bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Equipotent Doses of Intrathecal Hyperbaric Prilocaine 2% and Hyperbaric Bupivacaine 0.5% for Elective Caesarean Section: A Prospective, Randomized, Controlled, 2-Center Clinical Trial
Authors: Goffard P. , Leloup R. , Vercruysse Y. , Fils J.F. , Gautier P.E. , Kapessidou Y.
Published: February 2023

(Eur J Anaesthesiol. 2022;39:227–235)

Spinal anesthesia is the most common anesthetic for elective cesarean delivery (CD), usually with a long-acting local anesthesia like bupivacaine combined with opioids. While providing many benefits, bupivacaine also comes with risks. Hyperbaric prilocaine, an intermediate-acting local anesthetic, thus may have some advantages. Intrathecal (IT) 2% prilocaine provides rapid onset of sensory and motor block without significant side effects, however, has not been widely studied for CD. This study compared IT hyperbaric prilocaine 2% and hyperbaric bupivacaine 0.5% during elective CD.
Spinal Versus General Anesthesia for Cesarean Delivery in Pregnant Women With Moyamoya Disease: A Retrospective Observational Study
Authors: Kim H.J. , Choi S.H. , Kwon H. , Park E.K. , Kwon J.Y. , Yang H. , Kim S.H.
Published: February 2023

(Anesth Analg. 2022;135:617–624)

Moyamoya disease (MMD), a rare cerebrovascular disease causing the vascular network at the brain’s base to be fragile, requiring careful blood pressure control and proactive medical treatment to prevent life-threatening hemorrhage and/or ischemic events. The exact risks pregnancy, labor, and delivery for MMD patients is unknown. The aim of this study was to determine if the choice of spinal anesthesia versus general anesthesia would have a significant effect on the intraoperative mean arterial pressure in MMP patients undergoing cesarean section.
Frequency and Risk Factors for Difficult Intubation in Women Undergoing General Anesthesia for Cesarean Delivery: A Multicenter Retrospective Cohort Analysis
Authors: Reale S.C. , Bauer M.E. , Klumpner T.T. , Aziz M.F. , Fields K.G. , Hurwitz R. , Saad M. , Kheterpal S. , Bateman B.T.
Published: February 2023

(Anesthesiology. 2022;136:697–708)

Elucidating the contemporary rate of difficult or failed intubation in women undergoing general anesthesia for cesarean delivery is confounded in the literature by small sample size, and the unaccounted-for increased use of neuraxial anesthesia and video laryngoscope, all amounting to generally outdated information available for this question. As the mother and neonate are at high risk for adverse outcome with difficult intubation, it is important to understand characteristics that may increase the likelihood of this complication, as to initiate pertinent preparation and early neuraxial anesthesia. The aim of this study was to determine an updated frequency of difficult and failed intubation in the obstetric setting and identify risk factors of such that may be particular to women receiving general anesthesia for cesarean delivery.
Transversus Abdominis Plane Block Versus Local Anesthetic Wound Infiltration for Analgesia After Cesarean Section: A Systematic Review and Meta-analysis With Trial Sequential Analysis
Authors: Grape S. , Kirkham K.R. , Albrecht E.
Published: February 2023

(Eur J Anaesthesiol. 2022;39:244–251)

Cesarean delivery (CD) rates have been increasing, and regional anesthesia has been shown to mitigate negative postoperative maternal outcomes. When intrathecal opioid is absent, experts suggest fascial plane blocks, such as a transversus abdominis plane (TAP) block, or local anesthetic wound infiltration for analgesia following CD. This study aims to review TAP block and wound infiltration analgesic techniques and outcomes to determine which is better for CD.
Predictors of Patient Postdischarge Opioid Use After Cesarean Delivery: A Prospective Study
Authors: Cohen A. , Xie X. , Zeuner R. , Galperin S. , Brunei T.
Published: February 2023

(Int J Obstet Anesth. 2022;50:103249)

Many consider the United States’ opioid crisis a public health emergency. Therefore, all available avenues to discourage opioid use after medical intervention is necessary. Opioids are frequently prescribed after cesarean delivery (CD) but use is inconsistent. This study assessed post-CD opioid use and identified demographic characteristics that correspond with additional opioid use.
Pregnancy and Labor Epidural Effects on Gastric Emptying: A Prospective Comparative Study
Authors: Bouvet L. , Schulz T. , Piana F. , Desgranges F.-P. , Chassard D.
Published: February 2023

(Anesthesiology. 2022;136:542–550)

Strict fasting during labor has been practiced for more than 70 years in the United States. During that time, the incidence of peripartum aspiration pneumonia has significantly decreased, in part due to advances in anesthesia. Some European guidelines allow patients to consume low-residue food during labor, while US guidelines only allow for clear fluids. There is a lack of strong data concerning gastric emptying in labor. This study compared gastric emptying after a light meal in laboring patients with epidural analgesia, laboring patients without epidural analgesia, pregnant nonlaboring women, and nonpregnant women.
Well, That Could Have Gone Better
Authors: Cifu Adam S.
Published: February 2023

