bluuebunny/crossref_metadata_2025 huggingface dataset:
Numerical validation of thermal conductivity of Al6061 based hybrid nano metal matrix composite filled with nanoparticles of Ni and Cr
Authors: Kumar Raj , Shringi Dinesh , Bairwa Kedar Narayan
Published: November 2021

Aluminum composite matrix materials are regarded as the most popular type of composite materials. Metal matrix composites made of aluminum have better mechanical and thermal properties, including a higher strength-to-weight ratio, tensile strength, hardness, and a low coefficient of thermal expansion. In various types of applications viz, automobile, aviation, the thermal characterization of aluminum metal matrix composites has increased. Thermal conductivity as a function of temperature, thermal diffusivity, and the thermal gradient is one of the essential thermal characteristics of aluminum metal matrix composites needed to understand the material’s behavior. The current work evaluated thermal conductivity as a product of thermal diffusivity, density, and specific heat for Al6061/Ni/Cr hybrid nano metal matrix composites from 50 °C to 300 °C. Al6061 based metal matrix composite reinforced with varying wt.% of Ni and Cr nanoparticles whereas fixed wt.% of graphene and Mg added to improve thermal conductivity, self-lubrication, and wettability. Thermal diffusivity, specific heat, and density were evaluated using laser flash apparatus (LFA 447), differential scanning calorimetry (DSC), and Archimedes principle, respectively. Results revealed that the thermal conductivity of fabricated composites increases with Ni, Cr, Mg, and graphene nanoparticles. With further expansion of reinforced particles of Ni and Cr, the thermal conductivity decreases. Finite element analysis (FEA) has been conducted to determine the thermal gradient and thermal flux using experimental values such as density, thermal conductivity, specific heat, and enthalpy at various temperature ranges to validate the experimental results.
National and regional waste stream in the United States: conformance and disparity
Authors: Kumar Vikram , Garg Nishant
Published: November 2021

Accurate estimation of municipal solid waste (MSW) composition is critical for efficient waste management. In the United States, site-specific and material flow approaches determine the MSW composition at regional and national levels. The material flow-based national estimates are determined by the US EPA; the US EPA’s estimates are known to differ substantially from the aggregated tonnage of MSW managed by waste handling facilities in the United States. However, the material class-specific discrepancies of the US EPA’s material flow approach resulting in these differences are unknown. To find the basis of these discrepancies, we analyze the discarded MSW stream of 27 US states, which roughly accounts for 73 percent of the US population. Our analysis indicates that the material flow-based national estimates are accurate for the food, plastic, and glass material classes. In contrast, we find that the US EPA’s material flow-based predictions underestimate paper waste disposal by at least 15 million tons annually. These differences likely stem from incorrect assumptions of residence time. These results highlight the material class-specific strengths and drawbacks of the US EPA’s material flow-based MSW estimates.
A distribution function from population genetics statistics using Stirling numbers of the first kind: Asymptotics, inversion and numerical evaluation
Authors: Chen Swaine , Temme Nico
Published: November 2021

Stirling numbers of the first kind are common in number theory and combinatorics; through Ewen’s sampling formula, these numbers enter into the calculation of several population genetics statistics, such as Fu’s

F
s

F_s

. In previous papers we have considered an asymptotic estimator for a finite sum of Stirling numbers, which enables rapid and accurate calculation of Fu’s

F
s

F_s

. These sums can also be viewed as cumulative distribution functions, leading directly to the possibility of an inversion function, where, given a value for Fu’s

F
s

F_s

, the goal is to solve for one of the input parameters. We solve this inversion using Newton iteration for small parameters. For large parameters, we have to extend our earlier obtained asymptotic results to solve the inversion problem asymptotically. Numerical experiments are given to show the efficiency of both solving the inversion problem and the expanded asymptotic estimator for sums of Stirling numbers.
How a first research experience had an impact on my scientific journey
Authors: De Camilli Pietro
Published: November 2021

As I look back to my scientific trajectory on the occasion of being the recipient of the E. B. Wilson Medal of the American Society for Cell Biology, I realize how much an early scientific experience had an impact on my research many years later. The major influence that the first scientific encounters can have in defining a scientist’s path makes the choice of the training environment so important for a future career.
The two-hit theory hits 50
Authors: Chernoff Jonathan
Published: November 2021

Few ideas in cancer genetics have been as influential as the “two-hit” theory of tumor suppressors. This idea was introduced in 1971 by Al Knudson in a paper in the Proceedings of the National Academy of Science and forms the basis for our current understanding of the role of mutations in cancer. In this theoretical discussion proposing a genetic basis for retinoblastoma, a childhood cancer of the retina, Knudson posited that these tumors arise from two inactivating mutations, targeting both alleles of a putative tumor suppressor gene. While this work built on earlier proposals that cancers are the result of mutations in more than one gene, it was the first to propose a plausible mechanism by which single genes that are affected by germ-line mutations in heritable cancers could also cause spontaneous, nonheritable tumors when mutated in somatic tissues. Remarkably, Knudson described the existence and properties of a retinoblastoma tumor suppressor gene a full 15 years before the gene was cloned.
The story of science: successes, failures, luck, privilege, and bias
Authors: Ananthanarayanan Vaishnavi
Published: November 2021

