bluuebunny/crossref_metadata_2025 huggingface dataset:
Integrated superconducting nanowire single-photon detectors on titanium in-diffused lithium niobate waveguides
Authors: Höpker Jan Philipp , Verma Varun B , Protte Maximilian , Ricken Raimund , Quiring Viktor , Eigner Christof , Ebers Lena , Hammer Manfred , Förstner Jens , Silberhorn Christine , Mirin Richard P , Woo Nam Sae , Bartley Tim J
Published: June 2021

We demonstrate the integration of amorphous tungsten silicide superconducting nanowire single-photon detectors on titanium in-diffused lithium niobate waveguides. We show proof-of-principle detection of evanescently coupled photons of 1550 nm wavelength using bidirectional waveguide coupling for two orthogonal polarization directions. We investigate the internal detection efficiency as well as detector absorption using coupling-independent characterization measurements. Furthermore, we describe strategies to improve the yield and efficiency of these devices.
Full-field optical metrology in polar and cylindrical coordinates
Authors: Albertazzi G Armando , Viotti Matias
Published: June 2021

There are a large number of engineering measurement demands that can be very well met with optical methods. Among them, there are some that deal with circular or cylindrical geometries, for which Cartesian coordinates are not the ideal. Measurements in cylindrical and polar coordinates are much more natural choices. This paper presents an overview of various principles and configurations to measure textures, wear, geometry and deformations of external and internal cylindrical parts, displacements, deformations, stresses and residual stresses in cylindrical or polar coordinates. Optical measurement techniques such as triangulation, photogrammetry, deflectometry, white light interferometry, speckle interferometry, shearography in cylindrical or polar coordinates, are addressed. Most of the configurations presented here involve internal or external conical mirrors. These special optical components have several very interesting properties capable of performing transformations between coordinate systems. Examples of real engineering demands are presented and briefly discussed. The results obtained met the demands for which they were developed. Our expectation is that the configurations presented here can serve as a reference for already established applications and as a source of inspiration for new demands and possibilities.
In-line quality control utilizing close-range photogrammetry and a CAD-model
Authors: Sjödahl M , Bergström P , Fergusson M , Söderholm K , Andersson A
Published: June 2021

This paper presents an overview of a measurement system that is designed for in-line shape inspection of metal sheet components in real-time utilizing pre-calibrated close-range photogrammetry and a CAD-model. The system is currently designed to measure parts thrown out on a conveyor belt that moves at about 1 m s−1 at a frequency of 0.5 Hz or less without fixturing. Detected features on the components in the camera images are used to align the CAD-model, describing the nominal shape, to the images from which required deviations are computed using photogrammetry. The measurement volume of the current system is 500 × 800 × 200 mm3 and absolute measurements are performed with an accuracy in the order of 0.1 mm. The in-line functionalities of the system have been verified at several real production sites in Sweden. In this paper, the basic components of the system are described together with a few results from real tests.
An end-to-end trainable hybrid classical-quantum classifier
Authors: Chen Samuel Yen-Chi , Huang Chih-Min , Hsing Chia-Wei , Kao Ying-Jer
Published: June 2021

We introduce a hybrid model combining a quantum-inspired tensor network and a variational quantum circuit to perform supervised learning tasks. This architecture allows for the classical and quantum parts of the model to be trained simultaneously, providing an end-to-end training framework. We show that compared to the principal component analysis, a tensor network based on the matrix product state with low bond dimensions performs better as a feature extractor for the input data of the variational quantum circuit in the binary and ternary classification of MNIST and Fashion-MNIST datasets. The architecture is highly adaptable and the classical-quantum boundary can be adjusted according to the availability of the quantum resource by exploiting the correspondence between tensor networks and quantum circuits.
On a Lusin theorem for capacities
Authors: Wiesel Johannes
Published: June 2021

Let

X
X

be a compact metric space and let

v
v

be a sub-additive capacity defined on

X
X

. We show that Lusin’s theorem with respect to

v
v

holds if and only if

v
v

is continuous from above.
Effect of the light and dark conditions on flower opening time between cultivated rice (Oryza sativa) and a near-isogenic early-morning flowering line
Authors: Ishimaru Tsutomu , Sasaki Kazuhiro , Nozaki Ikuo , Ichihashi Masanori , Shimizu Hiroaki , Wakayama Masataka , Hirabayashi Hideyuki
Published: June 2021

Flower opening time (FOT) is affected by genetic and environmental factors, but little is known about the effect of light and dark conditions on FOT in cereal crops. FOT of an indica rice cultivar, IR64, and its near-isogenic line carrying a QTL for an early-morning flowering trait (IR64+qEMF3) were investigated in a natural-light and temperature-controlled small greenhouse by exposing either the panicle or stem or both plant organs to different light and dark conditions. FOT did not change in either genotype when panicles were exposed to light. A large difference in FOT was found between genotypes when panicles were exposed to dark conditions; no flower opening was observed in IR64, whereas flower opening was delayed but observed in IR64+qEMF3. These results suggest that the panicle is the organ that perceives light for flower opening in both genotypes, whereas the light requirement to reach flower opening was quite different between genotypes. Flower opening of IR64 occurred concomitantly with elongation of anther filament in the light after the dark treatment stopped, whereas approximately half of flowering of IR64+qEMF3 resulted in apparent cleistogamy even during dark treatment. An extended duration of the dark treatment until 1730H (30–50 min before sunset) made FOT of IR64 spikelets on the next day shifted to a time as early as that of IR64+qEMF3, with significant advancement of FOT compared to the control IR64 spikelets. Our results indicated that different flowering responses to light and dark conditions exist between IR64 and IR64+qEMF3. These findings provide clues for understanding the unique genetic controls of flowering in an EMF line in rice. This study also showed evidence that artificial light environments can shift the FOT of IR64 to that of IR64+qEMF3.
Tysserand—fast and accurate reconstruction of spatial networks from bioimages
Authors: Coullomb Alexis , Pancaldi Vera
Published: June 2021

