bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization and analysis of nitrate content of vegetable ferns (Pleocnemia irregularis (C. Presl) Holttum) from Dramaga District, Bogor
Authors: Novasari F , Kartika J G , Agusta H
Published: January 2022

Pleocnemia irregularis (C. Presl) Holttum or vegetable fern is common in partial shade in lowland forest and on the edge of forested hills, especially on slopes. The edible part of this plant is its fiddlehead that serves as a vegetable. This study aimed to characterize this vegetable fern phenotype, as well as analyze the nitrate content of its leaves. The research was conducted at the Arboretum of Faculty of Forestry, Bogor Agricultural University (Arboretum 1), Dramaga Research Forest of Bogor Research Centre, and Forest Conservation (CIFOR 1 and CIFOR 2). The result showed that there were no differences in the qualitative characteristics of the fern obtained from the three locations. Based on quantitative characteristics, the vegetable fern at CIFOR 2 is the smallest. Average NO3- (mg.100 g-1) from fiddlehead extraction is below the nitrate acceptable daily intake value based on human weight, recommended by European Commission’s Scientific Committee for Food, therefore, consuming vegetable fern with an average daily consumption of 100 grams Day-1 is considered safe.
Oil palm empty bunches as a growing media for white oyster mushroom (Pleurotus ostreatus)
Authors: Maliana T , Taskirawati I , Baharuddin
Published: January 2022

The media used to grow oyster mushrooms is sawdust waste, such as sengon, gmelina, and candlenut. Therefore, several researchers conducted research to find alternative media to replace sawdust, such as mulberry pulp, sago pulp, coconut fibre, and bamboo pulp. This research utilizes waste of oil palm empty bunches as a medium used to grow oyster mushrooms. In addition, this study aims to determine the duration of immersion of oil palm empty bunches as a pre-treatment before being used as a growing medium for white oyster mushroom (Pleurotus ostreatus). Before being used as a medium, empty fruit bunches of oil palm are cut into small pieces and then made into powder. The stages in this research are mixing raw materials, composting, making baglog, sterilization, inoculation, incubation, maintenance, and harvesting. There were seven treatments applied in this study, namely immersion in cold water for five days (P1), for seven days (P2), and nine days (P3); immersion in 100 °C hot water for 1 hour (P4), for 2 hours (P5), and 3 hours (P6); without immersion or control (P7). The results obtained are empty oil palm fruit bunches with cold soaking for five days (P1) and hot soaking at 100 °C for two hours can be used as a medium for oyster mushroom cultivation.
Assessment of reduced impact logging technique at different logging intensity
Authors: Heriansyah I , Hamid H A , Nurudin A A , Ibrahim S , Abdu A , Alias M A
Published: January 2022

Despite increased recognition of the value provided by forests, the tropical forest potential continued to be seriously degraded, especially by overexploitation. In the field of harvesting, achieving sustainable forest management requires environmentally responsible logging, hence the growing interest in reduced impact logging (RIL) as an alternative strategy to promoting good forestry practices be expected can continue to fulfil the functions of forest ecosystems. The study was conducted in 100 ha of the first cutting cycle and 200 ha of the second cutting cycle of 22 years logged over the forest in Indonesia Borneo. The degraded level is measured based on disclosed area, while potential production of the residual stand is predicted by using growth increment data from a permanent sample plot. Harvest intensity influence significantly to residual stand condition with a positive correlation. Potential production of residual trees in the first logged-over forest after 35 years is almost recovered then can be achieved sustainable yield. It means that 22 years is not a sustainable cutting cycle. The disclosure area after the second logging was high of 66.89 to 69.36. Potential production of residual trees was very low and need 35.5 to 42.8 years to recover, however, the cutting cycle needs a longer time to achieve sustainable forest management as long as 57.3 to 63.2 years. Based on this study, regulation of reduced cutting cycle on logged-over forest after 20 years is not recommended to implement in natural forests.
How the growth of natural forests meets Indonesia’s demand for wood for construction and household furniture?
Authors: Abdulah L , Yulianti M , Mindawati
Published: January 2022

Timber forest products are the main source of wood in meeting community needs such as house construction and furniture. However, in the regulation of timber forest products, the use of wood has not been considered. This has an impact on the value of wood, the value of the forest, and the availability of raw materials. For this reason, the purpose of this research is to increase the volume of natural forests that can be cut down to meet national household wood needs. The method used is a stochastic modeling method over the growth of each diameter class. The phenomenon of growth transfer includes ingrowth, upgrowth, and mortality. The results of the model simulation are the number of trees in each diameter class. Stand volume in the diameter class 40 cm up is a reference in the comparison of wood production and use of wood products. The data on the use of wood products is based on an analysis of wood consumption per FAO and Indonesian household wood consumption. The benefit of the research is to provide information on the application of an appropriate silvicultural system for forest management so that sustainable forest management can be realized.
Analysis of growth and vitality class of Ulin (Eusideroxylon zwageri T. et B.) on Sempaja Arboretum East Kalimantan
Authors: Abdurachman  , Susanty F H , Ngatiman
Published: January 2022

