bluuebunny/crossref_metadata_2025 huggingface dataset:
Structure of cosmic web in non-linear regime: the nearest neighbour and spherical contact distributions
Authors: Ansari Fard Mohammad , Baghkhani Zahra , Ghodsi Laya , Taamoli Sina , Hassani Farbod , Baghram Shant
Published: January 2022

In non-linear scales, the matter density distribution is not Gaussian. Consequently, the widely used two-point correlation function is not adequate anymore to capture the matter density field’s entire behaviour. Among all statistics beyond correlation functions, the spherical contact (or equivalently void function), and nearest neighbour distribution function seem promising tools to probe matter distribution in non-linear regime. In this work, we use haloes from cosmological N-body simulations, galaxy groups from the volume-limited galaxy group and central galaxies from mock galaxy catalogues, to compare the spherical contact with the nearest neighbour distribution functions. We also calculate the J-function (or equivalently the first conditional correlation function), for different samples. Moreover, we consider the redshift evolution and mass-scale dependence of statistics in the simulations and dependence on the magnitude of volume-limited samples in group catalogues as well as the mock central galaxies. The shape of the spherical contact probability distribution function is nearly skew-normal, with skewness and kurtosis being approximately 0.5 and 3, respectively. On the other hand, the nearest neighbour probability distribution function is nearly lognormal, with logarithmic skewness and kurtosis being approximately 0.1 and 2.5, respectively. Accordingly, the spherical contact distribution function probes larger scales compared to the nearest neighbour distribution function, which is influenced by details of structures. We also find a linear relation between the mean and variance of the spherical contact probability distribution function in simulations and mock galaxies, which could be used as a distinguishing probe of cosmological models.
Correlated orientations of the axes of large quasar groups on Gpc scales
Authors: Friday Tracey , Clowes Roger G , Williger Gerard M
Published: January 2022

Correlated orientations of quasar optical and radio polarization, and of radio jets, have been reported on Gpc scales, possibly arising from intrinsic alignment of spin axes. Optical quasar polarization appears to be preferentially either aligned or orthogonal to the host large-scale structure, specifically large quasar groups (LQGs). Using a sample of 71 LQGs at redshifts 1.0 ≤ z ≤ 1.8, we investigate whether LQGs themselves exhibit correlated orientation. We find that LQG position angles (PAs) are unlikely to be drawn from a uniform distribution (p-values 0.008 ≲ p ≲ 0.07). The LQG PA distribution is bimodal, with median modes at $\bar{\theta }\sim 45\pm 2^{\circ }, 136\pm 2^{\circ }$, remarkably close to the mean angles of quasar radio polarization reported in two regions coincident with our LQG sample. We quantify the degree of alignment in the PA data, and find that LQGs are aligned and orthogonal across very large scales. The maximum significance is $\simeq 0.8{{\ \rm per\ cent}}$ (2.4σ) at typical angular (proper) separations of ∼30° (1.6 Gpc). If the LQG orientation correlation is real, it represents large-scale structure alignment over scales larger than those predicted by cosmological simulations and at least an order of magnitude larger than any so far observed, with the exception of quasar-polarization/radio-jet alignment. We conclude that LQG alignment helps explain quasar-polarization/radio-jet alignment, but raises challenging questions about the origin of the LQG correlation and the assumptions of the concordance cosmological model.
The saturation of the VSI in protoplanetary discs via parametric instability
Authors: Cui Can , Latter Henrik N
Published: January 2022

The vertical shear instability (VSI) is a robust and potentially important phenomenon in irradiated protoplanetary discs (PPDs), yet the mechanism by which it saturates remains poorly understood. Global simulations suggest that the non-linear evolution of the VSI is dominated by radially propagating inertial wavetrains (called ‘body modes’), but these are known to be susceptible to a parametric instability. In this paper, we propose that the global VSI saturates via this secondary instability, which initiates a redistribution of energy from the large scales to smaller scale inertial waves, and finally into a turbulent cascade. We present an analytic theory of the instability in a simple idealized model that captures the main physical and mathematical details of the problem. In addition, we conduct numerical simulations with the snoopy code to consolidate the theory. We argue that it is challenging to capture parametric instability in global simulations unless the radial resolution is very fine, possibly ∼300 grid cells per scale height in radius; thus the VSI is likely far more disordered and incoherent than current global simulations suggest.
Detection of the Omicron Variant Virus With the Abbott BinaxNow SARS-CoV-2 Rapid Antigen Assay
Authors: Regan James , Flynn James P , Choudhary Manish C , Uddin Rockib , Lemieux Jacob , Boucau Julie , Bhattacharyya Roby P , Barczak Amy K , Li Jonathan Z , Siedner Mark J
Published: January 2022

We assessed the ability of the BinaxNow rapid test to detect severe acute respiratory syndrome coronavirus 2 antigen from 4 individuals with Omicron and Delta infections. We performed serial dilutions of nasal swab samples, and specimens with concentrations of ≥100 000 copies/swab were positive, demonstrating that the BinaxNow test is able to detect the Omicron variant.
Sympathetic Blocks for Raynaud’s Phenomena in Pediatric Rheumatological Disorders
Authors: Punj Jyotsna , Garg Heena , Gomez Gaurav , Bagri Narendra Kumar , Thakur Jay Prakash , Singh Longjam Darendrajit , Jain Dhruv , Darlong V , Pandey R
Published: January 2022

Objective

Sympathetic blocks are invaluable to prevent morbidity from Raynaud’s phenomenon (RP). RP may occur in children with rheumatological disorders and causes severe pain, discoloration of digits, gangrene, and auto-amputation. We describe the planning and execution of sympathectomy blocks in children with rheumatological disorders presenting with RP.

