bluuebunny/crossref_metadata_2025 huggingface dataset:
Low-temperature oxidative dehydrogenation of propane over NiV mixed oxides derived from LDH precursors
Authors: Liu Zhenxing , Wang Jiang , Wu Kailu , Xu Aiju , Jia Meilin
Published: April 2023

A series of NiV mixed metal oxide (MMO) catalysts were derived from the NiV layered double hydroxides (LDHs) synthesized by the constant pH coprecipitation method. The synthesis parameters, (i) Ni/V molar ratio and (ii) calcination temperature ( Tp), were controlled. The MMO catalysts were characterized by physicochemical characterization techniques and then tested for the oxidative dehydrogenation of propane (ODHP). The results showed that the calcination temperature affected the crystalline phase formation and grain size of NiO, as well as the activated temperature of propane, and the addition of V greatly regulated the activity and quantity of the surface oxygen species and improved the propylene selectivity. 4NiV-500 catalyst (Ni/V = 4, Tp = 500 °C) exhibited the best catalytic performance at low temperature (250 °C) with an initial propylene selectivity of about 70%. Therefore, it is an effective method to obtain NiV MMO catalysts with excellent low-temperature activity for ODHP, using LDHs as the precursors while controlling the appropriate amount of V and calcination temperature simultaneously.
Post treatment for precise size and shape control of monodisperse CsPbBr3 nanocrystals under ambient condition using ZnBr2
Authors: Foo Di Kai , Fang Yanan , Ankit Jaiswal , Lee Jing Jun , Cheng Baisong , Ji Rong , Zhu Qiang , Tan Cheng Cheh , Wei Fengxia , White Timothy J.
Published: April 2023

A mixed passivation strategy is deployed to produce monodisperse and pure CsPbBr3 nanocrystals under ambient condition via post treatment using ZnBr2 in mixed organic solvents. This room temperature synthesis route provides precise size and shape control, and colloidal nanocubes or nanospheres can be obtained depending on the choice of organic solvents. Any secondary phases’ nucleation was inhibited. The ZnBr2 can reduce the Br− vacancies at the surface termination layers, thus enhancing their properties. This approach can potentially offer a cheap and viable route for perovskite nanocrystals in optical and electrical devices.
Research on excited states of PPV-COF spectra based on first principles
Authors: Tang Xudong , Ding Wangyang , Chen Nan , Li Mingyang , Li Jiayu , Liu Boxun
Published: April 2023

An in-depth understanding of the excitation mechanism of covalent organic frameworks (COF) materials is very important for the preparation and modification of two-dimensional materials. This paper investigates the photoelectric properties of poly(p-phenylenevinylene) (PPV)-based COFs using first principles and quantum chemistry. Density functional theory (DFT) and time-dependent DFT were employed to analyze the state density and band structure of PPV-COF, confirming that PPV-COF has a direct bandgap of 2.15 eV. We further analyze the electron–hole distribution of all excited states with vibrator strength greater than 0.01, and discuss the mechanism of electron transition after photon absorption in each excited state of PPV-COF. Finally, based on quantitative calculations, UV-visible spectra of PPV-COF are provided. Our results showed that PPV-COF has a good photoelectric performance, which is beneficial to the application of PPV-COF in optoelectronic devices.
An Australian exploratory study of individual physical functioning and wellbeing of rural clients with chronic diseases whose structured exercise groups were cancelled due to social distancing requirements of the COVID-19 pandemic
Authors: Romein Jake , Bishop Jaclyn
Published: April 2023

Background The primary aim of this study was to describe if there was a change in physical functioning of rural clients with chronic diseases who were unable to attend their structured exercise groups during the COVID-19 pandemic. The secondary aim was to describe their physical activity during lockdown and their wellbeing upon return to their structured exercise groups. Method Physical functioning measures collected in January to March 2020 (prior to suspension of structured exercise groups due to the lockdown) were repeated in July 2020 (when face-to-face activity resumed) and compared. A survey collected information about the client’s level of physical activity during lockdown and wellbeing measures at the end of the lockdown. Results Forty-seven clients consented to provide physical functioning tests and 52 completed the survey. Only the modified 2-min step-up test displayed a statistically (but not clinically) significant change (n = 29, 51.7 vs 54.1 rep, P = 0.01). Physical activity undertaken during lockdown was less in 48% (n = 24), the same in 44% (n = 22) and increased in 8% (n = 4) of clients. Despite the lockdown, clients had high global satisfaction, high subjective wellbeing and normal resilience. Conclusions Clinically significant changes in physical functioning when clients were unable to attend structured exercise groups for three months during the COVID-19 pandemic were not observed in this exploratory study. Further research is required to confirm the impact of isolation on physical functioning in those participating in group exercise to improve their chronic disease management.
A remotely sensed weight gain model for sheep in the semi-arid Karoo shrublands of South Africa
Authors: Harmse Christiaan J. , van Niekerk Adriaan
Published: April 2023

