bluuebunny/crossref_metadata_2025 huggingface dataset:
Strong magnetic fields in gauge theories
Authors: Pérez Rojas Hugo Celso , Acosta Ávalo Jorge Luis
Published: August 2021

The problem of photon propagation in a medium in presence of a strong magnetic field in the frame of quantum electrodynamics is discussed in the present paper, based on previous literature in this area. The breaking of the spatial symmetry by the magnetic field determine the existence of a set of basic vectors and tensors which must satisfy the gauge and CPT invariance of quantum electrodynamics. The charge symmetric and non-symmetric cases are discussed. In the second case the Faraday effect is produced. A chiral current arises, associated to a pseudovector eigenvector ofthe polarization operator (due to the breaking of the spatial symmetry by the external magnetic field), related to the so-called axial anomaly. The path integrals and functional derivation are widely used to obtain the self-energy and vertex operators, and the Dyson equations. The inadequate introduction of a chiral chemical potential in the standard model is discussed for the Weinberg-Salam model for electroweak interactions.
Textos sobre F´ısica en la biblioteca de un cient´ıfico novohispano del siglo XVIII
Authors: Moreno Corral Marco A.
Published: August 2021

The titles of the Physics books owned by Antonio de Le´on y Gama are presented. In order to establish the degree of knowledge of this discipline that this New Spain native of the second half of the 18th century reached, the content of these works is discussed. It is shown that the knowledge reached in this matter by this person, were at the height of his European peers.
Efeito sedativo das diferentes doses de detomidina em equinos pelas vias intravenosa e intramuscular
Authors: Gonzaga Lucas
Published: August 2021

The present study aimed at the sedative effect of detomidine applications, in the dose range of 50 to 80 ug/kg intramuscularly, and from 20 to 40 ug/kg intravenously. The work was based on the pharmacokinetic parameters of maximum time (Tmax), maximum concentration (Cmax) and half-life (T ½). The relationship between head position and plasma concentration was established using a PK/PD model. If the time taken for the animal to return the head to the 100cm position is taken as a basis, it is observed that this time is 378, 396, 412 and 425 minutes for the doses of 50, 60, 70 and 80 ug/ml respectively, by the intramuscular route. It is possible to observe that the duration of the effect is approximately 78, 101, 122, 138 and 150 minutes for the concentrations of 20, 25, 30, 35 and 40 ug/kg, respectively, by the intravenous route. The effect considered desired lasted 66, 88, 104, 127 and 139 minutes with the doses of 20, 25, 30, 35 and 40 ug/Kg, respectively, through the intravenous route. The present study concluded that the higher the dose, the longer the duration of the effect, regardless of the route. Intramuscularly, there is an increase of approximately 20 minutes for each 10 ug/ml increase in the dose.
Insuficiência cardiocongestiva por trombose na veia cava com broncopneumonia necroexudativa secundária
Authors: Backes Geciane , . Maurijane Strapasson , . Daniel Rossi , . Júlia Fogilarini Moura , . Juliana Franciele Ruzycki , . Rodrigo Grando , . Diorges Henrique Setim , . Marina Menoncin Weschenfelder Rohenkohl , . Mauro Antônio de Almeida , . Daniela dos Santos de Oliveira
Published: August 2021

The aim of this study was to report a case of vena cava thrombosis with secondary bronchopneumonia in a two-year-old Holsten breed cow from the municipality of Jacutinga, Rio Grande do Sul State, Brazil. Vena cava thrombosis is a disease affecting adult cattle fed on concentrate-based diets. It is characterized by the presence of septic emboli in the bloodstream, which is formed from caudal vena cava thrombi that obliterate the vascular lumen, causing tissue hypoxia. The most common vena cava thrombosis etiology is ruminal acidosis, generating ruminitis and subsequent liver abscessation and pulmonary artery thromboembolism, abomasum ulcers, and polioencephalomalacia. The animal was in the final third of its gestation and it was fed with corn-silage-based feed and a 20% protein content balanced feed when it presented mastitis, walking pain, and coughing. Treatment for mastitis was carried out and 15 days after that, intramuscular enrofloxacin-based antibiotic therapy was performed. The animal died and necropsy and histopathological data indicated to be compatible with cardiocentesis insufficiency, possibly due to vena cava thrombosis with secondary necro-exudative bronchopneumonia.
Subprodutos da mandioca como alimento alternativo para frangos de corte
Authors: Daróz Matte Wanessa , Melo da Silva Henrique , Pieri Zeferino Cynthia
Published: August 2021

Cassava (Manihot esculenta crantz) is a plant originally from South America, mainly from the Amazon region, which has been cultivated in several countries due to its wide adaptation. The industries concerned with the processing of cassava for the manufacture of flour and starch, located mainly in the south and southeast of Brazil, generate solid and liquid residues with a high polluting capacity, which has resulted in a great impact on the environment. Currently, animal production suffers from the high cost of food, mainly due to the fluctuation of grain prices in the market. As a way of reducing environmental pollution and animal production costs, there is the use of residues from cassava processing in animal feed. This bibliographic review aims to highlight the use of the main by-products of the cassava processing industry, as a substitute for corn, in the broiler feed.
Produção de leite de vacas zebuínas manejadas em pastagens tropicais
Authors: Silva Lucas
Published: August 2021

