bluuebunny/crossref_metadata_2025 huggingface dataset:
Obstetric Anesthesia Procedure-based Workload and Facility Utilization of Society of Obstetric Anesthesia and Perinatology Centers of Excellence Designated Institutions
Authors: Im M. , Riley E.T. , Hoang D. , Lim G. , Zakowski M. , Carvalho B.
Published: May 2023

(Anesth Analg. 2022;135:1142–1150)

Determining appropriate and adequate staffing is essential for obstetric anesthesia care to safeguard favorable maternal and neonatal outcomes. Despite this, the optimal workload of obstetric anesthesia staff has yet to be determined, possibly because of the unpredictable and ever-changing needs within the obstetric clinical setting. This study aimed to define anesthesia time-based staffing workloads among the 53 Society of Obstetric Anesthesia and Perinatology (SOAP) Centers of Excellence (COE) and to offer procedure-based workload ratios that other institutions can utilize to help guide obstetric anesthesia staffing decisions.
Learning From the Law: A Review of 21 Years of Litigation for Anesthetic Negligence Resulting in Peripartum Hypoxic Ischemic Encephalopathy
Authors: McCombe K. , Bogod D.G.
Published: May 2023

(Anaesthesia. 2022;77:919–928)

The authors of this study reviewed 367 negligence claims in the United Kingdom in order to highlight anesthesia-service related errors. Specifically, they reviewed cases of hypoxic ischemic encephalopathy (HIE), which is caused by interrupted oxygen supply to the fetal/neonatal brain. The causes and effects range, but HIE may lead to a neonate requiring lifelong care. Verified maternity negligent claims are expensive and represent a comparatively large quantity of claims submitted to and granted by the NHSLA. In addition, because peripartum HIE is so severe, millions of pounds can be awarded decades after the inciting incident took place. Anesthetists are often included in obstetric and HIE negligence claims as they play an integral role in the wellbeing of both mother and child.
Abortion Access as a Racial Justice Issue
Authors: Kozhimannil K.B. , Hassan A. , Hardeman R.R.
Published: May 2023

(N Engl J Med. 2022;387:1537–1539)

Improvement of racial equity in health care is a significant priority for research and policy, as disparity in outcomes is readily apparent. The landmark US Supreme Court ruling on Dobbs v. Jackson Women’s Health in June 2022 severely constrained access to abortion, a procedure considered an essential element of comprehensive reproductive care. The legal status of abortion impacts the civil rights of all with the capacity for pregnancy, but has strong reverberations in the Black and Indigenous populations of the United States, who have historically suffered from acute reproductive oppression. Abortion access is proposed as a racial justice issue that should be addressed by policymakers, health care organizations and clinicians.
Trends in Active Treatment of Live-born Neonates Between 22 Weeks 0 Days and 25 Weeks 6 Days by Gestational Age and Maternal Race and Ethnicity in the United States, 2014-2020
Authors: Venkatesh K.K. , Lynch C.D. , Constantine M.M. , Backes C.H. , Slaughter J.L. , Frey H.A. , Huang X. , Landon M.B. , Klebanoff M.A. , Khan S.S. , Grobman W.A.
Published: May 2023

(JAMA. 2022;328:652–662)

In 2015, 0.4% of all deliveries in the United States occurred between 22 weeks 0 days gestation and 25 weeks 6 days gestation, but these periviable births accounted for 40% of neonatal deaths. Decisions regarding treatment of these neonates can be difficult and involve several factors, most of all gestational age at delivery, but also parental preferences, neonatal characteristics, obstetric characteristics, and clinician characteristics. Neonatal morbidity and mortality varies by race, with a higher mortality rate for Black infants compared with White infants. Previous data from more than a decade ago suggests there may be racial disparities in treatment decisions for periviable neonates. This study aimed to explore treatment decisions among this cohort of neonates from 2014 to 2020 and investigate whether these decisions vary by maternal race and ethnicity.
Predictors and Hospital Outcomes in Pregnant Patients Undergoing Extracorporeal Membrane Oxygenation: A Nationwide Study
Authors: Van den Bosch O.F.C. , Chaudhry R. , Wicker J. , Balki M.
Published: May 2023

(Anesth Analg. 2022;135:1172–1179)

Extracorporeal membrane oxygenation (ECMO) use, advanced cardiorespiratory support for patients with decreased cardiac or respiratory function, has been on the rise. ECMO for pregnant women has also become more common, however, studies on ECMO often lack inclusion of parturients. Given a lack of information regarding appropriate timing and indications for ECMO for pregnant women, this study seeks to identify in-hospital mortality and morbidity rates for parturients who underwent ECMO.
Severe Maternal Morbidity in Scotland
Authors: Masterson J.A. , Adamestam I. , Beatty M. , Boardman J.P. , Johnston P. , Joss J. , Lawrence H. , Litchfield K. , Walsh T.S. , Wise A. , Wood R. , Weir C.J. , Denison F.C. , Lone N.I.
Published: May 2023

(Anaesthesia. 2022;77:971–980)

The rate of maternal mortality in the United Kingdom is at its lowest in history. Studying severe maternal morbidity may give insights into how to further reduce both mortality and morbidity in pregnancy and childbirth. This study aimed to report on the incidence of severe maternal morbidity in the United Kingdom, and associated risk factors, by creating a composite measure of maternal morbidity.
Causes of Perinatal Deaths in Australia: Slow Progress in the Preterm Period
Authors: Tnadal K. , Bimal G. , Flenady  , Gordon A. , Farrell T. , Davies-Tuck M.
Published: May 2023

