bluuebunny/crossref_metadata_2025 huggingface dataset:
An alternative route towards the fabrication of 2D blue phosphorene
Authors: Schaal M , Picker J , Otto F , Gruenewald M , Forker R , Fritz T
Published: August 2021

Blue phosphorene (BlueP) is a novel two-dimensional material that shares properties with black phosphorene and is potentially even more interesting for opto-electronic applications because of its layer dependent wide band gap of ≈ 2 to 3 eV and superior charge carrier mobility. It was first fabricated on Au(111), where, however, a network consisting of BlueP subunits and Au-linker atoms is formed. The physical properties of such an arrangement strongly differ from a freestanding BlueP monolayer. Here, we report on the growth of epitaxial BlueP on the Au(100) surface, which is an interesting alternative when aiming at quasi-freestanding BlueP domains. We find two different phosphorus phases by means of scanning tunneling microscopy and distortion-corrected low-energy electron diffraction. In the low coverage regime, we observe a commensurate (2 × 2) phase, whereas for higher coverage, a nearly hexagonal structure is formed. For the latter, the lattice parameters measured via atomically resolved scanning tunneling hydrogen microscopy closely resemble those of freestanding BlueP, and the typical height modulation of the phosphorus atoms is verified in our layers by means of x-ray photoelectron diffraction. We further analyze the chemical and electronic properties of these films by means of x-ray and (angle resolved) ultraviolet photoelectron spectroscopy.
The role of plasma-molecule interactions on power and particle balance during detachment on the TCV tokamak
Authors: Verhaegh K. , Lipschultz B. , Harrison J.R. , Duval B.P. , Fil A. , Wensing M. , Bowman C. , Gahle D.S. , Kukushkin A. , Moulton D. , Perek A. , Pshenov A. , Federici F. , Février O. , Myatra O. , Smolders A. , Theiler C. , the TCV Team  , the EUROfusion MST1 Team
Published: August 2021

This paper shows experimental results from the TCV tokamak that indicate plasma-molecule interactions involving

D

2

+

and possibly D− play an important role as sinks of energy (through hydrogenic radiation as well as dissociation) and particles (ions) during divertor detachment if low target temperatures (<3 eV) are achieved. Both molecular activated recombination (MAR) and ion source reduction due to a power limitation effect are shown to be important in reducing the ion target flux during a density ramp. In contrast, the electron–ion recombination (EIR) ion sink is too small to play an important role in reducing the ion target flux. MAR or EIR do not occur during N2 seeding induced detachment as the target temperatures are not sufficiently low. The impact of

D

2

+

is shown to be underestimated in present (vibrationally unresolved) SOLPS-ITER simulations, which could result from an underestimated

D

2

+

D

+

→

D

2

+

+
D

rate. The converged SOLPS-ITER simulations are post-processed with alternative reaction rates, resulting in considerable contributions of

D

2

+

to particle and power losses as well as dissociation below the D2 dissociation area. Those findings are in quantitative agreement with the experimental results.
Performance of the MICE diagnostic system
Authors: Bogomilov M. , Tsenov R. , Vankova-Kirilova G. , Song Y.P. , Tang J.Y. , Li Z.H. , Bertoni R. , Bonesini M. , Chignoli F. , Mazza R. , Palladino V. , de Bari A. , Orestano D. , Tortora L. , Kuno Y. , Sakamoto H. , Sato A. , Ishimoto S. , Chung M. , Sung C.K. , Filthaut F. , Fedorov M. , Jokovic D. , Maletic D. , Savic M. , Jovancevic N. , Nikolov J. , Vretenar M. , Ramberger S. , Asfandiyarov R. , Blondel A. , Drielsma F. , Karadzhov Y. , Charnley G. , Collomb N. , Dumbell K. , Gallagher A. , Grant A. , Griffiths S. , Hartnett T. , Martlew B. , Moss A. , Muir A. , Mullacrane I. , Oates A. , Owens P. , Stokes G. , Warburton P. , White C. , Adams D. , Bayliss V. , Boehm J. , Bradshaw T.W. , Brown C. , Courthold M. , Govans J. , Hills M. , Lagrange J.-B. , Macwaters C. , Nichols A. , Preece R. , Ricciardi S. , Rogers C. , Stanley T. , Tarrant J. , Tucker M. , Watson S. , Wilson A. , Bayes R. , Nugent J.C. , Soler F.J.P. , Gamet R. , Cooke P. , Blackmore V.J. , Colling D. , Dobbs A. , Dornan P. , Franchini P. , Hunt C. , Jurj P.B. , Kurup A. , Long K. , Martyniak J. , Middleton S. , Pasternak J. , Uchida M.A. , Cobb J.H. , Booth C.N. , Hodgson P. , Langlands J. , Overton E. , Pec V. , Smith P.J. , Wilbur S. , Chatzitheodoridis G.T. , Dick A.J. , Ronald K. , Whyte C.G. , Young A.R. , Boyd S. , Greis J.R. , Lord T. , Pidcott C. , Taylor I. , Ellis M. , Gardener R.B.S. , Kyberd P. , Nebrensky J.J. , Palmer M. , Witte H. , Adey D. , Bross A.D. , Bowring D. , Hanlet P. , Liu A. , Neuffer D. , Popovic M. , Rubinov P. , DeMello A. , Gourlay S. , Lambert A. , Li D. , Luo T. , Prestemon S. , Virostek S. , Freemire B. , Kaplan D.M. , Mohayai T.A. , Rajaram D. , Snopok P. , Torun Y. , Cremaldi L.M. , Sanders D.A. , Summers D.J. , Coney L.R. , Hanson G.G. , Heidt C.
Published: August 2021

