bluuebunny/crossref_metadata_2025 huggingface dataset:
Advances in nanomaterials for heterogeneous photocatalysis
Authors: Thongam Debika Devi , Chaturvedi Harsh
Published: March 2021

Photocatalysis method for environmental applications has been using for a long time. This review article traces back the origin of catalysis, its classification and journey of development to heterogeneous photocatalysis and the article’s novelty is in the simplicity, and easily understandable language, designed for the beginners. These heterogeneous photocatalysts are grouped into eleven different categories. As the paper is focused on photocatalysis, an insight on fundamental principles and mechanisms of photocatalysis are explained systematically with schematic illustrations and reactions that take place during redox- oxidation and reduction reactions in photocatalysis. With an approach towards utilizing green energy and expanding the photocatalyst’ absorption wavelength range towards the visible regime, bandgap engineering techniques by adopting doping and hetero-structures are explained with examples of different materials. In addition, dominating factors of photocatalysis reaction viz. composition of a heterogeneous photocatalyst, doping, hetero-structures, pH, surface defects on photocatalysis reaction are explored, focussing on variable charge transfer mechanisms. The main influencing factor in generating reactive oxygen species is pH of the photocatalysis reaction and are studied indetail. The effect of alkalinity or acidity in catalyst surfaces and molecular interaction depending upon the point zero charges of the photocatalyst are discussed. For the better study of catalyst properties, careful analysis and study is a much-needed field as a scope for further improvement. Hence, this article will guide a beginner to understand the photocatalysis topic with ease.
Antimicrobial coating of fabric by biosynthesized silver nanoparticles from Panchakavya
Authors: Ukkund Shareefraza J , Adarsh D P , Nair Haritha , Manasa Jyothi , Krishna Swathi , Naveen Rashika , Jacob Sanjana , Shettar Anusha B , Badiuddin Aliya F , Nellerichale Abhinaya
Published: March 2021

Silver nanoparticles can be synthesized biologically by means of microbes and plants since they offer eco-friendly, non-toxic and uniform nanoparticles, though many researchers have done major work on biosynthesis there is very less research carried out on synthesis of nanoparticles by Panchakavya. Panchakavya is an Indian eco friendly fertilizer. Silver nitrate is treated with panchakavya to synthesize silver nanoparticles where in panchakavya acts as a reducing agent. The synthesized silver nanoparticles are monitored by UV-spectrophotometer then subjected to structural and morphological studies by XRD, SEM and AFM and silver nanoparticles of size 20–35 nm were obtained. The silver nanoparticles are then used against napkins containing urine sample for antimicrobial studies. Then the napkins are examined for the growth of colonies by carrying out bacterial culture method. The comparison study was done between the napkin without silver nanoparticles and with silver nanoparticles by using colony counting process. The antibacterial activity of silver nanoparticles were traced for two weeks and found same activity which was shown initially. Hence antimicrobial activity of AgNPs lasted even after weeks in napkin used.
Generalized versions of reverse Young inequalities
Authors: Gumus Ibrahim
Published: March 2021

In this note, we obtain generalized versions of reverse Young inequalities as follows: For

a

1

,

a

2

,
…
,

a

n

∈

[
m
,
M
]

a_{1},a_{2},\ldots ,a_{n}\in \left [ m,M\right ]

with

M
≥
m
>
0

M\geq m>0

\[
<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" alttext="v 1 a 1 plus v 2 a 2 plus midline-horizontal-ellipsis plus v Subscript n Baseline a Subscript n Baseline less-than-or-equal-to upper S left-parenthesis StartFraction upper M Over m EndFraction right-parenthesis a 1 Superscript v 1 Baseline a 2 Superscript v 2 Baseline ellipsis a Subscript n Superscript v Super Subscript n">

v

1

a

1

+

v

2

a

2

+
⋯
+

v

n

a

n

≤
S

(

M
m

)

a

1

v

1

a

2

v

2

…

a

n

v

n

v_{1}a_{1}+v_{2}a_{2}+\cdots +v_{n}a_{n}\leq S\left ( \frac {M}{m}\right ) a_{1}^{v_{1}}a_{2}^{v_{2}}\ldots a_{n}^{v_{n}}

\]
and
\[
<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" alttext="v 1 a 1 plus v 2 a 2 plus midline-horizontal-ellipsis plus v Subscript n Baseline a Subscript n Baseline less-than-or-equal-to max Underscript a Subscript i Baseline element-of left-bracket m comma upper M right-bracket Endscripts upper S left-parenthesis StartFraction a Subscript i Baseline Over a Subscript j Baseline EndFraction right-parenthesis upper L left-parenthesis a Subscript i comma Baseline a Subscript j Baseline right-parenthesis plus a 1 Superscript v 1 Baseline a 2 Superscript v 2 Baseline ellipsis a Subscript n Superscript v Super Subscript n">

v

1

a

1

+

v

2

a

2

+
⋯
+

v

n

a

n

≤

max

a

i

∈

[
m
,
M
]

S

(

a

i

a

j

)

L

(

a

i
,

a

j

)

+

a

1

v

1

a

2

v

2

…

a

n

v

n

v_{1}a_{1}+v_{2}a_{2}+\cdots +v_{n}a_{n}\leq \underset {a_{i}\in \left [ m,M\right ] }{\max }S\left ( \frac {a_{i}}{a_{j}}\right ) L\left ( a_{i,}a_{j}\right ) +a_{1}^{v_{1}}a_{2}^{v_{2}}\ldots a_{n}^{v_{n}}

\]
where

S

(
⋅
)

S\left ( \cdot \right )

is Specht’s ratio,

L

(

a

i
,

a

j

)

L\left ( a_{i,}a_{j}\right )

is logarithmic mean and

v

i

∈

[
0
,
1
]

v_{i}\in \left [ 0,1\right ]

such that

v

1

+

v

2

+
⋯
+

v

n

=
1.

v_{1}+v_{2}+\cdots +v_{n}=1.

