bluuebunny/crossref_metadata_2025 huggingface dataset:
The AGN fuelling/feedback cycle in nearby radio galaxies – IV. Molecular gas conditions and jet–ISM interaction in NGC 3100
Authors: Ruffa Ilaria , Prandoni Isabella , Davis Timothy A , Laing Robert A , Paladino Rosita , Casasola Viviana , Parma Paola , Bureau Martin
Published: December 2021

This is the fourth paper of a series investigating the AGN fuelling/feedback processes in a sample of 11 nearby low-excitation radio galaxies (LERGs). In this paper, we present follow-up Atacama Large Millimeter/submillimeter Array (ALMA) observations of one source, NGC 3100, targeting the 12CO(1-0), 12CO(3-2), HCO+(4-3), SiO(3-2), and HNCO(6-5) molecular transitions. 12CO(1-0) and 12CO(3-2) lines are nicely detected and complement our previous 12CO(2-1) data. By comparing the relative strength of these three CO transitions, we find extreme gas excitation conditions (i.e. Tex ≳ 50 K) in regions that are spatially correlated with the radio lobes, supporting the case for a jet–ISM interaction. An accurate study of the CO kinematics demonstrates that although the bulk of the gas is regularly rotating, two distinct non-rotational kinematic components can be identified in the inner gas regions: one can be associated to inflow/outflow streaming motions induced by a two-armed spiral perturbation; the second one is consistent with a jet-induced outflow with vmax ≈ 200 km s−1 and $\dot{M}\lesssim 0.12$ M⊙ yr−1. These values indicate that the jet-CO coupling ongoing in NGC 3100 is only mildly affecting the gas kinematics, as opposed to what expected from existing simulations and other observational studies of (sub-)kpc scale jet–cold gas interactions. HCO+(4-3) emission is tentatively detected in a small area adjacent to the base of the northern radio lobe, possibly tracing a region of jet-induced gas compression. The SiO(3-2) and HNCO(6-5) shock tracers are undetected: this – along with the tentative HCO+(4-3) detection – may be consistent with a deficiency of very dense (i.e. ncrit > 106 cm−3) cold gas in the central regions of NGC 3100.
Radio continuum properties of OH megamaser galaxies
Authors: Sotnikova Yu V , Wu Zhongzu , Mufakharov T V , Mikhailov A G , Mingaliev M G , Erkenov A K , Semenova T A , Bursov N N , Udovitskiy R Y , Stolyarov V A , Tsybulev P G , Chen Y J , Zhang J S , Shen Z , Jiang D R
Published: December 2021

We present a study of the radio continuum properties of two luminous/ultraluminous infrared galaxy samples: the OH megamaser (OHM) sample (74 objects) and the control sample (128 objects) without detected maser emission. We carried out pilot observations for 140 objects with the radio telescope RATAN-600 at 1.2, 2.3, 4.7, 8.2, 11.2, and 22.3 GHz in 2019–2021. The OHM sample has two times more flat-spectrum sources (32 per cent) than the control sample. Steep radio spectra prevail in both samples. The median spectral index at 4.7 GHz α4.7 = −0.59 for the OHM sample, and α4.7 = −0.71 for the non-OHM galaxies. We confirm a tight correlation of the far-infrared (FIR) and radio luminosities for the OHM sample. We found correlations between isotropic OH line luminosity LOH and the spectral index α4.7 (ρ = 0.26, p-val. = 0.04) and between LOH and radio luminosity P1.4 (ρ = 0.35, p-val. = 0.005). Reviewing subsamples of masers powered by active galactic nuclei (AGNs) and star formation revealed insignificant differences for their FIR and radio properties. None the less, AGN-powered galaxies exhibit larger scatter in a range of parameters and their standard deviations. The similarities in the radio and FIR properties in the two samples are presumably caused by the presence of a significant amount of AGN sources in both samples (47 and 30 per cent in the OHM and control samples) and/or possibly by the presence of undetected OH emission sources in the control sample.
High accuracy wide-field imaging method in radio interferometry
Authors: Ye Haoyang , Gull Stephen F , Tan Sze M , Nikolic Bojan
Published: December 2021

With the development of modern radio interferometers, wide-field continuum surveys have been planned and undertaken, for which accurate wide-field imaging methods are essential. Based on the widely used W-stacking method, we propose a new wide-field imaging algorithm that can synthesize visibility data from a model of the sky brightness via degridding, able to construct dirty maps from measured visibility data via gridding. Results carry the smallest approximation error yet achieve relative to the exact calculation involving the direct Fourier transform. In contrast to the original W-stacking method, the new algorithm performs least-misfit optimal gridding (and degridding) in all three directions, and is capable of achieving much higher accuracy than is feasible with the original algorithm. In particular, accuracy at the level of single precision arithmetic is readily achieved by choosing a least-misfit convolution function of width W = 7 and an image cropping parameter of x0 = 0.25. If the accuracy required is only that attained by the original W-stacking method, the computational cost for both the gridding and Fast Fourier Transform steps can be substantially reduced using the proposed method by making an appropriate choice of the width and image cropping parameters.
G17.8 + 16.7: A new supernova remnant
Authors: Araya M , Hurley-Walker N , Quirós-Araya S
Published: December 2021

