bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhancing Patient Outcomes in Aesthetic Breast Implant Procedures Using Proven Antimicrobial Breast Pocket Irrigations: A 20-Year Follow-up
Authors: Venkataram Aniketh , Lahar Nicholas , Adams William P
Published: August 2022

Background

Capsular contracture (CC) remains the most common complication of implant-based aesthetic and reconstructive breast surgery. With subclinical infection proven to be the primary etiology, antimicrobial breast pocket irrigation has been recommended as the key step to reduce CC but has not been universally adopted.

Objectives

The purpose of this study was to review the rates of CC observed when applying proven antimicrobial breast pocket irrigations.

Methods

Data from patients undergoing cosmetic breast augmentation were recorded prospectively from 1997 to 2017. The irrigation was performed with either a Betadine-containing (50% Betadine or “Betadine triple”) or a non-Betadine triple antibiotic regimen. The database was assessed to determine the type of implant used, the incidence of CC, and possible contributing factors. The degree of CC was recorded according to the Baker classification.

Results

A 20-year prospective data collection yielded 2088 patients with 4176 implants; of these patients, 826 had textured implants and 1262 had smooth implants. The incidence of Grade III/IV CC was found to be 0.57% in all patients undergoing primary breast augmentation (1.21% in textured implants and 0.16% in smooth implants).

Conclusions

This study constitutes the largest and longest review of CC in a controlled, single-surgeon setting. The incidence of CC is low and reinforces the efficacy/utility of antimicrobial breast pocket irrigation. Both the Betadine and non-Betadine antibiotic regimens were found to be effective, with the Betadine regimen being preferred. Universal adoption of Betadine-containing antimicrobial breast pocket irrigation is recommended to reduce CC and other device-associated infections.

Level of Evidence: 4
G-DIRT: a web server for identification and removal of duplicate germplasms based on identity-by-state analysis using single nucleotide polymorphism genotyping data
Authors: Sahu Tanmaya Kumar , Singh Amit Kumar , Mittal Shikha , Jha Shailendra Kumar , Kumar Sundeep , Jacob Sherry Rachel , Singh Kuldeep
Published: August 2022

Maintaining duplicate germplasms in genebanks hampers effective conservation and utilization of genebank resources. The redundant germplasm adds to the cost of germplasm conservation by requiring a large proportion of the genebank financial resources towards conservation rather than enriching the diversity. Besides, genome-wide-association analysis using an association panel with over-represented germplasms can be biased resulting in spurious marker-trait associations. The conventional methods of germplasm duplicate removal using passport information suffer from incomplete or missing passport information and data handling errors at various stages of germplasm enrichment. This limitation is less likely in the case of genotypic data. Therefore, we developed a web-based tool, Germplasm Duplicate Identification and Removal Tool (G-DIRT), which allows germplasm duplicate identification based on identity-by-state analysis using single-nucleotide polymorphism genotyping information along with pre-processing of genotypic data. A homozygous genotypic difference threshold of 0.1% for germplasm duplicates has been determined using tetraploid wheat genotypic data with 94.97% of accuracy. Based on the genotypic difference, the tool also builds a dendrogram that can visually depict the relationship between genotypes. To overcome the constraint of high-dimensional genotypic data, an offline version of G-DIRT in the interface of R has also been developed. The G-DIRT is expected to help genebank curators, breeders and other researchers across the world in identifying germplasm duplicates from the global genebank collections by only using the easily sharable genotypic data instead of physically exchanging the seeds or propagating materials. The web server will complement the existing methods of germplasm duplicate identification based on passport or phenotypic information being freely accessible at http://webtools.nbpgr.ernet.in/gdirt/.
Older People, Loneliness, Social Isolation and Technological Mitigations: Utilising Experiences of the Covid-19 Pandemic as we Move Forward
Authors: Fawcett Barbara , Karastoyanova Konstantina
Published: August 2022

In this article, the effects of social isolation which can lead to increasing feelings of loneliness and abandonment for some are examined. The article analyses findings which emerged from a qualitative study carried out with older people in three distinct areas in Scotland (city, rural and urban) who were shielding during Covid-19. It focuses on the ways in which social isolation affected them and the extent to which information and communication technology (ICT) and telecare technologies served to mitigate key aspects. The key themes which emerged from the research included loneliness as ‘multi-layered’, with these layers including ‘disconnections between loneliness and social isolation’; ‘well-being reversals’; ‘neighbours as strangers’; ‘disjointed communities and co-production’ and ‘service abandonment’. Additional themes which emerged focused on ‘ICT rebounds and evolvement’ and ‘hope, buoyancy and reciprocity’. These layers and themes can be seen to have longer term significance with regard to the implications for social work and social care planning as we move forward. They also emphasise the need for greater cohesiveness between health, telecare and social care services.
Habitual fish oil supplementation and the risk of incident atrial fibrillation: findings from a large prospective longitudinal cohort study
Authors: Zhang Junguo , Cai Anping , Chen Ge , Wang Xiaojie , Cai Miao , Li Haitao , Nissen Steven E , Lip Gregory Y H , Lin Hualiang
Published: August 2022

Aims

Mixed effects of fish oil supplementation on the risks of atrial fibrillation (AF) were observed in several large-scale randomized controlled trials. Whether this relationship would be modified by genetic AF risk, baseline cardiovascular disease (CVD) status and background oily fish consumption are unknown.