Unlike the proof methods used in the articles on Young’s inequality, the proofs of this study are obtained through first order conditions for constrained optimization problems.
On the minimal free resolution of symbolic powers of cover ideals of graphs
Authors: Seyed Fakhari S. A.
Published: March 2021

For any graph

G
G

, assume that

J
(
G
)

J(G)

is the cover ideal of

G
G

. Let

J
(
G

)

(
k
)

J(G)^{(k)}

denote the

k
k

th symbolic power of

J
(
G
)

J(G)

. We characterize all graphs

G
G

with the property that

J
(
G

)

(
k
)

J(G)^{(k)}

has a linear resolution for some (equivalently, for all) integer

k
≥
2

k\geq 2

. Moreover, it is shown that for any graph

G
G

, the sequence
<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" alttext="left-parenthesis normal r normal e normal g left-parenthesis upper J left-parenthesis upper G right-parenthesis Superscript left-parenthesis k right-parenthesis Baseline right-parenthesis right-parenthesis Subscript k equals 1 Superscript normal infinity">

(

r
e
g

(
J
(
G

)

(
k
)

)

)

k
=
1

∞

\big ({\mathrm {reg}}(J(G)^{(k)})\big )_{k=1}^{\infty }

is nondecreasing. Furthermore, we compute the largest degree of minimal generators of

J
(
G

)

(
k
)

J(G)^{(k)}

when

G
G

is either an unmixed of a claw-free graph.
An improvement on Furstenberg’s intersection problem
Authors: Yu Han
Published: March 2021

In this paper, we study a problem posed by Furstenberg on intersections between

×
2
,
×
3

\times 2, \times 3

invariant sets. We present here a direct geometrical counting argument to revisit a theorem of Wu and Shmerkin. This argument can be used to obtain further improvements. For example, we show that if

A
2

,

A
3

⊂
[
0
,
1
]

A_2,A_3\subset [0,1]

are closed and

×
2
,
×
3

\times 2, \times 3

invariant respectively, assuming that

dim
⁡

A
2

+
dim
⁡

A
3

>
1

\dim A_2+\dim A_3>1

then

A
2

∩
(
u

A
3

+
v
)

A_2\cap (uA_3+v)

is sparse (defined in this paper) and has box dimension zero uniformly with respect to the real parameters

u
,
v

u,v

such that

u
u

and

u

−
1

u^{-1}

are both bounded away from

0
0

.
Pithy Persuasion: Engagement in 3 Minute Thesis Presentations
Authors: Hyland Ken , (Joanna) Zou Hang
Published: March 2021

Academic communication crucially involves readers, or hearers, buying into an argument. The audience has to be hooked, involved and led to a desired conclusion, and this is perhaps no more urgent than in a Three Minute Thesis presentation (3MT). In this competitive environment, doctoral students present their research using only one static slide in just 180 seconds. Speakers are advised to tell a ‘story’ but they must still draw on familiar ways of ensuring their hearers can make connections in their presentation and be willing to accept their argument. In this paper we apply Hyland (2005a) engagement framework to a corpus of 120 3MT presentations to explore how academics establish interpersonal rapport with non-specialist audiences. We find engagement to be a useful analytical tool in this monologic speech context and discover disciplinary preferences in the use of engagement features. Our findings have important implications for postgraduate speaking and for EAP teachers preparing students to orally present their research.
A Comprehensive Approach to Asian Upper Eyelid Ptosis Correction: The Levator Musculo-Aponeurotic Junction Formula
Authors: Wong Chin-Ho , Hsieh Michael Ku Hung , Mendelson Bryan
Published: March 2021

Background

The unique anatomy of the Asian upper eyelid requires specific adaptation to the levator advancement technique for ptosis correction to achieve predictable and reproducible outcomes.

Objectives

The levator musculo-aponeurotic junction was employed as they key landmark. With a formula developed by the authors, the location of fixation relative to this landmark can be predicted preoperatively. The authors’ clinical experience and outcomes with this technique are presented.

Methods

Inclusion criteria were Asian patients with mild to severe ptosis with at least fair levator function. Patients with acquired or congenital ptosis and primary and revisional cases were all included. The location for placement of the advancement sutures was measured from the musculo-aponeurotic junction of the upper eyelid levator. This distance was determined by a formula that considers (1) the amount of elevation of the upper eyelid margin needed, (2) the degree of compensatory brow elevation present, and (3) eye dominance.

Results

A total 156 Asian patients were included in this prospective study. Of these, 148 were bilateral and 8 were unilateral corrections. The technique was predictable with resolution of symptoms of eyelid ptosis post-surgery and good long-term symmetry of the palpebral aperture and crisp upper eyelid creases. The formula for estimating the fixation point on the levator was accurate to within ±1 mm in the majority of patients. The aperture revision rate was 2%.

Conclusions

This novel technique provides a predictable and reliable approach for upper eyelid ptosis correction in Asian patients.

Level of Evidence: 4
Compact and evenly distributed k-mer binning for genomic sequences
Authors: Nyström-Persson Johan , Keeble-Gagnère Gabriel , Zawad Niamat
Published: March 2021

Motivation

The processing of k-mers (subsequences of length k) is at the foundation of many sequence processing algorithms in bioinformatics, including k-mer counting for genome size estimation, genome assembly, and taxonomic classification for metagenomics. Minimizers—ordered m-mers where m < k—are often used to group k-mers into bins as a first step in such processing. However, minimizers are known to generate bins of very different sizes, which can pose challenges for distributed and parallel processing, as well as generally increase memory requirements. Furthermore, although various minimizer orderings have been proposed, their practical value for improving tool efficiency has not yet been fully explored.

