bluuebunny/crossref_metadata_2025 huggingface dataset:
The detailed chemical abundance patterns of accreted halo stars from the optical to infrared
Authors: Carrillo Andreia , Hawkins Keith , Jofré Paula , de Brito Silva Danielle , Das Payel , Lucey Madeline
Published: February 2022

Understanding the assembly of our Galaxy requires us to also characterize the systems that helped build it. In this work, we accomplish this by exploring the chemistry of accreted halo stars from Gaia-Enceladus/Gaia-Sausage (GES) selected in the infrared from the Apache Point Observatory Galactic Evolution Experiment (APOGEE) Data Release 16. We use high resolution optical spectra for 62 GES stars to measure abundances in 20 elements spanning the α, Fe-peak, light, odd-Z, and notably, the neutron-capture groups of elements to understand their trends in the context of and in contrast to the Milky Way and other stellar populations. Using these derived abundances we find that the optical and the infrared abundances agree to within 0.15 dex except for O, Co, Na, Cu, and Ce. These stars have enhanced neutron-capture abundance trends compared to the Milky Way, and their [Eu/Mg] and neutron-capture abundance ratios (e.g. [Y/Eu], [Ba/Eu], [Zr/Ba], [La/Ba], and [Nd/Ba]) point to r-process enhancement and a delay in s-process enrichment. Their [α/Fe] trend is lower than the Milky Way trend for [Fe/H] > −1.5 dex, similar to previous studies of GES stars and consistent with the picture that these stars formed in a system with a lower rate of star formation. This is further supported by their depleted abundances in Ni, Na, and Cu abundances, again, similar to previous studies of low-α stars with accreted origins.
Population-Genomic Analysis Identifies a Low Rate of Global Adaptive Fixation in the Proteins of the Cyclical ParthenogenDaphnia magna
Authors: Fields Peter D , McTaggart Seanna , Reisser Céline M O , Haag Christoph , Palmer William H , Little Tom J , Ebert Dieter , Obbard Darren J
Published: February 2022

Daphnia are well-established ecological and evolutionary models, and the interaction between D. magna and its microparasites is widely considered a paragon of the host-parasite coevolutionary process. Like other well-studied arthropods such as Drosophila melanogaster and Anopheles gambiae, D. magna is a small, widespread, and abundant species that is therefore expected to display a large long-term population size and high rates of adaptive protein evolution. However, unlike these other species, D. magna is cyclically asexual and lives in a highly structured environment (ponds and lakes) with moderate levels of dispersal, both of which are predicted to impact upon long-term effective population size and adaptive protein evolution. To investigate patterns of adaptive protein fixation, we produced the complete coding genomes of 36 D. magna clones sampled from across the European range (Western Palaearctic), along with draft sequences for the close relatives D. similis and D. lumholtzi, used as outgroups. We analyzed genome-wide patterns of adaptive fixation, with a particular focus on genes that have an a priori expectation of high rates, such as those likely to mediate immune responses, RNA interference against viruses and transposable elements, and those with a strongly male-biased expression pattern. We find that, as expected, D. magna displays high levels of diversity and that this is highly structured among populations. However, compared with Drosophila, we find that D. magna proteins appear to have a high proportion of weakly deleterious variants and do not show evidence of pervasive adaptive fixation across its entire range. This is true of the genome as a whole, and also of putative ‘arms race’ genes that often show elevated levels of adaptive substitution in other species. In addition to the likely impact of extensive, and previously documented, local adaptation, we speculate that these findings may reflect reduced efficacy of selection associated with cyclical asexual reproduction.
RBBP4-p300 axis modulates expression of genes essential for cell survival and is a potential target for therapy in glioblastoma
Authors: Mladek Ann C , Yan Huihuang , Tian Shulan , Decker Paul A , Burgenske Danielle M , Bakken Katrina , Hu Zeng , He Lihong , Connors Margaret A , Carlson Brett L , Wilson Jonathan , Bommi-Reddy Archana , Conery Andy , Eckel-Passow Jeanette E , Sarkaria Jann N , Kitange Gaspar J
Published: February 2022

Background

RBBP4 activates transcription by histone acetylation, but the partner histone acetyltransferases are unknown. Thus, we investigated the hypothesis that RBBP4 interacts with p300 in a complex in glioblastoma (GBM).

Methods

shRNA silencing of RBBP4 or p300 and RNAseq was used to identify genes co-regulated by RBBP4 and p300 in GBM43 patient-derived xenograft (PDX). RBBP4/p300 complex was demonstrated using proximity ligation assay (PLA) and ChIPseq delineated histone H3 acetylation and RBBP4/p300 complex binding in promoters/enhancers. Temozolomide (TMZ)-induced DNA double strand breaks (DSBs) were evaluated by γ-H2AX and proliferation by CyQuant and live cell monitoring assays. In vivo efficacy was based on survival of mice with orthotopic tumors.

Results

shRBBP4 and shp300 downregulated 4768 genes among which 1485 (31%) were commonly downregulated by both shRNAs, while upregulated genes were 2484, including 863 (35%) common genes. The pro-survival genes were the top-ranked among the downregulated genes, including C-MYC. RBBP4/p300 complex was demonstrated in the nucleus, and shRBBP4 or shp300 significantly sensitized GBM cells to TMZ compared to the control shNT in vitro (P < .05). Moreover, TMZ significantly prolonged the survival of mice bearing GBM22-shRBBP4 orthotopic tumors compared with control shNT tumors (median shNT survival 52 days vs. median shRBBP4 319 days; P = .001). CREB-binding protein (CBP)/p300 inhibitor CPI-1612 suppressed H3K27Ac and RBBP4/p300 complex target proteins, including C-MYC, and synergistically sensitized TMZ in vitro. Pharmacodynamic evaluation confirmed brain penetration by CPI-1612 supporting further investigation to evaluate efficacy to sensitize TMZ.

