bluuebunny/crossref_metadata_2025 huggingface dataset:
Comprehensive analysis of Japanese nationwide cohort data of particle beam therapy for pulmonary, liver and lymph node oligometastases: particle beam therapy versus high-precision X-ray radiotherapy
Authors: Aibe Norihiro , Ogino Hiroyuki , Wakatsuki Masaru , Fujikawa Kei , Teramukai Satoshi , Fukumitsu Nobuyoshi , Shiba Shintaro , Yamamoto Naoyoshi , Nomoto Akihiro , Ono Takashi , Oguri Masanosuke , Yamaguchi Hisashi , Numajiri Haruko , Shibuya Kei , Okazaki Shohei , Miyasaka Yuhei , Okonogi Noriyuki , Murata Kazutoshi , Tatebe Hitoshi , Motegi Atsushi , Okimoto Tomoaki , Yoshino Takayuki , Mandai Masaki , Katoh Norio , Tsuji Hiroshi , Sakurai Hideyuki
Published: April 2023

Japanese national oncological experts convened to evaluate the efficacy and safety of particle beam therapy (PT) for pulmonary, liver and lymph node oligometastases (P-OM, L-OM and LN-OM, respectively) and to conduct a statistically comparative analysis of the local control (LC) rate and overall survival (OS) rate of PT versus those of X-ray stereotactic body radiotherapy (X-SBRT) and X-ray intensity-modulated radiotherapy (X-IMRT). They conducted [1] an analysis of the efficacy and safety of metastasis-directed therapy with PT for P-OM, L-OM and LN-OM using a Japanese nationwide multi-institutional cohort study data set; [2] a systematic review of X-ray high-precision radiotherapy (i.e. X-SBRT/X-IMRT) and PT for P-OM, L-OM and LN-OM; and [3] a statistical comparison between LC and OS of the cohort data set in PT and that of the extracted historical data set in X-SBRT/X-IMRT from the preceding systematic review. Safety was evaluated as the incidence of grade ≥ 3 adverse events, while statistical comparisons of LC and OS were conducted by estimating the incidence rate ratios (IRR) for local progression and mortality, respectively. This study demonstrated that PT provided durable LC (3-year LC rate: 72.8–83.2%) with acceptable OS (3-year OS rate: 38.5–68.1%) and risk of severe toxicity incidence of 0.8–3.5% in radical metastasis-directed therapy for P-OM, L-OM and LN-OM. Compared to LC with X-SBRT or X-IMRT, LC with PT was potentially superior for P-OM; superior for L-OM; and equivalent for LN-OM. In particular, this study demonstrated that PT may be a new treatment option for L-OM tumors measuring > 5 cm.
Strangulated interstitial interparietal hernia following lower segment caesarean section: a case report
Authors: Garrett Celine , Wijayawardana Ruwanthi , Morris David L
Published: April 2023

Interparietal hernias are rare and occur most commonly in the long-term postoperative setting following abdominopelvic surgery. This case report describes the development of a strangulated interparietal hernia through a defect in the posterior rectus sheath 4 days post-lower segment caesarean section (LSCS) in a 36-year-old female. Whilst she had an acute abdomen, she did not have a palpable incisional hernia. Her interparietal hernia was identified via a computed tomography scan of her abdomen and pelvis. She underwent a midline laparotomy where ischaemic small bowel was found within her hernia. This was resected and she had an unremarkable recovery. This case is the first of its kind and highlights the diagnostic challenge of interparietal hernias in acute postoperative patients as well as the importance of having a low threshold for suspicion for complicated interparietal hernias in patients with an acute abdomen following LSCS.
Giant pilomatrixoma in the infraclavicular region following an insect bite
Authors: Cóbar Juan P , Ghaddar Sawsane , Feucht Markus G , Ardebol Javier
Published: April 2023

Pilomatrixoma is a benign skin tumor typically presenting as a hard, slow-growing mass arising from hair follicle matrix cells. While most encountered in children, giant pilomatrixoma seldomly presents in adults. In the present case, a large subcutaneous, nonpainful and slow-growing mass was discovered in the infraclavicular region of a 52-year-old male. Biopsy confirmed the diagnosis of giant pilomatrixoma. Despite its benign nature, tumor size and location can result in significant morbidity and cosmetic deformity. This case highlights the importance of considering pilomatrixomas in patients with a slow-growing mass, especially after an inciting event, such as an insect bite. Timely diagnosis and proper management can result in successful tumor removal with minimal cosmetic compromise.
Thoracoscopic repair of iatrogenic diaphragmatic hernia following multiple abdominal surgeries: a case report
Authors: Kasa Kentaro , Tanishima Yuichiro , Kurogochi Takanori , Masuda Takahiro , Yano Fumiaki , Eto Ken
Published: April 2023

Iatrogenic diaphragmatic hernia (IDH) is a rare complication that has been reported after various interventions, including liver transplantation, liver resection and nephrectomy. A surgical procedure for IDH has not been optimized. A 56-year-old man presented to our hospital with a 1-week history of abdominal pain and nausea. His medical history included an open nephrectomy for renal cancer 8 years ago and open distal pancreatectomy for its recurrence 1.5 years ago. Enhanced computed tomography showed IDH with the fornix of the stomach herniating to the left pleural cavity, without radiographic signs of strangulation. His symptoms improved after gastric decompression with nasogastric tube placement, and he underwent elective surgery. The incarcerated stomach was repositioned, and the hernia orifice was closed and reinforced with expanded polytetrafluoroethylene mesh using a thoracoscopic procedure. The patient had an uneventful postoperative course. The operative procedure for IDH should be tailored depending on anatomical alternations after previous surgeries.
A case of recurrent epiphrenic esophageal diverticulum treated with lower esophagogastric resection and interstitial jejunal reconstruction
Authors: Ito Ayaka , Kitazono Masaki , Fujita Makoto , Ikeda Naotaka , Eguchi Mayumi , Oyama Tomohiro , Uchiyama Shuichiro , Toyosaki Ryoichi , Suenaga Toyokuni
Published: April 2023