Methods and results

We included 468 665 participants without AF at baseline from the UK Biobank cohort. The association between fish oil supplementation and the AF risk was assessed in the study cohort and in several subgroups, including genetic AF predisposition, baseline CVD status, and background oily fish consumption. During a median follow-up of 11.1 years, fish oil users had a higher rate of incident AF (6.2% vs. 5.2%, adjusted hazard ratio of 1.10, and 95% confidence interval of 1.07, 1.13). Compared with non-users, fish oil users had a higher rate of incident AF in the low (3.7% vs. 3.0%, P= 0.02), intermediate (5.8% vs. 4.8%, P < 0.0001), and high (9.8% vs. 8.1%, P < 0.0001) genetic AF risk groups. In participants without CVD at baseline, fish oil users had a higher rate of incident AF (5.3% vs. 4.1%, P < 0.0001), which was not observed in participants with CVD at baseline (11.6% vs. 11.1%, P = 0.56), with significant interaction (P-interaction < 0.0001). The association between fish oil supplementation and the AF risk was not modified by background oily fish consumption (P-interaction = 0.62).

Conclusion

Habitual fish oil supplementation was associated with the risk of incident AF, regardless of genetic AF predisposition and background oily fish consumption. This association was observed only in individuals without CVD at baseline.
A large-scale, multi-year microbial community survey of a freshwater trout aquaculture facility
Authors: Testerman Todd , Beka Lidia , Reichley Stephen R , King Stacy , Welch Timothy J , Wiens Gregory D , Graf Joerg
Published: August 2022

Aquaculture is an important tool for solving the growing worldwide food demand, but infectious diseases of farmed animals represent a serious roadblock to continued industry growth. Therefore, it is essential to understand the microbial communities that reside within the built environments of aquaculture facilities to identify reservoirs of bacterial pathogens and potential correlations between commensal species and specific disease agents. Here, we present the results from 3 years of sampling a commercial rainbow trout aquaculture facility. We observed that the microbial communities residing on the abiotic surfaces within the hatchery were distinct from those residing on the surfaces at the facility's water source as well as the production raceways, despite similar communities in the water column at each location. Also, a subset of the water community seeds the biofilm communities. Lastly, we detected a common fish pathogen, Flavobacterium columnare, within the hatchery, including at the source water inlet. Importantly, the relative abundance of this pathogen was correlated with clinical disease. Our results characterized the microbial communities in an aquaculture facility, established that the hatchery environment contains a unique community composition and demonstrated that a specific fish pathogen resides within abiotic surface biofilms and is seeded from the natural water source.
Genome Assembly of the Polyclad Flatworm Prostheceraeus crozieri
Authors: Leite Daniel J , Piovani Laura , Telford Maximilian J
Published: August 2022

Polyclad flatworms are widely thought to be one of the least derived of the flatworm classes and, as such, are well placed to investigate evolutionary and developmental features such as spiral cleavage and larval diversification lost in other platyhelminths. Prostheceraeus crozieri, (formerly Maritigrella crozieri), is an emerging model polyclad flatworm that already has some useful transcriptome data but, to date, no sequenced genome. We have used high molecular weight DNA extraction and long-read PacBio sequencing to assemble the highly repetitive (67.9%) P. crozieri genome (2.07 Gb). We have annotated 43,325 genes, with 89.7% BUSCO completeness. Perhaps reflecting its large genome, introns were considerably larger than other free-living flatworms, but evidence of abundant transposable elements suggests genome expansion has been principally via transposable elements activity. This genome resource will be of great use for future developmental and phylogenomic research.
Ever the Father: Caring Masculinities Among Older Men in Two Bollywood Films
Authors: Roy Senjooti , Ayalon Liat
Published: August 2022

Background and Objectives

Ideals of masculinity have gradually evolved from dominant traits of “hegemonic masculinity” to a more nurturing concept of “caring masculinity” that recognizes the caregiving roles of men. In this article, we explore the performance of caring masculinities among older men in later life. We do this specifically in the Indian context by analyzing 2 Bollywood films, Piku (2015) and 102, Not Out (2018), which revolve around the lives of 3 widowers aged 70, 75, and 102.

Research Design and Methods

We use a directed content analysis approach to examine the performance of caring masculinities in intergenerational (older parent–adult child) relationships.

Results

Both films exemplify tenets of caring masculinity as 3 older fathers continue to perform caring roles well into their later years. They also navigate a range of emotions and vulnerabilities that challenge behaviors associated with hegemonic masculinity, a mainstay of male role portrayal in Bollywood films. Additionally, the films highlight the complexity and fragility of intergenerational bonds, emphasizing the prevalence of ambivalence rather than pure solidarity or conflict that have traditionally been used to characterize such relationships.

