bluuebunny/crossref_metadata_2025 huggingface dataset:
Petrogenesis of the Girnar Complex in the Deccan Traps Province, India
Authors: Halder Mahesh , Paul Debajyoti , Stracke Andreas
Published: February 2023

The c. 66 Ma Girnar Complex of the Deccan Traps consists of various mafic to silicic rocks and provides a unique setting for understanding the dynamics of magma chamber processes. The intrusive alkaline rocks in Girnar are diorites/monzodiorites and contain syenite/nepheline syenite veins. Several (alkaline) mafic dykes cut the alkaline rocks. These rocks are surrounded by intrusive tholeiitic gabbro and extrusive basaltic flows and a silicic (SiO2 > 65 wt%) ring dyke at the outer margin of the complex. The tholeiitic gabbro and basaltic lavas have relatively flat light rare earth element (REE) patterns (La/SmN ~ 0.8 to 1.8) with positive Eu anomalies of 1.1–1.3. The tholeiitic basalts formed by 3–5% partial melting of an incompatible element depleted mid-ocean ridge basalts (MORB)-like source. Accumulating c. 20–30% of (olivine, orthopyroxene, clinopyroxene, and plagioclase) crystals from the tholeiitic melt generated the tholeiitic gabbro. The alkaline rocks display enriched light REE patterns (La/SmN ~ 5.0 to 7.8) consistent with (~9%) partial melting of a spinel lherzolite source, different from the MORB-like source for tholeiitic rocks. The subsequent 58–72% fractional crystallization of olivine, clinopyroxene, plagioclase, orthoclase, spinel, and apatite mineral assemblage formed the alkaline rocks. Reverse and oscillatory zoning in plagioclase (An30 to An50) phenocrysts of the silicic rocks suggest that convective movement of crystals in a magma chamber led to initial crystallization of high-An plagioclase in the hotter zone of the magma chamber, followed by addition of low-An plagioclase in cooler regions of the magma chamber. Pressure estimates from shattered (xenocryst or antecryst) clinopyroxene crystals in silicic rocks give a minimum value of 450 MPa. Ti-in-quartz geothermometry gives a crystallization temperature between 690°C and 1080°C. The distinct isotopic composition of the silicic rocks (87Sr/86Sri = 0.7204–0.7275, εNd(i) = −6.8 to −7.3, 206Pb/204Pbi = 18.74–19.02, 207Pb/204Pbi = 15.76–15.79, 208Pb/204Pbi = 39.63–40.03, εHf(i) = −6.0 to −7.3) further indicates that the silicic rocks assimilated 7 to 9% granitic basement rocks. Overall, therefore, the Girnar Complex started to form with the emplacement of mafic rocks (both alkaline and tholeiitic) in the central part along a reactivated fault lineament and silicic rocks along the concentric marginal fault. Petrography, mineral chemistry, and whole-rock geochemical and Sr-Nd-Pb-Hf isotope ratios of the Girnar Complex rocks indicate that despite the close spatial association of tholeiitic gabbro and basalt, alkaline rocks, and silicic rocks, these rocks originated from multiple sources and evolved in a complex magma drainage and storage network in a continental setting of the Deccan Large Igneous Province (LIP).
Reasoning by Analogy in Mathematical Practice
Authors: Cangiotti Nicolò , Nappo Francesco
Published: February 2023

In this paper, we offer a descriptive theory of analogical reasoning in mathematics, stating general conditions under which an analogy may provide genuine inductive support to a mathematical conjecture (over and above fulfilling the merely heuristic role of ‘suggesting’ a conjecture in the psychological sense). The proposed conditions generalize the criteria of Hesse in her influential work on analogical reasoning in the empirical sciences. By reference to several case studies, we argue that the account proposed in this paper does a better job in vindicating the use of analogical inference in mathematics than the prominent alternative defended by Bartha.
Soybean transporter AAT Rhg1 abundance increases along the nematode migration path and impacts vesiculation and ROS
Authors: Han Shaojie , Smith John M , Du Yulin , Bent Andrew F
Published: February 2023

Rhg1 (Resistance to Heterodera glycines 1) mediates soybean (Glycine max) resistance to soybean cyst nematode (SCN; H. glycines). Rhg1 is a 4-gene, ∼30-kb block that exhibits copy number variation, and the common PI 88788-type rhg1-b haplotype carries 9 to 10 tandem Rhg1 repeats. Glyma.18G022400 (Rhg1-GmAAT), 1 of 3 resistance-conferring genes at the complex Rhg1 locus, encodes the putative amino acid transporter AATRhg1 whose mode of action is largely unknown. We discovered that AATRhg1 protein abundance increases 7- to 15-fold throughout root cells along the migration path of SCN. These root cells develop an increased abundance of vesicles and large vesicle-like bodies (VLB) as well as multivesicular and paramural bodies. AATRhg1 protein is often present in these structures. AATRhg1 abundance remained low in syncytia (plant cells reprogrammed by SCN for feeding), unlike the Rhg1 α-SNAP protein, whose abundance has previously been shown to increase in syncytia. In Nicotiana benthamiana, if soybean AATRhg1 was present, oxidative stress promoted the formation of large VLB, many of which contained AATRhg1. AATRhg1 interacted with the soybean NADPH oxidase GmRBOHG, the ortholog of Arabidopsis thaliana RBOHD previously found to exhibit upregulated expression upon SCN infection. AATRhg1 stimulated reactive oxygen species (ROS) generation when AATRhg1 and GmRBOHG were co-expressed. These findings suggest that AATRhg1 contributes to SCN resistance along the migration path as SCN invades the plant and does so, at least in part, by increasing ROS production. In light of previous findings about α-SNAPRhg1, this study also shows that different Rhg1 resistance proteins function via at least 2 spatially and temporally separate modes of action.
Inverse square singularities and eigenparameter-dependent boundary conditions are two sides of the same coin
Authors: Guliyev Namig J
Published: February 2023

