bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of procedure type on revisional surgery and secondary reconstruction after immediate breast reconstruction in a population-based cohort
Authors: Johnson Leigh , White Paul , Holcombe Chris , O’Donoghue Joe , Jeevan Ranjeet , Browne John , Fairbrother Patricia , MacKenzie Mairead , Gulliver-Clarke Carmel , Mohiuddin Syed , Hollingworth Will , Potter Shelley
Published: March 2023

Background

Women considering immediate breast reconstruction require high-quality information about the likely need for secondary reconstruction and the long-term risk of revisional surgery to make fully informed decisions about different reconstructive options. Such data are currently lacking. This study aimed to explore the impact of reconstruction type on the number of revisions and secondary reconstructions performed 3, 5, and 8 years after immediate breast reconstruction in a large population-based cohort.

Methods

Women undergoing unilateral mastectomy and immediate breast reconstruction for breast cancer or ductal carcinoma in situ in England between 1 April 2009 and 31 March 2015 were identified from National Health Service Hospital Episode Statistics. Numbers of revisions and secondary reconstructions in women undergoing primary definitive immediate breast reconstruction were compared by procedure type at 3, 5, and 8 years after index surgery.

Results

Some 16 897 women underwent immediate breast reconstruction with at least 3 years’ follow-up. Of these, 14 069 had a definitive reconstruction with an implant only (5193), latissimus dorsi flap with (3110) or without (2373) an implant, or abdominal free flap (3393). Women undergoing implant-only reconstruction were more likely to require revision, with 69.5 per cent (747 of 1075) undergoing at least one revision by 8 years compared with 49.3 per cent (1568 of 3180) in other reconstruction groups. They were also more likely to undergo secondary reconstruction, with the proportion of women having further reconstructive procedures increasing over time: 12.8 per cent (663 of 5193) at 3 years, 14.3 per cent (535 of 3752) at 5 years, and 17.6 per cent (189 of 1075) at 8 years.

Conclusion

Long-term rates of revisions and secondary reconstructions were considerably higher after primary implant-based reconstruction than autologous procedures. These results should be shared with patients to support informed decision-making.
Cognitive training, but not EEG-neurofeedback, improves working memory in healthy volunteers
Authors: Barbazzeni Beatrice , Speck Oliver , Düzel Emrah
Published: March 2023

Working memory performance can be influenced by motivational factors, which may be associated with specific brain activities, including suppression of alpha oscillations. We investigated whether providing individuals online feedback about their ongoing oscillations (EEG-neurofeedback) can improve working memory under high and low reward expectancies. We combined working memory training with neurofeedback to enhance alpha suppression in a monetary-rewarded delayed match-to-sample task for visual objects. Along with alpha, we considered the neighbouring theta and beta bands. In a double-blind experiment, individuals were trained over 5 days to suppress alpha power by receiving real-time neurofeedback or control neurofeedback (placebo) in reward and no-reward trials. We investigated (i) whether neurofeedback enhances alpha suppression, (ii) whether monetary reward enhances alpha suppression and working memory, and (iii) whether any performance benefits of neurofeedback-training would transfer to unrelated cognitive tasks. With the same experimental design, we conducted two studies with differing instructions given at the maintenance, yielding together 300 EEG recording sessions. In Study I, participants were engaged in a mental calculation task during maintenance. In Study II, they were instructed to visually rehearse the sample image. Results from Study I demonstrated a significant training and reward-anticipation effect on working memory accuracy and reaction times over 5 days. Neurofeedback and reward anticipation showed effects on theta suppression but not on alpha suppression. Moreover, a cognitive training effect was observed on beta suppression. Thus, neurofeedback-training of alpha was unrelated to working memory performance. Study II replicated the training and reward-anticipation effect on working memory but without any effects of neurofeedback-training on oscillations or working memory. Neither study showed transfer effects of either working memory or neurofeedback-training. A linear mixed-effect model analysis of neurofeedback-independent training-related improvement of working memory combining both studies showed that improved working memory performance was related to oscillatory changes over training days in the encoding and maintenance phases. Improvements in accuracy were related to increasing beta amplitude in reward trials over right parietal electrodes. Improvements in reaction times were related to increases in right parietal theta amplitude during encoding and increased right parietal and decreased left parietal beta amplitudes during maintenance. Thus, while our study provided no evidence that neurofeedback targeting alpha improved the efficacy of working memory training or evidence for transfer, it showed a relationship between training-related changes in parietal beta oscillations during encoding and improvements in accuracy. Right parietal beta oscillations could be an intervention target for improving working memory accuracy.
PLAGL2 promotes Snail expression and gastric cancer progression via UCA1/miR-145-5p/YTHDF1 axis
Authors: Chen Wen , He Qunjun , Liu Jingjing , Li Ni , Xiao Kai , Chen Honghui
Published: March 2023

Objectives

Although great progress has made in gastric cancer (GC) in the past years, the overall 5-year survival rate remains to be low for advanced GC patients. A recent study showed that PLAGL2 was increased in GC and enhanced the proliferation and metastasis of GC. Nevertheless, the underlying mechanism still needs to be investigated.

Methods

Gene and protein expressions were assessed using RT-qPCR and western blot. The migration, proliferation and invasion of GC cells were examined using scratch assay, CCK-8 assay and Transwell assay, respectively. ChIP-PCR, dual-luciferase assay, RIP-qPCR and CoiP were utilized to confirm the interaction among PLAGL2, UCA1, miR-145-5p and YTHDF1 as well as METTL3, YTHDF1 and eEF-2. A mouse xenograft model was used utilized to further confirm the regulatory network.

