bluuebunny/crossref_metadata_2025 huggingface dataset:
Magnetic angle evolution in accreting neutron stars
Authors: Biryukov Anton , Abolmasov Pavel
Published: May 2021

The rotation of a magnetized accreting neutron star (NS) in a binary system is described by its spin period and two angles: spin inclination α with respect to the orbital momentum and magnetic angle χ between the spin and the magnetic moment. Magnetospheric accretion spins the NS up and adjusts its rotation axis, decreasing α to nearly perfect alignment. Its effect upon the magnetic angle is more subtle and relatively unstudied. In this work, we model the magnetic angle evolution of a rigid spherical accreting NS. We find that the torque spinning the NS up may affect the magnetic angle while both α and χ significantly deviate from zero, and the spin-up torque varies with the phase of the spin period. As the rotation axis of the NS is being aligned with the spin-up torque, the magnetic axis becomes misaligned with the rotation axis. Under favourable conditions, magnetic angle may increase by Δχ ∼ 15°−20°. This orthogonalization may be an important factor in the evolution of millisecond pulsars, as it partially compensates the χ decrease potentially caused by pulsar torques. If the direction of the spin-up torque changes randomly with time, as in wind-fed high-mass X-ray binaries, both the rotation axis of the NS and its magnetic axis become involved in a non-linear random-walk evolution. The ultimate attractor of this process is a bimodal distribution in χ peaking at χ = 0° and χ = 90°.
Mass calibration of distant SPT galaxy clusters through expanded weak-lensing follow-up observations with HST, VLT, & Gemini-South
Authors: Schrabback T , Bocquet S , Sommer M , Zohren H , van den Busch J L , Hernández-Martín B , Hoekstra H , Raihan S F , Schirmer M , Applegate D , Bayliss M , Benson B A , Bleem L E , Dietrich J P , Floyd B , Hilbert S , Hlavacek-Larrondo J , McDonald M , Saro A , Stark A A , Weissgerber N
Published: May 2021

Expanding from previous work, we present weak-lensing (WL) measurements for a total sample of 30 distant (zmedian = 0.93) massive galaxy clusters from the South Pole Telescope Sunyaev–Zel’dovich (SPT-SZ) Survey, measuring galaxy shapes in Hubble Space Telescope (HST) Advanced Camera for Surveys images. We remove cluster members and preferentially select z ≳ 1.4 background galaxies via V − I colour, employing deep photometry from VLT/FORS2 and Gemini-South/GMOS. We apply revised calibrations for the WL shape measurements and the source redshift distribution to estimate the cluster masses. In combination with earlier Magellan/Megacam results for lower-redshifts clusters, we infer refined constraints on the scaling relation between the SZ detection significance and the cluster mass, in particular regarding its redshift evolution. The mass scale inferred from the WL data is lower by a factor $0.76^{+0.10}_{-0.14}$ (at our pivot redshift z = 0.6) compared to what would be needed to reconcile a flat Planck νΛCDM cosmology (in which the sum of the neutrino masses is a free parameter) with the observed SPT-SZ cluster counts. In order to sensitively test the level of (dis-)agreement between SPT clusters and Planck, further expanded WL follow-up samples are needed.
Spectroscopic signatures of the vanishing natural coronagraph of Eta Carinae
Authors: Damineli A , Navarete F , Hillier D J , Moffat A F J , Corcoran M F , Gull T R , Richardson N D , Weigelt G , Morris P W , Stevens I
Published: May 2021

Eta Carinae is a massive interacting binary system shrouded in a complex circumstellar environment whose evolution is the source of the long-term brightening observed during the last 80 yr. An occulter, acting as a natural coronagraph, impacts observations from our perspective, but not from most other directions. Other sight-lines are visible to us through studies of the Homunculus reflection nebula. The coronagraph appears to be vanishing, decreasing the extinction towards the central star, and causing the star’s secular brightening. In contrast, the Homunculus remains at an almost constant brightness. The coronagraph primarily suppresses the stellar continuum, to a lesser extent the wind lines, and not the circumstellar emission lines. This explains why the absolute values of equivalent widths (EWs) of the emission lines in our direct view are larger than those seen in reflected by the Homunculus, why the direct view absolute EWs are decreasing with time, and why lower-excitation spectral wind lines formed at larger radii (e.g Fe ii 4585 Å) decrease in intensity at a faster pace than higher excitation lines that form closer to the star (e.g. H δ). Our main result is that the star, despite its 10-fold brightening over two decades, is relatively stable. A vanishing coronagraph that can explain both the large flux evolution and the much weaker spectral evolution. This is contrary to suggestions that the long-term variability is intrinsic to the primary star that is still recovering from the Great Eruption with a decreasing mass-loss rate and a polar wind that is evolving at a slower pace than at the equator.
Identity and compatibility of reference genome resources
Authors: Stolarczyk Michał , Xue Bingjie , Sheffield Nathan C
Published: May 2021

