bluuebunny/crossref_metadata_2025 huggingface dataset:
The Regularity of the Linear Drift in Negatively Curved Spaces
Authors: Ledrappier François , Shu Lin
Published: January 2023

We show that the linear drift of the Brownian motion on the universal cover of a closed connected smooth Riemannian manifold is

C

k
−
2

C^{k-2}

differentiable along any

C

k

C^{k}

curve in the manifold of

C
k

C^k

Riemannian metrics with negative sectional curvature. We also show that the stochastic entropy of the Brownian motion is

C
1

C^1

differentiable along any

C

3

C^{3}

curve of

C
3

C^3

Riemannian metrics with negative sectional curvature. We formulate the first derivatives of the linear drift and stochastic entropy, respectively, and show they are critical at locally symmetric metrics.
Higher Ramanujan Equations and Periods of Abelian Varieties
Authors: Fonseca Tiago
Published: January 2023

We describe higher dimensional generalizations of Ramanujan’s classical differential relations satisfied by the Eisenstein series

E
2

E_2

,

E
4

E_4

,

E
6

E_6

. Such “higher Ramanujan equations” are given geometrically in terms of vector fields living on certain moduli stacks classifying abelian schemes equipped with suitable frames of their first de Rham cohomology. These vector fields are canonically constructed by means of the Gauss-Manin connection and the Kodaira-Spencer isomorphism. Using Mumford’s theory of degenerating families of abelian varieties, we construct remarkable solutions of these differential equations generalizing

(

E
2

,

E
4

,

E
6

)

(E_2,E_4,E_6)

, which are also shown to be defined over

Z

\mathbf {Z}

.

This geometric framework taking account of integrality issues is mainly motivated by questions in Transcendental Number Theory regarding an extension of Nesterenko’s celebrated theorem on the algebraic independence of values of Eisenstein series. In this direction, we discuss the precise relation between periods of abelian varieties and the values of the above referred solutions of the higher Ramanujan equations, thereby linking the study of such differential equations to Grothendieck’s Period Conjecture. Working in the complex analytic category, we prove “functional” transcendence results, such as the Zariski-density of every leaf of the holomorphic foliation induced by the higher Ramanujan equations.
Planar Algebras in Braided Tensor Categories
Authors: Henriques André , Penneys David , Tener James
Published: January 2023

We generalize Jones’ planar algebras by internalising the notion to a pivotal braided tensor category

C

\mathcal {C}

. To formulate the notion, the planar tangles are now equipped with additional ‘anchor lines’ which connect the inner circles to the outer circle. We call the resulting notion an anchored planar algebra. If we restrict to the case when

C

\mathcal {C}

is the category of vector spaces, then we recover the usual notion of a planar algebra.

Building on our previous work on categorified traces, we prove that there is an equivalence of categories between anchored planar algebras in

C

\mathcal {C}

and pivotal module tensor categories over

C

\mathcal {C}

equipped with a chosen self-dual generator. Even in the case of usual planar algebras, the precise formulation of this theorem, as an equivalence of categories, has not appeared in the literature. Using our theorem, we describe many examples of anchored planar algebras.
Inflectionary Invariants for Isolated Complete Intersection Curve Singularities
Authors: Patel Anand , Swaminathan Ashvin
Published: January 2023

We investigate the role played by curve singularity germs in the enumeration of inflection points in families of curves acquiring singular members. Let

N
≥
2

N \geq 2

, and consider an isolated complete intersection curve singularity germ

f
:
(

C

N

,
0
)
→
(

C

N
−
1

,
0
)

f \colon (\mathbb {C}^N,0) \to (\mathbb {C}^{N-1},0)

. We define a numerical function

m
↦

AD

(
2
)

m

⁡
(
f
)

m \mapsto \operatorname {AD}_{(2)}^m(f)

that naturally arises when counting

m

t
h

m^{\mathrm {th}}

-order weight-

2
2

inflection points with ramification sequence

(
0
,
…
,
0
,
2
)

(0, \dots , 0, 2)

in a

1
1

-parameter family of curves acquiring the singularity

f
=
0

f = 0

, and we compute

AD

(
2
)

m

⁡
(
f
)

\operatorname {AD}_{(2)}^m(f)

for several interesting families of pairs

(
f
,
m
)

(f,m)

. In particular, for a node defined by

f
:
(
x
,
y
)
↦
x
y

f \colon (x,y) \mapsto xy

, we prove that

AD

(
2
)

m

⁡
(
x
y
)
=

(

m
+
1

4

)

,

\operatorname {AD}_{(2)}^m(xy) = {{m+1} \choose 4},

and we deduce as a corollary that
<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" alttext="upper A upper D Subscript left-parenthesis 2 right-parenthesis Superscript m Baseline left-parenthesis f right-parenthesis greater-than-or-equal-to left-parenthesis m u l t 0 normal upper Delta Subscript f Baseline right-parenthesis dot StartBinomialOrMatrix m plus 1 Choose 4 EndBinomialOrMatrix">

AD

(
2
)

m

⁡
(
f
)
≥
(

mult
0

⁡

Δ
f

)
⋅

(

m
+
1

4

)

