bluuebunny/crossref_metadata_2025 huggingface dataset:
Determination and Identification of Nicarbazin, Measured as 4,4′-Dinitrocarbanilide (DNC), in Chicken Tissues by Liquid Chromatography With Tandem Mass Spectrometry: Final Action 2013.07
Authors: Brunelle Sharon L , LaBudde Robert A , Lombardi Kimberly , Ward Clive
Published: January 2022

Background

AOAC Method 2013.07 was adopted as First Action in 2013. Since then, the method has been used in numerous residue depletion studies with favorable comments from analysts.

Objective

To analyze data from residue depletion studies to support Final Action status.

Method

Ten residue depletion studies were conducted during May 2014 through May 2019. For each study, harvested incurred tissues were analyzed for nicarbazin using AOAC Method 2013.07 in 1 of 4 laboratories. Each analytical run included one or more fortified quality control test portions. The data from these known fortified matrix test portions were analyzed for reproducibility and repeatability.

Results

For muscle tissues, relative recovery was 90.4% (95% CI 83.8 to 97.5); RSDr was 5.4% (95% CI 3.8 to 9.2); and RSDR was 7.9%. In the liver, values were 94.5% (95% CI 91.1 to 98.0), 5.8% (95% CI 4.1 to 9.9), and 6.8%, respectively. In the kidney, values were 91.5% (95% CI 85.3 to 98.1), 5.2% (95% CI 3.7 to 8.8), and 9.0%, respectively. In skin with adhering fat, values were 94.5% (95% CI 89.2 to 100.1), 8.9% (95% CI 6.3 to 15.1), and 8.9%, respectively. In all cases, repeatability and reproducibility were within acceptable limits.

Conclusions

The data and positive feedback support the transition of AOAC Method 2013.07 from First Action to Final Action.

Highlights

Final action status is supported by data collected during routine use of the method rather than a traditional multi-laboratory collaborative study. Data were subjected to statistical analysis using the pC-metamer, and then transformed back to the traditional C-metamer.
Intonational Commitments
Authors: Rudin Deniz
Published: January 2022

This paper presents an analysis of inquisitive rising declaratives (Gunlogson 2001, Jeong 2018) within the Table model (Farkas & Bruce 2010). On this account, intonational tunes are modifiers of context update functions: rising intonation removes the speaker commitment component of a context update. This delivers a compositional account of the contributions of sentence type and intonational tune to the illocutionary mood of an utterance, showing how the semantic type of declarative sentences, the rising intonational tune, and a general-purpose utterance function (Farkas & Roelofsen 2017) conspire to derive the basic discourse effect of rising declaratives without any construction-specific stipulations. The account makes use of only the most fundamental representational primitives independently necessary to model assertions and neutral questions, showing that rising declaratives can be accounted for without recourse to projected commitments, metalinguistic issues, or explicit marking of commitment strength, evidence source, or epistemic bias (cf. Gunlogson 2008, Northrup 2014, Malamud & Stephenson 2015, Farkas & Roelofsen 2017). Inferences of bias generated by rising declaratives are accounted for with a novel pragmatics for the Table model, formalizing what is implicit in discussions of the role played in the model by speaker commitments and projected Common Grounds.
The development and optimisation of gastro-retentive floating tablets using fused deposition modelling 3D printing
Authors: Oladeji Sinmisola A , Dadou Suha M , Zhao Min , Li Shu , Jones David S , Andrews Gavin P
Published: January 2022

Objectives

To develop a robust tablet design for the manufacture of gastro-retentive tablets using fused deposition modelling three-dimensional printing (FDM-3DP) that can provide prolonged gastric residence time with instant floating and minimum influence of process and/or formulation variables.

Methods

Three different polymers, such as polyvinyl alcohol (PVA), hydroxypropyl cellulose (HPC) and Soluplus were used, separately, for the manufacture of tablets using FDM-3DP. Tablets were designed in a sandwich model that included voids in the internal structure to support buoyancy.

Key findings

Fabricated tablets from all polymers were instantly buoyant with no floating lag time. Floating duration was in the order: HPC > Soluplus > PVA which can be explained by the density of the tablets. PVA tablets exhibited significantly (P < 0.05) higher density values (0.86 ± 0.02 mg/mm3) than HPC and Soluplus (0.69 ± 0.03 and 0.72 ± 0.02 mg/mm3, respectively). HPC and Soluplus showed similar zero-order drug release profiles (f2 > 50) and were able to sustain the release of theophylline for 12 h, whereas complete drug release was achieved from PVA tablets after 3 h.

Conclusions

Robust gastro-retentive tablets that show instant buoyancy regardless of the polymeric carrier type and composition were successfully manufactured utilising FDM-3DP. This allows for overcoming the restrictions posed by process/formulation parameters on the floatability of gastro-retentive tablets.
Oncocytic mucoepidermoid carcinoma of the parotid gland: case report
Authors: Alshammari Amjad , Aljufairi Eman , Alsayed Anwaar
Published: January 2022

