bluuebunny/crossref_metadata_2025 huggingface dataset:
Measurements of cosmic expansion and growth rate of structure from voids in the Sloan Digital Sky Survey between redshift 0.07 and 1.0
Authors: Woodfinden Alex , Nadathur Seshadri , Percival Will J , Radinovic Sladana , Massara Elena , Winther Hans A
Published: September 2022

We present measurements of the anisotropic cross-correlation of galaxies and cosmic voids in data from the Sloan Digital Sky Survey (SDSS) Main Galaxy Sample, Baryon Oscillation Spectroscopic Survey (BOSS), and extended BOSS luminous red galaxy catalogues from SDSS Data Releases 7, 12, and 16, covering the redshift range 0.07 < z < 1.0. As in our previous work analysing voids in subsets of these data, we use a reconstruction method applied to the galaxy data before void finding in order to remove selection biases when constructing the void samples. We report results of a joint fit to the multipole moments of the measured cross-correlation for the growth rate of structure, fσ8(z), and the ratio DM(z)/DH(z) of the comoving angular diameter distance to the Hubble distance, in six redshift bins. For DM/DH, we are able to achieve a significantly higher precision than that obtained from analyses of the baryon acoustic oscillations and galaxy clustering in the same data sets. Our growth rate measurements are of lower precision but still comparable with galaxy clustering results. For both quantities, the results agree well with the expectations for a Λ cold dark matter model. Assuming a flat Universe, our results correspond to a measurement of the matter density parameter $\Omega _\mathrm{m}=0.337^{+0.026}_{-0.029}$. For more general models, the degeneracy directions obtained are consistent with and complementary to those from other cosmological probes. These results consolidate void–galaxy cross-correlation measurements as a pillar of modern observational cosmology.
Stability analysis of supermassive primordial stars: a new mass range for general relativistic instability supernovae
Authors: Nagele Chris , Umeda Hideyuki , Takahashi Koh , Yoshida Takashi , Sumiyoshi Kohsuke
Published: September 2022

Observed supermassive black holes in the early Universe have several proposed formation channels in part because most of these channels are difficult to probe. One of the more promising channels, the direct collapse of a supermassive star has several possible probes including the explosion of a helium-core supermassive star triggered by a general relativistic instability. We develop a straightforward method for evaluating the general relativistic radial instability without simplifying assumptions and apply it to population III supermassive stars taken from a post Newtonian stellar evolution code. This method is more accurate than previous determinations and it finds that the instability occurs earlier in the evolutionary life of the star. Using the results of the stability analysis, we perform 1D general relativistic hydrodynamical simulations, and we find two general relativistic instability supernovae fuelled by alpha capture reactions as well as several lower mass pulsations, analogous to the puslational pair instability process. The mass range for the events ($2.6-3.0\times 10^4{\rm M}_\odot$) is lower than that had been suggested by previous works ($5.5\times 10^4{\rm M}_\odot$), because the instability occurs earlier in the star’s evolution. The explosion may be visible to among others JWST, while the discovery of the pulsations opens up additional possibilities for observation.
Radiomics as an emerging tool in the management of brain metastases
Authors: Nowakowski Alexander , Lahijanian Zubin , Panet-Raymond Valerie , Siegel Peter M , Petrecca Kevin , Maleki Farhad , Dankner Matthew
Published: September 2022

Brain metastases (BM) are associated with significant morbidity and mortality in patients with advanced cancer. Despite significant advances in surgical, radiation, and systemic therapy in recent years, the median overall survival of patients with BM is less than 1 year. The acquisition of medical images, such as computed tomography (CT) and magnetic resonance imaging (MRI), is critical for the diagnosis and stratification of patients to appropriate treatments. Radiomic analyses have the potential to improve the standard of care for patients with BM by applying artificial intelligence (AI) with already acquired medical images to predict clinical outcomes and direct the personalized care of BM patients. Herein, we outline the existing literature applying radiomics for the clinical management of BM. This includes predicting patient response to radiotherapy and identifying radiation necrosis, performing virtual biopsies to predict tumor mutation status, and determining the cancer of origin in brain tumors identified via imaging. With further development, radiomics has the potential to aid in BM patient stratification while circumventing the need for invasive tissue sampling, particularly for patients not eligible for surgical resection.
An all-round AI-Chemist with a scientific mind
Authors: Zhu Qing , Zhang Fei , Huang Yan , Xiao Hengyu , Zhao LuYuan , Zhang XuChun , Song Tao , Tang XinSheng , Li Xiang , He Guo , Chong BaoChen , Zhou JunYi , Zhang YiHan , Zhang Baicheng , Cao JiaQi , Luo Man , Wang Song , Ye GuiLin , Zhang WanJun , Chen Xin , Cong Shuang , Zhou Donglai , Li Huirong , Li Jialei , Zou Gang , Shang WeiWei , Jiang Jun , Luo Yi
Published: September 2022

The realization of automated chemical experiments by robots unveiled the prelude to an artificial intelligence (AI) laboratory. Several AI-based systems or robots with specific chemical skills have been demonstrated, but conducting all-round scientific research remains challenging. Here, we present an all-round AI-Chemist equipped with scientific data intelligence that is capable of performing basic tasks generally required in chemical research. Based on a service platform, the AI-Chemist is able to automatically read the literatures from a cloud database and propose experimental plans accordingly. It can control a mobile robot in-house or online to automatically execute the complete experimental process on 14 workstations, including synthesis, characterization and performance tests. The experimental data can be simultaneously analysed by the computational brain of the AI-Chemist through machine learning and Bayesian optimization, allowing a new hypothesis for the next iteration to be proposed. The competence of the AI-Chemist has been scrutinized by three different chemical tasks. In the future, the more advanced all-round AI-Chemists equipped with scientific data intelligence may cause changes to the landscape of the chemical laboratory.
The Irish-Language Traditional Song Collection of Patrick Lynch, 1802–1803
Authors: Carolan Nicholas
Published: September 2022

