bluuebunny/crossref_metadata_2025 huggingface dataset:
Stereoscopic diagnosing of a filament-cavity flux rope system by tracing the path of a two-sided-loop jet
Authors: Tan Song , Shen Yuandeng , Zhou Xinping , Duan Yadan , Tang Zehao , Zhou Chengrui , Yao Surui
Published: July 2022

The fine magnetic structure is vitally important to understanding the formation, stabilization, and eruption of solar filaments, but so far, it is still an open question yet to be resolved. Using stereoscopic observations taken by the Solar Dynamics Observatory and Solar TErrestrial RElations Obsevatory, we studied the generation mechanism of a two-sided-loop jet (TJ) and the ejection process of the jet plasma into the overlying filament-cavity system. We find that the generation of the two-sided-loop jet was due to the magnetic reconnection between an emerging flux loop and the overlying filament. The jet’s two arms ejected along the filament axis during the initial stage. Then, the north arm bifurcated into two parts at about 50 Mm from the reconnection site. After the bifurcation, the two bifurcated parts were along the filament axis and the cavity which hosted the filament, respectively. By tracing the ejecting plasma flows of the TJ inside the filament, we not only measured that the magnetic twist stored in the filament was at least 5π but also found that the fine magnetic structure of the filament-cavity flux rope system is in well agreement with the theoretical results of Magnetic flux rope models.
The Use of Preferred Music to Improve the Sleep Quality of a High School Athlete with Post-Concussion Syndrome
Authors: Smith Rebekah , Layman Deborah
Published: July 2022

Difficulty sleeping is a common long-term complaint for those who have experienced head trauma and brain injury (Hvingelby, 2020). A lack of sleep can lead to neurological dysfunction and reduce the ability to regulate thinking and behavior (Tan, 2004). Music therapy can promote sleep quality and may be an effective, safe, and affordable treatment for those with sleep problems (Kavurmaci et al., 2020). This study aimed to examine the use of preferred music to improve the self-reported sleep quality, pain, and mood of a high school athlete with post-concussion syndrome. A single-subject, quasi-experimental design was used to examine the use of a preferred music playlist to promote relaxation and sleep in conjunction with weekly live music therapy telehealth sessions. Results indicated an increase in relaxation and ability to sleep, along with improved mood and decreased pain. The results of this study suggest that music therapy may be helpful in addressing pain, mood, and sleep quality in individuals who have experienced concussions.
Notable predominant morphology of the smallest most abundant protozoa of the open ocean revealed by electron microscopy
Authors: Kamennaya Nina A , Kennaway Gabrielle , Sleigh Michael A , Zubkov Mikhail V
Published: July 2022

In the microbe-driven ecosystems of the open ocean, the small heterotrophic flagellates (sHF) are the chief microbial predators and recyclers of essential nutrients to phototrophic microbes. Even with intensive molecular phylogenetic studies of the sHF, the origins of their feeding success remain obscure because of limited understanding of their morphological adaptations to feeding. Here, we examined the sHF morphologies in the largest, most oligotrophic South Pacific and Atlantic (sub)tropical gyres and adjacent mesotrophic waters. On four research cruises, the sHF cells were flow cytometrically sorted from bacterioplankton and phytoplankton for electron microscopy. The sorted sHF comprised chiefly heterokont (HK) biflagellates and unikont choanoflagellates numerically at around 10-to-1 ratio. Of the four differentiated morphological types of HK omnipresent in the open ocean, the short-tinsel heterokont (stHK), whose tinsel flagellum is too short to propagate a complete wave, is predominant and a likely candidate to be the most abundant predator on Earth. Modeling shows that the described stHK propulsion is effective in feeding on bacterioplankton cells at low concentrations; however, owing to general prey scarcity in the oligotrophic ocean, selective feeding is unsustainable and omnivory is equally obligatory for the seven examined sHF types irrespective of their mode of propulsion.
Formation and reversibility of inducible morphological and behavioral defenses in Daphnia magna
Authors: Wang Zihang , Yu Bo , Lei Yulu , Sun Yunfei , Zhang Lu , Gu Lei , Yang Zhou
Published: July 2022

Inducible defense is an effective way for prey to improve its fitness under fluctuating predation risks. While the formation and reversibility of diverse inducible defensive traits are still not fully understood. This study focused on the inducible morphological and behavioral traits of Daphnia magna in the process of predator come and go, which were simulated by adding and removing fish kairomone, respectively. Results showed that D. magna exposed to fish kairomone inhabited deeper water and owned smaller individual size. The adult D. magna exposed to fish kairomone could develop the same inducible defensive traits as the individuals exposed to fish kairomone from neonate. In terms of the complete formation time, behavior (6 days) was faster than morphology (17 days). Besides, by removing kairomone after maturity, the inducible defensive traits of D. magna could reverse to the traits of the individuals never exposed to fish kairomone. In terms of the reversal time, behavior (18 days) was similar to morphology (21 days). Furthermore, the reversal degrees of morphological and behavioral defenses were equal at any specific time point. Such results suggest that inducible behavioral defensive traits are not always more reversible than inducible morphological defensive traits.
Linked brain connectivity patterns with psychopathological and cognitive phenotypes in drug-naïve first-episode schizophrenia
Authors: Sun Hui , Zhang Wenjing , Cao Hengyi , Sun Huaiqiang , Dai Jing , Li Siyi , Zeng Jiaxin , Wei Xia , Tang Biqiu , Gong Qiyong , Lui Su
Published: July 2022

Background

Schizophrenia is considered to be a disorder of dysconnectivity characterized by abnormal functional integration between distinct brain regions. Different brain connection abnormalities were found to be correlated with various clinical manifestations, but whether a common deficit in functional connectivity (FC) in relation to both clinical symptoms and cognitive impairments could present in first-episode patients who have never received any medication remains elusive.

