bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of the giant planets on the dynamical evolution of the mutual orbits of trans-Neptunian binaries
Authors: Brunini Adrián
Published: April 2023

The action of tidal friction, coupled with the Kozai cycles, drastically changed the original orbits of trans-Neptunian binaries (TNBs). The dynamics of the Kozai mechanism is driven by the solar torque on the mutual orbit, so that the orientation of the latter relative to the heliocentric orbital plane plays a fundamental role in this process, both in the magnitude and in the characteristic of the cycles. In this way, any effect that makes this relative orientation vary may be relevant in the dynamics of the process. In this paper, we will focus on the effect that the perturbations of the giant planets on the heliocentric orbit of TNBs have on the dynamics of the Kozai cycles and tidal friction. For this task, we have performed numerical simulations of the evolution of a synthetic population of TNBs subject to Kozai cycles and tidal friction adding planetary perturbation on their heliocentric orbits. We found that in a non-negligible fraction of cases (∼25 per cent), this additional perturbation produces substantial changes in the orbital evolution. The slow precession of the heliocentric orbit and the variation of its inclination can make the dynamical evolution of the mutual orbits very irregular, completely changing the morphology of the Kozai cycles. When these variations are coupled to tidal friction, the lifetime of the TNBs can change substantially.
Formation of star clusters and enrichment by massive stars in simulations of low-metallicity galaxies with a fully sampled initial stellar mass function
Authors: Lahén Natalia , Naab Thorsten , Kauffmann Guinevere , Szécsi Dorottya , Hislop Jessica May , Rantala Antti , Kozyreva Alexandra , Walch Stefanie , Hu Chia-Yu
Published: April 2023

We present new griffin project hydrodynamical simulations that model the formation of galactic star cluster populations in low-metallicity (Z = 0.00021) dwarf galaxies, including radiation, supernova, and stellar wind feedback of individual massive stars. In the simulations, stars are sampled from the stellar initial mass function (IMF) down to the hydrogen-burning limit of 0.08 M⊙. Mass conservation is enforced within a radius of 1 pc for the formation of massive stars. We find that massive stars are preferentially found in star clusters and follow a correlation set at birth between the highest initial stellar mass and the star cluster mass that differs from pure stochastic IMF sampling. With a fully sampled IMF, star clusters lose mass in the galactic tidal field according to mass-loss rates observed in nearby galaxies. Of the released stellar feedback, 60 per cent of the supernova material and up to 35 per cent of the wind material reside either in the hot interstellar medium (ISM) or in gaseous, metal-enriched outflows. While stellar winds (instantaneously) and supernovae (delayed) start enriching the ISM right after the first massive stars form, the formation of supernova-enriched stars and star clusters is significantly delayed (by >50 Myr) compared to the formation of stars and star clusters enriched by stellar winds. Overall, supernova ejecta dominate the enrichment by mass, while the number of enriched stars is determined by continuous stellar winds. These results present a concept for the formation of chemically distinct populations of stars in bound star clusters, reminiscent of multiple populations in globular clusters.
LOGGIC Core BioClinical Data Bank: Added clinical value of RNA-Seq in an international molecular diagnostic registry for pediatric low-grade glioma patients
Authors: Hardin Emily C , Schmid Simone , Sommerkamp Alexander , Bodden Carina , Heipertz Anna-Elisa , Sievers Philipp , Wittmann Andrea , Milde Till , Pfister Stefan M , von Deimling Andreas , Horn Svea , Herz Nina A , Simon Michèle , Perera Ashwyn A , Azizi Amedeo , Cruz Ofelia , Curry Sarah , Van Damme An , Garami Miklos , Hargrave Darren , Kattamis Antonis , Kotnik Barbara Faganel , Lähteenmäki Päivi , Scheinemann Katrin , Schouten-van Meeteren Antoinette Y N , Sehested Astrid , Viscardi Elisabetta , Wormdal Ole Mikal , Zapotocky Michal , Ziegler David S , Koch Arend , Hernáiz Driever Pablo , Witt Olaf , Capper David , Sahm Felix , Jones David T W , van Tilburg Cornelis M
Published: April 2023

Background

The international, multicenter registry LOGGIC Core BioClinical Data Bank aims to enhance the understanding of tumor biology in pediatric low-grade glioma (pLGG) and provide clinical and molecular data to support treatment decisions and interventional trial participation. Hence, the question arises whether implementation of RNA sequencing (RNA-Seq) using fresh frozen (FrFr) tumor tissue in addition to gene panel and DNA methylation analysis improves diagnostic accuracy and provides additional clinical benefit.

Methods

Analysis of patients aged 0 to 21 years, enrolled in Germany between April 2019 and February 2021, and for whom FrFr tissue was available. Central reference histopathology, immunohistochemistry, 850k DNA methylation analysis, gene panel sequencing, and RNA-Seq were performed.

Results

FrFr tissue was available in 178/379 enrolled cases. RNA-Seq was performed on 125 of these samples. We confirmed KIAA1549::BRAF-fusion (n = 71), BRAF V600E-mutation (n = 12), and alterations in FGFR1 (n = 14) as the most frequent alterations, among other common molecular drivers (n = 12). N = 16 cases (13%) presented rare gene fusions (eg, TPM3::NTRK1, EWSR1::VGLL1, SH3PXD2A::HTRA1, PDGFB::LRP1, GOPC::ROS1). In n = 27 cases (22%), RNA-Seq detected a driver alteration not otherwise identified (22/27 actionable). The rate of driver alteration detection was hereby increased from 75% to 97%. Furthermore, FGFR1 internal tandem duplications (n = 6) were only detected by RNA-Seq using current bioinformatics pipelines, leading to a change in analysis protocols.

