bluuebunny/crossref_metadata_2025 huggingface dataset:
An altered extracellular matrix–integrin interface contributes to Huntington’s disease-associated CNS dysfunction in glial and vascular cells
Authors: Hernandez Sarah J , Lim Ryan G , Onur Tarik , Dane Mark A , Smith Rebecca , Wang Keona , Jean Grace En-Hway , Reyes-Ortiz Andrea , Devlin Kaylyn , Miramontes Ricardo , Wu Jie , Casale Malcolm , Kilburn David , Heiser Laura M , Korkola James E , Van Vactor David , Botas Juan , Thompson-Peer Katherine L , Thompson Leslie M
Published: December 2022

Astrocytes and brain endothelial cells are components of the neurovascular unit that comprises the blood–brain barrier (BBB) and their dysfunction contributes to pathogenesis in Huntington’s disease (HD). Defining the contribution of these cells to disease can inform cell-type-specific effects and uncover new disease-modifying therapeutic targets. These cells express integrin (ITG) adhesion receptors that anchor the cells to the extracellular matrix (ECM) to maintain the integrity of the BBB. We used HD patient-derived induced pluripotent stem cell (iPSC) modeling to study the ECM–ITG interface in astrocytes and brain microvascular endothelial cells and found ECM–ITG dysregulation in human iPSC-derived cells that may contribute to the dysfunction of the BBB in HD. This disruption has functional consequences since reducing ITG expression in glia in an HD Drosophila model suppressed disease-associated CNS dysfunction. Since ITGs can be targeted therapeutically and manipulating ITG signaling prevents neurodegeneration in other diseases, defining the role of ITGs in HD may provide a novel strategy of intervention to slow CNS pathophysiology to treat HD.
Augmented Placemaking: Urban Technologies, Interaction Design and Public Spaces in a Post-Pandemic World
Authors: Hespanhol Luke
Published: December 2022

The COVID-19 pandemic has brought a sudden and widespread reorganization of public spaces, underpinned by digital technologies. The impromptu, ad hoc and collective character of this reorganization of shared places for social interactions echoes traditional practices of placemaking otherwise advocated for liveable cities, now applied to the new—physical, virtual and, increasingly, hybrid—public spaces people started to inhabit. In this article, I define the notion of ‘augmented placemaking’, referring to a particularly new form of digital placemaking, unleashed by the pandemic. First, I identify key new scenarios for the design of urban interfaces that emerged or gained impetus in response to COVID-19. Following that, I synthesize a model for augmented placemaking based on emerging topologies, discussing the opportunities and challenges they posed, and their potential to inform future HCI. I then conclude by proposing guidelines to inform the design process of augmented placemaking initiatives going forward.

Categories and subject descriptors: cities; pervasive computing; smart cities
Gradient boosting decision trees classification of blazars of uncertain type in the fourth Fermi-LAT catalogue
Authors: Sahakyan N , Vardanyan V , Khachatryan M
Published: December 2022

The deepest all-sky survey available in the γ-ray band – the last release of the Fermi-LAT catalogue (4FGL-DR3) based on the data accumulated in 12 years contains more than 6600 sources. The largest population among the sources is blazar subclass – 3743, 60.1 per cent of which are classified as BL Lacertae objects (BL Lacs) or Flat Spectrum Radio Quasars (FSRQs), while the rest are listed as blazar candidates of uncertain type (BCU) as their firm optical classification is lacking. The goal of this study is to classify BCUs using different machine learning algorithms, which are trained on the spectral and temporal properties of already classified BL Lacs and FSRQs. Artificial Neural Networks, XGBoost, and LightGBM algorithms are employed to construct predictive models for BCU classification. Using 18 input parameters of 2219 BL Lacs and FSRQs, we train (80 per cent of the sample) and test (20 per cent) these algorithms and find that LightGBM model, state-of-the-art classification algorithm based on gradient boosting decision trees, provides the highest performance. Based on our best model, we classify 825 BCUs as BL Lac candidates and 405 as FSRQ candidates, however, 190 remain without a clear prediction, but the percentage of BCUs in 4FGL is reduced to 5.1 per cent. The γ-ray photon index, synchrotron peak frequency, and high-energy peak frequency of a large sample are used to investigate the relationship between FSRQs and BL Lacs (LBLs, IBLs, and HBLs).
Non-ideal magnetohydrodynamic simulations of the first star formation: the effect of ambipolar diffusion
Authors: Sadanari Kenji Eric , Omukai Kazuyuki , Sugimura Kazuyuki , Matsumoto Tomoaki , Tomida Kengo
Published: December 2022

