bluuebunny/crossref_metadata_2025 huggingface dataset:
Neoclassical toroidal plasma viscosity in bounce-transit and drift resonance regimes in tokamaks
Authors: Shaing K.C. , Garcia-Munoz M. , Viezzer E.
Published: January 2023

Neoclassical toroidal plasma viscosity in the bounce-transit and drift resonance regimes is calculated using a version of the drift kinetic equation that encompasses the physics of the nonlinear trapping and quasilinear plateau regimes in tokamaks. It is demonstrated that the mirror-force like term controls the transition between these two regimes. When the effective collision frequency is larger than the mirroring or the nonlinear bounce frequency, the quasilinear regime prevails; otherwise, the nonlinear trapping regime reigns. The demonstration is accomplished by using the Eulerian approach and is beyond the grasp of the method of the integration along the unperturbed orbit in solving the drift kinetic equation. The neoclassical toroidal plasma viscosity in the quasilinear plateau regime is calculated. Approximate analytic expressions for the neoclassical toroidal plasma viscosity that include the asymptotic limits of the nonlinear trapping and quasilinear regimes are presented to facilitate thermal and energetic alpha particle transport modeling in tokamaks.
AFM characterization of morphological evolution and adhesion properties of ZnO/C nanosheet-modified asphalt under UV irradiation
Authors: Ding Yanhuai , Zhang Shuangshuang , Luo Xinrui , Zhou Ji
Published: January 2023

As an organic material, asphalt is vulnerable to ultraviolet (UV) irradiation. The effect of UV aging on physical properties has been intensively studied. In this study, large ZnO/C nanosheets were employed to shield asphalt from UV irradiation and delay the deterioration of its natural properties. The evolution of the morphology and adhesion properties of the ZnO/C nanosheet-modified asphalt material at the nanoscale was characterized by atomic force microscopy (AFM). The results show that the ZnO/C nanosheet-modified asphalt behaves differently from raw asphalt. The increase in the number of flaws can be suppressed by the addition of ZnO/C nanosheets, and the change in the adhesion properties caused by UV irradiation can also be hampered.
The effect of TiO2concentration on morphology, wear and corrosion properties of NiB-TiO2composite coatings by ultrasonic-assisted pulse electrodeposition
Authors: Gül Harun
Published: January 2023

In this study, TiO2particle reinforced NiB alloy matrix composite coatings were produced on steel substrates by using a modified Watts type bath with ultrasonic-assisted pulse electrodeposition (UAPED) method. The average particle size of the TiO2particles used in the composite coating is 500 nm, and the effect of different particle concentrations (0, 5, 10, 15 and 20 g l−1) on mechanical and electrochemical properties was investigated. The produced NiB alloy and NiB-TiO2composite coatings were heat treated at 400 °C for 2 h, and the properties of the coatings were compared before and after heat treatment. Microstructure and morphology were characterized by scanning electron microscope (SEM). Phases and structures were determined by x-ray diffraction analysis (XRD), and crystalline size and % distortion were calculated from XRD analysis. The hardness measurements of NiB alloy and NiB-TiO2composite coatings were carried out by microhardness measurement, and the wear tests of composites were carried out by the reciprocating method. Electrochemical measurements of coatings were carried out in 3.5% NaCl solution, and the effect of particle concentration on corrosion behaviour was investigated. The highest hardness value was 1268 HV, and it was obtained at 20 g l−1TiO2concentration and after heat treatment. The lowest crystalline size was obtained 34.4 nm with NiB-TiO2composite coatings. When the wear resistances were compared with NiB-TiO2composites and NiB alloy coating, composite coatings’ wear resistance increased approximately two times with the effect of heat treatment. In addition, when the coatings are evaluated in terms of corrosion behaviour, the best result was obtained in the composite coating produced with 20 g l−1TiO2concentration. Compared to NiB Alloy coating, the corrosion rate of the composite coating produced with 20 g l−1TiO2concentration was reduced from 32.49 mpy to 11.68 mpy. This indicates an improvement of approximately three times in corrosion rate.
Sustainability assessment of public bus transportation sector in westbank, palestine
Authors: Hassouna Fady M A
Published: January 2023

Urban transportation is considered one of the main sources of Greenhouse Gas (GHG) emissions. Therefore, there has been an essential need to develop a sustainable transportation system that could mitigate the environmental impacts by using high-capacity transportations modes, such as public buses. This study has aimed to assess the expected sustainability of the public bus sector in Westbank, Palestine, in case of developing this sector and increasing the number of buses to meet the minimum global requirements (number of buses/1000 population), by developing prediction models for number of buses and passenger cars. Then, the expected reduction in total travelled kilometers by passenger cars has been quantified. After that, the expected reduction in GHG emissions has been determined and the effects on traffic congestion have been investigated. After analyzing the results, the study has concluded that the public bus transport sector in Palestine suffers from the lack of number of buses compared to the number of population, with a value of 0.38 bus/1000 population, which is considered one of the lowest values among the world’s countries. Moreover, by increasing the number of buses to meet the minimum global requirement, there has been a significant expected reduction in CO2 emissions (94,628.56 ton) compared to the total CO2 emissions from other sectors in Palestine, and there has been an expected reduction in traffic congestion up to 5.84%.
Intraseasonal oscillations of the Silk Road pattern lead to predictability in East Asian precipitation patterns and the Mei Yu front
Authors: Muetzelfeldt Mark R , Schiemann Reinhard , Turner Andrew G , Vidale Pier Luigi , Menon Arathy
Published: January 2023

