bluuebunny/crossref_metadata_2025 huggingface dataset:
Insufficient Closing Forces of Yasargil Titanium Clips in Two Small Aneurysms Detected with Intraoperative Indocyanine Green Videoangiography
Authors: Scheller Christian , Prell Julian , Simmermacher Sebastian , Strauss Christian , Doenitz Christian , Schmidt Nils Ole , Schebesch Karl-Michael
Published: June 2022

Background and Study Aims Aneurysm clips must have adequate closing forces because residual blood flow in clipped aneurysms may result in aneurysm recurrence. Such flow can be intraoperatively detected by visual inspection, microvascular Doppler sonography, indocyanine green videoangiography (ICG-V), angiography, and puncture.

Patients We present two patients with ruptured very small middle cerebral artery aneurysms (3 and 2.9 mm). The necks of both aneurysms were microsurgically clipped with Yasargil aneurysm clips without any complications.

Results In both aneurysms, visual inspection suggested complete occlusion, but ICG-V showed persistent residual blood flow between the middle parts of the clip blades.

The first patient was treated with a 5.4-mm FT744T clip (closing force of 1.47 N). After the ICG-V finding, a second 3.9-mm FT714T clip (closing force of 1.08 N) was placed on the tips of the already implanted clip to increase the closing forces. Subsequent ICG-V did not show any further residual blood flow. In the second patient, the aneurysm was clipped with an 8.0-mm FE764K clip (closing force of 1.77 N). Intraoperative ICG-V showed persistent residual blood flow within the aneurysmal dome despite complete closure of the clip. The clip was repositioned closer to the parent vessel. Consecutive ICG-V did not show any residual blood flow.

Conclusion Visually undetected incomplete aneurysm occlusion can be revealed with ICG-V. In very small aneurysms, standard closing forces of clips may not be sufficient and complete closure of the clip branches should be intraoperatively validated with ICG-V.
Implementing a Neurotrauma Registry in Latin America and the Caribbean
Authors: Rolle Myron L. , Garba Deen L. , Griswold Dylan P. , Fernández Laura L. , Sánchez Diana M. , Clavijo Angelica , Rubiano Andrés M.
Published: June 2022

Background Traumatic brain injury (TBI) has a disproportionately greater impact in low- and middle-income countries (LMICs). One strategy to reduce the burden of disease in LMICs is through the implementation of a trauma registry that standardizes the assessment of each patient's management of care.

Objective This study aims to ascertain the interest of Latin America and the Caribbean (LAC) nations in establishing a shared neurotrauma registry in the regional block, based on an existing framework for collaboration.

Methods A descriptive review was performed regarding the interests of LAC nations in implementing a shared neurotrauma registry in their region. We convened a meeting with seven Caribbean and five Latin American nations.

Results One hundred percent (n = 12) of the LAC representatives including neurosurgeons, neurointensivists, ministers of health, and chief medical officers/emergency medical technicians (EMTs) agreed to adopt the registry for tracking the burden of TBI and associated pathologies within the region.

Conclusion The implementation of a neurotrauma registry can benefit the region through a shared database to track disease, improve outcomes, build research, and ultimately influence policy.
Analog of electromagnetically induced transparency from electric dipole and quadrupole excitation with a Reuleaux triangle split-ring resonator
Authors: Shen Zhaoyang , Wu Jiong
Published: June 2022

We simulate, measure, and analyze an electromagnetically induced transparency-like (EIT-like) metamaterial with a unit cell composed of a Reuleaux triangle split-ring resonator (RT-SRR) and a Y-type strip (YS). The transparency peak of the EIT-like metamaterial is located at 12.54 GHz, and the transmission coefficient is 91%. The electric field distributions indicate that the RT-SRR plays the role of the bright mode, and the YS plays the role of the dark mode. The coupling between the bright and dark modes leads to the EIT-like phenomenon. The surface current distributions and the calculated results for the radiated power of the electric multipoles are used to analyze the physical mechanism behind the transparency peak, which can be understood in terms of the electric dipole interacting with the electric quadrupole. As the polarization angle increases, the transmission coefficient of the transparency peak decreases, indicating polarization sensitivity. When the YS is rotated around the center and the RT-SRR is kept fixed, the EIT-like phenomenon appears and disappears. Therefore, the proposed metamaterial has potential applications in detectors and switches. The experimental results are well-matched with the simulation results.
A compact gas chromatography platform for detection of multicomponent volatile organic compounds biomarkers
Authors: Wu Xinyu , Wang Dazuo , Shi Lujia , Wang Hairong , Wang Jiuhong , Sun Jianhai , Li Changqing , Tian Xin
Published: June 2022

