bluuebunny/crossref_metadata_2025 huggingface dataset:
Global Network Organization of the Fetal Functional Connectome
Authors: De Asis-Cruz Josepheen , Andersen Nicole , Kapse Kushal , Khrisnamurthy Dhineshvikram , Quistorff Jessica , Lopez Catherine , Vezina Gilbert , Limperopoulos Catherine
Published: December 2020

Recent advances in brain imaging have enabled non-invasive in vivo assessment of the fetal brain. Characterizing brain development in healthy fetuses provides baseline measures for identifying deviations in brain function in high-risk clinical groups. We examined 110 resting state MRI data sets from fetuses at 19 to 40 weeks’ gestation. Using graph-theoretic techniques, we characterized global organizational features of the fetal functional connectome and their prenatal trajectories. Topological features related to network integration (i.e., global efficiency) and segregation (i.e., clustering) were assessed. Fetal networks exhibited small-world topology, showing high clustering and short average path length relative to reference networks. Likewise, fetal networks’ quantitative small world indices met criteria for small-worldness (σ > 1, ω = [−0.5 0.5]). Along with this, fetal networks demonstrated global and local efficiency, economy, and modularity. A right-tailed degree distribution, suggesting the presence of central areas that are more highly connected to other regions, was also observed. Metrics, however, were not static during gestation; measures associated with segregation—local efficiency and modularity—decreased with advancing gestational age. Altogether, these suggest that the neural circuitry underpinning the brain’s ability to segregate and integrate information exists as early as the late 2nd trimester of pregnancy and reorganizes during the prenatal period.

Significance statement.

Mounting evidence for the fetal origins of some neurodevelopmental disorders underscores the importance of identifying features of healthy fetal brain functional development. Alterations in prenatal brain connectomics may serve as early markers for identifying fetal-onset neurodevelopmental disorders, which in turn provide improved surveillance of at-risk fetuses and support the initiation of early interventions.
A comparative analysis of premature heart disease- and cancer-related mortality in women in the USA, 1999–2018
Authors: Khan Safi U , Yedlapati Siva H , Lone Ahmad N , Khan Muhammad Shahzeb , Wenger Nanette K , Watson Karol E , Gulati Martha , Hays Allison G , Michos Erin D
Published: December 2020

Aims

To compare premature heart disease- and cancer-related deaths in women in the USA.

Methods and results

We analysed the US national database of death certificates of women aged <65 from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research database between 1999 and 2018. We measured annual percentage changes (APCs) in age-adjusted mortality rates (AAMRs) and years of potential life lost per 100 000 persons due to heart disease and cancer. Overall, cancer was a more prevalent cause of premature death compared with heart disease. Between 1999 and 2018, the AAMRs decreased for both cancer (61.9/100 000 to 45.6/100 000) and heart disease (29.2/100 000 to 22.6/100 000). However, while APC in AAMR for cancer declined consistently over time, after an initial decline, APC in AAMR for heart disease increased between 2010 and 2018 [0.53 95% confidence interval (0.18–0.89)], with a significant rise in Midwest, medium/small metros, and rural areas after 2008. Compared with cancer, APC in AAMR for heart disease increased in women aged 25–34 years [2.24 (0.30–4.22); 2013–18) and 55–64 years [0.46 (0.13–0.80); 2009–13], as well as Non-Hispanic (NH) Whites [APC, 0.79 (0.46–1.13); 2009–18] and NH American Indian/Alaskan Native [2.71 (0.59–4.87); 2011–2018]. Consequently, the mortality gap between cancer and heart disease has narrowed from an AAMR of 32.7/100 000 to 23.0/100 000.

Conclusions

The mortality gap between cancer and heart disease is decreasing among women <65 years. Intensive cardiovascular health interventions are required focusing on vulnerable young demographic subgroups and underserved regional areas to meet the American Heart Association’s Impact Goal and Million Hearts Initiative.
d-Tartrate utilization correlates with phylogenetic subclade inPseudomonas cichorii
Authors: Iiyama Kazuhiro , Tani Sayo , Yagi Haruka , Hashimoto Sara , Suga Yasuhiro , Tsuchiya Kenichi , Furuya Naruto
Published: December 2020

Pseudomonas cichorii is divided into two subclades based on the 16S ribosomal RNA gene sequence and core genome multilocus sequence typing. It was shown that subclade 2 strains utilize d-tartrate as a sole carbon source, whereas subclade 1 strains do not. Draft genome sequencing was performed with P. cichorii strains to identify d-tartrate utilization genes. By genome comparative and homology search studies, an ∼7.1-kb region was identified to be involved in d-tartrate utilization. The region is subclade 2 specific, and contains tarD and dctA genes, which encode a putative enzyme and transporter of d-tartrate, respectively. When the region was introduced into subclade 1 strains, the transformants were able to utilize d-tartrate. Partial fragments of tarD and dctA were amplified from all subclade 2 strains tested in this study by PCR using gene-specific primers, but not from subclade 1 strains. This is the first report on the genetic analysis of biochemical characteristics corresponding to a specific phylogenetic group in P. cichorii.
Multitemporal hyperspectral tree species classification in the Białowieża Forest World Heritage site
Authors: Modzelewska Aneta , Kamińska Agnieszka , Fassnacht Fabian Ewald , Stereńczak Krzysztof
Published: December 2020

