bluuebunny/crossref_metadata_2025 huggingface dataset:
Variability in billfish vertical distribution and fishing interactions driven by environmental conditions in the Eastern Tropical Pacific Ocean
Authors: Blondin H E , Haulsee D E , Logan R , Shivji M , Hoffmayer E R , Walker J H , Dean J M , Hazen E L , Crowder L B
Published: June 2023

Blue marlin (Makaira nigricans) and sailfish (Istiophorus platypterus) are ecologically important predators and valuable species throughout the world’s recreational, commercial, and subsistence fisheries. Comparing multi-species vertical habitat use can inform ecological uncertainties such as inter-species competition, as well as relative vulnerabilities to fishing activities. In this study, we identified key differences in both depth use and which environmental variables drive these selections, which highlights the variability in the catchability both as target species in recreational fisheries and bycatch in commercial fisheries. To understand these two species’ vertical habitat use, we examined depth profiles from 26 sailfish and 48 blue marlin tagged with pop-up satellite archival tags deployed in the Eastern Tropical Pacific Ocean. While both species are surface-oriented, we found evidence of vertical niche partitioning where sailfish spend more time at deeper depths than blue marlin. Blue marlin recorded an average mean depth of 18.5 m (±10.8 m) during daytime and 5.2 m (±5.5 m) at nighttime (Figure 31a), while sailfish recorded an average mean depth of 23.6 m (±11.1 m) during daytime and 6.45 m (±4.64 m) at nighttime. Generalized additive mixed models fitted to predict mean and max depth revealed sea level anomaly (SLA), oxygen, sea surface temperature, and mixed layer depth as significant predictors of vertical habitat use for both species. We also examined catch logs from three recreational fishing lodges in Central America to understand the influence of environmental conditions on billfish sightings per unit effort. For blue marlin and sailfish, SLA was a significant predictor in each of the four depth models (mean day, mean night, max day, max night). SLA was the variable with highest percent deviance explained for all four sailfish depth models and three of the four blue marlin depth models and had a positive relationship with all response variables for all four blue marlin depth models and three sailfish depth models (mean daytime, max daytime, max nighttime), where higher positive SLA values were associated with deeper depth responses.
Potential distribution and spread of Japanese beetle in Washington State
Authors: Zhu Gengping , Oeller Liesl C , Wojahn Rian , Acosta Camilo , Milnes Joshua M , Crowder David W
Published: June 2023

The Japanese beetle, Popillia japonica (Newman, 1841) (Coleoptera: Scarabaeidae), was first detected in southern Washington State in 2020. Widespread trapping efforts ensued, and over 23,000 individuals were collected in both 2021 and 2022 in this region known for specialty crop production. The invasion of Japanese beetle is of major concern as it feeds on over 300 plant species and has shown an ability to spread across landscapes. Here, we created a habitat suitability model for Japanese beetle in Washington and used dispersal models to forecast invasion scenarios. Our models predict that the area of current establishment occurs in a region with highly suitable habitat. Moreover, vast areas of habitat that are likely highly suitable for Japanese beetle occur in coastal areas of western Washington, with medium to highly suitable habitat in central and eastern Washington. Dispersal models suggested that the beetle could spread throughout Washington within 20 years without management, which justifies quarantine and eradication measures. Timely map-based predictions can be useful tools to guide management of invasive species while also increasing citizen engagement to invaders.
Physical Activity Engagement: Perspectives From Adolescents With Comorbid Asthma and Overweight/Obesity and Their Caregivers
Authors: Koskela-Staples Natalie C , Yourell Jacqlyn L , Fedele David A , Doty Jennifer
Published: June 2023

Objective

Most adolescents do not meet physical activity (PA) guidelines, and engagement rates are even lower among adolescents with asthma and overweight/obesity (OW/OB). Understanding barriers and facilitators to PA engagement that are unique to youth with comorbid asthma and OW/OB is important for PA promotion. The current qualitative study identified caregiver- and adolescent-reported factors contributing to PA among adolescents with comorbid asthma and OW/OB across the four domains of the Pediatric Self-Management Model: individual, family, community, and health care system.

Methods

Participants were 20 adolescents (Mage = 16.01; 55% male) with asthma and OW/OB and their caregiver (90% mothers). Caregivers and adolescents participated in separate semistructured interviews about influences, processes, and behaviors related to adolescent PA engagement. Interviews were analyzed using thematic analysis.

Results

Factors contributing to PA varied across four domains. The individual domain included influences (e.g., weight status, psychological and physical challenges, asthma triggers and symptoms) and behaviors (e.g., taking asthma medications, self-monitoring). At the family level, influences included support, lack of modeling, and independence; processes included prompts and praise; and behaviors included engaging in shared PA and providing resources. Community-level influences included surrounding and settings, social support, and cornonavirus disease-2019-related changes, while behaviors included engaging in PA with others and extracurricular activities.

