bluuebunny/crossref_metadata_2025 huggingface dataset:
External or internal companion exciting the spiral arms in CQ Tau?
Authors: Hammond Iain , Christiaens Valentin , Price Daniel J , Ubeira-Gabellini Maria Giulia , Baird Jennifer , Calcino Josh , Benisty Myriam , Lodato Giuseppe , Testi Leonardo , Pinte Christophe , Toci Claudia , Fedele Davide
Published: August 2022

We present new high-contrast images in near-infrared wavelengths (λc = 1.04, 1.24, 1.62, 2.18, and 3.78 μm) of the young variable star CQ Tau, aiming to constrain the presence of companions in the protoplanetary disc. We reached a Ks-band contrast of 14 mag with SPHERE/IRDIS at separations greater than 0${_{.}^{\prime\prime}}$4 from the star. Our mass sensitivity curve rules out giant planets above 4 MJup immediately outside the spiral arms at ∼60 au and above 2–3 MJup beyond 100 au to 5σ confidence assuming hot-start models. We do, however, detect four spiral arms, a double-arc and evidence for shadows in scattered light cast by a misaligned inner disc. Our observations may be explained by an unseen close-in companion on an inclined and eccentric orbit. Such a hypothesis would also account for the disc CO cavity and disturbed kinematics.
Sub-stellar companions of intermediate-mass stars with CoRoT: CoRoT–34b, CoRoT–35b, and CoRoT–36b
Authors: Sebastian D , Guenther E W , Deleuil M , Dorsch M , Heber U , Heuser C , Gandolfi D , Grziwa S , Deeg H J , Alonso R , Bouchy F , Csizmadia Sz , Cusano F , Fridlund M , Geier S , Irrgang A , Korth J , Nespral D , Rauer H , Tal-Or L ,   the CoRoT-team
Published: August 2022

Theories of planet formation give contradicting results of how frequent close-in giant planets of intermediate mass stars (IMSs; $1.3\le M_{\star }\le 3.2\, \mathrm{M}_{\odot }$) are. Some theories predict a high rate of IMSs with close-in gas giants, while others predict a very low rate. Thus, determining the frequency of close-in giant planets of IMSs is an important test for theories of planet formation. We use the CoRoT survey to determine the absolute frequency of IMSs that harbour at least one close-in giant planet and compare it to that of solar-like stars. The CoRoT transit survey is ideal for this purpose, because of its completeness for gas-giant planets with orbital periods of less than 10 d and its large sample of main-sequence IMSs. We present a high precision radial velocity follow-up programme and conclude on 17 promising transit candidates of IMSs, observed with CoRoT. We report the detection of CoRoT–34b, a brown dwarf close to the hydrogen burning limit, orbiting a 1.1 Gyr A-type main-sequence star. We also confirm two inflated giant planets, CoRoT–35b, part of a possible planetary system around a metal-poor star, and CoRoT–36b on a misaligned orbit. We find that $0.12 \pm 0.10\, {{\ \rm per\ cent}}$ of IMSs between $1.3\le M_{\star }\le 1.6\, \mathrm{M}_{\odot }$ observed by CoRoT do harbour at least one close-in giant planet. This is significantly lower than the frequency ($0.70 \pm 0.16\, {{\ \rm per\ cent}}$) for solar-mass stars, as well as the frequency of IMSs harbouring long-period planets ($\sim 8\, {{\ \rm per\ cent}}$).
Abundance analysis of APOGEE spectra for 58 metal-poor stars from the bulge spheroid
Authors: Razera R , Barbuy B , Moura T C , Ernandes H , Pérez-Villegas A , Souza S O , Chiappini C , Queiroz A B A , Anders F , Fernández-Trincado J G , Friaça A C S , Cunha K , Smith V V , Santiago B X , Schiavon R P , Valentini M , Minniti D , Schultheis M , Geisler D , Sobeck J , Placco V M , Zoccali M
Published: August 2022

The central part of the Galaxy hosts a multitude of stellar populations, including the spheroidal bulge stars, stars moved to the bulge through secular evolution of the bar, inner halo, inner thick disc, inner thin disc, as well as debris from past accretion events. We identified a sample of 58 candidate stars belonging to the stellar population of the spheroidal bulge, and analyse their abundances. The present calculations of Mg, Ca, and Si lines are in agreement with the ASPCAP abundances, whereas abundances of C, N, O, and Ce are re-examined. We find normal α-element enhancements in oxygen, similar to magnesium, Si, and Ca abundances, which are typical of other bulge stars surveyed in the optical in Baade’s Window. The enhancement of [O/Fe] in these stars suggests that they do not belong to accreted debris. No spread in N abundances is found, and none of the sample stars is N-rich, indicating that these stars are not second generation stars originated in globular clusters. Ce instead is enhanced in the sample stars, which points to an s-process origin such as due to enrichment from early generations of massive fast rotating stars, the so-called spinstars.
Biermann battery powered by resistive heating induced by cosmic ray streaming
Authors: Yokoyama Shota L , Ohira Yutaka
Published: August 2022