Muon beams of low emittance provide the basis for the intense, well-characterised neutrino beams of a neutrino factory and for multi-TeV lepton-antilepton collisions at a muon collider. The international Muon Ionization Cooling Experiment (MICE) has demonstrated the principle of ionization cooling, the technique by which it is proposed to reduce the phase-space volume occupied by the muon beam at such facilities. This paper documents the performance of the detectors used in MICE to measure the muon-beam parameters, and the physical properties of the liquid hydrogen energy absorber during running.
Combined impacts of climate and air pollution on human health and agricultural productivity
Authors: Sillmann Jana , Aunan Kristin , Emberson Lisa , Büker Patrick , Van Oort Bob , O’Neill Connie , Otero Noelia , Pandey Divya , Brisebois Anouk
Published: August 2021

Climate change and air pollution can interact to amplify risks to human health and crop production. This has significant implications for our ability to reach the Sustainable Development Goals (e.g. SDGs 2, 3, 13, 15) and for the design of effective mitigation and adaptation policies and risk management. To be able to achieve the SDG targets, closer integration of climate change and air pollution both in terms of impact assessment for human health and agricultural productivity and respective policy development is needed. Currently, studies estimating the impacts of climate and air pollutants on human health and crops mostly treat these stressors separately, and the methods used by the health and agricultural science communities differ. Better insights into the methods applied in the different communities can help to improve existing and develop new methods to advance our knowledge about the combined impacts of climate change and air pollution on human health and crops. This topical review provides an overview of current methodologies applied in the two fields of human health and agricultural crop impact studies, ranging from empirical regression-based and experimental methods to more complex process-based models. The latter are reasonably well developed for estimating impacts on agricultural crops, but not for health impacts. We review available literature addressing the combined effects of climate and air pollution on human health or agricultural productivity to provide insights regarding state-of-the-art knowledge and currently available methods in the two fields. Challenges to assess the combined effect of climate and air pollution on human health and crops, and opportunities for both fields to learn from each other, are discussed.
Effects of Prior Exposure to Conflicting Health Information on Responses to Subsequent Unrelated Health Messages: Results from a Population-Based Longitudinal Experiment
Authors: Nagler Rebekah H , Vogel Rachel I , Gollust Sarah E , Yzer Marco C , Rothman Alexander J
Published: August 2021

Background

Accumulating evidence suggests that exposure to conflicting health information can adversely affect public understanding of and trust in health recommendations. What is not known is whether prior exposure to such information renders people less receptive to subsequent unrelated health messages about behaviors for which the evidence is clear and consistent.

Purpose

This study tests this “carryover” effects hypothesis, positing that prior exposure to conflict will reduce receptivity to subsequent unrelated health messages, and examines potential affective and cognitive pathways through which such effects might occur.

Methods

A three-wave, online, population-based survey experiment (N = 2,716) assessed whether participants who were randomly assigned to view a series of health news stories and social media posts featuring conflict at Times 1 and 2 were ultimately less receptive at Time 3 to ads from existing health campaigns about behaviors for which there is scientific consensus, compared to those who saw the same series of stories and posts that did not feature conflict.

Results

Structural equation modeling revealed evidence of carryover effects of exposure to conflict on two dimensions of message receptivity: greater resistance to the unrelated ads and lower perceptions of the health behaviors featured in the ads. Modeling indicated that carryover effects were a function of generalized backlash toward health recommendations and research elicited by prior exposure to conflicting information.

Conclusions

Findings suggest that the broader public information environment, which is increasingly characterized by messages of conflict and controversy, could undermine the success of large-scale public health messaging strategies.
What Strategy Is Better for Promoting COVID-19 Vaccination? A Comparison Between Gain-Framed, Loss-Framed, and Altruistic Messages
Authors: Gong Zepeng , Tang Zhiwei , Li Jie
Published: August 2021

Background/Objective

Vaccination is an efficient public health strategy for controlling infectious diseases like the COVID-19 pandemic. Therefore, this study evaluates the effect of gain-framed, loss-framed, and altruism messages on willingness to get a COVID-19 vaccine and confirms the best strategy for promoting vaccination.

Methods

Herein, we designed an online survey experiment, including a control (exposure to non-framed information) and three experimental (exposure to gain-framed, loss-framed, or altruistic messages) groups, to assess the vaccination willingness. All participants (n = 1316) were randomly assigned into one of the four groups.

Results

The individuals exposed to gain-framed, loss-framed, or altruism messages exhibited a higher willingness to get a COVID-19 vaccine than those exposed to non-framed information. Moreover, the loss-framed information effect on vaccination willingness was more substantial than the other two messages. However, no significant difference was observed between the gain-framed and altruism messages.

Conclusion

This study suggests that a loss-framed information dissemination strategy could be preferable to motivate vaccination willingness against COVID-19.
Imaging protein aggregates in the serum and cerebrospinal fluid in Parkinson’s disease
Authors: Lobanova Evgeniia , Whiten Daniel , Ruggeri Francesco S , Taylor Christopher G , Kouli Antonina , Xia Zengjie , Emin Derya , Zhang Yu P , Lam Jeff Y L , Williams-Gray Caroline H , Klenerman David
Published: August 2021

Aggregation of α-synuclein plays a key role in the development of Parkinson’s disease. Soluble aggregates are present not only within human brain but also the CSF and blood. Characterizing the aggregates present in these biofluids may provide insights into disease mechanisms and also have potential for aiding diagnosis.

