

Quiet TED is a subgroup of TED patients that defies the classic disease paradigm. It presents primarily with diplopia and proptosis. Further evaluation of this group might identify useful insights in TED pathophysiology and help optimize therapeutic choices.
Efficacy and Complications of External and Internal Pediatric Blepharoptosis Repair Techniques: A Systematic Review
Authors: Lim Hong Kai , Lau Ashton Z. , Charles Walton N. , Khajuria Ankur
Published: March 2021

Purpose:

To review and evaluate the efficacy and complication rates of external and internal blepharoptosis repair techniques in pediatric patients.

Methods:

The systematic review protocol was published on PROSPERO (CRD42020197343). Embase, MEDLINE, CENTRAL, and ClinicalTrials.gov were searched without date limitations. Two independent reviewers evaluated the articles for inclusion. Study quality and risk of bias were assessed using GRADE and Cochrane’s ROBINS-I tool, respectively.

Results:

Of 2,228 articles screened, 23 studies involving 730 patients were included. There were 20 case series and 3 retrospective cohort studies, but no randomized controlled studies. Overall study quality was low with serious risk of bias according to the GRADE and ROBINS-I criteria, respectively. External levator resection was the most studied procedure, evaluated in 18 studies. Seven studies investigated internal approaches including the Fasanella-Servat procedure. There was no standardized evaluation of surgical efficacy. Reoperation rates were 16.6% (range 3.6–50.9%) for external levator resection compared with 22.2% (range 0.0–25.8%) for internal approaches. The commonest postoperative complications were not sight-threatening. The most consistently reported complication was undercorrection, occurring at rates of 8.4% (range 2.4–16.7%) and 15.3% (range 2.7–75.0%) for external levator resection and internal approaches, respectively. There were no consistently applied, validated patient-reported outcomes or cosmetic outcomes.

Conclusions:

External and internal approaches have been successfully employed in pediatric blepharoptosis repair. However, noncomparative designs and risk-of-bias limit existing studies. Thus, prospectively designed studies with standardized outcome measures are required to minimize reporting bias, facilitate evidence synthesis, and support clinical decision making.
Alteration of Smell Sensation: Brief Review With Implications for Nursing Care During the COVID-19 Pandemic
Authors: Mortimer Diane Schretzman , Duverneau-Salifu Moira
Published: March 2021

BACKGROUND: Alteration in olfaction, the sense of smell, can lead to a surprisingly high level of functional disability. Effects can range from mild changes in nutrient intake to a significant decrease in quality of life. Olfactory dysfunction can follow clinical problems such as trauma to the brain and nose. During recent months, in the setting of the current worldwide pandemic of coronavirus disease 2019 (COVID-19), the infection caused by severe acute respiratory syndrome coronavirus 2, it has become clear that olfaction can also be damaged by viruses that enter the body through the nose. METHODS: To learn more about this important clinical problem, we reviewed the current literature about smell sensation and the contextual application of altered olfaction in the setting of COVID-19. Knowledge about this topic, along with other clinical aspects of COVID-19, is expanding quickly. CONCLUSION: Nurses perform assessments, assist with implementing treatment interventions, and provide vital education to patients and their families. These interventions help patients with olfactory dysfunction achieve the best possible functional outcome.
Parental Posttraumatic Growth After Pediatric Hematopoietic Stem Cell Transplant
Authors: Beckmann Nicole B. , Dietrich Mary S. , Hooke Mary C. , Gilmer Mary Jo , Akard Terrah Foster
Published: March 2021

Little is known about the development of posttraumatic growth among parents of children with serious advanced disease. The purpose of this study is to describe parental posttraumatic growth 100 days after pediatric stem cell transplant. This is a cross-sectional, descriptive study of 24 parents, approximately 100 days after their children received stem cell transplant. Participants reported environmental, personal, and disease characteristics and completed measures of distress, coping, rumination, and posttraumatic growth. Evidence of parental posttraumatic growth was described in each of 5 dimensions (relating to others, new possibilities, personal strength, spiritual change, and appreciation of life). Posttraumatic growth was positively associated with parental distress, disengagement coping, and rumination measures (r = 0.44-0.47, P < .05). Appreciation of life demonstrated the strongest associations with distress and rumination (r = 0.53-0.61, P < .01). Curvilinear relationships were observed for the association of distress, disengagement coping, and involuntary engagement with posttraumatic growth (P < .05). Study results highlight opportunities for palliative care nurses and clinicians to facilitate opportunities to support parent posttraumatic growth during treatment for children's advanced disease.
WT1 Positive Ovarian Endometrioid Tumors: Observations From Consult Cases and Strategies for Distinguishing From Serous Neoplasms
Authors: Rajendran Simon , McCluggage W. Glenn
Published: March 2021

