bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Chemical Compositions Between Two Fast Growing Species: Acacia mangium and Leucaena leucochephala
Authors: Rasat M S M , Amin M F M , Ahmad M I , Noor A M , Sobri S A , Hermawan A , Amini M H M , Geng B J , Amin M A M , Chotikhan A
Published: September 2021

Acacia mangium and Leuceana leucocephala are both exotic species known to be planted in Malaysia. Both species are well known to possess high growth rate, therefore made as reforestation species as well as a popular resource for pulp and paper industry. The main objectives of this study are to determine the chemical compositions of small diameter wild Acacia mangium and Leucaena leucocephala species and to compare that properties between of them at three (3) different stem portions (bottom, middle and top) and two (2) different parts (bark and wood). All analyses were done according to TAPPI standard method, except hemicellulose (Wise et al.) and holocellulose (formula). All the data and results were statistically analyzed using ANOVA and Tukey’s Post Hoc test. Results revealed alcohol-toluene solubles was highest in bottom portion of Acacia mangium bark (14.98%). Holocellulose can be found highest in middle portion of Leuceana leucocephala wood (90.61%). For α-cellulose, highest was in Leuceana leucocephala bark (69.36%). Hemicellulose was most abundant in Acacia mangium top portion of wood (36.14%), while highest lignin was in its bottom portion of bark (31.18%). ANOVA indicates there are statistically high significance between species for all chemical composition, but between portions, only alcohol-toluene soluble and holocellulose are significant. For parts, all chemical composition is significant, except for lignin. This study proved that small diameter wild Acacia mangium and Leuceana leucocephala as a viable resource for pulp and paper industry.
Investigation on the water vapor oxidation of Super304H at 600 ℃
Authors: Zhao Zhoufeng , Zhang Jie , Luo Hongjian , Chen Xiaolin , Zou Junwen , Zhou Zhen , Wan Qiang , Zhang Jun
Published: September 2021

Steam oxidation is the main limited factor for the heat-resistant steel in fossil power plant. Disclosing the oxidation mechanism and kinetics could be helpful for the daily inspection to ensure the safety operation. To investigate the water vapor oxidation behavior of Super304H, the oxidation test was conducted at 600 ℃ for 25, 50, 100, 150 and 200 h in flowing steam. The structure and compositions of the oxide layers were investigated by line-scanning of scanning electron microscopy (SEM) equipped with energy dispersive spectroscopy (EDS). Surface morphology was observed after the oxidation test. The oxide phases were identified by XRD. The results showed that the oxide layer was duplex structure consisted of a Fe3O4 - Fe2O3 outer layer and an inner oxide layer which contained nickel oxide, Cr2O3, and FeCr2O4. As the oxidation time increased, the thickness of the total oxide layer and inner layer both increased. After 100 h oxidation, oxide layer exfoliation occurred and resulted in rapid growth of new oxide layer in the exfoliation region.
Pre-breakdown to stable phase and origin of multiple current pulses in argon dielectric barrier discharge
Authors: GAUTAM Saurav , MORRA Gabriele
Published: September 2021

We report on the results of numerical models of the (i) initial growth and (ii) steady state phases of atmospheric-pressure homogeneous dielectric barrier discharge in argon. We employ our new in-house code called PyDBD, which solves continuity equations for both particles and energy, shows exceptional stability, is accelerated by adaptive time stepping and is openly available to the scientific community. Modeling argon plasma is numerically challenging due to the lower speeds of more inertial ions compared to more commonly modeled neon and helium, but its common use for plasma jets in medicine makes its modeling compelling. PyDBD is here applied to modeling two setups: (i) the exponential growth from natural electron-ion seeds (onset phase) until saturation is reached and (ii) the multiple current pulses that naturally appear during the steady state phase. We find that the time required for the onset phase, when the plasma density grows from 109 m−3 to 1017 m−3, varies from 80 μs at 4.5 kV down to a few μs above 6.5 kV, for voltage frequency f = 80 kHz and gap width d
g = 0.9 mm. At the steady state, our model reproduces two previously observed features of the current in dielectric barrier discharge reactors: (1) an oscillatory behavior associated to the capacitative character of the circuit and (2) several (N
p) current pulses occurring every half sinusoidal cycle. We show that the oscillations are present during the exponential growth, while current pulses appear approaching the steady state. After each micro-discharge, the gas voltage decreases abruptly and charged particles rapidly accumulate at the dielectric boundaries, causing avalanches of charged particles near the reactor boundaries. Finally, we run a parametric study finding that N
p increases linearly with voltage amplitude V
amp, is inversely proportional to dielectric gap d
g and decreases when voltage frequency f increases. The code developed for this publication is freely available at the address https://github.com/gabersyd/PyDBD.
The enigma and implications of brain hemispheric asymmetry in neurodegenerative diseases
Authors: Lubben Noah , Ensink Elizabeth , Coetzee Gerhard A , Labrie Viviane
Published: September 2021

