bluuebunny/crossref_metadata_2025 huggingface dataset:
The definition of the non-growing season matters: a case study of net ecosystem carbon exchange from a Canadian peatland
Authors: Rafat Arash , Byun Eunji , Rezanezhad Fereidoun , Quinton William L , Humphreys Elyn R , Webster Kara , Van Cappellen Philippe
Published: February 2022

Climate change is a threat to the 500 Gt carbon stored in northern peatlands. As the region warms, the rise in mean temperature is more pronounced during the non-growing season (NGS, i.e., winter and parts of the shoulder seasons) when net ecosystem loss of carbon dioxide (CO2) occurs. Many studies have investigated the impacts of climate warming on NGS CO2 emissions, yet there is a lack of consistency amongst researchers in how the NGS period is defined. This complicates the interpretation of NGS CO2 emissions and hinders our understanding of seasonal drivers of important terrestrial carbon exchange processes. Here, we analyze the impact of alternative definitions of the NGS for a peatland site with multiple years of CO2 flux records. Three climatic parameters were considered to define the NGS: air temperature, soil temperature, and snow cover. Our findings reveal positive correlations between estimates of the cumulative non-growing season net ecosystem CO2 exchange (NGS-NEE) and the length of the NGS for each alternative definition, with the greatest proportion of variability explained using snow cover (R
2 = 0.89, p < 0.001), followed by air temperature (R
2 = 0.79, p < 0.001) and soil temperature (R
2 = 0.54, p = 0.006). Using these correlations, we estimate average daily NGS CO2 emitted between 1.42 and 1.90 gCO2 m−2, depending on which NGS definition is used. Our results highlight the need to explicitly define the NGS based on available climatic parameters to account for regional climate and ecosystem variability.
Cefiderocol for the Treatment of Infections Due to Metallo-B-lactamase–Producing Pathogens in the CREDIBLE-CR and APEKS-NP Phase 3 Randomized Studies
Authors: Timsit Jean Francois , Paul Mical , Shields Ryan K , Echols Roger , Baba Takamichi , Yamano Yoshinori , Portsmouth Simon
Published: February 2022

In the CREDIBLE-CR and APEKS-NP studies, cefiderocol treatment was effective against gram-negative bacteria producing metallo-B-lactamases; rates of clinical cure (70.8% [17/24]), microbiological eradication (58.3% [14/24]), and day 28 all-cause mortality (12.5% [3/24]) compared favorably with comparators of best-available therapy and high-dose meropenem (40.0% [4/10], 30.0% [3/10], and 50.0% [5/10], respectively).
Late spontaneous internal thoracic artery graft dissection after coronary bypass grafting: a case report
Authors: Ishibuchi Kasumi , Yajima Shin , Yamamoto Wataru , Otsuji Satoru
Published: February 2022

Background

Internal thoracic artery (ITA) grafts are commonly used for coronary artery bypass grafting, with dissection to the graft being a rare occurrence. Herein, we describe a case of spontaneous ITA graft dissection occurring 11 years after grafting, with no clear precipitating incidence.

Case summary

The patient was a 61-year-old man who presented with a 3-month history of chest pain and dyspnoea. Dissection of the left internal thoracic artery (LITA) graft was observed on angiography, with a thrombolysis in the myocardial infarction (TIMI) grade 2 blood flow. Intravascular ultrasound confirmed an intimal tear in the proximal graft, with an intramural haematoma. In the absence of atherosclerotic changes, the dissection was treated directly using multiple drug-eluting stents to prevent further extension of the intramural haematoma proximally into the subclavian artery and distally to the anastomosis site. Post-procedural angiography revealed an enlarged true lumen of the LITA, shrinking of the intramural haematoma, and improvement in blood flow to a TIMI grade 3. Chest symptoms resolved immediately after the procedure, with the patient remaining asymptomatic over the 6-month period following the procedure.

Discussion

Dissection of the ITA graft can occur spontaneously long after the initial grafting. Intravascular ultrasound is useful for diagnosis. Ensuring adequate coverage of the edges of the dissection with stenting could prevent further extension of the intramural haematoma.
Watchman FLX vs. Watchman 2.5 in a Dual-Center Left Atrial Appendage Closure Cohort: the WATCH-DUAL study
Authors: Galea Roberto , Mahmoudi Khalil , Gräni Christoph , Elhadad Simon , Huber Adrian T , Heg Dik , Siontis George C M , Brugger Nicolas , Sebag Frederic , Windecker Stephan , Valgimigli Marco , Landolff Quentin , Roten Laurent , Amabile Nicolas , Räber Lorenz
Published: February 2022

Aims

No studies have compared Watchman 2.5 (W2.5) with Watchman FLX (FLX) devices to date. We aimed at comparing the FLX with W2.5 devices with respect to clinical outcomes, left atrial appendage (LAA) sealing properties and device-related thrombus (DRT).

