bluuebunny/crossref_metadata_2025 huggingface dataset:
Local anesthetic volume in ultrasound-guided interscalene block and opioid consumption during shoulder arthroscopic surgery
Authors: Lim Jung A. , Lim Hyungseop , Lee Ji Hyeon , Kwak Sang Gyu , Kim Jong Hae , Song Seok Young , Roh Woon Seok
Published: July 2021

Interscalene block (ISB) is commonly performed for regional anesthesia in shoulder surgery. Ultrasound-guided ISB enables visualization of the local anesthetic spread and a reduction in local anesthetic volume. However, little is known about the appropriate local anesthetic dose for surgical anesthesia without sedation or general anesthesia. The purpose of our study was to evaluate the appropriate local anesthetic volume by comparing intraoperative analgesics and hemodynamic changes in ISB in arthroscopic shoulder surgery.

Overall, 1007 patients were divided into groups 1, 2, and 3 according to the following volume of local anesthetics: 10–19, 20–29, and 30–40 mL, respectively. The use of intraoperative analgesics and sedatives, and the reduction in intraoperative maximum blood pressure and heart rate were compared through retrospective analysis.

Fentanyl was used in 55.6% of patients in group 1, which was significantly higher than in those groups 2 and 3 (22.3% and 30.7%, respectively); furthermore, it was also higher than those in groups 2 and 3 in dose-specific comparisons (P < .05). The percent of the maximum reduction in intraoperative systolic blood pressure and heart rate in group 3 was significantly higher than those in groups 1 and 2. Ephedrine administration was lower in group 2 than that in other groups (P < .05). The incidence of hypotensive bradycardic events was lowest (9.1%) at the local anesthetic volume of 24 mL as revealed by the quadratic regression analysis (R
2 = 0.313, P = .003).

Decreasing the local anesthetic volume to less than 20 mL for ultrasound-guided ISB as the sole anesthesia increases the opioid consumption during shoulder arthroscopic surgery. Local anesthetics >30 mL or increased opioid consumption with <20 mL of local anesthetics could increase the risk of cardiovascular instability intraoperatively. Our findings indicate that 24 mL of local anesthetic could be used to lower the incidence of hypotensive bradycardic events.
Posterior myocardial infarction caused by superdominant circumflex occlusion over an absent right coronary artery
Authors: Oh Seok , Kim Ju Han , Kim Min Chul , Hong Young Joon , Ahn Youngkeun , Jeong Myung Ho
Published: July 2021

Rationale:

Congenital agenesis of the right coronary artery (CARCA) initially presenting as acute myocardial infarction (AMI) due to total occlusion is a rare clinical condition that can lead to severe complications, including death. We report a case of successful percutaneous coronary intervention (PCI) in a patient with this condition.

Patient concerns:

A 57-year-old man was admitted to our center with chest pain that had occurred several hours prior. Since he was initially diagnosed with AMI with ST-segment elevation, we promptly commenced coronary angiography (CAG).

Diagnosis:

CAG revealed the absence of a right coronary artery (RCA). In the left coronary cusp area, the left circumflex coronary artery (LCX) was occluded totally.

Interventions:

We performed PCI for total occlusion of the proximal part of the LCX. Follow-up CAG showed a superdominant branch of the LCX, sprouting into the RCA territory.

Outcomes:

The patient was discharged uneventfully after successful PCI.

Lessons:

CARCA with AMI, which is an extremely unusual case, can be fatal; however, PCI seems to be an effective treatment option.
Predictors of clinical outcomes of self-expandable metal stent treatment for malignant colorectal obstruction
Authors: Han Bora , Hong Ji-Yun , Myung Eun , Oh Hyung-Hoon , Yang Hee-Chan , Kim Sang-Wook , Lee Jun , Kim Seong-Jung , Han Yeom-Dong , Seo Geom-Seok , Hong Gun-Young , Kim Ho-Dong , Kim Hyun-Soo , Joo Young-Eun
Published: July 2021

There has been increased use of self-expandable metal stents (SEMS) in treating malignant colorectal obstruction (MCO). The aim of this study was to investigate factors that are associated with the outcomes of SEMS placement for MCO.

Clinical data from patients who underwent SEMS placement for MCO at 6 hospitals in Honam province of South Korea between 2009 and 2018 were reviewed retrospectively. Eight hundred two patients were identified and their data were analyzed. Technical success, clinical success, complications, and predictors of outcome were included as main outcome measures.

Technical and clinical success rates were 98.8% (792/802) and 90.1% (723/802), respectively. Complications including stent migration, stent occlusion due to tumor ingrowth and outgrowth, perforation, bacteremia/fever, and bleeding occurred in 123 (15.3%) patients. In multivariate regression analyses, procedure time was significantly associated with the technical success of SEMS placement (P = .001). Longer length of obstruction, the use of covered stent, and longer procedure time were significant independent predictive factors for the clinical success of SEMS placement (odds ratio [OR] 0.974 (95% confidence interval [CI] 0.950–0.990); P = .043, OR 0.255 (95% CI 0.138–0.471); P < .001, and OR 0.957 (95% CI 0.931–0.984); P = .002, respectively). Stage IV colorectal cancer and the use of covered stent were significant independent predictive factors for the development of complications after SEMS placement (OR 2.428 (95% CI 1.407–4.188); P = .001 and OR 3.329 (95% CI 2.060–5.378); P < .001, respectively).

