bluuebunny/crossref_metadata_2025 huggingface dataset:
Predicting the Risk of Tart Cherry (Prunus cerasus) Infestation by Drosophila suzukii (Diptera: Drosophilidae)
Authors: Wilson Julianna K , Gut Larry J , Powers Karen , Huang Juan , Rothwell Nikki
Published: February 2022

Drosophila suzukii (Matsumura, 1931) (Diptera: Drosophilidae) is a vinegar fly native to East Asia that has rapidly expanded its range to become a pest of sweet cherry (Prunus avium, L. 1753 [Rosales: Rosaceae]) and tart cherry (P. cerasus, L. 1753) in North America and Europe. The goal of the research presented herein was to improve the decision-making process for managing D. suzukii in tart cherry. Knowing that D. suzukii females are attracted to ripening fruit, we measured fruit infestation by D. suzukii as it relates to an existing fruit development model that uses full bloom as a biofix, calculating accumulated growing degree days (GDD) with a lower threshold of 4°C. Increasing larval infestation was highly correlated with fruit development expressed as GDD post-bloom with very few larvae developing in fruit subjected to no-choice assays prior to 530 GDD (base 4°C) and no larvae detected in naturally infested fruit prior to 800 GDD. Our findings provide the first quantification of the relationship between fruit development and D. suzukii infestation that allows for pinpointing the timing of fruit susceptibility and that could be used as the basis for a more sustainable management program for this pest in tart cherry orchards.
(In)Vulnerable Masculinities and Human Trafficking: Men, Victimhood, and Access to Protection in the United Kingdom
Authors: Magugliani Noemi
Published: February 2022

The anti-trafficking movement has historically focussed almost entirely on the experiences of women and girls, excluding men from the narrative. This exclusion has led to a lack of understanding and identification of men's trafficking experiences, which in turn has hindered their access to protection. An analysis of decisions of the United Kingdom's Upper Tribunal on protection claims filed by adult male ‘victims of trafficking’ shows that substantial obstacles exist for adult male ‘victims of trafficking’ in accessing protection, mostly as a result of the reticence of decision-makers to perceive, understand, and acknowledge vulnerability outside of traditional gender stereotyping.
Global spread of a Japan-originated Delta lineage of SARS-CoV-2 after the Tokyo Olympics is most likely unrelated to the Olympics
Authors: Shimura Takako , Kosaki Kenjiro
Published: February 2022

Participants of the 2021 Summer Olympics in Tokyo were required to adhere to strict health protocols, and there were no major local outbreaks within the separation bubbles. However, based on viral genomic data, we report that the Japan-specific Delta variants did spread out globally during or after the Olympics.
From belief to trust: A quantitative framework based on modal logic
Authors: Tagliaferri Mirko , Aldini Alessandro
Published: February 2022

In this work, we provide a logical characterization of trust, which is based on a modal logic expressing a computational notion of trust quantitatively dependent on the beliefs possessed by the agent. The proposed framework encompasses decidability results and equivalence laws emphasizing the properties of trust. The overall aim is to obtain a formal notion of trust that could be employed for further developments of formal languages related to decision-making procedures and soft-security mechanisms in online, digital environments. Such formal counterpart of trust should support agents, either human or artificial, in devising secure decision strategies based on partial and/or indirect information.
Duties of Candour in Healthcare: The Truth, the Whole Truth, and Nothing but the Truth?
Authors: Quick Oliver
Published: February 2022

The creation of professional and statutory duties of candour has formalised the requirement for clinicians and healthcare organisations to be honest with patients and families when treatment has gone wrong. This article explains the background to creating both duties, analyses the concept of candour, the role of apologies, and considers evidence about compliance. It argues that making candour a statutory requirement appropriately reflects the ethical imperative of telling the truth about harm and is a powerful signal for honesty. However, being candid is not easy in the context of complex professional cultures, the realities of delivering care in under-funded health systems, and in the shadow of possible legal and regulatory proceedings. Proposals in the current Health and Care Bill to create investigatory ‘safe spaces’ which prohibit the disclosure of information submitted to the Health Service Safety Investigations Body undermine candour. This article argues against such proposals, which are both wrong in principle and highly problematic in practice. Candour should be respected as a cardinal principle governing not only the conduct of those providing care, but also those who investigate such incidents. Harmed patients and their families deserve to know the whole truth.
Modelling the kinematics of the decelerating jets from the black hole X-ray binary MAXI J1348–630
Authors: Carotenuto F , Tetarenko A J , Corbel S
Published: February 2022

