bluuebunny/crossref_metadata_2025 huggingface dataset:
Evolution of the Sun’s activity and the poleward transport of remnant magnetic flux in Cycles 21–24
Authors: Mordvinov Alexander V , Karak Bidya Binay , Banerjee Dipankar , Golubeva Elena M , Khlystova Anna I , Zhukova Anastasiya V , Kumar Pawan
Published: December 2021

Detailed study of the solar magnetic field is crucial to understand its generation, transport, and reversals. The timing of the reversals may have implications on space weather and thus identification of the temporal behaviour of the critical surges that lead to the polar field reversals is important. We analyse the evolution of solar activity and magnetic flux transport in Cycles 21–24. We identify critical surges of remnant flux that reach the Sun’s poles and lead to the polar field reversals. We reexamine the polar field build-up and reversals in their causal relation to the Sun’s low-latitude activity. We further identify the major remnant flux surges and their sources in the time-latitude aspect. We find that special characteristics of individual 11-yr cycles are generally determined by the spatiotemporal organization of emergent magnetic flux and its unusual properties. We find a complicated restructuring of high-latitude magnetic fields in Cycle 21. The global rearrangements of solar magnetic fields were caused by surges of trailing and leading polarities that occurred near the activity maximum. The decay of non-Joy and anti-Hale active regions resulted in the remnant flux surges that disturbed the usual order in magnetic flux transport. We finally show that the leading-polarity surges during cycle minima sometimes link the following cycle and a collective effect of these surges may lead to secular changes in the solar activity. The magnetic field from a Babcock–Leighton dynamo model generally agrees with these observations.
Cronomoons: origin, dynamics, and light-curve features of ringed exomoons
Authors: Sucerquia Mario , Alvarado-Montes Jaime A , Bayo Amelia , Cuadra Jorge , Cuello Nicolás , Giuppone Cristian A , Montesinos Matías , Olofsson J , Schwab Christian , Spitler Lee , Zuluaga Jorge I
Published: December 2021

In recent years, technical and theoretical work to detect moons and rings around exoplanets has been attempted. The small mass/size ratios between moons and planets means this is very challenging, having only one exoplanetary system where spotting an exomoon might be feasible (i.e. Kepler-1625b i). In this work, we study the dynamical evolution of ringed exomoons, dubbed cronomoons after their similarity with Cronus (Greek for Saturn), and after Chronos (the epitome of time), following the Transit Timing Variations and Transit Duration Variation that they produce on their host planet. Cronomoons have extended systems of rings that make them appear bigger than they actually are when transiting in front of their host star. We explore different possible scenarios that could lead to the formation of such circumsatellital rings, and through the study of the dynamical/thermodynamic stability and lifespan of their dust and ice ring particles, we found that an isolated cronomoon can survive for time-scales long enough to be detected and followed up. If these objects exist, cronomoons’ rings will exhibit gaps similar to Saturn’s Cassini Division and analogous to the asteroid belt’s Kirkwood gaps but instead raised due to resonances induced by the host planet. Finally, we analyse the case of Kepler-1625b i under the scope of this work, finding that the controversial giant moon could instead be an Earth-mass cronomoon. From a theoretical perspective, this scenario can contribute to a better interpretation of the underlying phenomenology in current and future observations.
Drivers of asymmetry in synthetic H i emission-line profiles of galaxies in the eagle simulation
Authors: Manuwal Aditya , Ludlow Aaron D , Stevens Adam R H , Wright Ruby J , Robotham Aaron S G
Published: December 2021

We study the shapes of spatially integrated $\rm{H}\, \small {{I}}$ emission-line profiles of galaxies in the eagle simulation using three separate measures of the profile’s asymmetry. We show that the subset of eagle galaxies whose gas fractions and stellar masses are consistent with those in the xGASS survey also have similar $\rm{H}\, \small {{I}}$ line asymmetries. Central galaxies with symmetric $\rm{H}\, \small {{I}}$ line profiles typically correspond to rotationally supported $\rm{H}\, \small {{I}}$ and stellar discs, but those with asymmetric line profiles may or may not correspond to dispersion-dominated systems. Galaxies with symmetric $\rm{H}\, \small {{I}}$ emission lines are, on average, more gas rich than those with asymmetric lines, and also exhibit systematic differences in their specific star formation rates, suggesting that turbulence generated by stellar or AGN feedback may be one factor contributing to $\rm{H}\, \small {{I}}$ line asymmetry. The line asymmetry also correlates strongly with the dynamical state of a galaxy’s host dark matter halo: older, more relaxed haloes host more-symmetric galaxies than those hosted by unrelaxed ones. At fixed halo mass, asymmetric centrals tend to be surrounded by a larger number of massive subhaloes than their symmetric counterparts, and also experience higher rates of gas accretion and outflow. At fixed stellar mass, central galaxies have, on average, more symmetric $\rm{H}\, \small {{I}}$ emission lines than satellites; for the latter, ram pressure and tidal stripping are significant sources of asymmetry.
Detecting low-mass haloes with strong gravitational lensing I: the effect of data quality and lensing configuration
Authors: Despali Giulia , Vegetti Simona , White Simon D M , Powell Devon M , Stacey Hannah R , Fassnacht Christopher D , Rizzo Francesca , Enzi Wolfgang
Published: December 2021