In the present-day universe, magnetic fields play such essential roles in star formation as angular momentum transport and outflow driving, which control circumstellar disc formation/fragmentation and also the star formation efficiency. While only a much weaker field has been believed to exist in the early universe, recent theoretical studies find that strong fields can be generated by turbulent dynamo during the gravitational collapse. Here, we investigate the gravitational collapse of a cloud core ($\sim 10^{3}\ \rm cm^{-3}$) up to protostar formation ($\sim 10^{20}\ \rm cm^{-3}$) by non-ideal magnetohydrodynamic simulations considering ambipolar diffusion (AD), the dominant non-ideal effects in the primordial-gas. We systematically study rotating cloud cores either with or without turbulence and permeated with uniform fields of different strengths. We find that AD can slightly suppress the field growth by dynamo especially on scales smaller than the Jeans-scale at the density range $10^{10}\!-\!10^{14}\ \rm cm^{-3}$, while we could not see the AD effect on the temperature evolution, since the AD heating rate is always smaller than compression heating. The inefficiency of AD makes the field as strong as $10^{3}\!-\!10^{5} \rm \ G$ near the formed protostar, much stronger than in the present-day cases, even in cases with initially weak fields. The magnetic field affects the inflow motion when amplified to the equipartition level with turbulence on the Jeans-scale, although disturbed fields do not launch winds. This might suggest that dynamo amplified fields have smaller impact on the dynamics in the later accretion phase than other processes such as ionization feedback.
The hot gas distribution, X-ray luminosity, and baryon budget in the L-Galaxies semi-analytic model of galaxy formation
Authors: Zhong Wenxin , Fu Jian , Sharma Prateek , Shen Shiyin , Yates Robert M
Published: December 2022

Hot ionized gas is important in the baryon cycle of galaxies and contributes the majority of their ‘missing baryons’. Until now, most semi-analytic models of galaxy formation have paid little attention to hot gaseous haloes and their X-ray emission. In this paper, we adopt the one-dimensional model from Sharma et al. instead of the isothermal sphere to describe the radial distribution of hot gas in the L-Galaxies semi-analytic model. The hot gas halo can be divided into two parts according to the ratio of the local thermal instability time-scale and the free-fall time-scale: a cool core with tTI/tff = 10 and a stable outer halo with tTI/tff > 10. We update the prescriptions of cooling, feedback, and stripping based on the new hot gas profiles, and then reproduce several X-ray observational results like the radial profiles of hot gas density, and the scaling relations of X-ray luminosity and temperature. We find: (1) Consistent with observations, flatter density profiles in halo centers produce lower X-ray emission than an isothermal sphere; (2) Cool core regions prone to precipitation have higher gas temperature than the virial temperature, and a larger TX/T200 ratio in smaller haloes leads to a steeper slope in the LX–TX relation; (3) The ionized gas in the unbounded reservoir and low-temperature intergalactic gas in low-mass haloes could be the main components of the halo ‘missing baryons’. Our model outputs can predict the observations of hot gas in the nearby universe and produce mock surveys of baryons probed by future X-ray telescopes.
Apsidal motion and absolute parameters of GV Nor and V881 Sco based on mid-resolution spectroscopy and TESS photometry
Authors: Sürgit Derya , Zasche Petr , Hadrava Petr , Erdem Ahmet , Engelbrecht Chris A , Marang Fred , Mašek Martin , Stevens Daniel J
Published: December 2022

The veracity of stellar evolution models and theoretical internal structure constants may be subjected to stringent tests by using physical parameters obtained from spectroscopic and photometric observations of eclipsing binary systems that exhibit apsidal motion. Two eclipsing binary stars from the southern hemisphere with no prior published spectroscopic analyses were selected for this study: GV Nor and V881 Sco. Spectroscopic observations of these two eccentric binary systems were made at the South African Astronomical Observatory (SAAO) in 2018 and 2019, and their mid-resolution spectra were obtained. The radial velocities were measured using the cross-correlation method as well as by disentangling the spectra. The rotational broadening of the disentangled spectra of the components was also determined. The absolute parameters of these two systems were obtained by analyzing the SAAO-based spectroscopic data in conjunction with photometric data from Transiting Exoplanet Survey Satellite. Apsidal motion parameters for these two eccentric binary systems were calculated by analysing eclipse timing variations. Granada and Padova evolution models indicated ages of 340 ± 35 Myr for GV Nor and 760 ± 15 Myr for V881 Sco, in agreement with the observational results. The theoretical internal structure constants estimated from the Granada models were compatible with the observational values within the error limits. However, for both systems, it was found that their circularization and synchronization timescales were shorter than their respective evolutionary ages. Therefore, the fact that the components rotate faster than their synchronized values and still have rather large eccentric orbits (e ∼ 0.11) challenges present theories of circularization and spin–orbit synchronization.
New Ritz wavelengths and transition probabilities for parity-forbidden, singly ionized nickel [Ni ii] lines of astrophysical interest
Authors: Clear Christian P , Uylings Peter , Raassen Ton , Nave Gillian , Pickering Juliet C
Published: December 2022

We report accurate Ritz wavelengths for parity-forbidden [Ni ii] transitions, derived from energy levels determined using high-resolution Fourier transform spectroscopy. Transitions between the 18 lowest Ni ii energy levels of even-parity produced Ritz wavelengths for 126 parity-forbidden lines. Uncertainties for the Ritz wavelengths derived in this work are up to two orders of magnitude lower than previously published values. Transition probabilities were calculated using the semi-empirical orthogonal operator method, with uncertainties ranging from approximately 1 per cent for strong M1 lines and up to 10 per cent for weak E2 lines. Accurate forbidden line wavelengths and transition probabilities, particularly for lines in the infrared, are important in the analyses of low-density astrophysical plasmas, such as supernova remnants, planetary nebulae, and active galactic nuclei.
Redshift–luminosity characterization of active galactic nucleus galaxies having obscuring dusty material using the spectral energy distribution from the X-ray to far-infrared
Authors: Gadallah Kamel A K
Published: December 2022