\operatorname {AD}_{(2)}^m(f) \geq (\operatorname {mult}_0 \Delta _f) \cdot {{m+1} \choose 4}

for any

f
f

, where

mult
0

⁡

Δ
f

\operatorname {mult}_0 \Delta _f

is the multiplicity of the discriminant

Δ
f

\Delta _f

at the origin in the deformation space. Significantly, we prove that the function
<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" alttext="m right-arrow from bar upper A upper D Subscript left-parenthesis 2 right-parenthesis Superscript m Baseline left-parenthesis f right-parenthesis minus left-parenthesis m u l t 0 normal upper Delta Subscript f Baseline right-parenthesis dot StartBinomialOrMatrix m plus 1 Choose 4 EndBinomialOrMatrix">

m
↦

AD

(
2
)

m

⁡
(
f
)
−
(

mult
0

⁡

Δ
f

)
⋅

(

m
+
1

4

)

m \mapsto \operatorname {AD}_{(2)}^m(f) -(\operatorname {mult}_0 \Delta _f) \cdot {{m+1} \choose 4}

is an analytic invariant measuring how much the singularity “counts as” an inflection point. We prove similar results for weight-

2
2

inflection points with ramification sequence

(
0
,
…
,
0
,
1
,
1
)

(0, \dots , 0, 1,1)

and for weight-

1
1

inflection points, and we apply our results to solve a number of related enumerative problems.
Doppler Ultrasound–Guided Filler Injections: Useful Tips to Integrate Ultrasound in Daily Practice
Authors: Vasconcelos-Berg Roberta , Izidoro Juliana Favaro , Wenz Franziska , Müller Alina , Navarini Alexander A , Sigrist Rosa M S
Published: January 2023

The development of high-frequency devices and transducers in recent years has enabled the growth of the use of dermatologic ultrasound. Real-time monitoring of the anatomy of the face during the application of aesthetic injectables potentially prevents complications such as vascular occlusions. Injecting physicians starting out in the practice of ultrasound-guided injections are commonly faced with practical questions about its use. In this article, based on the experience with ultrasound-guided filler injections of 2 large clinical centers in 2 countries, the authors summarize the steps involved when setting out to use ultrasound to guide injectable aesthetic procedures, such as fillers and biostimulators. First, the authors discuss factors that guide the choice of equipment and ultrasound transducers to perform the procedures. Next, a detailed discussion on practical issues related to the procedure is provided. The authors then consider the positioning of operators and equipment in the treatment field. The authors conclude by suggesting 2 possible techniques to guide injectable procedures: (1) scan before injecting or (2) scan while injecting.
Efficacy and Safety of Perioral Mound Region Liposuction–A Novel Concept to Improve Perioral Mound Fullness
Authors: Gu Yunpeng , Yang Mingzi , Li Jiyang , Sun Jingjing , Lv Qianwen , Qi Yue , Han Xuefeng , Qi Zuoliang , Ma Gui-e
Published: January 2023

Background

Fullness of the perioral mound is considered a dissatisfying aspect of premature aging and has become a common complaint of patients seeking facial rejuvenation.

Objectives

The authors propose a novel concept of improving perioral mound fullness by liposuction and verify its safety and efficacy through cadaver and clinical studies.

Methods

A cadaver study was conducted to discover the soft tissue structure of the perioral mound region and identify a vital use for liposuction. For clinical evaluation, 37 patients with perioral mound fullness who underwent liposuction were retrospectively reviewed.

Results

The cadaver study results showed moderate fatty tissue in the subcutaneous layer of the perioral mound region. The liposuction manipulation was limited to the subcutaneous fat layer. Among the 37 patients (including 74 perioral mound regions), the median fat removal volume per perioral mound region was 2.0 (1.2, 2.3) mL. After liposuction, the subcutaneous fat thickness significantly decreased (median 5.0 [3.9, 6.6] mm vs 0.7 [0.4, 1.0] mm per perioral mound region, P < .001). All patients were satisfied with their posttreatment outcomes. Two patients (5.4%) had slight skin hyperpigmentation in the liposuction area after treatment and recovered naturally in 3 months without any intervention. No other complications were noted.

Conclusions

Liposuction is effective in improving perioral mound fullness with a low risk of complications.

Level of Evidence: 4
Prevalence of Testing for Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus Among Medicaid Enrollees Treated With Medications for Opioid Use Disorder in 11 States, 2016–2019
Authors: Ahrens Katherine , Sharbaugh Michael , Jarlenski Marian P , Tang Lu , Allen Lindsay , Austin Anna E , Barnes Andrew J , Burns Marguerite E , Clark Sarah , Zivin Kara , Mack Aimee , Liu Gilbert , Mohamoud Shamis , McDuffie Mary Joan , Hammerslag Lindsey , Gordon Adam J , Donohue Julie M ,   for the Writing Committee for Medicaid Outcomes Distributed Research Network, Kelley David , James A Everette , Costlow Monica , Cohn Lisa , LaPres Marie , Walker Lauryn , Harrell Ashley , Voskuil Kristen , Tyska Steve , Parsons Cynthia , Becker James , Cai Yilin , Brown Alyssa , Middleton Alice , Woodcock Cynthia , Brown Elizabeth , Hall Dara , Rose Roderick , Sandoe Emma , Dowler Shannon , McGuire Catherine , Jorgenson David , Schutze Maik , Taylor Angela , Talbert Jeff , Applegate Mary , Markman Kendallyn , Rizzutti Mark , Truex-Powell Elizabeth , Ashmead Robert , Bailey Emelie
Published: January 2023

Background

Limited information exists about testing for human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) among Medicaid enrollees after starting medication for opioid use disorder (MOUD), despite guidelines recommending such testing. Our objectives were to estimate testing prevalence and trends for HIV, HBV, and HCV among Medicaid enrollees initiating MOUD and examine enrollee characteristics associated with testing.