Methods

With upper-limb involvement, ultrasound-guided stellate ganglion block (USGB) was given with ropivacaine and clonidine. When all four limbs were involved, intrathecal block with bupivacaine and clonidine was also given.

Results

A total of 68 sympathectomy blocks were performed: 28 bilateral USGBs, two unilateral USGBs, and 10 intrathecal injections. Multiple interventions in a single day were frequently required. For safety, all USGBs were performed with an ultrasound with strict adherence to local anaesthetic volume was maintained, with periprocedure monitoring of 2–3 hours. All blocks were performed by an experienced specialist. All children reported immediate pain relief with prevention of major amputation.

Conclusion

With meticulous planning, monitoring, and precautions, sympathectomy of limbs in pediatric rheumatological disorders with RP can be safely undertaken. Bilateral stellate ganglion block with ultrasound is safe in children, and clonidine is a useful adjunct for vasodilation and prolongation of the effect of sympathectomies in children.
Myocardial fibrosis and arrhythmic burden in systemic sclerosis
Authors: Ross Laura , Costello Benedict , Brown Zoe , Hansen Dylan , Lindqvist Anniina , Stevens Wendy , Burns Andrew , Prior David , Nikpour Mandana , La Gerche André
Published: January 2022

Objectives

Cardiac complications of SSc are a leading cause of SSc-associated death. Cardiac imaging for identifying substrate abnormality may be useful in predicting risk of cardiac arrhythmias or future cardiac failure. The aim of this study was to quantify the burden of asymptomatic fibro-inflammatory myocardial disease using cardiac magnetic resonance imaging (CMR) and assess the relationship between asymptomatic myocardial fibrosis and cardiac arrhythmias in SSc.

Methods

Thirty-two patients with SSc with no documented history of pulmonary vascular or heart disease underwent CMR with gadolinium and 24-h ambulatory ECG. Focal myocardial fibrosis was assessed using post-gadolinium imaging and diffuse fibro-inflammatory myocardial disease quantified using T1- and T2-mapping. CMR results were compared with an age- and sex-matched control group.

Results

Post-gadolinium focal fibrosis was prevalent in SSc but not controls (30% vs 0%, p < 0.01).. T1-mapping values (as a marker of diffuse fibrosis) were greater in SSc than controls [saturated recovery single-shot acquisition (SASHA): 1584 ms vs 1515 ms, P < 0.001; shortened Modified look locker sequence (ShMOLLI): 1218 ms vs 1138 ms, p < 0.001]. More than one-fifth (22.6%) of the participants had ventricular arrhythmias on ambulatory ECG, but no associations between focal or diffuse myocardial fibrosis and arrhythmias were evident.

Conclusion

In SSc patients without evidence of overt cardiac disease, a high burden of myocardial fibrosis and arrhythmias was identified. However, there was no clear association between focal or diffuse myocardial fibrosis and arrhythmias, suggesting CMR may have limited use as a screening tool to identify SSc patients at risk of future significant arrhythmias.
Gender- and age-specific rates of heart failure and other adverse cardiovascular outcomes in systemic sclerosis
Authors: Sun Guoli , Yafasova Adelina , Andersson Charlotte , McMurray John J V , Jhund Pardeep S , Docherty Kieran F , Faurschou Mikkel , Nielsen Christoffer T , Schou Morten , Gislason Gunnar H , Torp-Pedersen Christian , Fosbøl Emil L , Køber Lars , Butt Jawad H
Published: January 2022

Objective

To investigate the long-term rates of heart failure (HF) and other adverse cardiovascular outcomes, including arrhythmias, myocardial infarction, ischaemic stroke, venous thromboembolism, pulmonary hypertension and pericarditis, in SSc patients according to gender and age.

Methods

Using Danish nationwide registries, SSc patients (diagnosed from 1996 to 2018) were matched with four controls from the background population by gender, age and comorbidities. Cox regression was used to compare the rates of cardiovascular outcomes between SSc patients and controls and the rate of mortality between SSc patients developing HF and HF patients without SSc, according to gender and age (above/below median).

Results

In total, 1569 SSc patients were matched with 6276 non-SSc controls (median age 55 years, 80.4% women, median follow-up 7.3 years). SSc had a higher rate of HF in both women [HR 2.99 (95% CI 2.18, 4.09)] and men [HR 3.01 (1.83, 4.95)] (Pinteraction = 0.88), with similar trends for other cardiovascular outcomes. SSc had a higher rate of HF in patients <55 years of age [HR 4.14 (95% CI 2.54, 6.74)] and ≥55 years [HR 2.74 (1.98, 3.78)] (Pinteraction = 0.22), with similar trends for other cardiovascular outcomes. SSc patients with new-onset HF had a higher rate of mortality than HF patients without a history of SSc, irrespective of gender (Pinteraction = 0.53) and age (Pinteraction = 0.43).

