bluuebunny/crossref_metadata_2025 huggingface dataset:
Does Disease Activity After Induction Treatment With Biologics Predict Short-Term Outcome in Crohn’s Disease and Ulcerative Colitis?
Authors: Larsen Michael Due , Nørgård Bente Mertz , Kjeldsen Jens
Published: January 2022

Background

Secondary loss of response to biological therapy is a challenge when treating Crohn’s disease (CD) and ulcerative colitis (UC). Currently, no single marker has been found to be valid as a prognostic indicator of response to biologic therapy in patients with CD and UC. In this study, we aimed to assess whether disease activity after 14 weeks of biologic therapy has a prognostic impact on surgery and steroid-free remission during 6 months following completion of induction therapy.

Methods

In an unselected cohort study based on data from 4 national Danish health registries, we identified 493 patients with UC and 620 patients with CD who completed induction therapy with biologics from 2016 to 2019. Following induction therapy with biologics, we defined disease activity based on C-reactive protein and clinical scores of disease activity. The composite endpoint, “not being well treated,” included surgery or use of corticosteroid within 6 months following induction therapy.

Results

In patients with UC with disease activity following induction therapy, the adjusted odds ratio for surgery or steroid treatment during 6 months of follow-up was 3.9 (95% CI, 1.6-9.3) compared with patients without disease activity, and in patients with CD, the adjusted odds ratio was 3.6 (95% CI, 1.7-7.6).

Conclusions

A positive treatment response to biologic treatment after induction therapy (measured by C-reactive protein and clinical scores) predicts a better short-term outcome in patients with CD and UC.
Citizens’ Aversion to Pay Raises for Politicians: The Risk of Self-Interest Matter More Than the Promise of Competence
Authors: Pedersen Rasmus T , Hansen Kristina J , Pedersen Lene H
Published: January 2022

Citizens value competence in politicians. However, while offering high pay is a key strategy when recruiting competent candidates in the job market, most citizens are highly averse to paying politicians higher salaries. We argue that this aversion arises from one fundamental concern among citizens: self-interested politicians. Using data from a large-scale preregistered survey experiment, we show that citizens are affected by the argument that higher salaries may attract self-interested politicians, whereas they are not affected by the argument that higher salaries will attract competent politicians. Surprisingly, the more positively citizens view politicians, the more they are affected by the argument about self-interested politicians. These results suggest that citizens may view modest salaries as a guard against self-interested politicians.
Large-Data Equicontinuity for the Derivative NLS
Authors: Harrop-Griffiths Benjamin , Killip Rowan , Vişan Monica
Published: January 2022

We consider the derivative nonlinear Schrödinger equation in one spatial dimension, which is known to be completely integrable. We prove that the orbits of $L^2$ bounded and equicontinuous sets of initial data remain bounded and equicontinuous, not only under this flow, but also under the entire hierarchy. This allows us to remove the small-data restriction from prior conservation laws and global well-posedness results.
A time-series effect of phytase supplementation on phosphorus utilization in growing and finishing pigs fed a low-phosphorus diet
Authors: Babatunde Olufemi Oluwaseun , Adeola Olayiwola
Published: January 2022

Two experiments were carried out to determine a time-series effect of phytase on phosphorus (P) utilization in growing and finishing pigs using growth performance, apparent total tract digestibility (ATTD) of nutrients, P excretion, and plasma concentrations of minerals as the response criteria for evaluation. In both experiments, treatments were arranged as a 3 × 4 factorial in a randomized complete block design with 3 corn–soybean meal-based diets including a P-adequate positive control (PC), a low-P negative control (NC; no inorganic P), and NC supplemented with phytase at 1,000 FYT/kg (NC + 1,000); and 4 sampling time points at days 7, 14, 21, and 28 in experiment 1, and days 14, 26, 42, and 55 in experiment 2. In both trials, 96 growing pigs with average body weight (BW) of 19.8 ± 1.16 and 49.8 ± 3.21 kg, respectively, were allocated to the 3 diets with 8 replicates pens (4 barrows and 4 gilts) and 4 pigs per pen. In experiment 1, pigs fed the PC had higher (P < 0.01) BW, average daily gain (ADG), average daily feed intake (ADFI), and gain-to-feed ratio (G:F) when compared with pigs fed the NC. There was an interaction (P < 0.01) between time and diet on the BW and ADG of pigs while a linear and quadratic increase (P < 0.01) was observed with the ADFI and G:F, respectively, over time. Phytase supplementation improved (P < 0.01) all growth performance responses. Pigs fed the PC had greater (P < 0.01) ATTD of P and Ca than pigs fed the NC. There was no interaction effect on the ATTD of nutrients. Phytase addition improved the ATTD of P and Ca over pigs fed the NC. There was an interaction (P < 0.01) between diet and time on the total and water-soluble P (WSP) excreted. There was a quadratic decrease (P < 0.01) in plasma concentration of Ca in pigs over time. In experiment 2, there was a quadratic increase (P < 0.01) in BW, ADG, and G:F of pigs over time. Similarly, the inclusion of phytase improved (P < 0.05) all growth performance parameters except ADFI. A linear increase (P < 0.05) in the ATTD of DM, P, and Ca occurred over time. Phytase inclusion improved (P < 0.01) the ATTD of P and Ca. Plasma concentrations of P were improved by phytase addition. Phytase supplementation of the NC reduced WSP excretion by 45%, 32%, and 35% over the growing, finishing, and entire grow-finish period, respectively. In conclusion, phytase improves the utilization of P in growing and finishing pigs; however, the magnitude of effect on responses may vary over time.
Meat grinder injury of the arm: how to extract an arm safe, fast and pain free: case report and literature review
Authors: Al-Hassani Ammar , Wahlen Bianca M , Ayasa Mohammed A M , Hakim Suhail , Khoschnau Sherwan , El-Menyar Ayman , Al-Thani Hassan
Published: January 2022