Conclusions

RBBP4/p300 complex is present in GBM cells and is a potential therapeutic target.
Filamin A increases aggressiveness of human neuroblastoma
Authors: Bandaru Sashidar , Prajapati Bharat , Juvvuna Prasanna Kumar , Dosa Sandor , Kogner Per , Johnsen John I , Kanduri Chandrasekhar , Akyürek Levent M
Published: February 2022

Background

The actin-binding protein filamin A (FLNA) regulates oncogenic signal transduction important for tumor growth, but the role of FLNA in the progression of neuroblastoma (NB) has not been explored.

Methods

We analyzed FLNA mRNA expression in the R2 NB-database and FLNA protein expression in human NB tumors. We then silenced FLNA expression in human SKNBE2 and IMR32 NB cells by lentiviral vector encoding shRNA FLNA and assayed the cells for proliferation, migration, colony, spheroid formation, and apoptosis. SKNBE2 xenografts expressing or lacking FLNA in BALB/c nude mice were analyzed by both routine histopathology and immunohistochemistry.

Results

We observed shorter patient survival with higher expression of FLNA mRNA than patients with lower FLNA mRNA expression, and high-risk NB tumors expressed higher FLNA levels. Overexpression of FLNA increased proliferation of SH-SY5 NB cells. NB cell lines transfected with siRNA FLNA proliferated and migrated less, expressed lower levels of phosphorylated AKT and ERK1/2, formed smaller colonies and spheroids, as well as increased apoptosis. After inoculation of SKNBE2 cells infected with lentivirus expressing shRNA FLNA, size of NB tumors and number of proliferating cells were decreased. Furthermore, we identified STAT3 as an interacting partner of FLNA. Silencing FLNA mRNA reduced levels of NF-κB, STAT3 and MYCN, and increased levels of p53 and cleaved caspase 3.

Conclusion

Inhibition of FLNA impaired NB cell signaling and function and reduced NB tumor size in vivo, suggesting that drugs targeting either FLNA or its interaction with STAT3 may be useful in the treatment of NB.
Safety and Effectiveness of High-Dose Cefazolin in Patients With High Body Weight: A Retrospective Cohort Study
Authors: Ryu HaYoung , Mohayya Sana , Hong Thomas , Modi Mansi , Yang Jaehee , Abdul Azim Ahmed , Bhatt Pinki J , Brunetti Luigi , Narayanan Navaneeth
Published: February 2022

Background

Cefazolin is a commonly used antibiotic for the treatment of mild to severe infections. Despite the use of higher dose of cefazolin (3 g/dose) for surgical prophylaxis in patients with obesity, there is currently a paucity of data identifying the optimal dose to treat infections in this specific patient population.

Methods

This was a multicenter, retrospective cohort study of patients who received cefazolin at weight-based (up to 9 g/day) or standard doses (up to 6 g/day) for the treatment of bacteremia or skin and soft tissue infection (SSTI). Study groups were stratified by body weight and cefazolin dose received. Primary outcome was the composite of treatment-emergent adverse events (TEAEs) and secondary outcome was treatment failure rate.

Results

A total of 208 patients were included for study analysis. Fifty-nine patients had body weight >120 kg. Of these, 33 received high-dose cefazolin while 26 received standard doses. The remaining 149 patients had body weight of ≤120 kg and received standard doses. The occurrence of TEAEs did not differ across the 3 groups. The study also did not find any difference between the rate of treatment failure between groups.

Conclusions

High-dose cefazolin (9 g/day) for the treatment of bacteremia or SSTIs in patients with high body weight was safe and well tolerated. Larger studies are needed to further explore the benefit of high-dose cefazolin in improving clinical outcomes.
Intensive Care Unit–Acquired Weakness in Patients With COVID-19: Occurrence and Associated Factors
Authors: Schmidt Débora , Piva Taila Cristina , Glaeser Sheila Suzana , Piekala Daniele Martins , Berto Paula Pinheiro , Friedman Gilberto , Sbruzzi Graciele
Published: February 2022

Objective

The primary objective of this study was to identify the occurrence and factors associated with intensive care unit (ICU)-acquired weakness (ICUAW) in patients with COVID-19. Secondarily, we monitored the evolution of muscle strength and mobility among individuals with ICUAW and those without ICUAW and the association of these variables with length of stay, mechanical ventilation (MV), and other clinical variables.

Methods

In this prospective observational study, individuals admitted to the ICU for >72 hours with COVID-19 were evaluated for muscle strength and mobility at 3 times: when being weaned from ventilatory support, discharged from the ICU, and discharged from the hospital. Risk factors for ICUAW were monitored.

