bluuebunny/crossref_metadata_2025 huggingface dataset:
Activity cycles in RS CVn-type stars
Authors: Martínez C I , Mauas P J D , Buccino A P
Published: March 2022

We compile a list of 120 RS CVn-type stars from the bibliography in Southern hemisphere, to search for rotation periods and activity cycles, covering a large range of luminosities and effective temperatures for late stars. For each system of the list, we use photometric data from the All Sky Automated Survey (ASAS), and complement it with our own photometry, obtained with the Optical Robotic Observatory (ORO). We analyse these data with the Generalized Lomb–Scargle (GLS) periodogram to determine the rotation period and possible activity cycles for each system. We found rotation periods for 102 systems and activity cycles for 91 systems. From the statistical analysis of the results, we found that giant stars behave differently than subgiants and main-sequence stars, and that there is a good correlation between rotation periods and luminosities.
Towards a global map of the artificial all-sky brightness
Authors: Kocifaj M , Bará S , Falchi F
Published: March 2022

Modeling the hemispherical night sky brightness of anthropogenic origin is a demanding computational challenge, due to the intensive calculations required to produce all-sky maps with fine angular resolution including high-order scattering effects. We present in this letter a physically consistent, semi-analytic two-parameter model of the all-sky radiance produced by an artificial light source that encodes efficiently the spectral radiance in all directions of the sky above the observer. The two parameters of this function are derived from the state of the atmosphere, the distance to the observer, and the source’s angular and spectral emission pattern. The anthropogenic all-sky radiance at any place on Earth can be easily calculated by adding up the contributions of the surrounding artificial sources, using the information available from nighttime satellite imagery and ground-truth lighting inventories. This opens the way for the elaboration of a global world map of the artificial all-sky brightness.
Non-drug and surgical treatment algorithm and recommendations for the 2020 update of the Japan College of Rheumatology clinical practice guidelines for the management of rheumatoid arthritis—secondary publication
Authors: Ito Hiromu , Nishida Keiichiro , Kojima Toshihisa , Matsushita Isao , Kojima Masayo , Hirata Shintaro , Kaneko Yuko , Kishimoto Mitsumasa , Kohno Masataka , Mori Masaaki , Morinobu Akio , Murashima Atsuko , Seto Yohei , Sugihara Takahiko , Tanaka Eiichi , Nakayama Takeo , Yamanaka Hisashi , Kawahito Yutaka , Harigai Masayoshi
Published: March 2022

Objectives

The aim of this study was to update the Japan College of Rheumatology (JCR) clinical practice guidelines (CPGs) for the management of rheumatoid arthritis (RA) and prepare an algorithm for non-drug and surgical treatments. This article is a digest version of the guidelines.

Methods

The Japanese Ministry of Health, Labour and Welfare’s research group, in collaboration with the JCR, used the Grading of Recommendations, Assessment, Development, and Evaluation method to update the 2014 JCR CPG for RA. The consensus was formed by CPG panel members.

Results

We raised 19 clinical questions regarding non-drug and surgical treatments for RA and developed recommendations. The treatments included exercise therapy; occupational therapy; joint injection of corticosteroids; and orthopaedic surgeries including cervical spine surgery, wrist and foot arthroplasty, ankle arthrodesis, and replacement arthroplasty of the shoulder, elbow, finger, hip, knee, and ankle. Recommendations regarding the risks of surgery and perioperative discontinuation of medications have also been developed. Based on these recommendations, we created an original algorithm for the non-drug and surgical treatment of RA.

Conclusions

These recommendations are expected to serve rheumatologists, health care professionals, and patients with RA as tools for shared decision-making to treat residual limb joint symptoms and functional impairment.
Chemical order-disorder nanodomains in Fe3Pt bulk alloy
Authors: Li Qiang , Ren Yang , Zhang Qinghua , Gu Lin , Huang Qingzhen , Wu Hui , Sun Jing , Cao Yili , Lin Kun , Xing Xianran
Published: March 2022

Chemical ordering is a common phenomenon and highly correlated with the properties of solid materials. By means of the redistribution of atoms and chemical bonds, it invokes an effective lattice adjustment and tailors corresponding physical properties. To date, however, directly probing the 3D interfacial interactions of chemical ordering remains a big challenge. In this work, we deciphered the interlaced distribution of nanosized domains with chemical order/disorder in Fe3Pt bulk alloy. HAADF-STEM images evidence the existence of such nanodomains. The reverse Monte Carlo method with the X-ray pair distribution function data reveal the 3D distribution of local structures and the tensile effect in the disordered domains at the single-atomic level. The chemical bonding around the domain boundary changes the bonding feature in the disordered side and reduces the local magnetic moment of Fe atoms. This results in a suppressed negative thermal expansion and extended temperature range in Fe3Pt bulk alloy with nanodomains. Our study demonstrates a local revelation for the chemical order/disorder nanodomains in bulk alloy. The understanding gained from atomic short-range interactions within the domain boundaries provides useful insights with regard to designing new functional compounds.
Missed Pneumococcal Vaccination Opportunities in Adults With Invasive Pneumococcal Disease in a Community Health System
Authors: Schulz Paul S , Moore Sarah E , Smith Daniel , Javed Jessica , Wilde Ashley M
Published: March 2022

Background

Adult vaccination programs are suboptimal.

Methods

Pneumococcal vaccination history, and healthcare contact were assessed in patients with invasive pneumococcal disease.