Discussion and Implications

The films challenge the notion of older adults, especially older men, as being primarily care recipients as they age. The performance of caring masculinities allows for a reimagining of masculinity performance in society. The portrayal of men aging within nuclear households without spousal and/or intergenerational support encourages viewers to perceive new roles and realities for older men in India.
Omicron Severe Acute Respiratory Syndrome Coronavirus 2 Neutralization by Immunoglobulin Preparations Manufactured From Plasma Collected in the United States and Europe
Authors: Farcet Maria R , Karbiener Michael , Knotzer Simone , Schwaiger Julia , Kreil Thomas R
Published: August 2022

After >2 years of the coronavirus disease 2019 (COVID-19) pandemic, immunoglobulins (IGs) contain highly potent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) neutralizing antibodies, based on the large proportion of United States (US) plasma donors who have gone through COVID-19 or vaccination against the virus. Neutralization of Omicron SARS-CoV-2 by antibodies generated after non-Omicron infection or vaccination has been lower though, raising concerns about the potency of IG against this new virus variant. Also, as plasma collected in the US remains the main source of IG, the neutralization of SARS-CoV-2 for plasma collected elsewhere has been less well studied. Here, we confirm Omicron neutralization by US as well as European Union plasma–derived IG lots.
A ‘Right to Nutrition’ in its Social, Legal, and Political Context: How International Human Rights Translate to Zambian Realities
Authors: Harris Jody , Gibbons Sarah , Kaaba O’Brien , Hrynick Tabitha , Stirton Ruth
Published: August 2022

Every country has populations that are affected by malnutrition, and one third of all people in the world are malnourished. Among approaches to addressing malnutrition, the language of human rights is notably present in international nutrition discourse and national policy and covenants, but the conceptualization, implications and utility of human rights for nutrition practice are contested.

This empirical research explores how the utility of a ‘right to nutrition’ is perceived by different actors, and how differences in interpretation affect its potential for reducing malnutrition. In undertaking this qualitative case-study, we apply socio-legal, critical development studies, and political science approaches to compare and contrast written documents and stated viewpoints, across actors in different sectors and levels from global to local, with a focus on Zambia.

Human rights are clearly integrated with ideas of nutrition in written documents across levels, but these are largely rhetorical devices providing moral leverage and guiding language, not clearly directing action. Zambia has domesticated relevant international human rights law and has recent case law implicitly underpinning a right to nutrition; using the law brings a strengthening of policy, but also a narrowing of focus in terms of populations covered and issues justiciable. Views on what a right to nutrition means in practice are contested, with a lack of citizen’s rights education limiting participation, and a lack of clear norms on who should be doing what scattering accountability.

Our research demonstrates that there are three distinct aspects to a rights-based approach—rhetorical, legal and practical—but that these generally act in silos. We argue that explicitly acknowledging these three functions of human rights is an important first step if a right to nutrition is desired; and explicitly addressing these aspects in combination and in context is fundamental to a coherent rights-based approach to nutrition.
Distance and age of the massive stellar cluster Westerlund 1. I. Parallax method using Gaia-EDR3
Authors: Navarete Felipe , Damineli Augusto , Ramirez Aura E , Rocha Danilo F , Almeida Leonardo A
Published: August 2022

Westerlund 1 (Wd 1) is one of the most massive young star clusters in the Milky Way. Although relevant for star formation and evolution, its fundamental parameters are not yet very well constrained. We aim to derive an accurate distance and provide constraints on the cluster age. We used the photometric and astrometric information available in the Gaia Early Data Release 3 (Gaia-EDR3) to infer its distance of 4.06$^{+0.36}_{-0.34}$ kpc. Modelling of the eclipsing binary system W36, reported in Paper II, led to the distance of 4.03 ± 0.25 kpc, in agreement with the Gaia-EDR3 distance and, therefore, validating the parallax zero-point correction approach appropriate for red objects. The weighted average distance based on these two methods results in dwd1  =  4.05 ± 0.20 kpc (m − M  =  13.04$^{+0.11}_{-0.12}$ mag), which has an unprecedented accuracy of 5 per cent. Using the Binary Population and Spectral Synthesis (BPASS) models for the Red Supergiants with solar abundance, we derived an age of 10.7 ± 1 Myr, in excellent agreement with recent work by Beasor & Davies (10.4$^{+1.3}_{-1.2}$ Myr) based on MIST evolutionary models. In Paper II, W36B was reported to be younger than 7.1 Myr, supporting recent claims of a temporal spread of several Myrs for the star-forming process within Wd 1 instead of a single monolithic starburst episode scenario.
A random walk model for halo triaxiality
Authors: Menker Paul , Benson Andrew
Published: August 2022

We describe a semi-analytic model to predict the triaxial shapes of dark matter haloes utilizing the sequences of random merging events captured in merger trees to follow the evolution of each halo’s energy tensor. When coupled with a simple model for relaxation toward a spherical shape, we find that this model predicts distributions of halo axis length ratios that approximately agree with those measured from cosmological N-body simulations once constrained to match the median axial ratio at a single halo mass. We demonstrate the predictive and explanatory power of this model by considering conditioned distributions of axis length ratios, and the mass dependence of halo shapes, finding these to be in good agreement with N-body results. This model provides both insight into the physics driving the evolution of halo triaxial shapes, and rapid quantitative predictions for the statistics of triaxiality connected directly to the formation history of the halo.
Long-Term Trends in Secondhand Smoke Exposure in High-Rise Housing Serving Low-Income Residents in New York City: Three-Year Evaluation of a Federal Smoking Ban in Public Housing, 2018–2021
Authors: Anastasiou Elle , Gordon Terry , Wyka Katarzyna , Tovar Albert , Gill Emily , Rule Ana M , Elbel Brian , Kaplan J D Sue , Shelley Donna , Thorpe Lorna E
Published: August 2022

Introduction

In July 2018, the U.S. Department of Housing and Urban Development passed a rule requiring public housing authorities to implement smoke-free housing (SFH) policies. We measured secondhand smoke (SHS) exposure immediately before, and repeatedly up to 36 months post-SFH policy implementation in a purposeful sample of 21 New York City (NYC) high-rise buildings (>15 floors): 10 NYC Housing Authority (NYCHA) buildings subject to the policy and 11 privately managed buildings in which most residents received housing vouchers (herein “Section 8”).

