bluuebunny/crossref_metadata_2025 huggingface dataset:
Extracellular vesicles from immortalized cardiosphere-derived cells attenuate arrhythmogenic cardiomyopathy in desmoglein-2 mutant mice
Authors: Lin Yen-Nien , Mesquita Thassio , Sanchez Lizbeth , Chen Yin-Huei , Liu Weixin , Li Chang , Rogers Russell , Wang Yizhou , Li Xinling , Wu Di , Zhang Rui , Ibrahim Ahmed , Marbán Eduardo , Cingolani Eugenio
Published: June 2021

Aims

Arrhythmogenic cardiomyopathy (ACM) is characterized by progressive loss of cardiomyocytes, and fibrofatty tissue replacement. Extracellular vesicles (EVs) secreted by cardiosphere-derived cells, immortalized, and engineered to express high levels of β-catenin, exert anti-inflammatory, and anti-fibrotic effects. The aim of the current study was to assess efficacy of EVs in an ACM murine model.

Methods and results

Four-week-old homozygous knock-in mutant desmoglein-2 (Dsg2mt/mt) were randomized to receive weekly EVs or vehicle for 4 weeks. After 4 weeks, DSG2mt/mt mice receiving EVs showed improved biventricular function (left, P < 0.0001; right, P = 0.0037) and less left ventricular dilation (P < 0.0179). Electrocardiography revealed abbreviated QRS duration (P = 0.0003) and QTc interval (P = 0.0006) in EV-treated DSG2mt/mt mice. Further electrophysiology testing in the EV group showed decreased burden (P = 0.0042) and inducibility of ventricular arrhythmias (P = 0.0037). Optical mapping demonstrated accelerated repolarization (P = 0.0290) and faster conduction (P = 0.0274) in Dsg2mt/mt mice receiving EVs. DSG2mt/mt hearts exhibited reduced fibrosis, less cell death, and preserved connexin 43 expression after EV treatment. Hearts of Dsg2mt/mt mice expressed markedly increased levels of inflammatory cytokines that were, in part, attenuated by EV therapy. The pan-inflammatory transcription factor nuclear factor-κB (NF-κB), the inflammasome sensor NLRP3, and the macrophage marker CD68 were all reduced in EV-treated animals. Blocking EV hsa-miR-4488 in vitro and in vivo reactivates NF-κB and blunts the beneficial effects of EVs.

Conclusions

Extracellular vesicle treatment improved cardiac function, reduced cardiac inflammation, and suppressed arrhythmogenesis in ACM. Further studies are needed prior to translating the present findings to human forms of this heterogenous disease.
Cumulated burden of COVID-19 in Spain from a Bayesian perspective
Authors: Moriña David , Fernández-Fontelo Amanda , Cabaña Alejandra , Arratia Argimiro , Ávalos Gustavo , Puig Pedro
Published: June 2021

Background

The main goal of this work is to estimate the actual number of cases of COVID-19 in Spain in the period 31 January 2020 to 01 June 2020 by Autonomous Communities. Based on these estimates, this work allows us to accurately re-estimate the lethality of the disease in Spain, taking into account unreported cases.

Methods

A hierarchical Bayesian model recently proposed in the literature has been adapted to model the actual number of COVID-19 cases in Spain.

Results

The results of this work show that the real load of COVID-19 in Spain in the period considered is well above the data registered by the public health system. Specifically, the model estimates show that, cumulatively until 1 June 2020, there were 2 425 930 cases of COVID-19 in Spain with characteristics similar to those reported (95% credibility interval: 2 148 261–2 813 864), from which were actually registered only 518 664.

Conclusions

Considering the results obtained from the second wave of the Spanish seroprevalence study, which estimates 2 350 324 cases of COVID-19 produced in Spain, in the period of time considered, it can be seen that the estimates provided by the model are quite good. This work clearly shows the key importance of having good quality data to optimize decision-making in the critical context of dealing with a pandemic.
Novel auto-selection systems for transformation selection of Saccharomyces cerevisiae in rich complex media
Authors: Höler Sebastian , Bertl Adam , Degreif Daniel
Published: June 2021

The most widely used strategy for selection of yeast transformed with episomal plasmids comprises the use of auxotrophic yeast strains in combination with vectors containing complementing prototrophic marker genes. Another approach uses heterologous genes or cassettes which, if present in the vector, render the otherwise sensitive yeast strain resistant to antibiotics. In addition, auto-selection systems for Saccharomyces cerevisiae have been developed that eliminate the requirement for synthetic drop-out media or the use of antibiotics for transformation selection and subsequent plasmid maintenance in expression cultures. Here we describe a combination of host strain and vector system introducing a novel concept of auto-selection systems that allows for easy and robust propagation of host cells deleted in essential genes in supplemented media before being transformed with rescuing plasmids. With that, our approach is favorable over commonly used selection strategies and has major advantage over other auto-selection systems. Our approach complements the auto-selection toolbox already available for S. cerevisiae, thus contributing a novel system that enables the use of complex peptone-based media for protein expression and metabolic engineering approaches. We therefore expect that this new strategy will be of general interest to the yeast research community in academia and industry.
Steeling or Sensitizing? A Longitudinal Examination of How Ongoing Accumulation of Negative Life Events Affects Depressive Symptoms in Older Adults
Authors: Kok Almar A L , Twisk Jos W R , Blom Fenneke , Beekman Aartjan T F , Huisman Martijn
Published: June 2021

Objectives

To examine whether (a) as people age, accumulation of negative events increases (“sensitizing”) or decreases (“steeling”) the detrimental effects of subsequent events on depressive symptoms, and (b) how particular psychosocial factors are associated with the strength of these steeling or sensitizing effects.

