bluuebunny/crossref_metadata_2025 huggingface dataset:
Pre-Service Physics Teacher Education
Authors: Sorge Stefan , Otero Valerie K. , Lavonen Jari
Published: March 2023

In this chapter, we provide a comprehensive overview over trends in and research on pre-service physics teacher education. Pre-service teacher education lays the foundation for the instruction we can observe in physics classrooms, the ways physics teachers communicate, and develop further in their careers. Yet, often times physics teachers are not adequately prepared to teach physics specifically. In the past years, several attempts have been made to address this shortcoming of qualified physics teachers through increasing the enrollment of teacher candidates and strengthening pre-service physics teacher programs itself. Thus, in our review, we discuss current trends and standards in physics teacher education worldwide and highlight which different program structures of pre-service physics teacher education arose. Furthermore, we delineate frameworks that describe professional knowledge and skills as well as additional personal characteristics such as teacher identity that pre-service physics teachers are expected to develop. Based on those frameworks, we present research on the impact that teacher educators and specific learning environments can have on pre-service physics teachers. We conclude the chapter by highlighting initiatives that aim to increase the enrollment of pre-service physics teachers and by identifying possible ways to advance research on pre-service physics teacher education.
The Relationship between Alternative Assessment and Physics Learning from the Perspective of Different Functions of Assessment
Authors: Ogan Bekiroglu Feral
Published: March 2023

Assessment should reveal what students know and be able to do as well as determine the skills they need to work on. There are different purposes and many forms of assessment. Due to the changes in theories of learning, new trends have emerged in assessment. Consequently, relationship between learning and assessment has established and assessment for learning has been emphasized rather than assessment of learning. Recent research on learning, motivation, and instruction suggests the need to use more alternative forms of assessment, such as performance assessments, authentic assessment, and portfolios. Alternative assessments guide improvement throughout the learning process and require students to construct their answers. This review chapter explores the relationship between physics learning and assessment within the context of alternative assessment. Therefore, recent physics education research was reviewed and their results were discussed to gain better understanding of what have been done in implementation of alternative assessment to enhance physics learning.
Assessment of Conceptual Understanding in Physics
Authors: Kaltakci-Gurel Derya
Published: March 2023

Assessment is an integral component of learning process. It aids us in understanding what students bring to class before instruction, to what extend they accomplished the intended learning outcomes after instruction, which aspects of instruction and curriculum are working well and which are not, and what specific difficulties do our students hold. Research-based, research-validated conceptual assessment plays an important role in Physics Education Research (PER). Therefore, in the PER to assess conceptual understanding many different tools have been developed and used. Among them interviews, open-ended tests, and multiple-choice conceptual tests (which are usually called “inventories’) are found to be the ones commonly used in the PER to assess conceptual understanding. However, each tool has some advantages as well as disadvantages over the others that is discussed in this chapter. The present review chapter is expected to contribute to the PER literature with an overview of the assessment of conceptual understanding in physics.
Front Matter
Authors: Taşar Mehmet Fatih , Heron Paula R. L.
Published: March 2023

The International Handbook of Physics Education Research: Teaching Physics covers the topics of educational technologies, learning environments, teacher education, and assessment in relation to physics education. As the field of physics education research grows, it is increasingly difficult for newcomers to gain an appreciation of the major findings across all sub-domains, discern global themes, and recognize gaps in the literature. The current volume incorporates the understanding of both physics and education concepts and provides an extensive review the literature in a wide range of important topics.

The International Handbook of Physics Education Research: Teaching Physics includes:Various teaching perspectives including active learning, the modeling method, and teaching environments.Distance/online education, formative and summative assessment, and assessment in online education.Gender, race, and ethnicity equity.

Readers will find this comprehensive treatment of the literature useful in understanding physics education research and extending to all the physical sciences including chemistry, mathematics, astronomy, and other related disciplines.
Corrigendum to: Environmental impacts of the Australian poultry industry. 1. Chicken meat production
Authors: Copley M. A. , Wiedemann S. G.
Published: March 2023

 Context Steadily increasing consumption of chicken meat (Australia’s most consumed meat protein) has resulted in expanded production. With societal expectations that industries improve sustainability, understanding baseline impacts is vital.

 Aims This study determined carbon footprint (kg CO2-e), fossil energy (MJ), fresh water consumption (L), stress (LH2O-e) and scarcity (m3), and land-occupation (m2) impacts for conventional (C) and free-range (FR) production systems, identified hotspots and the implications of changes in production over the past decade, to establish targets for future improvement.

 Methods In the largest study of its kind, attributional life-cycle assessment with data collected for ∼50% of birds processed was used, reporting impacts per kilogram of the typical market mix of chicken products, and boneless chicken. Uncertainty was assessed through Monte Carlo analysis, and results are presented as the means and standard deviation.

 Key results Slightly lower impacts per kilogram of chicken meat product were observed for C production (2.1±0.03kgCO2-e, 18.0±0.3MJ, 178.6±22.4L, and 10.2±0.1m2) than for FR (2.2±0.03kgCO2-e, 18.5±0.3MJ, 189.6±24.6L, and 10.6±0.1m2). Feed production was the major hotspot, followed by grow-out and meat processing. Land use (LU) and direct land use-change (dLUC) impacts associated with imported soymeal added 1.7±0.3 and 1.8±0.3kgCO2-e to C and FR respectively. FR carbon footprint and land occupation were significantly (P<0.05) higher. Since 2010, fossil energy, arable land, and greenhouse-gas emissions have declined. One countertrend was LU and dLUC emissions, which increased due to changed soy imports, resulting in a slightly higher C carbon footprint.

