bluuebunny/crossref_metadata_2025 huggingface dataset:
Awake Intubation and Airway Blocks
Authors: Luansritisakul Choopong , Vlassakov Kamen V. , Zinboonyahgoon Nantthasorn
Published: April 2023

Awake fiberoptic intubation (a more accurate term would be flexible endoscopic intubation) is still considered the gold standard and the ultimate backup approach for difficult airway management. To perform the procedure successfully and minimize patient discomfort, a number of methods have been utilized to provide anesthesia for the upper airway. Each of them has its own advantages and disadvantages. It is important for an anesthesiologist to understand these techniques and to be able to choose and perform them properly. In this chapter, the innervation of the upper airway is described, and both topical and regional anesthesia techniques are discussed in detail.
Regional Techniques for Cardiothoracic and Cardiac-Related Procedures
Authors: Shariat Ali N. , Bhatt Himani V.
Published: April 2023

Pain intensity after cardiac surgery is often severe and is not adequately treated. Inadequately treated postoperative pain has adverse physiologic effects in the postoperative period and is a risk factor of the development of chronic pain. Chronic pain following sternotomy has an incidence ranging from 11% to 56% at 1 year after surgery. Multimodal pain management, including regional anesthesia, has an increasingly important role. The use of regional anesthesia provided good hemodynamic stability, analgesia, less opioid use, and allowed for early extubation. Neuraxial anesthesia have been extensively studied in the context of cardiac surgery, but the risk of neuraxial hematoma in the setting of full heparinization limits the use of this modality. Compared to neuraxial techniques, paravertebral blocks may offer the advantage of a lower risk of bleeding complications. Alternatives to neuraxial blocks have become available. Parasternal blocks include pecto-intercostal fascial block (PIFB) and transversus thoracic plane (TTP) block, or parasternal infiltration done by the surgeon. Other fascial plane blocks, including pectoral nerve, serratus anterior plane, and erector spinae, are found useful based on the type of the procedure. Reports of the successful use of these blocks in minimally invasive cardiac surgery keeps emerging as well. Literature is still evolving about the successful use of certain blocks in conventional cardiac pacemakers and recently in subcutaneously implantable cardioverter-defibrillators (S-ICDs). Potential benefits include better analgesia and less use of general anesthesia, which can be especially helpful.
Video-Assisted Thoracoscopy and Thoracotomy
Authors: Agyekum Davies G. , Grosh Taras
Published: April 2023

Pain management and chest physiotherapy are critical components of postoperative care following thoracic surgery. Effective management of acute pain is critical to ensure good pulmonary effort and function in an endeavor to decrease postoperative complications. Perioperative planning with discussions about surgical and anesthetic technique will have a significant impact on the postoperative course. Video-assisted thoracoscopy surgery (VATS) refers to the use of minimally invasive equipment to access thoracic structures during surgery through a series of small incisions. By contrast, an open thoracotomy is the surgical approach requiring a large incision and the spreading of the ribs to gain access to the thorax. A multimodal approach to analgesia, using a combination of systemic analgesia and regional analgesia procedures, has been used with success for pain management after thoracic surgery.
Postoperative Pain Management of Open Nephrectomy
Authors: Sidash Stanislav , Ranganath Yatish
Published: April 2023

Regional analgesia techniques employable for major abdominal surgery are reviewed in this chapter. Thoracic epidural analgesia (TEA) is widely used in clinical practice and is discussed here in detail. It is often advocated as the gold standard for analgesia for these procedures. However, the role of TEA is increasingly being challenged in the settings of enhanced recovery after surgery (ERAS) protocols and perioperative anticoagulation. Techniques like fascial plane blocks are being suggested as suitable alternatives. They are briefly discussed in this chapter. The chapter starts with the importance of the site of surgical incision and its effect on the respiratory muscles and the severity of postoperative pain. Different options available for postoperative pain management are discussed with a focus on TEA. Details of TEA administration, including placement, trouble shooting and management, epidural infusions used, common side effects and their management, are presented in detail. The use of alternative regional analgesia techniques in open abdominal surgery, such as paravertebral blocks, transversus abdominis plane block, rectus sheath blocks, quadratus lumborum blocks, and erector spinae blocks, is briefly presented in a separate section at the end of the chapter.
Arteriovenous Fistula Creation
Authors: Dienhart Peter , Kushelev Michael
Published: April 2023

The physiologic changes of end-stage renal disease (ESRD) requiring dialysis, in combination with the surgical goals for creation of an arteriovenous fistula (AVF), present significant challenges for the anesthesiologist. AVF is the preferred option for long-term dialysis access and the anesthetic choices may impact short-term patient morbidity and possibly the long-term function of the AVF for effective dialysis. Although general anesthesia is a mainstay for most surgical procedures, it is associated with an increase in overall morbidity and mortality in this vulnerable patient population. A number of regional anesthetic techniques provide a blunting of the sympathetic innervation of the arm. The subsequent vascular dilatation blunts vascular spasms during surgical manipulation and reliably increases blood flow through the anastomosis. Additionally, the sympathectomy created with regional anesthetics may allow for creation of a more favorable distal AVF. While the hemostatic, cardiovascular, and metabolic aberrations that accompany ESRD must be considered, peripheral nerve blocks may provide a more favorable risk-benefit profile. Despite the lack of definitive proof of the superiority of any one anesthetic choice on long-term fistula survival, a growing adoption of regional anesthesia has been observed, with the preponderance of scientific literature demonstrating short- and long-term gains.
Analgesia for Knee Arthroscopy and Anterior Cruciate Ligament Reconstruction
Authors: Feduska Michael , Feduska Colin
Published: April 2023

