bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations Between Mental and Physical Health Conditions and Occupational Impairments in the U.S. Military
Authors: Dunbar Michael S , Schuler Megan S , Meadows Sarah O , Engel Charles C
Published: February 2021

Introduction

Prior studies have identified associations between specific health conditions and occupational impairments in the U.S. military, but little is known about the relative magnitude of impairments associated with different mental and physical health conditions among military service members. The goal of this study is to comparatively assess occupational impairment associated with mental and physical conditions among active duty military service members.

Materials and Methods

Data on 11,055 U.S. active duty service members were from the Department of Defense 2015 Health Related Behaviors Survey, an anonymous online health survey. Items assessed common mental and physical health conditions. Absenteeism was assessed as number of lost work days and presenteeism was assessed as number of work days with impaired functioning in the past 30 days. This research was approved by the RAND Human Subjects Protections Committee.

Results

Back pain (23%) and anxiety (14%) were the most prevalent conditions in the sample. Mental health conditions (anxiety, depression, and PTSD) were associated with more absentee and presentee days than physical conditions. Adjusting for physical health conditions, anxiety, depression, and PTSD showed robust associations with both absenteeism and presenteeism.

Conclusions

Common mental health conditions such as anxiety, depression, and PTSD showed robust associations with absenteeism and presenteeism among active duty U.S. military service members. Efforts to rigorously evaluate and improve existing military screening programs and reduce barriers to accessing and engaging in mental healthcare may help to reduce work absenteeism and presenteeism among active duty service members.
Radiatively-driven black hole winds revisited
Authors: Yamamoto R , Fukue J
Published: February 2021

We examine general relativistic radiatively-driven spherical winds, using the basic equations for relativistic radiation hydrodynamics under the moment formalism. Moment equations are often closed, using the equilibrium diffusion approximation, which has an acausal problem, and furthermore, gives nodal-type critical points. Instead, we use the non-equilibrium diffusion approximation with a closure relation of a variable Eddington factor, f(τ, β), where τ is the optical depth and β is the flow speed normalized by the speed of light. We then analyse the critical properties in detail for several parameters, and found that there appear saddle-type critical points as well as nodal type and spiral one. The most suitable type is the saddle one appears in a region close to a black hole. We also calculate transonic solutions with typical parameters, and show that the luminosity is almost comparable to the Eddington luminosity, the gas is quickly accelerated in the vicinity of the black hole, and wind terminal speeds are on the order of 0.1–0.3 c. These results of radiatively-driven black hole winds can be applied e.g. to ultra-fast outflows, which are supposed to be fast outflows from the vicinity of supermassive black holes.
High-frequency radio observations of two magnetars, PSR J1622 − 4950 and 1E 1547.0 − 5408
Authors: Chu Che-Yen , Ng C-Y , Kong Albert K H , Chang Hsiang-Kuang
Published: February 2021

We investigated the radio spectra of two magnetars, PSR J1622 − 4950 and 1E 1547.0 − 5408, using observations from the Australia Telescope Compact Array and the Atacama Large Millimeter/submillimeter Array obtained in 2017. Our observations of PSR J1622 − 4950 show a steep spectrum with a spectral index of −1.3 ± 0.2 in the range of 5.5–45 GHz during its reactivating X-ray outburst in 2017. By comparing the data taken in different epochs, we found a significant enhancement in the radio flux density. The spectrum of 1E 1547.0 − 5408 was inverted in the range of 43–95 GHz, suggesting a spectral peak at a few hundred gigahertz. Moreover, we obtained X-ray and radio data of the radio magnetars PSR J1622 − 4950 and SGR J1745 − 2900 from the literature and found two interesting properties. First, radio emission is known to be associated with X-ray outbursts but has a different evolution; furthermore, we found that the rise time of the radio emission is much longer than that of the X-ray emission during the outburst. Second, radio magnetars may have double-peak spectra at a few GHz and a few hundred GHz. This could indicate that the emission mechanism is different in the cm and the submm bands. These two phenomena could provide a hint towards an understanding of the origin of radio emission and its connection with X-ray properties.
Formation of counter-rotating and highly eccentric massive black hole binaries in galaxy mergers
Authors: Nasim Imran Tariq , Petrovich Cristobal , Nasim Adam , Dosopoulou Fani , Antonini Fabio
Published: February 2021

Supermassive black hole (SMBH) binaries represent the main target for missions such as the Laser Interferometer Space Antenna and Pulsar Timing Arrays. The understanding of their dynamical evolution prior to coalescence is therefore crucial to improving detection strategies and for the astrophysical interpretation of the gravitational wave data. In this paper, we use high-resolution N-body simulations to model the merger of two equal-mass galaxies hosting a central SMBH. In our models, all binaries are initially prograde with respect to the galaxy sense of rotation. But, binaries that form with a high eccentricity, e ≳ 0.7, quickly reverse their sense of rotation and become almost perfectly retrograde at the moment of binary formation. The evolution of these binaries proceeds towards larger eccentricities, as expected for a binary hardening in a counter-rotating stellar distribution. Binaries that form with lower eccentricities remain prograde and at comparatively low eccentricities. We study the origin of the orbital flip by using an analytical model that describes the early stages of binary evolution. This model indicates that the orbital plane flip is due to the torque from the triaxial background mass distribution that naturally arises from the galactic merger process. Our results imply the existence of a population of SMBH binaries with a high eccentricity and could have significant implications for the detection of the gravitational wave signal emitted by these systems.
Principal component analysis tomography in near-infrared integral field spectroscopy of young stellar objects – I. Revisiting the high-mass protostar W33A
Authors: Navarete F , Damineli A , Steiner J E , Blum R D
Published: February 2021