Results

We present Discount, a distributed k-mer counting tool based on Apache Spark, which we use to investigate the behaviour of various minimizer orderings in practice when applied to metagenomics data. Using this tool, we then introduce the universal frequency ordering, a new combination of frequency-sampled minimizers and universal k-mer hitting sets, which yields both evenly distributed binning and small bin sizes. We show that this ordering allows Discount to perform distributed k-mer counting on a large dataset in as little as 1/8 of the memory of comparable approaches, making it the most efficient out-of-core distributed k-mer counting method available.

Availability and implementation

Discount is GPL licensed and available at https://github.com/jtnystrom/discount. The data underlying this article are available in the article and in its online supplementary material.

Supplementary information

Supplementary data are available at Bioinformatics online.
Inhibition of acid sphingomyelinase increases regulatory T cells in humans
Authors: Wiese Teresa , Dennstädt Fabio , Hollmann Claudia , Stonawski Saskia , Wurst Catherina , Fink Julian , Gorte Erika , Mandasari Putri , Domschke Katharina , Hommers Leif , Vanhove Bernard , Schumacher Fabian , Kleuser Burkhard , Seibel Jürgen , Rohr Jan , Buttmann Mathias , Menke Andreas , Schneider-Schaulies Jürgen , Beyersdorf Niklas
Published: March 2021

Genetic deficiency for acid sphingomyelinase or its pharmacological inhibition has been shown to increase Foxp3+ regulatory T-cell frequencies among CD4+ T cells in mice. We now investigated whether pharmacological targeting of the acid sphingomyelinase, which catalyzes the cleavage of sphingomyelin to ceramide and phosphorylcholine, also allows to manipulate relative CD4+ Foxp3+ regulatory T-cell frequencies in humans. Pharmacological acid sphingomyelinase inhibition with antidepressants like sertraline, but not those without an inhibitory effect on acid sphingomyelinase activity like citalopram, increased the frequency of Foxp3+ regulatory T cell among human CD4+ T cells in vitro. In an observational prospective clinical study with patients suffering from major depression, we observed that acid sphingomyelinase-inhibiting antidepressants induced a stronger relative increase in the frequency of CD4+ Foxp3+ regulatory T cells in peripheral blood than acid sphingomyelinase-non- or weakly inhibiting antidepressants. This was particularly true for CD45RA− CD25high effector CD4+ Foxp3+ regulatory T cells. Mechanistically, our data indicate that the positive effect of acid sphingomyelinase inhibition on CD4+ Foxp3+ regulatory T cells required CD28 co-stimulation, suggesting that enhanced CD28 co-stimulation was the driver of the observed increase in the frequency of Foxp3+ regulatory T cells among human CD4+ T cells. In summary, the widely induced pharmacological inhibition of acid sphingomyelinase activity in patients leads to an increase in Foxp3+ regulatory T-cell frequencies among CD4+ T cells in humans both in vivo and in vitro.
Cognitive fatigue in multiple sclerosis is associated with alterations in the functional connectivity of monoamine circuits
Authors: Cercignani Mara , Dipasquale Ottavia , Bogdan Iulia , Carandini Tiziana , Scott James , Rashid Waqar , Sabri Osama , Hesse Swen , Rullmann Michael , Lopiano Leonardo , Veronese Mattia , Martins Daniel , Bozzali Marco
Published: March 2021

Fatigue is a highly prevalent and debilitating symptom in multiple sclerosis, but currently the available treatment options have limited efficacy. The development of innovative and efficacious targeted treatments for fatigue in multiple sclerosis has been marred by the limited knowledge of the underlying mechanisms. One of the hypotheses postulates that multiple sclerosis pathology might cause reduced monoaminergic release in the central nervous system with consequences on motivation, mood and attention. Here, we applied the recently developed Receptor-Enriched Analysis of Functional Connectivity by Targets method to investigate whether patients with high and low fatigue differ in the functional connectivity (FC) of the monoamine circuits in the brain. We recruited 55 patients with multiple sclerosis, which were then classified as highly fatigued or mildly fatigued based on their scores on the cognitive sub-scale of the Modified Fatigue Impact scale. We acquired resting-state functional MRI scans and derived individual maps of connectivity associated with the distribution of the dopamine, noradrenaline and serotonin transporters as measured by positron emission tomography. We found that patients with high fatigue present decreased noradrenaline transporter (NAT)-enriched connectivity in several frontal and prefrontal areas when compared to those with lower fatigue. The NAT-enriched FC predicted negatively individual cognitive fatigue scores. Our findings support the idea that alterations in the catecholaminergic functional circuits underlie fatigue in multiple sclerosis and identify the NAT as a putative therapeutic target directed to pathophysiology.
Charles Byrne, Last Victim of the Bodysnatchers: the Legal Case for Burial
Authors: Lowth Mary
Published: March 2021

The retention and display of the remains of Charles Byrne, an Irishman with acromegaly, by the Hunterian Museum of the Royal College of Surgeons has been contentious for some years, and the moral case for his release for burial has been repeatedly made. This article makes the legal case through five arguments. The first three concern common law rights and duties; Byrne’s right to burial, the duty of the State to ensure his burial where others do not, and the right of his friends to assume that duty. The fourth concerns Byrne’s common law right to direct his disposal, and, related to this, not to be retained and displayed. The fifth, which underpins the rest, is that Byrne is not, and has never been property, and it is in fact intuitively and legally arguable that he, like other corpses, remains a person. The article finally outlines three options available to those wishing to ensure Byrne finally has the burial at sea that he sought to ensure in 1783.
President Warren G. Harding and the 5 Doctors Who Managed His Final Illness
Authors: Pappas Theodore N.
Published: March 2021