Genome analysis relies on reference data like sequences, feature annotations, and aligner indexes. These data can be found in many versions from many sources, making it challenging to identify and assess compatibility among them. For example, how can you determine which indexes are derived from identical raw sequence files, or which annotations share a compatible coordinate system? Here, we describe a novel approach to establish identity and compatibility of reference genome resources. We approach this with three advances: first, we derive unique identifiers for each resource; second, we record parent–child relationships among resources; and third, we describe recursive identifiers that determine identity as well as compatibility of coordinate systems and sequence names. These advances facilitate portability, reproducibility, and re-use of genome reference data. Available athttps://refgenie.databio.org.
Haemodialysis patients show a highly diminished antibody response after COVID-19 mRNA vaccination compared with healthy controls
Authors: Simon Benedikt , Rubey Harald , Treipl Andreas , Gromann Martin , Hemedi Boris , Zehetmayer Sonja , Kirsch Bernhard
Published: May 2021

Background

Haemodialysis (HD) patients are exposed to a high risk due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. They are prone to acquiring the infection and are threatened by high mortality rates in case of infection. However, HD patients were not included in the efficacy trials of the SARS-CoV-2 vaccines. Such efficacy data would have been critical because HD patients show decreased responses against various other vaccines and this could translate to the SARS-CoV-2 vaccines as well.

Methods

We conducted a prospective cohort study that contained a group of 81 HD patients and 80 healthy controls. All of them had been vaccinated with the BioNTech/Pfizer mRNA vaccine (two doses, as per the manufacturer’s recommendation). The anti-SARS-CoV-2 spike (S) antibody response was measured for all participants 21 days after the second dose. The groups were compared using univariate quantile regressions and a multivariate analysis. The adverse events (AEs) of the vaccination were assessed via a questionnaire. Finally, a correlation between the HBs-antibody response and the SARS-CoV-2 antibody response in the HD patients was established.

Results

The HD patients had significantly lower anti-SARS-CoV-2 S antibody titres than the control patients 21 days after vaccination (median was 171 U/mL for dialysis patients and 2500 U/mL for the controls). Further, the HD group presented fewer AEs than the control group. No correlation was found between the antibody response to previous Hepatitis B vaccination and that of the SARS-CoV-2 vaccine.

Conclusions

HD patients present highly diminished SARS-CoV-2 S antibody titres compared with a cohort of controls. Therefore, they could be much less protected by SARS-CoV-2 mRNA vaccinations than expected. Further studies to test alternative vaccination schemes should be considered.
Extended Retrosigmoid Craniotomy and Approach Through the Glossopharyngeal Cochlear Triangle for Clipping of a High-Riding Vertebral-Posterior Inferior Cerebellar Artery Aneurysm: 2-Dimensional Operative Video
Authors: Peitz Geoffrey W , McDermott Ryan A , Baranoski Jacob F , Lawton Michael T , Mascitelli Justin R
Published: May 2021

The far lateral transcondylar (FL) craniotomy is the standard approach for posterior inferior cerebellar artery (PICA) aneurysm exposure through microsurgical dissection in the vagoaccessory triangle (VAT).
1,2
However, the extended retrosigmoid (eRS) craniotomy and dissection through the glossopharyngeal-cochlear triangle (GCT) may be more appropriate when the patient has an aneurysm arising from a high-riding vertebral artery (VA)—PICA origin.
3-5
We present a case of a 41-yr-old woman with hypertension presenting with left occipital pain and left-side hearing loss and past facial spasm and pain. Computed tomography angiography and digital subtraction angiography demonstrated an unruptured 8.4 × 9.0 × 10.2 mm saccular aneurysm at the left VA-PICA junction. Surgical clipping was chosen over endovascular therapy given the relationship of the PICA origin to the aneurysm neck as well as the history of cranial neuropathy. It was noted that the VA-PICA junction and aneurysm was high-riding at the level of the internal auditory canal. An eRS craniotomy was performed with dissection through the GCT, and the aneurysm was clipped as shown in the accompanying 2-dimensional operative video. Postoperative angiography demonstrated complete occlusion of the aneurysm and patency of the left VA and PICA without stenosis, and the patient had a favorable postoperative course although her left-sided hearing remained diminished. The eRS craniotomy allowed direct exposure via the GCT for clipping of the high-riding VA-PICA junction aneurysm and decompression of the cranial nerves. The traditional FL craniotomy and exposure through the VAT would likely have resulted in a less desirable inferior trajectory.

The patient gave informed consent for the operation depicted in the video.

Animation at 2:43 in video is used with permission from Barrow Neurological Institute, Phoenix, Arizona.
Sirach
Authors: Corley Jeremy
Published: May 2021

This survey article on the Book of Sirach (Latin: Ecclesiasticus) first considers its composition by a Jerusalem scribe named Ben Sira, who lived in the early second century bce. The article then examines major themes in the book’s theology (wisdom, creation, theodicy, and death), as well as its much-criticized portrayal of women. The chapter also explores its ethics of honor, generosity, and friendship, as well as the review of biblical history in the Praise of the Ancestors (Sirach 44–50). Thereafter, the chapter notes the book’s parallels to the New Testament, as well as its mixed reception history within Jewish, Catholic, and Protestant faith communities. Finally, to illustrate aspects of the reception history, the article offers four case studies showing how various later interpreters have used the sage’s teaching on testing (2:1–18), friendship (6:5–17), social justice (34:21–31), and remembering godly ancestors (44:1–15).
The Additions of the Greek Book(s) of Esther
Authors: Smith Tyler , de Troyer Kristin
Published: May 2021

