bluuebunny/crossref_metadata_2025 huggingface dataset:
Single Stretch Wire and vibrating wire measurement system for characterization of multipole accelerator magnets
Authors: Teotia Vikas , Malhotra Sanjay
Published: July 2023

A stretch wire magnetometer is a versatile instrument and
can be treated as the primary standard of magnetic qualification of
accelerator magnets. Bhabha Atomic Research Centre has developed a
Stretch wire magnetic measurement system to cater to the
requirements of magnetic measurements on accelerator magnets. This
bench also includes a vibrating wire system. The scheme used in this
instrument for measurements of magnetic flux ensures drift
compensations after each scan. This feature along with post-signal
processing gives an accuracy of homogeneity measurements comparable
to that of a rotating coil magnetometer. Unlike conventional stretch
wire systems, wire moves in the r-z plane (along r-axis) at
different azimuthal angles. This provides the opportunity for drift
compensation at each scan. This has immensely enhanced the
measurement accuracy of non-homogeneity of integral fields to less
than 3 units. The same is cross-verified with a rotating coil
system. The comparison between rotating coil and stretch wire is
presented. The Paper gives the step-wise procedure for the
measurement of key performance indicators of an accelerator
magnet. This paper brings out salient features of the system along
with design and calibration results.
The procreation asymmetry, improvable-life avoidance and impairable-life acceptance
Authors: Thornley Elliott
Published: July 2023

Many philosophers are attracted to a complaints-based theory of the procreation asymmetry, according to which creating a person with a bad life is wrong (all else equal) because that person can complain about your act, whereas declining to create a person who would have a good life is not wrong (all else equal) because that person never exists and so cannot complain about your act. In this paper, I present two problems for such theories: the problem of impairable-life acceptance and an especially acute version of the problem of improvable-life avoidance. I explain how these problems afflict two recent complaints-based theories of the procreation asymmetry, from Joe Horton and Abelard Podgorski.
Wheat germ agglutinin affinity chromatography enrichment and glyco-proteomic characterization of tetrodotoxin-binding proteins from the plasma of cultured tiger pufferfish (Takifugu rubripes)
Authors: Zhang Yafei , Minami Ryoma , Tatsuno Ryohei , Gao Wei , Ueno Mikinori , Yamada Akinori , Yoshida Asami , Sedanza Mary Grace , Arima Kazunari , Takatani Tomohiro , Yamaguchi Kenichi , Oshima Yuji , Arakawa Osamu
Published: July 2023

Efficient enrichment of tetrodotoxin (TTX)-binding proteins from the plasma of cultured tiger pufferfish (Takifugu rubripes) was achieved by ammonium sulfate fractionation and wheat germ agglutinin (WGA) affinity chromatography. The enrichment efficiency was validated by ultrafiltration-LC/MS-based TTX-binding assay and proteomics. Major proteins in the WGA-bound fraction were identified as isoform X1 (125 kDa) and X2 variants (88 and 79 kDa) derived from pufferfish saxitoxin and tetrodotoxin-binding protein (PSTBP) 1-like gene (LOC101075943). The 125-kDa X1 protein was found to be a novel member of the lipocalin family, having three tandemly repeated domains. X2 variants, X2α and X2β, were estimated to have two domains, and X2β is structurally related to Takifugu pardalis PSTBP2 in their domain type and arrangement. Among 11 potential N-glycosylation sites in the X2 precursor, 5 N-glycosylated Asn residues (N55, N89, N244, N308, and N449) were empirically determined. Structural relationships among PSTBP homologs and complexity of their proteoforms are discussed.
Neoclassical Realism: Methodological Critiques and Remedies
Authors: Tang Shiping
Published: July 2023

The debate on how neoclassical realism (NCR) has fared as a new brand of realism and supposedly a more rigorous approach towards foreign policy has become increasingly acerbic. Most NCR critics have challenged NCR’s epistemological positions, and few have scrutinised NCR’s methodological practice. This essay seeks to fill the void and focuses on the latter. My aim is both critical and constructive. Because NCR’s mainstay method is comparative case studies (CCSs), I first examine how NCR has practiced this method. I argue that NCR has been saddled with several key shortcomings when doing CCSs. Drawing from the extensive new qualitative methodology literature, I propose several remedies corresponding to the shortcomings. Fixing these shortcomings will allow NCR to advance more valid theories and move towards better theoretical synthesis. I then highlight qualitative comparative analysis as a very useful tool for NCR. Finally, I address a common criticism against NCR, that is, with numerous variables, NCR lacks theoretical synthesis and hence a theoretical core. I accordingly advance a preliminary framework for possible theoretical synthesis.
Comfort Eating: Food, Drink and Emotional Health in Early Modern England
Authors: Winchcombe Rachel
Published: July 2023