It is recently proposed that cosmic rays generate a seed magnetic field in the early Universe. In this paper, we propose another generation mechanism of magnetic fields by cosmic rays, which is the Biermann battery driven by resistive heating induced by the streaming of cosmic rays. This mechanism is dominant in small-scale, low-temperature, and strongly ionized regions, compared with other previously proposed mechanisms. Because cosmic rays are expected to be accelerated after the death of the first stars, this mechanism can work during structure formation in the early Universe. We show that it makes the seed magnetic field with sufficient strength for the subsequent dynamo to amplify it to the micro Gauss level in the current galaxies.
A new emulated Monte Carlo radiative transfer disc-wind model: X-Ray Accretion Disc-wind Emulator – xrade
Authors: Matzeu G A , Lieu M , Costa M T , Reeves J N , Braito V , Dadina M , Nardini E , Boorman P G , Parker M L , Sim S A , Barret D , Kammoun E , Middei R , Giustini M , Brusa M , Cabrera J Pérez , Marchesi S
Published: August 2022

We present a new X-Ray Accretion Disc-wind Emulator (xrade) based on the 2.5D Monte Carlo radiative transfer code that provides a physically motivated, self-consistent treatment of both absorption and emission from a disc wind by computing the local ionization state and velocity field within the flow. xrade is then implemented through a process that combines X-ray tracing with supervised machine learning. We develop a novel emulation method consisting in training, validating, and testing the simulated disc-wind spectra into a purposely built artificial neural network. The trained emulator can generate a single synthetic spectrum for a particular parameter set in a fraction of a second, in contrast to the few hours required by a standard Monte Carlo radiative transfer pipeline. The emulator does not suffer from interpolation issues with multidimensional spaces that are typically faced by traditional X-ray fitting packages such as xspec. xrade will be suitable to a wide number of sources across the black hole mass, ionizing luminosity, and accretion rate scales. As an example, we demonstrate the applicability of xrade to the physical interpretation of the X-ray spectra of the bright quasar PDS 456, which hosts the best-established accretion disc wind observed to date. We anticipate that our emulation method will be an indispensable tool for the development of high-resolution theoretical models, with the necessary flexibility to be optimized for the next generation microcalorimeters onboard future missions, like X-Ray Imaging and Spectroscopy Mission (XRISM)/Resolve and Athena/X-ray Integral Field Unit (X-IFU). This tool can also be implemented across a wide variety of X-ray spectral models and beyond.
Molecular flows in contemporary active galaxies and the efficacy of radio-mechanical feedback
Authors: Tamhane Prathamesh D , McNamara Brian R , Russell Helen R , Edge Alastair C , Fabian Andrew C , Nulsen Paul E J , Babyk Iurii V
Published: August 2022

Molecular gas flows are analysed in 14 cluster galaxies (BCGs) centred in cooling hot atmospheres. The BCGs contain $10^{9}\!-\!10^{11}~\rm M_\odot$ of molecular gas, much of which is being moved by radio jets and lobes. The molecular flows and radio jet powers are compared to molecular outflows in 45 active galaxies within z < 0.2. We seek to understand the relative efficacy of radio, quasar, and starburst feedback over a range of active galaxy types. Molecular flows powered by radio feedback in BCGs are ∼10–1000 times larger in extent compared to contemporary galaxies hosting quasar nuclei and starbursts. Radio feedback yields lower flow velocities but higher momenta compared to quasar nuclei, as the molecular gas flows in BCGs are usually ∼10–100 times more massive. The product of the molecular gas mass and lifting altitude divided by the AGN or starburst power – a parameter referred to as the lifting factor – exceeds starbursts and quasar nuclei by 2–3 orders of magnitude, respectively. When active, radio feedback is generally more effective at lifting gas in galaxies compared to quasars and starburst winds. The kinetic energy flux of molecular clouds generally lies below and often substantially below a few per cent of the driving power. We find tentatively that star formation is suppressed in BCGs relative to other active galaxies, perhaps because these systems rarely form molecular discs that are more impervious to feedback and are better able to promote star formation.
The Three Hundred: cluster dynamical states and relaxation period
Authors: Zhang Bowei , Cui Weiguang , Wang Yuhuan , Dave Romeel , De Petris Marco
Published: August 2022

We introduce a new parameter λDS to quantify the dynamical state of galaxy clusters and test it using simulations from The Three Hundred cluster zoom suite. λDS is a combination of three previously used dynamical state measures, namely virial ratio, centre of mass offset, and substructure mass fraction, crafted to assume a double-Gaussian distribution, thereby yielding a natural division between relaxed and unrelaxed clusters where the Gaussians cross. Using dark matter-only simulations, we identify the optimal separator to be λDS = 3.424. We test this same criterion on two sets of fully hydrodynamical The Three Hundred runs (Gadget-X and GIZMO-SIMBA), and find only a weak dependence on the input baryonic physics. We correlate the evolution of λDS with the mass accretion history and find that halo mass changes of $\frac{\Delta M_{200}}{M_{200}} \lesssim 0.12$ do not typically alter the dynamical state. We examine the relaxation period, defined as the time taken to return to relaxation after becoming disturbed, and find a correlation between this relaxation period and the strength of halo mass change $\frac{\Delta M_{200}}{M_{200}}$. By fitting this correlation, we show that the relaxation period can be estimated from $\frac{\Delta M_{200}}{M_{200}}$ (even for multiple mass accretion events) with good accuracy.
Moon packing around an Earth-mass planet
Authors: Satyal Suman , Quarles Billy , Rosario-Franco Marialis
Published: August 2022