The lateralization of the human brain may provide clues into the pathogenesis and progression of neurodegenerative diseases. Though differing in their presentation and underlying pathologies, neurodegenerative diseases are all devastating and share an intriguing theme of asymmetrical pathology and clinical symptoms. Parkinson’s disease, with its distinctive onset of motor symptoms on one side of the body, stands out in this regard, but a review of the literature reveals asymmetries in several other neurodegenerative diseases. Here, we review the lateralization of the structure and function of the healthy human brain and the common genetic and epigenetic patterns contributing to the development of asymmetry in health and disease. We specifically examine the role of asymmetry in Parkinson’s disease, Alzheimer’s disease, amyotrophic lateral sclerosis, and multiple sclerosis, and interrogate whether these imbalances may reveal meaningful clues about the origins of these diseases. We also propose several hypotheses for how lateralization may contribute to the distinctive and enigmatic features of asymmetry in neurodegenerative diseases, suggesting a role for asymmetry in the choroid plexus, neurochemistry, protein distribution, brain connectivity and the vagus nerve. Finally, we suggest how future studies may reveal novel insights into these diseases through the lens of asymmetry.
Photodynamic therapy accelerates skin wound healing through promoting re-epithelialization
Authors: Yang Zengjun , Hu Xiaohong , Zhou Lina , He Yaxiong , Zhang Xiaorong , Yang Jiacai , Ju Zhenyu , Liou Yih-Cherng , Shen Han-Ming , Luo Gaoxing , Hamblin Michael R , He Weifeng , Yin Rui
Published: September 2021

Background

Epidermal stem cells (EpSCs) that reside in cutaneous hair follicles and the basal layer of the epidermis are indispensable for wound healing and skin homeostasis. Little is known about the effects of photochemical activation on EpSC differentiation, proliferation and migration during wound healing. The present study aimed to determine the effects of photodynamic therapy (PDT) on wound healing in vivo and in vitro.

Methods

We created mouse full-thickness skin resection models and applied 5-aminolevulinic acid (ALA) for PDT to the wound beds. Wound healing was analysed by gross evaluation and haematoxylin–eosin staining in vivo. In cultured EpSCs, protein expression was measured using flow cytometry and immunohistochemistry. Cell migration was examined using a scratch model; apoptosis and differentiation were measured using flow cytometry.

Results

PDT accelerated wound closure by enhancing EpSC differentiation, proliferation and migration, thereby promoting re-epithelialization and angiogenesis. PDT inhibited inflammatory infiltration and expression of proinflammatory cytokines, whereas the secretion of growth factors was greater than in other groups. The proportion of transient amplifying cells was significantly greater in vivo and in vitro in the PDT groups. EpSC migration was markedly enhanced after ALA-induced PDT.

Conclusions

Topical ALA-induced PDT stimulates wound healing by enhancing re-epithelialization, promoting angiogenesis as well as modulating skin homeostasis. This work provides a preliminary theoretical foundation for the clinical administration of topical ALA-induced PDT in skin wound healing.
Distinct gene expression dynamics in germ line and somatic tissue during ovariole morphogenesis in Drosophila melanogaster
Authors: Tarikere Shreeharsha , Ylla Guillem , Extavour Cassandra G
Published: September 2021

The survival and evolution of a species is a function of the number of offspring it can produce. In insects, the number of eggs that an ovary can produce is a major determinant of reproductive capacity. Insect ovaries are made up of tubular egg-producing subunits called ovarioles, whose number largely determines the number of eggs that can be potentially laid. Ovariole number in Drosophila is directly determined by the number of cellular structures called terminal filaments, which are stacks of cells that assemble in the larval ovary. Elucidating the developmental and regulatory mechanisms of terminal filament formation is thus key to understanding the regulation of insect reproduction through ovariole number regulation. We systematically measured mRNA expression of all cells in the larval ovary at the beginning, middle, and end of terminal filament formation. We also separated somatic and germ line cells during these stages and assessed their tissue-specific gene expression during larval ovary development. We found that the number of differentially expressed somatic genes is highest during the late stages of terminal filament formation and includes many signaling pathways that govern ovary development. We also show that germ line tissue, in contrast, shows greater differential expression during early stages of terminal filament formation, and highly expressed germ line genes at these stages largely control cell division and DNA repair. We provide a tissue-specific and temporal transcriptomic dataset of gene expression in the developing larval ovary as a resource to study insect reproduction.
Feasibility Randomized Controlled Trial of a Mind–Body Activity Program for Older Adults With Chronic Pain and Cognitive Decline: The Virtual “Active Brains” Study
Authors: Doorley James D , Mace Ryan A , Popok Paula J , Grunberg Victoria A , Ragnhildstveit Anya , Vranceanu Ana-Maria
Published: September 2021

Background and Objectives

Chronic pain (CP) and cognitive decline (CD) are highly comorbid and debilitating among older adults. We iteratively developed Active Brains–Fitbit (AB-F), a group mind–body activity program aided by a Fitbit that is feasible and associated with improvements in physical, cognitive, and emotional functioning when delivered in-person to older adults with CP and CD. We adapted our intervention and methodology for remote delivery to bypass barriers to participation. Here we report on a feasibility randomized controlled trial of the virtual AB-F versus a Health Enhancement Program (HEP) educational control followed by qualitative exit interviews.

Research Design and Methods

Older adults (aged ≥60) with CP and CD (2 cohorts) completed 8 weeks of AB-F (n = 8) or HEP (n = 11). Study procedures were fully remote via live video. Quantitative analyses explored feasibility and acceptability markers and within-group improvements in outcomes. Qualitative analyses were primarily deductive using the Framework Method.

Results

AB-F met a priori set feasibility benchmarks, similar to our in-person pilot. Participation in AB-F was associated with preliminary signals of improvement in multimodal physical function, emotional function (anxiety), cognitive function, pain intensity, and coping (e.g., pain self-efficacy, catastrophizing). Participation in HEP was associated with smaller or negligible improvements. Exit interviews confirmed feasibility and satisfaction with our completely remote interventions and methodology.