Among the work-related injuries, meat grinder injuries are not uncommon. One of the major challenges in the trauma resuscitation room is the appropriate choice of anesthesia/analgesia when the patient is still conscious and the second challenge is to find the best way to early extract the patient’s limb out of the machine without adding more suffering. Herein, we presented a 23-year-old male patient who was brought fully conscious in a kneeling position with the right forearm entrapped in a big meat grinder machine with part of the crushed fingers being extruded out of the machine. The patient was in severe pain; however, his vital signs were stable. Analgo-sedation with Midazolam/Ketamine followed by ultrasound guided upper limb regional anesthesia was used and showed to be a fast and safe alternative in a conscious, not fasting patient when the extremity is still entrapped in a meat grinder machine.
The ‘Gluttonous Child’ Narrative in Italy and Britain: A Transnational Analysis
Authors: Gasperini Anna
Published: January 2022

This article compares images of food as temptation, and hunger as test, in two samples of late-nineteenth century British and Italian children’s literature. It reads the narratives alongside coeval popular medical manuals on child health, examining recurring descriptions of children as natural gluttons in works dedicated to child nutrition. Putting the select fiction and non-fiction in dialogue with moral, scientific, and nation-building middle-class discourses circulating in both countries, the article finds that the ‘gluttonous child’ narrative was both transnational and transtextual.
Latent Class Patterns of Adverse Childhood Experiences and Their Relationship to Veteran Status and Sex in the National Epidemiologic Survey of Alcohol and Related Conditions Wave III
Authors: Tynan Mara , Wooldridge Jennalee S , Rossi Fernanda , McLean Caitlin L , Gasperi Marianna , Bosch Jeane , Timko Christine , Herbert Matthew , Afari Niloofar
Published: January 2022

Introduction

Adverse childhood experiences (ACEs) are associated with poor psychosocial and health outcomes in adulthood. Veterans and females experience ACEs disproportionately. A greater understanding of this disparity may be achieved by examining the relationship between distinct ACE patterns and these demographic characteristics. Therefore, this study examined distinct ACE patterns and their association with Veteran status, sex, and other demographics in a nationally representative sample of U.S. adults to inform interventions tailored to ACE patterns experienced by specific groups.

Materials and Methods

Latent class analysis (LCA) was conducted with data from the National Epidemiologic Survey of Alcohol and Related Conditions-III, a nationally representative structured diagnostic interview conducted from 2012-2013. The target population was the noninstitutionalized adult population living in the USA. The analytic sample was 36,190 (mean age 46.5 years; 48.1% male). Of these participants, 3,111 were Veterans. Data were analyzed between September 2020 and January 2021.

Results

Latent class analysis revealed a four-class solution: (1) “Low adversity” (75.3%); (2) “Primarily household dysfunction” (9.0%); (3) “Primarily maltreatment” (10.7%); and (4) “Multiple adversity types” (5.1%). Compared to “Low adversity,” members in the other classes were more likely to be Veterans (odds ratio (OR)C2vC1 = 1.33, ORC3vC1 = 1.55, ORC4vC1 = 1.98) and female (ORC2vC1 = 1.58, ORC3vC1 = 1.22, ORC4vC1 = 1.65). While lower education and income were also related to higher adversity class membership, Veteran status and sex were the strongest predictors, even when controlling for education and income.

Conclusions

Distinct and meaningful patterns of ACEs identified in this study highlight the need for routine ACE screenings in Veterans and females. As in the current study, operationalizing and clustering ACEs can inform screening measures and trauma-informed interventions in line with personalized medicine. Future work can test if classes are differentially associated with health outcomes.
Measuring the Impact of Operational Stress: The Relevance of Assessing Stress-related Health Across the Deployment Cycle
Authors: Wisén Niclas , Larsson Gerry , Risling Mårten , Arborelius Ulf
Published: January 2022

Introduction

Mental health issues from intense or prolonged stress are a common concern in regard to military deployment. Deployments can objectively vary in stress exposure, but it is the individuals’ perception of that stress that affects sustainability, mental health, and combat fitness, which calls for the need of a protocol to evaluate and maintain a current estimation of stress impact. So, how can we assess the impact of stressors during different phases of deployment?

Materials and Methods

We used three psychological self-rating forms, the PSS14—Perceived Stress Scale, SMBM—Shirom Melamed Burnout Measure, and KSQ—Karolinska Sleep Questionnaire, to measure the impact of stress before (T1), during (T2), and at homecoming (T3). We also wanted to see if T1 or T2 results could predict T3 results to be able to better prepare the homecoming program.The forms were handed out to Swedish soldiers deployed in Mali in 2017. The forms were collected as a way to assess the status of the mental health load at three timepoints based on the personnel function as a way to assess the current “psychological fitness level”.