All four giant planets in the Solar system host systems of multiple moons, whereas the terrestrial planets only host up to two moons. The Earth can capture small asteroids as temporary satellites, which begs the question as to how many moons could stably orbit the Earth, or an Earth-mass exoplanet. We perform a series of N-body simulations of closely spaced equal-mass moons in nested orbits around an Earth-mass planet orbiting a Sun-like star. The innermost moon begins near the host planet’s Roche radius, and the system is packed until the outermost moon begins near the stability limit for single moons. The initial spacing of the moons follows an iterative scheme commonly used for studies of compact planetary systems around single stars. For the three-moon system, we generate MEGNO maps to calculate periodic and chaotic regions and to identify the destabilizing mean motion resonances. Our calculations show that the maximum number of moons depends on the assumed masses of the satellites (Ceres-, Pluto-, and Luna-mass) that could maintain stable orbits in a tightly packed environment. Through our N-body simulations, we find stable configurations for up to 7 ± 1 Ceres-mass, 4 ± 1 Pluto-mass, and 3 ± 1 Luna-mass moons. However, outward tidal migration will likely play a substantial role in the number of moons on stable orbits over the 10 Gyr stellar lifetime of a Sun-like star.
The Role of Glia Underlying Acupuncture Analgesia in Animal Pain Models: A Systematic Review and Meta-Analysis
Authors: Yan Bing , Tang Shengyu , Zhang Yuqiu , Xiao Xiao
Published: August 2022

Background

As a traditional Chinese therapy, acupuncture is proposed worldwide as a treatment for pain and other health problems, but findings on acupuncture analgesia have been inconsistent because of its variable modalities of therapeutic intervention.

Objective

This study aimed to evaluate the existing animal studies for evidence on acupuncture and its effect on glia in association with a reduction in pain conditions.

Methods

Literature searches were performed in four English- and Chinese-language databases (Web of Science, PubMed, EMBASE, and CNKI) on October 8, 2021. Included studies reported the pain outcome (e.g., paw withdrawal latency, paw withdrawal threshold) and glia outcome (e.g., glial marker GFPA, Iba1, and OX42) in pain-induced animals during acupuncture treatment.

Results

Fifty-two preclinical studies were included in the meta-analysis. A single acupuncture treatment in rodents had an analgesic effect, which was more effective in inflammatory pain than in neuropathic pain in the early phase of treatment. The analgesic efficacy became more curative after repeated acupuncture. Furthermore, acupuncture treatment could effectively inhibit the activity of astrocytes and microglia in both inflammatory pain and neuropathic pain in a time-course pattern.

Conclusions

Acupuncture treatment improves analgesic effect in rodent pain conditions under the possible mechanism of glial inhibition. Therefore, these results provide an opportunity to evaluate the effectiveness of acupuncture analgesia and neuroinflammation in animal models to research further neurobiological mechanisms and to inform the design of future clinical trials.

Study registration

PROSPERO (ID: CRD42020196011).
Prof. Koshiba and electron–positron physics
Authors: Yamada Sakue
Published: August 2022

Prof. Masatoshi Koshiba was the physicist who initiated the e+e− physics effort in Japan. The first attempt goes back to the 1960s. Following a hard time in the early days the attempt turned out to be successful, leading to a number of productive projects, and eventually supported his neutrino experiments. In this article we detail the history of how these projects developed and entangled.
Phylogenomic Analysis of the Parrots of the World Distinguishes Artifactual from Biological Sources of Gene Tree Discordance
Authors: Smith Brian Tilston , Merwin Jon , Provost Kaiya L , Thom Gregory , Brumfield Robb T , Ferreira Mateus , Mauck William M , Moyle Robert G , Wright Timothy F , Joseph Leo
Published: August 2022

Gene tree discordance is expected in phylogenomic trees and biological processes are often invoked to explain it. However, heterogeneous levels of phylogenetic signal among individuals within data sets may cause artifactual sources of topological discordance. We examined how the information content in tips and subclades impacts topological discordance in the parrots (Order: Psittaciformes), a diverse and highly threatened clade of nearly 400 species. Using ultraconserved elements from 96% of the clade’s species-level diversity, we estimated concatenated and species trees for 382 ingroup taxa. We found that discordance among tree topologies was most common at nodes dating between the late Miocene and Pliocene, and often at the taxonomic level of the genus. Accordingly, we used two metrics to characterize information content in tips and assess the degree to which conflict between trees was being driven by lower-quality samples. Most instances of topological conflict and nonmonophyletic genera in the species tree could be objectively identified using these metrics. For subclades still discordant after tip-based filtering, we used a machine learning approach to determine whether phylogenetic signal or noise was the more important predictor of metrics supporting the alternative topologies. We found that when signal favored one of the topologies, the noise was the most important variable in poorly performing models that favored the alternative topology. In sum, we show that artifactual sources of gene tree discordance, which are likely a common phenomenon in many data sets, can be distinguished from biological sources by quantifying the information content in each tip and modeling which factors support each topology. [Historical DNA; machine learning; museomics; Psittaciformes; species tree.]
PreS/MD: Predictor of Sensitization Hazard for Chemical Substances Released From Medical Devices
Authors: Alves Vinicius M , Borba Joyce V B , Braga Rodolpho C , Korn Daniel R , Kleinstreuer Nicole , Causey Kevin , Tropsha Alexander , Rua Diego , Muratov Eugene N
Published: August 2022