This article explores early modern practices of ‘comfort eating’, arguing that they represent a crucial dimension of early modern preventative healthcare. The article argues that ideas of comfort eating were shaped not only by medical understandings of the composition of foods and their impact on the body, particularly on the levels of the four humours, but also by the cultural and social significance of certain foods, along with when, where, and with whom they were eaten. For early modern people, whether a food could provide comfort depended on its perceived medical properties, the quantities in which it was eaten, its social capital, and its use in other areas of daily life that were known to promote cheerfulness such as sharing meals and gift-giving. Focusing on this more holistic approach to emotional healthcare reveals how practices that have normally been defined as largely social in nature, such as gift-giving and hospitality, were viewed and performed through a medical lens, while also demonstrating how techniques for managing the passions seeped into everyday experiences of food consumption and culture. Practices of comfort eating represented a critical tool with which early modern people could manage their emotional health and the health of their wider communities, empowering them to adapt their diets where necessary, create medicines that could cure diseases of the passions, and consider how everyday social codes of hospitality and commensality could have medical implications for the health of their passions.
Tree-related microhabitat diversity as a proxy for the conservation of beetle communities in managed forests of Fagus sylvatica
Authors: Spina Pierdomenico , Parisi Francesco , Antonucci Serena , Garfì Vittorio , Marchetti Marco , Santopuoli Giovanni
Published: July 2023

Integrating the conservation of biodiversity into silvicultural practices is one of the main challenges facing forest owners in the promotion of an emergent approach to sustainable forest management across European forests. The Mediterranean forests are among the richest biodiverse forest ecosystems due to their environmental heterogeneity, but climate change is threatening their integrity, with critical implications for the availability of ecosystem services. Forests managed for commercial purposes are under increasing pressure to provide timber while supporting biodiversity. This study aims to analyse the relationship between tree-related microhabitats (TreMs), which are structures occurring on living or standing dead trees that constitute an essential substrate for several living species, and beetles, an important indicator species group for forest biodiversity monitoring. Four generalized linear models were fitted to assess the influence of environmental factors, forest structure, and biodiversity-related parameters on the abundance and richness of beetles, mainly on saproxylic beetles. The study highlights significant associations between the abundance and richness of individual groups and types of TreMs and the Italian Red List of saproxylic species. Therefore, TreMs can serve as a tool to map, monitor, and enhance forest biodiversity in managed forests.
Impacts of human forest management on seed dispersal patterns by scatter-hoarding rodents
Authors: Nóbrega Eva K , Vidal-Cardos Roger , Muñoz Alberto , Ferrandiz-Rovira Mariona
Published: July 2023

Scatter-hoarding rodents play a central role in seed dispersal, predating and dispersing seeds that affect many plant species’ population dynamics and influence forest regeneration. Anthropogenic changes in forest structure, such as clear-cutting in dense forests, may alter the ecological interactions between seeds and dispersers. This study compared predation and dispersal patterns of holm oak (Quercus ilex L.) acorns by wood mouse (Apodemus sylvaticus L.) in original dense forest [less managed forest (MF)] vs open MF (more MF) in north-eastern Spain. Results showed variations in the patterns of acorn predation and dispersal by wood mouse between forest types. In the MF, a greater fraction of acorns was harvested, and the acorns were being dispersed further than in the original forest. Despite the greater fraction of acorns dispersed in the MF, the proportion of acorns that survived and had the potential to grow was reduced in the MF because of increased predation. This shows that forest management has a significant influence on seed dispersal by rodents and thereby influences the natural regeneration potential of forests.
Is lifestyle modification with individual face-to-face education and counseling more effective than usual care for controlling hypertension? A systematic review and meta-analysis of randomized controlled trials
Authors: Soltani Danesh , Azizi Bayan , Behnoush Amir Hossein , Meysamie Alipasha , Aein Afsaneh , Nayebirad Sepehr , Vasheghani-Farahani Ali , Akbari Sari Ali
Published: July 2023

Hypertension (HTN) management continues to be a concern due to challenges with behavioral risk factors. Patient education to modify unhealthy behaviors appears to be effective in managing HTN. Therefore, this meta-analysis aimed to determine whether individualized face-to-face education and counseling have a beneficial effect on systolic and diastolic blood pressure (SBP and DBP) in hypertensive patients. Studies were extracted from PubMed, Scopus, Cochrane Library, and Web of Science databases. Nine studies, comprising 2627 participants, were included. Random effects models were used to pool estimates of mean differences (MDs) with 95% confidence intervals (CIs) in SBP and DBP between the intervention and usual care groups. SBP and DBP were significantly reduced at the 6-month (MD = −4.38 mmHg, 95% CI: −6.95 to −1.81; MD = −2.09 mmHg, 95% CI: −3.69 to −0.50, respectively) and 12-month time points (MD = −2.48 mmHg, 95% CI: −3.96 to −1.01; MD = −1.71 mmHg, 95% CI: −2.88 to −0.55, respectively) with intervention. At the 24-month time point, there was a significant change in SBP (MD = −2.13 mmHg, 95% CI: −3.94 to −0.32) with intervention compared with the usual care group. This study showed that individualized face-to-face education and counseling add significant benefits to usual care for lowering blood pressure in hypertensive patients.

