bluuebunny/crossref_metadata_2025 huggingface dataset:
Dominant Essential Tremor
Authors: Viswanathan Ashwin
Published: August 2022

Deep brain stimulation has emerged as the most common surgical treatment for movement disorders, such as essential tremor. However, stereotactic ablative techniques, including thalamotomy, remain an important intervention to offer patients who do not wish for an implanted device or who have a contraindication to brain surgery. Thalamotomy can be performed using radio-frequency technology, laser interstitial thermal therapy, radiosurgery, or focused ultrasound. There are unique advantages and limitations of each of these techniques. A case of radio-frequency thalamotomy is presented. Radio-frequency thalamotomy is an effective, fast, and inexpensive technique for improving unilateral tremor. Between 60% and 80% of patients will maintain excellent improvement, with either no tremor or significant improvement in tremor.
Non–Tremor-Predominant Parkinson Disease
Authors: Ostergard Thomas , Miller Jonathan P.
Published: August 2022

Strong evidence supports the use of deep brain stimulation of the globus pallidus internus (GPi) and subthalamic nucleus (STN) for the treatment of medically refractory Parkinson disease. Randomized controlled trials have confirmed that those with medically refractory Parkinson disease treated with deep brain stimulation will experience a higher quality of life and have also confirmed that the STN and GPi are equally effective in controlling the symptoms of Parkinson disease. For patients with cognitive impairment or depression, however, the GPi may be a safer target. Direct targeting through visualization of the GPi and STN on 3-tesla magnetic resonance imaging has emerged as a viable surgical strategy, though the use of intraoperative electrophysiology remains a common mode of intraoperative target verification.
Obsessive-Compulsive Disorder
Authors: Karas Patrick J. , Viswanathan Ashwin
Published: August 2022

Treatment-refractory obsessive-compulsive disorder (OCD) can have a profound impact on patients’ quality of life and functional status. Both lesional approaches (radiosurgery and radio-frequency ablation) and neuromodulation (deep brain stimulation, DBS) have a role in treatment of refractory OCD. Candidates for DBS will have disabling symptoms and have failed multimodal therapy, including three different selective serotonin reuptake inhibitors, supplementation of these inhibitors with neuroleptics, and cognitive behavioral therapy. Interdisciplinary consensus, including individuals from psychiatry, psychology, and neurosurgery areas, is critical for the optimal surgical care of patients with a neuropsychiatric illness such as OCD. The target for DBS for OCD is the anterior limb of the internal capsule, but understanding of the exact physiological and neuroanatomical target is evolving.
Asthma
Authors: Volcheck Gerald W.
Published: August 2022

Asthma is a common disease affecting approximately 8% of the adult population. This chapter focuses on categorizing asthma, identifying contributors to asthma, and reporting asthma medical management based on severity.
Ischemic Heart Disease
Authors: Anavekar Nandan S.
Published: August 2022

Ischemic heart disease results from diminished myocardial blood supply and its attendant clinicopathologic manifestations. It may be clinically silent or present with syndromes categorized as stable angina, unstable angina, non–ST-elevation acute coronary syndrome (NSTE-ACS), ST-elevation myocardial infarction (MI), or sudden death. Ischemic heart disease causes nearly 800,000 deaths annually in the United States. Notably, about one-third of deaths annually in the United States are due to MI.
Pericardial Disease and Cardiac Tumors
Authors: Klarich Kyle W.
Published: August 2022

The pericardium consists of a fibrous sac and a serous membrane. The space between visceral and parietal pericardium normally contains 15 to 25 mL of clear fluid. The pericardium functions to prevent cardiac distention, limit cardiac displacement (by its attachment to neighboring structures), and protect the heart from inflammation. Metastatic tumors are far more common than primary cardiac tumors (>40-fold). The most frequent metastases to the heart are melanoma, lymphoma, and breast, lung, and esophageal tumors. Patients with metastatic malignancies have metastatic disease to the heart up to 15% of the time. More than one-half of patients with malignant melanoma have metastases to the heart. Metastatic disease to the heart carries a poor prognosis.
Colonic Disorders
Authors: Kisiel John B.
Published: August 2022

This chapter discusses several colonic disorders. Disorders covered are inflammatory bowel disease, miscellaneous infectious causes, antibiotic colitis, radiation colitis, ischemia, irritable bowel syndrome, nontoxic megacolon, congenital megacolon, lower GI tract bleeding, diverticular disease, cancer screening, polyps, and hamartomatous polyposis syndromes.
Diarrhea, Malabsorption, and Small-Bowel Disorders
Authors: Sweetser Seth R.
Published: August 2022

This chapter covers the causes, diagnosis, and treatment of diarrhea and malabsorption.
Pancreatic Disorders
Authors: Majumder Shounak
Published: August 2022

This chapter covers the classification, diagnosis, and treatment of various types of pancreatic disorders.
Dermatology
Authors: Wieland Carilyn N.
Published: August 2022

Diagnostic tests are tools that either increase or decrease the likelihood of disease in a specific patient. When a diagnostic test is applied to a population at risk for a particular disease, patients in the studied population can be assigned to 1 of 4 groups on the basis of disease status and the test result.
Hospital Medicine
Authors: Kashiwagi Deanne T. , Ratelle John T.
Published: August 2022

