bluuebunny/crossref_metadata_2025 huggingface dataset:
Building (dis-)affiliative medical relationships through interactional practices of knowledge management
Authors: Džanko Minka
Published: August 2022

The goal of the current contribution is to consider and compare different aspects of (dys-)functional knowledge
management indexed by a conflict involving epistemics in Bosnian and German language. My research draws on 42 audiotaped
conversations of Bosnian and German doctors with their patients. The data was analyzed using Conversation Analysis.

This paper focuses first on the Bosnian data in which patients display an inability to provide the requested
information or display reduced access to information they are accountable for (Heritage
2012). Interactional practices of dysfunctional knowledge management lead to misunderstandings, a break in the
progressivity of the interaction, or face threatening actions such as criticism and disciplining of the patient (Holly 2001). In contrast, a focus on the German data shows a more patient-centered
approach which entails more active patient participation. Furthermore, German patients display higher medical knowledge and
more personal responsibility.
Twitter as a helping medium
Authors: Kabatnik Susanne
Published: August 2022

This article analyzes the German discourse space #depression on Twitter regarding relationship building. The data
basis is a corpus of German #depression tweets as well as follow-up communication. In the German #depression discourse space,
users initiate social exchange. This is realized interactively through narration, the formulation of wishes, questions or
requests, which evoke further reactions of the community. The basis for the relationship building, which will be demonstrated
in a case study, are the technical affordances provided by the medium and the resulting potential for interaction.
SARS-CoV-2 breakthrough infection in vaccinees induces virus-specific nasal-resident CD8+ and CD4+ T cells of broad specificity
Authors: Lim Joey Ming Er , Tan Anthony Tanoto , Le Bert Nina , Hang Shou Kit , Low Jenny Guek Hong , Bertoletti Antonio
Published: August 2022

Rapid recognition of SARS-CoV-2–infected cells by resident T cells in the upper airway might provide an important layer of protection against COVID-19. Whether parenteral SARS-CoV-2 vaccination or infection induces nasal-resident T cells specific for distinct SARS-CoV-2 proteins is unknown. We isolated T cells from the nasal mucosa of COVID-19 vaccinees who either experienced SARS-CoV-2 infection after vaccination (n = 34) or not (n = 16) and analyzed their phenotype, SARS-CoV-2 specificity, function, and persistence. Nasal-resident SARS-CoV-2–specific CD8+ and CD4+ T cells were detected almost exclusively in vaccinees who experienced SARS-CoV-2 breakthrough infection. Importantly, the Spike-specific T cells primed by vaccination did not suppress the induction of T cells specific for other SARS-CoV-2 proteins. The nasal-resident T cell responses persisted for ≥140 d, with minimal sign of waning. These data highlight the importance of viral nasal challenge in the formation of SARS-CoV-2–specific antiviral immunity at the site of primary infection and further define the immunological features of SARS-CoV-2 hybrid immunity.
Study of growth and broadband FMR spectroscopy in PLD grown Y3Fe5O12/Gd3Ga5O12 thin films
Authors: Satapathy S , Pant R P , Maurya K K
Published: August 2022

We report the structural and magnetization dynamics of pulsed laser ablated Y3Fe5O12 (YIG) thin films grown on gadolinium gallium garnet (GGG[110]) substrate. The co-planar waveguide ferromagnetic resonance measurement was performed to study the thickness and inhomogeneity effect on damping constant. We also estimated the effective demagnetization (

4
π

M

eff

) value which was lower than that of single-crystalline bulk YIG. A detailed line width analysis revealed the significant two-magnon scattering and inhomogeneity contribution to damping which varied for different thickness films. The Gilbert damping constant (α) of the grown film was found to be lowest in the case of 100 nm film (≈3 × 10−4), and the corresponding inhomogeneous broadening (ΔH
O) was recorded to be 77 Oe. Further angular measurements on 100 nm thin film revealed the presence of strong uniaxial magnetic anisotropy field of 735 Oe at 10 GHz RF frequency.
Enhanced Stark effect in Dirac materials
Authors: Pedersen Thomas Garm , Cornean Horia D
Published: August 2022

The Stark effect in confined geometries is sensitive to boundary conditions. The vanishing wave function required on the boundary of nanostructures described by the infinite-barrier Schrödinger equation means that such states are only weakly polarizable. In contrast, materials described by the Dirac equation are characterized by much less restrictive boundary conditions. Focusing on honeycomb-lattice armchair nanoribbons, we demonstrate an enhancement by more than an order of magnitude. This result follows from an exact Dirac polarizability valid for arbitrary mass, momentum and ribbon width. Moreover, an exact expression for the frequency-dependent dynamic polarizability has been derived. Our analytic Dirac results have been validated by comparison to numerical results from atomistic models.
Floquet topological properties in the non-Hermitian long-range system with complex hopping amplitudes
Authors: Guo Gang-Feng , Wang Yan , Bao Xi-Xi , Tan Lei
Published: August 2022