Tree species composition maps derived from hyperspectral data have been found to be accurate but it is still unclear whether an optimal time window exists to acquire the images. Trees in temperate forests are subject to phenological changes that are species-specific and can have an impact on species recognition. Our study examined the performance of a multitemporal hyperspectral dataset to classify tree species in the Polish part of the Białowieża Forest. We classified seven tree species including spruce (Picea abies (L.) H.Karst), pine (Pinus sylvestris L.), alder (Alnus glutinosa Gaertn.), oak (Quercus robur L.), birch (Betula pendula Roth), hornbeam (Carpinus betulus L.) and linden (Tilia cordata Mill.), using Support Vector Machines. We compared the results for three data acquisitions—early and late summer (2–4 July and 24–27 August), and autumn (1–2 October) as well as a classification based on an image stack containing all three acquisitions. Furthermore, the sizes (height and crown diameter) of misclassified and correctly classified trees of the same species were compared. The early summer acquisition reached the highest accuracies with an Overall Accuracy (OA) of 83–94 per cent and Kappa (κ) of 0.80–0.92. The classification based on the stacked multitemporal dataset resulted in slightly higher accuracies (84–94 per cent OA and 0.81–0.92 κ). For some species, e.g. birch and oak, tree size differed notably for correctly and incorrectly classified trees. We conclude that implementing multitemporal hyperspectral data can improve the classification result as compared with a single acquisition. However, the obtained accuracy of the multitemporal image stack was in our case comparable to the best single-date classification and investing more time in identifying regionally optimal acquisition windows may be worthwhile as long hyperspectral acquisitions are still sparse.
Predictors of lymph-node metastasis in surgically resected T1 colorectal cancer in Western populations
Authors: Zong Zhen , Li Hui , Hu Ce-Gui , Tang Fu-Xin , Liu Zhi-Yang , Deng Peng , Zhou Tai-Cheng , Yi Cheng-Hao
Published: December 2020

Background

The risk of lymph-node metastasis (LNM) in T1 colorectal cancer (CRC) has not been well documented in heterogeneous Western populations. This study investigated the predictors of LNM and the long-term outcomes of patients by analysing T1 CRC surgical specimens and patients’ demographic data.

Methods

Patients with surgically resected T1 CRC between 2004 and 2014 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Patients with multiple primary cancers, with neoadjuvant therapy, or without a confirmed histopathological diagnosis were excluded. Multivariate logistic-regression analysis was used to identify the predictors of LNM.

Results

Of the 22,319 patients, 10.6% had a positive lymph-node status based on the final pathology (nodal category: N1 9.6%, N2 1.0%). Younger age, female sex, Asian or African-American ethnicity, poor differentiation, and tumor site outside the rectum were significantly associated with LNM. Subgroup analyses for patients stratified by tumor site suggested that the rate of positive lymph-node status was the lowest in the rectum (hazard ratio: 0.74; 95% confidence interval: 0.63–0.86).

Conclusion

The risk of LNM was potentially lower in Caucasian patients than in API or African-American patients with surgically resected T1 CRC. Regarding the T1 CRC site, the rectum was associated with a lower risk of LNM.
Polygenic Risk Score of Longevity Predicts Longer Survival Across an Age Continuum
Authors: Tesi Niccolo’ , van der Lee Sven J , Hulsman Marc , Jansen Iris E , Stringa Najada , van Schoor Natasja M , Scheltens Philip , van der Flier Wiesje M , Huisman Martijn , Reinders Marcel J T , Holstege Henne
Published: December 2020

Studying the genome of centenarians may give insights into the molecular mechanisms underlying extreme human longevity and the escape of age-related diseases. Here, we set out to construct polygenic risk scores (PRSs) for longevity and to investigate the functions of longevity-associated variants. Using a cohort of centenarians with maintained cognitive health (N = 343), a population-matched cohort of older adults from 5 cohorts (N = 2905), and summary statistics data from genome-wide association studies on parental longevity, we constructed a PRS including 330 variants that significantly discriminated between centenarians and older adults. This PRS was also associated with longer survival in an independent sample of younger individuals (p = .02), leading up to a 4-year difference in survival based on common genetic factors only. We show that this PRS was, in part, able to compensate for the deleterious effect of the APOE-ε4 allele. Using an integrative framework, we annotated the 330 variants included in this PRS by the genes they associate with. We find that they are enriched with genes associated with cellular differentiation, developmental processes, and cellular response to stress. Together, our results indicate that an extended human life span is, in part, the result of a constellation of variants each exerting small advantageous effects on aging-related biological mechanisms that maintain overall health and decrease the risk of age-related diseases.
Obtaining Information From Different Sources Matters During the COVID-19 Pandemic
Authors: Chu Li , Fung Helene H , Tse Dwight C K , Tsang Vivian H L , Zhang Hanyu , Mai Chunyan
Published: December 2020

Background and Objectives

Older adults might be less information-seeking in comparison to younger adults. Yet, when a crisis hits, rather than relying on only a few information sources, it is important for people to gather information from a variety of different sources. With more information sources, people are more likely to obtain a more realistic perception of the situation and engagement of health behaviors. This study examined the association between age and information-seeking patterns, and how information-seeking patterns influenced worry about coronavirus disease 2019 (COVID-19) and protective measures taken during the pandemic.

