bluuebunny/crossref_metadata_2025 huggingface dataset:
Chromosome-level Genome of the Muskrat (Ondatra zibethicus)
Authors: Li Haimeng , Shi Minhui , Wang Qing , Xia Tian , Sahu Sunil Kumar , Zhang Yu , Wang Jiangang , Li Tianfeng , Ma Yue , Liu Tianlu , Liu Huan , Lan Tianming , Bai Suying
Published: September 2022

The muskrat (Ondatra zibethicus) is a semi-aquatic rodent species with ecological, economic, and medicinal importance. Here, we present an improved genome assembly, which is the first high-quality chromosome-level genome of the muskrat with high completeness and contiguity assembled using single-tube long fragment read, BGISEQ, and Hi-C sequencing technologies. The genome size of the final assembly was 2.63 Gb with 27 pseudochromosomes. The length of scaffold N50 reached 80.25 Mb with a Benchmarking Universal Single-Copy Ortholog score of 91.3%. We identified a 66.98 Mb X chromosome and a 1.14-Mb Y-linked genome region, and these sex-linked regions were validated by resequencing 32 extra male individuals. We predicted 19,396 protein-coding genes, among which 19,395 (99.99%) were functionally annotated. The expanded gene families in the muskrat genome were found to be enriched in several organic synthesis- and metabolism-related Gene Ontology terms, suggesting the likely genomic basis for the production and secretion of musk. This chromosome-level genome represents a valuable resource for improving our understanding of muskrat ecology and musk secretion.
Structural properties of the Southern San Andreas fault zone in northern Coachella Valley from magnetotelluric imaging
Authors: Share Pieter-Ewald , Peacock Jared R , Constable Steven , Vernon Frank L , Wang Shunguo
Published: September 2022

The Southern San Andreas fault (SSAF) poses one of the largest seismic risks in California. Yet, there is much ambiguity regarding its deeper structural properties around Coachella Valley, in large part due to the relative paucity of everyday seismicity. Here, we image a multistranded section of the SSAF using a non-seismic method, namely magnetotelluric (MT) soundings, to help inform depth-dependent fault zone geometry, fluid content and porosity. The acquired MT data and resultant inversion models highlight a conductive column encompassing the SSAF zone that includes a 2–3 km wide vertical to steeply northeast dipping conductor down to ∼4 km depth (maximum of ∼1 Ω·m at 2 km depth) and another prominent conductor in the ductile crust (∼1 Ω·m at 12 km depth and slightly southwest of the surface SSAF). We estimate porosities of 18–44 per cent for the conductive uppermost 500 m, a 10–15 per cent porosity at 2 km depth and that small amounts (0.1–3 per cent) of interconnected hypersaline fluids produce the deeper conductor. Located northeast of this conductive region is mostly resistive crust indicating dry crystalline rock that extends down to ∼20 km in places. Most of the local seismicity is associated with this resistive region. Located farther northeast still is a conductive region at >13 km depth and separate from the one to the southwest. The imaged anomalies permit two interpretations. The SSAF zone is vertical to steeply northeast dipping in the upper crust and (1) is near vertical at greater depth creating mostly an impermeable barrier for northeast fluid migration or (2) continues to dip northeast but is relatively dry and resistive up to ∼13 km depth where it manifests as a secondary deep ductile crustal conductor. Taken together with existing knowledge, the first interpretation is more likely but more MT investigations are required.
Mutant PfCRT Can Mediate Piperaquine Resistance in African Plasmodium falciparum With Reduced Fitness and Increased Susceptibility to Other Antimalarials
Authors: Wicht Kathryn J , Small-Saunders Jennifer L , Hagenah Laura M , Mok Sachel , Fidock David A
Published: September 2022

Background

Additional therapeutic strategies could benefit efforts to reverse the recent increase in malaria cases in sub-Saharan Africa, which mostly affects young children. A primary candidate is dihydroartemisinin + piperaquine (DHA + PPQ), which is effective for uncomplicated malaria treatment, seasonal malaria chemoprevention, and intermittent preventive treatment. In Southeast Asia, Plasmodium falciparum parasites acquired PPQ resistance, mediated primarily by mutations in the P falciparum chloroquine resistance transporter PfCRT. The recent emergence in Africa of DHA-resistant parasites creates an imperative to assess whether PPQ resistance could emerge in African parasites with distinct PfCRT isoforms.

Methods

We edited 2 PfCRT mutations known to mediate high-grade PPQ resistance in Southeast Asia into GB4 parasites from Gabon. Gene-edited clones were profiled in antimalarial concentration-response and fitness assays.

Results

The PfCRT F145I mutation mediated moderate PPQ resistance in GB4 parasites but with a substantial fitness cost. No resistance was observed with the PfCRT G353V mutant. Both edited clones became significantly more susceptible to amodiaquine, chloroquine, and quinine.