Non-equilibrium phases of matter have attracted much attention in recent years, among which the Floquet phase is a hot point. In this work, based on the periodic driving non-Hermitian model, we reveal that the winding number calculated in the framework of the Bloch band theory has a direct connection with the number of edge states even though the non-Hermiticity is present. Further, we find that the change of the phase of the hopping amplitude can induce the topological phase transitions. Precisely speaking, the increase in the value of the phase can bring the system into a topological phase with a large topological number. Moreover, it can be unveiled that the introduction of the purely imaginary hopping term brings an extremely rich phase diagram. In addition, we can select the even topological invariant exactly from the unlimited winding numbers if we only consider the next-nearest neighbor hopping term. Here, the results obtained may be useful for understanding the periodic driving non-Hermitian theory.
Particle detection by means of neural networks and synthetic training data refinement in defocusing particle tracking velocimetry
Authors: Dreisbach Maximilian , Leister Robin , Probst Matthias , Friederich Pascal , Stroh Alexander , Kriegseis Jochen
Published: August 2022

The presented work addresses the problem of particle detection with neural networks (NNs) in defocusing particle tracking velocimetry. A novel approach based on synthetic training data refinement is introduced, with the scope of revising the well documented performance gap of synthetically trained NNs, applied to experimental recordings. In particular, synthetic particle image (PI) data is enriched with image features from the experimental recordings by means of deep learning through an unsupervised image-to-image translation. It is demonstrated that this refined synthetic training data enables the neural-network-based particle detection for a simultaneous increase in detection rate and reduction in the rate of false positives, beyond the capability of conventional detection algorithms. The potential for an increased accuracy in particle detection is revealed with NNs that utilise small scale image features, which further underlines the importance of representative training data. In addition, it is demonstrated that NNs are able to resolve overlapping PIs with a higher reliability and accuracy in comparison to conventional algorithms, suggesting the possibility of an increased seeding density in real experiments. A further finding is the robustness of NNs to inhomogeneous background illumination and aberration of the images, which opens up defocusing PTV for a wider range of possible applications. The successful application of synthetic training-data refinement advances the neural-network-based particle detection towards real world applicability and suggests the potential of a further performance gain from more suitable training data.
Simultaneous measurement of pressure and temperature in a supersonic ejector using FBG sensors
Authors: Hegde Gautam , Himakar Balaji , Rao M V Srisha , Hegde Gopalkrishna , Asokan S
Published: August 2022

In this work, we have demonstrated the use of fiber Bragg grating (FBG) sensors for simultaneous measurement of wall static pressure and temperature in a supersonic ejector. Supersonic ejectors are ground-based high-speed aerodynamic test facilities characterized by harsh conditions, such as high pressure and temperature gradients. An FBG-based sensor setup was developed consisting of a pressure measuring bare FBG and a specially designed pressure-insensitive FBG temperature probe that can be mounted on the wall of the supersonic ejector. The FBG temperature probe was used for temperature measurement as well as temperature compensation of the pressure measuring FBG sensor. Wall static pressure measurements in the supersonic ejector were carried out at different tank pressures and Mach number flows. The FBG pressure measurements were validated with those of standard piezoresistive-based sensor measurements. Both responses were found to match closely, with FBG sensors having a faster response time and higher pressure resolution. Fluid structure interaction simulation was carried out in Comsol Multiphysics to understand the interaction of high-speed turbulent flow with FBG sensor. The FBG strain profile due to flow-induced stress and its dependence on flow pressure was studied. A detailed analysis of the effect of preceding fiber length on FBG pressure measurement was carried out. FBG sensors, due to their miniature size, ability to withstand harsh environments and multi-parameter sensing capability, can be used in ground-based aerodynamic test facilities with minimal intrusion into the flow.
Design of plasmonic enhanced all-optical phase-change memory for secondary storage applications
Authors: Lian Xiaojuan , Liu Cunhu , Fu Jinke , Liu Xiaoyan , Ren Qingying , Wan Xiang , Xiao Wanang , Cai Zhikuang , Wang Lei
Published: August 2022

Phase-change optical device has recently gained tremendous interest due to its ultra-fast transmitting speed, multiplexing and large bandwidth. However, majority of phase-change optical devices are only devoted to on-chip components such as optical tensor core and optical main memory, while developing a secondary storage memory in an optical manner is rarely reported. To address this issue, we propose a novel phase-change optical memory based on plasmonic resonance effects for secondary storage applications. Such design makes use of the plasmonic dimer nanoantenna to generate plasmonic resonance inside the chalcogenide alloy, and thus enables the performance improvements in terms of energy consumption and switching speed. It is found that choosing height, radius, and separation of the plasmonic nanoantenna as 10 nm, 150 nm, and 10 nm, respectively, allows for a write/erase energies of 100 and 240 pJ and a write/erase speed of 10 ns for crystallization and amorphization processes, respectively. Such performance merits encouragingly prevail conventional secondary storage memories and thus pave a route towards the advent of all-optical computer in near future.
Prediction of strain, inter-layer interaction and critical current in CORC® wires under axial strain by T-A modeling
Authors: Wang K , Gao Y W , Anvar V A , Radcliff K , Weiss J D , van der Laan D C , Zhou Y H , Nijhuis A
Published: August 2022