We show that inverse square singularities can be treated as boundary conditions containing rational Herglotz–Nevanlinna functions of the eigenvalue parameter with ‘a negative number of poles’. More precisely, we treat in a unified manner one-dimensional Schrödinger operators with either an inverse square singularity or a boundary condition containing a rational Herglotz–Nevanlinna function of the eigenvalue parameter at each endpoint and define Darboux-type transformations between such operators. These transformations allow one, in particular, to transfer almost any spectral result from boundary value problems with eigenparameter-dependent boundary conditions to those with inverse square singularities and vice versa.
Bioactive fibrous scaffolds with programmable release of polypeptides regulate inflammation and extracellular matrix remodeling
Authors: Xiang Zehong , Guan Xinghua , Ma Zhifang , Shi Qiang , Panteleev Mikhail , Ataullakhanov Fazly I
Published: February 2023

Inflammation manipulation and extracellular matrix (ECM) remodeling for healthy tissue regeneration are critical requirements for tissue engineering scaffolds. To this end, the bioactive polycaprolactone (PCL)-based scaffolds are fabricated to release aprotinin and thymosin β4 (Tβ4) in a programmable manner. The core part of the fiber is composed of hyaluronic acid and Tβ4, and the shell is PCL, which is further coated with heparin/gelatin/aprotinin to enhance biocompatibility. The in vitro assay demonstrates that the controlled release of aprotinin prevents initial excessive inflammation. The subsequent release of Tβ4 after 3 days induces the transition of macrophages from M1 into M2 polarization. The manipulation of inflammatory response further controls the expression of transforming growth factor-β and fibroblast activation, which oversee the quantity and quality of ECM remodeling. In addition, the gradual degradation of the scaffold allows cells to proliferate within the platform. In vivo implant evaluation convinces that PCL-based scaffolds possess the high capability to control the inflammatory response and restore the ECM to normal conditions. Hence, our work paves a new way to develop tissue engineering scaffolds for inflammation manipulation and ECM remodeling with peptide-mediated reactions.
Night-time smartphone use, sleep duration, sleep quality, and menstrual disturbances in young adult women: A population-based study with high-resolution tracking data
Authors: Severinsen Elin Rosenbek , Andersen Thea Otte , Dissing Agnete Skovlund , Jensen Andreas Kryger , Sejling Christoffer , Freiesleben Nina la Cour , Nielsen Henriette Svarre , Rod Naja Hulvej
Published: February 2023

Study Objectives

To explore the relationship among night-time smartphone use, sleep duration, sleep quality, and menstrual disturbances in young adult women.

Methods

Women aged 18–40 years were included in the SmartSleep Study in which they objectively tracked their smartphone use via the SmartSleep app between self-reported sleep onset and offset times (n = 764) and responded to a survey (n = 1068), which included background characteristics, sleep duration, sleep quality (Karolinska Sleep Questionnaire), and menstrual characteristics (International Federation of Gynecology and Obstetrics’ definitions).

Results

The median tracking time was four nights (interquartile range: 2–8). Higher frequency (p = .05) and longer duration (p = .02) of night-time smartphone use were associated with long sleep duration (≥9 h), but not with poor sleep quality or short sleep duration (<7 h). Short sleep duration was associated with menstrual disturbances (OR = 1.84, 95% confidence interval [CI] = 1.09 to 3.04) and irregular menstruation (OR = 2.17, 95% CI = 1.08 to 4.10), and poor sleep quality was associated with menstrual disturbances (OR = 1.43, 95% CI = 1.19 to 1.71), irregular menstruation (OR = 1.34, 95% CI = 1.04 to 1.72), prolonged bleedings (OR = 2.50, 95% CI = 1.44 to 4.43) and short-cycle duration (OR = 1.40, 95% CI = 1.06 to 1.84). Neither duration nor frequency of night-time smartphone use was associated with menstrual disturbances.

Conclusions

Night-time smartphone use was associated with longer sleep duration, but not with menstrual disturbances in adult women. Short sleep duration and sleep quality were associated with menstrual disturbances. Further investigation of the effects of night-time smartphone use on sleep and female reproductive function in large prospective studies is needed.
Transcriptomic analysis reveals differentially expressed genes associated with pine wood nematode resistance in resistant Pinus thunbergii
Authors: Wang Xin-Yu , Wu Xiao-Qin , Wen Tong-Yue , Feng Ya-Qi , Zhang Yan
Published: February 2023

