bluuebunny/crossref_metadata_2025 huggingface dataset:
Anterolateral Extraarticular Stabilisation of the Knee: Modified Lemaire Procedure
Authors: Giebel Gregor M. , Ahmad Sufian S. , Stöckle Ulrich , Konrads Christian
Published: March 2022

The anterolateral aspect of the knee is prone to laxity or symptomatic instability, if the anterior cruciate ligament (ACL) is torn. It is necessary to address this issue in
patients with general joint hyperlaxity, overextension of the knee, massive anterolateral instability, or re-tear of the ACL with chronic instability. In these cases, and in
addition to a preoperative bony workup and revision ACL reconstruction, anterolateral stabilisation should be considered to avoid persistent anterolateral rotation instability and
failure of the ACL reconstruction.

To stabilise the anterolateral corner of the knee, the modified Lemaire procedure as presented and illustrated here is a straight forward surgical technique that can be performed
right after standard ACL reconstruction surgery, if indicated. It is independent from the graft choice for the ACL reconstruction, and the surgical setting in the operating room
remains unchanged.
Cardiac Remodeling in Hypertension: Clinical Impact on Brain, Heart,
and Kidney Function
Authors: Mavrogeni Sophie , Piaditis George , Bacopoulou Flora , Chrousos George P.
Published: March 2022

Hypertension is the most common causative factor of cardiac remodeling, which, in
turn, has been associated with changes in brain and kidney function. Currently,
the role of blood biomarkers as indices of cardiac remodeling remains unclear.
In contrast, cardiac imaging, including echocardiography and cardiovascular
magnetic resonance (CMR), has been a valuable noninvasive tool to assess cardiac
remodeling. Cardiac remodeling during the course of systemic hypertension is not
the sole effect of the latter. “Remodeling” of other vital
organs, such as brain and kidney, also takes place. Therefore, it will be more
accurate if we discuss about “hypertensive remodeling” involving
the heart, the brain, and the kidneys, rather than isolated cardiac remodeling.
This supports the idea of their simultaneous assessment to identify the early,
silent lesions of total “hypertensive remodeling”. In this
context, magnetic resonance imaging is the ideal modality to provide useful
information about these organs in a noninvasive fashion and without radiation.
For this purpose, we propose a combined protocol to employ MRI in the
simultaneous assessment of the heart, brain and kidneys. This protocol should
include all necessary indices for the evaluation of “hypertensive
remodeling” in these 3 organs, and could be performed within a
reasonable time, not exceeding one hour, so that it remains patient-friendly.
Furthermore, a combined protocol may offer “all in one
examination” and save time. Finally, the amount of contrast agent used
will be limited granted that post-contrast evaluations of the three organs will
be performed after 1 injection.
Grizzly bear response to translocation into a novel environment
Authors: Stenhouse Gordon B. , Larsen Terrence A. , McClelland Cameron J. R. , Wilson Abbey E. , Graham Karen , Wismer Dan , Frame Paul , Phoebus Isobel
Published: March 2022

Context To mitigate conservation conflicts, some jurisdictions translocate large carnivores into novel environments where they have no previous experience. Behavioural responses of these individuals are not typically monitored to evaluate the impacts of this management approach on the animals or populations. Aims We examined how grizzly bears (Ursus arctos) involved in conservation conflict responded to novel environments after translocation. Methods We used GPS location data to compare grizzly bears translocated to a novel environment (n = 12) with bears resident within the new area (n = 12). Our analyses investigated differences between these groups in relation to exploration behaviour, habitat use and response to human-caused mortality risk. Key results Translocated bears had higher movement rates, greater daily displacement and revisited areas less frequently than did resident bears. They spent more time in poor-quality habitat and the habitat used was of even lower quality in the second year after translocation. Translocated bears selected for agricultural lands and active oil and gas wellsites. They also spent more time in areas with higher potential mortality risk than resident bears. However, translocated bears avoided residential areas, which resident bears selected, and crossed roads at the same rate as did resident bears. Both groups avoided campgrounds and recreation sites. Only 25% of bears engaged in further conflict behaviour after translocation and 67% of translocated bears survived over the 2-year monitoring period. Conclusions This work found differences in exploration behaviour and habitat use between translocated and resident bears, and showed that translocated bears can survive without reoffending during the critical few years following translocation. Implications Managers and the public should recognise potential impacts for translocating grizzly bears. Translocated bears require time to explore and learn within their new environment, a process that can occur without repeating conflict. When conflict behaviour does re-occur, it should be viewed as a part of animal learning and not immediately as failure. On the basis of the amount of time translocated bears spent near humans and anthropogenic features, our findings suggest that translocated bears do not pose a greater threat to humans than do resident bears.
Peer-to-peer accommodation and resilient hosts in split: the case of Radunica Street.
Authors: Tolić Helena , Matečić Ingeborg
Published: March 2022

