bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysing Maize Plant Height Using Unmanned Aerial Vehicle (UAV) RGB based on Digital Surface Models (DSM)
Authors: Letsoin Sri Murniani Angelina , Guth David , Herak David , Purwestri Ratna Chrismiari
Published: May 2023

Maize (Zea mays L.) is one of the essential agricultural products in Papua Province of Indonesia, specifically in the three largest maize producing regions, namely Nabire Regency, Biak Numfor Regency and Merauke Regency, with the number of productions of 991 tons, 764 tons, and 751 tons respectively in 2015. Unfortunately, since 2016 the secondary data on food crops productivity, including maize, has not been provided yet in the provinces statistical report, due to manual estimation methods, i.e., visual estimation. On the other side, the number of populations in this Province has a slight increase, from 2.97 million people in 2012 to 3.38 million in 2019. Further, approximately 1.20 million people are employed in the agricultural sector. Considerable population growth will intensify the demand for food stock and other utilization of food crops in this region; hence, relevant research in food crops needs to be considered. One of the dominant factors in the yield potential of maize is plant height, since it is associated with fertilizer, seed, and soil treatment and predicts yield area. Therefore, this study aims to analyse the plant height, particularly maize plant based on a digital surface model (DSM) derived from Unmanned Aerial Vehicle (UAV) Red Green Blue (RGB) images. The crop was monitored during the second and third week of January 2022 and then, processed using pix4d Mapper software to produce the DSM, Digital Terrain Model (DTM), and orthomosaic. Then, the Geographical Information System (GIS) software, and an open-source software, namely Python were used to estimate the plant height. Next, the results were assessed statistically to examine the validation, the strong correlation coefficient of the estimation to the actual height that obtained from UAV and ground-based plant height data. The findings will help to support the prior decision support on estimation of maize production in Papua Province.
Stability and Esterification Activity of Candida rugosa Lipase Immobilized on Celite with Acetone Solvent
Authors: Zamara Ramadhiani Afina , Yudhana Lathiifah Alyaa , Curie Catia Angli , Gozan Misri
Published: May 2023

Candida rugosa lipase (CRL) is an enzyme that is widely used in biopharmaceutical and biopesticide industries due to its high catalytic ability and reusability. However, conditions from industrial processes that are often outside CRL stability range may cause denaturation or destabilization of the enzyme, causing it to be not reusable, hence lowering its economic value. To increase its catalytic activity, stability, and reusability, CRL enzyme can be immobilized in a matrix. In this study, the CRL was physically adsorbed onto Celite-545. The immobilization process was done using buffer solution with the addition of acetone. The influence of initial enzyme concentration and immobilization condition (time, temperature, and pH) were optimized using OFAT method. The data were taken in terms of esterification activity, thermal stability, and protein content. The result showed good thermal stability of the immobilized biocatalysts and an increase in esterification activity at optimum conditions that supported the efficiency of Celite-545 as lipase immobilization supports.
Acrylamide and Acrylate Based Hydrogel for Water Adsorption in Biodiesel
Authors: Pratiwi Fatimah Tresna , Solikhah Maharani Dewi , Arisanti Anisa Galuh , Matheofani
Published: May 2023

Several countries have implemented the use of biodiesel as a diesel fuel blend. Indonesia currently implements the highest percentage of biodiesel, reaching 30% (B30), starting from 2020. Strict quality standards of biodiesel have been implemented worldwide, such as ASTM D6751 (USA), EN 14214 (EU), JASO M360 (Japan), and SNI 7182:2015 (Indonesia). Prior to blending with diesel, biodiesel must comply with the specification. One of the most concerning issues is the water content in biodiesel that is easily increased due to its hygroscopic nature. Currently, the handling procedure at the blending facility to maintain the immoderate water content of biodiesel is still limited. Therefore, experiments for reducing excessive water content in biodiesel were conducted using polyacrylamide-co-potassium acrylate (pAAm-co-PA) and potassium polyacrylate (PPA) hydrogels with varying contact times. The adsorption capacity of the hydrogel with the best performance was also observed. Four methods were carried out for hydrogel regeneration, i.e., drying at atmospheric pressure (A), drying at vacuum pressure (V), and a combination of solvent washing-atmospheric drying using acetone (AA) and ethanol (EA). The results indicate that the PPA hydrogel adsorps more water than the pAAm-co-PA hydrogel with the same contact time. PPA hydrogel capacity decreased to 13.4% after being used for seven adsorption cycles simultaneously. The ethanol-drying combination produces the highest water recovery in the regeneration process, reaching 39.24%.
Master Bellman equation in the Wasserstein space: Uniqueness of viscosity solutions
Authors: Cosso Andrea , Gozzi Fausto , Kharroubi Idris , Pham Huyên , Rosestolato Mauro
Published: May 2023

We study the Bellman equation in the Wasserstein space arising in the study of mean field control problems, namely stochastic optimal control problems for McKean-Vlasov diffusion processes. Using the standard notion of viscosity solution à la Crandall-Lions extended to our Wasserstein setting, we prove a comparison result under general conditions on the drift and reward coefficients, which coupled with the dynamic programming principle, implies that the value function is the unique viscosity solution of the Master Bellman equation. This is the first uniqueness result in such a second-order context. The classical arguments used in the standard cases of equations in finite-dimensional spaces or in infinite-dimensional separable Hilbert spaces do not extend to the present framework, due to the awkward nature of the underlying Wasserstein space. The adopted strategy is based on finite-dimensional approximations of the value function obtained in terms of the related cooperative

n
n

-player game, and on the construction of a smooth gauge-type function, built starting from a regularization of a sharp estimate of the Wasserstein metric; such a gauge-type function is used to generate maxima/minima through a suitable extension of the Borwein-Preiss generalization of Ekeland’s variational principle on the Wasserstein space.
The norm of time-frequency and wavelet localization operators
Authors: Nicola Fabio , Tilli Paolo
Published: May 2023

