bluuebunny/crossref_metadata_2025 huggingface dataset:
How can computable general equilibrium models serve low-carbon policy? A systematic review
Authors: An Kangxin , Zhang Shihui , Zhou Jiaxin , Wang Can
Published: February 2023

Computable general equilibrium (CGE) models have been widely employed in economic, social, and environmental impact assessments for low-carbon policies. As net-zero transition has become a global trend, it is crucial to conduct a systematic review of how CGE models serve low-carbon policies. This review examined 1002 studies published between 2001 and 2021, revealing the application of CGE models in low-carbon policy analysis by researchers in 51 countries, including the United States, China, Western Europe, Japan, and Australia, while studies in Latin America, Central Asia and Eastern Europe are limited. Climate targets, carbon pricing, and energy policy are the main policy focuses of CGE analysis, while land policy, demand-side actions, and several other policies are less studied. In addition, CGE analysis generally focuses on the economic impacts of carbon reduction, with a growing amount of attention on social and environmental consequences. The structure, database, and model coupling techniques of CGE models are becoming more complex in order to serve the increasingly multifaceted and diverse policy study purposes. This study provides a comprehensive overview of the research trends of CGE studies on low-carbon policies, thus improving our understanding on low-carbon policies, multiple impacts, and CGE models. We also identify the gaps and potential cutting-edge techniques of current low-carbon policy research. Future work should improve the capacity of CGE models to simulate actual ‘second-best’ policies, provide feedback of complex impacts on policy optimization, and enhance dynamic mechanisms on structural change.
Carbon-based perovskite solar cells with electron and hole-transporting/-blocking layers
Authors: Yu Wenjin , Zou Yu , Zhang Shining , Liu Zishi , Wu Cuncun , Qu Bo , Chen Zhijian , Xiao Lixin
Published: February 2023

Towards commercialization of perovskite solar cells (PSCs), further reducing the cost and increasing the stability of PSCs have been the most important tasks of researchers, as the efficiency of single-junction PSCs has reached a competitive level among all kinds of single-junction solar cells. Carbon-electrode-based PSCs (CPSCs), as one of the most promising constructions for achieving stable economical PSCs, now attract enormous attention for their cost-effectiveness and stability. Here, we briefly review the development of CPSCs and reveal the importance of n-i-p architecture for state-of-the-art CPSCs. However, despite their promising potential, challenges still exist in CPSCs in the n-i-p architecture, which mainly stem from the incompact contact of the hole-transporting layer (HTL)/carbon electrode. Thus, new carbon materials and/or novel manufacturing methods should be proposed. In addition, HTL is yet to be appropriate for state-of-the-art CPSCs because the fabrication of carbon electrode could result in the destruction of the underlayer. To further enhance the performance of CPSCs, both the HTL and electron transport layer as well as their interfaces with perovskite active layer need to be improved. We recommend that the perovskite active layer, with its long carrier lifetime, strong carrier transport capability, and long-term stability, is necessary as well for improved performance of CPSCs. We also highlight current researches on CPSCs and provide a systematic review of various types of regulation tools.
Poorer Inhibitory Control Uniquely Contributes to Greater Functional Disability in Post-9/11 Veterans
Authors: DeGutis Joseph , Agnoli Sam , Bernstein John P K , Jagger-Rickels Audreyana , Evans Travis C , Fortier Catherine B , McGlinchey Regina E , Milberg William P , Esterman Michael
Published: February 2023

Objective

Post-9/11 Veterans endorse greater self-reported functional disability than 80% of the adult population. Previous studies of trauma-exposed populations have shown that increased post-traumatic stress disorder (PTSD) and depressive symptoms are consistently associated with greater disability. Additionally, poorer cognitive performance in the domain of executive functions, particularly inhibitory control, has been associated with disability, though it is unclear if this effect is independent of and/or interacts with PTSD and depression.

Method

Three overlapping samples of n = 582, 297, and 183 combat-deployed post-9/11 Veterans completed comprehensive assessments of executive functions, PTSD and depressive symptoms, and self-reported World Health Organization Disability Assessment Schedule-II (WHODAS II).

Results

Poorer performance on measures of inhibitory control (Delis-Kaplan Executive Functioning System Color-Word Interference-CWI Test and gradual-onset Continuous Performance Test-gradCPT), but not other executive functions, were significantly associated with greater disability on the WHODAS II (ρ’s = −.13 and −.13, p = .002 and .026, respectively). CWI inhibitory control measures accounted for unique variance in disability after controlling for PTSD and depressive symptoms (R2 change = 0.02, p < .001). Further, CWI significantly moderated the effect of depressive symptoms on disability, such that better inhibitory control weakened the relationship between depression and disability.

Conclusions

Inhibitory control deficits are uniquely associated with increased disability in combat-deployed post-9/11 Veterans, and better inhibitory control abilities may serve as a protective factor for depressive symptoms leading to increased disability.

Key Points

Question

In a trauma-exposed Veteran population, does inhibitory control predict functional disability above and beyond PTSD and depressive symptoms?

Findings

After controlling for PTSD and depressive symptoms, inhibitory control explained unique variance in self-reported disability. Inhibitory control also showed a moderation effect on depression where greater inhibitory control on the color-word interference test reduced the association between depression and disability symptoms.

Importance

Inhibitory control represents an important mechanism in understanding and improving daily life functioning in trauma-exposed Veteran populations.