Black hole low mass X-ray binaries (BH LMXBs) can launch powerful outflows in the form of discrete ejecta. Observing the entire trajectory of these ejecta allows us to model their motion with great accuracy and this is essential for measuring their physical properties. In particular, observing the final deceleration phase, often poorly sampled, is fundamental to obtain a reliable estimate of the jet’s energy. During its 2019/2020 outburst, the BH LMXB MAXI J1348–630 launched a single-sided radio-emitting jet that was detected at large scales after a strong deceleration due to the interaction with the interstellar medium (ISM). We successfully modelled the jet motion with a dynamical external shock model, which allowed us to constrain the jet initial Lorentz factor $\Gamma _0 = 1.85^{+0.15}_{-0.12}$, inclination angle $\theta = {29.3 }_{-3.2}^{+2.7 }$ deg, and ejection date $t_{\rm ej} = 21.5_{-3.0}^{+1.8}$ (MJD–58500). Under simple assumptions on the jet opening angle and on the external ISM density, we find that the jet has a large initial kinetic energy $E_0 = 4.6^{+20.0}_{-3.4} \times 10^{46}$ erg, far greater than what commonly measured for LMXBs from the jet’s synchrotron emission. This implies that discrete ejecta radiate away only a small fraction of their total energy, which is instead transferred to the environment. The jet power estimate is larger than the simultaneous available accretion power, and we present several options to mitigate this discrepancy. We infer that MAXI J1348–630 is likely embedded in an ISM cavity with internal density $n = 0.0010^{+0.0005}_{-0.0003}$ cm−3 and radius $R_{\rm c} = 0.61^{+0.11}_{-0.09}$ pc, which could have been produced by the system’s previous activity, as proposed for other BH LMXBs.
X-ray/Hα scaling relationships in stellar flares
Authors: Kawai Hiroki , Tsuboi Yohko , Iwakiri Wataru B , Maeda Yoshitomo , Katsuda Satoru , Sasaki Ryo , Kohara Junya ,   MAXI TEAM
Published: February 2022

We report on the results of our simultaneous observations of three large stellar flares with soft X-rays (SXRs) and an Hα emission line from two binary systems of RS CVn type. The energies released in the X-ray and Hα emissions during the flares were 1036–1038 and 1035–1037 erg, respectively. This renders the set of the observations as the first successful simultaneous X-ray/Hα observations of the stellar flares with energies above 1035 erg; although the coverage of the Hα observations was limited, with $\sim\! 10\%$ of the e-folding time in the decay phase of the flares, that of the SXR ones was complete. Combining the obtained physical parameters and those in literature for solar and stellar flares, we obtained a good proportional relation between the emitted energies of X-ray and Hα emissions for a flare energy range of 1029–1038 erg. The ratio of the Hα-line to bolometric X-ray emissions was ∼0.1, where the latter was estimated by converting the observed SXR emission to that in the 0.1–100 keV band according to the best-fitting thin thermal model. We also found that the e-folding times of the SXR and Hα light curves in the decaying phase of a flare are in agreement for a time range of 1–104 s. Even very large stellar flares with energies of six orders of magnitude larger than the most energetic solar flares follow the same scaling relationships with solar and much less energetic stellar flares. This fact suggests that their physical parameters can be estimated on the basis of the known physics of solar and stellar flares.
Molecular innovations in plant TIR-based immunity signaling
Authors: Lapin Dmitry , Johanndrees Oliver , Wu Zhongshou , Li Xin , Parker Jane E
Published: February 2022

A protein domain (Toll and Interleukin-1 receptor [TIR]-like) with homology to animal TIRs mediates immune signaling in prokaryotes and eukaryotes. Here, we present an overview of TIR evolution and the molecular versatility of TIR domains in different protein architectures for host protection against microbial attack. Plant TIR-based signaling emerges as being central to the potentiation and effectiveness of host defenses triggered by intracellular and cell-surface immune receptors. Equally relevant for plant fitness are mechanisms that limit potent TIR signaling in healthy tissues but maintain preparedness for infection. We propose that seed plants evolved a specialized protein module to selectively translate TIR enzymatic activities to defense outputs, overlaying a more general function of TIRs.
TRITIUM AND IODINE-129 IN WATER SAMPLES COLLECTED ADJACENT TO A SPENT NUCLEAR FUEL REPROCESSING PLANT IN ROKKASHO, JAPAN
Authors: Ueda Shinji , Hasegawa Hidenao , Kakiuchi Hideki
Published: February 2022

Between April 2006 and October 2008, tritium ( 3H) and iodine-129 ( 129I) were released into the atmosphere and ocean from a spent nuclear fuel reprocessing plant in Rokkasho, Japan. From 2005 to 2020, water samples were collected from water bodies around the plant, including a river, groundwater wells, a brackish lake, a fishing port and a coastal sea, to measure spatiotemporal changes in 3H and 129I concentrations. Water samples from the brackish lake and the fishing port between 2006 and 2008 occasionally had higher than background levels of 3H and 129I. Batched discharge of waste 3H and 129I was quickly diluted by advection–diffusion processes in the coastal sea, causing 3H and 129I from the plant to be indetectable. By contrast, concentrations of 3H and 129I that flowed into the brackish lake and the fishing port through various routes were high, as these water bodies are mostly closed systems.
Depletion work: climate change and the mediation of stranded assets
Authors: Aitken Rob
Published: February 2022

The relationship between economy and society increasingly takes financialized form. In this article, I examine two mediations of climate change which attempt to re/settle this financialized relationship: (a) stranded assets, a representation of value lost as the long-term lives of assets are interrupted; and (b) internal proxy pricing for carbon, a mechanism which allows firms to integrate a price for carbon into investment decision-making. I argue that internal proxy pricing allows investors to protect assets whose long-term value has been thrown into question by climate change. This suggests that discussions of financialization should be focused not only on the construction of financial value, but also on the ways in which value dissipates over time. These contending mediations also provoke questions about the relationship between ‘risk’ and ‘uncertainty’ in ways that suggest a fundamental reordering of what it means to confront an unknowable future in a moment of financialized calculation.
Are seizures associated with neuroschistosomiasis mansoni? An exploratory survey in an endemic area of Brazil
Authors: Ferrari Teresa Cristina A , Oliveira Ana Elisa M , Logato Maria Júlia S , Ganzella Carolina G , Melo Rodolfo Ferreira Q , Rocha Ana Paula C , Barbosa Fernanda A , Cunha Pedro Ferrari S , Silva Rogério Augusto P , Faria Luciana C , Cançado Guilherme Grossi L , Couto Cláudia A , Cunha Aloísio S
Published: February 2022

Background

Deposition of Schistosoma mansoni eggs in the brain of patients with hepatosplenic schistosomiasis (HS-SM) is frequent and usually asymptomatic. However, it is questioned whether it could cause seizures. Thus, we investigated the occurrence of seizures in these patients and also searched for parameters associated with this disorder.