(Aust N Z J Obstet Gynaecol. 2022;62:511–517)

The rate of stillbirth in Australia decreased from 25% to 15% over the last 20 years. Ninety percent of Australian stillbirths are born before 28 gestational weeks (EGA), and the number of deaths following preterm birth in Australia has remained stable. Despite perinatal and neonatal death being relatively similar, many studies attempt to ignore their similarities and focus on one of them. This study researched the impact of EGA on preterm stillbirth and neonatal death to identify where future research should focus.
A Step Toward Better Audit: The Robson Ten Group Classification System for Outcomes Other Than Cesarean Section
Authors: Savchenko J. , Ladfors L. , Hjertberg L. , Hildebrand E. , Wendel S.B.
Published: May 2023

(Acta Obstet Gynecol Scand. 2022;101:827–835)

The Robson groups, a classification system created in 2001 by Michael S. Robson, is utilized for the review of cesarean delivery (CD) rates across different groups of parturients based on parity, number of fetuses, fetal presentation, gestational age, and mode of onset of labor. This study investigated if the Robson Ten System can be extended to studying and comparing other attributes of delivery besides CD such as obstetric and sphincter injury (OASIS), operative vaginal delivery (OVD), Apgar scores, and postpartum hemorrhage.
The Bupivacaine Story: A Tribute to George A. Albright, MD (1931-2020)
Authors: Larson C.P. , Youssefzadeh K. , Moon J.S.
Published: May 2023

(Anesth Analg. 2022;135:1115–1119)

In 1978, George A. Albright, MD (1931-2020) presented an editorial for publication titled, “Cardiac Arrest Following Regional Anesthesia with Etidocaine or Bupivacaine.” Starting in 1963, bupivacaine became a promising local anesthetic used around the world. At a time when bupivacaine during obstetric anesthesia was a standard practice, George Albright’s manuscript reported 5 cases showed that bupivacaine was associated with an increased mortality rate compared with other local anesthetics during epidurals or brachial plexus blocks. Raising the question of bupivacaine cardiotoxicity and calling for further investigation of bupivacaine use sparked controversy. C. Philip Larson, MDCM, MS, Professor and Chair of the Department of Anesthesia at Stanford and Editor-in-Chief of Anesthesiology at the time of Dr. Albright’s editorial submission, decided to publish the piece despite it receiving harsh criticism from expert reviewers. Dr Albright’s controversial editorial ultimately led to several important anesthesiology advancements, including laboratory studies proving bupivacaine cardiotoxicity, the discontinuation of bupivacaine 0.75% epidurally in clinic, safeguards before incremental anesthetic injection, development of less toxic local anesthetics, and further research into intravenous lipid emulsion to counteract adverse effects of bupivacaine cardiotoxicity. Stemming from Dr. Albright’s research, from 1983 to 1999, the US Food and Drug Administration (FDA) issued a black box warning against 0.75% bupivacaine use during obstetric anesthesia.
The Role of Total Intravenous Anesthesia for Cesarean Delivery
Authors: Metodiev Y. , Lucas D.N.
Published: May 2023

(Int J Obstet Anesth. 2022;51:103548)

Neuraxial anesthesia is the most utilized anesthetic technique for obstetric purposes, but general anesthesia (GA) is sometimes used in cesarean deliveries (CD) and rare other scenarios. In obstetric GA cases, the most common scenario is an IV induction followed by maintenance through inhaled volatile halogenated anesthetic gas. Outside of obstetrics, total intravenous aesthesia (TIVA) is gaining popularity because it causes fewer environmental concerns and exhibits superior recovery when compared to inhaled anesthesia. However, there are also potential drawbacks and not much has been published regarding the use of TIVA for CD. This paper is a review of the evidence available regarding both the benefits and the barriers of TIVA for CDs.
The impact of new and emerging agents on outcomes for febrile neutropenia: addressing clinical gaps
Authors: Crawford Jeffrey , Oswalt Cameron
Published: May 2023

Purpose of review

While chemotherapy treatment options for patients with solid and hematologic malignancies have dramatically improved over recent years, chemotherapy-induced neutropenia (CIN) and febrile neutropenia (FN) remain major barriers to delivering treatment at full doses and optimal timing. Despite concurrent advances in granulocyte colony-stimulating factor (G-CSF) administration, multiple barriers to the administration of and disparities in the access to these agents remain. The introduction of new, emerging agents, including biosimilars and novel therapies show promise in improving outcomes for CIN.

Recent findings

The introduction of biosimilar filgrastim products has improved access to G-CSF administration by driving marketplace competition and has reduced costs for both patients and healthcare systems without sacrificing efficacy. Emerging therapies to address similar issues include long-acting G-CSF products, efbemalenograstim alfa and eflapegrastin-xnst, as well as agents with novel mechanisms of action, plinabulin and trilaciclib. These agents have shown efficacy and cost-saving benefits in certain populations and disease groups.

Multiple emerging agents show promise in decreasing the burden of CIN. Use of these therapies will reduce access disparities and will improve outcomes for patients with cancer receiving cytotoxic chemotherapy. Many ongoing trials are underway to evaluate the roles of these agents for more widespread use.
New treatments for desmoid tumors
Authors: Kasper Bernd
Published: May 2023

Purpose of review

Desmoid tumor is a rare disease of intermediate malignancy characterized by a locally aggressive monoclonal, fibroblastic proliferation and accompanied by a variable and often unpredictable clinical course. The purpose of this review is to give an overview on the emerging new systemic treatment options for this intriguing disease for which no established or approved drugs are available yet.