This chapter describes song collecting trips made in Connacht and Ulster in 1802 and 1803 by Patrick Lynch (c.1750s–1838) of Loughinisland, Co. Down, for Edward Bunting and the promoters of the 1792 Belfast Harp Festival. The words of some four hundred Irish-language traditional pieces recorded by Lynch constitute the most important early collection of Irish song. He wrote them in longhand manuscript, mainly in Co. Mayo, and subsequently rewrote them in Gaelic script and translated them into English. His manuscripts are listed here and their history traced; they remain largely unpublished among those of Bunting in the Library of Queen’s University Belfast. In surviving letters and a journal, Lynch also preserved details of his source singers and of his collecting experiences and strategies. The social and political contexts of Lynch’s work are outlined, including his connections with the Irish-language scribal tradition and with Thomas Russell and the United Irishmen movement.
Root acid phosphatases and rhizobacteria synergistically enhance white lupin and rice phosphorus acquisition
Authors: Aslam Mehtab Muhammad , Pueyo José J , Pang Jiayin , Yang Jinyong , Chen Weiguo , Chen Hao , Waseem Muhammad , Li Ying , Zhang Jianhua , Xu Weifeng
Published: September 2022

The rhizosheath is a belowground area that acts as a communication hub at the root–soil interface to promote water and nutrient acquisition. Certain crops, such as white lupin (Lupinus albus), acquire large amounts of phosphorus (P), owing partially to exudation of acid phosphatases (APases). Plant growth-promoting rhizobacteria also increase soil P availability. However, potential synergistic effects of root APases and rhizosheath-associated microbiota on P acquisition require further research. In this study, we investigated the roles of root purple APases (PAPs) and plant growth-promoting rhizobacteria in rhizosheath formation and P acquisition under conditions of soil drying (SD) and P treatment (+P: soil with P fertilizer; –P: soil without fertilizer). We expressed purple acid phosphatase12 (LaPAP12) in white lupin and rice (Oryza sativa) plants and analyzed the rhizosheath-associated microbiome. Increased or heterologous LaPAP12 expression promoted APase activity and rhizosheath formation, resulting in increased P acquisition mainly under SD–P conditions. It also increased the abundance of members of the genus Bacillus in the rhizosheath-associated microbial communities of white lupin and rice. We isolated a phosphate-solubilizing, auxin-producing Bacillus megaterium strain from the rhizosheath of white lupin and used this to inoculate white lupin and rice plants. Inoculation promoted rhizosheath formation and P acquisition, especially in plants with increased LaPAP12 expression and under SD–P conditions, suggesting a functional role of the bacteria in alleviating P deficit stress via rhizosheath formation. Together, our results suggest a synergistic enhancing effect of LaPAP12 and plant growth-promoting rhizobacteria on rhizosheath formation and P acquisition under SD–P conditions.
Effects of High-Definition Transcranial Direct Current Stimulation Targeting the Anterior Cingulate Cortex on the Pain Thresholds: A Randomized Controlled Trial
Authors: Xiong Huan-Yu , Cao Yin-Quan , Du Shu-Hao , Yang Qi-Hao , He Si-Yi , Wang Xue-Qiang
Published: September 2022

Background

The majority of existing clinical studies used active transcranial direct current stimulation (tDCS) over superficial areas of the pain neuromatrix to regulate pain, with conflicting results. Few studies have investigated the effect of tDCS on pain thresholds by focusing on targets in deep parts of the pain neuromatrix.

Methods

This study applied a single session of high-definition tDCS (HD-tDCS) targeting the anterior cingulate cortex (ACC) and used a parallel and sham-controlled design to compare the antinociceptive effects in healthy individuals by assessing changes in pain thresholds. Sixty-six female individuals (mean age, 20.5 ± 2.4 years) were randomly allocated into the anodal, cathodal, or sham HD-tDCS groups. The primary outcome of the study was pain thresholds (pressure pain threshold, heat pain threshold, and cold pain threshold), which were evaluated before and after stimulation through the use of quantitative sensory tests.

Results

Only cathodal HD-tDCS targeting the ACC significantly increased heat pain threshold (P < 0.05) and pressure pain threshold (P < 0.01) in healthy individuals compared with sham stimulation. Neither anodal nor cathodal HD-tDCS showed significant analgesic effects on cold pain threshold. Furthermore, no statistically significant difference was found in pain thresholds between anodal and sham HD-tDCS (P > 0.38). Independent of HD-tDCS protocols, the positive and negative affective schedule scores were decreased immediately after stimulation compared with baseline.

