bluuebunny/crossref_metadata_2025 huggingface dataset:
Thoracic Outlet Syndrome after Minimally Invasive Repair of Pectus Excavatum in a 15-Year-Old Boy: A Case Report
Authors: Fernandes Sara , Soares-Aquino Carolina , Monteiro Joana , Estevinho Norberto , Borges-Dias Mariana
Published: July 2022

Nuss procedure has become the treatment of choice in pectus excavatum mainly because of the excellent functional and cosmetic results. Despite the good results, several complications have been reported. The aim of this study is to describe a case of thoracic outlet syndrome (TOS) after Nuss procedure and review the management of such rare complication. A 15-year-old boy otherwise healthy was submitted to Nuss procedure, with no perioperative complications. Two-weeks later, the patient complained of right-hand paresthesia, progressive weakness of the right arm and coldness. After imaging and electromyography, TOS diagnosis was established. Removal of the bar was proposed but refused by the patient. Conservative management with rehabilitation exercising and nerve nourishing was initiated. At 7 months, the patient recovered arm and hand function. Abrupt structural changes of thoracic cavity with marked elevation of the upper chest induce nerve and vascular compression arousing a TOS and should be acknowledged as one potential complication of Nuss procedure. Conservative management can be an alternative treatment to bar removal, showing good results on functional recovery in early stages of compression.
Assessing the Knowledge of Sick-Day Rules Among Patients on Long-Term Glucocorticoids and Healthcare Professionals in a UK District General Hospital
Authors: Alam Muhammad Masoud , Tariq Mohammad , Bondugulapati L. N. Rao , Pasha Mohammed Afraz , Bashir Jawad , Hassan Usman , Awan Tufail Ahmad
Published: July 2022

Introduction Adrenal insufficiency can happen because of decreased cortisol production as a result of negative feedback on the hypothalamic–pituitary–adrenal axis, caused by excess exogenous glucocorticoids (GC). The most common cause of adrenal insufficiency is, in fact, abrupt stoppage of exogenous GC. Patients with adrenal insufficiency are at risk of developing life-threatening adrenal crisis if GC is reduced or stopped abruptly, or if GC dose is not increased during periods of increased stress.

The adrenal crises should be preventable with education of patients and healthcare professionals (HCPs) about “sick-day” rules, the importance of “steroid cards,” and the utility of parenteral steroids.

Methods This study was aimed at assessing the knowledge of sick-day rules in patients on long-term GC as well as HCPs.

Patients aged above 18 years on long-term GC presenting to the endocrinology clinic over 6 weeks were included after audit-committee approval.

Results We assessed 18 consecutive patients in total, 61% (11/18) of whom said that they have received information about sick-day rules from an HCP. Only 38% (7/18) had access to emergency hydrocortisone-kit.

We assessed 36 HCPs. Thirty-six (13/36) percent were aware of steroid emergency card and 50% (18/36) HCPs exhibited awareness regarding steroid dose during acute event and 27% of (10/36) HCPs were aware of accessible hospital intranet resources.

Conclusion This study revealed significant lack of awareness of sick-day rules among patients and HCPs alike. Majority of patients failed to carry steroid emergency card or medic alert bracelet and majority of HCPs and patients lacked knowledge of sick-day rules.
Effects of Moderate Intensity Aerobic Exercise to FSTL-1 Regulation in Atherosclerosis: A Systematic Review
Authors: Damay Vito Anggarino , Setiawan Setiawan , Lesmana Ronny , Akbar Muhammad Rizki , Lukito Antonia Anna
Published: July 2022

Moderate intensity exercise is considered as a primary step to prevent coronary artery diseases (CADs) by stimulated FSTL-1 secretion as a novel myokines to improve endothelial cell function, prevent arterial stiffness, or vascular inflammation. This review aims to provide the current evident role of FSTL-1 as a novel myokine secreted during exercise to prevent atherosclerosis progression. A systematic review using databases from (PubMed), ScienceDirect, and The Cochrane Library, was conducted up to October 2021 to identify all the eligible experimental and observational studies that assess how moderate intensity exercises stimulate FSTL-1 secretion to prevent atherosclerosis. Results were described through narrative synthesis of the evidence. From 84 retrieved references, 15 studies met the inclusion criteria and were included in this review. The overall results suggest that exercise or physical activity can stimulate myokines secretion, especially in FSTL-1. FSTL-1 is a myokine or adipokine that plays a potential role in preventing atherosclerosis by various mechanisms such as via improvement of endothelial functions, suppression of smooth muscle cells (SMCs) proliferation, and reduction of arterial thickening. FSTL-1 is a relatively new and less known myokine, but probably holds a key role in assessing how moderate intensity aerobic exercise prevents atherosclerosis progression by preventing endothelial dysfunction, arterial stiffness, or vascular inflammation.
Nomogram for the Estimation of Intestinal Necrosis Risk in Incarcerated Inguinal Hernia in Infants under 6 Months
Authors: Chen Pengfei , Xiong Haiyi , Cui Mengying , Cao Jian , Hou Jinfeng , Liu Wei
Published: July 2022

Objective This article develops a nomogram to estimate intestinal necrosis risk in the incarcerated inguinal hernia (IIH) in infants under 6 months.

