bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of increasing supplemental zinc in beef feedlot steers administered a steroidal implant and beta agonist
Authors: Messersmith Elizabeth M , Smerchek Dathan T , Hansen Stephanie L
Published: February 2022

Ninety-two Angus-crossbred steers (424 ± 28.3 kg initial body weight) were used in a 98-d study to assess the effects of increasing Zn supplementation on cattle performance, liver and plasma trace mineral concentrations, blood metabolites, and carcass characteristics. All steers were implanted with a Component TE-200 (200 mg trenbolone acetate + 20 mg estradiol; Elanco Animal Health, Greenfield, IN) on d 0 and fed 300 mg‧steer−1‧d−1 of ractopamine hydrochloride (Zoetis, Parsippany, NJ) from d 70 to 98. Cattle were fed via GrowSafe bunks (GrowSafe Systems Ltd., Airdrie, AB, Canada), and steer served as the experimental unit (n = 22 or 23 steers/treatment). Supplemental Zn was administered through the diet at 0, 100, 150, or 180 mg Zn/kg on a dry matter basis from ZnSO4 (Zn0, Zn100, Zn150, or Zn180, respectively). Cattle were weighed on d −1, 0, 9/10, 20, 41, 59, 69, 70, 78/79, 97, and 98. Blood was collected on d 0, 9/10, 69, 78/79, and 97, and liver biopsies on d 9/10 and 78/79 (n = 12 steers/treatment). Data were analyzed as a complete randomized design. Contrast statements were formed to test the linear, quadratic, and cubic effects of Zn supplementation and test Zn0 vs. Zn supplementation. Day 10 and 70 body weight (BW) and d 0 to 10 and 0 to 70 average daily gain were linearly increased with Zn supplementation (P ≤ 0.05), and greater for Zn supplemented steers (P ≤ 0.03). No effects of Zn supplementation were observed on final BW, dressing percentage, ribeye area, 12th rib fat, or marbling (P ≥ 0.11). Hot carcass weight tended to be 7 kg greater for Zn supplemented steers than Zn0 (P = 0.07), and yield grade linearly increased with increasing Zn supplementation (P = 0.02). Day 10 liver Mn concentrations tended to quadratically decrease (P = 0.08) with increasing Zn supplementation, though d 79 liver Mn concentrations and arginase activity were not influenced by Zn (P ≥ 0.28). Day 10 liver arginase activity tended to be (r = 0.27; P = 0.07) and d 10 serum urea nitrogen was correlated with d 10 liver Mn (r = 0.55; P < 0.0001). Zinc supplementation linearly increased d 10 liver Zn and d 10, 69, 79, and 97 plasma Zn concentrations (P ≤ 0.05). A cubic effect of Zn was observed on d 79 liver Zn (P = 0.01) with lesser liver Zn in Zn0 and Zn150 steers. These data suggest increasing dietary Zn improves growth directly following the administration of a steroidal implant and that steroidal implants and beta agonists differ in their effects on protein metabolism.
UV-B and UV-C radiation trigger both common and distinctive signal perceptions and transmissions inPinus tabuliformisCarr.
Authors: Xu Jie , Luo Hang , Zhou Shan-Shan , Jiao Si-Qian , Jia Kai-Hua , Nie Shuai , Liu Hui , Zhao Wei , Wang Xiao-Ru , El-Kassaby Yousry A , Porth Ilga , Mao Jian-Feng
Published: February 2022

In plants, ultraviolet (UV)-light is an important driver for growth and natural distribution, and is also a valuable tool for manipulating productivity as well as biotic interactions. Understanding of plant responses to different UV radiation is sparse, especially from a systems biology perspective and particularly for conifers. Here, we evaluated the physiological and transcriptomic responses to the short-term application of high-irradiance UV-B and UV-C waves on Pinus tabuliformis Carr., a major conifer in Northern China. By undertaking time-ordered gene coexpression network analyses and network comparisons incorporating physiological traits and gene expression variation, we uncovered communalities but also differences in P. tabuliformis responses to UV-B and UV-C. Both types of spectral bands caused a significant inhibition of photosynthesis, and conversely, the improvement of antioxidant capacity, flavonoid production and signaling pathways related to stress resistance, indicating a clear switch from predominantly primary metabolism to enhanced defensive metabolism in pine. We isolated distinct subnetworks for photoreceptor-mediated signal transduction, maximum quantum efficiency of photosystem II (Fv/Fm) regulation and flavonoid biosynthesis in response to UV-B and UV-C radiation. From these subnetworks, we further identified phototropins as potentially important elements in both UV-B and UV-C signaling and, for the first time, suggesting peptide hormones to be involved in promoting flavonoid biosynthesis against UV-B, while these hormones seem not to be implicated in the defense against UV-C exposure. The present study employed an effective strategy for disentangling the complex physiological and genetic regulatory mechanisms in a nonmodel plant species, and thus, provides a suitable reference for future functional evaluations and artificial UV-light mediated growing strategies in plant production.
Ancestral Chromosomes for Family Peronosporaceae Inferred from a Telomere-to-Telomere Genome Assembly of Peronospora effusa
Authors: Fletcher Kyle , Shin Oon-Ha , Clark Kelley J. , Feng Chunda , Putman Alexander I. , Correll James C. , Klosterman Steven J. , Van Deynze Allen , Michelmore Richard W.
Published: February 2022

