bluuebunny/crossref_metadata_2025 huggingface dataset:
Mechanisms for improving phosphorus utilization efficiency in plants
Authors: Han Yang , White Philip J , Cheng Lingyun
Published: December 2021

Background

Limitation of plant productivity by phosphorus (P) supply is widespread and will probably increase in the future. Relatively large amounts of P fertilizer are applied to sustain crop growth and development and to achieve high yields. However, with increasing P application, plant P efficiency generally declines, which results in greater losses of P to the environment with detrimental consequences for ecosystems.

Scope

A strategy for reducing P input and environmental losses while maintaining or increasing plant performance is the development of crops that take up P effectively from the soil (P acquisition efficiency) or promote productivity per unit of P taken up (P utilization efficiency). In this review, we describe current research on P metabolism and transport and its relevance for improving P utilization efficiency.

Conclusions

Enhanced P utilization efficiency can be achieved by optimal partitioning of cellular P and distributing P effectively between tissues, allowing maximum growth and biomass of harvestable plant parts. Knowledge of the mechanisms involved could help design and breed crops with greater P utilization efficiency.
Molecular persistent spectral image (Mol-PSI) representation for machine learning models in drug design
Authors: Jiang Peiran , Chi Ying , Li Xiao-Shuang , Meng Zhenyu , Liu Xiang , Hua Xian-Sheng , Xia Kelin
Published: December 2021

Artificial intelligence (AI)-based drug design has great promise to fundamentally change the landscape of the pharmaceutical industry. Even though there are great progress from handcrafted feature-based machine learning models, 3D convolutional neural networks (CNNs) and graph neural networks, effective and efficient representations that characterize the structural, physical, chemical and biological properties of molecular structures and interactions remain to be a great challenge. Here, we propose an equal-sized molecular 2D image representation, known as the molecular persistent spectral image (Mol-PSI), and combine it with CNN model for AI-based drug design. Mol-PSI provides a unique one-to-one image representation for molecular structures and interactions. In general, deep models are empowered to achieve better performance with systematically organized representations in image format. A well-designed parallel CNN architecture for adapting Mol-PSIs is developed for protein–ligand binding affinity prediction. Our results, for the three most commonly used databases, including PDBbind-v2007, PDBbind-v2013 and PDBbind-v2016, are better than all traditional machine learning models, as far as we know. Our Mol-PSI model provides a powerful molecular representation that can be widely used in AI-based drug design and molecular data analysis.
Recognising children’s involvement in child and family therapy sessions: A microanalysis of audiovisual recordings of actual practice
Authors: Edman Kristina , Gustafsson Anna W , Cuadra Carin B
Published: December 2021

Children’s right to involvement in practices that address their well-being is frequently highlighted, yet how children exercise involvement in face-to-face encounters has remained fairly unknown. To fulfil our aim of identifying, describing and defining children’s involvement, we conducted an inductive microanalysis of face-to-face dialogue on audiovisual recordings of naturally occurring therapy sessions with children attending social services departments and mental health clinics. The resulting operationalisation generated six dimensions of children’s involvement: participatory, directive, positional, emotional, agentive and narrative. By operationalising how children exercise involvement, we render the abstract concept more amenable to fine-grained analysis, systematic evaluation and criticism. The domains also offer tools to recognise children’s involvement in practice. Lastly, the article discusses practical implications and presents a compass for orientation. Since many conversational elements in institutional talks are generic, the dimensions are potentially transferable to other settings, including school counselling, child protection investigation and clinical psychology. A high inter-analyst agreement, together with similar findings on utterance functions and interactional dominance in other types of dialogues, also enhance the dimensions’ transferability.
Pleural effusion: a potential surrogate marker for higher-risk patients with acute type B aortic dissections
Authors: Reutersberg Benedikt , Trimarchi Santi , Gilon Dan , Kaiser Clayton , Harris Kevin , Shalhub Sherene , Reece T Brett , Nienaber Christoph , Ehrlich Marek , Isselbacher Eric , De Oliveira Nilto , Montgomery Daniel , Eagle Kim , Tolva Valerio , Chen Edward P , Eckstein Hans-Henning ,   the IRAD Investigators
Published: December 2021

OBJECTIVES

Pleural effusions (PEffs) are known to occur in type B acute aortic dissection (TBAAD). We investigated the relationship between pleural effusion and the development of early or late complications following TBAAD.

METHODS

The incidence of PEff (defined as at least an obliteration of the costophrenic angle in a frontal projection) diagnosed on their initial chest X-ray in patients with TBAAD enrolled in the International Registry of Acute Aortic Dissection was examined. We analysed in-hospital outcomes and long-term survival separately for patients with and without PEffs (PEff+ versus PEff−, respectively).

RESULTS

Included were 1252 patients with TBAAD, of whom 224 (17.9%) had PEff. Compared with patients without PEff in the initial chest X-ray, these were significantly older [mean age 67 (SD: 14.7) vs 63.4 (SD: 14.2) years, P = 0.001] and more often female (42.4% vs 34.2%, P = 0.021) and had more comorbidities (known aortic aneurysm, chronic obstructive pulmonary disease, chronic renal failure, diabetes, congestive heart failure or mitral valve disease). PEff was associated with higher in-hospital mortality (16.1% vs 9.1%, P = 0.002) and increased rates of neurological complications (16.6% vs 11.1%, P = 0.029), acute renal failure (27.2% vs 19.7%, P = 0.017) and hypotension (17.4% vs 9.6%, P = 0.001). In addition, patients with PEff underwent aortic repair more frequently (44.6% vs 32.5%, P < 0.001). In the long-term patients with PEff showed lower 5-year post-discharge survival (67.6% vs 77.6%, P = 0.004). Multivariable analysis with propensity-matched data showed that PEff was not an independent risk factor for in-hospital mortality (odds ratio 1.9, 95% CI 0.8–4.4, P = 0.141).

