bluuebunny/crossref_metadata_2025 huggingface dataset:
Carboniferous crinoids
Authors: Ausich William I. , Kammer Thomas W. , Mirantsev Georgy V.
Published: November 2020

During the Carboniferous, crinoids were commonly so abundant that their skeletal ossicles formed limestones termed encrinites. Major evolutionary changes occurred within the Camerata and Articuliformes, as the former were displaced by the latter as the dominant clade. Both the Mississippian and the Pennsylvanian subperiods started with high evolutionary rates and ended with low evolutionary rates associated with glaciation. Although not typically used for biostratigraphy, crown-based crinoid genera can be used as biostratigraphic indicators for Carboniferous stages. Paleozoic crinoid biodiversity reached its maximum during the Carboniferous, from which there are numerous well-documented localities with high biodiversity. Faunas from the palaeobiogeographical regions of Laurussia, Palaeo-Tethys and Gondwana are reviewed. For Mississippian crinoids, 37 genera are designated as biostratigraphically useful; and, for the Pennsylvanian, 44 genera are identified. Recognition of the utility of these genera for biostratigraphy is important for dating crinoid deposits, which may be devoid of other biostratigraphically useful fossils, and add to our overall ability to delineate the temporal resolution of life on Earth.
Tracking Counterfeit Cryptocurrency End-to-end
Authors: Gao Bingyu , Wang Haoyu , Xia Pengcheng , Wu Siwei , Zhou Yajin , Luo Xiapu , Tyson Gareth
Published: November 2020

The production of counterfeit money has a long history. It refers to the creation of imitation currency that is produced without the legal sanction of government. With the growth of the cryptocurrency ecosystem, there is expanding evidence that counterfeit cryptocurrency has also appeared. In this paper, we empirically explore the presence of counterfeit cryptocurrencies on Ethereum and measure their impact. By analyzing over 190K ERC-20 tokens (or cryptocurrencies) on Ethereum, we have identified $2,117$ counterfeit tokens that target 94 of the 100 most popular cryptocurrencies. We perform an end-to-end characterization of the counterfeit token ecosystem, including their popularity, creators and holders, fraudulent behaviors and advertising channels. Through this, we have identified two types of scams related to counterfeit tokens and devised techniques to identify such scams. We observe that over 7,104 victims were deceived in these scams, and the overall financial loss sums to a minimum of \$ 17 million (74,271.7 ETH). Our findings demonstrate the urgency to identify counterfeit cryptocurrencies and mitigate this threat.
Chromophore-Assisted Retinal Break Detection to Manage Challenging Situations in Retinal Detachment Redo Surgery
Authors: Berarducci Antonio , Colasante Martina , Laborante Antonio
Published: November 2020

Introduction. The purpose of this case series is to demonstrate that subretinal blue dye injection, with and without 180-degree endolaser retinopexy, can be considered a useful tool in finding occult rhegmatogenous retinal breaks in eyes with recurrent retinal detachment. Case Presentation. Three patients with recurrent retinal detachment were treated between January and March 2018. In all cases, the intraoperative internal search did not demonstrate any obvious break or hole. MembraneBlue-Dual (Trypan Blue 0.15% + Brilliant Blue G 0.025% + 4% PEG) was then injected into the subretinal space using a 41-gauge cannula. The eye was rotated such that the dye was pushed through a tiny break which was causing the retinal detachment. 180-degree laser retinopexy was performed on a single eye. After silicon oil removal and absorption of the gas tamponade, retinas remained attached at three-months follow-up. Conclusions. Chromophore-assisted occult retinal break detection can be considered a useful but not risk-free surgical technique in managing some unexpected and challenging intraoperative situations.
Prophylaxis of Pain and Fractures within Feet in the Course of Osteoporosis: The Issue of Diagnosing
Authors: Bitenc-Jasiejko Aleksandra , Konior Krzysztof , Gonta Kinga , Dulęba Magdalena , Lietz-Kijak Danuta
Published: November 2020

Background. Considering the enormous risk of fractures in the course of osteoporosis in the area of the feet, an important aspect of prophylaxis is periodic and, in special cases, ongoing monitoring of defects and deformations as well as pressure distribution. The purpose of this article is to indicate the role of the examination of posture and pressure distribution during standing, postural balance, and gait, in the prevention of fatigue fractures in the course of osteoporosis, based on the literature review and examples of patients. Methods. The manuscript consists of two parts; it has a review-analytical character. The first part reviews the literature. The data were obtained using the MEDLINE (PubMed), as well as Cochrane and Embase databases. The database review was carried out focusing mainly on English-language publications, while taking into account the topicality of scientific and research works in the area of osteoporosis. The problem of multiaspects in the area of bone density was pointed out. Considering the above, in the second part, the authors analyzed 11 exemplary patients with osteoporosis, referring to the assessment of foot and lower limb defects using traditional posturological methods and including pedobarography to diagnostic procedures that are used in the assessment of pressure distribution, standing and moving, and an attempt to balance. Results. Analysis of the research and scientific literature proved the lack of unambiguous diagnostic procedures of the locomotor system recommended for the prevention of fatigue fractures in the course of osteoporosis. The main diagnostic recommendations are imaging tests (most often X-ray), which are recommended in the case of specific clinical symptoms. The analysis of exemplary patients with osteoporosis showed numerous disorders in the distribution of pressure in the plantar part of the feet, which are related, among other things, with their individual defects and lower limbs. Conclusions. Detailed posture diagnostics and gait estimation, along with the analysis of pressure distribution within the feet are a very important aspect of the prevention of structural degradation and fatigue fractures within the feet. An important postulate for further research and scientific work is the elaboration of the procedures that will serve the preventive diagnostics of the locomotor system, aimed at early detection of threats of fatigue fractures.
Analysis of the Relationships between Multiple Endocrine Hormones and Return of Spontaneous Circulation (ROSC) in Cardiac Arrest Patients: Possible Association of the Serum Free T4 Level with ROSC
Authors: Koizumi Go , Mikura Kentaro , Iida Tatsuya , Kaji Mariko , Hashizume Mai , Murai Norimitsu , Kigawa Yasuyoshi , Endo Kei , Iizaka Toru , Saiki Ryo , Otsuka Fumiko , Sasaki Jun , Hayashi Munetaka , Nagasaka Shoichiro
Published: November 2020