The spectral energy distribution (SED) from the X-ray to far-IR is used to characterize active galactic nuclei (AGNs) having obscuring dusty material. A sample of 73 AGNs, with redshifts of z < 2.5, is subdivided based on the optical spectra into subgroups of type 1 and 2 AGNs and no-AGN. The x-cigale code is used to produce the SEDs of these galaxies, fitting them with their observed flux densities. Accordingly, this code provides estimates of the physical properties, including the stellar mass, dust-to-gas mass ratio, far-UV attenuation, star-formation rate, and luminosity. All these properties and luminosity components, namely stellar, AGN, X-ray, and dust luminosities, are characterized versus the redshift. With the caveat that the sample is flux-limited and thus is affected by Malmquist bias, the results show that these properties increase as a function of redshift with various variation rates for each galaxy group, except for the far-UV attenuation of type 1 AGNs, which shows a slight reduction with redshift. The stellar, AGN, and X-ray luminosities show tight correlations with the intrinsic AGN luminosity, which is, in principle, attributed to the intrinsic AGN accretion power acting as a fuelling source. This power has an impact on most other correlations versus the redshift when the intrinsic AGN luminosity increases with redshift. Owing to their different emission sources, these luminosities make different fractional contributions to the total luminosity. The stellar luminosity, where the dust luminosity is the most effective, has the highest contribution of all galaxy groups, while the AGN luminosity has the lowest.
Dynamic phase separation of the androgen receptor and its coactivators key to regulate gene expression
Authors: Zhang Fan , Biswas Maitree , Massah Shabnam , Lee Joseph , Lingadahalli Shreyas , Wong Samantha , Wells Christopher , Foo Jane , Khan Nabeel , Morin Helene , Saxena Neetu , Kung Sonia H Y , Sun Bei , Parra Nuñez Ana Karla , Sanchez Christophe , Chan Novia , Ung Lauren , Altıntaş Umut Berkay , Bui Jennifer M , Wang Yuzhuo , Fazli Ladan , Oo Htoo Zarni , Rennie Paul S , Lack Nathan A , Cherkasov Artem , Gleave Martin E , Gsponer Jörg , Lallous Nada
Published: December 2022

Numerous cancers, including prostate cancer (PCa), are addicted to transcription programs driven by specific genomic regions known as super-enhancers (SEs). The robust transcription of genes at such SEs is enabled by the formation of phase-separated condensates by transcription factors and coactivators with intrinsically disordered regions. The androgen receptor (AR), the main oncogenic driver in PCa, contains large disordered regions and is co-recruited with the transcriptional coactivator mediator complex subunit 1 (MED1) to SEs in androgen-dependent PCa cells, thereby promoting oncogenic transcriptional programs. In this work, we reveal that full-length AR forms foci with liquid-like properties in different PCa models. We demonstrate that foci formation correlates with AR transcriptional activity, as this activity can be modulated by changing cellular foci content chemically or by silencing MED1. AR ability to phase separate was also validated in vitro by using recombinant full-length AR protein. We also demonstrate that AR antagonists, which suppress transcriptional activity by targeting key regions for homotypic or heterotypic interactions of this receptor, hinder foci formation in PCa cells and phase separation in vitro. Our results suggest that enhanced compartmentalization of AR and coactivators may play an important role in the activation of oncogenic transcription programs in androgen-dependent PCa.
Cdk1-mediated threonine phosphorylation of Sam68 modulates its RNA binding, alternative splicing activity and cellular functions
Authors: Malki Idir , Liepina Inara , Kogelnik Nora , Watmuff Hollie , Robinson Sue , Lightfoot Adam , Gonchar Oksana , Bottrill Andrew , Fry Andrew M , Dominguez Cyril
Published: December 2022

Sam68, also known as KHDRBS1, is a member of the STAR family of proteins that directly link signal transduction with post-transcriptional gene regulation. Sam68 controls the alternative splicing of many oncogenic proteins and its role is modulated by post-translational modifications, including serine/threonine phosphorylation, that differ at various stages of the cell cycle. However, the molecular basis and mechanisms of these modulations remain largely unknown. Here, we combined mass spectrometry, nuclear magnetic resonance spectroscopy and cell biology techniques to provide a comprehensive post-translational modification mapping of Sam68 at different stages of the cell cycle in HEK293 and HCT116 cells. We established that Sam68 is specifically phosphorylated at T33 and T317 by Cdk1, and demonstrated that these phosphorylation events reduce the binding of Sam68 to RNA, control its cellular localization and reduce its alternative splicing activity, leading to a reduction in the induction of apoptosis and an increase in the proliferation of HCT116 cells.
Insights into the molecular mechanism of translation inhibition by the ribosome-targeting antibiotic thermorubin
Authors: Paranjpe Madhura N , Marina Valeria I , Grachev Aleksandr A , Maviza Tinashe P , Tolicheva Olga A , Paleskava Alena , Osterman Ilya A , Sergiev Petr V , Konevega Andrey L , Polikanov Yury S , Gagnon Matthieu G
Published: December 2022