Next Steps

Future research should further characterize the different aspects of inhibitory control deficits in trauma-exposed populations and focus on enhancing inhibitory control paired with more standard psychological distress treatments.
Sampling distribution for single-regression Granger causality estimators
Authors: Gutknecht A J , Barnett L
Published: February 2023

The single-regression Granger–Geweke causality estimator has previously been shown to solve known problems associated with the more conventional likelihood ratio estimator; however, its sampling distribution has remained unknown. We show that, under the null hypothesis of vanishing Granger causality, the single-regression estimator converges to a generalized χ2 distribution, which is well approximated by a Γ distribution. We show that this holds too for Geweke’s spectral causality averaged over a given frequency band, and derive explicit expressions for the generalized χ2 and Γ-approximation parameters in both cases. We present a Neyman–Pearson test based on the single-regression estimators, and discuss how it may be deployed in empirical scenarios. We outline how our analysis may be extended to the conditional case, point-frequency spectral Granger causality and the important case of state-space Granger causality.
Double faecal immunochemical testing in patients with symptoms suspicious of colorectal cancer
Authors: Gerrard A D , Maeda Y , Miller J , Gunn F , Theodoratou E , Noble C , Porteous L , Glancy S , MacLean P , Pattenden R , Dunlop M G , Din F V N ,   Edinburgh Colorectal Group, Clark A , Collie M , Collins D , Duff M , Goodbrand S , Mander J , Ventham N , Paterson H , Potter M , Reddy C , Speake D , Shaban F , Smith G , Vaughan-Shaw P
Published: February 2023

Background

Faecal immunochemical test (FIT)-directed pathways based on a single test have been implemented for symptomatic patients. However, with a single test, the sensitivity is 87 per cent at 10 µg haemoglobin (Hb) per g faeces. This aims of this study were to define the diagnostic performance of a single FIT, compared with double FIT in symptomatic populations.

Methods

Two sequential prospective patient cohorts referred with symptoms from primary care were studied. Patients in cohort 1 were sent a single FIT, and those in cohort 2 received two tests in succession before investigation. All patients were investigated, regardless of having a positive or negative test (threshold 10 µg Hb per g).

Results

In cohort 1, 2260 patients completed one FIT and investigation. The sensitivity of single FIT was 84.1 (95 per cent c.i. 73.3 to 91.8) per cent for colorectal cancer and 67.4 (61.0 to 73.4) per cent for significant bowel pathology. In cohort 2, 3426 patients completed at least one FIT, and 2637 completed both FITs and investigation. The sensitivity of double FIT was 96.6 (90.4 to 99.3) per cent for colorectal cancer and 83.0 (77.4 to 87.8) per cent for significant bowel pathology. The second FIT resulted in a 50.0 per cent reduction in cancers missed by the first FIT, and 30.0 per cent for significant bowel pathology. Correlation between faecal Hb level was only modest (rs = 0.58), and 16.8 per cent of double tests were discordant, 11.4 per cent in patients with colorectal cancer and 18.3 per cent in those with significant bowel pathology.

Conclusion

FIT in patients with high-risk symptoms twice in succession reduces missed significant colorectal pathology and has an acceptable workload impact.
Mohs micrographic surgery for the treatment of primary cutaneous mucinous carcinoma
Authors: Kelly Áine , Anand Rakesh , Natkunarajah Jana , Samarasinghe Venura , Craythorne Emma
Published: February 2023

Primary cutaneous mucinous carcinoma (PCMC) is a rare adnexal tumour of the skin. Clinically, it appears as a benign cyst, but it has characteristic histopathology. It is a slow-growing tumour that rarely metastasizes but is associated with significant morbidity due to its high recurrence rate. Standard practice has been to surgically remove it with a wide local excision of 1–2-cm margin. In the last decade, increasing reports of Mohs micrographic surgery (MMS) for the treatment of PCMC have been described. MMS appears to reduce recurrence rates while allowing for more conservative margins. Given the rarity of PCMC, there are no prospective randomized control trials on treatment. This is the largest case series of PCMC treated by MMS to date.
Athena: Specialty Certificate Examination case for paediatrics and genetics
Authors: Awad Andrew , Colla Themis Getsos , Sinclair Rodney
Published: February 2023

A 13-year-old female patient presented with a 1-year history of irritation, dryness and wrinkling of her palms after 5 min of immersion in water. Her medical history included acne and she was currently taking doxycycline and using topical retinoid.
Skin surgery training: a literature review of methods and their efficacy
Authors: Passby Lauren , Tso Simon , Wernham Aaron
Published: February 2023

Skin surgery ranges from small biopsies to Mohs micrographic surgery and excisions necessitating complex skin flap design or grafting. For all dermatology doctors in training there is a need to acquire competence to perform skin surgery safely, in an appropriate timeframe and with minimal complication rates. There exist a range of different methods, with varying reliance upon advancing technology, to teach skin surgery and to refine surgical skills before procedures are performed on patients. We searched PubMed, MEDLINE and SCOPUS databases to identify all papers relevant to postgraduate dermatology skin surgery teaching and training published in the past 10 years in English (see Appendix S1 in the Supporting Information for our search strategy). This yielded 440 results, for which all abstracts were screened. Manuscripts related to aesthetic surgery training, such as robotic hair transplantation training are excluded.
Long-Term Within- and Between-Subject Biological Variation Data of Hematological Parameters in Recreational Endurance Athletes
Authors: Diaz-Garzon Jorge , Fernandez–Calle Pilar , Aarsand Aasne K , Sandberg Sverre , Coskun Abdurrahman , Equey Tristan , Aikin Reid , Buno Soto Antonio
Published: February 2023

Background

Hematological parameters have many applications in athletes, from monitoring health to uncovering blood doping. This study aimed to deliver biological variation (BV) estimates for 9 hematological parameters by a Biological Variation Data Critical Appraisal Checklist (BIVAC) design in a population of recreational endurance athletes and to assess the effect of self-reported exercise and health-related variables on BV.