Method

We used data from 6 measurement waves from 2,069 adults aged 55–84 (M = 68.0) at baseline in the Longitudinal Aging Study Amsterdam, the Netherlands. We included 18 different life events across the life course. Using hybrid multilevel models, we tested whether the effects of proximate life events (<3 years) on depressive symptoms (measured by the Center for Epidemiologic Studies Depression scale) were moderated by previous cumulative events (childhood until previous measurement wave). Additionally, we tested whether education, mastery, emotional support, neuroticism, having strong faith, and loneliness were associated with the strength of steeling/sensitizing effects.

Results

Cumulative and proximate life events were independently associated with more depressive symptoms. Interaction effects indicated that the more cumulative life events, the weaker the effects of recent life events, suggesting a “steeling” effect. Unexpectedly, 3-way interaction effects showed that higher mastery and lower neuroticism were associated with weaker steeling effects. These effects were predominantly attributable to within-person changes rather than to fixed between-person differences. Results from analyses with event severity scores were similar.

Conclusions

As a population, older adults appear to become more resilient against new stressors as they accumulate experience in dealing with negative life events. Findings on mastery tentatively suggest that accepting limits to one’s own control over life circumstances may foster a steeling effect.
Stress Among Older Adults With an Incarcerated Family Member: Testing the Buffering Model of Social Support
Authors: Fahmy Chantal , Testa Alexander
Published: June 2021

Objectives

This study investigates whether levels of social support moderate the association between age and stress among a sample of individuals who have a family member incarcerated.

Methods

Survey responses from individuals who are members of a nonprofit organization for individuals with a family member incarcerated in Texas were used (n = 376). Ordinary least squares regression analysis was conducted to assess the interaction between age and levels of social support on stress.

Results

Findings demonstrated a negative interaction between social support and age (b = −0.040, p = .027), indicating that higher levels of social support buffer against stress for older adults.

Discussion

The theoretical mechanisms linking social support to reductions in stress among older individuals experiencing highly stressful life events (i.e., familial incarceration), as well as the policy and practical implications for enhancing social support among older individuals with a family member incarcerated, are discussed.
Multiple graph realizations method: improving the accuracy and the efficiency of the shortest path method through random sampling
Authors: Bogiatzis Petros , Rychert Catherine A , Harmon Nicholas
Published: June 2021

We present a new implementation of the shortest path method (SPM) that calculates accurate traveltimes in arbitrarily large model spaces without the requirement of large computational times and large amounts of memory, an inherent problem of the Dijkstra's-like algorithms. The multiple graph realizations method is based upon multiple sampling of the model space, using numerous random graphs. The performance of this new method is compared against the conventional way to improve the accuracy of SPM, which is to use denser grids and connectivity stencils of higher order. Our results suggest that although for relatively small models, single runs of the SPM are more suitable to achieve the desired accuracy, in large models, and after a certain level of desired accuracy, this approach becomes inefficient or even unfeasible, as the requirements in memory and computational time increases dramatically. On the contrary our method can achieve the desired accuracy with linear impact in computational time and negligible impact in required memory.
Promoting a More Integrated Approach to Structure and Function
Authors: Jeffery Constance J , Dorgan Kelly M , Pysh Leonard
Published: June 2021

Synopsis

The connection between structure and function is one of the fundamental tenets of biology: a biological unit’s structure determines its function, and, conversely, its function depends upon its structure. Historically, important advances have been made either when understanding of structure leads to questions about function or when understanding of function raises questions about the structures involved. Consequently, considering the connections between structure and function from a broader perspective might lead to the development of novel hypotheses that move our understanding of the fundamental connections between structure and function forward. Better integration of structure and function is a key component in the broader goal of reintegrating biology within and across scales. Here, we provide examples of how integrating studies of structure and function as well as comparing structure–function relationships across biological scales can lead to scientific advances. We also emphasize the potential of integrating studies of structure and function across scales for bio-inspired design and for improving biology education.
Implementing Fabrication as a Pedagogical Tool in Vertebrate Anatomy Courses: Motivation, Inclusion, and Lessons
Authors: Staab Katie Lynn
Published: June 2021

Synopsis

Increasing course structure by incorporating active learning and multimodal pedagogical strategies benefits all learners. Students of vertebrate anatomy can especially benefit from practicing fabrication, or “making”, incorporating skills such as 3D digital modeling, 3D printing, and using familiar low-tech materials to construct informed replicas of animal anatomy. Student perceptions of active learning projects are shaped by motivation theories such as the expectancy-value theory and self-directed learning, both of which are briefly reviewed here. This paper offers inspiration and resources to instructors for establishing a makerspace in an anatomy lab and leveraging community partners to stimulate students to construct their own versions of nature's designs. Learning science in informal environments and specifically in makerspaces has been shown to promote equity and increase motivation to study science. Examples here emphasize accessibility for diverse learners, including strategies for instructors to ensure ease of student access to 3D technology. Scaffolding formative assessments builds student confidence and expertise, further closing opportunity gaps. Two specific cases are detailed where fabrication and the use of 3D digital models are used to augment student learning of vertebrate anatomy at a small liberal arts college. In a semester-long research project in an introductory biomechanics course, students investigate, write about, and build models of animal anatomy of their choice. They use simple materials, crafting supplies, household tools, and/or 3D printing to demonstrate structures of interest, enhancing understanding of the physical principles of animal form and function. Given increased availability of CT data online, students can download, analyze, and 3D print skeletal models of both common and endangered animals. Comparative anatomy students reported that they had increased motivation to study intricate skeletal anatomy simply by manipulating bones in a 3D software assignment. Students in both classes reported enjoying the use of fabrication in learning vertebrate anatomy and this may establish a pattern of lifelong learning.
A qualitative study of community pharmacists’ perceptions of their role in primary mental health care in New Zealand
Authors: Morris Caroline , Wong Mary , McKinlay Eileen
Published: June 2021

