bluuebunny/crossref_metadata_2025 huggingface dataset:
An astrophysically motivated ranking criterion for low-latency electromagnetic follow-up of gravitational wave events
Authors: Artale M Celeste , Bouffanais Yann , Mapelli Michela , Giacobbo Nicola , Sabha Nadeen B , Santoliquido Filippo , Pasquato Mario , Spera Mario
Published: May 2020

We investigate the properties of the host galaxies of compact binary mergers across cosmic time. To this end, we combine population synthesis simulations together with galaxy catalogues from the hydrodynamical cosmological simulation eagle to derive the properties of the host galaxies of binary neutron star (BNS), black hole-neutron star (BHNS), and binary black hole (BBH) mergers. Within this framework, we derive the host galaxy probability, i.e. the probability that a galaxy hosts a compact binary coalescence as a function of its stellar mass, star formation rate, Ks magnitude, and B magnitude. This quantity is particularly important for low-latency searches of gravitational wave (GW) sources as it provides a way to rank galaxies lying inside the credible region in the sky of a given GW detection, hence reducing the number of viable host candidates. Furthermore, even if no electromagnetic counterpart is detected, the proposed ranking criterion can still be used to classify the galaxies contained in the error box. Our results show that massive galaxies (or equivalently galaxies with a high luminosity in Ks band) have a higher probability of hosting BNS, BHNS, and BBH mergers. We provide the probabilities in a suitable format to be implemented in future low-latency searches.
Robust H i kinematics of gas-rich ultra-diffuse galaxies: hints of a weak-feedback formation scenario
Authors: Mancera Piña Pavel E , Fraternali Filippo , Oman Kyle A , Adams Elizabeth A K , Bacchini Cecilia , Marasco Antonino , Oosterloo Tom , Pezzulli Gabriele , Posti Lorenzo , Leisman Lukas , Cannon John M , di Teodoro Enrico M , Gault Lexi , Haynes Martha P , Reiter Kameron , Rhode Katherine L , Salzer John J , Smith Nicholas J
Published: May 2020

We study the gas kinematics of a sample of six isolated gas-rich low surface brightness galaxies, of the class called ultra-diffuse galaxies (UDGs). These galaxies have recently been shown to be outliers from the baryonic Tully–Fisher relation (BTFR), as they rotate much slower than expected given their baryonic mass, and to have a baryon fraction similar to the cosmological mean. By means of a 3D kinematic modelling fitting technique, we show that the H i in our UDGs is distributed in ‘thin’ regularly rotating discs and we determine their rotation velocity and gas velocity dispersion. We revisit the BTFR adding galaxies from other studies. We find a previously unknown trend between the deviation from the BTFR and the exponential disc scale length valid for dwarf galaxies with circular speeds ≲ 45 km s−1, with our UDGs being at the extreme end. Based on our findings, we suggest that the high baryon fractions of our UDGs may originate due to the fact that they have experienced weak stellar feedback, likely due to their low star formation rate surface densities, and as a result they did not eject significant amounts of gas out of their discs. At the same time, we find indications that our UDGs may have higher-than-average stellar specific angular momentum, which can explain their large optical scale lengths.
Probing the AGN unification model at redshift z ∼ 3 with MUSE observations of giant Ly α nebulae
Authors: den Brok J S , Cantalupo S , Mackenzie R , Marino R A , Pezzulli G , Matthee J , Johnson S D , Krumpe M , Urrutia T , Kollatschny W
Published: May 2020

A prediction of the classic active galactic nucleus (AGN) unification model is the presence of ionization cones with different orientations depending on the AGN type. Confirmations of this model exist for present times, but it is less clear in the early Universe. Here, we use the morphology of giant Ly α nebulae around AGNs at redshift z ∼ 3 to probe AGN emission and therefore the validity of the AGN unification model at this redshift. We compare the spatial morphology of 19 nebulae previously found around type I AGNs with a new sample of four Ly α nebulae detected around type II AGNs. Using two independent techniques, we find that nebulae around type II AGNs are more asymmetric than around type I, at least at radial distances r > 30 physical kpc (pkpc) from the ionizing source. We conclude that the type I and type II AGNs in our sample show evidence of different surrounding ionizing geometries. This suggests that the classical AGN unification model is also valid for high-redshift sources. Finally, we discuss how the lack of asymmetry in the inner parts (r ≲ 30 pkpc) and the associated high values of the He ii to Ly α ratios in these regions could indicate additional sources of (hard) ionizing radiation originating within or in proximity of the AGN host galaxies. This work demonstrates that the morphologies of giant Ly α nebulae can be used to understand and study the geometry of high-redshift AGNs on circumnuclear scales and it lays the foundation for future studies using much larger statistical samples.
Megaparsec-scale structure around the protocluster core SPT2349–56 at z = 4.3
Authors: Hill Ryley , Chapman Scott , Scott Douglas , Apostolovski Yordanka , Aravena Manuel , Béthermin Matthieu , Bradford C M , Canning Rebecca E A , De Breuck Carlos , Dong Chenxing , Gonzalez Anthony , Greve Thomas R , Hayward Christopher C , Hezaveh Yashar , Litke Katrina , Malkan Matt , Marrone Daniel P , Phadke Kedar , Reuter Cassie , Rotermund Kaja , Spilker Justin , Vieira Joaquin D , Weiß Axel
Published: May 2020