Some human exhaled volatile organic compounds (VOCs) can be employed to diagnose related human endogenous diseases as characteristic biomarkers, which is expected to be applied to rapid screening and grading because of their non-invasive and cost-effective advantages. In this study, we developed a compact gas chromatography (GC) platform mainly composed of an integrated silicon-based micro-column chip using micro-electromechanical system techniques and a miniaturized metal oxide semiconductor gas detector. In addition, the sampling/switching valve with related components and embedded microcontrollers was used for airflow control. The fabricated system selectively detected the five VOCs (pentane, acetone, toluene, octane, and decane) considered the typical endogenous disease biomarkers. In the experiments, the functional parameters of the system were investigated, and the optimum temperature conditions of the system for separation were determined. The results show that the system can successfully test the studied five VOCs as low as 1 ppm. In addition, the influence of interfering gas (carbon dioxide and ammonia) on the system for the VOC mixture is also investigated. Moreover, to prove the possibility of breath analysis of the fabricated system, the detection performance of isoprene and acetone at the ppb level is studied. Then, the concentration changes of the isoprene at the ppb concentration for human breath are successfully detected in the system. Therefore, we believe that the prepared compact GC system has potential applications in the human endogenous disease diagnosis for the VOC biomarkers.
Oxidation kinetics of SPS-densified U3Si2 fuels—Microstructure impact
Authors: Gong Bowen , Yang Kun , Zhao Dong , Nelson Andrew T. , Lian Jie
Published: June 2022

U3Si2 is a potential candidate for accident tolerant fuels because of its high uranium density and excellent thermal conductivity in comparison to UO2. However, U3Si2 suffers from oxidation, steam corrosion, and subsequent disintegration/pulverization. The detailed investigation of kinetics that incorporates fundamental treatment of oxidation of U3Si2 is scarcely reported, and the oxidation mechanisms have not been fully elucidated. In this paper, the oxidation behavior of microcrystalline (mc-) and nanocrystalline (nc-) U3Si2 have been systematically investigated using a thermogravimetric analysis (TGA) apparatus through a series of isothermal and non-isothermal kinetic studies. The isothermal kinetic study with a model-fitting approach indicates oxidation activation energy of 85 kJ/mol for dense mc-U3Si2 and 96.4 kJ/mol for nc-U3Si2 pellets, while the isoconversional approach leads to an activation energy in the range of 70–85 kJ/mol for mc-U3Si2 and 75–86 kJ/mol for nc-U3Si2 with three most common model-free methods, including Kissinger–Akahira–Sunose, Flynn–Wall–Ozawa, and Friedman methods. The derivation of oxidation activation energies using both isothermal and isoconversional methods highlights the approach to evaluate the oxidation resistance of nuclear materials using TGA quantitatively and makes it possible to compare among various nuclear fuels.
The curious temperature dependence of fluoride molten salt thermal conductivity
Authors: Robertson Sean G. , Wiser Ralph , Yang Wonseok , Kang Dokyu , Choi Sungyeol , Baglietto Emilio , Short Michael P.
Published: June 2022

To optimize the efficiency and safety of molten salt-based energy applications, accurate molten salt thermophysical property data are required. For molten fluorides, existing thermal conductivity results have large uncertainties and contradict the current theory by eliciting a positive temperature coefficient. Transient grating spectroscopy (TGS), a technique previously deemed reliable by the theoretical community, has been used to measure the thermal conductivity of fluorides (FLiNaK) for the first time. Results show a fairly flat but slightly increasing thermal conductivity as a function of temperature. The technique has been shown to not suffer from contributions from convection and radiation, an explanation used to discount the results of alternative experimental techniques. In addition to thermal conductivity, sound speed data as a function of temperature have also been obtained for the first time in FLiNaK. The use of accurate sound speed data in theoretical models of thermal conductivity provides better but not complete agreement with the results from TGS. The continued existence of a positive temperature coefficient highlights the need for new mechanistic proposals for why TGS, or current theoretical models, are unable to capture the correct temperature dependence for fluoride molten salt thermal conductivity.
Magnetospectroscopy of terahertz surface plasmons in subwavelength perforated superlattice thin-films
Authors: Karmakar Subhajit , Kumar Deepak , Varshney Ravendra Kumar , Roy Chowdhury Dibakar
Published: June 2022

Surface plasmons, the resonant oscillations of conducting electrons at the interface of negative and positive permittivity materials, pave the way for enhanced electromagnetic wave–matter interactions at a subwavelength scale. On the other hand, spin-dependent magnetotransport ushers an ingenious technology by inculcating electron spin to realize miniaturized, energy-efficient electromagnetic devices. Generally, magneto-resistive devices (viz., multilayer un-patterned magnetic–non-magnetic thin films) relying on magnetotransport mechanisms are not recognized for supporting surface plasmons toward enhanced electromagnetic interactions. However, an amalgamation of surface plasmons with spin-dependent magnetotransport can exploit magnetic (spintronic) degree of freedom in plasmonic devices. In this work, we propose a patterned superlattice (non-magnetic/ferromagnetic thin films) terahertz (THz) magneto-resistive device for supporting surface plasmons toward enhanced electromagnetic interactions. Magnetotransport dependent enhancement and dynamic magnetic modulation of resonant THz transmissions are experimentally demonstrated in subwavelength superlattice (Al/Ni) hole arrays for varying lattice parameters. Our experiments reveal that typical non-magnetic electromagnetic phenomena like surface plasmon resonances can be tweaked by externally applied low intensity magnetic fields [∼few tens of milli-tesla (0–30 mT)]. Experimental outcomes are explicated by spin-dependent terahertz magnetotransport theory in perforated superlattice metal sheets and, therefore, can stimulate a paragon for spin-based integrated photonic technology.
Identifying the octupole antiferromagnetic domain orientation in Mn3NiN by scanning anomalous Nernst effect microscopy
Authors: Johnson F. , Kimák J. , Zemen J. , Šobáň Z. , Schmoranzerová E. , Godinho J. , Němec P. , Beckert S. , Reichlová H. , Boldrin D. , Wunderlich J. , Cohen L. F.
Published: June 2022