Conclusions

A single PfCRT mutation can mediate PPQ resistance in GB4 parasites, but with a growth defect that may preclude its spread without further genetic adaptations. Our findings support regional use of drug combinations that exert opposing selective pressures on PfCRT.
Longitudinal Evaluation of Antibody Persistence in Mother-Infant Dyads After Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Pregnancy
Authors: Cambou Mary C , Liu Christine M , Mok Thalia , Fajardo-Martinez Viviana , Paiola Sophia G , Ibarrondo Francisco J , Kerin Tara , Fuller Trevon , Tobin Nicole H , Garcia Gustavo , Bhattacharya Debika , Aldrovandi Grace M , Arumugaswami Vaithilingaraja , Foo Suan-Sin , Jung Jae U , Vasconcelos Zilton , Brasil Patricia , Brendolin Michelle , Yang Otto O , Rao Rashmi , Nielsen-Saines Karin
Published: September 2022

Background

There are limited data on how coronavirus disease 2019 (COVID-19) severity, timing of infection, and subsequent vaccination impact transplacental transfer and persistence of maternal and infant antibodies.

Methods

In a longitudinal cohort of pregnant women with polymerase chain reaction-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, maternal/infant sera were collected at enrollment, delivery/birth, and 6 months. Anti-SARS-CoV-2 spike immunoglobulin (Ig)G, IgM, and IgA were measured by enzyme-linked immunosorbent assay.

Results

Two-hundred fifty-six pregnant women and 135 infants were enrolled; 148 maternal and 122 neonatal specimens were collected at delivery/birth; 45 maternal and 48 infant specimens were collected at 6 months. Sixty-eight percent of women produced all anti-SARS-CoV-2 isotypes at delivery (IgG, IgM, IgA); 96% had at least 1 isotype. Symptomatic disease and vaccination before delivery were associated with higher maternal IgG at labor and delivery. Detectable IgG in infants dropped from 78% at birth to 52% at 6 months. In the multivariate analysis evaluating factors associated with detectable IgG in infants at delivery, significant predictors were 3rd trimester infection (odds ratio [OR] = 4.0), mild/moderate disease (OR = 4.8), severe/critical disease (OR = 6.3), and maternal vaccination before delivery (OR = 18.8). No factors were significant in the multivariate analysis at 6 months postpartum.

Conclusions

Vaccination in pregnancy post-COVID-19 recovery is a strategy for boosting antibodies in mother-infant dyads.
A Theoretical Framework for Law and Macro-Finance
Authors: Borowicz M Konrad
Published: September 2022

This article considers the effects of legal protections of creditors within the macro-financial theory of leverage cycles developed by John Geanakoplos. The theory posits that leverage is procyclical. I propose a theoretical framework, ‘Law and Macro-Finance’, comprising two main clams: (1) the strength of legal protections of creditors has an impact on the quantum of debt creditors are willing to underwrite not just the interest rate on that debt and (2) that quantum varies across the cycle in a procyclical fashion. In a boom, when asset prices are higher, leverage decreases, creating incentives for creditors to underwrite additional leverage secured on those assets without increasing the interest rate. The stronger the legal protections of creditors, the stronger the incentives to underwrite additional leverage based solely on the increasing value of the collateral. By creating such incentives, strong legal protections of creditors, associated with claims designated in the law as ‘bankruptcy remote’, will accelerate the boom and increase the vulnerability of the economy to shocks. On the normative side, this article proposes a countercyclical design of strong legal protections of creditors. The design makes the availability of such protections, typically achieved by reliance on the legal doctrine of ‘true sales’, conditioned on the adequacy of the price paid in the transaction. The adequacy, in turn, is determined in reference to the applicable schedule of collateral haircuts determined by the central bank.
Spatial and phase resolution in electron microscopy
Authors: Ishikawa Ryo , Morishita Shigeyuki , Tanigaki Toshiaki , Shibata Naoya , Ikuhara Yuichi
Published: September 2022

With the invention of the aberration corrector in electron optics, the spatial resolution in electron microscopy has progressively improved and has now reached the sub-50-pm regime, and atomic-resolution electron microscopy has become a versatile tool for investigating the atomic structures in materials and devices. Furthermore, the phase resolution in electron microscopy also exhibits outstanding progress, and it has become possible to visualize electromagnetic fields at atomic dimensions, which strongly contributes to understanding the physical and chemical properties of materials. The electron microscopy society has grown with the improvements in spatial and phase resolutions, and hence, we must continuously develop new hardware, software and methodologies to boost these resolutions. Here, we review the historical progress of spatial and phase resolutions in electron microscopy, where we clarify the definition of these resolutions. We also discuss the future targets in electron microscopy.
Characterization of Cervus timorensis velvet antler and its effect on biofilm formation of Candida species
Authors: Mohd Badri Puteri Elysa Alia , Rismayuddin Nurul Alia Risma , Kenali Norzaiti Mohd , Darnis Deny Susanti , Arzmi Mohd Hafiz
Published: September 2022