Results

The results show that stress measured using PSS14 was high at homecoming. The same result was observed for SMBM. No measures from T1 or T2 could however predict the T3 results.

Conclusions

Taken together, we found that screening of all contingent staff is relatively easy and provides personnel with relevant data on mental health and stress at the current time. We also found that test results correlated between T1 and T2 but not with T3. This indicates that there might be different stressors that affect staff at different timepoints.
Genomic Signatures of Recent Adaptation in a Wild Bumblebee
Authors: Colgan Thomas J , Arce Andres N , Gill Richard J , Ramos Rodrigues Ana , Kanteh Abdoulie , Duncan Elizabeth J , Li Li , Chittka Lars , Wurm Yannick
Published: January 2022

Environmental changes threaten insect pollinators, creating risks for agriculture and ecosystem stability. Despite their importance, we know little about how wild insects respond to environmental pressures. To understand the genomic bases of adaptation in an ecologically important pollinator, we analyzed genomes of Bombus terrestris bumblebees collected across Great Britain. We reveal extensive genetic diversity within this population, and strong signatures of recent adaptation throughout the genome affecting key processes including neurobiology and wing development. We also discover unusual features of the genome, including a region containing 53 genes that lacks genetic diversity in many bee species, and a horizontal gene transfer from a Wolbachia bacteria. Overall, the genetic diversity we observe and how it is distributed throughout the genome and the population should support the resilience of this important pollinator species to ongoing and future selective pressures. Applying our approach to more species should help understand how they can differ in their adaptive potential, and to develop conservation strategies for those most at risk.
Methadone as First-line Opioid for the Management of Cancer Pain
Authors: Mercadante Sebastiano , Adile Claudio , Ferrera Patrizia , Pallotti Maria Caterina , Ricci Marianna , Bonanno Giuseppe , Casuccio Alessandra
Published: January 2022

Aim

The aim of this study was to assess the efficacy and adverse effects of methadone when used as first-line therapy in patients that are either receiving low doses of opioids or none.

Methods

Patients with advanced cancer were prospectively assessed. Opioid-naive patients (L-group) were started with methadone at 6 mg/day. Patients receiving weak or other opioids in doses of <60 mg/day of OME (H-group) were started with methadone at 9 mg/day. Methadone doses were changed according to the clinical needs to obtain the most favorable balance between analgesia and adverse effects. Edmonton Symptom Asssement Score (ESAS), Memorial Delirium Assessment Score (MDAS), doses of methadone, and the use of adjuvant drugs were recorded before starting the study treatment (T0), 1 week after (T7), 2 weeks after (T14), 1 month after (T30), and 2 months after (T60). Methadone escalation index percent (MEI%) and in mg (MEImg) were calculated at T30 and T60.

Results

Eighty-two patients were assessed. In both groups H and L, there were significant changes in pain and symptom intensity at the different times during the study. Adverse effects as causes of drop-out were minimal. Mean MEImg was 0.09 (SD 0.28) and 0.02 (SD 0.07) at T30 and T60, respectively. MEI% was 1.01 (SD 3.08) and 0.27 (SD 0.86) at T30 and T60, respectively.

Conclusion

Methadone used as a first-line opioid therapy provided good analgesia with limited adverse effects and a minimal opioid-induced tolerance.
Impact of Immune Checkpoint Inhibitors on COVID-19 Severity in Patients with Cancer
Authors: Tan Ruoding , Yun Cindy , Seetasith Arpamas , Sheinson Daniel , Walls Robert , Ngwa Innocent , Reddy Josina C , Zhang Qing , Secrest Matthew H , Lambert Peter , Sarsour Khaled
Published: January 2022

Background

Amid continued uncertainty about the management of cancer patients during the pandemic, this study sought to obtain real-world data on the use of immune checkpoint inhibitors (ICIs) before COVID-19 diagnosis and its association with severity and survival outcomes in cancer patients who contracted COVID-19.

Methods

Cancer patients diagnosed with COVID-19 were identified from a large electronic health record database; those treated with ICIs before COVID-19+ diagnosis were matched in a 1:2 ratio to those not treated with ICIs, using a 2-step matching procedure. A descriptive analysis examined the difference in COVID-19 mortality (30-day and overall) and severity outcomes between the 2 cohorts, and overall survival was compared.

Results

Among 17 545 adults ≥18 years with cancer who tested positive for COVID-19 between February 20, 2020, and January 28, 2021, in the US, 228 ICI-treated patients were matched to 456 non-ICI-treated patients, comprising the 2 study cohorts. Clinical characteristics differed significantly between the 2 cohorts before matching, with metastatic disease, lung cancer, a history of smoking, and the presence of pulmonary comorbidities being more common in the ICI-treated cohort; after matching, the 2 cohorts were similar. There were no significant differences between the ICI-treated and non-ICI-treated cohorts for 30-day mortality (12.7% vs. 14.9%, P = .235), overall mortality (22.4% vs. 22.4%, P = 1.000), hospitalization (38.6% vs. 39.0%, P = .912), or emergency department visits (16.7% vs. 14.7%, P = .500). Overall survival was similar between the 2 cohorts.