Objective

To find a core deficit in the brain connectome that is related to both psychopathological and cognitive manifestations.

Methods

A total of 75 patients with first-episode schizophrenia and 51 healthy control participants underwent scanning of the brain and clinical ratings of behaviors. A principal component analysis was performed on the clinical ratings of symptom and cognition. Partial correlation analyses were conducted between the main psychopathological components and resting-state FC that were found abnormal in schizophrenia patients.

Results

Using the principal component analysis, the first principal component (PC1) explained 37% of the total variance of seven clinical features. The ratings of GAF and BACS contributed negatively to PC1, while those of PANSS, HAMD, and HAMA contributed positively. The FCs positively correlated with PC1 mainly included connections related to the insula, precuneus gyrus, and some frontal brain regions. FCs negatively correlated with PC1 mainly included connections between the left middle cingulate cortex and superior and middle occipital regions.

Conclusion

In conclusion, we found a linked pattern of FC associated with both psychopathological and cognitive manifestations in drug-naïve first-episode schizophrenia characterized as the dysconnection related to the frontal and visual cortex, which may represent a core deficit of brain FC in patients with schizophrenia.
The Structure of Weight and Function Classes With Coprime Bases
Authors: Anderson Theresa C , Travesset Chiara , Veltri Joey
Published: July 2022

In a recent work of Anderson and Hu, the authors constructed a measure that was p-adic and q-adic doubling, for any primes p and q, yet not doubling. This work relied heavily on a developed number theory framework. Here we develop this framework further, which yields a measure that is m-adic and n-adic doubling for any coprime $m,n$, yet not doubling. Additionally, we show several new applications to the intersection of weight and function classes.
PARADOXICAL DUAL ROLES OF SOME CYTOKINES INTERPRETED BY CYTOGENETICS INVESTIGATIONS IN IRRADIATED HUMAN BLOOD CULTURES
Authors: Montaser Sherien A , Ahmed Mahmoud M , Mohammed Manal R
Published: July 2022

Four different cytokines (IL1-β, IL-6, IL-10 and TNF-α) and the cytokinesis-block micronucleus (CBMN) cytome assay investigations were evaluated in six human blood samples. They were divided into the control (nonirradiated) and five gamma-irradiated groups which were exposed to five different doses (0.5, 1, 2, 4 and 8 Gy). Blood groups were cultured in triplets for 72 h following 1 h of irradiation. Immunological and cytogenetics were investigated parallelly at different irradiation doses to understand the connection between them. Our aim is anchoring the active proliferation action of cytokines by presence of binucleated cells and resting immune system by mononuclear cell. Also, cell death by increasing necrotic cell count and TNF-α concentration. When compared with the control group, 0.5, 1, 2 and 4 Gy irradiation groups recorded a gradual increase in the cytokines levels, an increase in the total micronucleated cells (binucleated and mononucleated cells), an increase in necrotic and apoptotic cells counts. While 8 Gy irradiation leads to depletion in TNF-α concentration, although the number of necrotic cells was high.
Opposition Avoidance or Mutual Engagement? The Interdependent Dynamics between Opposing Transnational LGBT+ Networks
Authors: Velasco Kristopher
Published: July 2022

Embeddedness within transnational networks influences how countries govern LGBT+ communities. Research commonly highlights how pro-LGBT+ networks enable the expansion of rights; however, increased transnational coordination between anti-LGBT+ actors means network embeddedness also leads to policy backlash. Therefore, an important question to ask is: why are countries differentially embedded within these opposing networks to begin with? Moreover, does embeddedness in one network influence embeddedness in the other over time? To answer these questions, I develop original datasets of transnational pro- and anti-LGBT+ networks from 1990 to 2018. Using cross-lagged and dynamic panel models, results reveal that there is indeed an interdependent relationship where opposing networks mutually engage, or “follow,” one another; however, these patterns vary across region. These results give insights into how countries exist in tension between these opposing networks and can help illuminate where expansion and backlash may transpire. While focused on LGBT+ networks, these findings give insights into tensions over (il)liberalism and gender justice occurring within the international community.
Effects of calcium-magnesium carbonate and calcium-magnesium hydroxide as supplemental sources of magnesium on ruminal microbiome
Authors: Arce-Cordero Jose A , Liu Ting , Ravelo Anay , Lobo Richard R , Agustinho Bruna C , Monteiro Hugo F , Jeong Kwang C , Faciola Antonio P
Published: July 2022