Recent findings

Over decades, surgical resection has been the established initial treatment approach; however, more recently, a paradigm shift has been introduced towards a more conservative treatment strategy. Almost 10 years ago, The Desmoid Tumor Working Group has initiated a consensus process initially in Europe and then globally with the intention to harmonize the therapeutic strategy amongst clinicians and set up management recommendations for desmoid tumor patients.

This review will summarize and focus on the latest emerging impressive data on the use of gamma secretase inhibitors in this disease paving a possible future perspective in the treatment armamentarium for desmoid tumor patients.
Adjuvant and neoadjuvant approaches in pancreatic cancer
Authors: Conroy Thierry , Lambert Aurélien , Ducreux Michel
Published: May 2023

Purpose of review

Pancreatic cancer treatment remains a challenging problem for surgeons and oncologists. This review aims to summarize the current advances on adjuvant and neoadjuvant treatment approaches for resectable pancreatic cancer.

Recent findings

Recent phase III randomized trials of adjuvant therapy showed improvement of overall survival in both experimental and control groups. Effectiveness of adjuvant therapy in specific subgroups as elderly patients, intraductal papillary mucinous neoplasms, stage I, and DNA damage repair gene germline variants has been reported. Completion of all cycles of planned adjuvant chemotherapy is confirmed as an independent prognostic factor. Adjuvant chemotherapy remains underutilized, mainly because of early recurrence, prolonged recovery, or older age older than 75 years. So, neoadjuvant treatment is a logical approach to administer systemic treatment to more patients. Meta-analysis did not demonstrate an overall survival benefit of neoadjuvant treatments in resectable pancreatic cancer, and definitive conclusions cannot be drawn from available randomized controlled trials. Upfront surgery and adjuvant chemotherapy should still be considered a standard approach in resectable pancreatic cancer.

Adjuvant chemotherapy with mFOLFIRINOX remains the standard of care in fit patients with resected pancreatic cancer, and limited high-level evidence support the use of neoadjuvant therapy in upfront resectable pancreatic cancer.
PROMIS Profile-29 is a valid instrument with distinct advantages over legacy instruments for measuring the quality of life in chronic liver disease
Authors: Desai Archita P. , Madathanapalli Abhishek , Tang Qing , Orman Eric S. , Lammert Craig , Patidar Kavish R. , Nephew Lauren D. , Ghabril Marwan , Monahan Patrick O. , Chalasani Naga
Published: May 2023

Background and Aims:

The Patient-Reported Outcomes Measurement Information System (PROMIS) is increasingly used to measure health-related quality of life, yet, it has not been well-studied in chronic liver disease (CLD). This study compares PROMIS Profile-29 to Short-Form Health Survey (SF-36) and Chronic Liver Disease Questionnaire (CLDQ) in patients with CLD.

Approach and Results:

In all, 204 adult outpatients with CLD completed PROMIS-29, CLDQ, SF-36 and usability questionnaires. Mean scores were compared between groups, the correlation between domain scores was assessed, and floor/ceiling effects were calculated. Etiologies of CLD were NAFLD (44%), hepatitis C (16%), and alcohol (16%). Fifty-three percent had cirrhosis and 33% were Child-Pugh B/C with a mean model for end-stage liver disease score of 12.0. In all 3 tools, the poorest scores were in physical function and fatigue. The presence of cirrhosis or complications was associated with worse scores in most PROMIS Profile-29 domains, indicating known group validity. Strong correlations (r ≥ 0.7) were present between Profile-29 and SF-36 or CLDQ domains measuring similar concepts, indicating strong convergent validity. Profile-29 was completed faster than SF-36 and CLDQ (5.4 ± 3.0, 6.7 ± 3.3, 6.5 ± 5.2 min, p = 0.003) and rated equally on usability. All CLDQ and SF-36 domains reached the floor or ceiling, while none were noted for Profile-29. These floor/ceiling effects were magnified when assessed in those with and without cirrhosis, indicating the improved depth of measurement by Profile-29.

Conclusions:

Profile-29 is a valid, more efficient, well-received tool that provides an improved depth of measurement when compared to SF-36 and CLDQ and, therefore, an ideal tool to measure general health-related quality of life in CLD.
Quantifying Head Position Following Vitrectomy Using a 3-Dimensional Position Sensor Embedded in a Novel Ophthalmic Shield: A Pilot Study
Authors: Mahmoudzadeh Raziyeh , Shahlaee Abtin , Soares Rebecca R. , Patel Samir N. , Xu David , Gupta Omesh P. , Chiang Allen
Published: May 2023

Purpose:

To assess head position following pars plana vitrectomy (PPV) using a novel low-energy, non-intrusive 3-D position sensor platform.

Methods:

In this prospective non-randomized interventional case series, a low-energy Bluetooth smart sensor housed within a novel eye shield recorded 3-D positional data every five minutes. The device was placed on the patient immediately after PPV and data was retrieved at the postoperative day 1 visit. Readings were processed by vector analysis into 4 groups, stratified by the angle of deviation away from a completely prone head position. The primary outcome was the angle between vectors.

Results:

Ten patients were enrolled in this pilot study. The mean (SD) age was 57.5 (17.4). A total of 2318 readings with a mean (SD) of 231.8 (26.8) readings per patient were obtained. The mean (SD) number of readings were 132.9 (34.7) while awake and 98.9 (27.9) during sleep. Of total readings, only 11.7% fell into group 1 while a majority of readings fell in group 2 (52.4%), and group 3 (32.4%), and only 3.5% fell into group 4. Positional deviation increased during sleep hours, with about 46.8% of readings at a reclined angle (group 3) and 4.9% supine, which was 21.6% and 2.5% respectively during the wake time (p<0.001, p=0.002, respectively).

