bluuebunny/crossref_metadata_2025 huggingface dataset:
Whole-genome sequencing in clinically diagnosed Charcot–Marie–Tooth disease undiagnosed by whole-exome sequencing
Authors: Kim Young-gon , Kwon Hyemi , Park Jong-ho , Nam Soo Hyun , Ha Changhee , Shin Sunghwan , Heo Won Young , Kim Hye Jin , Chung Ki Wha , Jang Ja-Hyun , Kim Jong-Won , Choi Byung-Ok
Published: April 2023

Whole-genome sequencing is the most comprehensive form of next-generation sequencing method. We aimed to assess the additional diagnostic yield of whole-genome sequencing in patients with clinically diagnosed Charcot–Marie–Tooth disease when compared with whole-exome sequencing, which has not been reported in the literature. Whole-genome sequencing was performed on 72 families whose genetic cause of clinically diagnosed Charcot–Marie–Tooth disease was not revealed after the whole-exome sequencing and 17p12 duplication screening. Among the included families, 14 (19.4%) acquired genetic diagnoses that were compatible with their phenotypes. The most common factor that led to the additional diagnosis in the whole-genome sequencing was genotype-driven analysis (four families, 4/14), in which a wider range of genes, not limited to peripheral neuropathy-related genes, were analysed. Another four families acquired diagnosis due to the inherent advantage of whole-genome sequencing such as better coverage than the whole-exome sequencing (two families, 2/14), structural variants (one family, 1/14) and non-coding variants (one family, 1/14). In conclusion, an evident gain in diagnostic yield was obtained from whole-genome sequencing of the whole-exome sequencing-negative cases. A wide range of genes, not limited to inherited peripheral neuropathy-related genes, should be targeted during whole-genome sequencing.
Lesion-network mapping for tics: moving from replication to clinical translation
Authors: Ganos Christos , Horn Andreas
Published: April 2023

This scientific commentary refers to ‘Mapping a network for tics in Tourette syndrome using causal lesions and structural alterations’, by Zouki et al. (https://doi.org/10.1093/braincomms/fcad105).
Structural integrity of the insula and emotional facial recognition performance following stroke
Authors: Klepzig Kai , Domin Martin , Wendt Julia , von Sarnowski Bettina , Lischke Alexander , Hamm Alfons O , Lotze Martin
Published: April 2023

The role of the human insula in facial emotion recognition is controversially discussed, especially in relation to lesion-location-dependent impairment following stroke. In addition, structural connectivity quantification of important white-matter tracts that link the insula to impairments in facial emotion recognition has not been investigated. In a case–control study, we investigated a group of 29 stroke patients in the chronic stage and 14 healthy age- and gender-matched controls. Lesion location of stroke patients was analysed with voxel-based lesion-symptom mapping. In addition, structural white-matter integrity for tracts between insula regions and their primarily known interconnected brain structures was quantified by tractography-based fractional anisotropy. Our behavioural analyses showed that stroke patients were impaired in the recognition of fearful, angry and happy but not disgusted expressions. Voxel-based lesion mapping revealed that especially lesions centred around the left anterior insula were associated with impaired recognition of emotional facial expressions. The structural integrity of insular white-matter connectivity was decreased for the left hemisphere and impaired recognition accuracy for angry and fearful expressions was associated with specific left-sided insular tracts. Taken together, these findings suggest that a multimodal investigation of structural alterations has the potential to deepen our understanding of emotion recognition impairments after stroke.
Thymoquinone inhibits lung cancer stem cell properties via triggering YAP degradation
Authors: Zhang Yujiao , Liu Xizhi , Dang Wenhui , Liu Lu
Published: April 2023

Due to the characteristics of high recurrence and metastasis, it is still difficult to cure lung cancer. Cancer stem cells (CSCs) are a group of tumor cells with self-renewal ability and differentiation potential, which are responsible for lung cancer recurrence. Therefore, targeting CSCs may provide a new strategy for lung cancer treatment. Thymoquinone (TQ), the main active ingredient isolated from black seed oil, has shown significant anti-cancer effects in various cancers. However, the effect of TQ on lung cancer stem cells (LCSCs) has never been clarified. In the present study, we successfully separated and enriched lung cancer tumorsphere cells. Our data showed that TQ significantly inhibited the stem-like properties of LCSCs. In addition, we found TQ promoted Yes-associated protein (YAP) phosphorylation and ubiquitination, and the inhibitory effects of TQ on LCSCs could be enhanced by silencing YAP. Taken together, these results suggest that TQ, functions by targeting YAP, may be a potential therapeutic agent against lung cancer.
Temporal dynamics of electroencephalographic microstates during sustained pain
Authors: Qiu Shuang , Lyu Xiaohan , Zheng Qianqian , He Huiguang , Jin Richu , Peng Weiwei
Published: April 2023