Time-frequency localization operators (with Gaussian window)
<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" alttext="upper L Subscript upper F Baseline colon upper L squared left-parenthesis double-struck upper R Superscript d Baseline right-parenthesis right-arrow upper L squared left-parenthesis double-struck upper R Superscript d Baseline right-parenthesis">

L
F

:

L
2

(

R

d

)
→

L
2

(

R

d

)

L_F:L^2(\mathbb {R}^d)\to L^2(\mathbb {R}^d)

, where

F
F

is a weight in

R

2
d

\mathbb {R}^{2d}

, were introduced in signal processing by I. Daubechies [IEEE Trans. Inform. Theory 34 (1988), pp. 605–612], inaugurating a new, geometric, phase-space perspective. Sharp upper bounds for the norm (and the singular values) of such operators turn out to be a challenging issue with deep applications in signal recovery, quantum physics and the study of uncertainty principles.

In this note we provide optimal upper bounds for the operator norm

‖

L
F

‖

L
2

→

L
2

\|L_F\|_{L^2\to L^2}

, assuming

F
∈

L
p

(

R

2
d

)

F\in L^p(\mathbb {R}^{2d})

,

1
>
p
>
∞

1>p>\infty

or
<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" alttext="upper F element-of upper L Superscript p Baseline left-parenthesis double-struck upper R Superscript 2 d Baseline right-parenthesis intersection upper L Superscript normal infinity Baseline left-parenthesis double-struck upper R Superscript 2 d Baseline right-parenthesis">

F
∈

L
p

(

R

2
d

)
∩

L
∞

(

R

2
d

)

F\in L^p(\mathbb {R}^{2d})\cap L^\infty (\mathbb {R}^{2d})

,

1
≤
p
>
∞

1\leq p>\infty

. It turns out that two regimes arise, depending on whether the quantity

‖
F

‖

L
p

/

‖
F

‖

L
∞

\|F\|_{L^p}/\|F\|_{L^\infty }

is less or greater than a certain critical value. In the first regime the extremal weights

F
F

, for which equality occurs in the estimates, are certain Gaussians, whereas in the second regime they are proved to be Gaussians truncated above, degenerating into a multiple of a characteristic function of a ball for

p
=
1

p=1

. This phase transition through Gaussians truncated above appears to be a new phenomenon in time-frequency concentration problems. For the analogous problem for wavelet localization operators—where the Cauchy wavelet plays the role of the above Gaussian window—a complete solution is also provided.
Females with Increased Costs Maintain Reproductive Output: A Field Experiment in a Common Songbird
Authors: McDermott Molly T , Madden Sage A , Laubach Zachary M , Ayala Marina J , Safran Rebecca J
Published: May 2023

Synopsis

Reproduction and self-maintenance are energetically costly activities involved in classic life history trade-offs. However, few studies have measured the responses of wild organisms to simultaneous changes in reproductive and self-maintenance costs, which may have interactive effects. In free-living female Barn Swallows (Hirundo rustica), we simultaneously manipulated reproductive costs (by adding or removing two nestlings) and self-maintenance costs (by attaching a ∼1 g weight in the form of a GPS tag to half of our study birds) and measured mass, immune status, blood glucose, feather growth, and reproductive output (likelihood of a second clutch, number of eggs, and time between clutches). GPS tags allowed us to analyze how movement range size affected response to brood size manipulation. Tagging altered females’ immune function as evidenced by an elevated heterophil to lymphocyte (H:L) ratio, but all females were equally likely to lay more eggs. There was no evidence of interactive effects of the tagging and brood size treatment. Range size was highly variable, and birds with large ranges grew feathers more slowly, but analyzing the effect of brood size manipulation while accounting for variation in range size did not result in any physiological response. Our results support the theoretical prediction that short-lived vertebrates do face a trade-off between reproduction and self-maintenance and, when faced with increased costs, tend to preserve investment in reproduction at the expense of parental condition. This experiment also helps us to understand how movement patterns may be relevant to life history trade-offs in wild birds.
Consequences of Preterm Birth: Knowns, Unknowns, and Barriers to Advancing Cardiopulmonary Health
Authors: Hubbard Colin D , Bates Melissa L , Lovering Andrew T , Duke Joseph W
Published: May 2023

Synopsis

Preterm birth occurs in 10% of all live births and creates challenges to neonatal life, which persist into adulthood. Significant previous work has been undertaken to characterize and understand the respiratory and cardiovascular sequelae of preterm birth, which are present in adulthood, i.e., “late” outcomes. However, many gaps in knowledge are still present and there are several challenges that will make filling these gaps difficult. In this perspective we discuss the obstacles of studying adults born preterm, including (1) the need for invasive (direct) measures of physiologic function; (2) the need for multistate, multinational, and diverse cohorts; (3) lack of socialized medicine in the United States; (4) need for detailed and better-organized birth records; and (5) transfer of neonatal and pediatric knowledge to adult care physicians. We conclude with a discussion on the “future” of studying preterm birth in regards to what may happen to these individuals as they approach middle and older age and how the improvements in perinatal and postnatal care may be changing the phenotypes observed in adults born preterm on or after the year 2000.
Evaluating drivers of spatiotemporal variability in individual condition of a bottom-associated marine fish, Atlantic cod (Gadus morhua)
Authors: Lindmark M , Anderson S C , Gogina M , Casini M
Published: May 2023

