bluuebunny/crossref_metadata_2025 huggingface dataset:
Scarless Neck Feminization by Transoral Endoscopic Vestibular Approach Chondrolaryngoplasty: A Prospective Cohort
Authors: Shoffel‐Havakuk Hagit , Cohen Oded , Lahav Yonatan , Khafif Avi
Published: February 2023

Objective

Chondrolaryngoplasty (laryngeal‐prominence reduction) is a gender affirmation surgery for transgender women, or for cisgender people desiring an esthetic correction. Up until recently, chondrolaryngoplasty required a visible neck scar. The transoral endoscopic vestibular approach (TOEVA) is gaining widespread use as a scarless alternative for thyroid/parathyroid surgeries. This study aims to describe the feasibility, safety, and outcomes of TOEVA‐chondrolaryngoplasty, based on the first‐ever performed cases.

Study Design

A prospective cohort.

Setting

An academic referral center.

Methods

Adult patients interested in chondrolaryngoplasty underwent scarless TOEVA‐chondrolaryngoplasty between 2019 and 2022, according to the described protocol. Video stroboscopy was recorded pre‐and postoperatively. Surgical data, adverse events, and complications were recorded. Patients' satisfaction was measured using an outcome instrument for esthetic chondrolaryngoplasty.

Results

Twelve patients (10 transgender women, a cisgender man, and a woman) were included. The mean age was 26.7 ± 6.5 years, ranging from 19 to 37. The average operative time was 3:01 ± 0:51 hours. The thyroid cartilage and laryngeal prominence were easily and safely approached and reduced, with no adverse events or major complications. All patients were discharged on postoperative day 1. A single patient had a temporary mental nerve hypoesthesia that resolved spontaneously. Otherwise, no other complications were encountered. Vocal folds' function remained unchanged in all patients. Patients were very much to completely satisfied with the surgical results as measured by the outcome instrument; median (interquartile range), 25 (21‐27.75).

Conclusion

In this first reported cohort of scarless TOEVA‐chondrolaryngoplasty, this approach was proven to be safe and feasible, with no adverse events or major complications, and with high patient satisfaction.
Poly(vinyl alcohol)/Premna Oblongifolia Merr. Extract/Glutaraldehyde/Carbon Nanotube (VOGC)‐Based Composite Hydrogel: A Potential Candidate for Controlled‐Release Materials
Authors: Hendrawan Hendrawan , Aziz Hafiz Aji , Haryati Nina , Khoerunnisa Fitri
Published: February 2023

A hydrogel based on poly(vinyl alcohol) (V), Premna Oblongifolia Merr. extract (O), glutaraldehyde (G), and carbon nanotubes (C) has been synthesized in search of candidates to develop controlled‐release fertilizers (CRF). Referring to previous studies, O and C can be considered as two materials that have potential as modifiers in synthesizing CRF. This work is comprised of hydrogel synthesis, their characterisation, including measuring swelling ratio (SR) and water retention (WR) of VOGm, VOGe, VOGmC3, VOGmC5, VOGmC7, VOGmC7‐KCl, and release behaviour of KCl from VOGmC7‐KCl. We found that C interacts physically with VOG, increased the surface roughness of VOGm, and reduced the VOGm crystallite size. The addition of KCl into VOGmC7 reduced the pore size and increased the structural density of VOGmC7. The thickness and the C content of VOG affected its SR and WR. The addition of KCl into VOGmC7 reduced its SR, but did not significantly affect its WR.
Office‐Based Multilevel Radiofrequency Ablation for Mild‐to‐Moderate Obstructive Sleep Apnea
Authors: Herman Howard , Stern Jordan , Alessi David M. , Swartz Keith A. , Gillespie Marion Boyd
Published: February 2023

Objective

Investigate multilevel radiofrequency ablation (RFA) as an alternative therapy for patients with mild‐to‐moderate obstructive sleep apnea (OSA).

Study Design

Prospective, open‐label, single‐arm, nonrandomized clinical trial.

Setting

Multicenter academic and private clinics.

Methods

Patients with mild‐to‐moderate OSA (apnea‐hypopnea index [AHI] 10‐30; body mass index ≤ 32) were treated with 3 sessions of office‐based RFA to the soft palate and tongue base. The primary outcome was a change in the AHI and oxygen desaturation index (ODI 4%). Secondary outcomes included subjective sleepiness level; snoring level; and sleep‐related quality of life.

Results

Fifty‐six patients were enrolled, with 43 (77%) completing the study protocol. Following 3 sessions of office‐based RFA to the palate and base of the tongue, the mean AHI decreased from 19.7 to 9.9 (p = .001), while the mean ODI (4%) decreased from 12.8 to 8.4 (p = .005). Mean Epworth Sleepiness Scale scores declined from 11.2 (±5.4) to 6.0 (±3.5) (p = .001), while Functional Outcomes of Sleep Questionnaire scores improved from a mean of 14.9 at baseline to 17.4 (p = .001). The mean visual analog scale snoring scale was reduced from 5.3 (±1.4) at baseline to 3.4 (±1.6) at 6 months posttherapy (p = .001).