Methods and results

All consecutive left atrial appendage closure (LAAC) procedures performed at two European centres between November 2017 and February 2021 were included. Procedure-related complications and net adverse cardiovascular events (NACE) at 6 months after LAAC were recorded. At 45-day computed tomography (CT) follow-up, intra- (IDL) and peri- (PDL) device leak, residual patent neck area (RPNA), and DRT were assessed by a Corelab. Out of 144 LAAC consecutive procedures, 71 and 73 interventions were performed using W2.5 and FLX devices, respectively. There were no differences in terms of procedure-related complications (4.2% vs. 2.7%, P = 0.626). At 45-day CT, the FLX was associated with lower frequency of IDL [21.3% vs. 40.0%; P = 0.032; odds ratio (OR): 0.375; 95% confidence interval (CI): 0.160–0.876; P = 0.024], similar rate of PDL (29.5% vs. 42.0%; P = 0.170), and smaller RPNA [6 (0–36) vs. 40 (6–115) mm2; P = 0.001; OR: 0.240; 95% CI: 0.100–0.577; P = 0.001] compared with the W2.5 group. At 45 days, rate of DRT as detected by CT and/or transoesophageal echocardiography (TOE), was higher with W2.5 (6.0% vs. 0%, P = 0.045). At 6-month follow-up, NACE did not differ between groups.

Conclusions

In this cohort of consecutive LAACs, FLX as compared to W2.5, was associated with similar procedure-related complications and 6-month NACE, but with improved LAA neck coverage, and lower IDL and DRT.
Along-arc heterogeneous rheology inferred from post-seismic deformation of the 2011 Tohoku-oki earthquake
Authors: Dhar Sambuddha , Muto Jun , Ito Yoshiaki , Miura Satoshi , Moore James D P , Ohta Yusaku , Iinuma Takeshi
Published: February 2022

The Japan forearc plays a crucial role in modulating the post-seismic deformation in response to the enormous stress perturbation induced by the 2011 Tohoku-oki earthquake. Dense geodetic observations across Japan have revealed coupled interactions between afterslip on the subducting plate interface and viscous deformation within the mantle wedge, and detailed numerical models can provide further profound insights into the forearc rheology. Recent studies have revealed the presence of a stagnant section in the forearc mantle of the Tohoku subduction zone, and here we investigate the associated along-arc variation of the stagnant part of the mantle wedge (cold nose) across Japan. We utilize a newly deployed geodetic network along a corridor in the Fukushima–Niigata region and compare the surface deformation pattern to that of the Miyagi–Yamagata corridor close to the main rupture area. We present a 3-D rheological model using laboratory-derived constitutive laws to simulate the geodetic observations including displacement fields and their time-series. Our results suggest along-arc heterogeneity in the forearc mantle rheology; specifically, we find a narrower cold nose in the Miyagi region and a wider one in the Fukushima forearc. The geodetic inferences on the forearc variation are consistent with along-arc spatial heterogeneity in the cut-off depth for shallow earthquakes as well as comparative measurements of the respective geothermal gradients between the Miyagi and Fukushima regions.
Responses to unexpected events; folk-rock-blues anthems; memes and other non-genetically inherited traits
Authors: DeMartini Edward E
Published: February 2022

What follows is a look back over a long and productive career and avocation in a field that I love, but one that has also been struck occasionally by personal tragedy, including the loss of my father at an early age, the unexpected death of my beloved wife and life partner in 2010, and a stroke in 2020 that has left me partially disabled. But impactful events can be serendipitous in prompting productive research. The lesson learned by such experiences is that opportunities—and the self-imposed responsibilities—to make positive contributions to the world, and to thereby honor the memories of those lost, continue beyond such events. The lessons I have learned along the way should inspire others at the start of and during their own personal life trajectories, particularly in developing the ability to recognize and appreciate opportunities for mentorship and to inspire emerging scholars and junior researchers to both respond to such opportunities to be mentored and subsequently to be mentors themselves. Everyone, especially students and junior scientists, in particular those who will become resource managers, should realize that they are links in a chain—an important one connecting the past and the future! My goal herein is to use my story to advise students and young scientists, and remind my older colleagues, of the importance of keeping this perspective as they go forward. I have tried to weave this message together with justification for motivation.
ATOMS: ALMA Three-millimeter Observations of Massive Star-forming regions – IX. A pilot study towards IRDC G034.43+00.24 on multi-scale structures and gas kinematics
Authors: Liu Hong-Li , Tej Anandmayee , Liu Tie , Goldsmith Paul F , Stutz Amelia , Juvela Mika , Qin Sheng-Li , Xu Feng-Wei , Bronfman Leonardo , Evans Neal J , Saha Anindya , Issac Namitha , Tatematsu Ken’ichi , Wang Ke , Li Shanghuo , Zhang Siju , Baug Tapas , Dewangan Lokesh , Wu Yue-Fang , Zhang Yong , Lee Chang Won , Liu Xun-Chuan , Zhou Jianwen , Soam Archana
Published: February 2022