Most physician–patient relationships take little effort. The physician acts with the kindness, patience, empathy, and professionalism that they have brought to the field and honed over years of training and practice. However, there are a subset of patients with whom, to be successful, the doctor needs insight into their own weaknesses and countertransference. In this reflection, the author recounts his troubled relationship with a patient. The source of the tension was the physician’s countertransference. Self-awareness allows a physician to understand how countertransference can threaten good medical care and how it can be managed.
V-Y Flap Over Moberg’s Flap to Cover the Thumb’s Fingertip Injury: Technique and Cases
Authors: Díaz Luis Carlos , Vergara-Amador Enrique , Camacho Castro Felipe
Published: February 2023

The Moberg flap has been used to achieve coverage of amputations of the thumb’s fingertip. However, it has been associated with flexion contractures of the interphalangeal (IP) joint of the thumb. A modification of the surgical technique is presented, adding a distal V-Y flap to allow greater advancement, and avoiding IP joint contractures. The proposed surgical technique is presented, and a case series of patients treated with this modification is introduced. A total of 5 patients underwent this surgical technique. All the flaps healed without complications. No patient presented stiffness or flexion contracture of the thumb´s IP joint. There were no cases of neuropathic pain and the 2-point discrimination over the flap was 6.8 mm on average. In conclusion, the proposed variation to the Moberg’s flap allows adequate coverage of injuries to the thumb’s fingertip with a low rate of complications, adequate sensitivity of the reconstructed digit and avoiding flexion contractures of the IP joint.
Mortality and Sequential Organ Failure Assessment Score in Patients With Suspected Sepsis: The Impact of Acute and Preexisting Organ Failures and Infection Likelihood
Authors: Christensen Erik E. , Prebensen Christian H. , Martinsen Anders B. , Stiff Elisabeth T. , Hoff Rune , Kvale Dag , Holten Aleksander R.
Published: February 2023

IMPORTANCE:

The Sequential Organ Failure Assessment (SOFA) was chosen in the definition of sepsis due to superior validity in predicting mortality. However, few studies have assessed the contributions of acute versus chronic organ failures to SOFA for mortality prediction.

OBJECTIVES:

The main objective in this study was to assess the relative importance of chronic and acute organ failures in mortality prediction in patients with suspected sepsis at hospital admission. We also evaluated how the presence of infection influenced the ability of SOFA to predict 30-day mortality.

DESIGN, SETTING, AND PARTICIPANTS:

Single-center prospective cohort study including 1,313 adult patients with suspected sepsis in rapid response teams in the emergency department.

MAIN OUTCOMES AND MEASURES:

The main outcome was 30-day mortality. We measured the maximum total SOFA score during admission (SOFATotal), whereas preexisting chronic organ failure SOFA (SOFAChronic) score was assessed by chart review, allowing calculation of the corresponding acute SOFA (SOFAAcute) score. Likelihood of infection was determined post hoc as “No infection” or “Infection.”

RESULTS:

SOFAAcute and SOFAChronic were both associated with 30-day mortality, adjusted for age and sex (adjusted odds ratios [AORs], 1.3; 95% CI, 1.3–14 and 1.3; 1.2–1.7), respectively. Presence of infection was associated with lower 30-day mortality (AOR, 0.4; 95% CI, 0.2–0.6), even when corrected for SOFA. In “No infection” patients, SOFAAcute was not associated with mortality (AOR, 1.1; 95% CI, 1.0–1.2), and in this subgroup, neither SOFAAcute greater than or equal to 2 (relative risk [RR], 1.1; 95% CI, 0.6–1.8) nor SOFATotal greater than or equal to 2 (RR, 3.6; 95% CI, 0.9–14.1) was associated with higher mortality.

CONCLUSIONS AND RELEVANCE:

Chronic and acute organ failures were equally associated with 30-day mortality in suspected sepsis. A substantial part of the total SOFA score was due to chronic organ failure, calling for caution when using total SOFA in defining sepsis and as an outcome in intervention studies. SOFA’s mortality prediction ability was highly dependent on actual presence of infection.
An Adapted Self-screening Tool for Peripartum Cardiomyopathy in Haiti
Authors: Rene Cassandra , Faustin Mikerlyne , Bonhomme Jerry , Deschamps Marie-Marcelle , Jean-Gilles Michele , Rosenberg Rhonda , Ibrahim Michel , McNairy Margaret , Pape Jean W. , Devieux Jessy G.
Published: February 2023

Background:

Peripartum cardiomyopathy (PPCM) is considered rare in the United States; however, the literature notes that the disease has a higher prevalence in developing countries such as Haiti. Dr. James D. Fett, a US cardiologist, developed and validated a self-assessment measure for PPCM in the United States to aid women to easily differentiate the signs and symptoms of heart failure from those related to a normal pregnancy. Although this instrument was validated, it lacks the adaptation necessary to account for the language, culture, and education of the Haitian population.

Objective:

The aim of this study was to translate and culturally adapt the Fett PPCM self-assessment measure for use among a Haitian Creole speaking population.

Methods:

A preliminary Haitian Creole direct translation was developed from the original English Fett self-test. A total of four focus groups with medical professionals and 16 cognitive interviews with members of a community advisory board were conducted to refine the preliminary Haitian Creole translation and adaptation.

Results:

The adaptation focused on incorporating cues that would be tangible and connected to the reality of the Haitian population while maintaining the intended meaning of the original Fett measure.