Thermorubin (THR) is an aromatic anthracenopyranone antibiotic active against both Gram-positive and Gram-negative bacteria. It is known to bind to the 70S ribosome at the intersubunit bridge B2a and was thought to inhibit factor-dependent initiation of translation and obstruct the accommodation of tRNAs into the A site. Here, we show that thermorubin causes ribosomes to stall in vivo and in vitro at internal and termination codons, thereby allowing the ribosome to initiate protein synthesis and translate at least a few codons before stalling. Our biochemical data show that THR affects multiple steps of translation elongation with a significant impact on the binding stability of the tRNA in the A site, explaining premature cessation of translation. Our high-resolution crystal and cryo-EM structures of the 70S-THR complex show that THR can co-exist with P- and A-site tRNAs, explaining how ribosomes can elongate in the presence of the drug. Remarkable is the ability of THR to arrest ribosomes at the stop codons. Our data suggest that by causing structural re-arrangements in the decoding center, THR interferes with the accommodation of tRNAs or release factors into the ribosomal A site.
DNA processing by the Kaposi's sarcoma-associated herpesvirus alkaline exonuclease SOX contributes to viral gene expression and infectious virion production
Authors: Hartenian Ella , Mendez Aaron S , Didychuk Allison L , Khosla Shivani , Glaunsinger Britt A
Published: December 2022

Alkaline exonucleases (AE) are present in several large DNA viruses including bacteriophage λ and herpesviruses, where they play roles in viral DNA processing during genome replication. Given the genetic conservation of AEs across viruses infecting different kingdoms of life, these enzymes likely assume central roles in the lifecycles of viruses where they have yet to be well characterized. Here, we applied a structure-guided functional analysis of the bifunctional AE in the oncogenic human gammaherpesvirus Kaposi's sarcoma-associated herpesvirus (KSHV), called SOX. In addition to identifying a preferred DNA substrate preference for SOX, we define key residues important for DNA binding and DNA processing, and how SOX activity on DNA partially overlaps with its functionally separable cleavage of mRNA. By engineering these SOX mutants into KSHV, we reveal roles for its DNase activity in viral gene expression and infectious virion production. Our results provide mechanistic insight into gammaherpesviral AE activity as well as areas of functional conservation between this mammalian virus AE and its distant relative in phage λ.
Improved genome editing by an engineered CRISPR-Cas12a
Authors: Ma Enbo , Chen Kai , Shi Honglue , Stahl Elizabeth C , Adler Ben , Trinidad Marena , Liu Junjie , Zhou Kaihong , Ye Jinjuan , Doudna Jennifer A
Published: December 2022

CRISPR-Cas12a is an RNA-guided, programmable genome editing enzyme found within bacterial adaptive immune pathways. Unlike CRISPR-Cas9, Cas12a uses only a single catalytic site to both cleave target double-stranded DNA (dsDNA) (cis-activity) and indiscriminately degrade single-stranded DNA (ssDNA) (trans-activity). To investigate how the relative potency of cis- versus trans-DNase activity affects Cas12a-mediated genome editing, we first used structure-guided engineering to generate variants of Lachnospiraceae bacterium Cas12a that selectively disrupt trans-activity. The resulting engineered mutant with the biggest differential between cis- and trans-DNase activity in vitro showed minimal genome editing activity in human cells, motivating a second set of experiments using directed evolution to generate additional mutants with robust genome editing activity. Notably, these engineered and evolved mutants had enhanced ability to induce homology-directed repair (HDR) editing by 2–18-fold compared to wild-type Cas12a when using HDR donors containing mismatches with crRNA at the PAM-distal region. Finally, a site-specific reversion mutation produced improved Cas12a (iCas12a) variants with superior genome editing efficiency at genomic sites that are difficult to edit using wild-type Cas12a. This strategy establishes a pipeline for creating improved genome editing tools by combining structural insights with randomization and selection. The available structures of other CRISPR-Cas enzymes will enable this strategy to be applied to improve the efficacy of other genome-editing proteins.
Discovery and characterization of novel type I-D CRISPR-guided transposons identified among diverse Tn7-like elements in cyanobacteria
Authors: Hsieh Shan-Chi , Peters Joseph E
Published: December 2022

CRISPR-Cas defense systems have been naturally coopted for guide RNA-directed transposition by Tn7 family bacterial transposons. We find cyanobacterial genomes are rich in Tn7-like elements, including most of the known guide RNA-directed transposons, the type V-K, I-B1, and I-B2 CRISPR-Cas based systems. We discovered and characterized an example of a type I-D CRISPR-Cas system which was naturally coopted for guide RNA-directed transposition. Multiple novel adaptations were found specific to the I-D subtype, including natural inactivation of the Cas10 nuclease. The type I-D CRISPR-Cas transposition system showed flexibility in guide RNA length requirements and could be engineered to function with ribozyme-based self-processing guide RNAs removing the requirement for Cas6 in the heterologous system. The type I-D CRISPR-Cas transposon also has naturally fused transposase proteins that are functional for cut-and-paste transposition. Multiple attributes of the type I-D system offer unique possibilities for future work in gene editing. Our bioinformatic analysis also revealed a broader understanding of the evolution of Tn7-like elements. Extensive swapping of targeting systems was identified among Tn7-like elements in cyanobacteria and multiple examples of convergent evolution, including systems targeting integration into genes required for natural transformation.
Offences against Status
Authors: Letsas George
Published: December 2022