We present an extensive ALMA spectroscopic follow-up programme of the $z\, {=}\, 4.3$ structure SPT2349–56, one of the most actively star-forming protocluster cores known, to identify additional members using their [C ii] 158 μm and CO(4–3) lines. In addition to robustly detecting the 14 previously published galaxies in this structure, we identify a further 15 associated galaxies at $z\, {=}\, 4.3$, resolving 55$\, {\pm }\,$5 per cent of the 870 μm flux density at 0.5 arcsec resolution compared to 21 arcsec single-dish data. These galaxies are distributed into a central core containing 23 galaxies extending out to 300 kpc in diameter, and a northern extension, offset from the core by 400 kpc, containing three galaxies. We discovered three additional galaxies in a red Herschel-SPIRE source 1.5 Mpc from the main structure, suggesting the existence of many other sources at the same redshift as SPT2349–56 that are not yet detected in the limited coverage of our data. An analysis of the velocity distribution of the central galaxies indicates that this region may be virialized with a mass of (9$\pm 5)\, {\times }\, 10^{12}$  M⊙, while the two offset galaxy groups are about 30 and 60 per cent less massive and show significant velocity offsets from the central group. We calculate the [C ii] and far-infrared number counts, and find evidence for a break in the [C ii] luminosity function. We estimate the average SFR density within the region of SPT2349–56 containing single-dish emission (a proper diameter of 720 kpc), assuming spherical symmetry, to be roughly 4$\, {\times }\, 10^4$ M⊙ yr−1 Mpc−3; this may be an order of magnitude greater than the most extreme examples seen in simulations.
Prospective and Daily Effects of Cannabis Use on Smoking Outcomes During a Self-Guided Quit Attempt
Authors: Britton Maggie , Haddad Sana , Derrick Jaye L
Published: May 2020

Introduction

Past research suggests that cannabis use is a risk factor for relapse in people trying to quit smoking. Most people attempt to quit smoking without any assistance (ie, self-guided quitters), yet no one has examined the association between cannabis use and relapse among self-guided quitters. The current study examines how cannabis use might contribute to poorer smoking outcomes in a sample of self-guided quitters.

Aims and Methods

Data were taken from a study of unaided smoking cessation in 62 single-smoker couples. Quitters and their Partners completed baseline questionnaires and a 21-day ecological momentary assessment. This article examines Quitters’ and Partners’ past-year cannabis use reported at baseline and daily cannabis use during the ecological momentary assessment as predictors of prospective and daily smoking outcomes.

Results

We found very little evidence that past-year cannabis use was associated with poorer smoking outcomes. However, Quitters reported greater smoking on days when they or their Partners reported cannabis use.

Conclusions

This study produced evidence to support daily Quitter and Partner cannabis use as a risk factor for poor smoking outcomes. Smoking cessation programs might benefit from targeting cannabis use as well as taking a couples-oriented approach to treatment.

Implications

This article examined how cannabis use impacts smoking outcomes in a sample of self-guided quitters using prospective and daily diary analyses. We found very little evidence that past-year cannabis use was associated with poorer smoking outcomes. However, Quitters reported greater smoking on days when they or their Partners reported cannabis use. Findings suggest that smoking cessation programs might benefit from targeting cannabis use, as well as taking a couples-oriented approach to treatment.
Adolescent Cannabinoid and Nicotine Exposure Differentially Alters Adult Nicotine Self-Administration in Males and Females
Authors: Dukes Angeline J , Fowler James P , Lallai Valeria , Pushkin Anna N , Fowler Christie D
Published: May 2020

Introduction

During adolescence, exposure to nicotine or cannabis independently induces effects on neuromaturation and later cognitive function. However, the potential effect of both drugs under co-use conditions has become of increasing concern given the prevalence of e-cigarettes, legalization of cannabis, and availability of synthetic “spice” cannabinoid agonists.

Aims and Methods

The current studies investigated the effects of exposure to a cannabinoid receptor agonist (WIN55,212-2) and/or nicotine over a discrete time period in mid-adolescence on later intravenous nicotine self-administration in adult male and female mice. We further examined whether cannabinoid agonist administration in adulthood would alter nicotine reinforcement, with either acute or chronic pairing across 7 days.

Results

We found that adult males exhibited increased nicotine self-administration at a lower, rewarding nicotine dose following adolescent cannabinoid exposure, either alone or with nicotine coadministration. In contrast, adult females demonstrated an opposing effect in which adolescent cannabinoid and nicotine coexposure resulted in decreased nicotine intake compared with the nicotine only and control groups. Furthermore, after maintaining nicotine self-administration across sessions, pretreatment with a low dose of the cannabinoid agonist decreased nicotine intake in both male and female control mice, and this lowering effect was evidenced after both acute and chronic treatment. However, the cannabinoid agonist was ineffective in altering nicotine intake in mice previously exposed to nicotine, cannabinoid agonist, or both during adolescence.

Conclusions

These data provide evidence that adolescent drug exposure can alter later nicotine reinforcement in a sex-specific manner and can further modulate the effectiveness of interventions in reducing nicotine intake during adulthood.

