bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of the antibacterial envelope to prevent cardiac implantable electronic device infection in a high-risk population
Authors: Chaudhry Uzma , Borgquist Rasmus , Smith J Gustav , Mörtsell David
Published: August 2022

Aims

Infection is a serious complication of cardiac implantable electronic device (CIED) therapy. An antibiotic-eluting absorbable envelope has been developed to reduce the infection rate, but studies investigating the efficacy and a reasonable number needed to treat in high-risk populations for infections are limited.

Methods and results

One hundred and forty-four patients undergoing CIED implantation who received the antibacterial envelope were compared with a matched cohort of 382 CIED patients from our institution. The primary outcome was the occurrence of local infection, and secondary outcomes were any CIED-related local or systemic infections, including endocarditis, and all-cause mortality. The results were stratified by a risk score for CIED infection, PADIT. The envelope group had a higher PADIT score, 5.9 ± 3.1 vs. 3.9 ± 3.0 (P < 0.0001). For the primary endpoint, no local infections occurred in the envelope group, compared with 2.6% in the control group (P = 0.04), with a more pronounced difference in the stratum with a high (>7 points) PADIT score, 0 vs. 9.9% (P = 0.01). The total CIED-related infections were similar between groups, 6.3% compared with 5.0% (P = 0.567). Mortality after 1600 days of follow-up did not differ between groups, 22.9 vs. 26.4%, P = 0.475.

Conclusion

Our study confirms the clinical efficacy of an antibacterial envelope in the prevention of local CIED infection in patients with a higher risk according to the PADIT score. In an effort to improve cost–benefit ratios, ration of use guided by the PADIT score is advocated. Further prospective randomized studies in high-risk populations are called for.
Young Adult Male Patients With Childhood-onset IBD Have Increased Risks of Compromised Cortical and Trabecular Bone Microstructures
Authors: Sigurdsson Gudmundur Vignir , Schmidt Susanne , Mellström Dan , Ohlsson Claes , Saalman Robert , Lorentzon Mattias
Published: August 2022

Background

Young adults with childhood-onset inflammatory bowel disease (IBD) have increased risks of low areal bone mineral density and low skeletal muscle mass. Volumetric BMD (vBMD), bone geometry and microstructures, in addition to possible associations with skeletal muscle index (SMI) and physical exercise have been scarcely studied in this patient group.

Patients and methods

In total, 49 young adult male patients with childhood-onset IBD and 245 age- and height-matched young adult male controls were scanned with high-resolution peripheral quantitative computed tomography. Bone geometry, vBMD, and bone microstructures were calculated as median values and compared between the patients and controls. Multivariable linear regression analyses were performed to determine the independent associations among IBD diagnosis, SMI (kg/m2), and physical exercise.

Results

The group of young adult patients had, in comparison with the controls, significantly smaller median cortical area (126.1 mm2 vs151.1 mm2, P < .001), lower median total vBMD (296.7 mg/cm3 vs 336.7 mg/cm3, P < .001), and lower median cortical vBMD (854.4 mg/cm3 vs 878.5 mg/cm3, P < .001). Furthermore, the patients compared with the controls had lower median trabecular volume fraction (16.8% vs 18.2%, P < .001) and thinner median trabeculae (0.084 mm vs 0.089 mm, P < .001). The differences between the patients with IBD and controls persisted in multivariable analyses that included adjustments for SMI and physical exercise.

Conclusions

Young adult men with childhood-onset IBD are at increased risk of having reduced bone quality in both the cortical and trabecular bone structures compared with normative matched controls.
Research on carbon emissions of urban residents’ three types of dining based on the whole life cycle
Authors: Zhao Zimo , Lv Xiuyuan , Wang Yuanhao , Lv Guangfeng , Miao Bo , Hu Qing , Ouyang Cheng , Liu Yukun , Yan Luhui
Published: August 2022

Following the promulgation and implementation of China’s ‘carbon peak’ and ‘carbon neutrality’ policies, the evaluation of the carbon footprint of the domestic catering industry is particularly important. Currently, comparative studies on the life-cycle carbon footprint of different common dining styles, such as home cooking, restaurant dining and takeaway, are scarce. Focused on three dining methods, this paper involved in-depth research on carbon footprint of the whole life cycle from the perspectives of whole industry and specific dish. The carbon footprint contribution of each stage of three different dining ways is obtained from the four stages, namely, the stage of upstream raw materials and manufactures, the stage of platform empowerment, the stage of consumer dining and the stage of waste treatment. The study found that the carbon emissions of the three dining ways in the overall industry analysis were canteen (2.9564 kgCO2e/per person) > takeaway (2.4821 kgCO2e/per person) > home cooking (2.2778 kgCO2e/per person); and the carbon emissions of honey sauce fork-fired were canteen (6.5843 kgCO2e/per person) > home cooking (6.4721 kgCO2e/per person) > takeaway (5.6718 kgCO2e/per person). The production of raw materials and products is the largest stage of carbon emissions among the three dining ways. Besides the carbon emissions of raw materials, the storage and cooking of food products are the unit processes with large carbon emissions. According to the results of sensitivity analysis, traffic travel mode is an important factor affecting the carbon footprint of canteen food. The above research can provide effective basis and data support for policy formulation.
Intestinal ischemia in a patient with vascular malformation: a recipe for disaster
Authors: Fuentes Germanico , Molina Gabriel A , Jiménez Marie A , Espinoza Sindy M , Lara A Gabriela , Enriquéz Juan J , Ayala Andres V , Jiménez Galo , Rubio Cristina B
Published: August 2022