Conclusions

Influences, processes, and behaviors across multiple domains interact to impact adolescent PA engagement, highlighting factors that may be potential leverage points in prevention and intervention efforts to promote adolescent PA.
Instrumental variables: to strengthen or not to strengthen?
Authors: Heng Siyu , Zhang Bo , Han Xu , Lorch Scott A , Small Dylan S
Published: June 2023

Instrumental variables (IVs) are extensively used to handle unmeasured confounding. However, weak IVs may cause problems. Many matched studies have considered strengthening an IV through discarding some of the sample. It is widely accepted that strengthening an IV tends to increase the power of non-parametric tests and sensitivity analyses. We re-evaluate this conventional wisdom and offer new insights. First, we evaluate the trade-off between IV strength and sample size assuming a valid IV and exhibit conditions under which strengthening an IV increases power. Second, we derive a criterion for checking the validity of a sensitivity analysis model with a continuous dose and show that the widely used Γ sensitivity analysis model, which was used to argue that strengthening an IV increases the power of sensitivity analyses in large samples, does not work for continuous IVs. Third, we quantify the bias of the Wald estimator with a possibly invalid IV and leverage it to develop a valid sensitivity analysis framework and show that strengthening an IV may or may not increase the power of sensitivity analyses. We use our framework to study the effect on premature babies of being delivered in a high technology/high volume neonatal intensive care unit.
Maximum Entropy Design by a Markov Chain Process
Authors: Tillé Yves , Panahbehagh Bardia
Published: June 2023

In this article, we study an implementation of maximum entropy (ME) design utilizing a Markov chain. This design, which is also called the conditional Poisson sampling design, is difficult to implement. We first present a new method for calculating the weights associated with conditional Poisson sampling. Then, we study a very simple method of random exchanges of units, which allows switching from one sample to another. This exchange system defines an irreducible and aperiodic Markov chain whose ME design is the stationary distribution. The design can be implemented without enumerating all possible samples. By repeating the exchange process a large number of times, it is possible to select a sample that respects the design. The process is simple to implement, and its convergence rate has been investigated theoretically and by simulation, which led to promising results.
PNOC015: Repeated convection-enhanced delivery of MTX110 (aqueous panobinostat) in children with newly diagnosed diffuse intrinsic pontine glioma
Authors: Mueller Sabine , Kline Cassie , Stoller Schuyler , Lundy Shannon , Christopher Lauren , Reddy Alyssa T , Banerjee Anu , Cooney Tabitha M , Raber Shannon , Hoffman Carly , Luks Tracy , Wembacher-Schroeder Eva , Lummel Nina , Zhang Yalan , Bonner Erin R , Nazarian Javad , Molinaro Annette M , Prados Michael , Villanueva-Meyer Javier E , Gupta Nalin
Published: June 2023

Background

The objective of this study was to determine the safety, tolerability, and distribution of MTX110 (aqueous panobinostat) delivered by convection-enhanced delivery (CED) in patients with newly diagnosed diffuse intrinsic pontine glioma (DIPG) who completed focal radiation therapy (RT).

Methods

Patients with DIPG (2–21 years) were enrolled after RT. CED of MTX110 combined with gadoteridol was completed across 7 dose levels (DL) (30–90 µM; volumes ranging from 3 mL to 2 consecutive doses of 6 mL). An accelerated dose escalation design was used. Distribution of infusate was monitored with real-time MR imaging. Repeat CED was performed every 4–8 weeks. Quality-of-life (QoL) assessments were obtained at baseline, every 3 months on therapy, and end of therapy.

Results

Between May 2018 and March 2020, 7 patients who received a total of 48 CED infusions, were enrolled (median age 8 years, range 5–21). Three patients experienced dose-limited toxicities. Four grade 3 treatment-related adverse events were observed. Most toxicities were transient new or worsening neurologic function. Median overall survival (OS) was 26.1 months (95% confidence interval: 14.8–not reached). Progression-free survival was 4–14 months (median, 7). Cumulative percentage of tumor coverage for combined CED infusions per patient ranged from 35.6% to 81.0%. Increased CED infusions were negatively associated with self-reported QoL assessments.

Conclusion

Repeat CED of MTX110 with real-time imaging with gadoteridol is tolerable for patients with DIPG. Median OS of 26.1 months compares favorably with historical data for children with DIPG. The results support further investigation of this strategy in a larger cohort.
Externalizing traits: Shared causalities for COVID-19 and Alzheimer's dementia using Mendelian randomization analysis
Authors: Wang Haotian , Cao Mingyang , Xi Yingjun , Cao Weijie , Zhang Xiaoyu , Meng Xiaoni , Zheng Deqiang , Wu Lijuan , Wang Wei , Liu Di , Wang Youxin
Published: June 2023

Externalizing traits have been related with the outcomes of coronavirus disease 2019 (COVID-19) and Alzheimer's dementia (AD); however, whether these associations are causal remains unknown. We used the two-sample Mendelian randomization (MR) approach with more than 200 single-nucleotide polymorphisms (SNPs) for externalizing traits to explore the causal associations of externalizing traits with the risk of COVID-19 (infected COVID-19, hospitalized COVID-19, and severe COVID-19) or AD based on the summary data. The inverse variance–weighted method (IVW) was used to estimate the main effect, followed by several sensitivity analyses. IVW analysis showed significant associations of externalizing traits with COVID-19 infection (odds ratio [OR] = 1.456, 95% confidence interval [95% CI] = 1.224–1.731), hospitalized COVID-19 (OR = 1.970, 95% CI = 1.374–2.826), and AD (OR = 1.077, 95% CI = 1.037–1.119). The results were consistent using weighted median (WM), penalized weighted median (PWM), MR-robust adjusted profile score (MR-RAPS), and leave-one-out sensitivity analyses. Our findings assist in exploring the causal effect of externalizing traits on the pathophysiology of infection and severe infection of COVID-19 and AD. Furthermore, our study provides evidence that shared externalizing traits underpin the two diseases.
Generalized optical theorem
Authors: Takayanagi Kazuo , Kurino Mao
Published: June 2023