 Conclusions Multi-indicator analysis is fundamental to understanding, communicating, and improving performance, and distinguishing between short-term fluctuations and long-term trends. Since 2010, feed-production impacts have increased (due to imported soymeal in poultry diets), indicating that alternative feed protein sources are a priority. Efficiency improvements reduced per-kilogram impacts across other indicators, demonstrating a positive trend in producing more food from fewer inputs.

 Implications Australian chicken meat is a low-impact animal protein. Future improvements require alternative feed proteins, technology adoption and practice change to maintain or reduce impacts as production expands alongside consumer demand.
Use of e-cigarettes among young queer men living in Aotearoa New Zealand
Authors: Bouttier-Esprit Thibaut , Dobson Rosie , Saxton Peter , McCool Judith
Published: March 2023

Introduction Queer-identifying (non-heterosexual) men report higher rates of tobacco and e-cigarette use than the general population. The advent of e-cigarettes as a commercial product in Aotearoa New Zealand has been accompanied by aggressive marketing and a sharp uptake in use, especially among young people. Recent evidence suggests that e-cigarettes are widely used for purposes other than smoking cessation. Aim This study investigated how vaping is perceived and the role e-cigarettes play in the daily lives of young queer users. Methods Using focus groups with a semi-structured interview proforma, we interviewed twelve young queer men between July and August 2021. Interviews were queer-led, conducted via Zoom, and lasted up to 2 h. Interviews were audio-recorded and transcribed verbatim for subsequent inductive and thematic analysis. Results Of the twelve participants, 10 were daily users, and two described themselves as ‘social vapers’. We found strong evidence for minority and intra-minority stress as a driver to uptake and continued use of e-cigarettes. E-cigarettes were also used to navigate new social and cultural spaces and as currency for integration into various social milieux, including both mainstream and gay community spaces. There was little support for queer-targeted cessation initiatives. Discussion Vaping is highly socially acceptable within queer communities where it is a facilitator of social integration, managing stress and quitting tobacco.
Increasing the efficiency of drilling exploration wells with air bleeding based on the use of recovered heat of the compressor
Authors: Yuldoshov H , Dzhuraev R , Ganiev S , Khusanov Sh , An A
Published: March 2023

To date, the practice of drilling shows that the use of compressed air to clean the bottom of the cuttings is the most effective in difficult and unfavorable conditions for the use of drilling mud: when drilling in absorbing zones of flushing fluid, when it is impossible or difficult to supply water, when drilling in areas with negative ambient temperature. However, when drilling with bottomhole cleaning with air, the fuel and energy costs of drilling operations are significantly increased due to the use of compressor units, the drive energy costs of which are greater than pumps used in similar conditions. An analysis of the operation of mobile compressor units shows that a significant part of the energy losses falls on the internal combustion engine of the compressor drive, since not all of the combustible fuel is converted into useful power. Most of the thermal energy is removed from the engine to the cooling system and carried away with the exhaust gases. In this article, the energy losses of the internal combustion engine of the compressor are investigated and the possibility of increasing the energy efficiency due to the use of the recovered heat of the compressor drive and secondary energy resources is presented.
The effect of different doses of different biostimulants on the yield of oily sunflower
Authors: Yuldasheva Z F , Karabayeva D J
Published: March 2023

Biologically active substances (BASs), including plant phytohormones-regulators of plant growth and development, are becoming increasingly important in agriculture activities. Their use allows to better realize the genetic potential of crops, increase the resistance of plants to stress factors of biotic and abiotic nature, and as a result increase yields and improve quality. In this research, it was aimed at researching effect of different doses of different biostimulants on the yield of oily sunflower. In the research experiment, “Methods of field experiments” developed by B. Dospekhov was used. According to the results, it was found that microbio-fertilizers, biostimulants, immunostimulants had positive effect on the growth, development and seed formation of the local Dilbar variety of sunflower, the weight and yield of 1000 seeds. When biodux biostimulator was applied to the 1.0 ml/t seed variant, the height of sunflower stem was 28.5 cm higher than the control and 7.1 cm higher than the “UzGUMI” standard. Furthermore, when the MERS microbiota fertilizer was used in the 2.0 ml/ton variant, the stem height was 25.5 cm higher, and it was 4.1 cm higher than the UzGUMI standard. The 1000 seed weight was found to be heavier than the other biostimulants used in the experiment, especially in the variant using MERS microbiota.
Sustainable coastal management in supporting blue economy: an Indonesian experience
Authors: Safitri D P , Hakim A , Muluk M R K , Putra F
Published: March 2023