I am incredibly honored to receive the 2021 WICB Junior Award for Excellence in Research in WICB’s golden jubilee year. In this essay, I traverse my scientific journey starting with my PhD, highlighting the highs and the lows and how these intersect with luck, privilege, and bias.
2-Methylthio-N7-methyl-cis-zeatin, a new antimalarial natural product isolated from a Streptomyces culture
Authors: Lopez Julius Adam V , Nogawa Toshihiko , Yoshida Kazuko , Futamura Yushi , Osada Hiroyuki
Published: November 2021

2-Methylthio-N7-methyl-cis-zeatin (1) was isolated from the culture broth of Streptomyces sp. 80H647 along with 2 known purine derivatives, 5′-methylthioinosine (2) and AT-265 (dealanylascamycin, 3). The structure elucidation of compound 1 was accomplished by high-resolution mass spectrometry (HRMS) and nuclear magnetic resonance (NMR) analyses. It inhibited the growth of Plasmodium falciparum 3D7 with a GI50 of 2.4 µm and had no effect on the growth of Arabidopsis at 2 µm. This is the first report of an N7-methylated zeatin-type natural product from Streptomyces and as an antimalarial compound.
Influence of Neighborhood Competition on Douglas-Fir Growth Is Not Altered by Local Environmental Conditions and Climate
Authors: Puettmann Klaus J , Ganio Lisa M , Woodruff David , Morgan Bryn
Published: November 2021

To evaluate impacts of competitive conditions in tree neighborhoods on growth responses as influenced by moisture availability and local environmental conditions, we sampled 102 codominant 40- to 70-year-old coastal Douglas-fir (Pseudotsuga menziesii [Mirb.] Franco) in regions with relatively high and low moisture availability. We quantified local environmental conditions (topographic position index, heat load, and soil depth), and the annual basal area increment and climate moisture deficits during two growth periods: a five-year period prior to commercial thinning and years six to 10 after thinning. In both regions and growth periods, tree growth was higher for trees growing in local neighborhoods with lower competition. The density/growth relationships differed by region and by growth period in the moist regions, but they were not influenced by climate moisture deficit. Furthermore, including topographic position index, heat load, or soil depth did not improve model support. Our results highlight the importance of managing local competition and indicate that environmental factors such as soil depth, heat load, and topography may be less likely to warrant consideration when developing thinning prescriptions. This could allow foresters to accommodate other ecosystem services when designing density management treatments, at least within typical growing conditions.
Genetic parameter estimates for feet and leg traits in Red Angus cattle
Authors: Giess Lane K , Jensen Brady R , Bormann Jennifer M , Rolf Megan M , Weaber Robert L
Published: November 2021

The objective of this study was to estimate genetic parameters for feet and leg traits, relationships within feet and leg traits, and relationships between feet and leg traits and production traits in Red Angus cattle. Subjective scores for 14 traits including body condition score (BCS), front hoof angle (FHA), front heel depth (FHD), front claw shape (FCS), rear hoof angle (RHA), rear heel depth (RHD), rear claw shape (RCS), size of hoof (SIZE), front side view (FSV), knee orientation (KNEE), front hoof orientation (FHO), rear side view (RSV), rear view (RV), and a composite score (COMP) were collected by trained evaluators on 1,720 Red Angus cattle. All traits except COMP were scored as intermediate optimum traits. Performance data, and EPD were obtained on all animals measured and a three-generation pedigree was obtained from the Red Angus Association of America (RAAA) that contained 13,306 animals. Data were modeled using a linear bivariate animal model with random additive genetic and residual effects, and fixed effects of age and contemporary group (herd-year) implemented in ASREML 4.0. Heritability estimates of BCS, FHA, FHD, FCS, RHA, RHD, RCS, SIZE, FSV, KNEE, FHO, RSV, RV, and COMP were 0.11, 0.20, 0.17, 0.09, 0.19, 0.25, 0.17, 0.36, 0.16, 0.17, 0.17, 0.30, 0.14, and 0.12, respectively. These results demonstrate feet and leg traits are lowly to moderately heritable. Strong, positive genetic correlations were observed between FHA and FHD (0.89), FHA and RHA (0.88), FHD and RHA (0.85), FHA and RHD (0.85), FHD and RHD (0.94), and FHO and KNEE (0.95), indicating these traits were highly related to each other. Strong and negative genetic correlations were observed between KNEE and FSV (−0.59) and FHO and FSV (−0.75). The strongest Pearson correlation between front limb traits (FHA, FHD, FSV, FHO, KNEE, and COMP) and Stayability EPD (STAY) was FSV (r = 0.16) and for rear limb traits (RHA, RHD, RCS, RSV, RV, and COMP) and STAY was RCS (r = −0.12). This suggests cattle with more slope to the angle of the shoulder and cattle with less evidence of hoof curl may stay in the herd longer. Further investigation into the economic viability of feet and leg trait genetic prediction with a larger population of animals is required to help validate these findings.
Effect of COVID-19 pandemic on hip preservation surgery—a prospective surveillance from the UK Non-Arthroplasty Hip Registry
Authors: Bhargava Kartik , Bhandari Farzaan , Board Tim , Andrade Tony , McBryde Callum , Conroy Jon , Bankes Marcus , Khanduja Vikas , Malviya Ajay
Published: November 2021