Graphical Abstract
Saturated Orbit Closures in the Hodge Bundle
Authors: Winsor Karl
Published: July 2023

We give a new proof of the classification of $\operatorname {GL}^{+}(2,{\mathbb {R}})$-orbit closures that are saturated for the absolute period foliation of the Hodge bundle. As a consequence, we obtain a short proof of the classification of closures of leaves of the absolute period foliation of the Hodge bundle. Our approach is based on a method for classifying $\operatorname {GL}^{+}(2,{\mathbb {R}})$-orbit closures using deformations of flat pairs of pants.
Prevalence of hypertension among type 2 diabetes mellitus patients in China: a systematic review and meta-analysis
Authors: Zhang Xin , Yang Xiao-Lin , Liu Shan , Ye Yan-Sheng , Yang Qing-Tang , Xia Li-Na
Published: July 2023

This study aimed to estimate the prevalence of hypertension in Chinese patients with type 2 diabetes mellitus (T2DM) using the results of a regional study. The studies were reviewed using PubMed, EMBASE, Web of Science, the Cochrane Library, China National Knowledge Infrastructure, China Biology Medicine, Wan Fang Data and Chinese Science Citation Database. After screening articles and data extraction, Stata V.16 was used for statistical analysis. This study was registered in the Prospective Register Systematic Reviews (CRD42020170649). A total of 2126 articles were identified, and nine papers were finally included. Random-effects modelling showed that the pooled prevalence of hypertension among Chinese patients with T2DM was 54% (95% CI 47 to 61%). Subgroup analysis showed that the prevalence in men (59.8%; 95% CI 49.0 to 70.7%) was higher than that in women (40.2%; 95% CI 29.3 to 59.2%). The prevalence in North China was higher than that in East China. The prevalence in institution-based settings (56%; 95% CI 48 to 64%) was higher than that in community-based settings (51%; 95% CI 34 to 69%). Appropriate preventive measures should be undertaken, such as health education, to control and reduce the risk of hypertension in diabetic patients and reduce the burden of cardiovascular disease.
Sampling Lasioderma serricorne (Coleoptera: Anobiidae) in 2 coffee bean warehouses in New Jersey
Authors: Pan Xiaodan , Wang Changlu
Published: July 2023

Cigarette beetle, Lasioderma serricorne (F.), is one of the most common stored-product pests. We monitored their population dynamics and distribution in two coffee bean warehouses in New Jersey, USA, using pheromone traps and sticky traps during September 2018–October 2020, and light traps in 2020. The two warehouses only implemented treatment procedures for controlling Indian meal moth (Plodia interpunctella (Hübner) (Lepidoptera: Pyralidae)) during the study period. The first L. serricorne adult appeared on pheromone traps from late May to early June when temperature reached 21–22 °C, and the last L. serricorne adult appeared on pheromone traps from late October to mid-November when temperature dropped to 10–14 °C. The majority of L. serricorne was caught during July−October. Light traps caught 5.5- and 2.2-times more L. serricorne per trap than pheromone traps in Warehouse 1 and 2, respectively. Warehouse 1 had a significantly higher density of L. serricorne than Warehouse 2. The L. serricorne activity peaks were not always clear and varied between year and the two warehouses. Zero to 3 hot spots, where had the largest numbers of L. serricorne, were identified from July to October in each warehouse based on pheromone traps, and their locations were similar through the months both in 2019 and 2020. The L. serricorne counts from pheromone traps placed inside warehouse were at least 2.3-times more than those placed outside. Also, the L. serricorne active period outside of the warehouses was shorter than that from inside of the warehouses.
Plasmablastic transformation of chronic lymphocytic leukemia: a review of literature and report on 2 cases
Authors: Khanna Anurag , Drumheller Bradley R , Deeb George , Tolbert Ethan Wade , Asakrah Saja
Published: July 2023

Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is the most common leukemia in adults in Western countries. Transformation of CLL/SLL to plasmablastic lymphoma (PBL) is exceedingly rare and often has an extremely poor response to treatment. A thorough molecular workup may help in determining clonality-relatedness and prognosis. We describe two cases of CLL/SLL that transformed into PBL, with an extensive molecular workup in one case, and a review of the literature.
Physical properties of circumnuclear ionizing clusters – I. NGC 7742
Authors: Zamora S , Díaz Ángeles I
Published: July 2023

This work aims to derive the physical properties of the circumnuclear star-forming region in the ring of the face-on spiral NGC 7742 using integral field spectroscopy observations. We have selected 88 individual ionizing clusters that power H ii regions populating the ring of the galaxy that may have originated in a minor-merger event. For the H ii regions, the rate of Lyman continuum photon emission is between 0.025 and 1.5 × 1051, which points to these regions being ionized by star clusters. Their electron density, ionization parameter, filling factor, and ionized hydrogen mass show values consistent with those found in other studies of similar regions and their metal abundances, as traced by sulphur have been found to be between 0.25 and 2.4 times solar, with most regions showing values slightly below solar. The equivalent temperature of the ionizing clusters is relatively low, below 40 000 K, which is consistent with the high elemental abundances derived. The young stellar population of the clusters has contributions of ionizing and non-ionizing populations with ages around 5 and 300 Ma, respectively. The masses of ionizing clusters once corrected for the contribution of underlying non-ionizing populations were found to have a mean value of 3.5 × 104 M⊙, comparable to the mass of ionized gas and about 20 per cent of the corrected photometric mass.
T Tauri stars in the SuperWASP and NSVS surveys II. Spectral modelling
Authors: Hambálek L’ , Krushevska V , Pribulla T , Vaňko M , Budaj J , Fiorucci M , Garai Z , Guenther E , Komžík R , Kundra E , Munari U , Smalley B
Published: July 2023

