bluuebunny/crossref_metadata_2025 huggingface dataset:
Distinct myofibrillar sub-proteomic profiles are associated with the instrumental texture of aged pork loin
Authors: Johnson Logan G , Zhai Chaoyu , Steadham Edward M , Reever Leah M , Prusa Kenneth J , Nair Mahesh N , Huff-Lonergan Elisabeth , Lonergan Steven M
Published: September 2023

Fresh pork tenderness contributes to consumer satisfaction with the eating experience. Postmortem proteolysis of proteins within and between myofibrils has been closely linked with pork tenderness development. A clear understanding of the molecular features associated with pork tenderness development will provide additional targets and open the door to new solutions to improve and make pork tenderness development more consistent. Therefore, the objective was to utilize liquid chromatography and mass spectrometry with tandem mass tag (TMT) multiplexing to evaluate myofibrillar sub-proteome differences between pork chops of different instrumental star probe values. Pork loins (N = 120) were collected from a commercial harvest facility at 24 h postmortem. Quality and sensory attributes were evaluated at 24 h postmortem and after ~2 weeks of postmortem aging. Pork chops were grouped into 4 groups based on instrumental star probe value (group A,x¯ = 4.23 kg, 3.43 to 4.55 kg; group B,x¯ = 4.79 kg, 4.66 to 5.00 kg; group C,x¯ = 5.43 kg, 5.20 to 5.64 kg; group D,x¯ = 6.21 kg, 5.70 to 7.41 kg; n = 25 per group). Myofibrillar proteins from the samples aged ~2 wk were fractionated, washed, and solubilized in 8.3 M urea, 2 M thiourea, and 1% dithiothreitol. Proteins were digested with trypsin, labeled with 11-plex isobaric TMT reagents, and identified and quantified using a Q-Exactive Mass Spectrometer. Between groups A and D, 54 protein groups were differentially abundant (adjusted P < 0.05). Group A had a greater abundance of proteins related to the thick and thin filament and a lesser abundance of Z-line-associated proteins and metabolic enzymes than group D chops. These data highlight that distinct myofibrillar sub-proteomes are associated with pork chops of different tenderness values. Future research should evaluate changes immediately and earlier postmortem to further elucidate myofibrillar sub-proteome differences over the postmortem aging period.
The Direct Effect of Corporate Law on Entrepreneurship
Authors: Guzman Jorge
Published: September 2023

From 1946 to 1983, US states modernized their corporate law by adopting the Model Business Corporation Act (MBCA), a compendium of legal best practices. Better corporate law increased entrepreneurship. After the adoption of the MBCA, the number of new local corporations increased by 26% on average, half of which was substitution from other firm types, and the rest was net-new firms. States that only partially adopted saw no benefit, and the largest increases were concentrated in regions with ex ante lower quality law. At the individual level, people in states adopting the MBCA also report higher self-employment levels, but not higher wage employment or labor force participation. Consistent with the MBCA increasing efficiency and decreasing regulatory capture, the effect was larger for women, black, and those located outside the central city.
TLR4 sensitizes plasmacytoid dendritic cells for antiviral response against SARS-CoV-2 coronavirus
Authors: Lim King Hoo , Wang Lishi , Dotse Eunice , Wang Meijun , Tiu Cheuk Ying , Wijanarko Kevin Julio , Wang Xin , Chow Kwan T
Published: September 2023

Plasmacytoid dendritic cells are a rare subset of dendritic cells that exhibit antiviral functions in response to toll-like receptor 7/8 stimulations. Alternative toll-like receptors such as TLR4 have been known to be active in plasmacytoid dendritic cells for immune regulatory functions. However, it is unclear whether these toll-like receptors differentially activate plasmacytoid dendritic cells as compared with canonical toll-like receptor 7/8 stimulation. Here, we assessed alternative plasmacytoid dendritic cell activation states mediated by toll-like receptors other than endosomal toll-like receptors via the RNA sequencing approach. We found that toll-like receptor 4 stimulation induced a high degree of similarity in gene expression pattern to toll-like receptor 7/8 stimulation in plasmacytoid dendritic cells. Despite high resemblance to toll-like receptor 7/8, we discovered unique genes that were activated under toll-like receptor 4 activation only, as well as genes that were induced at a higher magnitude in comparison to toll-like receptor 7/8 activation. In comparison between toll-like receptor 4–activated plasmacytoid dendritic cells and conventional dendritic cells, we revealed that plasmacytoid dendritic cells and conventional dendritic cells expressed distinct gene sets, whereby conventional dendritic cells mostly favored antigen presentation functions for adaptive immune response regulation while plasmacytoid dendritic cells leaned toward immune response against infectious diseases. Last, we determined that toll-like receptor 4 activation sensitized plasmacytoid dendritic cells against SARS-CoV-2 (COVID-19) single-stranded RNA by enhancing antiviral-related responses and type I interferon production. These findings provided greater insights into the toll-like receptor 4 activation state in plasmacytoid dendritic cells, which can be beneficial for alternative therapeutic interventions involving plasmacytoid dendritic cells for various diseases.
A computational study for understanding the impact of p120-catenin on the cis-dimerization of cadherin
Authors: Su Zhaoqian , Vu Vinh H , Leckband Deborah E , Wu Yinghao
Published: September 2023