Philosophical accounts of status understand it either pejoratively, as social rank, or laudatorily, as the dignity possessed by all in virtue of our shared humanity. Status is considered to be something either we all have or no one should have. This article aims to show that there is a third, neglected, sense of status. It refers to the moral rights and duties one holds in virtue of one’s social position or role. Employees, refugees, doctors, teachers and judges all hold social roles in virtue of which they have distinctive obligations, rights, privileges, powers and the like. This article aims to do two things: first, to distinguish the role-based notion of status from ideas of social rank, and to identify the various ways in which it constitutes a distinct category of moral wrongdoing; and second, to show that status, thus understood, is justified on egalitarian grounds even though, unlike dignity, not everyone has it. The moral point of status, I argue, is to regulate asymmetrical relations in which one of the parties suffers from background vulnerabilities and dependencies. Status as a moral idea vests both parties with a complex set of rights and duties, whose aim is to restore moral equality between the parties.
Complete Genome Sequences of Septoria linicola: A Resource for Studying a Damaging Flax Pathogen
Authors: Lapalu Nicolas , Simon Adeline , Demenou Boris , Paumier Delphine , Guillot Marie-Pierre , Gout Lilian , Suffert Frederic , Valade Romain
Published: December 2022

Fungal genus Septoria causes diseases in a wide range of plants. Here, we report the first genome sequences of two strains of Septoria linicola, the causal agent of the pasmo disease of flax ( Linum usitatissimum). The genome of the first strain, SE15195, was fully assembled in 16 chromosomes, while 35 unitigs were obtained for a second strain, SE14017. Structural annotations predicted 13,096 and 13,085 protein-encoding genes and transposable elements content of 19.0 and 18.1% of the genome for SE15195 and SE14017, respectively. The four smaller chromosomes 13 to 16 show genomics features of potential accessory chromosomes. The assembly of these two genomes is a new resource for studying S. linicola and improving management of pasmo.

[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 .
Dystrophic Calcification of the Lower Leg in a Patient with Chronic Lower Extremity Venous Insufficiency and Diabetes Mellitus: A Case Report and Literature Review
Authors: Guo Jing , Shi Weichen , Zhang Guangming , Zhu Chaojun
Published: December 2022

Chronic lower extremity venous insufficiency can cause local dystrophy, and some patients will develop calf dystrophic calcification. In this case report, the authors describe a patient with varicose veins of both lower extremities, venous insufficiency of the lower extremities, recurring ulcers on the left leg for more than 20 years, and diabetes mellitus with dystrophic calcification of the calf. The patient’s left leg ulcer showed extensive chronic inflammation, pathological calcification, and necrosis of the subcutaneous tissue with a thickness of approximately 0.5 to 1 cm. The computed tomography, X-ray, and hematoxylin-eosin staining results confirmed calcification; the leg skin thickened because of inflammatory irritation. After 11 months of treatment, the calcified and necrotic calcification and necrotic tissue were removed, and the wound healed.
Nursing assessment and care of major burn injuries
Authors: Miller Nichole
Published: December 2022

Prioritize the patient's airway, the cause of the burn, burn depth, and the affected body surface area during the initial assessment to decrease the risk of burn shock.
Prevention of Postoperative Cognitive Dysfunction by Minocycline in Elderly Patients after Total Knee Arthroplasty: A Randomized, Double-blind, Placebo-controlled Clinical Trial
Authors: Takazawa Tomonori , Horiuchi Tatsuo , Orihara Masaki , Nagumo Kazuhiro , Tomioka Akihiro , Ideno Yuki , Hayashi Kunihiko , Yashima Hideaki , Araki Takuya , Hatayama Kazuhisa , Terauchi Masanori , Ikeda Yoshio , Saito Shigeru
Published: December 2022

Background

There are no effective pharmacologic interventions for preventing postoperative cognitive dysfunction in daily practice. Since the antibiotic minocycline is known to suppress postoperative neuroinflammation, this study hypothesized and investigated whether minocycline might have a preventive effect on postoperative cognitive dysfunction after noncardiac surgery.

Methods

This study included patients aged more than 60 yr undergoing total knee arthroplasty under general anesthesia. They were randomly assigned to minocycline and placebo groups, to orally receive 100 mg of minocycline or placebo twice daily from the day before surgery until the seventh day after surgery. Cognitive function was evaluated before surgery, and 1 week and 3 months after surgery, using a battery of four cognitive function tests, including Visual Verbal Learning Test, Trail Making Test, Stroop Color and Word Test, and Letter–Digit Coding Task. Additionally, 30 healthy volunteers were subjected to the same tests as the patients to examine the learning effect of repeated tests. The occurrence of postoperative cognitive dysfunction was judged from the results of the neurocognitive test battery, with consideration of the learning effect. The secondary endpoints were the effects of minocycline on postoperative delirium and postoperative pain.

Results

A total of 100 patients were randomized to the minocycline group, and 102 were randomized to the placebo group. The average age of patients was 75 yr. Evaluation showed no significant difference in the incidence of postoperative cognitive dysfunction between the minocycline and placebo groups at both 1 week (8 of 90 [8.9%] vs. 4 of 95 [4.2%]; odds ratio, 2.22 [95% CI, 0.64 to 7.65]; P = 0.240) and 3 months (15.3 of 90 [17.0%] vs. 15.3 of 95 [16.1%]; odds ratio, 1.07 [95% CI, 0.49 to 2.32]; P = 0.889) postoperatively. Missing data 3 months after surgery were corrected by the multiple imputation method. There were no differences between the two groups in postoperative delirium and postoperative pain.

