bluuebunny/crossref_metadata_2025 huggingface dataset:
Lanthanum substituted Ni-Zn ferrite (Ni0.75Zn0.25Fe2O4) nanomaterial and its composite with rGO for degradation of binary dyes under visible light irradiation
Authors: Shume Workneh Mechal , Zereffa Enyew , Ravikumar C R , Fakrudeen Sanaulla Pathapalya , Chan Kah-Yoong , Murthy H C Ananda
Published: May 2023

Magnetically separable lanthanum modified Ni-Zn spinel ferrite nanoparticles (Ni0.75Zn0.25La0.06Fe1.94O4) and Ni0.75Zn0.25La0.06Fe1.94O4@rGO nanocomposites were successfully synthesized by the sol-gel auto-combustion and sonication methods respectively, for the degradation of binary organic pollutants. The results of x-ray Diffraction (XRD) analysis confirmed the formation of the face centered cubic (FCC) ferrites with the crystallite sizes ranging between 29.74 and 44.94 nm. The optical bandgap of the nano-composite was found to be 1.691 eV as revealed by the diffused reflectance spectral (DRS) study. The formation of the desired composition nanoparticles with a nearly spherical shape and their homogeneous distribution on sheets of rGO were verified by the scanning electron microscopy (SEM) coupled with energy dispersive x-ray (EDAX) instrument. The HR-TEM/SEAD analysis also revealed the formation of spherical polycrystalline nanoparticles and their uniform dispensability with a little agglomeration on the sheet of rGO. The degradation studies were conducted using binary dyes (MB and MO) under the irradiation of visible light in the presence of peroxide. The effects of catalyst dose, irradiation time, initial dye concentration, pH value, and recyclability of nanocomposites have been systematically studied. The findings showed that as compared to La3+ substituted Ni-Zn ferrite nanoparticles (78% for MB and 85 % for MO), the magnetic Ni0.75Zn0. 25La0.06Fe1.94O4@rGO nanocomposite exhibited as a potential photocatalyst towards the simultaneous degradation of both dyes (95% for MB and 98% MO) within 40 min under the optimized conditions. The hydroxyl radical (·OH) play a key role for Ni0.75Zn0.25La0.06Fe1.94O4@rGO nanocomposite photocatalyst for photocatalytical degradation of the binary dyes (methyl orange and methylene blue).
Ultra-dense (Bi, V, B)-oxide-added zircon ceramics fabricated by liquid-phase assisted spark plasma sintering (SPS)
Authors: Musyarofah Musyarofah , Sari Yuliani P , Hilmi Allif R , Asrori Muhammad Z , Triwikantoro  , Zainuri Mochamad , Kim Byung-Nam , Pratapa Suminar
Published: May 2023

Ultra-high-density zircon (ZrSiO4) ceramics were prepared using the spark plasma sintering (SPS) technique of zircon nanopowder with the addition of three different sintering agents, i.e., Bi2O3, V2O5and B2O3. The effect of each agent and the SPS parameters (temperature and pressure) on phase composition, microstructure, thermal and mechanical properties of the ceramics were evaluated. The identified crystalline phases of the sintered ceramics were zircon and monoclinic zirconia. The addition of a sintering agent affects the structure of zircon ceramics, i.e. the lattice parameter and the crystallite size. The sintered ceramics reached relative densities up to 99.9% of the theoretical one when V2O5or B2O3was added. SEM observations confirmed the densification of the zircon ceramics. We found the ceramics exhibited thermal conductivity ranging from 0.39 to 0.61 Wm−1K−1at 373 K while the coefficient of thermal expansion was 2.3–4.0 × 10−6/°C and the Vickers hardness was obtained to be 9.52–12.66 GPa. The Young’s (E), bulk (B), and shear (G) moduli, Poisson’s ratio ν, Pugh’s ratioB/G, and the ratio ofHV3/E*2of the ceramics are in a range of 240 − 288 GPa, 207 − 267 GPa, 91 − 109 Pa, 1.95 − 2.45, and 0.011 − 0.019 respectively. We found that high-density, quasi-ductile zircon ceramics can be synthesized at a low sintering temperature and short holding time.
The inequitable distribution of power interruptions during the 2021 Texas winter storm Uri
Authors: Shah Zeal , Carvallo Juan Pablo , Hsu Feng-Chi , Taneja Jay
Published: May 2023

Climate change induced extreme weather events will increase in intensity and frequency, leading to longer and widespread electricity outages. As an example, Winter Storm Uri in Texas left over 4.5 million customers without power between 14 and 18 February 2021. The social justice consequences of these events remain an outstanding question, as outage data are, typically, only available at the county level, obscuring detailed experiences. We produce a first-of-its-kind unique spatially resolved dataset of interruptions using satellite data on nighttime lights to track blackouts at the census block group (CBG) level. Correlating this dataset with demographic data reveals that minority CBGs were 1.5–3 times more likely to suffer from interruptions compared to predominantly white CBGs, whereas income status was positively correlated with the likelihood of interruption. The presence of critical facilities—including police and fire stations, hospitals, and water treatment facilities—in a CBG reduced the chances of interruptions by around

16
%

, a small difference that does not otherwise explain the disparity among communities. We suggest explanations, test a subset of them, and propose further work needed to explain what drives these disparities.
copMEM2: robust and scalable maximum exact match finding
Authors: Grabowski Szymon , Bieniecki Wojciech
Published: May 2023

Finding Maximum Exact Matches, i.e. matches between two strings that cannot be further extended to the left or right, is a classic string problem with applications in genome-to-genome comparisons. The existing tools rarely explicitly address the problem of MEM finding for a pair of very similar genomes, which may be computationally challenging. We present copMEM2, a multithreaded implementation of its predecessor. Together with a few optimizations, including a carefully built predecessor query data structure and sort procedure selection, and taking care for highly similar data, copMEM2 allows to compute all MEMs of minimum length 50 between the human and mouse genomes in 59 s, using 10.40 GB of RAM and 12 threads, being at least a few times faster than its main contenders. On a pair of human genomes, hg18 and hg19, the results are 324 s and 16.57 GB, respectively.