A prototype of cross-membrane signal transduction is that extracellular binding of cell surface receptors to their ligands induces intracellular signalling cascades. However, much less is known about the process in the opposite direction, called inside-out signalling. Recent studies show that it plays a more important role in regulating the functions of many cell surface receptors than we used to think. In particular, in cadherin-mediated cell adhesion, recent experiments indicate that intracellular binding of the scaffold protein p120-catenin (p120ctn) can promote extracellular clustering of cadherin and alter its adhesive function. The underlying mechanism, however, is not well understood. To explore possible mechanisms, we designed a new multiscale simulation procedure. Using all-atom molecular dynamics simulations, we found that the conformational dynamics of the cadherin extracellular region can be altered by the intracellular binding of p120ctn. More intriguingly, by integrating all-atom simulation results into coarse-grained random sampling, we showed that the altered conformational dynamics of cadherin caused by the binding of p120ctn can increase the probability of lateral interactions between cadherins on the cell surface. These results suggest that p120ctn could allosterically regulate the cis-dimerization of cadherin through two mechanisms. First, p120ctn controls the extracellular conformational dynamics of cadherin. Second, p120ctn oligomerization can further promote cadherin clustering. Therefore, our study provides a mechanistic foundation for the inside-out signalling in cadherin-mediated cell adhesion, while the computational framework can be generally applied to other cross-membrane signal transduction systems.
Increasing Mental Health Screening in Pediatric Subspecialty Clinics: An Improvement Project at Brooke Army Medical Center
Authors: Cocozza Victoria , Sickbert Lydia , Kenny Timothy , Espinola Dimas , Welsh Sebastian , Turner Zachary , Pieroni Kevin
Published: September 2023

Introduction

Mental health screening allows for the early identification of patients at risk of mental health disorders such as anxiety and depression. The Defense Health Administration Procedures Manual 6025.01 established that patients older than 12 years of age should receive annual mental health screening assessing suicidality risk with a standardized screening tool.

Materials and Methods

To improve rates of mental health screening in this at-risk population, an A3 Lean approach to quality improvement was undertaken in the Pediatric Subspecialty Clinics at Brooke Army Medical Center.

Results

Baseline data of Patient Health Questionnaire-9 or General Anxiety Disorder-7 screening from pediatric pulmonology and cardiology clinics were 6.3%. Plan-Do-Study-Act quality improvement methods evaluated possible interventions to improve screening. A standard operating procedure (SOP) outlining scoring and interpretation recommendations was distributed in pediatric pulmonology and cardiology clinics. Using the Armed Forces Health Longitudinal Technology Application, a post-implementation chart review was conducted for 8 weeks. With the initiation of Military Health System Genesis, the SOP was adjusted and a root cause analysis was performed. The pediatric gastroenterology clinic cares for patients presenting with functional abdominal pain; therefore, the clinic was added to the second iteration to determine if anxiety or depression may play a role. Providers were educated on documentation and coding. A second post-implementation chart review was conducted for 8 weeks. Over two iterations, mental health screening of new adolescent patients in pediatric subspecialty clinics increased by 794% from baseline. Our providers screened 50% of the adolescent patients.

Conclusions

With increased surveillance of an at-risk population, more adolescents will receive the standard of care. With refinement of the SOP and expansion to other subspecialties, this project has the potential to expand within Brooke Army Medical Center and other clinics in the Defense Health Administration.
Astrophysical uncertainties in the gravitational-wave background from stellar-mass compact binary mergers
Authors: Lehoucq Léonard , Dvorkin Irina , Srinivasan Rahul , Pellouin Clément , Lamberts Astrid
Published: September 2023

We investigate the stochastic gravitational-wave background (SGWB) produced by merging binary black holes (BBHs) and binary neutron stars (BNSs) in the frequency ranges of Laser Interferometer Gravitational-Wave Observatory (LIGO)/Virgo/Kagra and Laser Interferometer Space Antenna (LISA). We develop three analytical models, which are calibrated to the measured local merger rates, and complement them with three population synthesis models based on the cosmic code. We discuss the uncertainties, focusing on the impact of the BBH mass distribution, the effect of the metallicity of the progenitor stars, and the time delay distribution between star formation and compact binary merger. We also explore the effect of uncertainties in binary stellar evolution on the background. For BBHs, our analytical models predict ΩGW in the range [4 × 10−10 to 1 × 10−9] (25 Hz) and [1 × 10−12 to 4 × 10−12] (3 mHz), and between [2 × 10−10 to 2 × 10−9] (25 Hz) and [7 × 10−13 to 7 × 10−12] (3 mHz) for our population synthesis models. This background is unlikely to be detected during the LIGO/Virgo/Kagra O4 run, but could be detectable with LISA. We predict about 10 BBH and no BNS mergers that could be individually detectable by LISA for a period of observation of 4 yr. Our study provides new insights into the population of compact binaries and the main sources of uncertainty in the astrophysical SGWB.
Oryzomys palustris (Rodentia: Cricetidae)
Authors: Rose Robert K
Published: September 2023

