bluuebunny/crossref_metadata_2025 huggingface dataset:
The origin of optical emission lines in the soft state of X-ray binary outbursts: the case of MAXI J1820+070
Authors: Koljonen K I I , Long K S , Matthews J H , Knigge C
Published: March 2023

The optical emission line spectra of X-ray binaries (XRBs) are thought to be produced in an irradiated atmosphere, possibly the base of a wind, located above the outer accretion disc. However, the physical nature of – and physical conditions in – the line-forming region remain poorly understood. Here, we test the idea that the optical spectrum is formed in the transition region between the cool geometrically thin part of the disc near the mid-plane and a hot vertically extended atmosphere or outflow produced by X-ray irradiation. We first present a VLT X-Shooter spectrum of XRB MAXI J1820+070 in the soft state associated with its 2018 outburst, which displays a rich set of double-peaked hydrogen and helium recombination lines. Aided by ancillary X-ray spectra and reddening estimates, we then model this spectrum with the Monte Carlo radiative transfer code python, using a simple biconical disc wind model inspired by radiation-hydrodynamic simulations of irradiation-driven outflows from XRB discs. Such a model can qualitatively reproduce the observed features; nearly all of the optical emission arising from the transonic ‘transition region’ near the base of the wind. In this region, characteristic electron densities are on the order of 1012–13 cm−3, in line with the observed flat Balmer decrement (H $\alpha$/H $\beta$ ≈ 1.3). We conclude that strong irradiation can naturally give rise to both the optical line-forming layer in XRB discs and an overlying outflow/atmosphere that produces X-ray absorption lines.
Global N-body simulations of circumbinary planet formation around Kepler-16 and -34 analogues I: Exploring the pebble accretion scenario
Authors: Coleman Gavin A L , Nelson Richard P , Triaud Amaury H M J
Published: March 2023

Numerous circumbinary planets have been discovered in surveys of transiting planets. Often, these planets are found to orbit near to the zone of dynamical instability, close to the central binary. The existence of these planets has been explained by hydrodynamical simulations that show that migrating circumbinary planets, embedded in circumbinary discs, halt at the central cavity that is formed by the central binary. Transit surveys are naturally most sensitive to finding circumbinary planets with the shortest orbital periods. The future promise of detecting longer period systems using radial-velocity searches, combined with the anticipated detection of numerous circumbinary planets by ESA’s PLATO mission, points to the need to model and understand the formation and evolution of circumbinary planets in a more general sense than has been considered before. With this goal in mind, we present a newly developed global model of circumbinary planet formation that is based on the mercury6 symplectic N-body integrator, combined with a model for the circumbinary disc and prescriptions for a range of processes involved in planet formation such as pebble accretion, gas envelope accretion, and migration. Our results show that under reasonable assumptions, the pebble accretion scenario can produce circumbinary systems that are similar to those observed, and in particular is able to produce planets akin to Kepler-16b and Kepler-34b. Comparing our results to other systems, we find that our models also adequately reproduce such systems, including multiplanet systems. Resonances between neighbouring planets are frequently obtained, whilst ejections of planets by the central binary acts as an effective source of free floating planets.
Biochemical characterisation of Mer3 helicase interactions and the protection of meiotic recombination intermediates
Authors: Altmannova Veronika , Firlej Magdalena , Müller Franziska , Janning Petra , Rauleder Rahel , Rousova Dorota , Schäffler Andreas , Bange Tanja , Weir John R
Published: March 2023

Crossing over between homologs is critical for the stable segregation of chromosomes during the first meiotic division. Saccharomyces cerevisiae Mer3 (HFM1 in mammals) is a SF2 helicase and member of the ZMM group of proteins, that facilitates the formation of the majority of crossovers during meiosis. Here, we describe the structural organisation of Mer3 and using AlphaFold modelling and XL-MS we further characterise the previously described interaction with Mlh1–Mlh2. We find that Mer3 also forms a previously undescribed complex with the recombination regulating factors Top3 and Rmi1 and that this interaction is competitive with Sgs1BLM helicase. Using in vitro reconstituted D-loop assays we show that Mer3 inhibits the anti-recombination activity of Sgs1 helicase, but only in the presence of Dmc1. Thus we provide a mechanism whereby Mer3 interacts with a network of proteins to protect Dmc1 derived D-loops from dissolution.
Rates of Age Verification for Cigarette and E-cigarette Purchases as a Function of State T21 Laws Before and After Implementation of the Federal T21 Law in the United States
Authors: Romm Katelyn F , Wang Yan , Schleicher Nina C , Pannel Alexandria , Williams River , Berg Carla J , Henriksen Lisa
Published: March 2023

Introduction

In the US, having a 21 minimum legal sales age for tobacco (T21) at the state level may have impacted age verification of cigarette and e-cigarette purchases among U.S. young adults (ages 18–26), before and/or after federal T21 implementation.

Aims and Methods

This study examined this by analyzing data from cigarette and/or e-cigarette users (n = 618 and n = 864) in six metropolitan areas in six states. Participants reported frequency of being age verified (“almost always” vs. less frequently) for cigarette and/or e-cigarette purchases across 3 timepoints (ie, wave 1 [w1]: September–December 2018, w2: September–December 2019, and w3: September–December 2020). Multilevel modeling examined time-varying state T21 status and time (reflecting federal T21 implementation) in relation to age verification of cigarette and e-cigarette purchases, respectively.