CONCLUSIONS

Patients with TBAAD and evidence of PEff showed a higher in-hospital mortality, are more likely to develop additional in-hospital complications and have a decreased likelihood of survival during follow-up. However, according to propensity-matched analysis, PEff remained not as an independent predictor of worse outcome but might serve as an early surrogate marker to identify higher-risk patients.
Physician-modified stent graft with inner branches for treating ruptured thoracoabdominal aortic aneurysm
Authors: Shibata Tsuyoshi , Kawaharada Nobuyoshi , Yasuhara Kiyomitsu , Naraoka Syuichi
Published: December 2021

Thoracoabdominal aortic aneurysm (TAAA) repair remains challenging in patients with high surgical risk. We report a case of TAAA in an 84-year-old woman with type Ib endoleak after thoracic endovascular aortic repair with coeliac artery coverage due to impending ruptured TAAA. A stent graft was assembled to create 3 fenestrations and sew 3 inner grafts for the superior mesenteric artery (SMA) and bilateral renal arteries. This stent graft system was inserted into the thoraco-abdominal aorta and partially unsheathed until the first inner branch endograft fully expanded. The wire was used to catheterize the stent graft, inner branch, and SMA from the left upper limb, and a bridge stent was deployed from the inner branch to the SMA. A similar procedure was performed for bilateral renal arteries. The stent graft system was fully unsheathed. Postoperative computed tomography angiography revealed no endoleak and good flow of the visceral artery. The use of the physician-modified inner branched endograft system described is feasible and can make TAAA endovascular repair simpler and safer.
Sub-growth-inhibitory concentrations of omadacycline inhibit Staphylococcus aureus haemolytic activity in vitro
Authors: Serio Alisa W , Tanaka S Ken , Wright Kelly , Garrity-Ryan Lynne
Published: December 2021

Objectives

To evaluate the effect of sub-growth-inhibitory concentrations of omadacycline on Staphylococcus aureus ATCC 10832 haemolytic activity in vitro.

Methods

Following determination of the MICs of omadacycline and comparator antibiotics, the strain was grown in the presence of individual antibiotics and the percentage of haemolysis assayed; ‘washout’ experiments were performed with omadacycline only.

Results

Omadacycline inhibited S. aureus haemolytic activity in vitro at sub-growth-inhibitory concentrations. Inhibition was maintained at least 4 h after removal of extracellular drug.

Conclusions

Omadacycline’s in vitro potency and suppression of virulence factors might contribute to its efficacy in the treatment of acute bacterial skin and skin structure infections and community-acquired bacterial pneumonia caused by virulent strains of S. aureus. This finding could be relevant for other organisms and virulence factors that depend on new protein synthesis.
Survivorship for Individuals Living With Advanced and Metastatic Cancers: National Cancer Institute Meeting Report
Authors: Mollica Michelle A , Smith Ashley Wilder , Tonorezos Emily , Castro Kathleen , Filipski Kelly K , Guida Jennifer , Perna Frank , Green Paige , Jacobsen Paul B , Mariotto Angela , Tesauro Gina , Gallicchio Lisa
Published: December 2021

An important and often overlooked subpopulation of cancer survivors is individuals who are diagnosed with or progress to advanced or metastatic cancer. Living longer with advanced or metastatic cancer often comes with a cost of burdensome physical and psychosocial symptoms and complex care needs; however, research is limited on this population. Thus, in May 2021, the National Cancer Institute convened subject matter experts, researchers, clinicians, survivors, and advocates for a 2-day virtual meeting. The purpose of this report is to provide a summary of the evidence gaps identified by subject matter experts and attendees and key opportunities identified by the National Cancer Institute in 5 research areas: epidemiology and surveillance, symptom management, psychosocial research, health-care delivery, and health behaviors. Identified gaps and opportunities include the need to develop new strategies to estimate the number of individuals living with advanced and metastatic cancers; understand and address emerging symptom trajectories; improve prognostic understanding and communication between providers, patients, and caregivers; develop and test models of comprehensive survivorship care tailored to these populations; and assess patient and provider preferences for health behavior discussions throughout the survivorship trajectory. To best address the needs of individuals living with advanced and metastatic cancer and to deliver comprehensive evidence-based quality care, research is urgently needed to fill evidence gaps, and it is essential to incorporate the survivor perspective. Developing such an evidence base is critical to inform policy and practice.
Politics, Strategy, and State Responses to Conflict-Generated Migration: Evidence from India
Authors: Paliwal Avinash
Published: December 2021

