bluuebunny/crossref_metadata_2025 huggingface dataset:
Digitalizing experiential celebrations in the early modern civic space: A methodological investigation of augmented reality as an interpretative tool
Authors: Guidicini Giovanna
Published: May 2021

This article investigates the methodological suitability of Virtual and Augmented Reality (VR and AR) to the recreation of early modern civic spectacles. These are presented as instances of controlled engagement of a (royal) user with a civic space temporarily ‘augmented’ by the engaging superimposition of structures, performances, and haptic experiences – hence fulfilling Ronald Azuma’s definition of AR. The writings of theorists of space and Cross Reality innovators provide the basis for a comparative discussion of practical applications of VR and AR in history-related fields (archaeology, history, education, and gaming and entertainment). For their methodological similarities to civic festivals in addressing the complexity of human experiences in augmented spaces, AR-based virtual reconstructions are demonstrated to be cognate and ductile investigative tools.
The Dark Energy Survey supernova programme: modelling selection efficiency and observed core-collapse supernova contamination
Authors: Vincenzi M , Sullivan M , Graur O , Brout D , Davis T M , Frohmaier C , Galbany L , Gutiérrez C P , Hinton S R , Hounsell R , Kelsey L , Kessler R , Kovacs E , Kuhlmann S , Lasker J , Lidman C , Möller A , Nichol R C , Sako M , Scolnic D , Smith M , Swann E , Wiseman P , Asorey J , Lewis G F , Sharp R , Tucker B E , Aguena M , Allam S , Avila S , Bertin E , Brooks D , Burke D L , Carnero Rosell A , Carrasco Kind M , Carretero J , Castander F J , Choi A , Costanzi M , da Costa L N , Pereira M E S , De Vicente J , Desai S , Diehl H T , Doel P , Everett S , Ferrero I , Fosalba P , Frieman J , García-Bellido J , Gaztanaga E , Gerdes D W , Gruen D , Gruendl R A , Gutierrez G , Hollowood D L , Honscheid K , Hoyle B , James D J , Kuehn K , Kuropatkin N , Maia M A G , Martini P , Menanteau F , Miquel R , Morgan R , Palmese A , Paz-Chinchón F , Plazas A A , Romer A K , Sanchez E , Scarpine V , Serrano S , Sevilla-Noarbe I , Soares-Santos M , Suchyta E , Tarle G , Thomas D , To C , Varga T N , Walker A R , Wilkinson R D , (DES Collaboration)
Published: May 2021

The analysis of current and future cosmological surveys of Type Ia supernovae (SNe Ia) at high redshift depends on the accurate photometric classification of the SN events detected. Generating realistic simulations of photometric SN surveys constitutes an essential step for training and testing photometric classification algorithms, and for correcting biases introduced by selection effects and contamination arising from core-collapse SNe in the photometric SN Ia samples. We use published SN time-series spectrophotometric templates, rates, luminosity functions, and empirical relationships between SNe and their host galaxies to construct a framework for simulating photometric SN surveys. We present this framework in the context of the Dark Energy Survey (DES) 5-yr photometric SN sample, comparing our simulations of DES with the observed DES transient populations. We demonstrate excellent agreement in many distributions, including Hubble residuals, between our simulations and data. We estimate the core collapse fraction expected in the DES SN sample after selection requirements are applied and before photometric classification. After testing different modelling choices and astrophysical assumptions underlying our simulation, we find that the predicted contamination varies from 7.2 to 11.7 per cent, with an average of 8.8 per cent and an r.m.s. of 1.1 per cent. Our simulations are the first to reproduce the observed photometric SN and host galaxy properties in high-redshift surveys without fine-tuning the input parameters. The simulation methods presented here will be a critical component of the cosmology analysis of the DES photometric SN Ia sample: correcting for biases arising from contamination, and evaluating the associated systematic uncertainty.
Constraints on variation in the speed of light based on gravitational constant constraints
Authors: Eaves R E
Published: May 2021

We consider the possibility of a varying speed of light based on a unit of length defined with a rigid rod or atomic standard. The reference for comparison is the international standard for the meter based on the transit of light, defined so that c is constant. If these two units do not correspond over time, then the gravitational constant G as measured with each will not be in agreement. We relate changes in the speed of light in atomic units of length to changes in G measured in the two systems. Reported experimental data that constrain yearly changes in G are sufficient to bound changes in c. Experimental constraints on $|\dot{G}/G|$ based on spacecraft microwave ranging and on helioseismology indicate that presently $|{\dot{c}/c}|\le .55 \times 10^{-12}\, \textrm {yr}^{-1}$. If this result is extended in epoch by relating c to a power of the scale factor, an, then variation in c is constrained by |n| < .0080. The approach is distinct from other efforts to constrain $\dot{c}$ in being based on data from within the Solar system instead of cosmological observations. A relationship between c and the fine-structure constant is identified that potentially provides tighter constraints.
Helium enrichment during classical nova outbursts
Authors: Guo Yunlang , Wu Chengyuan , Wang Bo
Published: May 2021