The patient is a 60-year-old female with a history of multiple times of recurrences of an esophageal diverticulum. She was referred for a diagnosis of persistent dysphagia and vomiting. Balloon dilation did not improve the symptoms; thus, she was referred for surgery. Esophageal fluoroscopy revealed a 5 cm diverticulum. There was no significant change in the size before and after dilation. Gastrointestinal endoscopy revealed a diverticulum in the lower esophagus, with a residue accumulation. The esophagus directly below the diverticulum was narrowed. The patient was diagnosed with recurrent lower esophageal diverticulum and underwent surgery. The operative findings showed poor coloration of the gastric fundus surrounding operated before by Nissen’s method, so the patient underwent lower esophagogastric resection and interstitial jejunal reconstruction. The postoperative course was uneventful and discharged on the 19th day. She is 6 years postoperatively and gained six kg compared to her preoperative weight. She has remained in excellent health.
Quantitative Detection of House Dust Mites–Specific IgE by Light-Initiated Chemiluminescence Assay
Authors: Yang Xiaohui , Zheng Lisheng , Sun Yuanmin , Tan Xin , Zhang Bei , Li Xue , Li Huiqiang
Published: April 2023

Objective

To establish a new method for quantitative detection of house dust mite (HDM)–sIgE based on light-initiated chemiluminescence assay (LiCA).

Methods

The assay was established after optimizing the reaction conditions, and the assay performance was evaluated according to the clinical guidelines. Further, the results of LiCA were compared with those from the ELISA and ImmunoCAP methods.

Results

Coefficients of variation for repeatability ranged from 4.22% to 7.69%, and intermediate precision from 8.38% to 10.34%. The limit of blank (LoB), limit of detection (LoD), and limit of quantitation (LoQ) were 0.066 kUA/L, 0.165 kUA/L, and 0.171 kUA/L, respectively. The coefficient of correlation (r) between the results of LiCA and ELISA was 0.9263, and the r between the results of LiCA and ImmunoCAP was 0.8870.

Conclusions

A HDM-sIgE quantitation assay based on LiCA was established, which could be used as a new reliable analytical tool for the determination of HDM-sIgE.
NEAT—Named Entities in Archaeological Texts: A semantic approach to term extraction and classification
Authors: di Buono Maria Pia , Nolano Gennaro , Monti Johanna
Published: April 2023

The lack of annotated datasets affects the development of Natural Language Processing applications and heavily impacts the access to textual data, in particular for specific domains and specific languages. In this paper, we propose a methodology to annotate texts concerning domain-specific knowledge, to provide a reliable source of data for the task of Named Entity Recognition (NER) in the domain of archaeology for the Italian laguage. This method integrates syntactic and semantic information from several structured sources to annotate entities’ mentions in unstructured texts. Furthermore, we make use of an ontology to label entities with the specific type they refer to. By using a corpus made up of item descriptions from Europeana’s Archaeology Collection, we first test our proposed methodology on a mock dataset composed of 1,000 texts. After several steps of improvements, we use the final process to create a complete dataset composed of 5,000 descriptions. The resulting dataset, Named Entities in Archaeological Texts has a total of 41,002 spans of texts annotated with their domain-specific entity classification according to the CIDOC Conceptual Reference Model.
Population of ground and lowest excited states of sulfur via the dissociative recombination of SH+ in the diffuse interstellar medium
Authors: Boffelli J , Gauchet F , Kashinski D O , Talbi D , Hickman A P , Chakrabarti K , Bron E , Orbán A , Mezei J Zs , Schneider I F
Published: April 2023

Our previous study on dissociative recombination of ground state SH+ through 2Π states of SH is extended by taking into account the contribution of 4Π states recently explored by quantum chemistry methods. Multichannel quantum defect theory is employed for the computation of cross sections and rate coefficients for dissociative recombination, but also for vibrational excitation. Furthermore, we produce the atomic yields resulting from recombination, quantifying the generation of sulfur atoms in their ground (3P) and lowest excited (1D) states, respectively.
Polarization of fast radio bursts: radiation mechanisms and propagation effects
Authors: Qu Yuanhong , Zhang Bing
Published: April 2023

Fast radio bursts (FRBs) are observed to be highly polarized. Most have high linear polarization but a small fraction shows significant circular polarization. We systematically investigate a variety of polarization mechanisms of FRBs within the magnetar theoretical framework considering two emission sites inside and outside the magnetosphere. For each site, we discuss both intrinsic radiation mechanisms and propagation effects. Inside the magnetosphere, we investigate the polarization properties of both coherent curvature radiation and inverse Compton scattering by charged bunches and conclude that both mechanisms produce 100 per cent linear polarization at an on-axis geometry but can produce circular polarization if the viewing angle is off axis. The lack of circular polarization for the majority of bursts requires that the bunches have a large transverse dimension size. Resonant cyclotron absorption within magnetosphere may produce high circular polarization if electrons and positrons have an asymmetric Lorentz factor distribution. Outside the magnetosphere, the synchrotron maser emission mechanism in general produces highly linearly polarized emission. Circular polarization would appear at off-beam angles but the flux is greatly degraded and such bursts are not detectable at cosmological distances. Synchrotron absorption in a nebula with ordered magnetic field may reduce the circular polarization degree. Cyclotron absorption in a strongly magnetized medium may generate significant circular polarization. Faraday conversion in a medium with field reversal can convert one polarization mode to another. The two absorption processes require stringent physical conditions. Significant Faraday conversion may be realized in a magnetized dense environment involving binary systems or supernova remnants.
A systematic survey of millimetre-wavelength flaring variability of young stellar objects in the Orion Nebula Cluster
Authors: Vargas-González J , Forbrich J , Rivilla V M , Menten K M , Güdel M , Hacar A
Published: April 2023