Conclusions

The present study has found that cathodal HD-tDCS targeting the ACC provided a strong antinociceptive effect (increase in pain threshold), demonstrating a positive biological effect of HD-tDCS.
High-fidelity reprogramming into Leydig-like cells by CRISPR activation and paracrine factors
Authors: Li Zhaohui , Fan Yuxiao , Xie Cankun , Liu Jierong , Guan Xiaoju , Li Shijun , Huang Yadong , Zeng Rong , Chen Haolin , Su Zhijian
Published: September 2022

Androgen deficiency is a common medical conditions that affects males of all ages. Transplantation of testosterone-producing cells is a promising treatment for male hypogonadism. However, getting a cell source with the characteristics of Leydig cells (LCs) is still a challenge. Here, a high-efficiency reprogramming of skin-derived fibroblasts into functional Leydig-like cells (LLCs) based on epigenetic mechanism was described. By performing an integrated analysis of genome-wide DNA methylation and transcriptome profiling in LCs and fibroblasts, the potentially epigenetic-regulating steroidogenic genes and signaling pathways were identified. Then by using CRISPR/dCas9 activation system and signaling pathway regulators, the male- or female-derived fibroblasts were reprogrammed into LLCs with main LC-specific traits. Transcriptomic analysis further indicated that the correlation coefficients of global genes and transcription factors between LLCs and LCs were higher than 0.81 and 0.96, respectively. After transplantation in the testes of hypogonadal rodent models, LLCs increased serum testosterone concentration significantly. In type 2 diabetic rats model, LLCs which were transplanted in armpit, have the capability to restore the serum testosterone level and improve the hyperglycemia status. In conclusion, our approach enables skin-derived fibroblasts reprogramming into LLCs with high fidelity, providing a potential cell source for the therapeutics of male hypogonadism and metabolic-related comorbidities.
Close (Causally Connected) Cousins?
Authors: Dinesen Peter Thisted , Sønderskov Kim Mannemar , Sohlberg Jacob , Esaiasson Peter
Published: September 2022

Trust in one’s fellow citizens and in politicians are both conducive to well-functioning government. Beyond their separate importance, it is a long-standing notion that generalized social trust and political trust are connected in a mutually reinforcing relationship that further undergirds democratic governance. While it is well established that social trust and political trust are robustly positively associated at the individual level, there is much less compelling evidence regarding the causal nature of this relationship. Previous analyses have been unable to adequately rule out confounding and correct for reverse causality. This paper tackles these challenges through data and a research design close to ideally suited for addressing the causal status of the relationship. Using a 20-wave individual-level panel survey from Sweden analyzed using a dynamic panel model, we find evidence for a relatively strong positive causal effect of political trust on social trust, but little evidence for the reverse relationship.
Relativistic correction of the Coulomb interaction in the local density approximation for energies and radii in doubly-magic nuclei
Authors: Naito Tomoya
Published: September 2022

Effects of the relativistic correction of the Coulomb interaction on doubly-magic nuclei are discussed with Skyrme Hartree–Fock calculations. The relativistic correction is treated by using the local density approximation. It is found that the correction to the total energy is about $2.4 \, \mathrm{MeV}$ for ${}^{208}_{}\mathrm{Pb}$, while the proton and neutron radii do not change significantly. This difference is larger than the difference of the Coulomb exchange (Fock) energy calculated with the local density (Hartree–Fock–Slater) approximation and that with the exact treatment and the neutron finite-size effect. Effects of the correction are also compared to the correction due to the vacuum polarization. It is shown that the two contributions to the total energy are comparable in light nuclei, but the latter dominates in heavy nuclei, while the contribution of the relativistic correction to the total energy is non-negligible compared to the target accuracy of the DFT calculation.
Board Reforms, Stock Liquidity, and Stock Market Development
Authors: Qiu Buhui , To Thomas Y
Published: September 2022

This paper studies the effect of board reforms on stock liquidity using data from 37 countries. We document that board reforms significantly increase stock liquidity: the effective spread on average decreases by 12.7% after a board reform. As information asymmetry is a key determinant of stock liquidity, we further find that board reforms decrease information asymmetry, and the treatment effect of board reforms on stock liquidity is stronger for firms with ex ante higher information asymmetry. Finally, board reforms facilitate healthy stock market development, with the effect being stronger for countries with lower aggregate stock market liquidity prior to reforms. (JEL G14, G15, G18)
Lower risk of gout in sodium glucose cotransporter 2 (SGLT2) inhibitors versus dipeptidyl peptidase-4 (DPP4) inhibitors in type-2 diabetes
Authors: Zhou Jiandong , Liu Xuejin , Chou Oscar Hou-In , Li Lifang , Lee Sharen , Wong Wing Tak , Zhang Qingpeng , Chang Carlin , Liu Tong , Tse Gary , Jing Fengshi , Cheung Bernard Man Yung
Published: September 2022

Objectives

The effects of sodium-glucose cotransporter 2 inhibitors (SGLT2I) vs dipeptidyl peptidase-4 inhibitors (DPP4I) on the risk of new-onset gout remains unknown. This study aims to compare the effects of SGLT2I against DPP4I on gout risks.

Methods

This was a retrospective population-based cohort study of patients with type-2 diabetes mellitus treated with SGLT2I or DPP4I between 1 January 2015 and 31 December 2020 in Hong Kong. The study outcomes are new-onset gout and all-cause mortality. Propensity score matching (1:1 ratio) between SGLT2I and DPP4I was performed. Univariable and multivariable Cox regression models were conducted. Competing risks models and multiple approaches based on the propensity score were applied.