We present the generalized optical theorem and its applications with special emphasis on the roles of bound states. First, we prove the theorem which gives a necessary and sufficient condition for a function $\langle {\boldsymbol {k}}^{\prime } | T | {\boldsymbol {k}} \rangle$ of two variables ${\boldsymbol {k}}^{\prime }$ and ${\boldsymbol {k}}$ to be physically acceptable as a half-on-shell T-matrix, i.e., to have an underlying Hermitian potential V. Secondly, using the theorem, we construct a scattering theory starting from a physically acceptable half-on-shell T-matrix $\langle {\boldsymbol {k}}^{\prime } | T | {\boldsymbol {k}} \rangle$, which in turn introduces a very useful classification scheme of Hermitian potentials. In the end, as an application of our theory, we present the most general solution of the inverse scattering problem with numerical examples.
The State of American Federalism 2022–2023: Escalating Culture Wars in the States
Authors: Bromley-Trujillo Rebecca , Nolette Paul
Published: June 2023

American federalism in 2022–2023 saw a continued escalation of the culture wars, with persistent battles fought between the heavily polarized political parties, different levels of government (including federal versus state governments and state versus local governments), and between states and private business. Policy conflicts have centered on a variety of issues related to reproductive rights, K-12 education, and gun policy, among others. This overview of American federalism during the last year proceeds by first considering major policy activity in Congress, much of which holds significant implications for federalism. Next, we discuss the 2022 midterm elections and the dynamics that largely prevented what many expected to be a “red wave”. We then move to discuss significant policy shifts in the areas of civil rights and liberties, environmental policy, and labor, with an emphasis on state policymaking and court decisions. A central theme has been the intensification of cultural disputes as a policymaking focus, particularly at the state level.
Trading Nontradables: The Implications of Europe’s Job-Posting Policy
Authors: Muñoz Mathilde
Published: June 2023

This article examines the labor market implications of the EU posting policy, a large temporary migration program facilitated by the liberalization of the free provision of services in Europe. Posting allows EU firms to send (post) their employees abroad to export customer-facing services. Combining administrative data and quasi-experimental policy variation, I find that the policy permanently increased total factor mobility in Europe without crowding out traditional migration. This result suggests that unrealized gains from trade in factor services remained despite the absence of regulatory barriers to trade and migration in the EU. Furthermore, posted workers are mostly sent from low-wage countries to perform manual tasks in sectors formerly insulated from trade, and they represent a substantial share of EU migrant workers. In receiving countries, posting had persistent negative effects on employment for domestic workers in the more exposed sectors and local labor markets, but it had no effects on domestic wages. In low-wage sending countries, firms in formerly “nontradable” sectors experienced increased sales, profits, and tax payments when exporting services through posting. Posted workers earn more once sent abroad but remain paid at lower wages than comparable domestic workers in the receiving country. Wage gains for posted workers are mostly explained by minimum wages enforced by the EU policy, highlighting the role of labor market regulations in shaping the way gains from globalization are shared between labor and capital owners in origin countries.
Assessment of uncertainties in threshold doses for tissue reactions following acute external radiation exposure
Authors: Osovets Sergey V , Azizova Tamara V , Moseeva Maria B
Published: June 2023

The study aimed to estimate threshold doses and their uncertainties for some human health effects after short-term high dose-rate radiation exposure by quantile technique and the effective dose threshold technique based on distribution functions. The relative uncertainty (U) of the threshold dose was estimated using the error propagation technique. The quantile technique provided statistically significant estimates of threshold doses for acute radiation syndrome onset (0.44 ± 0.12 Gy, U = 143%) and lethality (1.84 ± 0.44 Gy, U = 117%) but relative uncertainties were high. The effective threshold dose technique provided statistically significant and more precise threshold dose estimates for acute radiation syndrome onset (0.73 ± 0.02 Gy, U = 18%) and lethality (6.83 ± 0.08 Gy, U = 36%), as well as agranulocytosis (3.51 ± 0.03 Gy, U = 16%) and vomiting onset in the prodromal period (1.54 ± 0.02 Gy, U = 16%). Threshold doses estimated for the change in the peripheral blood neutrophil and leukocyte counts during the first days after short-term high dose-rate radiation exposure were not statistically significant.
Cystin is required for maintaining fibrocystin (FPC) levels and safeguarding proteome integrity in mouse renal epithelial cells
Authors: Zhang Yiming J. , Yang Chaozhe , Wang Wei , Harafuji Naoe , Stasiak Piotr , Bell P. Darwin , Caldovic Ljubica , Sztul Elizabeth , Guay‐Woodford Lisa M. , Bebok Zsuzsanna
Published: June 2023