Why do states respond differently to conflict-generated migration crises across space and time? Building on valuable existing literature, this article offers a new conceptual typology of “situational strategic contexts” (SSCs). It hypothesizes that the interactions between the host state's domestic-political and international-strategic priorities generate different SSCs that shape policy responses. These contexts favor either accommodation, toleration, or repatriation of migrants and are implemented with or without support from the United Nations High Commissioner for Refugees. Sensitive to the history and future ambitions of a country, this framework demonstrates how an interplay between domestic and international-strategic logics at specific historical moments influences state behavior toward conflict-generated migration. The SSC framework is developed inductively using evidence from India, a democracy in the global south, which hosts conflict-evading migrants from many neighboring countries.
Spikelet abortion in six-rowed barley is mainly influenced by final spikelet number, with potential spikelet number acting as a suppressor trait
Authors: Kamal Roop , Muqaddasi Quddoos H , Zhao Yusheng , Schnurbusch Thorsten
Published: December 2021

The potential to increase barley grain yield lies in the indeterminate nature of its inflorescence meristem, which produces spikelets, the basic reproductive unit in grasses that are linked to reproductive success. During early reproductive growth, barley spikes pass through the maximum yield potential—a stage after which no new spikelet ridges are produced. Subsequently, spikelet abortion (SA), a phenomenon in which spikelets abort during spike growth, imposes a bottleneck for increasing the grain yield potential. Here, we studied the potential of main culm spikes by counting potential spikelet number (PSN) and final spikelet number (FSN), and computed the corresponding SA (%) in a panel of 417 six-rowed spring barleys. Our phenotypic data analyses showed a significantly large within- and across-years genotypic variation with high broad-sense heritability estimates for all the investigated traits, including SA. Asian accessions displayed the lowest SA, indicating the presence of favourable alleles that may be exploited in breeding programs. A significantly negative Pearson’s product–moment correlation was observed between FSN and SA. Our path analysis revealed that PSN and FSN explain 93% of the observed phenotypic variability for SA, with PSN behaving as a suppressor trait that magnifies the effect of FSN. Based on a large set of diverse barley accessions, our results provide a deeper phenotypic understanding of the quantitative genetic nature of SA, its association with traits of high agronomic importance, and a resource for further genetic analyses.
A multigene approach secures hydroxy fatty acid production in Arabidopsis
Authors: Lunn Daniel , Wallis James G , Browse John
Published: December 2021

A central goal of green chemistry is to produce industrially useful fatty acids in oilseed crops. Although genes encoding suitable fatty acid-modifying enzymes are available from more than a dozen wild species, progress has been limited because expression of these enzymes in transgenic plants produces only low yields of the desired products. For example, fatty acid hydroxylase 12 (FAH12) from castor (Ricinus communis) produces only 17% hydroxy fatty acids (HFAs) when expressed in Arabidopsis (Arabidopsis thaliana), compared with 90% HFAs in castor seeds. The transgenic plants also have reduced oil content and seed vigor. Here, we review experiments that have provided for steady increased HFA accumulation and oil content. This research has led to exciting new discoveries of enzymes and regulatory processes in the pathways of both seed oil synthesis and lipid metabolism in other parts of the plant. Recent investigations have revealed that HFA-accumulating seeds are unable to rapidly mobilize HFA-containing triacylglycerol (TAG) storage lipid after germination to provide carbon and energy for seedling development, resulting in reduced seedling establishment. These findings present a new opportunity to investigate a different, key area of lipid metabolism—the pathways of TAG lipolysis and β-oxidation in germinating seedlings.
Palmitic acid conjugation enhances potency of tricyclo-DNA splice switching oligonucleotides
Authors: Relizani Karima , Echevarría Lucía , Zarrouki Faouzi , Gastaldi Cécile , Dambrune Chloe , Aupy Philippine , Haeberli Adrian , Komisarski Marek , Tensorer Thomas , Larcher Thibaut , Svinartchouk Fedor , Vaillend Cyrille , Garcia Luis , Goyenvalle Aurélie
Published: December 2021

Tricyclo-DNA (tcDNA) is a conformationally constrained oligonucleotide analog that has demonstrated great therapeutic potential as antisense oligonucleotide (ASO) for several diseases. Like most ASOs in clinical development, tcDNA were modified with phosphorothioate (PS) backbone for therapeutic purposes in order to improve their biodistribution by enhancing association with plasma and cell protein. Despite the advantageous protein binding properties, systemic delivery of PS-ASO remains limited and PS modifications can result in dose limiting toxicities in the clinic. Improving extra-hepatic delivery of ASO is highly desirable for the treatment of a variety of diseases including neuromuscular disorders such as Duchenne muscular dystrophy. We hypothesized that conjugation of palmitic acid to tcDNA could facilitate the delivery of the ASO from the bloodstream to the interstitium of the muscle tissues. We demonstrate here that palmitic acid conjugation enhances the potency of tcDNA-ASO in skeletal and cardiac muscles, leading to functional improvement in dystrophic mice with significantly reduced dose of administered ASO. Interestingly, palmitic acid-conjugated tcDNA with a full phosphodiester backbone proved effective with a particularly encouraging safety profile, offering new perspectives for the clinical development of PS-free tcDNA-ASO for neuromuscular diseases.
Effects of micronutrients on the detection of extracellular superoxide produced by the harmful raphidophyte Chattonella antiqua in culture
Authors: Yamasaki Yasuhiro , Hirayama Ryunosuke , Yamamoto Akiho , Yuasa Koki , Shikata Tomoyuki
Published: December 2021