The intrinsic anomalous Nernst effect in a magnetic material is governed by the Berry curvature at the Fermi energy and can be realized in non-collinear antiferromagnets with vanishing magnetization. Thin films of (001)-oriented Mn3NiN have their chiral antiferromagnetic structure located in the (111) plane facilitating the anomalous Nernst effect unusually in two orthogonal in-plane directions. The sign of each component of the anomalous Nernst effect is determined by the local antiferromagnetic domain state. In this work, a temperature gradient is induced in a 50 nm thick Mn3NiN two micrometer-size Hall cross by a focused scanning laser beam, and the spatial distribution of the anomalous Nernst voltage is used to image and identify the octupole macrodomain arrangement. Although the focused laser beam width may span many individual domains, cooling from room temperature to the antiferromagnetic transition temperature in an in-plane magnetic field prepares the domain state, producing a checkerboard pattern resulting from the convolution of contributions from each domain. These images together with atomistic and micromagnetic simulations suggest an average macrodomain of the order of 1 μm2.
A KNN composite-based piezoelectric helix for ultrasonic transcutaneous energy harvesting
Authors: Jiang Laiming , Xue Haoyue , Li Ruichen , Wu Jiagang
Published: June 2022

Ultrasonic energy harvesting has been developed as a promising power solution for implantable medical devices (IMDs) to perform tasks such as diagnosis, therapy, and monitoring. However, most current ultrasonic electronics use toxic lead-based piezoelectric materials (e.g., lead zirconate titanate) as core components and feature bulk or flat structures, representing common barriers to the development of future IMDs that should be eco-friendly and long-term fixation in the implanted position. Here, we present a KNN composite-based lead-free piezoelectric helix for ultrasonic transcutaneous energy harvesting. The device contains multilayer components (a matching layer, lead-free composites, a copper foil, and a Parylene-C film) to form a final self-supporting helix harvester, which can adapt to cylindrical objects (e.g., blood vessels) to maintain fixation. Nanodomain-induced high-performance (d33 ∼ 465 pC N−1) KNN ceramic was fabricated and further processed into 1–3 composites to enhance electromechanical coupling properties and mechanical flexibility. The developed prototype can be excited ultrasonically to generate adjustable power output up to ∼22.97 mW cm−2. The generated electricity was stored in capacitors and used to operate light-emitting diodes. Further ex vivo tests showed that the device is still sufficient to support wireless energy transfer through porcine tissues, demonstrating the great potential of the lead-free piezoelectric helix for IMDs.
Severe distortion in the representation of foveal visual image locations in short-term memory
Authors: Willeke Konstantin F. , Cardenas Araceli R. , Bellet Joachim , Hafed Ziad M.
Published: June 2022

The foveal visual image region provides the human visual system with the highest acuity. However, it is unclear whether such a high fidelity representational advantage is maintained when foveal image locations are committed to short-term memory. Here, we describe a paradoxically large distortion in foveal target location recall by humans. We briefly presented small, but high contrast, points of light at eccentricities ranging from 0.1 to 12°, while subjects maintained their line of sight on a stable target. After a brief memory period, the subjects indicated the remembered target locations via computer controlled cursors. The biggest localization errors, in terms of both directional deviations and amplitude percentage overshoots or undershoots, occurred for the most foveal targets, and such distortions were still present, albeit with qualitatively different patterns, when subjects shifted their gaze to indicate the remembered target locations. Foveal visual images are severely distorted in short-term memory.
Intraductal administration of transferrin receptor-targeted immunotoxin clears ductal carcinoma in situ in mouse models of breast cancer—a preclinical study
Authors: Wang Guannan , Kumar Alok , Ding Wanjun , Korangath Preethi , Bera Tapan , Wei Junxia , Pai Priya , Gabrielson Kathleen , Pastan Ira , Sukumar Saraswati
Published: June 2022

The human transferrin receptor (TFR) is overexpressed in most breast cancers, including preneoplastic ductal carcinoma in situ (DCIS). HB21(Fv)-PE40 is a single-chain immunotoxin (IT) engineered by fusing the variable region of a monoclonal antibody (HB21) against a TFR with a 40 kDa fragment of
Pseudomonas
exotoxin (PE). In humans, the administration of other TFR-targeted immunotoxins intrathecally led to inflammation and vascular leakage. We proposed that for treatment of DCIS, intraductal (i.duc) injection of HB21(Fv)-PE40 could avoid systemic toxicity while retaining its potent antitumor effects on visible and occult tumors in the entire ductal tree. Pharmacokinetic studies in mice showed that, in contrast to intravenous injection, IT was undetectable by enzyme-linked immunosorbent assay in blood following i.duc injection of up to 3.0 μg HB21(Fv)-PE40. We demonstrated the antitumor efficacy of HB21(Fv)-PE40 in two mammary-in-duct (MIND) models, MCF7 and SUM225, grown in NOD/SCID/gamma mice. Tumors were undetectable by In Vivo Imaging System (IVIS) imaging in intraductally treated mice within 1 wk of initiation of the regimen (IT once weekly/3 wk, 1.5 μg/teat). MCF7 tumor–bearing mice remained tumor free for up to 60 d of observation with i.duc IT, whereas the HB21 antibody alone or intraperitoneal IT treatment had minimal/no antitumor effects. These and similar findings in the SUM225 MIND model were substantiated by analysis of mammary gland whole mounts, histology, and immunohistochemistry for the proteins Ki67, CD31, CD71 (TFR), and Ku80. This study provides a strong preclinical foundation for conducting feasibility and safety trials in patients with stage 0 breast cancer.
Dynamic guidance performance of GdBaCuO and YBaCuO bulk single grain superconductors under a varying external magnetic field
Authors: Huang Zhichuan , Hong Ye , Lei Wuyang , Liu Jianxin , Deng Zigang , Shi Yunhua , Cardwell David A
Published: June 2022