Oryzomys palustris (Harlan, 1837), the common marsh rice rat, is an Oryzomyine rodent with a tail nearly as long as the head and body, grayish above and white below with long-toed white feet. This account is an update of Mammalian Species 176 on the subject species by James L. Wolfe (1982a), incorporating 103 new references, most published since 1982. Oryzomys palustris, one of six living and two extinct species in this Neotropical genus, is semiaquatic and omnivorous, being highly carnivorous in some populations. It is parapatric with O. texensis in the western portion of its distribution in the southern United States. Oryzomys palustris is classified as “Least Concern” (LC) on the International Union for Conservation of Nature Red List.
Saints’ Lives
Authors: Van Deusen Natalie M.
Published: September 2023

Saints’ lives (Latin vitae, sg. vita), also referred to as hagiographies (from the Greek hagios ‘holy’ and graphia ‘writing’), formed one of the most important literary genres in the European Middle Ages, and constitute a substantive portion of those texts composed in medieval Scandinavia. Medieval Scandinavian saints’ lives can be categorized as East Norse (that is, Danish and Swedish) and West Norse (that is, Norwegian and Icelandic). In both East and West Norse, these works comprise translations from imported foreign (primarily Latin) sources, as well as works produced within Scandinavia in both Latin and the vernacular, which refers to the language spoken by people living in a particular region. The composition of saints’ lives began shortly after the Christianization of the Scandinavian countries, which began during the 8th century and was completed by the 12th century. Indeed, saints’ lives were among the very first works composed in the vernacular in Scandinavia. The majority of the surviving manuscripts containing saints’ lives written in the Scandinavian vernaculars of the Middle Ages come from medieval Iceland and, to a lesser extent, Norway. In Iceland, the lives of saints played a key role in the development of vernacular saga literature, on which hagiographic texts had an ongoing influence throughout the Middle Ages. Saints’ lives from Denmark and Sweden were generally composed in Latin, though there existed translations of select lives as well as larger legendaries—that is to say, collections of saints’ lives—in both the Old Danish and Old Swedish vernaculars. Within the East Norse tradition, by far the largest number of natively produced saints’ lives are associated with St. Birgitta of Sweden (d. 1373), and can be connected to canonization efforts. Also of particular interest throughout the Nordic region were the lives of saintly bishops, dukes, kings, and other noblemen and noblewomen, which comprise the majority of the lives of Scandinavian saints and saintly individuals. The production of Latin and vernacular saints’ lives continued throughout the Scandinavian region and up until the Protestant Reformation, which took place during the first half of the 16th century and was completed by 1550, when Lutheranism officially took hold in Iceland.
Race and Yoga
Authors: Black Shameem
Published: September 2023

This article explores scholarship that analyzes yoga through the lens of race. “Race” is a construct primarily used to distinguish people from each other; it furnishes an axis for the unequal division of resources, status, rights, and recognition. Scholars have begun to ask how yoga has become an object of academic inquiry shaped through the racial categories, practices, and hierarchies of colonial and capitalist encounters; how yoga has made, and continues to make, meaning within different racialized contexts; and how yoga might serve as a resource to address racial inequality and injustice. Precisely because yoga is often imagined as a path toward an ideal, scholars have been keen to understand how its forms draw upon, normalize, or challenge social and political dynamics. Scholarly conversations on yoga and race tend to cluster around three key areas. Across these diverse debates, “race” and “yoga” are often interpreted quite differently. One field, largely informed by South Asian studies, religious studies, and history, addresses yoga in the context of Western colonial encounters with South Asia. These works often investigate the colonial dynamics shaping the retrieval, transmission, translation, production, or interpretation of key texts and practices. A second dominant field, anchored in ethnic studies, critical race theory, media studies, and sociology, focuses on yoga in multicultural Western societies, often with a strong focus on the United States. In this set of conversations, attention tends to focus on analyzing racial inequalities that shape yoga and assessing how yoga might reflect or respond to such inequalities. A third set of debates emerges in health and medicine, where scholars have begun to examine the importance of racial identity and racialized structures of power in relation to health outcomes. In contrast to more humanistic and social scientific approaches, this research often addresses yoga through a narrower historical and philosophical frame. However, this line of inquiry offers important resources to show how yoga is never simply a race-neutral health intervention, but instead constitutes a practice layered within complex structural and cultural conditions. These three scholarly conversations investigate “race and yoga” through interdisciplinary lenses. Researchers interested in this area should also consult the entry for the separate Oxford Bibliographies in Hinduism article “Contemporary Globalized and Commercialized Yoga,” which includes additional references to scholarship on yoga and related themes such as decolonization, non-Western histories, cultural appropriation, and caste.
East India Company and Hinduism
Authors: Chakrabarti Upal
Published: September 2023