Anatomical variations of the celiac and mesenteric artery have been described over the past two centuries; many of these variations will have no clinical repercussions and will only be found incidentally or during imaging studies. However, these variations can lead to severe complications if undetected during surgery, transplantation or when they are affected by ischemia. Therefore, prompt treatment is needed to overcome these dangerous scenarios. We present the case of a 71-year-old patient who had a celiacomesenteric trunk and developed transient intestinal ischemia; however, he suffered severe acidosis and hyperlactatemia that ultimately led to organ failure and death.
Framework and content of energy transition in Southeast Asia with ASEAN and the EU
Authors: Huck Winfried , Maaß Jennifer , Sood Saparya , Benmaghnia Tahar , Heß Sarah Maylin
Published: August 2022

According to the latest Intergovernmental Panel on Climate Change (IPCC) report, energy transition and globally collaborative solutions play a crucial role in mitigating or preferably preventing human-induced global warming. Factual, legal, security policy and economic determinants shape the field of energy use, energy transition as well as tied climate change policy. Both Association of Southeast Asian Nations (ASEAN) and the EU, aware of this fact, are coordinating their endeavours to achieve a climate neutral future. This article discusses the energy transition in the ASEAN in the context of climate change considerations, the effects of this transition on people, and if and how the unique ASEAN way, law and economic governance in ASEAN are conducive to it. Here, the 45-year strategic partnership between ASEAN and the European Union (EU) provides opportunities to shape a socially just energy transition. The article shows which actors are affected by this transition, and which challenges and practical opportunities energy governance and the EU–ASEAN partnership offers. The article concludes that a long-termism approach is crucial in this regard to keep costs to a minimum by spurring concerted cooperation efforts to align and harmonize climate change goals, and ensuring a secure, sustainable energy supply. In particular, it is the absence of judicial control mechanisms for (private) actors, groups and individuals affected by the energy transition that precludes accountability and contradicts a path for extending and strengthening the fundamental concept of trust in informal governance structures in ASEAN. At the same time, it is argued that this also prevents an effective and efficient expansion of joint EU–ASEAN efforts, which for the time being, it seems, will remain political in nature with no assertive effect.
Can decaying dark matter scenarios alleviate both H0 and σ8 tensions?
Authors: Davari Zahra , Khosravi Nima
Published: August 2022

Current tensions in cosmological parameters, including H0 and σ8, provide a strong reason to suspect the existence of physics beyond the standard model of cosmology (ΛCDM). In this work, we investigate whether there is a relation between these tensions and beyond cold dark matter (CDM) scenarios. To model non-cold dark matter, we assume decaying dark matter (DDM) that is unstable and may decay into two daughter particles, a combination of cold dark matter, warm dark matter (WDM), and dark radiation, to explore a vast era of possibilities. We check our model against CMB data and show that decaying dark matter does not seem a promising candidate to address cosmological tensions. As an exception to this, when DDM decays to CDM + WDM there are hints that H0 tension may be addressed.
Standardizing reverberation-measured C iv time-lag quasars, and using them with standardized Mg ii quasars to constrain cosmological parameters
Authors: Cao Shulei , Zajaček Michal , Panda Swayamtrupta , Martínez-Aldama Mary Loli , Czerny Bożena , Ratra Bharat
Published: August 2022

We use 38 C iv quasar (QSO) reverberation-mapped observations, which span eight orders of magnitude in luminosity and the redshift range 0.001064 ≤ z ≤ 3.368, to simultaneously constrain cosmological-model and QSO radius–luminosity (R–L) relation parameters in six cosmological models, using an improved technique that more correctly accounts for the asymmetric errors bars of the time-lag measurements. We find that R–L relation parameters are independent of the cosmological models used in the analysis and so the R–L relation can be used to standardize the C iv QSOs. The C iv QSO cosmological constraints are consistent with those from Mg ii QSOs, allowing us to derive joint C iv + Mg ii QSO cosmological constraints which are consistent with currently accelerated cosmological expansion, as well as consistent with cosmological constraints derived using better-established baryon acoustic oscillation (BAO) and Hubble parameter [H(z)] measurements. When jointly analysed with H(z) + BAO data, current C iv + Mg ii QSO data mildly tighten current H(z) + BAO data cosmological constraints.
Three-point intrinsic alignments of dark matter haloes in the IllustrisTNG simulation
Authors: Pyne Susan , Tenneti Ananth , Joachimi Benjamin
Published: August 2022

We use the IllustrisTNG suite of cosmological simulations to measure intrinsic alignment (IA) bispectra of dark matter subhaloes between redshifts 0 and 1. We decompose the intrinsic shear field into E- and B- modes and find that the bispectra BδδE and BδEE, between the matter overdensity field, δ, and the E-mode field, are detected with high significance. We also model the IA bispectra analytically using a method consistent with the two-point non-linear alignment model. We use this model and the simulation measurements to infer the IA amplitude AIA and find that values of AIA obtained from IA power spectra and bispectra agree well at scales up to $k_\mathrm{max}= 2 \, h \mathrm{Mpc}^{-1}$. For example at z = 1, AIA = 2.13 ± 0.02 from the cross power spectrum between the matter overdensity and E-mode fields and AIA = 2.11 ± 0.03 from BδδE. This demonstrates that a single physically motivated model can jointly model two-point and three-point statistics of IAs, thus enabling a cleaner separation between IAs and cosmological weak lensing signals.
Rheumatologic associations of microscopic colitis: A narrative review
Authors: Le Christopher , Zeffren Noam , Kramer Neil , Rosenstein Elliot D
Published: August 2022

