bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring migration intention among registered pharmacists in Kerala: a mixed-methods study
Authors: Kunnumbrath Navaneeth , Kodali Prakash Babu
Published: February 2023

Objectives

This study investigated the intention to migrate among pharmacists in Kerala and explored the factors driving pharmacist migration in Kerala.

Methods

A sequential mixed-methods study was carried out to explore the intention to migrate among pharmacists in Kerala, India. A survey of 256 registered pharmacists and in-depth interviews with 15 pharmacists having high migration intentions were undertaken. Quantitative data were analysed employing univariate approaches and binary logistic regression. Qualitative data were analysed employing thematic analysis.

Key findings

About 44.5% (n = 114) of pharmacists expressed a high intention to migrate. Younger age of up to 30 years (AOR = 8.31, 95% CI = 2.24–30.82), more opportunities abroad (AOR = 4.28, 95% CI = 1.87–9.80), better salaries (AOR = 2.48, 95% CI = 1.04–5.95) and a general negative outlook towards a pharmacy career in Kerala (AOR = 2.83, 95% CI = 1.22–6.56) predicted a high level of intention to migrate among pharmacists. Lower incomes, working conditions, respect and recognition in the society, professional conflict and social connections were observed to be major push factors influencing pharmacists’ migration intentions.

Conclusions

Just under half of the registered pharmacists in Kerala has a high intention to migrate abroad. Economic factors, workplace factors, lack of opportunities, social status and so on, were influencers of the intention to migrate among pharmacists. Ensuring implementation of equitable wage policies, preventing unlicensed pharmacy practice, improving societal awareness and providing clear job roles for pharmacists with PharmD and MPharm degrees are needed.
On a Connection Formula of a Higher Rank Analog of Painlevé VI
Authors: Xu Xiaomeng
Published: February 2023

In this paper, we derive a connection formula for a higher rank analog of Painlevé VI arising from the isomonodromic deformation theory and the study of Frobenius manifolds.
Evaluation of Variability in Interpretation of Disk Diffusion Testing for Cefiderocol Using Different Brands of Mueller–Hinton Agar
Authors: Potter Robert F , Wallace Meghan A , Muenks Carol E , Alvarado Kelly , Yarbrough Melanie L , Burnham Carey-Ann D
Published: February 2023

Background

Cefiderocol is a new antibiotic used to treat infections with antibiotic resistant Gram-negative bacilli. The impact of differences between Mueller–Hinton agar (MHA) brands on susceptibility testing is underexplored. Compounding the implementation of cefiderocol susceptibility testing is a lack of harmonization between different regulatory body breakpoint criteria.

Methods

We performed Kirby–Bauer disk diffusion using BD, Hardy, and Remel MHA, in addition to broth microdilution for Acinetobacter baumannii (n = 25), Enterobacterales (n = 25), Stenotrophomonas maltophilia (n = 24), and Pseudomonas aeruginosa (n = 23). We analyzed disk diffusion diameters and minimum inhibitory concentrations using interpretive criteria from the Clinical and Laboratory Standards Institute (CLSI), US Food and Drug Administration (FDA), and the European Committee on Antimicrobial Susceptibility Testing (EUCAST).

Results

Breakpoint criteria impacted interpretation of susceptibly testing results, for example with the broth microdilution we found 8% (2/25) of A. baumannii isolates change interpretation between CLSI and EUCAST and 32% (8/25) change between CLSI and FDA, 12% (3/25) of Enterobacterales change between CLSI and EUCAST, 13% (3/23) of P. aeruginosa interpretations change between CLSI and FDA, and 4% (1/25) S. maltophilia change between CLSI and FDA. There was a significant difference between the zone disk diffusion diameters for P. aeruginosa and S. maltophilia between Hardy and BD; which changed interpretation (using CLSI criteria) for 8.7% (2/23) for P. aeruginosa but 0% (0/24) for S. maltophilia.

Conclusions

Breakpoint criteria impact cefiderocol susceptibility testing interpretation for broth microdilution and disk diffusion. Choice of MHA brand can also affect result interpretation.
A Simple Admission Order-set Improves Adherence to Canadian Guidelines for Hospitalized Patients With Severe Ulcerative Colitis
Authors: Li Fraine Steven , Malhamé Isabelle , Cafaro Teresa , Simard Camille , MacNamara Elizabeth , Martel Myriam , Barkun Alan , Wyse Jonathan M
Published: February 2023

Background

Individuals hospitalized with severe ulcerative colitis represent a complex group of patients. Variation exists in the quality of care of admitted patients with inflammatory bowel disease. We hypothesized that implementation of a standardized admission order set could result in improved adherence to current best practice guidelines (Toronto Consensus Statements) for the management of this patient population.

Methods

A retrospective cohort study of patients admitted with severe ulcerative colitis to a Montreal tertiary center was conducted. Two cohorts were defined based on pre- and post-implementation of a standardized order set. Adherence to 11 quality indicators was assessed before and after implementation of the intervention. These included: Clostridioides difficile and stool cultures testing, ordering an abdominal X-ray and CRP, organizing a flexible sigmoidoscopy, documenting latent tuberculosis, initiating thromboprophylaxis, use of intravenous steroids, prescribing infliximab if refractory to steroids, limiting narcotics, and surgical consultation if refractory to medical therapy.