Mucoepidermoid carcinoma is the most common malignant tumour of salivary glands. Oncocytic variant is rare and could be mistaken for benign entities like oncocytoma and Warthin tumour on cytology. We present a case of a 67-year-old female presented with left parotid gland mass, which was diagnosed as a benign oncocytoma on cytologic examination. Later, the patient underwent left parotidectomy where the histologic examination revealed a malignant oncocytic mucoepidermoid carcinoma. The distinction between these entities is essential to get a proper management for the patient. On cytology alone, it is quite difficult to differentiate; however, histologic examination shows malignant features including infiltrative borders, lymphovascular invasion and perineural invasion excluding a benign tumour. The presence of mucin is an important clue to suspect oncocytic mucoepidermoid carcinoma. Ancillary studies can help reach a wright diagnose, as oncocytic mucoepidermoid carcinoma is positive for P63 and has MAML2 translocation.
Bayesian Nonparametric Joint Model For Domain Point Estimates and Variances Under Biased Observed Variances
Authors: Savitsky Terrance Dean , Gershunskaya Julie
Published: January 2022

Government statistical agencies compose a population statistic for a given domain using a sample of units nested in that domain. Subsequent modeling of these domain survey estimates is often used to “borrow strength” across a dependence structure among the domains to improve estimation accuracy and efficiency. This paper focuses on models jointly defined for sample-based point estimates along with their sample-based estimates of variances. Bias may be present in the sample-based (observed) variances due to small sample sizes or the estimation procedure. We propose a new formulation that extends existing joint model formulations to allow for a multiplicative bias in observed variances. Our approach capitalizes on the unbiasedness property of point estimates. We utilize a nonparametric mixture construction that allows the data to discover distinct bias regimes. As a consequence of the better variance estimation, domain point estimates are more robustly estimated under a joint model for the domain point estimates and their associated variances. We compare the performances of alternative models in application to estimates of total employment from the Current Employment Statistics survey conducted by the US Bureau of Labor Statistics, and in simulations.
Active O-acetylserine-(thiol) lyase A and B confer improved selenium resistance and degradel-Cys andl-SeCys in Arabidopsis
Authors: Kurmanbayeva Assylay , Bekturova Aizat , Soltabayeva Aigerim , Oshanova Dinara , Nurbekova Zhadyrassyn , Srivastava Sudhakar , Tiwari Poonam , Dubey Arvind Kumar , Sagi Moshe
Published: January 2022

The roles of cytosolic O-acetylserine-(thiol)-lyase A (OASTLA), chloroplastic OASTLB, and mitochondrial OASTLC in plant selenate resistance were studied in Arabidopsis. Impairment in OASTLA and OASTLB resulted in reduced biomass, chlorophyll and soluble protein content compared with selenate-treated OASTLC-impaired and wild-type plants. The generally lower total selenium (Se), protein-Se, organic-sulfur and protein-sulfur (S) content in oastlA and oastlB compared with wild-type and oastlC leaves indicated that Se accumulation was not the main cause for the stress symptoms in these mutants. Notably, the application of selenate positively induced S-starvation markers and the OASTLs, followed by increased sulfite reductase, sulfite oxidase activities, and increased sulfite and sulfide concentrations. Taken together, our results indicate a futile anabolic S-starvation response that resulted in lower glutathione and increased oxidative stress symptoms in oastlA and oastlB mutants. In-gel assays of l-cysteine and l-seleno-cysteine, desulfhydrase activities revealed that two of the three OASTL activity bands in each of the oastl single mutants were enhanced in response to selenate, whereas the impaired proteins exhibited a missing activity band. The absence of differently migrated activity bands in each of the three oastl mutants indicates that these OASTLs are major components of desulfhydrase activity, degrading l-cysteine and l-seleno-cysteine in Arabidopsis.
When Black Lives Really Do Matter: Subverting Medical Racism through African-Diasporic Healing Rituals in Toni Morrison’s Fiction
Authors: Cutter Martha J
Published: January 2022

Toni Morrison spent much of her career detailing the unpredictability of African American existence within a racist society, with a special focus on patriarchal violence and medical apartheid against women’s bodies. Yet Morrison also limns out alternative modes of healing within a Black metacultural framework that moves between Nigeria, Brazil, and Egypt. As we move forward from the COVID-19 crisis, research has suggested that training more African American doctors, nurses, and physician assistants might curtail medical racism. Morrison’s fiction looks to a more basic level in which love of the bodies of African American people is at the center of healing. This article therefore discusses medical racism and applies Morrison’s lessons to the COVID-19 moment that her writing trenchantly foreshadows. It focuses on three healers who elide the medical establishment to embody a metacultural ethics of healing: Baby Suggs (in Beloved [1987]), Consolata Sosa (in Paradise [1997]), and Ethel Fordham (in Home [2012]). Morrison fuses an African-diasporic framework with embodied new knowledge that allows individuals to gain insight and agency in a white-dominant medical world that still refuses to endorse the idea that Black people’s bodies and psyches really do matter. An examination of these healers’ practices therefore sheds light on the COVID-19 moment by suggesting ways that African American people can stay “woke” and have agency when encountering and navigating traditional health care systems, which even today view the bodies of African Americans as fodder for medical experiments, immune to disease, and not in need of ethical and humane medical care.
An updated glitch rate law inferred from radio pulsars
Authors: Millhouse M , Melatos A , Howitt G , Carlin J B , Dunn L , Ashton G
Published: January 2022

