bluuebunny/crossref_metadata_2025 huggingface dataset:
Symmetry breaking in repeating fast radio bursts
Authors: Katz J I
Published: October 2022

Repeating fast radio bursts (FRB) show temporal symmetry breaking on millisecond time-scales (the ‘sad trombone’). On a time-scale of days, the repetitions of FRB 180916B occur at frequency-dependent phases of its 16.3 d period. Some models predict that all such periodic repeating FRB have the same sign of temporal asymmetry, while others predict that sources with both signs are equally abundant. Future observations of other periodically modulated repeating FRB may distinguish among models on this basis.
Successful argon plasma coagulation treatment for self-expandable metal stent obstruction in colorectal cancer
Authors: Inoue Teruaki
Published: October 2022

Self-expandable metal stents (SEMS) have often been used to treat malignant colorectal obstruction. But SEMS obstruction occurs due to the ingrowth of colorectal cancer. We report a case in which treatment with argon plasma coagulation (APC) was effective for SEMS obstruction. An 89-year-old man was admitted to our hospital for obstructive colorectal cancer. A SEMS was inserted and it improved malignant colorectal obstruction. Computed tomography scans demonstrated liver and lung metastases. His clinical cancer staging was IVb and he wished to receive palliative care. Two months later, SEMS obstruction occurred due to ingrowth of colorectal cancer. Treatment other than stent-in-stent SEMS insertion was considered because SEMS obstruction occurred in a short period of time. APC treatment was chosen and it improved the obstruction. The duration of stent patency was 62 days. APC is an option but it needs further studies to assess the safety of APC.
Allgrove syndrome: a case report
Authors: Alhalabi Marouf , Alsayd Saddam , Alboushi Ebtesam
Published: October 2022

Allgrove syndrome (AS), or Triple-A syndrome, is a multi-system disorder characterized by alacrima (a decrease or absence of tear production), adrenal insufficiency and achalasia (absence of esophageal muscle peristalsis and failure to relax the lower esophageal sphincter). This syndrome may affect the autonomic nervous system, in which case it is called a 4A syndrome. It is a rare autosomal recessive inheritance, and early identification is difficult due to the rarity and wide phenotypic variation even among members of the same family. Endocrinologists, gastroenterologists, ophthalmologists, neurologists and surgeons are needed to coordinate care for these patients. We describe a case of AS that took several years to complete the diagnosis. She was diagnosed with alacrima at the age of 1-year-old, adrenal insufficiency at the age of 9 and achalasia at the age of 16. This case demonstrates the difficulty and delay in the diagnosis of AS.
Ayurvedic treatment induced severe alcoholic hepatitis and non-cirrhotic portal hypertension in a 14-year-old girl
Authors: Philips Cyriac Abby , Ahamed Rizwan , Abduljaleel Jinsha K , Rajesh Sasidharan , Theruvath Arif Hussain , Raveendran Resmi , Augustine Philip
Published: October 2022

We report a novel and as yet undescribed clinical scenario in a young girl with liver failure, in whom, the liver histopathology was suggestive of alcoholic hepatitis in the background of hepatoportal sclerosis and incomplete septal cirrhosis. An extensive clinical and investigational evaluation revealed chronic consumption of multiple Ayurvedic herbal medications for seizure disease. Six months after stopping herbal medicines, the repeat liver biopsy demonstrated resolution of alcohol-related changes but persistence of classical features of non-cirrhotic portal hypertension. Analysis of the retrieved agents, including state of the art chemical and toxicology analysis, using gas chromatography and mass spectroscopy methods demonstrated multiple organic and inorganic toxins associated with acute alcohol and arsenic poisoning related hepatoportal sclerosis/incomplete septal cirrhosis in the young girl.
Cranial osteology and palaeobiology of the Early Cretaceous birdJeholornis prima(Aves: Jeholornithiformes)
Authors: Hu Han , Wang Yan , Fabbri Matteo , O’Connor Jingmai K , McDonald Paul G , Wroe Stephen , Yin Xuwei , Zheng Xiaoting , Zhou Zhonghe , Benson Roger B J
Published: October 2022

Jeholornis is a representative of the earliest-diverging bird lineages, providing important evidence of anatomical transitions involved in bird origins. Although ~100 specimens have been reported, its cranial morphology remains poorly documented owing to poor two-dimensional preservation, limiting our understanding of the morphology and ecology of the key avian lineage Jeholornithiformes, in addition to cranial evolution during the origin and early evolution of birds. Here, we provide a detailed description of the cranial osteology of Jeholornis prima, based primarily on high-quality, three-dimensional data of a recently reported specimen. New anatomical information confirms the overall plesiomorphic morphology of the skull, with the exception of the more specialized rostrum. Data from a large sample size of specimens reveal the dental formula of J. prima to be 0–2–3 (premaxillary–maxillary–dentary tooth counts), contrary to previous suggestions that the presence of maxillary teeth is diagnostic of a separate species, Jeholornis palmapenis. We also present evidence of sensory adaptation, including relatively large olfactory bulbs in comparison to other known stem birds, suggesting that olfaction was an important aspect of Jeholornis ecology. The digitally reconstructed scleral ring suggests a strongly diurnal habit, supporting the hypothesis that early-diverging birds were predominantly active during the day.
Do Cultures Obtained During Primary THA Predict the Likelihood of Revision?
Authors: Vargas-Reverón Caribay , Font-Vizcarra Lluís , Morata Laura , Fernández-Valencia Jenaro A. , Soriano Alex , Muñoz-Mahamud Ernesto
Published: October 2022

Background

There can be unexpectedly positive culture results during elective hip arthroplasty, but the degree to which these are associated with an increased risk of subsequent premature revision is not known.

