bluuebunny/crossref_metadata_2025 huggingface dataset:
Conditions
Authors: Bowes Ashley
Published: March 2021

Almost all planning permissions that are granted are granted subject to conditions. It often happens that the problem with decisions relating to land use is not over the question of whether the development should be permitted at all, but on what terms it should be permitted. Conditions may be imposed, therefore, not only to enhance the quality of the development but to ameliorate any adverse effects that might otherwise flow from the development. In order to assist local planning authorities in the exercise of their power, extensive advice has been given to them by the Secretary of State. The latest policy advice is contained within paras 54–55 of the NPPF.
Remedies for Adverse Planning Decisions
Authors: Bowes Ashley
Published: March 2021

The general principle of allowing compensation to owners who suffer loss through the exercise by a planning authority of its statutory powers to control development was recognized in early legislation.
The Effect of Different Diameters of Fat Converters on Adipose Tissue and Its Cellular Components: Selection for Preparation of Nanofat
Authors: Qiu He , Jiang Yichen , Chen Chang , Wu Kelun , Wang Hang
Published: March 2021

Background

Nanofat is an autologous product prepared mechanically from harvested fat. In nanofat grafting, converters are employed for mechanical emulsification to facilitate fat injection. To date, the study of different converters has received scant attention regarding whether they affect the characteristics of nanofat in terms of the practical applications and indications.

Objectives

The authors set out to investigate the influence of different internal diameters of converters on biological functionality of nanofat during shuffling.

Methods

The 3-dimensional finite element method was employed to simulate the process of mechanical emulsification of fat and to research the stress with 5 different converters (3.76 mm, 2.00 mm, 1.20 mm, 1.00 mm, 0.80 mm). An assessment of the morphology of emulsified fat was conducted. Isolated stromal vascular fraction (SVF) was analyzed for cellular components, number, and viability through flowcytometry and live/ dead staining. Adipocytic and angiogenic differentiation assay allowed assessment of differentiation capacity of the SVF.

Results

The smaller the aperture of the converter, the greater the mechanical force on adipose tissue during mechanical emulsification, showing the different macroscopic and microscopic structure of the emulsified fat. No difference in viability or ratio of endothelial progenitor cells and other cells was found. Angiogenic and adipogenic differentiation capacity of the SVF significantly changed in 5 different converters.

Conclusions

The mechanical emulsification from different apertures of converters exerts different effects of adipose tissue structure, cell content, and multipotency differentiation but not its viability. Converters with different apertures can be selected according to clinical needs.
Giant and dwarf females: how to explain the fourfold variation in body size and fecundity in Trichonephila senegalensis (Aranea: Nephilidae)
Authors: Lissowsky Nelli , Kralj-Fišer Simona , Schneider Jutta M
Published: March 2021

Variation in life-history traits within a population is caused by genetic, maternal and environmental factors. We explored the high variability in development time, adult body weight and fecundity in females of the sexually size dimorphic spider Trichonephila senegalensis. Their mothers originated from two habitats—strongly seasonal Namibia and mildly seasonal South Africa—and we reared F1 females under standardized laboratory conditions. We found that a considerable part of the variability in recorded life-history traits is caused by family-specific effects, comprising genetic, maternal and early environmental influences. Furthermore, we show population differences in development time, where females originating from Namibia matured within shorter periods than females from South Africa. Also, the relationship between development time and adult weight differs between the two populations, as a significant correlation is only found in females with Namibian origin. Against common wisdom, there was a weak overall correlation between adult weight and clutch mass. We also found that females make different life-history decisions under increasing rather than under decreasing daylength. Although a considerable part of variability in life-history traits is family-specific, we discuss how the between-population differences in life histories and their trade-offs reflect adaptation to diverse habitats.
Diel cycle in a farmland bird is shaped by contrasting predation and human pressures
Authors: Harmange Clément , Bretagnolle Vincent , Chabaud Nathan , Sarasa Mathieu , Pays Olivier
Published: March 2021

In human-dominated landscapes, human disturbances may contrast (spatially and/or temporally) with risk imposed by non-human predators. However, how prey adjust behaviour to minimize risk from multiple threats remains unclear. In Central-Western France, we investigated patterns of activity, space and habitat use, and causes of variations during the diel cycle of the grey partridge (captive-reared, released), a farmland bird facing multiple risks (nocturnal predation, diurnal hunting pressure). We also investigated influence of individual space use, relative to risk-related features on the fate of birds. Birds adjusted their behaviours in ways consistent with the reduction of risk from nocturnal carnivores at night and hunters during daytime. We recorded bimodal crepuscular activity, likely explained by commuting movements between spatially-separated diurnal and nocturnal sites composed of different habitats: selection of open terrains and avoidance of predator reservoirs at night vs. use of high-vegetation cover during daytime. We observed space use differences between surviving, hunted and predated birds. Predation and hunting activities act as contrasting pressures, selecting birds based on their spatial behaviour, which has likely shaped diel adjustments at the population level. An improved consideration of temporal variation in environmental pressures would help to reliably address factors constraining populations, so increasing wildlife management efficiency.
ACTOR: a latent Dirichlet model to compare expressed isoform proportions to a reference panel
Authors: McCabe Sean D , Nobel Andrew B , Love Michael I
Published: March 2021