Methods

Samples were drawn from 30 triathletes monthly for 11 months and measured in duplicate for hematological measurands on an Advia 2120 analyzer (Siemens Healthineers). After outlier and homogeneity analysis, within-subject (CVI) and between-subject (CVG) BV estimates were delivered (CV-ANOVA and log-ANOVA, respectively) and a linear mixed model was applied to analyze the effect of exercise and other related variables on the BV estimates.

Results

CVI estimates ranged from 1.3% (95%CI, 1.2-1.4) for mean corpuscular volume to 23.8% (95%CI, 21.6-26.3) for reticulocytes. Sex differences were observed for platelets and OFF-score. The CVI estimates were higher than those reported for the general population based on meta-analysis of eligible studies in the European Biological Variation Database, but 95%CI overlapped, except for reticulocytes, 23.9% (95%CI, 21.6-26.5) and 9.7% (95%CI, 6.4-11.0), respectively. Factors related to exercise and athletes’ state of health did not appear to influence the BV estimates.

Conclusions

This is the first BIVAC-compliant study delivering BV estimates that can be applied to athlete populations performing high-level aerobic exercise. CVI estimates of most parameters were similar to the general population and were not influenced by exercise or athletes’ state of health.
Defining Relevant Markets in the Digital Era: Lessons from Merger Control in Brazil, Chile and Mexico
Authors: Canales Maria Paz , De Souza Michel Roberto , Da Motta Lucas Griebeler
Published: February 2023

Relevant market definition methodology has been a thorny issue over the years for antitrust doctrine and practice. This is especially true when it comes to digital markets, in which prices may not be a significant variable for defining relevant markets. Traditional or static views of competition may result in improper market definitions, which might result in the clearance of mergers in digital markets because antitrust authorities define market shares according to traditional methods of measurement. However, this seems like a chicken-and-egg problem, because it is only by appropriately defining relevant markets that it is possible to establish if market shares are high or low. This article discusses practical implications for antitrust enforcement derived from the relevant market definitions adopted in high-profile digital market mergers in Brazil, Chile and Mexico. Many of these cases have elements of conglomerate or vertical integration that go beyond traditional demand substitution measurement and test the authorities’ ability to foresee future competitive scenarios in which digital competition and brick-and-mortar competition have become increasingly complementary. These cases also show an increasingly large role of data concentration as a driver in the attractiveness of the acquisitions.
Multiple-model GWAS identifies optimal allelic combinations of quantitative trait loci for malic acid in tomato
Authors: Gai Wenxian , Yang Fan , Yuan Liangdan , ul Haq Saeed , Wang Yaru , Wang Ying , Shang Lele , Li Fangman , Ge Pingfei , Dong Haiqiang , Tao Jinbao , Wang Fei , Zhang Xingyu , Zhang Yuyang
Published: February 2023

Malic acid (MA) is an important flavor acid in fruits and acts as a mediator in a series of metabolic pathways. It is important to understand the factors affecting MA metabolism for fruit flavor improvement and to understand MA-mediated biological processes. However, the metabolic accumulation of MA is controlled by complex heredity and environmental factors, making it difficult to predict and regulate the metabolism of MA. In this study, we carried out a genome-wide association study (GWAS) on MA using eight milestone models with two-environment repeats. A series of associated SNP variations were identified from the GWAS, and 15 high-confidence annotated genes were further predicted based on linkage disequilibrium and lead SNPs. The transcriptome data of candidate genes were explored within different tomato organs as well as various fruit tissues, and suggested specific expression patterns in fruit pericarp. Based on the genetic parameters of population differentiation and SNP distribution, tomato MA content has been more influenced by domestication sweeps and less affected by improvement sweeps in the long-term history of tomato breeding. In addition, genotype × environment interaction might contribute to the difference in domestication phenotypic data under different environments. This study provides new genetic insights into how tomato changed its MA content during breeding and makes available function-based markers for breeding by marker-assisted selection.
Integrating economics into fisheries science and advice: progress, needs, and future opportunities
Authors: Thébaud O , Nielsen J R , Motova A , Curtis H , Bastardie F , Blomqvist G E , Daurès F , Goti L , Holzer J , Innes J , Muench A , Murillas A , Nielsen R , Rosa R , Thunberg E , Villasante S , Virtanen J , Waldo S , Agnarsson S , Castilla Espino D , Curtin R , DePiper G , Doering R , Ellefsen H , García del Hoyo1 J J , Gourguet S , Greene P , Hamon K G , Haynie A , Kellner J B , Kuikka S , Le Gallic B , Macher C , Prellezo R , Santiago Castro-Rial J , Sys K , van Oostenbrugge H , Vastenhoud B M J
Published: February 2023

