bluuebunny/crossref_metadata_2025 huggingface dataset:
Apparent dispersion in pulsar braking index measurements caused by timing noise
Authors: Vargas Andrés F , Melatos Andrew
Published: May 2023

Stochastic temporal wandering of the spin frequency ν of a rotation-powered pulsar (i.e. the achromatic component of timing noise unrelated to interstellar propagation) affects the accuracy with which the secular braking torque can be measured. Observational studies confirm that pulsars with anomalous braking indices $\vert n \vert = \vert \nu \ddot{\nu } / \dot{\nu }^2 \vert \gg 1$ exhibit elevated levels of timing noise, where an overdot symbolizes a derivative with respect to time. Here it is shown, through analytic calculations and Monte Carlo simulations involving synthetic data and modern Bayesian timing techniques, that the variance 〈n2〉 of the measured n scales with the square of the timing noise amplitude $\sigma _{\ddot{\nu }}$ . The anomalous regime 〈n2〉 ≫ 1 corresponds to $\sigma _{\ddot{\nu }}^2 \gg 10^{-60} (\gamma _{\ddot{\nu }}/10^{-6} \, {\rm s^{-1}})^2 (\dot{\nu } / 10^{-14} \, {\rm Hz \, s^{-1}})^4 (\nu / 1 \, {\rm Hz})^{-2} (T_{\rm obs} / 10^8 \, {\rm s}) \, {\rm Hz}^2{\rm s}^{-5 }$ , where $\gamma _{\ddot{\nu }}$ is a stellar damping time-scale, and Tobs is the total observing time. When the inequality in the earlier condition is reversed, n is dominated by the secular braking torque, and timing measurements return n ∼ 3, if the secular braking torque is electromagnetic. The variance 〈n2〉 is greater, when the stochastic process driving spin fluctuations differs from the red noise model (e.g. power-law spectral density) assumed in the timing solution.
Orbital precession of stars in the Galactic Centre
Authors: Capuzzo-Dolcetta R , Sadun-Bordoni M
Published: May 2023

The region around the centre of our Galaxy is very dense of stars. The kinematics of inner moving stars in the Galaxy (the so-called S-stars) has been deeply studied by different research groups leading to the conclusion of the existence of a very compact object (Sgr A*, likely a supermassive black hole) responsible for their high speed. Here, we start from the observational evidence of orbital apsidal line precession for the S2 (also called S0-2) star to investigate on a theoretical side what level of quality in such regime of relatively strong gravitational field is reached in the orbit angular precession determination when using a direct orbital integration of the star motion subjected to an acceleration computed in the post-Newtonian (PN) scheme up to different orders. This approach, although approximated and limited to particle speed not exceeding ∼ 0.3c, allows the inclusion of various effects, like that of a possible spin of the central massive object. Our results show that the inclusion of PN terms above the standard 1PN term (the one corresponding to the classic Einstein–Schwarzschild estimate of pericenter advance) is compulsory to determine angular precession at sufficient level of accuracy for those penetrating stars that would allow to pick contemporary the value of the mass and of the spin of a rotating (Kerr-like) supermassive black hole (SMBH). We discuss how future observational data, together with a proper modelization, could allow the determination of both mass and spin of the SMBH of our Galaxy.
A variable active galactic nucleus at z = 2.06 triply-imaged by the galaxy cluster MACS J0035.4−2015
Authors: Furtak Lukas J , Mainali Ramesh , Zitrin Adi , Plat Adèle , Fujimoto Seiji , Donahue Megan , Nelson Erica J , Bauer Franz E , Uematsu Ryosuke , Caminha Gabriel B , Andrade-Santos Felipe , Bradley Larry D , Caputi Karina I , Charlot Stéphane , Chevallard Jacopo , Coe Dan , Curtis-Lake Emma , Espada Daniel , Frye Brenda L , Knudsen Kirsten K , Koekemoer Anton M , Kohno Kotaro , Kokorev Vasily , Laporte Nicolas , Lee Minju M , Lemaux Brian C , Magdis Georgios E , Sharon Keren , Stark Daniel P , Su Yuanyuan , Suess Katherine A , Ueda Yoshihiro , Umehata Hideki , Vidal-García Alba , Wu John F
Published: May 2023

We report the discovery of a triply imaged active galactic nucleus (AGN), lensed by the galaxy cluster MACS J0035.4−2015 (zd = 0.352). The object is detected in Hubble Space Telescope imaging taken for the RELICS program. It appears to have a quasi-stellar nucleus consistent with a point-source, with a de-magnified radius of re ≲ 100 pc. The object is spectroscopically confirmed to be an AGN at zspec = 2.063 ± 0.005 showing broad rest-frame UV emission lines, and detected in both X-ray observations with Chandra and in ALCS ALMA band 6 (1.2 mm) imaging. It has a relatively faint rest-frame UV luminosity for a quasar-like object, MUV, 1450 = −19.7 ± 0.2. The object adds to just a few quasars or other X-ray sources known to be multiply lensed by a galaxy cluster. Some diffuse emission from the host galaxy is faintly seen around the nucleus, and there is a faint object nearby sharing the same multiple-imaging symmetry and geometric redshift, possibly an interacting galaxy or a star-forming knot in the host. We present an accompanying lens model, calculate the magnifications and time delays, and infer the physical properties of the source. We find the rest-frame UV continuum and emission lines to be dominated by the AGN, and the optical emission to be dominated by the host galaxy of modest stellar mass $M_{\star }\simeq 10^{9.2}\, \mathrm{M}_{\odot }$ . We also observe some variation in the AGN emission with time, which may suggest that the AGN used to be more active. This object adds a low-redshift counterpart to several relatively faint AGN recently uncovered at high redshifts with HST and JWST.
(130) Elektra Delta – on the stability of the new third moonlet
Authors: Valvano G , Oliveira R Machado , Winter O C , Sfair R , Borderes-Motta G
Published: May 2023