Oral biofilms comprise extracellular polysaccharides and polymicrobial microorganisms. The objectives of the study were to characterize the deer velvet antler (DVA) compounds and their effect on Candida species biofilm formation with the hypothesis that DVA inhibits the biofilm of Candida spp. Liquid Chromatography-Quadrupole Time of Flight-Mass Spectrometry (LC-QTOF-MS) was conducted to characterize the DVA compounds. To study the effect of DVA on biofilm, Candida albicans ATCC MYA-4901 (ALT5), AIDS isolate (ALC2), oral cancer isolate (ALC3), C. dubliniensis ATCC MYA-2975, C. glabrata ATCC 90030, C. krusei 14 243, C. lusitaniae ATCC 34449, C. parapsilosis ATCC 22019, and C. tropicalis ATCC 13803 were inoculated with DVA in separate wells of a 96-well plate containing RPMI-1640 followed by 72 h incubation. A total of 45 compounds were detected in the DVA extract. C. lusitaniae exhibited a higher percentage of biofilm biomass reduction when treated with DVA extract (66.10% ± 5.33), followed by ALC3 (44.12% ± 6.24). However, C. glabrata, C. krusei, and C. parapsilosis showed no reduction in biofilm biomass after being treated with DVA extract. Most Candida strains also exhibited decreased total cell count when treated with DVA extract, except for ALC3 and C. krusei. ALT5 had the lowest total cell count (0.17 × 105 cells/ml) when cultured with DVA extract. In conclusion, DVA extract inhibits Candida spp. biofilm formation except for C. glabrata, C. krusei, and C. parapsilosis.
A 3.8 yr optical quasi-periodic oscillations in blue quasar SDSS J132144+033055 through combined light curves from CSS and ZTF
Authors: Zhang XueGuang
Published: September 2022

In the manuscript, a 3.8 yr optical quasi-periodic oscillations (QPOs) is reported in blue quasar SDSS J132144+033055 (= SDSS J1321) at z = 0.269, based on 16.3yr-long light curve from both CSS and ZTF directly described by a sinusoidal function. The 3.8 yr QPOs can be confirmed through the Generalized Lomb–Scargle periodogram with confidence level higher than 5σ, through properties of the phase-folded light curve and the WWZ technique. Moreover, the collected Pan-STARRS light curves well follow the sinusoidal function described best fitting results to the Catalina Sky Survey (CSS) and Catalina Sky Survey (ZTF) light curves. The optical QPOs strongly indicate a central binary black hole (BBH) system in SDSS J1321, with expected space separation smaller than 0.018 pc, through the estimated upper limit of total BH mass 3.3 × 109 M⊙ through the correlation between BH mass and continuum luminosity. Meanwhile, we check disc precession applied to explain the optical QPOs. However, under the disc precession assumption, the determined optical emission regions from central BH have sizes about 37RG similar as the sizes 35RG of the expected NUV emission regions through the correlation between disc size and BH mass, indicating the disc precession is not preferred. And due to undetected radio emissions, jet precession can be ruled out. Furthermore, only 0.1 per cent probability can determined as the QPOs mis-detected through CAR process randomly created light curves related to intrinsic AGN activities, re-confirming the optical QPOs with significance level higher than 3σ. Therefore, combining long-term light curves from CSS and ZTF can lead to more QPOs candidates in the near future.
Fine’s Monster Objection Defanged
Authors: Costa Damiano , Cecconi Alessandro , Calosi Claudio
Published: September 2022

The Monster Objection has often been considered one of the main reasons to explore non-standard mereological views, such as hylomorphism. Still, it has been rarely discussed and then only in a cursory fashion. This paper fills this gap by offering the first thorough assessment of the objection. It argues that different metaphysical stances, such as presentism and three- and four-dimensionalism, provide different ways of undermining the objection.
Original Research: ‘It Would Be Nice to Think We Could Have a Voice’: Exploring RN Involvement in Hospital Staffing Policymaking
Authors: Bartmess Marissa P. , Myers Carole R. , Thomas Sandra P.
Published: September 2022

Background:

Hospitalized patient and nursing outcomes improve when nurses are involved in decision-making practices through shared governance structures. Yet there has been little research investigating how staff nurses are involved in hospital staffing policymaking and how they perceive this process.

Purpose:

The study's primary aims were to increase understanding of staff nurses' perceptions of factors that hinder or support nurse involvement in hospital nurse staffing policymaking and to learn more about how nurses are, or would like to be, so involved. We also collected nurses' work environment and demographic information to further inform our understanding.

Methods:

This study used a qualitative descriptive approach. Using QuestionPro software, we solicited open-ended responses to semistructured questions to explore the topics of interest. The online form was distributed via social media. Results were analyzed using conventional content analysis. Multiple-choice questions related to demographics and nurse work environments were also included, and these results were analyzed using descriptive statistics.

Results:

Thirty-two staff nurses completed the online form between April 5 and May 24, 2021. Identified themes include “We aren't asked”: structural barriers to staff nurse involvement; “No one cares”: workplace culture barriers to staff nurse involvement; and “‘They’ versus ‘we’”: lack of power sharing for staffing decision-making. Participants described feeling powerless with regard to, and having little to no involvement in, hospital staffing policymaking. Yet they also expressed their desire to be engaged in this process and offered suggestions for how nurse involvement in such policymaking could be improved.

Conclusion:

Our findings provide crucial insight into how organizations can address existing structural barriers to nurse involvement, offer more equitable opportunities for nurse involvement, foster more inclusive workplace cultures, and recognize the value of nurse input and autonomy regarding staffing decisions.
The Impaired Nurse
Authors: Salani Deborah , Goldin Deana , Valdes Beatriz , McKay Mary
Published: September 2022

Substance use disorders (SUDs) do not discriminate. Anyone can be affected regardless of age, sex, ethnicity, socioeconomic status, or profession. Nurses with SUDs present serious risks to both their patients and the nursing profession. Frontline nurses' responsibility to provide patients with safe, high-quality care may be too great a challenge for those with SUDs, resulting in adverse consequences. Early recognition and treatment of nurses with SUDs promotes patient safety and retention in the profession. For this reason, all nurses and other health care professionals should be able to recognize behaviors associated with SUDs and should be familiar with the available treatment modalities.
Perceived Role of Asian Indian Fathers in Florida During Mealtimes
Authors: Krishnakumar Priya , Coccia Catherine
Published: September 2022