Downy mildew disease of spinach, caused by the oomycete Peronospora effusa, causes major losses to spinach production. In this study, the 17 chromosomes of P. effusa were assembled telomere-to-telomere, using Pacific Biosciences high-fidelity reads. Of these, 16 chromosomes are complete and gapless; chromosome 15 contains one gap bridging the nucleolus organizer region. This is the first telomere-to-telomere genome assembly for an oomycete. Putative centromeric regions were identified on all chromosomes. This new assembly enables a reevaluation of the genomic composition of Peronospora spp.; the assembly was almost double the size and contained more repeat sequences than previously reported for any Peronospora species. Genome fragments consistently underrepresented in six previously reported assemblies of P. effusa typically encoded repeats. Some genes annotated as encoding effectors were organized into multigene clusters on several chromosomes. Putative effectors were annotated on 16 of the 17 chromosomes. The intergenic distances between annotated genes were consistent with compartmentalization of the genome into gene-dense and gene-sparse regions. Genes encoding putative effectors were enriched in gene-sparse regions. The near-gapless assembly revealed apparent horizontal gene transfer from Ascomycete fungi. Gene order was highly conserved between P. effusa and the genetically oriented assembly of the oomycete Bremia lactucae; high levels of synteny were also detected with Phytophthora sojae. Extensive synteny between phylogenetically distant species suggests that many other oomycete species may have similar chromosome organization. Therefore, this assembly provides the foundation for genomic analyses of diverse oomycetes.

[Formula: see text] Copyright © 2022 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Resilient Soils for Resilient Farms: An Integrative Approach to Assess, Promote, and Value Soil Health for Small- and Medium-Size Farms
Authors: Neher Deborah A. , Harris Jeanne M. , Horner Catherine E. , Scarborough Matthew J. , Badireddy Appala Raju , Faulkner Joshua W. , White Alissa C. , Darby Heather M. , Farley Joshua C. , Bishop-von Wettberg Eric J.
Published: February 2022

Healthy soils are the foundation of our food system and support broad environmental goals, including improved water quality and carbon sequestration. Increasingly, we appreciate that aspects of soil health such as fertility for plants, suppression of disease, and cycling of nutrients are linked to the functional diversity of soil microbial communities. The impact of functional capacity is influenced by farm management, which varies with farm size. Small to medium-size farms, with gross sales of less than $250,00 per year, make up 89% of farms in the United States, despite often being ignored in policy decisions. They are often more integrated into local food systems than larger farms, have greater investment in long-term sustainability due to their tendency to be passed from farmers to children, and are more reliant on soil health than larger farms. We describe a research framework to advance understanding of the soil microbiome and its role in soil health, environmental outcomes, and agricultural sustainability on small and medium farms. Our perspective elevates four research priorities to link the benefits of healthy soil microbiomes from the microscale to the macroscale. We hope this approach will lead to practical applications to enable success in the context of ongoing environmental and economic challenges that affect the agricultural landscape.
UV-Transmitting Plastics Reduce Powdery Mildew in Strawberry Tunnel Production
Authors: Onofre Rodrigo B. , Gadoury David M. , Stensvand Arne , Bierman Andrew , Rea Mark , Peres Natalia A.
Published: February 2022

Strawberry powdery mildew, caused by Podosphaera aphanis, can be particularly destructive in glasshouse and plastic tunnel production systems, which generally are constructed of materials that block ultraviolet (UV) solar radiation (about 280 to 400 nm). We compared epidemic progress in replicated plots in open fields and under tunnels constructed of polyethylene, which blocks nearly all solar UV-B, and two formulations of ethylene tetrafluoroethylene (ETFE), one of which contained a UV blocker and another that transmitted nearly 90% of solar UV-B. Disease severity under all plastics was higher than in open-field plots, indicating a generally more favorable environment in containment structures. However, the foliar severity of powdery mildew within the tunnels was inversely related to their UV transmissibility. Among the tunnels tested, incidence of fruit infection was highest under polyethylene and lowest under UV-transmitting ETFE. These effects probably transcend crop, and the blocking of solar UV transmission by glass and certain plastics probably contributes to the widely observed favorability of greenhouse and high-tunnel growing systems for powdery mildew.
Prophylactic Penehyclidine Inhalation for Prevention of Postoperative Pulmonary Complications in High-risk Patients: A Double-blind Randomized Trial
Authors: Yan Ting , Liang Xin-Quan , Wang Guo-Jun , Wang Tong , Li Wei-Ou , Liu Yang , Wu Liang-Yu , Yu Kun-Yao , Zhu Sai-Nan , Wang Dong-Xin , Sessler Daniel I.
Published: February 2022

Background

Postoperative pulmonary complications are common. Aging and respiratory disease provoke airway hyperresponsiveness, high-risk surgery induces diaphragmatic dysfunction, and general anesthesia contributes to atelectasis and peripheral airway injury. This study therefore tested the hypothesis that inhalation of penehyclidine, a long-acting muscarinic antagonist, reduces the incidence of pulmonary complications in high-risk patients over the initial 30 postoperative days.

Methods

This single-center double-blind trial enrolled 864 patients age over 50 yr who were scheduled for major upper-abdominal or noncardiac thoracic surgery lasting 2 h or more and who had an Assess Respiratory Risk in Surgical Patients in Catalonia score of 45 or higher. The patients were randomly assigned to placebo or prophylactic penehyclidine inhalation from the night before surgery through postoperative day 2 at 12-h intervals. The primary outcome was the incidence of a composite of pulmonary complications within 30 postoperative days, including respiratory infection, respiratory failure, pleural effusion, atelectasis, pneumothorax, bronchospasm, and aspiration pneumonitis.

