bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality of Life in Adults With Lower Limb Burn Injury
Authors: Riaz Hafiz Muddassir , Mehmood Bhatti Zahid
Published: May 2020

Burn injury is an unpredictable incident that may result in long-term disability. Complications after burn injury are most common, for example, contracture, hypertrophic scar, or infection. A descriptive cross-sectional study was conducted at a burn unit in Pakistan, and data were collected by “World Health Organization Disability Assessment Schedule (WHODAS) v 2.0 Self-Administered” from 140 burn victims with at least 6 months old injury. Subjects with at least 10% TBSA of either lower limb were included while patients suffering from any congenital or neurological disease or with amputation were excluded. The analyses were done by statistic version 16. Participant’s mean age was 28.13 years and SD was ±7.87 years. Of the 140 patients, 96 (68.6%) were males and 44 (31.4%) were females. The cause of the burn injury was flame burn [72.9% (102)], chemical burn [5% (7)], scald burn [7.9% (11)], and electrical burn [14.3% (20)]. There were 74(52.9%) victims having burn injury at the right-hand side of the body and 47.1% (66) were with the left-hand side affected; 32.9% (46) were having burn injury at the hip joint, 37.9% (53) with the knee joint, 8.6% (12) ankle joint, and 20.7% (29) are having burn injury at whole limb. The mean disability score calculated by WHODAS v 2.0 self-administered was 13.96 with a SD of ±4.696. Burn injuries to the lower limb have a negative impact on all domains of quality of life of the victims. These individuals should be assessed at various times while developing a comprehensive rehabilitation treatment plan, especially focusing on the issues faced by such individuals to improve their quality of life.
Bioimpedance Spectroscopy Is a Valid and Reliable Measure of Edema Following Hand Burn Injury (Part 1—Method Validation)
Authors: Edwick Dale O , Hince Dana A , Rawlins Jeremy M , Wood Fiona M , Edgar Dale W
Published: May 2020

The assessment of swelling following burn injury is complicated by the presence of wounds and dressings and due to patients experiencing significant pain and impaired movement. There remains a lack of sensitive objective measures for edema in patients presenting with hand burn injury. Bioimpedance spectroscopy (BIS) is a measure of body composition that has been demonstrated by our group to be reliable for measuring whole body and limb edema during resuscitation and to be sensitive to edema changes within healing wounds. The aim of this study was to determine the reliability and validity of BIS as a measure of edema following hand burn injury specifically. One hundred patients presenting with burn injury including a portion of a hand were recruited to this trial. Repeated measures of the hand were recorded using a novel application of BIS and in parallel with water displacement volumetry (WDV). The results were analyzed using mixed-effects regressions. Paired repeated measures were obtained for 195 hands, using four electrode configurations. BIS demonstrated high reliability in measuring hand BIS—Intraclass Correlation Coefficient 0.995 to 0.999 (95% CI 0.992–1.000) and sensitivity—Minimum Detectable Difference 0.74 to 3.86 Ω (0.09–0.48 Ω/cm). A strong correlation was shown with WDV, Pearson’s r = −0.831 to −0.798 (P < .001). BIS is a sensitive and reliable measure of edema following acute hand burn injury.
Safety of Early Postoperative Range of Motion in Burn Patients With Newly Placed Hand Autografts: A Pilot Study
Authors: Dewey William Scott , Cunningham Kyle B , Shingleton Sarah K , Pruskowski Kaitlin A , Welsh Ashley , Rizzo Julie A
Published: May 2020

Patients who suffer hand burns are at a high contracture risk, partly due to numerous cutaneous functional units, or contracture risk areas, located within the hand. Patients who undergo split-thickness skin grafting are often immobilized postoperatively for graft protection. Recent practice at our burn center includes an early range of motion (EROM) following hand grafting to limit unnecessary immobilization. The purpose of this study was to determine whether EROM is safe to perform after hand grafting and if there is any clinical benefit. This retrospective, matched case–control study of adults compared patients who received EROM to subjects who received the standard 3 to 5 days of postoperative immobilization. Patients were evaluated for graft loss and range of motion. Seventy-one patients were included in this study: 37 EROM patients and 34 matched controls. Six patients experienced minor graft loss, three of these were not attributable to EROM. All graft loss was less than 1 cm and none required additional surgery. Significantly more patients who received EROM achieved full-digital flexion by the first outpatient visit (25/27 = 92.6% vs 15/22 = 68.2%; P = .028). Performing EROM does not cause an increase in graft loss. All areas of graft loss from the EROM group healed without intervention. There appears to be a benefit to EROM since there was a significant improvement in the patients’ ability to make a full fist at initial outpatient follow-up. Additional prospective analysis is needed to examine the true clinical utility of EROM in the hand and other contracture-prone areas.
Adulticidal Activity of Melaleuca alternifolia (Myrtales: Myrtaceae) Essential Oil With High 1,8-Cineole Content Against Stable Flies (Diptera: Muscidae)
Authors: Dillmann Janaína Brand , Cossetin Luciana Filippin , de Giacometi Marjorie , Oliveira Dionatan , de Matos Antônio Francisco Igor Magalhães , Avrella Pamela Daniele , Garlet Quelen Iane , Heinzmann Berta Maria , Monteiro Silvia Gonzalez
Published: May 2020