Noxious Chattonella species cause many red tides and fish kills. The detection of extracellular O2− produced by these algae will be critical for the development of a rapid toxicity-evaluation method; however, such a development has been prevented by the mismatch of the extracellular O2− detection level between field and laboratory experiments. The aim of this study was to identify impediments to detect extracellular O2− in laboratory experiments. Our results indicate that Mn and Co in the medium decreased the detection levels of extracellular O2− produced by Chattonella antiqua, and the effect by Mn was stronger than that by Co. IC50 of the radical-scavenging activity of Mn was 17.5 μM, and little activity was detected at 8.75 μM or less. Furthermore, the level of extracellular O2− production by C. antiqua in Mn-depleted medium varied greatly under various culture conditions; the extracellular O2− production level of C. antiqua was high under conditions similar to those under which blooms develop in the field. Therefore, Mn is a key scavenger of extracellular O2−, and amounts of Mn must be carefully considered whenever extracellular O2− production levels of phytoplankton cultured with other kinds of media are measured.
The associations of plant-based food and metabolic syndrome using NHANES 2015–16 data
Authors: Jovanovic Christine E S , Hoelscher Deanna M , Chen Baojiang , Ranjit Nalini , van den Berg Alexandra E
Published: December 2021

Background

Consuming a diet rich in plant-based foods (PBFs) may be protective for risk of metabolic syndrome (MetS) and chronic disease. However, the impact of consuming healthy versus all types of PBF on MetS is unknown.

Methods

The relationship between consumption of PBF (both healthy and all) was examined using data from the 2015 to 2016 National Health and Nutrition Examination Survey (NHANES). The amount of PBFs consumed was calculated as average daily servings, whereas dichotomous MetS variables were based on the National Cholesterol Education Adult Program Treatment Panel III (2005). After weighting and multiple imputation, adjusted associations were examined using logistic regression and marginal probabilities.

Results

Consumption of healthy PBF was significantly associated with reduced risk for elevated waist circumference (P = 0.017; odds ratio, OR 0.96, 95% confidence interval, CI 0.94–0.98) and MetS (P = 0.006; OR 0.96, 95% CI 0.93–0.99). Interactions revealed significant protective effects for females who were $\ge$ 60 years.

Conclusions

In the adjusted model, a 1-unit increase in daily servings of healthy PBF was associated with a 4% lower risk for prevalence of elevated waist circumference and a 4% decrease in risk for prevalence of MetS. Increasing consumption of PBF may offer a viable strategy for reducing risk of MetS.
Meaning making through collective argumentation: The role of students’ argumentative discourse in their exploration of the graphic relationship between a function and its anti-derivative
Authors: Swidan Osama
Published: December 2021

This study aims at exploring the role of argumentation in the process of shared meaning making that occurs between students as they use digital tools to explore the concept of the indefinite integral. The study followed 11 pairs of 17-year-old students as they worked together to solve the Indefinite Integral Task with the aid of a digital tool. The study was guided by the phenomenology perspective, which considers meaning making in mathematics as a progressive disclosure of the mathematical objects at stake. The data analysis tracked and categorized the components of students’ argumentation as they progress in the meaning-making process of the indefinite integral. Our research findings revealed that the digital tool allows the students to produce evidence with which to substantiate and justify their arguments, and we also found that their frequent use of statements that built upon one another’s arguments fostered the transition between one layer of disclosure and the next one.
Molecular phylogeny supports invalidation of Didelphodiplostomum and Pharyngostomoides (Digenea: Diplostomidae) and reveals a Tylodelphys from mammals
Authors: Achatz Tyler J , Chermak Taylor P , Martens Jakson R , Woodyard Ethan T , Rosser Thomas G , Pulis Eric E , Weinstein Sara B , Mcallister Chris T , Kinsella John M , Tkach Vasyl V
Published: December 2021

Alaria, Didelphodiplostomum and Pharyngostomoides are among genera of diplostomid digeneans known to parasitize mammalian definitive hosts. Despite numerous recent molecular phylogenetic studies of diplostomids, limited DNA sequence data is available from diplostomids parasitic in mammals. Herein, we provide the first 28S rDNA and cox1 mtDNA sequences from morphologically identified, adult specimens of Didelphodiplostomum and Pharyngostomoides. Newly generated 28S sequences were used to infer the phylogenetic interrelationships of these two genera among other major lineages of diplostomoideans. The phylogeny based on 28S and a review of morphology clearly suggests that Pharyngostomoides should be considered a junior synonym of Alaria, while Didelphodiplostomum should be considered a junior synonym of Tylodelphys. Pharyngostomoides procyonis (type species), Pharyngostomoides adenocephala and Pharyngostomoides dasyuri were transferred into Alaria as Alaria procyonis comb. nov., Alaria adenocephala comb. nov. and Alaria dasyuri comb. nov.; Didelphodiplostomum variabile (type species) and Didelphodiplostomum nunezae were transferred into Tylodelphys as Tylodelphys variabilis comb. nov. and Tylodelphys nunezae comb. nov. In addition, Alaria ovalis comb. nov. (formerly included in Pharyngostomoides) was restored and transferred into Alaria based on a morphological study of well-fixed, adult specimens and the comparison of cox1 DNA sequences among Alaria spp. The diplostomid genus Parallelorchis was restored based on review of morphology.
First Report of a Mastrevirus (Geminiviridae) Transmitted by the Corn Leafhopper
Authors: Vilanova Euclides S. , Ramos Anderson , de Oliveira Maria C. Souza , Esteves Mariana B. , Gonçalves Marcos C. , Lopes João R. S.
Published: December 2021

