bluuebunny/crossref_metadata_2025 huggingface dataset:
Extracting angle domain common image gather with variable density acoustic-wave equation
Authors: Liu Yuzhu , Liu Weigang , Yang Jizhong , Dong Liangguo
Published: March 2021

Angle domain common image gathers (ADCIGs), commonly regarded as important prestacked gathers, provide the information required for velocity model construction and the phase and amplitude information needed for subsurface structures in oil/gas exploration. Based on the constant-density acoustic-wave equation assumption, the ADCIGs generated from reverse time migration ignore the fact that the subsurface density varies with location. Consequently, the amplitude versus angle (AVA) analysis extracted from these ADCIGs is not accurate. To partially solve this problem and to improve the accuracy of the AVA analysis, we developed amplitude-preserving ADCIGs suitable for density variations with the assumption of acoustic approximation. The Poynting vector approach, which is efficient and computationally inexpensive, was used to calculate the high-resolution wavefield propagation. The ADCIGs generated from the velocity and density perturbations match the theoretical AVA relationship better than ADCIGs with constant density. The extraction of the AVA analysis of the various combinations of the subsurface medium indicates that the density is non-negligible, especially when the density contrast is sharp. Numerical examples based on a layered model verify our conclusions.
∞-Groupoid Generated by an Arbitrary Topological λ-Model
Authors: Martínez-Rivillas Daniel O , de Queiroz Ruy J G B
Published: March 2021

The lambda calculus is a universal programming language. It can represent the computable functions, and such offers a formal counterpart to the point of view of functions as rules. Terms represent functions and this allows for the application of a term/function to any other term/function, including itself. The calculus can be seen as a formal theory with certain pre-established axioms and inference rules, which can be interpreted by models. Dana Scott proposed the first non-trivial model of the extensional lambda calculus, known as $ D_{\infty }$, to represent the $\lambda $-terms as the typical functions of set theory, where it is not allowed to apply a function to itself. Here we propose a construction of an $\infty $-groupoid from any lambda model endowed with a topology. We apply this construction for the particular case $D_{\infty }$, and we see that the Scott topology does not provide enough information about the relationship between higher homotopies. This motivates a new line of research focused on the exploration of $\lambda $-models with the structure of a non-trivial $\infty $-groupoid to generalize the proofs of term conversion (e.g., $\beta $-equality, $\eta $-equality) to higher-proofs in $\lambda $-calculus.
Influence of Pyrethroid Resistance on Vector Competency for Zika Virus by Aedes aegypti (Diptera: Culicidae)
Authors: Parker-Crockett Casey , Connelly C Roxanne , Siegfried Blair , Alto Barry
Published: March 2021

The vector competence of mosquitoes for pathogens has been shown to be influenced by the status of insecticide resistance in the mosquito population. However, to date, only two studies has explored the impact of insecticide resistance on arbovirus transmission. The global and widespread use of pyrethroids has led to the development of insecticide resistance in many mosquito species, including Aedes aegypti (Linnaeus) (Diptera: Culicidae), the primary vector of Zika virus. Strains of Ae. aegypti that were genetically similar, but responded differently to pyrethroid exposure, were developed using backcrossing techniques. These populations were orally infected with Zika virus and susceptibility to infection, disseminated infection, and transmission potential were evaluated. Analyses revealed differences in susceptibility to infection and disseminated infection between the pyrethroid susceptible and resistant strains of Ae. aegypti during the infection period. Here, we identify an additional challenge to that of widespread pyrethroid resistance. Specifically, resistance is associated with altered phenotypic traits that influence susceptibility to arbovirus infection and progression of infection in the mosquito, factors which ultimately influence risk of arbovirus transmission. These findings support the need to 1) consider insecticide resistance status during times of arbovirus transmission and 2) to implement insecticide resistance management/ mitigation strategies in vector control programs.
Toward a Poetics of Allyship: Rajiv Mohabir’s Radical, Animal Coolitude
Authors: Howerton Alex
Published: March 2021

I offer one alternative to media depictions of migrant bodies as animalistic threat by tracing animal movement in Rajiv Mohabir’s poetry. Mohabir is a queer Indo-Caribbean American poet whose poetry depicts animals’ fettered movement, often a consequence of heteropatriarchal and nationalist operations of power. Mohabir suggests that such artistic productions might align and thus ally themselves with disparate imperiled bodies due in part to the ethics of Coolitude, or, the state of having descended from Indo-Caribbean coolies. Mohabir has revitalized the term in a series of manifestos and craft essays published on Jacket2, where he claims Coolitude poetics as a corrective to the kind of nationalist mindset that would condemn imperiled migrants.

Mohabir’s poetry prominently features two kinds of creatures: those who enjoy conditional movement, such as the whales that populate verse from across his career, which denotes a subject’s attempts to free themselves from the conscripts of heterosexual or imperial legacies; and those such as the taxidermied wren or coyotes that adorn his first published collection, The Taxidermist’s Cut (2016). These figures best describe political subjects who have internalized the resentment of their political environment and are consequently destroyed. Mohabir does, however, offer one other figure: the unfettered whale of “Why Whales are Back in New York City” (2017). The whales of this poem represent a subject that succeeds in defending itself from the oppression that distinguishes the rest of his poetry; the poem thus serves as a model of sanctuary.
Parliamentary Representation in Six European Right-Wing Sovereignist Parties: Resemblance or Innovation?
Authors: Borri Rossella , Verzichelli Luca
Published: March 2021

