bluuebunny/crossref_metadata_2025 huggingface dataset:
Topological approximate Bayesian computation for parameter inference of an angiogenesis model
Authors: Thorne Thomas , Kirk Paul D W , Harrington Heather A
Published: February 2022

Motivation

Inferring the parameters of models describing biological systems is an important problem in the reverse engineering of the mechanisms underlying these systems. Much work has focused on parameter inference of stochastic and ordinary differential equation models using Approximate Bayesian Computation (ABC). While there is some recent work on inference in spatial models, this remains an open problem. Simultaneously, advances in topological data analysis (TDA), a field of computational mathematics, have enabled spatial patterns in data to be characterized.

Results

Here, we focus on recent work using TDA to study different regimes of parameter space for a well-studied model of angiogenesis. We propose a method for combining TDA with ABC to infer parameters in the Anderson–Chaplain model of angiogenesis. We demonstrate that this topological approach outperforms ABC approaches that use simpler statistics based on spatial features of the data. This is a first step toward a general framework of spatial parameter inference for biological systems, for which there may be a variety of filtrations, vectorizations and summary statistics to be considered.

Availability and implementation

All code used to produce our results is available as a Snakemake workflow from github.com/tt104/tabc_angio.
There is a topographic organization in human cortico-pontine connectivity
Authors: Karbasforoushan Haleh , Tian Runfeng , Baker James
Published: February 2022

Of the three largest outputs of the cerebral cortex, two have been extensively studied and mapped. Topographic maps of cortico-thalamic and cortico-striatal functional connectivity in humans are well established. However, for the third largest cerebral output, to the pontine nuclei, which connect the cerebrum to the cerebellum, the existence of such an organized connectivity pattern in humans is unknown. Here, using high-resolution functional MRI and a large sample size, we found a topographically organized pattern of functional connectivity between the human cerebral cortex and pons. Our results indicate a rostral-caudal topography; rostral (frontal) cerebral cortex shows connectivity to the rostral pons, and the more caudal cortical areas (i.e. the sensorimotor cortices) show functional connectivity more caudally in the pons, with the occipital lobe connectivity being most caudal. While prefrontal, sensorimotor and occipital cortices have a connectivity to the medial pontine nuclei, posterior parietal cortex and temporal lobe correlate with lateral pontine nuclei. Topography is sufficiently detailed to identify distinct connectivity for leg, trunk, hand and face areas of the motor cortex. These findings reveal the existence of a topographic organization in human cortico-pontine connectivity and provide the topographic map for future studies of cortico-ponto-cerebellum pathway in a variety of disorders.
Graphlets in multilayer networks
Authors: Sallmen Sallamari , Nurmi Tarmo , Kivelä Mikko
Published: February 2022

Representing various networked data as multiplex networks, networks of networks and other multilayer networks can reveal completely new types of structures in these systems. We introduce a general and principled graphlet framework for multilayer networks which allows one to break any multilayer network into small multilayered building blocks. These multilayer graphlets can be either analysed themselves or used to do tasks such as comparing different systems. The method is flexible in terms of multilayer isomorphism, automorphism orbit definition and the type of multilayer network. We illustrate our method for multiplex networks and show how it can be used to distinguish networks produced with multiple models from each other in an unsupervised way. In addition, we include an automatic way of generating the hundreds of dependency equations between the orbit counts needed to remove redundant orbit counts. The framework introduced here allows one to analyse multilayer networks with versatile semantics, and these methods can thus be used to analyse the structural building blocks of myriad multilayer networks.
Maternal tobacco smoke exposure is associated with increased DNA methylation at human metastable epialleles in infant cord blood
Authors: Joglekar Rashmi , Grenier Carole , Hoyo Cathrine , Hoffman Kate , Murphy Susan K
Published: February 2022

Metastable epialleles (MEs) are genomic regions that are stochastically methylated prior to germ layer specification and exhibit high interindividual but low intra-individual variability across tissues. ME methylation is vulnerable to environmental stressors, including diet. Tobacco smoke (TS) exposure during pregnancy is associated with adverse impacts on fetal health and maternal micronutrient levels as well as altered methylation. Our objective was to determine if maternal smoke exposure impacts methylation at MEs. Consistent with prior studies, we observed reductions in one-carbon pathway micronutrients with gestational TS exposure, including maternal folate (P = 0.02) and vitamins B6 (P = 0.05) and B12 (P = 0.007). We examined putative MEs BOLA3, PAX8, and ZFYVE28 in cord blood specimens from 85 Newborn Epigenetics STudy participants. Gestational TS exposure was associated with elevated DNA methylation at PAX8 (+5.22% average methylation; 95% CI: 0.33% to 10.10%; P = 0.037). In human conceptal kidney tissues, higher PAX8 transcription was associated with lower methylation (Rs = 0.55; P = 0.07), suggesting that the methylation levels established at MEs, and their environmentally induced perturbation, may have meaningful, tissue-specific functional consequences. This may be particularly important because PAX8 is implicated in several cancers, including pediatric kidney cancer. Our data are the first to indicate vulnerability of human ME methylation establishment to TS exposure, with a general trend of increasing levels of methylation at these loci. Further investigation is needed to determine how TS exposure-mediated changes in DNA methylation at MEs, and consequent expression levels, might affect smoking-related disease risk.
Direct current cardioversion-triggered atypical Tako-tsubo cardiomyopathy: a case report and review of literature
Authors: Bae Ju Young , Tartaglia Joseph , Chen Michael , Setaro John F
Published: February 2022

Background

Tako-tsubo stress cardiomyopathy is a clinical syndrome marked by transient reduction of left ventricular function in the setting of emotional or physical stress and in the absence of obstructive coronary artery disease. We describe a case of an atypical variant of Tako-tsubo in a male patient following an elective direct current cardioversion (DCCV).