A multi-centre, registry-based cohort study was conducted to assess the effect of the coronavirus disease 2019 (COVID-19) pandemic on the provision of non-arthroplasty hip surgery (NAHS) in the UK by (i) comparing the number of NAHS performed during the pandemic to pre-pandemic levels, (ii) prospectively auditing compliance to established guidance and (iii) evaluating post-operative outcomes and their predictors. Patients who underwent NAHS during the pandemic/pre-pandemic were selected from the Non-Arthroplasty Hip Registry, which collects demographic, procedural and pre-operative outcome data. Patients during the pandemic period were emailed separate COVID-19 surveillance questionnaires, which evaluated adherence to guidelines and post-operative outcomes. Fisher’s exact tests and logistic regression were used to identify predictors for developing COVID-19 and being re-admitted into hospital, post-surgery. There was a 64% reduction of NAHS performed during the pandemic compared to the pre-pandemic period. Ninety-nine percent of participants self-isolated, and 96.8% received screening, pre-operatively. No participant was COVID-19-positive peri-operatively. Post-operatively, participants had an intensive care unit admission rate of 2%, median hospital stay of 1 day, hospital readmission rate of 4.2%, COVID-19 development rate of 2.3% and a thromboembolic complication rate of 0.32%. No COVID-19-positive patient developed adverse post-operative outcomes. Participants who developed COVID-19 post-operatively had greater odds of having undergone osteotomy in comparison to arthroscopic surgery (P = 0.036, odds ratio = 5.36). NAHS was performed with good compliance to established guidance, and adverse operative outcomes remained low. If guidance is followed, the risk of COVID-19 post-op development is low. Although bigger operations have a slightly higher risk, this does not impact their prognosis.
Use of Cervid Serosurveys to Monitor Eastern Equine Encephalitis Virus Activity in Northern New England, United States, 2009–2017
Authors: Mutebi John-Paul , Mathewson Abigail A , Elias Susan P , Robinson Sara , Graham Alan C , Casey Patti , Lubelczyk Charles B
Published: November 2021

Vertebrate surveillance for eastern equine encephalitis virus (EEEV) activity usually focuses on three types of vertebrates: horses, passerine birds, and sentinel chicken flocks. However, there is a variety of wild vertebrates that are exposed to EEEV infections and can be used to track EEEV activity. In 2009, we initiated a pilot study in northern New England, United States, to evaluate the effectiveness of using wild cervids (free-ranging white-tailed deer and moose) as spatial sentinels for EEEV activity. In Maine, New Hampshire, and Vermont during 2009–2017, we collected blood samples from hunter-harvested cervids at tagging stations and obtained harvest location information from hunters. U.S. Centers for Disease Control and Prevention processed the samples for EEEV antibodies using plaque reduction neutralization tests (PRNTs). We detected EEEV antibodies in 6 to 17% of cervid samples in the different states and mapped cervid EEEV seropositivity in northern New England. EEEV antibody-positive cervids were the first detections of EEEV activity in the state of Vermont, in northern Maine, and northern New Hampshire. Our key result was the detection of the antibodies in areas far outside the extent of documented wild bird, mosquito, human case, or veterinary case reports of EEEV activity in Maine, New Hampshire, and Vermont. These findings showed that cervid (deer and moose) serosurveys can be used to characterize the geographic extent of EEEV activity, especially in areas with low EEEV activity or with little or no EEEV surveillance. Cervid EEEV serosurveys can be a useful tool for mapping EEEV activity in areas of North America in addition to northern New England.
Eastern Equine Encephalomyelitis in Michigan: Historical Review of Equine, Human, and Wildlife Involvement, Epidemiology, Vector Associations, and Factors Contributing to Endemicity
Authors: Stobierski Mary Grace , Signs Kimberly , Dinh Emily , Cooley Thomas M , Melotti Julie , Schalow Michele , Patterson Jon S , Bolin Steven R , Walker Edward D
Published: November 2021

Eastern equine encephalomyelitis (EEE) is a mosquito-borne viral disease that is an emerging public health concern in the state of Michigan. Although Michigan has one of the highest incidence rates of EEE in the United States, much of the information known about cases in humans, equines, and other animals residing in Michigan is unpublished. This article summarizes such information and explores spatial trends in the historic distribution of EEE in Michigan. Outbreaks in Michigan have occurred over an 80-yr interval, involving only horses in 1942–1943 and 1973–1976, and then episodically from 1980 to 2020, and involving horses, humans, and wild and domestic animals. An estimated 1,036 equine cases (confirmed and suspected) and 36 confirmed human cases have occurred, including 10 in 2019 (6 deaths) and 4 in 2020 (2 deaths). Human cases ranged in age from 1 to 81 yr; 70% were male, and fatality rate of 34.3%. Equine and human cases occurred from July to October, peaked in August, and cluster in space in southwestern and southeastern lower Michigan. Cases occurred in glacial outwash and ice-contact landscapes in glacial interlobate zones. EEE virus (EEEV) was recovered from Culiseta melanura, Coquillettidia perturbans, five species of Aedes, and other mosquito species near horse and human case sites. Virus isolations or presence of neutralizing antibodies in several passerine species of birds suggest broad EEEV–bird associations. White-tailed deer and other wildlife were also affected. Geographic spread to northern areas of the state suggests expansion of this disease system into new and unsuspected foci.
Addressing the transition to a chronic condition: exploring independent adoption of self-management by patients with ANCA-associated vasculitis
Authors: Litchfield Ian , Greenfield Sheila , Harper Lorraine ,   the FAB(V) Trial team
Published: November 2021

Objective

Improvements in care have led to the recognition of ANCA-associated vasculitis (AAV) as a chronic condition; however, the self-management strategies considered a crucial component of the care model for patients with more prevalent chronic conditions are yet to be integrated formally into the treatment of AAV patients. The aim of the work we present here is to identify those self-management processes and tasks already being adopted by patients with AAV to help inform existing care and the development of a structured self-management programme.