Longer length of obstruction, the use of covered stent, and longer procedure time were associated with lower clinical success rates. Having stage IV colorectal cancer and the use of covered stents were associated with an increased risk of complications.
Hip fractures in elderly patients with non-dialysis dependent chronic kidney disease
Authors: Roy Debajyoti , Pande Shrikant , Thalanki Srikiran , Yeon Wenxiang , Prasad Ankit , Lau Adrian , Varman Surendra , Carson John Allen
Published: July 2021

Chronic kidney disease (CKD) causes bone and mineral disorders and alterations in vitamin D metabolism that contribute to greater skeletal fragility. Hip fracture in elderly is associated with significant morbidity and mortality. The aim of this study was to investigate the outcome of elderly patients with non-dialysis dependent CKD and hip fracture undergoing surgery.

Retrospective study with IRB approval of patients above 65 years of age, with hip fractures admitted between June 2014 to June 2016 in a Southeast Asian cohort. Data collected included demographic variables and the haematological and biochemical parameters HBA1c, estimated glomerular filtration rate (eGFR), serum calcium, phosphorous, and 25(OH) Vitamin D. Co-morbidities investigated were ischemic heart disease, congestive heart failure, peripheral vascular disease, malignancy, chronic obstructive pulmonary disease, cerebro vascular accident, hypertension and hyperlipidaemia. All patients were followed up from index date to either death or June 1, 2018.

Of the 883 patients, 725 underwent surgery and 334 had CKD. Death rates for CKD patients with hip fractures and those with normal renal function did not differ significantly [8.08% vs 6.54%, (HR= 1.33, 95% CI: 0.95, 1.86; P = .102)], whilst median hospital length of stay was significantly higher in CKD patients [10.5 vs 9.03 days (P = .003)]. Significant risk factors associated with higher risk of mortality in the elderly with hip fracture were male gender, age ≥80 years and serum albumin < 30 g/L (all, P < .0001).

In summary, in elderly, non-dialysis dependent CKD patient with hip fracture we found that male gender, age ≥80 years, low serum albumin and eGFR < 30 mL/min/1.73 m2 were associated with higher risk of death. The hospital stay in the CKD group was also longer. Additional studies are needed to validate our findings.
Cryoballoon ablation as salvage therapy after nonradical resection of a high-risk T1b esophageal adenocarcinoma: a case report
Authors: Frederiks Charlotte N. , van de Water Jolanda M.W. , Ebrahimi Gati , Weusten Bas L.A.M.
Published: July 2021

Although esophagectomy with or without (neo)adjuvant chemoradiation therapy is the current standard of care for patients with early esophageal adenocarcinoma with high-risk features or after nonradical endoscopic resection of an early esophageal adenocarcinoma, not all patients are eligible for surgery due to varying reasons. In these patients, cryoballoon ablation may serve as an alternative treatment option considering the potential of deeper tissue ablation as compared to heat-based ablation techniques. We report the first case in which cryoballoon ablation was successfully performed as salvage therapy with a curative intent for positive deep resection margins after an incomplete endoscopic resection of a recurrent early esophageal adenocarcinoma.
Hormetic endoplasmic reticulum stress in hematopoietic stem cells
Authors: Luchsinger Larry L.
Published: July 2021

Purpose of review

Hematopoietic stem cells (HSCs) possess the ability to regenerate over a lifetime in the face of extreme cellular proliferation and environmental stress. Yet, mechanisms that control the regenerative properties of HSCs remain elusive. ER stress has emerged as an important signaling event that supports HSC self-renewal and multipotency. The purpose of this review is to summarize the pathways implicating ER stress as cytoprotective in HSCs.

Recent findings

Recent studies have shown multiple signaling cascades of the unfolded protein response (UPR) are persistently activated in healthy HSCs, suggesting that low-dose ER stress is a feature HSCs. Stress adaptation is a feature ascribed to cytoprotection and longevity of cells as well as organisms, in what is known as hormesis. However, assembling this information into useful knowledge to improve the therapeutic application of HSCs remains challenging and the upstream activators and downstream transcriptional programs induced by ER stress that are required in HSCs remain to be discovered.

The maintenance of HSCs requires a dose-dependent simulation of ER stress responses that involves persistent, low-dose UPR. Unraveling the complexity of this signaling node may elucidate mechanisms related to regeneration of HSCs that can be harnessed to expand HSCs for cellular therapeutics ex vivo and transplantation in vivo.
Long-term outcome of urethral and genital reconstruction in hypospadias and exstrophy-epispadias complex
Authors: Sinatti Céline , Schechter Michal Yaela , Spinoit Anne-Françoise , Hoebeke Piet
Published: July 2021

Purpose of review

Although immediate surgical outcomes of genitourinary reconstruction used to be the main focus in hypospadias and exstrophy-epispadias complex (EEC), recent research demonstrates rising concerns about long-term functional and psychosexual outcomes. Recent results about long-term outcomes of complex genitourinary reconstruction in those children transitioning into adulthood are summarized and discussed in this comprehensive review.

Recent findings

Long-term outcomes in hypospadias focus on psychosexual satisfaction and decisional regret. Interestingly, uncomplicated hypospadias repair results in equal satisfaction rates to those found in controls. Most adult patients are happy with their parents’ decision to have them undergo surgery during childhood. No decisional regret was found in parents. Reinterventions were associated with a decline in satisfaction, as was a decrease in perceived penile length. Long-term, males with EEC are more dissatisfied with penile length than with continence problems. In cases of severe penile insufficiency, phalloplasty shows promising psychosexual outcomes at the price of a high complication rate. Female EEC patients show higher rates of pregnancy complications, portending a higher risk of miscarriage.