In the United States, a pre-market regulatory submission for any medical device that comes into contact with either a patient or the clinical practitioner must include an adequate toxicity evaluation of chemical substances that can be released from the device during its intended use. These substances, also referred to as extractables and leachables, must be evaluated for their potential to induce sensitization/allergenicity, which traditionally has been done in animal assays such as the guinea pig maximization test (GPMT). However, advances in basic and applied science are continuously presenting opportunities to employ new approach methodologies, including computational methods which, when qualified, could replace animal testing methods to support regulatory submissions. Herein, we developed a new computational tool for rapid and accurate prediction of the GPMT outcome that we have named PreS/MD (predictor of sensitization for medical devices). To enable model development, we (1) collected, curated, and integrated the largest publicly available dataset for GPMT results; (2) succeeded in developing externally predictive (balanced accuracy of 70%–74% as evaluated by both 5-fold external cross-validation and testing of novel compounds) quantitative structure-activity relationships (QSAR) models for GPMT using machine learning algorithms, including deep learning; and (3) developed a publicly accessible web portal integrating PreS/MD models that can predict GPMT outcomes for any molecule of interest. We expect that PreS/MD will be used by both industry and regulatory scientists in medical device safety assessments and help replace, reduce, or refine the use of animals in toxicity testing. PreS/MD is freely available at https://presmd.mml.unc.edu/.
Detection of Critical Spinal Epidural Lesions on CT Using Machine Learning
Authors: Harris Robert J. , Baginski Scott G. , Bronstein Yulia , Schultze Dietrich , Segel Kenneth , Kim Shwan , Lohr Jerry , Towey Steve , Shahi Nishit , Driscoll Ian , Baker Brian
Published: July 2022

Background.

Critical spinal epidural pathologies can cause paralysis or death if untreated. Although magnetic resonance imaging is the preferred modality for visualizing these pathologies, computed tomography (CT) occurs far more commonly than magnetic resonance imaging in the clinical setting.

Objective.

A machine learning model was developed to screen for critical epidural lesions on CT images at a large-scale teleradiology practice. This model has utility for both worklist prioritization of emergent studies and identifying missed findings.

Materials and Methods.

There were 153 studies with epidural lesions available for training. These lesions were segmented and used to train a machine learning model. A test data set was also created using previously missed epidural lesions. The trained model was then integrated into a teleradiology workflow for 90 days. Studies were sent to secondary manual review if the model detected an epidural lesion but none was mentioned in the clinical report.

Results.

The model correctly identified 50.0% of epidural lesions in the test data set with 99.0% specificity. For prospective data, the model correctly prioritized 66.7% of the 18 epidural lesions diagnosed on the initial read with 98.9% specificity. There were 2.0 studies flagged for potential missed findings per day, and 17 missed epidural lesions were found during a 90-day time period. These results suggest almost half of critical spinal epidural lesions visible on CT imaging are being missed on initial diagnosis.

Conclusion.

A machine learning model for identifying spinal epidural hematomas and abscesses on CT can be implemented in a clinical workflow.
Assessment of Fusion After Anterior Cervical Discectomy and Fusion Using Convolutional Neural Network Algorithm
Authors: Park Sehan , Kim Jeoung Kun , Chang Min Cheol , Park Jeong Jin , Yang Jae Jun , Lee Gun Woo
Published: July 2022

Background.

A convolutional neural network (CNN) is a deep learning (DL) model specialized for image processing, analysis, and classification.

Objective.

In this study, we evaluated whether a CNN model using lateral cervical spine radiographs as input data can help assess fusion after anterior cervical discectomy and fusion (ACDF).

Study Design.

Diagnostic imaging study using DL.

Patient Sample.

We included 187 patients who underwent ACDF and fusion assessment with postoperative one-year computed tomography and neutral and dynamic lateral cervical spine radiographs.

Outcome Measures.

The performance of the CNN-based DL algorithm was evaluated in terms of accuracy and area under the curve.

Materials and Methods.

Fusion or nonunion was confirmed by cervical spine computed tomography. Among the 187 patients, 69.5% (130 patients) were randomly selected as the training set, and the remaining 30.5% (57 patients) were assigned to the validation set to evaluate model performance. Radiographs of the cervical spine were used as input images to develop a CNN-based DL algorithm. The CNN algorithm used three radiographs (neutral, flexion, and extension) per patient and showed the diagnostic results as fusion (0) or nonunion (1) for each radiograph. By combining the results of the three radiographs, the final decision for a patient was determined to be fusion (fusion ≥2) or nonunion (fusion ≤1). By combining the results of the three radiographs, the final decision for a patient was determined as fusion (fusion ≥2) or nonunion (nonunion ≤1).

Results.

The CNN-based DL model demonstrated an accuracy of 89.5% and an area under the curve of 0.889 (95% confidence interval, 0.793–0.984).

Conclusion.

The CNN algorithm for fusion assessment after ACDF trained using lateral cervical radiographs showed a relatively high diagnostic accuracy of 89.5% and is expected to be a useful aid in detecting pseudarthrosis.
Transcranial Motor-evoked Potentials for Intraoperative Nerve Root Monitoring During Adult Spinal Deformity Surgery: A Prospective Multicenter Study
Authors: Yoshida Go , Ushirozako Hiroki , Machino Masaaki , Shigematsu Hideki , Kawabata Shigenori , Yamada Kei , Kanchiku Tsukasa , Fujiwara Yasushi , Iwasaki Hiroshi , Ando Muneharu , Taniguchi Shinichirou , Takatani Tsunenori , Tadokoro Nobuaki , Takahashi Masahito , Wada Kanichiro , Yamamoto Naoya , Funaba Masahiro , Yasuda Akimasa , Hashimoto Jun , Morito Shinji , Kurosu Kenta , Kobayashi Kazuyoshi , Ando Kei , Takeshita Katsushi , Matsuyama Yukihiro , Imagama Shiro
Published: July 2022

Study Design.