Methods A total of 273 infants who underwent an emergency operation due to IIH were investigated retrospectively. Univariate and multivariate logistic regression were used to analyze the relationship between variables and intestinal necrosis and construct a nomogram of intestinal necrosis. The discrimination and concordance of the model were verified by receiver operating characteristic (ROC) analysis and calibration curve, and the bootstrap method was used for internal validation of the model. The clinical applicability of the model was evaluated using the decision curve and the clinical impact curve.

Results Intestinal necrosis was found in 37 of 273 infants (13.6%) in this study. The vomiting symptoms, platelet count, C-reactive protein, and neutrophil-lymphocyte ratio were independent risk factors for intestinal necrosis in IIH. We then constructed a nomogram with these four factors. ROC analysis showed that the nomogram had a good diagnostic performance, with the area under the curve (AUC), sensitivity, and specificity of 0.918 (95% confidence interval: 0.880–0.956), 97.3%, and 69.9%, respectively. The nomogram was further validated using 2,000-repetition internal bootstrap validation, and the values of AUC, sensitivity, and specificity were 0.899, 95.7%, and 50.5%, respectively. The decision curve and the clinical impact curve indicated that the predictive model has a favorable clinical application.

Conclusion The nomogram can be used to predict intestinal necrosis in IIH, and allow us to estimate the severity of IIH more accurately and arrange the treatment process more reasonably.
Ultrasound-guided Glossopharyngeal Nerve Block—A New Paradigm in Pain Management
Authors: Yadav Mukesh K. , Pulappadi Vishnu Prasad , Singh Vikram Pratap , Bharati Sachidanand J. , Bagga Barun
Published: July 2022

We report eight cases of oropharyngeal carcinoma in which ultrasound-guided percutaneous distal glossopharyngeal nerve (GPN) block was performed for pain relief. Mean age of the patients was 52 ± 11.5 [SD] years and median baseline pain score was 7 (IQR, 5–8). Under ultrasound guidance, mixture of ropivacaine and dexamethasone was injected into parapharyngeal space. Pain reduced after four weeks in all patients (median [IQR], 4 [2.5–5]). Median quality of life score improved as compared with baseline in physical health (63 [44–69] vs 50 [44–63]) and psychological domains (56 [56–63] vs 50 [50–63]), reduced in social relationships domain (31 [19–44] vs 44 [31–44]), remained same in environment domain (56 [44–69] vs 56 [56–56]). Seven patients showed improvement on Patients' Global Impression of Change scale, while six showed improvement on Clinical Global Impressions scale. These early results show that ultrasound guided distal GPN block can reduce pain intensity in oropharyngeal carcinoma patients.
Excited-state double proton transfer of 1,8-dihydroxy-2-naphthaldehyde: A MS-CASPT2//CASSCF study
Authors: Xie Bin-Bin , Wang Ke-Xin , Jia Pei-Ke , Liu Xiang-Yang , Cui Ganglong
Published: July 2022

Excited-state double proton transfer (ESDPT) is a controversial issue which has long been plagued with theoretical and experimental communities. Herein, we took 1,8-dihydroxy-2-naphthaldehyde (DHNA) as a prototype and used combined complete active space self-consistent field (CASSCF) and multi-state complete active-space second-order perturbation (MS-CASPT2) methods to investigate ES-DPT and excited-state deactivation pathways of DHNA. Three different tautomer minima of S1-ENOL, S1-KETO-1, and S1-KETO-2 and two crucial conical intersections of S1S0-KETO-1 and S1S0-KETO-2 in.and between the S0 and S1 states were obtained. S1-KETO-1 and S1-KETO-2 should take responsibility for experimentally observing dual-emission bands. In addition, two-dimensional potential energy surfaces (2D-PESs) and linear interpolated internal coordinate paths connecting relevant structures were calculated at the MS-CASPT2//CASSCF level and confirmed a stepwise ESDPT mechanism. Specifically, the first proton transfer from S1-ENOL to S1-KETO-1 is barrierless, whereas the second one from S1-KETO-1 to S1-KETO-2 demands a barrier of ca. 6.0 kcal/mol. The linear interpolated internal coordinate path connecting S1-KETO-1 (S1-KETO-2) and S1S0-KETO-1 (S1S0-KETO-2) is uphill with a barrier of ca. 12.0 kcal/mol, which will trap DHNA in the S1 state while therefore enabling dual-emission bands. On the other hand, the S1/S0 conical intersections would also prompt the S1 system to decay to the S0 state, which could be to certain extent suppressed by locking the rotation of the C5−C8−C9−O10 dihedral angle. These mechanistic insights are not only helpful for understanding ESDPT but also useful for designing novel molecular materials with excellent photoluminescent performances.
Omicron mutations enhance infectivity and reduce antibody neutralization of SARS-CoV-2 virus-like particles
Authors: Syed Abdullah M. , Ciling Alison , Taha Taha Y. , Chen Irene P. , Khalid Mir M. , Sreekumar Bharath , Chen Pei-Yi , Kumar G. Renuka , Suryawanshi Rahul , Silva Ines , Milbes Bilal , Kojima Noah , Hess Victoria , Shacreaw Maria , Lopez Lauren , Brobeck Matthew , Turner Fred , Spraggon Lee , Tabata Takako , Ott Melanie , Doudna Jennifer A.
Published: July 2022