Superconducting conductors on round core (CORC®) cables and wires can meet the needs of large high-field magnets, such as particle accelerators and compact nuclear fusion machines, due to their simple cabling process, high current-carrying capacity and reliable operation under high mechanical stresses. Many high-field magnets require CORC® cables to carry a current of thousands of amperes in a background magnetic field exceeding 20 T. As a result, the large electromagnetic forces will deform the cable in the axial direction due to hoop stress and in the transverse direction by compressive stress. Therefore, it is essential to determine the irreversible deformation limit of the CORC® cable under axial tensile load and optimize the cabling parameters to potentially extend this limit. Analytical and numerical methods are developed to assess the performance degradation of CORC® wires under axial tensile load. The strain level, interlayer contact pressure and friction and their impact on the critical current are calculated by combining the mechanical response and the T-A method. Analyzing the results shows that the winding angle of the tape and the Poisson’s ratio of the inner core are key factors affecting the irreversible tensile strain limit of CORC® wires. The smaller the winding angle and the higher the Poisson’s ratio of the inner core, the higher the irreversible tensile strain limit. For multi-layer CORC® wires, the initial contact pressure caused by the cabling process must also be considered. The inter-layer interaction is coupled with the tape strain of each layer. The results of this research can serve as a basis for optimizing and designing CORC® wires with extended irreversible strain limits.
Materials for a broadband microwave superconducting single photon detector
Authors: Lubsanov Viktor , Gurtovoi Vladimir , Semenov Alexander , Glushkov Evgenii , Antonov Vladimir , Astafiev Oleg
Published: August 2022

In this work, we develop and study superconducting materials for a broadband microwave single-photon detector for wide-range applications in superconducting quantum devices. Ideal materials of this type should have a superconducting gap of the order of 10 GHz (0.2 K), and possess a normal sheet resistance of the order of 50 

Ω

. We find that Ti/Pt bilayers are good candidates: it enables to vary the superconducting transition temperature in a wide range, from 0.1 to 0.4 K, and the sheet resistance in the range from 10 to 50 

Ω

. We present a proof-of-principle demonstration of a low-level microwave power detector based on a nanobridge made of a designed Ti/Pt bilayer. The response to the absorbed microwave power is consistent with the picture of the kinetic inductance detection in superconductors. The extracted response time corresponds to the recombination of quasiparticles with the emission of a photon to the microwave line.
Review on terpenoid mediated nanoparticles: significance, mechanism, and biomedical applications
Authors: Venkata Amrutha Lakshmi Konduru , Sivaram Salini , M Sajeet , P M Sanjay , Srilakshman G , Muthuraman Meenakshi Sundaram
Published: August 2022

The increasing incorporation of colloidal metal nanoparticles in various fields of science has increased the need to synthesise colloidal nanoparticles through economically viable and environmentally friendly methods. Synthesising nanoparticles using plant extracts is one such method. Plant secondary metabolites like polyphenols, flavonoids, terpenoids, alkaloids, tannic acids, and proteins reduce the metal ions resulting in colloidal nanoparticles and also stabilise them. Terpenoids are the most abundant and structurally distinct plant hydrocarbons capable of reducing metallic ions to corresponding nanoparticles. Terpenoids, in general, have excellent antibacterial properties. However, a detailed analysis of the synthesis, mechanism of action, and application has been very limited. Therefore, this review emphasises the significance of terpenoids and the biological synthesis of metal nanoparticles using terpenoids, their ability in reducing and stabilising metal ions, their application in the area of biomedicine such as wound dressings, as anti-microbial, anti-cancer, larvicidal, anti-fouling, nano-drugs and future trends of terpenoid mediated colloidal nanoparticles.
The potential for Treg-enhancing therapies in tissue, in particular skeletal muscle, regeneration
Authors: Hanna Bola S , Yaghi Omar K , Langston P Kent , Mathis Diane
Published: August 2022

Foxp3+CD4+ regulatory T cells (Tregs) are famous for their role in maintaining immunological tolerance. With their distinct transcriptomes, growth-factor dependencies and T-cell receptor (TCR) repertoires, Tregs in nonlymphoid tissues, termed “tissue-Tregs,” also perform a variety of functions to help assure tissue homeostasis. For example, they are important for tissue repair and regeneration after various types of injury, both acute and chronic. They exert this influence by controlling both the inflammatory tenor and the dynamics of the parenchymal progenitor-cell pool in injured tissues, thereby promoting efficient repair and limiting fibrosis. Thus, tissue-Tregs are seemingly attractive targets for immunotherapy in the context of tissue regeneration, offering several advantages over existing therapies. Using skeletal muscle as a model system, we discuss the existing literature on Tregs’ role in tissue regeneration in acute and chronic injuries, and various approaches for their therapeutic modulation in such contexts, including exercise as a natural Treg modulator.
COVID-19 infection and vaccination in immunodeficiency
Authors: Piano Mortari Eva , Pulvirenti Federica
Published: August 2022

During the last 2 years and a half, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide, causing about 6 million deaths. Clinical manifestations are highly variable, ranging from entirely asymptomatic infection to multiorgan failure and death. The outcome in immunocompromised patients is still a matter of debate, and so are the optimal strategies to prevent or treat the infection in these high-risk populations.
Somatosensory targeted memory reactivation enhances motor performance via hippocampal-mediated plasticity
Authors: Veldman Menno P , Dolfen Nina , Gann Mareike A , Van Roy Anke , Peeters Ronald , King Bradley R , Albouy Geneviève
Published: August 2022