Conclusions

SSc was associated with higher rates of HF and other cardiovascular outcomes than matched controls, irrespective of gender and age. Among patients with new-onset HF, a history of SSc was associated with higher mortality.
Staying vigilant during recurrent sleep restriction: dose-response effects of time-in-bed and benefits of daytime napping
Authors: Lo June Chi-Yan , Koa Tiffany B , Ong Ju Lynn , Gooley Joshua J , Chee Michael W L
Published: January 2022

Study Objectives

We characterized vigilance deterioration with increasing time-on-task (ToT) during recurrent sleep restriction of different extents on simulated weekdays and recovery sleep on weekends, and tested the effectiveness of afternoon napping in ameliorating ToT-related deficits.

Methods

In the Need for Sleep studies, 194 adolescents (age = 15–19 years) underwent two baseline nights of 9-h time-in-bed (TIB), followed by two cycles of weekday manipulation nights and weekend recovery nights (9-h TIB). They were allocated 9 h, 8 h, 6.5 h, or 5 h of TIB for nocturnal sleep on weekdays. Three additional groups with 5 h or 6.5 h TIB were given an afternoon nap opportunity (5 h + 1 h, 5 h + 1.5 h, and 6.5 h + 1.5 h). ToT effects were quantified by performance change from the first 2 min to the last 2 min in a 10-min Psychomotor Vigilance Task administered daily.

Results

The 9 h and the 8 h groups showed comparable ToT effects that remained at baseline levels throughout the protocol. ToT-related deficits were greater among the 5 h and the 6.5 h groups, increased prominently in the second week of sleep restriction despite partial recuperation during the intervening recovery period and diverged between these two groups from the fifth sleep-restricted night. Daytime napping attenuated ToT effects when nocturnal sleep restriction was severe (i.e. 5-h TIB/night), and held steady at baseline levels for a milder dose of nocturnal sleep restriction when total TIB across 24 h was within the age-specific recommended sleep duration (i.e. 6.5 h + 1.5 h).

Conclusions

Reducing TIB beyond the recommended duration significantly increases ToT-associated vigilance impairment, particularly during recurrent periods of sleep restriction. Daytime napping is effective in ameliorating such decrement.

Clinical Trial Registration

NCT02838095, NCT03333512, and NCT04044885.
Immuno-phenotyping of Canadian beef cattle: adaptation of the high immune response methodology for utilization in beef cattle
Authors: Husseini Nasrin , Beard Shannon C , Hodgins Douglas C , Barnes Christy , Chik Elfleda , Mallard Bonnie A
Published: January 2022

The high immune response (HIR) methodology measures the genetic performance of the adaptive immune system to identify and breed animals with balanced and robust immunity. The HIR methodology has previously been used in dairy and swine to reduce disease but has not been fully investigated in beef cattle. The first objective of the current study was to examine whether the HIR methodology as standardized for use in dairy cattle was appropriate for use in beef cattle. The second objective was to determine the earliest age for immune response phenotyping of beef calves. In this study, beef calves (n = 295) of various ages, as well as mature beef cows (n = 170) of mixed breeds, were immunized using test antigens to assess their antibody- (AMIR) and cell-mediated immune responses (CMIR). Heritability for AMIR and CMIR was estimated at 0.43 and 0.18, respectively. The HIR methodology was appropriate for use in beef cattle; beef calves as young as 2–3 wk of age were capable of mounting AMIR responses comparable with those seen historically in mature Holstein dairy cows. Three-week-old beef calves mounted CMIR responses comparable with those of Holstein cows, but 9-mo-old calves and mature beef cows had significantly higher CMIR responses than Holsteins. The HIR methodology can be used to measure both AMIR and CMIR in beef calves as young as 3 wk of age.
Extra-branchial processes manifest extra diversity: systematics of the genusTrapania(Nudibranchia: Goniodorididae) and nine new species descriptions
Authors: Smirnoff Dimitri S , Donohoo Samantha A , Gosliner Terrence M
Published: January 2022

Trapania is a genus of dorid nudibranchs and one of the lesser studied members in the family Goniodorididae. Previous studies have been limited to using morphological data for producing phylogenies and establishing species relationships. This study presents the first molecular phylogeny for the genus Trapania with the goal of resolving questions that surfaced in previous morphological studies and enhancing our understanding of Trapania clade structure and species relationships. Bayesian inference, maximum likelihood and two types of species delimitation analyses reveal 15 previously described species and nine new species, which are described: Trapania kahel sp. nov., Trapania kamagong sp. nov., Trapania kanaloa sp. nov., Trapania lemanioides sp. nov., Trapania stegodon sp. nov., Trapania tamaraw sp. nov., Trapania tatsulok sp. nov., Trapania tigger sp. nov. and Trapania undulata sp. nov. Preliminary evidence presented here suggests that Atlantic and eastern Pacific species form a distinct clade and diverged from ancestors that were more widespread. An Indo-Pacific clade is sister to this clade, but stronger support and broader taxon sampling are required to test this hypothesis.
FDA Warns Against Using Needle-Free Injection Devices For Dermal Fillers
Authors: Aschenbrenner Diane S.
Published: January 2022

The Food and Drug Administration (FDA) has issued a safety communication to warn the public and health care professionals not to use needle-free devices for injection of dermal fillers. These devices are not approved by the FDA. FDA-approved dermal fillers are for prescription use only with a syringe and either a needle or cannula.