Conclusion

This analysis adds to the clinical evidence base that use of ICIs before SARS-CoV-2 infection does not affect COVID-19 severity or survival outcomes, supporting the continued use of ICIs in cancer patients during the pandemic.
Does Pain Medication Use Influence the Outcome of 8 Weeks of Education and Exercise Therapy in Patients with Knee or Hip Osteoarthritis? An Observational Study
Authors: Koes Bart W , Chiarotto Alessandro , Thorlund Jonas Bloch , Grønne Dorte Thalund , Roos Ewa M , Skou Søren T
Published: January 2022

Objective

Patients with osteoarthritis are mainly managed in primary care settings and many patients use pain medication as symptomatic treatment. We investigated in OA-patients receiving an education and exercise program, the use and type of pain medication and its impact on outcomes at 3 months follow-up.

Design, Setting and Subjects

The design was a retrospective cohort study using prospectively collected data from the GLA: D® registry. The study included 15,918 primary care patients.

Results

Among the included patients, 62% were pain medication users and 38% were non-users. Among the pain medications users, 35% were classified as paracetamol users, 54% as NSAID users, and 11% as opioid users. Medication users and non-users differed regarding a higher pain intensity, poorer physical and mental health. Pain medication use before and during the education and exercise program was associated with the pain intensity at 3 months follow-up. However, patients either using or not using pain medications improved over time, and the magnitude of the difference between patient groups was small (less than 10 mm on a 0–100 scale).

Conclusions

Pain medication use is weakly associated with outcome at 3 months follow up in OA-patients receiving an education and exercise program. Between-group differences, however, are small and probably not clinically important.
Exploring the Perceptual Effects of Uniforms and Accoutrements Among a Sample of Police Officers: The Locker Room as a Site of Transformation
Authors: Simpson Rylan , Sargeant Elise
Published: January 2022

The effects of officer appearance on public perceptions of police have been the subject of considerable scholarly attention. Little known research, however, has explored such effects on officers’ perceptions of each other. As part of the present research, we complement previous literature by testing the perceptual effects of uniforms and accoutrements among a sample of sworn police officers (N = 238) from the Queensland Police Service. Our results reveal that different types of attire (e.g. uniform or civilian), different styles of uniforms (e.g. light blue shirt or dark blue shirt), different accoutrements (e.g. high-visibility vest or sunglasses), and different bodily manipulations (e.g. sleeve tattoo) can impact officers’ perceptions of each other along various outcomes, including accountability, aggression, approachability, competency, friendliness, intimidation, professionalism, respectfulness, and trustworthiness. We discuss our results with respect to policing research, policy, and practice.
Dimensions of Formal Thought Disorder and Their Relation to Gray- and White Matter Brain Structure in Affective and Psychotic Disorders
Authors: Stein Frederike , Buckenmayer Elena , Brosch Katharina , Meller Tina , Schmitt Simon , Ringwald Kai Gustav , Pfarr Julia Katharina , Steinsträter Olaf , Enneking Verena , Grotegerd Dominik , Heindel Walter , Meinert Susanne , Leehr Elisabeth J , Lemke Hannah , Thiel Katharina , Waltemate Lena , Winter Alexandra , Hahn Tim , Dannlowski Udo , Jansen Andreas , Nenadić Igor , Krug Axel , Kircher Tilo
Published: January 2022

Factorial dimensions and neurobiological underpinnings of formal thought disorders (FTD) have been extensively investigated in schizophrenia spectrum disorders (SSD). However, FTD are also highly prevalent in other disorders. Still, there is a lack of knowledge about transdiagnostic, structural brain correlates of FTD. In N = 1071 patients suffering from DSM-IV major depressive disorder, bipolar disorder, or SSD, we calculated a psychopathological factor model of FTD based on the SAPS and SANS scales. We tested the association of FTD dimensions with 3 T MRI measured gray matter volume (GMV) and white matter fractional anisotropy (FA) using regression and interaction models in SPM12. We performed post hoc confirmatory analyses in diagnostically equally distributed, age- and sex-matched sub-samples to test whether results were driven by diagnostic categories. Cross-validation (explorative and confirmatory) factor analyses revealed three psychopathological FTD factors: disorganization, emptiness, and incoherence. Disorganization was negatively correlated with a GMV cluster comprising parts of the middle occipital and angular gyri and positively with FA in the right posterior cingulum bundle and inferior longitudinal fascicle. Emptiness was negatively associated with left hippocampus and thalamus GMV. Incoherence was negatively associated with FA in bilateral anterior thalamic radiation, and positively with the hippocampal part of the right cingulum bundle. None of the gray or white matter associations interacted with diagnosis. Our results provide a refined mapping of cross-disorder FTD phenotype dimensions. For the first time, we demonstrated that their neuroanatomical signatures are associated with language-related gray and white matter structures independent of diagnosis.
Blood Vessel Resident Human Stem Cells in Health and Disease
Authors: Craig David J , James Aaron W , Wang Yiyun , Tavian Manuela , Crisan Mihaela , Péault Bruno M
Published: January 2022