This paper aims to quantify how the lowest halo mass that can be detected with galaxy-galaxy strong gravitational lensing depends on the quality of the observations and the characteristics of the observed lens systems. Using simulated data, we measure the lowest detectable NFW mass at each location of the lens plane, in the form of detailed sensitivity maps. In summary, we find that: (i) the lowest detectable mass Mlow decreases linearly as the signal-to-noise ratio (SNR) increases and the sensitive area is larger when we decrease the noise; (ii) a moderate increase in angular resolution (0.07″ versus 0.09″) and pixel scale (0.01″ versus 0.04″) improves the sensitivity by on average 0.25 dex in halo mass, with more significant improvement around the most sensitive regions; (iii) the sensitivity to low-mass objects is largest for bright and complex lensed galaxies located inside the caustic curves and lensed into larger Einstein rings (i.e rE ≥ 1.0″). We find that for the sensitive mock images considered in this work, the minimum mass that we can detect at the redshift of the lens lies between 1.5 × 108 and $3\times 10^{9}\, \mathrm{M}_{\odot }$. We derive analytic relations between Mlow, the SNR and resolution and discuss the impact of the lensing configuration and source structure. Our results start to fill the gap between approximate predictions and real data and demonstrate the challenging nature of calculating precise forecasts for gravitational imaging. In light of our findings, we discuss possible strategies for designing strong lensing surveys and the prospects for HST, Keck, ALMA, Euclid and other future observations.
Rapid build-up of the stellar content in the protocluster core SPT2349−56 at z = 4.3
Authors: Hill Ryley , Chapman Scott , Phadke Kedar A , Aravena Manuel , Archipley Melanie , Ashby Matthew L N , Béthermin Matthieu , Canning Rebecca E A , Gonzalez Anthony , Greve Thomas R , Gururajan Gayathri , Hayward Christopher C , Hezaveh Yashar , Jarugula Sreevani , MacIntyre Duncan , Marrone Daniel P , Miller Tim , Rennehan Douglas , Reuter Cassie , Rotermund Kaja M , Scott Douglas , Spilker Justin , Vieira Joaquin D , Wang George , Weiß Axel
Published: December 2021

The protocluster SPT2349−56 at $z = 4.3$ contains one of the most actively star-forming cores known, yet constraints on the total stellar mass of this system are highly uncertain. We have therefore carried out deep optical and infrared observations of this system, probing rest-frame ultraviolet to infrared wavelengths. Using the positions of the spectroscopically confirmed protocluster members, we identify counterparts and perform detailed source deblending, allowing us to fit spectral energy distributions in order to estimate stellar masses. We show that the galaxies in SPT2349−56 have stellar masses proportional to their high star formation rates, consistent with other protocluster galaxies and field submillimetre galaxies (SMGs) around redshift 4. The galaxies in SPT2349−56 have on average lower molecular gas-to-stellar mass fractions and depletion time-scales than field SMGs, although with considerable scatter. We construct the stellar-mass function for SPT2349−56 and compare it to the stellar-mass function of $z = 1$ galaxy clusters, finding consistent shapes between the two. We measure rest-frame galaxy ultraviolet half-light radii from our HST-F160W imaging, finding that on average the galaxies in our sample are similar in size to typical star-forming galaxies at these redshifts. However, the brightest HST-detected galaxy in our sample, found near the luminosity-weighted centre of the protocluster core, remains unresolved at this wavelength. Hydrodynamical simulations predict that the core galaxies will quickly merge into a brightest cluster galaxy, thus our observations provide a direct view of the early formation mechanisms of this class of object.
Matching Bayesian and frequentist coverage probabilities when using an approximate data covariance matrix
Authors: Percival Will J , Friedrich Oliver , Sellentin Elena , Heavens Alan
Published: December 2021

Observational astrophysics consists of making inferences about the Universe by comparing data and models. The credible intervals placed on model parameters are often as important as the maximum a posteriori probability values, as the intervals indicate concordance or discordance between models and with measurements from other data. Intermediate statistics (e.g. the power spectrum) are usually measured and inferences are made by fitting models to these rather than the raw data, assuming that the likelihood for these statistics has multivariate Gaussian form. The covariance matrix used to calculate the likelihood is often estimated from simulations, such that it is itself a random variable. This is a standard problem in Bayesian statistics, which requires a prior to be placed on the true model parameters and covariance matrix, influencing the joint posterior distribution. As an alternative to the commonly used independence Jeffreys prior, we introduce a prior that leads to a posterior that has approximately frequentist matching coverage. This is achieved by matching the covariance of the posterior to that of the distribution of true values of the parameters around the maximum likelihood values in repeated trials, under certain assumptions. Using this prior, credible intervals derived from a Bayesian analysis can be interpreted approximately as confidence intervals, containing the truth a certain proportion of the time for repeated trials. Linking frequentist and Bayesian approaches that have previously appeared in the astronomical literature, this offers a consistent and conservative approach for credible intervals quoted on model parameters for problems where the covariance matrix is itself an estimate.
Early rRNA processing is a stress-dependent regulatory event whose inhibition maintains nucleolar integrity
Authors: Szaflarski Witold , Leśniczak-Staszak Marta , Sowiński Mateusz , Ojha Sandeep , Aulas Anaïs , Dave Dhwani , Malla Sulochan , Anderson Paul , Ivanov Pavel , Lyons Shawn M
Published: December 2021