Brain dynamics can be modeled by a sequence of transient, nonoverlapping patterns of quasi-stable electrical potentials named “microstates.” While electroencephalographic (EEG) microstates among patients with chronic pain remained inconsistent in the literature, this study characterizes the temporal dynamics of EEG microstates among healthy individuals during experimental sustained pain. We applied capsaicin (pain condition) or control (no-pain condition) cream to 58 healthy participants in different sessions and recorded resting-state EEG 15 min after application. We identified 4 canonical microstates (A–D) that are related to auditory, visual, salience, and attentional networks. Microstate C had less occurrence, as were bidirectional transitions between microstate C and microstates A and B during sustained pain. In contrast, sustained pain was associated with more frequent and longer duration of microsite D, as well as more bidirectional transitions between microstate D and microstates A and B. Microstate D duration positively correlated with intensity of ongoing pain. Sustained pain improved global integration within microstate C functional network, but weakened global integration and efficiency within microstate D functional network. These results suggest that sustained pain leads to an imbalance between processes that load on saliency (microstate C) and processes related to switching and reorientation of attention (microstate D).
Myocardial perfusion imaging by 15O-H2O positron emission tomography predicts clinical revascularization procedures in symptomatic patients with previous coronary artery bypass graft
Authors: Vester Mazen , Madsen Simon , Kjærulff Mette Louise Gram , Tolbod Lars Poulsen , Nielsen Bent Roni Ranghøj , Kristensen Steen Dalby , Christiansen Evald Høj , Nielsen Per Hostrup , Sörensen Jens , Gormsen Lars Christian
Published: April 2023

Aims

We wanted to assess if 15O-H2O myocardial perfusion imaging (MPI) in a clinical setting can predict referral to coronary artery catheterization [coronary angiography (CAG)], execution of percutaneous coronary intervention (PCI), and post-PCI angina relief for patients with angina and previous coronary artery bypass graft (CABG).

Methods and results

We analysed 172 symptomatic CABG patients referred for 15O-H2O positron emission tomography (PET) MPI at Aarhus University Hospital Department of Nuclear Medicine & PET Centre, of which five did not complete the scan. In total, 145 (87%) enrolled patients had an abnormal MPI. Of these, 86/145 (59%) underwent CAG within 3 months; however, no PET parameters predicted referral to CAG. During the CAG, 25/86 (29%) patients were revascularized by PCI. Relative flow reserve (RFR) (0.49 vs. 0.54 P = 0.03), vessel-specific myocardial blood flow (MBF) (1.53 vs. 1.88 mL/g/min, P < 0.01), and vessel-specific myocardial flow reserve (MFR) (1.73 vs. 2.13, P < 0.01) were significantly lower in patients revascularized by PCI. Receiver operating characteristic analysis of the vessel-specific parameters yielded optimal cutoffs of 1.36 mL/g/min (MBF) and 1.28 (MFR) to predict PCI. Angina relief was experienced by 18/24 (75%) of the patients who underwent PCI. Myocardial blood flow was an excellent predictor of angina relief on both a global [area under the curve (AUC) = 0.85, P < 0.01] and vessel-specific (AUC = 0.90, P < 0.01) level with optimal cutoff levels of 1.99 mL/g/min and 1.85 mL/g/min, respectively.

Conclusion

For CABG patients, RFR, vessel-specific MBF, and vessel-specific MFR measured by 15O-H2O PET MPI predict whether subsequent CAG will result in PCI. Additionally, global and vessel-specific MBF values predict post-PCI angina relief.
Material deprivation in childhood and unequal political socialization: the relationship between children’s economic hardship and future voting
Authors: Jungkunz Sebastian , Marx Paul
Published: April 2023

Long-term socialization patterns are considered a key explanation for socio-economic inequalities in political participation. Material conditions in youth and childhood are assumed to contribute to rather stable trajectories of political apathy or involvement and lay the foundations for unequal participation from before voting age and far into adulthood. However, our understanding of when such inequalities begin to become noticeable, the importance of parental socio-economic status as opposed to personal socio-economic status, and potential long-term consequences is still limited. We address these issues using the youth questionnaire of the UK Household Longitudinal Study. We show that material deprivation in childhood is negatively related to turnout in young adults’ first election in which they are eligible to vote. This result holds when we control for an unusually exhaustive list of potential confounders, such as psychological childhood characteristics, parental–political interest and education, present material conditions, mental health, and future educational degrees. Our results, hence, suggest that—while personal socio-economic experiences in early adulthood are not irrelevant—socio-economic family background has an independent effect on political participation.
Illuminating the oral microbiome and its host interactions: animal models of disease
Authors: Hajishengallis George
Published: April 2023

Periodontitis and caries are driven by complex interactions between the oral microbiome and host factors, i.e. inflammation and dietary sugars, respectively. Animal models have been instrumental in our mechanistic understanding of these oral diseases, although no single model can faithfully reproduce all aspects of a given human disease. This review discusses evidence that the utility of an animal model lies in its capacity to address a specific hypothesis and, therefore, different aspects of a disease can be investigated using distinct and complementary models. As in vitro systems cannot replicate the complexity of in vivo host–microbe interactions and human research is typically correlative, model organisms—their limitations notwithstanding—remain essential in proving causality, identifying therapeutic targets, and evaluating the safety and efficacy of novel treatments. To achieve broader and deeper insights into oral disease pathogenesis, animal model-derived findings can be synthesized with data from in vitro and clinical research. In the absence of better mechanistic alternatives, dismissal of animal models on fidelity issues would impede further progress to understand and treat oral disease.
Esophageal mycobiome landscape and interkingdom interactions in esophageal squamous cell carcinoma
Authors: Rao Wen-Qing , Lin Zheng , Jiang Jian , Wang Jian-Wen , Lin Zhi-Feng , Fu Rong , Chen Wei-Lin , Chen Yuan-Mei , Peng Xian-E , Hu Zhi-Jian
Published: April 2023

Background

The study purpose was to characterize the mycobiome and its associations with the expression of pathogenic genes in esophageal squamous cell carcinoma (ESCC).