Methods

We conducted a serial cross-sectional study of 505 440 initiations of MOUD from 2016 to 2019 among 361 537 Medicaid enrollees in 11 states. Measures of MOUD initiation; HIV, HBV, and HCV testing; comorbidities; and demographics were based on enrollment and claims data. Each state used Poisson regression to estimate associations between enrollee characteristics and testing prevalence within 90 days of MOUD initiation. We pooled state-level estimates to generate global estimates using random effects meta-analyses.

Results

From 2016 to 2019, testing increased from 20% to 25% for HIV, from 22% to 25% for HBV, from 24% to 27% for HCV, and from 15% to 19% for all 3 conditions. Adjusted rates of testing for all 3 conditions were lower among enrollees who were male (vs nonpregnant females), living in a rural area (vs urban area), and initiating methadone or naltrexone (vs buprenorphine). Associations between enrollee characteristics and testing varied across states.

Conclusions

Among Medicaid enrollees in 11 US states who initiated medications for opioid use disorder, testing for human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and all 3 conditions increased between 2016 and 2019 but the majority were not tested.
Case report: peri-device leakage after percutaneous left atrial appendage occlusion: plug, clip, or amputate?
Authors: Ramdat Misier Nawin L , Kharbanda Rohit K , van Schaagen Frank R N , de Groot Natasja M S
Published: January 2023

Background

Although peri-device leakage is frequently observed after left atrial appendage occlusion (LAAO), there is no consensus on the optimal management strategy. It is unknown whether additional plugging should be preferred over surgical exclusion of the LAA, as experience with additional plugging is limited.

Case summary

In this case report, we demonstrate the clinical implications of additional plugging and surgical exclusion in a 65-year-old male patient with peri-device leakage and recurrent thromboembolic events. After the recurrence of paroxysmal atrial fibrillation (AF) and a transient ischaemic attack despite adequate anticoagulation, the patient was opted for re-do pulmonary vein isolation and LAAO with a Watchman device. Due to multiple ischaemic strokes and recurrent AF in combination with significant peri-device leakage, additional plugging with a second device was performed. Post-procedurally, the patient had another ischaemic stroke and persisting peri-device leakage was observed during follow-up. Due to progressive symptoms of AF and patient’s preference to discontinue DOAC, he underwent a Cox MAZE IV procedure, including amputation of the LAA with both devices. Within six months after surgery, the patient experienced two more ischaemic events. In the following two years, the patient remained free of any cerebrovascular accidents or recurrence of AF.

Discussion

Additional plugging of peri-device leakage is not always successful in stroke prevention. In combination with recurrent AF, progressive symptoms, contraindication for oral anticoagulation, and patient’s preference, surgical LAA exclusion could be preferred over additional plugging.
The polarization of real estate ownership and increasing wealth inequality in Spain
Authors: Boertien Diederik , López-Gay Antonio
Published: January 2023

Recent research has shown that differences in the distribution of real estate wealth across households are the most important explanation for cross-national variation in wealth inequality. We extend this line of research by looking at change over time and quantifying the importance of two opposing trends related to housing for wealth inequality: declining homeownership rates and increases in multiple property ownership. Our analysis is based on data from the Spanish survey Encuesta Financiera de Familias covering the period 2002–2017. We show how real estate ownership is becoming increasingly polarized: both the share of households without any property at all as well as the share of households with multiple properties is increasing. Decomposition models show, first, that inequality between homeowners and non-owners is becoming a more important component of wealth inequality between households. Second, whereas real estate that is not used by households as their main residence constituted a relatively small part of wealth inequality in 2002, its absolute contribution had almost doubled by 2017. We conclude that household investments in non-residence real estate are an important channel through which wealth inequality increased over time in Spain.
A systematic review documenting reasons whether physicians should provide treatment to their family and friends
Authors: Beigel Francisca , Mertz Marcel , Salloch Sabine
Published: January 2023

Background

Physicians are likely to be asked to provide medical care to relatives or friends. Evidence suggests that most physicians treat loved ones during their active years. However, in the academic literature, critical approaches to the matter are dominating. Ethical guidelines often discourage physicians from treating family members and friends outside of exceptional circumstances.

Objective

This systematic review aims to identify reasons for and against treating family and friends as portrayed in the literature published.

Methods

A search string designed for the database “PubMed,” snowball sampling, and hand searching was used to identify possibly eligible publications. Seventy-six publications were screened for all reasons presented in favour of and against physicians treating loved ones. Qualitative content analysis was used for data extraction. Combining a deductive and inductive approach, a coding system was developed.

Results

Many publications analysed represent articles portraying personal experiences; fewer show original research. Reasons against and in favour of treating family and friends were identified. Several publications specify conditions under which the treatment of loved ones may be legitimate. The reasons identified can be assigned to a micro or macro level of human interaction.