Objectives

Mental illness is an important public health issue internationally. As people with mild-to-moderate illness are usually cared for in primary health care, pharmacists are well placed to play an important role. The study objectives were to explore community pharmacists’ perceptions of their role in primary mental health care and the barriers and facilitators to the provision of care in New Zealand.

Methods

Fifteen face-to-face, semi-structured interviews were undertaken with practising pharmacists nationally. Interviews were audio-taped and transcribed verbatim. Data were analysed iteratively using an inductive thematic approach.

Key findings

Support offered to patients with mild-to-moderate mental illness ranged from solely dispensing to providing more holistic, patient-centred care. Three key themes were identified with the potential to influence whether participants were willing and able to support patients. These were pharmacists’ beliefs about their role in primary mental health care, their perception of patients’ needs and the environmental context in which they were practising. The connection to the local community and the philosophy of the business owner were contexts that strongly influenced the support provided.

Conclusions

Community pharmacists have a valuable contribution and role to play in supporting primary mental health care extending well beyond medicines supply and the provision of advice about medicines. Advocacy roles including health system navigation and much broader social support are also possible. The philosophy of the business owner and the actual impact this has on a pharmacist’s practice and the time available to support patients is likely to be influential.
Salvage of a perfectly functioning sacral neuromodulation device (InterStim™) with asymptomatic tined lead wire skin exposure
Authors: Al-Shaiji Tariq F
Published: June 2021

Sacral neuromodulation is a minimally invasive option to manage voiding dysfunction that is refractory to conservative measures and oral pharmacotherapy. The technique involves implantation of a sacral tined lead that is connected to a pulse generator to modulate the pelvic area. The procedure is carried out over two stages. Surgical explantation of the entire device with debridement of the infected tissue is recommended in instances of infection. Nevertheless, solid reports about management of device infections or skin erosions are lacking. Thus, I present a case of a tined lead wire skin exposure in a perfectly functioning device that was salvaged with surgical reposition without complications.
The GALAH survey: Chemical homogeneity of the Orion complex
Authors: Kos Janez , Bland-Hawthorn Joss , Buder Sven , Nordlander Thomas , Spina Lorenzo , Beeson Kevin L , Lind Karin , Asplund Martin , Freeman Ken , Hayden Michael R , Lewis Geraint F , Martell Sarah L , Sharma Sanjib , De Silva Gayandhi , Simpson Jeffrey D , Zucker Daniel B , Zwitter Tomaž , Čotar Klemen , Horner Jonti , Ting (丁源森) Yuan-Sen , Traven Gregor
Published: June 2021

Due to its proximity, the Orion star forming region is often used as a proxy to study processes related to star formation and to observe young stars in the environment they were born in. With the release of Gaia DR2, the distance measurements to the Orion complex are now good enough that the 3D structure of the complex can be explored. Here we test the hypothesis that, due to non-trivial structure and dynamics, and age spread in the Orion complex, the chemical enrichment of youngest stars by early core-collapse supernovae can be observed. We obtained spectra of 794 stars of the Orion complex with the HERMES spectrograph at the Anglo Australian telescope as a part of the GALAH and GALAH-related surveys. We use the spectra of ∼300 stars to derive precise atmospheric parameters and chemical abundances of 25 elements for 15 stellar clusters in the Orion complex. We demonstrate that the Orion complex is chemically homogeneous and that there was no self-pollution of young clusters by core-collapse supernovae from older clusters; with a precision of 0.02 dex in relative alpha-elements abundance and 0.06 dex in oxygen abundance we would have been able to detect pollution from a single supernova, given a fortunate location of the SN and favourable conditions for ISM mixing. We estimate that the supernova rate in the Orion complex was very low, possibly producing no supernova by the time the youngest stars of the observed population formed (from around 21 to 8 Myr ago).
The MOSDEF survey: the mass–metallicity relationship and the existence of the FMR at z ∼ 1.5
Authors: Topping Michael W , Shapley Alice E , Sanders Ryan L , Kriek Mariska , Reddy Naveen A , Coil Alison L , Mobasher Bahram , Siana Brian , Freeman William R , Shivaei Irene , Azadi Mojegan , Price Sedona H , Leung Gene C K , Fetherolf Tara , de Groot Laura , Zick Tom , Fornasini Francesca M , Barro Guillermo , Runco Jordan N
Published: June 2021