Increasing evidence suggests that reactivation of newly acquired memory traces during postlearning wakefulness plays an important role in memory consolidation. Here, we sought to boost the reactivation of a motor memory trace during postlearning wakefulness (quiet rest) immediately following learning using somatosensory targeted memory reactivation (TMR). Using functional magnetic resonance imaging, we examined the neural correlates of the reactivation process as well as the effect of the TMR intervention on brain responses elicited by task practice on 24 healthy young adults. Behavioral data of the post-TMR retest session showed a faster learning rate for the motor sequence that was reactivated as compared to the not-reactivated sequence. Brain imaging data revealed that motor, parietal, frontal, and cerebellar brain regions, which were recruited during initial motor learning, were specifically reactivated during the TMR episode and that hippocampo-frontal connectivity was modulated by the reactivation process. Importantly, the TMR-induced behavioral advantage was paralleled by dynamical changes in hippocampal activity and hippocampo-motor connectivity during task practice. Altogether, the present results suggest that somatosensory TMR during postlearning quiet rest can enhance motor performance via the modulation of hippocampo-cortical responses.
Epigenetic Age Acceleration Markers Are Associated With Physiologic Frailty and All-Cause Mortality in People With Human Immunodeficiency Virus
Authors: Oursler Krisann K , Marconi Vincent C , Wang Zeyuan , Xu Ke , Montano Monty , So-Armah Kaku , Justice Amy C , Sun Yan V
Published: August 2022

Background

Biomarkers that provide insight into drivers of aging are needed for people with human immunodeficiency virus (PWH). The study objective was to determine if epigenetic age acceleration (EAA) markers are associated with physiologic frailty measured by the Veterans Aging Cohort Study (VACS) Index and predict all-cause mortality for PWH.

Methods

Epigenome-wide DNA methylation was profiled in VACS total white blood cell samples collected during 2005–2007 from 531 PWH to generate 6 established markers of EAA. The association of each EAA marker was tested with VACS Index 2.0. All-cause mortality was assessed over 10 years. For each EAA marker, the hazard ratio per increased year was determined using Cox regression. To evaluate mortality discrimination, C-statistics were derived.

Results

Participants were mostly men (98.5%) and non-Hispanic Black (84.4%), with a mean age of 52.4 years (standard deviation [SD], 7.8 years). Mean VACS Index score was 59.3 (SD, 16.4) and 136 deaths occurred over a median follow-up of 8.7 years. Grim age acceleration (AA), PhenoAA, HannumAA, and extrinsic epigenetic AA were associated with the VACS Index and mortality. HorvathAA and intrinsic epigenetic AA were not associated with either outcome. GrimAA had the greatest mortality discrimination among EAA markers and predicted mortality independently of the VACS Index. One-year increase in GrimAA was associated with a 1-point increase in VACS Index and a 10% increased hazard for mortality.

Conclusions

The observed associations between EAA markers with physiologic frailty and mortality support future research to provide mechanistic insight into the accelerated aging process and inform interventions tailored to PWH for promoting increased healthspan.
Genomic and transcriptomic variation in Bordetella spp. following induction of erythromycin resistance
Authors: Fong Winkie , Timms Verlaine , Sim Eby , Pey Keenan , Nguyen Trang , Sintchenko Vitali
Published: August 2022

Background

The emergence of macrolide resistance in Bordetella pertussis, the causative agent of pertussis, due to mutations in the 23S rRNA gene has been recently recognized. However, resistance mechanisms to macrolides in Bordetella parapertussis and Bordetella holmesii remain unknown.

Objectives

This study investigated genomic changes induced by in vitro exposure to erythromycin in these three main pathogens responsible for pertussis-like disease.

Methods

A set of 10 clinical and reference strains of B. pertussis, B. parapertussis and B. holmesii was exposed to erythromycin for 15 weeks or 30 subculture passages. Antibiotic pressure was achieved by growth on the selective media with erythromycin Etest strips or impregnated discs. Genome polymorphisms and transcriptomic profiles were examined by short- and long-read sequencing of passaged isolates.

Results

B. parapertussis and B. holmesii isolates developed significant in vitro resistance to erythromycin (MIC >256 mg/L) within 2 to 7 weeks and at 5 to 12 weeks, respectively. B. pertussis remained phenotypically susceptible to the antibiotic following 15 weeks of exposure, with the MIC between 0.032 to 0.38 mg/L. Genomic analysis revealed that B. holmesii developed resistance due to mutations in the 23S rRNA gene. The resistance mechanism in B. parapertussis was hypothesized as being due to upregulation of an efflux pump mechanism.

Conclusions

These findings indicate that both B. holmesii and B. parapertussis can be more prone to induced resistance following exposure to treatment with erythromycin than B. pertussis. The surveillance of macrolide resistance in Bordetella isolates recovered from patients with pertussis, especially persistent disease, is warranted.
Motivations to Change Smoking Behaviors Between 2007 and 2019 in Australia: A Repeated Cross-sectional Study
Authors: Cho Ara , Chan Gary , Gartner Coral
Published: August 2022

Introduction

In 2010, Australian tobacco excise (administered federally) increased by 25%, and by 12.5% annually from 2013 to 2020, with additional increases on roll-your-own (RYO) tobacco between 2017 and 2020. We estimated past year changes in smoking behavior among Australian adults who smoked (daily and non-daily) in the past year, and the association between consumer characteristics and stated motivations to change/attempt to change smoking behavior between 2007 and 2019.

Methods

Logistic regression analysis of combined data from national representative triennial cross-sectional surveys in Australia (N = 22 977).