Methods

We conducted a series of focus groups and semi-structured interviews with AAV patients, collating the data and performing a post hoc deductive analysis based on a consolidated framework of self-management processes.

Results

Despite the unique attributes and demands of AAV, patients adopted self-management behaviours previously identified and supported in patients with more prevalent chronic diseases. They accessed information on their disease proactively and learnt to mitigate their symptoms and side-effects. They pursued a range of health-promotion activities and accessed support from their social network and beyond and, ultimately, learnt to integrate the condition into their everyday life.

Conclusion

Our work has highlighted some key areas of self-management that might be addressed usefully and immediately, including the provision of more consistent information relating to evolving symptoms and side-effects, additional support in accessing both appropriate care and community-based resources, and the use of interventions to bolster resilience. Our findings will inform the development of a tailored self-management programme, but in the meantime provide a more contemporary context for current clinician–patient conversations.
Influence of Flagellin Polymorphisms, Gene Regulation, and Responsive Memory on the Motility of Xanthomonas Species That Cause Bacterial Spot Disease of Solanaceous Plants
Authors: Malvino Maria L. , Bott Amie J. , Green Cory E. , Majumdar Tanvi , Hind Sarah R.
Published: November 2021

Increasingly, new evidence has demonstrated variability in the epitope regions of bacterial flagellin, including in regions harboring the microbe-associated molecular patterns flg22 and flgII-28 that are recognized by the pattern recognition receptors FLS2 and FLS3, respectively. Additionally, because bacterial motility is known to contribute to pathogen virulence and chemotaxis, reductions in or loss of motility can significantly reduce bacterial fitness. In this study, we determined that variations in flg22 and flgII-28 epitopes allow some but not all Xanthomonas spp. to evade both FLS2- and FLS3-mediated oxidative burst responses. We observed variation in the motility for many isolates, regardless of their flagellin sequence. Instead, we determined that past growth conditions may have a significant impact on the motility status of isolates, because we could minimize this variability by inducing motility using chemoattractant assays. Additionally, motility could be significantly suppressed under nutrient-limited conditions, and bacteria could “remember” its prior motility status after storage at ultracold temperatures. Finally, we observed larger bacterial populations of strains with flagellin variants predicted not to be recognized by either FLS2 or FLS3, suggesting that these bacteria can evade flagellin recognition in tomato plants. Although some flagellin variants may impart altered motility and differential recognition by the host immune system, external growth parameters and gene expression regulation appear to have more significant impacts on the motility phenotypes for these Xanthomonas spp.

[Formula: see text] Copyright © 2022 The Author(s). This is an open access article distributed under the CC BY 4.0 International license .
Current State and Future Direction of Postpartum Hemorrhage Risk Assessment
Authors: Ende Holly B. , Butwick Alexander J.
Published: November 2021

In the United States, postpartum hemorrhage is a leading preventable cause of maternal mortality and morbidity. To reduce morbidity from postpartum hemorrhage, risk assessment is an important starting point for informing decisions about risk management and hemorrhage prevention. Current perinatal care guidelines from the Joint Commission recommend that all patients undergo postpartum hemorrhage risk assessment at admission and after delivery. Three maternal health organizations—the California Maternal Quality Care Collaborative, AWHONN, and the American College of Obstetricians and Gynecologists’ Safe Motherhood Initiative—have developed postpartum hemorrhage risk-assessment tools for clinical use. Based on the presence of risk factors, each organization categorizes patients as low-, medium-, or high-risk, and ties pretransfusion testing recommendations to these categorizations. However, the accuracy of these tools' risk categorizations has come under increasing scrutiny. Given their low positive predictive value, the value proposition of pretransfusion testing in all patients classified as medium- and high-risk is low. Further, 40% of all postpartum hemorrhage events occur in low-risk patients, emphasizing the need for early vigilance and treatment regardless of categorization. We recommend that maternal health organizations consider alternatives to category-based risk tools for evaluating postpartum hemorrhage risk before delivery.
A Fluid-Management Drape for Hysteroscopy
Authors: Marshburn Paul B. , Anderson-Montoya Brittany L. , Baek Sally , Zhao Jing , Franco Cecilia H. , Deneault Lindsay M. , Hansen-Lindner Leslie , Matthews Michelle L. , Usadi Rebecca S. , Coddington Charles C. , Woolworth Melissa B. , Hurst Bradley S.
Published: November 2021

BACKGROUND:

Hysteroscopy requires accurate collection of unabsorbed distension media to measure patient fluid absorption. We assessed the effectiveness and usability of a novel total capture drape compared with a standard drape during hysteroscopy.

METHOD:

Simulation trials were followed by an early-phase study to compare fluid-capture efficiency and measures of drape usability during hysteroscopy randomizing the total capture drape compared with a standard drape.

EXPERIENCE:

Simulation trials indicated complete collection of unabsorbed fluid with the total capture drape and progressive loss of unabsorbed fluid with the standard drape. An early-phase study with 68 women found no statistical difference between groups for the hysteroscopic fluid deficit, but saw fewer cases with lost fluid in the total capture drape compared with the standard drape. Direct observation and focus group data indicated a trend for better capture of unabsorbed fluid with the total capture drape, along with increased usability once surgeons became familiar with correct placement.