Conclusions:

The final adaptation provides an instrument suitable for administration by auxiliary health providers and community health workers to help patients distinguish symptoms of heart failure from symptoms related to normal pregnancy and further quantify the severity of signs and symptoms that might be indicative of heart failure.
A Pilot Study on Standardized In-hospital Education About Heart Failure Conducted During the First Days After Decompensation
Authors: Siennicka Agnieszka , Biegus Jan , Gajewski Piotr , Młynarska Katarzyna , Sokolski Mateusz , Siwołowski Paweł , Zymliński Robert , Jedynak Kamila , Ponikowska Beata , Urban Szymon
Published: February 2023

Introduction:

Education addressed to heart failure (HF) patients constitutes an important element of modern comprehensive treatment programs. The present article demonstrates a novel method of standardized in-hospital education addressed to patients admitted due to decompensation in HF.

Methods:

This pilot study was conducted among 20 patients [19 men, age 63 ± 16 years, NYHA (Classification according to New York Heart Association) on admission (II/III/IV): 5/25/70%]. Five-day education was based on individual sessions conducted using colorful boards demonstrating selected, highly practical elements of the knowledge about HF management, prepared by experts in HF management (medical doctors, a psychologist, and a dietician). The level of knowledge about HF was measured before and after education, based on a questionnaire prepared by the authors of the boards.

Results:

All patients experienced an improvement of their clinical status (confirmed by reduced New York Heart Association class and body mass, both P < 0.05). Mini Mental State Exam (MMSE) confirmed that no one demonstrated cognitive impairment. The score reflecting the level of knowledge about HF improved significantly after 5 days of in-hospital treatment accompanied by education (P = 0.0001).

Conclusions:

We showed that the proposed model of education addressed to patients with decompensated HF, conducted using colorful boards demonstrating selected, highly practical elements of the knowledge about HF management, prepared by experts in HF management lead to significant increase of HF-related knowledge.
The Effects of Exercise Training on Low Back/Pelvic Girdle Pain During Pregnancy: A Systematic Review
Authors: McCarthy Traci A. , Reddy Pranav S. , Simonds Adrienne H. , Spaeth Andrea M.
Published: February 2023

Background:

Forty-five percent of pregnant women report moderate to severe low back and/or pelvic girdle pain (LBP/PGP) during pregnancy. Exercise, specifically muscular fitness training, is effective for the prevention and treatment of LBP/PGP in the general population. However, its efficacy during pregnancy is unknown.

Objectives:

The goal of this review is to examine the evidence supporting muscular fitness training for prevention and treatment of LBP/PGP during pregnancy.

Study Design:

A systematic review.

Methods:

A systematic review was conducted from February 2021 to June 2022 using online databases and hand searching. Randomized control trials were included if the population was pregnant women, the intervention was exercise training, the comparison was a nonexercise control group, and the outcome was LBP/PGP. A risk of bias analysis using the Cochran Risk of Bias (RoB) tool and quality assessment were performed using the GRADE method. The included articles were compiled into exercise types for comparison.

Results:

Of the 1707 articles found, 26 (n = 3946 pregnant women) were included in the final analysis after removing duplicates, articles that did not meet inclusion criteria, and articles unavailable in English. Seventeen out of 26 articles found that exercise during pregnancy had a positive effect on pain, but the quality of the studies ranged from very low to moderate. None of the included articles utilized strength training for muscular fitness, 2 used hypertrophy training, and the remaining articles utilized muscular endurance programs for muscular fitness.

Conclusion:

Strength and hypertrophy training for LBP/PGP during pregnancy is largely unknown and understudied; however, many other modes of exercise for muscular endurance improved pain. More research is warranted to determine the benefits of traditional strength and hypertrophy training for LBP/PGP management during pregnancy.
Oral Chemotherapeutic Ingestions Reported to a Poison Control Center Treated in a Health Care Facility
Authors: Ontiveros Sam , Hogue Brenna , Kreshak Allyson , Coyne Christopher , Cantrell Lee , Minns Alicia
Published: February 2023

Background:

The approach to cancer chemotherapy has changed in recent years, and there are several new oral chemotherapeutics that offer convenience to patients. These medications have toxicity, which may be particularly amplified in an overdose.

Study Design:

This was a retrospective review of all oral chemotherapy overdoses reported to the California Poison Control System between January 2009 and December 2019. Inclusion criteria were all ingestions coded as “antineoplastic, monoclonal antibody, or thalidomide” that were evaluated at a health care facility. We evaluated outcomes per AAPCC criteria (stratified as death, major, moderate, mild, or no effect) as well as symptoms and interventions.

Results:

There were 314 total cases reported; 169 single-substance ingestions (54%) and 145 cases with coingestant(s) (46%). One hundred eighty cases were female (57%) and 134 male (43%). Age ranges were as follows: ages 1–10 years old (87 cases); ages 11–19 years old (26 cases); 20–59 years old (103 cases); ages 60 and older (98 cases). The majority of cases were unintentional ingestions (199, 63%). The most common medication reported was methotrexate with 140 cases (45%), followed by anastrozole (32 cases) and azathioprine (25 cases). One hundred thirty-eight cases were admitted to the hospital for further care (ICU 63 cases; non-ICU 75 cases). Eighty-four of the methotrexate cases received the antidote leucovorin (60%). Five of the capecitabine ingestions received uridine (36%). Outcomes included 124 cases with no effect, 87 cases with minor effect, 73 case with moderate effect, 26 cases with major effect, and 4 deaths.