Radio pulsar glitches probe far-from-equilibrium processes involving stress accumulation and relaxation in neutron star interiors. Previous studies of glitch rates have focused on individual pulsars with as many recorded glitches as possible. In this work, we analyse glitch rates using all available data including objects that have glitched never or once. We assume the glitch rate follows a homogeneous Poisson process, and therefore exclude pulsars that exhibit quasiperiodic glitching behaviour. Calculating relevant Bayes factors shows that a model in which the glitch rate λ scales as a power of the characteristic age τ is preferred over models that depend arbitrarily on powers of the spin frequency ν and/or its time derivative $\dot{\nu }$. For λ = A(τ/τref)−γ, where τref = 1 yr is a reference time, the posterior distributions are unimodal with $A=0.0066_{-0.002}^{+0.003}\ \rm {yr}^{-1}$ and $\gamma =0.27_{-0.03}^{+0.03}$. Importantly, the data exclude with 99 per cent confidence the possibility γ = 1 canvassed in the literature. When objects with zero-recorded glitches are included, the age-based rate law is still preferred and the posteriors change to give $A=0.0099_{-0.003}^{+0.004}\ \rm {yr}^{-1}$ and $\gamma =0.31_{-0.03}^{+0.03}$. The updated estimates still support increased glitch activity for younger pulsars, while demonstrating that the large number of objects with zero glitches contain important statistical information about the rate, provided that they are part of the same population as opposed to a disjoint population which never glitches for some unknown physical reason.
Molecular Evolution across Mouse Spermatogenesis
Authors: Kopania Emily E K , Larson Erica L , Callahan Colin , Keeble Sara , Good Jeffrey M
Published: January 2022

Genes involved in spermatogenesis tend to evolve rapidly, but we lack a clear understanding of how protein sequences and patterns of gene expression evolve across this complex developmental process. We used fluorescence-activated cell sorting (FACS) to generate expression data for early (meiotic) and late (postmeiotic) cell types across 13 inbred strains of mice (Mus) spanning ∼7 My of evolution. We used these comparative developmental data to investigate the evolution of lineage-specific expression, protein-coding sequences, and expression levels. We found increased lineage specificity and more rapid protein-coding and expression divergence during late spermatogenesis, suggesting that signatures of rapid testis molecular evolution are punctuated across sperm development. Despite strong overall developmental parallels in these components of molecular evolution, protein and expression divergences were only weakly correlated across genes. We detected more rapid protein evolution on the X chromosome relative to the autosomes, whereas X-linked gene expression tended to be relatively more conserved likely reflecting chromosome-specific regulatory constraints. Using allele-specific FACS expression data from crosses between four strains, we found that the relative contributions of different regulatory mechanisms also differed between cell types. Genes showing cis-regulatory changes were more common late in spermatogenesis, and tended to be associated with larger differences in expression levels and greater expression divergence between species. In contrast, genes with trans-acting changes were more common early and tended to be more conserved across species. Our findings advance understanding of gene evolution across spermatogenesis and underscore the fundamental importance of developmental context in molecular evolutionary studies.
A case of simultaneous onset of highly active systemic lupus erythematosus and IgG4-related renal disease
Authors: Fujita Yuya , Iwata Shigeru , Nakano Kazuhisa , Nakayamada Shingo , Miyazaki Yusuke , Kawabe Akio , Korekoda-Yoshinari Hiroko , Nawata Aya , Tanaka Yoshiya
Published: January 2022

The patient was a 73-year-old woman who had hair loss, purpura, and numbness of the soles for past 1 year. Three months prior, she was diagnosed with interstitial lung disease (ILD) and was admitted to our department. She was diagnosed with systemic lupus erythematosus (SLE) based on positive antinuclear antibodies 1280× (speckled type), hair loss, low white blood cell count, positive anti-cardiolipin and anti-ds-DNA antibodies, and lupus retinopathy. In addition, the patient was also diagnosed with immunoglobulin G (IgG)4-related disease (IgG4RD) based on high serum IgG4 levels, ILD, urine occult blood, protein, and cast, and renal histological findings showed endocapillary proliferative glomerulonephritis, increased IgG4 positive plasma cells, and characteristic storiform fibrosis. High-dose glucocorticoid therapy, hydroxychloroquine, and belimumab were administered, which improved the SLE symptoms of lupus retinopathy and peripheral neuropathy, as well as the IgG4RD symptoms of ILD and urinary findings. Herein, we report a rare case of simultaneous onset of IgG4-related nephropathy with active glomerular lesions and SLE, in which renal histology, including fluorescent antibodies, was crucial for diagnosis.
RbgA ensures the correct timing in the maturation of the 50S subunits functional sites
Authors: Seffouh Amal , Trahan Chirstian , Wasi Tanzila , Jain Nikhil , Basu Kaustuv , Britton Robert A , Oeffinger Marlene , Ortega Joaquin
Published: January 2022

RbgA is an essential protein for the assembly of the 50S subunit in Bacillus subtilis. Depletion of RbgA leads to the accumulation of the 45S intermediate. A strain expressing a RbgA variant with reduced GTPase activity generates spontaneous suppressor mutations in uL6. Each suppressor strain accumulates a unique 44S intermediate. We reasoned that characterizing the structure of these mutant 44S intermediates may explain why RbgA is required to catalyze the folding of the 50S functional sites. We found that in the 44S particles, rRNA helices H42 and H97, near the binding site of uL6, adopt a flexible conformation and allow the central protuberance and functional sites in the mutant 44S particles to mature in any order. Instead, the wild-type 45S particles exhibit a stable H42-H97 interaction and their functional sites always mature last. The dependence on RbgA was also less pronounced in the 44S particles. We concluded that the binding of uL6 pauses the maturation of the functional sites, but the central protuberance continues to fold. RbgA exclusively binds intermediates with a formed central protuberance and licenses the folding of the functional sites. Through this mechanism, RbgA ensures that the functional sites of the 50S mature last.
CellDART: cell type inference by domain adaptation of single-cell and spatial transcriptomic data
Authors: Bae Sungwoo , Na Kwon Joong , Koh Jaemoon , Lee Dong Soo , Choi Hongyoon , Kim Young Tae
Published: January 2022