Hospital medicine is the fastest growing medical specialty. It has evolved into a field that focuses on illnesses managed in the inpatient setting. In addition, the practice of hospital medicine requires understanding of operations and care processes specific to the hospital. Hospitalized patients are at risk for such complications as venous thromboembolism (VTE) and hospital-acquired infections. Clinicians who practice hospital medicine must be familiar with the diagnosis, the management, and the prevention of these hospital-acquired conditions. This chapter provides an overview of topics specific to the care of hospitalized patients.
Medical Ethics
Authors: Tilburt Jon C. , Hook C. Christopher
Published: August 2022

Medicine is first and foremost a relationship—a coming together of a patient who is ill or has specific needs and a physician whose goal is to help the patient. The physician-patient relationship is a fiduciary relationship. Physicians have knowledge, skills, and privileges that patients do not have. In turn, patients trust that physicians act in the patients’ best interests.
Quality Improvement and Patient Safety
Authors: Kautz Jordan M. , Matulis John C. , Wittich Christopher M.
Published: August 2022

Quality improvement, broadly interpreted, refers to any formal approach taken to understand and better the performance of a system. Quality improvement, conversationally, more often is taken to mean application of those methodologies or tools from industry to health care. Quality improvement and patient safety are complementary but not synonymous. Safety is but 1 dimension of quality care, and quality improvement but 1 behavior of safe care. Understanding of human factors—the interactions among humans and other elements of the system—is critical to improving safety by constructing systems wherein it is easier for persons to do the right thing and harder to do the wrong thing.
Seizure Disorders
Authors: Wong-Kisiel Lily C.
Published: August 2022

Seizures are electroclinical events, and epilepsy indicates a tendency for recurrent unprovoked seizures. The proper treatment of epilepsy depends on accurate diagnosis of the seizure type, identification of the cause (if possible), and management of psychosocial problems.
Breast Cancer
Authors: Haddad Tufia C. , Moynihan Timothy J.
Published: August 2022

In the United States, approximately 252,000 new cases of invasive breast cancer are diagnosed annually. Breast cancer is the most common cancer in women and develops in approximately 1 in 8 women who achieve a normal life expectancy. It is the second most common cause of cancer death among women in the United States (lung cancer is the most common). The incidence decreased in the early 2000s and has leveled off since then. Breast cancer mortality rates have steadily decreased since the mid 1990s because of improvements in systemic therapy and early detection.
Substance Use Disorders, Personality Disorders, and Eating Disorders
Authors: Palmer Brian A. , Kolla Bhanuprakash
Published: August 2022

Alcohol and other substance use disorders are a major concern in all age groups and across all ethnic, socioeconomic, and racial groups. Despite high lifetime prevalence, less than 10% of persons with substance use disorders are involved in treatment. Personality disorders are grouped into 3 clusters and demand the most from internists. The disorder is treatable and generally improves despite common perceptions to the contrary. The 2 common eating disorders are anorexia nervosa and bulimia. Both are markedly more prevalent among women than men. Eating disorders are increasingly found across all income, racial, and ethnic groups. Both disorders have a primary symptom of preoccupation with weight and distortion of body image. Eating disorders have the highest lethality of all psychiatric illnesses.
Rheumatoid Arthritis and Spondyloarthropathies
Authors: Wright Kerry , Peterson Lynne S.
Published: August 2022

Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease characterized by symmetrical synovitis, morning stiffness, and joint destruction. It affects 0.03% to 1.5% of the population worldwide. Women are affected 3 times more frequently than men. Its incidence peaks between the ages of 50 and 75 years. Lifetime risk of RA in adults is 3.6% for women and 1.7% for men. The presentation of an unknown antigen to a genetically susceptible person is believed to trigger RA.
Ending the HIV Epidemic
Authors: Sokoloff Benjamin , Trang Tri Minh , Ngo Thanh Thu
Published: August 2022

This chapter identifies the goals of the current nationwide initiative to eliminate new HIV infections in the US and describes the pillars upon which the initiative was designed to achieve these goals. These goals include reducing the number of new infections by 75% by 2025 and 90% by 2030 by increasing the diagnosis, treatment, and prevention of HIV infection and rapid response to new clusters of HIV transmission.
Epidemiology and the Spread of HIV
Authors: Bolduc Philip , Chew Victoria , Girard Hannah , Weeks Craig Steven
Published: August 2022

This chapter discusses the global prevalence as well as the geographic distribution of HIV-1 and HIV-2 infections and updates on recent shared global initiatives. The demographic trends in HIV in the US, especially regarding gender, sexuality, race, ethnicity, age, injection-drug use, socioeconomic status, and recent initiatives, are reviewed. Special attention is paid to HIV among communities of color, as well as women, children, and adolescents. The role of HIV in men who have sex with men and the transgender community is reviewed in detail.
HIV Testing and Counseling
Authors: Delgado Alejandro
Published: August 2022

This chapter lists and describes the various types of HIV testing available. The chapter also presents an overview of HIV counseling. HIV testing terminology and algorithms are presented to the reader along with descriptive figures. Laboratory markers for HIV are reviewed. The chapter describes who should be tested, as well as pre- and post-test counseling elements. A section of the chapter is dedicated to special populations and environments (blood supply screening, prenatal screening, testing settings). Strategies to improve uptake of HIV testing are discussed.
Laboratory Testing Strategies, Detection, and Diagnosis
Authors: Salazar Alonso D. Pezo , Meisner Jessica A.
Published: August 2022