The coastal regions had a great ecosystem and potential for the sustainability of life. At the same time, growing human and environmental pressures in coastal areas significantly impact coastal systems. Various problems arise in the development and utilisation of the coastal regions. The issues have prompted the importance of studying coastal area management policies. Specifically, legal uncertainty in the management of utilisation has initiated the formulation of the RZWP3K policy. This study uses stakeholder analysis to map the actors involved and their influence on coastal area management policies. This study was conducted using a qualitative method and stakeholder analysis to explore and classify the actors shaping coastal area management policies. The stakeholder analysis method classified constituents into important actors, contextual fixers, users, and audiences using variables of interest and impact. Developing policies for coastal management is hampered by the conflicting agendas of many parties and their multiple goals and worries. This study recommends that the government maintain stakeholders by keeping them informed, actively groomed, monitored and managed, or satisfied. This paper contributes to conceptual stakeholder analysis literature to analyse coastal area management policies.
Atomic semigroup rings and the ascending chain condition on principal ideals
Authors: Gotti Felix , Li Bangzheng
Published: March 2023

An integral domain is called atomic if every nonzero nonunit element factors into irreducibles. On the other hand, an integral domain is said to satisfy the ascending chain condition on principal ideals (ACCP) if every ascending chain of principal ideals stabilizes. It was asserted by P. Cohn back in the sixties that every atomic domain satisfies the ACCP, but such an assertion was refuted by A. Grams in the seventies with a neat counterexample. Still, atomic domains without the ACCP are notoriously elusive, and just a few classes have been found since Grams’ first construction. In the first part of this paper, we generalize Grams’ construction to provide new classes of atomic domains without the ACCP. In the second part of this paper, we construct a new class of atomic semigroup rings without the ACCP.
MicroRNAs in septic acute kidney injury
Authors: Wang Bo , Xu Jun , Fu Ping , Ma Liang
Published: March 2023

Sepsis is a potentially fatal complication of burns and trauma that can cause acute kidney injury (AKI) with substantial morbidity and mortality, but this disease is poorly understood. Despite medical advances, effective therapeutic regimens for septic AKI remain uncommon. MicroRNAs (miRNAs) are endogenous non-coding RNAs that influence the translation of target messenger RNAs in a variety of biological processes. Emerging evidence has shown that miRNAs are intimately associated with septic AKI. The goal of this review was to summarize recent advances in the profound understanding of the functional role of miRNAs in septic AKI, as well as to provide new insights into miRNAs as feasible biomarkers and therapeutic targets for septic AKI.
Experimental investigation on flow condensation pressure drop of R134a in microfin tube at high mass flux
Authors: Qiu Fuqiang , Xu Taoping , He Dugui , Du Juanli
Published: March 2023

To clarify the influencing mechanisms of the experimental condition and the tube structure on the pressure drop of heat transfer fluid, the two-phase flow condensation pressure drop of R134a inside the microfin tube was experimentally studied at high mass flux, which is different from other conventional researches. The experimental result shows the pressure drop is proportional to mass flux and fin helical angle, and is inversely proportional to condensation temperature and coolant Reynolds number. Moreover, the experimental data of pressure drop was compared with the predicted value of some existing correlations for the microfin tube. It can be found that the correlations of Cavallini et al., Han et al. and Haraguchi et al. show a good prediction effect with mean relative deviation (MRD) of 13.89, 16.08 and −2.19%, respectively. The correlations of Pierre/0.053, Kedzierski et al. and Choi et al. all underestimate most of the experimental data of the pressure drop inside the tube, and their prediction deviations are >10%. That is, the application effect of the separated flow model is better than that of the homogeneous flow model. Finally, the Kedzierski et al. correlation was improved to realize a high-precision prediction of the fluid flow mechanism inside the tube. Because the prediction deviation of the improved correlation between the experimental value and the predicted value was greatly reduced, its prediction deviation is <10% for R134a and R410A; therefore, it can be said the improved correlation has a good predictive result for the pressure drop.
Why Aquinas Should Have Held That One May Intentionally Tell A Falsehood to an Unjust Aggressor
Authors: Vincelette Alan
Published: March 2023

Aquinas argued that one may never intentionally tell an outright falsehood, that is to say, lie, even if one is doing so to help save another person’s life. Yet his position here is very different from how he treats the nature of other moral norms such as stealing, promise-keeping, and murder. For the latter Aquinas defends exceptionless moral norms, but by carefully defining what constitutes stealing, promise-keeping, and murder, allows a limited number of disassociating circumstances wherein morally relevant situations (such as a grave necessity or the presence of an unjust aggressor) take actions out of the categories of stealing or murder strictly speaking. Aquinas furthermore allows divine disassociations from the moral law in cases of murder, stealing, and even adultery, which remove certain acts from being included in prohibited categories because of divine decree, but he does not do so for lying. As a consequence, Aquinas has to resort to various elaborations as to how what seems to be a telling of a falsehood by an Old Testament figure is not really so. I will argue here that there are reasons to think Aquinas was inconsistent in his approach, and that given his philosophical presuppositions he could have and indeed should have held that it is licit to intentionally tell a falsehood to an unjust aggressor, and that this would have rendered his thought more coherent as a whole.
Serum Ribonucleotide Reductase Subunit M2 in Patients with Chronic Liver Diseases and Hepatocellular Carcinoma
Authors: Jin Xuehang , Yu Wei , Wang Ange , Qiu Yunqing
Published: March 2023

Background

Ribonucleotide reductase subunit M2 (RRM2) plays a key role in cell and hepatitis B virus (HBV) replication. Nevertheless, its clinical implications for managing liver diseases have been inadequately studied.