Conclusion:

In this pilot study, a non-intrusive wireless 3-D position sensor-shield platform was tolerated well and capable of capturing positional data. Adherence to face-down positioning was low and positional deviation increased significantly while sleeping.
Discriminant ability of the shock index, modified shock index, and reverse shock index multiplied by the Glasgow coma scale on mortality in adult trauma patients: a PATOS retrospective cohort study
Authors: Chen Tse-Hao , Wu Meng-Yu , Do Shin Sang , Jamaluddin Sabariah F. , Son Do Ngoc , Hong Ki Jeong , Jen-Tang Sun , Tanaka Hideharu , Hsiao Chien-Han , Hsieh Shang-Lin , Chien Ding-Kuo , Tsai Weide , Chang Wen-Han , Chiang Wen-Chu ,   The PATOS Clinical Research Network
Published: May 2023

Background:

The shock index (SI) predicts short-term mortality in trauma patients. Other shock indices have been developed to improve discriminant accuracy. The authors examined the discriminant ability of the SI, modified SI (MSI), and reverse SI multiplied by the Glasgow Coma Scale (rSIG) on short-term mortality and functional outcomes.

Methods:

The authors evaluated a cohort of adult trauma patients transported to emergency departments. The first vital signs were used to calculate the SI, MSI, and rSIG. The areas under the receiver operating characteristic curves and test results were used to compare the discriminant performance of the indices on short-term mortality and poor functional outcomes. A subgroup analysis of geriatric patients with traumatic brain injury, penetrating injury, and nonpenetrating injury was performed.

Results:

A total of 105 641 patients (49±20 years, 62% male) met the inclusion criteria. The rSIG had the highest areas under the receiver operating characteristic curve for short-term mortality (0.800, CI: 0.791–0.809) and poor functional outcome (0.596, CI: 0.590–0.602). The cutoff for rSIG was 18 for short-term mortality and poor functional outcomes with sensitivities of 0.668 and 0.371 and specificities of 0.805 and 0.813, respectively. The positive predictive values were 9.57% and 22.31%, and the negative predictive values were 98.74% and 89.97%. rSIG also had better discriminant ability in geriatrics, traumatic brain injury, and nonpenetrating injury.

Conclusion:

The rSIG with a cutoff of 18 was accurate for short-term mortality in Asian adult trauma patients. Moreover, rSIG discriminates poor functional outcomes better than the commonly used SI and MSI.
The role of robotic retroperitoneal lymph node dissection in testicular cancer: a systematic review and meta-analysis
Authors: Ge Si , Zeng Zhiqiang , Li Yunxiang , Gan Lijian , Meng Chunyang , Li Kangsen , Wang Zuoping , Zheng Lei
Published: May 2023

Objective:

To compare the safety and efficacy of robotic-assisted retroperitoneal lymph node dissection (RA-RPLND) versus non-robotic retroperitoneal lymph node dissection (NR-RPLND) in testicular cancer.

Methods:

The statistical analysis software used Stata17. The weighted mean difference (WMD) represents the continuous variable, and the dichotomous variable chooses the odds ratio (OR), and calculates the 95% confidence interval (95% CI). This systematic review and cumulative meta-analysis was performed according to PRISMA criteria, and AMSTAR guidelines (assessing the methodological quality of systematic reviews). The Embase, PubMed, Cochrane Library, Web of Science, and Scopus databases were searched. The upper limit of the search time frame was February 2023, and no lower limit was set.

Results:

Seven studies involving 862 patients. Compared with open retroperitoneal lymph node dissection, RA-RPLND appears to have a shorter length of stay (WMD=−1.21, 95%CI [−1.66, −0.76], P<0.05), less estimated blood loss (WMD=−0.69, 95%CI [−1.07, −0.32], P<0.05), and lower overall complications (OR=0.45, 95%CI [0.28, 0.73], P<0.05). RA-RPLND appears to have more lymph node yields than laparoscopic retroperitoneal lymph node dissection (WMD=5.73, 95% CI [1.06, 10.40], P<0.05). However, robotic versus open/laparoscopic retroperitoneal lymph node dissection had similar results in operation time, lymph node positivity rate, recurrence during follow-up, and postoperative ejaculation disorders.

Conclusion:

Robotic-assisted retroperitoneal lymph node dissection appears to be safe and effective for testicular cancer, but longer follow-up and more studies are needed to confirm this.
Comparison of pure laparoscopic donor right posterior sectionectomy versus right hemihepatectomy for living donor liver transplantation
Authors: Cho Chan Woo , Choi Gyu-Seong , Lee Do Hyeon , Kim Hyoung Joo , Yun Sung Su , Lee Dong-Shik , Rhu Jinsoo , Kim Jong Man , Joh Jae-Won , Kim Kyeong Sik
Published: May 2023

