bluuebunny/crossref_metadata_2025 huggingface dataset:
Bacterial colonization and TH17 immunity are shaped by intestinal sialylation in neonatal mice
Authors: Irons Eric E , Cortes Gomez Eduardo , Andersen Valerie L , Lau Joseph T Y
Published: February 2022

Interactions between the neonate host and its gut microbiome are central to the development of a healthy immune system. However, the mechanisms by which animals alter early colonization of microbiota for their benefit remain unclear. Here, we investigated the role of early-life expression of the α2,6-sialyltransferase ST6GAL1 in microbiome phylogeny and mucosal immunity. Fecal, upper respiratory, and oral microbiomes of pups expressing or lacking St6gal1 were analyzed by 16S rRNA sequencing. At weaning, the fecal microbiome of St6gal1-KO mice had reduced Clostridiodes, Coprobacillus, and Adlercreutzia, but increased Helicobacter and Bilophila. Pooled fecal microbiomes from syngeneic donors were transferred to antibiotic-treated wild-type mice, before analysis of recipient mucosal immune responses by flow cytometry, RT-qPCR, microscopy, and ELISA. Transfer of St6gal1-KO microbiome induced a mucosal Th17 response, with expression of T-bet and IL-17, and IL-22-dependent gut lengthening. Early life intestinal sialylation was characterized by RT-qPCR, immunoblot, microscopy, and sialyltransferase enzyme assays in genetic mouse models at rest or with glucocorticoid receptor modulators. St6gal1 expression was greatest in the duodenum, where it was mediated by the P1 promoter and efficiently inhibited by dexamethasone. Our data show that the inability to produce α2,6-sialyl ligands contributes to microbiome-dependent Th17 inflammation, highlighting a pathway by which the intestinal glycosylation regulates mucosal immunity.
Polygenic risk impactsPDGFRAmutation penetrance in non-syndromic cleft lip and palate
Authors: Yu Yao , Alvarado Rolando , Petty Lauren E , Bohlender Ryan J , Shaw Douglas M , Below Jennifer E , Bejar Nada , Ruiz Oscar E , Tandon Bhavna , Eisenhoffer George T , Kiss Daniel L , Huff Chad D , Letra Ariadne , Hecht Jacqueline T
Published: February 2022

Non-syndromic cleft lip with or without cleft palate (NSCL/P) is a common, severe craniofacial malformation that imposes significant medical, psychosocial and financial burdens. NSCL/P is a multifactorial disorder with genetic and environmental factors playing etiologic roles. Currently, only 25% of the genetic variation underlying NSCL/P has been identified by linkage, candidate gene and genome-wide association studies. In this study, whole-genome sequencing and genome-wide genotyping followed by polygenic risk score (PRS) and linkage analyses were used to identify the genetic etiology of NSCL/P in a large three-generation family. We identified a rare missense variant in PDGFRA (c.C2740T; p.R914W) as potentially etiologic in a gene-based association test using pVAAST (P = 1.78 × 10−4) and showed decreased penetrance. PRS analysis suggested that variant penetrance was likely modified by common NSCL/P risk variants, with lower scores found among unaffected carriers. Linkage analysis provided additional support for PRS-modified penetrance, with a 7.4-fold increase in likelihood after conditioning on PRS. Functional characterization experiments showed that the putatively causal variant was null for signaling activity in vitro; further, perturbation of pdgfra in zebrafish embryos resulted in unilateral orofacial clefting. Our findings show that a rare PDGFRA variant, modified by additional common NSCL/P risk variants, have a profound effect on NSCL/P risk. These data provide compelling evidence for multifactorial inheritance long postulated to underlie NSCL/P and may explain some unusual familial patterns.
Distinct roles of the dystrophin–glycoprotein complex: α-dystrobrevin and α-syntrophin in the maintenance of the postsynaptic apparatus of the neuromuscular synapse
Authors: Valenzuela Isabel Martinez-Pena y , Chen Po-Ju , Barden Joseph , Kosloski Olivia , Akaaboune Mohammed
Published: February 2022

α-syntrophin (α-syn) and α-dystrobrevin (α-dbn), two components of the dystrophin–glycoprotein complex, are essential for the maturation and maintenance of the neuromuscular junction (NMJ) and mice deficient in either α-syn or α-dbn exhibit similar synaptic defects. However, the functional link between these two proteins and whether they exert distinct or redundant functions in the postsynaptic organization of the NMJ remain largely unknown. We generated and analyzed the synaptic phenotype of double heterozygote (α-dbn+/−, α-syn+/−), and double homozygote knockout (α-dbn−/−; α-syn−/−) mice and examined the ability of individual molecules to restore their defects in the synaptic phenotype. We showed that in double heterozygote mice, NMJs have normal synaptic phenotypes and no signs of muscular dystrophy. However, in double knockout mice (α-dbn−/−; α-syn−/−), the synaptic phenotype (the density, the turnover and the distribution of AChRs within synaptic branches) is more severely impaired than in single α-dbn−/− or α-syn−/− mutants. Furthermore, double mutant and single α-dbn−/− mutant mice showed more severe exercise-induced fatigue and more significant reductions in grip strength than single α-syn−/− mutant and wild-type. Finally, we showed that the overexpression of the transgene α-syn-GFP in muscles of double mutant restores primarily the abnormal extensions of membrane containing AChRs that extend beyond synaptic gutters and lack synaptic folds, whereas the overexpression of α-dbn essentially restores the abnormal dispersion of patchy AChR aggregates in the crests of synaptic folds. Altogether, these data suggest that α-syn and α-dbn act in parallel pathways and exert distinct functions on the postsynaptic structural organization of NMJs.
Matching in Cities
Authors: Dauth Wolfgang , Findeisen Sebastian , Moretti Enrico , Suedekum Jens
Published: February 2022