Case summary

A 78-year-old male whose atrial fibrillation persisted after earlier unsuccessful direct current DCCV and radiofrequency ablations presented to the emergency department for acutely worsening dyspnoea and orthopnoea 12 h following his most recent DCCV. Previously, he was known to have non-obstructive coronary artery disease. Evaluation was notable for troponin I 0.019 ng/mL (negative <0.050 ng/mL), pro-brain natriuretic peptide 2321 pg/mL (reference range 0.0–900 pg/mL). There were no acute electrocardiogram abnormalities. He required bilevel positive airway pressure but was weaned off eventually to room air. Transthoracic echocardiogram revealed newly reduced left ventricular ejection fraction of 45–50%, associated with hypokinesis of the basal anteroseptal segment, as well as akinesis of mid-inferoseptal and mid-anteroseptal segments. Apical contractility was preserved. On Day 5 of hospitalization, diagnostic left heart catheterization again revealed benign coronary anatomy, and he was discharged home the following day.

Discussion

Only five other cases of cardioversion mediated Tako-tsubo cardiomyopathy have been reported in the literature. To our knowledge, this is the first case of DCCV-induced atypical Tako-tsubo cardiomyopathy. Although overall prognosis is favourable, some have been observed to require advanced support therapy. Given risk for life-threatening complications, patients undergoing cardioversion should be educated on symptoms of congestive cardiomyopathy.
The epigenetic enzyme DOT1L orchestrates vascular smooth muscle cell–monocyte crosstalk and protects against atherosclerosis via the NF-κB pathway
Authors: Farina Floriana Maria , Serio Simone , Hall Ignacio Fernando , Zani Stefania , Cassanmagnago Giada Andrea , Climent Montserrat , Civilini Efrem , Condorelli Gianluigi , Quintavalle Manuela , Elia Leonardo
Published: February 2022

Aims

Histone H3 dimethylation at lysine 79 is a key epigenetic mark uniquely induced by methyltransferase disruptor of telomeric silencing 1-like (DOT1L). We aimed to determine whether DOT1L modulates vascular smooth muscle cell (VSMC) phenotype and how it might affect atherosclerosis in vitro and in vivo, unravelling the related mechanism.

Methods and results

Gene expression screening of VSMCs stimulated with the BB isoform of platelet-derived growth factor led us to identify Dot1l as an early up-regulated epigenetic factor. Mouse and human atherosclerotic lesions were assessed for Dot1l expression, which resulted specifically localized in the VSMC compartment. The relevance of Dot1l to atherosclerosis pathogenesis was assessed through deletion of its gene in the VSMCs via an inducible, tissue-specific knock-out mouse model crossed with the ApoE−/− high-fat diet model of atherosclerosis. We found that the inactivation of Dot1l significantly reduced the progression of the disease. By combining RNA- and H3K79me2-chromatin immunoprecipitation-sequencing, we found that DOT1L and its induced H3K79me2 mark directly regulate the transcription of Nf-κB-1 and -2, master modulators of inflammation, which in turn induce the expression of CCL5 and CXCL10, cytokines fundamentally involved in atherosclerosis development. Finally, a correlation between coronary artery disease and genetic variations in the DOT1L gene was found because specific polymorphisms are associated with increased mRNA expression.

Conclusion

DOT1L plays a key role in the epigenetic control of VSMC gene expression, leading to atherosclerosis development. Results identify DOT1L as a potential therapeutic target for vascular diseases.
Wearable Technologies Using Peripheral Neuromodulation to Enhance Mobility and Gait Function in Older Adults―A Narrative Review
Authors: Kahya Melike , Hackman Dawn , Jacobs Laura , Nilsson Daniel , Rumsey Yvonne , Oddsson Lars I E
Published: February 2022

Background

Mounting evidence suggests that wearable technologies using peripheral neuromodulation can provide novel ways of improving mobility and gait function in various patient populations including older adults. The purpose of this narrative review is to provide an overview of wearable technologies/devices to improve mobility and gait function through noninvasive peripheral neuromodulation in older adults over the age of 65 and to indicate the suggested mechanism of action behind these technologies.

Methods

We performed searches for articles and conference abstracts written in English, using the following databases: Embase Classic+Embase from 1947 to July 15, 2021; Ovid MEDLINE; Epub Ahead of Print, In-Process, In-Data-Review & Other Non-Indexed Citations, Daily and Versions from 1946 to July 15, 2021; PubMed; and Scopus.

Results

Forty-one technologies met the inclusion/exclusion criteria. We found that the primary implementation of the 41 technologies can be divided into 3 main categories: sensory substitution, sensory augmentation (open loop, closed loop), and motor stimulation. Using these technologies, various aspects of mobility are treated or addressed, including, gait function, fall risk, foot drop, navigating environment, and postural control.

