bluuebunny/crossref_metadata_2025 huggingface dataset:
Altitudinal variation in life-history features of a Qinghai-Tibetan Plateau lizard
Authors: Yu Wei , Zhu Zeyu , Zhao Xiaolong , Cui Shuang , Liu Zhensheng , Zeng Zhigao
Published: July 2022

Environmental changes along an altitudinal gradient can facilitate the differentiation of life-history features in ectothermic species, but little attention has been devoted to the reciprocal influence of altitude and alpine slope directionality on life-history variation. According to life-history theory, increased environmental stress causes a change in reproductive allocation from number to quality of offspring, as well as a stronger trade-off between size and number of offspring. To clarify the influence of environmental pressures on the life-history features of the Qinghai toad-headed lizard Phrynocephalus vlangalii along an altitudinal cline, we surveyed late pregnant females from 3 populations of low (2,600 m), middle (3,400 m), and high (3,600 m) elevations in the Dangjin Mountain of Gansu, China from July to October 2019, and compared their inter-population differences in maternal body size, reproductive characteristics, offspring growth, and locomotor performance. Because of lower temperatures, higher humidity, and lower light intensity caused by slope aspect and altitude, the middle-altitude region experienced stronger environmental stress than the high- and low-altitude regions. Our results showed that females were larger at middle- and high-altitude sites and smaller at the low-altitude site, following Bergmann’s rule. We also found that females from low-altitude population gave birth earlier than those from the middle and high altitudes. Our results showed a shift in the offspring size-number trade-off of P. vlangalii in response to colder and harsher environments, with lizards from the alpine steppe (i.e. the middle- and high-altitude habitats) producing fewer but larger offspring than those from the warm steppe (i.e. the low-altitude habitat). Low-altitude juveniles grew faster than high-altitude ones, but at the same rates as middle-altitude juveniles. This result demonstrates that the growth of P. vlangalii was associated with temperature and light intensity. Our findings contribute to enhancing our understanding of the altitudinal variation in life-history features of plateau ectotherms and their phenotypic plasticity or local adaptation.
Mismatch between calf paternity and observed copulations between male and female reindeer: Multiple mating in a polygynous ungulate?
Authors: Coombs Keenin R , Weladji Robert B , Holand Øystein , Røed Knut H
Published: July 2022

In polygynous systems, such as that exhibited by reindeer Rangifer tarandus, mate choice can be difficult to disentangle from male intrasexual competition because male behavior may constrain female choice. Multiple mating may provide an avenue for female mate choice, though it is difficult to identify using behavioral estimators alone. Molecular techniques address this issue by affording ecologists an opportunity to reassess mating systems from a genetic perspective. We assessed the frequency and possible explanations for multiple mating in reindeer using a genetic approach to determine the success of observed copulations in a semi-domesticated herd in Kaamanen, Finland. Behavioral and genetic data were synthesized with population characteristics over a 7-year period to test the hypothesis that, if present, polyandry in reindeer is driven by sexual harassment from sub-dominant males. We observed multiple mating in 42% of females, with as many as 60% exhibiting multiple mating in certain years. We found no evidence that multiple mating resulted from sexual harassment by sub-dominant males, suggesting that it is likely a deliberate strategy among females. Conversion rate of copulations into paternities varied with male size, with smaller males more likely to experience mismatch than larger males. Female preference for larger males persisted despite the occurrence of multiple mating, possibly suggesting a mechanism for cryptic post-copulatory selection. We suggest further research to delineate the possible influence of cryptic post-copulatory selection and multiple mating to defend against infertility in exhausted males.
Stochastic Dynamic Optimization for Forest Rotation with Uncertain Stumpage Prices
Authors: Huang Yu-Kai , Bawa Ranjit , Dwivedi Puneet , Zhao Dehai
Published: July 2022

This study investigates the effect of uncertain stumpage prices on the optimal forest rotation decision and related profitability under various silvicultural scenarios. The study applies loblolly pine (Pinus taeda L.) growth and yield models with distinct silvicultural scenarios in the Piedmont and Upper Coastal Plain region of the southeastern United States. It then applies chance-constrained dynamic optimization to derive optimal rotation age and related profitability on per acre basis. The growth and yield models show that using a combination of herbicide and fertilizer silvicultural treatment leads to a higher timber yield and profit at a lower optimal rotation age than other treatment scenarios. Furthermore, the stochastic optimization model shows that low risk tolerance results in low returns. Within a particular risk tolerance level, silvicultural treatment options with higher standard deviations almost always produce higher returns. The findings of this article contribute to the literature on optimizing forest management when considering uncertain stumpage prices over time, given different risk tolerance levels.
Imaging-associated stress causes divergent phase transitions of RNA-binding proteins in the Caenorhabditis elegans germ line
Authors: Elaswad Mohamed T , Munderloh Chloe , Watkins Brooklynne M , Sharp Katherine G , Breton Elizabeth , Schisa Jennifer A
Published: July 2022