Extraintestinal manifestations (EIMs) are frequent complications of the classical inflammatory bowel diseases, Crohn’s disease and ulcerative colitis. However, in addition to the classical diseases, there is a spectrum of conditions, often termed ‘microscopic colitis’ (MC), in which EIMs are less well described. Our objective was to review the literature regarding the EIMs complicating MC and describe their association with systemic autoimmune rheumatic diseases. A comprehensive search and review of peer-reviewed English-language and international journals and reports was completed based on key terms, including ‘microscopic colitis’, ‘lymphocytic colitis’, ‘collagenous colitis’, ‘inflammatory bowel disease’, and ‘extraintestinal manifestations’, and the specific disease associations utilizing the PubMed Central database and MEDLINE. A broad spectrum of rheumatologic manifestations has been reported in patients with MC. The identification of rheumatoid arthritis and limited scleroderma as comorbidities with MC was noteworthy. Inflammatory arthropathy was frequently seen in MC, usually preceding or occurring in conjunction with the onset of gastrointestinal symptoms. A variety of presentations of associated arthritis were reported: migratory, symmetric or asymmetric, peripheral or axial, oligoarticular or polyarticular, and erosive or non-erosive. There was a high incidence of autoantibodies in these patients, supporting a potential autoimmune association. On the basis of these anecdotal reports, we would suggest the development of a clinical registry to help define the incidence of EIMs and systemic autoimmune rheumatic diseases among MC patients to help elucidate shared predispositions, pathogenic mechanisms, and therapeutic opportunities.
Survey of Gravitationally lensed objects in HSC Imaging (SuGOHI). VIII. New galaxy-scale lenses from the HSC SSP
Authors: Wong Kenneth C , Chan James H H , Chao Dani C-Y , Jaelani Anton T , Kayo Issha , Lee Chien-Hsiu , More Anupreeta , Oguri Masamune
Published: August 2022

We conduct a search for galaxy-scale strong gravitational lens systems in Data Release 4 of the Hyper Suprime-Cam Subaru Strategic Program (HSC SSP), consisting of data taken up to the S21A semester. We select 103191 luminous red galaxies from the Baryon Oscillation Spectroscopic Survey (BOSS) sample that have deep multiband imaging from the HSC SSP and use the YattaLens algorithm to identify lens candidates with blue arc-like features automatically. The candidates are visually inspected and graded based on their likelihood of being a lens. We find eight definite lenses, 28 probable lenses, and 138 possible lenses. The new lens candidates generally have lens redshifts in the range 0.3 ≲ zL ≲ 0.9, a key intermediate redshift range to study the evolution of galaxy structure. Follow-up spectroscopy will confirm these new lenses and measure source redshifts to enable detailed lens modeling.
Appel à l’action : des recommandations pour améliorer la transition des jeunes ayant des besoins de santé complexes vers les soins aux adultes
Authors: Toulany Alene , Willem Gorter Jan , Harrison Megan E
Published: August 2022

Les jeunes qui ont des besoins de santé complexes, définis comme ceux qui nécessitent des soins et services spécialisés en raison d’affections physiques, développementales ou mentales, sont souvent traités par des pédiatres et autres spécialistes en pédiatrie. Au Canada, l’âge auquel les bailleurs de fonds provinciaux et territoriaux exigent le transfert des soins pédiatriques aux soins pour adultes varie entre 16 et 19 ans. La délimitation actuelle entre les services de santé pédiatriques et aux adultes est fragmentaire, ce qui entrave la continuité des soins pendant une période déjà vulnérable du développement. Le peu d’intégration des soins entre les domaines peut nuire à l’engagement des jeunes en matière de santé et compromettre leur santé à l’âge adulte. Pour renverser ces obstacles et améliorer les résultats de la transition, les dispensateurs de soins pédiatriques et de soins aux adultes, de même que les médecins de famille et d’autres partenaires communautaires, doivent collaborer de manière satisfaisante à l’élaboration de stratégies systémiques qui rationalisent et préservent les soins aux jeunes en transition vers des soins aux adultes en milieu tertiaire, communautaire et primaire. Il est recommandé de privilégier des limites d’âge flexibles pour effectuer cette transition vers les soins aux adultes et de tenir compte de la phase de développement et de l’aptitude de chaque jeune, ainsi que des besoins et de la situation de chaque patient et de chaque famille. Une formation et un enseignement spécialisés sur les enjeux liés aux soins de transition s’imposent pour renforcer les capacités et s’assurer que les professionnels de la santé des diverses disciplines et des divers milieux soient mieux outillés pour accepter et traiter les jeunes qui ont des besoins de santé complexes.
Knockout of MITOGEN-ACTIVATED PROTEIN KINASE 3 causes barley root resistance against Fusarium graminearum
Authors: Basheer Jasim , Vadovič Pavol , Šamajová Olga , Melicher Pavol , Komis George , Křenek Pavel , Králová Michaela , Pechan Tibor , Ovečka Miroslav , Takáč Tomáš , Šamaj Jozef
Published: August 2022