The British East India Company was a joint-stock trading corporation which took charge of revenue and civic governance in different parts of India over a century after it acquired the eastern Indian province of Bengal, defeating the erstwhile ruler of the region in the Battle of Plassey in 1757. The company ran a government in India until 1857, when the country’s governance was formally taken over by the British crown. In these hundred years the company had various encounters with the one of the dominant religious traditions of India, which had an enormous diversity of beliefs and practices, collectively known as Hinduism. The company’s interfaces with these beliefs and practices emerged out of its work of governance in different fields like law, education, economy, public order, social reform, and others. In these encounters, the company, as a carrier of modern European religious, economic, political, and moral visions, and as the bearer of governmental authority, crucially reshaped different aspects of Hinduism. Moreover, since Hinduism was inseparably interwoven with the moral order and quotidian practices of indigenous social life, these encounters went a long way in establishing the foundational tenets of a modern social order in India, which bore the imprints of this process. On the other side, this process also had a profound impact on the making of the imperial world, especially its perception of Indian religion.
Ceremonial Entries in Early Modern Europe
Authors: Cloud Jasmine R.
Published: September 2023

Ceremonial entries marked urban centers across early modern Europe. Types of entries varied widely, from events celebrating a newly elected monarch to festivities honoring foreign brides’ journeys across the continent. Such entries necessitated the cooperation and planning of a huge variety of people, depended upon an interactive audience, and became multi-sensory spectacles involving poets, composers, musicians, artists and architects, theater performers, and more. Evidence with which to study entries proliferates, including manuscript sources relating plans and expenditures, graphic material making permanent the ephemeral decorations of an event, eyewitness accounts and published pamphlets or books detailing the participants, visual materials, and the official record of the day. While entries in many European territories have been studied, scholars have focused the most attention on France, Italy, and England. To a lesser extent, entrance ceremonies in the Low Countries, Germany, and Spain have received scholarly attention. Even less studied are those in Portugal, Poland, and Scandinavia. As with scholarship across humanistic fields, the study of entries has become increasingly global and concerned with issues related to gender performance. The literature on ceremonial entries in early modern Europe has exploded in recent decades, becoming a more integrative and interdisciplinary concern. This is made evident by the existence of multiple research organizations that bring together scholars of diverse disciplines and nationalities. Digitization projects have resulted in several online resources, most notably the “Early Modern Festival Books Database” and “Treasures in Full: Renaissance Festival Books from the British Library.” Thus, research in this field is becoming both easier, through increasing accessibility of online sources, and more complicated, as the secondary literature grows. What began in the realm of theater studies, because of the appearance of pageants as features of entries, has become a truly interdisciplinary field. The most common kind of publication on an entry is a short essay; these and edited volumes appear frequently in this bibliography because of the challenges of monographic examination of these multivalent events. It is important to note that ceremonial entries are only one type of ritual that shaped civic identity in the early modern period, and many anthologies contend with ephemeral events of all kinds.
Are Large Cardinal Axioms Restrictive?
Authors: Barton Neil
Published: September 2023

The independence phenomenon in set theory, while pervasive, can be partially addressed through the use of large cardinal axioms. A commonly assumed idea is that large cardinal axioms are species of maximality principles. In this paper I question this claim. I show that there is a kind of maximality (namely absoluteness) on which large cardinal axioms come out as restrictive relative to a formal notion of restrictiveness. Within this framework, I argue that large cardinal axioms can still play many of their usual foundational roles.
Boundary conditions for constraint systems in variational principle
Authors: Izumi Keisuke , Shimada Keigo , Tomonari Kyosuke , Yamaguchi Masahide
Published: September 2023

We show the well-posed variational principle in constraint systems. In a naive procedure of the variational principle with constraints, the proper number of boundary conditions does not match that of physical degrees of freedom , which implies that, even in theories with up to first-order derivatives, the minimal (or extremal) value of the action with the boundary terms is not a solution of the equation of motion in the Dirac procedure of constrained systems. We propose specific and concrete steps to solve this problem. These steps utilize the Hamilton formalism, which allows us to separate the physical degrees of freedom from the constraints. This reveals the physical degrees of freedom that are necessary to be fixed on boundaries, and also enables us to specify the variables to be fixed and the surface terms.
CONSORZIO TUTELA VINI EMILIA v VIÑEDOS EMILIANA SA
Authors:   Appointed Person (Trade Mark)
Published: September 2023

H1 Trade Marks — Opposition proceedings — EMILIANA — Wines — Protected geographical indications — EMILIA — Regulation 1308/2013 (as retained) — Transitional provisions — Effect on opposition proceedings started before Brexit — Whether applications for marks consisting of or containing PGI to be refused where use would not be prohibited — Scope of protection — Evocation — Basis of assessment — Average consumer — Relevance of extent of reputation — Whether registration prohibited under s.3(4) of the Trade Marks Act 1994 — Extended passing off — Establishing goodwill — Nature of the relevant misrepresentation — Whether misrepresentation as to geographical origin enough — Appeal to Appointed Person
Time-series analysis of radon concentrations for Bengaluru’s atmosphere
Authors: Kumar K Charan , Nagaraja Kamsali
Published: September 2023