Question/purpose

Are unexpectedly positive culture results obtained during elective THA associated with an increased likelihood of revision within 5 years of the procedure?

Methods

Between March 2007 and March 2011, the hip unit at our institution performed elective primary THA in 829 patients. We systematically collected three samples in 52% (428 of 829) of the interventions. Of those, 26 patients were excluded because of sampling errors; 94% (402 of 428) had samples that were collected systematically and were eligible for the study. We only considered one hip randomly in bilateral procedures (4% [15 of 428]); patients presenting with acute (< 3 months) periprosthetic joint infection undergoing open debridement (4% [16 of 402]) and patients who died before 5 years of follow-up (2% [seven of 402]) were excluded from the study, leaving 91% (364 of 402) eligible for analysis in this retrospective study of a previous prospective trial. No patient included in the final analysis was lost to follow-up within 5 years from the index surgery. The patient group consisted of 52% (188 of 364) women, with a mean ± SD age of 64.8 ± 13.9 years.

Results

Positives culture results were associated with a higher risk of revision within 5 years of the index surgery. The proportion of revision surgery was higher in the group with positive culture results than in those with negative results (10% [eight of 77] versus 2% [seven of 290]; p = 0.01). The difference was mainly attributable to a higher proportion of aseptic loosening in those with positive culture results than in those with negative results (8% [six of 74] versus 1% [four of 290]; p = 0.01). After a multivariable analysis, the only independent variable associated with 5-year revision surgery was the presence of positive results during THA (odds ratio 4.9 [95% confidence interval 1.72 to 13.99]).

Conclusion

Our findings suggest that bacterial contamination during THA is associated with an increased likelihood of early revision. This higher risk of revision is mainly because of presumed aseptic loosening; thus, efforts should focus on the need to rule out infection. These results not only open new questions that should be answered in new prospective and well-designed studies, but also may help to better select patients to obtain a more favorable outcome after THA.

Level of Evidence

Level III, therapeutic study.
Stimulated whole-blood cytokine/chemokine responses are associated with interstitial cystitis/bladder pain syndrome phenotypes and features of nociplastic pain: a multidisciplinary approach to the study of chronic pelvic pain research network study
Authors: Schrepf Andrew , Kaplan Chelsea , Harris Richard E. , Williams David A. , Clauw Daniel J. , As-Sanie Sawsan , Till Sara , Clemens J. Quentin , Rodriguez Larissa V. , Van Bokhoven Adrie , Landis Richard , Gallop Robert , Bradley Catherine , Naliboff Bruce , Pontari Mike , O'Donnell Michael , Luo Yi , Kreder Karl , Lutgendorf Susan K. , Harte Steven E.
Published: October 2022

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a common and debilitating disease with poor treatment outcomes. Studies from the multidisciplinary approach to the study of chronic pelvic pain research network established that IC/BPS patients with chronic overlapping pain conditions (COPCs) experience poorer quality of life and more severe symptoms, yet the neurobiological correlates of this subtype are largely unknown. We previously showed that ex vivo toll-like receptor 4 (TLR4) cytokine/chemokine release is associated with the presence of COPCs, as well as widespread pain and experimental pain sensitivity women with IC/BPS. Here, we attempt to confirm these findings in the multisite multidisciplinary approach to the study of chronic pelvic pain Symptom Patterns Study using TLR4-stimulated whole blood (female IC/BPS patients with COPC n = 99; without n = 36). Samples were collected in tubes preloaded with TLR4 agonist, incubated for 24 hours, and resulting supernatant assayed for 7 cytokines/chemokines. These were subject to a principal components analysis and the resulting components used as dependent variables in general linear models. Controlling for patient age, body mass index, and site of collection, we found that greater ex vivo TLR4-stimulated cytokine/chemokine release was associated with the presence of COPCs (P < 0.01), extent of widespread pain (P < 0.05), but not experimental pain sensitivity (P > 0.05). However, a second component of anti-inflammatory, regulatory, and chemotactic activity was associated with reduced pain sensitivity (P < 0.01). These results confirm that the IC/BPS + COPCs subtype show higher levels of ex vivo TLR4 cytokine/chemokine release and support a link between immune priming and nociplastic pain in IC/BPS.
Identification of prognostic genes for early basal-like breast cancer with weighted gene co-expression network analysis
Authors: Yuan Keyu , Wu Min , Lyu Shuzhen , Li Yanping
Published: October 2022

Background:

Breast cancer (BC) has become the leading cause of death for women’s malignancies and increasingly threatens the health of women worldwide. However, there is a lack of effective targeted drugs for basal-like BC. Therefore, biomarkers related to the prognosis of early BC need to be identified.

Methods:

The RNA-seq data of 87 cases of early basal-like BC and 111 cases of normal breast tissue from The Cancer Genome Atlas were explored by the weighted gene co-expression network analysis method and Limma package. Then, intersected genes were identified, and hub genes were selected by the maximal clique centrality method. The prognostic effect of the hub genes was also evaluated in early basal-like BC.

