bluuebunny/crossref_metadata_2025 huggingface dataset:
Introduction
Authors: Klein Natalie , Parlett Kate
Published: November 2022

The introductory chapter to Judging the Law of the Sea first provides an overview of the UN Convention on the Law of the Sea (UNCLOS), indicating the diverse ocean matters addressed in UNCLOS as well as its general importance in the international legal system. Secondly, the chapter focuses on the existing process to settle international disputes under Part XV of UNCLOS. It explains why compulsory jurisdiction was included in UNCLOS and what choice exists between different courts and tribunals to settle law of the sea disputes. Thirdly, the chapter reflects on the role of dispute settlement under UNCLOS and the key goals for UNCLOS dispute settlement, taking into account the broader debate about the role of international courts in international law. The chapter concludes with an outline of Judging the Law of the Sea.
Preliminary, Incidental, and Other Proceedings
Authors: Klein Natalie , Parlett Kate
Published: November 2022

This chapter discusses how jurisdiction is established for arbitration or adjudication under the UN Convention on the Law of the Sea (UNCLOS). In particular, it considers the existence of a dispute, the requirement to exchange views, and addresses whether alternative methods of international dispute settlement must be used instead of arbitration or adjudication under UNCLOS. The chapter sets out the most common objections to the admissibility of disputes in UNCLOS dispute settlement, including standing, estoppel, indispensable third parties, exhaustion of local remedies, and clean hands. The chapter addresses the main incidental and other proceedings that have arisen in UNCLOS dispute settlement to date and focuses on jurisdictional issues in these cases. These proceedings include the prescription of provisional measures, counter-claims, and proceedings to secure the prompt release of vessels under Article 292 of UNCLOS.
Influence of “Decide + Be Ready” Contraceptive Decision Aid on Pre-deployment Health Decisions
Authors: Wilcox Shelby A , Witkop Catherine T , Thagard Andrew S
Published: November 2022

Introduction

The number of active duty servicewomen and the career opportunities available to them continue to increase. Of the approximately 350,000 women in uniform, 97% are estimated to be of reproductive age, underscoring the importance of reproductive health care. This study aimed to explore the influence of the Decide + Be Ready (DABR) contraceptive decision aid on providing contraceptive knowledge, facilitating a servicewoman’s contraceptive choice before and during deployment, and enabling understanding of individual preferences around contraception in a population of active duty women most at risk for unintended pregnancy.

Materials and Methods

We conducted a qualitative study, recruiting active duty women between the ages of 17 and 24 with at least one prior deployment who were stationed at Naval Station Norfolk and presented for evaluation at a primary care clinic. Participants downloaded and reviewed the DABR application. A semi-structured interview was conducted and audio-recorded. Interviews were transcribed and underwent thematic analysis.

Results

Twenty women participated in the study over 2 weeks. Analysis revealed three overarching themes: perceived utility of and attitudes toward DABR, knowledge of and comfort with contraceptive options, and challenges specific to active duty women. In total, eight subthemes were also identified and explored.

Conclusions

The DABR app provided study participants with new information about contraception. Participants reported improved knowledge of gynecologic and reproductive health options available during deployment. Other findings raise interest for future studies exploring incorporation of peer validation in counseling and decision-making tools, challenges with the deployed environment for obstetric/gynecologic health, and medical support on naval deployments.
Adsorption of atomic hydrogen as driving vector for solid-gas processes on ices
Authors: Tieppo N , Pauzat F , Parisel O , Ellinger Y
Published: November 2022

A consensus has progressively developed that the path towards complex organic molecules could be favoured by the icy mantles of interstellar dust particles. However, the question of whether activation energy is required to promote those reactions is open. This work deals with the simplest process thought to increase complexity i.e. successive additions of a single atom (H). Two situations can be considered, the direct additions of H in the gas phase and the atomic hydrogenation processes on water ice surfaces available in the interstellar medium (ISM). The synthesis of methanol, largely discussed in the literature is revisited as a case study. Computational investigations of the reactions leading from CO to CH3OH show that, with [H...(H2O)n] complexes as hydrogenation vectors, all steps of the process are barrier-less, contrary to the gas phase process and this, whatever the level of theory considered. The key parameter is the position of the CO + [H...(H2O)n] initial system on the global energy scale. At the present level of theory, when H is pre-adsorbed on the ice, the system happens to be high enough above the reaction path, namely, above any intermediates and possible transition states. This is true whatever the dimension of the ice support, even for the simplest model of one H2O molecule. Application of such a simplified synthetic approach, here validated for the synthesis of methanol, could be generalized, providing a simple way to get a fair insight into the important class of atomic hydrogenations on ices in the ISM.
FER and LecRK show haplotype-dependent cold-responsiveness and mediate freezing tolerance in Lotus japonicus
Authors: Mustamin Yusdar , Akyol Turgut Yigit , Gordon Max , Manggabarani Andi Madihah , Isomura Yoshiko , Kawamura Yasuko , Bamba Masaru , Williams Cranos , Andersen Stig Uggerhøj , Sato Shusei
Published: November 2022