The production of ribosomes is an energy-intensive process owing to the intricacy of these massive macromolecular machines. Each human ribosome contains 80 ribosomal proteins and four non-coding RNAs. Accurate assembly requires precise regulation of protein and RNA subunits. In response to stress, the integrated stress response (ISR) rapidly inhibits global translation. How rRNA is coordinately regulated with the rapid inhibition of ribosomal protein synthesis is not known. Here, we show that stress specifically inhibits the first step of rRNA processing. Unprocessed rRNA is stored within the nucleolus, and when stress resolves, it re-enters the ribosome biogenesis pathway. Retention of unprocessed rRNA within the nucleolus aids in the maintenance of this organelle. This response is independent of the ISR or inhibition of cellular translation but is independently regulated. Failure to coordinately control ribosomal protein translation and rRNA production results in nucleolar fragmentation. Our study unveils how the rapid translational shut-off in response to stress coordinates with rRNA synthesis production to maintain nucleolar integrity.
Development and external validation of a diagnostic model for biopsy-proven acute interstitial nephritis using electronic health record data
Authors: Moledina Dennis G , Eadon Michael T , Calderon Frida , Yamamoto Yu , Shaw Melissa , Perazella Mark A , Simonov Michael , Luciano Randy , Schwantes-An Tae-Hwi , Moeckel Gilbert , Kashgarian Michael , Kuperman Michael , Obeid Wassim , Cantley Lloyd G , Parikh Chirag R , Wilson F Perry
Published: December 2021

Background

Patients with acute interstitial nephritis (AIN) can present without typical clinical features, leading to a delay in diagnosis and treatment. We therefore developed and validated a diagnostic model to identify patients at risk of AIN using variables from the electronic health record.

Methods

In patients who underwent a kidney biopsy at Yale University between 2013 and 2018, we tested the association of >150 variables with AIN, including demographics, comorbidities, vital signs and laboratory tests (training set 70%). We used least absolute shrinkage and selection operator methodology to select prebiopsy features associated with AIN. We performed area under the receiver operating characteristics curve (AUC) analysis with internal (held-out test set 30%) and external validation (Biopsy Biobank Cohort of Indiana). We tested the change in model performance after the addition of urine biomarkers in the Yale AIN study.

Results

We included 393 patients (AIN 22%) in the training set, 158 patients (AIN 27%) in the test set, 1118 patients (AIN 11%) in the validation set and 265 patients (AIN 11%) in the Yale AIN study. Variables in the selected model included serum creatinine {adjusted odds ratio [aOR] 2.31 [95% confidence interval (CI) 1.42–3.76]}, blood urea nitrogen:creatinine ratio [aOR 0.40 (95% CI 0.20–0.78)] and urine dipstick specific gravity [aOR 0.95 (95% CI 0.91–0.99)] and protein [aOR 0.39 (95% CI 0.23–0.68)]. This model showed an AUC of 0.73 (95% CI 0.64–0.81) in the test set, which was similar to the AUC in the external validation cohort [0.74 (95% CI 0.69–0.79)]. The AUC improved to 0.84 (95% CI 0.76–0.91) upon the addition of urine interleukin-9 and tumor necrosis factor-α.

Conclusions

We developed and validated a statistical model that showed a modest AUC for AIN diagnosis, which improved upon the addition of urine biomarkers. Future studies could evaluate this model and biomarkers to identify unrecognized cases of AIN.
FRUITFULL-like genes regulate flowering time and inflorescence architecture in tomato
Authors: Jiang Xiaobing , Lubini Greice , Hernandes-Lopes José , Rijnsburger Kim , Veltkamp Vera , de Maagd Ruud A , Angenent Gerco C , Bemer Marian
Published: December 2021

The timing of flowering and the inflorescence architecture are critical for the reproductive success of tomato (Solanum lycopersicum), but the gene regulatory networks underlying these traits have not been fully explored. Here, we show that the tomato FRUITFULL-like (FUL-like) genes FUL2 and MADS-BOX PROTEIN 20 (MBP20) promote the vegetative-to-reproductive transition and repress inflorescence branching by inducing floral meristem (FM) maturation. FUL1 fulfils a less prominent role and appears to depend on FUL2 and MBP20 for its upregulation in the inflorescence- and floral meristems. MBP10, the fourth tomato FUL-like gene, has probably lost its function. The tomato FUL-like proteins cannot homodimerize in in vitro assays, but heterodimerize with various other MADS-domain proteins, potentially forming distinct complexes in the transition meristem and FM. Transcriptome analysis of the primary shoot meristems revealed various interesting downstream targets, including four repressors of cytokinin signaling that are upregulated during the floral transition in ful1 ful2 mbp10 mbp20 mutants. FUL2 and MBP20 can also bind in vitro to the upstream regions of these genes, thereby probably directly stimulating cell division in the meristem upon the transition to flowering. The control of inflorescence branching does not occur via the cytokinin oxidase/dehydrogenases (CKXs) but may be regulated by repression of transcription factors such as TOMATO MADS-box gene 3 (TM3) and APETALA 2b (AP2b).
A Basic Primer of Artificial Intelligence for Radiologists
Authors: Stahl Ethan , Blumer Steven L.
Published: December 2021