The stable fly, Stomoxys calcitrans (Linnaeus 1758), is a hematophagous fly responsible for causing loss of performance in horses, causing losses in cattle productivity, and impacting the animals’ health through the spread of pathogenic microorganisms. The objective of this work was to investigate the insecticidal activity of essential oil obtained from Melaleuca alternifolia (Cheel), presenting high 1,8-cineole content, against S. calcitrans adults. Insecticidal activity was determined using surface application methods and exposure to oil impregnated paper. It was observed that treatments at 25 and 50 μg/cm2 (P < 0.05) present fumigant activity through exposure to the impregnated paper, and in the first 15 min of exposure, the mortality rates obtained for these treatments were, respectively (96.6 ± 3.3% and 100%), equivalent to the positive control. Using the superficial application method, the only treatment concentration presenting adulticidal action was 5% (w/v) (P < 0.05). Respective toxicities LC50 (%, w/v) and LC80 for the impregnated paper method were 1.06 ± 0.02 and 1.47 ± 0.17; for the superficial application method, they were 3.82 ± 0.65 and 5.53 ± 0.74. As demonstrated, M. alternifolia essential oil presents adulticidal potential against S. calcitrans.
When cancer encounters COVID-19 in China: what have we suffered, experienced and learned
Authors: Chen Haiyang , Wu Xuan , Wang Wei , Wang Qiming
Published: May 2020

The outbreak of the coronavirus disease (COVID-19) occurred in Wuhan, China, in December 2019. As of 21 March 2020, this epidemic has spread to 179 countries with more than 200 000 confirmed cases and 8578 deaths. The outbreak has put enormous pressure on the medical establishment and even led to exhaustion of medical resources in the most affected areas. Other medical work has been significantly affected in the context of COVID-19 epidemic. In order to reduce or avoid cross-infection with COVID-19, many hospitals have taken measures to limit the number of outpatient visits and inpatients. For example, emergency surgery can only be guaranteed, and most other surgeries can be postponed. Patients with cancer are one of the groups most affected by the epidemic because of their systematic immunosuppressive state and requirement of frequent admission to hospital. Consequently, specific adjustments for their treatment need to be made to cope with this situation. Therefore, it is of significance to summarize the relevant experience of China in the prevention and control of COVID-19 infection and treatment of patients with cancer during the epidemic.
Is mutation analysis of β-catenin useful for the diagnosis of desmoid-type fibromatosis? A systematic review
Authors: Sakai Tomohisa , Hamada Shunsuke , Koike Hiroshi , Shimizu Koki , Yoshida Masahiro , Nishida Yoshihiro
Published: May 2020

Background

An accurate diagnosis is crucial to determine the treatment modality for desmoid-type fibromatosis, although the histopathological diagnosis is occasionally difficult to make. Many desmoid-type fibromatosis have been reported to have hotspot mutation of β-catenin gene (CTNNB1). In the present study, we performed a systematic review to verify the usefulness of CTNNB1 mutation analysis in the diagnosis of desmoid-type fibromatosis.

Methods

A literature search from January 1990 to August 2017 was conducted. Three reviewers independently assessed and screened the literature for eligibility and determined the final articles to be evaluated. Data regarding the sensitivity, specificity, accuracy and usefulness of CTNNB1 mutation analysis in the diagnosis of desmoid-type fibromatosis were recorded. We rated each report according to the Grading of Recommendations Development and Evaluation approach.

Results

The search yielded 90 studies, seven of which were included after the first and second screenings. The positive rate of CTNNB1 mutation in desmoid-type fibromatosis was 86.8%, but the cohort of six of the seven reports was already diagnosed histopathologically as desmoid-type fibromatosis. Therefore, the usefulness of CTNNB1 mutation analysis in a cohort that is difficult to diagnose histopathologically is not clear in this review. Nevertheless, CTNNB1 mutation showed very high specificity in desmoid-type fibromatosis, indicating the usefulness of CTNNB1 mutation analysis in its diagnosis in combination with histological examination.

Conclusion

Because the lack of data precludes any useful comparison with histological diagnosis, the evidence level is low. However, considering its specificity, CTNNB1 mutation analysis may be useful in cases in which the histopathological diagnosis is difficult.
Identifying Modifiable Factors Linking Parenting and Sleep in Racial/Ethnic Minority Children
Authors: Daniel Lauren C , Childress Jessica L , Flannery Jamie L , Weaver-Rogers Stephanie , Garcia Wanda I , Bonilla-Santiago Gloria , Williamson Ariel A
Published: May 2020

Background

Young children from racial and ethnic minority backgrounds are at risk for poor sleep, yet few studies have tested behavioral interventions in diverse samples. This study tests factors that could contribute to associations between parenting skills and child sleep to inform interventions for children at risk of poor sleep outcomes. Specifically, we examined household chaos, caregiver sleep knowledge, and caregiver sleep quality as putative mediators that may be relevant to interventions seeking to improve child sleep.

Methods

Caregivers (M age 31.83 years; 46.2% African American; 52.1% Hispanic/Latinx, 95% female) of 119 1- to 5-year-old children (M age 3.99 years; 43.7% African American; 42.0% Hispanic/Latinx, 14.3% biracial; 51.3% female) completed measures of parenting practices, child and caregiver sleep, household chaos, and sleep knowledge. Indices of pediatric insomnia symptoms (difficulty falling/remaining asleep) and sleep health (sleep duration/hygiene) were constructed based on previous research. Parallel mediation models were conducted using ordinary least squares path analysis.

Results

Lower household chaos significantly attenuated the relationship between positive parenting skills and better child sleep health, suggesting chaos may serve as a potential mediator. There were no significant contributing factors in the pediatric insomnia model. Sleep knowledge was related to sleep health and caregiver sleep quality was related to pediatric insomnia, independent of parenting skills.