The monitoring of animal weight gain is expensive as it often involves the rounding up of animals over large areas and long distances. Such monitoring is an arduous process that causes stress related health problems and weight loss in animals. The aim of this study was to evaluate the use of remotely sensed vegetation indices for modelling sheep weight gain in semi-arid rangelands. The temporal and spatial patterns of grazing were investigated using Sentinel-2 imagery, collar data obtained from a global position system (GPS), and data of sheep weight related to grazing hotspots. Historical animal weight data were compared statistically with nine commonly used spectral indices extracted from Sentinel-2 imagery to determine how vegetation conditions relate to sheep weight gain. Sheep appeared to adapt their grazing behaviour according to time of the year, with the average distance walked per sheep per day in line with previous studies. In contrast to distance walked, sheep at lower stocking densities used less grazing area than at higher densities. The normalised difference vegetation index (NDVI) proved to best model liveweight changes. By combining remote sensing (RS) and GPS data, our understanding of sheep grazing patterns and sheep weight gain was improved. This can lead to the optimisation of production potential through precision farming. The finding has applications for studies conducted on non-reproductive sheep in semi-arid Karoo rangeland systems of South Africa. Because the model is both cost-effective and replicable, it offers a long-term monitoring template for livestock studies elsewhere.
GmEID1 modulates light signaling through the Evening Complex to control flowering time and yield in soybean
Authors: Qin Chao , Li Haiyang , Zhang Shengrui , Lin Xiaoya , Jia Zhiwei , Zhao Fen , Wei Xiuzhi , Jiao Yuanchen , Li Zhuang , Niu Zhiyuan , Zhou Yonggang , Li Xiaojiao , Li Hongyu , Zhao Tao , Liu Jun , Li Haiyan , Lu Yuping , Kong Fanjiang , Liu Bin
Published: April 2023

Soybean (Glycine max) morphogenesis and flowering time are accurately regulated by photoperiod, which determine the yield potential and limit soybean cultivars to a narrow latitudinal range. The
E3
and
E4
genes, which encode phytochrome A photoreceptors in soybean, promote the expression of the legume-specific flowering repressor
E1
to delay floral transition under long-day (LD) conditions. However, the underlying molecular mechanism remains unclear. Here, we show that the diurnal expression pattern of
GmEID1
is opposite to that of
E1
and targeted mutations in the
GmEID1
gene delay soybean flowering regardless of daylength. GmEID1 interacts with J, a key component of circadian Evening Complex (EC), to inhibit
E1
transcription. Photoactivated E3/E4 interacts with GmEID1 to inhibit GmEID1–J interaction, promoting J degradation resulting in a negative correlation between daylength and the level of J protein. Notably, targeted mutations in
GmEID1
improved soybean adaptability by enhancing yield per plant up to 55.3% compared to WT in field trials performed in a broad latitudinal span of more than 24°. Together, this study reveals a unique mechanism in which E3/E4-GmEID1-EC module controls flowering time and provides an effective strategy to improve soybean adaptability and production for molecular breeding.
The semantic mapping of the German spatial preposition JENSEITS
Authors: Kermer Franka
Published: April 2023

The present study aims to investigate the semantic value of the German spatial preposition jenseits (‘beyond’). It is argued that our conceptualization of the spatial-physical world and how we interact with objects in our environment transforms a prepositions’ primary meaning into domains of meaning that are tied to time or social interactions. While the study of the semantic structure of English prepositions has received attention, German prepositions, particularly less frequently used ones such as hinter (‘behind’) or jenseits, present a gap in research. It is attempted to show that the different senses of jenseits form a semantic network in which meaning extensions of the spatial, primary sense of jenseits are motivated by varying construal patterns imposed upon an observed scene. The description of the semantic structure of jenseits also draws on previous studies on its English counterpart, beyond (Boers, 1996; Lindstromberg, 2010). Based on the sample collected for the purpose of this study, this paper analyzes 1000 occurrences of the preposition jenseits in the DWDS-subcorpus Die Zeit. The analysis shows that a high frequency of the occurrences found in the sample constitute non-spatial meanings of jenseits and thus encode a configuration between objects in more abstract domains. Furthermore, the notion of metaphorical mapping is used to explain the conceptualization and metaphorical transfer of spatial jenseits to abstract domains of human experience.
Fish oil supplementation fails to modulate indices of muscle damage and muscle repair during acute recovery from eccentric exercise in trained young males
Authors: Mackay Janna , Bowles Elena , Macgregor Lewis J. , Prokopidis Konstantinos , Campbell Christina , Barber Eloise , Galloway Stuart D. R. , Witard Oliver C.
Published: April 2023

We aimed to investigate the influence of 4‐wk of fish oil (FO) supplementation on markers of muscle damage, inflammation, muscle soreness, and muscle function during acute recovery from eccentric exercise in moderately trained males. Sixteen moderately‐trained males ingested 5 g/d of FO (n = 8) or soybean oil (placebo) capsules (n = 8) for 4‐wk prior to‐ and 3‐d following an acute eccentric exercise bout. Eccentric exercise consisted of 12 sets of isokinetic knee extension and knee flexion. Indices of muscle damage, soreness, function and inflammation were measured at baseline and during exercise recovery. Eccentric exercise elicited an increase in muscle soreness (p < 0.010) and thigh volume (p < 0.001), and reduced peak isometric torque by 31.7 ± 6.9%, (p < 0.05, 95% CI 10.6–52.8) during 3‐d of recovery. Blood omega‐3 polyunsaturated fatty acid concentration was 14.9 ± 2.4% higher in FO than PLA (p < 0.01, 95% CI 9.8–20.1). However, FO did not ameliorate the cumulative creatine kinase response (expressed as AUC; p = 0.368), inflammation (p = 0.400), muscle soreness (p > 0.140), or muscle function (p > 0.249) following eccentric exercise. FO supplementation confers no clear benefit in terms of ameliorating the degree of muscle damage, or facilitating the muscle repair process, during acute eccentric exercise recovery. These data suggest that FO supplementation does not provide an effective nutritional strategy to promote exercise recovery, at least in moderately‐trained young men.