We analyse the rest-optical emission-line ratios of z ∼ 1.5 galaxies drawn from the Multi-Object Spectrometer for Infra-Red Exploration Deep Evolution Field (MOSDEF) survey. Using composite spectra, we investigate the mass–metallicity relation (MZR) at z ∼ 1.5 and measure its evolution to z = 0. When using gas-phase metallicities based on the N2 line ratio, we find that the MZR evolution from z ∼ 1.5 to z = 0 depends on stellar mass, evolving by $\Delta \rm log(\rm O/H) \sim 0.25$ dex at M*< $10^{9.75}\, \mathrm{M}_{\odot }$ down to $\Delta \rm log(\rm O/H) \sim 0.05$ at M* ≳ $10^{10.5}\, \mathrm{M}_{\odot }$. In contrast, the O3N2-based MZR shows a constant offset of $\Delta \rm log(\rm O/H) \sim 0.30$ across all masses, consistent with previous MOSDEF results based on independent metallicity indicators, and suggesting that O3N2 provides a more robust metallicity calibration for our z ∼ 1.5 sample. We investigated the secondary dependence of the MZR on star formation rate (SFR) by measuring correlated scatter about the mean M*-specific SFR and M*−$\log (\rm O3N2)$ relations. We find an anticorrelation between $\log (\rm O/H)$ and sSFR offsets, indicating the presence of a M*−SFR−Z relation, though with limited significance. Additionally, we find that our z ∼ 1.5 stacks lie along the z = 0 metallicity sequence at fixed μ = log (M*/M⊙) − 0.6 × $\log (\rm SFR / M_{\odot } \, yr^{-1})$ suggesting that the z ∼ 1.5 stacks can be described by the z = 0 fundamental metallicity relation (FMR). However, using different calibrations can shift the calculated metallicities off of the local FMR, indicating that appropriate calibrations are essential for understanding metallicity evolution with redshift. Finally, understanding how [N ii]/H α scales with galaxy properties is crucial to accurately describe the effects of blended [N ii] and H α on redshift and H α fiux measurements in future large surveys utilizing low-resolution spectra such as with Euclid and the Roman Space Telescope.
The Deeper, Wider, Faster programme: exploring stellar flare activity with deep, fast cadenced DECam imaging via machine learning
Authors: Webb S , Flynn C , Cooke J , Zhang J , Mahabal A , Abbott T M C , Allen R , Andreoni I , Bird S A , Goode S , Lochner M , Pritchard T
Published: June 2021

We present our 500 pc distance-limited study of stellar flares using the Dark Energy Camera as part of the Deeper, Wider, Faster programme. The data were collected via continuous 20-s cadence g-band imaging and we identify 19 914 sources with precise distances from Gaia DR2 within 12, ∼3 deg2, fields over a range of Galactic latitudes. An average of ∼74 min is spent on each field per visit. All light curves were accessed through a novel unsupervised machine learning techniques designed for anomaly detection. We identify 96 flare events occurring across 80 stars, the majority of which are M dwarfs. Integrated flare energies range from ∼1031–1037 erg, with a proportional relationship existing between increased flare energy with increased distance from the Galactic plane, representative of stellar age leading to declining yet more energetic flare events. In agreement with previous studies we observe an increase in flaring fraction from M0 to M6 spectral types. Furthermore, we find a decrease in the flaring fraction of stars as vertical distance from the galactic plane is increased, with a steep decline present around ∼100 pc. We find that $\sim 70{{\ \rm per\ cent}}$ of identified flares occur on short time-scales of <8 min. Finally, we present our associated flare rates, finding a volumetric rate of 2.9 ± 0.3 × 10−6 flares pc−3 h−1.
Early Experience With Virtual and Synchronized Augmented Reality Platform for Preoperative Planning and Intraoperative Navigation: A Case Series
Authors: Louis Robert G , Steinberg Gary K , Duma Christopher , Britz Gavin , Mehta Vivek , Pace Jonathan , Selman Warren , Jean Walter C
Published: June 2021

BACKGROUND

Virtual reality (VR) allows for presurgical planning. Intraoperatively, augmented reality (AR) enables integration of segmented anatomic information with neuronavigation into the microsurgical scene to provide guidance without workflow disruption. Combining VR and AR solutions may help guide microsurgical technique to improve safety, efficiency, and ergonomics.

OBJECTIVE

To describe a VR/AR platform that provides VR planning and intraoperative guidance via microscope ocular injection of a comprehensive AR overlay of patient-specific 360°/3D anatomic model aligned and synchronized with neuronavigation.

METHODS

Custom 360° models from preoperative imaging of 49 patients were utilized for preoperative planning using a VR-based surgical rehearsal platform. Each model was imported to SyncAR, the platform's intraoperative counterpart, which was coregistered with Medtronic StealthStation S8 and Zeiss or Leica microscope. The model was injected into the microscope oculars and referenced throughout by adjusting overlay opacity. For anatomic shifts or misalignment, the overlay was reregistered via manual realignment with known landmarks.

RESULTS

No SyncAR-related complications occurred. SyncAR contributed positively to the 3D understanding of patient-specific anatomy and ability to operate. Preoperative planning and intraoperative AR with 360° models allowed for more precise craniotomy planning and execution. SyncAR was useful for guiding dissection, identifying critical structures including hidden anatomy, understanding regional anatomy, and facilitating resection. Manual realignment was performed in 48/49 surgeries. Gross total resection was achieved in 34/40 surgeries. All aneurysm clipping and microvascular decompression procedures were completed without complications.