Results

Adherence to 6 of the 11 quality indicators was improved in the post-intervention cohort. Significant increases were noted in adherence to C difficile testing (75.5% versus 91.9%, P < 0.05), CRP testing (71.4% versus 94.6%, P < 0.01), testing for latent tuberculosis (38.1% versus 84.6%, P < 0.01), thromboprophylaxis (28.6% versus 94.6%, P < 0.01), adequate corticosteroids prescription (72.9% versus 94.6%, P < 0.01), and limitation of narcotics prescribed (68.8% versus 38.9%, P < 0.01).

Conclusions

Implementation of a standardized order set, focused on pre-defined quality indicators for hospitalized patients with severe UC, was associated with meaningful improvements to most quality indicators defined by the Toronto Consensus Statements.
A Comparison of Preference-Based, Generic and Disease-Specific Health-Related Quality of Life in Pediatric Inflammatory Bowel Disease
Authors: Bashir Naazish S , Walters Thomas D , Griffiths Anne M , Otley Anthony , Critch Jeff , Ungar Wendy J
Published: February 2023

Objective

Generic preference-based HRQOL assessments used expressly for economic evaluation have not been examined in pediatric Crohn’s disease (CD) and ulcerative colitis (UC). The objective was to further assess the construct validity of preference-based HRQOL measures in pediatric IBD by comparing the Child Health Utility 9 Dimensions (CHU9D) and Health Utilities Index (HUI) to the disease-specific IMPACT-III and to the generic PedsQL in children with CD and with UC.

Methods

The CHU9D, HUI, IMPACT-III and/or PedsQL were administered to Canadian children aged 6 to 18 years with CD and UC. CHU9D total and domain utilities were calculated using adult and youth tariffs. HUI total and attribute utilities were determined for the HUI2 and HUI3. Total scores for IMPACT-III and PedsQL were determined. Spearman correlations were calculated between generic preference-based utilities and the IMPACT-III and PedsQL scores.

Results

The questionnaires were administered to 157 children with CD and 73 children with UC. Moderate to strong correlations were observed between the CHU9D, HUI2, HUI3 and the disease-specific IMPACT-III or generic PedsQL. As hypothesized, domains with similar constructs demonstrated stronger correlations, such as the Pain and Well-being domains.

Conclusions

While all questionnaires were moderately correlated with the IMPACT-III and PedsQL questionnaires, the CHU9D using youth tariffs and the HUI3 were most strongly correlated and would be suitable choices to generate health utilities for children with CD or UC for the purpose of economic evaluation of treatments in pediatric IBD.
Implementing Landscape-scale Environmental Management: Landscape Enterprise Networks
Authors: Rodgers Christopher , Kendall Helen
Published: February 2023

This article considers the use of Landscape Enterprise Networks (LENs) as an innovative model for developing collaborative landscape-scale environmental management. It does so by relying on case studies to present LENs as a model that can be successfully used to create, and then manage, the market for ecosystem services provided by multi-functional landscapes. LENs can, for example, be used to address diffuse water pollution and to establish landscape-scale biodiversity and pollution ‘offsets’ through the creation of new wetlands or large-scale rewilding initiatives. The analysis presented here concludes that LENs offers an imaginative and valuable tool for landscape-level environmental management but that changes will be needed in the legal framework for property rights and development planning if it is to fulfill its considerable potential. The governance arrangements for functioning LENs will also need refinement to introduce greater transparency, strategic direction and accountability to their future development.
Rules for robots, and why medical AI breaks them
Authors: Evans Barbara J
Published: February 2023

This article critiques the quest to state general rules to protect human rights against AI/ML computational tools. The White House Blueprint for an AI Bill of Rights was a recent attempt that fails in ways this article explores. There are limits to how far ethicolegal analysis can go in abstracting AI/ML tools, as a category, from the specific contexts where AI tools are deployed. Health technology offers a good example of this principle. The salient dilemma with AI/ML medical software is that privacy policy has the potential to undermine distributional justice, forcing a choice between two competing visions of privacy protection. The first, stressing individual consent, won favor among bioethicists, information privacy theorists, and policymakers after 1970 but displays an ominous potential to bias AI training data in ways that promote health care inequities. The alternative, an older duty-based approach from medical privacy law aligns with a broader critique of how late-20th-century American law and ethics endorsed atomistic autonomy as the highest moral good, neglecting principles of caring, social interdependency, justice, and equity. Disregarding the context of such choices can produce suboptimal policies when - as in medicine and many other contexts - the use of personal data has high social value.
Super-resolution method for SEM images based on pixelwise weighted loss function
Authors: Ito Akira , Miyamoto Atsushi , Kondo Naoaki , Harada Minoru
Published: February 2023

Scanning electron microscopy (SEM) has realized high-throughput defect monitoring of semiconductor devices. As miniaturization and complexification of semiconductor circuit patterns increase in recent years, so has the number of defects. There is thus a great need to further increase the throughput of SEM defect monitoring. Toward this end, we propose a deep learning–based super-resolution method that reproduces high-resolution (HR) images from corresponding low-resolution images. Image quality factors such as pattern contrast and sharpness are important in SEM HR images in order to evaluate the quality of printed circuit patterns. Our proposed method meets various image quality requirements by changing the loss calculation method pixelwise based on the pattern in the image. It realizes super-resolved images that compare favorably with actual HR images and can improve SEM throughput by 100% or more.
Hirst on educational theory
Authors: Kvernbekk Tone
Published: February 2023

