bluuebunny/crossref_metadata_2025 huggingface dataset:
Biological soft matter: intrinsically disordered proteins in liquid–liquid phase separation and biomolecular condensates
Authors: Fonin Alexander V. , Antifeeva Iuliia A. , Kuznetsova Irina M. , Turoverov Konstantin K. , Zaslavsky Boris Y. , Kulkarni Prakash , Uversky Vladimir N.
Published: November 2022

The facts that many proteins with crucial biological functions do not have unique structures and that many biological processes are compartmentalized into the liquid-like biomolecular condensates, which are formed via liquid–liquid phase separation (LLPS) and are not surrounded by the membrane, are revolutionizing the modern biology. These phenomena are interlinked, as the presence of intrinsic disorder represents an important requirement for a protein to undergo LLPS that drives biogenesis of numerous membrane-less organelles (MLOs). Therefore, one can consider these phenomena as crucial constituents of a new IDP–LLPS–MLO field. Furthermore, intrinsically disordered proteins (IDPs), LLPS, and MLOs represent a clear link between molecular and cellular biology and soft matter and condensed soft matter physics. Both IDP and LLPS/MLO fields are undergoing explosive development and generate the ever-increasing mountain of crucial data. These new data provide answers to so many long-standing questions that it is difficult to imagine that in the very recent past, protein scientists and cellular biologists operated without taking these revolutionary concepts into account. The goal of this essay is not to deliver a comprehensive review of the IDP–LLPS–MLO field but to provide a brief and rather subjective outline of some of the recent developments in these exciting fields.
Butyrate-producing colonic clostridia: picky glycan utilization specialists
Authors: Leth Maria Louise , Pichler Michael Jakob , Abou Hachem Maher
Published: November 2022

Butyrate-producing human gut microbiota members are recognized for their strong association with a healthy immune-homeostasis and protection from inflammatory disorders and colorectal cancer. These effects are attributed to butyrate, the terminal electron sink of glycan fermentation by prevalent and abundant colonic Firmicutes from the Lachnospiraceae and Oscillospiraceae families. Remarkably, our insight into the glycan utilization mechanisms and preferences of butyrogenic Firmicutes remains very limited as compared with other gut symbionts, especially from the Bacteroides, Bifidobacterium, and Lactobacillus genera. Here, we summarize recent findings on the strategies that colonic butyrate producers have evolved to harvest energy from major dietary fibres, especially plant structural and storage glycans, such as resistant starch, xylans, and mannans. Besides dietary fibre, we also present the unexpected discovery of a conserved protein apparatus that confers the growth of butyrate producers on human milk oligosaccharides (HMOs), which are unique to mother’s milk. The dual dietary fibre/HMO utilization machinery attests the adaptation of this group to both the infant and adult guts. These finding are discussed in relation to the early colonization of butyrogenic bacteria and the maturation of the microbiota during the transition from mother’s milk to solid food. To date, the described butyrogenic Firmicutes are glycan utilization specialists that target only a few glycans in a highly competitive manner relying on co-regulated glycan utilization loci. We describe the common pillars of this machinery, highlighting butyrate producers as a source for discovery of biochemically and structurally novel carbohydrate active enzymes.
Effects of Critical Distance and Reverberation on Listening Effort in Adults
Authors: Huang Haiping , Ricketts Todd A. , Hornsby Benjamin W. Y. , Picou Erin M.
Published: November 2022

Purpose:

Mixed historical data on how listening effort is affected by reverberation and listener-to-speaker distance challenge existing models of listening effort. This study investigated the effects of reverberation and listener-to-speaker distance on behavioral and subjective measures of listening effort: (a) when listening at a fixed signal-to-noise ratio (SNR) and (b) at SNRs that were manipulated so that word recognition would be comparable across different reverberation times and listening distances. It was expected that increased reverberation would increase listening effort but only when listening outside critical distance.

Method:

Nineteen adults (21–40 years) with no hearing loss completed a dual-task paradigm. The primary task was word recognition and the secondary task was timed word categorization; response times indexed behavioral listening effort. Additionally, participants provided subjective ratings in each condition. Testing was completed at two reverberation levels (moderate and high, RT30= 469 and 1,223 ms, respectively) and at two listener-to-speaker distances (inside and outside critical distance for the test room, 1.25 and 4 m, respectively).

Results:

Increased reverberation and listening distances worsened word recognition performance and both behavioral and subjective listening effort. The effect of reverberation was exacerbated when listeners were outside critical distance. Subjective experience of listening effort persisted even when word recognition was comparable across conditions.

Conclusions:

Longer reverberation times or listening outside the room's critical distance negatively affected behavioral and subjective listening effort. This study extends understanding of listening effort in reverberant rooms by highlighting the effect of listener's position relative to the room's critical distance.
An Acoustic-Phonetic Approach to Effects of Face Masks on Speech Intelligibility
Authors: Kim Yunjung , Thompson Austin
Published: November 2022

Purpose:

This study aimed to examine the effects of wearing a face mask on speech acoustics and intelligibility, using an acoustic-phonetic analysis of speech. In addition, the effects of speakers' behavioral modification while wearing a mask were examined.

Method:

Fourteen female adults were asked to read a set of words and sentences under three conditions: (a) conversational, mask-off; (b) conversational, mask-on; and (c) clear, mask-on. Seventy listeners rated speech intelligibility using two methods: orthographic transcription and visual analog scale (VAS). Acoustic measures for vowels included duration, first (F1) and second (F2) formant frequency, and intensity ratio of F1/F2. For consonants, spectral moment coefficients and consonant–vowel (CV) boundary (intensity ratio between consonant and vowel) were measured.