CONCLUSION

SyncAR combined with VR planning has potential to enhance surgical performance by providing critical information in a user-friendly, continuously available, heads-up display format.
Woven EndoBridge Embolized Aneurysm Clippings: 2-Dimensional Operative Video
Authors: Heiferman Daniel M , Peterson Jeremy C , Johnson Kendrick D , Nguyen Vincent N , Dornbos David , Moore Kenneth A , Inoa Violiza , Hoit Daniel A , Arthur Adam S
Published: June 2021

The Woven EndoBridge (WEB) device (MicroVention, Aliso Viejo, California) is an intrasaccular flow disruptor used for the treatment of both unruptured and ruptured intracranial aneurysms. WEB has been shown to have 54% complete and 85% adequate aneurysm occlusion rates at 1-yr follow-up.
1
Residual and recurrent ruptured aneurysms have been shown to have a higher risk of re-rupture than completely occluded aneurysms.
2
With increased utilization of WEB in the United States, optimizing treatment strategies of residual aneurysms previously treated with the WEB device is essential, including surgical clipping.
3,4
Here, we present an operative video demonstrating the surgical clip occlusion of previously ruptured middle cerebral artery and anterior communicating artery aneurysms that had been treated with the WEB device and had sizable recurrence on follow-up angiography. Informed consent was obtained from both patients. Lessons learned include the following: (1) the WEB device is highly compressible, unlike coils; (2) proximal WEB marker may interfere with clip closure; (3) no evidence of WEB extrusion into the subarachnoid space; (4) no more scarring than expected in ruptured cases; and (5) clipping is a feasible option for treating WEB recurrent or residual aneurysms.
“Save the Nerve”: Technical Nuances for Hearing Preservation and Restoration in Vestibular Schwannoma Surgery: 2-Dimensional Operative Video
Authors: Almefty Rami O , Ibn Essayed Walid , Al-Mefty Ossama
Published: June 2021

Hearing loss is a significant disability that inflects dysfunction and affects the patient quality of life. Consequently, hearing preservation and the potential of hearing restoration are prized quests in the management of vestibular schwannoma.
1
Although small intracanalicular vestibular schwannomas are commonly observed, progressive hearing loss occurs despite the absence of tumor growth; hence, surgical resection can be performed with the sole aim of hearing preservation in well-informed and eager patients. Hearing preservation by surgical resection has proven to be durable.
1-4
In this group of patients, we concur with Yamakami et al
2
that vascularized meatal flap to reconstruct the canal helps prevent scarring of the cochlear nerve and provides cerebrospinal fluid (CSF) bathing to the cochlear nerve, yielding better long-term hearing preservation.

 With larger tumors and more severe hearing loss at presentation, microsurgical resection should aim at preserving the cochlear nerve, a goal frequently achievable, which offers the potential for hearing restoration with cochlear implants.
3
The results of cochlear implants in restoration of severe hearing loss have been to say the least most impressive.
5
We demonstrate these 2 frequently encountered clinical situations with 2 surgical videos showing specific surgical tenets, including intra-arachnoidal dissection, medial to lateral manipulation of the tumor, preservation of the labyrinthine artery, as well as reconstruction of the internal auditory canal.
2,3,6,7
The patients consented to the surgery and to the publication of their picture in a surgical video.

 Illustration in video © 1997 O. Al-Mefty. Used with permission. All rights reserved.
Resection of Giant Invasive Parasagittal Atypical Meningioma With a Venous Graft Reconstruction of the Sagittal Sinus: 2-Dimensional Operative Video
Authors: Aboud Emad , Tamer Wardan Almir , Ibn Essayed Walid , Al-Mefty Ossama
Published: June 2021

Parasagittal meningioma becomes challenging when it involves the sagittal sinus and frequently invades the skull
1
; hence, resection of the invasive bone and management of the involved sinus are the two crucial issues in these tumors; notwithstanding the practice of conservative surgical resection coupled with irradiation (radiosurgery or stereotactic radiotherapy),
2
radical surgical removal, including the invaded bone and sinus (Simpson grade I), alleviates recurrences. It is more valuable and particularly recommended in grade II meningiomas,
3
since radical surgery is the principal factor in a long control of grade II meningioma
4
and radiation effectiveness is directly related to gross total removal.
5
On the other hand, removal of tumor involving the sinus and sinus reconstruction has been recommended and practiced for years.
6-10
When the sinus is occluded, preservation of the collateral venous drainage becomes paramount.
11
If the collateral venous drainage included cutaneous and dural channels, as in this patient, reconstructing of the sinus would become preventative of a major venous complication. Sindou et al
8
even advocate the routine reconstruction of occluded sinus to minimize morbidity.

 The patient is 39 yr old with a giant parasagittal meningioma that invaded the skull, occluded the sinus at the mid-third, and had venous collateral through the dura and cutaneous veins. He underwent radical resection with reconstruction of the sinus by saphenous vein graft. Patient consented for the operation and publication of images.

 Illustrations at 1:51 and 2:15 from Al-Mefty O, Operative Atlas of Meningiomas, © LWW, 1997, with permission.
Lower Hounsfield Units at the Upper Instrumented Vertebrae are Significantly Associated With Proximal Junctional Kyphosis and Failure Near the Thoracolumbar Junction
Authors: Mikula Anthony L , Fogelson Jeremy L , Lakomkin Nikita , Flanigan Patrick M , Pinter Zachariah W , Doan Matthew K , Bydon Mohamad , Nassr Ahmad , Freedman Brett , Sebastian Arjun S , Abode-Iyamah Kingsley , Anderson Paul A , Elder Benjamin D
Published: June 2021

BACKGROUND

Low bone mineral density (BMD) on dual energy x-ray absorptiometry (DXA) is likely a risk factor for proximal junctional kyphosis (PJK) and proximal junctional failure (PJF). However, prior instrumentation and degenerative changes can preclude a lumbar BMD measurement. Hounsfield units (HU) represent an alternative method to estimate BMD via targeted measurements at the intended operative levels.