W33A is a well-known example of a high-mass young stellar object showing evidence of a circumstellar disc. We revisited the K-band NIFS/Gemini North observations of the W33A protostar using principal components analysis tomography and additional post-processing routines. Our results indicate the presence of a compact rotating disc based on the kinematics of the CO absorption features. The position–velocity diagram shows that the disc exhibits a rotation curve with velocities that rapidly decrease for radii larger than 0.1 arcsec (∼250 au) from the central source, suggesting a structure about four times more compact than previously reported. We derived a dynamical mass of 10.0$^{+4.1}_{-2.2}$ $\rm {M}_\odot$ for the ‘disc + protostar’ system, about ∼33 per cent smaller than previously reported, but still compatible with high-mass protostar status. A relatively compact H2 wind was identified at the base of the large-scale outflow of W33A, with a mean visual extinction of ∼63 mag. By taking advantage of supplementary near-infrared maps, we identified at least two other point-like objects driving extended structures in the vicinity of W33A, suggesting that multiple active protostars are located within the cloud. The closest object (Source B) was also identified in the NIFS field of view as a faint point-like object at a projected distance of ∼7000 au from W33A, powering extended K-band continuum emission detected in the same field. Another source (Source C) is driving a bipolar $\rm {H}_2$ jet aligned perpendicular to the rotation axis of W33A.
Analytical halo models of cosmic tidal fields
Authors: Paranjape Aseem
Published: February 2021

The non-linear cosmic web environment of dark matter haloes plays a major role in shaping their growth and evolution, and potentially also affects the galaxies that reside in them. We develop an analytical (halo model) formalism to describe the tidal field of anisotropic halocentric density distributions, as characterized by the halocentric tidal tensor $\left\langle \, T_{ij}\, \right\rangle (\lt R)$ spherically averaged on scale R ∼ 4Rvir for haloes of virial radius Rvir. We focus on axisymmetric anisotropies, which allows us to explore simple and intuitive toy models of (sub)halo configurations that exemplify some of the most interesting anisotropies in the cosmic web. We build our models around the spherical Navarro–Frenk–White profile after describing it as a Gaussian mixture, which leads to almost fully analytical expressions for the ‘tidal anisotropy’ scalar α(< 4Rvir) extracted from the tidal tensor. Our axisymmetric examples include (i) a spherical halo at the axis of a cylindrical filament, (ii) an off-centred satellite in a spherical host halo, and (iii) an axisymmetric halo. Using these, we demonstrate several interesting results. For example, the tidal tensor at the axis of a pure cylindrical filament gives α(fil)(< R) = 1/2 exactly, for any R. Also, α(< 4Rvir,sat) for a satellite of radius Rvir,sat as a function of its hostcentric distance is a sensitive probe of dynamical mass-loss of the satellite in its host environment. Finally, we discuss a number of potentially interesting extensions and applications of our formalism that can deepen our understanding of the multiscale phenomenology of the cosmic web.
Evolution of subhalo orbits in a smoothly growing host halo potential
Authors: Ogiya Go , Taylor James E , Hudson Michael J
Published: February 2021

The orbital parameters of dark matter (DM) subhaloes play an essential role in determining their mass-loss rates and overall spatial distribution within a host halo. Haloes in cosmological simulations grow by a combination of relatively smooth accretion and more violent mergers, and both processes will modify subhalo orbits. To isolate the impact of the smooth growth of the host halo from other relevant mechanisms, we study subhalo orbital evolution using numerical calculations in which subhaloes are modelled as massless particles orbiting in a time-varying spherical potential. We find that the radial action of the subhalo orbit decreases over the first few orbits, indicating that the response to the growth of the host halo is not adiabatic during this phase. The subhalo orbits can shrink by a factor of ∼1.5 in this phase. Subsequently, the radial action is well conserved and orbital contraction slows down. We propose a model accurately describing the orbital evolution. Given these results, we consider the spatial distribution of the population of subhaloes identified in high-resolution cosmological simulations. We find that it is consistent with this population having been accreted at $z \lesssim 3$, indicating that any subhaloes accreted earlier are unresolved in the simulations. We also discuss tidal stripping as a formation scenario for NGC 1052-DF2, an ultra diffuse galaxy significantly lacking DM, and find that its expected DM mass could be consistent with observational constraints if its progenitor was accreted early enough, $z \gtrsim 1.5$, although it should still be a relatively rare object.
The promise of DNA damage response inhibitors for the treatment of glioblastoma
Authors: Majd Nazanin K , Yap Timothy A , Koul Dimpy , Balasubramaniyan Veerakumar , Li Xiaolong , Khan Sabbir , Gandy Katilin S , Yung W K Alfred , de Groot John F
Published: February 2021