Nova outbursts play an important role in the chemical evolution of Galaxy, especially they are the main source of synthetic $^{13}\rm C$, $^{15}\rm N$, $^{17}\rm O$, and some radioactive isotopes like $^{22}\rm Na$ and $^{26}\rm Al$. The enrichment of He in nova ejecta indicates that the accreted material may mix with the He-shell (He-mixing). The purpose of this work is to investigate how the He-mixing affects the nova outbursts in a systematic way. We evolved a series of accreting WD models, and found that the mass fraction of H and He in nova ejecta can be influenced by different He-mixing fractions significantly. We also found that both the nova cycle duration and ejected mass increase with the He-mixing fractions. Meanwhile, the nuclear energy generation rate of p–p chains decreases with the He-mixing fraction during the nova outbursts, whereas the CNO-cycle increases. This work can reproduce the chemical abundances in the ejecta of some representative novae, such as GQ Mus, ASASSN-18fv, HR Del, T Aur, and V443 Sct. This implies that the He-mixing process cannot be neglected when studying nova outbursts. This study also develops a He-mixing meter (i.e. $\rm He/H$) that can be used to estimate the He-mixing fraction in classical nova systems.
$t \to 0$
extrapolation function in the small flow time expansion method for the energy–momentum tensor
Authors: Suzuki Hiroshi , Takaura Hiromasa
Published: May 2021

We theoretically clarify the functional form to be used in $t \to 0$ extrapolation in the small flow time expansion method for the energy–momentum tensor (EMT), which facilitates lattice simulation of the EMT based on the gradient flow. We argue that in the $t \to 0$ extrapolation analysis, lattice data should be fitted by a power function in $g(\mu(t))$, the flow time dependent running coupling, where the power is determined by the perturbation order we consider. From actual lattice data, we confirm the validity of the extrapolation function. Using the new extrapolation function, we present updated lattice results for thermodynamics quantities in quenched QCD; our results are consistent with the previous study [T. Iritani et al., Prog. Theor. Exp. Phys. 2019, 023B02 (2019)] but we obtain smaller errors due to the reduction of systematic errors.
The role of religiosity in COVID-19 vaccine hesitancy
Authors: Garcia Louiegi L , Yap John Federick C
Published: May 2021

With the surge of COVID-19 cases worldwide, it is essential that vaccination be prioritized to facilitate herd immunity. However, there is vaccine hesitancy reflected in religiosity. This correspondence aims to understand religiosity as a factor that plays a role in vaccination hesitancy. Medical and scientifically sound evidence is influenced by religious beliefs resulting in varied responses toward getting vaccinated such as vaccination hesitancy.
Darwin’s ‘struggle for life’, suffering and incompetence recognition: a philoscientific perspective on COVID-19 crisis
Authors: Pacaol Niñoval F
Published: May 2021

Many of the academic papers that discussed the COVID-19 pandemic sought to present a reasonable analysis of the crisis and its underlying implications in government policies (for social and environmental reformations) and individual actions either in the present context or future. This paper attempted to contextualize the COVID-19 crisis through the lens of the Darwinian struggle for life and the philosophical notion of suffering while stressing the importance of defects admission. Generally, the author argues that these concepts are the primary roots of other dimensions of COVID-19-related studies.
The investigation of foot structure within children who have attention-deficit hyperactivity disorder: a case-controlled study
Authors: Kaya Mutlu Ebru , Birinci Tansu , Kaya Aytutuldu Guzin , Mutlu Caner , Razak Ozdincler Arzu
Published: May 2021

The impairments in motor performance could be related to the foot structure in children with attention-deficit/hyperactivity disorder (ADHD) while considering the close relationship between foot structure and lower extremity alignment. This study aimed to investigate the foot structure and its relationships between disease severity, physical activity and psychiatric traits in children with ADHD. Children with ADHD (n = 50; mean age: 12.02 ± 1.83 years) and typically developing peers (n = 30; mean age: 12.86 ± 2.56 years) were included. The static footprint analysis was collected by using digital images. The ImageJ program was used to calculate Clarke’s angle, Staheli arch index (SAI) and Chippaux–Smirak index (CSI). The Turgay DSM-IV disruptive behavior disorders rating scale (T-DSM-IV-S), physical activity questionnaire for older children (PQ-C), children’s depression inventory and state-trait anxiety inventory for children were all used to assess symptoms of ADHD, physical activity, depression, stress and anxiety, respectively. Approximately 52–53% of children with ADHD had mild to severe flatfoot, while only 8–13% of typically developing peers had flatfoot based on SAI and CSI (P = 0.01). Significant correlation was found between Clarke’s angle and PQ-C (r = 0.21, P = 0.04). Besides, T-DSM-IV-S was significantly correlated with SAI (r = 0.24, P = 0.01) and CSI (r = 0.25, P = 0.01) in children with ADHD. Children with ADHD had a significantly greater tendency of flatfoot compared to typically developing peers. Besides, the deterioration of the foot structure of children with ADHD was associated with disease severity.
Does the size of Thurston–Holland fragment have an effect on premature physeal closure occurrence in type 2 distal tibia epiphyseal fractures?
Authors: Turgut Ali , Kumbaraci Mert , Arli Hakan , Çiçek Ali Osman , Sariekiz Emre , Kalenderer Önder
Published: May 2021

The purpose of this study was to investigate the possible effect of Thurston–Holland fragment (THF) size on the development of premature physeal closure (PPC) in distal tibia type 2 epiphyseal injuries. Fifty-eight fractures in 57 patients with a minimum follow-up period of 12 months were included. For statistical analysis, sex and age of the patient, number of reduction attempts, percentage of THF base relative to physis length on anteroposterior or lateral radiograph, maximal initial and postreduction displacement amount, presence of accompanying fibula fracture and trauma mechanism were evaluated. PPC was observed in 12 fractures (20.7%). An increased amount of initial displacement, increased number of reduction attempts and passing the physis with three Kirschner wires were determined as statistically significant factors for PPC occurrence (P = 0.011, 0.011 and 0.005, respectively). The THF percentage was not found to be an important factor for the occurrence of PPC. In males, THF size was less than 50% more frequently than that in females (P = 0.013). THF size had no significant effect on PPC occurrence after distal tibial epiphyseal fractures.
Gait profile score and gait variable scores in spina bifida
Authors: Fusagawa Hiroyori , Fujita Hiroki , Matsuyama Toshikatsu , Himuro Nobuaki , Teramoto Atsushi , Yamashita Toshihiko , Selber Paulo
Published: May 2021