Results

The occurrences of ICUAW at the 3 times evaluated among the 75 patients included were 52%, 38%, and 13%. The length of the ICU stay (29.5 [IQR = 16.3–42.5] vs 11 [IQR = 6.5–16] days), the length of the hospital stay (43.5 [IQR = 22.8–55.3] vs 16 [IQR = 12.5–24] days), and time on MV (25.5 [IQR = 13.8–41.3] vs 10 [IQR = 5–22.5] days) were greater in patients with ICUAW. Muscle strength and mobility were lower at all times assessed in patients with ICUAW. Bed rest time for all patients (relative risk = 1.14; 95% CI = 1.02 to 1.28) and use of corticosteroids (relative risk = 1.01; 95% CI = 1.00 to 1.03) for those who required MV were factors independently associated with ICUAW. Muscle strength was found to have a positive correlation with mobility and a negative correlation with lengths of stay in the ICU and hospital and time on MV.

Conclusion

The occurrence of ICUAW was high on patients’ awakening in the ICU but decreased throughout hospitalization; however, strength and mobility remained compromised at hospital discharge. Bed rest time and use of corticosteroids (for those who needed MV) were factors independently associated with ICUAW in patients with COVID-19.

Impact

Patients who had COVID-19 and developed ICUAW had longer periods of ICU stay, hospital stay, and MV. Bed rest time and use of corticosteroids (for those who required MV) were factors independently associated with ICUAW.
Factors enabling social impact: The importance of institutional entrepreneurship in social science research
Authors: Reale Emanuela
Published: February 2022

This paper wants to shed light on organizational factors as conditions for the impact of academic research in social sciences. Organizations play a role as enablers of social impact, providing conditions that improve the probability of impacting on society. We try to ascertain whether this role is supported and stimulated through institutional entrepreneurship, changing the institutions’ organizational features, ideas, and beliefs to increase productive interactions and knowledge translation. Our work centres on exploring the actors’ social position and their ability to introduce changes that are likely to permanently engage the organizations in the pursuit of social impact and possibly support it in the long run. The empirical basis consists of three case studies about research projects in the social sciences, which brought together academic researchers from different universities and stakeholders. The analysis demonstrates that understanding impact requires adopting a broader perspective, considering also the transformations emerging at the organizational level.
Predators of Soil Bacteria in Plant and Human Health
Authors: Martins Samuel J. , Taerum Stephen J. , Triplett Lindsay , Emerson Joanne B. , Zasada Inga , de Toledo Beatriz F. , Kovac Jasna , Martin Kendall , Bull Carolee T.
Published: February 2022

Soil bacterial predators that use the biomass of bacterial hosts for growth (multiplication), energy, or replication have the potential to reduce bacterial populations in the wide variety of terrestrial ecosystems in which they are found. Bacterial predators, including bacteria-feeding nematodes, protists, bacteria ( Bdellovibrio and like organisms, Lysobacter, and myxobacteria), and bacteriophages are responsible for bacterial turnover in soils that lead to many ecosystem services. The demonstrated breadth and specificity of bacterial host ranges for these predators make them interesting targets for the management of bacterial plant and human pathogens. However, there remain significant gaps in knowledge that will need to be filled in order to effectively utilize these predators for disease management. Here, we compared predatory strategies of the major groups of soil bacterial predators and outlined the gaps in knowledge or techniques that are limiting research. We offered specific needs and next steps for integrating analyses of predator identity and impact into studies of soil ecosystems in natural and applied settings.
Characterization of Six Partial Resistance Genes and One Quantitative Trait Locus to Blast Disease Using Near Isogenic Lines with a Susceptible Genetic Background of Indica Group Rice (Oryza sativa)
Authors: Saito Hiroki , Tomita Asami , Yoshida Tomofumi , Nakamura Mitsuru , Suzuki Taro , Ikeda Akihiro , Kato Takahiro , Nakajima Yasunori , Tanimoto Ryo , Tani Toshio , Hayashi Nagao , Hirabayashi Hideyuki , Ando Ikuo , Fukuta Yoshimichi
Published: February 2022

Seven near isogenic lines (NILs) for six partial blast-resistance genes— Pi35, pi21, Pi37(t)( Pi37-KRIL17), Pb1, and Pi34 (two: Pi34-Chubu32 and Pi34-Chugoku40, originating from different Japonica Group rice lines, ‘Chubu 32’ and ‘Chugoku 40’, respectively)—and one quantitative trait locus (QTL), PiPHL9, derived from Japonica Group line ‘Hokkai PL9’, were developed in rice ( Oryza sativa L.). These NILs have the genetic background of an Indica Group susceptible line ‘US-2’, which does not harbor complete resistance genes and can clarify the effects of partial resistance genes and the QTL. These NILs and US-2 were used to determine the effects of the partial resistance genes and the QTL based on the results of an inoculation test for leaf blast using international standard differential blast isolates in the young seedling stage and a natural infection test in the mature stage after heading at a blast field. The NILs produced mainly moderate reactions in the inoculation test and rarely exhibited “resistant” and “susceptible” reactions. Each of the partial resistance genes and the QTL had different effects in panicle blast. Two genes, Pi35 and Pb1, were the most effective with respect to resistance, followed by Pi37-KRIL17. Pi34-Chugoku40 was the weakest. The effects of pi21, Pi34-Chubu32, and PiPHL9 varied among cultivation seasons and could be easily affected by environmental conditions. This is the first report clarifying the effects of partial resistance genes without the major complete genes, which will be helpful for advanced genetic and pathological studies and as a source of genes for rice breeding.