The aim of this work is to verify the stability of the proposed orbital solutions for the third moonlet (Delta) taking into account a realistic gravitational potential for the central body of the quadruple system (Alpha). We also aim to estimate the location and size of a stability region inside the orbit of Gamma. First, we created a set of test particles with intervals of semimajor axis, eccentricities, and inclinations that covers the region interior to the orbit of Gamma, including the proposed orbit of Delta and a wide region around it. We considered three different models for the gravitational potential of Alpha: irregular polyhedron, ellipsoidal body, and oblate body. For a second scenario, Delta was considered a massive spherical body and Alpha an irregular polyhedron. Beta and Gamma were assumed as spherical massive bodies in both scenarios. The simulations showed that a large region of space is almost fully stable only when Alpha was modelled simply as an oblate body. For the scenario with Delta as a massive body, the results did not change from those as mass-less particles. Beta and Gamma do not play any relevant role in the dynamics of particles interior to the orbit of Gamma. Delta’s predicted orbital elements are fully unstable and far from the nearest stable region. The primary instability source is Alpha’s elongated shape. Therefore, in the determination of the orbital elements of Delta, it must be taken into account the gravitational potential of Alpha assuming, at least, an ellipsoidal shape.
lemon: LEns MOdelling with Neural networks – I. Automated modelling of strong gravitational lenses with Bayesian Neural Networks
Authors: Gentile Fabrizio , Tortora Crescenzo , Covone Giovanni , Koopmans Léon V E , Li Rui , Leuzzi Laura , Napolitano Nicola R
Published: May 2023

The unprecedented number of gravitational lenses expected from new-generation facilities such as the ESA Euclid telescope and the Vera Rubin Observatory makes it crucial to rethink our classical approach to lens-modelling. In this paper, we present lemon (Lens Modelling with Neural networks): a new machine-learning algorithm able to analyse hundreds of thousands of gravitational lenses in a reasonable amount of time. The algorithm is based on a Bayesian Neural Network: a new generation of neural networks able to associate a reliable confidence interval to each predicted parameter. We train the algorithm to predict the three main parameters of the singular isothermal ellipsoid model (the Einstein radius and the two components of the ellipticity) by employing two simulated data sets built to resemble the imaging capabilities of the Hubble Space Telescope and the forthcoming Euclid satellite. In this work, we assess the accuracy of the algorithm and the reliability of the estimated uncertainties by applying the network to several simulated data sets of 104 images each. We obtain accuracies comparable to previous studies present in the current literature and an average modelling time of just ∼0.5 s per lens. Finally, we apply the lemon algorithm to a pilot data set of real lenses observed with HST during the SLACS program, obtaining unbiased estimates of their SIE parameters. The code is publicly available on GitHub (https://github.com/fab-gentile/LEMON).
First-Dose Antimicrobial Infusion Reactions in Patients Enrolled in Outpatient Parenteral Antimicrobial Therapy Services
Authors: Kovacik Carrie N , Shah Megan D , Thomas Tania A , Eby Joshua C
Published: May 2023

After receiving a monitored first-dose antimicrobial infusion at an infusion center, 6 of 93 (6%) patients enrolled in outpatient parenteral antimicrobial therapy services experienced an immediate reaction, none of which were consistent with immunoglobulin E-mediated reactions. These findings suggest it would be reasonable to forgo monitoring for most patients receiving first-dose intravenous antimicrobials outpatient.
CYCLOIDEA-like genes control floral symmetry, floral orientation, and nectar guide patterning
Authors: Yang Xia , Wang Yang , Liu Tian-Xia , Liu Qi , Liu Jing , Lü Tian-Feng , Yang Rui-Xue , Guo Feng-Xian , Wang Yin-Zheng
Published: May 2023

Actinomorphic flowers usually orient vertically (relative to the horizon) and possess symmetric nectar guides, while zygomorphic flowers often face horizontally and have asymmetric nectar guides, indicating that floral symmetry, floral orientation, and nectar guide patterning are correlated. The origin of floral zygomorphy is dependent on the dorsoventrally asymmetric expression of CYCLOIDEA (CYC)-like genes. However, how horizontal orientation and asymmetric nectar guides are achieved remains poorly understood. Here, we selected Chirita pumila (Gesneriaceae) as a model plant to explore the molecular bases for these traits. By analyzing gene expression patterns, protein–DNA and protein–protein interactions, and encoded protein functions, we identified multiple roles and functional divergence of 2 CYC-like genes, i.e. CpCYC1 and CpCYC2, in controlling floral symmetry, floral orientation, and nectar guide patterning. CpCYC1 positively regulates its own expression, whereas CpCYC2 does not regulate itself. In addition, CpCYC2 upregulates CpCYC1, while CpCYC1 downregulates CpCYC2. This asymmetric auto-regulation and cross-regulation mechanism might explain the high expression levels of only 1 of these genes. We show that CpCYC1 and CpCYC2 determine asymmetric nectar guide formation, likely by directly repressing the flavonoid synthesis-related gene CpF3′5′H. We further suggest that CYC-like genes play multiple conserved roles in Gesneriaceae. These findings shed light on the repeated origins of zygomorphic flowers in angiosperms.
The miR165/166–PHABULOSA module promotes thermotolerance by transcriptionally and posttranslationally regulating HSFA1
Authors: Li Jie , Cao Yiming , Zhang Jiaxin , Zhu Cuijing , Tang Guiliang , Yan Jun
Published: May 2023