The purpose of this study was to determine the growth and vitality class of Ulin stands after the age of 17 years at Sempaja Arboretum, Samarinda East Kalimantan. Collecting data by measuring all species of Ulin which were planted in the arboretum area of 2.5 ha covering diameter/circumference, tree height, and trunk condition in 2020. The growth analysis approach used individual tree increment calculations, while the vitality class and social dynamic assessment were based on the IUFRO classification. The results showed that in the arboretum Sempaja found 82 stems of Ulin which planted as a result of ex-situ conservation activities. The tree’s growth distribution after 17 years was wide both based on the diameter, namely 1.5-11.72 cm, and height, namely 2.4-16.21 m. Based on the mean annual diameter increment (MAId) is 0.09-0.69 cm. yr-1, the height increment (MAIh) is 0.14-0.95 m. yr-1and volume increment (MAIvol) is 0.00002-0.006 m3.yr-1. The vitality value of Ulin was classified into three classes, meanwhile, the dynamic social was divided into two classes. Based on this assessment, the stand is dominated by trees with average growth and trees requiring maintenance in their development. These results provide input for the need for silvicultural maintenance for the Ulin stand, especially in the management of Sempaja arboretum.
Magneto-optic surface plasmon resonance properties of core-shell Fe3O4@Ag nanoparticles
Authors: Panre Andi Marwanti , Yahya Ilyas Maulana , Juharni Juharni , Suharyadi Edi
Published: January 2022

The magneto-optic surface plasmon resonance (MOSPR) properties of core-shell Fe3O4@Ag nanoparticles (NPs) were successfully investigated using the Kretschmann configuration. The four layer configuration system consists of prism/Au/Fe3O4@Ag/air. At the plasmon resonance frequency, a prominent resonant enhancement of magneto-optical activity was observed. An external magnetic field of 40, 50 and 60 Oe was applied in the longitudinal, polar, and transversal configurations with variation in the positive and negative directions in the longitudinal configuration. In the longitudinal configuration, the SPR angle shifted to the larger and lower angles when an external magnetic field was applied in the positive and negative directions, respectively. Under an external magnetic field, the SPR angle shifted to the larger angle for polar and transversal configurations. The non-reciprocal reflection of light was exploited under an external magnetic field applied to core-shell Fe3O4@Ag magnetic NPs. The SPR angle shift is observed in each configuration. The results indicated that the MOSPR system might be used for next generation of biosensor application.
The dependence of N

KR

versus K
R: the initial, thermal, volumetric recombination and screening effect on the efficiency of collected charges on the calibration of si HDR1000 plus well chambers with 192Ir HDR sources
*
Authors: Álvarez Romero José T , De La Cruz Hernández Daniel , Cabrera Vertti Raymundo
Published: January 2022

By using the statistical techniques of the ANOVA means test and regression, it was found that the

N

K

R

calibration factor of Standard Imaging (SI) model HDR 1000 plus chambers presents a quadratic dependence with the Reference air kerma rate

K

R

(from 6.9 mGy h−1 to 43.9 mGy h−1). In order to understand and correct this dependency one model is presented for total recombination:

k

s

=

I

300

I

150

=
1
+

k

i
n
i

+

k

d

+

k

vol

·

I

300

+

k

s
c
r
e
e
n

·

I

300

2

,

where

k

ini

is the initial recombination,

k

vol

the thermal diffusion recombination,

k

vol

the volumetric recombination and

k

screen

the screening for the currents/charges collected at the potential differences of 300 and 150 V. In conclusion, the total recombination

k

s

is composed by one

k

ini

with a constant contribution of 0.019%, one k

d
contribution of 0.017%, one

k

vol

·

I

300

contribution from 0.022% to 0.138%, and the

k

s
c
r
e
e
n

·

I

300

2

effects from 0.002% to 0.09% in the range of

K
̇

R

rate above. However, when this model for

k

s

is applied to try to correct the quadratic dependence of the

N

K

R

versus

K

R

,

explicitly there is no improvement in the variation range of 0.5% of the

N

K

R

versus

K

R

.

Nonetheless, it allows to obtain

N

K

R

values consistent with a

u

c

 ≤ 0.7%, which is less than 1.25% reported in the literature by ADCLs or SSDLs.
State policy and environmental management: examining the intermediate mechanisms of ecological modernization
Authors: Adua Lazarus , Clark Brett , Jorgenson Andrew
Published: January 2022

Most quantitative research testing ecological modernization theory focuses on the direct relationship between development and environmental outcomes. In this study, we assess overlooked propositions of the perspective: the impacts of economic development on intermediate mechanisms—efficiency improvement and environmental consciousness—that are theorized to contribute to ecological ameliorations. We analyze fully balanced panel data covering all 50 U.S. states to evaluate the influence of both personal income per capita and GDP per capita on two intermediate mechanisms—state-level energy efficiency policies and state environmentalism. The findings indicate that personal income per capita is positively related to both state-level energy efficiency policies and state environmentalism, which is expected, while GDP per capita is related to neither of these measures. While these results provide mixed support for ecological modernization theory, we observe that the enactment of a policy does not, by default, lead to the realization of the expected benefits or outcomes. By investigating the role of intermediate mechanisms in mitigating environmental degradation, this study advances our shared understanding of the social, political, and economic factors shaping environmental policy and management in the United States.
Leptin and Its Signaling Are Not Involved in Zebrafish Puberty Onset
Authors: Hu Zhe , Ai Nana , Chen Weiting , Wong Queenie Wing-Lei , Ge Wei
Published: January 2022