We present a comprehensive study of the gas kinematics associated with density structures at different spatial scales in the filamentary infrared dark cloud, G034.43+00.24 (G34). This study makes use of the H13CO+ (1–0) molecular line data from the ALMA Three-millimeter Observations of Massive Star-forming regions (ATOMS) survey, which has spatial and velocity resolution of ∼0.04 pc and 0.2 km s−1, respectively. Several tens of dendrogram structures have been extracted in the position-position-velocity space of H13CO+, which include 21 small-scale leaves and 20 larger-scale branches. Overall, their gas motions are supersonic but they exhibit the interesting behaviour where leaves tend to be less dynamically supersonic than the branches. For the larger scale, branch structures, the observed velocity–size relation (i.e. velocity variation/dispersion versus size) are seen to follow the Larson scaling exponent while the smaller-scale, leaf structures show a systematic deviation and display a steeper slope. We argue that the origin of the observed kinematics of the branch structures is likely to be a combination of turbulence and gravity-driven ordered gas flows. In comparison, gravity-driven chaotic gas motion is likely at the level of small-scale leaf structures. The results presented in our previous paper and this current follow-up study suggest that the main driving mechanism for mass accretion/inflow observed in G34 varies at different spatial scales. We therefore conclude that a scale-dependent combined effect of turbulence and gravity is essential to explain the star-formation processes in G34.
What powers the radio emission in TDE AT2019dsg: A long-lived jet or the disruption itself?
Authors: Matsumoto Tatsuya , Piran Tsvi , Krolik Julian H
Published: February 2022

The tidal disruption event AT2019dsg was observed from radio to X-rays and was possibly accompanied by a high-energy neutrino. Previous interpretations have focused on continued injection by a central engine as the source of energy for radio emission. We show that continuous energy injection is unnecessary; the radio data can be explained by a single ejection of plasma that supplies all the energy needed. To support this assertion, we analyse the synchrotron self-absorbed spectra in terms of the equipartition model. Similar to previous analyses, we find that the energy in the radio-emitting region increases approximately ∝ t0.7 and the length-scale of this region grows ∝ t at a rate $\simeq 0.06\, c$. This event resembles the earliest stage of a supernova remnant: because the ejected mass is much greater than the shocked external mass, its velocity remains unchanged, while the energy in shocked gas grows with time. The radio-emitting material gains energy from the outflow, not from continuing energy injection by the central object. Although energy injection from an accreting BH cannot be completely excluded, the energy injection rate is very different from the fallback luminosity, and maintaining constant outflow velocity requires fine-tuning, demanding further physical explanation. If the neutrino association is real, the energy injection needed is much greater than for the radio emission, suggesting that the detected neutrino did not arise from the radio-emitting region.
Efficient method for estimating the time evolution of the proto-neutron star mass and radius from a supernova neutrino signal
Authors: Nagakura Hiroki , Vartanyan David
Published: February 2022

In this paper, we present a novel method to estimate the time evolution of the proto-neutron star (PNS) structure from the neutrino signal in a core-collapse supernova (CCSN). Employing recent results from multidimensional CCSN simulations, we delve into a relation between the total emitted neutrino energy (TONE) and PNS mass/radius, and we find that they are strongly correlated with each other. We fit the relation by simple polynomial functions connecting the TONE to the mass and radius of the PNS as a function of time. By combining another fitting function representing the correlation between the TONE and the cumulative number of events at each neutrino observatory, the PNS mass and radius can be retrieved from purely observed neutrino data. We demonstrate retrievals of PNS mass and radius from mock data of the neutrino signal, and we assess the capability of our proposed method. While underlining the limitations of the method, we also discuss the importance of the joint analysis with the gravitational wave signal. This would reduce uncertainties of parameter estimations in our method, and may narrow down the possible neutrino oscillation model. The proposed method is a very easy and inexpensive computation, which will be useful in real data analysis of the CCSN neutrino signal.
Revisiting the evolved hypergiants in the Magellanic Clouds
Authors: Kourniotis M , Kraus M , Maryeva O , Borges Fernandes M , Maravelias G
Published: February 2022

The massive stars that survive the phase of red supergiants (RSGs) spend the rest of their life in extremity. Their unstable atmospheres facilitate the formation and episodic ejection of shells that alter the stellar appearance and surroundings. In the present study, we revise the evolutionary state of eight hypergiants in the Magellanic Clouds, four of early-A type and four of FG type, and complement the short list of the eruptive post-RSGs termed as yellow hypergiants. We refine the outdated temperatures and luminosities of the stars by means of high-resolution spectroscopy with the Fiber-fed Extended Range Optical Spectrograph (FEROS). The A-type stars are suggested to be in their early, post-main-sequence phase, showing spectrophotometric characteristics of redward evolving supergiants. On the other hand, the FG-type stars manifest themselves through the enhanced atmospheric activity that is traced by emission filling in H α and the dynamical modulation of the low-excitation Ba ii line. Of these stars, the dusty HD269723 is suggested to have recently departed from a cool phase. We identify double-peaked emission in the FEROS data of HD269953 that emerges from an orbiting disc-hosting companion. The highlight of the study is an episode of enhanced mass-loss of HD271182 that manifests as a dimming event in the light curve and renders the star ‘modest’ analogue to ρ Cas. The luminosity log (L/L⊙) = 5.6 of HD271182 can serve as an updated threshold for the luminosity of stars exhibiting a post-RSG evolution in the Large Magellanic Cloud.
On the use of sulphur as a tracer for abundances in galaxies
Authors: Díaz Ángeles I , Zamora S
Published: February 2022