Conclusions

The addition of RNA-Seq to current diagnostic methods improves diagnostic accuracy, making precision oncology treatments (MEKi/RAFi/ERKi/NTRKi/FGFRi/ROSi) more accessible. We propose to include RNA-Seq as part of routine diagnostics for all pLGG patients, especially when no common pLGG alteration was identified.
High-timing-precision detection of single X-ray photons by superconducting nanowires
Authors: Guo Shuya , Tan Jingrou , Zhang Hengbin , Wang Jinguang , Ji Tianhao , Zhang Labao , Hu Xiaolong , Chen Jian , Xie Jun , Zou Kai , Meng Yun , Bei Xiaomin , Wu Ling-An , Chen Qi , Wang Hao , Tu Xuecou , Jia Xiaoqing , Zhao Qing-Yuan , Kang Lin , Wu Peiheng
Published: April 2023

Precisely acquiring the timing information of individual X-ray photons is important in both fundamental research and practical applications. The timing precision of commonly used X-ray single-photon detectors remains in the range of one hundred picoseconds to microseconds. In this work, we report on high-timing-precision detection of single X-ray photons through the fast transition to the normal state from the superconductive state of superconducting nanowires. We successfully demonstrate a free-running X-ray single-photon detector with a timing resolution of 20.1 ps made of 100-nm-thick niobium nitride film with an active area of 50 μm by 50 μm. By using a repeated differential timing measurement on two adjacent X-ray single-photon detectors, we demonstrate a precision of 0.87 ps in the arrival-time difference of X-ray photon measurements. Therefore, our work significantly enhances the timing precision in X-ray photon counting, opening a new niche for ultrafast X-ray photonics and many associated applications.
Pneumococcal Conjugate Vaccines Are Protective Against Respiratory Syncytial Virus Hospitalizations in Infants: A Population-Based Observational Study
Authors: Le Huong , Gidding Heather , Blyth Christopher C , Richmond Peter , Moore Hannah C
Published: April 2023

Background

Pneumococcal conjugate vaccines (PCV) reduced the risk of respiratory syncytial virus (RSV) in a randomized clinical trial. We aimed to assess the real-world effectiveness of PCV on RSV-hospitalizations among Western Australian infants.

Methods

We conducted a population-based cohort study of births during 2000–2012, using probabilistically linked individual-level immunization, hospitalization, respiratory microbiology testing, and perinatal data. We performed Cox proportional hazard models with time-varying exposure (receipt of infant PCV doses) against the first RSV-confirmed hospitalization 0–12 months adjusted for perinatal and sociodemographic factors.

Results

From 360 994 children, 3-dose PCV coverage in Aboriginal infants ranged from 29% to 51% in 2001–2004 when PCV was funded for Aboriginal children only. Following universal funding in 2005, coverage increased to 85% for Aboriginal and 73% for non-Aboriginal infants. RSV-hospitalization rates were highest in young infants aged 0–5 months (22.5/1000 child-years) and >2 times higher in Aboriginal infants than in non-Aboriginal infants. Receipt of ≥3 PCV doses in the universal funded period was associated with a 30% reduction in RSV-hospitalization in Aboriginal infants (adjusted hazard ratio, aHR 0.70 [95% confidence interval, CI 0.46–1.06]) and 21% reduction in non-Aboriginal infants (aHR 0.79 [95% CI 0.63–0.99]) compared with unvaccinated infants.

Conclusions

Prior to the introduction of RSV vaccines, our study suggests that universal childhood PCV vaccination may result in a reduction in severe RSV infections in children and may be important for countries that are yet to consider PCV programs.
Effectiveness of the Coronavirus Disease 2019 Bivalent Vaccine
Authors: Shrestha Nabin K , Burke Patrick C , Nowacki Amy S , Simon James F , Hagen Amanda , Gordon Steven M
Published: April 2023

Background

The purpose of this study was to evaluate whether a bivalent coronavirus disease 2019 (COVID-19) vaccine protects against COVID-19.

Methods

The study included employees of Cleveland Clinic in employment when the bivalent COVID-19 vaccine first became available. Cumulative incidence of COVID-19 over the following 26 weeks was examined. Protection provided by vaccination (analyzed as a time-dependent covariate) was evaluated using Cox proportional hazards regression, with change in dominant circulating lineages over time accounted for by time-dependent coefficients. The analysis was adjusted for the pandemic phase when the last prior COVID-19 episode occurred and the number of prior vaccine doses.

Results

Among 51 017 employees, COVID-19 occurred in 4424 (8.7%) during the study. In multivariable analysis, the bivalent-vaccinated state was associated with lower risk of COVID-19 during the BA.4/5-dominant (hazard ratio, 0.71 [95% confidence interval, .63–79]) and the BQ-dominant (0.80 [.69–.94]) phases, but decreased risk was not found during the XBB-dominant phase (0.96 [.82–.1.12]). The estimated vaccine effectiveness was 29% (95% confidence interval, 21%–37%), 20% (6%–31%), and 4% (−12% to 18%), during the BA.4/5-, BQ-, and XBB-dominant phases, respectively. The risk of COVID-19 also increased with time since the most recent prior COVID-19 episode and with the number of vaccine doses previously received.