The right posterior section (RPS) graft for living donor liver transplantation is an alternative graft in a live liver donor with insufficient remnant left lobe volume and portal vein anomaly. Although there have been some reports regarding pure laparoscopic donor right posterior sectionectomy (PLDRPS), no study has compared PLDRPS versus pure laparoscopic donor right hemihepatectomy (PLDRH). The aim of our study was to compare the surgical outcomes of PLDRPS versus PLDRH at centers achieving a complete transition from open to laparoscopic approach in liver donor surgery. From March 2019 to March 2022, a total of 351 living donor liver transplantations, including 16 and 335 donors who underwent PLDRPS and PLDRH, respectively, were included in the study. In the donor cohort, there were no significant differences in major complication (≥grade III) rate and comprehensive complication index between the PLDRPS versus PLDRH group (6.3% vs. 4.8%; p = 0.556 and 2.7 ± 8.6 vs.1.7 ± 6.4; p = 0.553). In the recipient cohort, there was a significant difference in major complication (≥grade III) rate (62.5% vs. 35.2%; p = 0.034) but no significant difference in comprehensive complication index (18.3 ± 14.9 vs. 15.2 ± 24.9; p = 0.623) between the PLDRPS and PLDRH groups. PLDRPS in live liver donors with portal vein anomaly and insufficient left lobe was technically feasible and safe with experienced surgeons. The PLDRPS group might be comparable with the PLDRH group based on the surgical outcomes of donors and recipients. However, in terms of recipient outcomes, more careful selection of donors of the RPS graft and further research in a large number of cases are necessary to evaluate the usefulness of PLDRPS.
Evaluation of the Validity of Endoscopic Transpapillary Gallbladder Drainage for Acute Cholecystitis Based on the Tokyo Guidelines 2018
Authors: Suzuki Keiichi , Naito Hirofumi , Naito Eri , Sasaki Taketo , Yoshikawa Yusuke , Omagari Kenshi , Yoshitake Naoto , Koike Takero , Hashimoto Takeo , Tamura Akihiko
Published: May 2023

Goals:

We evaluated the validity of endoscopic transpapillary gallbladder drainage (ETGBD) as a bridging therapy prior to elective Lap-C for the patients with acute cholecystitis (AC)

Background:

The Tokyo Guidelines 2018 recommend early laparoscopic cholecystectomy (Lap-C) for patients with AC, however, some patients require the preoperative drainage because of inadequate for early Lap-C du to background and comorbidities.

Study:

We performed a retrospective cohort analysis using data from our hospital records from 2018–2021. In total, 71 cases of 61 patients with AC underwent ETGBD.

Results:

The technical success rate was 85.9%. Patients in the failure group had more complicated branching of the cystic duct. The length of time until feeding was started and until WBC levels normalized, and the length of hospital stay were significantly shorter in the success group. The median waiting period for surgery was 39 days in the ETGBD success cases. The median operating time, amount of bleeding, and length of postoperative hospital stay were 134 min, 83.2g, and 4 days, respectively. In patients who underwent Lap-C, the waiting period for surgery and the operating time were similar between the ETGBD success and failure groups. However, the temporary discharge period after drainage and the length of postoperative hospital stay were significantly longer in the patients with ETGBD failure.

Conclusions:

Our study revealed that ETGBD has equivalent efficacy prior to elective Lap-C despite some challenges that lower its success rate. Preoperativ ETGBD can improve patient quality of life by eliminating the need for a drainage tube.
Neuromodulator Finesse for Masseter Hypertophy and Bruxism
Authors: Chiodo Michael V. , Lisiecki Jeffrey L. , Rohrich Rod J.
Published: May 2023

A particularly prominent mandibular angle or a hypertrophied masseter muscle can result in an excessively wide facial appearance which is often less aesthetically pleasing, especially for women. Though normally a benign condition and strictly an aesthetic concern, a hypertrophied masseter can also cause pain, bruxism, and headaches. Neuromodulator for masseter reduction and treatment of bruxism has become first line. Here we provide the senior author’s anatomic approach to neuromodulator injection of the masseter with a corresponding video of the injection technique.
Tracing the change and the contribution of subcutaneous adipose to skin expansion using a luciferase-transgenic fat transplantation model
Authors: Zhou Shuang-Bai , Zhang Pei-Qi , Zhang Xiao-Jie , Tan Poh-Ching , Kobayashi Eiji , Li Qing-Feng
Published: May 2023

Background:

During skin expansion, subcutaneous adipose tissue undergoes the greatest change. The adipose layer appears to gradually thin or even disappear in long-term expansion. The response and contribution of adipose tissue to skin expansion remain to be elucidated.

Methods:

We established a novel expansion model by transplanting luciferase-transgenic (Tg) adipose tissue into the rat dorsum followed by integrated expansion. We traced the dynamic changes in subcutaneous adipose tissue during expansion and the migration of adipose tissue-derived cells. In vivo luminescent imaging was performed to continuously track the adipose tissue changes. Histological analysis and immunohistochemical staining were performed to evaluate the regeneration and vascularization of the expanded skin. Growth factor expression in expanded skin with or without adipose tissue was determined to evaluate the paracrine effect of adipose tissue. Adipose tissue-derived cells were traced in vitro by anti-luciferase staining, and their fate was determined by costaining for PDGFRα, DLK1 and CD31.

Results:

In vivo bioimaging showed that cells in adipose tissue were alive during expansion. After expansion, the adipose tissue exhibited fibrotic-like structures, with more DLK1+ preadipocytes. Skin expanded with adipose tissue was significantly thicker than that without adipose tissue, with more blood vessels and cell proliferation. Vegf, Egf and bFgf expression was higher in adipose tissue than in skin, indicating paracrine support from adipose tissue. Luc+ adipose tissue-derived cells were observed in expanded skin, indicating direct participation in skin regeneration.

Conclusion:

Adipose tissue transplantation can effectively promote long-term skin expansion by contributing to vascularization and cell proliferation via various mechanisms.