Paul Hirst’s writings about the nature of educational theory continue to be important to the field of education. In this paper I unpack and analyse in some detail his conception of educational theory. I centre my discussion on three issues. First, I look at the ‘big picture’, how Hirst situates educational theory between the foundational disciplines and educational practice, and in so doing endows it with a specific function. His view is contrasted with the view of D. J. O’Connor; the discussion between the two of them is well known. Second, with the big picture in place, I inquire deeper into Hirst’s view of the raison d’être of educational theory. Here his views are compared with those of the German philosopher of education Erich Weniger. Finally, I discuss Hirst’s later revisions of his view, most notably his argument that the justification of educational theory by the foundational disciplines is not enough. Educational theory must also pass the test of practice, he claims. I judge this to be a considerable change, one that blurs the big picture rather than making it clearer.
Leucine deprivation results in antidepressant effects via GCN2 in AgRP neurons
Authors: Yuan Feixiang , Wu Shangming , Zhou Ziheng , Jiao Fuxin , Yin Hanrui , Niu Yuguo , Jiang Haizhou , Chen Shanghai , Guo Feifan
Published: February 2023

Essential amino acids (EAAs) are crucial nutrients, whose levels change in rodents and patients with depression. However, how the levels of a single EAA affects depressive behaviors remains elusive. Here, we demonstrate that although deprivation of the EAA leucine has no effect in unstressed mice, it remarkably reverses the depression-like behaviors induced by chronic restraint stress (CRS). This beneficial effect is independent of feeding and is applicable to the dietary deficiency of other EAAs. Furthermore, the effect of leucine deprivation is suppressed by central injection of leucine or mimicked by central injection of leucinol. Moreover, hypothalamic agouti-related peptide (AgRP) neural activity changes during CRS and leucine deprivation, and chemogenetically inhibiting AgRP neurons eliminates the antidepressant effects of leucine deprivation. Finally, the leucine deprivation-regulated behavioral effects are mediated by amino acid sensor general control non-derepressible 2 (GCN2) in AgRP neurons. Taken together, our results suggest a new drug target and/or dietary intervention for the reduction of depressive symptoms.
Stable lifetime of compact, evenly spaced planetary systems with non-equal masses
Authors: Rice David R , Steffen Jason H
Published: February 2023

Compact planetary systems with more than two planets can undergo orbital crossings from planet–planet perturbations. The time for which the system remains stable without orbital crossings has an exponential dependence on the initial orbital separations in units of mutual Hill radii. However, when a multiplanet system has period ratios near mean-motion resonances, its stability time differs from the time determined by planet separation. This difference can be up to an order of magnitude when systems are set-up with chains of equal period ratios. We use numerical simulations to describe the stability time relationship in non-resonant systems with equal separations but non-equal masses which breaks the chains of equal period ratios. We find a deviation of 30 per cent in the masses of Earth-mass planets that creates a large enough deviation in the period ratios where the average stability time of a given spacing can be predicted by the stability time relationship. The mass deviation where structure from equal period ratios is erased increases with planet mass but does not depend on planet multiplicity. With a large enough mass deviation, the distribution of stability time at a given spacing is much wider than in equal-mass systems where the distribution narrows due to period commensurabilities. We find the stability time distribution is heteroscedastic with spacing – the deviation in stability time for a given spacing increases with said spacing.
Unravelling the evolution of hot Jupiter systems under the effect of tidal and magnetic interactions and mass-loss
Authors: Lazovik Yaroslav A
Published: February 2023

Various interactions affect the population of close-in planets. Among them, the tidal and magnetic interactions drive orbital decay and star-planet angular momentum exchange, leading to stellar spin-up. As a result of the above processes, a planet may initiate the mass transfer to the host star once it encounters the Roche limit. Another mechanism providing substantial mass-loss is associated with the atmospheric escape caused by photoevaporation followed by orbital expansion, which is thought to be important for hot Neptunes and super-Earths. Thus, the fraction of the initial number of hot Jupiters may transform into lower-mass planets through the Roche lobe overflow (RLO) phase and continue secular evolution under the effect of photoevaporation. In this paper, we compile the latest prescriptions for tidal and magnetic migration and mass-loss rates to explore the dynamics of hot Jupiter systems. We study how the implemented interactions shape the orbital architecture of Jovian planets and whether their impact is enough to reproduce the observational sample. Our models suggest that the tidal interaction is able to generate the upper boundary of the hot Jupiter population in the mass–separation diagram. To recreate the sub-Jovian desert, we need to make additional assumptions regarding the RLO phase or the influence of the protoplanetary disc’s inner edge on the initial planetary location. According to our estimates, 12–15 per cent of hot Jupiters around solar-mass stars have been engulfed or become lower-mass planets. 0.20–0.25 per cent of the present-day giant planet population undergoes decay intense enough to be detected with modern facilities.
Prevalent Introgression Underlies Convergent Evolution in the Diversification ofPungitiusSticklebacks
Authors: Wang Yu , Wang Yingnan , Cheng Xiaoqi , Ding Yongli , Wang Chongnv , Merilä Juha , Guo Baocheng
Published: February 2023