Heat stress (HS) adversely affects plant growth and productivity. The Class A1 HS transcription factors (HSFA1s) act as master regulators in the plant response to HS. However, how HSFA1-mediated transcriptional reprogramming is modulated during HS remains to be elucidated. Here, we report that a module formed by the microRNAs miR165 and miR166 and their target transcript, PHABULOSA (PHB), regulates HSFA1 at the transcriptional and translational levels to control plant HS responses. HS-triggered induction of MIR165/166 in Arabidopsis thaliana led to decreased expression of target genes including PHB. MIR165/166 overexpression lines and mutations in miR165/166 target genes enhanced HS tolerance, whereas miR165/166 knockdown lines and plants expressing a miR165/166-resistant form of PHB were sensitive to HS. PHB directly repressed the transcription of HSFA1s and globally modulated the expression of HS-responsive genes. PHB and HSFA1s share a common target gene, HSFA2, which is essential for activation of plant responses to HS. PHB physically interacted with HSFA1s and exerted an antagonistic effect on HSFA1 transcriptional activity. PHB and HSFA1s co-regulated transcriptome reprogramming upon HS. Together, these findings indicate that heat-triggered regulation of the miR165/166–PHB module controls HSFA1-mediated transcriptional reprogramming and plays a critical role during HS in Arabidopsis.
Implementation of a Comprehensive Anti-Racism Plan in an Academic Physical Therapy Department: An Administrative Case Report
Authors: Matthews Ndidiamaka D , Rowley K Michael , Dusing Stacey C , Krause Libby , Yamaguchi Noriko , Gordon James
Published: May 2023

Objective

Transforming the University of Southern California health care system requires that institutions and organizations position equity, diversity, inclusion (EDI), and anti-racism as central to their missions. The purpose of this administrative case report was to describe a systematic approach taken by an academic physical therapy department to develop a comprehensive antiracism plan that engages all interested and affected parties and includes processes for sustainable, long-term engagement.

Methods

Four strategies contributed to organizational change toward anti-racism: Holding Ourselves Accountable; Developing a Plan; Building Consensus; and Providing Education, Support, and Resources. The attitudes of faculty and staff about racism and anti-racist actions were assessed through surveys at the start of the process and after 1 year. Engagement in activities, meetings, and trainings related to EDI and anti-racism was logged for faculty and staff.

Results

From November 2020 through November 2021, several outcomes were achieved, including: making structural organizational changes; updating faculty merit review to include EDI; developing a bias reporting mechanism; establishing faculty development activities, resources, and groups; and implementing structured efforts to recruit a diverse cohort. Within that year, faculty and staff engaged in 99.32 hours of EDI and anti-racism trainings, workshops, and resource groups. Survey data showed persistent high support and commitment to EDI and anti-racism. Faculty and staff reported that they felt more equipped to identify and address individual and institutional racism and they reported risking their reputations to talk about race more often. Confidence in their ability to identify and resolve conflicts related to microaggressions, cultural insensitivity, and bias improved. However, their self-reported ability to identify and address structural racism remained unchanged.

Conclusion

By approaching anti-racism as transformative rather than performative, an academic physical therapy department was able to develop and implement a comprehensive anti-racism plan with high support and engagement.

Impact

The physical therapy profession has not been immune to racism and health injustice. Organizational change to become anti-racist is imperative for excellence and a necessary challenge to undertake if the physical therapy profession is to transform society and improve the human experience.
Molecular mechanisms underlying adverse effects of dexamethasone and betamethasone in the developing cardiovascular system
Authors: Garrud Tessa A. C. , Teulings Noor E. W. D. , Niu Youguo , Skeffington Katie L. , Beck Christian , Itani Nozomi , Conlon Fiona G. , Botting Kimberley J. , Nicholas Lisa M. , Tong Wen , Derks Jan B. , Ozanne Susan E. , Giussani Dino A.
Published: May 2023

Antenatal glucocorticoids accelerate fetal lung maturation and reduce mortality in preterm babies but can trigger adverse effects on the cardiovascular system. The mechanisms underlying off‐target effects of the synthetic glucocorticoids mostly used, Dexamethasone (Dex) and Betamethasone (Beta), are unknown. We investigated effects of Dex and Beta on cardiovascular structure and function, and underlying molecular mechanism using the chicken embryo, an established model system to isolate effects of therapy on the developing heart and vasculature, independent of effects on the mother or placenta. Fertilized eggs were treated with Dex (0.1 mg kg−1), Beta (0.1 mg kg−1), or water vehicle (Control) on embryonic day 14 (E14, term = 21 days). At E19, biometry, cardiovascular function, stereological, and molecular analyses were determined. Both glucocorticoids promoted growth restriction, with Beta being more severe. Beta compared with Dex induced greater cardiac diastolic dysfunction and also impaired systolic function. While Dex triggered cardiomyocyte hypertrophy, Beta promoted a decrease in cardiomyocyte number. Molecular changes of Dex on the developing heart included oxidative stress, activation of p38, and cleaved caspase 3. In contrast, impaired GR downregulation, activation of p53, p16, and MKK3 coupled with CDK2 transcriptional repression linked the effects of Beta on cardiomyocyte senescence. Beta but not Dex impaired NO‐dependent relaxation of peripheral resistance arteries. Beta diminished contractile responses to potassium and phenylephrine, but Dex enhanced peripheral constrictor reactivity to endothelin‐1. We conclude that Dex and Beta have direct differential detrimental effects on the developing cardiovascular system.
Effectiveness and Safety of Varenicline for Smoking Cessation: An Overview and Meta-analysis
Authors: Shang Xue , E Fenfen , Guo Kangle , Yang Chaoqun , Zhou Liying , Wu Yanan , Yang Kehu , Li Xiuxia
Published: May 2023

Objective

An overview, meta-analysis, and trial sequential analysis were conducted to evaluate the efficacy and safety of varenicline for smoking cessation.