Our objective was to evaluate the inclusion of calcium-magnesium carbonate [CaMg(CO3)2] and calcium-magnesium hydroxide [CaMg(OH)4] in corn silage-based diets and their impact on ruminal microbiome. Our previous work showed a lower pH and molar proportion of butyrate from diets supplemented with [CaMg(CO3)2] compared to [CaMg(OH)4]; therefore, we hypothesized that ruminal microbiome would be affected by Mg source. Four continuous culture fermenters were arranged in a 4 × 4 Latin square with the following treatments defined by the supplemental source of Mg: 1) Control (100% MgO, plus sodium sesquicarbonate as a buffer); 2) CO3 [100% CaMg(CO3)2]; 3) OH [100% CaMg(OH)4]; and 4) CO3/OH [50% Mg from CaMg(CO3)2, 50% Mg from CaMg(OH)4]. Diet nutrient concentration was held constant across treatments (16% CP, 30% NDF, 1.66 MCal NEl/kg, 0.67% Ca, and 0.25% Mg). We conducted four fermentation periods of 10 d, with the last 3 d for collection of samples of solid and liquid digesta effluents for DNA extraction. Overall, 16 solid and 16 liquid samples were analyzed by amplification of the V4 variable region of bacterial 16S rRNA. Data were analyzed with R and SAS to determine treatment effects on taxa relative abundance of liquid and solid fractions. Correlation of butyrate molar proportion with taxa relative abundance was also analyzed. Treatments did not affect alpha and beta diversities or relative abundance of phylum, class and order in either liquid or solid fractions. At the family level, relative abundance of Lachnospiraceae in solid fraction was lower for CO3 and CO3/OH compared to OH and Control (P < 0.01). For genera, abundance of Butyrivibrio (P = 0.01) and Lachnospiraceae ND3007 (P < 0.01) (both from Lachnospiraceae family) was lower and unclassified Ruminococcaceae (P = 0.03) was greater in CO3 than Control and OH in solid fraction; while abundance of Pseudobutyrivibrio (P = 0.10) and Lachnospiraceae FD2005 (P = 0.09) (both from Lachnospiraceae family) and Ruminobacter (P = 0.09) tended to decrease in CO3 compared to Control in liquid fraction. Butyrate molar proportion was negatively correlated to Ruminococcaceae (r = –0.55) in solid fraction and positively correlated to Pseudobutyrivibrio (r = 0.61) and Lachnospiraceae FD2005 (r = 0.61) in liquid. Our results indicate that source of Mg has an impact on bacterial taxa associated with ruminal butyrate synthesis, which is important for epithelial health and fatty acid synthesis.
Etiology, Pathophysiology and Mortality of Shock in Children in Low (Middle) Income Countries: A Systematic Review
Authors: Assies Roxanne , Snik Ilse , Kumwenda Mercy , Chimalizeni Yamikani , Langton Josephine , van Woensel Job B M , Doctor Allan , Calis Job C J
Published: July 2022

Objectives

Shock is a life-threatening condition in children in low- and middle-income countries (LMIC), with several controversies. This systematic review summarizes the etiology, pathophysiology and mortality of shock in children in LMIC.

Methods

We searched for studies reporting on children with shock in LMIC in PubMed, Embase and through snowballing (up to 1 October 2019). Studies conducted in LMIC that reported on shock in children (1 month–18 years) were included. We excluded studies only containing data on neonates, cardiac surgery patients or iatrogenic causes. We presented prevalence data, pooled mortality estimates and conducted subgroup analyses per definition, region and disease. Etiology and pathophysiology data were systematically collected.

Results

We identified 959 studies and included 59 studies of which six primarily studied shock. Definitions used for shock were classified into five groups. Prevalence of shock ranged from 1.5% in a pediatric hospital population to 44.3% in critically ill children. Pooled mortality estimates ranged between 3.9-33.3% for the five definition groups. Important etiologies included gastroenteritis, sepsis, malaria and severe anemia, which often coincided. The pathophysiology was poorly studied but suggests that in addition to hypovolemia, dissociative and cardiogenic shock are common in LMIC.

Conclusions

Shock is associated with high mortality in hospitalized children in LMIC. Despite the importance few studies investigated shock and as a consequence limited data on etiology and pathophysiology of shock is available. A uniform bedside definition may help boost future studies unravelling shock etiology and pathophysiology in LMIC.
Telemedicine Visits Can Generate Highly Accurate Diagnoses and Surgical Plans for Spine Patients
Authors: Bovonratwet Patawut , Song Junho , Kim Yeo Eun , Shinn Daniel , Morse Kyle W. , Dowdell James E. , Huang Russel C. , Albert Todd J. , Sandhu Harvinder S. , Qureshi Sheeraz A. , Iyer Sravisht
Published: July 2022

Study Design.

A Retrospective cohort study.

Objective.

To (1) assess whether diagnoses and surgical plans established during a new patient telemedicine visit changed following an in-person evaluation and (2) determine any differences in perioperative outcomes between patients who only had a telemedicine visit before surgery versus those who had a telemedicine visit followed by an in-person evaluation before surgery.

Summary of Background Data.

Data on capability of telemedicine to deliver high-quality preoperative assessment without a traditional in-person interaction and physical examination is lacking.

Materials and Methods.

Records of patients who had a new patient telemedicine visit and indicated for surgery with documented specific diagnosis as well as surgical plans from a spine department at an urban tertiary center from April 2020 to April 2021 were reviewed. For a subset of patients that had a follow-up in-person evaluation before surgery, these diagnoses and plans were compared. Perioperative outcomes were compared between patients who only had a telemedicine visit before surgery versus those who had a telemedicine visit followed by an in-person evaluation before surgery.