Research Design and Methods

This study was conducted from March to May 2020. Ninety younger adults and 105 older adults were recruited in a 21-day daily diary study. Participants reported the types of sources where they received COVID-19-related information, worry from these information sources and protective health behaviors performed each day. Multilevel serial mediation analysis was performed.

Results

Concurrent and time-lagged analyses both revealed that older adults received information from more sources, and more frequently from traditional (e.g., newspaper and TV) and interpersonal sources (e.g., information shared by friends and families), than did younger adults. When receiving information from more sources, older adults were more worried about COVID-19 and performed more protective health behaviors.

Discussion and Implications

These results demonstrated the utility of having more information sources in the context of a public health crisis and offered suggestions for future public communication and community engagement.
Permanently Online—Always Stressed Out? The Effects of Permanent Connectedness on Stress Experiences
Authors: Freytag Anna , Knop-Huelss Katharina , Meier Adrian , Reinecke Leonard , Hefner Dorothée , Klimmt Christoph , Vorderer Peter
Published: December 2020

Concerns have been expressed that permanent online connectedness might negatively affect media user’s stress levels. Most research has focused on negative effects of specific media usage patterns, such as media multitasking or communication load. In contrast, users’ cognitive orientation toward online content and communication has rarely been investigated. Against this backdrop, we examined whether this cognitive orientation (i.e., online vigilance with its three dimensions salience, reactibility, monitoring) is related to perceived stress at different timescales (person, day, and situation level), while accounting for the effects of multitasking and communication load. Results across three studies showed that, in addition to multitasking (but not communication load), especially the cognitive salience of online communication is positively related to stress. Our findings are discussed regarding mental health implications and the origins of stress.
Repeat length increases disease penetrance and severity in C9orf72 ALS/FTD BAC transgenic mice
Authors: Pattamatta Amrutha , Nguyen Lien , Olafson Hailey R , Scotti Marina M , Laboissonniere Lauren A , Richardson Jared , Berglund J Andrew , Zu Tao , Wang Eric T , Ranum Laura P W
Published: December 2020

C9orf72 ALS/FTD patients show remarkable clinical heterogeneity, but the complex biology of the repeat expansion mutation has limited our understanding of the disease. BAC transgenic mice were used to better understand the molecular mechanisms and repeat length effects of C9orf72 ALS/FTD. Genetic analyses of these mice demonstrate that the BAC transgene and not integration site effects cause ALS/FTD phenotypes. Transcriptomic changes in cell proliferation, inflammation and neuronal pathways are found late in disease and alternative splicing changes provide early molecular markers that worsen with disease progression. Isogenic sublines of mice with 800, 500 or 50 G4C2 repeats generated from the single-copy C9–500 line show longer repeats result in earlier onset, increased disease penetrance and increased levels of RNA foci and dipeptide RAN protein aggregates. These data demonstrate G4C2 repeat length is an important driver of disease and identify alternative splicing changes as early biomarkers of C9orf72 ALS/FTD.
What Factors Drive Transport and Logistics Costs in Africa?
Authors: Plane Patrick
Published: December 2020

We analyze the domestic transport and logistics costs of importing a 20-foot container into Africa. We run regressions on a panel of 50 African countries for the period 2006–2014 using the RE-2SLS estimator. Distance from port of arrival to the point of delivery is an important explanatory factor of cost. Time-varying variables yield additional and valuable information. Reducing processing times and adjusting the ratio of the purchasing power parity conversion factor to the market exchange rate would contribute to save on the cost to import.
The impact of time spent on the electronic health record after work and of clerical work on burnout among clinical faculty
Authors: Peccoralo Lauren A , Kaplan Carly A , Pietrzak Robert H , Charney Dennis S , Ripp Jonathan A
Published: December 2020

Objective

To identify specific thresholds of daily electronic health record (EHR) time after work and daily clerical time burden associated with burnout in clinical faculty.

Materials and Methods

We administered an institution-wide survey to faculty in all departments at Mount Sinai Health System from November 2018 to February 2019. The Maslach Burnout Inventory and Mayo Well-Being Index assessed burnout. Demographics, possible confounding variables, and time spent on EHR work/clerical burden were assessed.

Results

Of 4156 eligible faculty members, 1781(42.9%) participated in the survey. After adjustment for background factors, EHR frustration (odds ratio [OR]=1.64–1.66), spending >90 minutes on EHR-outside the workday by self-report (OR = 1.41–1.90) and >1 hour of self-reported clerical work/day (OR = 1.39) were associated with burnout. Reporting that one’s practice unloads clerical burden (OR = 0.50–0.66) and higher resilience scores (OR = 0.77–0.84) were negatively associated with burnout.

Spending >90 minutes/day on EHR-outside work (OR = 0.66–0.67) and >60 minutes/day on clerical work (OR = 0.54–0.58) was associated with decreased likelihood of satisfactory work–life integration (WLI) and professional satisfaction (PS). Greater meaning in work was associated with an increased

likelihood

of achieving WLI (OR = 2.51) and PS (OR = 21.67).

