bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding the Enemy: A Review of the Genetics, Behavior and Chemical Ecology of Varroa destructor, the Parasitic Mite of Apis mellifera
Authors: Reams Taylor , Rangel Juliana
Published: December 2021

Varroa destructor (Mesostigmata: Varroidae) is arguably the most damaging parasitic mite that attacks honey bees worldwide. Since its initial host switch from the Asian honey bee (Apis cerana) (Hymenoptera: Apidae) to the Western honey bee (Apis mellifera) (Hymenoptera: Apidae), Varroa has become a widely successful invasive species, attacking honey bees on almost every continent where apiculture is practiced. Two haplotypes of V. destructor (Japanese and Korean) parasitize A. mellifera, both of which vector various honey bee-associated viruses. As the population of Varroa grows within a colony in the spring and summer, so do the levels of viral infections. Not surprisingly, high Varroa parasitization impacts bees at the individual level, causing bees to exhibit lower weight, decreased learning capacity, and shorter lifespan. High levels of Varroa infestation can lead to colony-wide varroosis and eventually colony death, especially when no control measures are taken against the mites. Varroa has become a successful parasite of A. mellifera because of its ability to reproduce within both drone cells and worker cells, which allows populations to expand rapidly. Varroa uses several chemical cues to complete its life cycle, many of which remain understudied and should be further explored. Given the growing reports of pesticide resistance by Varroa in several countries, a better understanding of the mite’s basic biology is needed to find alternative pest management strategies. This review focuses on the genetics, behavior, and chemical ecology of V. destructor within A. mellifera colonies, and points to areas of research that should be exploited to better control this pervasive honey bee enemy.
Logging effects on parasitic infections in a swamp rat (Malacomys edwardsi) in West Africa
Authors: Lawer Eric Adjei , Mupepele Anne-Christine , Darkoh Esther Love , Farwig Nina , Oware Seth , Larbi John Asiedu , Essiaw-Quayson Godwin , Klein Alexandra-Maria
Published: December 2021

Habitat disturbance can have negative impacts on biodiversity, such as reducing species richness. The effects of habitat disturbances on parasite infections of host species, potentially altering their survival rate and thus abundance, are less well known. We examined the influence of forest logging in combination with seasonality, host abundance, host body condition, and host sex, on the community composition of gastrointestinal parasites infecting Edward’s swamp rat, Malacomys edwardsi. Community composition of parasites did not differ between logged and undisturbed sites, but the abundance of some nematodes (i.e., Ascaris and hookworm) was higher in undisturbed than logged sites. The higher abundance of these nematode species implies a changed host-parasite relationship, thus potentially influencing host persistence.
Split Questionnaire Designs for Online Surveys: The Impact of Module Construction on Imputation Quality
Authors: Axenfeld Julian B , Blom Annelies G , Bruch Christian , Wolf Christof
Published: December 2021

Established face-to-face surveys encounter increasing pressures to move online. Such a mode switch is accompanied with methodological challenges, including the need to shorten the questionnaire that each respondent receives. Split Questionnaire Designs (SQDs) randomly assign respondents to different fractions of the full questionnaire (modules) and, subsequently, impute the data that are missing by design. Thereby, SQDs reduce the questionnaire length for each respondent. Although some researchers have studied the theoretical implications of SQDs, we still know little about their performance with real data, especially regarding potential approaches to constructing questionnaire modules. In a Monte Carlo study with real survey data, we simulate SQDs in three module-building approaches: random, same topic, and diverse topics. We find that SQDs introduce bias and variability in univariate and especially in bivariate distributions, particularly when modules are constructed with items of the same topic. However, single topic modules yield better estimates for correlations between variables of the same topic.
First reported case of intraocular gnathostomiasis in China
Authors: Wang Shuang , Zhang Ling , Miao Feng , Huang Jun , Guo Juan
Published: December 2021

A young man complained of his left eye painful and vision loss. We found a nematode body on the surface of the iris. The parasite was taken out and identified as the third-stage larva of Gnasthosoma spinigerum. This is the first intraocular report in China.
Unequal-mass mergers of dark matter haloes with rare and frequent self-interactions
Authors: Fischer Moritz S , Brüggen Marcus , Schmidt-Hoberg Kai , Dolag Klaus , Ragagnin Antonio , Robertson Andrew
Published: December 2021

Dark matter (DM) self-interactions have been proposed to solve problems on small length scales within the standard cold DM cosmology. Here, we investigate the effects of DM self-interactions in merging systems of galaxies and galaxy clusters with equal and unequal mass ratios. We perform N-body DM-only simulations of idealized setups to study the effects of DM self-interactions that are elastic and velocity-independent. We go beyond the commonly adopted assumption of large-angle (rare) DM scatterings, paying attention to the impact of small-angle (frequent) scatterings on astrophysical observables and related quantities. Specifically, we focus on DM-galaxy offsets, galaxy–galaxy distances, halo shapes, morphology, and the phase–space distribution. Moreover, we compare two methods to identify peaks: one based on the gravitational potential and one based on isodensity contours. We find that the results are sensitive to the peak finding method, which poses a challenge for the analysis of merging systems in simulations and observations, especially for minor mergers. Large DM-galaxy offsets can occur in minor mergers, especially with frequent self-interactions. The subhalo tends to dissolve quickly for these cases. While clusters in late merger phases lead to potentially large differences between rare and frequent scatterings, we believe that these differences are non-trivial to extract from observations. We therefore study the galaxy/star populations which remain distinct even after the DM haloes have coalesced. We find that these collisionless tracers behave differently for rare and frequent scatterings, potentially giving a handle to learn about the micro-physics of DM.
Using a chemical genetic screen to enhance our understanding of the antimicrobial properties of copper
Authors: Gugala Natalie , Salazar-Alemán Daniel A , Chua Gordon , Turner Raymond J
Published: December 2021