Results

PLAGL2 bound to the upstream promoter of UCA1, which regulated YTHDF1 by sponging miR-145-5p. METTL3 can mediate the m6A modification level of Snail. YTHDF1 recognized m6A-modified Snail by interacting with eEF-2 and thus promoted Snail expression, which eventually induced epithelial-mesenchymal transition (EMT) in GC cells and metastasis of GC.

Conclusions

Overall, our study demonstrates that PLAGL2 enhances Snail expression and GC progression via the UCA1/miR-145-5p/YTHDF1 axis, suggesting that PLAGL2 may become a therapeutic target for GC treatment.
Paediatric dermatology teleconsultations: a survey of healthcare professionals in the UK
Authors: McCusker Sarah , King Stokes Natalie , Hunjan Manrup , Daly Aoife , George Susannah , Solman Lea , Burden-Teh Esther
Published: March 2023

The COVID-19 pandemic catapulted dermatology services into a digital era, with the rapid introduction of teleconsultations. The UK National Health Service operational planning guidance recommends ≥ 25% of consultations are delivered remotely. There is a lack of data regarding the acceptability and effectiveness of paediatric dermatology teleconsultations. We surveyed UK healthcare professionals (HCPs) to explore their experiences of teleconsultations in paediatric dermatology, with a focus on follow-up consultations for paediatric eczema (PE), to inform a future clinical trial. There were 119 responses. Pre-pandemic, 37% provided some form of teleconsultation service, rising to 92% post-pandemic. In total, 41% (n = 49) now carry out > 25% of consultations remotely. We found 55% felt teleconsultations were less effective than face-to-face ones for PE follow-up. Eighty HCPs offered teleconsultations for PE. Among the HPCs who offered teleconsultations for PE, the most effective format for follow-up consultations was felt to be telephone with photographs (52/80, 65%). Our results demonstrate varying opinion on the effectiveness and optimal format of paediatric teleconsultations, supporting the need for further research.
Evaluation of Acebilustat, a Selective Inhibitor of Leukotriene B4 Biosynthesis, for Treatment of Outpatients With Mild-Moderate Coronavirus Disease 2019: A Randomized, Double-Blind, Placebo-Controlled Phase 2 Trial
Authors: Levitt Joseph E , Hedlin Haley , Duong Sophie , Lu Di , Lee Justin , Bunning Bryan , Elkarra Nadia , Pinsky Benjamin A , Heffernan Eileen , Springman Eric , Moss Richard B , Bonilla Hector F , Parsonnet Julie , Zamanian Roham T , Langguth Jamison J , Bollyky Jenna , Khosla Chaitan , Nicolls Mark R , Desai Manisha , Rogers Angela J
Published: March 2023

Background

The vast majority of coronavirus disease 2019 (COVID-19) disease occurs in outpatients where treatment is limited to antivirals for high-risk subgroups. Acebilustat, a leukotriene B4 inhibitor, has potential to reduce inflammation and symptom duration.

Methods

In a single-center trial spanning Delta and Omicron variants, outpatients were randomized to 100 mg/d of oral acebilustat or placebo for 28 days. Patients reported daily symptoms via electronic query through day 28 with phone follow-up on day 120 and collected nasal swab samples on days 1–10. The primary outcome was sustained symptom resolution to day 28. Secondary 28-day outcomes included time to first symptom resolution, area under the curve (AUC) for longitudinal daily symptom scores, duration of viral shedding through day 10, and symptoms on day 120.

Results

Sixty participants were randomized to each study arm. At enrollment, the median duration was 4 days (interquartile range, 3–5 days), and the median number of symptoms was 9 (7–11). Most patients (90%) were vaccinated, with 73% having neutralizing antibodies. A minority of participants (44%; 35% in the acebilustat arm and 53% in placebo) had sustained symptom resolution at day 28 (hazard ratio, 0.6 [95% confidence interval, .34–1.04]; P = .07 favoring placebo). There was no difference in the mean AUC for symptom scores over 28 days (difference in mean AUC, 9.4 [95% confidence interval, −42.1 to 60.9]; P = .72). Acebilustat did not affect viral shedding or symptoms at day 120.

Conclusions

Sustained symptoms through day 28 were common in this low-risk population. Despite this, leukotriene B4 antagonism with acebilustat did not shorten symptom duration in outpatients with COVID-19.

Clinical Trials Registration. NCT04662060.
Role of Cerebral Imaging on Diagnosis and Management in Patients With Suspected Infective Endocarditis
Authors: Papadimitriou-Olivgeris Matthaios , Guery Benoit , Ianculescu Nicoleta , Dunet Vincent , Messaoudi Yosra , Pistocchi Silvia , Tozzi Piergiorgio , Kirsch Matthias , Monney Pierre
Published: March 2023

Background

Cerebral embolic events (CEEs) are common complications of infective endocarditis (IE), and their presence can modify diagnosis and therapeutic plans. The aim of the present study was to assess the role of cerebral imaging (Cer-Im) on diagnosis and management of patients with suspected IE.

Methods

This study was conducted at the Lausanne University Hospital, Lausanne, Switzerland, from January 2014 to June 2022. CEEs and IE were defined according to modified Duke criteria of the European Society of Cardiology (ESC) guidelines.