Results

A total of 826 patients (mean age, 64 yr; 63% male) were included in the intention-to-treat analysis. A composite of pulmonary complications was less common in patients assigned to penehyclidine (18.9% [79 of 417]) than those receiving the placebo (26.4% [108 of 409]; relative risk, 0.72; 95% CI, 0.56 to 0.93; P = 0.010; number needed to treat, 13). Bronchospasm was less common in penehyclidine than placebo patients: 1.4% (6 of 417) versus 4.4% (18 of 409; relative risk, 0.327; 95% CI, 0.131 to 0.82; P = 0.011). None of the other individual pulmonary complications differed significantly. Peak airway pressures greater than 40 cm H2O were also less common in patients given penehyclidine: 1.9% (8 of 432) versus 4.9% (21 of 432; relative risk, 0.381; 95% CI, 0.171 to 0.85; P = 0.014). The incidence of other adverse events, including dry mouth and delirium, that were potentially related to penehyclidine inhalation did not differ between the groups.

Conclusions

In high-risk patients having major upper-abdominal or noncardiac thoracic surgery, prophylactic penehyclidine inhalation reduced the incidence of pulmonary complications without provoking complications.

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New
Breast Implant Illness and Cutibacterium acnes: A Case Report
Authors: McCarthy Philip H. , Teitler Nathaniel A. , Hon Heidi H. , Miller Jason J.
Published: February 2022

Breast implant illness (BII) is a term to describe a wide range of nonspecific symptoms after breast implant placement. At present, no specific diagnostic criteria for BII exist, and there is limited solid understanding of what causes BII. There is some evidence that biofilm infections such as those caused by Cutibacterium acnes may play a role in the development of BII. We present a case of a 38-year-old White woman who developed BII symptoms (psychological and integumentary). After en bloc explantation, her tissue cultures resulted in C. acnes growth. Plastic surgeons should be aware of this potential complication and discuss it thoroughly with patients before breast implantation. Evidence suggests that biofilm infection with C. acnes may play a role in BII development. En bloc explantation is the typical treatment of choice. Plastic surgeons should be aware of C. acnes as a potential cause of BII and should counsel patients on the potential risks and remedies for BII.
Canadian Expert Opinion on Breast Reconstruction Access: Strategies to Optimize Care during COVID-19
Authors: Isaac Kathryn V. , Buchel Edward W. , Brackstone Muriel M. , Doherty Christopher , Lipa Joan E. , Zhong Toni , Semple John L. , Brown Mitchell H. , Snell Laura , Mahoney Mary-Helen , Vorstenbosch Joshua , Wheelock Margaret , Macadam Sheina A. , Coroneos Christopher J. , Tremblay-Champagne Marie-Pascale , Voineskos Sophocles H. , Zhang Jing , Somogyi Ron , Temple-Oberle Claire , Ross Douglas
Published: February 2022

Background:

Breast reconstructive services are medically necessary, time-sensitive procedures with meaningful health-related quality of life benefits for breast cancer survivors. The COVID-19 global pandemic has resulted in unprecedented restrictions in surgical access, including access to breast reconstructive services. A national approach is needed to guide the strategic use of resources during times of fluctuating restrictions on surgical access due to COVID-19 demands on hospital capacity.

Methods:

A national team of experts were convened for critical review of healthcare needs and development of recommendations and strategies for patients seeking breast reconstruction during the pandemic. Following critical review of literature, expert discussion by teleconference meetings, and evidenced-based consensus, best practice recommendations were developed to guide national provision of breast reconstructive services.

Results:

Recommendations include strategic use of multidisciplinary teams for patient selection and triage with centralized coordinated use of alternate treatment plans during times of resource restrictions. With shared decision-making, patient-centered shifting and consolidation of resources facilitate efficient allocation. Targeted application of perioperative management strategies and surgical treatment plans maximize the provision of breast reconstructive services.

Conclusions:

A unified national approach to strategically reorganize healthcare delivery is feasible to uphold standards of patient-centered care for patients interested in breast reconstruction.
Cardiac amyloidosis: an update on diagnosis, current therapy, and future directions
Authors: Khedraki Rola
Published: February 2022

Purpose of review

This review aims to serve as a practical guide for differentiating the two most common forms of cardiac amyloidosis, as well as reviewing the approach to diagnosis and management, particularly as it pertains to transthyretin cardiac amyloidosis.

Recent findings

Emerging literature continues to unravel new understandings and challenges in the field of cardiac amyloidosis. Although cardiac amyloidosis has historically been thought of as a ‘zebra diagnosis’, current evidence has shown that this is a common cause of heart failure. Furthermore, it has become increasingly apparent that earlier diagnosis leads to improved outcomes and quality of life for patients.