Maize striate mosaic virus (MSMV; genus Mastrevirus) was recently reported in maize plants in Brazil and also detected by metagenomic analyses in the corn leafhopper, Dalbulus maidis (DeLong & Wolcott). Although these findings suggested that D. maidis is a potential vector, no transmission studies have been performed. Here, we tested the transmission of MSMV by D. maidis from field-collected infected plants and plants infected with MSMV via leafhopper-mediated transmission in the laboratory; all plants were confirmed positive for MSMV by PCR. In each one of three transmission replicates, aviruliferous D. maidis nymphs and adults were confined together on a source plant during a 4-day acquisition access period (AAP) and subsequently transferred to healthy maize seedlings (10 individuals per test plant) in a series of 4-day inoculation access periods (IAPs). We also tested transmission by the corn aphid, Rhopalosiphum maidis (Fitch) and by mechanical inoculation of healthy maize seedlings. Only D. maidis transmitted MSMV, with overall transmission rates of 29.4 and 39.5% on field-collected infected plants and 18.5% on infected plants in laboratory. D. maidis transmitted MSMV until the third (8 to 12 days after the AAP) or fourth successive IAP (12 to 16 days), with gradual loss in transmission efficiency and rate of viruliferous insects over time, suggesting a persistent but nonpropagative mode of transmission. Infected test plants showed mottling symptoms with mild chlorotic streaks and height reduction. This is the first report of transmission of a mastrevirus by D. maidis, facilitating the completion of Koch’s postulate for MSMV.
Gluteal and Posterior Thigh Pain From a Suture Compared With an Anchor-Based Device in Patients Undergoing Sacrospinous Ligament Fixation
Authors: Plair Andre , Smith Whitney , Hines Katherine , Schachar Jeffrey , Parker-Autry Candace , Matthews Catherine
Published: December 2021

OBJECTIVE:

To compare postoperative gluteal and posterior thigh pain, device performance, and perioperative complications in women undergoing sacrospinous ligament fixation with an anchor-based compared with a suture-capturing device.

METHODS:

This was a single-center, patient-blinded, parallel, superiority trial of patients undergoing native-tissue pelvic organ prolapse repair through sacrospinous ligament fixation with an anchor-based compared with suture-capturing device using randomized-block randomization. The primary outcome was the increase in gluteal and posterior thigh pain from baseline to 1-week postoperation using the numerical rating scale. Pain was also assessed at postoperative day 1, week 6, and a summarized assessment for the first postoperative week. Intraoperative device performance, home opioid pain medication use, and changes in prolapse symptom scores were also analyzed. To provide 80% power to detect a pain difference of 2.5 points between the groups with an SD of 2.8 and a 15% dropout estimate using a two-sided 5% significance level, 24 patients were required per group. Analysis with Student's t test, Wilcoxon rank-sum tests, and Fisher exact tests were performed as well as an analysis of covariance for the primary outcome.

RESULTS:

Between September 2018 and June 2020, 47 patients (24 anchor-based and 23 suture-capturing) were included in the study. There was no significant difference between the anchor-based and suture-capture groups in mean change in gluteal and posterior thigh pain from baseline to 1-week postoperation (−0.4, 95% CI −1.6 to 2.3). The highest pain increase from baseline during the first postoperative week was also similar between the two groups (up 4.00 and up 4.74, respectively) with no significant difference between the anchor-based and suture-capture groups (−0.7, 95% CI −1.4 to 2.8). There were no differences in changes in pain at any of the other timepoints, in opioid pain medication utilization, device performance, or in prolapse symptom scores.

CONCLUSION:

An anchor-based device did not reduce postoperative gluteal and posterior thigh pain compared with a suture-based device after sacrospinous ligament fixation.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT03565640.

FUNDING SOURCE:

Supported by Neomedic via Adler Instruments. Neomedic provided funding for this principal investigator-initiated study. Funding went to providing small value gift cards to patients for study completion, office supplies for the study, and funding the data analysis collaboration with the Wake Forest Baptist Health CTSI Biostatistics Department. Neomedic did not have any direct role in study design, patient recruitment, study execution, data analysis, or manuscript writing or editing.
Predictive Factors on Initial in-brace Correction in Idiopathic Scoliosis
Authors: Peeters Charles Marcelis Maria , van Hasselt Arthur Justus , Wapstra Frits Hein , Jutte Paulus Christiaan , Kempen Diederik Hendrik Ruth , Faber Christopher
Published: December 2021

Study Design.

Systematic literature review.

Objective.

The aim of this study was to systematically review the literature and provide an overview of reported predictive factors on initial in-brace correction in patients with idiopathic scoliosis (IS).

Summary of Background Data.

Brace therapy is the best proven non-surgical treatment for IS. There is strong evidence that lack of initial in-brace correction is associated with brace treatment failure. To improve initial in-brace corrections and subsequently long-term brace treatment success, knowledge about factors influencing initial in-brace correction is a prerequisite.

Methods.