Results:

In total, 601 IGs were identified in this study. An APPI network was constructed, and the top 10 hub genes were selected, namely, cyclin B1, cyclin A2, cyclin-dependent kinase 1, cell division cycle 20, DNA topoisomerase II alpha, BUB1 mitotic checkpoint serine/threonine kinase, aurora kinase B (AURKB), cyclin B2, kinesin family member 11, and assembly factor for spindle microtubules. Only AURKB was found to be significantly associated with the overall prognosis of early basal-like BC. The immune cell infiltration analysis showed that the infiltration numbers of CD4 + T cells and naïve CD8 + T cells were positively correlated with the AURKB expression level, while those of naïve B cells and macrophage M2 cells were negatively correlated with the AURKB expression level in basal-like BC.

Conclusion:

AURKB might be a potential prognostic indicator in early basal-like BC.
Effect of early interventions with manual lymphatic drainage and rehabilitation exercise on morbidity and lymphedema in patients with oral cavity cancer
Authors: Tsai Kuo-Yang , Liao Su-Fen , Chen Kuan-Lin , Tang Hao-Wei , Huang Hsin-Ya
Published: October 2022

Background:

There are clinical and statistical inconsistencies regarding early intervention with manual lymphatic drainage (MLD). The purpose of this study was to compare the short-term effect of early interventions with rehabilitation exercise versus MLD and rehabilitation exercise in terms of pain, range of motion (ROM) and lymphedema in patients with oral cancer after surgery.

Methods:

A total of 39 patients who underwent surgery from December 2014 to December 2018 participated in this randomized single-blind study. There were 20 patients in the rehabilitation (R) group and 19 in the MLD (M) plus rehabilitation group. The R group received 30 minutes of rehabilitation intervention; and the M group received 30 minutes of MLD, in addition to 30 minutes of rehabilitation intervention in a work day. Clinical measures, including the visual analog pain scale (VAS), ROM of the neck and shoulder, ultrasonography and face distance for lymphedema, and the Földi and Miller lymphedema scales, were assessed before surgery, before intervention and when discharged from the hospital.

Results:

The VAS pain score, ROM of the neck, and internal and external rotation of the right shoulder were significantly improved after the interventions. Right-face distance (P = .005), and skin-to-bone distance (SBD) of the bilateral horizontal mandible and left ascending mandibular ramus were significantly improved after the interventions. Left lateral flexion of the neck (P = .038) and SBD of the right ascending mandibular ramus (P < .001) in the MLD group showed more improvement than that of the rehabilitation group.

Conclusion:

Early intervention with MLD and the rehabilitation program were effective in improving ROM of the neck and controlling lymphedema in acute-phase rehabilitation. The preliminary findings suggest a potential therapeutic role for early intervention with MLD, in addition to rehabilitation exercise, in that they yielded more benefits in lymphedema control and improvement of ROM of the neck in acute care.
Delayed encephalopathy after COVID-19: A case series of six patients
Authors: Akimoto Takayoshi , Hara Makoto , Tasaki Kenta , Kurosawa Yusuke , Nakamoto Tadaharu , Hirose Satoshi , Mizoguchi Tomotaka , Yokota Yuki , Ninomiya Satoko , Nakajima Hideto
Published: October 2022

Rationale:

Acute encephalopathy is a severe neurological complication of coronavirus disease 2019 (COVID-19). Most cases of acute encephalopathy associated with COVID-19 occur within several weeks of COVID-19 onset. We describe a case series of 6 patients who developed delayed encephalopathy (DE) after COVID-19.

Patient concerns and diagnoses:

We evaluated patients who recovered from COVID-19 and showed acute disturbance of consciousness or focal neurological deficits without recurrence of pneumonitis. Six patients, 2 females and 4 males, with ages ranging from 65 to 83 years were included. Durations of hospitalization due to COVID-19 were between 25 and 44 days. The severity of COVID-19 was moderate in 5 and severe in 1 patient. Patients were rehospitalized for acute disturbance of consciousness concomitant with postural tremor and, abnormal behavior, hemiplegia, aphasia, or apraxia between 34 and 67 days after the onset of COVID-19. Chest computed tomography showed no exacerbation of pneumonitis. Brain magnetic resonance imaging showed no specific findings except in 1 patient with an acute lacunar infarction. Electroencephalogram demonstrated diffuse slowing in all patients. Repeat electroencephalogram after recovery from encephalopathy demonstrated normal in all patients. One of the 6 patients had cerebrospinal fluid (CSF) pleocytosis. CSF protein levels were elevated in all patients, ranging from 51 to 115 mg/dL. CSF interleukin-6 levels ranged from 2.9 to 10.9 pg/mL. The immunoglobulin index was 0.39 to 0.44. Qlim(alb) < QAlb indicating dysfunction of the blood–brain barrier was observed in all patients. Severe acute respiratory syndrome coronavirus 2 reverse transcription polymerase chain reaction of CSF was negative in all patients. Neuronal autoantibodies were absent in serum and CSF.

Interventions and outcomes:

Immunotherapy including steroid pulses was administered to 3 patients; however, symptoms of encephalopathy resolved within several days in all patients, regardless of treatment with immunotherapy, and their consciousness levels were recovered fully. Notably, postural tremor remained for 2 weeks to 7 months.