Many plant species have succeeded in colonizing a wide range of diverse climates through local adaptation, but the underlying molecular genetics remain obscure. We previously found that winter survival was a direct target of selection during colonization of Japan by the perennial legume Lotus japonicus and identified associated candidate genes. Here, we show that two of these, FERONIA-receptor like kinase (LjFER) and a S-receptor-like kinase gene (LjLecRK), are required for non-acclimated freezing tolerance and show haplotype-dependent cold-responsive expression. Our work suggests that recruiting a conserved growth regulator gene, FER, and a receptor-like kinase gene, LecRK, into the set of cold-responsive genes has contributed to freezing tolerance and local climate adaptation in L. japonicus, offering functional genetic insight into perennial herb evolution.
How Has COVID-19 Impacted Research Production in Economics and Finance?
Authors: Kruger Samuel , Maturana Gonzalo , Nickerson Jordan
Published: November 2022

Following the onset of COVID-19, research production in economics and finance (measured by the posting of working papers) increased by 29$\%$. Production increases were widespread across geographies, job titles, departments, and ages with larger increases in top departments and for people under the age of 35. Men and women both experienced production increases with the exception of women between the age of 35 and 49, who experienced no production gains despite large increases for men in the same age group. COVID-19 increased reliance on past coauthorship networks, with larger production gains for authors that are more central to the network.

Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Gender mainstreaming research funding: a study of effects on STEM research proposals
Authors: Sjöö Karolin , Kaltenbrunner Wolfgang
Published: November 2022

Policymakers increasingly try to steer researchers to choose topics of societal concern and to conduct research in ways that reflect such concerns. One increasingly common approach is prompting researchers to integrate certain perspectives into the content of their research, but little is known about the effects of this governance modality. We analyze 1,189 science, technology, engineering, and mathematics research proposals submitted to the Swedish Research Council which, starting in 2020, required all applicants to consider including the sex and/or gender perspectives in their research. We identify three overarching strategies upon which researchers rely (content-, performer-, and impact-centered) and analyze the ways in which researchers across disciplines motivate, through text, the inclusion or exclusion of these perspectives. Based on our findings, we discuss the scope of the desired effect(s) of a requirement of this kind.
Optimization of Ustilago nuda Inoculum Concentration for Screening Un8-Mediated Loose Smut Resistance in Barley Reveals a Resistance Reaction that Disrupts Seed Germination and Suggests a Role for Abscisic Acid in Disease Development
Authors: Zang Wen , Zhang Xiang M. , Eckstein Peter E. , Yang Fan , Colin Mark , Beattie Aaron D.
Published: November 2022

Barley loose smut has been effectively controlled for decades through resistance conferred by the Un8 gene. However, evaluation of loose smut reaction using floret inoculation at the standard inoculum concentration is associated with the production of small, discolored seeds in Un8 carriers and susceptible genotypes. Interestingly, Un8 carriers also displayed significantly poorer germination than susceptible genotypes and produce short-lived seedlings following inoculation. To understand these observations, a Un8 carrier (TR11698) and susceptible non- Un8 carrier (CDC Austenson) were assessed for seed traits, Ustilago nuda biomass in the seed, infection rate, and phytohormone profile across a range of lower inoculum concentrations. At lower inoculum concentrations, seed appearance and weight improved in both genotypes, and infection rate increased in CDC Austenson. Pathogen load in the seed was similar in both genotypes and was positively correlated with the CDC Austenson infection rate. No infection was ever observed in TR11698. Significantly, germination rate improved in CDC Austenson, whereas the very low germination rate and short-lived seedlings remained associated with TR11698. It appears that poor seed appearance in both genotypes and low germination rate in the susceptible genotype can be improved by lowering the inoculum concentration. However, the very low germination rates and seedling death associated with the Un8 carrier TR11698 are indicative of Un8-mediated resistance to loose smut. Finally, profiling of 38 phytohormones revealed that larger seeds observed at some inoculum concentrations compared with mock inoculation had higher abscisic acid concentrations. This could represent a pathogen survival strategy by ensuring better growth of the host.
Anesthesia-related Adverse Events in Obstetric Patients: A Population-based Study in Canada
Authors: Baghirzada L. , Archer D. , Walker A. , Balki M.
Published: November 2022

(Can J Anaesth. 2022;69:72–85)

Anesthesia-related morbidity, while rare, is a useful indicator for obstetric care quality and patient safety during childbirth. Previous studies—including those correlating anesthesia complications with cardiac arrest, pre-existing conditions, living in rural areas, neuraxial block, respiratory arrest, and unrecognized spinal catheterization—focused on specific neuraxial anesthesia or specific complications instead of analyzing multiple complications within a large population. The aim of this study was to determine the incidence of anesthesia complications as well as the association of anesthesia-related adverse events and medical or obstetric conditions.
Anesthesia and Developing Brains: Unanswered Questions and Proposed Paths Forward
Authors: Ing C. , Warner D.O. , Sun L.S. , Flick R.P. , Davidson A.J. , Vutskits L. , McCann M.E. , O’Leary J. , Bellinger D.C. , Rauh . , Orser B.A. , Suresh S. , Andropoulos D.B.
Published: November 2022

(Anesthesiology. 2022;136:500–512. doi: 10.1097/ALN.0000000000004116)

Decades ago, some studies showed early exposure to anesthetics increased the risk of altered neurodevelopment while others showed no such association. The debate about any association between anesthesia and neurodevelopment continues today. As these questions affect millions of children who undergo anesthetic-requiring procedures, this report aimed to provide current preclinical and clinical evidence, unanswered questions, and research suggestions going forward.
What Obstetrician-Gynecologists Should Know About Substance Use Disorders in the Perinatal Period
Authors: Smid M.C. , Terplan M.
Published: November 2022