A systematic literature search was performed in Pubmed, Embase, Web-of-Science, Scopus, Cinahl, and Cochrane in November 2020. Studies which reported factors influencing initial in-brace correction in IS patients treated with brace therapy were considered eligible for inclusion.

Results.

Of the 4562 potentially eligible articles identified, 28 studies fulfilled the inclusion criteria and were included in this systematic review. Nine studies (32%) were classified as high quality studies and the remaining 19 studies (68%) as low quality. Thirty-four different reported factors were collected from the included studies. Strong evidence was found for increased curve flexibility as favorable predictive factor for initial in-brace correction. Moderate evidence was found for thoracolumbar or lumbar curve pattern as favourable predictive factor, and double major curve pattern as unfavourable predictive factor for initial in-brace correction. Also moderate evidence was found that there is no significant difference on initial in-brace correction between computer-aided design and manufacturing systems (CAD/CAM) braces with or without finite element models (FEM) simulation, and braces fabricated using the conventional plaster-cast.

Conclusion.

The results of this systematic review indicate that increased curve flexibility is strongly associated with increased initial in-brace correction.

Level of Evidence: 1
Sutureless technique for repositioning and scleral fixation of the capsular bag–intraocular lens complex with permanent use of iris retractors
Authors: Krix-Jachym Karolina M. , Błagun Natalia , Kicińska Aleksandra K. , Dyda Wojciech , Rękas Marek T.
Published: December 2021

A new sutureless technique used for repositioning and scleral fixation of the capsular bag–intraocular lens (IOL) complex in the surgical treatment of subluxated lenses is described. Iris retractors were used not only to induce a tent effect on the capsule but also to permanently fix the capsular bag to the sclera in this method, without the need to prepare scleral or conjunctival flaps. Surgery with the use of a capsular tension ring (CTR) and iris retractors, the ends of which were brought out through the sclera and cauterized, was performed in 7 eyes of 7 patients with moderate or severe subluxation of the crystalline lens. In all cases, simultaneous use of a CTR and iris retractors ensured good centration of the capsular bag–IOL complex. The method was safe and effective in fixing the capsule to the sclera in the case of significant damage to the ligamentous apparatus of the lens.
Occupational Heat Stress: An Overview for Nurse Practitioners
Authors: Sabo Kathryn , Starodub R. , Smoller Sara , Quinn Lisa , Kelly Debra , Flaherty Karen , Nicholas Patrice K.
Published: December 2021

The health impacts of climate change are pervasive and complex. The role of nurse practitioners is a key in addressing these emerging health challenges. However, few health care providers are aware of the extensive signs and symptoms that accompany climate-related health sequelae. This article explores the increasing prevalence of occupational heat stress and best practices for nurse practitioners in addressing this problem. The A CLIMATE mnemonic is a clinical tool applied to occupational heat stress and aims to address a comprehensive health assessment and proactive management. Two clinical case studies will be offered as exemplars of occupational heat stress. The cases are framed within the A CLIMATE mnemonic for health assessment and physical examination for nurse practitioner practice.
Accessing the Stapedius Muscle Via Novel Surgical Retrofacial Approach: A Cadaveric Feasibility Study
Authors: Arnold Dirk , Schneider Fritz , Volk Gerd Fabian , Ossmann Steffen , Neudert Marcus , Hirt Bernhard , Löwenheim Hubert , Guntinas-Lichius Orlando
Published: December 2021

Hypothesis:

Despite the complete embodiment of the stapedius muscle (SM) into the pyramidal eminence, it is possible to safely gain access to the SM belly via a retrofacial approach. This presents a novel approach to directly measure the electrically evoked stapedius reflex threshold (eSRT).

Background:

Objective fitting of maximum comfortable loudness levels for cochlear implant users can improve the benefit introduced by the device. Sensing SM activity via direct surgical access represents a potential tool for objective eSRT fitting.

Methods:

Eighteen human temporal bones (TBs) were used. Micro-computed tomography was performed for six TBs. Standard computed tomography for six TBs. Manual 3D-segmentation of the relevant middle and inner ear anatomy was performed on 12 TBs. Mastoidectomy and posterior tympanotomy allowed the access to middle ear of all 18 the TBs. Once identified the mastoidal segment of the facial nerve (FN), the retrofacial access to the SM was drilled.

Results:

The total access rate was 72.2%. Only in the first three cases the posterior semi-circular canal was hit. The SM access was identified posterior to the FN at a 4 ± 0.78 mm distance from the stapes’ head, almost halfway to the chorda tympani's branching point along the FN direction. The drilling depth to access the SM posterior to the external surface of FN on average was 2 ± 0.30 mm. The exposure took on average of 5 to 8 minutes.

Conclusions:

The retrofacial approach seems to offer a feasible and reproducible access to the SM belly opening an avenue to electromyographic sensing of eSRT.
Calcium Channel Blockers and the Risk of Sensorineural Hearing Loss
Authors: Sutton S. Scott , Magagnoli Joseph , Cummings Tammy H. , Hardin James W.
Published: December 2021

Objective:

To evaluate calcium channel blockers as a potential prophylactic agent for sensorineural hearing loss (SNHL).

Patients: We used a retrospective cohort of US veterans treated by the Veteran's Affairs healthcare system. Patients were included in the study if 1) they were diagnosed with high blood pressure; 2) had no previous diagnosis of SNHL; 3) were prescribed a calcium channel blocker after diagnosis or as a control cohort, patients who had no antihypertensive medication use.