Using administrative German data, we show that large cities allow for a more efficient matching between workers and firms and this has important consequences for geographical inequality. Specifically, the match between high-quality workers and high-quality plants is significantly tighter in large cities relative to small cities. Wages in large cities are higher not only because of the higher worker quality but also because of a stronger assortative matching. Strong assortative matching in large cities magnifies wage differences caused by worker sorting, and is a key factor in explaining the growth of geographical wage disparities over the last three decades.
Lineage in Its Spatial Context: Epigraphy, Geography, and the Formation of Political Unity in Medieval Mewar
Authors: Newman Adam
Published: February 2022

This article examines the relationship between a late tenth-century Sanskrit inscription, a late fifteenth-century sthalapurāṇa known as Ekaliṅgamāhātmya, and several other intervening inscriptions coming from the Mewar region of Rajasthan. Through an examination of these records, I argue that the royal inscriptions coming from early medieval Mewar must be understood not only in terms of the light they place on the royal lineage, but also, and more importantly, they must be understood in terms of their geographical contexts. I further argue that the Ekaliṅgamāhātmya, a courtly narrative extolling the region of Mewar and its rulers, should be seen as the ideological culmination of these past inscriptional records. By privileging geographical descriptions of sacred spaces above royal lineage claims, the authors of these records demonstrate the mutual imbrication of geography and power in medieval Rajasthan.
A comparative analysis of intelligent techniques to predict energy generated by a small wind turbine from atmospheric variables
Authors: Porras Santiago , Jove Esteban , Baruque Bruno , Calvo-Rolle José Luis
Published: February 2022

The harmful consequences of fossil fuels use has resulted in the promotion of clean and renewable energies. During the past decades, green technologies have experienced a strong development, paying especial attention to wind energy, that covers a significant share of the electric energy demand. In this context, the main efforts are focused on the optimization of wind generator facilities, not only in the mechanic design but also in the energy management. Then, the present work deals with the prediction of the energy generated in a small wind turbine placed in a bioclimatic house located on the north west region of Spain. This includes an analysis of the characteristics of the atmospheric variables registered during the turbine operation for a period of one year and an exploratory examination of a range of regression techniques in order to assess the suitability of using the registered information to predict the installation’s power generation levels on the short term. The study detailed in this work proves that this objective is an attainable one with a good degree of accuracy.
Workforce Caring for Cancer Survivors in the United States: Estimates and Projections of Use
Authors: Mariotto Angela B , Enewold Lindsey , Parsons Helen , Zeruto Christopher A , Yabroff K Robin , Mayer Deborah K
Published: February 2022

Background

This study aims to quantify the extent and diversity of the cancer care workforce, beyond medical oncologists, to inform future demand because the number of cancer survivors is expected to grow in the United States.

Methods

Surveillance, Epidemiology, and End Results-Medicare data were used to evaluate health-care use of cancer survivors diagnosed between 2000 and 2014, enrolled in fee-for-service Medicare Parts A and B, and 65 years or older in 2008-2015. We calculated percentage of cancer survivors who saw each clinician specialty and their average annual number of visits in each phase of care. We projected the national number of individuals receiving care and number of annual visits by clinician specialty and phase of care through 2040.

Results

Cancer survivors had higher care use in the first year after diagnosis and last year of life phases. During the initial year after cancer diagnosis, most survivors were seen for cancer-related care by a medical oncologist (59.1%), primary care provider (55.9%), and/or other cancer-treating physicians (42.2%). The percentage of survivors with cancer-related visits to each specialty declined after the first year after diagnosis, plateauing after year 6-7. However, at 10 or more years after diagnosis, approximately 20% of cancer survivors had visits to medical oncologists and an average of 4 visits a year.

Conclusions

Cancer survivors had higher care use in the first year after diagnosis and last year of life. High levels of care use across specialties in all phases of care have important implications for models of survivorship care coordination and workforce planning.
Hyperoside, a natural flavonoid compound, attenuates Triptolide-induced testicular damage by activating the Keap1-Nrf2 and SIRT1-PGC1α signalling pathway
Authors: Wang Yucheng , Li Jiaqi , Gu Jingyu , He Wei , Ma Bo , Fan Hongqi
Published: February 2022

Objectives

Hyperoside (Hyp), as the main ingredient from Semen Cuscutae, Abelmoschus moschatus, Acanthopanax senticosus, its protective effect in testicular dysfunction and mechanisms have not been studied. Here, we explored the action of Hyp in preventing oxidative stress-induced testicular damage and underlying mechanisms.

Methods

The testicular injury model caused by oxidative stress was successfully built via Triptolide (TP) intraperitoneal injection in male mice. After Hyp (12.5, 25 and 50 mg/kg/day) treatment, testes weights, sperm count and morphology, histological changes, oxidative stress biomarkers from testicular tissue were detected. Also, the molecular mechanism was investigated by western blotting and immunohistochemistry assay.

Key findings

These data suggested that Hyp significantly ameliorated TP-induced testicular atrophy, microstructural injury and spermatogenic dysfunction. Besides, it was shown that apoptosis-related proteins (cleaved caspase-3 and cleaved PARP) were prominently suppressed. The mechanical results indicated that Hyp significantly promoted Nrf2 translocation and elevated antioxidant enzymes expression in the testicular tissue. Meanwhile, this study also found that Hyp could improve TP-induced mitochondrial dysfunction via the SIRT1-PGC-1α signalling pathway.