Leptin is a peptide hormone secreted from the adipose tissues and its signaling plays a central role in metabolic regulation of growth, especially on fat mass. In addition, leptin is also involved in regulating reproduction in mammals. In teleosts, there are two leptin ligands (lepa and lepb) and one cognate leptin receptor (lepr); however, their functions are still elusive. In this study, we created null-function mutants for lepa, lepb and lepr in zebrafish using CRISPR/Cas9 method and analyzed their phenotypes with emphasis on puberty onset, one major function widely reported for leptin in mammals. We demonstrated that the loss of leptin ligands or their receptor resulted in no obesity from prepubertal stage to adulthood. We then focused on leptin involvement in controlling puberty onset. We first confirmed the somatic threshold for puberty onset in females and proposed a criterion and somatic threshold for male puberty onset. We examined gonadal development and sex maturation in different genotypic combinations including single mutants (lepa−/−, lepb−/− and lepr−/−), double mutants (lepa−/−;lepb−/−) and triple mutants (lepa−/−;lepb−/−;lepr−/−). Our results showed that once the fish reached the thresholds, the siblings of all genotypes displayed comparable gonadal development in both sexes without obvious signs of changed puberty onset. In conclusion, this comprehensive genetic study on the lep-lepr system demonstrated that in contrast to its counterpart in mammals, leptin system plays little role in controlling growth and reproduction especially puberty onset in zebrafish.
Fulminant Influenza A myocarditis in a patient presenting with cardiogenic shock and biventricular thrombi: a case report
Authors: Cottet Mylène , Vivekanantham Hari , Arroja José David , Arroyo Diego
Published: January 2022

Background

Acute myocarditis is a common condition, with viral infections being the most common aetiology in North America and Europe. Influenza A myocarditis is however rare. As clinical manifestation may be fulminant, early recognition and management are paramount and may impact overall prognosis by hindering complications such as thromboembolism. A brief review of the literature, diagnostic modalities, work-up and treatment are discussed.

Case summary

We present the case of a 42-year-old, previously healthy woman with recent flu-like symptoms, developing decompensated heart failure (HF) and cardiogenic shock within a week, due to Influenza A myocarditis. Biventricular thrombi were identified. Pharmacological haemodynamic support, followed by HF therapy, allowed full recuperation of heart function. Intracavitary thrombi disappeared under unfractionated heparin with bridging to rivaroxaban.

Discussion

Fulminant myocarditis due to Influenza A is rare and, to the best of our knowledge, has not been associated with intracardiac thrombi formation. Echocardiography is the essential first-line imaging modality. Cardiac magnetic resonance plays a major role in the diagnosis of myocarditis and may preclude the need for an endomyocardial biopsy in selected cases. Coronary angiography may be required to rule out ischaemic aetiology. First-line therapy in fulminant disease is pharmacological and, if required, mechanical haemodynamic support. Standard HF therapy complete the therapeutic options and should be introduced as soon as possible. Complications such as intracardiac thrombi formation, require targeted treatment. Specific drug therapies targeting Influenza A have no proven benefit in myocarditis.
microRNA172 targets APETALA2 to regulate flavonoid biosynthesis in apple (Malus domestica).
Authors: Ding Tiyu , Tomes Sumathi , Gleave Andrew P , Zhang Hengtao , Dare Andrew P , Plunkett Blue , Espley Richard V , Luo Zhiwei , Zhang Ruiping , Allan Andrew C , Zhou Zhe , Wang Huan , Wu Mengmeng , Dong Haiqing , Liu Chonghuai , Liu Jihong , Yan Zhenli , Yao Jia-Long
Published: January 2022

MicroRNA172 (miR172) plays a role in regulating a diverse range of plant developmental processes, including flowering, fruit development and nodulation. However, its role in regulating flavonoid biosynthesis is unclear. In this study, we show that transgenic apple plants over-expressing miR172 show a reduction in red coloration and anthocyanin accumulation in various tissue types. This reduction was consistent with decreased expression of APETALA2 homolog MdAP2_1a (a miR172 target gene), MdMYB10, and targets of MdMYB10, as demonstrated by both RNA-seq and qRT-PCR analyses. The positive role of MdAP2_1a in regulating anthocyanin biosynthesis was supported by the enhanced petal anthocyanin accumulation in transgenic tobacco plants overexpressing MdAP2_1a, and by the reduction in anthocyanin accumulation in apple and cherry fruits transfected with an MdAP2_1a virus-induced-gene-silencing construct. We demonstrated that MdAP2_1a could bind directly to the promoter and protein sequences of MdMYB10 in yeast and tobacco, and enhance MdMYB10 promotor activity. In Arabidopsis, over-expression of miR172 reduced flavonoid (including anthocyanins and flavonols) concentration and RNA transcript abundance of flavonoid genes in plantlets cultured on medium containing 7% sucrose. The anthocyanin content and RNA abundance of anthocyanin genes could be partially restored by using a synonymous mutant of MdAP2_1a, which had lost the miR172 target sequences at mRNA level, but not restored by using a WT MdAP2_1a. These results indicate that miR172 inhibits flavonoid biosynthesis through suppressing the expression of an AP2 transcription factor that positively regulates MdMYB10.
Illustration of the variation in the content of flavanone rutinosides in various citrus germplasms from genetic and enzymatic perspectives
Authors: Li Wenyun , Li Gu , Yuan Ziyu , Li Mingyue , Deng Xiuxin , Tan Meilian , Ma Yuhua , Chen Jiajing , Xu Juan
Published: January 2022