Non-thermal radio emission is detected in the region of the gamma-ray source FHES J1723.5 − 0501. The emission has an approximately circular shape 0.8° in diameter. The observations confirm its nature as a new supernova remnant, G 17.8 + 16.7. We derive constraints on the source parameters using the radio data and gamma-ray observations of the region. The distance to the object is possibly in the range 1.4–3.5 kpc. An SNR age of the order of 10 kyr is compatible with the radio and GeV features, but an older or younger SNR cannot be ruled out. A simple one-zone leptonic model naturally explains the multi-wavelength non-thermal fluxes of the source at its location outside the Galactic plane.
GIP: an open-source computational pipeline for mapping genomic instability from protists to cancer cells
Authors: Späth Gerald F , Bussotti Giovanni
Published: December 2021

Genome instability has been recognized as a key driver for microbial and cancer adaptation and thus plays a central role in many diseases. Genome instability encompasses different types of genomic alterations, yet most available genome analysis software are limited to just one type of mutation. To overcome this limitation and better understand the role of genetic changes in enhancing pathogenicity we established GIP, a novel, powerful bioinformatic pipeline for comparative genome analysis. Here, we show its application to whole genome sequencing datasets of Leishmania, Plasmodium, Candida and cancer. Applying GIP on available data sets validated our pipeline and demonstrated the power of our tool to drive biological discovery. Applied to Plasmodium vivax genomes, our pipeline uncovered the convergent amplification of erythrocyte binding proteins and identified a nullisomic strain. Re-analyzing genomes of drug adapted Candida albicans strains revealed correlated copy number variations of functionally related genes, strongly supporting a mechanism of epistatic adaptation through interacting gene-dosage changes. Our results illustrate how GIP can be used for the identification of aneuploidy, gene copy number variations, changes in nucleic acid sequences, and chromosomal rearrangements. Altogether, GIP can shed light on the genetic bases of cell adaptation and drive disease biomarker discovery.
RNA self-splicing by engineered hairpin ribozyme variants
Authors: Hieronymus Robert , Zhu Jikang , Müller Sabine
Published: December 2021

Small RNAs capable of self-cleavage and ligation might have been the precursors for the much more complex self-splicing group I and II introns in an early RNA world. Here, we demonstrate the activity of engineered hairpin ribozyme variants, which as self-splicing introns are removed from their parent RNA. In the process, two cleavage reactions are supported at the two intron-exon junctions, followed by ligation of the two generated exon fragments. As a result, the hairpin ribozyme, here acting as the self-splicing intron, is cut out. Two self-splicing hairpin ribozyme variants were investigated, one designed by hand, the other by a computer-aided approach. Both variants perform self-splicing, generating a cut-out intron and ligated exons.
CTCF-mediated chromatin looping provides a topological framework for the formation of phase-separated transcriptional condensates
Authors: Lee Ryanggeun , Kang Moo-Koo , Kim Yong-Jin , Yang Bobae , Shim Hwanyong , Kim Sugyung , Kim Kyungwoo , Yang Chul Min , Min Byeong-gyu , Jung Woong-Jae , Lee Eun-Chong , Joo Jung-Sik , Park Gunhee , Cho Won-Ki , Kim Hyoung-Pyo
Published: December 2021

CTCF is crucial to the organization of mammalian genomes into loop structures. According to recent studies, the transcription apparatus is compartmentalized and concentrated at super-enhancers to form phase-separated condensates and drive the expression of cell-identity genes. However, it remains unclear whether and how transcriptional condensates are coupled to higher-order chromatin organization. Here, we show that CTCF is essential for RNA polymerase II (Pol II)-mediated chromatin interactions, which occur as hyperconnected spatial clusters at super-enhancers. We also demonstrate that CTCF clustering, unlike Pol II clustering, is independent of liquid-liquid phase-separation and resistant to perturbation of transcription. Interestingly, clusters of Pol II, BRD4, and MED1 were found to dissolve upon CTCF depletion, but were reinstated upon restoration of CTCF, suggesting a potent instructive function for CTCF in the formation of transcriptional condensates. Overall, we provide evidence suggesting that CTCF-mediated chromatin looping acts as an architectural prerequisite for the assembly of phase-separated transcriptional condensates.
PAGEANT: personal access to genome and analysis of natural traits
Authors: Huang Jie , Liang Zhi-Sheng , Pallotti Stefano , Ranson Janice M , Llewellyn David J , Zheng Zhi-Jie , King Daniel A , Zhou Qiang , Zheng Houfeng , Napolioni Valerio
Published: December 2021

GWASs have identified numerous genetic variants associated with a wide variety of diseases, yet despite the wide availability of genetic testing the insights that would enhance the interpretability of these results are not widely available to members of the public. As a proof of concept and demonstration of technological feasibility, we developed PAGEANT (Personal Access to Genome & Analysis of Natural Traits), usable through Graphical User Interface or command line-based version, aiming to serve as a protocol and prototype that guides the overarching design of genetic reporting tools. PAGEANT is structured across five core modules, summarized by five Qs: (i) quality assurance of the genetic data; (ii) qualitative assessment of genetic characteristics; (iii) quantitative assessment of health risk susceptibility based on polygenic risk scores and population reference; (iv) query of third-party variant databases (e.g. ClinVAR and PharmGKB) and (v) quick Response code of genetic variants of interest. Literature review was conducted to compare PAGEANT with academic and industry tools. For 2504 genomes made publicly available through the 1000 Genomes Project, we derived their genomic characteristics for a suite of qualitative and quantitative traits. One exemplary trait is susceptibility to COVID-19, based on the most up-to-date scientific findings reported.
Beyond Gutka: Evidence of Illegal Smokeless Tobacco in Rural and Semi-urban Areas in India
Authors: Welding Kevin , Saraf Sejal , Iacobelli Michael , Smith Katherine Clegg , Puntambekar Namrata , Gupta Prakash C , Cohen Joanna E
Published: December 2021