The relative proportion of RNA isoforms expressed for a given gene has been associated with disease states in cancer, retinal diseases, and neurological disorders. Examination of relative isoform proportions can help determine biological mechanisms, but such analyses often require a per-gene investigation of splicing patterns. Leveraging large public data sets produced by genomic consortia as a reference, one can compare splicing patterns in a data set of interest with those of a reference panel in which samples are divided into distinct groups, such as tissue of origin, or disease status. We propose A latent Dirichlet model to Compare expressed isoform proportions TO a Reference panel (ACTOR), a latent Dirichlet model with Dirichlet Multinomial observations to compare expressed isoform proportions in a data set to an independent reference panel. We use a variational Bayes procedure to estimate posterior distributions for the group membership of one or more samples. Using the Genotype-Tissue Expression project as a reference data set, we evaluate ACTOR on simulated and real RNA-seq data sets to determine tissue-type classifications of genes. ACTOR is publicly available as an R package at https://github.com/mccabes292/actor.
Challenges Facing Social Work in the Indigenous Arab Minority in Israel: Voices from the Field
Authors: Mahajne Ibrahim , Allassad Alhuzail Nuzha , Bar-On Arnon
Published: March 2021

The article identifies challenges to social work practice voiced by 43 Arab social workers in Israel, aimed at clarifying whether there is a need to indigenise their practice in Israel's hegemonic Jewish society in view of four challenges to their interventions that they identified: inappropriate professional training; insufficient knowledge of English as the international language of social work; local Arab authorities failure to recognise many welfare needs and social work’s role in mitigating them; and the unique situation of the country's Arab minority, such as restrictions on its contacts with colleagues in the Arab world. These challenges, in contrast to those that social workers face in the Arab world and in other non-‘Western’ countries, suggest that Arab social workers in Israel see little need to indigenise their practice.
Rohingya refugee resettlement as a community of practice
Authors: Cawley Buckley Morgan , Maher Helen , McDermott Stephanie
Published: March 2021

The following article argues that community development practices in conjunction with the United Nations High Commissioner for Refugees (UNHCR) resettlement process can be analysed and enhanced through the application of the Community of Practice social learning theory. This work is elucidated by critical reflections on community development by and with the Rohingya community in Ireland. Analysis of practices with this cohort is urgent given the wider context of the on-going humanitarian crisis in Myanmar. The Community of Practice here is conceptualised as the partners, stakeholders and agencies in addition to members of the Rohingya community that each practices community development. The article provides an overview of the resettlement process for the Rohingya before applying the model across its four components—community, practice, meaning and identity. Conclusions include the recognition that community development approaches of collaboration and partnership at the heart of the resettlement process equate to a Community of Practice model. This is described here as interdependent, in part, to distinguish this approach from the stated UNHCR goal of independence. Secondly, a longitudinal approach to strategy is supported by Community of Practice theory through processes of reiteration, reification and participation. Finally, Community of Practice theory informs concepts of identity and community to argue in favour of diverse and flexible goal setting.
Incorporating shared measurement in social change initiatives: benefits, challenges, and lessons learned
Authors: Judelsohn Alexandra , Hoey Lesli , Shapiro Lilly Fink , Colasanti Kathryn
Published: March 2021

Collective impact is increasingly being adopted as a systems-based approach for addressing complex social problems. Yet one of the critical components, shared measurement, remains challenging to implement (Hanleybrown, Kania and Kramer, 2012). Based around a common set of metrics, shared measurement is foundational to offering multi-organizational initiatives ongoing feedback that can allow them to share the lessons learned, make adjustments, and document the outcomes of their joint efforts. This paper examines the lessons practitioners have learned as they applied shared measurement strategies across diverse initiatives. We scrutinized food systems initiatives, in particular, hypothesizing that the complex, adaptive nature of food systems makes it more challenging to apply a commonly agreed upon set of measures in comparison to other sectors. Through seventeen semi-structured interviews, we found that interviewees shared similar perceptions about the multiple benefits of shared measurement whether they worked in food systems or other fields. Based on the major challenges they encountered, three primary lessons emerged about what it takes to establish a successful shared measurement system: trust across collaborating organizations, a streamlined process, and sufficient funding.
Reduction in Antibiotic Prescribing Attainable With a Gonococcal Vaccine
Authors: Kissler Stephen M , Mitchell Moriah , Grad Yonatan H
Published: March 2021

We estimated the fraction of antibiotic prescribing in the United States attributable to gonorrhea. Gonorrhea contributes to an outsized proportion of antibiotic prescriptions in young adults, males, and in the southern and western United States. A gonococcal vaccine could substantially reduce antibiotic prescribing in these populations.
Chimney reconstruction provides a wider subaortic space and reduces the risk of pulmonary artery compression in the Norwood-type aortic arch reconstruction without patch supplementation
Authors: Asada Satoshi , Yamagishi Masaaki , Maeda Yoshinobu , Itatani Keiichi , Fujita Shuhei , Hongu Hisayuki , Nakatsuji Hiroki , Yaku Hitoshi
Published: March 2021

OBJECTIVES

Pulmonary artery (PA) compression by the neoaorta is a serious complication after the Norwood-type palliation (NP) for hypoplastic left heart syndrome. Either excess patch tailoring or limited use of autologous tissue may cause narrowing of the subaortic space. The chimney technique could theoretically provide a wide subaortic space.