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant contains extensive sequence changes relative to the earlier-arising B.1, B.1.1, and Delta SARS-CoV-2 variants that have unknown effects on viral infectivity and response to existing vaccines. Using SARS-CoV-2 virus-like particles (VLPs), we examined mutations in all four structural proteins and found that Omicron and Delta showed 4.6-fold higher luciferase delivery overall relative to the ancestral B.1 lineage, a property conferred mostly by enhancements in the S and N proteins, while mutations in M and E were mostly detrimental to assembly. Thirty-eight antisera samples from individuals vaccinated with Pfizer/BioNTech, Moderna, or Johnson & Johnson vaccines and convalescent sera from unvaccinated COVID-19 survivors had 15-fold lower efficacy to prevent cell transduction by VLPs containing the Omicron mutations relative to the ancestral B.1 spike protein. A third dose of Pfizer vaccine elicited substantially higher neutralization titers against Omicron, resulting in detectable neutralizing antibodies in eight out of eight subjects compared to one out of eight preboosting. Furthermore, the monoclonal antibody therapeutics casirivimab and imdevimab had robust neutralization activity against B.1 and Delta VLPs but no detectable neutralization of Omicron VLPs, while newly authorized bebtelovimab maintained robust neutralization across variants. Our results suggest that Omicron has similar assembly efficiency and cell entry compared to Delta and that its rapid spread is due mostly to reduced neutralization in sera from previously vaccinated subjects. In addition, most currently available monoclonal antibodies will not be useful in treating Omicron-infected patients with the exception of bebtelovimab.
Preparing and comparing subtitles for quasi-experimental and experimental research in audiovisual translation
studies
Authors: Van Hoecke Senne M. , Schrijver Iris , Robert Isabelle S.
Published: July 2022

Empirical research on cognitive processing in AVT has been on the rise in recent years. A number of overarching
works have recommended more standardised approaches and methodological frameworks to contribute to more streamlined, replicable,
reproducible and valid future AVT research. To date, the issue of comparability of research materials (e.g., clips, subtitle
tracks, comprehension questionnaires) and, more specifically, how to achieve comparability in quasi-experimental and experimental
studies, particularly those involving repeated measures, has received little attention. This paper aims to address this knowledge
gap by proposing a common-sense ten-step preparatory process for quasi-experimental and experimental subtitling studies. This
preparatory process has previously been used in the S4AE project. The paper will focus on the final four steps, consisting of the
preparation and comparison of multiple subtitle tracks. These steps were conceptualized taking into account the present research
on subtitle parameters and the obstacles encountered while preparing comparable subtitle tracks.
Wave solutions and numerical validation for the coupled reaction-advection-diffusion dynamical model in a porous medium
Authors: Mubaraki Ali M , Kim Hwajoon , Nuruddeen R I , Akram Urooj , Akbar Yasir
Published: July 2022

The current study examines the special class of a generalized reaction-advection-diffusion dynamical model that is called the system of coupled Burger’s equations. This system plays a vital role in the essential areas of physics, including fluid dynamics and acoustics. Moreover, two promising analytical integration schemes are employed for the study; in addition to the deployment of an efficient variant of the eminent Adomian decomposition method. Three sets of analytical wave solutions are revealed, including exponential, periodic, and dark-singular wave solutions; while an amazed rapidly convergent approximate solution is acquired on the other hand. At the end, certain graphical illustrations and tables are provided to support the reported analytical and numerical results. No doubt, the present study is set to bridge the existing gap between the analytical and numerical approaches with regard to the solution validity of various models of mathematical physics.
Bethe states on a quantum computer: success probability and correlation functions
Authors: Li Wen , Okyay Mert , Nepomechie Rafael I
Published: July 2022

A probabilistic algorithm for preparing Bethe eigenstates of the spin-1/2 Heisenberg spin chain on a quantum computer has recently been found. We derive an exact formula for the success probability of this algorithm in terms of the Gaudin determinant, and we study its large-length limit. We demonstrate the feasibility of computing antiferromagnetic ground-state spin–spin correlation functions for short chains. However, the success probability decreases exponentially with the chain length, which precludes the computation of these correlation functions for chains of moderate length. Some conjectures for estimates of the Gaudin determinant are noted in an appendix.
High-fidelity multiqubit Rydberg gates via two-photon adiabatic rapid passage
Authors: Pelegrí G , Daley A J , Pritchard J D
Published: July 2022

We present a robust protocol for implementing high-fidelity multiqubit controlled phase gates (C

k

Z) on neutral atom qubits coupled to highly excited Rydberg states. Our approach is based on extending adiabatic rapid passage to two-photon excitation via a short-lived intermediate excited state common to alkali-atom Rydberg experiments, accounting for the full impact of spontaneous decay and differential AC Stark shifts from the complete manifold of hyperfine excited states. We evaluate and optimise gate performance, concluding that for Cs and currently available laser frequencies and powers, a CCZ gate with fidelity

F
>
0.995

for three qubits and CCCZ with

F
>
0.99

for four qubits is attainable in

∼
1.8

μs via this protocol. Higher fidelities are accessible with future technologies, and our results highlight the utility of neutral atom arrays for the native implementation of multiqubit unitaries.
Cancer-on-chip technology: current applications in major cancer types, challenges and future prospects
Authors: Baka Zakaria , Stiefel Marie , Figarol Agathe , Godier Claire , Mallick Abhik , Joubert Olivier , Ashammakhi Nureddin , Gaffet Eric , Alem Halima
Published: July 2022