Quantitative data assessment on the basis of three-dimensional gait analysis has been routinely used in the evaluation of pathological gait of children with cerebral palsy. However, a similar quantitative methodology has not been applied for spina bifida patients in whom atypical gait patterns are thought to correlate with various levels of neurological paralysis. The purpose of this study is to investigate the differences among gait patterns in spina bifida between different levels of neurological lesions using quantitative methods: Gait profile score (GPS) and gait variable scores (GVS), scoring subject’s gait deviation from a reference. In this cross-sectional study, 22 children with spina bifida (11 women, 11 men; mean age 9.4 years, SD 3.8 years, range 3–17 years), were examined using three-dimensional gait analysis from 2008 to 2018. Physical examination allowed for classification of each of the 44 limbs as either L4, L5 or S1 and comparison with the GPS and GVS using a linear mixed model. GPS and the GVS of the pelvis and hip range of motion in the coronal plane were significantly higher in the L4 group than in the L5 and S1 groups (GPS, P = 0.041, P = 0.003, respectively; GVS of pelvis, P = 0.001, P = 0.001; GVS of hip, P < 0.001, P < 0.001) GVS (foot progression angle) was significantly lower in the S1 group than in L4 and L5 groups (P < 0.001, P = 0.037). We found that GPS and GVS enable us to quantitatively assess the differences among gait patterns between different neurological levels. The scoring tool showed the potential for detecting individual neurological changes.
Parkinson Disease, Dysphagia, and Cervical Spine Surgery
Authors: Avila Mauricio J. , Aguilar-Salinas Pedro , Burket Aaron R. , Dumont Travis M.
Published: May 2021

Study Design:

An analysis of a National Database.

Objective:

The objective of this study was to evaluate the rate of dysphagia for Parkinson disease (PD) patients undergoing cervical spine surgery for cervical myelopathy.

Summary of Background Data:

Cervical spondylotic myelopathy (CSM) is an increasingly common problem in the aging population. Several surgical options exist to treat this condition including anterior, posterior and combined surgical approaches. Each approach carries its own set of postoperative complications. Little is known of the of outcomes after cervical spine surgery in PD.

Materials and Methods:

The National Inpatient sample was queried 1998 to 2016, all elective admissions with CSM were identified. Surgical treatments were identified as either: anterior cervical discectomy and fusion (ACDF), posterior laminectomies, posterior cervical fusion or combined anterior/posterior surgery. Preexisting PD was identified. Endpoints included mortality, length of stay (LOS), swallowing dysfunction measured by placement of feeding tube (NGT), and postprocedure pneumonia.

Results:

A total of 73,088 patients underwent surgical procedures for CSM during the study period. Of those, 552 patients (7.5%) had concomitant PD. The most common procedure was ACDF. Patients with PD had a higher rate of dysphagia (NGT placement) after surgery compared with those without PD (P<0.001). Multiple regression analysis showed that PD patients had a higher risk of having NGT placement or developing pneumonia [odds ratio 2.98 (1.7-5.2), P<0.001] after surgery.

Patients with PD who underwent ACDF, posterior laminectomies or posterior cervical fusion had a longer LOS compared with those who did not have PD (P<0.001). There was no difference in LOS for patients who underwent combined anterior/posterior surgery. Inpatient mortality was higher in patients with PD who underwent ACDF or combined surgery (P<0.001).

Conclusions:

While ACDF is the most commonly performed procedure for CSM in patients with PD, it is associated with longer LOS, higher incidence of postoperative dysphagia, and postprocedural pneumonia, as well as higher inpatient mortality compared with posterior cervical procedures.

Level of Evidence:

Level III.
Propofol, Ketamine, and Etomidate as Induction Agents for Intubation and Outcomes in Critically Ill Patients: A Retrospective Cohort Study
Authors: Wan Chun , Hanson Andrew C. , Schulte Phillip J. , Dong Yue , Bauer Philippe R.
Published: May 2021

IMPORTANCE:

Propofol, ketamine, and etomidate are common anesthetic agents for induction of anesthesia in the ICU. The choice between these agents is complex and may not depend solely upon severity of illness.

OBJECTIVES:

To evaluate the association between the administration of propofol, ketamine, and etomidate and ICU, hospital mortality, and length of stay.

DESIGN, SETTING, AND PARTICIPANTS:

Retrospective single-center cohort study. ICUs in a tertiary medical center, between January 01, 2012, and December 31, 2017. Critically ill adult patients given a single IV anesthetic for intubation.

MAIN OUTCOME AND MEASURES:

Primary outcomes were ICU and hospital mortality. Secondary outcomes were ICU- and hospital-free days through 28 days. An inverse probability of treatment weighed approach was used. The propensity score was estimated using a generalized logit model as a function of patient characteristics, admission source, ICU type, readmission status, length of ICU stays prior to intubation, and acute physiology score. Mortality outcomes were assessed with weighted logistic regression and -free days assessed by weighted linear regression with Bonferroni correction for pairwise comparisons.