Intervention:

Patients were categorized into mutually exclusive cohorts by their antihypertensive medication exposure: calcium channel blocker exposed and no antihypertensive medication exposure.

Main Outcome Measure:

Incident SNHL was defined as an inpatient or outpatient record with diagnosis codes international classification of diseases (ICD)-9-CM 389.1 or ICD-10-CM H90, H90.41, H90.42, H90.A21, H90.A22. An audiology or otolaryngology clinic visit was required for patients with an outpatient diagnosis of SNHL.

Results:

A total of 1,338,409 patients met the inclusion criteria consisting of 292,981 patients with CCBs (25,614 with verapamil and 267,367 with other CCBs) and 1,045,428 patients with no antihypertensive medication. On average, patients were middle-aged, White men with a body mass index (BMI) of 30+. Cox proportional hazards model estimates from propensity score matched data revealed CCB users had a 23.6% decreased risk of SNHL compared with those with no antihypertensive medication use (hazard ratios [HR] = 0.764; 95% confidence interval = [0.752–0.777]).

Conclusion:

This analysis found evidence supporting the theory that calcium channel blockers might be a potential prophylactic agent for sensorineural hearing loss. Additional research is warranted.
Usefulness of Cervical Vestibular-Evoked Myogenic Potentials for Diagnosing Patients With Superior Canal Dehiscence Syndrome: A Meta-Analysis
Authors: Kim Do Hyun , Kim Sung Won , Kim So-hyun , Jung Jae hoon , Hwang Se Hwan
Published: December 2021

Objectives:

To compare the diagnostic accuracy of cervical vestibular-evoked myogenic potential (cVEMP) for detecting superior canal dehiscence (SCD) syndrome to that of computed tomography (CT) and surgical findings.

Databases Reviewed:

PubMed, SCOPUS, Embase, Web of Science, and the Cochrane database.

Methods:

Databases were searched up to July 2021. True positives, true negatives, false positives, and false negatives were extracted. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool.

Results:

Our search yielded nine studies with 721 patients. Including all cVEMP thresholds, the diagnostic odds ratio (DOR) was 32.8483 (95% confidence interval [CI]: 19.6577, 54.8900; I
2 = 49.9%). The area under the summary receiver operating characteristic curve (AUC) was 0.879. Sensitivity and specificity were 0.8278 (95% CI: 0.7517, 0.8842; I
2 = 76.4%) and 0.8824 (95% CI: 0.7859, 0.9387; I
2 = 92.8%), respectively. However, there was a high degree of heterogeneity (I
2 ≥ 70%) due to the different VEMP threshold values used among the studies. In subgroup analysis, higher cVEMP threshold values showed higher sensitivity (threshold ≤ 85: 0.9568; threshold ≤ 65: 0.7691) but lower specificity (threshold ≤ 85: 0.5879; threshold ≤ 65: 0.8913). The threshold ≤75 subgroup showed moderate sensitivity of 0.7455, high specificity of 0.9526, and the highest DOR of 38.9062. The AUC of this subgroup was 0.894.

Conclusions:

cVEMP is a reliable adjunctive tool for the clinical diagnosis of SCD. Taking the balance between sensitivity and specificity into consideration, a cVEMP threshold value of 75 showed good diagnostic accuracy.
Paradoxical increase in ambulatory SBP in coarctation of aorta a compared to essential hypertension
Authors: Egbe Alexander C. , Miranda William R. , Shaik Likhita , Katta Renuka Reddy , Goda Sakr Ahmed , Devara Janaki , Connolly Heidi M.
Published: December 2021

Background

The relationship between office vs. ambulatory blood pressure (BP) indices are well-studied in patients with essential hypertension and based on these data, it is known that the average 24-h ambulatory BP is typically lower than office BP. However, emerging data show that office SBP underestimates arterial afterload in patients with coarctation of aorta (COA), and a minimal increase in stroke volume during low-intensity exercise results in an exaggerated rise in SBP as compared to those with essential hypertension. We hypothesized that COA patients will have higher ambulatory SBP and a higher prevalence of masked hypertension compared to patients with essential hypertension.

Methods

Case-control study of 118 COA patients and 118 patients with essential hypertension matched by age, sex, BMI and office SBP.

Results

Although both groups had similar office SBP (132 ± 17 mmHg) by design, the COA group had paradoxical increases in 24-h ambulatory SBP (135 ± 14 vs. 126 ± 13; P < 0.001) and daytime ambulatory SBP (142 ± 16 vs. 130 ± 13; P < 0.001), and less nocturnal dipping (−3 ± 5 vs. −9 ± 4; P < 0.001). The COA group also had a higher prevalence of masked hypertension [36 (31%) vs 14 (12%); P < 0.001), and worse arterial function indices.