Results

The proportions almost always age verified for cigarette purchases in states with T21 versus without were: W1: 38.5% versus 37.7%, w2: 33.0% versus 39.1%, and w3: 45.4% versus 30.6%. For e-cigarettes, the proportions were: W1: 30.6% versus 40.3%, w2: 42.3% versus 50.5%, and w3: 56.0% versus 58.3%. In multilevel modeling, state T21 status was associated with greater likelihood of age verification for e-cigarettes (aOR = 1.67, CI = 1.13 to 2.45), but not for cigarettes. Age verification increased over time for e-cigarettes—both accounting for and not accounting for state T21 status. There were no changes for cigarettes.

Conclusions

State T21 status and time correlated with age verification for e-cigarettes, but not cigarettes. These self-reported age verification data contribute to evidence from compliance checks, indicating that retailers require additional prompts and enforcement to enhance compliance with T21 laws.

Implications

Current findings suggest that variations in regulations and gaps in enforcement may hinder the potential impact of increasing the minimum legal sales age, which ultimately may undermine the promise of such policies, specifically with regard to preventing tobacco use among the underage. Therefore, it is crucial to monitor retailer compliance with T21 laws and evaluate their efficacy to increase ID checks, minimize illegal sales, and curb underage use of tobacco. Relatedly, particular attention to enforcement efforts that may promote compliance is warranted.
Epidemiological Characteristics and Risk Factors of Severe Fever With Thrombocytopenia Syndrome in Yantai City, Shandong Province
Authors: Hou Shuting , Zhang Nannan , Liu Jingyu , Li Haiwen , Liu Xiuwei , Liu Tao
Published: March 2023

Background

To better understand the epidemiological characteristics and risk factors associated with the incidence of severe fever with thrombocytopenia syndrome (SFTS) in Yantai City, Shandong Province, China.

Methods

The SFTS data from 2010 to 2019 were obtained from the National Notifiable Disease Reporting System, and visualization was performed using ArcGIS 10. A community-based, 1:2 matched case-control study was conducted to investigate the risk factors for SFTS in Yantai City. Standardized questionnaires were used to collect detailed information about the demographics and risk factors for SFTSV infection.

Results

A total of 968 laboratory-confirmed SFTS cases were reported, 155 (16.01%) of which were fatal. The SFTS epidemic curve revealed that most cases occurred from May to August, accounting for 77.27% of all studied cases. The SFTS cases were mainly distributed in Lai Zhou, Penglai, Zhaoyuan, Haiyang, and Qixia from 2010 to 2019 (accounting for 83.47% of all cases). No differences in demographics were observed between the cases and controls. In the multivariate analysis, presence of rats in the household (odds ratio [OR] = 2.89, 95% confidence interval [CI] = 1.94–4.30), bitten by the ticks 1 month before the onset of symptoms (OR = 15.97, 95% CI = 5.36–47.60), and presence of weeds and shrubs around the house (OR = 1.70, 95% CI = 1.12–2.60) were found to be the risk factors for SFTS.

Conclusions

Our results support the hypothesis that ticks are important vectors of the SFTS virus. Education on SFTS prevention and personal hygiene should be imparted in high-risk populations, especially among outdoor workers living in SFTS-endemic areas, while vector management should also be considered.
Energy metabolic pathways in neuronal development and function
Authors: Rumpf Sebastian , Sanal Neeraja , Marzano Marco
Published: March 2023

Neuronal development and function are known to be among the most energy-demanding functions of the body. Constant energetic support is therefore crucial at all stages of a neuron’s life. The two main adenosine triphosphate (ATP)-producing pathways in cells are glycolysis and oxidative phosphorylation. Glycolysis has a relatively low yield but provides fast ATP and enables the metabolic versatility needed in dividing neuronal stem cells. Oxidative phosphorylation, on the other hand, is highly efficient and therefore thought to provide most or all ATP in differentiated neurons. However, it has recently become clear that due to their distinct properties, both pathways are required to fully satisfy neuronal energy demands during development and function. Here, we provide an overview of how glycolysis and oxidative phosphorylation are used in neurons during development and function.
Devolution and the Prevent Strategy in Scotland: Constitutional Politics and the Path of Scottish P/CVE
Authors: Heath-Kelly Charlotte
Published: March 2023

This paper explores the implementation of the ‘Prevent Duty’ in Scotland. Using archival research into Parliamentary debates, as well as research interviews with Scottish government representatives and healthcare professionals, the paper sheds light on the constitutional politics surrounding the Counterterrorism and Security Act 2015 which resulted in the markedly different applications of Prevent between England and Scotland. The divergence of the policy between the nations, and the constitutional anomalies which facilitated a specifically Scottish Prevent program, have remained unaddressed in the academic literature—partly because of a mistaken assumption by researchers that the Prevent Strategy equally applies to all nations (given that Westminster legislates for the UK on matters of defence and security). To fill this gap in knowledge, this paper explores how the Scottish government was able to leverage the devolution settlement and associated constitutional conventions to implement a modest P/CVE program—dropping some components of the English and Welsh Prevent programs entirely. The paper contributes to studies on British constitutional conventions and the nature of inter-governmental politics in the UK by highlighting the surprising freedom to manoeuvre Scotland can enjoy, with regards to reserved policy areas.
Exploring Novel Polytubey Reproduction Pathways Utilizing Cumulative Genetic Tools
Authors: Sugi Naoya , Maruyama Daisuke
Published: March 2023