The competitive toxic and stress-inducing nature of copper necessitates systems that sequester and export this metal from the cytoplasm of bacterial cells. Several predicted mechanisms of toxicity include the production of reactive oxygen species, thiol depletion, DNA, and iron–sulfur cluster disruption. Accompanying these mechanisms include pathways of homeostasis such as chelation, oxidation, and transport. Still, the mechanisms of copper resistance and sensitivity are not fully understood. Furthermore, studies fail to recognize that the response to copper is likely a result of numerous mechanisms, as in the case for homeostasis, in which proteins and enzymes work as a collective to maintain appropriate copper concentrations. In this study, we used the Keio collection, an array of 3985 Escherichia coli mutants, each with a deleted non-essential gene, to gain a better understanding of the effects of prolonged exposure to copper. In short, we recovered two copper homeostatic genes involved in transporting and assembling that are required in mediating prolonged copper stress under the conditions assessed. The gene coding for the protein TolC was uncovered as a sensitive hit, and we demonstrated that tolC, an outer membrane efflux channel, is key in mitigating copper sensitivity. Additionally, the activity of tRNA processing was enriched along with the deletion of several proteins involved in importing generated copper tolerance. Lastly, key genes belonging to central carbon metabolism and nicotinamide adenine dinucleotide biosynthesis were uncovered as tolerant hits. Overall, this study shows that copper sensitivity and tolerance are a result of numerous mechanisms acting in combination within the cell.
Fiduciary Duties, Secret Profits, and the Illegality Defence: Crown Prosecution Service v Aquila Advisory Ltd [2021] UKSC 49
Authors: Purewal Anita
Published: December 2021

CPS v Aquila Advisory Ltd has provided a welcomed judgment on the application of the illegality defence in the context of secret profits accrued in breach of fiduciary duties. The judgment clarifies the priority to be given to constructive trusts over unauthorised fiduciary profits in the face of CPS confiscation orders, and examines the interrelationship between the rules of attribution and the application of the illegality defence today, namely whether a director’s unlawful intention can be attributed to their company to prevent the company, on illegality grounds, from exercising a proprietary interest over the secret profits accrued.
Effects of elevated CO2 concentration and nitrogen addition on the chemical compositions, construction cost and payback time of subtropical trees in Cd-contaminated mesocosm soil
Authors: Zang Xiaowei , Luo Xianzhen , Hou Enqing , Zhang Guihua , Zhang Xiaofeng , Xiao Meijuan , Wen Dazhi , Zhang Lingling
Published: December 2021

Rising atmospheric CO2 concentration ([CO2]) and nitrogen (N) deposition are changing plant growth, physiological characteristics and chemical compositions; however, few studies have explored such impacts in a heavy metal-contaminated environment. In this study, we conducted an open-top chamber experiment to explore the impacts of 2 years of elevated atmospheric [CO2] and N addition on the growth, physiological characteristics and chemical compositions of five subtropical tree species in a cadmium (Cd)-contaminated environment. Results showed that N addition significantly increased concentration of leaf N and protein in five tree species and also decreased payback time (PBT) and leaf carbon:nitrogen ratios and increased tree relative height growth rate (RGR-H) and basal diameter growth rate (RGR-B) in Liquidambar formosana Hance and Syzygium hainanense Chang et Miau. Elevated [CO2] increased leaf maximum photosynthetic rate (Amax) and concentration of total non-structural carbohydrates and shortened PBT to offset the negative effect of Cd contamination on RGR-B in Acacia auriculiformis A. Cunn. ex Benth. The combined effects of elevated [CO2] and N addition did not exceed their separate effects on RGR-H and RGR-B in Castanopsis hystrix Hook. f. & Thomson ex A. DC. and Cinnamomum camphora (L.) presl. The addition of N significantly increased the concentration of leaf Cd by 162.1% and 338.0%, and plant Cd bio-concentration factor by 464% and 861% in C. hystrix and C. camphora, respectively, compared with only Cd addition. Among the five tree species, the decrease in PBT and the increase in Amax, RGR-B and concentrations of leaf protein in response to N and Cd addition under elevated [CO2] were on average 86.7% higher in A. auriculiformis than other species, suggesting that the mitigation of the negative effects of Cd pollution by elevated [CO2] and N addition among five species was species-specific. Overall, we concluded that N addition and elevated [CO2] reduced Cd toxicity and increased the growth rate in A. auriculiformis, S. hainanense and L. formosana, while it maintained the growth rate in C. hystrix and C. camphora by differently increasing photosynthetic rate, altering the leaf chemical compositions and shortening PBT.
Anthropometric measurements of the pediatric hip using CT-based simulated anteroposterior radiographs of the pelvis
Authors: Darwich Ali , Bdeir Mohamad , Janssen Sonja , Schoenberg Stefan O. , Gravius Sascha , Jawhar Ahmed , Faymonville Christoph
Published: December 2021