Results

Among 573 patients with IE suspicion and Cer-Im, 239 (42%) patients had neurological symptoms. At least 1 CEE was found in 254 (44%) episodes. Based on Cer-Im findings, episodes were reclassified from rejected to possible or from possible to definite IE in 3 (1%) and 25 (4%) patients, respectively (0% and 2% in asymptomatic patients, respectively). Among the 330 patients with possible or definite IE, at least 1 CEE was found in 187 (57%) episodes. A new surgical indication (in association with left-side vegetation >10 mm) was established in 74/330 (22%) IE patients and 30/155 (19%) asymptomatic IE patients, respectively.

Conclusions

Cer-Im in asymptomatic patients with IE suspicion showed limited potential for improving the diagnosis of IE. In contrast, performing Cer-Im in asymptomatic patients with IE may be useful for decision making, because Cer-Im findings led to the establishment of new operative indication for valvular surgery in one fifth of patients according to ESC guidelines.
Resource and seasonality drive interspecific variability in simulations from a dynamic energy budget model
Authors: Mariño Joany , Dufour Suzanne C , Hurford Amy , Récapet Charlotte
Published: March 2023

Animals show a vast array of phenotypic traits in time and space. Such variation patterns have traditionally been described as ecogeographical rules; for example, the tendency of size and clutch size to increase with latitude (Bergmann's and Lack's rules, respectively). Despite considerable research into these variation patterns and their consequences for biodiversity and conservation, the processes behind trait variation remain controversial. Here, we show how food variability, largely set by climate and weather, can drive interspecific trait variation by determining individual energy input and allocation trade-offs. Using a dynamic energy budget (DEB) model, we simulated different food environments, as well as interspecific variability in the parameters for energy assimilation, mobilization and allocation to soma. We found that interspecific variability is greater when the resource is non-limiting in both constant and seasonal environments. Our findings further show that individuals can reach larger biomass and greater reproductive output in a seasonal environment than in a constant environment of equal average resource due to the peaks of food surplus. Our results agree with the classical patterns of interspecific trait variation and provide a mechanistic understanding that supports recent hypotheses which explain them: the resource and the eNPP (net primary production during the growing season) rules. Due to the current alterations to ecosystems and communities, disentangling the mechanisms of trait variation is increasingly important to understand and predict biodiversity dynamics under climate change, as well as to improve conservation strategies.
Identification of volatile compounds from fruits aroma and citrus essential oils and their effect on oviposition of Ceratitis capitata (Diptera: Tephritidae)
Authors: Antonatos Spyridon , Anastasaki Eirini , Balayiannis George , Michaelakis Antonios , Magiatis Prokopios , Milonas Panagiotis , Papadopoulos Nikolaos T , Papachristos Dimitrios P
Published: March 2023

Ceratitis capitata (Wiedemann), also known as the Mediterranean fruit fly, is one of the most serious pests for several fresh fruit commodities causing extensive fruit losses worldwide. The response of C. capitata adults to fruit and nonfruit volatiles has been extensively studied. However, the linkage between fruit volatiles and the female ovipositional choice has not been fully elucidated. The present study focused on identifying the volatile organic compounds emitted by detached intact fresh fruits (oranges, lemons, bergamots, and apples) and citrus essential oils and evaluate their effect on Mediterranean fruit fly oviposition. There were more than 130 and 45 volatiles compounds detected in fruits odors and citrus essential oils, respectively. The volatile profile of fruits was dominated either from terpenes and terpenoids or from esters of butanoic, hexanoic, and octanoic acids while limonene was by far the most abundant compound in all citrus essential oils. Oviposition of C. capitata was strongly affected by volatiles emanated from both intact fruit and the citrus essential oils. Regarding the volatiles of the intact fruits, the odor of sweet orange elicited strong oviposition responses to females, while bergamot had the least stimulatory effect on oviposition. Bergamot oil also elicited the least oviposition stimulation compared to sweet orange and lemon essential oils. Our discussion elaborates on the role of fruit volatiles on host finding behavior and fruit susceptibility to C. capitata infestation and includes possible practical implication of the above findings.
A step to the left? Gender ideologies and political party identification in Germany
Authors: Diabaté Sabine , Grunow Daniela , Braack Mirko
Published: March 2023

After decades in which gender relations, as anchored in work-family policies and egalitarian gender ideologies, moved towards greater equality, the status quo is currently being challenged. Gender-ambivalent ideologies have spread in both the political and private realms. It is unclear how the rise in gender-ambivalence documented in current research relates to party identification. On the one hand, gender ambivalence may represent a variation of post-materialist liberal values corresponding with support for centre-left parties in Germany. On the other, ambivalence may reflect a modified form of traditionalism and thus, a step to the left among voters leaning towards right-wing and conservative parties. This paper uses the Leitbild Survey 2012 to provide empirical evidence to fill this research gap. In line with cross-national research, latent class analyses reveal four main gender ideologies among young Germans: unidimensional ‘egalitarian’ and ‘moderate traditional’, as well as ambivalent, multidimensional ‘secondary earner’, and ‘intensive parenting’. Multinomial regression models show that egalitarian class members identify with centre-left parties while members of the ambivalent, multidimensional secondary earner, and intensive parenting classes as well as those of the moderate traditional class identify more strongly with centre-right parties. In light of the broader literature on gender ideology change, which documents a steep decline in traditionalism, our cross-sectional findings may be interpreted as capturing a step to the left among voters leaning towards right-wing and conservative parties in Germany, who now accept new mothers combining care-giving and part-time-work.
Cardiovascular outcomes in patients with atrial fibrillation concomitantly treated with antiarrhythmic drugs and non-vitamin k antagonist oral anticoagulants
Authors: Wu Victor Chien-Chia , Wang Chun-Li , Huang Yu-Chang , Tu Hui-Tzu , Huang Yu-Tung , Huang Chien-Hao , Chen Shao-Wei , Kuo Chang-Fu , Hung Kuo-Chun , Chang Shang-Hung
Published: March 2023