The vascular wall is comprised of distinct layers controlling angiogenesis, blood flow, vessel anchorage within organs, and cell and molecule transit between blood and tissues. Moreover, some blood vessels are home to essential stem-like cells, a classic example being the existence in the embryo of hemogenic endothelial cells at the origin of definitive hematopoiesis. In recent years, microvascular pericytes and adventitial perivascular cells were observed to include multi-lineage progenitor cells involved not only in organ turnover and regeneration but also in pathologic remodeling, including fibrosis and atherosclerosis. These perivascular mesodermal elements were identified as native forerunners of mesenchymal stem cells. We have presented in this brief review our current knowledge on vessel wall-associated tissue remodeling cells with respect to discriminating phenotypes, functional diversity in health and disease, and potential therapeutic interest.
Virulence Phenotypes of the Wheat Leaf Rust Pathogen, Puccinia triticina, in the United States from 2018 to 2020
Authors: Kolmer James A. , Fajolu Oluseyi
Published: January 2022

Collections of wheat leaves infected with the leaf rust fungus, Puccinia triticina, were obtained from the southeastern states, the Ohio Valley, the Great Plains, and Washington in 2018, 2019, and 2020 to determine the prevalent virulence phenotypes in the wheat-growing regions of the United States. In the hard red winter wheat region of the southern and mid Great Plains, MNPSD and MPPSD were the two most common phenotypes in 2018 and 2019. In 2020, BBBQD with high virulence to durum wheat was the most common phenotype in the southern Great Plains. In the hard red spring wheat region of the northern Great Plains, MNPSD, MPPSD, MBDSD, and TBBGS were the predominant phenotypes. In the soft red winter wheat region of the southeastern states and Ohio Valley region, MBTNB, MCTNB, and MNPSD were the three most common phenotypes. Collections in Washington had phenotypes LBDSG, LCDSG, LCDJG, and MBDSB that were not found in any other region. Isolates with virulence to the leaf rust resistance (Lr) gene Lr11 were most frequent in the southeastern states and Ohio Valley regions. The frequency of isolates with virulence to the Lr39 gene was highest in the Great Plains region and frequency of isolates with virulence to the Lr21 gene was highest in the northern Great Plains region. Selection of virulence phenotypes by Lr genes in the different market classes of wheat, combined with the effects of clonal reproduction, overwintering in southern regions, and low migration between the Great Plains region and eastern wheat-producing regions, has maintained the different P. triticina populations in the United States.
An Integrated Pest Management Program Outperforms Conventional Practices for Tomato (Solanum lycopersicum) in Cambodia
Authors: Porras Mitzy F. , Malacrinò Antonino , An Chanratha , Seng Kim Hian , Socheath Ong , Norton George , Miller Sally , Rosa Cristina , Rajotte Edwin G. , O’Rourke Megan E.
Published: January 2022

For several years, pest management in tomato production in Cambodia has generally focused on the use of synthetic pesticides. We compared conventional pest management (farmers’ traditional practices) with an integrated pest management (IPM) program on 12 farms in the northwestern part of Cambodia. The IPM program combined cultural, biological, and chemical practices. We found that IPM practices reduced aphid damage by 46%, and diseases such as Fusarium wilt and damping-off were substantially reduced. Our results indicate that the IPM package increased tomato yield and income by an average of 23 and 34%, respectively, compared with conventional practices during both dry and rainy seasons.
Response to erlotinib and bevacizumab combination therapy after acquired resistance to osimertinib in patients with non-small cell lung cancer
Authors: Satoh Hiroaki , Kagohashi Katsunori
Published: January 2022

Osimertinib is the most reliable epidermal growth factor receptor-tyrosine kinase (EGFR-TKI) and is recommended as the first-line EGFR-TKI. Therefore, developing acquired resistance to this TKI might be problematic because no appropriate treatment with TKIs has been established after acquired resistance to osimertinib. For patients with osimertinib resistance, antitumor drugs having different mechanism from that of EGFR-TKI are usually prescribed. However, these treatments do not include the effective utilization of several EGFR-TKIs for these patients. We herein report two cases of response to erlotinib and bevacizumab combination therapy after acquired resistance to osimertinib in patients with non-small cell lung cancer. Although the precise biological mechanism is unknown, this combination therapy may be an option for some patients who suffer from acquired resistance to osimertinib.
Breast Splint for Prevention of Nipple–areolar Complex Malposition after Direct-to-implant Breast Reconstruction
Authors: Sowa Yoshihiro , Kodama Takuya , Fuchinoue Yuko , Inafuku Naoki , Terao Yasunobu
Published: January 2022

Breast reconstruction with immediate placement of breast implants (direct-to-implant methods) following nipple-sparing mastectomy has increased because of the low burden on the patient and good aesthetic results. However, nipple–areolar complex (NAC) malposition after this surgery remains a common complication that has yet to be entirely resolved. Here, we introduce an approach using Duoactive CGF to prevent postoperative NAC malposition. Immediate postoperative fixation of Duoactive CGF cranially to the NAC of the operated breast was applied for 2–4 weeks. This is referred to as a breast splint. In the study, nine patients who received breast splints and 15 patients who did not were enrolled. The NAC position on the splint-treated breast was compared with that on the healthy side within 6 months after surgery. A case with little visual malposition was defined as having a good outcome, based on the deviation in the cranial direction not exceeding the position of the contralateral NAC. Our preliminary data demonstrated that the rate of good outcomes was significantly higher (P = 0.028) in cases in which a breast splint was used, compared with those that were not treated with a breast splint (7/9, 78.8% versus 4/15, 26.7%). Postoperative application of a breast splint using Duoactive CGF is a simple and useful method to prevent NAC malposition after breast reconstruction, using a direct-to-implant method.
Hip resection arthroplasty for acute femoral neck fractures in the non-ambulator
Authors: Steelman Kevin , Bolz Nicholas , Fleming Jennifer , Vaidya Rahul
Published: January 2022