Conclusions

The bivalent COVID-19 vaccine given to working-aged adults afforded modest protection overall against COVID-19 while the BA.4/5 lineages were the dominant circulating strains, afforded less protection when the BQ lineages were dominant, and effectiveness was not demonstrated when the XBB lineages were dominant.
Effectiveness of Casirivimab and Imdevimab Antibody Combination in Immunocompromised Hospitalized Patients With Coronavirus Disease 2019: A Post Hoc Analysis in a Phase 1/2/3 Double–Blind Trial
Authors: Somersan-Karakaya Selin , Mylonakis Eleftherios , Mou Jenni , Oviedo-Orta Ernesto , O’Brien Meagan P , Mas Casullo Veronica , Mahmood Adnan , Hooper Andrea T , Hussein Mohamed , Ali Shazia , Marty Francisco M , Forleo-Neto Eduardo , Bhore Rafia , Hamilton Jennifer D , Herman Gary A , Hirshberg Boaz , Weinreich David M
Published: April 2023

Background

Individuals who are immunocompromised (IC) are at high risk for severe coronavirus disease 2019 (COVID-19).

Methods

Post hoc analyses of a double-blind trial conducted prior to Omicron (June 2020–April 2021), in hospitalized patients with COVID-19 assessed viral load, clinical outcomes, and safety of casirivimab plus imdevimab (CAS + IMD) versus placebo in IC versus overall study patients.

Results

Ninety-nine of 1940 (5.1%) patients were IC. IC versus overall patients were more frequently seronegative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies (68.7% vs 41.2%) and had higher median baseline viral loads (7.21 vs 6.32 log10 copies/mL). On placebo, IC versus overall patients had slower viral load declines. CAS + IMD reduced viral load in IC and overall patients; least-squares mean difference versus placebo in time-weighted average change from baseline viral load at day 7 was −0.69 (95% confidence interval [CI], −1.25 to −.14) log10 copies/mL for IC patients and −0.31 (95% CI, −.42 to −.20) log10 copies/mL for overall patients. For IC patients, the cumulative incidence of death or mechanical ventilation at day 29 was lower with CAS + IMD (11.0%) versus placebo (17.2%), consistent with overall patients (15.7% CAS + IMD vs 18.3% placebo). IC and overall patients receiving CAS + IMD exhibited similar rates of treatment-emergent adverse events (30.4% and 26.6%, respectively), grade ≥2 hypersensitivity or infusion-related reactions (1.4% and 2.5%), and deaths (8.7% and 12.2%).

Conclusions

IC patients were more likely to exhibit high viral loads and be seronegative at baseline. For susceptible SARS-CoV-2 variants, CAS + IMD reduced viral load and resulted in fewer death or mechanical ventilation events in IC and overall study patients. There were no new safety findings among IC patients.

Clinical Trials Registration. NCT04426695.
Cotton leaf curl Multan virus C4 protein suppresses autophagy to facilitate viral infection
Authors: Yang Meng , Ismayil Asigul , Gao Teng , Ye Zihan , Yue Ning , Wu Jie , Zheng Xiyin , Li Yiqing , Wang Yan , Hong Yiguo , Liu Yule
Published: April 2023

Autophagy plays an important role in plant antiviral defense. Several plant viruses are reported to encode viral suppressor of autophagy (VSA) to prevent autophagy for effective virus infection. However, whether and how other viruses, in particular DNA viruses, also encode VSAs to affect viral infection in plants is unknown. Here, we report that the C4 protein encoded by Cotton leaf curl Multan geminivirus (CLCuMuV) inhibits autophagy by binding to the autophagy negative regulator eukaryotic translation initiation factor 4A (eIF4A) to enhance the eIF4A—Autophagy-related protein 5 (ATG5) interaction. By contrast, the R54A or R54K mutation in C4 abolishes its capacity to interact with eIF4A, and neither C4R54A nor C4R54K can suppress autophagy. However, the R54 residue is not essential for C4 to interfere with transcriptional gene silencing or post-transcriptional gene silencing. Moreover, plants infected with mutated CLCuMuV-C4R54K develop less severe symptoms with decreased levels of viral DNA. These findings reveal a molecular mechanism underlying how the DNA virus CLCuMuV deploys a VSA to subdue host cellular antiviral autophagy defense and uphold viral infection in plants.
Plant-on-chip: Core morphogenesis processes in the tiny plant Wolffia australiana
Authors: Li Feng , Yang Jing-Jing , Sun Zong-Yi , Wang Lei , Qi Le-Yao , A Sina , Liu Yi-Qun , Zhang Hong-Mei , Dang Lei-Fan , Wang Shu-Jing , Luo Chun-Xiong , Nian Wei-Feng , O’Conner Seth , Ju Long-Zhen , Quan Wei-Peng , Li Xiao-Kang , Wang Chao , Wang De-Peng , You Han-Li , Cheng Zhu-Kuan , Yan Jia , Tang Fu-Chou , Yang De-Chang , Xia Chu-Wei , Gao Ge , Wang Yan , Zhang Bao-Cai , Zhou Yi-Hua , Guo Xing , Xiang Sun-Huan , Liu Huan , Peng Tian-Bo , Su Xiao-Dong , Chen Yong , Ouyang Qi , Wang Dong-Hui , Zhang Da-Ming , Xu Zhi-Hong , Hou Hong-Wei , Bai Shu-Nong , Li Ling
Published: April 2023