Research has shown that fathers play an important role in children's mealtimes and dietary habits; yet, little is known about the factors that affect how fathers perceive this role, especially among Asian Indians. This study aimed to examine how Asian Indian fathers perceive their role during child mealtimes and the factors that are associated with fathers' mealtime perceptions. Eighty Asian Indian fathers of 6- to 11-year-old children completed an online survey including measures of demographics, acculturation, gender roles, nutrition knowledge, parental self-efficacy, perceived child weight, and the role of father at mealtime (ROFM). Data were analyzed using descriptive statistics and linear regression. Participants perceived a moderately high level of responsibility during child mealtimes. Regression analysis showed that fathers who had higher income, perceived child weight as being higher, and had higher self-efficacy in feeding children healthy food had higher ROFM. Higher father nutrition knowledge was correlated with lower perceived ROFM, indicating a lack of confidence in utilizing their nutrition knowledge during child mealtimes. The results indicate potential targets to improve Asian Indian fathers' involvement during child mealtimes. These results could be utilized to enhance their engagement in child mealtime healthy eating practices and for childhood obesity prevention.
Compounding of Low-Concentration Atropine for Myopia Control
Authors: Richdale Kathryn , Tomiyama Erin S. , Novack Gary D. , Bullimore Mark A.
Published: September 2022

Objectives:

Low-concentration atropine is commonly prescribed to slow myopia progression in children but is not Food and Drug Administration–approved for that indication and is only available in the United States from compounding pharmacies. The purpose of this study was to ascertain its reported compounding and labeling in the United States.

Methods:

US compounding pharmacies were identified through a survey of eye doctors, social media, conferences, and web search. Twenty-eight pharmacies were identified and contacted through telephone and asked a standard set of questions about their methods to compound and label low-concentration atropine.

Results:

Twenty-six pharmacies across 19 states provided responses, with 21 answering all nine items (81%) and a mean of 8.7 of nine responses. The most frequently reported bottle size was 5 mL (interquartile range [IQR]: 3.5–10). For storage, 10 pharmacies (38%) recommended refrigeration and 16 (62%) stated room temperature was sufficient. The median beyond-use date provided was 65 days (IQR: 45–158). For preparation, 12 pharmacies (50%) used commercially available 1% solution, 9 (38%) used powdered atropine, 2 (8%) used both, and 1 (4%) stated their approach was proprietary. For the added excipients, 11 (42%) used artificial tears only, 6 (23%) added 0.9% saline only, 7 (27%) used more than one ingredient, and 2 (8%) were proprietary. Only two pharmacies mentioned adding boric acid and two mentioned “pH-adjusted” saline.

Conclusions:

There were a wide variety of formulation methods in the United States, which may affect atropine stability and potency. Similarly, there are a wide variety of storage and beyond-use recommendations. Further research is needed to assess how these variations may affect the efficacy and safety of low-concentration atropine and of myopia control.
High Morbidity of Mycobacterial Infections Following Cosmetic Surgery Tourism
Authors: Massand Sameer , Butterfield James A. , Lee Charles C. , Ingraham John M. , Potochny John D.
Published: September 2022

Background

Medical tourism is an increasingly popular practice among cosmetic surgery patients. These procedures place patients at risk of infection by rapidly growing Mycobacterium. Rapidly growing Mycobacterium (RGM) is a relatively rare infection within developed nations. Management options vary, although all pose significant morbidity to patients. We present 2 cases treated at our institution and a comprehensive literature review of RGM infection in patients who have undergone cosmetic surgery in developing nations, analyzing its associated morbidity.

Methods

This is a review of institutional records for patients with RGM infections after cosmetic surgery tourism was performed. A comprehensive literature search was conducted to identify reports of similar cases. Individual treatment courses were reviewed and descriptive statistics performed for management and associated morbidities.

Results

Two patients underwent abdominoplasty in a developing nation and later presented to our institution with mycobacterial infection. They underwent a combined 7 procedures, received a combined 3 years of antibiotic therapy, and accounted for 1 line-associated deep venous thrombosis and line-associated bacteremia. Thirty-five similar cases were identified by literature review. Patients underwent an average of 2.4 surgical procedures and received antibiotics for an average of 8.7 months. At least half of the patients (51%) required medication adjustment due to adverse effects or expense. Further morbidities encountered were financial hardship, psychological distress, and scar hypersensitivity.