Methods

Systematic reviews (SRs) and randomized controlled trials evaluating varenicline versus placebo for smoking cessation were included. A forest plot was used to summarize the effect size of the included SRs. Traditional meta-analysis and trial sequential analysis (TSA) were performed using Stata software and TSA 0.9 software, respectively. Finally, the Grades of Recommendation, Assessment, Development, and Evaluation approach was used to assess the quality of evidence for the abstinence effect.

Results

A total of 13 SRs and 46 randomized controlled trials were included. Twelve review studies showed that varenicline was superior to placebo for smoking cessation. The meta-analysis results showed that, compared with the placebo, varenicline significantly increased the odds of smoking cessation (odds ratio = 2.54, 95% confidence interval = 2.20–2.94, P < 0.05, moderate quality). Subgroup analysis showed that there were significant differences in smokers with disease and general smokers (P < 0.05). Differences were also found in the follow-up time at 12, 24, and 52 weeks (P < 0.05). The common adverse events were nausea, vomit, abnormal dreams, sleep disturbances, headache, depression, irritability, indigestion, and nasopharyngitis (P < 0.05). The TSA results confirmed the evidence for the effect of varenicline on smoking cessation.

Conclusions

Existing evidence supports the superiority of varenicline over a placebo for smoking cessation. Varenicline had mild to moderate adverse events but was well tolerated. Future trials should investigate varenicline in combination with other smoking cessation approaches and compare it with other interventions.
Pediatric Pelvic and Acetabular Fractures: Discerning Severity by Classification and Clinical Management
Authors: Igboechi Oduche , Purtell Sarah R. , Carry Patrick , Sanders Julia S.
Published: May 2023

Background:

Existing classification systems may not adequately describe the injury patterns seen pelvic ring and acetabular fractures in the skeletally immature population. Pediatric patients, once stabilized, are often transferred for these injuries. We evaluated which commonly used systems correlate with clinical management in pediatric patients, including transfer patterns based on injury severity.

Methods:

A retrospective review of patients aged 1 to 15 treated for traumatic pelvic or acetabular fractures over a 10-year period at an academic level I Pediatric Trauma Center reviewed demographic, radiographic, and clinical data.

Results:

A total of 188 pediatric patients (average age 10.1 y) were included. Increasing injury severity based on classification Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA P<0.001; Young and Burgess P<0.001; Torode/Zieg P<0.001), increasing Injury Severity Score (P=0.0017), and decreasing hemoglobin levels (P=0.0144) were significantly associated with operative management. Injury characteristics did not differ between patients who were transferred versus patients who were brought in directly from the field. Air transport was significantly associated with surgical treatment, pediatric intensive care unit admission, polytrauma, and Torode/Zieg classification (P=0.036, <0.0001, 0.0297, 0.0003, respectively).

Conclusions:

Although not fully descriptive of skeletally immature fracture patterns, the AO/OTA and Young and Burgess classification systems adequately assess the severity of pelvic rings and injuries in pediatric patients and predict management patterns. The Torode and Zieg classification also predicts management. In a large cohort, air transport was significantly associated with surgical treatment, need for pediatric intensive care unit stay, the presence of an additional injury, and instability in the Torode and Zieg classification. These findings suggest that air transfers are being utilized to expedite advanced-level care in more severe injuries. Further studies with long-term follow-up are required to assess the clinical outcomes of both nonoperatively and operatively treated pediatric pelvic fractures and to guide both triage and treatment decisions for these rare but severe injuries.

Level of Evidence:

Level III
Impact of Preoperative Duration of Symptoms on Patient Satisfaction, Outcomes and Complications After Lumbar Discectomy
Authors: Andersen Mikkel Ø , Andresen Andreas Killerich , Carreon Leah Y. , Pedersen Casper Friis
Published: May 2023

Study Design.

Observational study.

Objective.

To identify associations between preoperative symptom duration and postoperative patient satisfaction.

Summary of Background Data.

Sciatica due to lumbar disk herniation (LDH) is a cause of disability and reduced quality life. Patients with severe pain and disability or were recovery is unacceptably slow, surgical intervention can be advised. For these patients, evidence-based recommendations on the timing of the surgical intervention needs to be established.

Methods.

All patients who underwent discectomy at a Spine Centre, due to radicular pain from June 2010 to May 2019 were included. Pre- and postoperative data including demographic data, smoking, consumption of pain medication, comorbidity, back and leg-pain, health-related quality of life as measured by EQ-5D, ODI, previous spine surgery, sick leave, and duration of back and leg-pain before surgery were utilized. The patients were divided into four groups based on their self-reported duration of leg-pain before surgery. To minimize baseline differences between the groups, propensity-score matching was employed in a 1:1 fashion, balancing the groups on all reported preoperative factors.

Results.