The Silk Road pattern (SRP) is analysed on intraseasonal timescales over summer using empirical orthogonal functions (EOFs) of the meridional wind at 200 hPa. The first two principal components explain almost equal amounts of variance, hence both are required to represent the intraseasonal SRP. The associated spatial loadings are 90° out of phase with each other, providing evidence that propagating oscillations are a natural mode of variability of the intraseasonal SRP. This is supported by Hovmöller diagrams of the meridional wind at 200 hPa and by phase diagrams of the first two EOFs, which both show a predominantly eastward-propagating oscillation. The oscillations are identified as plausibly being Rossby waves by means of waveguide theory. The subtropical westerly jet and East Asian rainfall patterns are found to be dependent on the phase of the oscillation: wet anomalies occur to the east of troughs in the jet, which are also regions where local jet entrances cause upper-level divergence via an ageostrophic circulation. Dry anomalies occur to the west of troughs, which are regions of upper-level convergence. The time-delayed location of the summer Mei Yu front relative to its climatology is dependent on the phase of the oscillation: when there is an upper-level trough located over the Korean Peninsula, the Mei Yu front is likely to be located further north than normal 3–8 days later, before returning to its climatological position. This suggests that the phase of the intraseasonal SRP acts as a potential source of predictability of the location of the Mei Yu front, which might allow for better prediction of the associated rains.
Fractal analysis revealed persistent correlations in long-term vegetation fire data in most South and Southeast Asian countries
Authors: Vadrevu Krishna Prasad
Published: January 2023

Vegetation fires are most common in South/Southeast Asian countries (S/SEA). Characterizing the statistical nature of long-term fire datasets can provide valuable information on fire management. Specifically, distinguishing random noise from correlated noise in long-term signals is critical for linking with the underlying processes. Fractal methods can help to assess long-range correlations in long-term timeseries data. This study tested the daily time-series fire data retrieved from the VIIRS satellite (2012–2021) for fractal behavior. Descriptive statistics and popular Detrended Fluctuation Analysis (DFA) were used to assess fire characteristics and persistent versus non-persistent correlations. Results over South Asia (SA) suggested India with the highest mean fire counts (FC) and the least in Bhutan. Fire radiative power (FRP), an indicator of fire intensity, was highest in India and least in Afghanistan. Among Southeast Asia (SEA), Myanmar had the highest mean FC and FRP and least in Timor Leste. The DFA results revealed the fractal nature of FC in different countries. In SA, FC over India, Nepal, Sri Lanka, Afghanistan, and Bhutan showed persistent correlation behavior, whereas anti-persistence in Bangladesh and Pakistan. In addition, FRP showed anti-persistent behavior in Afghanistan, Bangladesh, and Pakistan and a persistent signal for Bhutan, India, Sri Lanka, and Nepal. In contrast to SA, FC and FRP showed persistent behavior in all SEA countries. The persistent or non-persistence nature of the data can help model fire behavior to aid in management and mitigation efforts.
Koszul Feynman categories
Authors: Kaufmann Ralph , Ward Benjamin
Published: January 2023

A cubical Feynman category, introduced by the authors in previous work, is a category whose functors to a base category

C

\mathcal {C}

behave like operads in

C

\mathcal {C}

. In this note we show that every cubical Feynman category is Koszul. The upshot is an explicit, minimal cofibrant resolution of any cubical Feynman category, which can be used to model

∞
\infty

versions of generalizations of operads for both graph based and non-graph based examples.
Exponentially decaying solutions for models with delayed and advanced arguments: Nonlinear effects in linear differential equations
Authors: Berezansky Leonid , Braverman Elena , Pinelas Sandra
Published: January 2023

We consider a scalar linear mixed differential equation with several terms, both delayed and advanced arguments and a bounded right-hand side. Assuming that the deviations of the argument are bounded, we present sufficient conditions when there exists a unique bounded solution on the positive half-line. Explicit tests for a bounded solution of a homogeneous equation to decay exponentially are obtained. Existence of exponentially decaying solutions for this class of differential equations is studied for the first time, and we illustrate sharpness of the results with examples. We show that the standard approach when convergence of all solutions is stated does not work for mixed equations; in addition to an exponentially decaying, there may be a growing solution. All the coefficients and the mixed arguments are assumed to be Lebesgue measurable functions, not necessarily continuous. Though the equation is linear, some properties, as well as the methods applied, are more typical for nonlinear models, for example, fixed-point theorems are used in the proofs.
Chimeric a-subunit isoforms generate functional yeast V-ATPases with altered regulatory properties in vitro and in vivo
Authors: Tuli Farzana , Kane Patricia M.
Published: January 2023

V-ATPases are highly regulated proton pumps that are localized and regulated by a-subunit isoforms. Chimeric a-subunits containing parts of different isoforms were designed, their interactions with regulators analyzed, and their function under different stresses determined. One chimeric V-ATPase is as active as the wild-type enzyme but shows distinct regulatory properties in responses to stress.
The Oomycete Microbe-Associated Molecular Pattern, Arachidonic Acid, and an Ascophyllum nodosum-Derived Plant Biostimulant Induce Defense Metabolome Remodeling in Tomato
Authors: Lewis Domonique C. , van der Zwan Timo , Richards Andrew , Little Holly , Coaker Gitta L. , Bostock Richard M.
Published: January 2023