Methods

A total of 412 participants were enrolled, including 60 healthy control individuals, 55 patients with chronic hepatitis B (CHB), 173 patients with cirrhosis, and 124 patients with hepatocellular carcinoma (HCC). Serum RRM2 was measured via ELISA.

Results

The level of serum RRM2 in patients with CHB, cirrhosis, and HCC was higher than that in healthy controls (P < .05). A large difference in serum RRM2 was found between HBV-related and non–HBV-related patients in the cirrhosis group (P < .001), compared with the difference between HBV-related HCC and non–HBV-related HCC (P = .86). In the HBV-related cirrhosis group, the serum RRM2 level showed significant positive correlations with HBV DNA, hepatitis B surface antigen, hepatitis B e antigen, Child-Pugh scores, and MELD scores and played a strong role in diagnosing HBV-related cirrhosis in CHB, compared with fibrosis-4 score and aspartate aminotransferase–to-platelet ratio index.

Conclusions

Serum RRM2 is a reliable biomarker for accurate HBV-related cirrhosis diagnosis and evaluation. Also, serum RRM2 could reflect the expression state of HBV replication in patients with HBV-related cirrhosis.
Tame and full strict-Π11 reflection: A proof-theoretic approach
Authors: Jäger Gerhard
Published: March 2023

Strict-$\varPi ^{1}_{1}$ reflection is an important principle that is discussed in detail, e.g. in Barwise [ 2]. Whereas Barwise puts his focus on the importance of strict-$\varPi ^{1}_{1}$ formulas for generalized recursion theory and definability theory, we choose a proof-theoretic approach.
14-3-3 proteins facilitate the activation of MAP kinase cascades by upstream immunity-related kinases
Authors: Dong Xiaojing , Feng Feng , Li Yangjun , Li Lin , Chen She , Zhou Jian-Min
Published: March 2023

Activation of mitogen-activated protein kinase (MAP kinase) cascades is essential for plant immunity. Upon activation by surface-localized immune receptors, receptor-like cytoplasmic kinases (RLCKs) in the cytoplasm phosphorylate MAP kinase kinase kinases (MAPKKKs) to initiate MAP kinase activation. Surprisingly, we found that both the phosphorylation of Arabidopsis (Arabidopsis thaliana) MAPKKKs and the subsequent activation of MAP kinase cascades require the λ and κ isoforms of 14-3-3 proteins, which directly interact with multiple RLCKs and MAPKKKs. The N- and C-termini of MAPKKK5 interact intramolecularly to inhibit the access to the C terminus by RLCKs, whereas the 14-3-3 proteins relieve this inhibition and facilitate the interaction of RLCKs with the C-terminus of MAPKKK5. This enables the phosphorylation of MAPKK5 at Ser599 and Ser682, thus promoting MAP kinase activation and enhancing plant disease resistance. Our study reveals a role of 14-3-3 proteins as scaffolds and activators in the regulation of the RLCK-MAPKKK5 module and provides insight into the mechanism of plant immune signaling.
ABCC4 is a PGE2 efflux transporter in the ovarian follicle: A mediator of ovulation and a potential non‐hormonal contraceptive target
Authors: Yerushalmi Gil M. , Shuraki Batel , Yung Yuval , Maman Ettie , Baum Micha , Hennebold Jon D. , Adashi Eli Y. , Hourvitz Ariel
Published: March 2023

The role of prostaglandins (PGs) in the ovulatory process is known. However, the role of the ATP binding cassette subfamily C member 4 (ABCC4), transmembrane PG carrier protein, in ovulation remains unknown. We report herein that ABCC4 expression is significantly upregulated in preovulatory human granulosa cells (GCs). We found that PGE2 efflux in cultured human GCs is mediated by ABCC4 thus regulating its extracellular concentration. The ABCC4 inhibitor probenecid demonstrated effective blocking of ovulation and affects key ovulatory genes in female mice in vivo. We postulate that the reduction in PGE2 efflux caused by the inhibition of ABCC4 activity in GCs decreases the extracellular concentration of PGE2 and its ovulatory effect. Treatment of female mice with low dose of probenecid as well as with the PTGS inhibitor indomethacin or Meloxicam synergistically blocks ovulation. These results support the hypothesis that ABCC4 has an important role in ovulation and might be a potential target for non‐hormonal contraception, especially in combination with PGE2 synthesis inhibitors. These findings may fill the gap in understanding the role of ABCC4 in PGE2 signaling, enhance the understanding of ovulatory disorders, and facilitate the treatment and control of fertility.
Deletion of the tyrosine phosphatase Shp2 in cervical cancer cells promotes reprogramming of glutamine metabolism
Authors: Gao Xuehui , Kang Jie , Li Xiangke , Chen Chuan , Luo Duqiang
Published: March 2023