Conclusion

Office‐based, multilevel RFA of the soft palate and base of the tongue is a safe and effective treatment option with minimal morbidity for properly selected patients with mild‐to‐moderate OSA who are intolerant or refuse continuous positive airway pressure therapy.
Creation of an Open Bedside Tracheostomy Program at a Community Hospital With a Single Surgeon
Authors: Ziltzer Ryan S. , Millman Noah M. , Serrano Jorge , Swanson Mark , O'Dell Karla
Published: February 2023

Objective

To assess the adverse event rate and operating cost of open bedside tracheostomy (OBT) at a community hospital. To present a model for creating an OBT program at a community hospital with a single surgeon.

Study Design

Retrospective case series pilot study.

Setting

Academic‐affiliated community hospital.

Methods

Retrospective chart review of surgical OBT and operating room tracheostomy (ORT) at a community hospital from 2016 to 2021. Primary outcomes included operation duration; perioperative, postoperative, and long‐term complications; and crude time‐based estimation of operating cost to the hospital using annual operating cost. Clinical outcomes of OBT were assessed with ORT as a comparison using t tests and Fisher's exact tests.

Results

Fifty‐five OBT and 14 ORT were identified. Intensive care unit (ICU) staff training in preparing for and assisting with OBT was successfully implemented by an Otolaryngologist and ICU nursing management. Operation duration was 20.3 minutes for OBT and 25.2 minutes for ORT (p = .14). Two percent, 18%, and 10% of OBT had perioperative, postoperative, and long‐term complications, respectively; this was comparable to rates for ORT (p = .10). The hospital saved a crude estimate of $1902 in operating costs per tracheostomy when performed in the ICU.

Conclusion

An OBT protocol can be successfully implemented at a single‐surgeon community hospital. We present a model for creating an OBT program at a community hospital with limited staff and resources.
Outcomes of Wilms tumor therapy in Lilongwe, Malawi, 2016–2021: Successes and ongoing research priorities
Authors: Holmes David M. , Matatiyo Apatsa , Mpasa Atupele , Huibers Minke H. W. , Manda Geoffrey , Tomoka Tamiwe , Mulenga Maurice , Namazzi Ruth , Mehta Parth , Zobeck Mark , Mzikamanda Rizine , Chintagumpala Murali , Allen Carl , Nuchtern Jed G. , Borgstein Eric , Aronson Daniel C. , Ozuah Nmazuo , Nandi Bip , McAtee Casey L.
Published: February 2023

Introduction

Wilms tumor therapy in low‐ and middle‐income countries (LMICs) relies on treatment protocols adapted to resource limitations, but these protocols have rarely been evaluated in real‐world settings. Such evaluations are necessary to identify high‐impact research priorities for clinical and implementation trials in LMICs. The purpose of this study was to identify highest priority targets for future clinical and implementation trials in sub‐Saharan Africa by assessing outcomes of a resource‐adapted treatment protocol in Malawi.

Methods

We conducted a retrospective cohort study of children treated for Wilms tumor with an adapted SIOP‐backbone protocol in Lilongwe, Malawi between 2016 and 2021. Survival analysis assessed variables associated with poor outcome with high potential for future research and intervention.

Results

We identified 136 patients, most commonly with stage III (n = 35; 25.7%) or IV disease (n = 35; 25.7%). Two‐year event‐free survival (EFS) was 54% for stage I/II, 51% for stage III, and 13% for stage IV. A single patient with stage V disease survived to 1 year. Treatment abandonment occurred in 36 (26.5%) patients. Radiotherapy was indicated for 55 (40.4%), among whom three received it. Of these 55 patients, 2‐year EFS was 31%. Of 14 patients with persistent metastatic pulmonary disease at the time of nephrectomy, none survived to 2 years. Notable variables independently associated with survival were severe acute malnutrition (hazard ratio [HR]: 1.9), increasing tumor stage (HR: 1.5), and vena cava involvement (HR: 3.1).

Conclusion

High‐impact targets for clinical and implementation trials in low‐resource settings include treatment abandonment, late presentation, and approaches optimized for healthcare systems with persistently unavailable radiotherapy.
Phase Transitions, Mechanical and Dynamic Stability, and Electronic Properties of SnO Polymorphs under High Pressure
Authors: Hong Dan , Zeng Wei , Liu Fu-Sheng , Liu Zheng-Tang , Liu Qi-Jun
Published: February 2023

The structures, phase transition, mechanical properties, dynamic stability, and electronic properties of SnO polymorphs (α, γ, herzenbergite, B1, and B2 phases) under pressure have been studied using the first‐principles calculations. The obtained structural parameters are in agreement with the available data. According to the enthalpy–pressure curves of SnO, the pressure‐induced phase transitions are verified to be from α to γ at 0.94 GPa and from B1 to B2 at 49.1 GPa, respectively. The calculated elastic constants indicate that B2 and γ are unstable under zero pressure. With increasing pressure, there is stability–instability transition for B1, whose transition pressure is 20.6 GPa, respectively. Moreover, a range of mechanical stability is from 5.5 to 10.8 for α phase and from 3.4 to 14.3 GPa for γ phase. The corresponding elastic modulus has been analyzed under pressures. With regard to elastic anisotropy, a variety of methods are taken to analyze it and the causes of various anisotropic characters are explained. Phonon dispersions show the same dynamic stability of SnO with the mechanical stability. In addition, the density of states and charge density all reflect that the interactions between Sn and O elements are enhanced with the increasing pressure.
Glutathione conjugation of nitrogen mustards: In vitro study
Authors: Hamzah Nurhazlina , Kjellberg Matti , Vanninen Paula
Published: February 2023

Rationale

This paper describes an in vitro study designed to identify metabolic biomarkers resulting from the conjugation of nitrogen mustards (NMs) with glutathione (GSH). The method developed is essential in providing evidence in the event of NM exposure in biomedical samples.