We present results from long-term spectroscopic monitoring of 21 T-Tauri stars located in the Taurus–Auriga star-forming region (SFR). We combine medium and high-dispersion Echelle spectroscopy obtained at the Stará Lesná, Skalnaté Pleso (both in Slovakia), and Tautenburg (Germany) observatories with low-resolution flux-calibrated spectra from Asiago (Italy) observatory all taken between 2015 and 2018. We extend the coverage by additional medium-resolution spectra from Stará Lesná obtained in 2022. In the previous paper, we measured photometric periods of these targets in a range of 0.7–3.1 d, which could be due to the rotation of a spotted surface or binarity. Here, we use the broadening-function technique to determine the radial and projected rotational velocities to reveal any close binary companion. Our analysis concludes that no such companion is present with an orbital period equal to the photometric period. We focus our analysis primarily on determining atmospheric parameters such as surface gravity log g, effective temperature Teff, and metallicity [Fe/H]. Additionally, we measure the equivalent width of H α, Li i, and interstellar Na i lines. We also investigate the effect of possible reddening on individual targets and construct the HR diagram of our sample. Using pre-main-sequence evolutionary models, we determine the age of our targets. This analysis hints at ages younger than 50 Myr with mean age 5 ± 3 Myr, masses between 0.75 and 2.10 M⊙, and minimum radii in the range 0.60–3.17 R⊙. Altogether, the results are consistent with expected young stars with larger radii than those of main-sequence stars.
Multiple Sources of Uncertainty Confound Inference of Historical Human Generation Times
Authors: Ragsdale Aaron P , Thornton Kevin R
Published: July 2023

Wang et al. (2023) recently proposed an approach to infer the history of human generation intervals from changes in mutation profiles over time. As the relative proportions of different mutation types depend on the ages of parents, binning variants by the time they arose allows for the inference of changes in average paternal and maternal generation intervals. Applying this approach to published allele age estimates, Wang et al. (2023) inferred long-lasting sex differences in average generation times and surprisingly found that ancestral generation times of West African populations remained substantially higher than those of Eurasian populations extending tens of thousands of generations into the past. Here, we argue that the results and interpretations in Wang et al. (2023) are primarily driven by noise and biases in input data and a lack of validation using independent approaches for estimating allele ages. With the recent development of methods to reconstruct genome-wide gene genealogies, coalescence times, and allele ages, we caution that downstream analyses may be strongly influenced by uncharacterized biases in their output.
Engineering of the DNA replication and repair machinery to develop binary mutators for rapid genome evolution of Corynebacterium glutamicum
Authors: Cai Ningyun , Chen Jiuzhou , Gao Ning , Ni Xiaomeng , Lei Yu , Pu Wei , Wang Lixian , Che Bin , Fan Liwen , Zhou Wenjuan , Feng Jinhui , Wang Yu , Zheng Ping , Sun Jibin
Published: July 2023

Corynebacterium glutamicum is an important industrial workhorse for production of amino acids and chemicals. Although recently developed genome editing technologies have advanced the rational genetic engineering of C. glutamicum, continuous genome evolution based on genetic mutators is still unavailable. To address this issue, the DNA replication and repair machinery of C. glutamicum was targeted in this study. DnaQ, the homolog of ϵ subunit of DNA polymerase III responsible for proofreading in Escherichia coli, was proven irrelevant to DNA replication fidelity in C. glutamicum. However, the histidinol phosphatase (PHP) domain of DnaE1, the α subunit of DNA polymerase III, was characterized as the key proofreading element and certain variants with PHP mutations allowed elevated spontaneous mutagenesis. Repression of the NucS-mediated post-replicative mismatch repair pathway or overexpression of newly screened NucS variants also impaired the DNA replication fidelity. Simultaneous interference with the DNA replication and repair machinery generated a binary genetic mutator capable of increasing the mutation rate by up to 2352-fold. The mutators facilitated rapid evolutionary engineering of C. glutamicum to acquire stress tolerance and protein overproduction phenotypes. This study provides efficient tools for evolutionary engineering of C. glutamicum and could inspire the development of mutagenesis strategy for other microbial hosts.
Effects of the minimum wage on the nonprofit sector
Authors: Meer Jonathan , Tajali Hedieh
Published: July 2023

The nonprofit sector’s ability to absorb increases in labor costs differs from the private sector in a number of ways. We analyse how nonprofits are affected by changes in the minimum wage utilizing data from the Bureau of Labor Statistics and the Internal Revenue Service, linked to state minimum wages. We examine changes in reported employment and volunteering, as well as other financial statements such as revenues and expenses. The results from both datasets show a negative impact on employment for states with large statutory minimum wage increases. We observe some evidence for a reduction in the number of nonprofit establishments, fundraising expenses, and revenues from contributions.
Slow Workers: Labelling and Labouring in Britain, c. 1909–1955
Authors: Delap Lucy
Published: July 2023

