bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of flavonoid compound in coconut waste and its antioxidant activity
Authors: Wahab M , Rushdan Zaim I N , Ismail H F , Othman N , Hara H , Md Akhir F N
Published: February 2023

The coconut tree, Cocos nucifera L., is planted for a variety of purposes. According to the Malaysian Agricultural Research and Development Institute (MARDI), rising coconut production has resulted in an increase in agricultural waste (coconut husk) in Malaysia (536,606 million coconuts in 2018 compared to 22,167 million coconuts in 2016). More than 60% of solid waste degradation in the environment is caused by the manufacture of coconut husks each year. Recycling coconut waste, particularly coconut husk, as a source of natural compounds offers environmental and economic benefits. The objectives of this study are to extract the flavonoid compounds from coconut husk from three different types of coconut fruit (Pandan Coconut, MAWA Coconut and Yellow Coconut) by using ethanolic solvent and compare them. Secondly, the antioxidant activity of coconut husk was determined by using the free radical 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay. Thirdly, the alkaline reagent test was used to determine the presence of flavonoid compounds. The flavonoid compounds are existed in the coconut husk ethanolic extract and it have the antioxidant activity. IC50 of the standard compounds, ascorbic acid was 9.2 μg/ml. The most powerful radical scavenging effect was seen in Yellow Coconut husk extract, which had an IC50 value of 8.4 μg/ml. Flavonoids found in the husk of coconuts are known to have antioxidant properties. This shows that coconut husk extract has enormous potential as a natural preservative and a good bioresource of antioxidants.
Production of polyhydroxyalkanoate from nipa sap using Cupriavidus necator DSM545
Authors: Huzir NM , Aslan AKHN , Rosly MB , Hussin MH , Amin ANR , Tamunaidu P
Published: February 2023

Polyhydroxyalkanoate or PHA is produced through microbial fermentation of sugar and lipid where in nature it is stored as energy and carbon source for microorganisms. Most of the carbon feedstock used for PHA production are derived from biomass as they remain the cheapest carbon source to date. In this study, nipa palm sap was proposed as an alternative carbon feedstock since it is underutilized and widely distributed along river estuaries in Malaysia. This nipa sap contains high sugar content and essential nutrients which are required for PHA production. The aim of this work was to explore potential of nipa sap as a carbon source and to investigate effect of added and non-added nutrient nipa media on PHA production during batch fermentation using Cupriavidus necator DSM545. Extraction of PHA using chloroform showed that 2 g/L of PHA was recovered when nipa added with nutrient was used while nipa only media produced 2.16 g/L of PHA. All the samples showed presence of PHA carbonyl band (C=O) from extracted PHA granules by using FTIR while peak obtained using UV Spectrophotometer confirmed the presence of PHA. These findings proved that nipa palm sap as a novel and alternative carbon source for PHA production.
Empowering women for disaster risk reduction: a case study of geologically based disaster at Yan, Kedah, Malaysia
Authors: Tobi S U M , Razak K A , Siow Y M , Ramlee L H S , Aris N A M
Published: February 2023

The effects of disaster impact all levels of society equally. However, both men and women response to disaster differently. It is critical to acknowledge that both genders have different roles, responsibilities, access, and control over resources as well as how they are affected by crisis and disaster. This paper seeks to build an initial understanding on the importance of gender perspective through review of literature and single case study of Community Based Disaster Risk Management (CBDRM) program conducted at Yan, Kedah. Data was collected through survey questionnaires and focus group discussion with women that had experienced the geological disaster that occurred on the 18th of August 2021. The findings revealed that even though women and girls are more vulnerable to disasters and climate change, they also contribute vital information, skills, resources, and experiences to disaster risk reduction. These abilities are underutilised and are mostly missing from the creation of resilience strategies and decision-making processes for prevention, mitigation, preparedness, and recovery process of the disaster cycle. It is the responsibility of the national governments not only to identify these vulnerabilities but also to build the resilience of women and children to lessen disaster impact in the future.
Analysis on seismic control strategies for structural control device: A comparative study
Authors: Mamat N , Othman M F , Yakub F
Published: February 2023

The paper explores various control strategies proposed by researchers from decades ago in controlling the building structural system. It focuses on hybrid mass dampers used by many researchers in their previous work because the implementation of this device needs an excellent control strategy to provide a better performance in suppressing building vibration. The suitable choice of control strategy in structural control is important in giving the best structure response to withstand an earthquake or strong wind. Based on previous structure and control strategies, a simulation for a two-storey building structure system equipped with a hybrid mass damper at the top building has been conducted. Fuzzy logic controller (FLC), Sliding mode controller (SMC) and fuzzy sliding mode controller (FSMC) are used to suppress the building structure vibration during an earthquake by giving input from seismic excitation taken from El Centro earthquake. The simulation result shows that FSMC technique provides better performance compared to FLC and SMC in suppressing the building vibration based on the displacement response and frequency response. This paper concludes with the problems left and recommendations for structural control improvement.
Tribological properties of hemp fiber reinforced polylactic acid bio-composites: effect of different types of modification methods
Authors: Çevik Elen Nurhan , Yıldırım Musa , Kanbur Yasin
Published: February 2023