High temperature superconducting (HTS) maglev technology has attracted considerable attention from researchers around the world. It provides a new direction of development for urban rail and high-speed rail transit due to its considerable advantages of frictionless transportation, low noise, and environmental protection. HTS bulk materials are able to provide a significant performance advantage to maglev technology and are a key component to achieving both levitation and vehicle guidance. HTS bulk samples with enhanced flux pinning characteristics can enable improved curve negotiating ability and lateral stability for the maglev vehicle. This paper reports the results of experiments on the dynamic guidance force of single grain Y–Ba–Cu–O (YBCO) and Gd–Ba–Cu–O (GdBCO) bulk HTS single grains in order to explore their potential for enhanced maglev guidance performance. A customized HTS maglev dynamic measurement system (SCML-03) with a rotating, circular permanent magnet guideway (PMG) was employed to simulate the dynamic operation of the HTS vehicle above the PMG at different translational speeds. It was observed from the experimental results that the GdBCO bulk superconductor is more able to resist the attenuation of the dynamic guidance force compared to YBCO under the same operational conditions. In addition, the GdBCO bulk single grain is more able to return to the original equilibrium position following exposure to an external displacement. It is concluded that the GdBCO bulk single grain offers greater potential than YBCO for practical application in HTS maglev given its enhanced guidance performance. The results of these tests provide an important benchmark for the future design of HTS maglev transportation systems.
Ultra-wideband efficient polarization conversion of terahertz wave in a planar metamaterial
Authors: Sarkar Rakesh , Punjal Ajinkya , Prabhu S S , Kumar Gagan
Published: June 2022

We have investigated numerically and experimentally an ultra-wideband efficient polarization conversion of a linearly polarized terahertz wave in a planar metamaterial (MM) geometry comprising an array of C-shaped resonators. Both the co- and cross-polarization transmission spectra of the proposed MM configuration have been studied for numerous polarizations of incident terahertz starting from 0∘ to 90∘ in steps of 15∘. Our design promises a cross-polarization conversion of 40% from 1.22 to 2.75 THz with a maximum of 45% when the MM design is rotated by 45∘ with respect to the incident light. The change in rotation angle excites an electric dipole in the C resonator, which radiates an electric field in the co-and cross-polarization. The polarization conversion has been explained with induced electric field profiles as well as surface current profiles. It is shown that the change in dimension of the C-shaped resonator causes a shift in the transmission spectrum. Numerically simulated results are in good agreement with the experimental results. Our design eliminates the complexity of the fabrication of multilayer structures and opens avenues to design ultra-wideband and efficient polarization rotation devices in the terahertz frequency regime.
Chronoamperometric deposition of transparent WO3 film for application as power efficient electrochromic auxiliary electrode
Authors: Ghosh Tanushree , Rani Chanchal , Kandpal Suchita , Tanwar Manushree , Bansal Love , Kumar Rajesh
Published: June 2022

Inorganic oxide electrochromic electrodes can be made more robust by adopting suitable deposition techniques. Electrochemically deposited tungsten oxide (WO3) film through chronoamperometry has been studied here for application as electrochromic auxiliary electrode. Thoroughly characterized film using electron microscopy, x-ray diffraction and Raman spectroscopy has been used for electrochromic measurements. The electrode shows reversible transparent to blue color switching when biased with a very small bias of 1 V. Bias dependent in-situ spectroelectrochemistry measurements have been performed which shows excellent results in terms of reversibility, cyclability, color contrast, appreciable switching time and good current stability at low working potential. The results thus pave the way to an excellent deposition technique designed particularly for electrochromic applications.
Ultimate low leakage and EOT of high-κ dielectric using transferred metal electrode
Authors: Dang Weiqi , Lu Zheyi , Zhao Bei , Li Bo , Li Jia , Zhang Hongmei , Song Rong , Hossain Mongur , Le Zhikai , Liu Yuan , Duan Xidong
Published: June 2022