New mutations and standing genetic variations contribute significantly to repeated phenotypic evolution in sticklebacks. However, less is known about the role of introgression in this process. We analyzed taxonomically and geographically comprehensive genomic data from Pungitius sticklebacks to decipher the extent of introgression and its consequences for the diversification of this genus. Our results demonstrate that introgression is more prevalent than suggested by earlier studies. Although gene flow was generally bidirectional, it was often asymmetric and left unequal genomic signatures in hybridizing species, which might, at least partly, be due to biased hybridization and/or population size differences. In several cases, introgression of variants from one species to another was accompanied by transitions of pelvic and/or lateral plate structures—important diagnostic traits in Pungitius systematics—and frequently left signatures of adaptation in the core gene regulatory networks of armor trait development. This finding suggests that introgression has been an important source of genetic variation and enabled phenotypic convergence among Pungitius sticklebacks. The results highlight the importance of introgression of genetic variation as a source of adaptive variation underlying key ecological and taxonomic traits. Taken together, our study indicates that introgression-driven convergence likely explains the long-standing challenges in resolving the taxonomy and systematics of this small but phenotypically highly diverse group of fish.
Nationwide clinical and epidemiological study of large-vessel vasculitis in Japan in 2017
Authors: Konda Naoko , Sakai Ryoko , Saeki Keigo , Matsubara Yuri , Nakamura Yosikazu , Miyamae Takako , Nakaoka Yoshikazu , Harigai Masayoshi
Published: February 2023

Objective

We conducted a nationwide epidemiological study to estimate the number of patients with Takayasu arteritis (TAK) and giant cell arteritis (GCA) in Japan and to describe the clinical characteristics of these patients.

Methods

The first survey was designed to estimate the number of patients with TAK and GCA who were treated at medical institutions in Japan in 2017. The second survey was designed to collect data on the clinical characteristics of the patients who were reported in the first survey.

Results

Of the 3495 institutions selected for the first survey, 1960 (56.1%) responded. The number of patients with clinically diagnosed TAK and GCA was estimated to be 5320 (95% confidence interval, 4810–5820) and 3200 (95% confidence interval, 2830–3570), respectively. Aortic regurgitation was reported in 35% of patients with TAK, and eye-related comorbidities were observed in 30.4% of patients with GCA. The common carotid and internal carotid arteries were the most frequently involved in patients with TAK (62.7%). Subclavian artery lesions and thoracic or abdominal aorta lesions were reported in 31% and 42.6% of patients with GCA, respectively.

Conclusions

The number of patients with TAK and GCA was estimated simultaneously, and significant differences in clinical characteristics were observed between the two diseases.
The use of synchrotron X-ray fluorescent imaging to study distribution and content of elements in chemically fixed single cells: a case study using mouse pancreatic beta-cells
Authors: Slepchenko Kira G , Chen Si , Corbin Kathryn L , Colvin Robert A , Nunemaker Craig S
Published: February 2023

Synchrotron X-ray fluorescence microscopy (SXRF) presents a valuable opportunity to study the metallome of single cells because it simultaneously provides high-resolution subcellular distribution and quantitative cellular content of multiple elements. Different sample preparation techniques have been used to preserve cells for observations with SXRF, with a goal to maintain fidelity of the cellular metallome. In this case study, mouse pancreatic beta-cells have been preserved with optimized chemical fixation. We show that cell-to-cell variability is normal in the metallome of beta-cells due to heterogeneity and should be considered when interpreting SXRF data. In addition, we determined the impact of several immunofluorescence (IF) protocols on metal distribution and quantification in chemically fixed beta-cells and found that the metallome of beta-cells was not well preserved for quantitative analysis. However, zinc and iron qualitative analysis could be performed after IF with certain limitations. To help minimize metal loss using samples that require IF, we describe a novel IF protocol that can be used with chemically fixed cells after the completion of SXRF.
Dry tobacco leaves: anin vivoandin silicoapproach to the consequences of occupational exposure
Authors: Dalberto Daiana , Garcia Ana L H , De Souza Melissa R , Picinini Juliana , Soares Solange , De Souza Guilherme M S , Chytry Paola , Dias Johnny F , Salvador Mirian , Da Silva Fernanda R , Da Silva Juliana
Published: February 2023

Exposure of tobacco workers handling dried tobacco leaves has been linked to an increased risk of toxicity and respiratory illness due to the presence of nicotine and other chemicals. This study aimed to evaluate the DNA damage caused by the exposure of tobacco growers during the dry leaf classification process and the relation to cellular mechanisms. A total of 86 individuals participated in the study, divided into a group exposed to dry tobacco (n = 44) and a control group (n = 42). Genotoxicity was evaluated using the alkaline comet assay and lymphocyte micronucleus (MN) assay (CBMN-Cyt), and measurement of telomere length. The levels of oxidative and nitrosative stress were evaluated through the formation of thiobarbituric acid reactive species, and nitric oxide levels, respectively. The inorganic elements were measured in the samples using particle-induced X-ray emission method. The combination of variables was demonstrated through principal component analysis and the interactions were expanded through systems biology. Comet assay, MN, death cells, thiobarbituric acid reactive species, and nitrosative stress showed a significant increase for all exposed groups in relation to the control. Telomere length showed a significant decrease for exposed women and total exposed group in relation to men and control groups, respectively. Bromine (Br) and rubidium (Rb) in the exposed group presented higher levels than control groups. Correlations between nitrate and apoptosis; Br and MN and necrosis; and Rb and telomeres; besides age and DNA damage and death cells were observed. The systems biology analysis demonstrated that tobacco elements can increase the nuclear translocation of NFKB dimers inducing HDAC2 expression, which, associated with BRCA1 protein, can potentially repress transcription of genes that promote DNA repair. Dry tobacco workers exposed to dry leaves and their different agents showed DNA damage by different mechanisms, including redox imbalance.
Adaptation in the sensory cortex drives bistable switching during auditory stream segregation
Authors: Higgins Nathan C , Scurry Alexandra N , Jiang Fang , Little David F , Alain Claude , Elhilali Mounya , Snyder Joel S
Published: February 2023