By leveraging an understanding of the pathophysiology leading to amyloid fibril formation, new drug therapeutics are under investigation as promising candidates for the treatment of amyloid cardiomyopathy.
Cardiovascular outcome 6 months after severe coronavirus disease 2019 infection
Authors: Raafs Anne G. , Ghossein Mohammed A. , Brandt Yentl , Henkens Michiel T.H.M. , Kooi M. Eline , Vernooy Kevin , Spaanderman Marc E.A. , Gerretsen Suzanne , van Santen Susanne , Driessen Rob G.H. , Knackstedt Christian , van der Horst Iwan C.C. , van Bussel Bas C.T. , Heymans Stephane R.B. , Ghossein-Doha Chahinda
Published: February 2022

Objectives:

In coronavirus disease 2019 (COVID-19), cardiovascular risk factors and myocardial injury relate to increased mortality. We evaluated the extent of cardiac sequelae 6 months after hospital discharge in patients surviving ICU hospitalization for COVID-19.

Methods:

All survivors of Maastricht-ICU were invited for comprehensive cardiovascular evaluation 6 months after discharge from ICU. Cardiac screening included an electrocardiogram, cardiac biomarkers, echocardiography, cardiac magnetic resonance (CMR) and, wherever indicated, cardiac computed tomography or coronary angiogram.

Results:

Out of 52 survivors, 81% (n = 42) participated to the cardiovascular follow-up [median follow-up of 6 months, interquartile range (IQR) 6.1–6.7]. Eight patients (19%) had newly diagnosed coronary artery disease (CAD), of which two required a percutaneous intervention. Echocardiographic global longitudinal strain (GLS) was abnormal in 24% and CMR-derived GLS was abnormal in 12%, despite normal left ventricular ejection fraction in all. None of the patients showed elevated T1 relaxation times and five patients (14%) had an elevated T2 relaxation time. Late gadolinium enhancement (LGE) reflecting regional myocardial fibrosis was increased in eight patients (21%), of which three had myocarditis and three had pericarditis.

Conclusion:

Cardiovascular follow-up at 6 months after ICU-admission for severe COVID-19 revealed that one out of five invasively mechanically ventilated survivors had CAD, a quarter had subclinical left ventricular dysfunction defined as reduced echocardiographic GLS, and 42% of the patients had CMR abnormalities (reduced LVEF, reduced GLS, LGE presence, and elevated T2). On the basis of these findings, long-term cardiovascular follow-up is strongly recommended in all post-IC COVID-19 patients.

Clinical Trial Registration:

Trial Register number [NL8613]) https://www.trialregister.nl/trial/8613

Video abstract:
http://links.lww.com/HJH/B899.
Who Is at Risk of Developing Cannabis Dependence? Findings From an Extensive Online Study on Cannabis Users
Authors: Binkowska Alicja Anna , Ruban Anastasia , Gogolewska Mariszka , Sawicz Piotr , Rychlewski Leszek , Brzezicka Aneta
Published: February 2022

Objectives

Although frequency of cannabis use is considered to be the strongest risk factor for developing cannabis dependence, only up to half of daily users become dependent. In this study, we explored an array of risk factors and moderators of cannabis dependence symptoms from the International Classification of Diseases, Tenth Edition endorsed by participants.

Methods

A sample of 1,635 cannabis users completed an Internet survey consisting of measures of cannabis and other drug use. Multiple linear regression with a backward elimination method was employed to identify predictors of cannabis dependence symptoms. After that, a series of hierarchical multiple regression analyses were performed to test the predictive validity of the interactions between frequency of cannabis use and other predictors.

Results

Frequency of cannabis use appeared to be the strongest predictor of developing cannabis dependence symptoms; other significant predictors of cannabis dependence symptoms were substance-dependency-related treatment seeking, mental health problems in the family and pattern of substance use. Duration of cannabis use, relationship status, and drug use history in the family were identified as significant moderators of the relationship between frequency of cannabis use and the number of cannabis dependence symptoms.

Conclusions

This study confirms that the frequency of cannabis use is the strongest predictor of cannabis dependence symptoms but this relationship is significantly moderated by three abovementioned factors.
Adequacy of Emergency Department Documentation of Child Restraint Use After a Motor Vehicle Crash
Authors: Kendi Sadiqa , Chamberlain James M. , Pearman Ryan L. , Badolato Gia M. , Zonfrillo Mark R.
Published: February 2022

Objectives

There are limited data on how often providers collect and document adequate restraint information in children seen in the emergency department (ED) after motor vehicle crashes (MVCs). The objectives of this study are to determine (1) how often adequate child restraint information to determine age-appropriate use is documented after MVC; (2) the frequency of incorrect use of the child restraint when adequate details are documented; and (3) for those discharged from the ED with identified incorrect use, the frequency of provision of information on child passenger safety (CPS).

Methods

Retrospective chart review of visits of children younger than 13 years with an International Classification of Diseases, Tenth Revision code for MVC to an urban, academic, level 1 pediatric trauma center, from October 2015 to September 2018. Adequate documentation of child restraint use was defined as identification of location of the child in the car (front vs rear row), type of restraint used, and forward or rear facing for children 24 months or younger.

Results

A total of 165 visits qualified for inclusion. There was adequate documentation in 46% of visits. Of those, incorrect child restraint use was identified in 49%. Of discharged patients with incorrect use, 10% had documentation of provision of CPS information.