Deciphering the cellular composition in genome-wide spatially resolved transcriptomic data is a critical task to clarify the spatial context of cells in a tissue. In this study, we developed a method, CellDART, which estimates the spatial distribution of cells defined by single-cell level data using domain adaptation of neural networks and applied it to the spatial mapping of human lung tissue. The neural network that predicts the cell proportion in a pseudospot, a virtual mixture of cells from single-cell data, is translated to decompose the cell types in each spatial barcoded region. First, CellDART was applied to a mouse brain and a human dorsolateral prefrontal cortex tissue to identify cell types with a layer-specific spatial distribution. Overall, the proposed approach showed more stable and higher accuracy with short execution time compared to other computational methods to predict the spatial location of excitatory neurons. CellDART was capable of decomposing cellular proportion in mouse hippocampus Slide-seq data. Furthermore, CellDART elucidated the cell type predominance defined by the human lung cell atlas across the lung tissue compartments and it corresponded to the known prevalent cell types. CellDART is expected to help to elucidate the spatial heterogeneity of cells and their close interactions in various tissues.
Comparing recent and preindustrial cladoceran assemblages in 35 metal- and smelting-affected lakes near Sudbury (Ontario, Canada)
Authors: Simmatis Brigitte , Paterson Andrew M , Smol John P
Published: January 2022

Base metal smelting activity around Sudbury (Ontario, Canada) has persisted for over a century, emitting metals and acidifying contaminants that affected lakes downwind of smelter stacks. Although considerable research has been directed toward the paleolimnological study of diatoms and chrysophytes in the region, relatively little comparable work has been completed on invertebrates. Here, cladoceran (Branchiopoda: Cladocera) assemblages are compared using a paleolimnological “top-bottom approach”, comparing preimpact and recent assemblages. Spatiotemporal differences were likely driven by acidification-related stressors and legacy effects of metal contamination. The replacement of the Daphnia longispina complex with the Daphnia pulex complex is attributable to diminished lake-water calcium concentrations. Increased abundances of early colonist taxa demonstrate that many acidified lakes have not fully recovered. Regional stressors further complicate recovery and the interpretation of temporal changes. Finally, clustering of recent cladoceran assemblages reflects the effects of modern multiple stressors and persistent historical stressors. This study shows that acidification history partially explains differences in cladoceran assemblages, but also that multiple stressors will likely continue to influence assemblage composition and recovery in Sudbury lakes. Defining appropriate reference conditions, considering historical and modern stressors, will be important when assessing the extent and trajectory of ecosystem recovery from widespread anthropogenic impacts.
Effectiveness and Tolerability of Dronabinol Use in Patients with Chronic Pain: A Retrospective Analysis of 12-Week Open-Label Real-World Data Provided by the German Pain e-Registry
Authors: Ueberall Michael A , Horlemann Johannes , Schuermann Norbert , Kalaba Maja , Ware Mark A
Published: January 2022

Objective

To evaluate the effectiveness of Δ9-tetrahydrocannabinol (dronabinol [DRO]) as an add-on treatment in patients with refractory chronic pain (CP).

Methods

An exploratory retrospective analysis of 12-week data provided by the German Pain e-Registry on adult patients with treatment refractory CP who received DRO.

Results

Between March 10, 2017, and June 30, 2019, the German Pain e-Registry collected information on 89,095 patients with pain, of whom 1,145 patients (1.3%) received DRO (53.8% female, mean ± standard deviation age: 56.9 ± 10.6 years), and 70.0% documented use for the entire 12-week evaluation period. The average DRO daily dose was 15.8 ± 7.5 mg, typically in three divided doses (average DRO dose of 5.3 ± 2.1 mg). Average 24-hour pain intensity decreased from 46.3 ± 16.1 to 26.8 ± 18.7 mm on a visual analog scale (absolute visual analog scale difference: –19.5 ± 17.3; P < 0.001). Among patients who completed follow-up, an improvement from baseline of at least 50% was documented for pain (46.5%), activities of daily living (39%), quality of life (31.4%), and sleep (35.3%). A total of 536 patients (46.8%) reported at least one of 1,617 drug-related adverse events, none of which were serious, and 248 patients (21.7%) stopped treatment. Over the 12-week period, 59.0% of patients reported a reduction of other pain treatments, and 7.8% reported a complete cessation of any other pharmacological pain treatments.

Conclusion

Add-on treatment with DRO in patients with refractory CP was well tolerated and associated with a significant improvement.
Do recommended interventions widen or narrow inequalities in musculoskeletal health? An equity-focussed systematic review of differential effectiveness
Authors: Peat G , Jordan K P , Wilkie R , Corp N , van der Windt D A , Yu D , Narle G , Ali N
Published: January 2022

Background

It is unclear whether seven interventions recommended by Public Health England for preventing and managing common musculoskeletal conditions reduce or widen health inequalities in adults with musculoskeletal conditions.