This article surveys the experiences of historical actors labelled ‘mentally defective’ and ‘mentally handicapped’ in Britain in the first half of the twentieth century. It decentres institutions and experiences of segregation, and instead foregrounds employment as a way to historicise and make visible the experiences of individuals with intellectual impairments who lived in communities. The article discusses significant opportunities for paid employment, both formal and informal, for disabled people. Periods of economic growth or recession rendered such workers visible, as did efforts to regulate labour markets and wages. The article argues that rather than ‘mental age’ becoming dominant in framing intellectual disability, vernacular and negotiable categories of ‘wage age’ predominated in workplaces to the mid-twentieth century. Intellectually disabled people adopted precarious strategies of ‘getting by’ and while they commonly experienced low wages, could also sustain degrees of community inclusion at the margins of the economy.
Zerumbone attenuates the excessive proliferation of keratinocytes in psoriasis mice through regulating NLRP3/NF-κB pathway
Authors: Lin Jin , Fang Yimiao , Cao Yi , Ma Lili , Tao Maocan , Wang Xiao , Li Yuanyuan , Qing Lijun
Published: July 2023

Psoriasis is a common chronic disease, and existing treatment regimens often exhibit certain toxicities and side effects. Zerumbone (Zer) may possess therapeutic effect, and the objective of this study is to investigate the effect of Zer on psoriasis. A mouse model of psoriasis was established using imiquimod cream, and the role of Zer on the pathological alterations in psoriatic mouse skin was evaluated by psoriasis area and severity index (PASI) score; the effect of Zer on keratinocyte proliferation was evaluated via hematoxylin and eosin staining, Zen image analysis, and immunofluorescence; Immunohistochemistry and enzyme-linked immunoassay were used to evaluate the effect of Zer on tissue inflammatory responses, while malondialdehyde (MDA) and glutathione (GSH) levels were measured to elucidate the role of Zer in modulating oxidative stress; the signaling pathway regulated by Zer was evaluated by western blotting. The results demonstrated that Zer could alleviate the pathological manifestations of psoriasis, reduce PASI score, reduce skin pathological damage and epidermal hyperplasia, diminish the number of CD8+ T cells and cytokine expression levels, decrease the level of MDA and GSH and increase the expression of Nrf and HO-1. Zer was found to regulate the NLRP3/nuclear factor-kappa B (NF-κB) signaling pathway. In conclusion, Zer ameliorated the symptoms of psoriasis in mice, suppressed the keratinocyte hyperproliferation, and mitigates inflammation and oxidative stress in psoriatic skin tissue by regulating the NLRP3/NF-κB pathway.
Single-Incision, Four-Compartment Fasciotomy and Application of Negative Pressure Dressing for Compartment Syndrome of the Leg
Authors: Yong Taylor M. , Davis Max E. , Moreno-Diaz Andres F. , Obremskey William T.
Published: July 2023

The video described by this article presents a safe and effective technique for single-incision, 4-compartment fasciotomy of the leg in a patient with a tibial plateau fracture and clinically diagnosed compartment syndrome. We also demonstrate a technique for the application of a negative pressure wound dressing when delayed closure or coverage is planned.
An Interim 6-Month Analysis of the Dermatologic Effects and Midface Volume Correction With XTRCL Filler in a Prospective, Single-Center Study
Authors: Salti Giovanni , Siquier-Dameto Gabriel , Rharbaoui Siham , Hernandez Malgapo Dennis Malvin , Innocenti Silvia , Manni Martina
Published: July 2023

BACKGROUND

Hyaluronic acid-based filler injections with parenteral anesthetics have become the standard in treating midface volume deficits. There are currently limited data on the effects of these types of fillers on skin density, thickness, and firmness.

OBJECTIVE

This study aimed to assess the efficacy of XTRCL filler in improving skin quality and tissue volume in women with midface volume loss.

MATERIALS AND METHODS

In this prospective, noncomparative, single-center study, 50 women aged between 40 and 60 years with midface volume loss were recruited. The primary endpoint was the improvement in investigator-assessed Global Aesthetic Improvement Scores (GAIS) 1 month after treatment. Secondary endpoints include objective measurements of skin density, thickness, and quality measurements, facial and/or cheek volume augmentation, subjective GAIS, and device evaluation from after the first injection until 6 months, and the documentation of injection site reactions and adverse events.

RESULTS

XTRCL use led to significant improvement in midface volume deficits, and skin quality and skin thickness. Injector and subject satisfaction with the treatment were documented and only mild-to-moderate adverse reactions were reported.

CONCLUSION

XTRCL was shown to be effective in improving volume loss and skin quality at 6 months.
Endoscope-Assisted Visualization of the Internal Auditory Canal Using the Middle Fossa Approach
Authors: Cass Nathan D. , Mason Hannah G. , Khan Mohammad MR , Lindquist Nathan R. , Noble Jack H. , Tawfik Kareem O.
Published: July 2023

Hypothesis

Angled endoscopes have been postulated to increase visualization of the internal auditory canal (IAC); however, few studies have quantified the extent of IAC visualization using endoscopes of varying angles.

Background

Preservation of the bony labyrinth in middle fossa (MF) vestibular schwannoma surgery may limit visualization of the lateral IAC. We sought to determine the extent to which IAC visualization is increased with endoscopes in these situations.

Methods

Computed tomography (CT) scans were acquired before and after two cadaveric MF bony drill-outs. An atlas-based method was used to localize the IAC in the preprocedure CT and then registered with the postprocedure CT using standard image registration methods. Virtual microscope and endoscope positions and angles of approach were determined in a 3D rendering environment. Using ray casting techniques, the percentage of IAC surface area visible (unobscured by bony structures) with the microscope and 0°, 30°, and 45° endoscopes was calculated.