A plant can be thought of as a colony comprising numerous growth buds, each developing to its own rhythm. Such lack of synchrony impedes efforts to describe core principles of plant morphogenesis, dissect the underlying mechanisms, and identify regulators. Here, we use the minimalist known angiosperm to overcome this challenge and provide a model system for plant morphogenesis. We present a detailed morphological description of the monocot Wolffia australiana, as well as high-quality genome information. Further, we developed the plant-on-chip culture system and demonstrate the application of advanced technologies such as single-nucleus RNA-sequencing, protein structure prediction, and gene editing. We provide proof-of-concept examples that illustrate how W. australiana can decipher the core regulatory mechanisms of plant morphogenesis.
Regional superficial amygdala resting-state functional connectivity in adults infers childhood maltreatment severity
Authors: Liu Qi , Song Xinwei , Zhou Xinqi , Huang Linghong , Zhang Xiaodong , Wang Lan , Zhu Siyu , Lan Chunmei , Yang Wenxu , Zhao Weihua
Published: April 2023

Background

Childhood maltreatment (CM) is a potential risk factor for some neuropsychiatric disorders in adulthood (e.g. depression and anxiety) and alters trajectories of brain development. Accumulating evidence suggests that functional connectivity of the limbic system, especially the amygdala, is highly associated with childhood maltreatment, although not all studies have found this. These inconsistent results may be due to differential alterations of amygdala resting-state functional connectivity (rsFC) following childhood maltreatment.

Objective

Our aim was to investigate the relationship between the rsFC of amygdala subregions and CM severity, as well as to develop a stable rsFC-based model for inferring the severity of CM.

Methods

In this study, we employed the Childhood Trauma Questionnaire (CTQ) to assess CM severity in each individual. We explored the relationship between the rsFC of amygdala subregions (i.e. centromedial -CMA, basolateral -BLA, superficial-SFA amygdala) and CM experience in a discovery dataset of n = 110 healthy Chinese participants by linear multiple regression analysis. Subsequent dimensional and categorical approach were performed to elucidate the relationship between rsFCs and CM severity and CM subtypes, respectively. A support vector regression model was then conducted to validate the associations between rsFCs and total CTQ scores. Moreover, we also verified the model into another independent replication dataset (n = 38).

Results

Our findings suggested that childhood maltreatment was negatively associated with rsFC between the right superficial amygdala and perigenual anterior cingulate cortex (pgACC)/postcentral gyrus (PCG) but not the other two amygdala subregions. Moreover, SFA-pgACC coupling was more associated with physical neglect whereas the SFA-PCG was more related to emotional neglect. In addition, supervised machine learning confirmed that using these two rsFCs as predictors could stably estimate continuous maltreatment severity in both discovery and replication datasets.

Conclusion

The current study supports that the rsFCs of superficial amygdala are related to childhood maltreatment and which may be a potential biomarker for the effects of childhood maltreatment-related psychiatric disorders (i.e. depression and anxiety).
An injectable hydrogel combining medicine and matrix with anti-inflammatory and pro-angiogenic properties for potential treatment of myocardial infarction
Authors: Feng Jiayin , Xing Min , Qian Wenhao , Qiu Jiajun , Liu Xuanyong
Published: April 2023

One of the main illnesses that put people’s health in jeopardy is myocardial infarction (MI). After MI, damaged or dead cells set off an initial inflammatory response that thins the ventricle wall and degrades the extracellular matrix. At the same time, the ischemia and hypoxic conditions resulting from MI lead to significant capillary obstruction and rupture, impairing cardiac function and reducing blood flow to the heart. Therefore, attenuating the initial inflammatory response and promoting angiogenesis are very important for the treatment of MI. Here, to reduce inflammation and promote angiogenesis in infarcted area, we report a new kind of injectable hydrogel composed of puerarin and chitosan via in situ self-assembly with simultaneous delivery of mesoporous silica nanoparticles (CHP@Si) for myocardial repair. On the one hand, puerarin degraded from CHP@Si hydrogel modulated the inflammatory response via inhibiting M1-type polarization of macrophages and expression of pro-inflammatory factors. On the other hand, silica ions and puerarin released from CHP@Si hydrogel showed synergistic activity to improve the cell viability, migration and angiogenic gene expression of HUVECs in both conventional and oxygen/glucose-deprived environments. It suggests that this multifunctional injectable CHP@Si hydrogel with good biocompatibility may be an appropriate candidate as a bioactive material for myocardial repair post-MI.
A review of Zenalb 20 with the focus on its application in the clinical setting for patients requiring low sodium or chloride albumin
Authors: Patel Hitan , Dash Clive H , Paddick Martyn , Turnbull Robin , More John
Published: April 2023

Objectives

Perceptions that formulations of human albumin solution have not evolved and are interchangeable need to be reconsidered amid renewed appreciation of this therapy in its current uses, and in potential new uses. Initially indicated for volume expansion in severely ill or trauma patients, human albumin solution has been established in a broadening array of clinical applications as understanding of its structure–function relationships has deepened. This article reviews the clinical roles of human albumin solution, the evolution of manufacturing processes and the growing interest in the use of albumin as a therapeutic agent in an expanding range of clinical scenarios.

Methods

Literature searching was conducted through PubMed, bibliographies of prior publications specific to human albumin solution and ClinicalTrials.gov. This review includes multidisciplinary perspectives on the chemistry, physiology, extraction, processing, formulation and clinical applications of human albumin based on the published literature, authors’ professional experience and product quality-assurance data.

Key findings

Current formulations of human albumin solution vary in composition, including the use of chemical stabilizers and concentrations of key electrolytes, especially sodium and chloride. Through innovations in manufacturing processes since the 1990s, Zenalb 20 is defined by its high albumin purity, use of a single stabilizer and electrolyte concentrations that are substantially lower than in normal human plasma. The clinical relevance of these features may increase as the use of human serum albumin continues to expand in patient populations receiving multiple medications and fluids, for whom electrolyte balance is crucial.