The anterior cruciate ligament (ACL) is the most injured knee ligament, with most injuries occurring in young athletes participating in non-contact sports. Surgical consultation with an orthopedic surgeon is needed to determine operative vs. non-operative management after ACL injury. Surgical intervention is decided based on multiple factors, including, but not limited to, the patient’s level of activity and the presence of concomitant injuries to the meniscus or other knee ligaments. Surgical repair of the ACL can be accomplished via knee arthroscopy using donor allografts or patient autografts. The torn ligament is removed, and small holes are created through the femur and the tibia into the joint space. The graft material is threaded through these holes and anchored on the exterior surfaces of the femur and tibia, with enough tension to mimic the original ligament. Rehabilitation of the knee begins as soon as possible, often in the recovery area with simple exercises, and continues for approximately 6 months after the surgery.
Regional Anesthesia and Analgesia for Cesarean Delivery
Authors: Martinello Caroline , Williams Matthew , Mhyre Jill M.
Published: April 2023

Regional anesthesia for cesarean delivery (CD) plays a pivotal role in improving outcomes for CD by both avoiding general anesthesia and improving perioperative pain control, which results in less chronic pain, less opioid use, improved maternal-fetal bonding, and decreased postpartum depression. While multiple neuraxial techniques can be utilized successfully for anesthesia, side effects can occur and if not recognized quickly can predispose patients to serious complications. Postoperative pain management poses unique considerations as both the patient and the newborn can be affected by postoperative pain. Management options available include neuraxial, regional, and intravenous management, utilized either separately or in combination. A personalized anesthetic plan should be utilized for each patient to identify patients at risk of suboptimal pain control such as the parturient on medication-assisted treatment for opioid use disorder. Familiarity with the various anesthetic options for both CD and postoperative analgesia will likely lead toward safer outcomes and improved patient satisfaction.
Epidural and Neuraxial Techniques in Newborns and Children
Authors: Horvath Balazs , Kloesel Benjamin
Published: April 2023

Pediatric neuraxial anesthesia has more than 100 years of well-documented history, yet these techniques are not as universally utilized in children as in adults. The exceptions are the caudal and, to lesser extent, the lumbar epidural approach. Subarachnoid (“spinal”) and thoracic epidural blocks are infrequently used in neonates, infants, and children. More recently an increasing concern has grown both within the anesthesia community and in society regarding the potential negative long-term impact of general anesthesia on the developing brain. That has revived the interest in anesthetic methods that offer either an alternative to or a way of mitigating the exposure to general anesthetic agents in pediatric patients. Neuraxial anesthesia is a viable option, either as the sole technique or in conjunction with general anesthesia to allow reductions in administered agents. This chapter describes indications and technical aspects of specific neuraxial blocks. It discusses the optimal circumstances of executing subarachnoid and epidural blocks in pediatric patients and reviews anatomical, physiological, developmental, and pharmacological considerations. The contraindications and complications of neuraxial blocks are also addressed. A thorough knowledge and understanding of all general aspects of neuraxial anesthesia, including their application in infants and children based on their unique needs, are essential to choose the most appropriate technique for the benefit of pediatric patients.
Acute Coronary Syndrome in a Patient With a Thoracic Epidural Catheter
Authors: Lai Yan , Jinadu Samiat
Published: April 2023

Thoracic epidural catheters are often used for acute perioperative pain management in complex and extensive thoracic and abdominal surgeries. There are important clinical considerations when managing an indwelling thoracic epidural catheter postoperatively, especially to prevent catastrophic bleeding complications such as thoracic epidural hematomas in unique scenarios where anticoagulation is employed concomitantly. The timing of catheter removal, timing of postoperative anticoagulation to prevent thromboembolic events or to maintain cardiac stent patency, and adequate neurologic monitoring to identify hemorrhagic consequences can be challenging for the physician anesthesiologist and acute pain medicine physician. Perioperative acute coronary syndrome (ACS) is a complication that can occur after major surgery. The contemporary treatment options for acute coronary syndrome involve cardiothoracic surgery or percutaneous coronary intervention (PCI), followed by administration of potent fibrinolytic agents or anticoagulants. The use of anticoagulants complicates the management of thoracic epidural catheters and can increase the risk of a thoracic epidural hematoma. Prompt diagnosis of a thoracic epidural hematoma in this setting through adequate monitoring, detailed neurological exam, or MRI is paramount to facilitate emergent surgical decompression and to prevent catastrophic and irreversible neurological deficits. This chapter presents a case of a surgical patient with an indwelling thoracic epidural catheter postoperatively who had an episode of ACS treated with PCI and subsequent dual antiplatelet therapy. The patient developed an epidural hematoma and underwent surgical decompression. The chapter reviews the literature and discusses diagnosis, management, treatment options, and prognosis.
Big Toe Amputation With Diabetic Peripheral Neuropathy
Authors: Nada Eman , Kopp Sandra L.
Published: April 2023