Aims

Limited data compared antiarrhythmic drugs (AADs) with concomitant non-vitamin K antagonist oral anticoagulants in atrial fibrillation patients, hence the aim of the study.

Methods and results

National health insurance database were retrieved during 2012–17 for study. We excluded patients not taking AADs, bradycardia, heart block, heart failure admission, mitral stenosis, prosthetic valve, incomplete demographic data, and follow-up <3 months. Outcomes were compared in Protocol 1, dronedarone vs. non-dronedarone; Protocol 2, dronedarone vs. amiodarone; and Protocol 3, dronedarone vs. propafenone. Outcomes were acute myocardial infarction (AMI), ischaemic stroke/systemic embolism, intracranial haemorrhage (ICH), major bleeding, cardiovascular death, all-cause mortality, and major adverse cardiovascular event (MACE) (including AMI, ischaemic stroke, and cardiovascular death). In Protocol 1, 2298 dronedarone users and 6984 non-dronedarone users (amiodarone = 4844; propafenone = 1914; flecainide = 75; sotalol = 61) were analysed. Dronedarone was associated with lower ICH (HR = 0.61, 95% CI = 0.38–0.99, P = 0.0436), cardiovascular death (HR = 0.24, 95% CI = 0.16–0.37, P < 0.0001), all-cause mortality (HR = 0.33, 95% CI = 0.27–0.42, P < 0.0001), and MACE (HR = 0.56, 95% CI = 0.45–0.70, P < 0.0001). In Protocol 2, 2231 dronedarone users and 6693 amiodarone users were analysed. Dronedarone was associated with significantly lower ICH (HR = 0.53, 95%=CI 0.33–0.84, P = 0.0078), cardiovascular death (HR = 0.20, 95% CI = 0.13–0.31, P < 0.0001), all-cause mortality (HR 0.27, 95% CI 0.22–0.34, P < 0.0001), and MACE (HR = 0.53, 95% CI = 0.43–0.66, P < 0.0001), compared with amiodarone. In Protocol 3, 812 dronedarone users and 2436 propafenone users were analysed. There were no differences between two drugs for primary and secondary outcomes.

Conclusion

The use of dronedarone with NOACs was associated with cardiovascular benefits in an Asian population, compared with non-dronedarone AADs and amiodarone.
Digest: Recreating ancestral trait variation to understand adaptation
Authors: Gross Karin
Published: March 2023

Two highly correlated anther traits affect pollination efficacy in a wild radish population. Does the strength and type of selection on these traits differ through male and female fitness with increased ancestral trait variation? Waterman et al. (2023) found stabilizing selection on one trait and disruptive selection on the other trait, with no difference between male and female fitness. Such quantifications of selection in populations with the increased variation that reflects ancestral trait variation provide insights into processes of trait adaptation.
The Sphere of Semiadditive Height 1
Authors: Yuan Allen
Published: March 2023

We construct a lift of the $p$-complete sphere to the universal height $1$ higher semiadditive stable $\infty $-category of Carmeli–Schlank–Yanovski, providing a counterexample, at height $1$, to their conjecture that the natural functor $ _n \to \operatorname{\textrm{Sp}}_{T(n)}$ is an equivalence. We then record some consequences of the construction, including an observation of Schlank that this gives a conceptual proof of a classical theorem of Lee on the stable cohomotopy of Eilenberg–MacLane spaces.
Correlations of Multiplicative Functions with Coefficients of Automorphic L-Functions
Authors: Jiang Yujiao , Lü Guangshi
Published: March 2023

Let $\lambda _{\phi }(n)$ be the Fourier coefficients of a Hecke holomorphic or Hecke–Maass cusp form on $\textrm{SL}_{2}(\mathbb Z)$ and $f$ be any multiplicative function that satisfies two mild hypotheses. We establish a nontrivial upper bound for the correlation $\sum _{n \leq X}f(n)\lambda _{\phi }(n+h)$ uniformly in $0<|h|\leq X$. As applications, we consider some special cases, including $f(n)=\lambda _{\pi }(n), \,\mu (n)\lambda _{\pi }(n)$ and any divisor-bounded multiplicative function. Here, $\lambda _{\pi }(n)$ denotes the $n$-th Dirichlet coefficient of a $\textrm{GL}_{m}$ automorphic $L$-function $L(s,\pi )$ for an irreducible cuspidal automorphic representation $\pi $, and $\mu (n)$ denotes the Möbius function. In particular, nontrivial savings are achieved for shifted convolution problems on $\textrm{GL}_{m}\times \textrm{GL}_{2}\, (m\geq 4)$ and Hypothesis C of Iwaniec–Luo–Sarnak for the first time.
Characterization of a novel carbapenem-hydrolysing β-lactamase OXA-1041 in Escherichia coli
Authors: Wu Shikai , Feng Yu , Yang Yongqiang , Zhu Kairong , Wang Siyao , Wang Xinyue , Li Guo-Bo , Zong Zhiyong
Published: March 2023

Background

We found a carbapenem-resistant Escherichia coli without known carbapenemase-encoding genes and performed a study to identify the possible new carbapenemase.