Methods

In a cross-sectional survey, we compared 128 patients with HS-SM with 102 patients with portal hypertension due to compensated chronic hepatic disease of other etiologies. A standardized questionnaire, emphasizing epilepsy-related parameters, was applied to all participants.

Results

Eight (6.3%) patients with HS-SM had a history of seizures, whereas this condition was reported by three (2.9%) individuals from the comparison group (p=0.354). None of the variables were associated with the occurrence of seizures, either in univariate or in multivariate analysis.

Conclusions

The frequency of seizures was similar in both study groups. However, it was higher than that described in population-based studies. Thus, we hypothesize that HS-SM individuals may have a higher frequency of seizure. The lack of difference between the two study groups may be explained by the inclusion of cases of HS-MS overlapping other chronic liver diseases in the comparison group, because this finding is relatively common in schistosome-endemic areas.
Limited genomic reconstruction of SARS-CoV-2 transmission history within local epidemiological clusters
Authors: Gallego-García Pilar , Varela Nair , Estévez-Gómez Nuria , De Chiara Loretta , Fernández-Silva Iria , Valverde Diana , Sapoval Nicolae , Treangen Todd J , Regueiro Benito , Cabrera-Alvargonzález Jorge Julio , del Campo Víctor , Pérez Sonia , Posada David
Published: February 2022

A detailed understanding of how and when severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission occurs is crucial for designing effective prevention measures. Other than contact tracing, genome sequencing provides information to help infer who infected whom. However, the effectiveness of the genomic approach in this context depends on both (high enough) mutation and (low enough) transmission rates. Today, the level of resolution that we can obtain when describing SARS-CoV-2 outbreaks using just genomic information alone remains unclear. In order to answer this question, we sequenced forty-nine SARS-CoV-2 patient samples from ten local clusters in NW Spain for which partial epidemiological information was available and inferred transmission history using genomic variants. Importantly, we obtained high-quality genomic data, sequencing each sample twice and using unique barcodes to exclude cross-sample contamination. Phylogenetic and cluster analyses showed that consensus genomes were generally sufficient to discriminate among independent transmission clusters. However, levels of intrahost variation were low, which prevented in most cases the unambiguous identification of direct transmission events. After filtering out recurrent variants across clusters, the genomic data were generally compatible with the epidemiological information but did not support specific transmission events over possible alternatives. We estimated the effective transmission bottleneck size to be one to two viral particles for sample pairs whose donor–recipient relationship was likely. Our analyses suggest that intrahost genomic variation in SARS-CoV-2 might be generally limited and that homoplasy and recurrent errors complicate identifying shared intrahost variants. Reliable reconstruction of direct SARS-CoV-2 transmission based solely on genomic data seems hindered by a slow mutation rate, potential convergent events, and technical artifacts. Detailed contact tracing seems essential in most cases to study SARS-CoV-2 transmission at high resolution.
Renal Cell Carcinoma Subtypes and Associated Renal Malignancies: A Pictorial Review—Part II
Authors: Boora Naveenjyote S. , Perlau Michaela , Fung Christopher I.
Published: February 2022

In this second article in this series, we present a pictorial review of common renal neoplasms and renal malignancy mimics, including urothelial carcinoma, liposarcoma, oncocytoma, renal pseudotumors, and renal metastases. Renal cell carcinoma (RCC) subtypes and their respective radiologic findings were discussed in Part I of this series. Principles of management of select RCC subtypes and other renal neoplasms, including urothelial carcinoma and angiomyolipoma (AML), will be discussed. Management of solitary renal masses via active surveillance (AS) or surgical intervention and the indications for renal mass biopsy as part of the diagnostic workup will also be reviewed.
Trajectories of Dyspareunia From Pregnancy to 24 Months Postpartum
Authors: Rosen Natalie O. , Dawson Samantha J. , Binik Yitzchak M. , Pierce Marianne , Brooks Melissa , Pukall Caroline , Chorney Jill , Snelgrove-Clarke Erna , George Ronald
Published: February 2022

OBJECTIVE:

To identify distinct trajectories of dyspareunia in primiparous women and examine biopsychosocial risk factors of these trajectories.

METHODS:

This was a prospective cohort of 582 first-time mothers. Participants completed validated measures of dyspareunia at 20–24 (baseline) and 32–36 weeks of gestation and at 3, 6, 12, and 24 months postpartum. Risk factors were assessed at baseline and 3 months postpartum, with labor and delivery characteristics collected by medical record review. Latent class growth analysis was conducted to identify homogeneous subgroups with distinct trajectories of dyspareunia. Univariable and multivariable binomial logistic regressions examined whether predictors were associated with these trajectories.