In citrus, 1,6-rhamnosytransferase (1,6RhaT) and 1,2-rhamnosytransferase (1,2RhaT) catalyze flavanone-7-O-glucosides to form nonbitter flavanone rutinosides (FRs) and bitter flavanone neohesperidosides (FNs), respectively. As revealed in this study of fruit peels from 36 citrus accessions, FRs varied from undetectable levels in pummelo and kumquat to being the dominant flavonoids in sweet orange and loose-skin mandarins. Furthermore, a previously annotated full-length 1,6RhaT-like gene was identified as another 1,6RhaT-encoding gene by in vitro experiments. In total, 28 alleles of full-length 1,6RhaTs were isolated and classified into A, B and C types with only type A alleles encoding a functional protein. Coincidently, only the accessions that contained FRs harbored type A alleles, as was further verified in two F1 hybrid populations. Moreover, the inferior substrate conversion efficiency of 1,6RhaTs in comparison with that of 1,2RhaT in vitro might partly explain the lower proportions of FRs to total flavanone disaccharides in citrus hybrids harboring both functional rhamnosyltransferases. Our findings provide a better understanding of FR content variations among citrus and are meaningful for a mechanistic illustration of citrus flavonoid metabolism and fruit quality improvement practices.
DgMYB2 improves cold resistance in chrysanthemum by directly targeting DgGPX1
Authors: Yang Xiaohan , Luo Yunchen , Bai Huiru , Li Xin , Tang Si , Liao Xiaoqin , Zhang Lei , Liu Qinglin
Published: January 2022

MYB transcription factors play important roles in plant responses to cold stress, but the associated underlying mechanisms remain unclear. In this study, a cold-induced MYB transcription factor, DgMYB2, was isolated from chrysanthemum (Chrysanthemum morifolium Ramat). DgMYB2 was localized to the nucleus and exhibited transactivational activity. Overexpression of DgMYB2 improved cold tolerance in chrysanthemum, while cold tolerance in the antisense suppression lines decreased compared to that of the wild type. Additionally, electrophoretic mobility shift assays, chromatin immunoprecipitation, luciferase complementary imaging analysis, and dual-luciferase reporter gene detection experiments confirmed that DgMYB2 directly targets DgGPX1 and increases the activity of glutathione peroxidase to reduce the accumulation of reactive oxygen species, thereby improving cold resistance in chrysanthemum.
Variation burst during dedifferentiation and increased CHH-type DNA methylation after 30 years of in vitro culture of sweet orange
Authors: Wang Xia , Ke Lili , Wang Shuting , Fu Jialing , Xu Jidi , Hao Yujin , Kang Chunying , Guo Wenwu , Deng Xiuxin , Xu Qiang
Published: January 2022

Somaclonal variation arising from tissue culture may provide a valuable resource for the selection of new germplasm, but may not preserve true-to-type characteristics, which is a major concern for germplasm conservation or genome editing. The genomic changes associated with dedifferentiation and somaclonal variation during long-term in vitro culture are largely unknown. Sweet orange was one of the earliest plant species to be cultured in vitro and induced via somatic embryogenesis. We compared four sweet orange callus lines after 30 years of constant tissue culture with newly induced calli by comprehensively determining the single-nucleotide polymorphisms, copy number variations, transposable element insertions, methylomic and transcriptomic changes. We identified a burst of variation during early dedifferentiation, including a retrotransposon outbreak, followed by a variation purge during long-term in vitro culture. Notably, CHH methylation showed a dynamic pattern, initially disappearing during dedifferentiation and then more than recovering after 30 years of in vitro culture. We also analyzed the effects of somaclonal variation on transcriptional reprogramming, and indicated subgenome dominance was evident in the tetraploid callus. We identified a retrotransposon insertion and DNA modification alternations in the potential regeneration-related gene CLAVATA3/EMBRYO SURROUNDING REGION-RELATED 16. This study provides the foundation to harness in vitro variation and offers a deeper understanding of the variation introduced by tissue culture during germplasm conservation, somatic embryogenesis, gene editing, and breeding programs.
Highly efficient activation of endogenous gene in grape using CRISPR/dCas9-based transcriptional activators
Authors: Ren Chong , Li Huayang , Liu Yanfei , Li Shaohua , Liang Zhenchang
Published: January 2022

Overexpression and knockout (or knockdown) of gene of interest are two commonly used strategies for gene functional study. Clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 system-mediated gene knockout has been applied in most plant species, including grapevine. However, CRISPR/dCas9 (deactivated Cas9)-based transcriptional activation is still unreported in fruit crops, although a few studies have been documented in Arabidopsis and rice. Here, we tested two transcriptional activators VP64 and TV for transcriptional activation of endogenous genes in grape. Both the dCas9-VP64 and dCas9-TV systems are efficient enough for transcriptional activation of the UDP-glucose flavonoid glycosyltransferases (UFGT) gene in grape cells. The effectiveness of the dCas9-VP64 system in UFGT activation was about 1.6- to 5.6-fold, while the efficiency of the dCas9-TV system was around 5.7- to 7.2-fold. Moreover, in grapevine plants, highly efficient activation of the cold-responsive transcription factor gene CBF4 was achieved by using the dCas9-TV system. The expression of CBF4 was increased 3.7- to 42.3-fold in transgenic plants. Compared with the wild-type plants, the CBF4-activated plants exhibited lower electrolyte leakage after cold treatment. Our results demonstrate the effectiveness of the dCas9-VP64 and dCas9-TV systems in gene activation in grape, which will facilitate application of transcriptional activation in this economically important species.
Multi-omics data integration provides insights into the post-harvest biology of a long shelf-life tomato landrace
Authors: Aiese Cigliano Riccardo , Aversano Riccardo , Di Matteo Antonio , Palombieri Samuela , Termolino Pasquale , Angelini Claudia , Bostan Hamed , Cammareri Maria , Consiglio Federica Maria , Della Ragione Floriana , Paparo Rosa , Valkov Vladimir Totev , Vitiello Antonella , Carputo Domenico , Chiusano Maria Luisa , D’Esposito Maurizio , Grandillo Silvana , Matarazzo Maria Rosaria , Frusciante Luigi , D’Agostino Nunzio , Conicella Clara
Published: January 2022