The history of testing as well as the immunology behind testing is detailed in this chapter. A comprehensive overview of virologic immunoassays is provided to the reader. Algorithms for screening and diagnosing HIV infections are discussed and special attention is given to screening and detecting HIV in newborns and children.
Diversity and Health Disparities
Authors: Spinner Gary F. , Arrington-Sanders Renata , Spatafore Leah , Goldstein Zil Garner , Deutsch Maddie , Kapalko Angela , Prosser Rachel A. , David Abby , Garcia Deliana , Seda Claire Hutkins , Madaras Laszlo
Published: August 2022

This chapter will help the learner to understand about concepts of social determinants of health and racial and ethnic disparities and how they impact the care of people with HIV. It discusses the impact of stigma on healthcare-seeking behavior, treatment adherence, and safe practices among populations experiencing disproportionate access to healthcare, including adolescents, transgender persons, homeless or displaced individuals, incarcerated individuals, patients in rural settings, and immigrants and migrant workers.
HIV Care Coordination
Authors: Westlake Amanda A. , Spencer-Long Sally , Skiest Daniel J.
Published: August 2022

This chapter covers interdisciplinary care coordination in care for people with HIV. The HIV continuum of care is discussed as well as the complexity of care needs for people with HIV. Roles of the HIV patient care team are outlined in depth along with quality improvement information. The chapter concludes with a review of funding for HIV care.
Dermatologic Complications of HIV
Authors: Mutyambizi Kudakwashe , Bolduc Philip
Published: August 2022

This chapter describes the dermatologic complications of HIV infection and treatment. The chapter includes information about the incidence, presentation, and management of inflammatory dermatoses in HIV, including seborrheic dermatitis, psoriasis, atopic dermatitis and xerosis, papular pruritic eruption of AIDS, and HIV-associated eosinophilic pustular folliculitis. In addition, common and important cutaneous adverse drug reactions among people with HIV and management factors are presented for antiretroviral drug classes. Lastly, learners are presented with information on the diagnosis and management of viral, fungal, bacterial, and parasitic opportunistic infections occurring in HIV patients and presentation and treatment of cancers associated with HIV and aging.
Ethical Conduct of Clinical Trials, Institutional Review Boards, Informed Consent, and Financial Conflicts of Interest
Authors: Bortner Adam C. , Ramers Christian B.
Published: August 2022

This chapter discusses the essential components of the ethical code of conduct, including the roles of institutional review boards, informed consent, and disclosing financial conflicts of interest, for clinicians participating in clinical trials related to HIV medicine. The chapter also provides an overview of perceptions and misperceptions that patients may experience and updated guidance from the Food and Drug Administration on diversity of participants in clinical trials.
Chronic pulmonary aspergillosis is common among patients with presumed tuberculosis relapse in Ghana
Authors: Ocansey Bright K , Otoo Benjamin , Adjei Abraham , Gbadamosi Hafisatu , Kotey Fleischer C N , Kosmidis Chris , Afriyie-Mensah Jane S , Denning David W , Opintan Japheth A
Published: August 2022

Chronic pulmonary aspergillosis (CPA) may mimic pulmonary tuberculosis (PTB). The two diseases are clinically indistinguishable and may result in CPA misdiagnosed as PTB or vice versa. Although PTB is largely recognised as a differential diagnosis of CPA and often ruled out prior to CPA diagnosis, the reverse is uncommon. The aim of this study was to determine the proportion of CPA cases among patients being assessed for PTB. A cross-sectional survey was conducted among consecutive patients referred for GeneXpert Mycobacterium tuberculosis test for the diagnosis of PTB at the Korle-Bu Teaching Hospital, Accra, Ghana. Patients’ demographics, clinical and socioeconomic details were obtained using a structured questionnaire. Blood was collected for Aspergillus and HIV serology, and sputum samples obtained for Aspergillus culture. Chest radiograph was obtained, and computed tomography scan was also done for patients with positive Aspergillus serology or cavitation. CPA was defined using an algorithm developed by the Global Action for Fungal Infections (GAFFI) international expert panel. A total of 154 patients were included in the analysis, of whom 134 (87%) did not have a prior PTB diagnosis. There were 41 (26.6%) GeneXpert positive cases. CPA prevalence was 9.7% overall, but 50% in patients with a prior history of PTB and 3.7% in those without previous PTB. Although CPA is rarely considered as a differential diagnosis of PTB in Ghana, our findings show that CPA may affect half of patients being assessed for PTB relapse. Efforts to diagnose CPA should be prioritised in this patient group.
A new estimate of galaxy mass-to-light ratios from flexion lensing statistics
Authors: Fabritius Joseph M , Goldberg David M
Published: August 2022

We perform a flexion-based weak gravitational analysis of the first two Hubble Frontier Field clusters: Abell 2744 and MACS 0416. A parametric method for using radially projected flexion signals as a probe of cluster member mass is described in detail. The normalization and slope of a L − θE (as a proxy for L − σ) scaling relation in each cluster is determined using measured flexion signals. A parallel field analysis is undertaken concurrently to provide a baseline measure of method effectiveness. We find an agreement in the Faber–Jackson slope ℓ associated with galaxy age and morphology for both clusters, as well as a theoretical distinction in the cluster normalization mass.
Origination of LTR Retroelement–Derived NYNRIN Coincides with Therian Placental Emergence
Authors: Plianchaisuk Arnon , Kusama Kazuya , Kato Kiyoko , Sriswasdi Sira , Tamura Kazuhiro , Iwasaki Wataru
Published: August 2022