Background. Endocrine hormones are closely associated with homeostasis, so it is important to clarify hormone secretion dynamics in shock. Few reports, however, have examined the dynamics of endogenous hormone secretion relative to prognosis in cardiac arrest patients. Therefore, to clarify the roles of endocrine hormones in out-of-hospital cardiac arrest (OHCA) patients, the concentrations of anterior pituitary, thyroid, and adrenocortical hormones were measured, and their associations with return of spontaneous circulation (ROSC) were examined. Methods. The subjects were OHCA patients transported to our Emergency Department. In addition to conventional clinical laboratory tests, the following were measured: serum TSH, serum free T3, serum free T4 (F-T4), plasma ACTH, serum cortisol, serum GH, serum IGF-1, plasma aldosterone concentration (PAC), and plasma renin activity. The primary endpoint was the presence or absence of ROSC, and the secondary endpoint was 24-hour survival. Results. A total of 29 patients, 17 in the ROSC group and 12 in the non-ROSC group, were studied. There were associations between ROSC and low serum potassium, high F-T4, low cortisol, and low PAC on bivariate analyses. There were associations between ROSC and serum potassium, F-T4, and GH using the step-wise method. On multiple logistic regression analysis, a relationship between ROSC and high serum F-T4 level was identified by both methods. There were also associations between 24-hour survival and both low serum potassium and elevated blood glucose levels. Conclusions. The present findings suggest a possible relationship between the serum F-T4 level and ROSC in OHCA patients. A higher serum F-T4 level might cause an increase in the β-adrenergic response in cardiomyocytes and increased responsiveness to catecholamines and was possibly associated with ROSC.
Prognostic Significance of Homocysteine Level on Neurological Outcome in Brain Arteriovenous Malformations
Authors: Lin Fa , Zeng Chaofan , Ge Peicong , Zhang Dong , Wang Shuo , Zhao Jizong
Published: November 2020

Objective. We aimed to investigate the serum homocysteine (Hcy) level in patients with brain arteriovenous malformation (bAVM) and their impact on neurological outcome during hospitalization. Method. We retrospectively reviewed patients diagnosed with bAVMs in Beijing Tiantan Hospital from January 2019 to August 2020. Patients were divided into two groups according to the mRS (modified Rankin Scale) score at discharge. Clinical and laboratory characteristics were compared. Logistic regression analyses were performed to identify the potential risk factors for short-term neurological outcome. Results. A total of 175 bAVM patients were enrolled in the study, including 139 patients with favorable outcome (

mRS
≤
2

) and 36 patients with unfavorable outcome (

mRS
>
2

). Hyperhomocysteinemia was identified in 32.6% of cases (

n
=
57

). Serum Hcy level was related to seizure manifestation (

P
=
0.034

) and short-term neurological outcome (

P
=
0.027

). Logistic regression analysis showed that serum glucose (OR 1.897, 95% CI 1.115-3.229;

P
=
0.018

) and Hcy level (OR 0.838, 95% CI 0.720-0.976;

P
=
0.023

) were significantly associated with short-term disability. Conclusion. Our results indicated that the lower serum Hcy level is strongly associated with in-hospital unfavorable outcome. Further prospective studies of Hcy natural history and managements in bAVMs are required, which would be valuable for evaluating the disease-modifying efficacy of oral nutritional supplements in bAVM patients.
USAD: An Intelligent System for Slang and Abusive Text Detection in PERSO-Arabic-Scripted Urdu
Authors: Haq Nauman Ul , Ullah Mohib , Khan Rafiullah , Ahmad Arshad , Almogren Ahmad , Hayat Bashir , Shafi Bushra
Published: November 2020

The use of slang, abusive, and offensive language has become common practice on social media. Even though social media companies have censorship polices for slang, abusive, vulgar, and offensive language, due to limited resources and research in the automatic detection of abusive language mechanisms other than English, this condemnable act is still practiced. This study proposes USAD (Urdu Slang and Abusive words Detection), a lexicon-based intelligent framework to detect abusive and slang words in Perso-Arabic-scripted Urdu Tweets. Furthermore, due to the nonavailability of the standard dataset, we also design and annotate a dataset of abusive, offensive, and slang word Perso-Arabic-scripted Urdu as our second significant contribution for future research. The results show that our proposed USAD model can identify 72.6% correctly as abusive or nonabusive Tweet. Additionally, we have also identified some key factors that can help the researchers improve their abusive language detection models.
Exit Decision of Venture Capital Based on Linear Contract in Continuous Time: IPO or M&A
Authors: Chuan Ding , Li Dahai , Ye Meishu
Published: November 2020