Results

Of the 229 cases, 14% were vaccinated. Observed mortality was 20.1%.

Conclusions

Numerous missed vaccination opportunities were identified.
A Tale of 3 Pandemics: Severe Acute Respiratory Syndrome Coronavirus 2, Hepatitis C Virus, and Human Immunodeficiency Virus in an Urban Emergency Department in Baltimore, Maryland
Authors: Hsieh Yu-Hsiang , Rothman Richard E , Solomon Sunil S , Anderson Mark , Stec Michael , Laeyendecker Oliver , Lake Isabel V , Fernandez Reinaldo E , Dashler Gaby , Mehta Radhika , Kickler Thomas , Kelen Gabor D , Mehta Shruti H , Cloherty Gavin A , Quinn Thomas C ,   Johns Hopkins COVID-19 Emergency Medicine Investigators, Beck Evan J , Saraf Sharada , Baker Owen R , Wang Richard , Ricketts Erin P , Anderson Danna , Hurley Jennifer
Published: March 2022

Background

We sought to determine the prevalence and sociodemographic and clinical correlates of acute and convalescent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections among emergency department (ED) patients in Baltimore.

Methods

Remnant blood samples from 7450 unique patients were collected over 4 months in 2020 for SARS-CoV-2 antibody (Ab), HCV Ab, and HIV-1/2 antigen and Ab. Among them, 5012 patients were tested by polymerase chain reaction for SARS-CoV-2 based on clinical suspicion. Sociodemographics, ED clinical presentations, and outcomes associated with coinfections were assessed.

Results

Overall, 729 (9.8%) patients had SARS-CoV-2 (acute or convalescent), 934 (12.5%) HCV, 372 (5.0%) HIV infection, and 211 patients (2.8%) had evidence of any coinfection (HCV/HIV, 1.5%; SARS-CoV-2/HCV, 0.7%; SARS-CoV-2/HIV, 0.3%; SARS-CoV-2/HCV/HIV, 0.3%). The prevalence of SARS-CoV-2 (acute or convalescent) was significantly higher in those with HCV or HIV vs those without (13.6% vs 9.1%, P < .001). Key sociodemographic disparities (race, ethnicity, and poverty) and specific ED clinical characteristics were significantly correlated with having any coinfections vs no infection or individual monoinfection. Among those with HCV or HIV, aged 18–34 years, Black race, Hispanic ethnicity, and a cardiovascular-related chief complaint had a significantly higher odds of having SARS-CoV-2 (prevalence ratios: 2.02, 2.37, 5.81, and 2.07, respectively).

Conclusions

The burden of SARS-CoV-2, HCV, and HIV co-pandemics and their associations with specific sociodemographic disparities, clinical presentations, and outcomes suggest that urban EDs should consider implementing integrated screening and linkage-to-care programs for these 3 infections.
CAST-R: An application to visualize circadian and heat stress-responsive genes in plants
Authors: Bonnot Titouan , Gillard Morgane B , Nagel Dawn H
Published: March 2022

The circadian clock helps organisms to anticipate and coordinate gene regulatory responses to changes in environmental stimuli. Under stresses, both time of day and the circadian clock closely control the magnitude of plant responses. The identification of clock-regulated genes is, therefore, important when studying the influence of environmental factors. Here, we present CAST-R (Circadian And heat STress-Responsive), a “Shiny” application that allows users to identify and visualize circadian and heat stress-responsive genes in plants. More specifically, users can generate and export profiles and heatmaps representing transcript abundance of a single or of multiple Arabidopsis (Arabidopsis thaliana) genes over a 24-h time course, in response to heat stress and during recovery following the stress. The application also takes advantage of published Arabidopsis chromatin immunoprecipitation-sequencing datasets to visualize the connections between clock proteins and their targets in an interactive network. In addition, CAST-R offers the possibility to perform phase (i.e. timing of expression) enrichment analyses for rhythmic datasets from any species, within and beyond plants. This functionality combines statistical analyses and graphical representations to identify significantly over- and underrepresented phases within a subset of genes. Lastly, profiles of transcript abundance can be visualized from multiple circadian datasets generated in Arabidopsis, Brassica rapa, barley (Hordeum vulgare), and rice (Oryza sativa). In summary, CAST-R is a user-friendly interface that allows the rapid identification of circadian and stress-responsive genes through multiple modules of visualization. We anticipate that this tool will make it easier for users to obtain temporal and dynamic information on genes of interest that links plant responses to environmental signals.
Multiplex knockout of trichome-regulating MYB duplicates in hybrid poplar using a single gRNA
Authors: Bewg William P , Harding Scott A , Engle Nancy L , Vaidya Brajesh N , Zhou Ran , Reeves Jacob , Horn Thomas W , Joshee Nirmal , Jenkins Jerry W , Shu Shengqiang , Barry Kerrie W , Yoshinaga Yuko , Grimwood Jane , Schmitz Robert J , Schmutz Jeremy , Tschaplinski Timothy J , Tsai Chung-Jui
Published: March 2022