Objectives:

Hemiarthroplasty (HA) is the current standard of care for displaced femoral neck fractures (FNFs) in non-ambulators. Despite excellent outcomes, arthroplasty-specific risks remain, including dislocation, implant failure, periprosthetic fracture and infection, and fat embolization syndrome. To eliminate the possibility of these complications, should non-ambulatory patients with acute, native hip FNFs be treated with simple hip resection arthroplasty (HRA) instead of HA?

Design:

Retrospective case series.

Setting:

Large, urban level-1 trauma center.

Patients/Participants:

Five non-ambulatory patients (6 hips) with acute, native hip FNF underwent femoral head and neck resection. Also, the most recent 10 FNFs treated with HA were also identified for comparison purposes.

Intervention:

HRA was performed via a Smith-Peterson approach with an oscillating saw or osteotome to complete the fracture or perform a fresh neck cut.

Main Outcome Measurements:

Outcomes included postoperative vs preoperative VAS pain scores and narcotics usage, and return to baseline functional status (sit up in bed or a chair postoperatively). Procedure time for HRA was compared with the 10 most recent patients with FNF treated with HA.

Results:

HRA resulted in decreased postoperative vs preoperative VAS pain scores (7.7 vs 3.3, P = .002), and decreased operative times (59.2 minutes for HRA, 111.8 minutes for HA, P < .001). All HRA patients had immediate return of baseline function.

Conclusion:

HRA offers shorter operative times when compared with HA, decreased postoperative VAS pain scores, and immediate return to functional baseline status without possibility of arthroplasty-specific complications. HRA may be an acceptable treatment option for FNFs in the non-ambulator.

Level of evidence: IV
Immunomodulation by intravenous omega-3 fatty acid treatment in older subjects hospitalized for COVID-19: a single-blind randomized controlled trial
Authors: Arnardottir Hildur , Pawelzik Sven-Christian , Sarajlic Philip , Quaranta Alessandro , Kolmert Johan , Religa Dorota , Wheelock Craig E. , Bäck Magnus
Published: January 2022

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) with respiratory distress and systemic hyperinflammation. The primary objective of this single-blind randomized controlled proof-of-concept clinical trial was to establish the effects of intravenous (i.v.) omega-3 (n-3) polyunsaturated fatty acid (PUFA) treatment compared to placebo on inflammatory markers in COVID-19, represented by leukocytes as well as inflammatory protein and lipid mediators. Here we also present an exploratory analysis of the mechanisms of action to elucidate the potential to resolve the COVID-19 hyperinflammation through interfering with lipid mediators. Inclusion criteria were COVID-19 diagnosis and clinical status requiring hospitalization. Randomization was 1:1 to a once daily i.v. infusion (2 mL/kg) of either n-3 PUFA emulsion containing 10g of fish oil per 100 mL or placebo (NaCl) for 5 days. Results from 22 older subjects (mean age 81±6.1 years) were analyzed. The neutrophil to lymphocyte ratio was significantly decreased after n-3 PUFA administration. Liquid chromatography–mass spectrometry (LC-MS/MS) -based lipid metabolite analysis established increased proresolving lipid mediator precursor levels and decreased formation of leukotoxin and isoleukotoxin diols by n-3 PUFA treatment. The mechanistic exploration revealed decreased immunothrombosis and preserved interferon-response. Finally, n-3 PUFA treatment may serve to limit cortisone-induced immunosuppression, including preserving leukocyte phagocytic capacity. In conclusion, i.v. n-3 PUFA administration was safe and feasible during hospitalization of multimorbid older subjects for COVID-19. The results identified n-3 PUFA treatment mediated lipid signature of increased proresolving precursor levels and decreased leukotoxin diols in parallel to beneficial immune responses. EudraCT: 2020-002293-28; clinicaltrials.gov: NCT04647604.
Estimating the state of the Covid-19 epidemic curve in Mayotte during the period without vaccination
Authors: Manou-Abi Solym , Slaoui Yousri , Balicchi Julien
Published: January 2022

We study in this work some statistical methods to estimate the parameters resulting from the use of an age-structured contact mathematical epidemic model in order to analyze the evolution of the epidemic curve of Covid-19 in the French overseas department Mayotte from march 13, 2020 to february 26,2021. Using several statistic methods based on time dependent method, maximum likelihood, mixture method, we fit the probability distribution which underlines the serial interval distribution and we give an adapted version of the generation time distribution from Package R0. The best-fit model of the serial interval was given by a mixture of Weibull distribution. Furthermore this estimation allows to obtain the evolution of the time varying effective reproduction number and hence the temporal transmission rates. Finally based on others known estimates parameters we incorporate the estimated parameters in the model in order to give an approximation of the epidemic curve in Mayotte under the conditions of the model. We also discuss the limit of our study and the conclusion concerned a probable impact of non pharmacological interventions of the Covid-19 in Mayotte such us the re-infection cases and the introduction of the variants which probably affect the estimates.
Executive dysfunction following SARS-CoV-2 infection: A cross-sectional examination in a population-representative sample
Authors: Hall Peter A. , Meng Gang , Hudson Anna , Sakib Mohammad N. , Hitchman Sara C. , McKillop James , Bickel Warren K. , Fong Geoffrey T.
Published: January 2022

Background

Prior studies have documented reliable associations between SARS-CoV-2 infection and adverse cognitive impact in older adults. The current study sought to determine whether SARS-CoV-2 infection and COVID-19 symptom severity are associated with cognitive dysfunction among young adults and middled-aged adults in the general population.