Methods

The production of carbapenemase was examined using the modified carbapenem inactivation method. The strain was subjected to short- and long-read genome sequencing and the complete genome was obtained by hybrid assembly. The gene encoding a potential new OXA-type carbapenemase was cloned. The enzyme was purified and was then subjected to kinetic assays. Molecular docking analysis of the enzyme was performed using the MOE software suite. Mating experiments were attempted to obtain the plasmid carrying the corresponding gene.

Results

We identified and characterized a novel class D carbapenem-hydrolysing β-lactamase, OXA-1041, in a carbapenem-resistant E. coli clinical strain. OXA-1041 had 89.77% (237/264) amino acid identity with OXA-427, a known carbapenemase. By cloning in an E. coli laboratory strain, blaOXA-1041 was found to reduce susceptibility to ertapenem by 16 times (MIC 0.25 versus 0.016 mg/L) and meropenem by four times (MIC 0.06 versus 0.016 mg/L) but did not significantly reduce susceptibility to imipenem and doripenem. Enzyme kinetic measurement of purified OXA-1041 showed that OXA-1041 could hydrolyse ertapenem and meropenem with a turnover number (kcat)/Michaelis constant (KM) of 8.57 and 3.63 mM−1s−1, respectively. The complete genome contained a single plasmid (223 341 bp, IncF, containing five replicons), which was self-transmissible. blaOXA-1041 was downstream of insertion sequence ISCR1 and there were three tandem copies of ISCR1-blaOXA-1041-creDΔ (encoding an envelope protein) on this plasmid.

Conclusions

The above findings suggest OXA-1041 is a new plasmid-encoded carbapenemase with preferential activity against ertapenem.
Expert consensus on monitoring antimicrobial stewardship in French nursing homes using assessed reimbursement database indicators
Authors: Asquier-Khati Antoine , Deschanvres Colin , Chaslerie Anicet , Pereira Ouarda , Boutoille David , Birgand Gabriel
Published: March 2023

Objectives

Monitoring the appropriateness of antibiotic prescriptions with indicators based on reimbursement data is required to guide antibiotic stewardship (AMS) interventions in nursing homes (NHs). Quantity metrics (QMs) monitor the volume of prescriptions while proxy indicators (PIs) reflect the appropriateness of antibiotic use. Our objectives were: (i) to provide a relevant consensual set of indicators to be used in French NHs; and (ii) to assess the feasibility of their implementation at the national and local scale.

Methods

Nine French professional organizations implicated in AMS in NHs were asked to nominate at least one member to create a national expert panel of 20 physicians. Twenty-one recently published QMs and 11 PIs were assessed by the expert panel. Indicators were evaluated using a RAND-modified Delphi procedure comprising two online surveys and a videoconference meeting. Indicators were kept in the final list if >70% of stakeholders validated their relevance for estimating the volume (QMs) and appropriateness (PIs) of prescriptions.

Results

Of the 21 QM indicators submitted to the panel, 14 were selected, describing the consumption of antibiotics overall (n = 3), broad-spectrum (n = 6) and second-line antibiotics (n = 2). The three remaining QMs evaluated the route of administration (n = 1) and urine culture prescriptions (n = 2). Ten PIs (six modified, two rejected, one new) were selected to assess the appropriateness of prescriptions for urinary tract infections (n = 2), seasonal variations in prescriptions (n = 2), repeated prescriptions of fluoroquinolones (n = 1), cephalosporins’ route of administration (n = 1), duration of treatment (n = 1), rate of second-line antibiotics (n = 1), co-prescriptions with non-steroidal anti-inflammatory drugs (n = 1), and flu vaccine coverage (n = 1). The panel was in favour of using these indicators for regional and facility level AMS programmes (91%), feedback to NH prescribers (82%), benchmarking by health authorities (55%) and public reporting at the facility level (9%).

Conclusions

This consensual list of indicators, covering a wide range of frequent clinical situations, may be used as part of the French national AMS strategy for monitoring antibiotic prescriptions in NHs at the national and local levels. Regional AMS networks might manage this selected list to guide personalized action plans with concrete objectives of reducing the quantity and improving the quality of antibiotic prescriptions.
Model identification via total Frobenius norm of multivariate spectra
Authors: McElroy Tucker S , Roy Anindya
Published: March 2023

We study the integral of the Frobenius norm as a measure of the discrepancy between two multivariate spectra. Such a measure can be used to fit time series models, and ensures proximity between model and process at all frequencies of the spectral density. We develop new asymptotic results for linear and quadratic functionals of the periodogram, and apply the integrated Frobenius norm to fit time series models and test whether model residuals are white noise. The case of structural time series models is addressed, wherein co-integration rank testing is formally developed. Both applications are studied through simulation studies and time series data. The numerical results show that the proposed estimator can fit moderate- to large-dimensional structural timeseries in real time.
Nonparametric estimation of the continuous treatment effect with measurement error
Authors: Huang Wei , Zhang Zheng
Published: March 2023