Shp2 is a nonreceptor protein tyrosine phosphatase that is overexpressed in cervical cancer. However, the role of Shp2 in the regulation of cervical cancer metabolism and tumorigenesis is unclear. EGFR signaling pathways are commonly dysregulated in cervical cancer. We showed that Shp2 knockout in cervical cancer cells decreased EGFR expression and downregulated downstream RAS–ERK activation. Although AKT was activated in Shp2 knockout cells, inhibition of AKT activation could not make cells more sensitive to death. Shp2 depletion inhibited cervical cancer cell proliferation and reduced tumor growth in a xenograft mouse model. 1H NMR spectroscopic analysis showed that glutamine, glutamate, succinate, creatine, glutathione, and UDP‐GlcNAc were significantly changed in Shp2 knockout cells. The intracellular glutamine level was higher in Shp2 knockout cells than in control cells. Further analysis demonstrated that Shp2 knockout promoted glutaminolysis and glutathione production by up‐regulating the glutamine metabolism‐related genes such as glutaminase (GLS). However, inhibition of GLS did not always make cells sensitive to death, which was dependent on glucose concentration. The level of oxidative phosphorylation was significantly increased, accompanied by an increased generation of reactive oxygen species in Shp2 knockout cells. Shp2 deficiency increased c‐Myc and c‐Jun expression, which may be related to the upregulation of glutamine metabolism. These findings suggested that Shp2 regulates cervical cancer proliferation, glutamine metabolism, and tumorigenicity.
Developmental dysplasia of the hip and ultrasound reading by pediatric orthopedic surgeons: a pilot study
Authors: Kwart Ariel , Pacana Matthew , Otsuka Norman , Piazza Brian , Armstrong Douglas , Shaw Brian , S. Segal Lee , Sorenson Scott , Fortuna Kristine , Abzug Joshua , Hennrikus William
Published: March 2023

Ultrasound is an imaging modality utilized for early detection and follow-up of developmental dysplasia of the hip (DDH) in infants. Traditionally, pediatric orthopedic surgeons have relied on radiologists to perform ultrasound examinations and interpret the imaging. Today, however, many orthopedic surgeons are performing and interpreting ultrasound themselves. The purpose of this paper was to evaluate the reliability of pediatric orthopedic surgeons in interpreting ultrasound imaging of infant hips. This was a prospective observational pilot study. After reading an instructional handout about the Graf method of hip ultrasonography, eight pediatric orthopedic surgeons measured 28 hip ultrasound images to determine the alpha angle and percent femoral head coverage. On the basis of cited intraclass correlation coefficient cutoff values, interrater reliability was found to be ‘good’ for percent femoral head coverage and ‘fair’ for alpha angle. These findings are equivalent to findings of similar studies using radiologists as examiners. Pediatric orthopedic surgeons can interpret ultrasound exams for diagnosing DDH.
Submuscular nonlocking plates: an effective option for pediatric extra-articular proximal femur fractures
Authors: Waghela Ankit B. , Oka Gauri A. , Ranade Ashish S.
Published: March 2023

The aim of this study is to evaluate the results of submuscular plating using nonlocking plates for extra-articular proximal femur fractures (EPFF) in children. From our hospital records, we retrieved data of 15 children treated with submuscular plating with nonlocking dynamic compression plates (DCP) for EPFF between January 2010 and September 2021. EPFF was defined as a proximal femur fracture within 10% of the femoral length below the lesser trochanter. Patients’ demographics, as well as details of the duration of operation, type of DCP used, time to union, complications, and outcomes using Flynn criteria were noted. There were nine males and six females. Mean age of the patients was 10.8 ± 1.9 years (range 7–14 years). All the patients had fracture union and two patients had union with an angulation less than 10°. All fractures healed uneventfully with a mean time to union of 11.8 ± 1.2 weeks (range 10–15 weeks). No patient required surgery for complications or malunion. Using Flynn criteria, excellent outcomes were seen in 13 out of 15 patients. There were no poor outcomes. Our study shows that submuscular plating using nonlocking plates is an effective option for treating pediatric EPFF. Treatment of these tricky fractures with submuscular plating using nonlocking plates shows excellent outcomes with minimal complications.
Two-Surgeon Multidisciplinary Approach to Pediatric Cervical Spinal Fusion: A Single-Institution Series and Review of the Literature
Authors: Lynch Benjamin T. , Montgomery Blake K. , Verhofste Bram P. , Proctor Mark R. , Hedequist Daniel J.
Published: March 2023

Background:

A collaborative 2-surgeon approach is becoming increasingly popular in surgery but is not widely used for pediatric cervical spine fusions. The goal of this study is to present a large single-institution experience with pediatric cervical spinal fusion using a multidisciplinary 2-surgeon team, including a neurosurgeon and an orthopedic surgeon. This team-based approach has not been previously reported in the pediatric cervical spine literature.

Methods:

A single-institution review of pediatric cervical spine instrumentation and fusion performed by a surgical team composed of neurosurgery and orthopedics during 2002–2020 was performed. Demographics, presenting symptoms and indications, surgical characteristics, and outcomes were recorded. Particular focus was given to describe the primary surgical responsibility of the orthopedic surgeon and the neurosurgeon.

Results:

A total of 112 patients (54% male) with an average age of 12.1 (range 2–26) years met the inclusion criteria. The most common indications for surgery were os odontoideum with instability (n=21) and trauma (n=18). Syndromes were present in 44 (39%) cases. Fifty-five (49%) patients presented with preoperative neurological deficits (26 motor, 12 sensory, and 17 combined deficits). At the time of the last clinical follow-up, 44 (80%) of these patients had stabilization or resolution of their neurological deficit. There was 1 new postoperative neural deficit (1%). The average time between surgery and successful radiologic arthrodesis was 13.2±10.6 mo. A total of 15 (13%) patients experienced complications within 90 days of surgery (2 intraoperative, 6 during admission, and 7 after discharge).