Arachidonic acid (AA) is an oomycete-derived microbe-associated molecular pattern (MAMP) capable of eliciting robust defense responses and inducing resistance in plants. Similarly, Ascophylum nodosum extract (ANE) from the brown seaweed A. nodosum, a plant biostimulant that contains AA, can also prime plants for defense against pathogen challenges. A previous parallel study comparing the transcriptomes of AA- and ANE-root-treated tomatoes demonstrated significant overlap in transcriptional profiles, a shared induced resistance phenotype, and changes in the accumulation of various defense-related phytohormones. In this work, untargeted metabolomic analysis via liquid chromatography-mass spectrometry was conducted to investigate the local and systemic metabolome-wide remodeling events elicited by AA and ANE root treatment in tomatoes. Our study demonstrated AA and ANE's capacity to locally and systemically alter the metabolome of tomatoes with enrichment of chemical classes and accumulation of metabolites associated with defense-related secondary metabolism. AA- and ANE-root-treated plants showed enrichment of fatty acyl-glycosides and strong modulation of hydroxycinnamic acids and derivatives. Identification of specific metabolites whose accumulation was affected by AA and ANE treatment revealed shared metabolic changes related to ligno-suberin biosynthesis and the synthesis of phenolic compounds. This study highlights the extensive local and systemic metabolic changes in tomatoes induced by treatment with a fatty acid MAMP and a seaweed-derived plant biostimulant with implications for induced resistance and crop improvement.
Maternal Vaccination and Risk of Hospitalization for Covid-19 Among Infants
Authors: Halasa Natasha B. , Olson Samantha M. , Staat Mary A. , Newhams Margaret M. , Price Ashley M. , Pannaraj Pia S. , Boom Julie A. , Sahni Leila C. , Chiotos Kathleen , Cameron Melissa A. , Bline Katherine E. , Hobbs Charlotte V. , Maddux Aline B. , Coates Bria M. , Michelson Kelly N. , Heidemann Sabrina M. , Irby Katherine , Nofziger Ryan A. , Mack Elizabeth H. , Smallcomb Laura , Schwartz Stephanie P. , Walker Tracie C. , Gertz Shira J. , Schuster Jennifer E. , Kamidani Satoshi , Tarquinio Keiko M. , Bhumbra Samina S. , Maamari Mia , Hume Janet R. , Crandall Hillary , Levy Emily R. , Zinter Matt S. , Bradford Tamara T. , Flori Heidi R. , Cullimore Melissa L. , Kong Michele , Cvijanovich Natalie Z. , Gilboa Suzanne M. , Polen Kara N. , Campbell Angela P. , Randolph Adrienne G. , Patel Manish M.
Published: January 2023

(Abstracted from N Engl J Med 2022;387:109–119)

COVID-19 during pregnancy is associated with a greater risk of adverse pregnancy outcomes and neonatal complications. Studies have shown that mRNA vaccines are highly effective in preventing severe COVID-19 during pregnancy, and the Centers for Disease Control and Prevention recommends vaccination, including boosters, for people who are pregnant or plan to be pregnant.
Association of COVID-19 Vaccination During Early Pregnancy With Risk of Congenital Fetal Anomalies
Authors: Ruderman Rachel S. , Mormol Jessica , Trawick Emma , Perry Madeline F. , Allen Emma C. , Millan Danielle , Miller Emily S.
Published: January 2023

(Abstracted from JAMA Pediatr 2022;176(7):717–719)

COVID-19 infection increases the risk of maternal and neonatal morbidity in the pregnant population. While data suggest that COVID-19 vaccines are safe and effective during pregnancy, the risk to the fetus is unclear.
Obesity in Pregnancy
Authors: Creanga Andreea A. , Catalano Patrick M. , Bateman Brian T.
Published: January 2023

(Abstracted from N Engl J Med 2022;387:248–259)

Obesity poses a significant maternal risk during pregnancy, after delivery, and for long-term health issues. Maternal obesity can also adversely affect outcomes for the fetus, neonate, and child.
Physician Beliefs About Contraceptive Methods as Abortifacients
Authors: Swan Laura E. T. , Cutler Abigail S. , Lands Madison , Schmuhl Nicholas B. , Higgins Jenny A.
Published: January 2023

(Abstracted from Am J Obstet Gynecol 2022; doi: 10.1016/j.ajog.2022.09.039)

Several studies have demonstrated that contraception (including emergency contraception [EC]) does not disrupt an existing pregnancy. Contraceptives prevent pregnancy before fertilization; yet, many individuals who oppose abortion state or believe that contraceptives are abortifacients (ie, substances that cause the termination of an implanted fertilized egg).
Improved Survival in Cervical Cancer Patients Receiving Care at National Cancer Institute–Designated Cancer Centers
Authors: McDaniels-Davidson Corinne , Feng Christine H. , Martinez Maria Elena , Canchola Alison J. , Gomez Scarlett Lin , Nodora Jesse N. , Patel Sandip P. , Mundt Arno J. , Mayadev Jyoti S.
Published: January 2023

(Abstracted from Cancer 2022;128(19):3479–3486)

For a cancer center to receive National Cancer Institute (NCI) designation, it must undergo a rigorous review process and demonstrate comprehensive cancer care and quality. Treatment at an NCI-designated cancer center (NCICC) has been shown to improve survival in lung, breast, gastrointestinal, ovarian, and bladder cancers.
Surgical Resident Perspectives on the Preferred Qualities of Effective Intraoperative Teachers: A Qualitative Analysis
Authors: Collings Amelia T. , Doster Dominique L. , Longtin Krista , Choi Jennifer , Torbeck Laura , Stefanidis Dimitrios
Published: January 2023

Purpose

Intraoperative teaching is a critical component of surgery residents’ education. Although prior studies have investigated best practices from the viewpoint of the expert educator, the perspective of the learner has been less explored. This study examined the ideal faculty teaching behaviors that optimize intraoperative teaching from the surgical residents’ perspective.

