bluuebunny/crossref_metadata_2025 huggingface dataset:
A Chandra X-ray study of millisecond pulsars in the globular cluster Omega Centauri: a correlation between spider pulsar companion mass and X-ray luminosity
Authors: Zhao Jiaqi , Heinke Craig O
Published: September 2023

Millisecond pulsars (MSPs) are faint X-ray sources commonly observed in Galactic globular clusters (GCs). In this work, we investigate 18 MSPs newly found in the GC Omega Centauri (ω Cen) and search for their X-ray counterparts using Chandra observations with a total exposure time of 290.9 ks. We identify confident X-ray counterparts for 11 of the MSPs, with 9 of them newly identified in this work based on their positions, spectral properties, and X-ray colours. The X-ray spectra of nine MSPs are well described by a neutron star hydrogen atmosphere model, while two MSPs are well fitted by a power-law model. The identified MSPs have X-ray luminosities ranging from 1.0 × 1030 to 1.4 × 1031 erg s−1. Additionally, for population comparison purposes, we study the X-ray counterpart to MSP E in the GC M71, and find its X-ray spectrum is well described by blackbody-like models with a luminosity of 1.9 × 1030 erg s−1. We investigate the empirical correlations between X-ray luminosities and minimum companion masses, as well as mass functions, of spider pulsars. Clear correlations are observed, with best-fitting functions of log10LX = (1.0 ± 0.1)log10Mc, min + (32.5 ± 0.2) and (0.35 ± 0.04)log10MF + (32.71 ± 0.20), respectively, with an intrinsic scatter of log10LX of ∼0.3, where LX is the 0.5–10 keV X-ray luminosity, Mc, min is the minimum companion mass, and MF represents the mass function, in solar masses.
Small body harvest with the Antarctic Search for Transiting Exoplanets (ASTEP) project
Authors: Hasler S N , Burdanov A Y , de Wit J , Dransfield G , Abe L , Agabi A , Bendjoya P , Crouzet N , Guillot T , Mékarnia D , Schmider F X , Suarez O , Triaud A H M J
Published: September 2023

Small Solar system bodies serve as pristine records that have been minimally altered since their formation. Their observations provide valuable information regarding the formation and evolution of our Solar system. Interstellar objects can also provide insight on the formation of exoplanetary systems and planetary system evolution as a whole. In this work, we present the application of our framework to search for small Solar system bodies in exoplanet transit survey data collected by the Antarctic Search for Transiting ExoPlanets (ASTEP) project. We analysed data collected during the Austral winter of 2021 by the ASTEP 400 telescope located at the Concordia Station, at Dome C, Antarctica. We identified 20 known objects from dynamical classes ranging from Inner Main-belt asteroids to one comet. Our search recovered known objects down to a magnitude of V  = 20.4 mag, with a retrieval rate of ∼80 per cent for objects with V ≤ 20 mag. Future work will apply the pipeline to archival ASTEP data that observed fields for periods of longer than a few hours to treat them as deep-drilling data sets and reach fainter limiting magnitudes for slow-moving objects, on the order of V ≈ 23–24 mag.
Persianate Dynastic Period/Later Caliphate (c. 800–1000)
Authors: Peacock A.C.S.
Published: September 2023

The Persianate dynastic period of Islamic history refers to the ninth to tenth centuries in the lands stretching eastward from Iraq to Central Asia. By the ninth century, the power of the Abbasid caliphate (750–1258) was starting to wane, and in the eastern parts of the Islamic world was increasingly supplanted by dynasties that were either of or purported to be of Iranian origins. This transfer of power started with the civil war between the Abbasid caliph al-Maʾmun (r. 813–833) and his brother al-Amin, in which al-Maʾmun’s victorious armies were led by a general of origins in the Iranian gentry, Tahir b. al-Husayn (d. 822). Tahir was rewarded with the governorship of the great province of Khurasan (approximately modern eastern Iran, Turkmenistan and northern Afghanistan), a position which his successors, known as the Tahirids, succeeded in making both hereditary and effectively autonomous for the next fifty years. Further east, similar processes were at work; in 819, in Transoxiana (roughly modern Uzbekistan and Tajikistan), the descendants of another member of the Iranian gentry class, Saman, were appointed to governorships as a reward for military service, marking the beginnings of the Samanid dynasty (819–999) that would dominate the region for nearly two hundred years and ultimately supplant the Tahirids in Khurasan. Slightly later, another ethnically Iranian dynasty of more humble origins, the Saffarids (861–1003), built up an empire that briefly threatened Abbasid control of Baghdad, but by the beginning of the eleventh century had again been reduced to the status of local rulers of their powerbase, Sistan. Other dynasties arose from the Caspian, a remote area where Islam had spread only rather late and in the form of Shiʿism rather than Sunnism. The Ziyarids briefly managed to seize control of much of Iran, while their military followers, the Buyids, managed to establish a more lasting state that seized Baghdad in 945, enduring until the takeover by the Seljuk Turks in 1055. The degree to which these dynasties actively promoted Persian language and culture varied greatly. Despite the devolution of power to these dynasties, the Abbasid caliphs remained in office. Even if largely shorn of effective power, they remained useful to legitimize upstart rulers through granting them titles that justified their rule as appointees of the caliph.
The Body
Authors: Pedraza Gómez Zandra
Published: September 2023