Pine wilt disease (caused by the nematode Bursaphelenchus xylophilus) is extremely harmful to pine forests in East Asia. As a low-resistance pine species, Pinus thunbergii is more vulnerable to pine wood nematode (PWN) than Pinus densiflora and Pinus massoniana. Field inoculation experiments were conducted on PWN-resistant and -susceptible P. thunbergii, and the difference in transcription profiles 24 h after inoculation was analyzed. We identified 2603 differentially expressed genes (DEGs) in PWN-susceptible P. thunbergii, while 2559 DEGs were identified in PWN-resistant P. thunbergii. Before inoculation, DEGs between PWN-resistant and PWN-susceptible P. thunbergii were enriched in the REDOX (Oxidation-Reduction) activity pathway (152 DEGs), followed by the oxidoreductase activity pathway (106 DEGs). After inoculation with PWN, however, the opposite was observed; DEGs were enriched in the oxidoreductase activity pathway (119 DEGs), followed by the REDOX activity pathway (84 DEGs). Before inoculation, according to the metabolic pathway analysis results, we found more genes upregulated in phenylpropanoid metabolic pathways and enriched in lignin synthesis pathways; cinnamoyl-CoA reductase-coding genes related to lignin synthesis were upregulated in PWN-resistant P. thunbergii and downregulated in PWN-susceptible P. thunbergii, and the lignin content was always higher in resistant than in susceptible P. thunbergii. These results reveal distinctive strategies of resistant and susceptible P. thunbergii in dealing with PWN infections.
Investigation of the role of TmMYB16/123 and their targets (TmMTP1/11) in the tolerance of Taxus media to cadmium
Authors: Feng Shangguo , Hou Kailin , Zhang Hongshan , Chen Cheng , Huang Jiefang , Wu Qicong , Zhang Zhenhao , Gao Yadi , Wu Xiaomei , Wang Huizhong , Shen Chenjia
Published: February 2023

The toxicity and stress caused by heavy metal contamination has become an important constraint to the growth and flourishing of trees. In particular, species belonging to the genus Taxus, which are the only natural source for the anti-tumor medicine paclitaxel, are known to be highly sensitive to environmental changes. To investigate the response of Taxus spp. to heavy metal stress, we analyzed the transcriptomic profiles of Taxus media trees exposed to cadmium (Cd2+). In total, six putative genes from the metal tolerance protein (MTP) family were identified in T. media, including two Cd2+ stress inducible TMP genes (TmMTP1, TmMTP11 and Taxus media). Secondary structure analyses predicted that TmMTP1 and TmMTP11, which are members of the Zn-CDF and Mn-CDF subfamily proteins, respectively, contained six and four classic transmembrane domains, respectively. The introduction of TmMTP1/11 into the ∆ycf1 yeast cadmium-sensitive mutant strain showed that TmMTP1/11 might regulate the accumulation of Cd2+ to yeast cells. To screen the upstream regulators, partial promoter sequences of the TmMTP1/11 genes were isolated using the chromosome walking method. Several myeloblastosis (MYB) recognition elements were identified in the promoters of these genes. Furthermore, two Cd2+-induced R2R3-MYB TFs, TmMYB16 and TmMYB123, were identified. Both in vitro and in vivo assays confirmed that TmMTB16/123 play a role in Cd2+ tolerance by activating and repressing the expression of TmMTP1/11 genes. The present study elucidated new regulatory mechanisms underlying the response to Cd stress and can contribute to the breeding of Taxus species with high environmental adaptability.
Overlapping Local and Systemic Defense Induced by an Oomycete Fatty Acid MAMP and Brown Seaweed Extract in Tomato
Authors: Lewis Domonique C. , Stevens Danielle M. , Little Holly , Coaker Gitta L. , Bostock Richard M.
Published: February 2023

Eicosapolyenoic fatty acids are integral components of oomycete pathogens that can act as microbe-associated molecular patterns to induce disease resistance in plants. Defense-inducing eicosapolyenoic fatty acids include arachidonic acid (AA) and eicosapentaenoic acid and are strong elicitors in solanaceous plants, with bioactivity in other plant families. Similarly, extracts of a brown seaweed, Ascophyllum nodosum, used in sustainable agriculture as a biostimulant of plant growth, may also induce disease resistance. A. nodosum, similar to other macroalgae, is rich in eicosapolyenoic fatty acids, which comprise as much as 25% of total fatty acid composition. We investigated the response of roots and leaves from AA or a commercial A. nodosum extract (ANE) on root-treated tomatoes via RNA sequencing, phytohormone profiling, and disease assays. AA and ANE significantly altered transcriptional profiles relative to control plants, inducing numerous defense-related genes with both substantial overlap and differences in gene expression patterns. Root treatment with AA and, to a lesser extent, ANE also altered both salicylic acid and jasmonic acid levels while inducing local and systemic resistance to oomycete and bacterial pathogen challenge. Thus, our study highlights overlap in both local and systemic defense induced by AA and ANE, with potential for inducing broad-spectrum resistance against pathogens.

[Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Evaluation of Malus Germplasm Identifies Genetic Sources of Powdery Mildew and Frogeye Leaf Spot Resistance for Apple Breeding
Authors: Awan Shahid Iqbal , Thapa Ranjita , Svara Anze , Feulner Hana , Streb Nicholas , Khan Awais
Published: February 2023

Apple is an important fruit crop of temperate regions. The narrow genetic base of commercially cultivated apples has resulted in its vulnerability to a large number of fungal, bacterial, and viral pathogens. Apple breeders are always seeking new sources of resistance within the cross-compatible Malus species that can be deployed into elite genetic backgrounds. We have evaluated resistance to two major fungal diseases of apples: powdery mildew and frogeye leaf spot, using a germplasm collection of 174 Malus accessions to identify novel sources of genetic resistance. In 2020 and 2021, we evaluated these accessions for the incidence and severity of powdery mildew and frogeye leaf spot diseases at Cornell AgriTech, Geneva, New York, in a partially managed orchard. The severity and incidence of powdery mildew and frogeye leaf spot, as well as weather parameters were recorded in June, July, and August. Total incidence of powdery mildew and frogeye leaf spot infections increased from 33 to 38%, and 56 to 97% in 2020 and 2021, respectively. Our analysis showed that relative humidity and precipitation correlate with powdery mildew and frogeye leaf spot susceptibility. The predictor variables with highest impact to the variability of powdery mildew were accessions and relative humidity in May. A total of 65 Malus accessions were found to be resistant to powdery mildew, and only one accession showed moderate resistance to frogeye leaf spot. Several of these accessions belong to Malus hybrid species and domesticated apples and can therefore be potential sources of novel resistance alleles for apple breeding.
Milder Autumns May Increase Risk for Infection of Crops with Turnip Yellows Virus
Authors: Puthanveed Vinitha , Singh Khushwant , Poimenopoulou Efstratia , Pettersson Josefin , Siddique Abu Bakar , Kvarnheden Anders
Published: February 2023