One of the main issues with the Additions to the Greek version of Esther is that it needs to explain the relation between the Additions and the core text of the Esther story as present in the Old Greek or the Septuagint. For instance, with regard to Additions B and E, it has to be explained how the surrounding text after 3:13 and 8:13 was adapted to fit the contents of B and E, respectively. Similarly, with regard to Addition D, any explanatory theory needs to show how the text of 5:1–2 was rewritten in both the Old Greek (OG) and the Alpha Text (AT) to become what is now Addition C. Given the complexity of the relationship between the Masoretic Text, OG, and AT (and the daughter versions) and the similarities and the differences between the text of the Additions in the OG and the AT, an all-explaining theory remains a desideratum.
1 Esdras (Greek Ezra)
Authors: Grabbe Lester L.
Published: May 2021

1 Esdras is a Greek book parallel to Ezra and parts of Nehemiah and 2 Chronicles 35–36 in the Hebrew canon. There has been a long debate on the relationship of 1 Esdras to the Hebrew books. Three main theories are examined here, along with a summary of the book’s contents. The thesis favored in this essay is that 1 Esdras represents in some fashion an earlier stage of the Zerubbabel–Joshua and the Ezra traditions from which the compiler of the Hebrew Ezra–Nehemiah drew. 1 Esdras was not, however, the specific source used but is itself also a development of that source. The tradition picked up by the Hebrew Ezra–Nehemiah apparently did not have the story of the guards’ contest. This and other considerations indicate that this story was added at a later date to 1 Esdras.
Baruch
Authors: Hogan Karina Martin
Published: May 2021

Despite being cited relatively rarely by ancient exegetes, the book of Baruch enjoyed authority and inclusion in most Bible manuscripts because of its association with the prophet Jeremiah. In modern scholarship, the book of Baruch can be read as an example of the creative reuse of scriptures by a Jewish author (or authors) of the Hellenistic or Roman period. Its message about alienation, sin, repentance, and restoration is presented from different angles through the genres of confessional prayer, wisdom poem, and prophetic poem of consolation. Its Deuteronomic theology, which unites the various parts of the book, is very typical of the literature of ancient Judaism. At the same time, it is a powerful reminder to take responsibility for one’s own part in perpetuating structures of social injustice, even when one feels oppressed by them.
The US–Mexican War
Authors: Winders Bruce
Published: May 2021

Usually thought of as a two-year-long conflict between the United States and Mexico, the US–Mexican War (1846–1848) represents the culmination of a much longer struggle over the control of what became the American Southwest. Years before Mexico declared its independence, early citizens of the United States resolved to seize Spain’s North American possessions. Devastated by a decade of revolt, Mexico lacked the unity needed to halt American efforts to acquire land at its expense. The US–Mexican War revealed an important divide among Mexicans over the issue of federalism. In the end, the Treaty of Guadalupe Hidalgo defined the modern political boundary between the two nations. Far from bringing peace to either nation, though, the war generated internal strife for both the United States and Mexico. The historic conflict still affects the relationship between the two nations.
Romanticism in Mexico
Authors: Shelton Laura
Published: May 2021

During the nineteenth century, romanticism became central to how Mexicans engaged in practices of self-definition. Romanticism in Mexico was an intellectual and artistic movement that was at once autonomous and connected to transcultural influences. As evidenced by the works of historians and literary scholars, as well as novelists, politicians, poets, and antiquarians from the period, romanticism was gendered in terms of women’s participation and representation, and in themes such as love, family, virtue, domesticity, and eroticism. Women were critical to the transmission of romanticism in quotidian practices of attending theater and opera, hosting salons, and instilling appreciation for poetry and the natural world in their families and their communities. Romanticism also exercised a profound influence on how Mexicans thought about ethnicity, race, and nationalism. In their quest for a unique national identity, Mexican intellectuals looked to the indigenous past and celebrated mestizaje as the foundation of Mexico’s cultural patrimony, even as they persisted in exclusionary practices toward their indigenous and casta compatriots. Romanticism offers a fruitful area to reevaluate well-studied themes of Mexican history, particularly its complex relationship with nationalism, modernization, gender, and the politics of ethnicity and race.
World’s End: Punk Films from London and New York, 1977–1984
Authors: Halligan Benjamin
Published: May 2021

This chapter discusses punk films set in London and New York from the late 1970s to the early 1980s. Their chief characteristics are considered in relation to two areas of discussion. First, it addresses an idea of an endemic alienation that, unlike the alienation understood to determine previous periods of filmmaking about youthful rebels, may seem without the possibility of exit or alleviation. Punk versions of “no future” are contrasted with the optimism detected in films allied with disco. Second, it looks at an idea of liminal spaces, arising from uses and repurposings of semi-abandoned inner-city areas. An essential divergence in the possibilities of the punk lifestyle is identified and explored: that New York punk cinema more typically suggests the beginnings of a regeneration and cultural renaissance, while London punk cinema seems uniformly downbeat.
Postericide and Intergenerational Ethics
Authors: McKinnon Catriona
Published: May 2021