Body studies in Latin America emerged in the last decade of the 20th century and encompassed disciplinary and interdisciplinary perspectives in the social sciences and humanities. Latin American research has drawn on various academic trends. Poststructuralist and phenomenological currents and analysis of discourse and representations stand out. Much research involves essential elements of postcolonial and decolonial theories. The field has been especially interested in the possibilities of criticizing power and politics in everyday experiences and between subordinate and marginal groups and subjects. The publication of Latin American authors in journals from the Global North is scarce. The Latin American academic tradition in body studies is mainly compiled in books that bring together articles by various authors. Distinctive approaches to anthropology and history are recognized, but many publications correspond to inter- and multidisciplinary interests. Critical studies derived from the reception of concepts on power, hegemony, difference, and inequalities point at problems concerning education, gender, race, violence, beauty, and sexuality. The orientations of archeology and the genealogy of power proposed by Michel Foucault to analyze the functioning and inflections in anatomical-political and biopolitical terms have been influential. In studies with a phenomenological orientation, psychosomatic problems related to therapeutics, self-modeling, social change, and practices for reconciliation or social transformation stand out. From these perspectives have emerged the emphasis on performance and aesthetic studies and approaches that integrate body and emotions. These approaches have been interested in recognizing and strengthening the human condition as integral as well as the corporeal nature of culture without ignoring the political nature of existence. From this perspective, the authors propose body interventions for social and educational change, therapies, and practices for reconciliation.
Kiryas Joel and Satmar
Authors: Myers David N.
Published: September 2023

Hasidism was the powerful Jewish pietist movement that took rise in eastern Europe in the late 18th century and spread widely throughout the region in the 19th century. Among the places where Hasidism found a particularly receptive audience was Hungary, especially the northeast quadrant known as the Unterland. It was there that the Teitelbaum family of rabbis emerged as purveyors of a stringent form of religious Orthodoxy that came to be known as haredi. A scion of the family, Rabbi Joel Teitelbaum (b. 1887–d. 1979), was appointed rabbi of the city of Satu Mare, Romania (formerly Szatmár, Hungary) in 1928; after six years of opposition in the city, he assumed his new job in 1934, thereby inaugurating the Satmar movement of Hasidism. Unlike most of his followers (and for some, quite controversially), Teitelbaum survived World War II, and eventually made his way to the United States in 1946. There he settled in the Williamsburg neighborhood of Brooklyn and began the work of rebuilding the Satmar community. Over the course of the past seventy years, the Satmars have grown into the largest Hasidic group in the world with some 150,000 estimated members in North America, Europe, Israel, South America, and Australia. One of Rabbi Teitelbaum’s goals upon settling in the United States was to create, alongside the home base in Williamsburg, an enclave outside of the city where members of the Satmar flock could lead their traditional lives without interference. It took decades to find an appropriate site at a remove from New York City, but still close enough to commute for employment. In the early 1970s, Rabbi Teitelbaum’s advisors, to whom he entrusted the task of finding a venue, purchased land in the town of Monroe in Orange County, New York. In the summer of 1974, the first Satmar settlers began arriving from Brooklyn to the newly built neighborhood in Monroe that was called “Kiryas Joel,” the village of Joel. In 1977, after several years of conflict with town officials, the Satmar community was officially incorporated as the village of Kiryas Joel within the town of Monroe. The community has grown from the first hundred residents in 1974 to over thirty thousand residents today, almost all of whom are Satmar Hasidim. In 2019, Kiryas Joel residents ended decades of acrimony by exiting the town of Monroe altogether to create the new town of Palm Tree (the English for Teitelbaum).
Social innovation, transformation, and public policy: towards a conceptualization and critical appraisal
Authors: Edler Jakob , Ostertag Katrin , Schuler Johanna
Published: September 2023

This article conceptualizes the role of social innovation (SI) in transformational innovation policy, identifies policy options, and points out potential risks of mobilizing SI for transformations. We illustrate our conceptual claims based on selected policy examples and propose a set of distinctions about the basic role of policy for SI in the context of transformation. We distinguish the importance of SI for the two policy approaches: transformative innovation policy and mission-oriented innovation policy. It follows that politics must differentiate between the various types of SI and their different significance for missions and transformations. To decide whether and how policy intervenes, ex ante and ex post analyses of the transformational effects of SI and the policies that act on them must be developed and applied. It is crucial to accompany and promote the diversity of SIs politically in such a way that they can constructively unfold their transformation potential.
DNA methylome profiling in occupational radon exposure miners using an Illumina Infinium Methylation EPIC BeadChip
Authors: Zhang Pinhua , Wu Yunyun , Piao Chunnan , Song Yanchao , Zhao Yanfang , Lyu Yumin , Sun Quanfu , Liu Jianxiang
Published: September 2023

Background

A causal relationship between occupational radon exposure in underground miners and lung cancer risk has been demonstrated through large cohort epidemiological studies. However, the mechanisms by which radon exposure causes adverse effects on lung tissue remain unclear. Epigenetic alterations such as DNA methylation may provide new insights into interactions at molecular levels induced by prolonged radon exposure.

Methods

We used the Illumina Infinium Human Methylation 850 K BeadChip to detect and compare genome-wide DNA methylation profiles in peripheral blood samples from underground miners (n = 14) and aboveground workers (n = 9).