Methods

Patients with primary ESCC were recruited from two central hospitals. We performed internal transcribed spacer 1 (ITS1) ribosomal DNA sequencing analysis. We compared differential fungi and explored the ecology of fungi and the interaction of bacteria and fungi.

Results

The mycobiota diversity was significantly different between tumors and tumor-adjacent samples. We further analysed the differences between the two groups, at the species level, confirming that Rhodotorula toruloides, Malassezia dermatis, Hanseniaspora lachancei, and Spegazzinia tessarthra were excessively colonized in the tumor samples, whereas Preussia persica, Fusarium solani, Nigrospora oryzae, Acremonium furcatum, Golovinomyces artemisiae, and Tausonia pullulans were significantly more abundant in tumor-adjacent samples. The fungal co-occurrence network in tumor-adjacent samples was larger and denser than that in tumors. Similarly, the more complex bacterial–fungal interactions in tumor-adjacent samples were also detected. The expression of mechanistic target of rapamycin kinase was positively correlated with the abundance of N. oryzae and T. pullulans in tumor-adjacent samples. In tumors, the expression of MET proto-oncogene, receptor tyrosine kinase (MET) had a negative correlation and a positive correlation with the abundance of R. toruloides and S. tessarthra, respectively.

Conclusion

This study revealed the landscape of the esophageal mycobiome characterized by an altered fungal composition and bacterial and fungal ecology in ESCC.
Comment on ‘Rayleigh-wave H/V ratio measurement from ambient noise cross-correlations and its sensitivity to Vp: a numerical study’ by Malkoti et al
Authors: Haney Matthew M , Nakahara Hisashi
Published: April 2023

We present corrections to the expressions for surface-wave Green’s tensors shown in a recent paper by Malkoti et al.
Reference genome of the Virginia rail, Rallus limicola
Authors: Hall Laurie A , Wang Ian J , Escalona Merly , Beraut Eric , Sacco Samuel , Sahasrabudhe Ruta , Nguyen Oanh , Toffelmier Erin , Shaffer H Bradley , Beissinger Steven R
Published: April 2023

The Virginia rail, Rallus limicola, is a member of the family Rallidae, which also includes many other species of secretive and poorly studied wetland birds. It is recognized as a single species throughout its broad distribution in North America where it is exploited as a game bird, often with generous harvest limits, despite a lack of systematic population surveys and evidence of declines in many areas due to wetland loss and degradation. To help advance understanding of the phylogeography, biology, and ecology of this elusive species, we report the first reference genome assembly for the Virginia rail, produced as part of the California Conservation Genomics Project (CCGP). We produced a de novo genome assembly using Pacific Biosciences HiFi long reads and Hi-C chromatin-proximity sequencing technology with an estimated sequencing error rate of 0.191%. The assembly consists of 1,102 scaffolds spanning 1.39 Gb, with a contig N50 of 11.0 Mb, scaffold N50 of 25.3 Mb, largest contig of 45 Mb, and largest scaffold of 128.4 Mb. It has a high BUSCO completeness score of 96.9% and represents the first genome assembly available for the genus Rallus. This genome assembly will help resolve questions about the complex evolutionary history of rails and evaluate the potential of rails for adaptive evolution in the face of growing threats from climate change and habitat loss and fragmentation. It will also provide a valuable resource for rail conservation efforts by quantifying Virginia rail vagility, population connectivity, and effective population sizes.
The anterior superior iliac spine is a reliable novel landmark for preemptive periacetabular analgesia in hip arthroscopy
Authors: Lichtenstein Adi , Amar Eyal , Halperin Dania , Factor Shai , Ohana Nissim , Albagli Assaf , Efrima Ben , Rath Ehud
Published: April 2023

Appropriate post-operative (post-op) pain control has been shown to reduce length of stay and facilitate day case surgery. Periacetabular injection of bupivacaine is effective in pain reduction after hip arthroscopy. This study aims to evaluate the anterior superior iliac spine (ASIS) as an anatomical landmark to facilitate needle insertion prior to fluoroscopy. The meeting point derived from a vertical line one fingerbreadth distal to the ASIS and a longitudinal line from the greater trochanter (GT) was used as a landmark in 30 consecutive hip arthroscopy patients for periacetabular analgesia. The distance between the tip of the needle and the acetabular roof was measured via fluoroscopy. Needle location was corrected if needed, followed by periacetabular bupivacaine injection (at anterior, lateral and posterior joint aspects). Post-op pain was measured using the Visual Analog Scale (VAS) 4–6 h post-op and at discharge. The ASIS and GT were identified and used for periacetabular analgesia landmarks in all cases. Results revealed that 93.3% of needle entries fell within 10 mm of the lateral acetabular rim and only one case had fallen distal to it. The post-op mean VAS score was 1.03 (range 0–6, standard error – 0.30, median = 0). At hospital discharge, 90% (27/30 of patients) reported VAS score ≤ 5. Twenty-six of the 30 patients were discharged on the same day as the operation (remaining four patients stayed due to accommodation/traveling issues). The ASIS and GT can be used as an anatomical landmark for periacetabular analgesia in hip arthroscopy with reproducible needle location, significant analgesic effect and minimal radiation.
Experimenting with QR Codes and Envelope Size in Push-to-Web Surveys
Authors: Endres Kyle , Heiden Erin O , Park Ki , Losch Mary E , Harland Karisa K , Abbott Anne L
Published: April 2023