Availability and implementation

copMEM2 is available at https://github.com/wbieniec/copmem2.
Indocyanine green inhalation visualizes lung tumour during video-assisted thoracoscopic surgery
Authors: Wang Zhenfan , Tian Xue , Yang Feng , Wang Lu , Li Hao , Zhang Zeyu , He Kunshan , Chi Chongwei , Li Yun , Zhou Jian
Published: May 2023

OBJECTIVES

Accurate intraoperative identification of small lung tumours is crucial for precise resection of these lesions during video-assisted thoracoscopic surgery. This study aimed to evaluate the feasibility and safety of indocyanine green (ICG) inhalation for intraoperative visualization of lung tumours.

METHODS

From January 2022 to May 2022, 43 patients with lung nodules were included into this study. All patients received intraoperative ICG inhalation for visualization of lung tumours under near-infrared imaging. The primary outcomes of this trial were the detection rate and background-tumour ratio of lung nodules, and the secondary objectives were time to search for nodules and operative time to nodules excision.

RESULTS

A total of 50 pulmonary nodules in 43 patients were identified and completely resected. And 44 lung nodules were detected during intraoperative fluorescent exploration with a median inhaled ICG dose of 18.8 mg. In vivo, the median background-tumour ratio was 7.10. The median detection time of nodules was 100 s and the median operative time to nodules excision was 18 min. Quantification analysis showed that the fluorescence intensity of postoperative sputum declined to ∼10% of the first fluorescent sputum within 20 h. No adverse events attributed to ICG inhalation were recorded during the follow-up period.

CONCLUSIONS

Intraoperative inhalation of ICG was a feasible and safe method for detection of lung tumours at low dose of ICG. This technique could be a remedial measure for identification of unpalpable lung nodules without preoperative localization.

TRIAL REGISTRATION

Chinese Clinical Trial Registry, Identifier: ChiCTR2100053708.
Racial Discrimination in International Visa Policies
Authors: Rosenberg Andrew S
Published: May 2023

Does racial discrimination persist in global mobility rights? While many states explicitly discriminated based on race far into the twentieth century, contemporary migration policymaking is now putatively objective. The rise of white supremacist violence against all varieties of migrants, politician statements, and public support for restrictive policies calls this supposed color blindness into question. However, existing work is not discerning because most policies appear objective. In this article, I use new data on bilateral visa waiver policies from 1973 to 2013 to show that racial difference predicts whether a country receives a visa waiver, even after accounting for its economic, political, and security context. This conditional racial discrimination has worsened since 9/11. In so doing, I provide evidence of systematic racial discrimination in international visa policymaking. The results have important implications for the study of racial inequality in the international system.
Management of Mammographic Architectural Distortion Based on Contrast-enhanced MRI and US Correlation
Authors: DiPrete Olivia , Wei Catherine J , Phillips Jordana , Fishman Michael D C , Slanetz Priscilla J , Lotfi Parisa , Brook Alexander , Dialani Vandana
Published: May 2023

Objective

The objective was to evaluate outcomes of mammographic architectural distortion (AD) with and without MRI and US correlates.

Methods

A retrospective review of unexplained mammographic AD with subsequent MRI from January 1, 2007 to September 30, 2017 was performed using a reader-based study design. Mammographic, MRI, and US features and outcomes were documented. Truth was based on biopsy results or minimum two-year imaging follow-up. Measures of diagnostic accuracy were calculated.

Results

Fifty-six cases of AD were included: 29 (51.8%) detected on 2D mammogram and 27 (48.2%) detected on digital breast tomosynthesis. Of 35.7% (20/56) with MRI correlate, 40.0% (8/20) were enhancing masses, 55.0% (11/20) were non-mass enhancement (NME), and 5.0% (1/20) were nonenhancing AD. Of eight enhancing masses, 75.0% (6/8) were invasive cancers, and 25.0% (2/8) were high-risk lesions. Of 11 NME, 18.2% (2/11) were ductal carcinoma in situ, 36.4% (4/11) were high-risk lesions, and 45.4% (5/11) were benign. Of 64.3% (36/56) without MRI correlate, 94.4% (34/36) were benign by pathology or follow-up, one (2.8%, 1/36) was a 4-mm focus of invasive cancer with US correlate, and one (1/36, 2.8%) was a high-risk lesion. Of cases without MRI and US correlates, one (3.0%, 1/33) was a high-risk lesion and 97.0% (32/33) were benign. The negative predictive value of mammographic AD without MRI correlate was 97.2% (35/36) and without both MRI and US correlates was 100.0% (33/33).