Aims and Methods

We invited participants from nonsmoking households (NYCHA n = 157, Section-8 n = 118) to enroll in a longitudinal air monitoring study, measuring (1) nicotine concentration with passive, bisulfate-coated filters, and (2) particulate matter (PM2.5) with low-cost particle sensors. We also measured nicotine concentrations and counted cigarette butts in common areas (n = 91 stairwells and hallways). We repeated air monitoring sessions in households and common areas every 6 months, totaling six post-policy sessions.

Results

After 3 years, we observed larger declines in nicotine concentration in NYCHA hallways than in Section-8, [difference-in-difference (DID) = −1.92 µg/m3 (95% CI –2.98, −0.87), p = .001]. In stairwells, nicotine concentration declines were larger in NYCHA buildings, but the differences were not statistically significant [DID= −1.10 µg/m3 (95% CI −2.40, 0.18), p = .089]. In households, there was no differential change in nicotine concentration (p = .093) or in PM2.5 levels (p = .385).

Conclusions

Nicotine concentration reductions in NYCHA common areas over 3 years may be attributable to the SFH policy, reflecting its gradual implementation over this time.

Implications

Continued air monitoring over multiple years has demonstrated that SHS exposure may be declining more rapidly in NYCHA common areas as a result of SFH policy adherence. This may have positive implications for improved health outcomes among those living in public housing, but additional tracking of air quality and studies of health outcomes are needed. Ongoing efforts by NYCHA to integrate the SFH policy into wider healthier-homes initiatives may increase policy compliance.
Co-occurring insomnia and anxiety: a randomized controlled trial of internet cognitive behavioral therapy for insomnia versus internet cognitive behavioral therapy for anxiety
Authors: Mason Elizabeth C , Grierson Ashlee B , Sie Amanda , Sharrock Maria J , Li Ian , Chen Aileen Z , Newby Jill M
Published: August 2022

Study Objectives

Insomnia and anxiety are highly prevalent and frequently co-occur. Given limited therapeutic resources and time constraints, the aim of this study was to compare which treatment—internet cognitive behavioral therapy (CBT) for insomnia or internet CBT for anxiety—leads to the best outcomes in individuals with comorbid insomnia and anxiety.

Methods

120 participants with comorbid insomnia and clinical anxiety (as defined by scores above the clinical cutoff on the insomnia severity index (ISI) and the generalized anxiety disorder 7-item scale (GAD-7)) were randomized to receive internet-based cognitive behavioral therapy (iCBT) for insomnia or iCBT for anxiety. The primary outcome measures were the ISI and the generalized anxiety disorder 7-item scale. Primary outcome measures were assessed before treatment, at mid-treatment, at post-treatment, and 3 months after treatment. Secondary outcome measures assessed depression symptoms, distress, and sleep diary parameters.

Results

Participants in both groups experienced large reductions in symptoms of insomnia, anxiety, depression, and distress, as well as improvements in sleep efficiency and total sleep time. Improvements were maintained at follow-up. Crucially, at the end of treatment, the insomnia treatment was more effective in reducing symptoms of insomnia than the anxiety treatment, and equally effective in reducing symptoms of anxiety. Treatment gains were maintained at 3-month follow-up, however, there were no differences between groups at that time point.

Conclusions

These results suggest that in the common case of a patient presenting with comorbid insomnia and anxiety, treatment for insomnia may be the most efficient treatment strategy.

Trial Registration

The trial was registered with the Australian and New Zealand Clinical Trials Registry, https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12618001141235. Trial ID: ACTRN12618001141235. Trial name: a comparison of internet-based CBT for insomnia versus internet-based CBT for anxiety in a comorbid sample.
Management of persistent urine leak after partial nephrectomy: A case series
Authors: Guliev Bakhman , Komyakov Boris , Shevnin Maksim , Agagyulov Murad , Talyshinskii Ali
Published: August 2022

Urinary leak is one of the most significant complications after partial nephrectomy. In case of persistent urine leaks, placement of a ureteral stent is effective but not always sufficient. This study included 5 patients with persistent urinary leak after partial nephrectomy. The patients underwent flexible ureteroscopy wherein we identified the damaged calyx. Subsequently, we performed percutaneous puncture targeting the distal end of the endoscope at this calyx and installed a nephrostomy tube. Then, the endoscope was removed, and the ureter was drained with a stent. Ureteral stenting ensures elimination of urinary leak in most patients after partial nephrectomy. In patients with persistent urinary leak, retrograde endoscopic percutaneous drainage of the pelvicalyceal system is the method of choice because it allows for rapid and effective treatment of urinary fistulas.
The Oticon Ponto System in Adults With Severe-to-Profound and Mixed Hearing Loss: Audiologic Outcomes and Patient Satisfaction
Authors: Skarzynski Piotr Henryk , Dziendziel Beata , Wlodarczyk Elzbieta , Skarzynski Henryk
Published: August 2022

Objective

To measure audiologic outcomes and self-assessed satisfaction with the Ponto system in a group of patients who had severe to profound and mixed hearing loss.