Method

Using a grounded theory method, this study explored perspectives on intraoperative faculty teaching qualities of 5 focus groups of categorical clinical general surgical residents of the same postgraduate year from June to August 2021. Focus group discussions were recorded, transcribed, and coded. Emerging themes were identified, along with their corresponding subthemes.

Results

Thirty-nine general surgery residents participated in the focus groups. Overall, 6 themes emerged regarding resident priorities of intraoperative teaching, with 10 subthemes. Themes included the following: (1) character, with subthemes of caring, respect for resident, and self-control; (2) intraoperative skill, with subthemes of clinical and operative skill and modeling leadership in the operating room; (3) instructional approach; (4) feedback, with subthemes of content of feedback and debriefing; (5) discernment of resident needs, with subthemes of managing expectations, individualizing instruction, and autonomy; and (6) variety of teachers.

Conclusions

Certain tangible strategies, such as demonstrating genuine care for the learner, using clear directional words, and giving actionable feedback, were considered vital by residents. In the development of great surgical educators, the emphasis should not be on conformity to a single idealized teaching style but should celebrate and encourage diversity of personas and teaching styles within a department or program.
Measuring Team Hierarchy During High-Stakes Clinical Decision Making: Development and Validation of a New Behavioral Observation Method
Authors: Johansson Anna C. , Manago Bianca , Sell Jane , Jackson Cullen D.
Published: January 2023

Purpose

Hierarchy is often cited as a cause of health care team failure; however, there are no validated measures of team hierarchy. Research on group processes in sociology provides a theoretical framework—status characteristics and expectation states (SCES)—that explains the mechanisms that produce the observable power and prestige order (status hierarchy) of the team. The authors use this formal theoretical framework to gather evidence of validity by adapting the method to measure the status hierarchy of medical teams.

Method

In this retrospective, secondary analysis, the authors analyzed archived videorecorded training exercises conducted between 2007 and 2010 of mixed-gender health care teams of first-year residents and nurses engaged in simulated, complex decision-making scenarios. Analyses were conducted in 2013 with data reanalyzed in July 2022. By adapting the SCES framework for the unique features of academic health care, they developed and refined a coding method from videos and transcripts. To examine validity, they consider the content, response process, internal structure, relation to other variables, and consequences of the framework.

Results

Having established an acceptable level of coding reliability for key variables for videos and transcripts, the authors demonstrate relation to other variables, specifically detailing how the coding scheme delineates 2 status characteristics—occupation and gender. The mean numbers of statement types by gender and occupation were largely as predicted. Directives, question directives, patient work, and knowledge claims were more likely to be coded during video than transcript coding, whereas questions, statements of fact, and compliance were more likely to be coded during transcript than video coding. However, the relative rates of each statement type by status remained largely consistent among the coding methods.

Conclusions

This study provides important insight into the mechanisms by which hierarchy impacts team decision making and develops the necessary framework and measurement tool to perform larger studies.
Hepatitis C Virus Cascade of Care Among Perinatal Patients in Maine Diagnosed With Opioid Use Disorder, 2015–2020
Authors: Pfeiffer Mariah , O'Connor Alane , Zimmerman Caroline , Thakarar Kinna , Ahrens Katherine
Published: January 2023

Objective

This is a quality improvement project to determine the best process to identify and address gaps in care for perinatal patients in receiving appropriate hepatitis C virus (HCV) testing and treatment across the largest health system in Maine.

Study Design

We reviewed electronic medical record data between October 1, 2015, and February 1, 2020, to investigate rates of HCV testing and treatment among 916 perinatal patients with opioid use disorder across 8 hospitals using a “cascade of care” framework, a model used previously to identify gaps in care and treatment of chronic diseases.

Main Outcome Measure

We examined HCV testing and treatment rates along the cascade of care and patient characteristics associated with HCV antibody testing and treatment, separately, using log binomial regression models. Models were adjusted for age, residential distance to medical center, psychiatric diagnosis, and opioid agonist therapy at delivery.

Results

Of pregnant patients eligible for screening, 64% (582/916) received HCV antibody testing. Of 136 patients with active HCV infection, 32% (n = 43) received a referral for treatment, 21% (n = 28) were treated, and 13% (n = 18) achieved sustained virologic response. In the adjusted regression models, only opioid agonist therapy was associated with HCV antibody testing (adjusted risk ratio, 1.31; 95% confidence interval, 1.18–1.46), and no factors were significantly associated with receipt of treatment among HCV viremic patients.

Conclusion

Low referral and treatment rates signify the need for quality improvement interventions to improve coordination of care between multiple disciplines and practice settings to increase access to HCV treatment.
Weight loss and atrial fibrillation: a review
Authors: Tomaiko-Clark Emrie , Husain Farah , Su Wilber
Published: January 2023

Purpose of review

Despite technological advancements in catheter ablation, patients with atrial fibrillation often require multiple ablations, with diminishing returns depending on duration and persistence. Although early ablation is vital, modification of atrial fibrillation disease can be achieved with modification of existing risk factors. Obesity is an important modifiable risk factor, but there does not appear to be a consensus on the best method or goal for weight reduction.