Results:

Face masks had a negative impact on speech intelligibility as measured by both intelligibility ratings. However, speech intelligibility was recovered in the clear speech condition for VAS but not for transcription scores. Analysis of orthographic transcription showed that listeners tended to frequently confuse consonants (particularly fricatives, affricates, and stops), rather than vowels in the word-initial position. Acoustic data indicated a significant effect of condition on CV intensity ratio only.

Conclusions:

Our data demonstrate a negative effect of face masks on speech intelligibility, mainly affecting consonants. However, intelligibility can be enhanced by speaking clearly, likely driven by prosodic alterations.
Reconfigurable adaptive polarisation‐sensitive array optimisation for multiple interferences elimination in satellite communication
Authors: Sun Yandong , Xie Jian , Han Chuang , Gong Yanyun , Wang Ling
Published: November 2022

Polarisation‐sensitive array (PSA) has earned extensive attention in satellite communication owing to excellent anti‐interference performance. Nevertheless, the configuration of traditional PSA where each polarised antenna requires multiple radio frequency (RF) front‐ends makes it much more costly in terms of hardware and software for system design. In this paper, resorting to RF switches, a novel reconfigurable PSA optimisation technique is developed that utilises fewer RF front‐ends, which can considerably decrease computational expenditure and achieve high anti‐jamming performance. An RF switch switching (RFSS) scheme is devised to guide the implementation of PSA reconfiguration. To accurately demonstrate the effect of the array configuration on interference rejection performance, the polarisation‐spatial subspace correlation coefficient (PSC) is presented. Then the relationship between the optimal signal to interference plus noise ratio (SINR) and the PSC based on adaptive processing is formulated. Aiming to acquire the optimal reconstructed PSA outputting the maximum SINR, the mathematical model of the PSA reconfiguration problem is established. Subsequently, two optimisation methods are provided to address the problem efficiently, thereby gaining the optimal configuration of the reconstructed PSA and implementing the reconfiguration by RF switches. Numerical and experimental simulations verify the correctness and reliability of the developed scheme and approaches.
Prescribed‐time stabilisation control of differential driven automated guided vehicle
Authors: Chen Qiyuan , Zhang Pengfei
Published: November 2022

The position control problem of differential‐driven automated guided vehicles (AGVs) based on the prescribed‐time control method is studied. First, an innovative orientation error function is proposed by an auxiliary arcsine function about the orientation angle. Thus, the problem of position control of AGV is transformed into the stabilisation control of the kinematic system. Second, by introducing a reserved time parameter and a smooth switching function, a novel time‐varying scaling function is proposed. This novel scaling function avoids the risk of infinite gain in the conventional prescribed‐time control method while ensuring the smoothness of control laws. Then, an improved velocity constraint function is proposed using the Gaussian function. Compared with the existing constraint function, the proposed method not only has more smoothness but also solves the balance point errors caused by the large AGV orientation errors. The presented method ensures that the AGV reaches the target position in a prescribed time. Hence, the upper bound of the AGV system state can be determined by adjusting parameters. Matlab simulation results show that the proposed controller can effectively make the AGV system state satisfy the prescribed bound.
Classification and model reconstruction method of non‐cooperative multifunctional radar waveform unit
Authors: Jiang Neng , Zhang Hongmin
Published: November 2022

There are many variations in the form of multifunctional radar signals. At present, the problem associated with the highest concern in the field of electronic reconnaissance is the inversion of its working mode from the reconnaissance data. A method is proposed for waveform unit classification and model reconstruction using the non‐cooperatively extracted waveform units as input data based on the hierarchical structure of multifunctional radars. The method performs multiparametric matching on waveform units subject to the constraint of the match level to obtain the similarity measure between waveform units; it then recursively expands the waveform unit pairing score matrix to complete the classification of the waveform units. Further, based on similar waveform units, the matching state matrix of the waveform unit model can be reconstructed. The feasibility and performance of the proposed method are verified by setting up typical multitype simulation experiments. The experimental results show that the proposed method can complete the classification of waveform units in the small‐data content and extensive noise intensity cases and supports the reconstruction of waveform unit models with low errors.
Characterizing the specific energy and pressure in near-Earth magnetic clouds
Authors: Bhattacharjee Debesh , Subramanian Prasad , Vourlidas Angelos , Nieves-Chinchilla Teresa , Thejaswi Niranjana , Sachdeva Nishtha
Published: November 2022

Context.The pressure and energy density of the gas and magnetic field inside solar coronal mass ejections (in relation to that in the ambient solar wind) is thought to play an important role in determining their dynamics as they propagate through the heliosphere.

Aims.We compare the specific energy (erg g−1), comprising kinetic (Hk), thermal (Hth) and magnetic field (Hmag) contributions, inside magnetic clouds (MCs) and the solar wind background. We examine whether the excess thermal+magnetic pressure and specific energy inside MCs (relative to the background) are correlated with their propagation and internal expansion speeds. We consider whether the excess thermal+magnetic specific energy inside MCs might cause them to resemble rigid bodies in the context of aerodynamic drag.

Methods.We used near-Earth in situ data from the WIND spacecraft to identify a sample of 152 well-observed interplanetary coronal mass ejections and their MC counterparts. We compared various metrics based on these data to address our questions.