Climate change has increased the risk for infection of crops with insect-transmitted viruses. Mild autumns provide prolonged active periods to insects, which may spread viruses to winter crops. In autumn 2018, green peach aphids ( Myzus persicae) were found in suction traps in southern Sweden that presented infection risk for winter oilseed rape (OSR; Brassica napus) with turnip yellows virus (TuYV). A survey was carried out in spring 2019 with random leaf samples from 46 OSR fields in southern and central Sweden using DAS-ELISA, and TuYV was detected in all fields except one. In the counties of Skåne, Kalmar, and Östergötland, the average incidence of TuYV-infected plants was 75%, and the incidence reached 100% for nine fields. Sequence analyses of the coat protein gene revealed a close relationship between TuYV isolates from Sweden and other parts of the world. High-throughput sequencing for one of the OSR samples confirmed the presence of TuYV and revealed coinfection with TuYV-associated RNA. Molecular analyses of seven sugar beet ( Beta vulgaris) plants with yellowing, collected in 2019, revealed that two of them were infected by TuYV, together with two other poleroviruses: beet mild yellowing virus and beet chlorosis virus. The presence of TuYV in sugar beet suggests a spillover from other hosts. Poleroviruses are prone to recombination, and mixed infection with three poleroviruses in the same plant poses a risk for the emergence of new polerovirus genotypes.

[Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY 4.0 International license .
Examining Violaceous Skin Discoloration during the COVID-19 Pandemic: Conducting Research in Resource Scarcity
Authors: Savage Elizabeth , Lieder Jessica , Liu Helen , Lebovits Sarah
Published: February 2023

OBJECTIVE

To describe the observed patterns and presentations of violaceous discoloration that appeared to be related to the COVID-19 disease process.

METHODS

This retrospective observational cohort study included adults who were COVID-19 positive with purpuric/violaceous lesions in pressure-adjacent areas of the gluteus without preexisting pressure injury. Patients were admitted to an ICU at a single quaternary academic medical center between April 1 and May 15, 2020. Data were compiled by review of the electronic health record. The wounds were described by location, tissue type (violaceous, granulation, slough, eschar), wound margin (irregular, diffuse, nonlocalized), and periwound condition (intact).

RESULTS

A total of 26 patients were included in the study. Purpuric/violaceous wounds were found predominantly on White (92.3%) men (88.0%) aged 60 to 89 years (76.9%) with a body mass index 30 kg/m2 or higher (46.1%). The majority of wounds were located on the sacrococcygeal (42.3%) and fleshy gluteal regions (46.1%).

CONCLUSIONS

Wounds were heterogeneous in appearance (poorly defined violaceous skin discoloration of acute onset), and the patient population had clinical characteristics similar to acute skin failure (eg, concomitant organ failures and hemodynamic instability). Additional larger population-based studies with biopsies may assist in finding patterns related to these dermatologic changes.
Cross-setting Comparison of Risk Factors for Pressure Injuries Acquired in Post-Acute Care
Authors: Barch Daniel H. , Seibert Julie Hayes , Kandilov Amy , Bernacet Amarilys , Deutsch Anne , Wang Xiao (Joyce) , Scherer Elissa , McMullen Tara , Mandl Stella , Levitt Alan , Frank Jennifer , Stephanopoulos Cynthia , Smith Laura M.
Published: February 2023

GENERAL PURPOSE

To provide information on the association between risk factors and the development of new or worsened stage 2 to 4 pressure injuries (PIs) in patients in long-term care hospitals (LTCHs), inpatient rehabilitation facilities (IRFs), and skilled nursing facilities (SNFs).

TARGET AUDIENCE

This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES

After participating in this educational activity, the participant will:

1. Compare the unadjusted PI incidence in SNF, IRF, and LTCH populations.

2. Explain the extent to which the clinical risk factors of functional limitation (bed mobility), bowel incontinence, diabetes/peripheral vascular disease/peripheral arterial disease, and low body mass index are associated with new or worsened stage 2 to 4 PIs across the SNF, IRF, and LTCH populations.

3. Compare the incidence of new or worsened stage 2 to 4 PI development in SNF, IRF, and LTCH populations associated with high body mass index, urinary incontinence, dual urinary and bowel incontinence, and advanced age.

OBJECTIVE

To compare the incidence of new or worsened pressure injuries (PIs) and associated risk factors for their development in inpatient post-acute care settings: long-term care hospitals (LTCHs), inpatient rehabilitation facilities (IRFs), and skilled nursing facilities (SNFs).

METHODS

The authors investigated Medicare Part A SNF resident stays and LTCH patient stays that ended between October 1, 2016 and December 31, 2016 and IRF patient stays that ended between October 1, 2016 and March 31, 2017. They calculated the incidence of new or worsened PIs using the specifications of the National Quality Forum-endorsed PI quality measure #0678: Percent of Residents or Patients with Pressure Ulcers that are New or Worsened.