Recent findings

The relationship between atrial fibrillation and obesity has been acknowledged. This review examines the clinical evidence demonstrating the benefit of weight reduction in the management of atrial fibrillation. In particular, this review compares the different approaches of recent studies.

On the basis of the literature, the authors recommend a structured weight loss programme with dietary and behavioural modifications individualized to each patient and including the implementation of physical activity. Consideration of bariatric surgery is appropriate in certain patients with obesity.
Epithelial cell curette: simple solution to epithelial cell removal from small-incision lenticule extraction pocket or LASIK flap
Authors: Agarwal Smita , Thornell Erin
Published: January 2023

Epithelial ingrowth is one of the complications associated with refractive laser surgery. Although treatment is relatively simple following laser in situ keratomileusis (LASIK), the inaccessibility of the pocket makes treatment following small-incision lenticule extraction (SMILE) somewhat difficult. An innovative scraping tool that features a biconcave curette tip allows for the manual removal of epithelial cells from the SMILE pocket without flushing or conversion to a flap. The tool can also be used to remove cells from beneath the LASIK flap without performing a complete relift.
Necrostatin-1 prevents skeletal muscle ischemia reperfusion injury by regulating Bok-mediated apoptosis
Authors: Cao Yu , Wang Hong-Bo , Ni Chun-Jue , Chen Shun-Li , Wang Wan-Tie , Wang Liang-Rong
Published: January 2023

Background:

Receptor interacting serine/threonine kinase 1 (RIPK1) mediates apoptosis by regulating the classic proapoptotic effectors Bcl-2-associated X protein (Bax) and Bcl-2 homologous antagonist/killer (Bak). Although Bcl-2-related ovarian killer (Bok) is structurally similar to Bak and Bax, it is unclear whether it mediates apoptosis in skeletal muscle ischemia reperfusion (IR) injury. We hypothesized that by regulating Bok-mediated apoptosis, inhibiting RIPK1 with necrostatin-1 would reduce skeletal muscle IR injury.

Methods:

Rats were randomized into four groups: sham (SM), IR, IR treated with necrostatin-1 (NI), or vehicle dimethyl sulfoxide (DI). For the IR group, the right femoral artery was clamped for 4 hours and then reperfused for 4 hours, and for the NI and DI groups, necrostatin-1 (1.65 mg/kg) and the equal volume of dimethyl sulfoxide were intraperitoneally administered prior to IR induction. The structural damage of muscle tissue and protein expression of Bok, Bcl-2, and cleaved caspase-3 were investigated, and apoptotic cells were identified with terminal dUTP nick-end labeling (TUNEL) staining. In vitro, human skeletal muscle cells (HSMCs) were exposed to 6 hours of oxygen-glucose deprivation followed by normoxia for 6 hours to establish an oxygen-glucose deprivation/reoxygenation (OGD/R) model. To determine the role of Bok, cell viability, lactate dehydrogenase (LDH) release, and flow cytometry were examined to demonstrate the effects of necrostatin-1 and Bok knockdown on the OGD/R insult of HSMCs.

Results:

Necrostatin-1 pretreatment markedly reduced IR-induced muscle damage and RIPK1, Bok, and cleaved caspase-3 expression, whereas upregualted Bcl-2 expression (p < 0.05). Furthermore, necrostatin-1 prevented mitochondrial damage and decreased TUNEL-positive muscle cells (p < 0.05). In vitro, HSMCs treated with necrostatin-1 showed reduced Bok expression, increased cell viability, and reduced LDH release in response to OGD/R (p < 0.05), and Bok knockdown significantly blunted the OGD/R insult in HSMCs.

Conclusion:

Necrostatin-1 prevents skeletal muscle from IR injury by regulating Bok-mediated apoptosis.
High expression of NLRP12 predicts poor prognosis in patients with intracranial glioma
Authors: Cheng Yu-Wen , Chen Yang-Yi , Lin Chien-Ju , Chen Yi-Ting , Lieu Ann-Shung , Tsai Hung-Pei , Kwan Aij-Lie
Published: January 2023

Background:

Intracranial gliomas are the most common primary central nervous system tumors in humans, and glioblastoma multiforme is the most malignant intracranial glioma. The nucleotide-binding domain leucine-rich repeat (NLR)-containing family are crucial regulators of inflammatory and innate immune responses. NLRP12 codes for the monarch-1 protein, which regulates immune responses in humans. Data from a next-generation sequencing database indicated that NLRP12 expression is increased in glioma cells. However, the relationship between NLRP12 levels and gliomas is unclear.

Methods:

To explore the role of NLRP12-related translation factors and proteins in glioma, we evaluated the clinical data and paraffin sections from glioma patients. The expression of NLRP12 was evaluated using immunohistochemical analysis, and clinical parameters were analyzed using chi-square and Kaplan–Meier survival tests.

Results:

The degree of malignancy and prognosis highly correlated with NLRP12 levels. In addition, the siRNA-mediated downregulation of NLRP12 in glioma cell lines decreased proliferation, invasion, and migration. The levels of VEGF, N-cadherin, and cyclin D1 were downregulated after knockdown of NRLP12 in glioma cell lines, as observed using western blotting in vitro. Knockdown of NLRP12 attenuated the tumor progression in vivo.