Discussion and Implications

Results provide evidence for the feasibility of our completely remote study and for initial markers of improvement after AB-F. The results will inform a fully powered remote efficacy trial.

Clinical Trial Registration

NCT04044183.
Diel Patterns of Pheromone Release by Male Sea Lamprey
Authors: Fissette Skye D , Bussy Ugo , Huerta Belinda , Brant Cory O , Li Ke , Johnson Nicholas S , Li Weiming
Published: September 2021

Costs to producing sexual signals can create selective pressures on males to invest signaling effort in particular contexts. When the benefits of signaling vary consistently across time, males can optimize signal investment to specific temporal contexts using biological rhythms. Sea lamprey, Petromyzon marinus, have a semelparous life history, are primarily nocturnal, and rely on pheromone communication for reproduction; however, whether male investment in pheromone transport and release matches increases in spawning activity remains unknown. By measuring (1) 3keto-petromyzonol sulfate (3kPZS, a main pheromone component) and its biosynthetic precursor PZS in holding water and tissue samples at six points over the course of 24 hours and (2) 3kPZS release over the course of several days, we demonstrate that 3kPZS release exhibits a consistent diel pattern across several days with elevated pheromone release just prior to sunset and at night. Trends in hepatic concentrations and circulatory transport of PZS and 3kPZS were relatively consistent with patterns of 3kPZS release and suggest the possibility of direct upregulation in pheromone transport and release rather than observed release patterns being solely a byproduct of increased behavioral activity. Our results suggest males evolved a signaling strategy that synchronizes elevated pheromone release with nocturnal increases in sea lamprey behavior. This may be imperative to ensure that male signaling effort is not wasted in a species having a single, reproductive event.
B Part of It School Leaver Study: A Repeat Cross-Sectional Study to Assess the Impact of Increasing Coverage With Meningococcal B (4CMenB) Vaccine on Carriage of Neisseria meningitidis
Authors: McMillan Mark , Koehler Ann P , Lawrence Andrew , Sullivan Thomas R , Bednarz Jana , MacLennan Jenny M , Maiden Martin C J , Ladhani Shamez N , Ramsay Mary E , Trotter Caroline , Borrow Ray , Finn Adam , Kahler Charlene M , Whelan Jane , Vadivelu Kumaran , Richmond Peter C , Marshall Helen S
Published: September 2021

Background

Recombinant protein-based vaccines targeting serogroup B meningococci protect against invasive disease but impacts on carriage are uncertain. This study assessed carriage prevalence of disease-associated meningococci in 2018–2020 as the proportion of vaccinated adolescents increased following introduction of a school-based 4CMenB immunization program.

Methods

Eligible participants who completed high school (aged 17–25) in South Australia in the previous year had an oropharyngeal swab taken and completed a risk factor questionnaire. Disease-associated meningococci (genogroups A, B, C, W, X, Y) were detected by meningococcal and genogroup-specific polymerase chain reaction.

Results

The analysis included 4104 participants in 2018, 2690 in 2019, and 1338 in 2020. The proportion vaccinated with 4CMenB increased from 43% in 2018, to 78% in 2019, and 76% in 2020. Carriage prevalence of disease-associated meningococci in 2018 was 225/4104 (5.5%). There was little difference between carriage prevalence in 2019 (134/2690, 5.0%; adjusted odds ratio [aOR], 0.82; 95% confidence interval [CI], .64–1.05) and 2020 (68/1338, 5.1%; aOR, 0.82; 95% CI, .57–1.17) compared to 2018.

Conclusions

Increased 4CMenB uptake in adolescents was not associated with decline in carriage of disease-associated meningococci. 4CMenB immunization programs should focus on direct (individual) protection for groups at greatest risk of disease.

Clinical Trials Registration

NCT03419533.
Two-dimensional deep learning inversion of magnetotelluric sounding data
Authors: Liu Wei , Xi Zhenzhu , Wang He , Zhang Rongqing
Published: September 2021

Conventional linear iterative methods for magnetotelluric sounding (MT) suffer from considerable limitations related to difficulties in selecting the initial model and local optima. On the other hand, conventional intelligent nonlinear methods exhibit slow convergence and low accuracy. In this study, we propose an inversion strategy based on the deep learning (DL) deep belief network (DBN) to realise the instantaneous inversion of MT data. A scaled momentum learning rate is introduced to improve the convergence performance of the restricted Boltzmann machine during the DBN pre-training stage, and a novel activation function (DSoft) is introduced to enhance the global optimisation capability during the DBN fine-tuning stage. To address the difficulty in designing the sample data when prior information is lacking, we employ the k-means++ algorithm to cluster the MT field data and use the clustering results as the prior information to guide the construction of the sample dataset. Then, based on the proposed DBN, we ensure end-to-end mapping directly from the apparent resistivity to the resistivity model. We implement two groups of experiments to demonstrate the validity of both improvements on the DBN. We consider six types of geoelectric model from the test set to demonstrate the feasibility and effectiveness of the proposed DBN method for MT 2D inversion, which we further compare with the well-known least-square regularisation method for several extended geoelectric models and field data. The qualitative and quantitative analyses show that the DL inversion method is promising as it can accurately delineate the subsurface structures and perform rapid inversion.
Environmental–biomechanical reciprocity and the evolution of plant material properties
Authors: Niklas Karl J , Telewski Frank W
Published: September 2021