Introduction

Gutka, a popular smokeless tobacco (SLT) product combining chewing tobacco, areca nut, and spices, was banned by states in India beginning in 2012. Gutka can be recreated by the user mixing twin packets of tobacco and spice mixtures. We examine the availability of premixed gutka, the sale of twin packets (chewing tobacco and spice mixture sold together but in separate packets) and whether SLT was sold without legally mandated health warning labels (HWLs), without the printed maximum retail price (MRP), and above the MRP.

Aims and Methods

In October/November of 2017, unique SLT packets were purchased using a systematic protocol in 25 localities with populations under 50 000 across five Indian states. Purchase information (location, twin packets, price paid) and packaging information (SLT type, printed MRP, type of HWL) were used to assess legality.

Results

Of the 240 purchases of unique SLT packets, three were premade gutka. Twin packets were half of the sample, sold in every state, and illegally sold in Maharashtra where they were banned. Over half (62%) of single packets and 27% of twin packets did not feature a legal HWL. While only 5% of packets did not have a printed MRP, 29% of single packets, and 38% of twin packets were sold illegally for more than the MRP.

Conclusions

SLT without the proper HWL or sold above the MRP were common. Twin packets were widely available. India should consider a country-wide restriction to ban single serving tobacco packets that would decrease affordability.

Implications

This study is the earliest and that first outside of Mumbai that we are aware of to present evidence of tobacco products being sold above the MRP in India. While finding little evidence of premade gutka being sold, we found twin packets (chewing tobacco and spice mixture packets sold together) are widely available even in Maharashtra, which has a policy in place to ban twin packets. This study also finds evidence of SLT products sold without the correct HWL and without a MRP listed which shows that implementation and enforcement of regulations are as important as passing regulations.
Preliminary Evaluation of Short-Term Abstinence Effects Among Never-Smoking Experienced Users of Modern Electronic Cigarettes
Authors: Felicione Nicholas J , Douglas Ashley E , McClernon F Joseph , Blank Melissa D
Published: December 2021

Introduction

ECIG use has increased among non-smokers, with the potential negative consequence of developing nicotine dependence. ECIG users report withdrawal symptoms upon abstinence, though the significance of these symptoms has been questioned. This preliminary study aimed to characterize the early timecourse of ECIG withdrawal under forced abstinence.

Methods

Fifteen never-smoking ECIG users completed two conditions whereby participants either abstained from ECIG use (abstinence) or used their own ECIG (ad lib) for 3 h. Puff topography in this latter condition was measured via video observation. Outcome measures included heart rate, subjective ratings of withdrawal, cognitive performance, and choice behavior.

Results

Heart rate was lower during abstinence compared to ad lib use (F = 12.60, p < .01, ƞp2 = 0.47). Higher levels of craving (F = 4.98, p < .05, ƞp2 = 0.26) and lower levels of nicotine effects (e.g., dizzy, F = 4.62, p < .05, ƞp2 = 0.36) were reported during abstinence compared to ad lib use. Interaction effects were observed for both factors of the Questionnaire of Smoking Urges: Brief (Fs > 3.56, ps < .05, ƞp2s = 0.21–0.27), with factor scores increasing from baseline to 90 min in the abstinent condition only. Inhibitory control was impaired at 120 min in the abstinent condition only (F = 7.51, p < .05, ƞp2 = 0.50).

Conclusions

Never-smoking ECIG users experienced aversive withdrawal symptoms within 2–3 h of abstinence. Future work should include other control conditions, such as placebo ECIGs or nicotine replacement therapy, and biomarkers of nicotine exposure, as well as examine withdrawal as a function of device type.

Implications

Never-smoking ECIG users experience some aversive nicotine withdrawal symptoms within two to three hours of abstinence. Relative to ad lib ECIG use, abstinence decreased heart rate and inhibitory control, as well as increased subjective ratings of withdrawal such as craving and intention to vape. Those same symptoms might be suppressed by self-administration of ECIGs. Experiencing withdrawal upon abstinence may indicate that ECIGs can cause dependence without a history of other tobacco use.
Adherence to the Mediterranean diet and the risk of lung cancer: a systematic review and dose-response meta-analysis of observational studies
Authors: Bahrami Alireza , Khalesi Saman , Makiabadi Elham , Alibeyk Sepide , Hajigholam-Saryazdi Maryam , Hejazi Ehsan
Published: December 2021

Context

The literature supports the protective role of the Mediterranean diet (MD) in the prevention of some types of cancer, such as colorectal and liver cancer. The link between the MD and lung cancer, however, is still unclear.

Objective

The aim of this systematic review and meta-analysis was to investigate the association between the MD and risk of lung cancer.

Data Sources

Electronic databases (PubMed, Scopus, Embase, and Web of Science) were searched up to May 2021.

Study Selection

Case-control and cohort studies reporting the association between intake of the MD and risk of lung cancer and with accessible full texts published in English were included. Review articles, laboratory and animal studies, abstracts, letters to the editor, and studies lacking sufficient data were excluded.