Survey researchers are continually evaluating approaches to increase response rates, especially those that can be implemented with little or no costs. In this study, we experimentally evaluated whether or not including Quick Response (QR) codes in mailed recruitment materials for self-administered web surveys increased web survey participation. We also assessed whether mailing these materials in a non-standard envelope size (6 × 9 inch) yielded a higher response rate than invitations mailed in a standard, #10 envelope (4.125 × 9.5 inch). These experiments were embedded in a sequential mixed-mode (dual-frame phone and web) statewide survey. Including a QR code (in addition to a URL) significantly increased the response rate compared to invitations that only included a URL in our study. As expected, a consequence of including the QR code was an elevated number of completions on smartphones or tablets among households randomly assigned to the QR code condition. The use of a larger (6 × 9 inch) envelope did not affect the overall response rate but did significantly boost the response rate for the landline sample (envelopes addressed to “STATE resident”) while having little effect for the wireless sample (envelopes addressed by name). This study suggests that incorporating both QR codes and larger (6 × 9 inch) envelopes in mail recruitment materials for web surveys is a cost-effective approach to increase web participation.
Spatio-temporal analysis of strawberry architecture: insights into the control of branching and inflorescence complexity
Authors: Labadie Marc , Guy Karine , Demené Marie-Noëlle , Caraglio Yves , Heidsieck Gaetan , Gaston Amelia , Rothan Christophe , Guédon Yann , Pradal Christophe , Denoyes Béatrice
Published: April 2023

Plant architecture plays a major role in flowering and therefore in crop yield. Attempts to visualize and analyse strawberry plant architecture have been few to date. Here, we developed open-source software combining two- and three-dimensional representations of plant development over time along with statistical methods to explore the variability in spatio-temporal development of plant architecture in cultivated strawberry. We applied this software to six seasonal strawberry varieties whose plants were exhaustively described monthly at the node scale. Results showed that the architectural pattern of the strawberry plant is characterized by a decrease of the module complexity between the zeroth-order module (primary crown) and higher-order modules (lateral branch crowns and extension crowns). Furthermore, for each variety, we could identify traits with a central role in determining yield, such as date of appearance and number of branches. By modeling the spatial organization of axillary meristem fate on the zeroth-order module using a hidden hybrid Markov/semi-Markov mathematical model, we further identified three zones with different probabilities of production of branch crowns, dormant buds, or stolons. This open-source software will be of value to the scientific community and breeders in studying the influence of environmental and genetic cues on strawberry architecture and yield.
Maize LOST SUBSIDIARY CELL encoding a large subunit of ribonucleotide reductase is required for subsidiary cell development and plant growth
Authors: Cui Yongqi , He Meiqing , Liu Jie , Wang Shuang , Zhang Junli , Xie Shiyi , Hu Zhubing , Guo Siyi , Yan Dawei
Published: April 2023

The four-celled stomatal complex consists of a pair of guard cells (GCs) and two subsidiary cells (SCs) in grasses, which supports a fast adjustment of stomatal aperture. The formation and development of SCs are thus important for stomatal functionality. Here, we report a maize lost subsidiary cells (lsc) mutant, with many stomata lacking one or two SCs. The loss of SCs is supposed to have resulted from impeded subsidiary mother cell (SMC) polarization and asymmetrical division. Besides the defect in SCs, the lsc mutant also displays a dwarf morphology and pale and striped newly-grown leaves. LSC encodes a large subunit of ribonucleotide reductase (RNR), an enzyme involved in deoxyribonucleotides (dNTPs) synthesis. Consistently, the concentration of dNTPs and expression of genes involved in DNA replication, cell cycle progression, and SC development were significantly reduced in the lsc mutant compared with the wild-type B73 inbred line. Conversely, overexpression of maize LSC increased dNTP synthesis and promoted plant growth in both maize and Arabidopsis. Our data indicate that LSC regulates dNTP production and is required for SMC polarization, SC differentiation, and growth of maize.
Development of an animal-free nitrogen source for the liquid surface culture of Cordyceps militaris
Authors: Sripilai Kritsana , Chaicharoenaudomrung Nipha , Phonchai Ruchee , Chueaphromsri Phongsakorn , Kunhorm Phongsakorn , Noisa Parinya
Published: April 2023