Autosomal recessive polycystic kidney disease (ARPKD) is caused primarily by mutations in PKHD1, encoding fibrocystin (FPC), but Pkhd1 mutant mice failed to reproduce the human phenotype. In contrast, the renal lesion in congenital polycystic kidney (cpk) mice, with a mutation in Cys1 and cystin protein loss, closely phenocopies ARPKD. Although the nonhomologous mutation diminished the translational relevance of the cpk model, recent identification of patients with CYS1 mutations and ARPKD prompted the investigations described herein. We examined cystin and FPC expression in mouse models (cpk, rescued‐cpk (r‐cpk), Pkhd1 mutants) and mouse cortical collecting duct (CCD) cell lines (wild type (wt), cpk). We found that cystin deficiency caused FPC loss in both cpk kidneys and CCD cells. FPC levels increased in r‐cpk kidneys and siRNA of Cys1 in wt cells reduced FPC. However, FPC deficiency in Pkhd1 mutants did not affect cystin levels. Cystin deficiency and associated FPC loss impacted the architecture of the primary cilium, but not ciliogenesis. No reduction in Pkhd1 mRNA levels in cpk kidneys and CCD cells suggested posttranslational FPC loss. Studies of cellular protein degradation systems suggested selective autophagy as a mechanism. In support of the previously described function of FPC in E3 ubiquitin ligase complexes, we demonstrated reduced polyubiquitination and elevated levels of functional epithelial sodium channel in cpk cells. Therefore, our studies expand the function of cystin in mice to include inhibition of Myc expression via interaction with necdin and maintenance of FPC as functional component of the NEDD4 E3 ligase complexes. Loss of FPC from E3 ligases may alter the cellular proteome, contributing to cystogenesis through multiple, yet to be defined, mechanisms.
Using Complex Networks in the Hearing Sciences
Authors: Vitevitch Michael S. , Pisoni David B. , Soehlke Lauren , Foster Tabitha A.
Published: June 2023

In this Point of View, we review a number of recent discoveries from the emerging, interdisciplinary field of Network Science, which uses graph theoretic techniques to understand complex systems. In the network science approach, nodes represent entities in a system, and connections are placed between nodes that are related to each other to form a web-like network. We discuss several studies that demonstrate how the micro-, meso-, and macro-level structure of a network of phonological word-forms influence spoken word recognition in listeners with normal hearing and in listeners with hearing loss. Given the discoveries made possible by this new approach and the influence of several complex network measures on spoken word recognition performance we argue that speech recognition measures—originally developed in the late 1940s and routinely used in clinical audiometry—should be revised to reflect our current understanding of spoken word recognition. We also discuss other ways in which the tools of network science can be used in Speech and Hearing Sciences and Audiology more broadly.
Communicating Emotion: Vocal Expression of Linguistic and Emotional Prosody in Children With Mild to Profound Hearing Loss Compared With That of Normal Hearing Peers
Authors: de Jong Tjeerd J. , Hakkesteegt Marieke M. , van der Schroeff Marc P. , Vroegop Jantien L.
Published: June 2023

Objectives:

Emotional prosody is known to play an important role in social communication. Research has shown that children with cochlear implants (CCIs) may face challenges in their ability to express prosody, as their expressions may have less distinct acoustic contrasts and therefore may be judged less accurately. The prosody of children with milder degrees of hearing loss, wearing hearing aids, has sparsely been investigated. More understanding of the prosodic expression by children with hearing loss, hearing aid users in particular, could create more awareness among healthcare professionals and parents on limitations in social communication, which awareness may lead to more targeted rehabilitation. This study aimed to compare the prosodic expression potential of children wearing hearing aids (CHA) with that of CCIs and children with normal hearing (CNH).

Design:

In this prospective experimental study, utterances of pediatric hearing aid users, cochlear implant users, and CNH containing emotional expressions (happy, sad, and angry) were recorded during a reading task. Of the utterances, three acoustic properties were calculated: fundamental frequency (F0), variance in fundamental frequency (SD of F0), and intensity. Acoustic properties of the utterances were compared within subjects and between groups.

Results:

A total of 75 children were included (CHA: 26, CCI: 23, and CNH: 26). Participants were between 7 and 13 years of age. The 15 CCI with congenital hearing loss had received the cochlear implant at median age of 8 months. The acoustic patterns of emotions uttered by CHA were similar to those of CCI and CNH. Only in CCI, we found no difference in F0 variation between happiness and anger, although an intensity difference was present. In addition, CCI and CHA produced poorer happy–sad contrasts than did CNH.

Conclusions:

The findings of this study suggest that on a fundamental, acoustic level, both CHA and CCI have a prosodic expression potential that is almost on par with normal hearing peers. However, there were some minor limitations observed in the prosodic expression of these children, it is important to determine whether these differences are perceptible to listeners and could affect social communication. This study sets the groundwork for more research that will help us fully understand the implications of these findings and how they may affect the communication abilities of these children. With a clearer understanding of these factors, we can develop effective ways to help improve their communication skills.
Intraocular Inflammation Incidence Following Intravitreal Brolucizumab Injection for Exudative Age-Related Macular Degeneration
Authors: Pakravan Parastou , Patel Veshesh , Lai James , Shaheen Abdulla , Kalahasty Karthik , Reyes-Capo Daniela P. , Chau Viet , Rosenfeld Philip J. , Haddock Luis J. , Schwartz Stephen G. , Smiddy William E. , Kovach Jaclyn L. , Sridhar Jayanth , Flynn Harry W. , Albini Thomas A. , Yannuzzi Nicolas A.
Published: June 2023

Purpose:

We evaluated the clinical outcomes of Intraocular inflammation (IOI) of eyes with neovascular age-related macular degeneration (AMD) injected with brolucizumab in our tertiary referral center.