High-energy processes are ubiquitous even in the earliest stages of protostellar evolution. Motivated by the results of our systematic search for intense centimetre radio flares in Young Stellar Objects (YSOs) and by rare findings of strong millimetre-wavelength variability, we have conducted a systematic search for such variability in the Orion Nebula Cluster (ONC) using Atacama Large Millimetre/submillimetre Array (ALMA). Rapid variability on time-scales of minutes to hours in the (centimetre) millimetre-wavelength range indicates (gyro)synchrotron radiation. Additionally, mass accretion will also affect the millimetre-wavelength luminosity but typically on longer time-scales. Beyond studies of individual YSOs, our characterization of strong millimetre-wavelength variability with ALMA in the ONC sets first systematic constraints on the occurrence of such variability in a large number of YSOs (∼130). We report the discovery of an order of magnitude millimetre-flare within just a few minutes from a known YSO previously reported as a radio flaring source at cm-wavelengths (the ‘ORBS’ source). We also present an assessment of the systematic variability effects caused by the use of time-sliced imaging of a complex region. These are mostly due to the impact of a changing synthesized beam throughout the observations. We use simulated ALMA observations to reproduce and quantify these effects, and set a lower limit for the variability that can be studied using our method in a complex region such as the ONC. Our results demonstrate that the utility of time domain analysis of YSOs extends into the millimetre-wavelength range, potentially interfering with the conversion of observed fluxes into dust masses.
The optical behaviour of BL Lacertae at its maximum brightness levels: a blend of geometry and energetics
Authors: Raiteri C M , Villata M , Jorstad S G , Marscher A P , Acosta Pulido J A , Carosati D , Chen W P , Joner M D , Kurtanidze S O , Lorey C , Marchini A , Matsumoto K , Mirzaqulov D O , Savchenko S S , Strigachev A , Vince O , Aceti P , Apolonio G , Arena C , Arkharov A , Bachev R , Bader N , Banfi M , Bonnoli G , Borman G A , Bozhilov V , Brown L F , Carbonell W , Carnerero M I , Damljanovic G , Dhiman V , Ehgamberdiev S A , Elsaesser D , Feige M , Gabellini D , Galán D , Galli G , Gaur H , Gazeas K , Grishina T S , Gupta A C , Hagen-Thorn V A , Hallum M K , Hart M , Hasuda K , Heidemann K , Horst B , Hou W-J , Ibryamov S , Ivanidze R Z , Jovanovic M D , Kimeridze G N , Kishore S , Klimanov S , Kopatskaya E N , Kurtanidze O M , Kushwaha P , Lane D J , Larionova E G , Leonini S , Lin H C , Mannheim K , Marino G , Minev M , Modaressi A , Morozova D A , Mortari F , Nazarov S V , Nikolashvili M G , Otero Santos J , Ovcharov E , Papini R , Pinter V , Privitera C A , Pursimo T , Reinhart D , Roberts J , Romanov F D , Rosenlehner K , Sakamoto T , Salvaggio F , Schoch K , Semkov E , Seufert J , Shakhovskoy D , Sigua L A , Singh C , Steineke R , Stojanovic M , Tripathi T , Troitskaya Y V , Troitskiy I S , Tsai A , Valcheva A , Vasilyev A A , Vrontaki K , Weaver Z R , Wooley J H F , Zaharieva E , Zhovtan A V
Published: April 2023

In 2021 BL Lacertae underwent an extraordinary activity phase, which was intensively followed by the Whole Earth Blazar Telescope (WEBT) Collaboration. We present the WEBT optical data in the BVRI bands acquired at 36 observatories around the world. In mid-2021 the source showed its historical maximum, with R = 11.14. The light curves display many episodes of intraday variability, whose amplitude increases with source brightness, in agreement with a geometrical interpretation of the long-term flux behaviour. This is also supported by the long-term spectral variability, with an almost achromatic trend with brightness. In contrast, short-term variations are found to be strongly chromatic and are ascribed to energetic processes in the jet. We also analyse the optical polarimetric behaviour, finding evidence of a strong correlation between the intrinsic fast variations in flux density and those in polarization degree, with a time delay of about 13 h. This suggests a common physical origin. The overall behaviour of the source can be interpreted as the result of two mechanisms: variability on time-scales greater than several days is likely produced by orientation effects, while either shock waves propagating in the jet, or magnetic reconnection, possibly induced by kink instabilities in the jet, can explain variability on shorter time-scales. The latter scenario could also account for the appearance of quasi-periodic oscillations, with periods from a few days to a few hours, during outbursts, when the jet is more closely aligned with our line of sight and the time-scales are shortened by relativistic effects.
Ramucirumab Plus Docetaxel for Patients with Non-small cell Lung Cancer with Brain Metastases: A Multicenter, Open-Label Single-Arm Phase II Trial
Authors: Tanimura Keiko , Uchino Junji , Kimura Hideharu , Hiranuma Osamu , Chihara Yusuke , Tanzawa Shigeru , Takumi Chieko , Kita Toshiyuki , Inoue Koji , Minato Koichi , Takemoto Shinnosuke , Nakao Akira , Yoshimura Kenichi , Takayama Koichi
Published: April 2023

Background

Ramucirumab plus docetaxel combination therapy (DOC/RAM) for advanced non-small cell lung cancer (NSCLC) achieves favorable outcomes; however, efficacy and safety for patients with brain metastases are still unclear.