Conclusions:

A multidisciplinary 2-surgeon approach to pediatric cervical spine instrumentation and fusion provides a safe treatment option for complex pediatric cervical cases. It is hoped that this study could provide a model for other pediatric spine groups interested in implementing a multi-specialty 2-surgeon team to perform complex pediatric cervical spine fusions.

Level of Evidence:

Level IV—case series.
Association of Sublingual Microcirculation Parameters and Capillary Refill Time in the Early Phase of ICU Admission*
Authors: Huang Weipeng , Xiang Hui , Hu Chang , Wu Tong , Zhang Dandan , Ma Siqing , Hu Bo , Li Jianguo
Published: March 2023

Objectives:

This observational study was conducted to investigate capillary refill time (CRT) during the early phase of ICU admission in relationship with microvascular flow alteration and outcome in critically ill patients.

Design:

Prospective, observational, pilot study.

Setting:

ICU in a university hospital.

Patients:

Two hundred eighty-two critically ill adult patients admitted to the ICU.

Interventions:

None.

Measurements and Main Results:

All patients underwent simultaneous measurements by CRT and sidestream dark field imaging within 24 hours of ICU admission. Other clinical data such as demographic characteristics, hemodynamics, laboratory values, treatment, and physiologic parameters were also included simultaneously. Microcirculatory measurements were performed at 10.2 ± 5.7 hours after ICU admission. Of the 282 included patients, 106 (37.6%) were female, the median (interquartile range) age was 63 years (53–74 yr), and the median Sequential Organ Failure Assessment (SOFA) score was 5 (2–7). The primary finding was the association between CRT and simultaneous the condition of peripheral circulation (microvascular flow index [MFI]: r = –0.4430, p < 0.001; proportion of perfused vessels: r = –0.3708, p < 0.001; heterogeneity index: r = 0.4378, p < 0.001; perfused vessel density: r = –0.1835, p = 0.0020; except total vessel density: p = 0.9641; and De Backer score: p = 0.5202) in critically ill patients. In addition, this relationship was also maintained in subgroups. Microcirculatory flow abnormalities, 28-day mortality, and SOFA score appeared to be more severe for increasing CRT. In a multivariable analysis, prolonged CRT was independently associated with microvascular flow abnormalities (MFI < 2.6; odds ratio [OR], 1.608; 95% CI, 2.1–10.2; p < 0.001). Similarly, multivariable analysis identified CRT as an independent predictor of 28-day mortality (OR, 1.296; 95% CI, 1.078–1.558; p = 0.006).

Conclusions:

In our ICU population, a single-spot prolonged CRT was independently associated with abnormal microcirculation and increased mortality.
Universal screening for Lynch syndrome in operated colorectal cancer by immunohistochemistry: a cohort of patients in Liaoning province, China
Authors: Zhao Guangyue , Xiang Guoqing , Hu Xiaoru , Qiao Yun , Ma Shiyang , Tian Ye , Gao Xiaozuo , Liu Fang , Li Xiaohan , Shi Gang
Published: March 2023

Objective

Lynch syndrome (LS) is the most common hereditary colorectal cancer syndrome worldwide. Due to the decreasing family size in Liaoning province. The Bethesda and Amsterdam II criteria have lower sensitivity and specificity and are not suitable for the local population. Immunohistochemistry screening for mutations in DNA mismatch repair (MMR) in newly diagnosed colorectal cancer can improve the detection rate of LS.

Methods

All newly diagnosed colorectal cancer patients who underwent surgery between January 2018 and June 2020 at Cancer Hospital of China Medical University and Shengjing Hospital of China Medical University from Liaoning China were included retrospectively, and the ratio of universal LS screening by immunohistochemistry, MMR protein deficiency (dMMR) ratio, MLH1 loss, MSH2 loss, MSH6 loss, and PMS2 loss was analyzed. The clinicopathological characteristics of patients with pMMR and dMMR were analyzed.

Results

A total of 7019 colorectal cancer patients underwent surgery and 4802 (68.41%) patients were screened by immunohistochemistry for MMR, 258 (5.37%) cases were reported to have a loss of MMR expression. In the dMMR group, a higher number of patients were under 50 years old, more tumors were located at the right colon, less patients have lymph node metastasis, more tumors were stage II, and histological types of mucinous carcinoma or signet ring carcinoma were more common, compared with the pMMR group. Only 2.71% dMMR patients meet Amsterdam criteria II, 2.71% of patients meet Revised Bethesda guidelines, and 17.83% meet Chinese LS criteria. Twenty-five dMMR patients were confirmed by next-generation sequencing and five families were confirmed as Lynch family.