METHODS

Twenty-nine patients with both pre- and post-NP computed tomography data available of the 37 consecutive patients who underwent NP in our institution were reviewed. Arch height, arch width, sinus of Valsalva diameter, area under the neoaortic arch and arch angle were measured. These patients were divided according to the neo-arch reconstruction technique, chimney reconstruction technique (CR) or conventional direct reconstruction technique (DR).

RESULTS

Median age and weight at NP were 2.1 months and 3.5 kg, respectively. Twenty-two patients underwent previous bilateral PA banding. During NP, 17 CR and 12 DR were performed. Four patients in the DR group developed PA compression. No neoaortic arch dilatation was found in either group. Post-NP arch width, area under the neo-arch and the arch angle were significantly larger in the CR group. Pre-NP arch height was significantly smaller in DR patients with PA compression than in those without.

CONCLUSIONS

The chimney technique decreased the risk of PA compression and provided a wider subaortic space and a less acute arch angle. This technique had no short-term effect on the neoaortic root. Small preoperative arch height is a potential risk factor for PA compression in DR, and the chimney technique could be an effective solution.
Longitudinal Relationship of Leisure Activity Engagement With Cognitive Performance Among Non-Demented, Community-Dwelling Older Adults
Authors: Armstrong Nicole M , Tom Sarah E , Harrati Amal , Casaletto Kaitlin , Pa Judy , Arce Rentería Miguel , Gu Yian , Rajan Kumar B , Schupf Nicole , Fieo Robert , Weuve Jennifer , Simonsick Eleanor M , Manly Jennifer J , Stern Yaakov , Zahodne Laura B
Published: March 2021

Background and Objectives

Leisure activity engagement (LAE) may reduce the risk of incident dementia. However, cognitive performance may predict LAE change. We evaluated the temporal ordering of overall and subtypes of LAE (intellectual, physical, and social) and cognitive performance (global, language, memory, and visuospatial function) among non-demented older adults.

Research Design and Methods

The Washington Heights–Inwood Columbia Aging Project concurrently administered a survey measure of 13 leisure activities and a neuropsychological battery every 18–24 months for up to 14 years to 5,384 racially and ethnically diverse participants. We used parallel process conditional latent growth curve models to examine temporal ordering in the overall sample and within baseline diagnostic groups (mild cognitive impairment [MCI] vs. cognitively normal).

Results

Levels and changes of overall and subtypes of LAE were positively correlated with cognitive performance in the overall sample and within each diagnostic group. In the overall sample, higher initial memory was associated with slower declines in social LAE (estimate = 0.019, 95% confidence interval [95% CI]: 0.001–0.037). Among MCI, higher initial physical LAE was associated with slower declines in memory (estimate = 0.034, 95% CI: 0.001–0.067), but higher initial intellectual LAE was related to steeper declines in visuospatial function (estimate = −0.028, 95% CI: −0.052 to −0.004). Among cognitively normal, higher initial memory was associated with slower declines in intellectual LAE (estimate = 0.012, 95% CI: 0.002−0.022).

Discussion and Implications

Dynamic interplay of LAE with cognitive performance was observed across diagnostic groups. Levels of LAE subtypes could be more predictive of change in certain cognitive domains within older adults with MCI.
Secondary Burn Progression Mitigated by an Adenosine 2A Receptor Agonist
Authors: Haywood Nathan , Byler Matthew R , Zhang Aimee , Rotar Evan P , Money Dustin , Gradecki Sarah E , Ta Huy Q , Salmon Morgan , Kron Irving L , Laubach Victor E , Mehaffey J Hunter , Roeser Mark E
Published: March 2021

Current burn therapy is largely supportive with limited therapies to curb secondary burn progression. Adenosine 2A receptor (A2AR) agonists have anti-inflammatory effects with decreased inflammatory cell infiltrate and release of proinflammatory mediators. Using a porcine comb burn model, we examined whether A2AR agonists could mitigate burn progression. Eight full-thickness comb burns (four prongs with three spaces per comb) per pig were generated with the following specifications: temperature 115°C, 3-kg force, and 30-second application time. In a randomized fashion, animals (four per group) were then treated with A2AR agonist (ATL-1223, 3 ng/kg/min, intravenous infusion over 6 hours) or vehicle control. Necrotic interspace development was the primary outcome and additional histologic assessments were conducted. Analysis of unburned interspaces (72 per group) revealed that ATL-1223 treatment decreased the rate of necrotic interspace development over the first 4 days following injury (p < .05). Treatment significantly decreased dermal neutrophil infiltration at 48 hours following burn (14.63 ± 4.30 vs 29.71 ± 10.76 neutrophils/high-power field, p = .029). Additionally, ATL-1223 treatment was associated with fewer interspaces with evidence of microvascular thrombi through postburn day 4 (18.8% vs 56.3%, p = .002). Two weeks following insult, the depth of injury at distinct burn sites (adjacent to interspaces) was significantly reduced by ATL-1223 treatment (2.91 ± 0.47 vs 3.28 ± 0.58 mm, p = .038). This work demonstrates the ability of an A2AR agonist to mitigate burn progression through dampening local inflammatory processes. Extended dosing strategies may yield additional benefit and improve cosmetic outcome in those with severe injury.
#81: Care Process Measures and Outcomes of Percutaneous Pulmonary Valve Implantation-associated Infective Endocarditis
Authors: Rubbab B , Talluto C , Nuibe A , Levorson R
Published: March 2021