Conclusion

Mammographic AD without MRI or US correlate was not cancer in our small cohort and follow-up could be considered, reducing interventions.
Myeloid Bmal1 deletion suppresses the house dust mite–induced chronic lung allergy
Authors: Hong Huiling , Zhang Jizhou , Cao Xiaoyun , Wu Yalan , Chan Ting Fung , Tian Xiao Yu
Published: May 2023

Asthma is the chronic pulmonary inflammatory response that could lead to respiratory failure when allergic reactions exacerbate. It is featured by type 2 immunity with eosinophilic inflammation, mucus, and IgE production, and Th2 cytokine secretion upon repeated challenge of allergens. The symptom severity of asthma displays an apparent circadian rhythm with aggravated airway resistance in the early morning in patients. Bmal1 is the core regulator of the circadian clock, while the regulatory role of Bmal1 in asthma remains unclear. Here, we investigate whether the myeloid Bmal1 is involved in the pathogenesis of house dust mite (HDM)–induced lung allergy. We found that knockdown of Bmal1 in macrophages suppressed the time-of-day variance of the eosinophil infiltration in the alveolar spaces in chronic asthmatic mice. This was accompanied by decreased bronchial mucus production, collagen deposition, and HDM-specific IgE production. However, the suppression effects of myeloid Bmal1 deletion did not alter the allergic responses in short-term exposure to HDM. The transcriptome profile of alveolar macrophages (AMs) showed that Bmal1-deficient AMs have enhanced phagocytosis and reduced production of allergy-mediating prostanoids thromboxane A2 and prostaglandin F2α synthesis. The attenuated thromboxane A2 and prostaglandin F2α may lead to less induction of the eosinophil chemokine Ccl11 expression in bronchial epithelial cells. In summary, our study demonstrates that Bmal1 ablation in macrophages attenuates eosinophilic inflammation in HDM-induced chronic lung allergy, which involves enhanced phagocytosis and reduced prostanoid secretion.
This Shall Be Your Wisdom (Deut. 4:6): The Wisdom of Deuteronomy Amidst Changing Paradigms for Hebrew Wisdom
Authors: Tucker Paavo
Published: May 2023

The death of ‘Wisdom Literature’ as a literary genre that has controlled understandings of wisdom in the Hebrew Bible has resulted in a need for new investigations of the concept of wisdom in biblical books outside the ‘Wisdom Literature’, which have often been considered to be ‘influenced’ by the artificial genre of ‘Wisdom Literature’. This paper will analyse the relationship between wisdom and law in the book of Deuteronomy, in order to show how freeing the concept of wisdom in Deuteronomy from the influence of ‘Wisdom Literature’ opens up perspectives to appreciate the wisdom of Deuteronomy on its own terms as a unique contribution to conceptions of Hebrew wisdom. Rather than thinking of the wisdom of Deuteronomy as being influenced by ‘Wisdom Literature’, the wisdom terminology in Deuteronomy is better accounted for by Deuteronomy’s rhetorical appropriation of the ancient Near Eastern Instruction and Law Code literary forms, each of which focuses on transmitting wisdom for successful living. The wisdom of Deuteronomy, which is cultivated throughout the book in the literary forms of Instruction and Law Code for the transmission of knowledge and intellectual skill in Torah interpretation and application, is distinct yet complementary to the wisdom found in the traditional ‘Wisdom’ books, Proverbs, Job, and Ecclesiastes.
Steady heat conduction in general relativity
Authors: Kim Hyeong-Chan
Published: May 2023

We investigate the steady state of heat conduction in general relativity using a variational approach for two-fluid dynamics. We adopt coordinates based on the Landau–Lifschitz observer because it allows us to describe thermodynamics with heat, formulated in the Eckart decomposition, on a static geometry. Through our analysis, we demonstrate that the stability condition of a thermal equilibrium state arises from the fundamental principle that heat cannot propagate faster than the speed of light. We then formulate the equations governing steady-state heat conduction and introduce a binormal equilibrium condition that the Tolman temperature gradient holds for the directions orthogonal to the heat flow. As an example, we consider radial heat conductions in a spherically symmetric spacetime. We find that the total diffusion over a spherical surface satisfies a red-shifted form, $J(r) \sqrt{-g_{tt}} =$ constant. We also discuss the behavior of local temperature around an event horizon and specify the condition that the local temperature is finite there.
Effect of transnasal humidified rapid-insufflation ventilatory exchange on gastric insufflation during anaesthesia induction
Authors: Zhou Xiaotian , Huang Xinyi , Zhou Zijun , Xu Qingqing , Mei Aishuang , Mazomba Lelethu Xakatha , Sun Jiehao
Published: May 2023

BACKGROUND

Mask ventilation during anaesthesia induction is generally used to provide adequate oxygenation but improper mask ventilation can result in gastric insufflation. It has been reported that oxygen administered by transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) during anaesthesia induction can maintain oxygenation but its effect on gastric insufflation is unknown.

OBJECTIVES

The primary aim of this study was to evaluate whether THRIVE provided adequate oxygenation without gastric insufflation. The secondary aim was to explore the change in cross-sectional area of the antrum (CSAa) during anaesthesia induction. Other potential risk factors of gastric insufflation were also explored.

DESIGN

A prospective, randomised, double-blind study.

SETTING

Single centre, Department of Anaesthesiology, 1st Affiliated Hospital, Wenzhou Medical University, China, from May 2022 to September 2022.