Methods

We used citation searches of Web of Science (date of ‘parent publication’ for each intervention to April 2021) to identify original research articles reporting subgroup or moderator analyses of intervention effects by social stratifiers defined using the PROGRESS-Plus frameworks. Randomized controlled trials, controlled before-after studies, interrupted time series, systematic reviews presenting subgroup/stratified analyses or meta-regressions, individual participant data meta-analyses and modelling studies were eligible. Two reviewers independently assessed the credibility of effect moderation claims using Instrument to assess the Credibility of Effect Moderation Analyses. A narrative approach to synthesis was used (PROSPERO registration number: CRD42019140018).

Results

Of 1480 potentially relevant studies, seven eligible analyses of single trials and five meta-analyses were included. Among these, we found eight claims of potential differential effectiveness according to social characteristics, but none that were judged to have high credibility.

Conclusions

In the absence of highly credible evidence of differential effectiveness in different social groups, and given ongoing national implementation, equity concerns may be best served by investing in monitoring and action aimed at ensuring fair access to these interventions.
Morphological characteristics of DISH in patients with OPLL and its association with high-sensitivity CRP: inflammatory DISH
Authors: Nguyen Tran Canh Tung , Yahara Yasuhito , Yasuda Taketoshi , Seki Shoji , Suzuki Kayo , Watanabe Kenta , Makino Hiroto , Kamei Katsuhiko , Mori Kanji , Kawaguchi Yoshiharu
Published: January 2022

Objectives

To characterize and clarify evidence as to whether the ectopic bone formations of DISH in patients with ossification of the posterior longitudinal ligament (OPLL) are caused by inflammatory or degenerative processes.

Methods

Whole-spine CT and serum high-sensitivity CRP (hs-CRP) levels were obtained from 182 cervical OPLL patients (DISH+, n = 104; DISH−, n = 78). In the DISH+ group, ectopic bone formations were categorized into Flat and Jaggy types, then further divided into three subgroups: group 1 (Jaggy-dominant pattern), group 2 (Equivalence of pattern) and group 3 (Flat-dominant pattern). Data were compared between the DISH+ and DISH− groups, and among the three subgroups.

Results

The upper thoracic spine was most affected by the Flat type, whereas the Jaggy type was more frequent in the middle and lower thoracic regions. There was no difference in hs-CRP levels between the DISH+ and DISH− groups. Among the three subgroups, hs-CRP levels in group 3 [mean (s.d.) 0.16 (0.09) mg/dl] were significantly higher than in group 1 [0.04 (0.02) mg/dl] and group 2 [0.08 (0.06) mg/dl]. Higher levels of hs-CRP were associated with a greater number of vertebral units with Flat-type formations (β = 0.691, P < 0.0001) and with a lesser number of vertebral units with Jaggy-type formations (β = −0.147, P = 0.036).

Conclusion

The Flat type in DISH might be caused by an inflammatory pathogenesis rather than a degenerative process presented in the Jaggy type.
Anticipating Disagreement in Dynamic Contracting
Authors: Zhu John Y
Published: January 2022

This paper studies how anticipated disagreement between a financier and an entrepreneur affects optimal contracting and asset prices. The value of debt is uniquely immune to anticipated disagreement, and when the set of anticipated disagreements is sufficiently rich, this immunity causes the optimal contract to give the financier debt. In contrast, the values of other contracts, including equity, decline as anticipated disagreement becomes more severe. This suggests a channel through which an increase in the severity of anticipated disagreement increases the equity premium and the debt-to-equity ratio.
Cross-sectional study of intraocular cataract lens replacement, circadian rest–activity rhythms, and sleep quality in older adults
Authors: Chellappa Sarah L , Bromundt Vivien , Frey Sylvia , Schlote Torsten , Goldblum David , Cajochen Christian
Published: January 2022

Study Objectives

Age-related cataract decreases light transmission at the most sensitive spectrum for circadian photoentrainment, with negative ramifications for human health. Here, we assessed whether intraocular lens replacement (IOL) in older patients with previous cataract was associated with increased stability and amplitude of circadian rest–activity rhythms, and improved sleep quality.

Methods

Our cross-sectional study included sixteen healthy older individuals without ocular diseases (controls; 55–80 years; 63.6 ± 5.6y; 8 women) and 13 patients with previous cataract and bilateral IOL (eight with blue-blocking [BB] lens and five with ultraviolet-only [UV] blocking lens; 55–80 years; 69.9 ± 5.2y; 9 women). The study comprised three weeks of at home rest–activity assessments using wrist-worn actigraphs, and each week preceded a laboratory protocol. Primary outcomes were actigraphy-derived interdaily stability, intradaily variability, and relative amplitude of circadian rest–activity rhythms. Secondary outcomes were actigraphy-assessed sleep quality (i.e. time in bed, sleep duration, sleep efficiency, mean wake bout time and fragmentation index).

Results

Patients with IOL had significantly higher interdaily stability (“Group” effect: pFDR =.001), but not intradaily variability (“Group” effect: pFDR = n.s.), and significantly higher relative amplitude of rest–activity rhythms (“Group” effect: pFDR < .001). Moreover, patients with IOL had significantly higher activity levels during the day and lower levels during the evening, as compared to healthy older controls (“Group” effect: pFDR = .03). Analyses of actigraphy-derived sleep parameters yielded no significant differences across groups (“Group” effect: all pFDR > .1).