Results

For cadaver 1, the microscope led to visible IAC surface areas of 72%, whereas 0°, 30°, and 45° endoscopes visualized 58%, 79%, and 84%, respectively. For cadaver 2, the microscope led to visible surface areas of 67%, whereas the same endoscopes visualized 66%, 84%, and 84%, respectively.

Conclusions

Using a microscope yields similar proportions of visible IAC surface area to a 0° endoscope in MF bony drill-outs. Increased visualization of the IAC is possible with more angled endoscopes. Using angled endoscopes may facilitate improved tumor dissection in the lateral IAC with neural and vascular preservation in vestibular schwannoma surgery aimed at hearing preservation.
Psychodynamic Therapy: An Overview for Trainees and Their Teachers: Part 2—The Therapeutic Stance
Authors: Plakun Eric M.
Published: July 2023

This second column in a series on psychodynamic therapy (PDT) offers an overview of concepts related to the therapeutic stance of PDT. It reviews resistance, components of the therapeutic relationship, and elements that constitute the therapeutic stance of PDT.
Oncoplastic Breast Reconstruction for Large Pediatric Breast Tumors
Authors: Johnson Braden M. , Dewitt Jason , Balanoff Christa , Kilgore Lyndsey , Aripoli Allison , Collins Meredith
Published: July 2023

Large breast fibroadenomas in pediatric females may cause discomfort, asymmetry, and psychological stress, and patients may elect for surgical excision. There are no criteria for reconstruction after the excision of these masses, and the research is limited in describing oncoplastic techniques in pediatric fibroadenoma excision. Nononcoplastic techniques, such as mastectomy with implant or flap reconstruction, have been used for pediatric fibroadenoma excision reconstruction. Oncoplastic techniques using Wise pattern or circumareolar incisions have shown to have efficacious outcomes. In addition, pediatric females undergoing breast surgery risk long-term complications such as continued breast asymmetry due to further breast growth, nipple and breast hypoesthesia, and future breastfeeding difficulty. This case series describes the oncoplastic techniques used for large benign mass excision and reconstruction of 3 pediatric females. A Wise pattern technique was used for all 3 patients, and 2 underwent a free-nipple graft. Oncoplastic techniques for pediatric breast mass excision provide satisfactory aesthetic outcomes with minimal surgical morbidity. Further research assessing the long-term effects of pediatric breast mass excision and reconstruction would be beneficial.
Differences in Transient Fluid Retention and Lymphedema With Breast Cancer Treatment for Lymphatic Microsurgery
Authors: Tokumoto Hideki , Akita Shinsuke , Kosaka Kentaro , Nakamura Rikiya , Yamamoto Naohito , Kubota Yoshitaka , Mitsukawa Nobuyuki
Published: July 2023

Background

Breast cancer–related lymphedema (BCRL) is a common complication. Repeated taxane-based chemotherapy has been shown to induce endothelial inflammation, leading to fluid retention. Patients with transient fluid retention only have upper limb edema without lymphatic dysfunction. Therefore, indocyanine green lymphography revealed linear findings, and lymphatic microsurgery is not required. This study aimed to investigate the difference between BCRL and fluid retention and present the indication for lymphatic microsurgery for these patients.

Methods

The study population was divided into BCRL and fluid retention groups. Age, body mass index, laterality, surgery type (lymph node, breast, or no surgery), disease stage, regional lymph node irradiation, hormone therapy, chemotherapy type (taxane- or non–taxane-based group), and treatment with trastuzumab were compared.

Results

The BCRL and fluid retention groups consisted of 168 and 73 patients, respectively. The BCRL group had significantly higher rates of axillary lymph node dissection (96.4%) and lymph node irradiation (51.8%) than the fluid retention group (53.4% and 24.7%, respectively; P < 0.001 for both). The fluid retention group had a significantly higher rate of taxane-based chemotherapy (100%) than the BCRL group (92.9%; P = 0.02). No significant differences in other characteristics, including treatments with hormone and trastuzumab, were observed.

Conclusions

Lymphatic microsurgery should be performed after confirming the diagnosis by indocyanine green lymphography, particularly for patients with fluid retention induced by taxane-based chemotherapy. Because the generalized swelling induced by taxane-based chemotherapy is resolved 6 months after chemotherapy, we should wait at least 6 months to perform lymphatic microsurgery.
Classification of Skeletal Phenotypes of Adult Patients With Cleft Skeletal Class III Malocclusion Using Principal Component Analysis and Cluster Analysis
Authors: Yang Il-Hyung , Kim Haeddeuri , Chung Jee Hyeok , Choi Jin-Young , Lee Jong-Ho , Kim Myung-Jin , Kim Sukwha , Baek Seung-Hak
Published: July 2023