Warren G. Harding was elected president of the United States in 1920 and died before he finished his third year in office. Early in 1923, he had progressive weakness, shortness of breath, and chest pain. In July of 1923, while on a western trip, he developed an episode of abdominal pain and fever. His trip was truncated and he was taken to the Palace Hotel in San Francisco, where 5 physicians attempted to treat his worsening symptoms. He died on August 2 of what was presumed to be a stroke. Historians have disagreed over the President’s cause of death. This article reviews the medical evidence available from the doctors who cared for the President in an effort to define Harding’s terminal illness.
We Are What We Write
Authors: Barr Justin , Nesbit Robert R.
Published: March 2021

The profession of surgery has long purported to value its history. This study evaluates that interest by calculating the percent of historical articles in 4 major general surgery journals from 1885 to 2018 (Annals of Surgery; Surgery, Gynecology, and Obstetrics; American Journal of Surgery; and Archives of Surgery). Of all articles published over the last 133 years, 1.65% focused on history, although this percentage fluctuated between 0% and 4.77%. A peak in the 1920s likely both represents and buttresses a national movement to elevate and professionalize the field of surgery. A plurality of the articles were biographical. The proportion of history articles in these journals has been declining of late due to reasons such as the proliferation of periodicals and impact factor considerations. The new Annals of Surgery—Open promises an ideal forum to publish this work, celebrate our heritage, and study the history of who we are as surgeons.
High Versus Low Ligation of the Inferior Mesenteric Artery During Rectal Resection for Cancer: Oncological Outcomes After Three Years of Follow-Up From the HIGHLOW Trial
Authors: Mari Giulio M. , Crippa Jacopo , Achilli Pietro , Montroni Isacco , Ugolini Giampaolo , Taffurelli Giovanni , Cocozza Eugenio , Borroni Giacomo , Valenti Francesco , Roscio Francesco , Ferrari Giovanni , Origi Matteo , Zuliani Walter , Pugliese Raffaele , Costanzi Andrea T. M. , Fingherut Abe , Maggioni Dario
Published: March 2021

Objectives:

To determine the disease-free survival (DFS), disease-specific survival (DSS), and recurrence in patients who underwent laparoscopic low anterior rectal resection with total mesorectal excision (TME) with either high or low ligation of the inferior mesenteric artery (IMA).

Background:

The level of IMA ligation during anterior rectal resection with TME is still a matter of debate, especially in terms of oncological adequacy.

Methods:

Between June 2014 and December 2016, patients scheduled to undergo elective laparoscopic low anterior resection (LAR) and TME in 6 Italian nonacademic hospitals were randomized into 2 groups in the HIGHLOW Trial (ClinicalTrials.gov Identifier: NCT02153801) according to the level of IMA ligation: high ligation (HL) versus low ligation (LL). DFS, DSS, and recurrence were inquired. Recurrence was determined at 3, 6, 9, and 12 months and every 6 months thereafter. Patients and tumor characteristics as well as surgical outcomes were analyzed to identify risk factors for recurrence.

Results:

One hundred ninety-six patients from the HIGHLOW trial were analyzed. Median follow-up for DFS was 40.6 (interquartile range [IQR], 6–64.7) and 40 (IQR, 7.6–67.8), while median follow-up for DSS was 41.2 (IQR, 10.7–64.7) and 42.7 (IQR, 6–67.6) in the HL and LL groups, respectively. The 3-year DFS rate of HL and LL patients was 82.2% and 82.1% (P = 0.874), respectively. The 3-year DSS for HL and LL patients was 92.1% and 93.4% (P = 0.897), respectively. There was no statistically significant difference in the local recurrence rate (2% HL vs 2.1% LL), in the regional recurrence rate (3% HL vs 2.1% LL), and in the distant recurrence rate (12.9% HL vs 13.7% LL). Multivariate analysis found conversion to open surgery (hazard ratio [HR], 3.68; P = 0.001) and higher stage of disease (HR, 7.73; P < 0.001) to be significant determinant for DFS.

Conclusions:

The level of inferior mesenteric artery ligation during LAR and TME for rectal cancer does not affect DFS, DSS, and recurrence.
The Devastating Impact of the COVID-19 Pandemic on Breast Cancer Care Among Medically Underserved Populations at Two New York City Public Hospitals
Authors: Escobar Natalie , Crown Angelena , Pocock Ben , Joseph Kathie-Ann
Published: March 2021

The COVID-19 pandemic has stretched hospitals to their capacities and has forced them to restructure and divert resources to accommodate the influx of critically ill patients. Surgical specialties are particularly vulnerable to restructuring given the need for highly trained personnel with intensive care unit (ICU) experience and procedural skills and need for ventilators and spaces that can function as ICUs. The diversion of hospital resources and redeployment of staff to the care of COVID patients has led to unintended consequences, including delays in care for patients with oncologic diagnoses, such as breast cancer. These unintended consequences are illustrated by the COVID-19 experiences of 2 New York City public hospitals: Bellevue Hospital and Elmhurst Hospital. The Breast Services of both hospitals treat the city’s vulnerable, medically underserved breast cancer patients. Despite similar patient populations, Bellevue and Elmhurst had divergent COVID-19 experiences. With a larger surge capacity and an affiliation with New York University, the Breast Service at Bellevue Hospital was able to continue to offer essential breast operations, albeit at reduced volumes, whereas the Breast Service at Elmhurst Hospital was completely shut down. These experiences serve as a harbinger of the continually widening health care disparities and force hospital systems and policymakers to critically examine the impact of the COVID-19 pandemic on underserved patient populations that receive care at smaller public hospitals.
Why the Hips Remain Stable When the Spine Strays: A Deeper Analysis of the Relationship Between Hip Displacement and Severe Scoliosis in Patients With Cerebral Palsy
Authors: Hadad Matthew J. , Xu Amy L. , Bryant Barry R. , Andrade Nicholas S. , Hoon Alexander H. , Sponseller Paul D.
Published: March 2021

Background:

Many patients with spastic quadriplegic cerebral palsy (CP) and severe scoliosis develop hip displacement, whereas others do not. We investigated demographic characteristics, risk factors for CP, and imaging findings associated with nondisplaced hips in patients with CP and severe scoliosis.