The increase of gate leakage current when the gate dielectric layer is thinned is a key issue for device scalability. For scaling down the integrated circuits, a thin gate dielectric layer with a low leakage current is essential. Currently, changing the dielectric layer material or enhancing the surface contact between the gate dielectric and the channel material is the most common way to reduce gate leakage current in devices. Herein, we report a technique of enhancing the surface contact between the gate dielectric and the metal electrode, that is constructing an Au/Al2O3/Si metal–oxide–semiconductor device by replacing the typical evaporated electrode/dielectric layer contact with a transferred electrode/high-κ dielectric layer contact. The contact with a mild, non-invasive interface can ensure the intrinsic insulation of the dielectric layer. By applying 2–40 nm Al2O3 as the dielectric layer, the current density–electrical field (J–E) measurement reveals that the dielectric leakage generated by the transferred electrode is less than that obtained by the typical evaporated electrode with a ratio of 0.3 × 101 ∼ 5 × 106 at V
bias = 1 V. Furthermore, at J = 1 mA cm−2, the withstand voltage can be raised by 100–102 times over that of an evaporated electrode. The capacitance–voltage (C–V) test shows that the transferred metal electrode can efficiently scale the equivalent oxide layer thickness (EOT) to 1.58 nm, which is a relatively smaller value than the overall reported Si-based device’s EOT. This finding successfully illustrates that the transferred electrode/dielectric layer’s mild contact can balance the scaling of the gate dielectric layer with a minimal leakage current and constantly reduce the EOT. Our enhanced electrode/dielectric contact approach provides a straightforward and effective pathway for further scaling of devices in integrated circuits and significantly decreases the overall integrated circuit’s static power consumption (ICs).
Explicit stabilized multirate method for stiff differential equations
Authors: Abdulle Assyr , Grote Marcus , Rosilho de Souza Giacomo
Published: June 2022

Stabilized Runge–Kutta methods are especially efficient for the numerical solution of large systems of stiff nonlinear differential equations because they are fully explicit. For semi-discrete parabolic problems, for instance, stabilized Runge–Kutta methods overcome the stringent stability condition of standard methods without sacrificing explicitness. However, when stiffness is only induced by a few components, as in the presence of spatially local mesh refinement, their efficiency deteriorates. To remove the crippling effect of a few severely stiff components on the entire system of differential equations, we derive a modified equation, whose stiffness solely depends on the remaining mildly stiff components. By applying stabilized Runge–Kutta methods to this modified equation, we then devise an explicit multirate Runge–Kutta–Chebyshev (mRKC) method whose stability conditions are independent of a few severely stiff components. Stability of the mRKC method is proved for a model problem, whereas its efficiency and usefulness are demonstrated through a series of numerical experiments.
Uniformization and internal absoluteness
Authors: Müller Sandra , Schlicht Philipp
Published: June 2022

Measurability with respect to ideals is tightly connected with absoluteness principles for certain forcing notions. We study a uniformization principle that postulates the existence of a uniformizing function on a large set, relative to a given ideal. We prove that for all

σ
\sigma

-ideals

I
I

such that the ideal forcing

P

I

\mathbb {P}_I

of Borel sets modulo

I
I

is proper, this uniformization principle is equivalent to an absoluteness principle for projective formulas with respect to

P

I

\mathbb {P}_I

that we call internal absoluteness. In addition, we show that it is equivalent to measurability with respect to

I
I

together with

1
1

-step absoluteness for the poset

P

I

\mathbb {P}_I

. These equivalences are new even for Cohen and random forcing and they are, to the best of our knowledge, the first precise equivalences between regularity and absoluteness beyond the second level of the projective hierarchy.
A new class of finitely generated polynomial subalgebras without finite SAGBI bases
Authors: Kuroda Shigeru
Published: June 2022

The notion of initial ideal for an ideal of a polynomial ring appears in the theory of Gröbner basis. Similarly to the initial ideals, we can define the initial algebra for a subalgebra of a polynomial ring, or more generally of a Laurent polynomial ring, which is used in the theory of SAGBI (Subalgebra Analogue to Gröbner Bases for Ideals) basis. The initial algebra of a finitely generated subalgebra is not always finitely generated, and no general criterion for finite generation is known.

The aim of this paper is to present a new class of finitely generated subalgebras having non-finitely generated initial algebras. The class contains a subalgebra for which the set of initial algebras is uncountable, as well as a subalgebra with finitely many distinct initial algebras.
Cross-Linked Hyaluronic Acid for Cleft Lip and Palate Aesthetic Correction: A Preliminary Report
Authors: Ordynowski Łukasz
Published: June 2022

Background

Surgical treatment of cleft lip and palate is divided into primary and secondary procedures to restore physiological function and appearance of the face, mouth, and nose. Hyaluronic acid (HA) bio-implants have been successfully used for volume loss correction in several medical disciplines. However, there is paucity of information about its use in the management of facial clefting.

Objectives

The aim of this report is to present the preliminary findings on the feasibility of using a cross-linked HA for aesthetic correction in previously surgical treated cleft lip and palate cases.

Methods

The cross-linked HA STYLAGE L, XL, and XXL (LABORATOIRES VIVACY, Paris, France) were used in this case series. Multiple treatment sessions, 4-6 weeks apart, were performed if required.

Results

A total of 15 patients had undergone the HA injections between May 2018 and December 2021. Of these, 13 had simultaneous correction of the nose, lip, and paranasal scar and the remaining 2 only the lip and scar. The procedures were uneventful and well tolerated by the patients. At follow-up, aesthetic improvement was observed in all patients. Moreover, patients reported overall satisfaction with the outcome of the procedures particularly because of its minimally invasive nature.

Conclusions

Cross-linked HA is a feasible and promising complimentary option for aesthetic, and potentially functional, correction in cases of cleft lip and palate. Larger clinical trials are needed to validate these preliminary findings.