In this study, green composites are prepared with 30 wt.% hemp fibers reinforced polylactic acid (PLA) to enhance the impact and tribological properties. Different surface treatments of alkali and silane, compatibilizer of maleic anhydride (MA), and blends of thermoplastic polyurethane (TPU) and poly (butylene succinate) were applied to improve interfacial adhesion between fibers and matrix. Hemp-reinforced PLA bio-composites were fabricated and characterized by hardness, impact strength, wear, and friction properties. The tribological tests of the injection-molded components were performed under two different loads (10 N and 20 N) as dry-sliding linearly reciprocating motion per ASTM G133. Modified composites gave better tribological properties than unmodified composites. While no remarkable improvement was observed in the hardness value of untreated fiber-reinforced composite, alkali-treated composite reached up to 43% improvement in hardness value. In general, as the load increased, weight loss increase was observed in all composites. Unmodified bio-composite exhibited a very low weight loss and specific wear rate (SWR) compared to neat PLA under 10 N load. The SWR of the MA bio-composite had the lowest value for both loads (10 N and 20 N) compared to the other bio-samples. The TPU blended bio-composite exhibited the highest impact strength (22.96 kJ m−2) after pure PLA (26.5 kJ m−2). Therefore, due to surface treatments and blends applied to the fibers, some composites’ hardness and wear resistance were increased while the impact strength and friction coefficient was decreased. Especially silane surface treatment and MA compatibilizer application increased the wear resistance of composites. When the scanning electron microscope images were examined, it was revealed that the fiber and matrix interface bonding was good, and the fibers were firmly embedded in the matrix. Furthermore, forming a protective thin film layer formed by the polymer debris from the surface during dry-sliding increased the wear performance of the bio-composites.
Review of Botulinum Toxin Uptake and Novel Theory Regarding Potential Spread Days After Injection
Authors: Siperstein Robyn
Published: February 2023

Although most clinicians agree that diffusion of botulinum neurotoxin (BoNT) occurs, its extent, timeline, and clinical importance have been debated. A literature search on PubMed (National Institutes of Health, Bethesda, MD) was done up to January 15, 2023, which included the following search terms: botulinum toxin A uptake; botulinum toxin A diffusion; and botulinum spread. A total of 421 publication titles were found and analyzed. Based on titles, the author selected 54 publications as potentially applicable and reviewed each 1 in depth, along with its supporting references. There are several publications that support a novel theory that small amounts of BoNT can remain in the area days after injection and spread to adjacent muscles. Although current thinking is that BoNT is completely taken up within hours, making its spread days after injection of BoNT not a plausible theory, the following literature review and case report support a novel theory.

Level of Evidence: 5
SCMcluster: a high-precision cell clustering algorithm integrating marker gene set with single-cell RNA sequencing data
Authors: Wu Hao , Zhou Haoru , Zhou Bing , Wang Meili
Published: February 2023

Single-cell clustering is the most significant part of single-cell RNA sequencing (scRNA-seq) data analysis. One main issue facing the scRNA-seq data is noise and sparsity, which poses a great challenge for the advance of high-precision clustering algorithms. This study adopts cellular markers to identify differences between cells, which contributes to feature extraction of single cells. In this work, we propose a high-precision single-cell clustering algorithm-SCMcluster (single-cell cluster using marker genes). This algorithm integrates two cell marker databases(CellMarker database and PanglaoDB database) with scRNA-seq data for feature extraction and constructs an ensemble clustering model based on the consensus matrix. We test the efficiency of this algorithm and compare it with other eight popular clustering algorithms on two scRNA-seq datasets derived from human and mouse tissues, respectively. The experimental results show that SCMcluster outperforms the existing methods in both feature extraction and clustering performance. The source code of SCMcluster is available for free at https://github.com/HaoWuLab-Bioinformatics/SCMcluster.
Italian practices in German lute tablature  manuscripts, c.1500: practical script appearance
Authors: Schöning Kateryna
Published: February 2023

This article considers two manuscript lute tablatures—PL-WRk 352 and A-Wn Mus. Hs. 18827, both of which circulated in southern Germany and northern Italy in the 1530s and 40s—from the perspective of their function as performing manuscripts and portable travelling notebooks. The focus is on the transfer of Italian lute practices to the German regions, based on the study of notation. The analysis of prescriptive and descriptive notation, and also of the scribes’ manner of working with tablature prints and other manuscripts as models, demonstrates the coherence of print and manuscript culture at the time, as well as a flexible approach to the interaction of improvised playing and detailed notation. This continuity can be shown for the period from about 1500 to the 1540s. The two German manuscripts were based on northern Italian lute practices: not merely in the repertory itself, but also in its treatment and in the manner of recording it in the form of copies or prescriptively notated music entries. These results significantly expand and enrich our ideas about early lute practice in southern German regions.
Historical perspectives on the 2022 electoral cycle in France
Authors: Chabal Emile , Behrent Michael C , Van Renterghem Marion
Published: February 2023

This series of three essays explores the stakes and outcomes of the 2022 French electoral cycle. Written in real time, they call attention to several emerging trends in French politics, including the collapse of both the traditional political parties and the left–right divide, the dynamics of attraction and repulsion elicited by Macron’s personality, the far right’s ‘arrival’ as a mainstream party, and the cascading fractures that divide and weaken the left.
Breast Imaging Research: Tips for Obtaining Funding and Sustaining a Successful Career
Authors: Lawson Marissa B , Lee Christoph I , Partridge Savannah C , Rahbar Habib
Published: February 2023