Implications

These studies demonstrate a significant impact of nicotine, cannabinoids, or coexposure on developmental processes during adolescence. Differential effects were observed within each sex, with opposing results found for cannabinoid exposure on nicotine intake in males and females. Intriguingly, we also evidenced resistance to the lowering effects of a cannabinoid agonist on nicotine intake in adulthood based on adolescent drug exposure. Thus, these findings have important implications for our understanding of the impact of nicotine and cannabinoids (eg, Δ9-tetrahydrocannabinol (THC) and synthetic “spice” cannabinoids) during development, with further implications for the effectiveness of therapeutic interventions based on prior drug exposure in youth.
Case Report: Successful Rescue Therapy of Extensively Drug-Resistant Acinetobacter baumannii Osteomyelitis With Cefiderocol
Authors: Dagher Michael , Ruffin Felicia , Marshall Steven , Taracila Magdalena , Bonomo Robert A , Reilly Rachel , Fowler Vance G , Thaden Joshua T
Published: May 2020

Cefiderocol is a novel catechol siderophore cephalosporin antibiotic developed to treat resistant gram-negative infections. We describe its successful use as rescue therapy, combined with surgical debridement, to treat a patient with osteomyelitis due to extensively drug-resistant Acinetobacter baumannii. Bacterial whole-genome sequencing identified the strain and antibiotic resistance determinants.
Virus Accumulation and Whitefly Performance Modulate the Role of Alternate Host Species as Inoculum Sources of Tomato Yellow Leaf Curl Virus
Authors: Legarrea Saioa , Barman Apurba , Diffie Stanley , Srinivasan Rajagopalbabu
Published: May 2020

Evaluating alternate hosts that facilitate the persistence of a virus in the landscape is key to understanding virus epidemics. In this study, we explored the role of several plant species (eggplant, pepper, and Palmer amaranth) as inoculum sources of tomato yellow leaf curl virus (TYLCV) and as reservoirs for its insect vector, Bemisia tabaci (Gennadius). All inoculated species were infected with TYLCV, but whiteflies acquired fewer viral copies via feeding from pepper and eggplant than from tomato and Palmer amaranth. Further, back-transmission assays to recipient tomato resulted in TYLCV infection only when TYLCV was acquired from Palmer amaranth or tomato. Analysis suggested that the role of plant species as TYLCV inoculum sources may be determined by the accumulation of viral copies in the plant, and consequently in the insect vector. In addition, results showed that all three alternate species could sustain populations of B. tabaci, while differentially influencing fitness of whiteflies. Eggplant was a superior host for whiteflies, whereas whitefly survival was compromised on pepper. Together, we demonstrate that both plant-virus and plant-vector interactions could influence the role of an alternate host in TYLCV epidemics, and in our region of study we highlight the potential risk of hosts such as Palmer amaranth in the spread of TYLCV.
A Method to Reproduce Symmetry in Midfacial Reconstruction: A Report of 19 Cases
Authors: Lou Xiaoli , Xue Chunyu , Molnar Joseph A. , Bi Hongda
Published: May 2020

BACKGROUND

Reconstruction of facial skin defects remains a clinical challenge. With aging, ptosis of tissue over fixed structures creates an important facial feature known as the tear trough. This study aimed to evaluate the efficacy and aesthetic outcome of a novel surgical technique that reproduced this facial feature while avoiding ectropion during midfacial skin defect repair.

METHODS

Nineteen patients with midfacial skin defects received local flap reconstruction combined with an anchoring suture. The flap was designed in a unilateral pedicled V-Y pattern. When the flap was advanced to cover the defect, one or two sutures that connected the dermis of the flap with the infraorbital periosteum were made to reproduce the tear trough line.

RESULTS: Midfacial defects were successfully repaired with the V-Y flap in all 19 patients. No lower eyelid ectropion or conspicuous scars were noted in any of the patients. Further, the tear trough was successfully reconstructed in each patient. Facial symmetry was maintained with static positioning and animation.

CONCLUSIONS

The combination of local V-Y flap reconstruction with anchoring sutures to reproduce facial feature lines is an effective technique in midfacial skin defect repair.
Combined spinal epidural for labour analgesia and caesarean section: indications and recommendations
Authors: Guasch Emilia , Brogly Nicolas , Gilsanz Fernando
Published: May 2020

Purpose of review

Even if its use is scarce in most countries, many articles concerning combined spinal epidural (CSE) were published. In this review, we present the latest advances concerning CSE in obstetrics.

Recent findings

During labour, CSE improves epidural analgesia quality. Epidural with intradural opioids can produce maternal hypotension and foetal heart rate abnormalities (FHR-Ab), without increasing the caesarean section rate. For caesarean section, CSE decreases the neuraxial block failure rate, with no significant increase of complications. Epidural volume extension (EVE) after CSE for caesarean section could be an interesting option even though more evidence is needed.

For labour analgesia, CSE has the fastest onset time of analgesia. Its side effects have no consequences on maternal, labour or foetal outcomes. It provides better analgesia than epidural analgesia and can be used for external cephalic version and high-risk patients. For caesarean section, CSE has become the reference neuraxial technique for low-dose spinal anaesthesia, with higher success rate compared with regular spinal anaesthesia. Recent systematic revisions did not confirm this superiority. CSE offers the advantage of EVE, intraoperative top-ups, postoperative administration of neuraxial opioids and local anaesthetics. The risk of complications is balanced by the benefits of the technique.
Cannabis, e-cigarettes and anesthesia
Authors: Lynn Rachael S. Rzasa , Galinkin Jeffrey L.
Published: May 2020

Purpose of review

Both cannabis and e-cigarette use are increasing, particularly among adolescents. The use of cannabis products may impact patients’ physiology under anesthesia. Understanding the effects of cannabis and vaping are critical to the provision of safe and effective anesthetic care.