Conclusions

This systematic review shows that the discourse of physicians treating loved ones is held predominantly in the context of personal experiences. The majority of authors seem to have a rather pragmatic interest in the topic, and systematic or analytic approaches are rare. While most authors mention various codes of ethics, several publications criticize these or consider them insufficient.
Higher Prevalence of Monogenic Cause Among Very Early Onset Inflammatory Bowel Disease in Children: Experience From a Tertiary Care Center From Northern India
Authors: Poddar Ujjal , Aggarwal Amita , Jayalakshmi Krishnegowda , Sarma Moinak Sen , Srivastava Anshu , Rawat Amit , Yachha Surender Kumar
Published: January 2023

Background

Very early-onset inflammatory bowel disease (VEO-IBD) is generally defined as onset of IBD at <6 years of age. Up to 20% of VEO-IBD may have a monogenic cause; hence, next-generation sequencing is highly recommended for diagnostic accuracy. There remains a paucity of data on VEO-IBD and the proportion of monogeneic causes in South Asia. We analyzed our tertiary care center experience of monogenic VEO-IBD from Northern India and compared them with nonmonogenic VEO-IBD to find out the factors that differentiate monogenic from nonmonogenic VEO-IBD.

Methods

All children (<18 years of age) diagnosed with IBD between January 2010 to July 2021 were analyzed along with the next-generation sequencing data and functional assays when available. Clinical features and outcomes between monogenic and nonmonogenic VEO-IBD were compared.

Results

A total of 200 children with a median age of 15.3 (range, 0.17-17) years, 125 of whom were boys, were diagnosed to have IBD during the study period. VEO-IBD was seen in 48 (24%) children. Monogenic IBD was diagnosed in 15 (31%) children with VEO-IBD and 7.5% of all IBD cases. The causes of monogenic VEO-IBD included disorders of the immune system (including interleukin-10 receptor mutations) in 12 and epithelial barrier dysfunction in 3. Features that differentiated monogenic from nonmonogenic VEO-IBD were neonatal IBD, presence of perianal disease, IBD unclassified, history of consanguinity and sibling death, wasting, and stunting (P < .05). There were 6 deaths.

Conclusions

One-third of participants were monogenic among Indian children with VEO-IBD, the highest proportion reported to date in the world. Next-generation (either exome or whole genome) sequencing should be recommended in a subset of VEO-IBD with neonatal onset, perianal disease, history of consanguinity and siblings’ death, wasting, stunting, and IBD unclassified phenotype for an early diagnosis and referral to an appropriate center for hematopoietic stem cell transplantation for a better outcome.
Medication safety incidents associated with the remote delivery of primary care: a rapid review
Authors: Gleeson Laura L , Clyne Barbara , Barlow James W , Ryan Benedict , Murphy Paul , Wallace Emma , De Brún Aoife , Mellon Lisa , Hanratty Marcus , Ennis Mark , Holton Alice , Pate Muriel , Kirke Ciara , Flood Michelle , Moriarty Frank
Published: January 2023

Objectives

The COVID-19 pandemic triggered rapid, fundamental changes, notably increased remote delivery of primary care. While the impact of these changes on medication safety is not yet fully understood, research conducted before the pandemic may provide evidence for possible consequences. To examine the published literature on medication safety incidents associated with the remote delivery of primary care, with a focus on telemedicine and electronic prescribing.

Methods

A rapid review was conducted according to the Cochrane Rapid Reviews Methods Group guidance. An electronic search was carried out on Embase and Medline (via PubMed) using key search terms ‘medication error’, ‘electronic prescribing’, ‘telemedicine’ and ‘primary care’. Identified studies were synthesised narratively; reported medication safety incidents were categorised according to the WHO Conceptual Framework for the International Classification for Patient Safety.

Key Findings

Fifteen studies were deemed eligible for inclusion. All 15 studies reported medication incidents associated with electronic prescribing; no studies were identified that reported medication safety incidents associated with telemedicine. The most commonly reported medication safety incidents were ‘wrong label/instruction’ and ‘wrong dose/strength/frequency’. The frequency of medication safety incidents ranged from 0.89 to 81.98 incidents per 100 electronic prescriptions analysed.

This review of medication safety incidents associated with the remote delivery of primary care identified common incident types associated with electronic prescriptions. There was a wide variation in reported frequencies of medication safety incidents associated with electronic prescriptions. Further research is required to determine the impact of the COVID-19 pandemic on medication safety in primary care, particularly the increased use of telemedicine.
Evaluation of similar dietary roughage equivalency fed to beef steers during the growing and finishing phase
Authors: Hamilton Thomas G , Rusche Warren C , Smith Zachary K
Published: January 2023