In the anthers and ovaries of flowers, pollen grains and embryo sacs are produced with uniform cell compositions. This stable gametogenesis enables elaborate interactions between male and female gametophytes after pollination, forming the highly successful sexual reproduction system in flowering plants. As most ovules are fertilized with a single pollen tube, the resulting genome set in the embryo and endosperm is determined in a single pattern by independent fertilization of the egg cell and central cell by two sperm cells. However, if ovules receive four sperm cells from two pollen tubes, the expected options for genome sets in the developing seeds would more than double. In wild-type Arabidopsis thaliana plants, around 5% of ovules receive two pollen tubes. Recent studies have elucidated the abnormal fertilization in supernumerary pollen tubes and sperm cells related to polytubey, polyspermy, heterofertilization and fertilization recovery. Analyses of model plants have begun to uncover the mechanisms underlying this new pollen tube biology. Here, we review unusual fertilization phenomena and propose several breeding applications for flowering plants. These arguments contribute to the remodeling of plant reproduction, a challenging concept that alters typical plant fertilization by utilizing the current genetic toolbox.
It's only natural: Plant respiration in unmanaged systems
Authors: Schmiege Stephanie C , Heskel Mary , Fan Yuzhen , Way Danielle A
Published: March 2023

Respiration plays a key role in the terrestrial carbon cycle and is a fundamental metabolic process in all plant tissues and cells. We review respiration from the perspective of plants that grow in their natural habitat and how it is influenced by wide-ranging elements at different scales, from metabolic substrate availability to shifts in climate. Decades of field-based measurements have honed our understanding of the biological and environmental controls on leaf, root, stem, and whole-organism respiration. Despite this effort, there remain gaps in our knowledge within and across species and ecosystems, especially in more challenging-to-measure tissues like roots. Recent databases of respiration rates and associated leaf traits from species representing diverse biomes, plant functional types, and regional climates have allowed for a wider-lens view at modeling this important CO2 flux. We also re-analyze published data sets to show that maximum leaf respiration rates (R  max) in species from around the globe are related both to leaf economic traits and environmental variables (precipitation and air temperature), but that root respiration does not follow the same latitudinal trends previously published for leaf data. We encourage the ecophysiological community to continue to expand their study of plant respiration in tissues that are difficult to measure and at the whole plant and ecosystem levels to address outstanding questions in the field.
Exploring the potential of Δ17O in CO2 for determining mesophyll conductance
Authors: Adnew Getachew Agmuas , Pons Thijs L , Koren Gerbrand , Peters Wouter , Röckmann Thomas
Published: March 2023

Mesophyll conductance to CO2 from the intercellular air space to the CO2–H2O exchange site has been estimated using δ18O measurements (gm18). However, the gm18 estimates are affected by the uncertainties in the δ18O of leaf water where the CO2–H2O exchange takes place and the degree of equilibration between CO2 and H2O. We show that measurements of Δ17O (i.e.Δ17O=δ17O−0.528×δ18O) can provide independent constraints on gm (gmΔ17) and that these gm estimates are less affected by fractionation processes during gas exchange. The gm calculations are applied to combined measurements of δ18O and Δ17O, and gas exchange in two C3 species, sunflower (Helianthus annuus L. cv. ‘sunny’) and ivy (Hedera hibernica L.), and the C4 species maize (Zea mays). The gm18 and gmΔ17 estimates agree within the combined errors (P-value, 0.876). Both approaches are associated with large errors when the isotopic composition in the intercellular air space becomes close to the CO2–H2O exchange site. Although variations in Δ17O are low, it can be measured with much higher precision compared with δ18O. Measuring gmΔ17 has a few advantages compared with gm18: (i) it is less sensitive to uncertainty in the isotopic composition of leaf water at the isotope exchange site and (ii) the relative change in the gm due to an assumed error in the equilibration fraction θeq is lower for gmΔ17 compared with gm18. Thus, using Δ17O can complement and improve the gm estimates in settings where the δ18O of leaf water varies strongly, affecting the δ18O (CO2) difference between the intercellular air space and the CO2–H2O exchange site.
SCARECROW maintains the stem cell niche in Arabidopsis roots by ensuring telomere integrity
Authors: Wang Bingxin , Shi Xiaowen , Gao Jingbo , Liao Rui , Fu Jing , Bai Juan , Cui Hongchang
Published: March 2023