Brazilian milk production is characterized by the exploitation of tropical pastures, using zebu animals, purebred or crossed with European dairy breeds. Milk's composition is an important factor in the economic efficiency of the entire production chain. The objective of this study was to evaluate the milk production and composition of cows of different racial types in tropical pastures. The experiment was carried out at Fazenda Estância Orestes Prata Tibério Junior of Brazilian Zebu Breeders Association (ABCZ) using the 20 ha experimental area formed by 13 paddocks in a rotational grazing system, with Brachiaria Brizantha cv Paiaguas pasture. The animals were handled with 1 day of occupation in each paddock, offering 10% of the animal live weight in forage (DM). The experimental period was 18 days, with 13 days of adaptation and 5 days of evaluations. The protein-energetic supplement (28% CP) was supplied individually at the rate of 1 kg for each 3 kg of milk produced, being parceled twice a day, always after milking. 14 dairy cows were evaluated, 8 of the Gyr breed, 2 of the Sindi breed and 3 Guzolando animals. Milking was performed twice a day, at 5:00 am and 4:00 pm. Weighing the milk was done daily. The analysis of fat and non-fat solids (SNG), including protein, carbohydrates, minerals and vitamins, were carried out by the infrared process with a Bentley 2000 analyzer (Bentley Instruments ®). A completely randomized design was used, with 3 treatments (Gyr, Sindi and Guzolando breeds) and each animal corresponded to an experimental unit. The comparison of means was performed by the Tukey test with a 5% significance level. Milk production was higher (P = 0.0007) for the Guzolanda breed (20.02 kg.day-1), being similar between the Sindi (8.15 kg.day-1) and Gir (9.60) kg.day-1). Regarding the composition of milk, both the production of fat and the production of non-fat solids, there was an effect of race (P = 0.0017 and P = 0.0006, respectively). The Guzolanda breed was superior in both characteristics of milk composition, presenting fat production of 0.72 kg.day-1 and SNG of 1.78 kg.day-1. The pure zebu breeds, Gyr and Sindi did not differ in relation to fat production (0.32 and 0.26 kg.day-1, respectively) and SNG (0.87 and 0.77 kg.day-1). Thus, it was possible to conclude that the crossing promoted gains in milk production and composition in tropical pasture systems.
Penilaian Pengetahuan Tertulis Dalam Kurikulum 2013
Authors: Waizah Nurul , Herwani Herwani
Published: August 2021

This assessment is needed to measure whether students have succeeded in achieving competence or not; information on learning outcomes is needed. Information on learning outcomes is obtained from bills that students must meet. Each type of bill requires a set of measuring tools or assessment tools. Here, the teacher's role is needed to make measuring tools and gather information on learning outcomes appropriately. They measure tools or assessment tools that can produce valid and reliable measurement results. Assessment of knowledge or cognitive competence is an assessment carried out by teachers to measure students' achievement or mastery in aspects of knowledge, including memory or memorization, understanding, application or application, analysis, synthesis, and evaluation. The 2013 curriculum is a philosophical foundation that develops all the potential of students to become quality human beings.
New Palaearctic species of the genus Xyletinus Latreille, 1809 (Coleoptera: Anobiidae)
Authors: Toskina I.N.
Published: August 2021

Twenty one new species and two new subspecies of the genus Xyletinus (subgenera Calypterus and Xyletinus s. str.) are described from Palaearctic regions of Eurasia and Africa: Xyletinus (Calypterus?) aralicus, X. (Calypterus) lepidus, X. (C.) productus, X. (s. str.) armeniensis, X. brevipes, X. danilevskii, X. fursovi, X. gibberosus, X. iordanicus, X. iranicus, X. kamyshinensis, X. klapperichi, X. komarovi, X. lukjanovitshi, X. merkli, X. montanus, X. pseudosareptanus, X. stepposus, X. turkestanicus, X. turkmenicus, and X. udmurtianus spp. n., X. aralicus lindemani, and X. pectinatus inflatus sspp. n.
New tersilochines from the collection of Natural History Museum, London (Hymenoptera: Ichneumonidae, Tersilochinae)
Authors: Khalaim A.I.
Published: August 2021

Palpator sicilicus gen. et sp. n. from Italy and P. turpilucricupidus sp. n. from Tunisia, Tersilochus abyssinicus sp. n. and T. rusticulus sp. n. from Ethiopia, Zealochus gauldi sp. n. and Z. postfurcalis sp. n. from New Zealand are described. New data on the distribution of Z. supergranulatus Khalaim are presented. Keys to species of Palpator gen. n. and Zealochus Khalaim are given.
Camilleacanthus nom. n., a new replacement name for Priacanthopsis Arambourg, 1967 (non Fowler, 1906) (Teleostei: Perciformes)
Authors: Prokofiev A.M.
Published: August 2021

The new replacement name Camilleacanthus nom. n. is proposed for Priacanthopsis Arambourg, 1967 (non Fowler, 1906). The type and the only species C. crassispinus (Aramb.) deserves a separate generic rank, however, its relationships with the family Priacanthidae, in which it was originally placed, are obscure.
Reprise des échecs d’arthroplastie totale de cheville par arthrodèse tibiotalocalcanéenne à l’aide d’un enclouage centromédullaire rétrograde : à propos de sept cas
Authors: Hardy A. , Amouyel T. , Szymanski C. , Fontaine C. , Maynou C.
Published: August 2021

Introduction: La difficulté des reprises chirurgicales des échecs d’arthroplastie totale de cheville (ATC) est multifactorielle, liée à l’importance de la perte de substance osseuse, à la qualité tégumentaire et à la déformation secondaire de l’arrière-pied. Elles peuvent consister en un rescellement prothétique ou une arthrodèse tibiotalienne ou tibiotalocalcanéenne (TTC). Nous rapportons une série de sept patients ayant bénéficié d’une arthrodèse TTC par clou centromédullaire rétrograde après échec d’ATC.