Through a qualitative approach, including autoethnography and open-ended interviews, this study focuses on how offline peer-to-peer (P2P)-accommodation trading was used as a post-crisis recovery tool. We focused our study on Radunica Street, situated in the city centre of the Croatian city of Split. We identified the motives that led hosts to engage in offine P2P-accommodation trading and then, eventually, online P2P-accommodation trading and uncovered resilience attributes that characterize these individuals. Community networks and new relationships caused by offline P2P-accommodation trading and the cooperation between hosts and gatherers (locals who searched for tourists) were analysed. Our research explains how this arbitrary and unstable cooperation within the local community shaped its people. Moreover, it led us to a broader definition of the term 'peer-to-peer accommodation' since the results show that on Radunica Street this does not apply only to a 'host-to-tourist' way of doing business. Before paid-online P2P-network platforms entered the Croatian market, this 'peer-to-peer' relationship was actually based on a triangular 'gatherer-host-tourist' cooperation, which has changed the culture of everyday life in the street for good.
Local commitment and withdrawal in the wake of conspicuous Airbnb place dynamics on a cold-water island.
Authors: Röslmaier Michael , Albarrán David
Published: March 2022

In recent years, Airbnb has gained tremendous attention in sense-of-place and community-resilience research. Yet, we find few scholarly efforts to relate particular issues of community resilience to a sense of place that emerges in the wake of conspicuous place dynamics of Airbnb beyond the urban context. In this case study on Heimaey, Iceland, we use geographic information systems (GIS), AirDNA data on Airbnb, and in-depth interviews to address this research gap. We find that as professional Airbnbs concentrate in the 'downtown' (town centre) area, residents mourn over lost pasts with a heightened sense of place that fuels intentions to withdraw. The isolated, casual, Airbnb landscape in the 'residential west', meanwhile, still allows locals to retain stewardship over place meanings, identities and community structure, which translates into increasing commitment out of fear of losing these privileges in the near future. This chapter encourages future research to become concerned with Airbnb developments in non-urban environments where sense of place and community resilience are both intrinsically linked and negotiated by different types of host activities in different locations.
Understanding the Airbnb community and its community impact: the use of scenarios to build resilience.
Authors: Oskam Jeroen
Published: March 2022

This conceptual chapter looks back at two scenario studies of the development of 'home-sharing', and in particular Airbnb, that were conducted in 2015 and 2018, respectively. These studies revolved around analyses of different interpretations and controversies that surrounded the emergent phenomenon: (i) the question, whether 'home-sharing' facilitated a new mode of consumption and, with that, the integration of tourists in resident communities; (ii) the empowering effects Airbnb claimed to have in resident communities; and (iii) the spatial distribution of tourism that 'home-sharing' would cause. These three debates are closely linked to the 'community' concept as it is used by Airbnb. The scenario studies gave insight, at an early stage, into the decisiveness of tourism growth in the eventual development of Airbnb. They also gave an early warning that without transparency local communities would be unable to impose their norms to control the phenomenon's undesirable impacts. The implication is that scenarios can help communities in strategic decision making.
Elections, constituency consultation and political representation in Boko Haram-affected areas in Nigeria
Authors: Omoragbon Osaze , Okhade Nafisatu Irene
Published: March 2022

The Boko Haram insurgency has taken a toll on life in North East Nigeria. This briefing explores the impact of the conflict on elections, constituency consultation and political representation in affected areas. Using data on parliamentary recess, we estimate federal legislators’ consultation time and argue that the insurgency is a setback for participatory democracy.
Annealing-induced hardening of laminated structured nickel fabricated by electrodeposition
Authors: Zhang Jian , Lei Yun , Wang Ning , Yang Ping , Zhu Xinkun , Shu Baipo
Published: March 2022

Annealing of deformed metals is considered as a process which necessarily leads to softening, due to the annihilation of lattice defects. However, in laminated materials, annealing at moderate temperatures may induce hardening. In this study, a laminated structure at two sides of the sample is produced by ultrasonic introduced intermittently for 15 min, during the electrodeposition process. For comparison, a sandwich structure is prepared under ultrasonic without interruption at two sides of the sample. All the samples are annealed for 30 min at 373 K, 473 K and 573 K. The common softening after annealing is observed for the sample without laminated structure in the two sides. However, for the other sample that possesses laminated structure in the same area at the two sides, the strength and ductility increase rather than decrease after annealing. The sample that possesses laminated structure in the same area at the two sides annealed at 373 K shows an evident change, which increases in σ
0.2 from 299 to 353 MPa, in σ
UTS from 477 to 533 MPa, and in ε
ue from 7.6% to 9.5%. According to the XRD results, annealing-induced hardening is not attributable to occurring phase transformation. Detailed microstructural TEM results demonstrate that the annealing-induced hardening is attributed to the surface laminated interfaces and high-density growth twins in interfacial transition zones. In addition, the detwinning occurred during subsequent tensile deformation, also plays a crucial role.
Creation of a pharmacy leadership certificate program for pharmacists and pharmacy technicians using an innovative, low-cost framework
Authors: Wills Robert , Hunt Lindsey , Oswald Chris , Mason Barb , Crawford Lindsay
Published: March 2022

Purpose

To describe the creation of a statewide leadership training program for practicing pharmacists and pharmacy technicians. The 2 overarching goals were to (1) enable learners to develop foundational leadership skills that could be used at their place of work or would enable them to take on a new or advanced role and (2) help foster sustainability within our state pharmacy society through incorporation of the learners on committees and projects, bringing awareness to board member roles and functions. Overall, the program’s mission was to empower practicing pharmacists and pharmacy technicians to take on leadership roles within their organization and the state pharmacy society.