Abiotic–biotic interactions have shaped organic evolution since life first began. Abiotic factors influence growth, survival, and reproductive success, whereas biotic responses to abiotic factors have changed the physical environment (and indeed created new environments). This reciprocity is well illustrated by land plants who begin and end their existence in the same location while growing in size over the course of years or even millennia, during which environment factors change over many orders of magnitude. A biomechanical, ecological, and evolutionary perspective reveals that plants are (i) composed of materials (cells and tissues) that function as cellular solids (i.e. materials composed of one or more solid and fluid phases); (ii) that have evolved greater rigidity (as a consequence of chemical and structural changes in their solid phases); (iii) allowing for increases in body size and (iv) permitting acclimation to more physiologically and ecologically diverse and challenging habitats; which (v) have profoundly altered biotic as well as abiotic environmental factors (e.g. the creation of soils, carbon sequestration, and water cycles). A critical component of this evolutionary innovation is the extent to which mechanical perturbations have shaped plant form and function and how form and function have shaped ecological dynamics over the course of evolution.
Gravitomagnetic vorticity generation in black hole accretion discs: a potential spatial constraint on plasma flow stability
Authors: Bhattacharjee Chinmoy , Stark David J
Published: September 2021

We calculate the vorticity generation rate in the accretion disc near a slowly rotating black hole in the low-velocity, weak-field limit of general relativity. Specifically, we find that the frame-dragging effect due to the black hole’s rotation – manifested through the gravitomagnetic field – can generate vorticity in a moving plasma in the accretion disc. The mechanism remains operational as long as the accretion disc has non-negligible vertical height and is independent of the exact thermodynamical profile of the disc. The enstrophy density generation rate, as a measure of turbulence and dissipation, is presented, which indicates that the frame-dragging effect can disrupt the stability of the disc away from the z = 0 plane.
Microbes: a potential tool for selenium biofortification
Authors: Yang Dandan , Hu Chengxiao , Wang Xu , Shi Guangyu , Li Yanfeng , Fei Yuchen , Song Yinran , Zhao Xiaohu
Published: September 2021

Selenium (Se) is a component of many enzymes and indispensable for human health due to its characteristics of reducing oxidative stress and enhancing immunity. Human beings take Se mainly from Se-containing crops. Taking measures to biofortify crops with Se may lead to improved public health. Se accumulation in plants mainly depends on the content and bioavailability of Se in soil. Beneficial microbes may change the chemical form and bioavailability of Se. This review highlights the potential role of microbes in promoting Se uptake and accumulation in crops and the related mechanisms. The potential approaches of microbial enhancement of Se biofortification can be summarized in the following four aspects: (1) microbes alter soil properties and impact the redox chemistry of Se to improve the bioavailability of Se in soil; (2) beneficial microbes regulate root morphology and stimulate the development of plants through the release of certain secretions, facilitating Se uptake in plants; (3) microbes upregulate the expression of certain genes and proteins that are related to Se metabolism in plants; and (4) the inoculation of microbes give rise to the generation of certain metabolites in plants contributing to Se absorption. Considering the ecological safety and economic feasibility, microbial enhancement is a potential tool for Se biofortification. For further study, the recombination and establishment of synthesis microbes is of potential benefit in Se-enrichment agriculture.
Increased Smoking Cessation Among Veterans With Large Decreases in Posttraumatic Stress Disorder Severity
Authors: Salas Joanne , Gebauer Sarah , Gillis Auston , van den Berk-Clark Carissa , Schneider F David , Schnurr Paula P , Friedman Matthew J , Norman Sonya B , Tuerk Peter W , Cohen Beth E , Lustman Patrick J , Scherrer Jeffrey F
Published: September 2021

Introduction

Improvement in posttraumatic stress disorder (PTSD) is associated with better health behavior such as better medication adherence and greater use of nutrition and weight loss programs. However, it is not known if reducing PTSD severity is associated with smoking cessation, a poor health behavior common in patients with PTSD.

Aims and Methods

Veterans Health Affairs (VHA) medical record data (2008–2015) were used to identify patients with PTSD diagnosed in specialty care. Clinically meaningful PTSD improvement was defined as ≥20 point PTSD Checklist (PCL) decrease from the first PCL ≥50 and the last available PCL within 12 months and at least 8 weeks later. The association between clinically meaningful PTSD improvement and smoking cessation within 2 years after baseline among 449 smokers was estimated in Cox proportional hazard models. Entropy balancing controlled for confounding.

Results

On average, patients were 39.4 (SD = 12.9) years of age, 86.6% were male and 71.5% were white. We observed clinically meaningful PTSD improvement in 19.8% of participants. Overall, 19.4% quit smoking in year 1 and 16.6% in year 2. More patients with versus without clinically meaningful PTSD improvement stopped smoking (n = 36, cumulative incidence = 40.5% vs. 111, cumulative incidence = 30.8%, respectively). After controlling for confounding, patients with versus without clinically meaningful PTSD improvement were more likely to stop smoking within 2 years (hazard ratio = 1.57; 95% confidence interval: 1.04–2.36).

Conclusions

Patients with clinically meaningful PTSD improvement were significantly more likely to stop smoking. Further research should determine if targeted interventions are needed or whether improvement in PTSD symptoms is sufficient to enable smoking cessation.