Stem cells are the ultimate source of cells for various tissues and organs and thus are essential for postembryonic plant growth and development. SCARECROW (SCR) is a plant-specific transcription regulator well known for its role in stem cell renewal in plant roots, but the mechanism by which SCR exerts this function remains unclear. To address this question, we carried out a genetic screen for mutants that no longer express SCR in the stem cell niche of Arabidopsis (Arabidopsis thaliana) roots and characterized 1 of these mutants. Molecular genetics methods allowed us to pinpoint the causal mutation in this mutant in TELOMERIC PATHWAYS IN ASSOCIATION WITH STN 1 (TEN1), encoding a factor that protects telomere ends. Interestingly, TEN1 expression was dramatically reduced in the scr mutant. Telomerase and STN1 and CONSERVED TELOMERE MAINTENANCE COMPONENT 1 (CTC1), components of the same protein complex as TEN1, were also dramatically downregulated in scr. Loss of STN1, CTC1, and telomerase caused defects in root stem cells. These results together suggest that SCR maintains root stem cells by promoting expression of genes that ensure genome integrity. Supporting this conclusion, we demonstrated that the scr mutant accumulates more DNA damage than wild-type Arabidopsis and that this problem is aggravated after exposure to zeocin, a DNA damage reagent. Finally, we identified 2 previously uncharacterized motifs in TEN1 and provide evidence that a conserved amino acid residue in 1 of the motifs is indispensable for TEN1 function. SCR thus provides a connection between genome integrity and stem cell maintenance in Arabidopsis roots.
The microRNA ppe-miR393 mediates auxin-induced peach fruit softening by promoting ethylene production
Authors: Ma Li , Zhao Yingjie , Chen Miaojin , Li Yichen , Shen Zhijun , Cao Yang , Wu Di , Yu Mingliang , Grierson Donald , Shi Yanna , Chen Kunsong
Published: March 2023

Auxin can inhibit or promote fruit ripening, depending on the species. Melting flesh (MF) peach fruit (Prunus persica L. Batsch) cultivars produce high levels of ethylene caused by high concentrations of indole-3-acetic acid (IAA), which leads to rapid fruit softening at the late stage of development. In contrast, due to the low concentrations of IAA, the fruit of stony hard (SH) peach cultivars does not soften and produces little ethylene. Auxin seems necessary to trigger the biosynthesis of ethylene in peach fruit; however, the mechanism is not well understood. In this study, we identified miRNA gene family members ppe-miR393a and ppe-miR393b that are differentially expressed in SH and MF fruits. RNA ligase-mediated 5′ rapid amplification of cDNA ends and transient transformation of Nicotiana benthamiana revealed TRANSPORT INHIBITOR RESPONSE 1 (PpTIR1), part of the auxin perception and response system, as a target of ppe-miR393a and b. Yeast 2-hybrid assay and bimolecular fluorescence complementation assay revealed that PpTIR1 physically interacts with an Aux/IAA protein PpIAA13. The results of yeast 1-hybrid assay, electrophoretic mobility shift assay, and dual-luciferase assay indicated that PpIAA13 could directly bind to and trans-activate the promoter of 1-aminocyclopropane-1-carboxylic acid synthase 1 (PpACS1), required for ethylene biosynthesis. Transient overexpression and suppression of ppe-miR393a and PpIAA13 in peach fruit induced and repressed the expression of PpACS1, confirming their regulatory role in ethylene synthesis. Gene expression analysis in developing MF and SH fruits, combined with postharvest α-naphthalene acetic acid (NAA) treatment, supports a role for a ppe-miR393-PpTIR1-PpIAA13-PpACS1 module in regulating auxin-related differences in ethylene production and softening extent in different types of peach.
Sufficient coumarin accumulation improves apple resistance toCytospora maliunder high-potassium status
Authors: Du Youwei , Jia Hongchen , Yang Zi , Wang Shuanghong , Liu Yuanyuan , Ma Huiya , Liang Xiaofei , Wang Bo , Zhu Mingqi , Meng Yanan , Gleason Mark L , Hsiang Tom , Noorin Sadia , Zhang Rong , Sun Guangyu
Published: March 2023

Cytospora canker, caused by Cytospora mali, is the most destructive disease in production of apples (Malus domestica). Adding potassium (K) to apple trees can effectively control this disease. However, the underlying mechanisms of apple resistance to C. mali under high-K (HK) status remain unknown. Here, we found that HK (9.30 g/kg) apple tissues exhibited high disease resistance. The resistance was impeded when blocking K channels, leading to susceptibility even under HK conditions. We detected a suite of resistance events in HK apple tissues, including upregulation of resistance genes, callose deposition, and formation of ligno-suberized tissues. Further multiomics revealed that the phenylpropanoid pathway was reprogrammed by increasing K content from low-K (LK, 4.30 g/kg) status, leading to increases of 18 antifungal chemicals. Among them, the physiological concentration of coumarin (1,2-benzopyrone) became sufficient to inhibit C. mali growth in HK tissues, and exogenous application could improve the C. mali resistance of LK apple branches. Transgenic apple calli overexpressing beta-glucosidase 40 (MdBGLU40), which encodes the enzyme for coumarin synthesis, contained higher levels of coumarin and exhibited high resistance to C. mali even under LK conditions. Conversely, the suppression of MdBGLU40 through RNAi reduced coumarin content and resistance in HK apple calli, supporting the importance of coumarin accumulation in vivo for apple resistance. Moreover, we found that the upregulation of transcription factor MdMYB1r1 directly activated MdBGLU40 and the binding affinity of MdMYB1r1 to the MdBGLU40 promoter increased in HK apple tissue, leading to high levels of coumarin and resistance in HK apple. Overall, we found that the accumulation of defensive metabolites strengthened resistance in apple when raising K from insufficient to optimal status, and these results highlight the optimization of K content in fertilization practices as a disease management strategy.
Changes in opioid prescription duration for musculoskeletal injury associated with the North Carolina Strengthen Opioid Misuse Prevention (STOP) Act
Authors: Wally Meghan K , Thompson Michael E , Odum Susan , Kazemi Donna M , Hsu Joseph R , Seymour Rachel B ,   PRIMUM Group:, Beuhler Michael , Bosse Michael , Castro Manuel , Gibbs Michael , Griggs Christopher , Jarrett Steven , Leas Daniel , Rachal James , Roomian Tamar , Runyon Michael , Saha Animita , Watling Brad , Yu Ziqing
Published: March 2023

Objectives

To assess whether implementation of the Strengthen Opioid Misuse Prevention (STOP) Act was associated with an increase in the percentage of opioid prescriptions written for 7 days or fewer among patients with acute or postsurgical musculoskeletal conditions.