Leadership training for pharmacists and pharmacy technicians can be variable, elusive, and costly. We provide our experiences in establishing a 1-year leadership certificate program affiliated with the state pharmacy society. In the first 4 years, a total of 15 program fellows have graduated, with 8 more set to finish in September 2022. Since completion of the program, a majority of the graduates have taken on new leadership positions (65% have accepted new leadership positions and 35% have been elected to state pharmacy society board positions).

Conclusion

Implementation of a statewide pharmacy leadership program provided a low-cost, high-value option to develop local leaders, in affiliation with a state pharmacy society.
New Method for Genital Aesthetic Surgery: An Easy-to-Learn 2-Step Approach With Acellular Dermal Matrix
Authors: Li Yunzhu , Xia Zenan , Bai Ming , Wei Lan , Xiao Yiding , Zhang Dingyue , Chen Jie , Zhang Hailin , Long Xiao , Wang Xiaojun
Published: March 2022

Background

Vaginal laxity, usually accompanied with prolapse symptoms, affects women’s sexual satisfaction and quality of life. Vaginal tightening surgery aims to reinforce perivaginal muscle strength and restore normal vaginal anatomy.

Objectives

The aim of this study was to introduce a new surgical approach to vaginal tightening that uses acellular dermal matrix.

Methods

In this retrospective study, data from 80 patients with vaginal laxity who underwent surgery between April 2017 and April 2021 were analyzed. Three-dimensional transvaginal ultrasound was performed and the Female Sexual Function Index was evaluated.

Results

The mean age of the patients was 44.6 years. The mean patient follow-up was 13.2 months. No infection, rectovaginal fistula, or implant explantation occurred. Transvaginal ultrasound examination demonstrated a significant reduction of introital diameter on a maximum Valsalva maneuver (2.3 cm vs 4.1 cm; P < 0.05) and the reconstruction of acute vaginal angulation. The Female Sexual Function Index orgasm subscore increased significantly.

Conclusions

Vaginal tightening with acellular dermal matrix is a minimally invasive surgery that offers a safe and effective treatment for patients with vaginal laxity.

Level of Evidence: 4
A potential deimatic display revealed in a lizard
Authors: Whiting Martin J , Noble Daniel W A , Qi Yin
Published: March 2022

Conspicuously coloured signals may evolve via sexual selection to be ornaments or armaments, thereby conferring a fitness advantage to their bearer. Conversely, conspicuous colours may also evolve under natural selection as either aposematic signals or deimatic displays that deter attacks from predators. While conspicuous colour patches may evolve for one purpose (e.g. quality indicators), they may later be co-opted for another (e.g. anti-predator defence). Phrynocephalus mystaceus is a cryptic agamid lizard with flaps in both sexes that when folded against the head are inconspicuous, but when deployed are predicted to be highly conspicuous and to increase the appearance of body size. We tested whether head flaps play a role in social signalling via courtship or as status signals during contests in both sexes. We also tested whether the head flaps have an anti-predator function by simulating predatory encounters. Head flaps were never deployed in courtship or during contests and, therefore, are unlikely to be under sexual selection. However, head flaps and their deployment during simulated predatory encounters were consistent with the predictions associated with deimatic display theory. First, head flaps were similar in form and function between sexes. Second, they were highly conspicuous to both avian and snake predators. Third, there was a rapid transition from crypsis to conspicuousness when they deployed their head flaps during a late stage of predation, the subjugation phase, consistent with an ambush. Confirmation of the deimatic display hypothesis will require future testing of receiver responses.
Treatment of in-transit Merkel cell carcinoma by isolated limb infusion with cytotoxic drugs
Authors: Hindmarch Jake J , Coker David J , Waugh Richard , Kam Peter C A , Thompson John F , Saw Robyn P M
Published: March 2022

Merkel cell carcinoma of the skin is a rare but aggressive malignancy, which predominantly affects older adults with fair skin. Isolated limb infusion (ILI) using melphalan and actinomycin D was first developed as a minimally invasive treatment option to treat unresectable metastatic melanoma confined to the limb. We report on a 62-year-old male with in-transit metastases (ITMs) treated with ILI to highlight the ongoing role this treatment has when all other therapies have been exhausted. At presentation, the patient had widespread ITMs in the right leg. Positron emission tomography scan demonstrated recurrent disease in the thigh and pelvis, and it was decided to treat the patient with ILI. The patient progressed well in the immediate post-operative period. The patient was able to mobilize from Day 6 post-ILI and was discharged on Day 10. There was an immediate clinical response seen in the lesions, with necrosis developing in the larger lesions.
Severe Acute Respiratory Syndrome Coronavirus 2 Vaccines: A Historical Viral Vaccine Perspective
Authors: Sayers David R
Published: March 2022

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines are a remarkable scientific achievement. The perspective on past viral vaccine performance and viral characteristics, such as incubation period, can help with messaging and instilling vaccine confidence. Protection against mild infection occurs in the short term (months), but the persistence of protection against severe disease will likely endure longer.
Wearable energy systems: what are the limits and limitations?
Authors: Yin Lu , Wang Joseph
Published: March 2022