Conclusions

The present study indicated that Hyp exerted a potent ameliorative effect against testicular injury caused by oxidative stress via stimulating Keap1-Nrf2 and SIRT1-PGC1a signalling pathway.
Reactive lymphoid hyperplasia of the liver mimicking hepatocellular carcinoma: a case report
Authors: Thienhiran Anuparp , Charoenpitakchai Mongkon , Hongjinda Sermsak , Fuengfoo Pusit , Burasakarn Pipit
Published: February 2022

Reactive lymphoid hyperplasia (RLH) of the liver is an extremely rare benign lesion, which is often misdiagnosed as a malignant liver tumour. We present the case of a 69-year-old man with an incidental liver tumour revealed on the ultrasonography of the kidney-urinary bladder system for benign prostatic hyperplasia. Hepatocyte-specific contrast (gadoxetate disodium) magnetic resonance imaging revealed a round 6-mm lesion, which was hypointense on T1-weighted images, slightly hyperintense on T2-weighted images and highly intense on diffusion-weighted images. Other findings included arterial hyperintensity, venous and delayed hypointensity and a defect in liver segment 6. The patient was diagnosed with hepatocellular carcinoma; laparoscopic partial hepatectomy was performed. Intraoperatively, a 7-mm greyish white solid nodule was observed. In conclusion, it may be difficult to distinguish RLH from other malignant liver tumours. However, it should be considered as a differential diagnosis for small liver lesions in young, female patients without liver cirrhosis.
A remote-sensing method for sub-wavelength grains on planetary surfaces by optical polarimetry
Authors: Geake J E , Geake M
Published: February 2022

Some optical polarization effects for very fine powders are shown. The well-known curve of polarization versus phase angle is found to change in shape and scale when the grain size is reduced to less than the wavelength; strong negative polarization is found, even for a smooth powder surface of high albedo. The negative peak changes in shape, and its parameters are found to be related to grain size in simple ways. This distinctive shape provides a possible remote-sensing method for detecting subwavelength grains on planetary surfaces.
HEAO-1 observations of the X-ray pulsar 1E2259 + 586
Authors: Davies S R , Wood K S , Coe M J
Published: February 2022

We have analysed HEAO-1 scanning observations of the X-ray pulsar 1E2259 + 586, obtaining a pulse period from 1978 January of 6.978586 ± 0.000006 s. This extends the spindown trend seen by later observers to earlier times. No evidence is found for a second derivative to the period. The luminosity and pulse profile we derive are similar to those of subsequent observations, with no evidence for large-scale variability on a time-scale of days or months. We discuss how the conventional picture of the source as an accreting neutron star can be modified to accommodate the very stable spin period derivative, and assess various models for the pulsar’s formation and subsequent evolution.
On highly non-adiabatic stellar pulsations and the origin of strange modes
Authors: Gautschy Alfred , Glatzel Wolfgang , Gautschy Alfred , Glatzel Wolfgang
Published: February 2022

Using a new numerical method and considering complete evolutionary stellar models, the linear non-adiabatic pulsations of helium stars are re-examined. A variety of new strange modes are found, some of which are unstable and extend - consistently with the observations - the instability strip to high temperatures up to log Teff = 4.3. The origin of the various modes is identified and an alternative interpretation of the strange mode phenomenon is provided. The instabilities associated with the strange modes are not due to the K mechanism and are explained - as the strange mode phenomenon itself - by mode coupling. It is demonstrated, by considering the stability of AGB envelopes, that strange modes seem to be a common feature for strong deviations from adiabaticity and a pronounced core envelope structure of the star.
Cosmic filaments delay quenching inside clusters
Authors: Kotecha Sachin , Welker Charlotte , Zhou Zihan , Wadsley James , Kraljic Katarina , Sorce Jenny , Rasia Elena , Roberts Ian , Gray Meghan , Yepes Gustavo , Cui Weiguang
Published: February 2022

We investigate how large-scale cosmic filaments impact the quenching of galaxies within one virial radius of 324 simulated clusters from The Three Hundred project. We track cosmic filaments with the versatile, observation-friendly program DisPerSE and identify haloes hosting galaxies with VELOCIRaptor. We find that cluster galaxies close to filaments tend to be more star forming, bluer, and contain more cold gas than their counterparts further away from filaments. This effect is recovered at all stellar masses. This is in stark contrast with galaxies residing outside of clusters, where galaxies close to filaments show clear signs of density related pre-processing. We first show that the density contrast of filaments is reduced inside the intra-cluster medium. Moreover, examination of flows around and into cluster galaxies shows that the gas flows in intra-cluster filaments are colder and tend to stream along with galaxies in their midst, partially shielding them from strangulation by the hot, dense intra-cluster medium. This also preserves accretion on to satellites and limit ram pressure.
SDSS-IV MaNGA: spatial resolved properties of kinematically misaligned galaxies
Authors: Xu Haitong , Chen Yanmei , Shi Yong , Zhou Yuren , Bizyaev Dmitry , Bao Min , Beom Minje , Fernández-Trincado José G , Cao Xiao
Published: February 2022