RESULTS

The incidences of new or worsened stages 2 through 4 PIs varied across settings: 1.23% in SNFs, 1.56% in IRFs, and 3.07% in LTCHs. Seven risk factors were positively and consistently associated with new or worsened PIs across settings: limited bed mobility, bowel incontinence, low body mass index, diabetes/peripheral vascular disease/peripheral arterial disease, advanced age, urinary incontinence, and dual urinary and bowel incontinence.

CONCLUSION

These findings provide empirical support for the alignment of risk factors for the PI quality measures across post-acute care settings.
Pressure Injury Risk Assessment in Pediatric Intensive Care: A Prospective Validation Study of the Glamorgan Scale and Predictive Comparison with the Braden Q Scale
Authors: Vocci Marcelli Christine , Amante Miot Hélio , Mendes Bertoncello Fontes Cassiana , Fernandes Abbade Luciana Patricia
Published: February 2023

OBJECTIVE

To validate the Glamorgan Scale and compare its predictive ability in assessing pressure injury risk among patients in a pediatric ICU (PICU) with that of the Braden Q Scale.

METHODS

A prospective cohort study was performed to validate the Glamorgan Scale and compare its predictive ability with the Braden Q Scale in a PICU population. A total of 83 patients admitted in the PICU between February and July 2020 met the inclusion criteria and were included in the study, leading to 639 measurements. The authors tested the psychometric properties of the Glamorgan Scale to validate whether the characteristics of the original version were preserved. To this end, reliability (internal consistency) and concurrent and predictive validity (sensitivity and specificity) were assessed. For the predictive comparison, the authors performed the same tests with the Braden Q Scale.

RESULTS

The predictive validity, as assessed by the receiver operator characteristic curve and calculation of the area under the curve, showed satisfactory performance for the Glamorgan Scale (0.77; CI, 0.72–0.82); the Braden Q Scale values were similar (0.78; CI 0.73–0.84). The Spearman correlation coefficient showed a strong correlation between the total scores of the Glamorgan Scale (ρ = −0.76; P < .01), corroborating its validation.

CONCLUSIONS

The Glamorgan Scale was validated and showed good accuracy and consistency for pressure injury risk assessment in critically ill pediatric patients in Brazil. Its accuracy was similar to that of the Braden Q Scale.
T2-weighted Imaging Hyperintensity and Transcranial Motor-evoked Potentials During Cervical Spine Surgery: Effects of Sevoflurane in 150 Consecutive Cases
Authors: LeClair Nicole , Ejimone Milca , Lynch Davene , Dasika Jayanth , Rao Dinesh , Hoefnagel Amie L. , Mongan Paul D.
Published: February 2023

Background:

There is debate on the impact of inhalational esthetic agents on transcranial motor evoked potentials (TcMEPs) during intraoperative neuromonitoring. Current guidelines advise their avoidance, which contrasts with common clinical practice.

Methods:

This retrospective cohort study of 150 consecutive cervical spine surgeries at a single institution compared stimulation voltages and TcMEP amplitudes in patients who did and did not receive sevoflurane as part of a balanced anesthetic technique. Patients were divided into 3 groups stratified by the presence or absence of increased signal intensity within the cervical spinal cord on T2-weighted magnetic resonance imaging (indicative or myelopathy/spinal cord injury [SCI]) and sevoflurane use.

Results:

Patients with no magnetic resonance imaging evidence of myelopathy/SCI that received sevoflurane (n=80) had the lowest stimulation voltages and largest TcMEP amplitude responses in the lower extremities compared with those with no magnetic resonance imaging evidence of myelopathy/SCI (n=30). In patients with evidence of myelopathy/SCI who did not receive sevoflurane (n=19), lower extremity TcMEP amplitudes were similar to patients with a myelopathy/SCI that received sevoflurane. Six of these 19 patients had initial low-dose sevoflurane discontinued because of concerns of low/absent baseline TcMEP amplitudes.

Conclusions:

Balanced anesthesia with 0.5 MAC sevoflurane in patients with and without radiological evidence of myelopathy/SCI allows reliable TcMEP monitoring. However, in communication with surgical and neuromonitoring teams, it may be advisable in a subset of patients to avoid or discontinue sevoflurane in favor of a propofol/opioid-based anesthetic to ensure adequate and reproducible TcMEPs.
Risk and prognostic factors of brain metastasis in lung cancer patients: a Surveillance, Epidemiology, and End Results population‑based cohort study
Authors: Hao Yongping , Li Guang
Published: February 2023

Background

Brain is a common metastasis site in lung cancer patients. However, homogeneous and heterogeneous risk/prognostic factors of brain metastasis for lung cancer patients have not been comprehensively elucidated. This study aimed to explore the brain metastasis risk and prognostic factors in lung cancer patients using the Surveillance, Epidemiology, and End Results (SEER) database.

Methods

Lung cancer data were downloaded from SEER database to investigate risk factors for developing brain metastasis using logistic regression analysis. Univariate and multivariate Cox analyses were used to identify potential prognostic factors. Kaplan–Meier analysis was conducted to evaluate the survival. Propensity score matching was conducted to eliminate baseline differences between two groups.