The roles of mitogen-activated protein kinases (MAPKs) in plant–fungal pathogenic interactions are poorly understood in crops. Here, microscopic, phenotypic, proteomic, and biochemical analyses revealed that roots of independent transcription activator-like effector nuclease (TALEN)-based knockout lines of barley (Hordeum vulgare L.) MAPK 3 (HvMPK3 KO) were resistant against Fusarium graminearum infection. When co-cultured with roots of the HvMPK3 KO lines, F. graminearum hyphae were excluded to the extracellular space, the growth pattern of extracellular hyphae was considerably deregulated, mycelia development was less efficient, and number of appressoria-like structures and their penetration potential were substantially reduced. Intracellular penetration of hyphae was preceded by the massive production of reactive oxygen species (ROS) in attacked cells of the wild-type (WT), but ROS production was mitigated in the HvMPK3 KO lines. Suppression of ROS production in these lines coincided with elevated abundance of catalase (CAT) and ascorbate peroxidase (APX). Moreover, differential proteomic analysis revealed downregulation of several defense-related proteins in WT, and the upregulation of pathogenesis-related protein 1 (PR-1) and cysteine proteases in HvMPK3 KO lines. Proteins involved in suberin formation, such as peroxidases, lipid transfer proteins (LTPs), and the GDSL esterase/lipase (containing “GDSL” aminosequence motif) were differentially regulated in HvMPK3 KO lines after F. graminearum inoculation. Consistent with proteomic analysis, microscopic observations showed enhanced suberin accumulation in roots of HvMPK3 KO lines, most likely contributing to the arrested infection by F. graminearum. These results suggest that TALEN-based knockout of HvMPK3 leads to barley root resistance against Fusarium root rot.
ILLUMINA CAMBRIDGE LTD v LATVIA MGI TECH SIA
Authors:   Patents Court
Published: August 2022

H1 Patents — European Patents — Infringement — Validity — Process claims — DNA sequencing systems — Skilled person — Common general knowledge — Construction — Normal interpretation — Equivalence — Obviousness — Hindsight — Mere collocations — Priority — Insufficiency — Added matter — Amendment
CALCULATIONS FOR THE HEAVY WATER MODERATED 252CF REFERENCE FIELDS AT PTB
Authors: Al Qaaod Amer A , Reginatto Marcel , Zbořil Miroslav , Zimbal Andreas
Published: August 2022

Knowledge of the neutron spectra of reference fields is very important for calibration purposes. This paper presents new calculations of the neutron spectra and dosimetric parameters of a D2O moderated 252Cf source assembly used to produce a neutron reference field at the Physikalisch-Technische Bundeanstalt (PTB), based on recent 252Cf fission neutron spectrum data and conversion coefficients for operational radiation protection units recommended by the International Commission on Radiological Protection (ICRP) report 57. Neutron fluence and dose calculations were carried out using a detailed simulation model of the source assembly implemented using MCNP6 and the cross-section data library ENDF/B-VIII.0. The PTB moderator was compared with the International Organization for Standardization, ISO 8529 model and to previous calculations done at PTB. The results show differences to the previous calculations performed at PTB of the order of 5% and a slight discrepancy with the ISO 8529 moderator model regarding the values of the operational quantities.
RpoN Regulon in Erwinia amylovora Revealed by Transcriptional Profiling and In Silico Binding Site Analysis
Authors: Yang Ho-Wen , Lee Jae-Hoon , Zhao Youfu
Published: August 2022

Erwinia amylovora causes a devastating fire blight disease in apples and pears. One of the main virulence determinants in E. amylovora is the hypersensitive response (HR) and pathogenicity ( hrp)-type III secretion system (T3SS), which is activated by the RpoN-HrpL sigma factor cascade. However, the RpoN regulon in E. amylovora has not been investigated. In this study, we determined the RpoN regulon in E. amylovora by combining RNA-seq transcriptomic analysis with in silico binding site analysis. RNA-seq revealed that 262 genes, approximately 7.5% genes in the genome of E. amylovora, were differentially transcribed in the rpoN mutant as compared with the wild type. Specifically, genes associated with virulence, motility, nitrogen assimilation, the PspF system, stress response, and arginine biosynthesis are positively regulated by RpoN, whereas genes associated with biosynthesis of amino acids and sorbitol transport are negatively regulated by RpoN. In silico binding site analysis identified 46 potential target genes with a putative RpoN binding site, and the upstream sequences of six, three, and three genes also contain putative GlnG, PspF, and YfhA binding sites, respectively. Overall, RpoN directly regulates genes associated with virulence, nitrogen assimilation, the PspF system, motility and the YfhA/YfhK two-component regulatory system.
Contribution of keratinocytes to dermal fibrosis
Authors: Russo Barbara , Brembilla Nicolò C. , Chizzolini Carlo
Published: August 2022

Purpose of review

The cellular pathogenesis of fibrotic disorders including systemic sclerosis (SSc) remains largely speculative. Currently, the altered function of endothelial cells and fibroblasts under the influence of an inappropriate immune response are considered central pathogenic events in SSc. Adding to this complexity, novel evidence here reviewed suggests that keratinocytes may concur in the development of skin fibrosis.

Recent findings

Epidermal equivalents (EE) generated from primary SSc keratinocytes display a distinct gene expression program when compared to healthy donor (HD) EE. SSc-EE, among others, exhibited enhanced oxidative and metabolic response pathways. Immunohistochemical studies demonstrated similarities between SSc-EE and SSc epidermis including altered keratinocyte differentiation, enhanced expression of activation markers, and reduced rate of basal keratinocytes proliferation. SSc-EE supernatants more than HD-EE modified the inflammatory and extracellular matrix deposition/resorption program of dermal fibroblasts. Further evidence indicated that the relative lack rather than the excess of interleukin-25 in keratinocytes may contribute to enhanced dermal fibrotic changes. Overall, these data support keratinocyte-intrinsic SSc-related modifications.