Conclusions

Minocycline is likely to have no preventive effect on postoperative cognitive dysfunction.

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New
Do Cultures from Percutaneously Drained Intra-abdominal Abscesses Change Treatment: A Retrospective Review
Authors: Esposito Andrew C. , Zhang Yuqi , Nagarkatti Nupur , Laird William D. , Coppersmith Nathan A. , Reddy Vikram , Leeds Ira , Mongiu Anne , Longo Walter , Hao Ritche M. , Pantel Haddon
Published: December 2022

BACKGROUND:

Routinely obtaining intraoperative cultures for abdominal infections is not a currently recommended evidence-based practice. Yet, cultures are frequently sent from these infections when they are managed by image-guided percutaneous drains.

OBJECTIVE:

Determine the utility of cultures from percutaneously drained intra-abdominal abscesses.

DESIGN:

Retrospective chart review.

SETTING:

Single university-affiliated institution.

PATIENTS:

Inpatients with intra-abdominal abscess secondary to diverticulitis or appendicitis between 2013 and 2021 managed with image-guided percutaneous drain, excluding those with active chemotherapy, HIV, or solid organ transplant.

MAIN OUTCOME MEASURES:

Frequency culture data from percutaneous drains changed antimicrobial therapy.

RESULTS:

There were 221 patients meeting inclusion criteria. Of these, 56% were admitted for diverticulitis and 44% for appendicitis. Patients were 54% female, had a median age of 62 (18-93), and 14% were active smokers. The median length of hospitalization was 8 days (range, 1-78) and the median antibiotics course was 8 days (range, 1-22). Culture data from percutaneous drains altered antimicrobial therapy in 7% (16/221) of patients. A culture was obtained from 95% of drains, with 79% of cultures with growth. Cultures grew multiple bacteria in 63% and mixed variety without speciation in 13%. The most common pathogen was Bacteroides family at 33% of all bacteria. The most common empiric antibiotic regimen was ceftriaxone and metronidazole, used in 33% and 40% of patients, respectively. Female sex (p = 0.027) and presence of bacteria with any antibiotic resistance (p < 0.01) were associated with higher likelihood of cultures influencing antimicrobial therapy.

LIMITATIONS:

Retrospective and single institution’s microbiome.

CONCLUSIONS:

Microbiology data from image-guided percutaneous drains of abdominal abscesses altered antimicrobial therapy in 7% of patients, which is lower than previously published literature on cultures obtained surgically. Given this low rate, similar to recommendation on cultures obtained intraoperatively, routinely culturing material from drains placed in abdominal abscess is not recommended. See Video Abstract at http://links.lww.com/DCR/C64.
Recommendations on Attaining Departmental Status: A Survey of Division Chiefs Turned Department Chairs
Authors: Akhter Maheen F. , Keane Charles A. , Sarac Benjamin A. , Moore Amy M. , Sacks Justin M. , Rubin J. Peter , Janis Jeffrey E.
Published: December 2022

In 2009, the Association of Academic Chairmen of Plastic Surgery, now known as the American Council of Academic Plastic Surgeons (ACAPS), published a white paper endorsing the conversion of plastic surgery divisions into autonomous departments, motioning for other national organizations to follow suit. ACAPS’ rationale outlined 11 factors intended to promote the favorability of attaining departmental status within an institution. Through surveying division chiefs turned founding department chairs who successfully executed this transition, we evaluate the practicality and efficacy of these guidelines. A survey was distributed to founding chairs of plastic surgery departments that were established after ACAPS’ 2009 white paper. Information pertaining to institutions’ demographic information and respondents’ utilization of the principles and suggestions espoused in the white paper was obtained. The survey achieved an 86% response rate. The average time needed for the transition was 22 ± 12 months. Four of seven chairs were familiar with the 2009 ACAPS white paper. Garnering support from hospital administrators and institutional stakeholders, having fiscal profitability within the institution, and coordinating an integrated plastic surgery training program were ranked as the top three most important factors, respectively. This study assesses ACAPS’ recommendations on transitioning from a division to a department on the basis of perceived utility by academic leaders who recently navigated the process. The most frequently cited factors for a successful transition included rallying support from institutional stakeholders and ensuring profitability. Additionally, aligning the timing with a concurrent transition of leadership can expedite the process.
Clinical Outcomes of Preloaded Descemet Membrane Endothelial Keratoplasty With Endothelium Inward: A 24-Month Comparative Analysis Between Fuchs Endothelial Corneal Dystrophy and Bullous Keratopathy
Authors: Viola Pietro , Neri Enrico , Testa Valeria , Parekh Mohit , Cian Roberto , Grassetto Andrea , Romano Vito
Published: December 2022

Purpose:

The aim of this study was to compare long-term clinical outcomes of preloaded Descemet membrane endothelial keratoplasty (DMEK) between Fuchs endothelial corneal dystrophy (FECD) and bullous keratopathy (BK).