Conclusion:

Although methotrexate is the most common oral chemotherapeutic agent involved in overdoses reported to the California Poison Control System, there are many other oral chemotherapeutics from various drug classes, which can lead to toxicity. Although deaths are rare, further studies are needed to determine if particular drugs or drug classes warrant more scrutiny.
Anakinra—An Interleukin-1 Receptor Antagonist for COVID-19
Authors: Nguyen Timothy , Dima Lorena , Willett Kristine C.
Published: February 2023

Background:

Coronavirus disease (COVID-19) caused by SARS-CoV-2 virus caused a global pandemic in 2019. There are limited pharmacologic options available. The Food and Drug Administration initiated an emergency use authorization process to expedite pharmacologic agents to treat COVID-19. There are several agents available through the emergency use authorization process, ritonavir-boosted nirmatrelvir, remdesivir, and baricitinib. Anakinra is an interleukin (IL)-1 receptor antagonist that exhibits properties in fighting against COVID-19.

Mechanism of Action, Pharmacodynamics, and Pharmacokinetics:

Anakinra is a recombinant IL-1 receptor antagonist. The epithelial cell damage that may occur with COVID-19 enhances the release of IL-1, which plays a central role in severe cases. Thus, drugs that inhibit the IL-1 receptor may be beneficial in the management of COVID-19. Anakinra has good bioavailability after subcutaneous injection and a half-life of up to 6 hours.

Clinical Trials:

The SAVE-MORE, double-blind, randomized controlled trial, phase 3 evaluated the efficacy and safety of anakinra. Anakinra 100 mg was given subcutaneously daily for up to 10 days in patients with moderate and severe COVID-19 and plasma suPAR ≥6 ng/mL. Anakinra group had a 50.4% fully recovered with no viral RNA detected on day 28 versus 26.5% for placebo, and more than 50% of relative decrease in mortality. A significantly decreased risk of worse clinical outcome was observed.

Therapeutic Advance:

COVID-19 causes global pandemic and a serious viral disease. There are limited therapy options to combat this deadly disease. Anakinra is an IL-1 receptor antagonist and shown to be effective for the treatment of COVID-19 in some trials but not others. Anakinra, the first in this class, seems to have a mix result for the treatment of COVID-19.
Chronic kidney disease with unknown cause across the global spectrum
Authors: Nast Cynthia C.
Published: February 2023

Purpose of review

In the 1990s, a type of chronic kidney disease with unknown cause (CKDu) was identified in Central America and Sri Lanka. Patients lacked hypertension, diabetes, glomerulonephritis, or other usual causes of kidney failure. Affected patients are predominantly male agricultural workers aged 20–60 years, living in economically disadvantaged areas with poor access to medical care. Patients typically present late and progress to end-stage kidney disease within 5 years, resulting in social and economic hardship for families, regions, and countries. This review covers the current state of knowledge for this disease.

Recent findings

The prevalence of CKDu is increasing in known endemic regions and across the globe, reaching epidemic proportions. There is primary tubulointerstitial injury with secondary glomerular and vascular sclerosis. No definitive etiologic factors have been identified, and these may vary or overlap in different geographic locations. The leading hypotheses include exposure to agrochemicals, heavy metals and trace elements, and kidney injury from dehydration/heat stress. Infections and lifestyle factors may play a role, but are likely not key. Genetic and epigenetic factors are beginning to be explored.

CKDu is a leading cause of premature death in young-to-middle-aged adults in endemic regions and has become a public health crisis. Studies are underway to investigate clinical, exposome, and omics factors, and hopefully will provide insights into pathogenetic mechanisms resulting in biomarker discovery, preventive measures, and therapeutics.
PD-L1 and MHC Class I Expression in High-grade Ovarian Cancers, Including Platinum-resistant Recurrences Treated With Checkpoint Inhibitor Therapy
Authors: Griesinger Laurie , Nyarko-Odoom Akua , Martinez Santos Acosta , Shen Nancy W. , Ring Kari L. , Gaughan Elizabeth M. , Mills Anne M.
Published: February 2023

Immune-modulating therapies targeting the programmed cell death-1/programmed cell death ligand-1 (PD-L1) immunosuppressive system have been used successfully in many solid tumor types. There is evidence that biomarkers such as PD-L1 and major histocompatibility complex (MHC) class I help identify candidates for anti-programmed cell death-1/PD-L1 checkpoint inhibition, though the evidence is limited in ovarian malignancies. PD-L1 and MHC Class I immunostaining was performed on pretreatment whole tissue sections in 30 cases of high-grade ovarian carcinoma. The PD-L1 combined positive score was calculated (a score of ≥1 is considered positive). MHC class I status was categorized as an intact or subclonal loss. In patients who received immunotherapy, drug response was assessed using RECIST criteria. PD-L1 was positive in 26 of 30 cases (87%; combined positive score: 1 to 100). Seven of 30 patients showed subclonal loss of MHC class I (23%), and this occurred in both PD-L1 negative (3/4; 75%) and PD-L1 positive (4/26; 15%) cases. Only 1 of 17 patients who received immunotherapy in the setting of a platinum-resistant recurrence responded to the addition of immunotherapy, and all 17 died of disease. In the setting of recurrent disease, patients did not respond to immunotherapy regardless of PD-L1/MHC class I status, suggesting that these immunostains may not be effective predictive biomarkers in this setting. Subclonal loss of expression of MHC class I occurs in ovarian carcinoma, including in PD-L1 positive cases, suggesting that the 2 pathways of immune evasion may not be mutually exclusive and that it may be important to interrogate MHC class I status in PD-L1 positive tumors to identify additional immune evasion mechanisms in these tumors.
Assessing the Impact of COVID-19 on Facial Aesthetic Surgery Search Interest
Authors: Herzog Isabel , Park John , Didzbalis Christoper James , Weisberger Joseph , Tran Bao N. , Lee Edward S.
Published: February 2023