Lessons:

In our patients, DE after COVID-19 was characterized by symptoms of acute encephalopathy accompanied with tremor in the absence of worsening pneumonitis after the fourth week of COVID-19 onset. Our findings indicate blood–brain barrier dysfunction may contribute to the pathogenesis of DE after COVID-19.
Determinants of the prevalence and location of musculoskeletal pain in elite Para athletes
Authors: Zwierzchowska Anna , Gaweł Eliza , Rosołek Barbara
Published: October 2022

The tendency for musculoskeletal complaints, injuries, and traumas remains significant among Para athletes. The aim of the study was to identify and verify the variables that impact the incidence and location of musculoskeletal pain in elite athletes with disabilities. It was assumed, that the type of disability and not the type of sport, or the type of injuries and traumas is the crucial determinant of the prevalence and location of musculoskeletal pain in Para athletes. A direct-participatory observation method was used in the study including both subjective (surveys questionnaires) and objective (anthropometric) methods of assessment. The study included 35 male and female elite Para athletes from the Polish national team (sitting volleyball [SG1: n = 21], para swimming [SG2 = 14]). Both groups of Para athletes mostly reported pain in the neck (37%), and the lower back (34%). The Spearman’s rank-order correlation showed several large inversely proportional relationships between somatic parameters and the values in the Nordic Musculoskeletal Questionnaire from the last 7 days (NMQ-7) for SG2 and some moderate to large correlations between body adiposity index (BAI) and the prevalence of injuries, the total number of rehabilitation sessions, the number of humeral joint and fingers rehabilitation sessions, breaks from training over 4 weeks in SG1. In both groups relationships were found between the duration of Paralympic training and the number of injuries and rehabilitation sessions (R = −0.4; P < .02) and between the exclusion from training for less 4 and over 4 weeks (R = −0.4; P < .03). The age of the Para athletes correlated with the NMQ-7 (wrists) (R = 0.4; P < .01). Both duration of disability and the type and severity of the disability may be crucial determinants of the prevalence and location of pain in the musculoskeletal system in Para athletes. Sport-specific training seems to induce specific musculoskeletal complaints.
Pregnancy outcomes of four different cycle protocols for frozen embryo transfer: a large retrospective cohort study
Authors: Qian Yue , Wan Qi , Bu Xiao-Qing , Li Tian , Tang Xiao-Jun , Jia Yan , Feng Qian , Lv Xing-Yu , Meng Xiang-Qian , Yang Yin , Ding Yu-Bin , Geng Li-Hong , Xia Min , Zhong Zhao-Hui
Published: October 2022

Objective:

To evaluate the pregnancy outcomes of the four endometrial preparation protocols for people undergoing frozen-thawed embryo transfer (FET), including natural cycle (NC), hormone replacement therapy cycle (HRT), gonadotropin-releasing hormone agonist artificial cycle (GAC), and ovarian stimulation cycle (OC).

Methods:

This retrospective cohort study enrolled 10,333 cycles of frozen embryo transfer performed at Xinan Gynecological Hospital in Sichuan, China, from January 2018 to December 2018. The patient’s baseline characteristics and pregnancy outcomes were extracted from the medical record system. Pregnancy outcomes were compared among the four groups and multiple logistic regression models were used to adjust for the confounding factors.

Results:

After adjusting for covariates, multiple logistic regression analysis showed no statistical significance in pregnancy outcomes in the HRT group, GAC group, and OC group compared to the NC group in the entire population. The adjusted odds ratio of live birth was 0.976 (95% confidence interval [CI] 0.837–1.138) for the HRT group, 0.959 (95% confidence interval 0.797–1.152) for the GAC group, and 0.909 (95% confidence interval 0.763–1.083) for the OC group.

Conclusions:

The natural protocol had comparable pregnancy outcomes compared to the other three endometrial preparation protocols in the overall FET population. More high-quality prospective randomized controlled trials are required to assess the efficacy of the four protocols and explore the optimal one.
Integrated Plastic Surgery Residency Applicant Perceptions of Virtual Interviews
Authors: Yoon Joshua S. , Kim Julia , Puthumana Joseph , Ha Michael , Liang Yuanyuan , Rasko Yvonne , Grant Michael P. , Nam Arthur J. , Steinberg Jordan P. , Gosman Amanda A. , Lifchez Scott D. , Liang Fan
Published: October 2022

Purpose

The 2020–2021 interview cycle for integrated plastic surgery applicants was the first to be held virtually because of the COVID-19 pandemic. Here, we detail the largest study on integrated plastic surgery applicant perceptions after the virtual interview cycle.

Methods

A 35-question institutional review board–approved survey was distributed to medical students who had applied to the Johns Hopkins/University of Maryland or University of California San Diego integrated residency programs during the 2020–2021 interview cycle. Survey questions assessed the structure, strengths, and weaknesses of the exclusively virtual interview process. Survey administration and data collection were performed using the Qualtrics platform.

Results

Of 318 distributed surveys, 94 were completed. In addition, 91.5% of respondents preferred in-person interviews before the interview season, whereas 54.3% preferred in-person interviews afterward. Applicants who favored virtual interviews did not view being unable to physically meet with program staff as a detriment (P = .001) and felt they could effectively advocate for themselves (P = .002). Overall, the most cited strengths were the ability to complete more interviews (P = .01) and cost benefits (P = .02). Criticisms were directed at the impersonal nature of the exchange (86.2%), lack of physical tour (56.4%), and difficulties at self-advocacy (52.1%).