Of 1607 patients undergoing lumbar discectomy, four matched cohorts based on their self-reported duration of leg-pain before surgery were created. Each cohort consisted of 150 patients well balanced on preoperative factors. Overall 62.7% of the patients were satisfied with the surgical result ranging from 74.0% in the <3 months group to 48.7% in the >24 months group (P<0.000). The portion of patients achieving a minimum clinically important difference for EQ-5D decreased from 77.4% with early intervention to 55.6% in the late group (P<0.000). The number of surgical complications were not affected by the duration of preoperative leg-pain.

Conclusion.

We found significant difference in patient satisfaction and health-related quality of life in patients related to the duration of preoperative leg-pain due to symptomatic LDH.

Level of Evidence.

3.
Nonsteroidal Anti-inflammatory Drugs in the Acute Post-operative Period Are Associated With an Increased Incidence of Pseudarthrosis, Hardware Failure, and Revision Surgery Following Single-level Spinal Fusion
Authors: Lindsay Sarah E. , Philipp Travis , Ryu Won Hyung A. , Wright Christina , Yoo Jung
Published: May 2023

Study Design.

Retrospective study.

Summary of Background Data.

Research has shown that the use of NSAIDs and COX-2 inhibitors increases the risk of pseudoarthrosis following spinal fusion surgery. Pseudoarthrosis can lead to complications such as chronic pain and the need for additional surgeries.

Objective.

The purpose of this study was to examine the relationship between NSAID and COX-2 inhibitor use and pseudarthrosis, hardware complications, and revision surgeries in patients undergoing posterior spinal instrumentation and fusion.

Methods.

We queried the PearlDiver database using CPT and ICD-10 codes to identify patients between the ages of 50 and 85 who underwent posterior spinal instrumentation between 2016 and 2019 and experienced pseudarthrosis, hardware failure, or revision surgery. Information regarding age, Charlson Comorbidity Index, tobacco use, osteoporosis, and obesity were extracted from the database along with COX-2 or NSAID use during the first 6-week post-surgery period. Logistic regression was used to identify associations while adjusting for confounders.

Results.

There were 178,758 patients included in the cohort; 9,586 experienced pseudarthrosis (5.36%), 2828 (1.58%) experienced hardware failure, and 10,457 (5.85%) patients underwent revision fusion surgery. Of these patients 23,602 (13.2%) filled NSAID and 5278 (2.95%) filled COX-2 prescriptions. A significantly higher proportion of patients using NSAIDs experienced pseudarthrosis, hardware failure, and revision surgery compared to patients not taking NSAIDs. COX-2 inhibitors were also associated with a significantly higher rate of pseudarthrosis, hardware failure, and revision surgery. Postoperative ketorolac use was not associated with these complications. Regression models demonstrated that both NSAIDs and COX-2 inhibitors were associated with statistically higher pseudarthrosis, hardware failure, and revision surgery rates.

Conclusions.

Both NSAID and COX-2 inhibitor use in the early post-surgical period may be associated with increased rates of pseudarthrosis, hardware failure, and revision surgery in patients undergoing posterior spinal instrumentation and fusion.
An investigation of long-term outcome of rabbit anti-thymocyte globulin and cyclosporine therapy for pediatric severe aplastic anemia
Authors: Chang Lixian , Yan Mingchen , Zhang Jingliao , Liu Binghang , Zhang Li , Guo Ye , Sun Jing , Wan Yang , Yi Meihui , Lan Yang , Cai Yuli , Ren Yuanyuan , Zheng Haihui , Zhang Aoli , Li Zhenyu , Wang Jian , Li Yingrui , Zhu Xiaofan
Published: May 2023

Children with severe aplastic anemia (SAA) face heterogeneous prognoses after immunosuppressive therapy (IST). There are few models that can predict the long-term outcomes of IST for these patients. The objective of this paper is to develop a more effective prediction model for SAA prognosis based on clinical electronic medical records from 203 children with newly diagnosed SAA. In the early stage, a novel model for long-term outcomes of SAA patients with IST was developed using machine-learning techniques. Among the indicators related to long-term efficacy, white blood cell count, lymphocyte count, absolute reticulocyte count, lymphocyte ratio in bone-marrow smears, C-reactive protein, and the level of IL-6, IL-8 and vitamin B12 in the early stage are strongly correlated with long-term efficacy (P < .05). Taken together, we analyzed the long-term outcomes of rabbit anti-thymocyte globulin and cyclosporine therapy for children with SAA through machine-learning techniques, which may shorten the observation period of therapeutic effects and reduce treatment costs and time.
Trigeminocardiac Reflex: A Review and Key Implications to Dermatologic Surgery
Authors: Poe Emily , Bosley Rawn , Steele Robert , Chesnut Cameron
Published: May 2023

BACKGROUND

The trigeminocardiac reflex is a common but underreported occurrence that can vary from benign to life threatening. This reflex can be elicited by placing direct pressure on the globe of the eye or from traction of the extraocular muscles, stimulating the trigeminal nerve.

OBJECTIVE

To provide a review of potential stimuli for the trigeminocardiac reflex within dermatologic surgery and to discuss management options for the treatment of the trigeminocardiac reflex.

METHODS

PubMed and Cochrane were used to identify articles and case reports that established scenarios in which the trigeminocardiac reflex was provoked and subsequently how the reflex was managed.

RESULTS

Within the field of dermatologic surgery, the trigeminocardiac reflex can be stimulated during biopsies, cryoablations, injections, laser treatments, Mohs micrographic surgery, and oculoplastic interventions, most often occurring in an office setting. The most common presentations include significant bradycardia, hypotension, gastric hypermobility, and lightheadedness. The most definitive treatment is cessation of the inciting stimulus, monitoring, and symptomatic management. Glycopyrrolate and atropine are common treatments for severe, intractable cases of the trigeminocardiac reflex.