Conclusions

This narrative review summarizes wearable technologies that are currently commercially available and in stages of research and development. Overall, studies suggest that wearable peripheral neuromodulation technologies can improve aspects of mobility for older adults. Existing literature suggests that these technologies may lead to physiological changes in the brain through sensory reweighting or other neuroplastic mechanisms to enhance the performance of mobility and gait function in older adults over the age of 65.
Evolution of eastern segment of the Central India Tectonic Zone: an insight from a magnetotelluric study
Authors: Raju Khasi , Patro Prasanta K , Borah Ujjal K , Srivastava Shalivahan , Reddy K Chinna
Published: February 2022

The collision process between the South Indian Block (SIB) and North Indian Block (NIB) resulted in the development of the complex crustal nature of the Central India Tectonic Zone (CITZ). The evolutionary past of CITZ covers a long geological time (∼1000 Ma), which corresponds to the assembly and spreading of Columbia and Rodinia supercontinents. Despite several studies in the western and central parts of the CITZ, the location of the suture zone between the SIB and NIB is still under debate. In addition to that, the crustal structure in the eastern segment of CITZ is yet to be resolved. Therefore, for the first time, a dense station coverage magnetotelluric (MT) study is carried out along a 275 km transect in the eastern segment of CITZ from Pandaria to Rewa. The complexity of the Central Indian Shear (CIS) and Tan Shear Zone (TSZ) are reflected as anomalous phases (beyond 90°) in the MT data. A deep crustal resistivity model derived from 2-D and 3-D inversion of the MT data brought out a high-to-moderate conductivity structure (10–100 Ω-m) in the middle of the surface expressions of CIS and TSZ. The conductive structure could be related to a deformation zone formed by tectonic interaction of the CIS and TSZ or multiple tectonic boundaries in the middle of the CIS and TSZ. The conductive structure observed in the southern limit of the CITZ also may indicate the tectonic boundary between the SIB and NIB. The high conductivity in the deformation zone may be explained by the collision-related metallic rich sediments and/or mylonite associated with interconnected fluids. Moderately conductive vertical features delineated from the MT model correlate with the intrabasinal faults which might have acted as the pathways for Deccan volcanism. This study suggests that the CITZ could have been developed under the transition of oceanic subduction to continental collision processes at multiple geological times.
“Managing Up”: Cultivating Relationships With Practice Leaders
Authors: Wahab Rifat A , Brown Ann , Vijapura Charmi , Mahoney Mary C
Published: February 2022

“Managing up” for the radiologist means developing and cultivating work relationships to benefit high-level stakeholders and the institution at large, and to maximize one’s own effectiveness. Today’s breast radiologists are responsible for more than image interpretation and image-guided interventions. Radiologists’ roles and responsibilities have evolved to include clinical initiatives, staff development, quality improvement, and administrative tasks where management skills are needed. To be successful in these roles, developing skills to manage up will allow radiologists to be more effective team members. In this article, we discuss tactics to start developing strategies for managing up, including how to understand practice leaders and create meaningful relationships; explain various work style personalities and how to navigate them; describe how to understand oneself, including strengths and weaknesses; and, finally, provide tips on how to begin to cultivate managing up skills.
Immunotherapy Outcomes in Individuals With Non–Small Cell Lung Cancer and Poor Performance Status
Authors: Veluswamy Rajwanth , Hu Liangyuan , Smith Cardinale , Ji Jiayi , Wang Xiaoliang , Wisnivesky Juan , Morillo Jose , Kale Minal S
Published: February 2022

Background

Patients with non–small cell lung cancer (NSCLC) treated in real-world practice typically have worse performance status (PS) compared with clinical trial patients, and the effectiveness of immunotherapy in this population in unknown. In this study, we assessed the effectiveness of standard of care immunotherapy for the first-line treatment of stage IV patients with NSCLC with Eastern Cooperative Oncology Group (ECOG) PS greater than or equal to 2.

Methods

We selected ECOG PS greater than or equal to 2 patients from real-world oncology data from a deidentified database and included them if they were diagnosed with stage IV NSCLC and had documented Programmed death-ligand 1 [PD-(L)1] expression greater than 0. Patients with tumor PD-(L)1 expression of at least 50% treated with pembrolizumab monotherapy were compared with those who did not have any documented treatment. Patients with tumor PD-(L)1 expression less than 50% treated with pembrolizumab and chemotherapy were compared with those treated with pembrolizumab monotherapy and those without documented treatment.

Results

In our propensity score–adjusted analysis, patients with ECOG PS of at least 2 and tumor PD-(L)1 expression of at least 50% treated with pembrolizumab monotherapy had statistically significantly better real-world overall survival compared with those without documented treatment (adjusted hazard ratio [HR] = 0.39, 95% confidence internal [CI] = 0.32 to 0.47). For patients with tumor PD-(L)1 expression less than 50%, there was also a statistically significant real-world overall survival benefit for those who received treatment either with combination pembrolizumab plus chemotherapy (adjusted HR = 0.39, 95% CI = 0.32 to 0.46) or pembrolizumab monotherapy (adjusted HR = 0.55, 95% CI = 0.41 to 0.70) compared with patients receiving no documented treatment.