Level of Evidence: 4
Neurodegenerative and Cerebrovascular Brain Pathologies Are Differentially Associated With Declining Grip Strength and Gait In Older Adults
Authors: Oveisgharan Shahram , Yu Lei , Wang Tianhao , Schneider Julie A , Bennett David A , Buchman Aron S
Published: June 2022

Background

Understanding the pathological bases underlying the heterogeneity of motor decline in old age may lead to targeted treatments. We examined whether different brain pathologies are related to declining grip strength and gait function.

Methods

We examined postmortem brains of older adults who underwent annual motor testing. Postmortem exam measured 6 neurodegenerative and 5 cerebrovascular disease (CVD) pathologies. Grip strength was measured twice bilaterally using a hand-held dynamometer, and gait function was a composite measure based on time and steps taken to walk 8 ft and perform a 360° turn twice.

Results

In separate linear mixed-effects models including all autopsied adults (N = 1 217), neurodegenerative pathologies including tau tangles, TDP-43, and nigral neuronal loss were associated with declining grip strength, but not CVD pathologies. In contrast, although both CVD and neurodegenerative pathologies were associated with declining gait function, CVD pathologies accounted for 75% of the variance of declining rate of gait function explained by brain pathologies and neurodegenerative pathologies accounted for 25%. These findings were unchanged in adults (n = 970) without a history of stroke. Restricting analyses to only adults without dementia (n = 661), CVD pathologies continued to account for the majority of the variance of declining gait. However, we failed to detect in this subgroup the variance of declining grip strength explained by neurodegenerative or CVD pathologies.

Conclusion

Different pathologies accumulating in aging brains may contribute to the phenotypic heterogeneity of motor decline. Larger studies are needed in older adults without dementia to assess differences in the motor consequences of varied brain pathologies.
An eco-evo-devo genetic network model of stress response
Authors: Feng Li , Dong Tianyu , Jiang Peng , Yang Zhenyu , Dong Ang , Xie Shang-Qian , Griffin Christopher H , Wu Rongling
Published: June 2022

The capacity of plants to resist abiotic stresses is of great importance to agricultural, ecological and environmental sustainability, but little is known about its genetic underpinnings. Existing genetic tools can identify individual genetic variants mediating biochemical, physiological, and cellular defenses, but fail to chart an overall genetic atlas behind stress resistance. We view stress response as an eco-evo-devo process by which plants adaptively respond to stress through complex interactions of developmental canalization, phenotypic plasticity, and phenotypic integration. As such, we define and quantify stress response as the developmental change of adaptive traits from stress-free to stress-exposed environments. We integrate composite functional mapping and evolutionary game theory to reconstruct omnigenic, information-flow interaction networks for stress response. Using desert-adapted Euphrates poplar as an example, we infer salt resistance-related genome-wide interactome networks and trace the roadmap of how each SNP acts and interacts with any other possible SNPs to mediate salt resistance. We characterize the previously unknown regulatory mechanisms driving trait variation; i.e. the significance of a SNP may be due to the promotion of positive regulators, whereas the insignificance of a SNP may result from the inhibition of negative regulators. The regulator-regulatee interactions detected are not only experimentally validated by two complementary experiments, but also biologically interpreted by their encoded protein–protein interactions. Our eco-evo-devo model of genetic interactome networks provides an approach to interrogate the genetic architecture of stress response and informs precise gene editing for improving plants’ capacity to live in stress environments.
Diagnosis and management of type 2 diabetes in children
Authors: Garvick Sarah , Altenburg Lilli , Dunlap Bailey , Fisher Abby , Watson Amanda , Gregory Tanya
Published: June 2022

The incidence of type 2 diabetes in children has risen 4.8% over the past decade, correlating with steadily rising obesity rates in children. Updated guidelines from the American Academy of Pediatrics and the American Diabetes Association encourage early identification and pharmacologic intervention for children with type 2 diabetes. Because of the aggressive disease course in children, comprehensive treatment must include prevention of complications such as diabetic nephropathy and neuropathy as well as management of comorbidities such as cardiovascular disease and dyslipidemia. Because the highest incidence of type 2 diabetes is reported in patients from racial or ethnic minority groups and those of low socioeconomic status, clinicians must work with patients and families to identify socioeconomic disparities that could affect adherence to diabetes management plans and to connect patients with community resources.
Lower Respiratory Tract Coinfection in the ICU: Prevalence and Clinical Significance of Coinfection Detected via Microbiological Analysis of Bronchoalveolar Lavage Fluid With a Comparison of Invasive Methodologies
Authors: Zelus Casey S. , Blaha Michael A. , Samson Kaeli K. , Kalil Andre C. , Van Schooneveld Trevor C. , Marcelin Jasmine R. , Cawcutt Kelly A.
Published: June 2022

OBJECTIVES:

Pneumonia remains a significant cause of morbidity and mortality, with increasing interest in the detection and clinical significance of coinfection. Further investigation into the impact of bronchoalveolar lavage (BAL) sampling methodology and efficient clinical utilization of microbiological analyses is needed to guide the management of lower respiratory tract infection in the ICU.

DESIGN:

Retrospective observational study.

SETTING:

ICUs at a single center between August 1, 2012, and January 1, 2018.