The Fast Fourier Transform (FFT) analysis of the activity concentration of radon and selected meteorological parameters was carried out at Department of Physics, Bangalore University, Bengaluru (12056′44”N, 77030′25″E, 840 m above MSL). All of the measured parameters, with the exception of pressure, showed a clear diurnal trend, which can be explained by the presence of typical atmospheric processes such as temperature inversion in the morning and greater vertical mixing in the afternoon. Radon’s time series has a latent memory of sub-diurnal cycles, as shown via FFT analysis. The monthly average radon has higher levels of activity during winter months compared with monsoon and summer months. Days during the monsoon season had the lowest radon activity, which may be ascribed to the fact that less radon was being exhaled from the soil as a result of the rain. Radon was recorded at 8.06 ± 0.56 Bq/m3, temperature at 28.9 °C, humidity at 55.2% and pressure at 918 mbar.
A natural experiment to determine if FitEx works: Impact of a statewide walking program
Authors: Harden Samantha M , Balis Laura E , Armbruster Shannon , Estabrooks Paul A
Published: September 2023

The National Cooperative Extension System offers walking programs, but impacts are underreported. One program offered in two state systems is FitEx, an 8-week, group-based behavior change intervention. The purpose of this work was to evaluate FitEx through the RE-AIM (reach, effect, adoption, implementation, maintenance) Framework, with a primary focus on reach and effectiveness (individual-level dimensions). Through a pragmatic, natural experiment, the impact of FitEx was assessed from 2015 to 2020. Reach was operationalized as the number and characteristics of eligible community members who participated. Effectiveness was operationalized as changes in physical activity levels. From 2015 to 2020, there were 1995 FitEx participants (274 ± 233 participants per year) who were 45.22 ± 14.13 years of age, predominantly female (83%) and White (78%). At the start of the program, 33% met physical activity guidelines and during the program 58% met guidelines (X2(1, 1648) = 1.6; P < .0). The reach and effectiveness of FitEx are comparable to—and in some cases, greater than—similar community-based walking programs. FitEx consistently reached middle-aged insufficiently active adults. Future work is needed to reach a more diverse population, establish objectively measured impacts, and establish a process to scale FitEx across the nation.
An Interspecies Recombinant Sida Yellow Mosaic China Virus Isolate and Betasatellite Cause a Leaf Curl Disease in Tobacco in Hainan, China
Authors: Wang Duan , Yin Yuteng , Zhang Xuan , Ye Jian
Published: September 2023

Tobacco (Nicotiana tabacum) is an herbaceous crop. Cigar tobacco, a group of tobacco cultivars, has recently been planted in a few provinces in China. Since its introduction, symptoms such as leaf curling and vein thickening have appeared. Here we report a begomovirus, Sida yellow mosaic China virus-Hainan isolate (designated SiYMCNV-HN), associated with the betasatellite (designated SiYMCNB-HN) as the causal agent of a leaf curl disease in cigar tobacco (N. tabacum cv. Haiyan101) in Hainan Province, China. Phylogenetic and recombination analyses indicate that SiYMCNV-HN is an interspecies recombinant with a SiYMCNV isolate as the major parent and a Sida yellow vein Vietnam virus isolate as the minor parent. Full-length infectious clones of SiYMCNV-HN and SiYMCNB-HN were generated, which were highly infectious and induced high pathogenicity through agroinfiltration in Nicotiana benthamiana and N. tabacum. This newly reported recombinant begomovirus poses potential threats to tobacco plantations in the region.
Exploring the Mycovirus Sclerotinia sclerotiorum Hypovirulence-Associated DNA Virus 1 as a Biocontrol Agent of White Mold Caused by Sclerotinia sclerotiorum
Authors: Fu Min , Qu Zheng , Pierre-Pierre Nickisha , Jiang Daohong , Souza Fernanda L. , Miklas Phillip N. , Porter Lyndon D. , Vandemark George J. , Chen Weidong
Published: September 2023

Sclerotinia sclerotiorum is a necrotrophic fungal pathogen causing white mold on many important economic crops. Recently, some mycoviruses such as S. sclerotiorum hypovirulence-associated DNA virus 1 (SsHADV-1) converted S. sclerotiorum into a beneficial symbiont that helps plants manage pathogens and other stresses. To explore the potential use of SsHADV-1 as a biocontrol agent in the United States and to test the efficacy of SsHADV-1-infected United States isolates in managing white mold and other crop diseases, SsHADV-1 was transferred from the Chinese strain DT-8 to United States isolates of S. sclerotiorum. SsHADV-1 is readily transmitted horizontally among United States isolates of S. sclerotiorum and consistently conferred hypovirulence to its host strains. Biopriming of dry bean seeds with hypovirulent S. sclerotiorum strains enhanced resistance to white mold, gray mold, and Rhizoctonia root rot. To investigate the underlying mechanisms, endophytic growth of hypovirulent S. sclerotiorum in dry beans was confirmed using PCR, and the expression of 12 plant defense-related genes were monitored before and after infection. The results indicated that the endophytic growth of SsHADV-1-infected strains in plants stimulated the expression of plant immunity pathway genes that assisted a rapid response from the plant to fungal infection. Finally, application of the seed biopriming technology with SsHADV-1-infected hypervirulent strain has promise for the biological control of several diseases of wheat, pea, and sunflower.
Improving Outcomes in Infants With Neonatal Abstinence Syndrome With the Eat, Sleep, Console Method
Authors: Nicholson Sarah , Waskosky Aksana , Moon Debra
Published: September 2023

Background:

Neonatal abstinence syndrome (NAS) is a significant public health concern. A quality improvement project was executed in a neonatal intensive care unit at a large urban hospital. The aim was to address the prolonged hospitalization of infants and exposure to medications to treat NAS.