With over a decade of tremendous effort and exciting developments, we have yet to see the successful commercialization of wearable soft electronics due to the lack of reliable energy solutions. This perspective summarizes the theoretical limits and the practical limitations for wearable energy devices and proposes strategies to address such limitations.
Goldilocks Work Conditions for All Ages: Age-Conditional Effects of Work Design Profiles on Well-Being
Authors: El Khawli Elissa , Keller Anita C , Scheibe Susanne
Published: March 2022

Work design plays an important role in workers’ job-related well-being, but not every employee responds to work design in the same way. Given trends toward longer working lives and higher age diversity in the workforce, worker age is an important factor to consider. However, knowledge about the interplay between worker age and work design is limited, especially when considering the multitude of job characteristics that people experience at the same time. Integrating the work design and lifespan/career development literatures and adopting a person-centered approach, we investigated how worker age affects membership in work design profiles and the relationship between work design profiles and occupational well-being. Using two independent samples (N = 989; 980), we conducted latent profile analysis to group workers into work design profiles based on 6 age-relevant job characteristics (autonomy, information-processing, workload, social support, emotional demands, and social conflicts). We identified 3 profiles and linked them to well-being: motivating (most favorable), moderately stimulating, and socially taxing (least favorable). Older workers were more likely to be in, and responded better to motivating work design profiles, and less likely to be in, and responded worse to socially taxing profiles. Meanwhile, younger workers seemed more tolerant of socially taxing work design profiles than older workers. Most age-contingent effects were robust after adding organizational tenure as a covariate. Findings qualify lifespan development theories and shed light on workers’ nuanced responses to work design profiles.
Does Total Hip Arthroplasty Affect Spinopelvic and Spinal Alignment?
Authors: Haffer Henryk , Wang Zhen , Hu Zhouyang , Palmowski Yannick , Hardt Sebastian , Schmidt Hendrik , Perka Carsten , Pumberger Matthias
Published: March 2022

Study Design:

A prospective observational study, level of evidence 3.

Objectives:

The study with patients undergoing unilateral total hip arthroplasty (THA) aimed to evaluate the following hypotheses: (1) the spinal sagittal and coronal alignment alters due to THA, (2) the spinopelvic parameter changes after THA, (3) the spinopelvic alignment differs between sagittal balanced and imbalanced patients.

Summary of Background Data:

Surgical correction of spinal sagittal misalignment affects the spinopelvic alignment and pelvic tilt. It is not yet known to what extent THA affects spinopelvic, spinal sagittal, and coronal alignment.

Materials and Methods:

A total of 153 patients undergoing THA were assessed with biplanar stereoradiography in standing position preoperatively and postoperatively. Two independent investigators examined C7-sagittal vertical axis (C7-SVA), pelvic incidence-lumbar lordosis (PI-LL) mismatch, lumbar lordosis (LL), C7-central sacral vertical line, pelvic oblique angle lumbosacral, intra-pelvic oblique angle, pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), anterior plane pelvic tilt (APPT), and pelvic femoral angle (PFA). An analysis of the sagittal misaligned subgroups of C7-SVA and PI-LL on the influence of the spinopelvic alignment was performed.

Results:

A significant difference in spinopelvic parameters was detected in the preoperative to postoperative comparison (SS, PT, APPT, and PFA; P<0.000) (d=−0.394; d=0.609; d=−0.481; d=0.431). The coronal alignment and pelvic obliquity revealed no significant differences. The misaligned groups (C7-SVA; PI-LL) demonstrated significant increases in PI and PT and decreased in LL compared with the groups with normal sagittal alignment. Preoperatively, 66/153 (C7-SVA) and 46/153 (PI-LL) of the THA patients presented sagittal misalignment, respectively.

Conclusions:

The results suggest an effect of THA on sagittal spinal and spinopelvic alignment, with a significant reduction of PT postoperatively and no effect on coronal alignment. Particularly striking are the significant differences in the misaligned groups, which may be classified as risk population and potentially can contribute biomechanically to a higher risk of posterior impingement and anterior THA dislocation. The substantial proportion of sagittal misaligned patients in the THA collective illustrates the crucial need for interdisciplinary collaboration.
Decision-Making in Childhood Predicts Prodromal Eating Pathology in Adolescence
Authors: Harrison Amy , Francesconi Marta , Flouri Eirini
Published: March 2022

Objective:

Differences in decision-making under conditions of risk have been observed cross-sectionally in clinical groups of people with eating disorders but have never been studied longitudinally or in large cohorts. We investigated whether responses on the Cambridge Gambling Task (CGT), measured in the Millennium Cohort Study in childhood, would predict prodromal eating pathology in adolescence.

Method:

Regression models were built to explore relationships between CGT variables at age 11 years and prodromal eating pathology (body dissatisfaction, intention to lose weight, dietary restriction, significant under/overweight, and excessive exercise) at 14 years.

Results:

In 11,303 boys and girls, those with better quality decision-making were 34% less likely to show an intention to lose weight (b = −0.40, odds ratio [OR] = 0.66, p < 0.05) and 34% less likely to be overweight (b = −0.41, relative risk ratio [RRR] = 0.66, p < 0.05). Those with higher risk-taking were 58% more likely to report dietary restriction (b = 0.45, OR = 1.58, p < 0.05) and 46% more likely to report excessive exercise (b = 0.38, OR = 1.46, p < 0.05). In the complete-cases sample, higher risk-adjustment scores were associated with a 47% increased risk of underweight (b = 0.39, RRR = 1.47, p < 0.05), and better quality of decision-making was associated with a 46% lower risk of overweight (b = −0.60, RRR = 0.54, p < 0.05).