The emergence of the placenta is a revolutionary event in the evolution of therian mammals, to which some LTR retroelement–derived genes, such as PEG10, RTL1, and syncytin, are known to contribute. However, therian genomes contain many more LTR retroelement–derived genes that may also have contributed to placental evolution. We conducted large-scale evolutionary genomic and transcriptomic analyses to comprehensively search for LTR retroelement–derived genes whose origination coincided with therian placental emergence and that became consistently expressed in therian placentae. We identified NYNRIN as another Ty3/Gypsy LTR retroelement–derived gene likely to contribute to placental emergence in the therian stem lineage. NYNRIN knockdown inhibited the invasion of HTR8/SVneo invasive-type trophoblasts, whereas the knockdown of its nonretroelement-derived homolog KHNYN did not. Functional enrichment analyses suggested that NYNRIN modulates trophoblast invasion by regulating epithelial-mesenchymal transition and extracellular matrix remodeling and that the ubiquitin-proteasome system is responsible for the functional differences between NYNRIN and KHNYN. These findings extend our knowledge of the roles of LTR retroelement–derived genes in the evolution of therian mammals.
Onepot-Seq: capturing single-cell transcriptomes simultaneously in a continuous medium via transient localization of mRNA
Authors: Shin Dongju , Choi Jungwon , Lee Ji Hyun , Bang Duhee
Published: August 2022

The development of single-cell RNA-seq has broadened the spectrum for biological research by providing a high-resolution analysis of cellular heterogeneity. However, the requirement for sophisticated devices for the compartmentalization of cells has limited its widespread applicability. Here, we develop Onepot-Seq, a device-free method, that harnesses the transient localization of mRNA after lysis to capture single-cell transcriptomes simultaneously in a continuous fluid medium. In mixed-species experiments, we obtained high-quality single-cell profiles. Further, cell type-specific poly(A)-conjugated antibodies allow Onepot-Seq to effectively capture target cells in complex populations. Chemical perturbations to cells can be profiled by Onepot-Seq at single-cell resolution. Onepot-Seq should allow routine transcriptional profiling at single-cell resolution, accelerating clinical and scientific discoveries in many fields of science.
Designs for Science Literacy: with companion CD-ROM
Authors: American Association for the Advancement of Science
Published: August 2022

The call for science curriculum reform has been made over and over again for much of the twentieth century. Arguments have been made that the content of the curriculum is not appropriate for meeting the individual and social needs of people living in the modern world; that the curriculum has become overstuffed with topics and does not serve students especially well; and above all, that the curriculum does not generate the student learning it is expected to produce. The latest volume in a continuing series of publications from the AAAS designed to reform science education, Designs for Science Literacy presupposes that curriculum reform must be considerably more extensive and fundamental than the tinkering with individual courses and subjects that has been going on for decades. Designs deals with the critical issues involved in assembling sound instructional materials into a new, coherent K-12 whole. The book pays special attention to the need to link science-oriented studies to the arts and humanities, and also proposes how to align the curriculum with an established set of learning goals while preserving the American tradition of local responsibility for the curriculum itself. If fundamental curriculum reform is ever to occur, a new process for creating alternatives will have to be developed. Designs for Science Literacy provides the groundwork for such a process.
Curriculum Specifications
Authors: American Association for the Advancement of Science
Published: August 2022

Although the general principles of design may apply widely, as has been argued, they have to be shaped to respond to the kind of thing to be designed, whether a ballet, a housing development, or any other object, event, or system. How can we best characterize the essential features of the K-12 curriculum? In answering, the chapter starts with a more or less standard definition of curriculum and recasts it in more structural terms. Curriculum structure, content, and operation are discussed, and a case is made along the way for developing and using curriculum graphics to facilitate thinking about those salient aspects of curriculum design. Judging by how people talk about it, “curriculum” may be thought of as anything from what is written down in official district documents to what actually goes on in classrooms day to day. To complicate matters, curricula are often spoken of in terms of one or another of their special features (such as liberal arts, Great Books, language-immersion, activity-based, assessment-based, and—these days—standards-based curricula), in terms of students tracks (giving us college-preparatory, vocational, and “general” curricula), in terms of subject matter (the reading, mathematics, and Spanish curricula, for instance), and much else. In books on K-12 “curriculum,” a curriculum is usually treated as a collection of courses, where a “course” is an educational unit usually at the high-school or middle-school level, consisting of a series of instruction periods (such as lectures, discussions, and laboratory sessions) dealing with a particular subject. “Courses” are usually a year or a semester long, but quarter or trimester courses and courses spanning several years are becoming more common. In earlier grades, curriculum is more typically described in terms of “subjects.” Courses and subjects are themselves often subdivided into “units,” which run from only a few days to a few weeks. For purposes of designing an entire K-12 curriculum, the component parts should be quite large—more like a course in extent than like a teaching unit.
How It Could be: Three Stories
Authors: American Association for the Advancement of Science
Published: August 2022