The purpose of this study was to classify the skeletal phenotypes of adult patients with skeletal class III (C-III) malocclusion and unilateral or bilateral cleft lip and palate using principal component analysis and cluster analysis. The samples consisted of 81 adult C-III patients with cleft lip and palate (CLP) who underwent orthognathic surgery (OGS) or distraction osteogenesis (59 males and 22 females; 50 unilateral cleft lip and palate and 31 bilateral cleft lip and palate; mean age when lateral cephalograms were taken, 22.2±4.6 y). Thirteen angular and one ratio cephalometric variables were measured. Using 4 representative variables obtained from principal component analysis (SNA, SNB, Gonial angle, and Bjork sum), K-means cluster analysis was performed to classify the phenotypes. Then, statistical analysis was conducted to characterize the differences in the variables among the clusters. Five clusters were obtained from 3 groups: severely retrusive maxilla and moderately retrusive mandible group: cluster-1 (23.5%, severely hyperdivergent pattern), cluster-4 (27.2%, moderately hyperdivergent pattern), and cluster-5 (11.1%, normodivergent pattern); moderately retrusive maxilla and normal mandible group: cluster-2 (30.9%, normodivergent pattern); normal maxilla and moderately protrusive mandible group: cluster-3 (7.4%, normodivergent pattern). Although skeletal phenotypes were diverse, distribution of sex and cleft type did not differ among 5 clusters (P>0.05). Sixty-two percent of cleft patients showed a severely retrusive maxilla and moderately retrusive mandible (cluster-1, cluster-4, and cluster-5), which indicated that these are the main cause of skeletal C-III malocclusion in CLP patients who were treated with OGS. Therefore, it is necessary to consider presurgical orthodontic treatment and surgical planning based on the skeletal phenotypes of CLP patients.
Isolation and identification of chlorate-reducing Hafnia sp. from milk
Authors: McCarthy William P. , Srinivas Meghana , Danaher Martin , Connor Christine O. , Callaghan Tom F. O. , van Sinderen Douwe , Kenny John , Tobin John T.
Published: July 2023

Chlorate has become a concern in the food and beverage sector, related to chlorine sanitizers in industrial food production and water treatment. It is of particular concern to regulatory bodies due to the negative health effects of chlorate exposure. This study investigated the fate of chlorate in raw milk and isolated bacterial strains of interest responsible for chlorate breakdown. Unpasteurized milk was demonstrated to have a chlorate-reducing capacity, breaking down enriched chlorate to undetectable levels in 11 days. Further enrichment and isolation using conditions specific to chlorate-reducing bacteria successfully isolated three distinct strains of

Hafnia paralvei

. Chlorate-reducing bacteria were observed to grow in a chlorate-enriched medium with lactate as an electron donor. All isolated strains were demonstrated to reduce chlorate in liquid medium; however, the exact mechanism of chlorate degradation was not definitively identified in this study.
Effect of Tai Chi on Pain and Cognitive Function in Elderly Patients with Chronic Neck Pain: A Protocol for Systematic Review and Meta-analysis
Authors: Wang Yichen , Tang Xing , Fu Hongjuan , Hu Wenjiao , Zhang Feng
Published: July 2023

Background

The incidence of chronic neck pain (CNP) in the elderly is increasing. CNP in the elderly not only affects the physical function of patients, the quality of life, and work but also increases the direct medical cost and indirect social costs. The recent treatment trends of CNP, such as home self-exercise, focused specific training, and research into the underlying neural mechanisms of pain and cognitive improvement in patients with CNP, suggest that Tai Chi may be beneficial for pain and cognitive function in elderly patients with CNP.

Method and Methods

We will search 8 databases, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), China Biomedical Literature Database (CBM), VIP database, and Wanfang database. Randomized controlled trials (RCTs) of Tai Chi in the treatment of elderly CNP will be included. The search time is from the establishment of the database to May 31, 2023. In this study, data extraction and methodological quality evaluation will be carried out for the included literature, and statistical analysis will be performed using RevMan 5.4 software. The quality of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation system approach(GRADE).

Discussion

This review will search and collect RCTs related to Tai Chi for the prevention and treatment of elderly CNP, and aims to systematically evaluate the evidence of the effects of Tai Chi on pain and cognitive function in elderly patients with CNP. The results of this review are expected to provide more accurate and effective guidance for the prevention and treatment of elderly patients with CNP, and also provide evidence-based medicine references for the formulation of exercise prescriptions.

Systematic Review Registration

OSF registration number [DOI 10.17605/OSF.IO/YTZPX].
Disability associated with failure to seek medical care among Venezuelan immigrants in Peru
Authors: Miranda-Tueros Mercedes , Velarde-Meza Sonny Sthefanie , Alarco J. Jhonnel
Published: July 2023

Background

Currently, there are more than six million Venezuelan immigrants worldwide. This study aimed to estimate the association between disability and failure to seek medical care among Venezuelan immigrants in Peru.

Methods

A cross-sectional study was conducted using secondary data of the Encuesta Dirigida a la Población Venezolana que Reside en el País (ENPOVE) 2018. We developed four Poisson regression models and calculated prevalence ratios (PR) with their 95% confidence intervals (95% CI).

Results

After adjusting for multiple confounding variables, we found that immigrants who reported having only one type of disability were 78% more likely not to seek medical care compared with immigrants without disability (PR = 1.78; 95% CI 1.15–2.76).

Conclusions

Venezuelan immigrants with disabilities in Peru seek less medical care than those without disabilities.
Skin surface biomarkers are associated with future development of atopic dermatitis in children with family history of allergic disease
Authors: Sato Takahiro , Nikolovski Janet , Gould Russell , Lboukili Imane , Roux Pierre-Francois , Al-Ghalith Gabriel , Orie Jeremy , Insel Richard , Stamatas Georgios N.
Published: July 2023

Background

Atopic dermatitis (AD) is a common childhood chronic inflammatory skin disorder that can significantly impact quality of life and has been linked to the subsequent development of food allergy, asthma, and allergic rhinitis, an association known as the “atopic march.”