The objective of this experiment was to determine the influence that similar dietary roughage equivalency offered in a single or two-diet system during a 210-d growing-finishing period has on growth performance, the efficiency of dietary net energy (NE) utilization, and carcass traits in beef steers. Beef steers (n = 46; initial shrunk [4%]; body weight [BW] = 281 ± 40.4 kg) were fed once daily, and bunks were managed according to a slick bunk management system across all 10 pens. Treatments included the following: 1) A single diet program that was formulated to provide 16% (dry matter [DM] basis) dietary roughage equivalency; SD) or 2) multiple diet programs (formulated to provide a dietary roughage equivalency (DM basis) of 25% for 98 d, 16% for 14 d, and 7% for 98 d; MD). Day 1 to 112 was considered the growing period, and day 113 to 210 (the day of harvest) was considered the finishing period, all steers were implanted on day 1 with a 100 mg trenbolone acetate (TBA) and 14 mg estradiol benzoate (EB) implant and implanted with a 200 mg TBA and 28 mg EB implant on day 112. Average daily gain tended (P = 0.06) to be 9.5% greater for SD compared to MD during the growing portion, and average daily gain (ADG) was greater by 11.3% (P = 0.01) for MD compared to SD during the finishing phase of the experiment. Cumulative ADG did not differ (P ≥ 0.86) between treatments (1.61 vs. 1.62 ± 0.046 kg) for SD and MD, respectively. Cumulative dietary NEm and NEg calculated based on performance did not differ (P ≥ 0.96) between treatments. There were no differences (P ≥ 0.18) detected between treatments for hot carcass weight, dressing percent, longissimus muscle area, rib fat, United States Department of Agriculture (USDA) marbling score, kidney, pelvic, heart fat, yield grade, retail yield, empty body fat, or body weight at 28% estimated empty body fat. These data indicate that feedlot producers can feed a single growing-finishing diet to beef steers with minimal effects on overall growth performance or carcass traits.
Evaluation of the effects of corn silage maturity and kernel processing on steer growth performance and carcass traits
Authors: Francis Forest L , Gubbels Erin R , Hamilton Thomas G , Walker Julie A , Rusche Warren C , Smith Zachary K
Published: January 2023

Two experiments were conducted to investigate the effects of feeding kernel processed corn silage to growing calves at 65% inclusion (dry matter [DM] basis; Exp. 1] and finishing beef steers at 20% inclusion (DM basis; Exp. 2). In Exp. 1, steers (n = 184; initial shrunk body weight [BW] = 388 ± 22.3 kg) were used to evaluate the influence that kernel processing of corn silage has on production responses when fed at 65% diet inclusion (DM basis) during a 46-d growing period. Steers were allotted to 1 of 24 pens (12 replicate pens/treatment). Treatments were based upon corn silage that was either kernel processed or not. In Exp. 2, steers (n = 192; initial shrunk BW = 446 ± 28.3 kg) were used in a 112-d finishing experiment. Treatments were grouped in a 2 × 2 factorial arrangement (24 pens total; 8 steers/pen) to evaluate corn silage harvest maturity (1/2 to 2/3 milk line or black layer) and kernel processing (processed or not) at time of corn silage harvest on finishing steer growth performance and carcass traits when corn silage is fed at a dietary DM inclusion of 20%. Both experiments were analyzed as a randomized completed block design with pen as experimental unit. In Exp. 1, final BW tended (P = 0.07) to be increased by 3 kg in kernel processed corn silage. Daily weight gain and DM intake were increased (P ≤ 0.04) by 6% and 2%, respectively, in steers fed kernel processed corn silage compared to controls; however, gain efficiency was not appreciably influenced by treatment (P = 0.15). In Exp. 2, there were no harvest maturity × kernel processing interactions (P ≥ 0.26) for any growth performance measures or any parameters related to efficiency of dietary NE utilization. No harvest maturity × kernel processing interactions (P ≥ 0.08) were observed for any carcass traits except for the distribution of USDA Prime carcasses (P = 0.04). Steers fed 2/3 milk line and unprocessed corn silage had a lower (P = 0.05) proportion of carcasses grade USDA Prime (0.0%) compared to all other treatments (12.0%). Harvest time (P ≥ 0.07) and kernel processing (P ≥ 0.07) of corn silage had no appreciable influence on any other carcass trait measures. These data indicate that kernel processed corn silage fed to growing calves at 65% diet inclusion (DM basis) enhances intake and daily gain, while kernel processed corn silage fed to finishing steers at 20% diet inclusion (DM basis) does not appreciably influence daily gain, efficiency of gain, or carcass parameters.
Molecular epidemiology of clinical filamentous fungi in Qatar beyond Aspergillus and Fusarium with notes on the rare species
Authors: Salah Husam , Houbraken Jos , Boekhout Teun , Almaslamani Muna , Taj-Aldeen Saad J
Published: January 2023

Due to an increasing number of patients at risk (i.e., those with a highly compromised immune system and/or receiving aggressive chemotherapy treatment), invasive fungal infections (IFI) are increasingly being reported and associated with high mortality rates. Aspergillus spp., particularly A. fumigatus, is the major cause of IFI caused by filamentous fungi around the world followed by Fusarium spp., however, other fungi are emerging as human pathogens. The aim of this study was to explore the epidemiology and prevalence of the non-Aspergillus and non-Fusarium filamentous fungi in human clinical samples over an 11-year period in Qatar using molecular techniques. We recovered 53 filamentous fungal isolates from patients with various clinical conditions. Most patients were males (75.5%), 9.4% were immunocompromised, 20.7% had IFI, and 11.3% died within 30 days of diagnosis. The fungal isolates were recovered from a variety of clinical samples, including the nasal cavity, wounds, respiratory samples, body fluids, eye, ear, tissue, abscess, and blood specimens. Among the fungi isolated, 49% were dematiaceous fungi, followed by Mucorales (30%), with the latter group Mucorales being the major cause of IFI (5/11, 45.5%). The current study highlights the epidemiology and spectrum of filamentous fungal genera, other than Aspergillus and Fusarium, recovered from human clinical samples in Qatar, excluding superficial infections, which can aid in the surveillance of uncommon and emerging mycoses.
Evidence of extended cold molecular gas and dust haloes around z ~ 2.3 extremely red quasars with ALMA
Authors: Scholtz J , Maiolino R , Jones G C , Carniani S
Published: January 2023