PATIENTS:

Mechanically ventilated adult patients who underwent BAL testing during an ICU admission were included.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

BAL methodology (bronchoscopic vs nonbronchoscopic), microbiological diagnostic testing, and clinical outcomes measures were obtained. Chi-square or Fisher exact tests assessed associations between categorical variables, whereas Kruskal-Wallis tests analyzed differences in distributions of measures. BAL samples from 803 patients met inclusion criteria. Coinfection was detected more frequently via bronchoscopic BAL compared with nonbronchoscopic BAL (26% vs 9%; p < 0.001). Viruses were detected more frequently in bronchoscopic (42% vs 13%; p < 0.001) and bacteria in nonbronchoscopic (42% vs 33%; p = 0.011) BALs. A positive correlation between mortality and the number of organisms isolated was identified, with 43%, 48%, and 58% 30-day mortality among those with 0, 1, and more than 2 organisms, respectively (p = 0.003). Viral organism detection was associated with increased 30-day mortality (56% vs 46%; p = 0.033).

CONCLUSIONS:

Even in the setting of standardized institutional techniques, retrospective evaluation of bronchoscopic and nonbronchoscopic BAL methodologies did not reveal similar microbiologic yield in critically ill patients, though bronchoscopic BAL overall yielded more organisms, and occurrence of multiple organisms in BAL was associated with worse outcome. Prospective data are needed for direct comparison of both methods to develop more standardized approaches for use in different patient groups.
Dysphagia Post-Extubation Affects Long-Term Mortality in Mixed Adult ICU Patients—Data From a Large Prospective Observational Study With Systematic Dysphagia Screening
Authors: Zuercher Patrick , Moser Michel , Waskowski Jan , Pfortmueller Carmen A. , Schefold Joerg C.
Published: June 2022

OBJECTIVES:

Data on long-term effects of post-extubation dysphagia is lacking. We investigate mid- and long-term clinical outcomes in a large sample of ICU patients with systematic dysphagia screening.

DESIGN:

Outcome analysis with a follow-up of 6 years or death (whichever occurred earlier) of ICU patients from a prospective observational trial (Dysphagia in Mechanically Ventilated ICU Patients study) with systematic dysphagia screening.

SETTING:

ICU of a tertiary care academic center.

PATIENTS:

Nine-hundred thirty-three mixed medical-surgical ICU patients (median age, 66 yr; interquartile range [IQR], 54–74, Acute Physiology and Chronic Health Evaluation II score 19 [IQR, 14–24], 71% male).

INTERVENTIONS:

ICU patients were followed up for a mean follow-up period of 1,731 ± 772 days (4.7 ± 2.1 yr). Primary outcome measures were 180-day and 360-day all-cause mortality in ICU patients with versus without dysphagia.

MEASUREMENTS AND MAIN RESULTS:

Two-hundred seventy-three patients died (29.3%) during the observational interval (n = 76 lost to follow-up). In dysphagia screening positive versus negative ICU patients, mortality at 180 days was 16% versus 5.8% (excess mortality 10.2%), whereas mortality at 360 days was 25% versus 9.1% (excess mortality 15.9%). Adjustment for confounders in a Cox model revealed a significant association of dysphagia with all-cause mortality in a time-dependent manner. The risk of death in ICU patients with versus without post-extubation dysphagia declined from about 2.5 times higher to about equal risk for both groups over the first year (i.e. 1.03 yr) post-ICU admission (at 360 d: hazard ratio [HR], 1.03; 95% CI, 0.42–3.70). The mean mortality HR for the first year post-ICU admission was HR 2.09 (95% CI, 1.34–3.24; p = 0.0009).

CONCLUSIONS:

Long-term follow-up of a large cohort of medical-surgical adult ICU patients systematically screened for dysphagia showed that dysphagia is associated with increased hazards for death for up to 1 year after ICU admission. Our data underline effects of post-extubation dysphagia on long-term clinical outcomes in affected critically ill patients.
Sleep and Professional Burnout in Nurses, Nursing Technicians, and Nursing Assistants During the COVID-19 Pandemic
Authors: DOS SANTOS Mariana Alvina , PEREIRA Flávia Helena , DE SOUZA CALIARI Juliano , OLIVEIRA Henrique Ceretta , CEOLIM Maria Filomena , ANDRECHUK Carla Renata Silva
Published: June 2022

Background

The COVID-19 pandemic may trigger sleep disorders and burnout in nursing professionals.

Purpose

This study was designed to describe the occurrence of sleep disorders and burnout in a nursing team during the COVID-19 pandemic and to identify the associated factors.

Methods

A cross-sectional approach was used. The questionnaire was administered via the Internet. All of the participants were nursing professionals who had provided care during the COVID-19 pandemic, and data were collected between June and August 2020. Sociodemographic and work characterization instruments, the Jenkins Sleep Scale, and the Maslach Burnout Inventory were used.

Results

Five hundred seventy-two nursing professionals (nurses, nursing technicians, and nursing assistants) responded. Slightly over one quarter (26.4%) presented a sleep disorder, and 17.3% presented burnout. Professional category was a factor found to be associated with having a sleep disorder. Moreover, a lower prevalence both of disorders and of starting to use sleep medication was found among nurses than nursing assistants. Moreover, an association was found between having a high level of emotional exhaustion burnout and being a nursing technician, having a higher number of patients needing care, and starting to use sleep medication. The level of burnout related to depersonalization was significantly higher for nursing assistants, those with a weekly workload of 50 hours or more, and those starting to use sleep medication. Furthermore, burnout related to personal accomplishment was significantly higher in those starting to use sleep medication. Among the participants with sleep disorders, according to Jenkins Sleep Scale results, all of the participants presented a high or moderate level of emotional exhaustion and a high level of burnout related to personal accomplishment.