Ovarian endometrioid carcinoma, more than any other type of ovarian epithelial malignancy, demonstrates a varied morphology which can cause problems in diagnosis. In tubo-ovarian tumor pathology, WT1 is a commonly used marker as it is consistently expressed in low-grade and high-grade serous carcinomas and is often considered a specific marker of a serous phenotype. However, ovarian endometrioid neoplasms may also express WT1 which may contribute to misdiagnosis. We report our experience with 23 ovarian endometrioid neoplasms (4 borderline tumors, 19 carcinomas), mainly received in consultation, which were WT1 positive (diffuse in 11 cases) which often contributed to misdiagnosis. Endometriosis was identified in the same ovary in 6 cases and squamous elements in 7. We describe strategies for distinguishing such neoplasms, which may exhibit morphologic overlap with serous tumors, from low-grade and high-grade serous carcinomas and stress that a diagnosis of HGSC is unlikely with two grossly and histologically normal fallopian tubes. We also stress that a panel of markers should always be used rather than relying on a single marker and that when the morphology is classical of an endometrioid carcinoma, diagnostic immunohistochemistry is not needed given the potential for confusion in cases showing “aberrant” staining. We also discuss the phenomenon of “aberrant” immunohistochemical staining in endometrioid carcinomas which appears more common than in other ovarian carcinomas.
11C-Choline PET/CT Depiction of Rectal Gastrointestinal Stromal Tumor
Authors: Nguyen Ba D.
Published: March 2021

18F-FDG PET/CT is an established imaging modality for gastrointestinal stromal tumor evaluation and its posttherapeutic monitoring. 68Ga-PSMA has been recently reported with the incidental demonstration of this neoplasm on PET/CT. The author presents an uncommon case of this tumor detected by 11C-choline during the assessment of prostate cancer.
A Growing Inflammatory Mass of Gastrosplenic Ligament Mimicking Recurrent Colon Cancer on FDG PET/CT
Authors: Shen Guohua , Wang Rang , Kuang Anren
Published: March 2021

A 64-year-old man diagnosed with colon cancer underwent left hemicolectomy 1 year ago. The postoperative pathological stage was T4a N0 M0. Serial follow-up CT scans revealed a growing soft-tissue mass in the gastrosplenic ligament. FDG PET/CT was then performed for further restaging, and intense FDG uptake was observed inside the lesion, whereas no other abnormal uptake was seen. A solitary recurrence was suspected, and he underwent surgical resection. Histopathologic findings confirmed the diagnosis of chronic inflammation. This case demonstrates how a growing FDG-avid inflammatory mass of surgical site could easily be mistaken for recurrence.
Atypical Unilateral Lower-Limb Relapse of Breast Cancer
Authors: Alexandra Noeuveglise , Stephanie Becker , Pierre Vera , David Tonnelet
Published: March 2021

In July 2017, an 84-year-old woman was treated for grade III, RH+, HER2− infiltrative ductal carcinoma breast cancer by right mastectomy, adjuvant radiotherapy, and hormone therapy. In April 2020, moderated elevation of the CA-15.3 tumor marker was observed at 53 UI/mL (normal, <25.5 UI/mL). Clinical examination and CT TAP scan showed no argument for relapse. In August 2020, patient presented pain in her left foot. 99mTc-DPD bone scintigraphy showed multiple uptakes regarding osteolytic lesion of the left lower limb with no other pathological uptake. Echo-guided tibial biopsies confirmed breast origin adenocarcinoma, in favor of relapse of the originally treated cancer.
Identification of Isolated Hepatic Sarcoidosis With 18F-FDG PET/CT and MRI
Authors: Arnfield Evyn , Pattison David A.
Published: March 2021