The global COVID-19 pandemic reshaped many components of modern health care practice. Before the pandemic, research was beginning to demonstrate the impact of self-facing cameras, selfie images, and webcams on patient interest in head and neck (H&N) aesthetic surgery. We sought to determine temporal changes in patient interest in aesthetic surgery of the H&N as compared with the rest of the body because of COVID-19, and the subsequent surge in Web-conferencing and telecommunication. The 2020 Plastic Surgery Trends Report produced by the American Society of Plastic Surgeons was used to identify the 5 most common aesthetic surgical procedures performed on the H&N and the rest of the body for 2019: blepharoplasty, face lift, rhinoplasty, neck lift, cheek implant, and breast lift, liposuction, tummy tuck, breast augmentation, and breast reduction, respectively. Google Trends filters, which provide relative search interest for greater than 85% of Internet searches, were applied to gauge interest from January 2019 to April 2022. Relative search interest and mean interest were plotted as a function of time for each term. Our findings demonstrate a sharp decline in online aesthetic surgery interest in March 2020, coinciding with the beginning of the COVID-19 pandemic for both the H&N and the rest of the body. Search interest increased shortly after March 2020 and reached values greater than those of the prepandemic year (2019) in 2021 for rest of the body procedures. After March 2020, there was a brief, sharp increase in search interest for rhinoplasty, neck lift, and facelift, whereas patient interest in blepharoplasty increased more gradually. There was no increase in search interest for H&N procedures as a result of COVID-19 when using the mean values of the included procedures, although current interest has returned to prepandemic levels. The COVID-19 pandemic caused a disruption of normal trends in aesthetic surgery interest, with a sharp decline in search interest in March 2020. Afterward, there was a sharp increase in rhinoplasty, face lift, neck lift, and blepharoplasty interest. Patient interest in blepharoplasty and neck lift has remained elevated compared with 2019. Interest in rest of the body procedures has returned to and even surpassed prepandemic levels.
Comparative Evaluation of the Electronic Residency Application Service Versus the Plastic Surgery Common Application to a Single Institution in the 2022 Integrated Plastic Surgery Match
Authors: Cordero Justin J. , Kondra Katelyn , Etemad Shervin , Swerdlow Mark , Yenikomshian Haig , Carey Joseph N.
Published: February 2023

Background

The Plastic Surgery Common Application (PSCA) has emerged as a low-cost alternative application portal to the Electronic Residency Application Service (ERAS) for integrated plastic surgery applicants. During the 2021 to 2022 application cycle, our plastic surgery residency program accepted both the PSCA and ERAS applications to help recruit candidates otherwise deterred by prohibitively high application costs. We sought to determine how the PSCA compared with the ERAS application in a standardized review of applications scores.

Methods

The PSCA and ERAS applications from 28 candidates who received interviews from the Keck School of Medicine were analyzed. These 56 applications were randomly assigned across 22 independent reviewers. Each reviewer scored applications on a scale of 1 to 5 with regard to communication skills, leadership, intellectual curiosity, compatibility with the program, service, and perseverance. Mean scores between the applications were compared using 2-tailed z tests, with statistical significance set at P < 0.05.

Results

The 56 residency applications had a combined mean score of 4.21 (95% confidence interval [CI], 4.13–4.29). The mean score of PSCA applications (4.19; 95% CI, 4.08–4.31) did not significantly differ from the mean score of ERAS applications (4.24; 95% CI, 4.12–4.35; P = 0.57). The PSCA and ERAS applications did not have a significant difference in the mean scores for any review category.

Conclusion

There was no difference between the overall scores and the scores of each review category between the PSCA and ERAS applications, suggesting that the PSCA may be a reasonable alternative to ERAS for medical students applying to plastic surgery residency.
Expectations of efficient actions bias social perception: a pre-registered online replication
Authors: McDonough Katrina L. , Bach Patric
Published: February 2023

Humans take a teleological stance when observing others' actions, interpreting them as intentional and goal directed. In predictive processing accounts of social perception, this teleological stance would be mediated by a perceptual prediction of an ideal energy-efficient reference trajectory with which a rational actor would achieve their goals within the current environmental constraints. Hudson and colleagues (2018Proc. R. Soc. B285, 20180638. (doi:10.1098/rspb.2018.0638)) tested this hypothesis in a series of experiments in which participants reported the perceived disappearance points of hands reaching for objects. They found that these judgements were biased towards the expected efficient reference trajectories. Observed straight reaches were reported higher when an obstacle needed to be overcome than if the path was clear. By contrast, unnecessarily high reaches over empty space were perceptually flattened. Moreover, these perceptual biases increased the more the environmental constraints and expected action trajectories were explicitly processed. These findings provide an important advance to our understanding of the mechanisms underlying social perception. The current replication tests the robustness of these findings and whether they uphold in an online setting.
Blue tits are outperformed by great tits in a test of motor inhibition, and experience does not improve their performance
Authors: Urhan Utku , Mårdberg Magnus , Isaksson Emil , van Oers Kees , Brodin Anders
Published: February 2023