The appeal to the re-appropriation of national sovereignty has recently become the unifying trait of a heterogeneous group of right-wing parties. The underlying reasoning behind this claim is that globalised elites ignore the needs of the people—defined as a restricted and ethnically homogeneous group of natives—they are supposed to represent. After defining the perimeter of this party cluster, including populist, national conservatives and extreme-right parties, this article explores the extent to which the adoption of similar political platforms might also be reflected in a convergence of parliamentary party articulations. A qualitative account of the evolution of parliamentary representation in a few right-wing parties from Italy, Hungary and the Netherlands shows that a two-way street of institutionalisation might be at play in the complex balance between uncompromising grassroots components and a more pragmatic institutional component.
Recommandations sur la sédation lors d’une intervention diagnostique ou thérapeutique chez les nourrissons, les enfants et les adolescents
Authors: Krmpotic Kristina , Rieder Michael J , Rosen David
Published: March 2021

De nombreux patients pédiatriques ont besoin de sédation et d’analgésie lors de tests diagnostiques et d’actes thérapeutiques hors de la salle d’opération. Le présent document de principes contient une analyse bibliographique de la sédation interventionnelle (qu’on appelle aussi sédation procédurale), axée sur la prévention des événements indésirables grâce à la sélection des patients appropriés, à la préparation aux situations d’urgence et à la surveillance nécessaire pendant et après l’administration des agents pharmacologiques. Seuls des cliniciens formés en assistance respiratoire et en réanimation devraient être autorisés à l’effectuer, dans le cadre d’un programme hospitalier comportant des initiatives à la fois dynamiques et soutenues en matière de sécurité et d’assurance de la qualité. La rédaction de politiques et de protocoles sur la sédation interventionnelle sécuritaire chez les nourrissons, les enfants et les adolescents fait partie des recommandations.
Access to Finance and Job Growth: Firm-Level Evidence across Developing Countries
Authors: Ayyagari Meghana , Juarros Pedro , Martinez Peria Maria Soledad , Singh Sandeep
Published: March 2021

This paper investigates the effect of access to finance on job growth in over 780,000 firms across twenty-two developing countries. Using the introduction of credit bureaus as an exogenous shock to the supply of credit, the paper finds that increased access to finance results in higher employment growth, especially among micro, small, and medium enterprises. The results are robust to using firm-fixed effects, industry measures of external finance dependence, and propensity score matching. Our findings have implications for policy interventions targeted to produce job growth.
LOCAL LEVELS OF RADIATION EXPOSURE DOSES DUE TO RADIOCESIUM FOR RETURNED RESIDENTS IN TOMIOKA TOWN, FUKUSHIMA PREFECTURE
Authors: Yamaguchi Takumi , Taira Yasuyuki , Matsuo Masahiko , Orita Makiko , Yamada Yumiko , Takamura Noboru
Published: March 2021

Tomioka Town is located within a 20-km radius of the Fukushima Daiichi Nuclear Power Station. Radiation dose rates due to radiocesium in residents’ living spaces were evaluated from the measurements of ambient dose rates and environmental samples after returning home. The mean ambient dose rates were 0.15–0.18-μSv/h indoors and 0.23–0.26-μSv/h outdoors during 2018 and 2019, and the additional radiation dose rates were calculated to be 1.4 mSv/y in 2018 and 1.1 mSv/y in 2019. Ambient dose equivalent from surface soils within housing sites were estimated to be 0.66 mSv/y in 2018 and 0.54 mSv/y in 2019. Moreover, committed effective doses from local foods were calculated in 19–74 μSv/y for children and 39–100 μSv/y for adults during 2018 and 2019. These findings suggest that current radiation exposure doses have been controlled at the levels close to the public dose limit (1 mSv/y) in residents’ living spaces.
Microtubule‐dependent mechanism of anti‐inflammatory effect of SOCS1 in endothelial dysfunction and lung injury
Authors: Karki Pratap , Cha Boyoung , Zhang Chen‐Ou , Li Yue , Ke Yunbo , Promnares Kamoltip , Kaibuchi Kozo , Yoshimura Akihiko , Birukov Konstantin G. , Birukova Anna A.
Published: March 2021

Suppressors of cytokine signaling (SOCS) provide negative regulation of inflammatory reaction. The role and precise cellular mechanisms of SOCS1 in control of endothelial dysfunction and barrier compromise associated with acute lung injury remain unexplored. Our results show that siRNA‐mediated SOCS1 knockdown augmented lipopolysaccharide (LPS)‐induced pulmonary endothelial cell (EC) permeability and enhanced inflammatory response. Consistent with in vitro data, EC‐specific SOCS1 knockout mice developed more severe lung vascular leak and accumulation of inflammatory cells in bronchoalveolar lavage fluid. SOCS1 overexpression exhibited protective effects against LPS‐induced endothelial permeability and inflammation, which were dependent on microtubule (MT) integrity. Biochemical and image analysis of unstimulated EC showed SOCS1 association with the MT, while challenge with LPS or MT depolymerizing agent colchicine impaired this association. SOCS1 directly interacted with N2 domains of MT‐associated proteins CLIP‐170 and CLASP2. Furthermore, N‐terminal region of SOCS1 was indispensable for these interactions and SOCS1‐ΔN mutant lacking N‐terminal 59 amino acids failed to rescue LPS‐induced endothelial dysfunction. Depletion of endogenous CLIP‐170 or CLASP2 abolished SOCS1 interaction with Toll‐like receptor‐4 and Janus kinase‐2 leading to impairment of SOCS1 inhibitory effects on LPS‐induced inflammation. Altogether, these findings suggest that endothelial barrier protective and anti‐inflammatory effects of SOCS1 are critically dependent on its targeting to the MT.
RNF216 regulates meiosis and PKA stability in the testes
Authors: Li Dengfeng , Li Fangfang , Meng Lanlan , Wei Huafang , Zhang Qianjun , Jiang Fang , Chen Dan‐Na , Li Wei , Tan Yue‐Qiu , Li Jia‐Da
Published: March 2021