Conclusion

Interventions to improve sleep in early childhood may be enhanced by targeting parenting skills and household routines to reduce chaos. Future longitudinal research is needed to test household chaos and other potential mediators of child sleep outcomes over time.
How Peer Conflict Profiles and Socio-Demographic Factors Influence Type 1 Diabetes Adaptation
Authors: Banks Gabrielle G , Berlin Kristoffer S , Keenan Mary E , Cook Jessica , Klages Kimberly L , Rybak Tiffany M , Ankney Rachel , Semenkovich Katherine , Cohen Robert , Thurston Idia , Diaz-Thomas Alicia , Alemzadeh Ramin , Eddington Angelica
Published: May 2020

Objective

This study aimed to (a) validate the factor structure for a measure of peer conflict in youth with type 1 diabetes (T1D); (b) determine empirical patterns of peer conflict in terms of context (friend vs. nonfriend) and content (diabetes-specific vs. general) within a broader context of socio-demographic factors; and (c) examine how these patterns and socio-demographic factors relate to adolescents’ T1D adherence, quality of life, and glycemic control (HbA1c).

Methods

Youth with T1D (N = 178), ages 12–18, reported demographic variables, illness duration, adherence, quality of life, and peer conflict. HbA1c was extracted from medical records. Confirmatory factor analysis validated a factor structure for the Diabetes Peer Conflict Scale (DPCS) and latent profile analysis (LPA) determined profiles of peer conflict.

Results

A four-factor structure emerged for the DPCS: general friend conflict, general nonfriend conflict, T1D friend conflict, and T1D nonfriend conflict. Using these factors as indicators in LPA, four profiles were confirmed: (a) Low Overall Conflict (LOC) and (b) Moderate Overall Conflict (MOC), (c) a Nonfriend Conflict (NFC), and (d) a Friend Conflict (FC) profile. Differences were not identified between diabetes specific versus general conflict. Socio-demographic variables did not predict class membership. The LOC profile reported the highest quality of life and best glycemic control, whereas the FC profile reported the lowest adherence behaviors. Conclusions: Peer conflict uniquely contributes to diabetes adaptation above and beyond socio-demographic and illness factors.
Health Disparities in Transgender and Gender Expansive Adolescents: A Topical Review From a Minority Stress Framework
Authors: Delozier Alexandria M , Kamody Rebecca C , Rodgers Scott , Chen Diane
Published: May 2020

Objective

To present a topical review of minority stressors contributing to psychosocial and physical health disparities in transgender and gender expansive (TGE) adolescents.

Methods

We conducted a topical review of original research studies focused on distal stressors (e.g., discrimination; victimization; rejection; nonaffirmation), proximal stressors (e.g., expected rejection; identity concealment; internalized transphobia), and resilience factors (e.g., community connectedness; pride; parental support) and mental and physical health outcomes.

Results

Extant literature suggests that TGE adolescents experience a host of gender minority stressors and are at heightened risk for negative health outcomes; however, limited research has directly applied the gender minority stress framework to the experiences of TGE adolescents. Most research to date has focused on distal minority stressors and single path models to negative health outcomes, which do not account for the complex interplay between chronic minority stress, individual resilience factors, and health outcomes. Research examining proximal stressors and resilience factors is particularly scarce.

Conclusions

The gender minority stress model is a helpful framework for understanding how minority stressors contribute to health disparities and poor health outcomes among TGE adolescents. Future research should include multiple path models that examine relations between gender minority stressors, resilience factors, and health outcomes in large, nationally representative samples of TGE adolescents. Clinically, adaptations of evidence-based interventions to account for gender minority stressors may increase effectiveness of interventions for TGE adolescents and reduce health disparities in this population of vulnerable youth.
Getting more bark for your buck: nitrogen economy of deciduous forest trees
Authors: Castro-Rodríguez Vanessa , Ávila Concepción , Cánovas Francisco M
Published: May 2020

This article comments on:

Li G, Lin R, Egekwu C, Blakeslee J, Lin J, Pettengill E, Murphy AS, Peer WA, Islam N, Babst BA, Gao F, Komarov S, Tai Y-C, Coleman GD. 2020. Seasonal nitrogen remobilization and the role of auxin transport in poplar trees. Journal of Experimental Botany 71, 4512–4530.
The SAMI galaxy survey: gas velocity dispersions in low-z star-forming galaxies and the drivers of turbulence
Authors: Varidel Mathew R , Croom Scott M , Lewis Geraint F , Fisher Deanne B , Glazebrook Karl , Catinella Barbara , Cortese Luca , Krumholz Mark R , Bland-Hawthorn Joss , Bryant Julia J , Groves Brent , Brough Sarah , Federrath Christoph , Lawrence Jon S , Lorente Nuria P , Owers Matt S , Richards Samuel N , López-Sánchez Ángel R , Sweet Sarah M , van de Sande Jesse , Vaughan Sam P
Published: May 2020