Clinical Relevance Statement:

Our findings suggest that it would be better if the expander pocket is dissected over the superficial fascia to preserve a layer of adipose tissue with skin. Additionally, our findings support the treatment of fat grafting when expanded skin presents thinning.
Efficacy of Antithrombotic Therapy and Risk of Hemorrhagic Complication in Blunt Cerebrovascular Injury Patients with Concomitant Injury: A Systematic Review
Authors: D’Souza Karan , Norman Mathew , Rebchuk Alexander D , Samarasinghe Nadeesha , Hounjet Celine D , Griesdale Donald EG , Joos Emilie , Field Thalia S
Published: May 2023

Introduction

The risk-benefit balance of antithrombotic therapy administration for blunt cerebrovascular injuries (BCVI) patients with concomitant injuries at high risk for bleeding is an ongoing therapeutic conundrum for trauma clinicians. We performed a systematic review to assess the reported efficacy and safety of treatment in this population with respect to prevention of ischemic stroke and risk of hemorrhagic complications.

Study Design:

A systematic electronic literature search of MEDLINE, EMBASE, Cochrane Library, and Web of Science databases was performed from January 1, 1996 to December 31, 2021. Studies were included if they reported treatment-stratified clinical outcomes after antithrombotic therapy in BCVI patients with concomitant injuries at high risk of bleeding into a critical site. Data were extracted from selected studies by two independent reviewers, including the main outcomes of interest were BCVI-related ischemic stroke rates and rates of hemorrhagic complications.

Results

Of 5999 studies reviewed, 10 reported on the effects of treating BCVI patients with concurrent traumatic injuries and were included for review. In the pooled data, amongst patients with BCVI and concomitant injury who received any form of antithrombotic therapy, the BCVI-related stroke rate was 7.6%. In the sub-group of patients who did not receive therapy had an overall BCVI-related stroke rate of 34%. The total rate of hemorrhagic complications in the treated population was 3.4%.

Conclusions

In BCVI patients with concomitant injuries at high risk for bleeding, antithrombotic use reduces the risk of ischemic strokes with a low reported risk of serious hemorrhagic complications.
Genome-wide by environment interaction studies of maternal smoking and educational score in UK biobank
Authors: Huang Huimei , Liu Li , Feng Fenling , Sun Hongli , Li Fei , Wu Haibin , Liang Chujun , Chu Xiaomeng , Ning Yujie , Zhang Feng
Published: May 2023

Purpose

This study aimed to investigate the associations between maternal smoking (MS) and education score in adult offspring.

Methods

To better understand this link, we performed a two-stage genome-wide by environment interaction studies (GWEIS) of MS and offspring education score in UK Biobank cohort. Specifically, 276 996 subjects from England were enrolled in the discovery study, while 24 355 subjects from Scotland and 14 526 subjects from Wales were enrolled in the replication study. GWEIS were conducted by PLINK 2.0 with MS used as an environmental risk factor.

Results

Significant GWEIS associations (P < 0.0001) between MS and offspring education score in both the discovery cohort and two replicate cohorts (Scotland population and Wales population) were identified. GWEIS identified 2 independent significant single nucleotide polymorphism–MS interaction, with one variant located in the chromosomal 16 (rs72768988, Position: 22,768,798, P = 1.22 × 10-8, β = 6.7662) and the other one located in 2q32.3 region (2 : 196424612_GT_G, Position: 196 424 612, 3.60 × 10-9, β = −0.4721).

Conclusion

Our results suggested 2q32.3 region and HECW2 gene could negatively moderate the influence of MS on offspring's educational status.
Mindreading by body: incorporating mediolateral balance and mouse-tracking measures to examine the motor basis of adults’ false-belief tracking
Authors: Zani Giovanni , Butterfill Stephen A. , Low Jason
Published: May 2023

The role played by motor representations in tracking others’ belief-based actions remains unclear. In experiment 1, the dynamics of adults’ anticipatory mediolateral motor activity (leftwards–rightwards leaning on a balance board) as well as hand trajectories were measured as they attempted to help an agent who had a true or false belief about an object’s location. Participants’ leaning was influenced by the agent’s belief about the target’s location when the agent was free to act but not when she was motorically constrained. However, the hand trajectories participants produced to provide a response were not modulated by the other person’s beliefs. Therefore, we designed a simplified second experiment in which participants were instructed to click as fast as possible on the location of a target object. In experiment 2, mouse-movements deviated from an ideal direct path to the object location, with trajectories that were influenced by the location in which the agent falsely believed the object to be located. These experiments highlight that information about an agent’s false-belief can be mapped onto the motor system of a passive observer, and that there are situations in which the motor system plays an important role in accurate belief-tracking.
Climatic forcing and individual heterogeneity in a resident mountain bird: legacy data reveal effects on reproductive strategies
Authors: Eriksen Lasse Frost , Ringsby Thor Harald , Pedersen Hans Chr. , Nilsen Erlend B.
Published: May 2023