As the focus for CRISPR/Cas-edited plants moves from proof-of-concept to real-world applications, precise gene manipulation will increasingly require concurrent multiplex editing for polygenic traits. A common approach for editing across multiple sites is to design one guide RNA (gRNA) per target; however, this complicates construct assembly and increases the possibility of off-target mutations. In this study, we utilized one gRNA to target MYB186, a known positive trichome regulator, as well as its paralogs MYB138 and MYB38 at a consensus site for mutagenesis in hybrid poplar (Populus tremula × P. alba INRA 717-1B4). Unexpected duplications of MYB186 and MYB138 resulted in eight alleles for the three targeted genes in the hybrid poplar. Deep sequencing and polymerase chain reaction analyses confirmed editing across all eight targets in nearly all of the resultant glabrous mutants, ranging from small indels to large genomic dropouts, with no off-target activity detected at four potential sites. This highlights the effectiveness of a single gRNA targeting conserved exonic regions for multiplex editing. Additionally, cuticular wax and whole-leaf analyses showed a complete absence of triterpenes in the trichomeless mutants, hinting at a previously undescribed role for the nonglandular trichomes of poplar.
Systems for the Functional Evaluation of Human Heart Tissues Derived from Pluripotent Stem Cells
Authors: Murata Kozue , Masumoto Hidetoshi
Published: March 2022

Human pluripotent stem cells (hPSCs) are expected to be a promising cell source in regenerative medicine and drug discovery for the treatment of various intractable diseases. An approach for creating a 3-dimensional (3D) structure from hPSCs that mimics human cardiac tissue functions has made it theoretically possible to conduct drug discovery and cardiotoxicity tests by assessing pharmacological responses in human cardiac tissues by a screening system using a compound library. The myocardium functions as a tissue composed of organized vascular networks, supporting stromal cells and cardiac muscle cells. Considering this, the reconstruction of tissue structure by various cells of cardiovascular lineages, such as vascular cells and cardiac muscle cells, is desirable for the ideal conformation of hPSC-derived cardiac tissues. Heart-on-a-chip, an organ-on-a-chip system to evaluate the physiological pump function of 3D cardiac tissues might hold promise in medical researchs such as drug discovery and regenerative medicine. Here, we review various modalities to evaluate the function of human stem cell-derived cardiac tissues and introduce heart-on-a-chip systems that can recapitulate physiological parameters of hPSC-derived cardiac tissues.
Mental Health Interventions That Address Historical Trauma among Indigenous Peoples: A Systematic Review
Authors: Sevillano Lalaine , Wood Bethany , Franklin Cynthia
Published: March 2022

Indigenous Peoples (IP) face significant health disparities that stem from historical trauma (HT). This is the first systematic review to investigate mental health interventions that address HT in addition to treating mental health disorders among IP in the United States. The data search included seven databases for published studies, consultations with experts, hand searching journals, and reference list checking. Five studies met the inclusion criteria and were included in the review. In total, 608 clients were examined. Findings suggested that treatments that addressed HT had a marginally beneficial effect on psychological and HT symptom outcomes. However, one study found that the intervention was not successful at maintaining these gains. Due to the limited number of studies, and the heterogeneity of research findings and the methodological limitations suffered by included studies, no definite conclusions about mental health interventions that address HT can be drawn. Recommendations for practice, such as using traditional healing practices for IP in mental health interventions, and recommendations for future research are provided.
Sulfur metabolism, organic acid accumulation and phytohormone regulation are crucial physiological processes modulating the different tolerance to Pb stress of two contrasting poplars
Authors: Shi Wenguang , Li Jing , Kan Donxu , Yu Wenjian , Chen Xin , Zhang Yuhong , Ma Chaofeng , Deng Shurong , Zhou Jing , Fayyaz Payam , Luo Zhi-Bin
Published: March 2022

To investigate the pivotal physiological processes modulating lead (Pb) tolerance capacities of poplars, the saplings of two contrasting poplar species, Populus × canescens with high Pb sensitivity and Populus nigra with relatively low Pb sensitivity, were treated with either 0 or 8 mM Pb for 6 weeks. Lead was absorbed by the roots and accumulated massively in the roots and leaves, leading to overproduction of reactive oxygen species, reduced photosynthesis and biomass in both poplar species. Particularly, the tolerance index of P. × canescens was significantly lower than that of P. nigra. Moreover, the physiological responses including the concentrations of nutrient elements, thiols, organic acids, phytohormones and nonenzymatic antioxidants, and the activities of antioxidative enzymes in the roots and leaves were different between the two poplar species. Notably, the differences in concentrations of nutrient elements, organic acids and phytohormones were remarkable between the two poplar species. A further evaluation of the Pb tolerance-related physiological processes showed that the change of ‘sulfur (S) metabolism’ in the roots was greater, and that of ‘organic acid accumulation’ in the roots and ‘phytohormone regulation’ in the leaves were markedly smaller in P. × canescens than those in P. nigra. These results suggest that there are differences in Pb tolerance capacities between P. × canescens and P. nigra, which is probably associated with their contrasting physiological responses to Pb stress, and that S metabolism, organic acid accumulation and phytohormone regulation are probably the key physiological processes modulating the different Pb tolerance capacities between the two poplar species.
Genome-Wide Association Mapping of Resistance to Powdery Mildew in Regional Trials of Wheat Mainly from China
Authors: Jin Pengfei , Guo Xuan , Guo Mengying , Li Ruobing , Li Qiang , Cheng Peng , Wang Baotong
Published: March 2022