Abbreviations: ANOVA: Analysis of variance; AUC: Area under curve; CI: Confidence interval; CK: Creatine kinase; CMJ: Countermovement jump; COX: Cyclooxygenase; CRP: C‐reactive protein; DHA: Docosahexaenoic acid; DOMS: Delayed‐onset muscle soreness; EIMD: Exercise‐induced muscle damage; En%: Energy percent; EPA: Eicosapentaenoic acid; FO: Fish oil; IL‐6: Interleukin‐6; LDH: Lactate dehydrogenase; LOX: Lipoxygenase; Mb: Myoglobin; mTOR: Mechanistic target of rapamycin; PLA: Placebo; ROM: Range of motion; ROS: Reactive oxygen species; SD: Standard deviation; SEM: Standard error of the mean; TNF‐α: Tumour necrosis factor alpha; VAS: Visual analogue scale; Ω3‐PUFA: Omega‐3 polyunsaturated fatty acids; Ω6‐PUFA: Omega‐6 polyunsaturated fatty acids
Depolarization-induced bursts of miniature synaptic currents in individual synapses of developing cerebellum
Authors: Le Guellec Bastien , Gomez Laura C. , Malagon Gerardo , Collin Thibault , Marty Alain
Published: April 2023

In central synapses, spontaneous transmitter release observed in the absence of action potential firing is often considered as a random process lacking time or space specificity. However, when studying miniature glutamatergic currents at cerebellar synapses between parallel fibers and molecular layer interneurons, we found that these currents were sometimes organized in bursts of events occurring at high frequency (about 30 Hz). Bursts displayed homogeneous quantal size amplitudes. Furthermore, in the presence of the desensitization inhibitor cyclothiazide, successive events within a burst displayed quantal amplitude occlusion. Based on these findings, we conclude that bursts originate in individual synapses. Bursts were enhanced by increasing either the external potassium concentration or the external calcium concentration, and they were strongly inhibited when blocking voltage-gated calcium channels by cadmium. Bursts were prevalent in elevated potassium concentration during the formation of the molecular layer but were infrequent later in development. Since postsynaptic AMPA receptors are largely calcium permeant in developing parallel fiber-interneuron synapses, we propose that bursts involve presynaptic calcium transients implicating presynaptic voltage-gated calcium channels, together with postsynaptic calcium transients implicating postsynaptic AMPA receptors. These simultaneous pre- and postsynaptic calcium transients may contribute to the formation and/or stabilization of synaptic connections.
Towards sustainable transparent flexible heaters: Integration of a BNNT interlayer using green solvent substitution
Authors: Wagner Kaitlin , Zou Shan , Martinez-Rubi Yadienka , Kell Arnold J , Paquet Chantal , Lessard Benoît H
Published: April 2023

Processing materials in electronics with non-toxic, green solvents can provide environmental benefits while reducing manufacturing health and safety challenges. Unfortunately, green solvents are often unable to provide comparable solubilizing characteristics and present challenges in printing and film formation compared to conventional organic solvents. Therefore, green materials are often developed in parallel to their processing method for successful implementation. In this study, we report on the use of a polyvinyl butyral (PVB) and ethanol solution as a replacement for poly (3-hexylthiophene-2,5-diyl) (P3HT) and chloroform and its’ first demonstration in boron nitride nanotube (BNNT) thin film interlayers for improved thermal and mechanical performance in silver microgrid transparent heaters. Using PVB/ethanol led to comparable thin films of BNNT, achieving a clear tube network formation across the substrate surface and resulting in near identical optical transparency and surface energy measurements compared to the P3HT/chloroform system. Silver microgrids printed on BNNT-coated polyethylene terephthalate (PET) with PVB as dispersant exhibited a similar conductive performance to the microgrids printed on BNNT-coated PET with P3HT, providing the same level of mechanical endurance and maintaining thermal performance metrics upon applied voltage. The PVB and ethanol system presents an exemplary green material combination for the novel deposition of BNNT thin film interlayers for integration into transparent heaters.
Establishing a pharmacy revenue integrity team: A blueprint for increasing pharmacy’s role in health-system revenue cycle
Authors: Rodgers John Killian L , Francart Suzanne J , Amerine Lindsey B
Published: April 2023

Purpose

An increasing focus on driving margin has pushed health-system pharmacy departments to find new ways of generating new or protecting existing revenue. At UNC Health, a dedicated pharmacy revenue integrity (PRI) team has been operating since 2017. This team has been able to significantly reduce revenue loss from denials, increase billing compliance, and improve revenue capture. This article provides a framework for establishing a PRI program and reports results generated from it.

The activities of a PRI program can be grouped into 3 main pillars: minimizing revenue loss, optimizing revenue capture, and ensuring billing compliance. Minimizing revenue loss is accomplished primarily through management of pharmacy charge denials and can be an ideal first step in establishing a PRI program due to the tangible value generated. Optimizing revenue capture involves a combination of clinical expertise and understanding of billing operations to ensure medications are being billed and reimbursed appropriately. Finally, ensuring billing compliance, including ownership of the pharmacy charge description master and maintenance of electronic health record medication lists, is vital in preventing charge and reimbursement errors.