Methods:

A retrospective case series for which clinical records of all eyes that received intravitreal brolucizumab at Bascom Palmer Eye Institute between December 1, 2019, and April 1, 2021 were reviewed.

Results:

There were 345 eyes of 278 patients who received 801 brolucizumab injections. IOI was detected in 16 eyes of 13 patients (4.6%). In those patients, baseline logMAR best-corrected visual acuity (BCVA) was 0.32

0.2 (20/42), while it was 0.58

0.3 (20/76) at IOI presentation. The mean number of injections among eyes experiencing IOI was 2.4, and the interval between the last brolucizumab injection and IOI presentation was 20 days. There were no known case of retinal vasculitis. Management of IOI included topical steroids in 7 eyes (54%), topical and systemic steroids in 5 eyes (38%), and observation in one eye (8%). BCVA returned to baseline and inflammation resolved in all eyes by last follow-up examination.

Conclusions:

Intraocular inflammation following brolucizumab injection for neovascular AMD was not uncommon. Inflammation resolved in all eyes by last follow-up visit.
Influence of preoperative posturing on subfoveal fluid height in macula-off retinal detachments
Authors: Johannigmann-Malek Navid , Kaye Stephen B , Badawood Shadi , Maier Mathias , Baumann Carmen
Published: June 2023

Purpose:

To evaluate the effect of preoperative posturing on subfoveal fluid height (SFFH) in macula-off retinal detachment (RD)

Methods:

Prospective study including patients with macula-off RD with SFFH measurable on optical coherence tomography (OCT) and duration of loss of central vision (LCV) ≤ 7 days. Linear OCT volume scans were performed at baseline, after one minute, one hour, four hours and on the next morning. For the first hour all patients remained in an upright position. Patients were then either instructed to posture until the surgery according to the location of the primary retinal break (posturing group) or were not given any instructions (control group).

Results:

Twenty-four patients were included in the posturing group and 11 patients in the control group. There was no significant change in SFFH between baseline, 1 minute, 1 hour and 4 hours. Mean SFFH in the control group increased by 243 µm from 624 (±268) µm at baseline to 867 (±303) µm the next morning (p<0.01) but decreased in the posturing group by 150 µm from 728 (±416) to 578 (±445) µm (p=0.03). There was a significant association of the SFFH the next morning with posturing (p<0.01) and SFFH at baseline (p<0.01), but not with location of primary break (p=0.20). The change in SFFH from baseline to the next morning was significantly associated with posturing and primary break location (p<0.01) but not with SFFH at baseline (p=0.21).

Conclusion:

Preoperative posturing is an effective measure to prevent progression of macular detachment in macula-off RD.
MACULAR HOLE IN A PATIENT WITH PENTOSAN POLYSULFATE MACULOPATHY
Authors: Arora Neha , Hoyek Sandra , Patel Nimesh A.
Published: June 2023

Purpose:

Pentosan polysulfate (PPS), a drug used for interstitial cystitis, has recently been detected to cause maculopathy in a dose-dependent manner. Outer retinal atrophy is the hallmark of this condition.

Methods:

History, examination, and multimodal imaging were used to guide diagnosis and management.

Results:

We report a case of PPS-related maculopathy in a 77-year-old lady, who presented with florid retinal atrophy at the posterior pole in both eyes, and a concurrent macular hole in the left eye. She had been diagnosed with interstitial cystitis several years before for which she was prescribed PPS (Elmiron). She had noticed a drop in vision 5 years after initiation of PPS and self-discontinued the drug after 24 years of use. A diagnosis of PPS-related maculopathy with a macular hole was made. She was counselled regarding the prognosis and was advised to avoid PPS. Surgery for macular hole was deferred in view of the severe retinal atrophy.

Conclusion:

Pentosan polysulfate-related maculopathy can lead to severe retinal atrophy and a subsequent degenerative macular hole. A high index of suspicion is required for early detection and cessation of drug to prevent this irreversible vision loss.
The role of gut microbiota in acute pancreatitis: new perspectives in pathogenesis and therapeutic approaches
Authors: Du Zu-Chao , Li Guan-Qun , Luo Yan , Bai Xue-Wei , Sun Bei
Published: June 2023

Acute pancreatitis (AP) is one of the most common acute abdomen diseases with increasing incidence and substantial healthcare burden. Gut microbiota disturbance, mucosal barrier failure, and bacterial translocation are identified as the dominant cause of infected pancreatic necrosis and high mortality. With the advance of high-throughput sequencing, imbalance between beneficial and facultative pathogenic microorganisms with their metabolic activities in the development of AP has been increasingly recognized, whereas it remains unclear whether dysbacteriosis is the dominant cause of aggravating AP, or merely reflecting different epidemiological or environmental factors at the individual level. This review discussed the alterations of the gut microbiota and their metabolites during AP with detailed molecular mechanisms. Importantly, it highlights microbiome-based medical therapies which influence gut barrier function and immune homeostasis to mitigate inflammatory responses in AP. Our review will provide a novel roadmap of gastrointestinal microecology in AP progression, and contribute to the future development of microbiome-based diagnostic and therapeutic strategies in clinical practice.
Meningitis Risk in Patients with Inner Ear Malformations after Cochlear Implants: A Systematic Review and Meta-Analysis
Authors: Gowrishankar Shravan , Fleet Alex , Tomasoni Michele , Kuhn Isla , Tysome James , Smith Matthew E. , Donnelly Neil , Axon Patrick , Borsetto Daniele , Bance Manohar
Published: June 2023

Objective

The objective of this study is to determine the rate of postoperative meningitis after cochlear implantation in those with inner ear malformations (IEMs) via meta-analysis.