PATIENTS

A total of 210 patients (age >18 years, ASA classification I to III) scheduled to undergo general anaesthesia were enrolled.

INTERVENTIONS

For induction of general anaesthesia, patients were randomised into two groups: THRIVE and pressure-controlled facemask ventilation (PCFV). The THRIVE group received high-flow nasal oxygen with no additional ventilation. The PCFV group had pressure-controlled positive pressure ventilation from the anaesthesia machine via a tight fitting facemask. Gastric insufflation was detected using real-time ultrasonography. The CSAa was measured from ultrasonography images obtained before anaesthesia induction and at 0, 1, 2 and 3 min after loss of consciousness.

MAIN OUTCOME MEASURES

The incidence of gastric insufflation during the period from loss of consciousness until intubation.

RESULTS

The THRIVE group had a lower incidence of gastric insufflation during anaesthesia induction than the PCFV group (13.0 vs. 35.3%, odds ratio (OR) = 0.27, 95% confidence interval (CI), 0.14 to 0.56, P < 0.001). Increase in the CSA after anaesthesia induction was significantly correlated with gastric insufflation (OR = 5.35, 95% CI, 2.90 to 9.89, P < 0.001). Multivariate logistic regression analysis showed that advancing age (OR = 1.04, 95% CI, 1.01 to 1.07), obstructive sleep apnoea syndrome (OR = 2.43, 95% CI, 1.24 to 4.76), higher Mallampati score (OR = 2.66, 95% CI, 1.21 to 5.85) and PCFV (OR = 4.78, 95% CI, 2.06 to 11.06) were important independent risk factors for gastric insufflation.

CONCLUSION

During anaesthesia induction, the THRIVE technique provided adequate oxygenation with a reduced incidence of gastric insufflation. PCFV, advancing age, obstructive sleep apnoea syndrome and the Mallampati score were found to be independent risk factors for gastric insufflation during anaesthesia induction.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR200059555.
The effect of early and long-term propranolol therapy on learning and memory in mice
Authors: Orhan Mehmet Fatih , Tanyeri Pelin , Büyükokuroğlu Mehmet Emin , Büyükavci Mustafa
Published: May 2023

Propranolol is the treatment of choice for infantile hemangioma. We investigated the effects of long-term propranolol use in early infancy on learning and memory later in life in mice. At three weeks of age, mice were randomly divided into six experimental groups. Groups 1 and 2 (controls) received only saline for 21 days. Groups 3 and 4 received propranolol (2.5 mg/kg) for 21 days. Groups 5 and 6 received propranolol (5 mg/kg) for 21 days. Groups 1, 3 and 5 were tested at the end of 21 days of treatment (week 6). However, groups 2, 4 and 6 received a 2-week break and then (week 8) exposed to tests. In the Morris water maze test, propranolol (2.5 and 5 mg/kg) dose-dependently increased the time spent in the target quadrant in mice at weeks 6 and 8. However, propranolol did not affect the swimming speed in both time periods. There were no significant effects of propranolol on the number of errors evaluated during the radial arm maze tests. In conclusion, long-term use of propranolol in early infancy did not disrupt the learning and memory of mice.
Accelerated Repetitive Transcranial Magnetic Stimulation to Treat Major Depression: The Past, Present, and Future
Authors: Chen Leo , Klooster Deborah C. W. , Tik Martin , Thomas Elizabeth H. X. , Downar Jonathan , Fitzgerald Paul B. , Williams Nolan R. , Baeken Chris
Published: May 2023

Abstract: Repetitive transcranial magnetic stimulation (rTMS) is an effective and evidence-based therapy for treatment-resistant major depressive disorder. A conventional course of rTMS applies 20–30 daily sessions over 4–6 weeks. The schedule of rTMS delivery can be accelerated by applying multiple stimulation sessions per day, which reduces the duration of a treatment course with a predefined number of sessions. Accelerated rTMS reduces time demands, improves clinical efficiency, and potentially induces faster onset of antidepressant effects. However, considerable heterogeneity exists across study designs. Stimulation protocols vary in parameters such as the stimulation target, frequency, intensity, number of pulses applied per session or over a course of treatment, and duration of intersession intervals. In this article, clinician-researchers and neuroscientists who have extensive research experience in accelerated rTMS synthesize a consensus based on two decades of investigation and development, from early studies (“Past”) to contemporaneous theta burst stimulation, a time-efficient form of rTMS gaining acceptance in clinical settings (“Present”). We propose descriptive nomenclature for accelerated rTMS, recommend avenues to optimize therapeutic and efficiency potential, and suggest using neuroimaging and electrophysiological biomarkers to individualize treatment protocols (“Future”). Overall, empirical studies show that accelerated rTMS protocols are well tolerated and not associated with serious adverse effects. Importantly, the antidepressant efficacy of accelerated rTMS appears comparable to conventional, once daily rTMS protocols. Whether accelerated rTMS induces antidepressant effects more quickly remains uncertain. On present evidence, treatment protocols incorporating high pulse dose and multiple treatments per day show promise and improved efficacy.
The Impact of Sex Hormones on Transcranial Magnetic Stimulation Measures of Cortical Excitability: A Systematic Review and Considerations for Clinical Practice
Authors: Rivas-Grajales Ana Maria , Barbour Tracy , Camprodon Joan A. , Kritzer Michael D.
Published: May 2023

Repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising alternative for the treatment of major depressive disorder (MDD), although its clinical effectiveness varies substantially. The effects of sex hormone fluctuations on cortical excitability have been identified as potential factors that can explain this variability. However, data on how sex hormone changes affect clinical response to rTMS is limited. To address this gap, we reviewed the literature examining the effects of sex hormones and hormonal treatments on transcranial magnetic stimulation (TMS) measures of cortical excitability. Results show that variations of endogenous estrogen, testosterone, and progesterone have modulatory effects on TMS-derived measures of cortical excitability. Specifically, higher levels of estrogen and testosterone were associated with greater cortical excitability, while higher progesterone was associated with lower cortical excitability. This highlights the importance of additional investigation into the effects of hormonal changes on rTMS outcomes and circuit-specific physiological variables. These results call for TMS clinicians to consider performing more frequent motor threshold (MT) assessments in patients receiving high doses of estrogen, testosterone, and progesterone in cases such as in vitro fertilization, hormone replacement therapy, and gender-affirming hormonal treatments. It may also be important to consider physiological hormonal fluctuations and their impact on depressive symptoms and the MT when treating female patients with rTMS.
Effect of Irrigation Solution Temperature on the Corneal Endothelial Functions in Posterior Vitrectomy: Room Temperature Versus Cooled
Authors: Yıldız Seda Çeri , Seyyar Sevim Ayça , Saygılı Oğuzhan , Kimyon Sabit , Mete Alper , Güngör Kıvanç
Published: May 2023

Purpose:

To compare the effects of cooled and room temperature irrigation on the preoperative and early postoperative corneal endothelial parameter values in posterior vitrectomy.

Materials and Methods:

In this prospective, randomized, comparative study, 68 patients underwent a standard 3-port, 23-G posterior vitrectomy operation by a single surgeon. Cooled irrigation solution was applied to 36 patients during surgery (group 1), and room temperature irrigation solution was applied to 32 patients (group 2). The patients were also divided into four groups according to their history of noncomplicated cataract surgery (phakic or pseudophakic) and the types of tamponade used (silicone or gas). The central corneal thickness (CCT), endothelial cell density (ECD), mean cell area (MCA), hexagonal cell percent, and coefficient of variation of cell area (CV) parameter values of the groups at preoperative and postoperative 1 month were compared.

Results:

There were no statistically significant differences between the preoperative and postoperative corneal parameter values in groups 1 and 2 (P>0.05). However, it was remarkable that the percentage of preoperative–postoperative change in all the corneal parameter values was higher in group 2. When the results of the subgroup analyses of the patients who were pseudophakic and used gas tamponade (Group D) in group 2 were examined, it was determined that the negative effects were significantly higher in the postoperative values for the ECD, MCA, CV, and CCT parameters compared with the preoperative values (P<0.05).

Conclusion:

In patients with pseudophakia and gas tamponade, cooled irrigation was found to be more advantageous for corneal parameters.
Febrile Urinary Tract Infection in Infants Less Than 3 Months of Age
Authors: Lejarzegi Ainara , Fernandez-Uria Amaia , Gomez Borja , Velasco Roberto , Benito Javier , Mintegi Santiago
Published: May 2023

Introduction:

Urinary tract infection (UTI) is the leading cause of bacterial infection in infants younger than 3 months of age with fever without a source.

Objective:

The objective of the study was to analyze the characteristics of emergency department presentations of febrile infants younger than 3 months of age with a UTI and identify risk factors for invasive bacterial infection (IBI) secondary to UTI.

Methods:

This was a secondary analysis of a prospective observational registry that includes infants younger than 3 months with fever without a source managed at a pediatric emergency department between 2003 and 2019.

Results:

Of the 2850 patients included, 592 (20.8%) were diagnosed with a UTI (524, 88.5%, for Escherichia coli). Infants with UTIs showed significant clinical differences when compared with those not diagnosed with a bacterial infection: patients with a UTI were more likely to have a history of renal/urological problems (8.3% vs. 3.5%), temperature ≥39ºC (38.3% vs. 29%) and poor feeding (13% vs. 8.7%). Yet, nearly half (285 of the 592, 48.1%) of the infants with febrile UTIs had none of these 3 risk factors. Thirty-six infants (6.1%) had a secondary IBI. We identified the following independent risk factors for secondary IBI: infants younger than 1 month of age, parent-reported irritability, procalcitonin >0.5 ng/mL, and C-reactive protein >60 mg/L.

Conclusions:

History and physical examination do not allow us to safely rule out a UTI among young febrile infants. Age, parent-reported irritability, and biomarkers are useful in identifying patients at increased risk of secondary IBI.
Clinical Epidemiology and Antimicrobial Resistance Patterns of Infections Due to Salmonella Species in Children, Houston, TX. 2016-2021: A Retrospective Study
Authors: Tabarani Christy , De La Hoz Alejandro , Wanger Audrey , Flores Anthony R. , Arias Cesar A.
Published: May 2023

Background:

Salmonellosis continues to be a major public health issue and high rates of infection are reported among young children. The contemporary clinical epidemiology of pediatric Salmonella spp. infections in the US is not well characterized.

Methods:

We performed a retrospective observational study in a large hospital network in Houston, TX. We included all patients 18 years or younger identified as having a positive culture for Salmonella spp. from any body site during the years 2016–2021. The patient’s medical record was accessed and detailed demographic, clinical and microbiologic information were collected.