Many factors are involved in the successful development of early career breast imaging radiologists into independent investigators conducting impactful research. Key basic prerequisites for success include a motivated and resilient radiologist, institutional and departmental commitment to supporting early career physician-scientists, strong mentorship, and a flexible strategy for extramural funding that accounts for individualized professional goals. In this review, we describe these factors in greater detail, providing a practical overview for residents, fellows, and junior faculty who are interested in an academic career as a breast imaging radiologist engaged in original scientific research. We also describe the essential pieces of grant applications and summarize the professional milestones for early career physician-scientists as they look toward promotion to associate professor and sustained extramural funding.
The mechanism of efferocytosis in the pathogenesis of periodontitis and its possible therapeutic strategies
Authors: Huang Zhanyu , Zhao Qingtong , Jiang Xinrong , Li Zejian
Published: February 2023

Periodontitis is an inflammatory disease characterized by the destruction of periodontal tissues, and its etiology is related to several systemic factors. At present, the destruction of periodontal tissues is considered to be the result of inflammation resolution disorders. Efferocytosis plays an important role in the resolution of inflammation, and defective efferocytosis is an essential factor in the persistence of many chronic inflammatory diseases. Therefore, this review will describe the mechanisms involved in the efferocytosis of macrophages in the pathogenesis of periodontitis and highlight emerging therapeutic strategies to provide new ideas for future periodontal treatment.
Catfish Epidermal Club Cell Morphologic and Immunologic Attributes: Heterogeneous S-100 Immunoreactivity and Possible Neuroendocrine Function
Authors: Awad Mahmoud , Mohamedien Dalia
Published: February 2023

The fish epidermis (EP) contains several cell types, and it has several functional roles, though the secretory role prevails. The alarm or epidermal club cells (ECCs) represent a voluminous immune cell secreting an alarm substance. Our work targeted the histochemical and immunologic attributes of the ECCs in catfish. Matrix metalloproteinase (MMP-9) immunostaining revealed strong immunoreactive signals in the cytoplasm of all ECCs, while S-100 protein immunoreactivity selectively marked the ECCs. Individual ECCs exhibit intense S-100 immunoreactivity compared to neighboring ECCs. The difference in the intensity of the S-100 immunostaining was associated with the difference in the ECC size. This was confirmed by the semithin results where several developmental stages of ECCs could be distinguished. Some eosinophilic granular cells with their characteristic metachromatic granules were recorded juxtaposing the ECCs. Moreover, some free electron-dense granules could be demonstrated in the intercellular spaces surrounding the ECCs. Collectively, these findings suggest several functional profiles for the catfish ECCs depending on their developmental stage. Most importantly, S-100 immunoreactivity in the ECCs suggests its neuroendocrine function. Moreover, the difference in the intensity and polar distribution of S-100 staining is a sign of its role in the differentiation of the ECCs.
Types of Liquid Biopsies: Understanding the Different Lenses Through Which They Can Detect Cancer
Authors: Kasi Pashtoon Murtaza
Published: February 2023

This commentary remarks on the recently published article by Gouda et al on developing mutation-agnostic liquid biopsy, emphasizing the different types of liquid biopsies that are available to detect cancer.
Analysis of Female Participant Representation in Registered Oncology Clinical Trials in the United States from 2008 to 2020
Authors: Perera Nirosha D , Bellomo Tiffany R , Schmidt Walker M , Litt Henry K , Shyu Margaret , Stavins MaKenna A , Wang Max M , Bell Alexander , Saleki Massoud , Wolf Katherine I , Ionescu Ruxandra , Tao Jacqueline J , Ji Sunjong , O’Keefe Ryan M , Pun Matthew , Takasugi Jordan M , Steinberg Jecca R , Go Ronald S , Turner Brandon E , Mahipal Amit
Published: February 2023

Background

Female underrepresentation in oncology clinical trials can result in outcome disparities. We evaluated female participant representation in US oncology trials by intervention type, cancer site, and funding.

Materials and Methods

Data were extracted from the publicly available Aggregate Analysis of ClinicalTrials.gov database. Initially, 270,172 studies were identified. Following the exclusion of trials using Medical Subject Heading terms, manual review, those with incomplete status, non-US location, sex-specific organ cancers, or lacking participant sex data, 1650 trials consisting of 240,776 participants remained. The primary outcome was participation to prevalence ratio (PPR): percent females among trial participants divided by percent females in the disease population per US Surveillance, Epidemiology, and End Results Program data. PPRs of 0.8-1.2 reflect proportional female representation.

Results

Females represented 46.9% of participants (95% CI, 45.4-48.4); mean PPR for all trials was 0.912. Females were underrepresented in surgical (PPR 0.74) and other invasive (PPR 0.69) oncology trials. Among cancer sites, females were underrepresented in bladder (odds ratio [OR] 0.48, 95% CI 0.26-0.91, P = .02), head/neck (OR 0.44, 95% CI 0.29-0.68, P < .01), stomach (OR 0.40, 95% CI 0.23-0.70, P < .01), and esophageal (OR 0.40 95% CI 0.22-0.74, P < .01) trials. Hematologic (OR 1.78, 95% CI 1.09-1.82, P < .01) and pancreatic (OR 2.18, 95% CI 1.46-3.26, P < .01) trials had higher odds of proportional female representation. Industry-funded trials had greater odds of proportional female representation (OR 1.41, 95% CI 1.09-1.82, P = .01) than US government and academic-funded trials.