Spermatogenesis is a highly sophisticated process that comprises of mitosis, meiosis, and spermiogenesis. RNF216 (ring finger protein 216), an E3 ubiquitin ligase, has been reported to be essential for spermatogenesis and male fertility in mice. However, the stages affected by Rnf216 deficiency and its underlying molecular pathological mechanisms are still unknown. In this study, we generated Rnf216‐deficient mice (Rnf216−/−) using CRISPR‐Cas9 technology. Knockout of Rnf216 led to infertility in male but not female mice. Rnf216 knockout affected the prophase of meiosis I, as no genotypic difference was observed until 12 dpp (days postpartum). Rnf216−/− spermatocytes were incompletely arrested at the zygotene stage and underwent apoptosis at approximately the pachytene stage. The proportion of zygotene spermatocytes was significantly increased, whereas the proportion of pachytene spermatocytes was significantly decreased in Rnf216−/− testes. Nevertheless, there was no significantly genotypic difference in the number of diplotene spermatocytes. We further revealed that the PKA catalytic subunit β (PRKACB) was significantly increased, which subsequently resulted in elevated PKA activity in testes from adult as well as 9 dpp Rnf216−/− mice. RNF216 interacts with PRKACB and promotes its degradation through the ubiquitin‐lysosome pathway. Collectively, our results revealed an important role for RNF216 in regulation of meiosis and PKA stability in the testes.
Decabromodiphenyl ethane exposure damaged the asymmetric division of mouse oocytes by inhibiting the inactivation of cyclin‐dependent kinase 1
Authors: Shi Feifei , Feng Xizeng
Published: March 2021

Decabromodiphenyl ethane (DBDPE) is a new brominated flame retardant and is widely added to flammable materials to prevent fire. Because it has been continuously detected in a variety of organisms and humans, it is important to reveal the biological toxicity of DBDPE. However, the influence of DBDPE for female reproduction is unclear. In this study, we investigated whether and how DBDPE exposure affects oocyte development. Female mice as a model were orally exposed to DBDPE by 0, 0.05, 0.5, 5, 50 μg/kg bw/day for 30 days (0.05 μg/kg bw/day is close to the environmental exposure concentration). We found that exposure of mice to DBDPE did not affect the first polar body extrusion (PBE) of oocytes. Strikingly, however, asymmetric division of oocytes was markedly impaired in 5 and 50 μg/kg bw/day DBDPE exposed group, which resulted in oocytes with larger polar bodies (PBs). Then, we further explored and found that DBDPE exposure inhibited the spindle migration and membrane protrusion in oocytes during anaphase of meiosis I (anaphase I), thereby impairing asymmetric division. Additionally, we found that DBDPE exposure suppressed the inactivation of cyclin‐dependent kinase 1 (Cdk1), resulting in the decrease of cytoplasmic formin2 (FMN2)‐mediated F‐actin polymerization in oocytes at the onset of anaphase I. Simultaneously, DBDPE exposure damaged the structural integrity of the spindle and the perpendicular relationship between spindle and cortex. These together led to the failure of spindle migration and membrane protrusion required for oocytes asymmetric division. Finally, DBDPE exposure injured the development of blastocysts, leading to blastocyst apoptosis.
Novel roles for voltage‐gated T‐type Ca2+ and ClC‐2 channels in phagocytosis and angiogenic factor balance identified in human iPSC‐derived RPE
Authors: Mamaeva Daria , Jazouli Zhour , DiFrancesco Mattia L. , Erkilic Nejla , Dubois Gregor , Hilaire Cecile , Meunier Isabelle , Boukhaddaoui Hassan , Kalatzis Vasiliki
Published: March 2021

Human‐induced pluripotent stem cell (hiPSC)‐derived retinal pigment epithelium (RPE) is a powerful tool for pathophysiological studies and preclinical therapeutic screening, as well as a source for clinical cell transplantation. Thus, it must be validated for maturity and functionality to ensure correct data readouts and clinical safety. Previous studies have validated hiPSC‐derived RPE as morphologically characteristic of the tissue in the human eye. However, information concerning the expression and functionality of ion channels is still limited. We screened hiPSC‐derived RPE for the polarized expression of a panel of L‐type (CaV1.1, CaV1.3) and T‐type (CaV3.1, CaV3.3) Ca2+ channels, K+ channels (Maxi‐K, Kir4.1, Kir7.1), and the Cl− channel ClC‐2 known to be expressed in native RPE. We also tested the roles of these channels in key RPE functions using specific inhibitors. In addition to confirming the native expression profiles and function of certain channels, such as L‐type Ca2+ channels, we show for the first time that T‐type Ca2+ channels play a role in both phagocytosis and vascular endothelial growth factor (VEGF) secretion. Moreover, we demonstrate that Maxi‐K and Kir7.1 channels are involved in the polarized secretion of VEGF and pigment epithelium‐derived factor (PEDF). Furthermore, we show a novel localization for ClC‐2 channel on the apical side of hiPSC‐derived RPE, with an overexpression at the level of fluid‐filled domes, and demonstrate that it plays an important role in phagocytosis, as well as VEGF and PEDF secretion. Taken together, hiPSC‐derived RPE is a powerful model for advancing fundamental knowledge of RPE functions.
Preoperative Depression and Anxiety Impact on Inpatient Surgery Outcomes
Authors: Geoffrion Roxana , Koenig Nicole A. , Zheng Meimuzi , Sinclair Nicholas , Brotto Lori A. , Lee Terry , Larouche Maryse
Published: March 2021

Objectives:

To determine the association of preoperative mood symptoms and postoperative adverse outcomes; to explore sex-specific differences.