Results

The main motivation cited for changing smoking behavior switched from health-related from 2007 to 2010 to cost-related from 2013 to 2019. Among those who quit between one and 12 months ago, living in a lower socioeconomic area (odds ratio (OR) = 1.61, 95% CI = 1.18% to –2.18%), was associated with reporting the cost of smoking motivated them to quit. Among those who reduced their smoking, smoking daily and >20 cigarettes/day vs. non-daily smoking (OR = 2.11, 95% CI = 1.60% to 2.78%), having high/very high psychological distress (OR = 1.33, 95% CI = 1.12% to 1.59%), and alcohol consumption (ORdaily drinking = 1.38, 95% CI = 1.05% to 1.81%) was associated with cost as a motivation. Exclusive (OR = 0.65, 95% CI = 0.53% to 0.80%) and non-exclusive (OR = 0.77, 95% CI = 0.65% to 0.91%) RYO use was associated with being less likely to report the cost of tobacco as motivation for cutting down.

Conclusions

The cost of smoking became the most cited motivator to change smoking behavior (eg, quitting and cutting down), particularly for those who lived in low socioeconomic areas, smoked more cigarettes per day, drank alcohol, and had high/very high psychological distress.

Implications

A change in the main federal tobacco control intervention implemented in Australia from mass-media campaigns to tobacco tax increases has likely led to cost, rather than health, being the main motivation cited for changing smoking behavior in Australia since 2013. Further monitoring is needed to ensure the harmonization in tax rates for RYO and factory-made cigarettes has effectively reduced the price difference between these products because the lower cost of RYO may have reduced the effectiveness of tax increases as a motivator to change smoking behavior.
Uniform secured transactions law: the Model Inter-American Law and the UNCITRAL Model Law on Secured Transactions compared
Authors: Bazinas Spyridon V
Published: August 2022

In an effort to assist in the better understanding and implementation of the UNCITRAL Model Law on Secured Transactions (including its provisions on the registration of notices with respect to security interests) and the Model Inter-American Law on Secured Transactions with the Model Inter-American Registry Regulations, this article compares and briefly explains their key provisions.
Short‐term aerobic conditioning prior to resistance training augments muscle hypertrophy and satellite cell content in healthy young men and women
Authors: Thomas Aaron C. Q. , Brown Alex , Hatt Aidan A. , Manta Katherine , Costa‐Parke Anamaria , Kamal Michael , Joanisse Sophie , McGlory Chris , Phillips Stuart M. , Kumbhare Dinesh , Parise Gianni
Published: August 2022

Factors influencing inter‐individual variability of responses to resistance training (RT) remain to be fully elucidated. We have proposed the importance of capillarization in skeletal muscle for the satellite cell (SC) response to RT‐induced muscle hypertrophy, and hypothesized that aerobic conditioning (AC) would augment RT‐induced adaptations. Fourteen healthy young (22 ± 2 years) men and women underwent AC via 6 weeks of unilateral cycling followed by 10 weeks of bilateral RT to investigate how AC alters SC content, activity, and muscle hypertrophy following RT. Muscle biopsies were taken at baseline (unilateral), post AC (bilateral), and post RT (bilateral) in the aerobically conditioned (AC + RT) and unconditioned (RT) legs. Immunofluorescence was used to determine muscle capillarization, fiber size, SC content, and activity. Type I and type II fiber cross‐sectional area (CSA) increased following RT, and when legs were analyzed independently, AC + RT increased type I, type II, and mixed‐fiber CSA, where the RT leg tended to increase type II (p = .05), but not type I or mixed‐fiber CSA. SC content, activation, and differentiation increased with RT, where type I total and quiescent SC content was greater in AC + RT compared to the RT leg. Those with the greatest capillary‐to‐fiber perimeter exchange index before RT had the greatest change in CSA following RT and a significant relationship was observed between type II fiber capillarization and the change in type II‐fiber CSA with RT (r = 0.35). This study demonstrates that AC prior to RT can augment RT‐induced muscle adaptions and that these differences are associated with increases in capillarization.
Curcumin activates Nrf2/HO‐1 signaling to relieve diabetic cardiomyopathy injury by reducing ROS in vitro and in vivo
Authors: Wu Xia , Zhou Xueliang , Lai Songqing , Liu Jichun , Qi Jianwei
Published: August 2022

The hallmark feature of Diabetes mellitus (DM) is hyperglycemia which can lead to excess production of reactive oxygen species (ROS) in the myocardium, contributing to diabetic cardiomyopathy (DCM). Nuclear factor erythroid2‐related factor2 (Nrf2), a transcriptional activator, enhances its ability to resist oxidative stress by activating multiple downstream anti‐oxidants, anti‐inflammatory proteins, and detoxifying enzymes. However, the mechanism of Nrf2 signaling in HG‐induced DCM is unclear. In this study, we used HG pretreated H9c2 cells as the experimental basis in vitro, and established a high fat‐diet, streptozotocin (STZ) induced Type 2 diabetic rat model in vivo. Meanwhile, we used shRNA‐Nrf2 and curcumin (CUR) (as an activator) to affect H9c2 cells, to verify the role of the Nrf2 signaling pathway in DCM. The results showed that the excessive production of ROS caused by HG, which could inhibit the activation of Nrf2‐related signaling, resulting in a decrease in cell energy metabolism and an increase in cell apoptosis. Surprisingly, we found that the activation of the Nrf2 signaling pathway significantly increased cardiomyocyte viability, reduced ROS formation, increased antioxidant enzyme activity, and inhibited cardiomyocyte apoptosis. In conclusion, these findings conclusively infer that CUR activation of the Nrf2/HO‐1 signaling pathway exerts myocardial protection by reducing ROS formation.
Predictors of the Rate of Illicit Fentanyl Metabolism in a Cohort of Pregnant Individuals
Authors: Wanar Amita , Saia Kelley , Field Thomas
Published: August 2022

Introduction

Illicit fentanyl use is growing in the United States, including among pregnant persons. Despite the prevalence of illicit fentanyl in the drug supply, the pharmacokinetics of fentanyl remains understudied, especially for pregnant individuals. The variability of fentanyl pharmacokinetics influences detection of fentanyl in urine samples, the results of which can have significant legal consequences. For pregnant and parenting individuals, these legal consequences may include termination of parental rights.