In the Anthropocene, future people are dangerously vulnerable to the conduct of present people. The advances made by humanity since the Industrial Revolution give the current generation the ability to damage and degrade the environment in ways that could make humanity go extinct. What measures should be taken to protect future people from the dangers of extinction they face? This chapter outlines a new international crime of postericide as a morally required response to humanity’s changed circumstances. Postericide is committed when an agent intentionally or recklessly performs conduct fit to bring about the extinction of humanity. International criminal law contains no precedents for the prosecution of postericide. A proper understanding of the moral imperatives embodied in international criminal law shows that it is, in this respect, incomplete. Drawing on political and legal theory, moral philosophy, and jurisprudence, this chapter defends postericide as a moral necessity in the Anthropocene, and shows how it is entailed by the ideals at the heart of international criminal law.
Celebrating Holidays and Instilling Values
Authors: Baun Dylan
Published: May 2021

Religion is not often a subtopic in historical studies on youth culture in the twentieth century. This is because scholars often stress the retreat of religion in the face of global secularization. However, religion permeated through youth culture during the modern age in both overt and subtle ways. A focus on youth organizations—specifically in the so-called “sectarian society” of Lebanon and others like it in the Global South—and the sources they left behind work to prove this contention. Religion, nation, and masculine uprightness were inseparable and equal parts of youth culture in the twentieth century. This can be seen by exploring two fields in the historical construction of youth: religious holidays and values. Whether in practice or morals, religious doctrine was not central to youth organization in pluralistic societies during this period. Yet, religious identity served as the basis for group structure, discipline, and youth experience.
Health Justice, Activism, and the Crisis of HIV/AIDS in South Africa
Authors: Mbali Mandisa
Published: May 2021

The political economy of the AIDS crisis in South Africa’s past can be understood in terms of the concept of health justice. In particular, health justice can help us interpret the history of AIDS in South Africa according to the intersecting manifestations of socioeconomic inequality in the country, including the migrant labor system, the apartheid-era health system, with its racial segregation and inferior service provision for black people, the feminization of poverty, and, legal and institutionalized homophobia and transphobia. We can also use the overarching concept of health justice to understand the histories of public health and progressive health advocacy in relation to the epidemic over three periods. First, early in the history of the disease in South Africa, health injustice was manifest in the socioeconomic phenomena behind its arrival in the country in 1982. Secondly, its subsequent entrenchment in the country in the pre-1994 period can be related to South Africa’s late-apartheid political economy. Thirdly, in the postapartheid period, the Nelson Mandela (1994–1999) and Thabo Mbeki (1999–2008) administrations exhibited deficits in political will in the development of effective AIDS policies, most notably evident in Mbeki’s AIDS denialism. In response to this, in 1998 the Treatment Action Campaign (TAC) emerged from the AIDS advocacy of various strands of antiapartheid activism. The last section highlights how the TAC’s activism influenced global health politics from the late 1990s to the early 2000s. This history points to the TAC’s valuable legacy of activism in addressing AIDS and general health injustices. Interpreting the socioeconomic and political history of AIDS is of wider relevance to important historiographical bodies of literature in relation to South Africa, including those around medicine and health, gender and sexuality, black politics and social movements, and, South Africa’s role in world history. The topic is therefore especially deserving of sustained study.
The Priestly Writing(s): Scope and Nature
Authors: Wöhrle Jakob
Published: May 2021

The existence of the so-called priestly writing is one of the most important theories in the research on the formation of the Pentateuch. This essay will discuss the five most important aspects of the current debate about the priestly writing. It will address the literary character of the priestly passages, the original end of the priestly writing, the formation of the Holiness Code, the date of the priestly writing, and the overall intention of this corpus.
The Pentateuch: Five Books, One Canon
Authors: Artus Olivier
Published: May 2021

This essay investigates the division of the Pentateuch into five scrolls of unequal length. It considers the dating of this division and the structuring that it creates, especially in relation to the Pentateuch’s narrative cycles; it also considers the ways that the combined text reflects its earlier compositional history. Finally, the essay considers the evidence for understanding each pentateuchal scroll/book as well as the Pentateuch overall as a literary unit. In the latter discussion, it gives special attention to the book of numbers.
Ancient Near Eastern Literature and the Pentateuch
Authors: Wright David P.
Published: May 2021

Modern academic biblical scholarship has observed a range of correlations between biblical texts and other texts from the larger ancient Near Eastern world. The observed correspondences have been used phenomenologically and interpretively to raise questions for investigation and offer insights for understanding the biblical texts, especially by contrasts between the texts. A more dynamic and controversial mode of comparative analysis, the focus of this survey, is to ask whether similarities point to a genetic relationship between cultures with the goal of historical reconstruction and placing the Hebrew biblical texts and ideas in their Near Eastern context.
Pentateuchal and Ancient Near Eastern Ritual
Authors: Feder Yitzhaq
Published: May 2021

This essay will discuss recent developments in the comparative study of biblical ritual, focusing specifically on the Priestly source of the Pentateuch. It will introduce some basic problems with the definition of “ritual” and address the relationship between text and practice; provide an overview of theoretical developments in the study of ritual; focus on the identification and significant of extrabiblical parallels for dating and interpretation; and examine the contribution of these materials for understanding the textualization of priestly ritual.
The Pentateuch and the Samaritans
Authors: Kartveit Magnar
Published: May 2021