Results:

We identified a total of 110 pediatric patients with Salmonella spp. infections between 2016 and 2021. The highest frequency (69%) of infections was observed among children 0–5 years old. Bloody diarrhea was most frequently reported for children 0–1 years old. Although the highest number of salmonellosis was among infants smaller than 1 year, the percentage of bacteremia in this age group was the lowest (15%). Serotype Infantis was the most common (21%) and was less likely to cause Salmonella bacteremia. Among the Salmonella spp. isolates that had antimicrobial susceptibility performed 5 showed resistance to one or more antibiotics including 1 extensively drug-resistant S. ser. Typhi originating from Pakistan.

Conclusion:

Our findings suggest distinct clinical characteristics of Salmonella infections in the pediatric population. Consistent identification of isolates to the sub-species level along with serotyping seems critical to identify emerging lineages with increased virulence. Special consideration should be given to empiric treatment for patients who have recently returned from the Indian subcontinent.
Association Between Nasopharyngeal Colonization and Clinical Outcome in Children With Acute Otitis Media
Authors: Shaikh Nader , Hoberman Alejandro , Paradise Jack L. , Rockette Howard E. , Kurs-Lasky Marcia , Martin Judith M.
Published: May 2023

Background:

Young children with acute otitis media (AOM) frequently exhibit nasopharyngeal colonization with either Streptococcus pneumoniae, Haemophilus influenzae or both pathogens. We aimed to determine if antibiotics could be spared or shortened in those without nasopharyngeal colonization with either pathogen.

Methods:

In 2 separate randomized clinical trials in children aged 6–23 months with stringently-diagnosed AOM, we performed bacterial cultures on nasopharyngeal specimens collected at the time of diagnosis. In the first trial, we compared the efficacy of amoxicillin/clavulanate (amox/clav) administered for 10 days vs. that of placebo, and in the second trial, we compared the efficacy of amox/clav administered for 10 days vs. 5 days. In each trial, we classified children as being colonized with both S. pneumoniae and H. influenzae, S. pneumoniae alone, H. influenzae alone, or neither pathogen, and as experiencing either clinical success or clinical failure at the end-of-therapy visit, based on previously reported a priori criteria.

Results:

We evaluated 796 children. Among children randomized to amox/clav, those colonized with either S. pneumoniae or H. influenzae or both were approximately twice as likely to experience clinical failure as children not colonized with either pathogen (odds ratio: 1.8; confidence intervals: 1.2–2.9). In contrast, among children randomized to placebo, clinical failure at the end-of-therapy visit was not associated with nasopharyngeal culture results at the time of diagnosis.

Conclusions:

Children colonized with either S. pneumoniae or H. influenzae or both have a greater chance of treatment failure than children colonized with neither pathogen.
Propofol-Associated Hypertriglyceridemia in Adults With Acute Respiratory Distress Syndrome on Extracorporeal Membrane Oxygenation
Authors: Stallworth Sara , Ohman Kelsey , Schultheis Jennifer , Parish Alice , Erkanli Alaattin , Kim Heewon , Rackley Craig R.
Published: May 2023

The incidence and risk factors for propofol-associated hypertriglyceridemia (HTG) in patients receiving extracorporeal membrane oxygenation (ECMO) have not been evaluated. The purpose of this study was to determine the incidence and risk factors for propofol-associated HTG in patients with acute respiratory distress syndrome (ARDS) on ECMO. This retrospective, cohort study included 167 adults admitted to a medical intensive care unit (ICU) from July 1, 2013 to September 1, 2021, who received 24 hours of concurrent propofol and ECMO therapy. The primary outcome was the incidence of propofol-associated HTG. Secondary outcomes included HTG risk factors, time to development and resolution of HTG, and incidence of pancreatitis. HTG occurred in 58 (34.7%) patients. Patients with HTG had longer durations of ECMO (19 vs. 13 days, p < 0.001), longer ICU length of stay (26.5 vs. 23 days, p = 0.002), and higher in-hospital mortality (51.7 vs. 34.9%, p = 0.047). Baseline sequential organ failure assessment score was associated with an increased risk of developing HTG (hazard ratio [HR] = 1.19, 95% confidence interval [CI] = 1.09–1.30; p < 0.001). Propofol-associated HTG occurred in one-third of patients receiving ECMO for ARDS. Higher baseline illness severity and ECMO duration were associated with an increased risk of propofol-associated HTG.
Intravenous compounding robots in pharmacy intravenous admixture services: A systematic review
Authors: Yang Chunsong , Ni Xiaofeng , Zhang Lingli , Peng Lijuan
Published: May 2023

Background:

There is a lack of best evidence of intravenous compounding robots for hospital decision-makers. This study aimed to conduct a systematic review of intravenous compounding robots.

Methods:

A comprehensive search of relevant professional health technology assessment websites and electronic databases was conducted from inception to February 3, 2022. Current studies related to intravenous compounding robots were included in this systematic review. Two reviewers independently screened the literature, extracted data, and assessed quality. The results were reported by qualitative description because of heterogeneity in the characteristics of the data in the included studies.

Results:

Thirty-three studies were included. Effectiveness: The robots improved production efficiency compared with usual/manual preparation; however, the intravenous preparation process requires further optimization. Additionally, robots reduced the incidence of medicine residues, preparation errors, and preparation failures. The solution properties of intravenous admixture medicines were satisfactory, and the robots also contributed to error recognition. Safety: The robots reduced product pollution and environmental pollution, but vigilance is still required to ensure that pollution stays low. The robots also reduced the incidence of health damage to technicians. Economy: The robots reduced material costs in these studies; however, whether they can reduce labor costs remains unclear. Social suitability: Technicians had a high degree of satisfaction with the robots, but few relevant studies focused on this aspect.