Background:

Depression and anxiety can increase postoperative mortality. Psychological stress is associated with a chronic inflammatory response unfavorable to postsurgical healing.

Methods:

Prospective cohort study. Patients were recruited from surgical preadmission clinics at a university hospital. Preoperative depression and anxiety were measured via the Beck Depression and Beck Anxiety Inventories (BDI-II and BAI). Our primary outcome was a composite of postoperative complications, extended length of stay (ELOS) and early readmission. Associated variables included demographics, preoperative pain, pain tolerance/catastrophizing, coping mechanisms, postoperative pain, and opioid use. We adjusted for age, comorbidities, and surgical specialty.

Results:

Of 1061 recruited patients (ten surgical specialties, 2015–2020), 455 males and 486 females had preoperative and postoperative data available. Mean age was 62.9 (range 20.2–96.2). At baseline, 9.3% of patients had moderate or severe depression; 7.4% had moderate or severe anxiety. Females were more likely to be moderately or severely depressed (11% vs 7%, P = 0.036) and moderately or severely anxious (9% vs 6%, P = 0.034). Females had significantly fewer reported comorbidities and lower American Society of Anesthesiologists category (P < 0.001). Increasing BDI-II and BAI scores significantly increased likelihood of postoperative complications, ELOS, and/or hospital readmission in females (adjusted odds ratio [aOR] = 2.57 for BDI-II 1-19 vs 0, P = 0.041; aOR = 4.48 for BDI-II > 19 vs 0, P = 0.008; aOR = 1.54 for BAI ≤ 6 vs >6, P = 0.038) but not in males. Mood symptoms did not influence postoperative pain or opioid use.

Conclusion:

Preoperative depression and anxiety negatively impact surgical outcomes in female patients undergoing major surgery.
Risk Factors for Posttraumatic Stress Disorder in Acute Trauma Patients
Authors: Joseph Noah M. , Benedick Alex , Flanagan Christopher D. , Breslin Mary A. , Vallier Heather A.
Published: March 2021

Objective:

To identify risk factors for posttraumatic stress disorder (PTSD) after traumatic injury.

Setting:

Single urban Level I trauma center.

Design:

Prospective.

Patients/Participants:

Three hundred men (66%) and 152 women treated for traumatic injuries were administered the PTSD checklist for a Diagnostic and Statistical Manual of Mental Disorders fifth edition (PCL-5) survey during their first post-hospital visit over a 15-month period.

Intervention:

Screening for PTSD in trauma patients.

Main Outcome Measurement:

The prevalence of disease and risk factors for the development of PTSD based on demographic, medical, injury, and treatment variables.

Results:

One hundred three patients screened positive for PTSD (26%) after a mean of 86 days after injury. Age less than 45 years was an independent risk factor for the development of PTSD [odds ratio (OR) 2.64, 95% confidence interval (CI) (1.40–4.99)]. Mechanisms of injury associated with the development of PTSD included pedestrians struck by motor vehicles [OR 7.35, 95% CI (1.58–34.19)], motorcycle/all terrain vehicle crash [OR 3.17, 95% CI (1.04–9.65)], and victims of crime [OR 3.49, 95% CI (0.99–9.20)]. Patients sustaining high-energy mechanism injuries and those who were victims of crime scored higher on the PCL-5 [OR 2.39, 95% CI (1.35–4.22); OR 4.50, 95% CI (2.52–8.05), respectively].

Conclusions:

One quarter of trauma patients screened positive for PTSD at 3 months after their injury. A mechanism of injury is a risk factor for PTSD, and younger adults, victims of crime, and pedestrians struck by motor vehicles are at higher risk. These findings offer the potential to more effectively target and refer vulnerable patient populations to appropriate treatment.

Level of Evidence:

Prognostic Level II. See Instructions for Authors for a compete description of levels of evidence.
A Modified Levine Approach for Exposure of the Anterior Column, Anterior Wall, and Sacroiliac Joint: A Surgical Technique and a Case Series
Authors: Jang Yohan , Virkus Walter , Mckinley Todd
Published: March 2021

Surgical exposure of the anterior column, anterior wall, pelvic brim, and sacroiliac joint is accessible through the lateral window of the ilioinguinal approach. Residual attachment of the abdominal muscles and inguinal ligament to the anterior superior iliac spine (ASIS) is often a limiting factor to expanded distal and medial exposure, especially in patients with a large abdomen that hangs over the pelvis. An ASIS osteotomy has been described to improve exposure, particularly of the distal anterior wall and joint capsule, pubic ramus, and anterior quadrilateral plate. However, an ASIS osteotomy can be troublesome to reattach. In this study, we introduce a soft tissue release technique to mobilize the abdominal muscles and inguinal ligament to allow expanded surgical access to the distal anterior column/wall and sacroiliac joint and to create a working space for fracture reduction and fixation.
The Effects of Cannabis: Implications for the Surgical Patient
Authors: Copeland-Halperin Libby R. , Herrera-Gomez Laura C. , LaPier Jennifer R. , Shank Nina , Shin Joseph H.
Published: March 2021

Background:

Cannabis use is increasingly prevalent. Cannabinoid receptors regulate pro-inflammatory cytokines, and compounds in marijuana exert diverse physiologic effects. As more patients use cannabis, clinicians should recognize implications of perioperative cannabis use. Although the role of cannabis use in perioperative pain control has been explored, little is known about its effect on perioperative wound healing or on hematologic, pulmonary, and cardiovascular physiology.