Recent findings

E-cigarettes have recently been implicated in a severe presentation of acute lung injury, often in association with vaporization of the cannabinoid, THC. E-cigarette use appears to be associated with other less-acute pulmonary adverse effects that are yet to be fully understood. Cannabis affects many organ systems with alterations in cardiovascular, respiratory and neurological function. Specifically, there is emerging evidence that cannabis use may reduce the efficacy of sedative agents and postoperative pain management efforts.

There is a very wide variety of cannabis products currently available, with respect to both route of administration as well as cannabinoid content. Patients using cannabis products prior to anesthesia may present with altered physiology that place them at increased risk for cardiovascular and respiratory complications. They may also be tolerant to the effects of propofol and opioid for pain management, thus consideration should be given to use of a multimodal regimen.
Assessing the Predictive Validity of the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) in Alaska Native and American Indian People
Authors: Lillie Kate M. , Jansen Kelley J. , Dirks Lisa G. , Lyons Abram J. , Alcover Karl C. , Avey Jaedon P. , Hirchak Katherine , Herron Jalene , Buchwald Dedra , Donovan Dennis M. , McDonell Michael G. , Shaw Jennifer L.
Published: May 2020

Objectives:

The objective of this study was to examine the predictive validity of the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) among Alaska Native and American Indian (ANAI) people with an alcohol use disorder.

Methods:

The sample was 170 ANAI adults with an alcohol use disorder living in Anchorage, Alaska who were part of a larger alcohol intervention study. The primary outcome of this study was alcohol use as measured by mean urinary ethyl glucuronide (EtG). EtG urine tests were collected at baseline and then up to twice a week for four weeks. We conducted bivariate linear regression analyses to evaluate associations between mean EtG value and each of the three SOCRATES subscales (Recognition, Ambivalence, and Taking Steps) and other covariates such as demographic characteristics, alcohol use history, and chemical dependency service utilization. We then performed multivariable linear regression modeling to examine these associations after adjusting for covariates.

Results:

After adjusting for covariates, mean EtG values were negatively associated with the Taking Steps (P = 0.017) and Recognition (P = 0.005) subscales of the SOCRATES among ANAI people living in Alaska. We did not find an association between mean EtG values and the Ambivalence subscale (P = 0.129) of the SOCRATES after adjusting for covariates.

Conclusions:

Higher scores on the Taking Steps and Recognition subscales of the SOCRATES at baseline among ANAI people predicted lower mean EtG values. This study has important implications for communities and clinicians who need tools to assist ANAI clients in initiating behavior changes related to alcohol use.
Hypomagnesemia following posterior spinal fusion in adolescent idiopathic scoliosis
Authors: Marrero-Barrera Pablo , Ramírez Norman , Olivella Gerardo , Cruz Juan , Rivera Lenny , Marrero-Ortiz Pablo
Published: May 2020

Adolescent idiopathic scoliosis (AIS) patients undergoing posterior spinal fusion (PSF) usually require surveillance in the pediatric ICU (PICU). Some reports have documented evidence of hypomagnesemia following PSF at PICU. Little has been studied about relationship between AIS and postoperative serum magnesium (Mg+2) levels. The aim of this study is to determine the prevalence and risk factors of hypomagnesemia in AIS patients admitted to PICU after PSF. IRB approved the cross-sectional study of AIS patients admitted to PICU after PSF from January 2016 to May 2017. Serum electrolyte levels of phosphorous, calcium, sodium, potassium and hemoglobin were taken preoperative and 24 h postoperative and compared with postoperative magnesium levels. Blood volume reinfused from cell saver return (CSR), estimated blood loss (EBL), volume of fluids intraoperative and average of vertebra levels operated were charted and compared with postoperative magnesium levels. A total of 46 AIS patients undergoing PSF met inclusion criteria, with an average age of 15 years (78% female). Postoperatively, hypomagnesemia was reported in 24/46 patients (53%). No association was found between hypomagnesemia and serum electrolyte (phosphorous, calcium, sodium and potassium) or hemoglobin levels. In addition, no statistical association was found with age, operative time, vertebrae level fused, CSR, EBL and volume of fluids intraoperatively. Fifty-three percent of pediatric patients developed hypomagnesemia after surgical correction for AIS. Further investigation of this electrolyte disturbance will likely result in a useful clinical tool for physician in the management of AIS.
Time Course of Evolving Ventilator-Induced Lung Injury: The “Shrinking Baby Lung”
Authors: Marini John J. , Gattinoni Luciano
Published: May 2020

Objectives:

To examine the potentially modifiable drivers that injure and heal the “baby lung” of acute respiratory distress syndrome and describe a rational clinical approach to favor benefit.

Data Sources:

Published experimental studies and clinical papers that address varied aspects of ventilator-induced lung injury pathogenesis and its consequences.

Study Selection:

Published information relevant to the novel hypothesis of progressive lung vulnerability and to the biophysical responses of lung injury and repair.

Data Extraction:

None.