Conclusion

Patients who undergo cosmetic surgery as medical tourists are placed at risk of infection by rapidly growing mycobacterial species. Management is highly morbid, and they are often left with extensive surgical scarring and unanticipated additional out-of-pocket expense.
No association of postoperative opioid usage with long-term surgery outcomes in patients with liver cancer: a population-based retrospective cohort study
Authors: Yeh Pin-Hung , Yeh Han-Wei , Yang Shun-Fa , Wang Yu-Hsun , Chou Ming-Chih , Tsai Ping-Kun , Yeh Chao-Bin
Published: September 2022

Hepatocellular carcinoma (HCC) is a fatal cancer worldwide, and surgical resection remains the standard treatment. Postoperative opioid prescription has been believed to affect cancer recurrence through complex biological pathways. We conducted a retrospective cohort study using the Longitudinal Health Insurance Database of Taiwan to evaluate the relationship between postoperative opioid use and long-term surgical outcomes of patients with HCC. This study had a retrospective cohort design. In total, 812 patients older than 20 years who underwent hepatectomy because of HCC were included. The exposure group comprised patients who used opioids during hospitalization postoperatively. The comparison group included those who never used opioids during hospitalization postoperatively. A Cox proportional hazards model was used to evaluate the overall survival or recurrence-free survival rate between the opioid group and the nonopioid group. A total of 530 patients received opioids postoperatively and 282 patients did not. The hazard ratios of overall survival and recurrence-free survival were 1.10 (95% confidence interval [CI], 0.85-1.41) and 1.15 (95% CI, 0.91-1.46), respectively. Total postoperative opioids were converted into oral morphine milligram equivalents and then divided into 3 equal subgroups: low dose, <40 mg; medium dose, 40 to 144 mg; and high dose, ≥145 mg. The hazard ratios of overall survival were 0.88 (95% CI, 0.63-1.24) for the low-dose group, 1.27 (95% CI, 0.92-1.74) for the medium-dose group, and 1.14 (95% CI, 0.83-1.58) for the high-dose group. Postoperative opioids do not affect overall and recurrence-free survival in patients undergoing hepatectomy or liver transplantation because of HCC. Cancer recurrence should not be a clinical concern regarding postoperative opioid prescription.
Efficacy of semi-customized exercises in preventing low back pain in high school volleyball players: A randomized controlled trial
Authors: Mizoguchi Yasuaki , Akasaka Kiyokazu , Otsudo Takahiro , Shimada Naoki , Naka Hiroyuki
Published: September 2022

Background:

Low back pain (LBP) is a common injury in high school volleyball players. We hypothesized that a prevention program could decrease the incidence of LBP in high school volleyball players. This study was an in-season cluster-randomized controlled trial.

Methods:

We block-randomized 8 high school volleyball teams comprising 70 players aged 15 to 17 years into the intervention (4 teams, 34 players) and control (4 teams, 36 players) groups. The intervention program consisted of 9 physical function tests as well as 1 or 2 self-selected preventive exercises, including dynamic thoracic mobility, trunk stabilization exercises, and static stretching, performed during warm-up. Both groups were followed up for 4 weeks, during which the incidence of LBP was recorded. Physical function tests (back endurance; spinal and back flexibility; active or passive shoulder and trunk range of motion; ankle joint mobility; and iliopsoas, quadriceps, and hamstrings flexibility) were conducted before and after the intervention.

Results:

The intervention group had a significantly lower incidence of LBP (8.8%) than the control group (33.3%) (relative risk, 3.78; 95% confidence interval, 1.17–12.23; P = .017, 1 − β = 0.99). Lumbar extension accounted for nearly 70% of LBP incidences. Most players in the intervention group demonstrated improved physical function associated with the exercises.

Conclusion:

The semi-customized prevention program decreased the incidence of LBP and enhanced the physical function parameter in high school volleyball players.
The relationship between air pollutant levels and aneurysmal subarachnoid hemorrhage
Authors: Kim Jang Hun , Lee Sang-Hoon , Park Se-Heum , Lim Dong-Jun , Park Dong-Hyuk
Published: September 2022

Background:

The relationship between air pollutants, including fine particles (particulate matter [PM] < 10 μm and < 2.5 μm), and aneurysmal subarachnoid hemorrhage (SAH) has been inadequately studied, and the results remain inconclusive. In this study, we attempted to investigate the relationship between air pollutant levels and aneurysmal SAH.

Methods:

Ninety-two patients diagnosed with aneurysmal SAH were retrospectively included in the study. Medical records were reviewed, and levels of pollutants, including those of sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), carbon monoxide (CO), and PM with an aerodynamic diameter < 10 and 2.5 μm (PM10 and PM2.5), were collected from the open-source Air Korea website for a period of 4 days. Independent t-tests were conducted to identify the difference in the pollutant levels between the data obtained on the day of aneurysm rupture (D-0) and the other 3 days (D-7, D-2, and D-1).

Results:

A majority (40.2%) of the patients experienced aneurysm rupture during the fall season when the mean daily pollutant levels were 0.004 ± 0.001 (ppm, SO2), 0.517 ± 0.218 (ppm, CO), 0.02056 ± 0.012 (ppm, O3), 0.02628 ± 0.015 (ppm, NO2), 36.36957 ± 24.538 (μg/m3, PM10), and 19.75581 ± 13.494 (μg/m3, PM2.5), respectively. The level of NO2 was significantly higher on the day of aneurysm rupture (P = .035) than on the other days, while the levels of CO and O3 were nonsignificantly higher (P = .081, P = .055, respectively) on the day of aneurysm rupture than on the other days. There was no significant differences in the PM levels between the 4 days.

Conclusion:

A relationship between PM levels and aneurysm rupture was not identified. Only the levels of classic air pollutant (CO, O3, and NO2) were higher on the aneurysm rupture day than on the other days.
US Generalist Physicians and Groups That Focused Practice in a Single Care Setting
Authors: Ryskina Kira L. , Unruh Mark Aaron , Qian Yuting , Jung Hye-Young
Published: September 2022

Background:

Some generalist physicians whose training prepared them for primary care practice increasingly practice in a facility (eg, hospitals, nursing homes); however, whether this trend was accompanied by a complimentary rise in generalist physicians who focused their practice on office-based care is unknown.