Data sources

Medline, EMBASE, and the Cochrane Library.

Methods

This study was reported following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist. Proportion meta-analysis was conducted through an inverse variance random-effect model based on arcsin transformation and presented as forest plots. Quality assessment of the included studies was performed through the National Institutes of Health Quality Assessment Tool.

Results

Overall, 38 of 2966 studies met the inclusion criteria and were included in the analysis. There were 10 cases of meningitis after cochlear implantation in 1300 malformed ears. The overall rate of meningitis after cochlear implantation in IEMs was 0.12% (95% confidence interval, 0.006–0.380%; I
2 = 0%). Cases occurred in incomplete partition (n = 5), Mondini deformity (n = 2), common cavity (n = 2), and enlarged internal auditory canal (n = 1). Six of 10 cases of postoperative meningitis occurred with an intraoperative cerebrospinal fluid leak.

Conclusion

In those with IEMs, the risk of meningitis after cochlear implantation is very low.
Long-Term Hearing Outcomes After Hybrid Cochlear Implantation
Authors: Salmon Mandy K. , Quimby Alexandra E. , Bartellas Michael , Kaufman Hannah S. , Bigelow Douglas C. , Brant Jason A. , Ruckenstein Michael J.
Published: June 2023

Objective

To examine long-term (>5 yr) low-frequency hearing preservation after hybrid cochlear implantation.

Study Design

Retrospective cross-sectional study.

Setting

Tertiary care center outpatient clinic.

Patients

All patients older than 21 years implanted with a Cochlear Hybrid L24 device from 2014 to 2021.

Main Outcome Measure

Changes in low-frequency pure-tone average (LFPTA) were calculated at each of several time points relative to the date of implantation. The proportion of patients with preserved LFPTA at last follow-up and Kaplan-Meier estimates for loss of residual hearing were calculated in addition to hazard ratios for hearing loss according to patient- and surgery-specific factors.

Results

Thirty ears in 29 patients underwent hybrid cochlear implantation and were eligible for inclusion (mean age, 59 yr; 65% female). Mean preoperative LFPTA was 31.7 dB. Mean LFPTA across all implanted ears at first follow-up was 45.1 dB; no patient had experienced loss of residual hearing at first follow-up. Six patients had loss of residual hearing during the follow-up period, with Kaplan-Meier probability estimates of preserved hearing of 100% at 1 month, 90% at 12 months, 87% at 24 months, and 80% at 48 months. There was no association between loss of residual hearing and patient age, preoperative LFPTA, surgeon, or use of topical steroids intraoperatively (hazard ratios, 1.05 [0.96–1.15], 0.97 [0.88–1.05], 1.39 [0.20–9.46], 0.93 [0.09–9.74], respectively).

Conclusions

Long-term (>5 yr) outcomes after hybrid cochlear implantation demonstrate good preservation of low-frequency hearing, with only modest decline in the long-term postimplantation, and a low proportion of loss of residual low-frequency hearing.
Death and Ultrasound Evidence of the Akinetic Heart in Pediatric Cardiac Arrest
Authors: Su Erik , Dutko Amy , Ginsburg Sarah , Lasa Javier J. , Nakagawa Thomas A.
Published: June 2023

Point-of-care ultrasound (POCUS) is an expanding noninvasive diagnostic modality used for the management of patients in multiple intensive care and pediatric specialties. POCUS is used to assess cardiac activity and pathology, pulmonary disease, intravascular volume status, intra-abdominal processes, procedural guidance including vascular access, lumbar puncture, thoracentesis, paracentesis, and pericardiocentesis. POCUS has also been used to determine anterograde flow following circulatory arrest when organ donation after circulatory death is being considered. Published guidelines exist from multiple medical societies including the recent guidelines for the use of POCUS in neonatology for diagnostic and procedural purposes.
Low-dose naltrexone for treatment of pain in patients with fibromyalgia: a randomized, double-blind, placebo-controlled, crossover study
Authors: Bested Kirsten , Jensen Lotte M. , Andresen Trine , Tarp Grete , Skovbjerg Louise , Johansen Torben S.D. , Schmedes Anne V. , Storgaard Ida K. , Madsen Jonna S. , Werner Mads U. , Bendiksen Anette
Published: June 2023

Introduction:

Fibromyalgia (FM) is a chronic fluctuating, nociplastic pain condition. Naltrexone is a µ-opioid-receptor antagonist; preliminary studies have indicated a pain-relieving effect of low-dose naltrexone (LDN) in patients with FM. The impetus for studying LDN is the assumption of analgesic efficacy and thus reduction of adverse effects seen from conventional pharmacotherapy.