Design

An interrupted time-series study was conducted to determine the change in duration of opioid prescriptions associated with the STOP Act.

Setting

Data were extracted from the electronic health record of a large health care system in North Carolina.

Subjects

Patients presenting from 2016 to 2020 with an acute musculoskeletal injury and the clinicians treating them were included in an interrupted time-series study (n = 12 839).

Methods

Trends were assessed over time, including the change in trend associated with implementation of the STOP Act, for the percentage of prescriptions written for ≤7 days.

Results

Among patients with acute musculoskeletal injury, less than 30% of prescriptions were written for ≤7 days in January of 2016; by December of 2020, almost 90% of prescriptions were written for ≤7 days. Prescriptions written for ≤7 days increased 17.7% after the STOP Act was implemented (P < .001), after adjustment for the existing trend.

Conclusions

These results demonstrate significant potential for legislation to influence opioid prescribing behavior.
Erection hardness score or penile Doppler ultrasound: which is a better predictor of failure of nonsurgical treatment of erectile dysfunction?
Authors: Silva Alberto Costa , Silva Carlos Martins , Morgado Afonso
Published: March 2023

Background

In the evaluation of men presenting for erectile dysfunction (ED), specific diagnostic tests, such as an intracavernous injection test (IIT) with Erection Hardness Score (EHS) assessment or penile Doppler ultrasound (PDU), may be necessary.

Aim

The study sought to compare the prognostic value of PDU parameters with erection rigidity with EHS during IIT in predicting refractory ED after 5 years.

Methods

Patients referred for ED were evaluated and had a PDU with at least 15 μg of intracavernous alprostadil and without any sexual stimulation. At 5 years of follow-up, current and past ED treatments were noted. Refractory ED was defined as having a penile prosthesis (PP) implanted, having failed nonsurgical treatments but having refused PP implantation, or having discontinuation of nonsurgical treatments due to loss of efficacy. Patients with hypogonadism and pelvic surgery were excluded. Receiver-operating characteristic curves were drawn and the area under the curve (AUC) was calculated.

Outcomes

The outcome was the AUC for predicting refractory ED.

Results

At 5 years, 69 men were still in follow-up with a mean age of 58.47 ± 10.39 years, and 13 (18.8%) were classified as having refractory ED. The AUC for the EHS, peak systolic velocity, end-diastolic flow, and resistive index to discriminate refractory ED were 0.820, 0.613, 0.730, and 0.714, respectively.

Clinical Implications

EHS can be a good predictor of response to nonsurgical treatments in ED.

Strengths and Limitations

This was a prospective study to compare IIT with PDU, and validated disease-specific questionnaires were used to assess both clinical efficacy and satisfaction. PDU was performed by a blinded third party. However, resulting from a single-center study, our sample size can be considered small, and the number of events observed was also low.

Conclusion

Our data suggest that an abnormal EHS during an IIT is, at least, noninferior than an abnormal PDU in predicting those patients that will not respond to nonsurgical treatments and that will need a PP in long-term.
Evaluation of corn-fermented protein as a dietary ingredient in extruded dog and cat diets
Authors: Smith Spencer C , Aldrich Charles G
Published: March 2023

Most pet foods utilize traditional ingredients like corn, wheat, and soy. These ingredients and other grains, such as distillers dried grains (DDG), have been used by the pet food industry. Corn-fermented protein (CFP) is a nutrient-dense enhancement on DDG but has not been evaluated in pet food. Therefore, it was the objective of this study to determine the effect of CFP in the production of extruded pet diets, and to determine the effect on nutrient utilization (digestibility) and stool consistency in dogs, and palatability in dogs and cats. Experimental diets with treatment protein sources (corn gluten meal [CGM], soybean meal [SBM], and CFP) were produced in triplicate using a single-screw extruder. Processing parameters and kibble samples were collected at timed intervals during diet production. Kibbles were evaluated for physical dimension and texture. No differences (P > 0.05) were observed in any physical dimension or texture parameters evaluated, with exception of radial expansion, which was lower (P < 0.05) for CFP kibble compared to others. The CFP kibble required a smaller (P < 0.05) mass restriction valve opening, to keep similar bulk density among dietary treatments. However, there was no difference (P > 0.05) in specific mechanical energy among treatments during diet production. Twelve beagles were fed the experimental diets in a 3 × 3 replicated Latin Square design in which four dogs were randomly assigned to each of three treatments for each period. Diets were formulated to be isonitrogenous and were supplemented with titanium dioxide to serve as an external marker in order to estimate apparent total tract digestibility. Dogs were housed individually and fed twice daily, and water was available ad libitum. Feces were collected after feedings. The diet produced with CGM was more digestible (P < 0.05) than CFP and SBM for dry matter, organic matter, crude protein, crude fat, and gross energy. Further, the CFP diet was also less (P < 0.05) digestible than the SBM diet for dry matter and organic matter. Dogs fed the diet containing CFP had higher (P < 0.05) fecal mass than those fed SBM and CGM. The CFP diet also resulted in a higher fecal score (P < 0.05) than those fed diets with the CGM diet, but similar (P > 0.05) to the SBM diet. For palatability assessment, dogs had a preference (P < 0.05) for CGM over SBM or CFP, but cats showed a preference (P < 0.05) for SBM and CFP over CGM. Results indicate that CFP is acceptable for use in dog and cat diets. Further research should be conducted to evaluate the use of these ingredients at lower inclusion levels.
Rectal carriage of extended-spectrum β-lactamase-producing Enterobacteriales among neonates admitted into a special care baby unit, southwest Nigeria
Authors: Obadare Temitope O , Adeyemo Adeyemi T , Odetoyin Babatunde W , Ugowe Osagie J , Anyabolu Chineme H , Adejuyigbe Ebunoluwa A , Onipede Antony O
Published: March 2023