Networks provide a powerful framework to analyze spatial omics experiments. However, we lack tools that integrate several methods to easily reconstruct networks for further analyses with dedicated libraries. In addition, choosing the appropriate method and parameters can be challenging. We propose tysserand, a Python library to reconstruct spatial networks from spatially resolved omics experiments. It is intended as a common tool to which the bioinformatics community can add new methods to reconstruct networks, choose appropriate parameters, clean resulting networks and pipe data to other libraries.

Availability and implementation

tysserand software and tutorials with a Jupyter notebook to reproduce the results are available at https://github.com/VeraPancaldiLab/tysserand.

Supplementary information

Supplementary data are available at Bioinformatics online.
Snapshots Quiz
Authors: Zulian D , Samà L , Quagliuolo V
Published: June 2021

A 32-year-old woman presented with pain and numbness in the right leg. Radiological imaging and subsequent core biopsy diagnosed a large sciatic notch “dumbbell-shaped” lipoma measuring 17cm. What is the surgeon doing and why?
Soluble amyloid beta-containing aggregates are present throughout the brain at early stages of Alzheimer’s disease
Authors: Sideris Dimitrios I , Danial John S H , Emin Derya , Ruggeri Francesco S , Xia Zengjie , Zhang Yu P , Lobanova Evgeniia , Dakin Helen , De Suman , Miller Alyssa , Sang Jason C , Knowles Tuomas P J , Vendruscolo Michele , Fraser Graham , Crowther Damian , Klenerman David
Published: June 2021

Protein aggregation likely plays a key role in the initiation and spreading of Alzheimer’s disease pathology through the brain. Soluble aggregates of amyloid beta are believed to play a key role in this process. However, the aggregates present in humans are still poorly characterized due to a lack of suitable methods required for characterizing the low concentration of heterogeneous aggregates present. We have used a variety of biophysical methods to characterize the aggregates present in human Alzheimer’s disease brains at Braak stage III. We find soluble amyloid beta-containing aggregates in all regions of the brain up to 200 nm in length, capable of causing an inflammatory response. Rather than aggregates spreading through the brain as disease progresses, it appears that aggregation occurs all over the brain and that different brain regions are at earlier or later stages of the same process, with the later stages causing increased inflammation.
Inhibiting Hyper-O-GlcNAcylation of c-Myc accelerate diabetic wound healing by alleviating keratinocyte dysfunction
Authors: Zhang Jie , Yang Peilang , Liu Dan , Gao Min , Wang Jizhuang , Yu Tianyi , Zhang Xiong , Liu Yan
Published: June 2021

Background

Diabetic foot ulcers characterized by delayed healing are one of the main complications of diabetes. Epidermal keratinocyte dysfunction has been found to play a pivotal role in the poor healing ability of diabetic wounds. In this study, we aimed to explore the relationship between c-Myc and its O-linked N-acetylglucosamine (O-GlcNAc) glycosylation (O-GlcNAcylation) modification and keratinocyte dysfunction in diabetic wounds.

Methods

Clinical wound samples were collected and a full-thickness skin defect wound model of diabetic rats was established. Re-epithelialization of wounds was observed by H&E staining and expressions of proliferating cell nuclear antigen, transglutaminase 1, loricrin, c-Myc and O-GlcNAc were measured by immunohistochemistry. The functional changes of proliferation, migration and differentiation of human immortalized epidermal cells (HaCaT) cells after overexpression or knockdown of c-Myc were observed. O-GlcNAcylation of c-Myc was confirmed using immunoprecipitation and proximity ligation assay. Stability of the c-Myc protein was measured using cycloheximide. Wound healing was observed after topical application of compounds that inhibited c-Myc or O-GlcNAc on diabetic wounds.

Results

Keratinocytes at the diabetic wound margin were characterized by active proliferation and division, slow migration and poor differentiation. Similar phenomena were observed in HaCaT cells cultured in 30 mM glucose and keratinocytes at the wound margin of the diabetic rats. The expression of c-Myc was increased in keratinocytes at the wound margin of diabetic rats, patients, and in HaCaT cells cultured with 30 mM glucose. Increased expression of c-Myc promoted the proliferation while inhibiting the migration and differentiation of the HaCaT cells, and inhibition of c-Myc promoted diabetic wound healing. Increased O-GlcNAcylation of c-Myc with 30 mM glucose stabilized the c-Myc proteins. Inhibition of O-GlcNAc ameliorated keratinocyte dysfunction and promoted diabetic wound healing.