Conclusion:

The expression of NLRP12 may be an independent prognostic factor and a potential target for the treatment of intracranial glioma.
Reduced-penetrance Huntington’s disease-causing alleles with 39 CAG trinucleotide repeats could be a genetic factor of amyotrophic lateral sclerosis
Authors: Jih Kang-Yang , Lai Kuan-Lin , Lin Kon-Ping , Liao Yi-Chu , Lee Yi-Chung
Published: January 2023

Background:

Expanded HTT alleles with 40 or more CAG repeats were recently found to be a rare cause of frontotemporal dementia and amyotrophic lateral sclerosis (ALS) spectrum diseases. The aim of this study was to investigate the role of HTT repeat expansions in a Taiwanese cohort with ALS.

Methods:

We analyzed the numbers of CAG repeats in exon 1 of HTT in a cohort of 410 Taiwanese patients with ALS and 1514 control individuals by utilizing polymerase chain reaction and amplicon fragment length analysis.

Results:

Only one of the 410 ALS patients carried a reduced-penetrance HD-causing allele with 39 CAG repeats, and none had an expanded HTT CAG repeats ≥40. The patient presented with rapidly progressive bulbar-onset ALS with disease onset at the age of 64 years. He had neither chorea nor cognitive impairment. He had a family history of chorea, but no other family member manifested with ALS. None of the 1514 control individuals carried an HTT expanded allele with CAG repeats larger than 37 repeats.

Conclusion:

The HTT allele with 39 CAG repeats could be a genetic factor linked to ALS susceptibility.
Helicobacter pylori World Gastroenterology Organization Global Guideline
Authors: Katelaris Peter , Hunt Richard , Bazzoli Franco , Cohen Henry , Fock Kwong Ming , Gemilyan Manik , Malfertheiner Peter , Mégraud Francis , Piscoya Alejandro , Quach Duc , Vakil Nimish , Vaz Coelho Louis G. , LeMair Anton , Melberg Jim
Published: January 2023

Helicobacter pylori remains a major health problem worldwide, causing considerable morbidity and mortality due to peptic ulcer disease and gastric cancer. The burden of disease falls disproportionally on less well-resourced populations. As with most infectious diseases, the largest impact on reducing this burden comes from improvement in socioeconomic status, which interrupts transmission. This has been observed in many regions of the world, but the prevalence of infection remains high in many regions where improvements in living standards are slow to occur. Meanwhile, the optimal clinical management and treatment pathways remain unsettled and are evolving with changing antimicrobial resistance patterns. Despite decades of research and clinical practice, major challenges remain. The quest for the most effective, safe, and simple therapy remains the major issue for clinicians. The search for an effective vaccine appears to be elusive still. Clinical guidelines do not infrequently proffer discordant advice. A major challenge for guidelines is for relevance across a variety of populations with a varying spectrum of disease, antimicrobial resistance rates, and vastly different resources. As local factors are central to determining the impact and management strategies for H. pylori infection, it is important that pathways are based on the best available local knowledge rather than solely extrapolating from guidelines formulated in other regions, which may be less applicable. To this end, this revision of the World Gastroenterology Organisation (WGO) H. pylori guideline uses a “Cascades” approach that seeks to summarize the principles of management and offer advice for pragmatic, relevant and achievable diagnostic and treatment pathways based on established key treatment principles and using local knowledge and available resources to guide regional practice.
Response to Prolonged Duration of Therapeutic Dose Oral Iron Therapy in a Girl With Novel TMPRSS6 Gene Variants: A Case Report and Review Literature
Authors: Udomponglukkana Rawinun , Sasanakul Werasak , Tangbubpha Noppawan , Chuansumrit Ampaiwan , Tim-Aroon Thipwimol , Pongphitcha Pongpak , Sirachainan Nongnuch
Published: January 2023

Iron-refractory iron deficiency anemia (IRIDA) is an autosomal recessive disorder caused by mutations in theTMPRSS6gene, which impair iron homeostasis. We reported a 4-year-old girl who presented with a 1-year history of iron deficiency anemia. Her hemoglobin level increased from 6.5 g/dL to 12.6 g/dL with a prolonged duration of therapeutic dose oral iron therapy (5 mg/kg/d), and the level remained quite stable during the therapy. Genetic analysis of theTMPRSS6gene revealed compound heterozygotes of 2 novel pathogenic variants: c.811C> T (NM_153609.3) in exon 7 (NP_705837: p.R271Ter) and c.1254C> G in exon 11 (p.Y418Ter). The results highlight the significance of genetic investigation and long-term iron therapy in iron-refractory iron deficiency anemia patients.
Further Silencing the Voiceless
Authors: Hasking Penelope , Lewis Stephen P. , Staniland Lexy , Mirichlis Sylvanna , Hird Kirsty , Gray Nicole , Arai Mia , Pemberton Ethan , Preece David , Boyes Mark
Published: January 2023

Gatekeepers play a pivotal role in protecting individuals under their care and are central to keeping people safe and away from harm. In the field of nonsuicidal self-injury (NSSI), a range of gatekeepers exist, including those who protect access to vulnerable research participants, those who protect school children, those charged with making decisions about funding priorities, and those in charge of clinical care for people who self-injure. The aim of this commentary is to outline the roles these different gatekeepers have in protecting access to research participants, access to NSSI knowledge, and access to clinical care for individuals who self-injure. We provide examples in which gatekeepers may present barriers and offer solutions for how to work with gatekeepers for mutual benefit.
Coping Strategy Enhancement for Auditory Verbal Hallucinations Within Routine Clinical Practice
Authors: Zanello Adriano , Mutanda Daniel , Sentissi Othman , Hayward Mark
Published: January 2023