Background

The intestinal microbiota of neonates can be colonised by extended-spectrum β-lactamase-producing Enterobacteriales (ESBL-PE) with the risks of subsequent infections. The antimicrobial resistance profile of the gut flora of neonates is not well defined in Nigeria. This study determined the burden of rectal carriage of ESBL-PE among neonates.

Methods

We conducted a prospective longitudinal study among neonates admitted into a tertiary hospital from September 2019 to November 2019. Stools were sampled at admission and weekly until exit and processed by standard laboratory methods including polymerase chain reaction to identify ESBL genes. The ESBL-PE colonisation period prevalence at admission and acquisition rate were determined.

Results

The period prevalence of the ESBL-PE colonisation and acquisition rate were 46.5% (59/127) and 34.6% (36/104), respectively. Prolonged rupture of the amniotic membrane (PROM; >24 h; p=0.004, odds ratio [OR] 0.297), number of neonates on admission in the same room (p<0.001, OR 0.053) and presence of an ESBL-PE colonisers (p=0.004, OR 0.272) were independent risk factors for ESBL-PE rectal colonisation. ESBL-PE colonisation did not correlate with mortality (Fisher's exact test 1.342, p=0.196).

Conclusions

The rate of ESBL-PE neonatal rectal colonisation is high in our settings and this underscores the need for a review of neonatal admission protocols, embracing of antibiotic stewardship in the management of PROM, resistance surveillance and implementation of infection prevention and control in the neonatal unit.
Abnormally Increased Effective Connectivity of the Periaqueductal Gray in Migraine Without Aura Patients
Authors: Liu Kun , Cheng Jinming , Cao Yungang , Chen Keyang , Li Yan , Zhang Xi , Dong LiPeng , Wang Zhihong , Liu Xiaozheng
Published: March 2023

Objectives:

The periaqueductal gray (PAG) is a key region in the descending pain modulatory system. We applied a Granger causality analysis-based approach to examine resting-state effective connectivity of the bilateral PAG regions in migraine patients without aura (MwoA).

Materials and Methods:

Resting-state functional magnetic resonance imaging data were obtained from 28 MwoA patients and 17 healthy controls. The effective connectivity of the bilateral PAG was characterized using a voxel-wised Granger causality analysis method. The resulting effective connectivity measurements were assessed for correlations with other clinical features.

Results:

Compared with the healthy controls, MwoA patients showed increased effective connectivity from the left PAG to the left anterior cingulate gyrus and right postcentral gyrus. Meanwhile, MwoA patients also showed increased effective connectivity from the right PAG to the left precentral gyrus and increased effective connectivity from the left caudate and right middle occipital gyrus to the right PAG.

Discussion:

Abnormally increased effective connectivity between PAG and limbic system, primary sensorimotor cortex, and visual cortex may play a key role in neuropathological features, perception, and affection of MwoA. The current study provides further insights into the complex scenario of MwoA mechanisms.
Anesthesiology Performance Improvement and Reporting Exchange (ASPIRE) Quality Metrics in Patients Undergoing Decompressive Craniectomy and Endoscopic Clot Evacuation after Spontaneous Supratentorial Intracerebral Hemorrhage: A Retrospective Observational Study
Authors: Lele Abhijit V. , Fong Christine T. , Newman Shu-Fang , O’Reilly-Shah Vikas , Walters Andrew M. , Athiraman Umeshkumar , Souter Michael J. , Levitt Michael R. , Vavilala Monica S.
Published: March 2023

Background:

We report adherence to 6 Anesthesiology Performance Improvement and Reporting Exchange (ASPIRE) quality metrics (QMs) relevant to patients undergoing decompressive craniectomy or endoscopic clot evacuation after spontaneous supratentorial intracerebral hemorrhage (sICH).

Methods:

In this retrospective observational study, we describe adherence to the following ASPIRE QMs: acute kidney injury (AKI-01); mean arterial pressure < 65 mm Hg for less than 15 minutes (BP-03); myocardial injury (CARD-02); treatment of high glucose (> 200 mg/dL, GLU-03); reversal of neuromuscular blockade (NMB-02); and perioperative hypothermia (TEMP-03).