Methods

The mass spectral characterization of the proposed NMs–GSH conjugates was performed with liquid chromatography high‐resolution tandem mass spectrometry (LC‐HRMS/MS). The final reaction mixtures were analysed in positive electrospray ionisation (ESI) at different incubation times.

Results

This study identified three types of conjugates in addition to ethanolamines, the hydrolysis products of NMs. Monoglutathionyl, diglutathionyl and phosphorylated conjugates were produced for each of the NMs, bis(2‐chloroethyl)ethylamine (HN1), bis(2‐chloroethyl)methylamine (HN2) and tris(2‐chloroethyl)amine (HN3). The monoglutathionyl conjugates consisted of HN1‐GSH, HN2‐GSH and HN3‐GSH. The spontaneous and primary conjugates of diglutathionyl were HN1‐GSH2, HN2‐GSH2 and HN3‐GSH2. These included phosphorylated conjugates, namely HN1‐GSH‐PO4, HN2‐GSH‐PO4 and HN3‐GSH‐PO4, as might have formed due to hydrolysis in phosphate buffer.

Conclusions

The mass spectral data of all conjugates formed in the presence of all NMs and GSH are reported in this study. These GSH metabolites can be used to confirm NMs toxicity in biological samples such as urine.
Stabilizing control of Markovian jump systems with sampled switching and state signals and applications
Authors: Wang Guoliang , Ren Yunshuai , Huang Chao
Published: February 2023

This article addresses the stabilization problem of continuous‐time Markovian jump systems (MJSs). Because of both switching and state signals sampled, a novel system with an exponential matrix characterizing the sampling effects is developed. It is used to be an auxiliary system and plays important roles in system analysis and synthesis. Sufficient stabilization conditions are presented and fully consider the sampling rate. The applications of established methods and results are applied to networked control in the presence of denial‐of‐service (DoS). The frequency and duration of DoS attacks ensuring stability of the closed‐loop system are characterized. Meanwhile, more special situations about particular transition rate matrix, sampling logic and improved mode‐dependent controller are considered respectively. The analysis results are significant and bring an important method to study the control for MJSs with sampled switching and state signals. A numerical example is offered to verify the effectiveness and superiority of the methods proposed in this study.
Practical insights can help college, university leaders to successfully manage rapid changes
Authors: D'Orio Wayne
Published: February 2023

Michael Horn is the Co‐Founder and Distinguished Fellow at the Clayton Christensen Institute for Disruptive Innovation, a nonprofit think tank based on the theories of the former Harvard professor. He's also the author of several books on education, including most recently 2022's From Reopen to Reinvent: (Re)creating School for Every Child.
Take time to reflect on your career
Authors: Hodges Dawn Z.
Published: February 2023

It's critical to stop every now and then to take stock of accomplishments and challenges in the recently ended period, to restock with ideas for new activities and projects, and to determine strategies for improvement. I hope you'll take time to reflect on your life and career. Reflection is an important and necessary tool for success.
A comparison of elementary teachers' verbal supports for students in inclusive and general classroom contexts during an NGSS‐aligned science, engineering, and computer science unit
Authors: Lilly Sarah , McAlister Anne M. , Fick Sarah J. , Chiu Jennifer L.
Published: February 2023

Elementary teachers are tasked with the challenge of implementing Next Generation Science Standards‐aligned projects that integrate science, technology, engineering, mathematics, and computer science (STEM + CS) in a variety of classroom contexts. This study investigates how teachers verbally support students in two classrooms, one general education class and one inclusive class with a larger proportion of students with individualized educational plans, to engage in a Next Generation Science Standards‐aligned, STEM + CS unit. Teachers' verbal support for students to understand how (pragmatic) and when and why (epistemic) to use practices was examined during whole‐class discussions for a 4‐week unit in science, engineering, and computer science‐focused lessons. Bi‐weekly teacher surveys and weekly teacher interviews provided insight into the teachers' perceptions of students and project activities in each class section. Teachers reported instructional decisions to modify their enactment of the interdisciplinary curricular materials for the Inclusive Class and discussed their rationales for these modifications. Results suggest that instructional decisions that teachers made in how to verbally support students may depend upon their own knowledge of the different disciplines being integrated, their prior beliefs of students in different classroom contexts, and their in‐the‐moment perceptions of student needs. These factors may have led to different learning experiences for the students in each class section. Findings underscore the need for more research to better understand what kinds of support students and teachers need to be able to integrate engineering, science, and computer science content and practices within their elementary classrooms and provide equitable learning opportunities for all students.
Antibacterial Carbon Dots‐Based Composites
Authors: Huang Shan , Song Yuexin , Zhang Jian‐Rong , Chen Xiaojun , Zhu Jun‐Jie
Published: February 2023