Results

This study included 43 201 patients [median age: 63.23 years old (Interquartile range, IQR): 55.21–71.95, 53.74% males; SGLT2I group: n = 16 144; DPP4I group: n = 27 057] with a median follow-up of 5.59 years (IQR: 5.27–5.81 years) since initial drug exposure. The incidence rate of developing gout [Incidence rate (IR): 2.5; 95% CI: 2.2, 2.9] among SGLT2I users was significantly lower than DPP4I users (IR: 5.2; 95% CI: 4.8, 5.8). SGLT2I was associated with 51% lower risks of gout (HR: 0.49; 95% CI: 0.42, 0.58; P-value < 0.0001) and 51% lower risks of all-cause mortality (HR: 0.49; 95% CI: 0.42, 0.58; P-value < 0.0001) after adjusting for significant demographics, past comorbidities, medications and laboratory results. The results remained consistent on competing risk and other propensity score approaches.

Conclusions

SGLT2I use was associated with lower risks of new gout diagnosis compared with DPP4I use.
Relationship between the prevalence of subclinical tenosynovitis and treatment in patients with RA in clinical remission: STARTER study
Authors: Parisi Simone , Zanetti Anna , Carrara Greta , Scirè Carlo Alberto , Iagnocco Annamaria , Filippou Georgios ,   the STARTER Investigators, Batticciotto Alberto , Floris Alberto , Bortoluzzi Alessandra , Gabba Alessandra , Gattamelata Angelica , Adinolfi Antonella , Raffeiner Bernd , Venditti Carlo , Mastaglio Claudio , Scioscia Crescenzio , Rossi Daniela , Bellis Emanuela , Luccioli Filippo , Cavatorta Francesco Paolo , Ceccarelli Fulvia , Sakellariou Garifallia , Cagnotto Giovanni , Farina Ilaria , Menza Luana , Idolazzi Luca , Canzoni Marco , Massarotti Marco , Focherini Maria Cristina , Caprioli Marta , Gutierrez Marwin , Draghessi Antonella , Piga Matteo , Muratore Maurizio , De Lucia Orazio , Rossini Paola , Macchioni Pierluigi , Ramonda Roberta , Rossi Daniela , Rossi Silvia , Di Sabatino Valentina , Picerno Valentina
Published: September 2022

Objective

This study is a sub-analysis from the patient cohort of the STARTER (Sonographic Tenosynovitis Assessment in RheumaToid arthritis patiEnts in Remission) study. The aim was to evaluate differences in ultrasound-detected joint and/or tendon involvement between patients receiving therapies based on a combination of conventional synthetic DMARDs (csDMARDs) and biologic DMARDs (bDMARDs) and those who were treated with either csDMARDs or bDMARDs in monotherapy.

Material and methods

Four hundred and twenty-seven consecutive patients with a diagnosis of RA were recruited between October 2013 and June 2014. They were divided into three subgroups based on their therapy at baseline: patients with bDMARD in monotherapy, patients with csDMARD in monotherapy and patients in combination therapy (csDMARD + bDMARD). At baseline, 6 months and 12 months, a clinical examination (28 joint count) and an ultrasound evaluation were performed in each patient. A score of grey-scale (GS) and power Doppler (PD) synovitis and tenosynovitis was calculated based on the OMERACT scoring systems.

Results

Two hundred and fifty-six patients completed the observation period: 48 patients from the bDMARD group (18.75%), 152 patients from the csDMARD group (59.38%) and 56 patients from csDMARD + bDMARD group (21.88%). The analysis showed that GS tenosynovitis and PD tenosynovitis are better controlled in combination therapy than they are with csDMARD alone (P = 0.025 and P = 0.047, respectively); for PD synovitis, there was a better response in those who were treated with the combination therapy when compared with the patients receiving csDMARD (P = 0.01) or bDMARD (P = 0.02) alone.

Conclusions

The analysis showed a lower prevalence of subclinical inflammatory manifestations detected with ultrasound imaging in those patients treated with the combination therapy than in those in monotherapy.
Multimodal Magnetic Resonance Imaging Depicts Widespread and Subregion Specific Anomalies in the Thalamus of Early-Psychosis and Chronic Schizophrenia Patients
Authors: Alemán-Gómez Yasser , Baumgartner Thomas , Klauser Paul , Cleusix Martine , Jenni Raoul , Hagmann Patric , Conus Philippe , Do Kim Q , Bach Cuadra Meritxell , Baumann Philipp S , Steullet Pascal
Published: September 2022

Background and Hypothesis

Although the thalamus has a central role in schizophrenia pathophysiology, contributing to sensory, cognitive, and sleep alterations, the nature and dynamics of the alterations occurring within this structure remain largely elusive. Using a multimodal magnetic resonance imaging (MRI) approach, we examined whether anomalies: (1) differ across thalamic subregions/nuclei, (2) are already present in the early phase of psychosis (EP), and (3) worsen in chronic schizophrenia (SCHZ).

Study Design

T1-weighted and diffusion-weighted images were analyzed to estimate gray matter concentration (GMC) and microstructural parameters obtained from the spherical mean technique (intra-neurite volume fraction [VFINTRA)], intra-neurite diffusivity [DIFFINTRA], extra-neurite mean diffusivity [MDEXTRA], extra-neurite transversal diffusivity [TDEXTRA]) within 7 thalamic subregions.

Results

Compared to age-matched controls, the thalamus of EP patients displays previously unreported widespread microstructural alterations (VFINTRA decrease, TDEXTRA increase) that are associated with similar alterations in the whole brain white matter, suggesting altered integrity of white matter fiber tracts in the thalamus. In both patient groups, we also observed more localized and heterogenous changes (either GMC decrease, MDEXTRA increase, or DIFFINTRA decrease) in mediodorsal, posterior, and ventral anterior parts of the thalamus in both patient groups, suggesting that the nature of the alterations varies across subregions. GMC and DIFFINTRA in the whole thalamus correlate with global functioning, while DIFFINTRA in the subregion encompassing the medial pulvinar is significantly associated with negative symptoms in SCHZ.