We select 456 galaxies with kinematically misaligned gas and stellar components from 9456 parent galaxies in MaNGA, and classify them into 72 star-forming galaxies, 142 green-valley galaxies, and 242 quiescent galaxies. Comparing the spatial resolved properties of the misaligned galaxies with control samples closely match in the Dn4000 and stellar velocity dispersion, we find that: (1) the misaligned galaxies have lower values in Vgas/σgas and Vstar/σstar (the ratio between ordered to random motion of gas and stellar components) across the entire galaxies than their control samples; (2) the star-forming and green-valley misaligned galaxies have enhanced central concentrated star formation than their control galaxies. The difference in stellar population between quiescent misaligned galaxies and control samples is small; (3) gas-phase metallicity of the green valley and quiescent misaligned galaxies are lower than the control samples. For the star-forming misaligned galaxies, the difference in metallicity between the misaligned galaxies and their control samples strongly depends on how we select the control samples. All these observational results suggest that external gas accretion influences the evolution of star forming and green-valley galaxies, not only in kinematics/morphologies, but also in stellar populations. However, the quiescent misaligned galaxies have survived from different formation mechanisms.
The dark side of galaxy stellar populations – I. The stellar-to-halo mass relation and the velocity dispersion–halo mass relation
Authors: Scholz-Díaz Laura , Martín-Navarro Ignacio , Falcón-Barroso Jesús
Published: February 2022

The growth and properties of galaxies are thought to be closely connected to the ones of their host dark matter haloes. Despite the importance of this so-called galaxy–halo connection, the potential role of dark matter haloes in regulating observed galaxy properties remains yet to be fully understood. In this work, we derive the ages, metallicites, and [Mg/Fe] abundances from optical spectra from the Sloan Digital Sky Survey of nearby central galaxies, and study them in terms of their host haloes. We investigate how the scatter in the stellar-to-halo mass relation and the velocity dispersion–halo mass relation correlates with these stellar population parameters. In addition, we also study the differences when distinguishing between different galaxy morphologies and environments. We find that the ages and chemical enrichment of galaxies are not fully determined by their stellar masses or velocity dispersion, but also depend on the mass of the host haloes. Our findings suggest that the velocity dispersion is the best proxy of the stellar population parameters with halo mass playing a secondary yet noticeable role. We interpret that the origin of the correlation between the scatter of these relations and the ages and metallicities might be related to different halo formation times.
Successful transition from intravenous epoprostenol to oral selexipag and inhaled iloprost in a case of severe pulmonary arterial hypertension associated with systemic lupus erythematosus
Authors: Saiki Chihiro , Kashiwado Yusuke , Yokoyama Taku , Ayano Masahiro , Imabayashi Keisuke , Kawano Shotaro , Higashioka Kazuhiko , Kimoto Yasutaka , Fukata Mitsuhiro , Mitoma Hiroki , Ono Nobuyuki , Arinobu Yojiro , Akashi Koichi , Horiuchi Takahiko , Niiro Hiroaki
Published: February 2022

A 25-year-old woman was admitted to our hospital with severe pulmonary arterial hypertension associated with systemic lupus erythematosus (SLE-PAH). Her mean pulmonary arterial pressure was 56 mmHg, and her SLE Disease Activity Index-2 K score was 14 on admission. In addition to a strong immunosuppressive regimen, which included steroid pulse therapy followed by high-dose oral prednisolone (1 mg/kg) and intravenous cyclophosphamide, an upfront combination of vasodilator therapy, including oral tadalafil, macitentan, and intravenous epoprostenol, was administered in the early phase. Two months later, her mean pulmonary arterial pressure was 29 mmHg, and her other haemodynamic markers showed significant improvement. She refused to start life-long intravenous epoprostenol therapy and so was switched to oral selexipag and inhaled iloprost. The transition was successful, and she has experienced no exacerbations of SLE-PAH during the 10 months since the onset of pulmonary arterial hypertension. To the best of our knowledge, this is the first report of intravenous epoprostenol being switched to alternative oral and inhaled therapy in a patient with SLE-PAH. In combination with adequate immunosuppressive therapy, it is probably easier to make this transition in patients with SLE-PAH than in those with pulmonary arterial hypertension of a different aetiology. Continuous infusion of epoprostenol can have potentially life-threatening complications and a detrimental effect on the quality of life. Our alternative treatment strategy was successful, and we hope that it will prove beneficial in other cases.
True oxygen reduction capacity during photosynthetic electron transfer in thylakoids and intact leaves
Authors: Fitzpatrick Duncan , Aro Eva-Mari , Tiwari Arjun
Published: February 2022

Reactive oxygen species (ROS) are generated in electron transport processes of living organisms in oxygenic environments. Chloroplasts are plant bioenergetics hubs where imbalances between photosynthetic inputs and outputs drive ROS generation upon changing environmental conditions. Plants have harnessed various site-specific thylakoid membrane ROS products into environmental sensory signals. Our current understanding of ROS production in thylakoids suggests that oxygen (O2) reduction takes place at numerous components of the photosynthetic electron transfer chain (PETC). To refine models of site-specific O2 reduction capacity of various PETC components in isolated thylakoids of Arabidopsis thaliana, we quantified the stoichiometry of oxygen production and consumption reactions associated with hydrogen peroxide (H2O2) accumulation using membrane inlet mass spectrometry and specific inhibitors. Combined with P700 spectroscopy and electron paramagnetic resonance spin trapping, we demonstrate that electron flow to photosystem I (PSI) is essential for H2O2 accumulation during the photosynthetic linear electron transport process. Further leaf disc measurements provided clues that H2O2 from PETC has a potential of increasing mitochondrial respiration and CO2 release. Based on gas exchange analyses in control, site-specific inhibitor-, methyl viologen-, and catalase-treated thylakoids, we provide compelling evidence of no contribution of plastoquinone pool or cytochrome b6f to chloroplastic H2O2 accumulation. The putative production of H2O2 in any PETC location other than PSI is rapidly quenched and therefore cannot function in H2O2 translocation to another cellular location or in signaling.
COVID-19, poverty reduction, and partisanship in Canada and the United States
Authors: Béland Daniel , Dinan Shannon , Rocco Philip , Waddan Alex
Published: February 2022