While the science supporting fisheries management has generally been dominated by the natural sciences, there has been a growing recognition that managing fisheries essentially means managing economic systems. Indeed, over the past seven decades, economic ideas and insights have increasingly come to play a role in fisheries management and policy. As an illustration of this, the International Council for the Exploration of the Sea (ICES) has been actively seeking to expand the scope of its scientific expertise beyond natural sciences [another inter-governmental marine science organization which has done this over the same period is the North Pacific Marine Science organization (PICES)]. In particular, the recently created ICES Working Group on Economics set out to review current work and key future needs relating to economic research and management advice on marine capture fisheries. This article presents the results of this review and addresses how economic research can be incorporated into the science of ICES to provide integrated perspectives on fisheries systems that can contribute to the provision of advice in support of policy development and management decision-making for sustainable uses of living marine resources.
Generalized Permutahedra and Positive Flag Dressians
Authors: Joswig Michael , Loho Georg , Luber Dante , Alberto Olarte Jorge
Published: February 2023

We study valuated matroids, their tropical incidence relations, flag matroids, and total positivity. This leads to a characterization of permutahedral subdivisions, namely subdivisions of regular permutahedra into generalized permutahedra. Further, we get a characterization of those subdivisions arising from positive valuated flag matroids.
Adjunctive controlled intrusion of the maxillary first molar using orthodontic miniscrews
Authors: Marya Anand , Winoto Ervina Restiwulan
Published: February 2023

In the absence of the mandibular first molar, there is corresponding supra-eruption of the maxillary first molar, which can lead to occlusal interferences compromising the space available for restoration with a prosthesis. In this case report, the maxillary left first molar intrusion has been discussed with the use of two miniscrews. A 28-year-old female reported with a missing mandibular left first molar and wanting to replace it with a dental implant. The patient presented with a Class I skeletal relation, mild proclination of the anteriors and occlusal contacts. The maxillary first molar had erupted by >4 mm beyond the occlusal plane, thereby reducing the space available for placement of a lower prosthetic crown. After 5 months of intrusion, the desired occlusal clearance was achieved, and impressions were recorded. For retention, the patient was given an upper clear vacuum retainer and the crown was placed on the implant.
Two cases of interparietal inguinal hernias undergoing laparoscopic treatment: a case series
Authors: Ozawa Hiroki , Hara Asuka , Hayashi Keita , Kaneko Yasushi , Kikuchi Hiroto , Fujisaki Hiroto , Hirata Akira , Hongo Kumiko , Takano Kiminori , Suga Atsushi , Yo Kikuo , Yoneyama Kimiyasu , Nakagawa Motohito
Published: February 2023

Interparietal inguinal hernia, an exceedingly rare type of inguinal hernia in which the hernia sac anatomically lies between the tissue layers of the abdominal wall, is difficult to diagnose from physical findings. Given the few reports on interparietal inguinal hernias, this condition has remained fairly unrecognized. Herein, we report the successful imaging and laparoscopic diagnoses as well as repair of an interparietal inguinal hernia. Atypical physical findings and computed tomography data help in the diagnosis of an interparietal inguinal hernia. The laparoscopic approach is useful and feasible for both the diagnosis and treatment of interparietal inguinal hernia.
Glacial expansion of cold-tolerant species in low latitudes: megafossil evidence and species distribution modelling
Authors: Huang Luliang , Li Shufeng , Huang Weiye , Xiang Helanlin , Jin Jianhua , Oskolski Alexei A
Published: February 2023

Fossil wood of Chinese white pine (Pinus armandii Franch.) from the Late Pleistocene deposits of Maoming Basin of South China provides the first megafossil evidence for glacial expansion of the range of a cold-tolerant species in low latitudes.
The morphing of dictators: why dictators get worse over time
Authors: Basu Kaushik
Published: February 2023

Dictators, even those who seize power with the intention of helping the nation, frequently morph over time into tyrants. There may be many reasons for this. This paper focuses on one interesting and arguably pervasive driver behind this process. A model is developed which shows that the series of decisions taken over time by an authoritarian leader concerning how much political intrigue and evil to indulge in in order to stay in power leads to a dynamic inconsistency converting the leader into a tyrant. It is possible that the dictator will, eventually, come to regret this, but by then they have no exit options. The analysis prompts us to think about ex ante rules and term-limit provisions to prevent this from happening.
PHYTOCHROME INTERACTING FACTOR 4 regulates microtubule organization to mediate high temperature-induced hypocotyl elongation in Arabidopsis
Authors: Zhou Dingding , Wang Xiaohong , Wang Xiangfeng , Mao Tonglin
Published: February 2023