Cordyceps militaris is a medicinal mushroom in Asia in the 21st century, which cordycepin is a significant bioactive compound. This study, investigated the effect of culture conditions and vegetable seed extract powder as a supplementary source of animal-free nitrogen on the production of cordycepin by C. militaris in liquid surface culture. The highest cordycepin production was observed under soybean extract powder (SBEP) conditions, and 80 g L−1 of SBEP supplementation increased cordycepin production to 2.52 g L−1, which was greater than the control (peptone). Quantitative polymerase chain reaction was used to examine the transcription levels, and the results showed that supplementing with SBEP 80 g L−1 significantly increased the expression of genes associated with the carbon metabolic pathway, amino acid metabolism, and two key genes involved in the cordycepin biosynthesis (cns1 and NT5E) compared to peptone-supplemented culture. Under optimal culture conditions, the model predicted a maximum response of cordycepin production of 2.64 g L−1 at a working volume of 147.5 ml, an inoculum size of 8.8% v/v, and a cultivation time of 40.0 days. This optimized culture condition could be used to increase cordycepin production in large-scale bioreactors. Additional research can be conducted to assess the economic viability of this process.
Treatment
Authors: Evans Dwight L. , Benton Tami D. , Ellison Katherine
Published: April 2023

This chapter discusses medication as a treatment option for bipolar disorder. According to researchers, a combination of medication and psychotherapy will provide the best for managing a child’s bipolar disorder. The chapter highlights the importance of finding a trusted clinician to achieve the right medication, which could be “off-label” prescriptions that do not have approval for children and adolescents from the Food and Drug Administration. Even though the practice is sketchy, it is a common and well-respective practice since medications specifically approved for adolescent bipolar disorder remain limited compared to those approved for adults. The chapter lists the medication used for treating mania and depression, such as mood stabilizers, anticonvulsants, antipsychotics, serotonin reuptake inhibitors, lurasidone, and a combination of olanzapine and fluoxetine.
Coping With Crises
Authors: Evans Dwight L. , Rynn Moira A. , Ellison Katherine
Published: April 2023

This chapter shares recommendations on how to approach situations that evolve into crises for the child and loved ones. It highlights the importance of parents being a constant and stable loving presence as it is key support that will the child during a crisis. Self-harm, such as cutting and burning, is common among adolescents who experience depression, bullying, have low self-esteem, and know a friend who engages in the same behavior. For many self-harm is a cry for help and an expression of distress, which parent may miss. Moreover, some of the risk factors for a child to attempt suicide range among presence of a family history, mood disorders, substance use, LGBTQ+, and trauma/sexual abuse. The chapter suggests having a crisis plan in place and emergency contact information readily available. There are times when hospitalization may be needed for the adolescent in order to ensure safety and increase treatment intensity.
Conclusion
Authors: Evans Dwight L. , Rynn Moira A. , Ellison Katherine
Published: April 2023

This chapter looks at the advances in the treatment of adolescent depression. It discusses that depression is a very treatable medical illness, citing that millions of diagnosed adults are leading lives of happiness, success, and fulfillment. Legislators have been seeking ways to better regulate harmful social media and to address the nationwide shortage of behavioral health providers. At the same time, scientists continue to research brain neurocircuitry to develop new treatment interventions depression. The chapter also acknowledges the changes made in schools to provide appropriate supports for children for kids with mental health challenges. It explains how broader, societal structural issues have huge and inequitable impacts on mental health.
Other Skills: Relaxation/Mindfulness
Authors: Falk Avital , Bennett Shannon , Rozenman Michelle , Mohatt Justin , Bergman R. Lindsey
Published: April 2023

“Other Skills: Relaxation/Mindfulness” discusses supplemental skills that may be useful to augment exposure and response prevention (ERP) discussed in Chapter 11. Relaxation strategies and activities are briefly described, including deep breathing and progressive muscle relaxation. The chapter then turns to mindfulness as an attentional, experiential, and/or behavioral approach that may be used in response to the experience of obsessions. Examples of experiential mindfulness exercises that may be particularly relevant for OCD are provided. For each set of skills, information is provided about how to introduce the skills to patients, correct misperceptions about the purpose of each skill, and utilize skills to augment ERP.
Setting Up A Modern Acute Pain Service (APS)
Authors: Mojica Jeffrey J. , Washek Sean , Schwenk Eric S.
Published: April 2023

Poorly controlled pain can negatively impact a patient’s postoperative recovery and can have lasting effects on patient outcomes and quality of life. In the past, opioid-based therapies were the treatments of choice. Advances in regional anesthesia, medications, and drug-delivery systems have expanded the therapeutic armamentarium, but without an organized service to monitor safety and efficacy, the adoption of these therapies is challenging. An acute pain service (APS) serves an important role in addressing the complex pain of today’s patients. The effectiveness of postoperative pain relief is tied to patient satisfaction and carries financial incentives for healthcare providers. As the leaders in both regional anesthesiology and perioperative medicine, anesthesiologists are well equipped to address this healthcare deficiency. A regional anesthesia-driven APS that prioritizes multimodal analgesia can effectively treat the complex patients who are becoming increasingly common in today’s hospital environment.
Eye Blocks
Authors: Lozada Gustavo A. , Macias Alvaro Andres
Published: April 2023