Poor people proved especially vulnerable to economic disruption during the coronavirus disease (COVID-19) pandemic, which highlighted the importance of poverty reduction as a policy concern. In this article, we explore the politics of poverty reduction during the COVID-19 crisis in Canada and the United States, two liberal welfare-state regimes where poverty reduction is a key policy issue. We show that, since the beginning of the pandemic, policies likely to reduce poverty significantly have been adopted in both Canada and the United States. Yet, this poverty reduction logic has emerged in different ways in the two countries—with the United States embracing more significant departures from its policy status quo. This situation leads us to ask the following question: in each country, what are the political conditions under which public policies susceptible of reducing poverty are enacted? To answer this question, we study the politics of poverty reduction both before and during the pandemic, as we suggest that grasping the evolution of partisan and electoral patterns over time is necessary to explain what happened during the pandemic, whose impact is closely related to how it interacts with such patterns. Our analysis suggests the need to consider more carefully the impact of both crises and partisanship on social policy, including poverty reduction.
TRITIUM CONCENTRATION IN MONTHLY PRECIPITATION NEAR THE FUSION TEST FACILITY IN JAPAN BEFORE AND AFTER THE DEUTERIUM PLASMA EXPERIMENT
Authors: Akata Naofumi , Iwata Chie , Nakada Miki , Kato Akemi , Okada Kazusa , Kuwata Haruka , Nakasone Shunya , Tanaka Masahiro
Published: February 2022

In Japan, the deuterium plasma experiment using the Large Helical Device was started at the National Institute for Fusion Science (NIFS) in March 2017 to investigate high-temperature plasma physics and hydrogen isotope effects in research leading towards the realisation of fusion energy. The deuterium plasma experiment produces small amount of tritium by fusion reactions. To understand any impacts by the experiment to the surrounding environment, monthly precipitation samples have been collected at the NIFS site since November 2013 to assess the relationship between isotope composition and chemical species in precipitation including tritium. By comparing data before and after the deuterium plasma experiment start, it was found that tritium released from the main stack of the fusion test facility had no impact on the environment surrounding NIFS.
Some History
Authors: Husbands Phil
Published: February 2022

This chapter traces the history of robots. While stories
of artificial human-like creatures go back at least to the myths of ancient Greece, the notion
of embodied mechanical intelligence was thrust center stage in the years between the World Wars.
In 1921, Karel Čapek's play R.U.R. (Rossum's Universal Robots)
introduced the world to robots, in the process forging the associated myths and images that now
permeate our culture. From the late 1920s through into the 1940s various machines started to
appear that were described by their inventors as robots. Two of the most famous were Eric the
Robot and Elektro the Moto-Man. Entertaining as they were, the robots of the 1920s and 1930s
were far from autonomous. In 1948, the artificial animal became a reality when British
neurophysiologist William Grey Walter completed the first of a series of machines he called
“tortoises,” the first ever mobile robots that were genuinely autonomous. The chapter then looks
at cybernetics and the use of industrial robots in factories. From the early 1960s, the newly
established field of artificial intelligence began to take over from cybernetics as the dominant
force in attempts to make machines smart. But in the 1990s biologically-inspired approaches,
that echo the concerns of cybernetics, came back to the fore and today underpin many of the
methods used in robotics and artificial intelligence.
Revision of the generic system for the swimming crab subfamily Portuninae (Decapoda: Brachyura: Portunidae) based on molecular and morphological analyses
Authors: Koch Milan , Spiridonov Vassily A , Ďuriš Zdeněk
Published: February 2022

Swimming crabs of the genus Portunus are revised based on analysis of three genetic markers (COI, 16S and H3) and a morphological comparison. The analyses reveal the polyphyletic composition of Monomia, Portunus and Xiphonectes and the paraphyly of Achelous. Portunus, in our revised composition, is restricted to 13, Monomia to ten and Xiphonectes to 14 species. Other species are transferred to Achelous (28) and Cycloachelous (nine) or to newly established genera. Four new genera are separated from Xiphonectes and one new genus from Monomia. The systematic composition of the portunid subfamily Portuninae now comprises 11 genera: Arenaeus, Allomonomia gen. nov., Cavoportunus, Callinectes, Cycloachelous, Eodemus gen. nov., Incultus gen. nov., Monomia, Portunus, Trionectes gen. nov. and Xiphonectes. The genus Lupella is synonymized with Achelous (Achelouinae). Xiphonectes pulchricristatus and Xiphonectes spinipes are placed in Alionectes gen. nov., Portunus ponticus is transferred to Lupocycloporus (both Lupocyclinae), and Monomia euglypha is now placed in Cycloachelous (Portuninae). Portunus mokyevskyi is considered a junior synonym of Scylla tranquebarica (Necronectinae). Xiphonectes leptocheles is confirmed as a valid species. Cycloachelous granulatus unispinosus is also considered a valid species and is to be treated as Cycloachelous unispinosus.
Comparison Between Preoperative Methadone and Buprenorphine Use on Postoperative Opioid Requirement
Authors: Komatsu Ryu , Nash Michael , Peperzak Katherin A. , Ziga Taylor M. , Dinges Emily M. , Delgado Carlos , Wu Jiang , Terman Gregory W. , Dale Rebecca C.
Published: February 2022

Objectives:

Buprenorphine is a partial agonist at mu-opioid receptors and competes for these receptors with other opioids in vitro. Whether patients on buprenorphine maintenance require high doses of opioid analgesics to attain adequate postoperative pain control has not been determined. We evaluated differences in acute postoperative opioid consumption and pain burden between patients taking buprenorphine and those taking methadone preoperatively.