Methods:

We retrospectively analyzed records of 229 patients with spastic quadriplegic CP and severe scoliosis who presented for treatment at our US academic tertiary care hospital between August 2005 and September 2015. Demographic characteristics, risk factors for CP, and brain magnetic resonance imaging (MRI) findings were documented. Patients were classified as Gross Motor Function Classification System (GMFCS) level 4 or higher, with 58% at GMFCS level 5.3. Displaced hips (n=181 patients) were defined as a migration percentage of ≥30% or previous surgery for hip displacement/adductor contractures. Patients who did not meet these criteria were classified as nondisplaced (n=48 patients). We used univariate analysis and multivariate logistic regression to determine associations between patient factors and hip displacement (alpha=0.05).

Results:

Patients born at term (≥37 wk) had 2.5 times the odds [95% confidence interval (CI): 1.3-5.0] of having nondisplaced hips compared with patients born prematurely. Females had 2.0 times the odds (95% CI: 1.0-3.9) of having nondisplaced hips compared with males. Patients with normal brain MRI findings had 9.6 times the odds (95% CI: 2.3-41) of having nondisplaced hips compared with patients with abnormal findings. Hip displacement was not associated with race (P>0.05).

Conclusions:

Gestational age 37 weeks or above, female sex, and normal brain MRI findings are independently associated with nondisplaced hips in patients with spastic quadriplegic CP and severe scoliosis. These findings direct attention to characteristics that may place patients at greater risk of displacement. Future work may influence preventative screening practices and improve patient counseling regarding the risk of hip displacement.

Level of Evidence:

Level III—retrospective comparative study.
The Effect of Proximal Anchor Choice During Distraction-based Surgeries for Patients With Nonidiopathic Early-onset Scoliosis: A Retrospective Multicenter Study
Authors: El-Bromboly Yehia , Hurry Jennifer , Padhye Kedar , Johnston Charles , McClung Anna , Samdani Amer , Glotzbecker Michael , Salah Hossam , St. Hilaire Tricia , Flynn Tara , El-Hawary Ron
Published: March 2021

Background:

It is unclear whether the type of proximal anchor affects the spine length achieved with distraction-based surgeries in patients with nonidiopathic early-onset scoliosis (EOS). Since distraction may produce kyphosis, spine length should be assessed in the sagittal plane using the sagittal spine length (SSL—curved arc length of the spine in the sagittal plane). Our purpose was to determine if the type of proximal anchor in distraction-based surgeries will affect final spine length.

Methods:

Patients with nonidiopathic EOS treated with distraction-based systems (minimum 5 y follow-up, 5 lengthenings) were identified from 2 EOS registries. Radiographic analysis preoperative, postimplant (L1), and after each lengthening (L2-L5, L6-L10, L11-L15) was performed with the primary outcome of T1-S1 SSL.

Results:

We identified 126 patients—70 had rib-based implants (52 congenital, 9 syndromic, 9 neuromuscular) and 56 had spine-based implants (15 congenital, 29 syndromic, 12 neuromuscular) with preoperative age 4.6 years, scoliosis 75 degrees, and kyphosis 48 degrees. After initial correction (P<0.05), scoliosis remained constant [58 degrees (13 to 104 degrees) at L11-L15] and kyphosis increased over time [38 degrees (9 to 108 degrees) at L1 to 60 degrees (17 to 134 degrees) at L11-L15] (P<0.05). Preoperative SSL was higher in the spine-based group (29.6 cm) when compared with the rib-based group (25.2 cm) (P<0.05). This difference was maintained after initial implantation (spine-based: 32.2 cm vs. rib-based: 26.7 cm, P<0.05) and at final follow-up (spine-based: 37.0 cm vs. rib-based: 34.4 cm, P<0.05). As preoperative SSL differed between groups, maximum SSL gains per interval were also normalized to preoperative SSL. There was no statistically significant difference between groups at L1, L2-L5, and L6-L10. However, at L11-L15, the rib-based group achieved a more relative increase in spine length compared with the spine-based group (45% vs. 31%, P<0.05).

Conclusion:

At minimum 5 year follow-up, distraction-based surgeries increased spine length for patients with nonidiopathic EOS; regardless of proximal anchor type.
Maternal exposure to PM2.5 during pregnancy and asthma risk in early childhood
Authors: Hazlehurst Marnie F. , Carroll Kecia N. , Loftus Christine T. , Szpiro Adam A. , Moore Paul E. , Kaufman Joel D. , Kirwa Kipruto , LeWinn Kaja Z. , Bush Nicole R. , Sathyanarayana Sheela , Tylavsky Frances A. , Barrett Emily S. , Nguyen Ruby H. N. , Karr Catherine J.
Published: March 2021

Background:

Increasingly studies suggest prenatal exposure to air pollution may increase risk of childhood asthma. Few studies have investigated exposure during specific fetal pulmonary developmental windows.

Objective:

To assess associations between prenatal fine particulate matter exposure and asthma at age 4.