Conclusions

Among a highly representative sample of patients with advanced NSCLC and poor PS, our findings suggest that immunotherapy may provide an important survival benefit in individuals with high PD-(L)1–expressing tumors and in conjunction with chemotherapy in tumors with low PD-(L)1 expression.
The Enigma of Mehri and Southern Peninsular Arabic Existential śī and šī
Authors: Wilmsen David
Published: February 2022

The Modern South Arabian languages and the many varieties of Arabic share in the functions of a particle, realised in the largest extant MSA language, Mehri, as si and variously in Arabic as šay(y), še, ši and ši. In the Modern South Arabian languages and in the Arabic varieties of southern Arabian Peninsula, si and reflexes of ši serve as existential particles with a meaning analogous to English ‘there is/was’. The doublet si/ši also performs other grammatical operations in both sets of languages, functioning as partitives, polar interrogatives and as expressing the various meanings of ‘thing’. This similarity of form and function in Arabic and MSA suggests borrowing from one language to the other, although shared inheritance cannot be discounted completely. The assumption about Arabic reflexes of ši is that their grammatical functions derive originally from that word for ‘thing’ (of which there are others in both languages). Similarly, the assumption has been that MSA si is borrowed from the same Arabic word. Nevertheless, the analogous usages between Mehri and Arabic give cause to reassess such assumptions, leading to the opposite conclusion: The borrowing proceeded from MSA to Arabic and the substantive meaning is the end form, not the origin.
A map of the Urals emotional perception (based on modern regional poetry)
Authors: Semyan Tatyana , Smyshlyaev Eugene A , Babina Olga I , Sheremetyeva Svetlana O
Published: February 2022

The study of emotional categories in the literary texts of contemporary regional authors and creating a map of the Urals emotional perception based on the data obtained with the Digital Humanities methods is believed to be of great value for solving an important scientific and socio-cultural problems of revealing local specifics and regional identity that faced the Russian society at the turn of the 20th and 21st centuries. For several decades, the modern Ural literature has been a striking socio-cultural phenomenon, numbering more than a hundred writers from different cities (Perm, Yekaterinburg, Chelyabinsk, etc.). One of the key features of the modern Ural poetry is the reflection of regional identity in literary texts. The poems of the Ural writers are full of local toponyms, images of the Urals’ industrial cities and unique nature, as well as of local myths. In this article, a wide range of emotional categories (such as surprise, fear, anger, disgust, joy, contempt, sadness, love, etc.) in modern poetry is investigated based on the emotional models by the American psychologists Robert Plutchik (Emotion: Theory, Research, and Experience, Vol. 1: Theories of Emotion. New York: Academic), Carroll Izard (Izard, C. E., 2012, The Psychology of Emotions. New York: Plenum), and Paul Ekman (Ekman, P., 2007, Emotions Revealed: Recognizing Faces and Feelings to Improve Communication and Emotional Life. New York: Holt Paperbacks). The purpose of the research is to discover what emotions prevail in modern poetic texts dedicated to the Ural region by analysing how literary works absorb and critically rethink the space of the Urals. A comprehensive research methodology is proposed that combines a qualitative study of the literary material and automated quantitative-digital analysis of corpus data with the subsequent visualization of the results.
Theorizing Leadership Credibility: The Concept and Causes of the Perceived Credibility of Leadership Initiatives
Authors: Jakobsen Mads Leth Felsager , Andersen Lotte Bøgh , van Luttervelt Mads Pieter
Published: February 2022

There are important reasons to conceptualize leadership credibility and formulate explicit expectations about its causes. First, credibility can be an important precondition when leaders aim to increase performance in public organizations that face complex societal problems and volatile governance. Second, leadership credibility is often mentioned but seldom systematically studied in the public administration literature. Based on a conceptualization of five distinct systematized concepts of leadership credibility, this article develops a theory of the perceived credibility of leadership initiatives and its antecedents (leader credibility, leader investments in the initiative and rules concerning authority, benefits, and costs). We define perceived credibility of leadership initiatives as the plausibility followers assign to a leadership initiative being realized. The concept is applicable across various types of leadership initiatives including visionary and transactional leadership within the public sector. The theory illuminates how leadership credibility draws on individual follower perceptions, leader behaviors, and institutions such as formal rules and professional norms. Compared to existing conceptualizations within public administration, it is more specific as it separates credibility from its effects, its antecedents, and the applied leadership strategies. It provides a much needed theoretical vocabulary for the study of leadership credibility within public administration and adjacent disciplines.
Extra-articular findings with FDG-PET/CT in rheumatoid arthritis patients: more harm than benefit
Authors: Ulijn Evy , den Broeder Alfons A , Boers Nadine , Gotthardt Martin , Bouman Chantal A M , Landewé Robert , den Broeder Nathan , van Herwaarden Noortje
Published: February 2022

Objective

Whole-body PET with CT scanning using 18F-fluorodeoxyglucose (18F-FDG) is used occasionally in RA patients to detect arthritis. FDG-PET/CT might also detect malignancies, but the amount of incidental findings and the number of relevant malignant diseases that could be missed are currently unknown. We aimed to study the malignancy screening performance of whole-body FDG-PET/CT in longstanding RA patients with low disease activity.