The purpose of these stories is to suggest how curriculum reform could proceed using the ideas laid out in the preceding chapters. Written from the perspective of a time a decade or so in the future, they tell how three quite different school districts went about creating new designs for their K-12 curricula. The Palladio Unified, Edmond Halley, and Lewis & Clark Regional school districts don’t actually exist, except in our imagination, so we can purport to know everything about them and exactly what transpired. The stories in this chapter are most directly about the science, mathematics, and technology components of the curriculum, but much of the account is relevant to other subjects and to the entire curriculum as well. Never mind that these stories are made up. The intent here is to provoke fresh thinking about how we can get beyond marginal change in curriculum, not to prescribe a sure cure for current curriculum ills. Although in each case the reform process is presented as a series of steps, in the real world of schools, things happen in parallel and in loops. Stepwise presentation merely makes it possible to consider and describe the components of curriculum reform. As in architectural design, curriculum design draws as much on the spirit of art as on the spirit of engineering, and hence it inevitably involves compromise between form and function, between respect for the past and an eye for the future, between intellectual integrity and political reality. Knowledgeable readers will recognize that these tales make no effort to deal with any number of serious impediments to the realization of reform in K-12 education. The tales focus narrowly on the process of K-12 curriculum design writ large—not on turning a curriculum design into an actual curriculum and not on operating a curriculum once it is place. In fact, of course, little of that can possibly happen unless the conditions listed in Chapter 3’s Setting the Stage section are realized: consensus on the need for reform, well-developed and evaluated curriculum blocks, better prepared teachers and administrators, supportive policies, and adequate resources.
Nude Bodies in British Women’s Magazines at the Turn of the 1970s: Agency, Spectatorship, and the Sexual Revolution
Authors: Payling Daisy , Loughran Tracey
Published: August 2022

Around the turn of the 1970s, women’s magazines began to feature naked female bodies in advertisements for health and beauty products. By the mid-1970s, this nudity had largely disappeared. This article examines the reasons for this spike in nude images, the types of nakedness depicted, and what this tells us about prevalent attitudes to femininity, sexuality and women’s ‘liberation’. Focusing on representations of naked female bodies allows us to explore definitions and operations of sexual ‘knowledge’, especially the role of mass media sources in influencing inchoate ideas about sex and sexuality. In this way, we consider the complex interaction between representation and experience in constructions of sexual knowledge, challenge theories placing women as passive objects of the male gaze and nuance notions of female agency in ‘sexual revolution’.
Effectors from a Bacterial Vector-Borne Pathogen Exhibit Diverse Subcellular Localization, Expression Profiles, and Manipulation of Plant Defense
Authors: Reyes Caldas Paola A. , Zhu Jie , Breakspear Andrew , Thapa Shree P. , Toruño Tania Y. , Perilla-Henao Laura M. , Casteel Clare , Faulkner Christine R. , Coaker Gitta
Published: August 2022

Climate change is predicted to increase the prevalence of vector-borne disease due to expansion of insect populations. ‘ Candidatus Liberibacter solanacearum’ is a phloem-limited pathogen associated with multiple economically important diseases in solanaceous crops. Little is known about the strategies and pathogenicity factors ‘ Ca. L. solanacearum’ uses to colonize its vector and host. We determined the ‘ Ca. L. solanacearum’ effector repertoire by predicting proteins secreted by the general secretory pathway across four different ‘ Ca. L. solanacearum’ haplotypes, investigated effector localization in planta, and profiled effector expression in the vector and host. The localization of ‘ Ca. L. solanacearum’ effectors in Nicotiana spp. revealed diverse eukaryotic subcellular targets. The majority of tested effectors were unable to suppress plant immune responses, indicating they possess unique activities. Expression profiling in tomato and the psyllid Bactericera cockerelli indicated ‘ Ca. L. solanacearum’ differentially interacts with its host and vector and can switch effector expression in response to these environments. This study reveals ‘ Ca. L. solanacearum’ effectors possess complex expression patterns, target diverse host organelles and the majority are unable to suppress host immune responses. A mechanistic understanding of ‘ Ca. L. solanacearum’ effector function will reveal novel targets and provide insight into phloem biology.

[Formula: see text] Copyright © 2022 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Virulence Variability and Genetic Diversity in Blumeria graminis f. sp. hordei in Southeastern and Southwestern China
Authors: Wang Yanyu , Zhang Guoxin , Wang Fengtao , Lang Xiaowei , Zhao Xiaoqian , Zhu Jinghuan , Hu Chaoyue , Hu Jinghuang , Zhang Yanxia , Yao Xiaobo , Liu Haifeng , Ma Ting , Niu Yi , Wang Zhaodi , Feng Jing , Wangmu  , Lin Ruiming
Published: August 2022

Powdery mildew is a key airborne foliar disease of barley in southeastern and southwestern China. Barley varieties usually partially or wholly lose resistance to the pathogen Blumeria graminis (DC.) f. sp. hordei 3 to 5 years after release due to the frequent acquirements of new virulences in the pathogen population. However, no B. graminis f. sp. hordei virulence detection has been carried out in the recent decade and, thus, no information is available on the present virulence components and major pathotypes in epidemic regions. Twenty-one near-isogenic lines of Pallas were selected to detect B. graminis f. sp. hordei virulence variation, with 97 pathotypes identified from the isolates collected from 2015 to 2019. The virulence complexities ranged from 1 to 12, with 1.5 isolates on average assigned per pathotype, suggesting a natural trait of high pathotype diversity and low virulence complexity in the Chinese B. graminis f. sp. hordei populations. Eleven high-virulence pathotypes were detected in the traditional barley-growing regions in Yunnan and Zhejiang. Six virulent pathotypes to resistance gene mlo-5 were detected only in the two traditional epidemic regions, with a virulence frequency (VF) of 4.8% (7 of 147). Compared with the results from a decade ago, VFs for resistance alleles Mla3, mlo-5, Mla6 + Mla14, Mla7 + Mlk, Mlg + MlCP, and Mla13 + MlRu3 + MlaRu4 increased from 0 to 0.7 to 25.8%. Isolates from Yunnan and Zhejiang had similar virulence profiles, which differed from those identified in Tibet. In addition, genetic diversities differed in the isolate groups collected from Tibet, Yunnan, and Zhejiang.
Characterization of Pseudomonas syringae Strains Associated with Shoot Blight of Raspberry and Blackberry in Serbia
Authors: Ivanović Milan , Prokić Anđelka , Gašić Katarina , Menković Jelena , Kuzmanović Nemanja , Zlatković Nevena , Obradović Aleksa
Published: August 2022