This essay traces the development in the study of the Samaritan Pentateuch in the West from its beginnings until the present. It describes the various manuscript witnesses and editions and also considers inscriptional and other archaeological evidence. It also discusses the character of the Samaritan Pentateuch in comparison with other Hebrew texts as well as early translations. The essay concludes with a discussion of recent reconstructions of the Pentateuch’s emergence in the Persian and Hellenistic periods.
Foreign Direct Investment
Authors: Wellhausen Rachel L.
Published: May 2021

Consensus on the concept of foreign direct investment (FDI) has sparked an enormous body of research that confirms the importance of separating FDI and its politics from other forms of international economy activity. At the same time, international political economy research on FDI is in danger of becoming a victim of its own success: by too readily accepting the parameters of “F,” “D,” and “I,” we risk undervaluing high-priority research agendas that push conceptual boundaries. As evidence, this chapter highlights gains made by probing the “F” in FDI—by disaggregating national origins; separating foreign state or private owners; and considering “F” in the context of its domestic counterparts. Recognizing the huge progress made due to de facto agreement on what constitutes FDI, scholars in all IPE research traditions would do well to prioritize research questions that critically engage with the concept.
National Socialism
Authors: Siemens Daniel
Published: May 2021

National Socialism was a political and social movement built on ideas and traditions that were already prevalent throughout Imperial Germany. In the early years of the Weimar Republic it was just one of many antisemitic splinter groups of the völkisch and ultranationalist right, yet it had emerged as Germany’s most successful political party at the polls by 1932. This chapter argues that the National Socialists achieved this remarkable success not only through cunning political propaganda and successful exploitation of the post-1929 economic crisis, but even more so because they managed to present themselves as a genuine people’s party. By setting up a multitude of party-affiliated organizations, they penetrated different milieus of German society. For many voters it was ultimately the NSDAP’s promise of individual success as part of a wider national renewal that proved most attractive, rather than the party’s antisemitic platform that was key for the mobilization of party activists.
Ethics of Reproductive Genetic Carrier Screening: From the Clinic to the Population
Authors: Dive Lisa , Newson Ainsley J
Published: May 2021

Reproductive genetic carrier screening (RCS) is increasingly being offered more widely, including to people with no family history or otherwise elevated chance of having a baby with a genetic condition. There are valid reasons to reject a prevention-focused public health ethics approach to such screening programs. Rejecting the prevention paradigm in this context has led to an emphasis on more individually-focused values of freedom of choice and fostering reproductive autonomy in RCS. We argue, however, that population-wide RCS has sufficient features in common with other public health screening programs that it becomes important also to attend to its public health implications. Not doing so constitutes a failure to address the social conditions that significantly affect people’s capacity to exercise their reproductive autonomy. We discuss how a public health ethics approach to RCS is broader in focus than prevention. We also show that additional values inherent to ethical public health—such as equity and solidarity—are essential to underpin and inform the aims and implementation of reproductive carrier screening programs.
Physical Therapist Recognition and Referral of Individuals With Suspected Lyme Disease
Authors: Shea Jennifer
Published: May 2021

The most commonly reported vector-borne and tick-borne disease in the United States is Lyme disease. Individuals with Lyme disease may present with a wide array of symptoms with resultant musculoskeletal, neurological, and cardiac manifestations that may cause them to seek physical therapist services. The symptoms may develop insidiously and with a variable presentation among individuals. Many persons with Lyme disease do not recall a tick bite or present with an erythema migrans rash, which is considered pathognomonic for the disease. Even if they do, they may fail to associate either with their symptoms, making the diagnosis elusive. It is important to diagnose individuals early in the disease process when antibiotic treatment is most likely to be successful. Physical therapists are in a unique position to recognize the possibility that individuals may have Lyme disease and refer them to another practitioner when appropriate. The purpose of this article is to (1) present an overview of the etiology, incidence, and clinical manifestations of Lyme disease, (2) review evaluation findings that should raise the index of suspicion for Lyme disease, (3) discuss the use of an empirically validated tool for differentiating those with Lyme disease from healthy individuals, (4) discuss the current state of diagnostic testing, and (5) review options for diagnosis and treatment available to individuals for whom referral is recommended.
Complex Decongestive Therapy in the Physical Therapist Management of Rosacea-Related Edema (Morbus Morbihan Syndrome): A Case Report with a New Approach
Authors: Ҫinar Gamze Nalan , Özgül Serap , Nakip Gülbala , Üzelpasaci Esra , Baran Emine , Gürşen Ceren , Elҫin Gonca , Akbayrak Türkan
Published: May 2021

Objective: The aim of this case report was to describe the use of complete decongestive therapy (CDT) with a new approach in the management of a male patient with facial edema related to Morbus Morbihan Syndrome (MMS).