[Formula: see text] Copyright © 2022 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Caring for COVID's emotional long haulers
Authors: Tye Joe , Long Kimberly , Blake Nancy , Luu Allison , Tye Annie
Published: February 2022

14 strategies to safeguard nurses' mental health
Association between placental global DNA methylation and blood pressure during human pregnancy
Authors: Putra Sulistyo E. Dwi , Reichetzeder Christoph , von Websky Karoline , Neuber Corinna , Halle Horst , Kleuser Burkard , Krämer Bernhard K. , Hocher Berthold
Published: February 2022

Objective:

Gene-specific placental DNA methylation patterns differ between normal pregnancies and pregnancies complicated by hypertension. However, whether global placental DNA methylation is associated with maternal blood pressure remains controversial.

Methods:

Using multiple linear regression models, we analysed the association between maternal mean arterial pressure (MAP) at the third trimester of pregnancy and global DNA methylation in the placenta in 922 mothers using LC-ESI-MS/MS. To better characterize the contribution of genetic or epigenetic mechanisms, we performed isolated analyses in mothers with and without a family history of hypertension.

Results:

Mean placental global DNA methylation was 3.00 ± 0.46%. A significant negative correlation between placental global DNA methylation and mean arterial blood pressure (MAP) in the third trimester could be observed (P = 0.023, r = -0.075). This association remained significant after adjusting for confounders. In placenta samples from mothers with a family history of hypertension, mean maternal MAP was higher (86.1 ± 8.1 vs. 84.6 ± 7.5, P < 0.01) and placental global DNA methylation was lower (2.94 ± 0.43 vs. 3.04 ± 0.47, P < 0.01) compared with samples without a family history of hypertension. Furthermore, the significant independent negative correlation between global placental DNA methylation and MAP was only found in mothers without a family history of hypertension.

Conclusion:

This study showed an independent negative correlation between placental global DNA methylation and maternal MAP in mothers without a family history of hypertension.
The Peptide–Drug Conjugate Melflufen Modulates the Unfolded Protein Response of Multiple Myeloma and Amyloidogenic Plasma Cells and Induces Cell Death
Authors: Flanagan Ken , Kumari Romika , Miettinen Juho J. , Haney Staci L. , Varney Michelle L. , Williams Jacob T. , Majumder Muntasir M. , Suvela Minna , Slipicevic Ana , Lehmann Fredrik , Nupponen Nina N. , Holstein Sarah A. , Heckman Caroline A.
Published: February 2022

Immunoglobulin light-chain (AL) amyloidosis is a rare disease caused by clonal plasma cell secretion of misfolded light chains that assemble as toxic amyloid fibrils, depositing in vital organs including the heart and kidneys, causing organ dysfunction. Plasma cell–directed therapeutics are expected to reduce production of toxic light chain by eliminating amyloidogenic cells in bone marrow, thereby diminishing amyloid fibril deposition and providing the potential for organ recovery. Melphalan flufenamide (melflufen) is a first-in-class peptide–drug conjugate that targets aminopeptidases and rapidly releases alkylating agents inside tumor cells. Melflufen is highly lipophilic, permitting rapid uptake by cells, where it is enzymatically hydrolyzed by aminopeptidases, resulting in intracellular accumulation of the alkylating agents, including melphalan. Previous data demonstrating sensitivity of myeloma cells to melflufen suggest that the drug might be useful in AL amyloidosis. We describe the effects of melflufen on amyloidogenic plasma cells in vitro and ex vivo, demonstrating enhanced cytotoxic effects in comparison to melphalan, as well as novel mechanisms of action through the unfolded protein response (UPR) pathway. These findings provide evidence that melflufen-mediated cytotoxicity extends to amyloidogenic plasma cells, and support the rationale for the evaluation of melflufen in patients with AL amyloidosis.
Nurses' Practices With Persons Experiencing Opioid Use Disorder
Authors: Sowicz Timothy Joseph , Huneycutt Brittany , Lee Jung Min
Published: February 2022

Millions of persons globally use opioids, and more than two million persons in the United States report having opioid use disorder (OUD). Increases in overdose deaths associated with opioids have led to a declaration of an opioid epidemic in the United States. Many healthcare professionals are involved in the treatment of persons experiencing OUD; several discipline-specific (e.g., medicine and public health) interventions are available. Nurses comprise large portions of the global and national healthcare workforces; therefore, investigating their unique, disciplinary contributions for addressing the opioid epidemic is warranted. This narrative literature review was undertaken to understand nurses' actions, practices, and work with persons with OUD. Using several databases and keywords, 21 research studies met the inclusion criteria. Most studies used qualitative designs; most quantitative studies were nonexperimental. The studies were conducted mostly in Europe and North America. Descriptions of nurses' practices with people with OUD varied in their levels of specificity and aligned well with the scopes of practice outlined by the American Nurses Association and the International Nurses Society on Addictions. The absence of theories (specifically nursing theories) used in the studies was notable. Theoretically informed studies that move beyond descriptions of nurses' practices are needed to advance discipline-specific knowledge and to showcase the unique contributions of nurses who make significant contributions to lessening adverse outcomes associated with OUD.
Jordanian University Students' Lived Experience of Misusing Amphetamine (Captagon)
Authors: Al Omari Omar , Wynaden Dianne , Alkhawaldeh Abdullah , Alhalaiqa Fadwa , Al Dameery Khloud , Roach Erna Judith , Sunderraj Sheeba John , Khalaf Atika
Published: February 2022

Background

Substance misuse is a growing problem among Jordanian university students.

Purpose

The aim of this study was to explore the lived experiences of university students who misuse Captagon (amphetamines).