We identify the average dose–response function (ADRF) for a continuously valued error-contaminated treatment by a weighted conditional expectation. We then estimate the weights nonparametrically by maximising a local generalised empirical likelihood subject to an expanding set of conditional moment equations incorporated into the deconvolution kernels. Thereafter, we construct a deconvolution kernel estimator of ADRF. We derive the asymptotic bias and variance of our ADRF estimator and provide its asymptotic linear expansion, which helps conduct statistical inference. To select our smoothing parameters, we adopt the simulation-extrapolation method and propose a new extrapolation procedure to stabilise the computation. Monte Carlo simulations and a real data study illustrate our method’s practical performance.
Pregnancy Pearls
Authors: de Dhaem Olivia Begasse , Bernstein Carolyn
Published: March 2023

The book chapter entitled “Pregnancy Pearls” discusses headache-related key factors in pregnancy planning, evaluation of headache in pregnancy, migraine management in pregnancy, the differential diagnosis of post-partum headaches, and the treatment of headaches during breastfeeding. We discuss best practices for evaluation and treatment of headache during pregnancy, medications, red flags, conversations about migraine and headache during pregnancy and breast-feeding. This chapter details key points that are useful in evaluating and managing women during conception, pregnancy and breast-feeding.
Why Is the Alarm Clock Inside My Head?
Authors: Bernstein Carolyn , de Dhaem Olivia Begasse
Published: March 2023

Hypnic headaches are an unusual type of cyclic headache that occur in older adults. Headache presents at the same time every night, waking the patient up from sleep. There are no autonomic features; pain can be severe, and they generally occur at least 15 times per month. Hypnic headaches may spontaneously remit or may continue for years. Although this is a primary headache disorder, secondary causes must be ruled out. Although there are no evidenced treatments, melatonin, lithium, and caffeine may all be effective.
Severe Facial Pain in the Emergency Department
Authors: Robertson Carrie E.
Published: March 2023

The chapter “Severe Facial Pain in the Emergency Department” examines the diagnosis, evaluation, and management of trigeminal neuralgia. Trigeminal neuralgia is an extremely painful condition involving repetitive, triggered, electrical shock–like pain on one side of the face. The diagnosis is made based on history and examination. However, imaging is needed to identify either vascular compression of the nerve or a secondary cause of trigeminal neuralgia. Preferred imaging is an MRI with gadolinium and thin cuts through the posterior fossa. First-line treatment for trigeminal neuralgia is carbamazepine or oxcarbazepine. If these medications are not effective or not tolerated, it is reasonable to consult neurosurgery for procedural options while trying a second-line pharmacologic option.
The Pain Persists
Authors: Chiang Chia-Chun
Published: March 2023

The chapter “The Pain Persists” examines the evaluation, work-up, and management of headache secondary to ischemic stroke and/or cervical artery dissection. Headache is reported in up to 44%, and 100% of patients with ischemic stroke and cervical artery dissection, respectively. It should be identified and appropriately managed. Risk factors for post–ischemic stroke headache include younger age (<50 years), female sex, preexisting headache disorder, larger size of the ischemic lesion, posterior circulation stroke, and cortical infarcts. Thorough evaluations, including MRI, MRA, or CTA of the head and neck; MR venogram or CT venogram; and fundoscopic exam should be considered when evaluating headache after stroke. Additionally, clinicians should be mindful that depression, limb spasticity, and obstructive sleep apnea are common post-stroke complications that could contribute to headache. The treatment of post-stroke headache should be based on the headache phenotype. Acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and anti-emetics can be used as needed for headache. Lasmiditan can be considered for the acute treatment of migraine, as triptans and ergots are contraindicated. The choice of headache preventive therapy should take comorbidities into account. More data are needed to evaluate the safety of calcitonin gene-related peptide (CGRP)–targeted therapy in patients with various level of cardiovascular/cerebrovascular risk profile.
Catch It Before It Bursts: Headache and Posterior Communicating Artery Aneurysm
Authors: Kuruvilla Deena E.
Published: March 2023

The global prevalence of headache approaches 46%, which makes it a common chief complaint. When evaluating these patients, it is crucial to first differentiate between a primary cause for headache such as migraine or tension-type headache and a secondary cause for headache such as intracranial aneurysm or a space-occupying lesion to reduce morbidity and mortality. This case presentation provides guidance on how to obtain a history, recognize red flags, and how to formulate a differential diagnosis based on the history and neurological exam. Once a differential diagnosis is formulated, the discussion provides pearls on how to decide between computed tomography scan (CT scan) and magnetic resonance imaging (MRI). This case also highlights the need to partner with necessary specialists early on in the patient’s workup if needed. A multidisciplinary approach can be helpful for managing primary and secondary headache disorders.
I’m Not Sick Anymore!: Why Am I Still Having Headaches?
Authors: Alex Ashley
Published: March 2023

The chapter “I’m Not Sick Anymore! Why Am I Still Having Headaches?” outlines proposed mechanisms, characteristics, evolution, and approaches to diagnosis and treatment of headache attributed to coronavirus disease 2019 (COVID-19) infection. Headache is a common symptom of systemic infection due to coronavirus disease 2019 (COVID-19). Its presence is not necessarily correlated with a previous history of headaches. Having COVID-19-related headaches is associated with a more benign and shorter disease course. Headaches may vary but are most typically bilateral, frontotemporal, moderate to severe intensity, and resistant to simple analgesics. Treatment should be targeted at the underlying cause and phenotype of the headaches with a combination of preventive and acute therapies.
Investigating the distribution of double neutron stars and unconventional component mass
Authors: Yang Y-Y , Zhang C-M , Li D , Chen L , Zhang J-W , Wang D-H , Jiang L-Y , Cui X-H
Published: March 2023