Implications

Patients with PTSD are more likely to develop chronic health conditions such as heart disease and diabetes. Poor health behaviors, including smoking, partly explain the risk for chronic disease in this patient population. Our results demonstrate that clinically meaningful PTSD improvement is followed by greater likelihood of smoking cessation. Thus, PTSD treatment may enable healthier behaviors and reduce risk for smoking-related disease.
Acute Q Fever With Dermatologic Manifestations, Molecular Diagnosis, and No Seroconversion
Authors: Uribe Pulido Natalí , Escorcia García Clara , Cabrera Orrego Ruth , Gutiérrez Lina Andrea , Agudelo Carlos Andrés
Published: September 2021

We herein described a case of acute infection by Coxiella burnetii (acute Q fever) that started with a short incubation period and showed prominent dermatological manifestations and unusual serological behavior. The infection was confirmed by molecular detection through real-time polymerase chain reaction using genomic DNA collected from peripheral blood.
Understanding Tax Policy: How do People Reason?
Authors: Stantcheva Stefanie
Published: September 2021

I study how people understand, reason, and learn about two major tax policies: income taxation and estate taxation. Using large-scale social economics surveys issued to representative U.S. samples and associated experiments, I elicit respondents’ factual knowledge about tax policy and the income or wealth distributions. Most important, I study their understanding of the mechanisms of tax policy and the reasoning that underlies their policy views. In decomposing policy views, I find that support for income and estate taxes is most strongly correlated with social preferences, that is, the perceived benefits of redistribution and concerns around the fairness of inequality and taxation, as well as with broader views of the government. Efficiency concerns play a more minor role. These correlational patterns are confirmed by the experimental approach, which shows people instructional videos that explain the workings and consequences of one of the aspects of tax policy (the Redistribution and the Efficiency treatments) or that bring the two together and focus on the trade-off (the Economist treatment). The Redistribution and Economist treatments significantly increase support for more progressive income or estate taxes, while the Efficiency treatment has no effect. There are large partisan gaps in both the final policy views and at every step of the reasoning about the underlying mechanisms of taxes. Democrats’ and Republicans’ divergences in tax policy views can ultimately be traced back to different normative criteria (social preferences) and views of the government, rather than to different perceptions of the efficiency implications of taxation.
Glucocorticoid dosing and relapses in giant cell arteritis—a single centre cohort study
Authors: Felten Laura , Leuchten Nicolai , Aringer Martin
Published: September 2021

Objective

To investigate the relationship between real life glucocorticoid (GC) dosing and relapse rates in patients with new onset GCA in a single centre.

Methods

Complete clinical data taken from the inpatient and outpatient records of consecutive GCA patients followed beyond stopping GC were retrospectively analysed for GC doses, other immunomodulatory agents and relapses.

Results

We included 54 patients with GCA confirmed by biopsy or imaging and followed over their complete GC course. In the 25% dose percentile, patients who needed no pulse therapy at onset reached a dose of 15 mg prednisolone or lower at day 40, of 7.5 mg prednisolone or lower on day 169 (after 24 weeks), and were off prednisolone on day 496 (70 weeks). They were below British Society for Rheumatology recommended doses between week 4 and week 12 and above these after week 14. The cumulative prednisolone dose reached in this 25% quartile was 3.74 g. Of the 54 patients, 24 (44%) relapsed, only four of whom had stopped GC clearly (17–58 weeks) earlier than the 25% dose quartile and one was distinctly (>10%) below the 25% GC percentile. MTX treatment was not significantly associated with fewer relapses (P = 0.178).

Conclusion

Despite a long-term GC regimen with slow rates of reduction in the low dose range and high cumulative prednisolone doses, 44% of the patients relapsed. Only five (21%) of these relapses may have been prevented by adhering to the recommended GC regimen.
To mix or not to mix in allergy immunotherapy vaccines
Authors: Nelson Harold S.
Published: September 2021

Purpose of review

European and US allergists generally do not agree on the approach to subcutaneous allergy immunotherapy in patients with multiple allergies. The North American approach is to treat with a mixture that contains all the allergen extracts to which the patient has evident clinical sensitivity, whereas the European approach is to select for treatment the one or at the most two allergens that are clinically most important for the patient.

Recent findings

Recent society guidelines continue to recommend these differing practices of treating the polyallergic patient and reviews of prescribing practices indicate these divergent recommendations are followed in Europe and the USA.

The objections by European allergists to the practice by US allergists are that multiallergen immunotherapy leads to dilution of allergens to less than effective doses, that proteases in some extracts can degrade allergens in other extracts, that there is a problem of safety and inability to determine which component extract caused a systemic reaction, and finally that there is alack of convincing studies demonstrating efficacy of multiallergen mixtures. Each of these contentions is addressed.
Implementation of a Geriatrics-Focused Orthopaedic and Hospitalist Fracture Program Decreases Perioperative Complications and Improves Resource Utilization
Authors: Bub Christine , Stapleton Erik , Iturriaga Cesar , Garbarino Luke , Aziz Hadi , Wei Nicole , Mota Frank , Goldin Mark Eliot , Sinvani Liron Danay , Carney Maria Torroella , Goldman Ariel
Published: September 2021

Objective:

To evaluate whether the implementation of a geriatrics-focused orthopaedic and hospitalist comanagement program can improve perioperative outcomes and decrease resource utilization.

Design:

A retrospective chart review study was conducted before and after the implementation of a geriatrics-focused orthopaedic and hospitalist comanagement program, based on the American Geriatrics Society (AGS) AGS CoCare:Ortho.

Setting:

A large urban, academic tertiary center, located in the greater New York metropolitan area.

Participants:

Patients 65 years and older hospitalized for operative hip fracture. Those with pathologic or periprosthetic fractures and chronic substance use were excluded.