Conclusion

These data imply that universal screening for LS by immunohistochemistry may be effective in Liaoning province.
Quality of Social Relationships with Parents and Peers in Adolescents Born Extremely Preterm
Authors: Taylor H. Gerry , Hoskinson Kristen R. , Vrantsidis Daphne M. , Minich Nori Mercuri , Busch Tyler , Horn Timothy , Mattson Whitney I. , Nelson Eric E.
Published: March 2023

Objective:

Adolescents born extremely preterm (EPT, gestational age [GA] <28 weeks) are at higher risk for problems in peer socialization than those born full-term (FT, GA >36 weeks). This study was designed to examine the possibility that adolescents born EPT may also have difficulty in transitioning from parents to peers for socialization, a process referred to as “social reorienting.” A secondary aim was to investigate associations of social reorienting with other neurodevelopmental characteristics.

Methods:

The Network of Relationships Inventory, Relationship Quality Version was administered to 24 adolescents (ages 11–16 years) born EPT and 29 born FT to obtain self-ratings of closeness and discord with parents and peers. Measures of other neurodevelopmental characteristics included tests of cognitive and social skills, adolescent self-ratings of adjustment and victimization, and parent ratings of youth behavior and adaptive skills. Mixed model analyses controlling for sex, socioeconomic status, and race were conducted to examine group differences in measures of relationship quality and their associations with other neurodevelopmental characteristics.

Results:

The EPT group had higher ratings of closeness with parents than the FT group. For adolescents from lower socioeconomic backgrounds, those born EPT had lower closeness with peers. Higher closeness with parents was associated with lower test scores. Lower closeness and more discord with peers were associated with more behavior problems.

Conclusion:

Findings suggest that adolescents born EPT have difficulties in social reorientation toward peers and identify factors related to these difficulties. Results imply a need for interventions to improve peer socialization in youth born EPT.
MELD 3.0 for adolescent liver transplant candidates
Authors: Kwong Allison J. , Zhang Ke-You , Ebel Noelle , Mannalithara Ajitha , Kim W. Ray
Published: March 2023

Background and Aims:

Adolescents constitute a unique waitlist cohort that is distinct from younger children. Model for End-stage Liver Disease (MELD) 3.0, which was developed in an adult population of liver transplant candidates, is planned to replace MELD-Sodium in the current liver allocation system for both adults and adolescents aged 12–17. We evaluated the predictive performance of MELD-Sodium, MELD 3.0, and Pediatric End-stage Liver Disease for 90-day waitlist mortality risk among adolescent liver transplant registrants.

Approach and Results:

New waitlist registrations for primary liver transplants among individuals aged 12–17 and 18–25 for comparison were identified using Organ Procurement and Transplantation Network (OPTN) data from November 17, 2004, to December 31, 2021. The predictive performance of the current and proposed MELD and Pediatric End-stage Liver Disease scores was assessed using Harrell’s concordance (c) statistic. There were 1238 eligible listings for adolescents aged 12–17 and 1740 young adults aged 18–25. In the adolescent group, 90-day survival was 97.8%, compared with 95.9% in those aged 18–25 (log-rank p = 0.005), with no significant differences when stratified by sex or indication. Among adolescents, increasing MELD 3.0 was associated with an increased hazard of mortality (HR=1.27, 95% CI: 1.18–1.37), and the c-statistic for 90-day waitlist survival using MELD 3.0 was 0.893 compared with 0.871 using MELD-Sodium and 0.852 using Pediatric End-stage Liver Disease.

Conclusions:

The discriminative ability of MELD 3.0 to rank adolescents according to the risk of death within 90 days was robust. Although MELD 3.0 was initially developed and validated in adults, MELD 3.0 may also improve the prediction of waitlist mortality in adolescents and better represent their urgency for liver transplants.
Novel oral medications for retinal disease: an update on clinical development
Authors: DeBoer Charles Meno Theodore , Agrawal Rajat , Rahimy Ehsan
Published: March 2023

Purpose of review

Intravitreal and periocular injections for retinal disease provide a targeted delivery of medication to the eye. However, given risks of injections, including endophthalmitis, pain and treatment burden for both patients and retina specialists, there has been significant interest and effort in developing oral medications for the management of retinal disease. This article provides clinical and preclinical details of new oral medications in the pipeline for management of retinal disease.

Recent findings

Several new oral medications show clinical and preclinical promise for the management of retinal disease, including macular degeneration, diabetic retinopathy and Stargardt disease.

Oral medications provide promise for treating retinal disease, possibly increasing compliance, and reducing side effects of intravitreal or periocular injections. However, difficulties in this approach include systemic side effects and efficacy targeting the eye. There are multiple medications that are currently under investigation with the potential to act as stand-alone treatment or as an adjunct treatment for management of retinal diseases such as diabetic retinopathy, macular degeneration and Stargardt disease.
Research objectives and general considerations for pragmatic clinical trials of pain treatments: IMMPACT statement
Authors: Hohenschurz-Schmidt David J. , Cherkin Dan , Rice Andrew S.C. , Dworkin Robert H. , Turk Dennis C. , McDermott Michael P. , Bair Matthew J. , DeBar Lynn L. , Edwards Robert R. , Farrar John T. , Kerns Robert D. , Markman John D. , Rowbotham Michael C. , Sherman Karen J. , Wasan Ajay D. , Cowan Penney , Desjardins Paul , Ferguson McKenzie , Freeman Roy , Gewandter Jennifer S. , Gilron Ian , Grol-Prokopczyk Hanna , Hertz Sharon H. , Iyengar Smriti , Kamp Cornelia , Karp Barbara I. , Kleykamp Bethea A. , Loeser John D. , Mackey Sean , Malamut Richard , McNicol Ewan , Patel Kushang V. , Sandbrink Friedhelm , Schmader Kenneth , Simon Lee , Steiner Deborah J. , Veasley Christin , Vollert Jan
Published: March 2023