Conclusion

Preference for virtual interviews increased from 7.5% to 34.0% after the virtual interview cycle. For several students, the ideal interview structure permits both in-person and virtual interviews to maximize flexibility. Augmenting with virtual city tours and one-on-one interviews may mitigate the impersonal nature of virtual interviews as perceived by some applicants.
Division of Fasciocutaneous Pedicled Flaps—Is It Time to Change Practice?
Authors: Mohsina Subair , Sharma Ramesh Kumar , John Jerry R. , Tripathy Satya Swarup , Singh Harbans
Published: October 2022

Introduction

The study was carried out to evaluate the safety of early division of the pedicled flaps and to identify the optimum day of division.

Methods

This prospective, parallel arm, open-label, noninferiority, randomized controlled trial was carried out from January 2019 to July 2020. All patients (age, ≥5 years) undergoing reconstructive procedures using pedicled flaps were randomized in 1:1 ratio to receive either early division or conventional division protocol. In the early-division group, the flap perfusion, if satisfactory on day 8 by clinical and thermographic methods, a clamp was applied on the pedicle. The clamp was gradually tightened to produce controlled delay, and perfusion assessment was repeated after complete tightening. If satisfactory, the flaps were divided. Primary endpoints were flap at 24 hours after division, day of division, and day of complete inset of the flap. Secondary end points included perfusion of the flap on day 8, morbidity parameters (wound infection/suture dehiscence, need for secondary surgery and donor site morbidity), quality of life, and function scores.

Results

Thirty-five patients were included in each group. The 2 groups were similar in terms of various demographic, clinicopathological variables, defect and flap characteristics. The flap survival rate was similar (P = 0.31) between the early (34/35) and standard (35/35) division groups. The early-division group had a significantly early mean day of flap division (mean difference of 12.74 days; P < 0.00001) and complete flap inset (mean difference of 12.09 days; P < 0.00001). All flaps had satisfactory perfusion on day 8. The wound infection rate was 1.33 times significantly higher in the conventional group (P = 0.033). There was a higher incidence of donor site morbidity (9% vs 0%) in the conventional group when compared with the early division group. The quality of life and function scores at 3 weeks (mean difference 2.37; P < 0.001) and 6 weeks (mean difference 3.76; P < 0.001) and adjacent joint stiffness were significantly higher in the early division group when compared with conventional group.

Conclusions

The pedicled flaps can be divided significantly early at an average duration of 10 to 11 days after flap inset with increased patient satisfaction rate and with a reduced postoperative morbidity. The authors have included a diversity of pedicled flaps used in different anatomic locations. By using stratified block randomization, we could ensure that the distribution was similar between the 2 groups, thus minimizing the heterogeneity in the analysis. This could also potentially indicate the usefulness of the controlled delay technique, irrespective of the anatomic location and type of the flap.
Multidisciplinary Team in Severe Infectious Complications Caused by Pharyngeal Foreign Body
Authors: Wang Tianyu , Cheng Yin , Liang Caiquan , Zha Siluo , Lin Bojian , Zha Xudong , Cai Boyu , Peng Hu , Liu Huanhai
Published: October 2022

Background:

Pharyngeal foreign body is not only a common emergency in people’s daily life, but also a common simple disease in otorhinolaryngology. However, the disease is easy to be ignored due to its common occurrence, which may lead to a series of serious complications including sepsis and local abscess.

Case Presentation:

In this case, a patient with sepsis, piriform fistula, deep neck abscess, and mediastinal abscess caused by a fishbone was reported. After reviewing the international literature on severe infectious complications caused by foreign bodies in pharynx, the authors emphasize the important role of multidisciplinary team in dealing with complex complications.

Result:

The whole process of patient from onset to recovery was summarized in a timeline. During hospitalization, the value of leukocyte counts and C-reactive protein in routine blood test was record dynamically. The electronic laryngoscopy, neck computed tomography and chest computed tomography were used to judge treatment efficacy. After about 2 months of hospitalization, the patient was recovered without sequelae. No adverse reactions were found during the follow-up.

Conclusion:

The incorrect method of removing foreign body after mis-swallowing may develop serious complications. Therefore, It is important to strengthen medical preaching for general population of correct treatments after foreign body ingestion. In addition, the case reminds clinicians to pay more attention to patients’ medical history and details of all medical examinations, which may provide significant clues for making the correct diagnosis and treatment quickly.
Prospective validation and application of the Trauma-Specific Frailty Index: Results of an American Association for the Surgery of Trauma multi-institutional observational trial
Authors: Joseph Bellal , Saljuqi Abdul Tawab , Amos Joseph D. , Teichman Amanda , Whitmill Melissa L. , Anand Tanya , Hosseinpour Hamidreza , Burruss Sigrid K. , Dunn Julie A. , Najafi Kaveh , Godat Laura N. , Enniss Toby M. , Shoultz Thomas H. , Egodage Tanya , Bongiovanni Tasce , Hazelton Joshua P. , Colling Kristin P. , Costantini Todd W. , Stein Deborah M. , Schroeppel Thomas J. , Nahmias Jeffry ,   the AAST Frailty MIT Study Group
Published: October 2022

BACKGROUND

The frailty index is a known predictor of adverse outcomes in geriatric patients. Trauma-Specific Frailty Index (TSFI) was created and validated at a single center to accurately identify frailty and reliably predict worse outcomes among geriatric trauma patients. This study aims to prospectively validate the TSFI in a multi-institutional cohort of geriatric trauma patients.