A prospective, multicenter study.

Objective.

This study clarified the uses and limitations of transcranial motor-evoked potentials (Tc-MEPs) for nerve root monitoring during adult spinal deformity (ASD) surgeries.

Summary of Background Data.

Whether Tc-MEPs can detect nerve root injuries (NRIs) in ASD surgeries remains controversial.

Materials and Methods.

We prospectively analyzed neuromonitoring data from 14 institutions between 2017 and 2020. The subjects were ASD patients surgically treated with posterior corrective fusion using multichannel Tc-MEPs. An alert was defined as a decrease of ≥70% in the Tc-MEP’s waveform amplitude from baseline, and NRI was considered as meeting the focal Tc-MEP alerts shortly following surgical procedures with postoperative nerve root symptoms in the selected muscles.

Results.

A total of 311 patients with ASD (262 women and 49 men) and a mean age of 65.5 years were analyzed. Tc-MEP results revealed 47 cases (15.1%) of alerts, including 25 alerts after 10 deformity corrections, six three-column osteotomies, four interbody fusions, three pedicle screw placements or two decompressions, and 22 alerts regardless of surgical maneuvers. Postoperatively, 14 patients (4.5%) had neurological deterioration considered to be all NRI, 11 true positives, and three false negatives (FN). Two FN did not reach a 70% loss of baseline (46% and 65% loss of baseline) and one was not monitored at target muscles. Multivariate logistic regression analysis revealed that risk factors of NRI were preexisting motor weakness (P<0.001, odds ratio=10.41) and three-column osteotomies (P=0.008, odds ratio=7.397).

Conclusions.

Nerve root injuries in our ASD cohort were partially predictable using multichannel Tc-MEPs with a 70% decrease in amplitude as an alarm threshold. We propose that future research should evaluate the efficacy of an idealized warning threshold (e.g., 50%) and a more detailed evoked muscle selection, in reducing false negatives.
Second Booster BNT162b2 Restores SARS-CoV-2 Humoral Response in Patients With Multiple Myeloma, Excluding Those Under Anti-BCMA Therapy
Authors: Ntanasis-Stathopoulos Ioannis , Karalis Vangelis , Gavriatopoulou Maria , Malandrakis Panagiotis , Sklirou Aimilia D. , Eleutherakis-Papaiakovou Evangelos , Migkou Magdalini , Roussou Maria , Fotiou Despina , Alexopoulos Harry , Theodorakakou Foteini , Kastritis Efstathios , Iconomidou Vassiliki A. , Trougakos Ioannis P. , Dimopoulos Meletios A. , Terpos Evangelos
Published: August 2022

COVID-19 vaccination leads to a less intense humoral response in patients with multiple myeloma (MM) compared with healthy individuals, whereas the SARS-CoV-2-specific immunity fades over time. The purpose of this study was to explore the kinetics of SARS-CoV-2 neutralizing antibodies (NAbs) in patients with MM after vaccination with the BNT162b2 mRNA vaccine, focusing on their response before (B4D) and at 1 month after the fourth vaccination (M1P4D). Overall, 201 patients with a median age of 67 years were included, whereas 114 (56.7%) were men. The median NAbs levels B4D were 80.0% (±3.5%) and at M1P4D they increased to a median value of 96.1% (±3.7%). The NAb values at M1P4D were similar to those at 1 month post the third dose and superior to all previous timepoints. At M1P4D, the NAbs levels of all the treatment groups increased, apart from the anti-BCMA group. A significant increase in median NAbs values was observed for those receiving CD38-based treatment (n = 43, from 71.0% B4D to 96.0% at M1P4D) and those who did not receive CD38- or BCMA-targeted therapy (n = 137, from 89.6% B4D to 96.3% at M1P4D). Regarding the patients under BCMA-based therapy (n = 21), there was no remarkable increase in NAbs values following the second booster shot (from 3.0% B4D to 4.0% at M1P4D). In conclusion, booster vaccination with the BNT162b2 results in a substantially improved humoral response against SARS-CoV-2 in patients with MM. Anti-BCMA treatment remains an adverse predictive factor for NAbs response; thus, tailored prevention measures should be considered for this patient subgroup.
Sex-specific effects of neuropathic pain on long-term pain behavior and mortality in mice
Authors: Millecamps Magali , Sotocinal Susana G. , Austin Jean-Sebastien , Stone Laura S. , Mogil Jeffrey S.
Published: August 2022