Methods

Through this medical-legal lens, we conducted a retrospective cohort analysis using the electronic medical records of women receiving integrated prenatal care and substance use disorder treatment. A total of 420 medical records were reviewed and 112 individuals who had a positive fentanyl immunoassay and met the selection criteria were included. Metabolic ratios (level of norfentanyl/level of fentanyl) were calculated for each study individual. A linear regression analysis was used to determine if the following physiologic factors were predictors of the rate of fentanyl metabolism: hepatic function, renal function, body mass index, medication dosage, gestational age, and maternal age.

Results

Results indicated that advanced maternal age predicted a slower conversion of fentanyl to norfentanyl, whereas increased gestational age predicted a faster conversion.

Conclusions

Variations in fentanyl metabolism in pregnancy highlight the importance of clinician vigilance when interpreting fentanyl rests results, especially for individuals with advancing maternal age. In such cases, clinician caution and advocacy may prevent unwarranted and unjust removal of a child from maternal custody.
Cochlear Reimplantation Rate and Cause: a 22-Year, Single-Center Experience, and a Meta-Analysis and Systematic Review
Authors: Liu Haotian , Yao Xinyi , Kong Weili , Zhang Lin , Si Jingyuan , Ding Xiuyong , Zheng Yun , Zhao Yu
Published: August 2022

Objectives:

In terms of cochlear reimplantation, there is no consensus on the definition, range, or calculation formulation for the reimplantation rate. This study aims to put forward a relatively standardized and more explicit definition based on a literature review, calculate the rate of cochlear reimplantation, and examine the classification and distribution of the reimplantation causes.

Design:

A systematic review and retrospective study. A relatively clearer definition was used in this study: cochlear reimplantation is the implantation of new electrodes to reconstruct the auditory path, necessitated by the failure or abandonment of the initial implant. Seven English and Chinese databases were systematically searched for studies published before July 23, 2021 regarding patients who accepted cochlear reimplantation. Two researchers independently applied the inclusion and exclusion criteria to select studies and complete data extraction. As the effect size, the reimplantation rate was extracted and synthesized using a random-effects model, and subgroup and sensitivity analyses were performed to reduce heterogeneity. In addition, a retrospective study analyzed data on cochlear reimplantation in a tertiary hospital from April 1999 to August 2021. Kaplan-Meier survival analysis and the log-rank test were adopted to analyze the survival times of cochlear implants and compare them among different subgroups.

Results:

A total of 144 articles were included, with 85,851 initial cochlear implantations and 4276 cochlear reimplantations. The pooled rate of cochlear reimplantation was 4.7% [95% CI (4.2% to 5.1%)] in 1989 to 2021, 6.8% [95% CI (4.5% to 9.2%)] before 2000, and 3.2% [95% CI (2.7% to 3.7%)] after 2000 (P=0.003). Device failures accounted for the largest proportion of reimplantation (67.6% [95% CI (64.0% to 71.3%)], followed by medical reasons (28.9% [95% CI (25.7% to 32.0%)]). From April 1999 to August 2021, 1775 cochlear implants were performed in West China Hospital (1718 initial implantations and 57 reimplantations; reimplantation rate 3.3%). In total, 45 reimplantations (78.9%) were caused by device failure, 10 (17.5%) due to medical reasons, and 2 (3.5%) from unknown reasons. There was no difference in the survival time of implants between adults and children (P = 0.558), while there existed a significant difference between patients receiving implants from different manufacturers (P < 0.001).

Conclusions:

The cochlear reimplantation rate was relatively high, and more attention should be paid to formulating a standard definition, calculation formula, and effect assessment of cochlear reimplantation. It is necessary to establish a sound mechanism for long-term follow-up and rigorously conduct longitudinal cohort studies.
Time to Completion of Pediatric PROMIS Computerized Adaptive Testing Measures and the SRS-22r in an Adolescent Idiopathic Scoliosis Population
Authors: Paranjape Chinmay S. , de Araujo Olivia B. , Reider Lisa M. , Sponseller Paul D. , Carlini Anthony R. , McLaughlin Kevin , Bachmann Keith R. , Mitchell Stuart L.
Published: August 2022

Background:

Patient-reported outcome measures are useful tools to quantify patients’ pre-treatment and post-treatment symptoms. Historically used “legacy measures”, such as the Scoliosis Research Society-22 revised questionnaire (SRS-22r), are often disease-specific and can be time-intensive. Recently developed Patient-Reported Outcomes Measurement Information System (PROMIS) computerized adaptive testing (CAT) measures may reduce administrative burdens and permit more efficient outcome collection within clinic workflows. In an era of medicine where payments are becoming tied to outcomes, we sought to assess the time to completion (TTC) of 8 pediatric PROMIS CAT measures and the SRS-22r in adolescents with idiopathic scoliosis.