2+We present a methodology for the use of sulphur as global metallicity tracer in galaxies, allowing performing a complete abundance analysis using only the red-to-near-infrared spectral region. We have applied it to a compilation of high-quality data split into two samples: H ii regions (DHR) in spiral and irregular galaxies, and dwarf galaxies dominated by a strong starburst (H ii Gal). Sulphur abundances have been derived by direct methods under the assumption of an ionization structure composed of two zones: an intermediate-ionization one where S++ is originated, and a low-ionization one where S+ is formed. Ionization correction factors (ICF) have been calculated from the Ar/Ar3+ ratio and are shown to correlate with the hardness of the radiation field. Only about 10 per cent of the objects show S3+ contributions to the total abundance larger than 30 per cent. A good correlation exists between sulphur abundance and ionizing temperature with low-metallicity objects being ionized by hotter stars. No correlation is found between ionization parameter and total S/H abundance. Most of the H ii Gal objects show S/O ratios below the solar value and a trend for increasing S/O ratios with increasing sulphur abundances, while DHR objects show S/O ratios larger than solar and a tendency for lower S/O ratios for higher metallicities. Finally, we present a calibration of the sulphur abundance through the S23 parameter that remains single valued up to sulphur abundances well beyond the solar value. S23 is independent of the ionization parameter and only weakly dependent on ionizing temperature.
Changes in Inflammatory and Atherogenesis Biomarkers With the 2-Drug Regimen Dolutegravir Plus Lamivudine in Antiretroviral Therapy–Experienced, Virologically Suppressed People With HIV-1: A Systematic Literature Review
Authors: Llibre Josep M , Cahn Pedro E , Lo Janet , Barber Tristan J , Mussini Cristina , van Welzen Berend J , Hernandez Beatriz , Donovan Cynthia , Kisare Michelle , Sithamparanathan Myooran , van Wyk Jean
Published: February 2022

Background

The 2-drug regimen dolutegravir plus lamivudine has demonstrated long-term noninferior efficacy vs 3-/4-drug regimens (3/4DRs) in phase 3 trials. This systematic literature review summarizes clinical trial and real-world evidence evaluating impact of dolutegravir plus lamivudine on inflammatory and atherogenesis biomarkers in people with human immunodeficiency virus type 1 (PWH).

Methods

Using Ovid MEDLINE, Embase, PubMed, and Cochrane library databases and conference proceedings, we searched for studies published from 1 January 2013 to 14 July 2021, reporting changes in inflammatory and atherogenesis biomarkers with dolutegravir plus lamivudine in antiretroviral therapy–experienced, virologically suppressed PWH aged ≥18 years.

Results

Four records representing 2 randomized controlled trials (RCTs) and 6 records of real-world evidence met eligibility criteria. All real-world studies evaluated CD4+/CD8+ ratio, while only 1 assessed inflammatory biomarkers. Across both RCTs, no consistent pattern of change in biomarkers was observed between dolutegravir/lamivudine and 3/4DR comparators. There were significant changes in soluble CD14 favoring dolutegravir/lamivudine in TANGO at weeks 48 and 144 and SALSA at week 48, and in interleukin-6 favoring the control group in TANGO at weeks 48 and 144. In the real-world study evaluating inflammatory biomarkers, median soluble CD14 significantly decreased 48 weeks postswitch to dolutegravir plus lamivudine (P < .001), while other biomarkers remained stable. In all 6 real-world studies, increases in CD4+/CD8+ ratio were reported after switch to dolutegravir plus lamivudine (follow-up, 12–60 months).

Conclusions

Results show that dolutegravir plus lamivudine has a comparable impact on inflammatory and atherogenesis biomarkers vs 3/4DRs, with no consistent pattern of change after switch in virologically suppressed PWH.
Percutaneous Versus Transcutaneous Electrical Nerve Stimulation for the Treatment of Musculoskeletal Pain. A Systematic Review and Meta-Analysis
Authors: Beltran-Alacreu Hector , Serrano-Muñoz Diego , Martín-Caro Álvarez David , Fernández-Pérez Juan J , Gómez-Soriano Julio , Avendaño-Coy Juan
Published: February 2022

Background

The justification for this review is the need for high-quality evidence to assist in the decision-making process when applying percutaneous electrical nerve stimulation (PENS) or transcutaneous electrical nerve stimulation (TENS) in a clinical setting. The main aim was to determine if the use of PENS is more effective and should be recommended when compared to TENS for the reduction of musculoskeletal pain intensity.

Methods

A search for randomized controlled trials (RCTs) was performed. Studies published until 31/12/2020, comparing the effectiveness of PENS and TENS, were considered. The main outcome was pain assessed with a visual analog scale or numerical pain rating scale.

Results

Nine RCTs were included in the qualitative analysis, with seven of them in the quantitative analysis (n = 527). The overall effect of PENS on pain was statistically but not clinically superior to TENS (mean difference [MD]=−1.0 cm; 95% confidence interval [CI]: −1.5 to −0.4) with a high level of heterogeneity (I2=76%, P > .01). When only studies with a lower risk of bias (n = 3) were analyzed, the heterogeneity decreased to I = 0% (P = .06) and no difference was observed between TENS and PENS (MD=−0.81 cm; 95% CI:−1.6 to 0.02) with a moderate recommendation level according to GRADE. There were no data concerning adverse effects.