We infer the intrinsic ionized gas kinematics for 383 star-forming galaxies across a range of integrated star formation rates (SFR ∈ [10−3, 102] M⊙ yr−1) at z ≲ 0.1 using a consistent 3D forward-modelling technique. The total sample is a combination of galaxies from the Sydney-AAO Multiobject Integral field Spectrograph (SAMI) Galaxy survey and DYnamics of Newly Assembled Massive Objects survey. For typical low-z galaxies taken from the SAMI Galaxy Survey, we find the vertical velocity dispersion (σv,z) to be positively correlated with measures of SFR, stellar mass, H i gas mass, and rotational velocity. The greatest correlation is with SFR surface density (ΣSFR). Using the total sample, we find σv,z increases slowly as a function of integrated SFR in the range SFR ∈ [10−3, 1]  M⊙ yr−1 from 17 ± 3 to 24 ± 5 km s−1 followed by a steeper increase up to σv,z ∼80 km s−1 for SFR ≳ 1 M⊙ yr−1. This is consistent with recent theoretical models that suggest a σv,z floor driven by star formation feedback processes with an upturn in σv,z at higher SFR driven by gravitational transport of gas through the disc.
Physics of tidal dissipation in early-type stars and white dwarfs: hydrodynamical simulations of internal gravity wave breaking in stellar envelopes
Authors: Su Yubo , Lecoanet Daniel , Lai Dong
Published: May 2020

In binaries composed of either early-type stars or white dwarfs, the dominant tidal process involves the excitation of internal gravity waves (IGWs), which propagate towards the stellar surface, and their dissipation via non-linear wave breaking. We perform 2D hydrodynamical simulations of this wave breaking process in a stratified, isothermal atmosphere. We find that, after an initial transient phase, the dissipation of the IGWs naturally generates a sharp critical layer, separating the lower stationary region (with no mean flow) and the upper ‘synchronized’ region (with the mean flow velocity equal to the horizontal wave phase speed). While the critical layer is steepened by absorption of these waves, it is simultaneously broadened by Kelvin–Helmholtz instabilities such that, in steady state, the critical layer width is determined by the Richardson criterion. We study the absorption and reflection of incident waves off the critical layer and provide analytical formulae describing its long-term evolution. The result of this study is important for characterizing the evolution of tidally heated white dwarfs and other binary stars.
Snow lines can be thermally unstable
Authors: Owen James E
Published: May 2020

Volatile species in protoplanetary discs can undergo a phase change from vapour to solid. These ‘snow lines’ can play vital roles in planet formation at all scales, from dust coagulation to planetary migration. In the outer regions of protoplanetary discs, the temperature profile is set by the absorption of reprocessed stellar light by the solids. Further, the temperature profile sets the distribution of solids through sublimation and condensation at various snow lines. Hence, the snow line position depends on the temperature profile and vice versa. We show that this coupling can be thermally unstable, such that a patch of the disc at a snow line will produce either runaway sublimation or condensation. This thermal instability arises at moderate optical depths, where heating by absorption of reprocessed stellar light from the disc’s atmosphere is optically thick, yet cooling is optically thin. Since volatiles in the solid phase drift much faster than volatiles in the vapour phase, this thermal instability results in a limit cycle. The snow line progressively moves in, condensing volatiles, before receding, as the volatiles sublimate. Using numerical simulations, we study the evolution of the carbon monoxide (CO) snow line. We find the CO snow line is thermally unstable under typical disc conditions and evolves inwards from ∼50 to ∼30 au on time-scales from 1000 to 10 000 yr. The CO snow line spends between ${\sim}10{{\ \rm per\ cent}}\,\mathrm{ and}\,50{{\ \rm per\ cent}}$ of its time at smaller separations, where the exact value is sensitive to the total opacity and turbulent viscosity. The evolving snow line also creates ring-like structures in the solid distribution interior to the snow line. Multiple ring-like structures created by moving snow lines could potentially explain the substructures seen in many ALMA images.
On the Geometry of the X-ray emission from pulsars a consistent inclination and beaming solution for the Be/X-ray pulsar SXP 1062
Authors: Cappallo R C , Laycock S G T , Christodoulou D M , Roy A , Bhattacharya S , Coe M J , Zezas A
Published: May 2020

SXP 1062 is a long-period X-ray pulsar (XRP) with a Be optical companion located in the Small Magellanic Cloud. First discovered in 2010 from XMM–Newton data, it has been the target of multiple observational campaigns due to the seeming incongruity between its long spin period and recent birth. In our continuing modelling efforts to determine the inclination angle (i) and magnetic axis angle (θ) of XRPs, we have fitted 19 pulse profiles from SXP 1062 with our pulsar model, Polestar, including three consecutive Chandra observations taken during the trailing end of a Type I outburst. These fittings have resulted in most likely values of i = 76○ ± 2○ and θ = 40○ ± 9○. SXP 1062 mostly displays a stable double-peaked pulse profile with the peaks separated by roughly a third of a phase, but recently the pulsar has spun up and widened to a spacing of roughly half of a phase, yet the Polestar fits for i and θ remain constant. Additionally, we note a possible correlation between the X-ray luminosity and the separation of the peaks in the pulse profiles corresponding to the highest luminosity states.
A bipartite thermodynamic-kinetic contribution by an activating mutation to RDF-independent excision by a phage serine integrase
Authors: Fan Hsiu-Fang , Su Bo-Yu , Ma Chien-Hui , Rowley Paul A , Jayaram Makkuni
Published: May 2020