Materials and Methods:

A retrospective review of medical records of 928 patients, of whom 195 were on buprenorphine and 733 were on methadone preoperatively, was performed. Among methadone and buprenorphine patients, 615 and 89, respectively, continued to receive the medications postoperatively. Buprenorphine patients were compared with methadone patients for the first 48 hours postoperatively with regard to acute opioid dose requirements (morphine milligram equivalents [MME] above their baseline buprenorphine and methadone doses) and time-weighted average (TWA) pain scores (using targeted maximum likelihood estimation).

Results:

Opioid dose requirements for 48 hours postoperatively were 150 (22 to 297) (median [interquartile range]) and 220 [90 to 360] MME for buprenorphine and methadone patients, respectively. Preoperative buprenorphine was associated with a 59.9% lower postoperative MME (95% confidence interval: 46.6%-69.8%, P<0.0001) compared with methadone. Postoperative TWA pain scores for the first 48 hours were 5.0±2.7 (mean±SD), and 5.4±2.3 for buprenorphine and methadone patients, respectively. Preoperative buprenorphine was associated with a 0.37-point lower TWA pain score (95% confidence interval: 0.14-0.61, P=0.002) compared with methadone.

Discussion:

Preoperative buprenorphine use was associated with >50% reduction in postoperative opioid dose requirement and a statistically significant, though clinically unimportant, reduction in acute pain burden in comparison to methadone. The study is limited by several important factors such as the exclusion of patients requiring intravenous patient-controlled analgesia, small number of patients were on higher dose of buprenorphine, and a large percentage of methadone patients were not on a stable dose of methadone yet.
Trapeziectomy With Intermetacarpal Suspension: A Surgical Technique
Authors: Wasef Kareem , Sraj Shafic A.
Published: February 2022

A wide variety of techniques are available for surgical management of thumb carpometacarpal osteoarthritis, and current literature does not favor one in particular. We present a simple method that relies on anchoring the thumb metacarpal using the intermetacarpal ligament. This technique is time-efficient, technically simple, cost effective, and does not require donor tendons, hardware, or powered instruments.
The Psychological Impact on Relatives of Critically Ill Patients: The Influence of Visiting Hours
Authors: Iglesias Judit , Martín Juan , Alcañiz Montserrat , Ezquiaga Elena , Vega Gema
Published: February 2022

OBJECTIVES:

To identify the psychologic impact of admission to the ICU on the relatives of critically ill patients, the influence of coping, and the factors involved.

DESIGN:

We performed a cohort study with repeated measures evaluation using descriptive and comparative bivariate and multivariate analyses.

SETTINGS:

An adult ICU of a third-level complexity hospital.

PATIENTS:

The family members of patients (maximum of three per patient) staying longer than 3 days.

INTERVENTIONS:

Not applicable.

MEASUREMENTS AND MAIN RESULTS:

Psychologic impact was assessed using two subgroups of psychologic distress: anxiety (by the State-Trait Anxiety Inventory) and depression (by the Beck Depression Inventory). Satisfaction and coping were assessed by the Critical Care Family Needs Inventory and the Brief Coping Orientations to Problems Experienced Inventory, respectively. We included 104 family members; psychologic distress was high at admission (72% had anxiety, 45% had depression, and 42% had both) but decreased at discharge (34% had anxiety, 23% had depression, and 21% had both). The risk factors related to psychologic impact were severity (anxiety: Acute Physiology and Chronic Health Evaluation score ≥ 18 points: relative risk [RR], 2; 95% CI, 1–4; p = 0.03), invasive mechanical ventilation (anxiety: RR, 1.9; 95% CI, 1–3.6; p = 0.04), recent psychotropic medication use by relatives (depression: RR, 1.6; 95% CI, 1–2.9; p = 0.05), a restrictive visiting policy (anxiety: RR, 5.7; 95% CI, 2–10.4; p = 0.002), no emotion-focused coping strategy (anxiety: strategy < 11 points, RR, 6.1; 95% CI, 1.2–52; p = 0.01), and functional impairment (depression: Barthel index ≤ 60 points, RR, 7.4; 95% CI, 1.7–26.3; p = 0.01).

CONCLUSIONS:

The psychologic impact from admission to the ICU on family members is high. Visiting hours is the main modifiable factor to reduce the impact.
Early Clinical and Electrophysiological Brain Dysfunction Is Associated With ICU Outcomes in COVID-19 Critically Ill Patients With Acute Respiratory Distress Syndrome: A Prospective Bicentric Observational Study*
Authors: Benghanem Sarah , Cariou Alain , Diehl Jean-Luc , Marchi Angela , Charpentier Julien , Augy Jean-Loup , Hauw-Berlemont Caroline , Gavaret Martine , Pène Frédéric , Mira Jean-Paul , Sharshar Tarek , Hermann Bertrand
Published: February 2022

OBJECTIVES:

Describe the prevalence of acute cerebral dysfunction and assess the prognostic value of an early clinical and electroencephalography (EEG) assessment in ICU COVID-19 patients.

DESIGN:

Prospective observational study.