Result:

The study included 95 patients (70% male) with median (interquartile range) age 55 (47 to 66) years and ICH score 2 (1 to 3) undergoing craniectomy (n=55) or endoscopic clot evacuation (n=40) after sICH. In-hospital mortality attributable to sICH was 23% (n=22). Patients with American Society of Anesthesiologists physical status class 5 (n=16), preoperative reduced glomerular filtration rate (n=5), elevated cardiac troponin (n=21) and no intraoperative labs with high glucose (n=71), those who were not extubated at the end of the case (n=62) or did not receive a neuromuscular blocker given (n=3), and patients having emergent surgery (n=64) were excluded from the analysis for their respective ASPIRE QM based on predetermined ASPIRE exclusion criteria. For the remaining patients, the adherence to ASPIRE QMs were: AKI-01, craniectomy 34%, endoscopic clot evacuation 1%; BP-03, craniectomy 72%, clot evacuation 73%; CARD-02, 100% for both groups; GLU-03, craniectomy 67%, clot evacuation 100%; NMB-02, clot evacuation 79%, and; TEMP-03, clot evacuation 0% with hypothermia.

Conclusion:

This study found variable adherence to ASPIRE QMs in sICH patients undergoing decompressive craniectomy or endoscopic clot evacuation. The relatively high number of patients excluded from individual ASPIRE metrics is a major limitation.
Inflammatory eye disease for rheumatologists
Authors: Corbitt Kelly , Nowatzky Johannes
Published: March 2023

Purpose of review

This review provides a framework for understanding inflammatory eye disease diagnosis, differential diagnosis, and management for rheumatologists. Uveitis, scleritis, episcleritis, peripheral ulcerative keratitis, and orbital inflammation are all discussed. The goal is to facilitate the development of approaches to inflammatory eye diseases that will help rheumatologists co-manage these patients with eye care providers specializing in ocular inflammation.

Recent findings

In recent years, studies have aimed to advance biologic treatments and define standard-of-care therapy. Inflammatory eye diseases are highly heterogeneous and often rare, which poses significant challenges to their research and the interpretation of existing data. To date, glucocorticoids, mycophenolate, methotrexate, and TNF inhibitors remain the mainstay of treatment options for many of these diseases.

Patients with inflammatory eye diseases require multidisciplinary care for best outcomes, frequently including rheumatologists. Understanding the differentials, diagnostics, and treatment are essential to preserving vision in these patients. The diverse nature of the disease processes within this field requires focusing on specific disease phenotypes and endotypes in research and clinical practice.
Study Quality and Patient Inclusion in Geriatric Orthopaedic Trauma Research: A Scoping Review
Authors: Schuijt Henk Jan , McCormick Brian. P. , Webb Alexander. R. , Fortier Luc M. , von Keudell Arvind , Weaver Michael J.
Published: March 2023

Objectives:

To evaluate the quality of evidence published in geriatric traumatology, to investigate how many studies include patients with cognitive impairment, and to investigate which methods are used to determine cognitive impairment.

Data Sources:

A search was conducted in PubMed for all publications in English in 154 selected journals between 01/01/2017 and 01/01/2020.

Study Selection:

Clinical studies investigating patients 65 years of age and older with fractures in the appendicular skeleton or pelvis were included.

Data Extraction:

Two independent reviewers performed full-text screening and data extraction for all articles.

Data Synthesis:

A comparative analysis was performed for prospective cohort studies and RCTs. The results are discussed in a narrative review.

Conclusions:

A total of 2711 publications were screened for eligibility, and after exclusion, a total of 723 articles were included. There is a focus on retrospective studies investigating mortality and complications. Studies are often small in sample size, and there are relatively few prospective studies, RCT studies, patient-reported outcomes, and quality of life. Patients with cognitive impairment are selectively excluded from clinical studies, and no consensus exists on how cognitive impairment is diagnosed. This review identified pitfalls and provides recommendations to navigate these issues for future studies. Many studies exclude cognitively impaired patients, which may result in selection bias and inability to extrapolate results. The lack of use of objective measures to define cognitive impairment and lack appropriate outcome measures for the cognitively impaired is an important issue that needs to be addressed in future research.
No short-term clinical improvement and mean 6° of thoracic kyphosis correction using limited-level Ponte osteotomy near T7 for Lenke type 1 and 2 adolescent idiopathic scoliosis: a preliminary study
Authors: Tanida Shimei , Masamoto Kazutaka , Tsukanaka Masako , Futami Toru
Published: March 2023

This study was a retrospective single surgeon case series approved by institutional review board and showed the efficacy of limited Ponte osteotomy at T6/7, 7/8 and 8/9 (limited-PO) in the sagittal plane for patients with Lenke type 1 and 2 adolescent idiopathic scoliosis (AIS). A total of 37 consecutive patients [7 males and 30 females; average age 16.0 ± 2.5 (range: 12–21)] over a 4-year period with posterior corrective fusion surgery were included. Initially, 18 patients were operated on without limited-PO [P(−)-group]. Midway in the series, the senior author switched to the limited-PO [P(+)-group]. The limited-PO has been performed to form the apex of thoracic kyphosis at the T7 level, together with the restoration of thoracic kyphosis. The mean amount of the correction angle of thoracic kyphosis was more in the P(+)-than in P(−)-group (13.8 ± 9.6° vs. 7.8 ± 8.0°, P = 0.046) at 1-year after surgery. Cervical lordosis was spontaneously corrected more in P(+)-than in P(−)-group. The apex of thoracic kyphosis was controlled around the T7 level postoperatively in most cases (18/19 cases). There was no significant difference between the two groups in terms of blood loss and operative time per level, or Scoliosis Research Society-22 domain scores. Limited-PO contributed to the restoration of the whole spinal sagittal alignment for Lenke type 1 and 2 AIS; however, in this preliminary study, the clinical improvement was unclear at least in the short term, because the kyphosis angle obtained by limited-PO was only approximately 6°.
Extracorporeal Carbon Dioxide Removal With the Hemolung in Patients With Acute Respiratory Failure: A Multicenter Retrospective Cohort Study*
Authors: Tiruvoipati Ravindranath , Akkanti Bindu , Dinh Kha , Barrett Nicholas , May Alexandra , Kimmel Jeremy , Conrad Steven A.
Published: March 2023