Normal anatomical variants and pathological deformities of the pediatric hip can only be differentiated after a prior definition of normal ranges for anthropometric parameters with increasing age. Aim of the present study was to provide reliable reference values of the pediatric hip morphometry, using computed tomography (CT)-based rotation-corrected summation images of the pelvis that simulate the widely available plain radiograph-based measurements, but offer the higher precision of the CT technique. This retrospective study included 85 patients (170 hips) under 15 years of age (0–15). The measured anthropometric parameters included femur head extrusion index, lateral center-edge angle, acetabular inclination, Tönnis angle, and femoral neck-shaft angle. Mean values, range, SD, P values, intra-rater, and inter-rater reliability were calculated. All measurements correlated with age. None of the measurements correlated with gender or side. Rapid growth phases were noted in all measurements at the age of 12 (14 in males and 11 in females). The inter-rater and intra-rater reliability was high (range inter/intraclass correlation coefficient 0.926–0.998 Cronbach’s alpha 0.986–0.998). The present work provides age- and gender-related normative values of the classically used hip measurements as well as growth phases describing pediatric hip morphology in a broad age range. A discrepancy was noted between the values measured in the current study and the classical X-ray-based reference values in the literature especially for the Tönnis angle and LCEA values. This suggests that the rotation and inclination correction in the CT-based techniques might have the advantage of compensating for a possible overestimation in the conventional X-ray-based methods.
Altered Heart Rate Variability Early in ICU Admission Differentiates Critically Ill Coronavirus Disease 2019 and All-Cause Sepsis Patients
Authors: Kamaleswaran Rishikesan , Sadan Ofer , Kandiah Prem , Li Qiao , Coopersmith Craig M. , Buchman Timothy G.
Published: December 2021

IMPORTANCE:

Altered heart rate variability has been associated with autonomic dysfunction in a number of disease profiles, in this work we elucidate differences in the biomarker among patients with all-cause sepsis and coronavirus disease 2019.

OBJECTIVES:

To measure heart rate variability metrics in critically ill coronavirus disease 2019 patients with comparison to all-cause critically ill sepsis patients.

DESIGN, SETTING, AND PARTICIPANTS:

Retrospective analysis of coronavirus disease 2019 patients admitted to an ICU for at least 24 hours at any of Emory Healthcare ICUs between March 2020 and April 2020 up to 5 days of ICU stay. The comparison group was a cohort of all-cause sepsis patients prior to coronavirus disease 2019 pandemic.

MAIN OUTCOMES AND MEASURES:

Continuous waveforms were captured from the patient monitor. The electrocardiogram was then analyzed for each patient over a 300 seconds observational window that was shifted by 30 seconds in each iteration from admission till discharge. A total of 23 heart rate variability metrics were extracted in each iteration. We use the Kruskal-Wallis and Steel-Dwass tests (p < 0.05) for statistical analysis and interpretations of heart rate variability multiple measures.

RESULTS:

A total of 141 critically ill coronavirus disease 2019 patients met inclusion criteria, who were compared with 208 patients with all-cause sepsis. Three nonlinear markers, including the ratio of standard deviation derived from the Poincaré plot, sample entropy, and approximate entropy and four linear features, including mode of beat-to-beat interval, acceleration capacity, deceleration capacity, and the proportion of consecutive RR intervals that differ by more than 50 ms, were all statistically significant (p < 0.05) between the coronavirus disease 2019 and all-cause sepsis cohorts. The three nonlinear features and acceleration capacity, deceleration capacity, and beat-to-beat interval (mode) were statistically significant (p < 0.05) when comparing pairwise analysis among the combinations of survivors and nonsurvivors between the coronavirus disease 2019 and sepsis cohorts. Temporal analysis of the main markers showed low variability across the 5 days of analysis compared with sepsis patients.

CONCLUSIONS AND RELEVANCE:

In this descriptive statistical study, heart rate variability measures were found to be statistically different across critically ill patients infected with severe acute respiratory syndrome coronavirus 2 and distinct from bacterial sepsis.
A Tale of Two Waves: Changes in the Use of Noninvasive Ventilation and Prone Positioning in Critical Care Management of Coronavirus Disease 2019
Authors: Parker Alexander J. , Mishra Monalisa , Tiwary Pooja , Sharman Mike , Priya-Sharma Manu , Duncan Alastair , Shanmugam Mohan , Bhatia Kailash , Fullwood Catherine , Martin Andrew D. , Wilson Anthony
Published: December 2021

Importance:

New treatments and increased experience are changing the management of hospitalized coronavirus disease 2019 patients but the impact on ICU management is unclear.

Objectives:

To examine characteristics, ventilatory management, and outcomes of critically ill patients in two distinct waves of the pandemic.

Design, Setting, and Participants:

Observational cohort study in an ICU in a single-center university-affiliated U.K. hospital. Two-hundred ten adults with coronavirus disease 2019 admitted to ICU between March 17, 2020, to May 31, 2020, and September 1, 2020, to December 10, 2020, with hourly data and 100% follow-up to ICU discharge.

Main Outcomes and Measures:

Data were extracted from the electronic medical record for patient characteristics and clinical data. Patients were classified into distinct waves of the pandemic and assessed for differences between the two waves.