Data Synthesis:

In acute respiratory distress syndrome, the reduced size and capacity for gas exchange of the functioning “baby lung” imply loss of ventilatory capability that dwindles in proportion to severity of lung injury. Concentrating the entire ventilation workload and increasing perfusion to these already overtaxed units accentuates their potential for progressive injury. Unlike static airspace pressures, which, in theory, apply universally to aerated structures of all dimensions, the components of tidal inflation that relate to power (which include frequency and flow) progressively intensify their tissue-stressing effects on parenchyma and microvasculature as the ventilated compartment shrinks further, especially during the first phase of the evolving injury. This “ventilator-induced lung injury vortex” of the shrinking baby lung is opposed by reactive, adaptive, and reparative processes. In this context, relatively little attention has been paid to the evolving interactions between lung injury and response and to the timing of interventions that worsen, limit or reverse a potentially accelerating ventilator-induced lung injury process. Although universal and modifiable drivers hold the potential to progressively injure the functional lung units of acute respiratory distress syndrome in a positive feedback cycle, measures can be taken to interrupt that process and encourage growth and healing of the “baby lung” of severe acute respiratory distress syndrome.
Use of a compact high-definition two-dimensional exoscope in surgical treatment of large vestibular schwannoma
Authors: Chen Xin , Gao Xiang-Liang , Chai Yan , Shi Ming-Ming , Zhang Jian-Ning , Yue Shu-Yuan
Published: May 2020

Background:

Extra-corporeal video telescope operating monitor system provides a necessary instrument to perform high-precision neurosurgical procedures that could substitute or supplement the traditional surgical microscope. The present study was designed to evaluate a compact high-definition two-dimensional exoscope system for assisting in surgical removal of large vestibular schwannoma (VS), as an alternative to a binocular surgical microscope.

Methods:

Patients with Koos grade 3 and grade 4 VS undergoing surgery were enrolled in this prospective cohort study between January 2013 and June 2018. The demographics and tumor characteristics (size, Koos grade, composition [cystic or solid mass]) were matched between the two groups of patients. The following outcome measurements were compared between the two groups: duration of surgery, volume of blood loss, extent of tumor resection, number of operating field adjustments, pre- and post-operative facial and cochlear nerve function evaluated at 3 months post-surgery, complications and surgeons’ comfortability.

Results:

A total of 81 patients received tumor resection through the retrosigmoid approach under either an exoscope (cases, n = 39) or a surgical microscope (control, n = 42). Patients in the two groups had comparable tumor location (P = 0.439), Koos grading (P = 0.867), and composition (P = 0.891). While no significant differences in the duration of surgery (P = 0.172), extent of tumor resection (P = 0.858), facial function (P = 0.838), and hearing ability (P = 1.000), patients operated on under an exoscope had less blood loss (P = 0.036) and a fewer field adjustments (P < 0.001). Both primary and assistant surgeons reported a high level of comfort operating under the exoscope (P = 0.001 and P < 0.001, respectively).

Conclusions:

The compact high-definition two-dimensional exoscope system provides a safe and efficient means to assist in removing large VSs, as compared to a surgical microscope. After the acquaintance with a visual perception through a dynamic hint and stereoscopically viewing corresponding to the motion parallax, the exoscope system provided a comfortable, high-resolution visualization without compromising operational efficiency and patient safety.
A Dynamically Cooled, Variable Spot-Sized 1,064 nm Neodymium-doped Yttrium Aluminum Garnet Laser as a Treatment Option for Facial Reticular Veins
Authors: Aleisa Abdullah , Goldman Mitchel P.
Published: May 2020

BACKGROUND

Facial reticular veins can be treated with laser therapy, sclerotherapy, or surgical removal. The use of a 1,064 nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser has been reported to be successful in the treatment of facial reticular veins.

OBJECTIVE

To report a large retrospective study examining the efficacy, side effects, and satisfaction of a dynamically cooled, variable spot-sized 1,064 nm Nd:YAG laser for the treatment of facial reticular veins in the periorbital and temporal area.

PATIENTS AND METHODS

Contact was made with 100 patients from 2006 to 2019 who underwent treatment with a 1,064 nm Nd:YAG laser for facial reticular veins through office follow-up or telephone interviews. Percent resolution of veins, satisfaction, and adverse effects were evaluated.

RESULTS

Eighty-nine of the 100 patients ranked their satisfaction with the treatment as 3 or very satisfied. Most patients reported 75% to 100% improvement. The most commonly reported adverse event seen after treatment was mild edema. Sixty-eight percent of patients reported no adverse effects at all.

CONCLUSION

The dynamically cooled, variable spot-sized 1,064 nm Nd:YAG laser is a safe and effective treatment for facial reticular veins with minimal side effects. The results are usually immediate and, based on the long-term follow-up, tend to be long lasting.
Pre-operative chronic opioid or glucocorticoid use and mortality after noncardiac surgery
Authors: Oh Tak Kyu , Kim Saeyeon , Song In-Ae , Jeon Young-Tae
Published: May 2020

BACKGROUND

The chronic use of opioids and glucocorticoids is associated with serious side effects. Moreover, both medications are related to poor long-term postoperative outcomes.

OBJECTIVE

The study aimed to investigate the association between pre-operative chronic opioid and glucocorticoid use and 90-day mortality after noncardiac surgery.

DESIGN

Retrospective, population-based cohort study.

SETTING

Single tertiary academic hospital.

PATIENTS

The study enrolled adult (≥18 years of age) patients admitted to Seoul National University Bundang Hospital, between January 2012 and December 2018 for planned, elective, noncardiac surgery.