Results.

A total of 166 patients were included. Of these, 101 patients (61%) only had a new patient telemedicine visit before surgery while 65 (39%) had a telemedicine visit followed by an in-person evaluation. There were no differences in the rate of case cancellations before surgery and patient-reported outcome measures between these two groups (P>0.05). Of 65 patients who had both a telemedicine followed by an in-person visit, the diagnosis was unchanged for 61 patients (94%) and the surgical plan did not change for 52 patients (80%). The main reason for surgical plan change was due to updated findings on new imaging, 10 patients, (77%).

Conclusions.

The current study suggests that telemedicine evaluations can provide an effective means of preoperative assessment for spine patients.

Level of Evidence.

Level 3.
Cervical Spine Research Society-Cervical Stiffness Disability Index (CSRS-CSDI): Validation of a Novel Scoring System Quantifying the Effect of Postarthrodesis Cervical Stiffness on Patient Quality of Life
Authors: Jack Andrew S. , Hayman Erik , Pierre Clifford , Ramey Wyatt L. , Witiw Christopher D. , Oskouian Rod J. , Daniels Alan H. , Pugley Andrew , Hamilton Kojo , Ames Christopher P. , Chapman Jens R. , Ghogawala Zoher , Hart Robert A.
Published: July 2022

Study Design.

Cross-sectional study.

Objective.

The aim was to create and validate a novel patient-reported outcome measure (PROM) focusing on stiffness-related patient functional limitations after cervical spine fusion.

Summary of Background Data.

Cervical arthrodesis is a common treatment for myelopathy/radiculopathy, however, results in increased neck stiffness as a collateral outcome. No current PROM exists quantifying the impact of postoperative stiffness on patient function.

Methods.

The Cervical Spine Research Society-Cervical Stiffness Disability Index (CSRS-CSDI) was created through a modified Delphi process. The resultant 10-item questionnaire yields a score out of 100 with higher scores indicating increased functional difficulty related to neck stiffness. Cross-sectional study of control and postoperative patients was completed for CSRS-CSDI validation. Retest reliability (intraclass correlation coefficient), internal consistency (Cronbach alpha), responsiveness (levels fused vs. CSRS-CSDI scores), and discriminatory validation (CSRS-CSDI vs. neck disability index) scores) were completed.

Results.

Fifty-seven surgical and 24 control patients completed the questionnaire. Surgical patients underwent a variety of procedures: 11 (19%) motion preserving operations, nine (16%) subaxial 1–2 level fusions, seven (12%) subaxial 3–5 level fusions, five (9%) C1-subaxial cervical spine fusions, 20 (35%) C2-upper thoracic spine fusions, five (9%) occiput-subaxial or thoracic spine fusions. The questionnaire demonstrated high internal consistency (Cronbach alpha=0.92) and retest reliability (intraclass correlation coefficient=0.95, P<0.001). Good responsiveness validity with a significant difference between fusion cohorts was found (P<0.001, r
s=0.63). Patient CSRS-CSDI scores also correlated with neck disability index scores recorded (P<0.001, r=0.70).

Conclusion.

This is the first study to create a PROM addressing the functional impact of cervical stiffness following surgical arthrodesis. The CSRS-CSDI was a reliable and valid measure of postoperative stiffness impact on patient function. This may prove useful in counseling patients regarding their expected outcomes with further investigation demonstrating its value in a prospective fashion.
Nuances of Ileal Pouch-Anal Anastomosis in Familial Adenomatous Polyposis
Authors: Church James
Published: July 2022

BACKGROUND:

Patients with familial adenomatous polyposis are sometimes treated with prophylactic or therapeutic proctocolectomy to either prevent or treat the almost inevitable colorectal cancer that develops in the numerous, early onset tubular adenomas to which they are prone. These patients are potential candidates for a restorative IPAA.

OBJECTIVE:

This study aimed to highlight the particular nuances of ileal pouch-anal surgery faced by patients with familial adenomatous polyposis and point out the implications of the syndrome for patients who are candidates for an IPAA and the surgeons operating on them.

STUDY SELECTION:

A literature search was performed on PubMed and MEDLINE using the terms “ulcerative colitis,” “familial adenomatous polyposis,” “surgery,” and “ileal pouch-anal anastomosis.”

CONCLUSIONS:

As a result of a fundamental difference in pathophysiology, there are significant differences in demographics, presentation, surgical strategy, and sequelae of proctocolectomy and IPAA between familial adenomatous polyposis and ulcerative colitis. Proctocolectomy with IPAA in selected familial adenomatous polyposis patients can be performed in 1 stage, but their lack of symptoms means that any complications assume a greater significance. In polyposis patients, postoperative endoscopic surveillance of residual large intestine begins immediately, whereas surveillance of the pouch itself becomes increasingly important. Symptoms leading to a diagnosis of pouchitis are instead often due to structural and functional issues.
Novel Technique for Obtaining Aesthetic Results in Multiple Lipomatosis Surgery
Authors: Ramasamy Karthik , Jesudass Joyce , Appaka C. V. Jagadish Kiran , Tripathee Sanjib , Sivanesan Surya
Published: July 2022

Introduction:

Multiple lipomatosis is often perceived as a cosmetically disfiguring condition‚ and therefore‚ patients seek treatment. Multiple lipomas are commonly treated with excision or liposuction or a combination of both. To obtain a better aesthetic result, various modifications of the above have been tried, like using remote small incision, squeeze delivery technique‚ and endoscopic-assisted removal. We have used a combination of the above techniques, with the aim of removing the maximum number of lipomas with fewer and smaller incisions. The ultimate outcome is that the patient has a less scarred body.