Human epidemiological studies suggest that chronic pain can increase mortality risk. We investigated whether this was true in mice so that underlying mechanisms might be identified. At 10 weeks of age, C57BL/6 mice of both sexes received sham or spared nerve injury (SNI) surgery producing neuropathic pain. Mice were weighed monthly, tested behaviorally for mechanical and cold sensitivity and guarding behavior every 3 months postsurgery, and otherwise left undisturbed in their cages until death by natural causes. Evidence of pain over the lifespan displayed a strikingly sex-specific pattern. Male mice displayed largely stable mechanical and cold hypersensitivity and guarding at 6 to 30 months post-SNI. By contrast, female mice displayed a biphasic temporal pattern of mechanical hypersensitivity and guarding behavior, with a complete resolution of SNI-induced pain behavior at 6 to 9 months post-SNI followed by the return of pain thereafter. Mouse lifespan was not significantly altered by SNI in either sex nor was frailty as assessed by cage inspection in the last 6 months of life. However, in male mice with SNI, we observe a significant correlation between average lifetime mechanical hypersensitivity and lifespan, such that death occurred sooner in male mice exhibiting more evidence of chronic pain. This relationship was not observed in female SNI mice nor in sham-operated mice of either sex. This experiment is the first to investigate pain behavior over an entire adult lifetime and suggests that biology of relevance to human chronic pain is being ignored by the very short timespans of most extant preclinical pain research.
The Relationship Between Pedagogy and Changes in Students’ Learning Styles in Physician Assistant Education
Authors: Wardley C. Sonia , Applegate E. Brooks , Wang Qian , Van Rhee James
Published: August 2022

Introduction

The purpose of this study was to examine the relationship between instructional pedagogy and changes in physician assistant (PA) students’ learning styles during a 2-year master’s program.

Methods

Two parallel curricular tracks were established in the didactic year, one using problem-based learning (PBL) and the other lecture-based learning (LBL) for 6 years. Kolb’s Learning Style Inventory (LSI) was administered to both groups at matriculation and at the end of the first and second years. Multivariate analyses, including logarithmic transformations of LSI data because of its ipsative nature, were conducted to evaluate differences and changes in students’ learning style.

Results

A majority of students changed learning styles during the program. Despite considerable movement within and between learning styles, the percentage distribution of LBL students’ learning styles changed little during the program, whereas there was a significant increase in PBL students having a Convergent learning style after 2 years. PBL students preferred more transformation than prehension in information processing than LBL students. About a third of LBL students, compared to a fifth of PBL students, had reverted to close to their matriculation learning style by the end of the clinical year.

Discussion

Primary care physicians and PAs tend to have a convergent learning style. Little movement towards this learning style was seen with LBL students, whereas a significant increase in the number of PBL students had adopted this learning style by the end of the program.
Emerging functional microfluidic assays for the study of thromboinflammation in sickle cell disease
Authors: An Ran , Gurkan Umut A.
Published: August 2022

Purpose of review

This review briefly summarizes the significant impact of thromboinflammation in sickle cell disease in relation to recent advances in biomarkers that are used in functional microfluidic assays.

Recent findings

Sickle cell disease (SCD) is an inherited hemoglobinopathy that affects 100 000 Americans and millions worldwide. Patients with SCD exhibit chronic haemolysis, chronic inflammation and thrombosis, and vaso-occlusion, triggering various clinical complications, including organ damage and increased mortality and morbidity. Recent advances in functional microfluidic assays provide direct biomarkers of disease, including abnormal white blood cell and red blood cell adhesion, cell aggregation, endothelial degradation and contraction, and thrombus formation.

Novel and emerging functional microfluidic assays are a promising and feasible strategy to comprehensively characterize thromboinflammatory reactions in SCD, which can be used for personalized risk assessment and tailored therapeutic decisions.
The effect of perichondrium on cartilage graft properties
Authors: Akkina Sarah R. , Most Sam P.
Published: July 2022

Purpose of review

The role of perichondrium in cartilage graft survival has been long debated. Although the innate function of perichondrium in providing mechanical and regenerative support to cartilage in its native position is relatively undisputed, studies continue to vacillate over how the perichondrium effects cartilage grafts once transplanted. This review evaluates historical and recent experiments showing how perichondrium may or may not impact graft survival.

Recent findings

Experimental studies in animal models have more recently evaluated macroscopic and microscopic properties of diced cartilage grafts with and without perichondrium, finding that in general grafted cartilage with perichondrial components retains greater weight and mechanical strength compared with cartilage without perichondrial components. However, these findings have not been replicated in humans. Solid pieces of rib cartilage have most recently been used without perichondrium to prevent warping, though no studies have evaluated whether retaining perichondrium with oblique and concentric cutting techniques may effect overall resorption.

Although historical opinions and more recent animal studies suggest a role of perichondrium in cartilage graft survival, randomized controlled human studies are still lacking on whether retaining perichondrium truly effects graft survival and ultimate surgical outcomes.
Clinical considerations for open versus endoscopic approaches in skull base surgery
Authors: Jawad Basit , Vankoevering Kyle , Carrau Ricardo , Patil Yash
Published: July 2022

Purpose of review

We aim to distill the current body of evidence to consider when selecting an endoscopic versus open approach to address cranial base disease. We evaluate the evolution of modern surgical techniques and their respective limitations.

Recent findings

Greater understanding of the role of tumor biology in relation to patient outcomes has led to increasingly sophisticated treatment algorithms. This combined with further development of advanced instrumentation and technique has led to the adoption of new surgical corridors previously unapproachable via traditional surgery.