One emerging paradigm of cellular organization of RNA and RNA-binding proteins is the formation of membraneless organelles. Examples of membraneless organelles include several types of ribonucleoprotein granules that form via phase separation. A variety of intracellular pH changes and posttranslational modifications, as well as extracellular stresses, can stimulate the condensation of proteins into granules. For example, the assembly of stress granules induced by oxidative stress, osmotic stress, and heat stress has been well characterized in a variety of somatic cell types. In the germ line, similar stress-induced condensation of proteins occurs; however, less is known about the role of phase separation during gamete production. Researchers who study phase transitions often make use of fluorescent reporters to study the dynamics of RNA-binding proteins during live cell imaging. In this report, we demonstrate that common conditions of live-imaging Caenorhabditis elegans can cause an inadvertent stress and trigger phase transitions of RNA-binding proteins. We show that this imaging-associated stress stimulates decondensation of multiple germ granule proteins and condensation of several P-body proteins. Proteins within larger ribonucleoprotein granules in meiotically arrested oocytes do not appear to be as sensitive to the stress as proteins in diakinesis oocytes of young hermaphrodites, with the exception of the germ granule protein PGL-1. Our results have important methodological implications for all researchers using live-cell imaging techniques. The data also suggest that the RNA-binding proteins within large ribonucleoprotein granules of arrested oocytes may have distinct phases, which we characterize in our companion article.
Genomic and gene expression associations to morphology of a sexual ornament in the chicken
Authors: Bakovic Vid , Höglund Andrey , Martin Cerezo Maria Luisa , Henriksen Rie , Wright Dominic
Published: July 2022

How sexual selection affects the genome ultimately relies on the strength and type of selection, and the genetic architecture of the involved traits. While associating genotype with phenotype often utilizes standard trait morphology, trait representations in morphospace using geometric morphometric approaches receive less focus in this regard. Here, we identify genetic associations to a sexual ornament, the comb, in the chicken system (Gallus gallus). Our approach combined genome-wide genotype and gene expression data (>30k genes) with different aspects of comb morphology in an advanced intercross line (F8) generated by crossing a wild-type Red Junglefowl with a domestic breed of chicken (White Leghorn). In total, 10 quantitative trait loci were found associated to various aspects of comb shape and size, while 1,184 expression QTL were found associated to gene expression patterns, among which 98 had overlapping confidence intervals with those of quantitative trait loci. Our results highlight both known genomic regions confirming previous records of a large effect quantitative trait loci associated to comb size, and novel quantitative trait loci associated to comb shape. Genes were considered candidates affecting comb morphology if they were found within both confidence intervals of the underlying quantitative trait loci and eQTL. Overlaps between quantitative trait loci and genome-wide selective sweeps identified in a previous study revealed that only loci associated to comb size may be experiencing on-going selection under domestication.
Monte Carlo and molecular dynamics simulations of CH4 molecules adsorption behavior in bituminous coal
Authors: Zhao Dan , Liu Xiaoqing
Published: July 2022

In this study, we established a macromolecular structure model of the Wiser bituminous coal (C192H166N4O19S9) to study the adsorption characteristics of CH4 molecules in bituminous coal. We then combined the grand canonical Monte Carlo and molecular dynamics simulation methods to study the adsorption behavior of CH4 molecules in coal at different temperatures and moisture contents with fugacity values of 0–12 MPa. The simulation results showed that the adsorption isotherms of CH4 gas are consistent with those of the Langmuir model, and the adsorption of CH4 molecules is negatively correlated with temperature and positively correlated with fugacity. The adsorption amount and rate of CH4 molecules in bituminous coal decreased as the moisture content in the coal molecules increased. The presence of H2O molecules in coal reduced the interaction between the coal and CH4 molecules. H2O molecules exhibited a stronger interaction with the heteroatomic groups in coal molecules than that of the CH4 molecules. Finally, the main factors causing a linear negative correlation between moisture content and the adsorption of CH4 molecules were the preferential occupation of H2O molecules in effective adsorption sites in coal molecules and the linear reduction of free volume in coal.
Applications of intelligent techniques in modeling geothermal heat pumps: an updated review
Authors: Almutairi Khalid
Published: July 2022

Regarding the significance of energy efficiency in cooling and heating systems, it is crucial to apply proper technologies. Heat pumps are among the systems with ability of efficient performance applicable in different operating conditions. These technologies can be coupled with renewable energy sources such as solar and geothermal, which cause lower energy consumption and emission of greenhouse gases. In the present work, studies considered utilization of intelligent techniques in modeling performance of geothermal heat pumps (GHPs) are reviewed. The main findings of the reviewed works reveal that intelligent techniques are able to model heat pumps output with significant and remarkable exactness; for instance, in some cases, R2 of the models proposed that the coefficient of performance of the ground sources heat pumps is around 0.9999, revealing closeness of the predicted data and actual quantities. The precision of the models, based on the intelligent methods, is affected by different elements including the used function, algorithm and architecture. Furthermore, it is observed that using optimization algorithms for tuning the hyperparameters of intelligent techniques cause higher estimation exactness. In addition to performance prediction, some other parameters related to the GHPs such as well temperature and thermal conductivity of the soil layers could be predicted by utilization of intelligent methods.
Delivering an mRNA vaccine using a lymphatic drug delivery device improves humoral and cellular immunity against SARS-CoV-2
Authors: Chen Runqiang , Xie Hui , Khorsandzadeh Sahba , Smith Madison , Shaabani Namir , Hu Qidong , Lyu Xiaoxuan , Wang Hua , Lim Wan-lin , Sun Haotian , Ji Henry , Cooley Brian , Ross Russell , Francis David M
Published: July 2022