Conclusions

Adequate details to determine proper age-appropriate restraint use are documented in only half of ED visits for MVC. Very few are given CPS instructions on discharge, even when incorrect use has been identified. Identification of incorrect restraint use in the ED is an opportunity for a teachable moment that is being underused.
A Brief, Just-in-Time Sedation Training in the Pediatric Emergency Department Improves Performance During Adverse Events Encountered in Simulated Procedural Sedations
Authors: Schinasi Dana Aronson , Colgan Jennifer , Nadel Frances M. , Hales Roberta L. , Lorenz Douglas , Donoghue Aaron J.
Published: February 2022

Background

Procedural sedation (PS) is commonly performed in emergency departments (EDs) by nonanesthesiologists. Although adverse events (AEs) are rare, providers must possess the clinical skills to react in a timely manner. We previously described residents' experience and confidence in PS as part of a needs assessment. We found that their ability to perform important clinical tasks as a result of the usual training experience demonstrates educational needs. We developed an educational intervention to address the deficiencies uncovered during our needs assessment.

Objective

To evaluate the effectiveness of an educational intervention on pediatric residents' clinical performance and confidence when faced with an AE during a simulated PS.

Methods

This was a prospective observational cohort study of residents at a tertiary care children's hospital. All ED attending physicians and fellows were trained in uniform delivery of the educational intervention, which was delivered extemporaneously at the bedside (“Just-in-Time” [JIT]) to all residents performing PS on actual patients in the pediatric ED, over the course of 1 year. Subjects completed the following both before and after the educational intervention: a survey pertaining to confidence in PS, followed by a standardized, video-recorded simulated PS complicated by apnea and desaturation. Clinical performance was evaluated and assessed both in real time and by a video-rater blinded to participants' year of training. We summarized baseline resident characteristics, confidence questionnaire item rankings and success in both the preparation and AE tasks. We compared successful task completion and time to task completion before and after intervention.

Results

Forty residents completed both the PRE and POST phases of the study. There was significant improvement in the proportion of residents who completed both preparation and AE tasks after the JIT training. Specifically, there was a significant improvement in the proportion of residents who performed positive-pressure ventilation to treat an apneic event associated with desaturation during the PS (P = 0.007). Residents' confidence scores also significantly improved after the training.

Conclusion

A brief JIT training in the pediatric ED improves resident clinical performance and confidence when faced with an AE during a simulated PS. Future direction includes correlating this improved performance with patient outcomes in PS.
Use of POCUS in the Diagnosis of Paradoxical Vocal Cord Movement
Authors: Wiltrakis Susan M. , Gutierrez Peter
Published: February 2022

Point-of-care ultrasound has been instrumental in allowing providers to make prompt diagnoses at the bedside but has been historically underutilized for the diagnosis of upper airway processes, including paradoxical vocal fold motion (PVFM), also known as vocal cord dysfunction. PVFM is characterized by adduction of the vocal cords during inspiration, resulting in stridor and shortness of breath. This case report describes a teenage girl who presented to the pediatric emergency department (ED) with difficulty breathing. Point-of-care ultrasound diagnosed PVFM, which was confirmed with bedside flexible laryngoscopy by otorhinolaryngology (ENT) in the ED.
Pediatric Ovarian Torsion
Authors: Sims Morgan J. , Price Amanda B. , Hirsig Leslie E. , Collins Heather R. , Hill Jeanne G. , Titus M. Olivia
Published: February 2022

Objectives

Ovarian torsion (OT) is an emergency that mandates early detection and surgical detorsion to avoid catastrophic consequences of further adnexal injury. Prompt ultrasound is critical for accurate diagnosis. Traditionally, evaluation of arterial and venous flow was used as a diagnostic tool for OT, but recent radiologic research has indicated that ovarian size and size discrepancy between sides is a better diagnostic criterion. This study seeks to determine whether ovarian size discrepancy or vascular flow to the ovary is more accurate in the diagnosis of OT in the pediatric emergency population and to better describe symptoms that distinguish OT from other abdominal and pelvic pathology.

Methods

This was a retrospective, cross-sectional study evaluating all female pediatric patients, aged 1 to 18 years, who underwent a pelvic ultrasound to evaluate for OT over a 2-year period in our pediatric emergency department. Patients suitable for inclusion were identified via Nuance mPowerTM, a search engine that provides clinical analytics based on radiology reports generated within our institution.

Results

We reviewed the medical records of 193 female patients aged 1 to 18 years, all of whom had a pelvic ultrasound (with or without Doppler) to evaluate for OT during the study period. In comparing ovarian size on ultrasound, patients with OT had a significantly larger magnitude of difference in ovarian volume than patients without torsion (5.57× [interquartile range, 3–12.5] vs 1.56× [interquartile range, 1.24–2.25; P < 0.001]). Ovarian torsion was associated with a 33-fold increased risk of lack of arterial flow (relative risk, 33.33) and with a 9-fold increased risk of lack of venous flow (relative risk, 9.27), when compared with those patients without OT. Patients with OT were significantly more likely to have emesis and peritoneal signs on examination, as well as previous history of OT (P = 0.01, 0.02, and 0.002, respectively) than those without OT. All patients with OT reported abdominal pain.