Main Outcome Measurements:

Outcome measures included time to operating room (TtOR), length of stay, daily and total morphine milligram equivalents, use of preoperative transthoracic echocardiogram and blood transfusions, perioperative complications (eg, urinary tract infections), and 6-month mortality.

Results:

Our study included 290 patients hospitalized with hip fracture, before (N = 128) and after (N = 162) implementation. When compared with the preimplementation group, the postimplementation comanagement group had a lower TtOR (36.2 vs. 30.0 hours, P = 0.026) and hospital length of stay, decreased use of indwelling bladder catheters preoperatively and postoperatively (68.0% vs. 46.9%, P < 0.001, and 83.6 vs. 58.0%, P < 0.001, respectively), reduced daily opiate use (16.0 vs. 11.1 morphine milligram equivalents, P = 0.011), and decreased 30-day complications (32.8% vs. 16.7%, P = 0.002). There was no difference in 6-month mortality between the 2 groups.

Conclusions:

The implementation of an AGS CoCare:Ortho-based comanagement program led to decreased perioperative complications and resource utilization. Comanagement programs are essential to improving and standardizing hip fracture care for older adults.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Art and Pediatric Orthopaedics: Cot and the Crutch
Authors: Rebello Gleeson , Joseph Benjamin
Published: September 2021

Pierre Auguste Cot’s painting, “Mireille giving alms at the door of Saint-Trophime,” depicts a wealthy lady giving alms to a crippled beggar boy. The beautiful painting portrays the striking contrast between the rich and the poor. The painting also draws attention to the crude crutch the boy was using. This type of crutch was used over the centuries; improvements in the design of the axillary crutch occurred only in the 20th century.
Current treatments of medulloblastoma
Authors: Beccaria Kevin , Padovani Laetitia , Bouchoucha Yassine , Doz François
Published: September 2021

Purpose of review

The biological knowledge and the new biopathological classification of medulloblastoma subtypes have dramatically changed the therapeutic indications, taking into account not only age and staging but also biopathological risk criteria. This review covers the multidisciplinary approach including surgery, radiation oncology and medical treatments.

Recent findings

The neurosurgical management of tumor-related hydrocephalus has been modified by the introduction of third ventriculostomy. The initial complete excision is no longer always the first choice, to preserve neurological function. The recent technical improvements of radiotherapy are also implemented to optimize outcome in terms of survival as well as quality of survival. The different medical treatments are adapted according to age and risk factors. The role of high-dose chemotherapy with autologous hematopoietic stem cell rescue has become larger in the high-risk situations.

The rarity of the disease and the high-level of technicity of diagnosis, biopathological subtyping and treatments justifies the referral of these patients to highly specialized centers where all these techniques can be routinely applied, most often in the context of international prospective studies.
Macrophage exosomes transfer angiotensin II type 1 receptor to lung fibroblasts mediating bleomycin-induced pulmonary fibrosis
Authors: Sun Na-Na , Zhang Yue , Huang Wen-Hui , Zheng Bo-Jun , Jin Si-Yi , Li Xu , Meng Ying
Published: September 2021

Background:

Macrophages are involved in the pathogenesis of idiopathic pulmonary fibrosis, partially by activating lung fibroblasts. However, how macrophages communicate with lung fibroblasts is largely unexplored. Exosomes can mediate intercellular communication, whereas its role in lung fibrogenesis is unclear. Here we aim to investigate whether exosomes can mediate the crosstalk between macrophages and lung fibroblasts and subsequently induce fibrosis.

Methods:

In vivo, bleomycin (BLM)-induced lung fibrosis model was established and macrophages infiltration was examined. The effects of GW4869, an exosomes inhibitor, on lung fibrosis were assessed. Moreover, macrophage exosomes were injected into mice to observe its pro-fibrotic effects. In vitro, exosomes derived from angiotensin II (Ang II)-stimulated macrophages were collected. Then, lung fibroblasts were treated with the exosomes. Twenty-four hours later, protein levels of α-collagen I, angiotensin II type 1 receptor (AT1R), transforming growth factor-β (TGF-β), and phospho-Smad2/3 (p-Smad2/3) in lung fibroblasts were examined. The Student's t test or analysis of variance were used for statistical analysis.

Results:

In vivo, BLM-treated mice showed enhanced infiltration of macrophages, increased fibrotic alterations, and higher levels of Ang II and AT1R. GW4869 attenuated BLM-induced pulmonary fibrosis. Mice with exosomes injection showed fibrotic features with higher levels of Ang II and AT1R, which was reversed by irbesartan. In vitro, we found that macrophages secreted a great number of exosomes. The exosomes were taken by fibroblasts and resulted in higher levels of AT1R (0.22 ± 0.02 vs. 0.07 ± 0.02, t = 8.66, P = 0.001), TGF-β (0.54 ± 0.05 vs. 0.09 ± 0.06, t = 10.00, P < 0.001), p-Smad2/3 (0.58 ± 0.06 vs. 0.07 ± 0.03, t = 12.86, P < 0.001) and α-collagen I (0.27 ± 0.02 vs. 0.16 ± 0.01, t = 7.01, P = 0.002), and increased Ang II secretion (62.27 ± 7.32 vs. 9.56 ± 1.68, t = 12.16, P < 0.001). Interestingly, Ang II increased the number of macrophage exosomes, and the protein levels of Alix (1.45 ± 0.15 vs. 1.00 ± 0.10, t = 4.32, P = 0.012), AT1R (4.05 ± 0.64 vs. 1.00 ± 0.09, t = 8.17, P = 0.001), and glyceraldehyde-3-phosphate dehydrogenase (2.13 ± 0.36 vs. 1.00 ± 0.10, t = 5.28, P = 0.006) were increased in exosomes secreted by the same number of macrophages, indicating a positive loop between Ang II and exosomes production.