Auditory verbal hallucinations (AVH) are often multiple distressing experiences. Emerging evidence suggests that interventions informed by the principles of cognitive behavioral therapy, such as brief Cognitive Strategy Enhancement (brief-CSE), can reduce the distress related to AVH. The benefits of brief-CSE have been demonstrated for English-speaking patients. This uncontrolled pilot study, conducted in routine clinical practice, evaluated the benefits of brief-CSE within a group of French-speaking AVH hearers. Thirty-two patients were offered the brief-CSE intervention. Self-administered questionnaires were completed pre-post intervention. A significant reduction was observed in AVH distress, with a large effect size, and for more than half of the patients, this reduction was clinically meaningful. AVH severity and anxiety also decreased significantly. This study demonstrates that brief-CSE can be implemented in non–English-speaking routine clinical practice and can reduce several aspects of AVH subjective experience. There is a need to confirm these findings in a larger sample.
Adrenal Hemorrhage: A Review
Authors: Doiron Tucker , Odom Lettie A. , Magann Everett F.
Published: January 2023

Importance

Adrenal hemorrhage in pregnancy is rare. The prevalence of pregnant patients whose pregnancies are complicated by preeclampsia or eclampsia is hypothesized to be slightly higher than the 0.4% to 1.1% occurrence rate in the nonpregnant population. However, the mortality rate of adrenal hemorrhage is reportedly as high as 15%. Therefore, it is critical for obstetric providers to have basic knowledge on the presentation, diagnosis, and management of adrenal hemorrhage in the pregnant population so that prompt diagnosis can be made.

Objective

This review highlights incidence, pathophysiology, risk factors, diagnosis, management, and complications of adrenal hemorrhage in the peripartum period.

Evidence Acquisition

A literature search was undertaken by our research university librarian using the search engines of PubMed, CINAHL, and EMBASE (Medline items removed). The search terms used included “adrenal hemorrhage” OR “adrenal gland hemorrhage” AND “pregnancy” OR “maternal.” The search was limited to articles in English, and the years searched were from January 1, 2015 to December 31, 2021.

Results

There were 130 abstracts identified, and 30 of the articles were ultimately used as the basis for this review. Presenting signs and symptoms of adrenal hemorrhage were typically abdominal, back, and flank pain. Diagnosis was typically made with ultrasound and computed tomography or magnetic resonance imaging without contrast for confirmation. Management options include conservative management versus surgical management with adrenalectomy or interventional radiology embolization in the unstable patient. For patients with evidence of adrenal insufficiency, steroid replacement was used. Most patients with adrenal hemorrhage in the literature had unilateral adrenal hemorrhage; however, several cases of bilateral adrenal hemorrhage have been reported. Patients with bilateral adrenal hemorrhage were more likely to require steroids for adrenal insufficiency. There are no known contraindications to vaginal delivery in this group of patients, and patients who were managed conservatively were often able to continue the pregnancy to term.

Conclusions

Early recognition and management are integral in decreasing the morbidity and mortality associated with adrenal hemorrhage.

Relevance Statement

This is an evidence-based review of adrenal hemorrhage in pregnancy and how to diagnose and manage a pregnancy complicated by adrenal hemorrhage.

Target Audience

Obstetricians and gynecologists, family physicians.

Learning Objectives

After completing this learning activity, the participant should be able to identify the pregnancy-related risk factors for adrenal hemorrhage; interpret the presenting signs and symptoms of an adrenal hemorrhage in pregnancy; describe the imaging modalities available to diagnose adrenal hemorrhage; and outline treatment options including conservative and surgical management.
Preemptive Infiltration of Local Anesthetics During Vaginal Hysterectomy: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Authors: Zacharakis Dimitrios , Prodromidou Anastasia , Douligeris Athanasios , Athanasiou Stavros , Hadzilia Sophia , Kathopoulis Nikolaos , Athanasiou Veatriki , Grigoriadis Themos
Published: January 2023

(Abstracted from Urogynecology 2022;28:667–678)

Undergoing pelvic floor reconstructive surgery bears a lifetime risk between 14% and 19%, with a significantly higher risk in elderly and postmenopausal women. The traditional preferred surgical approach for pelvic floor disorders (PFDs) is vaginal hysterectomy (VH) with or without pelvic floor repair.
Rates of Complications and Reoperation After Myomectomy—The Impact of Surgical Approach: A Statewide Population-Based Cohort Study From 2005–2018
Authors: Simko Sarah , Dallas Kai , Molina Andrea L. , Siedhoff Matthew T. , Wright Kelly N. , Anger Jennifer T. , Truong Mireille D.
Published: January 2023

(Abstracted from J Minim Invasive Gynecol 2022;29:1157–1164)

Approximately 70% of women are affected with uterine leiomyomata (ULM) by the age of menopause. Uterine leiomyomata disease accounts for 29% of gynecologic hospitalizations among women aged 15 to 54 years.
Effect of an Intensive Nurse Home Visiting Program on Adverse Birth Outcomes in a Medicaid-Eligible Population: A Randomized Clinical Trial
Authors: McConnell Margaret A. , Rokicki Slawa , Ayers Samuel , Allouch Farah , Perreault Nicolas , Gourevitch Rebecca A. , Martin Michelle W. , Zhou R. Annetta , Zera Chloe , Hacker Michele R. , Chien Alyna , Bates Mary Ann , Baicker Katherine
Published: January 2023