Methods: An 18-year-old male patient with MMS after acne treatment was the subject of this case report. Volume assessment was performed with distance measurements of the facial area using standard reference points, the overflow method, and the measurement of the percentage of subdermal fluid. Patient-reported symptoms of lymphedema (feeling of swelling and tightness) and body image perception were evaluated with the “Visual Analogue Scale (VAS)”, and the severity of anxiety was evaluated with the “State and Trait Anxiety Inventory (STAI)”. In addition, the patient’s perception of improvement was determined using a Likert-type scale. Evaluations were performed at baseline, week-4 (during the treatment) and week-8 (immediately after treatment). CDT was applied to the patient in a total of 24 sessions, 3 days a week for 8 weeks.

Results: Compared to the baseline measurement, the facial distances (tragus-mental cavity, tragus-mouth corner, mandibula-nasal canal, mandibula-internal orbita, mandibula-external orbita, mental cavity-internal orbita, mental cavity-mandibula, right–left tragus, and hairline in the forehead-mental cavity), the volume and the percentage of subdermal fluid of facial area were found to be decreased at the 4th and 8th week measurements. The anxiety score, patient reports of feelings of swelling and tightness, and body image perception improved after the 8-weeks of treatment compared to baseline.

Conclusion: This case report described the use of CDT in treating edema and patient symptoms in a patient with facial lymphedema related to MMS. Body image and level of anxiety improved.
Identification of a shared genetic risk locus for Kawasaki disease and immunoglobulin A vasculitis by a cross-phenotype meta-analysis
Authors: Carmona Elio G , García-Giménez Jose A , López-Mejías Raquel , Khor Chiea Chuen , Lee Jong-Keuk , Taskiran Ekim , Ozen Seza , Hocevar Alojzija , Liu Lili , Gorenjak Mario , Potočnik Uroš , Kiryluk Krzysztof , Ortego-Centeno Norberto , Cid María C , Hernández-Rodríguez José , Castañeda Santos , González-Gay Miguel A , Burgner David , Martín Javier , Márquez Ana ,   Spanish IgA Vasculitis Consortium;* International Kawasaki Disease Genetics Consortium
Published: May 2021

Objectives

Combining of genomic data of different pathologies as a single phenotype has emerged as a useful strategy to identify genetic risk loci shared among immune-mediated diseases. Our study aimed to increase our knowledge of the genetic contribution to Kawasaki disease (KD) and IgA vasculitis (IgAV) by performing the first comprehensive large-scale analysis on the genetic overlap between them.

Methods

A total of 1190 vasculitis patients and 11 302 healthy controls were analysed. First, in the discovery phase, genome-wide data of 405 KD patients and 6252 controls and 215 IgAV patients and 1324 controls, all of European origin, were combined using an inverse variance meta-analysis. Second, the top associated polymorphisms were selected for replication in additional independent cohorts (570 cases and 3726 controls). Polymorphisms with P-values ≤5 × 10−8 in the global IgAV–KD meta-analysis were considered as shared genetic risk loci.

Results

A genetic variant, rs3743841, located in an intron of the NAGPA gene, reached genome-wide significance in the cross-disease meta-analysis (P = 8.06 × 10−10). Additionally, when IgAV was individually analysed, a strong association between rs3743841 and this vasculitis was also evident [P = 1.25 × 10−7; odds ratio = 1.47 (95% CI 1.27, 1.69)]. In silico functional annotation showed that this polymorphism acts as a regulatory variant modulating the expression levels of the NAGPA and SEC14L5 genes.

Conclusion

We identified a new risk locus with pleiotropic effects on the two childhood vasculitides analysed. This locus represents the strongest non-HLA signal described for IgAV to date.
ESTIMATION OF THE EFFECTIVE DOSES FROM TYPICAL FLUOROSCOPIC EXAMINATIONS WITH BARIUM CONTRAST
Authors: Vodovatov Aleksandr , Golikov Vladislav , Kamyshanskaja Irina , Cheremysin Vladimir , Zinkevich Kseniya , Bernhardsson Christian
Published: May 2021

The current study aimed to estimate the effective doses and conversion coefficients (CCs) for typical barium swallow (BS), barium meal (BM) and barium enema (BE) protocols and to evaluate the impact of different examination parameters on the resulting CCs. Data were collected in surgical and therapy departments in St. Petersburg Urban Mariinsky Hospital. Computational models were developed using PCXMC 2.0 software. CCs (μSv × μGy−1 × m−2) were estimated, as follows, for over couch and under couch exposure geometries, respectively: 2.3 and 1.7 for BS (surgical department); 2.4 and 2.0 for BM (surgical department); 2.6 and 2.1 for BE (surgical department) 2.5 and 3.8 for BM (therapy department). The effective doses and CCs are mainly influenced by the combination of different fluoroscopic series and X-ray images taken in different projections, the irradiation field size and the energy characteristics of the X-ray beam.
Visceromotor roots of aesthetic evaluation of pain in art: an fMRI study
Authors: Ardizzi Martina , Ferroni Francesca , Umiltà Maria Alessandra , Pinardi Chiara , Errante Antonino , Ferri Francesca , Fadda Elisabetta , Gallese Vittorio
Published: May 2021