OBJECTIVE

To determine if patients with lower HU at the upper instrumented vertebrae (UIV) and vertebral body superior to the UIV (UIV + 1) are at greater risk for PJK and PJF.

METHODS

A retrospective chart review identified patients at least 50 yr of age who underwent instrumented lumbar fusion with pelvic fixation, a UIV from T10 to L2, and a preoperative computed tomography (CT) encompassing the UIV. HU were measured at the UIV, UIV + 1, and the L3-L4 vertebral bodies.

RESULTS

A total of 150 patients (80 women and 70 men) were included with an average age of 66 yr and average follow-up of 32 mo. Multivariable logistic regression analysis with an area under the curve (AUC) of 0.89 demonstrated HU at the UIV/UIV + 1 as the only independent predictor of PJK/PJF with an odds ratio of 0.94 (P-value = .031) for a change in a single HU. Patients with HU at UIV/UIV + 1 of <110 (n = 35), 110 to 160 (n = 73), and >160 (n = 42) had a rate of PJK/PJF of 63%, 27%, and 12%, respectively (P-value < .001).

CONCLUSION

Patients with lower HU at the UIV and UIV + 1 were significantly associated with PJK and PJF, with an optimal cutoff of 122 HU that maximizes sensitivity and specificity.
To return or not to return: on post-Anthropocene and the pandemic
Authors: Rivas Virgilio A
Published: June 2021

Some studies indirectly link the pandemic to the Anthropocene. However, this brief essay identifies the Anthropocene as a Western-bred phenomenon, which has evolved from Europe’s colonial past. Pandemics are not new to settler colonialism, for instance. In this broader framework, the Covid-19 pandemic comes at a time when the West is confronting a new challenge to its global influence, i.e. the climate emergency resulting from a long history of colonial experiments, successes and failures.
Microarchitecture of titanium cylinders obtained by additive manufacturing does not influence osseointegration in the sheep
Authors: Rony Louis , Aguado Eric , Verlee Bruno , Pascaretti-Grizon Florence , Chappard Daniel
Published: June 2021

Large bone defects are a challenge for orthopedic surgery. Natural (bone grafts) and synthetic biomaterials have been proposed but several problems arise such as biomechanical resistance or viral/bacterial safety. The use of metallic foams could be a solution to improve mechanical resistance and promote osseointegration of large porous metal devices. Titanium cylinders have been prepared by additive manufacturing (3D printing/rapid prototyping) with a geometric or trabecular microarchitecture. They were implanted in the femoral condyles of aged ewes; the animals were left in stabling for 90 and 270 days. A double calcein labeling was done before sacrifice; bones were analyzed by histomorphometry. Neither bone volume, bone/titanium interface nor mineralization rate were influenced by the cylinder’s microarchitecture; the morphometric parameters did not significantly increase over time. Bone anchoring occurred on the margins of the cylinders and some trabeculae extended in the core of the cylinders but the amount of bone inside the cylinders remained low. The rigid titanium cylinders preserved bone cells from strains in the core of the cylinders. Additive manufacturing is an interesting tool to prepare 3D metallic scaffolds, but microarchitecture does not seem as crucial as expected and anchoring seems limited to the first millimeters of the graft.
Oncologists’ experience with discussing cancer prognosis with patients and families: perspectives from India
Authors: Maya Sravannthi , Banerjee Smita C , Chawak Shweta , Parker Patricia A , Kandikattu Sreekanth , Chittem Mahati
Published: June 2021

Nondisclosure of prognosis of advanced cancer is commonly practiced in some Asian cultures including India; but research is limited. To describe experiences of Indian oncologists in discussing cancer prognosis with people with cancer and their caregivers, with a focus on barriers and facilitators of prognostic discussions. Thirty oncologists practicing in South India, Hyderabad participated in semi-structured interviews; and analyzed using Interpretative Phenomenological Analysis. Barriers included system-level, patient-level, and physician-level challenges as obstructions to open and honest interactions around cancer prognosis. Most of the barriers focused on communication-related challenges. Lack of communication skills training for providers coupled with over-reliance on use of euphemisms, hesitation in communicating with “weak” patient, and struggles to establish healthcare proxy described communication-related barriers. The study also described factors including family involvement in cancer care and empathic communication as facilitators of honest and open communication about prognosis. In particular, rapport building and getting to know the patient, use of empathic communication, engaging in gradual and individualized disclosure, and balancing hope with honesty were communication-related facilitators that aid open communication with patients with cancer and their caregivers about prognosis and plan of care. Results provide implications for development of communication skills trainings for oncology physicians in India. Adapting, delivering, and evaluating existing communication skills training programs, particularly around discussions of prognosis and goals of care is a requisite step for providing patient-centered and supportive care to patients with cancer and their caregiving families.
Motivating people to stay at home: using the Health Belief Model to improve the effectiveness of public health messaging during the COVID-19 pandemic
Authors: Maunder Larah
Published: June 2021