(Abstracted from JAMA 2022:328(1):27–37)

Mortality, morbidity, and childhood developmental challenges can all result from adverse birth outcomes. In regard to these outcomes, the United States exhibits significant racial and socioeconomic inequities, and effective interventions targeting low-income pregnant people are necessary.
Time of Delivery Among Low-Risk Women at 37–42 Weeks of Gestation and Risks of Stillbirth and Infant Mortality, and Long-term Neurological Morbidity
Authors: Razaz Neda , Muraca Giulia M. , Fink Katharina , Boutin Amélie , John Sid , Lisonkova Sarka , Stephansson Olof , Cnattingius Sven , Joseph K. S.
Published: January 2023

(Abstracted from Paediatr Perinat Epidemiol 2022;36:577–587)

Time of delivery in low-risk pregnancies is an important consideration for clinicians. They must balance the risks associated with early delivery, including respiratory and other neonatal complications, versus those associated with later delivery, including stillbirth, meconium aspiration syndrome and maternal complications.
Overlapping Features of Primary Cutaneous Marginal Zone Lymphoproliferative Disorder and Primary Cutaneous CD4+ Small/Medium T-Cell Lymphoproliferative Disorder
Authors: Obiorah Ifeyinwa E. , Karrs Jeremiah , Brown Laura , Wang Hao-Wei , Karai Laszlo J. , Pham Trinh Hoc-Tran , Pham Thu Anh , Xi Liqiang , Pittaluga Stefania , Raffeld Mark , Jaffe Elaine S.
Published: January 2023

Primary cutaneous marginal zone lymphoproliferative disorder (PCMZL) and primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder (CD4+ TLPD) are indolent lymphoproliferative disorders. However, cases with overlapping features can be challenging. We identified 56 CD4+ TLPD and 38 PCMZL cases from our pathology archives. Clinical, morphologic, and immunophenotypic features were reviewed. Polymerase chain reaction for immunoglobulin (IG) and T-cell receptor gamma (TRG) gene rearrangements were analyzed. Next-generation sequencing studies were performed on 26 cases with adequate material, 19 with CD4+ TLPD, and 7 with PCMZL. CD4+ TLPD presented mostly (91%) as solitary lesions, located in the head and neck area (64%), while PCMZL occurred mostly in the upper extremity (47%) and trunk (34%). Lesions were sometimes multiple (40%) and recurrences (67%) were more common. Cases of PCMZL had an increase in reactive CD3+ T cells, with frequent programmed cell death protein 1 expression, whereas cases of CD4+ TLPD often contained abundant reactive B cells. Twenty-five cases were identified as having overlapping features: 6 cases of PCMZL were clonal for both IG and TRG; 11 cases of CD4+ TLPD were clonal for IG and TRG and 6 cases of CD4+ TLPD had light chain–restricted plasma cells. By next-generation sequencing, 23 variants were detected in 15 genes, with PCMZL more likely to show alterations, most commonly affecting TNFAIP3 and FAS, altered in 5 cases. Both entities have an indolent clinical course with response to conservative therapy and management, and warrant interpretation as a lymphoproliferative disorder rather than overt lymphoma.
Lymphoid Interstitial Pneumonia (LIP) Revisited
Authors: Fraune Christoph , Churg Andrew , Yi Eunhee S. , Khoor Andras , Kelemen Katalin , Larsen Brandon T. , Butt Yasmeen M. , Smith Maxwell L. , Gotway Michael B. , Ryu Jay H. , Tazelaar Henry D.
Published: January 2023

The use of lymphoid interstitial pneumonia (LIP) as a diagnostic term has changed considerably since its introduction. Utilizing a multi-institutional collection of 201 cases from the last 20 years that demonstrate features associated with the LIP rubric, we compared cases meeting strict histologic criteria of LIP per American Thoracic Society (ATS)/European Respiratory Society (ERS) consensus (“pathologic LIP”; n=62) with cystic cases fulfilling radiologic ATS/ERS criteria (“radiologic LIP”; n=33) and with other diffuse benign lymphoid proliferations. “Pathologic LIP” was associated with immune dysregulation including autoimmune disorders and immune deficiency, whereas “radiologic LIP” was only seen with autoimmune disorders. No case of idiopathic LIP was found. On histology, “pathologic LIP” represented a subgroup of 70% (62/88) of cases with the distinctive pattern of diffuse expansile lymphoid infiltrates. In contrast, “radiologic LIP” demonstrated a broad spectrum of inflammatory patterns, airway-centered inflammation being most common (52%; 17/33). Only 5 cases with radiologic cysts also met consensus ATS/ERS criteria for “pathologic LIP.” Overall, broad overlap was observed with the remaining study cases that failed to meet consensus criteria for “radiologic LIP” and/or “pathologic LIP.” These data raise concerns about the practical use of the term LIP as currently defined. What radiologists and pathologist encounter as LIP differs remarkably, but neither “radiologic LIP” nor “pathologic LIP” present with sufficiently distinct findings to delineate such cases from other patterns of diffuse benign lymphoid proliferations. As a result of this study, we believe LIP should be abandoned as a pathologic and radiologic diagnosis.