Methods:

We searched PubMed for English-language articles related to cannabis (ie, marijuana, cannabidiol oil, and tetrahydrocannabinol) and wound healing, cardiovascular, pulmonary, or hematologic outcomes, and surgery. Titles and abstracts were reviewed, and relevant articles were analyzed. Human, animal, and pathology studies were included. Editorials, case reports, and review articles were excluded.

Results:

In total, 2549 wound healing articles were identified; 5 human studies and 8 animal/pathology studies were included. Results were conflicting. An estimated 2900 articles related to cardiovascular effects were identified, of which 2 human studies were included, which showed tetrahydrocannabinol and marijuana caused tachycardia. A total of 142 studies regarding pulmonary effects were identified. Three human studies were included, which found no difference in respiratory complications. In total, 114 studies regarding hematologic effects were identified. The 3 included human studies found conflicting venous thromboembolism risks. The overall study quality was poor. Information about dose/duration, administration route, and follow-up was reported with variable completeness.

Conclusions:

Surgeons should consider effects of cannabis in the perioperative setting. Little is known about its perioperative effects on wound healing, or on cardiovascular, pulmonary, and hematologic physiology. Further research should elucidate the effects of administration route, dose, and timing of cannabis use among surgical patients.
The Biomechanical Properties of Meshed versus Perforated Acellular Dermal Matrices (ADMs)
Authors: Sweitzer Keith , Carruthers Katherine H. , Blume Lauren , Tiwari, Pankaj , Kocak, Ergun
Published: March 2021

Background:

Acellular dermal matrices (ADMs) are used for soft tissue augmentation across surgical specialties. Since allograft incorporation depends on direct opposition between the ADM and a vascular bed, seroma formation can be detrimental to incorporation. Since most ADM products are available in many meshed and perforated forms, there is a lack of consistency between manufacture designs. We set out to determine the fluid egress properties and increase in surface area resulting from common cut patterns.

Methods:

Three ADM cut patterns were studied: 1 meshed and 2 perforated. We calculated the surface area of these modified ADM samples. Fluid was passed through each ADM, and time required for fluid passage was recorded. An ANOVA (P < 0.05) was used to determine if there was a significant difference in egress properties across the 3 patterns.

Results:

Meshing in a 1:1 pattern resulted in a 97.50% increase in surface area compared with the uncut product. In comparison, only a 0.30% increase resulted from Perforation Pattern #1 and a 0.59% increase resulted from Perforation Pattern #2. There was a significant difference in egress properties across the three cut patterns (P = 0.000). The average egress time of Mesh Pattern #1 was 1.974 seconds. The average egress time of Perforation Pattern #2 was 6.504 seconds, and of Perforation Pattern #1 was 10.369 seconds.

Conclusions:

Quantitative comparison revealed that meshing ADM significantly improves fluid egress and increases the surface area. Therefore, the use of meshed ADM tissue could improve the incorporation of ADM with the recipient, with improved patient outcomes.
Lower Lip Reanimation: Experience Using the Anterior Belly of Digastric Muscle in 2-stage Procedure
Authors: Tzafetta Kallirroi , Ruston Julia C. , Pinto-Lopes Rui , Mabvuure Nigel Tapiwa
Published: March 2021

Background:

Lower lip depression was historically regarded a neglected area of facial paralysis, but, with refinement of techniques, has gained increasing attention. We present the first detailed description and evaluation of a 2-stage technique, using first cross facial nerve graft and then the anterior belly of digastric muscle (ABDM), innervated by the cross facial nerve graft, to restore dynamic and spontaneous lower lip depression.

Methods:

Retrospective analysis of 2-stage lower lip reanimations between 2010 and 2018 was performed. Demographics, etiology, and operative details were recorded. Videos were graded pre/postoperatively using a 5-point Likert scale by 21 independent observers. Objective changes of symmetry were analyzed using Photogrammetry (Emotrics).

Results:

Twenty-seven patients were identified (median age 34.9 years, range 6–64). The mean duration between the 2 stages was 15.1 months. Follow-up ranged from 18–72 months. There were minor complications in 4 patients, and 1 case was abandoned due to insufficient length of anterior belly of digastric muscle. Average peer-reviewed scores improved from 2.1 to 3.2 (P < 0.05). Emotrics did not show improvement in static symmetry (P > 0.05). However, during open-lip smiling, lower lip height improved significantly (P < 0.05) whilst dental show improvements approached significance (P < 0.08). Lower lip symmetry was also improved during lower lip depression, as shown by improvements in lower lip height (P < 0.05), smile angle, and dental show (both P < 0.05).

Conclusions:

These results show the safety and efficacy of 2-stage lower lip reanimation using anterior belly of digastric muscle transposition. This procedure is our choice for longstanding lower lip paralysis and provides coordinated spontaneous lower lip depression, thus enhancing the overall perioral animation and smile.
Going Silent: Redesigning the Activation Process for In-Hospital Cardiopulmonary Arrests
Authors: Stinehart Kyle R. , Spitzer Carleen R. , Evans Kimberly A. , Buehler Jeri , Attar Talal , Besecker Beth
Published: March 2021

Introduction:

Reducing environmental noise has become a priority for many health systems. Following a 10-week preparation period, our health system transitioned from an overhead-activated to a silently activated in-hospital code team notification system. The goal of this initiative was to reduce environmental noise and support code team communication and function without adversely affecting response time, provider availability, or key quality metrics.

Methods:

Transitioning from overhead to silently activated events involved a three-step quality improvement approach. Input from key stakeholders and preimplementation education were of key importance. Multiple timed trials and a full in situ simulation were completed before going live with the new process.