Conclusions:

Intravenous compounding robots have certain advantages in terms of effectiveness, safety, economy, and social adaptability.
Mechanisms of severe acute respiratory syndrome coronavirus-2 induced liver damage and alteration of some liver biomarkers: A review
Authors: Seyoum Fikadu
Published: May 2023

The most serious problem for people suffering from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is liver damage. The liver is a frequently affected organ due to the metabolizing and detoxifying functions of several endogenous and exogenous molecules. In COVID-19-affected individuals, even moderate loss of hepatic function could dramatically affect the therapeutic efficacy of antiviral drugs metabolized in the liver. The clear mechanism of hepatocellular damage from SARS-CoV-2 infection is not fully understood. The main objective of this review is to identify potential mechanisms of SARS-2 induced liver damage, treatment outcomes in SARS-CoV-2-infected patients, and future direction. Electronic databases including Web of Science, Google Scholar, MEDLINE, Scopus, and Cochrane library were used to systematically search without limitation of publication date and status. Observational, retrospective cohort, prospective case-control, cohort studies, cross-sectional studies, or clinical trials were included. Liver damage in coronavirus patients is characterized by histopathological changes and abnormal elevation of some liver function tests. These abnormalities include elevation of Alanine aminotransferase, Aspartate aminotransferase, Gamma-glutamyl transferase, Alkaline phosphatase, and Serum bilirubin levels. Histopathological changes of the liver might consist of complete or partial thrombosis of the portal and sinusoidal vessels, portal tract fibrosis, and focally markedly enlarged and fibrotic hepatocytes. Understanding the fundamental molecular and immunological processes of COVID-19-related liver injury is essential for the selection of appropriate drugs and the logical development of successful treatment.
The prognosis of NX stage in patients with pT1 papillary thyroid cancer who underwent lobectomy
Authors: Ahn Ha Rim , Kang Sang Yull , Youn Hyun Jo , Jung Sung Hoo
Published: May 2023

Lymph node (LN) metastasis is known to impact the prognosis of patients with well-differentiated thyroid cancer. Herein, we aimed to determine the effect of NX stage on the prognosis of patients with papillary thyroid cancer who underwent thyroid lobectomy. We initially selected 1257 patients who underwent thyroid cancer surgery from 2012 to 2015. Of the 1257 patients, we included 556 in the analysis, excluding patients diagnosed with other types of thyroid cancer, those who underwent total or completion thyroidectomy, and those diagnosed with LN metastasis prior to surgery. The median follow-up time was 61.8 months (range: 12.3–108.9 months). After dividing the patients into N0, N1, and NX stage groups, we performed univariate and multivariate analyses. The 5-year recurrence-free survival (RFS) was analyzed using R version 3.2.5. The mean patient age was 45.0 ± 10.9 years. Of the 556 patients, 336 patients (60.4%) were diagnosed with N0 stage, 134 (24.1%) were N1 stage, and 86 (15.5%) were NX stage. Univariate and multivariate analyses were performed to identify prognostic factors for RFS. Considering gender, age, tumor size, surgery types, extrathyroidal extension, multifocality, and recurrence, no statistically significant differences were noted between the 3 groups. The 5-year RFS rates were 98.8%, 95.5%, and 97.6% for N0, N1, and NX groups, respectively, without significant differences between the 3 groups (P = .56). Considering the T1b stage, the 5-year RFS rates were 100%, 93.1%, and 93.7% in the N0, N1, and NX groups, respectively, with a statistically significant difference between the 3 groups (P = .018). Accordingly, the NX status cannot be deemed a prognostic factor for RFS in patients with papillary thyroid cancer who underwent thyroid lobectomy. However, the benefit of prophylactic central-LN dissection should be considered in patients with well-differentiated thyroid cancer diagnosed with T1b stage.
Longitudinal follow-up of pediatric Graves’ disease in preschool children: Clinical characteristics and a case report
Authors: Yang Ju-Wen , Kao Ling-Yuh , Chuang Lan-Hsin , Chen Ho-Min
Published: May 2023

Rationale:

Pediatric Graves’ disease at preschool age is a rare condition. Previous reports have indicated that adolescents with this disease are girls. Pediatric Graves’ ophthalmopathy in young children is rare, and long-term follow-up reports are lacking.

Patient concerns:

The patient had hyperthyroidism and bilateral proptosis for 2 years, but she was only 4 years old.

Diagnoses:

The blood test revealed hyperthyroidism and the ophthalmic examination revealed proptosis. The patient had Graves’ disease and Graves’ ophthalmopathy.

Interventions:

Initially, she was followed up in the pediatric department. Bilateral proptosis developed, and she was brought to the ophthalmology department for assistance. Orbital computed tomography revealed borderline enlargement of the extraocular muscles bilaterally. Other initial clinical findings included bilateral upper and lower eyelid trichiasis and mild punctate epithelial erosions of the cornea. She received conservative medical treatment in the ophthalmology department.