We used two optical single-molecule imaging methods called aptamer DNA-PAINT and single-aggregate confocal fluorescence, together with high-resolution atomic force microscopy for specific detection and characterization of individual aggregates with intermolecular β-sheet structure, present in the CSF and serum of 15 early stage Parkinson’s disease patients compared to 10 healthy age-matched controls.

We found aggregates ranging in size from 20 nm to 200 nm, in both CSF and serum. There was a difference in aggregate size distribution between Parkinson’s disease and control groups with a significantly increased number of larger aggregates (longer than 150 nm) in the serum of patients with Parkinson’s disease. To determine the chemical composition of the aggregates, we performed aptamer DNA-PAINT on serum following α-synuclein and amyloid-β immunodepletion in an independent cohort of 11 patients with early stage Parkinson’s disease and 10 control subjects. β-Sheet aggregates in the serum of Parkinson’s disease patients were found to consist of, on average, 50% α-synuclein and 50% amyloid-β in contrast to 30% α-synuclein and 70% amyloid-β in control serum [the differences in the proportion of these aggregates were statistically significant between diseased and control groups (P = 1.7 × 10−5 for each species)]. The ratio of the number of β-sheet α-synuclein aggregates to β-sheet amyloid-β aggregates in serum extracted using our super-resolution method discriminated Parkinson’s disease cases from controls with an accuracy of 98.2% (AUC = 98.2%, P = 4.3 × 10−5).

Our data suggest that studying the protein aggregates present in serum can provide information about the disruption of protein homeostasis occurring in Parkinson’s disease and warrants further investigation as a potential biomarker of disease.
Ischaemic tissue released microvesicles induce monocyte reprogramming and increase tissue repair by a tissue factor-dependent mechanism
Authors: Arderiu Gemma , Peña Esther , Badimon Lina
Published: August 2021

Aims

Despite increasing evidence that monocytes may acquire endothelial features, it remains unclear how monocytes participate in angiogenesis after ischaemic damage. We investigated whether ischaemic cells can release microvesicles (MVs) and promote neovascularization in a model of peripheral artery disease (PAD).

Methods and results

To model PAD, we used an in vivo experimental model of hind-limb ischaemia (HLI) in mice. MVs were isolated from the ischaemic muscle and from peripheral blood at different times after unilateral femoral artery ligation. MVs were phenotypically characterized to identify cell origin. HLI in mice induced the release of MVs with a much higher content of tissue factor (TF) than non-HLI control mice both in the MVs isolated from the affected limb muscle area and from blood. MVs were mainly released from endothelial cells (ECs) and induced Mo differentiation to endothelial cell-like (ECL) cells. Differentiation to ECL cells encompassed highly strict hierarchical transcription factor activation, initiated by ETS1 activation. MVs secreted by microvascular ECs over-expressing TF (upTF-EMVs), were injected in the ischaemic hind-limb in parallel with control EMVs (from random siRNA-treated cells) or EMVs released by silenced TF ECs. In animals treated with upTF-EMVs in the ischaemic zone, there was a highly significant increase in functional new vessels formation (seen by magnetic resonance angiography), a concomitant increase in the pool of circulating Ly6Clow Mo expressing vascular EC markers, and a significantly higher number of Mo/macrophages surrounding and integrating the newly formed collaterals.

Conclusion

Ischaemia-activated ECs release EMVs rich in TF that induce monocyte differentiation into ECL cells and the formation of new vessels in the ischaemic zone. TF by this mechanism of formation of new blood microvessels can contribute to ischaemic tissue repair.
Blockchain: The New Art House
Authors: Gellman Philippe
Published: August 2021

NFTs (Non-fungible tokens) have been thrust into the spotlight as companies, people and artists seek to monetise creations, from artworks to tweets. Philippe Gellman, co-founder and CEO of Arteïa, talks to Johanna Hamilton about his creation of ‘the first Digital Catalogue Raisonné supported by blockchain’ and how cutting-edge tech is changing the art world.
Data First Strategy for AI in Project Management Success
Authors: Skinner Lloyd
Published: August 2021

There are many benefits of using AI in your project management strategies, writes Lloyd Skinner, CEO of Greyfly. However, to really excel, there’s one key thing to focus on: data.
Bombay High Court (re)assures that copyright registration is not required to remedy infringement
Authors: Wadhwa Muskaan , Saidha Manvee Kumar
Published: August 2021

Sanjay Soya Private Limited v. Narayani Trading Company, Interim Application (L) No. 5011 of 2020 and Commercial IP Suit No. 2 of 2021, High Court of Bombay, Maharashtra, judgment of 9 March 2021, by Mr. Justice G.S. Patel

The Bombay High Court, in the case of Sanjay Soya Private Limited v. Narayani Trading Company, held that copyright registration is not a prerequisite to claiming relief in copyright infringement cases. The judgment clarifies the dubiety created previously by a contrary judicial opinion and aligns the Indian position with international copyright principles.
Miley Cyrus ‘came in like a wrecking ball’: the American pop star succeeds in registering her name as an EU trade mark
Authors: Antoniou Alexandros
Published: August 2021

General Court, T–368/20, Smiley Miley, Inc. v European Union Intellectual Property Office (EUIPO), EU:T:2021:372

The article analyses the decision in Smiley Miley v EUIPO, in which the General Court held that the American singer-songwriter and actress Miley Cyrus was entitled to use her name as a trade mark. It considers the importance of this ruling in relation to the protection afforded to public figures of international recognition through trade marks in the EU.
Insect Pathogenic Fungi for Biocontrol of Plague Vector Fleas: A Review
Authors: Eads David A , Jaronski Stefan T , Biggins Dean E , Wimsatt Jeffrey
Published: August 2021