Empathy for pain involves sensory and visceromotor brain regions relevant also in the first-person pain experience. Focusing on brain activations associated with vicarious experiences of pain triggered by artistic or non-artistic images, the present study aims to investigate common and distinct brain activation patterns associated with these two vicarious experiences of pain and to assess whether empathy for pain brain regions contributes to the formation of an aesthetic judgement (AJ) in non-art expert observers. Artistic and non-artistic facial expressions (painful and neutral) were shown to participants inside the scanner and then aesthetically rated in a subsequent behavioural session. Results showed that empathy for pain brain regions (i.e. bilateral insular cortex, posterior sector of the anterior cingulate cortex and the anterior portion of the middle cingulate cortex) and bilateral inferior frontal gyrus are commonly activated by artistic and non-artistic painful facial expressions. For the artistic representation of pain, the activity recorded in these regions directly correlated with participants’ AJ. Results also showed the distinct activation of a large cluster located in the posterior cingulate cortex/precuneus for non-artistic stimuli. This study suggests that non-beauty-specific mechanisms such as empathy for pain are crucial components of the aesthetic experience of artworks.
Gender differences in the association of insomnia symptoms and coronary artery calcification in the multi-ethnic study of atherosclerosis
Authors: Bertisch Suzanne M , Reid Michelle , Lutsey Pamela L , Kaufman Joel D , McClelland Robyn , Patel Sanjay R , Redline Susan
Published: May 2021

Study Objectives

To quantify the gender-specific associations between insomnia symptoms and subclinical atherosclerosis, measured by coronary artery calcium (CAC) scores, which has strong predictive value for incident cardiovascular disease.

Methods

We analyzed data from 1,429 participants in the Multi-Ethnic Study of Atherosclerosis (MESA). Participants completed standardized questionnaires and underwent polysomnography (PSG) and 7-day actigraphy. Insomnia symptoms were defined as: self-reported trouble falling, staying or returning to sleep, early-morning awakenings, or hypnotic use, for ≥5 nights/week. MESA assessed CAC using computed tomography. We employed multivariable linear regression to model the probability of CAC >0 overall and to model the linear continuous effect among those with nonzero CAC.

Results

Our sample was a mean age of 68.1 ± 9.1 years, 53.9% female, and 36.2% white, 28.0% black, 24.2% Hispanic, and 11.5% Chinese-American. Insomnia symptoms were present in 49.7% of men and 47.2% of women. In multivariable-adjusted analyses, insomnia symptoms was associated with an 18% higher prevalence of CAC (PR 1.18, 95% CI 1.04, 1.33) among females, but no association was observed among males (PR 1.00, 95% CI 0.91, 1.08). There was no evidence that the association between insomnia symptoms and prevalence of CAC >0 differed by objective sleep duration status (by single-night PSG or multi-night actigraphy) in females or males.

Conclusions

We found that among women, insomnia symptoms were associated with an 18% higher prevalence of CAC compared to no insomnia. Insomnia symptoms were not associated with CAC prevalence in men. Additionally, there was no evidence that the association between insomnia symptoms and CAC score >0 differed by objective short sleep duration status.
Single-Center Experience of Outcomes and Prescribing Patterns of IV Immunoglobulin Use in Critically Ill Patients
Authors: Torbic Heather , Abdul-Wahab Sinan Samir , Ennala Sravanthi , Guduguntla Nagamani , Han Xiaozhen , Wang Xiaofeng , Duggal Abhijit , Krishnan Sudhir
Published: May 2021

Objectives:

Previous literature has not compared prescribing practices of IV immunoglobulin in medical ICU survivors and nonsurvivors. The objective of this study was to study IV immunoglobulin use in patients admitted to a medical ICU evaluating differences between hospital survivors and nonsurvivors in regards to level of evidence supporting use, prescribing patterns, and cost.

Design:

Retrospective, observational study.

SETTING:

Single, academic medical center medical ICU.

PATIENTS:

Adults who received greater than or equal to 1 dose of IV immunoglobulin during their medical ICU admission from 2011 to 2018.

INTERVENTIONS:

Prescribing patterns, level of evidence supporting use, and cost.

MEASUREMENTS AND MAIN RESULTS:

A total of 389 patients received greater than or equal to 1 dose of IV immunoglobulin for 46 discrete indications and 36.5% of indications had low-quality data supporting use of IV immunoglobulin. The primary indication for IV immunoglobulin was hypogammaglobulinemia (35.5%) followed by antibody-mediated lung transplant rejection (15.4%). Nonsurvivors received lower median dosing (g/kg) and number of doses compared with survivors (0.4 g/kg [0.4–1 g/kg] vs 0.5 g/kg [0.4–1 g/kg] [p = 0.0003] and 1.0 [1–2] vs 2 [1–3] doses [p = 0.0001], respectively). Dosing was based on ideal body weight in 258 patients (66%). High-quality data supported IV immunoglobulin use in 15 patients (4%). The median cost per dose of IV immunoglobulin in nonsurvivors was $4,893 ($4,078–$8,155) versus $5,709 ($4,078–$10,602) in survivors (p = 0.04).