Methods:

This is a nonrandomized uncontrolled case series, conducted over 3 years from 2018 to 2021. It included all patients with visible multiple lipomas over upper limbs, lower limbs, chest, abdomen, and back. A total of 30 patients were operated on. The technique used in all patients was liposuction, limited incisions, tunneling, and squeezing out the lipomas. The patients were regularly followed up for 6 months.

Result:

Lipomas of various sizes were removed by the above mentioned technique. Early postoperative period bruising was noted in seven cases which needed no intervention. Two patients had hematoma collection and one seroma, which was managed with aspiration. Among the 30 patients, 90% were pleased with the cosmetic result‚ and recurrence was seen in five cases.

Conclusions:

Our modified technique of treating multiple lipomatosis gives a good aesthetic result and high patient satisfaction for a short-term study. However, comparable and long-term studies need to be performed for more conclusive results.
Irregularly Irregular Stellate Incisions for Selective Reduction of Benign Facial Lesions
Authors: Teplica David , Cooney Emmett , Srock Jamey , Sayers Michael
Published: July 2022

Background:

Cosmetic outcomes are among patients’ top concerns when discussing treatment options for facial nevi. Benign lesions of the face often enlarge with time, and many patients seek care to minimize the perceived deformity. Complete excision remains the frontline treatment for facial lesions, but a choice must be made between the deformity from the lesion itself and scar deformity incurred from its removal. Traditional elliptical excision results in a linear scar that is often conspicuous, while alternatives to surgical excision seek to minimize scarring but possess their own disadvantages. We report a new application for nevus reduction (subtotal or near-total excision) to diminish deformity from the lesion itself while minimizing scar visibility with a novel “irregularly irregular stellate incision” approach.

Methods:

Incisions are made in a stellate pattern with irregularly irregular borders circumscribed within the lesion. Therefore, the scar is restricted to the lesion surface, while a reduction in area and projection off the skin surface can be tailored to fit the patient’s wishes for any benign skin feature.

Results:

This technique has been employed with hundreds of facial lesions, with two representative cases shown. No significant complications have been observed and the method has been used on a wide variety of sizes and types of lesions.

Conclusions:

The technique presented meets the need for minimal scarring when reducing benign lesions of the face. The method is applicable to a wide range of presentations and can also function as a method to biopsy lesions, should there be concerns about pathology.
The Need for Reliable Robust Maternal Transport Program to Improve Maternal Outcomes in Rural America
Authors: HORAK TERESA S. , SANBORN AMY N.
Published: July 2022

There is great evidence to support improved maternal and neonatal outcomes when a patient delivers in a center that is suited to the needs of both the birthing person and the fetus. As rural centers have closed, access remains challenging. This manuscript examines The Emergency Medical Treatment and Labor Act, Emergency Medical Services (EMS) challenges, needs of rural hospitals including education, and elaborates further upon the need to expand maternal transport in rural areas to improve outcomes in the future.
Discordant Congenital Toxoplasmosis and Cytomegalovirus Infection in Dichorionic Diamniotic Twins
Authors: Wade Joshua , Johnson Sarah May , Burkhardt Ingrid , Egloff Alexia , Thomas Jessica , Guy Edward , Demirjian Alicia
Published: July 2022

Background:

Toxoplasmosis and cytomegalovirus (CMV) congenital infection present with similar clinical pictures. Both infections have long-term sequelae that can be mitigated by early detection and treatment. Coinfection is uncommonly reported.

Methods:

Dichorionic diamniotic twins born at 35 weeks of gestation were investigated for congenital infections due to abnormalities on the antenatal scan at 31 weeks of gestation. Antenatal investigations were delayed due to late booking and delay in maternal investigations. In the neonatal period, they suffered discordant symptoms and were both investigated for Toxoplasma gondii infection. This diagnosis was confirmed in twin 2 but proved difficult in twin 1 who had a weakly positive polymerase chain reaction with inconclusive serology. Twin 1 was also diagnosed with congenital CMV, further complicating the clinical picture. Toxoplasmosis can cause long-term sequelae, and definitive diagnosis requires serology at 12 months of age; in view of this, treatment for congenital toxoplasmosis was initiated in both twins. Twin 1 was also treated for congenital CMV.