Conventional 2D cell cultures are widely used for the development of new anticancer drugs. However, their relevance as in vitro models is increasingly questioned as they are considered too simplistic compared to complex, three-dimensional in vivo tumors. Moreover, animal experiments are not only costly and time-consuming, but also raise ethical issues and their use for some applications has been restricted. Therefore, it becomes crucial to develop new experimental models that better capture the complexity and dynamic aspects of in vivo tumors. New approaches based on microfluidic technology are promising. This technology has indeed been used to create microphysiological systems called ‘organ-on-chip’ which simulate key structural and functional features of human tissues and organs. These devices have further been adapted to create cancer models giving rise to the ‘cancer-on-chip’ (COC) concept. In this review, we will discuss the main COC models described so far for major cancer types including lung, prostate, breast, colorectal, pancreatic, and ovarian cancers. Then, we will highlight the challenges that this technology is facing and the possible research perspectives that can arise from them.
Specialization Morphisms
Authors: Gaisin Ildar , Welliaveetil John
Published: July 2022

We define the notion of a specialization morphism from a locally noetherian analytic adic space to a scheme. This captures the (classical) specialization morphism associated with a formal scheme. There is a well-behaved theory of compactifications and it turns out that the classical specialization morphism is proper in this setup. As an application, we show that the nearby cycles functor commutes with lower shriek in great generality.
Predicting ribeye area and circularity in live calves through 3D image analyses of body surface
Authors: Caffarini Joseph G , Bresolin Tiago , Dorea Joao R R
Published: July 2022

The use of sexed semen at dairy farms has improved heifer replacement over the last decade by allowing greater control over the number of retained females and enabling the selection of dams with superior genetics. Alternatively, beef semen can be used in genetically inferior dairy cows to produce crossbred (beef x dairy) animals that can be sold at a higher price. Although crossbreeding became profitable for dairy farmers, meat cuts from beef x dairy crosses often lack quality and shape uniformity. Technologies for quickly predicting carcass traits for animal grouping before harvest may improve meat cut uniformity in crossbred cattle. Our objective was to develop a deep learning approach for predicting ribeye area and circularity of live animals through 3D body surface images using two neural networks: 1) nested Pyramid Scene Parsing Network (nPSPNet) for extracting features and 2) Convolutional Neural Network (CNN) for estimating ribeye area and circularity from these features. A group of 56 calves were imaged using an Intel RealSense D435 camera. A total of 327 depth images were captured from 30 calves and labeled with masks outlining the calf body to train the nPSPNet for feature extraction. Additional 42,536 depth images were taken from the remaining 26 calves along with three ultrasound images collected for each calf from the 12/13th ribs. The ultrasound images (three by calf) were manually segmented to calculate the average ribeye area and circularity and then paired with the depth images for CNN training. We implemented a nested cross-validation approach, in which all images for one calf were removed (leave-one-out, LOO), and the remaining calves were further divided into training (70%) and validation (30%) sets within each LOO iteration. The proposed model predicted ribeye area with an average coefficient of determination (R2) of 0.74% and 7.3% mean absolute error of prediction (MAEP) and the ribeye circularity with an average R2 of 0.87% and 2.4% MAEP. Our results indicate that computer vision systems could be used to predict ribeye area and circularity in live animals, allowing optimal management decisions toward smart animal grouping in beef x dairy crosses and purebred.
Diversity of Sooty Blotch and Flyspeck Fungi on Cider Apples in Spain
Authors: Batzer Jean Carlson , Prado Marcos Miñarro , Svendsen Jennifer M. , Gleason Mark L.
Published: July 2022

Fungi in the sooty blotch and flyspeck (SBFS) complex blemish fruit and reduce the market value of fresh-market apples. In 2010, apples were collected from 16 orchards in northern Spain that had received few to no fungicide sprays. SBFS colonies with the subtending cuticle were excised, pressed, and shipped to Ames, Iowa, United States, for isolation. A total of 213 sequences were aligned after a portion of the rRNA was amplified with primer pair VG9/LR5, and two regions were sequenced with primer pairs ITS1/ITS4 and LROR/LR5. Distance and parsimony analyses of the 28S gene sequences were used to compare the collection with previously isolated SBFS species. Most isolates (89%) were within the subclass Dothideomycetes, order Capnodiales. Within this order, the predominant genus was Schizothyrium (anamorph Zygophiala) (86 isolates), including S. pomi, Z. cryptogama, Z. cylindrica, and two previously undescribed putative species. Also widely prevalent were Microcyclosporella mali (45 isolates), four Microcyclospora spp. (36 isolates), and four Stomiopeltis-like putative species (34 isolates). Seven isolates were within the Eurotiomycetes. Twenty-five putative species were delineated using the ITS sequences and morphological characterization. These included 11 species previously named and reported as members of the SBFS complex, two putative SBFS species that were previously reported but have not yet been described, and 12 newly detected putative SBFS species. The findings add substantially to knowledge of the taxonomic diversity of this ectophytic fungal assemblage in Europe.

[Formula: see text] Copyright © 2022 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Global patterns of drug allergy-induced fatalities: a wake-up call to prevent avoidable deaths
Authors: Tanno Luciana K. , Gauthier Amélie , Allichon Salome , Demoly Pascal
Published: July 2022

Purpose of review

To identify patterns and key issues though a systematic review in order to support prevention strategies and reduce avoidable deaths related to drug-induced anaphylaxis (DAF).