Matériel et méthodes: Entre 2012 et 2017, sept échecs d’ATC ont bénéficié d’une arthrodèse TTC par enclouage rétrograde. Six femmes, un homme d’âge moyen 61,3 ans (52–77) ont été opérés suite à un descellement pour six patients et une infection pour un patient. La durée moyenne entre l’ATC et l’arthrodèse était de 9,2 ans (1,3–19). Une allogreffe était utilisée dans cinq cas, associée à une autogreffe dans deux cas. Un patient a bénéficié d’un espaceur en métal trabéculaire. Les variables cliniques étaient l’échelle visuelle analogique (EVA), l’évaluation de la satisfaction subjective, le score AOFAS et le score SF-36. Le bilan paraclinique se composait d’une radiographie standard en charge de face et de profil et d’un scanner en cas de suspicion de pseudarthrodèse.

Résultats: Le suivi moyen était de 33,1 mois (6–72). Au dernier recul, l’EVA moyenne était de 3/10. Six patients se sont déclarés très satisfaits ou satisfaits. Le score AOFAS moyen était de 58,2 (51–66), le SF-36 physique de 33,5 et le SF-36 mental de 57,1. Le taux de fusion radiographique atteignait 86 % (6/7 chevilles) avec un délai moyen de 11,2 semaines (7–12). Une pseudarthrodèse sous-talienne confirmée au scanner a été reprise, aucune autre complication n’a été relevée.

Discussion: Le taux de consolidation et les résultats cliniques sont satisfaisants chez les patients bénéficiant d’arthrodèse TTC par clou rétrograde après échec d’ATC. Dans les cas où l’articulation sous-talienne est arthrosique ou s’il existe une perte de substance osseuse massive, cette technique apparaît être la technique de référence.
MORPHOMETRIC PARAMETERS OF YAK SKIN ALTAI POPULATION
Authors: Bakhtushkina A. I.
Published: August 2021

The results of studies of morphometric parameters of the yak skin of the Altai population are presented. It was found that the yield of paired skins is on average from 5,5 % in yak bulls of 18 months to 6.3 and 8,3 % in yak bulls and yak cows, respectively. The measurements of the length and width of the skin are almost the same or the length is slightly inferior to the width, which is due to the fact that the body of the yak is shorter than that of the local cattle. When examining the raw leather, all the skins were without any defects in life. The weight of the skins of yak-bulls of the Altai population was 34,3±1,2 kg and they are classified as heavy, the skins of yak-bulls at the age of 18 months correspond to the category “half-skin” (from 10 to 13 kg), and the weight of the skins of yak cows of the Altai population-”yalovka” is suitable for the average weight category - from 17 to 25 kg. The thickness of the skins of Yak bulls on the last edge was 7.1 mm, which is higher than the requirements of GOST by 2.3 mm, in bull calves the excess was 3.1 mm, in yak cows-1.1 mm. According to their morphometric characteristics, the skins of Altai yaks meet the requirements of GOST 28425-90. The raw materials are leather and refer to the raw leather intended for the production of leather for the bottom of shoes and shoe leather. They can also be widely used by the local population as raw materials for the production of saddlery and technical leather.
ENERGY RESOURCE-SAVING TECHNOLOGY OF ACCELERATED POTATO SEED BREEDING IN THE FOREST STEPPE OF THE NOVOSIBIRSK PROBIE
Authors: Galeev R. R. , Shulga M. S. , Kovalev E. A.
Published: August 2021

The results of comprehensive research in 2017–2020 on the effectiveness of improving the health of new zoned and promising potato varieties of three groups of ripeness in the conditions of leached chernozem of the forest-steppe of the Novosibirsk Ob region are presented. The energy-saving, environmentally friendly technology of accelerated potato seed production was used. It is shown that the recovery from viruses of the planting material provides an increase in the yield of different potato varieties up to 42% relative to the unhealthy background. The high efficiency of accelerated propagation of planting material with the use of modern aeroponic plants in comparison with hydroponic plants, and growing in a greenhouse and open ground, is established. The developed technology makes it possible to increase the energy efficiency coefficient by 40 % and the level of profitability by 32 %.
Neurosurgery residency and fellowship education in the United States: 2 decades of system development by the One Neurosurgery Summit organizations
Authors: Selden Nathan R. , Barbaro Nicholas M. , Barrow Daniel L. , Batjer H. Hunt , Branch Charles L. , Burchiel Kim J. , Byrne Richard W. , Dacey Ralph G. , Day Arthur L. , Dempsey Robert J. , Derstine Pamela , Friedman Allan H. , Giannotta Steven L. , Grady M. Sean , Harsh Griffith R. , Harbaugh Robert E. , Mapstone Timothy B. , Muraszko Karin M. , Origitano Thomas C. , Orrico Katie O. , Popp A. John , Sagher Oren , Selman Warren R. , Zipfel Gregg J.
Published: August 2021