Conclusions

Increased expression of c-Myc promoted abnormal proliferation and inhibited migration and differentiation of keratinocytes at the diabetic wound margin. Increased O-GlcNAcylation of c-Myc with 30 mM glucose stabilized the c-Myc proteins. Inhibition of c-Myc or O-GlcNAc alleviated delayed diabetic wound healing. These findings make c-Myc and O-GlcNAc potential therapeutic targets for diabetic wounds.
Evaluation and management of cancer patients presenting with acute cardiovascular disease: a Consensus Document of the Acute CardioVascular Care (ACVC) association and the ESC council of Cardio-Oncology—Part 1: acute coronary syndromes and acute pericardial diseases
Authors: Gevaert Sofie A , Halvorsen Sigrun , Sinnaeve Peter R , Sambola Antonia , Gulati Geeta , Lancellotti Patrizio , Van Der Meer Peter , Lyon Alexander R , Farmakis Dimitrios , Lee Geraldine , Boriani Giuseppe , Wechalekar Ashutosh , Okines Alicia , Asteggiano Riccardo
Published: June 2021

Advances in treatment, common cardiovascular (CV) risk factors and the ageing of the population have led to an increasing number of cancer patients presenting with acute CV diseases. These events may be related to the cancer itself or the cancer treatment. Acute cardiac care specialists must be aware of these acute CV complications and be able to manage them. This may require an individualized and multidisciplinary approach. We summarize the most common acute CV complications of cytotoxic, targeted, and immune-based therapies. This is followed by a proposal for a multidisciplinary approach where acute cardiologists work close together with the treating oncologists, haematologists, and radiation specialists, especially in situations where immediate therapeutic decisions are needed. In this first part, we further focus on the management of acute coronary syndromes and acute pericardial diseases in patients with cancer.
Emergency surgical retrieval of a migrated LAmbre device through the mitral valve
Authors: Martinez-Lopez Daniel , de Villarreal Soto Juan Esteban , Mosquera Victor Manuel Ospina , Gil Alberto Forteza
Published: June 2021

Left atrial appendage occlusion has become an alternative for long-term anticoagulation for patients with non-valvular atrial fibrillation. Although the procedure is safe, life-threatening complications such as embolization of the device or cardiac tamponade might occur. We present a case of a LAmbre device that migrated 4 days after being implanted and remained trapped in the mitral valve. Secondary massive mitral regurgitation with severe stenosis and haemodynamic instability required emergency surgery. The device was successfully removed, but severe damage in the anterior leaflet and chords forced a valve replacement.
Longitudinal Associations Between Expectations of Receiving Care in the Future and Life Satisfaction Among Older Adults in Korea
Authors: Kim Jinho , Yoon Heesoo
Published: June 2021

Objectives

Uncertainty about receiving care and assistance in the future has been increasing among older adults in Korea. This study examines whether expectations about receiving care from various sources (i.e., formal and/or filial caregivers) are related to life satisfaction among older adults in Korea.

Methods

Using data from the Korean Longitudinal Study of Ageing (N = 3,607, aged 65 or older), this study estimated fixed effects regression models to investigate longitudinal within-person associations between future care expectations and life satisfaction.

Results

The results of this study revealed that developing expectations of care from family caregivers is positively associated with life satisfaction. Beginning to expect care from nonfamily caregivers, however, is not associated with life satisfaction. When disaggregating different sources of care by family member type, expecting care from a spouse or daughter(s), but not son(s), is associated with higher life satisfaction. Gender-specific analyses showed that expecting care from daughter(s) is positively associated with life satisfaction among both men and women, whereas expectations of spousal care are associated with only men’s life satisfaction. This study also found suggestive but not conclusive evidence that an association between care expectations from family caregivers and life satisfaction is stronger among older adults with lower education.

Discussion

Reducing uncertainty about future care may improve older adults’ subjective well-being. Policymakers may consider policies and programs that support family care of the aged, and more fundamentally, encourage family involvement in the lives of older people.
A Role Theory Approach to Grand Strategy: Horizontal Role Contestation and Consensus in the Case of China
Authors: Demirduzen Cagla , Thies Cameron G
Published: June 2021

This paper develops a framework for examining the grand strategies of great powers through the use of the role contestation literature. We first identify national role conceptions advocated by leaders and political factions, and then compare them to detect contestation between their favored foreign policy roles. We argue that long-term consensus on certain roles may coalesce into the enduring ingredients of grand strategies, while the existence of a high amount of role contestation between leaders and political factions over roles may suggest foreign policy is guided by more temporary foreign policy beliefs. We explore this argument through an illustrative case of contemporary China. Our findings identify substantial variation between the national role conceptions of China's leaders and their factions over time. Of particular note, we find that (1) President Xi Jinping seems to be experiencing a much higher amount of role contestation within the party on more nationalistic and aggressive roles than his predecessors, and (2) certain roles, such as developer, Tianxia, regional leadership, and internal developer, are very consistent among both leaders and their factions over time such that these roles can be considered as part of China's grand strategy. This study shows how role theory might inform the analysis of grand strategy by offering a means of observing enduring features of grand strategy that could be applied more broadly to other countries.
How Torture Fails: Evidence of Misinformation from Torture-Induced Confessions in Iraq
Authors: Einolf Christopher J
Published: June 2021

This article examines the testimony of fifty-seven torture victims in Saddam Hussein's Iraq to illustrate the processes by which torture fails to gain true confessions or accurate information. Theoretical analyses have identified several ways in which torture is likely to fail, but this is the first study to examine empirically how this occurs. In the study sample, victims stated that torture frequently led to inaccurate results, with respondents who were guilty of anti-regime activity refusing to confess or give information, innocent victims giving false information and confessions, and guilty victims giving accurate information followed by inaccurate information when the torture continued. The majority of victims stated that they resisted torture and did not confess or give any information. They did so because they knew that the regime relied on confessions to get criminal convictions and because they knew that confessing or providing information would only lead to more torture.
How Is Criminal Punishment Forward-Looking?
Authors: Sifferd Katrina L
Published: June 2021