Wheat powdery mildew (Blumeria graminis f. sp. tritici [Bgt]) is a widespread disease that causes significant economic losses to common wheat (Triticum aestivum L.) crops worldwide. To identify effective resistance genes, we evaluated 120 common wheat accessions mainly from different wheat producing regions in China for responses to different Bgt isolates in the seedling stage and to natural infection in three field trials and genotyped them with a wheat 55K iSelect single-nucleotide polymorphism array for a genome-wide association study. A total of 26 loci were identified, which explained 6.6 to 26.2% of the phenotypic variation depending on individual locus. Of the 26 loci, 10 were detected in the A genomes, 10 in the B genomes, and only 6 in the D genome. Sixteen loci overlapped with known powdery mildew resistance genes or quantitative trait loci, and the remaining 10 loci were potentially novel. This study improves the understanding of the genetic structure of wheat powdery mildew resistance and provides germplasms and information on genes and markers for breeding new wheat cultivars with effective resistance to powdery mildew.
Fluid Handling Dynamics and Durability of Silver-Containing Gelling Fiber Dressings Tested in a Robotic Wound System
Authors: Orlov Aleksei , Lustig Adi , Grigatti Angela , Gefen Amit
Published: March 2022

OBJECTIVE

To develop a robotic phantom system containing multiple simulated wound replicates to determine the synergy in fluid absorbency and retention (sorptivity) performances and the post-simulated-use mechanical durability of silver-containing gelling fiber primary dressings when used with a secondary dressing, as per clinical practice.

METHODS

Using a robotic system containing six identical wound simulators, the authors tested the sorptivity performances of the Exufiber Ag + (Mölnlycke Health Care, Gothenburg, Sweden) primary dressing (ExAg-polyvinyl alcohol [PVA]) against a market-leading comparator product, when used with a secondary foam dressing. The durability of the primary dressings after simulated use was further investigated through tensile mechanical testing.

RESULTS

The ExAg-PVA primary dressing delivered greater fluid amounts for absorbency and retention by the secondary foam dressing, approximately 2- and 1.5-fold more than the comparator dressing pair after 10 and 15 hours, respectively. The ExAg-PVA dressing was also substantially less sensitive to the direction of pulling forces and, accordingly, exhibited post-use mechanical strength that was approximately four and six times greater than that of the other primary dressing (when the latter dressing was tested out-of-alignment with its visible seams) after 10 and 15 hours, respectively.

CONCLUSIONS

The dynamics of the sorptivity and fluid sharing between primary and secondary dressings and the effect of directional preference of strength of the primary dressings for adequate durability, resulting in safe post-use removals, have been described. The comparative quantification of these capabilities should help clinical and nonclinical decision-makers select dressings that best meet their patient needs.
A New Model for Intensive Care Unit Follow-up
Authors: Østergaard Kija
Published: March 2022

Supplemental digital content is available in the text.

The purpose of this paper is to investigate a new model for ICU follow-up co-designed by nurses from four different wards. This paper aims to compare the checklist aiding the ICU follow-ups with an alternative “attention-to” list. Nurses from four wards co-designed a new take on the ICU follow-up procedure. The study included users in designing the procedure and provided the users with the opportunity to influence the product that affects their clinical practices. We compare the “attention-to” list with the checklist and suggest a new model for follow-up after patients are transferred from an ICU to a general ward. The nurses who participated found that the traditional checklist approach creates more obstacles than it supports. The obstacles are due to the change in context as the follow-up plan is initiated in the ICU but is performed on the general ward. Therefore, the plan must accommodate both working environments. In conclusion, the new model for ICU follow-up is characterized by being goal-oriented and putting nursing expertise at its core. Furthermore, the new model can adapt to the change in context as it is initiated in the ICU setting and executed in a general ward.
Research Trends in Artificial Intelligence-Associated Nursing Activities Based on a Review of Academic Studies Published From 2001 to 2020
Authors: Hwang Gwo-Jen , Chang Po-Ya , Tseng Wan-Yu , Chou Chia-An , Wu Chih-Hsin , Tu Yun-Fang
Published: March 2022

The present study referred to the technology-based learning model to conduct a systematic review of the dimensions of nursing activities, research samples, research methods, roles of artificial intelligence, applied artificial intelligence algorithms, evaluation measure of algorithms, and research foci. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedure, this study obtained and analyzed a total of 102 high-quality artificial intelligence–associated nursing activities studies published from 2001 to 2020 in the Web of Science database. The results showed: (1) In terms of nursing activities, nursing management was explored the most, followed by nursing assessment; (2) quantitative methods were most frequently adopted in artificial intelligence–associated nursing activities studies to investigate issues related to patients, followed by nursing staff; (3) the most adopted roles of artificial intelligence in artificial intelligence–associated nursing activities studies were profiling and prediction, followed by assessment and evaluation; (4) artificial intelligence–associated nursing activities studies frequently mixed applied artificial intelligence algorithms and evaluation measure of algorithms; (5) in the dimension of research foci, most studies mainly paid attention to the design or evaluation of the artificial intelligence systems/instruments, followed by investigating the correlation and affect issues. Based on the findings, several recommendations are raised as a reference for future researchers, educators, and policy makers.
Affirming Hormone Treatment for a Transgender Adolescent After a Venous Thromboembolic Event
Authors: Penney Scott W. , Jung Jenny H. , Ballantyne Aaron J. , Parekh Dina S. , Klein David A. , Viola Shelton A.
Published: March 2022

Background:

Medical affirmation, including gender-affirming hormones, is an essential component in the treatment of many transgender and gender-diverse youth. The risk of venous thromboembolism (VTE) during testosterone therapy for gender-affirming care is not fully elucidated.