RESULTS:

Overall, the prevalence of dyspareunia ranged from 31.4% at 3 months postpartum to 11.9% at 24 months. We identified two distinct classes of dyspareunia with 21% of women in the class with moderate dyspareunia and 79% in the class with minimal dyspareunia, with pain decreasing in both groups until 12 months postpartum and little change thereafter. Biomedical factors—prior chronic pain (including preexisting dyspareunia), labor epidural analgesia, induction, episiotomy, perineal laceration, mode of delivery, breastfeeding, and whether the woman had a new pregnancy during the postpartum period—did not significantly predict dyspareunia class. Greater fatigue (odds ratio [OR] 1.30; 95% CI 1.05–1.60) and depressive symptoms (OR 1.08; 95% CI 1.02–1.14) in pregnancy and fatigue (OR 1.27; 95% CI 1.04–1.56) and pain catastrophizing (OR 1.10; 95% CI 1.05–1.16) at 3 months postpartum increased the odds for the moderate relative to the minimal pain trajectory in univariable models. In a multivariable model, pain catastrophizing at 3 months postpartum (OR 1.09; 95% CI 1.04–1.15) was associated with the moderate relative to the minimal pain trajectory.

CONCLUSION:

We identified two distinct trajectories of dyspareunia across pregnancy and postpartum. One in five nulliparous women experienced moderate dyspareunia. Pain catastrophizing at 3 months postpartum was associated with experiencing moderate relative to minimal levels of dyspareunia.
Augmented Renal Clearance: An Under-Recognized Phenomenon Associated With COVID-19
Authors: Rhoney Denise H. , Brooks Ashley B. , Nelson Nicholas R.
Published: February 2022

Augmented renal clearance (ARC) is a phenomenon that has been described mainly in critically ill patients and is characterized by increased creatinine clearance and elimination of renally cleared medications that could place patients at risk of therapeutic failure. The COVID-19 pandemic has led to an overwhelming number of ICU admissions with many reports of the impact of COVID-19 on the kidney. This report aims to increase clinician awareness of, and risk factors for ARC in patients with COVID-19, especially in comparison to other critical illnesses.
Low Tidal Volume Ventilation for Emergency Department Patients: A Systematic Review and Meta-Analysis on Practice Patterns and Clinical Impact*
Authors: De Monnin Karlee , Terian Emily , Yaegar Lauren H. , Pappal Ryan D. , Mohr Nicholas M. , Roberts Brian W. , Kollef Marin H. , Palmer Christopher M. , Ablordeppey Enyo , Fuller Brian M.
Published: February 2022

OBJECTIVES:

Data suggest that low tidal volume ventilation (LTVV) initiated in the emergency department (ED) has a positive impact on outcome. This systematic review and meta-analysis quantify the impact of ED-based LTVV on outcomes and ventilator settings in the ED and ICU.

DATA SOURCES:

We systematically reviewed MEDLINE, EMBASE, Scopus, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, references, conferences, and ClinicalTrials.gov.

STUDY SELECTION:

Randomized and nonrandomized studies of mechanically ventilated ED adults were eligible.

DATA EXTRACTION:

Two reviewers independently screened abstracts. The primary outcome was mortality. Secondary outcomes included ventilation duration, lengths of stay, and occurrence rate of acute respiratory distress syndrome (ARDS). We assessed impact of ED LTVV interventions on ED and ICU tidal volumes.

DATA SYNTHESIS:

The search identified 1,023 studies. Eleven studies (n = 12,912) provided outcome data and were meta-analyzed; 10 additional studies (n = 1,863) provided descriptive ED tidal volume data. Overall quality of evidence was low. Random effect meta-analytic models revealed that ED LTVV was associated with lower mortality (26.5%) versus non-LTVV (31.1%) (odds ratio, 0.80 [0.72–0.88]). ED LTVV was associated with shorter ICU (mean difference, −1.0; 95% CI, −1.7 to −0.3) and hospital (mean difference, −1.2; 95% CI, −2.3 to −0.1) lengths of stay, more ventilator-free days (mean difference, 1.4; 95% CI, 0.4–2.4), and lower occurrence rate (4.5% vs 8.3%) of ARDS (odds ratio, 0.57 [0.44–0.75]). ED LTVV interventions were associated with reductions in ED (−1.5-mL/kg predicted body weight [PBW] [−1.9 to −1.0]; p < 0.001) and ICU (−1.0-mL/kg PBW [−1.8 to −0.2]; p = 0.01) tidal volume.

CONCLUSIONS:

The use of LTVV in the ED is associated with improved clinical outcomes and increased use of lung protection, recognizing low quality of evidence in this domain. Interventions aimed at implementing and sustaining LTVV in the ED should be explored.
The Effect of Clusters of Double Triggering and Ineffective Efforts in Critically Ill Patients
Authors: Magrans Rudys , Ferreira Francini , Sarlabous Leonardo , López-Aguilar Josefina , Gomà Gemma , Fernandez-Gonzalo Sol , Navarra-Ventura Guillem , Fernández Rafael , Montanyà Jaume , Kacmarek Robert , Rué Montserrat , Forné Carles , Blanch Lluís , de Haro Candelaria , Aquino-Esperanza José ,   For the ASYNICU group
Published: February 2022

OBJECTIVES:

To characterize clusters of double triggering and ineffective inspiratory efforts throughout mechanical ventilation and investigate their associations with mortality and duration of ICU stay and mechanical ventilation.

DESIGN:

Registry-based, real-world study.