Results

The average concentration of radon in underground workplaces was significantly higher than that of aboveground places (1,198 Bq·m−3 vs 58 Bq·m−3, p < 0.001). A total of 191 differentially methylated positions (DMPs) corresponding to 104 hub genes were identified when |Δβ| ≥ 0.1 and p < 0.05, with 107 hypermethylated sites and 84 hypomethylated sites. GO and KEGG analysis revealed that differentially methylated genes between underground miners and aboveground workers were prominently enriched in pathways/networks involved in neurotransmitter regulation, immunomodulatory effects and cell adhesion ability. Furthermore, methylation changes of selected genes FERMT1, ALCAM, HLA-DPA1, PON1 and OR2L13 were validated by pyrosequencing, which may play vital roles in these biological processes induced by radon.

Conclusion

In summary, the DNA methylation pattern of the underground miners exposed to radon was distinct from that of the aboveground workers. Such abnormalities in the genomic DNA methylation profile associated with prolonged radon exposure are worth studying in terms of neuro- and immune-system regulation, as well as cell adhesion ability in the future.
Assessing Foliar Fungicides for Soybean Disease Management and Yield in Indiana
Authors: Brown Mariama T. , Shim Su , Da Silva Camila R. , Waibel Kaitlin G. , Telenko Darcy E. P.
Published: September 2023

Foliar diseases can significantly impact soybeans in Indiana, and fungicides can be an effective management tool to protect yield against disease. Fourteen foliar fungicide products were evaluated for efficacy on soybean foliar diseases and yield in 10 field trials from 2019 to 2021 in Indiana. Fungicides were applied at their recommended rates in a single application at the beginning pod (R3) growth stage. Cercospora leaf blight ( Cercospora spp.), brown spot ( Septoria glycines Hemmi), and frogeye leaf spot ( Cercospora sojina Hara) were the most prominent foliar diseases observed in the trials. Under low to moderate Cercospora leaf blight disease pressure, there were no significant differences between foliar fungicides and the nontreated control averaged across all site-years. In contrast, all foliar fungicides significantly suppressed brown spot from 69 to 92% relative to the nontreated control. Only bixafen + flutriafol and azoxystrobin + pydiflumetofen + propiconazole significantly suppressed frogeye leaf spot severity over the nontreated control. Foliar fungicide applications did not significantly increase yield over the nontreated control across all site-years. Therefore, under low to moderate foliar disease risk, fungicide applications may not be warranted in Indiana. Growers should continue to scout soybean fields prior to the beginning pod (R3) growth stage, then make an informed, sustainable decision to use a fungicide for disease management.
Nursing Students’ Self-Efficacy and Performance in Self-Management Support for Patients in Rural Primary Care
Authors: Abuatiq Alham , Brown Robin , Kvigne Valborg , Schmit Marie , Hultman Cassy , Plemmons Christina , Currier Danielle , Mennenga Heidi
Published: September 2023

There is currently no evidence of undergraduate nursing students’ self-efficacy and performance in self-management support for chronic diseases in rural primary care. Using the Self-Efficacy and Performance in Self-Management Support instrument, this quasi-experimental study assessed students’ self-efficacy and performance in self-management support before and after implementation of a primary care enhanced curriculum. Nursing students (n = 140) reported a significant increase in total mean scores (pretest, M = 268.01; posttest, M = 289.51), p = .0001. Providing a primary care enhanced curriculum increased nursing students’ self-efficacy and performance in self-management support.
Tracheal Agenesis
Authors: Hackman Pamela S. , Stephens Heather
Published: September 2023

Background:

Tracheal agenesis is a rare and often fatal congenital anomaly that occurs early in fetal development. Tracheal agenesis occurs in one in 50,000 to 100,000 live births. This case study describes the nursing aspect of caring for this type of patient.

Clinical Findings:

Airway anomalies in neonates can be diagnosed immediately at birth or later when the infant develops respiratory distress or respiratory failure. Diagnosis and management of tracheal agenesis is difficult and a complex problem requiring a multidisciplinary medical team's expert approach for its treatment.

Primary Diagnosis:

Respiratory distress syndrome versus tracheoesophageal fistula was suspected.

Interventions:

The infant quickly decompensated, requiring intubation and eventual transfer to our tertiary care center for further evaluation of a possible airway anomaly. Because of deteriorating status, surgery was performed, and it was discovered the patient had tracheal agenesis, requiring the development of a 3-dimensional trachea specific for this patient.

Outcomes:

This article describes the nursing aspect of caring for this type of patient.

Practice Recommendations:

This article describes the success of nursing interventions and teamwork among nursing and the multidisciplinary team for the successful discharge of this patient home to her family.
Predictors of Stress Exposure in Hospitalized Preterm Infants
Authors: Nist Marliese Dion , Harrison Tondi M. , Shoben Abigail B. , Pickler Rita H.
Published: September 2023

Background:

Stress exposure in the neonatal intensive care unit (NICU) is associated with poor outcomes in preterm infants. However, factors predicting subsequent NICU stress exposure have not been identified.

Purpose:

To characterize NICU stressors experienced by preterm infants during the first 2 weeks of life and identify demographic, perinatal, and institutional variables associated with stress exposure.