Conclusion:

Disadvantageous decision-making in childhood may predict prodromal eating pathology in adolescence and might represent a prevention target.
The burden of road traffic accidents in trauma in low-resource settings: a retrospective cohort analysis of patient admissions to 2 Médecins Sans Frontières trauma facilities
Authors: de Costa Josephine , Briskin Emily , Trelles Miguel , Dominguez Lynette , Nyaruhirira Innocent , Shinwari Esmatullah , Niyonzima Ferdinand , Adel Akbar , Haberisoni Jean-Berchmans , Ali Engy
Published: March 2022

Introduction:

Medecins Sans Frontieres (MSF) is known for its work providing surgical care for victims of violent trauma (VT) in conflict zones. However, the trauma centers also deal with road traffic accidents (RTAs) which may require different staffing, facilities and supplies as compared with those required for VT. This study aimed to compare differences in types of injuries, clinical outcomes, and resources needed to properly operate trauma centers in low and middle-income countries.

Material and methods:

This was a retrospective analysis of routine program data of >70,000 patient presentations in the emergency, in-patient, and operating departments of 2 of MSF’s major trauma centers, in Kunduz (Afghanistan) and Bujumbura (Burundi), using data from 2011 to 2018.

Results:

RTAs comprised a significant proportion of overall presentations to these centers (23% in Kunduz and 56% in Bujumbura). RTA patients presented with different patterns of injury, with higher rates of fractures, extremity injuries, and traumatic brain injury. RTA patients were 2.3 times more likely to have a peripheral injury (extremities and head) as VT patients, and 12.5 times more likely to undergo an orthopedic procedure. VT patients had higher rates of abdominal injury. However, there was no statistically significant difference in overall mortality and length of stay between the 2 groups.

Conclusion:

This study demonstrates that trauma centers, even in zones of conflict, need to be prepared and resourced to manage RTA cases. Policy-makers in such centers should be aware of the different injury patterns associated with this patient group and have appropriate, sustainable capacity to manage RTA trauma, particularly in terms of management of orthopedic injuries.
The Arched Rainbow Brow in Thyroid Eye Disease
Authors: Tran Ann Q. , Yang Cameron , Tooley Andrea A. , Mahan Marielle , Jamerson Emery C. , Kazim Michael , Dagi Glass Lora R.
Published: March 2022

Purpose:

To morphologically describe and mathematically quantify a novel clinical feature of thyroid eye disease (TED).

Methods:

A retrospective study was conducted of TED patients and age-sex-matched normal controls. The arched Rainbow Brow appearance in TED patients was determined by unanimous agreement of 3 oculoplastic surgeons. Eyebrow curvature was assessed by plotting 15 points along the eyebrow in ImageJ. The fourth-degree polynomial (y = ax4 + bx3 + cx2 + dx + e) was fitted to each eyebrow.

Results:

Two hundred seventy-one eyes were analyzed (200 TED and 71 age-sex-matched normal controls). A Rainbow Brow was identified in 42% of TED patients. A unilateral Rainbow Brow was seen in 15% of patients. The fourth-degree polynomial coefficients yielded significant differences between Rainbow Brow patients and age-sex-matched normal controls for the coefficients a, b, c, and d. Similar analysis of TED patients with and without a Rainbow Brow showed differences in coefficients a and b. Age >50 years (p = 0.009) and the presence of brow fat expansion (p < 0.001) were associated with the presence of a Rainbow Brow. Proptosis >24 mm showed a trend toward association with the presence of a Rainbow Brow (p = 0.057). When considering the contribution of these features in a multivariable analysis, only brow fat expansion was a significant contributing factor (p = 0.009).

Conclusions:

The Rainbow Brow is a distinct entity in TED and is likely consequent to brow fat pad expansion. Patients with a Rainbow Brow have different eyebrow curvature as compared to both normal age-sex-matched controls and TED patients without a Rainbow Brow.
Facial Asymmetry in Children With Unilateral Congenital Ptosis
Authors: Tenzel Phillip A. , Brown Karen , Zhou Brenda , Itani Kamel M. , Mancini Ronald
Published: March 2022

Purpose:

To analyze facial asymmetry in children with unilateral congenital ptosis.

Methods:

This is a retrospective review of pediatric patients undergoing ptosis repair between January 1, 2017, and December 31, 2020. Charts were reviewed to ensure a diagnosis of idiopathic unilateral congenital ptosis. Sex, age, laterality, margin to reflex distance 1, levator function, and surgical intervention were collected.

Clear preoperative photos without head turn were included. Using the ImageJ software (nih.gov), landmarks of the periorbital region, midface, and lower face were marked, and measurements between these landmarks were taken.

Two-tailed Student t tests were used to compare measurements between the ptotic and non-ptotic sides. Relationships between different measurements on the same side of the face were analyzed using paired-variable regressions.