Methods

The interpretative phenomenological analysis methodology was used. In-depth face-to-face interviews were conducted with 10 Jordanian university students, aged 17–22 years, who were using Captagon (amphetamines) for the last 6 months.

Results

Three major themes detailed participants' experiences with Captagon: (a) causes for use, (b) effects of taking amphetamines, and (c) seeking help behaviors and support. Participants who experienced academic and personal stress sought help from friends, who provided them with Captagon pills as a way to overcome their life challenges. Initially, taking Captagon provided participants with a sense of control, but it did not solve their problems. Later or as the days passed by, they experienced increased level of stress, felt disorganized in a way that they missed classes, and were being socially isolated. Participants finally sought community help for their problem, but this was difficult because of stigmatizing attitudes in their community toward substance misuse.

Conclusions

Increasing university students' knowledge about the negative consequences of substance misuse and raising awareness of strategies to address the problem will help young people to make more informed choices, because today's young generation are tomorrow's citizens.
Hyperbaric Oxygen to Assist Adults With Opioid Use Disorder in Reducing Methadone Dose
Authors: Wilson Marian , Odom-Maryon Tamara , Stanek Karen , Roush Trevor , Muriungi Joseph , Jesse Alvina , Quock Raymond M. , Layton Matthew
Published: February 2022

Opioid withdrawal symptoms can interfere with substance use disorder treatment goals. This study investigated the acceptability, feasibility, and treatment effects of hyperbaric oxygen therapy (HBOT) as an adjunct to reduce withdrawal symptoms for adults initiating a medically supervised methadone dose reduction. Adults prescribed methadone for opioid use disorder were randomized into either a hyperbaric oxygen group (n = 17) or an attention control group (n = 14). The study site was an outpatient opioid treatment program in the northwestern United States. Participants were asked to attend five consecutive daily 90-minute HBOT sessions offered at 2.0 atmospheres absolute with 100% oxygen in a pressurized chamber. Treatment attendance and reported satisfaction were measures of acceptability and feasibility. Medication doses were tracked posttreatment at 1 week, 1 month, and 3 months. Withdrawal symptoms were assessed at baseline and daily during the 5-day intervention period. After randomization, 13 (76.5%) followed through with medical screening and HBOT sessions, and of those, nine (69.2%) completed all five 90-minute HBOT sessions. At 3 months, the treatment group maintained, on average, a 4.3-mg methadone dose reduction compared with an average reduction of 0.25 mg for control group participants. Opioid withdrawal symptoms were reduced after Day 1 of HBOT by twice as much, on average, compared with the control condition. Satisfaction surveys found participants were generally satisfied with ease and comfort of the treatment. The evidence that HBOT is an acceptable, feasible adjunct warrants future trials to determine more conclusively effects on withdrawal symptoms associated with methadone dose taper.
Acute Vulvar Aphthous Ulceration After COVID-19 Vaccination: 3 Cases
Authors: Wijaya Marlene , Zhao Cathy , Forward Emily , Nguyen Yvonne , Kherlopian Ashod , Jollow David , Trujillo Dalia Cardenes , Fischer Gayle
Published: February 2022

Objective

We present a case series of acute vulvar aphthosis immediately following COVID-19 vaccination.

Materials and Methods

We describe 3 cases of acute vulvar aphthosis following Pfizer Comirnaty BNT162b2 mRNA and AstraZeneca (Vaxzevria) ChAdOx1 nCoV-19 COVID-19 vaccination in adolescent girls.

Results

All patients developed vulvar aphthosis within a few days after receiving COVID-19 vaccination. The onset of vulvar aphthosis was observed to correlate with the dosing schedule known to produce the highest likelihood of adverse effects, first dose in AstraZeneca (Vaxzevria) ChAdOx1 nCoV-19 and second dose in Pfizer Comirnaty BNT162b2 mRNA COVID-19 vaccine. Two patients required oral prednisolone and hospital admission for indwelling urinary catheterization due to urinary retention. Full disease resolution with no sequalae was achieved in all three patients.

Conclusions

Clinicians should be aware of the possible risk of vulvar aphthosis after COVID-19 vaccine administration. Nevertheless, its occurrence should not prevent affected patients from receiving future doses of COVID-19 vaccines, as the mortality and morbidity of COVID-19 infection significantly outweigh the risk of vulvar aphthosis recurrence.
Cardiac lymphatics: state of the art
Authors: Heron Coraline , Ratajska Anna , Brakenhielm Ebba
Published: February 2022

Purpose of review

The beneficial role of cardiac lymphatics in health and disease has begun to be recognized, with both preclinical and clinical evidence demonstrating that lymphangiogenesis is activated in cardiovascular diseases. This review aims to summarize our current understanding of the regulation and impact of cardiac lymphatic remodeling during development and in adult life, highlighting emerging concepts regarding distinguishing traits of cardiac lymphatic endothelial cells (LEC).

Recent findings

Genetic lineage-tracing and clonal analyses have revealed that a proportion of cardiac LECs originate from nonvenous sources. Further, these sources may vary between different regions of the heart, and could translate to differences in LEC sensitivity to molecular regulators. Several therapeutic approaches have been applied to investigate how lymphatics contribute to resolution of myocardial edema and inflammation in cardiovascular diseases. From these studies have emerged novel insights, notably concerning the cross-talk between lymphatics and cardiac interstitial cells, especially immune cells.