Current theories of perception emphasize the role of neural adaptation, inhibitory competition, and noise as key components that lead to switches in perception. Supporting evidence comes from neurophysiological findings of specific neural signatures in modality-specific and supramodal brain areas that appear to be critical to switches in perception. We used functional magnetic resonance imaging to study brain activity around the time of switches in perception while participants listened to a bistable auditory stream segregation stimulus, which can be heard as one integrated stream of tones or two segregated streams of tones. The auditory thalamus showed more activity around the time of a switch from segregated to integrated compared to time periods of stable perception of integrated; in contrast, the rostral anterior cingulate cortex and the inferior parietal lobule showed more activity around the time of a switch from integrated to segregated compared to time periods of stable perception of segregated streams, consistent with prior findings of asymmetries in brain activity depending on the switch direction. In sound-responsive areas in the auditory cortex, neural activity increased in strength preceding switches in perception and declined in strength over time following switches in perception. Such dynamics in the auditory cortex are consistent with the role of adaptation proposed by computational models of visual and auditory bistable switching, whereby the strength of neural activity decreases following a switch in perception, which eventually destabilizes the current percept enough to lead to a switch to an alternative percept.
Hearing Loss in Bacterial Meningitis Revisited—Evolution and Recovery
Authors: Jensen Elisa Skovgaard , Cayé-Thomasen Per , Bodilsen Jacob , Nielsen Henrik , Friis-Hansen Lennart , Christensen Thomas , Christiansen Malina , Kirchmann Malene , Brandt Christian Thomas
Published: February 2023

Background

Hearing loss and deafness are well-known sequelae from bacterial meningitis (ABM) and may result in social dysfunction and learning difficulties. Yet, the timely development of hearing loss and restitution is poorly studied, especially among adults. Hearing loss was revisited using otoacoustic emissions (OAEs) to determine the occurrence, magnitude, and development of hearing loss among adults with ABM.

Methods

Distortion product OAEs were measured in patients with ABM the day of admission and days 2, 3, 5–7, and 10–14 and at follow-up 30–60 days after discharge. Frequencies were categorized as low (1, 1.5, 2 kHz), mid (3, 4, 5 kHz), mid-high (6, 7, 8 kHz), and high (9, 10 kHz). Audiometry was performed on discharge and 60 days after. Results were compared with 158 healthy controls.

Results

OAE was obtained in 32 patients. ABM was due to S. pneumoniae in 12 patients (38%). All patients were treated with dexamethasone. OAE emission threshold levels (ETLs) were significantly decreased upon admission and at follow-up in all frequencies compared with healthy controls. A substantial and significant decrease in ETLs was found in S. pneumoniae meningitis. Sensorineural hearing loss (SNHL) >20 dB was present in 13 of 23 (57%) at discharge and in 11 of 18 patients (61%) 60 days after discharge. Hearing recovery decreased from day 3.

Conclusions

Hearing loss in ABM still affects >60% of patients despite treatment with dexamethasone. In S. pneumoniae meningitis, SNHL is profound and permanent. A window of opportunity for systemic or local treatments aiming to preserve cochlear function is proposed.
Adoption and Utilization of Social Media Among Adult and Pediatric Infectious Diseases Divisions and Fellowship Programs in the United States
Authors: Ryder Jonathan H , Mowrer Clayton , Van Roy Zachary , Lyden Elizabeth , Cawcutt Kelly A , Marcelin Jasmine R
Published: February 2023

Background

Social media (SoMe) is ubiquitous, but its adoption and utilization by infectious diseases (ID) divisions are poorly characterized in the United States.

Methods

A systematic search of US ID fellowship/division Twitter, Facebook, and Instagram accounts occurred in November–December 2021. Social media account and program characteristics, post frequency and content, and other measures of SoMe adoption and utilization were recorded and compared between adult and pediatric programs. Posts were thematically categorized as social, promotional, educational, recruitment, or other.

Results

Of 222 ID programs identified, 158 (71.2%) were adult and 64 (28.8%) pediatric. Seventy (31.5%) Twitter, 14 (6.3%) Facebook, and 14 (6.3%) Instagram accounts were identified from US programs. Twitter accounts were associated with larger programs and higher match rates. More adult than pediatric programs had Twitter accounts (37.3% vs 17.2%, P = .004); utilization was similar between adult and pediatric programs. Most Twitter posts were educational (1653 of 2859, 57.8%); most Facebook posts were promotional (68 of 128, 53.1%); and most Instagram posts were social (34 of 79, 43%). Facebook was the earliest adopted SoMe platform, but Twitter and Instagram have more recent growth. Rate of Twitter account creation increased from 1.33 accounts/month in the year before March 2020 (coronavirus disease [COVID] pandemic declaration) to 2.58 accounts/month in the year after March 2020 (P = .18).