Background:

Asynchronies during invasive mechanical ventilation can occur as isolated events or in clusters and might be related to clinical outcomes.

Subjects:

Adults requiring mechanical ventilation greater than 24 hours for whom greater than or equal to 70% of ventilator waveforms were available.

INTERVENTIONS:

We identified clusters of double triggering and ineffective inspiratory efforts and determined their power and duration. We used Fine-Gray’s competing risk model to analyze their effects on mortality and generalized linear models to analyze their effects on duration of mechanical ventilation and ICU stay.

MEASUREMENTS AND MAIN RESULTS:

We analyzed 58,625,796 breaths from 180 patients. All patients had clusters (mean/d, 8.2 [5.4–10.6]; mean power, 54.5 [29.6–111.4]; mean duration, 20.3 min [12.2–34.9 min]). Clusters were less frequent during the first 48 hours (5.5 [2.5–10] vs 7.6 [4.4–9.9] in the remaining period [p = 0.027]). Total number of clusters/d was positively associated with the probability of being discharged alive considering the total period of mechanical ventilation (p = 0.001). Power and duration were similar in the two periods. Power was associated with the probability of being discharged dead (p = 0.03), longer mechanical ventilation (p < 0.001), and longer ICU stay (p = 0.035); cluster duration was associated with longer ICU stay (p = 0.027).

CONCLUSIONS:

Clusters of double triggering and ineffective inspiratory efforts are common. Although higher numbers of clusters might indicate better chances of survival, clusters with greater power and duration indicate a risk of worse clinical outcomes.
Advances in new antivirals for chronic hepatitis B
Authors: Tang Yanhua , Liang Hongyan , Zeng Ge , Shen Sheng , Sun Jian
Published: February 2022

Chronic hepatitis B virus (HBV) infection remains a global health burden. Timely and effective antiviral therapy is beneficial for patients with HBV infection. With existing antiviral drugs, including nucleos(t)ide analogs and interferon-alfa, patients can achieve viral suppression with improved prognosis. However, the rate of hepatitis B surface antigen loss is low. To achieve a functional cure and even complete cure in chronic hepatitis B patients, new antivirals need to be developed. In this review, we summarized the advantages and disadvantages of existing antiviral drugs and focused on new antivirals including direct-acting antiviral drugs and immunotherapeutic approaches.
Corneal Endothelial Dysfunction as a Manifestation of Digoxin Toxicity
Authors: Mendoza-Moreira Angi Lizbeth , Rodrigo-Rey Sara , Figuerola-García María Belén , González-Alonso Ángela , Marcos-Parra María Teresa , Pérez-Santonja Juan J.
Published: February 2022

Purpose:

The purpose of this study was to report a case of corneal endothelial dysfunction and subsequent corneal edema in a patient with digoxin toxicity.

Method:

This was a case report.

Results:

A 77-year-old woman diagnosed with open-angle glaucoma and treated with a topical prostaglandin analog for 5 years developed blurred vision and photopsia in both eyes. Systemic medications included digoxin, furosemide, apixaban, amlodipine, enalapril, and simvastatin. Ocular examination revealed folds in Descemet membrane and corneal stromal edema in both eyes, with normal fundoscopy. Ancillary tests revealed elevated serum digoxin levels. No intervention other than discontinuation of digoxin was initiated. The corneal edema improved after that and resolved in the next 2 weeks.

Conclusions:

We encountered 1 case of corneal edema secondary to corneal endothelial dysfunction in a patient with digoxin toxicity. Special care should be taken to elicit a complete history because ocular signs can be manifestations of systemic alterations with vital importance for patients.
Posterior Chamber Intraocular Lens Dislocation Into the Vitreous in Association With Descemet Stripping Lamellar Keratoplasty
Authors: Rodler Kristóf Dániel , Pregun Tamás , András Bernadett , Pluzsik Milán Tamás , Hargitai János , Kerényi Ágnes
Published: February 2022

Purpose:

The purpose of this study was to report 3 cases of a single-piece, acrylic, foldable, modified C loop posterior chamber intraocular lens (PCIOL) dislocated into the vitreous cavity after Descemet stripping automated endothelial keratoplasty (DSAEK).

Method:

We describe the clinical course and management of the 3 cases in which a previously implanted foldable, single-piece, acrylic posterior chamber intraocular lens with modified C loops dislocated into the vitreous in association with DSAEK. Surgical management consisted of pars plana vitrectomy in each case with either PCIOL repositioning (2 cases) or PCIOL exchange (1 case) and with different fixation methods, combined with repeated DSAEK in 1 case with previous primary graft failure.

Results:

In 2 cases where the cornea cleared after the DSAEK, the cornea kept its clarity and the PCIOL remained stable. In the third case in which the PCIOL exchange was combined with DSAEK, the cornea only partially cleared up, both the PCIOL and the state of the eye remained stable.

Conclusions:

PCIOL dislocation is a possible and notable complication that requires attention while performing DSAEK on pseudophakic eyes. Not only plate-haptic silicone but also acrylic, single-piece PCIOLs with modified C loops may dislocate into the vitreous in association with DSAEK in cases with compromised capsular or zonular integrity.
Diurnal Variation in Straylight in Patients With Fuchs Endothelial Corneal Dystrophy and Controls
Authors: de Jong Bram , Brandi-Dohrn Franziska , van der Meulen Ivanka J. E. , van den Berg Thomas J. T. P. , Wacker Katrin
Published: February 2022

Purpose:

The goal of this study was to investigate diurnal changes in intraocular straylight in relation to other corneal parameters and subjective complaints in patients with Fuchs endothelial dystrophy and healthy controls.

