bluuebunny/crossref_metadata_2025 huggingface dataset:
134 Using a 100% Extruded DDGS Cube on Steers Grazing Native Range
Authors: Grigsby Zane N , Beck Paul A
Published: March 2022

A 2-year trial was conducted at the Marvin Klemme Range Research Station in Bessie, OK, to analyze the effects of supplementing steers on native range with extruded 100% DDGS cubes (MasterHand Milling, Lexington, NE). Two main plot treatments were: Positive Control (PC, 249 ± 3.5 kg) supplemented with DDGS cubes at 1.8 kg/steer on alternate days only in late summer stocked at 2.5 ha/steer and High Supplement (HS, 247 ± 3.5 kg),1/3 increase in stocking rate with 0.75% of BW supplement rate with DDGS cubes 5 days per week for the entire duration of the season. For both years all steers were implanted with 200 mg progesterone and 20 mg estradiol benzoate (Synovex S, Zoetis Animal Health) upon arrival. Three reimplant treatments were applied in mid-summer: 1) no reimplant; 2) Synovex S; or 3) 40 mg trenbolone acetate and 8 mg estradiol (Revalor G, Merck Animal Health). In each pasture, 1/3 of the steers received each reimplant treatment. Steers grazed from mid to late May to late September in both 2019 and 2020. Data recorded for both years were combined and were analyzed using the PROC MIXED in SAS as a split-plot experimental design, with supplement treatment in the main plot and mid-season reimplant in the split plot. Early season ADG for HS was 0.36 kg greater (P < 0.01) than PC. However, late season ADG did not differ (P ≥ 0.81). Gain per hectare was 43.3 kg greater (P < 0.01) for HS as compared to PC. Results from this 2-year trial show that the use of an extruded 100% DDGS cube is a viable option to successfully increase stocking while not only minimizing the potential lack of performance on an individual animal basis, but instead increased the performance of these animals in western Oklahoma. More research needs to be done to determine the effect on range condition.
2 Conducting and Communicating Environmental Impacts of Research: Forage Production, Soil Health, Sustainability
Authors: Johnson Myriah D , Dubeux José C , Franzluebbers Alan J
Published: March 2022

Sustainability research is complex and involves the evaluation of tradeoffs. Environmental, economic, and social aspects should ideally be considered. Even when one only pillar of sustainability is evaluated, results should be assessed within the broader context of overall sustainability. Environmental impacts from forage and livestock systems, as well as confined animal feeding operations, can be positive and negative, depending on the type of operation, environmental setting, weather episodes, and management conditions. These systems also have associated social and economic impacts. As in all agricultural management systems, there are likely to be hotspots of damage due to a particular management style combined with the right soil, landscape, and climatic conditions. Widespread, positive benefits of pasture-based management are possible when forage resources are utilized ideally with best grazing management principles leading to enhanced soil organic carbon storage, high water infiltration, efficient nutrient cycling, and minimal water and nutrient runoff into nearby water bodies. Research to quantify the environmental impacts of livestock management systems can be designed in detail on research stations to understand the direct implications of management differences on plant biomass production that captures atmospheric CO2, on carbon stored in soil organic matter, and on greenhouse gas emissions from ruminant livestock fed controlled diets. On-farm research is also valuable to characterize the impacts of a particular style of management across a diversity of environments using a system-level approach integrated across the farm. Communication strategies engaging major stakeholders from the livestock industry are key to deliver a consistent message to the general public. Perceived benefits, challenges, and opportunities must be science based, seeking opportunities to reduce negative impacts, and enhancing the positive ones. Messaging to the lay audience about environmental impacts can be focused on solutions from positive benefits or problems from negative effects, but should also address economic and social components.
84 Carcass Characteristics, Meat Color and Fatty Acid Profile of Feedlot Lambs Fed Novel Anthocyanin-rich Corn Cobs
Authors: Quadros Danilo G , Xu Wenwei , Kerth Chris , Tolleson Douglas , Whitney Travis R
Published: March 2022

Hi-A™ is a unique type of corn developed by Texas A&M AgriLife that has high anthocyanin. A completely randomized design trial was used to evaluate the effects of three roughages, Hi-A™ corn cobs, low-A (regular) corn cobs and bermudagrass hay (BGH), in feedlot Rambouillet ewe lamb (n = 10/treatment) diets on carcass characteristics, meat color and fatty acids (FA) profile. Lambs were fed experimental diets (20% roughage and 80% concentrate) for 63-d. Then, lambs were harvested, and the carcasses evaluated. Boneless lamb loin chops, 2.5 cm thick, were fabricated and analyzed for color and FA. Data were analyzed by ANOVA for a completely randomized design with diet as fixed effects and animal as a random effect with an alpha of 0.05. Carcass weight, loin eye area (LEA), body wall thickness, fat thickness, leg score, marbling, skeletal maturity, lean maturity, and flank streaking did not differ among treatments (P > 0.05). Dressing percentage was greater (P < 0.05) in the lambs fed BGH compared to Hi-A™ diets; neither of which differed (P > 0.05) from lambs fed Low-A. Instrumental color characteristics L* (darkness to lightness), a* (redness), b* (yellowness) and chroma (total color) of fresh lamb loin chops measured under retail display did not vary (P > 0.05) among treatments. Hue Angle (discoloration) was greater (P < 0.05) in loin chops from lambs fed Hi-A™ than Low-A diets, while BGH did not differ (P > 0.05) from the other treatments. Retail display day influenced (P < 0.05) all the instrumental color characteristics, with the highest values of L*, a*, b*, and chroma on day 1 and Hue Angle on days 3 and 4. No differences (P > 0.05) were observed in the meat FA profile. No advantages of using Hi-A™ corn cobs in feedlot lamb diets were observed regarding carcass characteristics, meat color and FA profile.
73 Successful Development and Transition to a Hybrid Livestock Science Camp Experience
Authors: Pickworth Carrie L , Adams Madison
Published: March 2022