Study Design

Retrospective case review.

Setting

Tertiary referral center.

Patients

Sixteen patients aged 21 to 74 years with severe-to-profound and mixed hearing loss (bone conduction thresholds, ≥45 dB HL).

Interventions

Ponto implant surgery.

Main Outcome Measure(s)

Pure-tone audiometry, free-field hearing thresholds, effective gain, word recognition score in quiet, and speech reception threshold (SRT) in noise were assessed. Patient-reported outcomes were collected using the Clinical Global Impression Scale, Glasgow Benefit Inventory, and Abbreviated Profile of Hearing Aid Benefit. Information concerning any medical complications was also gathered.

Results

Both word recognition score and SRT were significantly better after 12 months compared with before surgery. At normal speech level (65 dB SPL), 12 of 16 users had speech discrimination ≥70%. However, at the 12-month follow-up, the average effective gain was −6.2 dB. In general, the self-report outcomes showed good satisfaction in most patients. Postoperatively, skin complications were noted in six patients, of whom two underwent reoperation. All patients were still using the Ponto after an average observation time of 2.7 years.

Conclusion

Although skin complications were not uncommon, the Ponto system seems to be an effective method of improving hearing performance and provides subjective satisfaction in real-life situations in patients with severe-to-profound and mixed hearing loss. However, considering the significantly increased bone conduction thresholds and the risk of their further deterioration, long-term follow-up is still needed.
Predictive Value of Transimpedance Matrix Measurements to Detect Electrode Tip Foldover
Authors: Kay-Rivest Emily , McMenomey Sean O. , Jethanamest Daniel , Shapiro William H. , Friedmann David R. , Waltzman Susan B. , Roland J. Thomas
Published: August 2022

Objective

To evaluate the ability of the transimpedance matrix (TIM) measurement to detect cochlear implant electrode tip foldover by comparing results to a “gold standard,” the intraoperative plain film radiograph.

Study Design

Retrospective case series.

Setting

Tertiary referral hospital.

Patients

One hundred three patients who underwent cochlear implantation between June 2020 and August 2021.

Interventions

Intraoperative electrophysiologic monitoring (electrode impedances, neural response telemetry, and TIM measurement) and modified Stenver's view plain film radiographs.

Main Outcome Measures

Identification of tip foldover on both TIM and plain films.

Results

In total, 103 patients (117 ears) had both a TIM measurement and intraoperative X-ray available for review, including 68 adults and 35 children. One hundred patients (85%) received the Cochlear Slim Modiolar electrode. Tip foldovers were noted in three of 117 implants (2.5%). In all cases, TIM was able to detect the foldover, and the electrode arrays were reinserted with the patients still under anesthesia, with repeat X-ray demonstrating a normal configuration. Two other abnormal TIM patterns were identified. One was in a patient with an obstructed cochlea in whom only 10 electrodes could be inserted, the other was in a patient with a common cavity abnormality. One additional patient underwent electrode repositioning intraoperatively because of overinsertion. In this patient, the TIM appeared to be within normal limits, but the over-insertion was apparent on X-ray. Overall, the sensitivity and specificity of TIM measurements in detecting electrode tip foldover were both 100%.

Conclusion

TIM measurements were able to accurately identify tip foldovers. More research is needed to define the adjunctive role of TIM as an intraoperative measure.
Outcome of Water Exchange and Air Insufflation Colonoscopy Performed by Supervised Trainee and Their Assessment of the Training Experience
Authors: Leung Felix W.
Published: August 2022

Goals:

The hypotheses that supervised trainees would provide a more favorable assessment of the learning experience and could achieve superior results with water exchange (WE) compared with air insufflation were tested.

Background:

WE decreased pain, increased cecal intubation rate (CIR), and polyp detection rate (PDR).

Study:

In a prospective pilot observational study, the trainees were taught WE in unsedated and WE and air insufflation in alternating order in sedated veterans. Trainee scores and procedural outcomes were tracked.

Results:

83 air insufflation and 119 WE cases were included. Trainee evaluations of the respective methods were scored based on a 5-point scale [1 (strongly agree) to 5 (strongly disagree, with lower scores being more favorable]. Evaluation scores [mean (SD)] were as follows: my colonoscopy experience was better than expected: WE 2.02 (1.00) versus air insufflation 2.43 (1.19), P=0.0087; I was confident with my technical skills using this method: WE 2.76 (0.91) versus air insufflation 2.85 (0.87), P=0.4822. Insertion time was 40 (21) min for WE and 30 (20) min for air insufflation (P=0.0008). CIR were 95% (WE, unsedated); 99% (WE, overall), and 89% (air insufflation, overall). WE showed significantly higher CIR (99% vs. 89%, P=0.0031) and PDR (54% vs. 32%, P=0.0447).