Bubonic plague is a lethal bacterial disease of great historical importance. The plague organism, Yersinia pestis, is primarily transmitted by fleas (Siphonaptera). In natural settings, where its range expands, Y. pestis resides in association with wild rodents and their fleas (sylvatic plague). While chemical insecticides are used against plague vector fleas, biological approaches have not been as critically evaluated. Benign and cost-effective control methods are sorely needed, particularly where imperiled species are at risk. Here we explore the potential of two representative insect pathogenic fungi, Beauveria bassiana Vuillemin 1912 (Hypocreales: Cordycipitaceae) and Metarhizium anisopliae Metschnikoff 1879 (Hypocreales: Clavicipitaceae), each already used commercially worldwide in large-scale agricultural applications, as candidate biopesticides for application against fleas. We review the life cycles, flea virulence, commercial production, and field application of these fungi, and ecological and safety considerations. Pathogenic fungi infections among natural flea populations suggest that conditions within at least some rodent burrows are favorable, and laboratory studies demonstrate lethality of these fungi to at least some representative flea species. Continued study and advancements with these fungi, under appropriate safety measures, may allow for effective biocontrol of plague vector fleas to protect imperiled species, decrease plague outbreaks in key rodent species, and limit plague in humans.
Integrated Tick Management in South Central Wisconsin: Impact of Invasive Vegetation Removal and Host-Targeted Acaricides on the Density of QuestingIxodes scapularis(Acari: Ixodidae) Nymphs
Authors: Mandli Jordan T , Lee Xia , Bron Gebbiena M , Paskewitz Susan M
Published: August 2021

As tick-borne disease incidence increases and pathogens expand into new areas, the need for effective tick management strategies is paramount. In this 5-yr study (2014–2018) conducted in south central Wisconsin, we assessed whether an integrated tick management approach, deployed during peak tick activity (May–August), was more effective at reducing black-legged ticks (Ixodes scapularis Say (Ixodida: Ixodidae)), than individual interventions. Using a factorial design, invasive vegetation removal (Amur honeysuckle, Lonicera maackii Ruprecht (Dipsacales: Caprifoliaceae) and common buckthorn, Rhamnus cathartica Linnaeus (Rosales: Rhamnaceae)) was coupled with deployments of permethrin-treated cotton nesting materials (tick tubes) that target the white-footed mouse (Peromyscus leucopus Rafinesque (Rodentia: Cricetidae)). Results show that the probability of encountering a larval tick by drag sampling was unaffected by treatments at the cumulative 5-yr level. However, vegetation removal significantly reduced larval encounters in 2014, 2015, and 2018, by 33%, 57%, and 61% respectively, and reduced the density of questing nymphal (DON) ticks by 45% in 2015 compared to controls. Despite the limited effect on DON, vegetation removal significantly reduced the cumulative 5-yr density of Borrelia burgdorferi sensu stricto infected nymphs (DIN) (70%) compared to controls as a result of decreased nymphal infection prevalence. Sites treated with tick tubes had lower DIN (66%) and DON (54%) across the study and nymphs were reduced every year following the initial year of deployment compared to controls. Combining treatments did not further reduce DIN or DONs. We conclude that long-term integration of tick tubes with invasive vegetation removal does not provide additional benefit over individual treatments alone.
From ‘Chinese Music’ to ‘Guoyue’: Shanghai Musicians and Translated Traditionality, 1919–1937
Authors: Chen Vincent Mu-chien
Published: August 2021

To explain the formation of guoyue (today also called huayue, minyue, or zhongyue) as a genre of music, I propose the concept of ‘translated traditionality’. I define traditionality as Shanghai musicians’ ideal of traditional Chinese music shown in their cultural enterprises named guoyue. By ‘translated’, I highlight that these musicians exercised the power of agenda-setting by actively debating and shaping the concept. First, I describe how different regional musics were gathered together under the title guoyue, analysing the socio-economic backgrounds that contributed to this convergence. Second, I examine guoyue musicians’ various approaches to conceptualizing ‘tradition’ and re-presenting these musics in the mediasphere. By investigating the gap between musical discourse and practice, I highlight the agency of guoyue musicians in utilizing such a difference to incorporate seemingly contradictory elements. In the end, with traditionality, musicians transformed guoyue into a genre that encompasses more than merely traditional Chinese musics.
SWALO: scaffolding with assembly likelihood optimization
Authors: Rahman Atif , Pachter Lior
Published: August 2021

Scaffolding, i.e. ordering and orienting contigs is an important step in genome assembly. We present a method for scaffolding using second generation sequencing reads based on likelihoods of genome assemblies. A generative model for sequencing is used to obtain maximum likelihood estimates of gaps between contigs and to estimate whether linking contigs into scaffolds would lead to an increase in the likelihood of the assembly. We then link contigs if they can be unambiguously joined or if the corresponding increase in likelihood is substantially greater than that of other possible joins of those contigs. The method is implemented in a tool called Swalo with approximations to make it efficient and applicable to large datasets. Analysis on real and simulated datasets reveals that it consistently makes more or similar number of correct joins as other scaffolders while linking very few contigs incorrectly, thus outperforming other scaffolders and demonstrating that substantial improvement in genome assembly may be achieved through the use of statistical models. Swalo is freely available for download at https://atifrahman.github.io/SWALO/.
Clinically amyopathic dermatomyositis during the COVID-19 pandemic
Authors: Kitamura Masakazu , Sugimoto Hiroshi
Published: August 2021