Large-scale outflows are believed to be an important mechanism in the evolution of galaxies. We can determine the impact of these outflows by studying either current galaxy outflows and their effect in the galaxy or by studying the effect of past outflows on the gas surrounding the galaxy. In this work, we examine the CO(7−6), [C i] ($^{3} \rm P_{1} \rightarrow {\rm ^3 P}_{0}$), H2O 211–202, and dust continuum emission of 15 extremely red quasars at z ∼ 2.3 using ALMA. By investigating the radial surface brightness profiles of both the individual sources and the stacked emission, we detect extended cold gas and dust emission on scales of ∼14 kpc in CO(7−6), [C i](2−1), and dust continuum. This is the first time that the presence of a large amount of molecular gas was detected on large, circumgalactic medium scales around quasar host galaxies using [C i] extended emission. We estimate the dust and molecular gas mass of these haloes to be 107.6 and 1010.6 M⊙, indicating significant dust and molecular gas reservoirs around these extreme quasars. By estimating the time-scale at which this gas can reach these distances by molecular gas outflows (7–32 Myr), we conclude that these haloes are a relic of past AGN or starburst activity, rather than an effect of the current episode of extreme quasar activity.
Accurate prediction of isocitrate dehydrogenase -mutation status of gliomas using SLOW-editing magnetic resonance spectroscopic imaging at 7 T MR
Authors: Weng Guodong , Ermiş Ekin , Maragkou Theoni , Krcek Reinhardt , Reinhardt Philipp , Zubak Irena , Schucht Philippe , Wiest Roland , Slotboom Johannes , Radojewski Piotr
Published: January 2023

Background

2-hydroxy-glutarate (2HG) is a metabolite that accumulates in isocitrate dehydrogenase (IDH)-mutated gliomas and can be detected noninvasively using MR spectroscopy. However, due to the low concentration of 2HG, established magnetic resonance spectroscopic imaging (MRSI) techniques at the low field have limitations with respect to signal-to-noise and to the spatial resolution that can be obtained within clinically acceptable measurement times. Recently a tailored editing method for 2HG detection at 7 Tesla (7 T) named SLOW-EPSI was developed. The underlying prospective study aimed to compare SLOW-EPSI to established techniques at 7 T and 3 T for IDH-mutation status determination.

Methods

The applied sequences were MEGA-SVS and MEGA-CSI at both field strengths and SLOW-EPSI at 7 T only. Measurements were performed on a MAGNETOM-Terra 7 T MR-scanner in clinical mode using a Nova 1Tx32Rx head coil and on a 3 T MAGNETOM-Prisma scanner with a standard 32-channel head coil.

Results

Fourteen patients with suspected glioma were enrolled. Histopathological confirmation was available in 12 patients. IDH mutation was confirmed in 9 out of 12 cases and 3 cases were characterized as IDH wildtype. SLOW-EPSI at 7 T showed the highest accuracy for IDH-status prediction (91.7% accuracy, 11 of the 12 predictions correct with 1 false negative case). At 7 T, MEGA-CSI had an accuracy of 58.3% and MEGA-SVS had an accuracy of 75%. At 3 T, MEGA-CSI showed an accuracy of 63.6% and MEGA-SVS of 33.3%. The co-edited cystathionine was detected in 2 out of 3 oligodendroglioma cases with 1p/19q codeletion.

Conclusions

Depending on the pulse sequence, spectral editing can be a powerful tool for the noninvasive determination of the IDH status. SLOW-editing EPSI sequence is the preferable pulse sequence when used at 7 T for IDH-status characterization.
Globalization, Trade Imbalances, and Labor Market Adjustment
Authors: Dix-Carneiro Rafael , Pessoa João Paulo , Reyes-Heroles Ricardo , Traiberman Sharon
Published: January 2023

We argue that modeling trade imbalances is crucial for understanding transitional dynamics in response to globalization shocks. We build and estimate a general equilibrium, multicountry, multisector model of trade with two key ingredients: (i) endogenous trade imbalances arising from households’ consumption and saving decisions; (ii) labor market frictions across and within sectors. We use our model to perform several empirical exercises. We find that the “China shock” accounted for 28% of the decline in U.S. manufacturing between 2000 and 2014—1.65 times the magnitude predicted from a model imposing balanced trade. A concurrent rise in U.S. service employment led to a negligible aggregate unemployment response. We benchmark our model’s predictions for the gains from trade against the popular ACR sufficient-statistics approach. We find that our predictions for the long-run gains from trade and consumption dynamics significantly diverge.
Molecular detection of Schistosoma species in unusual snail hosts: a note of caution
Authors: Pinto Hudson Alves
Published: January 2023

The interaction between snails and species of Schistosoma results from an evolutionary process with an intrinsic host–parasite specificity to the snail genus. Faced with this fact, the recent molecular-based report on the potential infection of the thiarid Melanoides tuberculata with human schistosome should be cautiously interpreted. The high sensibility of molecular tools can result in false positives, perhaps by amplifying DNA from an external (contaminant) or invasive stage of schistosome found in this non-permissive snail host. Thus, parasitological data are mandatory to extrapolate the importance of the finding for the epidemiology and control of schistosomiasis.
Congenital vertical talus deformity in children with distal arthrogryposis: good clinical outcomes despite high rate of residual radiographic deformity
Authors: Cummings Jason L. , Hosseinzadeh Pooya
Published: January 2023

Background

Patients with a diagnosis of arthrogryposis often present with various orthopedic conditions, one of which is congenital vertical talus (CVT). This is the first study of this specific subset of syndromic patients to evaluate the medium-term outcomes of CVT correction using the minimally invasive Dobbs method.