CONCLUSION:

Simulation and early-phase study results are favorable for the total capture drape, demonstrating comparable fluid collection with the standard drape. With repeated use and in-service training, surgeons expressed greater confidence in the accuracy of the hysteroscopic fluid deficit with the total capture drape compared with the standard drape. Design modifications should improve overall usability and fluid-capture efficiency.
Minimally Invasive Compared With Open Hysterectomy in High-Risk Endometrial Cancer
Authors: Segarra-Vidal Blanca , Dinoi Giorgia , Zorrilla-Vaca Andres , Mariani Andrea , Student Vladimir , Garcia Nuria Agustí , Llueca Abella Antonio , Ramirez Pedro T.
Published: November 2021

OBJECTIVE:

To compare disease-free survival between minimally invasive surgery and open surgery in patients with high-risk endometrial cancer.

METHODS:

We conducted a multicentric, propensity-matched study of patients with high-risk endometrial cancer who underwent hysterectomy, bilateral salpingo-oophorectomy, and staging between January 1999 and June 2016 at two centers. High-risk endometrial cancer included grade 3 endometrioid, serous, clear cell, undifferentiated carcinoma or carcinosarcoma with any myometrial invasion. Patients were categorized a priori into two groups based on surgical approach, propensity scores were calculated based on potential confounders and groups were matched 1:1 using nearest neighbor technique. Cox hazard regression analysis and Kaplan-Meier curves evaluated the association of surgical technique with survival.

RESULTS:

Of 626 eligible patients, 263 (42%) underwent minimally invasive surgery and 363 (58%) underwent open surgery. In the matched cohort, there were no differences in disease-free survival rates at 5 years between open (53.4% [95% CI 45.6–60.5%]) and minimally invasive surgery (54.6% [95% CI 46.6–61.8]; P=.82). Minimally invasive surgery was not associated with worse disease-free survival (hazard ratio [HR] 0.85, 95% CI 0.63–1.16; P=.30), overall survival (HR 1.04, 95% CI 0.73–1.48, P=.81), or recurrence rate (HR 0.99; 95% CI 0.69–1.44; P=.99) compared with open surgery. Use of uterine manipulator was not associated with worse disease-free survival (HR 1.01, 95% CI 0.65–1.58, P=.96), overall survival (HR 1.18, 95% CI 0.71–1.96, P=.53), or recurrence rate (HR 1.12, 95% CI 0.67–1.87; P=.66).

CONCLUSION:

There was no difference in oncologic outcomes comparing minimally invasive and open surgery among patients with high-risk endometrial cancer.
Necrobiosis Lipoidica following Breast Reduction
Authors: Absil Gilles , Collins Patrick , El Hayderi Lara , Nikkels Arjen F.
Published: November 2021

Necrobiosis lipoidica (NL) is a rare granulomatous skin disorder of unknown physiopathology that is frequently associated with diabetes mellitus. The typical skin lesions of NL present as chronic, bilateral, well-defined red to yellow-brown plaques with telangectasias, a violaceous border and a waxy atrophic center. The lower legs are the most often involved areas, but NL may exceptionally develop on scar tissue following surgery. The treatment is very challenging and notoriously difficult. We report a 60-year-old diabetic woman who developed NL all along the surgical scars following breast reduction, without presenting NL on the lower legs. NL should be considered among the rare but possible skin healing complications of surgery.
Failure of Miniplate Fixation in a Fracture of the Mandibular Coronoid Process
Authors: Hwang Kun , Hwan Ma Sung
Published: November 2021

Mandibular coronoid fractures are mainly the result of motor vehicle accidents, followed by assaults and falls. We report a case of failure of miniplate fixation in a coronoid fracture. A 57-year-old man fell onto his face from a 3-m height. Panoramic radiography and computed tomography confirmed a right tripod fracture, a LeFort I fracture, and a right coronoid process fracture. On day 6 posttrauma, open reduction and miniplate fixation were performed. Instead of performing intermaxillary fixation, we recommended consumption of a soft diet for at least 1 month. On postoperative day 30, while opening his mouth to eat, the patient felt a strange sensation in his right cheek and heard a clicking sound. He then began to feel pain and had difficulty chewing. On postoperative day 40, follow-up panoramic radiography revealed breakdown of the previously fixed miniplate. Pain and difficulty chewing continued, and coronoidectomy and plate removal were performed at 18 months postoperatively. It is thought that a miniplate large enough to withstand the pull of the temporalis muscle should not be applied to a fractured coronoid process due to the shallow anterior border of the coronoid process. Although the patient’s quality of life, feeding and oral hygiene care are a big burden of care in postoperative intermaxillary fixation, rigid internal fixation and intermaxillary fixation for at least 1 month are recommended in patients with significant displacement of a fractured coronoid process or limited mouth opening.
Evaluation of Predictive Values of an Automatic Device Measuring Oximetry in Free Flaps
Authors: Rendón-Medina Marco Aurelio , Galeana-Pavón Alberto , Vázquez-Medina Martín Uriel , Hernández-Ordoñez Rubén , Ocharan-Hernández María Esther , Hanson-Viana Erik , Sashida-Mendez Hirosi , Mendoza-Vélez María de los Ángeles , Pacheco-López Ricardo César
Published: November 2021