An organism’s body condition describes its mass given its length and is often positively associated with fitness. The condition of Atlantic cod (Gadus morhua) in the Baltic Sea has declined dramatically since the early 1990s, possibly due to increased competition for food and hypoxia. However, the effects of biotic and abiotic variables on body condition have not been evaluated at local scales, which is important given spatial heterogeneity. We evaluate changes in distribution, experienced environmental conditions, and individual-level condition of cod in relation to covariates at different spatial scales using geostatistical models with spatial and spatiotemporal random effects. Sprat, Saduria entomon, temperature and oxygen were positively associated with condition, and depth was negatively associated. However, the effects of explanatory variables were small—spatial and spatiotemporal latent variables explained 5.7 times more variation than all covariates together (year excluded). Weighting environmental oxygen with local biomass densities revealed steeper declining trends compared to the unweighted oxygen in the environment, while the effect of weighting was less clear for condition. Understanding the drivers of spatiotemporal variation in body condition is critical for predicting responses to environmental change and to effective fishery management; yet low explanatory power of covariates on individual condition constitutes a major challenge.
Characterization of a prophage and a defective integrative conjugative element carrying the optrA gene in linezolid-resistant Streptococcus dysgalactiae subsp. equisimilis isolates from pigs, Italy
Authors: Cinthi Marzia , Massacci Francesca Romana , Coccitto Sonia Nina , Albini Elisa , Cucco Lucilla , Orsini Massimiliano , Simoni Serena , Giovanetti Eleonora , Brenciani Andrea , Magistrali Chiara Francesca
Published: May 2023

Objectives

To investigate the optrA-carrying genetic elements and their transferability in two linezolid-resistant Streptococcus dysgalactiae subsp. equisimilis (SDSE) strains of swine origin.

Methods

SDSE strains (V220 and V1524) were phenotypically and genotypically characterized. Transferability of oxazolidinone resistance genes (filter mating), genetic elements and relatedness between isolates (WGS) were analysed. Excision of the genetic elements was assayed by inverse PCR.

Results

SDSE isolates were resistant to chloramphenicol, florfenicol and linezolid, but susceptible to tedizolid and both carried the optrA gene.

In SDSE V220 optrA was located on a 72.9-kb ICESdyV220 inserted in the 3′ end of the chromosomal rum gene. It was 94%–96% identical (coverage, from 31% to 61%) to other optrA-carrying ICEs. In-depth ICESdyV220 sequence analysis revealed that optrA was carried by an IMESdyV220 (17.9 kb), also containing the tet(O/W/32/O) gene. Inverse PCR assays excluded the ICESdyV220 mobility. In SDSE V1524, optrA was carried by the ΦSdyV1524 prophage, integrated near the 5′ end of the chromosomal had gene, showing a genetic organization similar to that of other streptococcal phage. Conjugation and transduction assays failed to demonstrate the optrA transferability to streptococcal recipients. V220 and V1524 belonged to two novel sequence types (ST704 and ST634, respectively).

Conclusions

To the best of our knowledge, this is the first identification of the optrA gene on a prophage and an ICE in SDSE isolates from swine brain.

These findings are consistent with the current belief in the key role of bacteriophages and ICEs in the streptococcal evolution and adaptation.
On the Anatomy of Health-related Actions for Which People Could Reasonably be Held Responsible: A Framework
Authors: Bærøe Kristine , Albertsen Andreas , Cappelen Cornelius
Published: May 2023

Should we let personal responsibility for health-related behavior influence the allocation of healthcare resources? In this paper, we clarify what it means to be responsible for an action. We rely on a crucial conceptual distinction between being responsible and holding someone responsible, and show that even though we might be considered responsible and blameworthy for our health-related actions, there could still be well-justified reasons for not considering it reasonable to hold us responsible by giving us lower priority. We transform these philosophical considerations into analytical use first by assessing the general features of health-related actions and the corresponding healthcare needs. Then, we identify clusters of structural features that even adversely affected people cannot reasonably deny constitute actions for which they should be held responsible. We summarize the results in an analytical framework that can be used by decision-makers when considering personal responsibility for health as a criterion for setting priorities.
Normalised latent measure factor models
Authors: Beraha Mario , Griffin Jim E
Published: May 2023

We propose a methodology for modelling and comparing probability distributions within a Bayesian nonparametric framework. Building on dependent normalised random measures, we consider a prior distribution for a collection of discrete random measures where each measure is a linear combination of a set of latent measures, interpretable as characteristic traits shared by different distributions, with positive random weights. The model is nonidentified and a method for postprocessing posterior samples to achieve identified inference is developed. This uses Riemannian optimisation to solve a nontrivial optimisation problem over a Lie group of matrices. The effectiveness of our approach is validated on simulated data and in two applications to two real-world data sets: school student test scores and personal incomes in California. Our approach leads to interesting insights for populations and easily interpretable posterior inference.
More than meets the eye: characterizing the cryptic species complex and Symbiodiniaceae communities in the reef-dwelling nudibranch Pteraeolidia ‘semperi’ (Nudibranchia: Aeolidioidea) from Singapore
Authors: Soon Nathaniel , Quek Z B Randolph , Pohl Sebastian , Wainwright Benjamin J
Published: May 2023