(Obstet Gynecol. 2022;139:317–337. doi: 10.1097/AOG.0000000000004657)

Substance use and substance use disorders (SUD) are a huge cause for concern among obstetrician–gynecologists (ob-gyns), and overdose is a leading cause of maternal death in the United States. Although almost 20% of women one month postpartum have substance use and nearly 15% of women fall within the SUD category, ob-gyns receive little training on how to screen for and treat SUD in their patients.
Recurrence of Postpartum Hemorrhage in Relatives: A Population-based Cohort Study
Authors: Linde L.E. , Ebbing C. , Moster D. , Kessler J. , Baghestan E. , Gissler M. , Rasmussen S.
Published: November 2022

(Acta Obstet Gynecol Scand. 2021;100:2278–2284. doi: 10.1111/aogs.14262)

While postpartum hemorrhage (PPH) continues to be a serious cause of maternal mortality and morbidity worldwide, there are very few studies on the family aggregation of PPH, and existing studies give inconsistent results. Impact of current birthweight on PPH recurrence between relatives has also not been studied. The aim of this study was to determine PPH recurrence in relatives, the impact of birthweight on PPH recurrence, and the rate at which family history of high birthweight and PPH contributes to current PPH cases.
The Association Between Birth by Caesarean Section at Term and Offspring Cognitive and Academic Performance: A Birth Cohort Study
Authors: Blake J.A. , Pelecanos A. , Najman J.M. , Callaway L. , Scott J.G.
Published: November 2022

(Aust N Z J Obstet Gynaecol. 2022;62:226–233. doi: 10.1111/ajo.13403)

There is increased recent literature suggesting an association of birth by cesarean delivery (CD) with neurodevelopmental disorders in offspring. Considering the world-wide utilization of CD, it is critical to understand any long-term adverse outcomes. Previous findings related to cognitive and educational outcomes in CD-born individuals are limited and conflicting, necessitating further investigation. Long-term follow-up over 5, 14, and 21 years is presented to evaluate academic performance and other cognitive measures of those delivered by elective CD versus emergency CD versus vaginal birth.
Intramuscular Tranexamic Acid: A Real-world Application of Pharmacokinetics
Authors: Cortegiani A. , Absalom A.R. , Hunt B.J.
Published: November 2022

(Br J Anaesth. 2021;126:17–20. doi: 10.1016/j.bja.2020.10.003)

Pharmacokinetics, while perhaps seen as arcane and opaque to the clinical practice of anesthetists, is the research data on which the foundation of all drug dosing derives. Developing the clinical dosing of tranexamic acid (TXA) was based on its pharmacokinetic properties and calibrated for administration in various applications. As an antifibrinolytic, TXA is a competitive inhibitor of plasmin, binding to its lysyl groups to inhibit the plasmin-fibrin binding interaction. It has been administered orally and intravenously as an inexpensive intervention in the setting of blood loss due to trauma, hemorrhage, and other hemostatic emergencies.
Developing an Institutional Focused Cardiac Ultrasound Course for Obstetric Anesthesiologists
Authors: Brohan J. , Taylor J. , West A. , Albert A. , Chau A.
Published: November 2022

(Int J Obstet Anes. 2022;49:103233)

While focused cardiac ultrasound (FCU) is being used more widely in medicine, obstetric anesthesiologists in the authors’ department often lacked basic FCU knowledge. The department created an initiative (FCU-op) to train FCU novices in basic knowledge and skills and create interest in FCU. The free in-house course was led by a local expert and included reading materials, an in-person workshop, and a 20-question multiple-choice questionnaire (MCQ).
The Use of Transthoracic Echocardiography in Caesarean Section Surgical Patients in the Intensive Care Unit: A Retrospective Cohort Study
Authors: Smith B. , Dennis A. , Davies K. , Cramp P. , Gregory K. , Sturgess D.
Published: November 2022

(Aust N Z J Obstet Gynaecol. 2022;62:155–159)

During pregnancy, cardiovascular changes can cause previously unknown cardiac pathologies to become life-threatening. Transthoracic echocardiography (TTE) can be used for identifying cardiac lesions, though there is little data of its use in high-risk postcesarean patients. This retrospective study analyzed TTEs in postcesarean patients in the intensive care unit (ICU), aiming to identify indications for TTE referral, examining the findings from TTE, and assessing whether these findings would have impacted anesthetic decisions had they been known preoperatively.
Morphology of Antemortem Dural Puncture Healing: An Ex Vivo Sheep Study
Authors: García-Vitoria C. , García -Roselló M. , Redondo J.I. , Gutiérrez-Bautista A.J. , De Andres J. , Boezaart A. , Vicente-Montaña A. , Reina M.A.
Published: November 2022

(Reg Anesth Pain Med. 2022;47:131–133)

Postdural puncture headache is thought to be caused by the leaking of cerebrospinal fluid through puncture holes in the dural sac. This study used an ex vivo sheep model to examine the time and mode of closure of dural puncture holes after 1, 3, and 7 days following dural puncture.
Survival Outcomes and Resuscitation Process Measures in Maternal In-hospital Cardiac Arrest
Authors: Thomas M. , Hejjaji . , Tang Y. , Kennedy K. , Grodzinsky A. , Chan P.S. ,   American Heart Association’s Get With The Guidelines-Resuscitation Investigators
Published: November 2022

(Am J Obstet Gynecol. 2022;226:401.e1–401.e10. doi: 10.1016/j.ajog.2021.09.046)