Conclusions

We found that a large size discrepancy between ovaries is indicative of OT. Our data also suggest that presence of Doppler flow on ultrasound cannot be used to exclude OT but that lack of Doppler flow on ultrasound is a significant diagnostic marker. As previous studies have also found, clinical symptoms of OT are nonspecific and do not offer any certainty in differentiating OT from other pathologies.
Contrast-Enhanced Ultrasound of Brain Perfusion in Cardiopulmonary Resuscitation
Authors: Hwang Misun , Sridharan Anush , Freeman Colbey W. , Viaene Angela N. , Kilbaugh Todd J.
Published: February 2022

To evaluate the feasibility and potential utility of contrast-enhanced ultrasound for real-time imaging of whole-brain perfusion during cardiopulmonary resuscitation (CPR), cardiac arrest was induced in 8- to 7-week-old 10-kg piglets (Sus scrofa domesticus). Contrast-enhanced ultrasound was performed through a parietal cranial window in the coronal plane visualizing the thalami during hemodynamic-directed CPR. Whole-brain mean and maximum pixel intensities in each slice during resuscitation were calculated. Piglets were monitored for 24 hours postarrest. Seven piglets achieved return of spontaneous circulation and 6 survived to 24 hours. Of the 6 surviving piglets, 2 piglets demonstrated greater intra-CPR brain enhancement at maximum 73.2% and 42.1% and mean 36.7% and 31.9% enhancement above background, respectively, compared with maximum 5.8%, 22.9%, 6.0%, and 26.6% and mean 5.1%, 8.9%, 2.9%, and 6.6% above background, respectively, in the other 4. Intra-CPR average mean arterial pressures were similar between all 6 surviving piglets. One piglet achieved return of spontaneous circulation but expired 10 minutes later with enhancement maximum 45.2% and mean 18.9% enhancement above background. The final piglet did not achieve return of spontaneous circulation and exhibited minimal enhancement at maximum 2.8% and mean 0.9% enhancement above background. Contrast-enhanced ultrasound can detect brain perfusion during CPR, identifying a spectrum of cerebral blood flow responses in the brain despite similar systemic hemodynamics. This novel application can form the basis for future large animal model studies and eventually human clinical studies to further explore the neurologic implications of cerebral blood flow responses during resuscitation and stimulate novel strategies for optimizing brain perfusion restoration.
Survey Study on the Experience, Practice Patterns, and Preferences of the Fellows of the Society of Radiologists in Ultrasound for Evaluation and Management of Gallbladder Polyps Detected With Ultrasound
Authors: Middleton William D. , Fung Christopher , Dahiya Nirvikar , Szpakowski Jean-Luc , Corwin Michael T. , Fetzer David T. , Gabriel Helena , Rodgers Shuchi K. , Tublin Mitchell E. , Walsh Andrew J. , Kamaya Aya
Published: February 2022

Gallbladder polyps (GPs) are a common incidental finding on ultrasound; however, important differences in recommended management exist among professional society guidelines.

An electronic survey was sent to 189 fellows of the Society of Radiologists in Ultrasound. Main outcomes included preferences and current practice patterns for evaluation, management, and surveillance of GPs as well as personal lifetime experience with gallbladder sonography and GPs.

A total of 64 subjects (34%) with experience in gallbladder sonography completed the study. The estimated combined total number of gallbladder scans seen by the responders was 3,071,880. None of fellows had ever seen a pedunculated GP <1 cm detected on ultrasound that was proven to be malignant at the time of detection or during subsequent follow-up. All of the fellows used size as a feature to stratify recommendations. The median size threshold currently used by Society of Radiologists in Ultrasound fellows for recommending ultrasound follow-up was 6 mm, and their preferred threshold was 7 mm. The median size threshold for recommending surgical consultation was 10 mm, and the preferred threshold was 10 mm. Wall thickening and shape were considered important factors by 76% and 67% of respondents, respectively.

Society of Radiologists in Ultrasound fellows tend to provide recommendations most similar to the American College of Radiology and Canadian Association of Radiology guidelines for management of GPs. Many would prefer guidelines that result in fewer recommendations for follow-up and surgical consultation. Despite a substantial combined experience, this survey did not uncover any case of a small GP that was malignant.
Popliteal Artery Injury After Fracture and/or Dislocation of the Knee: Risk Stratification for Revascularization Outcome
Authors: Hsieh Yun-Huan , Lee Min-Chao , Hsu Chung-Chen , Chen Shih-Heng , Lin Yu-Te , Lin Chih-Hung , Lin Cheng-Hung
Published: February 2022

Background

Managing complex knee trauma involving both vascular and osseous injuries is challenging, yet the available guidelines for efficient popliteal artery injury management after high-velocity blunt knee trauma remain conflicting and inconsistent. In this study, the authors aim to identify the risk factors associated with delayed limb amputation and ischemic muscular sequela postrevascularization. Furthermore, we propose a treatment algorithm to improve the limb salvage rate.

Methods

Patients who presented with traumatic popliteal artery injury resulting in vessel occlusion or rupture, followed by fracture and/or dislocation of the knee from January 2008 to December 2013, were included for retrospective review.

Results

Overall delayed amputation rate was 24% (7/29) and 16% (4/25) after successful revascularization. Mangled Extremity Severity Score is higher in the delayed amputation group than the limb-salvaged group (P = 0.02). Higher-impact force (P = 0.03), ischemic limb on presentation (P = 0.03), prolonged ischemia time (P = 0.04), unstable hemodynamics (P = 0.01), longer operation time (P = 0.04), and prolonged intensive care unit stay (P = 0.03) are risk factors of delayed amputation. Longer ischemia time (P = 0.04) and length of popliteal artery injury (P = 0.02) are associated with ischemic muscular sequela.