RESULTS:

Of 2,673 patients, 36% received propofol, 30% ketamine and 34% etomidate. Overall ICU and hospital mortality were 19% and 29%, respectively. Patients given ketamine had higher odds of ICU mortality (1.45; [95% CI, 1.07–1.94]; p = 0.015) and patients given etomidate had higher odds of ICU mortality (1.87; 1.40–2.49; p < 0.001), hospital mortality (1.43; 1.09–1.86; p = 0.009), and less ICU-free days (–2.10; –3.21 to –1.00; p < 0.001) than those given propofol. Patients given ketamine and etomidate had similar odds of hospital mortality (1.06; 0.80–1.42; p = 0.761) and similar hospital-free days (0.30; –0.81 to 1.40; p = 0.600).

CONCLUSIONS AND RELEVANCE:

Compared with ketamine and etomidate, propofol was associated with better outcome in critically ill patients undergoing anesthesia for intubation. Even after adjusting for severity of illness prior to intubation, residual confounders cannot be excluded.
Building a Handoff Communication Virtual Experience for Nursing Students Using Virtual Humans
Authors: Stuart Jacob , Aul Karen , Bumbach Michael D. , Stephen Anita , Lok Benjamin
Published: May 2021

Effective communication among healthcare professionals is critical to delivering safe, high-quality patient care. One important real-world skill that nursing students must acquire is generating accurate handoff communication reports. The central aim of this study was to build, assess, and revise a virtual experience simulation that allows nursing students to observe a standardized clinical situation in an immersive environment and then practice the situation-background-assessment-recommendation communication method. This between-groups experimental study, which was modified in light of COVID-19 concerns, evaluated how well 69 prelicensure nursing students understood a handoff communication report after viewing a virtual human patient and nurse interact during a triage assessment scenario. Results indicate student comprehension levels did not differ based on which of two metacognitive learning strategies was used. Participants in both study groups were able to accurately complete a situation-background-assessment-recommendation instrument based on the virtual experience. Further, they believed that watching a virtual nurse perform a triage assessment would help them perform one themselves in a similar virtual environment. There was also an unexpected study finding related to patient safety within the context of the simulation. This finding warrants further research that will lead to revision of the virtual experience used to train future nurses.
Association Between Symptoms of Patients With Heart Failure and Patient Outcomes Based on Electronic Nursing Records
Authors: Baik Seung Yeon , Ryu Gi Wook , Lee Hyangkyu , Lee Siwook , Choi Mona
Published: May 2021

We examined the association between symptoms (ie, dyspnea and pain) and patient outcomes (ie, length of stay, 30-day readmission, and death in hospital) among patients with heart failure using EMRs. This was a descriptive study that was conducted from July 1, 2014, to November 30, 2017. Participants were 754 hospitalized patients with heart failure (mean age, 70.62 ± 14.78 years; male-to-female ratio, 1:1.1). Data were analyzed using descriptive statistics, χ
2 tests, and logistic regression analyses. Patients' average length of stay was 8.92 ± 13.12 days. Thirty-two patients (4.2%) were readmitted, and 100 patients (13.3%) died during hospitalization. Two-thirds (67.7%) experienced dyspnea, and 367 (48.7%) experienced pain. Symptoms and ICU admission were significantly related to patient outcomes. In the regression analyses, dyspnea, pain, and ICU admission were significantly related to higher-than-average lengths of stay. Dyspnea and ICU admission were related to death in hospital. Information regarding patients' symptoms, which was extracted from records, was a valuable resource in examining the relationship between symptoms and patient outcomes. The use of EMRs may be more advantageous than self-reported surveys when examining patients' symptom and utilizing big data.
Clinical Impact of Oral Intake in Second-line or Third-line Chemotherapy for 589 Patients With Advanced Gastric Cancer
Authors: Ogata Takatsugu , Narita Yukiya , Kumanishi Ryosuke , Nakazawa Taiko , Matsubara Yuki , Kato Kyoko , Nozawa Kazuki , Honda Kazunori , Masuishi Toshiki , Bando Hideaki , Kadowaki Shigenori , Ando Masashi , Tajika Masahiro , Muro Kei
Published: May 2021

Objectives:

Insufficient oral intake in advanced gastric cancer (AGC) limits the use of several drugs. We aimed to determine the oral intake status of patients with AGC during later-line chemotherapy.

Materials and Methods:

We retrospectively evaluated data of patients with AGC who experienced disease progression during first-line chemotherapy administered from January 2012 to December 2018 in a single institution. We defined “insufficient oral intake” as requiring daily intravenous fluids or hyperalimentation. Multivariate logistic regression was performed to identify oral intake-related factors.

Results:

Among 589 included patients, at disease progression during first-line, second-line, and third-line chemotherapy, 78.3% (461), 53.3% (314), and 30.4% (179) of patients, respectively, exhibited sufficient oral intake. Fourth-line chemotherapy was initiated for 22.2% (131) of patients, with 20.0% (118) exhibiting sufficient oral intake. During second-line and third-line chemotherapy, 11/67 (16%) and 2/39 (5%) patients, respectively, exhibited improvements in oral intake; 85/428 (19.9%) and 70/259 (27.0%), respectively, exhibited deteriorations in oral intake. Factors correlated to deterioration in oral intake during second-line chemotherapy were poor Eastern Cooperative Oncology Group Performance Status (odds ratio, 4.32; P<0.001), moderate or severe ascites (1.96; P=0.045), peritoneal metastasis (2.12; P=0.029), prior palliative surgery (3.41; P=0.003), and high neutrophil-to-lymphocyte ratio (3.09; P<0.001); those correlated to deterioration in oral intake during third-line chemotherapy were poorly differentiated pathology (2.52; P=0.025) and high neutrophil-to-lymphocyte ratio (2.65; P=0.006).