Observation:

The case describes a 17-year-old transgender male treated with testosterone therapy who presented with an occlusive deep vein thrombosis of right axillary and subclavian veins. Testosterone level was 920 ng/dL at the time of the deep vein thrombosis, and he had no risk factors for VTE. A complete hypercoagulable workup was negative.

Conclusions:

The possibility of testosterone therapy as a risk factor for VTE may suggest the need to include this information during informed consent discussions. Long-term anticoagulation may be considered for those restarting testosterone therapy.
Measuring the Quality of Cardiopulmonary Resuscitation in the Emergency Department at a Quaternary Children's Hospital
Authors: Falco Lucas , Timmons Zebulon , Swing Ted , Luciano William , Bulloch Blake
Published: March 2022

Aim of Study

The aim of this study was to evaluate the quality of cardiopulmonary resuscitation (CPR) as it relates to American Heart Association (AHA) guidelines during cardiac arrests in a pediatric emergency department at a quaternary children's hospital.

Background and Objectives

High-quality CPR increases the likelihood of survival from pediatric out-of-hospital cardiac arrest. However, optimal performance of high-quality CPR during transition of care between prehospital and pediatric emergency department providers is challenging, and survival without comorbidities remains extremely low for out-of-hospital cardiac arrest.

Methods

This was a retrospective study of data collected from a free-standing children's hospital emergency department and level 1 trauma center.

Results

There were 23 pediatric CPR events for subjects younger than 18 years in the emergency department during the time of the study. Median chest compression (CC) fraction was 85% overall with the AHA goal of 80%. Compliance with this recommendation was achieved in all age groups. The CC rate averaged 112 for the entire sample. Median depth was 2.06 cm in subjects younger than 1 year, 3.95 cm in subjects 1 year old to younger than 8 years, and 5.33 cm in subjects 8 years old to younger than 18 years. These compression depth rates fell below the AHA recommendations, with the exception of those 8 years and older.

Conclusions

In our study, CC fraction and CC rate were found to meet AHA targets for all age groups, whereas CC depth only met AHA targets for the 8- to 18-year-old group. The most difficult parameter was CC depth for the group of subjects younger than 1 year.
Improving Verbal Handoff for Patients Admitted From the Pediatric Emergency Department to Medical Inpatient Services
Authors: Gross Elise , Bunke Carissa , Schellpfeffer Natalie
Published: March 2022

Objective

Transitions of care are a well-identified source of adverse events. At our academic tertiary children's hospital, no standardized verbal handoff is used in the emergency department with a lack of education provided to clinicians on handoff. We aimed to increase the percent of handoffs from the pediatric emergency department to inpatient medical services including 7 critical elements and increase clinician score of individual handoffs and overall clinician satisfaction with handoff key components.

Methods

Study occurred from Fall 2017 through Winter 2019. After collecting baseline data, a modified I-PASS tool was visually integrated into work areas. Tool education was performed by brief lecture, with iterative education occurring cyclically. Handoff assessment and clinician satisfaction surveys were then recollected. Outcome measures included clinician scores of individual handoffs and overall satisfaction with handoff. Process measure was percent handoffs including 7 critical elements. Balancing measure was handoff length in minutes.

Results

Clinician satisfaction scores improved from baseline (response rate, 38%) to postintervention (response rate, 30%) in efficiency (57%–69%), detail (57%–66%), and safety (55%–64%). Clinician scores of individual handoffs improved from 66% rating very good or excellent at baseline to 77% postintervention. Handoff time did not increase. Percent handoffs with all 7 critical elements did not show improvement.

Conclusions

Trainee-led implementation of handoff standardization increased clinician satisfaction and clinician score of individual handoffs without compromising handoff length. Although feasibility can be a challenge, trainee-led quality improvement is meaningful and should be promoted and valued in graduate medical education, despite limitations.
FDG PET/CT in Mixed Langerhans Cell Histiocytosis and Erdheim-Chester Disease
Authors: Ngo Victoria T. , Wassef Heidi R.
Published: March 2022

The histiocytoses arise from hematopoietic bone marrow stem cells or monocytes. They range from limited to disseminated disease. We report a 31-year-old woman with multisystem Langerhans cell histiocytosis (LCH). The recognition that pericardial disease was rare in LCH prompted review of the initial limited biopsies, which helped establish a second diagnosis of Erdheim-Chester disease. The increasing recognition of mixed histiocytoses requires searching for Erdheim-Chester disease when a patient is diagnosed with LCH and vice versa. FDG PET/CT can help establish the diagnosis or suggest mixed disease based on the organs involved.
The extent to which geography explains one of trauma’s troubling trends: Insurance-based differences in appropriate interfacility transfer
Authors: Zogg Cheryl K. , Schuster Kevin M. , Maung Adrian A. , Davis Kimberly A.
Published: March 2022

BACKGROUND

A growing body of literature suggests the persistence of a counterproductive triage pattern wherein uninsured adults with major injuries presenting to nontrauma centers (NTCs) are more likely than insured adults to be transferred. Geographic differences are frequently blamed. The objective of this study was to explore geography's influence on variations in insurance transfer patterns, asking whether differences in distance and travel time by road from NTCs to the nearest level 1 or 2 trauma center alter the effect. As a secondary objective, differences in neighborhood socioeconomic disadvantage were also assessed.