Results.We find that the total specific energy (H) inside MCs is approximately equal to that in the background solar wind. We find that the excess (thermal+magnetic) pressure and specific energy are not well correlated with the near-Earth propagation and expansion speeds. We find that the excess thermal+magnetic specific energy is greater or equivalent to the specific kinetic energy of the solar wind incident in 81–89% of the MCs we study. This might explain how MCs retain their structural integrity and resist deformation by the solar wind bulk flow.
Spatially resolved mid-infrared observations of the circumstellar environment of the born-again object FG Sge
Authors: Ohnaka K. , Jara Bravo B. A.
Published: November 2022

Context. FG Sge has evolved from the hot central star of the young planetary nebula Hen 1–5 to a G–K supergiant in the last 100 yr. It is one of the three born-again objects that have been identified as of yet, and they are considered to have undergone a thermal pulse in the post-asymptotic giant branch evolution.

Aims. We present mid-infrared spectro-interferometric observations of FG Sge and probe its dusty environment.

Methods. FG Sge was observed with MIDI at the Very Large Telescope Interferometer at baselines of 43 and 46 m between 8 and 13 µm.

Results. The circumstellar dust environment of FG Sge was spatially resolved, and the Gaussian fit to the observed visibilities results in a full width at half maximum of ~10.5 mas. The observed mid-infrared visibilities and the spectral energy distribution can be fairly reproduced by optically thick (τV ≈ 8) spherical dust shell models consisting of amorphous carbon with an inner radius rin of ~30 R★ (corresponding to a dust temperature of 1100 ± 100 K). The dust shell is characterized with a steep density profile proportional to r−3.5±0.5 from the inner radius rin to (5–10) × rin, beyond which it changes to r−2. The dust mass is estimated to be ~ 7 × 10−7 M⊙, which translates into an average total mass-loss rate of ~ 9 × 10−6 M⊙ yr−1 as of 2008 with a gas-to-dust ratio of 200 being adopted. In addition, the 8–13 µm spectrum obtained with MIDI with a field of view of 200 mas does not show a signature of the polycyclic aromatic hydrocarbon (PAH) emission, which is in marked contrast to the spectra taken with the Spitzer Space Telescope six and 20 months before the MIDI observations with wide slit widths of 3″.6–10″. This implies that the PAH emission originates from an extended region of the optically thick dust envelope.

Conclusions. The dust envelope of FG Sge is much more compact than that of the other born-again stars’ Sakurai’s object and V605 Aql, which might reflect the difference in the evolutionary status. The PAH emission from the extended region of the optically thick dust envelope likely originates from the material ejected before the central star became H-deficient, and it may be excited by the UV radiation from the central star escaping through gaps among dust clumps and/or the bipolar cavity of a disk-like structure.
Baryonic effective field theory for light hypernuclei
Authors: Barnea Nir , Bazak Betzalel , Contessi Lorenzo , Gal Avraham , Mareš Jiří , Schäfer Martin
Published: November 2022

Light hypernuclei containing one or two Λ baryons are the subject of an ongoing experimental campaign aiming to study the spectrum of these systems, as well as the 2 and 3-body interaction between Λ hyperons and nucleons. Here we shortly review the theoretical study of these systems within the framework of baryonic effective field theory.
Feasibility study for measurement of beta-decay rates of Λ hypernuclei
Authors: Kamada Kento , Fujita Manami , Tamura Hirokazu
Published: November 2022

The baryon structure may be modified in nuclear medium. The quark meson coupling model predicts that the beta decay rate of a Λ hyperon in Λ hypernuclei decreases by 20% at maximum. We propose an experiment to precisely measure the beta-decay rate of 5ΛHe at J-PARC via the (π+, K+) reaction. A feasibility study via GEANT4 simulation has been done, showing that the background can be suppressed down to ~ 3.9% of the betadecay electron yield, using a calorimeter covering the whole solid angle around the target. The measurement of the beta-decay of a Λ in a nucleus is found to be feasible.
Hypernuclear production spectroscopy with an extended shell model
Authors: Umeya Atsushi , Motoba Toshio , Itonaga Kazunori
Published: November 2022

The (e, e’K+) reaction experiments with several nuclear targets performed recently at the Jefferson laboratory have provided high-resolution spectroscopic data. Among others, the 10B(e, e’K+) 10ΛBe reaction data are particularly interesting due to new appearance of extra sub-peaks which seem difficult to be explained within the conventional model with the p-shell nuclear naturalparity configurations. To describe this novel hypernuclear structure, we have extended the model space by introducing the new configurations which include unnatural-parity nuclear core-excited states. This configuration mixing successfully explains the sub-peaks in the 10B(e, e’K+) reaction data. For adjacent hypernuclei with A = 9–11, we show the DWIA spectra of (K−, π−), (π+, K+) and (γ, K+) reactions that are calculated within the extended model in a consistent way. We discuss the theoretical spectra of 9,10ΛBe and 11ΛB production reactions.
Mean field and beyond mean field calculations of hypernuclei for study of electroproduction
Authors: Veselý P. , De Gregorio G. , Knapp F. , Petrellis D. , Bydžovský P. , Denisova D. , Pokorný J. , Skoupil D. , Lo Iudice N.
Published: November 2022