Glioblastoma (GBM), the most aggressive primary brain tumor, has a dismal prognosis. Despite our growing knowledge of genomic and epigenomic alterations in GBM, standard therapies and outcomes have not changed significantly in the past two decades. There is therefore an urgent unmet need to develop novel therapies for GBM. The inter- and intratumoral heterogeneity of GBM, inadequate drug concentrations in the tumor owing to the blood–brain barrier, redundant signaling pathways contributing to resistance to conventional therapies, and an immunosuppressive tumor microenvironment, have all hindered the development of novel therapies for GBM. Given the high frequency of DNA damage pathway alterations in GBM, researchers have focused their efforts on pharmacologically targeting key enzymes, including poly(ADP-ribose) polymerase (PARP), DNA-dependent protein kinase, ataxia telangiectasia-mutated, and ataxia telangiectasia and Rad3-related. The mainstays of GBM treatment, ionizing radiation and alkylating chemotherapy, generate DNA damage that is repaired through the upregulation and activation of DNA damage response (DDR) enzymes. Therefore, the use of PARP and other DDR inhibitors to render GBM cells more vulnerable to conventional treatments is an area of intense investigation. In this review, we highlight the growing body of data behind DDR inhibitors in GBM, with a focus on putative predictive biomarkers of response. We also discuss the challenges involved in the successful development of DDR inhibitors for GBM, including the intracranial location and predicted overlapping toxicities of DDR agents with current standards of care, and propose promising strategies to overcome these hurdles.
Newly discovered neuron-to-glioma communication: new noninvasive therapeutic opportunities on the horizon?
Authors: Sprugnoli Giulia , Golby Alexandra J , Santarnecchi Emiliano
Published: February 2021

The newly discovered functional integration of glioma cells into brain networks in mouse models provides groundbreaking insight into glioma aggressiveness and resistance to treatments, also suggesting novel potential therapeutic avenues and targets. In the context of such neuron-to-glioma communication, noninvasive brain modulation techniques traditionally applied to modulate neuronal function in neurological and psychiatric diseases (eg, increase/decrease cortical excitability and plasticity) could now be tested in patients with brain tumors to suppress glioma’s activity and its pathological crosstalk with healthy brain tissue.
A case series of extraneural metastatic glioblastoma at Memorial Sloan Kettering Cancer Center
Authors: Noch Evan K , Sait Sameer F , Farooq Shama , Trippett Tanya M , Miller Alexandra M
Published: February 2021

Background

Extraneural metastasis of glioma is a rare event, often occurring in patients with advanced disease. Genomic alterations associated with extraneural glioma metastasis remain incompletely understood.

Methods

Ten patients at Memorial Sloan Kettering Cancer Center diagnosed with extraneural metastases of glioblastoma (9 patients) and gliosarcoma (1 patient) from 2003 to 2018 were included in our analysis. Patient characteristics, clinical course, and genomic alterations were evaluated.

Results

Patient age at diagnosis ranged from 14 to 73, with 7 men and 3 women in this group. The median overall survival from initial diagnosis and from diagnosis of extraneural metastasis was 19.6 months (range 11.2 to 57.5 months) and 5 months (range 1 to 16.1 months), respectively. The most common site of extraneural metastasis was bone, with other sites being lymph nodes, dura, liver, lung, and soft tissues. All patients received surgical resection and radiation, and 9 patients received temozolomide, with subsequent chemotherapy appropriate for individual cases. 1 patient had an Ommaya and then ventriculoperitoneal shunt placed, and 1 patient underwent craniectomy for cerebral edema associated with a brain abscess at the initial site of resection. Genomic analysis of primary tumors and metastatic sites revealed shared and private mutations with a preponderance of tumor suppressor gene alterations, illustrating clonal evolution in extraneural metastases.

Conclusions

Several risk factors emerged for extraneural metastasis of glioblastoma and gliosarcoma, including sarcomatous dedifferentiation, disruption of normal anatomic barriers during surgical resection, and tumor suppressor gene alterations. Next steps with this work include validation of these genomic markers of glioblastoma metastases in larger patient populations and the development of preclinical models. This work will lead to a better understanding of the molecular mechanisms of metastasis to develop targeted treatments for these patients.
Infective Endocarditis Due to Corynebacterium Species: Clinical Features and Antibiotic Resistance
Authors: Bläckberg Anna , Falk Linn , Oldberg Karl , Olaison Lars , Rasmussen Magnus
Published: February 2021

Background

Corynebacterium species are often dismissed as contaminants in blood cultures, but they can also cause infective endocarditis (IE), which is a severe condition. Antibiotic resistance of corynebacteria is increasing making treatment challenging. Reports on IE caused by Corynebacterium species are scarce and more knowledge is needed.

Methods

Cases of IE caused by Corynebacterium species were identified through the Swedish Registry of Infective Endocarditis. Isolates were collected for species redetermination by matrix-assisted laser desorption ionization-time of flight and for antibiotic susceptibility testing using Etests.

Results

Thirty episodes of IE due to Corynebacterium species were identified between 2008 and 2017. The median age of patients was 71 years (interquartile range, 60–76) and 77% were male. Corynebacterium striatum (n = 11) was the most common IE causing pathogen followed by Corynebacterium jeikeium (n = 5). Surgery was performed in 50% and in-hospital mortality rate was 13%. Patients with IE caused by Corynebacterium species were significantly more likely to have prosthetic valve endocarditis (70%), compared with patients with IE due to Staphylococcus aureus or non-beta-hemolytic streptococci (14% and 26%, respectively) (P < .0001). Vancomycin was active towards all Corynebacterium isolates, whereas resistance towards penicillin G was common.