How the Health Belief Model can be applied to public health messaging to create messages that are more effective at motivating people to stay-at-home during the COVID-19 pandemic.
Diversity and Entrepreneurialism: PN Review, Feminism and the Arts Council of Great Britain, 1973–1990
Authors: Jaillant Lise
Published: June 2021

This article examines the evolution of PN Review, a leading Manchester-based poetry magazine, in relation to second-wave feminism in the 1970s and 1980s. Largely funded by the Arts Council of Great Britain, the magazine was initially not a welcoming place for female poets and contributors. Women’s poetry was often disparaged, and few women contributed to the magazine. From the early 1980s, however, PN Review started to include more women voices—a transition led by the founding editor Michael Schmidt, who was eager to include forgotten and neglected female poets on his list. This essay argues that changes in public funding, and increased market opportunities for women authors and feminist ideas, forced the magazine to evolve and adapt quickly. Women were taking a more visible role in the publishing world, as the success of the feminist press Virago (created in 1973) shows. Women poets were becoming more vocal, and openly denounced their marginalization in the poetry scene. The funding cuts decided by Margaret Thatcher’s government led to profound changes as Arts Council ‘clients’ competed fiercely to survive in a tough landscape. Changing priorities at the Arts Council—including the need for more diversity in publishing—also had an impact on grant holders. PN Review therefore offers a good example of a literary institution that was directly pushed towards gender diversity through external pressures from the Arts Council of Great Britain and the market.
Deaths due to COVID-19 in a state of northeastern Brazil: spatiotemporal distribution, sociodemographic and clinical and operational characteristics
Authors: da Silva Weslei Melo , Brito Paula dos Santos , de Sousa Giana Gislanne da Silva , Santos Livia Fernanda Siqueira , da Silva Janiel Conceição , Costa Ana Cristina Pereira de Jesus , Pascoal Livia Maia , Santos Floriacy Stabnow , Graepp Fontoura Iolanda , Lobato Jaisane Santos Melo , Fontoura Volmar Morais , Pereira Ana Lucia Fernandes , dos Santos Leonardo Hunaldo , Santos Neto Marcelino
Published: June 2021

Background

The detection of spatiotemporal clusters of deaths by coronavirus disease 2019 (COVID-19) is essential for health systems and services, as it contributes to the allocation of resources and helps in effective decision making aimed at disease control and surveillance. Thus we aim to analyse the spatiotemporal distribution and describe sociodemographic and clinical and operational characteristics of COVID-19-related deaths in a Brazilian state.

Methods

A descriptive and ecological study was carried out in the state of Maranhão. The study population consisted of deaths by COVID-19 in the period from 29 March to 31 July 2020. The detection of spatiotemporal clusters was performed by spatiotemporal scan analysis.

Results

A total of 3001 deaths were analysed with an average age of 69 y, predominantly in males, of brown ethnicity, with arterial hypertension and diabetes, diagnosed mainly by reverse transcription polymerase chain reaction in public laboratories. The crude mortality rates the municipalities ranged from 0.00 to 102.24 deaths per 100 000 inhabitants and three spatiotemporal clusters of high relative risk were detected, with a mortality rate ranging from 20.25 to 91.49 deaths per 100 000 inhabitants per month. The headquarters was the metropolitan region of São Luís and municipalities with better socio-economic and health development.

Conclusions

The heterogeneous spatiotemporal distribution and the sociodemographic and clinical and operational characteristics of deaths by COVID-19 point to the need for interventions.
Tracing the potential extra-household contacts of TB patients: findings from a personal social network survey in a high TB burden setting in India
Authors: Nagarajan Karikalan , Muniyandi Malaisamy , Palani Bharathidasan , Sellappan Senthil
Published: June 2021

Background

Evidence on the extra-household contacts of TB patients who drive disease transmission is scarce.

Methods

We conducted a cross-sectional personal social network survey among 300 newly diagnosed index pulmonary TB patients to identify their first-degree extra-household contacts.

Results

A significantly higher proportion of neighbourhood (3.5; 95% CI 1.3 to 7.5), occupational (3.2; 95% CI 1.3 to 9.2) and friendship contacts (2.2; 95% CI 0.8 to 4.5) developed TB within 1 y of the index patient's diagnosis than their household contacts (0.7; 95% CI 0.3 to 1.3). Similarly, a higher proportion of extra-household contacts had TB at different time points before the index patient was diagnosed.

Conclusion

Extra-household contacts of TB patients could be a potential source of TB or could be at increased risk of TB.
Complete Genomic Data of Enterobacter asburiae Strain SD4L Associated with Bacterial Palea Browning of Rice in China
Authors: Cao Peng , Li Chenxu , Tan Kefei , Zhao Junwei , Wang Xiangjing , Xiang Wensheng
Published: June 2021

Enterobacter asburiae is the causal agent of rice bacterial palea browning disease. Here, we report the complete genome of E. asburiae strain SD4L, which represents the first whole genome sequence of an isolate from rice seedlings in China. The assembled genome consisted of two contigs, with a circular chromosome of 4,574,166 bp, and a plasmid of 85,271 bp, respectively. This complete genome will provide a valuable resource for further studies on bacterial palea browning worldwide.
Species Diversification of the Coniferous Pathogenic Fungal Genus Coniferiporia (Hymenochaetales, Basidiomycota) in Association with Its Biogeography and Host Plants
Authors: Wang Xue-Wei , Jiang Ji-Hang , Liu Shi-Liang , Gafforov Yusufjon , Zhou Li-Wei
Published: June 2021