Artificial intelligence (AI) comprises computer systems that behave in ways previously thought to require human intelligence.1 AI and related technologies are increasingly prevalent in business and society and are beginning to be applied to health care.2 Within health care, AI has increasingly influenced the field of radiology, and its role is likely only to grow in the future. Within radiology, AI has demonstrated benefits in the areas of image analysis and interpretation, various noninterpretive domains, and resident training. And yet, AI remains vaguely and incompletely understood by a great many practicing radiologists, radiology residents, and students considering a career in radiology. The purpose of this article is to describe the primary current and potential future applications of AI to the field of radiology and to define some of the key terms used in discussions of AI. This article is meant to provide readers with a clear, foundational understanding of AI in radiology and to equip radiologists with literacy and fluency in the AI lexicon.
Using Classification Tree Analysis to Predict the Type of Infection in Preterm Neonates: Proof of Concept Study
Authors: Kurul Şerife , Simons Sinno H. P. , Ramakers Christian R. B. , De Rijke Yolanda B. , Kornelisse René F. , Kroon André A. , Reiss Irwin K. M. , Taal H. Rob
Published: December 2021

BACKGROUND:

Late-onset neonatal sepsis is a major complication in preterm neonates. Early identification of the type of infection could help to improve therapy and outcome depending on the suspected microorganism by tailoring antibiotic treatment to the individual patient based on the predicted organism. Results of blood cultures may take up to 2 days or may remain negative in case of clinical sepsis. Chemical biomarkers may show different patterns in response to different type of microorganisms.

OBJECTIVE:

The aim of this study was to develop, as a proof of concept, a simple classification tree algorithm using readily available information from biomarkers to show that biomarkers can potentially be used in discriminating in the type of infection in preterm neonates suspected of late-onset neonatal sepsis.

DERIVATION COHORT:

A total of 509 suspected late-onset neonatal sepsis episodes in neonates born before less than 32 weeks of gestation were analyzed. To examine model performance, 70% of the original dataset was randomly selected as a derivation cohort (n = 356; training dataset).

VALIDATION COHORT:

The remaining 30% of the original dataset was used as a validation cohort (n = 153; test dataset).

PREDICTION MODEL:

A classification tree prediction algorithm was applied to predict type of infection (defined as no/Gram-positive/Gram-negative sepsis).

RESULTS:

Suspected late-onset neonatal sepsis episodes were classified as no sepsis (80.8% [n = 411]), Gram-positive sepsis (13.9% [n = 71]), and Gram-negative sepsis (5.3% [n = 27]). When the derived classification tree was applied to the test cohort, the overall accuracy was 87.6% (95% CI, 81.3–92.4; p = 0.008). The classification tree demonstrates that interleukin-6 is the most important differentiating biomarker and C-reactive protein and procalcitonin help to further differentiate.

CONCLUSION:

We have developed and internally validated a simple, clinically relevant model to discriminate patients with different types of infection at moment of onset. Further research is needed to prospectively validate this in a larger population and assess whether adaptive antibiotic regimens are feasible.
Age at menopause in women living with HIV: a systematic review
Authors: Van Ommen Clara E. , King Elizabeth M. , Murray Melanie C. M.
Published: December 2021

Importance:

With improved HIV care, more women living with HIV (WLWH) are aging and entering menopause. Understanding any increased risk conferred by a potentially earlier menopause transition is important for the care of these women.

Objective:

There is conflicting literature regarding the association between HIV and an earlier onset of menopause. We conducted a systematic review to summarize the literature on the association between HIV and age at menopause.

Evidence Review:

A search of Ovid MEDLINE, EMBASE, and Web of Science identified 894 articles. We included cohort studies that assessed age at menopause, primary ovarian insufficiency (POI), or early menopause among WLWH and used the World Health Organization definition of menopause as ≥12 months of amenorrhea.

Findings:

Nine studies were included and eight reported on age at menopause. Across studies, the age at menopause for WLWH fell between 46 and 50 years. Five of seven studies reported that WLWH had an earlier menopausal transition than HIV negative controls/the general population. Six studies reported on the prevalence of POI or early menopause among WLWH, with all studies demonstrating an increased prevalence of both among WLWH.

Conclusions:

Our systematic review summarizes the literature around HIV and age at menopause. Many studies reported a high prevalence of POI and early menopause among WLWH; a factor that may partially account for the observed lower age at menopause. As only one study included biochemical confirmation of menopause, it remains unclear whether individuals with early menopause or POI were truly menopausal or had prolonged amenorrhea due to other causes. Overall, our findings highlight the need for further investigation with studies that include an HIV negative control group and biochemical confirmation of menopause to better understand whether menopause truly is occurring earlier among WLWH.
Effectiveness and Controversy of Convalescent Plasma Therapy for Coronavirus Disease 2019 Patients
Authors: Shu Zhanjun , Wu Peipei , Qian Qianqian , Zhou Li , Du Dandan , Ding Mengxuan , Peng Tao , Fang Ke
Published: December 2021