Methods

Eligible patients included those with advanced NSCLC with measurable asymptomatic brain metastases that progressed after chemotherapy. Patients were intravenously administered ramucirumab (10 mg/kg) and docetaxel (60 mg/m2) every 21-day cycle.

Results

Due to difficulties in accumulating the planned 65 participants, enrollment was terminated early when 25 patients were enrolled. Primary endpoint: Median progression-free survival (PFS) was 3.9 months (95% CI, 1.8-5.3). Secondary endpoints: Median intracranial progression-free survival was 4.6 months (95% CI, 2.5-5.9); median overall survival was 20.9 months (95% CI, 6.6-not possible to estimate); objective response rate was 20% (95% CI, 6.8-40.7); disease control rate was 68% (95% CI, 46.5-85.1). The most common grade 3 or higher toxicities were neutropenia in 10 patients (40%). Neither intracranial hemorrhage nor grade 5 adverse events were observed. Patients with higher serum soluble vascular endothelial growth factor receptor 2 concentrations at the start of treatment had slightly longer PFS.

Conclusion

No clinical concerns were identified with DOC/RAM for NSCLC with brain metastases in this study. Further investigation with a larger sample size is needed to determine the tolerability and safety of these populations (Trial Identifiers: University Hospital Medical Information Network in Japan [UMIN000024551] and Japan Registry of Clinical Trials [jRCTs071180048]).
Natural variation of maize root hydraulic architecture underlies highly diverse water uptake capacities
Authors: Rishmawi Louai , Bauget Fabrice , Protto Virginia , Bauland Cyril , Nacry Philippe , Maurel Christophe
Published: April 2023

Plant water uptake is determined by the root system architecture and its hydraulic capacity, which together define the root hydraulic architecture. The current research aims at understanding the water uptake capacities of maize (Zea mays), a model organism and major crop. We explored the genetic variations within a collection of 224 maize inbred Dent lines and successively defined core genotype subsets to access multiple architectural, anatomical, and hydraulic parameters in the primary root (PR) and seminal roots (SR) of hydroponically grown seedlings. We found 9-, 3.5-, and 12.4-fold genotypic differences for root hydraulics (Lpr), PR size, and lateral root size, respectively, that shaped wide and independent variations of root structure and function. Within genotypes, PR and SR showed similarities in hydraulics and, to a lesser extent, in anatomy. They had comparable aquaporin activity profiles that, however, could not be explained by aquaporin expression levels. Genotypic variations in the size and number of late meta xylem vessels were positively correlated with Lpr. Inverse modeling further revealed dramatic genotypic differences in the xylem conductance profile. Thus, tremendous natural variation of maize root hydraulic architecture underlies a high diversity of water uptake strategies and paves the way to quantitative genetic dissection of its elementary traits.
Creditor-Control Rights and the Nonsynchronicity of Global CDS Markets
Authors: Hasan Iftekhar , Marra Miriam , Wu Eliza , Zhang Gaiyan
Published: April 2023

We analyze how creditor rights affect the nonsynchronicity of global corporate credit default swap spreads (CDS-NS). CDS-NS is negatively related to the country-level creditor-control rights, especially to the “restrictions on reorganization” component, where creditor-shareholder conflicts are high. The effect is concentrated in firms with high investment intensity, asset growth, information opacity, and risk. Pro-creditor bankruptcy reforms led to a decline in CDS-NS, indicating lower firm-specific idiosyncratic information being priced in credit markets. A strategic-disclosure incentive among debtors avoiding creditor intervention seems more dominant than the disciplining effect, suggesting how strengthening creditor rights affects power rebalancing between creditors and shareholders. (JEL G14, G15, G33, G34)
Cancer risk in patients with rheumatoid arthritis treated with janus kinase inhibitors: a nationwide Danish register-based cohort study
Authors: Westermann Rasmus , Cordtz René Lindholm , Duch Kirsten , Mellemkjaer Lene , Hetland Merete Lund , Burden Andrea Michelle , Dreyer Lene
Published: April 2023

Objectives

We aimed to investigate the risk of first primary cancer in patients with RA treated with janus kinase inhibitors (JAKi) compared with those who received biologic DMARDs (bDMARDs) in a real-world setting.

Methods

We performed an observational cohort study using the nationwide registers in Denmark. Patients with RA aged 18+ years, without a previous cancer diagnosis, and who initiated treatment with JAKi or bDMARDs from 1 January 2017 to 31 December 2020 were followed for any cancer (except non-melanoma skin cancer). We applied inverse probability of treatment weighting (IPTW) to account for covariate differences between treatment groups. IPTW-generated weights were used with cause-specific Cox (CSC) models to calculate hazard ratios (HRs) for cancer incidence in JAKi-treated compared with bDMARD-treated patients with RA.