Recent findings

DAF rate has been estimated by 0.13–0.53/106 population/year. General global trends of DAF are increasing over time, mostly occurring at healthcare settings (62%) with a similar gender distribution and an average age of 53 years. Antibiotics, anaesthetics, radio-contrast media and NSAIDs were the most frequently implicated agents. Main comorbidities were personal history of drug allergy, cardiovascular diseases and asthma. Main manifestations were cardiovascular and respiratory commitments. Use of adrenaline is mentioned in only 29% of the articles.

DAF is increasing worldwide and most cases are iatrogenic. This first systematic review of DAF identified key gaps and served as a wake-up call to prevent avoidable deaths. Phenotype at risk for DAF was represented by patients aged more than 54 years, with personal history of drug allergy/hypersensitivity with no or incomplete allergological work-up, cardiovascular disease and/or asthma with need of hospitalization and/or frequent healthcare assistance. Additional risk for those who need frequent use of intravenous antibiotics and/or undergoing surgery or image investigation with radiocontrast media.
Maternal and Neonatal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Immunoglobulin G Levels After the Pfizer-BioNTech Booster Dose for Coronavirus Disease 2019 (COVID-19) Vaccination During the Second Trimester of Pregnancy
Authors: Kugelman Nir , Nahshon Chen , Shaked-Mishan Pninit , Kleifeld Shiran , Cohen Nadav , Sher Maayan Lahav , Zahran Hazar , Barsha Hanin , Assaf Wisam , Shalabna Eiman , Stein Nili , Lavie Ofer , Kedar Reuven , Riskin-Mashiah Shlomit
Published: July 2022

OBJECTIVE:

To evaluate maternal and neonatal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G (IgG) antibody levels at birth after a third (booster) dose of the Pfizer-BioNTech messenger RNA (Pfizer) coronavirus disease 2019 (COVID-19) vaccine during the second trimester of pregnancy, and compare them with those in women who received two vaccine doses during the second trimester.

METHODS:

We conducted a prospective cohort study of women admitted to the delivery ward at a single center who received the third Pfizer COVID-19 vaccine dose (booster group) at 17–30 weeks of pregnancy and who did not have previous SARS-CoV-2 infection. Maternal and neonatal antibody levels were measured on admission for delivery and in the umbilical cord blood after birth. Antibody levels for the booster group were compared with those in a historical control group of pregnant women who received their second vaccine dose (two-dose group) within the same gestational age window.

RESULTS:

Between October 2021 and February 2022, antibody levels were measured in 121 women and 109 neonates at a mean±SD of 15.3±3.9 weeks after booster vaccination. Neonatal titers measured two times higher than maternal titers, with inverse correlation between maternal and neonatal titers at birth and time interval from third vaccination. The two-dose group included 121 women and 107 neonates, with antibody levels measured at a mean±SD of 14.6±2.6 weeks after the second dose. Median [interquartile range] maternal antibody titers were higher in the booster group (4,485 [2,569–9,702] AU/mL) compared with the two-dose group (1,122 [735–1,872] AU/mL) (P<.001). Furthermore, neonatal antibody titers were higher in the booster group (8,773 [5,143–18,830] AU/mL) compared with the two-dose group (3,280 [2,087–5,754] AU/mL) (P<.001).

CONCLUSION:

Maternal and neonatal SARS-CoV-2 IgG antibody titers after second-trimester maternal Pfizer COVID-19 vaccination were significantly higher after the booster dose compared with the two-dose vaccination series. Although there is uncertainty as to whether antibody levels correlate with protection, these data support the importance of booster vaccination during pregnancy to restore maternal and neonatal protection against COVID-19.
Distortion Product Otoacoustic Emission Component Behavior as a Function of Primary Frequency Ratio and Primary Level
Authors: Durante Alessandra Spada , Shaheen Akhtar Uzma , Dhar Sumitrajit
Published: July 2022

Objectives:

Distortion product otoacoustic emissions (DPOAEs) are composed of distortion and reflection components. Much is known about the influence of the stimulus frequency ratio (f2/f1) on the overall/composite DPOAE level. However, the influence of f2/f1 on individual DPOAE components is not as well examined. The goals of this pilot study were to systematically evaluate the effects of f2/f1 on DPOAE components in clinically normal-hearing young adult ears. To extend the limited reports in the literature, this examination was carried out over an extended frequency range using two stimulus-level combinations.

Design:

DPOAEs were recorded from seven normal-hearing, young adult ears for f2 frequencies between 0.75 and 16 kHz over a range of f2/f1 using two stimulus-level combinations. The distortion (DPOAED) and reflection (DPOAER) components were separated using an inverse fast Fourier transform algorithm. Optimal ratios for the composite DPOAE and DPOAE components were determined from smoothed versions of level versus ratio functions in each case.

Results:

The optimal ratio for the composite DPOAE level increased with stimulus level and decreased as a function of frequency above 1 kHz. The optimal ratios for the DPOAE components followed a similar trend, decreasing with increasing frequency. The optimal ratio for DPOAED was generally higher than that for DPOAER. The overall level for DPOAED was greater than that of DPOAER, both decreasing with increasing frequency. DPOAER, but not DPOAED, became unrecordable above the noise floor at the higher frequencies.