Conclusion

Our data reveals both widespread and more localized thalamic anomalies that are already present in the early phase of psychosis.
Abstract 27 Limitations of Current Human Cell, Tissue, and Cellular-based Product Donor Eligibility Guidance: Analyzing the Impact on a Large Public Cord Blood Bank
Authors: Guggenheim Dana S , Kurtzberg Joanne , Shaz Beth
Published: September 2022

Introduction

Cord blood (CB) is considered a human cell, tissue, and cellular-based product (HCT/P) by the U.S. Food and Drug Administration (FDA) and is licensed through a Biological Licensing Application (BLA). Cord blood units (CBUs) require less precise donor tissue matching than other stem cell sources, which increases their availability for racial/ethnic minorities. However, a small percentage of banked CBUs are used for transplants. Updating FDA donor eligibility guidance may expand licensed CBU supply and cord blood bank (CBB) sustainability.

Objective

The objectives of this study were to analyze the impact of Zika virus (ZIKV) donor screening recommendations on the licensing status of banked CBUs and to propose updated policy recommendations.

Methods

A retrospective analysis of Carolinas Cord Blood Bank (CCBB) data (from January 2016 to May 2022) was performed to describe CBU eligibility and shipment status. Qualitative comparisons of FDA guidance to reduce the risk of relevant communicable diseases were completed for blood versus HCT/P.

Results

CCBB: 8,877 banked CBUs from 2016-2022 (85.3% licensed; 14.7% unlicensed) (Table 1). 4,361 (49.1%) of CBUs were from Caucasian donors and 1,349 (15.2%) were from African American donors. 689 (52.7%) CBUs were unlicensed due to ZIKV risk. The number of CBUs with ZIKV risk banked annually has decreased significantly since 2020, with 174 ZIKV-risk CBUs in 2020 versus 63 in 2021. 26 unlicensed CBUs collected in 2016 or later have been infused versus 210 licensed CBUs. 7 unlicensed, infused CBUs had identified ZIKV risk. No ZIKV transmission was reported from these transplants. FDA Guidance: HCT/P ZIKV recommendations have not been updated since 2018 despite FDA removal of ZIKV from the relevant transfusion-transmitted infections in 2021. Recommendations for minimizing transfusion-transmission risk of human immunodeficiency virus (HIV) and variant Creutzfeldt-Jakob disease (vCJD) were updated in 2020 and 2022, respectively, to increase blood supply. New vCJD guidance eliminated geographic risk-related donor restrictions.

Discussion

Guidance for reducing disease transmission for blood and blood components have recently been updated to increase blood supply. The FDA must consider new data to revise the HCT/P donor screening recommendations. Adopting these changes will increase the number of HCT/P donors, the quantity of licensed CBUs, and potentially improve access to cellular therapies for a more diverse patient population.
Abstract 33 A Diverse and Sustainable State-Run Public Cord Blood Program
Authors: Wilt Kristen , Ober Charis , Garcia John , Botsford Jennifer
Published: September 2022

Introduction

The Arizona Public Cord Blood Program was created in 2011 by the Arizona Biomedical Research Centre, a subsection of the Arizona Department of Health Services, to advance the collection and increase the number of racially and ethnically diverse cord blood units available for transplantation, as well as to promote awareness of the benefits of cord blood stem cells through our educational partner, Save the Cord Foundation (STCF).

Objective

The main objective of this study was to create a sustainable program for women of all racial and ethnic backgrounds to have the opportunity to donate cord blood, with the primary goal of transplantation and the secondary goal of providing non-transplantable cord blood units for research. A second objective was to educate the residents of the state of Arizona about cord blood stem cells and the need for their preservation.

Methods

A portion of state lottery funds support the program monetarily. Those funds are provided to four partner collection hospitals employing "cord blood consenters," whose responsibility it is to consent patients, assist delivery providers with collections, and package and ship cord blood units to our partner cord blood bank at MD Anderson Cancer Center. There are also two clinical coordinators who educate and train hospital staff on quality collection practices, with special emphasis on the importance of high-volume, sterile collections. STCF provides education across the state to expectant parents, health care providers, schools, and the public about the need for cord blood stem cell donation for transplant and research.

Results

Since 2011, the Arizona Public Cord Blood Program has banked several hundreds of racially and ethnically diverse cord blood units with the National Marrow Donor Program (Figure 1) and has had 80 life-saving cord blood units matched with patients in need around the globe. This innovative program has expanded cord blood awareness and promoted the preservation of cord blood, and it also has resulted in the creation of an economic engine for the state of Arizona that is an attractant for STEM-based businesses and careers.