Conclusions

Stakeholders should look to hematologic, pancreatic, and industry-funded cancer trials as exemplars of female participant representation and consider female representation when interpreting trial results.
Patient Engagement With Early Stage Advance Care Planning at a Comprehensive Cancer Center
Authors: Zhukovsky Donna S , Soliman Pamela , Liu Diane , Meyer Margaret , Haider Ali , Heung Yvonne , Gaeta Susan , Lu Karen , Stepan Karen , Stanton Penny , Rodriguez Alma , Bruera Eduardo
Published: February 2023

Background

Establishing care preferences and selecting a prepared medical decision-maker (MDM) are basic components of advance care planning (ACP) and integral to treatment planning. Systematic ACP in the cancer setting is uncommon. We evaluated a systematic social work (SW)-driven process for patient selection of a prepared MDM.

Methods

We used a pre/post design, centered on SW counseling incorporated into standard-of-care practice. New patients with gynecologic malignancies were eligible if they had an available family caregiver or an established Medical Power of Attorney (MPOA). Questionnaires were completed at baseline and 3 months to ascertain MPOA document (MPOAD) completion status (primary objective) and evaluate factors associated with MPOAD completion (secondary objectives).

Results

Three hundred and sixty patient/caregiver dyads consented to participate. One hundred and sixteen (32%) had MPOADs at baseline. Twenty (8%) of the remaining 244 dyads completed MPOADs by 3 months. Two hundred and thirty-six patients completed the values and goals survey at both baseline and follow-up: at follow-up, care preferences were stable in 127 patients (54%), changed toward more aggressive care in 60 (25%), and toward the focus on the quality of life in 49 (21%). Correlation between the patient’s values and goals and their caregiver’s/MPOA’s perception was very weak at baseline, improving to moderate at follow-up. Patients with MPOADs by study completion had statistically significant higher ACP Engagement scores than those without.

Conclusion

A systematic SW-driven intervention did not engage new patients with gynecologic cancers to select and prepare MDMs. Change in care preferences was common, with caregivers’ knowledge of patients’ treatment preferences moderate at best.
Quantification of the spatial–temporal patterns of great ideas
Authors: Li Xiaokai , Zhang Peng , Zeng An
Published: February 2023

Quantitative understanding of the process of knowledge creation is crucial for accelerating the advance of science. Recent years have witnessed a great effort to address this issue by studying the publication data of scientific journals, leading to a variety of surprising discoveries at both individual level and disciplinary level. However, before scientific journals appeared on a large scale and became the mainstream for publishing research results, there are also intellectual achievements that have changed the world, which have usually become classic and are now referred to as the great ideas of great people. So far, little is known about the general law of their birth. In this paper, we reference Wikipedia and academic history books to collect 2001 magnum opuses as representations of great ideas, covering nine disciplines. Using the year and place of publication of these magnum opuses, we show that the birth of great ideas is very concentrated in geography, and more concentrated than other human activities such as contemporary knowledge production. We construct a spatial–temporal bipartite network to study the similarity of output structures between different historical periods and discover the existence of a Great Transformation around the 1870s, which may be associated with the rise of the US in academia. Finally, we re-rank cities and historical periods by employing an iterative approach to study cities’ leadership and historical periods’ prosperity.
How to Express Implicit Attitudes
Authors: Unnsteinsson Elmar
Published: February 2023

I argue that what speakers mean or express can be determined by their implicit or unconscious states, rather than explicit or conscious states. Further, on this basis, I show that the sincerity conditions for utterances can also be fixed by implicit states. This is a surprising result, which goes against common assumptions about speech acts and sincerity. Roughly, I argue that the result is implied by two plausible and independent theories of the metaphysics of speaker meaning and, further, that this is a robust basis on which to make an inference, with a fair degree of confidence, about the relationship between expression and implicit attitudes.
Unusual clinical presentations in leprosy: a case series and review
Authors: Sawatkar Gitesh Upendra , Sharma Apoorva , Keshavamurthy Vinay , Mehta Hitaishi , Chatterjee Debajyoti , Narang Tarun , Dogra Sunil
Published: February 2023

Conventionally, leprosy has been divided into various spectra of presentation ranging from the tuberculoid to the lepromatous pole, as well as histoid, pure neuritic leprosy and reactional states. This however is an oversimplification as leprosy can present in unusual clinical forms that may obfuscate the diagnosis. Our objective was to highlight unusual clinical presentations of leprosy occurring across all spectra of the disease. Our case series describes eight uncommon presentations of leprosy seen over a period of 10 y from 2011 to 2021, wherein clinical diagnosis followed by a histopathological confirmation of leprosy was performed. These include rare presentations such as psoriasiform plaques, Lazarine leprosy, verrucous plaques and hypertrophic scarring. Many of these rare presentations remain hitherto unreported, such as primary hypogonadism and annular plaques mimicking erythema annulare centrifugum and erythema gyratum repens. Sarcoidosis and syphilis have been labeled as great mimickers in dermatology. The current case series and review is an attempt to highlight a multitude of unusual presentations of leprosy that need a separate mention to make a correct and timely diagnosis and prevent the debilitating sequelae of this otherwise treatable infectious disease.
Getting to the Root of Tree Soil Microbiome Sampling
Authors: Addison Sarah L. , Rúa Megan A. , Smaill Simeon J. , Daley Kaitlyn J. , Singh Brajesh K. , Wakelin Steve A.
Published: February 2023