Conclusions:

The long air insufflation insertion time indicated the trainees were inexperienced. The significantly longer WE insertion time confirmed that learning WE required extra time. This pilot study revealed that supervised trainees reported more favorable learning experience with WE and equivalent confidence in technical skills scores. They completed both unsedated and sedated colonoscopy in over 89% of cases achieved significantly higher CIR and PDR with WE than air insufflation. It appeared that trainee education in WE might be an acceptable alternative to augment air insufflation to meet the challenges of training posed by traditional air insufflation colonoscopy.
Differences between spinal cord injury and cervical compressive myelopathy in intramedullary high-intensity lesions on T2-weighted magnetic resonance imaging: A retrospective study
Authors: Kamei Naosuke , Nakanishi Kazuyoshi , Nakamae Toshio , Tamura Takayuki , Tsuchikawa Yuji , Moisakos Taiki , Harada Takahiro , Maruyama Toshiaki , Adachi Nobuo
Published: August 2022

Increases in aging populations have raised the number of patients with cervical spinal cord injury (SCI) without fractures due to compression of the cervical spinal cord. In such patients, it is necessary to clarify whether SCI or cervical compressive myelopathy (CCM) is the cause of disability after trauma. This study aimed to clarify the differences in magnetic resonance imaging (MRI) features between SCI and CCM.

Overall, 60 SCI patients and 60 CCM patients with intramedullary high-intensity lesions on T2-weighted MRI were included in this study. The longitudinal lengths of the intramedullary T2 high-intensity lesions were measured using sagittal MRI sections. Snake-eye appearance on axial sections was assessed as a characteristic finding of CCM. The T2 values of the high-intensity lesions and normal spinal cords at the first thoracic vertebra level were measured, and the contrast ratio was calculated using these values.

The longitudinal length of T2 high-intensity lesions was significantly longer in SCI patients than in CCM patients. Snake-eye appearance was found in 26 of the 60 CCM patients, but not in SCI patients. On both the sagittal and axial images, the contrast ratio was significantly higher in the SCI group than in the CCM group. Based on these results, a diagnostic scale was created. This scale made it possible to distinguish between SCI and CCM with approximately 90% accuracy.
Postoperative discal pseudocyst after percutaneous endoscopic transforaminal discectomy treated by drainage: Case report
Authors: Wang Shuai , Yang Yang , Yu Xiuchun , Chang Zhengqi
Published: August 2022

Rationale:

This article reports 2 cases of symptomatic postoperative discal pseudocysts (PDP), a rare complication of percutaneous endoscopic transforaminal lumbar discectomy (PELD). In this report, we propose a possible mechanism of PDP and introduce an effective therapeutic strategy. To our knowledge, there have been no reports of the use of indwelling drainage techniques for the PDP treatment after PELD.

Patient concerns:

Herein, we report 2 cases of PDP after PELD in our hospital. Both patients had disc herniation at the L4/5 level, and the symptoms of low back pain and radiculopathy were significantly relieved after PELD. However, the signs in both 2 cases recurred 20 days after surgery. MRI indicated PDP in both 2 patients with high intensity on T1- and T2-weighted imaging in the primary surgical area.

Interventions:

Given the progressive symptoms in both cases, PELD was performed again and 3-lumen drainage catheters were placed at the surgical site for adequate drainage.

Outcomes:

The patient’s symptoms were significantly relieved after adequate drainage and disappeared 3 months after surgery. There was no clinical or MRI recurrence at the 6-month follow-up.

Conclusion:

According to operative findings, we found that PDP symptoms may not be attributable mainly to cyst compression but to the excessive accumulation of local inflammatory factors. Treatment of PELD combined with indwelling drainage is feasible and effective in treating PDP.
Bayesian network analysis of long-term oncologic outcomes of open, laparoscopic, and robot-assisted radical cystectomy for bladder cancer
Authors: Dong Lin , Xiaoli Feng , Ya Lu , Dan Wu , Jingwen Hu , Xun Liu , Shujin Chen , Zhijun Zhou , Tian Zhang , Hao Luo , Chuanlang Yi , Guangrong Chen , Xiaodong Wang , Gewen Luo , Yichi Zhang , Pei Cao , Yang Liu , Youliang Wang
Published: August 2022

Background:

To understand the long-term oncologic outcomes of open radical cystectomy (ORC) versus laparoscopic radical cystectomy (LRC) versus robot-assisted radical cystectomy (RARC) for bladder cancer (BCa). Therefore, we performed the conventional meta-analysis and network meta-analysis to evaluate the long-term oncologic outcomes of ORC, LRC, and RARC for BCa.

Methods:

A systematic search of PubMed, Embase, Cochrane Library, Medline, and Web of science was performed up until July 1, 2021. Long-term oncologic outcomes include the 5-year overall survival (OS) rate, the 5-year recurrence-free survival (RFS) rate, and the 5-year cancer specific-survival (CSS) rate. The Bayesian network analysis has been registered in PROSPERO (CRD42020208396).

Results:

We found that 10 articles (including 3228 patients) were included in our Bayesian network analysis. No significant differences were found between ORC, LRC, and RARC in long-term oncologic outcomes in either direct meta-analysis or network meta-analysis. Therefore, the clinical effects of 5-year OS, RFS, and CSS of RARC, LRC, and ORC are similar. But LRC may be ranked first in 5-year OS, RFS, and CSS compared to other surgical approaches by probabilistic analysis ranking via Bayesian network analysis.