The emergence and global spread of bacterial resistance to conventionally used antibiotics have highlighted the urgent need for new antimicrobial agents that might replace antibiotics. Currently, nanomaterials hold considerable promise as antimicrobial agents in anti‐inflammatory therapy. Due to their distinctive functional physicochemical characteristics and exceptional biocompatibility, carbon dots (CDs)‐based composites have attracted a lot of attention in the context of these antimicrobial nanomaterials. Here, a thorough assessment of current developments in the field of antimicrobial CDs‐based composites is provided, starting with a brief explanation of the general synthesis procedures, categorization, and physicochemical characteristics of CDs‐based composites. The many processes driving the antibacterial action of these composites are then thoroughly described, including physical destruction, oxidative stress, and the incorporation of antimicrobial agents. Finally, the obstacles that CDs‐based composites now suffer in combating infectious diseases are outlined and investigated, along with the potential applications of antimicrobial CDs‐based composites.
Ultra‐Thin 2D Ionic Salt Supported with Strong Hydrogen‐Bonding Assisted Ionic Interaction
Authors: Feng Jiaxin , Zhang Ganbing , Wen Ju , He Xianying , Li Ming
Published: February 2023

2D materials have attracted great interest since the report of graphene. However, because of the fragile stability of ultra‐thin nanosheets, most studies are restricted to sheets maintained by strong covalent or coordination bonds. The research on which kind of bonds can maintain the free‐standing existence of 2D nanosheets is still of great significance. Recently, 2D ionic salts are successfully synthesized on substrates, but whether 2D ionic salts can free‐stand is still a problem. Herein this problem is addressed by a free‐standing 2D ionic salt (thickness: ≈2 nm) exfoliated from a 4,4′‐bipyridinium hydrochloride salt crystal. The stability of this 2D salt is supported by a strong NH···Cl hydrogen (H)‐bonding assisted ionic interaction (17.99 kcal mol−1), which is verified by density functional theory calculation and natural bond orbital analysis. The salt crystal has strong air‐stable radicals inside and the 2D ionic salt exhibits red fluorescence in solution and in solid‐state, especially in solution the stokes shifts are very large (≈ 386 nm). This breakthrough work is not only beneficial for the construction of novel 2D materials but also for the understanding of H‐bonding interactions.
High Efficiency Near‐Infrared Perovskite Light Emitting Diodes With Reduced Rolling‐Off by Surface Post‐Treatment
Authors: Wei Jianwu , Li Jiong , Duan Chenghao , Yuan Ligang , Zou Shibing , Pang Qi , Yan Keyou
Published: February 2023

The rolling‐off phenomenon of device efficiency at high current density caused by quenching of luminescence in perovskite light‐emitting diodes (PeLED) is challenging to be solved. Here, 2‐amino‐5‐iodopyrazine (AIPZ) is dissolved in a mixed solvent of chlorobenzene (CB)/isopropanol (IPA) (7:3 volume ratio) for surface post‐treatment of FAPbI3 perovskite film. The interaction of AIPZ and perovskite surface not only balances the charge injection but also passivates defects to enhance radiative recombination in PeLED. Therefore, the PeLED champion yields peak external quantum efficiency reaching 23.2% at the current density of 45 mA cm−2 with a radiance brightness of 290 W sr−1 m−2. More importantly, the rolling‐off of device efficiency is significantly reduced. The lowest rolling‐off devices can maintain 80% of peak EQE (22.1%) at a high current density of 460 mA cm−2, whereas the control device only retains 25% of the peak EQE value. This work provides an effective strategy to improve performance and reduce the EQE rolling‐off of PeLED for practical application.
Ultralarge Pixel Array Photothermal Film based on 3D Self‐Suspended Microbridge Structure for Infrared Scene Projection
Authors: Hao Yan , Yang Suhui , Ling Chen , Gao Yanze , Liao Yingqi , Yao Zhaozhao , Li Zhuo
Published: February 2023

Infrared emitter is highly desirable for applications in infrared imaging and infrared stealth technology. It is also a core device in infrared scene generation. Light‐driven photothermal film has attracted considerable interest due to its outstanding photothermal properties and easy fabrication. However, the existing photothermal films suffer from low photothermal conversion efficiency (PCE) as well as small sizes. The improvement of the PCE is usually achieved at the expense of dynamic frame rate. Here, this work designs and fabricates a photothermal film based on 3D self‐suspended microbridge structure. Silicon (Si) microbridges are introduced into each microstructure to manipulate the thermal conductivity of the films. By optimizing the parameters of the Si microbridges, the high PCE and fast frame rate are both achieved. Moreover, the 3D structure microbridge film is 4‐inch in diameter, forming an ultralarge array with over 2200 × 2200 pixels. Finally, a high PCE infrared scene projector is realized based on this photothermal film. A visible image is projected on the film, the 3D‐microstructured photothermal film absorbs the visible light and emits an infrared image same as the visible one with high resolution and fast frame rate due to the excellent photothermal properties.
Instructors are learners too: Making faculty development accessible to faculty
Authors: Silverman Sarah
Published: February 2023

This chapter explores the range of barriers that instructors, especially adjunct and other non‐tenure track instructors, may face when attempting to learn new pedagogical techniques or improve their courses. The author will present concrete strategies for using a disability‐informed Universal Design for Learning (UDL) approach to making faculty development programming accessible for a range of instructors by modeling effective UDL practices that instructors can use in their own classrooms.
Communicate with financial aid offices to successfully re‐enroll stopped‐out students
Authors: Taylor Zach
Published: February 2023

As the enrollment cliff is approaching in 2025, enrollment managers need to explore new and creative methods of re‐engaging with stopped‐out students. Although there has been much written about how to help this population, many students during the pandemic left school for financial reasons, which will require enrollment managers to work closely with financial aid leadership on campus.
Keep adult learners connected to campus with peer mentoring program
Authors: Sutton Halley
Published: February 2023