Conclusions

Corynebacterium species cause IE, where prosthetic valves are mainly affected and surgery is often performed. Corynebacterium striatum is an important causative agent of IE within the genus. Antibiotic resistance of corynebacteria is relatively common but resistance towards vancomycin could not be detected in vitro.
Innervation of the Posterior Hip Capsule: A Cadaveric Study
Authors: Nagpal Ameet S , Brennick Caroline , Occhialini Annette P , Leet Jennifer Gabrielle , Clark Tyler Scott , Rahimi Omid B , Hulk Kendall , Bickelhaupt Brittany , Eckmann Maxim S
Published: February 2021

Objective

Recent studies of hip anatomy have turned to the posterior hip capsule to better understand the anatomic location of the posterior capsular sensory branches and identify nerves with potential for neural blockade. Current literature has shown the posterior hip capsule is primarily supplied by branches from the sciatic nerve, nerve to quadratus femoris, and superior gluteal nerve (1, 2). This cadaveric study investigated the gross anatomy of the posterior hip, while also identifying potential targets for hip analgesia, with emphasis on the superior gluteal nerve and nerve to quadratus femoris.

Design

Cadaveric study.

Setting

UT Health San Antonio Anatomy Lab.

Methods

In total, 10 total cadavers (18 hips total), were posteriorly dissected identifying nerve to quadratus femoris, superior gluteal nerve, and sciatic nerve. Nerves were labeled with radio-opaque markers. Following the dissections, fluoroscopic images were obtained at sequential angles to identify neural anatomy and help expand anatomic knowledge for interventional pain procedures.

Results

The posterior hip capsule was supplied by the sciatic nerve in 1/16 hips, the nerve to quadratus femoris in 15/18 hips, and the superior gluteal nerve in 6/18 hips.

Conclusions

The nerve to quadratus femoris reliably innervates the posterior hip joint. Both the sciatic nerve and superior gluteal nerve have small articular branches that may be involved in posterior hip innervation, but this is not seen commonly. The results of this study may elucidate novel therapeutic targets for treatment of chronic refractory hip pain (i.e., the nerve to quadratus femoris).
Anti-phospholipid syndrome and COVID-19 thrombosis: connecting the dots
Authors: Tung Moon Ley , Tan Bryce , Cherian Robin , Chandra Bharatendu
Published: February 2021

As the coronavirus disease 2019 (COVID-19) pandemic, which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is spreading rapidly worldwide, it has emerged as a leading cause of mortality, resulting in >1 million deaths over the past 10 months. The pathophysiology of COVID-19 remains unclear, posing a great challenge to the medical management of patients. Recent studies have reported an unusually high prevalence of thromboembolic events in COVID-19 patients, although the mechanism remains elusive. Several studies have reported the presence of aPLs in COVID-19 patients. We have noticed similarities between COVID-19 and APS, which is an autoimmune prothrombotic disease that is often associated with an infective aetiology. Molecular mimicry and endothelial dysfunction could plausibly explain the mechanism of thrombogenesis in acquired APS. In this review, we discuss the clinicopathological similarities between COVID-19 and APS, and the potential role of therapeutic targets based on the anti-phospholipid model for COVID-19 disease.
Clinical significance of E148Q heterozygous variant in paediatric familial Mediterranean fever
Authors: Tirosh Irit , Yacobi Yonatan , Vivante Asaf , Barel Ortal , Ben-Moshe Yishay , Erez Granat Ortal , Spielman Shiri , Semo Oz Rotem , Shinar Yael , Gerstein Maya
Published: February 2021

Objectives

FMF results from mutations in the Mediterranean fever (MEFV) gene. The p. E148Q protein alternation is one of the most frequent in the MEFV gene, yet the exact E148Q genotype–phenotype correlation remains unclear. The aim of this study was to examine clinical significance of heterozygous E148Q variant in a paediatric FMF cohort.

Methods

We compared the clinical manifestations and disease severity score of four genetic subgroups: (group 1) patients harbouring a single heterozygous p. E148Q variant (n = 6); (group 2) patients harbouring a single p. M694V heterozygous variant (n = 88); (group 3) patients harbouring compound heterozygous p. M694V and p. E148Q variants (n = 36); and (group 4) homozygotes for p. M694V variant (n = 160).

Results

Of 646 FMF children from our centre, only 1% (six patients) of our genetically characterized FMF cohort had a single E148Q variant, most presenting with recurrent fevers and abdominal pain. None of the participants was found to harbour homozygous E148Q. Overall, M694V/E148Q compound heterozygosity did not exhibit a more severe phenotype compared with patients with a single M694V variant. The former group were less likely to have abdominal pain and exertional leg pain (P < 0.004 and P < 0.001, respectively) and more likely to have chest pain (P < 0.01). Both subgroups showed milder clinical phenotype compared with patients with M694V homozygosity.

Conclusion

Our findings demonstrate that a single heterozygous E148Q variant is unlikely to cause FMF in children and that E148Q/M694V is clinically indistinguishable from a single M694V variant. Thus, E148Q heterozygosity does not result in clinically meaningful phenotype in children.
Trend in women representation among authors of high rank rheumatology journals articles, 2002–2019
Authors: Levinsky Yoel , Vardi Yoav , Gafner Michal , Cohen Neta , Mimouni Michael , Scheuerman Oded , Furst Daniel E , Amarilyo Gil
Published: February 2021

Objective

The representation of women among authors of peer reviewed scientific papers is gradually increasing. The aims of this study were to examine the trend of the proportion of women among authors in the field of rheumatology during the last two decades.