The ongoing pandemic has created a need to pivot many face-to-face programs into virtual and hybrid formats. In 2017, NC State created a week-long, immersive residential Livestock Science Camp for high school aged youth. The 2020 rapid transition to all-virtual programming reduced participation in half (36 down to 18) due to lack of perceived kinesthetic learning opportunities and direct engagement with animals. The objective herein is to describe the development and implementation of the Hybrid Livestock Science Camp Experience. The hybrid format and a scholarship program yielded diverse participation (38 in 2021). The camp included four, 5-hour days of live virtual experiential learning, a resource website, and in person workshop. Virtual programming included tours by industry leaders; at-home lab activities; interactive lab experiences, educational lectures; and collaborative reflection in break-out rooms. Following the virtual programming, campers were divided into two cohorts to attend an action filled, hands-on animal workshop for engagement with six livestock rotations. The hybrid format increased camper diversity (race, economic status, first generation college seeking, and urban youth). Campers completed a post-event survey that collected feedback on the programming and impact of camp on future goals. The results of the surveys conveyed that virtual programming was engaging and educational (mean= 4.6/5.0) and that break-out reflections are valued (mean = 4.3/5.0) meanwhile the live workshop was rated superior (mean 5.0/5.0). Additionally, over 85% of virtual Livestock Science Campers increased interest in participating in-person programming, attending college in Animal Science, and pursuing a career in a livestock industry. As one participant reflected… “My love for livestock animals has only grown in the aftermath of this camp!” Overall, a hybrid camp can be transformational in youth knowledge and perception of the livestock industries if experiences are interactive, relevant, and novel.
Egg production in the porcellanid crab Pachycheles laevidactylus Ortmann, 1892 (Decapoda: Anomura: Porcellanidae) in southern Brazil
Authors: Horch Amanda P , Terossi Mariana
Published: March 2022

We analysed the egg production of the porcellanid crab Pachycheles laevidactylus Ortmann, 1892 in two coastal locations (Tramandaí and Torres) in southern Brazil. The number of eggs and egg volume were analysed during one year and compared between locations and seasons. A total of 438 ovigerous females were collected from sand banks formed by the polychaete Phragmatopoma caudata Krøyer in Mörch, 1863. The eggs were measured, classified into three stages of development, and quantified. Females with stage-I eggs were more frequent than those with stages II and III, possibly because it is the longest-duration stage. A positive correlation between female body size and fecundity (stage I) was observed, represented by a power function. The ovigerous females of Tramandaí and Torres had the mean/median (Tramandaí) and the maximum (both locations) fecundity higher than previously recorded for the species, nevertheless they also reached the largest body sizes. Fecundity differences were found between locations and among seasons, all attributed mainly to female size, air exposure time, and temperature. Pachycheles laevidactylus did not follow the expected latitudinal pattern of fecundity. The volume of stage-I eggs fluctuated between seasons in Tramandaí only, showing a tendency to be smaller in the warmer seasons. Ovigerous females in Torres lost 36.8% of their eggs between stages II and III, whereas no egg loss was detected in Tramandaí. A similar increase in egg volume was found from stage I to III in both locations, 44.4% in Tramandaí and 41.2% in Torres.
Increased CD8+ T-cell Infiltration and Efficacy for Multikinase Inhibitors After PD-1 Blockade in Hepatocellular Carcinoma
Authors: Kikuchi Hiroto , Matsui Aya , Morita Satoru , Amoozgar Zohreh , Inoue Koetsu , Ruan Zhiping , Staiculescu Daniel , Wong Jeffrey Sum-Lung , Huang Peigen , Yau Thomas , Jain Rakesh K , Duda Dan G
Published: March 2022

Immune checkpoint blockade combined with antiangiogenic therapy induces vascular normalization and antitumor immunity and is efficacious in hepatocellular carcinoma (HCC); but whether and how initial immunotherapy affects the efficacy of subsequent antiangiogenic therapy are unknown. We evaluated a cohort of HCC patients (n = 25) who received the pan–vascular endothelial growth factor receptor multikinase inhibitor sorafenib after initial therapy with an antiprogrammed cell death protein (PD)–1 antibody and found superior outcomes in these patients (12% overall response rate to sorafenib and a median overall survival of 12.1 months). To prove this potential benefit, we examined the impact of an anti–PD-1 antibody on response to subsequent sorafenib treatment in orthotopic models of murine HCC. Prior anti–PD-1 antibody treatment amplified HCC response to sorafenib therapy and increased survival (n = 8-9 mice per group, hazard ratio = 0.28, 95% confidence interval = 0.09 to 0.91; 2-sided P = .04). Anti–PD-1 therapy showed angioprotective effects on HCC vessels to subsequent sorafenib treatment, which enhanced the benefit of this therapy sequence in a CD8+ T-cell–dependent manner. This priming approach using immunotherapy provides an immediately translatable strategy for effective HCC treatment while reducing drug exposure.
Variation and adaptation in leaf sulfur content across China
Authors: Zhao Wenzong , Xiao Chunwang , Li Mingxu , Xu Li , He Nianpeng
Published: March 2022