Data Extraction

The risk ratio (RR) was extracted from eligible studies, and meta-analysis was performed to calculate the pooled RR of the included studies.

Results

Nine studies (8 cohort, 1 case-control) were included in the meta-analysis. High adherence to the MD was associated with a lower likelihood of lung cancer compared with low adherence (RR = 0.84; 95%CI, 0.77–0.91; I2 = 52%, heterogeneity P = 0.03). Dose-response analysis showed that a 2-score increment in MD adherence was associated with a 6% lower risk of lung cancer (RR = 0.94; 95%CI, 0.91–0.96; nonlinearity P = 0.97). Subgroup analyses showed a protective association between MD adherence and risk of lung cancer among former smokers (n = 3 studies) (RR = 0.81; 95%CI, 0.74–0.89), but no significant association was observed for never smokers (n = 3 studies) (RR = 0.78; 95%CI, 0.29–2.07) or current smokers (n = 3 studies) (RR = 0.82; 95%CI, 0.58–1.16). In addition, an inverse association between the MD and lung cancer was observed in both males (RR = 0.84; 95%CI, 0.74–0.96) and females (RR = 0.87; 95%CI, 0.77–0.98).

Conclusions

High adherence to the MD is associated with a lower risk of lung cancer, especially in former smokers.

Systematic Review Registration

PROSPERO registration no. CRD42019146460.
Opposing views: associations of political polarization, political party affiliation, and social trust with COVID-19 vaccination intent and receipt
Authors: Dolman Andrew J , Fraser Timothy , Panagopoulos Costas , Aldrich Daniel P , Kim Daniel
Published: December 2021

Introduction

Political polarization has increased in the USA within recent years. Studies have shown Republicans are less likely to accept COVID-19 vaccinations than Democrats; however, little is known regarding the association between COVID-19 vaccination acceptance and political polarization.

Methods

We used data from a nationally-representative survey of 1427 participants conducted between 9 February 2021 and 17 February 2021. We estimated multivariate-adjusted odds ratios for COVID-19 vaccination intent and receipt according to perceived political polarization (measured as the perceived size of the ideological gap between Democrats and Republicans), political party affiliation, and social trust, controlling for demographic and socioeconomic factors.

Results

Among participants perceiving high levels of polarization, Republicans (versus Democrats) reported a 90% lower odds of vaccination intent (OR = 0.10 [0.05, 0.19], P < 0.001). Participants with high (versus low) social trust and low perceived polarization had a 2-folder higher vaccination intent (OR = 2.39 [1.34, 4.21], P = 0.003); this association was substantially weaker in the high perceived polarization group.

Conclusions

High perceived levels of political polarization appear to magnify the decrease in the odds of receiving the COVID-19 vaccine and the intent to get vaccinated among Republicans versus Democrats. Political polarization may further attenuate the protective associations of high social capital with vaccination.
Efficacy of pulse dexamethasone in non-systemic juvenile idiopathic arthritis: a double-blind randomized controlled trial
Authors: Bhardwaj Umang , Bagri Narendra K , Lodha Rakesh , Kabra Sushil K , Velpandian Thirumurthy , Pandey Ravindra M
Published: December 2021

Objective

Early aggressive therapy using biologicals is increasingly being used in JIA for early disease remission. Pulse steroids are used in induction regimes for rheumatic disorders such as SLE and systemic JIA; however, no controlled studies have demonstrated their use in non-systemic JIA. The objective of the present study was to evaluate the efficacy and safety of pulse dexamethasone therapy in children with treatment-naïve non-systemic JIA as early aggressive therapy in resource-limited settings.

Methods

Sixty treatment-naïve children with non-systemic JIA with an active joint count of ≥5 and/or involvement of hip or cervical joints were randomized to receive either pulse dexamethasone (3 mg/kg/day, max 100 mg/day) or placebo (normal saline) for three consecutive days during each visit at 0, 6 (±2) and 12 (±2) weeks; along with standard therapy (MTX and NSAIDs). The use of oral bridge steroids was permissible for persistent severe disease as per predefined criteria. The primary outcome was ACR-Pedi 70 response at 16 (±2) weeks after enrolment in the two groups.

Results

The proportion of children achieving ACR-Pedi 70 in the two groups at last follow-up was 11/30 (36.7%) in pulse dexamethasone arm vs 11/28 (39.3%) in the placebo arm (P-value 0.837, relative risk 0.93, 95% CI 0.48, 1.80). We did not observe any significant difference in the proportion of children requiring bridge steroids. Adverse events were comparable in the two groups.

Conclusion

The addition of pulse dexamethasone to standard treatment may not add any advantage in improving ACR-Pedi 70 scores at medium-term follow-up.