Methods:

This study included mother–child dyads from two pregnancy cohorts—CANDLE and TIDES—within the ECHO-PATHWAYS consortium (births in 2007–2013). Three child asthma outcomes were parent-reported: ever asthma, current asthma, and current wheeze. Fine particulate matter (PM2.5) exposures during the pseudoglandular (5–16 weeks gestation), canalicular (16–24 weeks gestation), saccular (24–36 weeks gestation), and alveolar (36+ weeks gestation) phases of fetal lung development were estimated using a national spatiotemporal model. We estimated associations with Poisson regression with robust standard errors, and adjusted for child, maternal, and neighborhood factors.

Results:

Children (n = 1,469) were on average 4.3 (SD 0.5) years old, 49% were male, and 11.7% had ever asthma; 46% of women identified as black and 53% had at least a college/technical school degree. A 2 μg/m3 higher PM2.5 exposure during the saccular phase was associated with 1.29 times higher risk of ever asthma [95% confidence interval (CI): 1.06, 1.58]. A similar association was observed with current asthma (risk ratio 1.27, 95% CI: 1.04, 1.54), but not current wheeze (risk ratio 1.11, 95% CI: 0.92, 1.33). Effect estimates for associations during other developmental windows had CIs that included the null.

Conclusions:

Later phases of prenatal lung development may be particularly sensitive to the developmental toxicity of PM2.5.
Racial disparities in Coronavirus Disease 2019 (COVID-19) outcomes
Authors: Aleligne Yeabsra Kefyalew , Appiah Duke , Ebong Imo A.
Published: March 2021

Purpose of review

The Coronavirus Disease 2019 (COVID-19) pandemic has exposed preexisting racial disparities in the healthcare system. This review discusses racial-ethnic differences in COVID-19 related outcomes with an emphasis on the social determinants of health that are responsible for these disparities.

Recent findings

Higher hospitalizations and deaths have been reported amongst minority individuals after a COVID-19 infection. Cardiovascular disease and its risk factors are also more common in minority populations and negatively impact clinical outcomes after a COVID-19 illness. The racial disparities seen after COVID-19 infections appear to be driven by multiple preexisting comorbidities, adverse socioeconomic conditions, and lack of access to healthcare. These disadvantages were present before the COVID-19 pandemic. To effectively reduce disparities in outcomes of COVID-19 and the impact of the virus on minority communities, a multifaceted approach will be needed.

Government-backed policies that foster health equity and promote easily accessible testing and fair distribution of COVID-19 therapies and vaccines are necessary to successfully combat racial disparities in COVID-19 outcomes.
Red blood cells from patients with pre-eclampsia induce endothelial dysfunction
Authors: McCann Haworth Sarah M. , Zhuge Zhengbing , Nihlén Carina , Von Rosen Matilda Fornell , Weitzberg Eddie , Lundberg Jon O. , Krmar Rafael T. , Nasiell Josefine , Carlström Mattias
Published: March 2021

Rationale:

Pre-eclampsia is a multisystem disorder associated with systemic vascular dysfunction and decreased nitric oxide (NO) bioactivity. Arginase competes with NO synthase (NOS) for l-arginine, and its upregulation may reduce NOS-derived NO formation or induce production of reactive oxygen species (ROS) via uncoupling of NOS, resulting in endothelial dysfunction. Red blood cells (RBCs) have emerged as key players in NO homeostasis via their interactions with the endothelium. Studies have demonstrated that abnormal RBC arginase function in patients with diabetes contributes to oxidative stress and endothelial dysfunction.

Aim:

The aim of the study was to investigate if reduced NO bioavailability and increased ROS in pre-eclampsia is mediated via RBC-dependent mechanisms.

Methods:

In this translational study, plasma and RBCs were isolated from gestationally matched pre-eclamptic and healthy pregnant women and co-incubated overnight with mouse aortas for vascular reactivity studies. NO bioactivity, that is, nitrate, nitrite and cGMP, was assessed in plasma. Arginase activity and expression were analysed in RBCs.

Results:

Plasma markers of NO homeostasis and signalling were decreased in pre-eclamptic women vs. healthy pregnant women. Co-incubation of aorta with pre-eclamptic RBCs, but not healthy pregnant RBCs, induced endothelial dysfunction, which was ameliorated by pharmacological inhibition of arginase, scavenging of ROS, and by nitrite treatment. This pathological vascular phenotype was not observed following incubation with pre-eclamptic plasma. Arginase expression and activity in RBCs were increased in pre-eclamptic vs. healthy pregnant women and was associated with pre-eclampsia severity. Pre-eclamptic RBC-induced endothelial dysfunction was not because of increased haemolysis/cell-free haemoglobin.

Conclusion:

This study demonstrates a novel role of the RBC in mediating the endothelial dysfunction associated with pre-eclampsia through arginase-dependent and oxidative stress-dependent mechanisms. Targeting of RBC arginase may provide a novel treatment modality for pre-eclampsia.
Feasibility and Acceptability of a Telephone-Based Intervention for Hispanic Children to Promote Treatment Adherence After Traumatic Brain Injury: A Pilot Study
Authors: Jimenez Nathalia , Fuentes Molly , Virtue Alyssa , Alonso-Gonzalez Laura , Lopez Edgar , Zhou Chuan , Crawley Deborah , Apkon Susan , Johnston Brian , Rivara Frederick
Published: March 2021

Objective:

To assess the feasibility and acceptability of a telephone-based education and navigation program for Hispanic parents of children hospitalized with traumatic brain injury (TBI).

Setting:

Level I trauma hospital and pediatric inpatient rehabilitation unit in the Northwestern United States.

Participants:

Fourteen Hispanic parent-child dyads. Parents were 85% female, with a mean age of 35 years. Children were 58% male, with a mean age of 9.7 years, and had been hospitalized for complicated mild/moderate (n = 5) or severe (n = 9) TBI.

Design:

Pilot prospective cohort design.