Methods:

This is a prospective study conducted in 2 tertiary care hospitals in Germany and the Netherlands. Patients with Fuchs endothelial dystrophy (n = 71) and healthy controls (n = 34) were included. Patients with Fuchs dystrophy were grouped by the presence of subjective complaints and measured over multiple time points during the day. Measurements included intraocular straylight using the C-Quant and corneal thickness and backscatter using a Scheimpflug camera. A separate group of healthy controls was measured intensively with repeated straylight measurements directly after waking. An exponential decay model was used to model the diurnal change.

Results:

Healthy controls showed an average straylight baseline of 1.17 log(s) with an increase in straylight after waking of 0.22 log(s). In the repeated measurements subgroup, the increase in morning straylight lasted for 22 minutes. Patients with Fuchs dystrophy showed a morning increase in straylight of 0.21 log(s) present up to 4 hours after waking before reaching an average baseline of 1.30 log(s). Straylight was positively correlated with anterior corneal backscatter, r = 0.21, P = 0.022, and corneal thickness, r = 0.46, P < 0.01.

Conclusions:

Healthy eyes experience a diurnal straylight increase similar to patients with Fuchs dystrophy in intensity. However, in Fuchs dystrophy, the resolution of increased straylight is prolonged over multiple hours compared with minutes in healthy eyes. This suggests pathological exacerbation of a physiological diurnal change. This mechanism can play a role in subjective complaints experienced by patients with Fuchs dystrophy.
Consensus on Treatment of Acne Scars in China (2021) #
Authors:   Laser Cosmetology Group, Medical Aesthetics and Cosmetology Branch of Chinese Medical Association; Cosmetic Laser Group, Chinese Society of Dermatology; Laser Group, Cosmetic and Plastic Surgeon Branch of Chinese Medical Doctor Association, Yang Sen , Lu Zhong , Lin Tong , Zhou Guo-Yu , Yao Min , Liu Yi , Yang Rong-Ya , Liu Zhi-Fei , Li Yuan-Hong , Li Dong-Ni , Chen Xiao-Dong , Yan Shu-Xian , Gao Lin , Sun Qiu-Ning , Cai Hong , Liang Yan-Hua , Xiao Rong , Jia Xiao-Ming , Chen Jin , Cai Jing-Long , Tu Cai-Xia
Published: February 2022

Acne scars are caused by inflammatory reactions, infections, and improper handling of acne lesions. Such scars have a high incidence and are difficult to treat. There are many methods currently used to treat acne scars, including medications, photoelectric technology, surgery, filling, chemical peeling, traditional Chinese medicine, biotherapy, and microneedle therapy, and many new methods are constantly emerging. However, there are still many issues, such as the lack of high-quality clinical studies, non-uniform treatment methods, and unsatisfactory therapeutic effects. The selection of appropriate methods for the comprehensive treatment of different types of acne scars at different stages in clinical practice remains challenging and is a research topic of great interest. From the perspective of evidence-based medicine, this consensus aims to provide a reference for the treatment of acne scars in clinical practice.
p62/SQSTM1 Participates in the Innate Immune Response of Macrophages Against Candida albicans Infection
Authors: He Yan-Zhi , Duan Zhi-Min , Chen Xu , Li Min
Published: February 2022

Objective:

This study was designed to evaluate whether p62/SQSTM1 (hereafter referred to as p62) is involved in the immune response of macrophages against challenge by Candida albicans (C. albicans).

Methods:

We cultured bone marrow-derived macrophages (BMDMs) to investigate the immune response to challenge by C. albicans. The p62 gene was knocked down by transfection with p62 small interfering RNA (siRNA) in the p62 siRNA group. BMDMs transfected with nonsense siRNA served as the negative control (NC) group. These two groups of BMDMs were challenged with C. albicans in vitro. We detected p62 expression through quantitative reverse transcription PCR and western blotting. The phagocytosis ability of BMDMs was evaluated by flow cytometry and microscopic examination using an Olympus FV1000 laser scanning confocal microscope. Moreover, we determined the level of reactive oxygen species (ROS) in BMDMs. The mRNA levels of proinflammatory cytokines were determined by quantitative reverse transcription PCR.

Results:

After stimulation by C. albicans, the relative expression of p62 mRNA was increased in a dose-dependent manner, the relative expression of p62 and the ratio of BMDMs to C. albicans is 1.893 ± 0.2156 (1:1, P < 0.05), 2.873 ± 0.4787 (1:3, P < 0.05) and 3.556 ± 0.2892 (1:5, P < 0.01). The p62 protein level was also increased. After transfection with p62 siRNA, the mRNA and protein levels of p62 were significantly decreased in BMDMs (P < 0.05). After 0.5, 1 and 2 hours of co-culture of BMDMs with C. albicans, flow cytometry showed that the phagocytosis rates of C. albicans by BMDMs were significantly lower in the p62 siRNA group than in the NC group (39.70 ± 1.69% vs. 55.23 ± 0.72%, 46.70 ± 0.89% vs. 60.80 ± 1.78%, 51.90 ± 0.98% vs. 64.43 ± 2.0%, respectively, all P < 0.05). Consistent results were seen in the production of ROS (4269 ± 392.6 vs. 13426 ± 1859.7, 4967 ± 721.2 vs. 13687 ± 2611.2, 7647 ± 1950.0 vs. 17719 ± 1814.2, respectively, all P < 0.05). The ROS levels were higher in BMDMs of the NC group than in BMDMs transfected with p62 siRNA at 0.5, 1, and 2 hours after treatment with C. albicans. BMDMs was co-cultured with C. albicans for 4 and 12 hours, the mRNA levels of interleukin-1β and interleukin-18 in NCs were also higher than p62 siRNA group, interleukin-1β: (6.14 ± 1.63 vs. 12.12 ± 0.54, 8.81 ± 0.86 vs. 26.2 ± 4.67, respectively, all P < 0.05), IL-18: (0.38 ± 0.02 vs. 0.97 ± 0.06, 0.44 ± 0.02 vs. 2.23 ± 0.46, respectively, all P < 0.05).