Results:

Forty-four patients with unilateral congenital ptosis were included. The surgical management consisted of Mullerectomy in 9 of 44 (20%), levator resection in 15 of 44 (34%), and frontalis suspension in 20 of 44 (46%) patients. The side of the face with blepharoptosis was found to more often have smaller margin to reflex distance 1 (p < 0.001), smaller margin to reflex distance 2 (p < 0.005), smaller horizontal palpebral fissure (p < 0.05), shorter midface height (p < 0.001), and a more inferiorly displaced lateral canthus (canthal angle, p < 0.001) relative to the non-ptotic side of the face. The mean head tilt of patients with right sided ptosis (1.37° right tilt) was statistically significantly different from those with left sided ptosis (0.85° left tilt; p = 0.04).

Conclusions:

In children with unilateral congenital ptosis, the ptotic side of the face was found to be the nondominant side of the face. Patients were also found to have ipsilateral head tilt.
Investigation of clinical predictors of survival in idiopathic pulmonary fibrosis patients: A cohort study in Taiwan
Authors: Tseng Ching-Min , Chen Mei-Yin , Kao Chen-Yu , Tao Chi-Wei
Published: March 2022

Background:

Two antifibrotic medications, pirfenidone and nintedanib, have been approved as treatments for idiopathic pulmonary fibrosis (IPF)—a life-threatening interstitial lung disease. However, there are insufficient current data regarding clinical predictors of survival for patients with IPF in the era of antifibrotics.

Methods:

We retrospectively analyzed the medical records of patients with IPF treated between April 2017 and May 2020. Univariate and multivariate Cox proportional hazard models were used to identify independent predictors of mortality among these patients with IPF.

Results:

A total of 40 patients with IPF (average age, 75.58 ± 8.34 years) were included in the study, 27 (67.5%) of whom were treated with antifibrotic drugs. In the entire cohort, 14 (35%) patients died, and the overall survival of the study population was 48.52 ± 5 months (median, not applicable [NA] [29-NA] months). The univariate and multivariate Cox proportional hazard models indicated that chest tightness, finger clubbing, acute exacerbation after medication, decreased percentage forced vital capacity (%FVC), and decreased percentage 1-second forced expiratory volume were clinical factors linked to all-cause mortality among all patients, although without statistical significance at the multivariate level. Meanwhile, only finger clubbing was a significant mortality predictor among patients who received antifibrotic medications. A mortality scoring system was built upon the aforementioned risk factors, with the exclusion of %FVC, whose individual mortality score was nearly zero.

Conclusion:

Chest tightness, finger clubbing, acute exacerbation after medication, and decreased %FVC were clinical factors associated with mortality in patients with IPF, although without statistical significance. A scoring system including these factors can be used to predict all-cause mortality in patients with IPF. The mere intake of antifibrotic medications was not a significant mortality predictor in this study. This might be owed to the retrospective nature of the study, where many patients started the medications after the deterioration of their pulmonary function rather than from the start.
Prevalence of opioid prescriptions in Taiwan (2008–2018)
Authors: Wang Jhi-Joung , Chu Yu-Roo , Teng Shu-Fang , Chu Chin-Chen , Ho Chung-Han , Chu Li-Ling
Published: March 2022

Background:

Opioids are effective for severe pain; however, the safety issue is also a primary concern. To better understand the opioid use in Taiwan, we conducted this study.

Methods:

Data on patients with opioid prescriptions, including morphine, fentanyl, pethidine, codeine, oxycodone, hydromorphone, and buprenorphine were collected using the Taiwan National Health Insurance Database (NHID).

Results:

Our analysis of opioid prescriptions from 2008 to 2018 in Taiwan indicated that (1) A slow increase in prevalence of opioid prescription was found during the study period. Among the drugs studied, morphine accounted for the majority of the prescriptions written, with a gradual increase annually. Pethidine prescriptions showed a significant and rapid decline over the years; (2) medical centers prescribed the largest number of opioids, followed by regional hospitals, local hospitals, and clinics; (3) the number of prescriptions per year per capita in cancer group was much higher than that in noncancer group. In noncancer group, most of the prescriptions were used in acute pain service (98.7%); and (4) use of opioids increased with age in both cancer and noncancer patients.

Conclusion:

The total number of opioid prescriptions in Taiwan gradually increased annually, among which morphine was the most commonly used opioid. Cancer patients consumed more opioid prescriptions than noncancer patients and most of the prescriptions in noncancer patients were used in acute pain service. The number of prescriptions increased with the age of the patients in both cancer and noncancer patients. The low prescription rate of opioids in chronic pain in Taiwan is not similar as those in high opioid–consuming countries, such as United States.
The Gastrointestinal Microbiome in Infant Colic
Authors: Johnson Jessica M. , Adams Ellise D.
Published: March 2022

The significant crying of infantile colic adds stress to the infant and their family, yet it has no recognized etiology. Gastrointestinal health problems and dysfunction have been suspected in the etiology of colic. Disruptions to the microbiome colonization of the gastrointestinal system may lead to excess gas and inflammation that are associated with the crying of colic. Infants with colic have increased colonization with gas-producing bacteria, like Escherichia coli and Klebsiella, and they have lower colonization of anti-inflammatory bacteria, like Bifidobacterium and Lactobacillus. Colic is known to self-resolve around 3 months of age. However, few researchers have investigated how the microbiome may be changing at colic's natural resolution without the intervention of a probiotic. With a better understanding of what leads to colic's self-resolution, future researchers may be able to identify more effective therapies for colic prevention or treatment. This scoping review presents the collective evidence from 21 original, primary research articles on what is known about the gastrointestinal microbiome at colic onset and resolution.
An Opioid Sparing Anesthesia Protocol for Pediatric Open Inguinal Hernia Repair: A Quality Improvement Project
Authors: Chiem Jennifer L. , Franz Amber , Bishop Nicholas , Liston David , Low Daniel K.
Published: March 2022

Introduction:

Using plan-do-study-act (PDSA) cycles, this quality improvement (QI) project aimed to standardize an anesthetic protocol to optimize multimodal pain management for pediatric open inguinal hernia repair (OIHR).