Sulfur is an essential functional element in leaves, and it plays important roles in regulating plant growth, development and abiotic stress resistance in natural communities. However, there has been limited information on the spatial variation in leaf sulfur content (LSC) and adaptive characters on a large community scale. Sulfur in leaves of 2207 plant species from 80 widespread ecosystems (31 forests, 38 grasslands and 11 deserts) in China was measured. One-way analysis of variance with Duncan’s multiple-range tests were used to evaluate the differences in LSC among different plant growth forms and ecosystems. We fitted the relationships of LSC to spatial and climate factors using regression. Structural equation modeling analysis and phylogenetic analysis helped us further explore the main factors of LSC variation. LSC ranged from 0.15 to 48.64 g kg–1, with an average of 2.13 ± 0.04 g kg–1 at the community scale in China. We observed significant spatial variation in LSC among different ecosystems and taxa. Overall, LSC was higher in arid areas and herbs. Furthermore, higher LSC was observed under environments of drought, low temperatures and intense ultraviolet radiation. Temperature, precipitation, radiation, soil sulfur content and aridity jointly regulated LSC, explaining 79% of the spatial variation. However, LSC was not significantly related to phylogeny. Our results demonstrate that LSC plays an important role in plant adaptations to extreme environments and further extend our understanding of the biological function of sulfur from the organ to the community level. These findings highlight the importance of sulfur metabolism for our understanding of the impact of global climate change on plants.
The role of bars on the dynamical-friction-driven inspiral of massive objects
Authors: Bortolas Elisa , Bonetti Matteo , Dotti Massimo , Lupi Alessandro , Capelo Pedro R , Mayer Lucio , Sesana Alberto
Published: March 2022

In this paper, we systematically explore the impact of a galactic bar on the inspiral time-scale of a massive object (MO) within a Milky Way-like galaxy. We integrate the orbit of MOs in a multicomponent galaxy model via a semi-analytical approach that accounts for dynamical friction generalized to rotationally supported backgrounds. We compare the MO evolution in a galaxy featuring a Milky Way-like rotating bar to the evolution within an analogous axisymmetric galaxy without the bar. In agreement with previous studies, we find that the bar presence may significantly affect the inspiral, sometimes making it shorter by a factor of a few, and sometimes hindering it for a Hubble time. The erratic behaviour is mainly impacted by the relative phase at which the MO encounters the stronger bar-induced resonances. In particular, the effect of the bar is more prominent for initially in-plane, prograde MOs, especially those crossing the bar co-rotation radius or outer Lindblad resonance. In the barred galaxy, we find the sinking of the most massive MOs ($\gtrsim 10^{7.5}\, \mathrm{M}_{\odot {}}$) approaching the galaxy from large separations (≳8 kpc) to be most efficiently hampered. Neglecting the effect of global torques associated with the non-symmetric mass distribution is thus not advisable even within an idealized, smooth galaxy model; we further note that spiral patterns are unlikely to affect the inspiral due to their transient and fluctuating nature. We speculate that the sinking efficiency of massive black holes involved in minor galaxy mergers may be hampered in barred galaxies, making them less likely to host a gravitational wave signal accessible to low-frequency detectors.
A comprehensive analysis of WASP-17b’s transmission spectrum from space-based observations
Authors: Alderson L , Wakeford H R , MacDonald R J , Lewis N K , May E M , Grant D , Sing D K , Stevenson K B , Fowler J , Goyal J , Batalha N E , Kataria T
Published: March 2022

Due to its 1770 K equilibrium temperature, WASP-17b, a 1.99 RJup, 0.486 MJup exoplanet, sits at the critical juncture between hot and ultra-hot Jupiters. We present its 0.3–5 $\rm{\mu m}$ transmission spectrum, newly obtained with Hubble Space Telescope (HST) Wide Field Camera 3 (WFC3) measurements, and, taking advantage of improved analysis techniques, reanalysed HST Space Telescope Imaging Spectrograph and Spitzer Space Telescope Infrared Array Camera observations. We achieve a median precision of 132 ppm, with a mean of 272 ppm across the whole spectrum. We additionally make use of Transiting Exoplanet Survey Satellite (TESS) and ground-based transit observations to refine the orbital period of WASP-17b. To interpret the observed atmosphere, we make use of free and equilibrium chemistry retrievals using the POSEIDON and ATMO retrieval codes, respectively. We detect absorption due to H2O at >7σ and find evidence of absorption due to CO2 at >3σ. We see no evidence of previously detected Na i and K i absorption. Across an extensive suite of retrieval configurations, we find that the data favour a bimodal solution with high- or low-metallicity modes as a result of poor constraints in the optical and demonstrate the importance of using multiple statistics for model selection. Future JWST GTO observations, combined with the presented transmission spectrum, will enable precise constraints on WASP-17b’s atmosphere.
Looking through the Lens of the Ribosome Biogenesis Evolutionary History: Possible Implications for Archaeal Phylogeny and Eukaryogenesis
Authors: Jüttner Michael , Ferreira-Cerca Sébastien
Published: March 2022