Conclusion

Results suggest there are thresholds of excessive time on the EHR-outside the workday (>90 minutes) and overall clerical tasks (>60 minutes), above which clinical faculty may be at increased risk for burnout, as well as reduced WLI and PS, independent of demographic characteristics and clinical work hours. These thresholds of EHR and clerical burden may inform interventions aimed at mitigating this burden to reduce physician burnout.
Evaluating human–coyote encounters in an urban landscape using citizen science
Authors: Drake David , Dubay Shelli , Allen Maximilian L
Published: December 2020

Coyotes are ubiquitous in habitats across North America, including in urban areas. Reviews of human–coyote encounters are limited in scope and analysis and predominantly document encounters that tend to be negative, such as human–wildlife conflict, rather than benign experiences. The objective of our study was to use citizen science reports of human–coyote interactions entered into iNaturalist to better understand the range of first person accounts of human–coyote encounters in Madison, WI. We report 398 citizen science accounts of human–coyote encounters in the Madison area between October 2015 and March 2018. Most human–coyote encounters occurred during coyote breeding season and half of all encounters occurred in moderate development land cover. Estimated level of coyote aggressiveness varied significantly, with 90% of citizen scientists scoring estimated coyote aggression as a 0 and 7% scoring estimated aggression as a 1 on a 0–5 scale (with 0 being calm and 5 being aggressive). Our best performing model explaining the estimated distance between the human observer and a coyote (our proxy for a human–coyote encounter) included the variables distance to nearest paved road, biological season of the year relative to coyote life history, and time of day/night. We demonstrate that human–coyote interactions are regularly more benign than negative, with almost all first-hand reported human–coyote encounters being benign. We encourage public outreach focusing on practices that can foster benign encounters when educating the public to facilitate human–coyote coexistence.
Algorithmic properties of first-order superintuitionistic logics of finite Kripke frames in restricted languages
Authors: Rybakov Mikhail , Shkatov Dmitry
Published: December 2020

We consider the effect of restricting the number of individual variables, as well as the number and arity of predicate letters, in languages of first-order predicate superintuitionistic logics of finite Kripke frames on the logics’ algorithmic properties. By a finite frame we mean a frame with a finite set of possible worlds. The languages we consider have no constants, function symbols or the equality symbol. We show that positive fragments of many predicate superintuitionistic logics of natural classes of finite Kripke frames are not recursively enumerable—more precisely, $\varPi ^0_1$-hard—in languages with three individual variables and a single monadic predicate letter; this applies to the logics of finite frames of the predicate counterparts of propositional logics lying between the intuitionistic logic and the logic of the weak law of the excluded middle.
The phase-space structure of dark matter haloes
Authors: Aung Han , Nagai Daisuke , Rozo Eduardo , García Rafael
Published: December 2020

The phase space structure of dark matter haloes can be used to measure the mass of the halo, infer mass accretion rates, and probe the effects of modified gravity. Previous studies showed that the splashback radius can be measured in position space using a sharp drop in the density profile. Using N-body simulations, we model the distribution of the kinematically distinct infalling and orbiting populations of subhaloes and haloes. We show that the two are mixed spatially all the way to redge, which extends past the splashback radius defined by the drop in the spherically averaged density profile. This edge radius can be interpreted as a radius that contains a fixed fraction of the apocentres of dark matter particles. Our results highlight the possibility of measuring the outer boundary of a dark matter halo using its phase space structure and provide a firm theoretical foundation to the satellite galaxy model adopted in the companion paper, where we analysed the phase space distribution of Sloan Digital Sky Survey redMaPPer clusters.
A Preliminary Overview of Music Therapy Reimbursement Practice in the United States
Authors: Sena Moore Kimberly , Peebles Laurie
Published: December 2020

Music therapy services are currently being reimbursed through state and private insurance funding streams, yet to date, there is no known systematic exploration on music therapy reimbursement practices. Such information would be helpful to include when communicating with third-party payers and can assist in tracking reimbursement trends. Thus, we sought to provide baseline information on how music therapy services are currently being reimbursed in the United States, with a focus on approved treatment parameters, referral sources, Current Procedural Terminology (CPT) codes used, and types of music interventions and music therapy experiences implemented. Board-certified music therapists in private practice who had successfully obtained reimbursement for music therapy services between 2012 and 2018 completed a 28-item online survey. In total, 7 respondents provided information on 55 unique reimbursement cases from 5 different states, most of which were based on Medicaid waiver programs. We conducted descriptive analyses to summarize music therapy reimbursement practices. Most of the clients were referred by doctors or physician’s assistants. The most common CPT code utilized was 97530 (Therapeutic Activities, one-on-one, each 15 minutes), and most of the International Classification of Diseases, 10th Revision (ICD-10) diagnostic codes were based on specific diagnoses rather than general clinical needs. In most of the cases, reimbursement of music therapy was ongoing, and services incorporated a variety of music therapy methods, with few specific music interventions identified. Most notably, reimbursement practice varied by state; thus, we recommend the creation and dissemination of state-specific surveys.
Aggregation-induced emission luminogens reveal cell cycle-dependent telomerase activity in cancer cells
Authors: Wu Xia , Wu Jun , Dai Jun , Chen Biao , Chen Zhe , Wang Shixuan , Wu Feng , Lou Xiaoding , Xia Fan
Published: December 2020