Discussion

A decade later, the Arizona Public Cord Blood Program has proven to be a sustainable model for collecting and providing suitable cord blood units for transplant to diverse patient populations.
Sertraline inhibits stress-induced tumor growth through regulating CD8+ T cell-mediated anti-tumor immunity
Authors: Zhou Shuang , Ye Di , Xia Hongwei , Xu Huanji , Tang Weiping , Tang Qiulin , Bi Feng
Published: September 2022

Chronic stress has been reported to be associated with tumor initiation and progression. But the underlying mechanism and the specific role of tumor immunity in this process are still unknown. Herein, we applied the repeated restrain stress model in C57BL/6J mice and found that the tumor growth in stressed mice was accelerated compared with that in control mice. In addition, serotonin, also called 5-hydroxytryptamine (5-HT), in the serum of stressed mice was also elevated. Sertraline, a selective serotonin reuptake inhibitor used in the clinic, can restore the serum 5-HT level in stressed mice and restrain tumor growth. We further explored the distribution of major immune cells, including B lymphocytes cells, T lymphocytes, natural killer cells, dendritic cells, tumor-associated macrophages (TAM) and regulatory T cells (Treg). We found that the infiltration of CD8+ T cells in the tumor microenvironment (TME) decreased significantly in stressed mice. And the extra 5-HT treatment could further decrease the infiltration of CD8+ T cells in the TME. The expression of IFN-γ and Granular enzyme B (GzmB) in CD8+ T cells were also dropped in the stressed mice group, whereas the expression of programmed cell death protein 1 (PD-1) on CD8+ T cells was increased. The T cell deficiency induced by stress can be reversed by sertraline, indicating its promising role in strengthening the efficacy of anti-PDL1/PD-1 immunotherapy. The present study provides new mechanistic insights into the impact of chronic stress on antitumor immunity and implicates a novel combined immunotherapy strategy for cancer patients with chronic stress.
Racial disparities in menopausal hormone therapy acceptance: a pilot study
Authors: Pershad Anita , Morris Joshua M. , Pace Diane , Khanna Pallavi
Published: September 2022

Objective

Previous studies provide little data on the role of race in acceptance and utilization of hormone therapy. Our primary objective was to examine differences in hormone therapy acceptance between self-reported racial groups, whereas our secondary objective was to assess patient comorbidities and reported symptom frequency at presentation in these cohorts in a menopause-focused care clinic.

Methods

We conducted a retrospective medical record review of patients presenting to a menopause clinic at an urban university-affiliated academic medical center in the Midsouth between July 2018 and July 2021. Statistical analysis was performed with Student t tests and odds ratios and P values ≤ 0.05 were considered statistically significant. During the 3-year study period, 113 patients presented with menopausal symptoms and were included in the study.

Results

The cohort's self-reported racial composition was 51% Black (58 patients), and 42% White (47), and 7% unknown/declined to answer (8). Of the 42 patients who presented to the clinic with a primary complaint of vasomotor symptoms, 55% (23 patients) accepted lifestyle modification therapy, and 45% (19 patients) accepted hormone therapy. Of 34 patients who presented with a primary complaint of vaginal dryness, 85% (29 patients) accepted the recommendation of moisturizers or lubricants, whereas only 15% (5) accepted vaginal hormone therapy. Of patients with vasomotor symptoms, 10 (25%) were excluded from eligibility for systemic hormone therapy due to medical comorbidities. Thirty-seven individuals were eligible for systemic hormone therapy; 18 (49%) White patients accepted hormone therapy; however, only 9 (24%) Black patients accepted with similar clinical criteria (P = 0.01). Black patients were 24% less likely to accept hormones for menopausal symptom management. The odds ratio was 0.24 (95% confidence interval, 0.09-0.64).

Conclusions

Our pilot study suggests a racial disparity in acceptance of both systemic and local hormonal therapy among perimenopausal and postmenopausal patients. The presence of racial disparity in acceptance of these treatment modalities can inform clinicians about patient factors affecting treatment choice for menopausal symptoms and opportunities to explore racial differences in quality of care.
Diagnostic Accuracy of Bronchoscopy Procedures
Authors: Gonzalez Anne V. , Ost David E. , Shojaee Samira
Published: September 2022

The field of diagnostic bronchoscopy has developed at an accelerated pace. Certain limitations have plagued the evaluation of advanced bronchoscopy techniques, including the use of inconsistently defined measures of diagnostic accuracy, and confusion around the definition of “diagnostic yield.” This methodological review outlines standard measures of diagnostic accuracy and highlights how these differ from “diagnostic yield.” We draw examples from the interventional bronchoscopy literature to illustrate key concepts and potential pitfalls.
Effect of Laughter Therapy on Mood Disturbances, Pain, and Burnout in Terminally Ill Cancer Patients and Family Caregivers
Authors: Moon Hee , Journ Songjah , Lee Seonah
Published: September 2022

Background

Humor has been commonly used in palliative care and identified as a coping strategy of palliative care patients and family caregivers. However, the use of humor or laughter in palliative care settings is still limited.

Objective

The aim of this study was to examine the effect of laughter therapy involving spontaneous laughter on mood disturbances and pain in terminally ill patients with cancer and mood disturbances and the levels of burnout in family caregivers.

Methods

This quasi-experimental study used a nonequivalent control group pretest-posttest design. The laughter therapy developed was provided for 20 to 30 minutes a day for 5 consecutive days. Twenty-six pairs of terminally ill cancer patients and family caregivers in the intervention group and 23 pairs in the comparison group from the hospice ward of a tertiary teaching hospital participated in this study. The data were collected using structured questionnaires and analyzed using descriptive statistics and 2-way repeated-measures analysis of variance.

Results

There were significant decreases in mood disturbances in the patients (P < .001) and family caregivers (P < .001), pain in the patients (P < .001), and levels of burnout in the caregivers (P < .001) in the intervention group.

Conclusion

Laughter therapy can be an alternative intervention to support both terminally ill patients with cancer and their family caregivers experiencing multidimensional distress in palliative care settings.