Results:

Evaluation of 6-month pre- and postimplementation quality metrics showed no significant difference in compliance with defibrillating shockable rhythms within two minutes, event survival, or survival to discharge. Provider survey data and Hospital Consumer Assessment of Healthcare Providers and Systems “quiet at night” scores were not significantly different.

Conclusion:

By utilizing a multistep implementation approach, transitioning from overhead pages to a silently activated system for in-hospital code team activation was feasible and safe. Abandoning the overhead paging system did not lead to a decrease in key quality metrics nor impair team perception of code function.
Effect and safety of acupuncture for autism spectrum disorders
Authors: Zhang Ying , Zeng Jianfei , Wu Dan , Li Xiujuan , Chen Yangxia , Dai Shixia , Wang Bing , Qi Yu , Lu Jianping
Published: March 2021

Background:

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition, which is characterized by impairment in social interaction or communication and lack of flexibility of imagination and behavior. Acupuncture is one of the most common modality of Traditional Chinese medicine (TCM) and has been used to treat various disease in clinical practice for more than 2000 years in China by correcting disharmony and dysregulation of body. It has sometimes been used as a treatment aimed at improving ASD symptoms and outcomes, but its clinical effectiveness and safety has not been rigorously reviewed. We will plan to conduct a systematic review and meta-analysis to summarize the current evidence on the effects and safety of acupuncture for ASD.

Methods:

The following databases will be searched: PubMed, the Cochrane Library, Embase, Wanfang Data, China National Knowledge Infrastructure, SinoMed, and VIP. Randomised controlled trials will be included to evaluate the effect and safety of acupuncture on patients with ASD. The primary outcome will be the core features of ASD. The risk of bias will be assessed by the Cochrane risk of bias tool. We will conduct a meta-analysis and sensitivity analysis, as well as a subgroup analysis if high heterogeneity is present, using Revman 5.3. We will use funnel plots to identify potential reporting biases. The Grading of Recommendations Assessment, Development and Evaluation will be used to evaluate the quality of evidence.

Results:

This study will be to assess the effect and safety of acupuncture for ASD.

Conclusions:

This study will assess the effect of acupuncture for ASD and provide reliable evidence for the choice of treatments.

Ethics and dissemination:

The protocol will not need ethical approval because no issues of participant privacy exist. The results of this systematic review will provide evidence about the effect and safety of acupuncture for ASD. The results will be disseminated through peer review.
Quantification of immobilization-induced changes in human calf muscle using speed-of-sound ultrasound
Authors: Ruby Lisa , Sanabria Sergio J. , Martini Katharina , Frauenfelder Thomas , Jukema Gerrolt Nico , Goksel Orcun , Rominger Marga B.
Published: March 2021

Short-term immobilization leads to fatty muscular degeneration, which is associated with various negative health effects. Based on literature showing very high correlations between MRI Dixon fat fraction and Speed-of-Sound (SoS), we hypothesized that we can detect short-term-immobilization-induced differences in SoS.

Both calves of 10 patients with a calf cast on one side for a mean duration of 41 ± 26 days were examined in relaxed position using a standard ultrasound machine. Calf perimeters were measured for both sides. A flat Plexiglas-reflector, placed vertically on the opposite side of the probe with the calf in-between, was used as a timing reference for SoS. SoS was both manually annotated by two readers and assessed by an automatic annotation algorithm. The thickness values of the subcutaneous fat and muscle layers were manually read from the B-mode images. Differences between the cast and non-cast calves were calculated with a paired t test. Correlation analysis of SoS and calf perimeter was performed using Pearson's correlation coefficient.

Paired t test showed significant differences between the cast and non-cast side for both SoS (P < .01) and leg perimeter (P < .001). SoS was reduced with the number of days after cast installment (r = −0.553, P = .097). No significant differences were found for muscle layer thickness, subcutaneous fat layer thickness, mean fat echo intensity, or mean muscle echo intensity.

Short-term-immobilization led to a significant reduction in SoS in the cast calf compared to the healthy calf, indicating a potential role of SoS as a biomarker in detecting immobilization-induced fatty muscular degeneration not visible on B-mode ultrasound.
The risk factors for delayed recovery in patients with cardiopulmonary bypass
Authors: Chen Baozeng , Feng Mingjing , Sheng Chen , Wang Yinhua , Cao Wenya
Published: March 2021

Cardiopulmonary bypass (CPB) is very commonly performed among the cardiovascular surgeries, and delayed recovery (DR) is a kind of serious complications in patients with CPB. It is necessary to assess the risk factors for DR in patients with CPB, to provide evidence into the management of CPB patients.

Patients undergoing CPB in our hospital from January 2018 to March 2020 were included. Cases that consciousness has not recovered 12 hours after anesthesia were considered as DR. The preoperative and intraoperative variables of CPB patients were collected and analyzed. Logistic regressions were conducted to analyze the potential influencing factor.

A total of 756 CPB patients were included, and the incidence of DR was 9.79%. There were significant differences on the age, aspartate aminotransferase (AST), glutamic pvruvic transaminase (ALT), blood urea nitrogen (BUN), and serum creatinine (SCr) between patients with and without DR (all P < .05); there were no significant differences in the types of surgical procedure (all P > .05); there were significant differences on the duration of CPB, duration of aortic cross clamp (ACC), duration of surgery, minimum nasopharyngeal temperature, and transfusion of packed red blood cells between patients with and without DR (all P < .05). Logistic regression analysis indicated that duration of CPB ≥132 minutes (odds ratio [OR] 4.12, 1.02–8.33), BUN ≥9 mmol/L (OR 4.05, 1.37–8.41), infusion of red blood cell suspension (OR 3.93, 1.25–7.63), duration of surgery ≥350 minutes (OR 3.17, 1.24–5.20), age ≥6 (OR 3.01, 1.38–6.84) were the independent risk factors for DR in patients with CPB (all P < .05).