Conclusions

Mangled Extremity Severity Score is a reliable predictor of limb salvage. An algorithmic approach may improve the outcome of popliteal artery injury after high-velocity blunt knee trauma.
A New Approach for Alar Grafting Technique to Support Soft Triangle
Authors: Öztürk Güncel
Published: February 2022

Rhinoplasty is 1 of the leading surgical procedures among all aesthetic and plastic surgeries. Grafting is an important part of both primary and revision rhinoplasties. The grafts are used for improving the functional and as well as aesthetical deformities of the nose. The choice of a graft is important for long term results in rhinoplasty operations. In present research, the author aimed to present a new approach for alar grafting in a special patient group for providing better cosmetic and functional outcomes. The patients who received rhinoplasty, who had a retraction in the soft triangle region, who had a wide alar base and who gave permission for sharing their photos for medical purposes were included in the study. According to inclusion and exclusion criteria 21 patients were included in the study. All patients included in the study completed the Rhinoplasty Outcome Evaluation (ROE) before operation and at their 1-year follow-up appointment. Twelve months after surgery, the ROE scores ranged between 90 and 100 points. The median score increased from 56.8 to 91.5 points (P < 0.001). Patient satisfaction was excellent in 100% of the included cases according to ROE scale. Physical examination and assessment of postoperative photographs demonstrated that there were no asymmetry or functional problems in all participants. This new alar graft approach has advantages such as; because the alar graft was obtained from the similar tissue, the accordance of the graft will be much more compared with other tissues. Another advantage is not making an intervention to septum, rib or auricle and this advantage can bring more suitability for both patients and as well as surgeons.

Level of Evidence:

Level III, therapeutic study.
Stress-testing development pathways under a changing climate: water-energy-food security in the lake Malawi-Shire river system
Authors: Bhave Ajay G. , Conway Declan , Dessai Suraje , Dougill Andrew J. , Mkwambisi David
Published: February 2022

Malawi depends on Lake Malawi outflows into the Shire River for its water, energy and food (WEF) security. We explore future WEF security risks under the combined impacts of climate change and ambitious development pathways for water use expansion. We drive a bespoke water resources model developed with stakeholder inputs, with 29 bias-corrected climate model projections, alongside stakeholder elicited development pathways, and examine impacts on stakeholder-elicited WEF sector performance metrics. Using scenario analysis, we stress-test the system, explore uncertainties, assess trade-offs between satisfying WEF metrics, and explore whether planned regulation of outflows could help satisfy metrics. While uncertainty from potential future rainfall change generates a wide range of outcomes (including no lake outflow and higher frequency of major downstream floods), we find that potential irrigation expansion in the Lake Malawi catchments could enhance the risk of very low lake levels and risk to Shire River hydropower and irrigation infrastructure performance. Improved regulation of lake outflows through the upgraded barrage does offer some risk mitigation, but trade-offs emerge between lake level management and downstream WEF sector requirements. These results highlight the need to balance Malawi's socio-economic development ambitions across sectors and within a lake-river system, alongside enhanced climate resilience.

This article is part of the theme issue 'Developing resilient energy systems'.
Policy and political perceptions of risk: the challenges to building resilient energy systems
Authors: Gluckman Peter , Bardsley Anne
Published: February 2022

Decisions relating to energy systems resilience must take into account a range of environmental and societal transitions together with an array of future threats. These must be assessed broadly and systematically but also must consider how risks and vulnerabilities are linked, and that small events can cascade across a system and between systems to escalate into large-scale collapse. Developing resilience involves not only identifying such threats and potential points of failure but acting upon them with an appropriate level of future planning. Decision-making in complex systems is often affected by cognitive biases and runs into contestation and obstacles of politics, policy complexities and differing views of potential futures. This paper discusses the challenges to building resilient systems for the future, given the inevitable biases and differing risk perspectives of decision-makers at all levels that often confound expert analysis.

This article is part of the theme issue ‘Developing resilient energy systems’.
Salinarimonas soli sp. nov., isolated from soil
Authors: Jin Chun-Zhi , Jin Long , Liu Min-Jiao , Kang Min-Kyoung , Park So Hee , Park Dong-Jin , Kim Chang-Jin
Published: February 2022

A light pink coloured bacterium, designated strain BN140002T, was isolated from a soil sample collected in Goesan-gun, Chungcheongbuk-do, Republic of Korea. Cells of strain BN140002T were Gram-stain-negative, aerobic, motile and rod-shaped. Phylogenetic analysis based on 16S rRNA gene sequences showed 94.7, 94.7, 93.9, 93.3, 93.4 and 93.0% similarities to

Salinarimonas rosea

KCTC 22346T,

Salinarimonas ramus

DSM 22962T,

Saliniramus fredricksonii

HL-109T,

Microvirga soli

R491T,

Chelatococcus caeni

EBR-4-1T and

Chelatococcus composti

PC-2T, respectively. The major polar lipids were diphosphatidylglycerol, phosphatidylglycerol, phosphatidylcholine and phosphatidylethanolamine. The major cellular fatty acids were summed feature 8 (C18 : 1
 ω7c and/or C18 : 1
 ω6c) and summed feature 1 (C12 : 0 aldehyde and/or unknown 10.98) and the predominant ubiquinone was Q-10. The genomic DNA G+C content of strain BN140002T was 70.1 mol%. The genomic orthoANI values between strain BN140002T and