Objectives:

First, to examine if LDN is associated with analgesic efficacy compared with control in the treatment of patients with FM. Second, to ascertain the analgesic efficacy of LDN in an experimental pain model in patients with FM evaluating the competence of the descending inhibitory pathways compared with controls. Third, to examine the pharmacokinetics of LDN.

Methods:

The study used a randomized, double-blind, placebo-controlled, crossover design and had a 3-phase setup. The first phase included baseline assessment and a treatment period (days −3 to 21), the second phase a washout period (days 22–32), and the third phase a baseline assessment followed by a treatment period (days 33–56). Treatment was with either LDN 4.5 mg or an inactive placebo given orally once daily. The primary outcomes were Fibromyalgia Impact Questionnaire revised (FIQR) scores and summed pain intensity ratings (SPIR).

Results:

Fifty-eight patients with FM were randomized. The median difference (IQR) for FIQR scores between LDN and placebo treatment was −1.65 (18.55; effect size = 0.15; P = 0.3). The median difference for SPIR scores was −0.33 (6.33; effect size = 0.13; P = 0.4).

Conclusion:

Outcome data did not indicate any clinically relevant analgesic efficacy of the LDN treatment in patients with FM.
Evaluating the clinical effects of a dynamic shoulder orthosis
Authors: Haarman Claudia J. W. , Hekman Edsko E. G. , van der Kooij Herman , Rietman Johan S.
Published: June 2023

Background:

Shoulder orthoses reduce the gravitational pull on the shoulder by providing an upward force to the arm, which can decrease shoulder pain caused by stress on the glenohumeral structures.

Objective:

In this interventional study, the clinical effects of a recently developed dynamic shoulder orthosis were assessed in 10 patients with chronic shoulder pain. The shoulder orthosis provides an upward force to the arm with 2 elastic bands. These bands are arranged to statically balance the arm, such that the supportive force is always directed toward the glenohumeral joint and shoulder movements are not impeded.

Study design:

Clinical effect study.

Methods:

The study population was provided with a dynamic shoulder orthosis for 2 weeks. In the week before the orthosis fitting, the participants had no intervention. The primary outcome measures were the mean shoulder pain scores before and during the intervention, and the distance between the humeral head and the acromion without and with orthosis.

Results:

Ultrasound evaluation showed that the shoulder orthosis resulted in a reduction of the distance between the acromion and humeral head at different levels of arm support. In addition, it was demonstrated that the mean shoulder pain scores (range 0–10) decreased from 3.6 to 3 (in rest) and from 5.3 to 4.2 (during activities) after 2 weeks of orthosis use. In general, patients were satisfied with the weight, safety, ease in adjusting, and effectiveness of the orthosis.

Conclusions:

The results of this study show that the orthosis has the potential to reduce shoulder complaints in patients with chronic shoulder pain.
Increased Preoperative Stress Test Utilization is Not Associated With Reduced Adverse Cardiac Events in Current US Surgical Practice
Authors: Columbo Jesse A. , Scali Salvatore T. , Neal Dan , Powell Richard J. , Sarosi George , Crippen Cristina , Huber Thomas S. , Soybel David , Wong Sandra L. , Goodney Philip P. , Upchurch Gilbert R. , Stone David H.
Published: June 2023

Objective:

To measure the frequency of preoperative stress testing and its association with perioperative cardiac events.

Background:

There is persistent variation in preoperative stress testing across the United States. It remains unclear whether more testing is associated with reduced perioperative cardiac events.

Methods:

We used the Vizient Clinical Data Base to study patients who underwent 1 of 8 elective major surgical procedures (general, vascular, or oncologic) from 2015 to 2019. We grouped centers into quintiles by frequency of stress test use. We computed a modified revised cardiac risk index (mRCRI) score for included patients. Outcomes included in-hospital major adverse cardiac events (MACEs), myocardial infarction (MI), and cost, which we compared across quintiles of stress test use.

Results:

We identified 185,612 patients from 133 centers. The mean age was 61.7 (±14.2) years, 47.5% were female, and 79.4% were White. Stress testing was performed in 9.2% of patients undergoing surgery, and varied from 1.7% at lowest quintile centers, to 22.5% at highest quintile centers, despite similar mRCRI comorbidity scores (mRCRI>1: 15.0% vs 15.8%; P=0.068). In-hospital MACE was less frequent among lowest versus highest quintile centers (8.2% vs 9.4%; P<0.001) despite a 13-fold difference in stress test use. Event rates were similar for MI (0.5% vs 0.5%; P=0.737). Mean added cost for stress testing per 1000 patients who underwent surgery was $26,996 at lowest quintile centers versus $357,300 at highest quintile centers.