Psychosexual satisfaction of patients with repaired hypospadias transitioning into adulthood demonstrates equal satisfaction rates to those found in controls, without decisional regret associated with surgery during childhood. In EEC, more complications are seen when transitioning into a sexually active adult life.
The use of Clostridium in cancer therapy: a promising way
Authors: Yaghoubi Atieh , Ghazvini Kiarash , Khazaei Majid , Hasanian Seyed Mahdi , Avan Amir , Soleimanpour Saman
Published: July 2021

In recent decades, the traditional cancer therapeutic agents such as surgery, radiotherapy, and chemotherapy have failed. One of the main reasons for repeated failures in the field of solid tumors is the hypoxic/necrotic regions within the tumors. Recently, looking for new therapeutic approaches, using bacteria as a therapeutic agent for cancer attract attention. In the case of solid tumors, several strains of anaerobic bacteria have been shown to selectively colonize, which made them the suitable agent for selective targeting and destruction. Interestingly to know that Clostridium species as an anaerobic bacterium has shown the high ability for selective internalization and colonization in the hypoxic and necrotic areas of the tumor which allow them to use as a target delivery for therapeutics agent and significant oncolytic. Furthermore, Clostridium can be modified to use as a producer of prodrug-converting enzymes or cytokines that allow the production of specific proteins or toxic agents within the tumors resulting in tumor destruction. The present study is a comprehensive review of the progress and current status of Clostridia as a promising agent for anticancer treatment.
Esthesioneuroblastoma Presenting With Orbital Hypertelorism and Foster-Kennedy Syndrome
Authors: Shah Saumya M. , Halbach Caroline S. , Wagner Lilly H.
Published: July 2021

Esthesioneuroblastoma is a rare neoplasm originating from the olfactory neuroepithelium at the cribriform plate. The superior nasal cavity is primarily affected. Morbidity and mortality are related to locally destructive growth as well as metastatic potential. Orbital involvement is associated with decreased survival. The authors describe a case of advanced esthesioneuroblastoma with bilateral orbital involvement, presenting with a rare constellation of orbital hypertelorism and Foster-Kennedy Syndrome.
The Use of Dual Energy X-Ray Bone Density Scan in Assessment of Alveolar Cleft Grafting Using Bone Marrow Stem Cells Concentrate/Platelet-Rich Fibrin Regenerative Technique
Authors: Mossaad Aida M. , Ahmady Hatem H. Al , Ghanem Wael H. , Abdelrahman Moustapha A. , Abdelazim Ahmed F. , Elsayed Shadia A.
Published: July 2021

Objectives:

To determine the densitometric quality of regenerated bone at the site of bone marrow and platelet-rich membrane grafting technique at unilateral alveolar cleft region using dual energy x-ray bone density scan (DEXA).

Methods:

The present prospective cohort study included 16 unilateral alveolar cleft patients who were selected randomly from the outpatient maxillofacial surgery clinic and suffered from unilateral alveolar cleft. Bone marrow aspirate and platelet-rich fibrin (PRF) (bone marrow stem cells + PRF) were used as the grafting material. Six months of follow-up have been conducted for all patients’ including clinical and radiographic assessments with (DEXA scan).

Results:

Sixteen unilateral patients with a mean age of 12.56 ± 1.71 years were included in the sample and the majority of patients were females with a frequency of 56.2 percent. The current research revealed no infection or wound dehiscence. After surgery, the pain and edema scores were reasonable. Our findings showed that, after 6 months of regenerative graft, the average bone mineral density of the cleft side DEXA scan value was 1.56 ± 0.32 gm/cm2, compared to 1.51 ± 0.488 gm/cm2 on the normal side of the noncleft scan. There was no statistically significant difference in DEXA bone mineral content measurements between the cleft and standard sides (P = 0.461).

Conclusions:

The bone marrow stem cells + PRF regenerative graft technique has been successfully integrated, and the DEXA scan approach for measuring regenerated grafted bone mineral content was found to be appropriate for simple and inexpensive follow-up of alveolar cleft lip patients.
Effect of Perioperative Systemic Dexamethasone on Pain, Edema, and Trismus in Mandibular Fracture Surgery: A Randomized Trial
Authors: Oksa Marko , Haapanen Aleksi , Furuholm Jussi , Thorén Hanna , Snäll Johanna
Published: July 2021

The authors’ aim was to evaluate the effect of perioperative systemic dexamethasone (DXM) administration on postoperative pain, edema, and trismus in mandibular fracture patients. The authors conducted a prospective randomized study of 45 patients with one or 2 noncomminuted fractures of the dentate part of the mandible. All patients underwent surgery for intraoral miniplate fixation. Patients in the study group were given a total of 30 mg DXM, while patients in the control group received neither DXM nor placebo. Only paracetamol and opioids were served as analgesics. Pain severity was assessed using the visual analog scale. The effect in facial swelling was measured in centimeters and analyzed as percentage change. Trismus was evaluated as the difference in maximal mouth opening by measuring interincisal distance in millimeters. The Mann-Whitney U test was applied to determine the statistical significance of differences between the groups. Thirty-four patients were included in the statistical analysis. The visual analog scale score was significantly lower in the study group than in the control group at 18 hours postoperatively (P = 0.033). Significant differences in edema or trismus were not found postoperatively between the DXM and control groups. In conclusion, perioperative DXM decreases postoperative pain in mandibular fracture patients when nonsteroidal anti-inflammatory drugs are not used, but it does not seem to be effective in reducing edema or trismus.
Temporal Bone Pneumatization: Relationship With Sex and Variants of the Ethmoid and Sphenoid Bone
Authors: Gibelli Daniele , Cellina Michaela , Gibelli Stefano , Panzeri Marta , Termine Giovanni , Floridi Chiara , Sforza Chiarella
Published: July 2021

Pneumatization variants of the temporal bone have a crucial importance in several surgical interventions. However, very few data are known about possible correlation with other pneumatization variants.