Free-flap monitoring is challenging to perform in some centers. It requires the availability of trained health care personnel for 24 hours a day and seven days a week. Many methods had been proposed for flap monitoring, and none of them are superior to clinical evaluation. This study aimed to present a murine model to evaluate the accuracy (sensitivity, specificity, and the positive or negative predictive values) of a device. Wistar rats weighing 240–490 g were included for intervention and data collection. A murine model of left inferior epigastric vessel flaps was implemented. Intermittent pedicle clamping was performed to calculate the accuracy of the device that detects flow obstruction. The general variables studied were age, weight, and gender. The sensitivity, specificity, and negative or predictive values were calculated. The results showed a sensitivity of 97%, a specificity of 95% with a positive predictive value of 95%, and negative predictive value of 97%. The sensitivity and specificity showed excellent results within the range of clinical security. We require more data to analyze the multiparameter monitoring to see if it is feasible and cost-effective.
Total Maxillectomy and Free Flap Reconstruction in Hemodialysis Patients: Report of Two Cases
Authors: Fujisawa Kou , Miyamoto Shimpei , Saito Yuki , Fukuoka Osamu , Okazaki Mutsumi
Published: November 2021

Currently, an increasing number of patients are undergoing hemodialysis. However, little is known regarding the outcome or perioperative management of head and neck cancer reconstruction in patients undergoing hemodialysis. Here, we report two cases of patients with maxillary squamous cell carcinoma undergoing hemodialysis. The patients underwent total maxillectomy and free abdominal flap transfer. A short-thread double-needle was used in one patient because arterial calcification and intimal dissection were observed during microvascular anastomosis. Maintenance hemodialysis was performed the day before and after the surgery. Nafamostat mesylate, an ultra-short acting anticoagulant, was used in the postoperative hemodialysis for 2–3 weeks to prevent bleeding. The flaps survived completely, and no major postoperative complications occurred in either case. One patient showed no evidence of disease at 1 year following the surgery, whereas the other patient died of cancer metastasis 6 months following the surgery. Although further standardization of perioperative hemodialysis management is needed, free flap reconstruction could be considered a safe and effective therapeutic strategy for patients with head and neck cancer undergoing hemodialysis.
Dermatological Changes in Patient With Infective Endocarditis
Authors: Armstrong Brittney , Chance Kasey , Simpler Brandy , Wyckoff Elizabeth
Published: November 2021

This is a case study of a 69-year-old man who presented with fever of unknown origin, nausea, vomiting and diarrhea, confusion, and expressive aphasia with multiple dermatological abnormalities, including Osler nodes, Janeway lesions, petechia on conjunctiva of eyes, and splinter hemorrhages underneath the nails. After further assessment, the patient was diagnosed with infective endocarditis.
COVID-19 Associated With Encephalitis
Authors: Meshref Mostafa , Hewila Ibrahim M. , Abdel Mageed Sarah , Morra Mostafa E.
Published: November 2021

Introduction:

Neurological problems may be part of severe and early course of coronavirus disease 2019 (COVID-19). COVID-19 associated encephalitis as an evident etiology of altered consciousness has been rarely reported in the literature.

Case Report:

A case of 66-year-old female presented with classic COVID-19 symptoms and associated diabetic ketoacidosis. Although diabetic ketoacidosis was managed, the patient had persistent impaired level of consciousness with recurrent attacks of left focal fits because of COVID-19-associated encephalitis. However, the patient has markedly improved after recovering from COVID-19.

Conclusion:

Neurologists should be involved in the evaluation and management of COVID-19 patients who present with associated neurological problems.
The Effect of Orthognathic Surgery on Changes in Masticatory Muscle Volume in Patients With Facial Asymmetry
Authors: Eo Pil Seon , Park Tae Hyun , Ryu Jeong Yeop , Lee Joon Seok , Yang Jung Dug , Chung Ho Yun , Cho Byung Chae , Choi Kang Young
Published: November 2021

The masseter muscle changes remarkably with orthognathic surgery and has a marked influence on the contours of the lower face. If the postoperative volume change of masticatory muscles, including the masseter muscles, can be predicted, it will facilitate preoperative planning and outcome prediction. This study investigated the association of masticatory muscle volume according to the presence or absence of facial asymmetry, and evaluated whether the volume of masticatory muscles, including that of the masseter muscle, changes after orthognathic surgery in facial asymmetry patients.

Twenty patients who underwent LeFort I osteotomy and bilateral sagittal segmentation ramus osteotomy (BSSRO) with facial asymmetry between 2011 and 2017 were assigned to the asymmetric group. Additionally, 207 patients with a simple nasal fracture between 2016 and 2019 were included as the common group. Threedimensional computed tomography images were retrospectively analyzed and compared between the asymmetric group and common group.

The volume of both temporal and masseter muscles differed according to facial asymmetry, with the asymmetry in the muscle volume increasing in proportion to the degree of facial asymmetry. The difference in masseter volume on the shortened and lengthened sides was significantly reduced after orthognathic surgery, but a difference of about 1 cm3 remained. Additionally, the masticatory muscle volume on the lengthened side tended to be decreased more than that on the shortened side.

Consideration of the postoperative change in the volume of the masticatory muscles may be helpful in planning orthognathic surgery in facial asymmetry patients.
Craniosynostosis Surgery for Increased Intracranial Pressure
Authors: Still Megan E.H. , Chidarala Shreya , Alvarado Abraham , Neal Dan , Governale Lance , Ching Jessica
Published: November 2021

Introduction:

Craniosynostosis is the premature fusion of 1 or more cranial sutures. The presentation may vary, and there are differing opinions regarding surgical indications and timing. Though increased intracranial pressure (ICP) is a well-established risk of craniosynostosis, its response to treatment is not uniform. This study aims to identify the signs and symptoms indicative of increased ICP that are most likely to improve after craniosynostosis surgery.