Purpose:

The goal was to determine whether the eat, sleep, console (ESC) method decreases the length of stay (LOS) and morphine usage when compared with the Finnegan Neonatal Abstinence Scoring System (FNASS).

Methods:

The inclusion criteria were 36 weeks' or longer gestation and exposure to opiates in utero. The FNASS method was replaced by the ESC method with a refocus on nonpharmacologic care. Data were collected for 6 months during implementation of the ESC method and compared with the 6 months prior to implementation.

Results:

The results of the project include: the average LOS decreased from 25.9 days to 13.7 days, a 47% reduction; the rate of scheduled morphine initiation decreased from 58% to 7%, an 88% reduction; as-needed morphine initiation decreased from 33% to 7%, a 79% reduction; and the rate of adjunctive medication initiation decreased from 17% to 0%, a 100% reduction.

Implications for Practice and Research:

The outcomes of LOS and rate of morphine usage were significantly improved when using the ESC method when compared with the FNASS at this facility. The results support future implications including expanding the ESC program to the well newborn population at this facility and other similar units. Further research needs to be done on long-term neurodevelopmental outcomes.
Risk Factors for Extubation Failure After Pediatric Cardiac Surgery and Impact on Outcomes: A Multicenter Analysis
Authors: Byrnes Jonathan , Bailly David , Werho David K. , Rahman Fazlur , Esangbedo Ivie , Hamzah Mohammed , Banerjee Mousumi , Zhang Wenying , Maher Kevin O. , Schumacher Kurt R. , Deshpande Shriprasad R.
Published: September 2023

IMPORTANCE:

Extubation failure (EF) after pediatric cardiac surgery is associated with increased morbidity and mortality.

OBJECTIVES:

We sought to describe the risk factors associated with early (< 48 hr) and late (48 hr ≤ 168 hr) EF after pediatric cardiac surgery and the clinical implications of these two types of EF.

DESIGN, SETTING, AND PARTICIPANTS:

Retrospective cohort study using prospectively collected clinical data for the Pediatric Cardiac Critical Care Consortium (PC4) Registry. Pediatric patients undergoing Society of Thoracic Surgeons benchmark operation or heart transplant between 2013 and 2018 available in the PC4 Registry were included.

MAIN OUTCOMES AND MEASURES:

We analyzed demographics and risk factors associated with EFs (primary outcome) including by type of surgery. We identified potentially modifiable risk factors. Clinical outcomes of mortality and length of stay (LOS) were reported.

RESULTS:

Overall 18,278 extubations were analyzed. Unplanned extubations were excluded from the analysis. The rate of early EF was 5.2% (948) and late EF was 2.5% (461). Cardiopulmonary bypass time, ventilator duration, airway anomaly, genetic abnormalities, pleural effusion, and diaphragm paralysis contributed to both early and late EF. Extubation during day remote from shift change and nasotracheal route of initial intubation was associated with decreased risk of early EF. Extubation in the operating room was associated with an increased risk of early EF but with decreased risk of late EF. Across all operations except arterial switch, EF portrayed an increased burden of LOS and mortality.

CONCLUSION AND RELEVANCE:

Both early and late EF are associated with significant increase in LOS and mortality. Study provides potential benchmarking data by type of surgery. Modifiable risk factors such as route of intubation, time of extubation as well as treatment of potential contributors such as diaphragm paralysis or pleural effusion can serve as focus areas for reducing EFs.
Potential impact of specific therapy on pregnant women with pulmonary arterial hypertension without cardiac shunt: a descriptive study in northern China
Authors: Lu Weida , Li Min , Ji Fuqing , Feng Hua , Li Guo , Ji Qiushang , Zhang Hongyu , Cui Xiaopei
Published: September 2023

Background

Pregnancy in women with pulmonary arterial hypertension (PAH) is a fatal condition, despite the effectiveness of PAH-specific therapies. The coverage status and effect of specific therapies in pregnant patients with PAH without cardiac shunts in China remain unclear. To investigate this issue, we conducted a multicenter retrospective study in northern China.

Methods

The study included 85 patients who were admitted to 4 clinical centers in Shandong Province between October 2010 and August 2020. Maternal endpoint events included (1) maternal death and/or (2) major adverse cardiac events, both occurring during pregnancy or within 6 weeks postpartum.

Results

Although the overall mortality rate was encouraging (11.8%), the number of patients receiving PAH-specific therapies was extremely low (28.2%). Moreover, only 15.3% of patients received adequate duration of PAH-specific therapy (≥4 weeks) before delivery, and this subgroup showed the lowest major adverse cardiac events rate (7.7%) compared with that in the untreated (19.7%) and short-time treated groups (<4 weeks; 54.5%).