Telomerase acts as an important biomarker for tumor identification, and synthesizes telomeric repeats at the end of chromosome telomeres during the replicative phase of the cell cycle; thus, the expression level of telomerase changes as the cell cycle progresses. TERT mRNA expression and telomerase activity were significantly increased in over 80% of human cancers from tissue specimens. Although many efforts have been made in detecting the activity of TERT mRNA and active telomerase, the heterogeneous behavior of the cell cycle was overlooked, which might affect the accuracy of the detection results. Herein, the AIEgen-based biosensing systems of PyTPA-DNA and Silole-R were developed to detect the cellular level of TERT mRNA and telomerase in different cell cycles. As a result, the fluorescence signal of cancer cells gradually increased from G0/G1, G1/S to S phase. In contrast, both cancer cells arrested at G2/M phase and normal cells exhibited negligible fluorescence intensities. Compared to normal tissues, malignant tumor samples demonstrated a significant turn-on fluorescence signal. Furthermore, the transcriptomics profiling revealed that tumor biomarkers changed as the cell cycle progressed and biomarkers of CA9, TK1 and EGFR were more abundantly expressed at early S stage. In this vein, our study presented advanced biosensing tools for more accurate analysis of the cell-cycle-dependent activity of TERT mRNA and active telomerase in clinical tissue samples.
Clinical Accuracy, Technical Precision, and Workflow of the First in Human Use of an Augmented-Reality Head-Mounted Display Stereotactic Navigation System for Spine Surgery
Authors: Molina Camilo A , Sciubba Daniel M , Greenberg Jacob K , Khan Majid , Witham Timothy
Published: December 2020

BACKGROUND

Augmented reality mediated spine surgery is a novel technology for spine navigation. Benchmark cadaveric data have demonstrated high accuracy and precision leading to recent regulatory approval. Absence of respiratory motion in cadaveric studies may positively bias precision and accuracy results and analogous investigations are prudent in live clinical scenarios.

OBJECTIVE

To report a technical note, accuracy, precision analysis of the first in-human deployment of this technology.

METHODS

A 78-yr-old female underwent an L4-S1 decompression, pedicle screw, and rod fixation for degenerative spine disease. Six pedicle screws were inserted via AR-HMD (xvision; Augmedics, Chicago, Illinois) navigation. Intraoperative computed tomography was used for navigation registration as well as implant accuracy and precision assessment. Clinical accuracy was graded per the Gertzbein-Robbins (GS) scale by an independent neuroradiologist. Technical precision was analyzed by comparing 3-dimensional (3D) (x, y, z) virtual implant vs real implant position coordinates and reported as linear (mm) and angular (°) deviation. Present data were compared to benchmark cadaveric data.

RESULTS

Clinical accuracy (per the GS grading scale) was 100%. Technical precision analysis yielded a mean linear deviation of 2.07 mm (95% CI: 1.62-2.52 mm) and angular deviation of 2.41° (95% CI: 1.57-3.25°). In comparison to prior cadaveric data (99.1%, 2.03 ± 0.99 mm, 1.41 ± 0.61°; GS accuracy 3D linear and angular deviation, respectively), the present results were not significantly different (P > .05).

CONCLUSION

The first in human deployment of the single Food and Drug Administration approved AR-HMD stereotactic spine navigation platform demonstrated clinical accuracy and technical precision of inserted hardware comparable to previously acquired cadaveric studies.
Detection of the hard X-ray non-thermal emission from Kepler’s supernova remnant
Authors: Nagayoshi Tsutomu , Bamba Aya , Katsuda Satoru , Terada Yukikatsu
Published: December 2020

We report the first robust detection of the hard X-ray emission in the 15–30 keV band from Kepler’s supernova remnant with the silicon PIN-type semiconductor detector of the hard X-ray detector (HXD-PIN) onboard Suzaku. The detection significance is 7.17σ for the emission from Kepler’s entire X-ray emitting region. The energy spectrum is found to be well reproduced by a single power-law function with a photon index of $3.13^{+1.85+0.69}_{-1.52-0.36}$, where the first and second errors represent $90\%$-statistical and systematic errors, respectively. The X-ray flux is determined to be $2.75_{-0.77-0.82}^{+0.78+0.81}\times 10^{-12}\:$erg s−1 cm−2 in the 15–30 keV band. The wider-band X-ray spectrum in the 3–30 keV band, where the soft X-ray Suzaku/XIS spectrum is combined, shows that the non-thermal component does not have a significant X-ray roll-off structure. We find that the broad-band energy spectrum from the radio band, X-ray data of this work, and TeV upper limits can be reproduced with the one-zone leptonic model with a roll-off energy of νroll = 1.0 × 1017 Hz and magnetic field strength of B > 40 μG. Application of the diagnostic method using indices in the soft and hard X-ray band to the data indicates that the maximum energy of the accelerated electrons in Kepler’s SNR is limited by the age of the remnant. The indication is consistent with the results of the one-zone leptonic modeling.
Estimating frontline health workforce for primary healthcare service delivery in Bauchi State, Nigeria
Authors: Okoroafor S C , Ongom M , Mohammed B , Salihu D , Ahmat A , Osubor M , Nyoni J , Dayyabu H , Alemu W
Published: December 2020

Background

In Nigeria, adoption of the primary healthcare approach led to the establishment of numerous primary healthcare facilities, and training of new cadres of community health officers (CHOs), community health extension workers (CHEWs) and junior community health extension workers (JCHEWs). These new groups complemented the work of nurses and midwives.

Methods

We conducted a workload indicators of staffing needs study in the 20 local governments of Bauchi State, from March 2016 to September 2018, in all 317 ward-level primary healthcare facilities.