Streptomyces phage ϕC31 integrase (Int)—a large serine site-specific recombinase—is autonomous for phage integration (attP x attB recombination) but is dependent on the phage coded gp3, a recombination directionality factor (RDF), for prophage excision (attL x attR recombination). A previously described activating mutation, E449K, induces Int to perform attL x attR recombination in the absence of gp3, albeit with lower efficiency. E449K has no adverse effect on the competence of Int for attP x attB recombination. Int(E449K) resembles Int in gp3 mediated stimulation of attL x attR recombination and inhibition of attP x attB recombination. Using single-molecule analyses, we examined the mechanism by which E449K activates Int for gp3-independent attL x attR recombination. The contribution of E449K is both thermodynamic and kinetic. First, the mutation modulates the relative abundance of Int bound attL-attR site complexes, favoring pre-synaptic (PS) complexes over non-productively bound complexes. Roughly half of the synaptic complexes formed from Int(E449K) pre-synaptic complexes are recombination competent. By contrast, Int yields only inactive synapses. Second, E449K accelerates the dissociation of non-productively bound complexes and inactive synaptic complexes formed by Int. The extra opportunities afforded to Int(E499K) in reattempting synapse formation enhances the probability of success at fruitful synapsis.
Reconstitution of the human tRNA splicing endonuclease complex: insight into the regulation of pre-tRNA cleavage
Authors: Hayne Cassandra K , Schmidt Casey A , Haque Maira I , Matera A Gregory , Stanley Robin E
Published: May 2020

The splicing of tRNA introns is a critical step in pre-tRNA maturation. In archaea and eukaryotes, tRNA intron removal is catalyzed by the tRNA splicing endonuclease (TSEN) complex. Eukaryotic TSEN is comprised of four core subunits (TSEN54, TSEN2, TSEN34 and TSEN15). The human TSEN complex additionally co-purifies with the polynucleotide kinase CLP1; however, CLP1’s role in tRNA splicing remains unclear. Mutations in genes encoding all four TSEN subunits, as well as CLP1, are known to cause neurodegenerative disorders, yet the mechanisms underlying the pathogenesis of these disorders are unknown. Here, we developed a recombinant system that produces active TSEN complex. Co-expression of all four TSEN subunits is required for efficient formation and function of the complex. We show that human CLP1 associates with the active TSEN complex, but is not required for tRNA intron cleavage in vitro. Moreover, RNAi knockdown of the Drosophila CLP1 orthologue, cbc, promotes biogenesis of mature tRNAs and circularized tRNA introns (tricRNAs) in vivo. Collectively, these and other findings suggest that CLP1/cbc plays a regulatory role in tRNA splicing by serving as a negative modulator of the direct tRNA ligation pathway in animal cells.
White Matter-Governed Superior Frontal Sulcus Surgical Paradigm: A Radioanatomic Microsurgical Study—Part I
Authors: Monroy-Sosa Alejandro , Chakravarthi Srikant S , Fukui Melanie B , Kura Bhavani , Jennings Jonathan E , Celix Juanita M , Nash Kenneth C , Kassam Mikaeel , Rovin Richard A , Kassam Amin B
Published: May 2020

BACKGROUND

Frontal subcortical and intraventricular pathologies are traditionally accessed via transcortical or interhemispheric-transcallosal corridors.

OBJECTIVE

To describe the microsurgical subcortical anatomy of the superior frontal sulcus (SFS) corridor.

METHODS

Cadaveric dissections were undertaken and correlated with magnetic resonance imaging/diffusion-tensor imaging-Tractography. Surgical cases demonstrated clinical applicability.

RESULTS

SFS was divided into the following divisions: proximal, precentral sulcus to coronal suture; middle, 3-cm anterior to coronal suture; and distal, middle division to the orbital crest. Anatomy was organized as layered circumferential rings projecting radially towards the ventricles: (1) outer ring: at the level of the SFS, the following lengths were measured: (A) precentral sulcus to coronal suture = 2.29 cm, (B) frontal bone projection of superior sagittal sinus (SSS) to SFS = 2.37 cm, (C) superior temporal line to SFS = 3.0 cm, and (D) orbital crest to distal part of SFS = 2.32 cm; and (2) inner ring: (a) medial to SFS, U-fibers, frontal aslant tract (FAT), superior longitudinal fasciculus I (SLF-I), and cingulum bundle, (b) lateral to SFS, U-fibers, (SLF-II), claustrocortical fibers (CCF), and inferior fronto-occipital fasciculus, and (c) intervening fibers, FAT, corona radiata, and CCF. The preferred SFS parafascicular entry point (SFSP-EP) also referred to as the Kassam-Monroy entry point (KM-EP) bisects the distance between the midpupillary line and the SSS and has the following coordinates: x = 2.3 cm (lateral to SSS), y ≥ 3.5 cm (anterior to CS), and z = parallel corona radiata and anterior limb of the internal capsule.

CONCLUSION

SFS corridor can be divided into lateral, medial, and intervening white matter tract segments. Based on morphometric assessment, the optimal SFSP-EP is y ≥ 3.5 cm, x = 2.3 cm, and z = parallel to corona radiata and anterior limb of the internal capsule.
Symptomatic Primary Tethered Optic Chiasm: Technical Case Report
Authors: Byrne Nika , Kochanski Ryan B , Tajudeen Bobby , Byrne Richard W
Published: May 2020

BACKGROUND AND IMPORTANCE

Symptomatic tethering of the optic nerves and chiasm is a rare occurrence and has been reported following both surgical and medical treatment of pituitary adenoma. Here we present a case of primary optic chiasm tethering in a patient with empty sella syndrome.

CLINICAL PRESENTATION

The patient was a 61-yr-old female who presented with progressively worsening bitemporal hemianopsia. Magnetic resonance imaging (MRI) brain revealed an empty sella with herniation of the optic chiasm into the sella. The patient underwent an endoscopic, endonasal/trans-sphenoidal approach to the sella, where the optic chiasm was then detethered via lysis of arachnoid adhesions and ultimately buttressed with an abdominal fat graft. Postoperatively, the patient did well with subjective and objective improvements in her visual fields.