Results

We identified 875 and 4247 RA patients treated with JAKi and bDMARDs, respectively. The JAKi group contributed 1315 person years (PYRS) and 19 cancers, the bDMARD group contributed 8597 PYRS and 111 cancers, with corresponding crude incidence rates per 1000 PYRS of 14.4 and 12.9. Comparing the two groups using weighted CSC models, a HR of 1.41 (95% CI 0.76, 2.37, 95% CIs) was seen for JAKi- vs bDMARD-treated patients with RA.

Conclusion

JAKi treatment in real-world patients with RA was not associated with a statistically significant increased risk of first primary cancer compared with those who received bDMARDs. However, several numerically increased risk estimates were detected, and a clinically important excess risk of cancer among JAKi recipients cannot be dismissed.
Adolescents’ neural reactivity to parental criticism is associated with diminished happiness during daily interpersonal situations
Authors: James Kiera M , Sequeira Stefanie L , Dahl Ronald E , Forbes Erika E , Ryan Neal D , Hooley Jill , Ladouceur Cecile D , Silk Jennifer S
Published: April 2023

The goal of this study was to examine the relation between real-world socio-emotional measures and neural activation to parental criticism, a salient form of social threat for adolescents. This work could help us understand why heightened neural reactivity to social threat consistently emerges as a risk factor for internalizing psychopathology in youth. We predicted that youth with higher reactivity to parental criticism (vs neutral comments) in the subgenual anterior cingulate cortex (sgACC), amygdala and anterior insula would experience (i) less happiness in daily positive interpersonal situations and (ii) more sadness and anger in daily negative interpersonal situations. Participants (44 youth aged 11–16 years with a history of anxiety) completed a 10-day ecological momentary assessment protocol and a neuroimaging task in which they listened to audio clips of their parents’ criticism and neutral comments. Mixed-effects models tested associations between neural activation to critical (vs neutral) feedback and emotions in interpersonal situations. Youth who exhibited higher activation in the sgACC to parental criticism reported less happiness during daily positive interpersonal situations. No significant neural predictors of negative emotions (e.g. sadness and anger) emerged. These findings provide evidence of real-world correlates of neural reactivity to social threat that may have important clinical implications.
Occurrence and Distribution of Common Diseases and Pests of U.S. Cannabis: A Survey
Authors: Munir Misbakhul , Leonberger Kimberly , Kesheimer Katelyn , Bolt Marguerite , Zuefle Marion , Aronson Emma , Ricciardi Magdalena , Schluttenhofer Craig , Joly David , Smith Henry S. , Coburn Jacqueline , Filho Jose Franco Da Cunha Leme , Rondon Silvia I. , Smart Christine D. , Collins Alyssa , Garfinkel Andrea , Gauthier Nicole A.
Published: April 2023

Hemp and marijuana, both Cannabis sativa L., are revitalized crops to U.S. agricultural and horticultural industries. Hemp (Δ⁹-Tetrahydrocannabinol content < 0.3%) was reintroduced in 2014 under a pilot research program and legalized in 2018. Hemp can now be grown in all 50 states. Marijuana (Δ⁹-THC content > 0.3%), although classified as a Schedule I narcotic by the U.S. Drug Enforcement Administration, is legal in 37 states for medical and/or recreational use. Although C. sativa is often promoted as a pest-free crop, multiple diseases and arthropod pests have been identified and confirmed in recent years. There are limited options for control of diseases and pests affecting hemp. A survey of diagnosticians, researchers, and industry leaders conducted from 2021 to 2022 sought to determine the distribution and occurrence of 76 common diseases and pests on C. sativa across the United States. A total of 148 responses were collected and grouped by U.S. region: Western, Great Plains, North Central, Northeastern, and Southern. Survey results suggest that whereas some pathogens and pests are widely distributed across the United States, others occur more frequently in specific regions. This finding may indicate variations in economic importance by region. Results from this survey provide a foundation for regional and national prioritization of research and regulatory activities.
The HIF‐1α/miR‐26a‐5p/PFKFB3/ULK1/2 axis regulates vascular remodeling in hypoxia‐induced pulmonary hypertension by modulation of autophagy
Authors: Ma Chaoqun , Xu Qiang , Huang Songqun , Song Jingwen , Sun Minglei , Zhang Jingyu , Chu Guojun , Zhang Bili , Bai Yuan , Zhao Xianxian , Wang Zhongkai , Li Pan
Published: April 2023

Pulmonary arterial hypertension (PAH) is a progressive and life‐threatening disease characterized by pulmonary vascular remodeling, which may cause right heart failure and even death. Accumulated evidence confirmed that microRNA‐26 family play critical roles in cardiovascular disease; however, their function in PAH remains largely unknown. Here, we investigated the expression of miR‐26 family in plasma from PAH patients using quantitative RT‐PCR, and identified miR‐26a‐5p as the most downregulated member, which was also decreased in hypoxia‐induced pulmonary arterial smooth muscle cell (PASMC) autophagy models and lung tissues of PAH patients. Furthermore, chromatin immunoprecipitation (ChIP) analysis and luciferase reporter assays revealed that hypoxia‐inducible factor 1α (HIF‐1α) specifically interacted with the promoter of miR‐26a‐5p and inhibited its expression in PASMCs. Tandem mRFP‐GFP‐LC3B fluorescence microscopy demonstrated that miR‐26a‐5p inhibited hypoxia‐induced PAMSC autophagy, characterized by reduced formation of autophagosomes and autolysosomes. In addition, results showed that miR‐26a‐5p overexpression potently inhibited PASMC proliferation and migration, as determined by cell counting kit‐8, EdU staining, wound‐healing, and transwell assays. Mechanistically, PFKFB3, ULK1, and ULK2 were direct targets of miR‐26a‐5p, as determined by dual‐luciferase reporter gene assays and western blots. Meanwhile, PFKFB3 could further enhance the phosphorylation level of ULK1 and promote autophagy in PASMCs. Moreover, intratracheal administration of adeno‐miR‐26a‐5p markedly alleviated right ventricular hypertrophy and pulmonary vascular remodeling in hypoxia‐induced PAH rat models in vivo. Taken together, the HIF‐1α/miR‐26a‐5p/PFKFB3/ULK1/2 axis plays critical roles in the regulation of hypoxia‐induced PASMC autophagy and proliferation. MiR‐26a‐5p may represent as an attractive biomarker for the diagnosis and treatment of PAH.
Implicit Bias Toward Lesbian and Gay Persons Among Nursing Students: A Correlation Study
Authors: Murphy Michael G.
Published: April 2023