Diabetic peripheral neuropathy is the most common form of neuropathy in developed countries. Surgical procedures in people with diabetes are not uncommon, and the need for regional anesthesia in these patients continues to rise. Regional anesthesia provides satisfactory surgical conditions and good postoperative pain relief with little systemic effect. Diabetic nerves are more sensitive to local anesthetic toxicity. Due to that sensitivity, nerve blocks in these patients have higher success rates, shorter onset times, and a longer duration; in addition, patients generally require less postoperative analgesia. However, the incidence of neurologic injury in this patient cohort is higher than in patients without neuropathy. When performing nerve blocks in patients with diabetic peripheral neuropathy, providers must consider the risk-to-benefit ratio and avoid localizing the nerve-by-nerve stimulation alone. Ultrasound guidance can improve the accuracy of needle placement and help reduce the volume of local anesthetic used. Because local anesthetics are generally neurotoxic, lower volumes and concentrations are recommended.
Cauda Equina Syndrome After Spinal Anesthesia
Authors: Steffel Lauren , Neal Joseph M.
Published: April 2023

Cauda equina syndrome is a rare condition (but likely underestimated in incidence) that occurs with lesions to the nerve roots distal to the conus medullaris. Lower extremity sensorimotor loss, bowel/bladder dysfunction, and, variably, radicular back pain are the most common presentations. Associated etiologies for non-compressive cauda equina syndrome following spinal anesthesia include local anesthetic neurotoxicity, neural inflammation, spinal stenosis, and surgical positioning, but most cases are idiopathic. Spinal stenosis and certain surgical positioning are associated with higher incidence of CSE. Clinical presentation and physical examination may be nonspecific; therefore, timely evaluation and emergent neurologic consultation are paramount. Rapid and readily available CT imaging may rule out a reversible cause, such as a decompressible mass lesion. Treatment options are limited.
Nerve Blocks in a Patient With Multiple Sclerosis
Authors: Klesius Lisa L. , Borden Shelly B.
Published: April 2023

Multiple sclerosis (MS) is an immune-mediated inflammatory demyelinating disease of the nervous system. Etiology of MS includes environmental and genetic susceptibilities. An immune etiology related to a chronic viral infection has been proposed; however, no individual virus has been consistently associated with MS. In addition, a genetic predisposition has also been suggested. Perioperative management of patients with MS presents a challenge to the anesthesiologist given the heterogenous nature of the disease. Anesthetic decisions should be tailored to the patient’s phenotypic presentation, including disease severity, symptoms, and comorbidities, in addition to patient preferences. Regional anesthesia is generally safe in this category of patients. However, the decision to use it is based on the risk/benefit ratio. The chapter discusses the available evidence of the safety of using regional anesthetic techniques on patients with MS. Neuraxial anesthesia in MS pregnant patients is also discussed.
Anatomy of galactic star formation history: roles of different modes of gas accretion, feedback, and recycling
Authors: Noguchi Masafumi
Published: April 2023

We investigate how the diverse star formation histories observed across galaxy masses emerged using models that evolve under gas accretion from host haloes. They also include ejection of interstellar matter by supernova feedback, recycling of ejected matter and preventive feedback that partially hinders gas accretion. We consider three schemes of gas accretion: the fiducial scheme that includes the accretion of cold gas in low-mass haloes and high-redshift massive haloes as hinted by cosmological simulations; the flat scheme in which high-mass cold accretion is removed; and finally, the shock-heating scheme that assumes radiative cooling of the shock-heated halo gas. The fiducial scheme reproduces dramatic diminishment in star formation rate (SFR) after its peak as observed for the present halo mass $M_{\rm vir}\gt 10^{12.5}\, {\rm M}_\odot$ , while other two schemes show reduced or negligible quenching. This scheme reproduces the high-mass slope in the SFR versus stellar mass relation decreasing towards recent epochs, whereas other two schemes show opposite trend that contradicts observation. Success in the fiducial scheme originates in the existence of high-mass cold-mode accretion, which retards transition to the slow hot-mode accretion, thereby inducing a larger drop in SFR. Aided by gas recycling, which creates monotonically increasing SFR in low-mass haloes, this scheme can reproduce the downsizing galaxy formation. Several issues remain, suggesting non-negligible roles of missing physics. Feedback from active galactic nuclei could mitigate upturn of SFR in low-redshift massive haloes, whereas galaxy mergers could remedy early inefficient star formation.
Which is a better cosmological probe: number counts or cosmic magnification?
Authors: Duniya Didam G A , Kumwenda Mazuba
Published: April 2023

The next generation of cosmological surveys will have unprecedented measurement precision, hence they hold the power to put theoretical ideas to the most stringent tests yet. However, in order to realize the full potential of these measurements, we need to ensure that we apply the most effective analytical tools. We need to identify which cosmological observables are the best cosmological probes. Two commonly used cosmological observables are galaxy redshift number counts and cosmic magnification. Both of these observables have been investigated extensively in cosmological analyses, but only separately. In the light of interacting dark energy (IDE) emerging as a plausible means of alleviating current cosmological tensions, we investigate both observables on large scales in a universe with IDE, using the angular power spectrum, taking into account all known terms, including relativistic corrections, in the observed overdensity. Our results suggest that (given multitracer analysis) measuring relativistic effects with cosmic magnification will be relatively better than with galaxy redshift number counts, at all redshifts z . Conversely, without relativistic effects, galaxy redshift number counts will be relatively better in probing the imprint of IDE, at all z . At low z (up to around $z \, {=}\, 0.1$ ), relativistic effects enable cosmic magnification to be a relatively better probe of the IDE imprint, while at higher z (up to $z \, {\lt }\, 3$ ) galaxy redshift number counts become the better probe of IDE imprint. However, at $z \, {=}\, 3$ and higher, our results suggest that either of the observables will suffice.
A search for transients in the Reionization Lensing Cluster Survey (RELICS): three new supernovae
Authors: Golubchik Miriam , Zitrin Adi , Pierel Justin , Furtak Lukas J , Meena Ashish K , Graur Or , Kelly Patrick L , Coe Dan , Andrade-Santos Felipe , Asif Maor , Bradley Larry D , Chen Wenlei , Frye Brenda L , Gomez Sebastian , Jha Saurabh , Mahler Guillaume , Nonino Mario , Strolger Louis-Gregory , Su Yuanyuan
Published: April 2023