Since the coronavirus disease 2019 (COVID-19) began to spread, it remains pandemic worldwide. The European Medicines Agency's human medicines committee and Food and Drug Administration have only granted a conditional marketing authorization for remdesivir to treat COVID-19. It is essential to apply other valuable treatments. Convalescent plasma (CP), donated by persons who have recovered from COVID-19, is the cellular component of blood that contains specific antibodies. Therefore, to determine the feasibility of CP for COVID-19, the effectiveness and controversy are discussed in depth here. It is suggested that CP plays a certain role in the treatment of COVID-19. As a treatment, it may have its own indications and contraindications, which need to be further discussed. Meanwhile, it is critical to establish a standard procedure for treatment from CP collection, preservation, transport, to transfusion, and conduct some large sample randomized controlled trials to confirm the transfusion dosage, appropriate time, frequency, and actively prevent adverse outcomes that may occur.
Serious opioid-related adverse outcomes associated with opioids prescribed by dentists
Authors: Khouja Tumader , Zhou Jifang , Gellad Walid F. , Mitsantisuk Kannop , Hubbard Colin C. , Yan Connie H. , Sharp Lisa K. , Calip Gregory S. , Evans Charlesnika T. , Suda Katie J.
Published: December 2021

Although nonsteroidal anti inflammatory drugs are superior to opioids in dental pain management, opioids are still prescribed for dental pain in the United States. Little is known about the serious adverse outcomes of short-acting opioids within the context of dental prescribing. The objective of this study was to evaluate adverse outcomes and persistent opioid use (POU) after opioid prescriptions by dentists, based on whether opioids were overprescribed or within recommendations. A cross-sectional analysis of adults with a dental visit and corresponding opioid prescription (index) from 2011 to 2018 within a nationwide commercial claims database was conducted. Opioid overprescribing was defined as >120 morphine milligram equivalents per Centers for Disease Control and Prevention guidelines. Generalized estimating equation models were used to assess adverse outcomes (emergency department visits, hospitalizations, newly diagnosed substance use disorder, naloxone administration, or death within 30 days from index) and POU (≥1 prescription 4-90 days postindex). Predicted probabilities are reported. Of 633,387 visits, 2.6% experienced an adverse outcome and 16.6% had POU. Adverse outcome risk was not different whether opioids were overprescribed or within recommendations (predicted probability 9.0%, confidence interval [CI]: 8.0%-10.2% vs 9.1%, CI: 8.1-10.3), but POU was higher when opioids were overprescribed (predicted probability 27.4%, CI: 26.1%-28.8% vs 25.2%, CI: 24.0%-26.5%). Visits associated with mild pain and those with substance use disorders had the highest risk of both outcomes. Findings from this study demonstrate that dental prescribing of opioids was associated with adverse outcomes and POU, even when prescriptions were concordant with guidelines. Additional efforts are required to improve analgesic prescribing in dentistry, especially in groups at high risk of opioid-related adverse outcomes.
Long-term prescription opioid users' risk for new-onset depression increases with frequency of use
Authors: Scherrer Jeffrey F. , Salas Joanne , Miller-Matero Lisa R. , Sullivan Mark D. , Ballantyne Jane C. , Debar Lynn , Grucza Richard A. , Lustman Patrick J. , Ahmedani Brian
Published: December 2021

Long-term opioid therapy (LTOT) is associated with increased risk for depression. It is not known if the frequency of opioid use during LTOT is associated with new-onset depression. We used Optum's de-identified Integrated Claims-Clinical dataset (2010-2018) to create a cohort of 5146 patients, 18 to 80 years of age, with an encounter or claims in the year before new LTOT. New LTOT was defined by >90-day opioid use after remaining opioid free for 6 months. Opioid use frequency during the first 90 days of LTOT was categorized into occasional use (<50% days covered), intermittent use (50% to <80% days covered), frequent use (80% to <90% days covered), and daily use (≥90% days covered). Propensity scores and inverse probability of exposure weighting controlled for confounding in models estimating risk for new-onset depression. Patients were on average 54.5 (SD ± 13.6) years of age, 55.7% were female, 72.5% were White, and 9.5% were African American. After controlling for confounding, daily users (hazard ratio = 1.40; 95% confidence interval: 1.14-1.73) and frequent users (hazard ratio = 1.34; 95% confidence interval: 1.05-1.71) were significantly more likely to develop new-onset depression compared with occasional users. This association remained after accounting for the contribution of post-index pain diagnoses and opioid use disorder. In LTOT, risk for new depression episodes is up to 40% greater in near-daily users compared with occasional users. Patients could reduce depression risk by avoiding opioid use on as many low pain days as possible. Repeated screening for depression during LTOT is warranted.
Caregiver Quality of Life After Cochlear Implantation in Older Adults
Authors: Aylward Alana , Gordon Steven A. , Murphy-Meyers Morganne , Allen Chelsea McCarty , Patel Neil S. , Gurgel Richard K.
Published: December 2021

Objective:

To evaluate factors affecting quality of life (QOL) in caregivers of older cochlear implant (CI) recipients.

Study Design:

Cross-sectional survey.

Setting:

Academic medical center.

Patients:

Adults over age 65 receiving CI between July 13, 2000 and April 3, 2019.

Interventions:

Cochlear implantation.

Main Outcome Measures:

Linear regression models for caregiver QOL measured by Significant Other Scale for Hearing Disability (SOS-HEAR), with independent variables: caregiver role, patient gender, 11 factor modified frailty index (mFI), duration of hearing loss, hearing aid use, age at surgery, time since surgery, change in pure tone average (PTA), processor input type and Nijmegen Cochlear Implant Questionnaire (NCIQ). Correlations between SOS-HEAR and patient speech recognition scores.