Objectives:

Our objective in this study was to examine trends in the prevalence of generalist physicians and physician groups that practice in a single setting.

Research Design:

This was a retrospective cross-sectional study of generalist physicians trained in family medicine, internal medicine, or geriatrics. We used 2014–2017 billing data for Medicare fee-for-service beneficiaries to measure the proportion of all patient visits made by physicians in the following care settings: office, outpatient hospital department, inpatient hospital, and other sites.

Results:

From 2014 to 2017, the proportion of generalist physicians who narrowed their practice to a single setting increased by 6.69% (from 62.80% to 67.00%, pfor trend<0.001). In 2017, 4.63% of physician groups included more than 1 type of setting-based physicians.

Conclusions:

Generalist physicians treating older adults increasingly narrowed their practice focus to a single type of health care setting. This trend was not accompanied by growth among physician groups that included different types of setting-based physicians. Further evaluation of the consequences of these trends on the fragmentation of primary care delivery across different health care settings and primary care outcomes is needed.
Resolution of apolipoprotein A1 and A2 proteoforms: their cardiometabolic correlates and implications for future research
Authors: Wilkins John T. , Rohatgi Anand
Published: September 2022

Purpose of review

A ‘proteoform’ is defined as one specific protein structural form that results from the combination of allelic variation, alternative RNA splicing, and/or posttranslational modifications (PTMs) in specific locations on the amino acid backbone. Apolipoproteins A1 and A2 are highly abundant apolipoproteins that mediate HDL structure and function. ApoA1 and apoA2 are known to undergo PTMs, which results in multiple proteoforms. However, the catalogue of apoA1 and apoA2 proteoforms as well as their associations with cardiometabolic health characteristics has not been described until recently. In this brief review, we discuss recent efforts to catalogue the spectrum of apoA1 and apoA2 proteoforms, to understand the relationships between the relative abundance of these proteoforms with cardiometabolic phenotypic characteristics, and we will discuss the implications of these findings to future research.

Recent findings

A broad spectrum of apoA1 and apoA2 proteoforms has been characterized. Although, the types of apoA1 and A2 proteoforms are consistent across individuals, the relative abundances of proteoforms can vary substantially between individuals. Proteoform-specific associations with cardiometabolic characteristics in humans, independent of absolute apolipoprotein abundance, have been described. These recent findings suggest multiple levels of protein structural variation that arise from known and unknown metabolic pathways may be important markers or mediators of cardiometabolic health.

Understanding the associations between apolipoprotein proteoforms and phenotype may lead to enhanced understanding of how apolipoproteins mediate lipid metabolism and affect atherosclerotic cardiovascular disease (ASCVD) risk, which may lead to discovery of novel markers of risk and/or key mechanistic insights that may drive further druggable targets for modifying lipid metabolism and reducing ASCVD risk.
Prenatal genetic testing 1: screening tests
Authors: Jenkins Morgan , Seasely Angela R. , Subramaniam Akila
Published: September 2022

Purpose of review

Prenatal genetic testing can be divided into two categories: screening and diagnostic. This article will focus on reviewing prenatal genetic screening tests.

Recent findings

Cell-free DNA (cfDNA) is a new prenatal genetic screening test with a high degree of accuracy for identifying certain genetic conditions like trisomy 21, 18, and 13. However, cfDNA has also been applied in the screening of other genetic conditions without similar research support.

Prenatal genetic screening evaluates at risk pregnancies - including both carrier screening, which can be done at any point in a person's life, and aneuploidy screening, which is done during pregnancy. Within screening, there is a new noninvasive technology that has revolutionized prenatal screening called cfDNA testing. Compared to previous methods, this technology is easier to administer and more accurate for certain genetic conditions. However, cfDNA has also been applied to test for less common genetic conditions without efficacious research support. In this time of expansion in genetic testing, it is important that providers educate themselves on the research support behind each type of genetic test. It is vital that professional organizations continuously update their testing approach to match these rapidly evolving technologies and the patient population they serve.
Metabolic syndrome, obesity and cancer risk
Authors: Belladelli Federico , Montorsi Francesco , Martini Alberto
Published: September 2022

Purpose of review

This review aims to report the latest discoveries regarding the relationship between BMI, obesity, and cancer development and treatment.

Recent findings

Obesity and metabolic syndrome relationships with cancer have been deeply investigated in the literature but their association is still debated. Currently, it has been recorded an association between BMI and endometrial, colorectal, gastric, liver, bladder, and prostate cancer. The mechanisms behind this association have also been investigated. It has been hypothesized that chronic inflammation determined by obesity may concur to the development of tumors and that Insulin Resistance may enhance cell proliferation directly or indirectly. Moreover, different studies suggest that the relationship between higher BMI and cancer may include metabolic disturbances comparable to those linked to metabolic syndrome. However, greater weight has been linked to a better overall prognosis in patients with advanced disease, a concept called the obesity paradox. This paradox has been recently investigated in the context of urological malignancies, such as bladder, prostate, and kidney cancer.