Method

The Canadian COVID-19 Experiences Project (CCEP) survey involves 1,958 adults with equal representation of vaccinated and vaccine hesitant adults between the ages of 18 and 54 years. The sample comprised 1,958 adults with a mean age of 37 years (SD=10.4); 60.8% were female. The primary outcome was symptoms of cognitive dysfunction assessed via an abbreviated form of the Barkley Deficits in Executive Functioning Scale (BDEFS) and performance on a validated decision-making task.

Results

Young and middle-aged adults with a positive SARS-CoV-2 infection history reported a significantly higher number of symptoms of executive dysfunction (Madj=1.89,SE=0.08,CI: 1.74, 2.04;n=175) than their non-infected counterparts (Madj=1.63,SE=0.08,CI: 1.47,1.80;n=1,599; β=0.26,p=.001). Among those infected, there was a dose-response relationship between COVID-19 symptom severity and level of executive dysfunction, with moderate (β=0.23,CI: 0.003-0.46) and very/extremely severe (β= 0.69,CI: 0.22-1.16) COVID-19 symptoms being associated with significantly greater dysfunction, compared to asymptomatic. These effects remained reliable and of similar magnitude after controlling for age, sex, vaccination status, income, and geographic region, and after removal of those who had been intubated during hospitalization. Similar effects were found for the decision-making task.

Conclusions

Positive SARS-CoV-2 infection history and COVID-19 symptom severity are associated with executive dysfunction among young and middle-aged adults with no history of medically induced coma. These findings are evident on self-reported and task-related indicators of cognitive function.
Preserved recognition of Omicron Spike following COVID-19 mRNA vaccination in pregnancy
Authors: Bartsch Yannic , Atyeo Caroline , Kang Jaewon , Gray Kathryn J , Edlow Andrea G , Alter Galit
Published: January 2022

Background

SARS-CoV-2 infection is associated with enhanced disease severity in pregnant women. Despite the potential of COVID-19 vaccines to reduce severe disease, vaccine uptake remained relatively low among pregnant women. Just as coordinated messaging from the CDC and leading obstetrics organizations began to increase vaccine confidence in this vulnerable group, the evolution of SARS-CoV-2 variants of concerns (VOC) including the Omicron VOC raised new concerns about vaccine efficacy, given their ability to escape vaccine-induced neutralizing antibodies. Early data point to a milder disease course following omicron VOC infection in vaccinated individuals. Thus, these data suggest that alternate vaccine induced immunity, beyond neutralization, may continue to attenuate omicron disease, such as antibody-Fc-mediated activity. However, whether vaccine induced antibodies raised in pregnancy continue to bind and leverage Fc-receptors remains unclear.

Methods

VOC including Omicron receptor binding domain (RBD) or full Spike specific antibody isotype binding titers and FcγR binding were analyzed in pregnant women after the full dose regimen of either Pfizer/BioNtech BNT62b2 (n=10) or Moderna mRNA-1273 (n=10) vaccination using a multiplexing Luminex assay.

Findings

Comparable, albeit reduced, isotype recognition was observed to the Omicron Spike and receptor binding domain (RBD) following both vaccines. Yet, despite the near complete loss of Fc-receptor binding to the Omicron RBD, Fc-receptor binding was largely preserved to the Omicron Spike.

Interpretation

Reduced binding titer to the Omicron RBD aligns with observed loss of neutralizing activity. Despite the loss of neutralization, preserved Omicron Spike recognition and Fc-receptor binding potentially continues to attenuate disease severity in pregnant women.

Funding

NIH and the Bill and Melinda Gates Foundation
Prenatal murine skeletogenesis partially recovers from absent skeletal muscle as development progresses
Authors: Sotiriou V. , Ahmed S. , Nowlan N. C.
Published: January 2022

Skeletal muscle contractions are critical for normal growth and morphogenesis of the skeleton, but it is unclear how the detrimental effects of absent muscle on the bones and joints change over time. Joint size, shape and cavitation, and rudiment length and mineralisation were assessed in multiple rudiments at two developmental stages (Theiler Stage (TS)24 and TS27) in the splotch-delayed “muscleless limb” mouse model and littermate controls. As development progressed, the effects of absent muscle on all parameters except for cavitation become less severe. All major joints in muscleless limbs were qualitatively and quantitatively abnormal in shape at TS24, while, by TS27, most muscleless joint shapes were normal, or nearly normal. In contrast, any joints which were fused at TS24 did not cavitate by TS27. Therefore, recovery in joint shape over development occurred despite absent cavitation. Mineralisation showed the most pronounced changes between TS24 and TS27 in the muscleless limbs. At TS24, all muscleless rudiments studied had less mineralisation than the controls, while at TS27, muscleless limb rudiments had either the same or significantly more mineralisation than controls of the same age. We conclude that the effects of absent muscle on prenatal murine skeletogenesis are most pronounced in early skeletal development and reduce in severity prior to birth. Understanding how mammalian bones and joints continue to develop in an environment without muscle contractions, but with mechanical stimulation due to the movement of the mother, provides important insights into conditions affecting human babies such as developmental dysplasia of the hip and arthrogryposis.
Potential geographic distribution and ecological niche of New World dobsonflies (Megaloptera, Corydalidae): the case of the Neartic-Neotropical transition zone
Authors: Álvarez Hugo Alejandro , Rivas-Soto Miguel A.
Published: January 2022