Conclusion

These findings underscore the potential limitations of relying on office SBP for screening/monitoring of hypertension in COA and potential pitfalls in extrapolating essential hypertension guidelines recommendations to the treatment of COA. It also provides the rationale for further studies to determine if pharmacologic BP interventions guided by ambulatory BP data will improve clinical outcomes in the COA population.
The Role of Cerebral CT Angiogram in Subacute Ischemic Cerebrovascular Events
Authors: Alshumrani Ghazi , Alzahrani Fares , Alamri Ahmad , Al-Khani Abdullah Murhaf , Shehata Shehata , Alsabaani Abdullah , Alhazzani Adel
Published: December 2021

Background:

Stroke is a spectrum of medical emergencies resulting from a direct insult to the cerebral blood flow. Cerebral computed tomography angiogram (CTA) plays an important role in the diagnostic algorithm of acute stroke. However, the role of CTA in the subacute phase is not well-established. This study aimed to assess the diagnostic role of CTA in subacute ischemic stroke and transient ischemic attack (TIA) in identifying underlying etiology. It also aimed to describe the commonly encountered CTA findings in the subacute phase of ischemic events.

Methods:

This is a retrospective study in which we evaluated the radiologic records of all patients who had a cerebral CTA for subacute stroke and TIA during the period from January 1, 2010 to May 30, 2018.

Results:

The study included 104 cases diagnosed with subacute ischemic stroke or TIA. Patients’ ages ranged from 8 to 96 years with a mean age of 52.9 (18.1) years. Most of the patients were males (68.3%; 71). CTA findings were abnormal in 86 cases (82.7%). Stenosis was diagnosed in 34 (32.7%) cases, followed by acute arterial thrombosis (25; 24%) and chronic occlusion (17; 16.3%). The internal carotid artery was the most affected (57.6%), followed by the vertebrobasilar arteries.

Conclusion:

The current study revealed that CTA has a high diagnostic yield in the subacute phase of ischemic cerebrovascular events, with an important role in detecting clinically relevant findings in this group of patients.
Adrenal Crisis Presenting as Recurrent Encephalopathy Mimicking Autoimmune, Infectious Encephalitis, and Common Variable Immune Deficiency
Authors: Poon Jason T. , Salzman Karen , Clardy Stacey L. , Paz Soldan M. Mateo
Published: December 2021

Introduction:

Adrenal crisis can present with life-threatening complications and mimic autoimmune or infectious encephalitis, and common variable immune deficiency (CVID). The literature regarding the neurological complications of adrenal crisis is limited and focuses on patients who present with hypotension and electrolyte abnormalities.

Case Report:

A 30-year-old man presented 3 times to our hospital with encephalopathy, fever, and left sided weakness with a history of multiple autoimmune diseases and prior hospitalizations for encephalopathy. During his first 2 admissions, he was normotensive and without electrolyte abnormalities. Extensive workup for infectious, paraneoplastic, seizure, metabolic, toxic, and vascular etiologies, and autoimmune encephalitis was negative. His exam returned to baseline with empiric steroid treatment, and he was discharged. He re-presented 2 months later with encephalopathy for a third admission. During this subsequent presentation, he had hyponatremia, low serum osmolality, elevated urine sodium, undetectable morning cortisol, and 21-α hydroxylase autoantibodies. A diagnosis of autoimmune adrenal insufficiency was established, he was treated with physiological doses of hydrocortisone and fludrocortisone, and improved rapidly to near baseline function. He has remained relapse-free at 4-year follow up. During all admissions, he was also found to have low immunoglobulin G levels and met criteria for CVID; however, his immunoglobin levels recovered with steroid replacement.

Conclusion:

The reported patient demonstrated some of the neurological complications of adrenal crisis which can mimic other autoimmune conditions such as CVID. The neurologist should be aware that recurrent encephalopathy from adrenal insufficiency can occur regardless of hemodynamic or electrolyte changes on typical hospital metabolic panels.
Retrospective Evaluation of Acute Headache in Pediatric Emergency Department
Authors: Güngör Ali , Göktuğ Aytaç , Bodur İlknur , Öztürk Betül , Güneylioğlu Muhammed M. , Yaradilmiş Raziye M. , Tekeli Aysun , Karacan Can D. , Tuygun Nilden
Published: December 2021

Background:

The aims of this study were to describe the etiologies of acute headache presenting to the pediatric emergency department, determine their clinical characteristics, the prevalence of red flag findings and neuroimaging and identify predictors of headaches because of serious intracranial diseases.

Materials and Methods:

Patients from 2 to 18 years of age who visited pediatric emergency department with a chief complaint of headache between January 1, 2016 and August 31, 2020 were retrospectively evaluated.

Results:

The mean age of the 558 patients included in the study was 11.17±3.78 years, and 290 (52%) were female. The most common cause of acute headache was head and neck area infections (except central nervous system infections) in 355 (63.6%) patients. Forty patients (7.2%) had a headache because of serious intracranial diseases. According to binary logistic regression analysis, the findings that predicted a serious intracranial diseases were abnormal neurological physical examination [odds ratio (OR): 187.57; 95% confidence interval (CI): 32.67-1076.64], recent onset or suddenly severe headache (OR: 14.41; 95% CI: 3.14-65.91), and vomiting (OR: 9.42; 95% CI: 1.90-46.63). Neuroimaging was performed in 63 (11.3%) patients, and 7 (1.25%) had a pathology requiring emergency treatment.

Conclusions:

The majority of acute headaches were evaluated as secondary headache. The most common cause of acute headache was head and neck area infections. Abnormal neurological physical examination, recent onset or suddenly severe headache, and vomiting were the most useful red flags for predicting serious intracranial diseases. The requirement for neuroimaging should be evaluated individually for each patient.