Based on the assumption that the long-term value of a venture capital satisfies the algebraic Brownian motion, we develop a continuous-time exit model of venture capital under different exit modes, namely, initial public offering (IPO) and mergers and acquisitions (M&A). The employee incentive problem is analyzed jointly with the exit decision of the firm in terms of the exit timing and the exit mode. Further, the problem of capital exit is considered from two perspectives, namely, optimal venture capital and social welfare maximization, and the differences between these exit decisions are compared. Our model predicts that the timing of an IPO, the purpose of which is to maximize the utility of the capitalists, lags behind the exit timing, whose purpose is to maximize social welfare. Using a numerical analysis, this paper also proves that increasing the production efficiency, lowering the interest rates, and improving risk management can make the exit decision of venture capitalists converge with that of maximizing social welfare.
Application of an Estimation Method in the Lure System
Authors: Huang Zhaoxia
Published: November 2020

The presence of set-valued mapping affects the stability of the output of the lure system, adding to the difficulty in observer design. To overcome the difficulty, the author mapped the system output error to the nonlinear term of the framer, creating a framer of the extended Luenberger structure, and analyzed the coordination of the error system by the monotonic system theory. On this basis, the interval observer was designed for the lure system. Then, the lure system and its observer systems were proved as asymptotically stable. Finally, it is proved that the observer system trajectory always followed the original state trajectory through the simulation under the different selections of set-valued mapping.
Systematic Analysis of the Whole-Body Tissue Distribution and Fatty Acid Compositions of Membrane Lipids in CD1 and NMRI Mice and Wistar Rats
Authors: Xu Lina , Schmitt Maximilian V. , Ruan Huabin , Jiao Yupei , Wang Xueying , Wang Yusong , Yang Tao , Lienau Philip , Reichel Andreas , Liu Xiaohui
Published: November 2020

Understanding the tissue distribution of phospholipids and glycerolipids in animal models enables promoting the pharmacokinetic study of drugs and related PK predictions. The measurement of lipid compositions in animal models, usually mice and rats, without a standardized approach hindered the accuracy of PBPK investigation. In this work, high resolution mass spectrometry was applied to profile the tissue distribution of phospholipids and glycerolipids in 12 organs/tissues of mice and rats. Using this method, not only the amounts of phospholipids and glycerolipids in each organ/tissue but also the fatty acid compositions were acquired. In order to explore the interspecies specificity of lipid distribution in different organs/tissues, three animal species including CD1 mice, NMRI mice, and Wister rats were used in this systematic study. Globally, more organ specificity was observed. It was found that the brain is the organ containing the most abundant phosphatidylserine lipids (PSs) in all three animal models, leading to brain tissues having the most concentrated acidic phospholipids. Diverse fatty acid compositions in each lipid class were clearly revealed. Certain tissues/organs also had a specific selection of unique fatty acid compositions, for example, unreferenced FA(18 : 2) in the brain. It turned out that the access of free fatty acids affects the incorporation of acyl chain in phospholipids and glycerolipids. In the analysis, ether lipids were also profiled with the observation of dominant ePEs in brain tissues. However, little interspecies difference was found for fatty acid constituents and tissues distribution of phospholipids and glycerolipids.
CO2 Emissions, Energy Consumption, and Economic Growth Nexus: Evidence from 30 Provinces in China
Authors: Zou Shaohui , Zhang Tian
Published: November 2020

Under the situation of global low-carbon development, the contradiction among energy consumption, economic growth, and CO2 emissions is increasingly prominent. Considering the possible two-way feedback among the three, based on the panel data of 30 regions in China from 2000 to 2017, this paper establishes a spatial Durbin model including economic growth, energy consumption equation, and CO2 emissions and studies the dynamic relationship and spatial spillover among economic growth, energy consumption, and CO2 emissions effects. The results show that the economic growth can significantly improve carbon dioxide emissions, and China’s economic growth level has become a positive driving force for carbon dioxide emissions. However, economic growth will not be significantly affected by the reduction of carbon dioxide emissions. There is a two-way relationship between energy consumption (ENC) and carbon dioxide emissions (CO2). Energy consumption and carbon emissions are interrelated, which has a negative spatial spillover effect on the carbon dioxide emissions of the surrounding provinces and cities.
Evaluating Knowledge, Practices, and Barriers of Paediatric Pain Management among Nurses in a Tertiary Health Facility in the Northern Region of Ghana: A Descriptive Cross-Sectional Study
Authors: Wuni Abubakari , Salia Solomon Mohammed , Mohammed Ibrahim Mudasir , Iddriss Iman , Abena Nyarko Brenda , Nabila Seini Samaku , Tonsagri Imoro , Mohammed Jauharatu
Published: November 2020