Nurses should inform patients not to purchase any needle-free devices or products over the internet. Adverse effects from these devices should be reported to the FDA's MedWatch system.
New Naloxone Concentration Treats Opioid Overdose
Authors: Aschenbrenner Diane S.
Published: January 2022

The Food and Drug Administration has approved another injectable form of naloxone in the effort to control opioid deaths. Zimhi is a single-dose prefilled syringe containing 5 mg/0.5 mL of naloxone. Zimhi is administered subcutaneously or intramuscularly.

Nurses should educate patients receiving opioids and their families on how to use Zimhi or other prescribed naloxone products.
Employer Vaccine Mandates
Authors: Brous Edie
Published: January 2022

What nurses need to know as hospitals institute COVID-19 vaccine mandates.
One-Day Workshop Beneficial for Postpartum Depression
Authors: Rosenberg Karen
Published: January 2022

According to this study:

An online one-day workshop based on cognitive behavioral therapy, in addition to treatment as usual, improves postpartum depression, anxiety, social support, the mother–infant relationship, and infant temperament.

Online one-day workshops for postpartum depression could be an efficient means of improving treatment access and reducing symptoms.
Preemptive Intervention Beneficial for Infants with Early Signs of Autism
Authors: Rosenberg Karen
Published: January 2022

According to this study:

A preemptive intervention in infants showing early behavioral signs of autism spectrum disorder led to a significant reduction in the severity of these behaviors and lower odds of a diagnosis at age three.
A Conversation with Abigail Matos-Pagán
Authors: Fauteux Nicole
Published: January 2022

An expert in disaster nursing discusses COVID-19, Hurricane Maria, and emergency preparedness.
Variation in Functional Mobility Within Gross Motor Function Classification System Levels
Authors: Rethlefsen Susan A. , Hanson Alison M. , Ciccodicola Eva , Wren Tishya A.L. , Kay Robert M.
Published: January 2022

Background and Objective:

Variation in walking performance within Gross Motor Function Classification System (GMFCS) levels for patients with cerebral palsy (CP) is often unrecognized. The Functional Mobility Scale (FMS) rates mobility at household, school, and community distances. This study evaluated the variability of walking performance within GMFCS levels as measured by the FMS.

Methods:

Retrospective review of gait analysis records for ambulatory patients with CP. FMS rating distribution at each distance was examined for GMFCS levels I-IV within age groups (below 12 or above 12 y) and compared among levels using χ2 tests.

Results:

A total of 788 patients (499 male; age 11.2, SD 3.9 y) were included. FMS score distribution differed significantly among GMFCS levels for all distances (P<0.001).

GMFCS Level:

I—Children walked independently on all surfaces at home and school distances at all ages. In all, 5% to 7% used wheeled mobility in the community. II—Most walked at home and school distances. Some younger children crawled at home, and 5% to 8% of all subjects used walls and furniture. Approximately 50% of subjects in both age groups used some form of walking aids or a stroller/wheelchair in the community. III—Twenty-five percent to 30% walked unaided at home, requiring walking aids or wheeled mobility at school or in the community. Forty-five percent of younger and 18% of older subjects crawled at home. Eight percent of younger and 28% of older subjects used wheelchairs at school. Seventy-three percent to 75% of all subjects used strollers/wheelchairs in the community. IV—Sixty-two percent of younger and 43% of older subjects crawled at home. Approximately 15% of all subjects did some aided walking at home. Twenty-seven percent of younger children did some aided walking at school, while only 1 older subject did so. All used strollers/wheelchairs in the community.

Conclusion:

Mobility function varies within each GMFCS level with the most variability in GMFCS II at school and community distances and GMFCS III at household distances. These findings highlight the importance of using both the GMFCS and FMS when assessing functional mobility in children with CP.

Level of Evidence:

Level III—retrospective study.
A Novel Internal Negative Pressure Delivery System in Prepectoral Breast Reconstruction—Preliminary Experience
Authors: Paul Robert
Published: January 2022

Background:

Seroma remains a common complication after breast surgery, despite meticulous surgical technique to obliterate dead space and use of standard postsurgical drains for fluid evacuation. Therefore, novel approaches are needed. The Interi System is an internal, negative-pressure delivery system consisting of a manifold that is a silicone tubing with a central trunk and three peel-apart channeled branches connected to an external therapy unit, which simultaneously delivers continuous negative pressure of 125 mm Hg and removes excess fluid from internal tissue planes. This retrospective study evaluated the safety and effectiveness of Interi compared with standard drains in consecutive patients undergoing immediate, prepectoral, acellular dermal matrix-assisted, and implant-based breast reconstruction.

Methods:

Patient records were reviewed, and data on demographics, mastectomy, and reconstructive variables, postoperative complications, fluid output volume, and manifold/drain duration were retrieved and compared between the two groups.

Results:

Interi was used in 23 patients (38 breasts) and standard drains in 23 patients (39 breasts). Patients in both groups were well matched in all demographic, reconstructive, and mastectomy variables. Interi duration was significantly shorter than drains (16.7 versus 19.7 days; P = 0.020). There were no instances of seroma formation after removal of the manifold, edematous flap, or reconstructive failure with Interi. Seroma rate was 20.5% after drain removal (P = 0.005). All other complications were similar between the two groups.