Results

A total of 10 818 (14.1%) patients with brain metastasis were diagnosed among 76 483 lung cancer patients. For non–small-cell lung carcinoma (NSCLC), distant liver/bone/lymph node metastases, higher T, N stages were risk factors. Black race, bone metastases and distant lymph node metastases and T4 were brain metastasis risk factors for SCLC patients. Cox analysis suggested that older age, male, primary lesion at main bronchus, liver/ bone/distant lymph node metastases, T2-4, N1-3, no surgery/chemotherapy/radiotherapy were associated with worse prognosis of NSCLC-brain metastasis patients. Age older than 80, liver/bone metastases, without radiotherapy and chemotherapy were associated with worse prognosis of SCLC-brain metastasis patients. Surgery of primary site could prolong the overall survival (OS) of NSCLC patients with brain metastasis, but not SCLC.

Conclusion

In this study, we analyzed the homogeneous and heterogeneous risk/prognostic factors of brain metastasis in lung cancer patients. What is more, our results showed that surgery of primary site was associated with longer OS of NSCLC patients with brain metastasis.
Association between low ambient temperature during pregnancy and adverse birth outcomes: a systematic review and meta-analysis
Authors: Ruan Tiechao , Yue Yan , Lu Wenting , Zhou Ruixi , Xiong Tao , Jiang Yin , Ying Junjie , Tang Jun , Shi Jing , Wang Hua , Xiao Guoguang , Li Jinhui , Qu Yi , Mu Dezhi
Published: February 2023

Background:

Extreme temperature events, including extreme cold, are becoming more frequent worldwide, which might be harmful to pregnant women and cause adverse birth outcomes. We aimed to investigate the association between exposure to low ambient temperature in pregnant women and adverse birth outcomes, such as preterm birth, low birth weight, and stillbirth, and to summarize the evidence herein.

Methods:

Relevant studies were searched in PubMed, Cochrane, and Embase electronic databases until November 2021. Studies involving low ambient temperature, preterm birth, birth weight, and stillbirth were included. The guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses were followed to conduct this study risk of bias and methods for data synthesis.

Results:

A total of 34 studies were included. First, pregnant women exposed to low ambient temperature had an increased risk of preterm birth (risk ratio [RR] 1.08; 95% confidence interval [CI] 1.04–1.13). Subgroup analyses revealed that exposure during late pregnancy was more likely to induce preterm birth. In addition, only pregnant women exposed to <1st percentile of the mean temperature suffered increasing risk of preterm birth. Moreover, pregnant women living in medium or hot areas were more prone to have preterm births than those in cold areas when exposed to low ambient temperatures. Asians and Blacks were more susceptible to low ambient temperatures than Caucasians. Second, pregnant women exposed to low ambient temperature had an increased risk of low birth weight (RR 1.07 [95% CI 1.03–1.12]). Third, pregnant women had an increased risk of stillbirth while exposed to low ambient temperature during the entire pregnancy (RR 4.63 [95% CI 3.99–5.38]).

Conclusions:

Exposure to low ambient temperature during pregnancy increases the risk of adverse birth outcomes. Pregnant women should avoid exposure to extremely low ambient temperature (<1st percentile of the mean temperature), especially in their late pregnancy. This study could provide clues for preventing adverse outcomes from meteorological factors.

Registration:

No. CRD42021259776 at PROSPERO.
Dual therapy for Helicobacter pylori infection
Authors: Duan Miao , Liu Jing , Zuo Xiuli
Published: February 2023

Bismuth-containing quadruple therapy (BQT) has long been recommended for Helicobacter pylori (H. pylori) eradication in China. Meanwhile, in the latest national consensus in China, dual therapy (DT) comprising an acid suppressor and amoxicillin has also been recommended. In recent years, the eradication rate of H. pylori has reached >90% using DT, which has been used not only as a first-line treatment but also as a rescue treatment. Compared with BQT, DT has great potential for H. pylori eradication; however, it has some limitations. This review summarizes the development of DT and its application in H. pylori eradication. The H. pylori eradication rates of DT were comparable to or even higher than those of BQT or standard triple therapy, especially in the first-line treatment. The incidence of adverse events associated with DT was lower than that with other therapies. Furthermore, there were no significant differences in the effects of dual and quadruple therapies on gastrointestinal microecology. In the short term, H. pylori eradication causes certain fluctuations in the gastrointestinal microbiota; however, in the long term, the gastrointestinal microbiota eventually returns to its normal state. In the penicillin-naïve population, patients receiving DT have a high eradiation rate, better compliance, lower incidence of adverse reactions, and lower primary and secondary resistance to amoxicillin. These findings suggest the safety, efficacy, and potential of DT for H. pylori eradication.
Age-related Outcomes of Chest Masculinization Surgery: A Single-surgeon Retrospective Cohort Study
Authors: Skorochod Ron , Rysin Roman , Wolf Yoram
Published: February 2023

Background:

Many transmasculine individuals face chest dysphoria, an emotional distress associated with breast development. The definitive management for reduction of existing breast tissue and alleviation of chest dysphoria comes in the form of chest masculinization surgery. Over the years, a substantial increase in the number of youth seeking gender-affirming chest masculinization surgery was observed globally. The study was hypothesized to answer the question as to whether the age limit of chest masculinization surgery should be lowered to include adolescents.

Methods:

A retrospective cohort study was conducted, based on the experience of a single surgeon over a period of 20 years.

Results:

Two-hundred eight patients were included in this cohort. Patients were divided into two equal groups based on their age. No statistically significant differences between the groups were observed in terms of resected breast tissue (P = 0.62 and 0.30, for the right and left breast, accordingly), auxiliary liposuction (P = 0.30), liposuction volume (P = 0.20), procedure (P = 0.15), postoperative drains (P = 0.79), and surgery duration (P = 0.72). Statistically significant differences were found in the 18 years or younger group, with lower rates of complication (P < 0.001), lower rates of revision surgery (P = 0.025), and higher satisfaction rankings (P < 0.001). Apart from age, no other factors were found to potentially explain the different rates of complications between the age groups.