Background. Pain is a major source of distress for children on admission, parents, and clinician. Hospitalized children continuously experience unrelieved pain; hence, the provision of effective pain management is an integral and important part of the nurse’s role. Adequate knowledge and positive practices of nurses regarding pain management among children are key if optimal pain management is to be achieved among paediatric cases. However, there is a paucity of published data on paediatric management among nurses in the northern part of Ghana. Aim. The current study, therefore, evaluated nurse’s knowledge and practices and identified the barriers to paediatric pain management in the Tamale Teaching Hospital, Ghana. Methodology. This was a descriptive cross-sectional facility-based study that employed a quantitative approach to data collection. A total of 180 nurses were selected conveniently from 10 selected wards of the hospital for the study. Data were collected using a questionnaire. The data were subsequently analyzed using the Statistical Package for Social Sciences version 23.0. Logistic regression analysis was done to determine the association between the dependent and independent variables of interest. Results. The findings revealed that the majority (61.1%) of all the nurses had an overall good knowledge of paediatric pain management while 57.8% demonstrated good practices of pain management. From the study, the most reported barriers to paediatric pain management by the nurses were insufficient knowledge in pain management (76.1%), inadequate paediatric pain assessment tools (73.9%), and inadequate staffing (72.2%). In further analysis, critical care nurses were 5.87 times more likely to engage in good practices of paediatric pain management than paediatric nurses (OR = 5.87 (95% CI : 1.07–32.00),

p
=
0.041

). Conclusion. The majority (61.1%) of all the respondents showed good knowledge of pain management and 57.8% demonstrated good pain management practices. Despite the high knowledge and practice, factors such as insufficient knowledge in pain management (76.1%), inadequate paediatric pain assessment tools (73.9%), and inadequate nurse staffing (72.2%) affect effective pain management. Paediatric pain management should be treated as a priority, and hence more efforts should be put in place to curtail the barriers that hinder its practice.
Feature Selections Using Minimal Redundancy Maximal Relevance Algorithm for Human Activity Recognition in Smart Home Environments
Authors: Fang Hongqing , Tang Pei , Si Hao
Published: November 2020

In this paper, maximal relevance measure and minimal redundancy maximal relevance (mRMR) algorithm (under D-R and D/R criteria) have been applied to select features and to compose different features subsets based on observed motion sensor events for human activity recognition in smart home environments. And then, the selected features subsets have been evaluated and the activity recognition accuracy rates have been compared with two probabilistic algorithms: naïve Bayes (NB) classifier and hidden Markov model (HMM). The experimental results show that not all features are beneficial to human activity recognition and different features subsets yield different human activity recognition accuracy rates. Furthermore, even the same features subset has different effect on human activity recognition accuracy rate for different activity classifiers. It is significant for researchers performing human activity recognition to consider both relevance between features and activities and redundancy among features. Generally, both maximal relevance measure and mRMR algorithm are feasible for feature selection and positive to activity recognition.
Genetic Testing Distinguishes Multiple Chondroid Chordomas with Neuraxial Bone Metastases from Multicentric Tumors
Authors: Kobayashi Hiroshi , Shin Masahiro , Makise Naohiro , Shinozaki-Ushiku Aya , Ikegami Masachika , Taniguchi Yuki , Shinoda Yusuke , Kohsaka Shinji , Ushiku Tetsuo , Oda Katsutoshi , Miyagawa Kiyoshi , Aburatani Hiroyuki , Mano Hiroyuki , Tanaka Sakae
Published: November 2020

Background. Chordomas are rare malignant bone tumors preferentially forming in neuraxial bones. Chondroid chordoma is a subtype of chordoma. Chordomas reportedly present as synchronous multiple lesions upon initial diagnosis. However, it remains unknown whether these lesions are multicentric or metastatic multiple chordoma tumors. Case Presentation. Here, we present the case of a 57-year-old woman with multiple chordomas at the clivus, C6, and T12 upon initial presentation. Sequential surgeries and radiotherapy were performed for these lesions, and postoperative histological diagnosis revealed that all lesions were chondroid chordomas. Next-generation sequencing revealed that these lesions harbored a common somatic mutation in epidermal growth factor receptor (EGFR), c.3617A>C, which is not considered a pathogenic chordoma mutation, thus indicating that these lesions were not multicentric but rather multiple metastatic tumors. Subsequent multiple metastases to the lung and appendicular and axial bones were detected 15 months after the initial surgery. Recurrent lesions at the clivus progressed despite EGFR-targeted therapy, surgery, and radiotherapy. Conclusion. The present evidence indicates that multiple chordomas in this case were caused by multiple metastases rather than multicentric lesions. Multiple presentations of chordoma imply systemic dissemination of tumor cells, and novel efficient systemic therapy is required to treat this disease.
A Genetic Mouse Model Recapitulates Immune Checkpoint Inhibitor–Associated Myocarditis and Supports a Mechanism-Based Therapeutic Intervention
Authors: Wei Spencer C. , Meijers Wouter C. , Axelrod Margaret L. , Anang Nana-Ama A.S. , Screever Elles M. , Wescott Elizabeth C. , Johnson Douglas B. , Whitley Elizabeth , Lehmann Lorenz , Courand Pierre-Yves , Mancuso James J. , Himmel Lauren E. , Lebrun-Vignes Benedicte , Wleklinski Matthew J. , Knollmann Bjorn C. , Srinivasan Jayashree , Li Yu , Atolagbe Oluwatomisin T. , Rao Xiayu , Zhao Yang , Wang Jing , Ehrlich Lauren I.R. , Sharma Padmanee , Salem Joe-Elie , Balko Justin M. , Moslehi Javid J. , Allison James P.
Published: November 2020

Immune checkpoint inhibitors (ICI) targeting CTLA4 or PD-1/PD-L1 have transformed cancer therapy but are associated with immune-related adverse events, including myocarditis. Here, we report a robust preclinical mouse model of ICI-associated myocarditis in which monoallelic loss of Ctla4 in the context of complete genetic absence of Pdcd1 leads to premature death in approximately half of mice. Premature death results from myocardial infiltration by T cells and macrophages and severe ECG abnormalities, closely recapitulating the clinical and pathologic hallmarks of ICI-associated myocarditis observed in patients. Using this model, we show that Ctla4 and Pdcd1 functionally interact in a gene dosage–dependent manner, providing a mechanism by which myocarditis arises with increased frequency in the setting of combination ICI therapy. We demonstrate that intervention with CTLA4–Ig (abatacept) is sufficient to ameliorate disease progression and additionally provide a case series of patients in which abatacept mitigates the fulminant course of ICI myocarditis.