Recent years have witnessed a significant expansion in our knowledge of the molecular characteristics and regulation of cardiac lymphatics. The current body of work is in support of critical contributions of cardiac lymphatics to maintain both fluid and immune homeostasis in the heart.
Resources for Improving Pediatric Readiness and Quality of Care in Rural Communities and Emergency Departments
Authors: Kothari Shikha Yashwant , Haynes Sarah C. , Sigal Ilana , Magana Julia N. , Ruttan Timothy , Kuppermann Nathan , Horeczko Timothy , Ludwig Lorah , Karsteadt Larry , Chapman Wendy , Pinette Vickie , Marcin James P.
Published: February 2022

Objectives

To share the process and products of an 8-year, federally funded grant from the Health Resources and Services Administration Emergency Medical Services for Children program to increase pediatric emergency readiness and quality of care provided in rural communities located within 2 underserved local emergency medical services agencies (LEMSAs) in Northern California.

Methods

In 2 multicounty LEMSAs with 24 receiving hospital emergency departments, we conducted focus groups and interviews with patients and parents, first responders, receiving hospital personnel, and other community stakeholders. From this, we (a regional, urban children's hospital) provided a variety of resources for improving the regionalization and quality of pediatric emergency care provided by prehospital providers and healthcare staff at receiving hospitals in these rural LEMSAs.

Results

From this project, we provided resources that included regularly scheduled pediatric-specific training and education programs, pediatric-specific quality improvement initiatives, expansion of telemedicine services, and cultural competency training. We also enhanced community engagement and investment in pediatric readiness.

Conclusions

The resources we provided from our regional, urban children's hospital to 2 rural LEMSAs facilitated improvements in a regionalized system of care for critically ill and injured children. Our shared resources framework can be adapted by other regional children's hospitals to increase readiness and quality of pediatric emergency care in rural and underserved communities and LEMSAs.
Aligning Provider Prescribing With Guidelines for Soft Tissue Infections
Authors: Kovaleski Christopher , Courter Joshua D. , Ghulam Enas , Hagedorn Philip A. , Haslam David B. , Kurowski Eileen Murtagh , Rudloff James , Szczesniak Rhonda , Dexheimer Judith W.
Published: February 2022

Objective

Despite evidence-based guidelines, antibiotics prescribed for uncomplicated skin and soft tissue infections can involve inappropriate microbial coverage. Our aim was to evaluate the appropriateness of antibiotic prescribing practices for mild nonpurulent cellulitis in a pediatric tertiary academic medical center over a 1-year period.

Methods

Eligible patients treated in the emergency department or urgent care settings for mild nonpurulent cellulitis from January 2017 to December 2017 were identified by an International Classification of Diseases, Tenth Revision, code for cellulitis. The primary outcome was appropriateness of prescribed antibiotics as delineated by adherence with the Infectious Diseases Society of America guidelines. Secondary outcomes include reutilization rate as defined by revisit to the emergency department/urgent cares within 14 days of the initial encounter.

Results

A total of 967 encounters were evaluated with 60.0% overall having guideline-adherent care. Common reasons for nonadherence included inappropriate coverage of MRSA with clindamycin (n = 217, 56.1%) and single-agent coverage with sulfamethoxazole-trimethoprim (n = 129, 33.3%). There were 29 revisits within 14 days of initial patient encounters or a reutilization rate of 3.0%, which was not significantly associated with the Infectious Diseases Society of America adherence.

Conclusions

Our data show antibiotic prescription for nonpurulent cellulitis as a potential area of standardization and optimization of care at our center.
Extensive Gingivoperiosteoplasty Versus Secondary Alveolar Bone Grafting in Patients With Complete Bilateral Cleft Lip and Palate During the Mixed Dentition Period
Authors: Lu Ting-Chen , Bhandari Kishor , Yao Chuan-Fong , Tangco Ivy , Bajracharya Manish , Chen Philip Kuo-Ting
Published: February 2022

Background

The concept of gingivoperiosteoplasty (GPP) in the mixed dentition stage as compared with secondary alveolar bone grafting (ABG) in management of alveolar cleft has not been much discussed upon. The authors present the experience with extensive GPP and ABG in the mixed dentition stage in complete bilateral alveolar cleft cases.

Methods

A retrospective review of nonsyndromic patients with complete bilateral alveolar cleft operated on with either GPP or ABG (iliac crest) in the mixed dentition stage with at least 1-year follow-up was performed. Dental occlusal radiographs were evaluated for level of bone gain using Bergland and Witherow scales. Statistical evaluation of clinical success and procedure-related complications was conducted using χ2 test and odds ratio.

Results

Twenty-four patients in the GPP group and 20 in the ABG group were comparatively studied. Clinical success rate as indicated by Bergland scales I and II (87.5% in GPP vs 82.5% in ABG; P = 0.731), complication rate (20.83% in GPP vs 30% in ABG; P = 0.484), and status of canine eruption showed no significant differences in clinical outcomes in both groups.