Trial registration

Clinical Trial Registry-India; www.ctri.nic.in CTRI/2018/08/015151.
STATISTICAL MODELING OF GLANDULARITY FROM MAMMOGRAPHY IMAGES
Authors: Castrillón Carolina Osorio , Puerta Jorge Anselmo
Published: December 2021

This study presents a methodology for estimation of breast glandularity, which is an important factor to assess radiological risk in mammography patients. The investigation took place in an institution located at department of Antioquia-Colombia, where 200 patients participated. The models were obtained using partial least squares regression, where Dance’s model was used as reference; parameters of mammography images, equipment and patient were used as predicting variables (kV, mAs, patient’s weight, breast area and mean gray value of breast images). Coefficients of correlation equal to 89 and 88 were obtained for training and validation respectively in mediolateral oblique (MLO) and 84 and 89 for craniocaudal (CC). These models were used to estimate the mean glandular dose for all patients and later to obtain the institutional reference levels, 0.87 and 0.96 mGy for CC and MLO, respectively, following the recommendations of the ICRP publication No. 135. This study suggests that glandularity could be estimated with few parameters from equipment and patient.
Carbon allocation strategies and water uptake in young grafted and own-rooted hazelnut (Corylus avellana L.) cultivars
Authors: Portarena Silvia , Gavrichkova Olga , Brugnoli Enrico , Battistelli Alberto , Proietti Simona , Moscatello Stefano , Famiani Franco , Tombesi Sergio , Zadra Claudia , Farinelli Daniela
Published: December 2021

In this study, grafted and own-rooted young hazelnut plants of three high-quality cultivars were cultivated in Central Italy to investigate possible differences in growth, fruit and flower production, and physiological processes encompassing water uptake, photosynthetic variables and non-structural carbohydrate allocation. Stable isotopes and photosynthetic measurements were used to study carbon and water fluxes in plants. For the first time, an ecophysiological study was carried out to understand the seasonal growth dynamics of grafted plants in comparison with own-rooted plants. The own-rooted hazelnuts showed rapid above-ground development with large canopy volume, high amount of sprouts and earlier yield. The grafted plants showed greater below-ground development with lower canopy volumes and lower yield. However, later, the higher growth rates of the canopy led these plants to achieve the same size as that of the own-rooted hazelnuts and to enter the fruit production phase. Different seasonal behaviour in root water uptake and leaf photosynthesis-related variables was detected between the two types of plants. The grafted plants showed root development that allowed deeper water uptake than that of the own-rooted hazelnuts. Moreover, the grafted plants were characterized by a higher accumulation of carbohydrate reserves in their root tissues and by higher stomatal reactivity, determining significant plasticity in response to seasonal thermal variations.
Clonal Distribution and Antibiotic Susceptibility ofStaphylococcus aureusfrom Pediatric Patients: 8-Year Trends in a Children’s Hospital in Colombia
Authors: Montes Oscar , Hernández Jordan , Correa Oscar , Reyes Jeison , Pinzon Hernando , Reyes Niradiz
Published: December 2021

Emergence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) strains in healthcare settings has changed the hospital epidemiology of MRSA in the last few years. Despite a global increase in MRSA frequency, infections caused by methicillin-susceptible S. aureus (MSSA) have persisted in healthcare settings and the community. Staphylococcus aureus isolates were collected between 2009 and 2017 at the Children’s Hospital of a Caribbean city in South America. Methicillin-resistant isolates were subjected to SCCmec typing. Representative isolates were analyzed by multilocus sequence typing (MLST) and spa typing. Antibiotic susceptibility was assessed by agar dilution method. D-zone test was performed in erythromycin-resistant isolates to determine macrolide/lincosamide/streptogramin resistance. Spa typing revealed 10 different spa types. The main epidemic clones circulating during the study period were: ST8-MRSA-IVc, ST923-MRSA-IVa and ST8-MRSA-IVa. The study found high frequencies of PVL genes and resistance to erythromycin and clindamycin in the isolates. This study provides the first description of the population structure of MRSA and MSSA causing infections attended in the participating Children’s Hospital. ST8-MRSA-IVc, ST923-MRSA-IVa and ST8-MRSA-IVa were the most prevalent in the isolate population.
Access to the EU Courts in Environmental and Public Health Cases and the Reform of the Aarhus Regulation: Systemic Vision, Pragmatism, and a Happy Ending
Authors: Leonelli Giulia Claudia
Published: December 2021

After years of debate, the Aarhus Regulation has finally been reformed. This article focuses on the amendments to the scope of application of the Regulation’s internal review and access to justice provisions, and demonstrates that these are the most important changes introduced by the reform. Not only do these amendments mark an important development towards full compliance by the European Union (EU) with its obligations under the Aarhus Convention; they also fill a vacuum, and solve the main problem which lay at the heart of the EU system of access to justice in environmental public interest cases. First, the article explores the obstacles faced by different stakeholders seeking access to the EU Courts by reference to specific categories of EU environmental law and risk regulation acts. This provides a systemic overview of different problematic aspects associated with different scenarios, unpacking all relevant implications. Secondly, it embraces a pragmatic perspective and draws a clear distinction between challenges to legislative and regulatory acts. Against the backdrop of this examination, the article identifies the main problem of the EU system: the application of the ‘complete system of legal remedies’ rationale to the specific case of regulatory acts. Further, it highlights that there is no ‘interpretative’ way out of the TFEU conundrum. Thirdly, the article analyses the Commission’s disappointing proposal for a reform of the Aarhus Regulation and the final text of the 2021 amendments to the Regulation. The story has a (surprisingly) happy ending. The EU institutions have finally acknowledged the main problem in the system of access to the EU Courts in environmental matters, and recognized the need to solve it in the specific context of the Aarhus Regulation.
Standardizing a Postoperative Protocol for Supracondylar Humerus Fractures
Authors: Heyer Jessica H. , Anari Jason B. , Baldwin Keith D. , Arkader Alexandre
Published: December 2021

Background:

Supracondylar humerus fractures are the most commonly operated upper extremity fracture in pediatric orthopaedics, yet there does not currently exist a standardized recommendation for a postoperative protocol. As advanced practice providers take on larger roles in the care of fracture patients, it may alleviate confusion to standardize postoperative protocols. The aim of this study was to compare outcomes between three different postoperative management protocols following operative fixation of supracondylar humerus fractures.