Significance:

We provide a preclinical model of ICI-associated myocarditis which recapitulates this clinical syndrome. Using this model, we demonstrate that CTLA4 and PD-1 (ICI targets) functionally interact for myocarditis development and that intervention with CTLA4–Ig (abatacept) attenuates myocarditis, providing mechanistic rationale and preclinical support for therapeutic clinical studies.

See related commentary by Young and Bluestone, p. 537.

This article is highlighted in the In This Issue feature, p. 521
Combined Intraoperative Identification and Monitoring of Recurrent Laryngeal Nerve Paresis during Minimally Invasive Esophagectomy: Surgical Technique Using Nerve Integrity Monitoring for Esophageal Carcinoma
Authors: Nitta Toshikatsu , Kawai Masaru , Kataoka Jun , Ohta Masato , Tashiro Keitaro , Ishibashi Takashi
Published: November 2020

Recurrent laryngeal palsy occurs after No. 106 rec RL lymphadenectomy procedure, which is assumed to cause postoperative respiratory complications. A 71-year-old Japanese man with T1b N0 M0 stage 1 esophageal cancer was scheduled for thoracoscopic esophagectomy with two-field lymph node dissection using nerve integrity monitoring (NIM). The patient demonstrated an uneventful postoperative course with 56 days remission. Under general anesthesia conditions, a single-lumen intubation tube was inserted for NIM. The automatic periodic stimulation electrode was placed on the bilateral vagus nerves on the left and right, respectively. The NIM had set and enabled the identification of the nerve accurately and continuous intraoperative nerve monitoring using impulses from the stimulation probe. The postoperative outcomes and comparison of the potential amplitudes of electromyography were observed while no postoperative vocal cord paresis was present. Combined intraoperative identification and monitoring of recurrent laryngeal nerve significantly changes the quality of the lymphadenectomy procedure and is a promising optical imaging technique. It has gained recognition for being able to reduce or prevent recurrent laryngeal nerve paralysis. It was considered a reasonable method, but it has been superseded by NIM, which is a novel technology.
Placental Site Plaque of the Uterine Cervix Misinterpreted as Low-Grade Squamous Intraepithelial Lesion in Liquid-Based Cervicovaginal Cytology: Usefulness of Inhibin-α Immunocytochemistry
Authors: Kim Hyunjin , Woo Ha Young , Lee Sang Hwa , Do Sung-Im , Kim Hyun-Soo
Published: November 2020

Cytological features of placental site plaques in liquid-based cervicovaginal preparations have been seldom documented in the literature. We present a rare case of endocervical placental site plaque misinterpreted as a low-grade squamous intraepithelial lesion in a liquid-based cytological preparation. A 32-year-old woman with polycystic ovarian syndrome gave birth 7 months previously. After delivery, she was diagnosed with cervical low-grade squamous intraepithelial lesion during routine cytological examination. Cytologically, many atypical cells showed large hyperchromatic nuclei with irregular membranes. The perinuclear cytoplasmic clearing closely resembled koilocytosis. Histologically, the endocervix showed typical histological features of a placental site plaque. Immunohistochemically, the trophoblasts were positive for p63, CD10, and inhibin-α but negative for p16. Based on genotyping, both the cytological and biopsied specimens tested negative for human papillomavirus. We re-examined the liquid-based preparation cytology slides thoroughly and concluded that the atypical cells initially misinterpreted as low-grade squamous intraepithelial lesion were actually trophoblasts. Immunocytochemical staining revealed uniform cytoplasmic inhibin-α expression in the trophoblasts. In summary, we demonstrated that endocervical placental site plaques can mimic low-grade squamous intraepithelial lesions in liquid-based cytological preparations. Immunocytochemical staining results and negative results on human papillomavirus genotyping further support that atypical cells resembling koilocytes are trophoblasts obtained from the placental site plaque.
A Rare Case of Sensory Neuropathy Associated with Transitional Cell Carcinoma of the Bladder
Authors: Ketineni Sujitha , Kodali Sreenath , Gorantla Sasikanth
Published: November 2020

Malignancies can trigger an autoimmune response against the nervous system and manifest as paraneoplastic neurological syndromes (PNS). Initial symptoms of PNS may develop up to 5 years prior to the diagnosis of the underlying malignancy. We report a rare case of PNS associated with transitional cell carcinoma of the bladder in a 70-year-old male with a 6-month history of rapidly progressive symmetric sensory neuropathy. Peripheral neuropathy serological workup was unremarkable. A paraneoplastic neuropathy panel revealed anti-Hu autoantibodies. Further evaluation with a whole-body PET scan could not identify the primary malignancy, but it showed hypermetabolic hilar lymph nodes. An endobronchial ultrasound biopsy of the hilar lymph nodes was negative for cancer. The patient developed painless hematuria 2.5 years after the onset of the sensory neuropathy. Cystoscopy with biopsy revealed non-muscle-invasive transitional cell carcinoma of the bladder. Progression of the sensory neuropathy stopped after tumor resection. This case highlights the importance of a diligent and systematic approach to diagnose PNS. A relentless search is often required to detect PNS-associated occult malignancies.
Assessing the Performance of a Novel Point-of-Care Qualitative Assay for Early Diagnosis of Acute Coronary Syndrome
Authors: Alcalai Ronny , Varshisky Boris , Marhig Ahmad , Leibowitz David , Kogan-Boguslavsky Larissa , Dorfman Elisheva , Steiner David , Katz Emil , Salameh Shaden , Lotan Chaim
Published: November 2020