Our understanding of microbial diversity and its evolutionary relationships has increased substantially over the last decade. Such an understanding has been greatly fueled by culture-independent metagenomics analyses. However, the outcome of some of these studies and their biological and evolutionary implications, such as the origin of the eukaryotic lineage from the recently discovered archaeal Asgard superphylum, is debated. The sequences of the ribosomal constituents are amongst the most used phylogenetic markers. However, the functional consequences underlying the analysed sequence diversity and their putative evolutionary implications are essentially not taken into consideration. Here, we propose to exploit additional functional hallmarks of ribosome biogenesis to help disentangle competing evolutionary hypotheses. Using selected examples, such as the multiple origins of halophily in archaea or the evolutionary relationship between the Asgard archaea and Eukaryotes, we illustrate and discuss how function-aware phylogenetic framework can contribute to refining our understanding of archaeal phylogeny and the origin of eukaryotic cells.
A comprehensive atlas of fetal splicing patterns in the brain of adult myotonic dystrophy type 1 patients
Authors: Degener Max J F , van Cruchten Remco T P , Otero Brittney A , Wang Eric T , Wansink Derick G , ‘t Hoen Peter A C
Published: March 2022

In patients with myotonic dystrophy type 1 (DM1), dysregulation of RNA-binding proteins like MBNL and CELF1 leads to alternative splicing of exons and is thought to induce a return to fetal splicing patterns in adult tissues, including the central nervous system (CNS). To comprehensively evaluate this, we created an atlas of developmentally regulated splicing patterns in the frontal cortex of healthy individuals and DM1 patients, by combining RNA-seq data from BrainSpan, GTEx and DM1 patients. Thirty-four splice events displayed an inclusion pattern in DM1 patients that is typical for the fetal situation in healthy individuals. The regulation of DM1-relevant splicing patterns could partly be explained by changes in mRNA expression of the splice regulators MBNL1, MBNL2 and CELF1. On the contrary, interindividual differences in splicing patterns between healthy adults could not be explained by differential expression of these splice regulators. Our findings lend transcriptome-wide evidence to the previously noted shift to fetal splicing patterns in the adult DM1 brain as a consequence of an imbalance in antagonistic MBNL and CELF1 activities. Our atlas serves as a solid foundation for further study and understanding of the cognitive phenotype in patients.
Laboratories of Bureaucracy: How Bureaucrats Learn across States in Setting Early Childhood Education Standards
Authors: Smith Kelly B
Published: March 2022

How and under what conditions might bureaucrats look to other states? Using a novel dataset of state early learning standards, I conduct dyad analysis to explain across-state citations in bureaucratic documents. Federal government programs can affect which states are looked to for ideas by defining which states are successful through competitive grant programs. Furthermore, the success of programs within the state affect whether bureaucrats look to other states. This article makes two important contributions to our understanding of policy. First, it explores how bureaucrats can participate in policy knowledge diffusion by looking to other states for information. Second, it sheds light on how we measure states as laboratories by marshaling an innovative dataset of citations within state documents. The article suggests states may not be limited to acting as laboratories through electoral institutions, but rather, they may also innovate as laboratories of bureaucracy.
Treatment of childhood-onset Takayasu arteritis: switching between anti-TNF and anti-IL-6 agents
Authors: Sener Seher , Basaran Ozge , Kaya Akca Ummusen , Atalay Erdal , Kasap Cuceoglu Muserref , Balik Zeynep , Aliyev Emil , Bayindir Yagmur , Batu Ezgi Deniz , Hazirolan Tuncay , Bilginer Yelda , Ozen Seza
Published: March 2022

Objectives

Biologics are new treatment alternatives in Takayasu arteritis (TA), although data in childhood are limited. The aim of this study was to share our experience in seven childhood-onset TA patients who received a TNF-α inhibitor (adalimumab) or an IL-6 receptor inhibitor (tocilizumab) and the effect of switching therapy.

Methods

We retrospectively evaluated the medical treatment records of seven patients with TA, followed between August 2005 and January 2021 at the Pediatric Rheumatology Department of Hacettepe University Faculty of Medicine.

Results

The median age of patients was 14 (IQR 4) years, and six were female. All of the patients had severe disease and high acute-phase reactants. The patients initially received only steroids or steroids+CYC. Prednisone was decreased, and biologic agents were started once the acute phase reactants decreased, and the Indian Takayasu Activity Score (ITAS) returned to normal. Initially, four patients received tocilizumab (TCZ) [median 25.5 (IQR 41) months] and three patients received adalimumab (ADA) [median 13 (IQR 31) months]. However, due to the progression of MR angiography findings or persistent elevation in acute-phase reactants, the biologic agents were switched from TCZ to ADA in four patients and from ADA to TCZ in three patients. The patients' median follow-up time after changing was 50 (IQR 77) months, and median ITAS was evaluated as ‘0’ after 2 (IQR 4) months.

Conclusions

In conclusion, both TNF-α and IL-6 inhibitors are effective alternatives in treating patients with childhood-onset TA. However, prospective randomized controlled trials are needed for the comparison of their effectiveness.
Anti-Bartlett clauses after IQEQ in the Hong Kong Court of Final Appeal
Authors: Hayton David
Published: March 2022

As a donor of assets over a continuing period via a trustee, the settlor and the trustee are free to negotiate how far an exoneration clause can extend to oust a trustee's duties and so limit the extent of the bounty conferred on beneficiaries by the settlor. In particular, where an aggressive speculative investment policy is required to be pursued via a controlled underlying company, so that beneficiaries may benefit from massive gains or suffer the burden of massive losses, the vulnerable trustee is entitled to protect itself from all liability for losses unless guilty of dishonesty or of failing to intervene in circumstances where it had actual knowledge of dishonesty in the management of the company.
Evaluation and Identification of Resistance Lines and QTLs of Maize to Seedborne Fusarium verticillioides
Authors: Ma Peipei , Li Haojie , Liu Enpeng , He Kewei , Song Yunxia , Dong Chaopei , Wang Zhao , Zhang Xuecai , Zhou Zijian , Xu Yufang , Wu Jianyu , Zhang Huiyong
Published: March 2022