SETTING:

Two tertiary critical care units in Paris, France, between April and December 2020.

PATIENTS:

Adult critically ill patients with COVID-19 acute respiratory distress syndrome.

INTERVENTIONS:

Neurologic examination and EEG at two time points during the ICU stay, first under sedation and second 4–7 days after sedation discontinuation.

MEASUREMENTS AND MAIN RESULTS:

Association of EEG abnormalities (background reactivity, continuity, dominant frequency, and presence of paroxystic discharges) with day-28 mortality and neurologic outcomes (coma and delirium recovery). Fifty-two patients were included, mostly male (81%), median (interquartile range) age 68 years (56–74 yr). Delayed awakening was present in 68% of patients (median awakening time of 5 d [2–16 d]) and delirium in 74% of patients who awoke from coma (62% of mixed delirium, median duration of 5 d [3–8 d]). First, EEG background was slowed in the theta-delta range in 48 (93%) patients, discontinuous in 25 patients (48%), and nonreactive in 17 patients (33%). Bifrontal slow waves were observed in 17 patients (33%). Early nonreactive EEG was associated with lower day-28 ventilator-free days (0 vs 16; p = 0.025), coma-free days (6 vs 22; p = 0.006), delirium-free days (0 vs 17; p = 0.006), and higher mortality (41% vs 11%; p = 0.027), whereas discontinuous background was associated with lower ventilator-free days (0 vs 17; p = 0.010), coma-free days (1 vs 22; p < 0.001), delirium-free days (0 vs 17; p = 0.001), and higher mortality (40% vs 4%; p = 0.001), independently of sedation and analgesia.

CONCLUSIONS:

Clinical and neurophysiologic cerebral dysfunction is frequent in COVID-19 ARDS patients. Early severe EEG abnormalities with nonreactive and/or discontinuous background activity are associated with delayed awakening, delirium, and day-28 mortality.
Neurologic Outcomes of Survivors of COVID-19–Associated Acute Respiratory Distress Syndrome Requiring Intubation
Authors: Jaquet Pierre , Legouy Camille , Le Fevre Lucie , Grinea Alexandra , Sinnah Fabrice , Franchineau Guillaume , Patrier Juliette , Marzouk Mehdi , Wicky Paul-Henri , Alexis Geoffroy Pierre , Arnoult Florence , Vledouts Serafima , de Montmollin Etienne , Bouadma Lila , Timsit Jean-François , Sharshar Tarek , Sonneville Romain
Published: February 2022

OBJECTIVES:

To describe 3–6-month neurologic outcomes of survivors of COVID-19–associated acute respiratory distress syndrome, invasively ventilated in the ICU.

DESIGN:

A bicentric prospective study during the two first waves of the pandemic (March to May and September to December, 2020).

SETTING:

Two academic hospital ICUs, Paris, France.

PATIENTS:

Adult COVID-19–associated acute respiratory distress syndrome survivors, invasively ventilated in the ICU, were eligible for a neurologic consultation between 3 and 6 months post ICU discharge.

INTERVENTIONS:

Follow-up by face-to-face neurologic consultation.

MEASURES AND MAIN RESULTS:

The primary endpoint was favorable functional outcome defined by a modified Rankin scale score less than 2, indicating survival with no significant disability. Secondary endpoints included mild cognitive impairment (Montreal Cognitive Assessment score < 26), ICU-acquired weakness (Medical Research Council score < 48), anxiety and depression (Hospital Anxiety and Depression score > 7), and posttraumatic stress disorder (posttraumatic stress disorder checklist for Diagnostic and Statistical Manual of Mental Disorders 5 score > 30). Of 54 eligible survivors, four non-French-speaking patients were excluded, eight patients were lost-to-follow-up, and one died during follow-up. Forty-one patients were included. Time between ICU discharge and neurologic consultation was 3.8 months (3.6–5.9 mo). A favorable functional outcome was observed in 16 patients (39%) and mild cognitive impairment in 17 of 33 patients tested (52%). ICU-acquired weakness, depression or anxiety, and posttraumatic stress disorder were reported in six of 37 cases (16%), eight of 31 cases (26%), and two of 27 cases (7%), respectively. Twenty-nine patients (74%) required rehabilitation (motor, cognitive, or psychologic). ICU and hospital lengths of stay, tracheostomy, and corticosteroids were negatively associated with favorable outcome. By contrast, use of alpha-2 agonists during ICU stay was associated with favorable outcome.

CONCLUSIONS:

COVID-19–associated acute respiratory distress syndrome requiring intubation led to slight-to-severe functional disability in about 60% of survivors 4 months after ICU discharge. Cognitive impairment, muscle weakness, and psychologic symptoms were frequent. A large multicenter study is warranted to allow identification of modifiable factors for improving long-term outcome.
Propensity Scoring in Plastic Surgery Research: An Analysis and Best Practice Guide
Authors: Chu Jacqueline J. , Shamsunder Meghana G. , Yin Shen , Rubenstein Robyn R. , Slutsky Hanna , Fischer John P. , Nelson Jonas A.
Published: February 2022