A 69-year-old woman presented with symptomatic hypercalcemia and deranged liver function. 18F-FDG PET/CT showed intense confluent avidity throughout the hepatic parenchyma, which was an isolated abnormality. Subsequent MRI demonstrated a diffuse infiltrative hepatic abnormality, with percutaneous liver biopsy findings consistent with hepatic sarcoidosis.
Spurious Uptake on 68Ga–Prostate-Specific Membrane Antigen PET/CT Due to Ankylosing Spondylitis; A Rare Pitfall in Imaging of Biochemical Recurrence of Prostate Cancer
Authors: Heaney Roisin M. , Johnston Ciaran , Nasoodi Afshin
Published: March 2021

Bone is one of the most common sites of prostate cancer recurrence, and 68Ga–prostate-specific membrane antigen (PSMA) uptake by benign bone entities poses a diagnostic dilemma. We describe the case of a 60-year-old man with recurrence in a small presacral node on 68Ga-PSMA PET/CT. Of note, the images also demonstrated bilateral asymmetrical sacroiliac joint uptake. A history of ankylosing spondylitis was subsequently elicited, confirming the radiographic suspicion of sacroiliitis, therefore confirming the nonmalignant nature of 68Ga-PSMA uptake related to sacroiliitis rather than osseous recurrence from prostate carcinoma. 68Ga-PSMA uptake may indicate angioneogenesis in sacroiliitis and consequently may be helpful in assessing disease activity and therapy response.
Discordant Uptake Between Diagnostic 68Ga-HA-DOTATATE PET/CT and Posttherapy 177Lu-HA-DOTATATE SPECT/CT in Patients With Neuroendocrine Tumors
Authors: Huizing Daphne M.V. , Aalbersberg Else A. , van der Hiel Bernies , Stokkel Marcel P.M. , Versleijen Michelle W.J.
Published: March 2021

Patients with unresectable or metastasized neuroendocrine tumors are assumed eligible for PRRT (peptide receptor radionuclide therapy) with 177Lu-HA-DOTATATE if tumor uptake on somatostatin receptor imaging is higher than normal liver tissue. In our clinic, 2 patients presented with sufficient uptake of 68Ga-HA-DOTATATE in most metastases but with limited uptake in liver lesions. Posttherapy 177Lu imaging, however, showed good uptake in all neuroendocrine tumor lesions, including all liver metastases. Therefore, the presence of liver metastases in which the uptake of 68Ga-HA-DOTATATE is not or only slightly higher than in surrounding normal liver tissue should not be an absolute contraindication for PRRT.
High-resolution single-molecule long-fragment rRNA gene amplicon sequencing for uncultured bacterial and fungal communities
Authors: Fang Chao , Sun Xiaohuan , Fan Fei , Zhang Xiaowei , Wang Ou , Zheng Haotian , Peng Zhuobing , Luo Xiaoqing , Chen Ao , Zhang Wenwei , Drmanac Radoje , Peters Brock A. , Song Zewei , Kristiansen Karsten
Published: March 2021

Although several large-scale environmental microbial projects have been initiated in the past two decades, understanding of the role of complex microbiotas is still constrained by problems of detecting and identifying unknown microorganisms1-6.Currently, hypervariable regions of rRNA genes as well as internal transcribed spacer regions are broadly used to identify bacteria and fungi within complex communities7,8, but taxonomic and phylogenetic resolution is hampered by insufficient sequencing length9-11. Direct sequencing of full length rRNA genes is currently limited by read length using second generation sequencing or sacrificed quality and throughput by using single molecule sequencing. We developed a novel method to sequence and assemble nearly full length rRNA genes using second generation sequencing.Benchmarking was performed on mock bacterial and fungal communities as well as two forest soil samples. The majority of rRNA gene sequences of all species in the mock community samples were successfully recovered with identities above 99.5% compared to the reference sequences. For soil samples we obtained exquisite coverage with identification of a large number of putative new species, as well as high abundance correlation between replicates. This approach provides a cost-effective method for obtaining extensive and accurate information on complex environmental microbial communities.