The purpose of this report is to chronicle a 2-decade period of educational innovation and improvement, as well as governance reform, across the specialty of neurological surgery. Neurological surgery educational and professional governance systems have evolved substantially over the past 2 decades with the goal of improving training outcomes, patient safety, and the quality of US neurosurgical care. Innovations during this period have included the following: creating a consensus national curriculum; standardizing the length and structure of neurosurgical training; introducing educational outcomes milestones and required case minimums; establishing national skills, safety, and professionalism courses; systematically accrediting subspecialty fellowships; expanding professional development for educators; promoting training in research; and coordinating policy and strategy through the cooperation of national stakeholder organizations. A series of education summits held between 2007 and 2009 restructured some aspects of neurosurgical residency training. Since 2010, ongoing meetings of the One Neurosurgery Summit have provided strategic coordination for specialty definition, neurosurgical education, public policy, and governance. The Summit now includes leadership representatives from the Society of Neurological Surgeons, the American Association of Neurological Surgeons, the Congress of Neurological Surgeons, the American Board of Neurological Surgery, the Review Committee for Neurological Surgery of the Accreditation Council for Graduate Medical Education, the American Academy of Neurological Surgery, and the AANS/CNS Joint Washington Committee. Together, these organizations have increased the effectiveness and efficiency of the specialty of neurosurgery in advancing educational best practices, aligning policymaking, and coordinating strategic planning in order to meet the highest standards of professionalism and promote public health.
Complications after 1002 endoscopic endonasal approach procedures at a single center: lessons learned, 2010–2018
Authors: Hardesty Douglas A. , Montaser Alaa , Kreatsoulas Daniel , Shah Varun S. , VanKoevering Kyle K. , Otto Bradley A. , Carrau Ricardo L. , Prevedello Daniel M.
Published: August 2021

OBJECTIVE

The endoscopic endonasal approach (EEA) has evolved into a mainstay of skull base surgery over the last two decades, but publications examining the intraoperative and perioperative complications of this technique remain scarce. A prior landmark series of 800 patients reported complications during the first era of EEA (1998–2007), parallel to the development of many now-routine techniques and technologies. The authors examined a single-institution series of more than 1000 consecutive EEA neurosurgical procedures performed since 2010, to elucidate the safety and risk factors associated with surgical and postoperative complications in this modern era.

METHODS

After obtaining institutional review board approval, the authors retrospectively reviewed intraoperative and postoperative complications and their outcomes in patients who underwent EEA between July 2010 and June 2018 at a single institution.

RESULTS

The authors identified 1002 EEA operations that met the inclusion criteria. Pituitary adenoma was the most common pathology (n = 392 [39%]), followed by meningioma (n = 109 [11%]). No patients died intraoperatively. Two (0.2%) patients had an intraoperative carotid artery injury: 1 had no neurological sequelae, and 1 had permanent hemiplegia. Sixty-one (6.1%) cases of postoperative cerebrospinal fluid leak occurred, of which 45 occurred during the original surgical hospitalization. Transient postoperative sodium dysregulation was noted after 87 (8.7%) operations. Six (0.6%) patients were treated for meningitis, and 1 (0.1%) patient died of a fungal skull base infection. Three (0.3%) patients died of medical complications, thereby yielding a perioperative 90-day mortality rate of 0.4% (4 deaths). High-grade (Clavien-Dindo grade III–V) complications were identified after 103 (10%) EEA procedures, and multivariate analysis was performed to determine the associations between factors and these more serious complications. Extradural EEA was significantly associated with decreased rates of these high-grade complications (OR [95% CI] 0.323 [0.153–0.698], p = 0.0039), whereas meningioma pathology (OR [95% CI] 2.39 [1.30–4.40], p = 0.0053), expanded-approach intradural surgery (OR [95% CI] 2.54 [1.46–4.42], p = 0.0009), and chordoma pathology (OR [95% CI] 9.31 [3.87–22.4], p < 0.0001) were independently associated with significantly increased rates of high-grade complications.

CONCLUSIONS

The authors have reported a large 1002-operation cohort of EEA procedures and associated complications. Modern EEA surgery for skull base pathologies has an acceptable safety profile with low morbidity and mortality rates. Nevertheless, significant intraoperative and postoperative complications were correlated with complex intradural procedures and meningioma and chordoma pathologies.
Launching the Quality Outcomes Database Tumor Registry: rationale, development, and pilot data
Authors: Asher Anthony L. , Khalafallah Adham M. , Mukherjee Debraj , Alvi Mohammed Ali , Yolcu Yagiz U. , Khan Inamullah , Pennings Jacquelyn S. , Davidson Claudia A. , Archer Kristin R. , Moshel Yaron A. , Knightly John , Roguski Marie , Zacharia Brad E. , Harbaugh Robert E. , Kalkanis Steven N. , Bydon Mohamad
Published: August 2021

OBJECTIVE

Neurosurgeons generate an enormous amount of data daily. Within these data lie rigorous, valid, and reproducible evidence. Such evidence can facilitate healthcare reform and improve quality of care. To measure the quality of care provided objectively, evaluating the safety and efficacy of clinical activities should occur in real time. Registries must be constructed and collected data analyzed with the precision akin to that of randomized clinical trials to accomplish this goal.

METHODS

The Quality Outcomes Database (QOD) Tumor Registry was launched in February 2019 with 8 sites in its initial 1-year pilot phase. The Tumor Registry was proposed by the AANS/CNS Tumor Section and approved by the QOD Scientific Committee in the fall of 2018. The initial pilot phase aimed to assess the feasibility of collecting outcomes data from 8 academic practices across the United States; these outcomes included length of stay, discharge disposition, and inpatient complications.

RESULTS

As of November 2019, 923 eligible patients have been entered, with the following subsets: intracranial metastasis (17.3%, n = 160), high-grade glioma (18.5%, n = 171), low-grade glioma (6%, n = 55), meningioma (20%, n = 184), pituitary tumor (14.3%, n = 132), and other intracranial tumor (24%, n = 221).

CONCLUSIONS

The authors have demonstrated here, as a pilot study, the feasibility of documenting demographic, clinical, operative, and patient-reported outcome characteristics longitudinally for 6 common intracranial tumor types.
Memory recovery in relation to default mode network impairment and neurite density during brain tumor treatment
Authors: Romero-Garcia Rafael , Suckling John , Owen Mallory , Assem Moataz , Sinha Rohitashwa , Coelho Pedro , Woodberry Emma , Price Stephen J. , Burke Amos , Santarius Thomas , Erez Yaara , Hart Michael G.
Published: August 2021

OBJECTIVE

The aim of this study was to test brain tumor interactions with brain networks, thereby identifying protective features and risk factors for memory recovery after resection.