Outcomes:

Remission of hyperthyroidism was achieved 2 years after medical control. No elevated intraocular pressure, strabismus, or optic neuropathy developed during follow-up. Significant cosmetic improvement and gradual resolution of punctate epithelial erosions were found over 10 years. Finally, the patient had only mild bilateral lower trichiasis.

Lessons:

Longitudinal follow-up revealed that the ocular manifestations of proptosis and eyelid trichiasis may have good outcomes. Proptosis gradually improved as the patient grew up.
Incidence and severity of nonionic low-osmolar iodinated contrast medium-related adverse drug reactions in the Republic of Korea: Comparison by generic
Authors: Jang Eun Bee , Suh Chong Hyun , Kim Pyeong Hwa , Kim Ah Young , Do Kyung-Hyun , Lee Jeong Hyun , Gwon Dong-Il , Jung Ah Young , Lee Choong Wook
Published: May 2023

We aimed to report the incidence and severity of nonionic low-osmolar iodine contrast medium (ICM)-related adverse drug reactions (ADRs) in the Republic of Korea, by analyzing data from our single tertiary institution and published Korean reports, and to determine whether there is a difference in the incidence of ICM-related ADR by ICM generics. A total of 1,161,419 consecutive contrast-enhanced computed tomography (CT) examinations between January 2016 and December 2021 at Asan Medical Center were included. A systematic search of the literature investigating the incidence of ICM-related ADR in the Republic of Korea published up to December 31, 2021 was performed. We pooled these outcomes with those of our study using a binomial-normal model, and the pooled incidences of ADRs were compared among ICM generics using chi-square tests. Seven studies with a total of 2,570,986 contrast-enhanced CT examinations from 12 institutions were included. The pooled incidences of overall, mild, moderate, and severe ICM-related ADRs in the Republic of Korea were 0.82% (95% CI: 0.61%–1.10%), 0.72% (95% CI: 0.50%–1.04%), 0.11% (95% CI: 0.08%–0.15%), and 0.013% (95% CI: 0.010%–0.018%), respectively. In multiple pairwise comparisons, there were no significant differences in the overall incidence of ADRs between ICM generics, except iomeprol versus iobitridol and iomeprol versus iohexol. For moderate and severe ADRs, there were no significant differences in ADR incidence between ICM generics. The incidence of moderate and severe ICM-related ADRs did not differ among ICM generics. Our results suggest that no restriction is required for selection among nonionic low-osmolar ICMs.
Development and evaluation of an adenosine-to-inosine RNA editing-based prognostic model for survival prediction of bladder cancer patients
Authors: Tang Yin-Chao , Yang Chang-Shun , Liang Ming-Xing , Zhang Yong , Liu Yuan , Zou Shao-Hui , Shi Shu-Fan
Published: May 2023

Adenosine-to-inosine RNA editing (ATIRE) is a common form of ribonucleic acid (RNA) editing, which has highlighted the importance of ATIRE in tumors. However, its role in bladder cancer (BLCA) remains poorly understood. To study ATIRE impact on BLCA patient prognosis, we obtained ATIRE, gene expression, and clinical data from the Cancer Genome Atlas (TCGA) database for 251 patients, randomly dividing them into training and testing groups. Univariate proportional hazards model (COX) regression identified prognosis-associated ATIRE loci, while the least absolute shrinkage and selection operator (LASSO) selected final loci to construct prognostic models and generate ATIRE scores. We developed a nomogram to predict BLCA patients’ overall survival (OS) and analyzed the effect of ATIRE editing levels on host gene expression. We also compared immune cell infiltration and drug treatment between patients with high and low ATIRE scores. The ATIRE prognostic prediction model was constructed using ten ATIRE loci that are closely associated with BLCA survival. Patients with high ATIRE scores showed significantly worse OS than those with low ATIRE scores. Furthermore, the nomogram, which incorporates the ATIRE score, can better predict the prognosis of patients. Multiple functional and pathway changes associated with immune responses, as well as significant differences in immune cell infiltration levels and response to drug therapy were observed between patients with high and low ATIRE scores. This study represented the first comprehensive analysis of the role of ATIRE events in BLCA patient prognosis and provided new insights into potential prognostic markers for BLCA research.
Latent infection after spinal cord stimulation device implantation for complex regional pain syndrome: A case report
Authors: Ki Yu Min , Park Hue Jung , Yi Seung Hyun , Sim Woo Seog , Lee Jin Young
Published: May 2023

Rationale:

Spinal cord stimulation (SCS) is one of the invasive treatments of complex regional pain syndrome (CRPS). The positive effect has been observed for several years after implantation. However, infection is a common cause of SCS failure and device removal.

Patient concerns:

Here we describe a case of latent infection at the implantable generator pocket site 9 years after SCS implantation in a patient with CRPS.

Diagnoses:

A 52-year-old patient was diagnosed with type 1 CRPS. The right foot pain was intractable with standard treatments. SCS implantation was performed and SCS worked well without complication. Nine years later, the patient revisited due to pain, tenderness, and redness at the abdominal wall for 2 weeks. The right foot pain was maintained with NRS 4 for 8 years, and the stimulation stopped 1 year back. SCS infection was diagnosed.

Interventions:

The patient underwent SCS removal surgery.

Outcomes:

All SCS devices were removed successfully. The patient was discharged without any complications.

Conclusions:

While uncommon, infection after SCS implantation can occur even 9 years later. Immediate diagnosis, proper antibiotics, and surgical removal could be needed to prevent further spread of infection and better prognosis.