MAIN OUTCOME MEASURES

The study compared the 90-day mortality for patients using opioids or glucocorticoids chronically (≥3 months) prior to surgery and for opioid-naïve and glucocorticoid-naïve patients.

RESULTS

A total of 112 606 patients were included in the study. Among them, 107 843 (95.9%) were opioid-naïve and glucocorticoid-naïve patients; 3373 (3.0%), 1199 (1.1%) and 191 patients (0.2%) were chronic users of opioids, glucocorticoids or both, respectively. In the multivariable model, compared with opioid-naïve and glucocorticoid-naïve patients, the odds of dying within 90 days were significantly higher for chronic users of opioids [3.56-fold; 95% confidence intervals (CIs) 2.36 to 5.38; P < 0.001], glucocorticoids (4.17-fold; 95% CI 3.28 to 5.29; P < 0.001) and combined opioids and glucocorticoids (7.66-fold; 95% CI 3.91 to 15.01; P < 0.001).

CONCLUSION

Chronic pre-operative use of opioids and glucocorticoids, together or individually, were associated with increased 90-day mortalities after noncardiac surgery, compared with opioid-naïve and glucocorticoid-naïve patients. Our results suggest that chronic pre-operative use of opioids and glucocorticoids should be managed carefully.
Hyponatremia accompanying volatile hypertension caused by baroreflex failure after neck surgery: case report and literature review
Authors: Sarafidis Pantelis A. , Theodorakopoulou Marieta , Dipla Konstantina , Zafeiridis Andreas , Boutou Afroditi , Loutradis Charalampos , Faitatzidou Danae , Papagianni Aikaterini , Parati Gianfranco
Published: May 2020

The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the most common cause of euvolemic hyponatremia, and many disorders have been associated with it. Baroreflex failure is a rare disorder characterized by extreme blood pressure (BP) fluctuations, most frequently caused by neck or head trauma and irradiation. We report a case of a 48-year-old patient referred to our department for asymptomatic hyponatremia and volatile hypertension. His past medical history included nasopharyngeal carcinoma treated with surgery and bilateral neck radiation. Following the diagnostic algorithm for hyponatremia, the diagnosis of SIADH was made. Ambulatory BP monitoring revealed highly variable BP; extensive autonomic nervous system function testing suggested baroreflex-cardiovagal failure. We propose the hypothesis that not only labile hypertension because of baroreflex failure but also hyponatremia can develop as a late consequence of neck trauma and irradiation.
Outcomes in adults with systolic blood pressure between 130 and 139 mmHg in Action to Control Cardiovascular Risk in Diabetes Blood Pressure trial and Systolic Blood Pressure Intervention Trial
Authors: Contreras Gabriel , Lu Lingyi , Tamariz Leonardo , Rocco Michael V. , Papademetriou Vasilios , Kostis John B. , Pisoni Roberto , Glasser Stephen P. , Sweeney Mary E. , Basile Jan , Gren Lisa H. , Zamanian Sara , Cushman William C.
Published: May 2020

Background:

Patients with stage 1 systolic hypertension have increased risk of cardiovascular disease (CVD) events.

Methods:

Using Cox models, we assess the effect of targeting an intensive SBP goal of less than 120 mmHg compared with standard SBP goal of less than 140 mmHg on the risk of CVD events in adults with stage 1 systolic hypertension with diabetes mellitus enrolled in Action to Control Cardiovascular Risk in Diabetes Blood Pressure trial (ACCORD BP) (n = 1901) and without diabetes mellitus enrolled in Systolic Blood Pressure Intervention Trial (SPRINT) (n = 3484) that used identical SBP goal interventions.

Outcomes:

In ACCORD BP, the primary composite CVD outcome was the first occurrence of myocardial infarction, stroke, or CVD mortality. In SPRINT, the primary composite CVD outcome was the first occurrence of myocardial infarction, other acute coronary syndrome, stroke, heart failure, or CVD mortality.

Results:

In SPRINT, targeting an intensive SBP goal significantly reduced the risk of the primary CVD outcome [hazard ratio 0.75 (95% confidence interval, 0.58–0.98); events 1.78 vs. 2.37%/year]. In ACCORD BP, the relationships of SBP goal with the primary CVD outcome was modified by the glycemia goal intervention (interaction P = 0.039). In the standard glycemia subgroup (A1c target 7–7.9%), intensive SBP goal significantly reduced the risk of the primary CVD outcome [hazard ratio 0.61 (0.40–0.94); events 1.63 vs. 2.56%/year]. In the intensive glycemia subgroup (A1c target <6%), the risk of the primary CVD outcome was not significantly different between groups [hazard ratio 1.20 (0.76–1.89); events 1.91 vs. 1.60%/year].