Patients’ metabolic and morphological status may impact their risk of developing different types of tumors and the response to systemic therapy. However, further research is necessary to better delineate the mechanisms behind these associations and how they could or should affect medical decision.
Dying in Isolation: An Islamic Perspective on End-of-Life Care During COVID-19
Authors: Mahmoud Sally , Moughrabi Samira M. , Khasawneh Wafa F.
Published: September 2022

COVID-19 has taken 1 million lives as of March 22, 2022. The restrictions and enforced social distancing imposed because of the COVID-19 pandemic adversely affected the way people die, often alone in hospitals without their family members or loved ones by their side. Religious and cultural beliefs predominantly influence every aspect of people's lives, especially during the end of life (EOL). Islam is the fastest growing religion worldwide after Christianity and the third most practiced religion in the United States. The Islamic religion specifies how Muslim practice health and wellness, death, and EOL care. Islamic teachings provide a roadmap on EOL practices and death rituals that must be followed by the practicing individual. Scarce empirical studies exist on practices and rituals of Muslims near death and dying. Therefore, the aim of this case report is to provide a practical framework for health care practitioners to understand essential Islamic EOL practices and provide resources to guide clinical practice.
FGFR1 Antibody Validation and Characterization of FGFR1 Protein Expression in ER+ Breast Cancer
Authors: Gonzalez-Ericsson Paula I. , Servetto Alberto , Formisano Luigi , Sánchez Violeta , Mayer Ingrid A. , Arteaga Carlos L. , Sanders Melinda E.
Published: September 2022

Clinical trials in patients with ER+ breast cancer with or without FGFR pathway somatic alterations have shown limited clinical benefit from treatment with FGFR tyrosine kinase inhibitors alone or in combination with endocrine therapy. This is likely because of an inadequate predictive biomarker to select appropriate patients. In this study, we evaluated 4 anti-FGFR1 antibodies in breast cancer cell lines and patient-derived xenografts with FGFR1 amplification. We correlated D8E4 expression in 209 tumors from postmenopausal patients with stage I-III operable ER+ breast cancer with FGFR1 amplification status as determined by fluorescence in situ hybridization. FGFR1 amplification was identified in 10% of tumors (21/209), 80% of which exhibited membranous FGFR1 expression; however, only 50% of amplified cases showed strong, complete membranous staining (3+) based on established criteria to score HER2 by immunohistochemistry. These findings suggest the combined evaluation of FGFR1 status by immunohistochemistry and fluorescence in situ hybridization may need to be incorporated into the selection of patients for trials with FGFR inhibitors.
The underlying mechanisms of sports injuries in Paralympic Goalball – a mixed-method study
Authors: Rebai Malek , Tan Rin , Vanlandewijck Yves , Derman Wayne , Webborn Nick , Fagher Kristina
Published: September 2022

Objective

Data from the Paralympic Games indicate a fluctuating injury incidence in the Paralympic sport Goalball, but the mechanisms behind have not been explored. The aims of this study were to; i) quantitatively analyze Goalball injuries reported in the London 2012 and Rio 2016 Paralympic Games, ii) qualitatively explain the differences between both Games, and iii) qualitatively assess general injury mechanisms and prevention opportunities of injuries in Goalball.

Design

This was a mixed-method study. Injury incidence rate (IR) were analysed from data collected during the 2012 and 2016 Paralympic Games. Then, semi-structured interviews of Games participants qualitatively explored injury mechanisms and prevention opportunities.

Results

A reduction of injuries occurred from 2012 (IR: 19.5; 95% CI 12.5- 26.5) to 2016 (IR: 5.6; 95% CI 1.7-9.5). In both Games, acute traumatic injuries were most common. Female athletes reported higher rate of injuries compared to males (p = 0.05). Qualitative data revealed that causes of injuries were collisions, overuse and poor physical conditioning. The differences between the two Games were explained by equipment, environment, and preparations.

Conclusion

The result from this study indicates that injuries in Goalball are multifactorial. Ultimately, the mixed-method data from this study can help the sports context to develop prevention measures.
Improving Vitamin D Screening in a Pediatric Rheumatology Clinic Using Structured Quality Improvement Process
Authors: Sarkissian Aliese , Oberle Edward , Al Ahmed Ohoud , Piccinich Dawn , Barbar-Smiley Fatima , Zak Helen , Sivaraman Vidya
Published: September 2022

Introduction:

Monitoring levels of 25-hydroxyvitamin D (25-OHD) is an integral part of bone health assessment in the general pediatric population, especially in at-risk populations such as children with juvenile idiopathic arthritis (JIA), childhood-onset systemic lupus erythematosus (c-SLE), and juvenile dermatomyositis (JDM). However, only 38% of the patients with JIA, c-SLE, and JDM receiving care at Nationwide Children’s Hospital Rheumatology clinic in 2016 had a 25-OHD level ordered in the preceding year. The objective of this project was to increase the percentage of 25-OHD levels ordered in patients with JIA, c-SLE, and JDM from 38% to 80% in 11 months and sustain it for 6 months.

Methods:

A multidisciplinary team initiated a continuous improvement project utilizing the Lean Six Sigma methodology. The team diagrammed the clinical process and identified steps that needed improvement. In addition, the team completed a root cause analysis of the process and brainstormed subsequent countermeasures.

Results:

The team did not meet the 80% target but did order a 25-OHD level on 61% of patients by the end of the study period compared to 38% at the start of the study (P value 0.001). The level was sustained after the study period, with 68% of these children having a 25-OHD level ordered.