Conclusion

Successfully bringing traditional revenue cycle functions into the department of pharmacy can be a daunting task but provides significant opportunities to create value for a health system. Key factors to the success of a PRI program include robust data access, hiring individuals with financial and pharmacy expertise into PRI positions, strong relationships with the existing revenue cycle teams, and a progressive model that allows for incremental expansion of services.
Glycemic patterns and impact of early hyperglycaemia in patients with cardiogenic shock on mechanical circulatory support
Authors: Nair Raunak Mohan , Chawla Sanchit , Mentias Amgad , Saleem Talha , Vural Adil , Ko Taeyong , Rampersad Penelope , Cremer Paul , Menon Venu
Published: April 2023

Aims

Hyperglycaemia has been an established predictor of poor outcomes in critically ill patients. The aim of this study is to assess the pattern of early glycemic control in patients with cardiogenic shock (CS) on temporary mechanical circulatory support (MCS) and its impact on short-term outcomes.

Methods and results

All adult patients admitted to the Cleveland clinic cardiac intensive care unit (CICU) between 2015 and 2019 with CS necessitating MCS with intra-aortic balloon pump (IABP), Impella or venous arterial- extra corporeal membrane oxygenation (VA- ECMO) exclusively for CS were retrospectively analyzed. Blood glucose values were collected for the first 72 h from the time of MCS insertion. Patients were categorized into three groups [group 1 = mean blood glucose (MBG) < 140, group 2 = MBG between 140 and 180, and group 3 = MBG >180]. The primary outcome was 30-day all-cause mortality. A total of 393 patients with CS on temporary MCS [median age (Q1, Q3), 63 (54, 70), 42% females], were admitted to our CICU during the study period. Of these, 144 patients (37%) were on IABP, 121 patients (31%) were on Impella, and 128 (32%) were on VA-ECMO. Upon stratifying the patients into groups depending on MBG during the initial time period after MCS placement, 174 patients (44%) had MBG less than 140 mg/dL, 126 patients (32%) had MBG between 140 and 180 mg/dL whereas 93 (24%) patients had MBG > 180 mg/dL. Overall, patients on IABP had the best glycemic control during the early period whereas those on ECMO had the highest MBG during the initial timeframe. A comparison of 30-day mortality revealed that patients with MBG >180 mg/dL had worse outcomes compared to the other two groups (P = 0.005). Multivariable logistic regression revealed that hyperglycaemia was an independent predictor of poor outcomes in CS patients on MCS when undifferentiated by device type (aOR 2.27, 95% CI 1.19–4.42, P = 0.01). However, upon adjusting for the type of MCS device, this effect was no longer present.

Conclusion

A significant proportion of patients with CS on MCS manifest early hyperglycaemia regardless of diabetic status. The presence of early hyperglycaemia in these patients acted predominantly as a surrogate of the underlying shock severity and was associated with worse short-term outcomes. Future studies should assess whether strategies to optimize glycemic control in this high-risk cohort can independently improve clinical outcomes.
A humanized yeast model reveals dominant-negative properties of neuropathy-associated alanyl-tRNA synthetase mutations
Authors: Meyer-Schuman Rebecca , Marte Sheila , Smith Tyler J , Feely Shawna M E , Kennerson Marina , Nicholson Garth , Shy Mike E , Koutmou Kristin S , Antonellis Anthony
Published: April 2023

Aminoacyl-tRNA synthetases (ARSs) are essential enzymes that ligate tRNA molecules to cognate amino acids. Heterozygosity for missense variants or small in-frame deletions in six ARS genes causes dominant axonal peripheral neuropathy. These pathogenic variants reduce enzyme activity without significantly decreasing protein levels and reside in genes encoding homo-dimeric enzymes. These observations raise the possibility that neuropathy-associated ARS variants exert a dominant-negative effect, reducing overall ARS activity below a threshold required for peripheral nerve function. To test such variants for dominant-negative properties, we developed a humanized yeast assay to co-express pathogenic human alanyl-tRNA synthetase (AARS1) mutations with wild-type human AARS1. We show that multiple loss-of-function AARS1 mutations impair yeast growth through an interaction with wild-type AARS1, but that reducing this interaction rescues yeast growth. This suggests that neuropathy-associated AARS1 variants exert a dominant-negative effect, which supports a common, loss-of-function mechanism for ARS-mediated dominant peripheral neuropathy.
Children’s Religious Identity in Alternative Care and Adoption: The Need to Recentre the Child’s Best Interest in International Human Rights Adjudication
Authors: Do Vale Alves Ayla
Published: April 2023

This article argues that international human rights (quasi-)adjudicatory institutions should do better in considering the best interests of the child and freedom of religion in cases involving human rights aspects of alternative care and adoption. The European Court of Human Rights, particularly, has been using obscure and contradictory standards, which ultimately do not privilege the child’s best interests in matters affecting them directly. Recent Grand Chamber jurisprudence instead puts parents’ interests above the child’s. A child-centred approach where children are not objectified, but treated as autonomous, rights-bearing, legal persons, with independent interests that may override those of other stakeholders is needed. This article explores general international and European rules governing children’s religious rights in alternative care and adoption to expose the Court’s pitfalls in centring children in decision-making involving religion particularly. It generally promotes adoption of a child-centred approach in international human rights courts, and particularly highlights existing hurdles in such approach where the decision-making involves conflicting interests concerning religion.
Using machine learning to alleviate the allometric effect in otolith shape-based species discrimination: the role of a triplet loss function
Authors: Chen Yuwen , Zhu Guoping
Published: April 2023