The advent of molecular systematics has revolutionized our knowledge of biodiversity, revealing undiscovered cryptic lineages across the tree of life. Correspondingly, an increasing number of nudibranch species complexes have been found and described through integrative taxonomic approaches. Pteraeolidia ‘semperi’ (Nudibranchia: Cladobranchia: Aeolidioidea) presently represents a species complex, possessing ambiguous systematics and an underestimated diversity. Sequencing and phylogenetic reconstructions based on the cytochrome c oxidase subunit I marker from 48 samples of P. ‘semperi’ collected from Singapore's southern waters, as well as morphological analyses including scanning electron microscopy of the radula, suggest that P. ‘semperi’ comprises several distinct cryptic lineages. We further characterized the Symbiodiniaceae communities of P. ‘semperi’ from Singapore using metabarcoding of the internal transcribed spacer 2 gene. Pteraeolidia ‘semperi’ from Singapore was found to predominantly host Cladocopium and Durusdinium symbionts, and was significantly structured by biogeography. This study elucidates the present taxonomic diversity of P. ‘semperi’ in Singapore and contributes to the growing body of work on the diversity of algal symbionts associated with this enigmatic taxon.
Advancing Rehabilitation Paradigms for Older Adults in Skilled Nursing Facilities: An Effectiveness-Implementation Hybrid Type 1 Clinical Trial Protocol
Authors: Beisheim-Ryan Emma H , Butera Katie A , Hinrichs Lauren A , Derlein Danielle L , Malone Daniel J , Holtrop Jodi S , Forster Jeri E , Diedrich Donna , Gustavson Allison M , Stevens-Lapsley Jennifer E
Published: May 2023

Objective

Skilled nursing facility rehabilitation is commonly required to address hospital-associated deconditioning among older adults with medical complexity. In skilled nursing facilities, standard-of-care rehabilitation focuses on low-intensity interventions, which are not designed to sufficiently challenge skeletal muscle and impart functional improvements. In contrast, a high-intensity resistance training approach (IntenSive Therapeutic Rehabilitation for Older NursinG homE Residents; i-STRONGER) in a single-site pilot study resulted in better physical function among patients in skilled nursing facilities. To extend this work, an effectiveness-implementation hybrid type 1 design, cluster-randomized trial will be conducted to compare patient outcomes between 16 skilled nursing facilities utilizing i-STRONGER principles and 16 Usual Care sites.

Methods

Clinicians at i-STRONGER sites will be trained to deliver i-STRONGER as a standard of care using an implementation package that includes a clinician training program. Clinicians at Usual Care sites will continue to provide usual care. Posttraining, changes in physical performance (eg, gait speed, Short Physical Performance Battery scores) from patients’ admission to discharge will be collected over a period of 12 months. The Reach, Effectiveness, Adoption, Implementation, and Maintenance framework will be used to evaluate i-STRONGER effectiveness and factors underlying successful i-STRONGER implementation. Effectiveness will be evaluated by comparing changes in physical function between study arms. Reach (proportion of patients treated with i-STRONGER), adoption (proportion of clinicians utilizing i-STRONGER), implementation (i-STRONGER fidelity), and maintenance (i-STRONGER sustainment) will be concurrently quantified and informed by clinician surveys and focus groups.

Impact

This effectiveness-implementation hybrid type 1 cluster-randomized trial has the potential to shift rehabilitation care paradigms in a nationwide network of skilled nursing facilities, resulting in improved patient outcomes and functional independence. Furthermore, evaluation of the facilitators of, and barriers to, implementation of i-STRONGER in real-world clinical settings will critically inform future work evaluating and implementing best rehabilitation practices in skilled nursing facilities.
Coloniality in science diplomacy—evidence from the Atlantic Ocean
Authors: Polejack Andrei
Published: May 2023

Ocean science diplomacy stands for the social phenomena resulting from the interaction of science and diplomacy in ocean affairs. It refers, inter alia, to the provision of scientific evidence in support of international decision-making, the building of alliances through scientific cooperation, and the enhancement of international collaborative marine research. Despite this generalization, we still lack an understanding of the sense practitioners make of ocean science diplomacy. This paper reports on perceptions of ocean science diplomacy collected through twenty in-depth interviews with South and North Atlantic government officials and researchers involved in the All-Atlantic Ocean Research Alliance. In principle, interviewees perceive ocean science diplomacy as a positive and critically important phenomenon that combines the best of science and diplomacy. However, below this generally positive perception, there seems to be a polarization of power between science and policy and also between South and North Atlantic perspectives. Scientists have reported feeling suspicious of policymaking processes, while officials portray science as unaccountable and segregated from policy. South Atlantic researchers expressed concern over limited research capabilities, and officials reported an openness to the scientific evidence presented by scientists. Northern interviewees, with reported enhanced research capabilities, seem more inclined to search for the right scientific evidence in support of national political goals. A preconceived sense of the other is what seems to permeate South–North Atlantic relationships. Northern subjects make sense of their Southern peers as those in need of assistance, while Southern interviewees claimed being unheard and victims of tokenism. I discuss these findings in light of postcolonial and decolonial theories, advocating for the need to decolonize ocean science diplomacy in the Atlantic Ocean if we are to achieve its alluded benefits.
Arbitration in trust disputes under Israeli law
Authors: Kaplan Alon , Liberman Meytal
Published: May 2023