Conclusions:

Exosomes mediate intercellular communication between macrophages and fibroblasts plays an important role in BLM-induced pulmonary fibrosis.
Inhibition of GARS1-DT Protects Against Hypoxic Injury in H9C2 Cardiomyocytes via Sponging miR-212-5p
Authors: Li Xinning , Dang Yi
Published: September 2021

The present study aimed to elucidate the function of long noncoding RNA GARS1-DT in hypoxia-induced injury in ex-vivo cardiomyocytes and explore its underlying mechanism. Hypoxic injury was confirmed in H9C2 cells by the determination of cell viability, migration, invasion, and apoptosis. GARS1-DT expression was estimated in H9C2 cells after hypoxia. We then measured the effects of GARS1-DT knockdown on hypoxia-induced H9C2 cells. The interaction between GARS1-DT and miR-212-5p was also investigated. Hypoxia treatment led to cell damage in H9C2 cardiomyocytes, accompanied with the upregulation of GARS1-DT expression. Transfection of GARS1-DT small interfering RNA remarkably attenuated hypoxia-induced injury by enhancing cell viability, migration, and invasion, and reducing apoptosis. Furthermore, GARS1-DT served as an endogenous sponge for miR-212-5p, and its expression was negatively regulated by GARS1-DT. The effects of GARS1-DT knockdown on hypoxia-induced injury were significantly abrogated by miR-212-5p silence. Besides, suppression of GARS1-DT activated PI3K/AKT pathway in hypoxia-treated H9C2 cells, which were reversed by inhibition of miR-212-5p. Our findings demonstrated the novel molecular mechanism of GARS1-DT/miR-212-5p/PI3K/AKT axis on the regulation of hypoxia-induced myocardial injury in H9C2 cells, which may provide potential therapeutic targets for acute myocardial infarction treatment.
OCULAR ANGIOGRAPHIC FEATURES IN JAPANESE PATIENTS WITH VAL30MET HEREDITARY TRANSTHYRETIN AMYLOIDOSIS
Authors: Kakihara Shinji , Hirano Takao , Kitahara Junya , Matsuda Yorishige , Imai Akira , Miyahara Teruyoshi , Murata Toshinori
Published: September 2021

Purpose:

To investigate ocular angiographic features of hereditary transthyretin amyloidosis with transthyretin Val30Met mutation (hATTR-V30M) in Japanese patients.

Methods:

We retrospectively reviewed 102 eyes of 51 patients with hATTR-V30M who underwent fluorescein angiograms and indocyanine green angiograms between 2012 and 2018. Systemic severity score, fluorescein angiograms, indocyanine green angiograms, and ocular amyloidosis presentations at the final angiograms and subsequent neovascular events were evaluated. Primary outcomes were the frequency of choroidal amyloid angiopathy and retinal amyloid angiopathy (RAA). Secondary outcomes were their correlations to the systemic severity score.

Results:

Six eyes could not be evaluated by fluorescein angiogram because of vitreous opacity. Of 96 eyes evaluated, RAA was detected in 36 (37.5%). Neovascularization was not detected. Indocyanine green angiogram indicated choroidal amyloid angiopathy in 46/51 patients (90.2%), with distinct patterns―diffuse (n = 6), focal (n = 14), and punctiform (n = 26)―based on late-phase hypercyanescence. Retinal amyloid angiopathy and choroidal amyloid angiopathy grades were associated with systemic severity (ρ = 0.57 and 0.50, respectively; both P < 0.05). At 35.4 ± 28.4 (0–96) months, iris-rubeosis was observed in one eye and vitreous hemorrhage in two.

Conclusion:

Retinal amyloid angiopathy was less common and choroidal amyloid angiopathy was frequent, and their severity correlated with the systemic severity score. The frequencies of RAA and subsequent neovascular events in this study may suggest regional differences in the ocular angiographic features of hATTR-V30M.
Long-term Outcomes of Fibrin Glue–Assisted Intrascleral Haptic Fixation of Posterior Chamber Intraocular Lenses in Children
Authors: Sinha Rajesh , Asif Mohamed Ibrahime , Kalra Nidhi , Bansal Mayank , Chauhan Divya , Shekhar Himanshu , Sharma Namrata , Titiyal Jeewan S.
Published: September 2021

Objectives:

To evaluate the long-term outcomes of intrascleral haptic fixation of posterior chamber intraocular lens (PCIOL) with fibrin glue in children.

Methods:

This is a retrospective case study conducted in a tertiary eye institute in North India. A total of 118 eyes of 82 children who underwent glued intrascleral haptic fixation of PCIOLs were retrospectively analyzed. Detailed analysis of the indication for surgery and ocular and systemic associations was performed. The outcome measures included intraoperative complications, final visual and refractive outcomes, and postoperative complications.