Salinarimonas rosea

KCTC 22346T and

Salinarimonas ramus

DSM 22962T were 75.0 and 74.8 %, respectively. Strain BN140002T had a class I-C type CRISPR-Cas system (CRISPR-associated helicase Cas3, CRISPR-associated protein Cas8c, CRISPR-associated protein Cas7, CRISPR-associated RecB family exonuclease Cas4, CRISPR-associated protein 1, 2). Based on phenotypic, chemotaxonomic and phylogenetic data, strain BN140002T should be assigned as a novel species of the genus

Salinarimonas

, for which the name Salinarimonas soli sp. nov. is proposed. The type strain is BN140002T (=KCTC 42643T=CCTCC AB 2017173T).
Variation of sexual dimorphism of wing shape in the family Dolichopodidae (Diptera)
Authors: Chursina M.A. , Maslova O.O.
Published: February 2022

Although sexual dimorphism manifestations are widespread in the family Dolichopodidae, a detailed characterization of their phylogenetic significance is lacking. Purpose: in order to study the distribution patterns of wing sexual dimorphism, we analysed 57 species from 17 genera of 9 subfamilies. Methods: A comparative analysis of the evidence, obtained by geometric morphometry and molecular data, allowed us to assess the phylogenetic signal in the sexual dimorphism of the wing. Results: The results of the study confirm the presence of diverse patterns of sexual variability in the wings of this family. More often, females have larger wings with blunted apexes, whereas males are characterized by a more pointed apex. In some cases, the larger size of females’ wings is associated with an increase in body size, while in other cases, differences in shape and size can be explained by differences in behavioural and life patterns. Although there exists a general pattern of sexual dimorphism, its features differ even in closely related species. Conclusion: the absence of a significant phylogenetic signal in seven out of nine studied wing points indicates that the sexual dimorphism in form evolved, at least partially, in each of the studied species.
NEDD8 activity is important for direct antigen MHC class I antigen presentation
Authors: Vijayasimha Kartikeya , Leestemaker-Palmer Amy L. , Gibbs James S. , Yewdell Jonathan W. , Dolan Brian P.
Published: February 2022

Successful direct MHC class I antigen presentation is dependent on the protein degradation machinery of the cell to generate antigenic peptides which can be loaded onto MHC class I molecules for surveillance by CD8+T cells of the immune system. Most often this process involves the ubiquitin-proteasome system, however other ubiquitin-like (UBL) proteins have also been implicated in protein degradation and direct antigen presentation. Here, we examine the role of neuronal precursor cell-expressed developmentally down-regulated protein 8 (NEDD8) in direct antigen presentation. NEDD8 is the UBL with highest similarity to ubiquitin and fusion of NEDD8 to the amino-terminus of a target protein can lead to the target proteins degradation. We find that appending NEDD8 to the N-terminus of the model antigen ovalbumin resulted in degradation by both the proteasome and autophagy protein degradation pathways, but only proteasomal degradation, involving the proteasomal subunit NEDD8 ultimate buster 1 (NUB1), resulted in peptide presentation. When directly compare to ubiquitin, NEDD8-fusion was less efficient at generating peptides. However, inactivation of the NEDD8-conugation machinery by treating cells with MLN4924, inhibited the presentation of peptides from Defective Ribosomal Products (DRiPs) derived from a model antigen. These results demonstrate that NEDD8 activity in the cell is important for direct antigen presentation, but not by directly targeting proteins for degradation.
Exercise Training Outcomes in Patients with Chronic Heart Failure with Reduced Ejection Fraction Depend on Medications and Disease Conditions: Proposal of SEEM Score to Judge Exercise Suitability
Authors: Soejima Yukako , Yoshioka Hideki , Guro Sayuri , Sato Hiromi , Hatakeyama Hiroto , Sato Yasunori , Fujimoto Yoshihide , Anzai Naohiko , Hisaka Akihiro
Published: February 2022

Background

Exercise training is an accepted evidence-based adjunct treatment modality for patients with chronic heart failure. However, the influence of medications or conditions on exercise has not been fully explored.

Methods

The patient records of the Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION) study were obtained from the National Heart, Lung, and Blood Institute, and analyzed by medications used at baseline (renin-angiotensin system inhibitors [RASIs], beta-blockers [BBs], and combination of both) with multivariable Cox regression models focusing on the interactions with exercise effects, and a score to indicate exercise training suitability was proposed accordingly.

Results

Medication type strongly influenced the exercise effect on all-cause death (AD) (P = 0.007) even though medication itself did not change prognosis significantly in HF-ACTION trial. In patients taking both BBs and RASIs at baseline, exercise reduced the AD risk (hazard ratio [HR], 0.86; 95% confidence interval [CI], 0.75–0.98), whereas in patients not taking BBs, exercise increased the risk (HR, 4.58; 95% CI, 2.90–6.86). The exercise on AD was also influenced by pulse pressure, hemoglobin level, electrocardiography conditions, body mass index, and history of stroke. Accordingly, we constructed the Score for Eligibility of Exercise on Mortality (SEEM). When exercise training was chosen based on SEEM score, both AD and AD and hospitalization (ADH) risks were expected to reduce significantly (HR, 0.54; 95% CI, 0.44–0.68; HR, 0.83; 95% CI, 0.75–0.93, respectively).

Conclusions

Exercise training in patients with heart failure should be recommended carefully with consideration of patient background.

Clinical Trial Registration

Clinicaltrials.govidentifier:NCT00047437. Trial registration date: 4 October 2002.