Maternal in-hospital cardiac arrest (IHCA) is a serious concern. Hospital staff’s inability to address IHCA and perform resuscitation; obstetrical ward insufficient access to security protocols; and improper equipment may be delaying resuscitation treatment in emergent situations. This study aimed to analyze whether process measure delays were associated with survival outcome differences in pregnant and nonpregnant women with IHCA.
The Effects of Obstetric Emergency Team Training on Patient Outcome: A Systematic Review and Meta-Analysis
Authors: Brogaard L. , Glerup Lauridsen K. , Løfgren B. , Krogh K. , Paltved C. , Boie S. , Hvidman L.
Published: November 2022

(Acta Obstet Gynecol Scand. 2022;101:25–36. doi: 10.1111/aogs.14263)

Participants in simulation-based team training in obstetric emergencies often report increased confidence in their ability to manage unfolding emergencies that may present in actual practice. However, empirical data that examines the efficacy of such training on impacting clinical outcomes is incomplete. This review assesses the contribution of simulation-based training for health care providers to the outcomes of obstetric emergencies.
Mortality, In-Hospital Morbidity, Care Practices, and 2-Year Outcomes for Extremely Preterm Infants in the United States, 2013-2018
Authors: Bell E. , Hintz S. , Hansen N. , Bann C. , Wyckoff M. , DeMaruo S. , Walsh M. , Vohr B. , Stoll B. , Carlo W. , Van Meurs K. , Rysavy M. , Patel R. , Merhar S. , Sanchez P. , Laptook A. , Hibbs A. , Cotten C.M. , D’Angio C. , Winter S. , Fuller J. , Das A.
Published: November 2022

(JAMA. 2022;327:248–263. doi: 10.1001/jama.2021.2358)

While mortality rates of preterm infants have decreased over time, differences in age assessment, assessment instruments, and other factors have made determining neurodevelopmental outcomes difficult. This study used data collected from preterm infants born before the gestational age of 29 weeks between January 1, 2013 and December 31, 2018 from 19 network centers in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.
Treating Hypertension in Pregnancy
Authors: Greene M. , Williams W.
Published: November 2022

(N Engl J Med. 2022;386:1846–1847. doi: 10.1056/NEJMe2203388)

Chronic hypertension impacts 2.2% of 3.7 million births in 2019 in the United States, and this number continues to grow, likely due to the increasing rate (55.9% of all pregnancies in 2019) of obesity in pregnancy and the number of pregnancies occurring after the maternal age of 35. Impacts of maternal hypertension include preeclampsia, eclampsia, stroke, heart failure, pulmonary edema, acute kidney injury, placental abruption, increased risk of preterm birth, failed fetal growth, perinatal death, and maternal death. Unfortunately, Black women are specifically affected. In an effort to combat this, medication and other medical treatment are given to those women suffering from severe chronic hypertension. However, small original studies examining the impact of hypertension treatment on those with less severe or mild chronic hypertension did not demonstrate improvement. In fact, the fetus was possibly negatively impacted.
Extracellular Vesicles in Preeclampsia: Can Small Packages Carry a Big Punch?
Authors: Hess P. , Winn V.
Published: November 2022

(Anesth Analg. 2022;134:710–712)

Globally, 9%, 5%, and 1.2% of pregnancies are complicated by preeclampsia, developing preeclampsia, and eclampsia, respectively. These complicated pregnancies represent 8% to 16% of maternal pregnancy deaths in high-income countries. In addition, these medical conditions often result in persistent vascular dysfunction after delivery, increased risk of lifelong hypertension and cardiovascular disease, diabetes, stroke, renal failure, and a 40% increase in premature mortality for the mother. In the child, hypertensive disorders often result in preterm delivery and subsequent severe complications of prematurity. This article analyzes two primary possible causes for preeclampsia and their corresponding studies.
Outcomes Associated With Antibiotic Administration for Isolated Maternal Fever in Labor
Authors: Bank T.C. , Nuss E. , Subedi K. , Hoffman M.K. , Sciscione A.
Published: November 2022

(Am J Obstet Gynecol. 2022;226:255.e1–7)

Maternal fever may be a sign of intraamniotic infection and inflammation, which are associated with maternal and neonatal morbidity. Antibiotic administration is recommended by the American College of Obstetricians and Gynecologists in the presence of isolated maternal fever—with no additional signs of intraamniotic infection. This retrospective cohort study aimed to evaluate the impact of antibiotic treatment in patients with isolated maternal fever.
Association of SARS-CoV-2 Infection With Serious Maternal Morbidity and Mortality From Obstetric Complications
Authors: Metz T.D. , Clifton R.G. , Hughes B.L. , Sandoval G.J. , Grobman W.A. , Saade G.R. , Manuck T.A. , Longo M. , Sowles A. , Clark K. , Simhan H.N. , Rouse D.J. , Mendez-Figueroa H. , Gyamfi-Bannerman C. , Bailit J.L. , Costantine M.M. , Sehdev H.M. , Tita A.T.N. , Macones G.A. ,   for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units (MFMU) Network
Published: November 2022

(JAMA. 2022;327:748–759)