Hypocotyl elongation is an important morphological response during plant thermomorphogenesis. Multiple studies indicate that the transcription factor PHYTOCHROME-INTERACTING FACTOR 4 (PIF4) is a key regulator of high temperature-induced hypocotyl elongation. However, the underlying cellular mechanisms regarding PIF4-mediated hypocotyl elongation are largely unclear. In this study, we found that PIF4 regulates the PLANT U-BOX TYPE E3 UBIQUITIN LIGASE 31 (PUB31)–SPIRAL1 (SPR1) module and alters cortical microtubule reorganization to promote hypocotyl cell elongation during Arabidopsis thaliana (Arabidopsis) thermomorphogenesis. SPR1 loss-of-function mutants exhibit much shorter hypocotyls when grown at 28 °C, indicating a positive role for SPR1 in high ambient temperature-induced hypocotyl elongation. High ambient temperature induces SPR1 expression in a PIF4-dependent manner, and stabilizes SPR1 protein to mediate microtubule reorganization. Further investigation showed that PUB31 interacts with and ubiquitinates SPR1. In particular, the ubiquitinated effect on SPR1 was moderately decreased at high temperature, which was due to the direct binding of PIF4 to the PUB31 promoter and down-regulating its expression. Thus, this study reveals a mechanism in which PIF4 induces SPR1 expression and suppresses PUB31 expression, resulting in the accumulation and stabilization of SPR1 protein, and further promoting hypocotyl cell elongation by altering cortical microtubule organization during Arabidopsis thermomorphogenesis.
Soybean ZINC FINGER PROTEIN03 targets two SUPEROXIDE DISMUTASE1s and confers resistance to Phytophthora sojae
Authors: Li Wei , Zheng Xiang , Cheng Rong , Zhong Chanjuan , Zhao Jie , Liu Tyler H , Yi Tuyong , Zhu Zhendong , Xu Jieting , Meksem Khalid , Dai Liangying , Liu Shiming
Published: February 2023

Phytophthora sojae causes Phytophthora root and stem rot disease of soybean (Glycine max), leading to huge annual yield loss worldwide, but resistance to Phytophthora sojae (Rps) genes remains elusive. Soybean cultivar “Yudou 29” is resistant to P. sojae strain PsMC1, and this study aimed to clone, identify, and characterize the Rps gene in Yudou 29 (RpsYD29) and clarify its functional mechanism. We map-based cloned RpsYD29 (ZINC FINGER PROTEIN03, GmZFP03) using the families of a cross between Yudou 29 and a P. sojae-susceptible soybean cultivar “Jikedou 2”. P. sojae resistance of GmZFP03 was functionally validated by stable soybean genetic transformation and allele-phenotype association analysis. GmZFP03 was identified as a C2H2-type zinc finger protein transcription factor, showing 4 amino acid residue polymorphisms (V79F, G122-, G123-, and D125V) and remarkably different expression patterns between resistant and susceptible soybeans. Notably boosted activity and gene expression of superoxide dismutase (SOD) in resistant-type GmZFP03-expressed transgenic soybean, substantial enhancement of P. sojae resistance of wild-type soybean by exogenous SOD treatment, and GmZFP03 binding to and activation of 2 SOD1 (Glyma.03g242900 and Glyma.19g240400) promoters demonstrated the involvement of SOD1s in GmZFP03-mediated resistance to P. sojae strain PsMC1. Thus, this study cloned the soybean P. sojae-resistant GmZFP03, the product of which specifically targets 2 SOD1 promoters. GmZFP03 can be directly used for precise P. sojae-resistance soybean breeding.
Computed tomography for malignancy screening in patients with rheumatoid arthritis before initiation of disease modifying antirheumatic drug
Authors: Miyata Hiroko , Sonomoto Koshiro , Fukuyo Shunsuke , Nakayamada Shingo , Nakano Kazuhisa , Iwata Shigeru , Miyazaki Yusuke , Kawabe Akio , Aoki Takatoshi , Tanaka Yoshiya
Published: February 2023

Objectives

This study aimed to clarify the usefulness of screening for malignancies using CT before the initiation of biologic and targeted synthetic DMARDs (b/tsDMARDs) in patients with active RA.

Methods

We examined 2192 patients with RA who underwent plain CT scans prior to the initiation of b/tsDMARDs. The sensitivity for detecting malignancy was measured and compared with that of regular screening (physical examination and X-ray). We then evaluated the clinical characteristics, prognosis and treatment of patients with RA with concomitant malignancies. Additionally, we determined the incidence rate of malignancy in patients with RA who were initiated on b/tsDMARDs after CT screening.

Results

Of the 2192 patients, 33 (1.5%) were diagnosed with malignancy after CT screening. Whereas regular screening detected only seven malignancies, CT screening further detected 26 (including 19 at the early stage). On the other hand, 86% of the malignancies detectable by regular screening were at an advanced stage. Patients diagnosed with early-stage malignancies received RA treatments that included b/tsDMARDs after curative resection; 80% of these patients achieved low disease activity after 1 year. This rate was comparable to the patients without malignancy detection after screening (70%). The 5 year incidence of malignancy after the initiation of b/tsDMARDs after CT screening was lower than that of the RA cohort without CT screening (standardized incidence ratio: 0.35).

Conclusion

Screening in patients with RA using CT before the initiation of b/tsDMARDs allows for the early detection and treatment of malignancy, resulting in safer and more stable b/tsDMARD treatments.
How Christian Nurses Respond to Patient Requests for Prayer
Authors: Mamier Iris , Park Carla Gober , Taylor Elizabeth Johnston
Published: February 2023

Nurse-provided spiritual care includes support of patient spiritual practices such as prayer. However, limited evidence exists about how nurses respond when a patient requests prayer. A subsample of nurses (n = 381) from a larger study responded to two open-ended questions in an online survey in response to a prayer scenario. Among these mostly Christian nurses, 97% indicated willingness to pray. Content analysis revealed a five-component structure for praying: Open, Set the Stage, Request, Wrap-up, Close. The structure provides a template for future research and nurse prayer in clinical contexts.
Using Nursing Interventions Classifications to Document Faith Community Nursing Transitional Care
Authors: Ziebarth Deborah J. , Campbell Katora , Ahn SangNam , Williams Janice , Lane Myron
Published: February 2023