METHODS

Adults (16–64 years) with major injuries (Injury Severity Score, >15) presenting to NTC emergency departments (EDs) were abstracted from 2007 to 2014 state inpatient/ED claims. Differences in the risk-adjusted odds of admission versus transfer were compared using mixed-effect hierarchical logistic regression and spatial analysis.

RESULTS

A total of 48,283 adults presenting to 492 NTC EDs were included. Among them, risk-adjusted admission differences based on insurance status exist (e.g., private vs. uninsured odds ratio [95% confidence interval], 1.60 [1.45–1.76]). Spatial analysis revealed significant geographic variation (p < 0.001). However, in contrast to expectations, the largest insurance-based discrepancies were seen in less disadvantaged NTCs located closer to larger trauma centers. Stratified analyses comparing the closest versus furthest distance, shortest versus longest travel time, and least versus most deprived populations agreed, as did sensitivity analyses restricting uninsured transfer patients to those who remained uninsured versus subsequently became insured.

CONCLUSION

Adults with major injuries presenting to NTCs were less likely to be transferred if insured. The trend persisted after accounting for differences in access to care, revealing that, while significant geographic variation in the phenomenon exists, geography alone does not explain the issue. Taken together, the findings suggest that additional and potentially subjective elements to insurance-based triage disparities at NTCs are likely to exist.

LEVEL OF EVIDENCE

Prognostic/Epidemiological, Level III.
Characterizing physical trauma in children and youth with special health care needs
Authors: Lillvis Denise F. , Sheehan Karen M. , Yu Jihnhee , Noyes Katia , Bass Kathryn D. , Kuo Dennis Z.
Published: March 2022

BACKGROUND

Children and youth with special health care needs (CYSHCN) have or are at an increased risk for a chronic condition necessitating medical and related services beyond what children usually require. While evidence suggests that CYSHCN are at an increased risk of injury, little is known about this population within the trauma system. This study describes CYSHCN within the pediatric trauma system and examines patterns of injury risk (i.e., intent, place of injury, trauma type, and mechanism of injury) based on special health care need (SHCN) status.

METHODS

For this cross-sectional study, we used data from the 2018 National Trauma Data Bank to identify pediatric encounters (1–18 years, N = 115,578) and compare demographics (sex, race/ethnicity, insurance status, and age) by CYSHCN status using χ2 and t tests. Children and youth with special health care needs encounters were compared with non-SHCN encounters using multinomial logistic regression models, controlling for demographics.

RESULTS

Overall, 16.7% pediatric encounters reported an SHCN. Children and youth with special health care needs encounters are older, and a higher proportion is publicly insured than non-SHCN encounters (p < 0.001). Furthermore, CYSHCN encounters have a higher risk of assault (relative risk, 1.331) and self-inflicted (relative risk, 4.208) injuries relative to unintentional injury (p < 0.001), as well as a higher relative risk of traumatic injury occurring in a private residence (p < 0.01) than other locations such as school (relative risk, 0.894). Younger CYSHCN encounters have a higher risk of assault relative to unintentional injury when compared with non-SHCN encounters (p < 0.01). Pediatric trauma encounters reporting mental health and alcohol/substance use disorder SHCN have a higher probability of self-inflicted and assault injuries than non-SHCN encounters (p < 0.001).

CONCLUSIONS

These findings suggest that CYSHCN have different traumatic injury patterns than their non-SHCN peers, particularly in terms of intentional and private residence injury, and deserve a special focus for traumatic injury prevention.

LEVEL OF EVIDENCE

Prognostic/epidemiologic, level III.
Developing a National Trauma Research Action Plan: Results from the Pediatric Research Gap Delphi Survey
Authors: Groner Jonathan I. , Phuong Jimmy , Price Michelle A. , Bixby Pamela J. , Ehrlich Peter F. , Burd Randall S. , Jensen Aaron R. , Rivara Frederick P. , Sribnick Eric A. , Bulger Eileen M.
Published: March 2022

BACKGROUND

In 2016, the National Academies of Sciences, Engineering, and Medicine trauma report recommended a National Trauma Research Action Plan to “strengthen trauma research and ensure that the resources available for this research are commensurate with the importance of injury and the potential for improvement in patient outcomes.” With a contract from the Department of Defense, the Coalition for National Trauma Research created 11 expert panels to address this recommendation, with the goal of developing a comprehensive research agenda, spanning the continuum of trauma and burn care. This report outlines the work of the group focused on pediatric trauma.

METHODS

Experts in pediatric trauma clinical care and research were recruited to identify gaps in current clinical pediatric trauma research, generate research questions, and establish the priority of these questions using a consensus-driven Delphi survey approach. Using successive surveys, participants were asked to rank the priority of each research question on a 9-point Likert scale categorized to represent priority. Consensus was defined as >60% agreement within the priority category. Priority questions were coded based on a dictionary of 118 National Trauma Research Action Plan taxonomy concepts in 9 categories to support comparative analysis across all panels.

RESULTS

Thirty-seven subject matter experts generated 625 questions. A total of 493 questions (79%) reached consensus on priority level. Of those reaching consensus, 159 (32%) were high, 325 (66%) were medium, and 9 (2%) were low priority. The highest priority research questions related to surgical interventions for traumatic brain injury (intracranial pressure monitoring and craniotomy); the second highest priority was hemorrhagic shock. The prehospital setting was the highest priority phase of care.