Ophthalmic surgical procedures require the anesthesia provider to have fundamental knowledge of and skills with eye blocks to deliver a safe, optimal anesthetic. Cataract surgery, the most common surgical procedure performed in the United States, and vitreoretinal, glaucoma-related procedures represent a large percentage of eye surgeries performed. Eye blocks are anesthetic modalities that are well suited and widely used for these interventions. Having in-depth understanding of relevant anatomy is paramount for both choosing the appropriate regional technique and performing it safely and successfully. Retrobulbar, peribulbar, and sub-Tenon’s blocks are commonly used for eye surgeries. Regardless of whether these are performed by the anesthesia provider or the surgeon, the operator must be conversant with these blocks, including technique, potential side effects and complications, treatment of such, and options for sedation. This chapter reviews relevant anatomy, describes the three commonly performed eye blocks, discusses their potential side effects and complications with some treatment suggestions, mentions common adjuvants used for eye blocks, offers alternatives for the three blocks, and suggests options for patient sedation.
The Trauma Patient With Fractured Ribs
Authors: Warfield Dennis J. , Adhikary Sanjib Das
Published: April 2023

Rib fractures, in particular those involving various levels, are frequent in multi-trauma patients. These injuries are typically seen after blunt thoracic trauma, most commonly involving motor vehicle accidents. Rib fractures alone are associated with significant morbidity and mortality as well as long-term disability without appropriate management. Patients with rib fractures require safe, effective analgesia to prevent respiratory compromise. Choosing an effective pain management strategy for this patient population can prove to be challenging due to a spectrum of additional injuries, body habitus, coagulation status, and preexisting comorbidities. Many strategies have been implemented to provide appropriate pain control. These range from opioid treatment as sole therapy to multimodal approaches which often include regional anesthesia. Regional anesthesia techniques have consisted of midline neuraxial procedures as well as a variety of truncal nerve blocks. Successful pain management and favorable outcomes rely on a prompt and accurate diagnosis, along with an integrated team approach which includes providers skilled in performing regional anesthesia.
Shoulder Arthroscopy
Authors: Ardon Alberto E. , Porter Steven B. , McClain Robert L.
Published: April 2023

Most shoulder innervation arises from nerves C5 to T1, with occasional contributions from C4 or T2. A patient’s pulmonary status and ability to tolerate a change in diaphragmatic function should be assessed prior to an interscalene block. Regional anesthetic options for a patient with compromised pulmonary function include a more distal brachial plexus block, superior trunk block, and suprascapular block. Expectations regarding the regional anesthetic technique should be set with the patient. The role of the block in the context of the overall pain-control plan and other analgesic agents should be explained. Rebound pain is significant when it alters a patient’s recovery trajectory. A single-injection interscalene block may not be sufficient to properly address pain after shoulder surgery. Anesthesiologists should properly educate patients about peripheral nerve blockade, including expected pain control, possible side effects, and ambulatory nerve catheter care, if applicable.
Enhanced Recovery After Total Knee Replacement
Authors: Metesky Jamie-Lee , Rosenblatt Meg A.
Published: April 2023

Currently there are more than 700,000 total knee replacements (TKRs) performed annually in the United States, and this number is increasing with an aging population. Total knee replacement is one of the most commonly performed procedures worldwide. Knee replacement is usually the last resort for degenerative arthritis of the knee. Recent efforts have focused on developing enhanced recovery after surgery (ERAS) protocols with hopes of improving patient outcomes while decreasing healthcare costs. The protocol focuses on intensive patient education, multimodal analgesia, including opioid and non-opioid analgesics, both neuraxial and peripheral nerve blocks, and early ambulation are integral components of these fast-track joint pathways. Regional nerve blocks have evolved to more distal and selective blocks to help in early ambulation and rehabilitation.
Regional Anesthesia for Ischemic Pain
Authors: Reddy Shanthi , Sumner Cameron , Kim James
Published: April 2023

Regardless of surgical indication, patients undergoing amputation commonly suffer immediate postoperative pain that is moderate to severe in nature. The goal of this chapter is to review the relevant literature in order to outline a framework for analgesia that optimizes the perioperative pain management of patients undergoing lower extremity amputation. The evidence for various analgesic modalities, including neuraxial, peripheral nerve blocks, and pharmacologic therapies, has been variable. It is well proven that neuraxial analgesia has opioid-sparing and analgesic benefits. Results have been historically mixed regarding perineural catheters in the immediate post-amputation setting. These conflicting results may have been due to suboptimal placement and/or shorter duration of perineural catheter maintenance. Perioperatively, the analgesic approach for management of post-amputation pain should be multidisciplinary and multimodal in nature, utilizing pharmacologic and interventional techniques. Some recent studies are now looking beyond the immediate postoperative period and investigating the impact of perioperative analgesic interventions on the incidence of chronic persistent pain after amputation.
Lower Extremity Weakness in a Patient With Epidural Analgesia
Authors: Helander Erik , Zasimovich Yury
Published: April 2023