An 84-year-old Japanese woman presented to our hospital with a month-long dry cough during the coronavirus disease 2019 (COVID-19) pandemic. She also had skin lesions on her fingers from 3 months prior. A chest computed tomography (CT) scan showed bilateral ground- glass opacities with a subpleural distribution, similar to the findings of COVID-19. The results of COVID-19 tests were negative. The titer of the anti-melanoma differentiation-associated gene 5 (MDA5) antibody was elevated. Consequently, we confirmed the diagnosis of clinically amyopathic dermatomyositis (CADM) and then administered oral prednisolone combined with tacrolimus. After the treatment, her symptoms, skin lesions and CT findings were gradually resolved.
Bilateral subdural hygromas after endovascular coiling for ruptured aneurysmal subarachnoid hemorrhage: an unusual and rare complication
Authors: Ahmed Walid O , Mashhour Shady N , Abdelfattah Marwa E
Published: August 2021

Subarachnoid hemorrhage (SAH) with subdural hygroma (SH) was rarely reported after endovascular coiling. A 60-year-old male presented with impaired consciousness and convulsions due to SAH from a ruptured aneurysm. It was managed by endovascular coiling 20 h after the onset of symptoms. Serial brain imaging for 2 weeks revealed progressive bilateral SHs, more on contralateral side of leaking aneurysm. Management of SH was discussed in a multidisciplinary setting to be conservative as there was neither significant mass effect nor hydrocephalus. The patient recovered neurologically except for mild dysarthria. The SH persisted for 2 months and then cleared gradually. We concluded that SH may arise and become symptomatic as an unusual sequela of post-coiling of a ruptured intracranial aneurysm, in which the SH can complicate the clinical course of SAH. However, the symptomatic SH may resolve spontaneously and completely without any intervention, but needs meticulous neurological assessment and follow-up.
Efficient Coding and Risky Choice
Authors: Frydman Cary , Jin Lawrence J
Published: August 2021

We experimentally test a theory of risky choice in which the perception of a lottery payoff is noisy due to information processing constraints in the brain. We model perception using the principle of efficient coding, which implies that perception is most accurate for those payoffs that occur most frequently. Across two preregistered laboratory experiments, we manipulate the distribution from which payoffs in the choice set are drawn. In our first experiment, we find that risk taking is more sensitive to payoffs that are presented more frequently. In a follow-up task, we incentivize subjects to classify which of two symbolic numbers is larger. Subjects exhibit higher accuracy and faster response times for numbers they have observed more frequently. In our second experiment, we manipulate the payoff distribution so that efficient coding modulates the strength of valuation biases. As we experimentally increase the frequency of large payoffs, we find that subjects perceive the upside of a risky lottery more accurately and take greater risk. Together, our experimental results suggest that risk taking depends systematically on the payoff distribution to which the decision maker’s perceptual system has recently adapted. More broadly, our findings highlight the importance of imprecise and efficient coding in economic decision making.
THE IN-SITU CALIBRATION METHOD FOR AMBIENT DOSE EQUIVALENT DOSEMETERS
Authors: Gao Fei , Wang Feifei , Xu Yang , Zhang Xinyu
Published: August 2021

Ambient dose equivalent dosemeters are widely distributed in nuclear facilities for routine continuous monitoring or nuclear accident emergency monitoring, they are inconvenient to be disassembled and sent to the metrology laboratory for calibration. To ensure the accuracy of such dosemeters, the research of in-situ calibration method has been carried out. Ambient dose equivalent secondary standard ionization chamber and portable gamma ray irradiation facility have been designed for in-situ calibration. The experiments of in-situ calibration were carried out in five typical sites located in China Institute of Atomic Energy, results showed that the relative deviation between in-situ calibration factors and metrology laboratory calibration factors are within 5%.The combined standard uncertainty of the in-situ calibration factor is 2.8%, and the expanded uncertainty is 5.6% (k=2).The in-situ calibration method can meet the calibration requirements of the fixed ambient dose equivalent dosemeters.
Pushing the Limits: Perinatal Outcomes Beyond Prolonged Second Stage
Authors: Gimovsky Alexis C. , Aizman Leora , Sparks Andrew , Levine Jordan T.
Published: August 2021

(Abstracted from J Matern Fetal Neonatal Med 2021;34:409–415)

The management of prolonged second stage (PSS) of labor has been a topic of debate for many years. In nulliparous women, PSS had been defined as 3 hours of labor with epidural and 2 hours without, according to American College of Obstetricians and Gynecologists guidelines for many years.
Race and Genetic Ancestry in Medicine—A Time for Reckoning With Racism
Authors: Borrell Luisa N. , Elhawary Jennifer R. , Fuentes-Afflick Elena , Witonsky Jonathan , Bhakta Nirav , Wu Alan H. B. , Bibbins-Domingo Kirsten , Rodríguez-Santana José R. , Lenoir Michael A. , Gavin James R. , Kittles Rick A. , Zaitlen Noah A. , Wilkes David S. , Powe Neil R. , Ziv Elad , Burchard Esteban G.
Published: August 2021

(Abstracted from N Engl J Med 2021;384:474–480)

This article published in The New England Journal of Medicine emphasizes the importance of including race and ethnicity in biomedical research and clinical practice. These variables are important in the consideration of epidemiologic information, including social determinants of health such as racism and discrimination, socioeconomic position, and environmental exposures.
Long-Term Risk of Ovarian Cancer and Borderline Tumors After Assisted Reproductive Technology
Authors: Spaan Mandy , van den Belt-Dusebout Alexandra W. , Lambalk Cornelis B. , van Boven Hester H. , Schats Roel , Kortman Marian , Broekmans Frank J. M. , Laven Joop S. E. , van Santbrink Evert J. P. , Braat Didi D. M. , van der Westerlaken Lucette A. J. , Cohlen Ben J. , Cantineau Astrid E. P. , Smeenk Jesper M. J. , van Rumste Minouche M. , Goddijn Mariëtte , van Golde Ron J. T. , Meeuwissen Paul A. M. , Hamilton Carl J. C. M. , Ouwens Gabriële M. , Gerritsma Miranda A. , Schaapveld Michael , Burger Curt W. , van Leeuwen Flora E.
Published: August 2021