While pregnant patients with COVID-19 are at an increased risk of severe maternal morbidity related to the virus, it is not clear whether SARS-CoV-2 also increases the risk of maternal morbidity related to obstetric complications. The most common causes of obstetric morbidity in the United States are hypertensive disorders of pregnancy, postpartum hemorrhage (PPH), and other infections. Patients with COVID-19 may receive fewer visits or be isolated, possibly delaying evaluation and treatment. COVID-19 can cause irregularities in coagulation and hypertension, which may also play a role in obstetric morbidity. This study investigated the effects of SARS-CoV-2 infection on the risk of maternal morbidity or mortality from obstetric complications including PPH, hypertensive disorders of pregnancy, or infections.
Interventions to Prevent Spontaneous Preterm Birth in Women With Singleton Pregnancy Who Are at High Risk: Systematic Review and Network Meta-Analysis
Authors: Care A. , Nevitt S.J. , Medley N. , Donegan S. , Goodfellow L. , Hampson L. , Tudur Smith C. , Alfirevic Z.
Published: November 2022

(BMJ. 2022;376:e064547. doi: https://doi.org/10.1136/bmj-2021-064547)

Two-thirds of preterm births (<37 wk gestation) occur spontaneously, while one-third are intentionally induced. Patients at risk of spontaneous preterm birth may or may not exhibit symptoms. Among high-risk patients without symptoms, cervical length <25 mm and history of spontaneous preterm birth are the 2 strongest predictors of a subsequent spontaneous preterm birth. In the United Kingdom, vaginal progesterone or cervical cerclage are the recommended interventions for preventing spontaneous preterm birth in patients with those 2 predictors, though only 16% of preterm birth clinics in the UK routinely administer vaginal progesterone in this setting. This study used network meta-analysis estimates and compares the effectiveness of vaginal progesterone and cervical cerclage in preventing spontaneous preterm birth in at-risk patients.
Letter to the Editor: Management of Placental Transfusion to Neonates After Delivery
Authors: Lerner H.M.
Published: November 2022

(Obstet Gynecol. 2022;139:693. doi: 10.1097/AOG.0000000000004740)

This article comments on “Management of Placental Transfusion to Neonates After Delivery” by McAdams and Lakshminrusimha. While the article was interesting, it does not sufficiently support the conclusions made. The authors concluded that the practice of delayed umbilical cord clamping is beneficial for preterm and term neonates, yet the article only supports preterm delayed cord clamping. Statements regarding delayed umbilical cord clamping for late preterm and term neonates requires further support and evidence-based research.
Implications of Nocebo in Anaesthesia Care
Authors: Arrow K. , Burgoyne L.L. , Cyna A.M.
Published: November 2022

(Anaesthesia. 2022;77(suppl 1):11–20. doi: 10.1111/anae.15601)

Nocebo, sometimes recognized as the adverse counterpart to placebo, refers to an increased pain sensitivity related to a previous experience or communication that confers a negative expectation for the course of an intervention. These unfavorable responses potentially can be mitigated by certain presentation tactics by providers. Conversely, the lack of awareness of the nocebo effect in provider interactions and other situational circumstances may, intentionally or unintentionally, induce or exacerbate “real” side-effects that are unpleasant for the patient. The literature attributes many factors to the patient’s experience of nocebo and brings the potential for this consideration to enter into every physician-patient anesthesia encounter.
Neonatal Outcomes Following Phenylephrine or Norepinephrine for Treatment of Spinal Anesthesia-induced Hypotension at Emergency Cesarean Section in Women With Fetal Compromise: A Randomized Controlled Study
Authors: Mohta M. , Bambode N. , Chilkoti G.T. , Agarwal R. , Malhotra R.K. , Batra P.
Published: November 2022

(Int J Obstet Anes. 2022;49:103247)

While phenylephrine is the current preferred treatment for spinal anesthesia-induced hypotension in patients undergoing cesarean delivery (CD), norepinephrine may be equally effective while reducing the incidence of maternal bradycardia. Norepinephrine may also be associated with adverse neonatal outcomes, such as lower umbilical artery pH. Studies comparing the 2 have so far been conducted using healthy patients. This study aimed to compare phenylephrine and norepinephrine in terms of neonatal outcomes, specifically umbilical artery pH, in patients with fetal compromise.
Infrared Thermographic Assessment of Spinal Anesthesia-related Temperature Changes During Cesarean Section
Authors: Murphy B. , McCaul C.C.L. , O’Flaherty D.
Published: November 2022

(Int J Obstet Anes. 2022;49:103245)

Spinal anesthesia is often assessed by the subjective method of cold and light touch perception. Inadequate anesthesia can cause pain during surgery and negligence claims. Infrared thermography (ITH) objectively measures skin surface temperature, which increases during spinal anesthesia due to blood vessel dilatation and increased blood flow. There have been conflicting results in studies investigating skin temperature changes during neuraxial anesthesia in nonpregnant patients. This study aimed to determine whether ITH measured consistent and significant skin temperature changes during spinal anesthesia for cesarean delivery (CD).
Regional Analgesia Following Caesarean Section: New Kid and a Block?
Authors: Kearsley R. , Campbell J.P.
Published: November 2022

(Anaesthesia. 2022;77:376–379. doi: 10.1111/anae.15646)

It is anticipated by the World Health Organization (WHO) that the rapidly rising global trend for cesarean delivery (CD) will increase from 21.1% in 2022 to 28.5% in 2030, accounting for 38 million CD per year. Mitigating pain after CD is an important focus, as high pain scores can develop into chronic pain for the mother, prevent bonding with and caring for the infant, and may exacerbate postpartum depression risk.
Surgical management of aphakia
Authors: Cheng Kelvin K.W. , Tint Naing L. , Sharp John , Alexander Philip
Published: November 2022