Motor inhibition refers to the ability to inhibit immediate responses in favour of adaptive actions that are mediated by executive functions. This ability may be an indication of general cognitive ability in animals and is important for advanced cognitive functions. In this study, our aim was to compare motor inhibition ability of two closely related passerines that share the same habitat. To do this, we tested motor inhibition ability using a transparent cylinder task in blue tits in the same way as we previously tested great tits. To test whether the experience of transparent objects would affect the performance of these species differently, both in the present experiment using blue tits and our previous one on great tits, we divided 33 wild-caught individuals into three different treatment groups with 11 birds each. Before the test we allowed one group to experience a transparent cylindrical object, one group to experience a transparent wall and a third group was kept naive. In general, blue tits performed worse than great tits, and unlike the great tits, they did not improve their performance after experience with a transparent cylinder-like object. The performance difference may stem from difference in foraging behaviour between these species.
Preparation and performance evaluation of non-foaming styrene-acrylic latex for cementing slurry
Authors: Guo Shenglai , Li Ming , Li Sihe , Zhao Jiaxin , Bu Yuhuan , Liu Huajie , Wang Yindong
Published: February 2023

The latex used conventionally for oil-well cementing can lead to serious foaming issues in the cement slurry, which not only affects the accurate measurement of the density of the latex-containing cement slurry, but also is detrimental to cementing construction. A large amount of a foam stabilizer used for latex preparation is mainly responsible for foaming of the latex-containing cement slurry. In this study, soap-free emulsion polymerization was conducted using 2-acrylamido-2-methylpropanesulfonic acid (AMPS), styrene (St), and butyl acrylate (BA) as the reaction monomers and the effects of the AMPS dosage, monomer ratio, reaction temperature and stirring speed on the performance of the latex were investigated. The optimum synthesis conditions included a 30% monomer concentration, an St : BA : AMPS monomer ratio of 5 : 4 : 6, a synthesis temperature of 85°C, a stirring speed of 400 r.p.m. and 1.5% of the initiator. As-prepared latex exhibited good filtration loss control, excellent freeze–thaw stability, and extremely low foaming of the cement slurry with the added latex, which was extremely beneficial for on-site cementing construction.
Draft Genome Sequences of 11 Xanthomonas Strains associated with bacterial spot disease in Turkey
Authors: Subedi Aastha , Kara Serhat , Aysan Yesim , Minsavage Gerald V. , Timilsina Sujan , Roberts Pamela D. , Goss Erica M. , Jones Jeffrey B.
Published: February 2023

Bacterial spot is an economically significant disease in tomato and pepper-producing countries globally. We report the whole genome sequence of 11 Xanthomonas strains associated with bacterial spot disease on pepper, tomato, and eggplant in the Southeastern Anatolia Region, Turkey.  This genomic information can be used as a reference to study the genetic diversity of these species and contribute to illuminating pathogen evolution with respect to host specificity.
Subcortical brain alterations in carriers of genomic copy number variants
Authors: Kumar Kuldeep , Modenato Claudia , Moreau Clara , Ching Christopher R. K. , Harvey Annabelle , Martin-Brevet Sandra , Huguet Guillaume , Jean-Louis Martineau , Douard Elise , Martin Charles-Olivier , Younis Nadine , Tamer Petra , Maillard Anne M. , Rodriguez-Herreros Borja , Pain Aurélie , Richetin Sonia ,   16p11.2 European Consortium,   Simons Searchlight Consortium, Kushan Leila , Isaev Dmitry , Alpert Kathryn , Ragothaman Anjani , Turner Jessica A. , Wang Lei , Ho Tiffany C. , Schmaal Lianne , Silva Ana I. , van den Bree Marianne B.M. , Linden David E.J. , Owen Michael J. , Hall Jeremy , Lippé Sarah , Dumas Guillaume , Draganski Bogdan , Gutman Boris A. , Sønderby Ida E. , Andreassen Ole A. , Schultz Laura , Almasy Laura , Glahn David C. , Bearden Carrie E. , Thompson Paul M. , Jacquemont Sébastien
Published: February 2023

Objectives

Copy number variants (CNVs) are well-known genetic pleiotropic risk factors for multiple neurodevelopmental and psychiatric disorders (NPDs) including autism (ASD) and schizophrenia (SZ). Overall, little is known about how different CNVs conferring risk for the same condition may affect subcortical brain structures and how these alterations relate to the level of disease risk conferred by CNVs. To fill this gap, we investigated gross volume, and vertex level thickness and surface maps of subcortical structures in 11 different CNVs and 6 different NPDs.

Methods

Subcortical structures were characterized using harmonized ENIGMA protocols in 675 CNV carriers (at the following loci: 1q21.1, TAR, 13q12.12, 15q11.2, 16p11.2, 16p13.11, and 22q11.2) and 782 controls (Male/Female: 727/730; age-range: 6-80 years) as well as ENIGMA summary-statistics for ASD, SZ, ADHD, Obsessive-Compulsive-Disorder, Bipolar-Disorder, and Major-Depression.

Results

Nine of the 11 CNVs affected volume of at least one subcortical structure. The hippocampus and amygdala were affected by five CNVs. Effect sizes of CNVs on subcortical volume, thickness and local surface area were correlated with their previously reported effect sizes on cognition and risk for ASD and SZ. Shape analyses were able to identify subregional alterations that were averaged out in volume analyses. We identified a common latent dimension - characterized by opposing effects on basal ganglia and limbic structures - across CNVs and across NPDs.