Conclusion

As a low electrolyte formulation, Zenalb 20 provides a clinical option to increase oncotic pressure when a colloid is needed without worsening pathological hypernatraemia, hyperchloraemia and hyperkalaemia.
Plant–soil feedback regulates the trade-off between phosphorus acquisition pathways in Pinus elliottii
Authors: Ma Ning , Kou Liang , Li Shenggong , Dai Xiaoqin , Meng Shengwang , Jiang Lei , Xue Yafang , Zheng Jiajia , Fu Xiaoli , Wang Huimin
Published: April 2023

Plant–soil feedback (PSF) is conventionally characterized by plant biomass growth, yet it remains unclear how PSF affects plant nutrient acquisition strategies (e.g., nutrient absorption and nutrient resorption) associated with plant growth, particularly under changing soil environments. A greenhouse experiment was performed with seedlings of Pinus elliottii Englem and conditioned soils of monoculture plantations (P. elliottii and Cunninghamia lanceolata Hook). Soil sterilization was designed to test plant phosphorus (P) acquisition strategy with and without native soil fungal communities. Soils from P. elliottii and C. lanceolata plantations were used to explore the specific soil legacy effects on two different P acquisition pathways (absorption and resorption). Phosphorus addition was also applied to examine the separate and combined effects of soil abiotic factors and soil fungal factors on P acquisition pathways. Due to diminished mycorrhizal symbiosis, PSF prompted plants to increasingly rely on P resorption under soil sterilization. In contrast, P absorption was employed preferentially in the heterospecific soil, where species-specific pathogenic fungi could not affect P absorption. Higher soil P availability diluted the effects of soil fungal factors on the trade-off between the two P acquisition pathways in terms of the absolute PSF. Moreover, P addition plays a limited role in terms of the relative PSF and does not affect the direction and strength of relative PSF. Our results reveal the role of PSF in regulating plant P acquisition pathways and highlight the interaction between mycorrhizal and pathogenic fungi as the underlying mechanism of PSF.
Shift of root nitrogen-acquisition strategy with tree age is mediated by root functional traits along the collaboration gradient of the root economics space
Authors: Ren Hao , Gao Guoqiang , Ma Yaoyuan , Li Zuwang , Wang Siyuan , Gu Jiacun
Published: April 2023

Root nitrogen (N)-uptake rate and uptake preference, and their association with root morphological and chemical traits are important to characterize root N-acquisition strategies of trees. However, how the root N-acquisition strategy varies with tree age, especially for those species that coexist at a common site, remains unknown. In this study, a field isotopic hydroponic method was used to determine the uptake rate and contribution of NH4+, NO3− and glycine, for three coexisting ectomycorrhizal coniferous species [Pinus koraiensis (Korean pine), Picea koraiensis (Korean spruce) and Abies nephrolepis (smelly fir)] at three age classes (young, middle-aged and mature) in a temperate forest. Concurrently, root morphological and chemical traits, as well as mycorrhizal colonization rate were determined. Our results show that the root uptake rate of total N and NH4+ gradually decreased across all three species with increasing tree age. The three species at all age classes preferred NH4+, except for middle-aged Korean spruce and mature smelly fir, which preferred glycine. In contrast, all three species showed the lowest acquisition of NO3−. According to the conceptual framework of ‘root economics space’, only a ‘collaboration’ gradient (i.e. dimension of root diameter vs specific root length or area) was identified for each species, in which root N-uptake rate loaded heavily on the side of ‘do-it-yourself’ (i.e. foraging N more by roots). Young trees of all species tended to exhibit the ‘do-it-yourself’ strategy for N uptake, and mature trees had an ‘outsourcing’ strategy (i.e. foraging N by a mycorrhizal partner), whereas middle-aged trees showed a balanced strategy. These findings suggest that shifts of root N-acquisition strategy with tree age in these species are mainly mediated by root traits along the ‘collaboration’ gradient, which advances our understanding of belowground competition, species coexistence and N cycling in temperate forests.
Healthcare practitioners' knowledge of snakebite management and associated factors in high-burden, low-resource settings in Uganda
Authors: Wafula Solomon T , Mugume Innocent B , Namakula Lydia N , Nalugya Aisha , Naggayi Vencia , Walekhwa Abel W , Musoke David
Published: April 2023

Background

Snakebites cause significant morbidity and mortality in Uganda. Effective management of snakebites requires knowledge of the appropriate first aid measures, as well as knowledge of the appropriate antivenom to use, but little is known about familiarity with effective snakebite management techniques and associated factors among healthcare practitioners (HCPs) in Uganda.

Methods

In May 2022, we collected data on sociodemographic characteristics, knowledge of snakebite first aid, envenomation signs, diagnosis and antivenom administration among 311 HCPs from two snakebite high-incidence districts in Uganda using a semi-structured questionnaire.

Results

Of the 311 HCPs, 64.3% had ever treated snakebite cases, 87.1% were confident to provide supportive treatment, but only 9.6% had ever been trained on snakebite management. Overall, 22.8% of HCPs had high knowledge of snakebite management. Higher education (at least degree vs certificate; PR=2.21 95% CI 1.508 to 4.56), older age (30–45 vs <30 y; PR=1.97, 95% CI 1.22 to 3.21) and previous training (PR=1.82, 95% CI 1.08 to 3.05) were associated with high knowledge of snakebite diagnosis and management.