The Reionization Cluster Survey imaged 41 galaxy clusters with the Hubble Space Telescope (HST), in order to detect lensed and high-redshift galaxies. Each cluster was imaged to about 26.5 AB mag in three optical and four near-infrared bands, taken in two distinct visits separated by varying time intervals. We make use of the multiple near-infrared epochs to search for transient sources in the cluster fields, with the primary motivation of building statistics for bright caustic crossing events in gravitational arcs. Over the whole sample, we do not find any significant (≳5σ) caustic crossing events, in line with expectations from semi-analytical calculations but in contrast to what may be naively expected from previous detections of some bright events or from deeper transient surveys that do find high rates of such events. Nevertheless, we find six prominent supernova (SN) candidates over the 41 fields: three of them were previously reported and three are new ones reported here for the first time. Out of the six candidates, four are likely core-collapse SNe – three in cluster galaxies, and among which only one was known before, and one slightly behind the cluster at z ∼ 0.6–0.7. The other two are likely Ia – both of them previously known, one probably in a cluster galaxy and one behind it at z ≃ 2. Our study supplies empirical bounds for the rate of caustic crossing events in galaxy cluster fields to typical HST magnitudes, and lays the groundwork for a future SN rate study.
Alignment and rotational disruption of dust grains in the Galactic Centre revealed by polarized dust emission
Authors: Akshaya M S , Hoang Thiem
Published: April 2023

We study the alignment and rotational disruption of dust grains at the centre of our Galaxy using polarized thermal dust emission observed by SOFIA/HAWC+ and JCMT/SCUPOL at 53, 216, and 850 µm. We analysed the relationship between the observed polarization degree with total emission intensity, dust temperature, gas column density, and polarization angle dispersion. Polarization degree from this region follows the predictions of the RAdiative Torque (RAT) alignment theory, except at high temperatures and long wavelengths where we found evidence for the rotational disruption of grains as predicted by the RAdiative Torque Disruption mechanism. The grain alignment and disruption sizes were found to be around 0.1 and 1 µm,  respectively. The maximum polarization degree observed was around p ∼ 13 per cent at 216 µm and comes from a region of high dust temperature, low column density, and ordered magnetic field. Magnetically enhanced RAT alignment (MRAT) was found to be important for grain alignment due to the presence of a strong magnetic field and can induce perfect alignment even when grains contain small iron clusters. We estimated the mass fraction of aligned grains using a parametric model for the fraction of the grains at high-J attractors and found it to correlate weakly with the observed polarization degree. We observe a change in the polarization ratio, from p216µm/p850µm < 1 to p216µm/p850µm > 1 at Td ≳ 35 K, which suggests a change in the grain model from a composite to a separate population of carbon and silicate grains as implied by previous numerical modelling.
CO or no CO? Narrowing the CO abundance constraint and recovering the H2O detection in the atmosphere of WASP-127 b using SPIRou
Authors: Boucher Anne , Lafreniére David , Pelletier Stefan , Darveau-Bernier Antoine , Radica Michael , Allart Romain , Artigau Étienne , Cook Neil J , Debras Florian , Doyon René , Gaidos Eric , Benneke Björn , Cadieux Charles , Carmona Andres , Cloutier Ryan , Cortés-Zuleta Pía , Cowan Nicolas B , Delfosse Xavier , Donati Jean-François , Fouqué Pascal , Forveille Thierry , Grankin Konstantin , Hébrard Guillaume , Martins Jorge H C , Martioli Eder , Masson Adrien , Vinatier Sandrine
Published: April 2023

Precise measurements of chemical abundances in planetary atmospheres are necessary to constrain the formation histories of exoplanets. A recent study of WASP-127 b, a close-in puffy sub-Saturn orbiting its solar-type host star in 4.2 d, using Hubble Space Telescope (HST) and Spitzer revealed a feature-rich transmission spectrum with strong excess absorption at 4.5 μm. However, the limited spectral resolution and coverage of these instruments could not distinguish between CO and/or CO2 absorption causing this signal, with both low and high C/O ratio scenarios being possible. Here we present near-infrared (0.9–2.5 μm) transit observations of WASP-127 b using the high-resolution SPIRou spectrograph, with the goal to disentangle CO from CO2 through the 2.3 μm CO band. With SPIRou, we detect H2O at a t-test significance of 5.3 σ and observe a tentative (3σ) signal consistent with OH absorption. From a joint SPIRou + HST + Spitzer retrieval analysis, we rule out a CO-rich scenario by placing an upper limit on the CO abundance of log10[CO] <−4.0, and estimate a log10[CO2] of −3.7$^{+0.8}_{-0.6}$ , which is the level needed to match the excess absorption seen at 4.5 μm. We also set abundance constraints on other major C-, O-, and N-bearing molecules, with our results favouring low C/O (0.10$^{+0.10}_{-0.06}$ ), disequilibrium chemistry scenarios. We further discuss the implications of our results in the context of planet formation. Additional observations at high and low resolution will be needed to confirm these results and better our understanding of this unusual world.
Effects of feedback on galaxies in the VELA simulations: elongation, clumps, and compaction
Authors: Ceverino Daniel , Mandelker Nir , Snyder Gregory F , Lapiner Sharon , Dekel Avishai , Primack Joel , Ginzburg Omri , Larkin Sean
Published: April 2023