This article first reviews key issues in Israeli arbitration law, and then discusses the Israeli trust and its creation modalities. It then focuses on the validity of arbitration agreements with respect to trust disputes under Israeli law by reviewing the relevant case law. In this context, the article distinguishes between commercial trusts set up by contract, charitable trusts and trusts set up as estate planning instruments. The article goes on to highlight the difficulty of imposing arbitration on beneficiaries of a trust, and finally concludes.
Coupling the H295R with ERα and AR U2OS CALUX assays enables simultaneous testing for estrogenic, anti-androgenic and steroidogenic modalities
Authors: Nikopaschou Martha S , Félix Alexandre , Mollergues Julie , Scholz Gabriele , Schilter Benoit , Marin-Kuan Maricel , Fussell Karma C
Published: May 2023

Endocrine active substances, including steroidogenesis modulators, have received increased attention. The in vitro H295R steroidogenesis assay (OECD TG 456) is commonly used to test for this modality. However, current detection methods often fail to capture alterations to estrogen biosynthesis. The present study explored the potential of ERα and AR CALUX bioassays to serve as a detection system for the original H295R assay, as they can quantify lower hormone concentrations and can simultaneously provide information about estrogen- and androgen-receptor activities. Using substances from the original OECD validation study, we obtained lowest observed effect concentrations for steroidogenesis mostly equivalent to those previously reported and sometimes lower for estrogen biosynthesis. However, categorization of many of these substances as receptor (ant)agonists or disruptors of steroidogenesis was difficult because often substances had both modalities, including some where the receptor-mediated activities were identified at concentrations below those triggering steroidogenic effects. When the leading activity was not accounted for, H295R-CALUX assay sensitivity in comparison to the OECD validation study was 0.50 for androgen and 0.78 for estrogen biosynthesis. However, upon reinterpretation of the combined assay results to identify endocrine activities without regard to the modality or direction of effects, assay sensitivity was equal to 1.00. These proof-of-concept study findings indicate the high relevance of this assay for the identification of endocrine active substances with additional valuable mode-of-action information and the capacity to detect smaller changes in estrogen biosynthesis, suggesting that the coupled H295R-CALUX assay has promise for the analysis of samples in a decision-making context.
Immediate Norepinephrine in Endotoxic Shock: Effects on Regional and Microcirculatory Flow*
Authors: Ospina-Tascón Gustavo A. , Aldana José L. , García Marín Alberto F. , Calderón-Tapia Luis E. , Marulanda Angela , Escobar Elena P. , García-Gallardo Gustavo , Orozco Nicolás , Velasco María I. , Ríos Edwin , De Backer Daniel , Hernández Glenn , Bakker Jan
Published: May 2023

OBJECTIVES:

To investigate the effects of immediate start of norepinephrine versus initial fluid loading followed by norepinephrine on macro hemodynamics, regional splanchnic and intestinal microcirculatory flows in endotoxic shock.

DESIGN:

Animal experimental study.

SETTING:

University translational research laboratory.

SUBJECTS:

Fifteen Landrace pigs.

INTERVENTIONS:

Shock was induced by escalating dose of lipopolysaccharide. Animals were allocated to immediate start of norepinephrine (i-NE) (n = 6) versus mandatory 1-hour fluid loading (30 mL/kg) followed by norepinephrine (i-FL) (n = 6). Once mean arterial pressure greater than or equal to 75 mm Hg was, respectively, achieved, successive mini-fluid boluses of 4 mL/kg of Ringer Lactate were given whenever: a) arterial lactate greater than 2.0 mmol/L or decrease less than 10% per 30 min and b) fluid responsiveness was judged to be positive. Three additional animals were used as controls (Sham) (n = 3). Time × group interactions were evaluated by repeated-measures analysis of variance.

MEASUREMENTS AND MAIN RESULTS:

Hypotension was significantly shorter in i-NE group (7.5 min [5.5–22.0 min] vs 49.3 min [29.5–60.0 min]; p < 0.001). Regional mesenteric and microcirculatory flows at jejunal mucosa and serosa were significantly higher in i-NE group at 4 and 6 hours after initiation of therapy (p = 0.011, p = 0.032, and p = 0.017, respectively). Misdistribution of intestinal microcirculatory blood flow at the onset of shock was significantly reversed in i-NE group (p < 0.001), which agreed with dynamic changes in mesenteric-lactate levels (p = 0.01) and venous-to-arterial carbon dioxide differences (p = 0.001). Animals allocated to i-NE showed significantly higher global end-diastolic volumes (p = 0.015) and required significantly less resuscitation fluids (p < 0.001) and lower doses of norepinephrine (p = 0.001) at the end of the experiment. Pulmonary vascular permeability and extravascular lung water indexes were significantly lower in i-NE group (p = 0.021 and p = 0.004, respectively).