Conclusions

There is low-quality of evidence for more pain intensity reduction with PENS, but the difference was not clinically significant. However, when only studies with low risk of bias are meta-analyzed, there is a moderate quality of evidence that there is no difference when TENS or PENS is applied for pain intensity.
Climate–ecological–economic modelling for the cost-effective spatiotemporal allocation of conservation measures in cultural landscapes facing climate change
Authors: Gerling Charlotte , Drechsler Martin , Keuler Klaus , Leins Johannes A , Radtke Kai , Schulz Björn , Sturm Astrid , Wätzold Frank
Published: February 2022

Climate change has become a key threat to biodiversity. As a response to climate change, species may adapt spatially (with range shifts) and temporally (with phenological adaptations), which may alter the impact of conservation measures. In cultural landscapes, where conservation often depends on specifically timed land use, climate change may also induce spatial changes in opportunity costs of conservation measures and with respect to their timing. Thus, previously cost-effectiveness conservation efforts may become less cost-effective. We develop a climate–ecological–economic model to investigate climate change-induced modifications of the cost-effective spatiotemporal allocation of conservation measures. We apply the model to a case study to investigate the cost-effectiveness of grassland measures to conserve the large marsh grasshopper in northern Germany for the periods 2020–39 and 2060–79. Our model shows modifications in the cost-effective spatial allocation of conservation measures and that the timing of measures adapted to phenological changes remains cost-effective under climate change.
Political Beta
Authors: Fisman Raymond , Knill April , Mityakov Sergey , Portnykh Margarita
Published: February 2022

Using a portfolio theory framework, we introduce the concept of “political beta” to model firm-level export diversification in response to global political risk. Our model predicts that firms are less responsive to changes in political relations with lower beta countries—those that contribute less to the firm’s total political risk. We document patterns consistent with our model using disaggregated Russian firm-by-destination-country data during 2001–2011: Trade is positively correlated with political relations, though the effect is far weaker for trading partners whose political relations with Russia are relatively uncorrelated with those of other partners in a firm’s export portfolio.
StarBeast3: Adaptive Parallelized Bayesian Inference under the Multispecies Coalescent
Authors: Douglas Jordan , Jiménez-Silva Cinthy L , Bouckaert Remco
Published: February 2022

As genomic sequence data become increasingly available, inferring the phylogeny of the species as that of concatenated genomic data can be enticing. However, this approach makes for a biased estimator of branch lengths and substitution rates and an inconsistent estimator of tree topology. Bayesian multispecies coalescent (MSC) methods address these issues. This is achieved by constraining a set of gene trees within a species tree and jointly inferring both under a Bayesian framework. However, this approach comes at the cost of increased computational demand. Here, we introduce StarBeast3—a software package for efficient Bayesian inference under the MSC model via Markov chain Monte Carlo. We gain efficiency by introducing cutting-edge proposal kernels and adaptive operators, and StarBeast3 is particularly efficient when a relaxed clock model is applied. Furthermore, gene-tree inference is parallelized, allowing the software to scale with the size of the problem. We validated our software and benchmarked its performance using three real and two synthetic data sets. Our results indicate that StarBeast3 is up to one-and-a-half orders of magnitude faster than StarBeast2, and therefore more than two orders faster than *BEAST, depending on the data set and on the parameter, and can achieve convergence on large data sets with hundreds of genes. StarBeast3 is open-source and is easy to set up with a friendly graphical user interface. [Adaptive; Bayesian inference; BEAST 2; effective population sizes; high performance; multispecies coalescent; parallelization; phylogenetics.]
High-Intensity Interval Training for Reducing Cancer-Related Fatigue in Survivors of Cancer: Challenges and Solutions for Translation and Implementation in Cancer Rehabilitation
Authors: Hidde Mary C. , Leach Heather J. , DeBord Alexa , Schmid Arlene A. , Eagan Jeffrey
Published: February 2022

Moderate-intensity continuous aerobic exercise training (MICT) is used to help alleviate symptoms of cancer-related fatigue (CRF) in many cancer rehabilitation programs. High-intensity interval training (HIIT) has become increasingly popular, including several research studies demonstrating promising effects of HIIT on CRF among patients and survivors of cancer. However, we propose that 2 primary limitations exist in the current literature that must be addressed before HIIT should be translated from research studies and implemented in cancer rehabilitation. These limitations are the lack of generalizability of this research and a paucity of studies that have directly compared MICT with HIIT while matching for total exercise volume. In this commentary, we expand on the rationale for the proposed limitations and provide suggestions for future research directions.
Completion Total Mesorectal Excision After Transanal Local Excision of Early Rectal Cancer: A Systematic Review and Meta-analysis
Authors: Wyatt James N. R. , Powell Simon G. , Altaf Kiran , Barrow Hannah E. , Alfred Joshua S. , Ahmed Shakil
Published: February 2022

BACKGROUND:

Completion total mesorectal excision is recommended when local excision of early rectal cancers demonstrates high-risk histopathological features. Concerns regarding the quality of completion resections and the impact on oncological safety remain unanswered.

OBJECTIVE:

This study aims to summarize and analyze the outcomes associated with completion surgery and undertake a comparative analysis with primary rectal resections.

DATA SOURCES:

Data sources included PubMed, Cochrane library, MEDLINE, and Embase databases up to April 2021.

STUDY SELECTION:

All studies reporting any outcome of completion surgery after transanal local excision of an early rectal cancer were selected. Case reports, studies of benign lesions, and studies using flexible endoscopic techniques were not included.

INTERVENTION:

The intervention was completion total mesorectal excision after transanal local excision of early rectal cancers.

MAIN OUTCOME MEASURES:

Primary outcome measures included histopathological and long-term oncological outcomes of completion total mesorectal excision. Secondary outcome measures included short-term perioperative outcomes.