Objective

The aim of this study was to identify biomarkers collected non-invasively from the skin surface in order to predict AD before diagnosis across a broad age range of children.

Methods

Non-invasive skin surface measures and biomarkers were collected from 160 children (3-48 months of age) of three groups: (A) healthy with no family history of allergic disease, (B) healthy with family history of allergic disease, and (C) diagnosed AD.

Results

Eleven of 101 children in group B reported AD diagnosis in the subsequent 12 months following the measurements. The children who developed AD had increased skin immune markers before disease onset, compared to those who did not develop AD in the same group and to the control group. In those enrolled with AD, lesional skin was characterized by increased concentrations of certain immune markers and transepidermal water loss, and decreased skin surface hydration.

Conclusions

Defining risk susceptibility before onset of AD through non-invasive methods may help identify children who may benefit from early preventative interventions.
Water, sanitation, and hygiene in selected health facilities in Ethiopia: risks for healthcare acquired antibiotic resistant infections
Authors: Bekele Teshome , Assefa Abebe , Verstraete Lavuun , Desta Adey Feleke , Al-Mulla Taha , Goyol Kitka , Baye Kaleab
Published: July 2023

Background

Inadequate water, sanitation and hygiene (WASH) in health facilities and the low adherence to infection control protocols can increase the risk of hospital-acquired (nosocomial) infections, which in turn can increase morbidity and mortality, health care cost, but also contribute to increased microbial resistance.

Objectives

The study aimed to assess WASH facilities and practices, and levels of nosocomial pathogens in surface and water samples collected from selected health facilities in Oromia Region and Southern, Nations and Nationalities and Peoples Region (SNNPR).

Methods

WASH in health care facilities in Bulle and Doyogena (SNNPR) and Bidre (Oromia) were assessed through interviews and direct observations (n= 26 facilities). Water and surface samples were collected from major hospitals and health centers. A total of 90 surface swabs and 14 water samples were collected from which a number of bacteria (n=224) were identified, characterized and tested for antimicrobial susceptibility.

Results

Water supply, toilet facilities, and waste management procedures were suboptimal. Only 11/26 of the health facilities had access to water at the time of the survey. The lowest hand-hygiene compliance was for Bidre (4%), followed by Doyogena (14%), and Bulle (36%). Over 70% of the identified bacteria were from four categories:Staphylococcusspp,Bacillusspp,E. coli,andKlebsiella spp.These bacteria were also found in high risk locations including neonatal intensive care units, delivery and surgical rooms. Antimicrobial susceptibility was detected in ≥ 50% of the isolates for penicillin, cefazolin, ampicillin, oxacillin, and cotrimoxazole, and ≥ 50% of the isolates displayed multi-drug resistance.

Conclusion

Investing in WASH infrastructures, promotion of handwashing practices, implementing infection prevention and control (IPC) measures and antibiotic stewardship is critical to ensure quality care in these settings.
GPT-4, an artificial intelligence large language model, exhibits high levels of accuracy on dermatology specialty certificate exam questions
Authors: Shetty Meghna , Ettlinger Michael , Lynch Magnus
Published: July 2023

Artificial Intelligence (AI) has shown considerable potential within medical fields including dermatology. In recent years a new form of AI, large language models, has shown impressive performance in complex textual reasoning across a wide range of domains including standardised medical licensing exam questions. Here, we compare the performance of different models within the GPT family (GPT-3, GPT-3.5, and GPT-4) on 89 publicly available sample questions from the Dermatology specialty certificate examination. We find that despite no specific training on dermatological text, GPT-4, the most advanced large language model, exhibits remarkable accuracy - answering in excess of 85% of questions correctly, at a level that would likely be sufficient to pass the SCE exam.
Consequences of Heterogeneity in Aging: Parental Age at Death Predicts Midlife All-Cause Mortality and Hospitalization in a Swedish National Birth Cohort
Authors: Thalén Anna , Ledberg Anders
Published: July 2023

Background

The processes that underlie aging may advance at different rates in different individuals and an advanced biological age, relative to the chronological age, is associated with increased risk of disease and death. Here we set out to quantify the extent to which heterogeneous aging shapes health outcomes in midlife by following a Swedish birth-cohort and using parental age at death as a proxy for biological age in the offspring.

Methods

We followed a nationwide Swedish birth cohort (N= 89 688) between the ages of 39 to 66 with respect to hospitalizations and death. Cox regressions were used to estimate the association, in the offspring, between parental age at death and all-cause mortality, as well as hospitalization for conditions belonging to one of 10 different ICD-10 chapters.

Results

Longer parental lifespan was consistently associated with reduced risks of hospitalization and all-cause mortality. Differences in risk were mostly evident before the age of 50. Each additional decade of parental survival decreased the risk of offspring all-cause mortality by 22% and risks of hospitalizations by 9 to 20 percent across the ten diseases categories considered. The number of deaths and hospitalizations attributable to having parents not living until old age were 1500 (22%) and 11000 (11%) respectively.

Conclusions

Our findings highlight that increased parental lifespan is consistently associated with health benefits in the offspring across multiple outcomes and suggests that heterogeneous aging processes have clinical implications already in midlife.