Materials and Methods:

Patients presenting to a large, urban tertiary referral hospital were prospectively enrolled into the study. Subjects were first-time survey respondents in various phases and types of treatment for adolescent idiopathic scoliosis. In total, 200 patients ranging from 10 to 17 years old completed 8 Pediatric PROMIS CATs and the SRS-22r. PROMIS CATs administered include Physical Activity, Mobility, Anxiety, Depressive symptoms, Peer Relationships, Physical Stress Experiences, Pain Behavior and Pain Interference. TTC was calculated using start and stop timestamps in the REDCap software.

Results:

The mean (±SD) TTC for each PROMIS CAT was 1.1 (±0.9) minutes with physical activity, mobility, anxiety, depressive symptoms, peer relationships, physical stress experiences, pain behavior, and pain interference taking 1.2, 1.4, 1.0, 0.9, 1.2, 1.0, 1.0, and 1.2 minutes on average to complete, respectively. Mean TTC for the SRS-22r was 5.2 (±3.0) minutes.

Conclusions:

In this pediatric orthopaedic cohort, completion of 8 PROMIS CATs demonstrated minimal test-taker burden and time required for completion. These findings support rapid and easily integrable PROMIS CATs in clinical practice to aid in increased delivery of efficient, patient-centered care.

Level of Evidence:

III, cross-sectional study.
A Multiple Baseline Trial of an Electronic ICU Discharge Summary Tool for Improving Quality of Care*
Authors: Stelfox Henry T. , Brundin-Mather Rebecca , Soo Andrea , Whalen-Browne Liam , Kashyap Devika , Sauro Khara M. , Bagshaw Sean M. , Fiest Kirsten M. , Taljaard Monica , Parsons Leigh Jeanna
Published: August 2022

Objective:

Effective communication between clinicians is essential for seamless discharge of patients between care settings. Yet, discharge summaries are commonly not available and incomplete. We implemented and evaluated a structured electronic health record–embedded electronic discharge (eDischarge) summary tool for patients discharged from the ICU to a hospital ward.

DESIGN:

Multiple baseline trial with randomized and staggered implementation.

SETTING:

Adult medical-surgical ICUs at four acute care hospitals serving a single Canadian city.

PATIENTS:

Health records of patients 18 years old or older, in the ICU 24 hours or longer, and discharged from the ICU to an in-hospital patient ward between February 12, 2018, and June 30, 2019.

INTERVENTION:

A structured electronic note (ICU eDischarge tool) with predefined fields (e.g., diagnosis) embedded in the hospital-wide electronic health information system.

MEASUREMENTS AND MAIN RESULTS:

We compared the percent of timely (available at discharge) and complete (included goals of care designation, diagnosis, list of active issues, active medications) discharge summaries pre and post implementation using mixed effects logistic regression models. After implementing the ICU eDischarge tool, there was an immediate and sustained increase in the proportion of patients discharged from ICU with timely and complete discharge summaries from 10.8% (preimplementation period) to 71.1% (postimplementation period) (adjusted odds ratio, 32.43; 95% CI, 18.22–57.73). No significant changes were observed in rapid response activation, cardiopulmonary arrest, death in hospital, ICU readmission, and hospital length of stay following ICU discharge. Preventable (60.1 vs 5.7 per 1,000 d; p = 0.023), but not nonpreventable (27.3 vs 40.2 per 1,000d; p = 0.54), adverse events decreased post implementation. Clinicians perceived the eDischarge tool to produce a higher quality discharge process.

CONCLUSIONS:

Implementation of an electronic tool was associated with more timely and complete discharge summaries for patients discharged from the ICU to a hospital ward.
Optimum Methotrexate Exposure in Patients With Suspected or Confirmed CNS Invasive Hematological Malignancies: A Systematic Critical Review
Authors: Faria Monteiro Joaquim , Rita Damas , Rui Bergantim , Fernanda Trigo
Published: August 2022

Background and Methods:

The present review aims to evaluate the current state-of-the-art dosing regimens of high-dose (HD) and intrathecal methotrexate (MTX) using therapeutic drug monitoring (TDM) to optimize its therapeutic response and minimize associated toxicity, particularly in the central nervous system (CNS).

Results:

MTX is administered systemically in a HD regimen (>1 g/m2) for the treatment of various hematological neoplasms. HD-MTX treatment becomes complicated by marked interindividual drug elimination variability. TDM is specified to manage this high variability. Approximately 3%–7% of adults with acute lymphoblastic leukemia are diagnosed with CNS involvement, and the incidence of CNS relapse in patients, despite receiving prophylaxis, ranges from 5% to 10%. HD-MTX penetrates the blood–brain barrier and can be administered intrathecally, making this drug an important component of chemotherapy regimens for patients with hematologic malignancies involving the CNS or those at high risk of CNS relapse.

Conclusions:

The major evidence found was that an MTX area under the curve target between 1000 and 1100 μmol hour−1 L is associated with better clinical outcomes. However, there seems to be a clinical gap in the prospective validation of HD and IT MTX management to optimize clinical outcomes and minimize toxicity, using the relationship between exposure level (area under the curve MTX) and optimal response to MTX, at systemic and CNS exposure.
Data-driven Normative Reference of Pediatric Cranial Bone Development
Authors: Liu Jiawei , Elkhill Connor , LeBeau Scott , French Brooke , Lepore Natasha , Linguraru Marius George , Porras Antonio R.
Published: August 2022

Background:

Available normative references of cranial bone development and suture fusion are incomplete or based on simplified assumptions due to the lack of large datasets. We present a fully data-driven normative model that represents the age- and sex-specific variability of bone shape, thickness, and density between birth and 10 years of age at every location of the calvaria.