Conclusion

Pregnant patients with PAH without cardiac shunts face significantly increased mortality risks. Short-term PAH-specific therapy does not guarantee favorable maternal outcomes. Prepregnancy screening, early identification, and timely intervention are expected to improve maternal outcomes in pregnant women with PAH.
Intracameral phenylephrine for surgical mydriasis and intraoperative floppy-iris syndrome: systemic adverse effects and optimal dose
Authors: Chua Matthew J. , Varshney Natasha , Eke Tom
Published: September 2023

Phenylephrine, a potent sympathomimetic, induces mydriasis via iris dilator muscle contraction. Intracameral (IC) phenylephrine has been successfully used in cataract surgery for initial mydriasis, maintaining mydriasis, and management of intraoperative floppy-iris syndrome. Serious systemic adverse events (mainly cardiovascular) have been described with topical phenylephrine drops, but we found very little evidence of such adverse events associated with IC phenylephrine use. However, we suspect under-reporting of such adverse events, as they may instead be ascribed to anxiety, positioning, anesthesia, etc. Optimal dosage/concentrations for IC phenylephrine use in different purposes have not been fully studied. In the absence of robust evidence, we suggest that lower but effective IC phenylephrine concentrations are used: a lower concentration (0.31%), in conjunction with an anticholinergic and lidocaine, may be used for initial mydriasis. For management of intraoperative floppy-iris syndrome, 0.31% may be effective, though a higher concentration (1% to 1.25%) may be required.
Accuracy comparison of tomography devices for ray tracing–based intraocular lens calculation
Authors: Wagner Felix M. , Hoffmann Peter , Preußner Paul-Rolf
Published: September 2023

Purpose:

To evaluate the interchangeability of different tomography devices used for ray tracing–based intraocular lens (IOL) calculation.

Setting:

Eye clinic, Castrop-Rauxel, Germany.

Design:

Retrospective analysis.

Method:

Measurements from 3 Placido-Scheimpflug devices and 3 optical coherence tomography (OCT) devices were compared in 83 and 161 other eyes after cataract surgery, respectively. 2-dimensional matrices of anterior local corneal curvature and local corneal thickness are transferred to the ray-tracing software OKULIX. Calculations are performed with the same IOL in the same position of an eye with the same axial length. Differences in spherical equivalent (SE), astigmatism, and spherical aberration are evaluated. Furthermore, the influence of the size of the matrices (optical zone) on the accuracy is quantified.

Results:

For the Placido-Scheimpflug devices, the deviations from the average of three measurements taken for each eye in SE (mean ± SD) were 0.17 ± 0.24 diopters (D), −0.26 ± 0.29 D, and 0.08 ± 0.39 D (P < .001, analysis of variance [ANOVA]), for the centroids of the astigmatic differences 0.04 D/173 degrees, 0.14 D/93 degrees, and 0.10 D/7 degrees, and for the median of the absolute values of the vector differences 0.31 D, 0.33 D, and 0.29 D. For OCT devices, the corresponding results were 0.01 ± 0.21 D, −0.03 ± 0.21 D, and 0.02 ± 0.20 D (P = .005, ANOVA); 0.18 D/120 degrees, 0.07 D/70 degrees, and 0.22 D/4 degrees; and 0.26 D, 0.30 D, and 0.33 D. The accuracy of the calculated spherical aberrations allows for an individual selection of the best fitting IOL model in most cases.

Conclusions:

The differences are small enough to make the devices interchangeable regarding astigmatism and spherical aberration. Although there are significant differences in SE between Scheimpflug and OCT devices, the differences between OCT devices are also small enough to make them interchangeable, but the differences between Placido-Scheimpflug devices are too large to make these devices interchangeable.
Reported long-term effects of COVID-19 patients after hospital discharge in Jordan
Authors: Karasneh Reema , Al Sharie Sarah , Al-Azzam Sayer , Altawalbeh Shoroq M. , Khassawneh Basheer , Talafha Muna , Nusair Mohammad , Al-Mistarehi Abdel-Hameed , Yonis Othman Beni , Al-Omary Mousa A. , Kabbaha Suad , Aldeyab Mamoon A.
Published: September 2023

Coronavirus Disease 2019 (COVID-19) long-term effect is the new challenge facing healthcare providers that should be further assessed. We aim to describe the characteristics and patterns of long-term consequences of COVID-19 among recovered patients. COVID-19 patients baseline data was extracted from hospital records and alive patients filled self-reported symptoms questionnaires. A follow-up chest X-ray (CXR) was then scored based on lung abnormalities and compared with baseline CXR images. Six hundred ninety-four patients were included for the questionnaire and final analysis. Patients who were categorized as critical or severe were more prone to develop at least one symptom than those who were categorized as moderate. The most newly diagnosed comorbidities after discharge were diabetes (40.9%), cardiovascular diseases (18.6%), and hypertension (11.9%). Most patients with prolonged symptoms after discharge had a significant decrease in the quality of life. Small number of CXR showed persistent abnormalities in the middle right, the lower right, and lower left zones with an average overall score during admission 13.8 ± 4.9 and 0.3 ± 1.01 for the follow-up images. Effects of COVID-19 were found to persist even after the end of the infection. This would add on to the disease burden and would foster better management.
Efficacy of first-line immunization combined with antiangiogenesis treatment and chemotherapy for the treatment of tongue cancer: A case report
Authors: Zhao Limin , Liu Yongmin , Chen Chunhong , Lv Lili , Xu Boran , Su Lihua , Gao Feng
Published: September 2023

Background:

There is currently no uniform and effective treatment for patients with locally advanced oral cancer who cannot tolerate surgery or radiotherapy. The prognosis of oral cancer patients with lymph node metastasis is very poor, but the clinical treatment of such patients faces certain challenges.