Methods:

Pre- and post-operative data were retrospectively collected from patients at our institution with syndromic and non-syndromic craniosynostosis from January 2009 to June 2020. Demographics, symptoms (headache, nausea, emesis, and lethargy), signs (visual disturbances and papilledema), and imaging characteristics (copper beaten changes), if available, were analyzed.

Results:

One hundred fifty-three children with craniosynostosis were identified, and 56 with preoperative symptoms met inclusion criteria. Older age was significantly correlated with the number of symptoms improved postoperatively (P = 0.015). Papilledema, headache, nausea, and irritability (if present preoperatively) were the features most likely to improve after craniosynostosis repair. Optic nerve or disc anomalies, feeding difficulties, seizures, and need for glasses were least likely to improve.

Conclusions:

Older children undergoing craniosynostosis surgery had a greater number of improved symptoms. Classical features of increased ICP were more likely to improve than developmental difficulties and multifactorial causes. These findings may be useful when considering craniosynostosis repair in a symptomatic child.
Combined Drainage and Protocolized Necrosectomy Through a Coaxial Lumen-apposing Metal Stent for Pancreatic Walled-off Necrosis
Authors: Dayyeh Barham K. Abu , Chandrasekhara Vinay , Shah Raj J. , Easler Jeffrey J. , Storm Andrew C. , Topazian Mark , Levy Michael J. , Martin John A. , Petersen Bret T. , Takahashi Naoki , Edmundowicz Steven , Hammad Hazem , Wagh Mihir S. , Wani Sachin , DeWitt John , Bick Benjamin , Gromski Mark , Al Haddad Mohammad , Sherman Stuart , Merchant Ambreen A. , Peetermans Joyce A. , Gjata Ornela , McMullen Edmund , Willingham Field F.
Published: November 2021

Objective:

We evaluated a protocolized endoscopic necrosectomy approach with a lumen-apposing metal stent (LAMS) in patients with large symptomatic walled-off pancreatic necrosis (WON) comprising significant necrotic content, with or without infection.

Summary Background Data:

Randomized trials have shown similar efficacy of endoscopic treatment compared with surgery for infected WON.

Design:

We conducted a regulatory, prospective, multicenter single-arm clinical trial examining the efficacy and safety of endoscopic ultrasound -guided LAMS with protocolized necrosectomy to treat symptomatic WON ≥6 cm in diameter with >30% solid necrosis. After LAMS placement, protocolized WON assessment was conducted and endoscopic necrosectomy was performed for insufficient WON size reduction and persistent symptoms. Patients with radiographic WON resolution to ≤ 3 cm and/or 60-day LAMS indwell had LAMS removal, then 6-month follow-up. Primary endpoints were probability of radiographic resolution by 60 days and procedure-related serious adverse events.

Results:

Forty consecutive patients were enrolled September 2018 to March 2020, of whom 27 (67.5%) were inpatients and 19 (47.5%) had clinical evidence of infection at their index procedure. Mean WON size was 15.0 ± 5.6 cm with mean 53.2% ± 16.7% solid necrosis. Radiographic WON resolution was seen in 97.5% (95% CI, 86.8%, 99.9%) by 60 days, without recurrence in 34 patients with 6-month follow-up data. Mean time to radiographic WON resolution was 34.1 ± 16.8 days. Serious adverse events occurred in 3 patients (7.5%), including sepsis, vancomycin-resistant enterococcal bacteremia and shock, and upper gastrointestinal bleeding. There were no procedure-related deaths.

Conclusions:

Endoscopic ultrasound-guided drainage with protocolized endoscopic necrosectomy to treat large symptomatic or infected walled-off necrotic pancreatic collections was highly effective and safe. Clinicaltrials.-gov no: NCT03525808.
Coiled Coil Crosslinked Alginate Hydrogels Dampen Macrophage-Driven Inflammation
Authors: Clapacs Zain , O’Neill Conor , Shrimali Paresh , Lokhande Giriraj , Files Megan , Kim Darren D. , Gaharwar Akhilesh , Rudra Jai S.
Published: November 2021

Alginate hydrogels are widely used for tissue engineering and regenerative medicine due to their excellent biocompatibility. A facile and commonly used strategy to crosslink alginate is the addition of Ca2+ that leads to hydrogelation. However, extracellular Ca2+ is a secondary messenger in activating inflammasome pathways following physical injury or pathogenic insult leading to persistent inflammation and scaffold rejection. Here we present graft copolymers of charge complementary heterodimeric coiled coil (CC) peptides and alginate that undergo supramolecular self-assembly to form Ca2+ free alginate hydrogels. The formation of heterodimeric CCs was confirmed using circular dichroism spectroscopy and scanning electron microscopy revealed a significant difference in pore size between Ca2+ and CC crosslinked gels. The resulting hydrogels were self-supporting and display shear-thinning and shear-recovery properties. In response to lipopolysaccharide (LPS) stimulation, peritoneal macrophages and bone marrow derived dendritic cells cultured in the CC crosslinked gels exhibited a 10-fold reduction in secretion of the proinflammatory cytokine IL-1β compared to Ca2+ crosslinked gels. A similar respose was also observed in vivo upon peritoneal delivery of Ca2+ or CC crosslinked gels. Analysis of peritoneal lavage showed that macrophages in mice injected with Ca2+ crosslinked gels display a more inflammatory phenotype compared to macrophages from mice injected with CC crosslinked gels. These results suggest that CC peptides by virtue of their tunable sequence-structure-function relationship and mild gelation conditions are promising alternative crosslinkers for alginate and other biopolymer scaffolds used in tissue engineering.
Partial characterization and the evaluation of antimicrobial activities of silver nanoparticles biosynthesized from Cymbopogon citratus leaf extract
Authors: Rakib-Uz-Zaman S M , Muntasir Mohammed Nimeree , Apu Ehsanul Hoque , Mowna Sadrina Afrin , Khanom Mst Gitika , Jahan Shah Saif , Akter Nahid , R. Khan M. Azizur , Shuborna Nadia Sultana , Shams Shahriar Mohd , Khan Kashmery
Published: November 2021