Species identification by fish otoliths is an effective and appropriate approach. However, the allometric growth of otoliths can cause discrimination confusion, particularly in juvenile otolith classification. In the Southern Ocean, Chionodraco rastrospinosus,Krefftichthys anderssoni,Electrona carlsbergi, andPleuragramma antarcticum are frequently caught together in krill fishery as bycatch species. Furthermore, the otolith shape of these four species is relatively similar in juvenile fish, making the identification of fish species difficult. In this study, we tried and evaluated many commonly used machine learning techniques to solve this problem. Eventually, by introducing a triplet loss function (function used to reduce intraspecific variation and increase inter-specific variation), the discrimination confusion caused by the allometric growth of otoliths was reduced. The classification results show that the neural network model with the triplet loss function achieves the best classification accuracy of 96%. The proposed method can help improve otolith classification performance, especially under the context of limited sampling effort, which is of great importance for trophic ecology and the study of fish life history.
Does the low-carbon construction of cities in China reduce carbon emission intensity?
Authors: He Chengkang , Shu Cheng , Zou Jinlang , Li Yunliang
Published: April 2023

Currently, realizing the coordinated green development of the economy and environment has become the focus of all walks of life. To achieve this goal, it is important for cities to promote carbon reduction. China has implemented a low-carbon city pilot (LCP) policy since 2010 to achieve green transformative development. In this context, this study aims to assess whether the LCP policy achieves carbon peaking and carbon neutrality goals. Using 2007–2019 prefecture-level panel data from China and a time-varying difference-in-difference model, we conduct a quasi-natural experiment. The empirical results show that the carbon emission intensity (CEI) is greatly reduced in cities that implemented the LCP policy. Compared with the control group, the average value of CEI of cities in the experimental group is approximately three percentage points lower, and the robustness test results prove the reliability of the baseline estimates. In addition, we examine the time lag effect and find that in the experimental group, the CEI of cities is significantly lower in the fourth year and has a tendency to gradually increase. Meanwhile, the heterogeneity analysis in this research groups the samples according to economic development, population agglomeration and resource endowment. We find that in cities with better economic development, higher population agglomeration and relatively underdeveloped resource endowment, there is a greater reduction in CEI. Finally, we conduct a mechanism test and find that in the experimental group, the CEI of cities is severely reduced due to industrial structure optimization, environmental enforcement strengthening and technological innovation capabilities enhancement.
Five-Point Toponogov Theorem
Authors: Lebedeva Nina , Petrunin Anton
Published: April 2023

We give an if-and-only-if condition on five-point metric spaces that admit isometric embeddings into complete nonnegatively curved Riemannian manifolds.
Dirichlet Sub-Laplacians on Homogeneous Carnot Groups: Spectral Properties, Asymptotics, and Heat Content
Authors: Carfagnini Marco , Gordina Maria
Published: April 2023

We consider sub-Laplacians in open bounded sets in a homogeneous Carnot group and study their spectral properties. We prove that these operators have a pure point spectrum and prove the existence of the spectral gap. In addition, we give applications to the small ball problem for a hypoelliptic Brownian motion and the large time behavior of the heat content in a regular domain.
The association between prescription drug monitoring programs and controlled substance prescribing: a cross-sectional study using data from 2019 National Electronic Health Records Survey
Authors: Mehta Shivani , Brown William , Ferguson Erin , Najera James , Pantell Matthew S
Published: April 2023

Objective

The use of controlled medications such as opioids, stimulants, anabolic steroids, depressants, and hallucinogens has led to an increase in addiction, overdose, and death. Given the high attributes of abuse and dependency, prescription drug monitoring programs (PDMPs) were introduced in the United States as a state-level intervention.

Materials and methods

Using cross-sectional data from the 2019 National Electronic Health Records Survey, we assessed the association between PDMP usage and reduced or eliminated controlled substance prescribing as well as the association between PDMP usage and changing a controlled substance prescription to a nonopioid pharmacologic therapy or nonpharmacologic therapy. We applied survey weights to produce physician-level estimates from the survey sample.

Results

Adjusting for physician age, sex, type of medical degree, specialty, and ease of PDMP, we found that physicians who reported “often” PDMP usage had 2.34 times the odds of reducing or eliminating controlled substance prescriptions compared to physicians who reported never using the PDMP (95% confidence interval [CI] 1.12–4.90). Adjusting for physician age, sex, type of doctor, and specialty, we found that physicians who reported “often” use of the PDMP had 3.65 times the odd of changing controlled substance prescriptions to a nonopioid pharmacologic therapy or nonpharmacologic therapy (95% CI: 1.61–8.26).

Discussion

These results support the continued use, investment, and expansion of PDMPs as an effective intervention for reducing controlled substance prescription and changing to nonopioid/pharmacologic therapy.