Methods

FDG-PET/CT scanning was done in the intervention arm of the Dose REduction Strategy of Subcutaneous TNF-inhibitors (DRESS) study, a randomized controlled trial on dose-tapering of biological DMARDs. The reference standard was clinical diagnosis of malignancy during the 3-year follow-up period of the study. Prevalence of extra-articular abnormalities, follow-up and treatments were summarized post hoc.

Results

One hundred and twenty-one scans were carried out in 79 patients. Extra-articular abnormalities were found in 59 of 121 (49%) scans, resulting in additional diagnostic procedures in 21 of 79 (26.6%) patients. Nine patients (7.4%) were suspected of malignancy; none turned out to be malignant. Six clinical malignancies that developed during follow-up were all negative on baseline FDG-PET/CT.

Conclusion

Whole-body FDG-PET/CT scanning used in RA patients for imaging of arthritis results in frequent incidental extra-articular findings, whereas some who apparently had normal scans also developed malignancies.

Trial registration

Netherlands Trial Register, www.trialregister.nl, NL6771.
A systematic review and proposed conceptual model of sleep disturbances during pediatric hospitalizations
Authors: Fidler Andrea L , Voorhees Sara , Zhou Eric S , Stacciarini Jeanne-Marie , Fedele David A
Published: February 2022

Study Objectives

The current review aims to examine factors that influence pediatric inpatient sleep and determine the effectiveness of sleep promotion interventions among hospitalized children.

Methods

A systematic literature search was conducted across PubMed, PsycINFO, CINAHL, Cochrane Central, Web of Science, Embase, and Scopus databases. Studies included children with a mean age between 1 and 18 years old that either described factors affecting the sleep of children who are hospitalized on a non-intensive care unit or reported on sleep-related intervention outcomes. We conducted separate narrative reviews for each of the two aims and then synthesized findings from quantitative and qualitative studies across both aims.

Results

Forty-five articles were included for review. Despite most sleep disturbances being attributed to environmental disruptions (e.g. noise, staff interruptions), most interventions targeted the child level using relaxation techniques. Although the majority of interventions were small pilot studies, preliminary findings appear to positively impact sleep duration. The Pediatric Inpatient Sleep Model was proposed to illustrate connections between sleep disturbances, factors influencing sleep, and existing intervention components.

Conclusions

Replication studies are needed, including larger-scale sleep promotion interventions among hospitalized children. Given the identification of environmental factors as the main cause of night wakings, environmental modifications are crucial. Additional research examining contributors to intraindividual variability in disrupted sleep patterns during hospitalizations as well as the consequences of these disturbances is warranted.
Cardiovascular risks and sociodemographic correlates of multidimensional sleep phenotypes in two samples of US adults
Authors: Lee Soomi , Smith Claire E , Wallace Meredith L , Andel Ross , Almeida David M , Patel Sanjay R , Buxton Orfeu M
Published: February 2022

Study Objectives

Sleep is a modifiable risk factor for cardiovascular conditions. Holistic examination of within-person, multidimensional sleep patterns may offer more detailed information about the sleep-cardiovascular condition link, including who is more vulnerable to both. This study aimed to identify common sleep phenotypes in adulthood, establish the validity of the phenotypes in relation to cardiovascular conditions, and explore sociodemographic and background characteristics of the phenotypes.

Methods

Across two independent samples of adults (N1 = 4600; N2 = 2598) from the Midlife in the United States Study, latent class analysis (LCA) extracted sleep phenotypes using five key self-reported sleep dimensions. Log-binomial regression was used to determine whether sleep phenotypes differentially predicted cardiovascular conditions, adjusting for known risk factors. LCA with covariates was used to compare sociodemographic characteristics of the identified sleep phenotypes.

Results

Four sleep phenotypes were identified consistently across the two samples: good sleepers, nappers, dissatisfied/inefficient sleepers, and irregular sleepers. Compared to good sleepers (reference), dissatisfied/inefficient sleepers exhibited a higher risk of cardiovascular conditions in both samples (RRSample1: 29%, RRSample2: 53%) and consisted of relatively more racial/ethnic minorities. Nappers exhibited a higher risk of cardiovascular conditions in one sample (RRSample1: 38%) and consisted of more women and older adults. Irregular sleepers exhibited no significantly different cardiovascular risk and were relatively younger.

Conclusions

Common sleep phenotypes in adulthood exhibit differential risks for cardiovascular conditions. Cooccurring sleep dissatisfaction and inefficiency, in particular, may relate to increased risk of cardiovascular conditions. Certain sociodemographic groups (racial minorities, women, older adults) disproportionately fit within high-risk sleep phenotypes.
Changes in Fungal and Oomycete Community Composition Following Irrigation Reductions Aimed at Increasing Water Use Efficiency in a Containerized Nursery Crop
Authors: Del Castillo Múnera Johanna , Poret-Peterson Amisha T. , Swett Cassandra L.
Published: February 2022