Conclusion:

Patients aged 18 or younger opting for chest masculinization surgery experience fewer complications and revision procedures while having higher satisfaction rates with the surgical outcome.
Widening Aging Eyes and Ending Outdoor Tearing with Retrobulbar Injections of Dermal Fillers
Authors: Lemperle Gottfried , Kassem-Trautmann Katja , Schmidt Katarzyna
Published: February 2023

Background:

As people age, the intraorbital fat may diminish and palpebral fissures may narrow, causing the eyes to increasingly tear outside in cold weather. As the bulbus recedes from the conjunctiva, a “wind trap” is formed in the lateral corner of the eye. This wind trap appears to irritate the adjacent lacrimal gland. In this article, an 84-year-old patient experienced annoying outdoor tearing despite having undergone three tarsal strip canthopexies during the past 20 years.

Methods:

Retrobulbar injections of 3.5-mL high-viscous dermal fillers (Bellafill or Radiesse) pushed the eyeballs forward, aligned the bulbus with the conjunctiva, and closed the wind trap behind the lateral canthus. Magnetic resonance imaging confirmed the filler material in the posterior lateral corner of the orbit.

Results:

The effect was immediate: the patient’s constant outdoor tearing had resolved after the first treatment of his senile enophthalmos. In addition, the narrow palpebral fissure had widened by 2 mm and rejuvenated his aging eyes.

Conclusions:

An eyeball that has receded with age can be pushed forward with a retrobulbar injection of a long lasting dermal filler to reattach to the eyelids.
Subjective Assessment Underestimates Fraility in Patients With Heart Failure Referred for Advanced Therapies
Authors: Heaney Cassandra , Knisel Alexis , Vuthoori Ravi , Golombeck David , Fernandez Harold , Lima Brian , Taylor James , Davidson Kathleen , Kennedy Kevin , Nursey Vishaan , Miller Ed , Maybaum Simon
Published: February 2023

Assessment of frailty is key for evaluation for advanced therapies (ATs). Most programs use a subjective provider assessment (SPA) or “eye-ball” test; however, objective measures exist. The modified five-item Fried Frailty Index (mFFI) is a validated tool to assess frailty. We compared SPA to mFFI testing in patients referred for AT. We also compared levels of macrophage migration inhibitory factor (MIF), an inflammatory biomarker associated with worse outcomes in heart failure, between frail and not frail subjects. Seventy-eight patients referred for evaluation for AT underwent both SPA and mFFI testing. Three cardiac surgeons independently assessed patients for frailty (SPA). SPA significantly underestimated frailty compared with mFFI testing and correlation between SPA and mFFI was not strong (κ = 0.02–0.14). Providers were correct 84% of the time designating a subject as frail, but only 40% of the time designating as not frail. Agreement between all three providers was robust (76%), which was primarily driven by designation as not frail. There was no significant difference in plasma MIF levels between frail and not frail subjects (47.6 ± 25.2 vs. 45.2 ± 18.9 ng/ml; p = 0.6). Clinicians significantly underestimate frailty but are usually correct when designating a patient as frail.
Predicting obstetric anal sphincter injuries among laboring women: 2 prediction models and 1 risk calculator
Authors: Hu Yinchu , Lu Hong , Zhang Jie , Ren Lihua , Yang Minghui
Published: February 2023

Background:

Although several prediction models have been developed to estimate the risk of obstetric anal sphincter injuries (OASIS) among laboring women, none have been used in clinical practice because of controversial or unavailable predictors included in the prediction models and the format used to present them. Thus, it is essential to develop evidence-based prediction models for OASIS using known antenatal and modifiable intrapartum factors and to present them in user-friendly formats.

Objective:

The objective of this study was to develop evidence-based prediction models for OASIS and a risk calculator to present prediction models.

Methods:

Models were developed based on a systematic review and meta-analysis in which risk factors for OASIS were identified, and the pooled odds ratio for each risk factor was calculated. A logistic regression model was used to develop the prediction models, and MATLAB with a graphical user interface was used to develop the risk calculator.

Results:

Two prediction models for OASIS were established: Model I and Model II. Model I included 7 known antenatal variables: maternal age, parity, prior cesarean delivery, prepregnancy body mass index, gestational age, estimated birth weight, and fetal position. Model II added 5 modifiable intrapartum variables to Model I: epidural analgesia, labor induction, labor augmentation, episiotomy, and operative vaginal birth. The risk calculator developed by writing the parameters in the logistic regression models into MATLAB scripts included 2 interfaces, each consisting of risk factors for OASIS and the possibility of OASIS occurring.

Conclusions:

This study developed 2 prediction models and a risk calculator for OASIS based on a systematic review and meta-analysis. Although the models were more scientific in model development methods and predictors included in the prediction models, they should be externally validated and updated to ensure better performance before they can be widely applied to guide clinical practice.
Metabolic signatures and potential biomarkers in the progression of type 2 diabetes mellitus with cognitive impairment patients: a cross-sectional study
Authors: Zheng Jie , Cheng Fangxiao , Du Yage , Song Ying , Cao Zhaoming , Li Mingzi , Lu Yanhui
Published: February 2023

Background:

Type 2 diabetes mellitus (T2DM), a growing global chronic disease, can increase the risk of cognitive impairment. The microbiota-gut-brain axis has a crucial role in the development of neurological pathologies. Therefore, it is necessary to examine host-gut microbiota metabolites associated with diabetic cognitive impairment (DCI) progression.