One out of five Medicare beneficiaries is readmitted within 30 days after hospital discharge, and as many as three in four readmissions are preventable. This study describes transitional care interventions (TCIs) delivered by one faith community nurse (FCN) to at-risk seniors living in a certain ZIP code. Two years of nursing documentation (2,280 interventions) were translated into Nursing Interventions Classification standardized nursing language. Results indicate the FCN provided priority TCIs including spiritual care. In fully describing TCIs using a nursing language, results support that the FCN transitional care model is a method worth exploring to provide wholistic transitional care.
The association between adverse childhood experiences and peripartal pain experience
Authors: Zehetmeier Katharina Fiona , Fröhlich Melissa Kathrin , Schilder Andreas , Lis Stefanie , Schmahl Christian , Treede Rolf-Detlef , Sütterlin Marc
Published: February 2023

Adverse childhood experiences (ACEs) are associated with altered ongoing and evoked pain experiences, which have scarcely been studied for the peripartum period. We aimed to investigate how ACEs affect pain experience in pregnancy and labor. For this noninterventional trial with a short-term follow-up, pregnant women were divided into a trauma group (TG) with ACEs (n = 84) and a control group (CG) without ACEs (n = 107) according to the Childhood Trauma Questionnaire. Pain experience in pregnancy and labor was recorded by self-report and the German Pain Perception Scale. Pain sensitivity prepartum and postpartum was assessed by Quantitative Sensory Testing and a paradigm of conditioned pain modulation (CPM), using pressure pain thresholds (PPTs) and a cold pressor test. The TG showed higher affective and sensory scores for back pain and a more than doubled prevalence of preexisting back pain. Pelvic pain differences were nonsignificant. The TG also exhibited increased affective scores (1.71 ± 0.15 vs 1.33 ± 0.11), but not sensory scores for labor pain during spontaneous delivery. There were no group differences in prepartum pain sensitivity. While PPTs increased through delivery in the CG (clinical CPM), and this PPT change was positively correlated with the experimental CPM (r = 0.55), this was not the case in the TG. The association of ACEs with increased peripartal pain affect and heightened risk for preexisting back pain suggest that such women deserve special care. The dissociation of impaired clinical CPM in women with ACEs and normal prepartum experimental CPM implies at least partly different mechanisms of these 2 manifestations of endogenous pain controls.
Reducing Diabetic Ketoacidosis Readmissions with a Hospital-School-Based Improvement Partnership
Authors: King Zoe M. , Kurzum Jordan E. , Cooper Mary Reich , Hanley Patrick C.
Published: February 2023

Diabetic ketoacidosis (DKA) is the leading cause of morbidity and mortality in pediatric type 1 diabetes mellitus (T1D). Baseline data showed 139 of 182 DKA readmissions (76.4%) were due to missed basal insulin dosing. The team used quality improvement tools to implement a process change around basal insulin. The project utilized insulin degludec and school-based nurses when missed basal insulin was noted as a main driver for readmission. The DKA readmission rate averaged 5.25 per month from January 2017 to April 2019. The rate decreased to 3.64 per month during the intervention from May 2019 to March 2020, a 31% reduction over 11 months. This standardized approach for patients with T1D readmitted with DKA, using a school-based intervention and insulin degludec, reduced the number of DKA readmissions. This method is safe and effective for lowering DKA readmissions due to missed basal insulin in areas with reliable school nursing.
Growth differences by school-age and adolescence according to in utero and peripartum antiretroviral therapy exposure among Ugandan children
Authors: Awadu Jorem E. , Zalwango Sarah K. , Sikorskii Alla , Giordani Bruno , Bovin Michael J. , Musoke Philippa M. , Ezeamama Amara E.
Published: February 2023

In utero/peripartum antiretroviral (IPA) drug exposure in human immunodeficiency virus (HIV)-exposed children has established benefit for prevention of HIV mother-to-child-transmission but its association with height-for-age by adolescence is unknown. Hence we quantify IPA-associated growth differences at 6 to 18 years old among children with perinatally acquired HIV (CPHIV) infection and children HIV exposed but uninfected (CHEU) relative to children HIV unexposed and uninfected (CHUU). Cohort study. Kampala, Uganda. Two hundred thirty eight community controls and 490 children of women living with HIV born between 2000 and 2011 in a community were enrolled at 6 to 18 years of age and followed every 6 months for 1 year. Height-for-age determined at enrollment, 6 and 12 months after enrollment using the World Health Organization reference. IPA exposure was retrospectively determined from medical records and categorized as: no IPA, single-dose nevirapine with/without zidovudine (sdNVP ± AZT), sdNVP + AZT + lamivudine, or combination antiretroviral therapy (cART). Mean differences (β) with 95% confidence intervals (CIs) in height-for-age over 12 months were evaluated according to IPA exposure for CPHIV and CHEU and relative to CHUU using longitudinal linear mixed effects models adjusted for caregiver factors (sex, age, education, functioning in caregiving role, and lifetime adversity) in Statistical Analysis Software (v.9.4). Regardless of IPA type, CPHIV grew worse than CHUU by school-age/adolescence (β = −0.30, 95% CI: −0.48, −0.11). Relative to CHUU height-for-age was similar for CHEU exposed to sdNVP ± AZT (β = −0.16, 95% CI: −0.46, 0.14) and for CHEU exposed to sdNVP + AZT + lamivudine (β = 0.08, 95% CI: −0.20, 0.35). However, CHEU without any IPA exposure had lower height-for-age (β = −0.27, 95% CI: −0.52, −0.00) whereas CHEU with cART exposure had greater height-for-age (β = 0.41, 95% CI: 0.10, 0.71) in comparison with CHUU by 6 to 18 years old. Our findings suggest that CHEU may achieve height-for-age parity with CHUU by school-age and adolescent years- especially if provided benefit of effective cART in the peripartum period. However, CPHIV regardless of IPA exposure type and CHEU without IPA exposure remain at a disadvantage and will benefit from intervention to support their growth.
Small cell lung cancer transformation after EGFR-TKIs treatment in lung adenocarcinoma: A case report and literatures review
Authors: Chen Xiaoli , Li Dongmei , Miao Kun , Shou Tao , Zhang Wenjing
Published: February 2023