AIM

The purpose of this study was to measure implicit bias among nursing students toward lesbian and gay (LG) persons.

BACKGROUND

Implicit bias is identified as a contributor to the health disparities experienced by LG persons. This bias has not been studied among nursing students.

METHOD

This descriptive, correlation study used the Implicit Association Test to measure implicit bias in a convenience sample of baccalaureate nursing students. Demographic information was collected to identify relevant predictor variables.

RESULTS

Implicit bias in this sample (n = 1,348) favored straight persons over LG persons (D-score = 0.22). Participants identifying as male (B = 0.19), straight (B = 0.65), other sexuality (B = 0.33), somewhat (B = 0.09) or very religious (B = 0.14), or enrollment in an RN-BSN program (B = 0.11) predicted stronger bias favoring straight persons.

CONCLUSION

Implicit bias toward LG persons among nursing students remains a challenge for educators.
Simulation Utilized for Mentoring and Measuring Integrative Thinking: A Model for Advanced Practice Nurse Competence Evaluation
Authors: Paxton Kim L. , Diamond Lisa
Published: April 2023

S.U.M.M.I.T (Simulation Utilized for Mentoring and Measuring Integrative Thinking) to practice is a summative advanced practice nurse (APN) evaluation model using virtual simulation to assess clinical decision-making competencies of APN students. Students engage as grand round participants in an unfolding recorded patient encounter. Competence is assessed through their application of evidence-based rationales for diagnosis, diagnostics, interpretation, and care plan. S.U.M.M.I.T incorporates an objective competency-based rubric and concurrent feedback. Results demonstrate clear details of clinical reasoning, communication, diagnosis-focused care plan, patient safety, and education, allowing specific competency need mentoring by faculty.
Put Down the Tin
Authors: Cole Matthew W. , Collins Lacee K. , Waters Timothy L. , Salas Zachary , Sherman William F. , Cyriac Mathew
Published: April 2023

Study Design:

Retrospective study.

Objective:

This study evaluated the impact of chewing tobacco on both medical and spine-related complication rates after spinal lumbar fusions in comparison to both a control cohort and a smoking cohort.

Summary of Background Data:

Smoking is a prevalent modifiable risk factor that has been demonstrated to be associated with increased complications after lumbar fusion. Although smoking rates have decreased in the United States, chewing tobacco use has not similarly reduced. Despite chewing tobacco delivering up to 4 times the dose of smoking, the impact of chewing tobacco is incompletely understood.

Methods:

A retrospective cohort study was conducted using the PearlDiver database. Patients who underwent lumbar spine fusion and used chewing tobacco were matched with a control cohort and a smoking cohort. Medical complications within 90 days after primary lumbar fusion were evaluated, including deep venous thrombosis, acute kidney injury, pulmonary embolism, transfusion, acute myocardial infarction, and inpatient readmission. Spine-related complications were evaluated at 2 years postoperatively, including pseudoarthrosis, incision and drainage (I&D), instrument failure, revision, and infection.

Results:

After primary lumbar fusion, the chewing tobacco cohort demonstrated significantly higher rates of pseudoarthrosis [odds ratio (OR): 1.41], revision (OR: 1.57), and any spine-related complication (OR: 1.32) compared with controls. The smoking cohort demonstrated significantly higher rates of pseudoarthrosis (OR: 1.88), I&D (OR: 1.27), instrument failure (OR: 1.39), revision (OR: 1.54), infection (OR: 1.34), and any spine-related complication (OR: 1.77) compared with controls. The chewing tobacco cohort demonstrated significantly lower rates of pseudoarthrosis (OR: 0.84), I&D (OR: 0.49), infection (OR: 0.70), and any spine-related complication (OR: 0.81) compared with the smoking cohort.

Conclusions:

This study demonstrated that chewing tobacco is associated with higher rates of both spine-related and medical complications after primary lumbar fusion. However, chewing tobacco use is associated with less risk of complications compared with smoking.

Level of Evidence:

Level III.
A Portfolio Coach–Informed Professional Development Framework
Authors: Bose-Brill Seuli , Bardales Cheryl , Anjum Phillip , Prater Laura , Otsubo Masami , Walker Curtis , Miles Laura , Kreger Cynthia , Childerhose Janet E. , Kopechek Jack
Published: April 2023

Introduction:

A majority of US medical schools have incorporated faculty coach–supported educational portfolios into the curriculum. Existing research describes coach professional development, competencies, and program perceptions. However, limited research exists on how programs address coach professional development needs. Our sequential objectives were to (1) explore faculty coach professional development experiences within medical student coaching programs and (2) develop a preliminary framework for medical faculty coach professional development.