CONCLUSION

This diverse panel of experts determined that most significant pediatric trauma research gaps were in traumatic brain injury, hemorrhagic shock, and the prehospital phase of care. These research domains should be top priorities for funding agencies.

LEVEL OF EVIDENCE

Therapeutic / Care Management; Level IV.
Simultaneous Kidney and Parathyroid Transplantation in the Management of Genetic Hypoparathyroidism in a Child
Authors: Vallant Natalie , Sinha Manish D. , Cheung Moira , Ware Nick , Jones Helen , Buck Jackie , Boffa Catherine , Irving Melita , Carroll Paul V. , Hubbard Johnathan , Gökmen Refik , Rees Lesley , Gogalniceanu Petrut , Kessaris Nicos
Published: March 2022

Background.

Genetically determined hypoparathyroidism can lead to life-threatening episodes of hypocalcemia and, more rarely, to end-stage kidney disease at a young age. Parathyroid allotransplantation is the only curative treatment, and in patients already receiving immunosuppression for kidney transplantation, there may be little additional risk involved. We report the first such case in a child.

Methods.

An 11-y-old girl, known to have hypoparathyroidism secondary to an activating pathogenic variant in the calcium-sensing receptor, developed end-stage kidney disease and was started on intermittent hemodialysis. Since the age of 2.5 y, she had been receiving treatment with exogenous synthetic parathyroid hormone (PTH). In June 2019, at the age of 11.8 y, she received a living-donor kidney and simultaneous parathyroid gland transplant from her father. The kidney was implanted into the right iliac fossa, followed by implantation of the parathyroid gland into the exposed rectus muscle.

Results.

The kidney graft showed immediate function while the intrinsic serum PTH level remained low at 3 ng/L. Exogenous PTH infusion was reduced on day 6 posttransplantation to stimulate PTH production by the new gland, which resulted in improving intrinsic PTH concentrations of 28 ng/L by day 9. Twelve months after transplantation, PTH levels remain in normal range and the kidney graft function is stable with a serum creatinine of 110 μmol/L.

Conclusions.

Simultaneous living donation and transplantation of a kidney and a parathyroid gland into a child is safe and feasible and has the potential to cure primary hypoparathyroidism as well as kidney failure.
Psychological Impact of Predictive Genetic Testing for Inherited Alzheimer Disease and Frontotemporal Dementia
Authors: Galluzzi Samantha , Mega Anna , Di Fede Giuseppe , Muscio Cristina , Fascendini Sara , Benussi Luisa , Tagliavini Fabrizio ,   The Italian-DIAfN Working Group, Frisoni Giovanni B. , Di Maria Emilio
Published: March 2022

Aim:

Our aim was to evaluate the psychological impact of predictive genetic testing in individuals at-risk for inherited dementia who underwent a structured counseling and testing protocol.

Methods:

Participants were healthy at-risk relatives from families with at least one affected patient, in whom a disease-associated genetic variant had been ascertained. A comprehensive psychological assessment (personality, anxiety and depression, quality of life, coping strategies, resilience and health-related beliefs) was administered at baseline, at 6 months and 12 months follow-up.

Results:

Twenty-four participants from 13 families were included. Sixteen participants underwent blood sampling and genetic analysis; 6 resulted to be carriers of pathogenic variants (1 in PSEN1, 1 in PSEN2, 4 in GRN). Carriers showed higher score on the Resilience Scale for Adults (RSA) – social competence, and on Multidimensional Health Locus of Control – internal, than noncarriers (P=0.03 for both). Ten at-risk relatives who completed the follow-up showed improvement in RSA – planned future (P=0.01) with respect to baseline.

Discussion:

Our case series showed that at-risk individuals undergoing predictive testing showed benefit on personal life and no detrimental impact on a broad range of psychological outcomes. Higher social skills and lower internal health locus of control in carriers may be an early psychological correlate of preclinical dementia.
Screening for Dementia and Cognitive Decline in Adults With Down Syndrome
Authors: Prado Mattar Guilherme , Uchida Ricardo R. , Haddad Glenda G. , Shiozawa Pedro , Rebouças da Silva Maria de Fátima , Hoexter Marcelo Q. , Busatto Geraldo F. , de Campos Bottino Cassio M. , Fonseca Luciana M. , Forlenza Orestes V.
Published: March 2022

Objective:

The aim was to examine the psychometric properties of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) as a diagnostic tool to screen for dementia in aging individuals with Down syndrome (DS).

Methods:

This was a cross-sectional study of 92 individuals with DS 30 y or above of age) evaluated with the IQCODE. Using the informant questionnaire of the Cambridge Examination for Mental Disorders of Older People with Down’s Syndrome and Others with Intellectual Disabilities, we divided the subjects into 3 diagnostic groups: stable cognition; prodromal dementia; and dementia. The ability of the IQCODE to discriminate between diagnostic groups was analyzed by calculating the areas under the receiver operator characteristic curves (AUCs).

Results:

The optimal IQCODE cutoffs were 3.14 for dementia versus stable cognition (AUC=0.993; P<0.001) and 3.11 for prodromal dementia+dementia versus stable cognition (AUC=0.975; P<0.001), with sensitivity/specificity/accuracy of 100%/96.8%/97.3%, and 93.3%/91.9%/92.4%, respectively. The IQCODE showed a weak-to-moderate correlation with cognitive performance (P<0.05).