During May 2016, severe blight symptoms were observed in several raspberry and blackberry fields in Serbia. In total, 22 strains were isolated: 16 from symptomatic raspberry shoots, 2 from asymptomatic raspberry leaves, and 4 from symptomatic blackberry shoots. Additionally, eight raspberry strains, isolated earlier from two similar outbreaks, were included in the study. Pathogenicity of the strains was confirmed on detached raspberry and blackberry shoots by reproducing the symptoms of natural infection. The strains were Gram-negative, fluorescent on King’s medium B, ice nucleation positive, and utilized glucose oxidatively. All strains were levan positive, oxidase negative, nonpectolytic, arginine dihydrolase negative, and induced hypersensitivity in tobacco leaves (LOPAT + − − − +, Pseudomonas group Ia). Furthermore, all strains liquefied gelatin and hydrolyzed aesculin but did not show tyrosinase activity or utilize tartrate (GATTa + + − −). Tentative identification using morphology, LOPAT, GATTa, and ice-nucleating ability tests suggested that isolated strains belong to Pseudomonas syringae. The syrB gene associated with syringomycin production was detected in all strains. DNA fingerprints with REP, ERIC, and BOX primers generated identical profiles for 29 strains, except for strain KBI 222, which showed a unique genomic fingerprint. In all, 9 of 10 selected strains exhibited identical sequences of four housekeeping genes: gyrB, rpoD, gapA, and gltA. Five nucleotide polymorphisms were found in strain KBI 222 at the rpoD gene locus only. In the phylogenetic tree based on a concatenated sequence of all four housekeeping genes, strains clustered within phylogroup 2 (i.e., genomospecies 1) of the P. syringae species complex, with pathotype strains of P. syringae pv. aceris and P. syringae pv. solidagae as their closest relatives. There was no correlation between genotype and geographic origin, particular outbreak, host, or cultivar.
Bone marrow transplantation as a therapy for autosomal dominant osteopetrosis type 2 in mice
Authors: Alam Imranul , Gerard‐O'Riley Rita L. , Acton Dena , Hardman Sara L. , Murphy Madeline , Alvarez Marta B. , Blosser Rachel J. , Sinn Anthony , Srour Edward F. , Kacena Melissa A. , Econs Michael J.
Published: August 2022

Autosomal dominant osteopetrosis type II (ADO2) is a heritable bone disease of impaired osteoclastic bone resorption caused by missense mutations in the chloride channel 7 (CLCN7) gene. Clinical features of ADO2 include fractures, osteomyelitis of jaw, vision loss, and in severe cases, bone marrow failure. Currently, there is no effective therapy for ADO2, and patients usually receive symptomatic treatments. Theoretically, bone marrow transplantation (BMT), which is commonly used in recessive osteopetrosis, could be used to treat ADO2, although the frequency of complications related to BMT is quite high. We created an ADO2 knock‐in (p.G213R mutation) mouse model on the 129 genetic background, and their phenotypes mimic the human disease of ADO2. To test whether BMT could restore osteoclast function and rescue the bone phenotypes in ADO2 mice, we transplanted bone marrow cells from 6–8 weeks old male WT donor mice into recipient female ADO2 mice. Also, to determine whether age at the time of transplant may play a role in transplant success, we performed BMT in young (12‐week‐old) and old (9‐month‐old) ADO2 mice. Our data indicate that ADO2 mice transplanted with WT marrow achieved more than 90% engraftment up to 6 months post‐transplantation at both young and old ages. The in‐vivo DXA data revealed that young ADO2 mice transplanted with WT marrow had significantly lower whole body and spine areal bone mineral density (aBMD) at month 6 post‐transplantation compared to the ADO2 control mice. The old ADO2 mice also displayed significantly lower whole body, femur, and spine aBMD at months 4 and 5 post‐transplantation compared to the age‐matched control mice. The in‐vivo micro‐CT data showed that ADO2 experimental mice transplanted with WT marrow had significantly lower BV/TV at months 2 and 4 post‐transplantation compared to the ADO2 control mice at a young age. In contrast, ADO2 control and experimental mice displayed similar BV/TV values for all post‐transplantation time points at old age. In addition, serum CTX was significantly higher at month 2 post‐transplantation in both young and old ADO2 experimental mice compared to the ADO2 control mice. Serum P1NP levels in young ADO2 experimental mice were significantly higher at baseline and month 2 post‐transplantation compared to the ADO2 control mice. These data suggest that BMT may provide, at least, some beneficial effect at both young and adult ages.
Wildfire Smoke Exposure Is Associated with Adverse Respiratory Events under General Anesthesia in At-risk Pediatric Patients
Authors: Marsh Benjamin J. , Kolodzie Kerstin , Robinowitz David , Jacobson Adam , Ferschl Marla
Published: August 2022

Background

Increasing wildfire activity worldwide has led to exposure to poor air quality and numerous detrimental health impacts. This study hypothesized an association between exposure to poor air quality from wildfire smoke and adverse respiratory events under general anesthesia in pediatric patients.