Conclusions:

DPOAE components behave similarly but not identically as a function of f2/f1. The ear canal DPOAE is generally dominated by DPOAED. The behavior of DPOAED as a function of f2/f1 is entirely consistent with known properties of cochlear mechanics. The behavior of DPOAER is more variable across ears, perhaps reflective of the increased number of parameters that influence its final form. Attempting to use an f2/f1 that would allow a greater bias of the ear canal DPOAE toward one component or the other does not appear to be practical.
Assessing Postoperative Pseudarthrosis in Anterior Cervical Discectomy and Fusion (ACDF) on Dynamic Radiographs Using Novel Angular Measurements
Authors: Balouch Eaman , Burapachaisri Aonnicha , Woo Dainn , Norris Zoe , Segar Anand , Ayres Ethan W. , Vasquez-Montes Dennis , Buckland Aaron J. , Razi Afshin , Smith Michael L. , Protopsaltis Themistocles S. , Kim Yong H.
Published: July 2022

Study Design.

A retrospective review of operative patients at a single institution.

Objective.

The aim was to validate a novel method of detecting pseudarthrosis on dynamic radiographs.

Summary of Background Data.

A common complication after anterior cervical discectomy and fusion is pseudarthrosis. A previously published method for detecting pseudarthrosis identifies a 1 mm difference in interspinous motion (ISM), which requires calibration of images and relies on anatomic landmarks difficult to visualize. An alternative is to use angles between spinous processes, which does not require calibration and relies on more visible landmarks.

Materials and Methods.

ISM was measured on dynamic radiographs using the previously published linear method and new angular method. Angles were defined by lines from screw heads to dorsal points of spinous processes. Angular cutoff for fusion was calculated using a regression equation correlating linear and angular measures, based on the 1 mm linear cutoff. Pseudarthrosis was assessed with both cutoffs. Sensitivity, specificity, inter-reliability and intrareliability of angular and linear measures used postoperative computed tomography (CT) as the reference.

Results.

A total of 242 fused levels (81 allograft, 84 polyetheretherketone, 40 titanium, 37 standalone cages) were measured in 143 patients (mean age 52.0±11.5, 42%F). 36 patients (66 levels) had 1-year postoperative CTs; 13 patients (13 levels) had confirmed pseudarthrosis. Linear and angular measurements closely correlated (R=0.872), with 2.3° corresponding to 1 mm linear ISM. Potential pseudarthroses was found in 28.0% and 18.5% levels using linear and angular cutoffs, respectively. Linear cutoff had 85% sensitivity, 87% specificity; angular cutoff had 85% sensitivity, 96% specificity for detecting CT-validated pseudarthrosis. Interclass correlation coefficients were 0.974 and 0.986 (both P<0.001); intrarater reliability averaged 0.953 and 0.974 (P<0.001 for all) for linear and angular methods, respectively.

Conclusions.

The angular measure for assessing potential pseudarthrosis is as sensitive as and more specific than published linear methods, has high interobserver reliability, and can be used without image calibration.

Level of Evidence.

3.
Incidence and Predictors of Eosinophilic Myocardial Hypersensitivity in Patients Receiving Home Dobutamine
Authors: Dagan Misha , Lankaputhra Malanka , Yeung Timothy , Tee Su Ling , Bader Illona , Easton Kellie , Linton Ashlee , McLean Catriona , Taylor Andrew , Bergin Peter , Kaye David M. , Leet Angeline , Hare James L. , Patel Hitesh C.
Published: July 2022

We sought to examine incidence and predictors of eosinophilic myocardial hypersensitivity (EMH) in a cohort of patients in the home inotrope program of a quaternary cardiac transplant center. Patients on home inotropes with progression to heart transplantation or ventricular assist device (VAD) between January 2000 and May 2020 were included. EMH was diagnosed by the presence of an interstitial predominate eosinophilic infiltrate within the myocardium by experienced cardiac pathologists. From a cohort of 74 patients, 58% (43) were on dobutamine and 42% (31) were on milrinone. Dobutamine was associated with EMH incidence of 14% (6/43), with zero cases in the milrinone cohort. Mean age was 52 ± 12 years, 22% were female. More than half (62%) were nonischemic dilated cardiomyopathies, the remainder were ischemic cardiomyopathy. Dobutamine dose [250 (200–282) vs. 225 (200–291) μg/min] and duration of therapy [41 (23–79) vs. 53 (24–91) days] was similar between those with and without EMH. Median change in eosinophil count was 0.31 × 109/L in the EMH group compared with only 0.03 × 109/L in the non-EMH cohort, P = 0.02. Increase in peripheral eosinophil count of >0.20 × 109/L demonstrated good discrimination between those with and without EMH, c-statistic 0.83 (95% CI 0.66–1.0). Heart failure hospitalization occurred in 83% of the EMH group versus 59% in the non-EMH group, P = 0.26. Requirement for VAD was significantly higher in the EMH group (83% vs. 41%, P = 0.05). In conclusion, EMH occurred in 14% of patients receiving home dobutamine. Rising eosinophil count should prompt physicians to consider EMH and switch to milrinone to avoid possible escalation to VAD.
Influence of CYP2B6 and CYP3A4 polymorphisms on the virologic and immunologic responses of patients treated with efavirenz-containing regimen
Authors: Kassogue Yaya , Diakite Brehima , Maiga Mamoudou , Kassogue Oumar , Konate Issa , Tamboura Kadidiatou , Diarra Fousseyni , Diarra Zoumana , Sawadogo Mahamadou Karamoko , Goita Yaya , Sissoko Sidi Boula , Sissoko Adama Seydou , Guirou Nouhoum , Dehbi Hind , Nadifi Sellama , Bah Sekou , Traore Cheick Bougadari , Kamate Bakarou , Dao Sounkalo , Dolo Guimogo
Published: July 2022