Ornamental production in the United States spans an estimated 267,000 ha and uses approximately 169,000 m3 of water yearly. Ornamental growers, particularly those with air-closed systems, are interested in implementing reduced irrigation technologies such as sensor-controlled irrigation systems to improve water use efficiency in response to water scarcity. To evaluate phytobiome impacts, we utilized an Illumina metabarcoding approach to characterize changes in fungal and oomycete rhizosphere communities of commercially grown poinsettia, complementing previous studies of single-pathogen impacts. Minor reductions (from 54 to 50% volumetric water content [VWC]) did not have large effects on rhizosphere fungal community structure but shifts in plant health status (symptomatic to asymptomatic) correlated with shifts in fungal diversity and evenness, with an increased abundance of several taxa, including Plectosphaerella cucumerina and Fusarium spp., in symptomatic plants. Further reductions in irrigation (45, 35, and 25% VWC) did not affect overall fungal community composition but the lowest VWC increased the abundance of potential root rot pathogens such as Phoma multirostrata and Plectosphaerella cucumerina. Reduced irrigation volumes decreased oomycete diversity and abundance of several known pathogens in the Phytophthora genus. Addition of a bacterial product (Companion) with putative pathogen-suppressive and drought-tolerance enhancing effects had no influence on fungal community composition or abundance but did increase abundance of some oomycete species at 45% VWC. This study shows that adoption of reduced irrigation may have greater effects on fungal versus oomycete taxa in the system, with consistent patterns of fungal enhancement, including putative fungal pathogens and beneficial organisms, and oomycete suppression.
Impacts of Fracture Types on Success Rate of Closed Reduction and Percutaneous Pinning in Pediatric Lateral Condyle Humerus Fractures Displaced >4 mm
Authors: Xie Li-wei , Tan Gang , Deng Zhi-qiang , Liu Xin , Zhou Ying , Zhang Hui , Yin De-long
Published: February 2022

Background:

Closed reduction and percutaneous pinning (CRPP) is a promising treatment for pediatric lateral condyle humerus fractures (LCHFs) displaced >4 mm. However, few studies discussed roles of fracture types on success of CRPP in LCHFs. This study aimed to analyze the impacts of types of LCHFs displaced >4 mm on the success rate of CRPP.

Methods:

We retrospectively reviewed 66 consecutive pediatric LCHFs attempted CRPP at our center. Song, Milch, Jakob, and Weiss classification were used to classify LCHFs. The fracture gap ≤2 mm and step of articular surface ≤2 mm were deemed as a successful CRPP. Otherwise, open reduction and internal fixation (ORIF) would be performed. Different fracture types and preoperative displacement were analyzed for their roles on success rate of CRPP in treating LCHFs displaced >4 mm.

Results:

Fifty patients met the inclusion criteria were finally included in this study. Results showed that Milch type II LCHFs had a higher success rate of CRPP than type I LCHFs (P=0.03, <0.05). Correlation was found between Milch types and success rate of CRPP displaced >4 mm. No difference was found between Song stage 4 and 5 LCHFs displaced >4 mm in success rate of CRPP (P=0.90, >0.05), also no difference was found in pre-operative displacement between CRPP group and ORIF group.

Conclusions:

Milch classification is more important than Song classification in the success rate of CRPP when treating LCHFs displaced >4 mm. Milch type II LCHFs are recommended to be treated with CRPP, while Milch type I LCHFs are recommended to be treated with ORIF. The current study confirm Song’s initial report that closed reduction can be successful and should be attempted for fractures with such displacement rather than going directly to ORIF.

Level of Evidence:

Level III.
Major Bleeding and Thrombosis Events in COVID-19 Versus Influenza Patients Requiring Extracorporeal Membrane Oxygenation
Authors: Northam Kalynn A. , Murray Brian P. , Fischer William A. , Charles Anthony G.
Published: February 2022

Initial reports described a hypercoagulable state and an increased risk of thrombosis in patients who tested positive for SARS-CoV-2. Infected patients with severe acute respiratory distress syndrome in the setting of coronavirus disease 2019 (COVID-19) may require extracorporeal membrane oxygenation (ECMO), leading to coagulopathies and further increasing the risk for bleeding and thrombosis. We conducted a single-center retrospective cohort study to compare the incidence of major bleeding and thrombosis in COVID-19 versus influenza-positive patients requiring ECMO. There was no difference in the incidence of major bleeding (67.7% vs. 85.7%, p = 0.287) or major thrombosis (9.7% vs. 21.4%, p = 0.356) between COVID-19 and influenza patients, respectively. COVID-19 patients experienced significantly fewer major bleeding events per ECMO days compared with influenza (0.1 [interquartile range 0–0.2] vs. 0.2 [interquartile range 0.1–0.5], p = 0.026). Influenza patients may be at higher risk for developing coagulopathies that contribute to bleeding. Larger evaluations are needed to confirm these results and further assess bleeding and thrombosis risk in these populations.
In Vivo Suction Pressures of Venous Cannulas During Veno-venous Extracorporeal Membrane Oxygenation
Authors: Robak Oliver , Grafeneder-Weissteiner Theresa , Schellongowski Peter , Bojic Andja , Paschen Christopher , Hermann Alexander , Staudinger Thomas
Published: February 2022