Background

Percutaneous pulmonary valve implantation (PPVI) is being increasingly used as a minimally invasive corrective procedure for right ventricular outflow tract (RVOT) dysfunction. Ten-year survival following PPVI is estimated at over 90% due to the durability of the various bioprosthetic valves. However, infective endocarditis (IE) remains a potential complication of such valves with significant morbidity and mortality. We evaluated the presenting symptoms, clinical features, pathogens, and outcomes of patients with IE following PPVI to identify opportunities to improve early diagnosis and management.

Methods

A convenience sample of patients at a large Pediatric Cardiology practice in Northern Virginia was queried for PPVI and IE from January 1, 2016, to June 30, 2019. Manual chart review was done to extract clinical points of interest and descriptive analyses were performed. Patients were classified as having IE per modified Duke’s criteria.

Results

We identified 14 patients who underwent PPVI. Five of these patients (36%) developed IE. All IE patients had underlying Tetralogy of Fallot and none had previous episodes of IE. 60% of patients with IE were male with a median age of 26 years old (IQR 20–30). Four IE patients had a Melody valve and 1 had a SAPIEN valve. The median elapsed time between PPVI and IE diagnosis was 128 days (IQR 32–391) with a median duration of illness prior to the diagnosis of IE of 6 days (IQR 5–9). All IE patients had to present fever. 40% of IE patients had to present chest pain and 20% had presenting musculoskeletal pain. All IE patients had an elevated initial C-reactive protein (CRP) with a median value of 13.1 mg/dL (IQR 12.5–15.2). The median initial white blood cell count was 9.3 × 103/μL (IQR 8.1–10.3). The median duration of bacteremia was 1 day (IQR 1–2). A pathogen was recovered in all five IE patients with different organisms amongst the patients: coagulase-negative Staphylococcus species were recovered in patients who developed IE within 60 days from PPVI (Staphylococcus lugdunensis and Staphylococcus epidermidis) whereas coagulase-negative Staphylococcus species and oral commensal organisms were found in IE patients beyond 60 days from PPVI (Staphylococcus sanguinis, Gamella haemolysans, and Neisseria elongata). The initial echocardiogram did not show vegetations in any of the patients and 40% went on to have sternotomy with valve replacement. There were no deaths.

Conclusions

With an increase in PPVI, clinicians should have a high index of suspicion for IE in patients with underlying Tetralogy of Fallot who present with fever and elevated CRP, regardless of elapsed time from PPVI or valve type. Empiric antimicrobial therapy for suspected IE following PPVI should remain broad with other possible pathogens beyond coagulase-negative Staphylococcus species.
#3: A Historical Perspective to US Syphilis Reporting and the Recent Rise of Risky Behaviors Among Women with Syphilis
Authors: Quintana G
Published: March 2021

Background

Congenital syphilis is a vertically transmitted infectious disease with devastating consequences during the perinatal period, including stillbirth. On October 8, 2019, the CDC published a press release stating the urgent action needed to break the cycle of STD increases, including syphilis. The purpose of this study was to provide a brief historical perspective of syphilis coding, reporting, and monitoring system changes since 1992, discuss US syphilis incidence and trends, and assess risky behaviors among women with primary or secondary syphilis.

Methods

Quantitative data were obtained from CDC AtlasPlus, STD Surveillance 2018 report, and CDC Syphilis Surveillance Supplement 2013–2017.

Results

The possible association between risky sexual behaviors among reproductive-age women, such as the use of phone applications like Tinder, and increased rates of congenital syphilis have come into question. In 2017, risky behaviors reported by American women with syphilis were having sex while intoxicated (36.7%), having sex with an anonymous partner (21.8%), use of methamphetamine (16.6%), and having met a sex partner through the internet (11.6%). Women aged 35–39 were most likely to report of having sex while intoxicated (45.3%) followed by ages 25–34 (41.3%). Women aged 15–19 were most likely to meet a sex partner on the internet (16.7%). 22.6% of women reported the use of “other drug,” not categorized under “crack”, “poppers”, “cocaine,” “heroin,” “methamphetamine,” “injection drugs.” Furthermore, younger individuals were more likely to report the use of an “other drug” with increasing annual trends since 2013.

Conclusion

The highest reported risky behavior among women with syphilis was having sex while intoxicated. Unexpectedly, having met a sex partner on the internet was not among the highest reported risky behavior. Clarification of “other drugs” may be beneficial in understanding the risky behaviors among young women with syphilis. The correlation between risky sexual behaviors and drug use among reproductive-age women and increasing congenital syphilis rates warrants further investigation. A causal relationship between these two variables cannot be excluded until linked data are available, including further stratification of “other drug” categories.
#36: Can Astrovirus VA1, a Novel Human Astrovirus, Cause Diseases of the Central Nervous and Cardiovascular Systems?
Authors: Janowski A B , Dudley H , Feehley T , Ingle H , Baldridge M T , Virgin H W , Klein R S , Wang D
Published: March 2021

Background

Since their original isolation from human stool samples in 1975, astroviruses have been assumed to be pathogens exclusive to the gastrointestinal tract. However, astroviruses have been recently identified from brain tissue of humans and other mammals suffering from neurological diseases, suggesting that members of this family of viruses have a previously unrecognized neurotropism. One human astrovirus genotype, astrovirus VA1/HMO-C (VA1) is the most frequently identified astrovirus from cases of human encephalitis. We previously described the ability of several cell lines, including Caco-2, A549, and HEK293, to support VA1 growth in cell culture. Our goals were to develop cell culture and animal models to study the pathogenic potential of VA1.