Endoscopic and open craniofacial approaches both remain important surgical techniques in the management of cranial base tumors. The modern skull base surgeon may employ a combination of approaches to optimize tumor extirpation while preserving functional outcomes. Patient history, anatomic tumor extent, histology, and functional goals should be considered thoroughly when planning any surgical intervention.
Outcomes of COVID-19 and Factors Associated With Its Severity Among Hospitalized Patients With and Without Systemic Rheumatic Disease During the First Wave of the Pandemic in New York City
Authors: Siegel Caroline H. , Choi Jacky M. , D'Angelo Debra , Christos Paul , Lally Lindsay , Navarro-Millan Iris , Cooke Joseph , Goyal Parag , Mandl Lisa A. , Barbhaiya Medha
Published: July 2022

Background/Objective

Conflicting data exist regarding whether patients with systemic rheumatic disease (SRD) experience more severe outcomes related to COVID-19. Using data from adult patients hospitalized with COVID-19 in New York City during the first wave of the pandemic, we evaluated whether patients with SRD were at an increased risk for severe outcomes.

Methods

We conducted a medical records review study including patients aged ≥18 years with confirmed SARS-CoV-2 infection hospitalized at 3 NewYork-Presbyterian sites, March 3–May 15, 2020. Inverse probability of treatment weighting was applied to a multivariable logistic regression model to assess the association between SRD status and the composite of mechanical ventilation, intensive care unit admission, or death.

Results

Of 3710 patients hospitalized with COVID-19 (mean [SD] age, 63.7 [17.0] years; 41% female, 29% White, and 34% Hispanic/Latinx), 92 (2.5%) had SRD. Patients with SRD had similar age and body mass index but were more likely to be female, ever smokers, and White or Black, compared with those without SRD. A higher proportion of patients with versus without SRD had hypertension and pulmonary disease, and used hydroxychloroquine, corticosteroids, and immunomodulatory/immunosuppressive medications before admission. In the weighted multivariable analysis, patients with SRD had an odds ratio of 1.24 (95% confidence interval, 1.10–1.41; p < 0.01) for the composite of mechanical ventilation, intensive care unit admission, or death, compared with patients without SRD.

Conclusions

During the initial peak of the pandemic in New York City, patients with versus without SRD hospitalized with COVID-19 had a 24% increased likelihood of having severe COVID-19 after multivariable adjustment.
Developing a National Trauma Research Action Plan (NTRAP): Results from the Post-Admission Critical Care Research Gap Delphi Survey
Authors: Brasel Karen , Braverman Maxwell A. , Phuong Jimmy , Price Michelle A. , Kaplan Lewis J. , Kozar Rosemary , Michetti Christopher P. , Callcut Rachael , Bulger Eileen M. ,   the Post-Admission Critical Care Research Panel Group
Published: August 2022

Introduction

The 2016 NASEM report included a proposal to establish a National Trauma Research Action Plan (NTRAP). In response, the Department of Defense funded the Coalition for National Trauma Research to generate a comprehensive research agenda spanning the continuum of trauma and burn care from prehospital care to rehabilitation as part of an overall strategy to achieve zero preventable deaths and disability after injury. The Post-Admission Critical Care Research panel was one of 11 panels constituted to develop this research agenda.

Methods

We recruited interdisciplinary experts in surgical critical care and recruited them to identify current gaps in clinical critical care research, generate research questions and establish the priority of these questions using a consensus-driven Delphi survey approach. The first of four survey rounds asked participants to generate key research questions. On subsequent rounds, we asked survey participants to rank the priority of each research question on a 9-point Likert scale, categorized to represent low-, medium-, and high-priority items. Consensus was defined as ≥ 60% of panelists agreeing on the priority category.

Results

Twenty-five subject matter experts generated 595 questions. By Round 3, 249 questions reached ≥60% consensus. Of these, 22 questions were high, 185 were medium and 42 were low priority. The clinical states of hypovolemic shock and delirium were most represented in the high-priority questions. Traumatic brain injury was the only specific injury pattern with a high-priority question.

Conclusions

The NTRAP critical care research panel identified 22 high-priority research questions, that, if answered, would reduce preventable death and disability after injury.

Level of Evidence

IV

Type of Study

Delphi panel gap analysis
Lung ultrasound to assess pulmonary congestion in patients with acute exacerbation of COPD - a feasibility study
Authors: Johannessen Øyvind , Reite Fride Uthaug , Bhatnagar Rahul , Øvrebotten Tarjei , Einvik Gunnar , Myhre Peder L.
Published: July 2022

Background

Chronic heart failure (HF) coexist with chronic obstructive pulmonary disease (COPD) in approximately 25% of patients and is associated with worse outcomes. Lung ultrasound (LUS) is a validated technique to diagnose pulmonary congestion by detecting vertical lung artifacts, B-lines. Pulmonary inflammation is also associated with B-lines, but little is known about LUS in patients with acute exacerbation of COPD (AECOPD).

Aims

To assess the feasibility of LUS to detect concurrent acute HF in AECOPD and examine the associations between B-lines, clinical parameters during hospitalization and re-hospitalizations and mortality.

Methods & results

In a prospective cohort study 123 patients with AECOPD (age 75±9 years, 57 [46%] men) underwent 8-zone bedside LUS within 24h after admission. A positive LUS was defined by ≥3 B-lines in ≥2 zones bilaterally. A cardiologist committee blinded for LUS adjudicated whether concurrent HF was present (n=48, 39%). The median number of B-lines was 8 (IQR 5-13) and 16 (13%) patients had positive LUS. Positive LUS was associated with infiltrates on chest X-ray. The prevalence of positive LUS was similar with and without concurrent HF 8 (17%) vs 8 (11%), p=0.34, while the number of B-lines was higher in concurrent HF: median 10 (IQR 6–16) vs 7 (IQR 5-12) (p=0.03). The sensitivity and specificity for positive LUS to detect concurrent HF was 16.7% and 89.3%, respectively. Positive LUS was not associated with re-hospitalization and mortality: Adjusted HR 0.93 (0.49-1.75), p=0.81.