Results:

Due to limitations in serological investigations in neonates, diagnosing congenital toxoplasmosis can be challenging, and initiating treatment may be warranted in suspected cases, given the risk of infective complications. Discordant presentations between twins are known in congenital toxoplasmosis and CMV, but coinfection has rarely been reported without concurrent immunocompromise. A high index of suspicion should be maintained in the twin of an infected neonate, and the possibility of multiple infections should be considered. Multidisciplinary working is crucial in reaching a diagnosis and treating appropriately.
Comprehensiveness of Testing Among Herpes Simplex Virus Infected Infants: A Multicenter Cohort Study
Authors: Pruitt Christopher M. , Nigrovic Lise E. , Freedman Stephen B. , Bradin Stuart A. , Curtis Sarah J. , Lyons Todd W. , Miller Aaron S. , Okada Pamela J. , Schmidt Suzanne M. , Schnadower David , Thomson Joanna E. , Cruz Andrea T.
Published: July 2022

Despite clear testing recommendations for herpes simplex virus (HSV) infection in infants, few data exist on the comprehensiveness of HSV testing in practice. In a 23-center study of 112 infants with confirmed HSV disease, less than one-fifth had all recommended testing performed, highlighting the need for increased awareness of and adherence to testing recommendations for this vulnerable population.
Encoding of inflammatory hyperalgesia in mouse spinal cord
Authors: Barkai Omer , Rayi Prudhvi Raj , Butterman Rachely , Katz Ben , Lev Shaya , Binshtok Alexander M.
Published: July 2022

Inflammation modifies the input–output properties of peripheral nociceptive neurons such that the same stimulus produces enhanced nociceptive firing. This increased nociceptive output enters the superficial dorsal spinal cord (SDH), an intricate neuronal network composed largely of excitatory and inhibitory interneurons and a small percentage of projection neurons. The SDH network comprises the first central nervous system network integrating noxious information. Using in vivo calcium imaging and a computational approach, we characterized the responsiveness of the SDH network in mice to noxious stimuli in normal conditions and investigated the changes in SDH response patterns after acute burn injury–induced inflammation. We show that the application of noxious heat stimuli to the hind paw of naïve mice results in an overall increase in SDH network activity. Single-cell response analysis reveals that 70% of recorded neurons increase or suppress their activity, while ∼30% of neurons remain nonresponsive. After acute burn injury and the development of inflammatory hyperalgesia, application of the same noxious heat stimuli leads to the activation of previously nonresponding neurons and desuppression of suppressed neurons. We further demonstrate that an increase in afferent activity mimics the response of the SDH network to noxious heat stimuli under inflammatory conditions. Using a computational model of the SDH network, we predict that the changes in SDH network activity result in overall increased activity of excitatory neurons, amplifying the output from SDH to higher brain centers. We suggest that during acute local peripheral inflammation, the SDH network undergoes dynamic changes promoting hyperalgesia.
Access to pediatric dermatology
Authors: Barry Kelly K. , Hawryluk Elena B.
Published: July 2022

Purpose of review

To identify factors that impact accessibility to pediatric dermatology and review healthcare delivery models that improve access and address these barriers.

Recent findings

Up to one-third of pediatric primary care visits include a skin-related problem, yet pediatric dermatology subspecialist services are highly inaccessible. Workforce shortages and geographic, sociocultural, and economic barriers perpetuate inaccessibility. Teledermatology expands care, particularly to underserved or geographically remote communities, and reduces healthcare-related costs. Federal legislation to support telehealth services with adequate reimbursement for providers with parity between live, video, and phone visits will dictate the continued feasibility of virtual visits. Innovative care delivery models, such as language-based clinics, multidisciplinary teleconferencing, or embedded dermatology services within primary care are other promising alternatives.

Despite efforts to expand access, dermatology still ranks among the most underserved pediatric subspecialties. Improving access requires a multipronged approach. Efforts to expand exposure and mentorship within pediatric dermatology, diversify the workforce and clinical curriculum, recruit and retain clinicians in geographically underserved areas, and collaborate with policymakers to ensure adequate reimbursement for teledermatology services are necessary.
Findings From the 2021 Organizational Value of Nursing Professional Development Practice Study, Part 1
Authors: Harper Mary G. , Maloney Patsy , Aucoin Julia , MacDonald Ryan
Published: July 2022

A 2015 study exploring the correlations between nursing professional development (NPD) staffing and organizational outcomes was replicated in 2021. Part 1 of this two-part report provides background information and descriptive data, including organizational characteristics, NPD department structures, and NPD practitioner ratios per employee, per RN, and per hospital bed. Findings reflect the proliferation of hospital systems, expansion of NPD practice to include other professions and all employees, and little change in NPD certification.
Psychiatric Futility and Palliative Care for a Patient With Clozapine-resistant Schizophrenia
Authors: Rosenbaum Daniel M.S. , Robertson David , Law Samuel
Published: July 2022

Recognizing futility is a challenging aspect of clinical medicine, particularly in psychiatry. We present a case of a man who suffered from clozapine-resistant schizophrenia. His illness was characterized by prominent religious delusions and severe self-starvation. Neither the intensity of his symptoms nor his quality of life improved with available psychiatric interventions, and he experienced significant iatrogenic harms from enforced treatments. Recognizing clinical futility, in collaboration with a diverse multidisciplinary team, and making a clear shift to a patient-centered palliative approach allowed the patient’s treatment team to prioritize his autonomy and subjective meaning in his final months. Such approaches are understudied in psychiatry and warrant greater attention.
Comparison of Single-Dermatome Laparoscopic Appendectomy With Standard Laparoscopic Appendectomy in Terms of Postoperative Pain and Patient Satisfaction: A Randomized Controlled Trial
Authors: Ergin Anil , İşcan Yalin , Çiyiltepe Hüseyin , Fersahoğlu Mehmet M. , Esen Bulut Nuriye , Taşdelen İksan
Published: July 2022

Background:

Laparoscopic appendectomy (LA), used since 1980, is a common surgical technique for acute appendicitis (AA) treatment. Laparoscopic surgical techniques can achieve higher patient satisfaction than conventional open surgery techniques. However, many patients complain of severe pain after laparoscopic abdominal surgeries. In this study, we compared single-dermatome laparoscopic appendectomy (SDLA), wherein all trocars were placed at the same dermatome field, with standard laparoscopic appendectomy (SLA), wherein trocars were placed at multiple dermatome sites, in terms of postoperative pain and patient satisfaction.