Methods:

PDSA cycle 1: in December 2017, we standardized the intraoperative OIHR anesthesia protocol by replacing transversus abdominis plane (TAP) or ilioinguinal-iliohypogastric (II) blocks and fentanyl with exclusively II blocks and fentanyl. PDSA cycle 2: in January 2019, we used an opioid sparing strategy, replacing II blocks and fentanyl with II blocks and dexmedetomidine. We used statistical process control (SPC) charts to analyze data from the medical record. Outcome measures included the percent of patients requiring rescue morphine in the postanesthesia care unit (PACU), maximum PACU pain score, PACU length of stay (LOS), and anesthesia preparation duration.

Results:

The team performed a total of 641 pediatric OIHRs between July 2015 and June 2021. The three groups included 203 patients in our baseline group, 127 patients in the PDSA cycle 1 group, and 311 patients in the PDSA cycle 2 group. Special cause variation (SCV) occurred for the percent of patients requiring rescue morphine, anesthesia preparation duration, and PACU LOS. The percent of patients requiring rescue morphine showed improvement. Anesthesia preparation duration improved compared to baseline. There was no SCV detected in the SPC chart for maximum PACU pain score.

Conclusion:

We implemented an opioid sparing anesthetic protocol for pediatric OIHR utilizing II blocks and dexmedetomidine without adversely affecting postoperative pain score or morphine rescue rate over 6 years.
Toward bioinspired polymer adhesives: activation assisted via HOBt for grafting of dopamine onto poly(acrylic acid)
Authors: Alberts Erik M. , Fernando P. U. Ashvin Iresh , Thornell Travis L. , George Hannah E. , Koval Ashlyn M. , Shukla Manoj K. , Weiss Charles A. , Moores Lee C.
Published: March 2022

The design of bioinspired polymers has long been an area of intense study, however, applications to the design of concrete admixtures for improved materials performance have been relatively unexplored. In this work, we functionalized poly(acrylic acid) (PAA), a simple analogue to polycarboxylate ether admixtures in concrete, with dopamine to form a catechol-bearing polymer (PAA-g-DA). Synthetic routes using hydroxybenzotriazole (HOBt) as an activating agent were examined for their ability in grafting dopamine to the PAA backbone. Previous literature using the traditional coupling reagent 1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide (EDC) to graft dopamine to PAA were found to be inconsistent and the sensitivity of EDC coupling reactions necessitated a search for an alternative. Additionally, HOBt allowed for greater control over per cent functionalization of the backbone, is a simple, robust reaction, and showed potential for scalability. This finding also represents a novel synthetic pathway for amide bond formation between dopamine and PAA. Finally, we performed preliminary adhesion studies of our polymer on rose granite specimens and demonstrated a 56% improvement in the mean adhesion strength over unfunctionalized PAA. These results demonstrate an early study on the potential of PAA-g-DA to be used for improving the bonds within concrete.
Context-dependent host dispersal and habitat fragmentation determine heterogeneity in infected tick burdens: an agent-based modelling study
Authors: Tardy Olivia , Vincenot Christian E. , Bouchard Catherine , Ogden Nicholas H. , Leighton Patrick A.
Published: March 2022

As the incidence of tick-borne diseases has sharply increased over the past decade, with serious consequences for human and animal health, there is a need to identify ecological drivers contributing to heterogeneity in tick-borne disease risk. In particular, the relative importance of animal host dispersal behaviour in its three context-dependent phases of emigration, transfer and settlement is relatively unexplored. We built a spatially explicit agent-based model to investigate how the host dispersal process, in concert with the tick and host demographic processes, habitat fragmentation and the pathogen transmission process, affects infected tick distributions among hosts. A sensitivity analysis explored the impacts of different input parameters on infected tick burdens on hosts and infected tick distributions among hosts. Our simulations indicate that ecological predictors of infected tick burdens differed among the post-egg life stages of ticks, with tick attachment and detachment, tick questing activity and pathogen transmission dynamics identified as key processes, in a coherent way. We also found that the type of host settlement strategy and the proportion of habitat suitable for hosts determined super-spreading of infected ticks. We developed a theoretical mechanistic framework that can serve as a first step towards applied studies of on-the-ground public health intervention strategies.
Transcriptomic profiling implicates PAF1 in both active and repressive immune regulatory networks
Authors: Kenaston Matthew W. , Pham Oanh H. , Petit Marine J. , Shah Priya S.
Published: March 2022

Background

Sitting at the interface of gene expression and host-pathogen interaction, polymerase associated factor 1 complex (PAF1C) is a rising player in the innate immune response. The complex localizes to the nucleus and associates with chromatin to modulate RNA polymerase II (RNAPII) elongation of gene transcripts. Performing this function at both proximal and distal regulatory elements, PAF1C interacts with many host factors across such sites, along with several microbial proteins during infection. Therefore, translating the ubiquity of PAF1C into specific impacts on immune gene expression remains especially relevant.