Spinal epidural hematomas (SEHs) are rare but potentially devastating injuries and are the most common cause of neuraxial injury leading to litigation. Although the incidence of SEHs is low, it is likely underestimated. An emerging risk factor for SEHs is the use of anticoagulants, and knowledge of guidelines can help limit this risk. Prompt diagnosis is necessary to restrict neurological deterioration and improve chances for recovery, with magnetic resonance imaging (MRI) as the gold standard. Computerized tomography (CT) should be considered if MRI is not immediately available in order to avoid delaying diagnosis. Treatment of clinically significant SEHs typically involves decompressive laminectomy with evacuation of the hematoma. Outcomes are best in patients who undergo surgical decompression within 8 hours of the onset of symptoms, but full recovery is not guaranteed.
Nerve Injury After Plexus and Peripheral Nerve Blocks for Regional Anesthesia and Medicolegal Implications
Authors: Hardman H. David
Published: April 2023

Postoperative neurologic symptoms (PONS) or perioperative nerve injury (PNI) are frequently observed after peripheral nerve and plexus blocks (PNB). Many of these examples of PNI are falsely attributed to PNB, and clinicians fail to consider inherent risks associated with orthopedic surgery and patient-related conditions that predispose to subclinical peripheral neuropathy. Most PNIs spontaneously resolve within several months after surgery, although up to 0.2% may persist beyond 1 year. PNB is not an independent risk factor for developing PONS after surgery. Post-surgical inflammatory neuropathy may be responsible for many cases of PONS that have been incorrectly attributed to PNB. A separate anesthesia consent form, along with a comprehensive block note, can establish standard of care practice for regional anesthesia and PNBs and is encouraged for diagnostic and medicolegal reasons. Any serious motor nerve injury warrants a neurology consultation followed by ultrasound, magnetic resonance imaging, or electrodiagnostic studies. These studies usually localize the site and severity of injury but do not necessarily establish causation. The malpractice risk associated with PNB is low, accounting for 2% of anesthesia-related claims in the American Society of Anesthesiologists Closed Claims Project.
Amphotericin B, itraconazole, posaconazole, and isavuconazole MICs against clinical Mucorales isolates obtained by visual inspection and spectrophotometric reading according to the EUCAST 9.4 procedure
Authors: Escribano Pilar , Mesquida Aina , López-Montesinos Sara , Reigadas Elena , Muñoz Patricia , Guinea Jesús
Published: April 2023

We compared the antifungal susceptibility of 92 Mucorales isolates obtained by visual inspection and spectrophotometric readings following EUCAST (European Committee on Antimicrobial Susceptibility Testing) testing. Amphotericin B minimum inhibitory concentrations (MICs) were up to 1 mg/l against most isolates and variable among species, except for Cunninghamella bertholletiae. Posaconazole MICs against most isolates were up to 1 mg/l and high against Mucor circinelloides, some Rhizopus arrhizus, and Rhizopus microsporus. Isavuconazole MICs ranged between 1 and 8 mg/l but were invariably >8 mg/l against M. circinelloides and C. bertholletiae. The agreement between MICs obtained by visual endpoint or spectrophotometric readings was moderate and higher when using the ≥90% fungal growth inhibition endpoint.
A numerical study of the impact of jet magnetic topology on radio galaxy evolution
Authors: Chen Yi-Hao , Heinz Sebastian , Hooper Eric
Published: April 2023

The propagation of active galactic nucleus jets depends both on the environment into which they propagate and on their internal structure. To test the impact that different magnetic topologies have on the observable properties of radio galaxies on kpc scales, we conducted a series of magnetohydrodynamic simulations of jets injected with different magnetic field configurations propagating into a gaseous atmosphere modelled on the Perseus cluster. The simulations show that the structure of the field affects the collimation and propagation of the jets on cluster scales and thus the morphology of the radio lobes inflated by the jets, due to both magnetic collimation and the development of dynamical instabilities in jets with different magnetic topologies. In all cases, the simulations show a distinct reversal of the synchrotron spectral age gradient in the radio lobes about a dynamical time after the jets turn off due to large-scale circulation inside the radio lobe, driven primarily by buoyancy, which could provide a way to constrain the age of radio sources in cluster environments without the need for detailed spectral modelling and thus constrain the radio-mode feedback efficiency. We suggest a robust diagnostic to search for such age gradients in multifrequency radio data.
Dynamo modelling for cycle variability and occurrence of grand minima in Sun-like stars: rotation rate dependence
Authors: Vashishth Vindya , Karak Bidya Binay , Kitchatinov Leonid
Published: April 2023