RESULTS:

Twenty-three studies including 646 patients met the eligibility criteria, and 8 studies were included in the meta-analyses. Patients undergoing completion surgery have longer operative times (standardized mean difference, 0.49; 95% CI, 0.23–0.75; p = 0.0002) and higher intraoperative blood loss (standardized mean difference, 0.25; 95% CI, 0.01–0.5; p = 0.04) compared with primary resections, but perioperative morbidity is comparable (risk ratio, 1.26; 95% CI, 0.98–1.62; p = 0.08). Completion surgery is associated with higher rates of incomplete mesorectal specimens (risk ratio, 3.06; 95% CI, 1.41–6.62; p = 0.005) and lower lymph node yields (standardized mean difference, –0.26; 95% CI, –0.47 to 0.06; p = 0.01). Comparative analysis on long-term outcomes is limited, but no evidence of inferior recurrence or survival rates is found.

LIMITATIONS:

Only small retrospective cohort and case-control studies are published on this topic, with considerable heterogeneity limiting the effectiveness of meta-analysis.

CONCLUSIONS:

This review provides the strongest evidence to date that completion surgery is associated with an inferior histopathological grade of the mesorectum and finds insufficient long-term results to satisfy concerns regarding oncological safety. International collaborative research is required to demonstrate noninferiority.

Registration No.

CRD42021245101.
Immunosuppressive drugs and associated complications in abdominal organ transplantation
Authors: Olson Jody C.
Published: February 2022

Purpose of review

Intensive care management of patients who have undergone organ transplantation of liver, small bowel, pancreas, and/or kidney requires a basic knowledge of immunosuppression principles and the management of immunosuppressive medications. This review highlights the core principles of immunosuppression management in abdominal organ transplantation with a focus on complications arising from immunosuppressive drugs, both in the immediate postoperative period and in long-term usage.

Recent findings

The general principles of management of immunosuppression in the abdominal organ transplant population have remained largely unchanged. Improvements in drug monitoring coupled with improvements in knowledge of pathways involved in allograft rejection have further refined immunosuppressive therapy. Infectious and central nervous system complications remain prevalent and are common complications of immunosuppressive drug therapy.

For the intensive care professional who cares for abdominal organ transplant recipients, a foundational knowledge of the core principles of immunosuppression management is essential. In addition, an understanding of the common immunosuppressive drug regimens and the complications associated with these regimens is required for optimal management, risk assessment, and outcomes.
Comparing bowel lengthening procedures: which, when, and why?
Authors: van Praagh Jasper B. , Hofker H. Sijbrand , Haveman Jan-Willem
Published: February 2022

Purpose of review

Intestinal failure secondary to short bowel syndrome is still a very serious condition. Treatment consists of parenteral nutrition to provide nutrients and maintain body weight. During the last decades, intestinal lengthening procedures have become more available. The goal of this review is to discuss the results of the literature on the most commonly performed intestinal lengthening procedures.

Recent findings

Longitudinal Intestinal Lengthening, Serial Transverse Enteroplasty (STEP), and Spiral Intestinal Lengthening and Tailoring (SILT) are currently the most frequently reported intestinal lengthening procedures. The most recent literature of these procedures is described with respect to indication, technical details, complications, short and long-term outcome, and PN independence.

On the basis of indication, surgical complexity, complications, and clinical success, we conclude that the STEP procedure is probably the best choice for most centers.
Nontransplant options for portomesenteric thrombosis
Authors: Hibi Taizo
Published: February 2022

Purpose of review

Portomesenteric thrombosis (PMT) is a serious condition encountered mainly in cirrhotic patients awaiting liver transplantation. More recently, this potentially fatal complication has been described after bariatric surgery and inflammatory bowel disease. Several consensus guidelines have been published over the past few years and this mini review was conducted to discuss updated nontransplant treatment options based on currently available evidence.

Recent findings

Anticoagulation is the mainstay of treatment for PMT involving <50% of the main portal vein. Transjugular intrahepatic portosystemic shunt are usually preserved for patients with more extensive disease or those with clinically significant portal hypertension that are treatment refractory.

The extent of PMT, response to therapy, and complications related with PMT are the determinants of therapy.
Recurrent Ovarian Cancer Presenting as a Solitary Chest Wall Metastasis Revealed by FDG PET/CT
Authors: Shen Guohua , Kuang Anren
Published: February 2022

A 55-year-old woman who was diagnosed with ovarian cancer 4 years ago complained of back pain for 1 month, and the CA-125 level was elevated. FDG PET/CT was then performed for restaging, and the images revealed a hypermetabolic mass in the right posterior chest wall. Postsurgical pathology confirmed metastasis from ovarian cancer.
Integrated PET/MRI With 68Ga-DOTATATE and 18F-FDG in Pheochromocytomas and Paragangliomas
Authors: Xu Si , Pan Yu , Zhou Jinxin , Ju Huijun , Zhang Yifan
Published: February 2022

Purpose

Pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumors with metastatic potential. Both 68Ga-DOTATATE and 18F-FDG PET/CT scans have been demonstrated to have important roles in imaging PPGLs, but less is known about the performance of PET/MRI for PPGLs. The study is aimed to investigate whether diffusion-weighted imaging–MRI (DWI-MRI) has an added value to PET imaging in the identification of PPGL lesions by means of integrated PET/MRI.