(Abstracted from J Natl Cancer Inst 2021;113:699–709)

Despite inconclusive evidence, concerns that assisted reproductive technology may be associated with increased risk of ovarian cancer remain. Significant increases in gonadotropin levels and disruption of ovarian epithelium have been proposed as mechanisms to explain this potential association.
Preoperative Counseling Method and Postoperative Opioid Usage: A Secondary Analysis of the PREOP Study
Authors: Sassani Jessica C. , Artsen Amanda M. , Grosse Philip J. , Baranski Lindsey , Kunkle Lauren , Ackenbom Mary F.
Published: August 2021

(Abstracted from Female Pelvic Med Reconstr Surg 2021;27:175–180)

Preoperative counseling either in an office setting or by phone has been associated with improved postoperative satisfaction, surgical outcomes, and decreased postoperative opioid use in some surgical fields. A recent study analyzing perioperative opioid counseling versus standard of care found no significant decrease in opioid usage among a urogynecologic patient population.
Development and Performance Evaluation of a Clinical Predictive Model to Estimate the Risk of Red Blood Cell Requirements in Brain Tumor Surgery
Authors: Tomás-Biosca Ana , Martinez-Simon Antonio , Guridi Jorge , Honorato-Cia Cristina , Cacho-Asenjo Elena , Tejada Solís Sonia , Bejarano Bartolomé , Becerra-Castro Maria V. , Nuñez-Cordoba Jorge M.
Published: August 2021

Background:

The identification of factors associated with perioperative red blood cell (RBC) transfusion provides an opportunity to optimize the patient and surgical plan, and to guide perioperative crossmatch and RBC orders. We examined the association among potential bleeding risk factors and RBC requirements to develop a novel predictive model for RBC transfusion in patients undergoing brain tumor surgery.

Methods:

This retrospective study included 696 adults who underwent brain tumor surgery between 2008 and 2018. Multivariable logistic regression with backward stepwise selection for predictor selection was used during modeling. Model performance was evaluated using area under the receiver operating characteristic curve, and calibration was evaluated with Hosmer-Lemeshow goodness-of-fit χ2-estimate.

Results:

Preoperative hemoglobin level was inversely associated with the probability of RBC transfusion (odds ratio [OR]: 0.50; 95% confidence interval [CI]: 0.39-0.63; P<0.001). The need for RBC transfusion was also greater in patients who had a previous craniotomy (OR: 2.71; 95% CI: 1.32-5.57; P=0.007) and in those with larger brain tumor volume (OR: 1.01; 95% CI: 1.00-1.02; P=0.009). The relationship between number of planned craniotomy sites and RBC transfusion was not statistically significant (OR: 2.11; 95% CI: 0.61-7.32; P=0.238). A predictive model for RBC requirements was built using these 4 variables. The area under the receiver operating characteristic curve was 0.79 (95% CI: 0.70-0.87; P<0.001) showing acceptable calibration for predicting RBC transfusion requirements.

Conclusions:

RBC requirements in patients undergoing brain tumor surgery can be estimated with acceptable accuracy using a predictive model based on readily available preoperative clinical variables. This predictive model could help to optimize both individual patients and surgical plans, and to guide perioperative crossmatch orders.
Moral Injury in Veterans
Authors: Cox Michael , Skjolsvik Vonda , Rathfon Becki , Buckner Ellen
Published: August 2021

The objective of this article is to provide validation, application, and understanding of the concept of moral injury and build provider awareness to reduce veteran self-harm. Two focus groups were conducted: one to identify characteristics of moral injury and the other to refine the concepts and generate clinical approaches that address maladaptive coping strategies. The focus group sessions verified moral injury's existence, and focus group consensus centered on loss of role identity and shattering of the veteran's core integrity. The veteran's inability to self-reflect is identified as a significant contributor to the maladaptive thought process, creating internal triggers based on violations of deeply held beliefs. A Supplemental Digital Content video abstract is available at http://links.lww.com/ANS/A33.
Expert Consensus on Nail Procedures and Selection of CPT Codes
Authors: Baltz Julia O. , Rubin Adam , Adigun Chris , Daniel C. Ralph , Hinshaw Molly , Knacksedt Thomas , Lipner Shari R. , Rich Phoebe , Stern Dana , Zaiac Martin , Jellinek Nathaniel J.
Published: August 2021

BACKGROUND

Dermatologists specialize in treating conditions of the skin, hair, and nails; however, it is our experience that the field of nail diseases is the least discussed facet of dermatology. Even less acknowledged is the complexity of nail procedures and how best to accurately code for these procedures.

OBJECTIVE

To convene a panel of experts in nail disease to reach consensus on the most accurate and appropriate Current Procedural Terminology (CPT) codes associated with the most commonly performed nail procedures.

METHODS

A questionnaire including 9 of the most commonly performed nail procedures and potential CPT codes was sent to experts in the treatment of nail disease, defined as those clinicians running a nail subspecialty clinic and performing nail procedures with regularity. A conference call was convened to discuss survey results.

RESULTS

Unanimous consensus was reached on the appropriate CPT codes associated with all discussed procedures.

LIMITATIONS

Although this article details the most commonly performed nail procedures, many were excluded and billing for these procedures continues to be largely subjective. This article is meant to serve as a guide for clinicians but should not be impervious to interpretation in specific clinical situations.