Objectives

The main objective of this study was to evaluate the effect of CYP2B6 and CYP3A4 polymorphisms on the virological and immunologic responses of HIV patients. A total of 153 HIV-positive patients were enlisted for the study.

Patients and methods

Viral load and median CD4 T cell counts were evaluated at baseline and month 6 (M6). Samples were identified using TaqMan genotyping assays.

Results

The AG in CYP2B6 rs2279343 was associated with VLS compared to homozygous AA. In the dominant model, the AG/GG genotypes were associated with VLS compared to the AA genotype. Moreover, in overdominant model, the AG genotype was associated with VLS compared to AA/GG. Regarding immunological response, only the AG in SNP rs2279343 CYP2B6 was associated with an increase in CD4 cell count between baseline and M6. In CYP2B6 rs3745274, the CD4 cell count at M6 was higher than that of baseline for GG carriers and for GT carriers. In CYP3A4 rs2740574, the TC carriers showed a higher median CD4 count at M6 compared to that of the baseline count, as well as for CC carriers. The best genotypes combination associated with CD4 cell count improvement were AA/AG in SNP rs2279343 and GG/GT in SNP rs3745274.

Conclusion

Our findings support the fact that CYP2B6 rs2279343 could help in the prediction of VLS and both SNPs rs3745274 and rs2279343 in CYP2B6 and CYP3A4 rs2740574 were associated with immune recovery in Malian HIV-positive patients.
Monitoring compliance to topical therapy in children and young people with uveitis
Authors: Green EKY , McGrath O , Steeples L , Ashworth J
Published: July 2022

Background

Uveitis in children and young people is a rare but potentially debilitating condition. Steroid eye drops are the first step in treatment and poor compliance may result in vision-threatening complications. This study aimed to measure compliance with prescribed eye drops prospectively and investigate reasons for non-compliance in a child-specific manner.

Methods

50 patients aged 0-18 years attending a tertiary paediatric uveitis clinic using steroid drops were recruited. Both the child or young person, and parent completed questionnaires about compliance. A subgroup had bottles of Prednisolone 1% drops weighed and dispensed at the first appointment and reweighed at follow-up. The reduction in weight was compared with expected weight change over the interval.

Results

The study was completed by 31 patients. Drop errors for all eye drops were reported more than “once a week” by 13 (33.3%) children and young people, and 3 (9.7%) parents. A large proportion of parents could not recall the frequency of drops prescribed to their child (13, 40.6%). Insufficient bottle weight reduction was found in 9 (75%), although this was not associated with self-reported drop errors. Within the eye drop weighing subgroup three (25%) used <50% the expected weight of drops.

Conclusions

Eye drop compliance was demonstrated to be poor by all the study outcomes in children and young people with uveitis. Self-reported compliance is unreliable in this population, as subjective responses were not supported by objective bottle weight change. Worryingly, some patients miss more than 50% of drops and may suffer worse disease control.

Clinical implications

What is already known on this topic

Poor drop compliance among children and young people with uveitis has been suggested by a previous retrospective study looking at self-reported compliance.

What this study adds

All subjective and objective metrics in this prospective study suggest steroid eye drop compliance is often poor among children with uveitis.

Parental administration of steroid eye drops and shorter disease duration appear to be associated with improved compliance.

How this study might affect research, practice or policy

Self-reported compliance is highly unreliable and should be treated as such by practising clinicians and any future studies.

Among the patients with drop errors a small but clinically significant number have very poor compliance and miss drops daily. These patients are at high risk for sub-optimal disease control or persistent disease activity and this requires further investigation.

Synopsis/Precis

This prospective study of drop compliance in children and young people with non-infectious uveitis suggests drop compliance is poor. Some individuals use drops less than half of the prescribed frequency. Self-reported compliance was highly unreliable.
Seasonal bee communities vary in their responses to local and landscape scales: implication for land managers
Authors: Kammerer Melanie , Iverson Aaron L. , Li Kevin , Tooker John F. , Grozinger Christina M.
Published: July 2022

Context

There is great interest in land management practices for pollinators; however, a quantitative comparison of landscape and local effects on bee communities is necessary to determine if adding small habitat patches can increase bee abundance or species richness. The value of increasing floral abundance at a site is undoubtedly influenced by the phenology and magnitude of floral resources in the landscape, but due to the complexity of measuring landscape-scale resources, these factors have been understudied.

Objectives

To address this knowledge gap, we quantified the relative importance of local versus landscape scale resources for bee communities, identified the most important metrics of local and landscape quality, and evaluated how these relationships vary with season.

Methods

We studied season-specific relationships between local and landscape quality and wild-bee communities at 33 sites in the Finger Lakes region of New York, USA. We paired site surveys of wild bees, plants, and soil characteristics with a multi-dimensional assessment of landscape composition, configuration, insecticide toxic load, and a spatio-temporal evaluation of floral resources at local and landscape scales.