The dobsonflies (Megaloptera, Corydalidae) are an interesting group of insects, but among the New World dobsonflies, it is not known the effect of the Neartic-Neotropical transition zone on their biogeographic distribution. Here we studied at the species level, the records on the geographic range of the dobsonflies that occurred in and near the transition zone. We presented potential geographic distributions based on ecological niche models for several species of dobsonflies. Results suggested that the geographic range of dobsonflies in the transition zone is associated to mountainous formations and that most species favor warm climates with higher precipitation rates. Climate types tend to be important for species that show narrow geographic ranges, but precipitation tends to be the most important variable to explain species dispersion. Overall, our models support the dispersion of dobsonflies from the Neotropics to North America and explain the two endemic species in Mexico as the result of the formation of the transition zone.
Factors predicting serum clozapine levels in Middle Eastern patients: an observational study
Authors: Errasoul Ahmed Hassab , Alarabi Mohammed A.
Published: January 2022

Background

Despite its superiority over other drugs for psychosis, clozapine remains underused and is associated with many clinical challenges, including difficulties in predicting serum levels. We found no large or recent study that investigated the determinants of serum clozapine levels in Middle Eastern patients. We thus investigated the association between clozapine dose and serum levels and the clinical predictors of clozapine serum levels in Middle Eastern patients.

Methods

This was a cross-sectional study including 94 patients of Middle Eastern ethnicity attending the Clozapine Clinic in King Saud University Medical City in Riyadh, Saudi Arabia.

Results

The average clozapine dose and serum level were 400 mg/daily and 705 ng/mL, respectively. Clozapine dose and serum levels were positively correlated (rs[94]=0.32,p=0.002). We generated a predictive model of serum clozapine levels which revealed that the daily dose, smoking status, use of fluvoxamine or lamotrigine, and body mass index (BMI) predicted 43.6% of the variance in serum levels (p<0.001). Using this model, we calculated that the maximum doses of clozapine to avoid levels above the optimal range (>650 ng/mL) were 300, 250, or 225 mg/day for non-smokers with a body mass index of 25, 30, or 35 kg/m2, respectively, and 475, 425, or 400 mg/day for smokers with a body mass index of 25, 30, or 35 kg/m2, respectively.

Conclusions

This is a naturalistic study of the clozapine dose-level relationship and the clinical predictors of serum clozapine levels in Middle Eastern patients. These findings do not reduce the value of individualised therapeutic drug monitoring but may assist clinicians when prescribing clozapine to Middle Eastern patients. Further psychopharmacological studies are needed on this demographic population.
Potential application of Rapid Antigen Diagnostic Tests for the detection of infectious individuals attending mass gatherings – a simulation study
Authors: McAloon Conor G. , Dahly Darren , Walsh Cathal , Wall Patrick , Smyth Breda , More Simon , Teljeur Conor
Published: January 2022

Rapid Antigen Diagnostic Tests (RADTs) for the detection of SARS-CoV-2 offer advantages in that they are cheaper and faster than currently used PCR tests but have reduced sensitivity and specificity. One potential application of RADTs is to facilitate gatherings of individuals, through testing of attendees at the point of, or immediately prior to entry at a venue. Understanding the baseline risk in the tested population is of particular importance when evaluating the utility of applying diagnostic tests for screening purposes. We used incidence data to estimate the prevalence of infectious individuals in the community at a particular time point and simulated mass gatherings by sampling from a series of age cohorts. Nine different illustrative scenarios were simulated, small (n=100), medium (n=1000) and large (n=10,000) gatherings each with 3 possible age constructs: mostly younger, mostly older or a gathering with equal numbers from each age cohort. For each scenario, we estimated the prevalence of infectious attendees, then simulated the likely number of positive and negative test results, the proportion of cases detected and the corresponding positive and negative predictive values, and the cost per case identified. Our findings suggest that for each detected individual on a given day, there are likely to be 13.8 additional infectious individuals also present in the community. Prevalence of infectious individuals at events was highest with ‘mostly younger’ attendees (1.00%), followed by homogenous age gatherings (0.55%) and lowest with ‘mostly older events’ (0.26%). For small events (100 attendees) the expected number of infectious attendees was less than 1 across all age constructs of attendees. For large events (10,000 attendees) the expected number of infectious attendees ranged from 26 (95% confidence intervals 12 to 45) for mostly older events, to almost 100 (95% confidence intervals 46 to 174) infectious attendees for mostly younger attendees. Given rapid changes in SARS-CoV-2 incidence over time, we developed an RShiny app to allow users to run updated simulations for specific events.