CONCLUSION

We report a rare case of primary tethered optic chiasm, which was successfully treated via an endoscopic, endonasal approach with abdominal fat graft harvest.
Becoming parents again: Challenges affecting grandparent primary caregivers raising their grandchildren
Authors: Martin Ashley , Albrechtsons Daniel , MacDonald Noni , Aumeerally Nadia , Wong Tania
Published: May 2020

Background

A growing number of Canadian children live in the care of their grandparents, called skip-generation families. Reasons for this include teen pregnancy, death of a parent, mental/physical illnesses, and addictions. These grandparents and grandchildren are at increased risk of physical and mental illness, yet have few resources available to them.

Objective

Our study aims to describe the lived experiences of skip-generation families to better identify their needs.

Methods

We conducted semistructured interviews of grandparent primary caregivers from ten households in our community to chronicle their experiences raising their grandchildren. Participants were recruited by paediatricians using convenience sampling. Interviews were recorded, transcribed, and coded using Atlas Ti software, and classified into themes by consensus.

Results

Five primary themes emerged from the interviews: (1) Changes in family dynamics, (2) Psychosocial impact on grandchild and grandparent, (3) Lack of resources for grandparent caregivers, (4) The challenges of parenting later in life, and (5) Resilience inspired by the love of family. Many participants (n=10) described feeling unsupported after assuming care of their grandchildren and identified a need for additional counselling services, financial support and respite care. All (n=11) highlighted that caring for their grandchildren changed their lives in positive ways.

Conclusion

When grandparents are prioritized as primary caregivers for their grandchildren, our study suggests they receive insufficient community resources to meet their emotional, respite and financial needs. Further research involving this population in Canada is required. Paediatricians can play an essential role in recognizing these vulnerable families and advocating for additional supports and services.
Systematic review of methemoglobinemia in acetaminophen poisoning
Authors: Sahu K K , George S V , Siddiqui A D
Published: May 2020

Acetaminophen (N-acetyl-p-aminophenol paracetamol (APAP)) toxicity is one of the commonly encountered poisonings by emergency physicians. Methemoglobinemia is an uncommon association and rarely seen in APAP poisoning. The study involves the retrospective analysis of all the published reports on APAP-induced methemoglobinemia from 1968 to 2019.

 

In total, there were 14 cases with nine females and six males. The median age of the study cohort was 59 years. The most common presenting feature was altered mentation (nine patients) followed by cyanosis (three patients). The intent of consumption was therapeutic (seven cases) vs. suicidal (five cases) attempt. In most cases, the dose of APAP consumption was not known. Aspirin, sulfasalazine, benzocaine spray, nitrate preservative, contaminated water, detergents, and so on where the other agents consumed by the patients in addition to APAP before developing methemoglobinemia. The median MethHb level of the study cohort was 15.85%. Patients were treated with NAC, hemodialysis, methylene blue and ascorbic acid and continuous renal replacement therapy in various combinations. Full recovery was seen in nine patients while four patients died.

 

APAP toxicity is a well-known and a common entity with multiple sequelae that presents with a variable spectrum of mild to fulminant multiorgan failure. Awareness of non-classical presentations like methemoglobinemia is essential to ensure timely intervention.
Osteoimmunomodulatory effects of biomaterial modification strategies on macrophage polarization and bone regeneration
Authors: Xie Yajuan , Hu Cheng , Feng Yi , Li Danfeng , Ai Tingting , Huang Yulei , Chen Xiaodan , Huang Lijia , Tan Jiali
Published: May 2020

Biomaterials as bone substitutes are always considered as foreign bodies that can trigger host immune responses. Traditional designing principles have been always aimed at minimizing the immune reactions by fabricating inert biomaterials. However, clinical evidence revealed that those methods still have limitations and many of which were only feasible in the laboratory. Currently, osteoimmunology, the very pioneering concept is drawing more and more attention—it does not simply regard the immune response as an obstacle during bone healing but emphasizes the intimate relationship of the immune and skeletal system, which includes diverse cells, cytokines, and signaling pathways. Properties of biomaterials like topography, wettability, surface charge, the release of cytokines, mediators, ions and other bioactive molecules can impose effects on immune responses to interfere with the skeletal system. Based on the bone formation mechanisms, the designing methods of the biomaterials change from immune evasive to immune reprogramming. Here, we discuss the osteoimmunomodulatory effects of the new modification strategies—adjusting properties of bone biomaterials to induce a favorable osteoimmune environment. Such strategies showed potential to benefit the development of bone materials and lay a solid foundation for the future clinical application.
Banks’ Noninterest Income and Systemic Risk
Authors: Brunnermeier Markus K , Dong Gang Nathan , Palia Darius
Published: May 2020

This paper finds noninterest income is positively correlated with the total systemic risk for U.S. banks. Decomposing total systemic risk into three components, we find that noninterest income is positively related to a bank’s tail risk, positively related to a bank’s interconnectedness risk, and an insignificantly related to a bank’s exposure to macroeconomic and finance factors. We also find that noninterest income is more volatile and negatively related to interest income. Finally, we find trading and other noninterest income to be positively correlated with systemic risk. Other noninterest income, compared with trading income, has a slightly larger economic impact. (JEL G01, G18, G20, G21, G32, G38)