Methods:

A secondary analysis of data from a nonexperimental, prospective study was conducted using data from 60 very preterm infants born 28 to 31 weeks gestational age. Stress exposures during the first 2 weeks of life, operationalized as number of invasive procedures, were characterized by type and quantity for each infant using data extracted from electronic health records. Associations between number of invasive procedures and demographic, perinatal, or institutional variables were analyzed using linear regressions with robust standard errors.

Results:

Preterm infants experienced, on average, 98 (SD = 41.8) invasive procedures. Of these invasive procedures, nasal and/or oral suctioning episodes (58.1%), followed by skin-breaking procedures (32.6%), were most frequent. Differences in the number of invasive procedures were found for maternal race; infants born to Black mothers experienced fewer total invasive procedures than infants born to White mothers. The number of invasive procedures also varied across NICUs.

Implications for Practice and Research:

Preterm infant stress exposure differed by maternal race and NICU, consistent with research findings of differential treatment of diverse infants. Further research is needed to understand the reasons for these differences and to identify best practices to standardize neonatal care.
Foreign Language Acquisition in Adolescent Cochlear Implant Users
Authors: Everhardt Marita K. , Jung Dorit Enja , Stiensma Berrit , Lowie Wander , Başkent Deniz , Sarampalis Anastasios
Published: September 2023

Objectives:

This study explores to what degree adolescent cochlear implant (CI) users can learn a foreign language in a school setting similar to their normal-hearing (NH) peers despite the degraded auditory input.

Design:

A group of native Dutch adolescent CI users (age range 13 to 17 years) learning English as a foreign language at secondary school and a group of NH controls (age range 12 to 15 years) were assessed on their Dutch and English language skills using various language tasks that either relied on the processing of auditory information (i.e., listening task) or on the processing of orthographic information (i.e., reading and/or gap-fill task). The test battery also included various auditory and cognitive tasks to assess whether the auditory and cognitive functioning of the learners could explain the potential variation in language skills.

Results:

Results showed that adolescent CI users can learn English as a foreign language, as the English language skills of the CI users and their NH peers were comparable when assessed with reading or gap-fill tasks. However, the performance of the adolescent CI users was lower for English listening tasks. This discrepancy between task performance was not observed in their native language Dutch. The auditory tasks confirmed that the adolescent CI users had coarser temporal and spectral resolution than their NH peers, supporting the notion that the difference in foreign language listening skills may be due to a difference in auditory functioning. No differences in the cognitive functioning of the CI users and their NH peers were found that could explain the variation in the foreign language listening tasks.

Conclusions:

In short, acquiring a foreign language with degraded auditory input appears to affect foreign language listening skills, yet does not appear to impact foreign language skills when assessed with tasks that rely on the processing of orthographic information. CI users could take advantage of orthographic information to facilitate foreign language acquisition and potentially support the development of listening-based foreign language skills.
Combined Hyperselective Neurectomy and Fractional Lengthening Technique for Triceps Spasticity
Authors: Pino Paula A. , Wu Kitty Y. , Rhee Peter C.
Published: September 2023

Triceps spasticity can occur in patients with upper motor neuron syndrome. It is often undetected when there is predominant elbow flexion spasticity and/or contracture. This condition can become apparent after surgery for elbow flexor spasticity, leading to impaired active elbow. Although triceps muscle-tendon lengthening procedures can be performed, these techniques do not directly address the issue of spasticity which is neurally mediated. This article presents a surgical technique for addressing triceps spasticity with a combined approach of hyperselective neurectomy of the medial head of the triceps and muscle-tendon lengthening of the long and lateral heads.
Ambulatory Care Coordination Data Gathering and Use
Authors: Geary Carol Reynolds , Hook Mary , Popejoy Lori , Smith Erica , Pasek Lana , Heermann Langford Laura , Hewner Sharon
Published: September 2023

Care coordination is a crucial component of healthcare systems. However, little is known about data needs and uses in ambulatory care coordination practice. Therefore, the purpose of this study was to identify information gathered and used to support care coordination in ambulatory settings. Survey respondents (33) provided their demographics and practice patterns, including use of electronic health records, as well as data gathered and used. Most of the respondents were nurses, and they described varying practice settings and patterns. Although most described at least partial use of electronic health records, two respondents described paper documentation systems. More than 25% of respondents gathered and used most of the 72 data elements, with collection and use often occurring in multiple locations and contexts. This early study demonstrates significant heterogeneity in ambulatory care coordination data usage. Additional research is necessary to identify common data elements to support knowledge development in the context of a learning health system.
Guideline adherence to statin therapy and association with short-term and long-term cardiac complications following noncardiac surgery
Authors: Glarner Noemi , Puelacher Christian , Gualandro Danielle Menosi , Lurati Buse Giovanna , Hidvegi Reka , Bolliger Daniel , Lampart Andreas , Burri Katrin , Pargger Mirjam , Gerhard Hatice , Weder Samantha , Maiorano Silvia , Meister Rebecca , Tschan Carla , Osswald Stefan , Steiner Luzius A. , Guerke Lorenz , Kappos Elisabeth A. , Clauss Martin , Filipovic Miodrag , Arenja Nisha , Mueller Christian
Published: September 2023

BACKGROUND

Peri-operative complications are common and associated with high morbidity and mortality. Optimising the use of statins might be of important benefit in peri-operative care and reduce morbidity and mortality.