Microbiomes play critical roles in host functioning and, therefore, there is increasing interest in the microbiome assembly of plants. However, sampling strategies for long-lived perennial trees need to be standardized to produce robust data that accurately represent the microbiome over time. This issue is currently unresolved because there is little evidence indicating which portion of perennial tree species (e.g., root region or surrounding soil) is the best to sample to produce the most accurate measure of microbiome communities. Our aim was to sample different compartments of a plant's belowground microbiome to identify the optimal sampling strategy to account for the microbial community present. We found that the structure of the microbial community depends most strongly on the environment (site) and compartment of sample collected (bulk soil, rhizosphere, or rhizoplane), rather than the depth or cardinal direction of the sample. We also found that the microbial community increased in diversity with increased distance from the tree within the rhizoplane and rhizosphere. The data presented here provide systematic evidence for a pragmatic and robust sampling regime that was tested and validated across different environments and soil types while controlling for host genotype. This sampling regime will enable effective partitioning of root compartments when studying the microbiome associated with perennial tree species, allowing targeted questions about the microbiome to be explored with greater accuracy.
One-Year Functional Outcomes After Invasive Mechanical Ventilation for Older Adults With Preexisting Long-Term Care-Needs*
Authors: Ohbe Hiroyuki , Ouchi Kei , Miyamoto Yuki , Ishigami Yuichiro , Matsui Hiroki , Yasunaga Hideo , Sasabuchi Yusuke
Published: February 2023

OBJECTIVES:

To examine 1-year functional outcomes after invasive mechanical ventilation for adults greater than or equal to 65 years with preexisting long-term care-needs.

DESIGN:

We used medical and long-term care administrative databases. The database included data on functional and cognitive impairments that were assessed with the national standardized care-needs certification system and were categorized into seven care-needs levels based on the total daily estimated care minutes. Primary outcome was mortality and care-needs at 1 year after invasive mechanical ventilation. Outcome was stratified by preexisting care-needs at the time of invasive mechanical ventilation: no care-needs, support level 1–2 and care-needs level 1 (estimated care time 25–49 min), care-needs level 2–3 (50–89 min), and care-needs level 4–5 (≥90 min).

SETTING:

A population-based cohort study in Tochigi Prefecture, one of 47 prefectures in Japan.

PATIENTS:

Among people greater than or equal to 65 years old registered between June 2014 and February 2018, patients who received invasive mechanical ventilation were identified.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Among 593,990 eligible people, 4,198 (0.7%) received invasive mechanical ventilation. The mean age was 81.2 years, and 55.5% were male. The 1-year mortality rates after invasive mechanical ventilation in patients with no care-needs, support level 1–2 and care-needs level 1, care-needs level 2–3, and care-needs level 4–5 at the time of invasive mechanical ventilation were 43.4%, 54.9%, 67.8%, and 74.1%, respectively. Similarly, those with worsened care-needs were 22.8%, 24.2%, 11.4%, and 1.9%, respectively.

CONCLUSIONS:

Among patients in preexisting care-needs levels 2–5 who received invasive mechanical ventilation, 76.0–79.2% died or had worsened care-needs within 1 year. These findings may aid shared decision-making among patients, their families, and heath care professionals on the appropriateness of starting invasive mechanical ventilation for people with poor functional and cognitive status at baseline.
Refractive Error and Anterior Chamber Depth as Risk Factors in Primary Angle Closure Disease: The Chinese American Eye Study
Authors: Zhou Sarah , Pardeshi Anmol A. , Burkemper Bruce , Apolo Galo , Cho Austin , Jiang Xuejuan , Torres Mina , McKean-Cowdin Roberta , Varma Rohit , Xu Benjamin Y.
Published: February 2023

Précis:

The risk of primary angle closure disease (PACD) rises rapidly with greater hyperopia while remaining relatively low for all degrees of myopia. Refractive error (RE) is useful for angle closure risk stratification in the absence of biometric data.

Purpose:

To assess the role of RE and anterior chamber depth (ACD) as risk factors in PACD.

Methods:

Chinese American Eye Study participants received complete eye examinations including refraction, gonioscopy, amplitude-scan biometry, and anterior segment ocular coherence tomography imaging. PACD included primary angle closure suspect (≥3 quadrants of angle closure on gonioscopy) and primary angle closure/primary angle closure glaucoma (peripheral anterior synechiae or intraocular pressure >21 mm Hg). Logistic regression models were developed to assess associations between PACD and RE and/or ACD adjusted for sex and age. Locally weighted scatterplot smoothing curves were plotted to assess continuous relationships between variables.