Results

Findings show a total of 128 existing nurses/midwives, a calculated requirement of 402 and a shortage of 274 nurses/midwives. Existing CHOs/CHEWs were 735, a calculated requirement was 948 and a shortage of 213 CHOs/CHEWs. The JCHEWs were 477, a calculated requirement of 481, with a shortage of four JCHEWs.

Conclusion

Results from this study highlight the unequal distribution of health workers; the abundance of some frontline workers in some communities and dire need of others. We emphasize the need to strengthen health workforce planning to deliver essential primary healthcare services, particularly in rural and remote communities with high levels of vulnerability to diseases.
Of ensuring equitable participation of persons with disabilities during the COVID-19 pandemic
Authors: Medallon Kim Gerald G
Published: December 2020

The recent pandemic has affected everyone’s participation to their meaningful tasks that shape one’s role and overall identity. Such situation tends to be more complex and challenging for persons with disabilities whose participation to the social and economic fabric of one’s community has been limited even prior to the pandemic due to ongoing attitudinal barriers. The call towards a more inclusive and responsive healthcare service delivery, which includes rehabilitation programs, should be institutionalized in order for them to have an access and a fair chance to participate and to contribute despite the restrictions of the pandemic.
Situated Causality: What Ethnography Can Contribute to Causal Inquiry in Social Work
Authors: Mathias John , Doering-White John , Smith Yvonne , Hardesty Melissa
Published: December 2020

This article considers how ethnography can contribute to developing causal theories relevant to social work practice. Social work researchers typically reserve causal inferences for studies that rely on certain quantitative study designs, and ethnography tends to be seen as insufficient for making causal claims. Integrating data from three ethnographies of social work practice, this article posits that ethnography is particularly well equipped to (a) identify causal processes that do not fit existing academic theories, (b) document causal theories implicit in social action, and (c) examine how competing causal theories are contested. Such contributions can enrich causal inquiry that has traditionally prioritized prediction (what is the likelihood of this happening?) over explanation (how does this work?). This is consistent with recent calls for attention to causal mechanisms in implementation science and other fields. Ethnography can expand the causal vocabulary of social work research, bringing depth and nuance to causal theories while also making these theories more amenable to uptake by practitioners.
UV-B-induced molecular mechanisms of stress physiology responses in the major northern Chinese coniferPinus tabuliformisCarr.
Authors: Xu Jie , Nie Shuai , Xu Chao-Qun , Liu Hui , Jia Kai-Hua , Zhou Shan-Shan , Zhao Wei , Zhou Xian-Qing , El-Kassaby Yousry A , Wang Xiao-Ru , Porth Ilga , Mao Jian-Feng
Published: December 2020

During their lifetimes, plants are exposed to different abiotic stress factors eliciting various physiological responses and triggering important defense processes. For UV-B radiation responses in forest trees, the genetics and molecular regulation remain to be elucidated. Here, we exposed Pinus tabuliformis Carr., a major conifer from northern China, to short-term high-intensity UV-B and employed a systems biology approach to characterize the early physiological processes and the hierarchical gene regulation, which revealed a temporal transition from primary to secondary metabolism, the buildup of enhanced antioxidant capacity and stress-signaling activation. Our findings showed that photosynthesis and biosynthesis of photosynthetic pigments were inhibited, while flavonoids and their related derivates biosynthesis, as well as glutathione and glutathione S-transferase mediated antioxidant processes, were enhanced. Likewise, stress-related phytohormones (jasmonic acid, salicylic acid and ethylene), kinase and reactive oxygen species signal transduction pathways were activated. Biological processes regulated by auxin and karrikin were, for the first time, found to be involved in plant defense against UV-B by promoting the biosynthesis of flavonoids and the improvement of antioxidant capacity in our research system. Our work evaluated the physiological and transcriptome perturbations in a conifer’s response to UV-B, and generally, highlighted the necessity of a systems biology approach in addressing plant stress biology.
Occupational respiratory and skin diseases among workers exposed to metalworking fluids
Authors: Nett Randall J. , Stanton Marcia , Grimes George R.
Published: December 2020

Purpose of review

To examine respiratory and skin diseases that occur among workers exposed to metalworking fluids (MWFs) used during machining processes.

Recent findings

Five cases of a severe and previously unrecognized lung disease characterized by B-cell bronchiolitis and alveolar ductitis with emphysema (BADE) were identified among workers at a machining facility that used MWFs, although MWF exposure could not be confirmed as the etiology. In the United Kingdom, MWF is now the predominant cause of occupational hypersensitivity pneumonitis (HP). Under continuous conditions associated with respiratory disease outbreaks, over a working lifetime of 45 years, workers exposed to MWF at 0.1 mg/m3 are estimated to have a 45.3% risk of acquiring HP or occupational asthma under outbreak conditions and a 3.0% risk assuming outbreak conditions exist in 5% of MWF environments. In addition to respiratory outcomes, skin diseases such as allergic and irritant contact dermatitis persist as frequent causes of occupational disease following MWF exposure.

Healthcare providers need to consider MWF exposure as a potential cause for work-related respiratory and skin diseases. Additional work is necessary to more definitively characterize any potential association between MWF exposures and BADE. Medical surveillance should be implemented for workers regularly exposed to MWF.
Allergy prevention through breastfeeding
Authors: Mennini Maurizio , Arasi Stefania , Fiocchi Alessandro Giovanni
Published: December 2020

Purpose of review

To perform a nonsystematic review of the literature on the role of breastfeeding as primary prevention tool for allergic diseases.