Methods

Eleven patients who underwent both 18F-FDG and 68Ga-DOTATATE PET/MRI within 2 weeks were retrospectively included in the study. A total of 56 PPGL lesions were analyzed, and lesion-based detection rates of 68Ga-DOTATATE PET, 18F-FDG PET, DWI-MRI, and PET/MRI were calculated and compared, respectively.

Results

68Ga-DOTATATE PET was superior to 18F-FDG PET and DWI-MRI in imaging PPGLs with a lesion-based detection rate of 96.4% (54/56) (95% confidence interval [CI], 87.7%–99.6%), 85.7% (48/56) (95% CI, 76.3%–95.2%), and 89.3% (50/56) (95% CI, 80.9%–97.6%), respectively. PET/MRI with DWI could improve the detection rate of 68Ga-DOTATATE and 18F-FDG PET alone up to 100% in metastatic PPGLs. Lesions of PPGL demonstrated markedly higher tracer uptake in 68Ga-DOTATATE PET than in 18F-FDG PET (P = 0.009 for primary lesion, P = 0.033 for metastases).

Conclusions

68Ga-DOTATATE PET showed a higher detection rate than 18F-FDG for PPGLs. In integrated PET/MRI, MRI had an added value to 18F-FDG PET but not much to 68Ga-DOTATATAE PET in identifying PPGL lesions.
Unusual Radiotracer Deposition to the Forearm After Intrahepatic Injection of 99mTc-Macroaggregated Albumin Using a Transradial Approach
Authors: Mugweru Jon , Elman Shana , Rieter William J. , Gutjahr Christopher , Elojeimy Saeed
Published: February 2022

Arterial mapping and 99mTc-macroaggregated albumin (99mTc-MAA) hepatic perfusion imaging are routinely performed before 90Y radioembolization of hepatic tumors. These procedures serve multiple purposes, including an anatomical survey of hepatic arterial anatomy, interrogating expected microsphere distribution to avoid nontargeted embolization during therapy, and evaluating for possible hepatopulmonary shunting. We present a case where 99mTc-MAA planar images revealed unexpected soft tissue uptake within the left forearm, an unexpected complication that may result from residual 99mTc-MAA in the catheter being expelled as the catheter is removed, which is particularly important to avoid during the 90Y radioembolization procedure given the risk for associated radionecrosis.
Pediatric Plastic Surgery Operating Room Block-Time Utilization: A Casualty of Illness
Authors: Maliha Samantha G. , Bruce Madeleine K. , Anstadt Erin A. , Roy Eva , Pfaff Miles J. , Goldstein Jesse A. , Losee Joseph E.
Published: February 2022

Background:

Optimizing operating room (OR) utilization is a critical component of health care system efficiency. The purpose of our study was to analyze the extent of OR cancellation and its effect on raw utilization of OR block time allotted to surgeons in the pediatric plastic surgery department.

Methods:

The authors retrospectively reviewed the cases of 4 plastic surgeons at a tertiary pediatric hospital between 2018 and 2019. Data collected included patient demographics, type of surgery, time of cancellation, reason for cancellation, length of surgery, and minutes of block time allotted to each surgeon per year. Percent of cases canceled, scheduled times lost, and block times lost were calculated.

Results:

Surgeons A, B, C, and D scheduled 170, 416, 305, and 474 cases, respectively. Overall, 7% of cases were canceled, 9.1% of scheduled time was lost, and a total of 5.1% of block time was lost due to cancellation. Patients of surgeon A and D were more likely to cancel due to reasons classified as ‘‘other,’’ including causes such as failure of nil per os or a family’s last-minute decision to forego elective surgery (33.3% and 37.2%, respectively), whereas patients of surgeon B and C were more likely to cancel due to illness (67.9% and 36.4%, respectively).

Conclusions:

Cancellations negatively impact raw utilization times; if fewer cases are performed, allotted block times are redistributed. Communication with patients in the week prior to surgery may allow for earlier identification of likely cancellations. Future directions include exploring whether particular surgeon characteristics are linked to rate of cancellations.
Uncovering the Pathogenesis of Orofacial Clefts Using Bioinformatics Analysis
Authors: Dong Xinxin , Meng Teng , Lei Liu
Published: February 2022

Objective:

Many genes have been found to be associated with the occurrence of the orofacial clefts (OFC). The links between these pathogenic genes are rarely studied. In this study, bioinformatics analysis were performed in order to find associations between OFC- related genes and provide new ideas for etiology study of OFCs.

Methods:

Orofacial clefts-related genes were searched and identified from the Online Mendelian Inheritance of Man (OMIM.org). These genes were then analyzed by bioinformatics methods, including protein–protein interaction network, functional enrichment analysis, module analysis, and hub genes analysis.

Results:

After searching the database of OMIM.org and removing duplicate results, 279 genes were finally obtained. These genes were involved to 369 pathways in biological process, 56 in cell component, 64 in molecular function, and 45 in the Kyoto Encyclopedia of Genes and Genomes. Most identified genes were significantly enriched in embryonic appendage morphogenesis (29.17%), embryonic limb morphogenesis (6.06%), and limb development (4.33%) for biological process (Fig. 5A); ciliary tip (42.86%), MKS complex (28.57%), ciliary basal body (14.29%), and ciliary membrane (14.29%) for cell component. The top 10 hub genes were identified, including SHH, GLI2, PTCH1, SMAD4, FGFR1, BMP4, SOX9, SOX2, RUNX2, and CDH1.