Despite the safety and efficacy of cataract surgery, intraoperative complications can hamper the ability to place an intraocular lens in the capsular bag. With vast numbers of cataract surgeries performed daily, complications occur often enough that every ophthalmologist should be equipped with techniques to manage aphakia. Medical management of aphakia used to be commonplace but these techniques have their disadvantages including thick bulky lenses, poor cosmesis, and aniseikonia. Surgical management of aphakia overcomes these disadvantages and offers patients the possibility of a spectacle and contact lens-free lifestyle. This article reviews the various options of surgical management of aphakia and their advantages and disadvantages. Comparison of outcomes between techniques and a protocol for deciding between techniques is presented.
Effect of anatomical differences and intraocular lens design on negative dysphotopsia
Authors: van Vught Luc , Que Ivo , Luyten Gregorius P.M. , Beenakker Jan-Willem M.
Published: November 2022

Purpose:

To assess the effect of ocular anatomy and intraocular lens (IOL) design on negative dysphotopsia (ND).

Setting:

Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands.

Design:

Ray-tracing study based on clinical data.

Methods:

Ray-tracing simulations were performed to assess the effect of anatomical differences and differences in IOL design on the peripheral retinal illumination. To that end, eye models that incorporate clinically measured anatomical differences between eyes of patients with ND and eyes of pseudophakic controls were created. The anatomical differences included pupil size, pupil centration, and iris tilt. The simulations were performed with different IOL designs, including a simple biconvex IOL design and a more complex clinical IOL design with a convex–concave anterior surface. Both IOL designs were analyzed using a clear edge and a frosted edge. As ND is generally considered to be caused by a discontinuity in peripheral retinal illumination, this illumination profile was determined for each eye model and the severity of the discontinuity was compared between eye models.

Results:

The peripheral retinal illumination consistently showed a more severe discontinuity in illumination with ND-specific anatomy. This difference was the least pronounced, 8%, with the frosted edge clinical IOL and the most pronounced, 18%, with the clear edge biconvex IOL.

Conclusions:

These results show that small differences in the ocular anatomy or IOL design affect the peripheral retinal illumination. Therewith, they can increase the severity of ND by up to 18%.
Noncoding rare variants in PANX3 are associated with chronic back pain
Authors: Belonogova Nadezhda M. , Kirichenko Anatoly V. , Freidin Maxim B. , Williams Frances M. K. , Suri Pradeep , Aulchenko Yurii S. , Axenovich Tatiana I. , Tsepilov Yakov A.
Published: November 2022

Back pain is the leading cause of years lived with disability worldwide, yet surprisingly, little is known regarding the biology underlying this condition. The impact of genetics is known for chronic back pain: its heritability is estimated to be at least 40%. Large genome-wide association studies have shown that common variation may account for up to 35% of chronic back pain heritability; rare variants may explain a portion of the heritability not explained by common variants. In this study, we performed the first gene-based association analysis of chronic back pain using UK Biobank imputed data including rare variants with moderate imputation quality. We discovered 2 genes, SOX5 and PANX3, influencing chronic back pain. The SOX5 gene is a well-known back pain gene. The PANX3 gene has not previously been described as having a role in chronic back pain. We showed that the association of PANX3 with chronic back pain is driven by rare noncoding intronic polymorphisms. This result was replicated in an independent sample from UK Biobank and validated using a similar phenotype, dorsalgia, from FinnGen Biobank. We also found that the PANX3 gene is associated with intervertebral disk disorders. We can speculate that a possible mechanism of action of PANX3 on back pain is due to its effect on the intervertebral disks.
Delphi study to explore a new diagnosis for “ineffective” long-term opioid therapy for chronic pain
Authors: Edmond Sara N. , Snow Jennifer L. , Pomeranz Jamie , Van Cleve Raymond , Black Anne C. , Compton Peggy , Becker William C.
Published: November 2022

A challenge in clinical, research, and policy spheres is determining whether and how to apply the Diagnostic and Statistical Manual-5 Opioid Use Disorder criteria to patients receiving long-term opioid therapy (LTOT) for the management of chronic pain. This study explored perspectives on the merits of creating a new diagnostic entity to characterize the problems that arise for certain patients prescribed LTOT and develop consensus on its definition and diagnostic criteria. We conducted 3 rounds of online surveys and held one discussion-based workshop to explore a new diagnostic entity and generate consensus with subject matter experts (n = 51) in pain and opioid use disorder, including a wide range of professional disciplines. The first survey included open-ended questions and rapid qualitative analysis to identify potential diagnostic criteria. Rounds 2 and 3 involved rating potential diagnostic criteria on a Likert-type scale to achieve consensus. The workshop was a facilitated conversation aimed at further refining criteria. Three-quarters of Delphi panelists were in favor of a new diagnostic entity; consensus was reached for 19 potential diagnostic criteria including benefits of LTOT no longer outweighing harms and a criterion related to difficulty tapering. A subgroup of expert panelists further refined the new diagnostic entity definition and criteria. Consensus on potential criteria for the new diagnostic entity was reached and further refined by a subgroup of experts. This Delphi study represents the opinions of a small group of subject matter experts; perspectives from other experts and additional stakeholder groups (including patients) are warranted.
Pro-opiomelanocortin neurons in the nucleus of the solitary tract mediate endorphinergic endogenous analgesia in mice
Authors: Patra Pabitra Hriday , Tench Becks , Hitrec Timna , Holmes Fiona , Drake Robert , Cerritelli Serena , Spanswick David , Pickering Anthony Edward
Published: November 2022