Methods

VA1 was inoculated into primary astrocytes, primary neurons, and SK-N-SH cells in tissue culture. Viral RNA was measured in multistep growth curves by qRT-PCR, capsid was detected by immunofluorescence, and infectious titer was measured by a TCID50 assay. For development of an in vivo model of infection, mice were inoculated with VA1 with simultaneous intracranial, intraperitoneal, intravenous, and oral gavage inoculations with a VA1 stock. Mice were sacrificed 7 days after inoculation, RNA extracted from tissues, and viral load quantified by qRT-PCR. Tissue was also processed for histology and staining with hematoxylin and eosin. Primary human cardiac endothelial and myocytes were also inoculated with VA1 and viral RNA was measured in multistep growth curves by qRT-PCR.

Results

We detected the completion of the full VA1 lifecycle in primary astrocytes and SK-N-SH cells with >100-fold increase in viral RNA in a multistep growth curve, detection of intracellular viral capsid, and a >100-fold increase in the infectious titer. These results support the neurotropic potential of VA1. In the development of a mouse model of VA1 infection, we detected the virus in the brain tissue of mice 7 days after inoculation. Unexpectedly, we detected the highest titer of VA1 in heart tissue, which was associated with histological evidence of myocarditis. Furthermore, we demonstrated VA1 can replicate in primary human cardiac endothelial cells but not in primary human cardiac myocytes.

Conclusions

Our data demonstrate that astroviruses have tissue tropisms outside of the gastrointestinal tract. We provide the first demonstration that cultured neural-derived cells can support infection and replication of astroviruses, providing a model for studying the neuropathogenic potential of VA1. Furthermore, we have identified a novel cardiotropism for VA1, raising the possibility that VA1 may contribute to human cardiac diseases currently without an ascribed etiology.
#16: Use of a Multiplex PCR Panel for Diagnosis of Complicated Pneumonia in Pediatrics
Authors: Armas Elisa A , Melgar M , Juárez J , Vidal M , Eguizábal J , Gordillo R
Published: March 2021

Background

Pleural fluid cultures performed in the period from April 2015 to April 2017 (prior to having the test) were reviewed, 120 cultures were found, of which 7.5% were positive.

Methods

Descriptive study in patients from 0 to 12 years old, from April 2017 to April 2019, at Roosevelt Hospital, Guatemala City, June 2019

Results

In the period from April 2017 to April 2019, pleural fluids were evaluated in which multiplex PCR was performed, obtaining 41 results, 24 positive PCR for pneumonia producing bacteria in the community, of which only 1 positive culture was found, which, if correlated, which means 25 times more detection capacity, than the Gold standard of culture. Forty-one cultures of pleural fluids were evaluated, of which 58% were detected by FilmArray® The most frequently isolated microorganisms were Streptococcus pneumoniae 42%, Streptococcus sp. 3% Haemophilus influenzae 13% and Pseudomonas aeruginosa 3%

Conclusion

The use of Multiplex PCR in pleural fluid allowed the identification of a high percentage of microorganisms in the pleural fluid. Although the test is not valid for this use, its use could mean a great advantage for the etiological diagnosis.
#60: Knowledge of Diagnosis and Management of Chagas-related Heart Disease Among Pediatric Cardiologists in the United States
Authors: Malhotra Sanchi , Masood Imran , Giglio Noberto , Pruetz Jay , Pannaraj Pia
Published: March 2021

Background

Chagas disease is a highly pathogenic infection with a prevalence of approximately 5.7 million cases worldwide and greater than 300,000 cases in the United States. Up to 40% of immigrants to the United States are from highly endemic Latin American countries. An estimated 40,000 women of childbearing age in the United States are infected, with a 1–5% risk of vertical transmission. The impact of this disease is extensive, often life-long, and difficult to eradicate. The purpose of our study was to better understand current knowledge and experience among pediatric cardiologists in the United States with the cardiac presentations of Chagas disease to determine where to focus educational programs and critical content.

Methods

We prospectively disseminated a 19-question survey to pediatric cardiologists via the PediHeart, WSOPC, and Pediatric CHF listservs three times between September and November 2019. The survey included demographic, multiple-choice and Likert-scale questions. We used Qualtrics to ensure anonymity. Respondents outside of the United States were excluded.