CONCLUSION

The trigeminocardiac reflex, while underreported and underrepresented in dermatologic literature and dermatologic surgery settings, should be considered in the setting of bradycardia and hypotension during dermatologic procedures.
Association of Heart Failure Patients With and Without Sacubitril–Valsartan Use With Incident Cancer Risk
Authors: Hu Wei-Syun , Lin Cheng-Li
Published: May 2023

This study was to evaluate the association between heart failure (HF) patients with and without sacubitril–valsartan use with incident cancer risk. This study consisted of 18,072 patients receiving sacubitril–valsartan and 18,072 control group participants. In the Fine and Gray model, which extends the standard Cox proportional hazards regression model, we estimated the relative risk of developing cancer between the sacubitril–valsartan cohort and the non–sacubitril–valsartan cohort by using subhazard ratios (SHRs) and 95% confidence intervals (CIs). The incidence rates of cancer were 12.02 per 1000 person-years for the sacubitril–valsartan cohort and 23.31 per 1000 person-years for the non–sacubitril–valsartan cohort. Patients receiving sacubitril–valsartan had a significantly lower risk of developing cancer with an adjusted SHR of 0.60 (0.51, 0.71). Sacubitril–valsartan users were less to be associated with the development of cancer.
Optimal alpha-1 antitrypsin level cutoffs for genotype identification in patients with chronic liver disease
Authors: Prakash Sameer , Murali Arvind R.
Published: May 2023

Background:

Controversy exists whether alpha-1 antitrypsin (A1AT) genotype testing should be performed as a first-line screening for A1AT heterozygous variants.

Methods:

We calculated the median and interquartile range of A1AT level for each genotype in 4378 patients with chronic liver disease and “miss rate” of MZ genotype identification at various cutoff levels.

Findings:

Significant overlap in A1AT level noted with Pi*MM, MZ, and MS variants. Miss rate of Pi*MZ at a cutoff level <100 was 29%, <110 was 18%, <120 was 8%, and <130 was 4%. We suggest simultaneous measurement of A1AT level and genotype in patients with chronic liver disease.
Telerehabilitation in pulmonary diseases
Authors: Cox Narelle S. , Khor Yet H.
Published: May 2023

Purpose of review

Telerehabilitation is an alternative delivery model for pulmonary rehabilitation, an evidence-based nonpharmacological intervention, in people with chronic pulmonary disease. This review synthesizes current evidence regarding the telerehabilitation model for pulmonary rehabilitation with an emphasis on its potential and implementation challenges, as well as the clinical experiences from the COVID-19 pandemic.

Recent findings

Different models of telerehabilitation for delivering pulmonary rehabilitation exist. Current studies comparing telerehabilitation to centre-based pulmonary rehabilitation primarily focus on the evaluation in people with stable chronic obstructive pulmonary disease, which demonstrated equivalent improvements in exercise capacity, health-related quality of life and symptoms with improved programme completion rates. Although telerehabilitation may improve access to pulmonary rehabilitation by addressing travel burden, improving schedule flexibility and geographic disparity, there are challenges of ensuring satisfaction of healthcare interactions and delivering core components of initial patient assessment and exercise prescription remotely.

Further evidence is needed on the role of telerehabilitation in various chronic pulmonary diseases, as well as the effectiveness of different modalities in delivering telerehabilitation programmes. Economic and implementation evaluation of currently available and emerging models of telerehabilitation in delivering pulmonary rehabilitation are needed to ensure sustainable adoption into clinical management for people with chronic pulmonary disease.
Evidence-Based Medicine: Systemic Perioperative Antibiotic Prophylaxis for Prevention of Surgical-Site Infections in Plastic and Reconstructive Surgery
Authors: Klifto Kevin M. , Rydz Alexandria C. , Biswas Sonali , Hultman C. Scott , Erdmann Detlev , Phillips Brett T.
Published: May 2023

Background:

After nearly a decade of new data, the Evidence-Based Consensus Conference Statement from the AAPS was updated for prophylactic systemic antibiotics to prevent surgical site infections (SSI). Pharmacotherapeutic concepts using antimicrobial stewardships were applied for clinical interpretation and management to optimize patient outcomes and minimize resistance.

Methods:

PRISMA, Cochrane, and GRADE certainty of evidence guidelines were implemented for the structure and synthesis of the review. PubMed, Embase, Cochrane Library, Web of Science, and Scopus databases were systematically and independently searched for randomized controlled trials (RCTs). We included patients that had Plastic and Reconstructive Surgery and were treated with prophylactic systemic antibiotics administered perioperatively (preoperative, intraoperative, postoperative). Comparisons were made between active interventions and/or non-active interventions (placebo) at different prespecified durations to determine the development of an (SSI). Meta-analyses were performed.

Results:

We included 138 RCTs that met eligibility criteria. RCTs consisted of 18 Breast, 10 Cosmetic, 21 Hand/Peripheral Nerve, 61 Pediatric/Craniofacial, and 41 Reconstructive studies. We further examined bacterial data extracted from studies for patients that did and did not take prophylactic systemic antibiotics for prevention of SSI. Clinical recommendations were provided using Level-I evidence.