Extracorporeal lung support includes the risk of hemolysis due to suction pressures. Manufacturers measure the negative suction pressure across drainage cannulas for their products in vitro using water. Clinical experience suggests that hemolysis occurs in vivo already at much lower flow rates. The aim of this study was to analyze the in vivo suction pressure for veno-venous extracorporeal membrane oxygenation (VV-ECMO) cannulas. Prospective, observational study at a tertiary-care intensive care unit: 15 patients on VV-ECMO for severe ARDS were prospectively included. In vitro, the 25 Fr drainage cannula pressure drops below a critical level of around –100 mm Hg at a flow rate of 7.9 L/min, the 23 Fr drainage cannula at 6.6 L/min. In the clinical setting, critical suction pressures were reached at much lower flow rates (5.5 and 4.7 L/min; p < 0.0001, nonlinear regression). The in vitro data largely overestimate the safely achievable flow rates in daily clinical practice by 2.4 L/min (or 44%, 25 Fr) and 1.9 L/min (or 41%, 23 Fr). In vivo measurement of suction pressure of venous drainage cannulas differed significantly from in vitro derived measurements as the latter largely underestimate the resulting suction pressure.
Improved Flow Dynamics of Extracorporeal Membrane Oxygenation via Design Modification of Dual-Lumen Cannulas
Authors: Azimi Marjan , Liao Sam , Vatani Ashkan , Burrell Aidan , Gregory Shaun D.
Published: February 2022

Veno-venous extracorporeal membrane oxygenation (VV-ECMO) supports patients with severe respiratory failure not responding to conventional treatments. Single-site jugular venous cannulation with dual-lumen cannulas (DLC) have several advantages over traditional single-lumen cannulas, however, bleeding and thrombosis are common, limiting their clinical utility. This study numerically investigated the effects of DLC side holes on blood flow dynamics since the maximum wall shear stress (WSS) occurs around the side holes. A DLC based on the Avalon Elite 27Fr model was implanted into an idealized 3D model of the vena cava and right atrium (RA). Eight DLCs were developed by changing the number, diameter, and spacing of side holes through an iterative design process. Physiologic flow at the inferior vena cava (IVC) and superior vena cava (SVC) were applied along with a partial ECMO support of 2 L/min. The SST k-ω turbulent model was solved for 6.4 seconds. WSS, washout, stagnation volume, and recirculation were compared. For all DLCs, no stasis region lasted more than one cardiac cycle and a complete washout was obtained in less than 4 seconds. Due to the IVC and SVC backflows, maximum WSS occurred around the DLC side holes at late systole and late diastole. A DLC with 16 and three side holes within the IVC and SVC, respectively, reduced the maximum WSS by up to 67% over the Avalon Elite 27Fr. Improved DLCs provided a more uniform WSS distribution with lower WSS around the side holes, potentially reducing the chance of thrombosis and bleeding.
Use of Impella in Patients Listed for Heart Transplantation
Authors: Pahwa Siddharth , Dunbar-Matos Christina , Slaughter Mark S. , Trivedi Jaimin R.
Published: February 2022

The new United Network for Organ Sharing (UNOS) policy has resulted in a significantly higher number of temporary mechanical circulatory support device usage such as extracorporeal membrane oxygenation, Impella, and intra-aortic balloon pump due to provision of higher priority with their use while on the waiting list. We aimed to identify Impella use in patients awaiting heart transplantation and temporal changes in its usage. The UNOS database was queried between years 2015 and 2019 for patients aged greater than or equal to 18 years, listed to undergo heart transplantation. A total of 378 patients had Impella support while listed for heart transplantation. Impella use skyrocketed from 2015 (1%) to 2019 (4%, p < 0.01). The most substantial increase in Impella use occurred after the UNOS policy change. The patients listed on Impella support after the policy change had significantly lower waiting time (median 12 days vs. 45 days, p < 0.01). More patients with Impella were directly transplanted (80% vs. 56%, p < 0.01) after the policy change, had significantly lower waitlist mortality (25% vs. 13%, p < 0.01) and fewer converted to a durable support (13% vs. 3%). The translatability (likelihood for receiving organs faster) was significantly improved after the policy change. A multivariable Cox regression model showed that post-transplant survival of Impella patients was not adversely affected after the policy change (hazard ratio = 0.9; p = 0.8). This increase in Impella use represents a substantial change in practice patterns of listing and managing patients on the heart transplant waiting list.
Celebrating Magnet® Nursing Excellence
Authors: Curto Christine
Published: February 2022

The ANCC National Magnet Nurse of the Year® awards recognize 5 outstanding clinical nurses in Magnet® designated organizations who demonstrate outstanding contributions in nursing leadership, professional practice, innovation, and research. The awards represent the 5 components of the Magnet Model: transformational leadership; structural empowerment; exemplary professional practice; new knowledge, innovations, and improvements; and empirical outcomes.
Decreasing On-shift Stress With a Crisis Intervention Cart
Authors: Ruby Cheyenne
Published: February 2022

Because of the pandemic's impact on morbidity and mortality, nursing leaders have witnessed a marked increase in the number of staff who experience crisis and extreme stress during their shift. This hospital's Engagement and Resilience Council aimed to mediate this stress by implementing resilience-building interventions during moments of peaked stress. Preliminary data show these interventions may markedly improve stress levels in frontline caregivers by up to 52% in some clinical settings.
Leadership and Staff Perceptions on Long-term Care Staffing Challenges Related to Certified Nursing Assistant Retention
Authors: Creapeau Lindsey J. G. , Johs-Artisensi Jennifer L. , Lauver Kristy J.
Published: February 2022

OBJECTIVE

This study investigates practices that may help retain certified nursing assistants (CNAs) and address the staffing challenges faced in long-term care.