Randomized controlled trials, though considered the gold standard in clinical research, are often not feasible in plastic surgery research. Instead, researchers rely heavily on observational studies, leading to potential issues with confounding and selection bias. Propensity scoring—a statistical technique that estimates a patient’s likelihood of having received the exposure of interest—can improve the comparability of study groups by either guiding the selection of study participants or generating a covariate that can be adjusted for in multivariate analyses. In this study, we conducted a comprehensive review of research articles published in three major plastic surgery journals (Plastic and Reconstructive Surgery, Journal of Plastic, Reconstructive, & Aesthetic Surgery, and Annals of Plastic Surgery) to determine the utilization of propensity scoring methods in plastic surgery research from August 2018 to August 2020. We found that propensity scoring was used in only eight (0.8%) of 971 research articles, none of which fully reported all components of their propensity scoring methodology. We provide a brief overview of propensity score techniques and recommend guidelines for accurate reporting of propensity scoring methods for plastic surgery research. Improved understanding of propensity scoring may encourage plastic surgery researchers to incorporate the method in their own work and improve plastic surgeons’ ability to understand and analyze future research studies that utilize propensity score methods.
The “Frogger Flap”: A Novel Quadruple Rhomboid Flap for Complex Central Upper Lip Reconstruction
Authors: Robinson Jordan N. , Elhage Sharbel A. , Marturano Matthew N. , Teng Edward
Published: February 2022

Upper lip reconstruction represents a unique challenge for the reconstructive plastic surgeon. Given its prominent aesthetic role in addition to its functional role in facial expression, speech, and oral intake, preservation of this region’s natural form and function is paramount. In this report, we present a novel technique for the reconstruction of a complex central upper lip defect, restoring the natural aesthetic of this essential structure. We describe the case of a 51-year-old woman who presented with recurrence of a previously resected basal cell carcinoma center on the upper lip at the level of the white roll and philtral depression. Following surgical resection via Mohs micrographic surgery, a 1.8 × 1.6 cm partial-thickness defect centered around the Cupid bow involving both cutaneous and vermillion tissues remained. Reconstruction was achieved through a novel quadruple rhomboid flap primarily based on the preservation of the aesthetic subunits of the upper lip. A functional and aesthetic reconstruction was achieved through local tissue rearrangement, restoring the appearance of the white roll and red line. Native perfusion and innervation were preserved during the reconstruction of the Cupid bow, recreating this region’s natural appearance. The design of the flap resembles a jumping frog, which is the etiology of the “Frogger flap” moniker. The Frogger flap recreates the natural aesthetic of the central upper lip through the geometric transposition of tissue commensurate with native anatomy. Through the application of aesthetic subunit principles, it reliably reconstructs central upper lip defects while preserving function and providing an aesthetically pleasing outcome.
There is No “Axillary Tail”: Rethinking the Assumption of James Spence
Authors: Teplica David , Cooney Emmett , Jeffers Eileen , Sayers Michael
Published: February 2022

Widely quoted, “the axillary tail of Spence” refers to a contiguous extension of adipose angling superolaterally from the primary breast into the axilla. Described anecdotally in 1871, the “tail of Spence” has been considered important to the fields of general surgery, oncology, plastic surgery, and anatomy ever since. Despite the ubiquitous presence of the concept in literature, clinical discussions, and educational settings, we argue against the very existence of Spence’s “tail.” While pinch-testing and topographically mapping 316 consecutive patients in preparation for breast and gynecomastia surgery, we found a consistent pattern of focal fat mounds without continuity between breast and axilla. The absence of an uninterrupted superolateral tail was reaffirmed while analyzing 20 research participants who were pinch-tested with calipers and topographically mapped, specifically to define fat pad anatomy. We documented that the axillary breast mound was always distinct from the primary breast and that all women and many men had an additional “lateral chest wall tail” that never angled toward the axilla. In most, rolling the shoulder girdle anteriorly created a visible groove between the axillary mound and the primary breast, with little or no pinchable fat beneath that crease. With all deference to Spence, we have established that the outer half of the chest is consistently defined by three focal adipose structures—an axillary mound, the primary breast mound, and a previously unnamed “lateral chest wall tail”—with no anatomic evidence of an “axillary tail” of fat extending superolaterally from breast to axilla.
Streamlining the Diagnosis of Atypical Facial Palsies: A 5-year Review of 805 Patients
Authors: Cheung Lok Ka , Kannan Ruben Y. , Neville Catriona , Gwynn Tamsin , Young Karen , Ching Rosanna C. , Nduka Charles
Published: February 2022

Background:

Currently, there are no definitive guidelines in the investigation and management of atypical facial palsies (AFPs). Our aim was to determine the etiology of AFPs presenting to a tertiary facial palsy center and to review the current spectrum of diagnostic and management approaches to these conditions.

Methods:

A retrospective cohort analysis of attendees at the Queen Victoria Hospital multidisciplinary facial palsy clinic over a 5-year period from 2016 to 2020 was conducted. Demographic data were collated from the QVH Research and Governance team. Those presenting with classic Bell’s palsy or Ramsay-Hunt syndrome were excluded. Anyone with atypical presentations (including multiple recurrences, focal neurological deficits, polycranial neuropathies, autoimmune conditions, hemifacial spasms, hearing/balance issues, weight loss, segmental facial palsies, and gradual onset presentations) were included under the AFP category. These patients were subjected to standard serological and radiological investigations and their follow-ups were reviewed.

Results:

A total of 849 patients were identified, and 805 had actual facial palsy presentations. Of these, 172 patients had AFP. The majority of these patients had MRI imaging tests, which were useful, but the remaining serological tests were found to correlate more with symptom clusters and specific questions rather than with random tests for all AFPs.

Conclusions:

Although serological and radiological investigations help in the diagnosis of AFP, specific questions and presentations help streamline the diagnosis, without affecting its accuracy whilst reducing unnecessary tests and, thereby, cost and time. We present an algorithm organized by specific questions of presentations in those with AFPs.