Conclusion:

The team successfully improved the screening processes for vitamin D deficiency in a busy subspecialty clinic setting using Lean Six Sigma methodology.
18F-FDG and 68Ga-FAPI-04 PET/CT Imaging of a Case With Immunoglobulin G4–Related Disease Presenting as Hepatic Masses
Authors: Zhang Zeyu , Jiang Hui , Zhang Lu , Cheng Chao , Zuo Changjing
Published: September 2022

Two hepatic masses were discovered through ultrasonography in a 50-year-old man with increased CA19-9, which is highly suspicious for malignancy. PET/CT images revealed intense 18F-FDG and 68Ga-FAPI-04 uptake in intrahepatic lesions. Histopathology with biopsy confirmed the diagnosis of immunoglobulin G4 (IgG4)–related disease. Here, we reported a case of IgG4-related primary localized pseudotumor without any other organ involvement. We concluded that in clinical work, if intrahepatic masses show high uptake of 18F-FDG or 68Ga-FAPI-04, intrahepatic IgG4-related disease should be considered for differential diagnosis.
FDG PET of Isolated Right Ventricular Sarcoidosis
Authors: Siegel Alan , Hoegemann Savellano Dagmar
Published: September 2022

A 62-year-old man with a history of allergic rhinitis and lightheadedness was admitted after an episode of sustained ventricular tachycardia detected by Holter monitor. A chest CT revealed peribronchial nodules, and mediastinal and hilar lymphadenopathy. The findings raised concern for sarcoidosis. MRI and FDG PET/CT were performed and revealed cardiac sarcoidosis isolated to the right ventricle only. Sarcoidosis of the right ventricle, sparing the left ventricle, is an extremely uncommon entity.
To Identify Small Bowel Metastasis From Lobular Breast Cancer on 18F-Fluoroestradiol PET/CT
Authors: Lu Yang
Published: September 2022

A 61-year-old woman was incidentally found to have small bowel metastasis from an undiagnosed lobular breast cancer in a workup for her acute presentation of small bowel obstruction. However, outside-hospital mammogram and breast ultrasound failed to reveal primary breast cancer. At 3.5 months postsurgery, the patient transferred her care to our hospital and received initial staging 18F-fluoroestradiol (FES) PET/CT. The occult primary right breast cancer and previously biopsied right axilla lymph node were visualized on FES PET/CT. The intense small bowel uptake of FES was initially considered as physiological; however, after readjusting the background FES level on PET, an intense focus at small bowel anastomosis site became obvious.
Understanding Nasal Valve Compromise in Nasal Airway Obstruction: A New Classification System
Authors: AlQuniabut Ibrahim , Oh Jung-Hyun , Choi Ji-Yun
Published: September 2022

Objectives:

A key aspect of rhinoplasty is integrity of nasal valves area because of its fundamental role in patent nasal airway. furthermore, nasal obstruction is a dominant feature in patient with nasal valves dysfunction (NVD) which can be devastating outcome after rhinoplasty.

Methods:

Nonetheless, NVD has been widely investigated regarding their etiologies and management. However, it has been assumed that the anatomical complexity and interplay between its structures causing a confusion for a beginner surgeon to diagnose and treat NVD. This study was approved by the institutional review board of Chosun University Hospital, Gwangju, Korea (2022-11-005).

Results:

To date, the lack of consensus on nasal valve pathologies and corrective procedures has led to its underestimations during analysis and management. As result, we proposed a classification system based on its affected anatomical part, location, and their management. Thus, implementing a classification system for NVD will help guide the practice of rhinoplasty and introduce a more structured approach.

Conclusion:

This approach will prove useful in expanding our understanding of how important to locate the pathology of NVD and apply the most relevant management options, particularly for a beginner surgeons.

Level of Evidence:

V.
Perioperative Morbidity of Secondary Frontal Orbital Advancement After Initial Frontal Orbital Advancement
Authors: Grove Austin M. , Sitzman Thomas J. , Kurnik Nicole M. , Singh Davinder J.
Published: September 2022

Frontal orbital advancement (FOA) is frequently performed for patients with syndromic and/or multisuture craniosynostosis. A small proportion of patients who undergo FOA have unfavorable growth and subsequently require a second FOA later in life; however, the perioperative risks associated with this second procedure are not well studied. We report results from a retrospective review of FOAs conducted from 2007 to 2022 at a single site with the same craniofacial surgeon. A total of 33 patients were included. Perioperative outcomes were compared between primary and secondary FOA procedures. The two groups were similar in regard to suture involvement and diagnosis, although the secondary FOA group was older at the time of their FOA (1.23 versus 7.07 y, P<0.001). There was no significant difference between groups in operating time, volume of blood transfusion by weight, or in the incidence of postoperative wound complications (P>0.05). Primary FOA procedures had significantly higher weight-adjusted blood loss (28 versus 18 mL/kg, P=0.014), with a higher proportion of patients receiving a blood transfusion (95% versus 62%, P=0.025). There was no significant difference between groups in the incidence of intraoperative dural injury (50% versus 84%, P=0.067). Our findings suggest that secondary procedures appear to impose less of a surgical risk relative to primary FOA traditionally performed in infancy, likely because of the advanced age at the time of secondary FOA.