Coniferiporia, belonging to Hymenochaetaceae and now segregated from Phellinidium, is a wood-inhabiting fungal genus with three species, each having a specific geographic distribution and a strong host specificity as a forest pathogen of coniferous trees. In this study, the species diversity of Coniferiporia is further clarified with the aid of a wider sampling and multilocus-based phylogenetic analysis, which reveals a new species Coniferiporia uzbekistanensis. The molecular clock and ancestral geographic origin analyses indicate that the ancestor of Coniferiporia emerged in one of the Pinaceae and Cupressaceae, then jumped to the other plant family originated in eastern Eurasia 17.01 million years ago (Mya; 95% highest posterior density: 9.46 to 25.86 Mya), and later extended its distribution to western North America, Central Asia, and eastern Europe. Coniferiporia sulphurascens speciated on Pinaceae in eastern Eurasia 8.78 Mya (9.46 to 25.86 Mya) and then extended its distribution to western North America and eastern Europe. Coniferiporia qilianensis and C. uzbekistanensis speciated on Juniperus przewalskii in eastern Eurasia 3.67 Mya (0.36 to 8.02 Mya) and on Juniperus polycarpos in Central Asia 4.35 Mya (0.94 to 8.37 Mya), respectively. The speciation event of Coniferiporia weirii occurred 4.45 Mya (0.77 to 9.33 Mya) right after the emergence of its host, the endemic Cupressaceae species Thuja plicata, and soon after, this fungus evolved to also inhabit another endemic Cupressaceae species Calocedrus decurrens. In summary, this study for the first time unambiguously clarified and timed the adaptive evolutionary event of Coniferiporia in association with its biogeography and host plants.
Obliterated Posterior Cul-de-sac Laparoscopic Surgical Simulation
Authors: Senapati Sangeeta , Alsaden Iman M. , Schroer Margaret , Tu Frank
Published: June 2021

BACKGROUND:

Obliteration of the posterior cul-de-sac is a challenging, often unexpected surgical finding. Developing the dissection skills required to manage this finding during laparoscopy is essential for optimizing treatment of many pain disorders during hysterectomy or ovarian surgery; however, exposure of trainees to cul-de-sac dissection is variable. Currently, there are no widely available simulation models for teaching and practicing this technique.

METHOD:

Our aim is to design a low-cost and high-fidelity laparoscopic simulation model that represents key anatomical structures and emphasizes skills for laparoscopic dissection of an obliterated posterior cul-de-sac.

EXPERIENCE:

A three-dimensional model was created and is described. Nine experts (gynecologic surgery fellows and attendings) and 17 residents completed a single 30-minute simulation session and completed several assessments to begin establishing the face validity of this model.

CONCLUSION:

Experts and residents rated the obliterated cul-de-sac simulation as highly realistic and useful. Residents showed a statistically significant increase in comfort with the dissection, from a median Likert score of 1 out of 5 (interquartile range 1–1) to 3 out of 5 (interquartile range 2–3) (P<.001). Experts scored better than residents on blinded video grading of model performance (P<.001). This low-cost and easily reproducible model fills a critical gap in gynecologic surgery education.
Identification of SLC38A7 as a Prognostic Marker and Potential Therapeutic Target of Lung Squamous Cell Carcinoma
Authors: Haratake Naoki , Hu Qingjiang , Okamoto Tatsuro , Jogo Tomoko , Toyokawa Gouji , Kinoshita Fumihiko , Takenaka Tomoyoshi , Tagawa Tetsuzo , Iseda Norifumi , Itoh Shinji , Yamada Yuichi , Oda Yoshinao , Shimokawa Mototsugu , Kikutake Chie , Suyama Mikita , Unoki Motoko , Sasaki Hiroyuki , Mori Masaki
Published: June 2021

Background:

No effective molecular targeted therapy has been established for SCC. We conducted a comprehensive study of SCC patients using RNA-sequencing and TCGA dataset to clarify the driver oncogene of SCC.

Method:

Forty-six samples of 23 patients were totally analyzed with RNA-sequencing. We then searched for candidate-oncogenes of SCC using the TCGA database. To identify candidate oncogenes, we used the following 2 criteria: (1) the genes of interest were overexpressed in tumor tissues of SCC patients in comparison to normal tissues; and (2) using an integrated mRNA expression and DNA copy number profiling analysis using the TCGA dataset, the DNA copy number of the genes was positively correlated with the mRNA expression.

Result:

We identified 188 candidate-oncogenes. Among those, the high expression of SLC38A7 was a strong prognostic marker that was significantly associated with a poor prognosis in terms of both overall survival (OS) and recurrence-free survival in the TCGA dataset (P < 0.05). Additionally, 202 resected SCC specimens were also subjected to an immunohistochemical analysis. Patients with the high expression of SLC38A7 (alternative name is sodium-coupled amino acid transporters 7) protein showed significantly shorter OS in comparison to those with the low expression of SLC38A7 protein [median OS 3.9 years (95% confidence interval, 2.4–6.4 years) vs 2.2 years (95% confidence interval, 1.9–4.1 years); log rank test: P = 0.0021].

Conclusion:

SLC38A7, which is the primary lysosomal glutamine transporter required for the extracellular protein-dependent growth of cancer cells, was identified as a candidate therapeutic target of SCC.