CONCLUSIONS:

In endotoxemic shock, immediate start of norepinephrine significantly improved regional splanchnic and intestinal microcirculatory flows when compared with mandatory fixed-dose fluid loading preceding norepinephrine. Immediate norepinephrine strategy was related with less resuscitation fluids and lower vasopressor doses at the end of the experiment.
Rise in alanine aminotransferase after HCV treatment is a highly sensitive screen for treatment failure
Authors: Flower Barnaby , Nguyen Thi Ngoc Phuong , McCabe Leanne , Le Ngoc Chau , Vo Thi Thu , Thi Kim Hang Vu , Dang Trong Thuan , Rahman Motiur , Thwaites Guy , Walker Ann Sarah , Hung Le Manh , Vinh Chau Nguyen Van , Cooke Graham S. , Day Jeremy N. ,   on behalf of SEARCH and STOPHCV investigators
Published: May 2023

Nucleic acid testing to confirm sustained virological response (SVR) after HCV therapy is technical, often expensive, and frequently unavailable where disease prevalence is highest. Alternative surrogate biomarkers merit evaluation. In a short-treatment trial in Vietnam (SEARCH-1; n = 52) we analysed how changes in alanine transaminase (ΔALT) and aspartate transaminase (ΔAST), from end of treatment (EOT) to EOT + 12 weeks, related to SVR, defined as HCV RNA < lower limit of quantification 12 weeks after EOT. In a separate UK trial (STOPHCV1; n = 202), we then tested the hypothesis that any elevation in ALT or AST between EOT and EOT12 is a sensitive screen for treatment failure. In SEARCH-1, among 48 individuals with data, 13 failed to achieve SVR. Median ΔALT and ΔAST were negative in cured patients but elevated when treatment failed [median ΔALT (IQR): −2 IU/L (−6, +2)] versus +17 IU/L (+7.5, +38) (p< 0.001). Amongst treatment failures, 12/13 had increase in ALT and 13/13 had increase in AST after EOT, compared with 12/35 in those cured. In STOPHCV1, 196/202 patients had evaluable data, of which 57 did not achieve SVR. A rise in ALT after EOT was 100% sensitive (95% C.I. [93.7 – 100%]) and 51% specific (42.4 – 59.7%) for detecting treatment failure. ΔAST >0 IU/L was 98.1% (89.9 – 99.9%) sensitive and 35.8% (27.3 – 45.1%) specific. A rise in ALT or AST after HCV therapy is a highly sensitive screen for treatment failure in mild liver disease. This finding could reduce costs and complexity of managing HCV.
Role of virtual reality in improving the spatial perception of the kidney during flexible ureteroscopy: A feasibility study using virtual reality simulators and 3D models
Authors: Talyshinskii Ali , Hameed Bm Zeeshan , Zhanbyrbekuly Ulanbek , Silay Mesrur Selcuk , Naik Nithesh , Shah Milap , Singh Anshuman , Guliev Bakhman , Juliebø-Jones Patrick , Somani Bhaskar Kumar
Published: May 2023

Background

The aims were to describe a software-based reconstruction of the patient-specific kidney cavity intraluminal appearance via a head-mounted device and to estimate its feasibility for training novices.

Materials and methods

In total, 15 novices were recruited. Each novice was shown a three-dimensional reconstruction of a patient’s computed tomography scan, whose kidney was printed. They then joined the surgeon in the operating room and assisted them in detecting the stone during flexible ureteroscopy on the printed model. Then, each participant did a 7-day virtual reality (VR) study followed by virtual navigation of the printed kidney model and came to the operating room to help the surgeon with ureteroscope navigation. The length of the procedure and the number of attempts to find the targeted calyx were compared.

Results

With VR training, the length of the procedure (p = 0.0001) and the number of small calyces that were incorrectly identified as containing stones were significantly reduced (p = 0.0001). All the novices become highly motivated to improve their endourological skills further. Participants noticed minimal values for nausea and for disorientation. However, oculomotor-related side effects were defined as significant. Five specialists noticed a good similarity between the VR kidney cavity representation and the real picture, strengthening the potential for the novice’s education via VR training.

Conclusions

Virtual reality simulation allowed for improved spatial orientation within the kidney cavity by the novices and could be a valuable option for future endourological training and curricula.
Intra-esophageal Cyst – An Unusual Location of Bronchogenic Cyst: A Case Report
Authors: Nguyen Tuan Anh , Pham Hiep Van , Tran Thang Manh
Published: May 2023

A bronchogenic cyst is a congenital anomaly of the foregut, usually located in the lung parenchyma or mediastinum. Paraesophageal bronchogenic cysts are rare and esophageal locations even rarer. We report that a 19-year-old man was referred to our hospital due to dysphagia. Endoscopic ultrasound and computed tomography showed results for esophageal leiomyoma, and we performed thoracoscopic resection to enucleate the lesion. Although the cyst was located entirely in the wall of the esophagus, pathological findings revealed an esophageal bronchogenic cyst. The patient was discharged without any problems on postoperative day seven. This case reminded gastrointestinal surgeons about the unusual location of bronchogenic cysts – intra-esophageal – and thoracoscopic enucleation is a safe, less invasive, and practical approach.
Disproportionate increases in alcohol-associated hepatitis incidence in women and individuals of low socioeconomic status: A population-based study using the Rochester epidemiology project database
Authors: Ahn Joseph C. , Wi Chung-Il , Buryska Seth , Sivasubramaniam Priyadharshini , Harmsen William S. , Kamath Patrick S. , Simonetto Douglas A. , Juhn Young , Shah Vijay H.
Published: May 2023

Background:

Alcohol-associated hepatitis (AH) is among the deadliest liver diseases, but its incidence is poorly defined. The aim of our study was to define the incidence of AH meeting the National Institute on Alcohol Abuse and Alcoholism criteria and to identify risk factors for AH.