Results:

The duration of noninvasive ventilation/nasal high flow increased in wave 2 versus wave 1, both in self-ventilating patients (107 vs 72 hr; p = 0.02), and in those ultimately requiring invasive mechanical ventilation (34 vs 10 hr; p = 0.02). The proportion of survivors treated without invasive mechanical ventilation increased in wave 2 (59% vs 39%; p = 0.01). In both waves, longer duration of noninvasive ventilation/nasal high flow prior to intubation was associated with higher ICU mortality (survivors 10 hr [4–21 hr] vs nonsurvivors 50 hr [23–124 hr]; p < 0.01). Proned invasive mechanical ventilation was common (54.7%) and prolonged. In wave 2, invasive mechanical ventilation patients were generally more hypoxic with proning initiated at lower Pao2/Fio2 ratios (81 vs 116 mm Hg; p = 0.02) and yielding smaller improvements in Fio2 requirements. Continued proning episodes despite poor responses were commonplace and typically futile. Length of stay for patients requiring tracheostomy increased markedly in wave 2 (51.3 vs 33.7 d; p = 0.03). Overall survival remained similar in wave 2 (68.0% vs 60.9%; p = 0.31).

Conclusions and Relevance:

Our data suggest that management of critically ill coronavirus disease 2019 patients is changing with more survivors avoiding invasive mechanical ventilation. Duration of noninvasive ventilation/nasal high flow use is increasing, which may be associated with worsening outcomes for individuals who require invasive mechanical ventilation. Among invasively ventilated patients, changes in the use of and response to prone positioning and increased length of stay following tracheostomy may imply that the care of these patients is becoming more challenging.
Definitive Chemoradiotherapy Results in Synchronous Oligometastatic Non–small Cell Lung Cancer Patients
Authors: Duru Birgi Sumerya , Akgun Zuleyha , Hurmuz Pervin , Akyurek Serap , Kaytan Saglam Esra , Yilmaz Melek Tugce , Bakirarar Batuhan , Cengiz Mustafa
Published: December 2021

Objective:

It is aimed to investigate the survival outcomes and prognostic factors after curative treatment of patients diagnosed with synchronous oligometastatic non–small cell lung carcinoma.

Materials and Methods:

Fifty-two patients from 3 centers diagnosed between 2014 and 2019 were analyzed. The treatment results of thoracic and oligometastatic regions were retrospectively evaluated. The Kaplan-Meier method was used to determine the overall survival (OS) and progression-free survival (PFS) and log-rank tests for the factors affecting survival. Cox regression analysis was employed for multivariate analysis.

Results:

Of the 52 patients, 46 (88%) had <2 organ involvement at diagnosis. Treatment of oligometastasis was radiotherapy (RT) in 37, surgery in 4, and surgery with RT in 11 patients. Median 60 Gy were administered to the thoracic tumor. Median RT dose for oligometastasis was 30 Gy in median 5 fractions with either stereotactic body radiation therapy or conventional RT. The median follow-up was 18 months. The median OS and PFS were 35 and 20 months, respectively. The 1-, 2-, and 3-year OS rates were 80.5%, 60.2%, and 41.2%, while the corresponding PFS rates were 75%, 42.5%, and 21.5%, respectively. Multivariate Cox regression analysis revealed that the Eastern Cooperative Oncology Group performance status of “0” and thoracic RT dose over 60 Gy were significant prognostic factors for both the OS and PFS.

Conclusions:

Definitive chemoradiotherapy to the thoracic tumor and treatment of oligometastasis region indicate promising survival outcomes.
Comparison of Long-Term Effectiveness and Safety of Microwave and Surgery in the Treatment of Axillary Osmidrosis: A Single-Center Retrospective Study
Authors: Chen Si-Qi , Wang Ting-Ting , Zhou Yuan , Li Wei , Man Xiao-Yong
Published: December 2021

BACKGROUND

A microwave-based device is a newly developed method for treating axillary osmidrosis. Few studies have compared the difference between microwave therapy and subcutaneous curettage for axillary osmidrosis.

OBJECTIVE

To compare the long-term effectiveness, complications, and recurrence of osmidrosis after microwave therapy and subcutaneous curettage.

METHODS AND MATERIALS

Medical records of 155 patients with osmidrosis treated with microwave therapy or subcutaneous curettage were reviewed retrospectively. Demographic data, visual analog scale for odor, hyperhidrosis disease scale, complications, and recurrence were analyzed.

RESULTS

Osmidrosis improved significantly in both treatment groups at 6 months. Effective improvement was observed in 90% and 23% of the patients in the surgery and microwave groups, respectively, after 3 years postoperatively. The recurrence rates were 39% and 21% in the microwave and surgery groups, respectively. The transient complication rate was higher in the microwave group, and long-term complications only occurred in the surgery group.

CONCLUSION

Subcutaneous curettage is a more effective approach for axillary osmidrosis. However, microwave therapy is recommended for patients with cosmetic concerns.
The Joint Effects of Depression and Comorbid Psychiatric Disorders on Suicide Deaths
Authors: Jiang Tammy , Nagy Dávid , Rosellini Anthony J. , Horváth-Puhó Erzsébet , Keyes Katherine M. , Lash Timothy L. , Galea Sandro , Sørensen Henrik T. , Gradus Jaimie L.
Published: December 2021

Background:

Previous studies of the effect of interaction between psychiatric disorders on suicide have reported mixed results. We investigated the joint effect of depression and various comorbid psychiatric disorders on suicide.

Methods:

We conducted a population-based case–cohort study with all suicide deaths occurring between 1 January 1995 and 31 December 2015 in Denmark (n = 14,103) and a comparison subcohort comprised of a 5% random sample of the source population at baseline (n = 265,183). We quantified the joint effect of pairwise combinations of depression and major psychiatric disorders (e.g., organic disorders, substance use disorders, schizophrenia, bipolar disorder, neurotic disorders, eating disorders, personality disorders, intellectual disabilities, developmental disorders, and behavioral disorders) on suicide using marginal structural models and calculated the relative excess risk due to interaction. We assessed for the presence of competing antagonism for negative relative excess risk due to interactions.