The nucleus of the solitary tract (NTS) contains pro-opiomelanocortin (POMC) neurons that are 1 of the 2 major sources of β-endorphin in the brain. The functional role of these NTSPOMC neurons in nociceptive and cardiorespiratory function is debated. We have shown that NTSPOMC optogenetic activation produces bradycardia and transient apnoea in a working heart–brainstem preparation and chemogenetic activation with an engineered ion channel (PSAM) produced opioidergic analgesia in vivo. To better define the role of the NTSPOMC neurons in behaving animals, we adopted in vivo optogenetics (ChrimsonR) and excitatory/inhibitory chemogenetic DREADD (hM3Dq/hM4Di) strategies in POMC-Cre mice. We show that optogenetic activation of NTSPOMC neurons produces time-locked, graded, transient bradycardia and bradypnoea in anaesthetised mice that is naloxone sensitive (1 mg/kg, i.p.), suggesting a role of β-endorphin. Both optogenetic and chemogenetic activation of NTSPOMC neurons produces sustained thermal analgesia in behaving mice that can be blocked by naloxone. It also produced analgesia in an inflammatory pain model (carrageenan) but not in a neuropathic pain model (tibial nerve transection). Inhibiting NTSPOMC neurons does not produce any effect on basal nociception but inhibits stress-induced analgesia (unlike inhibition of arcuate POMC neurons). Activation of NTSPOMC neuronal populations in conscious mice did not cause respiratory depression, anxiety, or locomotor deficit (in open field) or affective preference. These findings indicate that NTSPOMC neurons play a key role in the generation of endorphinergic endogenous analgesia and can also regulate cardiorespiratory function.
Comparison between cutting versus retraction of anterior cervical musculature during endoscopic thyroidectomy
Authors: Lian Dongbo , Chen Weijian , Chen Guanyang , Liu Chen , Du Dexiao , Zhang Nengwei
Published: November 2022

To compare the different techniques of managing the anterior cervical muscle group during endoscopic thyroidectomy via the trans-thoraco-areolar approach. A total of 90 patients with thyroid tumors less than 3 cm were evaluated. The time for each intraoperative step, total surgery duration, intraoperative blood loss volume, pathology results, number of lymph nodes dissected and patient satisfaction with esthetics were assessed. Intraoperative blood loss volume, drainage volume on the first postoperative day, number of lymph nodes dissected in the central region, postoperative hospitalization duration, number of transient laryngeal nerve palsy cases, and number of transient hypocalcemia cases were similar between the muscle transection (MT) and muscle retraction (MR) groups. The MT group had significantly higher postoperative pain scores after 12 hours, but pain scores at 48 hours postoperatively were not significantly different between the 2 groups. In the unilateral thyroidectomy subgroup, the durations of isthmus resection, freeing the lateral thyroid, exposing the laryngeal recurrent nerve, and management of the inferior pole were similar for both muscle management methods. The muscle dissection and suture time was significantly longer for the MT group than that for the MR group; in contrast, the upper pole management time of the muscle resection group was significantly shorter. In the bilateral resection subgroup, both muscle management methods required similar durations for managing the contralateral upper pole after ipsilateral thyroidectomy. However, intraoperative blood loss was significantly higher for MR than for MT, while postoperative pain was relatively mild. In the malignant tumor subgroup, duration of inferior thyroid pole management was significantly less for MT than for MR. There are significant differences between the 2 muscle management methods in handling and suturing muscles. Both methods have satisfactory postoperative outcomes for resection of thyroid nodules with diameters ≤3 cm. For tumors located in the upper pole, transection of the anterior cervical muscles confers higher feasibility of the thyroidectomy technique; however, suturing becomes difficult in such scenarios.
Identification of a novel cell cycle-related risk signature predicting prognosis in patients with pancreatic adenocarcinoma
Authors: Xu Dapeng , Qin Rong , Li Ming , Shen Jun , Mao Yongmin , Tang Kai , Zhang Aiguo , Wang Dafeng , Shi Yingzuo
Published: November 2022

Background:

Growing evidence have indicated that cell cycle-related genes (CRGs) play an essential role in the progression of pancreatic adenocarcinoma (PAAD). Nevertheless, the application of CRGs in estimating the prognosis of PAAD patients is still lacking. This study aimed to establish a risk signature based on CRGs that can predict patients’ overall survival for PAAD.

Methods:

The expression and corresponding clinical data of PAAD patients from The Cancer Genome Atlas database and 200 cell cycle-related genes from the MSigDB were used for the generation and validation of the signature. LASSO Cox regression was applied to build the prediction model. The diagnostic value of signature was evaluated by receiver operating characteristic curves. Univariate and multivariate regression was used to construct the nomogram providing the clinicians a useful tool.

Results:

A total of 103 CRGs were identified. Seven genes (RBM14, SMAD3, CENPA, KIF23, NUSAP1, INCENP, SMC4) with non-zero coefficients in LASSO analysis were used to construct the prognostic signature. The 7-gene signature significantly stratified patients into high- and low-risk groups in terms of overall survival, and the area under the receiver operating characteristic curve of 5-year survival reached 0.749. Multivariate analysis showed that the signature is an independent prognostic factor. We then mapped a nomogram to predict 1-, 3-, and 5-year survival for PAAD patients. The calibration curves indicated that the model was reliable. Finally, we discovered that TP53 and KRAS mutated most frequently in low and high-risk groups, respectively.