Conclusions

Overall, knowledge of snakebite management was limited. Training, level of education and age of the HCP all had an impact on knowledge. Deliberate efforts are required to increase HCPs' knowledge of snakebite case care in high-burden regions to manage incident cases.
Audiology for the Neurosurgeon
Authors: Kingsbury Sarah E. , Bogle Jamie M. , Weisskopf Peter A. , Deep Nicholas L.
Published: April 2023

Many conditions that neurosurgeons manage are associated with audiologic symptoms. Unilateral hearing loss and tinnitus, poor suprathreshold speech understanding, and dizziness are hallmarks of retrocochlear lesions. Understanding the difference between air and bone conduction thresholds and the importance of speech discrimination helps differentiate types of hearing loss and their neurological importance. Acoustic reflex, otoacoustic emissions, and auditory brainstem response testing are objective measures used to determine function of the auditory structures. Accurate interpretation of these results can aid neurosurgeons in making differential diagnoses and determining surgical approaches. Cooperation among neurosurgeons, otolaryngologists, and audiologists ensures abnormal auditory symptoms are assessed correctly.
Assessing HeartSong as a Neonatal Music Therapy Intervention
Authors: van Dokkum Nienke H. , Fagan Lauren J. , Cullen Marie , Loewy Joanne V.
Published: April 2023

Background:

The music therapy HeartSong intervention pairs newborn infant heartbeats with parents' Song of Kin. Formal evidence on professional and personal caregiver perspectives of this intervention is lacking.

Purpose:

This survey study evaluates the HeartSong music therapy intervention from parent and staff perspectives.

Methods:

A qualitative study assessing inclusion of HeartSong for family neonatal intensive care unit (NICU) care surveyed 10 professional caregivers comprising medical and psychosocial NICU teams anonymously reflecting their impressions of the intervention. Digital survey of parents/guardians contacted through semistructured phone interviews relayed impressions of recordings: subsequent setup, Song of Kin selection, and use of HeartSong, including thoughts/feelings about it as an intervention.

Results:

Professional and personal caregivers valued the HeartSong intervention for bereavement support, family support, including parental, extended family/infant support, and to enhance bonding. Emergent themes: memory-making, connectedness/closeness, support of parent role, processing mental health needs of stressful NICU days, and subsequent plans for lifelong HeartSong use. Therapeutic experience was named as a crucial intervention aspect and participants recommended the HeartSong as a viable, accessible NICU intervention.

Implications for Practice and Research:

HeartSong's use showed efficacy as a clinical NICU music therapy intervention for families of critically ill and extremely preterm infants, when provided by trained, specialized, board-certified music therapists. Future research focusing on HeartSong in other NICU populations might benefit infants with cardiac disease, parental stress, and anxiety attending to parent–infant bonding. Costs and time benefits related to investment are needed before implementation is considered.
Patient-Reported Outcome Measures for Use in Women With Pelvic Organ Prolapse
Authors: Dieter Alexis A. , Halder Gabriela E. , Pennycuff Jon F. , Singh Ruchira , El-Nashar Sherif A. , Lipetskaia Lioudmila , Orejuela Francisco J. , Jeppson Peter C. , Sleemi Ambereen , Raman Sonali V. , Balk Ethan M. , Rogers Rebecca G. , Antosh Danielle D. ,   for the Society of Gynecologic Surgeons Systematic Review Group
Published: April 2023

OBJECTIVE:

To describe the psychometric properties of existing patient-reported outcome measures for women with prolapse using the COSMIN (Consensus-Based Standards for the Selection of Health Measurement Instruments) framework. Additional objectives were to describe the patient-reported outcome scoring method or interpretation, methods of administration, and to compile a list of the non-English languages in which the patient-reported outcomes are reportedly validated.

DATA SOURCES:

PubMed and EMBASE was searched through September 2021. Study characteristics, patient-reported outcome details, and psychometric testing data were extracted. Methodologic quality was assessed with COSMIN guidelines.

METHODS OF STUDY SELECTION:

Studies reporting the validation of a patient-reported outcome in women with prolapse (or women with pelvic floor disorders that included a prolapse assessment) and reporting psychometric testing data on English-language patient-reported outcome for at least one measurement property per COSMIN and the U.S. Department of Health and Human Services definitions were included, as well as studies reporting the translation of an existing patient-reported outcome into another language, a new method of patient-reported outcome administration, or a scoring interpretation. Studies reporting only pretreatment and posttreatment scores, only content or face validity, or only findings for nonprolapse domains of the patient-reported outcome were excluded.

TABULATION, INTEGRATION, AND RESULTS:

Fifty-four studies covering 32 patient-reported outcomes were included; 106 studies assessing translation into a non-English language were excluded from the formal review. The number of validation studies per patient-reported outcome (one version of one questionnaire) ranged from 1 to 11. Reliability was the most reported measurement property, and most measurement properties received an average rating of sufficient. The condition-specific patient-reported outcomes had on average more studies and reported data across more measurement properties compared with adapted and generic patient-reported outcomes.

CONCLUSION:

Although measurement property data vary on patient-reported outcomes for women with prolapse, most data were of good quality. Overall, condition-specific patient-reported outcomes had more studies and reported data across more measurement properties.