Recent findings

Human milk contains vast amounts of biologically active components that have a significant impact on the development of the gut microbiota. Exclusively breastfed infants show a different microbiota, with a predominance of Bifidobacterium species in their intestines.

The mechanisms underlying the antiallergic effects of human milk are most probably complex, as human milk contains not only nutritional substances but also functional molecules including polysaccharides, cytokines, proteins, and other components which can produce an epigenetic modulation of the innate and adaptive immune responses of the infant in very early life.

Currently, there is not sufficient strong evidence to guarantee its effectiveness in allergy prevention and therefore the main international scientific societies still do not count it among the recognized primary prevention strategies of allergy.
Comparison of Saccadic Eye Movements Among the High-tension Glaucoma, Primary Angle-closure Glaucoma, and Normal-tension Glaucoma
Authors: Ballae Ganeshrao Shonraj , Jaleel Amina , Madicharla Srija , Kavya Sri Vanga , Zakir Juwariah , Garudadri Chandra S. , Senthil Sirisha
Published: December 2020

Précis:

Saccadic eye movements were compared between high-tension glaucoma (HTG), normal-tension glaucoma (NTG), and primary angle-closure glaucoma (PACG). Saccades were differently affected between the subtypes of primary glaucoma.

Aim:

The aim of the study was to compare saccadic eye movements in eyes with HTG, PACG, and NTG.

Methods:

Saccadic eye movements were recorded using the eye tracker Eyelink-1000 in 52 participants: 15 HTG, 14 PACG, 8 NTG, and 15 normal controls. All participants underwent a complete ophthalmic and visual field examination. Prosaccades were measured using the gap paradigm. Prosaccades were measured at 3 target eccentricities (5-, 7-, and 10-degree eccentricity). All prosaccade targets were projected outside the area of visual field defect. Saccade latency, average and peak velocity, and amplitude difference of the saccades were compared between glaucoma subtypes.

Results:

The mean±SD age was lesser in controls compared with glaucoma (P=0.02). The mean age in all the glaucoma subtypes was comparable (P=0.92). The average mean deviation in PACG (−16.66±6.69 dB) was worse (P=0.01) than in HTG (−11.56±6.08 dB) and NTG (−9.55±3.96 dB). The latencies were delayed, average and peak velocities were reduced, and saccades were hypometric in glaucoma compared with controls (P<0.01). Between subtypes, the differences in latency (P<0.01), peak velocity (P=0.02), and amplitude (P=0.02) were significant. Saccadic eye movements were significantly different in NTG compared with other glaucoma subtypes (post hoc analysis; latency (HTG vs. NTG; P<0.01, HTG vs. PACG; P=0.01), peak velocity (HTG vs. NTG; P=0.02) and amplitude difference (HTG vs. NTG; P=0.02).

Conclusions:

Saccadic eye movement parameters were differently affected among the glaucoma subtypes. Saccadic parameters were more affected in NTG.
Bilateral Ocular Ischemic Syndrome in the Setting of Chronic Angle Closure Glaucoma
Authors: Naravane Ameay V. , Mallory Paul W. , Boysen Jess , Koozekanani Dara , Lee Michael S.
Published: December 2020

We report novel case of a 57-year-old woman who developed bilateral ocular ischemic syndrome in the setting of chronic angle closure glaucoma without associated angle neovascularization. Detailed is a course in which markedly prolonged, elevated intraocular pressure led to significantly reduced arterial perfusion at the level of the central retinal artery, leading to the clinical picture of ocular ischemic syndrome.
Fluctuation in Blood Pressure and Intraocular Pressure in Normal Tension Glaucoma Using Ambulatory Monitoring
Authors: Tan Boo Hui , Young Alexandra , Bianchi Eleonora , Brown Lyndsay , Tatham Andrew J.
Published: December 2020

Précis:

Ambulatory blood pressure (BP) and intraocular pressure (IOP) monitoring of patients with normal tension glaucoma (NTG) revealed features of vascular dysregulation including hypertension, blunted nocturnal BP dipping, and morning BP surge.

Purpose:

The aim was to examine ambulatory fluctuations in IOP and BP in patients with NTG.

Methods:

A prospective study of 45 participants with NTG and 10 controls. All participants had a comprehensive ophthalmological examination followed by glaucoma medication washout. Patients using systemic antihypertensives were excluded. IOP and BP were recorded using home monitoring over 48 hours using a self-rebound tonometer and ambulatory blood pressure monitor. BP was recorded every 30 minutes by day and every 60 minutes overnight. IOP was recorded at 09:00, 11:00, 13:00, 16:00, 20:00, and 04:00.

Results:

Participants with NTG had a median mean deviation (MD) of −4.66 dB (interquartile range: −7.16 to −2.81 dB) in the worse eye. Among those with glaucoma, 18 of 45 (40%) had normal nocturnal BP dipping, 24 (53%) blunted dipping and 3 (6.7%) exaggerated dipping. Each 10 mm Hg lower minimum sleeping systolic BP was associated with a 0.9 dB (95% confidence interval: 0.1-1.6 dB) worse MD. Sixteen of 45 participants with glaucoma (35.6%) and 1 of 10 controls (10%) were found to have systemic hypertension on ambulatory blood pressure monitoring and 32 of those with glaucoma (71%) had a surge in morning BP, compared with 5 controls (50%). There was no difference in MD between patients with normal, exaggerated and blunted dipping (P=0.813).