METHODS

Seventeen patients with diffuse nonenhancing glioma (ages 22–56 years) underwent longitudinal MRI before and after surgery, and during a 12-month recovery period (47 MRI scans in total after exclusion). After each scanning session, a battery of memory tests was performed using a tablet-based screening tool, including free verbal memory, overall verbal memory, episodic memory, orientation, forward digit span, and backward digit span. Using structural MRI and neurite orientation dispersion and density imaging (NODDI) derived from diffusion-weighted images, the authors estimated lesion overlap and neurite density, respectively, with brain networks derived from normative data in healthy participants (somatomotor, dorsal attention, ventral attention, frontoparietal, and default mode network [DMN]). Linear mixed-effect models (LMMs) that regressed out the effect of age, gender, tumor grade, type of treatment, total lesion volume, and total neurite density were used to test the potential longitudinal associations between imaging markers and memory recovery.

RESULTS

Memory recovery was not significantly associated with either the tumor location based on traditional lobe classification or the type of treatment received by patients (i.e., surgery alone or surgery with adjuvant chemoradiotherapy). Nonlocal effects of tumors were evident on neurite density, which was reduced not only within the tumor but also beyond the tumor boundary. In contrast, high preoperative neurite density outside the tumor but within the DMN was associated with better memory recovery (LMM, p value after false discovery rate correction [Pfdr] < 10−3). Furthermore, postoperative and follow-up neurite density within the DMN and frontoparietal network were also associated with memory recovery (LMM, Pfdr = 0.014 and Pfdr = 0.001, respectively). Preoperative tumor and postoperative lesion overlap with the DMN showed a significant negative association with memory recovery (LMM, Pfdr = 0.002 and Pfdr < 10−4, respectively).

CONCLUSIONS

Imaging biomarkers of cognitive recovery and decline can be identified using NODDI and resting-state networks. Brain tumors and their corresponding treatment affecting brain networks that are fundamental for memory functioning such as the DMN can have a major impact on patients’ memory recovery.
Incidence and risk factors for prolonged postoperative opioid use following lumbar spine surgery: a cohort study
Authors: Goyal Anshit , Payne Stephanie , Sangaralingham Lindsey R. , Jeffery Molly Moore , Naessens James M. , Gazelka Halena M. , Habermann Elizabeth B. , Krauss William , Spinner Robert J. , Bydon Mohamad
Published: August 2021

OBJECTIVE

Sustained postoperative opioid use after elective surgery is a matter of growing concern. Herein, the authors investigated incidence and predictors of long-term opioid use among patients undergoing elective lumbar spine surgery, especially as a function of opioid prescribing practices at postoperative discharge (dose in morphine milligram equivalents [MMEs] and type of opioid).

METHODS

The OptumLabs Data Warehouse (OLDW) was queried for postdischarge opioid prescriptions for patients undergoing elective lumbar decompression and discectomy (LDD) or posterior lumbar fusion (PLF) for degenerative spine disease. Only patients who received an opioid prescription at postoperative discharge and those who had a minimum of 180 days of insurance coverage prior to surgery and 180 days after surgery were included. Opioid-naive patients were defined as those who had no opioid fills in 180 days prior to surgery. The following patterns of long-term postoperative use were investigated: additional fills (at least one opioid fill 90–180 days after surgery), persistent fills (any span of opioid use starting in the 180 days after surgery and lasting at least 90 days), and Consortium to Study Opioid Risks and Trends (CONSORT) criteria for persistent use (episodes of opioid prescribing lasting longer than 90 days and 120 or more total days’ supply or 10 or more prescriptions in 180 days after the index fill). Multivariable logistic regression was performed to identify predictors of long-term use.

RESULTS

A total of 25,587 patients were included, of whom 52.7% underwent PLF (n = 13,486) and 32.5% (n = 8312) were opioid-naive prior to surgery. The rates of additional fills, persistent fills, and CONSORT use were 47%, 30%, and 23%, respectively, after PLF and 35.4%, 19%, and 14.2%, respectively, after LDD. The rates among opioid-naive patients were 18.9%, 5.6%, and 2.5% respectively, after PLF and 13.3%, 2.0%, and 0.8%, respectively, after LDD. Using multivariable logistic regression, the following were identified to be significantly associated with higher risk of long-term opioid use following PLF: discharge opioid prescription ≥ 500 MMEs, prescription of a long-acting opioid, female sex, multilevel surgery, and comorbidities such as depression and drug abuse (all p < 0.05). Elderly (age ≥ 65 years) and opioid-naive patients were found to be at lower risk (all p < 0.05). Similar results were obtained on analysis for LDD with the following significant additional risk factors identified: discharge opioid prescription ≥ 400 MMEs, prescription of tramadol alone at discharge, and inpatient surgery (all p < 0.05).

CONCLUSIONS

In an analysis of pharmacy claims from a national insurance database, the authors identified incidence and predictors of long-term opioid use after elective lumbar spine surgery.
Intraarterial delivery of bevacizumab and cetuximab utilizing blood-brain barrier disruption in children with high-grade glioma and diffuse intrinsic pontine glioma: results of a phase I trial
Authors: McCrea Heather J. , Ivanidze Jana , O’Connor Ashley , Hersh Eliza H. , Boockvar John A. , Gobin Y. Pierre , Knopman Jared , Greenfield Jeffrey P.
Published: August 2021

OBJECTIVE

Delivery of drugs intraarterially to brain tumors has been demonstrated in adults. In this study, the authors initiated a phase I trial of superselective intraarterial cerebral infusion (SIACI) of bevacizumab and cetuximab in pediatric patients with refractory high-grade glioma (diffuse intrinsic pontine glioma [DIPG] and glioblastoma) to determine the safety and efficacy in this population.