Internal fungal contamination in cereal grains may affect plant growth and result in health concerns for humans and animals. Fusarium verticillioides is a seedborne fungus that can systemically infect maize. However, few efforts had been devoted to studying the genetics of maize resistance to seedborne F. verticillioides. In this study, we developed a disease evaluation method to identify resistance to seedborne F. verticillioides in maize, by which a set of 121 diverse maize inbred lines were evaluated. A 160 F10-generation recombinant inbred line (RIL) population derived from a cross of the resistant (BT-1) and susceptible (N6) inbred line was further used to identify major quantitative trait loci (QTLs) for seedborne F. verticillioides resistance. Eighteen inbred lines with a high resistance to seedborne F. verticillioides were characterized and could be used as potential germplasm resources for genetic improvement of maize resistance. Six QTLs with high heritability across multiple environments were detected on chromosomes 3, 4, 6, and 10, among which was a major QTL, qISFR4-1. Located on chromosome 4 at the interval of 12922609-13418025, qISFR4-1 could explain 16.63% of the total phenotypic variance. Distinct expression profiles of eight candidate genes in qISFR4-1 between BT-1 and N6 inbred lines suggested their pivotal regulatory roles in seedborne F. verticillioides resistance. Taken together, these results will improve our understanding of the resistant mechanisms of seedborne F. verticillioides and would provide valuable germplasm resources for disease resistance breeding in maize.
Pain Characteristics, Fear-avoidance Variables, and Pelvic Floor Function as Predictors of Treatment Response to Physical Therapy in Women With Provoked Vestibulodynia
Authors: Bélanger Clémence , Dumoulin Chantale , Bergeron Sophie , Mayrand Marie-Hélène , Khalifée Samir , Waddell Guy , Dubois Marie-France ,   PVD Group, Morin Mélanie
Published: March 2022

Objective:

The aim was to investigate whether pretreatment pain characteristics, psychological variables, and pelvic floor muscle (PFM) function predict the response to physical therapy (PT) in women with provoked vestibulodynia (PVD).

Materials and Methods:

One hundred-five women diagnosed with PVD underwent 10 weekly sessions of individual PT comprising education, PFM exercises with biofeedback, manual therapy, and dilators. Treatment outcomes were evaluated at pretreatment, post-treatment, and 6-month follow-up and included pain intensity (numerical rating scale 0 to 10) and sexual function (Female Sexual Function Scale). Multilevel analyses were used to examine the potential predictors of response over time including pain characteristics (PVD subtype, pain duration), psychological variables (fear of pain, pain catastrophizing), and PFM function assessed with a dynamometric speculum (tone, flexibility, and strength).

Results:

PVD subtype and PFM tone were significant predictors of greater treatment response for pain intensity reduction. Secondary PVD (ie, pain developed after a period of pain-free intercourse) and lower PFM tone at baseline were both associated with greater reduction in pain intensity after PT and at follow-up. Among the psychological variables, fear of pain was the only significant predictor of better treatment response when assessed through improvement in sexual function, where higher fear of pain at baseline was associated with greater improvement after PT.

Discussion:

This study identified PVD secondary subtype, lower PFM tone, and higher fear of pain as significant predictors of better treatment response to PT in women with PVD.
Anatomical characterization of the too-long anterior process of the calcaneum: a computed tomography scan analysis of 69 feet
Authors: Lucchesi Giovanni , Bonnel François , Wartelle Juliette , Boutry Nathalie , Orlando Natalie , Dimeglio Alain , Beltrami Giovanni , Canavese Federico
Published: March 2022

Our work aims to identify and measure the morpho-anatomical characteristics of too-long anterior calcaneal process based on computed tomography scans done in patients with a history of pain and who have experienced repeated ankle sprains. The computed tomography scans of 69 feet were reviewed. These scans were used to calculate (1) the calcaneo-navicular distance; (2) the height, length, and width of the too-long anterior calcaneal process; (3) the length of the calcaneum; (4) the angle of the too-long anterior calcaneal process in the sagittal (anterior-superior angle), axial (anterior-medial angle), and frontal plane. Out of 69 feet, forty-nine were pathological (71%) with abnormalities of the too-long anterior calcaneal process, while the rest (29%) had no morphological abnormalities. The calcaneo-navicular distance was found to be <5 mm (mean: 2.8 ± 1.2 mm) in all pathological feet, which also had significantly reduced calcaneo-navicular distance (P < 0.001) and longer bone portion distal to the calcaneocuboid tangent (P < 0.001) in comparison to normal feet. In pathological feet, the mean too-long anterior calcaneal process length was 10.7 ± 1.9 mm; the mean anterior-superior angle was 29.6 ° ± 11.6, the mean angle anterior-medial angle was 40.7 ° ± 8.3, the mean angle frontal plane was 74.2 ° ± 14.1. Similar to a cone or a parallelepiped, the too-long anterior calcaneal process has a complex three-dimensional anatomy, with a superior, medial, and anterior direction. Using the measurements obtained, four different too-long anterior calcaneal process morphotypes could be identified: absence of TLACP, triangular shape, rectangular shape, and coalition (level of evidence III).
Preoperative immunotherapy for head and neck cancers: state of art
Authors: Egloff Ann Marie , Uppaluri Ravindra
Published: March 2022

Purpose of review

Programmed cell death 1 (PD-l)-targeting agents have been FDA-approved for treatment of recurrent/ metastatic head and neck squamous cell carcinoma (HNSCC). Clinical studies employing these agents preoperatively for HNSCC in the definitive setting are emerging and have important implications.