Optimization of clutch size and timing of reproduction have substantial effects on lifetime reproductive success in vertebrates, and both individual quality and environmental variation may impact life history strategies. We tested hypotheses related to maternal investment and timing of reproduction, using 17 years (1978–1994) of individual-based life history data on willow ptarmigan (Lagopus l. lagopus,n= 290 breeding females withn= 319 breeding attempts) in central Norway. We analysed whether climatic variation and individual state variables (age and body mass) affected the number of offspring and timing of reproduction, and individual repeatability in strategies. The results suggest that willow ptarmigan share a common optimal clutch size that is largely independent of measured individual states. While we found no clear direct weather effects on clutch size, higher spring temperatures advanced onset of breeding, and early breeding was followed by an increased number of offspring. Warmer springs were positively related to maternal mass, and mass interacted with clutch size in production of hatchlings. Finally, clutch size and timing of reproduction were highly repeatable within individuals, indicating that individual quality guided trade-offs in reproductive effort. Our results demonstrate how climatic forcing and individual heterogeneity in combination influenced life history traits in a resident montane keystone species.
Spatial monitoring of flying insects over a Swedish lake using a continuous-wave lidar system
Authors: Jansson Samuel , Brydegaard Mikkel , Mei Liang , Li Tianqi , Larsson Jim , Malmqvist Elin , Åkesson Susanne , Svanberg Sune
Published: May 2023

We have used a continuous-wave bi-static lidar system based on the Scheimpflug principle in measurements on flying insects above, and in the vicinity of, a small lake located in a forested area in Southern Sweden. The system, which operates on triangulation principles, has a high spatial resolution at close distance, followed by a subsequent decline in resolution further from the sensor, related to the compact system design with a separation of transmitter and receiver by only 0.81 m. Our study showed a strong increase in insect abundance especially at dusk, but also at dawn. Insect numbers decreased over water compared to over land, and larger insects were over-represented over water. Further, the average size of the insects increased at night compared to day time.
Synthesis of cuprous oxide/silver (Cu
2
O/Ag) hybrid as surface-enhanced Raman scattering probe for trace determination of methyl orange
Authors: Pham Thi Thu Ha , Vu Xuan Hoa , Dien Nguyen Dac , Trang Tran Thu , Van Hao Nguyen , Toan Nguyen Duc , Thi Ha Lien Nghiem , Tien Tong Sy , Chi Tran Thi Kim , Hien Nguyen Thi , Tan Pham Minh , Linh Dong Thi
Published: May 2023

Recently, there have been publications on preparing hybrid materials between noble metal and semiconductor for applications in surface-enhanced Raman scattering (SERS) substrates to detect some toxic organic dyes. However, the use of cuprous oxide/silver (Cu
2
O/Ag) to measure the trace amounts of methyl orange (MO) has not been reported. Therefore, in this study, the trace level of MO in water solvent was determined using a SERS substrate based on Cu
2
O microcubes combined with silver nanoparticles (Ag NPs). Herein, a series of Cu
2
O/Ag
x
(

x
=

1–5) hybrids with various Ag amounts was synthesized via a solvothermal method followed by a reduction process, and their SERS performance was studied in detail. X-ray diffraction (XRD) and scanning electron microscopy results confirmed that 10 nm Ag NPs were well dispersed on 200–500 nm Cu
2
O microcubes to form Cu
2
O/Ag heterojunctions. Using the as-prepared Cu
2
O and Cu
2
O/Ag
x
as MO probe, the Cu
2
O/Ag5 nanocomposite showed the highest SERS activity of all samples with the limit of detection as low to 1 nM and the enhancement factor as high as 4 × 10
8
. The logarithm of the SERS peak intensity at 1389 cm
−1
increased linearly with the logarithm of the concentration of MO in the range from 1 nM to 0.1 mM.
A boost in self-esteem after positive social evaluation predicts social and non-social learning
Authors: van Schie Charlotte , Cook Jennifer L. , Elzinga Bernet , Ly Verena
Published: May 2023

Fluctuations in self-esteem resulting from social acceptance and rejection could guide social behaviour by putting us in a state that is more or less open to social experiences. However, it remains unclear whether social acceptance and rejection may shape learning from social information depending on individual differences in self-esteem changes. Here we used a social feedback paradigm to manipulate social acceptance and rejection in a between-subjects design. Subsequently, we administered a behavioural task that enables the assessment of how well individuals learn on the basis of own experiences versus social information. Participants receiving positive (
N
= 43) versus negative (
N
= 44) social evaluation demonstrated an increase in subjective self-esteem. Importantly, the effect of the social evaluation on social learning was moderated by self-esteem changes. Specifically, an increase in self-esteem, as induced by positive evaluation, was associated with increased learning from social, but decreased learning from individual information. A decrease in self-esteem in response to negative evaluation was associated with decreased learning from individual information. These data suggest that increases in self-esteem in response to positive evaluation can induce a shift in the inclination to use social versus non-social information and may open one up to constructive learning from others.
The ethology of wolves foraging on freshwater fish in a boreal ecosystem
Authors: Freund Danielle R. , Gable Thomas D. , Johnson-Bice Sean M. , Homkes Austin T. , Windels Steve K. , Bump Joseph K.
Published: May 2023

Through global positioning system (GPS) collar locations, remote cameras, field observations and the first wild wolf to be GPS-collared with a camera collar, we describe when, where and how wolves fish in a freshwater ecosystem. From 2017 to 2021, we recorded more than 10 wolves (Canis lupus) hunting fish during the spring spawning season in northern Minnesota, USA. Wolves ambushed fish in creeks at night when spawning fish were abundant, available and vulnerable in shallow waters. We observed wolves specifically targeting sections of rivers below beaver (Castor canadensis) dams, suggesting that beavers may indirectly facilitate wolf fishing behaviour. Wolves also cached fish on shorelines. We documented these findings across five different social groups at four distinct waterways, suggesting that wolf fishing behaviour may be widespread in similar ecosystems but has probably remained difficult to study given its annual brevity. Spawning fish may serve as a valuable pulsed resource for packs because the spring spawning season coincides with low primary prey (deerOdocoileus virginianus)availability and abundance, and when packs have higher energetic demands owing to newly born pups. We demonstrate the flexibility and adaptability of wolf hunting and foraging behaviour, and provide insight into how wolves can survive in a myriad of ecosystems.
Mass mortality of the invasive alien echinoid
Diadema setosum
(Echinoidea: Diadematidae) in the Mediterranean Sea
Authors: Zirler Rotem , Schmidt Lisa-Maria , Roth Lachan , Corsini-Foka Maria , Kalaentzis Konstantinos , Kondylatos Gerasimos , Mavrouleas Dimitris , Bardanis Emmanouil , Bronstein Omri
Published: May 2023