Conclusions

Social media remains underutilized across ID divisions, but COVID-19 and virtual recruiting may have influenced recent account creation. Twitter was the most frequently used ID program SoMe platform. Social media may benefit ID programs in recruitment and amplification of their trainees, faculty, and specialty.
Linking discoveries, mechanisms, and technologies to develop a clearer perspective on plant long noncoding RNAs
Authors: Palos Kyle , Yu Li’ang , Railey Caylyn E , Nelson Dittrich Anna C , Nelson Andrew D L
Published: February 2023

Long noncoding RNAs (lncRNAs) are a large and diverse class of genes in eukaryotic genomes that contribute to a variety of regulatory processes. Functionally characterized lncRNAs play critical roles in plants, ranging from regulating flowering to controlling lateral root formation. However, findings from the past decade have revealed that thousands of lncRNAs are present in plant transcriptomes, and characterization has lagged far behind identification. In this setting, distinguishing function from noise is challenging. However, the plant community has been at the forefront of discovery in lncRNA biology, providing many functional and mechanistic insights that have increased our understanding of this gene class. In this review, we examine the key discoveries and insights made in plant lncRNA biology over the past two and a half decades. We describe how discoveries made in the pregenomics era have informed efforts to identify and functionally characterize lncRNAs in the subsequent decades. We provide an overview of the functional archetypes into which characterized plant lncRNAs fit and speculate on new avenues of research that may uncover yet more archetypes. Finally, this review discusses the challenges facing the field and some exciting new molecular and computational approaches that may help inform lncRNA comparative and functional analyses.
Conceptualizing and Measuring (Public) Reputation Management
Authors: Pedersen Mette Østergaard , Salomonsen Heidi Houlberg
Published: February 2023

This article develops and empirically validates a conceptualization of reputation management in a public sector context. We define reputation management as management behaviors intended to identify and affect how external audiences perceive an organization, including their perceptions of what the organization is, what it strives to be, and the organization’s positive impact on society more broadly. Such behaviors include strategically communicating the organization’s vision to its most important external audiences. The empirical analysis is based on survey responses from 499 employees and 59 managers from three Danish agencies. The analysis yields support for our measure of reputation management. We conclude with a future research agenda on how our conceptualization and scale can be used to further develop Bureaucratic Reputation Theory, as well as public management research aimed at investigating the simultaneous use as well as simultaneous external and internal effects of different types of public management and leadership behaviors.
Ideology and Support for Federalism in Theory—And in Practice
Authors: Glaser James M , Berry Jeffrey M , Schildkraut Deborah J
Published: February 2023

Conservatives are more likely than liberals to support the concept of federalism. In this article, we look at this support in the context of particular issues. Using multiple national surveys, including an original module on the 2020 Congressional Election Study, we find that conservatives are more likely to prefer a devolution of power to state and local jurisdictions, even if doing so might make it harder to achieve conservative policy aims, whereas liberals are more instrumental, more likely to prioritize policy aims and to support whichever level of government seems most likely to achieve them. We then examine reasons why conservatives might display a stronger adherence to the federalist structure of the American government. We find that the idea of “states’ rights” continues to loom large for self-identified conservatives, as does a generalized level of trust toward political units described as small versus large.
Effects of a Novel, Transdiagnostic Ecological Momentary Intervention for Prevention, and Early Intervention of Severe Mental Disorder in Youth (EMIcompass): Findings From an Exploratory Randomized Controlled Trial
Authors: Reininghaus Ulrich , Paetzold Isabell , Rauschenberg Christian , Hirjak Dusan , Banaschewski Tobias , Meyer-Lindenberg Andreas , Boehnke Jan R , Boecking Benjamin , Schick Anita
Published: February 2023

Background/Hypothesis

Digital interventions targeting transdiagnostic mechanisms in daily life may be a promising translational strategy for prevention and early intervention of psychotic and other severe mental disorders. We aimed to investigate the feasibility and initial signals of efficacy of a transdiagnostic, compassion-focused, hybrid ecological momentary intervention for improving resilience (ie, EMIcompass) in youth with early mental health problems.

Study Design

In an exploratory, assessor-blind randomized controlled trial, youth aged 14–25 with current distress, broad at-risk mental state, or first episode of severe mental disorder were randomly allocated to experimental (EMIcompass+treatment as usual [TAU]) or control condition (TAU). Data on primary (stress reactivity) and secondary candidate mechanisms as well as candidate primary (psychological distress) and secondary outcomes were collected.