Objective:

This study aimed to describe metabolic signatures, identify potential biomarkers in the progression from T2DM to DCI, and analyze the correlation between the potential biomarkers and clinical characteristics.

Methods:

A cross-sectional study involving 8 patients with T2DM and 8 with DCI was carried out between May 2018 and May 2020. The characteristic clinical data of the patients, such as demographics, hematological parameters, Mini-Mental State Examination, and Montreal Cognitive Assessment, were collected. Metabolomics profiling measured the host-gut microbiota metabolites in the serum. The potential biomarkers were found by getting intersection of the differential host-gut microbiota metabolites from multidimensional statistics (Orthogonal Partial Least Squares-Discriminant Analysis and permutation plot) and univariate statistics (independent-sample t test and Mann-Whitney U test). In addition, we examined the relationship between potential biomarkers and characteristic clinical data using the Spearman correlation coefficient test.

Results:

A total of 22 potential biomarkers were identified in the T2DM and DCI groups, including 15 upregulated potential biomarkers (such as gluconolactone, 4-hydroxybenzoic acid, and 3-hydroxyphenylacetic acid) and 7 downregulated potential biomarkers (such as benzoic acid, oxoglutaric acid, and rhamnose) in DCI group. Most of the potential biomarkers were associated with clinical characteristics, such as Mini-Mental State Examination, Montreal Cognitive Assessment, and glycated hemoglobin A1c.

Conclusion:

This study showed that metabolic signatures in the serum were associated with DCI development and clinical severity, providing new ideas for extensive screening and targeted treatment.
The Value of Immunohistochemical Expression of TOX, ICOS, and GATA-3 in the Diagnosis of Mycosis Fungoides
Authors: Atwa Hanaa A. , Abdelrahman Doaa I.
Published: February 2023

Background:

Mycosis fungoides (MF) is considered the commonest type of cutaneous T-cell lymphoma representing about 50% of all primary cutaneous lymphomas. Differentiation between MF and another inflammatory dermatitis (BIDs) is important to ensure proper management.

Aim:

We aimed to evaluate the immunohistochemical expression of TOX, ICOS, and GATA binding protein 3 (GATA-3) in early stages MF (stage IA and IB) to establish their diagnostic value and to guide the use of inhibitors in the treatment of cutaneous T-cell lymphomas.

Materials and Methods:

A retrospective study of 75 skin paraffin blocks (punch biopsy) 40 cases of MF and 35 cases of eczematous dermatitis as a group representing other inflammatory dermatitis were retrieved from archives of the pathology department of our University, during the period from October 2017 to May 2021.

Results:

About 98% and 90% of patients in the MF group had positive TOX and ICOS, while 70% of them had positive GATA-3. High expression of TOX, ICOS, and GATA-3 was associated with higher stages.

Conclusions:

TOX is considered a diagnostic marker for early MF. The importance of identifying novel markers in MF expressed by immunohistochemistry, such as ICOS, has been established. According to our results, GATA-3 could be used as an accessory marker in the diagnosis of MF when combined with TOX and ICOS in a panel.
Structured Multidisciplinary Follow-Up After Pediatric Intensive Care: A Model for Continuous Data-Driven Health Care Innovation
Authors: de Sonnaville Eleonore S. V. , van Woensel Job B. M. , van Goudoever Johannes B. , Otten Marieke H. , Teela Lorynn , Aarnoudse-Moens Cornelieke S. H. , Terheggen-Lagro Suzanne W. J. , van der Hulst Annelies E. , Engelen Marc , Kӧnigs Marsh , Oosterlaan Jaap , Knoester Hennie ,   the Emma Children’s Hospital Amsterdam UMC Follow Me Program Consortium
Published: February 2023

OBJECTIVES:

Morbidity after PICU admission for critical illness is a growing concern. Sequelae may occur in various domains of functioning and can only appropriately be determined through structured follow-up. Here, we describe the process of designing and implementing a structured multidisciplinary follow-up program for patients and their parents after PICU admission and show the first results illustrating the significance of our program.

DESIGN:

Prospective observational cohort study.

SETTING:

Outpatient PICU follow-up clinic.

PATIENTS:

Patients 0–18 years old admitted to our PICU.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

In our structured multidisciplinary follow-up program, follow-up care is provided by a pediatric intensivist and psychologist and in addition, depending on patient’s critical illness and received PICU treatment(s), by a pediatric pulmonologist, cardiologist, neurologist, and/or neuropsychologist. All consultations are scheduled consecutively. Collected data are stored in a hospital-wide data warehouse and used for yearly health care evaluation sessions as well as scientific research. Challenges in organizing this follow-up program include technological challenges, providing time-efficient care, participation rate, and completeness of questionnaires. In our experience, a dedicated team is essential to tackle these challenges. Our first results, obtained in 307 of 388 referred patients (79.1%), showed the diversity of problems arising after PICU discharge, including physical, neurocognitive, and psychosocial sequelae. In addition, our data also reflected the risk of psychosocial problems among parents. Within the limited operation time of our follow-up program, the program has evolved based on our experiences and the data collected.

CONCLUSIONS:

We successfully developed and implemented a structured multidisciplinary follow-up program for patients and their parents after PICU admission. This program may help to timely initiate appropriate interventions, improve the standard of care during and after PICU admission, and facilitate scientific research on outcome and prognosis after PICU admission.