Implications for Practice

The appropriate use of laughter or humor therapy needs to be encouraged as a support tool in palliative care. Palliative care teams must be properly trained to provide spontaneous laughter therapy or planned humor therapy.
Prognostic and Goals-of-Care Communication in the PICU: A Systematic Review
Authors: McSherry Megan L. , Rissman Lauren , Mitchell Riley , Ali-Thompson Sherlissa , Madrigal Vanessa N. , Lobner Katie , Kudchadkar Sapna R.
Published: September 2022

OBJECTIVE:

Admission to the PICU may result in substantial short- and long-term morbidity for survivors and their families. Engaging caregivers in discussion of prognosis is challenging for PICU clinicians. We sought to summarize the literature on prognostic, goals-of-care conversations (PGOCCs) in the PICU in order to establish current evidence-based practice, highlight knowledge gaps, and identify future directions.

DATA SOURCES:

PubMed (MEDLINE and PubMed Central), EMBASE, CINAHL, PsycINFO, and Scopus.

STUDY SELECTION:

We reviewed published articles (2001–2022) that examined six themes within PGOCC contextualized to the PICU: 1) caregiver perspectives, 2) clinician perspectives, 3) documentation patterns, 4) communication skills training for clinicians, 5) family conferences, and 6) prospective interventions to improve caregiver-clinician communication.

DATA EXTRACTION:

Two reviewers independently assessed eligibility using Preferred Reporting Items for Systematic Reviews and Meta-Analysis methodology.

DATA SYNTHESIS:

Of 1,420 publications screened, 65 met criteria for inclusion with several key themes identified. Parent and clinician perspectives highlighted the need for clear, timely, and empathetic prognostic communication. Communication skills training programs are evaluated by a participant’s self-perceived improvement. Caregiver and clinician views on quality of family meetings may be discordant. Documentation of PGOCCs is inconsistent and most likely to occur shortly before death. Only two prospective interventions to improve caregiver-clinician communication in the PICU have been reported. The currently available studies reflect an overrepresentation of bereaved White, English-speaking caregivers of children with known chronic conditions.

CONCLUSIONS:

Future research should identify evidence-based communication practices that enhance caregiver-clinician PGOCC in the PICU and address: 1) caregiver and clinician perspectives of underserved and limited English proficiency populations, 2) inclusion of caregivers who are not physically present at the bedside, 3) standardized communication training programs with broader multidisciplinary staff inclusion, 4) improved design of patient and caregiver educational materials, 5) the development of pediatric decision aids, and 6) inclusion of long-term post-PICU outcomes as a measure for PGOCC interventions.
Effect of Prearrival Orders on Time to Antibiotics for Immunocompromised Oncology Patients Presenting to the Emergency Department With Fever
Authors: Carolan Patrick L. , Lammers Shea M. , Anderson Cynthia M. , Messinger Yoav H.
Published: September 2022

Objective

Pediatric cancer patients with fever are at risk for invasive bacterial infection. The administration of antibiotics to these patients within the first hour of evaluation is viewed as a quality of care metric with potential to improve outcome. We sought to evaluate the impact of prearrival patient orders on the timeliness of antibiotic administration for this patient population presenting to the emergency department (ED) because of fever.

Methods

A single-site pediatric ED intervention study was performed. Four hundred thirty-nine consecutively referred febrile immunocompromised pediatric oncology patients were included in the study. The intervention used structured monthly messages sent to oncology and emergency medicine providers highlighting specific roles in prehospital communication and in ED-based care emphasizing the use of standardized, prearrival order (PAO) sets. Primary outcome measures were time to antibiotic administration (TTA) and the proportions of patients receiving PAO placement and antibiotics within 60 minutes of ED arrival. Results were analyzed for the preintervention (September 2016–July 2017), intervention (August 2017–February 2018), and postintervention (March–December 2018) periods.

Results

Improvements occurred across the study periods in the proportion of patients with PAO placement (preintervention, 68%; intervention, 82%; postintervention, 87%; P = 0.001) as well as in the percentages of patients receiving antibiotics in less than 60 minutes (preintervention, 73%; intervention, 84%; postintervention, 85%; P = 0.02). Median TTA decreased from 48 to 40 minutes (P = 0.018). Linear regression with TTA as a dependent variable revealed that PAO placement predicted a shorter TTA, decreasing by more than 15 minutes (B = −15.90; [95% confidence interval, −20.03–−11.78]; P < 0.001).

Conclusions

Standardizing elements of prehospital communication and ED-based care using PAO sets resulted in significant improvements in time to antibiotics and in the proportion of febrile immunocompromised oncology patients receiving antibiotics within 60 minutes of ED arrival.
Physiological Response to the 6-Minute Frame Running Test in Children and Adults With Cerebral Palsy
Authors: Edelman Bos Arnoud M. M. , Hjalmarsson Emma , Dallmeijer Annet J. , Fernandez-Gonzalo Rodrigo , Buizer Annemieke I. , Pingel Jessica , Pontén Eva , von Walden Ferdinand , van Schie Petra E. M.
Published: September 2022

Purpose:

To determine the physiological response and association to peak oxygen uptake of the 6-minute Frame Running test (6-MFRT) in persons with cerebral palsy (CP).

Methods:

Twenty-four participants with CP, Gross Motor Function Classification System II/III/IV, performed the 6-MFRT. Distance, peak heart rate (HRpeak), peak respiratory exchange ratio (RERpeak), and peak oxygen uptake (

O2peak) were measured.

Results:

HRpeak ranged from 146 to 201 beats per minute, RERpeak from 0.94 to 1.49, 6-MFRT distance from 179 to 1220 m and

O2peak from 0.62 to 2.18 L/min. HRpeak was achieved in 63%, RERpeak in 71%. A strong correlation was observed between 6-MFRT and

O2peak.