Study Results

Criteria for the feasibility of trial methodology and intervention delivery were met (n = 92 randomized participants). No serious adverse events were observed. Initial outcome signals were evident for reduced momentary stress reactivity (stress×time×condition, B = −0.10 95%CI −0.16–−0.03, d = −0.10), aberrant salience (condition, B = −0.38, 95%CI −0.57–−0.18, d = −0.56) as well as enhanced momentary resilience (condition, B = 0.55, 95%CI 0.18–0.92, d = 0.33) and quality of life (condition, B = 0.82, 95%CI 0.10–1.55, d = 0.60) across post-intervention and 4-week follow-up. No outcome signals were observed for self-reported psychological distress (condition, B = 0.57, 95%CI −1.59–2.72, d = 0.09), but there was suggestive evidence of reduced observer-rated symptoms at the 4-week follow-up (B = −1.41, 95%CI −2.85–0.02, d = −0.41).

Conclusions

Our findings provide evidence of feasibility and initial signals that EMIcompass may reduce stress reactivity and improve quality of life. A definitive trial is now warranted.
An incubation method to determine the age of available nonstructural carbon in woody plant tissues
Authors: Peltier Drew M P , Lemoine Jim , Ebert Chris , Xu Xiaomei , Ogle Kiona , Richardson Andrew D , Carbone Mariah S
Published: February 2023

Radiocarbon (∆14C) measurements of nonstructural carbon enable inference on the age and turnover time of stored photosynthate (e.g., sugars, starch), of which the largest pool in trees resides in the main bole. Because of potential issues with extraction-based methods, we introduce an incubation method to capture the ∆14C of nonstructural carbon via respired CO2. In this study, we compared the ∆14C obtained from these incubations with ∆14C from a well-established extraction method, using increment cores from a mature trembling aspen (Populus tremuloides Michx). To understand any potential ∆14C disagreement, the yields from both methods were also benchmarked against the phenol-sulfuric acid concentration assay. We found incubations captured less than 100% of measured sugar and starch carbon, with recovery ranging from ~ 3% in heartwood to 85% in shallow sapwood. However, extractions universally over-yielded (mean 273 ± 101% expected sugar carbon; as high as 480%), where sugars represented less than half of extracted soluble carbon, indicating very poor specificity. Although the separation of soluble and insoluble nonstructural carbon is ostensibly a strength of extraction-based methods, there was also evidence of poor separation of these two fractions in extractions. The ∆14C of respired CO2 and ∆14C from extractions were similar in the sapwood, whereas extractions resulted in comparatively higher ∆14C (older carbon) in heartwood and bark. Because yield and ∆14C discrepancies were largest in old tissues, incubations may better capture the ∆14C of nonstructural carbon that is actually metabolically available. That is, we suggest extractions include metabolically irrelevant carbon from dead tissues or cells, as well as carbon that is neither sugar nor starch. In contrast, nonstructural carbon captured by extractions must be respired to be measured. We thus suggest incubations of live tissues are a potentially viable, inexpensive and versatile method to study the ∆14C of metabolically relevant (available) nonstructural carbon.
A Genomic Resource for the Strawberry Powdery Mildew Pathogen Podosphaera aphanis
Authors: Heaven Thomas , Cockerton Helen M. , Xu Xiangming , Goddard Matthew , Armitage Andrew D.
Published: February 2023

Powdery mildew is one of the most economically destructive diseases in protected strawberry production. Here we present the first genome assembly for Podosphaera aphanis, the causal agent of powdery mildew on strawberry. This obligate-biotrophic fungal pathogen was sampled from a naturally occurring outbreak on Fragaria × ananassa ‘Malling Centenary’ plants grown under cover in the United Kingdom. Assembled reads resolved a 55.6 Mb genome, composed of 12,357 contigs whose annotation led to prediction of 17,239 genes encoding 17,328 proteins. The genome is highly-complete, with 97.5% of conserved single-copy Ascomycete genes shown to be present. This annotated P. aphanis genome provides a molecular resource for further investigation into host−pathogen interactions in the strawberry powdery mildew pathosystem.
Pediatric Limb Lengthening and Reconstruction Surgical Coding Survey Results
Authors: Iobst Christopher A. , Rowan Mallory R. , Bafor Anirejuoritse
Published: February 2023

Background:

In surgical specialties like orthopaedics, documenting the surgery performed involves applying the appropriate current procedural terminology (CPT) code(s). For limb reconstruction surgeons, the wide-ranging types of surgeries and rapid evolution of the field create a variety of factors making it difficult to code the procedures. We sought to (1) assess whether appropriate limb reconstruction codes currently exist and (2) determine whether there is agreement among experienced pediatric orthopaedic surgeons when applying these codes to similar cases.

Methods:

A REDCAP survey comprised of 10 common pediatric limb reconstruction cases was sent to experienced pediatric limb reconstruction surgeons in the United States. Based on the description of each case, the surgeons were asked to code the cases as they usually would in their practice. There were no limitations regarding the number or the types of codes each surgeon could choose to apply to the case. Nine additional demographic and general coding questions were asked to gauge the responding surgeon’s coding experience.

Results:

Survey participants used various codes for each case, ranging from only 1 code to a maximum of 9 codes to describe a single case. The average number of codes per case ranged from 1.2 to 3.6, with an average of 2.5 among all 10 cases. The total number of unique codes provided by the respondents for each case ranged from 5 to 20. Only 3 of the 10 cases had an agreement >75% for any single code, and only 2 of the 10 cases had >50% agreement on any combination of 2 codes.

Conclusions:

There are dramatic variations in coding methods among pediatric orthopaedic limb reconstruction surgeons. This information highlights the need to improve the current CPT coding landscape. Possible solutions include developing new codes that better represent the work done, developing standardized guidelines with the existing codes to decrease variation, and improving CPT coding education by developing limb reconstruction coding “champions.”