Rationale:

Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are commonly used in the treatment of advanced non-small cell lung cancer. However, patients will inevitably develop resistance to EGFR-TKIs in the long-term treatment process. In this paper, we report a case of small cell lung cancer transformation after EGFR-TKIs treatment in lung adenocarcinoma. We summarize the characteristics of this case and the treatment after transformation, and emphasized the repeat biopsy and dynamic monitoring its genetic mutation was necessary.

Patient concerns:

A 75-years-old man with no smoking history was admitted to our hospital with repeated cough and expectoration for 1 month and chest enhancement computed tomography showed paracbronchial soft tissue mass in the lower lobe of the left lung, which was considered to be central lung cancer.

Diagnoses:

The first pathological analysis of lung biopsy confirmed left lung adenocarcinoma and clinical stage was T3N3M1 IVA. In June 2021, the second bronchoscopic biopsy was performed, and pathology showed small cell neuroendocrine carcinoma in the left lung.

Interventions:

Gefitinib was given to patients when the first next generation sequence test showed EGFR L858 mutation. When the second next generation sequence test revealed EGFR T790M mutation, the patient received with osimertinib. The patient got 2 cycles chemotherapy of etoposide plus netaplatin when diagnosed with small cell lung cancer.

Outcomes:

Progression-free survival was only 8 months after gefitinib treatment. Moreover, the patient was insensitive to Oxitinib, and the disease progressed after 2 months of treatment with Oxitinib. Finally, he died of severe infection and hepatic failure after a diagnosis of small cell lung cancer.

Lessons:

Our case highlights that if a patient has rapid disease progression, increase of serum neuron-specific enolase, and TP53 and Rb1 inactivation during EGFR-TKIs treatment, we should be alert to the pathological type transformation to small cell lung cancer.
A large family of hereditary spherocytosis and a rare case of hereditary elliptocytosis with a novel SPTA1 mutation underdiagnosed in Taiwan: A case report and literature review
Authors: Shih Yu-Hung , Huang Ying-Chih , Lin Ching-Yeh , Lin Hsuan-Yu , Kuo Su-Feng , Lin Jen-Shiou , Shen Ming-Ching
Published: February 2023

Rationale:

Hereditary spherocytosis (HS) has a defect in the vertically connected proteins on the cell membrane of red blood cells (RBC). Hereditary elliptocytosis (HE) has a defect in proteins that connect the cell membrane horizontally. We reported two families of RBC membrane disorders in Taiwanese, one was HS and the other was HE.

Patient concerns:

Case 1. A 19-year-old male student with chronic jaundice and splenomegaly. His mother, maternal uncle, grandmother, and many members of older generations also had splenomegaly and underwent splenectomy. Case 2. A 40-year-old man has experienced pallor and jaundice since the age of 20 and was found to have splenomegaly, and gall bladder stones in the older age. His younger sister also had pallor and jaundice for a long time.

Diagnoses:

In case 1, a peripheral blood smear showed 20% spherocytes. Eosin-5-maleimide labeled RBC by flow cytometry showed a result of 30.6 MCF (cutoff value: 45.5 MCF). He was diagnosed with HS. The gene analysis identified a heterozygous mutation with c.166A > G (p.Lys56Glu) in the SLC4A1 gene in this proband, his mother, and maternal uncle. In case 2, more than 40% of ellipsoid RBC present in the peripheral blood smear. He was diagnosed with HE. Genetic analysis of the SPTA1 gene identified a novel heterozygous exon2, c.86A > C, p.Gln29Prol mutation.

Interventions:

The two patients had compensated anemia, clinical follow-up instead of splenectomy was done.

Outcomes:

The two patients had normal daily activities and lives.