The evolution of star-forming galaxies at high redshifts is very sensitive to the strength and nature of stellar feedback. Using two sets of cosmological, zoom-in simulations from the VELA suite, we compare the effects of two different models of feedback: with and without kinetic feedback from the expansion of supernovae shells and stellar winds. At a fixed halo mass and redshift, the stellar mass is reduced by a factor of ∼1–3 in the models with stronger feedback, so the stellar mass–halo mass relation is in better agreement with abundance matching results. On the other hand, the three-dimensional shape of low-mass galaxies is elongated along a major axis in both models. At a fixed stellar mass, M* < 1010 M⊙, galaxies are more elongated in the strong-feedback case. More massive, star-forming discs with high surface densities form giant clumps. However, the population of round, compact, old (agec > 300 Myr), quenched, stellar (or gas-poor) clumps is absent in the model with strong feedback. On the other hand, giant star-forming clumps with intermediate ages (agec = 100–300 Myr) can survive for several disc dynamical times, independently of feedback strength. The evolution through compaction followed by quenching in the plane of central surface density and specific star formation rate is similar under the two feedback models.
The ALMA REBELS Survey: the first infrared luminosity function measurement at z ∼ 7
Authors: Barrufet L , Oesch P A , Bouwens R , Inami H , Sommovigo L , Algera H , da Cunha E , Aravena M , Dayal P , Ferrara A , Fudamoto Y , Gonzalez V , Graziani L , Hygate A P S , de Looze I , Nanayakkara T , Pallottini A , Schneider R , Stefanon M , Topping M , van der Werf P
Published: April 2023

We present the first observational infrared luminosity function (IRLF) measurement in the Epoch of Reionization (EoR) based on a ultraviolet (UV)-selected galaxy sample with the Atacama Large Millimeter Array (ALMA) spectroscopic observations. Our analysis is based on the ALMA large program Reionization Era Bright Emission Line Survey (REBELS), which targets 42 galaxies at z  = 6.4–7.7 with [C ii] 158 $\rm{\mu m}$ line scans. 16 sources exhibit dust detection, 15 of which are also spectroscopically confirmed through the [C ii] line. The infrared (IR) luminosities of the sample range from log LIR/L⊙ = 11.4 to 12.2. Using the UV luminosity function as a proxy to derive the effective volume for each of our target sources, we derive IRLF estimates, both for detections and for the full sample including IR luminosity upper limits. The resulting IRLFs are well reproduced by a Schechter function with the characteristic luminosity of $\log L_{*}/\mathrm{ L}_\odot =11.6^{+0.2}_{-0.1}$ . Our observational results are in broad agreement with the average of predicted IRLFs from simulations at z ∼ 7. Conversely, our IRLFs lie significantly below lower redshift estimates, suggesting a rapid evolution from z ∼ 4 to z ∼ 7, into the reionization epoch. The IR obscured contribution to the cosmic star formation rate density at z ∼ 7 amounts to $\mathrm{log(SFRD/{\rm M}_{\odot }\,yr^{-1}\,Mpc^{-3}) = -2.66^{+0.17}_{-0.14} }$ that is at least ∼10 per cent of UV-based estimates. We conclude that the presence of dust is already abundant in the EoR and discuss the possibility of unveiling larger samples of dusty galaxies with future ALMA and JWST observations.
SKF96365 modulates activity of CatSper channels in human sperm
Authors: Torrezan-Nitao Elis , Brown Sean G , Lefievre Linda , Morris Jennifer , Correia Joao , Harper Claire V , Publicover Stephen
Published: April 2023

Exposure of human sperm to progesterone (P4) activates cation channel of sperm (CatSper) channels, inducing an intracellular Ca2+ concentration ([Ca2+]i) transient followed by repetitive [Ca2+]i activity (oscillations), which are believed to be functionally important. We investigated the potential significance of store-operated Ca2+-entry in these oscillations using the inhibitor SKF96365 (30 µM; SKF). Following pre-treatment of human sperm with 3 µM P4, exposure to SKF doubled the proportion of oscillating cells (P = 0.00004). In non-pre-treated cells, SKF had an effect similar to P4, inducing a [Ca2+]i transient in >80% of cells which was followed by oscillations in ≈50% of cells. The CatSper blocker RU1968 (11 µM) inhibited the SKF-induced [Ca2+]i increase and reversibly arrested [Ca2+]i oscillations. Using whole-cell patch clamp, we observed that SKF enhanced CatSper currents by 100% within 30 s, but amplitude then decayed to levels below control over the next minute. When cells were stimulated with P4, CatSper currents were stably increased (by 200%). Application of SKF then returned current amplitude to control level or less. When sperm were prepared in medium lacking bovine serum albumin (BSA), both P4 and SKF induced a [Ca2+]i transient in >95% of cells but the ability of SKF to induce oscillations was greatly reduced (P = 0.0009). We conclude that SKF, similar to a range of small organic molecules, activates CatSper channels, but that a secondary blocking action also occurs, which was detected only during patch-clamp recording. The failure of SKF to induce oscillations when cells were prepared without BSA emphasizes that the drug does not fully mimic the actions of P4.
Proactive crime prevention through problem-oriented governance: A case study of South Korea’s recent efforts to tackle new types of fraud
Authors: Na Chongmin
Published: April 2023