We present two methods, the Nucleon-Lambda Tamm Dancoff Approximation (NΛ TDA) and the Equation of Motion Phonon Method (EMPM) suitable for calculating hypernuclear energy spectra and structure. These methods are applicable for hypernuclei of wide range of masses with one Λ particle replacing one nucleon in an even-even nuclear cores. Using an effective Lambda-nucleon (ΛN) potential both methods were applied to calculate the energy spectrum of 12ΛB and also one body density matrix elements (OBDME). The OBDME were applied to calculate the electroproduction cross section of 12ΛB. We obtained better agreement with the experimental data by using EMPM than NΛ TDA. We plan to provide theoretical prediction (by applying the same methods and ΛN potentials) of the cross section in electroproduction of 40ΛK and 48ΛK.
Kinematical effects in electroproduction of hypernuclei
Authors: Denisova Daria
Published: November 2022

On the example of electroproduction of 12ΛB we show effects in the cross section caused by various choices of the momentum of the initial proton. We have found that the effects are quite noticeable, mainly for small kaon angles. This extention of our model calculations beyond the frosen-proton approximation represents an important improvement of theoretical predictions.
The strangeness program at GlueX
Authors: Pauli Peter
Published: November 2022

The GlueX experiment located at Jefferson Lab studies the spectrum of hadrons using photoproduction on a LH2 target in a wide variety of final states. With its detector system capable of measuring neutral and charged final state particles over almost the full solid angle, and very good particle identification capabilities, GlueX can measure many different hadrons containing strangeness. A linearly polarized photon beam allows the measurement of polarization observables, which contain information about the production mechanisms involved in generating strange particles in photoproduction. In addition, GlueX can perform precise cross-section measurements, which help to study the spectrum of strange hadrons. In this presentation, the GlueX experiment is introduced, and recent progress of its strangeness program is discussed. We present recent results on Σ0 beam asymmetries, Λ(1520) spin-density matrix elements and ongoing studies of the Λ(1405) lineshape. We also present our recent progress on measurements of ΛΛ̅ and Ξ(∗) photoproduction. Also, future prospects for strangeness measurements at GlueX are discussed.
High resolution spectroscopy of the “ΣN cusp” by using the d(K−, π−) reaction
Authors: Ichikawa Yudai , Ahn Jungkeun , Choi Sungwook , Fujita Manami , Gogami Toshiyuki , Hasegawa Shoichi , Harada Takeshi , Hayakawa Shuhei , Ishimoto Shigeru , Jung Woose-ung , Kang Byungmin , Kim Shinhyung , Miwa Koji , Nagae Tomofumi , Nanamura Takuya , Sako Hiroyuki , Sato Susumu , Suzuki Shoji , Tamura Hirokazu , Tanida Kiyoshi , Ukai Mifuyu , Yamamoto Takeshi , Yang Seongbae
Published: November 2022

We present a new proposal, J-PARC E90, to measure a missing-mass spectrum near the ΣN threshold for the d(K−, π−) reactions at 1.4 GeV/c. While many previous experiments support apparent enhancement near the ΣN thresh-old, the dynamical origin of this so-called “ΣN cusp” remains yet unsolved. The enhancement suggests either a cusp structure or a weakly bound state. One of the keys to making it clear is improving the missing-mass resolution and statistics. Our new experiment can achieve the missing-mass resolution of 0.4 MeV in σ using the K1.8 beam line and S-2S spectrometers at J-PARC. Further-more, we can suppress quasi-free background processes with the time projection chamber (HypTPC), which operated nicely for the H-dibaryon search experi-ment (J-PARC E42). The J-PARC E90 aims to extract the scattering length of the ΣN system with isospin T = 1/2 and spin-triplet channels.
How can we solve the hyperon puzzle? —Introduction to “topical session on ΛNN three-body force”
Authors: Tamura Hirokazu
Published: November 2022

As an introduction to the “topical session on ΛNN three-body force” in HYP2022, a scenario to solve the hyperon puzzle and to elucidate high density matter in neutron stars is proposed. It is related to the J-PARC Hadron Facility extension project, in which experimental studies of ΛNN three-body force (3BF) via high precision spectroscopy of Λ hypernuclei and high quality ΛN scattering are one of the flagship subjects in the project. Development of theoretical methods to extract 3BF effects from experimental data and to reliably extrapolate them to higher density is challenging but extremely important.
Study of charge symmetry breaking in A = 4 hypernuclei in √sNN = 3 GeV Au+Au collisions at RHIC
Authors: Shao Tianhao
Published: November 2022

In these proceedings, we present the measurement of the charge symmetry breaking in A = 4 hypernuclei in Au+Au collisions at √sNN = 3 GeV. The signal reconstruction and binding energy measurements of 4ΛH and 4ΛHe, including corrections on momentum, are discussed. Our result of Λ binding energy difference for ground states is ΔBΛ(0+) = 0.16 ± 0.14(stat.) ± 0.10(syst.) MeV. Combined with the energy levels of excited states, the difference for excited states is ΔBΛ(1+) = −0.16 ± 0.14(stat.) ± 0.10(syst.) MeV which shows a negative sign with a magnitude comparable to the result of ground states. These results are compared with previous measurements and theoretical model calculations.
Zystoskopien in der urologischen Praxis – was muss ich beachten?
Authors: Schöne Markus , Uhthoff Holger , Schöne Sabrina
Published: November 2022