SYSTEMATIC REVIEW REGISTRATION:

PROSPERO, CRD42021278796.
Not All Proximal Humerus Fractures Do Well Without Surgery: Anterior Translation Predicts the Need for Surgery
Authors: Shahien Amir , Likine Elive F. , Soles Gillian , Samborski Steven , Mehta Siddhant K. , Ryan Scott Patrick , Leroy Taryn E. , Mullis Brian , Spitler Clay A. , Tornetta Paul
Published: April 2023

Objectives:

To evaluate the effect of translation on a large series of low-energy proximal humerus fractures initially treated nonoperatively.

Design:

Retrospective multicenter analysis.

Setting:

Five level-one trauma centers.

Patients/Participants:

Two hundred ten patients (152 F; 58 M), average age 64, with 112 left- and 98 right-sided low-energy proximal humerus fractures (OTA/AO 11-A-C).

Intervention:

All patients were initially treated nonoperatively and were followed for an average of 231 days. Radiographic translation in the sagittal and coronal planes was measured. Patients with anterior translation were compared with those with posterior or no translation. Patients with ≥80% anterior humeral translation were compared with those with <80% anterior translation, including those with no or posterior translation.

Main Outcomes:

The primary outcome was failure of nonoperative treatment resulting in surgery and the secondary outcome was symptomatic malunion.

Results:

Nine patients (4%) had surgery, 8 for nonunion and 1 for malunion. All 9 patients (100%) had anterior translation. Anterior translation compared with posterior or no sagittal plane translation was associated with failure of nonoperative management requiring surgery (P = 0.012). In addition, of those with anterior translation, having ≥80% anterior translation compared with <80% was also associated with surgery (P = 0.001). Finally, 26 patients were diagnosed with symptomatic malunion, of whom translation was anterior in 24 and posterior in 2 (P = 0.0001).

Conclusions:

In a multicenter series of proximal humerus fractures, anterior translation of >80% was associated with failure of nonoperative care resulting in nonunion, symptomatic malunion, and potential surgery.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Bone Transport Through Induced Membrane Versus Conventional Bone Transport in Management of Infected Long-Bone Defects of Lower Limbs: A Randomized Controlled Trial
Authors: Thakeb Mootaz F. , Kozman Michael A. , ElGebeily Mohamed A. , Baraka Mostafa M. , Al Kersh Mohamed A.
Published: April 2023

Objectives:

To compare bone transport through induced membrane (BTM) and conventional bone transport (BT) regarding docking site union and infection recurrence in the management of infected long-bone defects.

Design:

Prospective, randomized, controlled study.

Setting:

Tertiary-level center.

Participants:

Thirty patients with infected nonunited long-bone fractures of lower limbs were included.

Intervention:

Fifteen patients were treated by BTM in group A, and 15 patients were treated by BT in group B.

Outcome Measurements:

The outcome measures were external fixation time, external fixation index, and docking time. Bone and functional outcomes were evaluated by the Association for the Study and Application of the Method of Ilizarov scoring system. Postoperative complications were evaluated according to the Paley classification.

Results:

The mean docking time was significantly lower in the BTM group than in the BT group (3.6 ± 0.82 months vs. 4.8 ± 0.86 months, respectively; P value 0.001). Docking site nonunion and infection recurrence were significantly lower in the BTM group than in the BT group (0% vs. 40%; P value 0.02 and 0% vs. 33.3%; P value 0.04, respectively), with no significant difference in the external fixation index (P value 0.08).

Conclusions:

This is the first prospective, randomized, controlled study comparing BTM and BT techniques, showing that BTM had significantly faster docking site union, lower incidence of postoperative complications including docking site nonunion and infection recurrence rates, and lower number of additional procedures needed at the expense of 2-staged operation in comparison with BT.

Level of Evidence:

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Evolving Trends in the Use of Sacroiliac Fusion From 2015 to 2020
Authors: Halperin Scott J. , Dhodapkar Meera M. , Jiang Will , Elaydi Ali , Jordan Yusef J. , Whang Peter G. , Grauer Jonathan N.
Published: April 2023

Study Design.

Retrospective cohort analysis.

Objective.

To assess the evolution of patients undergoing sacroiliac (SI) fusion with minimally invasive surgery (MIS) relative to open approaches.

Summary of Background Data.

The SI joint can be a contributor to lumbopelvic symptoms. The MIS approach to SI fusion has been shown to have fewer complications compared with the open approach. Recent trends and evolved patient populations have not been well-characterized.

Materials and Methods.

Data were abstracted from the large, national, multi-insurance, administrative 2015-2020 M151 PearlDiver database. The incidence, trends, and patient characteristics of MIS, as well as open, SI fusions for adult patients with degenerative indications, were determined. Univariable and multivariable analyses were then performed to compare the MIS relative to open populations. The primary outcome was to assess the trends of MIS and open approaches for SI fusions.

Results.

In total, 11,217 SI fusions were identified (of which 81.7% were MIS), with a clear increase in numbers over the years from 2015 (n=1318, 62.3% of which were MIS) to 2020 (n=3214 86.6% of which were MIS). Independent predictors of MIS (as opposed to open) SI fusion included: older age (odds ratio [OR] 1.09 per decade increase), higher Elixhauser-Comorbidity Index (OR 1.04 per two-point increase), and geographic region (relative to South, Northeast OR 1.20 and West OR 1.64). As might be expected, 90-day adverse events were lower for MIS than open cases (OR 0.73).

Conclusion.