Results:

Three thousand nine hundred seventy eyes (3403 open angle and 567 PACD) were included. The risk of PACD increased with greater hyperopia [odds ratio (OR) = 1.41 per diopter (D); P < 0.001] and shallower ACD (OR = 1.75 per 0.1 mm; P < 0.001). Hyperopia (≥ + 0.5 D; OR = 5.03) and emmetropia (−0.5 D to +0.5 D; OR = 2.78) conferred a significantly higher risk of PACD compared with myopia (≤0.5 D). ACD (standardized regression coefficient = −0.54) was a 2.5-fold stronger predictor of PACD risk compared with RE (standardized regression coefficient = 0.22) when both variables were included in one multivariable model. The sensitivity and specificity of a 2.6 mm ACD cutoff for PACD were 77.5% and 83.2% and of a +2.0 D RE cutoff were 22.3% and 89.1%.

Conclusion:

The risk of PACD rises rapidly with greater hyperopia while remaining relatively low for all degrees of myopia. Although RE is a weaker predictor of PACD than ACD, it remains a useful metric to identify patients who would benefit from gonioscopy in the absence of biometric data.
Retinal Nerve Fiber Layer Thickness in Patients With Obstructive Sleep Apnea
Authors: Devi Thounaojam S. , Agrawal Ajai , Gupta Neeti , Gupta Ravi , Samanta Ramanuj , Nishant Prateek
Published: February 2023

Précis:

Average and superior quadrant retinal nerve fiber layer thickness (RNFLT) was lower in the more severe obstructive sleep apnea (OSA) group and inversely associated with apnea-hypopnea index (AHI). OSA may have an impact on RNFLT.

Purpose:

The purpose of this study was to study the RNFLT using optical coherence tomography (OCT) in patients with different severities of OSA.

Patients and Methods:

In this hospital-based prospective cross-sectional study, 90 (90 eyes) newly diagnosed OSA patients aged 18 years or above were enrolled. Based on the AHI, there were 38.8%, 30%, and 31.1% cases of mild (AHI≥5 to <15), moderate (AHI≥15 to <30), and severe (AHI≥30) OSA, respectively. All the participants underwent a comprehensive ocular examination. OCT was done using CIRRUS HD-OCT 500 to measure the RNFLT.

Results:

The average RNFLT among the 3 OSA groups was significantly different (P=0.002) and inversely associated with AHI (P=0.02, r
s=−0.16). Severe OSA had thinner average RNFLT than those with mild and moderate OSA (P=0.01 and 0.003, respectively). Among the 4 quadrants observed, only the superior quadrant RNFLT among the 3 OSA groups was significantly different (P<0.00001) and inversely associated with AHI (P=0.01, r
s=−0.17). Severe OSA had thinner superior quadrant RNFLT than those with moderate OSA (P<0.01). The differences in the intraocular pressure among the 3 OSA groups were statistically significant (P<0.0008). Patients with moderate and severe OSA had higher intraocular pressure than patients with mild OSA (P=0.002 and 0.001, respectively).

Conclusions:

Attention should be paid to the patients with OSA as it may have an impact on RNFLT. OSA patients should be screened for glaucoma as early detection of glaucoma can reduce vision loss in these patients.
Saroglitazar improves nonalcoholic fatty liver disease and metabolic health in liver transplant recipients
Authors: Siddiqui Mohammad Shadab , Parmar Deven , Shaikh Farheen , Forsgren Mikael , Patel Samarth , Bui Anh Tuan , Boyett Sherry , Patel Vaishali , Sanyal Arun J.
Published: February 2023

NAFLD is common after liver transplantation (LT) and is associated with an increased metabolic burden. Currently, there is a paucity of investigations into the treatment of post-LT NAFLD. In the present study, we evaluated the safety and efficacy of saroglitazar, a novel dual peroxisome proliferator–associated receptor α/γ agonist, on the treatment of post-LT NAFLD and metabolic burden. This is a phase 2A, single-center, open-label, single-arm study in which patients with post-LT NAFLD received saroglitazar magnesium 4 mg daily for 24 weeks. NAFLD was defined by a controlled attenuation parameter ≥264 dB/m. The primary endpoint was the reduction in liver fat as measured by MRI proton density fat fraction (MRI-PDFF). Secondary MRI-based metabolic endpoints included visceral adipose tissue, abdominal subcutaneous adipose tissue volumes, muscle fat infiltration, and fat-free muscle volume. Saroglitazar treatment led to a reduction in MRI-PDFF from 10.3±10.5% at baseline to 8.1±7.6%. A relative 30% reduction from baseline MRI-PDFF value was noted in 47% of all patients and 63% of patients with baseline MRI-PDFF >5%. Reduction in serum alkaline phosphatase was an independent predictor of MRI-PDFF response. Saroglitazar did not decrease fat-free muscle volume nor increase muscle fat infiltration, but did lead to a mild increase in visceral adipose tissue and abdominal subcutaneous adipose tissue. The study drug was well tolerated and a mild nonsignificant increase in serum creatinine was noted. Saroglitazar did not affect the weight. The study provides preliminary data demonstrating the safety and metabolic benefits of saroglitazar in LT recipients and underscores the importance of future studies to establish its efficacy after LT.
Effects of the 2020 COVID-19 pandemic on outcomes of out-of-hospital cardiac arrest and bystander resuscitation efforts: a nationwide cohort study in Japan
Authors: Kurosaki Hisanori , Okumura Kazuki , Nunokawa Chika , Yao Shintaro , Murasaka Kenshi , Inaba Hideo
Published: February 2023