Level of Evidence:

Level V.
Rod Fracture in Magnetically Controlled Growing Spine Rods
Authors: Tognini Martina , Hothi Harry , Bergiers Sean , Broomfield Edel , Tucker Stewart , Henckel Johann , Hart Alister
Published: February 2023

Background:

The mechanisms of fracture in magnetically controlled growing rods (MCGRs) and the risk factors associated with this are poorly understood. This retrospective analysis of explanted MCGRs aimed to add understanding to this subject.

Methods:

From our cohort of over 120 retrieved MCGRs, we identified 7 rods that had fractured; all were single-rod constructs, retrieved from 6 patients. These were examined and compared with 15 intact single-rod constructs. Retrieval and fractographic analyses were used to determine the failure mode at the fracture site and the implant's functionality. Cobb angle, degree of rod contouring, and the distance between anchoring points were computed on anteroposterior and lateral radiographs.

Results:

5/7 versus 3/15 rods had been inserted after the removal of a previously inserted rod, in the fractured versus control groups. All fractured rods failed due to bending fatigue. Fractured rods had greater rod contouring angles in the frontal plane (P = 0.0407) and lateral plane (P = 0.0306), and greater distances between anchoring points in both anteroposterior and lateral planes (P = 0.0061 and P = 0.0074, respectively).

Conclusions:

We found all failed due to a fatigue fracture and were virtually all single rod configurations. Fracture initiation points corresponded with mechanical indentation marks induced by the intraoperative rod contouring tool. Fractured rods had undergone greater rod contouring and had greater distances between anchoring points, suggesting that it is preferable to implant double rod constructs in patients with sufficient spinal maturity to avoid this complication.

Clinical Relevance:

Level III.
Plasma proteomic signature of fatty liver disease: The Rotterdam Study
Authors: Abozaid Yasir J. , Ayada Ibrahim , van Kleef Laurens A. , Vallerga Costanza L. , Pan Qiuwei , Brouwer Willem P. , Ikram M. Arfan , Van Meurs Joyce , de Knegt Robert J. , Ghanbari Mohsen
Published: February 2023

Background and Aims:

Fatty liver disease (FLD) is caused by excess fat in the liver, and its global prevalence exceeds 33%. The role of protein expression on the pathogenesis of FLD and accompanied fibrosis and its potential as a disease biomarker is currently not clear. Hence, we aimed to identify plasma proteomics associated with FLD and fibrosis using population-based data.

Approach and Results:

Blood samples were collected from 2578 participants from the population-based Rotterdam Study cohort. The proximity extension assay reliably measured plasma levels of 171 cardiometabolic and inflammatory-related proteins (Olink Proteomics). FLD was assessed by ultrasound, and fibrosis by transient elastography. Logistic regression models quantified the association of plasma proteomics with FLD and fibrosis. In addition, we aimed to validate our results in liver organoids. The cross-sectional analysis identified 27 proteins significantly associated with FLD surpassing the Bonferroni-corrected p<2.92×10−4. The strongest association was observed for FGF-21 (β=0.45, p=1.07×10−18) and carboxylesterase 1 (CES1) protein (β=0.66, p=4.91×10−40). Importantly, 15 of the 27 proteins significantly associated with FLD were also associated with liver fibrosis. Finally, consistent with plasma proteomic profiling, we found the expression levels of IL-18 receptor 1 (IL-18R1) and CES1 to be upregulated in an FLD model of 3-dimensional culture human liver organoids.

Conclusions:

Among the general population, several inflammatory and cardiometabolic plasma proteins were associated with FLD and fibrosis. Particularly, plasma levels of FGF-21, IL-18R1, and CES1 were largely dependent on the presence of FLD and fibrosis and may therefore be important in their pathogenesis.
Hepatitis delta: Epidemiology to recent advances in therapeutic agents
Authors: Abdul Majeed Nehna , Zehnder Benno , Koh Christopher , Heller Theo , Urban Stephan
Published: February 2023

Hepatitis D virus (HDV) was first described in 1977 and is dependent on the presence of hepatitis B surface antigen (HBsAg) for its entry into cells and on the human host for replication. Due to the envelopment with the hepatitis B virus (HBV) envelope, early phases of HDV entry resemble HBV infection. Unlike HBV, HDV activates innate immune responses. The global prevalence of HDV is estimated to be about 5% of HBsAg positive individuals. However, recent studies have described a wide range of prevalence between 12 to 72 million individuals. Infection can occur as super-infection or co-infection. The diagnosis of active HDV infection involves screening with anti HDV antibodies followed by quantitative PCR testing for HDV RNA in those who are HBsAg positive. The diagnostic studies have evolved over the years improving the validity and reliability of the tests performed. HDV infection is considered the most severe form of viral hepatitis and the HDV genotype may influence the disease course. There are eight major HDV genotypes with prevalence varying by geographic region. HDV treatment has been challenging as HDV strongly depends on the host cell for replication and provides few, if any viral targets. Better understanding of HDV virology has led to the development of several therapeutic agents currently being studied in different phase II and III clinical trials. There is increasing promise of effective therapies that will ameliorate the course of this devastating disease.