Conclusions

Our cross-sectional study suggests that enhancing spectral lens transmission in patients with cataract may benefit their circadian health.
Supporting the Ross procedure: preserving root physiology while mitigating autograft dilatation
Authors: Tanaka Dustin , Mazine Amine , Ouzounian Maral , El-Hamamsy Ismail
Published: January 2022

Purpose of review

The purpose of this article is to describe the optimized approach to nonrepairable aortic valve disease in young adults with a Ross procedure, while preserving the dynamic physiology of the aortic root.

Recent findings

As the techniques for supporting pulmonary autografts continue to be refined, and the applicability of the Ross procedure continues to expand, an assessment of the various techniques based on aortic root physiology is warranted. Semi-resorbable scaffolds show promise in ovine models for improving the Ross procedure. Recent long-term outcomes for the Dacron inclusion technique in comparison to more physiologic methods of support emphasize the importance of balancing the prevention of early dilatation with the preservation of root haemodynamics. As this review will synthesize, the dynamic physiology of the root may be preserved even in patients at a higher risk of autograft dilatation.

The favourable long-term outcomes of the Ross procedure can be partly attributed to the ability of the autograft to restore dynamism to the neoaortic root. Patient-specific modifications that respect root physiology can tailor the Ross procedure to address each patient's risk factors for early dilatation and late failure. As such, the Ross procedure should be recognized as an increasingly favourable solution for a wide spectrum of nonpreservable aortic valve disease in young adults.
Surgical Management of Fuchs Endothelial Corneal Dystrophy: A Treatment Algorithm and Individual Patient Meta-Analysis of Descemet Stripping Only
Authors: Din Nizar , Cohen Eyal , Popovic Marko , Mimouni Michael , Trinh Tanya , Gouvea Larissa , Alshaker Sara , Ong Tone Stephan , Chan Clara C. , Slomovic Allan R.
Published: January 2022

Purpose:

This study aims to determine predictive factors for success of Descemet stripping only (DSO) in Fuchs corneal endothelial dystrophy and propose a DSO treatment algorithm.

Methods:

Ovid MEDLINE, Embase, and Cochrane CENTRAL databases were searched to evaluate DSO case series, including combined phacoemulsification and DSO, and the use of Rho-kinase inhibitors (ROC-i). Our primary outcome was success of corneal clearance. Secondary outcomes included the time to corneal clearance, the postoperative endothelial cell count (ECC), and the impact of ROC-i.

Results:

Sixty-eight cases were evaluated with a mean follow-up of 12.4 months. DSO corneal clearance was achieved in 85% (n = 58) with a mean time of 4.9 weeks for the ROC-i group compared with 10.1 weeks in the observation group (P < 0.0001). The mean central ECC postoperatively was higher in the ROC-i group compared with the observation group 1151 ± 245 versus 765 ± 169 cells/mm2, respectively (P < 0.018). The postoperative best-corrected visual acuity (BCVA) improved in 61 eyes (90%), with mean final BCVA of 0.17 (0.26) logMAR (P = 0.001), which was statistically significant compared with preoperative BCVA. Factors influencing success were 4-mm descemetorhexis size, a clear peripheral ECC with no clinical sequelae of decompensation or guttae, and a low central corneal thickness. No intraoperative complications were noted. The commonest postoperative complication was deep corneal stromal scars noted at the descemetorhexis edge (n = 9).

Conclusions:

DSO has a role in the treatment of a subset of patients with Fuchs corneal endothelial dystrophy and that adjuvant treatment with ROC-i may lead to faster corneal clearance.
Systemic administration of monosodium glutamate induces sexually dimorphic headache- and nausea-like behaviours in rats
Authors: Benbow Tarique , Ekbatan Maryam Ranjbar , Wang Grace Hong Yue , Teja Felisha , Exposto Fernando G. , Svensson Peter , Cairns Brian E.
Published: January 2022

Ingestion of monosodium glutamate (MSG) causes headache, nausea, and craniofacial tenderness in healthy individuals. The present study explored whether MSG produces behavioural signs of headache, nausea, and changes in craniofacial sensitivity in rats. The behavior of male and female Sprague-Dawley rats was video recorded before and after intraperitoneal (i.p.) injections of MSG (1-1000 mg/kg), nitroglycerin (GTN, 10 mg/kg), or normal saline. Behaviors (grimace score, head-flicks, rearing, head scratches, facial grooming, lying-on-belly, and temporalis muscle region mechanical withdrawal threshold) were evaluated. Facial cutaneous temperature of the nose and forehead was measured before and after i.p. injections via infrared thermography. Plasma glutamate and calcitonin gene–related peptide concentrations after administration of 1000 mg/kg MSG were measured in anesthetized rats. Monosodium glutamate induced nocifensive, headache-like, and nausea-like behaviors in a dose-related manner but had no effect on mechanical threshold. Monosodium glutamate (1000 mg/kg) induced a significantly greater frequency of headache-like behavior in females but a longer duration of nausea-like behavior in males. Monosodium glutamate produced a prolonged increase in plasma glutamate and calcitonin gene–related peptide concentrations. Co-administration of the median effective dose of MSG (350 mg/kg) with GTN (10 mg/kg) amplified headache-like behaviors, induced significant craniofacial sensitivity, and produced increased nausea-like behaviour. Co-administration of sumatriptan or naproxen with MSG (1000 mg/kg) significantly attenuated MSG-induced nocifensive and headache-like behaviors. Our data suggest that systemic administration of MSG to rats induces behavioral correlates of headache and nausea. This model may offer another avenue for research on the mechanism and treatment of primary headache disorders such as migraine.
Noninvasive vagus nerve stimulation modulates trigeminal but not extracephalic somatosensory perception: functional evidence for a trigemino-vagal system in humans
Authors: Peng Kuan-Po , May Arne
Published: January 2022