Extra attention and care are needed for those CPB patients with duration of CPB ≥132 minutes, BUN ≥9 mmol/L, infusion of red blood cell suspension, duration of surgery ≥350 minutes, and age ≥60.
Endobronchial lipoma with tracheobronchial aspergillosis
Authors: Wang Yuanyuan , Teng Yongliang , Li Jie , Lin Tingting , Lu Na , Yuan Ye
Published: March 2021

Introduction:

Benign neoplasm of the endobronchial tree is quite rare, while endobronchial lipoma is extremely rare. Tracheobronchial aspergillosis is a relatively uncommon but severe form of invasive aspergillosis involving the tracheobronchial tree.

Patient concerns:

A 54-year-old male presented to our hospital for investigation and treatment of a cough and hemoptysis.

Diagnosis:

The diagnosis was confirmed as endobronchial lipoma with tracheobronchial aspergillosis.

Interventions:

The patient received pneumonectomy and voriconazole treatment.

Outcomes:

The patient's postoperative course was uneventful, and he was discharged 10 days after surgery. The patient had no evidence of the fungal infection and recurrence during 1 year of follow-up.

Conclusion:

Endobronchial lipoma is a rare benign lung tumor, and this is the first report of endobronchial lipoma with tracheobronchial aspergillosis. In patients with suspected endobronchial lipoma, especially those who present with hemoptysis as the initial symptom, it is advisable to exclude coexistent aspergillosis.
An innovative emergency transportation scenario for mass casualty incident management
Authors: Lin Ming-Wei , Pan Chih-Long , Wen Jet-Chau , Lee Cheng-Haw , Wu Zong-Ping , Chang Chin-Fu , Chiu Chun-Wen
Published: March 2021

The purpose of this research is to analyze and introduce a new emergency medical service (EMS) transportation scenario, Emergency Medical Regulation Center (EMRC), which is a temporary premise for treating moderate and minor casualties, in the 2015 Formosa Fun Color Dust Party explosion in Taiwan. In this mass casualty incident (MCI), although all emergency medical responses and care can be considered as a golden model in such an MCI, some EMS plans and strategies should be estimated impartially to understand the truth of the successful outcome.

Factors like on-scene triage, apparent prehospital time (appPHT), inhospital time (IHT), and diversion rate were evaluated for the appropriateness of the EMS transportation plan in such cases. The patient diversion risk of inadequate EMS transportation to the first-arrival hospital is detected by the odds ratios (ORs). In this case, the effectiveness of the EMRC scenario is estimated by a decrease in appPHT.

The average appPHTs (in minutes) of mild, moderate, and severe patients are 223.65, 198.37, and 274.55, while the IHT (in minutes) is 18384.25, 63021.14, and 83345.68, respectively. The ORs are: 0.4016 (95% Cl = 0.1032–1.5631), 0.1608 (95% Cl = 0.0743–0.3483), and 4.1343 (95% Cl = 2.3265–7.3468; P < .001), respectively. The appPHT has a 47.61% reduction by employing an EMRC model.

Due to the relatively high appPHT, diversion rate, and OR value in severe patients, the EMS transportation plan is distinct from a prevalent response and develops adaptive weaknesses of MCIs in current disaster management. Application of the EMRC scenario reduces the appPHT and alleviates the surge pressure upon emergency departments in an MCI.
Cytochrome P450 2C19 enzyme, Cytochrome P450 2C9 enzyme, and Cytochrome P450 2D6 enzyme allelic variants and its possible effect on drug metabolism
Authors: Naujokaitis Domas , Asmoniene Virginija , Kadusevicius Edmundas
Published: March 2021

The objective of the present study was to assess the allelic variations of Cytochrome P450 (CYP) enzymes Cytochrome P450 2C19 (CYP2C19), Cytochrome P450 2C9 (CYP2C9), and Cytochrome P450 2D6 (CYP2D6) as they play a major role in drug metabolism. The interindividual genetic variabilities of these enzymes can account for different responsiveness as well as concentration fluctuations for a particular drug.

During the period of 2017 to 2018 a total of 54 patients have received pharmacogenetic testing at the Department of Genetics and Molecular Medicine at Kaunas Clinics. According to the genotype-metabolic phenotypes of CYP2C19, CYP2D6, CYP2C9 enzymes patients were classified according to the guidelines by Clinical Pharmacogenetics Implementation Consortium (CPIC): normal metabolizers (NMs), intermediate metabolizers (IMs), rapid metabolizers (RMs), ultrarapid metabolizers (UMs), and poor metabolizers (PMs).

CYP2C19 enzyme allelic distribution: 18 patients (33.33%) with ∗1/∗1 genotype were NMs; 14 patients (25.93%) with ∗1/∗2; ∗2/∗17 genotypes were classified as IMs; 15 patients (27.78%) possessed ∗1/∗17 genotype and were RMs; 4 patients (7.4%) had ∗17/∗17 genotype with increased enzyme activity compared with RMs, were classified as UMs; 3 patients (5.56%) had ∗2/∗2 genotype and were marked as PMs. CYP2D6 enzyme allelic distribution: 26 patients (48.148%) contained ∗1/∗1,∗2/∗2,∗1/∗2,∗1/∗41,∗2/∗41 genotypes with normal enzymatic function so were accounted as NMs; 21 patients (38.89%) with ∗1/∗5, ∗2/∗4, ∗10/∗41, ∗1/∗4, ∗1/∗3, ∗2/∗5, ∗2/∗4, ∗2/∗6 genotypes were accounted as IMs; 2 patients (3.7%) possessed ∗2XN genotype and were accounted as UMs and 5 patients (9.26%) possessed ∗4/∗5,∗4/∗10,∗4/∗9,∗4/∗41 genotypes and had non-functional enzymatic activity so were accounted as PMs; CYP2C9 enzyme allelic distribution: 44 patients (81.48%) with∗1/∗1 genotype were NMs; 10 patients (18.52%) with ∗1/∗2;∗1/∗3 genotypes were IMs.