Methods:

The model was built using a cross-sectional and multi-institutional pediatric computed tomography image dataset with 2068 subjects without cranial pathology (age 0–10 years). We combined principal component analysis and temporal regression to build a statistical model of cranial bone development at every location of the calvaria. We studied the influences of sex on cranial bone growth, and our bone density model allowed quantifying for the first time suture fusion as a continuous temporal process. We evaluated the predictive accuracy of our model using an independent longitudinal image dataset of 51 subjects.

Results:

Our model achieved temporal predictive errors of 2.98 ± 0.69 mm, 0.27 ± 0.29 mm, and 76.72 ± 91.50 HU in cranial bone shape, thickness, and mineral density changes, respectively. Significant sex differences were found in intracranial volume and bone surface areas (P < 0.01). No significant differences were found in cephalic index, bone thickness, mineral density, or suture fusion.

Conclusions:

We presented the first pediatric age- and sex-specific statistical reference for local cranial bone shape, thickness, and mineral density changes. We showed its predictive accuracy using an independent longitudinal dataset, we studied developmental differences associated with sex, and we quantified suture fusion as a continuous process.
Reconsidering Fordyce's classic article, “Pain and suffering: what is the unit?” to help make our model of chronic pain truly biopsychosocial
Authors: Sullivan Mark D. , Sturgeon John A. , Lumley Mark A. , Ballantyne Jane C.
Published: August 2022

The biopsychosocial model (BPS) of chronic pain aspires to be comprehensive, incorporating psychological and social factors omitted from biomedical models. Although psychosocial factors are viewed as highly influential in understanding behavioral and psychological responses to pain, these factors are usually viewed as modifiers of biological causes of the experience of pain itself, rather than as equal contributors to pain. To further advance the BPS model, we re-examine a classic 1994 article by Wilbert “Bill” Fordyce, “Pain and suffering: what is the unit?” In this article, Fordyce suggested that pain-related disability and suffering should be viewed as “transdermal,” as having causes both inside and outside the body. We consider Fordyce's article theoretically important because this concept allows us to more fully break free of the medical model of chronic pain than customary formulations of the BPS model. It makes it possible to place psychological and social factors on an equal footing with biological ones in explaining pain itself and to remove distinctions between pain mechanisms and pain meanings. The brain's salience network now offers a platform on which diverse influences on pain experience—from nociception to multisensory indicators of safety or danger—can be integrated, bridging the gap between impersonal nociceptive mechanisms and personal meanings. We also argue that Fordyce's article is practically important because this concept expands the BPS model beyond the bounds of the clinical encounter, opening the door to the full range of social, psychological, and biological interventions, empowering patients and nonmedical providers to tackle chronic pain.
Correlation analysis of I-131 SPECT/CT uptake parameters with the success ablation treatment of thyroid remnant in patients with low-intermediate-risk differentiated thyroid cancer
Authors: Zhang Qian , Xu Weina
Published: August 2022

Objective

To predict the successful outcome of radioactive iodine-131 (I-131) ablation treatment for differentiated thyroid cancer (DTC) patients using quantitative parameters from therapeutic I-131 SPECT/CT.

Methods

This retrospective study enrolled 145 DTC patients (41 males and 104 females) who had radioactive iodine-131 (I-131) (RAI) ablation therapy following thyroidectomy surgery from July 2020 to May 2021. The median age was 47 years (24-65 years). All the patients underwent therapeutic I-131 thyroid SPECT/CT scan after RAI ablation. The I-131 uptake quantitative parameters SUVmax, SUVmean %ID and ∆Tg (defined as the Tg level before RAI ablation minus the Tg level after six months) were assessem. Successful ablation treatment was defined as the level of TSH-stimulated Tg≤1 ng/mL and the disappearance of the thyroid bed on a whole-body I-131 scan six months or later after ablation treatment.

Results

The quantitative parameters from therapeutic I-131 SPECT/CT of the successful ablation (n=130) group with SUVmax 7.74 (3.84, 18.78) g/ml, SUVmean 4.02 (2.11, 6.39) g/ml and %ID 2.21% (0.67%, 7.30%) were significantly higher than those of the unsuccessful (n=15) group 0.75 (0.53, 1.28) g/ml, 0.44 (0.29, 0.79) g/ml and 0.16% (0.06%, 1.48%) (Z=-5.87, -5.71 and -4.99, all P < 0.001). SUVmax, SUVmean and %ID were positively correlated with ΔTg (all P < 0.001). Receiver operating characteristics curve analysis showed that %ID performed better predict value than either SUVmax (AUC=0.914, and 0.874, P=0.009) or SUVmean (AUC= 0.863 P=0.002). SUVmax, SUVmean and%ID (OR =1.50, 2.85 and 1.01 all P < 0.001) were all independent predictors of successful RAI ablation.

Conclusion

The quantitative parameters of therapeutic I-131 SPECT/CT were related to the efficacy of ablation treatment, and %ID could predict the successful outcome of ablation treatment for DTC patients.