Main Measures:

Feasibility measures include recruitment, retention, and intervention adherence rates. Acceptability of intervention was measured by parents' use of educational materials and satisfaction with navigation program. We also evaluated study processes, including completion of baseline, 3, 6, and 12 months functional assessments of the child; assessment of parental health literacy and self-efficacy; and adherence to follow-up rehabilitation appointments.

Results:

Eighty-two percent of approached potential participants were recruited into the study. One hundred percent of participants completed the intervention, and 85% had 1-year follow-up. Intervention acceptability was high: 90% reported satisfaction with navigator, and 92% used the educational manual. Assessments demonstrated significant improvement in parents' TBI caregiving and community self-efficacy; 92% attendance to follow-up rehabilitation appointments; and improvement in the child's functional measures, except communication skills.

Conclusions:

Findings support feasibility and acceptability of a culturally relevant program to facilitate transitions of care for Hispanic children with TBI. A future randomized trial is warranted to determine the efficacy of the intervention on long-term treatment adherence and the child's post-TBI function.
Associations Among PTSD and Postconcussive Symptoms in the Long-Term Impact of Military-Relevant Brain Injury Consortium–Chronic Effects of Neurotrauma Consortium Prospective, Longitudinal Study Cohort
Authors: O'Neil Maya E. , Klyce Daniel W. , Pogoda Terri K. , Cifu David X. , Eggleston Barry E. , Cameron David C. , Wilde Elisabeth A. , Walker William C. , Carlson Kathleen F.
Published: March 2021

Objective:

To describe rates of mild traumatic brain injury (mTBI) with and without concurrent posttraumatic stress disorder a sample of former and current military personnel, and to compare the factor structure of the Neurobehavioral Symptom Inventory (NSI) based on whether participants sustained mTBI with and without a positive posttraumatic stress disorder (PTSD) screen.

Setting:

Participants recruited and tested at 7 Veterans Affairs (VA) sites and 1 military training facility as part of a national, longitudinal study of mental health, physical, and cognitive outcomes among veterans and service members. Participants: Total of 1540 former and current military personnel with a history of combat exposure.

Design:

Cross-sectional analysis of observational data, including confirmatory factor analysis. Main Measures: NSI and PTSD Checklist for DSM-5 (PCL-5).

Results:

Most participants (81.5%) had a history of mTBI and almost half of these screened positive for PTSD (40.5%); only 23.9% of participants without a history of mTBI screened positive for PTSD. Participants with a history of mTBI reported higher elevations of NSI and PCL-5 symptoms compared with those without a history of mTBI. Confirmatory factor analyses of the NSI demonstrated good model fit using a 4-factor structure (somatosensory, affective, cognitive, and vestibular symptoms) among groups of participants both with and without a history of mTBI.

Conclusion:

Symptoms of mTBI and PTSD are strongly associated with each other among veterans and service members with a history of combat exposure. The 4-factor NSI structure is supported among participants with and without a history of mTBI. These findings suggest the potential benefit of a holistic approach to evaluation and treatment of veterans and service members with concurrent and elevated postconcussive and posttraumatic stress symptoms.
Effects of Recurrent Mild Traumatic Brain Injuries on Incidence, Severity, and Recovery of Concussion in Young Student-Athletes
Authors: Hannah Theodore C. , Spiera Zachary , Li Adam Y. , Durbin John , Dreher Nickolas , Ali Muhammad , Marayati Naoum Fares , Gometz Alex , Lovell Mark , Choudhri Tanvir
Published: March 2021

Objective:

To examine the effects of recurrent concussions on the incidence, severity, and recovery of significant neurocognitive dysfunction (SND) in young athletes.

Setting:

Various US youth sports organizations that utilize Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) for baseline and postinjury concussion testing.

Participants:

Data from 11 563 ImPACT baseline evaluations of US student-athletes aged 12 to 22 years were separated into 2 cohorts: subjects reporting 2 or more previous concussions (PC; n = 976 baseline evaluations) at baseline and a control group reporting zero previous concussions (CT; n = 7743 baseline evaluations). Subjects reporting 1 prior concussion were excluded.

Design:

Retrospective cohort.

Main Measures:

Differences in SND incidence, severity, and recovery between the 2 cohorts were assessed using chi-squared tests, t tests, survival analyses, and multivariate regressions.

Results:

The PC cohort had a higher incidence of head injury leading to ImPACT (436.7 per 1000 person-years vs 194.4 per 1000 person-years, P < .0001) and a higher incidence of SND (140.4 vs 71.8, P < .0001) than controls. However, the Severity Index (SI) demonstrated that SND severity was lower in the PC group (7.55 vs 8.59, P = .04). Adjusted analyses similarly demonstrated that the PC cohort had increased SND incidence (odds ratio = 1.93; 95% CI, 1.61 to 2.31; P < .0001), decreased SI (β = −1.37; 95% CI, −2.40 to −0.34; P = .009), and equivalent recovery (hazard ratio = 0.98; 95% CI, 0.76 to 1.72; P = .90).

Conclusion:

Participants with a history of concussion have a higher incidence of SND but present with lower severity SND, which may be a result of increased concussion education or symptom awareness. Recurrent concussion has no significant impact on acute neurocognitive recovery. Together, these results provide evidence against the supposition that a history of concussion increases the severity of future SND.
COMPARISON OF SPECTRALIS AND CIRRUS OPTICAL COHERENCE TOMOGRAPHY FOR THE DETECTION OF INCOMPLETE AND COMPLETE RETINAL PIGMENT EPITHELIUM AND OUTER RETINAL ATROPHY
Authors: Corvi Federico , Corradetti Giulia , Nittala Muneeswar Gupta , Velaga Swetha Bindu , Haines Jonathan L. , Pericak-Vance Margaret Ann , Stambolian Dwight , Sadda SriniVas R.
Published: March 2021

Purpose:

To evaluate and compare the detection of incomplete and complete retinal pigment epithelial and outer retinal atrophy (iRORA and cRORA) using Spectralis and Cirrus optical coherence tomography (OCT) devices.