Background and importance There is limited knowledge about the nationwide impact of the 2020 COVID-19 pandemic in Japan on out-of -hospital cardiac arrest (OHCA) outcomes.Objectives The aim of this study was to investigate the impact of the 2020 COVID-19 pandemic on OHCA outcomes and bystander resuscitation efforts in Japan. Design Retrospective analysis of a nationwide population-based registry of OHCA cases. Settings and participants To conduct this study, we created a comprehensive database comprising 821 665 OHCA cases by combining and reconciling the OHCA database for 835 197 OHCA cases between 2017 and 2020 with another database, including location and time records. After applying exclusion and inclusion criteria, we analysed 751 617 cases.Outcome measures and analysis The primary outcome measure for this study was survival with neurologically favourable outcome (cerebral performance category 1 or 2). We compare OHCA characteristics and outcomes between prepandemic and pandemic years, and also investigated differences in factors associated with outcomes. Results We found that survival with neurologically favourable outcome and the rates of bystander cardiopulmonary resuscitation (CPR) slightly increased in the pandemic year [2.8% vs. 2.9%; crude odds ratio (OR), 1.07; 95% confidence interval (CI), 1.03–1.10; 54.1% vs. 55.3%, 1.05 (1.04–1.06), respectively], although the incidence of public access defibrillation (PAD) slightly decreased [1.8% vs. 1.6%, 0.89 (0.86–0.93)]. Calls for hospital selection by emergency medical service (EMS) increased during the pandemic. Subgroup analysis showed that the incidence of neurologically favourable outcome increased in 2020 for OHCA cases that occurred on nonstate of emergency days, in unaffected prefectures, with noncardiac cause, nonshockable initial rhythm, and during daytime hours. Conclusions During the 2020 COVID-19 pandemic in Japan, survival with neurologically favourable outcome of OHCA patients and bystander CPR rate did not negatively change, despite the decrement in PAD incidence. However, these effects varied with the state of emergency, region, and characteristics of OHCA, suggesting an imbalance between medical demand and supply, and raising concerns about the pandemic.
Objective Comparison of Eyebrow Position after Internal and External Browpexy
Authors: Huang Po-Jen , Mao Shih-Hsuan , Yen Cheng-I , Yang Shih-Yi , Hsiao Yen-Chang , Yang Jui-Yung , Chang Shu-Yin , Chuang Shiow-Shuh , Chen Hung-Chang
Published: February 2023

Background:

Several brow lift techniques have been used to prevent brow ptosis after blepharoplasty. For example, both internal and external browpexies have been adopted worldwide. However, few studies have compared these two methods. We compared postoperative eyebrow position changes between upper eyelid skin excision, internal, and external browpexy.

Methods:

We retrospectively reviewed the cases of 87 patients who underwent upper blepharoplasty performed by a single clinician at our institute between April 2018 and June 2020. Patients with routine outpatient photographs taken before and after surgery were enrolled in the study. Image J was used to measure brow height at eight points in each eye. Brow height changes were compared among the three groups.

Results:

Routine photographs were available for 68 patients (133 eyes). Thirty-nine patients underwent internal browpexy (78 eyes), nine external browpexy (17 eyes), and 20 upper eyelid skin excisions (38 eyes). Three months after surgery, significant elevation was noted on the lateral side of the brow in the internal browpexy group and across the whole brow in the external browpexy group. In the upper eyelid skin excision group, whole brow ptosis was observed. Brow lift outcomes were better in the external than in the internal browpexy group, while both browpexy groups showed better outcomes than the upper eyelid skin excision group.

Conclusions:

Within 3 months of surgery, both internal and external browpexy provided significant brow lift effects, preventing brow ptosis due to blepharoplasty with skin excision. External browpexy had better brow-lift outcomes than did internal browpexy.
Heating pretreatment of the recipient site enhances survival of transplanted fat in a mouse model
Authors: Kim Sun Eung , Kim Yu Jin , Kim Yang Woo , Cheon Young Woo
Published: February 2023

Background:

Despite several studies about the preparation of the recipient site in fat grafting, optimizing techniques with clinical usefulness is still necessary. Through previous animal studies reporting that heat can increase tissue VEGF and vascular permeability, we hypothesize that heating pretreatment of the recipient site will increase retention of grafted fat.

Methods:

Twenty 6-week-old female BALB/c mice had two pretreatment sites on their back, one for the experimental temperature (44℃ and 48℃) and the other for the control. A digitally controlled aluminum block was used to apply the contact thermal damage. Human fat (0.5ml) was grafted on each site and harvested on day 7, 14, and 49. The percentage volume and weight, histological changes, and peroxisome proliferator-activated receptor gamma expression, a key regulator of adipogenesis, were measured by water displacement method, light microscopy, and qRT-PCR, respectively.

Results:

The harvested percentage volumes were 74.0 ± 3.4%, 82.5 ± 5.0%, and 67.5 ± 9.6% for the control, 44℃-pretreatment, and 48℃-pretreatment groups, respectively. The percentage volume and weight of 44℃-pretreatment group was higher than the other groups (p < 0.05). The 44℃-pretreatment group exhibited significantly higher integrity with fewer cysts and vacuoles than the other groups. Both heating pretreatment groups showed markedly higher rates of vascularity than the control group (p < 0.017), and also increased the expression of PPARγ over 2-fold.