METHODS

SIACI was used to deliver mannitol (12.5 ml of 20% mannitol) to disrupt the blood-brain barrier (BBB), followed by bevacizumab (15 mg/kg) and cetuximab (200 mg/m2) to target VEGF and EGFR, respectively. Patients with brainstem tumors had a balloon inflated in the distal basilar artery during mannitol infusion.

RESULTS

Thirteen patients were treated (10 with DIPG and 3 with high-grade glioma). Toxicities included grade I epistaxis (2 patients) and grade I rash (2 patients). There were no dose-limiting toxicities. Of the 10 symptomatic patients, 6 exhibited subjective improvement; 92% showed decreased enhancement on day 1 posttreatment MRI. Of 10 patients who underwent MRI at 1 month, 5 had progressive disease and 5 had stable disease on FLAIR, whereas contrast-enhanced scans demonstrated progressive disease in 4 patients, stable disease in 2, partial response in 2, and complete response in 1. The mean overall survival for the 10 DIPG patients was 519 days (17.3 months), with a mean posttreatment survival of 214.8 days (7.2 months).

CONCLUSIONS

SIACI of bevacizumab and cetuximab was well tolerated in all 13 children. The authors’ results demonstrate safety of this method and warrant further study to determine efficacy. As molecular targets are clarified, novel means of bypassing the BBB, such as intraarterial therapy and convection-enhanced delivery, become more critical.

Clinical trial registration no.: NCT01884740 (clinicaltrials.gov)
Type I collagen scaffold with WNT5A plasmid for in situ cartilage tissue engineering
Authors: Tang Ruo-Fu , Zhou Xiao-Zhong , Niu Lie , Qi Yi-Ying
Published: August 2021

BACKGROUND: Cartilage tissue lacks the ability to heal. Cartilage tissue engineering using cell-free scaffolds has been increasingly used in recent years. OBJECTIVE: This study describes the use of a type I collagen scaffold combined with WNT5A plasmid to promote chondrocyte proliferation and differentiation in a rabbit osteochondral defect model. METHODS: Type I collagen was extracted and fabricated into a collagen scaffold. To improve gene transfection efficiency, a cationic chitosan derivative N,N,N-trimethyl chitosan chloride (TMC) vector was used. A solution of TMC/WNT5A complexes was adsorbed to the collagen scaffold to prepare a WNT5A scaffold. Osteochondral defects were created in the femoral condyles of rabbits. The rabbits were divided into defect, scaffold, and scaffold with WNT5A groups. At 6 and 12 weeks after creation of the osteochondral defects, samples were collected from all groups for macroscopic observation and gene expression analysis. RESULTS: Samples from the defect group exhibited incomplete cartilage repair, while those from the scaffold and scaffold with WNT5A groups exhibited “preliminary cartilage” covering the defect. Cartilage regeneration was superior in the scaffold with WNT5A group compared to the scaffold group. Safranin O staining revealed more proteoglycans in the scaffold and scaffold with WNT5A groups compared to the defect group. The expression levels of aggrecan, collagen type II, and SOX9 genes were significantly higher in the scaffold with WNT5A group compared to the other two groups. CONCLUSIONS: Type I collagen scaffold showed effective adsorption and guided the three-dimensional arrangement of stem cells. WNT5A plasmid promoted cartilage repair by stimulating the expression of aggrecan, type II collagen, and SOX9 genes and proteins, as well as inhibiting cartilage hypertrophy.
Getting caught in “the chair effect” after becoming a manager
Authors: Ülgen Beliz
Published: August 2021

BACKGROUND:

Unfortunately, in most organizations, the promotion process is not always managed under fairness conditions and usually, this issue produces harmful results for both organizations and employees. One of these results refers to the people who are promoted to managerial positions. After the promotion process, negative changes such as being selfish, manipulative, rude, behaving unfairly, underestimating others, putting exaggerated distance to his/her relations with others, are observed in their positive behaviors and attitudes that they displayed within the organization in the past. Many reasons can be cited for this situation. The degree and scope of the status may be one of the reasons for this change and this study named this phenomenon as “Chair Effect”. The chair is one of the major symbols representing managerial positions, and for this reason, the term chair is used in naming this effect.

OBJECTIVE:

This study aims to examine the “Chair Effect” phenomenon and define the possible factors which cause this phenomenon.

METHOD:

An inductive and qualitative research method is used in this study. Data were collected through a semi-structured interview technique with 12 participants who are middle- level and upper-level managers and have experience or observation about any manager who got caught in the chair effect. The Gioia method was used in the data analysis process.

RESULTS:

According to the results of the study, the factors that cause the chair effect are classified into three categories such as individual factors, organizational factors, and contextual factors.