The exploration and identification of safe and effective vaccines for the SARS-CoV-2 pandemic have captured the world's attention and remains an ongoing issue due to concerns of balancing protection against emerging variants of concern while also generating long-lasting immunity. Here, we report the synthesis of a novel messenger ribonucleic acid encoding the spike protein in a lipid nanoparticle formulation (STI-7264) that generates robust humoral and cellular immunity following immunization of C57Bl6 mice. In an effort to improve immunity, a clinically focused lymphatic drug delivery device (MuVaxx) was engineered to modulate immune cells at the injection site (epidermis and dermis) and draining lymph node (LN) and tested to measure adaptive immunity. Using MuVaxx, immune responses were elicited and maintained at a 10-fold dose reduction compared to traditional intramuscular (IM) administration as measured by anti-spike antibodies, cytokine-producing CD8 T cells, neutralizing antibodies against the Washington (wild type) strain and South African (Beta) variants, and LN-resident spike-specific memory B cells. Remarkably, a 4-fold-elevated T cell response was observed in MuVaxx-administered vaccination compared to that of IM-administered vaccination. Thus, these data support further investigation into STI-7264 and lymphatic-mediated delivery using MuVaxx for SARS-CoV-2 and VoC vaccines.
Obstructive jaundice, early satiety and xerostomia in an 82-year-old woman
Authors: Bhanot Kunal , Taheem Muhesh , Perry Robert , Wong Christopher , Muehlschlegel Charlotte , Cheent Kuldeep
Published: July 2022

Amyloid light-chain (AL) amyloidosis is a multisystem disease with obstructive jaundice and gastrointestinal (GI) involvement being uncommon initial presentations. Patients with AL amyloidosis seldom have jaundice and advanced GI tract involvement as their presenting symptoms. This case report describes an 82-year-old lady who presented with a 6-month history of early satiety, weight loss, xerostomia and progressive jaundice. Imaging did not suggest a biliary cause but demonstrated hepatomegaly and ascites. Oesophagogastroduodenoscopy revealed a duodenal stricture. Duodenal and liver biopsies were consistent with amyloid deposition. Multiple myeloma was confirmed to be the underlying cause. Significant cholestatic liver dysfunction and a duodenal stricture have not been previously described as simultaneous manifestations of amyloidosis. This case also highlights the difficulty in treating multiple myeloma as the cause of AL amyloidosis in the context of liver dysfunction, given that many chemotherapy agents undergo hepatic metabolism.
The Impact of Churn on HIV Outcomes in a Southern United States Clinical Cohort
Authors: Gopalsamy Srinivasa Nithin , Shah N Sarita , Marconi Vincent C , Armstrong Wendy S , del Rio Carlos , Pennisi Eugene , Wortley Pascale , Colasanti Jonathan A
Published: July 2022

Background

Persons with human immunodeficiency virus (PWH) may experience a cycle of engaging and disengaging in care referred to as “churn.” While human immunodeficiency virus (HIV) churn is predicted to be more prevalent in the southern United States (US), it has not been well characterized in this region.

Methods

We conducted a retrospective cohort study involving PWH newly establishing care at a large urban clinic in Atlanta, Georgia, from 2012 to 2017, with follow-up data collected through 2019. The primary exposure was churn, defined as a ≥12-month gap between routine clinic visits or viral load (VL) measurements. We compared HIV metrics before and after churn and assessed the risk of future churn or loss to follow-up.

Results

Of 1303 PWH newly establishing care, 81.7% were male and 84.9% were Black; 200 (15.3%) experienced churn in 3.3 years of median follow-up time. The transmissible viremia (TV) rate increased from 28.6% prechurn to 66.2% postchurn (P < .0001). The 122 PWH having TV on reengagement had delayed time to subsequent viral suppression (adjusted hazard ratio, 0.59 [95% confidence interval {CI}, .48–.73]), and PWH returning to care contributed disproportionately to the community viral load (CVL) (proportion of CVL/proportion of patients, 1.96). Churn was not associated with an increased risk of subsequent churn (adjusted odds ratio [aOR], 1.53 [95% CI, .79–2.97]) or loss to follow-up (aOR, 1.04 [95% CI, .60–1.79]).

Conclusions

The rate of churn in a southern US clinic was high, and those who experienced churn had increased TV at reentry and disproportionately contributed to the CVL and likely contributing to ongoing HIV transmission.
Identification of curcumin as a novel potential drug for promoting the development of small ovarian follicles for infertility treatment
Authors: Zhao Yu , Zhang Yihui , Liu Dongteng , Feng Haiwei , Wang Xiaohui , Su Jiajun , Yao Yuanqing , Ng Ernest H Y , Yeung William S B , Li Raymond H W , Rodriguez-Wallberg Kenny A , Liu Kui
Published: July 2022