Conclusion:

As later-line chemotherapy is ineffective in improving oral intake in patients with AGC, careful adaptation of regimens is required for patients at risk for impaired oral intake.
Condensed Outpatient Rehabilitation Early After Lung Transplantation: A Retrospective Analysis of 6-Minute Walk Distance and Its Predictors
Authors: Byrd Rebecca , Smith Patrick J. , McHugh Hannah F. , Snyder Laurie D. , Pastva Amy M.
Published: May 2021

Purpose:

The objectives were to evaluate the effect of a condensed post-lung transplant outpatient rehabilitation program started immediately after hospital discharge on 6-minute walk distance (6MWD) and to explore predictors of change in 6MWD and time to complete rehabilitation.

Methods:

Data were retrospectively collected from July 2009 to February 2019 on recipients who completed physical therapy-based posttransplant outpatient rehabilitation (PTOR). Changes in 6MWD prerehabilitation to postrehabilitation were assessed using repeated measures, and predictors were assessed using multiple linear regression.

Results:

Participants (N = 819, 61% men, 61 years) began PTOR 2 days (interquartile range [IQR] 1–3) after hospital discharge. The mean 6MWD of 324 m (SD = 107) improved after rehabilitation to 488 m (SD = 105). Factors associated with improvement were younger age (P = .003), higher baseline forced expiratory volume in 1 second (FEV1) (P < .001), and lower baseline 6MWD (P < .001). Participants averaged 22 sessions in 41 days (IQR 35–50); with lower baseline FEV1 (P = .002) and 6MWD (P < .001) associated with longer completion time.

Conclusions:

A condensed outpatient rehabilitation program early after lung transplantation was associated with a large, clinically meaningful improvement in 6MWD. Salient predictors of improvement included age, lung function, and starting 6MWD. These findings from a large cohort of lung transplant recipients who participated in PTOR can assist clinicians in tailoring strategies to optimize patient management.
Surgical Intervention for Paronychia Induced by Targeted Anticancer Therapies
Authors: Hanania Hannah L. , Pacha Omar , Heberton Meghan , Patel Anisha B.
Published: May 2021

BACKGROUND

Paronychia is a common toxicity associated with targeted anticancer therapies. Antibiotics and steroids are the standard treatments for severe paronychia, yet they are often inadequate, prolonging the patient's suffering and resulting in changes to effective cancer therapy.

OBJECTIVE

This article describes the clinical course of drug-induced paronychia and attempts to identify circumstances under which nail surgery may be beneficial.

MATERIALS AND METHODS

This is a retrospective case series from a single institution's electronic medical record for patients on paronychia-inducing anticancer therapies with nail disease visit diagnosis codes.

RESULTS

The authors identified 36 nail procedures performed on 12 patients, all of whom were managed with conservative steroid and antibiotic therapy with varying degrees of improvement; however, no further improvement was seen after 90 days. Partial matricectomy, nail avulsion, debridement/clipping, and incision and drainage were performed with resolution rates of 100% (11/11), 38.5% (5/13), 12.5% (1/8), and 0% (0/4), respectively. The average time to surgical intervention was 196 days, and the average time to resolution was 268 days.

CONCLUSION

This series highlights the prolonged course of severe drug-induced paronychia and the importance of surgical intervention to reduce pain and impact on cancer treatment. Partial matricectomy should be considered for paronychia unresponsive to conservative therapy by 3 months.
5-HT7 Receptor Restrains 5-HT–induced 5-HT2A Mediated Contraction in the Isolated Abdominal Vena Cava
Authors: Gonzalez-Pons Romina , McRae Kiera , Thompson Janice M. , Watts Stephanie W.
Published: May 2021

Although discovered as a vasoconstrictor, 5-hydroxytryptamine (5-HT, serotonin) infused into man and rodent reduces blood pressure. This occurs primarily through activation of 5-HT7 receptors and, at least in part, venodilation. Vascular mechanisms by which this could occur include direct receptor activation leading to vasodilation and/or suppression of contractile 5-HT receptor activation. This study tests the hypothesis that the 5-HT7 receptor restrains activation of the 5-HT2A receptor. A subhypothesis is whether agonist-induced activation—independent of constitutive activity—of the 5-HT7 receptor is necessary for this restraint. The isolated abdominal aorta and vena cava from the normal male Sprague–Dawley rat was our model. Studies used real-time PCR and a pharmacological approach in the isolated tissue bath for measurement of isometric tone. Although 5-HT2A receptor mRNA expression in both aorta and vena cava was significantly larger than that of the 5-HT7 receptor mRNA, the 5-HT7/5-HT2A receptor mRNA ratio was greater in the vena cava (0.30) than in the aorta (0.067). 5-HT7 receptor antagonism by SB266970 and DR 4458 increased maximum contraction to 5-HT in the isolated vein by over 50% versus control. The 5-HT2A receptor agonists TCB-2 and NBOH were more potent in the aorta compared with 5-HT but less efficacious, serving as partial agonists. By contrast, these same three agonists caused no contraction in the vena cava isolated from the same rats up to 10 μM agonist. Antagonism of the 5-HT7 receptor by SB269970 did not increase either the potency or efficacy of TCB-2 or NBOH. These data support that the 5-HT7 receptor itself needs to be stimulated to reduce contraction and suggest there is little constitutive activity of the 5-HT7 receptor in the isolate abdominal vena cava.
AAPS Podium Presentations—Has the Level of Evidence Changed over the Past Decade?
Authors: Chattopadhyay Arhana , Wu Robin , Wan Derrick , Momeni Arash
Published: May 2021

Background:

An increase in the number and quality of randomized controlled trials (RCTs) and trends toward higher levels of evidence (LOE) in the plastic surgery literature has been reported; however, there has not been a specific focus on the LOE of presentations at scientific meetings. The purpose of this study was to ascertain trends in the LOE of studies presented at the annual meeting of the American Association of Plastic Surgeons.