Results:

The mean age of the patients was 10.16±3.94 years. Fifty-one patients (62.2%) were male and 31 (37.8%) were female. The mean follow-up period was 31.28±13.22 months. The mean preoperative corrected distance visual acuity was 1.18±0.63 Logarithm of Mean angle of resolution (logMAR) which improved to 0.60±0.58 logMAR postoperatively at 6 weeks (P<0.001). The mean preoperative and 6 weeks postoperative endothelial cell density were 3,176.08±318.6 and 2,936±289.9 cells/mm2, respectively (P=0.23). In the immediate postoperative period, corneal edema (19 eyes; 16.1%), decentered IOL/tilt (3 eyes; 2.54%), vitreous hemorrhage (3 eyes; 2.54%), optic capture (4 eyes; 3.38%), and hypotony (2 eyes; 1.69%) were seen. In the late postoperative period (>6 weeks), retinal detachment was observed in two eyes that had associated Marfan syndrome. Cystoid macular edema was seen in four eyes (3.38%), and glaucoma was seen in five eyes (4.23%).

Conclusions:

Fibrin glue–assisted intrascleral haptic fixation of a PCIOL is a safe and effective method to manage aphakia with inadequate capsular support in children.
Clinical outcomes of transepithelial photorefractive keratectomy with epithelial ablation targeting actual epithelial thickness vs default laser platform values
Authors: Hashemian Mohammad Naser , Faegh Adeleh , Latifi Golshan , Abdi Parisa
Published: September 2021

Purpose:

To investigate the clinical outcomes of transepithelial photorefractive keratectomy (tPRK) with actual epithelial thickness vs default software values.

Setting:

Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Design:

Prospective controlled study.

Methods:

Patients with refractive spherical error of −1.50 to −7.00 diopters (D) and refractive astigmatism up to 4.00 D were consecutively enrolled and divided into 2 groups: group 1 undergone tPRK with actual central and peripheral epithelial thickness input in right eyes, group 2 undergone tPRK with actual central and 10 mm higher peripheral epithelial thickness in right eyes. Left eyes in both groups underwent tPRK with default protocol. Outcome measures were induced refractive error, achieved optical zone (OZ), and wasted stromal tissue.

Results:

83 patients were included in this study. Mean ± SD of induced spherical equivalent was +0.15 ± 0.39 D and +0.01 ± 0.35 D in right and left eyes of group 1 (P = .01) and +0.04 ± 0.22 D and +0.03 ± 0.23 D in right and left eyes of group 2 (P = .75), respectively. There was no statistically significant difference between wasted tissue between right and left eyes in group 1 and group 2 (P = .77 and P = .49, respectively). OZ contraction was significantly higher in right compared with left eyes in group 1 (P = .05), but not in group 2 (P = .95).

Conclusions:

In tPRK, refractive outcomes, wasted tissue, and OZ contraction depend little on preexisting corneal epithelial thickness in corneas with normal range epithelial thickness. However, OZ contraction may be a concern in lower amount of ablations.
Use of P1-P4 Purkinje reflections as a surrogate sign for intraoperative patient fixation
Authors: Thompson Vance , Holladay Jack , Sretavan David
Published: September 2021

Circumferential, even anterior capsular overlap maximizes intraocular lens stability and posterior capsular opacification mitigation and provides best long-term outcomes for the cataract patient. P1 and P4 Purkinje reflections at patient fixation may provide a reliable marker for capsulotomy centration. However, patient fixation may be hindered during surgery because of anesthesia or light sensitivity. In this study, we demonstrate that the relationship between the P1 and P4 Purkinje reflections previewed prior to surgery when the patient is fixating may be recreated intraoperatively if fixation becomes difficult. The final position of P1 and P4 relative to one another at fixation is invariant in a given patient, but there are variations among patients. Knowledge of the P1 and P4 relationship can be used as a surrogate sign of patient fixation to assist in capsulotomy centration during cataract surgery.
Effect of decentration on the quality of vision: comparison between aspheric balance curve design and posterior aspheric design intraocular lenses
Authors: Chandra Kedarisetti Kiran , Malhotra Chintan , Jain Arun Kumar , Sachdeva Kulbhushan , Singh Shubhi
Published: September 2021

Purpose:

To study the effect of decentration on the quality of vision in 2 aspheric intraocular lenses (IOLs): aspheric balance curve (ABC) design Vivinex iSert XY1 (Hoya Surgical Opticals, Inc.) and posterior aspheric design AcrySof IQ SN60WF (Alcon Laboratories, Inc.)

Setting:

Advanced Eye Centre, PGIMER, Chandigarh, India.

Design:

Randomized prospective trial using a random number table.

Methods:

85 eyes were randomized to group 1 (Vivinex XY1) and group 2 (AcrySof IQ) with 40 and 45 eyes, respectively. The higher-order aberration (HOA) profile, Strehl ratio, decentration of the IOL from the visual axis (decentration from the visual axis [DVA]) and the geometric axis (decentration from the geometric axis [DGA]), angle α, and κ were recorded on the iTrace aberrometer, and contrast sensitivity was measured using the Functional Acuity Contrast Test at 12 weeks postsurgery.

Results:

A total of 85 eyes in 60 patients were evaluated in this study. The mean values of the Strehl ratio (P = .48) and the HOAs (P = .12) of both IOLs were comparable. The HOAs gradually increased with increasing DVA for both lenses at 3.0 mm, 4.0 mm, and 5.0 mm pupil sizes. On comparing the HOAs with the DGA, a statistically insignificant positive correlation was observed. The Strehl ratio did not deteriorate with an increasing angle α in the Vivinex XY1 group; however, it worsened in the AcrySof IQ group. Contrast sensitivity was comparable in both the IOLs except at 1.5 cycles per degree under photopic conditions where the AcrySof IQ was better.

Conclusions:

Decentration of the lens was best measured with respect to the visual axis. In eyes with a large α, the ABC design induced lesser HOAs and maintained a better Strehl ratio.