CONCLUSION:

In the promotion processes of the organizations, evaluating the manager candidates’ personality traits and their success in relationship management besides their other qualifications (such as experience, performance degree, seniority time) objectively will be effective to cope with “the chair effect” issue.
APOE E2/E2 Is Associated with Slower Rate of Cognitive Decline with Age
Authors: Sweigart Benjamin , Andersen Stacy L. , Gurinovich Anastasia , Cosentino Stephanie , Schupf Nicole , Perls Thomas T. , Sebastiani Paola
Published: August 2021

Background: The E4 allele of the APOE gene is known to be associated with cognitive impairment. However, a limited number of studies have examined the association between the E2 allele and longitudinal changes of cognitive function. Objective: To determine whether rates of cognitive change differ in carriers of the APOE E2 allele compared to other genotypes. Methods: We conducted a secondary analysis of data from two ongoing longitudinal cohort studies, the Long Life Family Study (LLFS) and New England Centenarian Study (NECS). We included participants who had APOE genotyping data, data from longitudinal administrations of the Telephone Interview for Cognitive Status (TICS), and age, sex, and education available. We assessed whether cognitive change as measured by rate of decline in TICS score differed among people with different APOE genotypes. We used a hierarchical mixed effect model with APOE genotypes, their interactions with age, and potential confounders. Results: After adjusting for sex and education, in carriers of the common E3/E3 genotype, TICS score decreased by 0.15 points per year of age. In those with the E2/E2 genotype, TICS score decreased by 0.05 points per year of age, a significantly slower rate of decline (p = 0.017). We observed no protective effect of the E2/E3 genotype on cognitive decline. Conclusion: These results suggest a protective effect of the E2/E2 genotype on a measure of global cognitive function.
Association Between the Prognostic Nutritional Index and Cognitive Function Among Older Adults in the United States: A Population-Based Study
Authors: Zhou Jie , Ma Luping , Zhao Lulei , Sheng Jiamin , Xu Yuhua , Chen Jie , Yu Liangjun , Sun Quan , Zhou Hangyang , Zhu Shaofeng , Lu Zefeng , Wei Bo
Published: August 2021

Background: Nutritional status has been recognized as an important factor influencing cognitive function-related diseases, but few comprehensive nutrition indicators are available to assess the risk of cognitive decline. Objective: This study aimed to investigate the relationship between the prognostic nutritional index (PNI) and cognitive function in an elderly population, and the differences in nutrient intake between different levels of nutritional risk. Methods: Based on cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) 2011–2014, we included 2,564 older participants. The lower quartile of each of the four cognitive tests was considered to have cognitive function impairment (CFI). Binary and multivariate logistic regression models were used to estimate the relationship between the PNI and the odds ratio of CFI. Results: After adjustment for confounding variables, we found that the odds of CFI were significantly lower for participants with normal PNI levels than for those with low PNI levels. In a comparison of global cognitive impairment scores, participants with a normal PNI had lower ratios of poor cognitive performance than those with a low PNI. By comparing the nutrient intake at different PNI levels, we found a reduction in the intake of protein, dietary fiber, total saturated fatty acids, and multiple micronutrients in the low PNI group. Conclusion: Our study shows that the PNI can be a good predictor of the odds of CFI in the elderly population and that it is a convenient indicator of reduced intake of nutrients which may be important to brain health.
Pilot Evaluation of the Unsupervised, At-Home Cogstate Brief Battery in ADNI-2
Authors: Edgar Chris J. ,   for the Alzheimer’s Disease Neuroimaging Initiative, Siemers Eric , Maruff Paul , Petersen Ronald C. , Aisen Paul S. , Weiner Michael W. , Albala Bruce
Published: August 2021

Background: There is a need for feasible, scalable assessments to detect cognitive impairment and decline. The Cogstate Brief Battery (CBB) is validated for Alzheimer’s disease (AD) and in unsupervised and bring your own device contexts. The CBB has shown usability for self-completion in the home but has not been employed in this way in a multisite clinical trial in AD. Objective: The objective of the pilot was to evaluate feasibility of at-home, self-completion of the CBB in the Alzheimer’s Disease Neuroimaging Initiative (ADNI) over 24 months. Methods: The CBB was included as a pilot for cognitively normal (CN) and mild cognitive impairment (MCI) participants in ADNI-2, invited to take the assessment in-clinic, then at at-home over a period of 24 months follow-up. Data were analyzed to explore acceptability/usability, concordance of in-clinic and at-home assessment, and validity. Results: Data were collected for 104 participants (46 CN, 51 MCI, and 7 AD) who consented to provide CBB data. Subsequent analyses were performed for the CN and MCI groups only. Test completion rates were 100%for both the first in-clinic supervised and first at-home unsupervised assessments, with few repeat performances required. However, available follow-up data declined sharply over time. Good concordance was seen between in-clinic and at-home assessments, with non-significant and small effect size differences (Cohen’s d between -0.04 and 0.28) and generally moderate correlations (r = 0.42 to 0.73). Known groups validity was also supported (11/16 comparisons with Cohen’s d≥0.3). Conclusion: These data demonstrate the feasibility of use for the CBB for unsupervised at-home, testing, including MCI groups. Optimal approaches to the application of assessments to support compliance over time remain to be determined.
Comparing a Single Clinician Versus a Multidisciplinary Consensus Conference Approach for Dementia Diagnostics
Authors: Thorlacius-Ussing Gorm , Bruun Marie , Gjerum Le , Frederiksen Kristian S. , Rhodius-Meester Hanneke F.M. , van der Flier Wiesje M. , Waldemar Gunhild , Hasselbalch Steen G.
Published: August 2021