CONCLUSION

Billing of nail procedures remains a practice gap within our field. The authors hope that the expert consensus on the most appropriate CPT codes associated with commonly performed nail procedures will aid clinicians as they diagnose and treat disorders of the nail unit and encourage accurate and complete billing practices.
Gaseous and Particulate Content of Laser Tattoo Removal Plume
Authors: Levin Yakir S. , Grant Michael P. , Glassford Eric , Green Brett J. , Lemons Angela R. , Avram Mathew M.
Published: August 2021

BACKGROUND

There is increasing awareness of the potential hazards of surgical plumes. The plume associated with laser tattoo removal remains uncharacterized.

OBJECTIVE

To determine the gaseous, particulate, and microbiological content of the laser tattoo removal plume.

MATERIALS AND METHODS

Air sampling was performed during laser tattoo removal from pig skin and from patients. Measurement of metals, volatile organic compounds (VOCs), carbon monoxide (CO), hydrogen sulfide (HS), and ultrafine particulates (UPs) as well as bacterial 16S ribosomal DNA sequencing were performed.

RESULTS

Metals were identified in the plume from both pig and human skin. Volatile organic compounds were found at similar levels within and outside the treatment room. Several bacterial phyla were detected in the treatment room, but not outside. High levels of UPs were measured throughout the treatment room during tattoo removal from pig skin. Ultrafine particulates were detected at low levels in the room periphery during tattoo removal from human skin, but at higher levels in the immediate treatment zone. HS and CO were not detected.

CONCLUSION

Metals, VOCs, HS, and CO were found at levels below applicable occupational exposure limits. The presence of bacteria is of uncertain significance, but may be hazardous. High levels of UPs require further investigation.
Complications and Surgical Treatment of Breast Augmentation Using Autologous Fat Transfer and Fillers
Authors: Sakai Shigeki , Ishii Naohiro , Nakamura Yukie , Matsuzaki Kyoichi , Sakai Shigemi , Kishi Kazuo
Published: August 2021

Background:

Breast augmentation with autologous fat grafting or hyaluronic acid injection requires minimal loss of healthy tissue. With an increasing trend of breast augmentation with these fillers, accompanying complications have also increased. Patients with complications often complain of induration, cyst formation, calcification, and infection, which require surgical treatment. We will discuss these complications and their surgical treatment through our experience of cases.

Methods:

This retrospective study included 20 patients who all required surgical treatment due to breast augmentation complications such as induration, cyst formation, calcification, and infection, and who visited us between May 2007 and June 2018. The patients’ ages ranged from 25 to 63, and the mean age was 39.9. The material used for breast augmentation was fat for 17 cases, and hyaluronic acid, paraffin, and silicon for one case each. The results were analyzed through plastic surgeons at our hospital.

Results:

We performed a zigzag incision in the peri-areola margin to 17 of 18 patients for complications of autologous fat grafting and hyaluronic acid injection. The one excluded patient required an adipo-fascial flap from an inframammary fold incision. For one patient with silicon injection complication and one patient with paraffin injection complication, each required mammary gland resection.

Conclusions:

A zigzag incision in the peri-areolar margin was useful for treating complications of breast augmentation with autologous fat grafting and hyaluronic acid injection. All cases resulted in inconspicuous fine scars, with high patient satisfaction. However, this incision was insufficient to remove injected silicon and paraffin.
Capillary vascular density in the retina of hypertensive patients is associated with a non-dipping pattern independent of mean ambulatory blood pressure
Authors: Nolde Janis M. , Frost Shaun , Kannenkeril Dennis , Lugo-Gavidia Leslie Marisol , Chan Justine , Joyson Anu , Azzam Omar , Carnagarin Revathy , Kiuchi Marcio G. , Vignarajan Janardhan , Schlaich Markus P.
Published: August 2021

Background:

A nocturnal non-dipping pattern has been associated with hypertension-mediated organ damage (HMOD), morbidity and mortality. Retinal imaging through application of modern technologies including optical coherence tomography angiography (OCT-A) can provide detailed insights into early vascular damage. In this observational study, we investigated the relationship of microscopic vascular density in the retina measured with OCT-A and nocturnal blood pressure (BP) dipping.

Methods:

Retinal OCT-A and ambulatory BP monitoring (ABPM) data prospectively obtained from 142 patients referred to a tertiary hypertension clinic were analysed with regression models for associations between BP night-time dipping and retinal capillary vascular density in three different zones around the fovea.

Results:

More pronounced nocturnal SBP and DBP dipping was significantly associated with increased vascular density in the central foveal area of the retina. These associations were robust to adjustment for other available risk factors including mean daytime BP. Parafoveal and whole image vascular density did not show equivalent significant associations with nocturnal BP dipping. The results were reproducible when assessed in a subgroup of patients who had concomitant type 2 diabetes.

Conclusion:

Foveal vascular density was associated with the nocturnal BP dipping pattern in hypertensive patients. These associations were robust to adjustment of relevant factors such as daytime BP. Our findings highlight the importance of nocturnal BP features reflected in ambulatory BP monitoring in the assessment of HMOD. Whether routine assessment of retinal damage markers may improve risk management of hypertensive patients remains to be determined.
Changes in visual outcomes and ocular morphometrics after foldable myopic and toric intraocular lens implantation: 5-year results
Authors: Jonker Soraya M.R. , Berendschot Tos T.J.M. , Ronden Annick E. , Saelens Isabelle E.Y. , Bauer Noël J.C. , Nuijts Rudy M.M.A.
Published: August 2021

Purpose:

To evaluate the refractive, visual, and morphometric changes after implantation with a foldable iris-fixated phakic intraocular lens (pIOL) to correct myopia or astigmatism.