In-vitro fertilization is an effective treatment for various causes of infertility. However, management of women with poor ovarian response or premature ovarian insufficiency remains challenging because these women have underdeveloped small ovarian follicles that do not respond to hormone treatment. In-vitro activation of small follicles has been developed but its efficiency has much room for improvement. In the current study, we provide several lines of evidence showing that curcumin, an FDA-approved traditional medicine, can specifically promote the development of mouse ovarian follicles from the primary to secondary stage, which greatly potentiates these small follicles for subsequent in-vivo development into antral follicles that can be ovulated. Mechanistically, we show that curcumin promotes the proliferation and differentiation of granulosa cells and the growth of oocytes by activating the phosphatidylinositol 3 kinase (PI3K) signaling pathway. Most importantly, we show that in-vitro treatment of human ovarian tissues with curcumin can promote the in-vivo survival and development of small human ovarian follicles, showing that curcumin can be used as a potential drug to increase the success rate of in-vitro activation of small human follicles. We thus identify curcumin as a novel potential drug for promoting the development of small human ovarian follicles for infertility treatment.
Does Ethnic Federalism Lead to Greater Ethnic Identity? The Case of Ethiopia
Authors: Ishiyama John
Published: July 2022

In this article, I examine the connection between ethnic federalism and the development of ethnic rather than national identities. The literature suggests such ethnification can lead to conflict and collapse of federal states—does such ethnification occur and is it attributable to ethnofederalism? Using recent data from the Afrobarometer for Ethiopia, which adopted an ethnofederal arrangement in 1995, I examine whether individuals who were politically socialized under the conditions of ethnic federalism are more likely to favor ethnic identity over a national, Ethiopian, identity. I find that individuals politically socialized under the conditions of ethnic federalism are indeed significantly more likely to embrace an ethnic rather than a national identity. However, generational affects do not appear to be related to perceptions of continuing ethnic federalism as a political arrangement. Differences of opinion on ethnic federalism are more a function of one’s group identity, rather than the intensity of ethnic identification.
Mapping Stripe Rust Resistance QTL in ‘N2496’, a Synthetic Hexaploid Wheat Derivative
Authors: Hou Shuai , Wu Fangkun , Wang Zhiqiang , Yan Ning , Chen Hao , Li Haojie , Yang Peiyu , Zhang Ying , Li Caixia , Lin Yu , Ma Jian , Huang Lin , Liu Yaxi
Published: July 2022

Stripe rust is a destructive disease that affects plant growth and substantially reduces wheat yields globally. An economically and environmentally friendly way to control this disease is to use resistant cultivars. ‘N2496’ is a synthetic hexaploid wheat derivative that exhibits high resistance and could serve as a source of resistance for breeding programs. We developed three recombinant inbred lines (RILs) populations by crossing ‘N2496’ with common wheat cultivars ‘CN16’, ‘CM107’, and ‘MM37’. Stripe rust responses were evaluated in all three populations using a mixture of current predominant Chinese Puccinia striiformis f. sp. tritici races. A stripe rust resistance quantitative trait locus (QTL) in the ‘N2496’/‘CN16’ RIL population was mapped on chromosome arm 6BL at 519.35 to 526.55 Mb using bulked segregant RNA sequencing. The population was genotyped using simple sequence repeats and kompetitive allele-specific polymerase (KASP) markers. The QTL QYr.sicau-6B was localized to a 1.19-cM interval flanked by markers KASP-TXK-10 and KASP-TXK-6. The genetic effect of QYr.sicau-6B was validated in the ‘N2496’ × ‘CM107’ and ‘N2496’ × ‘MM37’ RILs populations and explained up to 63.16% of the phenotypic variation. RNA sequencing and quantitative real-time polymerase chain reaction identified two differentially expressed candidate genes in the physical interval of QYr.sicau-6B.
“Just Be There”: Desired Partner Behaviors Among Pregnant People Living With Opioid Use Disorder, a Qualitative Study
Authors: Sack Daniel E. , Sheridan Maria E. , Audet Carolyn M.
Published: July 2022

Objectives

Elicit how partners impact pregnant peoples experience living with opioid use disorder (OUD) during pregnancy and summarize participant recommendations to improve partner support from people engaged in treatment for OUD during pregnancy.

Methods

In this qualitative study, we completed 20 in-depth interviews in pregnant people with OUD at an outpatient clinic in Tennessee. We employed inductive and deductive coding based on a relationship intimacy model and thematic analysis to elicit the perspectives, attitudes, and experiences that shaped desired partner behaviors during their pregnancy. We placed our findings in a modified relationship intimacy model of couple adaptation to OUD. Finally, we summarized interviewed participants’ recommendations on how to best educate and involve their partners.

Results

Our analysis generated 24 codes and 5 themes. Previous lived experience and interpersonal factors influenced participants’ experiences with relationship-compromising and relationship-enhancing behaviors. They also reported that positive, or relationship-enhancing behaviors, could mitigate some of their negative intrapersonal feelings such as self-stigma. Participants agreed that partners should display emotional intelligence and empathy, provide supportive logistic and physical behaviors, and be open to improve. Participants also suggested that partners be equipped with information about expected physiological changes during pregnancy, supportive behavior examples, and information about OUD treatment.