Methods:

In this single-center retrospective clinical case series, 71 eyes of 64 patients indicated with FECD (62%) or BK (38%) (with or without cataract) were treated with preloaded DMEK grafts between March 2018 and February 2020. Standard DMEK peeling, followed by manual folding of the tissue with endothelium-inward orientation and storing in a preloaded fashion inside a 2.2-mm intraocular lens cartridge. All tissues were delivered using a bimanual pull-through technique, followed by air tamponade. Graft unfolding time, endothelial cell loss, corrected distance visual acuity, central corneal thickness, rebubbling rate, and intraoperative and postoperative complications at 1, 3, 6, 12, and 24 months were recorded.

Results:

The mean intraoperative graft unfolding time in FECD did not differ from the BK group (P= 0.6061). Cystoid macular edema did not differ in either group (P= 0.6866). The rebubbling rate was found to be significantly higher in FECD compared with the BK group (P= 0.0423). Corrected distance visual acuity significantly improved at the first month after surgery (P= 0.0012), with no differences between FECD and BK at 24 months (P= 0.2578). Central corneal thickness was stable postoperatively and showed no differences between the groups (P= 0.3693). Significantly higher endothelial cell counts were observed in the FECD group at 24 months (P= 0.0002).

Conclusions:

Preloaded DMEK with “endothelium-in” offers acceptable intraoperative time, rebubbling rate, and clinical outcomes in both FECD and BK groups. Patients with FECD show better postoperative clinical outcomes even if the rebubbling rate is relatively high.
Asset Performance Management Command Center for Saudi Ministry of Health
Authors: Algablan Fahad , AlTurairi Ibrahim , Mobarek Iyad
Published: December 2022

This article describes the journey of developing, implementing, and evaluating a unique state-of-the-art Asset Performance Management Command Center for the Ministry of Health in Saudi. Several successful pilots have been established to test the usability and performance of the Asset Performance Management tools that are developed and planned to be scaled for all (~300) ministry of health hospitals. To accommodate the complexity of the mission, several proof of concepts have been established including inventory management for 7 types of medical equipment on kingdom-level covering ventilators: anesthesia, blood gas analyzers, magnetic resonance imaging, computed tomography, renal and dental units in addition to inventory management platform for all ministry of health hospitals hospitals. A basic computerized maintenance management system is then implemented at 1 Ministry of health hospital, and another equipment direct connectivity use case was implemented at another hospital. Continuously refreshed data for medical equipment at the targeted hospitals are reported at the national command center of the Ministry of Health situated in Riyadh digital City, including inventory information related to 200+ hospitals in addition to key performance indicator dashboards illustrating downtime, work order status, basic utilization, and many other key performance indicators related to assets specifically developed and verified for Ministry of health needs.
Extending health care access via telemedicine in public libraries
Authors: DeGuzman Pamela B. , Garth Jennifer L. , Sanjay Kamya , Compton Rebekah M.
Published: December 2022

Background:

Despite the potential for telemedicine in public libraries to expand health care access to those living a long distance from care and in broadband poor areas, there are few libraries that collaborate with providers to extend access.

Purpose:

To explore licensed health care providers' perspectives on telemedicine in public libraries as a method of improving equitable access to care for populations lacking the ability to connect to telemedicine from home.

Methods:

We used a two-phase explanatory sequential mixed methods design with a quantitative strand followed by a qualitative strand. Surveys were analyzed descriptively. Interviews were analyzed thematically using descriptive content analysis.

Results:

Of the 50 survey respondents, 13 were physicians and 36 were nurse practitioners (NPs); 12 NPs were interviewed. NPs were overwhelmingly supportive of telemedicine in public libraires, describing how connecting at-risk populations to a video visit (VV) allowed for a more thorough and accurate assessment than a phone call. Although several NPs were concerned with privacy, others considered a library to be more private than the home. Interviews revealed how chronic illness management may be the ideal visit type for public library-based telemedicine.

Conclusions:

Given the importance of expanding access sites for telemedicine, NPs should consider partnering with libraries in their catchment areas where broadband access is sparse and patients must travel long distances to care.

Implications:

Managing chronic illnesses using telemedicine in public libraries may be an important approach toward reducing health disparities in populations who live in long distances from care and do not have home-based internet access.
Frailty as tested by the Liver Frailty Index in out-patient patients with cirrhosis in China: a cross-sectional study
Authors: Siyu Li , Yuan Yuan , Ran An , Minyan Li
Published: December 2022

Background

Early identification and prevention of frailty are very important for patients with cirrhosis.

Methods

The study was the first to use Liver Frailty Index in out-patient patients with cirrhosis in China, and to analyze the influencing factors.

Result

This study included 387 patients with cirrhosis. Frailty was diagnosed using the Liver Frailty Index. Multiple Logistic regression model were used to analyze influencing factors of frailty in out-patient patients with cirrhosis. Frailty was diagnosed in 9.6% of patients and prefrailty was diagnosed in 54.8% of patients. Age, sex, BMI, education level, monthly economic income, number of unplanned hospital admissions in the past year, cause of cirrhosis, Child-Pugh classification of cirrhosis, nutritional risk, physical activity, gait speed and Activity of Daily Living (ADL) Scale in the frailty, prefrailty and no frailty of groups were statistically significant. Age (OR, 1.103; CI, 0.064–0.132), BMI (OR, 0.817; CI, −0.302 to −0.104), education level (OR, 4.321; CI, 0.754–2.173), physical activity (OR, 3.580; CI, 0.534–2.016) and gait speed (OR, 0.001; CI, −8.188 to −4.972) were influential factors of frailty in out-patient patients with cirrhosis.