Background: Evidence-based recommendations on the optimal evaluation approach for dementia diagnostics are limited. This impedes a harmonized workup across clinics and nations. Objective: To evaluate the diagnostic performance of a multidisciplinary consensus conference compared to a single clinician approach. Methods: In this prospective study, we enrolled 457 patients with suspected cognitive decline, from two European memory clinics. A diagnostic evaluation was performed at baseline independently in two ways: 1) by a single clinician and 2) at a multidisciplinary consensus conference. A syndrome diagnosis and an etiological diagnosis was made. The confidence in the diagnosis was recorded using a visual analogue scale. An expert panel re-evaluation diagnosis served as reference for the baseline syndrome diagnosis and a 12-24-month follow-up diagnosis for the etiological diagnosis. Results: 439 patients completed the study. We observed 12.5%discrepancy (k = 0.81) comparing the baseline syndrome diagnoses of the single clinician to the consensus conference, and 22.3%discrepancy (k = 0.68) for the baseline etiological diagnosis. The accuracy of the baseline etiological diagnosis was significantly higher at the consensus conference and was driven mainly by increased accuracy in the MCI group. Confidence in the etiological diagnosis at baseline was significantly higher at the consensus conference (p < 0.005), especially for the frontotemporal dementia diagnosis. Conclusion: The multidisciplinary consensus conference performed better on diagnostic accuracy of disease etiology and increased clinicians’ confidence. This highlights the importance of a multidisciplinary diagnostic evaluation approach for dementia diagnostics, especially when evaluating patients in the MCI stage.
High-Definition Transcranial Direct Current Stimulation Improves Delayed Memory in Alzheimer’s Disease Patients: A Pilot Study Using Computational Modeling to Optimize Electrode Position
Authors: Rasmussen Ingrid Daae , Boayue Nya Mehnwolo , Mittner Matthias , Bystad Martin , Grønli Ole K. , Vangberg Torgil Riise , Csifcsák Gábor , Aslaksen Per M.
Published: August 2021

Background: The optimal stimulation parameters when using transcranial direct current stimulation (tDCS) to improve memory performance in patients with Alzheimer’s disease (AD) are lacking. In healthy individuals, inter-individual differences in brain anatomy significantly influence current distribution during tDCS, an effect that might be aggravated by variations in cortical atrophy in AD patients. Objective: To measure the effect of individualized HD-tDCS in AD patients. Methods: Nineteen AD patients were randomly assigned to receive active or sham high-definition tDCS (HD-tDCS). Computational modeling of the HD-tDCS-induced electric field in each patient’s brain was analyzed based on magnetic resonance imaging (MRI) scans. The chosen montage provided the highest net anodal electric field in the left dorsolateral prefrontal cortex (DLPFC). An accelerated HD-tDCS design was conducted (2 mA for 3×20 min) on two separate days. Pre- and post-intervention cognitive tests and T1 and T2-weighted MRI and diffusion tensor imaging data at baseline were analyzed. Results: Different montages were optimal for individual patients. The active HD-tDCS group improved significantly in delayed memory and MMSE performance compared to the sham group. Five participants in the active group had higher scores on delayed memory post HD-tDCS, four remained stable and one declined. The active HD-tDCS group had a significant positive correlation between fractional anisotropy in the anterior thalamic radiation and delayed memory score. Conclusion: HD-tDCS significantly improved delayed memory in AD. Our study can be regarded as a proof-of-concept attempt to increase tDCS efficacy. The present findings should be confirmed in larger samples.
Japanese National Dementia Plan Is Associated with a Small Shift in Location of Death: An Interrupted Time Series Analysis
Authors: Wammes Joost D. , Nakanishi Miharu , van der Steen Jenny T. , MacNeil Vroomen Janet L.
Published: August 2021

Background: Japan has one of the highest percentages of persons with dementia and hospital deaths in the world. Hospitals are often not equipped to handle the care complexity required for persons with dementia at the end of life. The National Dementia Orange plan aimed to decrease hospital deaths by expanding time in the community. Objective: The aim of this study is to evaluate whether the National Dementia Orange Plan is associated with a decrease in hospitals deaths for persons with dementia. Methods: We used quarterly, cross-sectional, national death certificate data consisting of the total Japanese dementia population 65 years and older, spanning a period from 2009 to 2016. The primary outcome was quarterly adjusted relative risk rates (aRRR) of dying in hospital, nursing home, home, or elsewhere. An interrupted time series analysis was performed to study the slope change over time. Analyses were adjusted for sex and seasonality. Results: 149,638 died with dementia. With the implementation of the Orange Plan, death in nursing home (aRRR 1.08, [1.07–1.08], p < 0.001) and elsewhere (aRRR 1.05, [1.05–1.06], p < 0.001) increased over time compared to hospital death. No changes were found in death at home. Conclusion: This study provides evidence that the National Dementia Orange plan was associated with a small increase in death in nursing home and elsewhere. Hospital death remained the primary location of death. End-of-life strategies should be expanded in national dementia policies to increase aging in the community until death.
A Case of Early-Onset Alzheimer’s Disease Mimicking Schizophrenia in a Patient with Presenilin 1 Mutation (S170P)
Authors: Kim Hang-Rai , Jang Ja Hyun , Ham Honggi , Choo Seung Ho , Park Jeongho , Kang Sung Hoon , Hwangbo Song , Jang Hyemin , Na Duk L. , Seo Sang Won , Baek Ji Hyun , Kim Hee Jin
Published: August 2021

Atypical psychological symptoms frequently occur in early-onset Alzheimer’s disease (EOAD), which makes it difficult to differentiate it from other psychiatric disorders. We report the case of a 28-year-old woman with EOAD, carrying a presenilin-1 mutation (S170P), who was initially misdiagnosed with schizophrenia because of prominent psychiatric symptoms in the first 1–2 years of the disease. Amyloid-β positron emission tomography (PET) showed remarkably high tracer uptake in the striatum and thalamus. Tau PET showed widespread cortical uptake and relatively low uptake in the subcortical and medial temporal regions. Our case advocates for considering EOAD diagnosis for young patients with psychiatric and atypical cognitive symptoms.