Received October 31, 2019; editorial decision February 3, 2020 by Editor Andrew Ellul.
The Union Threat
Authors: Taschereau-Dumouchel Mathieu
Published: May 2020

This article develops a search theory of labour unions in which the possibility of unionization distorts the behaviour of non-union firms. In the model, unions arise endogenously through a majority election within firms. As union wages are set through a collective bargaining process, unionization compresses wages and lowers profits. To prevent unionization, non-union firms over-hire high-skill workers— who vote against the union— and under-hire low-skill workers— who vote in its favour. As a consequence of this distortion in hiring, firms that are threatened by unionization hire fewer workers, produce less and pay a more concentrated distribution of wages. In the calibrated economy, the threat of unionization has a significant negative impact on aggregate output, but it also reduces wage inequality.
Whole-body MRI in the diagnosis of paediatric CNO/CRMO
Authors: Andronikou Savvas , Kraft Jeannette K , Offiah Amaka C , Jones Jeremy , Douis Hassan , Thyagarajan Manigandan , Barrera Christian A , Zouvani Andrea , Ramanan Athimalaipet V
Published: May 2020

Chronic recurrent multifocal osteomyelitis (CRMO) is an auto-inflammatory disorder affecting the skeleton of children and adolescents. Whole-body MRI (WBMRI) is key in the diagnosis and follow-up of CRMO. Imaging protocols should include sagittal short Tau inversion recovery of the spine, imaging of the hands and feet, and T1 images for distinguishing normal bone marrow. CRMO lesions can be metaphyseal, epiphyseal and physeal—potentially causing growth disturbance and deformity. Spinal lesions are common, important and can cause vertebral collapse. Lesion patterns include multifocal tibial and pauci-focal patterns that follow a predictable presentation and course of disease. Common pitfalls of WBMRI include haematopoietic marrow signal, metaphyseal signal early on in bisphosphonate therapy and normal high T2 signal in the hands and feet. Pictorial reporting assists in recording lesions and follow-up over time. The purpose of this paper is to review the different WBMRI protocols, imaging findings, lesion patterns and common pitfalls in children with CRMO
Effects of isoquinoline alkaloids on apparent ileal digestibility of amino acids, acid hydrolyzed ether extract, and starch by young growing pigs fed corn-soybean meal diets
Authors: Rundle Carly M , Artuso-Ponte Valeria , Stein Hans H
Published: May 2020

An experiment was conducted to test the hypothesis that a preparation of isoquinoline alkaloids (IQ) obtained from Macleaya cordata and added to corn-soybean meal diets increases the apparent ileal digestibility (AID) of amino acids (AA), crude protein (CP), starch, and acid hydrolyzed ether extract (AEE) when fed to young growing pigs. Thirty-two ileal cannulated barrows (initial body weight = 12.19 ± 1.38 kg) were allotted to a randomized complete block design with four diets and eight replicate pigs per diet. Diets were supplemented with 0, 90, 180, or 360 mg/kg IQ and with 0.40% chromic oxide. Diets were fed for 27 d and ileal digesta were collected on days 13 and 14 (period 1) and on days 26 and 27 (period 2). Effects of IQ inclusions were analyzed using contrast statements, and differences between periods were analyzed using a repeated measures statement. A quadratic increase (P < 0.05) in the AID of Thr, Trp, Val, Pro, and Tyr was observed in period 1 as IQ was included in the diets, and AID of CP, Arg, His, Ile, Leu, Met, Phe, Thr, Trp, Val, Pro, and Tyr was greater in period 2 than in period 1 (P < 0.05). In period 1, a quadratic increase (P < 0.05) was observed for the AID of starch as IQ increased in the diet, but the AID of starch was less (P < 0.05) in period 2 than in period 1. No differences among treatments or periods were observed for AID of AEE. Results indicate that inclusion of approximately 90 mg/kg of IQ in diets for weanling pigs may increase the AID of starch and some AA.
Effect of inclusion rate of silage with or without alpha-amylase trait on finishing steer growth performance, carcass characteristics, and agronomic efficiency measures
Authors: Rusche Warren C , Walker Julie A , Smith Zachary K
Published: May 2020

One hundred ninety-two Continental × British steers [initial body weight (BW) = 420 kg (standard deviation = 24.7)] were used in a randomized complete block design finishing study to evaluate the effects of feeding two types of silage germplasm at two inclusion rates. A 2 × 2 factorial arrangement of treatments was used with either a conventional hybrid (Golden Harvest G07B39-311A, Syngenta Seeds LLC, Minnetonka, MN; CON) or a hybrid with increased expression of alpha-amylase (Syngenta Enogen Feed corn, Golden Harvest E107B3-3011A-EVT5, Syngenta Seeds, LLC; ENO) fed at either 12% (12SIL) or 24% (24SIL) of diet dry matter. Steers were blocked by source and location (source 1: first three pen replicates, n = 10 steers per pen with a fourth pen replicate of six steers per pen; source 2: one pen replicate, n = 12 steers per pen) and assigned randomly within block to treatments, resulting in five pens and 48 steers per treatment. Steers were harvested after 126 (12SIL) or 140 (24SIL) days on feed (DOF). There were no silage hybrid by inclusion rate interactions detected for live growth performance (P ≥ 0.15). Silage hybrid did not affect average daily gain (ADG), gain-to-feed ratio (G:F), or final BW (FBW; P ≥ 0.35). Feeding 24% silage reduced ADG (P = 0.04) and increased G:F (P = 0.01) but increased FBW (P = 0.02) because of greater DOF compared with 12SIL. A hybrid by inclusion rate interaction was detected (P = 0.04) for calculated yield grade (YG) with steers fed 24SIL having increased YG within CON but not ENO. Hot carcass weight and rib fat were unaffected by silage hybrid (P ≥ 0.81) but were increased by feeding 24SIL (P = 0.03 and P = 0.02, respectively). Feeding increased amounts of silage increased beef produced per hectare (P = 0.05). Source of silage did not affect feedlot growth performance of cattle but, because of slight differences in estimated silage yield, conventional silage produced more kilograms of beef per hectare (P < 0.01). Feeding increased amounts of silage reduced G:F on both a live and carcass-adjusted basis but increased kilograms of beef produced per unit of land, which is paramount to cattle feeders who grow their own feedstuffs.
Impact of sow lactation feed intake on the growth and suckling behavior of low and average birthweight pigs to 10 weeks of age
Authors: Hawe Samuel J , Scollan Nigel , Gordon Alan , Magowan Elizabeth
Published: May 2020