Kathy Cavanaugh, Education Program Coordinator for Continuing Education at Pennsylvania State University, Berks, attended community college straight out of high school, earning an associate degree in film production, then worked in the film industry in Los Angeles and New York for several years. Then, after having children, she got a part‐time job at Penn State.
Denise Kathryn Brudenall
Authors: Eastwood Jane
Published: February 2023

A specialist in ophthalmology, she was also a brilliant, all‐round ‘supervet’, who thrived on keeping fit and enjoying outdoor pursuits.
Roger Stanley Windsor
Authors: Wilson Alan , Trethewey John
Published: February 2023

He travelled extensively, carrying out veterinary work in many countries around the world.
Interpolating boundary conditions on AdS2
Authors: Canazas Garay Anthonny F. , Correa Diego H. , Faraggi Alberto , Silva Guillermo A.
Published: February 2023

Abstract

We consider two instances of boundary conditions for massless scalars on AdS2 that interpolate between the Dirichlet and Neumann cases while preserving scale invariance. Assessing invariance under the full SL(2; ℝ) conformal group is not immediate given their non-local nature. To further clarify this issue, we compute holographically 2- and 4-point correlation functions using the aforementioned boundary conditions and study their transformation properties. Concretely, motivated by the dual description of some multi-parametric families of Wilson loops in ABJM theory, we look at the excitations of an open string around an AdS2 ⊂ AdS4 × ℂℙ3 worldsheet, thus obtaining correlators of operators inserted along a 1-dimensional defect in $$ \mathcal{N} $$
N
= 6 super Chern-Simons-matter theory at strong coupling. Of the two types of boundary conditions analyzed, only one leads to the expected functional structure for conformal primaries; the other exhibits covariance under translations and rescalings but not under special conformal transformations.
Phases of a 10-D holographic hard wall model
Authors: Singh Akash , Yogendran K. P.
Published: February 2023

Abstract

In this article, we study the finite temperature properties of a 10-D version of a hardwall model for QCD. Introducing fundamental matter via probe D7-branes and separate cutoffs rm and rg for the branes and the bulk, we present a detailed exploration of the phases for varying temperature and quark mass. Finite thermodynamic quantities are calculated using the procedure of holographic renormalization and used to characterize the phases. Finally, by fitting glueball and vector meson masses, we show how a unique phase diagram can be isolated.
Uniform Convergent Expansions of the Error Function in Terms of Elementary Functions
Authors: Ferreira Chelo , López José L. , Sinusía Ester Pérez
Published: February 2023

We derive a new analytic representation of the error function $${\text {erf}}\,\, z$$

erf

z

in the form of a convergent series whose terms are exponential and rational functions. The expansion holds uniformly in z in the double sector $$\vert \arg (\pm z)\vert <\pi /4$$

|
arg
(
±
z
)
|
<
π
/
4

. The expansion is accompanied by realistic error bounds.
Production of wood-based panel from recycled wood resource: a literature review
Authors: Nguyen Duy Linh , Luedtke Jan , Nopens Martin , Krause Andreas
Published: February 2023

This article presents and discusses the available studies on utilization of waste wood (WW) resource for wood-based panel production. The cited literature indicated that the majority of WW research was from Europe and conducted mainly on recycled material from particleboard. In addition, particleboard was presented as the first option of wood-based panel product manufactured from waste wood. There was a lack of research on the recycling of plywood. Physical and chemical contaminants fluctuated strongly between low- and high-quality recycled wood mixes depending on their origins. Findings from studies also noticed that wood-based panels (e.g., particleboard) could be produced from 100% WW. However, the physical and mechanical properties of wood-based panel drop with the high proportion of WW content due to the decrease in slenderness ratio and increase in contaminants. Moreover, formaldehyde emission content of particleboard and Oriented Strand Board (OSB) manufactured from WW particles increases when the WW percentage increases. Contrary, the formaldehyde amount decreases with the increase in recycled fiber content in fiberboards. Notably, the properties and emission of recycled wood composite products could be improved by applying high-tech sorting technologies, appropriate chipping techniques, pretreatment steps and formaldehyde-free binders during waste wood handling and production process.
Skeletal muscle and intermuscular adipose tissue gene expression profiling identifies new biomarkers with prognostic significance for insulin resistance progression and intervention response
Authors: Lutter Dominik , Sachs Stephan , Walter Marc , Kerege Anna , Perreault Leigh , Kahn Darcy E. , Wolide Amare D. , Kleinert Maximilian , Bergman Bryan C. , Hofmann Susanna M.
Published: February 2023

Aims/hypothesis

Although insulin resistance often leads to type 2 diabetes mellitus, its early stages are often unrecognised, thus reducing the probability of successful prevention and intervention. Moreover, treatment efficacy is affected by the genetics of the individual. We used gene expression profiles from a cross-sectional study to identify potential candidate genes for the prediction of diabetes risk and intervention response.

Methods

Using a multivariate regression model, we linked gene expression profiles of human skeletal muscle and intermuscular adipose tissue (IMAT) to fasting glucose levels and glucose infusion rate. Based on the expression patterns of the top predictive genes, we characterised and compared individual gene expression with clinical classifications using k-nearest neighbour clustering. The predictive potential of the candidate genes identified was validated using muscle gene expression data from a longitudinal intervention study.