The sea urchin
Diadema setosum
is an ecological key species across its range, particularly on coral reefs. In 2006
D. setosum
was first observed in the Mediterranean Sea, and since, it has proliferated to occupy the entire Levantine Basin. Here we report the mass mortality of the invasive
D. setosum
in the Mediterranean Sea. This is the first report of
D. setosum
mass mortality. The mortality spans over 1000 km along the Levantine coast of Greece and Turkey. The current mortality shows similar pathologies to previously reported
Diadema
mass mortality events, suggesting pathogenic infection as the cause of mortalities. Maritime transport, local currents, and fish predation of infected individuals may distribute pathogens at varying geographical scales. Due to the proximity of the Levantine Basin to the Red Sea, the risk of pathogen transport to the native Red Sea
D. setosum
population is imminent—with potentially catastrophic consequences.
Dinosaur trackways from the Upper Cretaceous Nichkesai Formation near Mayluu Suu City, Southern Tien Shan Mountains, north-western Kyrgyzstan
Authors: Flannery-Sutherland Joseph T. , Kogan Ilja , Trubin Yaroslav S. , Falkingham Peter L. , Winkler Alina , De Sousa David Donner , Krylov Kiril D. , Pokhaznikova Anastasia A. , Derbisheva Meerim , Kapitany Tamas , Dudashvili Alexey
Published: May 2023

Trackways provide essential data on the biogeographic distribution, locomotion and behaviour of dinosaurs. Cretaceous dinosaur trackways are abundant in the Americas, Europe, North Africa and East Asia, but are less well documented in Central Asia despite extensive exposure of Cretaceous terrestrial sedimentary rocks in the region. Here we report the presence of bipedal, tridactyl dinosaur trackways near the city of Mayluu Suu, Jalal Abad Oblast, north-western Kyrgyzstan, the first discovery of dinosaur trace fossils within the country. The trackways are situated on a steep slope uncovered by a landslide around the year 2000 in a highly landslide-affected area. Photogrammetry is used to digitally analyse and conserve the trace fossils. We infer a shoreface setting for the trackways based on the locality sedimentology, discuss the identity of the track makers and highlight the potential for future trackway discovery in the area. This discovery contributes vital data to an otherwise sparse record on the spatio-temporal distribution of dinosaurs in Kyrgyzstan, and to the dinosaur trackway record of Central Asia.
Wastewater Surveillance for SARS-CoV-2 in an Atlanta, Georgia Jail: A study of the feasibility of wastewater monitoring and correlation of building wastewater and individual testing results
Authors: Saber Lindsay B. , Kennedy Shanika , Yang Yixin , Moore Kyler , Wang Yuke , Hilton Stephen P. , Chang Tylis , Liu Pengbo , Phillips Victoria L. , Akiyama Matthew J. , Moe Christine L. , Spaulding Anne C.
Published: May 2023

Background

Wastewater-based surveillance (WBS) on an institutional level was implemented during the COVID-19 pandemic, including carceral facilities. In this study of a mega-jail, we examined the relationship between COVID-19 diagnostic test results from jail residents and the PCR signal for SARS-CoV-2 detection in weekly samples of jail wastewater over a 28-week period.

Methods

This study in a Georgia Jail (average population ∼2,700) was conducted October 2021-May 2022. Weekly on-site wastewater samples were collected (Moore Swabs) and tested for SARS-CoV-2 RNA using RTqPCR. The source of wastewater was identified using a tracer dye. The jail offered residents rapid antigen testing at entry. We conducted periodic mass screenings via RT-PCR of nasal swabs. We aggregated individual test data, calculated the Spearman correlation coefficient, and performed logistic regression to examine the relationship between the strength of the SARS-CoV-2 PCR signal (Ct value) in wastewater and the proportion of the jail population that tested positive for COVID-19.

Results

Overall, 3770 individual nasal specimens were collected; 3.4% were COVID-positive. Weekly diagnostic test positivity ranged from 0%-29.5%. Dye tests demonstrated that a single wastewater collection point was sufficiently representative of the jail’s aggregate viral load. Twenty-five wastewater samples were collected. RT-qPCR Ct values for wastewater samples with SARS-CoV-2 RNA ranged from 28.1-39.9. A strong inverse correlation was observed between diagnostic test positivity and Ct value (r= −0.67, p < 0.01).

Conclusion

WBS was shown to be an effective strategy for surveilling COVID-19 in a large jail. Strong partnerships with the jail administration are essential to the success of WBS surveillance.

Key Points

Monitoring the wastewater of a large jail can be effective for infectious disease surveillance.

To diagnose COVID-19, jail residents used self-collected nasal specimens.

There was a strong correlation between the prevalence of COVID-19 cases and the SARS-CoV-2 PCR signal in wastewater samples from the jail.