Methods

This was a single-center retrospective double-cohort study examining two significant wildfire events in Northern California. Pediatric patients presenting for elective surgery during periods of unhealthy air quality were compared with those during periods of healthy air quality. The primary exposure, unhealthy air, was determined using local air quality sensors. The primary outcome was the occurrence of an adverse respiratory event under anesthesia. Secondary analysis included association with other known risk factors for adverse respiratory events.

Results

A total of 625 patients were included in the analysis. The overall risk of a respiratory complication was 42.4% (265 of 625). In children without a history of reactive airway disease, the risk of adverse respiratory events did not change during unhealthy air periods (102 of 253, 40.3%) compared with healthy air periods (95 of 226, 42.0%; relative risk 0.96 [0.77 to 1.19], P = 0.703). In children with a history of reactive airway disease, the risk of adverse respiratory events increased from 36.8% (25 of 68) during healthy air periods to 55.1% (43 of 78) during periods with unhealthy air (1.50 [1.04 to 2.17], P = 0.032). The effect of air quality on adverse respiratory events was significantly modified by reactive airways disease status (1.56 [1.02 to 2.40], P = 0.041).

Conclusions

Pediatric patients with underlying risk factors for respiratory complications under general anesthesia had a greater incidence of adverse respiratory events during periods of unhealthy air quality caused by wildfire smoke. In this vulnerable patient population, postponing elective anesthetics should be considered when air quality is poor.

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Anatomical Characteristics and Variations of Thoracic Segmental Arteries with 3-dimensional CT Analysis
Authors: Yamada Yohei , Demura Satoru , Kato Satoshi , Shinmura Kazuya , Yokogawa Noriaki , Handa Makoto , Annen Ryohei , Kobayashi Motoya , Nagatani Satoshi , Tsuchiya Hiroyuki
Published: August 2022

Study Design.

Observational study using retrospective contrast-enhanced computed tomography (CT) analysis.

Objective.

This study aimed to investigate the anatomical characteristics and variations of the thoracic segmental arteries.

Summary of Background Data.

Few cadaver studies of segmental arteries to the thoracic spine have been reported; however, no previous studies have reported the use of contrast-enhanced CT in the upper to middle thoracic spine. Detailed anatomical information of the thoracic segmental arteries is essential to avoid vascular injuries in thoracic spine surgery, such as in the anterior and posterior approaches and minimally invasive surgery.

Methods.

Patients who underwent CT angiography of the thoracic spine between 2012 and 2021 were retrospectively analyzed. The pathways of the thoracic segmental arteries were reviewed. Anatomical differences depending on the vertebral level and right/left segmental arteries were investigated.

Results.

Thirty-one patients (15 men and 16 women; mean age 55.8 y) with 591 segmental arteries were surveyed. The distribution of segmental arteries differed depending on the vertebral level, which ran more longitudinally in the upper thoracic region and transversely in the lower thoracic region. Common trunks were frequently observed in the segmental arteries of T3-5. Segmental arteries frequently crossed the discs in the right anterior and left middle areas of the thoracic spine, whereas in the T4/5 discs, segmental arteries crossed the discs over a wide area. The presence of multiple segmental arteries within a single vertebra was higher at the T5-7 vertebral level.

Conclusion.

The distribution of the segmental arteries was asymmetrical and varied depending on the vertebral level. In the upper to middle thoracic, segmental arteries ran at every position of the vertebral body due to their longitudinal nature and the presence of multiple segmental arteries within a single vertebra, especially in T5-7. The results of this study provide critical information for thoracic spine surgery.
Point-of-Care Lung Ultrasound Predicts Severe Disease and Death Due to COVID-19: A Prospective Cohort Study
Authors: Blair Paul W. , Siddharthan Trishul , Liu Gigi , Bai Jiawei , Cui Erja , East Joshua , Herrera Phabiola , Anova Lalaine , Mahadevan Varun , Hwang Jimin , Hossen Shakir , Seo Stefanie , Sonuga Olamide , Lawrence Joshua , Peters Jillian , Cox Andrea L. , Manabe Yukari C. , Fenstermacher Katherine , Shea Sophia , Rothman Richard E. , Hansoti Bhakti , Sauer Lauren , Crainiceanu Ciprian , Clark Danielle V.
Published: August 2022

OBJECTIVES:

The clinical utility of point-of-care lung ultrasound (LUS) among hospitalized patients with COVID-19 is unclear.

DESIGN:

Prospective cohort study.

SETTING:

A large tertiary care center in Maryland, between April 2020 and September 2021.