Pneumatization of glenoid fossa, petrous apex, and infralabyrinthine portion of temporal bone was assessed in 200 computed tomography scans, equally divided between males and females (18–92 years). Pneumatization variants of the ethmoid (concha bullosa, agger nasi, pneumatized crista galli) and the sphenoid sinuses (pneumatized pterygoid processes, anterior clinoid processes, dorsum sellae, volume) were recorded as well.

Differences in prevalence of each pneumatization type according to sex and side, among different portions of the temporal bone, and between temporal bone and the pneumatized variants of the ethmoid bone and sphenoid sinuses, were assessed through chi-square test (P < 0.05). Differences in sphenoid volume among different pneumatization degrees of the temporal bone were assessed through 1-way analysis of covariance test (P < 0.05).

Pneumatization of the petrous apex and the infralabyrinthine portion was significantly more frequent in males than in females, whereas pneumatization of the glenoid fossa was more often observed on the right side (P < 0.05). Variants of the temporal bone are all related one with each other in males, whereas in females only the relationship between pneumatized petrous apex and infralabyrinthine portion was found. Moreover, in females the pneumatized petrous apex was related with pneumatized anterior clinoid process, and the pneumatized infralabyrinthine portion was related with the sphenoid sinus volume.

Results may be useful for predicting these important variants in planning surgical interventions of the cranial base.
Benefits and Reduced Hospital Costs of Direct Surgery in Perforated Appendicitis With Abscess Cost-effectiveness Analysis of Treatment Complicated Appendicitis
Authors: Kim Euitae , Kim Kilhwan , Park Yoonjoon
Published: July 2021

Purpose:

Elective interval appendectomy (IA) after percutaneous catheter drainage (PCD) is traditionally advocated for perforated appendicitis with an abscess. However, this is not the only way to manage these patients when we consider the cost-effectiveness of treatment. This study compared the outcomes and cost-effectiveness of patients who underwent IA and those who underwent direct surgery.

Materials and Methods:

A retrospective analysis of 79 patients who were diagnosed with perforated appendicitis with abscess was conducted. We compared the hospital course, outcomes, and total medical costs between the 2 groups.

Results:

Forty-three patients underwent PCD insertion for the management of appendiceal abscess (IA group), and 36 underwent appendectomy (DS group). There was no significant difference in abscess size (5.67 vs. 5.35 cm, P=0.15), appendectomy method (laparoscopic/open 39/4 vs. 37/5, P=0.523), or complications (7 vs. 6 cases, P=0.963) between the 2 groups. The operation time was longer in the DS group (83.8 vs. 112.7 min, P<0.001). However, length of hospitalization (15.4 vs. 7.7 d, P<0.001) and total hospital cost (US$2090.47 vs. US$3402.22, P<0.001) was greater in the IA group.

Conclusion:

Direct surgery without PCD insertion in perforated appendicitis accompanied by abscess is more cost-effective and reduces the total length of hospitalization compared with the traditional IA.
Cancer care disparities among Australian and Aotearoa New Zealand Indigenous peoples
Authors: Davies Amy , Gurney Jason , Garvey Gail , Diaz Abbey , Segelov Eva
Published: July 2021

Purpose of review

Persistent and significant inequalities for Indigenous people with cancer around the globe exist, arising from colonial settlement of Indigenous land with profound social, economic and cultural impacts. We summarize recent publications concerning cancer disparities affecting Australian Aboriginal and Torres Strait Islander Peoples and Aotearoa New Zealand Māori Peoples.

Recent findings

Cancer-free survival and overall survival statistics testify to the urgent need to ‘close the gap’. For Indigenous peoples in Australia and New Zealand, disparity persists along the cancer care pathway, from increased risk factors to lower screening access, health resource utilization and survivorship care. Recent publications highlight multimorbidity as contributing to poor cancer outcomes in Indigenous populations. The implementation of tailored Optimal Care Pathways is described, as is the validation of tailored tools capturing the perspectives of Indigenous persons. Finally, the importance of Indigenous-led research is emphasized.

Cancer-specific outcomes in Indigenous people of Australia and New Zealand remain poor with many widening disparities compared to non-indigenous populations. A growing body of epidemiological, health service and clinical research is documenting both the problems and potential solutions. Further work is needed in both broad health policies and the workforce, in building cultural competence to optimize individual care encounters.
Hypoventilation syndrome in neuromuscular disorders
Authors: Wenninger Stephan , Jones Harrison N.
Published: July 2021

Purpose of review

Hypoventilation syndrome in neuromuscular disorders (NMDs) is primarily due to respiratory muscle weakness and results in increased morbidity and mortality. This article highlights current aspects of neuromuscular hypoventilation syndrome, including pathophysiology, clinical symptoms, assessment, respiratory involvement in various NMD, and causal and symptomatic treatments with an emphasis on recent research and advances.