Recent findings

Preclinical studies demonstrate enhanced effectiveness of preoperative PD-1 targeting compared with postoperative treatment. Nine HNSCC clinical studies evaluating preoperative treatment with PD-1-targeted pembrolizumab/nivolumab alone or in combination therapy were recently reported. These studies differed by preoperative treatment type and duration and reported no surgical delays, no unexpected surgical complications and grade 3–4 immune-related adverse events consistent with the employed immunotherapeutic agent(s). Rates of major pathologic response (MPR), reduced residual viable tumour to 10% or less, ranged from 2.9–31% across eight trials without neoadjuvant radiation therapy. Higher PD-1 ligand (PD-L1) expression, increased inflammatory gene expression and enhanced immune cell tumour infiltration in baseline biopsies were associated with pathologic tumour response (pTR) in some studies. Any degree of pTR was associated with improved survival/relapse outcomes in two studies.

Emerging preoperative anti-PD-1 HNSCC clinical studies indicate that preoperative treatment does not impact surgical management. Defining predictive biomarkersand tumour pathologic response implications for patient survival are areas for further investigation.
Hepatopancreatoduodenectomy for advanced biliary malignancies
Authors: Wu Xiangsong , Li Maolan , Wu Wenguang , Wang Xu’an , Li Huaifeng , Bao Runfa , Shu Yijun , Shen Jun , Gu Jun , Wang Xuefeng , Gong Wei , Peng Shuyou , Liu Yingbin
Published: March 2022

Background:

Hepatopancreatoduodenectomy (HPD) has been considered the only curative treatment for metastatic cholangiocarcinoma and some locally advanced gallbladder cancers (GBCs). However, HPD has not yet been included in treatment guidelines as a standard surgical procedure in consideration of its morbidity and mortality rates. The aim of this study was to evaluate the safety and effectiveness of HPD in treating biliary malignancies.

Methods:

The medical records of 57 patients with advanced biliary cancer undergoing HPD from January 2009 to December 2019 were retrospectively retrieved. A case–control analysis was conducted at our department. Patients with advanced GBC who underwent HPD (HPD-GBC group) were compared with a control group (None-HPD-GBC group) Baseline characteristics, preoperative treatments, tumor pathologic features, operative results, and prognosis were assessed.

Results:

Thirteen patients with cholangiocarcinoma and 44 patients with GBC underwent HPD at our department. Significant postoperative complications (grade III or greater) and postoperative pancreatic fistula were observed in 24 (42.1%) and 15 (26.3%) patients, respectively. One postoperative death occurred in the present study. Overall survival (OS) was longer in patients with advanced cholangiocarcinoma than in those with GBC (median survival time [MST], 31 months vs. 11 months; P 
< 0.001). In the subgroup analysis of patients with advanced GBC, multivariate analysis demonstrated that T4 stage tumors (P = 0.012), N2 tumors (P = 0.001), and positive margin status (P = 0.004) were independently associated with poorer OS. Patients with either one or more prognostic factors exhibited a shorter MST than patients without those prognostic factors (P < 0.001).

Conclusion:

HPD could be performed with a relatively low mortality rate and an acceptable morbidity rate in an experienced high- volume center. For patients with advanced GBC without an N2 or T4 tumor, HPD can be a preferable treatment option.
Childhood maltreatment and the menopause transition in a cohort of midlife New Zealand women
Authors: Cleland Lana , McLeod Geraldine F.H. , Dhakal Bhubaneswor , Fenton Anna , Welch Jacqui-Lyn , Horwood L. John , Boden Joseph M.
Published: March 2022

Objective

Knowledge surrounding the link between childhood adversity and reproductive outcomes at midlife is limited. The present study examined the relationship between childhood maltreatment (childhood sexual abuse [CSA], childhood physical punishment [CPP]), and menopause status at age 40.

Methods

Data were gathered from female members of the Christchurch Health and Development Study, a longitudinal birth cohort of 1,265 individuals (630 females) born in Christchurch, New Zealand in 1977. Menopause status was defined by categorizing the female cohort at age 40 as either: 1) premenopausal, or 2) peri/ postmenopausal. Retrospective reports of CSA (<16 y) and CPP (<16 y) were obtained at ages 18 and 21 years.

Results

The analysis sample comprised n = 468 women with data recorded on both their menopause status at age 40 and history of maltreatment (<16 y), of whom 22% (n = 104) were classified as peri/postmenopausal. A statistically significant association was found between and severity of CSA and menopause status, but not between CPP and menopause status. The association with CSA was robust to control for both childhood confounding factors (<16 y) and intervening adult factors (18-40 y) associated with the menopause transition. In the fully adjusted model, women who had experienced severe CSA involving attempted/completed sexual penetration had twice the rate of entering peri/postmenopause compared with those who reported no CSA (39.0% vs 18.8%).

Conclusions

Severity of CSA exposure was associated with earlier menopausal transition in this female cohort. These findings are consistent with the emerging literature on the long-term health and developmental impacts of CSA.
Effect of socioeconomic status on survival in patients on the Diabetes Shared Care Program: Finding from a Taiwan nationwide cohort
Authors: Chuang Wan-Chi , Chu Chih-Hsun , Hsu Ying Hsin , Yao Cai-Sin
Published: March 2022

Background:

The Diabetes Shared Care Program (DSCP) is an integrated care model in Taiwan to improve the care quality of patients with diabetes. Socioeconomic status (SES) is one of the important factors affecting health, and it is confirmed as a predictor of various diseases and deaths.This study aimed to determine the relationship between survival rate and SES among patients who participated in the DSCP.