Like the solar cycle, stellar activity cycles are also irregular. Observations reveal that rapidly rotating (young) Sun-like stars exhibit a high level of activity with no Maunder-like grand minima and rarely display smooth regular activity cycles. On the other hand, slowly rotating old stars like the Sun have low activity levels and smooth cycles with occasional grand minima. We, for the first time, try to model these observational trends using flux transport dynamo models. Following previous works, we build kinematic dynamo models of one solar mass star with different rotation rates. Differential rotation and meridional circulation are specified with a mean-field hydrodynamic model. We include stochastic fluctuations in the Babcock–Leighton source of the poloidal field to capture the inherent fluctuations in the stellar convection. Based on extensive simulations, we find that rapidly rotating stars produce highly irregular cycles with strong magnetic fields and rarely produce Maunder-like grand minima, whereas the slowly rotating stars (with a rotation period of 10 d and longer) produce smooth cycles of weaker strength, long-term modulation in the amplitude, and occasional extended grand minima. The average duration and the frequency of grand minima increase with decreasing rotation rate. These results can be understood as the tendency of less supercritical dynamo in slower rotating stars to be more prone to produce extended grand minima.
The SZ flux-mass (Y–M) relation at low-halo masses: improvements with symbolic regression and strong constraints on baryonic feedback
Authors: Wadekar Digvijay , Thiele Leander , Hill J Colin , Pandey Shivam , Villaescusa-Navarro Francisco , Spergel David N , Cranmer Miles , Nagai Daisuke , Anglés-Alcázar Daniel , Ho Shirley , Hernquist Lars
Published: April 2023

Feedback from active galactic nuclei (AGNs) and supernovae can affect measurements of integrated Sunyaev–Zeldovich (SZ) flux of haloes (YSZ) from cosmic microwave background (CMB) surveys, and cause its relation with the halo mass (YSZ–M) to deviate from the self-similar power-law prediction of the virial theorem. We perform a comprehensive study of such deviations using CAMELS, a suite of hydrodynamic simulations with extensive variations in feedback prescriptions. We use a combination of two machine learning tools (random forest and symbolic regression) to search for analogues of the Y–M relation which are more robust to feedback processes for low masses ($M\lesssim 10^{14}\, \mathrm{ h}^{-1} \, \mathrm{ M}_\odot$); we find that simply replacing Y → Y(1 + M*/Mgas) in the relation makes it remarkably self-similar. This could serve as a robust multiwavelength mass proxy for low-mass clusters and galaxy groups. Our methodology can also be generally useful to improve the domain of validity of other astrophysical scaling relations. We also forecast that measurements of the Y–M relation could provide per cent level constraints on certain combinations of feedback parameters and/or rule out a major part of the parameter space of supernova and AGN feedback models used in current state-of-the-art hydrodynamic simulations. Our results can be useful for using upcoming SZ surveys (e.g. SO, CMB-S4) and galaxy surveys (e.g. DESI and Rubin) to constrain the nature of baryonic feedback. Finally, we find that the alternative relation, Y–M*, provides complementary information on feedback than Y–M.
The north–south asymmetry of the ALFALFA H i velocity width function
Authors: Brooks Richard A N , Oman Kyle A , Frenk Carlos S
Published: April 2023

The number density of extragalactic 21-cm radio sources as a function of their spectral line widths – the H i width function (H i WF) – is a sensitive tracer of the dark matter halo mass function (HMF). The Lambda cold dark matter model predicts that the HMF should be identical everywhere provided it is sampled in sufficiently large volumes, implying that the same should be true of the H i WF. The Arecibo Legacy Fast ALFA (ALFALFA) 21-cm survey measured the H i WF in northern and southern Galactic fields and found a systematically higher number density in the north. At face value, this is in tension with theoretical predictions. We use the Sibelius-DARK N-body simulation and the semi-analytical galaxy formation model GALFORM to create a mock ALFALFA survey. We find that the offset in number density has two origins: the sensitivity of the survey is different in the two fields, which has not been correctly accounted for in previous measurements; and the 1/Veff algorithm used for completeness corrections does not fully account for biases arising from spatial clustering in the galaxy distribution. The latter is primarily driven by a foreground overdensity in the northern field within $30\, \mathrm{Mpc}$ , but more distant structure also plays a role. We provide updated measurements of the ALFALFA H i WF (and H i mass function) correcting for the variations in survey sensitivity. Only when systematic effects such as these are understood and corrected for can cosmological models be tested against the H i WF.
S-ACF: a selective estimator for the autocorrelation function of irregularly sampled time series
Authors: Kreutzer Lars T , Gillen Edward , Briegal Joshua T , Queloz Didier
Published: April 2023

We present a generalized estimator for the autocorrelation function, S-ACF, which is an extended version of the standard estimator of the autocorrelation function (ACF). S-ACF is a versatile definition that can robustly and efficiently extract periodicity and signal shape information from a time series, independent of the time sampling and with minimal assumptions about the underlying process. Calculating the autocorrelation of irregularly sampled time series becomes possible by generalizing the lag of the standard estimator of the ACF to a real parameter and introducing the notion of selection and weight functions. We show that the S-ACF reduces to the standard ACF estimator for regularly sampled time series. Using a large number of synthetic time series, we demonstrate that the performance of the S-ACF is as good or better than commonly used Gaussian and rectangular kernel estimators, and is comparable to a combination of interpolation and the standard estimator. We apply the S-ACF to astrophysical data by extracting rotation periods for the spotted star KIC 5110407, and compare our results to Gaussian process (GP) regression and Lomb–Scargle (LS) periodograms. We find that the S-ACF periods typically agree better with those from GP regression than from LS periodograms, especially in cases where there is evolution in the signal shape. The S-ACF has a wide range of potential applications and should be useful in quantitative science disciplines where irregularly sampled time series occur. A python implementation of the S-ACF is available under the MIT license.