Conclusion:

Interi effectively removed excess fluid from internal tissue compartments in prepectoral breast reconstruction and may offer significant improvement over current standards of care for seroma prevention in this procedure.
The Effect of the Coal Industry on Indoor Radon Concentrations in eMalahleni, Mpumalanga Province of South Africa
Authors: le Roux Rikus
Published: January 2022

South Africa has rich coal deposits concentrated in the northeast of the country, and as a result, most of the country’s coal mining is located in this region. Two of the principal coalfields exploited are the Witbank and Highveld coalfields, located in the Mpumalanga province. Coal contains trace quantities of the naturally occurring radionuclides whose mass concentration can be enhanced by anthropogenic activity. The radioactive fallout from these activities could lead to elevated radon concentrations indoors. Two towns, Secunda and eMalahleni, were identified due to their proximity to coal-based industries. A previous study investigated whether these industries caused elevated radon levels in Secunda homes but found a lower-than-expected average concentration of 76.4 ± 7.6 Bq m−3. This was attributed to either the prevailing wind depositing the radioactive fallout to neighboring towns, such as eMalahleni, or the type of industrial activity. This paper builds on this study by investigating whether elevated radon levels are found in homes in eMalahleni. Measurements were performed in 22 homes during December 2019, and the average indoor radon concentration was calculated as 122.1 ± 8.5 Bq m−3. The cause of these elevated levels was then investigated, and it was found that even though the coal industry contributes to elevated radon levels, the town’s underlying geology seems to be the primary contributor.
Radiopharmaceutical Extravasation: Pragmatic Radiation Protection
Authors: Fisher Darrell R. , Liverett Misty
Published: January 2022

Inadvertent injection of a radiopharmaceutical agent into a patient's arm tissue instead of into the appropriate blood vessel can cause the injection to infiltrate underlying tissue and produce a potentially substantial, localized irradiation to the patient's arm and skin tissue. When this type of misadministration occurs, called an extravasation, it should be recognized, mitigated, and monitored for patient health and safety. Immediate symptoms of radiopharmaceutical extravasation may include swelling, edema, pain, or numbness in the vicinity of the extravasation site; inflammation; and drainage from the site. Some infiltrations may go unnoticed until later. Pragmatic elements of radiation safety include imaging to assess the geometry, volume, and anatomic distribution of activity, collection of tissue count-rate data over retention times, calibration against known activity levels, and dosimetry to help clinicians determine whether an extravasation is severe and whether the patient should be followed for adverse tissue reactions.
Glaucoma Progression After Lens Extraction in Primary Angle-closure Glaucoma According to Angle-closure Mechanism
Authors: Song Min Kyung , Sung Kyung Rim , Shin Joong Won
Published: January 2022

Précis:

Long-term prognosis of primary angle-closure was assessed after lens extraction (LE) according to different mechanisms of angle closure (AC). Patients with pupillary block (PB) had a higher probability of glaucomatous progression than patients with plateau iris configuration (PIC).

Purpose:

The aim was to investigate and compare the clinical characteristics and long-term prognosis of primary angle-closure disease (PACD) after LE according to different mechanisms of AC.

Methods:

In this retrospective observational cohort study, 118 eyes with PACD that underwent LE (mean follow-up; 6.0±3.5 y after surgery) were included. PACD eyes were categorized into three subgroups according to their dominant AC mechanisms, determined by anterior segment optic coherent tomography obtained before LE; PB, PIC, and exaggerated lens vault (ELV). Postoperative glaucomatous progression was determined according to functional (visual field) or structural (optic disc photographs or optic coherent tomography measured retinal nerve fiber layer thickness) criteria. Univariate and multivariate logistic regression analysis was performed to determine the risk factors associated with glaucomatous progression.

Results:

Fifty-two, 51, and 15 eyes with PB, PIC, and ELV, respectively, were included. All eyes showed significant intraocular pressure reduction, with a greater reduction in the ELV group than in the PB group after LE (27.0% vs. 12.5%, P=0.018). Lower baseline retinal nerve fiber layer thickness [odds ratio (OR): 0.966, P=0.004] and thinner central corneal thickness (OR: 0.985, P=0.021), and the PB group (OR: 2.891, P=0.022, reference to PIC group) were significantly associated with glaucomatous progression after LE.

Conclusions:

In eyes with PACD, glaucoma progression was observed following LE despite reduced intraocular pressure. The probability of progression was highest in eyes with pupil block as a mechanism of AC. Close monitoring of glaucoma in these patients is suggested.
How do placebo effects contribute to mindfulness-based analgesia? Probing acute pain effects and interactions using a randomized balanced placebo design
Authors: Davies Jonathan N. , Sharpe Louise , Day Melissa A. , Colagiuri Ben
Published: January 2022

Recent sham-controlled studies suggest placebo effects contribute to acute pain relief after mindfulness interventions. However, the specific effects of mindfulness processes and their interaction with placebo effects remain unclear. This study aimed to characterize the role of mindfulness and placebo processes underlying mindfulness-based pain attenuation. Both treatment (focused attention mindfulness vs sham) and instruction (told mindfulness vs told sham) were manipulated in a balanced placebo design. Changes in acute heat pain were evaluated in 153 healthy adults randomized to receive 6 × 20 minutes of 1 of 4 treatment by instruction interventions or no treatment. Participants receiving any intervention demonstrated improved pain outcomes (unpleasantness, intensity, and tolerance) relative to those receiving no treatment. The instruction manipulation increased expectation for pain relief in those told mindfulness relative to those told sham, but there were no main effects or interactions of treatment or instruction on pain outcomes. However, irrespective of actual intervention received, the belief of receiving mindfulness predicted increased pain threshold and tolerance, with expectancy fully mediating the effect on pain tolerance. These findings suggest a lack of specific effects of mindfulness and instruction on acute pain. Nonetheless, participants' expectancies and beliefs about the treatment they received did predict pain relief. Together with the overall improvement after any intervention, these findings suggest that expectancy and belief may play a stronger role in attenuating acute pain in novices following brief mindfulness interventions than the actual mindfulness-specific processes or instructions delivered.
Individually unique dynamics of cortical connectivity reflect the ongoing intensity of chronic pain
Authors: Mayr Astrid , Jahn Pauline , Deak Bettina , Stankewitz Anne , Devulapally Vasudev , Witkovsky Viktor , Dietrich Olaf , Schulz Enrico
Published: January 2022