Conclusion

Our findings demonstrate that subcortical alterations associated with CNVs show varying levels of similarities with those associated with neuropsychiatric conditions. We also observed distinct effects with some CNVs clustering with adult conditions while others clustered with ASD. This large cross-CNV and NPDs analysis provide insight into the long-standing questions of why CNVs at different genomic loci increase the risk for the same NPD, as well as why a single CNV increases the risk for a diverse set of NPDs.
The Utility of ChatGPT as an Example of Large Language Models in Healthcare Education, Research and Practice: Systematic Review on the Future Perspectives and Potential Limitations
Authors: Sallam Malik
Published: February 2023

An artificial intelligence (AI)-based conversational large language model (LLM) was launched in November 2022 namely, “ChatGPT”. Despite the wide array of potential applications of LLMs in healthcare education, research and practice, several valid concerns were raised. The current systematic review aimed to investigate the possible utility of ChatGPT and to highlight its limitations in healthcare education, research and practice. Using the PRIMSA guidelines, a systematic search was conducted to retrieve English records in PubMed/MEDLINE and Google Scholar under the term “ChatGPT”. Eligibility criteria included the published research or preprints of any type that discussed ChatGPT in the context of healthcare education, research and practice. A total of 280 records were identified, and following full screening, a total of 60 records were eligible for inclusion. Benefits/applications of ChatGPT were cited in 51/60 (85.0%) records with the most common being the utility in scientific writing followed by benefits in healthcare research (efficient analysis of massive datasets, code generation and rapid concise literature reviews besides utility in drug discovery and development). Benefits in healthcare practice included cost saving, documentation, personalized medicine and improved health literacy. Concerns/possible risks of ChatGPT use were expressed in 58/60 (96.7%) records with the most common being the ethical issues including the risk of bias, plagiarism, copyright issues, transparency issues, legal issues, lack of originality, incorrect responses, limited knowledge, and inaccurate citations. Despite the promising applications of ChatGPT which can result in paradigm shifts in healthcare education, research and practice, the embrace of this application should be done with extreme caution. Specific applications of ChatGPT in health education include the promising utility in personalized learning tools and shift towards more focus on critical thinking and problem-based learning. In healthcare practice, ChatGPT can be valuable for streamlining the workflow and refining personalized medicine. Saving time for the focus on experimental design and enhancing research equity and versatility are the benefits in scientific research. Regarding authorship in scientific articles, as it currently stands, ChatGPT does not qualify to be listed as an author unless the ICMJE/COPE guidelines are revised and amended. An initiative involving all stakeholders involved in healthcare education, research and practice is urgently needed to set a code of ethics and conduct on the responsible practices involving ChatGPT among other LLMs.
Efficient Viral Capture and Inactivation from Bioaerosols Using Electrostatic Precipitation
Authors: Preston Hannah E. , Bayliss Rebecca , Temperton Nigel , Neto Martin Mayora , Brewer Jason , Parker Alan L
Published: February 2023

The presence of infectious viral particles in bioaerosols generated during laparoscopic surgery places surgical staff at significant risk of infection and represents a major cause of nosocomial infection. These factors contributed to the postponement and cancellation of countless surgical procedures during the early stages of the ongoing COVID-19 pandemic, causing backlogs, increased waiting times for surgical procedures and excess deaths indirectly related to the pandemic. The development and implementation of devices that effectively inactivate viral particles from bioaerosols would be beneficial in limiting or preventing the spread of infections from such bioaerosols. Here, we sought to evaluate whether electrostatic precipitation (EP) is a viable means to capture and inactivate both non-enveloped (Adenovirus) and enveloped (SARS-CoV-2 Pseudotyped Lentivirus) viral particles present in bioaerosols. We developed a closed-system model to mimic the release of bioaerosols during laparoscopic surgery. Known concentrations of each virus were aerosolised into the model system, exposed to EP using a commercially available system (UltravisionTM, Alesi Surgical Limited, UK) and collected in a BioSampler for analysis. Using qPCR to quantify viral genomes and transduction assays to quantify biological activity, we show that both enveloped and non-enveloped viral particles were efficiently captured and inactivated by EP. Both capture and inactivation could be further enhanced when increasing the voltage to 10kV, or when using two Ultravision™discharge electrodes together at 8kV. This study highlights EP as an efficient means for capturing and inactivating viral particles present in bioaerosols. The use of EP may limit the spread of diseases, reducing nosocomial infections and potentially enable the continuation of surgical procedures during periods of viral pandemics.

Highlights

Bioaerosols released from patients during surgery have the potential to facilitate viral spread.

Ultravision™technology works via the process of electrostatic precipitation.

Electrostatic precipitation can be manipulated to capture and inactivate aerosolised viral particles, preventing viral spread.

Electrostatic precipitation is effective against both enveloped and non-enveloped viral particles.

Electrostatic precipitation represents a viable means to reduce nosocomial infections.