Conclusions:

IV immunoglobulin is prescribed for many indications in the medical ICU with low-quality evidence supporting its use and dosing regimens are variable. Hospital survivors received a higher dose and greater number of doses of IV immunoglobulin compared with nonsurvivors. National guidelines are needed to help inform IV immunoglobulin utilization and reduce healthcare costs.
Treatment of Bronchopleural and Alveolopleural Fistulas in Acute Respiratory Distress Syndrome With Extracorporeal Membrane Oxygenation, a Case Series and Literature Review
Authors: Odish Mazen F. , Yang Jenny , Cheng George , Yi Cassia , Golts Eugene , Madani Michael , Pollema Travis , Owens Robert L.
Published: May 2021

OBJECTIVES:

To describe a ventilator and extracorporeal membrane oxygenation management strategy for patients with acute respiratory distress syndrome complicated by bronchopleural and alveolopleural fistula with air leaks.

DESIGN, SETTING, AND PARTICIPANTS:

Case series from 2019 to 2020. Single tertiary referral center—University of California, San Diego. Four patients with various etiologies of acute respiratory distress syndrome, including influenza, methicillin-resistant Staphylococcus aureus pneumonia, e-cigarette or vaping product use-associated lung injury, and coronavirus disease 2019, complicated by bronchopleural and alveolopleural fistula and chest tubes with air leaks.

MEASUREMENTS AND MAIN RESULTS:

Bronchopleural and alveolopleural fistula closure and survival to discharge. All four patients were placed on extracorporeal membrane oxygenation with ventilator settings even lower than Extracorporeal Life Support Organization guideline recommended ultraprotective lung ventilation. The patients bronchopleural and alveolopleural fistulas closed during extracorporeal membrane oxygenation and minimal ventilatory support. All four patients survived to discharge.

CONCLUSIONS:

In patients with acute respiratory distress syndrome and bronchopleural and alveolopleural fistula with persistent air leaks, the use of extracorporeal membrane oxygenation to allow for even lower ventilator settings than ultraprotective lung ventilation is safe and feasible to mediate bronchopleural and alveolopleural fistula healing.
Chrysiasis: Gold Aggregates Around a Nevus and Osteoma Cutis
Authors: Ravi Vignesh , Cohen Brandon , Kim Gene , Abraham Jerrold L. , Sanyal Soma , Tran Danielle , Ngo Binh
Published: May 2021

Parenteral gold has historically been used to treat several conditions, including rheumatoid arthritis. Gold administration leads to a variety of cutaneous reactions, including chrysiasis, which is a permanent blue–grey hyperpigmentation of the skin due to dermal gold deposition. In this report, we describe the case of a patient who received parenteral gold injections 22 years before the onset of her chrysiasis for the treatment of rheumatoid arthritis. Biopsy of the macules showed dermal gold deposits aggregating around a melanocytic nevus, as well as around preexisting osteoma cutis. To the authors' knowledge, this is the first report in the literature describing a case of chrysiasis with gold deposits concentrated around a melanocytic nevus and an area of osteoma cutis.
Advances in corneal graft rejection
Authors: Yin Jia
Published: May 2021

Purpose of review

Immune rejection after corneal transplantation is a major risk for graft failure. We aim to summarize recent advances in the understanding and management of graft rejection.

Recent findings

Immune rejection remains the leading cause of graft failure in penetrating keratoplasty (PKP). While ABO blood type and sex match between donor and recipient may reduce rejection, human leucocyte antigens class II matching in a randomized study did not reduce the risk of rejection in high-risk PKP. Compared with PKP, deep anterior lamellar keratoplasty, descemet stripping automated endothelial keratoplasty, and descemet membrane endothelial keratoplasty have lower immune rejection rates of 1.7–13%, 5–11.4%, and 1.7–2.8%, respectively, based on long-term (5 years and more) studies. Whether immune rejection is a major risk factor for graft failure in these lamellar keratoplasties is unclear. While there have not been major advances in the systemic management of graft rejection, topical nonsteroid agents such as tacrolimus and anti-vascular endothelial growth factor have shown promise in high-risk cases.

Immune rejection remains the leading cause of graft failure in PKP. Lamellar keratoplasties have significantly lower rejection rates compared with PKP. The significance of rejection in the failure of lamellar grafts warrants further investigation.
The role of imaging technologies for ocular surface tumors
Authors: Venkateswaran Nandini , Sripawadkul Wathanee , Karp Carol L.
Published: May 2021

Purpose of review

This review will discuss the utility of high-resolution anterior segment optical coherence tomography (HR-OCT), in-vivo confocal microscopy (IVCM) and ultrasound biomicroscopy (UBM) in characterizing and diagnosing various ocular surface tumors, namely ocular surface squamous neoplasia (OSSN), conjunctival lymphoma and conjunctival melanoma. The strengths and limitations of each imaging modality will be discussed along with the characteristics findings of each lesion on each imaging platform.

Recent findings

HR-OCT can consistently be utilized in the clinic setting to distinguish between epithelial ocular surface tumors such as OSSN as compared with subepithelial tumors such as conjunctival lymphoma and conjunctival melanoma given their distinctive findings. IVCM can be used as an adjunct to HR-OCT to obtain cellular and surface characteristics, whereas UBM can be used to assess tumor depth and thickness for larger and highly pigmented lesions as well as to detect intraocular invasion.

HR-OCT, IVCM and UBM are all helpful imaging modalities to diagnose and characterize various ocular surface tumors and can serve as valuable adjuncts to monitor treatment response and assess for recurrence ocular surface tumors.