Forward-looking aims tend to play a much less significant role than retribution in justifying criminal punishment, especially in common law systems. In this paper I attempt to reinvigorate the idea that there are important forward-looking justifications for criminal law and punishment by looking to social theories of responsibility. I argue that the criminal law may be justified at the institutional level because it is a part of larger responsibility practices that have the effect of bolstering our reasons-responsiveness by making us sensitive to the potential reactive attitudes of a larger societal audience. I further claim that forward-looking effects may justify criminal law institutions even if retribution is the primary aim of assigning punishments to specific offenders.
Tuberculous Meningitis: Impact of Timing of Treatment Initiation on Mortality
Authors: Soria Jaime , Chiappe Alfredo , Gallardo Jorge , Zunt Joseph R , Lescano Andres G
Published: June 2021

We conducted a retrospective cross-sectional study of adult hospitalized patients with confirmed tuberculous meningitis to determine the impact of the timing of treatment initiation on mortality. The mortality of tuberculous meningitis patients was high and was associated with delay in initiation of treatment, older age, HIV infection, and higher disease severity at admission.
Female Genital Schistosomiasis and HIV-1 Incidence in Zambian Women: A Retrospective Cohort Study
Authors: Sturt Amy S , Webb Emily L , Phiri Comfort R , Mudenda Maina , Mapani Joyce , Kosloff Barry , Cheeba Maina , Shanaube Kwame , Bwalya Justin , Kjetland Eyrun F , Francis Suzanna C , Corstjens Paul L A M , van Dam Govert J , van Lieshout Lisette , Hansingo Isaiah , Ayles Helen , Hayes Richard J , Bustinduy Amaya L
Published: June 2021

Background

Female genital schistosomiasis (FGS) has been associated with prevalent HIV-1. We estimated the incidence of HIV-1 infection in Zambian women with and without FGS.

Methods

Women (aged 18–31, nonpregnant, sexually active) were invited to participate in this study in January–August 2018 at the final follow-up of the HPTN 071 (PopART) Population Cohort. HIV-1-negative participants at enrollment (n = 492) were included in this analysis, with testing to confirm incident HIV-1 performed in HPTN 071 (PopART). The association of incident HIV-1 infection with FGS (Schistosoma DNA detected by polymerase chain reaction [PCR] in any genital specimen) was assessed with exact Poisson regression.

Results

Incident HIV-1 infections were observed in 4.1% (20/492) of participants. Women with FGS were twice as likely to seroconvert as women without FGS but with no statistical evidence for a difference (adjusted rate ratio, 2.16; 95% CI, 0.21–12.30; P = .33). Exploratory analysis suggested an association with HIV-1 acquisition among women with ≥2 positive genital PCR specimens (rate ratio, 6.02; 95% CI, 0.58–34.96; P = .13).

Conclusions

Despite higher HIV seroconversion rates in women with FGS, there was no statistical evidence of association, possibly due to low power. Further longitudinal studies should investigate this association in a setting with higher schistosomiasis endemicity.
Temporal Changes in the Risk of Superspreading Events of Coronavirus Disease 2019
Authors: Lim Jun-Sik , Noh Eunbi , Shim Eunha , Ryu Sukhyun
Published: June 2021

To identify the temporal change in the possible risk of superspreading events, we estimated the overdispersion parameter in 2 different periods of the coronavirus disease 2019 pandemic. We determined that the possible risk of superspreading events was reduced 90% during the second epidemic period in South Korea.
Cervical to Petrous Carotid Artery High-Flow Bypass for Carotid Artery Pseudoaneurysm Through Zygomatic Approach: 2-Dimensional Operative Video
Authors: Almefty Rami O , Al-Mefty Ossama
Published: June 2021

Pseudoaneurysms of the cervical internal carotid artery may generate grave risk from catastrophic rupture, thromboembolic stroke, or mass effect. They have many causes, including malignancy, infection, and iatrogenic and most commonly blunt or penetrating trauma.
1
These aneurysms require treatment to eliminate their risk. Treatment options include trapping, with or without revascularization, or endovascular stenting. Trapping without revascularization requires evaluation of the cerebral collateral under a physiological challenge, which is usually done with a balloon occlusion test, which is not applicable in this lesion.
2
Occluding the carotid without revascularization carries the risk of delayed ischemia and aneurysm formation.
3,4
Carotid stenting has been applied in the treatment of these lesions
5,6
; however, the extent of the lesion in our patient from the carotid bifurcation to the petrous carotid makes endovascular treatment challenging. We present a patient with a delayed post-traumatic pseudoaneurysm of the carotid artery that extended from the bifurcation to the petrous carotid who was treated with trapping and high-flow saphenous vein bypass from the proximal cervical internal carotid to the petrous carotid. Adequate exposure of the petrous carotid to perform anastomosis requires a thorough knowledge of the anatomy and surgical nuances, which we demonstrate here through a zygomatic approach.
7
The patient consented to the procedure and publication of imaging.