Patients and methods:

Case 1 was a 59-year-old patient with tongue cancer (cT 3 N x M 0 G 2) who refused radiotherapy because of a history of leukoderma. After evaluation of disease condition, a 4-drug combination therapy of toripalimab + anlotinib + nabpaclitaxel + carboplatin was administered. Case 2 was a 55-year-old patient with tongue cancer (cT 3 N 2 M 0 G 1) who could not receive radiotherapy because of a medical history of cervicofacial burns. After disease evaluation, toripalimab + anlotinib + docetaxel + carboplatin combination therapy was administered.

Case summary:

Both patients did not experience any adverse reactions during treatment and achieved a complete response after 2 cycles of treatment. Their progression-free survival is currently 6 and 8 months, respectively, and they are in sustained remission.

Conclusion:

Currently, the efficacy of immune checkpoint inhibitors targeting programmed death-1 as a first-line treatment of inoperable and non-radiatable locally advanced oral cancer is unknown. Here, we describe 2 cases of locally advanced oral cancer treated with first-line immune checkpoint inhibitors in combination with targeted therapy and chemotherapy. This approach was successful in these patients, but a larger sample size is required to verify our findings.
Investigation of the metabolic and endocrinological differences between daily and weekly growth hormone replacement therapy, somapacitan, in patients with adult growth hormone deficiency: A real-world pilot study
Authors: Abe Ichiro , Takeshita Kaori , Nagata Mai , Fujita Yuya , Ochi Kentaro , Koga Midori , Kudo Tadachika , Shimada Hideaki , Abe Makiko , Mukoubara Shigeaki , Kobayashi Kunihisa
Published: September 2023

In this real-world pilot study, we evaluated the metabolic and endocrinological effects in patients with adult growth hormone deficiency (AGHD) who switched from daily growth hormone (GH) replacement therapy to weekly GH replacement therapy using somapacitan. Eleven patients with AGHD, whose medical treatment aside from GH replacement therapy did not change, were enrolled. We investigated the metabolic and endocrinological parameters between at switching and 6 months after switching from daily GH formulation to somapacitan. The results showed that body mass index (BMI), homeostasis model assessment of insulin resistance (HOMA-IR), fasting plasma glucose (FPG), and liver functions were significantly improved 6 months after switching compared to those at switching (each P < .05). Besides, the improvement in HOMA-IR was significantly associated with the period of daily GH replacement therapy before switching (P = .048), while age, sex, improvement in BMI or liver functions, presence of any hormonal deficiency, and the existence of any hormonal replacement therapy significantly associated (P > .05). In addition, switching to GH replacement therapy did not affect endocrinological parameters. In conclusion, this study might indicate that weekly GH replacement therapy with somapacitan could have more beneficial points than daily GH replacement therapy. Considering the cohort of this study was small, future studies with larger cohorts should be necessary to confirm the results of this study.
Incidence of lumbar spondylolysis in athletes with low back pain: A systematic evaluation and single-arm meta-analysis
Authors: Li Jingyuan , Liang Jinlong , Xu Yongqing , Du Di , Feng Fanzhe , Shen Junhong , Cui Yi
Published: September 2023

Background:

Low back pain (LBP) is a common chief complaint from athletes. Lumbar spondylolysis (LS) is a common sport injury. Severe LS is likely to cause spinal instability, resulting in lumbar spondylolisthesis or lumbar disc herniation, and even damage to the spinal nerve roots. The incidence of LS is approximately 5% in the adult population, and nearly half of young athletes with LBP are diagnosed with LS. This meta-analysis analyzed the incidence of LS in athletes with LBP.

Methods:

PubMed, Embase, Cochrane (Cochrane Central Register of Controlled Trials), and Web of Science databases were systematically searched for published case report and retrospective analyses related to the topic from the date of database creation to January 1,2023. Relevant literature was screened and information extracted, and risk of bias was assessed for included studies using the methodological index for non-randomized-studies scale. Single-arm Meta-analysis was performed using R4.04 software. Heterogeneity was quantified by Cochran Q test and Higgins I
2. Funnel plots were used to visualize publication bias, and Egger test and Begg test were used to statistical tests.

Results:

A total of 9 studies (835 patients) were included in this study. Meta-analysis revealed that the prevalence of LS in athletes with LBP was estimated at 41.7%, [95% CI = (0.28–0.55)], but this prevalence varied considerably with the gender and age of the athletes.

Conclusion:

The estimated prevalence of LS in athletes with LBP is 41.7%, and future correlations between the prevalence of LS in adolescent athletes worldwide need to be assessed from different perspectives, including biomechanical, hormonal, anatomical, behavioral, and gender differences.