Police organizations around the world are facing new challenges never previously experienced or anticipated. This is largely due to the advancement in information and communication technology and prolonged COVID-19 pandemic, both of which are reshaping the nature of social relationships. In particular, the prevalence and frequency of online fraud are increasing sharply, resulting in social harm that is also expected to rise without proactive prevention efforts that emasculate criminals when they first attempt to approach potential victims. Drawing on literature for both problem-oriented governance and police innovation, this paper discusses the importance of developing the core capabilities of problem-oriented governance to address many complex, uncertain, and unprecedented crime-related problems that have arisen during the COVID era. Police organizations should continue to learn and adapt, and their anticrime efforts should involve stakeholders other than traditional police force members by developing a consolidated database system to make such efforts more efficient, effective, and sustainable.
Does the Federal Reserve Obtain Competitive and Appropriate Prices in Monetary Policy Implementation?
Authors: An Yu , Song Zhaogang
Published: April 2023

Many of the Federal Reserve’s (the Fed’s) monetary policy operations involve trading with primary dealers. We find that, for agency MBS, dealers charge 2.5 cents (per $100 face value) higher selling to the Fed than to non-Fed customers. Controlling for the same dealer, same security, and same trading time, this discriminatory pricing likely arises from dealers’ market power rather than inventory costs. Further, matching trade size reduces the price differential by more than half, implying that dealers’ market power greatly relates to the Fed’s purchases in large amounts, whereas the Fed’s limited breadth of counterparty choice also plays some role.
The bidirectional association between chronic musculoskeletal pain and sleep-related problems: a systematic review and meta-analysis
Authors: Santos Mayara , Gabani Flávia L , de Andrade Selma M , Bizzozero-Peroni Bruno , Martínez-Vizcaíno Vicente , González Alberto D , Mesas Arthur Eumann
Published: April 2023

Objectives

This systematic review and meta-analysis synthesizes the evidence on prospective bidirectional associations between sleep-related problems (SRP) and chronic musculoskeletal pain (CMP).

Methods

A literature search for cohort studies available in the PubMed, Scopus, Web of Science, PsycINFO and Cochrane Library databases as of 19 July 2022 was performed. Pooled odds ratios and effect sizes were calculated through random effects meta-analysis. Subgroup and meta-regression analyses were performed to explore differences by follow-up time, proportion of each sex and mean age. The Meta-analysis Of Observational Studies in Epidemiology guidelines were strictly followed.

Results

Twenty studies with a total of 208 190 adults (aged 34.4–71.7 years) were included, with 17 of them being used in the meta-analysis. Individuals with SRP at baseline had a 1.79-fold higher incidence (odds ratio [OR] = 1.79; 95% CI: 1.55, 2.08; I2 = 84.7%; P < 0.001) and a 2.04-fold higher persistence (OR = 2.04; 95% CI: 1.42, 2.94; I2 = 88.5%; P < 0.005) of CMP than those without SRP. In the subgroup analysis of the association between SRP and CMP, the longer the follow-up time of the studies, the higher the heterogeneity between them. In the corresponding meta-regression, no significant effect was observed for follow-up time, sex proportion or age. Individuals with CMP at baseline had a 2.02-fold higher incidence of SRP (OR = 2.02; 95% CI: 1.62, 2.53; I2 = 90.0%; P < 0.001) than those without CMP.

Conclusion

This study provides robust evidence concerning the longitudinal association between SRP and incidence-persistence of CMP in adults. In addition, the available prospective studies support the existence of a bidirectional relationship between CMP and SRP.

PROSPERO registration number

CRD42020212360
EVALUATION OF RADIATION DOSE IN MULTI-SLICE COMPUTED TOMOGRAPHY PROTOCOLS OF HEAD AND NECK REGIONS
Authors: Jeyasugiththan Jeyasingam , Karunarathna Sanjaya , Satharasinghe Duminda , Hishaam Urshella , Pallewatte Aruna
Published: April 2023

In head and neck computed tomography (CT) imaging, the optimisation of radiation dose is crucial due to the presence of radio-sensitive organs. This study aimed to evaluate the radiation dose in multi-slice CT for head and neck examinations. Volume CT dose index, dose length product and effective dose (E) were assessed for 10 head and neck CT scans performed on 292 adult patients (mean age 49.2 ± 15.9 y). The study resulted in median E values of 0.82, 1.62, 2.43, 0.93, 1.70, 0.83, 3.55, 6.25, 2.19 and 5.26 mSv, respectively, for sinuses (non-contrast (NC)), sinuses (NC) and contrast-enhanced (CE), petrous bone (PTB)/internal auditory meatus (IAM) (NC + CE), PTB/IAM (NC), orbit (NC + CE), orbit (NC), brain with the orbit (NC), brain CT angiography (CTA) subtraction, neck (NC) and brain/neck (NC). Furthermore, the overall radiation doses of this institution were found to be below the values suggested by similar studies. However, optimisation of the dose is required for brain CTA.
Progressive arousal: a new concept and definition for premature ejaculation
Authors: Lucas Bustos Pedro , Parrón Carreño Tesifón , Moreno Gutiérrez Salvador , Fernández Agis Inmaculada
Published: April 2023

Background

Premature ejaculation (PE) is a nosologic entity with issues in its conceptualization and definition.