Setting:

University Eye Clinic Maastricht, the Netherlands.

Design:

Prospective case series.

Methods:

We evaluated patients implanted with the Artiflex Myopia Toric (Ophtec B.V.) iris-fixated pIOL as of January 2004. Measurements were performed annually and reported after 1 and 5 years.

Results:

The study included 481 eyes (277 patients; age 39.8 ± 10.9 years [SD]). 5 years postoperatively, 91% of eyes were within ±1.0 diopter (D) of target, and the mean myopization over a 5-year period was 0.22 D (P < .001). The logMAR corrected distance visual acuity (CDVA) increased by a mean 0.015 (P = .015) over 5 years; 88% of eyes had a CDVA of 20/20 or better, and 5.5% lost 2 or more lines of CDVA. Mean uncorrected distance visual acuity (UDVA) increased by 0.045 logMAR over 5 years (P < .001); 96% reached an UDVA of 20/40 or more. Anterior chamber depth (ACD) decreased by 0.04 mm (P < .001), and axial length (AL) increased by 0.23 mm (P < .001) over 5 years. Chronic endothelial cell loss showed a 5-year decline of 320 cells/mm2 in the myopic and 310 cells/mm2 in the toric subgroups (P < .001). Cataract resulted in pIOL explantation in 4.0% of eyes (mean survival 59.0 ± 40.0 months); higher preoperative age (hazard ratio [HR], 1.13; P < .001) and smaller ACD (HR, 6.80; P = .035) were risk factors for shorter survival due to cataract formation.

Conclusions:

Over 5 years, logMAR CDVA and UDVA decreased significantly due to myopization caused by lenticular changes and AL elongation.
Astigmatic change as a predictor of intrastromal corneal ring segment late extrusion
Authors: D'Oria Francesco , Alio Jorge L. , Martinez-Abad Antonio , Izquierdo Luis , Larco Pablo , Abdelghany Ahmed A.
Published: August 2021

Purpose:

To evaluate changes in keratoconic corneas implanted with intrastromal corneal ring segments (ICRSs) that have been explanted because of late extrusion of the segment after >2 years.

Setting:

Vissum Miranza, Alicante, Spain; OftalmoSalud, Lima, Peru; Minya University Hospital, Egypt.

Design:

Retrospective multicenter case series.

Methods:

23 keratoconic corneas that were implanted for ≥2 years and explanted because of natural extrusion of the segment. Clinical measures of visual, refractive, topographic, pachymetric, and aberrometric data were analyzed. To perform exploratory factor analysis, the Kaiser-Meyer-Olkin (KMO) test was used to evaluate sampling adequacy. Factor analysis with VARIMAX rotation was used to determine the main factors of the inventory.

Results:

The mean time interval was 5 years. Topographic findings were reversed nearly to the baseline level after segment explantation (Km: 48.97 ± 3.47 D pre implantation and 47.60 ± 3.67 D after explantation, P =.374). Significant worsened in refractive cylinder was found pre-ICRS extrusion (‒2.54 ± 3.40 D after implantation and ‒3.96 ± 1.72 before extrusion, P < .05). The main factor obtained in the preimplantation moment included keratoconus grade, keratometric readings, and visual acuities. After ICRS implantation, the most strength components were the refractive cylinder, corrected distance visual acuity, and uncorrected distance visual acuity. Corneal aberrations were the main factors in the pre-explantation analysis.

Conclusions:

ICRSs were safely extracted, with a reversal of the corneal topographic data to the preoperative level. A significant astigmatic change was shown in patients implanted with ICRSs before late extrusion of the segment, suggesting the role of this parameter as a prognostic factor of extrusion.
The fertility preservation decision-making and testicular sperm retrieval outcome in older adolescents with nonmosaic Klinefelter syndrome and azoospermia
Authors: Weng Han-Yu , Lin Tsung-Yen , Lin Yung-Ming , Cheng Yu-Sheng
Published: August 2021

Background:

This study aims to analyze the fertility preservation decision-making and the sperm retrieval rate (SRR) in older adolescents (age 15–19 years) with nonmosaic Klinefelter syndrome (KS) and azoospermia in a male reproductive clinic, and to determine the accumulated SRR in older adolescents by literature review.

Methods:

Older adolescents with nonmosaic KS and azoospermia referred for hypogonadism and fertility concerns were enrolled. Reproductive counseling and fertility preservation options were offered to patients/parents. The acceptability and the reasons affecting the reproductive decision-making were analyzed. Patients/parents who agreed on fertility preservation received microdissection testicular sperm extraction (mTESE) and cryopreservation. A comprehensive literature review regarding the SRRs in older adolescents with KS was conducted.

Results:

A total of eight older adolescents were enrolled. After fertility preservation counseling, three patients/parents (37.5%) agreed to receive mTESE, and spermatozoa were successfully retrieved in two. “Lack of interest” and “inconsistent sperm retrieval result” were the main reasons for refusal. A total of 89 older adolescents from nine articles, and ours were collected for SRR analysis. Most of the reports had a limited number of cases, and none of them described the acceptance rate of sperm retrieval in adolescents. Forty-three out of 89 older adolescents (48.3%) had successful sperm retrieval, and there was no significant difference in the SRR between the mTESE and conventional TESE.

Conclusion:

Successful testicular sperm retrieval in older adolescents with KS is not superior to those reported in adults. Adolescents and their parents should undergo a detailed reproductive consultation process and shared decision-making discussion before considering testicular sperm retrieval.