Methods:

A hand search was conducted identifying all abstracts of podium presentations from 2009 to 2019. LOE, using American Society of Plastic Surgeons guidelines, were ascribed to each presentation, along with identification of any corresponding journal publications. RCTs were further analyzed using the 12-item Modified Consolidated Standard of Reporting Trials checklist.

Results:

Four hundred forty-one studies with a median LOE of 3 were included in the study. A non-significant improvement in the mean level of evidence was noted over time (P = 0.09) along with an increase in the number of level 2 studies (P = 0.589) and RCTs (P = 0.717). Level 1 studies were rare (0.91%) and of fair quality (median checklist score 8 out of 12). Seventy-two percent of abstracts resulted in publication, and the mean lag time to publication was 422 days.

Conclusions:

A favorable trend is observed with respect to the mean LOE as well as the number of level 2 studies and RCTs over time. The importance of research meeting attendance to maintain up-to-date information is noteworthy, given the long lag time from presentation to publication.
NIVOLUMAB-INDUCED HARADA-LIKE UVEITIS WITH BACILLARY DETACHMENT MIMICKING CHOROIDAL METASTASIS
Authors: Ng Caleb C. , Ng Joshua C. , Johnson Robert N. , McDonald H. Richard , Agarwal Anita
Published: May 2021

Purpose:

To describe a patient with metastatic clear cell renal cell carcinoma in remission on maintenance nivolumab therapy who developed late-onset ocular toxicity manifesting as creamy chorioretinal lesions with exudative retinal detachment concerning for choroidal metastasis.

Method:

Case report. Main outcome measures include ophthalmoscopic examination, fundus photography, fundus autofluorescence, fluorescein angiography, indocyanine green angiography, spectral domain optical coherence tomography, and B-scan ultrasonography.

Results:

A 49-year-old woman with a medical history of metastatic clear cell renal cell carcinoma in remission for two years after immunotherapy with four cycles of ipilimumab and nivolumab followed by maintenance nivolumab infusions developed lesions concerning for choroidal metastases in her right eye. Optical coherence tomography of the lesions revealed a bacillary layer detachment containing possible fibrinous exudate organized into layers and underlying choroidal thickening with chorioretinal folds. Later, choroidal thickening and chorioretinal folds also occurred in the left eye. Given that pan imaging detected no metastasis and the posterior segment abnormalities resolved after cessation of nivolumab and treatment with systemic corticosteroids, the patient was diagnosed with nivolumab-induced Vogt–Koyanagi–Harada-like uveitis.

Conclusion:

This case expands on the clinical spectrum of nivolumab-induced Vogt–Koyanagi–Harada-like uveitis, a condition that can also present with bacillary layer detachment mimicking an early choroidal metastasis, manifest asymmetrically in each eye, and develop after long-standing treatment.
The “Two-Flaps” Technique for Descemet Stripping Only
Authors: Cohen Eyal , Din Nizar , Mimouni Michael , Trinh Tanya , Gouvea Larissa , AlShaker Sara , Chan Clara C. , Slomovic Allan R.
Published: May 2021

Purpose:

The success of Descemet stripping only (DSO) is optimized by performing a well-centered, accurately sized diameter of descemetorhexis with a smooth curvilinear border. To achieve this success, we describe a repeatable and relatively straightforward technique to optimize this descemetorhexis for DSO.

Methods:

The “two-flaps” technique uses the Gorovoy DSO forceps. The technique takes advantage of the flat and smooth surface of the forceps to create the desired 4-mm Descemet stripping with minimal stromal trauma along with a continuous curvilinear descemetorhexis, minimizing the risk of postoperative stromal scarring and extension of the rhexis beyond 4 mm.

Results:

This technique has been used successfully in 11 cases performed by 1 surgeon or directly supervised by him. All cases achieved the desired 4-mm circumference without any residual tags or visually significant stromal scarring, with successful clearing of the central cornea and endothelial cells repopulating the central stripped area.

Conclusions:

This technique described provides a consistent, reproducible, and relatively trauma-free peeling of Descemet membrane and associated endothelial cells/guttae to optimize the success of DSO.
Long-Term Safety and Efficacy of Tacrolimus 0.1% in Severe Pediatric Vernal Keratoconjunctivitis
Authors: Caputo Roberto , Marziali Elisa , de Libero Cinzia , Di Grande Laura , Danti Gioia , Virgili Gianni , Villani Edoardo , Mori Francesca , Bacci Giacomo M. , Lucenteforte Ersilia , Pucci Neri
Published: May 2021

Purpose:

The aim of this study was to evaluate the safety and efficacy of tacrolimus 0.1% eye drops in a large population of pediatric patients affected by a severe form of vernal keratoconjunctivitis (VKC) who responded poorly to cyclosporine eye drops.