In this study we investigated the transcriptome and epigenome dynamics of the tomato fruit during post-harvest in a landrace belonging to a group of tomatoes (Solanum lycopersicum L.) collectively known as “Piennolo del Vesuvio”, all characterized by a long shelf-life. Expression of protein-coding genes and microRNAs as well as DNA methylation patterns and histone modifications were analysed in distinct post-harvest phases. Multi-omics data integration contributed to the elucidation of the molecular mechanisms underlying processes leading to long shelf-life. We unveiled global changes in transcriptome and epigenome. DNA methylation increased and the repressive histone mark H3K27me3 was lost as the fruit progressed from red ripe to 150 days post-harvest. Thousands of genes were differentially expressed, about half of which were potentially epi-regulated as they were engaged in at least one epi-mark change in addition to being microRNA targets in ~5% of cases. Down-regulation of the ripening regulator MADS-RIN and of genes involved in ethylene response and cell wall degradation was consistent with the delayed fruit softening. Large-scale epigenome reprogramming that occurred in the fruit during post-harvest likely contributed to delayed fruit senescence.
The Cumulative Incidence of Pouchitis in Pediatric Patients With Ulcerative Colitis
Authors: Cowherd Ellen , Egberg Matthew D , Kappelman Michael D , Zhang Xian , Long Millie D , Lightner Amy L , Sandler Robert S , Herfarth Hans H , Barnes Edward L
Published: January 2022

Background

Despite highly effective therapies, many children develop medically refractory ulcerative colitis (UC) and undergo proctocolectomy with ileal pouch–anal anastomosis (IPAA). We sought to determine the incidence, risk, and burden of pouchitis in the first 2 years following the final stage of IPAA in pediatric UC patients.

Methods

Within the IQVIA Legacy PharMetrics Adjudicated Claims Database, we identified pediatric patients with UC who underwent proctocolectomy with IPAA between January 1, 2007, and June 30, 2015. We utilized International Classification of Diseases–Ninth Revision–Clinical Modification or International Classification of Diseases–Tenth Revision–Clinical Modification codes to identify patients with UC and Current Procedural Terminology codes to identify colectomy and IPAA. Continuous variables were compared using t tests and Wilcoxon rank sum testing, while categorical variables were compared using chi-square testing.

Results

A total of 68 patients with an IPAA were identified. In the first 2 years following IPAA, the cumulative incidence of pouchitis was 54%. Patients with pouchitis required more outpatient visits in the first 2 years after IPAA (mean 21.8 vs 10.2; P = .006) and were more likely to be hospitalized compared with patients without pouchitis (46% vs 23%; P = .045). Patients with pouchitis also demonstrated higher mean total costs in year 1 and year 2 ($27 489 vs $8032 [P = .001] and $27 699 vs $6058 [P = .003], respectively).

Conclusions

Our findings confirm the high incidence of pouchitis demonstrated in earlier single-center studies of pediatric patients undergoing proctocolectomy with IPAA for UC. Identification of risk factors for pouchitis would be useful to optimize early intervention.
End-tidal Carbon Dioxide for Diagnosing Anaphylaxis in Patients with Severe Postinduction Hypotension
Authors: Erlich Clémence , Lamer Antoine , Moussa Mouhamed D. , Martin Julien , Rogeau Stéphanie , Tavernier Benoit
Published: January 2022

Background

Perioperative hypersensitivity reactions may be difficult to diagnose during general anesthesia. Postinduction hypotension is the most common sign but is not specific. It was recently suggested that low end-tidal carbon dioxide (ETco
2) might be a marker of anaphylaxis (Ring and Messmer grades III to IV immediate hypersensitivity reactions) in hypotensive patients under mechanical ventilation. To test this hypothesis, the authors compared ETco
2 in patients with a diagnosis of anaphylaxis and in patients with severe hypotension from any other cause after the induction of anesthesia.

Methods

This was a retrospective single-center case-control study in which two groups were formed from an anesthesia data warehouse. The anaphylaxis group was formed on the basis of tryptase/histamine assay data and allergy workup data recorded over the period 2010 to 2018. The control (hypotension) group consisted of all patients having experienced severe hypotension (mean arterial pressure less than 50 mmHg for 5 min or longer) with a cause other than anaphylaxis after anesthesia induction in 2017.

Results

The anaphylaxis and hypotension groups comprised 49 patients (grade III: n = 38; grade IV: n = 11) and 555 patients, respectively. The minimum ETco
2 value was significantly lower in the anaphylaxis group (median [interquartile range]: 17 [12 to 23] mmHg) than in the hypotension group (32 [29 to 34] mmHg; P < 0.001). The area under the receiver operating characteristic curve (95% CI) for ETco
2 was 0.95 (0.91 to 0.99). The sensitivity and specificity (95% CI) for the optimal cutoff value were 0.92 (0.82 to 0.98) and 0.94 (0.92 to 0.99), respectively. In multivariable analysis, minimum ETco
2 was associated with anaphylaxis after adjusting for confounders and competing predictors, including arterial pressure, heart rate, and peak airway pressure (odds ratio [95% CI] for ETco
2: 0.51 [0.38 to 0.68]; P < 0.001).

Conclusions

In case of severe hypotension after anesthesia induction, a low ETco
2 contributes to the diagnosis of anaphylaxis, in addition to the classical signs of perioperative immediate hypersensitivity.