Methods:

We conducted a retrospective cohort study using the Rochester epidemiology project database on adult patients hospitalized with AH between January 1, 2000 and December 31, 2018. Patients were screened using ICD-9 codes and then included if they met the National Institute on Alcohol Abuse and Alcoholism criteria on manual chart review. Baseline demographics, comorbidities, access to care, liver-related complications, and outcomes were obtained. The HOUsing-based index of SocioEconomic status index was used to measure socioeconomic status. Incidence rates were calculated in cases per 100,000 person-years of follow-up.

Results:

Among 204 patients, the cumulative AH incidence was 6.8 per 100,000 person-years. Between 2000–2004 and 2015–2018, AH incidence among males increased from 8.4 to 14.7 per 100,000 py, whereas AH incidence among females increased by 7-fold from 0.8 to 5.9 per 100,000 py. Such increases among females were accompanied by increases in comorbid depression and anxiety. The proportion of patients with AH in the lower socioeconomic status quartiles increased from 62.9% between 2000 and 2004 to 73.3% between 2015 and 2019.

Conclusions:

The incidence of AH is increasing rapidly, especially among females and individuals of lower socioeconomic status. There are areas of unmet need in preventative measures and treatments for comorbid psychiatric disorders in patients at high risk of AH.
Incidence and Clinical Phenotype of Multisystem Inflammatory Syndrome in Children After Two SARS-CoV-2 Pandemic Waves: A Croatian Prospective Nationwide Study
Authors: Stemberger Marić Lorna , Trkulja Vladimir , Petrović Davor , Lah Tomulić Kristina , Bartulović Ines , Tešović Goran ,   on behalf of the CroMIS-C Study Group
Published: May 2023

This prospective nationwide study in Croatia (March 1, 2020–December 31, 2021) embraced 121 children with multisystem inflammatory syndrome. Incidence rates, disease course and outcomes were similar to those reported from other European countries. The severe acute respiratory syndrome coronavirus 2 virus Alpha strain appeared associated with a higher propensity to result in multisystem inflammatory syndrome in children than the Delta strain but did not appear related to disease severity.
Therapeutic visual rehabilitation in a patient with high hyperopia and flat cornea years after radial keratotomy
Authors: Santhiago Marcony R. , Dutra Barbara A.L. , Morgado Claudia R. , Seiler Theo G. , Wendelstein Jascha , Awwad Shady T. , Assaf Jad F. , Ghanem Ramon C. , Ghanem Vinícius C. , Talley Rostov Audrey R. , Wiley William F.
Published: May 2023

A 51-year-old man was referred for refractive surgery evaluation. Spectacle dependence and poor visual quality in both eyes was his chief complaint. He cannot tolerate contact lenses. Corrected distance visual acuity (CDVA) was 20/40 in both eyes. Manifest refraction was +5.25 −2.25 @ 90 (20/40) in the right eye and +6.25 −2.25 @ 105 (20/40) in the left eye.

The patient had a history of radial keratotomy (RK) almost 30 years ago in both eyes and at the slitlamp presented 8 RK incisions, proportionally spaced between one another. All incisions were closed, and there were no relevant signs of scarring. The patient denied any history of ocular trauma, systemic disease, or medications.

Corneal topography with different technologies revealed an irregular pattern with marked central flattening in both eyes, with some points below 30 diopters (D) (Supplemental Figures 1 and 2, available at http://links.lww.com/JRS/A862 and http://links.lww.com/JRS/A863, respectively). There were no signs of cataract, and fundus examination was normal.

Optical coherence tomography (OCT) of the right eye revealed a more homogeneous thickness pattern, little variation between the thinnest and thickest areas, and adequate transparency (Figure 1

JOURNAL/jcrs/04.03/02158034-202306000-00018/figure1/v/2023-08-19T002657Z/r/image-tiff

). In the left eye, there is wide variability between the thinnest and thickest stromal points, with annular thinning and central thickening (Figure 2

JOURNAL/jcrs/04.03/02158034-202306000-00018/figure2/v/2023-08-19T002657Z/r/image-tiff

). Both eyes show marked epithelial irregularity.

Considering this patient's current ocular status, how would you reach visual rehabilitation? Because he is contact lens intolerant, would you consider surface ablation, for example, photorefractive keratectomy (PRK) with mitomycin-C (MMC)? If that were the case, would you think of an optimized or a topography-guided (TG) treatment? Would you immediately consider a corneal transplant option? Would you instead consider a more conservative approach? Which one and why?
COVID-19 and Lifetime Experiences of Trauma, Moral Injury, and Institutional Betrayal Among Healthcare Providers
Authors: DeBeer Bryann B. , Mignogna Joseph , Nance Morgan , Bahraini Nazanin , Penzenik Molly , Brenner Lisa A.
Published: May 2023

Objective

The aim of the study is to increase understanding regarding healthcare provider experiences with psychological trauma, moral injury, and institutional betrayal, both over the lifetime and during the COVID-19 pandemic.

Methods

The study employed a cross-sectional design to understand traumatic experiences, moral injury, and institutional betrayal among medical and mental health providers. Participants were asked to identify an index trauma, and experiences were coded qualitatively using categories for traumatic events, moral injury, and institutional betrayal.