Chronic pain diseases are characterised by an ongoing and fluctuating endogenous pain, yet it remains to be elucidated how this is reflected by the dynamics of ongoing functional cortical connections. In this study, we investigated the cortical encoding of 20 patients with chronic back pain and 20 chronic migraineurs in 4 repeated fMRI sessions. A brain parcellation approach subdivided the whole brain into 408 regions. Linear mixed-effects models were fitted for each pair of brain regions to explore the relationship between the dynamic cortical connectivity and the observed trajectory of the patients' ratings of fluctuating endogenous pain. Overall, we found that periods of high and increasing pain were predominantly related to low cortical connectivity. The change of pain intensity in chronic back pain was subserved by connections in left parietal opercular regions, right insular regions, as well as large parts of the parietal, cingular, and motor cortices. The change of pain intensity direction in chronic migraine was reflected by decreasing connectivity between the anterior insular cortex and orbitofrontal areas, as well as between the PCC and frontal and anterior cingulate cortex regions. Of interest, the group results were not mirrored by the individual patterns of pain-related connectivity, which rejects the idea of a common neuronal core problem for chronic pain diseases. The diversity of the individual cortical signatures of chronic pain encoding results adds to the understanding of chronic pain as a complex and multifaceted disease. The present findings support recent developments for more personalised medicine.
Early Perinatal Workforce Adaptations to the COVID-19 Pandemic
Authors: Vanderlaan Jennifer , Woeber Kate
Published: January 2022

The objective of this study was to describe the system's initial pandemic response from the perspectives of perinatal health workers and to identify opportunities for improved future preparedness. An exploratory survey was designed to identify perinatal practice changes and workforce challenges during the initial weeks of the COVID-19 pandemic. The survey included baseline data collection and weekly surveys. A total of 181 nurses, midwives, and physicians completed the baseline survey; 84% completed at least 1 weekly survey. Multiple practice changes were reported. About half of respondents (50.8%) felt the changes protected patients, but fewer (33.7%) felt the changes protected themselves. Most respondents providing out-of-hospital birth services (91.4%) reported increased requests for transfer to out-of-hospital birth. Reports of shortages of personnel and supplies occurred as early as the week ending March 23 and were reported by at least 10% of respondents through April 27. Shortages were reported by as many as 38.7% (personal protective equipment), 36.8% (supplies), and 18.5% (personnel) of respondents. This study identified several opportunities to improve the pandemic response. Evaluation of practice changes and timing of supply shortages reported during this emergency can be used to prepare evidence-based recommendations for the next pandemic.
Breastfeeding Practices During the SARS-CoV-2 Pandemic Were Influenced by Women's Life Event
Authors: Duru Pınar , Başaran Fatma , Örsal Özlem
Published: January 2022

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, which affects the whole world, negatively affects breastfeeding mothers and newborns. This study aimed to evaluate the breastfeeding practices influenced by women's life events and the breastfeeding women compliance with the rules established against the risk of SARS-CoV-2. This prospective cross-sectional online survey design study was carried out on 339 breastfeeding mothers between April 21 and May 10, 2020, in Turkey. Data were collected by an information form and the Impact of Events Scale-Revised (IES-R); 39.2% of breastfeeding mothers were traumatically affected by events experienced as a result of the pandemic. Study results reveal that breastfeeding mothers concerned about the risk of SARS-COV-2 transmission to their infants through human milk or breastfeeding. Noncompliance with SARS-CoV-2 measures among breastfeeding women was high. Policymakers and healthcare providers should not ignore this situation. It may be beneficial to conduct consciousness-raising and awareness studies to increase the compliance ratios of breastfeeding women with the recommended measures to prevent SARS-CoV-2 transmission.
What Neonatal Intensive Care Nurses Have Experienced in COVID-19 Pandemic in Turkey
Authors: Karakul Atiye , Doğan Pınar , Gümüş İsmailcan , Yilmaz Halime , Dorum Bayram Ali
Published: January 2022

Neonatal intensive care nurses have faced additional difficulties in adapting to a new work environment with a stressful situation brought about by the pandemic. The aim of this study is to evaluate the experiences of nurses working in neonatal intensive care units during the coronavirus disease-2019 (COVID-19) pandemic. Experiences were determined using phenomenology, a form of qualitative research. The study involved 14 neonatal intensive care nurses. The data were analyzed on the MAXQDA qualitative data analysis software in accordance with Colaizzi's 7-step method. Four themes were identified after the interviews: the experiences related to working conditions, neonatal care, psychosocial effect, and social life. In addition, 17 subthemes were created. The study revealed that neonatal intensive care nurses experienced physical, psychological, and social difficulties during the COVID-19 pandemic. It is thought that these results have become even more important to reduce the workload of nurses and to increase the quality of nursing care, especially in times of crisis such as pandemics.
Effectiveness of different acupuncture therapies for chronic cancer pain
Authors: Wan Qingyun , Chen Hao , Wang Xiaoqiu , Xi Hanqing , Zheng Shiyu , Luo Shuting , Wu Wenzhong , Pan Rui
Published: January 2022