Die Urethrozystoskopie ist ein wichtiges diagnostisches Werkzeug zur Abklärung des unteren Harntraktes. Die Standardzystoskopie (Weißlicht) wird fortwährend weiterentwickelt, moderne Endoskope und Videosysteme stehen zur Verfügung. Unterstützende Verfahren wie die photodynamische Diagnostik (PDD), narrow band imaging (NBI) oder digitale Kontrastverstärkungen verbessern die Detektionsrate von Blasentumoren. Besondere Bedeutung im Praxisalltag haben eine korrekte Indikationsstellung, die sorgfältige Vorbereitung und Aufklärung der Patienten und eine fachliche Expertise bei der Durchführung der Untersuchung, um Beschwerden und Komplikationen zu minimieren und zielführende Befunde zu erheben. Die Hygieneanforderung an Aufbereitung und Infrastruktur werden derzeit im Vergütungssystem nicht adäquat abgebildet. Technische Bildverarbeitung und Systeme mit künstlicher Intelligenz (KI) haben das Potential den Urologen bereits während der Untersuchung zu unterstützen.
Berberine Regulates GPX4 to Inhibit Ferroptosis of Islet β Cells
Authors: Bao Lei , Jin Yixuan , Han Jiani , Wang Wanqiu , Qian Lingling , Wu Weiming
Published: November 2022

Ferroptosis, as a kind of non-apoptotic cell death, is involved in the pathogenesis of type 1 diabetes mellitus (T1DM). Islet B cells mainly produce insulin that is used to treat diabetes. Berberine (BBR) can ameliorate type 2 diabetes and insulin resistance in many ways. However, a few clues concerning the mechanism of BBR regulating ferroptosis of islet β cells in T1DM have been detected so far. We measured the effects of BBR and GPX4 on islet β cell viability and proliferation by MTT and colony formation assays. Western blot and qRT-PCR were utilized to examine GPX4 expression in islet β cells with distinct treatments. The influence of BBR and GPX4 on ferroptosis of islet β cells was investigated by evaluating the content of Fe2+ and reactive oxygen species (ROS) in cells. The mechanism of BBR targeting GPX4 to inhibit ferroptosis of islet β cells was further revealed by the rescue experiment. Our results showed that BBR and overexpression of GPX4 could notably accelerate cell viability and the proliferative abilities of islet β cells. Moreover, BBR stimulated GPX4 expression to reduce the content of Fe2+ and ROS, thereby repressing the ferroptosis of islet β cells, which functioned similarly as ferroptosis inhibitor Fer-1. In conclusion, BBR suppressed ferroptosis of islet β cells via promoting GPX4 expression, providing new insights into the mechanism of BBR for islet β cells.
Nekrolytisches migratorisches Erythem – Ein Fallbericht
Authors: Kreibich Katja , Talas Joud , Stock Karsten , Zouboulis Christos C.
Published: November 2022

Es wird über einen 58-jährigen Mann mit therapieresistenten makulopapulösen Effloreszenzen an den Unterschenkeln sowie multiplen, krustig belegten Papeln im Gesichts- und Rückenbereich berichtet. Auffällig waren zudem eine B-Symptomatik und eine chronische Anämie ohne bekannte Malignomerkrankung. Diese Hinweise ließen eine Paraneoplasie vermuten und schließlich die Diagnose eines nekrolytisch migratorischen Erythems (NME) im Rahmen eines Glukagonom-Syndroms stellen. Der Fall zeigt die Herausforderung für die Diagnosestellung eines NME bei wiederholt unspezifischer Dermatopathologie und initial negativ verlaufender Tumorsuche.
Pregnancy Outcomes in Women with Arrhythmias following Surgical Repair of Cardiac Defects
Authors: Chornock Rebecca , Lewis Dana , Gabaud Stephany , Fries Melissa , Greenberg Victoria , Kawakita Tetsuya
Published: November 2022

Objective The goal of this study was to investigate whether preexisting cardiac arrhythmias are associated with adverse obstetrical outcomes in women with a history of open cardiac surgery.

Study Design This was a retrospective cohort study of women with a history of open cardiac surgery who delivered at MedStar Washington Hospital Center (Washington, DC) from January 2007 through December 2018. Women with the isolated percutaneous cardiac surgical repair were excluded. Maternal and neonatal outcomes were compared between patients with preexisting cardiac arrhythmias and patients without preexisting cardiac arrhythmias. Maternal outcomes studied were intensive care unit admission, postpartum blood loss greater than 1,000 mL, congestive heart failure development, preeclampsia with severe features, postpartum readmission, postpartum cardiac events, and postpartum length of stay >5 days. Neonatal outcomes investigated were low birth weight <2,500 g, Apgar's scores <7 at 5 minutes, and neonatal intensive care unit admission. Multivariate logistic regression model was used to calculate the adjusted odds ratio (aOR) and 95% confidence intervals.

Results The outcomes for 69 deliveries from 56 women with a history of open cardiac surgery were examined. Thirty-three women (48%) had arrhythmias after cardiac surgery with fourteen (20%) requiring implantable cardioverted defibrillators. Two women (6%) with preexisting arrhythmias after cardiac surgery developed postpartum volume overload requiring readmission (p = 0.06). After controlling for age, gestational age at delivery, and BMI, preeclampsia with severe features (p = 0.02) and low birth weight neonates (p = 0.02, aOR = 2.26 [0.56–9.03]) remained statistically more like to occur in patients with preexisting cardiac arrhythmias than in patients without preexisting arrhythmias.

Conclusion Women with a history of open cardiac surgery and preexisting cardiac arrhythmias prior to pregnancy are more likely to develop preeclampsia with severe features and have low birth weight neonates compared with women with a history of open cardiac surgery without preexisting cardiac arrhythmias.