METHODS

This is a prospective, observational, multi-institutional trial across 17 American College of Surgeons Levels I, II, and III trauma centers. All geriatric trauma patients (65 years and older) presenting during a 3-year period were included. Frailty status was measured within 24 hours of admission using the TSFI (15 variables), and patients were stratified into nonfrail (TSFI, ≤0.12), prefrail (TSFI, 0.13–0.25), and frail (TSFI, >0.25) groups. Outcome measures included index admission mortality, discharge to rehabilitation centers or skilled nursing facilities (rehab/SNFs), and 3-month postdischarge readmissions, fall recurrences, complications, and mortality among survivors of index admission.

RESULTS

A total of 1,321 geriatric trauma patients were identified and enrolled for validation of TSFI (nonfrail, 435 [33%]; prefrail, 392 [30%]; frail, 494 [37%]). The mean ± SD age was 77 ± 8 years; the median (interquartile range) Injury Severity Score was 9 (5–13). Overall, 179 patients (14%) had a major complication, 554 (42%) were discharged to rehab/SNFs, and 63 (5%) died during the index admission. Compared with nonfrail patients, frail patients had significantly higher odds of mortality (adjusted odds ratio [aOR], 1.93; p = 0.018), major complications (aOR, 3.55; p < 0.001), and discharge to rehab/SNFs (aOR, 1.98; p < 0.001). In addition, frailty was significantly associated with higher adjusted odds of mortality, major complications, readmissions, and fall recurrence at 3 months postdischarge (p < 0.05).

CONCLUSION

External applicability of the TSFI (15 variables) was evident at a multicenter cohort of 17 American College of Surgeons trauma centers in geriatric trauma patients. The TSFI emerged as an independent predictor of worse outcomes, both in the short-term and 3-month postdischarge.

LEVEL OF EVIDENCE

Prognostic and Epidemiological; Level III.
The Reality of Inadequate Patient Care and the Need for a Global Action Framework in Organ Donation and Transplantation
Authors: Domínguez-Gil Beatriz , Ascher Nancy L. , Fadhil Riadh A.S. , Muller Elmi , Cantarovich Marcelo , Ahn Curie , Berenguer Marina , Bušić Mirela , Egawa Hiroto , Gondolesi Gabriel E. , Haberal Mehmet , Harris David , Hirose Ryutaro , Ilbawi André , Jha Vivekanand , López-Fraga Marta , Andrés Madera Sergio , Najafizadeh Katayoun , O’Connell Philip J. , Rahmel Axel , Shaheen Faissal A.M. , Twahir Ahmed , Van Assche Kristof , Wang Haibo , Haraldsson Boerje , Chatzixiros Efstratios , Delmonico Francis L.
Published: October 2022

Background.

Transplant therapy is considered the best and often the only available treatment for thousands of patients with organ failure that results from communicable and noncommunicable diseases. The number of annual organ transplants is insufficient for the worldwide need.

Methods.

We elaborate the proceedings of the workshop entitled “The Role of Science in the Development of International Standards of Organ Donation and Transplantation,” organized by the Pontifical Academy of Sciences and cosponsored by the World Health Organization in June 2021.

Results.

We detail the urgency and importance of achieving national self-sufficiency in organ transplantation as a public health priority and an important contributor to reaching relevant targets of the United Nations Agenda for Sustainable Development. It details the elements of a global action framework intended for countries at every level of economic development to facilitate either the establishment or enhancement of transplant activity. It sets forth a proposed plan, by addressing the technical considerations for developing and optimizing organ transplantation from both deceased and living organ donors and the regulatory oversight of practices.

Conclusions.

This document can be used in governmental and policy circles as a call to action and as a checklist for actions needed to enable organ transplantation as treatment for organ failure.
Regulation and Function of a Polarly Localized Lignin Barrier in the Exodermis
Authors: Manzano Concepcion , Morimoto Kevin W. , Shaar-Moshe Lidor , Mason G. Alex , Cantó-Pastor Alex , Gouran Mona , Bellis Damien De , Ursache Robertas , Kajala Kaisa , Sinha Neelima , Bailey-Serres Julia , Geldner Niko , Pozo J Carlos del , Brady Siobhan M.
Published: October 2022

Multicellular organisms control interactions with their environment through the development of specialized barriers in specific cell types. A conserved barrier in plant roots is the endodermal Casparian strip (CS). The CS is made of polymerized lignin and forms a ring-like structure that seals the apoplastic space between the endodermal cells. Most angiosperms also have another root cell type, the exodermis, that is reported to form a barrier. Our understanding of exodermal developmental and molecular regulation, as well as function, is limited as this cell type is absent from the model speciesArabidopsis thaliana. Using tomato (Solanum lycopersicum) as a model system we demonstrate that in this species, the exodermis does not form a CS. Instead, it forms a polar lignin cap with an equivalent barrier function to the endodermal CS. We demonstrate that although endodermal regulators are conserved between Arabidopsis and tomato, exodermal differentiation occurs by a distinct regulatory pathway involving theSlSCZandSlEXO1transcription factors. Although the exodermis and endodermis both produce barriers that restrict mineral ion uptake, they have unique and overlapping roles in their selectivity. Whether conservation and similarities between the endodermis and exodermis exist in other species remains to be determined. Nonetheless, in tomato, these distinct lignin structures have a convergent function with different genetic regulations.
Crystal and mesophase structure of a bicyclohexyl cyano mesogen
Authors: Gupta Sakuntala , Das Partha Pratim , Crispini Alessandra , Scarpelli Francesca , Borbone Fabio , Centore Roberto
Published: October 2022