Results:

All combinations of depression and comorbid psychiatric disorders were associated with increased suicide risk. For example, the rate of suicide among men with depression and neurotic disorders was 20 times (95% CI = 15, 26) the rate in men with neither disorder. Most disorder combinations were associated with subadditive suicide risk, and there was evidence of competing antagonism in most of these cases.

Conclusions:

Subadditivity may be explained by competing antagonism. When both depression and a comorbid psychiatric disorder are present, they may compete to cause the outcome such that having 2 disorders may be no worse than having a single disorder with respect to suicide risk.
Facial Skin Revitalization with Cohesive Polydensified Matrix-HA20G: Results from a Randomized Multicenter Clinical Study
Authors: Kerscher Martina , Prager Welf , Fischer Tanja C. , Gauglitz Gerd G. , Pavicic Tatjana , Kühne Ulrich , Kravtsov Maria , Hofmann Matthias , Dersch Hanna , Sattler Sonja
Published: December 2021

Background:

There is a growing interest in the application of hyaluronic acid (HA) derivatives in skin quality improvement. The aim of this study was to confirm safety and effectiveness of cohesive polydensified matrix-hyaluronic acid + glycerol (CPM-HA20G; Belotero Revive) in revitalization of early-onset photodamaged facial skin.

Methods:

A total of 159 subjects with early signs of facial photodamaged skin were randomized in a 2:1 ratio to multiple- or single-dose treatment with CPMHA20G. Effectiveness assessments included biophysical measurements of skin hydration; elasticity, firmness, and roughness; investigator- and subject-assessed Global Aesthetic Improvement Scales; and FACE-Q Skin Changes and Treatment Satisfaction questionnaires.

Results:

In both treatment groups, skin hydration improved from baseline to all follow-up visits in subjects with dry or very dry skin. This improvement was significant at week 16 after initial treatment in the multiple-dose group (P = 0.0013). Investigator- and subject-reported outcomes showed that the majority of subjects across all skin hydration types benefited from treatment, with higher satisfaction rates observed in the multiple-dose group. According to investigator-assessed Global Aesthetic Improvement Scale, 90.7% of subjects at week 12 in the multiple-dose and 74.6% of subjects at week 4 in the single-dose group were rated as at least “improved.” All related treatment-emergent adverse events were transient, expected injection-site reactions of mild to moderate intensity.

Conclusions:

Effectiveness of CPM-HA20G for skin hydration in subjects with dry or very dry skin was demonstrated up to 9 months after last injection. Overall, CPM-HA20G demonstrated effective and safe use in facial skin revitalization among subjects with early-onset photodamaged skin.
Mental Health in Obstetric Patients and Providers During the COVID-19 Pandemic
Authors: Raiff Elizabeth M. , D’Antonio Kristina M. , Mai Christine , Monk Catherine
Published: December 2021

Psychiatric morbidity is the most common childbirth complication with 1 in 5 women experiencing a perinatal mood or anxiety disorder. The cost of this psychiatric morbidity is pervasive, contributing to devastating maternal health, child developmental, and economic consequences. The coronavirus disease 2019 (COVID-19) pandemic, and associated changes to perinatal experiences, resulted in profound psychological reactions including increased anxiety, depression, stress disorders, and sleep disturbance, further impacting obstetric patients. Providers’ mental health has been challenged by moral injury and shared trauma. This article reviews mental health outcomes in regard to the COVID-19 pandemic for obstetric patients and their providers.
POTENTIAL TREATMENT FOR PERIPAPILLARY PACHYCHOROID SYNDROME
Authors: Pothof Alexander B. , Fernández-Avellaneda Pedro , Behar-Cohen Francine , Martinez Ciriano José P. , Yzer Suzanne
Published: December 2021

Purpose:

The purpose of this study was to describe the effect of topical prednisolone on intraretinal fluid in patients with peripapillary pachychoroid syndrome.

Methods:

We selected 11 consecutive patients (17 eyes) with a diagnosis of peripapillary pachychoroid syndrome, who were treated with topical prednisolone (Pred Forte [PF] 10 mg/mL) three times daily for 4 weeks. We tapered off PF among patients who demonstrated a reduction of intraretinal fluid.

Results:

Of the included 17 eyes, the average follow-up before PF treatment ranged from 6 to 192 months, during which patients experienced no apparent reduction of intraretinal fluid. The baseline mean best-corrected VA (BCVA) was 0.6 (20/33) Snellen. The median subfoveal and peripapillary choroidal thickness were 430 µm and 202 µm, respectively. All patients showed an initial reduction of intraretinal fluid after 4 weeks of topical prednisolone. Six patients (35%) experienced a prolonged reduction of intraretinal fluid when the dosage was reduced to once daily. On tapering off PF, four eyes (24%) experienced a recurrence of intraretinal fluid. Four eyes (24%) experienced elevated intraocular pressure above 26 mmHg. In two eyes, PF was discontinued, on which intraretinal fluid reappeared. The BCVA seemed to be improved in 9 eyes (53%) and remained equal in 4 eyes (24%).