Improved methods for engineering epidermal and skin equivalents are helping to address the question whether keratinocyte alterations in SSc are primary and capable to dysregulate dermal homeostasis or secondary following dermal fibrotic changes.
Calcinosis in systemic sclerosis
Authors: Davuluri Srijana , Lood Christian , Chung Lorinda
Published: August 2022

Purpose of review

The aim of this study was to provide updated information on the prevalence, pathogenesis, diagnostics and therapeutics of calcinosis cutis associated with systemic sclerosis (SSc).

Recent findings

Observational studies show ethnic and geographical differences in the prevalence of calcinosis. In addition to clinical and serological associations, biochemical studies and in-vivo models have attempted to explain theories behind its pathogenesis, including prolonged state of inflammation, mechanical stress, hypoxia and dysregulation in bone and phosphate metabolism. Long-term use of proton pump inhibitors may increase the risk for calcinosis in SSc. Few single-centre observational studies have shown mild benefit with minocycline and topical sodium thiosulfate.

Calcinosis cutis is the deposition of insoluble calcium in the skin and subcutaneous tissues. It affects up to 40% of SSc patients and causes significant morbidity. Long disease duration, features of vascular dysfunction and osteoporosis have been associated with calcinosis. Altered levels of inorganic pyrophosphate and fibroblast growth factor-23 have been implicated in dysregulated phosphate metabolism that may lead to calcinosis in SSc. Plain radiography can help with diagnosis and quantifying the calcinosis burden. Surgical treatment remains the most effective therapy when feasible. At present, no medical therapies have proven efficacy in large randomized controlled trials.
“You’re O.K. Anesthesia”: Closed Reduction of Displaced Pediatric Forearm and Wrist Fractures in the Office Without Anesthesia
Authors: Livingstone John , Opanova Maria , Beaman Amanda , Radi Joshua , Izuka Byron
Published: August 2022

Background:

Angulated wrist and forearm fractures are among the most common pediatric fractures, and they often require closed reduction with anesthesia. There are several issues associated with pediatric anesthesia including the low but non-zero risk of significant complications, increased physician and staff time and effort, and increased cost. Despite these issues, there have not been any studies to prove that using anesthesia results in better outcomes or higher caregiver satisfaction in comparison to performing closed reductions without anesthesia. The purpose of this study was to evaluate the quality of closed reductions of angulated pediatric wrist and forearm fractures and to determine caregiver satisfaction with an anesthesia-free reduction technique.

Methods:

This study included 54 pediatric patients with closed, angulated fractures of the radius or combined radial and ulnar shafts. All closed reductions were performed by a single pediatric fellowship-trained orthopaedic surgeon in the office setting without any anesthesia. Radiographs were obtained to assess the quality of the reduction. At the first follow-up visit, caregivers were asked about their interim use of pain medications. Caregivers were later surveyed about patient use of analgesics and their satisfaction with an anesthesia-free reduction technique.

Results:

The average age of the 54 patients in this study was 9 years (1.8 to 16.8 y). Thirty-three fractures were combined radial and ulnar forearm shaft fractures, 18 were distal radius fractures, and 3 were radial shaft fractures. ≤10 degrees of residual angulation was achieved in 98% of patients. Nine percent (5/54) of the patients used ibuprofen or acetaminophen for pain control. Seventy eight percent (42/54) of the caregivers responded to the telephone and email surveys. All responding caregivers stated that the patients returned to full function and had satisfactory outcomes. Ninety eight percent (41/42) of the caregivers stated they would choose the same anesthesia-free reduction technique again.

Conclusions:

Closed reduction of angulated pediatric wrist and forearm fractures in the office without anesthesia can achieve satisfactory reductions and high caregiver satisfaction while eliminating the risks and complications associated with pediatric anesthesia.

Level of Evidence:

Level IV Case series.
Postneoadjuvant treatment for triple-negative breast cancer
Authors: Trapani Dario , Ferraro Emanuela , Giugliano Federica , Boscolo Bielo Luca , Curigliano Giuseppe , Burstein Harold J.
Published: August 2022

Purpose of the review

Triple-negative breast cancer (TNBC) has been conventionally associated with poor prognosis, as a result of limited therapeutic options. In the early setting, prognosis is informed by clinical–pathological factors; for patients receiving neoadjuvant treatments, pathological complete response (pCR) is the strongest factor. In this review, we mapped the landscape of clinical trials in the postneoadjuvant space, and identified three patterns of clinical trial design.

Recent findings

For patients at higher risk, effective postneoadjuvant treatments are of paramount importance to address a high clinical need. Postneoadjuvant risk-adapted treatments have demonstrated to improve survival in patients at high of recurrence.