PATIENTS:

Hospitalized adults (≥ 18 yr old) with positive severe acute respiratory syndrome coronavirus 2 reverse transcriptase-polymerase chain reaction results.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

All patients were scanned using a standardized protocol including 12 lung zones and followed to determine clinical outcomes until hospital discharge and vital status at 28 days. Ultrasounds were independently reviewed for lung and pleural line artifacts and abnormalities, and the mean LUS Score (mLUSS) (ranging from 0 to 3) across lung zones was determined. The primary outcome was time to ICU-level care, defined as high-flow oxygen, noninvasive, or invasive mechanical ventilation, within 28 days of the initial ultrasound. Cox proportional hazards regression models adjusted for age and sex were fit for mLUSS and each ultrasound covariate. A total of 264 participants were enrolled in the study; the median age was 61 years and 114 participants (43.2%) were female. The median mLUSS was 1.0 (interquartile range, 0.5–1.3). Following enrollment, 27 participants (10.0%) went on to require ICU-level care, and 14 (5.3%) subsequently died by 28 days. Each increase in mLUSS at enrollment was associated with disease progression to ICU-level care (adjusted hazard ratio [aHR], 3.61; 95% CI, 1.27–10.2) and 28-day mortality (aHR, 3.10; 95% CI, 1.29–7.50). Pleural line abnormalities were independently associated with disease progression to death (aHR, 20.93; CI, 3.33–131.30).

CONCLUSIONS:

Participants with a mLUSS greater than or equal to 1 or pleural line changes on LUS had an increased likelihood of subsequent requirement of high-flow oxygen or greater. LUS is a promising tool for assessing risk of COVID-19 progression at the bedside.
Ultrasound-guided selective trunk block: Evaluation of ipsilateral sensorimotor block dynamics, hemidiaphragmatic function and efficacy for upper extremity surgery. A single-centre cohort study
Authors: Sivakumar Ranjith Kumar , Samy Winnie , Pakpirom Jatuporn , Songthamwat Banchobporn , Karmakar Manoj Kumar
Published: August 2022

BACKGROUND

Selectively locating and blocking the individual trunks of the brachial plexus with small volumes of local anaesthetic, a selective trunk block (SeTB), may produce anaesthesia of the entire upper extremity except for the T2 dermatome.

OBJECTIVE

This study aimed to evaluate the effects of an ultrasound-guided (USG) SeTB on ipsilateral sensorimotor block dynamics, hemidiaphragmatic function, and efficacy as an all-purpose regional anaesthetic technique for upper extremity surgery.

DESIGN

Prospective cohort study.

SETTING

Single-centre, university hospital in Hong Kong, China from February 2021 to July 2021.

PATIENTS

Thirty patients (aged 53.2 ± 14.8 years and BMI 23.8 ± 3.6 kg m
-2), ASA physical status I to III, scheduled for upper extremity surgery under a brachial plexus block.

INTERVENTIONS

USG SeTB with 25 ml (7, 8 and 10 ml to the superior, middle and inferior trunks, respectively) of a 1 : 1 mixture of 2% lidocaine with 1 : 200 000 epinephrine and 0.5% levobupivacaine.

MAIN OUTCOME MEASURES

Ipsilateral sensorimotor blockade of the suprascapular (only motor), axillary, radial, ulnar, median and musculocutaneous nerves were assessed at regular intervals for 45 min. Ipsilateral hemidiaphragmatic excursion was also measured, at 30 min after the SeTB, using M-mode ultrasound. The SeTB was considered a success if it was possible to complete surgery without any rescue analgesia or conversion to general anaesthesia.

RESULTS

Complete motor blockade of the suprascapular nerve was achieved in median [range] 5 [5 to 15] min. Complete sensory and motor blockade were achieved in all the other 5 nerves in 17.5 [10 to 30] and 15 [10 to 30] min respectively. The SeTB was successful in 93% and ipsilateral hemidiaphragmatic paresis (HDP) was present in 82%, of patients.

CONCLUSION

SeTB produces sensorimotor blockade of the entire upper extremity, causes ipsilateral HDP, and is effective as the sole anaesthetic for surgery from the proximal humerus to the hand.

TRIAL REGISTRION

ClinicalTrials.gov, Trial Registration No: NCT 04752410, Date submitted for Registration: 09 February 2021, Date first posted: 12 February 2021, Dates of patient enrolment: 19 February 2021 to 27 July 2021 (https://clinicaltrials.gov/ct2/show/NCT04752410).
Diagnosis and management of hypertension in patients with Cushing's syndrome: a position statement and consensus of the Working Group on Endocrine Hypertension of the European Society of Hypertension
Authors: Fallo Francesco , Di Dalmazi Guido , Beuschlein Felix , Biermasz Nienke R. , Castinetti Frederic , Elenkova Atanaska , Fassnacht Martin , Isidori Andrea M. , Kastelan Darko , Korbonits Márta , Newell-Price John , Parati Gianfranco , Petersenn Stephan , Pivonello Rosario , Ragnarsson Oskar , Tabarin Antoine , Theodoropoulou Marily , Tsagarakis Stylianos , Valassi Elena , Witek Przemysław , Reincke Martin
Published: August 2022

Endogenous/exogenous Cushing's syndrome is characterized by a cluster of systemic manifestations of hypercortisolism, which cause increased cardiovascular risk. Its biological basis is glucocorticoid excess, acting on various pathogenic processes inducing cardiovascular damage. Hypertension is a common feature in Cushing's syndrome and may persist after normalizing hormone excess and discontinuing steroid therapy. In endogenous Cushing's syndrome, the earlier the diagnosis the sooner management can be employed to offset the deleterious effects of excess cortisol. Such management includes combined treatments directed against the underlying cause and tailored antihypertensive drugs aimed at controlling the consequences of glucocorticoid excess. Experts on endocrine hypertension and members of the Working Group on Endocrine Hypertension of the European Society of Hypertension (ESH) prepared this Consensus document, which summarizes the current knowledge in epidemiology, genetics, diagnosis, and treatment of hypertension in Cushing's syndrome.