Results:

Questionnaires were mailed to all 294 living CI recipients. Seventy-one caregivers completed the questionnaire. Only patient gender and mFi were significant predictors of caregiver QOL on both univariate (p ≤ 0.001, β= −20.26 [95% confidence interval –30.21, –10.3]; 0.005, –0.72 [–1.20, –0.23], respectively) and multivariate (p = 0.005, β = –20.09, –33.05 to –7.13; 0.003, –0.93 [–1.50, –0.37]) analysis, where caregivers of female patients with lower mFI (better health) had better QOL scores. Caregiver QOL was significantly associated with patient's change in PTA and self-reported QOL scores on univariate (p = 0.041, β = 0.52 [0.08, 0.96]; 0.024, –0.27 [–0.52, –0.02]) but not multivariate analysis. Time since CI was significant only on multivariate analysis (0.041, –0.17 [–0.33, –0.01]). Caregiver QOL did not correlate with patient speech recognition scores.

Conclusions:

Higher QOL scores were found among caregivers of healthier, female CI recipients. Patient hearing measurements did not correspond with better caregiver QOL.
Augmented Reality Based Transmodiolar Cochlear Implantation
Authors: Guigou Caroline , Hussain Raabid , Lalande Alain , Bozorg Grayeli Alexis
Published: December 2021

Hypothesis:

Transmodiolar auditory implantation via the middle ear cavity could be possible using an augmented reality system (ARS).

Background:

There is no clear landmark to indicate the cochlear apex or the modiolar axis. The ARS seems to be a promising tool for transmodiolar implantation by combining information from the preprocedure computed tomography scan (CT-scan) images to the real-time video of the surgical field.

Methods:

Eight human temporal bone resin models were included (five adults and three children). The procedure started by the identification of the modiolar axis on the preprocedure CT-scan followed by a 3D reconstruction of the images. Information on modiolar location and navigational guidance was supplemented to the reconstructed model, which was then registered with the surgical video using a point-based approach. Relative movements between the phantom and the microscope were tracked using image feature-based motion tracking. Based on the information provided via the ARS, the surgeon implanted the electrode-array inside the modiolus after drilling the helicothrema. Postprocedure CT-scan images were acquired to evaluate the registration error and the implantation accuracy.

Results:

The implantation could be conducted in all cases with a 2D registration error of 0.4 ± 0.24 mm. The mean entry point error was 0.6 ± 1.00 mm and the implant angular error 13.5 ± 8.93 degrees (n = 8), compatible with the procedure requirements.

Conclusion:

We developed an image-based ARS to identify the extremities and the axis of the cochlear modiolus on intraprocedure videos. The system yielded submillimetric accuracy for implantation and remained stable throughout the experimental study.
Leiomyo-adenomatoid Tumor of the Uterus: Finding the Rare in the Routine
Authors: McGrath Nathan , Aja-Okorie Ugonna , Pather Sugeshnee
Published: December 2021

Leiomyo-adenomatoid tumour (LMAT) is a rare benign neoplasm and very few cases of LMAT of the uterus are documented in the literature. Uterine LMATs are usually detected incidentally during the histopathologic evaluation of routine myomectomy or hysterectomy specimens for leiomyomata. Thorough evaluation of the morphological features and a concise immunohistochemical panel allows for accurate classification of this benign neoplasm.
Ten years of interfaculty pain curriculum at the University of Toronto: impact on student learning
Authors: Cioffi Iacopo , Dale Craig M. , Murphy Laura , Langlois Sylvia , Musa Renata , Stevens Bonnie
Published: December 2021

Introduction:

Delivery of interprofessional pain education for prelicensure healthcare professionals is strongly recommended to advance a workforce ready for collaborative practice and to improve the quality and outcomes of pain care.

Objectives:

We report a 10-year (2009–2019) longitudinal evaluation of a 20-hour undergraduate Interfaculty Pain Curriculum (IPC) delivered to students in the Faculties of Dentistry, Nursing, Pharmacy, and Medicine (also including the Departments of Physical Therapy, Occupational Therapy and Physician Assistant) at the University of Toronto, Canada. The IPC follows a constructivist approach to facilitate interactive and multifaceted learning.

Methods:

Evaluation methods based on the Kirkpatrick model were used to appraise changes in participating students' pain knowledge and beliefs and their ability to collaboratively develop an interprofessional pain management plan.

Results:

A total of 10,693 students participated over the 10-year study period. The mean annual attendance was 972 students and participation to the program increased significantly over the years. Overall, the IPC was effective in improving students' mean pain knowledge and beliefs scores; however, the mean knowledge score gains were negatively correlated with time, likely related to increased uniprofessional pain education. Although an increasing trend in mean interprofessional pain management plan scores was observed, the scores were not significantly correlated with time.

Conclusions:

The interactive and multifaceted IPC is consistently effective in improving knowledge and beliefs and interprofessional pain management care plan development among participating student cohorts. Future inquiry is required to better understand the mechanisms behind student learning in interprofessional pain education to enhance pain curriculum development and delivery.
The Superior Mesenteric Artery Angle and Abdominal Main Vessel Diameters in Normovolemic Children
Authors: Keçeli Merter
Published: December 2021

Background

Knowledge of the normal size of important abdominal vessels is important for determination of hydration status and intravascular volume. Knowing the normal value of superior mesenteric artery (SMA) exit angle from the aorta (SMA angle) is necessary for the diagnosis of clinical pathologies caused by SMA compression.