Methods

All patients with vertical talus and distal arthrogryposis who received treatment at our institution between January 2006 and June 2021 were identified. Radiographs, clinical notes and Patient-Reported Outcome Measurement Information System (PROMIS) scores (when available) were retrospectively reviewed. An alpha of 0.05 was used for all statistical analyses.

Results

In total 12 patients (19 feet) met all inclusion criteria and were included in the final analysis. By the time of the most recent visit, the average lateral Talar-Axis First Metatarsal Base Angle of the entire cohort increased from 13.73 ± 9.75 degrees 2 weeks postoperatively to 28.75 ± 23.73 degrees (P = 0.0076). Radiographic recurrence of the talonavicular deformity was seen in nine feet (47.4%), 4 (21.1%) of which required additional unplanned surgery, The average PROMIS scores of the entire cohort in the pain interference, mobility and peer relationship domains were 48.97 ± 9.56, 47.9 ± 11.60 and 52.87 ± 8.31, respectively.

Conclusion

Despite a higher radiographic recurrence rate of talonavicular deformity in this specific subset of syndromic patients, these patients still report PROMIS scores near the population average in the pain interference, mobility and peer relationships domains. We believe that the minimally invasive Dobbs method should be recommended as the first-line treatment method for these patients. Level of evidence: Level III
INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury, Part III: Executive Functions
Authors: Jeffay Eliyas , Ponsford Jennie , Harnett Amber , Janzen Shannon , Patsakos Eleni , Douglas Jacinta , Kennedy Mary , Kua Ailene , Teasell Robert , Welch-West Penny , Bayley Mark , Green Robin
Published: January 2023

Introduction:

Moderate-to-severe traumatic brain injury (MS-TBI) causes debilitating and enduring impairments of executive functioning and self-awareness, which clinicians often find challenging to address. Here, we provide an update to the INCOG 2014 guidelines for the clinical management of these impairments.

Methods:

An expert panel of clinicians/researchers (known as INCOG) reviewed evidence published from 2014 and developed updated recommendations for the management of executive functioning and self-awareness post-MS-TBI, as well as a decision-making algorithm, and an audit tool for review of clinical practice.

Results:

A total of 8 recommendations are provided regarding executive functioning and self-awareness. Since INCOG 2014, 4 new recommendations were made and 4 were modified and updated from previous recommendations. Six recommendations are based on level A evidence, and 2 are based on level C. Recommendations retained from the previous guidelines and updated, where new evidence was available, focus on enhancement of self-awareness (eg, feedback to increase self-monitoring; training with video-feedback), meta-cognitive strategy instruction (eg, goal management training), enhancement of reasoning skills, and group-based treatments. New recommendations addressing music therapy, virtual therapy, telerehabilitation-delivered metacognitive strategies, and caution regarding other group-based telerehabilitation (due to a lack of evidence) have been made.

Conclusions:

Effective management of impairments in executive functioning can increase the success and well-being of individuals with MS-TBI in their day-to-day lives. These guidelines provide management recommendations based on the latest evidence, with support for their implementation, and encourage researchers to explore and validate additional factors such as predictors of treatment response.
Variable Identification of Children With Medical Complexity in United States PICUs
Authors: Heneghan Julia A. , Goodman Denise M. , Ramgopal Sriram
Published: January 2023

OBJECTIVES:

Children with medical complexity are at increased risk for critical illness and adverse outcomes. However, there is currently no consensus definition of medical complexity in pediatric critical care research.

DESIGN:

Retrospective, cross-sectional cohort study.

SETTING:

One hundred thirty-one U.S. PICUs participating in the Virtual Pediatric Systems Database.

SUBJECTS:

Children less than 21 years old admitted from 2017 to 2019. Multisystem complexity was identified on the basis of two common definitions of medical complexity, Pediatric Complex Chronic Conditions (CCC), greater than or equal to 2 qualifying diagnoses, and Pediatric Medical Complexity Algorithm (PMCA), complex chronic disease.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Of 291,583 index PICU admissions, 226,430 (77.7%) met at least one definition of multisystem complexity, including 168,332 patients identified by CCC and 201,537 by PMCA. Of these, 143,439 (63.3%) were identified by both definitions. Cohen kappa was 0.39, indicating only fair agreement between definitions. Children identified by CCC were younger and were less frequently scheduled admissions and discharged home from the ICU than PMCA. The most common reason for admission was respiratory in both groups, although this represented a larger proportion of CCC patients. ICU and hospital length of stay were longer for patients identified by CCC. No difference in median severity of illness scoring was identified between definitions, but CCC patients had higher inhospital mortality. Readmission to the ICU in the subsequent year was seen in approximately one-fifth of patients in either group.

CONCLUSIONS:

Commonly used definitions of medical complexity identified distinct populations of children with multisystem complexity in the PICU with only fair agreement.
Nomogram-based survival predictions of patients with soft tissue cancer including heart in the United States
Authors: Ahmmad Roungu
Published: January 2023

Introduction

This study aimed to assess the effects of cancer treatment on sarcoma types and to predict overall survival probabilities using nomograms.