Image at 2:28 from Al-Mefty O, Operative Atlas of Meningiomas, © LWW, 1997, with permission.
BO Ceti: Dwarf nova showing both IW And-type and SU UMa-Type features
Authors: Kato Taichi , Tampo Yusuke , Kojiguchi Naoto , Shibata Masaaki , Ito Junpei , Isogai Keisuke , Itoh Hiroshi , Hambsch Franz-Josef , Monard Berto , Kiyota Seiichiro , Vanmunster Tonny , Sosnovskij Aleksei A , Pavlenko Elena P , Dubovsky Pavol A , Kudzej Igor , Medulka Tomas
Published: June 2021

IW And stars are a recently recognized subgroup of dwarf novae which are characterized by (often repetitive) slowly rising standstills terminated by brightening, but the exact mechanism for this variation is not yet identified. We have identified BO Cet, which had been considered as a novalike cataclysmic variable, as a new member of IW And stars based on its behavior in 2019–2020. In addition to this, the object showed dwarf nova-type outbursts in 2020–2021, and superhumps that had periods $7.8\%$ longer than the orbital one developed during at least one long outburst. This object has been confirmed as an SU UMa-type dwarf nova with an exceptionally long orbital period (0.1398 d). BO Cet is thus the first cataclysmic variable showing both SU UMa-type and IW And-type features. We obtained a mass ratio (q) of 0.31–0.34 from the superhumps in the growing phase (stage A superhumps). At this q, the radius of the 3 : 1 resonance, responsible for tidal instability and superhumps, and the tidal truncation radius are very similar. We interpret that in some occasions this object showed IW And-type variation when the disk size was not large enough, but that the radius of the 3 : 1 resonance could be reached as a result of thermal instability. We also discuss that there are SU UMa-type dwarf novae above q = 0.30, which is above the previously considered limit (∼0.25) derived from numerical simulations and that this is possible since the radius of the 3 : 1 resonance is inside the tidal truncation radius. We constrained the mass of the white dwarf larger than 1.0 M⊙, which may be responsible for the IW And-type behavior and the observed strength of the He ii emission. The exact reason, however, why this object is unique in that it shows both SU UMa-type and IW And-type features is still unsolved.
A pH-responsive mesoporous silica nanoparticles-based drug delivery system with controlled release of andrographolide for OA treatment
Authors: He Mingwei , Qin Zainen , Liang Xiaonan , He Xixi , Zhu Bikang , Lu Zhenhui , Wei Qingjun , Zheng Li
Published: June 2021

Andrographolide (AG) has favorable anti-inflammatory and antioxidative capacity. However, it has low bioavailability due to high lipophilicity and can be easily cleared by the synovial fluid after intra-articular injection, leading to low therapeutic efficiency in osteoarthritis (OA). Herein, we designed a nano-sized pH-responsive drug delivery system (DDS) for OA treatment by using modified mesoporous silica nanoparticles (MSNs) with pH-responsive polyacrylic acid (PAA) for loading of AG to form AG@MSNs-PAA nanoplatform. The nanoparticles have uniform size (∼120 nm), high drug loading efficiency (22.38 ± 0.71%) and pH-responsive properties, beneficial to sustained release in OA environment. Compared with AG, AG@MSNs-PAA showed enhanced antiarthritic efficacy and chondro-protective capacity based on IL-1β-stimulated chondrocytes and anterior cruciate ligament transection-induced rat OA model, as demonstrated by lower expression of inflammatory factors and better prevention of proteoglycan loss. Therefore, the AG@MSNs-PAA nanoplatform may be developed as a promising OA-specific and on-demand DDS.
Plasma-polymerized pericyte patches improve healing of murine wounds through increased angiogenesis and reduced inflammation
Authors: Thomas Hannah M , Ahangar Parinaz , Fitridge Robert , Kirby Giles T S , Mills Stuart J , Cowin Allison J
Published: June 2021

Pericytes have the potential to be developed as a cell therapy for the treatment of wounds; however, the efficacy of any cell therapy relies on the successful delivery of intact and functioning cells. Here, the effect of delivering pericytes on wound repair was assessed alongside the development of a surface-functionalized pericyte patch. Plasma polymerization (PP) was used to functionalize the surface of silicone patches with heptylamine (HA) or acrylic acid (AA) monomers. Human pericytes were subsequently delivered to murine excisional wounds by intradermal injection or using the pericyte-laden patches and the comparative effects on wound healing, inflammation and revascularization determined. The AA surface provided the superior transfer of the cells to de-epidermized dermis. Excisional murine wounds treated either with pericytes injected directly into the wound or with the pericyte-laden AA patches showed improved healing with decreased neutrophil infiltration and reduced numbers of macrophages in the wounds. Pericyte delivery also enhanced angiogenesis through a mechanism independent of VEGF signalling. Pericytes, when delivered to wounds, improved healing responses by dampening inflammation and promoting angiogenesis. Delivery of pericytes using PP-AA-functionalized patches was equally as effective as direct injection of pericytes into wounds. Pericyte-functionalized dressings may therefore be a clinically relevant approach for the treatment of wounds.
Development of a Single-Institution Virtual Internal Medicine Subinternship With Near-Peer Teaching in Response to the COVID-19 Pandemic
Authors: Holmberg Mackenzie H. , dela Cruz Erin , Longino August , Longino Natalie , Çoruh Başak , Merel Susan E.
Published: June 2021

Problem

In March 2020, medical students at the University of Washington School of Medicine were removed from clinical settings in response to the COVID-19 pandemic. As subinternships are required for graduation and an important way to prepare for internship, a virtual subinternship was created to include practical elements of in-person learning and to address limited teaching faculty from COVID-19 inpatient surges.