Conclusion

Overall, frequent usage of PDMPs was significantly associated with reducing, eliminating, or changing controlled substance prescription patterns.
A Path to Real-World Evidence in Critical Care Using Open-Source Data Harmonization Tools
Authors: Heavner Smith F. , Anderson Wesley , Kashyap Rahul , Dasher Pamela , Mathé Ewy A. , Merson Laura , Guerin Philippe J. , Weaver Jeff , Robinson Matthew , Schito Marco , Kumar Vishakha K. , Nagy Paul
Published: April 2023

COVID-19 highlighted the need for use of real-world data (RWD) in critical care as a near real-time resource for clinical, research, and policy efforts. Analysis of RWD is gaining momentum and can generate important evidence for policy makers and regulators. Extracting high quality RWD from electronic health records (EHRs) requires sophisticated infrastructure and dedicated resources. We sought to customize freely available public tools, supporting all phases of data harmonization, from data quality assessments to de-identification procedures, and generation of robust, data science ready RWD from EHRs. These data are made available to clinicians and researchers through CURE ID, a free platform which facilitates access to case reports of challenging clinical cases and repurposed treatments hosted by the National Center for Advancing Translational Sciences/National Institutes of Health in partnership with the Food and Drug Administration. This commentary describes the partnership, rationale, process, use case, impact in critical care, and future directions for this collaborative effort.
Wallerian degeneration in the brain after organophosphorus poisoning: a case report
Authors: Gajurel Bikram P. , Giri Subarna , Poudel Navin , Kharel Sanjeev , Karn Ragesh , Rajbhandari Reema , Ojha Rajeev , Gautam Niraj , Shrestha Aashish
Published: April 2023

Introduction and Importance:

The type, quantity, and potency of the organophosphorus compound (OPC) taken determine the symptoms of OPC poisoning as well as their severity. The exact etiology for organophosphorus (OP) poisoning delay neuropathy regulating Wallerian degeneration is still unknown.

Case Presentation:

We report here a rare case of a 25-year-old lady with Wallerian degeneration in the brain found in an MRI in a patient after OPC ingestion. MRI of the brain, in our case, shows Wallerian degeneration of the corona radiata, internal capsule, and midbrain.

Clinical Discussion:

Some OPCs can lead to OP-induced delayed neuropathy, a form of delayed neurotoxicity in humans (OPIDN). The distal axonopathy’s (in OPIDN) morphological pattern resembles Wallerian degeneration, which happens in vitro following nerve damage. Although delayed Wallerian degeneration from organophosphate poisoning often affects the peripheral nervous system, it can also affect the central nervous system. Rehabilitation therapy combined with appropriate nursing care has been demonstrated to improve the disease.

Conclusion:

Central nervous system involvement after OP poisoning is rare, and MRI of the brain and spinal cord can document evidence of Wallerian degeneration after OP poisoning.
Link between excessive social media use and psychiatric disorders
Authors: Zubair Ujala , Khan Muhammad K. , Albashari Muna
Published: April 2023

Mental health disorders are an emerging challenge with the progressively increasing usage of social media platforms. Social media use is the second leading cause of disability among psychiatric disorders. A great deal of literature has tried to establish links between social media exposure and mental health diseases. However, there is a need to discuss the current literature that presents crucial perspectives on social media-induced psychiatric disorders to establish a holistic, evidence-based approach for their prevention and treatment. The use of social networks is strongly correlated with the development of anxiety and other psychological problems such as depression, insomnia, stress, decreased subjective happiness, and a sense of mental deprivation. The majority of the cited literature predicts that the likelihood of social media-induced mental health problems is directly proportional to the amount of time spent on these sites, the frequency of usage, and the number of platforms being used. Various possible explanations have been implicated, including a negative impact on self-esteem through unhealthy comparisons, social media burnout, stress, lack of emotional regulation due to social media preoccupation, and development of social anxiety due to decreased real-life social interactions. It has been postulated that increased social media use is driven by preexisting anxiety and is a coping strategy. This era of progressively increasing digitalization, the recent trend of a dramatic shift toward online social life, and the desire to get social attention is expected to take a gruesome toll on the population’s mental health, which therefore warrants more attention to mental health care.
Vaping, an emerging public health concern in South Asia: a short communication
Authors: Gul Fahad , Khan Alishba A. , Kazmi Syed N.H. , Abbas Khawar , Basit Jawad
Published: April 2023

Electronic cigarettes, or “vaping,” are battery-operated devices that heat a liquid containing propylene glycol, nicotine, and some flavoring agents, which aerosolize to produce vapors that the user inhales. They were introduced in 2003 and became popular worldwide as a less irritating alternative to combustible cigarettes. While they were initially advertised as smoking cessation aids, their use has taken the shape of an epidemic in some regions of the world. Vaping prevalence is high in South Asia, where a significant number of people use tobacco and smokeless tobacco. According to data from Pakistan, 6.2% of the population uses vaping/e-cigarettes, while 15.9 million (12.4%) use smokeless tobacco. Vaping may be a safer alternative to cigarette smoking, as e-cigarettes do not contain all the toxins that regular cigarettes do, and the aerosol from e-cigarettes has no appreciable cytotoxic, genotoxic, or inflammatory effects when inhaled. However, nicotine addiction is a concern, as it is the main culprit behind smoking addiction, and e-cigarettes may become a new pathway toward nicotine addiction. Hence, their effectiveness in smoking cessation is still debatable, and their role as a tool for smoking cessation needs further research.
Thymoma: a fatal case report of recurring pneumonia from Tanzania
Authors: Sadiq Abid M. , Mukamuri Ruvimbo R. , Kamabu Eugenie M. , Kimondo Faustini C. , Sadiq Adnan M. , Nkya Gilbert Z.
Published: April 2023

Introduction and importance:

Thymomas present either concurrently with myasthenia gravis, with local pressure symptoms, or asymptomatically as a mediastinal mass. Due to its variable presentation, the incidence is low, as not all cases would be identified. Thymomas can present with a rare entity of combined T-cell and B-cell immunodeficiency in adults. Thymectomy is the most important prognostic factor, including preventing autoimmune manifestations of thymoma, but immunodeficiency may persist after thymectomy.