Results

We found that genes with a strong association with clinical measures clustered into three distinct expression patterns. Their predictive values for insulin resistance varied substantially between skeletal muscle and IMAT. Moreover, we discovered that individual gene expression-based classifications may differ from classifications based predominantly on clinical variables, indicating that participant stratification may be imprecise if only clinical variables are used for classification. Of the 15 top candidate genes, ST3GAL2, AASS, ARF1 and the transcription factor SIN3A are novel candidates for predicting a refined diabetes risk and intervention response.

Conclusion/interpretation

Our results confirm that disease progression and successful intervention depend on individual gene expression states. We anticipate that our findings may lead to a better understanding and prediction of individual diabetes risk and may help to develop individualised intervention strategies.

Graphical abstract
Weighing psychosocial factors in relatives for the risk of psychopathology: a study of patients with depressive and anxiety disorders and their siblings
Authors: van Sprang Eleonore D. , Maciejewski Dominique F. , Milaneschi Yuri , Kullberg Marie-Louise J. , Elzinga Bernet M. , van Hemert Albert M. , Hartman Catharina A. , Penninx Brenda W. J. H.
Published: February 2023

Purpose

Siblings of probands with depressive and anxiety disorders are at increased risk for psychopathology, but little is known about how risk factors operate within families to increase psychopathology for siblings. We examined the additional impact of psychosocial risk factors in probands—on top of or in combination with those in siblings—on depressive/anxious psychopathology in siblings.

Methods

The sample included 636 participants (Mage = 49.7; 62.4% female) from 256 families, each including a proband with lifetime depressive and/or anxiety disorders and their sibling(s) (N = 380 proband-sibling pairs). Sixteen psychosocial risk factors were tested. In siblings, depressive and anxiety disorders were determined with standardized psychiatric interviews; symptom severity was measured using self-report questionnaires. Analyses were performed with mixed-effects models accounting for familial structure.

Results

In siblings, various psychosocial risk factors (female gender, low income, childhood trauma, poor parental bonding, being single, smoking, hazardous alcohol use) were associated with higher symptomatology and likelihood of disorder. The presence of the same risk factor in probands was independently associated (low income, being single) with higher symptomatology in siblings or moderated (low education, childhood trauma, hazardous alcohol use)—by reducing its strength—the association between the risk factor and symptomatology in siblings. There was no additional impact of risk factors in probands on likelihood of disorder in siblings.

Conclusion

Our findings demonstrate the importance of weighing psychosocial risk factors within a family context, as it may provide relevant information on the risk of affective psychopathology for individuals.
Pirfenidone affects human cardiac fibroblast proliferation and cell cycle activity in 2D cultures and engineered connective tissues
Authors: Meyer Friederike Elisabeth Ugi , Santos Gabriela Leao , Doan Thao Phuong , DeGrave Alisa Nicole , Bues Bastian , Lutz Susanne
Published: February 2023

The anti-fibrotic drug pirfenidone (PFD) is currently in clinical testing for the treatment of heart failure with preserved ejection fraction; however, its effects on human cardiac cells have not been fully investigated. Therefore, we aimed to characterize the impact of PFD on human cardiac fibroblasts (CF) in 2D culture as well as in 3D-engineered connective tissues (ECT). We analyzed proliferation by automated cell counting and changes in signaling by immunoblotting. We generated ECT with different geometries to modify the cellular phenotype and investigated the effects of PFD on cell number and viability as well as on cell cycle activity. We further studied its effect on ECT compaction, contraction, stiffening, and strain resistance by ECT imaging, pole deflection analysis, and ultimate tensile testing. Our data demonstrate that PFD inhibits human CF proliferation in a concentration-dependent manner with an IC50 of 0.43 mg/ml and its anti-mitogenic effect was further corroborated by an inhibition of MEK1/2, ERK1/2, and riboprotein S6 (rpS6) phosphorylation. In ECT, a lower cell cycle activity was found in PFD-treated ECT and fewer cells resided in these ECT after 5 days of culture compared to the control. Moreover, ECT compaction as well as ECT contraction was impaired. Consequently, biomechanical analyses demonstrated that PFD reduced the stiffness of ECT. Taken together, our data demonstrate that the anti-fibrotic action of PFD on human CF is based on its anti-mitogenic effect in 2D cultures and ECT.
From Vlasov Equation to Degenerate Nonlocal Cahn-Hilliard Equation
Authors: Elbar Charles , Mason Marco , Perthame Benoît , Skrzeczkowski Jakub
Published: February 2023

We provide a rigorous mathematical framework to establish the hydrodynamic limit of the Vlasov model introduced in Takata and Noguchi (J. Stat. Phys. 172:880-903, 2018) by Noguchi and Takata in order to describe phase transition of fluids by kinetic equations. We prove that, when the scale parameter tends to 0, this model converges to a nonlocal Cahn-Hilliard equation with degenerate mobility. For our analysis, we introduce apropriate forms of the short and long range potentials which allow us to derive Helmhotlz free energy estimates. Several compactness properties follow from the energy, the energy dissipation and kinetic averaging lemmas. In particular we prove a new weak compactness bound on the flux.
Sudden Cardiac Arrest During a Sedated Cardiac Magnetic Resonance Study in a Nonsyndromic Child with Evolving Supravalvar Aortic Stenosis Due to Familial ELN Mutation
Authors: Markush Dor , Sanchez-Lara Pedro A. , Grand Katheryn , Wong Robert , Garg Ruchira
Published: February 2023