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New
The 3-Dimensional-Computed Tomography Texture Is Useful to Predict Pancreatic Neuroendocrine Tumor Grading
Authors: Ricci Claudio , Mosconi Cristina , Ingaldi Carlo , Vara Giulio , Verna Martina , Pettinari Irene , Alberici Laura , Campana Davide , Ambrosini Valentina , Minni Francesco , Golfieri Rita , Casadei Riccardo
Published: January 2022

Objectives

The aim of this study is to evaluate the computed tomography texture parameters in predicting grading.

Methods

This study analyzed 68 nonfunctioning pancreatic neuroendocrine neoplasms (Pan-NENs). Clinical and radiological parameters were studied. Four model models were built, including clinical and standard radiologic parameters (model 1), first- and second-order computed tomography features (models 2 and 3), all parameters (model 4). The diagnostic accuracy was reported as area under the curve. A score was computed using the best model and validated to predict progression-free survival.

Results

The size of tumors and heterogeneous enhancement were related to the risk of “non-G1” Pan-NENs (coefficients 0.471, P = 0.012, and 1.508, P = 0.027). Four second-order parameters were significantly related to the presence of “non-G1” Pan-NENs: the gray level co-occurrence matrix correlation (6.771; P = 0.011), gray level co-occurrence matrix contrast variance (0.349; P = 0.009), the neighborhood gray-level different matrix contrast (−63.129; P = 0.001), and the gray-level zone length matrix with the low gray-level zone emphasis (−0.151; P = 0.049). Model 4 was the best, with a higher area under the curve (0.912; P = 0.005). The score obtained predicted the progression-free survival.

Conclusions

Computed tomography radiomics signature can be useful in preoperative workup.
Outcomes of Endoscopic Management of Sterile Walled-Off Pancreatic Necrosis
Authors: Valverde-López Francisco , Han Samuel , Coughlin Sarah , Thiruvengadam Nikhil , Moreau Christopher , Akshintala Venkata S. , Lee Peter J. ,   on behalf of the Collaborative Alliance for Pancreatic Education and Research
Published: January 2022

Objectives

The aim of this study is to systematically review outcomes related to treatment success, mortality, and adverse events of endoscopic management in patients with sterile walled-off pancreatic necrosis.

Methods

We reviewed studies published from 2008 to 2018 from Medline and Embase that evaluated the endoscopic treatment of necrotizing pancreatitis. The primary outcome was success of treatment in resolving the collection. Secondary outcomes included length of hospitalization, mortality rate, and adverse events.

Results

Five studies were included, which entailed a total of 280 patients with a mean age of 51.8 years. The primary indication for endoscopic treatment was symptomatic walled-off pancreatic necrosis. Four studies used endoscopic transmural drainage, one of them combining percutaneous drainage and 1 study performed transpapillary drainage. The pooled treatment success was 94.3% with a mean time to resolution of 77.8 days. The mean length of stay was 16.3 days, and mortality rate was 1.3%. The overall adverse event rate was 24.6%, with bleeding the most common adverse event (11%), followed by pancreatic fistula formation (3.4%) and perforation (2.7%).

Conclusions

Although endoscopic management of sterile pancreatic necrosis has a high rate of treatment success, there is a relatively high rate of adverse events, bleeding being the most common.
Pancreatogenic Diabetes, 2 Onset Forms and Lack of Metabolic Syndrome Components Differentiate It From Type 2 Diabetes
Authors: Valdez-Hernández Pedro , Pérez-Díaz Ivan , Soriano-Rios Andrea , Gómez-Islas Valeria , García-Fong Kevin , Hernández-Calleros Jorge , Uscanga-Dominguez Luis , Pelaez-Luna Mario
Published: January 2022

Objectives

We compared pancreatogenic (DM3c) and type 2 diabetes mellitus.

Methods

We compared age-, sex-, and diabetes mellitus duration–matched DM3c cases (n = 142) and type 2 diabetes mellitus (n = 142). Pancreatogenic diabetes was considered when it appeared after the diagnosis of pancreatitis or after pancreatic surgery.

Results

Pancreatogenic diabetes presented lower body mass index (BMI) [odds ratio (OR), 1.2; 95% confidence interval (CI), 1.13–1.28; P < 0.001], worse glycemic control (OR, 1.196; 95% CI, 1.058–1.35; P = 0.004), required insulin more frequently (OR, 4.21; 95% CI, 2.57–6.93; P = 0.0001), had more hypoglycemic episodes (OR, 3.65; 95% CI, 1.64–8.16; P = 0.001) but lower frequency of dyslipidemia (OR, 0.42; 95% CI, 0.26–0.68; P = 0.001) and arterial hypertension (OR, 0.52; 95% CI, 0.32–0.86; P = 0.01). Pancreatogenic diabetes cases on pancreatic enzyme replacement therapy had lower glycosylated hemoglobin (8.52% vs 9.44%; P = 0.026), serum carotenes (79.1 vs 116.1; P = 0.03), and BMI (23.4 vs 26.1; P = 0.0005) than those not on pancreatic enzyme replacement therapy. Pancreatogenic diabetes onset occurred earlier in necrotizing pancreatitis and after pancreatic surgery.

Conclusions

Pancreatogenic diabetes presents with low BMI and lacks metabolic syndrome components. The type of pancreatic disease or surgery defines its onset time.
A Classification Algorithm for Types of Diabetes in Chronic Pancreatitis Using Epidemiological Characteristics
Authors: Kempeneers Marinus A. , Issa Yama , Ahmed Ali Usama , Bruno Marco J. , van Geenen Erwin J. M. , van Hooft Jeanin E. , Römkens Tessa E. H. , Siersema Peter D. , Spanier B. W. Marcel , Yahya Ibtisam , DeVries J. Hans , Besselink Marc G. , van Santvoort Hjalmar C. , Boermeester Marja A. ,   for the Dutch Pancreatitis Study Group
Published: January 2022

Objectives

We developed an epidemiological algorithm to classify types of diabetes mellitus (DM) in chronic pancreatitis (CP), and applied it to a nationwide prospective longitudinal cohort of CP patients.