Case presentation:

The authors report a case of thymoma with evidence of immunodeficiency, manifesting as recurrent pneumonia and respiratory distress in an HIV-seronegative 62-year-old man with a suspected diagnosis 3 years before admission. During his bouts of pneumonia, blood cultures revealed methicillin-resistant Staphylococcus aureus, which was initially treated with vancomycin and then with clindamycin. Although hypogammaglobulinemia was not established in our low-resource setting, there was a reduced CD4-cell count with an abnormal CD4/CD8 ratio. The patient responded well to the first course of antibiotics. However, the second attempt was unsuccessful, which led to his demise.

Conclusion:

Clinicians should be aware that thymoma can cause immunodeficiency. Clinical suspicion should be raised in patients who present with recurrent infections, particularly in thymoma cases with adult-onset immunodeficiency.
Endometriosis of the umbilicus in a 36-year-old woman: a case report and literature review
Authors: Yahaya James J. , Morgan Emmanuel D. , Abraham Zephania S.
Published: April 2023

Introduction and importance:

Extrapelvic endometriosis is quite rare, with a reported prevalence ranging between 0.5 and 1%, and the condition is more likely to pose diagnostic challenges. This condition is more likely to pose clinical diagnostic challenges as it may mimic metastasis such as Sister Mary Joseph’s nodule.

Case presentation:

Herein is reported the case of a 36-year-old woman who presented with a hard nodular dark-bluish umbilicus mass that had a tendency to increase in size and was accompanied by severe pain during menstruation for ∼2 years is reported. Laparotomy revealed a normal uterus without involvement of any other pelvic organ by the endometrial tissue except the umbilicus part. Histological evaluation revealed endometriosis of the umbilicus.

Clinical discussion:

By far, primary endometriosis of the umbilicus is extremely rare, and most of the time, extrapelvic endometriosis involving the umbilicus would be secondary to surgical procedures involving the abdominal cavity as it was for the presented patient. Although endometriosis is rare, it should always be considered among women of reproductive age presenting with cyclic pains.

Conclusions:

Meticulous investigation of patients suspected to have umbilical endometriosis helps to confirm the diagnosis and hence expedites proper management of the patients; this also prevents chances of malignant transformation of the condition despite such possibilities being extremely rare.
An unprecedented occurrence of incidental tonsillar ectopic primary Papillary Thyroid Carcinoma in an adult female: A case report
Authors: Abdul Khalek Gheed , Al Laham Omar , Abazid Eias , Asaad Wisam , Almaydaani Mohamad , Ahmad Mohamad
Published: April 2023

Introduction and Importance:

Any defect in the early phases of the normal complex embryogenic pathway might lead to anatomical anomalies that lead to the formation of ectopic thyroid gland tissue. Overall, ectopic thyroid tissue incidence is one in 300 000, and the rate of malignant transformation among those is merely 1%. However, documented cases of malignant transformation of ectopic thyroid tissue in the tonsils have not yet been – to the best of the knowledge – documented in published literature.

Case Presentation:

We illustrate the case of a 58-year-old female who was referred to the clinic after she underwent a tonsillectomy due to chronic discomfort and gradual difficulty in swallowing. Documentation of an ectopic primary Papillary Thyroid Carcinoma in one of the patient’s excised tonsils was achieved after thorough histopathological and immunohistochemical analyses took place. Radiological evaluation excluded any metastatic involvement and paved the path toward surgical intervention, which was comprised of a total thyroidectomy.

Clinical Discussion:

Surgical resection of the patient’s thyroid gland was achieved, and the subsequent histopathological analysis of the specimens revealed nodular hyperplasia with degenerative changes but without evidence of malignant transformation in her thyroid gland.

Conclusion:

Ectopic primary Papillary Thyroid Carcinoma is an immensely rare occurrence, regardless of population parameters. Its incidence could originate in various anatomical locations, but to the best of the knowledge, its incidence in the tonsils has not been previously documented in published literature. Adequate levels of clinical awareness in this situation could timely alleviate patient complaints and aid in performing optimal life-saving interventions.
A rare case of intramuscular hemangioma of splenius capitis: a case report
Authors: Maharjan Suman , Hona Anil , Karki Sabin
Published: April 2023

Introduction and Importance:

Intramuscular hemangiomas are benign lesion that rarely occurs within the skeletal muscle of the head and neck regions. These lesions present with nonspecific symptoms resulting in only a few instances of accurate preoperative diagnosis.

Case Presentation:

A 20-year-old male presented with swelling over the nape of the neck on the right side. On clinical examination, the solitary swelling was 4×4 cm on measurement, soft on consistency with regular margin, fluctuant, with no skin changes over the swelling, nontender, no restriction in range of motion of the neck, and no pulsation felt.