Conclusions:

There is substantial variation in preoperative stress testing across the United States despite similar patient risk profiles. Increased testing was not associated with reduced perioperative MACE or MI. These data suggest that more selective stress testing may be an opportunity for cost savings through a reduction of unnecessary tests.
Assessing the Dose-Dependent Effects of tDCS on Neurometabolites using Magnetic Resonance Spectroscopy
Authors: Shinde Anant , Nagarajan Rajakumar , Gunduz Muhammed Enes , Visintainer Paul , Schlaug Gottfried
Published: June 2023

Concurrent transcranial direct current stimulation (tDCS) and proton Magnetic Resonance Spectroscopy (1H MRS) experiments have shown up- or downregulation of neurotransmitter concentration. However, effects have been modest applying mostly lower current doses and not all studies found significant effects. Dose of stimulation might be an important variable in eliciting a consistent response. To investigate dose effects of tDCS on neurometabolites, we placed an electrode over the left supraorbital region (with a return electrode over the right mastoid bone) and utilized an MRS voxel (3x3x3cm) that was centered over the anterior cingulate/inferior mesial prefrontal region which is in the path of the current distribution. We conducted 5 epochs of acquisition, each one with a 9:18min acquisition time, and applied tDCS in the third epoch. We observed significant dose and polarity dependent modulation of GABA and to a lesser degree of Glutamine/Glutamate (GLX) with the highest and reliable changes seen with the highest current dose, 5mA (current density 0.39 mA/cm2), during and after the stimulation epoch compared with pre-stimulation baselines. The strong effect on GABA concentration (achieving a mean change of 63% from baseline, more than twice as much as reported with lower doses of stimulation) establishes tDCS-dose as an important parameter in eliciting a regional brain engagement and response. Furthermore, our experimental design in examining tDCS parameters and effects using shorter epochs of acquisitions might constitute a framework to explore the tDCS parameter space further and establish measures of regional engagement by non-invasive brain-stimulation.
Multielectrode Network Stimulation (ME-NETS) demonstrated by concurrent tDCS and fMRI
Authors: Ross David A. , Shinde Anant B. , Lerud Karl D , Schlaug Gottfried
Published: June 2023

Non-invasive transcranial direct current stimulation (tDCS) can modulate activity of targeted brain regions. Whether tDCS can reliably and repeatedly modulate intrinsic connectivity of entire brain networks is unclear. We used concurrent tDCS-MRI to investigate the effect of high dose anodal tDCS on resting state connectivity within the Arcuate Fasciculus (AF) network, which spans the temporal, parietal, and frontal lobes and is connected via a structural backbone, the Arcuate Fasciculus (AF) white matter tract. Effects of high-dose tDCS (4mA) delivered via a single electrode placed over one of the AF nodes (single electrode stimulation, SE-S) was compared to the same dose split between multiple electrodes placed over AF-network nodes (multielectrode network stimulation, ME-NETS). While both SE-S and ME-NETS significantly modulated connectivity between AF network nodes (increasing connectivity during stimulation epochs), ME-NETS had a significantly larger and more reliable effect than SE-S. Moreover, comparison with a control network, the Inferior Longitudinal Fasciculus (ILF) network suggested that the effect of ME-NETS on connectivity was specific to the targeted AF-network. This finding was further supported by the results of a seed-to-voxel analysis wherein we found ME-NETS primarily modulated connectivity between AF-network nodes. Finally, an exploratory analysis looking at dynamic connectivity using sliding window correlation found strong and immediate modulation of connectivity during three stimulation epochs within the same imaging session.
Cohort Profile: Born in Wales - a birth cohort with maternity, parental, and child data linkage for life course research in Wales, UK
Authors: Jones HE , Seaborne MJ , Kennedy NL , James ML , Dredge S , Bandyopadhyay A , Battaglia A , Davies S , Brophy S
Published: June 2023

Purpose

Parental and neonatal child health and education records have been linked to provide an entire country birth cohort, to examine what will improve the health and wellbeing of families growing up in Wales. Established in 2020, Born in Wales utilised data linkage techniques to connect information from the 2011 census with health, social care, and education routine data in the Secure Anonymised Information Linkage (SAIL) Databank. We present the descriptive data available in the linked database, emphasise the robust data security and governance frameworks, and present the future expansion plans for the database beyond its initial development stage.

Participants

Descriptive information from 2011 to 2023 has been gathered from SAIL. This comprehensive dataset comprises over 400,000 child electronic records. To augment this data, the Born in Wales and primary school surveys have contributed quantitative and qualitative responses.

Findings to date

The cohort comprises all children born in Wales since 2011, with follow-up conducted until they finish primary school at age 11. 2,500 parents and 30,000 primary school children have been recruited for enhanced data collection and linkage to the data spine. The child cohort is 51%: 49% female: male, and 6% are from ethnic minority backgrounds. When considering age distribution, 26.8% of children are under the age of 5, while 63.2% fall within the age range of 5-11.

Future plans

Born in Wales will expand by 30,000 new births annually in Wales, while including follow-up data of children and parents already in the database. Supplementary datasets complement the existing linkage, including primary care, hospital data, educational attainment and social care. Future research includes exploring the long-term implications of COVID-19 on child health and development, the influence of environmental factors including climate change on health and examining the impact of parental work environment on child health and development.

Strengths and limitations of this study

Born in Wales has established a comprehensive, Wales-wide population-based database which consolidates clinical data from maternity, neonatal, child health, and education records.

This national-scale database is supplemented by quantitative and qualitative results from surveys conducted by Born in Wales, providing rich insights into details that cannot be obtained through routinely collected data.

The existence of this database enables further data linkage, facilitating life course research on the health and wellbeing of the Wales population.

Missing data or errors in routine and administrative data may be constraint.

A potential restriction of Born in Wales is the loss of data pertaining to individuals who relocate outside of Wales during pregnancy or after the child’s birth.