Methods:

This is a retrospective study of all patients who underwent operative fixation of a supracondylar humerus fracture during the 2014 to 2015 academic year. Postoperative protocols were classified as either “liberal,” “intermediate,” or “conservative,” based on how quickly the surgeon allowed unrestricted motion of the elbow postoperatively. Patients were evaluated for range of motion, functional elbow motion, and elbow clinical function, as well for postoperative complications. Univariate analysis was conducted to detect the differences in outcomes between protocol groups with P<0.01 considered significant.

Results:

One hundred patients were included in the final analysis, with 17 patients in the liberal group, 50 in the intermediate group, and 33 in the conservative group. There were no differences in patient population (age, sex, fracture type, concomitant nerve palsy, ipsilateral injuries, or physical therapy referrals) between the groups (P>0.01). There were no differences in range of motion, functional motion, or elbow clinical function (P>0.01) between the postoperative protocol groups. There were no postoperative complications (unplanned return to operating room, refracture, need for fixation revision, or infection) in any patient.

Conclusions:

There were no differences in postoperative complications or outcomes between the patients in the liberal, intermediate, or conservative protocol groups. In an efficiency-focused era, we conclude that a standardized liberal protocol be considered at a busy orthopaedic center.

Level of Evidence:

This study is a level III therapeutic study. It is a retrospective study that compares the outcomes after following 1 of 3 different postoperative protocols.
Reinjury Rates in Adolescent Patients 2 Years Following ACL Reconstruction
Authors: Kew Michelle E. , Bodkin Stephan , Diduch David R. , Brockmeier Stephen F. , Lesevic Milos , Hart Joseph M. , Werner Brian C.
Published: December 2021

Background:

Sports injuries have increased dramatically in the pediatric and adolescent population. Return-to-sport testing and criteria are increasingly utilized, however, the guidelines for return to play in adolescents are unclear. The purpose of this study was to compare strength and function at the time of the return-to-sport progression to those with and without a failed anterior cruciate ligament reconstruction (ACLR).

Methods:

A total of 105 adolescent patients with primary ACLR were assessed at the time of return to sport. We identified graft failures/contralateral injury through medical records, clinic visits, or phone interviews at minimum 2 years of postsurgical follow-up. All patients completed bilateral isokinetic strength tests of the knee extensor/flexor groups and hop tests. Strength was expressed as torque-normalized-to-mass (Nm/kg), and limb-symmetry-index was expressed as a percentage of the uninvolved limb’s strength. All patients completed outcome surveys. The χ2 analysis was used to compare failures between sexes and graft types. Independent sample t tests were used to compare knee extensor/flexor strength, symmetry, and hop test results between patients with and without secondary anterior cruciate ligament (ACL) injury. One-way analysis of variance was used to compare knee extensor/flexor strength and symmetry, hop test, and survey results between those (1) without secondary injury, (2) ACLR graft failure, and (3) contralateral ACL injury.

Results:

A total of 100 of 105 patients (95.2%) were included with 4±1.2 years of follow-up, with 28 (28%) sustaining subsequent injury (12% graft, 16% contralateral). Patients with graft failure demonstrated (1) stronger quadriceps strength (2.00±0.46 Nm/kg) compared with those with contralateral ACL injury (1.58±0.35 Nm/kg, P=0.039) and patients that did not have a secondary injury (1.58±0.44 Nm/kg, P=0.007), (2) greater quadriceps strength symmetry (85.7±0.11.2%) compared with patients without secondary injury ACL (72.9±17.9%, P=0.046), (3) a greater proportion of hamstring grafts compared with those without reinjury (P=0.028).

Conclusions:

Adolescent patients who sustained ACLR graft failure had greater and more symmetric quadriceps strength at the time of return to sport compared with patients with no secondary injury. Objective measures of quadriceps strength at the time of the return-to-sport progression may not solely identify individuals that have a secondary ACL injury.

Study Design:

Level IV—retrospective cohort study.
Minimally Invasive Interphalangeal Arthrodesis
Authors: Folberg Celso R. , Alves Jairo André O. , Pereira Fernando M.S.
Published: December 2021

Distal interphalangeal joint fusion is usually the surgical treatment for primary or posttraumatic osteoarthrosis when conservative measures fail. All fusion techniques aim for solid fusion with joint chondral resection, bone to bone contact and stable fixation in an adequate position. This is performed with an open dorsal approach considering the risks of soft tissue complications. We describe a technique of resecting bone cartilage and getting stable fixation with 2 mini incisions, 1 lateral and 1 in the digital pulp. Using a digital block anesthesia and under fluoroscopy, a small round burr is introduced into the joint by a lateral joint line stab incision. The joint space is enlarged by manual traction on the finger. After adequate cartilage resection, good bone to bone contact in an adequate position is fixed with a cannulated Herbert screw inserted percutaneously by the finger pulp. We describe 4 cases operated with this technique, 3 for pain and 1 for esthetics. All 4 demonstrated good results and were satisfied. X-rays showed solid fusion in 8 to 12 weeks. There was one complication with skin burning because of the burr heating and the authors describe how to avoid it. Minimally invasive distal interphalangeal joint fusion is a simple, reproducible technique that maintains the important steps for a solid arthrodesis with the advantage of preserving the soft tissue envelope.
A Daily, Respiratory Therapist Assessment of Readiness to Liberate From Venovenous Extracorporeal Membrane Oxygenation in Patients With Acute Respiratory Distress Syndrome
Authors: Pratt Elias H. , Mausert Sarah , Wilson Michael D. , Emerson Logan J. , Navuluri Neelima , Pulsipher Aaron M. , Brucker Amanda , Green Cynthia L. , Bonadonna Desiree K. , Bryner Benjamin S. , Rackley Craig R.
Published: December 2021