Conclusions:

Heating preconditioning of the recipient site during fat grafting can increase the retention volume and improve the integrity, which is partly explained by increased adipogenesis in a short-term mouse model.
“Neurocognitive Outcomes in Deformational Plagiocephaly: Is There an Association between Morphologic Severity and Results? “
Authors: Park Kitae E. , Chandler Ludmila , Ahmad Maham , Singh Anusha , Allam Omar , Mets Elbert , Bridgett David J. , Persing John A. , Alperovich Michael
Published: February 2023

Background:

The neurodevelopmental impact of skull asymmetry and orthotic helmet therapy for deformational plagiocephaly (DP) have had limited investigation. This study assessed the long-term neurocognitive outcomes in DP patients and their association with orthotic helmet therapy and head shape abnormality.

Methods:

138 School-age children with a history of DP of whom 108 received helmet therapy were tested with a neurocognitive battery assessing academic achievement, intelligence quotient, and visual-motor function. Severity of presenting plagiocephaly was calculated using anthropometric and photometric measurements. Analysis of covariance was used to compare outcomes between helmeted and non-helmeted cohorts, unilateral plagiocephaly and concomitant brachycephaly, and left and right-sided plagiocephaly. The association between severity of plagiocephaly and neurocognitive outcome was assessed through a residualized change approach.

Results:

There were no significant differences in neurocognitive outcomes between the helmeted and non-helmeted DP cohorts or the unilateral plagiocephaly and brachycephaly cohorts. Left-sided DP patients performed significantly worse in motor coordination than right-sided patients (84.8 vs 92.7, ES=-0.50, p=0.03). There was a significant laterality by cephalic index (CI) interaction, with a negative association between CI and reading comprehension and spelling for left-sided patients. No significant associations were found between severity of presenting or post-treatment deformity and neurocognitive outcome.

Conclusion:

Pre- and post-treatment severity of plagiocephaly were not correlated with neurocognitive function at school age. Helmet therapy was not associated with better or worse long-term neurocognitive function. However, patients with left-sided DP demonstrated worse neurocognitive outcomes than right-sided patients in the domains of motor coordination and some types of academic achievement.
A Cautionary Tale: The Use of Propensity Matching to Evaluate Hemorrhage-Related Trauma Mortality in the American College of Surgeons TQIP Database
Authors: Harfouche Melike N , Feliciano David V , Kozar Rosemary A , DuBose Joseph J , Scalea Thomas M
Published: February 2023

BACKGROUND:

Propensity-matched methods are increasingly being applied to the American College of Surgeons TQIP database to evaluate hemorrhage control interventions. We used variation in systolic blood pressure (SBP) to demonstrate flaws in this approach.

STUDY DESIGN:

Patients were divided into groups based on initial SBP (iSBP) and SBP at 1 hour (2017 to 2019). Groups were defined as follows: iSBP 90 mmHg or less who decompensated to 60 mmHg or less (immediate decompensation [ID]), iSBP 90 mmHg or less who remained greater than 60 mmHg (stable hypotension [SH]), and iSBP greater than 90 mmHg who decompensated to 60 mmHg or less (delayed decompensation [DD]). Individuals with Head or Spine Abbreviated Injury Scale score 3 or greater were excluded. Propensity score was assigned using demographic and clinical variables. Outcomes of interest were in-hospital mortality, emergency department death, and overall length of stay.

RESULTS:

Propensity matching yielded 4,640 patients per group in analysis #1 (SH vs DD) and 5,250 patients per group in analysis #2 (SH vs ID). The DD and ID groups had 2-fold higher in-hospital mortality than the SH group (DD 30% vs 15%, p < 0.001; ID 41% vs 18%, p < 0.001). Emergency department death rate was 3 times higher in the DD group and 5 times higher in the ID group (p < 0.001), and length of stay was 4 days shorter in the DD group and 1 day shorter in the ID group (p < 0.001). Odds of death were 2.6 times higher for the DD vs SH group and 3.2 times higher for the ID vs SH group (p < 0.001).

CONCLUSIONS:

Differences in mortality rate by SBP variation underscore the difficulty of identifying individuals with a similar degree of hemorrhagic shock using the American College of Surgeons TQIP database despite propensity matching. Large databases lack the detailed data needed to rigorously evaluate hemorrhage control interventions.
Separable solutions to nonlinear anisotropic diffusion equation in elliptic coordinates
Authors: Tretiakova K. , Nec Y.
Published: February 2023

Two- and three-dimensional exact solutions of the nonlinear diffusion equation are proved to exist in elliptic coordinates subject to an arbitrary piecewise constant azimuthal anisotropy. Degrees of freedom traditionally used to satisfy boundary conditions are instead employed to ensure continuity and conservation of mass across contiguity surfaces between subdomains of distinct diffusivities. Not all degrees of freedom are exhausted thereby, and conditions are given for the inclusion of higher harmonics. Degrees of freedom associated with one isotropic subdomain are always available to satisfy boundary conditions. The second harmonic is pivotal in the solution construction as well as the identification of partial symmetries in the domain partition. The anisotropy gives rise to an unconventional mixed type critical point that combines saddle and node-like characteristics.

This article is part of the theme issue ‘New trends in pattern formation and nonlinear dynamics of extended systems’.