Conclusions

The technique of extensive GPP as described by authors shows equal efficacy to secondary ABG for management of bilateral alveolar clefts during the mixed dentition period.
Double Fillet Flap for End-Stage Pelvic Pressure Injuries in a Paraplegic Patient
Authors: Wang Yu-Chi , Lin Tzu-Yu , Huang Shu-Hung
Published: February 2022

Recurrent pelvic pressure injuries are common among paraplegic patients with spinal cord injury. Most of them experienced multiple surgical treatments because of recurrence. Based on the “spare part” concept, the double fillet flap is feasible when all other reconstructive procedures were exhausted. In this case report, we present the double fillet flap technique to manage recurrent extended pelvic pressure ulcers in a paraplegic spinal cord injury patient.
Simultaneous Paramedian Pedicle Forehead and Free Medial Sural Artery Perforator Flap Reconstruction of a Composite Nasal Defect: A Case Report
Authors: Liao Kuan-Hao , Yen Cheng-I , Chang Chun-Shin , Hsiao Yen-Chang
Published: February 2022

Background

Extensive nasal defects after resection of a malignancy are a challenge for all plastic surgeons. Nasal composite tissue defects have to be reconstructed with multiple staging surgeries. A paramedian pedicled forehead flap and free tissue transfer can be used for lining and skin replacement at different stages. In general, free tissue transfer is used for nasal lining and nasal floor reconstruction at the preliminary stage. Several weeks or months later, a paramedian pedicled forehead flap is used to replace the skin. Intermediate stages will also be necessary, and therefore the total therapeutic course is very long.

Aim and Objectives

The aim of this study was to report the simultaneous use of a paramedian pedicle forehead flap and a free medial sural artery perforator (MSAP) flap to reconstruct a composite nasal defect after wide excision of squamous cell carcinoma.

Patient

In 2015, a 57-year-old woman with squamous cell carcinoma of the nose underwent tumor wide excision, which caused a composite defect involving multiple nasal subunits (partial tip, dorsum, right sidewall, right ala subunits). She received both a pedicled paramedian forehead flap to replace the skin and an MSAP flap to reconstruct the lining during the same procedure. At the intermediate stage 4 weeks later, the pedicled forehead flap was elevated and tailored. Then, a further 4 weeks later, flap division was performed.

Results

The patient received a total of 3 surgical procedures to reconstruct the composite defects of multiple nasal subunits. Nasal reconstruction was done within 2 months. The patient was satisfied with the aesthetic appearance and functional outcome.

Conclusions

Simultaneous paramedian pedicle forehead and free flap reconstruction can provide an effective solution for composite nasal defects. Satisfactory functional and aesthetic results can be achieved.
Hydrogen and wood-burning stoves
Authors: Palacios Adriana , Bradley Derek
Published: February 2022

Wood-burning stoves, in Kenya and Mexico, are reviewed. With a Kenyan stove, burning charcoal, only 24% of the energy released reached the cooking pot. Initially, the proportion of CO in the leaving gases was 3%. Indoor concentrations of particulate matter (less than 2.5 µm diameter) can be abnormally high near a stove. Decarbonization, by using H
2
, is facilitated by a distribution system. Replacement by H
2
would ultimately rest upon wind or water power, or it being a by-product in the production of heavier hydrocarbons from CH
4
. The averaged burning rate in the Kenyan stove was 10 kW, over 20 min, with an initial peak value of about 30 kW. A possible replacement is a hob, composed of an array of small diameter H
2
jet flames. As an example, combustion of a 2 mm internal diameter H
2
jet flame, with a H
2
exit velocity of 27.2 m s
−1
, would release 0.84 kW. Bearing in mind its improved efficiency, a single compact hob with an array of about 10 jets would suffice. A difficulty is the low mass-specific energy of H
2
. H
2
has a high acoustic velocity, and both high velocity subsonic combustion and blending with natural gas are briefly discussed.

This article is part of the theme issue ‘Developing resilient energy systems’.
Socio-economic impacts of energy access through off-grid systems in rural communities: a case study of southwest Nigeria
Authors: Babalola Samuel O. , Daramola Michael O. , Iwarere Samuel A.
Published: February 2022

The development of resilient energy systems is important for sustainable cities and communities. However, in countries with insufficient national energy supply, electricity distributors rarely consider remote communities due to their distant settlement, low electricity demand and poor payment capabilities. The United Nations has set a goal to deliver universal energy access by 2030; hence, it has become imperative to deploy clean and affordable off-grid mini-grid solutions to previously abandoned communities. Access to energy in rural communities is expected to result in unlocking their economic potentials. This paper investigates the impact of a solar hybrid mini-grid on the socio-economic growth of local entrepreneurs in Gbamu Gbamu village, Nigeria. A total of 83 micro- and small-enterprises has been surveyed; descriptive statistics, paired-sample
t
-test, cross-tabulation and χ
2
test, were used to assess the performance of businesses before and after electrification. The outcomes include the number of business enterprises created, employment statistics, energy expenses and income generated. Regression analysis was conducted on the relationship between the average income generated by businesses and independent socio-economic variables such as gender, marital status, household size, age, education level, years of business establishment, hours of operation, building tenure, capital source, number of employees, generator ownership and the days of operation.