Results

Of 140 responses received, 120 cardiologists treated pediatric patients in the United States. Over half (62.5%) of respondents served a >10% Latin American patient population. Most providers (87%) had not seen a case of Chagas disease in their practice; however, most (72%) also had never tested for Chagas. In response to the statement: “I feel comfortable recognizing cardiac presentations of Chagas disease in children”, (85%) of respondents disagreed. Most respondents selected that they would not include Chagas on their differential diagnosis for cardiac presentations that included conduction anomalies, myocarditis, and/or apical aneurysms (Figure 1). However, when considering patients who recently immigrated from Latin American nations, inclusion of Chagas in the differential diagnosis increased. In response to the statement: “If I was offered a lecture on Chagas-related heart disease, I would be likely to attend,” 87% of respondents agreed.

Conclusions

In our sample of pediatric cardiologists, very few had seen cases of Chagas disease, albeit very few tested for it or included it in their differential diagnosis. However, most individuals agreed that education on Chagas disease would be worth-while. Education could help ensure these cases are not missed in pediatrics. Future analysis should focus on changes in provider knowledge and/or testing as the incidence grows, or as educational programs are implemented.
#6: Varicella Outbreak Investigation in a Cancer Hospital
Authors: Vishnu Kaniyarakkal , Najna Edakuneri , Ambili Pottammal , Kavitha Dinesh
Published: March 2021

Background

Primary varicella infection is usually self-limited in immunocompetent hosts, whereas it can be quite severe in immunocompromised hosts. Atypical presentations of varicella in immunocompromised hosts can be diagnostically challenging, without laboratory testing. Varicella is an occupational hazard for susceptible healthcare providers (HCP). It assumes importance in infection prevention and control, due to the possibility of spread to other susceptible coworkers and patients.

Methods

This outbreak investigation report is from a 300-bed cancer care hospital in South India. A 62-year-old male patient with lymphoplasmacytic non-Hodgkin’s lymphoma was admitted on October 1 with features of bronchopneumonia and extensive skin lesions, 2 months after his last chemotherapy cycle. The patient was received in the emergency department (ED) and later shifted to the intensive care unit (ICU) due to worsening clinical condition. The clinical picture was more in favor of Stevens–Johnson syndrome, but oral acyclovir therapy was given considering a differential diagnosis of varicella. His condition deteriorated further requiring ventilator support and on the 19th day of admission, the patient succumbed to his illness and passed away. From October 14 to 19, eight HCP presented with vesicular eruptions and fever, clinically diagnosed as having varicella. This aroused the suspicion of an outbreak. An emergency outbreak control group meeting was convened to assess and address the situation.

Results

All outbreak cases were confirmed as varicella, clinically. Contacts, including patients assigned to HCP involved in the outbreak were traced, and their varicella immune status was assessed. Nonimmune contacts were given oral acyclovir prophylaxis as per CDC recommendations. Other HCP in the hospital were offered first dose of varicella vaccine based on their varicella immune status. With these infection prevention and control measures in place, no additional cases were identified.

Being a hospital in low- to middle-income country, it was not routine practice to vaccinate susceptible HCP, after screening of varicella immune status at the time of recruitment. In the wake of the outbreak, assessment of immunity against varicella, and vaccination of susceptible HCP, is being followed up meticulously.

Conclusion

Varicella can present with atypical symptoms, especially in the immunocompromised host. Suspected cases should be isolated until sensitive PCR studies are done. Varicella immune status of HCP should be assessed at recruitment and vaccination should be offered to susceptible individuals. Implementation and infection prevention and control measures can help prevent and mitigate varicella outbreaks within healthcare facilities.
#34: Measles Outbreak in Pediatric Oncology Patients in Hue Central Hospital, Vietnam
Authors: Hoa Nguyen Thi Kim , Hao Tran Kiem , Van Ha Chau
Published: March 2021

Background

Measles outbreaks in immunocompromised populations present a significant challenge, and to interrupt endemic transmission can be difficult. This study aimed to investigate measles in pediatric oncology patients at Hue Central Hospital, Vietnam to describe demographic, epidemiological, and clinical features.

Methods

Potential measles infections among children with cancer were prospectively identified between April 20 to July 10, 2019 at Hue Central Hospital. Measles diagnoses were based on both clinical features and IgM laboratory evaluation. Data were abstracted from patient medical records and analyzed in SPSS v.18.0 (IBM Corp., Armonk, NY, USA).

Results

From April 20 to July 10 in 2019, a total of 11 patients with malignancies were identified as having measles, with a median age of 4.0 years (range: 1 years to 9 years). Of these 11 patients, 2 (18.2%) had not received any dose of measles vaccine, 4 (36.4%) had received 1 dose of measles vaccine, and 5 (45.5%) had received the recommended 2 doses. All patients had fever with the median temperature of 39 degrees Celsius (range: 38.5–39.5), and median fever duration of 7 days. All patients had cough and rash, while 3 (27.3%) were complicated by pneumonia, and 2 (18.2%) had elevated liver transaminases. All patients had hospital visits or were hospitalized before measles onset, with the median length of stay of 10 days (range: 7–24 days). All patients were likely to exposed each other. 100% of these patients recovered.