Conclusion:

In this case series of patients with peripapillary pachychoroid syndrome, we observed a reduction of peripapillary intraretinal fluid after treatment with topical prednisolone for 4 weeks in all 17 eyes. The disappearance of intraretinal fluid seemed to concede with a slight improvement in BCVA for some cases. Thus, topical prednisolone may prove to be a viable treatment option in peripapillary pachychoroid syndrome.
Navigating Student Challenges: From the Lens of First-Year Doctor of Physical Therapy Students
Authors: Plack Margaret M. , Healey William E. , Huhn Karen , Costello Ellen , Maring Joyce , Hilliard Marjorie Johnson
Published: December 2021

Introduction.

Anxiety, depression, and burnout are being discussed across health professions. Despite rising concern, studies investigating stress in students enrolled in Doctor of Physical Therapy (DPT) programs remain limited. Only recently have studies exploring stress in DPT students surfaced with any consistency. In this study, our aim was to elucidate the self-identified challenges first-year DPT students faced, how they reacted, and what they did to manage them.

Review of the Literature.

Evidence suggests that DPT students, like other health professional students, report high levels of anxiety. Despite rising concern, studies investigating the impact of stress on DPT students remain limited. This concern also raises the question of the role of health professions educators in helping students develop the coping strategies needed to manage stress. Programs across the health professions have been proffered to address student stress; however, limited data exist to effectively guide educators. From the insights gained, we offer recommendations linked to the emic or student perspective that may help educators facilitate adaptive coping skills in their learners.

Subjects.

Participants included first-year DPT students from 3 private universities.

Methods.

A critical incident questionnaire was used to capture the student experience. Narratives were submitted electronically. Responses were deidentified, and researchers were blinded to participation. An inductive interpretivist approach was used to analyze the data. Strategies to ensure trustworthiness included prolonged engagement, triangulation of investigators, and peer review.

Results.

Eighty-two first-year DPT students responded; 70 complete responses were analyzed. Three major themes were identified: 1) first-year DPT students faced academic, personal, and mixed challenges; 2) challenges evoked a range of negatively charged emotions; and 3) students relied on adaptive and some potentially maladaptive personal characteristics, behaviors, and strategies to manage their challenges.

Discussion and Conclusion.

First-year DPT students face many of the same challenges as other health professional students. Most successfully navigated their challenges, however, not without some degree of emotion. As educators, we must prepare students to develop the coping strategies needed to manage not only current academic stressors but ultimately the stressors inherent in clinical practice. Toward that end, we offer recommendations, linked to the emic perspective obtained, that may help educators facilitate adaptive coping skills in their learners.
Thrombosis in Extracorporeal Membrane Oxygenation (ECMO) Circuits
Authors: Figueroa Villalba Cristina A. , McMullan David M. , Reed Robyn C. , Chandler Wayne L.
Published: December 2021

Thrombosis in extracorporeal membrane oxygenation (ECMO) circuits remains a frequent complication. We characterize the location, extent, structure, and clinical implications of thrombi in 53 ECMO circuits from 46 pediatric patients. The tubing, pump, and oxygenator were examined for visible thrombi. Representative samples of thrombi were collected for histologic, immunofluorescence, and immunohistochemical analysis. Thrombi were found in 81% of ECMO circuits. The most clinically significant were inflow oxygenator membrane surface thrombi (11% of circuits), arterial tubing thrombi (30%), and venous tubing (26%) or connector thrombi (26%). Oxygenator membrane surface thrombi resulted in rapidly increasing delta pressure across the oxygenator over 1–2 days, oxygenator failure, and circuit replacement. Oxygenator membrane surface thrombi were associated with intravascular venous thrombosis and bacterial infection before starting ECMO. Arterial cannula/tubing thrombi led in one case to aortic and mesenteric artery thrombosis followed by bowel infarction. In 11% of cases, venous tubing thrombi grew large enough to break off and embolize to the pump, resulting in increased hemolysis. Antifibrinolytic therapy during ECMO was associated with an increased risk of pump thromboembolism. Other less clinically significant thrombi included pump axle thrombi with thrombus fragments trapped in the oxygenator (45%), and deep oxygenator membrane thrombi (15%). Examination of ECMO circuits after removal is a useful quality improvement tool that can elucidate the cause of circuit problems, indicate patients at increased risk of thrombosis, and suggest areas for possible improvements.
Mapping of global research output in congenital cataracts from 1903 to 2021
Authors: Idriss Lujain Talaat , Hussain Maryam , Khan Muhammad , Ahmad Tauseef , Muhammad Khushi , Baig Mukhtiar , Khan Muhammad Mumtaz , Inamullah
Published: December 2021

Background and aim:

Globally, congenital cataract remains one of the main causes of visual loss in children. This study was designed to plot the overall research output and evaluate some key bibliometric indicators in congenital cataracts research.

Methods:

Publications on congenital cataracts were retrieved from the Web of Science Core Collection database. The published literature was searched using the keywords “congenital cataract” OR “congenital cataracts” in the title filed with document types and language restrictions. The data were exported into HistCite to analyze; publication year, top authors, countries, institutions, journals, keywords, and most cited studies. VOSviewer software was used to construct network visualization mapping.