Supravalvar aortic stenosis (SVAS) is a less common but clinically important form of left ventricular outflow tract obstruction, and commonly associated with Williams syndrome (WS). SVAS outside of WS may also occur sporadically or in a familial form, often with identifiable mutations in the elastin (ELN) gene. While risk of sudden cardiac death in patients with SVAS has been extensively described in the context of WS, less is known about risk in patients with isolated SVAS. We report a case of a nonsyndromic two-year-old boy with evolving manifestations of SVAS who developed sudden cardiac arrest and death during a sedated cardiac magnetic resonance imaging study. A strong family history of SVAS was present and targeted genetic testing identified an ELN gene mutation in the boy’s affected father and other paternal relatives. We review risk factors found in the literature for SCA in SVAS patients and utilize this case to raise awareness of the risk of cardiac events in these individuals even in the absence of WS or severe disease. This case also underscores the importance of genetic testing, including targeted panels specifically looking for ELN gene mutations, in all patients with SVAS even in the absence of phenotypic concerns for WS or other genetic syndromes.
Multidimensional Quality of Life After Robotic Versus Laparoscopic Surgery for Rectal Cancer: A Systematic Review and Meta‐Analysis
Authors: Martins Russell Seth , Fatimi Asad Saulat , Mahmud Omar , Jahangir Arshia , Mahar Muhammad Umar , Aamir Syed Roohan , Khan Maria , Ahmad Ali
Published: February 2023

Introduction

Maximizing patients’ quality of life (QoL) is a central goal in surgical oncology. Currently, both laparoscopic and robotic surgery are viable options in rectal cancer (RC) resections. The aim of this systematic review was to analyze the differences in postoperative QoL between the two operative modalities.

Methodology

This review was conducted in adherence to the PRISMA guidelines. MEDLINE, Embase, Scopus, and CENTRAL databases were searched for articles comparing QoL in patients undergoing laparoscopic versus robotic surgery for RC. Seven studies were included (two randomized controlled trials, four prospective cohorts, and one retrospective cohort) out of which six reported data suitable for meta‐analysis. Global QoL and QoL subdomains, such as physical and social functioning, were meta‐analyzed using a random‐effects model. Risk of bias was assessed using the ROBINS‐I and Cochrane RoB‐2 tools.

Results

Data on 869 patients (440 laparoscopic and 429 robotic surgery) across six studies were meta‐analyzed. There was no significant difference in global QoL (Mean Difference:−0.43 [95% Confidence Interval:−3.49–2.62]). Physical functioning was superior after robotic surgery (1.92 [0.97–2.87]). However, nausea/vomiting, pain, and fatigue did not differ between groups. Perception of body image was worse after laparoscopic surgery (−5.06 [−9.05– −1.07]). Other psychosocial subdomains (emotional, cognitive, role, and social functioning) were comparable between groups.

Conclusion

Laparoscopic and robotic surgery for RC have comparable QoL overall, for both physical and psychological dimensions. Our results may assist the management‐related decision‐making in surgical treatment of RC.
A free boundary problem-in time-for the spread of Covid-19
Authors: Luckhaus Stephan , Stevens Angela
Published: February 2023

In this paper we deal with two aspects of the Covid epidemic. The first is a phase change during the epidemic. The empirical observation is that once a certain threshold of active infections is reached, the rate of infection is increasing significantly. This threshold depends, among others, also on the season. We model this phenomenon as a jump in the coefficient of the virus exposition, giving the force of infection. In a chemical mass action law this coefficient corresponds to the reaction rate. We get a free boundary problem in time, which exhibits deterministic ‘metastability’. In a population which is in a state of herd immunity, still, if the number of imported infections is large enough, an epidemic wave can start. The second aspect is the two scale nature of the infection network. On one hand side, there is always a finite number of reoccuring–deterministic–contacts, and on the other hand there is a large number of possible random contacts. We present a simple example, where the group size of deterministic contacts is two, and the graph of random contacts is complete.
1.5-T MR relaxometry in quantifying splenic and pancreatic iron: retrospective comparison of a commercial 3D-Dixon sequence and an established 2D multi-gradient echo sequence
Authors: Plaikner Michaela , Lanser Lukas , Kremser Christian , Weiss Günter , Henninger Benjamin
Published: February 2023

Objectives

To compare the quantitative measurement of splenic and pancreatic iron content using a commercial 3D-Dixon sequence (qDixon) versus an established fat-saturated R2* relaxometry method (ME-GRE).

Methods

We analyzed splenic and pancreatic iron levels in 143 MR examinations (1.5 T) using the qDixon and a ME-GRE sequence (108 patients: 65 males, 43 females, mean age 61.31 years). Splenic and pancreatic R2* values were compared between both methods using Bland–Altman plots, concordance correlation coefficients (CCC), and linear regression analyses. Iron overload (R2* > 50 1/s) was defined for both organs and compared using contingency tables, overall agreement, and Gwet’s AC1 coefficient.

Results

Of all analyzable examinations, the median splenic R2* using the qDixon sequence was 25.75 1/s (range: 5.6–433) and for the ME-GRE sequence 35.35 1/s (range: 10.9–400.8) respectively. Concerning the pancreas, a median R2* of 29.93 1/s (range: 14–111.45) for the qDixon and 31.25 1/s (range: 14–97) for the ME-GRE sequence was found. Bland–Altman analysis showed a mean R2* difference of 2.12 1/s with a CCC of 0.934 for the spleen and of 0.29 1/s with a CCC of 0.714 for the pancreas. Linear regression for the spleen/pancreas resulted in a correlation coefficient of 0.94 (p < 0.001)/0.725 (p < 0.001). Concerning iron overload, the proportion of overall agreement between the two methods was 91.43% for the spleen and 93.18% for the pancreas.