Objectives:

We assessed the effect of implementing a protocol-directed strategy to determine when patients can be liberated from venovenous extracorporeal membrane oxygenation on extracorporeal membrane oxygenation duration, time to initiation of first sweep-off trial, duration of mechanical ventilation, ICU length of stay, hospital length of stay, and survival to hospital discharge.

Design:

Single-center retrospective before and after study.

Setting:

The medical ICU at an academic medical center.

Patients:

One-hundred eighty patients with acute respiratory distress syndrome managed with venovenous extracorporeal membrane oxygenation at a single institution from 2013 to 2019.

Interventions:

In 2016, our institution implemented a daily assessment of readiness for a trial off extracorporeal membrane oxygenation sweep gas (“sweep-off trial”). When patients met prespecified criteria, the respiratory therapist performed a sweep-off trial to determine readiness for discontinuation of venovenous extracorporeal membrane oxygenation.

Measurements and Main Results:

Sixty-seven patients were treated before implementation of the sweep-off trial protocol, and 113 patients were treated after implementation. Patients managed using the sweep-off trial protocol had a significantly shorter extracorporeal membrane oxygenation duration (5.5 d [3–11 d] vs 11 d [7–15.5 d]; p < 0.001), time to first sweep-off trial (2.5 d [1–5 d] vs 7.0 d [5–11 d]; p < 0.001), duration of mechanical ventilation (15.0 d [9–31 d] vs 25 d [21–33 d]; p = 0.017), and ICU length of stay (18 d [10–33 d] vs 27.0 d [21–36 d]; p = 0.008). There were no observed differences in hospital length of stay or survival to hospital discharge.

Conclusions:

In patients with acute respiratory distress syndrome managed with venovenous extracorporeal membrane oxygenation at our institution, implementation of a daily, respiratory therapist assessment of readiness for a sweep-off trial was associated with a shorter time to first sweep-off trial and shorter duration of extracorporeal membrane oxygenation. Among survivors, the postassessment group had a reduced duration of mechanical ventilation and ICU lengths of stay. There were no observed differences in hospital length of stay or inhospital mortality.
Fall 2021 Update
Authors: Schoonover-Shoffner Kathy
Published: December 2021

The COVID-19 pandemic and subsequent development of COVID vaccines have resulted in unique challenges for nurses. Nurses are being asked to make recommendations about vaccinations that have only been available since December 2020 even as vaccine information evolves on an almost daily basis. Standards of professional care and a Christian perspective on nursing to help guide nurses' practice in the current climate are discussed in this article. An overview of information and research findings published up to October 31, 2021 about COVID-19 vaccination is given to assist nurses in answering vaccination questions.
Rapid Initiation of Neoadjuvant Chemoradiotherapy After Diagnosis is Associated With Improved Pathologic Response in Locally Advanced Rectal Cancer
Authors: Lutsyk Myroslav , Turgeman Ilit , Bar-Sela Gil
Published: December 2021

Introduction:

In rectal cancer, neoadjuvant chemoradiation (NCRT) is preferred because of toxicity profile, improved resectability and sphincter preservation, although with no impact on overall survival. Pathologic complete response (pCR) to NCRT has been linked with longer disease-free survival (DFS). The study purpose was to evaluate an association between clinical factors and treatment schedule with tumor response and treatment outcome, among patients with locally advanced rectal cancer.

Patients and Methods:

In this single-center retrospective study, conducted over 9 years (2011 to 2020), patients with stage II to III rectal cancer who had received NCRT were enrolled. The standard radiotherapy was 45 Gy to the pelvis, with a simultaneous integrated 50 Gy boost to the primary tumor. Continuous 5-Fluorouracil or oral capecitabine was administered concurrently. Surgery was preplanned within 6 to 8 weeks. Multinomial logistic regressions for evaluation of clinical factors, Kaplan-Meier method for DFS estimation, and receiver operating characteristic analysis for determination of the optimal timeframe were used.

Results:

Of 279 cases, pCR was observed in 72 (25.8%). In 207 cases, pTis-4N-negative was obtained in 137 (66.2%), pT0N-positive in 6 (2.9%), and pTis-4N-positive in 64 (30.9%). The pCR group had shorter diagnosis-NCRT time (P<0.01) and on-treatment time (P=0.05). DFS was longer for pCR and partial responders with clinical stage II and III (P<0.0001). Diagnosis-NCRT time was shown different between pCR and non-pCR groups. receiver operating characteristic analysis (P<0.01) showed that a diagnosis-NCRT time of <4.5 weeks predicts pCR with a sensitivity of 88% and specificity of 81% accuracy.