Lessons:

We reported two Taiwanese families, one was hereditary spherocytosis affected by a heterozygous mutation with c.166A > G (p.Lys56Glu) in SLC4A1, and the other was hereditary elliptocytosis caused by a novel heterozygous SPTA1 gene mutation, c. 86A > C, p.Gln29Prol. These 2 seemingly common hereditary red blood cell membrane protein defects induced by hemolysis are usually underdiagnosed or misdiagnosed.
Imaging parameters and clinical significance of posterior ligament complex injury in thoracolumbar fracture
Authors: Guo Zhiquan , Shi Shouliang , Liu Feifei , Wang Ligong , Shi Yunli , Peng Xiaofang , Zhang Lei , Liu Chunsheng , Liu Yingjie
Published: February 2023

This study aims to investigate whether the combination of radiographs and computed tomography (CT) images can be used as an alternative means of magnetic resonance imaging examination or a preliminary screening method before examination, so as to improve the accuracy of determining the degree of posterior ligament complex injury in thoracolumbar fracture patients. From May 2011 to May 2019, the patients with thoracolumbar fracture were collected. A total of 150 patients were enrolled. The reference standard was 1.5T magnetic resonance imaging examination and lipid suppression sequence was applied. All radiographs and CT imaging results were measured in the Picture Archiving and Communication System workstation. The upper endplate angle and lower endplate angle, the percentage of vertebral height drop, the difference of inter-spinous process distance on CT images and the translation distance were statistically significant between the 2 groups (P < .05). Receiver operating characteristic curve showed that the diagnostic performance was excellent (all area under the curve > 0.7). To sum, the results showed that endplate angle + inter-spinous process distance on CT images combination had relatively high-quality diagnostic value for posterior ligamentous complex injury in thoracolumbar fracture patients.
The effect of individual oocyte matched follicular fluid oxidant, antioxidant status, and pro- and anti-inflammatory cytokines on IVF outcomes of patients with diminished ovarian reserve
Authors: İlhan Gülşah , Bacanakgil Besim Haluk , Vuruşkan Ayşe Köse , Eken Meryem Kürek , Karasu Ayse Filiz Gokmen , Bilgiç Bülent Emre , Küçükyurt Ayça Kubat
Published: February 2023

Oocyte matched follicular fluid oxidant, antioxidant status, and pro- and anti-inflammatory cytokine levels were assessed to reveal a possible effect of local-intrafollicular levels of these markers on the individual oocyte with its quality, ability to achieve fertilization, further embryo development, and pregnancy. A cross-sectional study of infertile women with diminished ovarian reserve undergoing antagonist protocol in vitro fertilization (IVF); in the form of ICSI, and fresh single embryo transfer were included. When follicular fluid was collected, each ovarian follicle was aspirated independently, and each follicular fluid was collected into a separate test tube to match it with a single cumulus-oocyte complex obtained from the same follicle. Oocyte matched follicular fluid samples and blood specimens were taken from the participants. Relationships of total antioxidant status, total oxidant status, oxidative stress index, total thiol, interleukin (IL)-6, IL-8, and IL-10 levels of each follicle with oocyte grade, grade of transferred embryos, and pregnancy rate of a given follicle were assessed. A total of 23 infertile women with diminished ovarian reserve and 79 individual follicles of these women were assessed. Serum total oxidant status level of metaphase II (MII) group was significantly lower than non-MII group (P < .001). Follicular fluid IL-6 level of MII group was significantly lower than non-MII group (P = .005). Follicular fluid IL-8 value was significantly low with positive pregnancy results (P < .001). Serum oxidative stress status and follicular fluid pro-inflammatory cytokines were associated with IVF outcomes. This unique study might guide IVF practice with the aim of developing and establishing more effective therapeutic strategies and choosing embryos with more potential for success.
Morbidity and Mortality in Neonates with Symptomatic Congenital Lung Malformation
Authors: Engwall-Gill Abigail J , Weller Jennine H , Salvi Pooja S , Penikis Annalise B , Sferra Shelby R , Rhee Daniel S , Solomon Daniel G , Kunisaki Shaun M
Published: February 2023

Objective:

Neonatal resection is the mainstay treatment of children presenting with symptomatic congenital lung malformations (CLM) at birth. The objective of this study was to evaluate risk factors for increased morbidity and mortality after neonatal CLM resection using a large multicenter database.

Study Design:

Retrospective review of the Pediatric Health Information System database was performed. Children with a symptomatic CLM managed by lung resection before 30 days of age were included (2016-2021). Primary outcome measures were postoperative respiratory complications and any complication, including death.

Results:

Of 1791 CLM patients identified, 256 (14%) underwent neonatal resection for symptomatic disease. Pathology included 123 (48%) congenital pulmonary airway malformations, 24 (10%) bronchopulmonary sequestrations (BPS), 5 (2%) congenital lobar emphysema, 16 (6%) hybrid, and 88 (34%) unclassified lesions. Preoperative mechanical ventilation and extracorporeal membrane oxygenation (ECMO) were employed in 149 (58.2%) and 17 (6.7%) of cases, respectively. The median age at resection was 6.5 days (IQR 2-23). Postoperatively, 25 (10%) required mechanical ventilation for ≥48 hrs, 3 (1%) continued ECMO, and 3 (1%) required ECMO rescue. Overall respiratory complication rate was 34% (n=87), any complication was 51% (n=130), median postoperative length of stay (LOS) was 20 days (IQR 9, 52), and mortality rate was 14.5% (n=37). Birthweight was inversely correlated with complication risk (IRR: 0.55, CI: 0.36-0.83, p=0.006). Cardiac structural anomalies were associated with a 21 day longer postoperative LOS (CI: 6-35, p=0.006) and 2.2 times increased risk of any complication (CI 1.18-4.02, p=0.014).

Conclusion:

In this large multicenter study, ECMO use and mortality are relatively uncommon among neonates undergoing lung resection for a symptomatic CLM. However, postoperative morbidity remains high, particularly in those with cardiac structural disease.