Noninvasive vagus nerve stimulation (nVNS) is effective in several types of headache disorders. We sought to unravel the mechanism of how nVNS exhibits this efficacy. This study used a randomized, single-blind, sham-controlled, crossover design and comprised 3 projects with 3 independent cohorts of healthy participants. Project I (n = 15) was explorative. Six quantitative sensory test parameters, including mechanical pain threshold (MPT), were measured over the left V1 dermatome and forearm and compared before and after unilateral nVNS. Projects II (n = 20) and III (n = 21) were preregistered online (https://osf.io/r4jb9). Quantitative sensory test parameters were compared over the left (Project II) or bilateral V1 and V3 dermatomes (Project III), respectively, in addition to the left forearm as a control. A secondary analysis of heart rate variability (HRV) using a historical control group was used to control for systemic effects of nVNS. Verum-nVNS induced trigeminal-specific modulation of pain threshold (ie, MPT) over the left V1 in Project I, left V1 and V3 in Project II, and bilateral V1 and V3 in Project III. Data pooled from Projects II and III demonstrated a greater increase in MPT in the V1 vs V3 dermatome. There were no differences associated with sham-nVNS in any projects. Heart rate variability parameters did not change after nVNS. Our results provide functional evidence of a long hypothesized functional trigemino-vagal system in humans and may explain why nVNS is effective in some headache disorders but not in somatic pain disorders. Because unilateral nVNS modulated the trigeminal thresholds bilaterally, this effect is probably indirect through a central top-down mechanism.
Prevalence, Demographic Correlates, and Medical Correlates of Cognitive Impairment Among Iranian People Living With HIV: A Cross-sectional Survey Study
Authors: Etesami Maede S. , Jones Deborah L. , Sadeghi-Firoozabadi Vahid , Abbasian Ladan , Ghayomzadeh Morteza , Mohraz Minoo , Vance David E. , Cysique Lucette A. , Asgarabad Mojtaba Habibi
Published: January 2022

While taking antiretroviral therapy, 30%–60% of people living with HIV (PLWH) experience neurocognitive impairment (NCI). To determine NCI prevalence among Iranian PLWH, by the computerized Vienna Test System, 63 adults living without HIV and 63 Iranian PLWH aged 18–50 years (M = 35.3, SD = 7.9) were assessed for cognitive function. NCI was determined by receiver operating characteristic curve cutoff points based on the adults living without HIV. Associations between demographics, HIV serostatus markers, and mean T-scores were investigated. Performance differences were tested by including significant covariates in an analysis of covariance. NCI prevalence rates were 57.14% in PLWH and 19.05% in adults living without HIV. Global neurocognitive performance and all cognitive domains were significantly different between the groups, except for visual memory and selective attention. In Iran, NCI prevalence parallels that reported in PLWH worldwide. There should be a strategy to screen Iranian PLWH for NCI.
Dizziness Symptoms, Balance Confidence, and Vestibular Function in Older Women Reporting Dizziness and Unsteadiness
Authors: Lindell Ellen , Kollén Lena , Finizia Caterina
Published: January 2022

Objective:

The aim of this article is to evaluate older women who report dizziness on a daily or weekly basis, but not seeking medical care for their problems, for levels of patient-reported outcome measures related to dizziness, balance confidence, vestibular impairment, benign paroxysmal positional vertigo walking speed, Timed Up and Go (TUG), balance confidence, depression, and anxiety.

Study Design:

Cross-sectional survey.

Setting:

Secondary referral center.

Patients:

Patients coming for bone density measurements answered questions regarding occurrence of dizziness. Women reporting dizziness on a daily or weekly basis were considered eligible and invited for investigation at the Ear, Nose, and Throat clinic at Södra Älvsborg Hospital, Sweden.

Main Outcome Measure:

Patients completed the Dizziness Handicap Inventory (DHI), Activities-specific Balance Confidence Scale, and Hospital Anxiety and Depression Scale and were investigated with the video Head Impulse Test, for benign paroxysmal positional vertigo, walking speed, and TUG test.

Results:

Fifty-two female patients were enrolled. Associations were found between high levels of DHI and high distress due to dizziness, and low levels of balance confidence and reduced walking speed and TUG test time. Participants with higher DHI levels reported higher levels of both depression and anxiety. No associations were found between levels of DHI and results on vestibular tests.