Patients at high risk have indication for adjuvant treatment intensification, informed by baseline clinical, pathological or molecular factors (type 1 approach), on the presence, extent and molecular characteristics of the residual disease at the time of surgery (type 2) or on risk factors assessed in the postsurgical setting (type 3), for example, circulating tumour DNA. Most of the past trials were based on type 2 approaches, for example, with capecitabine and Olaparib. Few trials were based on a type 1 approach, notably pembrolizumab for early TNBC. Eventually, clinical validity of type 3 approaches is under investigation in trials.
Dysregulation and implications of N6-methyladenosine modification in renal cell carcinoma
Authors: Wu Yaohai , Zhang Shiqiang , Chen Chujie , Pang Jun
Published: August 2022

Increasing evidence indicates that N6-methyladenosine (m6A) methylation modification serves important functions in biological metabolism. Dysregulation of m6A regulators is related to the progression of different malignancies, including renal cell carcinoma (RCC). Recent studies have reported preliminary findings on the influence of m6A regulator dysregulation on RCC tumorigenesis and development. However, no comprehensive review that integrates and analyzes the roles of m6A modification in RCC has been published to date. In this review, we focus on the dysregulation of m6A regulators as it relates to RCC tumorigenesis and development, as well as possible applications of m6A modification in RCC diagnosis and therapeutics.
How Learning from Trauma Benefits the Obstetric Population? Damage Control Surgery
Authors: Vidarte María Fernanda Escobar , Nasner Daniela , Nieto-Calvache Albaro José , Echavarría María Paula , Carvajal Javier Andrés
Published: August 2022

The recent implementation of trauma-validated damage control strategies in severe postpartum hemorrhage proves the importance of interdisciplinary management in the obstetric patient. Massive hemorrhage control techniques and damage control surgery are clear examples of how learning from trauma can benefit the obstetric population. Currently, most obstetric programs do not include training in this type of interventions. Nevertheless, it has been shown that these interventions are useful in the management of severe postpartum hemorrhage. The aim of this article is to introduce the application of damage control surgery principles in the management of massive obstetric hemorrhage. We propose to include appropriate training and the implementation of damage control surgery in obstetric management protocols. The prompt application of damage control principles can be considered in patients with persistent hemodynamic instability despite control of the source of bleeding.
An Insight Into Pathophysiology, Epidemiology, and Management of Cardiovascular Complications of SARS-CoV-2 Infection, Post-acute COVID Syndrome, and COVID Vaccine
Authors: Davoudi Farideh , Miyashita Satoshi , Yoo Tae Kyung , Lee Patrick T. , Foster Gabriel P.
Published: August 2022

Coronavirus disease 2019 (COVID-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a pandemic health emergency in March 2020. Elderly patients and those with pre-existing medical conditions including cardiovascular disease are at increased risk of developing severe disease. Not only is the viral infection with SARS-CoV-2 associated with higher mortality in patients with underlying cardiovascular disease, but development of cardiovascular complications is also common in patients with COVID-19. Even after recovery from the acute illness, post-acute COVID syndrome with cardiopulmonary manifestations can occur in some patients. Additionally, there are rare but increasingly recognized adverse events, including cardiovascular side effects, reported with currently available COVID-19 vaccines. In this review, we discuss the most common cardiovascular complications of SARS-CoV-2 and COVID-19 vaccines, cardiopulmonary manifestations of post-acute COVID syndrome and the current evidence-based guidance on the management of such complications.
Tablet-Based Assessment of Cognitive Function Among Heart Failure Patients
Authors: Urban Szymon , Horożaniecka Paulina , Włodarczak Szymon , Błaziak Mikołaj , Jura Maksym , Zymliński Robert , Biegus Jan , Siennicka Agnieszka
Published: August 2022

Background:

Cognitive impairment accompanying heart failure (HF) is an additional HF comorbidity, which may potentially affect the patient’s self-care and compliance. We aimed to assess cognitive function (CF) using an application with games created as a cognitive training tool for children and adults, applied using a tablet, and to compare the results obtained by HF patients with the results obtained by healthy age-matched controls.

Methods:

A total of 69 individuals (49 HF patients and 10 healthy controls) were assessed using 4 games dedicated to measuring cognitive skills as well as questionnaires regarding their socioeconomic status. Additionally, HF patients were asked about their quality of life and anxiety and depression.

Results:

HF patients demonstrated worse results in each game assessing their cognitive functions as compared to the healthy age-matched controls, which is consistent with the previous studies on CF in HF. We have also noticed interesting patterns of relations between CF and sleep and education.

Conclusions:

We have demonstrated that information and communication technology devices can be successfully applied as feasible tools for cognitive assessment in the HF population. This is important as tablet-based CF assessment can be done on a large population without the involvement of trained personnel.
Establishing a Cardiac ICU Recovery Clinic: Characterizing a Model for Continuity of Cardiac Critical Care
Authors: Whiteside Hoyle L. , Hillerson Dustin , Buescher Victoria , Kreft Kayla , Mayer Kirby P. , Montgomery-Yates Ashley , Gupta Vedant A.
Published: August 2022

Background:

Care in the cardiovascular intensive care unit (CICU) has become increasingly intricate due to a temporal rise in noncardiac diagnoses and overall clinical complexity with high risk for short-term rehospitalization and mortality. Survivors of critical illness are often faced with debility and limitations extending beyond the index hospitalization. Comprehensive ICU recovery programs have demonstrated some efficacy but have primarily targeted survivors of acute respiratory distress syndrome or sepsis. The efficacy of dedicated ICU recovery programs on the CICU population is not defined.

Methods:

We aim to describe the design and initial experience of a novel CICU-recovery clinic (CICURC). The primary outcome was death or rehospitalization in the first 30 days following hospital discharge. Self-reported outcome measures were performed to assess symptom burden and independence in activities of daily living.