Conclusions

Children with cancer are at extra risk of measles infection due to their immunocompromised status. Getting vaccinated is the best way to prevent measles, and improved infection control is critical for the prevention of measles in patients with malignancies. Following this measles outbreak, a designated outpatient area was established to separate the inpatient unit and limit hospital transmission.
Diachronic delta: A computational method for analysing periods of accelerated change in literary datasets
Authors: Beausang Chris
Published: March 2021

In his recently published book Distant Horizons (2019), Ted Underwood argues that literary change takes place incrementally. By analysing a dataset of English language fiction obtained from the digital research library HathiTrust, Underwood demonstrates that from the early 18th to the 21st century, literature written in English evinces a steady increase in words associated with physical description, concrete nouns as well as sensory perception and that this increase is accompanied by a proportional decrease in words associated with politics, economics as well as religion (Underwood 25). This article represents an effort to test Underwood’s incremental hypothesis by operationalizing Peter W.H. Smith and W. Aldridge’s cosine distance-based emendation to John Burrows’ ‘Delta’ method (Smith, P. W. H. and Aldridge, W. (2011). Improving authorship attribution: optimising burrows’ delta method. Journal of Quantitative Linguistics 18(1): 63–88). By applying cosine Delta across time rather than as it is conventionally applied, across text (Evert, Stefan et al. Understanding and Explaining Delta Measures for Authorship Attribution. Digital Scholarship in the Humanities 32 (suppl_2) (2017): ii4–ii16), we can identify particular years as being associated with extensive amounts of ‘novelty’ (which years introduce the most amount of distance from their predecessors) and also possess extensive amounts of ‘resonance’ (are relatively proximate to their successors). According to Alexander T.J. Barron et al.’s method for analysing the parliamentary debates of the French revolution, agents within a dataset which have high amounts of novelty and high amounts of resonance are both innovative and influential, as they are significantly different from the years which come before and relatively similar to the years which come after. We might refer to these years as ‘breaks’ and contrast their behaviour with the longue-durée approach otherwise prevalent within the computational literary studies discourse. Though, as this article demonstrates, Underwood’s hypothesis of incremental change remains robust when considering the changes which come over the novel from the mid-18th to the early 20th century, applying this method to poetic and dramatic production over the same period of time, thereby examining the distinct ways in which novelty and resonance behave, allow us to modulate Underwood’s hypothesis and to understand literary history within a more conjunctural framework.
Development and Overview
Authors: Burgio Louis D. , Wynn Matthew J.
Published: March 2021

This chapter describes the basic tenets of the REACH OUT protocol and how they came to be. It begins with an overview of the development of the REACH OUT protocol and details the program’s evolution over more than two decades. The chapter describes the five risk areas around which the REACH OUT program revolves: home safety, physical health, emotional well-being, behavior management, and social support. Following this, it provides a brief description of the tools available to the clinician as well as the intervention strategies utilized on a session-by-session basis. The chapter ends with a sample intervention schedule to help the clinician organize a potential timeline for treatment.
Risk Area 1: Home Safety
Authors: Burgio Louis D. , Wynn Matthew J.
Published: March 2021

This chapter describes one of the five risk areas, namely, home safety. It aims to lead clinicians and caregivers through the process of ensuring personal safety for both the person with dementia and the caregiver. Clinicians are given a brief list of home safety items to check, arranged by area of the home, and referenced to an Appendix of this manual where a full Home Safety Checklist can be found. When safety problems are identified through the risk assessment, clinicians can incorporate items from these lists into their Action Plans in order to promote home safety. This chapter may be revisited throughout the REACH OUT protocol as new issues related to safety are identified.
Risk Area 2: Keeping the Caregiver Physically Healthy
Authors: Burgio Louis D. , Wynn Matthew J.
Published: March 2021

This chapter describes one of the five risk areas, namely, caregiver physical health. Outcomes in caregiver intervention research commonly have focused on the mental health or psychosocial consequences of caregiving. Caregiving can be a prolonged stressor, however, and caregivers may be at risk for conditions such as high blood pressure or other negative physical health symptoms. This chapter focuses on basic education regarding caregiver health by referring clinicians and caregivers to the Healthy Lifestyle Guide, located in the Appendix. When caregiver health issues are identified through the risk assessment, clinicians can reference this chapter as they create their Action Plans targeting improvement in caregiver physical health.
What Are School Attendance Problems?
Authors: Kearney Christopher A.
Published: March 2021

This chapter provides an overview of types of school attendance problems, including full-day absences, partial absences or skipped classes, tardiness, morning behavior problems in an attempt to miss school, and distress during the school day. This chapter also includes a summary of what the book is about as well as a discussion of conditions under which the book will be more helpful or less helpful to parents. This chapter provides suggestions for seeking outside professional help if the book is deemed less helpful. This chapter also covers prevalence of school attendance problems, common characteristics of this population, adjusting to a new school, medical conditions associated with absenteeism, and how to define success. This chapter also asks parents to collate main contact information for parties needed to help resolve a child’s school attendance problems.
Mechanism of REST/NRSF regulation of clustered protocadherin α genes
Authors: Tang Yuanxiao , Jia Zhilian , Xu Honglin , Da Lin-tai , Wu Qiang
Published: March 2021