The phase behaviour of 4-[trans-4-(trans-4-propylcyclohexyl)cyclohexyl]benzonitrile, C22H31N, 1, has been examined. This compound has two different solid phases, denoted I and II, and exhibits thermotropic liquid-crystalline behaviour, with a remarkable interval of stability of the mesophase between the lower melting solid phase (75 °C) and the isotropization temperature (247 °C). The crystal and molecular structures of solid phase I have been determined at 173 K. The cyclohexyl rings both adopt the chair conformation and are equatorially substituted. The packing of 1 in the crystalline state is driven by the antiparallel arrangement of cyano dipoles with the formation of close contacts involving the strong cyano acceptor and weak aromatic C—H or aliphatic C—H donors. The crystal packing is discussed and compared with X-ray diffraction data in the liquid-crystalline state. The combination of thermal analysis, optical polarizing microscopy and X-ray diffraction analysis suggests that the mesophase is a partially ordered smectic phase. The lamellar structure of the mesophase is retained in crystalline solid phase II obtained by cooling the liquid-crystalline phase.
Socio-political factors underlying the adoption of green bond financing of infrastructure projects: the case of Ghana
Authors: Babon-Ayeng Prosper , Oduro-Ofori Eric , Owusu-Manu De-Graft , Edwards David James , Kissi Ernest , Kukah Augustine Senanu Komla
Published: October 2022

Purpose

There is a pressing need to increase investments in sustainable infrastructure to promote low carbon economic growth and ensure environmental sustainability. Consequently, this study examines the socio-political factors underlying the adoption of green bond financing of infrastructure projects.

Design/methodology/approach

Primary data was gathered from experts with advanced experience in, or knowledge of green bonds in the Kumasi Metropolis. To identify respondents with pertinent knowledge that is relevant to the study, purposive and snowball sampling techniques were used. One-sample t-test and relative importance index were used in this study's statistical analysis.

Findings

‘Training and experience with sustainable finance’ was seen as the most important social factor underlying the adoption of green bond financing of infrastructure projects by the respondents and ‘Governmental tax-based incentives’ was rated as the leading political factor.

Originality/value

This pioneering research attempts to ascertain the socio-political factors affecting the adoption of green bond financing of infrastructure projects. Emergent results of analysis and concomitant discussions add knowledge to fill a void in literature on the social and political factors affecting the adoption of green bond financing of infrastructure projects in developing countries.
A comprehensive evaluation of factors affecting nurse leaders’ work-related well-being
Authors: Niinihuhta Milja , Terkamo-Moisio Anja , Kvist Tarja , Häggman-Laitila Arja
Published: October 2022

Purpose

This study aims to describe nurse leaders’ experiences of work-related well-being and its association with background variables, working conditions, work engagement, sense of coherence and burnout.

Design/methodology/approach

An electronic survey design was used. Data was collected between December 2015 and May 2016 with an instrument that included demographic questions and four internationally validated scales: the Utrecht Work Engagement Scale, QPS Nordic 34+, the shortened Sense of Coherence scale and the Maslach Burnout Inventory. Data was analysed using statistical methods.

Findings

A total of 155 nurse leaders completed the questionnaire, giving a 44% response rate. Most of them worked as nurse managers (89%). Participants’ work-related well-being scores ranged from 8 to 10. Statistically significant relationships were found between participants’ work-related well-being and their leadership skills, current position, sense of coherence and levels of burnout. In addition, there were statistically significant relationships between work-related well-being and all dimensions of working conditions.

Originality/value

This study underlines the fact that work-related well-being should not be evaluated based on a single factor. The participants’ perceived work-related well-being was high, although almost half of them reported always or often experiencing stress. The results suggest that nurse leaders may have resources such as good leadership and problem-solving skills, supportive working conditions and a high sense of coherence that prevent the experienced stress from adversely affecting their work-related well-being.
Iqbal Geoffrey v. The Museum of Modern Art
Authors: Sharpe Gemma
Published: October 2022

In 1971, Pakistan‐born lawyer and artist Iqbal Geoffrey (1939–2021) lodged a discrimination case against the Museum of Modern Art in New York. This essay connects Geoffrey's complaint, which he filed with the New York State Division of Human Rights, to MoMA's situation at the centre of activist debates over race and equality during the late 1960s and early 1970s, and the museum's prominent role in exporting US art around the world during the Cold War. At a time when Asian modernists received a mostly transactional, diplomatic welcome from US cultural institutions including MoMA, Geoffrey mobilized his legal, artistic, and epistolary practices to stake his claim to permanent belonging within the US art world. Today, his case raises questions over where expanding histories of ‘global modernism’ meet incomplete histories of ‘American’ modernism, against a backdrop and the legacies of the Cold War era.
Will Truss's Time end in Failure? Assessing the Prospects of the latest ‘Takeover’ Prime Minister
Authors: Worthy Ben
Published: October 2022

In September 2022, Elizabeth Truss became the third Prime Minister in a row to take office directly as a result of a party leadership election. My study of takeovers between 1916 and 2016 found they have a shorter time in office than those who are elected, because they inherit deep crisis and divided parties. They also face the dilemma of whether, and when, to call a general election.
Developing the EQUIPED approach to quality management using multi‐grounded theory
Authors: Kirkegaard Amy , Mitchell Lana , Ball Lauren , Williams Lauren T.
Published: October 2022

Aim

This study aimed to develop a theoretical approach to quality management for dietetics services operating in primary care settings in Australia.