The results of our study indicate that deviations from the normal enzymatic activity is common amongst Lithuanian people and combinatory genotyping of CYP2D6, CYP2C9, and CYP2C19 has to be promoted as an advanced method because of most commonly prescribed medicines like analgesics, antihypertensive, antidepressants are metabolized by multiple pathways involving enzymes in the CYP450 family.
Integration of summary data from GWAS and eQTL studies identified novel risk genes for coronary artery disease
Authors: Zhong Yigang , Chen Liuying , Li Jingjing , Yao Yinghao , Liu Qiang , Niu Kaimeng , Ma Yunlong , Xu Yizhou
Published: March 2021

Several genetic loci have been reported to be significantly associated with coronary artery disease (CAD) by multiple genome-wide association studies (GWAS). Nevertheless, the biological and functional effects of these genetic variants on CAD remain largely equivocal. In the current study, we performed an integrative genomics analysis by integrating large-scale GWAS data (N = 459,534) and 2 independent expression quantitative trait loci (eQTL) datasets (N = 1890) to determine whether CAD-associated risk single nucleotide polymorphisms (SNPs) exert regulatory effects on gene expression. By using Sherlock Bayesian, MAGMA gene-based, multidimensional scaling (MDS), functional enrichment, and in silico permutation analyses for independent technical and biological replications, we highlighted 4 susceptible genes (CHCHD1, TUBG1, LY6G6C, and MRPS17) associated with CAD risk. Based on the protein–protein interaction (PPI) network analysis, these 4 genes were found to interact with each other. We detected a remarkably altered co-expression pattern among these 4 genes between CAD patients and controls. In addition, 3 genes of CHCHD1 (P = .0013), TUBG1 (P = .004), and LY6G6C (P = .038) showed significantly different expressions between CAD patients and controls. Together, we provide evidence to support that these identified genes such as CHCHD1 and TUBG1 are indicative factors of CAD.
Ultrasound, electromyography, and balloon guidance for injecting botulinum toxin for cricopharyngeal achalasia
Authors: Chen Jian-Min , Chen Yang-Jia , Ni Jun , Wang Zhi-Yong
Published: March 2021

Introduction:

Botulinum toxin (BTX) injection is a widely used treatment option for dysphagia associated with cricopharyngeal (CP) muscle achalasia, but uniform standards and protocols for administration techniques and injection sites are still lacking. This case study suggests that a unique administration technique involving a combination of ultrasound, electromyography, and balloon guidance for injecting the CP muscle can reduce inadvertent migration of BTX to non-injected tissues and increase the effectiveness and safety of BTX treatment.

Patient concerns:

We describe the case of a 74-year-old man who could not swallow food or saliva for 8 months.

Diagnosis:

The patient showed signs of true bulbar paralysis, including dizziness, hoarseness, and dysphagia. The fiberoptic endoscopic evaluation of swallowing showed massive mucilage secretion and residual materials in the postcricoid region and aspiration when swallowing 1 ml of yogurt. The video fluoroscopic swallowing study showed profoundly limited epiglottic folding and CP muscle non-relaxation, despite several unsuccessful swallow attempts.

Interventions:

To manage insufficient relaxation opening of the CP muscle, BTX injection was performed using ultrasound, electromyography, and balloon catheter guidance. The narrow CP muscle situated above the balloon was identified as the target of injection by ultrasound.

Outcomes:

The patient was able to eat a soft diet. The follow-up fibrotic endoscopic swallowing study demonstrated a reduction in the amount of pharyngeal residue. The video fluoroscopic swallowing study showed that CP muscle relaxation was significantly enhanced and no penetration was shown.

Conclusion:

The unique administration technique with triple guidance holds several advantages, suggesting that it may be a promising treatment for CP muscle achalasia.
Pheochromocytoma-related cardiomyopathy presenting as acute myocardial infarction
Authors: Jiang Xuandong , Zhang Weimin , Fang Qiang
Published: March 2021

Introduction:

Pheochromocytoma (PHEO)-related cardiomyopathy is a rare condition in which release of a large amount of catecholamines leads to severe vasoconstriction, coronary vasospasm, myocardial ischemia, injury, and necrosis. Its clinical manifestations can be similar to those of acute coronary syndrome.

Patient concerns:

A 63-year-old woman was diagnosed with acute non-ST segment elevation myocardial infarction following chest pain for 8 hours. The results of coronary angiography were normal. The patient developed dyspnea, cough with frothy pink sputum, paroxysmal sweating, arrhythmia, and blood pressure fluctuation, and was transferred to the intensive care unit for monitoring and treatment.

Diagnosis:

PHEO, catecholamine cardiomyopathy (CICMP)

Intervention:

After monitoring the pulse index continuous cardiac output and treatment with α and β adrenergic receptor blockers for 18 days, laparoscopic resection of the left adrenal mass was performed.

Outcomes:

The patient's condition improved and she was discharged 31 days after admission. Outpatient follow-up examinations 1 month and 1 year later did not show recurrence.

Lessons:

PHEO can cause CICMP, the manifestations of which are partly similar to those of takotsubo cardiomyopathy (TTC). Once the patient's condition stabilizes, surgery should be considered. Fluid management is necessary, and agents such as α and β adrenergic receptor blockers should be administered.