Methods

Patients with definite CP (M-ANNHEIM criteria) were classified as having DM types 1, 2, or 3c, or no DM using an algorithm based on epidemiological characteristics: DM onset in relation to age, CP onset, exocrine insufficiency. Variables associated with development of DM were identified.

Results

Of 1130 included patients with CP between 2011 and 2018, 368 patients (33%) had DM at inclusion. Among patients with DM, 11 were classified as having type 1 (3%), 159 as type 2 (43%), and 191 as type 3c (52%). Patients with DM type 3c had longer duration of CP, more severe pain and lower physical quality of life. During longitudinal follow-up of median 47 months, 120 (20%) patients developed DM, of which 99 patients were classified as type 3c. This was independently associated with pancreatic endoscopy and surgery.

Conclusions

The described algorithm based on epidemiological characteristics can help to classify types of DM in patients with CP. Diabetes mellitus type 3c is associated with longer duration of CP and more severe CP sequelae.
Time to Stop Routinely Prescribing Opiates after Carpal Tunnel Release
Authors: Lalonde Donald H. , Lalonde Janice F. , MacDermid Joy C. , Chung Kevin C. , Gan Bing Siang , Mierisch Cassandra , Van Demark Robert E. , Luc Mario
Published: January 2022

Background:

North American surgeons continue to routinely order narcotic medication for postoperative pain relief after carpal tunnel surgery. For some patients, this instigates persistent use. This double-blind, multicenter trial investigated whether over-the-counter medications were inferior to opioid pain control after carpal tunnel release.

Methods:

Patients undergoing carpal tunnel release in five centers in Canada and the United States (n = 347) were randomly assigned to postoperative pain control with (opioid) hydrocodone/acetaminophen 5/325 mg versus over-the-counter ibuprofen/acetaminophen 600/325 mg. The two primary outcome measures were the Numeric Pain Rating Scale (0 to 10) and the six-item Patient-Reported Outcome Measurement Information System Pain Interference T-score. Secondary outcome measures were total medication used and overall satisfaction with pain medication management.

Results:

The authors found no significant differences between opioid and over-the-counter patients in the Numeric Pain Rating Scale scores, Pain Interference T-scores, number of doses of medication, or patient satisfaction. The highest Numeric Pain Rating Scale group difference was the night of surgery, when opiate patients had 0.9/10 more pain than over-the-counter patients. The highest group difference in Pain Interference T-scores (2.1) was on the day of surgery, when the opiate patients had more pain interference than the over-the-counter group. Patient nationality or sex did not generate significant pain score differences.

Conclusions:

Pain management is not inferior for patients managed with over-the-counter acetaminophen/ibuprofen versus opioids. This study provides high-quality evidence that U.S. and Canadian surgeons should stop the routine prescription of narcotics after carpal tunnel surgery for patients who are not taking pain medicines daily before surgery.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, II.
Analysis of Adverse Effects of Multimodal Gabapentin in Abdominal Wall Reconstruction
Authors: Sarac Benjamin A. , Schoenbrunner Anna R. , Brower Kristin I. , Joshi Girish P. , Janis Jeffrey E.
Published: January 2022

Background:

Multimodal analgesia, a key component of enhanced recovery after surgery protocols, emphasizes the use of nonopioid analgesics. Preoperative and postoperative gabapentin is often included within multimodal analgesia because it has been shown to reduce postoperative opioid use. However, the role of gabapentin has been questioned because of concerns of adverse effects, particularly in the elderly. In an effort to better understand the specific role of gabapentin within the context of an established enhanced recovery after surgery protocol, the authors studied the prevalence of its adverse effects in patients undergoing abdominal wall reconstruction.

Methods:

Following institutional review board approval, a retrospective review of a prospectively collected database of 267 consecutive patients who underwent abdominal wall reconstruction performed by a single surgeon was conducted. Demographic variables; operative details; postoperative analgesic use; the presence of dizziness, lightheadedness, or altered mental status; hypotension; negative Richmond Agitation Sedation Scale scores; and postoperative falls were recorded and analyzed according to postoperative gabapentin administration.

Results:

Two hundred thirteen patients (80 percent) met inclusion criteria, of which 138 (65 percent) received postoperative gabapentin. Postoperative gabapentin use was not associated with dizziness, lightheadedness, or altered mental status; hypotension; negative Richmond Agitation Sedation Scale scores; or falls. Furthermore, even among those aged 65 years or older, postoperative gabapentin use was not significantly associated with these adverse events.

Conclusions:

In patients undergoing abdominal wall reconstruction, postoperative gabapentin administration was not associated with an increase in adverse effects. Further prospective analysis may better allow the characterization of the adverse effects of perioperative gabapentin.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
Physician Residents Shadowing a Certified WOC Nurse to Develop Interprofessional Competencies
Authors: Monahan Laura , Zhao Meng , Monahan Michael , Acker Katelijne , Sandrik Mary
Published: January 2022

PURPOSE:

The aim of this quality improvement (QI) project was to assess a shadowing experience with a certified WOC nurse (CWOCN) on 4 interprofessional collaborative practice domains: interprofessional communication, role awareness and responsibilities, teams and teamwork, and values and ethics for interprofessional practice.