Conclusion

Out-patient patients with cirrhosis have a high incidence of frailty and prefrailty. Elderly, reduced gait speed, no physical activity and low culture level are risk factors for frailty and prefrailty, and we should be identification and intervention early.
Prevalence of Stress and Anxiety Among Nursing Students
Authors: Vo Thi Nhi , Chiu Hsiao-Yean , Chuang Yeu-Hui , Huang Hui-Chuan
Published: December 2022

Background:

There is variability in the reported prevalence of stress and anxiety among nursing students across studies, and few studies have investigated the pooled prevalence of stress and anxiety of these students.

Purpose:

To investigate the prevalence and associated factors related to stress and anxiety among nursing students.

Methods:

Various electronic databases were searched up to October 26, 2022. A random-effects model and a moderator analysis were used to examine the overall prevalence and related factors. Begg's test was adopted to examine publication bias.

Results:

In total, 121 studies were included in the meta-analysis. Most nursing students experienced moderate stress (42.1%) and mild to moderate anxiety (19.4%-25.1%). Third- and fourth-year nursing students had severe stress levels compared with those in the first and second years (29.0% vs 15.1%).

Conclusions:

Nurse educators should design appropriate curricula to strengthen student knowledge and provide regular assessments and supportive interventions to reduce stress and anxiety.
Field Services Facilitated Treatment and Prevention: Challenges and Opportunities
Authors: Bachmann Laura Hinkle , Kerani Roxanne P.
Published: December 2022

Assisted partner services (APS) is a longstanding public health strategy to reduce transmission of STI and HIV in the U.S. However, with rapidly increasing rates of STI, innovations to APS are needed to allow health departments to conserve limited public health resources while improving the effectiveness of APS. Disease Intervention Specialists (DIS), public health staff who conduct APS, have a wealth of experience in identifying, locating, and interviewing index patients and their sexual partners, but are currently limited in the services that they are able to provide in the field. While several state and local health departments are working to expand the role of DIS to incorporate less traditional APS activities, such programs are uncommon. We discuss several services that DIS could conceivably provide in the field, such as STI testing, treatment, and vaccination, and identify critical issues to be addressed in order to implement these changes in DIS activities on a larger scale. Broadening the scope of DIS activities may result in multiple benefits to health departments, including more effectively delivering STI testing and treatment to hard to reach populations, imparting more responsibility to DIS, thereby potentially increasing job satisfaction, and building a workforce that is better prepared for public health crises. Effective approaches to address variable state level regulations governing DIS scope of practice are needed.
IDH2-Mutated Sinonasal Tumors: A Review
Authors: Alzumaili Bayan , Sadow Peter M.
Published: December 2022

Introduction:

Genetic profiling has caused an explosion in the subclassification of sinonasal malignancies. Distinguishing several of these tumor types by histomorphology alone has been quite challenging, and although pathologic classification aims to be as specific as possible, it remains to be seen if this recent move toward tumor speciation bears clinical relevance, most particularly focused on subtyping for the sake of prognostication and treatment. One such recently described cohort, predominantly lumped under the moniker of sinonasal undifferentiated carcinoma (SNUC) is IDH2-mutated sinonasal carcinoma, a high-grade carcinoma associated with mutations in the isocitrate dehydrogenase-2 (IDH2) gene. A hotspot mutation in the R172 codon has been described in 50% to 80% of the tumors classified as SNUC, large cell neuroendocrine carcinomas, and rarely in cases classified as olfactory neuroblastoma. The use of immunohistochemical and molecular approaches is required to correctly identify this subset of sinonasal tumors, with further study necessary to elucidate their unique pathophysiology, ultimately determining whether a revision is required toward the current therapeutic approach.

Aims:

Here, we provide an overview of the IDH2-mutated sinonasal tumors, discuss histopathologic and clinical features, and focus on molecular diagnostics and novel immunohistochemical markers.

Results:

A review of the literature reveals 82 reported cases with IDH2-mutated sinonasal tumors (IST), confirmed either by molecular studies or diagnostic immunohistochemical markers. The mean patient age is 60 years (female/male: 1/1.4), the median tumor size is 5 cm (range: 2.5 to 7.0 cm), and the most common location is the nasal cavity (81%). IST displays tumor necrosis and increased mitotes. Histopathologically, IST shows SNUC-like, large cell neuroendocrine carcinomas-like, or poorly differentiated carcinoma-like features (77%, 12%, and 9%, respectively). The molecular hotspot alterations in mitochondrial IDH2 are: R172S (61%), R172T (19%), R172G (7%), and R172M (3%). Sixty-five percent of tumors are surgically resectable, and all patients received chemotherapy, radiation therapy, or both. Rates of locoregional recurrence and distant metastasis are 60% and 40%, respectively. One-, 3- and 5-year survival rates are 83%, 50%, and 43%, respectively. In all but 1 study, IST is associated with better outcomes than IDH2 wild-type tumors and SMARCB1-deficient sinonasal tumors.