Graphical Abstract
Longitudinal dynamics ofStreptococcus pneumoniaecarriage and SARS-CoV-2 infection in households with children
Authors: Miellet Willem R. , Mariman Rob , Eggink Dirk , Nicolaie Mioara A. , van Veldhuizen Janieke , Pluister Gerlinde , Kolodziej Lisa M. , van Lelyveld Steven F.L. , Euser Sjoerd M. , Sanders Elisabeth A.M. , van Houten Marianne A. , Trzciński Krzysztof
Published: February 2023

Background

To characterize interferences betweenStreptococcus pneumoniaeand SARS-CoV-2 we investigated the longitudinal patterns of viral infection and pneumococcal carriage in households infected with SARS-CoV-2.

Methods

SARS-CoV-2 and pneumococcus were detected with quantitative molecular methods in saliva from members of eighty participating households. Samples were collected between October 2020 and January 2021 from n=197 adults and n=118 children of which n=176 adults and n=98 children had a complete set of ten samples collected within 42 days since enrolment. Time-dependent Cox models were used to evaluate the associations between SARS-CoV-2 and pneumococcal carriage.

Results

In the entire cohort, cumulative pneumococcal carriage and SARS-CoV-2 infection rates were 58% and 65%, respectively. Pneumococcal abundances were associated with an increased risk of SARS-CoV-2 infection (HR 1.14, 95% CI, 1.01 – 1.29,P=0.04) and delayed clearance of SARS-CoV-2 infection (HR 0.90, 95% CI, 0.82 – 0.99,P=0.03). Elevated viral loads were observed among pneumococcal carriers and individuals with high overall bacterial 16S abundances, however, there were no longitudinal differences in viral loads in linear mixed-effects models. Individuals with high 16S abundances displayed delayed viral clearance (HR 0.65, 95% CI 0.55 – 0.78,P<0.0001).

Conclusions

Although we found insufficient evidence for a strong impact of SARS-CoV-2 infection on pneumococcal carriage. Results from the current study suggest that pneumococcal carriers may have an increased risk of SARS-CoV-2 infection and high pneumococcal abundances and 16S abundances may be associated with elevated viral loads and delayed clearance of SARS-CoV-2 infection.
The Snoring Survivors
Authors: Ogbu Ikechukwu , Hakobyan Bagrat , Sossou Christoph , Levisman Jeffrey , Obiagwu Chukwudi , Danielian Alfred
Published: February 2023

Background

The routine administration of supplemental oxygen to non-hypoxic patients with acute myocardial infarction has been abandoned for lack of mortality benefit. However, the benefits of continuous positive airway pressure (CPAP) use in patients hospitalized with acute cardiovascular disease and concomitant obstructive sleep apnea (OSA) remain to be elucidated.

Methods

Using ICD-10-CM codes, we searched the 2016-2019 Nationwide Inpatient Sample for patients diagnosed with unstable angina, acute myocardial infarction (AMI), acute decompensated heart failure (ADHF), and atrial fibrillation with rapid ventricular response (AFRVR), who also carried a diagnosis of OSA. We identified in-hospital CPAP use with ICD-10-PCS codes. In-hospital death, length of stay (LOS) and hospital charges were compared between patients with and without OSA, and between OSA patients with and without CPAP use.

Results

Our sample included 2,959,991 patients, of which 1.5% were diagnosed with UA, 30.3% with AMI, 37.5% with ADHF, and 45.8% with AF. OSA was present in 12.3%. Patients with OSA were more likely to be younger, male, smokers, obese, have chronic obstructive pulmonary disease, renal failure, and heart failure (p< 0.001 for all). Patients with OSA had significantly lower in-hospital mortality (aOR: 0.71, 95% CI [0.7-0.73]). Among patients with OSA, CPAP use significantly increased the odds of in-hospital death (aOR: 1.51, 95% CI [1.44-1.60]), LOS (adjusted mean difference of 1.49 days, 95% CI [1.43, 1.55]), and hospital charges (adjusted mean difference of $1168, 95% CI [273, 2062]).

Conclusion

Our study showed that patients with recognized OSA and hospitalized for AMI, ADHF or AFRVR, who were not treated with CPAP, had significantly lower in-hospital mortality and resource utilization.
Minimal determinants for lifelong antiviral antibody responses in BALB/c mice from a single exposure to virus-like immunogens at low doses
Authors: Wholey Wei-Yun , Meyer Alexander R. , Yoda Sekou-Tidiane , Chackerian Bryce , Zikherman Julie , Cheng Wei
Published: February 2023

However, due to the complex compositions of natural virions, the molecular determinants of Ab durability from viral infection or inactivated viral vaccines have been incompletely understood. Here we used a reductionist system of liposome-based virus-like structures to examine the durability of Abs in primary immune responses in mice. This system allowed us to independently vary fundamental viral attributes and to do so without additional adjuvants to model natural viruses. We show that a single injection of antigens (Ags) orderly displayed on a virion-sized liposome is sufficient to induce a long-lived neutralizing Ab (nAb) response. Introduction of internal nucleic acids dramatically modulates the magnitude of long-term Ab responses without alteration of the long-term kinetic trends. These Abs are characterized by exceptionally slow off-rates of ~0.0005 s-1, which emerged as early as day 5 after injection and these off-rates are comparable to that of affinity-matured monoclonal Abs. A single injection of these structures at doses as low as 100 ng led to lifelong nAb production in BALB/c mice. Thus, a minimal virus-like immunogen can give rise to potent and long-lasting antiviral Abs in a primary response in mice without live infection. This has important implications for understanding both live viral infection and for optimized vaccine design.