The mass distribution of double neutron stars (DNSs) can help us to understand the evolution of binary systems, which can also contain information about DNSs induced by gravitational wave radiation. Henceforth, for the 25 pairs of DNS systems so far discovered by radio observations, we have only statistically analysed 13 systems with precisely measured masses of two-component NSs, by employing the classical Gaussian mixture models based on the Akaike and Bayesian information criteria. The result infers that the mass distributions for recycled and non-recycled NSs follow a double-Gaussian and single-Gaussian distribution, respectively. In the conventional scenario of DNS formation, the mass of the first formed recycled NS is higher than that of the second-formed companion NS. However, there exist some unconventional cases with a reverse mass ratio. To explore the phenomenon of this ‘unconventional component mass’ of DNSs, we employed Monte Carlo sampling. We find that the unconventional DNS systems occupy about 27.7 per cent of all DNSs, which could be a useful reference for the future gravitational wave detection by LIGO/Virgo. Furthermore, we discuss a possible explanation for the unconventional DNS mass ratio, which involves the recycling process and its birth rate. This also has an implication for the mass distribution of the DNS progenitors.
The wave energy density and growth rate for the resonant instability in relativistic plasmas
Authors: Jeong Seong-Yeop , Watt Clare
Published: March 2023

The wave instability acts in astrophysical plasmas to redistribute energy and momentum in the absence of frequent collisions. There are many different types of waves, and it is important to quantify the wave energy density and growth rate for understanding what types of wave instabilities are possible in different plasma regimes. There are many situations throughout our Universe where plasmas contain a significant fraction of relativistic particles. Theoretical estimates for the wave energy density and growth rate are constrained to either field-aligned propagation angles or non-relativistic considerations. Based on linear theory, we derive the analytic expressions for the energy density and growth rate of an arbitrary resonant wave with an arbitrary propagation angle in relativistic plasmas. For this derivation, we calculate the Hermitian and anti-Hermitian parts of the relativistic-plasma dielectric tensor. We demonstrate that our analytic expression for the wave energy density presents an explicit energy increase in resonant waves in the wavenumber range where the analytic expression for the growth rate is positive (i.e. where a wave instability is driven). For this demonstration, we numerically analyse the loss-cone driven instability, as a specific example, in which the whistler-mode waves scatter relativistic electrons into the loss cone in the radiation belt. Our analytic results further develop the basis for linear theory to better understand the wave instability, and have the potential to combine with quasi-linear theory, which allows to study the time evolution of not only the particle momentum distribution function but also resonant wave properties through an instability.
Multiclass classification of Fermi-LAT sources with hierarchical class definition
Authors: Malyshev Dmitry V , Bhat Aakash
Published: March 2023

In this paper, we develop multiclass classification of Fermi-large area telescope (LAT) gamma-ray sources using machine learning with hierarchical determination of classes. One of the main challenges in the multiclass classification of the Fermi-LAT sources is that the size of some of the classes is relatively small, for example with less than 10 associated sources belonging to a class. In this paper, we propose a hierarchical structure for the determination of the classes. This enables us to have control over the size of classes and to compare the performance of the classification for different numbers of classes. In particular, the class probabilities in the two-class case can be computed either directly by the two-class classification or by summing probabilities of children classes in multiclass classification. We find that the classifications with few large classes have comparable performance with classifications with many smaller classes. Thus, on one hand, the few-class classification can be recovered by summing probabilities of classification with more classes while, on the other hand, the classification with many classes gives a more detailed information about the physical nature of the sources. As a result of this work, we construct three probabilistic catalogues, which are available online. This work opens up a possibility to perform population studies of sources including unassociated sources and to narrow down searches for possible counterparts of unassociated sources, such as active galactic nuclei, pulsars, or millisecond pulsars.
The orbits of outer planetary satellites using theGaiadata
Authors: Emelyanov N V , Kovalev M Yu , Varfolomeev M I
Published: March 2023

Launch of the Gaia space observatory started a new era in astrometry when the accuracy of star coordinates increased by thousands of times. Significant improvement in accuracy was also expected for the coordinates of the Solar system bodies. Gaia Data Release 3 (DR3) provided us with the data that could be used to test our expectations. In this work, we refine the orbits of a number of outer planetary satellites using both ground-based and Gaia observations. From 13 outer satellites observed by Gaia, we chose 6 to obtain their orbits. Some specific moments in using observations of outer satellites made by Gaia are demonstrated. These peculiarities stem from scanning motion of Gaia, in particular from the fact that the accuracy of observations is significantly different along and across the scanning direction. As expected, Gaia observations proved to be more precise than those made from Earth, which results in more accurate satellite ephemerides. We estimate accuracy of the ephemerides of considered satellites for the interval between 1996 and 2030. As astrometric positions published in Gaia DR3 were not corrected for the relativistic light deflection by the Sun, we took into account this effect, which slightly diminished the rms residuals. In addition, relativistic light deflection by the giant planets was estimated, which, as it turned out, can be neglected with the given accuracy of Gaia observations.
On the impact off(Q) gravity on the large scale structure
Authors: Sokoliuk Oleksii , Arora Simran , Praharaj Subhrat , Baransky Alexander , Sahoo P K
Published: March 2023