Conclusions

Additional input from pregnant people and partners in future projects can build on these findings and guide the creation and assessment of comprehensive interventions to improve care for pregnant people with OUD.
Association of Cannabis Use With Nausea and Vomiting of Pregnancy
Authors: Metz Torri D. , Allshouse Amanda A. , McMillin Gwendolyn A. , Silver Robert M. , Smid Marcela C. , Haas David M. , Simhan Hyagriv N. , Saade George R. , Grobman William A. , Parry Samuel , Chung Judith H. , Jarlenski Marian P.
Published: July 2022

Our objective was to evaluate whether cannabis use was associated with nausea and vomiting in early pregnancy. Participants from nuMoM2b (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be) enrolled from October 2010 through September 2013 with a PUQE (Pregnancy-Unique Quantification of Emesis) questionnaire and an available stored urine sample from the first study visit (median gestational age 12 weeks) were included. Cannabis exposure was ascertained by urine immunoassay for 11-nor-9-carboxy-delta-9-tetrahydrocannabinol (THC-COOH); positive results were confirmed with liquid chromatography tandem mass spectrometry. The primary outcome was moderate-to-severe nausea by the PUQE score. Overall, 9,250 participants were included, and 5.8% (95% CI 5.4–6.3%) had detectable urine THC-COOH. In adjusted analyses, higher THC-COOH levels were associated with greater odds of moderate-to-severe nausea (20.7% in the group with THC-COOH detected vs 15.5% in the group with THC-COOH not detected, adjusted odds ratio 1.6, 95% CI 1.1–2.2 for a 500 ng/mg Cr THC-COOH increment).
Neurocysticercosis Complicating Pregnancy
Authors: Cunningham F. Gary , Twickler Diane M.
Published: July 2022

OBJECTIVE:

Infection with the pork tapeworm can result in neurocysticercosis caused by infestation of central nervous system tissues by the parasite cysts. Parenchymal brain infection can cause symptoms from mass effect that include headache, seizures, confusion, and even coma. Our objective was to describe the clinical course of neurocysticercosis infections in pregnant women.

METHODS:

This was a case series that described clinical findings and pregnancy outcomes of women diagnosed with neurocysticercosis from 1994 through 2016 at a single institution. Their medical records were reviewed, cranial computed tomography and magnetic resonance imaging scans were assessed, and the infections were classified according to the criteria of the 2018 Infectious Diseases Society of America and the American Society of Tropical Medicine and Hygiene.

RESULTS:

Overall, 37 pregnant women with neurocysticercosis were identified. Of the 37 women, 32 were symptomatic, and 16 each had severe headaches or new-onset seizures or other neurologic sequelae. Some of these women had multiple symptoms. Others were diagnosed when neuroimaging was done for a history of neurocysticercosis or evaluation of a preexisting seizure disorder. The most common treatment was with anthelmintics—albendazole, praziquantel, or both—usually given with anticonvulsants and corticosteroids to decrease inflammation. There were eight women in whom invasive neurosurgical procedures were performed, usually for hydrocephaly. Overall, 32 healthy neonates were born at term, and there was one preterm delivery at 34 weeks of gestation. The four pregnancy losses included two molar pregnancies, one anembryonic miscarriage, and a 23-week stillbirth of a pregnancy complicated by preeclampsia with severe features.

CONCLUSION:

Neurocysticercosis in pregnant women may be asymptomatic or result in headaches, seizures, confusion, nausea and vomiting, altered mental status, or obtundation. Anthelmintic treatment is usually successful, but in some women neurosurgical procedures are necessary to relieve obstructive hydrocephaly.
Prophylactic Methylergonovine and Oxytocin Compared With Oxytocin Alone in Patients Undergoing Intrapartum Cesarean Birth
Authors: Masse Nicole , Dexter Franklin , Wong Cynthia A.
Published: July 2022

OBJECTIVE:

To evaluate whether the administration of prophylactic methylergonovine in addition to oxytocin in patients undergoing intrapartum cesarean birth reduces the need for additional uterotonic agents.

METHODS:

This was a single-center, placebo-controlled, randomized trial of patients undergoing intrapartum cesarean birth. Patients were randomly allocated to receive intravenous oxytocin 300 mL/minute plus intramuscular methylergonovine 0.2 mg (1 mL) or intravenous oxytocin 300 mL/minute plus intramuscular normal saline (1 mL). The primary outcome was the receipt of additional uterotonic agents. Secondary outcomes included surgeon assessment of uterine tone, incidence of postpartum hemorrhage, quantitative blood loss, and blood transfusion. To detect a twofold decrease in the need for additional uterotonic agents (assuming a 42% baseline) with a two-sided type 1 error of 5% and power of 80%, a sample size of 76 patients per group was required.

RESULTS:

From June 2019 through February 2021, 80 patients were randomized to receive methylergonovine plus oxytocin and 80 were randomized to receive to oxytocin alone. Significantly fewer patients who were allocated to the methylergonovine group received additional uterotonic agents (20% vs 55%, relative risk [RR] 0.4, 95% CI 0.2–0.6). Participants receiving methylergonovine were more likely to have satisfactory uterine tone (80% vs 41%, RR 1.9, 95% CI 1.5–2.6), lower incidence of postpartum hemorrhage (35% vs 59%, RR 0.6, 95% CI 0.4–0.9), lower mean quantitative blood loss (967 mL vs 1,315 mL; mean difference 348, 95% CI 124–572), and a lower frequency of blood transfusion (5% vs 23%, RR 0.2, 95% CI 0.1–0.6).

CONCLUSION:

The administration of prophylactic methylergonovine in addition to oxytocin in patients undergoing intrapartum cesarean birth reduces the need for additional uterotonic agents.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT03904446.
Associations Between Implementation of the Collaborative Care Model and Disparities in Perinatal Depression Care
Authors: Snowber Khadija , Ciolino Jody D. , Clark Crystal T. , Grobman William A. , Miller Emily S.
Published: July 2022

OBJECTIVE:

To evaluate whether perinatal collaborative care model implementation was associated with a reduction in racial disparities in depression care.