Conclusion:

The time elapsed between rectal cancer diagnosis and NCRT initiation is significantly associated with pCR. Reducing this time may increase the probability of achieving pCR.
Longitudinal Monitoring of Hair Cortisol Using Liquid Chromatography–Mass Spectrometry to Prevent Hypercortisolism in Patients Undergoing Glucocorticoid Replacement Therapy
Authors: Kostolanská Katarína , Šiprová Helena , Bartečků Elis , Juřica Jan , Řiháček Ivan , Táborská Eva , Souček Miroslav , Peš Ondřej
Published: December 2021

Objective:

Currently available methods for endogenous cortisol monitoring in patients with hormonal insufficiency rely on measurements of plasma levels only at a single time point; thus, any kind of chronic exposure to cortisol is challenging to evaluate because it requires collecting samples at different time points. Hair cortisol levels acquired longitudinally better reflected chronic exposure (both cortisol synthesis and deposition) and may significantly contribute to better outcomes in glucocorticoid replacement therapies.

Design:

Twenty-two patients on cortisol substitution therapy were monitored for plasma, urinary, and hair cortisol levels for 18 months to determine whether hair cortisol may serve as a monitoring option for therapy setting and adjustment.

Methods:

Plasma and urinary cortisol levels were measured using standardized immunoassay methods, and segmented (∼1 cm) hair cortisol levels were monitored by liquid chromatography coupled to mass spectrometry. A log-normal model of the changes over time was proposed, and Bayesian statistics were used to compare plasma, urinary, and hair cortisol levels over 18 months.

Results and conclusions:

Hair cortisol levels decreased over time in patients undergoing substitutional therapy. The residual variance of hair cortisol in comparison to plasma or urinary cortisol levels was much lower. Thus, longitudinal monitoring of hair cortisol levels could prove beneficial as a noninvasive tool to reduce the risk of overdosing and improve the overall patient health.
Antibiotic Stewardship and Therapeutic Drug Monitoring of β-Lactam Antibiotics: Is There a Link? An Opinion Paper
Authors: Richter Daniel C. , Heininger Alexandra , Chiriac Ute , Frey Otto Roman , Rau Heike , Fuchs Thomas , Röhr Anka C. , Brinkmann Alexander , Weigand Markus A.
Published: December 2021

Purpose:

In critically ill patients, changes in the pharmacokinetics (PK) of β-lactams can lead to significant variations in serum concentrations, with possibly detrimental effects on outcomes. The utilization of individually calculated doses, extended infusion regimen, and therapeutic drug monitoring (TDM)-guided dose adjustments can mitigate the PK changes and help to achieve and attain an individual PK target.

Methods:

We reviewed relevant literature from 2004 to 2021 using 4 search engines (PubMed, Web of Science, Scopus, and Google Scholar). Unpublished clinical data were also examined.

Results:

TDM-guided, individualized dosing strategies facilitated PK target attainment and improved patient outcomes. TDM-guided therapy is a core concept of individualized dosing that increases PK target attainment and identifies possible toxic β-lactam concentrations.

Conclusions:

Individualized dosing and TDM facilitate the rational use of β-lactams and are integral for antibiotic stewardship interventions in critical care, affording the optimal exposure of both pathogen and drugs, along with enhanced treatment efficacy and reduced emergence of antimicrobial resistance.
Extreme Gigantomastia Caused by Pseudoangiomatous Stromal Hyperplasia at Hopital Universitaire de Mirebalais: A Case Report
Authors: Jean-Louis Willy F. , Bowder Alexis , Dupont Claude R. , Delva Ruth , Jean-Louis McLee , Mixter Roger C. , Duffy Frederick J.
Published: December 2021

Gigantomastia is a rare pathologic condition characterized by an excessive and abnormal breast development. To date, there is no universally accepted definition or classification of this disease. The purpose of this article is to present a case of extreme and disabling gigantomastia caused by pseudoangiomatous stromal hyperplasia, the rarest etiology of gigantomastia. Very few cases have been listed in the literature. We believe this case of gigantomastia is unique because of its associated severe morbidity considerably impacting the patient’s life. Good aesthetic results and high patient satisfaction can be achieved with bilateral breast reduction and free nipple areola grafts.
Seminal and testicular microbiome and male fertility
Authors: Brandão Pedro , Gonçalves-Henriques Manuel , Ceschin Nathan
Published: December 2021

Microbiome is of upmost importance for the well-being of the human body. Based on culture and PCR methods, seminal flora has been pointed as a potential cause for some of the unexplained male infertility.

This is a systematic review about the effect of seminal microbiota studied by Next Generation Sequencing techniques on sperm quality and male fertility, performed according to PRISMA statement.

Nine articles were included. Results of different studies are diverse. It seems that microbiota may a play a role in seminal quality and further male fertility, but the way this effect is modulated is still to be unknown. Lactobacillus spp seemed to play a beneficial role in semen quality, but the role of the remaining bacteria is unclear.

Due to the lack of research and the incongruence of the results so far, the effect of microbiota on seminal quality is still unclear.
The Role of Endoplasmic Reticulum Stress in Melanoma
Authors: Shi Hao-Ze , Sun Jian-Fang , Chen Hao
Published: December 2021

Evidence has shown that endoplasmic reticulum (ER) stress plays a role in the regulation of skin physiological functions such as melanocyte transformation and keratinocyte-related epidermal homeostasis. Other pathological processes may also be influenced. Recently, more evidence has suggested that ER stress participates in the pathogenesis of melanoma. Many biological functions of melanoma can be affected by the disturbance of ER stress. We herein review the network of ER stress and its role in melanoma and discuss several chemicals or drugs that may act as tumor inhibitors by influencing ER stress.