Conclusions:

Surgeons have long been overprescribing systemic antibiotic prophylaxis in Plastic and Reconstructive Surgery. Evidence supports antibiotic prophylaxis to prevent SSI for specific indications and durations. Prolonged antibiotic use has not been linked to reductions in SSIs and misuse may increase the bacterial diversity of infections. Greater efforts should focus on transitioning from practice-based medicine to pharmacotherapeutic evidence-based medicine.
Correlation of viral loads in disease transmission could affect early estimates of the reproduction number
Authors: Harris Thomas , Geard Nicholas , Zachreson Cameron
Published: May 2023

Early estimates of the transmission properties of a newly emerged pathogen are critical to an effective public health response, and are often based on limited outbreak data. Here, we use simulations to investigate how correlations between the viral load of cases in transmission chains can affect estimates of these fundamental transmission properties. Our computational model simulates a disease transmission mechanism in which the viral load of the infector at the time of transmission influences the infectiousness of the infectee. These correlations in transmission pairs produce a population-level convergence process during which the distributions of initial viral loads in each subsequent generation converge to a steady state. We find that outbreaks arising from index cases with low initial viral loads give rise to early estimates of transmission properties that could be misleading. These findings demonstrate the potential for transmission mechanisms to affect estimates of the transmission properties of newly emerged viruses in ways that could be operationally significant to a public health response.
Native adiponectin plays a role in the adipocyte-mediated conversion of fibroblasts to myofibroblasts
Authors: El-Hattab Mariam Y. , Sinclair Noah , Liszewski Jesse N. , Schrodt Michael V. , Herrmann Jacob , Klingelhutz Aloysius J. , Sander Edward A. , Ankrum James A.
Published: May 2023

Adipocytes regulate tissues through production of adipokines that can act both locally and systemically. Adipocytes also have been found to play a critical role in regulating the healing process. To better understand this role, we developed a three-dimensional human adipocyte spheroid system that has an adipokine profile similar toin vivoadipose tissues. Previously, we found that conditioned medium from these spheroids induces human dermal fibroblast conversion into highly contractile, collagen-producing myofibroblasts through a transforming growth factor beta-1 (TGF-β1) independent pathway. Here, we sought to identify how mature adipocytes signal to dermal fibroblasts through adipokines to induce myofibroblast conversion. By using molecular weight fractionation, heat inactivation and lipid depletion, we determined mature adipocytes secrete a factor that is 30–100 kDa, heat labile and lipid associated that induces myofibroblast conversion. We also show that the depletion of the adipokine adiponectin, which fits those physico-chemical parameters, eliminates the ability of adipocyte-conditioned media to induce fibroblast to myofibroblast conversion. Interestingly, native adiponectin secreted by cultured adipocytes consistently elicited a stronger level of α-smooth muscle actin expression than exogenously added adiponectin. Thus, adiponectin secreted by mature adipocytes induces fibroblast to myofibroblast conversion and may lead to a phenotype of myofibroblasts distinct from TGF-β1-induced myofibroblasts.
Seed size variation impacts local adaptation and life-history strategies in a perennial grass
Authors: Razzaque Samsad , Heckman Robert W. , Juenger Thomas E.
Published: May 2023

Seed mass is an ecologically important trait that often differs considerably among ecotypes. Yet, because few studies examine the impacts of seed mass on adult life-history traits, its role in local adaptation is unclear. In this study, using accessions of
Panicum hallii
that spanned the two major ecotypes, we examined whether covariation between seed mass, seedling and reproductive traits impacts ecotypic divergence and local adaptation. The perennial grass
P. hallii
has two distinct ecotypes—a large-seeded upland ecotype adapted to xeric environments and a small-seeded lowland ecotype adapted to mesic environments. In the greenhouse, seed mass varied greatly across
P. hallii
genotypes in a manner consistent with ecotypic divergence. Seed mass covaried significantly with several seedling and reproductive traits. At field sites representing the habitats of the two ecotypes, seed mass had different impacts on seedling and adult recruitment: selection favoured large seeds in upland habitat and small seeds in lowland habitat, which was consistent with local adaptation. By demonstrating the central role of seed mass in ecotypic differences in
P. hallii
and its importance to seedling and adult recruitment under field conditions, these studies show that early life-history traits can promote local adaptation and potentially explain ecotype formation.
Identification of anaerobic and aerobic bacteria that can be associated with DFI and their therapeutic in Elnaw teaching hospital
Authors: Ahmed Fathi Sharief , Ibrahim Hiba Siddig , Saeed Mohammed Ibrahim
Published: May 2023

Diabetic foot infection (DFI) is one of the commonest diabetic complications, it's considered a major public health concern across the world, and its prevalence is rising, especially in developing countries. Globally, adults with diabetes accounted for 463 million in 2019 according to the International Diabetes Federation.Aim of this study was to identify the anaerobic and aerobic bacteria that causing and their therapeutic implications in Elnaw teaching hospital on diabetic clinics -Khartoum stateThe study showed that there was no infection by anaerobic organism while the most frequently isolated was gram negative rods (70%)  and recorded (65%) on diabetic patients.S.aureus (30%) was the most isolated organism followed by E.coli (25%) in control group (non-diabetic), while the clinic room swabs revealed that Klebsiella.spp and S.aureus(20%) for each.Early diagnosis, optimal management and effective antibiotic therapy are necessary to prevent DFI and amputation.
Gaoshiqia sediminis gen. nov., sp. nov., isolated from coastal sediment
Authors: Yu Wen-Xing , Liang Qi-Yun , Xuan Xiao-Qi , Du Zong-Jun , Mu Da-Shuai
Published: May 2023