Improved genetics in commercial pig production have resulted in larger litter sizes. However this has increased the prevalence of compromised pigs exhibiting inferior birthweights, weaning weights, and lifetime performance. This study aimed to determine the effects of increased sow lactation feed intake on growth of low and average birthweight piglets until 10 wk of age. Low (Low BW; <1 kg) and average (Av BW; 1.3–1.7 kg) birthweight animals were reared in uniformly weighted litters comprising 14 piglets on a foster mother offered either a low (Low FA; max 7.5 kg/d) or high (High FA; max 11 kg/d) feed allowance over a 28- ± 1-d lactation. Piglet performance was monitored from birth until 10 wk of age. Sows offered a High FA consumed 42.4 kg more feed on average than those offered Low FA, resulting in a greater derived milk yield (P < 0.05). Animals of Av BW remained heavier than Low BW pigs throughout the trial (P < 0.05). Piglets reared by High FA sows were heavier at weeks 3, 4, 5, and 7 (P < 0.05) but not week 10 (P > 0.05). Growth rate of piglets relative to their birthweight was significantly greater for Low BW piglets than those of Av BW during lactation (P < 0.001). Piglets reared by sows offered a High FA expressed greater relative growth preweaning (P < 0.05); however, postweaning relative growth for piglets reared on sows offered a Low FA was greater (P < 0.05) suggesting compensatory growth. Neither birthweight nor sow feed allowance significantly affected preweaning mortality (P > 0.05). However, Low BW animals on sows with a High FA recorded half the preweaning mortality of Low BW pigs on sows with a Low FA. During week 1 of lactation, Av BW litters recorded a greater total suckling duration compared to Low BW litters (P < 0.05) but there was no difference in suckling frequency (P > 0.05). During week 3 of lactation, High FA litters displayed a significantly lower suckling frequency (P < 0.05) yet a greater total suckling duration (P < 0.001). Average daily gain was greater for Av BW pigs during weeks 4–7 (P < 0.001) but no difference was recorded between weeks 7 and 10 (P > 0.05). Average daily feed intake was greater for Av BW pigs throughout the nursery period (P < 0.05) but feed–conversion ratio did not differ compared to Low BW pens (P>0.05). In conclusion, offering sows a High FA increased weaning weight of all animals; however, birthweight was the major determinant of postweaning performance.
Covid-19 Pandemic in relation to levels of Pollution with PM2.5 and Ambient Salinity – An Environmental Wake-up Call
Authors: Baron Yves Muscat
Published: May 2020

INTRODUCTION

Covid-19 infection continues to be a source of great loss of life and global suffering, necessitating national lockdowns. There are however some countries and cities which appear to have contained the pandemic. Common to these countries are environmental factors including the levels of particulate matter (PM2.5) and ambient salinity.

METHOD

PM2.5 and ambient salinity were assessed in a number of cities, differentially affected by Covid-19 infection. The cities chosen to be assessed were divided into two groups. The first group included cities having significantly high rates of Covid-19 infection, while the second group consisted of coastal cities or small island countries, all of which have low rates of Covid-19 infection. Minimum and maximum levels of PM2.5 were obtained from the Air Quality Index, one month before and one month after statutory lockdown. Salinity levels were obtained from a study that assessed chloride ion wet deposition, a surrogate for ambient salinity.

RESULTS

One month prior to the statutory national lock-down or mandatory restrictions, there appear to be high levels of particulate matter, PM2.5 (min-max 67.4 - 118.7 AQI), in countries which had a high incidence of Covid-19 infection compared to lower levels in countries that have contained the infection (min-max 45.6 - 79.8) (p<0.046). One month after national restrictions there still appeared to be higher levels of particulate matter, PM2.5 (min-max 51 - 90.5 AQI), in countries which had a high incidence of Covid-19 infection compared to countries that have contained the infection (min-max 42.7 - 69.5 AQI) but this was not statistically significant.

There seemed to be an inverse relationship between Covid-19 infection and ambient salinity levels. Countries that were spared high Covid-19 infection rates, besides their geographical isolation, also have higher ambient salinity levels (124 - 617mgCl/m2/TAG) compared to salinity levels noted in countries with high Covid-19 rates of infection (28.4 - 162. mgCl/m2/TAG) (p<0.003).

CONCLUSION

High levels of PM2.5 in the presence of low ambient salinity may increase the risk of Covid-19 infection in the population. Addressing these two environmental factors may attenuate the severity of the pandemic.