Results

Advancing past work, we treat PAF1 knockout cells with a slate of immune stimuli to identify key trends in PAF1-dependent gene expression with broad analytical depth. From our transcriptomic data, we confirm PAF1 is an activator of traditional immune response pathways as well as other cellular pathways correlated with pathogen defense. With this model, we employ computational approaches to refine how PAF1 may contribute to both gene activation and suppression. Specifically focusing on transcriptional motifs, we predict gene regulatory elements strongly associated with PAF1, including those implicated in an immune response. Overall, our results suggest PAF1 is potentially involved in innate immunity at several distinct axes of regulation.

Conclusions

By identifying PAF1-dependent gene expression across several pathogenic contexts, we confirm PAF1C to be a key mediator of innate immunity. Combining these transcriptomic profiles with potential regulatory networks corroborates the previously identified functions of PAF1C. With this, we foster new avenues for its study as a regulator of innate immunity, and our results will serve as a basis for targeted study of PAF1C in future validation studies.
Cell-free prototyping enables implementation of optimized reverse β-oxidation pathways in heterotrophic and autotrophic bacteria
Authors: Vögeli Bastian , Schulz Luca , Garg Shivani , Tarasava Katia , Clomburg James M. , Lee Seung Hwan , Gonnot Aislinn , Moully Elamar Hakim , Kimmel Blaise R. , Tran Loan , Zeleznik Hunter , Brown Steven D. , Simpson Séan D. , Mrksich Milan , Karim Ashty S. , Gonzalez Ramon , Köpke Michael , Jewett Michael C.
Published: March 2022

Carbon-negative synthesis of biochemical products has the potential to mitigate global CO2 emissions. An attractive route to do this is the reverse β-oxidation (r-BOX) pathway coupled to the Wood-Ljungdahl pathway. Here, we optimized and implemented r-BOX for the synthesis of C4-C6 acids and alcohols. With a high-throughput in vitro prototyping workflow, we screened 762 unique pathway combinations using cell-free extracts tailored for r-BOX to identify enzyme sets for enhanced product selectivity. Implementation of these pathways into Escherichia coli generated designer strains for the selective production of butanoic acid (4.9 ±0.1 gL-1), hexanoic acid (3.06 ± 0.03 gL-1) and 1-hexanol (1.0 ± 0.1 gL-1) at the best performance reported to date in this bacterium. We also generated Clostridium autoethanogenum strains able to produce 1-hexanol from syngas, achieving a titer of 0.26 gL-1 in a 1.5-L continuous fermentation. Our strategy enables optimization of rBOX derived products for biomanufacturing and industrial biotechnology.
Paclitaxel-loaded Cationic Fluid Lipid Nanodiscs and Liposomes with Brush-Conformation PEG Chains Penetrate Breast Tumors and Trigger Caspase-3 Activation
Authors: Simón-Gracia Lorena , Scodeller Pablo , Fisher William S. , Sidorenko Valeria , Steffes Victoria M. , Ewert Kai K. , Safinya Cyrus R. , Teesalu Tambet
Published: March 2022

Novel approaches are required to address the urgent need to develop lipid-based carriers of paclitaxel (PTX) and other hydrophobic drugs for cancer chemotherapy. Carriers based on cationic liposomes (CLs) with fluid (i.e., chain-melted) membranes (e.g., EndoTAG-1®) have shown promise in preclinical and late-stage clinical studies. Recent work found that the addition of a cone-shaped poly(ethylene glycol)-lipid (PEG-lipid) to PTX-loaded CLs (CLsPTX) promotes a transition to sterically stabilized, higher-curvature (smaller) nanoparticles consisting of a mixture of PEGylated CLsPTXand PTX-containing fluid lipid nanodiscs (nanodiscsPTX). These CLsPTXand nanodiscsPTXshow significantly improved uptake and cytotoxicity in cultured human cancer cells at PEG coverage in the brush regime (10 mol% PEG-lipid).

Here, we studied the PTX loading,in vivocirculation half-life, and biodistribution of systemically administered CLsPTXand nanodiscsPTXand assessed their ability to induce apoptosis in triple-negative breast cancer-bearing immunocompetent mice. We focused onfluidrather thansolidlipid nanodiscs because of the significantly higher solubility of PTX in fluid membranes. At 5 and 10 mol% of a PEG-lipid (PEG5K-lipid, molecular weight of PEG 5000 g/mol), the mixture of PEGylated CLsPTXand nanodiscsPTXwas able to incorporate up to 2.5 mol% PTX without crystallization for at least 20 h. Remarkably, compared to preparations containing 2 and 5 mol% PEG5K-lipid (with the PEG chains in the mushroom regime), the particles at 10 mol% (with PEG chains in the brush regime) showed significantly higher blood half-life, tumor penetration and proapoptotic activity. Our study suggests that increasing the PEG coverage of CL-based drug nanoformulations can improve their pharmacokinetics and therapeutic efficacy.