Approach

A virtual, interactive subinternship was developed with case-based teaching sessions, communication and critical literature evaluation skill building, professional development, and creation of independent learning plans. Near-peer teachers (NPTs) were selected from graduating senior medical students who matched into internal medicine. In addition to teaching topics from the Clerkship Directors of Internal Medicine curriculum, NPTs engaged in course development, recruited teaching faculty, gathered feedback, and facilitated small groups. Participating students completed pre- and postcourse surveys.

Outcomes

The 10 students (100%) enrolled in the course who completed both surveys indicated significant improvement in mean scores across 4 domains: evaluating medical literature (3.1/5 to 4.5/5; +1.4, P < .001); developing individual learning plans (3.6/5 to 4.7/5; +1.1, P = .001); perceived ability to efficiently evaluate patients with common internal medicine concerns (3.7/5 to 4.6/5; +0.9, P = .004); and formulating initial diagnostic and therapeutic plans (3.6/5 to 4.6/5; +1.0, P < .001). Themes extracted from open-ended responses included initial skepticism of an online format, the course exceeding expectations, and feeling prepared for internship.

Next Steps

Although a virtual subinternship lacks direct patient care, students reported improvement in all 4 domains studied. Future courses would benefit from greater use of simulation and role-playing scenarios for practical skills. The experience with NPTs was encouraging, aiding in the success of the subinternship. The role of NPTs should be cultivated to fill gaps in content delivery and enhance the development of students as educators.
Disparities in Gender and Race Among Physician–Scientists: A Call to Action and Strategic Recommendations
Authors: Ward Heather Burrell , Levin Frances R. , Greenfield Shelly F.
Published: June 2021

The size of the physician–scientist workforce has declined for the past 3 decades, which raises significant concerns for the future of biomedical research. There is also a considerable gender disparity among physician–scientists. This disparity is exacerbated by race, resulting in a compounding effect for women of color. Proposed reasons for this disparity include the time and expense physicians must devote to obtaining specialized research training after residency while at the same time burdened with mounting medical school debt and domestic and caretaking responsibilities, which are disproportionately shouldered by women. These circumstances may contribute to the overall gender disparity in research funded by the National Institutes of Health (NIH). Women apply for NIH grants less often than men and are therefore less likely to receive an NIH grant. However, when women do apply for NIH grants, their funding success is comparable with that of men.

Increasing representation of women and groups underrepresented in medicine (UIM) requires not only improving the pipeline (e.g., through training) but also assisting early- and midcareer women—and especially women who are UIM—to advance. In this article, the authors propose the following solutions to address the challenges women and other UIM individuals face at each of these career stages: developing specific NIH research training programs targeted to women and UIM individuals in medical school and residency; creating institutional and individual grant initiatives; increasing student loan forgiveness; setting up robust institutional mentorship programs for individuals seeking to obtain independent funding; providing childcare stipends as part of NIH grants; and instituting an NIH requirement that funded investigators participate in efforts to increase diversity in the physician–scientist workforce. Enabling more women and UIM individuals to enter and thrive in the physician–scientist workforce will increase the size and diversity of this critical component of biomedical research.
Optimizing Safety for the Postradiation Face Lift
Authors: Boustany Ashley N. , Laikhter Elizabeth , Shiah Eric , Lin Samuel J. , Slavin Sumner A.
Published: June 2021

Background:

The growing population of aging patients who have received head or neck radiation has brought attention to the unique considerations for surgical face lifts. Tissue fibrosis and impaired microcirculation can compromise wound healing and increase overall complication rates. Our review of the literature identified few reported cases of postradiation face lifts.

Methods:

Three patients who underwent postradiation face lift procedures were identified within two senior surgeons’ practices. Patient demographics, medical history, surgical technique, postoperative course, and photographs were obtained. Complications were analyzed, including infections, hematomas, seromas, wound dehiscence, delayed healing, necrosis, nerve injuries, poor scarring, and systemic events.

Results:

None of the patients experienced immediate or major complications. All patients reported satisfaction with the procedure. One patient required a revision of the earlobe.

Conclusions:

Our limited series suggests that with a comprehensive approach and a deliberate surgical technique, safe and desirable outcomes may be achieved in the appropriately selected patient. We outline perioperative considerations to assist surgeons in caring for these patients. Additional research is necessary to assess the impact of patient and therapeutic variables.
Value-Based Healthcare Initiatives in Practice: A Systematic Review
Authors: Zanotto Bruna Stella , Etges Ana Paula Beck da Silva , Marcolino Miriam Allein Zago , Polanczyk Carisi Anne
Published: June 2021

EXECUTIVE SUMMARY

Value-based initiatives are growing in importance as strategic models of healthcare management, prompting the need for an in-depth exploration of their outcome measures. This systematic review aimed to identify measures that are being used in the application of the value agenda. Multiple electronic databases (PubMed/MEDLINE, Embase, Scopus, Cochrane Central Register of Controlled Trials) were searched. Eligible studies reported various implementations of value-based healthcare initiatives. A qualitative approach was used to analyze their outcome measurements. Outcomes were classified according to a tier-level hierarchy. In a radar chart, we compared literature to cases from Harvard Business Publishing. The value agenda effect reported was described in terms of its impact on each domain of the value equation. A total of 7,195 records were retrieved; 47 studies were included. Forty studies used electronic health record systems for data origin. Only 16 used patient-reported outcome surveys to cover outcome tiers that are important to patients, and 3 reported outcomes to all 6 levels of our outcome measures hierarchy. A considerable proportion of the studies (36%) reported results that contributed to value-based financial outcomes focused on cost savings. However, a gap remains in measuring outcomes that matter to patients. A more complete application of the value agenda by health organizations requires advances in technology and culture change management.
Persistent Postural-Perceptual Dizziness in Children and Adolescents
Authors: Wang Alicia , Fleischman Katie M. , Kawai Kosuke , Corcoran Meghan , Brodsky Jacob R.
Published: June 2021