Methods:

This is a retrospective study based on standardized clinical charts and data collection of consecutive patients affected by severe VKC who responded poorly to cyclosporine eye drops topical treatment but treated with tacrolimus 0.1% eye drops with a follow-up of 18 months. Four clinical signs were graded for analysis: hyperemia, tarsal papillae, giant papillae, and limbal papillae. The blood tests for kidney and liver function and the tacrolimus level were studied. Visits were scheduled at baseline and at 3, 6, 12, and 18 months. Patients received tacrolimus 0.1% eye drops in both eyes 2 times daily.

Results:

Four hundred thirty-one patients were included. Three hundred twenty-five patients were affected by a seasonal form, whereas the remaining 106 by a perennial form. Statistical analysis on each single score showed a positive relevance (P < 0.001) from baseline to all other visits. No local or systemic complications were recorded.

Conclusions:

Tacrolimus has been proposed as a treatment for severe forms of VKC. This study has confirmed the safety and efficacy of tacrolimus 0.1% eye drops in a large pediatric population of patients affected by a severe form of VKC who responded poorly to cyclosporine eye drops.
Conditional knockout of CRMP2 in neurons, but not astrocytes, disrupts spinal nociceptive neurotransmission to control the initiation and maintenance of chronic neuropathic pain
Authors: Boinon Lisa , Yu Jie , Madura Cynthia L. , Chefdeville Aude , Feinstein Douglas L. , Moutal Aubin , Khanna Rajesh
Published: May 2021

Mechanistic studies principally focusing on primary afferent nociceptive neurons uncovered the upregulation of collapsin response mediator protein 2 (CRMP2)—a dual trafficking regulator of N-type voltage-gated calcium (Cav2.2) as well as Nav1.7 voltage-gated sodium channels—as a potential determinant of neuropathic pain. Whether CRMP2 contributes to aberrant excitatory synaptic transmission underlying neuropathic pain processing after peripheral nerve injury is unknown. Here, we interrogated CRMP2's role in synaptic transmission and in the initiation or maintenance of chronic pain. In rats, short-interfering RNA-mediated knockdown of CRMP2 in the spinal cord reduced the frequency and amplitude of spontaneous excitatory postsynaptic currents, but not spontaneous inhibitory postsynaptic currents, recorded from superficial dorsal horn neurons in acute spinal cord slices. No effect was observed on miniature excitatory postsynaptic currents and inhibitory postsynaptic currents. In a complementary targeted approach, conditional knockout of CRMP2 from mouse neurons using a calcium/calmodulin-dependent protein kinase II alpha promoter to drive Cre recombinase expression reduced the frequency and amplitude of spontaneous excitatory postsynaptic currents, but not miniature excitatory SCss. Conditional knockout of CRMP2 from mouse astrocytes using a glial fibrillary acidic protein promoter had no effect on synaptic transmission. Conditional knockout of CRMP2 in neurons reversed established mechanical allodynia induced by a spared nerve injury in both male and female mice. In addition, the development of spared nerve injury–induced allodynia was also prevented in these mice. Our data strongly suggest that CRMP2 is a key regulator of glutamatergic neurotransmission driving pain signaling and that it contributes to the transition of physiological pain into pathological pain.
Immersive interactive virtual walking reduces neuropathic pain in spinal cord injury: findings from a preliminary investigation of feasibility and clinical efficacy
Authors: Trost Zina , Anam Monima , Seward Joshua , Shum Corey , Rumble Deanna , Sturgeon John , Mark Victor , Chen Yuying , Mitchell Lucie , Cowan Rachel , Perera Robert , Richardson Elizabeth , Richards Scott , Gustin Sylvia
Published: May 2021

Chronic neuropathic pain (NP) is a common and often debilitating secondary condition for persons with spinal cord injury (SCI) and is minimally responsive to existing pharmacological and nonpharmacological treatments. The current preliminary investigation describes the feasibility and initial comparative efficacy of an interactive virtual reality walking intervention, which is a novel extension of visual feedback/illusory walking therapies shown to reduce SCI NP. Virtual reality walking intervention builds on previous research by, for the first time, allowing individuals with SCI NP to volitionally control virtual gait to interact with a fully immersive virtual environment. The current pilot study compared this interactive, virtual walking intervention to a passive, noninteractive virtual walking condition (analogous to previous illusory walking interventions) in 27 individuals with complete paraplegia (interactive condition, n = 17; passive condition, n = 10; nonrandomized design). The intervention was delivered over 2 weeks in individuals' homes. Participants in the interactive condition endorsed significantly greater reductions in NP intensity and NP-related activity interference preintervention to postintervention. Notable improvements in mood and affect were also observed both within individual sessions and in response to the full intervention. These results, although preliminary, highlight the potentially potent effects of an interactive virtual walking intervention for SCI NP. The current study results require replication in a larger, randomized clinical trial and may form a valuable basis for future inquiry regarding the mechanisms and clinical applications of virtual walking therapies.
Neuroaesthetics: a narrative review of neuroimaging techniques
Authors: Chen Zhitang , Yang Xiangyu , Wang Lihui , Li Weidong
Published: May 2021

As a new discipline, neuroaesthetics has developed rapidly to become an important branch of neuroscience. The study of neuroaesthetics is of great significance to understanding the mechanisms underlying human aesthetics. In this review, we briefly define neuroaesthetics, and then review the current state of aesthetics research with a focus on single-modal and multi-modal neuroimaging technologies using the visual and auditory modalities. Finally, we summarize current challenges and trends in the field.
Overview of the molecular mechanisms of migration and invasion in glioblastoma multiforme
Authors: Liu Xian , Chen Ju-Yu , Chien Yueh , Yang Yi-Ping , Chen Ming-Teh , Lin Liang-Ting
Published: May 2021