Objectives

The aim of this study was to determine the normal SMA angles and normal diameters of the main abdominal vascular structures of pediatric participants on ultrasonography (USG).

Methods

Between January 2019 and July March 2019, the USG examinations obtained from 210 participants (age range, 1–214 years; mean age, 83.5 [SD, 5.5] months; females 51%, males 49%) with normal abdominal examinations were prospectively evaluated. The participants were divided into 5 groups according to age. Body mass index values of the participants were kept equal.

Results

The diameters of the abdominal vascular structures increased with age, and the statistical differences among the age groups were significant. In all groups, no statistically significant difference was observed between sexes (P > 0.05). The SMA angle was between 17° and 58° (mean, 37.8° [SD, 8.5°]). A statistically significant difference was observed between the age groups in terms of SMA angle (P < 0.05). No statistically difference was found between sexes (P > 0.58–0.912).

Conclusions

In our study, we think that the measurements obtained by USG provide normal values of the diameters of the abdominal main vessels and SMA angle. These values can be used as a reference for interpreting hydration status, vascular diameter assessment, and SMA compression syndromes.
Challenging Management of Plexiform Schwannoma and Plexiform Neurofibroma
Authors: Nicoli Taija K. , Saat Riste , Tarkkanen Jussi , Kinnunen Ilpo , Mäkitie Antti A. , Jero Jussi
Published: December 2021

Plexiform variants of neurofibromas and schwannomas are rare and typically arise in superficial soft tissues in the head and neck region. The treatment of these tumors is challenging and no generally accepted guidelines exist for their optimal management. The purpose of this study was to review the management and longterm prognosis of head and neck plexiform neurofibromas and schwannomas at 2 tertiary care academic hospitals in Finland over a 31-year period. The pathology files were searched for plexiform neurofibromas and schwannomas between the years 1990 and 2020. The case notes were reviewed for full management details. Two plexiform schwannomas and 6 plexiform neurofibromas were identified. Five of the 6 plexiform neurofibromas were managed operatively. All patients with a surgically managed plexiform neurofibroma underwent multiple operations. Sclerotherapy abolished 1 patient's cutaneous plexiform neurofibromas. The management of plexiform neurofibromas and plexiform schwannomas remains challenging. Sclerotherapy may offer a promising management option for cutaneous plexiform neurofibromas.
Scaphoideus titanus Ball feeding behaviour on three grapevine cultivars with different susceptibilities to Flavescence dorée
Authors: Ripamonti Matteo , Maron Federico , Cornara Daniele , Marzachì Cristina , Fereres Alberto , Bosco Domenico
Published: December 2021

Scaphoideus titanus (Ball) is a grapevine-feeder leafhopper, and the most important vector of Flavescence dorée of grapevine (FD), a disease associated with phytoplasmas belonging to ribosomal subgroups 16Sr-V–C and –D. FD is a major constraint to viticulture in several European countries and, so far, its control has relied on roguing of infected plants and insecticide applications against the vector. Detailed knowledge on different levels of the multifaceted phytoplasma-plant-vector relationship is required to envisage and explore more sustainable ways to control the disease spread. In the present work, S. titanus feeding behaviour was described on three grapevine cultivars: Barbera (susceptible to FD), Brachetto, and Moscato (tolerant to FD) using the Electrical Penetration Graph (EPG) technique. Interestingly, no differences were highlighted in the non-phloem feeding phases, thus suggesting that the tested cultivars have no major differences in the biochemical composition or structure of the leaf cuticle, epidermis or mesophyll, that can affect the first feeding activities. On the contrary, the results showed significant differences in leafhopper feeding behaviour in terms of the duration of the phloem feeding phase, longer on Barbera and shorter on Brachetto and Moscato, and of the frequency of interruption-salivation events inside the phloem, higher on Brachetto and Moscato. These findings indicate a possible preference for the Barbera cultivar, a better host for the leafhopper. Scaphoideus titanus feeding behaviour on Barbera correlates with an enhanced FDp transmission efficiency, thus explaining, at least in part, the higher susceptibility of this cultivar to FD. The mechanisms for the possible non-preference for Brachetto and Moscato are discussed, and an antixenosis is hypothesized. We propose that breeding for resistance against FD should take into account both plant traits associated with the response to the phytoplasmas and to the vector.
Clinical Characteristics and Treatment Experience of Individuals with SCN8A Developmental and Epileptic Encephalopathy (SCN8A-DEE): Findings from an Online Caregiver Survey
Authors: Cutts Alison , Savoie Hillary , Hammer Michael F. , Schreiber John , Grayson Celene , Luzon Constanza , Butterfield Noam , Pimstone Simon N. , Aycardi Ernesto , Harden Cynthia , Yonan Chuck , Jen Eric , Nguyen Trung , Carmack Tara , Haubenberger Dietrich
Published: December 2021

Purpose

SCN8A developmental epileptic encephalopathy (SCN8A-DEE) is a rare and severe genetic epilepsy syndrome characterized by early-onset developmental delay, cognitive impairment, and intractable seizures. Variants in the SCN8A gene are associated with a broad phenotypic spectrum and variable disease severity. A caregiver survey, solicited by the advocacy group The Cute Syndrome Foundation (TCSF), was conducted to gather information on the demographics/disease presentation, seizure history, and treatment of patients with SCN8A-related epilepsies.