Objective:

Persistent postural-perceptual dizziness (PPPD) is a recently defined diagnostic syndrome characterized by chronic symptoms of dizziness, unsteadiness, and/or non-spinning vertigo. Although PPPD has been studied in adults, reports in the pediatric population are few. The goal of this study was to describe the presentation and treatment of PPPD in a group of pediatric patients.

Study Design:

Retrospective chart review.

Setting:

Tertiary referral center.

Patients:

≤21 years old, who met Bárány Society consensus criteria for a diagnosis of PPPD and were followed for ≥6 months or until symptom resolution.

Main Outcome Measures(s):

Patient demographics, comorbidities, symptom chronicity, and response to treatment(s).

Results:

Of the 53 patients identified, 44 (83.0%) were women. Mean age at the time of initial evaluation was 14.6 years old. Common diagnoses in addition to PPPD included benign paroxysmal positional vertigo (64.2%), vestibular migraine (56.6%), and anxiety (28.3%). A high proportion of patients (43.4%) reported initially missing school or work due to their symptoms. Eighteen patients (34.0%) reported symptom resolution ranging from 2 to 48 months after diagnosis (median 9 mo). Of these patients, 15 of 18 attended physical therapy (PT), 11 of 18 attended cognitive behavioral therapy (CBT) and/or biofeedback therapy, and 10 of 18 took selective serotonin reuptake inhibitor (SSRI) medications, and 7 of 18 (40%) did a combination of all three therapies.

Conclusion:

PPPD can impact patients at a young age, and prolonged symptoms present a significant burden to children and adolescents, many of whom are unable to attend school. Treatments such as PT, CBT, and SSRI medication may be effective.
Surgical Experience and Early Audiological Outcomes With New Active Transcutaneous Bone Conduction Implant
Authors: Sprinzl Georg Mathias , Schoerg Philipp , Ploder Marlene , Edlinger Stefan Herwig , Magele Astrid
Published: June 2021

Objectives:

Our objective was to report the very first surgical experiences, audiologic benefits, and satisfaction with the new active transcutaneous bone conduction implant, generation 602 (BCI602), in patients with mixed/conductive hearing loss (M/CHL) and single-sided deafness.

Methods:

A retrospective chart review from patients who underwent BCI602 surgery was performed.

Results:

Twelve subjects were implanted (mean age 33.17 ± 21.67 yrs). Mean surgery time was 29.89 ± 8.59 minutes, with the longest being a difficult passive-BCI explantation due to excessive osseointegration. No surgical nor post-surgical complications occurred. No pre-operative surgical planning for device placement was necessary, no BCI-lifts were used and complete transmastoid implantation was possible. The mean functional gain in the M/CHL cohort significantly increased after 3 months (ρ < .0001). The mean word recognition score (%) in quiet for the M/CHL group significantly improved at activation and 3 months post-surgery (ρ = .0002; ρ < .0001). At the 3 months follow-up the subjects reported high satisfaction with the device accompanied with a mean wearing time of 10.13 hours per day (range 18–6 h/d) resulting in a reported battery change of every 8.29 ± 0.49 days.

Conclusions:

These early results of the new BCI602 showed significantly improved audiological performance, no limitations during surgery (youngest subject 2 yrs at surgery), no prior surgical planning necessary, accompanied by high patient satisfaction and increased wearing time. Based on these results, the BCI602 can be highly recommended and especially for difficult anatomical and surgical cases and the given indication for children older than 5 years should probably be revaluated.

Level of Evidence: Level 4.
Renal Considerations in COVID-19: Biology, Pathology, and Pathophysiology
Authors: Kapp Meghan E. , Fogo Agnes B. , Roufouse Candice , Najafian Behzad , Radhakrishnan Jai , Mohan Sumit , Miller Sara E. , D’Agati Vivette D. , Silberzweig Jeffrey , Barbar Tarek , Gopalan Tulasi , Srivatana Vesh , Mokrzycki Michele H. , Benstein Judith A. , Ng Yue-Harn , Lentine Krista L. , Aggarwal Vikram , Perl Jeffrey , Salenger Page , Koyner Jay L. , Josephson Michelle A. , Heung Michael , Velez Juan Carlos , Ikizler Alp , Vijayan Anitha , William Preethi , Thajudeen Bijin , Slepian Marvin J.
Published: June 2021