Conclusions:

Though glaucoma has been associated with exaggerated nocturnal BP dipping, we found a higher proportion of patients had systemic hypertension, blunted nocturnal BP dipping, and a morning BP surge, measures also associated with vascular dysregulation.
Smartphone-based Ophthalmic Imaging Compared With Spectral-domain Optical Coherence Tomography Assessment of Vertical Cup-to-disc Ratio Among Adults in Southwestern Uganda
Authors: Idriss Baimba R. , Tran Tu M. , Atwine Daniel , Chang Robert T. , Myung David , Onyango John
Published: December 2020

Precis:

Using optical coherence tomography (OCT) measurements as a reference standard for vertical cup-to-disc ratio (vCDR), a smartphone-based ophthalmic camera has a sensitivity of 67.7% and specificity of 96.7% to detect a vCDR>0.5.

Purpose:

The purpose of this study was to assess the performance of a smartphone-based ophthalmic camera system using an Apple iPhone 6S and an adapter, Paxos Scope, to obtain adequate dilated fundus photos to measure clinically useful vCDR cutoffs.

Patients and Methods:

Adult patients from a government tertiary level eye hospital in Southwestern Uganda were prospectively recruited from January to April 2019. All patients experienced a comprehensive eye examination, dilated posterior segment indirect ophthalmoscope imaging with the Paxos Scope, and spectral-domain OCT imaging with a Cirrus HD-OCT to measure vCDR. Patients’ eyes excluded had media opacities or existing disease precluding a view of the fundus. Fundus images underwent a single masked review to assign vCDR at increments of 0.1. Descriptive statistics, parametric and χ2 tests for significance, repeated measures correlation, κ, receiver operating characteristics curve, and Bland-Altman were used to assess the data.

Results:

Among 467 (consecutive) individuals, fundus photographs acquired with the Paxos Scope demonstrated a 67.7% [95% confidence interval (CI), 63.0-72.0] sensitivity and 96.7% (95% CI, 94.2-98.3) specificity to detect a vCDR>0.5, using OCT as the reference standard. A total of 138 eyes were excluded due to poor imaging acquisition, such as dense cataract, rendering 796 eyes for analysis. The vCDR from graded Paxos Scope images and OCT correlated well with repeated measures correlation of 0.82 (95% CI, 0.77-0.86, P<0.001) and agreement, dichotomized as >0.5 or ≤0.5, was 80.9% (κ=0.63±0.034, P<0.001). Among glaucoma and glaucoma suspects (85 eyes), the sensitivity and specificity dichotomized using vCDR>0.5 were 97.5% (95% CI, 91.3-99.7) and 80.0% (95% CI, 28.4-99.5), respectively. The area under the receiver operating characteristics curve was 0.92 (95% CI, 0.89-0.94) for all eyes and 0.98 (95% CI, 0.78-1.0) for glaucoma and glaucoma suspects.

Conclusions:

The Paxos Scope produced images that can be reliably used to estimate vCDR, which is closely aligned with the automated algorithm from the OCT optic disc cube scan. The low-cost, ready-to-integrate adapter, and minimal training requirements make it a viable option for population-based screening in low-resource settings.
Intracanalicular Vestibular Schwannoma: A Systematic Review and Meta-analysis of Therapeutics Outcomes
Authors: Neves Cavada Marina , Fook-Ho Lee Michael , Jufas Nicholas Emmanuel , Harvey Richard John , Patel Nirmal P.
Published: December 2020

Objective:

To perform a systematic review and meta-analysis summarizing the current evidence on the management of intracanalicular vestibular schwannoma.

Data Sources:

Embase (1947–), Medline (1946–), Cochrane library (1947–), Scopus (2010–), and CINAHL (1961–) were searched from 1969 to October 5, 2019 (50 years).

Study Selection:

A search strategy was performed to identify patients with vestibular schwannoma confined to the internal auditory canal without extension to the cerebellopontine angle. Studies with patients aged less than 18, Neurofibromatosis type 2, revision cases, and non-English language were excluded.

Data Extraction:

A standardized collection sheet was used for the extracted data and a quality assessment was performed using the Newcastle-Ottawa Scale with the comparability criterion omitted.

Data Synthesis:

Seventy-one studies were included with 24 on observation, 14 on radiotherapy, and 34 on surgery. The primary outcome was serviceable hearing preservation. Secondary outcomes were preservation of facial nerve function, growth, involution, and dizziness. Sub-analysis on the type of surgery and type of radiotherapy were performed. Excel 2016 with MIX 2.0 Pro add-on package was used to analyze the data and create forest plots. Data were presented in proportion with a 95% confidence interval.

Conclusions:

Serviceable hearing was observed in 31% of patients after observation, 56% after radiotherapy, and 51% after surgical treatment with mean follow-up time of 4.04 years, 4.92 years, and 2.23 years, respectively. Facial nerve function was found to be best preserved in both observation and radiotherapy groups. Vestibular schwannoma growth occurred in 33% of patients under observation. Involution occurred in 2% of patients under observation and in 38% after radiotherapy.