Recent findings and Summary

New therapeutic agents have been developed within the last years, proving a positive effect on respiratory system. Symptomatic therapies, including mechanical ventilation and cough assistance approaches, are important in NMD and respiratory muscle training may have benefit in strengthening respiratory muscles and should be offered patients with respiratory muscle weakness the same way as physiotherapy. Correct respiratory assessments and their correct interpretation are hallmarks for early diagnosis of hypoventilation syndrome and treatment.
The impact of thiamine deficiency and benfotiamine treatment on Nod-like receptor protein-3 inflammasome in microglia
Authors: Xu Yangqi , Zhao Lei , Qiu Hongyan , Qian Ting , Sang Shaoming , Zhong Chunjiu
Published: July 2021

Thiamine-dependent processes are critical in cerebral glucose metabolism, it is abnormity induces oxidative stress, inflammation and neurodegeneration. Nod-like receptor protein-3 (NLRP3) inflammasome-mediated inflammation is closely related to neurologic diseases and can be activated by oxidative stress. However, the impact of thiamine deficiency on NLRP3 inflammasome activation remains unknown. In this study, we found that NLRP3 inflammasomes were significantly activated in the microglia of thiamine deficiency mice model. In contrast, benfotiamine dampened inflammation NLRP3 mediated in BV2 cells stimulated with LPS and ATP through reducing mitochondrial reactive oxygen species levels and mitigating autophagy flux defect. These data identify an important role of thiamine metabolism in NLRP3 inflammasome activation, and correcting thiamine metabolism through benfotiamine provides a new therapeutic strategy for NLRP3 inflammasome related neurological, metabolic, and inflammatory diseases.
Inhibition of CAMK II modulates water permeability by reducing AQP4 expression in astrocytes after oxygen-glucose deprivation
Authors: Li Siyi , Jiang Bingjian , Lu Huanhuan , Huang Shuxuan , Fan Binglin , Chen Zhi , Li Yanhua
Published: July 2021

The predominant form of edema that occurs during the early stage of ischemic stroke is cytotoxic, resulting in neuronal injury during brain ischemia and reperfusion. Intracellular calcium (Ca2+) is elevated following brain ischemia leading to increased cell membrane permeability. Ca2+/calmodulin-dependent protein kinase II (CaMK II), the downstream molecular signal of N-methyl-d-aspartate receptors (NMDARs), is sensitive to elevations in intracellular Ca2+. Aquaporin-4 (AQP4), which is expressed primarily in the brain, is a water-transport protein. However, it is unclear whether CaMK II regulates AQP4 expression to modulate cellular water permeability. We exposed cultured astrocytes to a hypoxic and glucose-free environment to mimic an ischemic environment in vitro. We investigated the effects of oxygen-glucose deprivation (OGD) on astrocytic viability and swelling, as well as CaMK II and AQP4 expression. We also studied the effects of CaMK II inhibition on cell swelling, viability and AQP4 expression. OGD increased astrocytic swelling and expression of CaMK II and AQP4, and it decreased astrocyte viability. Inhibition of CaMK II resulted in reduced astrocyte water permeability and AQP4 expression. We concluded that the upregulation of CaMK II promoted astrocyte swelling by increasing the expression of AQP4 after OGD.
Springtail coloration at a finer scale: mechanisms behind vibrant collembolan metallic colours
Authors: Vanthournout Bram , Rousaki Anastasia , Parmentier Thomas , Janssens Frans , Mertens Johan , Vandenabeele Peter , D'Alba Liliana , Shawkey Matthew
Published: July 2021

The mechanisms and evolution of metallic structural colours are of both fundamental and applied interest, yet most work in arthropods has focused on derived butterflies and beetles with distinct hues. In particular, basal hexapods—groups with many scaled, metallic representatives—are currently poorly studied and controversial, with some recent studies suggesting either that thin-film (lamina thickness) or diffraction grating (longitudinal ridges, cross-ribs) elements produce these colours in early Lepidoptera and one springtail (Collembola) species. Especially the collembolan basal scale design, consisting of a single lamina and longitudinal ridges with smooth valleys lacking cross-ribs, makes them an interesting group to explore the mechanisms of metallic coloration. Using microspectroscopy, Raman spectroscopy, electron microscopy and finite-difference time-domain optical modelling, we investigated scale colour in seven springtail species that show clear metallic coloration. Reflectance spectra are largely uniform and exhibit a broadband metallic/golden coloration with peaks in the violet/blue region. Our simulations confirm the role of the longitudinal ridges, working in conjunction with thin-film effects to produce a broadband metallic coloration. Broadband coloration occurs through spatial colour mixing, which probably results from nanoscale variation in scale thickness and ridge height and distance. These results provide crucial insights into the colour production mechanisms in a basal scale design and highlight the need for further investigation of scaled, basal arthropods.
The evolution of darker wings in seabirds in relation to temperature-dependent flight efficiency
Authors: Rogalla Svana , Nicolaï Michaël P. J. , Porchetta Sara , Glabeke Gertjan , Battistella Claudia , D'Alba Liliana , Gianneschi Nathan C. , van Beeck Jeroen , Shawkey Matthew D.
Published: July 2021