Methods

This study uses the SEER-18 database, Version 2020, sponsored by the National Cancer Institute (NCI). The study cohort included participants diagnosed between 2000 and 2018 with soft tissue cancers including heart. A multivariable Cox proportional hazards model was applied to predict mortality rate, and nomograms were used to predict overall survival probability.

Results

The median survival time for 24,849 study participants was 48 months (IQR: 19-102) with Spindle Cell Sarcoma (ScS) having a shorter median survival time compared with Liposarcoma (LiS). A significant number of STS patients had surgery, where surgery on ScS improved survival by 75% (HR: 0.25, 95%CI: 0.19-0.32, p<0.001) and those who received radiation had a 26% improvement (HR: 0.74, 95%CI: 0.61-0.89, p=0.001). Furthermore, chemotherapy on GcS resulted in a 40% reduction in mortality for patients compared to those who did not receive chemotherapy (HR 0.60, 95%CI:0.45-0.80, p<0.001). Based on nomogram, after two, five, and ten years, a patient who received surgery on their primary sites would have a survival rate of approximately 90 percent. In contrast, a patient who did not receive surgery on their primary sites would only live for 20 percent or less. Patients with MyS have a 90% chance of surviving for 5 and 10 years after surgery, but only 22% and 10% without surgery.

Conclusions

Based on the results of this study, surgical and radiation intervention on sarcomas was associated with improved survival in patients with STS, while chemotherapy and primary systemic therapy had contradictory effects.
A Physiologically-Based Pharmacokinetic Model for Tuberculosis Drug Disposition at Extrapulmonary Sites
Authors: Ramachandran Aparna , Gadgil Chetan J.
Published: January 2023

Tuberculosis (TB) is a leading cause of mortality due to an infectious agent. TB primarily targets the lungs but in about 16% cases can affect other organs as well, giving rise to extrapulmonary TB (EPTB). However, an optimal regimen for EPTB treatment is not defined. While the recommended treatment for most forms of EPTB is the same as pulmonary TB, pharmacokinetics of EPTB therapy are not as well-studied. To address this gap, we formulate a whole-body physiologically-based pharmacokinetic (PBPK) model for EPTB that for the first time includes the ability to simulate drug concentrations in the pleura and lymph node. Using this model, we estimate the time-dependent concentrations, at potential EPTB infection sites, of the 4 first-line anti-TB drugs: Rifampicin, Ethambutol, Isoniazid and Pyrazinamide. We utilise reported plasma concentration kinetics data to estimate model parameters for each drug, and validate our model using reported concentration data not used for model formulation or parameter estimation. Model predictions match the validation data and reported PK parameters (Cmax, tmax) for the drugs. The model also predicts Ethambutol, Isoniazid and Pyrazinamide concentrations in the pleura that match reported experimental values from an independent study. For each drug, the model is used to simulate the time-dependent drug concentrations at various EPTB sites. Predicted drug concentrations are compared to their critical concentration. Simulations suggest that while Rifampicin and Isoniazid concentrations are greater than critical concentration values at most EPTB sites, the concentrations of Ethambutol and Pyrazinamide are lower than their critical concentrations at most EPTB sites.
Evaluation of Simple and Convenient Methods for SARS-CoV-2 Detection in Wastewater in high and Low Resource Settings
Authors: Liu Pengbo , Guo Lizheng , Cavallo Matthew , Cantrell Caleb , Hilton Stephen Patrick , Dunbar Jillian , Barbero Robbie , Barclay Robert , Sablon Orlando III , Wolfe Marlene , Lepene Ben , Moe Christine
Published: January 2023

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) RNA monitoring in wastewater has become an important tool for COVID-19 surveillance. Although many viral concentration methods such as membrane filtration and skim milk are reported, these methods generally require large volumes of wastewater, expensive lab equipment, and laborious processes. We utilized a Nanotrap®Microbiome A Particles (Nanotrap particle) method for virus concentration in wastewater. The method was evaluated across six parameters: pH, temperature, incubation time, wastewater volumes, RNA extraction methods, and two virus concentration approaches vs. a one-step method. The method was further evaluated with the addition of the Nanotrap Enhancement Reagent 1 (ER1) by comparing the automated vs. a manual Nanotrap particle method. RT-qPCR targeting the nucleocapsid protein was used for detection and quantification of SARS-CoV-2 RNA. Different pH, temperature, incubation time, wastewater volumes, and RNA extraction methods did not result in reduced SARS-CoV-2 detection in wastewater samples. The two-step concentration method showed significantly better results (P<0.01) than the one-step method. Adding ER1 to wastewater prior to viral concentration using the Nanotrap particles significantly improved PCR Ct results (P<0.0001) in 10 mL grab samples processed by automated Nanotrap particle method or 10 mL and 40 mL samples processed by manual Nanotrap particle method. SARS-CoV-2 detection in 10 mL grab samples with ER1 and the automated method showed significantly better (P=0.0008) results than 150 mL grab samples using the membrane filtration method. SARS-CoV-2 detection in 10 mL swab samples with ER1 via the automated method was also significantly better than without ER1 (P<0.0001) and the skim milk method in 250 mL Moore swab samples (P=0.012). These results suggest that Nanotrap methods could substitute the traditional membrane filtration and skim milk methods for viral concentration without compromising on the assay sensitivity. The manual method can be used in resource-limited areas, and the high-throughput platform is appropriate for large-scale COVID-19 wastewater-based surveillance.