Conclusion:

Our findings suggested that the seven genes identified in this study are valuable prognostic predictors for patients with PAAD. These findings provided us with a novel insight that it is useful for understanding cell cycle mechanisms and for identifying patients with PAAD with poor prognosis.
Plasma proteins from several components of the immune system differentiate chronic widespread pain patients from healthy controls – an exploratory case-control study combining targeted and non-targeted protein identification
Authors: Gerdle Björn , Wåhlén Karin , Gordh Torsten , Bäckryd Emmanuel , Carlsson Anders , Ghafouri Bijar
Published: November 2022

Chronic widespread pain (CWP), including fibromyalgia (FM), is characterized by generalized musculoskeletal pain and hyperalgesia. Plasma proteins from proteomics (non-targeted) and from targeted inflammatory panels (cytokines/chemokines) differentiate CWP/FM from controls. The importance of proteins obtained from these two sources, the protein-protein association network, and the biological processes involved were investigated. Plasma proteins from women with CWP (n = 15) and CON (n = 23) were analyzed using two-dimensional gel electrophoresis analysis and a multiplex proximity extension assay for analysis of cytokines/chemokines. Associations between the proteins and group were multivarietly analyzed. The protein-protein association network and the biological processes according to the Gene Ontology were investigated. Proteins from both sources were important for group differentiation; the majority from the two-dimensional gel electrophoresis analysis. 58 proteins significantly differentiated the two groups (R
2 = 0.83). A significantly enriched network was found; biological processes were acute phase response, complement activation, and innate immune response. As with other studies, this study shows that plasma proteins can differentiate CWP from healthy subjects. Focusing on cytokines/chemokines is not sufficient to grasp the peripheral biological processes that maintain CWP/FM since our results show that other components of the immune and inflammation systems are also highly significant.
Is lumbopelvic motor control associated with dynamic stability during gait, strength, and endurance of core musculatures?: The STROBE study
Authors: Jeong Siwoo , Kim Si-Hyun , Park Kyue-Nam
Published: November 2022

Core stability has been described as the product of motor control and muscular capacity of the lumbopelvic-hip complex. Because of the wide range of functions of the lumbopelvic-hip complex, the gold standard for evaluating core stability remains controversial. The Sahrmann core stability test (SCST), used in conjunction with the stabilizer pressure biofeedback unit (PBU), is widely applied to objectively evaluate core stability as this pertains lumbopelvic motor control. However, the association between such control and other elements of core stability including core strength, endurance, and dynamic stability during gait has not been well-studied. We investigated the relationships among the ability to control the lumbopelvic complex, core strength and endurance, and gait parameters. We compared lateral core endurance, hip strengths, and gait parameters (lateral oscillation of the center of mass (COM), the single support time, and the peak ground reaction force) between good and poor core stability groups, as determined by the SCST. In addition, logistic regression analysis was used to determine whether other core stability measures correlated with the core stability status defined by the SCST. Only lateral oscillation of the COM during walking differed significantly between the good and poor core stability groups and was a significant predictor of SCST core stability status. Lumbopelvic motor control, (as defined by the SCST), affects dynamic stability during gait, but not to the strength or endurance of the core musculatures.
The effect of systemic versus local transcutaneous laser therapy on tension-type cephalea and orofacial pain in post-COVID-19 patients: A pragmatic randomized clinical trial
Authors: Costanti Vilela Campos Mayra , Simoes Velloso Schuler Silvana , de Barros Motta Pamella , Cátia Mazzoni Adriana , Cristina da Silva Francine , Domingues Martins Manoela , Porta Santos Fernandes Kristianne , Agnelli Mesquita-Ferrari Raquel , Ratto Tempestini Horliana Anna Carolina , Kalil Bussadori Sandra , Jansiski Motta Lara
Published: November 2022

Introduction:

Orofacial pain and tensional cephalea were symptoms commonly reported in COVID-19 patients, even after recovery, and were considered chronic pain in these cases. The aim of this research is to evaluate the effect of the application of photobiomodulation with red and infrared lasers applied locally and systemically.

Methods and analysis:

For this purpose, individuals who have been diagnosed with COVID-19 and have had a tension headache and/or orofacial pain for more than 3 months will be selected by convenience. The participants will be divided into two different groups: G1-photobiomodulation with red and infrared laser with local application on the pain points (808 nm and 660 nm, 100 mW, 6 J per point) and G2-photobiomodulation with red laser with transcutaneous application on the radial artery (660 nm, 100 mW, 30 minutes). All participants will be treated for a period of 4 weeks, with 8 application sessions. The effects will be measured by means of blood lactate level, Brief Pain Inventory, Visual Analog Scale (VAS), and Cephalea Impact Test. The data will be collected weekly before and after the treatment, and the following tests will be applied: Analysis of variance (ANOVA), Tukey paired t test, Kruskal–Wallis, or Wilcoxon, according to data distribution. α = 0.05 will be considered as the level of statistical significance.

Ethics and dissemination:

This study was approved by the Research Projects Committee of the Nove de Julho University (approval number 4.673.963). Results will be disseminated through peer-reviewed journals and events for the scientific and clinical community, and the general public. It is registered in the ClinicalTrials.gov database with the number NCT05430776.