METHODS:

This retrospective cohort study included pregnant and postpartum people who self-identified as either Black or White, and received prenatal care at academic faculty offices affiliated with an urban quaternary medical center. Individuals were divided into two cohorts to reflect the epochs of implementation. The primary outcome was the frequency of depression screening. The secondary outcome was the frequency of provision of a treatment recommendation for those with a positive depression screen. Antenatal and postpartum care were analyzed separately. A propensity score was used in multivariable models to control for confounders chosen a priori across implementation epoch. Interaction terms were created between race and implementation epoch to identify whether effect modification was present. Subgroup analyses were performed for outcomes with significant race-by-epoch interaction terms.

RESULTS:

Of the 4,710 individuals included in these analyses, 4,135 (87.8%) self-identified as White and 575 (12.2%) self-identified as Black. Before implementation, Black individuals were more likely to receive screening (adjusted odds ratio [aOR] 2.44) but less likely to have a treatment recommended when a positive screen was identified (aOR 0.05). In multivariable models, race-by-epoch interaction terms were significant for both antenatal screening (P<.001) and antenatal treatment recommendation (P=.045), demonstrating that implementation of the perinatal collaborative care model was associated with reductions in extant racial disparities. After implementation, there were no significant differences by race (referent=White) in screening for antenatal depression (aOR 1.22, 95% CI 0.89–1.68) or treatment recommendations for those who screened positive (aOR 0.64, 95% CI 0.27–1.53). Race-by-epoch interaction terms were not significant in multivariable models for either postpartum screening or treatment recommendation.

CONCLUSION:

Implementation of the perinatal collaborative care model is associated with a mitigation of racial disparities in antenatal depression care and may be an equity-promoting intervention for maternal health.
Three-Dimensional–Printed Vaginal Molds for Use After McIndoe Neovagina Creation
Authors: Kisby Cassandra K. , Agosta Patrina O. , Alexander Amy , Erie Eric , Morris Jonathan M. , Gebhart John B.
Published: July 2022

BACKGROUND:

Surgical vaginoplasty is a highly successful treatment for congenital absence of the vagina. One key to long-term success is the use of an appropriate vaginal mold in the immediate postoperative period. We present the use of a three-dimensional (3D)–printed vaginal mold, customizable to the anatomy of individual patients.

TECHNIQUE:

Vaginal molds were designed using a 3D modeling software program. The design included narrowing around the urethra, holes for egress of secretions, and a knob for insertion and removal. Dental resin was 3D-printed into various-sized vaginal molds, and postprocessing was performed.

EXPERIENCE:

We present the use of the 3D-printed mold for a patient with a history of cloacal exstrophy and a unique pelvic shape. Two prior neovagina surgeries in this patient had been unsuccessful due to ineffective handheld dilator use; the patient experienced success with the 3D-printed intravaginal mold.

CONCLUSION:

The use of the 3D-printed vaginal mold is an alternative to the limited commercially available models today and allows for customization to user anatomy. With 3D printers becoming more widely accessible, we believe this method could become universally accepted, with hopes of contributing to increased patient satisfaction and decreased complications.
Indications and Technical Considerations for Transanal Total Mesorectal Excision
Authors: McFadgen Heather L. , Farooq Ameer O.
Published: July 2022

CASE SUMMARY:

A 53-year-old man presented after noting bright red blood from his rectum. On examination, he was found to have a mass 1 cm above the anal sphincter complex. He had a BMI of 40 kg/m2and was otherwise healthy. MRI revealed a T2/early T3 lesion with extramural venous invasion and suspicious perirectal lymph nodes. Low rectal cancer was diagnosed. He underwent long-course neoadjuvant chemoradiation with good but not complete clinical response. Given his obesity and the low nature of his rectal cancer, a transanal total mesorectal excision (taTME) was planned.
Plume Generated by Different Electrosurgical Techniques: An In Vitro Experiment on Human Skin
Authors: Riopelle Alexandria M. , Potter Christian T. , Jeong Daehee , Schanbacher Carl F.
Published: July 2022

BACKGROUND

Plume generated by electrosurgical techniques is a health hazard to patients and dermatologists.

OBJECTIVE

To compare the particle concentration generated by various energy devices used in dermatologic surgery.

MATERIALS AND METHODS

Five surgical techniques were tested on human tissue samples in a closed chamber. A particle counter, positioned at a fixed point 20 cm away from the sample, recorded the concentrations of aerosolized particles generated over 7 particle sizes (0.3, 0.5, 0.7, 1, 2.5, 5, and 10 μm).

RESULTS

Monopolar electrocoagulation created the greatest concentration of particles followed by electrocautery, electrodesiccation, electrofulguration, and bipolar electrocoagulation. Bipolar electrocoagulation created 80 times fewer 0.3 μm particles and 98 times fewer 0.5 μm particles than monopolar electrocoagulation. Across all electrosurgical techniques, the greatest concentrations of particles generated were of the 0.3 and 0.5 μm particle size.