Methods

Articles published in journals ranked in the top quartile of the field of rheumatology in the years 2002–2019 were analysed. The authorship positions of all authors, country of the article's source and manuscript type were retrieved by specifically designed software.

Results

Overall, 153 856 author names were included in the final analysis. Of them, 55 608 (36.1%) were women. There was a significant rise in the percentage of women authors over time (r = 0.979, P <0.001) from 30.9% in 2002 to 41.2% in 2018, with a slight decline to 39.8% in 2019. There were significantly fewer women in the senior author positions compared with the first author positions (24.3% in senior position vs 40.9% as first author, P <0.001).

Conclusion

The proportion of women among authors of rheumatology articles has increased over the years, both in general and as a first or senior author; however, their proportion is still <50% and there is still a gap between the proportion of women among first authors and the proportion of women among senior authors.
Performance of 2019 EULAR/ACR classification criteria for systemic lupus erythematosus in a paediatric population—a multicentre study
Authors: Levinsky Yoel , Broide Mor , Kagan Shelly , Goldberg Ori , Scheuerman Oded , Tal Rotem , Tirosh Irit , Butbul Yoni , Furst Daniel E , Harel Liora , Amarilyo Gil
Published: February 2021

Objectives

The European League Against Rheumatism and American College of Rheumatology 2019 (EULAR/ACR-19) criteria for the diagnosis of SLE were recently published, with the stated goal of maintaining the level of sensitivity and raising the level of specificity for classification of SLE in adults. The aim of this study is to examine their application to juvenile SLE (jSLE) patients.

Methods

In this multicentre study the charts of jSLE patients from three tertiary medical centres were reviewed and compared with patients with non-jSLE diagnosis. Paediatric rheumatologists, blinded to the original diagnosis, reviewed and diagnosed all cases. Paediatric patients' clinical and laboratory data were retrospectively extracted and then examined with regard to how they met the new and old criteria.

Results

Included were 225 patients (112 jSLE, 113 non-SLE). When applied to juvenile SLE classification, the sensitivity of the new EULAR/ACR-19 criteria was 0.96 (95% CI: 0.9, 0.99) and the specificity was 0.89 (95% CI: 0.82, 0.94). These were comparable to the SLICC criteria. The sensitivity of the EULAR/ACR-19 criteria improves over time and was 0.83 12 months following disease onset, reaching 0.96 after longer than 24 months.

Conclusion

Among a cohort of jSLE patients, sensitivity of the new EULAR/ACR-19 criteria was found to be high and specificity may have improved slightly compared with the SLICC-12 criteria. We support the use of the new classification criteria for paediatric patients in future jSLE studies, but it should be noted that its specificity is lower than for adults.
The effects of high-oleic peanuts as an alternate feed ingredient on performance, ileal digestibility, apparent metabolizable energy, and histology of the small intestine in laying hens
Authors: Redhead Adam K , Sanders Elliot , Vu Thien C , Malheiros Ramon D , Anderson Kenneth E , Toomer Ondulla T
Published: February 2021

We aimed to determine the effects of feeding a high-oleic peanut (HOPN) diet to egg-producing laying hens on egg quality, digestibility, and feed conversion. Three isonitrogenous and isocaloric dietary treatments were formulated with 1) Control diet (CON)—a corn-soybean meal conventional diet with 7.8 % added poultry fat, 2) HOPN diet—dietary inclusion of ~20% coarse-ground whole HOPN, and 3) oleic acid (CON-OA) diet—a control diet supplemented with 2.6% oleic fatty acid oil. Ninety-nine 57-wk-old brown Leghorn laying hens were randomly assigned to 33 animals per treatment. Animals were housed individually for 8 wk. Body and feed weights were recorded weekly and feed conversation ratio was calculated. Bi-weekly, shell eggs were analyzed for quality (yolk color, albumen height, and Haugh unit [HU]). Jejunum samples were collected at week 8 for histomorphometric analysis. Analysis of variance was performed on all variables using a general linear mixed model. Laying hens fed the CON-OA diet produced greater number of eggs relative to those fed the HOPN and control diets (P < 0.05). The roche yolk color value was higher (P < 0.001) in eggs from hens fed the HOPN diet. There were no differences in laying hen performance, eggshell color, eggshell strength, eggshell elasticity and egg albumen height, or egg HU, ileal fat digestibility, or villi surface among treatment groups. However, the apparent metabolizable energy (P < 0.01) and ileal protein digestibility (P = 0.02) were greater in laying hens fed the HOPN diet relative to the CON diet. This study suggests that whole unblanched high-oleic peanuts may be an acceptable alternative feed ingredient for laying hens.
Paediatric allergy practice in the era of coronavirus disease 2019
Authors: Mustafa S. Shahzad , Shaker Marcus S. , Munblit Daniel , Greenhawt Matthew
Published: February 2021

Purpose of review

To summarize the impact of the COVID-19 pandemic on the practice of paediatric allergy.