OBJECTIVE

To evaluate adherence to current guideline recommendations regarding statin therapy and its association with peri-operative and long-term cardiac complications.

DESIGN

Prospective cohort study.

SETTING

Multicentre study with enrolment from October 2014 to February 2018.

PATIENTS

Eight thousand one hundred and sixteen high-risk inpatients undergoing major noncardiac surgery who were eligible for the institutional peri-operative myocardial injury/infarction (PMI) active surveillance and response program.

MAIN OUTCOME MEASURES

Class I indications for statin therapy were derived from the current ESC Clinical Practice Guidelines during the time of enrolment. PMI was prospectively defined as an absolute increase in cTn concentration of the 99th percentile in healthy individuals above the preoperative concentration within the first three postoperative days. Long-term cardiac complications included cardiovascular death and spontaneous myocardial infarction (MI) within 120 days.

RESULTS

The mean age was 73.7 years; 45.2% were women. Four thousand two hundred and twenty-seven of 8116 patients (52.1%) had a class I indication for statin therapy. Of these, 2440 of 4227 patients (57.7%) were on statins preoperatively. Adherence to statins was lower in women than in men (46.9 versus 63.9%, P < 0.001). PMI due to type 1 myocardial infarction/injury (T1MI; n = 42), or likely type 2 MI (lT2MI; n = 466) occurred in 508 of 4170 (12.2%) patients. The weighted odds ratio in patients on statin therapy was 1.15 [95% confidence interval (CI) 1.01 to 1.31, P = 0.036]. During the 120-day follow-up, 192 patients (4.6%) suffered cardiovascular death and spontaneous MI. After multivariable adjustment, preoperative use of statins was associated with reduced risk; weighted hazard ratio 0.59 (95% CI 0.41 to 0.86, P = 0.006).

CONCLUSION

Adherence to guideline-recommended statin therapy was suboptimal, particularly in women. Statin use was associated with an increased risk of PMI due to T1MI and lT2MI but reduced risk of cardiovascular death and spontaneous MI within 120 days.

TRIAL REGISTRATION

Clinicaltrials.gov identifier NCT02573532
Assessment of explicit and implicit memories during remimazolam anaesthesia using the process dissociation procedure
Authors: Kim Kyung Mi , Bang Ji-Yeon , Choi Byung-Moon , Noh Gyu-Jeong
Published: September 2023

BACKGROUND

Memory formation during remimazolam anaesthesia, where a bispectral index (BIS) is sometimes not maintained at less than 60 despite the maximal dose, is worthy of evaluation.

OBJECTIVE

Investigate the formation of explicit and implicit memories using the process dissociation procedure during remimazolam anaesthesia at a BIS of 60 to 80.

DESIGN

A prospective cohort study.

SETTING

A tertiary medical centre in Seoul, South Korea, between March 2022 and July 2022.

PATIENTS

One hundred patients undergoing general anaesthesia using remimazolam.

INTERVENTIONS

The BIS was maintained at 60 to 80 during anaesthesia induction with remimazolam. Words were spoken to patients via headphones for 15 min.

MAIN OUTCOME MEASURE

The primary outcome was the probability of explicit or implicit memory formation as calculated using the original and extended models, within 24 h after word presentation. Conscious recall memory was assessed using a short-structured interview within 1 and 24 h after surgery. Memory formation was inferred to be absent if 0 was included in the 95% confidence interval (CI) of the probability.

RESULTS

The main results showed no evidence of explicit or implicit memory. The 95% CI of the probability of explicit memory formation included 0 for both models, –0.01 (–0.04 to 0.02) and –0.04 (–0.10 to 0.01), respectively. The 95% CI of the probability of implicit memory formation did not include 0 when evaluated using the original model, 0.08 (0.06 to 0.10), but included 0 when evaluated using the extended model, 0.00 (–0.03 to 0.03). The modified Brice interview revealed no evidence of awareness.

CONCLUSIONS

There was no evidence of explicit or implicit memory formation during remimazolam anaesthesia (BIS 60 to 80). Further research is warranted to establish whether explicit and implicit memories are still absent even in the presence of surgical stimulation.

CLINICAL TRIAL REGISTRATION

KCT0006752 (http://cris.nih.go.kr)
Twitter Buzz and Citations: Who’s Tweeting Matters for Plastic Surgery Literature
Authors: Slovacek Cedar , Cook Tracey , Sheppard Acacia , Palacios Pablo , Bradley James P. , Chen Kevin C.
Published: September 2023

Background:

Plastic surgery and social media have become inextricably linked through patient procurement, practice growth, and academic exposure. Other surgical fields have demonstrated that tweeting is positively correlated with increased citations. This study aimed to elucidate the effect of Twitter on traditional bibliometrics in plastic surgery and parse out the kinds of tweets that are most correlated with citations.

Methods:

Articles from May to October of 2018 from Plastic and Reconstructive Surgery and Aesthetic Surgery Journal were analyzed to determine the citation count, number and backgrounds of Twitter users tweeting about the article, and total tweets. Multiple linear regression was performed to correlate these variables to citation count.