Repressor element-1 silencing transcription factor (REST) or neuron-restrictive silencer factor (NRSF) is a zinc-finger (ZF) containing transcriptional repressor that recognizes thousands of neuron-restrictive silencer elements (NRSEs) in mammalian genomes. How REST/NRSF regulates gene expression remains incompletely understood. Here, we investigate the binding pattern and regulation mechanism of REST/NRSF in the clustered protocadherin (PCDH) genes. We find that REST/NRSF directionally forms base-specific interactions with NRSEs via tandem ZFs in an anti-parallel manner but with striking conformational changes. In addition, REST/NRSF recruitment to the HS5–1 enhancer leads to the decrease of long-range enhancer-promoter interactions and downregulation of the clustered PCDHα genes. Thus, REST/NRSF represses PCDHα gene expression through directional binding to a repertoire of NRSEs within the distal enhancer and variable target genes.
A Systematic Review of Minimally Invasive Procedures for Mesial Temporal Lobe Epilepsy: Too Minimal, Too Fast?
Authors: Wang Ryan , Beg Usman , Padmanaban Varun , Abel Taylor J , Lipsman Nir , Ibrahim George M , Mansouri Alireza
Published: March 2021

BACKGROUND

Cortico-amygdalohippocampectomy (CAH) is effective for mesial temporal lobe epilepsy (mTLE). Concerns regarding surgical morbidity have generated enthusiasm for more minimally invasive interventions. A careful analysis of current data is warranted before widespread adoption of these techniques.

OBJECTIVE

To systematically review the use of laser interstitial thermal therapy (LITT), stereotactic radiosurgery (SRS), radiofrequency thermocoagulation (RF-TC), and focused ultrasound for mTLE.

METHODS

Major online databases were searched for prospective observational studies, randomized clinical trials, and retrospective studies (>50 patients), including mTLE patients. Outcomes of interest were seizure freedom (Engel I), complications and re-operation rates, and neuropsychological and quality-of-life (QoL) data.

RESULTS

Nineteen publications were identified. At ≥6 mo postoperatively, LITT (9/19) Engel I outcomes ranged from 52% to 80%. SRS (3/19) has a latency period (52%-67%, 24-36 mo postoperatively) and the radiosurgery vs. open surgery for epilepsy (ROSE) trial reported inferiority of SRS compared to CAH. RF-TC (7/19) demonstrated variable seizure freedom rates (0%-79%) and high re-operation rates (0%-90%). Twelve studies reported neuropsychological outcomes but QoL (4/19) was not widely reported, and few studies (3/19) assessed both. Study quality ranged from fair to good.

CONCLUSION

Based on nonrandomized data, LITT has compelling evidence of efficacy; however, comparisons to surgical resection are lacking. SRS has a latency period and is inferior to CAH (ROSE trial). RF-TC is a less resource-intensive alternative to LITT; however, comparisons of efficacy are limited. Additional studies are needed before minimally invasive procedures can supplant standard surgery.
Magnetic Resonance Imaging Parameters for Noninvasive Prediction of Epidermal Growth Factor Receptor Amplification in Isocitrate Dehydrogenase-Wild-Type Lower-Grade Gliomas: A Multicenter Study
Authors: Park Yae Won , Park Ji Eun , Ahn Sung Soo , Kim Eui Hyun , Kang Seok-Gu , Chang Jong Hee , Kim Se Hoon , Choi Seung Hong , Kim Ho Sung , Lee Seung-Koo
Published: March 2021

BACKGROUND

The epidermal growth factor receptor (EGFR) amplification status of isocitrate dehydrogenase-wild-type (IDHwt) lower-grade gliomas (LGGs; grade II/III) is one of the key markers for diagnosing molecular glioblastoma. However, the association between EGFR status and imaging parameters is unclear.

OBJECTIVE

To identify noninvasive imaging parameters from diffusion-weighted and dynamic susceptibility contrast imaging for predicting the EGFR amplification status of IDHwt LGGs.

METHODS

A total of 86 IDHwt LGG patients with known EGFR amplification status (62 nonamplified and 24 amplified) from 3 tertiary institutions were included. Qualitative and quantitative imaging features, including histogram parameters from apparent diffusion coefficient (ADC), normalized cerebral blood volume (nCBV), and normalized cerebral blood flow (nCBF), were assessed. Univariable and multivariable logistic regression models were constructed.

RESULTS

On multivariable analysis, multifocal/multicentric distribution (odds ratio [OR] = 11.77, P = .006), mean ADC (OR = 0.01, P = .044), 5th percentile of ADC (OR = 0.01, P = .046), and 95th percentile of nCBF (OR = 1.24, P = .031) were independent predictors of EGFR amplification. The diagnostic performance of the model with qualitative imaging parameters increased significantly when quantitative imaging parameters were added, with areas under the curves of 0.81 and 0.93, respectively (P = .004).

CONCLUSION

The presence of multifocal/multicentric distribution patterns, lower mean ADC, lower 5th percentile of ADC, and higher 95th percentile of nCBF may be useful imaging biomarkers for EGFR amplification in IDHwt LGGs. Moreover, quantitative imaging biomarkers may add value to qualitative imaging parameters.
Overview and General Preconditions
Authors: Schillig Michael
Published: March 2021

The chapter provides an overview of the available resolution tools and powers in the jurisdictions under consideration. The remainder of the chapter focuses on the general preconditions for and effects of resolution proceedings, It covers the resolution triggers, notably the so-called ‘regulatory threshold’, and discusses the institutional framework for the initiation and control of the resolution process. Further key considerations are the independent ex ante and ex post valuations of the institution at issue and the write-down and conversion of capital instruments, as well as the general effects of resolution proceedings on the financial contracts to which the institution is a party.