Methods:

Subjects with late age-related macular degeneration were imaged on the same day with Spectralis and Cirrus OCT. Two, masked, independent, and experienced retina specialist graders evaluated each case for the presence of cRORA and iRORA lesions.

Results:

A significantly higher number of lesions were observed using Spectralis compared with Cirrus (239 vs. 226 and 223 vs. 209). Higher number of iRORA lesions were identified with Spectralis (105 vs. 90 and 96 vs. 82), and no significant difference was observed between devices for cRORA lesions (134 vs. 136 and 128 vs. 126). When considering the presence or absence of iRORA or cRORA, the agreement between devices for both graders was excellent for cRORA and good for iRORA.

Conclusion:

Spectralis and Cirrus OCT identified a similar number of cRORA lesions, although more iRORA lesions could be detected with Spectralis OCT. These findings may have implications for developing acquisition protocols for trials based on the intended atrophy targets and highlight the importance of using a consistent OCT instrument across a study.
Factors Associated With Myocardial Infarction Reoccurrence
Authors: Abel Willie M. , Scanlan Lauren N. , Horne Carolyn E. , Crane Patricia B.
Published: March 2021

Background

As recurrent myocardial infarctions (MIRs) constitute almost a third of the annual incidence of myocardial infarction, identifying the traditional and novel variables related to MIR is important.

Objective

The aim of this study was to examine modifiable cardiac risks, adiposity, symptoms associated with inflammation (fatigue, depression, sleep) and inflammatory cytokines, and MIR by sex and race.

Methods

Using a cross-sectional descriptive design, we recruited a convenience sample of adults (N = 156) discharged with first myocardial infarction or had MIR in the last 3 to 7 years. Surveys measured demographics, cardiac risk factors, depression, sleep, and fatigue. Anthropometric measures and cytokines tumor necrosis factor-α, interleukin-6, and high-sensitivity C-reactive protein (hsCRP) were obtained. A maximum likelihood regression was calculated to predict MIR.

Results

The sample included 57% male and 30% Black participants, and the mean (SD) age was 65 (12) years. The hsCRP was the only cytokine related to symptoms: fatigue (r = 0.309, P < .001) and depression (r = 0.255, P = .002). An MIR was not associated with race despite White participants reporting better sleep (t
146 = −3.25, P = .002), lower body mass index (t
154 = −3.49, P = .001), and fewer modifiable risk factors (t
152 = −2.05, P = .04). An MIR was associated with being male, higher hsCRP and tumor necrosis factor-α levels (P < .001), and higher inflammatory symptoms of fatigue (P = .04), depression (P = .01), and poor sleep (P < .001).

Conclusion

Further examination of biomarkers to understand the mechanisms associated with inflammatory symptoms of fatigue, depression, and poor sleep and MIR is needed.
Fleshy Papules on Left Upper Body
Authors: Vassantachart Janna M.
Published: March 2021

Teledermatology is a term to describe the provision of dermatologic medical services through telecommunication technology. In this modality, there is a transfer of medical information electronically (including history and visual data) on a patient in one location to a provider who is in another location (Roman & Jacob, 2015). The construct of this column is such that cases are presented in a standardized teledermatology reader format. This is a case of asymptomatic fleshy papules on the left upper trunk and shoulder.
Blaschkolinear Keratotic Spines With Erythronychia and V-Shaped Nicking of the Fingernails
Authors: Rosenfeld Adam H. , Alghalith Yazan , Martin Kari
Published: March 2021

This case describes a man in his late 30s who presented with a 25-year history of malodorous keratotic papules on the face, neck, chest, and back, as well as thick, painful linear spines along the lines of Blaschko on the lower extremities. His father had similar diffuse skin findings. A Type II mosaicism of Darier disease was likely because of the focal linear keratotic spines with a background of classic Darier lesions.
Skin Cancer: Back to Basics—Merkel Cell Carcinoma
Authors: Brickley Sylvana A. , Franco Abigail , Somers Kathryn
Published: March 2021

Merkel cell carcinoma (MCC) is a rare and aggressive skin cancer. Advanced disease portends a poor prognosis in most patients. We review the pathogenesis, clinical features, dermoscopic findings, differential diagnosis, workup, treatment modalities, and follow-up of MCC for dermatology nurses. It is important for nurses to be familiar with MCC to prevent delayed diagnosis.
Impact of Ergonomics on Cardiometabolic Risk in Office Workers
Authors: Jindo Takashi , Kai Yuko , Kitano Naruki , Makishima Mitsuru , Takeda Koji , Arao Takashi
Published: March 2021

Objective:

Ergonomic office redesigning possibly improves physical activity (PA) and sedentary behavior (SB); however, its impact on cardiometabolic risk has not yet been determined. This study aimed to examine the effect of office relocation on cardiometabolic risk factors.

Methods:

Annual health check-up data of 95 office workers from four offices in Tokyo, Japan, who relocated to an office with activity-based working (ABW) and height-adjustable desk (HAD) and a propensity-score matched control-cohort were analyzed. PA and SB on weekdays were measured only in the relocation group before and 10 months after relocation.

Results:

Significant interactions were observed for waist circumference, high-density lipoprotein cholesterol, and glycosylated hemoglobin (HbA1c). HbA1c changes showed a significant negative association with moderate-to-vigorous-intensity PA.

Conclusion:

An ABW office with HAD improves cardiometabolic risk factors in office workers, possibly through changes in PA and SB.