Seabirds have evolved numerous adaptations that allow them to thrive under hostile conditions. Many seabirds share similar colour patterns, often with dark wings, suggesting that their coloration might be adaptive. Interestingly, these darker wings become hotter when birds fly under high solar irradiance, and previous studies on aerofoils have provided evidence that aerofoil surface heating can affect the ratio between lift and drag, i.e. flight efficiency. However, whether this effect benefits birds remains unknown. Here, we first used phylogenetic analyses to show that strictly oceanic seabirds with a higher glide performance (optimized by reduced sink rates, i.e. the altitude lost over time) have evolved darker wings, potentially as an additional adaptation to improve flight. Using wind tunnel experiments, we then showed that radiative heating of bird wings indeed improves their flight efficiency. These results illustrate that seabirds may have evolved wing pigmentation in part through selection for flight performance under extreme ocean conditions. We suggest that other bird clades, particularly long-distance migrants, might also benefit from this effect and therefore might show similar evolutionary trajectories. These findings may also serve as a guide for bioinspired innovations in aerospace and aviation, especially in low-speed regimes.
Carry-over effects of tool functionality and previous unsuccessfulness increase overimitation in children
Authors: Frick Aurélien , Schleihauf Hanna , Satchell Liam P. , Gruber Thibaud
Published: July 2021

Children ‘overimitate’ causally irrelevant actions in experiments where both irrelevant and relevant actions involve a single common tool. This study design may make it harder for children to recognize the irrelevant actions, as the perceived functionality of the tool during the demonstration of the relevant action may be carried over to the irrelevant action, potentially increasing overimitation. Moreover, little is known how overimitation is affected by the demonstrator's expressed emotions and the child's prior success with the task. Here, 131 nine- to ten-year-old French and German children first engaged in a tool-based task, being successful or unsuccessful, and then watched an adult demonstrating the solution involving one irrelevant and one relevant action before smiling or remaining neutral. These actions were performed with the same tool or with two separate tools, testing potential carry-over effects of the functionality of the relevant action on the irrelevant action. We show that overimitation was higher when the same tool was used for both actions and when children were previously unsuccessful, but was not affected by the demonstrator's displayed emotion. Our results suggest that future overimitation research should account for the number of tools used in a demonstration and participants' previous task experience.
Fatigue, boredom and objectively measured smartphone use at work
Authors: Dora Jonas , van Hooff Madelon , Geurts Sabine , Kompier Michiel , Bijleveld Erik
Published: July 2021

Nowadays, many people take short breaks with their smartphone at work. The decision whether to continue working or to take a smartphone break is a so-called labour versus leisure decision. Motivational models predict that people are more likely to switch from labour (work) to leisure (smartphone) the more fatigue or boredom they experience. In turn, fatigue and boredom are expected to decrease after the smartphone was used. However, it is not yet clear how smartphone use at work relates to fatigue and boredom. In this study, we tested these relationships in both directions. Participants (
n
= 83, all PhD candidates) reported their current level of fatigue and boredom every hour at work while an application continuously logged their smartphone use. Results indicate that participants were more likely to interact with their smartphone the more fatigued or bored they were, but that they did not use it for longer when more fatigued or bored. Surprisingly, participants reported increased fatigue and boredom after having used the smartphone (more). While future research is necessary, our results (i) provide real-life evidence for the notion that fatigue and boredom are temporally associated with task disengagement, and (ii) suggest that taking a short break with the smartphone may have phenomenological costs.
Self-rotating 3D chiral mechanical metamaterials
Authors: Dudek K. K. , Drzewiński A. , Kadic M.
Published: July 2021

In this work, we demonstrate that three-dimensional chiral mechanical metamaterials are able to self-twist and control their global rotation. We also discuss the possibility of adjusting the extent of the global rotation manifested by the system in a programmable manner. In addition, we show that the effect of the global rotation can be observed both for small systems composed of a single structural unit as well as more complex structures incorporating several structural elements connected to each other. Finally, it is discussed that the results presented in this work are very promising from the point of view of potential applications such as satellites or telescopes in space, where appropriately designed mechanical metamaterials could be used for the attitude control as well as other systems where the control of the rotational motion is required.
Creation of discontinuities in circle maps
Authors: Derks G. , Glendinning P. A. , Skeldon A. C.
Published: July 2021

Circle maps frequently arise in mathematical models of physical or biological systems. Motivated by Cherry flows and ‘threshold’ systems such as integrate and fire neuronal models, models of cardiac arrhythmias, and models of sleep/wake regulation, we consider how structural transitions in circle maps occur. In particular, we describe how maps evolve near the creation of a discontinuity. We show that the natural way to create discontinuities in the maps associated with both threshold systems and Cherry flows results in a singularity in the derivative of the map as the discontinuity is approached from either one or both sides. For the threshold systems, the associated maps have square root singularities and we analyse the generic properties of such maps with gaps, showing how border collisions and saddle-node bifurcations are interspersed. This highlights how the Arnold tongue picture for tongues bordered by saddle-node bifurcations is amended once gaps are present. We also show that a loss of injectivity naturally results in the creation of multiple gaps giving rise to a novel codimension two bifurcation.
Positive species interactions strengthen in a high-CO2ocean
Authors: Ferreira Camilo M. , Connell Sean D. , Goldenberg Silvan U. , Nagelkerken Ivan
Published: July 2021