Background:

Pain is a common and distressing symptom experienced by cancer patients. Previous research found acupuncture was associated with significant reductions in pain intensity and opioid use. Acupuncture therapies are various, and the difference in efficacy and safety has never been assessed. This paper aims to assess and rank the effectiveness of the different acupuncture methods and provide an acupuncture treatment guideline for relieving chronic pain in cancer survivors.

Methods:

Four English databases (PubMed, Embase, Cochrane library, and Web of Science) and 4 Chinese databases (China National Knowledge Infrastructure, Wanfang Data, and Chinese Biomedical Literature Database) will be searched for randomized controlled trials (RCTs) published from the database inception to November 30, 2021. The primary outcomes will be patient-reported pain intensity measured by the Brief Pain Inventory, Visual Analog Scale, Verbal Rating Scale, Numerical Rating Scale, and other valid outcome measures. The Grading of Recommendations Assessment, and Development and Evaluation System will evaluate the quality of evidence. Bayesian network meta-analysis will be performed in WinBUGS V.1.4.3 to determine the comparative effectiveness of the acupuncture therapies.

Results:

This study will quantify the effectiveness of each acupuncture intervention for chronic cancer pain with pain scores and the use of analgesics. The adverse events of acupuncture treatment for cancer pain will also be reported.

Conclusion:

The conclusion of our study will help physicians and patients choose suitable acupuncture methods to manage cancer pain.
Cyclosporin-A reduced the cytotoxicity of propranolol in HUVECs via p38 MAPK signaling
Authors: Lv Zhong , Xie Guanhao , Cui Haowen , Yao Zhi , Shao Congxiang , Yuan Weiquan , Chen Bailing
Published: January 2022

Propranolol (PROP) is a nonselective β-adrenergic receptor antagonist used to treat hypertension and cardiac arrhythmias. Oral administration of PROP has recently emerged as a new treatment modality for hemangiomas. However, the side effects of PROP at the cellular level have not been adequately described.

The present study investigates and highlights the mechanisms of coupling of the drugs cyclosporin-A (CyA) and PROP on cell proliferation and the occurrence of apoptosis. It also relays the antioxidant effect of PROP on human umbilical vein endothelial cells (HUVECs).

HUVECs were treated with CyA and PROP. At 24 hours after treatment, the levels of reactive oxygen species (ROS), cell proliferation, and apoptosis were determined using the ROS kit, MTT assay, and Annexin V staining. In addition, the related proteins of phospho-p38 mitogen-activated protein kinase were determined by western blotting. Subsequently, HUVECs pretreated with CyA or PROP were treated with the p38 inhibitor (SB203580). Finally, the ROS level, cell proliferation, and apoptosis were measured again in both active HUVECs and HUVECs, in which the p38 proteins were inhibited.

The combination of CyA and PROP reversed the effect of CyA on cell viability, reduced the ROS level and the cell apoptosis induced by PROP. Moreover, inhibition of p38 protein catalase activity immediately stopped the effect of CyA–propranolol in HUVECs.

The effect of the CyA–propranolol combination on HUVECs is associated with the p38 pathway changes, which is proven to be a potential chemotherapeutic agent that minimizes the side effects of PROP in hemangioma therapy.
Predictive value of liver cirrhosis using metabolite biomarkers of bile acid in the blood
Authors: Han Xu , Wang Juan , Gu Hao , Liao Xing , Jiang Miao
Published: January 2022

Background:

Previous studies have indicated that the changes of bile acids are associated with liver cirrhosis. The objective of our study is to perform a systematic review to explore the relationship between bile acids and the pathologic process of cirrhosis, and to find minimally invasive, accurate and reliable potential biomarkers for predicting cirrhosis.

Methods:

EMBASE, the Cochrane Library, PubMed, Web of Science, WanFang Data and Chinese National Knowledge Infrastructure (CNKI) will be searched, using the search strategy of liver cirrhosis, bile acids and metabolomic. The screening process will be conducted strictly based on inclusion and exclusion criteria. Clinical studies based on human including randomized controlled trial, cohort study and case control study will be included without restriction of time. Cochrane collaboration's tool for assessing risk of bias and Newcastle-Ottawa Scale (NOS) will be applied to assess the risk of bias to randomized controlled trial and observational study, respectively. The bile acids and their concentrate which are different between liver cirrhosis and control group will be the mainly outcome. A qualitative analysis will be performed to profile the trajectory change of bile acids, then the meta-analysis will be done for quantitative analysis.

Results:

The bile acids profile of liver cirrhosis that has potential predictive value for cirrhosis will be identified.

Conclusion:

The conclusion of this systematic review will finding potential biomarkers for predicting cirrhosis.