Recent findings

Given significant overlap in symptoms, care must be taken to differentiate routine allergic conditions from COVID-19 infection but it appears that most allergic diseases are not risk factors for a severe COVID-19 course. The full impact of restricted allergy/immunology ambulatory services will take months to years to fully understand. One benefit of having to adapt practice style is greater awareness and acceptance of shared decision-making and recognition of preference-sensitive care options in food allergy, in particular for approaches towards allergy prevention, treatment, and anaphylaxis care. Social distancing and masks have helped reduce spread of common respiratory viruses, which may be helping to lower the incidence of viral-associated wheezing episodes, enhancing evidence of the effects of preventing exposure of young children to respiratory viruses on asthma pathogenesis, as well as on allergic rhinitis. There has been a revolution in the rise of telemedicine to increase access to high-quality allergy/immunology specialty care.

Although the field has adapted to remain operational in the face of a significant challenge, it is important to apply lessons learned to evolve patient care and optimize treatment in the aftermath of the pandemic.
Physeal sparing distal radio-ulnar joint ligament reconstruction in children
Authors: Aly Amr M. , El-Sadek Rashed Emam
Published: February 2021

Distal radio-ulnar joint (DRUJ) injuries are under-reported in the paediatric population. No single study has discussed methods of DRUJ reconstruction in immature patients with chronic instability. We present a physeal sparing ligamentoplasty for chronic DRUJ instability and describe the outcomes in two patients. Two consecutive children with chronic DRUJ instability were treated using physeal sparing ligamentoplasy. After the failure of triangular fibrocartilage complex repair, reconstruction was done using palmaris longus tendon graft that was tunnelled through the distal radius epiphysis and wrapped subperiosteally around the ulnar neck. Graft was tied in a neutral forearm position. DRUJ stability was achieved in both patients. Grip strength averaged 90% of the healthy side. Prono-supination range of motion (ROM) averaged 88 and 86%, respectively, of the healthy side, without intraoperative nor postoperative complications. Our novel technique was effective in the regain of DRUJ stability with minor effect on the prono-supination ROM. Further studies are planned to experiment the biomechanical effectiveness of our technique. Level of evidence: Therapeutic IV.
Factors Influencing Outcomes of the Dysplastic Hip in Nonambulatory Children With Cerebral Palsy
Authors: Carroll Kristen L. , Stotts Alan K. , Baird Glen O. , Thorman Alyssa L. , Talmage Matthew , Moss Whitney D. , McMulkin Mark L. , MacWilliams Bruce A.
Published: February 2021

Background:

Hip dysplasia in the nonambulatory child with spastic cerebral palsy (CP) is a common condition not always effectively treated with conservative measures even when recognized early. Optimal surgical intervention strategies and timing are not clear from previous studies. Contralateral hips with less severe subluxation in these patients also often undergo surgery and little is known of outcomes of these less severe hips. This study aims to clarify treatment factors related to long term success following hip surgery for subluxation in nonambulatory children with CP.

Methods:

A total of 183 nonambulatory subjects with CP and a minimum of 2-year follow-up were included. All subjects underwent varus rotational osteotomy of the femur; other surgical factors considered were addition of pelvic osteotomy (PO), capsulorrhaphy, and soft tissue releases. Additional factors studied were age at index surgery, sex, and unilateral versus bilateral surgery. Severely subluxated (SS) hips, defined as having >50% migration, were studied separately from contralateral nonsevere hips. Surgeries were deemed successful if final follow-up indicated a migration of <25%; patients with any revision surgeries or >25% migration were categorized as failures.

Results:

A 60% success rate was found in SS hips and a 68% success rate in nonsevere hips. Age at index surgery did not influence success rates in SS hips. In the nonsevere hips, success was associated with index surgery at older age. The addition of a PO was the only concomitant procedure demonstrated to improve outcomes. In SS hips, those with a successful outcome were 2.5 times more likely to have had a PO. The addition of capsulorrhaphy had a negative effect on the entire group, reducing odds of success to 0.8. No other factors were significant.

Conclusions:

The findings from this multicenter retrospective study suggest that PO be added to varus rotational osteotomies in patients with severe hip subluxation. Surgery should be undertaken for severe dysplasia without concern for age. The addition of capsulorrhaphy does not improve rate of success.

Level of Evidence:

Level III—retrospective comparative study.
Professor D.M. Davies, founder of Adverse Drug Reaction Bulletin: a tribute on the 50th anniversary of Adverse Drug Reaction Bulletin
Authors: Routledge Philip A.
Published: February 2021

The Adverse Drug Reaction Bulletin has been published bimonthly for the last 50 years. The format has remained the same with four sides of approximately 2000 words on an important adverse reaction, but has grown from sheets stencilled for distribution locally to a bulletin with a large circulation both in English and Italian. Its aim remains, as then, to provide a succinct summary of the causes and mechanisms of a particular adverse reaction, or the types of reactions which affect a particular system organ class.
Achieving Predictability in Augmentation Mastopexy: An Update
Authors: Xue Amy S. , Dayan Erez , Rohrich Rod J.
Published: February 2021

Background:

One-stage augmentation mastopexy is a challenging procedure, with the highest cited revision rates in plastic surgery. This is because when mastopexy and augmentation are performed together, they lead to opposing forces, which must be balanced carefully to avoid complications. The goal of this study was to revisit a previously described predictable and safe approach to one-stage augmentation mastopexy, and provide long-term updated results.

Methods:

One hundred seventy-one patients who underwent augmentation mastopexy, performed by a single surgeon (R.J.R.), were included in this retrospective review between January 2005 and January 2019. Wise pattern mastopexy with wide pedicle was performed before placement of a small subpectoral implant. Demographic information, preoperative breast measurements, intraoperative technique, implant choice, and postoperative complications were analyzed. Specifically, postoperative measurement of vertical limbs was performed to assess long-term elongation of the lower breast pole.