Materials and Methods:

The study was designed as a double-blind randomized controlled trial. Patients who underwent LA for AA between May 2019 and December 2019 were included in the study and randomized into 2 groups, wherein patients were included sequentially. The first group was operated with SLA surgery, whereas the second group was operated with SDLA surgery. All patients were assessed in terms of visual analog scale (VAS) scores, hemodynamic parameters, and patient satisfaction at postoperative 1, 2, 4, 6, 12, and 24 hours.

Results:

In the SLA technique, VAS values at postoperative 1, 2, and 4 hours were significantly higher than in the SDLA (P=0.009; P<0.05). No significant difference was observed between the surgical techniques in terms of VAS levels at postoperative 6, 12, and 24 hours (P>0.05). In the SDLA group, patient satisfaction was significantly higher than in the SLA group (P=0.024; P<0.05).

Conclusions:

In our study, SDLA caused less pain in AA cases during postoperative period than SLA. Further, the SDLA method achieved higher patient satisfaction during the postoperative period than the SLA method.
Bradyrhizobium cenepequi sp. nov., Bradyrhizobium semiaridum sp. nov., Bradyrhizobium hereditatis sp. nov. and Bradyrhizobium australafricanum sp. nov., symbionts of different leguminous plants of Western Australia and South Africa and definition of three novel symbiovars
Authors: Klepa Milena Serenato , Helene Luisa Caroline Ferraz , O´Hara Graham , Hungria Mariangela
Published: July 2022

Bradyrhizobiumis a heterogeneous bacterial genus capable of establishing symbiotic associations with a broad range of legume hosts, including species of economic and environmental importance. This study was focused on the taxonomic and symbiovar definition of four strains – CNPSo 4026T, WSM 1704T, WSM 1738Tand WSM 4400T– previously isolated from nodules of legumes in Western Australia and South Africa. The 16S rRNA gene phylogenetic tree allocated the strains to theBradyrhizobium elkaniisupergroup. The multilocus sequence analysis (MLSA) with partial sequences of six housekeeping genes– atpD,dnaK,glnII,gyrB,recAandrpoB– did not cluster the strains under study as conspecific to any describedBradyrhizobiumspecies. Average nucleotide identity and digital DNA–DNA hybridization values were calculated for the four strains of this study and the closest species according to the MLSA phylogeny with the highest values being 95.46 and 62.20 %, respectively; therefore, both being lower than the species delineation cut-off values. ThenodCandnifHphylogenies included strains WSM 1738Tand WSM 4400Tin the symbiovars retamae and vignae respectively, and also allowed the definition of three new symbiovars, sv. cenepequi, sv. glycinis, and sv. cajani. Analysis of morphophysiological characterization reinforced the identification of four novel proposedBradyrhizobiumspecies that are accordingly named as follows:Bradyrhizobium cenepequisp. nov. (CNPSo 4026T=WSM 4798T=LMG 31653T), isolated fromVigna unguiculata;Bradyrhizobium semiaridumsp. nov. (WSM 1704T=CNPSo 4028T=LMG 31654T), isolated fromTephrosia gardneri;Bradyrhizobium hereditatissp. nov. (WSM 1738T=CNPSo 4025T=LMG 31652T), isolated fromIndigoferasp.; andBradyrhizobium australafricanumsp. nov. (WSM 4400T=CNPSo 4015T=LMG 31648T) isolated fromGlycinesp.
Long-Term Impact of Digital Media on Brain Development in Children
Authors: Nivins Samson , Sauce Bruno , Liebherr Magnus , Judd Nicholas , Klingberg Torkel
Published: July 2022

Digital media (DM) takes an increasingly large part of children’s time, yet the long-term effect on brain development remains unclear. We investigated how individual effects of DM use (i.e., using social media, playing video games, or watching television/videos) on the development of the cortex (i.e., global cortical surface area), striatum, and cerebellum in children over four years, accounting for both socioeconomic status and genetic predisposition. We used a prospective, multicentre, longitudinal cohort of children from the Adolescent Brain and Cognitive Development Study, aged 9.9 years when entering the study, and who were followed for four years. Annually, children reported their DM usage through the Youth Screen Time Survey and underwent brain magnetic resonance imaging scans every two years. Quadratic-mixed effect modelling was used to investigate the relationship between individual DM usage and brain development. We found that individual DM usage did not alter the development of cortex or striatum volumes. However, high social media usage was associated with a statistically significant change in the developmental trajectory of cerebellum volumes, and the accumulated effect of high-vs-low social media users on cerebellum volumes over four years was only β= −0.03, which was considered insignificant. Nevertheless, the developmental trend for heavy social media users was accelerated at later time points. This calls for further studies and longer follow-ups on the impact of social media on brain development.
Impact of dementia, living in a long-term care facility, and physical activity status on COVID-19 severity in older adults
Authors: Tsuzuki Shinya , Akiyama Takayuki , Matsunaga Nobuaki , Ohmagari Norio
Published: July 2022

Background

Japan is fast becoming an extremely aged society and older adults are known to be at risk of severe COVID-19. However, the impact of risk factors specific to this population for severe COVID-19 caused by the Omicron variant of concern (VOC) are not yet clear.