Conclusion:

Targeting an intensive SBP goal significantly reduced the risk of CVD events in patients with stage 1 systolic hypertension without diabetes and with diabetes on standard glycemia goal.
Misuse of a Medical Radioisotope: 125I Labeled Playing Cards in Germany, a Case Study
Authors: Kroeger Emily Alice , Rupp Alexander , Gregor Joachim
Published: May 2020

The security of medical radioactive sources, both open and sealed, is an important consideration for reducing the risk of an intentional or inadvertent additional radiation dose to the public, according to the principle of keeping any additional radiation dose as low as reasonably achievable. The detection and following radiological investigation of the misuse of iodine-125 (125I), a medically used radionuclide, in Germany is described in detail with the aim of sharing experience and raising awareness. The misuse of 125I shows that the security of 125I is not guaranteed completely at the present time.
Suspected Close Contacts as the Pilot Indicator of the Growth Trend of Confirmed Population During the COVID-19 Pandemic: A Simulation Approach
Authors: Huang Sisi , Zhu Anding , Wang Yan , Xu Yancong , Li Lu , Kong Dexing
Published: May 2020

Regarding to the actual situation of the new coronavirus disease 2019 epidemic, social factors should be taken into account and the increasing growth trend of confirmed populations needs to be explained. A proper model needs to be established, not only to simulate the epidemic, but also to evaluate the future epidemic situation and find a pilot indicator for the outbreak. The original susceptible-infectious-recover model is modified into the susceptible-infectious-quarantine-confirm-recover combined with social factors (SIDCRL) model, which combines the natural transmission with social factors such as external interventions and isolation. The numerical simulation method is used to imitate the change curve of the cumulative number of the confirmed cases and the number of cured patients. Furthermore, we investigate the relationship between the suspected close contacts (SCC) and the final outcome of the growth trend of confirmed cases with a simulation approach. This article selects four representative countries, that is, China, South Korea, Italy, and the United States, and gives separate numerical simulations. The simulation results of the model fit the actual situation of the epidemic development and reasonable predictions are made. In addition, it is analyzed that the increasing number of SCC contributes to the epidemic outbreak and the prediction of the United States based on the population of the SCC highlights the importance of external intervention and active prevention measures. The simulation of the model verifies its reliability and stresses that observable variable SCC can be taken as a pilot indicator of the coronavirus disease 2019 pandemic.
Penumbra volume predicts unfavorable outcome in patients with acute minor stroke or transient ischemic attack
Authors: Liao Chih-Hsiang , Liao Nien-Chen , Chen Wen-Hsien , Chen Hung-Chieh , Chang Ming-Hong , Tsuei Yuang-Seng , Shen Chiung-Chyi , Yang Shun-Fa , Chen Po-Lin
Published: May 2020

Background:

A subgroup of patients with acute minor stroke (AMS) or transient ischemic attack (TIA) become disabled due to disease progression (DP) or recurrent stroke within 3 months. The aim of this article is to identify the risk factors for DP in AMS/TIA patients. In the literature, no studies focused on computed tomography perfusion (CTP) in AMS/TIA patients at the acute stage.

Methods:

This retrospective study included patients with AMS or TIA (onset of symptoms ≤4.5 hours, baseline National Institutes of Health Stroke Scale [NIHSS] score of 0-4). DP was defined as a deterioration of NIHSS score of ≥2 points during hospitalization or modified Ranking Scale ≥2 at 3-month follow-up. Clinical data and imaging results were retrieved and measured for statistical analysis.

Results:

From 2011 to 2017, total 135 patients were eligible for further analysis: 28 patients (20.7%, DP group) and 107 patients (79.3%, non-DP group). The DP group had significantly higher larger penumbra volumes (p = 0.028). In univariate model of the logistic regression, patients with the following risk factors tended to have unfavorable outcome: female gender, higher HbA1c, chronic kidney disease stage ≥3b, intracranial atherosclerosis, and penumbra volume were associated unfavorable outcome, but larger deadcore volume was not. In further multivariate analysis, only penumbra volume >5 cm3 (p = 0.049, odds ratio [OR] = 3.21, 95% CI: 1.00-10.27) had the statistical significance. The cut-point value of the penumbra volume for unfavorable outcome in AMS/TIA patients was 4.73 cm3.

Conclusion:

One fifth of the AMS/TIA patients had unfavorable outcome at 90 days. In CTP performed within 4.5 hours after the onset of AMS/TIA, the penumbra volume (>5 cm3) was a significant risk factor for DP, and the cut-point value was 4.73 cm3. Further studies could be designed to involve this subgroup of patients for more aggressive treatment.
Redox reaction and clinical outcome of primary diffuse large B-cell lymphoma of the central nervous system: Prognostic role of metabolic and textural parameters of 62Cu-diacetyl-bis (N4-methylthiosemicarbazone) PET/computed tomography in a small patient cohort
Authors: Tsuchiya Junichi , Yoneyama Tomohiro , Ohtake Makoto , Tateishi Kensuke , Bae Hyeyeol , Kishino Mitsuhiro , Tateishi Ukihide
Published: May 2020

Objective

This study aimed to clarify the relationship between tumor redox reaction evaluated by 62Cu-diacetyl-bis (N4-methylthiosemicarbazone) (62Cu-ATSM) PET/computed tomography (CT) and disease-free survival (DFS) in patients with primary diffuse large B-cell lymphoma of the central nervous system (DLBCL-CNS).

Methods

Fifteen consecutive patients with histologically confirmed DLBCL-CNS underwent preoperative 62Cu-ATSM PET/CT and 18F-fluorodeoxyglucose (FDG) PET/CT. Statistical features of seven first-order parameters, including the standardized uptake value (SUV); 12 second-order parameters, including gray-level co-occurrence matrices and gray-level zone size matrices; and 5 high-order parameters, including neighborhood gray-tone difference matrices, were calculated from the volume of interest. We compared DFS with parameters, including SUVmax and tumor-to-background (T/B) ratio of FDG, and SUVmax, T/B ratio, and other textural features of 62Cu-ATSM.