Conclusions:

The 6-MFRT represented a (near) maximum effort for 75% of the participants and the 6-MFRT can be used to estimate oxygen consumption on an individual basis.
Evolution in Parental Leave Policies: Plastic Surgery and Obstetrics & Gynecology Lead the Way
Authors: Kasemodel Kaitlyn , Hemal Kshipra , Chen Wendy , Wallace Chelsea , Bourne Debra A
Published: September 2022

Background:

Forty percent of physicians anticipate becoming parents during residency. This often occurs in the absence of clear parental leave and breastfeeding policies, which may adversely impact parental and child health or jeopardize residents’ board eligibility, fellowship, and job prospects. This study reports on the current status of parental leave and breastfeeding policies across all specialties.

Methods:

Twenty-six specialties recognized by the Accreditation Council on Graduate Medical Education (ACGME) were included. The maximum leave allowed in 2020 and breastfeeding accommodations during board examinations were collected for each specialty. Change in leave since 2006, 2018, and breastfeeding accommodations were analyzed by specialty.

Results:

In 2020, the median time allowed for parental leave without the extension of training was five weeks and there was no significant difference between 2006, 2018, and 2020 (p=0.58). In 2020, Plastic Surgery and Obstetrics/Gynecology provided the longest parental leave at 12 weeks. Surgical specialties provided one additional week of leave as compared to medical specialties after adjusting for year (p=0.02). Twenty-one (81%) specialties allowed additional time for lactation during board examinations, however only seven (27%) guaranteed a private location to pump.

Conclusion:

There has been little improvement in parental leave allowances since 2006 and the current median, five weeks, falls short of guidelines recommending 6-12 weeks following the birth of a child. Starting in July 2021, the ACGME will require medical boards to provide a minimum of six weeks of leave. Ongoing improvement in culture and policy are needed to support residents and their families.
“Videofluorographic analysis of swallowing function after total glossolaryngectomy.”
Authors: Kadota Hideki , Shimamoto Ryo , Fukushima Seita , Ikemura Ko , Kamizono Kenichi , Hanada Masuo , Yoshida Sei , Fukushima Junichi , Yasumatsu Ryuji , Nakagawa Takashi
Published: September 2022

Previously, surgeons believed that after total glossolaryngectomy (TGL), swallowing is mainly dependent on gravity. However, swallowing function after TGL varies widely between patients, and a thorough analysis is lacking. We aimed to clarify the post-TGL swallowing function and determine whether it is primarily dependent on gravity. We retrospectively analyzed videofluorographic examinations (VFs) of patients who underwent TGL and free or pedicle flap reconstruction. We enrolled 20 patients (male, n=12; mean age, 61 years; age range, 43 to 89 years). All patients demonstrated constriction of the reconstructed pharynx to some degree, and no patient’s ability to swallow was dependent on gravity alone. VF showed excellent barium clearance in eight patients and poor clearance in 12. All patients with excellent clearance showed strong constriction of the posterior pharyngeal wall, whereas only 8.3% of the patients with poor clearance showed adequate constriction, which was significantly different (p=0.0007). Velopharyngeal closure and lip closure also contributed significantly to excellent clearance (p=0.041). The shape of the reconstructed pharynx (depressed, flat, protuberant) showed no statistically significant association with excellent clearance. Contrary to our previous understanding, the constriction of the remnant posterior pharyngeal wall played an important role in post-TGL swallowing, and gravity played a secondary role. Dynamic posterior pharyngeal wall movement might result from the increased power of the pharyngeal constrictor muscle and compensate for the immobility of the transferred flap. A well-functioning pharyngeal constrictor muscle and complete velopharyngeal and lip closures can contribute to excellent barium clearance in patients after TGL.
Risk Factors for Partial Flap Loss in a Free Flap: A 12-Year Retrospective Study of Anterolateral Thigh Free Flap in 303 Lower Extremity Cases
Authors: Min Kyunghyun , Hong Joon Pio , Suh Hyunsuk Peter
Published: September 2022

Background:

Despite remarkable improvements in free flap procedures, partial flap losses in perforator flap still occur. This study aimed to analyze partial necrosis cases which underwent reconstruction of the lower extremities using anterolateral thigh (ALT) free flaps and identifies risk factors causing the occurrence of partial necrosis.

Methods:

From January 2005 to February 2017, 303 ALT free flaps were retrospectively analyzed. After collecting patient’s data, receiver operating characteristic (ROC) curve was conducted to find the critical distance between the perforator and the flap margin which distinguishes incidence of partial necrosis. Also, the rate of partial losses was calculated for each section after dividing the distance from the perforator to the flap margin into 1cm sections. Lastly, logistic regression analyses were performed to identify the risk factors.

Results:

43 cases had partial flap losses (14.19%). Flaps with supra-deep fat layer elevation showed the highest rate of partial necrosis (25.53 %) with statistical significance (p = 0.0001). In ROC curve, the cut-off distance was 10.25 cm. In addition, flap tissues 8 cm away from the perforator have a 10.3 % chance of necrosis, whereas those 12 cm away from the perforator have a 22.9 % chance. Lastly, supra-deep fat layer elevation (OR: 3.952) and large flap dimension (OR: 1.041) were risk factors of partial flap necrosis on multivariate analysis.

Conclusions:

The distance from perforator to flap margin, flap elevation layer, and flap dimension affected the occurrence of partial necrosis. Taking these into consideration, ALT free flap of appropriate size and thickness should be harvested.