Negative interactions among species are a major force shaping natural communities and are predicted to strengthen as climate change intensifies. Similarly, positive interactions are anticipated to intensify and could buffer the consequences of climate-driven disturbances. We usedin situexperiments at volcanic CO2vents within a temperate rocky reef to show that ocean acidification can drive community reorganization through indirect and direct positive pathways. A keystone species, the algal-farming damselfishParma alboscapularis,enhanced primary productivity through its weeding of algae whose productivity was also boosted by elevated CO2. The accelerated primary productivity was associated with increased densities of primary consumers (herbivorous invertebrates), which indirectly supported increased secondary consumers densities (predatory fish) (i.e. strengthening of bottom-up fuelling). However, this keystone species also reduced predatory fish densities through behavioural interference, releasing invertebrate prey from predation pressure and enabling a further boost in prey densities (i.e. weakening of top-down control). We uncover a novel mechanism where a keystone herbivore mediates bottom-up and top-down processes simultaneously to boost populations of a coexisting herbivore, resulting in altered food web interactions and predator populations under future ocean acidification.
A phylogeny-aware approach reveals unexpected venom components in divergent lineages of cone snails
Authors: Fedosov Alexander , Zaharias Paul , Puillandre Nicolas
Published: July 2021

Marine gastropods of the genusConusare renowned for their remarkable diversity and deadly venoms. WhileConusvenoms are increasingly well studied for their biomedical applications, we know surprisingly little about venom composition in other lineages of Conidae. We performed comprehensive venom transcriptomic profiling forConasprella coriolisiandPygmaeconus traillii, first time for both respective genera. We complemented reference-based transcriptome annotation by ade novotoxin prediction guided by phylogeny, which involved transcriptomic data on two additional ‘divergent’ cone snail lineages,Profundiconus, andCaliforniconus. We identified toxin clusters (SSCs) shared among all or some of the four analysed genera based on the identity of the signal region—a molecular tag present in toxins. In total, 116 and 98 putative toxins represent 29 and 28 toxin gene superfamilies inConasprellaandPygmaeconus, respectively; about quarter of these only found by semi-manual annotation of the SSCs. Two rare gene superfamilies, originally identified from fish-hunting cone snails, were detected outsideConusrather unexpectedly, so we further investigated their distribution across Conidae radiation. We demonstrate that both these, in fact, are ubiquitous in Conidae, sometimes with extremely high expression. Our findings demonstrate how a phylogeny-aware approach circumvents methodological caveats of similarity-based transcriptome annotation.
Isolation of Corynebacterium freneyi from a case of exudative pharyngitis, a close mimicker of Corynebacterium diphtheriae
Authors: Kannambath Rachana , Sistla Sujatha , Jayakar Sunil , Pillai Vivekanandan M.
Published: July 2021

Corynebacterium freneyi

is a recently described coryneform bacteria. It is only rarely identified from clinical specimens and its pathogenic significance has not been well studied. Here we report the isolation of the species from the throat swab of a patient with suspected diphtheria. The morphology on direct microscopy and culture also closely resembled

Corynebacterium diphtheriae

, which almost led to misidentification. The prompt clinical and microbiological response suggests a probable pathogenic role. This is the first report of the isolation of this species from an oropharyngeal sample.
Niveibacterium microcysteis sp. nov., isolated from a cyanobacterial bloom sample
Authors: Kang Mingyeong , Park Woojun
Published: July 2021

A novel bacterial strain, named HC41T, was isolated from a cyanobacterial bloom sample and was characterized as Gram-stain-negative, rod-shaped and non-motile. According to 16S rRNA phylogenetic analyses, this strain HC41T belongs to the family

Rhodocyclaceae

and is most closely related to

Niveibacterium umoris

KACC 17062T (=MIC 2059T; 98.63 %) and

Uliginosibacterium gangwonense

5YN10-9 T (=KACC 11603T; 93.64 %). The genome size and DNA G+C content of strain HC41T were 4.8 Mbp and 64.17 mol%, respectively. Moreover, the average nucleotide identity, digital DNA–DNA hybridization and amino acid identity values between strain HC41T and

N. umoris

KACC 17062T were 81.8, 43.1 and 90.89 %, respectively. Additionally, strain HC41T exhibited weak catalase and oxidase activities and had no motility (swimming and swarming motilities). The cells grew at 11–40 °C (optimum, 30 °C), pH 5.5–8.0 (optimum, pH 7) and with 0–1.0 % (w/v) NaCl (optimum, 0 % NaCl) in Reasoner’s 2A medium. Its major respiratory quinone was ubiquinone-8 and its major polar lipids were diphosphatidylglycerol, phosphatidylglycerol and phosphatidylethanolamine. Furthermore, C16 : 0 and summed feature 3 (C16 : 1 ω7c and/or C16 : 1 ω6c; C16 : 1 ω6c and/or C16 : 1 ω7c) were the predominant cellular fatty acids in strain HC41T according to fatty acid methyl ester analysis. Based on its genotypic and phenotypic characteristics, strain HC41T was identified as representing a novel

Niveibacterium

species, for which the name Niveibacterium microcysteis sp. nov. is proposed (=KACC 22091T=DSM 111425T).
Microbacterium chengjingii sp. nov. and Microbacterium fandaimingii sp. nov., isolated from bat faeces of Hipposideros and Rousettus species
Authors: Zhou Juan , Huang Yuyuan , Yang Jing , Lai Xin-He , Jin Dong , Lu Shan , Pu Ji , Zhang Sihui , Zhu Wentao , Xu Mingchao , Huang Ying , Liang Junrong , Zheng Han , Xu Jianguo
Published: July 2021

Four aerobic, Gram-stain-positive, rod-shaped bacteria (HY60T, HY54, HY82T and HY89) were isolated from bat faeces of Hipposideros and Rousettus species collected in PR China. Phylogenetic analyses based on 16S rRNA gene sequences indicated that the four novel strains formed two separate but adjacent subclades close to