Results:

A total of 1427 publications (1903–2021) published in English language were included in this study. Over the past few decades, the total number of publications in congenital cataracts was found to be increased. The most productive year was 2016 (n = 72), while the most cited year was 1941 (1268 citations). The Investigative Ophthalmology & Visual Science (Impact Factor: 4.799) was the most attractive journal with 161 publications, and the Molecular Vision (Impact Factor : 2.367) was the most cited journal with 1915 citations and 161.723 citations per year. The most productive country was the United States of America (USA) (n = 325), while the most active institute was Sun Yat-sen University, China (n = 36). The most prolific author was Yao K (n = 27). The most studied Web of Science category was ophthalmology (n = 852). The most widely used keyword was congenital (n = 1427). The most cited paper in congenital cataracts was “Congenital cataract following German measles in the mother, cited 1268 times. The USA and author keyword congenital cataract had the highest total link strength.

Conclusion:

These findings provide useful insights, current status, and trends in clinical research in congenital cataracts. This study can be used to identify future research areas and standard bibliography references for better diagnosis and disease control.
Electromyographic study assessing swallowing function in subacute stroke patients with respiratory muscle weakness
Authors: Liaw Mei-Yun , Lin Meng-Chih , Leong Chau-Peng , Wang Lin-Yi , Pong Ya-Ping , Yang Tsung-Hsun , Huang Yu-Chi
Published: December 2021

Background:

Dysphagia has been reported to be associated with the descent of the hyolaryngeal complex. Further, suprahyoid muscles play a greater role than infrahyoid muscles in elevation of the hyolarngeal complex. Respiratory muscle training (RMT) can improve lung function, and expiratory muscle strength training can facilitate elevation of the hyoid bone and increase the motor unit recruitment of submental muscles during normal swallowing. This study aimed to investigate the surface electromyography (sEMG) of the swallowing muscles, bilaterally, and the effect of RMT on swallowing muscles in stroke patients with respiratory muscle weakness.

Methods:

Forty patients with first episode of unilateral stroke were included in this retrospective controlled trial. After exclusion of 11 patients with respiratory muscle strength stronger than 70% of the predicted value, 15 were allocated to the RMT group and 14 to the control group. However, eventually, 11 patients in RMT group and 11 patients in control group completed the study. The sEMG of the orbicularis oris, masseter, submental, and infrahyoid muscles were recorded during dry swallowing, water swallowing (2 mL), and forced exhalation against a threshold breathing trainer set at different intensities, at baseline and after 6-week RMT.

Results:

Regarding the sEMG of submental muscles, there were significant between-group differences on the latency of the unaffected side (P = .048), significant change from baseline force on the unaffected side (P = .035), and significant between-side difference (P = .011) in the RMT group during dry swallowing. Significant change in the duration from baseline was observed on the affected side of the RMT group when blowing was set at 50% maximal expiratory pressure (MEP; P = .015), and on the unaffected side of the control group when blowing set at 15% MEP (P = .005). Significant difference was observed in the duration between 50% MEP and 15% MEP after 6-week program in the control group (P = .049).

Conclusions:

A 6-week RMT can improve the electric signal of the affected swallowing muscles with more effect on the unaffected side than on the affected side during dry swallowing. Furthermore, RMT with 50% MEP rather than 15% MEP can facilitate greater submental muscle activity on the affected side in stroke patients with respiratory muscle weakness.
Dexmedetomidine effect on delirium in elderly patients undergoing general anesthesia
Authors: Wang Youran , Bu Xinyi , Zhao Na , Wang Shuxia , Wang Xiaoliang , Ge Yali , Yi Honggang
Published: December 2021

Background:

Delirium is a common postoperative complication. Many studies have found that dexmedetomidine is associated with a reduced incidence of postoperative delirium (POD). This meta-analysis aimed to analyze the effects of dexmedetomidine on POD incidence among elderly patients undergoing general anesthesia.

Methods:

We searched 4 electronic databases (i.e., Pubmed, Embase, Cochrane, and Web of Science) from inception to November 30, 2020, for randomized controlled trials that evaluated the effects of dexmedetomidine in preventing the occurrence of POD in elderly patients (aged ≥60 years). The study protocol was registered in PROSPERO (CRD42020192114).

Results:

14 studies with 4173 patients showed that dexmedetomidine was significantly associated with a decreased POD incidence among elderly patients (relative risk [RR] = 0.58; 95% confidence interval [CI] = 0.44–0.76). The incidence of POD was significantly reduced in the noncardiac surgery group (RR 0.51; 95% CI 0.37–0.72), when dexmedetomidine was applied during the postoperative period (RR = 0.53; 95% CI = 0.40–0.70), and in patients received low-doses (RR = 0.54; 95% CI = 0.34–0.87) and normal-doses (RR = 0.59; 95% CI = 0.42–0.83). There were no significant differences in POD incidence in the cardiac surgery group (RR = 0.71; 95% CI = 0.45–1.11), and when dexmedetomidine was applied during the intra- (RR = 0.55; 95% CI = 0.29–1.01) or perioperative period (RR = 0.95; 95% CI = 0.64–1.40).

Conclusions:

Our meta-analysis suggests that dexmedetomidine may significantly reduce POD incidence in elderly noncardiac surgery patients and when applied during the postoperative period, in addition, both low- and normal-doses of dexmedetomidine may reduce POD incidence. However, its use in cardiac surgery patients and during the intra- or perioperative period may have no significant effects on POD incidence.
Relationship between annualized case volume and in-hospital motality in subarachnoid hemorrhage
Authors: Huang Jian-Yi , Lin Hong-Yu , Wei Qing-Qing , Pan Xing-Hua , Liang Ning-Chao , Gao Wen , Shi Sheng-Liang
Published: December 2021

Studies on the relationship between hospital annualized case volume and in-hospital mortality in patients with subarachnoid hemorrhage (SAH) have shown conflicting results. Therefore, we performed a meta-analysis to further examine this relationship.