Methods

A 36-question online survey was developed to obtain de-identified data from caregivers of children with SCN8A-related epilepsy. The survey included questions on genetic diagnosis, disease manifestations/comorbidities, seizure severity/type, current/prior use of antiseizure medicines (ASMs), and best/worst treatments per caregiver perception.

Results

In total, 116 survey responses (87 USA, 12 Canada, 12 UK, 5 Australia) were included in the quantitative analysis. Generalized tonic/clonic was the most common seizure type at onset and time of survey; absence and partial/focal seizures were also common. Most patients (77%) were currently taking ≥2 ASMs; 50% had previously tried and stopped ≥4 ASMs. Sodium channel blockers (oxcarbazepine, phenytoin, lamotrigine) provided the best subjective seizure control and quality of life.

Conclusion

The SCN8A-DEE patient population is heterogeneous and difficult to treat, with high seizure burden and multiple comorbidities. The high proportion of patients who previously tried and stopped ASMs indicates a large unmet treatment need. Further collaboration between families, caregivers, patient advocates, clinicians, researchers, and industry can increase awareness and understanding of SCN8A-related epilepsies, improve clinical trial design, and potentially improve patient outcomes.

HIGHLIGHTS

This is the first survey-based study of caregiver experiences in SCN8A-DEE

Caregivers report a broad range of seizure types and genetic variants in patients

Patients generally suffer from high seizure burden and multiple comorbidities

Results suggest new treatments and standardized treatment protocols are needed

Patient-centered research may improve awareness of SCN8A-DEE and patient outcomes
Potential use of antibodies to provide an earlier indication of lymphatic filariasis resurgence in post-mass drug administration surveillance, American Samoa
Authors: Cadavid Restrepo Angela M. , Gass Katherine , Won Kimberly Y. , Sheel Meru , Robinson Keri , Graves Patricia M. , Fuimaono Saipale , Lau Colleen L
Published: December 2021

Objectives

Under the Global Programme to Eliminate Lymphatic Filariasis (LF), American Samoa conducted seven rounds of mass drug administration between 2000 and 2006. The territory passed transmission assessment surveys (TAS) in 2011 (TAS-1) and 2015 (TAS-2) based on World Health Organization guidelines. In 2016, the territory failed TAS-3, indicating resurgence. This study aims to determine if antibodies (Ab) may have provided a timelier indication of LF resurgence in American Samoa.

Methods

We examined school-level Ag and Ab status (presence/absence of Ag- and Ab- positive children) and prevalence of single and combined Ab responses to Wb123, Bm14, Bm33 Ags at each TAS. Pearson’s chi-squared tests and logistic regression were used to examine associations between school-level Ab prevalence in TAS-1 and TAS-2 and school-level Ag status in TAS-3.

Results

Schools with higher prevalence of Wb123 Ab in TAS-2 had higher odds of being Ag-positive in TAS-3 (odds ratio [OR] 24.5, 95% CI:1.2-512.7). Schools that were Ab-positive for WB123 plus Bm14, Bm33 or both Bm14 and Bm33 in TAS-2 had higher odds of being Ag-positive in TAS-3 (OR 16.0-24.5).

Conclusion

Anti-filarial Abs could provide earlier signals of resurgence and enable a timelier response. The promising role of Abs in post-MDA surveillance and decision making should be further investigated in other settings.
Ambiguous Body Ownership Experience Caused by Feeling–judgement Conflict: Evidence from Subjective Measurement in Rubber Hand Illusion using Integrated Information Theory
Authors: Niizato Takayuki , Nishiyama Yuta , Sakamoto Kotaro , Kazama Takumi , Okabayashi Tatsuya , Yamaguchi Taiki
Published: December 2021

Abstract

Human body awareness is malleable and adaptive to changing contexts. The illusory sense of body-ownership has been studied since the publication of the rubber hand illusion, where ambiguous body ownership feeling, expressed as “the dummy hand is my hand even though that is not true”, was first defined. Phenomenologically, the ambiguous body ownership is attributed to a conflict between feeling and judgement; in other words, it characterises a discrepancy between first-person (i.e. bottom-up) and third-person (i.e. top-down) processes. Although Bayesian inference can explain this malleability of body image sufficiently, the theory does not provide a good illustration of why we have different experiences to the same stimuli – the difficulty lies in the uncertainty regarding the concept of judgement in their theory.

This study attempts to explain subjective experience during rubber hand illusions using integrated information theory (IIT). The integrated information Φ in IIT measures the difference between the entire system and its subsystems. This concept agrees with the phenomenological interpretation – that is, there is conflict between judgement and feeling. By analysing the seven nodes of a small body– brain system, we demonstrate that the integrity of the entire system during the illusion decreases with increasing integrity of its subsystems. These general tendencies agree well with many brain-image analyses and subjective reports; furthermore, we found that subjective ratings were associated with the Φs. Our result suggests that IIT can explain the general tendency of the sense of ownership illusions and individual differences in subjective experience during the illusions.