Results:

Cumulative complication rate was 11.7%. This rate decreased to 6% in the last 88 patients in this series as the technique matured. The most common complication was revision for implant size exchange. Long-term follow-up demonstrated elongation of nipple-to-inframammary fold distance by 1.0–2.2 cm. There was no recurrence of ptosis requiring reoperation.

Conclusions:

This one-stage augmentation mastopexy technique provides a safe and reliable surgical approach with predictable and minimal elongation of the lower breast pole. The reoperation rate of this technique is less than half of >20% revision rate currently cited in the literature.
Tubed Anterolateral Thigh Free Flap for Pharyngoesophageal Reconstruction
Authors: Kuta Victoria , French Daniel , Al Afif Ayham , Trites Jonathan R.B. , Rigby Matthew H.
Published: February 2021

Caustic ingestions can severely injure the upper and lower aerodigestive tract, resulting in detrimental mucosal changes both acutely and chronically. Injuries are most severe following alkaline ingestion. Esophagectomy is often recommended in patients with high-grade esophageal injuries to mitigate the risk of perforation. Esophageal reconstruction after these injuries is often delayed, and staged, allowing adequate tissue stabilization before further manipulation. Here, we report on a 25 year-old woman who presented with a high-grade caustic esophageal injury following the ingestion of an alkaline drain cleaner. She underwent an emergent thoracic esophagectomy, gastrectomy and a cervical salivary esophagostomy. Post-operatively, she developed supraglottic and hypopharyngeal strictures, but maintained a functional larynx. She subsequently underwent a staged, extrathoracic total esophageal reconstruction using an anterolateral thigh (ALT) myocutaneous free flap with laryngeal preservation. Although serial esophageal dilatations and trans-oral laser procedures for pharyngeal strictures were required, she was able to maintain the ability to swallow.
Anaphylactic Reaction to Lymphazurin 1% during Breast Reconstruction Surgery: An Uncommon but Serious Complication
Authors: Krishna Vikram , Muetterties Corbin , DiNome Maggie L. , Tseng Charles Y.
Published: February 2021

Lymphazurin 1% (isosulfan blue dye) is the most frequently used blue dye in the United States, and it is commonly used for sentinel node biopsy in breast cancer patients. Although cases of allergic reaction to lymphazurin have been reported in the general surgery literature, to our knowledge, no cases of an adverse reaction to isosulfan blue have been reported in the plastic surgery literature. We describe a case of an intraoperative biphasic anaphylactic reaction to isosulfan blue in a female patient undergoing bilateral mastectomy and immediate bilateral DIEP breast reconstruction. The severity of her anaphylactic reaction required that we stop flap dissection and abort the reconstruction. Although an allergic reaction is uncommon, recognizing the signs of an acute hypersensitivity reaction is critical to good outcomes in these situations. Given the volume of combined breast oncologic and breast reconstruction surgeries and the increasing number of vascularized lymph node transfer and lymphovenous anastomosis performed annually, it is essential for the plastic surgeon to be cognizant of this rare hypersensitivity reaction.
A Navajo Patient with Morbihan’s Disease: Insight into Oculoplastic Treatment of a Rare Disease
Authors: Pflibsen Lacey R. , Howarth Ashley L. , Meza Rochin Ana , Decapite Tim , Casey William J. , Mansueto Lisa A.
Published: February 2021

Morbihan’s disease is classically defined as primarily a Caucasian disease of chronic, recurrent erythema and nonpitting edema of the middle and upper thirds of the face. The disease is often difficult to diagnose and challenging to treat. Medical management is the primary treatment modality; however, if there is progression of the disease that causes visual impairment, surgical debulking is often required. We present the first reported case of Morbihan’s disease in a Navajo patient in conjunction with a review of the literature on surgical management of this challenging disease.
Radial to Axillary Nerve Transfer Outcomes in Shoulder Abduction: A Systematic Review
Authors: Wells Matthew E. , Gonzalez Gilberto A. , Childs Benjamin R. , Williams Matthew R. , Nesti Leon J. , Dunn John C.
Published: February 2021

Background:

Brachial plexus and axillary nerve injuries often result in paralysis of the deltoid muscle. This can be functionally debilitating for patients and have a negative impact on their activities of daily living. In these settings, transferring the branch of the radial nerve innervating the triceps to the axillary nerve is a viable treatment option. Additional nerve transfers may be warranted. This study sought to determine the efficacy of nerve transfer procedures in the setting of brachial plexus and axillary nerve injuries and factors affecting clinical outcomes.

Methods:

The U.S. National Library of Medicine’s website “PubMed” was queried for “radial to axillary nerve transfer” and “brachial plexus nerve transfer.” An initial review by two authors was performed to identify relevant articles followed by a third author validation utilizing inclusion and exclusion criteria. Individual patient outcomes were recorded and pooled for final analysis.

Results:

Of the 80 patients, 66 (82.5%) had clinical improvement after surgical nerve transfer procedures. Significant difference in clinical improvement following nerve transfer procedures was correlated with patient age, mechanism of injury, brachial plexus vs isolated axillary nerve injuries, multiple nerve transfers vs single nerve transfers, and surgery within the first 7 months of injury. The branch of the radial nerve supplying the triceps long head showed improved clinical results compared with the branch of the radial nerve supplying the triceps medial head and anconeus.