We investigate the exponential f(Q) symmetric teleparallel gravitation, namely $f(Q)=Q+\alpha Q_0(1-e^{-\beta \sqrt{Q/Q_0}})$ using ME-GADGET code to probe the structure formation with box sizes LBox = 10/100 Mpc h–1 and middle resolution $N_p^{1/3}=512$. To reproduce viable cosmology within the aforementioned modified gravity theory, we first perform Markov Chain Monte Carlo (MCMC) sampling on OHD/BAO/Pantheon data sets and constrain a parameter space. Furthermore, we also derive theoretical values for deceleration parameter q(z), statefinder pair {r, s} and effective gravitational constant Geff, perform Om(z) diagnostics. While carrying out N-body+SPH simulations, we derive CDM+baryons over density/temperature/mean molecular weight fields, matter power spectrum (both 2/3D, with/without redshift space distortions), bispectrum, two-point correlation function and halo mass function. Results for small and big simulation box sizes are therefore properly compared, halo mass function is related to the Seth–Tormen theoretical prediction and matter power spectrum to the standard CAMB output.
Analytical models of rotating magnetized gas filaments
Authors: Grafton William , Fiege Jason D , Au Kelvin , Rogers Adam
Published: March 2023

Several rotating molecular gas filaments with striking helical morphology have been observed in the Central Molecular Zone, including the Double Helix Nebula (DHN), the Galactic Centre Tornado (GCT), and the Pigtail Nebula (PTN). We present a model for isothermal, rotating, magnetized, pressure-truncated, non-self-gravitating filaments, as a model for these objects. We find a novel analytical stationary solution for these molecular tornadoes by assuming a propagating torsional Alfvén wave resulting in balance between toroidal magnetic stress and centrifugal force, as well as constant flux to mass ratio for the poloidal magnetic field. Our model allows for differential rotation and the density profile for the stationary solution goes asymptotically as r−1 at large radius for a special case where the flux to mass ratios for the poloidal and toroidal fields are constant inside the filament. We subject our stationary solutions to a virial analysis and show that they satisfy the virial equation for cylindrical symmetry $2\mathcal {K}+\mathcal {M}=0$. Finally, we estimate the ratio of gravitational potential energy per unit length, $\mathcal {W}$, to the bulk kinetic energy per unit length, $\mathcal {K}_0$, and calculate $|\mathcal {W}|/\mathcal {K}_0$ for the DHN, GCT, and PTN. Our estimates suggest that self-gravity is negligible in the DHN and the PTN and GCT are at most weakly self-gravitating. We also briefly address an application of our model to filamentary plasma lenses in the interstellar medium.
Interplay Between Polymorphic Short Tandem Repeats and Gene Expression Variation inCaenorhabditis elegans
Authors: Zhang Gaotian , Andersen Erik C
Published: March 2023

Short tandem repeats (STRs) have orders of magnitude higher mutation rates than single nucleotide variants (SNVs) and have been proposed to accelerate evolution in many organisms. However, only few studies have addressed the impact of STR variation on phenotypic variation at both the organismal and molecular levels. Potential driving forces underlying the high mutation rates of STRs also remain largely unknown. Here, we leverage the recently generated expression and STR variation data among wild Caenorhabditis elegans strains to conduct a genome-wide analysis of how STRs affect gene expression variation. We identify thousands of expression STRs (eSTRs) showing regulatory effects and demonstrate that they explain missing heritability beyond SNV-based expression quantitative trait loci. We illustrate specific regulatory mechanisms such as how eSTRs affect splicing sites and alternative splicing efficiency. We also show that differential expression of antioxidant genes and oxidative stresses might affect STR mutations systematically using both wild strains and mutation accumulation lines. Overall, we reveal the interplay between STRs and gene expression variation by providing novel insights into regulatory mechanisms of STRs and highlighting that oxidative stress could lead to higher STR mutation rates.
Paediatric harmful adverse drug events (PHADE)
Authors: Burns Donogh , Lal Renu , Mc Donnell Conor
Published: March 2023

Background and Objectives

It is well established that adverse drug events are frequent in paediatric hospital practice. The objective of this study is to systematically quantify and report the incidence of harmful adverse drug events across our institution and to identify predominant medications and error types.

Methods

We prospectively compiled a validated medication safety database for paediatric inpatients within our institution over a three-and-a-half-year period. All incidences of apparent patient harm relating to medication error were investigated and analyzed to determine veracity, severity of harm, phase of medication process, error type, causative medication, and contributory factors enabling each event.

Results

We identified 59 harmful adverse drug events, with an overall rate of 15.5 per 105 patient bed days. Most events occurred during administration (n = 27) and prescribing (n = 26) phases. Almost half of all harm (49%) was associated with opioids; a broad range of medication classes accounted for other harm. Harmful events occurred in 7.3 per 105 administrations of morphine and 13.3 per 105 administrations of hydromorphone. Wrong dose was the most frequently encountered error type.

Conclusions

This is the first study to quantify harmful adverse drug events in paediatric hospital practice. Our prospective analysis and compilation of harmful medication errors in paediatric hospital practice, reported with denominators of opioid administrations, and patient bed days, is a new standard for comparison in the long-discussed problem of paediatric harmful adverse drug events. By focusing on identified problematic drugs, error types, and contributory factors, we identify opportunities for interventions, error prevention and harm reduction.