Many questions regarding the clinical management of people experiencing pain and related health policy decision-making may best be answered by pragmatic controlled trials. To generate clinically relevant and widely applicable findings, such trials aim to reproduce elements of routine clinical care or are embedded within clinical workflows. In contrast with traditional efficacy trials, pragmatic trials are intended to address a broader set of external validity questions critical for stakeholders (clinicians, healthcare leaders, policymakers, insurers, and patients) in considering the adoption and use of evidence-based treatments in daily clinical care. This article summarizes methodological considerations for pragmatic trials, mainly concerning methods of fundamental importance to the internal validity of trials. The relationship between these methods and common pragmatic trials methods and goals is considered, recognizing that the resulting trial designs are highly dependent on the specific research question under investigation. The basis of this statement was an Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) systematic review of methods and a consensus meeting. The meeting was organized by the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) public–private partnership. The consensus process was informed by expert presentations, panel and consensus discussions, and a preparatory systematic review. In the context of pragmatic trials of pain treatments, we present fundamental considerations for the planning phase of pragmatic trials, including the specification of trial objectives, the selection of adequate designs, and methods to enhance internal validity while maintaining the ability to answer pragmatic research questions.
Metabolic and histomorphological changes of adipose tissue in cachexia
Authors: Molfino Alessio , Imbimbo Giovanni , Muscaritoli Maurizio
Published: March 2023

Purpose of review

To describe the role of the main changes occurring in adipose tissue during cachexia and how these affects patient's outcomes, with a specific focus on cancer.

Recent findings

In cachexia, the changes within the adipose tissue have been recently described as the presence of inflammatory infiltration (T-lymphocytes and macrophages), enhanced fibrosis, and the occurrence of beige adipocytes (i.e., browning). The latter one is a process driving cachexia enhancing thermogenesis, primarily via modulation of uncoupling protein 1. Also, increased lipolysis of white adipose tissue, especially in cancer, via higher expression of hormone sensible and adipose tissue triglyceride lipases, was detected in experimental models and in human adipose tissue. Other systemic metabolic alterations occur in association with changes in adiposity, including insulin resistance and increased inflammation, all conditions associated with a worse outcome. Moreover, these profound metabolic alterations were shown to be implicated in several consequences, including extreme and progressive unvoluntary body weight loss.

Alterations in adiposity occur early during cachexia. Adipose tissue atrophy, as well as metabolic changes of white adipose tissues were observed to be pivotal in cachexia, and to be implicated in several clinical complications and poor prognosis.

Further research is necessary to clarify the mechanisms underlying the loss of adiposity and therefore to identify novel therapeutic options to counteract this phenomenon in cachexia.
Updates in the management of pediatric dyslipidemia
Authors: Choudhari Pooja , Patni Nivedita
Published: March 2023

Purpose of review

Pediatric dyslipidemias increase the risk of atherosclerosis and clinical cardiovascular disease and are the leading cause of morbidity and mortality. Lifestyle modifications and pharmacotherapies have measurably improved abnormal lipids and reduced cardiovascular events. The review will focus on current standards of care and investigative medications with the potential to improve cardiovascular health in children and adults.

Recent findings

Lifestyle interventions and statins remain cornerstones in the treatment of pediatric hyperlipidemias. Bile acid sequestrants and ezetimibe continue to be used in the pediatric population as well. In recent years, successful clinical trials have approved use of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in children with familial hypercholesterolemia. Use of angiopoietin-like protein 3 (ANGPTL3) inhibitors is also promising as it causes marked improvement in low-density lipoprotein cholesterol with safe side effect profiles. Additional medications undergoing pediatric clinical trials include inclisiran, bempedoic acid, and lomitapide.

Recent advances in pharmacotherapy, especially for treatment of familial hypercholesterolemia, greatly impact treatment of dyslipidemias in children. Despite the overall progress in the development of these medications, therapies targeted towards treating hypertriglyceridemia have lagged behind. Continuing research for the treatment of pediatric dyslipidemias remains an important endeavor to reduce the risk of atherosclerosis and future cardiovascular events in children.
A Case of Spontaneous Coronary Artery Dissection in the Setting of Exogenous Testosterone
Authors: Gongolli Julita , Vanderschaegen Anna , Prahlow Joseph A.
Published: March 2023

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome, occurring when there is separation of the coronary artery walls by intramural hemorrhage creating a false lumen. This compresses the arterial lumen, compromising the ability of the coronary artery to perfuse the myocardial tissue. Spontaneous coronary artery dissection is usually fatal, with risk factors including pregnancy, young age, and female sex, birth control, and other hormonal therapies.

In this case report, we describe the case of a 31-year-old biological female transitioning to male with exogenous testosterone who experienced a SCAD. Given the known risk factors for SCAD, such as pregnancy and exogenous hormone therapy, this case raises additional considerations regarding rare unintended consequences of testosterone therapy.