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has emerged into a worldwide pandemic of epic proportion. Beyond pulmonary involvement in coronavirus disease 2019 (COVID-19), a significant subset of patients experiences acute kidney injury. Patients who die from severe disease most notably show diffuse acute tubular injury on postmortem examination with a possible contribution of focal macro- and microvascular thrombi. Renal biopsies in patients with proteinuria and hematuria have demonstrated a glomerular dominant pattern of injury, most notably a collapsing glomerulopathy reminiscent of findings seen in human immunodeficiency virus (HIV) in individuals with apolipoprotein L-1 (APOL1) risk allele variants. Although various mechanisms have been proposed for the pathogenesis of acute kidney injury in SARS-CoV-2 infection, direct renal cell infection has not been definitively demonstrated and our understanding of the spectrum of renal involvement remains incomplete. Herein we discuss the biology, pathology, and pathogenesis of SARS-CoV-2 infection and associated renal involvement. We discuss the molecular biology, risk factors, and pathophysiology of renal injury associated with SARS-CoV-2 infection. We highlight the characteristics of specific renal pathologies based on native kidney biopsy and autopsy. Additionally, a brief discussion on ancillary studies and challenges in the diagnosis of SARS-CoV-2 is presented.
Individual and combined effects of GSTM1, GSTT1, and GSTP1 polymorphisms on lung cancer risk
Authors: Zhang Wen-Ping , Yang Chen , Xu Ling-Jun , Wang Wei , Song Liang , He Xiao-Feng
Published: June 2021

Thirty-five previous meta-analyses have been reported on the individual glutathione S-transferase M1 (GSTM1) present/null, glutathione S-transferase T1 (GSTT1) present/null, and glutathione S-transferase P1 (GSTP1) IIe105Val polymorphisms with lung cancer (LC) risk. However, they did not appraise the credibility and explore the combined effects between the 3 genes and LC risk.

We performed a meta-analysis and re-analysis of systematic previous meta-analyses to solve the above problems.

Meta-analyses of Observational Studies in Epidemiology guidelines were used. Moreover, we employed false-positive report probability (FPRP), Bayesian false discovery probability (BFDP), and the Venice criteria to verify the credibility of current and previous meta-analyses.

Significantly increased LC risk was considered as “highly credible” or “positive” for GSTM1 null genotype in Japanese (odds ratio (OR) = 1.30, 95% confidence interval (CI) = 1.17–1.44, I
2 = 0.0%, statistical power = 0.997, FPRP = 0.008, BFDP = 0.037, and Venice criteria: AAB), for GSTT1 null genotype in Asians (OR = 1.23, 95% CI = 1.12–1.36, I
2 = 49.1%, statistical power = 1.000, FPRP = 0.051, BFDP = 0.771, and Venice criteria: ABB), especially Chinese populations (OR = 1.31, 95% CI = 1.16–1.49, I
2 = 48.9%, Statistical power = 0.980, FPRP = 0.039, BFDP = 0.673, and Venice criteria: ABB), and for GSTP1 IIe105Val polymorphism in Asians (Val vs IIe: OR = 1.28, 95% CI = 1.17–1.42, I
2 = 30.3%, statistical power = 0.999, FPRP = 0.003, BFDP = 0.183, and Venice criteria: ABB). Significantly increased lung adenocarcinoma (AC) risk was also considered as “highly credible” or “positive” in Asians for the GSTM1 (OR = 1.35, 95% CI = 1.22–1.48, I
2 = 25.5%, statistical power = 0.988, FPRP < 0.001, BFDP < 0.001, and Venice criteria: ABB) and GSTT1 (OR = 1.36, 95% CI = 1.17–1.58, I
2 = 30.2%, statistical power = 0.900, FPRP = 0.061, BFDP = 0.727, and Venice criteria: ABB) null genotype.

This study indicates that GSTM1 null genotype is associated with increased LC risk in Japanese and lung AC risk in Asians; GSTT1 null genotype is associated with increased LC risk in Chinese, and GSTP1 IIe105Val polymorphism is associated with increased LC risk in Asians.
Factors associated with a high-risk return visit to the emergency department: a case-crossover study
Authors: Sung Chih-Wei , Lu Tsung-Chien , Fang Cheng-Chung , Lin Jia-You , Yeh Huang-Fu , Huang Chien-Hua , Tsai Chu-Lin
Published: June 2021

Background and importance

Although factors related to a return emergency department (ED) visit have been reported, few studies have examined ‘high-risk’ return ED visits with serious adverse outcomes. Understanding factors associated with high-risk return ED visits may help with early recognition and prevention of these catastrophic events.

Objectives

We aimed to (1) estimate the incidence of high-risk return ED visits, and (2) to investigate time-varying factors associated with these revisits.

Design

Case-crossover study.

Settings and participants

We used electronic clinical warehouse data from a tertiary medical center. We retrieved data from 651 815 ED visits over a 6-year period. Patient demographics and computerized triage information were extracted.

Outcome measure and analysis

A high-risk return ED visit was defined as a revisit within 72 h of the index visit with ICU admission, receiving emergency surgery, or with in-hospital cardiac arrest during the return ED visit. Time-varying factors associated with a return visit were identified.

Main results

There were 440 281 adult index visits, of which 19 675 (4.5%) return visits occurred within 72 h. Of them, 417 (0.1%) were high-risk revisits. Multivariable analysis showed that time-varying factors associated with an increased risk of high-risk revisits included the following: arrival by ambulance, dyspnea, or chest pain on ED presentation, triage level 1 or 2, acute change in levels of consciousness, tachycardia (>90/min), and high fever (>39°C).

Conclusions

We found a relatively small fraction of discharges (0.1%) developed serious adverse events during the return ED visits. We identified symptom-based and vital sign-based warning signs that may be used for patient self-monitoring at home, as well as new-onset signs during the return visit to alert healthcare providers for timely management of these high-risk revisits.