Conclusion:

Nerve transfers have been shown to be effective in restoring shoulder abduction in both isolated axillary nerve injuries and brachial plexus injuries.
Thumb Reconstruction after Severe Trauma Using the Masquelet Technique and the Foucher Neurovascular Flap
Authors: Luttenberger Martin , Taqatqeh Feras , Dragu Adrian , Bota Olimpiu
Published: February 2021

Complex injuries of fingers with bone and soft tissue loss often result in amputation. We present here a case of thumb reconstruction in a severely injured thumb with bone and dorsal soft tissue loss. Primarily a radical debridement of devascularized tissue was performed and a spacer was implanted, to ensure tissue decontamination and induce a Masquelet’s bone membrane. After 6 weeks the spacer was replaced with autologous cancellous bone and a pedicled Foucher neurovascular flap was used to augment the soft tissues. Eight months postoperatively the patient showed a great outcome with thumb length preservation, excellent range of motion and aesthetics. This novel technique facilitates finger and especially thumb preservation without the risk of infection. The Masquelet technique can hereby be safely used for reconstruction of finger injuries and the microsurgical flap coverage can be postponed for the secondary procedure, without compromising the bone regeneration.
Three-dimensional Printed Microvascular Clamps: A Safe, Cheap, and Effective Instrumentation for Microsurgery Training
Authors: Papavasiliou Theodora , Chatzimichail Stelios , Pafitanis George
Published: February 2021

Summary: Microsurgical training involves practice in ex vivo models during the early learning curve, and poor instrument handling by the inexperienced microsurgeons can cause damage to microsurgical instrumentation or clamps, which is particularly costly. To address this, we demonstrate the development, design, manufacturing, and application of 3 different types of 3-dimensional printed microvascular clamps in an ex vivo simulation training model. This report provides evidence of a low-cost and easily accessible device that facilitates the process of microsurgical training. The clamps were found to provide advantages akin to normal stainless-steel microvascular clamps in training settings.
Free Dorsal Toe Flap for Reconstruction of the Hallux
Authors: Chan James K.-K. , Song Marie , Shirley Rebecca , Rodrigues Jeremy
Published: February 2021

Soft tissue defects of the hallux represent a reconstructive challenge. Traditional options include regional flaps based on the first dorsal metatarsal artery (FDMA). However, the resultant bulky neo-hallux and contouring defect of the donor site are significant limiting factors. Here, we present the case of a young male athlete who underwent successful reconstruction of a dorsal defect of the hallux, with open exposed joint, using a free flap from the contralateral toe. We believe this is the first report of a free dorsal toe flap to reconstruct a defect of the hallux. The flap was based on the lateral dorsal digital artery, an extension of the FDMA. The donor site was reconstructed using a full thickness skin graft from the groin. Postoperatively, the flap survived completely, and both the recipient and donor sites healed without complication. There was no contour abnormality and he was able to wear his normal shoes and ambulate normally by week 3. Although the dorsal metatarsal artery perforators that supply the dorsal skin of the forefoot have been well described, there have been limited studies investigating the vascular supply of the dorsal skin overlying the hallux distally. Our experience shows that it is possible to raise a free dorsal toe flap based on the lateral dorsal digital artery only. This flap represents the ideal like-for-like reconstruction for soft tissue defects of the hallux.
Psychosocial Predictors of Upper Extremity Transplantation Outcomes: A Review of the International Registry 1998–2016
Authors: Kinsley Sarah E. , Song Shuang , Petruzzo Palmina , Sardu Claudia , Losina Elena , Talbot Simon G.
Published: February 2021

Background:

Upper extremity transplantation (UET) is becoming increasingly common. This article attempts to collate data from cases contributing to the International Registry on Hand and Composite Tissue Transplantation (IRHCTT), define psychosocial themes perceived as predictors of success using statistical methods, and provide an objective measure for optimization and selection of candidates.

Methods:

The IRHCTT provided anonymous data on UET recipients. A supplementary psychosocial survey was developed focusing on themes of depression, posttraumatic stress disorder (PTSD), anxiety, interpersonal functioning and dependence, compliance, chronic pain, social support, quality of life, and patient expectations. We determined the risk of transplant loss and psychological factors associated with higher risk of transplant loss.

Results:

Sixty-two UET recipients reported to the IRHCTT. Forty-three psychosocial surveys (68%) were received, with 38 (88%) having intact transplants and 5 (12%) being amputated. Among recipients with a diagnosis of anxiety (N = 29, 67%), 5 (17%) reported transplant loss (P = 0.03). Among those with depression (N = 14, 33%), 2 recipients (14%) has transplant loss (P = 0.17); while 4 recipients (22%) with PTSD (N = 18, 42%) had transplant loss (P = 0.01). Of participants active in occupational therapy (N = 28, 65%), 2 (7%) reported transplant loss (P = 0.09). Of recipients with realistic functional expectations (N = 34, 79%), 2 (6%) had transplant loss versus 3 (34%) who were felt to not have realistic expectations (N = 9, 21%, P = 0.05). Recipients with strong family support (N = 33, 77%) had a lower risk of transplant loss compared with poor or fair family support (N = 10, 23%), but did not reach statistical significance (6% versus 30%, P = 0.14).

Conclusion:

Anxiety, depression, PTSD, participation in occupational therapy, expectations for posttransplant function, and family support are associated with postsurgical transplant status.