Methods:

A cohort population-based study was conducted using the National Health Insurance Research Database of Taiwan from 2008 to 2013. The study subjects were type 2 diabetes. We defined individual SES and neighborhood SES by each patient’s job category and household income, which were characterized as advantaged or disadvantaged. Then we compared the survival rates of SES groups by Cox proportional hazards model to adjust risk factors.

Results:

This study included 16 614 patients with type 2 diabetes who participated in the DSCP program. The DSCP cohort showed a high hospitalization rate in low individual SES. In terms of 10-year overall survival, DSCP participants with high individual SES living in advantaged and disadvantaged neighborhoods had lower risk of mortality than those with low SES living in advantaged and disadvantaged neighborhoods, after adjustment for age and comorbidity. DSCP participants with low individual SES living in disadvantaged neighborhoods had no significant difference of mortality as those with low individual SES living in advantaged neighborhoods.

Conclusion:

In this study, we found that low individual SES, but not neighborhood SES, was associated with an increased mortality rate among DSCP participants.
Candidemia in hospitalized cirrhotic patients with bloodstream infection: A retrospective analysis and brief summary of published studies
Authors: Chang Yu-Chen , Chen Jin-Shuen , Yin Chun-Hao , Shin-Jung Lee Susan , Chen Wen-Chi
Published: March 2022

Background:

Candidemia is a life-threatening condition; however, the predictive markers for candidemia and mortality are inadequate in cirrhotic patients. This study was conducted to propose candidate predictors for the occurrence of candidemia and 30-day mortality in hospitalized cirrhotic patients with bloodstream infection (BSI) and review the related literature.

Methods:

Cirrhotic patients with BSI between January 2011 and March 2020 were screened from the databank of a medical center and eligible patients were enrolled. Patients were separated into candidemia and bacteremia groups according to the results of blood cultures. Baseline characteristics, clinical presentation, and biochemistry data were collected at this time, as were microbiological data, medical management, use of antimicrobial agents, and outcome of the patients. The parameters and 30-day mortality were compared between candidemia and bacteremia groups. A combination of the MeSH terms and text terms related to candidemia and cirrhosis was searched in the electronic databases.

Results:

Four hundred and sixty cirrhotic patients with BSI were enrolled. Thirty-five patients with candidemia (7.6%) were identified. Nosocomial infection, intensive care unit (ICU) admission, antibiotics exposure ≥14 days, white cell count >10 K/mm3, and model for end-stage liver disease (MELD) score >24 were associated with candidemia. The 30-day mortality was 65.7% in the candidemia group and 37.9% in the bacteremia group (p = 0.001). Nosocomial infection, ICU admission, hepatoma, hepatic encephalopathy, international normalized ratio ≥1.2, platelet ≤150 K/mm3, estimated glomerular filtration rate <60 mL/min/1.73m2, and MELD score >24 were associated with 30-day mortality. Six studies were identified. The results were consistent with our findings regarding low incidence of candidemia, and relevant risk factors are listed.

Conclusion:

Candidemia had low incidence but high mortality in hospitalized cirrhotic patients with BSI. New predictors were proposed for the occurrence of candidemia and 30-day mortality in these patients.
The impact of blood pressure variation on mortality and symptomatic intracerebral hemorrhage in acute stroke patients after thrombolysis
Authors: Kotruchin Praew , Kliangsa-ard Harirak , Imoun Supap , Kongbunkiat Kannikar , Mitsungnern Thapanawong
Published: March 2022

Blood pressure variation (BPV) is a known risk factor for unfavorable stroke outcomes. However, little is known about the association between BPV and short-term outcomes in stroke patients after receiving thrombolytic therapy, namely, recombinant tissue plasminogen activator (rt-PA). We conducted a cross-sectional study in the specialized stroke unit of a tertiary-level hospital. Stroke patients who were eligible for rt-PA were enrolled. Blood pressure (BP) was measured every 4 h for 24 h. The SD, coefficient of variation (CV) and successive variation (SV) of both SBP and DBP were calculated. The final outcomes were symptomatic intracerebral hemorrhage (sICH) or in-hospital death from neurologic complications. A total of 278 patients (49.6% men) were enrolled, mean age was 65 years. The final outcomes were reported in 33 patients (11.9%). All systolic and diastolic BPV profiles were associated with the final outcome. Odds ratios (95% confident interval) were SD, 1.07 (1.02–1.13); CV, 1.10 (1.03–1.18) and SV, 1.05 (1.01–1.09) for SBP, and SD, 1.10 (1.02–1.19); CV, 1.08 (1.01–1.16) and SV, 1.09 (1.02–1.15) for DBP. After adjustment for conventional risk factors, SD, CV and SV of SBP, and SD and SV of DBP were still significantly associated with the final outcome. In conclusion, in-hospital systolic (SD, SV and CV) and diastolic (SV, SD) BPV profiles were associated with death and sICH in stroke patients after rt-PA therapy.
Implementing the Medical Model in Aesthetic Consultation
Authors: Wicklund Anna Katherine
Published: March 2022