Results

We found that the most relevant spatial scale varied by season. Spring bees depended on landscape resources, but summer bees responded more to local quality, implying that site-level management is most likely to be successful in supporting summer bees. Semi-natural habitats, including forests, wetlands, and other aquatic habitats, were particularly important for spring bees.

Conclusions

By considering spatial and temporal variation in resources, we developed season-specific recommendations to improve habitat quality for wild bees and offset manifold stressors threatening these essential pollinators.
β-bursts over frontal cortex track the surprise of unexpected events in auditory, visual, and tactile modalities
Authors: Tatz Joshua R. , Mather Alec , Wessel Jan R.
Published: July 2022

One of the fundamental ways in which the brain regulates and monitors behavior is by making predictions about the sensory environment and adjusting behavior when those expectations are violated. As such, surprise is one of the fundamental computations performed by the human brain. In recent years, it has been well-established that one key aspect by which behavior is adjusted during surprise is inhibitory control of the motor system. Moreover, since surprise automatically triggers inhibitory control without much proactive influence, it can provide unique insights into largely reactive control processes. Recent years have seen tremendous interest in burst-like β frequency events in the human (and non-human) local field potential – especially over (pre)frontal cortex) – as a potential signature of inhibitory control. To date, β-bursts have only been studied in paradigms involving a substantial amount of proactive control (such as the stop-signal task). Here, we used two cross-modal oddball tasks to investigate whether surprise processing is accompanied by increases in scalp-recorded β-bursts. Indeed, we found that unexpected events in all tested sensory domains (haptic, auditory, visual) were followed by low-latency increases in β-bursting over frontal cortex. Across experiments, β-burst rates were positively correlated with estimates of surprise derived from Shannon’s information theory, a type of surprise that represents the degree to which a given stimulus violates prior expectations. As such, the current work clearly implicates frontal β-bursts as a signature of surprise processing. We discuss these findings in the context of common frameworks of inhibitory and cognitive control after unexpected events.
The activity of deep cortical layers characterizes the complexity of brain responses during wakefulness following electrical stimulation
Authors: Hönigsperger Christoph , Storm Johan F. , Arena Alessandro
Published: July 2022

It has been suggested that the complexity of the brain is closely related to its state of consciousness. The perturbational complexity index (PCI) has been used in humans and rodents to distinguish conscious from unconscious states based on the global cortical responses (recorded by electroencephalography; EEG) to local cortical stimulation (CS). However, it has been unclear how different cortical layers respond to CS and contribute to the resulting intra- and inter-areal cortical communication and PCI. A detailed investigation of these local dynamics is needed to understand the basis for PCI.

We hypothesized that the complexity level of global cortical responses (PCI) corresponds to variations in layer-specific activity and connectivity patterns.

We investigated global cortical dynamics and layer specific activity in mice, combining cortical electrical stimulation, global EEG, and local multi-electrode, laminar recordings from layers 1-6 in somatosensory cortex, during wakefulness and general anesthesia (sevoflurane).

We found that transition from wake to sevoflurane anesthesia correlated with a drop in global and local PCI values (complexity). This was accompanied by a local decrease in neural firing rate, spike-field coherence, and long-range functional connectivity specific to deep layers (L5, L6).

Our results suggest that deep cortical layers are mechanistically important for changes in PCI, and thereby for variations in the states of consciousness.

Highlights

Anesthesia caused a reduction in the perturbational complexity index (PCIST) at both global (inter-areal) and local (intra-areal, across layers) cortical scales.

Deep cortical layers (L6 and L5), exhibited strong connectivity with remote cortical areas during wakefulness but not during anesthesia.

Layer 6 showed the strongest modulation of spike firing and spike field coherence compared to more superficial layers during wakefulness.
Computational model of the full-length TSH receptor
Authors: Mezei Mihaly , Latif Rauf , Davies Terry F
Published: July 2022

The receptor for thyroid stimulating hormone (TSHR), a GPCR, is of particular interest as the primary antigen in autoimmune hyperthyroidism (Graves’ disease) caused by stimulating TSHR antibodies. To date, only one domain of the extracellular region of the TSHR has been crystallized. We have now generated a model of the entire TSHR by merging the extracellular region of the receptor, obtained using artificial intelligence, with our recent homology model of the transmembrane domain, embedded it in a lipid membrane solvated it with water and counterions, and performed 1000ns Molecular Dynamic simulations on it.

The simulations showed that the structure of the transmembrane and leucine-rich domains were remarkably constant while the linking region (LR), known more commonly as the “hinge region”, showed significant flexibility, forming several transient secondary structural elements. Furthermore, the relative orientation of the leucine-rich domain with the rest of the receptor was also seen to be variable. These data suggest that this linker region is an intrinsically disordered protein (IDP). Furthermore, preliminary data simulating the full TSHR model complexed with its ligand (TSH) showed that (a) there is a strong affinity between the linker region and TSH ligand and (b) the association of the linker region and the TSH ligand reduces the structural fluctuations in the linker region.

This full-length model illustrates the importance of the linker region in responding to ligand binding and lays the foundation for studies of pathologic TSHR autoantibodies complexed with the TSHR to give further insight into their interaction with the flexible linker region.