Clinical Findings and Investigations:

Ultrasonography and contrast-enhanced MRI revealed intramuscular hemangioma involving the right splenius capitis muscle with no extension to adjacent muscles and minimal extension to the subcutaneous tissue.

Interventions and Outcome:

Excision of the lesion along with splenius capitis was performed with stable postoperative hemodynamics.

Conclusion:

Since intramuscular hemangiomas pose a challenge in preoperative diagnosis, it requires the sensible use of imaging modalities. Although several treatment modalities have surfaced, intramuscular hemangiomas require definitive operative management to reduce their recurrence.
Management of appendicitis: appendicectomy, antibiotic therapy, or both?
Authors: Weledji Elroy P. , Zisuh Anutebeh V. , Ngounou Eleanore
Published: April 2023

Introduction:

Appendicitis is a global disease with an incidence of 7–12% in the population of the USA and Europe but is low and rising in the developing world. It is the most common acute general surgical emergency, but as no investigation is accurate, the diagnosis has to rely on clinical symptoms and signs and, thus, frequently misdiagnosed. The aim of the study was to debate the arguments for managing appendicitis (operative, nonoperative, or both).

Patients and methods:

Electronic searches of the MEDLINE (PubMed) database, Cochrane Library, and Science Citation Index were performed to identify original published studies on appendicitis and the pre-COVID-19 (coronavirus disease 2019) and post-COVID-19 management. Relevant articles were searched from relevant chapters in specialized texts, and all have been included.

Discussion:

There are indications for operative (surgery), nonoperative (antibiotics), or both in the management of acute appendicitis. Although laparoscopic appendicectomy is becoming the gold standard of treatment, knowledge of the pros and cons of this approach versus the open approach is important. The controversy in the management of the appendix mass/abscess between an expedient appendicectomy or a combination of conservative management (antibiotics) and interval appendicectomy remains.

Conclusion:

Laparoscopic appendicectomy is becoming the gold standard for the treatment of appendicitis. However, the advantages of the innovations in minimally invasive and endoscopic surgery are unlikely to render formal open appendicectomy obsolete. Nonoperative management with antibiotics may suffice in selected cases with uncomplicated appendicitis. It is imperative that patients are counseled appropriately if primary antibiotic treatment is to be routinely offered as first-line therapy.
Neglected bilateral geno valgum deformity managed with a dynamic compression plate and the ilizarov construct: a case report
Authors: Ibrahim Yasin B. , Mohamed Abdullahi Y. , Ibrahim Hassan S. , Cicek Engin I. , Mohamed Abdulkhalek H. , MAY Hasan
Published: April 2023

Introduction:

Deformities of the lower limb are common in childhood; however, they are mainly variations of the natural growth pattern. The rare case showed up late with a genu valgum deformity centered on both tibias and a closed physis.

Case presentation:

A 20-year-old male has suffered from bilateral knee pain and genu valgum deformity centered at both tibias with a closed physis. Management was challenging, requiring multiple surgeries and high patient cooperation. The patient underwent two surgeries: a right-sided osteotomy and Ilizarov fixation with gradual deformity correction. In the second operation, a proximal tibia osteotomy of the left side was executed with acute correction of the deformity and open reduction and internal fixation of the tibia with a medial tibial dynamic compression plate. Ultimately, the authors successfully corrected both leg deformities.

Conclusion:

This results reflect the efficacy of dynamic compression plates and Ilizarov for correcting genu valgum deformity in patients with closed epiphyseal plates.
The sCD14-ST predictive value in the development of adverse outcomes in operated colorectal cancer patients (diagnostic study)
Authors: Turgunov Yermek , Ogizbayeva Alina , Avdiyenko Olga , Mugazov Miras , Shakeyev Kayrat , Komarov Timofey , Asamidanova Sofiko
Published: April 2023

Background:

The main aim was to analyze dynamic changes in the level of soluble CD14 subtype (sCD14-ST) in blood serum and assess it as a possible risk factor for the development of systemic inflammatory response syndrome, infectious and inflammatory complications, organ dysfunction, and mortality in operated colorectal cancer (CRC) patients.

Materials and methods:

For the period 2020–2021, 90 operated CRC patients were examined. Patients were divided into two groups: 1 – 50 patients operated on for CRC without acute bowel obstruction (ABO); 2 – 40 patients operated on for tumor ABO caused by CRC. To determine sCD14-ST by the ELISA (enzyme-linked immunosorbent assay) method, venous blood was taken 1 h before surgery and 72 h after it (third day).

Results:

sCD14-ST levels were higher in CRC patients with ABO, organ dysfunction, and dead patients. If the sCD14-ST level on the third day after surgery is greater than 520 pg/ml, the risk of a fatal outcome is 12.3 times higher than at its lower level [odds ratio (OR): 12.3, 95% CI: 2.34–64.20]. With the increase in the sCD14-ST level on the third day after surgery from baseline or its decrease by no more than 8.8 pg/ml, the risk of organ dysfunctions is 6.5 times higher than with its greater decline (OR: 6.5, 95% CI: 1.66–25.83).

Conclusions:

This study has demonstrated that in CRC patients, sCD14-ST can be used as a predictive criterion for the development of organ dysfunction and death. Significantly worse results and prognosis were observed in the patients with higher levels of sCD14-ST on the third day after surgery.