Conclusion:

We found that there were no statistical differences in the 3 surgical approaches of RAPC, LPC, and OPC for Bca in long-term oncologic outcomes by direct meta-analysis. However, Subtle differences between these surgical approaches can be concluded that LRC may be a better surgical approach than RARC or ORC in long-term oncologic outcomes by probabilistic analysis ranking via Bayesian network analysis. Moreover, we need a large sample size and more high-quality studies to improve and verify further.
Intra- and Inter-observer Agreement of High Resolution Antroduodenal Manometry in Pediatric Patients Among Single Center Experts
Authors: Valitutti Francesco , Lindley Keith , Saliakellis Efstratios , Chanpong Atchariya , Pesce Marcella , Rybak Anna , Thapar Nikhil , Borrelli Osvaldo
Published: August 2022

Objectives:

Studies in adults have suggested that high-resolution technology increases the diagnostic yield of antroduodenal manometry (ADM). However, there is no study comparing high-resolution with low-resolution ADM recordings as well as comparing the 2 types of high-resolution display [conventional line plot (CLP) and pressure topographic plots (PTP)]. We hypothesized that high-resolution ADM is a superior diagnostic modality with higher inter-observer and intra-observer agreement compared with low-resolution recordings.

Methods:

Twenty-four anonymized ADM studies were blindly analyzed by 3 experienced pediatric neurogastroenterologists. All studies had been performed using a low-compliance water-perfused system with a 20-channels catheter. Data were displayed as CLP, as both high-resolution and low-resolution, and PTP in different sessions with at least 6-week interval. Accuracy was evaluated using previous established diagnosis and specific pre-prandial and post-prandial manometric patterns. Inter-observer and intra-observer agreements were calculated.

Results:

Analysis with high-resolution CLP revealed a substantial inter-observer agreement among the 3 observers regarding the diagnosis (Krippendorff’s alpha: 0.832; average pairwise percentage agreement: 88.9%). Conversely, PTP and low-resolution CLP showed poor agreement for diagnoses (Krippendorff’s alpha: 0.600; average pairwise percentage agreement: 75.3%; Krippendorff’s alpha: 0.390; average pairwise percentage agreement: 60.2%, respectively). For the intra-observer agreement, Krippendorff’s alpha ranges were 0.891–1 for CLP and 0.19393–0.34621 for PTP.

Conclusions:

Our study demonstrated higher diagnostic accuracy for high-resolution ADM compared to the low-resolution recordings. However, although it is well established for other motility investigations, PTP is not yet reliable in assessing foregut motor patterns. Advanced and more sophisticated software are clearly required for analyzing PTP display.
Myxoid Pseudotumor Involving the Renal Sinus
Authors: Hogan Kevin , McKenney Jesse K. , Cox Roni M. , Nguyen Jane K. , Shah Rajal B. , Billings Steven D. , Przybycin Christopher G.
Published: August 2022

We describe 33 cases of myxoid pseudotumor involving the renal sinus from 31 patients. Patients included 21 men and 10 women, ages 30 to 95 years. Twenty-seven cases (82%) had an associated malignancy, including urothelial carcinoma of the renal pelvis (22 cases), clear cell renal cell carcinoma (3 cases), urothelial carcinoma of the bladder (1 case), and poorly differentiated carcinoma of uncertain lineage (1 case). The remaining 6 (18%) had no associated malignancy and included 3 nephrectomies for ureteral stricture, 2 ureteropelvic junction repairs, and 1 resection of a “periureteral mass” (subsequently shown to be myxoid pseudotumor). Myxoid pseudotumor was identified by preoperative computed tomography imaging in 2 patients (6%) and identified by the gross dissector in 9 cases (27%). The mean size was 14 mm (range: 5 to 38 mm). All cases had an admixture of adipocytes, myxoid stromal matrix, variable collagenization, and a hypocellular population of bland spindled and stellate stromal cells. No multilobated atypical stromal cells were present. Clinical follow-up was available for 28 patients (90%), ranging from 1 to 132 months (mean: 24.6 mo). No patients had adverse events related to the myxoid pseudotumor. Myxoid pseudotumor of the renal sinus is often associated with a variety of adjacent neoplastic and non-neoplastic conditions and may present as a mass lesion detectable by imaging and/or gross inspection. Awareness of this benign process is important to avoid confusion with a neoplasm, especially liposarcoma.
Improving Estimation of Intervention Impact on Antibody Titer Increase in the Presence of Missing Values: A Proposed Method for Addressing Limit of Detection Issues
Authors: Ge Yang , Zane Billings W. , Skarlupka Amanda L. , Cao Wannan , Dobbin Kevin K. , Ross Ted M. , Handel Andreas , Shen Ye
Published: August 2022

In many laboratory assays that measure immunological quantities, a portion of the measured values fall below a limit of detection (LOD). This is also the case for the hemagglutination inhibition assay (HAI), a common method used to quantify antibodies in influenza research. The conventional approach is to treat values below the LOD as either equal to the LOD or LOD/2, which can introduce potential biases. These biases can become more pronounced when calculating compound measures such as the difference between post-vaccination and pre-vaccination antibody titers (titer increase). To address this issue, we conducted simulations using LOD measurements with LOD/2 values as the standard imputation. We then developed a new method to adjust coefficient estimates that account for the censored nature of measurements below the LOD. Applying this new method to data from an influenza vaccine cohort study, we compared the impact of vaccine dose on the titer increase of HAI.