Results:

A total of 369 articles were analyzed. Plastic and Reconstructive Surgery had significantly more average tweets per article compared to Aesthetic Surgery Journal (21.8 versus 10.2, P < 0.001), Additionally, a number of tweets (r = 0.45, P < 0.001) and reaching more total followers (r = 0.48, P < 0.001) were both positively correlated with citations. Multiple linear regression demonstrated that tweets from self-identified scientists were positively correlated with citations (r = 0.99, P = 0.001). Tweets from science communicators had no correlation with citations (r = −0.012, P = 0.726). Tweets coming domestically from the country of the author were also associated with more citations (r = 0.164, P = 0.013).

Conclusions:

Twitter activity, including the number of followers reached, for an article is positively correlated with citations. Interestingly, the kind of person tweeting affected the citations as well. Domestic tweets and those from scientists were associated with more citations. This implies that Twitter can be an effective form of academic dissemination, provided the “right” Twitter users are promoting the article.
Multi-Zonal Outer Retinopathy and Retinal Pigment Epitheliopathy (MORR). A Newly Recognized Entity or an Unusual Variant of AZOOR?
Authors: Ramtohul Prithvi , Marchese Alessandro , Introini Ugo , Goldstein Debra A. , Freund K. Bailey , Jampol Lee M. , Yannuzzi Lawrence A.
Published: September 2023

Purpose:

To describe specific clinical, multimodal imaging, and natural history features of an unusual variant of acute zonal occult outer retinopathy (AZOOR).

Methods:

Retrospective, observational, longitudinal, multi-center case series. Patients exhibiting this unusual clinical condition among cases previously diagnosed with AZOOR were included. Multimodal imaging, laboratory evaluations and genetic testing for inherited retinal diseases were reviewed.

Results:

Twenty eyes from 10 patients (8 females and 2 males) with a mean age of 54.1±13.3 years (range, 38-71 years) were included. The mean follow-up duration was 13.1±5.3 years (range, 8-23 years). Presenting symptoms were bilateral in 7 patients (85% of eyes) and included scotomata and photopsia. All patients had bilateral lesions at presentation involving the peripapillary and far peripheral retina. Baseline optical coherence tomography showed alteration of both the retinal pigment epithelium (RPE) and photoreceptor layers corresponding to zonal areas of fundus autofluorescence abnormalities. Centrifugal and centripetal progression of the peripapillary and far-peripheral lesions, respectively, occurred over the follow-up resulting in areas of complete outer retinal and RPE atrophy.

Conclusions:

Initial alteration of both photoreceptors and RPE and a stereotypical natural course, that includes involvement of the far retinal periphery, characterize this unusual condition. It may represent a variant of AZOOR or may be a new entity. We suggest to call it multizonal outer retinopathy and retinal pigment epitheliopathy (MORR).
Polypoidal Lesions Associated with Choroidal Nevi
Authors: Gomel Nir , Goldstein Michaella , Fung Adrian T. , Iovino Claudio , Tatti Filippo , Peiretti Enrico , Habot-Wilner Zohar , Loewenstein Anat , Iglicki Matias , Zur Dinah
Published: September 2023

Purpose:

To investigate eyes with polypoidal lesions associated with choroidal nevi, their multimodal imaging characteristics, and long clinical follow-up.

Methods:

Multicenter, retrospective case series study of patients with polypoidal lesions overlying choroidal nevi. Demographic and clinical information was recorded. Multimodal imaging including colour fundus photography (CFP), optical coherence tomography (OCT), OCT angiography, fundus fluorescein angiography (FA), indocyanine angiography (ICGA) and A- and B-scan ultrasonography were analyzed for nevus and polypoidal lesion characteristics.

Results:

Fourteen eyes (14 patients; mean age: 70.3±6.7 years) with polypoidal lesions overlying choroidal nevi were included. The mean follow-up duration was 50.0±27.9 months (range 12-108). All nevi were pigmented on CFP, flat on ultrasonography with a mean basal diameter of 3.8±0.4 mm. In all but one eye, OCT showed a shallow irregular pigment epithelium detachment (SIRE) overlying the nevus. A total of 11/14 eyes (78.6%) had exudative activity, 9 eyes received intravitreal anti-vascular endothelial growth factor (VEGF) injections, and one eye required intravitreal anti-VEGF combined with photodynamic therapy (PDT). Mean visual acuity was 20/32 at baseline and 20/50 at final visit.

Conclusions:

We present the largest known cohort of eyes with polypoidal lesions associated with choroidal nevi with up to 9 years follow-up. The exudative degree of the polypoidal lesion in this condition is variable and treatment decisions should be taken on an individual basis. We hypothesize that choroidal ischemia due to altered choroidal vasculature rather than Haller layer hyperpermeability plays a role in the formation of polypoidal lesions overlying nevi.
Impact of Methylprednisolone Pulse on the Mortality of Patients With Acute Respiratory Distress Syndrome Secondary to COVID-19
Authors: Sousa Adrián , Lima Olalla , Pérez-González Alexandre , Araujo Alejandro , Longueira Rebeca , Otero Antón , Núñez Marta , Ramos Cristina , Martínez-Lamas Lucía , Crespo-Casal Manuel , Rubianes Martin , Pérez-Rodríguez María Teresa
Published: September 2023

Introduction

Corticosteroids have been thoroughly used in the treatment of COVID-19. The aim of the study was to analyze the impact of methylprednisolone pulse on in-hospital mortality of patients with acute respiratory distress syndrome (ARDS) due to COVID-19.