Conclusions

LUS did not detect concurrent HF or predict risk in patients hospitalized with AECOPD.
Priority age targets for COVID-19 vaccination in Ethiopia under limited vaccine supply
Authors: Galli Margherita , Zardini Agnese , Gamshie Worku Nigussa , Santini Stefano , Tsegaye Ademe , Trentini Filippo , Marziano Valentina , Guzzetta Giorgio , Manica Mattia , d’Andrea Valeria , Putoto Giovanni , Manenti Fabio , Ajelli Marco , Poletti Piero , Merler Stefano
Published: July 2022

Background

The worldwide inequitable access to vaccination claims for a re-assessment of policies that could minimize the COVID-19 burden in low-income countries. An illustrative example is what occurred in Ethiopia, where nine months after the launch of the national vaccination program in March 2021, only 3% of the population received two doses of COVID-19 vaccine. In the meantime, a new wave of cases caused by the emergence of Delta variant of SARS-CoV-2 was observed between July and November 2021.

Methods

We used a SARS-CoV-2 transmission model to estimate the level of immunity accrued before the launch of vaccination in the Southwest Shewa Zone (SWSZ) and to evaluate the impact of alternative age priority vaccination targets in a context of limited vaccine supply. The model was informed with available epidemiological evidence and detailed contact data collected across different socio-demographic settings.

Results

We found that, during the first year of the pandemic, 46.1-58.7% of SARS-CoV-2 infections and 24.9-48% of critical cases occurred in SWSZ were likely associated with infectors under 30 years of age. During the Delta wave, the contribution of this age group in causing critical cases was estimated to increase to 66.7-70.6%. However, our findings suggest that, when considering the vaccine product available at the time (ChAdOx1 nCoV-19; 65% efficacy against infection after 2 doses), prioritizing the elderly for vaccination remained the best strategy to minimize the disease burden caused by Delta, irrespectively to the number of available doses. Vaccination of all individuals aged 50□years or older would have averted 40 (95%CI: 18-60), 90 (95%CI: 61-111), and 62 (95%CI: 21-108) critical cases per 100,000 residents in urban, rural, and remote areas, respectively. Vaccination of all individuals aged 30□years or more would have averted an average of 86-152 critical cases per 100,000 individuals, depending on the setting considered.

Conclusions

Despite infections among children and young adults likely caused 70% of critical cases during the Delta wave in SWSZ, most vulnerable ages should remain a key priority target for vaccination against COVID-19.
Graph lesion-deficit mapping of fluid intelligence
Authors: Cipolotti Lisa , Ruffle James K , Mole Joe , Xu Tianbo , Hyare Harpreet , Shallice Tim , Chan Edgar , Nachev Parashkev
Published: August 2022

Fluid intelligence is arguably the defining feature of human cognition. Yet the nature of its relationship with the brain remains a contentious topic. Influential proposals drawing primarily on functional imaging data have implicated “multiple demand” frontoparietal and more widely distributed cortical networks, but extant lesion-deficit studies with greater causal power are almost all small, methodologically constrained, and inconclusive. The task demands large samples of patients, comprehensive investigation of performance, fine-grained anatomical mapping, and robust lesion-deficit inference, yet to be brought to bear on it.

We assessed 165 healthy controls and 227 frontal or non-frontal patients with unilateral brain lesions on the best-established test of fluid intelligence, Raven’s Advanced Progressive Matrices, employing an array of lesion-deficit inferential models responsive to the potentially distributed nature of fluid intelligence. Non-parametric Bayesian stochastic block models were used to reveal the community structure of lesion deficit networks, disentangling functional from confounding pathological distributed effects.

Impaired performance was confined to patients with frontal lesions (F(2,387) = 18.491; p < .001; frontal worse than non-frontal and healthy participants p < .01; p <.001), more marked on the right than left (F(4,385) = 12.237; p < .001; right worse than left and healthy participants p<.01; p<.001). Patients with non-frontal lesions were indistinguishable from controls and showed no modulation by laterality. Neither the presence nor the extent of multiple demand network involvement affected performance. Both conventional network-based statistics and non-parametric Bayesian stochastic block modelling heavily implicated the right frontal lobe. Crucially, this localisation was confirmed on explicitly disentangling functional from pathology-driven effects within a layered stochastic block model, prominently highlighting a right frontal network involving middle and inferior frontal gyrus, pre- and post-central gyri, with a weak contribution from right superior parietal lobule. Similar results were obtained with standard lesion-deficit analyses.

Our study represents the first large-scale investigation of the distributed neural substrates of fluid intelligence in the focally injured brain. Combining novel graph-based lesion-deficit mapping with detailed investigation of cognitive performance in a large sample of patients provides crucial information about the neural basis of intelligence. Our findings indicate that a set of predominantly right frontal regions, rather than a more widely distributed network, is critical to the high-level functions involved in fluid intelligence. Further they suggest that Raven’s Advanced Progressive Matrices is a useful clinical index of fluid intelligence and a sensitive marker of right frontal lobe dysfunction.