Background: Early and accurate diagnosis of acute coronary syndrome (ACS) is essential for initiating lifesaving interventions. In this article, the diagnostic performance of a novel point-of-care rapid assay (SensAheart©) is analyzed. This assay qualitatively determines the presence of 2 cardiac biomarkers troponin I and heart-type fatty acid-binding protein that are present soon after onset of myocardial injury. Methods: We conducted a prospective observational study of consecutive patients who presented to the emergency department with typical chest pain. Simultaneous high-sensitive cardiac troponin T (hs-cTnT) and SensAheart testing was performed upon hospital admission. Diagnostic accuracy was computed using SensAheart or hs-cTnT levels versus the final diagnosis defined as positive/negative. Results: Of 225 patients analyzed, a final diagnosis of ACS was established in 138 patients, 87 individuals diagnosed with nonischemic chest pain. In the overall population, as compared to hs-cTnT, the sensitivity of the initial SensAheart assay was significantly higher (80.4 vs. 63.8%, p = 0.002) whereas specificity was lower (78.6 vs. 95.4%, p = 0.036). The overall diagnostic accuracy of SensAheart assay was similar to the hs-cTnT (82.7% compared to 76.0%, p = 0.08). Conclusions: Upon first medical contact, the novel point-of-care rapid SensAheart assay shows a diagnostic performance similar to hs-cTnT. The combination of 2 cardiac biomarkers in the same kit allows for very early detection of myocardial damage. The SensAheart assay is a reliable and practical tool for ruling-in the diagnosis of ACS.
miR-6838-5p Affects Cell Growth, Migration, and Invasion by Targeting GPRIN3 via the Wnt/β-Catenin Signaling Pathway in Gastric Cancer
Authors: Zhou Weidong , Ding Xiaoyun , Jin Peihua , Li Peifei
Published: November 2020

Gastric cancer (GC) is a highly prevalent digestive malignant tumor, ranking second in the tumor-related mortality globally. The microRNAs have been confirmed to be connected with GC progression. Accumulative evidence has suggested that miR-6838-5p exerts a suppressive effect on human cancers. Nonetheless, whether miR-6838-5p is involved in the regulation of GC remains to be investigated. During our research, miR-6838-5p was downregulated in GC cells. Upregulated miR-6838-5p repressed GC cell cycle progression, proliferation, migration, and invasion. Furthermore, miR-6838-5p overexpression repressed the nuclear import of β-catenin, thus inactivating Wnt/β-catenin pathway. Moreover, we observed that GPRIN3 was targeted by miR-6838-5p in GC with luciferase reporter and RIP assays. GPRIN3 upregulation reversed the suppression of miR-6838-5p in GC cellular processes. These findings suggest miR-6838-5p restrains the malignant behaviors of GC cells via targeting GPRIN3 to repress Wnt/β-catenin signaling pathway, which may provide novel targets for GC treatment.
Breast Disorders in Adolescence: A Review of the Literature
Authors: Mareti Evangelia , Vatopoulou Anastasia , Spyropoulou Georgia-Alexandra , Papanastasiou Anastasios , Pratilas Georgios Chrysostomos , Liberis Anastasios , Hatzipantelis Emmanouil , Dinas Konstantinos
Published: November 2020

Background: Adolescence is accompanied by a variety of changes in young breast development, which greatly affects the adolescent’s psychology and socialization. Summary: PubMed, EMBASE, and the Cochrane Library were searched for studies relative to epidemiology, clinical characteristics, diagnosis, and management of all breast disorders in adolescence and their consequences. Development disorders are breast asymmetry, breast atrophy, breast hypoplasia, hypomastia, juvenile breast hypertrophy, and tuberous breast. Breast congenital abnormalities include athelia, amastia, accessory breast tissue, polymastia, polythelia, and congenital disorders of nipples. Breast infections are commonly caused from Gram-positive coccus rather than Gram-negative bacteria. Breast abscess occurs when breast infections are not promptly treated. Nipple discharge is caused by a variety of conditions and should be managed carefully. Fibrocystic changes, cysts, and fibroadenomas are the most common benign masses in adolescence. Primary, secondary, or metastatic breast cancer is extremely rare in adolescence. However, clinicians should include breast cancer in the differential diagnosis of a breast mass in adolescence. Key Messages: Clinicians should be aware of all breast disorders that may occur in adolescence. Early diagnosis and treatment will result in the reassurance of adolescents and their families without any detrimental effect on their psychology, sexual behavior, and socialization. Adolescents with breast disorders may require a multidisciplinary approach by a pediatrician, a gynecologist specializing in pediatric-adolescent gynecology, a plastic surgeon, and a psychologist for the best management of breast disorders.
Novel Findings in Floating-Harbor Syndrome and a Mini-Review of the Literature
Authors: Ercoskun Pelin , Yuce-Kahraman Cigdem
Published: November 2020