Methods

We conducted a retrospective, single-center observational study. We selected adult patients admitted to the hospital with the diagnosis of COVID-19 between March and June 2020. Cox regression was used to identify the factors associated with in-hospital mortality.

Results

A total of 306 patients were analyzed. In-hospital crude mortality rate was 17%. Diabetes mellitus (hazard ratio [HR], 5.5; 95% confidence interval [CI], 1.40–4.55), dementia (HR, 7.7; 95% CI, 4.25–13.87) and ARDS (HR, 4.2; 95% CI, 2.34–7.46) were associated with in-hospital mortality. In patients with ARDS diagnosis, the only in-hospital mortality risk factor was dementia (HR, 5.2; 95% CI, 2.44–11.07), whereas methylprednisolone pulse was a protective factor (HR, 0.2; 95% CI, 0.09–0.63). In the follow-up, 40% of patients had some symptom related to COVID-19.

Conclusions

Methylprednisolone pulse reduced the in-hospital mortality in patients with ARDS due to COVID-19. A high percentage of patients presented persistent symptoms in 90 days after the hospital discharge.
Effect of pelvic floor muscles exercises by extracorporeal magnetic innervations on the bladder neck and urinary symptoms
Authors: Chang Chieh-Yu , Tang Feng-Hsiang , Lin Kun-Ling , Liu Yi-Yin , Loo Zi-Xi , Long Cheng-Yu
Published: September 2023

Background:

This study aimed to investigate the changes in the bladder neck (BN) and urinary symptoms using extracorporeal magnetic innervation (ExMI) therapy before and after performing passive pelvic floor exercises.

Methods:

Twenty women with stress urinary incontinence (SUI) were assessed by transperineal ultrasound and questionnaires before and after the ExMI therapy from January 2011 to February 2021.

Results:

The incidence of urinary frequency and SUI were significantly decreased after the therapy (McNemar test, p < 0.01). The therapeutic efficacy of SUI was 75%. A significant decrease was noted in pad test results (paired t test, p < 0.05). At the same time, there was a considerable difference in Urinary Distress Inventory-6 scale measures (paired t test, p < 0.001). However, results for the Incontinence Impact Questionnaire-7 showed a marginally significant difference (paired t test, p = 0.066). Three domains of lubrication, orgasm, and satisfaction in the Female Sexual Function Index showed significant differences (paired t test, p < 0.05). Transperineal ultrasound found that BN mobility and Q-tip straining angle were not statistically significant (paired t test, p > 0.05).

Conclusion:

The ExMI is effective for SUI by strengthening the pelvic floor muscle without significantly decreasing BN mobility.
We Have to Really Decide
Authors: Osteen Kathryn , Tucker Cheryl A. , Meraz Rebecca
Published: September 2023

Background

Medical management and surgical improvement techniques permit persons with congenital heart conditions to live longer. Adults with congenital heart disease (CHD) have more childbearing options than previously available to them. However, there is an increased childbearing risk associated with certain types of CHD. Minimal investigation has been given to the childbearing decision-making experiences and adaptation of women with CHD.

Objective

The aim of this study was to gain insight into the childbearing decision-making and adaptation experiences of women with CHD.

Methods

Using a narrative inquiry approach, 17 adult women with CHD of any severity, of childbearing age, who had, within the last 5 years, made a decision regarding childbearing, were interviewed. In this study, we applied the key components of the Roy Adaptation Model to understand childbearing decision-making experiences and their adaptation. Data were analyzed using thematic analysis.

Results

Data analysis revealed 5 stages of childbearing decision making: (1) prologue: stimulus to consider childbearing; (2) exploring childbearing options; (3) considering childbearing options; (4) choosing to bear or not to bear a child; and (5) epilogue: adapting to the childbearing decision. Adaptation occurred in the areas of self-concept (ie, emotional adaptation), role function (ie, relational adaptation), and interdependence (ie, interactional adaptation).

Conclusion

Childbearing decision making is a complex personal decision that is carefully and deliberately made. Women with CHD long for children and seek childbearing information from various resources and may experience grief regarding the inability to bear children. A greater understanding of childbearing decision making can be useful in addressing women's childbearing emotions and assist with adaptation to childbearing needs.
Incidence and risk factors for occult lesions in low-risk papillary thyroid microcarcinoma patients with tumor characteristics appropriate for thermal ablation: A retrospective study
Authors: Jin Langping , Zhu Kaijun , Xu Changliang , Lu Jiaying , Huang Liming
Published: September 2023