Objectives:

Extracorporeal carbon dioxide removal (ECCO2R) devices are effective in reducing hypercapnia and mechanical ventilation support but have not been shown to reduce mortality. This may be due to case selection, device performance, familiarity, or the management. The objective of this study is to investigate the effectiveness and safety of a single ECCO2R device (Hemolung) in patients with acute respiratory failure and identify variables associated with survival that could help case selection in clinical practice as well as future research.

Design:

Multicenter, multinational, retrospective review.

Setting:

Data from the Hemolung Registry between April 2013 and June 2021, where 57 ICUs contributed deidentified data.

Patients:

Patients with acute respiratory failure treated with the Hemolung. The characteristics of patients who survived to ICU discharge were compared with those who died. Multivariable logistical regression analysis was used to identify variables associated with ICU survival.

Interventions:

None.

Measurements and Main Results:

Of the 159 patients included, 65 (41%) survived to ICU discharge. The survival was highest in status asthmaticus (86%), followed by acute respiratory distress syndrome (ARDS) (52%) and COVID-19 ARDS (31%). All patients had a significant reduction in Paco
2 and improvement in pH with reduction in mechanical ventilation support. Patients who died were older, had a lower Pao
2:Fio
2 (P/F) and higher use of adjunctive therapies. There was no difference in the complications between patients who survived to those who died. Multivariable regression analysis showed non-COVID-19 ARDS, age less than 65 years, and P/F at initiation of ECCO2R to be independently associated with survival to ICU discharge (P/F 100–200 vs <100: odds ratio, 6.57; 95% CI, 2.03–21.33).

Conclusions:

Significant improvement in hypercapnic acidosis along with reduction in ventilation supports was noted within 4 hours of initiating ECCO2R. Non-COVID-19 ARDS, age, and P/F at commencement of ECCO2R were independently associated with survival.
Barriers and facilitators related to COVID-19 vaccine acceptance and uptake among people living with HIV
Authors: Krause Kristen D. , Pérez-Figueroa Rafael E. , Halkitis Perry N.
Published: March 2023

Purpose of review

This review reports on the myriad barriers and facilitators related to COVID-19 vaccine hesitancy and factors contribution to uptake among people living with HIV (PLWH) globally published over the past year (2021–2022).

Recent findings

Across the literature, participants indicated concerns about the safety, efficacy and overall rapid development of the COVID-19 vaccine as a reason for delaying or not being vaccinated. Medical mistrust and perceptions about the risk of COVID-19 immune response and severity also played a role in COVID-19 vaccine hesitancy among PLWH. Almost every study examined different sociodemographic characteristics associated with COVID-19 vaccination acceptance and uptake, and although strong themes emerged around race/ethnicity, sex and educational attainment, the results were mixed across other characteristics, including age. Some studies also examined medical factors specifically related to PLWH including CD4+ cell count and adherence to antiretroviral therapy.

The findings highlight individual, structural and social differences in COVID-19 vaccine acceptance and uptake among PLWH, which are varied throughout the world. We call on researchers and interventionists to not just consider the role of medical mistrust and disinformation, but also how emotional, financial and political vulnerability plays into making decisions around COVID-19 vaccine uptake and overall healthcare.
Surgical Subcision for Acne Scars: A Review of Instrumentation
Authors: Lobo Yolanka , Lim Davin S.
Published: March 2023

BACKGROUND

Subcision is a surgical technique for managing atrophic acne scars. Over time, new instruments have emerged to increase the efficiency, efficacy, and safety of the subcision procedure, including sharp, blunt, and energy-assisted devices.

OBJECTIVE

To review the instrumentation used for the subcision of acne scars and to provide clinicians with practical information regarding the selection of instrumentation, with a focus on advantages and disadvantages.

METHODS

A search of PubMed, MEDLINE, and Google Scholar was conducted for articles from January 2000 to June 2022 describing the use of subcision alone for the management of acne scarring. Demographic and clinical data were collected from the included articles.

RESULTS

A total of 417 patients from 17 articles were included; 155 patients underwent sharp subcision, 235 patients underwent blunt subcision, and 27 patients underwent energy-assisted subcision. The main indication for subcision was atrophic facial acne scars. Subcision using sharp, blunt, and energy-assisted instruments were all effective in treating atrophic acne scars. Adverse effects common to all subcision methods included erythema and edema.

CONCLUSION

Subcision is a safe and effective modality for the revision of selected acne scars and is a valuable skill set for dermatologists who perform scar revision to master.