Aim

To understand if the altered sexual response in men with PE is in the orgasm phase, as currently assumed, or the arousal phase with difficulties in modulating, regulating, or decreasing sexual arousal.

Methods

Men were recruited who looked for help for PE and met the diagnostic criteria according to clinical standards. The participants completed a sociodemographic survey and the Premature Ejaculation Diagnostic Tool. They also performed a masturbation exercise with a maximum of 5 stops, with the intention of prolonging the arousal phase. The time of the exercise was measured from the beginning of genital masturbation to ejaculation.

Outcomes

We calculated the total time of the exercise, the median time at each start, and the number of dropouts. We performed a pairwise comparison analysis between starts and made a survival curve representing the percentage of men who remained in the exercise.

Results

A total of 481 men with PE participated (mean ± SD; age, 29.25 ± 8.72 years). We found that the expected median survival time until ejaculation was 317.00 seconds (95% CI, 288.34-345.65). However, the average time during stimulation decreased as the exercise progressed, and statistically significant differences were observed in their pairwise comparison (P < .001). Also, the chances of ejaculation increased as the exercise progressed, with 62.16% of the participants ejaculating before the end of the exercise. The results indicated increasing sexual arousal, where stops in stimulation were progressively less effective at maintaining ejaculation times at starts.

Clinical Implications

We showed that the arousal phase is altered in PE, not the orgasm phase, and this could finally have implications in the diagnosis and/or treatment of this condition.

Strengths and Limitations

The analysis of the times at starts and stops in a masturbation exercise in men with PE, had been barely addressed before. In the future, it would be important to verify the effect of stops during sexual intercourse and to incorporate a control group of men without PE.

Conclusions

We propose a new conceptualization and definition for PE: progressive arousal disorder is the inability to modulate, regulate, or decrease arousal during any sexual activity, even with brief stops during sexual stimulation, causing unwanted ejaculation.
Female sexual health digital resources: women and health care providers need more options
Authors: Dubinskaya Alexandra , Heard John R , Choi Eunice , Cohen Tara , Anger Jennifer , Eilber Karyn , Scott Victoria
Published: April 2023

Introduction

Female sexual health and female sexual dysfunction (FSD) are usually poorly diagnosed and treated because of the numerous barriers providers and patients face. Internet platforms, such as mobile applications (apps) are potential tools that help overcome these barriers and improve patient access to education and management options for FSD.

Objectives

The aim of this review was to identify existing applications on female sexual health and evaluate their educational content and services.

Methods

We searched the internet and Apple App Store using multiple keywords. A panel of physicians specialized in the treatment of FSD reviewed the apps for content quality, the scientific basis of provided information, interactivity, usability, and whether they would recommend it as a reference tool for patients.

Results

Of the 204 apps identified, 17 met the inclusion criteria and were reviewed further. The selected apps were organized into groups based on common themes such as educational (n = 6), emotions and communication (n = 2), relaxation and meditation (n = 4), general sexual health (n = 2), and social and fun (n = 3). All apps from the educational category provided scientific information in collaboration with health experts. When assessed for usability, 1 app received good and 5 received excellent scores based on the System Usability Scale. Most apps (n = 5) provided information on pathology and treatments of orgasmic dysfunction, but only 1 app, created by a physician, provided comprehensive information on all the types of FSD.

Conclusion

Digital technology could be an effective way to overcome barriers to accessing information and ultimately care for female sexual health. Our review demonstrated that there is still a need for more accessible educational resources addressing female sexual health and FSD for patients and providers.
Maize Phytocytokines Modulate Pro-Survival Host Responses and Pathogen Resistance
Authors: Koenig Maurice , Moser Daniel , Leusner Julian , Depotter Jasper R. L. , Doehlemann Gunther , Misas Villamil Johana
Published: April 2023

Phytocytokines are signaling peptides that alert plant cells of danger. However, the downstream responses triggered by phytocytokines and their effect on plant survival are still largely unknown. Here, we have identified three biologically active maize orthologues of phytocytokines previously described in other plants. The maize phytocytokines show common features with microbe-associated molecular patterns (MAMPs), including the induction of immune-related genes and activation of papain-like cysteine proteases. In contrast to MAMPs, phytocytokines do not promote cell death in the presence of wounding. In infection assays with two fungal pathogens, we found that phytocytokines affect the development of disease symptoms, likely due to the activation of phytohormonal pathways. Collectively, our results show that phytocytokines and MAMPs trigger unique and antagonistic features of immunity. We propose a model in which phytocytokines activate immune responses partially similar to MAMPs but, in contrast to microbial signals, they act as danger and survival molecules to the surrounding cells. Future studies will focus on the components determining the divergence of signaling outputs upon phytocytokine activation.

[Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Thioredoxin facilitates hepatocellular carcinoma stemness and metastasis by increasing BACH1 stability to activate the AKT/mTOR pathway
Authors: Wang Chengmeng , Zhang Lu , Cao Manqing , Fu Zhou , Wang Huaqi , Zhang Su , Zhu Keyun , Hou Zhenyu , Cui Jinfang , Yue Ping , Guo Hua , Zhang Ti
Published: April 2023

Thioredoxin (TXN) is essential for preserving balance and controlling the intracellular redox state. Most studies have focused on the function of TXN in redox reactions, which is critical for tumor progression. Here, we showed that TXN promotes hepatocellular carcinoma (HCC) stemness properties in a non‐redox‐dependent manner, which has rarely been reported in previous studies. TXN exhibited upregulated expression in human HCC specimens, which was associated with a poor prognosis. Functional studies showed that TXN promoted HCC stemness properties and facilitated HCC metastasis both in vitro and in vivo. Mechanistically, TXN promoted the stemness of HCC cells by interacting with BTB and CNC homology 1 (BACH1) and stabilized BACH1 expression by inhibiting its ubiquitination. BACH1 was positively correlated with TXN expression and was significantly upregulated in HCC. In addition, BACH1 promotes HCC stemness by activating the AKT/mammalian target of rapamycin (mTOR) pathway. Furthermore, we found that the specific inhibition of TXN in combination with lenvatinib in mice significantly improved the treatment of metastatic HCC. In summary, our data demonstrate that TXN plays a crucial role in HCC stemness and BACH1 plays an integral part in regulating this process by activating the AKT/mTOR pathway. Thus, TXN is a promising target for metastatic HCC therapy.
Prognostic Relevance of Negative Lymph Node Count in Resected Stage I–IIIa Small-cell Lung Cancer
Authors: Yang Hao , Li Dongmei , Liu Tong
Published: April 2023

Objectives:

The prognostic significance of the negative lymph node (NLN) count has been confirmed in various cancers but not in small-cell lung cancer (SCLC). We aimed to evaluate the correlation between the NLN count and the prognosis of patients with stages I–IIIa SCLC who underwent lobectomy.

Methods:

Data on the clinical characteristics of SCLC patients who underwent lobectomy between 2000 and 2019 were collected from the SEER database and organized based on the X-tile plots to identify the optimal cutoff point for the NLN count. Kaplan–Meier curves and a Cox proportional hazard model were used to evaluate the prognostic factors for overall survival (OS) and lung cancer-specific survival.

Results:

Based on the X-tile plot-determined cutoff points of 3 and 7, the participants were grouped into the low (<3), middle (3–7), and high (>7) NLN subgroups for the analysis of OS. Univariable analysis showed that a higher NLN count correlated with more favorable OS and lung cancer-specific survival (both P<0.001). Multivariate analysis demonstrated that, after adjustment for related factors, the NLN count was positively associated with the prognosis and might thus be an independent risk factor for prognosis. Subgroup analyses revealed that, among different LN statuses and varied positive LN counts, the NLN count could predict the prognosis independently.

Conclusions:

Higher NLNs correlated with better survival for patients who underwent lobectomy of stages I–IIIa SCLC. A predictive marker that combines the NLN count with the N stage and positive LN count could provide more prognostic information in SCLC.
UNILATERAL, SECTORAL RETINAL METASTASIS OF SMALL-CELL LUNG CANCER MIMICKING VIRAL RETINITIS
Authors: Ustaoglu Melih , Eagle Ralph J. , Bloom Steven M. , Wang Wei , Barr Charles C. , Adeniran Janelle Fassbender
Published: April 2023

Purpose:

To report a case of unilateral, sectoral retinal metastasis of small cell lung cancer (SCLC) that mimicked cytomegalovirus retinitis.

Method:

Case report.

Results:

A 48-year-old woman presented with a 4-week history of a visual field loss in her right eye. She had a medical history of extensive-stage SCLC with brain metastasis, stable on maintenance atezolizumab for 2 years. On initial presentation, she was diagnosed with cytomegalovirus retinitis. No improvement was observed with 4 weeks of oral valganciclovir. Upon referral for a second opinion, her fundus examination appeared compatible with cytomegalovirus retinitis, and anterior chamber tap for polymerase chain reaction for viral etiologies was performed followed by intravitreal and IV ganciclovir without improvement. She was referred for a third opinion, where diagnostic vitrectomy with vitreous and retinal biopsies were consistent with SCLC metastatic to the retina. The patient underwent enucleation of the right eye for definitive pathologic analysis and subsequently was started on additional systemic chemotherapy.

Conclusion:

Retinal metastases are exceedingly rare, particularly retinal metastasis of SCLC. Retinal metastasis should be considered in patients initially diagnosed with viral retinitis who fail to improve despite antiviral therapy, particularly if they have a known history of malignancy. Furthermore, retinal metastasis of SCLC potentially could be misdiagnosed histopathologically as retinoblastoma if the patient's history is unknown and appropriate immunohistochemical stains are not performed.
Overview of diet and autoimmune demyelinating optic neuritis: a narrative review
Authors: Plafker Scott M. , Titcomb Tyler , Zyla-Jackson Katarzyna , Kolakowska Aneta , Wahls Terry
Published: April 2023

This review summarizes the cellular and molecular underpinnings of autoimmune demyelinating optic neuritis (ADON), a common sequela of multiple sclerosis and other demyelinating diseases. We further present nutritional interventions tested for people with multiple sclerosis focusing on strategies that have shown efficacy or associations with disease course and clinical outcomes. We then close by discuss the potential dietary guidance for preventing and/or ameliorating ADON.