Floating-Harbor syndrome (FHS) is a rare autosomal dominant genetic disorder characterized by proportionate short stature with delayed bone maturation, lack of expressive language, and distinctive facial features including a large nose, long eyelashes, deeply set eyes, and triangular face. Mutations in the SRCAP gene cause truncated SNF2-related CREBBP activator protein (SRCAP) and lead to FHS. SRCAP is one of several proteins that act as coactivator for the CREB-binding protein which is associated with Rubinstein-Taybi syndrome (RSTS). This condition likely explains the phenotypic overlap between FHS and RSTS. Herein, we report on a patient with FHS who also had dystrophic toenails, preauricular skin tag, and nasolacrimal duct obstruction which is also defined in patients with RSTS. In summary, the fact that especially nasolacrimal duct obstruction has also been observed in RSTS reinforces the idea that this finding is one of the features of FHS. Assessment of the lacrimal system and examination of skin and nails should be suggested in patients with FHS.
Impact of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers on in-hospital mortality among patients with COVID-19: a systematic review and meta-analysis
Authors: Cai XJ , Tay JCK , Kui SL , Tin AS , Tan VH
Published: November 2020

INTRODUCTION There are concerns that angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) may worsen the outcomes of patients with COVID-19. This systematic review and meta-analysis aimed to study the in-hospital mortality among COVID-19 patients who were on ACEIs/ARBs as compared to those not on ACEIs/ARBs. METHODS We searched PubMed, EMBASE, clinicaltrials.gov and Google Scholar between 1 January 2020 and 30 May 2020 to identify all studies that evaluated the use of ACEIs/ARBs and reported the in-hospital mortality outcomes of COVID-19 patients. Nine non-randomised studies were eligible for inclusion in the analysis. The primary outcome studied was the in-hospital mortality of COVID-19 patients who were on ACEIs/ARBs compared with those not on ACEIs/ARBs. RESULTS Of the 8,313 patients in the nine studies, 7,622 (91.7%) were from studies with all-comers, while 691 (8.3%) were from studies involving only patients with hypertension. 577 (14.6%) in-hospital deaths were observed out of a total of 3,949 patients with an outcome in the nine studies. Overall, no significant difference was observed in the in-hospital mortality between patients on ACEIs/ARBs and those not on ACEIs/ARBs (odds ratio [OR] 1.06, 95% confidence interval [CI] 0.75–1.50; p = 0.73). Further sensitivity analysis in the hypertension group and the all-comers group showed similar results (OR 0.88, 95% CI 0.58–1.32; p = 0.53 and OR 1.85, 95% CI 1.00–3.43; p = 0.05, respectively). CONCLUSION We observed that ACEIs/ARBs had no significant impact on the in-hospital mortality of COVID-19 patients and can be used safely in patients with indications.
Innovative digital tools in EBP and information literacy education for undergraduate nursing students
Authors: Chan Bryan , Wei Ruth , Fetherston Catherine
Published: November 2020

Background: Information literacy (IL) skills are essential for the translation of current knowledge into evidence-based practice (EBP) in healthcare, which in turn improves patient outcomes. However, students enter pre-registration nursing programs with variable IL skills, which can present challenges when preparing research-literate nursing graduates. Objectives: To develop an online module for nursing students to learn the information literacy skills they require to effectively implement EBP. Project design: A self-paced, interactive online module was developed for final year pre-registration nursing students at an Australian university and launched in late January 2019. Four different digital tools, including screen-capture videos, split-screen tutorials, e-portfolio/learning journey platforms, and digital badges, were integrated to create an interactive module on database searching and systematic reviews. A student feedback survey was added to collect information on the students’ learning experience. Results: Students reported the online module was challenging but engaging and that its self-paced interactive nature assisted their learning. Digital badges were reported as a motivating factor by students, and their attitudes toward EBP were positive. Students were able to complete the module on their own, but a handful required face-to-face assistance. Conclusion: This project successfully integrated screen-capture videos, split-screen tutorials, e-portfolios and micro-credentialing into one online learning module to assist nursing students with developing the IL skills required for effective EBP.
Revision of Eugenia section Phyllocalyx (Myrtaceae)
Authors: BÜNGER MARIANA DE OLIVEIRA , MAZINE FIORELLA FERNANDA , STEHMANN JOÃO RENATO
Published: November 2020

Eugenia section Phyllocalyx, a mainly Brazilian Atlantic Forest group of 16 species, is revised based on a study of over 2000 plant collections. The relationships of Eugenia sect. Phyllocalyx to other sections in Eugenia are discussed. All species are described and comments about geographic distribution and morphology are provided. An identification key and notes about its conservation status are also presented. Lectotypes are chosen for six species and second-step lectotypification is proposed for two species.
Taxonomic review and cladistic analysis of Neotropical spider genus Epicratinus Jocqué & Baert, 2005 (Araneae: Zodariidae) with description of eleven new species
Authors: GONÇALVES RICARDO ANTONIO , BRESCOVIT ANTONIO DOMINGOS
Published: November 2020