Throughout the process of building a new medical spa, it is important to standardize and implement safe, evidenced-based practice standards. As medical spas and aesthetic services become more prevalent and popular, it is more important than ever for providers to ensure that patient safety is a top priority. Integrating a structured medical model into the aesthetic consultation and treatment ensures that a mutual decision-making process is shared between the provider and the patient. Together, the provider and the patient can determine whether the treatment will improve the patient's overall health and well-being. The patient is given the opportunity to fully understand and choose which procedure will best address their overall psychological health, aesthetic concern, and anatomical diagnosis. In establishing agreement with the patient on a common goal, the provider can first assess the risks and benefits, and then determine which intervention or treatment will provide the patient with the greatest benefit. When providers establish and adhere to an easy-to-use, decision-making algorithm, patients are empowered in the decision-making process. This helps build a working, trusting relationship between the patient and the provider, which leads to greater patient satisfaction and patient loyalty. Sharing this medical model algorithm will greatly benefit other aesthetic providers by helping to create a standardized evaluation process in a medically based aesthetic practice.
COVID-19: The Effects on the Course, Outcomes, and Discharge Destination From Acute Rehabilitation
Authors: Amato-Curran Shelly , Green Kimberly , Rader Terrie , Shimek Adrianne
Published: March 2022

This study aimed to (1) describe the rehabilitation hospital course after diagnosis with COVID-19 and the impact on functional outcomes and discharge destination and (2) compare outcomes for patients with and without COVID-19-related debility.

Design

A descriptive cohort study was performed.

Methods

Retrospective data were collected for 63 patients aged >18 years with COVID-19- or non-COVID19-related debility between January 2015 and September 2020.

Results

Patients admitted with COVID-19-related debility had a mean length of stay of 20.35 days. 15.4% were transferred back to acute service, 92.3% required respiratory interventions, and 88.5% were discharged to the same residence.

Patients with COVID-19-related debility were significantly older, required more respiratory interventions, and had a longer length of stay than the non-COVID-19 group. No significant differences were found in functional outcomes.

Conclusions

Functional outcomes improved, allowing most patients to return to their same residence.

Clinical Relevance

Patients with COVID-19-related debility responded to rehabilitation as well as the non-COVID-19 group.
Rate of Fat Graft Volume Loss After Parotidectomy
Authors: Sagalow Emily S. , Christopher Vanessa , Banoub Raphael G. , Gill Kurren S. , Xu Vivian , Jain Nikhita , Malkani Kabir , Elmer Nicholas , Zhan Tingting , Stanek Joel J. , Hwang Michelle , Krein Howard D. , Heffelfinger Ryan N.
Published: March 2022

Background:

Reconstruction after parotidectomy can include fat grafting, which allows for symmetry, but grafts have demonstrated volume loss over time.

Objectives:

To provide quantitative evidence for the rate of volume loss of fat grafts.

Methods:

Patients who received parotidectomy with fat graft reconstruction at a single institution from August 2016 to October 2020 were identified. Relationships between clinical factors and the logarithmic rate of fat graft volume loss were analyzed.

Results:

Twelve patients received parotidectomy, fat graft reconstruction, and underwent a postoperative magnetic resonance imaging (MRI) scan. Rate of fat graft volume loss was a mean of 1.8% per month (standard deviation [SD]: 2.1% per month). Total parotid fat graft volume loss was a mean of 57.4% (SD: 67.5%). The mean follow-up time was 35.5 months (range: 9–89.8 months). Correlations between body mass index (BMI), history of smoking, and history of alcohol consumption and logarithmic rates of fat graft volume loss were increased but not significantly.

Conclusions:

Fat grafts have the potential of 60% volume loss at approximately 1 year. If there is clinical suspicion that patients will require adjuvant radiation or have clinical factors such as a smoking or alcohol-use history, volume requirements may be even greater to maintain adequate parotid volume for aesthetic purposes.
Endoscopic Ultrasound–guided Drainage of Patients With Infected Walled-off Necrosis: Which Stent to Choose?
Authors: Muktesh Gaurav , Samanta Jayanta , Dhar Jahnvi , Agarwala Roshan , Bellam Balaji L. , James Deepak , Gupta Pankaj , Chauhan Rajeev , Yadav Thakur D. , Gupta Vikas , Sinha Saroj K. , Kochhar Rakesh
Published: March 2022

Background:

Endoscopic ultrasound (EUS)-guided drainage is the preferred treatment of pancreatic fluid collections (PFC). However, the choice of the stent for EUS-guided drainage in critically ill PFC cases with infected walled-off necrosis (WON) and/or organ failure (OF) remains unknown.

Materials and Methods:

Between January 2018 and December 2019, consecutive patients with symptomatic PFC subjected to EUS-guided drainage using biflanged metal stents (BFMS) or double-pigtail plastic stents (DPPS) were compared for technical success, clinical success, duration of the procedure, need for intensive care unit stay, duration of intensive care unit stay, ventilator need, resolution of OF, the duration for resolution of OF, complications, need for salvage percutaneous drainage or surgery and mortality. A subgroup of patients having infected WON with/without OF were analyzed separately.

Results:

Among 120 patients (84.6% males) with PFC (108 WON, 22 pseudocyst) who underwent EUS-guided drainage, there was no difference in outcome parameters in BFMS and DPPS groups. Among patients with WON, clinical success was significantly higher (96.2% vs. 81.8%, P=0.04), with significantly shorter hospital stay (6 vs. 10 d) and procedure duration (17.18±4.6 vs. 43.6±9.7 min, P<0.0001) in the BFMS group. Among patients with infected WON with/without OF, the clinical success was significantly higher (100% vs. 73.9%, P=0.02), and the duration of the procedure was significantly lower (16.28±4.4 vs. 44.39±10.7, P<0.0001) in BFMS compared with DPPS group.

Conclusion:

EUS-guided drainage of WON using BFMS scores over DPPS. In patients having infected WON with/without OF, BFMS may be preferred over DPPS.