Microbacterium agarici

CGMCC 1.12260T (97.6–97.7 % similarity),

Microbacterium humi

JCM 18706T (97.3–97.5 %) and

Microbacterium lindanitolerans

JCM 30493T (97.3–97.4 %). The 16S rRNA gene sequence similarity was 98.3 % between strains HY60T and HY82T, and identical within strain pairs HY60T/HY54 and HY82T/HY89. The DNA G+C contents of strains HY60T and HY82T were 61.9 and 63.3 mol%, respectively. The digital DNA–DNA hybridization and average nucleotide identity values between each novel strain and their closest relatives were all below the 70 % and 95–96 % thresholds for species delimitation, respectively. All four novel strains contained anteiso-C15 : 0, anteiso-C17 : 0, iso-C16 : 0 and iso-C15 : 0 as the main fatty acids, MK-11 and MK-12 as the major respiratory quinones, and diphosphatidylglycerol, phosphatidylglycerol and one unidentified glycolipid as the predominant polar lipids. The cell-wall peptidoglycan was of B type and contained alanine, glutamate, glycine and ornithine. The acyl type of the muramic acid was glycolyl. The whole-cell sugars were rhamnose and ribose. Based on the foregoing polyphasic analyses, it was concluded that the four uncharacterized strains represented two novel species of the genus

Microbacterium

, for which the names Microbacterium chengjingii sp. nov. [type strain HY60T (=CGMCC 1.17468T=GDMCC 1.1951T=KACC 22102T)] and Microbacterium fandaimingii sp. nov. [type strain HY82T (=CGMCC 1.17469T=GDMCC 1.1949T=KACC 22101T)] are proposed, respectively.
Depression predicts chronic pain interference in racially-diverse, low-income patients
Authors: Nephew Benjamin C. , Rodriguez Angela C. Incollingo , Melican Veronica , Polcari Justin J. , Nippert Kathryn E. , Rashkovskii Mikhail , Linnell Lilly-Beth , Hu Ruofan , Ruiz Carolina , King Jean A. , Gardiner Paula
Published: July 2021

Background

Chronic pain is one of the most common reasons adults seek medical care in the US, with estimates of prevalence ranging from 11% to 40%. Mindfulness meditation has been associated with significant improvements in pain, depression, physical and mental health, sleep, and overall quality of life. Group medical visits are increasingly common and are effective at treating myriad illnesses including chronic pain. Integrative Medical Group Visits (IMGV) combine mindfulness techniques, evidence based integrative medicine, and medical group visits and can be used as adjuncts to medications, particularly in diverse underserved populations with limited access to non-pharmacological therapies.

Objective and Design

The objective of the present study was to use a blended analytical approach of machine learning and regression analyses to evaluate the potential relationship between depression and chronic pain in data from a randomized clinical trial of IMGV in socially diverse, low income patients suffering from chronic pain and depression.

Methods

This approach used machine learning to assess the predictive relationship between depression and pain and identify and select key mediators, which were then assessed with regression analyses. It was hypothesized that depression would predict the pain outcomes of average pain, pain severity, and pain interference.

Results

Our analyses identified and characterized a predictive relationship between depression and chronic pain interference. This prediction was mediated by high perceived stress, low pain self-efficacy, and poor sleep quality, potential targets for attenuating the adverse effects of depression on functional outcomes.

Conclusions

In the context of the associated clinical trial and similar interventions, these insights may inform future treatment optimization, targeting, and application efforts in racially diverse, low income populations, demographics often neglected in studies of chronic pain.
Efficacy of remdesivir-containing therapy in hospitalized COVID-19 patients: a prospective clinical experience
Authors: Russo Alessandro , Binetti Erica , Borrazzo Cristian , Cacciola Elio Gentilini , Battistini Luigi , Ceccarelli Giancarlo , Mastroianni Claudio Maria , d’Ettorre Gabriella
Published: July 2021

Objectives

remdesivir is currently approved for the treatment of COVID-19. The recommendation for using remdesivir in COVID-19 was based on the in vitro and in vivo activity of this drug against SARS-CoV-2.

Methods

this was a prospective, observational study conducted on a large population of patients hospitalized for COVID-19. The primary endpoint of the study was to evaluate the impact of remdesivir-containing therapy on 30-day mortality; secondary endpoint was the impact of remdesivir-containing therapy on the need of high flow oxygen therapy (HFNC) or non-invasive ventilation (NIV) or mechanical ventilation. Data were analyzed after propensity score matching.

Results

407 patients with SARS-CoV-2 pneumonia were consecutively enrolled. Out of these, 294 (72.2%) and 113 (27.8%) were respectively treated or not with remdesivir. Overall, 61 (14.9%) patients were treated during hospitalization with non-invasive or mechanical ventilation, while a 30-day mortality was observed in 21 (5.2%) patients with a global in-hospital mortality of 11%. Cox regression analysis, after propensity score matching, showed that therapies, including remdesivir-containing therapy, were not statistically associated with 30-day survival or mortality, while need of HFNC/NIV (HR 17.921, CI95% 0.954-336.73, p=0.044) and mechanical ventilation (HR 3.9, CI95% 5.36-16.2, p=0.003) resulted independently associated with 30-day mortality. Finally, therapies including or not remdesivir were not independently associated with a lower or higher risk of HFNC/NIV or mechanical ventilation.

Conclusions

this real-life experience about the remdesivir use in hospitalized patients with COVID-19 was not associated with significant increase in rates of survival or reduced use of HFNC/NIV or mechanical ventilation, compared to patients treated with other therapies not including remdesivir.