Conclusions:

Bioinformatics methods were used to analyze OFC- related genes in this study, including hub gene identifying and analysis, protein – protein interaction network construction, and functional enrichment analysis. Several potential mechanisms related to occurrence of OFCs were also discussed. These results may be helpful for further studies of the etiology of OFC.
Case series on aripiprazole and dopamine supersensitivity psychosis
Authors: Russell Geoffrey , Reinfeld Samuel , Kam Olivia , Lee Gloria , Weiss Melissa , Koola Maju Mathew
Published: February 2022

A potential link between switching to aripiprazole and worsening of psychosis was first reported in the early 2000s. There have since been numerous published case reports describing this phenomenon, but only recently has the concept of a theoretical aripiprazole-induced dopamine supersensitivity psychosis (DSP) caused by D2 receptor activation in patients undergoing a switch to aripiprazole appeared in the literature. There is less awareness in clinical practice of the possibility of inducing DSP with aripiprazole, which may be particularly severe in some patients. The objective of this article is to present four cases demonstrating rapid and dramatic onset of DSP during switching to aripiprazole. In each case, a patient with a Diagnostic and statistical manual of mental disorders (5th ed.) diagnosis of schizophrenia experienced severe worsening of psychosis within 4–5 days of abrupt switching to aripiprazole from a full D2 antagonist. To our knowledge, this is the first case series characterizing the previously well-documented worsening of psychosis during switching to aripiprazole specifically as aripiprazole-induced DSP. We discuss clinical relevance, prevention and future directions. Careful cross-titration per clinical practice guidelines may reduce occurrence of DSP during aripiprazole switching or augmentation treatment.
Reconciling GenBank names with standardized avian taxonomies to improve linkage between phylogeny and phenotype
Authors: Hosner Peter A. , Zhao Min , Kimball Rebecca T. , Braun Edward L. , Burleigh J. Gordon
Published: February 2022

Biodiversity research has advanced by testing expectations of ecological and evolutionary hypotheses through the linking of large-scale genetic, distributional, and trait datasets. The rise of molecular systematics over the past 30 years has resulted in a wealth of DNA sequence data from around the globe, facilitating biodiversity research. However, advances in molecular systematics also have created taxonomic instability, as new estimates of evolutionary relationships and interpretations of species limits have led to widespread scientific name changes. Taxonomic instability, or “splits, lumps, and shuffles”, present logistical challenges to large-scale biodiversity research because species or populations may be listed under different names in different data sources, or because different species or populations may be listed under previous names. Consequently, distributional and trait data are often difficult to link directly to DNA sequence data without extensive and time consuming curation. Here, we present RANT: Reconciliation of Avian NCBI Taxonomy. RANT applies taxonomic reconciliation to standardize all avian names in use in NCBI GenBank, a primary source of genetic data, to a widely-used and regularly-updated avian taxonomy: eBird/Clements. Of 14,341 avian species or subspecies names used by GenBank, 11,031 names directly matched an eBird/Clements name, which were linked to over 6 million nucleotide sequences. For the remaining unique avian names in GenBank, we used Avibase’s taxonomic concepts, taxonomic descriptions in Cornell’s Birds of the World, and DNA sequence metadata to identify corresponding eBird/Clements names. Reconciled names were linked to over 600,000 nucleotide sequences, approximately 9% of all avian sequences on GenBank. Nearly 10% of eBird/Clements names had nucleotide sequences listed under two or more GenBank names. Our avian GenBank naming reconciliation is open source and available at GitHub, where it can be updated to correspond with future annual eBird/Clements taxonomic updates.

LAY SUMMARY

– 23% of avian names on GenBank do not match eBird/Clements, a widely-used standardized avian taxonomy

– 600,000 nucleotide sequences on GenBank are associated with names that do not match eBird/Clements

– 10% of eBird/Clements names have nucleotide sequences listed under multiple GenBank names

– We provide an open source taxonomic reconciliation to mitigate difficulties associated with non-standardized name use for GenBank data
Host origin is a determinant of parallel evolution between influenza virus gene segments
Authors: Jones Jennifer E. , Lakdawala Seema S.
Published: February 2022

Several emerging influenza viruses, including H7N9 and H5N6 viruses, trace their origins to reassortment with H9N2 viruses that contributed internal gene segments. However, the evolutionary constraints governing reassortment of H9N2 viruses remain unknown. In seasonal human influenza A viruses, gene segments evolve in parallel at both the gene and protein levels. Here, we demonstrate that parallel evolution in human H3N2 viruses differs from avian H9 viruses, with both genes and proteins of avian H9 viruses characterized by high phylogenetic divergence. Strikingly, protein trees corresponding to avian H9 polymerase subunits diverge despite known functional constraints on polymerase evolution. Gene divergence was consistent across avian H9 isolates from different continents, suggesting that parallel evolution between H9 gene segments is not dependent on regionally defined lineages. Instead, parallel evolution in H9 viruses was dependent upon host origin. Our study reveals the role of the host in parallel evolution of influenza gene segments and suggests that high reassortment potential in avian species may be a consequence of evolutionary flexibility between gene segments.