Author Summary

Analysis of measurements obtained from widely used antibody assays frequently overlooks the underlying data structure, leading to potential biases in the results. To address this issue, we have developed a method that effectively reduces these biases.
Re-assessing niche partitioning in MacArthur’s Warblers: foraging behavior, morphology, and diet metabarcoding in a phylogenetic context
Authors: Miller Eliot T. , Wood Andrew , Baiz Marcella D. , Welch Andreanna J. , Fleischer Robert C. , Dale Adrienne S. , Toews David P. L.
Published: August 2022

Due in large part to MacArthur’s classic 1958 paper, wood-warblers (Parulidae) are ecological icons, textbook protagonists of a story of competition and niche partitioning. As the story goes, subtle differences in foraging behavior are the principal means by which these nearly morphologically indistinguishable species are able to co-occur and avoid extinction. Yet, MacArthur’s study was in fact quite limited in scale, and he said little about the relevance of evolution to the study system. Here, we reassess MacArthur’s conclusions across an expanded set of syntopic warbler species in a forest in northern New York. We combine morphometrics, quantitative foraging data, and fecal metabarcoding—a direct measure of warbler diet—to study competition and niche partitioning in an evolutionary framework. We find close and kinematically realistic relationships between morphology and foraging behavior, but little connection between warbler ecomorphology and the 2,882 invertebrate taxa detected in their diets. Instead, diet remains phylogenetically conserved—closely related warblers eat similar suites of invertebrates, regardless of where they forage. Finally, we present evidence that these species not only partition niche space in the present day, but that competition has shaped their behaviors over evolutionary time. MacArthur (1958) may have drawn a few incorrect inferences, but his overall conclusion that evolved differences in foraging position, driven by competition among close relatives, does indeed appear to be a key reason these warblers can occur in such close sympatry.
A computational framework linking synaptic adaptation to circuit behaviors in the early visual system
Authors: He Liuyuan , He Yutao , Lun Kehuan , Ma Lei , Du Kai , Huang Tiejun
Published: August 2022

Retina ribbon synapses are the first synapses in the visual system. Unlike the conventional synapses in the central nervous system triggered by action potentials, ribbon synapses are uniquely driven by graded membrane potentials and are thought to transfer early sensory information faithfully. However, how ribbon synapses compress the visual signals and contribute to visual adaptation in retina circuits is less understood. To this end, we introduce a physiologically constrained module for the ribbon synapse, termed Ribbon Adaptive Block (RAB), and an extended “hierarchical Linear-Nonlinear-Synapse” (hLNS) framework for the retina circuit. Our models can elegantly reproduce a wide range of experimental recordings on synaptic and circuit-level adaptive behaviors across different cell types and species. In particular, it shows strong robustness to unseen stimulus protocols. Intriguingly, when using the hLNS framework to fit intra-cellular recordings from the retina circuit under stimuli similar to natural conditions, we revealed rich and diverse adaptive time constants of ribbon synapses. Furthermore, we predicted a frequency-sensitive gain-control strategy for the synapse between the photoreceptor and the CX bipolar cell, which differ from the classic contrast-based strategy in retina circuits. Overall, our framework provides a powerful analytical tool for exploring synaptic adaptation mechanisms in early sensory coding.
Increased ozone levels disrupt insect sexual communication
Authors: Jiang Nan-Ji , Chang Hetan , Weisflog Jerrit , Eberl Franziska , Veit Daniel , Weniger Kerstin , Hansson Bill S. , Knaden Markus
Published: August 2022

Insect sexual communication often relies upon sex pheromones1-3. Most insect pheromones, however, contain carbon-carbon double bonds and potentially degrade by oxidation4. Here, we show that already frequently reported increased levels of Anthropocenic ozone can oxidize all described male-specific pheromones of Drosophila melanogaster5-7, resulting in reduced amounts of e.g. cis-Vaccenyl Acetate and (Z)-7-Tricosene. At the same time female acceptance of ozone-exposed males is significantly delayed. Interestingly, groups of ozonized males also exhibit unnaturally high levels of male-male courtship behavior. When repeating similar experiments with nine other drosophilid species, we observe pheromone degradation and/or corrupted sex recognition in eight of them. Our data suggest that Anthropocenic levels of ozone can oxidize double bonds in a variety of insect pheromones extensively, thereby leading to deviations in sexual recognition.
Interpretable Prediction of mRNA Abundance from Promoter Sequence using Contextual Regression Models
Authors: Wang Song , Wang Wei
Published: August 2022

While machine learning models have been successfully applied to predicting gene expression from promoter sequences, it remains a great challenge to derive intuitive interpretation of the model and reveal DNA motif grammar such as motif cooperation and distance constraint between motif sites. Previous interpretation approaches are often time-consuming or hard to learn the combinatory rules. In this work, we designed interpretable neural network models to predict the mRNA expression levels from DNA sequences. By applying the Contextual Regression framework we developed, we extracted weighted features to cluster samples into different groups, which have different gene expression levels. We performed motif analysis in each cluster and found motifs with active or repressive regulation on gene expression as well as motif combination grammars including several motif communities and distance constraints between cooperative motifs.