This article is part of the theme issue 'Developing resilient energy systems'.
Distributed renewable energy systems for resilient and sustainable development of remote and vulnerable communities
Authors: Ahmad Tanvir , Ali Saddam , Basit Abdul
Published: February 2022

More than 940 million people (13% of the world population) do not have any access to electricity. Most of these people live in rural and remote areas, where the lack of electricity access is significantly damaging the quality of life, economic development and the environment. Distributed energy systems (DESs) (based on clean energy technologies) for energy access offer a potentially important strategy for pursuing environment-friendly sustainable development and poverty alleviation; especially in rural and remote communities. DESs are also helpful in reducing deforestation and greenhouse gas (GHG) emissions as the fossil fuel-based energy production is among the largest contributors to GHG emissions. This paper presents the importance of energy access through DESs for resilient and sustainable development using two projects case studies from Pakistan. The first project case study is based on the Afghan refugee villages, where, currently, there is no electricity access. A baseline survey was conducted to assess the socio-economic conditions and energy demand of the refugees. This assessment is then used to devise clean energy solutions as per the local context. This project aims to improve the quality of life of the refugees by providing energy access. In the second case study, electricity access was provided to the local communities a few years ago. Analyses of primary data collected in this case study show that DES integrated with socio-economic and cultural systems can bring a significantly positive impact on the local communities, advancing all the sustainability development goals. This work concludes that DES can be significantly generative, if effectively integrated into socio-economic processes.

This article is part of the theme issue ‘Developing resilient energy systems’.
Hysteresis in hybrid perovskite indoor photovoltaics
Authors: Bulloch Alasdair , Wang Shaoyang , Ghosh Paheli , Jagadamma Lethy Krishnan
Published: February 2022

Halide perovskite indoor photovoltaics (PV) are a viable solution to autonomously power the billions of sensors in the huge technology field of the Internet of Things. However, there exists a knowledge gap in the hysteresis behaviour of these photovoltaic devices under indoor lighting conditions. The present work is the first experimental study dedicated to exploring the degree of hysteresis in halide perovskite indoor photovoltaic devices by carrying out both transient J–V scan and steady state maximum power point tracking (MPPT) measurements. Dependence of hysteresis on device architecture, selection of electron transporting layers and the composition of the perovskite photoactive layers were investigated. Under indoor illumination, the p-i-n MAPbI
3
-based devices show consistently high power conversion efficiency (PCE) (stabilized PCE) of greater than 30% and negligible hysteresis behaviour, whereas the n-i-p MAPbI
3
devices show poor performance (stabilized PCE ∼ 15%) with pronounced hysteresis effect. Our study also reveals that the n-i-p triple cation perovskite devices are more promising (stabilized PCE ∼ 25%) for indoor PV compared to n-i-p MAPbI
3
due to their suppressed ion migration effects. It was observed that the divergence of the PCE values estimated from the J–V scan measurements, and the maximum power point tracking method is higher under indoor illumination compared to 1 Sun, and hence for halide perovskite-based indoor PV, the PCE from the MPPT measurements should be prioritized over the J–V scan measurements. The results from our study suggest the following approaches for maximizing the steady state PCE from halide perovskite indoor PV: (i) select perovskite active layer composition with suppressed ion migration effects (such as Cs-containing triple cation perovskites) and (ii) for the perovskite composition such as MAPbI
3
, where the ion migration is very active, p-i-n architecture with organic charge transport layers is beneficial over the n-i-p architecture with conventional metal oxides (such as TiO
2
, SnO
2
) as charge transport layers.

This article is part of the theme issue ‘Developing resilient energy systems’.
On the potential of pristine
Cocos nucifera L
. tissues for green desalination
Authors: Adelodun Adedeji A.
Published: February 2022

Coconut palm tree (
Cocos nucifera L
.) tissues were used as a readily available, low-cost and green adsorbent to desalinate seawater. The tree bark (CB), husk (CH), leaves (CL) and roots (CR) were examined in their fresh (F) and dry (D) forms. The salinity removal (adsorption) efficiency followed the trend: F_CB ≈ F_CR > F_CL > D_CR > F_CL > D_CR. The sorbents from the coastal region desalinated more efficiently than those from a non-coastal region. Also, the fresh tissues were more effective and efficient than the dry parts. The salinity retention ability (desalination : desorption) follows the trend: F_CR (22.2) > F_CB (19.0) ≫ D_CR (12.3) > D_CB (11.0) > D_CL (6.14) ≈ F_CL (6.10) > F_CH (4.3) > D_CH (2.1). Moreover, the desalination fitted the pseudo-second-order kinetics than the pseudo-first-order, suggesting the predominance of chemisorption over physical removal. Overall, water pH, conductivity, total dissolved solids and dissolved oxygen (DO) correlated positively and strongly with desalination. By contrast, the density and redox potential correlated negatively, whereas temperature and DO showed no definite influence. Conclusively, F_CR and F_CB are the most suitable coconut palm tree tissues for desalination. Future studies should include chemical characterization of the tissues and system optimization for upscaling.

This article is part of the theme issue ‘Developing resilient energy systems’.
Multidrug-resistant Mycolicibacterium fortuitum infection in a companion cat (Felis silvestris catus) in Brazil
Authors: Morgado Sergio , Ramos Nilcéia de Veiga , Pereira Bárbara Bianca do Nascimento , Freitas Fernanda , Fonseca Érica Lourenço da , Vicente Ana Carolina
Published: February 2022

Mycolicibacterium fortuitum

is a fast-growing bacterium and an opportunistic pathogen implicated in human and animal infections. Here we report the first case and genetic characterization of a strain of

M. fortuitum

isolated from skin lesions of a companion cat with atypical cutaneous mycobacteriosis in Brazil. In addition, the genome of this strain was sequenced, representing the first genome of this opportunistic pathogen isolated from an animal infection. The in silico and in vitro analysis regarding antibiotic resistance of this strain showed an intrinsic multiresistance antibiotic profile. However, this strain showed sensitivity to amikacin and ciprofloxacin, and the cat was treated long-term with these drugs.