Conclusions

Our data show good concordance between R2* values obtained with a commercial qDixon sequence and a validated ME-GRE relaxometry method. The 3D-qDixon sequence, originally intended for liver assessment, seems to be a reliable tool for non-invasive evaluation of iron content also in the spleen and the pancreas.

Key Points

• A 3D chemical shift imaging sequence and 2D multi-gradient echo sequence show good conformity quantifying splenic and pancreatic R2* values.

• The 3D chemical shift imaging sequence allows a reliable analysis also of splenic and pancreatic iron status.

• In addition to the liver, the analysis of the spleen and pancreas is often helpful for further differential diagnostic clarification and patient guidance regarding the iron status.
A prognostic score based on B cell and plasma cell densities compared to T cell densities in colorectal cancer
Authors: Karjalainen Henna , Sirniö Päivi , Tuomisto Anne , Mäkinen Markus J. , Väyrynen Juha P.
Published: February 2023

Purpose

The purpose of this study was to compare a B cell/plasma cell–based scoring system to T cell score and evaluate their prognostic value in colorectal cancer.

Methods

We used immunohistochemistry to analyze the expression of CD20, CD138, CD3, and CD8 in 221 colorectal cancer patients. CD20+ B cell and CD138+ plasma cell densities in the tumor center and invasive margin were calculated and converted into a B cell/plasma cell score. T cell score was defined similarly, using CD3+ and CD8+ T cell densities. Their associations with tumor and patient characteristics and survival were analyzed.

Results

Kaplan–Meier analysis showed a high B cell/plasma cell score was associated with a tendency towards longer survival (p = 0.089), but no statistically significant association was found. High T cell score associated with longer cancer-specific survival in Kaplan–Meier analysis and multivariable Cox regression analysis (p < 0.001). Additionally, high T cell score associated with lower disease stage (p < 0.001) and lesser lymphovascular invasion (p = 0.020).

Conclusions

High T cell score is associated with longer survival and clinicopathological factors typical to less aggressive tumors. This study did not support the additional prognostic value of B cell/plasma cell quantification.
Endoscopic stapedotomy: classic versus reversal technique
Authors: Moneir Waleed , Khafagy Yasser Wafeek , Salem Nada Nagah , Hemdan Ahmed
Published: February 2023

Objectives

To compare hearing outcome and surgical complications between endoscopic classic and reversal stapedotomies.

Patients and methods

A prospective single blinded randomized clinical study carried out on 60 patients with otosclerosis who were randomized into two groups; each containing 30 patients. Patients in group 1 underwent endoscopic classic stapedotomy. Patients in group 2 underwent endoscopic reversal stapedotomy. Both groups were compared as regards hearing outcome and surgical complications.

Results

The difference in the hearing outcome between the two groups was statistically non-significant. Post-operative closure of the air bone gap (ABG) within 10 dB was attained in 76.67% and 80% of patients in groups 1 and 2, respectively. The differences in the surgical complications between the two studied groups were statistically non-significant.

Conclusion

Endoscopic classic and reversal stapedotomies are comparable to each other as regards hearing outcome and surgical complications. The authors recommend further studies with relatively larger sample size.
Validation of a guideline to reduce variability in diagnosing cervical dystonia
Authors: Defazio Giovanni , Belvisi Daniele , Comella Cynthia , Hallett Mark , Jinnah Hyder A. , Cimino Paola , Latorre Anna , Mascia Marcello Mario , Rocchi Lorenzo , Gigante Angelo Fabio , Ercoli Tommaso , Berardelli Alfredo
Published: February 2023

Background

Cervical dystonia is characterized by a variable pattern of neck muscle involvement. Due to the lack of a diagnostic test, cervical dystonia diagnosis is based on clinical examination and is therefore subjective. The present work was designed to provide practical guidance for clinicians in confirming or refuting suspected cervical dystonia.

Methods

Participants were video recorded according to a standardized protocol to assess 6 main clinical features possibly contributing to cervical dystonia diagnosis: presence of repetitive, patterned head/neck movements/postures inducing head/neck deviation from neutral position (item 1); sensory trick (item 2); and red flags related to conditions mimicking dystonia that should be absent in dystonia (items 3–6). Inter-/intra-rater agreement among three independent raters was assessed by k statistics. To estimate sensitivity and specificity, the gold standard was cervical dystonia diagnosis reviewed at each site by independent senior neurologists.

Results

The validation sample included 43 idiopathic cervical dystonia patients and 41 control subjects (12 normal subjects, 6 patients with isolated head tremor, 4 with chorea, 6 with tics, 4 with head ptosis due to myasthenia or amyotrophic lateral sclerosis, 7 with orthopedic/rheumatologic neck diseases, and 2 with ocular torticollis). The best combination of sensitivity and specificity was observed considering all the items except for an item related to capability to voluntarily suppress spasms (sensitivity: 96.1%; specificity: 81%).

Conclusions

An accurate diagnosis of cervical dystonia can be achieved if, in addition to the core motor features, we also consider some clinical features related to dystonia mimics that should be absent in dystonia.