The authors searched the PubMed and Embase databases from inception through July 2020 to identify studies that assessed the relationship between hospital annualized SAH case volume and in-hospital SAH mortality. Studies that reported in-hospital mortality in SAH patients and an adjusted odds ratio (OR) comparing mortality between low-volume and high-volume hospitals or provided core data to calculate an adjusted OR were eligible for inclusion. No language or human subject restrictions were imposed.

Five retrospective cohort studies with 46,186 patients were included for analysis. The pooled estimate revealed an inverse relationship between annualized case volume and in-hospital mortality (OR, 0.53; 95% confidence interval, 0.42–0.68, P < .0001). This relationship was consistent in almost all subgroup analyses and was robust in sensitivity analyses.

This meta-analysis confirms an inverse relationship between hospital annualized SAH case volume and in-hospital SAH mortality. Higher annualized case volume was associated with lower in-hospital mortality.
Emergency air evacuation of patients with acute respiratory failure due to SARS-CoV-2 from Mayotte to Reunion Island
Authors: Berguigua Hamza , Iche Ludovic , Roche Philippe , Aubert Cyril , Blondé Renaud , Legrand Antoine , Puech Bérénice , Combe Chloé , Vidal Charles , Caron Margot , Jaffar-Bandjee Marie-Christine , Caralp Christophe , Oulehri Nora , Kerambrun Hugo , Allyn Jérôme , Boué Yvonnick , Allou Nicolas
Published: December 2021

In February 2021, an explosion of cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia overwhelmed the only hospital in Mayotte. To report a case series of patients with acute respiratory failure (ARF) due to SARS-CoV-2 who were evacuated by air from Mayotte to Reunion Island.

This retrospective observational study evaluated all consecutive patients with ARF due to SARS-CoV-2 who were evacuated by air from Mayotte Hospital to the intensive care unit (ICU) of Félix Guyon University Hospital in Reunion Island between February 2, and March 5, 2021.

A total of 43 patients with SARS-CoV-2 pneumonia were evacuated by air, for a total flight time of 2 hours and a total travel time of 6 hours. Of these, 38 patients (88.4%) with a median age of 55 (46–65) years presented with ARF and were hospitalized in our ICU. Fifteen patients were screened for the SARS-CoV-2 501Y.V2 variant, all of whom tested positive. Thirteen patients (34.2%) developed an episode of severe hypoxemia during air transport, and the median paO2/FiO2 ratio was lower on ICU admission (140 [102–192] mmHg) than on departure (165 [150–200], P = .022). Factors associated with severe hypoxemia during air transport was lack of treatment with curare (P = .012) and lack of invasive mechanical ventilation (P = .003). Nine patients (23.7%) received veno-venous extracorporeal membrane oxygenation support in our ICU. Seven deaths (18.4%) occurred in hospital.

Emergency air evacuation of patients with ARF due to SARS-CoV-2 was associated with severe hypoxemia but remained feasible. In cases of ARF due to SARS-CoV-2 requiring emergency air evacuation, sedated patients receiving invasive mechanical ventilation and curare should be prioritized over nonintubated patients. It is noteworthy that patients with SARS-CoV-2 pneumonia related to the 501Y.V2 variant were very severe despite their young age.
Aspirin in the prevention of preeclampsia
Authors: Mkhize P.Z. , Phoswa W.N. , Khaliq O.P. , Dorsamy V. , Moodley J.
Published: December 2021

Introduction:

Aspirin is widely used to prevent pregnancy related vascular disorders such as preeclampsia (PE), intrauterine growth restriction and maternal disorders. However, the indications for the use of aspirin during pregnancy is currently controversial because the dosage of aspirin used and the sample sizes in various studies differ considerably. Furthermore, women of African ancestry are more likely to have higher rates of PE and more severe cases than those of their Caucasian counterparts. Yet, there are very few studies in this population group. Therefore, the aim of this review will be to determine the effect of low-dose aspirin (LDA) for prevention of PE in women of African ancestry.

Methods and Analysis:

This is a protocol for a systematic review and meta-analysis of published studies on the effect of LDA for prevention of PE. Relevant information will be accessed from the following databases; PubMed, Cochrane Central Register of Controlled Trials, Google Scholar, Google, EBSCO Host, and the Web of Science. The studies will be mapped in 2 stages: stage 1 will map studies descriptively by focus and method; stage 2 will involve additional inclusion criteria, quality assessment and data extraction undertaken by 2 reviewers in parallel. Evidence will be synthesized using relevant systematic research tools. Meta-analysis and subgroup analysis will be conducted using RevMan whilst Stata 13 will be used for meta-regressions. We will follow recommendations described in the preferred reporting items for systematic reviews and meta-analyses statement and the Cochrane Handbook for Intervention Reviews.

Discussion:

The use of LDA as a prophylactic treatment has been considered for the prevention of PE. However, studies evaluating the use of LDA in women of African ancestry are few. Therefore, with the increase in the prevalence of PE in the African population, it is critical to further investigate the use of LDA in pregnant women of African ancestry.

Ethics and dissemination:

The review and meta-analysis will not require ethical approval and the findings will be published in peer-reviewed journals and presented at local and international conferences. The findings of this review will inform all stakeholders on current and future guidelines on the use of aspirin in pregnancy, especially in populations of African ancestry.

Systematic review registration:

International prospective Register of Systematic Reviews (PROSERO) number: (CRD42020213213).