Key Points
Evaluation of Low-Dose Aspirin to Prevent Preeclampsia in Pregnant People with Chronic Hypertension
Authors: Derrah Kelli , Greiner Karen S. , Rincón Mónica , Burwick Richard M.
Published: November 2022

Objective Our objective was to evaluate if the use of low-dose aspirin (LDA) among pregnant individuals with chronic hypertension (CHTN) reduces the rate of superimposed preeclampsia or other adverse maternal and neonatal outcomes.

Study Design Our study included single-center cohort of pregnant individuals with CHTN who had a live birth after 23 weeks' gestation, between 2013 and 2018. The primary exposure was the use of LDA in pregnancy and the primary outcome was superimposed preeclampsia. LDA use was also evaluated by the timing of initiation, before or after 16 weeks' gestation. Secondary outcomes included preeclampsia subtypes (e.g., preeclampsia with severe features, early-onset disease), as well as adverse maternal and neonatal outcomes. Differences were analyzed by χ
2, Fisher's exact, or t tests, with logistic regression to adjust for confounders.

Results Of 11,825 deliveries during the study period, 494 (4.2%) occurred in women with CHTN. Among those with CHTN, 174 (35%) were prescribed LDA, most often 81 mg daily (173 out of 174, 99%). Baseline characteristics were similar between groups, but the history of preeclampsia was more common in those prescribed LDA. The rate of superimposed preeclampsia was no different among those with CHTN-prescribed LDA compared with those who were not (36% vs. 30%, p = 0.2), even when restricting the analysis to those prescribed LDA before 16 weeks' gestation (33 vs. 30%, p = 0.2). In addition, LDA did not lead to a reduction in the rate of preeclampsia with severe features, early-onset preeclampsia, or other adverse maternal outcomes. However, the composite rate of adverse neonatal outcomes was lower in LDA users versus nonusers (4.0 vs. 13%, p = 0.002), which persisted after multivariable adjustment (adjusted odds ratio: 0.28, 95% confidence interval: 0.12–0.67).

Conclusion Among pregnant individuals with CHTN, LDA did not decrease the rate of superimposed preeclampsia. Further studies are warranted to validate our observed reduction in adverse neonatal outcomes and to determine if aspirin is more beneficial at dosages greater than 81 mg daily.

Key Points
Thromboelastography versus Standard Coagulation Assays in Patients with Postpartum Hemorrhage
Authors: Perelman Allison D. , Limaye Meghana , Blakemore Jennifer , Hoskins Iffath A.
Published: November 2022

Objective Thromboelastography (TEG), a point-of-care test that measures blood's dynamic viscoelastic properties, is routinely used to guide resuscitation in surgical specialties with high hemorrhage risk. Patients with ongoing postpartum hemorrhage (PPH) often develop coagulopathy and hypofibrinogenemia. Timely assessment of fibrinogen is crucial because cryoprecipitate for repletion requires thawing time prior to administration. TEG may provide rapid assessment of coagulopathy in ongoing hemorrhage but this has not been thoroughly studied. Our objective was to determine if TEG accurately reflects coagulopathy in ongoing PPH when compared with standard assays.

Study Design This was a retrospective cohort study of people with ongoing PPH (quantified blood loss >1,000 mL), from January 1, 2016, to December 31, 2019. TEG variables and standard coagulation parameters were compared in patients who had both assays drawn simultaneously. As a secondary analysis, patients who had TEG were compared with those who did not. The Mann–Whitney, Fisher's exact, Kruskal–Wallis, Spearman's rho, and logistic regression tests were used for analysis. Significance was set at p < 0.05.

Results A total of 680 patients were included, 69 of whom had TEG and coagulation parameters drawn simultaneously and were included in the primary analysis. The remainder were included in the secondary analysis. TEG variables and coagulation assays correlated significantly—prolonged R with increased PTT (rho 0.25, p = 0.04), prolonged K and decreased α angle with decreased fibrinogen (rho −0.61, p < 0.001; rho 0.24, p < 0.001), and decreased maximum amplitude with decreased platelets (rho 0.62, p < 0.001). Those who had thromboelastographic assays had higher blood loss and need for interventions to manage hemorrhage than those who did not.

Conclusion TEG correlated significantly with standard laboratory assays in ongoing PPH, including for patients with hypofibrinogenemia. Given the point-of-care nature and rapid turnaround time, TEG should be considered for timely hemorrhage evaluation and directed resuscitation of coagulopathy.

Key Points
A Resolved Placenta Previa Is Still Associated with Postpartum Hemorrhage
Authors: Kim Sun Woo , Hamm Rebecca F. , Schwartz Nadav
Published: November 2022

Objective Our objective was to determine whether resolution of a low-lying placenta or placenta previa is associated with postpartum hemorrhage (PPH).

Study Design This is a retrospective, matched-control cohort study of women who underwent transvaginal sonography during fetal anatomic survey between 18 and 24 weeks of gestation at the University of Pennsylvania from January 2017 to May 2019. Exposure was defined as low-lying placenta (≤1 cm from the internal cervical os) or placenta previa (covering the os) at anatomic survey that was found to be resolved by transvaginal ultrasound in the third trimester. For each exposure, we identified a control patient whose placenta was > 1 cm from internal os at anatomic survey performed on the same day. The primary outcome was PPH at delivery, defined as estimated blood loss ≥ 1,000 mL.