Conclusion:

p62 plays an important role in the process of phagocytosis in BMDMs challenged by C. albicans through ROS production and expression of proinflammatory cytokines.
Impact of Pre-admission Observation Hours on Key Physical Therapist Clinical Education Stakeholders: Qualitative Analysis
Authors: Hoang Thuha , Watkins Molly , Bayliss Jamie , Schack-Dugre Judi , Mitchell Katy , Mariano Mira , Greco Jamie , Colgrove Yvonne , Wheeler Emma , Kiyota Hiroshi , Pientok Colette , Stephens Laura , McCarthy Casey , Canham Lara , McBride Gavin , Gleeson Peggy
Published: February 2022

Introduction.

Inclusion of preadmission observation hours (ObHr) as one component of the admissions process is commonly required in physical therapy education programs. The purpose of this study was to describe the value and impact of ObHr on 4 key stakeholder groups: doctor of physical therapy students, physical therapy clinicians, directors of clinical education, and admissions committee (AC) members.

Review of Literature.

The number of required and/or recommended ObHr and practice settings varies greatly. No previous study has explored a national dataset of key stakeholders' perspectives on ObHr experiences.

Subjects.

Four key stakeholder groups were targeted in the study (N = 4,471).

Methods.

Four stakeholder surveys were developed and distributed via email using a snowball sampling technique. Responses to the open-ended questions were analyzed using conventional content analysis for creating codes, categories, and themes within and across groups.

Results.

Five main themes emerged: 1) ObHr have value in career decision making; 2) students driven by hours, but all stakeholders value variety; 3) use of ObHr for program admissions decisions varies; 4) as the number of hours and settings increase, so do the challenges for students; and 5) there is interest in developing alternative ObHr experiences.

Discussion and Conclusion.

There was consensus among all stakeholder groups regarding ObHr's value for exploring the profession of physical therapy and helping applicants determine if the profession is a good fit. Respondents highlighted the value of observing in a variety of practice settings. Perspectives differed between AC members and students regarding the impact of ObHr on admissions decision making. Students reported a variety of personal and organizational challenges associated with ObHr completion. Physical therapy programs should reexamine their current ObHr practices and consider alternative methods that support all applicants in their pursuit of a career in physical therapy.
Virtual Reality Instructional Design in Orthopedic Physical Therapy Education: A Randomized Controlled Trial
Authors: Hartstein Aaron J. , Zimney Kory , Verkuyl Margaret , Yockey Jean , Berg-Poppe Patti
Published: February 2022

Introduction.

Effective clinical decision-making (CDM) skills are essential for physical therapist practice. The purpose of this study was to compare the effects of virtual reality (VR) patient simulation with those of a traditional standardized patient simulation on the CDM of student physical therapists (SPTs).

Review of Literature.

Authentic experiential learning opportunities are needed to promote CDM. The effects of VR simulation on the CDM of SPTs are unknown.

Subjects.

Fifty-nine first-year SPTs participated in this study.

Methods.

A randomized controlled trial compared the effects of VR with those of standardized patient simulation on several aspects of CDM in 59 first-year students after an upper extremity orthopedic unit. Perceived CDM abilities and metacognitive awareness were assessed before and after allocated instruction. Diagnostic accuracy and diagnostic efficiency were measured during instruction. Student engagement was assessed immediately after instruction and psychomotor skill was assessed 1 week later.

Results.

Statistically significant within-group differences in CDM were noted after both VR and standardized patient instruction, but no between-group differences were found. Although effect sizes were considered large with either learning experience, the observed experimental effect was greater after a VR experience. No between-group differences were found between metacognitive awareness, diagnostic accuracy, or psychomotor skill assessment. Diagnostic efficiency was statistically significantly greater in the standardized patient condition, while engagement was significantly greater in the VR condition.

Discussion and Conclusion.