Results:

Using standardized criteria, 41 patients were referred to CICURC of which 78.1% established care and were followed for a median of 88 (56–122) days. On intake, patients reported a high burden of heart failure symptoms (KCCQ overall summary score 29.8 [18.0–47.5]), and nearly half (46.4%) were dependent on caretakers for activities of daily living. Thirty days postdischarge, no deaths were observed and the rate of rehospitalization for any cause was 12.2%.

Conclusions:

CICU survivors are faced with significant residual symptom burden, dependence upon caretakers, and impairments in mental health. Dedicated CICURCs may help prioritize treatment of ICU related illness, reduce symptom burden, and improve outcomes. Interventions delivered in ICU recovery clinic for patients surviving the CICU warrant further investigation.
RETINAL THICKNESS AND FOVEAL HYPOPLASIA IN ADULTS BORN PRETERM WITH AND WITHOUT RETINOPATHY OF PREMATURITY
Authors: Fieß Achim , Pfisterer Anna , Gißler Sandra , Korb Christina , Mildenberger Eva , Urschitz Michael S. , Zepp Fred , Stoffelns Bernhard , Pfeiffer Norbert , Schuster Alexander K.
Published: August 2022

Purpose:

This study analyses whether prematurity, retinopathy of prematurity (ROP), and associated factors lead to altered foveal shape in adulthood and whether these alterations are associated with visual acuity.

Methods:

The Gutenberg Prematurity Eye Study is a German cohort study with a prospective ophthalmologic examination (participants aged 18–52 years) of individuals born preterm and full-term that were examined with spectral domain optical coherence tomography. Participants were grouped according to gestational age (GA) and postnatal ROP status. Multivariable linear regression analyses for foveolar retinal thickness, foveal hypoplasia, and posterior vitreous status were performed.

Results:

A total of 755 eyes of 414 preterm and full-term individuals were included (aged 28.6 ± 8.6 years, 233 female individuals). Central foveal retinal thickness increased as GA decreased. The prevalence of foveal hypoplasia was 2% (control group), 9% (GA 33–36), 18% (GA 29–32), 48% (GA ≤28), 50% (ROP without treatment), and 82% of eyes (with ROP requiring treatment). In multivariable analyses, central foveal thickness was independently associated with GA and advanced stages of ROP requiring treatment while foveal hypoplasia was only associated with GA. Posterior vitreous was more frequently visible as partially detached in full-term than in preterm individuals. Lower distant-corrected visual acuity correlated with increased foveolar thickness (rho = 0.08; P = 0.03) and with foveal hypoplasia (rho = 0.15, P < 0.001).

Conclusion:

Our findings indicate that there are fetal origins affecting foveal shape, resulting in foveal hypoplasia potentially affecting the visual acuity in adulthood.
AN 82-YEAR-OLD WOMAN WITH RETINAL VASCULAR SHEATHING AND VITREOUS HEMORRHAGE
Authors: Hudson Julia L. , Schwartz Stephen G. , Davis Janet L.
Published: August 2022

Purpose:

This report describes a case of hereditary transthyretin amyloidosis in an 82-year-old woman who presented with bilateral retinal arteriolar vascular sheathing and vitreous hemorrhage in one eye.

Methods:

The patient underwent a full history, physical examination, genetic workup, and cardiac imaging to establish the diagnosis. Fundus photographs, optical coherence tomography, fluorescein angiography, and indocyanine green angiography were performed throughout the patient's treatment course.

Results:

Fundus examination demonstrated segmental sheathing of the retinal arterioles, telangiectasias, and intraretinal hemorrhages in both eyes without neovascularization. Fluorescein angiography revealed delayed filling of the nasal retinal arterioles in the right eye with severe temporal nonperfusion and areas hyperfluorescent segmental sheathing in both eyes. Ocular coherence tomography demonstrated retinal vessels with hyperreflective thickened walls. Cardiac amyloid nuclear scan was consistent with transthyretin-mediated amyloidosis amyloid heart disease, and genetic testing confirmed a heterozygous pathogenic transthyretin mutation: c.290 C>A (p.Ser97Tyr) also known as Ser77Tyr.

Conclusion:

Amyloidosis should be considered in the differential of vasculitis and vitreous hemorrhage with or without significant vitreous opacities. Ophthalmologists aware of this diagnosis should complete a full review of systems with specific focus on cardiac history and symptoms of peripheral neuropathy when amyloidosis is in the differential.
A Qualitative Longitudinal Study of Workplace Issues, Authorities and Media, and Relationships Recounted by Oklahoma City Bombing Survivors After Nearly a Quarter Century
Authors: North Carol S. , Surís Alina , McDonald Katy , Pollio David E.
Published: August 2022

Objective

The aim of the study is to examine the long-term course of disaster-related experience among survivors of a terrorist bombing and the long-term recollection of initial workplace effects across nearly a quarter century.

Methods

From an initial randomly selected sample of highly trauma-exposed survivors of the 1995 Oklahoma City bombing, 103 participated in qualitative open-ended interviews about their bombing experience approximately 23 years after disaster.

Results

The survivors described their bombing experience clearly with extensive detail and expression of persistent strong emotion. Their discussions reflected findings from earlier assessments and also continued over the course of the next decades to complete their stories of the course of their occupational and interpersonal postdisaster journeys.