Methods

Multi‐grounded theory was used to develop a theoretical approach to quality management across three phases. A preliminary approach was developed in the first phase using empirical data outlining quality management activities employed by primary care dietetics services. In the second phase, the preliminary approach was matched to theoretical data captured from the Australian National Safety and Quality in Primary and Community Healthcare Standards, the Quality in Nutrition Care Model for Dietitians, and complex adaptive systems theory. Central concepts were defined and described in the final phase.

Results

Seventeen small (n = 7) and medium‐large (n = 10) dietetics services from all Australian states and territories, except Tasmania, participated. The theoretical approach to quality management comprised 107 rules organised into six attractors (culture, integrated care, evidence‐based care, safe environment and care, client partnerships and personalised care) and 10 governance elements. Rules had one or more foci that aimed to: improve quality within the service (internally focused), improve care by influencing other healthcare professionals (externally focused), improve the client relationship (client‐focused), or monitor and respond to external systems (system‐focused).

Conclusions

The theoretical approach developed in this study produced a set of rules that primary care dietetics services can use to inform quality management activities. The use of multi‐grounded theory should be investigated in other healthcare disciplines and settings to address quality.
Advanced glycation end products induce senescence of atrial myocytes and increase susceptibility of atrial fibrillation in diabetic mice
Authors: Zheng Dan‐Lin , Wu Qing‐Rui , Zeng Peng , Li Sui‐Min , Cai Yong‐Jiang , Chen Shu‐Zhen , Luo Xue‐Shan , Kuang Su‐Juan , Rao Fang , Lai Ying‐Yu , Zhou Meng‐Yuan , Wu Fei‐Long , Yang Hui , Deng Chun‐Yu
Published: October 2022

Diabetes mellitus (DM) is a common chronic metabolic disease caused by significant accumulation of advanced glycation end products (AGEs). Atrial fibrillation (AF) is a common cardiovascular complication of DM. Here, we aim to clarify the role and mechanism of atrial myocyte senescence in the susceptibility of AF in diabetes. Rapid transesophageal atrial pacing was used to monitor the susceptibility of mice to AF. Whole‐cell patch‐clamp was employed to record the action potential (AP) and ion channels in single HL‐1 cell and mouse atrial myocytes. More importantly, anti‐RAGE antibody and RAGE‐siRNA AAV9 were used to investigate the relationship among diabetes, aging, and AF. The results showed that elevated levels of p16 and retinoblastoma (Rb) protein in the atrium were associated with increased susceptibility to AF in diabetic mice. Mechanistically, AGEs increased p16/Rb protein expression and the number of SA‐β‐gal‐positive cells, prolonged the action potential duration (APD), reduced protein levels of Cav1.2, Kv1.5, and current density of ICa,L, IKur in HL‐1 cells. Anti‐RAGE antibody or RAGE‐siRNA AAV9 reversed these effects in vitro and in vivo, respectively. Furthermore, downregulating p16 or Rb by siRNA prevented AGEs‐mediated reduction of Cav1.2 and Kv1.5 proteins expression. In conclusion, AGEs accelerated atrial electrical remodeling and cellular senescence, contributing to increased AF susceptibility by activating the p16/Rb pathway. Inhibition of RAGE or the p16/Rb pathway may be a potential therapeutic target for AF in diabetes.
External Validity and Meta‐Analysis
Authors: Slough Tara , Tyson Scott A.
Published: October 2022

Meta‐analysis is a method that combines estimates from studies conducted on different samples, in different contexts, or at different times. Social scientists increasingly use meta‐analyses to aggregate evidence and learn about general substantive phenomena. We develop a framework to examine the theoretical foundations of meta‐analysis, with emphasis on clarifying the role of external validity. We identify the conditions under which multiple studies are target‐equivalent, meaning they identify the same empirical target. Our main result shows that external validity and harmonization, in comparisons made and how outcomes are measured, are necessary and sufficient for target‐equivalence. We examine common formulations of meta‐analysis—fixed‐ and random‐effects models—developing the theoretical assumptions that underpin them and providing design‐based identification results for these models. We then provide practical guidance based on our framework and results. Our results reveal limits to agnostic approaches to the combination of causal evidence from multiple studies.
Effect of news and noise shocks of US monetary policy on economic fluctuations in emerging market economies
Authors: Kim Wongi , Kim Kyunghun
Published: October 2022

This study investigates the effect of news and noise shocks of US monetary policy on economic fluctuations in emerging market economies. In the first part of our two‐step estimation method, the news and noise shocks of US monetary policy are estimated using dynamic structural vector autoregression identification. In the second step, the impact of the news and noise shocks on macro variables reflecting the business cycle (e.g., production, consumption, investment and trade balance) is examined using local projection. Our empirical results show no significant differences in the responses to both shocks at the early stage, when news and noise are not separable. However, when the monetary policy becomes known, emerging market economies enter a full‐scale recession with respect to a news shock of raised US interest rates. Meanwhile, emerging market economies enter an economic boom phase of the business cycle when the shock turns out to be noise. Fluctuations driven by noise are likely to incur greater costs than normal economic fluctuations because the former are out of sync with the fundamentals.