Methods:

Faculty portfolio coaches who completed 4 years of a longitudinal coaching program were recruited to complete a semi-structured exit interview. Interviews were transcribed using detailed transcription. Two analysts inductively generated a codebook of parent and child codes to identify themes. They compared themes to the professional development model proposed by O'Sullivan and Irby.

Results:

Of the 25 eligible coaches, 15 completed the interview. Our team organized themes into two broad domains paralleling the established model: program-specific professional development and career-relevant professional development. Four program-specific professional development themes emerged: doing; modeling; relating; and hosting. Three career-relevant professional development themes emerged: advancement; meaning; and understanding. We then applied themes within each domain to propose strategies to optimize coach professional development and develop a framework modeled after O'Sullivan and Irby.

Discussion:

To our knowledge, we propose the first portfolio coach–informed framework for professional development. Our work builds on established standards, expert opinion, and research responsible for portfolio coach professional development and competencies. Allied health institutions with portfolio coaching programs can apply the framework for professional development innovation.
Using “Big Data” to Provide Insights into Early Adopters of Continuing Professional Development: An Example from Project ECHO
Authors: Crawford Allison , Sockalingam Sanjeev , Serhal Eva , Zhou Carrol , Gambin Amanda , de Oliveira Claire , Iwajomo Tomisin , Kurdyak Paul
Published: April 2023

Introduction:

Mental health care is often managed in primary care with limited specialist support, particularly in rural and remote communities. Continuing professional development programs (CPD) can offer a potential solution to further mental health training; however, engaging primary care organizations (PCOs) can be challenging. The use of “big data” to identify factors influencing engagement in CPD programs has not been well studied. Therefore, the aim of this project was to use administrative health data from Ontario, Canada to identify characteristics of PCOs associated with early engagement in a virtual CPD program, Project Extension for Community Healthcare Outcomes (ECHO) Ontario Mental Health (ECHO ONMH).

Methods:

Ontario health administrative data for fiscal year 2014 was used to compare the characteristics of ECHO ONMH-adopting PCOs, and their patients, to nonadopter organizations (N = 280 vs. N = 273 physicians).

Results:

ECHO-adopting PCOs did not differ with respect to physician age or years of practice, although PCOs with more female physicians were somewhat more likely to participate. ECHO ONMH adoption was more likely in regions with lower psychiatrist supply, among PCOs using partial salary payment models, and those with a greater interprofessional complement. Patients of ECHO-adopters did not differ on the basis of gender or health care utilization (physical or mental health); however, ECHO-adopting PCOs tended to have patients with less psychiatric comorbidity.

Discussion:

Models such as Project ECHO, which deliver CPD to primary care, are advanced to address lack of access to specialist health care. These findings support the use of administrative health data to assess the implementation, spread, and impact of CPD.
Mobile Bony Cap (Meysem Yorgun Technique): An Innovative Technique in Preservation Rhinoplasty for Crooked Nose Deformity
Authors: Yorgun Meysem , Çekiç Erdinç , Evlice Ali
Published: April 2023

Background:

Crooked nose deformity is a vertical axis deviation of the nasal pyramid; despite all advancements, it remains a significant problem to resolve. In this study, we present our I- and C-shaped crooked nose rhinoplasty results with this new osteotomy technique.

Methods:

This study included 25 patients with I- or C-shaped crooked nose deformities who underwent correction with a closed-approach let-down procedure. In this technique, the middle vault is preserved, the bony cap is mobilized and preserved, and the lateral nasal bones are equalized by a piezo device or classical osteotomes. By the mobilization of the bony cap, tension on the dorsal septum is released, and slight asymmetries are hidden behind this mobile bony cap.

Results:

The postoperative angles for both type I and C deformities were closer to the ideal angle, and the difference was statistically significant. All patients were satisfied with their aesthetic and functional results.

Conclusions:

In this procedure, we correct asymmetries at the lower maxillary nasal junction, such as in the let-down approach, as well as asymmetries at the K-point, such as in the structural approach. Thus, we combine the advantages of both techniques. Additionally, the mobile-bony cap left on the patient is very useful for releasing the tension of the septal dorsum and hiding slight asymmetries that remain below in the patients.
Intramedullary Insetting of Silicone Implant for Lateral Stability in Distal Interphalangeal Joint Arthroplasty
Authors: Usami Satoshi , Minamikawa Yoshitaka , Kinoshita Yukiko , Ohira Kenji , Hamada Yoshitaka
Published: April 2023

Silicone implant arthroplasty is an alternative surgical intervention for painful and deformed osteoarthritis of the distal interphalangeal (DIP) joints. DIP joint stability is essential for hand function; however, it carries a potential risk of postoperative joint instability. To address this concern, an intramedullary implant insetting method was used to maintain joint stability by minimum resection of the head of the middle phalanx and preserving the collateral ligament. In the new method, the length of the bone excision was limited to maintain the lateral cortical bone with the insertion of the collateral ligament, and the medullary cavity of the middle phalanx was partially removed to intentionally set the hinge part of the silicone implant in the medullary canal. Between 20 digits of the conventional approach and 23 digits of the intramedullary insetting method, there were no significant differences in patient demographics (ie, age, affected hand, and finger), and clinical characteristics (ie, active DIP joint arc, DIP joint extension loss, grip strength, visual analog scale, and Quick Disabilities of the Arms, Shoulder and Hand questionnaire score) before and over 6 months after surgery. However, postoperative joint instability was significantly lower with the intramedullary insetting method, with a significantly shorter length of bone excision of the middle phalanx. This new approach is more beneficial than the conventional approach for preventing postoperative joint instability.
Targeted Muscle Reinnervation for Limb Amputation to Avoid Neuroma and Phantom Limb Pain in Patients Treated at a Pediatric Hospital
Authors: Bjorklund Kim A. , Alexander John , Tulchin-Francis Kirsten , Yanes Natasha S. , Singh Satbir , Valerio Ian , Klingele Kevin , Scharschmidt Thomas
Published: April 2023

Background:

Amputees frequently experience chronic neuroma-related residual limb and phantom limb pain (PLP). Targeted muscle reinnervation (TMR) transfers transected nerves to nearby motor nerves to promote healing and prevent neuroma formation and PLP. The purpose of this study was to report outcomes of TMR in a series of children and young adults treated at a pediatric hospital.