Ethics and dissemination:

This systematic review is based on published researches, so there is no ethical approval required. We intend to disseminate our findings in a peer-reviewed journal.
Comparison of clinical outcome between stereotactic body radiotherapy and radiofrequency ablation for unresectable hepatocellular carcinoma
Authors: Ji Ren , Ng Kelvin K. , Chen Wenqi , Yang Weihong , Zhu Hongtao , Cheung Tan-To , Chiang Chi-Leung , Wong Tiffany C.L. , Kong Feng-Ming , Wu G. , Lo Chung-Mau
Published: January 2022

Stereotactic body radiotherapy (SBRT) is a novel noninvasive treatment for unresectable hepatocellular carcinoma (HCC). Whether its efficacy is comparable to radiofrequency ablation (RFA), a recommended therapy for unresectable HCC, is unknown. The present study aims to compare the clinical outcome between SBRT and RFA for patients with unresectable HCC.

The clinical data of 60 patients with unresectable HCC from January 2018 to January 2021 were retrospectively reviewed. There were 22 cases treated by SBRT and 38 cases by RFA. The short-term and long-term clinical outcomes were compared.

There was no significant difference in the baseline demographic characteristics between two groups. The complete remission rate at 3 months was comparable between SBRT group (81.8%) and RFA group (89.4%). Local tumor control rate was also similar between two groups (90.9% vs. 94.7%). There was no severe complication (grade IIIa or above) in both groups. The 1-year and 2-year overall survival rates were 88.2% and 85.7% in SBRT group and 100% and 75% in RFA group, respectively. There was no statistical significant difference between groups (P = .576).

SBRT can achieve similar short and long-term clinical outcome as RFA for unresectable HCC. Future prospective clinical study is needed to justify its role in patients with HCC.
Serum cadmium is associated with hepatic steatosis and fibrosis
Authors: Han Seogoo , Sung Gi-Ho , Lee Sangheun , Han Ki Jun , Han Hyun-Jeong
Published: January 2022

Although cadmium (Cd) is correlated with elevated levels of hepatic amino transferases, its influence on the degree of liver steatosis and fibrosis are unknown yet. We aimed to investigate the associations between the serum level of Cd and degree of liver steatosis/fibrosis.

Clinical data were obtained from Korean National Health and Nutrition Examination Surveys IV–VII. Alanine aminotransferase (ALT) elevation was defined as ≥ 33 IU/L for men and ≥ 25 IU/L for women. Significant steatosis was defined as a hepatic steatosis index ≥ 36, while significant fibrosis was defined as a fibrosis index (FIB-4) ≥ 2.67 and as an aspartate aminotransferase and platelet ratio index ≥ 0.7. Adjusted odds ratios and 95% confidence intervals were calculated after adjustment.

The levels of serum Cd were assessable in 15,783 subjects. The serum cadmium concentrations were significantly associated with ALT elevation, significant liver steatosis and fibrosis. Multivariate logistic regression analysis demonstrated serum Cd level in the forth quartile had a positive correlation with ALT elevation, hepatic steatosis index ≥ 36, FIB-4 ≥ 2.67 and aspartate aminotransferase-to-platelet ratio ≥ 0.7 using the first quartile of serum Cd level as the reference, (adjusted odds ratios 1.90, 1.26, 1.73, and 2.53, respectively; P values <.001).

The serum level of Cd was associated with liver steatosis and fibrosis. The evaluation of serum Cd may help for assessing an unexplained liver steatosis and fibrosis, and further prospective studies are needed to confirm our findings.
Factors affecting the duration of antibiotic use due to surgical site inflammation after complication-free classical total knee arthroplasty
Authors: Jang Jae Seok , Choi Won Kee
Published: January 2022

We researched on the factors affecting the duration of antibiotic use due to surgical site inflammation after complication-free classical total knee arthroplasty (TKA).

Four hundred and eighty-nine cases who underwent primary TKA performed by 1 surgeon from January 2015 to December 2018 were enrolled. Including the day of operation, first-generation cephalosporin was injected intravenously for 3 days for antimicrobial prophylaxis. At the third postoperative day, we inspected the surgical wound for any signs of inflammation. If there were any signs of redness, pain, heatness, or swelling, which are the cardinal signs of superficial incisional surgical site infection defined by the Centers of Disease Control (CDC), additional antibiotics were injected until the symptoms of surgical site inflammation improved. We presumed that the duration of antibiotic use was affected by factors including gender, age, body mass index, whether operating on both legs or one leg, predisposing diabetes mellitus, preoperative glomerular filtration rate, preoperative serum albumin level, prior history of anticoagulant usage including anti-platelet agents, allogenic blood transfusion during admission, and total operative time.

Average duration of intravenous antibiotic use in 489 cases was 5.73 ± 4.03 days. Pearson correlation analysis showed significant correlation (P < .01) between operative time and duration of antibiotic use due to surgical site inflammation. In univariate analysis, total operative time and transfusion were factors affecting the duration of antibiotic use due to surgical site inflammation (<6 days or ≥6 days). Multivariate analysis of age, gender, body mass index, staged bilateral TKA, diabetes mellitus, preoperative glomerulus filtration rate, preoperative albumin level, prior history of anticoagulant usage, allogenic blood transfusion during admission, and total operative time revealed that longer operative time was related to higher likelihood of antibiotic use for >6 days during admission.

When prophylactic antibiotics are prescribed, surgeons must note that signs of superficial incisional surgical site inflammation after classical complication free TKA may manifest more often in patients with longer operative time.