Conclusion:

The IQCODE is a useful tool to screen for cognitive decline in individuals with DS and is suitable for use in a primary care setting.
Analysis of Electrocorticography in Epileptic Patients With Responsive Neurostimulation Undergoing Scalp Electroencephalography Monitoring
Authors: Lemus Hernan Nicolas , Gururangan Kapil , Fields Madeline Cara , Jetté Nathalie , Bolden Dina , Yoo Ji Yeoun
Published: March 2022

Purpose:

To describe the relationship of electrocorticography events detected by a brain-responsive neurostimulation system (RNS) and their association with ictal and interictal activity detected on simultaneous scalp EEG.

Methods:

We retrospectively identified patients with drug-resistant epilepsy implanted with RNS who subsequently underwent long-term scalp EEG monitoring. RNS detections were correlated to simultaneous activity recorded on scalp EEG to determine the characteristics of electrocorticography-stored long episodes associated with seizures or other findings on scalp EEG.

Results:

Eleven patients were included with an average of 3.6 days of monitoring. Most RNS detections were of very brief duration (<10 seconds, 92.9%) and received one stimulation therapy (80.8%). A high proportion of long episodes (67.1%) were not identified as electrographic seizures on scalp EEG. Of those ictal-appearing (71.2%) long episodes, 68.2% had seizure correlates. Long episodes associated with seizures on scalp EEG had a longer median duration compared with those without (39.7 vs. 16.8 seconds,P< 0.002) and had broader spread pattern and were of higher amplitude on electrocorticography. Brief potentially ictal rhythmic discharges were the most common EEG findings associated with long episodes that did not have scalp EEG seizure correlates (100% for ictal- and 50% for non–ictal-appearing long episodes).

Conclusions:

Longer, broader spread and higher amplitude intracranial RNS detections are more likely to manifest as electrographic seizures on scalp EEG. Brief potentially ictal rhythmic discharges may serve as a scalp EEG biomarker of ictal intracranial episodes that are detected as long episodes by the RNS but not identified as electrographic seizures on scalp EEG.
Thomas Michael Jessell. 2 August 1951—28 April 2019
Authors: Briscoe James , Wood John N.
Published: March 2022

Tom Jessell was a British neuroscientist who made pioneering discoveries in developmental neurobiology. Beginning with a neuropharmacology training in London and Cambridge, Tom moved to Harvard and finally Columbia University. There, Tom embraced the dramatic late twentieth-century developments in molecular biology to unravel the genetic basis of spinal cord neuronal diversity and developmental mechanisms of circuit formation. Combining encyclopaedic knowledge of the classical neurobiology literature with virtuoso molecular genetic, anatomical and electrophysiological techniques, exploited by his team of gifted students, post-docs and collaborators, Tom made seminal contributions to broad areas of neuroscience. Notable contributions included the discovery of extracellular factors that induce distinct neuronal cell types and guide their connectivity, as well as the identification of the transcriptional repertoires that led to neuronal complexity in the developing spinal cord. Important insights into circuitry and behaviour followed these defining studies. At the same time, Tom was heavily involved in neuroscience education and the development of new neuroscience research institutes. For all his Herculean energy for research, he still found great pleasure in fine art, cricket and jazz, and his life was greatly enriched by his partner Jane Dodd, also a Cambridge-trained neuroscientist, and their three daughters. Tom's wit, energy and incisive intelligence will be sorely missed. His legacy is not only a paradigm-shifting body of papers, but also his educational and institutional achievements and the remarkable group of scientists, once his trainees, who, in their turn, continue to advance neuroscience research around the world.
Phillip Vallentine Tobias. 14 October 1925—7 June 2012
Authors: McKee Jeffrey K.
Published: March 2022

Phillip Tobias was certainly best known as the doyen of African palaeoanthropology, but his interests and accomplishments ranged far beyond that. He was skilled in cytogenetics, human biology and, of course, human anatomy, as a long-time chair of anatomy at his academic home, the University of the Witwatersrand, Johannesburg. The passion of Tobias also made him a leading figure as a warrior for academic freedom and human dignity in the fight against South African apartheid. His oratorical skills gave him power in the classroom and in public, although he was well-known for often going on too long. Fondly known as ‘PVT’, Tobias was a gracious yet demanding scholar, with a work ethic few could attempt to mimic.
Émigré neurophysiologists' situated knowledge economies and their roles in forming international cultures of scientific excellence
Authors: Stahnisch F. W.
Published: March 2022

This article investigates the scientific performance and impact of Jewish and politically oppositional émigré German-speaking neurophysiologists from Nazi-occupied Europe since the 1930s. The massive loss of nearly 30% of all academic psychiatrists and neurologists in Germany between 1933 and 1945 also shattered the basis of German-speaking neuroscientific research. A focus will be laid here on the contingency of situated knowledge economies in Central Europe, the UK and North America, as well as their roles in the formation of international cultures of scientific excellence in the forced migration process. While examining excellent émigré laboratory research, the intriguing biographies of three Nobel Prize-winning neurophysiologists––Otto Loewi (1873–1961; from Germany/Austria to the USA), Bernard Katz (1911–2003; from Germany to the UK) and Eric Kandel (b. 1929; from Austria to the USA)—can tell us considerably more about the appraisal of medico-scientific knowledge through an epistemic lens representing world history along explicit regional knowledge economies. This article examines some of the more intricate scientific practices and professional patterns of determining academic excellence related to situated knowledge communities in the contemporary brain sciences.