Methods:

Patients undergoing major limb amputation with TMR were included with minimum one year follow-up and completed questionnaires. Primary clinical outcomes included incidence of symptomatic neuromas, PLP, residual limb pain, narcotic use, and neuromodulator use. A follow-up phone survey was conducted assessing five pediatric Patient Reported Outcomes Measurement Information System (PROMIS) metrics adapted to assess residual limb and PLP.

Results:

Nine patients (seven male and two female patients, avg. age = 16.83 ± 7.16 years) were eligible. Average time between surgery and phone follow-up was 21.3 ± 9.8 months. Average PROMIS Pediatric t-scores for measures of pain behavior, interference, quality—affective, and quality—sensory for both PLP and residual limb pain were nearly 1 standard deviation lower than the United States general pediatric population. One patient developed a symptomatic neuroma 1 year after surgery.

Conclusions:

Compared with an adult patient sample reported by Valerio et al, our TMR patients at Nationwide Children’s Hospital (NCH) showed similar PLP PROMIS t-scores in pain behavior (50.1 versus 43.9) and pain interference (40.7 versus 45.6). Both pediatric and adult populations had similar residual limb pain including PROMIS pain behavior (36.7 adult versus 38.6 pediatric) and pain interference (40.7 adult versus 42.7 pediatric). TMR at the time of amputation is feasible, safe, and should be considered in the pediatric population.
Long-Term Benefits of Tear Exchangeable Limbal-Rigid Contact Lens Wear Therapy in Stevens–Johnson Syndrome Cases
Authors: Yoshikawa Yamato , Ueta Mayumi , Kinoshita Shigeru , Kida Teruyo , Sotozono Chie
Published: April 2023

Objectives:

To evaluate the long-term benefits of tear-exchangeable, limbal-rigid contact lens (CL) wear therapy in patients with Stevens–Johnson syndrome (SJS)–associated ocular sequelae.

Methods:

This retrospective study evaluated 50 eyes of 41 SJS patients (15 men and 26 women) who underwent limbal-rigid CL wear therapy for more than 2 years post fitting. Ocular sequelae (i.e., conjunctival hyperemia, corneal neovascularization, and upper tarsus scarring) before fitting and at 3 months, 6 months, 12 months, and annually after initiating CL wear therapy were evaluated and then graded on a severity score (range: 0–3, maximum score: 3). Moreover, visual acuity (VA) at immediately post initiating CL wear therapy was evaluated.

Results:

The mean follow-up period was 4.3±1.1 years. Compared with before fitting, the mean conjunctival hyperemia score improved from 1.14 to 0.86 at 3 months of CL wear therapy (P<0.01) and was maintained thereafter; the mean corneal neovascularization score improved from 2.10 to 1.98 at 3 months of CL wear therapy, with no deterioration of the score observed in all cases at the final follow-up examination, and mean VA (log of minimum angle of resolution) improved from 1.60 to 1.04 at immediately post initiating CL wear therapy (P<0.01).

Conclusions:

Limbal-rigid CL wear therapy can provide long-term ocular surface stabilization and improved VA in SJS patients.
Frequency of Visual Fields Needed to Detect Glaucoma Progression: A Computer Simulation Using Linear Mixed Effects Model
Authors: Sabouri Samaneh , Haem Elham , Masoumpour Masoumeh , Vermeer Koenraad A. , Lemij Hans G. , Yousefi Siamak , Pourahmad Saeedeh
Published: April 2023

Précis:

Irregular visual field test frequency at relatively short intervals initially and longer intervals later on in the disease provided acceptable results in detecting glaucoma progression.

Purpose:

It is challenging to maintain a balance between the frequency of visual field testing and the long-term costs that may result from insufficient treatment of glaucoma patients. This study aims to simulate real-world circumstances of visual field data to determine the optimum follow-up scheme for the timely detection of glaucoma progression using a linear mixed effects model (LMM).

Materials and Methods:

An LMM with random intercept and slope was used to simulate the series of mean deviation sensitivities over time. A cohort study including 277 glaucoma eyes that were followed for 9.0±1.2 years was used to derive residuals. Data were generated from patients with early-stage glaucoma having various regular and irregular follow-up scenarios and different rates of visual field loss. For each condition, 10,000 series of eyes were simulated, and one confirmatory test was conducted to identify progression.

Results:

By doing one confirmatory test, the percentage of incorrect progression detection decreased considerably. The time to detect progression was shorter for eyes with an evenly spaced 4-monthly schedule, particularly in the first 2 years. From then onward, results from twice-a-year testing were similar to results from examinations scheduled 3 times per year.

Conclusions:

Irregular visual field test frequency at relatively short intervals initially and longer intervals later on in the disease provided acceptable results in detecting glaucoma progression. This approach could be considered for improving glaucoma monitoring. Moreover, simulating data using LMM may provide a better estimate of the disease progression time.