Results A total of 450 women were included (225/group). The exposed group of resolved placental previa included 85.0% with resolved low-lying placenta and 15.0% with resolved previa. The rate of PPH was significantly higher in the exposed group versus controls (9.8% vs. 4.4%, p = 0.03). Women with resolved previa were 2.5 times more likely to experience PPH than controls (adjusted odds ratio = 2.58, 95% confidence interval: 1.17–5.69), even when controlling for parity, prior cesarean, and delivery mode. Women with resolved previa were also more likely to present to triage with bleeding (16.4% vs. 8.0%, p = 0.006), receive antenatal corticosteroids, (9.3% vs. 3.1%, p = 0.006), and receive intravenous iron postpartum (7.6% vs. 3.1%, p = 0.04).

Conclusion Our data demonstrate that women with a resolved low-lying placenta or placenta previa remain at significantly increased risk of bleeding-related complications in pregnancy and during delivery when compared with those who never had a previa. Clinicians should consider this association when counseling patients and performing hemorrhage risk stratification.

Key Points
Racial Disparities in Sterilization Procedure Performed at Time of Cesarean Section
Authors: Walheim Lauren K. , Hong Christopher X. , Hamm Rebecca F.
Published: November 2022

Objectives While bilateral tubal ligation has historically been performed for sterilization at cesarean delivery (CD), recent data supports the use and safety of opportunistic bilateral salpingectomy during CD to decrease lifetime ovarian cancer risk. Prior studies have described racial disparities in sterilization rates, but there is a paucity of data regarding racial disparities in type of sterilization procedure. Our objective was to determine differences in sterilization procedure type performed at CD by race (Black vs. non-Black) to evaluate for equity in bilateral salpingectomy utilization.

Study Design We performed a retrospective cohort study of patients included in the American College of Surgeons National Surgical Quality Improvement Program database who underwent sterilization at time of CD from January 2019, to December 2020, identified using Current Procedural Terminology codes. Patients without documented race were excluded. Multivariable logistic regression was used to determine odds of undergoing bilateral salpingectomy compared with bilateral tubal ligation by race while controlling for confounders.

Results Of 28,147 patients who underwent CD, 3,087 underwent concurrent sterilization procedure, and 2,161 met inclusion criteria (Black: n = 279; non-Black: n = 1,882). Black patients were significantly more likely to have hypertension (10.8 vs. 5.3%, p < 0.01), bleeding disorders (3.9 vs. 1.3%, p < 0.01), preoperative anemia (hemoglobin < 11 g/dL; 36.9 vs. 21.3%, p < 0.01), and be of American Society of Anesthesiologist class 3 or higher (29.4 vs. 22.5%, p = 0.01) than non-Black patients. After adjusting for differences, Black patients were almost 50% less likely than non-Black patients to undergo bilateral salpingectomy compared with bilateral tubal ligation for sterilization at CD (adjusted odds ratio = 0.52, 95% confidence interval: 0.36–0.75).

Conclusion Despite evidence that bilateral salpingectomy decreases ovarian cancer risk and is safe at CD, there is a racial disparity in bilateral salpingectomy utilization. While the cause of this disparity is unclear, further research is warranted to determine root causes and equitable solutions.

Key Points
Delayed Cord Clamping Uptake and Outcomes for Infants Born Very Preterm in California
Authors: Quinn Mary K. , Katheria Anup , Bennett Mihoko , Lu Tianyao , Lee Henry
Published: November 2022

Objective The aim of this study is to investigate whether the purported benefits of delayed cord clamping (DCC) translate into a reduction in mortality and intraventricular hemorrhage (IVH) among preterm neonates in practice.

Study Design This was a prospective cohort study of very preterm infants constructed from data from the California Perinatal Quality Care Collaborative for infants admitted into 130 California neonatal intensive care units (NICUs) within the first 28 days of life from 2016 through 2020. Individual-level analyses were conducted using log-binomial regression models controlling for confounders and allowing for correlation within hospitals to examine the relationship of DCC to the outcomes of mortality and IVH. Hospital-level analyses were conducted using Poisson regression models with robust variance controlling for confounders.

Results Among 13,094 very preterm infants included (5,856 with DCC and 7,220 without), DCC was associated with a 43% lower risk of mortality (adjusted risk ratio [aRR]: 0.57; 95% confidence interval [CI]: 0.47–0.66). Furthermore, every 10% increase in the hospital rate of DCC among preterm infants was associated with a 4% lower hospital mortality rate among preterm infants (aRR: 0.96; 95% CI: 0.96–0.99). DCC was associated with severe IVH at the individual level, but not at the hospital level.

Conclusion At the individual level and hospital level, the use of DCC was associated with lower mortality among preterm infants admitted to NICUs in California. These findings are consistent with clinical trial results, suggesting that the effects of DCC seen in clinical trials are translating to improved survival in practice.

Key Points
Intrapartum Risk Factors and Prediction of Obstetric Hemorrhage–Related Morbidity
Authors: Abbas Diana , Wang Michelle J. , Claus Lindsey , Alexander Megan , Srivastava Akanksha , Young Sara , Tummala Swetha , Iverson Ronald , Yarrington Christina , Comfort Ashley
Published: November 2022

Objective The aim of this study was to assess whether inclusion of intrapartum risk factors improves our obstetric hemorrhage risk stratification tool in predicting obstetric hemorrhage, transfusion, and related severe morbidity.