Measures of perceived CDM improved regardless of instructional method; however, the effect size was greater after VR. These findings reveal 2 effective experiential learning options to promote CDM. These results exemplify the normative trajectory of CDM development and recommendations for differentiated curricular instruction. Although resource intensive initially, VR technology appears capable of advancing CDM skills in an efficient manner that may minimize future cost and the faculty facilitation associated with standardized patient instruction.
GLP-1 receptor agonists and cardiovascular outcomes in patients with type 2 diabetes: Clinical evidence and best practice
Authors: Coke Lola A. , Deedwania Prakash C. , Hinnen Debbie , Magwire Melissa , Miller Nancy H.
Published: February 2022

Cardiovascular disease (CVD) is a major cause of death and disability among people with type 2 diabetes (T2D), presenting a significant impact on longevity, patient quality of life, and health care costs. In the United States, attainment of recommended glycemic targets is low and T2D-related cardiovascular complications remain a significant burden. Many glucose-lowering treatment options are available, but glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 (SGLT-2) inhibitors are recommended in recent guidelines as the preferred add-on therapy to metformin to improve glycemic control. This is particularly the case for patients with T2D and established atherosclerotic CVD, at high risk of atherosclerotic CVD, and/or with chronic kidney disease. Recommendations were based on GLP-1RA and SGLT-2 inhibitor cardiovascular outcomes trials (CVOTs), which consistently showed that these agents pose no additional cardiovascular risk compared with placebo. Three GLP-1RAs (liraglutide, dulaglutide, and subcutaneous semaglutide) demonstrated significantly lower major adverse cardiovascular events versus placebo and are now approved for this indication. However, to realize improvement in outcomes in the clinical setting, organized, systematic, and coordinated approaches to patient management are also needed. For example, nurse-led diabetes self-management education and support programs have been shown to be effective. This article explores T2D management with emphasis on cardiovascular risk and CVOTs performed to date and reviews the clinical experience with GLP-1RAs for managing hyperglycemia and their impact on cardiovascular risk. In addition, practical guidance is given for key health care providers involved in the care of patients with T2D with cardiovascular risk outside of diabetes clinics/endocrinology centers.
Understanding the nomenclature of mitochondrial DNA mutations through examples of two specific disease entities: Mitochondrial encephalopathy with lactic acidosis and stroke-like episodes and Leber hereditary optic neuropathy
Authors: Heuer Beth , Seibert Diane C.
Published: February 2022

Mitochondrial diseases are genetic disorders that can arise either from maternally inherited mitochondrial DNA (mtDNA) or from mutations in nuclear DNA. This article is the second in a series of papers reviewing mitochondrial genetics and several of the disorders associated with mitochondrial gene variants. With a prevalence of 1:∼4,300 persons, mitochondrial disorders are diagnostic entities with which nurse practitioners should be familiar. In describing genetic mutations, numbering nucleotides (nuclear or mtDNA) is critical for communicating exactly where a variation has occurred in a stretch of nucleotides. This article discusses the nomenclature associated with mtDNA mutations, using the examples of mutations causing mitochondrial encephalopathy with lactic acidosis and stroke-like episodes and Leber hereditary optic neuropathy. Pathophysiology, symptoms, and treatment options for these disease entities are discussed.
Quantitative Gas Exchange in Extracorporeal Membrane Oxygenation-A New Device: Accuracy, Approach-based Difficulties, and Caloric Targeting
Authors: Müller Michael C. , Wilke Sarah K. , Dobbermann Andrej , Carbon Niklas M. , Lammel Stella , Russ Martin , Weber-Carstens Steffen , Wollersheim Tobias
Published: February 2022

Measurement of oxygen uptake (VO2) and carbon dioxide removal (VCO2) on membrane lungs (MLs) during extracorporeal membrane oxygenation (ECMO) provides potential for improved and safer therapy. Real-time monitoring of ML function and degradation, calculating caloric needs as well as cardiac output, and weaning algorithms are among the future possibilities. Our study compared the continuous measurement of the standalone Quantum Diagnostics System (QDS) with the published Measuring Energy Expenditure in ECMO patients (MEEP) approach, which calculates sequential VO2 and VCO2 values via blood gas analysis and a physiologic gas content model. Thirty-nine datasets were acquired during routine venovenous ECMO intensive care treatment and analyzed. VO2 was clinically relevant underestimated via the blood-sided measurement of the QDS compared to the MEEP approach (mean difference −42.61 ml/min, limits of agreement [LoA] −2.49/−87.74 ml), which could be explained by the missing dissolved oxygen fraction of the QDS equation. Analysis of VCO2 showed scattered values with wide limits of agreement (mean difference 54.95 ml/min, LoA 231.26/−121.40 ml/min) partly explainable by a calculation error of the QDS. We described potential confounders of gas-sided measurements in general which need further investigation and recommendations for enhanced devices.
The efficacy of Tai Chi for depression
Authors: He Guojian , Zhang Xiucai , Yan Ting , Wang Jiayi , Li Qi , Liu Tianyu , Oh Youn-Poong
Published: February 2022

Background:

Depression is a commonly occurring and recurrent mental disorder cross the world. Tai Chi is a traditional Chinese mind-body exercise which could be used to treat mental disorders including depression. This study aimed to conduct a systematic review and meta-analysis to assess the efficiency of Tai Chi for patients with depression.

Methods:

This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol statement. Literature will be searched at PubMed, EMBASE, Web of Science, Cochrane Library, China Biology Medicine Database, China National Knowledge Infrastructure, Technology Journal Database, and Wan Fang database from the start date to September 2021. The Review Manager 5.3 software will be used to manage literature. After literature screening, 2 reviewers will extract data from the respects of general information, methodology, and results. The data analysis will be conducted with Review Manager and Stata 16 software, and the publication bias and literature quality will be both evaluated.

Results:

The results will contain the evaluation of clinical efficacy of Tai Chi practice for depression, as well as the assessment of literature quality and publication bias.

Conclusion:

The current review will provide new evidence on whether and to what extent patients with depression can benefit from Tai Chi practice.

Registration number: DOI: 10.17605/OSF.IO/AUDNQ (https://osf.io/audnq).