Results

Results revealed that experiences of trauma, moral injury, and institutional betrayal were common in relation to the pandemic, as were prepandemic histories of traumatic exposures. Findings indicate that trauma exposure was a work hazard for healthcare providers during the pandemic, which could result in negative long-term mental health outcomes.

Conclusions

Future research is needed to explore potential long-term negative outcomes among healthcare providers.
The Use and Utility of Food and Drug Administration Adverse Event Data from the Manufacturer and User Facility Device Experience Database in Otology: A Systematic Review
Authors: Davies Camron , Nieri Chad Alexander , Sheyn Anthony , Rangarajan Sanjeet , Yawn Robert J.
Published: May 2023

Objective

To review otology-related studies using the US Food and Drug Administration's Manufacturer and User Facility Device Experience (MAUDE) database to identify the opportunities and limitations of using MAUDE.

Databases Reviewed

PubMed, Science Direct, Web of Science, SCOPUS, and EMBASE.

Methods

All studies reporting otology-related adverse events extracted from MAUDE were included from June 20, 2002, to 2022. Two reviewers independently screened abstracts, selected articles for exclusion, extracted data, and appraised studies. Critical appraisal was done according to the National Institutes of Health quality assessment tool for case series.

Results

The search yielded 5,645 studies, of which 8 studies met the inclusion criteria. All eight studies were case series; three evaluated cochlear implants, two evaluated osseointegrated hearing implants, and one evaluated illuminated operating microscope use. Quality assessment revealed all studies to be of poor quality. The most common domains contributing to these ratings included unclear study population, lack of consecutive participants, comparability of participants, clear and consistent outcome measures, and appropriate statistical analysis.

Conclusion

Otology studies using the MAUDE database are of poor quality. This was primarily due to MAUDE's structural limitations as a passive surveillance system using nonstandardized free-text reports. The quality of studies also suffered from inappropriate analysis of MAUDE data, given its design. The utility of MAUDE could be improved by implementing case report best practices and converting the free fields to allow controlled and adaptive responses wherever possible to help standardize adverse event reporting.
Time Analysis of Recidivism in Acquired Cholesteatoma Using the Kaplan-Meier Method
Authors: Nakazawa Takara , Yamamoto Yutaka , Kanno Kazuki , Kurihara Sho , Takahashi Masahiro , Morino Tsunetaro , Motegi Masaomi , Yamamoto Kazuhisa , Sakurai Yuika , Kojima Hiromi
Published: May 2023

Objective

To analyze the time trends of recidivism of acquired cholesteatoma using the Kaplan-Meier method.

Study Design

We conducted a retrospective, observational study of 256 patients having their first cholesteatoma surgery. The cumulative recidivism-free rate was calculated using Kaplan-Meier survival analysis related to the follow-up period, pathophysiology, the extent of the disease, and recidivism pathologies.

Results

Pars flacida cholesteatoma with tympanic cavity progression had a high likelihood of recurrence disease. Pars tensa cholesteatoma led to more recurrence of the disease than the residual disease. In both pars flacida and pars tensa cholesteatoma, the incidence of disease recurrence increased even 3 years after surgery. On the contrary, the incidence of residual disease peaked within 3 years after surgery, and thereafter, the incidence of residual disease tended to be small. In particular, pars flacida cholesteatoma extending into the mastoid cavity or tympanic cavity tended to recur up to 5 years postoperatively.

Conclusions

We calculated the cumulative recidivism-free rates of 256 patients with cholesteatoma using Kaplan-Meier survival analysis. These results can lead to better estimates of the length of the follow-up period.

Level of Evidence

Level IV evidence from case-control studies.
Individualizing primary prophylaxis in patients with hemophilia A and B, adherence and new products
Authors: Berrueco Rubén
Published: May 2023

The purpose of prophylaxis in hemophilic patients is to prevent bleeding. The latest guidelines of the World Hemophilia Federation recommend that all patients with a severe hemorrhagic phenotype should receive prophylactic treatment, defined as the regular administration of therapeutic products (either factor concentrates or nonfactor replacement treatments). These products are aimed at preserving hemostasis and preventing bleeding, especially into joints. The guidelines also stipulate that prophylaxis should allow patients with hemophilia to lead healthy and active lives, participating in most physical and social activities, similar to the nonhemophilic population.
Disability and the social impact of hemophilia
Authors: García-Ripoll Montserrat , De la Corte-Rodríguez Hortensia
Published: May 2023

In addition to receiving the medical treatment they need, people with hemophilia or other coagulopathies must acquire the strategies required to deal with the physical, emotional and social challenges they will encounter at the different stages of their lives. To this end, it is necessary to offer support for any uncertainty that may arise for the patient or parents upon diagnosis of the disease, and to help them develop a healthy response pattern to bleeding episodes. First years and decades of life are essential because self-image is built and the foundations for socialization are laid, making it necessary to foster communication and self-esteem. However, in later life, the social impact of the consequences of hemophilia, including disability and dependency, require the introduction of technical and human adaptations and aids. Hematological, rehabilitative, orthopedic psychological and social approaches focus on improving the individual's ability to carry out daily activities independently and facilitate social integration. Patient associations play a key role in minimizing the social impact of hemophilia. Finally, recognition of disability helps to compensate to some extent for the difficulties faced by people with hemophilia.