Study Design This is a retrospective cohort study using all live deliveries at a single institution over a 2-year period (n = 5,332). Obstetric hemorrhage risk factors, hemorrhage burden, and severe maternal morbidity index outcomes were assessed through chart abstraction. Hemorrhage risk was assessed at (1) “time of admission” through chart abstraction and (2) “predelivery” by calculation after inclusion of all abstracted intrapartum risk factors. Admission high risk was compared with predelivery high risk for sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio in predicting obstetric hemorrhage, obstetric hemorrhage requiring transfusion, and obstetric hemorrhage–related severe morbidity. Significance levels were calculated using descriptive statistical methods including chi-squared tests and McNemar's tests.

Results The sensitivities of the risk assessment tool using admission risk classification for high-risk patients is 25% for obstetric hemorrhage, 37% for obstetric hemorrhage requiring transfusion, and 22% for obstetric hemorrhage–related severe morbidity. After intrapartum factor inclusion, the sensitivities increase to 55% for obstetric hemorrhage, 59% for obstetric hemorrhage requiring transfusion, and 47% for obstetric hemorrhage–related severe morbidity. This “predelivery” risk assessment is significantly more sensitive across all three end points (p < 0.001 for all three outcomes). While the positive likelihood ratios for obstetric hemorrhage are equal on admission and predelivery (2.10 on admission and predelivery), they increase after intrapartum factor inclusion for obstetric hemorrhage requiring transfusion and obstetric hemorrhage–related severe morbidity (on admission, 2.74 and 1.6, respectively, and predelivery: 4.57 and 3.58, respectively).

Conclusion Inclusion of intrapartum risk factors increases the accuracy of this obstetric hemorrhage risk stratification tool in predicting patients requiring hemorrhage management with transfusion and obstetric hemorrhage–related severe morbidity.

Key Points
Diagnostic reasoning in neurogenetics: a general approach
Authors: Fussiger Helena , Pedroso José Luiz , Saute Jonas Alex Morales
Published: November 2022

Establishing the definitive diagnosis of a neurogenetic disease is usually a complex task. However, like any type of clinical diagnostic reasoning, an organized process of development and consideration of diagnostic hypotheses may guide neurologists and medical geneticists to solve this difficult task. The aim of the present review is to propose a general method for diagnostic reasoning in neurogenetics, with the definition of the main neurological syndrome and its associated topographical diagnosis, followed by the identification of major and secondary neurological syndromes, extraneurological findings, and inheritance pattern. We also discuss general rules and knowledge requirements of the ordering physician to request genetic testing and information on how to interpret genetic variants in a genetic report. By guiding the requests for genetic testing according to an organized model of diagnostic reasoning and with the availability of specific treatments, clinicians may find greater resoluteness and efficacy in the diagnostic investigation, shortening the struggle of patients for a definitive diagnosis.
Bioflavonoid exerts analgesic and anti-inflammatory effects via transient receptor potential 1 channel in a rat model
Authors: Zarei Mohammad Mahdi , Abdolmaleki Zohreh , Shahidi Siamak
Published: November 2022

Background Pain is an uncomfortable sensation in the body. Kaempferol is a flavonoid with antinociceptive effects. Transient receptor potential (TRP) channels have been characterized in the sensory system.

Objective This study evaluated the central antinociceptive effect of Kaempferol and possible mechanisms of action of transient receptor potential cation channel subfamily V member 1 (TRPV1).

Methods Capsaicin as a TRPV agonist (5 μg/μL, intracerebroventricular [ICV]) and capsazepine as its antagonist (10 μg/μL, icv) were used to test the analgesic effect of kaempferol (1.5 mg, ICV). Morphine (10 μg, ICV) was used as a positive control. The other groups were treated with a combination of kaempferol and capsaicin, kaempferol and capsazepine, and capsaicin and capsazepine. The cannula was implanted in the cerebroventricular area. The tail-flick, acetic acid, and formalin tests were used to assess analgesic activity. For evaluation of antiinflammatory effect, the formalin-induced rat paw edema was used.

Results Kaempferol significantly decreased pain in the acute pain models, including the tail-flick and the first phase of the formalin test. In the late phase of the formalin test, as a valid model of nociception, capsazepine inhibited the antinociceptive effect of kaempferol.

Conclusions Kaempferol has an analgesic effect in the acute pain model and can affect inflammatory pain. Also, the TRPV1 channel plays a role in the antinociceptive activity of kaempferol.
Symptomatic Radial-Sided Tears of the Triangular Fibrocartilage Complex: An All-Arthroscopic Repair Using Bone Anchors
Authors: Choudhury Muntasir M. , Yap Robert T. J. , Chia Dawn S. Y. , Sajeev Suraj , Alizada Ghulam S. , Jiang Jackson K. H.
Published: November 2022

Radial-sided tears of the triangular fibrocartilage, though uncommon, can still be a reason for ulnar-sided wrist pain, and, at times, instability of the distal radioulnar joint. Historically, it has been believed that because of the paucity of vascularity along the radial edge of the triangular fibrocartilage complex (TFCC), any form of repair will not lead to healing, thus stating it to be an exercise in futility. Current literature deftly argues against this previously prevailing concept and supports the need of repair in case of symptomatic radial-sided TFCC tears. In our study, we describe an all-arthroscopic technique of repairing radial-sided tears using a bone anchor which can be a fast and simple procedure in the hands of an orthopaedic or hand surgeon trained in arthroscopy. This technique also circumvents the risk of injuring the superficial radial nerve and other radial-sided structures which are stated complications of the current arthroscopic repairs.