The presented data quantify the increasing incidence of SI fusions over the years, with the increase being driven by MIS cases. This was largely related to an expanded population (those who are older and with greater comorbidity), fitting the definition of disruptive technology with lesser adverse events than open procedures. Nonetheless, geographic variation highlights the differential adoption of this technology.
Effect of Clinical and Radiographic Degenerative Spondylolisthesis Classification on Patient-reported Outcomes and Spinopelvic Parameters for Patients With Single-level L4–L5 Degenerative Spondylolisthesis After Lumbar Fusion
Authors: Karamian Brian A. , Levy Hannah A. , DiMaria Stephen L. , Ju Derek G. , Canseco Jose A. , Yen Winston , Maheu Arlene , Mangan John J. , Goyal Dhruv K.C. , Radcliff Kris E. , Kaye I. David , Rihn Jeffrey A. , Hilibrand Alan S. , Kepler Christopher K. , Vaccaro Alexander R. , Schroeder Gregory D.
Published: April 2023

Study Design:

Retrospective cohort study.

Objectives:

To determine whether preoperative clinical and radiographic degenerative spondylolisthesis (CARDS) classification is associated with differences in patient-reported outcomes and spinopelvic parameters after posterior decompression and fusion for L4–L5 degenerative spondylolisthesis (DS).

The CARDS classification for lumbar DS, an alternative to the Meyerding system, considers additional radiographic findings such as disc space collapse and segmental kyphosis and stratifies DS into 4 radiographically distinct classes. Although CARDS has been shown to be a reliable and reproducible method for classifying DS, very few studies have assessed whether the CARDS types represent distinct clinical entities.

Patients and Methods:

A retrospective cohort analysis was conducted on patients with L4–L5 DS who underwent posterior lumbar decompression and fusion. Changes in spinopelvic alignment and patient-reported outcomes measures, including recovery ratios and percentage of patients achieving the minimal clinically important difference, were compared among patients in each CARDS classification 1-year postoperatively using analysis of variance or Kruskal-Wallis H with Dunn post hoc analysis. Multiple linear regression determined whether CARDS groups significantly predicted patient-reported outcomes measures, lumbar lordosis (LL), and pelvic incidence-lumbar lordosis mismatch (PI-LL) while controlling for demographic and surgical characteristics.

Results:

Preoperative type B spondylolisthesis predicted decreased improvement in “physical component and mental component score of the short form-12” compared with type A spondylolisthesis (β-coefficient = −5.96, P = 0.031) at 1 year. Significant differences were found between CARDS groups with regards to ΔLL (A: −1.63 degrees vs B: −1.17 degrees vs C: 2.88 degrees vs D: 3.19 degrees, P = 0.010) and ΔPI-LL (A: 1.02 degrees vs B: 2.09 degrees vs C: −2.59 degrees vs D: −3.70 degrees, P = 0.012). Preoperative type C spondylolisthesis was found to predict increased LL (β-coefficient = 4.46, P = 0.0054) and decreased PI-LL (β-coefficient = −3.49, P = 0.025) at 1 year compared with type A spondylolisthesis.

Conclusions:

Clinical and radiographic outcomes differed significantly by preoperative CARDS classification type for patients undergoing posterior decompression and fusion for L4–L5 DS.

Level of Evidence:

Level III.
Diagnostic value of ACR TI-RADS combined with three-dimensional shear wave elastography in ACR TI-RADS 4 and 5 thyroid nodules
Authors: Hao Lijun , Liu Peiqing , Ding Changwei , Li Jing , Zhang Yingchun
Published: April 2023

Background:

Three-dimensional shear wave elastography ((3D-SWE) is a promising method in distinguishing benign and malignant thyroid nodules recently. By combining with conventional method, it may further improve the diagnostic value. The study aimed to assess the diagnostic value of American College of Radiology (ACR) thyroid imaging reporting and data system (TI-RADS) combined with 3D-SWE in ACR TI-RADS 4 and 5 thyroid nodules.

Methods:

All nodules were examined by conventional ultrasonography, ACR TI-RADS classification, and 3D-SWE examination. Conventional ultrasonography was used to observe the location, size, shape, margin, echogenicity, taller-than-wide sign, microcalcification, and blood flow of thyroid nodules, and then ACR TI-RADS classification was performed. The Young's modulus values (3D-C-Emax, 3D-C-Emean, and elastography standard deviation [3D-C-Esd]) were measured on the reconstructed coronal plane images. According to the receiver operating characteristic (ROC) curve, the best diagnostic efficiency among 3D-C-Emax, 3D-C-Emean, and 3D-C-Esd was selected and the cut-off threshold was calculated. According to the surgical pathology, they were divided into benign group and malignant group. And appropriate statistical methods such as t-test and Mann–Whitney U test were used to compare the difference between the two groups. On this basis, 3D-SWE combined with conventional ACR TI-RADS was reclassified as combined ACR TI-RADS to determine benign or malignant thyroid nodules.

Results:

Of the 112 thyroid nodules, 62 were malignant and 50 were benign. The optimal cut-off value of three-dimensional maximum Young's modulus in coronal plane (3D-C-Emax) was 51.5 kPa and the area under the curve (AUC) was 0.798. The AUC, sensitivity, specificity, and accuracy of conventional ACR TI-RADS were 0.828, 83.9%, 66.0%, and 75.9%, respectively. The AUC, sensitivity, specificity, and accuracy of combined ACR TI-RADS were 0.845, 90.3%, 66.0%, and 79.5%, respectively. The difference between the two AUC values was statistically significant.

Conclusions:

Combined ACR TI-RADS has higher diagnostic efficiency than conventional ACR TI-RADS. The sensitivity and accuracy of combined ACR TI-RADS showed significant improvements. It can be used as an effective method in the diagnosis of thyroid nodules.