Conclusions

Long-term psychosocial ramifications in these survivors’ lives continue to warrant psychosocial interventions, such as occupational and interpersonal counseling.
A Prospective Investigation of the Impact of Telemedicine and Telemetry on Global Medical Evacuation Rates
Authors: Stilz Imogen , Freire de Carvalho Mary , Toner Sharyn , Berg Johannes
Published: August 2022

Objectives

This study examines whether the availability of telemedicine on offshore installations reduces medical evacuation rates.

Methods

This is a prospective cohort study on offshore platforms in the United States, Malaysia, and the United Kingdom. Emergency evacuation rates were compared between locations with telemedicine (United States) and 2 control groups without telemedicine (Malaysia, United Kingdom).

Results

Three hundred eighty-four cases in the telemedicine group and 261 cases in the control groups were included. The odds (adjusted and unadjusted) of medical evacuation were significantly higher for assets without telemedicine, contractors, and age older than 60 years. Analysis indicated a shift from emergency evacuation to routine transport for the telemedicine group.

Conclusions

Telemedicine reduces emergency medical evacuations from offshore installations. This reduction is likely due to an increased capacity for transforming emergency care into routine care at the offshore location.
Exercise Training During Working Hours at a Hospital Department
Authors: Molsted Stig , Justesen Just Bendix , Møller Sofie Fønsskov , Særvoll Charlotte Ahlgren , Krogh-Madsen Rikke , Pedersen Bente Klarlund , Fischer Thea Kølsen , Dalager Tina , Lindegaard Birgitte
Published: August 2022

Objectives

This pilot study tested the use of an exercise offer to hospital employees during working hours and changes in work and health parameters.

Methods

Employees (n = 214) from a medical department on a Danish hospital were invited to 30 minutes' exercise training twice weekly for 12 weeks. Outcomes included health- and work-related parameters.

Results

Eighty employees (mean age, 44.4 [SD, 10.7] years; 81.3% women) completed the study. Intervention adherence was 36.3% (SD, 25.1%). Aerobic capacity increased from 34.6 (95% confidence interval [CI], 32.3 to 36.9) to 36.7 (95% CI, 34.1 to 39.4) mL O2/min per kilogram, P = 0.004. Blood pressure decreased from 120 (95% CI, 117 to 123)/79 (95% CI, 76 to 81) to 116 (95% CI, 112 to 120)/76 (95% CI, 74 to 79) mm Hg, P = 0.003. Waist circumference and musculoskeletal pain decreased. Well-being, social capital, and quality of life increased.

Conclusions

Despite low training adherence, completers improved outcomes related to metabolic and self-rated health.
Near-lossless compression of PET/CT images using singular value decomposition
Authors: Chaudhary Jagrati , Pandey Anil Kumar , Sharma Param D. , Jaleel Jasim , Patel Chetan , Bal Chandra Sekhar , Kumar Rakesh
Published: August 2022

Aims and objectives

The aim of the study is to compare the single matrix approach and slice-by-slice approach for computing singular value decomposition (SVD) to achieve near-lossless compression of PET/CT images.

Materials and methods

The parameters used for comparison were SVD computation time, percentage compression and percentage difference between ROI counts on compressed and original images. SVD of 49 F-18-FDG PET/CT studies (33 370 PET/CT images) was computed using both approaches. The smaller singular values contributing insignificant information to the image were truncated, and then, the compressed image was reconstructed. A mask (101 × 101pixels) was used to extract the ROI counts from compressed and original images. Two nuclear medicine physicians compared compressed images with their corresponding original images for loss of clinical details and the presence of generated artifacts. Structural Similarity Index Measure, blur, brightness, contrast per pixel and global contrast factor were used for objective assessment of image quality. Wilcoxon test was applied to find a statistically significant difference between the parameters used for comparison at alpha = 0.05.

Results

Nuclear medicine physicians found compressed image identical to the corresponding original image. The values of comparation parameters were significantly larger for the single matrix approach in comparison with the slice-by-slice approach. The maximum percentage error between the compressed image and original image was less than 5%.

Conclusions

Up to 64 % and 44% near-lossless compression of PET and CT images were achieved, respectively using the slice-by-slice approach, and up to 58 and 53% near-lossless compression of PET and CT images were achieved respectively using the single matrix approach.
Psychological treatment for pediatric functional abdominal pain disorders
Authors: Puckett-Perez Stevie , Gresl Brittany
Published: August 2022

Purpose of review

The purpose of this review is to discuss up-to-date psychological treatment strategies for functional abdominal pain disorders (FAPDs) with practical implications for primary care providers who are the “front line” of treatment for pediatric FAPD.

Recent findings

Positive diagnosis, pain education, and access to multidisciplinary care improve outcomes for FAPD patients. Cognitive behavioral therapy (CBT) and hypnosis continue to have the strongest evidence in psychological treatments, but educational interventions and other nonpharmacological approaches show promise as well. There are innovative programs that combine these tools into group or internet-based treatments to expand access to care. Additionally, nonpharmacological tools, including neurostimulation and virtual reality programs, are increasing in popularity.

FAPD is prevalent across pediatric practices, yet there is no standard medical or dietary approach, and there are many barriers to diagnosis and treatment. It is important for patients to have positive encounters around diagnosis and education, access to multidisciplinary care, and integrated psychological support. Consistently, studies show that psychology continues to be a vital component of care. This review discusses supported uses of psychology, innovative programming for increasing access to care, and how primary care providers can incorporate lessons learned from psychology in FAPD care.

Video Abstract

http://links.lww.com/MOP/A67.