Glioblastoma (GBM) is one of the most devastating cancers, with an approximate median survival of only 16 months. Although some new insights into the fantastic heterogeneity of this kind of brain tumor have been revealed in recent studies, all subclasses of GBM still demonstrate highly aggressive invasion properties to the surrounding parenchyma. This behavior has become the main obstruction to current curative therapies as invasive GBM cells migrate away from these foci after surgical therapies. Therefore, this review aimed to provide a relatively comprehensive study of GBM invasion mechanisms, which contains an intricate network of interactions and signaling pathways with the extracellular matrix (ECM). Among these related molecules, TGF-β, the ECM, Akt, and microRNAs are most significant in terms of cellular procedures related to GBM motility and invasion. Moreover, we also review data indicating that Musashi-1 (MSI1), a neural RNA-binding protein (RBP), regulates GBM motility and invasion, maintains stem cell populations in GBM, and promotes drug-resistant GBM phenotypes by stimulating necessary oncogenic signaling pathways through binding and regulating mRNA stability. Importantly, these necessary oncogenic signaling pathways have a close connection with TGF-β, ECM, and Akt. Thus, it appears promising to find MSI-specific inhibitors or RNA interference-based treatments to prevent the actions of these molecules despite using RBPs, which are known as hard therapeutic targets. In summary, this review aims to provide a better understanding of these signaling pathways to help in developing novel therapeutic approaches with better outcomes in preclinical studies.
Virtual reality-based preprocedural education increases preparedness and satisfaction of patients about the catheter ablation of atrial fibrillation
Authors: Chang Shih-Lin , Kuo Ming-Jen , Lin Yenn-Jiang , Chen Shih-Ann , Chen Chung-Ting , Yang Ying-Ying , Yang Ling-Yu , Kao Shou-Yen , Shulruf Boaz , Lee Fa-Yauh
Published: May 2021

Background:

A recent study suggested to develop and implement more interacted material for preprocedural education to decrease patients’ anxiety about the atrial fibrillation (AF) ablation. This study compared the effectiveness of using either newly developed virtual reality (VR) materials (VR group) or paper-based materials (paper group) on giving AF preprocedural education.

Methods:

This study consequentially enrolled 33 AF patients preparing for ablation from November 2019 to October 2020. After enrollment, patients were randomized as either paper (n = 22) or VR (n = 11) groups.

Results:

In comparison with the baseline stage, at the posteducation stage, the degree of improvement in patients’ self-assessed self-efficacy on AF ablation knowledge was higher among VR group patients than those in the paper group. At the posteducation stage, the patients’ satisfaction to preprocedural education and used materials were higher among the VR group than that among the paper group. In addition to meet their needs and give accurate medical information, VR group patients reported that VR materials increased the effectiveness of education, increased their preparedness for AF catheter ablation, achieved paperless purposes, and willing to recommend VR materials to others. Operators subjectively reported that the periprocedure cooperation was increased both among paper and VR group patients after preprocedural education for the details of procedure. Better preparedness of VR group patients was supported by less periprocedure pain, anxiety, and impatience than those among paper group patients.

Conclusion:

Interactive VR-based materials are superior to the paper-based materials to provide patients immerse and imagine the journey and detail knowledge of AF catheter ablation before the procedure and better prepared patients for the procedure.
Association of Antidepressant Continuation in Pregnancy and Infant Birth Weight
Authors: Wartko Paige D. , Weiss Noel S. , Enquobahrie Daniel A. , Chan K. C. Gary , Stephenson-Famy Alyssa , Mueller Beth A. , Dublin Sascha
Published: May 2021

Purpose

The aim of the study was to evaluate the association of antidepressant continuation in pregnancy with infant birth weight among women using antidepressants before pregnancy.

Methods

This retrospective cohort study used electronic health data linked with state birth records. We identified singleton live births (2001–2014) to enrolled women with 1 or more antidepressant prescriptions filled 6 months or less before pregnancy, including “continuers” (≥1 antidepressant fills during pregnancy, n = 1775) and “discontinuers” (no fill during pregnancy, n = 1249). We compared birth weight, small or large for gestational age (SGA or LGA), low birth weight (LBW; <2500 g), and macrosomia (>4500 g) between the 2 groups, using inverse probability of treatment weighting to account for pre-pregnancy characteristics, including mental health conditions.

Results

After weighting, infants born to antidepressant continuers weighed 71.9 g less than discontinuers' infants (95% confidence interval [CI], −115.5 to −28.3 g), with a larger difference for female infants (−106.4 g; 95% CI, −164.6 to −48.1) than male infants (−48.5 g; 95% CI, −107.2 to 10.3). For female infants, SGA risk was greater in continuers than discontinuers (relative risk [RR],1.54; 95% CI, 1.02 to 2.32). Low birth weight risk was greater in continuers with 50% or more of days covered (RR, 1.69; 95% CI, 1.11 to 2.58) and exposure in the second trimester (RR, 1.53; 95% CI, 1.02 to 2.29), as compared with discontinuers.

Conclusions

Depending on infant sex, as well as duration and timing of use, continuation of antidepressant use during pregnancy may be associated with lower infant birth weight, with corresponding increases in LBW and SGA.