Conclusion:

Women reporting higher levels of distress due to dizziness had reduced walking speed and reported less balance confidence and higher levels of anxiety and depression. The findings support the theory that DHI captures aspects of overall self-rated wellbeing and function rather than structural vestibular deficits.
Pediatric Emergency Medicine Fellowship Education on Adolescent Sexual Health Care
Authors: Weber Emily , Chao Jennifer , Koyama Atsuko , Sinert Richard
Published: January 2022

Objectives

Many adolescents use the emergency department as their sole resource for primary care and sexual health care. This provides an opportunity to prevent sexually transmitted infections and unintended pregnancy as well as to educate teenagers about their bodies and sexual health. There is no standard curriculum on sexual health as part of pediatric emergency medicine (PEM) fellowship education. Our goal is to evaluate what is taught in PEM fellowship about adolescent sexual health.

Methods

We administered an anonymous questionnaire to both PEM fellows and program directors (PDs). The questionnaire was distributed through the PEM Program Director Survey Committee. The questionnaire was sent to 88 PDs and 305 fellows total. An introductory email explaining the purpose of the study and a link to the online questionnaire was sent. The questionnaire was created using SurveyMonkey (www.surveymonkey.com). Data were analyzed using descriptive statistics.

Results

We achieved a 43% survey response rate from PDs (38 of 88) and a 24% survey response rate from fellows (73 of 305). The PD respondents included 61% females, and almost all (86%) are between ages 35 and 54 years. Seventy-three percent of the fellows are female, and they are all between 25 to 44 years old. There was a great deal of variability in the amount of adolescent sexual health education PDs provide their fellows in the form of lectures and bedside teaching cases. A majority of survey respondents (86% of fellows and 66% of the PDs) agreed that there should be a standard PEM curriculum to teach about adolescent sexual health. More than half (53% of PDs and 56% of fellows) are not satisfied with the number of training opportunities for adolescent sexual health.

Conclusions

We found variability in adolescent sexual health training during PEM fellowship, although fellows and PDs agree that there should be a standardized curriculum. We recommend that the American Board of Pediatrics form a committee to decrease variability in the training of PEM fellows on adolescent sexual health.
Delayed Diagnosis in a Male With Congenital Chloride Losing Diarrhea
Authors: Sanchez Raul E. , Erdman Steven H. , Hill Ivor D.
Published: January 2022

Congenital chloride diarrhea is a secretory type of diarrhea, inherited in as autosomal recessive. Our case involves a 12-month-old male who initially presented in infancy and was treated with an exclusive elemental formula diet. At 12 months of age, he presented with significant hypokalemia, hypochloremia, and metabolic alkalosis. The diagnosis was established with stool electrolytes demonstrating a stool chloride of 145 mmol/L. He initially was treated with sodium and potassium supplementation and a proton pump inhibitor. Genetic testing revealed a large 4.3-kb deletion encompassing exons 15 to 17 of the SLC26A3 gene and a sequence variant of the SLC26A3 gene, c.610T>G; pTyr204Asp initially reported as a variant of unknown significance. His parents had genetic testing confirming that the deletion and sequence variant were found in opposite alleles in the patient, meaning the sequence variant is a pathogenic variant. He is maintaining stable serum electrolytes and gaining appropriate weight on oral electrolyte supplementation.
A review of upper limb pediatric prostheses and perspectives on future advancements
Authors: Battraw Marcus A. , Fitzgerald Justin , Joiner Wilsaan M. , James Michelle A. , Bagley Anita M. , Schofield Jonathon S.
Published: January 2022

Many complex factors affect whether a child with a congenital upper limb deficiency will wear a prosthetic limb. Ultimately, for a child to wear and use their prosthesis, it must facilitate the effective performance of daily tasks and promote healthy social interactions. Although numerous pediatric devices are available, most provide a single open-close grasp (if a grasping function is available at all) and often offer nonanthropomorphic appearances, falling short of meeting these criteria. In this narrative review, we provide a critical assessment of the state of upper limb prostheses for children. We summarize literature using quality of life measures and categorize driving factors affecting prosthesis use into two main groupings: psychosocial and physical functioning. We define psychosocial functioning as factors related to social inclusion/exclusion, emotional function, independence, and school functioning. Physical functioning is defined as factors associated with the physical use of a prosthesis. The reviewed literature suggests that psychosocial domains of quality of life may be influenced by a congenital limb deficiency, and currently available prostheses provide little benefit in the physical functioning domains. Finally, we discuss technological advancements in adult prostheses that have yet to be leveraged for pediatric devices, including describing recently developed adult electric hands that may improve physical functioning through multiple grasping configurations and provide more hand-like cosmesis. We outline actions necessary to translate similar technologies for children and discuss further strategies to begin removing barriers to pediatric device adoption.
18F-FDG PET/CT and 99mTc-MIBI SPECT/CT Findings in a Patient With Eosinophilic Solid and Cystic Renal Cell Carcinoma
Authors: Tong Zhenghao , Shen Qi , Sun Hongwei , Zhang Jianhua , Fan Yan
Published: January 2022

A 26-year-old woman was incidentally discovered to have bilateral renal tumors on ultrasound, and percutaneous biopsy of the right kidney lesion proved eosinophilic solid and cystic renal cell carcinoma.18F-FDG PET/CT demonstrated hyperdense or isodense lesions on CT without FDG uptake, whereas99mTc-MIBI SPECT/CT fusion images showed tumors with increased99mTc-MIBI uptake. This case indicates that the99mTc-MIBI SPECT/CT is a potential method for the differentiation of renal tumor with eosinophilic features from other renal tumor histology.