Conclusions/Implications for Practice

The findings indicate that the incidence of sleep disorders and burnout were high among nursing professionals during the COVID-19 pandemic and mainly related with starting to use sleep medication. The results demonstrate the importance of detecting and assessing the frequency of sleep disorders and professional exhaustion. Interventions that aim to improve sleep quality and working conditions for these professionals should be developed.
Relationship Among Treatment Adherence, Family Functioning, and Self-Care Agency in Colombian Patients With Cardiovascular Disease
Authors: VARGAS-ESCOBAR Lina María , VALLE-BALLESTEROS Ruth , ALEMÁN-PARRA Claudia Marcela , PARRADO-SARMIENTO Ana Cristina , CORTES-MUÑOZ Fabián , SÁNCHEZ-CASAS Carolina
Published: June 2022

Background

Multiple factors affect treatment adherence in individuals with cardiovascular disease. However, information on the relationships among treatment adherence, family functioning, and self-care agency in these patients and their families is limited.

Purpose

This study was developed to determine the relationships among treatment adherence, family functioning, self-care agency, and sociodemographic variables in patients with cardiovascular disease. Self-care agency, as defined by Orem, is the dynamic process patients use to engage in their own healthcare that involves discerning and addressing factors that allow their making decisions that improve self-care abilities.

Methods

This cross-sectional, observational–analytical study enrolled 151 adult patients with cardiovascular diseases who had undergone pharmacological and nonpharmacological treatments and 108 family members of these patients who had consented to participate. Measurements were performed using the “Questionnaire for measuring treatment adherence in patients with cardiovascular disease,” the “Family Functioning Assessment Scale,” and the “Self-care Agency Scale.”

Results

Of the 151 patients, 119 (78.8%) were assessed as having a low risk of nonadherence, 60 (39.7%) as having low family functioning, and 131 (86.8%) as having high self-care agency. Treatment adherence and self-care agency showed a moderate and significant correlation (r = .66, p < .001). Similarly, treatment adherence and family functioning showed a low but significant correlation (r = .35, p < .001). Moreover, significant multivariate associations were found among the variables of interest. Patients with a low risk of nonadherence were found to be more likely to have a secondary or postsecondary education, not to have vision or hearing problems, and to have a contributory affiliation mode with the health system or private health insurance. In addition, participants with moderate or high levels of family functioning were less likely to be workers or to not have hearing or vision problems. Finally, significant differences were noted between patients with low self-care agency and those with high self-care agency in terms of kinship relationship with family members and affiliation mode with the health system.

Conclusions/Implications for Practice

The results of this research help clarify the issue of treatment adherence in patients with cardiovascular disease. Although family functioning and self-care agency were found to be low to moderately correlated with treatment adherence, relevant information regarding these variables and sociodemographic variables is presented in this study. Nurses may use these results as a reference to design nursing care plans and interventions to address the conditions of their patients more appropriately.
Participatory Approach to Create a Supportive Work Environment for Employees With Chronic Conditions
Authors: Bosma Astrid R. , Boot Cécile R.L. , Schaap Rosanne , Schaafsma Frederieke G. , Anema Johannes R.
Published: June 2022

Objective

To evaluate a pilot implementation of an organizational-level intervention. The participatory approach (PA) was used to create a supportive work environment for employees with chronic conditions, with a key role for occupational physicians (OPs).

Methods

Twenty-eight semi-structured interviews were conducted with OPs and stakeholders within their organizations. Furthermore, observational data and research notes were gathered. Data analysis occurred through content analysis.

Results

Recruitment of organizations was challenging, with a reach of 25%. Dose delivered, dose received, and fidelity differed across the three organizations. Organizations were positive about the PA as a method to improve support for employees with chronic conditions.

Conclusions

The PA could be of added value for creating a supportive work environment. However, research is needed on activating organizations to improve support for employees with chronic conditions.
Association of Polyfluoroalkyl Substances and Allergy in US Adolescents
Authors: Wang Huan , Gong Zekun , Zhang Lei
Published: June 2022

Objective

The aim of this study was to investigate association between polyfluoroalkyl substances (PFASs) and allergy in US adolescents.

Methods

This study was conducted in the National Health and Nutrition Examination Survey 2005–2006. PFAS as a universal pollutant can be obtained directly from laboratory data files. Allergy included current allergic symptoms and allergen sensitization. The aim of the study was to investigate the association between PFAS and allergy in US adolescents.

Results

Multivariate regression models showed that PFAS was positively associated with current allergic symptoms (adjusted odds ratio, 1.01; 95% confidence interval [CI], 1–1.03). With PFAS as a categorical variable, compared with the lowest tertile, the adjusted odds ratios with increasing tertiles were 1.21 (95% CI, 0.74–1.96) and 1.67 (95% CI, 1.01–2.74).

Conclusions

Our study shows that PFASs are associated with increased incidence of current allergic symptoms in US adolescents. More prospective studies are needed to provide evidences.