Background

Silver nanoparticles (AgNPs) are toxic to microorganisms and can potentially kill multidrug-resistant bacteria. Nanoparticles can be synthesized in many different ways, such as physical or chemical methods. Recently, it has been found that plant molecules can perform the same reduction reactions necessary for the production of nanoparticles but in a much more efficient way.

Results

Here, green chemistry was employed to synthesize silver nanoparticles using leaf extracts of Cymbopogon citratus. Effects of different parameters such as temperature, pH and volume of plant extract were also tested using their absorbance pattern at different wavelengths. The Surface Plasmon Resonance (SPR) changed with the changes in parameters. Changes in temperature from 20°C to 60°C have changed the highest absorbance from 0.972 to 3.893 with an SPR of 470 nm. At higher pH (11.1), the particles become highly unstable and have irregular shapes and sizes. At lower pH (3.97), the peak shifts to the right, indicating a smaller but unstable compound. We have also investigated the effect of the volume of plant extracts on the reaction time. The sample with the highest amount of plant extract showed the most absorbance with a value of 0.963 at λmax, which was calculated to be 470 nm. The total formation of the AgNPs was observed visually with a color change from yellow to brownish-black. UV-visible spectroscopy was used to monitor the quantitative formation of silver nanoparticles, showing a signature peak in absorbance between 400 and 500 nm. We have estimated the size of the nanoparticles as 47nm by comparing the experimental data with the theoretical value using Mieplot. The biosynthesized silver nanoparticles showed enhanced antibacterial activity against several multidrug-resistant bacteria, determined based on the minimal inhibitory concentration and zone of inhibition.

Conclusion

The findings of this study indicate that an aqueous extract of C. citratus can synthesize silver nanoparticles when silver nitrate is used as a precursor and silver nanoparticles act as antimicrobial properties enhancers. These findings can influence further studies in this field to better understand the properties and applications of nanoparticles.
Age-dependent Effect Imposed by Rotenone Exposure
Authors: Moseley Madeleine C. , Rawls Ashley , Sponsel Valerie M. , Berger Mitchel S. , Abate Adam R. , Lin Chin-Hsing Annie
Published: November 2021

Background

The increasing awareness that environmental exposure may lead to sporadic neurological disorders has implicated rotenone to the etiology of some neurodegenerative diseases. However, the risk associated with rotenone toxicity remains controversial as a limited amount of research has studied its effects on brain health.

Objectives

This work assessed the risk of rotenone exposure to mice of different ages, gender, and duration by examining in vivo effects on brains.

Methods

Using a mouse model, the impact of rotenone exposure was determined by analyzing the cellular phenotype in the murine brain.

Results

Our results highlight the neurological susceptibility to long-term rotenone exposure in younger ages. For such, younger mice exhibit seizures and convulsions, resulting in shorter lifespan. At the cellular level, rotenone exposure specifically alters the migrating neuroblast populations in the dentate gyrus and causes disorganized pyramidal neurons in the CA3 within the hippocampus. Our findings, albeit the absence of transgenerational inheritance, demonstrated age-related outcomes from rotenone exposure.

Discussion

We demonstrated that rotenone exposure specifically influences the population of neuroblasts and pyramidal neurons residing in the hippocampus, a brain region important for learning/memory and associated with convulsive seizure. Our understanding of how exactly rotenone affected region-specific neuronal cells and the molecular mechanism behind exposure risk is still limited. From the perspective of public health, our in vivo study highlights age-related susceptibility to rotenone toxicity. Future investigations in environmental epidemiology should determine whether age and duration of exposure to rotenone in human subjects pertains to the development of seizures or other neurological abnormalities over time.
Proteomic and single-cell transcriptomic dissection of human plasmacytoid dendritic cell response to influenza virus
Authors: Ghanem Mustafa H. , Shih Andrew J. , Khalili Houman , Werth Emily , Chakrabarty Jayanta K. , Brown Lewis M. , Simpfendorfer Kim R. , Gregersen Peter K.
Published: November 2021

Plasmacytoid dendritic cells [pDCs] represent a rare innate immune subset uniquely endowed with the capacity to produce substantial amounts of type-I interferons [IFN-I]. This function of pDCs is critical for effective antiviral defenses and has been implicated in autoimmunity. While IFN-I and select cytokines have been recognized as pDC secreted products, a comprehensive agnostic profiling of the pDC secretome in response to a physiologic stimulus has not been reported. We applied LC-MS/MS to catalogue the repertoire of proteins secreted by pDCs in response to challenge with live influenza H1N1. Additionally, using single-cell RNA-seq [scRNA-seq], we perform multidimensional analyses of pDC transcriptional diversification following stimulation. Our data reveal an abundance of protein species released by pDCs in addition to IFN-I, and evidence highly specialized roles within the pDC population ranging from dedicated cytokine super-producers to cells with APC-like functions. Moreover, dynamic expression of transcription factors and surface markers characterize activated pDC fates.