PARTICIPANTS AND SETTING:

Forty-nine physician residents in Family and Internal Medicine participated in this project set at a health system in Chicago, Illinois.

APPROACH:

Residents spent 16 hours shadowing a CWOCN and completed the Interprofessional Education Collaborative Competency Self-Assessment Tool (IPESAT) pre- and postshadowing that measured 4 interprofessional education (IPE) domains: interprofessional communication, role awareness and responsibilities, teams and teamwork, and values and ethics for interprofessional practice. Paired t tests were performed to determine differences in IPESAT scores before and after the shadowing experience.

OUTCOMES:

Residents demonstrated significant improvement in their overall knowledge of IPE (P = .000) as well as knowledge within each of the 4 domains (P = .000). After the shadowing experience, the overall ranking improved by 7.5%; the greatest gain (10.8%) occurred in the teamwork domain.

IMPLICATIONS FOR PRACTICE:

We found that even a comparatively brief shadowing experience with a CWOCN improved knowledge in IPE competencies. The shadowing experience is now permanently part of the Internal Medicine Residency program, and based on these IPE outcomes, other residency programs in our setting, such as the Rehabilitation and Family Medicine program, have increased their requests to shadow with the CWOCN.
The Impact of State Paid Sick Leave Policies on Longitudinal Weekday Workplace Mobility During the COVID-19 Pandemic
Authors: Pollack Catherine C. , Deverakonda Akshay , Hassan Fahim , Haque Syed , Desai Angel N. , Majumder Maimuna S.
Published: January 2022

Objectives

To evaluate whether the Families First Coronavirus Response Act (FFCRA) modified the association between pre-existing state paid sick leave (PSL) and weekday workplace mobility between February 15 and July 7, 2020.

Methods

The 50 US states and Washington, D.C. were divided into exposure groups based on the presence or absence of pre-existing state PSL policies. Derived from Google COVID-19 Community Mobility Reports, the outcome was measured as the daily percent change in weekday workplace mobility. Mixed-effects, interrupted time series regression was performed to evaluate weekday workplace mobility after the implementation of the FFCRA on April 1st, 2020.

Results

States with pre-existing PSL policies exhibited a greater drop in mobility following the passage of the FFCRA (β=-8.86,95%CI:-11.6,-6.10,P< 001). This remained significant after adjusting for state-level health, economic, and sociodemographic indicators (β=-3.13,95%CI:-5.92,-0.34,P=.039).

Conclusions

Pre-existing PSL policies contributed to a significant decline in weekday workplace mobility after the FFCRA, which may have influenced local health outcomes.

Policy implications

The presence of pre-existing state policies may differentially influence the impact of federal legislation enacted during emergencies.
Cell viability assessment associated with a contact of gas bubbles produced by femtosecond laser breakdown in cell culture media
Authors: Yasukuni Ryohei , Koyanagi Akari , Tanaka Yukihiro , Okano Kazunori , Hosokawa Yoichiroh
Published: January 2022

High intensity near infrared femtosecond laser is a promising tool for three-dimensional processing of biological materials. During the processing of cells and tissues, long lasting gas bubbles randomly appeared around the laser focal point, however physicochemical and mechanical effects of the gas bubbles has not been emphasized. This paper presents characteristic behaviors of the gas gabbles and their contact effects on cell viability. High-speed imaging of the gas bubble formation with various additives in physiological medium confirms that the gas bubble consists of dissolved air, and amphipathic proteins stabilize the bubble surface. This surface protective layer reduces interactions of gas bubbles and cell membranes. Consequently, the gas bubble contact does not cause critical effects on cell viability. On the other hands, burst of gas bubbles stimulated by an impact of femtosecond laser induced cavitation can lead to liquid jet flow that might cause serious mechanical damages on cells. These results provide insights for the parameter of biological tissue processing with intense fs laser pulses.
3D black blood MRI atlases of congenital aortic arch anomalies and the normal fetal heart: application to automated multi-label segmentation
Authors: Uus Alena U. , van Poppel Milou P.M. , Steinweg Johannes K. , Grigorescu Irina , Collado Alexia Egloff , Gilliland Paula Ramirez , Roberts Thomas A. , Rutherford Mary A. , Hajnal Joseph V. , Lloyd David F.A. , Pushparajah Kuberan , Deprez Maria
Published: January 2022

Background

3D image-domain reconstruction of black blood contrast T2w SSTSE fetal MRI datasets using slice-to-volume registration methods showed to provide high-resolution 3D images of the heart with superior visualisation of fetal aortic arch anomalies [1]. However, there is a lack of formalisation of the MRI appearance of fetal cardiovascular anatomy and standardisation of vessel segmentation protocols.

Methods

In this work, we present the first set of 3D fetal MRI atlases defining normal and abnormal fetal aortic arch anatomy created from 3D reconstructed images from 87 subjects scanned between 29-34 weeks of gestation with postnatally confirmed outcomes. We also implement and evaluate atlas-guided registration and deep learning (UNETR) methods for automated 3D multi-label fetal heart vessel segmentation.

Results

We created four atlases representing the average anatomy of the normal fetal heart, coarctation of the aorta, right aortic arch and suspected double aortic arch. Inspection of atlases confirmed the expected pronounced differences in the anatomy of the aortic arch. The results of the multi-label heart vessel UNETR segmentation showed 100% per-vessel detection rate for both normal and abnormal aortic arch anatomy.

Conclusions

This work introduces the first set of 3D black blood T2w MRI atlases of the normal and abnormal fetal cardiovascular anatomy along with detailed segmentation of the major cardiovascular structures. We also demonstrated the feasibility of using deep learning for multi-label vessel segmentation.