Methods

We performed an exploratory analysis using logistic regression to identify risk factors for severe COVID-19 illness among 4,868 older adults with a positive SARS-CoV-2 test result who were admitted to a healthcare facility between 1 January 2022 and 16 May 2022. We then conducted one-to-one propensity score (PS) matching for three factors—dementia, admission from a long-term care facility, and poor physical activity status—and used Fisher’s exact test to compare the proportion of severe COVID-19 cases in the matched data. We also estimated the average treatment effect on treated (ATT) in each PS matching analysis.

Results

Of the 4,868 cases analyzed, 1,380 were severe. Logistic regression analysis showed that age, male sex, cardiovascular disease, cerebrovascular disease, chronic lung disease, renal failure and/or dialysis, physician-diagnosed obesity, admission from a long-term care facility, and poor physical activity status were risk factors for severe disease. Vaccination and dementia were identified as factors associated with non-severe illness. The ATT for dementia, admission from a long-term care facility, and poor physical activity status was −0.04 (95% confidence interval −0.07, −0.01), 0.09 (0.06, 0.12), and 0.17 (0.14, 0.19), respectively.

Conclusions

Our results suggest that poor physical activity status and living in a long-term care facility have a substantial impact on the risk of severe COVID-19 caused by the Omicron VOC, while dementia might be associated with non-severe illness.
Deep learning segmentation of the nucleus basalis of Meynert on 3T MRI
Authors: Doss Derek J. , Johnson Graham W. , Narasimhan Saramati , Jiang Jasmine W. , González Hernán F. J. , Paulo Danika L. , Lucas Alfredo , Davis Kathryn A. , Chang Catie , Morgan Victoria L. , Constantinidis Christos , Dawant Benoit M. , Englot Dario J.
Published: July 2022

The nucleus basalis of Meynert (NBM) is a key subcortical structure that is important in arousal, cognition, brain network modulation, and has been explored as a deep brain stimulation target. It has also been implicated in several disease states, including Alzheimer’s disease, Parkinson’s disease, and temporal lobe epilepsy (TLE). Given the small size of NBM and variability between patients, NBM is difficult to study; thus, accurate, patient-specific segmentation is needed. We investigated whether a deep learning network could produce accurate, patient-specific segmentations of NBM on commonly utilized 3T MRI. It is difficult to accurately segment NBM on 3T MRI, with 7T being preferred. Paired 3T and 7T MRI datasets of 21 healthy subjects were obtained, with 6 completely withheld for testing. NBM was expertly segmented on 7T MRI, providing accurate labels for the paired 3T MRI. An external dataset of 14 patients with TLE was used to test the model on brains with neurological disorders. A 3D-Unet convolutional neural network was constructed, and a 5-fold cross-validation was performed. The model was evaluated on healthy subjects using the held-out test dataset and the external dataset of TLE patients. The model demonstrated significantly improved dice coefficient over the standard probabilistic atlas for both healthy subjects (0.68MEAN±0.08SD vs. 0.47±0.06, p=0.0089, t-test) and TLE patients (0.63±0.08 vs. 0.38±0.19, p=0.0001). Additionally, the centroid distance was significantly decreased when using the model in patients with TLE (1.22±0.33mm, 3.25±2.57mm, p=0.0110). We developed the first model, to our knowledge, for automatic and accurate patient-specific segmentation of the NBM.
An ultra-sensitive bacterial pathogen and antimicrobial resistance diagnosis workflow using Oxford Nanopore adaptive sampling sequencing method
Authors: Cheng Hang , Sun Yuhong , Yang Qing , Deng Minggui , Yu Zhijian , Liu Lei , Yang Liang , Xia Yu
Published: July 2022

Metagenomic sequencing analysis has been implemented as an alternative approach for pathogen diagnosis in recent years, which is independent on cultivation and able to identify all potential antibiotic resistant genes. However, current metagenomic sequencing analysis methods have to deal with low amounts of prokaryotic DNA and high amounts of host DNA in clinical samples, which significantly decrease the overall microbial detection resolution. The recently released nanopore adaptive sampling (NAS) technology facilitates immediate mapping of individual nucleotides to a given reference as each molecule is sequenced. User-defined thresholds allow for the retention or rejection of specific molecules, informed by the real-time reference mapping results, as they are physically passing through a given sequencing nanopore. We developed a metagenomics workflow for ultra-sensitive diagnosis of bacterial pathogens and antibiotic resistance genes (ARGs) from clinic samples, which is based on the efficient selective ‘human host depletion’ NAS sequencing, real-time species identification and species-specific resistance gene prediction. Our method increased microbial sequence yield at least 8-fold in all 11 sequenced clinical Bronchoalveolar Lavage Fluid (BALF) samples (4.5h from sample to result), displayed 100% sensitivity and specificity for pathogen detection compared with cultivation method, and accurately detected antibiotic resistance genes at species level.