CONCLUSION

Bipolar electrocoagulation created the lowest concentration of particulate matter. Given the noxious and hazardous nature of surgical plume, the bipolar forceps offer surgeons a safer method of performing electrical surgery for both the surgical staff and the patient.
Lessons Learned: Building a Comprehensive Telehealth Quality Program
Authors: Kong-Wong Crystal , Weiss Meridith A. , Shumway Molly , Schleyer Anneliese , Aas Erin , Rhodes Marcia , Scott John D.
Published: July 2022

The UW Medicine Telehealth Services team developed a comprehensive telehealth Quality Improvement (QI) program founded upon 5 QI pillars: incident reporting, patient experience surveys, patient complaints, peer review, and targeted QI projects. The authors outline the foundation of this QI program, early trends from peer review, patient experience surveys, and telehealth utilization by demographic group. Telehealth quality should be scrutinized with the same rigor applied to in-person care. All health systems should establish a telehealth QI program.
Evaluation of coagulation parameters and impact of transfusion on coagulation in patients with beta thalassemia major
Authors: Kurt Zehra Deniz Çelik , Sönmez Çiğdem , Kaçar Dilek , Eker İbrahim , Bayhan Turan , Yarali Neşe , Özbek Namik Yaşar
Published: July 2022

There have been several studies that have shown that patients with beta thalassemia major are at a higher risk of thrombosis due to the procoagulant activity of thalassemic erythrocytes, decreased liver synthetic function, increased platelet activity and vascular endothelial activation attributed to chronic oxidative stress, although there are no established tests to predict thrombotic risk in TM patients.

In this study, we evaluated whether or not the platelet function analyser (PFA-200) and thrombin generation test (TGT) would be useful tools to identify hypercoagulability and risk of thrombosis in thalassemia major patients.

The study included 50 patients with thalassemia major and 104 healthy control group. Pretransfusion and posttransfusion PFA-200 and TGT results were compared with control group. We found that median C/ADP and C/EPI values in the thalassemia major group were greater in both the pre and posttransfusion samples than the C/ADP and C/EPI results from the control group. The TGT results showed there was no difference between control group and the results from the thalassemia major group.

The TGT and PFA-200 testing did not identify hypercoagulability nor identify clear testing parameters to predict a thalassemia major patient's risk of thrombosis. There may be other mechanisms/causes yet unidentified that could better explain thalassemia major patient's increased risk from thromboembolic events.
Establishment of the First Professional Organization of Traditional Chinese Medicine and Acupuncture in California
Authors: Huang Sam Xian Sheng , Hu Jun , Chen Da-Ren , Chau Jackson
Published: July 2022

The California Chinese Medicine and Acupuncture Research Association, founded on March 25, 1974, is the first Chinese medicine organization registered with the state government in California. It was established after more than a year of arduous preparation and had 15 founding members. Over time, it evolved into the biggest organization of Chinese medicine and acupuncture in California. And in 2015, it became the American Association of Chinese Medicine and Acupuncture with more than 500 members.
A Comparative Research of Two English Translations of the Chapter “Comprehensive Discourse on Phenomena Corresponding to Yin and Yang” in Huangdi's Internal Classic
Authors: Zhou Zhi-Wei , Li Yan-Qing , Li Hai-Ying
Published: July 2022

Culture-loaded words refer to words with specific cultural connotations that can express an abstract or a specific concept, which may be related to religious beliefs or social customs, but do not exist in other languages and cultures. Therefore, culture-loaded words bring some difficulties to translation work. Huang Di Nei Jing (《黄帝内经》 Huangdi's Internal Classic) is the foundation of traditional Chinese medicine (TCM) theory, and is listed as the first of the four classics of TCM. It contains a large number of culture-loaded words, which embody the ancient Chinese traditional culture. The translation of culture-loaded words is a difficult but crucial point in the translation of Huangdi's Internal Classic and directly relates to the quality of the translation of Huangdi's Internal Classic as a whole. Taking the two English versions of Maoshing Ni and Li Zhaoguo as examples, this work identifies the culture-loaded words appearing in the chapter “Yin Yang Ying Xiang Da Lun” (阴阳应象大论 Comprehensive Discourse on Phenomena Corresponding to the Yin and Yang). This work studies the strategies and translation process of culture-loaded words in Huangdi's Internal Classic, with a view to contribute to the English translation of TCM classics.
Confucian Medicine: A Medical Handbook of 19th Century England
Authors: Feng Yu-Rong , Wu Xue-Mei
Published: July 2022

This article takes the “A Medical Handbook” as an example to try to reveal how Western missionaries and Chinese translators jointly translated Western medical knowledge when it was introduced into the East during the 19th century. In this process, the fusion of Chinese and Western medical knowledge led to the Chinese version of A Medical Handbook. Not only did Western missionaries unilaterally promote their medical knowledge, but Chinese local elites also played an indispensable role in the dissemination of Western medical knowledge. In the early days of Western knowledge spreading into China, Western medical knowledge was incorporated into the knowledge pedigree of traditional Chinese medicine to a certain extent, which enabled the Chinese public to accept the use of Western medicine. The collision between Chinese and Western cultures at the level of medical knowledge affected the integration of Western medical knowledge systems into the local Chinese medical knowledge system.
Progress of Research on Aṣtāṅgahṛdaya Saṃhitā
Authors: Zhang Li-Ying , Wang Xing-Yi
Published: July 2022