A taxonomic revision and phylogenetic analysis of the spider genus Epicratinus Jocqué & Baert, 2005 is presented. The phylogenetic analysis is based on a data set including 16 Epicratinus species plus 9 outgroups representing by five related zodariid gen­era and one of them considered most basal as the root. These taxa were scored for 49 morphological characters. Parsimony was used as the op­timality criterion and a sensitivity analysis was performed using different character weighting concavities. Five unambiguous synapomorphies support the monophyly of Epicratinus. Some internal clades within the genus are well-supported and their relationships are discussed. Epicratinus includes 16 species, all with males and females. A species identification key and distribution maps are provided for all. New morphological data are also pre­sented for five previously described species. All 16 species occur only in the New World. The following species are transferred to Epicratinus: E. perfidus (Jocqué & Baert), comb. nov. from Tenedos; Epicratinus perfidus Jocqué & Baert comb. nov. and newly synonymized with E. santacruz Grismado & Izquierdo and this last species is treated as the junior synonym. Epicratinus petropolitanus (Mello-Leitão) has the male described for the first time. The following 11 species are newly described as new: E. zangief sp. nov.; E. pegasus sp. nov.; E. pikachu sp. nov.; E. stitch sp. nov.; E. ehonda sp. nov.; E. anakin sp. nov.; E. vader sp. nov.; E. omegarugal sp. nov.; E. zelda sp. nov.; E. dookan sp. nov. and E. mauru sp. nov., all from Brazil.
Separating the Indian and Pacific Ocean Impacts on the Euro-Atlantic Response to ENSO and Its Transition from Early to Late Winter
Authors: Abid Muhammad Adnan , Kucharski Fred , Molteni Franco , Kang In-Sik , Tompkins Adrian M. , Almazroui Mansour
Published: November 2020

The present study focuses on the mechanism that controls the transition of the Euro-Atlantic circulation responses to El Niño–Southern Oscillation (ENSO) from early (December) to late winter (February) for the period 1981–2015. A positive phase of ENSO induces a precipitation dipole with increased precipitation in the western and reduced precipitation in the eastern tropical Indian Ocean; this occurs mainly during early winter (December) and less so in late winter (February). It is shown that these interbasin atmospheric teleconnections dominate the response in the Euro-Atlantic sector in early winter by modifying the subtropical South Asian jet (SAJET) and forcing a wavenumber-3 response that projects spatially onto the positive North Atlantic Oscillation (NAO) pattern. On the contrary, during late winter, the response in the Euro-Atlantic sector is dominated by the well-known ENSO wave train from the tropical Pacific region, involving extratropical anomalies that project spatially on the positive phase of the Pacific–North American (PNA) pattern and the negative phase of the NAO pattern. Numerical experiments with an atmospheric model (an AGCM) forced by an Indian Ocean heating dipole anomaly support the hypothesis that the Indian Ocean modulates the SAJET and enforces the Rossby wave propagation to the Euro-Atlantic region in early winter. These phenomena are also investigated using the ECMWF SEAS5 reforecast dataset. In SEAS5, the ENSO interbasin tropical teleconnections and the response of the Euro-Atlantic circulation anomalies and their change from early to late winter are realistically predicted, although the strength of the early winter signal originated from the Indian Ocean is underestimated.
Triple Disadvantage: Neighborhood Networks of Everyday Urban Mobility and Violence in U.S. Cities
Authors: Levy Brian L. , Phillips Nolan E. , Sampson Robert J.
Published: November 2020

This article develops and assesses the concept of triple neighborhood disadvantage. We argue that a neighborhood’s well-being depends not only on its own socioeconomic conditions but also on the conditions of neighborhoods its residents visit and are visited by, connections that form through networks of everyday urban mobility. We construct measures of mobility-based disadvantage using geocoded patterns of movement estimated from hundreds of millions of tweets sent by nearly 400,000 Twitter users over 18 months. Analyzing nearly 32,000 neighborhoods and 9,700 homicides in 37 of the largest U.S. cities, we show that neighborhood triple disadvantage independently predicts homicides, adjusting for traditional neighborhood correlates of violence, spatial proximity to disadvantage, prior homicides, and city fixed effects. Not only is triple disadvantage a stronger predictor than traditional measures, it accounts for a sizable portion of the association between residential neighborhood disadvantage and homicides. In turn, potential mechanisms such as neighborhood drug activity, interpersonal friction, and gun crime prevalence account for much of the association between triple disadvantage and homicides. These findings implicate structural mobility patterns as an important source of triple (dis)advantage for neighborhoods and have implications for a broad range of phenomena beyond crime, including community capacity, gentrification, transmission in a pandemic, and racial inequality.
Comparison of Patient Satisfaction Between Virtual Visits During the COVID-19 Pandemic and In-person Visits Pre-pandemic
Authors: Itamura Kyohei , Tang Dennis M. , Higgins Thomas S. , Rimell Franklin L. , Illing Elisa A. , Ting Jonathan Y. , Lee Matthew K. , Wu Arthur
Published: November 2020

Objective:

To compare the patient experience of a virtual otolaryngology clinic visit to an in-person visit, especially with its significantly increased implementation during the COVID-19 pandemic.

Methods:

Patient satisfaction (PS) metrics from the Clinician and Group Consumer Assessment of Healthcare Providers and Systems survey were queried from March 1, 2020 to May 1, 2020 for telehealth visits and January 1, 2020 to March 1, 2020 for in-person visits. Overlapping and comparable questions were analyzed using Mann-Whitney U test, Chi-square test for independence, and Student’s t-test.

Results:

There were 1284 partial or complete PS surveys from in-person visits and 221 partial or complete virtual PS surveys. There were statistically significantly worse virtual visit evaluations of provider listening, conveyance of information, likelihood to recommend, and overall provider ratings compared to in-person visits.

Conclusion:

Telehealth has become the new norm for most healthcare providers in the United States. This study demonstrates some of the initial shortcomings of telehealth in an otolaryngology practice and identifies challenges with interpersonal communication that may need to be addressed as telehealth becomes increasingly prevalent.

Level of Evidence:

3.