A Gram-stain-negative, facultative anaerobic, motile, rod-shaped and orange bacterium, designated A06T, was obtained off the coast of Weihai, PR China. Cells were 0.4–0.5×0.6–1.0 µm in size. Strain A06T grew at 20–40 °C (optimum, 33 °C), at pH 6.0–8.0 (optimum, pH 6.5–7.0) and in the presence of 0–8 % NaCl (w/v) (optimum, 2 %). Cells were oxidase and catalase positive. Menaquinone-7 was detected as the major respiratory quinone. The dominant cellular fatty acids were identified as C15:0 2-OH, iso-C15:0, anteiso-C15:0 and iso-C15:1
 ω6c. The DNA G+C content of strain A06T was 46.1 mol%. The polar lipids were phosphatidylethanolamine, one aminolipid, one glycolipid and three unidentified lipids. Phylogenetic analysis based on 16S rRNA gene sequences revealed that strain A06T is a member of the family

Prolixibacteraceae

and exhibited the highest sequence similarity to

Mangrovibacterium diazotrophicum

DSM 27148T (94.3 %). Based on its phylogenetic and phenotypic characteristics, strain A06T is considered to represent a novel genus in the family

Prolixibacteraceae

, for which the name Gaoshiqia gen. nov. is proposed. The type species is Gaoshiqia sediminis sp. nov., with type strain A06T (=KCTC 92029T=MCCC 1H00491T). The identification and acquisition of microbial species and genes in sediments will help broaden the understanding of microbial resources and lay a foundation for its application in biotechnology. Strain A06T uses an enrichment method, so the isolation of strain A06T is of great significance to the enrichment of marine microbial resources.
Comparative genome analysis of Sesbania cannabina-nodulating Rhizobium spp. revealing the symbiotic and transferrable characteristics of symbiosis plasmids
Authors: Han Kunming , Li Yan , Zhang Zhenpeng , Sun Liqin , Wang En Tao , Li Yan
Published: May 2023

Symbiotic nitrogen fixation between legumes and rhizobia makes a great contribution to the terrestrial ecosystem. The successful symbiosis between the partners mainly depends on the nod and nif genes in rhizobia, while the specific symbiosis is mainly determined by the structure of Nod factors and the corresponding secretion systems (type III secretion system; T3SS), etc. These symbiosis genes are usually located on symbiotic plasmids or a chromosomal symbiotic island, both could be transferred interspecies. In our previous studies, Sesbania cannabina-nodulating rhizobia across the world were classified into 16 species of four genera and all the strains, especially those of

Rhizobium

spp., harboured extraordinarily highly conserved symbiosis genes, suggesting that horizontal transfer of symbiosis genes might have happened among them. In order to learn the genomic basis of diversification of rhizobia under the selection of host specificity, we performed this study to compare the complete genome sequences of four

Rhizobium

strains associated with S. cannabina, YTUBH007, YTUZZ027, YTUHZ044 and YTUHZ045. Their complete genomes were sequenced and assembled at the replicon level. Each strain represents a different species according to the average nucleotide identity (ANI) values calculated using the whole-genome sequences; furthermore, except for YTUBH007, which was classified as

Rhizobium binae

, the remaining three strains were identified as new candidate species. A single symbiotic plasmid sized 345–402 kb containing complete nod, nif, fix, T3SS and conjugal transfer genes was detected in each strain. The high ANI and amino acid identity (AAI) values, as well as the close phylogenetic relationships among the entire symbiotic plasmid sequences, indicate that they have the same origin and the entire plasmid has been transferred among different

Rhizobium

species. These results indicate that S. cannabina stringently selects a certain symbiosis gene background of the rhizobia for nodulation, which might have forced the symbiosis genes to transfer from some introduced rhizobia to the related native or local-condition-adapted bacteria. The existence of almost complete conjugal transfer related elements, but not the gene virD, indicated that the self-transfer of the symbiotic plasmid in these rhizobial strains may be realized via a virD-independent pathway or through another unidentified gene. This study provides insight for the better understanding of high-frequency symbiotic plasmid transfer, host-specific nodulation and the host shift for rhizobia.
Distinguishing GPT-4-generated Radiology Abstracts from Original Abstracts: Performance of Blinded Human Observers and AI Content Detector
Authors: Ufuk Furkan , Peker Hakki , Sagtas Ergin , Yagci Ahmet Baki
Published: May 2023

Objective

To determine GPT-4’s effectiveness in writing scientific radiology article abstracts and investigate human reviewers’ and AI Content detectors’ success in distinguishing these abstracts. Additionally, to determine the similarity scores of abstracts generated by GPT-4 to better understand its ability to create unique text.

Methods

The study collected 250 original articles published between 2021 and 2023 in five radiology journals. The articles were randomly selected, and their abstracts were generated by GPT-4 using a specific prompt. Three experienced academic radiologists independently evaluated the GPT-4 generated and original abstracts to distinguish them as original or generated by GPT-4. All abstracts were also uploaded to an AI Content Detector and plagiarism detector to calculate similarity scores. Statistical analysis was performed to determine discrimination performance and similarity scores.

Results

Out of 134 GPT-4 generated abstracts, average of 75 (56%) were detected by reviewers, and average of 50 (43%) original abstracts were falsely categorized as GPT-4 generated abstracts by reviewers. The sensitivity, specificity, accuracy, PPV, and NPV of observers in distinguishing GPT-4 written abstracts ranged from 51.5% to 55.6%, 56.1% to 70%, 54.8% to 60.8%, 41.2% to 76.7%, and 47% to 62.7%, respectively. No significant difference was observed between observers in discrimination performance.

Conclusion

GPT-4 can generate convincing scientific radiology article abstracts. However, human reviewers and AI Content detectors have difficulty in distinguishing GPT-4 generated abstracts from original ones.