Aṣtāṅgahṛdaya Saṃhitā (Compendium of the Essence of the Eight Branches)is one of the most important works on Ayurvedic medicine from ancient India. It provides a comprehensive overview and synthesis of Ayurvedic theories from different schools of thought. With concise and clear contents, it was an essential textbook for Ayurvedic medicine in India and many other regions at the time it was written. This article summarizes the main contents of the book, reviews the current status of research, and finds that the modern research on Aṣtāṅgahṛdaya Saṃhitā focuses on religious philosophy, the theory of bodily humors, discussion of drug use, and its relationship with Chinese medicine. The book was widely disseminated in the areas surrounding India and influenced Tibetan and Arabic medicine, as well as multiethnic medicine along the Silk Road.
Systematic Review and Meta-Analysis on the Effect of Transdermal Preparations of Sinomenium Acutum on Rheumatoid Arthritis
Authors: Du Si-Si , Fu Qin-Hui , Pei Jian , Zhou Hua
Published: July 2022

Objective:

We evaluated the efficacy and safety of transdermal preparations of Sinomenium acutum (SA) for rheumatoid arthritis (RA).

Methods:

Randomized controlled trials (RCTs) of SA transdermal preparations for RA were extracted from relevant databases and screened in accordance with the inclusion criteria. The Cochrane System Evaluation Manual (version 5.1.0) was used to assess the quality of the included trials. We used the Cochrane Review Manager (version 5.4) to conduct the meta-analysis.

Results:

Six trials comprising 436 patients (220 patients in the treatment group and 216 patients in the control group) were analyzed. The meta-analysis indicated that SA transdermal preparations in combination with disease-modifying antirheumatic drugs (DMARDs) enhanced the overall effect (odds ratio [OR] 3.97, 95% confidence interval [CI] [2.25, 7.00], P<0.00001), decreased visual analogue scale (VAS) results (mean difference [MD] –0.64, 95% CI [–1.20, –0.09], P=0.02), decreased laboratory indexes including the erythrocyte sedimentation rate (ESR) (MD –4.36, 95% CI [–5.63, –3.08], P<0.00001) and C-reactive protein (CRP) (MD –3.6, 95% CI [–3.99, –3.21, P<0.00001]), and decreased the Disease Activity Score-28 (DAS28) (MD –0.41, 95% CI [–0.78, –0.03], P=0.03). The results suggest that combination therapy did not shorten the duration of morning stiffness (DMS; standardized MD [SMD] –6.13, 95% CI [–17.33, 5.06], P=0.28) or reduce rheumatoid factor (RF) laboratory indexes (SMD –0.85; 95% CI [–2.19, 0.49], P=0.21). Only one study reported adverse reactions, and thus, it was difficult to determine whether adverse drug reactions in the combination therapy group were significantly different from those in the control group.

Conclusion:

We found that SA transdermal preparations combined with DMARDs may have greater clinical efficacy than DMARDs for RA. More well-designed and high-quality RCTs are required to verify the findings and determine whether transdermal preparations cause fewer adverse events.
Discussion of Medicine and Religion: Study of Missionary Hospitals in Modern Shanghai, China
Authors: Chen Lyu-Hua , Chen Li-Yun
Published: July 2022

In modern times, 15 missionary hospitals were established in Shanghai, including 6 Protestant hospitals and 9 Catholic hospitals. These hospitals were the products of Western missionaries in China. The establishment of missionary hospitals objectively introduced Western medicine into China and changed its original medical system. Based on documents and periodicals, Shanghai archives, Xujiahui library materials, hospital historical records, and domestic and foreign library historical materials, this paper systematically reviews the development of missionary hospitals in Shanghai, and discusses their balance between medicine and religion, to provide ideas and references for future research.
Case report: novel mutations of NDUFS6 and NHLRC2 genes potentially cause the quick postnatal death of a Chinese Hani minority neonate with mitochondrial complex I deficiency and FINCA syndrome
Authors: Li Yangfang , Zhang Yu , Jiang Gengpan , Wang Yan , He Canlin , Zhao Xiaofen , Liu Ling , Li Li
Published: July 2022

Introduction:

Mitochondrial complex I deficiency (MCID) and abbFINCA syndrome are lethal congenital diseases and cases in the neonatal period are rarely reported. Here, we identified a Chinese Hani minority neonate with rare MCID and FINCA syndrome. This study was to analyze the clinical manifestations and pathogenic gene variations, and to investigate causes of quick postnatal death of patient and possible molecular pathogenic mechanisms.

Patient concerns:

A 17-day-old patient had reduced muscle tension, diminished primitive reflexes, significantly abnormal blood gas analysis, and progressively increased blood lactate and blood glucose. Imaging studies revealed pneumonia, pulmonary hypertension, and brain abnormalities.

Diagnosis:

Whole-exome sequencing revealed that the NDUFS6 gene of the patient carried c. 344G > T (p.C115F) novel homozygous variation, and the NHLRC2 gene carried c. 1749C > G (p.F583L) and c. 2129C > T (p.T710M) novel compound heterozygous variation.

Interventions and outcomes:

The patient was given endotracheal intubation, respiratory support, high-frequency ventilation, antishock therapy, as well as iNO and Alprostadil to reduce pulmonary hypertension and maintain homeostatic equilibrium. However, the patient was critically ill and died in 27 days.

Conclusion:

The patient has MCID due to a novel mutation in NDUFS6 and FINCA syndrome due to novel mutations in NHLRC2, which is the main reason for the rapid onset and quick death of the patient.