BACKGROUND

CNAs are critical to quality care and retention has never been more challenging. To solve this staffing crisis, understanding the unique perspective of CNAs is imperative.

METHODS

In semistructured interviews, 5 nursing assistants, the director of nursing, and the nursing home administrator at 59 long-term care facilities answered 4 questions, providing multiple perspectives about causes and solutions to CNA staffing challenges.

RESULTS

Key responses for each stakeholder group were identified. CNAs highlighted the nature of the job as a bigger challenge than leadership recognized. Although pay is a top concern, emotional support, training, relationship-building, communication, and the work culture can be equally important in reducing turnover.

CONCLUSION

When organizational leaders understand how to meet the needs and interests of CNAs, they can reduce turnover.
Anatomic Comparison of Recipient Nerves for Deep Inferior Epigastric Perforator Flap Neurotization
Authors: Glassman Gabriella E. , Al-Kassis Salam , Assi Patrick E. , Rust Sophie J. , Perdikis Blake , Pollins Alonda C. , Patrinely James R. , Forte Antonio J. , Thayer Wesley P. , Perdikis Galen
Published: February 2022

Introduction

Although neurotization has the potential to improve sensory outcomes after autologous breast reconstruction, this technique remains controversial. There is debate regarding the clinical outcomes and the recipient nerve of choice. This histoanatomical study aims to quantitatively compare the sensory components of the recipient nerves involved in neurotization of the deep inferior epigastric perforator flap.

Methods

Subjects undergoing bilateral autologous breast reconstruction were enrolled. Transected nerve specimens underwent immunohistochemical staining with antibodies against neurofilament 1 and choline acetyltransferase for total and motor neurons within the axons, respectively. Photomicrographs were captured, and axons were analyzed using ImageJ. Sensory axons were calculated as equal to the difference between the total and cholinergic axonal counts.

Results

Thirty-eight nerves from 19 subjects were included. The overall mean sensory axon count was 1246.3 (±1171.9) in the lateral cutaneous branch (LCB) of the fourth intercostal nerve and 1123.8 (±1213.0) in the anterior cutaneous branch (ACB) of the third intercostal nerve.

The fourth LCB presented with an additional 10.9% sensory axonal count (P > 0.05). On average, sensory fibers constituted 36.7% and 31.7% of all fibers in the third ACBs and fourth LCBs, respectively.

Conclusions

This study provides anatomic and histological evidence that the fourth LCB and third ACB contain comparable mean numbers of sensory axons. Both constitute adequate recipient nerves for coaptation in deep inferior epigastric perforator reinnervation to achieve optimal sensory return after breast reconstruction. The fourth LCB should be preferable when the third ACB remains intact to preserve any native breast flap sensation.
A Personal Approach to Brachioplasty
Authors: Sergesketter Amanda R. , Erdmann Detlev
Published: February 2022

Brachioplasty has become one of the fastest-growing aesthetic surgery procedures, paralleling rising rates of weight loss surgery nationally. However, controversy persists regarding incision placement and utility of concurrent liposuction. In this article, the authors describe indications, patient selection, expected outcomes, and photographic standards for patients seeking brachioplasty after weight loss. Preoperative markings, scar placement, and operative steps of a posterior incision technique with or without concurrent liposuction if indicated are described. A personal experience with posterior incision brachioplasty along with current controversies, complications, and patient-reported outcomes after upper arm contouring are reviewed.
Improving Gender-Affirming Surgery Terminology
Authors: Makhoul Alan T. , Morrison Shane D. , Mundra Leela S. , Kaoutzanis Christodoulos , Satterwhite Thomas , Winocour Julian S. , Al Kassis Salam , Drolet Brian C.
Published: February 2022

Background

To promote patient safety and build trust, plastic surgeons must use patient-centered language when discussing gender-affirming surgery. However, the existing terminology has not been evaluated from a patient perspective. This study sought to understand how gender-affirming surgery patients from 3 US geographic regions perceive common terminology.

Methods

An anonymous, 24-item electronic survey was distributed to gender-affirming surgery patients seen in Tennessee, Colorado, and California. After institutional review board exemption, the survey instrument was pretested and piloted with gender-affirming surgery patients. Internal consistency was assessed by computation of Cronbach α (0.87).

Results

A total of 306 participants completed the survey: 68 from a Tennessee academic center (response rate, 56%), 131 from a California private practice (response rate, 8%), and 107 from a Colorado academic center (response rate, 53%). A greater proportion of respondents felt the terms “top surgery” and “bottom surgery” were appropriate (83% and 82%, respectively) relative to “chest surgery” and “genital surgery” (41% and 30%, respectively). More respondents favored the phrase “gender-affirming surgery” than “gender-confirming surgery” (86% vs 67%). Nearly half (43%) perceived the phrase “sex reassignment surgery” as inappropriate. Most respondents (80%) preferred their surgeon ask for their pronouns.

Conclusions

Optimizing communication is an actionable way for plastic surgeons to improve the healthcare experiences of gender-affirming surgery patients. “Top surgery” and “bottom surgery” are favored terms, and “gender-affirming surgery” is the preferred name for this discipline. Language preferences should be openly discussed with each patient to ensure professional communication.