In recent years, thermal ablation has been increasingly employed for the treatment of low-risk papillary thyroid microcarcinoma (PTMC) across various institutions. Its use as a standard or initial treatment continues to be a subject of debate. Retrospective analyses of the surgical pathology in post-ablation patients have indicated that occult lesions are not uncommon. This retrospective study aimed to examine the incidence and risk factors of occult lesions via postoperative pathology in low-risk PTMC patients who fulfilled the criteria for thermal ablation therapy. We examined the medical records of patients who underwent thyroid surgery and had a Bethesda classification V or VI based on fine needle aspiration cytology between November 22, 2020, and December 31, 2022. A total of 413 patients with preoperative tumor characteristics appropriate for thermal ablation were included in this study. Occult lesions, encompassing ipsilateral or contralateral occult carcinoma or central lymph node metastases may have occurred in 34.7% of patients. Male gender (OR: 2.526, 95% CI: 1.521–4.195, P = .000), tumor location in the lower pole (OR: 1.969, 95% CI: 1.186–3.267, P = .009), multiple microcalcifications (OR: 5.620, 95% CI: 2.837–11.134, P = .000), and Hashimoto’s thyroiditis (OR: 2.245, 95% CI: 1.292–3.899, P = .004) were independent risk factors for the presence of occult lesions. In low-risk PTMC patients exhibiting tumor characteristics amenable to thermal ablation, over one-third of the patients may present with occult lesions. Meticulous evaluation of the presence of additional lesions is necessary before performing thermal ablation, particularly in patients exhibiting high-risk factors for occult lesions.
Investigating the association of breast cancer and stroke: A two-sample Mendelian randomization study
Authors: Qu Huiling , He Chao , Xu Haichun , Sun Xiaoyu
Published: September 2023

We conducted a two-sample Mendelian randomization (MR) design to evaluate the causal relation between breast cancer and stroke. Genetic variants associated with breast cancer and stroke were both obtained from genome-wide association study summary data. The single nucleotide polymorphisms were selected as instrumental variables. Effect estimates were primarily evaluated using standard inverse variance weighted. Finally, sensitivity analyses were performed for the detection of potential pleiotropy and heterogeneity in the cause-effect evaluation. There was a causal association of ER-positive breast cancer (odds ratio = 0.11, 95% confidence interval: 0.08–0.16, P < .001), and ER-negative breast cancer (odds ratio = 1.04, 95% confidence interval: 1.00–1.07, P = .045) with stroke. MR-egger regression revealed that the cause-effect of ER-positive breast cancer (P < .001) is drove by the directional horizontal pleiotropy, while there was no directional pleiotropy in the cause-effect of ER-negative breast cancer (P = .82). Cochran Q-derived P-value from inverse variance weighted (P = .27) shown that the cause-effect of ER-negative breast cancer on stroke do not need to consider the effect of heterogeneity. In addition, the leave-one-out analysis showed no influential instruments driving the associations, suggesting robust results for all outcomes. The present MR study reveals that ER negative breast cancer increase the risk of stroke.
The directed acyclic graph helped identify confounders in the association between coronary heart disease and pesticide exposure among greenhouse vegetable farmers
Authors: Li Honghui , Zheng Cheng , Zhang Yue , Yang Huifang , Li Jiangping
Published: September 2023

To explore the causal pathways associated with coronary heart disease (CHD) and pesticide exposure using a directed acyclic graph (DAG) analysis and to investigate the potential benefits of DAG by comparing it with logistic regression. This cross-sectional study enrolled 1368 participants from April 2015 to May 2017. Trained research investigators interviewed farmers using a self-administered questionnaire. Logistic regression and DAG models were used to identify the associations between CHD and chronic pesticide exposure. A total of 150 (11.0%) of the 1368 participants are characterized as having CHD. High pesticide exposure (odds ratio = 2.852, 95% confidence intervals: 1.951–4.171) is associated with CHD when compare with low pesticide exposure by both DAG and logistic analyses. After adjusting for the additional potential influence of factors identified by the DAG analysis, there is no significant association, such as the results in logistic regression: ethnicity, education level, settlement time, and mixed pesticide status. Specifically, age, meal frequency, and consumption of fresh fruit, according to the DAG analysis, are independent factors for CHD. High pesticide exposure is a risk factor for CHD as indicated by both DAG and logistic regression analyses. DAG can be a preferable improvement over traditional regression methods to identify sources of bias and causal inference in observational studies, especially for complex research questions.
Analgesic comparison of erector spinae plane block with intercostal nerve block for thoracoscopic surgery: A meta-analysis of randomized controlled trials
Authors: Ma Guineng , Gou Jiwei , Chen Limimg , Qiao Xiaojian
Published: September 2023

Introduction:

The analgesic efficacy of erector spinae plane block (ESPB) versus intercostal nerve block (ICNB) for thoracoscopic surgery remains controversial. We conducted a systematic review and meta-analysis to explore the impact of ESPB versus ICNB on thoracoscopic surgery.

Methods:

We searched PubMed, EMbase, Web of Science, EBSCO, and Cochrane library databases through May 2023 for randomized controlled trials (RCTs) assessing the effect of ESPB versus ICNB on thoracoscopic surgery. This meta-analysis was performed using the random-effect model or fixed-effect model based on the heterogeneity.

Results:

Four RCTs and 203 patients are included in the meta-analysis. Overall, compared with ICNB for thoracoscopic surgery, ESPB results in significantly reduced pain scores at 48 hours (SMD [standard mean difference] = −3.49; 95% CI [confidence interval] = −6.76 to −0.21; P = .04), but demonstrated no impact on pain scores at 24 hours (SMD = −0.04; 95% CI = −1.24 to 1.16; P = .95), pain scores at 4 to 6 hours (SMD = −0.16; 95% CI = −2.02 to 1.71; P = .87), pain scores at 12 hours (SMD = −0.16; 95% CI = −2.38 to 2.05; P = .88) or analgesic consumption (SMD = 0.27; 95% CI = −0.80 to 1.35; P = .62).

Conclusions:

ESPB may be comparable with ICNB for the postoperative pain control of thoracoscopic surgery.