Results

The mean follow-up duration after PET/CT was 458 (range, 41–1071) days. The SUVmax of FDG was significantly higher than that of 62Cu-ATSM (P = 0.001), but the T/B ratio was not significantly different between the scans (3.49 ± 2.29 vs 2.48 ± 1.18; P = 0.244). A Mantel–Cox log-rank test revealed no significant association between SUVmax of FDG and DFS (P = 0.641). A high SUVmax of 62Cu-ATSM had a tendency of shorter DFS (P = 0.055). Total lesion reduction, reductive tumor volume, and T/B ratio of 62Cu-ATSM were significantly correlated with poor DFS by univariate analysis (P = 0.049, 0.031, and 0.007, respectively). Neighborhood gray-level co-occurrence matrix dissimilarity was significantly correlated with poor DFS (P = 0.015).

Conclusions

Metabolic and textural features derived from pretreatment 62Cu-ATSM PET/CT could be used for predicting DFS and establishing a novel treatment strategy in DLBCL-CNS patients.
Cystic fibrosis transmembrane conductance receptor modulator therapy in cystic fibrosis, an update
Authors: Egan Marie E.
Published: May 2020

Purpose of review

Cystic fibrosis transmembrane conductance receptor (CFTR) modulators are a new class of drugs that treat the underlying cause of cystic fibrosis. To date, there are four approved medications, which are mutation-specific. Although the number of mutations that respond to these agents is expanding, effective CFTR modulators are not available to all cystic fibrosis patients. The purpose of this article is to review the approved CFTR modulators and discuss the mutations that can be treated with these agents, as well as, review the long-term benefits of modulator therapy.

Recent findings

More people with cystic fibrosis can be effectively treated with CFTR modulators. The new, highly effective triple therapy, elexacaftor/tezacaftor/ivacaftor is indicated for more than 90% of patients with cystic fibrosis and ivacaftor is now approved for children as young as 6 months of age with 1 of 30 CFTR mutations. Long-term use of modulator therapy is associated with fewer pulmonary exacerbations, maintenance of lung function, improved weight gain, and quality of life.

CFTR modulators are the first therapies developed to treat the underlying defect in cystic fibrosis. Their use is associated with preserved lung function and improved health in patients with cystic fibrosis.
Cardiomyopathies in children: classification, diagnosis and treatment
Authors: De Angelis Giulia , Bobbo Marco , Paldino Alessia , D’Agata Mottolese Biancamaria , Altinier Alessandro , Dal Ferro Matteo , Merlo Marco , Sinagra Gianfranco
Published: May 2020

Purpose of review

Cardiomyopathies are rare in the pediatric population, but significantly impact on morbidity and mortality. The present review aims to provide an overview of cardiomyopathies in children and some practical guidelines for their prognostic stratification and management.

Recent findings

Pediatric cardiomyopathies may present as isolated cardiac muscle disease or in the context of complex clinical syndromes. The etiologic characterization represents an important step in the diagnosis and treatment of cardiomyopathies because of its impact on prognosis and on therapeutic measures. Indeed, replacement therapy is nowadays widely available and changes the natural history of the disease. More complex is the management of isolated cardiomyopathies, which lack specific therapies, mainly aimed at symptomatic relief. In this context, heart transplantation shows excellent outcomes in children, but wait-list mortality is still very high. Device therapy for sudden cardiac death prevention and the use of mechanical assist devices are becoming more common in the clinical practice and may help to reduce mortality.

Providing insight into pediatric cardiomyopathies classification helps in the prognostication and management of such diseases. Recent years witnessed a significant improvement in mortality, but future research is still needed to improve quality of life and life expectations in the pediatric population.
Objective evaluation of Nintendo Wii Fit Plus balance program training on postural stability in Multiple Sclerosis patients: a pilot study
Authors: Cimino Vincenzo , Chisari Clara Grazia , Raciti Gianfranco , Russo Anna , Veca Donata , Zagari Francesco , Calabrò Rocco Salvatore , Patti Francesco
Published: May 2020

The use of the Nintendo Wii system has become a common tool for balance rehabilitation in patients with multiple sclerosis, but few studies verified the effectiveness of such an approach using quantitative measures of postural control. We aimed to evaluate the impact of rehabilitation treatment using the Nintendo Wii Fit Plus balance program on objective stabilometric parameters in multiple sclerosis patients. We enrolled 36 multiple sclerosis patients, with mild-moderate disability, referring to the multiple sclerosis Centre of the University of Catania from September 2013 to June 2014. Twenty participants underwent 20 individual sessions of balance exercise using the Nintendo Wii Fit Plus. They were assessed at baseline (T0) and at the end of rehabilitation program (T1) by Neurocom Balance Manager. Functional independence measure, Barthel index, and Berg balance scale were also administered. At T1, we found a significant improvement in total path length-open eyes, sway area-open eyes, and mean sway velocity-open eyes. Patients showed significant improvement in functional independence measure motor score, Barthel index, and in Berg balance scale. No significant differences between T0 and T1 in closed eyes trials were found. A significant correlation between delta values between T0 and T1 of sway area-open eyes and the Berg balance scale (r = −0.76; P < 0.0001) was found. This study confirmed that balance rehabilitation training performed using the Nintendo Wii with balance board significantly reduced some postural sway parameters in multiple sclerosis patients. It could be a good support to standard rehabilitation program in multiple sclerosis patients.